2014-08-08T14:26:33-05:00 2013-09-30 420714325 McGladrey LLP 1 S Wacker Drive Ste 800 Chicago IL 60606 990 2012-10-01 383740839 Vidant Medical Group LLC VIDA 2528475129 2100 Stantonsburg Road Greenville NC 27835 Travis Douglass 2528475129 2014-08-08 Wayne Harder P00294296 3126343400 2012 2015-11-30 17:44:51Z Travis Douglass 2100 Stantonsburg Road Greenville NC 27835 143065647 0 X www.vidanthealth.com X 2006 NC To provide medical services in Eastern North Carolina. 1 0 1098 0 0 0 0 0 96211200 143049358 9105 16289 0 0 96220305 143065647 0 0 0 0 80485454 106409760 0 0 0 40932898 71007268 121418352 177417028 -25198047 -34351381 28613736 35217938 13939918 22634357 14673818 12583581 To enhance the quality of life for the people and communities we serve, touch and support. 0 0 170567629 143049358 Vidant Health professionals provided evaluations, clinical care management and medically necessary procedures. 170567629 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 1098 1 0 0 0 0 0 0 0 0 0 0 X 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 X X Chris Townsend 2528475129 2100 Stantonsburg Road Greenville NC 27835 Travis Douglass 40.00 0.00 X X 0 308287 67952 David Herman MD 2.00 50.00 X 0 1188222 89223 Roger Robertson 2.00 46.00 X 0 400870 90819 David Hughes 2.00 50.00 X 0 404052 139056 William Floyd 2.00 40.00 X 0 314590 82893 Clyde Brooks 40.00 0.00 X 293201 0 71037 Matthew Meyers 40.00 0.00 X 186789 0 57806 Randal White 40.00 0.00 X 560603 0 39749 Jon Dubose 40.00 0.00 X 543249 0 37987 Edward Birdsong 40.00 0.00 X 541268 0 33843 Matthew McKenna 40.00 0.00 X 549654 0 31294 Thomas Ruffolo 40.00 0.00 X 518702 0 45448 3193466 2616021 787107 225 0 1 0 ECU School of Medicine PO Box 75514 Charlotte NC 282750514 Physician Services 4354808 Bunn Medical Associates 606 Ashburton Drive Greenville NC 27858 Physician Services 1994207 Eastern Emergency Physicians Inc 3102 Star Hill Farm Road Greenville NC 27834 Physician Services 1960952 Eastern Urological Associates 275 Bethesda Drive Greenville NC 27834 Physician Services 982292 Greenville Psychiatric Associates PA PO Box 20128 Greenville NC 27858 Physician Services 355650 23 Patient Revenue 621110 96411989 96411989 Contract Management Fees 621110 46637369 46637369 143049358 16289 16289 143065647 143049358 0 16289 X 479990 469603 10387 92582052 90578477 2003575 1334010 1305141 28869 7099016 6945386 153630 4914692 4808333 106359 102208 99996 2212 15513 15177 336 34058026 33700344 357682 403589 395293 8296 10937463 10700765 236698 605661 592554 13107 485508 475001 10507 222322 144509 77813 40572 39694 878 125911 11332 114579 1545235 1511794 33441 6707264 3018269 3688995 Bad Debt Expense 15663990 15663990 Books/Subscriptions 31367 30688 679 62639 61283 1356 177417028 170567629 6849399 0 3895947 3866338 12356194 16025529 442079 768714 1590492 1272388 10821281 3125481 3814242 7695800 24512 10507 6490270 5578662 28613736 35217938 13807772 17369838 132146 5264519 13939918 22634357 X 14673818 12583581 14673818 12583581 28613736 35217938 X -34351381 32261144 X 0 1 X 1 0 X 3268920 19217070 34419109 96211200 127385368 280501667 3268920 19217070 34419109 96211200 127385368 280501667 0 0 0 280501667 1692 4515 7728 9105 16287 39327 1692 4515 7728 9105 16287 39327 3270612 19221585 34426837 96220305 127401655 280540994 0.99990 0.99980 0.00010 0.00020 X 1147744 177697 970047 9673537 2947784 6725753 7695800 Other Receivables 2600660 Sales Tax Receivables 539985 Intercompany Receivables 1219298 Physician Loan Receivables 1218719 5578662 Worker Compensation Long Term 200519 Self-Insurance Reserve 5064000 5264519 X Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: Vidant Medical Group LLC has been determined to qualify as a tax-exempt organization under Section 501(c)(3) of the Internal Revenue Code. Vidant Medical Group has reviewed its tax positions for all open years and has concluded that no material liabilities exist as of September 30, 2013 and 2012. Vidant Medical Group files tax returns with the US federal and State of North Carolina jurisdictions. With few exceptions, Vidant Medical Group is no longer subject to US federal examinations by tax authorities for years before 2009. 0 1 0 0 0 0 0 0 0 Travis Douglass 0 266276 0 42011 0 0 0 34133 0 33819 0 376239 0 0 David Herman MD 0 907202 0 185606 0 95414 0 72500 0 16723 0 1277445 0 0 Roger Robertson 0 362398 0 36780 0 1692 0 70556 0 20263 0 491689 0 0 David Hughes 0 357502 0 45500 0 1050 0 100966 0 38090 0 543108 0 0 William Floyd 0 294412 0 19826 0 352 0 48652 0 34241 0 397483 0 0 Clyde Brooks 273357 0 19844 0 0 0 32600 0 38437 0 364238 0 0 0 Matthew Meyers 173289 0 13500 0 0 0 19901 0 37905 0 244595 0 0 0 Randal White 560603 0 0 0 0 0 0 0 39749 0 600352 0 0 0 Jon Dubose 543249 0 0 0 0 0 0 0 37987 0 581236 0 0 0 Edward Birdsong 541268 0 0 0 0 0 0 0 33843 0 575111 0 0 0 Matthew McKenna 536134 0 0 0 13520 0 0 0 31294 0 580948 0 0 0 Thomas Ruffolo 518702 0 0 0 0 0 0 0 45448 0 564150 0 0 0 Part I, Line 3 The compensation is determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2012. It will be performed again in fiscal year 2014. All compensation discussions and actions are documented and approved in the minutes of the Committee. Part I, Line 4b The following individuals participated in a supplemental non-qualified retirement plan during the year. The yearly change of such plan is included in their compensation per Schedule J, Part II, column C: - David Hughes, $55,608 - Roger Robertson, 19,716 - William Floyd, 12,396 Form 990, Part VI, Section B, line 11 The Board Member is provided a copy of the return for review prior to filing. The return is also reviewed by the Chief Financial Officer, Chief General Counsel and the Chief Audit and Compliance Officer of University Health Systems of Eastern Carolina, Inc. (D/B/A Vidant Health) prior to filing. Form 990, Part VI, Section B, line 12 As described in the Conflict of Interest policy maintained by VH, all Officers, Board Members and Key Employees are required to complete a yearly comprehensive conflict of interest questionnaire. These are reviewed by legal counsel and any potential or actual conflicts are brought to the Board for disposition. Board Members are instructed to report any potential conflicts arising during the year for review. Board Members are required to recuse themselves from voting on issues in which they are deemed to have a conflict. The compensation is determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2012. It will be performed again in fiscal year 2014. Compensation of other officers and key employees is also determined by the Compensation and Benefits Committee of the VH Board using comparative data from like organizations and input from consultants. This process is performed every two years, the last year being 2012. It will be performed again in fiscal year 2014. All compensation discussions and actions are documented and approved in the minutes of the Committee. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Other Fees Form 990, Part IX, line 11g Intercompany Shared Services: Program service expenses 12,987,857. Management and general expenses 137,848. Fundraising expenses 0. Total expenses 13,125,705. Physician Fees: Program service expenses 14,588,569. Management and general expenses 154,837. Fundraising expenses 0. Total expenses 14,743,406. Other Service Contracts: Program service expenses 6,123,918. Management and general expenses 64,997. Fundraising expenses 0. Total expenses 6,188,915. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Contributed Capital 32,261,144. University Health Systems of Eastern Carolina (DBA Vidant Health) 2100 Stantonsburg Road Greenville NC 27835 562141073 Healthcare NC 501(c)(3) Line 11c, III-FI N/A 0 0 1 1 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 Vidant Medical Center B 7120468 Actual Cash Payment Vidant Edgecombe Hospital B 2819974 Actual Cash Payment Vidant Roanoke-Chowan Hospital B 2482952 Actual Cash Payment Vidant Chowan Hospital B 513181 Actual Cash Payment Vidant Duplin Hospital B 1620016 Actual Cash Payment Vidant Beaufort Hospital B 1182561 Actual Cash Payment Vidant Pungo Hospital B 452669 Actual Cash Payment Vidant Health C 49000000 Actual Cash Payment Vidant Chowan Hospital J 275546 Actual Cash Payment Vidant Duplin Hospital J 120742 Actual Cash Payment OBH Medical Office Building J 89998 Actual Cash Payment PCMH Management Inc J 1220273 Actual Cash Payment Vidant Medical Center K 7141335 Actual Cash Payment Vidant Edgecombe Hospital K 3440099 Actual Cash Payment Vidant Roanoke-Chowan Hospital K 2708529 Actual Cash Payment Vidant Chowan Hospital K 513763 Actual Cash Payment Vidant Duplin Hospital K 1644508 Actual Cash Payment The Outer Banks Hospital Inc K 3223303 Actual Cash Payment Vidant Beaufort Hospital K 1185059 Actual Cash Payment Vidant Pungo Hospital K 452669 Actual Cash Payment Vidant Health L 3078801 Actual Cash Payment Vidant Medical Center L 4832847 Actual Cash Payment Vidant Health N 388629 Actual Cash Payment Vidant Health O 179914 Actual Cash Payment