FORSYTH MEMORIAL HOSPITAL INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- FORSYTH MEMORIAL HOSPITAL INC (EIN 56-0928089)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-13
- IRS object ID
- 201313179349304966
- Schema version
- 2012v2.1
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-13T15:08:53-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560928089 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORSYTH MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | FORS | NameControl |
| Phone | 3367182803 | Phone |
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 |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | FRED HARGETT | Name |
| Title | EVP & CFO | Title |
| Phone | 3367182803 | Phone |
| Date Signed | 2013-11-13 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORSYTH MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JEFFERY LINDSAY | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| 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 | 1064314661 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.FORSYTHMEDICALCENTER.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1968 | YearFormation |
| State Legal Domicile | NC | StateLegalDomicile |
| Activity Or Mission Description | SEE SCHEDULE O | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 20 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 16 | NbrIndependentVotingMembers |
| Total Nbr Employees | 7566 | TotalNbrEmployees |
| Total Nbr Volunteers | 997 | TotalNbrVolunteers |
| Total Gross UBI | 473508 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 110036 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2577799 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3227743 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 887587244 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 994150186 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -244870 | InvestmentIncomePriorYear |
| Investment Income Current Year | 302022 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 65567008 | OtherRevenuePriorYear |
| Other Revenue Current Year | 66353407 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 955487181 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1064033358 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 372774 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 174071 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 425101646 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 442325759 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 477298833 | OtherExpensePriorYear |
| Other Expenses Current Year | 515637285 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 902773253 | TotalExpensesPriorYear |
| Total Expenses Current Year | 958137115 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 52713928 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 105896243 | RevenuesLessExpensesCY |
| Total Assets BOY | 889125682 | TotalAssetsBOY |
| Total Assets EOY | 988511859 | TotalAssetsEOY |
| Total Liabilities BOY | 46251404 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 49625408 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 842874278 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 938886451 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SEE SCHEDULE O | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 790806548 | Expense |
| Grants | 174071 | Grants |
| Revenue | 1052954493 | Revenue |
| Description | FORSYTH MEMORIAL HOSPITAL, INC. (FMH), KERNERSVILLE MEDICAL CENTER (KMC), AND CLEMMONS MEDICAL CENTER (CMC) CARRY OUT THE PURPOSE OF THE FORSYTH COUNTY BOARD OF COMMISSIONERS BY ADVANCING AND SUPPORTING THE PROMOTION OF THE HEALTH OF THE INHABITANTS OF FORSYTH COUNTY AND THE KERNERSVILLE AREA. FMH AND KMC MAINTAIN AN OPEN DOOR POLICY, ACCEPTING ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. FMH HAS 921 LICENSED BEDS. DURING 2012 THERE WERE 224,587 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 6 DAYS, AN AVERAGE DAILY CENSUS OF 614, AND 40,639 DISCHARGES. THERE WERE 24,859 INPATIENT AND OUTPATIENT SURGERIES, A TOTAL OF 1,150,970 OUTPATIENT ENCOUNTERS AND 93,870 EMERGENCY DEPARTMENT VISITS. (CONTINUED ON SCHDULE 0)KMC HAS 50 LICENSED BEDS. DURING 2012 THERE WERE 6,504 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 3.26 DAYS, AND AVERAGE DAILY CENSUS OF 17.7, AND 1,987 DISCHARGES. THERE WERE 2,148 INPATIENT AND OUTPATIENT SURGERIES, A TOTAL OF 25,640 OUTPATIENT ENCOUNTERS AND 25,291 EMERGENCY DEPARTMENT VISITS. | Description |
| Total Program Service Expense | 790806548 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 3 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 7566 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 20 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 16 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NC | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KAREN DAUGHERTY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3367182803 | TelephoneNumber |
Address US AddressUS
| 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 | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (34 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| BAREFOOTSAMUEL | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| CARROLLJOE | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| EARNHARDTHAROLD | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| EDWARDSJOEL LYNN | ||||||||
| TRUSTEE | 2.00 | X | 460114 | 0 | 50374 | |||
| EGGERSGERALD | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| ELYJOSEPH | ||||||||
| SEC | 2.00 | X | 0 | 0 | 0 | X | ||
| FORIESTBRYANT | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| FULLERSTANLEY BRIAN | ||||||||
| TRUSTEE | 2.00 | X | 0 | 435421 | 43030 | |||
| GREENGARY | ||||||||
| TREASURER | 2.00 | X | 0 | 0 | 0 | X | ||
| HAULSEEHADA DE VARONA | ||||||||
| VICE CHAIR | 2.00 | X | 0 | 0 | 0 | X | ||
| JOHNSONJOIA | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| JONESBRUCE | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| LAMBECLARENCE | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| LEAVITT JRROBERT | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| MCNEIL-MILLERKAREN | ||||||||
| CHAIR | 2.00 | X | 0 | 0 | 0 | X | ||
| POLLARD IIIHAROLD | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| POLONSKYSHERRY | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| REAVESDONALD | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| SIGALBARRY | ||||||||
| TRUSTEE | 2.00 | X | 0 | 6710 | 0 | |||
| WOLFE IIIJOHN | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| LINDSAYJEFFERY T | ||||||||
| PRESIDENT FMC/COO WS MARKET | 60.00 | 827408 | 0 | 435022 | X | |||
| MCGEELAWRENCE UPCHURCH | ||||||||
| ASST SEC | 2.00 | 0 | 1074617 | 501213 | X | |||
| MORRISJOHN BENTON | ||||||||
| ASST SEC | 2.00 | 0 | 286616 | 43622 | X | |||
| ALLENJOANNE | ||||||||
| PRESIDENT KERNERSVILLE | 60.00 | 221844 | 0 | 24738 | X | |||
| HAMMESPAUL H | ||||||||
| FMR SVP & COO FMC | 60.00 | 524243 | 4625 | 39351 | X | |||
| LARSONKIP LEROY | ||||||||
| VP & SR MED DIR SPECIALTY SERV | 60.00 | 358650 | 0 | 26010 | X | |||
| LEWISLINDA C | ||||||||
| VP NURSING | 60.00 | 326960 | 0 | 26760 | X | |||
| MIHALDENISE BARBARA | ||||||||
| SVP WS MARKET COO | 60.00 | 289479 | 233123 | 259173 | X | |||
| WALLEYBRUCE DOUGLAS | ||||||||
| SVP MEDICAL AFFAIRS | 60.00 | 550303 | 0 | 19240 | X | |||
| CHRYSSONNICK G | ||||||||
| ONCOLOGIST | 40.00 | 992097 | 0 | 39166 | X | |||
| GROTETHOMAS H | ||||||||
| ONCOLOGIST | 40.00 | 911051 | 0 | 37262 | X | |||
| PASCHOLD EUGENE H | ||||||||
| ONCOLOGIST | 40.00 | 724373 | 0 | 32444 | X | |||
| PIPPITTCHARLES H | ||||||||
| ONCOLOGIST | 40.00 | 700339 | 0 | 39466 | X | |||
| SHEARERHEATHER H | ||||||||
| ONCOLOGIST | 40.00 | 690927 | 0 | 39698 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 7577788 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2041112 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1656569 | TotalOtherCompensation |
| Number Individuals GT100 K | 418 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MORRISON MANAGEMENT SPECIALISTS | |||||
| PO BOX 102289 | ATLANTA | GA | 30368 | FOOD SERVICES | 8489687 |
| PIEDMONT TRIAD ANESTHESIA | |||||
| PO BOX 602365 | CHARLOTTE | NC | 28260 | ANESTHESIA SERVICES | 4219039 |
| AMERICAN RED CROSS | |||||
| PO BOX 905890 | CHARLOTTE | NC | 28290 | BLOOD PROCESSING | 4122233 |
| LABORATORY CORPORATION OF AMERICA | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | LAB SERVICES | 3396105 |
| NURSEFINDERS INC | |||||
| PO BOX 910738 | DALLAS | TX | 75391 | STAFFING | 2048872 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 81 | NumberOfContractorsGT100K |
| Related Organizations | 2991953 | RelatedOrganizations |
| All Other Contributions | 235790 | AllOtherContributions |
| Noncash Contributions | 249179 | NoncashContributions |
| Total Contributions | 3227743 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT REVENUE | Description |
| Business Code | 621990 | BusinessCode |
| Total Revenue Column | 994150186 | TotalRevenueColumn |
| Related Or Exempt Function Income | 994150186 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 994150186 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 113847 | TotalRevenueColumn |
| Exclusion | $113,847 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2746421 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2746421 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2746421 | TotalRevenueColumn |
| Exclusion | $2,746,421 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 469478 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 281303 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 188175 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 188175 | TotalRevenueColumn |
| Exclusion | $188,175 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| PHARMACY | 446110 | 51022310 | 50588926 | 433384 | |
| MISCELLANEOUS REVENUE | 621990 | 7221900 | 7183662 | 38238 | |
| CAFETERIA | 722210 | 3020750 | $3,020,750 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2342026 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1031719 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1886 | UnrelatedBusinessRevenue |
| Exclusion | $1,308,421 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 63606986 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1064033358 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1052954493 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 473508 | UnrelatedBusinessRevenue |
| Exclusion | $7,377,614 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 56853 | Total |
| Program Services | 56853 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 117218 | Total |
| Program Services | 117218 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5406431 | Total |
| Management And General | 5406431 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 348080994 | Total |
| Program Services | 330955409 | ProgramServices |
| Management And General | 17125585 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18599718 | Total |
| Program Services | 17684612 | ProgramServices |
| Management And General | 915106 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46363562 | Total |
| Program Services | 44082475 | ProgramServices |
| Management And General | 2281087 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23875054 | Total |
| Program Services | 22700401 | ProgramServices |
| Management And General | 1174653 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2677892 | Total |
| Management And General | 2677892 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1492 | Total |
| Management And General | 1492 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3150 | Total |
| Management And General | 3150 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57405558 | Total |
| Program Services | 44645496 | ProgramServices |
| Management And General | 12760062 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6719747 | Total |
| Program Services | 6389135 | ProgramServices |
| Management And General | 330612 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5775230 | Total |
| Program Services | 5491089 | ProgramServices |
| Management And General | 284141 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9549477 | Total |
| Program Services | 9079643 | ProgramServices |
| Management And General | 469834 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27754896 | Total |
| Program Services | 26389355 | ProgramServices |
| Management And General | 1365541 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 898545 | Total |
| Program Services | 854337 | ProgramServices |
| Management And General | 44208 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 398625 | Total |
| Program Services | 379013 | ProgramServices |
| Management And General | 19612 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16403302 | Total |
| Program Services | 15596363 | ProgramServices |
| Management And General | 806939 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30105250 | Total |
| Program Services | 28624072 | ProgramServices |
| Management And General | 1481178 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2105877 | Total |
| Program Services | 2002268 | ProgramServices |
| Management And General | 103609 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| CORPORATE ALLOCATION | 118721944 | 118721944 | |
| UBI TAXES | 28179 | 28179 | |
| MEDICAL SUPPLIES | 92569690 | 92569690 | |
| DRUGS | 80133947 | 80133947 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64384484 | Total |
| Program Services | 63055172 | ProgramServices |
| Management And General | 1329312 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 958137115 | Total |
| Program Services | 790806548 | ProgramServices |
| Management And General | 167330567 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3529739 | BOY |
| EOY | 2937802 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 167577 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 98613263 | BOY |
| EOY | 116770799 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30685 | BOY |
| EOY | 211460 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7792203 | BOY |
| EOY | 2686015 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14946588 | BOY |
| EOY | 15877650 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 368711 | BOY |
| EOY | 1306979 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 383362107 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 237542411 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 156771340 | BOY |
| EOY | 145819696 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31165047 | BOY |
| EOY | 31015047 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 575740529 | BOY |
| EOY | 671886411 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 889125682 | BOY |
| EOY | 988511859 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38342075 | BOY |
| EOY | 43830247 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 189281 | BOY |
| EOY | 177878 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7720048 | BOY |
| EOY | 5617283 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46251404 | BOY |
| EOY | 49625408 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 842874278 | BOY |
| EOY | 938886451 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 842874278 | BOY |
| EOY | 938886451 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 889125682 | BOY |
| EOY | 988511859 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 105896243 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -9884070 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $57,164 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 57164 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART IV, SUPPLEMENTAL INFORMATION: | Identifier |
| Explanation | SCHEDULE C, PART II-B, LINE 1I DUES PAID TO CERTAIN ORGANIZATIONS WHICH INCLUDE A PORTION RELATED TO LOBBYING ACTIVITIES. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4082278 | OtherCostOrOtherBasis |
| Book Value | 4082278 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 73754456 | OtherCostOrOtherBasis |
| Depreciation | 5400932 | Depreciation |
| Book Value | 68353524 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9973628 | OtherCostOrOtherBasis |
| Depreciation | 6205552 | Depreciation |
| Book Value | 3768076 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 283090877 | OtherCostOrOtherBasis |
| Depreciation | 221348710 | Depreciation |
| Book Value | 61742167 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12460868 | OtherCostOrOtherBasis |
| Depreciation | 4587217 | Depreciation |
| Book Value | 7873651 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 145819696 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM AFFILIATES | 671885626 |
| STATE INCOME TAX RECEIVABLE | 785 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 671886411 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 2070 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| CAPITAL LEASE PAYABLE | $178,962 |
| THIRD PARTY PAYMENT ADJUSTMENTS | $5,436,251 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 5617283 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X, LINE 2: | ReturnReference |
| Explanation | 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, 2012 AND 2011. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To Most Hospitals | X | PolicyAppliedToMostHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 300.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | 0 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 36111570 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 36111570 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03770 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 135397348 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 130365227 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5032121 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00530 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9987916 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6456137 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3531779 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00370 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 181496834 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 136821364 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 44675470 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04670 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1655244 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 41704 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1613540 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00170 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1457760 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 845971 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 611789 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 43060449 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 30350432 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 12710017 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01330 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 134804 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 134804 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 46308257 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 31238107 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 15070150 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01570 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 227805091 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 168059471 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 59745620 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06240 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 5675 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 5675 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 5675 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 5675 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $37,369,567 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 166372410 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 176453658 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -10081248 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 3 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (3 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | Facility Reporting GroupFacilityReportingGroup |
|---|---|---|---|---|---|---|---|---|
| FORSYTH MEMORIAL HOSPITAL INC | ||||||||
| 1 | 3333 SILAS CREEK PARKWAY | WINSTON SALEM | NC | 27103 | X | X | X | A |
| FMH DBA KERNERSVILLE MEDICAL CENTER | ||||||||
| 2 | 1750 KERNERSVILLE MEDICAL PARKWAY | KERNERSVILLE | NC | 27284 | X | X | X | A |
| FMH DBA CLEMMONS MEDICAL CENTER | ||||||||
| 3 | 6915 VILLAGE MEDICAL CIRCLE | CLEMMONS | NC | 27012 | X | X | A | |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FACILITY REPORTING GROUP - A | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 300.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 0 | UsesFPGDiscounted |
| Explains Basis | 0 | ExplainsBasis |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 54 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (54 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| WINSTON-SALEM HEALTH CARE | ||||
| 250 CHARLOIS BOULEVARD | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC |
| FMCIMAPLEWOOD | ||||
| 3155 MAPLEWOOD AVENUE | WINSTONSALEM | NC | 27103 | IMAGING CENTER |
| WINSTON SALEM CARDIOLOGY | ||||
| 186 KIMEL PARK DRIVE | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC |
| FMCIBREAST CLINIC | ||||
| 2025 FRONTIS PLAZA BLVD SUITE 300 | WINSTONSALEM | NC | 27103 | IMAGING CENTER |
| MAPLEWOOD FAMILY PRACTICE | ||||
| ROBINHOOD MEDICAL PLAZA BLDG 100 | WINSTONSALEM | NC | 27106 | PHYSICIAN CLINIC |
| INPATIENT PHYSICIANS OF FORSYTH | ||||
| 3333 SILAS CREEK PARKWAY | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC |
| SALEM FAMILY PRACTICE | ||||
| 105 VEST MILL CIRCLE | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC |
| PHOA KERNERSVILLE | ||||
| 445 PINEVIEW DRIVE | KERNERSVILLE | NC | 27284 | PHYSICIAN CLINIC |
| MOUNTAINVIEW MEDICAL | ||||
| 216 MOORE ROAD | KING | NC | 27021 | PHYSICIAN CLINIC |
| FORSYTH INTERNAL MEDICINE | ||||
| 1381 WESTGATE CENTER DRIVE | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC |
| FMCIWSHC RADIOLOGY | ||||
| 250 CHARLOIS BOULEVARD | WINSTONSALEM | NC | 27103 | IMAGING CENTER |
| KERNERSVILLE FAMILY PRACTICE | ||||
| 291 BROAD STREET | KERNERSVILLE | NC | 27284 | PHYSICIAN CLINIC |
| PHOA MT AIRY | ||||
| 865 WESTLAKE DRIVE SUITE 200 | MOUNT AIRY | NC | 27030 | PHYSICIAN CLINIC |
| PHOA LEXINGTON | ||||
| 1370 PIEDMONT DRIVE SUITE 202 | LEXINGTON | NC | 27295 | PHYSICIAN CLINIC |
| FMCIKERNERSVILLE IMAGING CENTER | ||||
| 445 PINEVIEW DRIVE SUITE 100 | KERNERSVILLE | NC | 27284 | IMAGING CENTER |
| MEDICAL ASSOCIATES OF SURRY | ||||
| 865 WESTLAKE DRIVE | MOUNT AIRY | NC | 27030 | PHYSICIAN CLINIC |
| MEDICAL ASSOCIATES OF DAVIE | ||||
| 485 VALLEY ROAD | MOCKSVILLE | NC | 27028 | PHYSICIAN CLINIC |
| FORSYTH HEALTHCARE PHARMACY | ||||
| 3333 SILAS CREEK PARKWAY | WINSTONSALEM | NC | 27103 | PHARMACY |
| UROLOGY PARTNERS | ||||
| 180 KIMEL PARK DRIVE SUITE 110 | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC |
| CHAIR CITY FAMILY PRACTICEMEDZONE | ||||
| 903 RANDOLPH STREET | THOMASVILLE | NC | 27360 | PHYSICIAN CLINIC |
| PREMIER MEDICAL ASSOCIATES | ||||
| 3333 BROOKVIEW HILLS BLVD STE 204 | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC |
| YADKIN MEDICAL ASSOCIATES | ||||
| 305 EAST LEE AVENUE | YADKINVILLE | NC | 27055 | PHYSICIAN CLINIC |
| FAMILY MEDICAL ASSO OF LEWISVILLE | ||||
| 1225 LEWISVILLE-CLEMMONS ROAD | LEWISVILLE | NC | 27023 | PHYSICIAN CLINIC |
| WINSTON-SALEM HEALTH CARE DERMATOLOGY | ||||
| 175 KIMEL PARK DRIVE | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC |
| FORSYTH ENDOCRINE CONSULTANTS | ||||
| 755 HIGHLAND OAKS DRIVE SUITE 201 | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC |
| KING HEALTHCARE PHARMACY | ||||
| 212 MOORE ROAD | KING | NC | 27021 | PHARMACY |
| THOMASVILLE MEDICAL ASSOCIATES | ||||
| 309 PINEYWOOD ROAD | THOMASVILLE | NC | 27360 | PHYSICIAN CLINIC |
| CLEMMONS FAMILY PRACTICE | ||||
| 6301 STADIUM DRIVE | CLEMMONS | NC | 27012 | PHYSICIAN CLINIC |
| ARCADIA FAMILY PRACTICE | ||||
| 12208 HWY 150 NORTH | WINSTONSALEM | NC | 27127 | PHYSICIAN CLINIC |
| INFECTIOUS DISEASE SPECIALISTS | ||||
| 1381 WESTGATE CENTER DRIVE | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC |
| NORTH POINT MEDICAL ASSOCIATES | ||||
| 1995 BETHABARA ROAD | WINSTONSALEM | NC | 27106 | PHYSICIAN CLINIC |
| LEXINGTON PRIMARY CARE | ||||
| 110 WEST MEDICAL PARK DRIVE | LEXINGTON | NC | 27292 | PHYSICIAN CLINIC |
| RHEUMATOLOGY & ARTHRITIS ASSOCIATES | ||||
| 1995 BETHABARA ROAD | WINSTONSALEM | NC | 27106 | PHYSICIAN CLINIC |
| WEST FORSYTH FAMILY MEDICINE | ||||
| 105 STADIUM OAKS DRIVE | CLEMMONS | NC | 27012 | PHYSICIAN CLINIC |
| GATEWAY FAMILY PRACTICE | ||||
| 390 SALEM AVENUE | WINSTONSALEM | NC | 27101 | PHYSICIAN CLINIC |
| FORSYTH FAMILY MEDICINE | ||||
| 400 JONESTOWN RD | WINSTONSALEM | NC | 27104 | PHYSICIAN CLINIC |
| SALEM HEALTHCARE PHARMACY | ||||
| 105 VEST MILL CIRCLE | WINSTONSALEM | NC | 27103 | PHARMACY |
| NEW GARDEN MEDICAL ASSOCIATES | ||||
| 1941 NEW GARDEN ROAD | GREENSBORO | NC | 27410 | PHYSICIAN CLINIC |
| MAPLEWOOD FAMILY PRACTICE | ||||
| 5110 ROBINHOOD VILLAGE DR SUITE C-1 | WINSTONSALEM | NC | 27106 | PHYSICIAN CLINIC |
| PHOA STATESVILLE | ||||
| 276 OLD MOCKSVILLE ROAD | STATESVILLE | NC | 28625 | PHYSICIAN CLINIC |
| FORSYTH INTERNAL MEDICINE K'VILLE | ||||
| 445 PINEVIEW DRIVE SUITE 240 | KERNERSVILLE | NC | 27284 | PHYSICIAN CLINIC |
| FORSYTH COMPREHENSIVE NEUROLOGY | ||||
| 2025 FRONTIS PLAZA BLVD SUITE 120 | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC |
| PILOT MOUNTAIN FAMILY MEDICINE | ||||
| 207 MEDICAL STREET | PILOT MOUNTAIN | NC | 27041 | PHYSICIAN CLINIC |
| MEDICAL ASSOCIATES OF DAVIE HILLSDALE | ||||
| 121 MEDICAL DRIVE | ADVANCE | NC | 27006 | PHYSICIAN CLINIC |
| PALLIATIVE CARE SERVICES | ||||
| 3333 SILAS CREEK PARKWAY | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC |
| INPATIENT PHYSICIANS OF DAVIDSON | ||||
| 207 OLD LEXINGTON ROAD | THOMASVILLE | NC | 27360 | PHYSICIAN CLINIC |
| WINSTON-SALEM HEALTH CARE PSYCHIATRY | ||||
| 280 CHARLOIS BOULEVARD | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC |
| WS CARDIOLOGY KERNERSVILLE | ||||
| 1750 KERNERSVILLE MEDICAL BLVD | KERNERSVILLE | NC | 27284 | PHYSICIAN CLINIC |
| PHOA ELKIN | ||||
| 505 SAMARITANS RIDGE COURT | ELKIN | NC | 28621 | PHYSICIAN CLINIC |
| TRIAD ENDOCRINE CONSULTANTS | ||||
| 500 PINEVIEW DRIVE SUITE 101 | KERNERSVILLE | NC | 27284 | PHYSICIAN CLINIC |
| PINEVIEW FAMILY MEDICINE | ||||
| 500 PINEVIEW DRIVE SUITE 101 | KERNERSVILLE | NC | 27284 | PHYSICIAN CLINIC |
| STROKE BRIDGE CLINIC | ||||
| 3333 SILAS CREEK PARKWAY | WINSTONSALEM | NC | 27103 | PHYSICIAN CLINIC |
| FRIEDBERG FAMILY MEDICINE | ||||
| 5010 PETERS CREEK PARKWAY | WINSTONSALEM | NC | 27127 | PHYSICIAN CLINIC |
| WALKERTOWN FAMILY PRACTICE | ||||
| 2800 DARROW ROAD | WALKERTOWN | NC | 27051 | PHYSICIAN CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (25 entries)
| ExplanationExplanation | Return ReferenceReturnReference | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 6A: THE ORGANIZATION IS PART OF THE NOVANT HEALTHCARE SYSTEM AND THE COMMUNITY BENEFIT REPORT IS PREPARED BY A RELATED ORGANIZATION. NOVANT HEALTH, INC. PRODUCES ITS OWN COMMUNITY BENEFIT REPORT, WHICH REPRESENTS THE HEALTH SYSTEM AS A WHOLE AND CAN BE FOUND ATHTTP://WWW.NOVANTHEALTH.ORG/GIVEBACK/COMMUNITYBENEFITREPORT.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 OF CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AMOUNTS ARE CALCULATED USING AN ENTITY SPECIFIC COST TO CHARGE RATIO BASED ON WORKSHEET 2 (RCC). | ||
| PART I, L7 COL(F): THE AMOUNT OF BAD DEBT REMOVED FROM TOTAL EXPENSES (DENOMINATOR) WAS $37,369,567. | ||
| PART II: NOVANT HEALTH 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. | ||
| 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 2: | |
| 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 PROVISION 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 HEALTH CARE 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 RCC 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 OR OFFER 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 TO 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: NEEDS ASSESSMENTTHE ORGANIZATION IS PART OF THE NOVANT HEALTHCARE SYSTEM, WHICH HAS A COMMUNITY BENEFIT COMMITTEE. THE COMMUNITY BENEFIT COMMITTEE IS RESPONSIBLE FOR ASSISTING THE HOSPITALS WITHIN THE HEALTHCARE SYSTEM WITH PREPARING COMMUNITY NEEDS ASSESSMENTS. 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 HEALTHCARE SYSTEM'S HOSPITAL FOUNDATIONS. EACH HOSPITAL, WITH THE ASSISTANCE OF THE COMMUNITY BENEFIT COMMITTEE, WILL IDENTIFY ORGANIZATIONS AND RESOURCES WITHIN ITS COMMUNITY TO CONTRIBUTE TO THE HOSPITAL'S COMMUNITY NEEDS ASSESSMENT. THESE ORGANIZATIONS AND RESOURCES INCLUDE LOCAL HEALTH DEPARTMENTS, UNITED WAY, UNIVERSITIES, PUBLIC HEALTH DEPARTMENTS, ETC. THE EXISTING COMMUNITY HEALTH ASSESSMENTS PREPARED BY OTHER ORGANIZATIONS IN THE COMMUNITY WILL BE COMBINED WITH INTERNAL HOSPITAL DATA AND INFORMATION COLLECTED FROM LOCAL AGENCIES TO BECOME THE HOSPITAL'S COMMUNITY NEEDS ASSESSMENT. EACH HOSPITAL HAS ALSO TRADITIONALLY RESPONDED TO REQUESTS FOR CERTAIN COMMUNITY BENEFIT ACTIVITIES OR PROGRAMS FROM PUBLIC AGENCIES OR COMMUNITY GROUPS AND THIS WILL ALSO BE INCLUDED IN THE HOSPITAL'S COMMUNITY NEEDS ASSESSMENT. ONCE THE COMMUNITY NEEDS ASSESSMENT IS COMPLETED, WHICH WILL BE EVERY THREE YEARS, THE HOSPITAL WILL PRIORITIZE THE NEEDS BY DETERMINING WHAT HOSPITAL RESOURCES ARE AVAILABLE TO MEET THE NEEDS AND WHAT OTHER COMMUNITY RESOURCES ARE BEING USED TO MEET A PARTICULAR NEED. THE HOSPITAL WILL DEVELOP A COMMUNITY BENEFIT PLAN, WHICH WILL BE REVIEWED AND UPDATED AS NECESSARY, AT LEAST EVERY THREE YEARS. ALL HOSPITALS' COMMUNITY NEEDS ASSESSMENTS WILL BE MADE AVAILABLE TO THE PUBLIC. | ||
| PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEAS 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 THREE 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 OR 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 CORPORATE WEBSITE AS WELL AS EACH INDIVIDUAL FACILITY'S WEBSITE, ALONG WITH CONTACT INFORMATION FOR OUR FINANCIAL COUNSELORS. ADDITIONALLY, OUR PROGRAMS ARE DOCUMENTED ON PATIENT FLYERS THROUGHOUT THE NOVANT 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. 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 EXECUTIVE TEAM. | ||
| PART VI, LINE 4: COMMUNITY INFORMATIONTHE FORSYTH MEMORIAL HOSPITAL, INC. FORM 990 INCLUDES THE OPERATIONS OF THREE HOSPITALS. FORSYTH MEMORIAL HOSPITAL, INC. DBA FORSYTH MEDICAL CENTER, AS KERNERSVILLE MEDICAL CENTER AND AS CLEMMONS MEDICAL CENTERTHE ORGANIZATION DEFINES ITS COMMUNITY BY ITS PRIMARY SERVICE AREA, WHICH IS FORSYTH COUNTY, NORTH CAROLINA. THIS IS AN URBAN AREA.THERE ARE FOUR NONPROFIT ACUTE CARE HOSPITALS IN THE COMMUNITY, THREE OF WHICH ARE THE ORGANIZATION AND ONE OF WHICH IS PART OF THE NOVANT HEALTHCARE SYSTEM. THERE IS ALSO ONE ACADEMIC, TEACHING HOSPITAL. ACCORDING TO TRUVEN HEALTH DATA, THE SPECIFIC POPULATION GROUPS (ETHNIC AND CULTURAL) ARE AS FOLLOWS: WHITE NON-HISPANIC (225,551) 58.9%; BLACK NON-HISPANIC (92,888) 24.3%; HISPANIC (48,591) 12.7%; ASIAN AND PACIFIC ISLAND (7,738) 2.0%; OTHERS (7,980) 2.1%; FOR A TOTAL POPULATION OF 382,748. ACCORDING TO TRUVEN HEALTH DATA, THE MEDIAN HOUSEHOLD INCOME LEVEL WAS $45,356.ACCORDING TO TRUVEN HEALTH DATA, THE AGE BREAKDOWN IS AS FOLLOWS: 0-17 YEARS (92,677) 24.2%; 18-64 YEARS (236,581) 61.8%; 65+ YEARS (53,490) 14.0%. | ||
| 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 PROVIDE SERVICES TO ALL BENEFICIARIES OF MEDICARE, MEDICAID, AND OTHER GOVERNMENT PAYMENT PROGRAMS, AND PROVIDING SERVICES IN A NONDISCRIMINATORY MANNER TO SUCH BENEFICIARIES;3. OPERATING FULL-TIME EMERGENCY ROOMS WHICH ARE OPEN TO AND ACCEPT 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 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/GIVEBACK/COMMUNITYBENEFITREPORT.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: AFFILIATED HEALTH CARE SYSTEMTHE ORGANIZATION 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 INTEGRATED HEALTHCARE SYSTEMS CARING FOR PATIENTS AND COMMUNITIES IN NORTH CAROLINA, VIRGINIA AND SOUTH CAROLINA. 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 HEALTHCARE SYSTEM AS A WHOLE IS DOCUMENTED IN A SYSTEM-WIDE COMMUNITY BENEFIT REPORT, LOCATED AT HTTP://WWW.NOVANTHEALTH.ORG/GIVEBACK/COMMUNITYBENEFITREPORT.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. THE NOVANT HEALTHCARE SYSTEM ALSO INCLUDES AN ORGANIZATION THAT OWNS PHYSICIAN PRACTICES IN VIRGINIA, SOUTH CAROLINA, AND NORTH CAROLINA, WHICH PROVIDE ADDITIONAL COMMUNITY BENEFIT TO THEIR COMMUNITIES, AND FIVE HOSPITAL FOUNDATIONS, WHICH SUPPORT AND ENHANCE THE COMMUNITY BENEFIT ACTIVITIES IN THOSE HOSPITAL'S COMMUNITIES. FURTHER, THE NOVANT HEALTHCARE SYSTEM INCLUDES AMBULATORY SURGERY CENTERS, SKILLED NURSING FACILITIES, REHABILITATION PROGRAMS, AND OTHER OUTPATIENT FACILITIES, WHICH ALSO PROVIDE COMMUNITY BENEFIT TO THEIR COMMUNITIES. THERE ARE SIGNIFICANT COMMUNITY BENEFIT ACTIVITIES WITHIN THE NOVANT HEALTH SYSTEM, WHICH MAY NOT BE REPORTABLE ON A SCHEDULE H BECAUSE THEY ARE NOT CONDUCTED BY AN ENTITY WHICH OWNS OR OPERATES A HOSPITAL. THE HEALTHCARE SYSTEM HAS A COMMUNITY BENEFIT COMMITTEE, WHICH WILL OVERSEE AND ASSIST ALL TAX-EXEMPT HOSPITALS WITHIN NOVANT HEALTH IN PREPARING THEIR COMMUNITY NEEDS ASSESSMENTS AND COMMUNITY BENEFIT PLANS. THE GOAL OF HAVING A SYSTEM-WIDE COMMITTEE IS TO IDENTIFY COMMUNITY BENEFIT ACTIVITIES THAT ARE DUPLICATIVE IN COMMUNITIES AND TO STREAMLINE AND COORDINATE EFFORTS TO RESULT IN BETTER AND MORE EFFICIENT USES OF RESOURCES, WHICH COULD LEAD TO ADDITIONAL RESOURCES TO BE ALLOCATED TO MEET OTHER COMMUNITY NEEDS, AND TO REPLICATE SUCCESSFUL PROGRAMS AND ACTIVITIES IN COMMUNITIES WHERE A SIMILAR NEED IS INDICATED. ALL OF THE TAX-EXEMPT HOSPITALS WITHIN THE NOVANT HEALTHCARE SYSTEM ARE COMMITTED TO IMPROVING THE HEALTH OF THEIR COMMUNITIES AND PROVIDING COMMUNITY BENEFIT ACTIVITIES TO SUPPORT THEIR MISSION. | ||
| 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. | PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT | |
| A SINGLE PART V, SECTION B HAS BEEN COMPLETED FOR THE FOLLOWING HOSPITALS INCLUDED IN THE FORSYTH MEMORIAL HOSPITAL REPORTING GROUP; FORSYTH MEDICAL CENTER, KERNERSVILLE MEDICAL CENTER AND CLEMMONS MEDICAL CENTER. | PART VI, LINE 8: FACILITY REPORTING GROUP | |
| SEE BELOW | PART V, LINE 8 FACILITY REPORTING GROUP A | |
| 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% (3A: FREE CARE). | PART V, SECTION B, LINE 11: | FACILITY 1 -- FORSYTH MEMORIAL HOSPITAL, INC |
| WE DID NOT CHECK BOXES FOR QUESTIONS 16, 17 AND 18 BECAUSE WE PROCEED WITH ALL REASONABLE EFFORTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE PRIOR TO INITIATING ANY COLLECTION ACTIONS. | PART V, SECTION B, LINE 18E: | FACILITY 1 -- FORSYTH MEMORIAL HOSPITAL, INC |
| 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 V, SECTION B, LINE 20D: | FACILITY 1 -- FORSYTH MEMORIAL HOSPITAL, INC |
| 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% (3A: FREE CARE). | PART V, SECTION B, LINE 11: | FACILITY 2 -- FMH DBA KERNERSVILLE MEDICAL CENTER |
| WE DID NOT CHECK BOXES FOR QUESTIONS 16, 17 AND 18 BECAUSE WE PROCEED WITH ALL REASONABLE EFFORTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE PRIOR TO INITIATING ANY COLLECTION ACTIONS. | PART V, SECTION B, LINE 18E: | FACILITY 2 -- FMH DBA KERNERSVILLE MEDICAL CENTER |
| 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 V, SECTION B, LINE 20D: | FACILITY 2 -- FMH DBA KERNERSVILLE MEDICAL CENTER |
| 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% (3A: FREE CARE). | PART V, SECTION B, LINE 11: | FACILITY 3 -- FMH DBA CLEMMONS MEDICAL CENTER |
| WE DID NOT CHECK BOXES FOR QUESTIONS 16, 17 AND 18 BECAUSE WE PROCEED WITH ALL REASONABLE EFFORTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE PRIOR TO INITIATING ANY COLLECTION ACTIONS. | PART V, SECTION B, LINE 18E: | FACILITY 3 -- FMH DBA CLEMMONS MEDICAL CENTER |
| 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 V, SECTION B, LINE 20D: | FACILITY 3 -- FMH DBA CLEMMONS MEDICAL CENTER |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| DAVIE COMMUNITY FOUNDATION | |||||||
| 194 WILKESBORO STREET | MOCKSVILLE | NC | 27028 | 581850531 | 501(C)(3) | 25353 | CONTRIBUTION |
| MORAVIAN CHURCH IN AMERICA SOUTHERN PROVINCE | |||||||
| 459 S CHURCH STREET | WINSTONSALEM | NC | 27127 | 560552778 | 501(C)(3) | 20353 | CONTRIBUTION |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | DISCOUNTED PRESCRIPTION DRUG PROGRAM | TypeOfGrant |
| Number Of Recipients | 744 | NumberOfRecipients |
| Amount Of Non Cash Assistance | 117218 | AmountOfNonCashAssistance |
| Method Of Valuation | FMV | MethodOfValuation |
| Description Of Non Cash Assistance | PRESCRIPTION DRUG ASSISTANCE | DescriptionOfNonCashAssistance |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | 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. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | X | FirstClassOrCharterTravel |
| Travel For Companions | X | TravelForCompanions |
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Discretionary Spending Account | X | DiscretionarySpendingAccount |
| Housing Allowance Or Residence | X | HousingAllowanceOrResidence |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EDWARDSJOEL LYNN | ||||||||||||||
| TRUSTEE | 428666 | 0 | 19716 | 0 | 11732 | 0 | 32046 | 0 | 18328 | 0 | 510488 | 0 | 0 | 0 |
| FULLERSTANLEY BRIAN | ||||||||||||||
| TRUSTEE | 0 | 353738 | 0 | 80089 | 0 | 1594 | 0 | 15000 | 0 | 28030 | 0 | 478451 | 0 | 0 |
| LINDSAYJEFFERY T | ||||||||||||||
| PRESIDENT FMC/COO WS MARKET | 520767 | 0 | 281200 | 0 | 25441 | 0 | 412993 | 0 | 22029 | 0 | 1262430 | 0 | 0 | 0 |
| MCGEELAWRENCE UPCHURCH | ||||||||||||||
| ASST SEC | 0 | 414338 | 0 | 277860 | 0 | 382419 | 0 | 476900 | 0 | 24313 | 0 | 1575830 | 0 | 361584 |
| MORRISJOHN BENTON | ||||||||||||||
| ASST SEC | 0 | 227267 | 0 | 44265 | 0 | 15084 | 0 | 21578 | 0 | 22043 | 0 | 330237 | 0 | 0 |
| ALLENJOANNE | ||||||||||||||
| PRESIDENT KERNERSVILLE | 167498 | 0 | 38920 | 0 | 15426 | 0 | 16137 | 0 | 8601 | 0 | 246582 | 0 | 0 | 0 |
| HAMMESPAUL H | ||||||||||||||
| FMR SVP & COO FMC | 162485 | 0 | 228545 | 0 | 133213 | 4625 | 15736 | 0 | 23615 | 0 | 563594 | 4625 | 0 | 0 |
| LARSONKIP LEROY | ||||||||||||||
| VP & SR MED DIR SPECIALTY SERV | 344103 | 0 | 0 | 0 | 14547 | 0 | 3808 | 0 | 22202 | 0 | 384660 | 0 | 0 | 0 |
| LEWISLINDA C | ||||||||||||||
| VP NURSING | 239167 | 0 | 67078 | 0 | 20715 | 0 | 14501 | 0 | 12258 | 0 | 353719 | 0 | 0 | 0 |
| MIHALDENISE BARBARA | ||||||||||||||
| SVP WS MARKET COO | 269945 | 58979 | 0 | 163620 | 19534 | 10524 | 247500 | 0 | 11673 | 0 | 548652 | 233123 | 0 | 0 |
| WALLEYBRUCE DOUGLAS | ||||||||||||||
| SVP MEDICAL AFFAIRS | 340717 | 0 | 195000 | 0 | 14586 | 0 | 10251 | 0 | 8989 | 0 | 569543 | 0 | 0 | 0 |
| CHRYSSONNICK G | ||||||||||||||
| ONCOLOGIST | 819652 | 0 | 136984 | 0 | 35461 | 0 | 15000 | 0 | 24166 | 0 | 1031263 | 0 | 0 | 0 |
| GROTETHOMAS H | ||||||||||||||
| ONCOLOGIST | 444306 | 0 | 430125 | 0 | 36620 | 0 | 15000 | 0 | 22262 | 0 | 948313 | 0 | 0 | 0 |
| PASCHOLD EUGENE H | ||||||||||||||
| ONCOLOGIST | 443822 | 0 | 242535 | 0 | 38016 | 0 | 15000 | 0 | 17444 | 0 | 756817 | 0 | 0 | 0 |
| PIPPITTCHARLES H | ||||||||||||||
| ONCOLOGIST | 340275 | 0 | 323533 | 0 | 36531 | 0 | 15000 | 0 | 24466 | 0 | 739805 | 0 | 0 | 0 |
| SHEARERHEATHER H | ||||||||||||||
| ONCOLOGIST | 393443 | 0 | 262876 | 0 | 34608 | 0 | 15000 | 0 | 24698 | 0 | 730625 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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 GROUP 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. 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. AT THIS TIME NOVANT HAS ONE SUCH MEMBERSHIP. | |
| 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, LINES 4A-B | PART I, LINE 4B: PART I, LINE 4-SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE NONQUALIFIED EQUITY-BASED HAMMES, PAUL H. 95,130 0 0 MCGEE, LAWRENCE UPCHURCH 0 361,584 0 | |
| PART III | 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 INDEPENDENT AND DISINTERESTED MEMBERS OF THE BOARD OF TRUSTEES 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. 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 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. 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 AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THE PLAN. SCHEDULE J PART I LINE 4A - SEVERANCE PLAN: ELIGIBLE EXECUTIVES MAY RECEIVE SEVERANCE PAY THAT IS A SPECIFIED MULTIPLE OF ANNUAL COMPENSATION. 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. 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 AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS SEVERANCE PLAN. SCHEDULE J PART I LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS: THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") IS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES, AND TO OFFER COMPETITIVE TOTAL COMPENSATION. THESE SERP BENEFITS ARE CALCULATED WITH REFERENCE TO A FORMULA THAT TAKES INTO CONSIDERATION THE EXECUTIVE'S TOTAL YEARS OF SERVICE WITH THE ORGANIZATION AND OTHER RETIREMENT INCOME. THESE BENEFITS ARE FULLY AT RISK AND WILL NOT BE PAID UNLESS THE EXECUTIVE PROVIDES SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION. UNTIL THOSE REQUIREMENTS ARE SATISFIED, IF EVER, THE EXECUTIVE IS NOT ENTITLED TO ANY SERP BENEFIT. IF THE EXECUTIVE WERE TO HAVE LEFT THE ORGANIZATION VOLUNTARILY DURING THE YEAR FOR WHICH THESE AMOUNTS ARE BEING REPORTED (BEFORE REACHING BOTH AGE 55 AND HAVING FIVE YEARS OF SERVICE WITH THE ORGANIZATION), THE EXECUTIVE'S SERP BENEFIT WOULD HAVE BEEN ENTIRELY FORFEITED. THE SERP BENEFIT IS REDUCED AT THE RATE OF 2 PERCENTAGE POINTS PER YEAR FOR PAYMENTS RECEIVED BETWEEN THE AGES OF 55 AND 62. CURRENT YEAR PAYMENTS OF SERP BENEFITS HAVE BEEN INCLUDED IN THE COMPENSATION AMOUNTS REPORTED IN PART VII AND IN COLUMN (B)(III) OF SCHEDULE J. AN ESTIMATE OF THE ANNUAL INCREASE IN ACTUARIAL VALUE IS REPORTED AS DEFERRED COMPENSATION IN PART VII AND IN COLUMN (C) OF SCHEDULE J FOR ELIGIBLE EXECUTIVES. 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 AND ALL ELEMENTS OF EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE AMOUNTS AWARDED UNDER THIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. | SUPPLEMENTAL INFORMATION |
Schedule L IRS990ScheduleL
Loan Table LoanTable (5 entries)
| Relationship With OrganizationRelationshipWithOrganization | Purpose Of LoanPurposeOfLoan | Loan From OrganizationLoanFromOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|---|---|
| NICK CHRYSSON | |||||||
| EMPLOYEE | EMPLOYMENT RELATED | X | $105,000 | 42292 | 0 | 1 | 1 |
| THOMAS GROTE | |||||||
| EMPLOYEE | EMPLOYMENT RELATED | X | $105,000 | 42292 | 0 | 1 | 1 |
| LAWRENCE NYCUM | |||||||
| EMPLOYEE | EMPLOYMENT RELATED | X | $105,000 | 42292 | 0 | 1 | 1 |
| EUGENE PASCHOLD | |||||||
| EMPLOYEE | EMPLOYMENT RELATED | X | $105,000 | 42292 | 0 | 1 | 1 |
| HEATHER SHEARER | |||||||
| EMPLOYEE | EMPLOYMENT RELATED | X | $105,000 | 42292 | 0 | 1 | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 211460 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | ELIZABETH WALLEY | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | FAMILY MEMBER OF BRUCE WALLEY, KEY EMPLOYEE | Relationship |
| Amount Of Transaction | 96536 | AmountOfTransaction |
| Description Of Transaction | COMPENSATION PAID BY THE FILING ORGANIZATION TO A FAMILY MEMBER OF THE INTERESTED PERSON. | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 2 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 19160 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
Cars And Other Vehicles CarsAndOtherVehicles
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 228000 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
Other Non Cash Contributions Table OtherNonCashContributionsTable (4 entries)
| Non Cash CheckboxNonCashCheckbox | DescriptionDescription | Number Of ContributionsNumberOfContributions | Noncash Contribs Rptd F990NoncashContribsRptdF990 | Method Of Determining RevenuesMethodOfDeterminingRevenues |
|---|---|---|---|---|
| X | TV | 1 | 509 | FMV |
| X | NESTING PROGRAM | 1 | 1266 | FMV |
| X | MISCELLANEOUS | 4 | 205 | FMV |
| X | TABLE | 1 | 39 | FMV |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of8283 Received | 0 | NumberOf8283Received |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Form990 Schedule M Part II Form990ScheduleMPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: | Identifier |
| Return Reference | PART I, COLUMN (B): | ReturnReference |
| Explanation | NUMBER OF CONTRIBUTIONS | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (15 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ACTIVITIES | FORM 990, PART I, LINE 1: ORGANIZATION'S MISSION OR MOST SIGNIFICANT | IN 2012, FORSYTH MEDICAL CENTER (FMC), A 921-BED NOVANT HEALTH TERTIARY CARE HOSPITAL LOCATED IN WINSTON-SALEM, NC, FOCUSED ON PROVIDING COMMUNITY SUPPORT, CONSISTENT QUALITY, EXCELLENT SERVICE AND A REMARKABLE WORK ENVIRONMENT FOR STAFF. IT 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 INTEGRATED HEALTHCARE SYSTEMS CARING FOR PATIENTS AND COMMUNITIES IN NORTH CAROLINA, VIRGINIA AND SOUTH CAROLINA. THE NOVANT HEALTH SYSTEM REPORTED $3.555 BILLION IN REVENUES IN 2012. OUR HOSPITAL IS COMMITTED TO MEETING THE HEALTHCARE NEEDS OF RESIDENTS OF THE PIEDMONT TRIAD REGION OF NORTH CAROLINA, ONE PERSON AT A TIME. WE ARE PROUD OF THE ACHIEVEMENTS IN QUALITY THIS YEAR AS WE RANK WELL ABOVE STATE AVERAGES IN HEART ATTACK, HEART FAILURE AND PNEUMONIA CARE. IN ADDITION, FORSYTH MEDICAL CENTER'S BREAST CANCER CENTER PROGRAM IS NATIONALLY CERTIFIED. OUR STROKE AND NEUROSCIENCES INSTITUTE AND CARDIAC & VASCULAR CENTER HEART FAILURE PROGRAM AND STROKE REHABILITATION PROGRAM ARE ALL NATIONALLY ACCREDITED AS WELL AS ITS TOTAL HIP AND KNEE JOINT REPLACEMENT PROGRAM. OUR HEART FAILURE PROGRAM RECEIVED ADVANCED HEART FAILURE CERTIFICATION FOR EXCEPTIONAL EFFORTS TO IMPROVE HEART FAILURE PATIENT OUTCOMES AND THE AMERICAN COLLEGE OF SURGEONS (ACS) NAMED FORSYTH MEDICAL CENTER WITHIN ITS NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM. FORSYTH MEDICAL CENTER HAS BEEN RECOGNIZED FOR ACHIEVING THE TOP 10% OF HOSPITALS NATIONALLY FOR PATIENT SATISFACTION BASED ON HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) DATA AS WELL AS IN THE TOP 10% IN THE NATION FOR CUSTOMER SATISFACTION, EARNING THE HEALTHGRADES OUTSTANDING PATIENT EXPERIENCE AWARD. OUR COMMITMENT TO EXCELLENCE IN PATIENT CARE, INCLUDING NURSING CARE, CONTINUED DURING THE YEAR. FORSYTH MEDICAL CENTER IS AMONG ONLY FIVE PERCENT OF HOSPITALS IN THE UNITED STATES TO BE DESIGNATED BY THE AMERICAN NURSES CREDENTIALING CENTER AS A MAGNET FACILITY, CONFIRMING THE EXCEPTIONAL QUALITY OF CARE THAT OUR NURSES PROVIDE. AT THE STATE LEVEL, TWO NURSES FROM FORSYTH MEDICAL CENTER WERE SELECTED BY THE NORTH CAROLINA NURSES' ASSOCIATION TO BE AMONG THE "GREAT 100 NURSES." TO FURTHER ADVANCE THE QUALITY OF ITS NURSING, FORSYTH MEDICAL CENTER ADOPTED A NEW NURSING PROFESSIONAL PRACTICE MODEL IN 2012; THE DUFFY'S QUALITY-CARING MODEL WHICH, SOON AFTER, WAS ADOPTED BY NOVANT HEALTH'S ENTIRE ACUTE NURSING SYSTEM. DURING 2012, FORSYTH MEDICAL CENTER RECEIVED A NUMBER OF ACCREDITATIONS AND AWARDS FOR ITS HIGH LEVEL OF PATIENT CARE IN SPECIFIC CATEGORIES, INCLUDING THESE ACCOMPLISHMENTS: *FORSYTH MEDICAL CENTER RANKS WELL ABOVE THE STATE AVERAGE IN APPROPRIATE CARE MEASURE (ACM), A PATIENT-CENTERED COMPOSITE SCORE THAT CAPTURES WHETHER OR NOT A PATIENT RECEIVED ALL OF THE RECOMMENDED TREATMENTS IN THE FOLLOWING MEASURES: HEART ATTACK (100%) HEART FAILURE (100%) PNEUMONIA CARE (100%) SURGICAL CARE IMPROVEMENT PROJECT (99%) *FORSYTH MEDICAL CENTER ACHIEVED CYCLE IV CHEST PAIN NATIONAL ACCREDITATION FROM THE SOCIETY OF CHEST PAIN CENTERS. FORSYTH BECAME THE FIRST HOSPITAL IN NORTH CAROLINA AND ONE OF ONLY 26 IN THE NATION TO RECEIVE THIS DESIGNATION. THE NATIONAL SOCIETY EVALUATED FORSYTH'S ABILITY TO RAPIDLY AND ACCURATELY DIAGNOSE AND TREAT PATIENTS WHO MAY BE HAVING A HEART ATTACK, AND DETERMINED THE HOSPITAL'S SUCCESS AT MEETING STRICT CRITERIA: REDUCING THE TIME FROM ONSET OF SYMPTOMS TO DIAGNOSIS AND TREATMENT; TREATING PATIENTS MORE QUICKLY DURING THE CRITICAL WINDOW OF TIME WHEN THE INTEGRITY OF THE HEART MUSCLE CAN BE PRESERVED; AND MONITORING PATIENTS TO ENSURE THAT THEY ARE NOT SENT HOME TOO QUICKLY OR NEEDLESSLY ADMITTED TO THE HOSPITAL. THIS HIGHEST LEVEL OF ACCREDITATION ALSO RECOGNIZES TEAMWORK AMONG HOSPITAL CHEST PAIN EXPERTS, EMERGENCY DEPARTMENTS AND EMS PARTNERS. *THE DERRICK L. DAVIS FORSYTH REGIONAL CANCER CENTER RECEIVED NATIONAL RECOGNITION FOR ITS RESEARCH PROGRAM FROM THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY (ASCO). FORSYTH'S AWARD, PRESENTED BY THE CONQUER CANCER FOUNDATION OF THE ASCO, RECOGNIZES ORGANIZATIONS THAT HAVE ESTABLISHED HIGH QUALITY CLINICAL CANCER RESEARCH PROGRAMS. FORSYTH IS ONE OF ONLY SIX PROGRAMS IN THE UNITED STATES AND THE ONLY ONE IN NORTH CAROLINA TO RECEIVE THIS AWARD IN 2012. *THE CANCER CENTER ALSO ACHIEVED THREE-YEAR ACCREDITATION WITH COMMENDATION FROM THE NATIONAL COMMISSION ON CANCER. THE COMMISSION IS DEDICATED TO IMPROVING SURVIVAL RATES AND QUALITY OF LIFE FOR CANCER PATIENTS THROUGH STANDARD-SETTING, PREVENTION, RESEARCH EDUCATION AND THE MONITORING OF COMPREHENSIVE QUALITY CARE. FORSYTH MET ALL 36 COMMISSION STANDARDS. *FORSYTH CARDIAC AND VASCULAR CENTER RECEIVED RE-DESIGNATION FOR ADVANCED HEART FAILURE CERTIFICATION FROM THE JOINT COMMISSION WITH NO RECOMMENDATIONS FOR IMPROVEMENT. THE SURVEYOR COMPLIMENTED THE EXPERTISE OF THE TEAM, THE STRENGTH OF THE PROGRAM, THE CONTINUUM OF CARE PROVIDED, AND THE PROGRAM'S QUALITY OUTCOMES. *FOR THE FOURTH CONSECUTIVE YEAR, FORSYTH CARDIAC AND VASCULAR CENTER HAS EARNED THE SOCIETY OF THORACIC SURGEONS (STS) 3-STAR RATING, REPRESENTING THE HIGHEST QUALITY RATING AWARDED FOR HEART SURGERY. THIS DESIGNATION IS BASED ON A COMPREHENSIVE RATING SYSTEM THAT COMPARES THE QUALITY OF CARDIAC SURGERY AMONG HOSPITALS ACROSS THE COUNTRY. ONLY 14 PERCENT OF ALL CARDIAC SURGERY HOSPITALS IN THE U.S. RECEIVED THIS TOP RANKING, WHICH PLACES OUR PHYSICIANS AMONG THE NATION'S BEST AT CONSISTENTLY PROVIDING EXCELLENT SURGICAL OUTCOMES. IN ITS FIRST FULL YEAR OF OPERATION, FORSYTH MEDICAL CENTER AFFILIATE HOSPITAL, KERNERSVILLE MEDICAL CENTER (KMC) IN KERNERSVILLE, NC, FOCUSED ON PROVIDING A FAST-ACCESS EMERGENCY DEPARTMENT, GENERAL, ORTHOPAEDIC AND EYE SURGICAL SERVICES, CONSISTENT QUALITY, EXCELLENT SERVICE AND A REMARKABLE WORK ENVIRONMENT FOR STAFF TO RESIDENTS IN THE KERNERSVILLE AREA, WESTERN GUILFORD AND ROCKINGHAM COUNTIES, AS WELL AS EASTERN STOKES AND FORSYTH COUNTIES. THE MEDICAL CENTERS ALSO MADE SIGNIFICANT CONTRIBUTIONS TOWARD IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. THE HIGHLIGHTS FOR 2012 INCLUDE THE FOLLOWING: *FORSYTH MEDICAL CENTER AND ITS AFFILIATE KERNERSVILLE MEDICAL CENTER SERVED MORE THAN 12,000 PATIENTS THROUGH A FREE SERVICE CALLED CARE CONNECTIONS, A 24/7 ADVICE SERVICE IN WHICH NURSES CAN MAKE RECOMMENDATIONS FOR A PRIMARY CARE PHYSICIAN, URGENT CARE LOCATION OR EMERGENCY DEPARTMENT. NURSES CAN VIEW CURRENT WAIT TIMES AT LOCAL NOVANT URGENT CARE LOCATIONS AND OFFER A RESERVED, SAME-DAY VISIT AND TIME. THEY CAN ALSO MAKE APPOINTMENTS AT SOME PRIMARY CARE PRACTICES OR CALL AHEAD TO TELL NOVANT HOSPITAL EMERGENCY DEPARTMENTS THAT A PATIENT IS ARRIVING. *FORSYTH MEDICAL CENTER OPENED THE MAYA ANGELOU CENTER FOR WOMEN'S HEALTH AND WELLNESS TO COORDINATE COMPREHENSIVE SERVICES SPECIFICALLY DESIGNED TO MEET THE UNIQUE NEEDS OF WOMEN THROUGH EVERY STAGE OF LIFE. THE CENTER IS THE REGION'S FIRST TO EMPLOY WOMEN'S HEALTH NAVIGATORS TO HELP COORDINATE THE VAST ARRAY OF WOMEN'S SERVICES AVAILABLE THROUGHOUT THE MEDICAL CENTER. THE CENTER BRINGS TOGETHER ALL OF THE CLINICAL PROGRAMS AND SERVICES AT FMC THAT TOUCH WOMEN'S HEALTH, INCLUDING HEART, WELLNESS, CANCER, SURGICAL SERVICES, MATERNITY, EMERGENCY CARE, BONE AND JOINT HEALTH, AND BEHAVIORAL HEALTHCARE, INCLUDING A NEW MIDLIFE WOMEN'S CENTER. THE CENTER WILL CREATE COLLABORATION IN RESEARCH, EDUCATION AND TREATMENT THAT WILL BRING ABOUT INNOVATIONS IN CARE TO IMPROVE THE HEALTH OF WOMEN IN OUR COMMUNITY AND THROUGHOUT NORTH CAROLINA. *FORSYTH BEHAVIORAL HEALTH OPENED A NEW 24-HOUR ASSESSMENT CENTER AS PART OF A HUB OF SERVICES DEDICATED TO MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES. THE HUB, LOCATED OFFSITE FROM THE HOSPITAL, HOUSES THE NEW ASSESSMENT CENTER, A 24-HOUR BEHAVIORAL HEALTH CALL CENTER. PARTIAL HOSPITAL AND INTENSIVE OUTPATIENT PROGRAMS AND THE MOBILE CRISIS RESPONSE TEAM. THIS CREATES THE MOST COMPREHENSIVE BEHAVIORAL HEALTH CENTER IN THE REGION. ABOUT ONE-THIRD OF BEHAVIORAL HEALTH-RELATED ADMISSIONS TO FORSYTH MEDICAL CENTER'S EMERGENCY DEPARTMENT WOULD QUALIFY TO COME TO THE ASSESSMENT CENTER, SO THE NEW HUB WILL BENEFIT THE EMERGENCY DEPARTMENT BY HELPING TO DECOMPRESS THE NUMBER OF BEHAVIORAL HEALTH PATIENTS. THE HUB IS ALSO EQUIPPED WITH VIDEO MONITORING EQUIPMENT, CONNECT TO FORSYTH MEDICAL CENTER'S PUBLIC SAFETY SYSTEM, TO ENSURE THE SAFETY OF PATIENTS AND STAFF. |
| COMMUNITY BENEFIT REPORT: | HTTP://WWW.NOVANTHEALTH.ORG/GIVEBACK/COMMUNITYBENEFITREPORT.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 $546,000,000 IN 2012. 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 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 WE 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. | |
| FORM 990, PART I, LINE 6: | THE NUMBER OF VOLUNTEERS REPORTED INCLUDES THOSE VOLUNTEERS SERVING AS BOARD MEMBERS. | |
| *DURING 2012, FORSYTH MEDICAL CENTER BECAME THE FIRST HOSPITAL IN CENTRAL AND EASTERN NORTH CAROLINA TO OFFER PATIENTS AT RISK OF SUDDEN CARDIAC ARREST A NEW LIFE-SAVING DEVICE THAT CAN SHOCK THE HEART MUSCLE TO RESTORE NORMAL RHYTHM. THE DEVICE, A SUBCUTANEOUS IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (S-ICD), IS THE FIRST HEART DEFIBRILLATOR THAT CAN BE IMPLANTED UNDER THE SKIN WITHOUT TOUCHING THE HEART. IT WAS APPROVED FOR USE BY THE FOOD AND DRUG ADMINISTRATION ON SEPTEMBER 28, 2012. *THE EMERGENCY DEPARTMENT AT FMC HAS TRANSFORMED ITS OPERATIONS IN THE PAST TWO YEARS TO ACHIEVE ITS LOWEST DOOR-TO-PROVIDER WAIT TIMES ALONG WITH PROVIDING NEW SERVICES. -39 MINUTES FOR THE AVERAGE PATIENT. UPON ARRIVAL, EVERY PERSON IS GREETED AND EVALUATED BY A NURSE PRACTITIONER WHO, IN MOST CASES, CAN BEGIN THEIR PLAN OF CARE RIGHT AWAY INCLUDING ORDERING DIAGNOSTIC TESTS BEFORE A PATIENT GOES BACK TO A TREATMENT ROOM. -58 MINUTES AVERAGE DOOR-TO-TPA TIME TO BEGIN ADMINISTERING TPA TO STROKE PATIENTS WHICH BEGINS THE PROCESS OF DISSOLVING THE BLOOD CLOT IN THEIR BRAIN. A NEW PRACTICE ALSO BRINGS POTENTIAL STROKE PATIENTS DIRECTLY TO A CT SCANNER, SKIPPING VALUABLE TIME THAT HAS BEEN LOST IN A TREATMENT ROOM. -ADDING A CLINICAL SERVICE NAVIGATOR WHO IS A CLINICAL NURSE THAT CALLS PATIENTS AFTER DISCHARGE ABOUT LAB RESULTS AND FOLLOW-UP NEEDS. *VASCULAR CLINIC/PAD SCREENINGS COMBINE FREE EDUCATION AND SCREENINGS ON CARDIOVASCULAR DISEASE RISK FACTORS WITH AN EMPHASIS ON PREVENTING PERIPHERAL ARTERIAL DISEASE (PAD) IN THE COMMUNITY. *BEHAVIORAL HEALTH COMMUNITY OUTREACH WHICH PROVIDES A 24/7 BEHAVIORAL HEALTH CALL CENTER, DEPRESSIONS AND BIPOLAR SUPPORT GROUP, DIALECTIC BEHAVIORAL THERAPY SKILLS TRAINING, A FAMILY RECOVERY PROGRAM AND A MOBILE CRISIS RESPONSE TEAM. *THE DERRICK L. DAVIS FORSYTH REGIONAL CANCER CENTER'S COMMUNITY SERVICES INCLUDE COMMUNITY EDUCATION FORUMS, A PALLIATIVE CARE SYMPOSIUM, AN EMPLOYEE MAMMOGRAM PROGRAM AS WELL AS PUBLIC SUPPORT GROUPS AND LEARNING SESSIONS FOR CAREGIVERS AND THOSE WITH LEUKEMIA AND LYMPHOMA, GASTROINTESTINAL CANCER, GYNECOLOGIC CANCER AS WELL AS TEACHING ABOUT SPIRITUALITY AND CANCER. *CARDIAC COMMUNITY SERVICES INCLUDE COMMUNITY HEALTH & NUTRITION EDUCATION AND SCREENINGS, A HEART FAILURE CLINIC AND LIPID CLINIC, AN OPEN HEART CLINIC, STRESS MANAGEMENT PROGRAMS AS WELL AS TOBACCO AND SMOKING CESSATION PROGRAMS. *DIABETES SERVICES FEATURE CONTINUOUS GLUCOSE MONITORING, DIABETES PREVENTION AND SCREENING SESSIONS, DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT GROUPS AS WELL AS INSULIN PUMP TRAINING. *REHABILITATION SERVICES TO THE COMMUNITY INCLUDE AN APHASIA SUPPORT GROUP, AUDIOLOGY AND POSTURE SCREENINGS. *STROKE AND NEUROSCIENCES COMMUNITY SUPPORT INCLUDES A SLEEP MEDICINE SYMPOSIUM, A STROKE SYMPOSIUM AS WELL AS STROKE EDUCATION AND SUPPORT GROUPS. *WOMEN'S SERVICES COMMUNITY OUTREACH INCLUDE BIRTH AND BEGINNING CLASSES, BREASTFEEDING EDUCATION AND SUPPORT GROUPS, A FREE ON-LINE HEALTH RISK ASSESSMENT, GIRLS ON THE RUN AND GIRLS ON TRACK WHICH PROMOTE YOUTH TO LEAD ACTIVE, HEALTHY LIFESTYLES, AND THE HANESBRANDS HEALTH LEARNING LIBRARY WHICH PROVIDES SCREENINGS, HEALTH CHECKS AND EDUCATION SERVICES. *FORSYTH MEDICAL CENTER RECEIVED A GRANT FROM THE KATE B. REYNOLDS CHARITABLE TRUST TO EDUCATE AND HELP LOW-INCOME ADULTS IN FORSYTH COUNTY MANAGE AND PREVENT DIABETES. OVER THREE YEARS THE HOSPITAL WILL ENROLL 300 ADULTS NEWLY DIAGNOSED WITH DIABETES OR WITH UNCONTROLLED DIABETES IN ITS DIABETES SELF-MANAGEMENT PROGRAM, WHICH IS RECOGNIZED BY THE AMERICAN DIABETES ASSOCIATION FOR MEETING NATIONAL EXCELLENCE STANDARDS. THE HOSPITAL WILL ALSO ENROLL 200 ADULTS WITH PRE-DIABETES IN AN EDUCATIONAL PREVENTION PROGRAM. *THE MEDICAL CENTER'S MAYA ANGELOU CENTER FOR WOMEN'S HEALTH AND WELLNESS HELD A THREE-DAY INTERNATIONAL SUMMIT FOCUSING ON CONTEMPORARY ISSUES AFFECTING WOMEN'S AND GIRLS' HEALTH. OPEN TO THE PUBLIC, THE SUMMIT BROUGHT TOGETHER INTERNATIONALLY RECOGNIZED ADVOCATES FOR WOMEN'S HEALTH TO DISCUSS A BROAD RANGE OF TOPICS RANGING FROM BARRIERS AND DISPARITIES IN WOMEN'S HEALTHCARE, TO VIOLENCE AGAINST WOMEN TO EMPOWERING WOMEN AND GIRLS TO LEAD. SPEAKERS INCLUDED EXPERTS IN THE FIELDS OF HEALTHCARE DESIGN, HEALTH SCIENCES, HEALTH POLICY, LAW, SOCIAL POLICY AND EDUCATION AS WELL AS LEADERS OF SEVERAL INTERNATIONAL ORGANIZATIONS WITH MISSIONS TO IMPROVE WOMEN'S HEALTH. IN ADDITION TO OUR QUALITY AND COMPREHENSIVE CATEGORIES OF SERVICES, 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. | ||
| FORM 990, PART VI, SECTION A, LINE 2 | FAMILY AND/OR BUSINESS RELATIONSHIPS BUSINESS RELATIONSHIPS PAUL HAMMES GARY GREEN | |
| 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 | ELECTION OF MEMBERS AND THEIR RIGHTS NOVANT HEALTH, INC. ELECTS ALL MEMBERS OF THE GOVERNING BODY OF FORSYTH MEMORIAL HOSPITAL,INC. | |
| 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 AMENDEMNTS 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 | 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 | 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 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 CERTAIN LEADERS AND EXECUTIVES ("EXECUTIVES") SERVING 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 DO NOT EXCEED FAIR MARKET VALUE WHEN COMPARED TO THE MARKET DATA FOR SIMILAR POSITIONS. 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. THE COMMITTEE REVIEWS AND APPROVES EACH ITEM OF THE NOVANT HEALTH SYSTEM CEO'S COMPENSATION AND BENEFITS. 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 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 DO NOT EXCEED FAIR MARKET VALUE WHEN COMPARED TO THE MARKET DATA FOR SIMILAR POSITIONS. 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. LASTLY, IT REVIEWS AND APPROVES ALL OF THE ELEMENTS AND SPECIFICATIONS INCLUDED IN ALL OTHER EXECUTIVE AND LEADER COMPENSATION PLANS AND PROGRAMS (E.G., INCENTIVE PLAN DESIGN, AWARD OPPORTUNITIES, ETC.). | |
| 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. | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 9: | FMCF AND AUXILIARY OF FMC CONTRIBUTION: -2,763,953. AFFILIATE TRANSFERS: -3,354,434. MALPRACTICE INSURANCE: -3,765,692. ROUNDING 9. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Total IncomeTotalIncome | EOY AssetsEOYAssets | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| EXCEL IMAGING LLC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | 204253946 | INACTIVE | NC | 0 | 0 | FORSYTH MEMORIAL HOSPITAL |
| SALEM MRI LLC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | INACTIVE | NC | 0 | 0 | FORSYTH MEMORIAL HOSPITAL | |
| THE BREAST CLINIC MRI LLC | |||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTONSALEM | NC | 27103 | INACTIVE | NC | 0 | 0 | FORSYTH MEMORIAL HOSPITAL | |
Form990 Schedule R Part II Form990ScheduleRPartII (24 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | 1 | |
| 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 | |
| CONTINUING CARE SERVICES | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 541288473 | HEALTHCARE | VA | 501(C)(3) | LINE 9 | PRINCE WILLIAM HEALTH SYSTEM | 0 | |
| FORSYTH MEDICAL CENTER FOUNDATION | |||||||||||
| 2085 FRONTIS PLAZA BLVD | WINSTON SALEM | NC | 27103 | 562120959 | HEALTHCARE | NC | 501(C)(3) | LINE 7 | FORSYTH MEMORIAL HOSPITAL INC | 1 | |
| 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 | |
| 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 (FKA ROWAN MEDICAL PRACTICES) | |||||||||||
| 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 | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (14 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | |||||
| NEW STAR 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 Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| FORSYTH MEDICAL CENTER FOUNDATION | ||
| C | 2742254 | CASH |
| FORSYTH MEDICAL CENTER FOUNDATION | ||
| C | 228000 | COST |
| FORSYTH MEDICAL CENTER FOUNDATION | ||
| R | 3354434 | CASH |
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