FORSYTH MEDICAL CENTER FOUNDATION: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- FORSYTH MEDICAL CENTER FOUNDATION (EIN 56-2120959)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-14
- IRS object ID
- 201413189349300436
- Schema version
- 2013v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-14T08:11:40-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 562120959 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORSYTH MEDICAL CENTER FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FORS | BusinessNameControlTxt |
| Phone | 3367182803 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2085 FRONTIS PLAZA BLVD | AddressLine1 |
| City | WINSTON SALEM | City |
| State | NC | State |
| ZIP Code | 27103 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | FRED HARGETT | PersonNm |
| Person Title | EVP & CFO | PersonTitleTxt |
| Phone | 3367182803 | PhoneNum |
| Signature | 2014-11-13 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NOVANT HEALTH FOUNDATION FORSYTH MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PAULA VINCENT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2085 FRONTIS PLAZA BLVD | AddressLine1 |
| City | WINSTON SALEM | City |
| State | NC | State |
| ZIP Code | 27103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,716,948 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NOVANTHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1981 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O | ActivityOrMissionDesc |
| Voting Members Governing Body | 23 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 19 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 107 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,198,496 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,262,534 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,650,326 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,018,019 | CYInvestmentIncomeAmt |
| PY Other Revenue | $36,377 | PYOtherRevenueAmt |
| CY Other Revenue | $28,086 | CYOtherRevenueAmt |
| PY Total Revenue | $3,885,199 | PYTotalRevenueAmt |
| CY Total Revenue | $4,308,639 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $4,412,118 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,344,606 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $242,202 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,041,025 | PYOtherExpensesAmt |
| CY Other Expenses | $677,883 | CYOtherExpensesAmt |
| PY Total Expenses | $5,453,143 | PYTotalExpensesAmt |
| CY Total Expenses | $4,022,489 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,567,944 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $286,150 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $53,096,918 | TotalAssetsBOYAmt |
| Total Assets EOY | $60,326,734 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $725,101 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $504,456 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $52,371,817 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $59,822,278 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,608,336 | ExpenseAmt |
| Grant | $3,344,606 | GrantAmt |
| Desc | FORSYTH MEDICAL CENTER FOUNDATION FOCUSES ITS EFFORTS TO RAISE COMMUNITY SUPPORT AND FUNDING THROUGH CHARITABLE GIVING FOR MUCH-NEEDED PROGRAMS, IMPROVED FACILITIES, AND STATE-OF-THE-ART TECHNOLOGY FOR FORSYTH MEDICAL CENTER, KERNERSVILLE MEDICAL CENTER, AND CLEMMONS MEDICAL CENTER. | Desc |
| Total Program Service Expenses | $3,608,336 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | Yes (1) | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 23 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 19 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KAREN DAUGHERTY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3367182803 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2085 FRONTIS PLAZA BLVD | AddressLine1 |
| City | WINSTON SALEM | City |
| State | NC | State |
| ZIP Code | 27103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| CARTER PEGGY | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $27,728 | $0 | |
| GREGORY CHERE | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $590,646 | $53,066 | |
| WALLEY BRUCE | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $613,981 | $61,346 | |
| ZEKAN PATRICIA | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $308,185 | $431,402 | |
| ALEXANDER J CANTEY | ||||||
| TREAS | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| BERNTHAL LISA | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| CALLOWAY THOMAS | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| CHADEN SHELBY | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| COPELAND DOUGLAS | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DAVIS DERRICK | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DUNHAM ROBERT | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| LIVENGOOD MICHELLE | ||||||
| CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| MARLEY MORRIS | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MARTIN DAVIDA | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MILLER MICHAEL | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| NEWELL WILLIAM | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| PAULY SUSAN | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| POLLARD III HAROLD | ||||||
| VICE CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| POPE SCOTT | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| PROCTOR RALAN | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| SHORE RICHARD | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| WESTON CLAUDETTE | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| WODARZ NAN | ||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MCGEE LAWRENCE SEC | ||||||
| (*SEE ADD'L INFO IN SCH J P3) | 2.00 | $0 | $1,280,041 | $180,634 | Yes (X) | |
| MYERS SCOTT | ||||||
| ASST SEC | 2.00 | $0 | $466,038 | $113,223 | Yes (X) | |
| VINCENT PAULA SVP FOUNDATIONS | ||||||
| (*SEE ADD'L INFO IN SCH J P3) | 60.00 | $0 | $3,269,464 | $66,706 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,556,083 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $906,377 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $32,682 | FundraisingAmt |
| Related Organizations | $10,000 | RelatedOrganizationsAmt |
| Government Grants | $57,965 | GovernmentGrantsAmt |
| All Other Contributions | $2,161,887 | AllOtherContributionsAmt |
| Noncash Contributions | $8,776 | NoncashContributionsAmt |
| Total Contributions | $2,262,534 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $985,630 | TotalRevenueColumnAmt |
| Exclusion | $985,630 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $9,424,746 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,392,357 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,032,389 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,032,389 | TotalRevenueColumnAmt |
| Exclusion | $1,032,389 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $44,038 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $32,682 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $15,952 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,086 | TotalRevenueColumnAmt |
| Exclusion | $28,086 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,308,639 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,046,105 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,308,313 | TotalAmt |
| Program Services | $3,308,313 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,293 | TotalAmt |
| Program Services | $36,293 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,989 | TotalAmt |
| Management And General | $114,989 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $451,182 | TotalAmt |
| Program Services | $221,079 | ProgramServicesAmt |
| Management And General | $27,071 | ManagementAndGeneralAmt |
| Fundraising | $203,032 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,628 | TotalAmt |
| Program Services | $29,217 | ProgramServicesAmt |
| Management And General | $3,578 | ManagementAndGeneralAmt |
| Fundraising | $26,833 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,081 | TotalAmt |
| Program Services | $6,410 | ProgramServicesAmt |
| Management And General | $785 | ManagementAndGeneralAmt |
| Fundraising | $5,886 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,998 | TotalAmt |
| Management And General | $1,998 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,446 | TotalAmt |
| Management And General | $5,446 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,888 | TotalAmt |
| Program Services | $2,395 | ProgramServicesAmt |
| Management And General | $293 | ManagementAndGeneralAmt |
| Fundraising | $2,200 | FundraisingAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SUPPLIES | $16,819 | $16,819 | ||
| MISCELLANEOUS | $9,447 | $567 | $4,629 | $4,251 |
| DUES AND SUBSCRIPTIONS | $405 | $405 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,022,489 | TotalAmt |
| Program Services | $3,608,336 | ProgramServicesAmt |
| Management And General | $171,951 | ManagementAndGeneralAmt |
| Fundraising | $242,202 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $972,401 | BOYAmt |
| EOY | $1,176,514 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,800 | BOYAmt |
| EOY | $91,200 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $7,595 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $74,627 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $66,789 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,726 | BOYAmt |
| EOY | $7,838 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,884,166 | BOYAmt |
| EOY | $46,791,702 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,064,537 | BOYAmt |
| EOY | $12,250,046 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,288 | BOYAmt |
| EOY | $1,839 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,096,918 | BOYAmt |
| EOY | $60,326,734 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,150 | BOYAmt |
| EOY | $4,783 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $685,951 | BOYAmt |
| EOY | $499,673 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $725,101 | BOYAmt |
| EOY | $504,456 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,672,950 | BOYAmt |
| EOY | $48,011,768 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,623,851 | BOYAmt |
| EOY | $11,733,494 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,016 | BOYAmt |
| EOY | $77,016 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,371,817 | BOYAmt |
| EOY | $59,822,278 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,096,918 | BOYAmt |
| EOY | $60,326,734 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $286,150 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $5,050,121 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $2,114,190 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,988,952 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,538,294 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,323,750 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,198,496 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,262,534 | CurrentTaxYearAmt |
| Total | $15,312,026 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,988,952 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,538,294 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,323,750 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,198,496 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,262,534 | CurrentTaxYearAmt |
| Total | $15,312,026 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $3,605,919 | SubstantialContributorsTotAmt |
| Public Support Total170 | $11,706,107 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $705,934 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $680,048 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $727,512 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,174,066 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $985,630 | CurrentTaxYearAmt |
| Total | $4,273,190 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $8,942 | CurrentTaxYearMinus1YearAmt |
| Total | $8,942 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $19,594,158 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $221,739 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.59740 | PublicSupportCY170Pct |
| Public Support PY170 | 0.61060 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part IV Form990ScheduleAPartIVGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS INCOME - 2012 AMOUNT: $ 8,942. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,698,867 | BeginningYearBalanceAmt |
| Contributions | $1,594,460 | ContributionsAmt |
| Investment Earnings Or Losses | -$14,581 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $67,000 | GrantsOrScholarshipsAmt |
| Other Expenditures | $1,401,236 | OtherExpendituresAmt |
| End Year Balance | $11,810,510 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $12,235,136 | BeginningYearBalanceAmt |
| Contributions | $1,737,322 | ContributionsAmt |
| Investment Earnings Or Losses | $57,605 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $65,000 | GrantsOrScholarshipsAmt |
| Other Expenditures | $2,266,196 | OtherExpendituresAmt |
| End Year Balance | $11,698,867 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $12,021,408 | BeginningYearBalanceAmt |
| Contributions | $2,173,133 | ContributionsAmt |
| Investment Earnings Or Losses | $92,226 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $14,285 | GrantsOrScholarshipsAmt |
| Other Expenditures | $2,034,319 | OtherExpendituresAmt |
| End Year Balance | $12,238,163 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $12,847,411 | BeginningYearBalanceAmt |
| Contributions | $2,286,538 | ContributionsAmt |
| Investment Earnings Or Losses | $104,407 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $2,917 | GrantsOrScholarshipsAmt |
| Other Expenditures | $3,214,031 | OtherExpendituresAmt |
| End Year Balance | $12,021,408 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $12,692,664 | BeginningYearBalanceAmt |
| Contributions | $2,430,441 | ContributionsAmt |
| Investment Earnings Or Losses | $134,613 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $4,990 | GrantsOrScholarshipsAmt |
| Other Expenditures | $2,405,317 | OtherExpendituresAmt |
| End Year Balance | $12,847,411 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.01000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.99000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $74,627 | OtherCostOrOtherBasisAmt |
| Depreciation | $66,789 | DepreciationAmt |
| Book Value | $7,838 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,838 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER SECURITIES | Desc |
| Book Value | $12,250,046 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $12,250,046 | TotalBookValueSecuritiesAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATE | Desc |
| Amt | $499,673 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $499,673 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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. |
| PART V, LINE 4 - INTENDED USES FOR ENDOWMENT FUNDS | THE ENDOWMENT FUNDS ARE HELD FOR AFFILIATE HOSPITAL SERVICE COSTS RELATED TO VARIOUS CENTERS AT THE ACUTE CARE FACILITIES. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | SMASH CANCER | NameOfEvent1Amt |
| Gross Receipts Event1 | $21,190 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $18,332 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $2,858 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $4,101 | FoodAndBeverageEvent1Amt |
| Name Of Event2 | GARDEN PARTY | NameOfEvent2Amt |
| Gross Receipts Event2 | $55,530 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $14,350 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $41,180 | GrossRevenueEvent2Amt |
| Food And Beverage Event2 | $6,607 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $5,244 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $76,720 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $32,682 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $44,038 | GrossRevenueTotalEventsAmt |
| Food And Beverage Total Events | $10,708 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $5,244 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $15,952 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $28,086 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (8 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| FORSYTH FUTURES | |||||||
| 601 N CHERRY ST STE 250 | WINSTON SALEM | NC | 27101 | 561092807 | 501(C)(3) | $25,000 | COMMUNITY OUTREACH |
| FORSYTH MEMORIAL HOSPITAL | |||||||
| 3333 SILAS CREEK PARKWAY | WINSTON SALEM | NC | 27103 | 560928089 | 501(C)(3) | $2,217,741 | COMMUNITY HEALTHCARE |
| SECU FAMILY HOUSE | |||||||
| 1970 FAMILY HOUSE WAY | WINSTON SALEM | NC | 27103 | 203604576 | 501(C)(3) | $25,000 | COMMUNITY OUTREACH |
| COMMUNITY CARE CENTER | |||||||
| 2135 NEW WALKERTON RD | WINSTON SALEM | NC | 27101 | 581403699 | 501(C)(3) | $250,000 | COMMUNITY OUTREACH |
| FOUNDATION HEALTH SYSTEMS CORP | |||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561373175 | 501(C)(3) | $500,000 | COMMUNITY HEALTHCARE |
| STOKES COUNTY EMS | |||||||
| PO BOX 20 | DANBURY | NC | 27016 | 566000340 | STOKES COUNTY | $5,500 | COMMUNITY OUTREACH |
| NOVANT HEALTH | |||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561376950 | 501(C)(3) | $64,573 | COMMUNITY HEALTHCARE |
| FORSYTH HEALTHCARE INC | |||||||
| 501 N CLEVELAND AVE SUITE 4 | WINSTON SALEM | NC | 27101 | 320097975 | 501(C)(3) | $215,000 | COMMUNITY HEALTHCARE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 8 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| EMERGENCY ASSISTANCE | 41 | $17,730 |
| SCHOLARSHIPS | 54 | $18,563 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2 - PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GREGORY CHERE | ||||||||||||||
| TRUSTEE | $0 | $400,835 | $0 | $111,420 | $0 | $78,391 | $0 | $31,810 | $0 | $21,256 | $0 | $643,712 | $0 | $0 |
| WALLEY BRUCE | ||||||||||||||
| TRUSTEE | $0 | $349,797 | $0 | $245,580 | $0 | $18,604 | $0 | $46,117 | $0 | $15,229 | $0 | $675,327 | $0 | $0 |
| ZEKAN PATRICIA | ||||||||||||||
| TRUSTEE | $0 | $262,127 | $0 | $20,050 | $0 | $26,008 | $0 | $417,026 | $0 | $14,376 | $0 | $739,587 | $0 | $7,500 |
| MCGEE LAWRENCE SEC | ||||||||||||||
| (*SEE ADD'L INFO IN SCH J P3) | $0 | $384,909 | $0 | $304,420 | $0 | $590,712 | $0 | $156,200 | $0 | $24,434 | $0 | $1,460,675 | $0 | $445,287 |
| MYERS SCOTT | ||||||||||||||
| ASST SEC | $0 | $274,388 | $0 | $179,868 | $0 | $11,782 | $0 | $107,978 | $0 | $5,245 | $0 | $579,261 | $0 | $0 |
| VINCENT PAULA SVP FOUNDATIONS | ||||||||||||||
| (*SEE ADD'L INFO IN SCH J P3) | $0 | $332,914 | $0 | $247,516 | $0 | $2,689,034 | $0 | $53,755 | $0 | $12,951 | $0 | $3,336,170 | $0 | $264,675 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 MCGEE, LAWRENCE 0 *437,787 0 VINCENT, PAULA 0 *2,653,713 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. |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $4,000 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp (3 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | POWER WHEELCH | 1 | $4,000 | FMV |
| Yes (X) | GIFT CARDS | 12 | $600 | FMV |
| Yes (X) | FRAMING OF PA | 1 | $176 | FMV |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | NUMBER OF CONTRIBUTIONS | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PI, L1: ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES | THE FORSYTH MEDICAL CENTER FOUNDATION DOING BUSINESS AS THE NOVANT HEALTH FOUNDATION FORSYTH MEDICAL CENTER WAS FORMED TO ACCEPT GIFTS, SEEK GRANTS AND INVEST FUNDS TO SUPPORT NOVANT HEALTH FORSYTH MEDICAL CENTER'S MISSION TO IMPROVE THE HEALTH OF COMMUNITIES, ONE PERSON AT A TIME. IT HAS EXPANDED ITS REACH TO INCLUDE ADVISORY BOARDS AT NEW MEDICAL CENTERS IN KERNERSVILLE, NC AND CLEMMONS, NC. THE NOVANT HEALTH FOUNDATION FORSYTH MEDICAL CENTER 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 THE NATION'S TOP 25 INTEGRATED HEALTHCARE SYSTEMS CARING FOR PATIENTS AND COMMUNITIES IN GEORGIA, NORTH CAROLINA, SOUTH CAROLINA AND VIRGINIA. IN 2013, THE SYSTEM REPORTED $3.6 BILLION IN REVENUES. THE FOUNDATION SUPPORTS PEOPLE, PROGRAMS AND SERVICES WITHIN THE MEDICAL CENTER, PROVIDING EXPANDED TREATMENT AND PREVENTION OPTIONS. THE FOUNDATION ALSO PROVIDES MISSION-ALIGNED GRANTS TO COMMUNITY PARTNERS THAT HELP SUPPLEMENT HEALTHCARE AND PREVENTION PROGRAMS FOR UNDERSERVED PATIENTS. THE FOUNDATION'S DIVERSE BOARD OF COMMUNITY LEADERS IN WINSTON-SALEM, NC, CLEMMONS, NC, AND KERNERSVILLE, NC PROVIDES STEWARDSHIP AND OVERSIGHT OF THE ORGANIZATION'S OPERATIONS AND ACTIVITIES. IN 2013, NEARLY 1,061 DONORS CONTRIBUTED TO THE MISSION OF THE FOUNDATION. GIFTS, GRANTS AND EARNINGS FROM INVESTMENTS TOUCHED VIRTUALLY EVERY SERVICE AREA AT NOVANT HEALTH FORSYTH MEDICAL CENTER. SOME EXAMPLES OF THIS ARE AS FOLLOWS: -THE FOUNDATION MADE GRANTS TO SUPPORT TWO IMPORTANT FREE CLINICS: TODAY'S WOMAN, A PRENATAL CLINIC SEEKING TO REDUCE INFANT MORTALITY; AND THE COMMUNITY CARE CENTER, NORTH CAROLINA'S LARGEST FREE CLINICS. -THE FOUNDATION HELPED FUND A NEW HEMODIALYSIS UNIT THAT INCREASED CAPACITY BY 50 PERCENT AND CHANGED THE ENTIRE ATMOSPHERE OF THE SERVICE, TO THE PATIENTS' BENEFIT. -RESTRICTED GIFTS FROM FOUNDATION FUNDS WENT TO SUPPORT NURSE NAVIGATORS, PATIENT SUPPORT, STAFF EDUCATION, RESEARCH, MAMMOGRAMS, DISEASE PREVENTION, SCREENINGS AND REHABILITATION. -THE WOMEN'S COUNCIL OF NOVANT HEALTH FOUNDATION FORSYTH MEDICAL CENTER HAS A MISSION TO ENGAGE COMMUNITY WOMEN IN RAISING THE STANDARD FOR WOMEN'S HEALTHCARE AND EXPANDING HEALTHCARE OPPORTUNITIES FOR ALL REGARDLESS OF THEIR ECONOMIC CIRCUMSTANCES. IN 2013, THE COUNCIL FINISHED A THREE-YEAR, $195,000 GRANT COMMITMENT TO FUND A GYN CANCER NURSE NAVIGATOR. 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 4 | FORM 990, PART VI, SECTION A, LINE 4: SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS THE ORGANIZATION AMENDED IT'S BYLAWS TO REVISE PURPOSE LANGUAGE TO BE CONSISTENT WITH PUBLIC CHARITY STATUS AND TO REMOVE REFERENCES TO SUPPORTING ORGANIZATION STATUS; TO ADD CERTAIN EX-OFFICIO MEMBERS OF THE BOARD; TO CLARIFY THAT BOARD MEMBERS DO NOT RECEIVE COMPENSATION; TO CLARIFY THAT THE BOARD WILL COMPLY WITH UPMIFA; AND TO REVISE INDEMNIFICATION PROVISIONS CONSISTENT WITH STATE LAW. |
| 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 FORSYTH MEMORIAL HOSPITAL, INC. ELECTS THE MAJORITY OF THE FORSYTH MEDICAL CENTER FOUNDATION'S 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 15A | 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, LINE 15B - COMPENSATION PROCESS FOR OFFICERS THE ORGANIZATION DOES NOT HAVE ANY KEY EMPLOYEES AND THE ORGANIZATION'S ONLY OFFICERS, OTHER THAN THE TOP MANAGEMENT OFFICIAL, ARE STATE LAW BOARD OFFICERS. THESE EMPLOYEES DO NOT HOLD A CORPORATE POSITION OF INFLUENCE THAT RESULTS IN REVIEW OF THEIR COMPENSATION BY THE PARENT ORGANIZATION'S COMPENSATION AND LEADERSHIP COMMITTEE, AS DESCRIBED IN LINE 15A. |
| 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 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 | CONSULTING FEES : PROGRAM SERVICE EXPENSES 19,395. MANAGEMENT AND GENERAL EXPENSES 2,375. FUNDRAISING EXPENSES 17,812. TOTAL EXPENSES 39,582. CONTRACTED SERVICES : PROGRAM SERVICE EXPENSES 201,684. MANAGEMENT AND GENERAL EXPENSES 24,696. FUNDRAISING EXPENSES 185,220. TOTAL EXPENSES 411,600. |
| FORM 990, PART XI, LINE 9: | AFFILIATE TRANSFERS 2,114,191. ROUNDING -1. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (23 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 HEALTH PARTNERS INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 560636250 | HEALTHCARE | NC | 501(C)(3) | LINE 3 | NOVANT HEALTH TRIAD REGION LLC | 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 | 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 | 0 | N/A | |
| 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 - NOVANT HEALTH INC | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 581867242 | HEALTHCARE | NC | 501(C)(3) | LINE 11C, III-FI | NOVANT HEALTH INC | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (14 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1 | CityForeignAddress/City | Province Or StateForeignAddress/ProvinceOrState | CountryForeignAddress/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNICARE INC | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561952950 | RENTAL REAL ESTATE | NC | N/A | C | 0 | |||||
| CHOICEHEALTH INC | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561896065 | MANAGED CARE | NC | N/A | C | 0 | |||||
| NOVANT HEALTH SHARED SERVICES INC (FKA ADEPT HEALTH INC) | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 562226937 | ADMIN SVCS | NC | N/A | C | 0 | |||||
| SALEM HEALTH SERVICES INC | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561342654 | HEALTH RELATED | NC | N/A | C | 0 | |||||
| SALEM DIAGNOSTICS INC | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561513621 | HEALTH RELATED | NC | N/A | C | 0 | |||||
| MEDQUEST ASSOCIATES INC | ||||||||||||||
| 3480 PRESTON RIDGE RD STE 600 | ALPHARETTA | GA | 30005 | 223860764 | DIAGNOSTIC IMAGING | DE | N/A | C | 0 | |||||
| TRINOVA INSURANCE LTD | ||||||||||||||
| 980615601 | INSURANCE | N/A | C | 0 | 58 PAR LA VILLE ROAD PO BOX 1995 | HAMILTON | BERMUDA HMHX | BD | BD | |||||
| PRESBYTERIAN WOMEN'S CARE CORP | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 562217545 | HEALTHCARE | NC | N/A | C | 0 | |||||
| NOVANT HEALTH RISK RETENTION GROUP INC | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 203382230 | INSURANCE | SC | N/A | C | 0 | |||||
| ROWAN MEDICAL FACILITIES INC | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561424672 | MEDICAL SUPPLIES | NC | N/A | C | 0 | |||||
| ROWAN MEDICAL ALLIANCE INC | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 561992669 | INSURANCE | NC | N/A | C | 0 | |||||
| FISCAL CORP LTD | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 541282069 | HEALTH RELATED | VA | N/A | C | 0 | |||||
| PRINCE WILLIAM FAMILY HEALTHCARE | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 541748199 | HEALTH RELATED | VA | N/A | C | 0 | |||||
| PRINCE WILLIAM MEDICAL SUPPLY | ||||||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 541307554 | HEALTH RELATED | VA | N/A | C | 0 | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |