2014-11-14T08:11:40-06:00 2013-12-31 990 2013-01-01 560636250 COMMUNITY GENERAL HEALTH PARTNERS INC COMM 3367182803 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 FRED HARGETT EVP & CFO 3367182803 2014-11-13 2013 2015-11-30 17:44:51Z NOVANT HEALTH THOMASVILLE MEDICAL CENTER JEFFERY LINDSAY 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 81056702 0 X WWW.NOVANTHEALTH.ORG X 1929 NC SEE SCHEDULE O 20 18 750 70 161060 -102365 218601 179615 75126915 79346383 4205 48964 1241726 1398539 76591447 80973501 210647 259099 0 0 33417685 34194604 0 0 0 40775210 42340219 74403542 76793922 2187905 4179579 62018799 67422585 5285217 7092968 56733582 60329617 X SEE SCHEDULE O 0 0 58560911 259099 79606185 CONSISTENT WITH THE ORGANIZATION'S EXEMPT PURPOSE, COMMUNITY GENERAL HEALTH PARTNERS, INC (CGHP) PROMOTES THE HEALTH AND WELL-BEING OF THE INHABITANTS OF THE COMMUNITY IN WHICH THE ORGANIZATION OPERATES, SERVING ALL MEMBERS OF THE COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY. CGHP HAS 146 LICENSED BEDS. FROM JANUARY 1, 2013 TO DECEMBER 31, 2013 THERE WERE 24,331 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 6 DAYS AND AN AVERAGE DAILY CENSUS OF 67. THERE WERE 4,209 DISCHARGES; 4,057 INPATIENT AND OUTPATIENT SURGERIES; 57,098 OUTPATIENT ENCOUNTERS AND 35,991 EMERGENCY DEPARTMENT VISITS. 58560911 1 1 0 1 0 0 0 0 0 0 1 0 0 1 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 0 0 0 1 0 0 750 1 1 1 0 0 0 0 0 0 0 0 0 X 20 18 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 1 1 0 NC X KAREN DAUGHERTY 3367182803 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 X BAREFOOT SAMUEL CHAIR 2.00 X X 0 0 0 BOLES-WHITMAN MISTI TRUSTEE 2.00 X 0 0 0 CARTER MONICA TRUSTEE 2.00 X 0 0 0 CAUSEY EDDIE TRUSTEE 2.00 X 0 0 0 CLIFTON DAVID TRUSTEE 2.00 X 0 0 0 COLEMAN RON TRUSTEE 2.00 X 0 0 0 CRAVER KELLY SEC 2.00 X X 0 0 0 DAVIS MARK TRUSTEE 2.00 X 0 0 0 FORIEST BRYANT TRUSTEE 2.00 X 0 0 0 GONDEK ALBERT TRUSTEE 2.00 X 0 0 0 HOLT DONNIE VICE CHAIR 2.00 X X 0 0 0 KEATES WILLIAM TRUSTEE 2.00 X 0 284988 44709 MARKS PHILLIP TRUSTEE 2.00 X 0 554217 74676 MCCLURE FRED TREAS 2.00 X X 0 0 0 MORRIS JOHN ASST SEC 2.00 X X 0 323127 75001 MORRIS SCOTT TRUSTEE 2.00 X 0 0 0 OWEN LAURA TRUSTEE 2.00 X 0 0 0 PEOPLES REBECCA TRUSTEE 2.00 X 0 0 0 PERDUE LARRY TRUSTEE 2.00 X 0 0 0 RICE CAROLYN ASST SEC 2.00 X X 51460 0 23921 SOJKA PETER TRUSTEE 2.00 X 0 0 0 YOUNTS JUDY TRUSTEE 2.00 X 0 0 0 JOHNSON KATHIE PRESIDENT NHTMC 60.00 X 398324 0 75694 LINDSAY JEFFERY PRES FMCCOO WS MKT (*SEE ADD'L INFO IN SCH J P3) 60.00 X 0 2880561 75721 ANDERSON JENNIFER MGR PHARMACY 40.00 X 125218 0 39530 ASBILL-RUSSELL AUDREY DIR SURGICAL SVCS 40.00 X 127746 0 23119 BALLENGEE JOHN PHARMACIST 40.00 X 144103 0 17604 GRABUS CHRISTINA SR DIR CHIEF NURSING OFFICER 40.00 X 163301 0 39979 KONERU MADHU MGR PHARMACY 40.00 X 131579 0 27429 1141731 4042893 517383 12 0 1 0 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 FOOD MANAGEMENT SERVICES 1221721 LABORATORY CORPORATION OF AMERICA HOLDIN PO BOX 12140 BURLINGTON NC 27216 LAB SERVICES 1055249 DAVIDSON ANESTHESIA CONSULTANTS PA 4005 BRAMBLETYE CT GREENSBORO NC 27407 HEALTH SERVICES 856365 HORIZON HEALTH CORPORATION UNIVERSAL HEA PO BOX 840830 DALLAS TX 75284 HEALTH SERVICES 819747 DLP CARDIAC PARTNERS LLC 3700 ARCO CORPORATE DR STE 450 CHARLOTTE NC 28273 CATH LAB SERVICES 333935 15 29040 150575 179615 NET PATIENT REVENUE 622110 79346383 79346383 79346383 8004 8004 7870 0 7870 7870 7870 40960 0 40960 40960 40960 138609 83201 55408 55408 CHILD DEVELOPMENT 624410 732009 161060 570949 CAFETERIA MEALS 722514 343450 343450 MISCELLANEOUS REVENUE 900099 259606 259606 196 196 1335261 80973501 79606185 161060 1026641 X 259099 259099 549398 549398 25653452 24162986 1490466 1410736 1328772 81964 4699968 4426900 273068 1881050 1771761 109289 8077539 6369123 1708416 668498 629658 38840 431442 406375 25067 823591 775740 47851 1837821 1731044 106777 50847 47893 2954 24274 22864 1410 722332 722332 2232180 2102490 129690 111835 105337 6498 CORPORATE ALLOCATION 12821230 12821230 BAD DEBT 5963232 5963232 MEDICAL SUPPLIES 4971699 4971699 DRUGS 1576815 1576815 2026884 1909123 117761 76793922 58560911 18233011 0 172075 323865 8354707 8946561 511662 1508545 1501381 1461862 19155 0 62273024 45126068 17809934 17146956 1095304 1097350 32554581 36937446 62018799 67422585 4787199 5224235 498018 1868733 5285217 7092968 X 56733582 60329617 56733582 60329617 62018799 67422585 X 4179579 -583544 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 20671 20671 0 PART II-B, LINE 1I, LOBBYING ACTIVITIES DUES PAID TO CERTAIN ORGANIZATIONS WHICH INCLUDE A PORTION RELATED TO LOBBYING ACTIVITIES. 184862 184862 31382019 19141894 12240125 28493351 24199841 4293510 2212792 1784333 428459 17146956 DUE FROM AFFILIATE 36937446 36937446 0 THIRD PARTY PAYMENT ADJUSTMENTS 848980 OTHER LIABILITIES 1019753 1868733 X PART X, LINE 2: PART X, LINE 2: LIABILITY UNDER FIN 48 (ASC 740) FOOTNOTE THE AUDIT FOR NOVANT HEALTH AND ITS AFFILIATES IS PREPARED ON A CONSOLIDATED BASIS. THE COMPANY 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 OUR FOR-PROFIT SUBSIDIARIES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE COMPANY'S STATEMENT OF OPERATIONS FOR THE YEARS ENDED DECEMBER 31, 2013 AND 2012. 1 1 X 1 X 300.000000000000 0 0 1 0 1 1 7438618 0 7438618 0.10500 12164892 14436544 0 0.00000 440791 343609 97182 0.00140 20044301 14780153 7535800 0.10640 59030 2732 56298 0.00080 277330 0 277330 0.00390 15892216 10991742 4900474 0.06920 0 0 0 0.00000 216767 0 216767 0.00310 16445343 10994474 5450869 0.07700 36489644 25774627 12986669 0.18340 0 0 0 0.00000 24204 0 24204 0.00030 11604 0 11604 0.00020 0 0 0 0.00000 1000 0 1000 0.00000 179 0 179 0.00000 0 0 0 0.00000 3287 0 3287 0.00000 0 0 0 0.00000 40274 0 40274 0.00050 1 5963232 0 18722218 18292350 429868 X 1 0 1 1 CGHP DBA NH THOMASVILLE MEDICAL CENTER 207 OLD LEXINGTON ROAD THOMASVILLE NC 27360 WWW.NOVANTHEALTH.ORG H0112 X X X NOVANT HEALTH THOMASVILLE MEDICAL CENTER 1 1 X X X X X X 13 1 0 1 X WWW.NOVANTHEALTH.ORG X X X X 0 0 1 1 300.000000000000 0 0 1 1 X X X X X X 1 0 X X X X 1 X 0 0 NOVANT HEALTH THOMASVILLE MEDICAL CENTER PART V, SECTION B, LINE 3: WHILE CONDUCTING THE CHNA, THE HOSPITAL FACILITY(IES) SOLICITED INPUT FROM, AND CONSULTED WITH, A VARIETY OF COMMUNITY REPRESENTATIVES INCLUDING, BUT NOT LIMITED TO, REPRESENTATIVES OF CITY AND COUNTY GOVERNMENT INCLUDING HEALTH DEPARTMENTS, COMMUNITY-BASED ORGANIZATIONS, FOUNDATIONS, CHURCHES, COLLEGES/UNIVERSITIES, COMMUNITY COALITIONS AND OTHER SOCIAL SERVICE AGENCIES. THE SCOPE OF EXPERTISE WAS BROAD AND INCLUDED SUCH AREAS AS PUBLIC HEALTH, MINORITY POPULATIONS, HEALTH DISPARITIES, AND SOCIAL SERVICES. THE ORGANIZATION IS A PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. AS SUCH, NOVANT HEALTH INCLUDES MULTIPLE HOSPITAL FACILITIES AND HAS ENGAGED IN CHNAS FOR ALL OF THE COMMUNITIES BEING SERVED. WHERE POSSIBLE, WE HAVE LEVERAGED THE RESOURCES OF THE ORGANIZATION TO BEST ADDRESS THOSE NEEDS THAT ARE HIGHEST IN PRIORITY AND CONSISTENT ACROSS COMMUNITIES. NOVANT HEALTH THOMASVILLE MEDICAL CENTER PART V, SECTION B, LINE 7: THE HOSPITAL FACILITY(IES) IS/ARE A PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. AS SUCH, NOVANT HEALTH INCLUDES MULTIPLE HOSPITAL FACILITIES AND HAS ENGAGED IN CHNAS FOR ALL OF THE COMMUNITIES BEING SERVED. THE FACILITY'S CHNA IDENTIFIED MULTIPLE NEEDS FOR THE COMMUNITY SERVED. THE NEEDS IDENTIFIED WERE REVIEWED AND PRIORITIZED BY THE CHNA RESOURCE GROUP AND SUBSEQUENTLY BY THE ORGANIZATION'S BOARD AND THE NOVANT HEALTH EXECUTIVE TEAM. THEY EVALUATED EACH DOCUMENTED NEED AND ITS INTERSECTION WITH THE ORGANIZATION'S VISION, COMMITMENTS, AND KEY STRENGTHS BEFORE FURTHER PRIORITIZING THE HEALTH NEEDS AND AGREEING UPON THE TOP HEALTH PRIORITIES TO BE ADDRESSED. WHERE POSSIBLE, WE HAVE LEVERAGED THE SYSTEM'S STRENGTHS AND RESOURCES TO BEST ADDRESS THOSE NEEDS THAT ARE HIGHEST IN PRIORITY AND CONSISTENT ACROSS COMMUNITIES. NOVANT HEALTH AND EACH OF ITS HOSPITAL FACILITIES ARE WORKING DILIGENTLY TO ADDRESS EACH OF THE IDENTIFIED AREAS OF NEED THROUGH RESOURCE ALLOCATION AND SUPPORT. CERTAIN NEEDS THAT WERE IDENTIFIED BY THE CHNA HAVE NOT BEEN ADDRESSED. IT WAS DETERMINED THAT THERE ARE OTHER RESOURCES IN THE COMMUNITY THAT CAN MORE APPROPRIATELY ADDRESS THESE NEEDS BASED ON SCOPE OF SERVICES AND SKILL SET. FOR MORE DETAILED INFORMATION, REFER TO THE PUBLICLY AVAILABLE IMPLEMENTATION PLAN AVAILABLE ON THE WEBSITE; REFER TO LINE 5B FOR THE URL. NOVANT HEALTH THOMASVILLE MEDICAL CENTER PART V, SECTION B, LINE 11: ALL UNINSURED PATIENTS RECEIVE A STANDARD DISCOUNT REGARDLESS OF THEIR ABILITY TO PAY. THIS DISCOUNT MIRRORS OUR AVERAGE MANAGED CARE RATE. PATIENTS BELOW 300% OF THE FEDERAL POVERTY GUIDELINES ARE DISCOUNTED AT 100%. NOVANT HEALTH THOMASVILLE MEDICAL CENTER PART V, SECTION B, LINE 20D: ALL FINANCIAL ASSISTANCE POLICY (FAP) ELIGIBLE PATIENTS RECEIVE 100% FREE CARE AND THEREFORE DO NOT RECEIVE BILLS ONCE FAP ELIGIBILITY HAS BEEN ESTABLISHED. ALL PATIENTS DO RECEIVE INFORMATIONAL STATEMENTS WHICH INCLUDE TOTAL CHARGES LESS ANY NON-FINANCIAL ASSISTANCE POLICY ADJUSTMENTS. PART I, LINE 6A: THE ORGANIZATION IS A PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. THE COMMUNITY BENEFIT REPORT IS PREPARED BY A RELATED ORGANIZATION. NOVANT HEALTH, INC. IS THE NOVANT HEALTH PARENT COMPANY AND PRODUCES A COMMUNITY BENEFIT REPORT REPRESENTING THE HEALTH SYSTEM AS A WHOLE. THE REPORT CAN BE FOUND AT HTTP://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMPANY-INFORMATION/FINANCIAL -PROFILE/COMMUNITY-BENEFIT-REPORT.ASPX. PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. PART I, LINE 7: COSTS REPORTED IN THE TABLE FOR CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AMOUNTS ARE CALCULATED USING AN ENTITY SPECIFIC COST TO CHARGE RATIO BASED ON WORKSHEET 2 (CCR). PART I, LN 7 COL(F): THE AMOUNT OF BAD DEBT REMOVED FROM TOTAL EXPENSES (DENOMINATOR) WAS $5,963,232. PART II, COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION IS A PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. NOVANT HEALTH'S COMMUNITY BUILDING ACTIVITIES IMPACTS THE HEALTH OF OUR COMMUNITY THROUGH PARTNERSHIPS WITH LOCAL AGENCIES DEDICATED TO IMPROVING THE LIVES OF ALL INDIVIDUALS. OUTREACH INCLUDES PROVIDING SUPPORT FOR ORGANIZATIONS SUCH AS HABITAT FOR HUMANITY AND LOCAL CHAMBERS OF COMMERCE, ASSISTING WITH COMMUNITY/COUNTY COALITIONS, PROVIDING EDUCATIONAL SEMINARS AND TRAINING FOR COMMUNITY WORKFORCES, AND SUPPORTING COMMUNITY AGENCIES SUCH AS ROTARY, LIONS CLUBS AND MORE. THROUGH EACH OF THESE PARTNER AGENCIES, NOVANT HEALTH ADDRESSES THE UNDERLYING ISSUES IMPACTING THE HEALTH OF OUR COMMUNITIES AND ENSURES THAT OUR COMMUNITIES GROW FOR YEARS TO COME. PART II, LINE 2: THE ALLOWANCE FOR BAD DEBT IS DETERMINED BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, THE AGE OF THE ACCOUNTS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS. PART III, LINE 4: BAD DEBT EXPENSE ONLY REPRESENTS ACCOUNTS FOR WHICH COLLECTION EFFORTS HAVE BEEN MADE BUT NO PAYMENTS HAVE BEEN RECEIVED. DISCOUNTS ARE RECORDED AS EITHER CONTRACTUALS (FOR PATIENTS WHO DO NOT QUALIFY FOR CHARITY) OR AS CHARITY (FOR PATIENTS WHO DO QUALIFY FOR CHARITY). THE TEXT OF THE NOVANT HEALTH, INC. CONSOLIDATED FINANCIAL STATEMENTS READS: "THE ALLOWANCE FOR BAD DEBTS IS DETERMINED BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, THE AGE OF THE ACCOUNTS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS." PART III, LINE 8: THE METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6 IS DETERMINED BY FOLLOWING THE MEDICARE PRINCIPLES OF ALLOWABLE COSTS. COST FOR THE OVERHEAD DEPARTMENTS ARE STEPPED DOWN TO THE REMAINING COST CENTERS BASED ON STATISTICS FOR EACH OVERHEAD COST CENTER. ONCE THE STEP-DOWN PROCESS IS COMPLETE, A RATIO OF COST TO CHARGES IS DEVELOPED FOR EACH COST CENTER. THE CCR IS THEN APPLIED TO THE MEDICARE REVENUE BY COST CENTER AND TOTALED.IT SHOULD BE NOTED THAT THE MEDICARE COST REPORTS DO NOT ADDRESS ANY MANAGED CARE MEDICARE REVENUES, COSTS, OR RELATED SHORTFALL. THE TOTAL REVENUES REPORTED AS RECEIVED FROM MEDICARE IN LINE 5 OF SECTION B ARE ONLY REPRESENTATIVE OF MEDICARE FEE FOR SERVICE PAYMENTS RECEIVED. THE ALLOWABLE COSTS ON LINE 6 ARE SIGNIFICANTLY LOWER THAN THE ACTUAL EXPENDITURES. AS SUCH, THE SHORTFALL IS UNDERESTIMATED. EVERY HOSPITAL TREATS MEDICARE PATIENTS. SOME HOSPITALS ARE LOCATED IN HIGH MEDICARE POPULATION AREAS; OTHERS PROVIDE SERVICES DISPROPORTIONATELY USED BY MEDICARE PATIENTS. MEDICARE RATES AND NUMBERS OF MEDICARE PATIENTS ARE NOT NEGOTIATED. AS REIMBURSEMENT RATES DECLINE RELATIVE TO COSTS OF CARE, HOSPITALS CONTINUE TO SERVE THE MEDICARE POPULATION. WITHOUT THIS SERVICE THESE PATIENTS WOULD BECOME AN OBLIGATION ON THE GOVERNMENT. ANY UNREIMBURSED COSTS OF THIS CARE ARE A COMMUNITY BENEFIT PROVIDED BY THE HOSPITAL TO THE COMMUNITY AND GOVERNMENT. PART III, LINE 9B: THE ORGANIZATION'S BILLING AND COLLECTIONS POLICY DOES EXPLAIN ACTIONS AGAINST PATIENTS WHO HAVE OUTSTANDING DELINQUENT AMOUNTS, BUT THE POLICY DOES NOT CONTAIN PROVISIONS FOR COLLECTION PRACTICES AGAINST PATIENTS WHO ARE ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY (FAP) BECAUSE FAP ELIGIBLE PATIENTS RECEIVE 100% FREE CARE AND THEREFORE DO NOT RECEIVE BILLS ONCE FAP ELIGIBILITY HAS BEEN ESTABLISHED. PART VI, LINE 2: PART VI, LINE 2: NEEDS ASSESSMENTTHE ORGANIZATION IS PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM, WHICH HAS A COMMUNITY BENEFIT COMMITTEE. THE COMMUNITY BENEFIT COMMITTEE IS RESPONSIBLE FOR ASSISTING THE HOSPITALS WITHIN THE SYSTEM PREPARE THEIR COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) INCLUDING THE CHNAS REPORTED IN PART V, SECTION B. THE COMMUNITY BENEFIT COMMITTEE IS MADE OF INDIVIDUALS REPRESENTING CORPORATE-WIDE DEPARTMENTS, SUCH AS COMMUNITY RELATIONS, LEGAL, TAX, INTERNAL AUDIT, MARKETING/COMMUNICATIONS, AS WELL AS INDIVIDUALS FROM VARIOUS DEPARTMENTS OF HOSPITAL OPERATIONS AND THE SYSTEM'S HOSPITAL FOUNDATIONS. EACH HOSPITAL, WITH THE ASSISTANCE OF THE COMMUNITY BENEFIT COMMITTEE, IDENTIFIES ORGANIZATIONS AND RESOURCES WITHIN ITS COMMUNITY THAT CONTRIBUTE TO THE PROCESS. THESE ORGANIZATIONS AND RESOURCES INCLUDE LOCAL HEALTH DEPARTMENTS, UNITED WAY, UNIVERSITIES, PUBLIC HEALTH DEPARTMENTS, ETC. COMMUNITY HEALTH ASSESSMENTS PREPARED BY OTHER ORGANIZATIONS IN THE COMMUNITY ARE USED IN COMBINATION WITH INTERNAL HOSPITAL DATA AND INFORMATION COLLECTED FROM LOCAL AGENCIES TO PREPARE THE HOSPITAL'S CHNA. IN ADDITION TO ADDRESSING NEEDS IDENTIFIED THROUGH THE CHNA, EACH HOSPITAL MAY RESPOND TO REQUESTS FOR SPECIFIC COMMUNITY BENEFIT ACTIVITIES OR PROGRAMS FROM PUBLIC AGENCIES OR COMMUNITY GROUPS. PART VI, LINE 3: PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHE ORGANIZATION IS PART OF NOVANT HEALTH, AN INTEGRATED NOT-FOR-PROFIT HEALTH SYSTEM. AS A NOT-FOR-PROFIT ORGANIZATION, NOVANT HEALTH IS COMMITTED TO PROVIDING OUTSTANDING HEALTHCARE TO ALL MEMBERS OF OUR COMMUNITIES, REGARDLESS OF THEIR ABILITY TO PAY. OUR ACUTE CARE FACILITIES PROVIDE CARE IN 35 COUNTIES ACROSS FOUR STATES. ADDITIONALLY, OUR PHYSICIANS AND ACUTE CARE FACILITIES OFFER CARE TO NATIONAL AND INTERNATIONAL MISSION PATIENTS. OUR FINANCIAL COUNSELING TEAMS ARE CONSTANTLY WORKING WITH THE PATIENTS WITHIN OUR COMMUNITIES TO UNDERSTAND THEIR NEEDS AND ENSURE THAT OUR POLICIES AND PROCESSES ADDRESS THESE NEEDS. WE ALSO MAINTAIN CONTRACTS WITH MEDICAID ELIGIBILITY VENDORS AND LOCAL DEPARTMENT OF SOCIAL SERVICES TEAMS TO HAVE EMBEDDED CASE WORKERS WITHIN OUR FACILITIES. THESE TEAMS OFFER ADDITIONAL SUPPORT IN PROCESSING AND ASSESSING HOW WE SERVE THE FINANCIAL NEEDS OF OUR PATIENTS. BASED ON THE ASSESSMENTS OF OUR COMMUNITIES, NOVANT HEALTH HAS DEVELOPED FINANCIAL ASSISTANCE POLICIES AND PROGRAMS THAT ADDRESS THE FINANCIAL NEEDS OF OUR PATIENTS. WE PRIDE OURSELVES IN THE TRANSPARENCY OF OUR PROGRAMS AND THE EDUCATION WE OFFER OUR PATIENTS AROUND OUR FINANCIAL ASSISTANCE POLICIES. OUR PROGRAMS ARE DOCUMENTED ON OUR WEBSITE, ALONG WITH CONTACT INFORMATION FOR OUR FINANCIAL COUNSELORS. ADDITIONALLY, OUR PROGRAMS ARE DOCUMENTED ON PATIENT FLYERS THROUGHOUT THE NOVANT HEALTH AFFILIATED FACILITIES AND PHYSICIAN OFFICES. OUR PATIENT ACCESS SPECIALISTS, FINANCIAL COUNSELORS AND BUSINESS OFFICE TEAMS WORK WITH ALL ELIGIBLE PATIENTS TO EDUCATE THEM ON THE VARIOUS OPTIONS AVAILABLE VIA OUR FINANCIAL ASSISTANCE PROGRAMS OR GOVERNMENT SPONSORED CARE. THEY ALSO REFERENCE OUR FINANCIAL ASSISTANCE POLICY IN ALL CONVERSATIONS RELATED TO PATIENTS BILLS. FINALLY, WE WORK WITH LOCAL AREA FREE HEALTH CLINICS AND OTHER CHARITABLE ORGANIZATIONS TO PROVIDE CONTINUATION OF CARE FOR THEIR PATIENTS. IN ADDITION TO OUR FINANCIAL COUNSELING PROCESSES USED TO IDENTIFY CHARITY CARE PATIENTS, OUR COLLECTIONS PROCESSES WITHIN OUR BUSINESS OFFICES ALSO HELP IDENTIFY PATIENTS WHO ARE ALREADY ELIGIBLE FOR CHARITY OR WHO MAY BE ELIGIBLE BASED ON THEIR STATUS WITHIN THE FEDERAL POVERTY GUIDELINES ("FPG"). WE UTILIZE PREVIOUSLY SUBMITTED PATIENT DOCUMENTATION AND CREDIT AGENCY REPORTED FPG FOR DETERMINATION. SUPPORTING DOCUMENTS ARE VALID 6 MONTHS FROM THE DATE OF SUBMISSION. OUR POLICIES ARE CONSIDERED FLUID AND ARE UPDATED FREQUENTLY BASED ON LOCAL AND NATIONAL MARKET STANDARDS AND NATIONAL ECONOMIC CONDITIONS. ANY UPDATES TO OUR POLICIES REQUIRE MULTI-LEVEL LEADERSHIP APPROVAL AND ARE ULTIMATELY APPROVED BY THE NOVANT HEALTH EXECUTIVE TEAM. PART VI, LINE 4: PART VI, LINE 4: COMMUNITY INFORMATIONCOMMUNITY GENERAL HEALTH PARTNERS, INC. DBA NOVANT HEALTH THOMASVILLE MEDICAL CENTER THE ORGANIZATION DEFINES ITS COMMUNITY BY ITS PRIMARY SERVICE AREA, WHICH IS DAVIDSON COUNTY. THIS IS A SUBURBAN AREA.THERE ARE TWO NONPROFIT ACUTE CARE HOSPITALS IN THE COMMUNITY, ONE OF WHICH IS THE ORGANIZATION. ACCORDING TO SG2 DATA, THE SPECIFIC POPULATION GROUPS (RACIAL AND ETHNIC) ARE AS FOLLOWS: WHITE NON-HISPANIC (109,605) 79.9%; BLACK NON-HISPANIC (13,153) 9.6%; HISPANIC (10,047) 7.3%; ASIAN AND PACIFIC ISLAND (1,766) 1.3%; OTHERS (2,533) 1.8%; FOR A TOTAL POPULATION OF 137,104. ACCORDING TO SG2, THE MEDIAN HOUSEHOLD INCOME LEVEL WAS $40,369.ACCORDING TO SG2 DATA, THE AGE BREAKDOWN IS AS FOLLOWS: 0-17 YEARS (31,327) 22.8%; 18-64 YEARS (83,601) 61.0%; 65+ YEARS (22,176) 16.2%. PART VI, LINE 5: PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHTHE ORGANIZATION FURTHERS ITS EXEMPT PURPOSES BY DOING THE FOLLOWING:1.ADOPTING A CHARITY CARE POLICY, WHICH PROVIDES FREE CARE TO INDIVIDUALS WHOSE INCOME IS AT OR BELOW 300% OF THE FEDERAL POVERTY LEVEL;2.REMAINING CERTIFIED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES TO PROVIDES SERVICES TO ALL BENEFICIARIES OF MEDICARE, MEDICAID, AND OTHER GOVERNMENT PAYMENT PROGRAMS, AND PROVIDING SERVICES IN A NONDISCRIMINATORY MANNER TO SUCH BENEFICIARIES;3. OPERATING A FULL-TIME EMERGENCY ROOM WHICH IS OPEN TO AND ACCEPTS ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY;4. MAINTAINING AN OPEN MEDICAL STAFF, SUBJECT TO EXCLUSIVE CONTRACTS FOR HOSPITAL-BASED SERVICES SUCH AS ANESTHESIOLOGY, RADIOLOGY, PATHOLOGY, HOSPITALIST, AND EMERGENCY DEPARTMENT SERVICES, TO THE EXTENT AN EXCLUSIVE CONTRACT FOR THOSE SERVICES IS REQUIRED TO OBTAIN PROPER STAFFING COVERAGE OR TO PERMIT A MORE EFFICIENT DELIVERY OF THOSE SERVICES WITHIN THE HOSPITAL FACILITY;5. MAINTAINING A GOVERNING BOARD CONSISTING PRIMARILY OF A BROAD CROSS-SECTION OF LEADERS IN THE COMMUNITY;6. ADOPTING AND APPLYING A CONFLICT OF INTEREST POLICY, WHICH APPLIES TO THE GOVERNING BOARD AND ORGANIZATION OFFICERS;7. PROVIDING HEALTH EDUCATION LECTURES AND WORKSHOPS;8. PROVIDING HEALTH FAIRS, EDUCATION ON SPECIFIC DISEASES OR CONDITIONS, AND HEALTH PROMOTION AND WELLNESS PROGRAMS TO THE COMMUNITIES IT SERVES;9. PROVIDING SUPPORT GROUPS AND SELF HELP PROGRAMS TO THE COMMUNITIES IT SERVES;10. PROVIDING COMMUNITY-BASED CLINICAL SERVICES, INCLUDING WITHOUT LIMITATION, HEALTH SCREENINGS AND CLINICS FOR UNINSURED OR UNDERINSURED PERSONS TO THE COMMUNITIES IT SERVES;11. PROVIDING HEALTHCARE SUPPORT SERVICES, INCLUDING WITHOUT LIMITATION, INFORMATION AND REFERRAL TO COMMUNITY SERVICES, CASE MANAGEMENT OF UNDERINSURED AND UNINSURED PERSONS, TELEPHONE INFORMATION SERVICES AND ASSISTANCE TO ENROLL IN PUBLIC PROGRAMS, SUCH AS STATE CHILDREN'S HEALTH INSURANCE PROGRAM (SCHIP) AND MEDICAID TO THE COMMUNITIES IT SERVES;12. PROVIDING SUBSIDIZED HEALTH SERVICES AND CLINICAL PROGRAMS TO THE COMMUNITIES IT SERVES;13. PROVIDING CASH AND IN-KIND CONTRIBUTIONS TO NONPROFIT COMMUNITY HEALTHCARE ORGANIZATIONS IN THE COMMUNITIES IT SERVES; AND14. GENERALLY PROMOTING THE HEALTH, WELLNESS, AND WELFARE OF THE COMMUNITIES IT SERVES BY PROVIDING QUALITY HEALTHCARE SERVICES AT REASONABLE COST.FOR SPECIFIC EXAMPLES OF THIS ORGANIZATION'S COMMUNITY BENEFIT ACTIVITIES, WHICH FURTHER THE ORGANIZATION'S EXEMPT PURPOSES (AND THOSE OF ALL HOSPITALS AND HEALTHCARE FACILITIES IN THE SAME HEALTHCARE SYSTEM), PLEASE SEE THE NOVANT HEALTH COMMUNITY BENEFIT REPORT, LOCATED AT HTTP://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMPANY-INFORMATION/FINANCIAL -PROFILE/COMMUNITY-BENEFIT-REPORT.ASPX.PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. PART VI, LINE 6: PART IV, LINE 6: AFFILIATED HEALTH CARE SYSTEMTHE ORGANIZATION IS AN INTEGRAL PART OF NOVANT HEALTH, A NOT-FOR-PROFIT INTEGRATED GROUP OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICE PROVIDERS. NOVANT HEALTH IS RANKED AS ONE OF OUR NATION'S TOP 25 INTEGRATED HEALTHCARE SYSTEMS - CARING FOR PATIENTS AND COMMUNITIES IN GEORGIA, NORTH CAROLINA, SOUTH CAROLINA, AND VIRGINIA. EACH HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITY IT SERVES, AS REPORTED INDIVIDUALLY ON EACH HOSPITAL'S FORM 990, SCHEDULE H. THE COMMUNITY BENEFIT OF THE SYSTEM AS A WHOLE IS DOCUMENTED IN A SYSTEM-WIDE COMMUNITY BENEFIT REPORT, LOCATED AT HTTP://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMPANY-INFORMATION/FINANCIAL -PROFILE/COMMUNITY-BENEFIT-REPORT.ASPX. PLEASE NOTE THAT THE NUMERIC INFORMATION IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. THERE ARE SIGNIFICANT COMMUNITY BENEFIT ACTIVITIES WITHIN NOVANT HEALTH WHICH MAY NOT BE REPORTABLE ON A SCHEDULE H BECAUSE THEY ARE NOT CONDUCTED BY AN ENTITY WHICH OWNS OR OPERATES A HOSPITAL.IN ADDITION TO HOSPITALS, NOVANT HEALTH INCLUDES A PHYSICIAN ORGANIZATION WITH PRACTICES IN GEORGIA, NORTH CAROLINA, SOUTH CAROLINA, AND VIRGINIA AND FIVE HOSPITAL FOUNDATIONS WHICH SUPPORT AND ENHANCE THE ACTIVITIES IN THOSE HOSPITALS' COMMUNITIES. FURTHER, NOVANT HEALTH INCLUDES AMBULATORY SURGERY CENTERS, IMAGING CENTERS, REHABILITATION CENTERS, AND OTHER OUTPATIENT FACILITIES; ALL DEDICATED TO PROMOTING THE HEALTH OF THEIR RESPECTIVE COMMUNITIES. PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT NOVANT HEALTH, INC. FILES A SYSTEM-WIDE COMMUNITY BENEFIT REPORT PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES WITH THE NORTH CAROLINA MEDICAL CARE COMMISSION AS PART OF THE DOCUMENTATION REQUIRED FOR THE ISSUANCE OF TAX EXEMPT BOND FINANCING. 1 UNITED WAY OF DAVIDSON COUNTY 11 COURT SQUARE SUITE 100 LEXINGTON NC 27293 561847133 501(C)(3) 9500 COMMUNITY OUTREACH CAROLINA SENIORCARE 100 LEONARD AVENUE NEWTON NC 28658 274450562 501(C)(3) 150000 TO DEVELOP A PACE PROGRAM (AN ALL INCLUSIVE CARE FOR THE ELDERLY) CHAMBER OF COMMERCE 411 W 4TH STREET WINSTON SALEM NC 27101 560459820 501(C)(6) 20854 COMMUNITY OUTREACH DAVIDSON MEDICAL MINISTRIES CLINIC INC PO BOX 584 LEXINGTON NC 27293 561746266 501(C)(3) 10000 COMMUNITY OUTREACH 3 1 PART I, LINE 2 - PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS THE ORGANIZATION IS AN AFFILIATE IN AN INTEGRATED HEALTHCARE SYSTEM AND FOLLOWS A SYSTEM-WIDE CORPORATE POLICY WITH STANDARDIZED GUIDELINES THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE ORGANIZATION MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS ARE MAINTAINED VIA THE GENERAL LEDGER. FUNDS ARE GENERALLY NOT TRACKED AFTER BEING GRANTED, AS THE ORIGINAL ELIGIBILITY AND SELECTION CRITERIA HAVE ALREADY BEEN MET. X X X X X X 1 1 0 1 0 0 0 0 0 0 0 KEATES WILLIAM TRUSTEE 0 252014 0 31813 0 1161 0 15966 0 28743 0 329697 0 0 MARKS PHILLIP TRUSTEE 0 534673 0 0 0 19544 0 38298 0 36378 0 628893 0 0 MORRIS JOHN ASST SEC 0 237363 0 80201 0 5563 0 56043 0 18957 0 398127 0 0 JOHNSON KATHIE PRESIDENT NHTMC 219165 0 153668 0 25491 0 48529 0 27164 0 474017 0 7500 0 LINDSAY JEFFERY PRES FMCCOO WS MKT (*SEE ADD'L INFO IN SCH J P3) 0 598311 0 355104 0 1927146 0 52049 0 23672 0 2956282 0 708380 ANDERSON JENNIFER MGR PHARMACY 122080 0 2361 0 777 0 22689 0 16841 0 164748 0 0 0 ASBILL-RUSSELL AUDREY DIR SURGICAL SVCS 112530 0 13320 0 1896 0 14345 0 8774 0 150865 0 0 0 BALLENGEE JOHN PHARMACIST 126047 0 16980 0 1076 0 8667 0 8937 0 161707 0 0 0 GRABUS CHRISTINA SR DIR CHIEF NURSING OFFICER 133874 0 18864 0 10563 0 22469 0 17510 0 203280 0 0 0 KONERU MADHU MGR PHARMACY 129396 0 0 0 2183 0 4650 0 22779 0 159008 0 0 0 PART I, LINE 1A PART I, LINE 1A: FRINGE OR EXPENSE EXPLANATION FIRST-CLASS OR CHARTER TRAVEL: FIRST-CLASS OR CHARTER TRAVEL IS NOT A COVERED TRAVEL EXPENSE FOR EXECUTIVES; THEY ARE LIMITED TO BUSINESS OR COACH CLASS FARES FOR COMMERCIAL FLIGHTS. HOWEVER, CHARTER TRAVEL IS AVAILABLE TO CERTAIN EXECUTIVES, BOARD MEMBERS, AND APPROVED BUSINESS PERSONNEL IN LIMITED CIRCUMSTANCES DEEMED TO INVOLVE BUSINESS NECESSITY. TRAVEL FOR COMPANIONS: COMPANIONS ARE ALLOWED ON CERTAIN CHARTER FLIGHTS PAID FOR BY THE ORGANIZATION. IN THAT CASE, THE VALUE OF THE COMPANION'S FLIGHT IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S TAXABLE INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: EXECUTIVES WHO PURCHASE SPLIT DOLLAR INSURANCE THROUGH THEIR DISCRETIONARY SPENDING ACCOUNT MAY HAVE THE ADDITIONAL INCOME TAX OWED ON THE PS-58 COSTS PAID BY THE ORGANIZATION. EXECUTIVES WHO RECEIVE TAXABLE RELOCATION INCOME MAY HAVE THE ADDITIONAL INCOME TAX OWED ON THE INCOME PAID BY THE ORGANIZATION. EXECUTIVES MAY RECEIVE AS SEVERANCE BENEFITS CASH PAYMENTS IN LIEU OF PREMIUMS PAID FOR COVERAGE OF CERTAIN BENEFITS THAT ENDED WITH THE EXECUTIVE'S TERMINATION. THE ORGANIZATION MAY PAY THE ADDITIONAL TAX OWED ON ACCOUNT OF THESE PAYMENTS. DISCRETIONARY SPENDING ACCOUNT: CERTAIN EXECUTIVES RECEIVE A DISCRETIONARY SPENDING ACCOUNT. THE DOLLAR AMOUNT IN THE ACCOUNT IS PRE-APPROVED BY THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE NOVANT HEALTH BOARD OF TRUSTEES. THE ACCOUNT CAN BE USED ONLY FOR AN APPROVED LIST OF EXPENDITURES. ALL OPTIONS OTHER THAN A DEFERRED, AT-RISK, COMPENSATION OPTION ARE CONSIDERED TAXABLE AND ARE INCLUDED IN THE EXECUTIVE'S TAXABLE INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: WE PROVIDE TEMPORARY HOUSING ALLOWANCES IN CERTAIN EXECUTIVE RECRUITMENT AND RELOCATION PACKAGES. IN THE CASE THAT SUCH EXPENSE IS NOT REIMBURSABLE UNDER THE ACCOUNTABLE PLAN RULES, THE VALUE IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S INCOME AS PRESCRIBED BY THE APPLICABLE TAX LAWS. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: IN CASES WHERE CORPORATE MEMBERSHIPS ARE NOT AVAILABLE, A MEMBERSHIP MAY BE OBTAINED IN AN EXECUTIVE'S NAME WITH A "BUSINESS USE ONLY" RESTRICTION. PART I, LINE 3 PART I, LINE 3: THE FILING ORGANIZATION IS AN AFFILIATE IN AN INTEGRATED HEALTHCARE SYSTEM AND IS SUPPORTED BY A PARENT ORGANIZATION THAT USES THE PROCESS DESCRIBED IN PART VI, LINE 15A OF THIS RETURN TO ESTABLISH THE COMPENSATION OF THE TOP MANAGEMENT OFFICIAL OF THE FILING ORGANIZATION. THIS PROCESS ADHERES TO THE REQUIREMENTS SET FORTH TO SECURE THE REBUTTABLE PRESUMPTION OF REASONABLENESS AND INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT AND DISINTERESTED MEMBERS OF A COMPENSATION COMMITTEE, CONSULTATION WITH INDEPENDENT COMPENSATION CONSULTANTS, THE UTILIZATION OF THIRD-PARTY COMPARABILITY DATA SUCH AS PUBLISHED COMPENSATION SURVEYS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. PART I, LINE 4B PART I, LINE 4A-C: SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE NONQUALIFIED EQUITY-BASED LINDSAY, JEFFERY 0 *1,885,932 0 *SCHEDULE J PART II COLUMN B(III): IN 2012, THE INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH BOARD OF TRUSTEES COMPENSATION AND LEADERSHIP COMMITTEE (THE "COMMITTEE") ENGAGED INTEGRATED HEALTHCARE STRATEGIES TO ASSESS THE MARKET AND DESIGN A NEW SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("NEW SERP") THAT WOULD BE MORE IN LINE WITH MARKET PRACTICE AND INDUSTRY TRENDS AND THAT WOULD BETTER ACCOMPLISH NOVANT HEALTH'S STRATEGIC EXECUTIVE RETENTION AND ATTRACTION GOALS, AND TO REPLACE THE EXISTING PLAN. IN 2013, THE COMMITTEE APPROVED A NEW DEFINED CONTRIBUTION SERP, TO BE EFFECTIVE 1/1/2014, AND TERMINATED THE EXISTING DEFINED BENEFIT PLAN, WHICH HAS BEEN DESCRIBED IN DETAIL IN PRIOR NOVANT HEALTH FORM 990S. AS 2013 WAS A TRANSITION YEAR, SERP BENEFITS PAID OUT AS A RESULT OF THE TERMINATION OF THE EXISTING DEFINED BENEFIT PLAN HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(III) OF SCHEDULE J, AND DEFERRED COMPENSATION AMOUNTS THAT ACCRUED IN 2013 UNDER THE NEW SERP TO BE CONTRIBUTED TO PARTICIPANTS IN 2014 ARE REPORTED IN COLUMN (C) OF SCHEDULE J. THE AMOUNTS REFLECTED IN COLUMN F AS PREVIOUSLY REPORTED REFLECT THE CUMULATIVE AMOUNTS RECORDED ON PRIOR 990S IN COLUMN C AS DEFERRED COMPENSATION. THE AMOUNT IS THEN ADJUSTED FOR ANY PRIOR YEAR'S PAYMENTS THAT HAVE BEEN REPORTED PREVIOUSLY IN COLUMNS B(III) AND F. THE AMOUNTS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN COLUMN C WERE DETERMINED USING AN ACTUARIAL CALCULATION THAT IS BASED ON SEVERAL FACTORS INCLUDING CURRENT AND FUTURE SALARY EXPECTATIONS, EXPECTED FUTURE YEARS OF SERVICE, AND DISCOUNTED USING INTEREST RATES IN PLACE AT THE TIME OF CALCULATION. THE AMOUNT REPORTED IN COLUMN B(III) FOR THE PLAN PAYOUT WILL NOT EXACTLY REFLECT THE CUMULATIVE ACCRUALS REPORTED IN COLUMN F BECAUSE OF THE VARIABILITY OF THE CALCULATION'S FACTORS OVER TIME. IN ADDITION, DUE TO THE LUMP SUM NATURE OF THE FINAL PAYOUT, THE AMOUNTS REPORTED IN COLUMN C AS ACCRUED IN THE PRIOR YEAR WOULD NOT INCLUDE A PORTION OF THE AMOUNTS ACCELERATED INTO 2013. THE EXISTING DEFINED BENEFIT PLAN PARTICIPANTS' PAYMENTS VARIED BASED ON LENGTH OF SERVICE TO THE ORGANIZATION, WHICH RANGED FROM 8 TO 37 YEARS, AND VESTING STATUS AT THE TIME OF PLAN TERMINATION. THE NEW SERP IS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES, AND TO OFFER COMPETITIVE TOTAL COMPENSATION. ELIGIBLE EXECUTIVES WILL BE NOMINATED BY THE CEO AND APPROVED BY THE COMMITTEE TO PARTICIPATE. GENERALLY, ANNUAL CONTRIBUTIONS TO THE PLAN OR PAYMENTS TO PARTICIPANTS WILL BE BASED ON A PERCENTAGE OF THE PARTICIPANT'S BASE SALARY AS OF JANUARY 1ST OF THE PREVIOUS PLAN YEAR. PRIOR TO MAKING THE CONTRIBUTIONS OR PAYMENTS, THE COMMITTEE WILL APPROVE THE AMOUNTS AS TO REASONABLENESS, WHEN COMBINED WITH ALL OTHER ANNUAL COMPENSATION. A 3 YEAR CLASS-YEAR VESTING PERIOD WILL APPLY UP TO AGE 62, WHEN ALL MONEY WOULD BE VESTED AND PAID OUT TO THE PARTICIPANT. OTHERWISE, VESTING WILL OCCUR ON JANUARY 1ST OF EACH YEAR FOR THE APPROPRIATE CLASS-YEAR VESTING PERIOD. THE COMMITTEE REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS. PART III - OTHER ADDITIONAL INFORMATION DESCRIPTIONS OF SUPPLEMENTAL EXECUTIVE BENEFITS INCLUDED IN PART VII AND SCHEDULE J: EXECUTIVE ANNUAL INCENTIVE PLAN: AS PART OF THE REPORTED COMPENSATION AMOUNTS, THE REPORTING ORGANIZATION PROVIDES ANNUAL INCENTIVE COMPENSATION TO OFFICERS AND KEY EMPLOYEES UNDER AN EXECUTIVE ANNUAL INCENTIVE PLAN. THE INCENTIVE PLAN IS DESIGNED TO OFFER OPPORTUNITIES FOR ADDITIONAL COMPENSATION, BUT ONLY TO THE EXTENT THAT ELIGIBLE EXECUTIVES HAVE PROVIDED EXTRAORDINARY SERVICES AND ACHIEVED EXTRAORDINARY RESULTS THAT MEET OR EXCEED PREDETERMINED GOALS IN THE AREAS OF QUALITY, PATIENT SATISFACTION, EMPLOYEE SATISFACTION AND FINANCIAL VITALITY. THESE GOALS ARE ESTABLISHED AND APPROVED BY INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD). THESE GOALS ARE WEIGHTED EQUALLY. THE ADDITIONAL COMPENSATION CAN RANGE ANYWHERE FROM ZERO TO A MAXIMUM PERCENTAGE OF BASE SALARY THAT DIFFERS BY THE CLASS OF EXECUTIVE; THIS MAXIMUM PERCENTAGE RANGES FROM 30% TO 70% OF BASE SALARY. IN ADDITION, THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD WHO OVERSEE THE INCENTIVE COMPENSATION PROGRAM APPLY TWO "CIRCUIT BREAKERS," WHICH ARE SUBSTANTIAL LEVELS OF ORGANIZATION-WIDE ACHIEVEMENT THAT MUST BE SATISFIED BEFORE ANY AWARDS ARE PAID TO ANY EXECUTIVE UNDER THE PROGRAM. THE INCENTIVE COMPENSATION AWARDS HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(II) OF SCHEDULE J. THEY ARE REPORTED IN THE YEAR PAID. THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD REVIEW, APPROVE, AND OVERSEE ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS ANNUAL INCENTIVE PLAN. LONG-TERM INCENTIVE PLAN: THE REPORTING ORGANIZATION OFFERS A LONG-TERM INCENTIVE PLAN (THE "PLAN") TO CERTAIN KEY EXECUTIVES. THE PLAN TIES A KEY EXECUTIVE'S COMPENSATION TO THE ORGANIZATION'S LONG-TERM STRATEGIC PERFORMANCE, PROVIDES A RETENTION INCENTIVE FOR KEY EXECUTIVES, AND ALLOWS THE ORGANIZATION TO COMPETE IN THE MARKETPLACE FOR TOP LEADERSHIP TALENT. THE PLAN OPERATES ON THREE-YEAR PERFORMANCE CYCLES THAT BEGIN EACH YEAR. LONG-TERM STRATEGIC GOALS (IN THE PRINCIPAL AREAS OF QUALITY OF PATIENT CARE AND LONG-TERM FINANCIAL STRENGTH) ARE ESTABLISHED AND APPROVED FOR EACH CYCLE, IN ADVANCE, BY INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD). NOVANT HEALTH'S INTERNAL AUDIT DEPARTMENT REVIEWS THE METHODOLOGY AND PROCESS USED TO DETERMINE ACHIEVEMENT OF THE QUALITY METRICS. AWARDS ARE PAYABLE FOR A PARTICULAR THREE-YEAR PERFORMANCE CYCLE ONLY IF THE REQUISITE LEVEL OF COMMUNITY BENEFIT AND CHARITY CARE, ALONG WITH THE REQUIRED LEVEL OF FINANCIAL PERFORMANCE TO DEMONSTRATE LONG-TERM FINANCIAL STRENGTH, HAVE BEEN MET FOR THAT RESPECTIVE THREE-YEAR PERFORMANCE PERIOD. IF AN AWARD IS EARNED AT THE END OF A PERFORMANCE CYCLE, THEN THE INCENTIVE AWARD IS PAID OUT AND IS INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(II) OF SCHEDULE J. THEY ARE REPORTED IN THE YEAR PAID. THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THE PLAN. PART I, LINE 4A - SEVERANCE PLAN: ELIGIBLE EXECUTIVES MAY RECEIVE SEVERANCE PAY THAT IS BASED ON ANNUAL COMPENSATION FOR A SPECIFIED PERIOD OF TIME. THE SEVERANCE PAY WOULD BE PAID ONLY IN THE EVENT OF CERTAIN TYPES OF EMPLOYMENT TERMINATION, AND IS FURTHER CONTINGENT ON THE SATISFACTION OF OTHER CONDITIONS SUCH AS COMPLIANCE WITH A NON-COMPETITION COVENANT. ANY CURRENT YEAR PAYMENTS HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(III) OF SCHEDULE J. THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD REVIEWS, APPROVES, AND OVERSEES ALL ASPECTS AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS SEVERANCE PLAN. FORM 990, PI, L1: ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES COMMUNITY GENERAL HEALTH PARTNERS INC., DOING BUSINESS AS NOVANT HEALTH THOMASVILLE MEDICAL CENTER ("NHTMC"), IS AN INTEGRAL PART OF THE NOVANT HEALTH SYSTEM (COLLECTIVELY KNOWN AS "NOVANT HEALTH"), A NOT-FOR-PROFIT INTEGRATED GROUP OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICE PROVIDERS. NOVANT HEALTH IS RANKED AS ONE OF OUR NATION'S TOP 25 BEST HEALTHCARE SYSTEMS - CARING FOR PATIENTS AND COMMUNITIES IN GEORGIA, NORTH CAROLINA, SOUTH CAROLINA AND VIRGINIA. IN 2013, THE NOVANT HEALTH SYSTEM REPORTED $3.6 BILLION IN REVENUES. NHTMC, A NOVANT HEALTH COMMUNITY HOSPITAL, FOCUSED ON COMMUNITY SUPPORT, QUALITY, UNSURPASSED SERVICE AND MAINTAINING A REMARKABLE STAFF DURING 2013. IN ADDITION TO OUR QUALITY OF SERVICES AND COMPREHENSIVE CATEGORIES OF SERVICE, WE'RE VERY PROUD OF OUR PATIENT FINANCIAL ASSISTANCE PROGRAM. WE WORK WITH CUSTOMERS TO HELP QUALIFY THEM FOR PUBLIC ASSISTANCE, ESTABLISH A REASONABLE PAYMENT PLAN, DISCOUNT THEIR BILL OR PROVIDE THEM WITH FREE CHARITY CARE. NHTMC RECEIVED A NUMBER OF AWARDS IN 2013 INCLUDING: 2013 ADVANCED PRIMARY STROKE CERTIFICATION BY THE JOINT COMMISSION; ISO 9001:2008 CERTIFICATION THROUGH DNV (DET NORSKE VERITAS) HEALTHCARE; BRONZE ACHIEVEMENT AWARD FROM AMERICAN HEART AND STROKE ASSOCIATION FOR IMPROVEMENT IN THE TREATMENT OF STROKE BY IMPLEMENTATION OF "GET WITH THE GUIDELINES"; AND DISEASE SPECIFIC CERTIFICATION FOR OUR CHRONIC OBSTRUCTIVE PULMONARY DISEASE PROGRAM, BECOMING THE FIRST HOSPITAL IN THE STATE OF NORTH CAROLINA TO RECEIVE THIS CERTIFICATION AND ONLY THE EIGHTH IN THE NATION. DURING THE THOMASVILLE, NC AREA CHAMBER'S "EVERYBODY'S DAY FESTIVAL," ARCHDALE, NC CHAMBER'S "BUSH HILL FESTIVAL" AND DENTON, NC'S "FALL FESTIVAL" THOUSANDS OF ATTENDEES RECEIVED INFORMATION ABOUT HEALTHY EATING AND ABOUT HAVING A REGULAR HEALTH SCREENING TO REDUCE HEALTH RISKS. ATTENDEES WERE GIVEN A LISTING OF ROUTINE SCREENINGS RECOMMENDED FOR EACH DECADE OF LIFE. NHTMC ALSO DISTRIBUTED COLORING BOOKS TO AREA SCHOOL CHILDREN THROUGHOUT THE COUNTY AND PROVIDED EDUCATIONAL MATERIALS TO THE COMMUNITY TO ASSIST EFFORTS TO RAISE AWARENESS OF THE IMPORTANCE OF HAND WASHING, RECEIVING A FLU VACCINATION AND OTHER FLU PRECAUTION STEPS. DURING OUR ANNUAL MLK JR. HEALTH FAIR HELD IN COOPERATION WITH THE MLK JR. SOCIAL ACTION COMMITTEE, MORE THAN 100 COMMUNITY MEMBERS WERE OFFERED WELLNESS EDUCATION AND COMPLIMENTARY SCREENINGS INCLUDING FOR VISION, HEARING, BLOOD PRESSURES, PULMONARY DISEASE, STROKE, AND DIABETES. HUNDREDS OF COMMUNITY MEMBERS ATTENDED OUR BLOOD PRESSURE AND BLOOD SUGAR SCREENINGS OFFERED AROUND THE COMMUNITY AND WE PARTNERED FOR FOLLOW-UP VISITS WITH A PHYSICIAN WHEN THE NEED AROSE. NHTMC STAFF ATTENDS YEAR-ROUND EVENTS AT SENIOR SERVICES, AREA SCHOOL PTO FAIRS, LOCAL CHURCHES AND CIVIC EVENTS TO REACH OUT TO THE COMMUNITY TO IMPROVE HEALTH. IN 2013, WE LAUNCHED A FREE CONCUSSION CLINIC FOR MIDDLE AND HIGH SCHOOLS IN DAVIDSON COUNTY, NC, TRAINING ATHLETIC DIRECTORS AND COACHES HOW TO DO THE BASELINE SCREENING FOR THEIR ATHLETE TO ASSIST THEM BETTER IDENTIFYING A POSSIBLE CONCUSSION FOR PLAYERS. EXAMPLES OF THE ACTIVITIES AIMED AT IMPROVING THE COMMUNITY'S HEALTH NEEDS INCLUDE THE FOLLOWING: *IN 2013, NHTMC COORDINATED THE DISTRIBUTION OF FREE AND DISCOUNTED MEDICATIONS THROUGH THE MEDICATION ASSISTANCE PROGRAM WITH THE NORTH CAROLINA HEALTH AND WELLNESS TRUST FUND. *NHTMC HOSTED A VARIETY OF FREE SEMINARS TO HELP PROMOTE EDUCATION AND WELLNESS AND GAVE FREE COMMUNITY TALKS ON A VARIETY OF HEALTH AND WELLNESS RELATED TOPICS INCLUDING PARENTING CLASSES, BABY SITTING TRAINING, STROKE PREVENTION, WOMEN'S HEART ISSUES, HEALTHY EATING, END OF LIFE DECISIONS AND DIABETES MANAGEMENT. *NHTMC IS PROUD TO SERVE AS THE THOMASVILLE, NC LOCATION FOR THE DAVIDSON COUNTY MEDICAL MINISTRIES. WITH LIMITED COUNTY TRANSPORTATION, IT WAS BECOMING INCREASINGLY DIFFICULT FOR THOMASVILLE, NC RESIDENTS TO ACCESS THE FREE SERVICES OF DAVIDSON MEDICAL MINISTRIES. NHTMC PARTNERED WITH THE CLINIC TO ASSIST RESIDENTS IN MORE EASILY ACCESSING HEALTHCARE. THE CLINIC HOURS INCLUDE ALL DAY MONDAY, TUESDAY EVENINGS AND PHARMACY CLINIC WEDNESDAY AFTERNOONS, IN ADDITION TO TWO ADMINISTRATIVE DAYS. *THE FOOD AND NUTRITION DEPARTMENT PREPARES NEARLY 100 MEALS EACH WEEKDAY FOR THE MEALS ON WHEELS PROGRAM TO ASSIST IN PROVIDING COST EFFECTIVE AND HIGHLY NUTRITIOUS MEALS FOR HOMEBOUND RESIDENTS. *THE LEARNING PLACE, NOVANT HEALTH THOMASVILLE MEDICAL CENTER'S ONSITE CHILD DEVELOPMENT CENTER, IN COLLABORATION WITH SMART START, SERVES AS A MORE-AT-FOUR PRE-KINDERGARTEN LOCATION. THIS INITIATIVE OFFERS A QUALITY PRESCHOOL PROGRAM TO PREPARE KIDS FOR KINDERGARTEN WHO HAVE ENGLISH AS A SECOND LANGUAGE, CHILDREN WITH DISABILITIES AND CHILDREN THAT ARE FINANCIALLY CHALLENGED. *NHTMC ALSO OFFERS THE COMMUNITY A SEXUAL ASSAULT NURSE EXAMINER ("SANE") ROOM FOR VICTIMS OF SEXUAL ASSAULT AND PROVIDES TRAINED SANE NURSES TO SERVE RESIDENTS THROUGHOUT THE COUNTY DURING THIS CRISIS. *TO ASSIST PATIENTS WITH END OF LIFE CARE, NHTMC PROVIDES OFFICE SPACE WITH HOSPICE OF DAVIDSON COUNTY TO HOUSE A FULL-TIME NURSE TO COORDINATE HOSPICE SERVICES WITH PATIENTS AND FAMILIES. NHTMC'S ONCOLOGY PROGRAM COORDINATOR, ASSISTING CANCER PATIENTS AND THEIR FAMILIES THROUGH THEIR CANCER JOURNEY OF TREATMENTS AND PROCEDURES, HOSTS A FEEL DAY FRIDAY FOR ANY CANCER PATIENT AND THEIR FAVORITE CAREGIVER, PROVIDING THEM A FREE LUNCH AND TIME OF CHAIR MASSAGES, HAIRCUTS, HAND MASSAGES, MANICURE, ENTERTAINMENT AND CRAFT TIME. THIS EVENT WELCOMED MORE THAN 200 CANCER PATIENTS IN 2013. ALSO ADDED WAS MUSCLES TO MOTION PROGRAM THAT PROVIDES ANY CANCER PATIENT WHO IS COMPLETING OR HAS COMPLETED TREATMENT IN THE LAST YEAR, AT LEAST 11 SESSIONS OF EXERCISE TO BUILD STRENGTH AND ENDURANCE. *FREE PERIPHERAL ARTERY DISEASE SCREENINGS ARE AVAILABLE THE FIRST MONDAY OF EACH MONTH TO COMMUNITY MEMBERS TO IDENTIFY POSSIBLE HEALTH ISSUES BEFORE THEY CAUSE IRREPARABLE HARM. BY PROVIDING THIS FREE TEST TO THE COMMUNITY, MANY MEDICAL ISSUES THAT MIGHT GO UNDIAGNOSED ARE IDENTIFIED AND TREATED. *NHTMC HAS INITIATED SEVERAL PROGRAMS TO HELP MEET THE MEDICAL NEEDS OF SENIORS. WE OFFER THE AREA'S ONLY GERIATRIC BEHAVIORAL HEALTH UNIT AND INTENSIVE OUTPATIENT PROGRAM WITH 45 BEDS. FAMILIES FROM ACROSS THE STATE ENTRUST THEIR FAMILY MEMBERS TO OUR CARE ON THIS DEDICATED UNIT. *NHTMC ALSO HOSTS THE CONNECTIONLINK PROGRAM THAT ENGAGES SENIORS FROM ACROSS THE COUNTY FOR LUNCH TO LEARN ABOUT HEALTH ISSUES AND LINKS THEM WITH MEDICAL SERVICES THAT WILL IMPROVE THEIR QUALITY OF LIFE. TWO ADDITIONAL CONNECTIONLINK PROGRAMS WERE LAUNCHED IN BOTH THE TRINITY AND LEXINGTON, NC COMMUNITIES IN 2013. *NOVANT HEALTH THOMASVILLE MEDICAL CENTER, THE COUNTY HEALTH DEPARTMENT AND LEXINGTON MEMORIAL HOSPITAL PARTNERED TOGETHER IN RECEIVING A GRANT FROM THE SUSAN G. KOMEN FOUNDATION TO PROVIDE UNDERSERVED WOMEN IN THE COUNTY WITH SCREENING MAMMOGRAPHY AND TREATMENT. *NHTMC PROUDLY PARTNERS WITH LOCAL HIGH SCHOOLS AND COLLEGES TO SERVE AS A TRAINING SITE FOR MEDICAL PROFESSIONALS INCLUDING NURSING ASSISTANTS, LAB TECHS, NURSES AND PHARMACISTS. *BASIC PERSONAL CARE ITEMS SUCH AS COMBS, SHAMPOO, TOOTH PASTE AND SOAP ITEMS WERE DISTRIBUTED TO STUDENTS IN THOMASVILLE, NC, LEXINGTON, NC AND DAVIDSON COUNTY, NC COMMUNITY IN SCHOOLS PROGRAMS TO ASSIST SCHOOL OFFICIALS TO MEET THEIR BASIC NEEDS IN ADDITION TO THEIR EDUCATIONAL NEEDS. *NHTMC'S REGISTERED NURSE AND AN OUTPATIENT PROGRAM, NHTMC TO HOME, DESIGNED TO REDUCE READMISSION RATES FOR VULNERABLE PATIENTS WITH A PRIMARY DIAGNOSIS OF CONGESTIVE HEART FAILURE, ACUTE MYOCARDIAL INFARCTION, PNEUMONIA, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, OR DIABETES, IS IN ITS THIRD YEAR. THIS FREE SERVICE ENABLES PATIENTS TO SAFELY TRANSITION FROM HOSPITAL TO HOME UTILIZING EDUCATION, HOME VISITS AND PHONE CALLS TO HELP THE PATIENT MANAGE THEIR HEALTH MORE EFFECTIVELY. COMMUNITY BENEFIT REPORT: HTTP://WWW.NOVANTHEALTH.ORG/HOME/ABOUT-US/COMPANY-INFORMATION/FINANCIAL -PROFILE/COMMUNITY-BENEFIT-REPORT.ASPX THE COMMUNITY BENEFIT REPORT PREPARED BY NOVANT HEALTH IS A SYSTEM-WIDE REPORT THAT INCLUDES QUALITATIVE AND QUANTITATIVE INFORMATION. IN THIS REPORT, THE NOVANT HEALTH SYSTEM'S COMMUNITY BENEFIT WAS APPROXIMATELY $566,000,000, INCLUDING $129,000,000 IN CHARITY CARE, IN 2013. PLEASE NOTE THAT THE NUMERIC DATA IN THIS REPORT IS NOT BASED UPON THE FORM 990, SCHEDULE H CRITERIA, BUT RATHER IT HAS BEEN PREPARED IN ACCORDANCE WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION REPORTING GUIDELINES. IT SHOULD NOT BE RELIED UPON AS THE ORGANIZATION'S FORM 990, SCHEDULE H COMMUNITY BENEFIT REPORT. FORM 990, PART III, LINE 1: MISSION, VISION, AND VALUES MISSION: NOVANT HEALTH EXISTS TO IMPROVE THE HEALTH OF COMMUNITIES, ONE PERSON AT A TIME. VISION: WE, THE EMPLOYEES OF NOVANT HEALTH AND OUR PHYSICIAN PARTNERS, WILL DELIVER THE MOST REMARKABLE PATIENT EXPERIENCE, IN EVERY DIMENSION, EVERY TIME. VALUES: COMPASSION: WE TREAT OUR CUSTOMERS AND THEIR FAMILIES, STAFF AND OTHER HEALTHCARE PROVIDERS AS FAMILY MEMBERS BY SHOWING THEM KINDNESS, PATIENCE, EMPATHY AND RESPECT. DIVERSITY: WE RECOGNIZE THAT EVERY PERSON IS DIFFERENT, EACH SHAPED BY UNIQUE LIFE EXPERIENCES. THIS ENABLES US TO BETTER UNDERSTAND ONE ANOTHER AND OUR CUSTOMERS. PERSONAL EXCELLENCE: WE STRIVE TO GROW PERSONALLY AND PROFESSIONALLY, AND APPROACH EACH SERVICE OPPORTUNITY WITH A POSITIVE, FLEXIBLE ATTITUDE. HONESTY AND PERSONAL INTEGRITY GUIDE ALL THAT WE DO. TEAMWORK: THE NEEDS AND EXPECTATIONS OF ANY ONE CUSTOMER ARE GREATER THAN THAT WHICH ONE PERSON'S SERVICE EFFORTS CAN SATISFY. WE SUPPORT EACH OTHER SO THAT TOGETHER AS A TEAM, WE CAN BE SUCCESSFUL IN THE EYE OF THE CUSTOMER AS A QUALITY SERVICE PROVIDER. NOVANT HEALTH'S BRAND PROMISE: WE ARE MAKING YOUR HEALTHCARE EXPERIENCE REMARKABLE. WE WILL BRING YOU WORLD-CLASS TECHNOLOGY, CLINICIANS, AND CARE - WHEN AND WHERE YOU NEED IT. WE ARE REINVENTING THE HEALTHCARE EXPERIENCE TO BE SIMPLER, MORE CONVENIENT, AND MORE AFFORDABLE, SO THAT YOU CAN FOCUS ON GETTING BETTER AND STAYING HEALTHY. FORM 990, PART I, LINE 6: THE NUMBER OF VOLUNTEERS REPORTED INCLUDES THOSE VOLUNTEERS SERVING AS BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 6 FORM 990, PART VI, SECTION A, LINE 6: CLASSES OF MEMBERS OR STOCKHOLDERS THE CORPORATION IS A NONPROFIT CORPORATION WITH MEMBERS (OR A MEMBER). FORM 990, PART VI, SECTION A, LINE 7A FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF MEMBERS AND THEIR RIGHTS NOVANT HEALTH, INC. ELECTS THE BOARD MEMBERS OF COMMUNITY GENERAL HEALTH PARTNERS. FORM 990, PART VI, SECTION A, LINE 7B FORM 990, PART VI, SECTION A, LINE 7B: DECISIONS SUBJECT TO APPROVAL OF MEMBERS NOVANT HEALTH, INC. HAS CERTAIN RESERVED POWERS, SUCH AS APPROVAL OF AMENDMENTS TO THE ARTICLES AND BYLAWS OF THE CORPORATION, AND TO ADOPT CERTAIN POLICIES WHICH SHALL BE IMPLEMENTED BY THE CORPORATION BOARD. FORM 990, PART VI, SECTION B, LINE 11 FORM 990, PART VI, SECTION B, LINE 11: ORGANIZATION'S PROCESS TO REVIEW FORM 990 THE BOARD HAS DELEGATED REVIEW OF THE FORM 990 TO NOVANT HEALTH'S AUDIT AND COMPLIANCE COMMITTEE, WHICH OVERSEES TAX MATTERS FOR NOVANT HEALTH. THE AUDIT AND COMPLIANCE COMMITTEE IS THE REVIEW BODY FOR ALL OF THE FORM 990S FILED FOR ORGANIZATIONS WITHIN THE NOVANT HEALTH SYSTEM. THE AUDIT AND COMPLIANCE COMMITTEE MEETS BEFORE THE FORM 990S ARE FILED WITH THE IRS AND AFTER ALL BOARD MEMBERS HAVE RECEIVED A COPY OF THE FORM 990 AND A SUMMARY OF ITS CONTENTS. THE SENIOR DIRECTOR OF TAX AND LEGAL COUNSEL FOR NOVANT HEALTH ATTEND THE MEETING TO ANSWER ANY QUESTIONS AND ADDRESS ANY SIGNIFICANT DISCLOSURES WITHIN THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C FORM 990, PART VI, SECTION B, LINE 12C: MONITORING AND ENFORCEMENT OF COI THE ORGANIZATION'S TRUSTEE CONFLICT OF INTEREST POLICY APPLIES TO ALL TRUSTEES, PRINCIPAL OFFICERS OR MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS INCLUDING ANY APPLICABLE DISREGARDED ENTITIES. ALL TRUSTEES ARE SENT AN ANNUAL DISCLOSURE FORM. ANY POSITIVE ANSWERS ON THE TRUSTEE ANNUAL DISCLOSURE FORM ARE REVIEWED BY THE GENERAL COUNSEL. IF THE RELATIONSHIP DISCLOSED IS DETERMINED NOT TO POSE A POTENTIAL CONFLICT OF INTEREST GENERALLY, THEN NO ACTION IS TAKEN. WITH RESPECT TO PARTICULAR TRANSACTIONS THAT COME BEFORE THE BOARD, THE CONFLICT OF INTEREST POLICY WOULD BE FOLLOWED. THE POTENTIAL CONFLICT OF INTEREST WOULD BE DISCLOSED BY THE BOARD MEMBER BEFORE A VOTE ON THE TRANSACTION AND THE REST OF THE BOARD WOULD DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. IF THE REST OF THE BOARD DETERMINED THAT A CONFLICT OF INTEREST EXISTED THEN THE BOARD MEMBER WITH THE CONFLICT OF INTEREST WOULD NOT PARTICIPATE IN THE DELIBERATIONS AND VOTE. FORM 990, PART VI, SECTION B, LINE 13: WRITTEN WHISTLEBLOWER POLICY THE ORGANIZATION IS PART OF THE INTEGRATED HEALTHCARE SYSTEM OPERATED BY NOVANT HEALTH, INC. ("NOVANT HEALTH"), THE PARENT ORGANIZATION. NOVANT HEALTH'S BYLAWS AUTHORIZE IT TO ESTABLISH CERTAIN POLICIES FOR ALL OF ITS SUBSIDIARIES WITHIN THE SYSTEM. ALL SUBSIDIARY ORGANIZATIONS FOLLOW ALL APPLICABLE NOVANT HEALTH CORPORATE POLICIES IN THEIR OPERATIONS. NOVANT HEALTH HAS ESTABLISHED A WHISTLEBLOWER POLICY, WHICH ALL SUBSIDIARY ORGANIZATIONS IN THE SYSTEM FOLLOW. THE INDIVIDUAL SUBSIDIARY ORGANIZATION'S BOARD OF TRUSTEES DO NOT SPECIFICALLY ADOPT OR APPROVE EACH OPERATING POLICY, AS THERE ARE HUNDREDS OF POLICIES THAT APPLY TO ALL SUBSIDIARY ORGANIZATIONS AND THEY CANNOT PRACTICABLY BE APPROVED BY ALL OF THE INDIVIDUAL BOARDS. FORM 990, PART VI, SECTION B, LINE 14: WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY THE ORGANIZATION IS PART OF THE INTEGRATED HEALTHCARE SYSTEM OPERATED BY NOVANT HEALTH, INC. ("NOVANT HEALTH"), THE PARENT ORGANIZATION. NOVANT HEALTH'S BYLAWS AUTHORIZE IT TO ESTABLISH CERTAIN POLICIES FOR ALL OF ITS SUBSIDIARIES WITHIN THE SYSTEM. ALL SUBSIDIARY ORGANIZATIONS FOLLOW ALL APPLICABLE NOVANT HEALTH CORPORATE POLICIES IN THEIR OPERATIONS. NOVANT HEALTH HAS ESTABLISHED A DOCUMENT RETENTION AND DESTRUCTION POLICY, WHICH ALL SUBSIDIARY ORGANIZATIONS IN THE SYSTEM FOLLOW. THE INDIVIDUAL SUBSIDIARY ORGANIZATION'S BOARD OF TRUSTEES DO NOT SPECIFICALLY ADOPT OR APPROVE EACH OPERATING POLICY, AS THERE ARE HUNDREDS OF POLICIES THAT APPLY TO ALL SUBSIDIARY ORGANIZATIONS AND THEY CANNOT PRACTICABLY BE APPROVED BY ALL OF THE INDIVIDUAL BOARDS. FORM 990, PART VI, SECTION B, LINE 15 FORM 990, PART VI, SECTION B, LINE 15A: COMPENSATION PROCESS FOR TOP OFFICIAL INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD) REVIEW, APPROVE, AND OVERSEE ALL ASPECTS OF COMPENSATION AND BENEFITS FOR NOVANT HEALTH'S CEO AND FOR CERTAIN LEADERS AND EXECUTIVES ("EXECUTIVES") SERVING NOVANT HEALTH AND ITS RELATED OR DISREGARDED ENTITIES. THE COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT, USES THIRD PARTY COMPARABILITY DATA FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS, AND MAKES SURE THAT TOTAL COMPENSATION AND BENEFITS FOR EACH EXECUTIVE IS REASONABLE FOR THAT EXECUTIVE'S POSITION. THE COMMITTEE REVIEWS AND APPROVES EXECUTIVE COMPENSATION AND BENEFITS ANNUALLY, CONSISTENT WITH THE WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY OF NOVANT HEALTH, AND IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THEREBY ASSURING THAT TOTAL COMPENSATION AND BENEFITS PROVIDED TO EACH EXECUTIVE IS REASONABLE. FORM 990, PART VI, SECTION B, LINE 15B: COMPENSATION PROCESS FOR OFFICERS INDEPENDENT AND DISINTERESTED MEMBERS OF THE NOVANT HEALTH BOARD OF TRUSTEES (WHO COMPRISE THE COMPENSATION AND LEADERSHIP COMMITTEE OF THE BOARD) REVIEW, APPROVE, AND OVERSEE ALL ASPECTS OF COMPENSATION AND BENEFITS FOR CERTAIN LEADERS AND EXECUTIVES ("EXECUTIVES") SERVING NOVANT HEALTH AND ITS RELATED OR DISREGARDED ENTITIES. THE COMMITTEE WORKS WITH AN INDEPENDENT COMPENSATION CONSULTANT, USES THIRD PARTY COMPARABILITY DATA FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS, AND MAKES SURE THAT TOTAL COMPENSATION AND BENEFITS FOR EACH EXECUTIVE IS REASONABLE FOR THAT EXECUTIVE'S POSITION. THE COMMITTEE REVIEWS AND APPROVES EXECUTIVE COMPENSATION AND BENEFITS ANNUALLY, CONSISTENT WITH THE WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY OF NOVANT HEALTH, AND IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THEREBY ASSURING THAT TOTAL COMPENSATION AND BENEFITS PROVIDED TO EACH EXECUTIVE IS REASONABLE. FORM 990, PART VI, SECTION C, LINE 19 FORM 990, PART VI, SECTION C, LINE 19: GOVERNING DOCUMENTS DISCLOSURE THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAINING ALL ORGANIZATIONS IN THE NOVANT HEALTH SYSTEM ARE POSTED TO THE NOVANT HEALTH WEBSITE. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART VII, SECTION A, COLUMN B: RELATED ORGANIZATIONS THE ORGANIZATION EMPLOYS CERTAIN EXECUTIVES WHOSE ROLES ARE SUCH THAT THEY PROVIDE SERVICES TO NOT ONLY THE ORGANIZATION, BUT ALSO TO SOME OR ALL OF THE OTHER TAX-EXEMPT ORGANIZATIONS WITHIN THE NOVANT HEALTH HEALTHCARE SYSTEM. FOR EXAMPLE, MANY OF THESE EXECUTIVES' ROLES FOCUS ON PARTICULAR SERVICE LINES WHICH CROSS THE VARIOUS GEOGRAPHIC MARKETS OUR ORGANIZATIONS SERVE, THUS THE SERVICES PROVIDED BY THESE EXECUTIVES MAY BENEFIT AND BE RECEIVED BY MULTIPLE ORGANIZATIONS WITHIN THE SYSTEM. THE EXECUTIVES DO NOT ALLOCATE THEIR HOURS BETWEEN THE VARIOUS ORGANIZATIONS, BUT RATHER THEIR TIME SPENT ON SERVICES TO THE ORGANIZATION IS INCLUSIVE OF SERVICES TO ALL OF THE ORGANIZATIONS THEY SERVE WITHIN THE SYSTEM. FORM 990, PART IX, LINE 11G OUTSIDE SERVICES : PROGRAM SERVICE EXPENSES 5,814,961. MANAGEMENT AND GENERAL EXPENSES 358,689. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,173,650. CONSULTING FEES : PROGRAM SERVICE EXPENSES 164,606. MANAGEMENT AND GENERAL EXPENSES 10,153. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 174,759. CONTRACTED SERVICES : PROGRAM SERVICE EXPENSES 387,830. MANAGEMENT AND GENERAL EXPENSES 23,923. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 411,753. RECRUITMENT : PROGRAM SERVICE EXPENSES 138. MANAGEMENT AND GENERAL EXPENSES 8. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 146. REFERRALS : PROGRAM SERVICE EXPENSES 1,588. MANAGEMENT AND GENERAL EXPENSES 98. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,686. FOOD MANAGEMENT SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,315,545. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,315,545. FORM 990, PART XI, LINE 9: MALPRACTICE INSURANCE -160,106. EQUITY IN EARNINGS ELIMINATION 2,046. PROGRAM INVESTMENT ADJUSTMENT -425,484. AUXILIARY OF FORSYTH MEMORIAL HOSPITAL 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 560862112 HEALTHCARE NC 501(C)(3) LINE 9 FORSYTH MEMORIAL HOSPITAL INC 0 BRUNSWICK NOVANT MEDICAL CENTER FOUNDATION 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 274616751 HEALTHCARE NC 501(C)(3) LINE 7 BRUNSWICK COMMUNITY HOSPITAL LLC 0 CAROLINA MEDICORP ENTERPRISES INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 581466368 HEALTHCARE NC 501(C)(3) LINE 11B, II NOVANT MEDICAL GROUP INC 0 COMMUNITY GENERAL HOSPITAL FOUNDATION INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561828629 HEALTHCARE NC 501(C)(3) LINE 7 COMMUNITY GENERAL HEALTH PARTNERS INC 1 FORSYTH MEDICAL CENTER FOUNDATION 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 562120959 HEALTHCARE NC 501(C)(3) LINE 7 FORSYTH MEMORIAL HOSPITAL INC 0 FORSYTH MEMORIAL HOSPITAL INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 560928089 HEALTHCARE NC 501(C)(3) LINE 3 NOVANT HEALTH TRIAD REGION LLC 0 FOUNDATION HEALTH SYSTEMS CORP 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561373175 HEALTHCARE NC 501(C)(3) LINE 9 NOVANT HEALTH INC 0 MEDICAL PARK HOSPITAL INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561340424 HEALTHCARE NC 501(C)(3) LINE 3 NOVANT HEALTH TRIAD REGION LLC 0 NOVANT HEALTH INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561376950 HEALTHCARE NC 501(C)(3) LINE 11C, III-FI N/A 0 NOVANT MEDICAL GROUP INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 581728803 HEALTHCARE NC 501(C)(3) LINE 3 NMG SERVICES INC 0 PERSONAL CARE SERVICES 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 541291284 HEALTHCARE VA 501(C)(3) LINE 9 PRINCE WILLIAM HEALTH SYSTEM 0 THE PRESBYTERIAN HOSPITAL 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 560554230 HEALTHCARE NC 501(C)(3) LINE 3 NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC 0 PRESBYTERIAN HOSPITAL FOUNDATION 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 581413074 HEALTHCARE NC 501(C)(3) LINE 7 NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC 0 PRESBYTERIAN MEDICAL CARE CORPORATION 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561376368 HEALTHCARE NC 501(C)(3) LINE 3 NOVANT HEALTH SOUTHERN PIEDMONT REGION LLC 0 PRINCE WILLIAM HEALTH SYSTEM 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 541278944 HEALTHCARE VA 501(C)(3) LINE 11C, III-FI NOVANT HEALTH INC 0 PWHS FOUNDATION 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 541307595 HEALTHCARE VA 501(C)(3) LINE 7 PRINCE WILLIAM HEALTH SYSTEM 0 PRINCE WILLIAM HOSPITAL 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 540696355 HEALTHCARE VA 501(C)(3) LINE 3 PRINCE WILLIAM HEALTH SYSTEM 0 ROWAN HEALTH SERVICES CORP 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561424814 HEALTHCARE NC 501(C)(3) LINE 11C, III-FI NOVANT HEALTH INC 0 NMG SERVICES INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 562098809 HEALTHCARE NC 501(C)(3) LINE 9 NOVANT HEALTH INC 0 ROWAN REGIONAL MEDICAL CENTER AUXILIARY 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 237022472 HEALTHCARE NC 501(C)(3) LINE 9 ROWAN REGIONAL MEDICAL CENTER INC 0 ROWAN REGIONAL MEDICAL CENTER FOUNDATION INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 561424818 HEALTHCARE NC 501(C)(3) LINE 7 ROWAN REGIONAL MEDICAL CENTER INC 0 ROWAN REGIONAL MEDICAL CENTER INC 2085 FRONTIS PLAZA BLVD WINSTON SALEM NC 27103 560547479 HEALTHCARE NC 501(C)(3) LINE 3 ROWAN HEALTH SERVICES CORP 0 SELF INSURANCE FUND - 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