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WAKE FOREST UNIVERSITY HEALTH SCIENCES GROUP RETURN: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
WAKE FOREST UNIVERSITY HEALTH SCIENCES GROUP RETURN (EIN 90-0222618)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-14
IRS object ID
201221359349300627
Schema version
2010v3.4
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-05-14T07:53:53-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN900222618EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1WAKE FOREST UNIVERSITY HEALTH SCIENCESBusinessNameLine1
Business Name Line2GROUP RETURNBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlWAKENameControl
Phone3367164445Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1MEDICAL CENTER BLVDAddressLine1
CityWINSTONSALEMCity
StateNCState
ZIP Code27157ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN D MCCONNELL MDName
TitlePRESIDENTTitle
Phone3367164445Phone
Date Signed2012-05-14DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOHN D MCCONNELL MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1MEDICAL CENTER BLVDAddressLine1
CityWINSTON SALEMCity
StateNCState
ZIP Code27157ZIPCode
FieldValueIRS element (for citing)
Gross Receipts63339370GrossReceipts
Group Return For Affiliates1GroupReturnForAffiliates
All Affiliates Included1AllAffiliatesIncluded
Group Exemption Number3884GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2003YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionOUTPATIENT MEDICAL CLINICS FOR THE PROMOTION OF HEALTH FOR THE BENEFIT OF THE COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body4NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year63479453ProgramServiceRevenuePriorYear
Program Service Revenue CY63338388ProgramServiceRevenueCY
Investment Income Prior Year2660InvestmentIncomePriorYear
Investment Income Current Year982InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year63482113TotalRevenuePriorYear
Total Revenue Current Year63339370TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year52729534OtherExpensePriorYear
Other Expenses Current Year51630336OtherExpensesCurrentYear
Total Expenses Prior Year52729534TotalExpensesPriorYear
Total Expenses Current Year51630336TotalExpensesCurrentYear
Revenues Less Expenses Prior Year10752579RevenuesLessExpensesPriorYear
Revenues Less Expenses CY11709034RevenuesLessExpensesCY
Total Assets BOY92321697TotalAssetsBOY
Total Assets EOY104213267TotalAssetsEOY
Total Liabilities BOY8038168TotalLiabilitiesBOY
Total Liabilities EOY8220704TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY84283529NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY95992563NetAssetsOrFundBalancesEOY
Mission DescriptionOUTPATIENT MEDICAL CLINICS FOR THE PROMOTION OF HEALTH FOR THE BENEFIT OF THE COMMUNITY AND AS A SUPPORTING ORGANIZATION EXCLUSIVELY FOR THE BENEFIT OF WAKE FOREST UNIVERSITY AND ITS SUPPORTING ORGANIZATION,WAKE FOREST UNIVERSITY HEALTH SCIENCES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense48264344Expense
Revenue63338388Revenue
DescriptionHEMODIALYSIS: THE CLINICS SERVE THE TEACHING AND RESEARCH PROGRAMS OF WAKE FOREST UNIVERSITY HEALTH SCIENCES AND WAKE FOREST UNIVERSITY BY PROVIDING DIALYSIS TREATMENTS TO END STAGE RENAL DISEASE PATIENTS (1,542 PATIENTS).Description
Total Program Service Expense48264344TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096105NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members4NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNCStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1HEALTH SYSTEMS MANAGEMENT INCBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2293865505TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 7710AddressLine1
CityTIFTONCity
StateGAState
ZIP Code317937710ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
WILLIAM B APPLEGATE MD 0710-1210
BOARD CHAIR AND PRESIDENT4.50XX0643438100103
JOHN D MCCONNELL MD EFF 1210
BOARD CHAIR AND PRESIDENT0.50XX01875612624197
BARRY I FREEDMAN MD
DIRECTOR1.00XX050848541127
DOUGLAS L EDGETON
DIRECTOR, VP AND TREASURER3.50XX061376941279
TERRY L HALES JR
DIRECTOR, ASSISTANT TREASURER3.00XX044109759536
J REID MORGAN
SECRETARY0.50X036522949026
DONNA H HAMILTON
ASSISTANT SECRETARY1.00X016999831617
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs4617628TotalReportableCompFrmRltdOrgs
Total Other Compensation946885TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HSM DIALYSIS CENTERS LLC
PO BOX 7710TIFTONGA31793MANAGEMENT COMPANY6514415
NEPHROLOGY ASSOCIATES
730 HIGHLAND OAKS DRIVEWINSTONSALEMNC27103MEDICAL DIRECTOR281667
IREDELL NEPHROLOGY CENTER
2043 SIMONTON RD SUITE BSTATESVILLENC28625MEDICAL DIRECTOR110000
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPAYMENTS FOR MEDICAL SDescription
Business Code621300BusinessCode
Total Revenue Column63338388TotalRevenueColumn
Related Or Exempt Function Income63338388RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue63338388TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column982TotalRevenueColumn
Exclusion$982ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column63339370TotalRevenueColumn
Related Or Exempt Function Income63338388RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$982ExclusionAmount

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total103297Total
Program Services103297ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total43635Total
Management And General43635ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total26308746Total
Program Services22986394ProgramServices
Management And General3322352ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total376070Total
Program Services376070ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total21857630Total
Program Services21857630ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2568279Total
Program Services2568279ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total135817Total
Program Services135817ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total35074Total
Program Services35074ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total5Total
Management And General5ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total201783Total
Program Services201783ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total51630336Total
Program Services48264344ProgramServices
Management And General3365992ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2090766BOY
EOY3512180EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY12115362BOY
EOY11434872EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1539970BOY
EOY1325650EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY20532BOY
EOY85498EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY76555067BOY
EOY87855067EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY92321697BOY
EOY104213267EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6178228BOY
EOY6731410EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1859940BOY
EOY1489294EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY8038168BOY
EOY8220704EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY84283529BOY
EOY95992563EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY84283529BOY
EOY95992563EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY92321697BOY
EOY104213267EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses11709034ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (2 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
WAKE FOREST UNIVERSITY
5605321382111$0
WAKE FOREST UNIVERSITY HEALTH SCIENCES
2238491992111$0
FieldValueIRS element (for citing)
Total Number Of Supported Orgs2TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Book Value0BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Book Value0BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Book Value0BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionWFUHS CAPITAL CONTRIBUTIONDescription
Book Value87855067BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets87855067TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO WFUDescription
Amount$1,489,294Amount
FieldValueIRS element (for citing)
Total Of Amounts1489294TotalOfAmounts
Total Revenue63339370TotalRevenue
Total Expenses51630336TotalExpenses
Excess Or Deficit For Year11709034ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS11709034ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt64131996TotRevenueEtcAuditedFinclStmt
Other Revenues792626OtherRevenues
Revenue Not Rptd F990792626RevenueNotRptdF990
Revenue Subtotal63339370RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99063339370TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt52443805TotExpensesEtcAuditedFinclStmt
Other Expenses Included813469OtherExpensesIncluded
Expenses Not Rptd F990813469ExpensesNotRptdF990
Expenses Subtotal51630336ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99051630336TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

ExplanationExplanation
SCHEDULE D, PART XII AND PART XIII, LINE 2D: RECLASS DRUG & SUPPLIES REBATES
PART X, LINE 2: IT IS THE OPINION OF MANAGEMENT THAT THE COMPANY HAS NO SIGNIFICANT TAX POSITIONS THAT WOULD BE SUBJECT TO CHANGE UPON EXAMINATION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
WILLIAM B APPLEGATE MD 0710-1210
0518231099900025307076394023709074354100
JOHN D MCCONNELL MD EFF 1210
08789090500000049670306061450180520249980900
BARRY I FREEDMAN MD
016395003436150920019643021484054961200
DOUGLAS L EDGETON
04843600111700017709018602022677065504800
TERRY L HALES JR
0347002083000011095038602020934050063300
J REID MORGAN
0303894050000011335024500024526041425500
DONNA H HAMILTON
0164278050000720017087014530020161500

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 4BReturnReference
ExplanationCERTAIN EXECUTIVES OF THE FILING ORGANIZATION DURING THE TAX PERIOD, PARTICIPATED IN SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS AND EXECUTIVE BONUS PLANS (ALL OF WHICH COMPENSATION IS PAID BY RELATED ORGANIZATIONS, WAKE FOREST UNIVERSITY HEALTH SCIENCES AND WAKE FOREST UNIVERSITY, AS PART OF SUCH EXECUTIVES' COMPENSATION FROM THE RELATED ORGANIZATIONS). WILLIAM B. APPLEGATE, M.D. WAS A DIRECTOR OF THE FILING ORGANIZATION (UNTIL DECEMBER 2010 WHEN HE WAS SUCCEEDED BY JOHN D MCCONNELL, M.D.) AND AN OFFICER ("PRESIDENT OF HEALTH SCIENCES") OF THE FILING ORGANIZATION UNTIL JUNE 30, 2011. ALL COMPENSATION OF BOTH MEN WAS PAID BY RELATED ORGANIZATIONS FOR THEIR WORK AS EXECUTIVES OF SUCH RELATED ORGANIZATIONS.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 6WAKE FOREST UNIVERSITY HEALTH SCIENCES IS THE PARENT ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE MEMBERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATION ARE APPOINTED BY THE GOVERNING BODY OF WAKE FOREST UNIVERSITY HEALTH SCIENCES OR BY A MEMBER OF THE GOVERNING BODY OR BY AN OFFICER OF WAKE FOREST UNIVERSITY HEALTH SCIENCES ACTING IN HIS OFFICIAL CAPACITY, IN ACCORDANCE WITH PROCEDURES PRESCRIBED BY THE BOARD OF DIRECTORS OF WAKE FOREST UNIVERSITY HEALTH SCIENCES.
FORM 990, PART VI, SECTION A, LINE 7BDECISIONS OF THE ORGANIZATION'S GOVERNING BODY WHICH REQUIRE APPROVAL BY THE PARENT ORGANIZATION, WAKE FOREST UNIVERSITY HEALTH SCIENCES, INCLUDE AMENDMENTS TO THE ORGANIZATION'S GOVERNANCE DOCUMENTS (ARTICLES OF INCORPORATION AND BYLAWS), AND THE ELECTION AND REMOVAL OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVES COPIES OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. THE AUDIT AND COMPLIANCE COMMITTEES OF THE GOVERNING BOARD OF WFUHS REVIEWS IN ADDITIONAL DETAIL THE FILING ORGANIZATION'S FORM 990 WITH THE ORGANIZATION'S CHIEF FINANCIAL OFFICER OR HIS DESIGNEE, WHO ANSWERS QUESTIONS AND ADDRESSES CONCERNS RAISED BY SUCH COMMITTEE MEMBERS OR OTHER FILING ORGANIZATION DIRECTORS. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL DIRECTORS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS.
THE ORGANIZATION REQUIRES ITS OFFICERS AND DIRECTORS TO DISCLOSE CONFLICTS OF INTEREST ANNUALLY, AND AS THEY ARISE. ANY ITEMS DISCLOSED ARE REVIEWED AND MANAGED IN ACCORDANCE WITH THE ORGANIZATION'S POLICY ON CONFLICTS OF INTEREST.FORM 990, PART VI, SECTION B, LINE 12C
THE ORGANIZATION PAYS NO COMPENSATION TO OFFICERS OR DIRECTORS; AS THE ORGANIZATION HAS NO EMPLOYEES, IT DOES NOT PAY ANY COMPENSATION TO ANY KEY EMPLOYEES. ALL COMPENSATION PAID TO OFFICERS, DIRECTORS AND FORMER OFFICERS OR DIRECTORS WAS PAID BY RELATED ORGANIZATIONS. THE EXECUTIVE COMMITTEE OF THE WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER BOARD IS (THROUGH AUTHORITY DELEGATED TO IT BY WAKE FOREST UNIVERSITY HEALTH SCIENCES - THE PARENT ORGANIZATION OF THE FILING ORGANIZATION) RESPONSIBLE FOR REVIEWING AND APPROVING MOST OFFICERS' COMPENSATION. THE COMMITTEE UTILIZES INDEPENDENT COMPENSATION CONSULTANTS, COMPENSATION SURVEYS, AND STUDIES TO DETERMINE THE APPROPRIATENESS OF EACH SUCH OFFICER'S COMPENSATION.FORM 990, PART VI, SECTION B, LINE 15
THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST AND ARE AVAILABLE ON THE WEBSITE OF THE NORTH CAROLINA SECRETARY OF STATE. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES, AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE.FORM 990, PART VI, SECTION C, LINE 19
THE FOLLOWING PERSONS WERE COMPENSATED DIRECTLY BY WAKE FOREST UNIVERSITY HEALTH SCIENCES, THE FILING ORGANIZATION, WAKE FOREST UNIVERSITY, A RELATED (SUPPORTED) ORGANIZATION OF THE FILING ORGANIZATION, OTHER ORGANIZATIONS RELATED TO WAKE FOREST UNIVERSITY, OR NORTH CAROLINA BAPTIST HOSPITAL, AN UNRELATED ORGANIZATION, FOR SERVICES PERFORMED FOR THE FILING ORGANIZATION. EACH PERSON'S POSITION IN EACH ORGANIZATION, AND THE AVERAGE HOURS PER WEEK THAT THEY DEVOTE TO EACH ENTITY, ARE SHOWN BELOW. J. REID MORGAN DIRECTOR, SECRETARY, FILING ORGANIZATION _0.5_ HOURS PER WEEK DIRECTOR, SECRETARY, PTRP _7_ HOURS PER WEEK SECRETARY AND GENERAL COUNSEL, WAKE FOREST UNIV _20_ HOURS PER WEEK SECRETARY, WFU FOUNDATION _.2_ HOURS PER WEEK SECRETARY, WFU DEVELOPMENT FOUNDATION _.3_ HOURS PER WEEK SECRETARY AND GENERAL COUNSEL, WFU HEALTH SCIENCES _5_ HOURS PER WEEK ASSISTANT SECRETARY, WFU BAPTIST MEDICAL CENTER _6_ HOURS PER WEEK DIRECTOR, SECRETARY, PTRP DEVELOPMENT CORPORATION _.6_ HOURS PER WEEK SECRETARY, IDEALLIANCE _.2_ HOURS PER WEEK SECRETARY, IDEALLIANCE FOUNDATION _.2_ HOURS PER WEEK DONNA HAMILTON ASSISTANT SECRETARY, FILING ORGANIZATION _1_ HOUR PER WEEK WILLIAM B. APPLEGATE, M.D. DIRECTOR/CHAIR, PRESIDENT, FILING ORGANIZATION _4.5_ HOURS PER WEEK PRESIDENT, DIRECTOR, WFU HEALTH SCIENCES _30_ HOURS PER WEEK DIRECTOR AND OFFICER, PTRP DEVELOPMENT CORPORATION _1_ HOUR PER WEEK OFFICER, IDEALLIANCE _.2_ HOURS PER WEEK OFFICER, IDEALLIANCE FOUNDATION _.2_ HOURS PER WEEK TRUSTEE, THE MEDICAL FOUNDATION _.1 _ HOURS PER WEEK PRES, DIALYSIS ACCESS GP OF WAKE FOREST UNIV, LLC _1_ HOUR PER WEEK OFFICER, PTRP _3_ HOURS PER WEEK DOUGLAS L. EDGETON DIRECTOR, VP/TREASURER, FILING ORGANIZATION _3.5_ HOURS PER WEEK EXECUTIVE VICE PRESIDENT, WFU HEALTH SCIENCES _15_ HOURS PER WEEK DIRECTOR, PRESIDENT, PTRP DEVELOPMENT CORPORATION _5_ HOURS PER WEEK DIRECTOR, PRESIDENT, IDEALLIANCE _.2_ HOURS PER WEEK DIRECTOR, PRESIDENT, IDEALLIANCE FOUNDATION _.2_ HOURS PER WEEK TRUSTEE, SECRETARY, TREASURER, THE MEDICAL FDTN _.1_ HOURS PER WEEK VICE PRESIDENT/TREASURER, DIALYSIS ACCESS GROUP OF WAKE FOREST UNIVERSITY, LLC _1_ HOUR PER WEEK PRESIDENT, PTRP _10_ HOURS PER WEEK EXECUTIVE VICE PRESIDENT, WFU BAPTIST MEDICAL CTR _5_ HOURS PER WEEK TERRY L. HALES, JR. DIRECTOR/ASSISTANT TREASURER, FILING ORGANIZATION _3_ HOURS PER WEEK VICE PRESIDENT, TREASURER, PTRP _6_ HOURS PER WEEK ASSISTANT TREAS, WAKE FOREST UNIV HEALTH SCIENC _27_ HOURS PER WEEK TREASURER, PTRP DEVELOPMENT CORPORATION _2.5_ HOURS PER WEEK DIRECTOR, TREASURER, IDEALLIANCE _.2_ HOURS PER WEEK DIRECTOR, TREASURER, IDEALLIANCE FOUNDATION _.2_ HOURS PER WEEK ASSIST TREAS, DIALYSIS ACCESS GP OF WAKE FOREST UNIVERSITY, LLC _1.1_ HOURS PER WEEK DIRECTOR, DAVIDSON HEALTHCARE INC. _3_ HOURS PER WEEK DIRECTOR, LEXINGTON MEMORIAL HOSPITAL _3_ HOURS PER WEEK JOHN D. MCCONNELL, M.D. DIRECTOR/CHAIR, PRESIDENT, FILING ORGANIZATION _.5_ HOURS PER WEEK DIRECTOR, PTRP _1_ HOUR PER WEEK DIRECTOR, CEO WFU HEALTH SCIENCES _11_ HOURS PER WEEK CEO, WFU BAPTIST MEDICAL CENTER _5_ HOURS PER WEEK DIRECTOR/CEO, NC BAPTIST HOSPITAL _20.6_ HOURS PER WEEK DIRECTOR, PTRP DEVELOPMENT CORPORATION _1_ HOUR PER WEEK DIRECTOR, IDEALLIANCE _.2_ HOURS PER WEEK DIRECTOR, IDEALLIANCE FOUNDATION _.2_ HOURS PER WEEK PRESIDENT, DIALYSIS ACCESS GP OF WAKE FOREST UNIV, LLC _.5_ HOURS PER WEEK BARRY I FREEDMAN, M.D. DIRECTOR, FILING ORGANIZATION _1_ HOUR PER WEEK _FORM 990, PART VII, SECTION A:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
WAKE FOREST UNIVERSITY
PO BOX 7201WINSTON SALEMNC27109561532138PRIVATE, COED. INST. OF HIGHER ED.NC501(C)(3)2N/A0
WAKE FOREST UNIVERSITY HEALTH SCIENCES
MEDICAL CENTER BLVDWINSTON SALEMNC27157223849199HEALTH CARE - CLINICAL SVCS, RESEARCH, EDNC501(C)(3)20WAKE FOREST UNIVERSITY
PIEDMONT TRIAD RESEARCH PARK
MEDICAL CENTER BLVDWINSTON SALEMNC27157200177581RESEARCH PARK DEVELOPMENTNC501(C)(3)11A0WAKE FOREST UNIVERSITY HEALTH SCIENCES
PTRP DEVELOPMENT CORPORATION
MEDICAL CENTER BLVDWINSTON SALEMNC27157061818498RESEARCH PARK DEVELOPMENTNC501(C)(3)11A0WAKE FOREST UNIVERSITY HEALTH SCIENCES
IDEALLIANCE
MEDICAL CENTER BLVDWINSTON SALEMNC27157562094067RESEARCH PARK DEVELOPMENTNC501(C)(6)N/A0WAKE FOREST UNIVERSITY HEALTH SCIENCES
IDEALLIANCE FOUNDATION
MEDICAL CENTER BLVDWINSTON SALEMNC27157562094000SUPP. ORG. IDEALLIANCENC501(C)(3)11A0WAKE FOREST UNIVERSITY HEALTH SCIENCES
WFUBMC COMMUNITY PHYSICIANS (CP)
MEDICAL CENTER BLVDWINSTON SALEMNC27157561903275HEALTH CARE - CLINICAL SERVICESNC501(C)(3)170(B)(1)(A)0WAKE FOREST UNIVERSITY HEALTH SCIENCES
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

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