2012-05-15T13:40:27-04:00 2011-06-30 990 2010-07-01 562070036 DUKE UNIVERSITY HEALTH SYSTEM INC DUKE 9196138997 615 DOUGLAS STREET DURHAM NC 27705 KENNETH C MORRIS 2012-03-06 2010 2016-02-24 21:20:13Z VICTOR J DZAU MD 615 DOUGLAS STREET STE 700 DURHAM NC 27705 2609423531 false X WWW.DUKEHEALTH.ORG X 1998 NC DUHS IS COMMITTED TO EXCELLENCE, INNOVATION AND LEADERSHIP IN PROVIDING THE HEALTH CARE NEEDS OF THE PEOPLE WE SERVE, IMPROVING COMMUNITY HEALTH, AND FOSTERING THE VERY BEST MEDICAL EDUCATION. 20 13 16547 2300 0 0 14733592 5769880 2077077285 2181972792 246521983 121177481 50384488 59642402 2388717348 2368562555 5601569 5641045 0 0 1016995699 1030668755 0 0 696773 935397822 1062048680 1957995090 2098358480 430722258 270204075 3155357986 3519120113 1582862863 1472869787 1572495123 2046250326 X DUHS IS COMMITTED TO EXCELLENCE, INNOVATION AND LEADERSHIP IN PROVIDING THE HEALTH CARE NEEDS OF THE PEOPLE WE SERVE, IMPROVING COMMUNITY HEALTH, AND FOSTERING THE VERY BEST MEDICAL EDUCATION. false false 1537777662 5641045 2226773111 HISTORY AND ORGANIZATION IN 1925, JAMES B. DUKE WILLED $4 MILLION TO ESTABLISH DUKE HOSPITAL AND ITS MEDICAL SCHOOL TO IMPROVE HEALTH CARE IN THE CAROLINAS, THEN A POOR REGION LACKING HOSPITALS AND HEALTH CARE PROVIDERS. DUKE UNIVERSITY HOSPITAL HAS GROWN TO BE RECOGNIZED AS ONE OF THE WORLD'S GREAT HEALTH CARE PROVIDERS. IN 1998 AND CONCURRENT WITH ACQUIRING CONTROL OF TWO LOCAL COMMUNITY HOSPITALS, THE DUKE UNIVERSITY BOARD OF TRUSTEES ESTABLISHED DUKE UNIVERSITY HOSPITAL AS THE FLAGSHIP OF THE NEWLY INCORPORATED DUKE UNIVERSITY HEALTH SYSTEM, INC. (DUHS) TO MANAGE A WIDE RANGE OF HEALTH CARE PROGRAMS AT THE SAME HIGH LEVEL OF QUALITY THAT HAS TRADITIONALLY MADE DUKE UNIVERSITY HOSPITAL A WORLD LEADER. THIS NETWORK OF REGIONAL HEALTH CARE ORGANIZATIONS IS DEDICATED TO EMPLOYING DUKE'S STRENGTHS IN PATIENT CARE, EDUCATION, AND RESEARCH TO ENHANCE AND IMPROVE HEALTH CARE THROUGHOUT NORTH CAROLINA AND SOUTHERN VIRGINIA. THE DUHS MISSION IS CLINICAL CARE AND IS ENHANCED BY THE RESEARCH AND EDUCATION MISSIONS OF DUKE UNIVERSITY (THE DUKE UNIVERSITY SCHOOL OF MEDICINE AND SCHOOL OF NURSING). TOGETHER THEY SERVE THE COMMUNITY AS DUKE MEDICINE. MANY PROGRAM SERVICE ACCOMPLISHMENTS ARE INCLUDED IN SCHEDULE H TO THIS FORM INCLUDING THE FINANCIAL COMMITMENT MADE TO THE COMMUNITY BY DUHS IN TERMS OF CHARITY CARE AND OTHER DIRECT AND MEASURABLE INVESTMENTS. BELOW ARE EXCERPTS FROM THE ANNUAL DUHS REPORT ON COMMUNITY BENEFIT. THE COST OF THESE ACTIVITIES CAN BE DIFFICULT TO MEASURE. SOMETIMES THEY INCLUDE THE PARTICIPATION OF DUKE UNIVERSITY SO REFERENCES TO "DUKE" ARE MEANT TO INCLUDE DUHS AND DUKE UNIVERSITY IN THEIR RESPECTIVE MISSION CAPACITIES. SERVING THE COMMUNITY BY PROVIDING OUTSTANDING CARE FOR EVERY PATIENT DUKE UNIVERSITY HEALTH SYSTEM'S PRIMARY COMMITMENT IS PROVIDING EXCELLENT, EFFECTIVE AND COMPASSIONATE HEALTH CARE SERVICES TO OUR PATIENTS. THE PATIENTS AND FAMILIES WE SERVE BENEFIT FROM THE HEALTH SYSTEM'S DIRECT AND IMPORTANT ASSOCIATION WITH DUKE UNIVERSITY SCHOOL OF MEDICINE, WHOSE CLINICAL FACULTY ARE RECOGNIZED LEADERS IN THEIR FIELDS. AS A LEADING ACADEMIC MEDICAL CENTER, DUKE IS UNIQUELY POSITIONED TO TRANSFORM MEDICINE AND HEALTH LOCALLY AND GLOBALLY THROUGH INNOVATIVE SCIENTIFIC RESEARCH, RAPID TRANSLATION OF BREAKTHROUGH DISCOVERIES AND EDUCATING FUTURE CLINICAL AND SCIENTIFIC LEADERS. DUKE IS A STRONG ADVOCATE OF PRACTICING EVIDENCE-BASED MEDICINE AND IS A LEADER IN EFFORTS TO ELIMINATE HEALTH INEQUALITIES. EACH YEAR, THE 15,000 PROFESSIONALS OF DUKE UNIVERSITY HEALTH SYSTEM SERVE PATIENTS THROUGH MORE THAN 60,000 HOSPITAL ADMISSIONS AND 1.9 MILLION OUTPATIENT VISITS. FOR 21 CONSECUTIVE YEARS, DUKE UNIVERSITY HOSPITAL HAS BEEN NAMED AMONG THE TOP 10 IN THE NATION BY U.S. NEWS & WORLD REPORT. IN PRIVATE AND GOVERNMENT SURVEYS, PATIENTS HAVE CONSISTENTLY RATED THEIR SATISFACTION WITH THE CARE PROVIDED AT DUKE CLINICS AND HOSPITALS ABOVE STATE AND NATIONAL AVERAGES. DUKE UNIVERSITY HEALTH SYSTEM IS A WORLD-CLASS PROVIDER OF HEALTH CARE SERVICES BASED IN DURHAM, N.C., BUT WITH AN IMPACT ACROSS NORTH CAROLINA. IT INCLUDES: DUKE UNIVERSITY HOSPITAL A TERTIARY AND QUATERNARY CARE HOSPITAL AND SPECIALTY OUTPATIENT CLINICS, LOCATED ON THE CAMPUS OF DUKE UNIVERSITY MEDICAL CENTER IN DURHAM, N.C., THAT IS CONSISTENTLY RATED AS ONE OF THE NATION'S BEST. DUKE CHILDREN'S HOSPITAL & HEALTH CENTER A PART OF DUKE UNIVERSITY HOSPITAL, DUKE CHILDREN'S IS CONSISTENTLY RANKED AMONG THE TOP PEDIATRIC SPECIALTY PROGRAMS IN THE NATION. DURHAM REGIONAL HOSPITAL A FULL-SERVICE COMMUNITY HOSPITAL IN DURHAM SERVING THE HEALTH CARE NEEDS OF DURHAM, ORANGE, PERSON AND GRANVILLE COUNTIES, AND SURROUNDING COMMUNITIES. DUKE RALEIGH HOSPITAL A COMMUNITY HOSPITAL IN RALEIGH, N.C., THAT PROVIDES AN ARRAY OF MEDICAL CARE SERVICES TO PATIENTS IN WAKE COUNTY. DUKE PRIMARY CARE A NETWORK OF COMMUNITY-BASED PRIMARY CARE PHYSICIANS, PHYSICIAN ASSISTANTS AND NURSE PRACTITIONERS SERVING PATIENTS AT TWO DOZEN LOCATIONS ACROSS EIGHT COUNTIES IN THE GREATER TRIANGLE AREA. DAVIS AMBULATORY SURGICAL CENTER A MULTI-SPECIALTY OUTPATIENT SURGICAL FACILITY IN DURHAM. DUKE HOMECARE & HOSPICE A PROVIDER OF HOSPICE SERVICES IN ORANGE, DURHAM, GRANVILLE, WAKE, PERSON, CHATHAM, ALAMANCE AND VANCE COUNTIES THAT ALSO OFFERS INFUSION SERVICES THROUGHOUT NORTH CAROLINA, SOUTH CAROLINA AND VIRGINIA. PHARMACY SERVICES ARE PROVIDED THROUGHOUT THE UNITED STATES. AFFILIATED PROGRAMS DUKE UNIVERSITY HEALTH SYSTEM MAINTAINS MANY COLLABORATIONS AND AFFILIATIONS WITH HOSPITALS AND HEALTH CARE FACILITIES ACROSS NORTH CAROLINA AND THE SOUTHEAST. AMONG THESE ARE THE DUKE HEART NETWORK AND DUKE ONCOLOGY NETWORK. CHARITY CARE AND SIMILAR COMMUNITY BENEFITS: PEOPLE WITH URGENT AND EMERGENT MEDICAL NEEDS RECEIVE MEDICAL CARE AT DUKE UNIVERSITY HEALTH SYSTEM FACILITIES REGARDLESS OF THEIR ABILITY TO PAY. IN THE FISCAL YEAR THAT ENDED JUNE 30, 2011, DUKE PROVIDED CHARITY CARE AT COST VALUED AT $65 MILLION TO PATIENTS FROM EVERY NORTH CAROLINA COUNTY. IN ADDITION TO PROVIDING PRIMARY CARE AT NO CHARGE, DUKE PHYSICIANS DONATE SPECIALTY CARE SERVICES TO ELIGIBLE UNINSURED PATIENTS THROUGH A PROGRAM CALLED PROJECT ACCESS. WE WORK WITH PATIENTS TO ACCESS THE BENEFITS TO WHICH THEY ARE ENTITLED. AND, WHEN GOVERNMENT PROGRAMS DON'T COMPLETELY COVER THE COST OF CARE, DUKE MAKES UP THE DIFFERENCE. DUKE ALSO WORKS TO CONTROL MEDICAID COSTS THROUGH ITS LEADERSHIP ROLE IN THE COMMUNITY CARE OF NORTH CAROLINA (CCNC) PROGRAM, WHICH IMPROVES THE CARE OF MORE THAN A MILLION PATIENTS WHILE REDUCING UNNECESSARY HOSPITAL AND EMERGENCY DEPARTMENT VISITS. BETWEEN 2006 AND 2010, CCNC, NOW A NATIONAL MODEL, SAVED STATE TAXPAYERS NEARLY $1 BILLION. BY THE NUMBERS " $65 MILLION - CHARITY CARE AT COST " $89 MILLION - UNREIMBURSED MEDICAID COSTS COVERED BY DUKE " $90 MILLION - UNREIMBURSED MEDICARE COSTS COVERED BY DUKE " $23 MILLION - UNRECOVERABLE PATIENT DEBT " 300,077 -- VISITS TO DUKE FROM PATIENTS WITH MEDICAID BENEFITS AID TO COMMUNITY GROUPS DUKE CONTINUES TO BUILD ON ITS LONGSTANDING PARTNERSHIPS WITH COMMUNITY GROUPS TO COLLABORATIVELY IDENTIFY AND ELIMINATE HEALTH DISPARITIES AND REMOVE OBSTACLES TO ACCESSING MEDICAL CARE. IN 2011, DUKE PROVIDED $3 MILLION IN DIRECT SUPPORT AND $4 MILLION IN IN-KIND SUPPORT FOR LINCOLN COMMUNITY HEALTH CENTER AND ITS SATELLITE COMMUNITY AND SCHOOL CLINICS, WHICH SERVE AN OVERWHELMINGLY POOR, UNINSURED PATIENT POPULATION IN DURHAM. DUKE ALSO PROVIDED $2 MILLION FOR DURHAM COUNTY'S EMERGENCY MEDICAL SERVICES OPERATION. DUKE RALEIGH HOSPITAL PROVIDED IN-KIND LAB SERVICES OF MORE THAN $1.5 MILLION IN VALUE IN 2011 TO THE OPEN DOOR CLINIC, WHICH PROVIDES NO-COST COMPREHENSIVE CARE TO UNINSURED AND INDIGENT PEOPLE IN WAKE COUNTY. BY THE NUMBERS " $10 MILLION -AID TO COMMUNITY GROUPS " 40,670 - LINCOLN COMMUNITY HEALTH CENTER (LCHC) PATIENTS " 86.6 - PERCENTAGE OF LCHC PATIENTS BELOW THE FEDERAL POVERTY LEVEL " $1.5 MILLION - VALUE OF IN-KIND LAB SERVICES PROVIDED BY DUKE RALEIGH HOSPITAL TO THE OPEN DOOR CLINIC COMMUNITY HEALTH OVER MANY YEARS, DUKE AND COMMUNITY LEADERS HAVE FORGED A CLOSE, COLLABORATIVE PARTNERSHIP TO IMPROVE THE HEALTH AND ACCESS TO HEALTH CARE OF ALL DURHAM COUNTY RESIDENTS. AN EXCELLENT EXAMPLE OF THAT VIBRANT PARTNERSHIP IS DURHAM HEALTH INNOVATIONS (DHI), WHICH IS DEVELOPING NEW WAYS TO REDUCE DEATH AND DISABILITY FROM SPECIFIC DISEASES AND DISORDERS IN THE COMMUNITY. DDC INTEGRATES INNOVATIVE APPROACHES TO COMMUNITY HEALTH, SUCH AS USE OF GEOSPATIAL TECHNOLOGY TO TRACK DISEASE, WITH TRADITIONAL GRASSROOTS, NEIGHBORHOOD-BASED EFFORTS. BY THE NUMBERS: " $6.2 MILLION - AMOUNT OF FIVE-YEAR GRANT SUPPORTING THE DURHAM DIABETES COALITION EFFORT " 12 - PERCENTAGE OF PEOPLE IN DURHAM COUNTY BELIEVED TO HAVE DIABETES " 26 MILLION - NUMBER OF AMERICANS AFFECTED BY DIABETES HEALTH PROFESSIONS EDUCATION AT THE CORE OF DUKE'S MISSION IS IMPROVING HEALTH CARE FOR PATIENTS AND COMMUNITIES BY TRAINING DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS FOR TOMORROW'S INCREASINGLY COMMUNITY-FOCUSED HEALTH CARE DELIVERY SYSTEM. THE TRAINING RECOGNIZES THAT CARE WILL BE DELIVERED IN AN EMERGING VARIETY OF NON-TRADITIONAL SETTINGS USING INNOVATIVE MODELS OF CARE. DUKE'S LEARNING TOGETHER PROGRAM IS AN EXAMPLE OF HOW HEALTH PROFESSIONS STUDENTS DEVELOP THOSE SKILLS BY TEACHING HEALTH AND WELLNESS PRACTICES TO DIVERSE COMMUNITY POPULATIONS, INCLUDING ELEMENTARY SCHOOL CHILDREN AND THE ELDERLY. IN DOING SO, THE LEARNERS GAIN SKILLS THEY CAN USE AS HEALTH PROFESSIONALS TO WORK EFFECTIVELY IN ANY COMMUNITY. BY THE NUMBERS: " $47 MILLION - INVESTMENT IN HEALTH PROFESSIONS EDUCATION " 15 - LEARNING TOGETHER PROJECTS, INCLUDING: " 1,224 - COMMUNITY CHILDREN SERVED " 239 - COMMUNITY ADULTS SERVED 1537777662 true true false true false false false false true true true false false true false false true false false true false false false true false true true true true true true false false false false false false false true true true true true false false true true true true false false true X 343 0 true 16547 true false true BD false false false true true false false false false X 20 13 true false false false false true true true true false false true true true true true true true true true false AK AZ FL GA HI IL KS KY MD MA MI MN MS NH NJ NY NC OH OK OR PA SC TN UT WI X X MIKE LAZAR 9196138997 DUKE UNIV HEALTH SYSTEM DURHAM NC 27705 X NANCY C ANDREWS MD 1.0 X 0 679311 45100 THE HONORABLE DANIEL T BLUE JR 1.0 X 0 0 0 JACK O BOVENDER JR 1.0 X 0 0 0 MARK BRANCH III MD 1.0 X 0 20000 1780 RICHARD H BRODHEAD 10.0 X 0 776073 191410 VICTOR J DZAU MD 40.0 X X 0 2037221 759796 FRANK E EMORY JR 1.0 X 0 0 0 JAMES F GOODMON 1.0 X 0 0 0 THOMAS M GORRIE 1.0 X 0 0 0 REV KENNETH R HAMMOND 1.0 X 0 0 0 DANNY O JACOBS MD 1.0 X 0 344165 44706 REBECCA TRENT KIRKLAND MD 1.0 X 0 0 0 RICHARD D KLAUSNER MD 1.0 X 0 0 0 HENRY C KNIGHT 1.0 X 0 0 0 JOHN H MCARTHUR 1.0 X 0 0 0 LLOYD B MORGAN 1.0 X 0 0 0 CARL E RAVIN MD 12.0 X 0 273090 39574 STEVEN SCOTT MD 1.0 X 0 0 0 SUSAN M STALNECKER 1.0 X 0 0 0 PETER VAN ETTEN 1.0 X 0 0 0 MONTE D BROWN MD 50.0 X 516360 0 50678 WILLIAM J FULKERSON JR MD 60.0 X 1052828 0 34090 KENNETH C MORRIS 60.0 X 883074 0 36870 ASIF AHMAD 40.0 X 589928 0 39290 MARY ANN FUCHS 40.0 X 321849 0 34557 PAUL R NEWMAN 0.0 X 0 315687 60633 KEVIN W SOWERS 60.0 X 621977 0 36615 DOUGLAS B VINSEL 60.0 X 570032 0 46312 KERRY R WATSON 40.0 X 432548 0 64169 MARC CALABRESE 40.0 X 355936 0 47171 JOHN M KELSCH 40.0 X 395043 0 43567 MOLLY K ONEILL 40.0 X 554851 0 38430 THOMAS A OWENS 40.0 X 350845 0 41164 JOSEPH G TAYLOR 40.0 X 395477 0 47417 HARVEY JAY COHEN MD 0.0 X 0 403839 39574 KIMBERLY J JENKINS 0.0 X 0 37500 4565 FRANCES D MAUNEY 0.0 X 0 127125 20435 R SANDERS WILLIAMS MD 0.0 X 0 245568 30821 MICHAEL S CUFFE MD 27.0 X 514026 0 38720 MARK D GUSTAFSON 0.0 X 0 273697 42448 7554774 5533276 1879892 902 true true false BEK BUILDING GROUP INC 5400 TRINITY ROAD STE 303 RALEIGH NC 27607 CONSTRUCTION SERVICE 58653963 PRIVATE DIAGNOSTIC CLINIC PLLC DUMC 3810 DURHAM NC 27710 PHYSICIAN SERVICES 31608788 ARAMARK HEALTHCARE SUPPORT SERVICES PO BOX 651009 CHARLOTTE NC 282651009 HEALTHCARE SERVICES 10372990 SKANSKA USA PO BOX 2860 DURHAM NC 27715 CONSTRUCTION SERVICE 5734272 PERKINS WILL INC 1382 PEACHTREE ST NE ATLANTA GA 30309 ARCHITECT SERVICES 5714093 216 106688 16575 577536 5069081 124692 5769880 PATIENT REVENUE 621990 2158359530 2158359530 MEDICAL SERVICES 621990 2511449 2511449 ANCILLARY MEDICAL 621990 21101813 21101813 SERVICES 2181972792 13857767 13857767 1217357 1217357 3156895 3156895 15996994 15041637 955357 955357 955357 331220664 622471 219585571 6155207 111635093 -5532736 106102357 106102357 64389 106688 78561 -14172 -14172 0 0 BILLING FEES 621990 37657383 37657383 TUITION REVENUE 900099 2024670 2024670 DEEMED DIVIDEND REVENUE 900003 6667089 6667089 9195180 5118266 4076914 55544322 2368562555 2226773111 136019564 5612270 5612270 28775 28775 0 0 5106194 166589 4846803 92802 651538 27032 624506 822087819 578713528 243374291 32346568 20017544 12322559 6465 114984120 78096631 36874791 12698 55492516 38319452 17166759 6305 12192089 12192089 1139896 149213 990683 503045 503045 0 0 3405653 3405653 126429567 75286529 51143038 4782933 1128414 3654519 503134773 488229165 14882866 22742 26824839 3671370 23153469 0 45146466 29614076 15532383 7 6255991 4372994 1880411 2586 0 2892090 266840 2623674 1576 31975001 31975001 46124561 45574561 550000 87907593 67327905 20579688 12345226 6625222 5720004 EQUIPMENT RENTAL & MAINTENANCE 67246889 45747671 21498413 805 BAD DEBT 71709911 71709911 LAUNDRY 7886244 7803874 82370 SHARED EXPENSES 558408 558408 DUES & MEMBERSHIPS 2392243 917085 1474558 600 1195262 1195075 187 2098358480 1537777662 559884045 696773 47438 49068 353242558 356503510 18523454 18030089 304383857 305877825 12811035 1394532 60992338 62751534 8985829 8806735 1954787798 977092339 877076034 977695459 47957035 2920163 1431838245 1680758563 644069 644069 38856094 103688566 3155357986 3519120113 260374010 283599625 3905029 2930320 844462095 830779105 474121729 355560737 1582862863 1472869787 X 1516863658 1992550258 44864766 44049489 10766699 9650579 1572495123 2046250326 3155357986 3519120113 X 270204075 203551128 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 false false false true false false false false true 199426 false true 119955 319381 false false MEMBERSHIP DUES SCHEDULE C, PART II-B, LINE 1i DUKE UNIVERSITY HEALTH SYSTEM, INC. PAYS MEMBERSHIP DUES TO OTHER ORGANIZATIONS. PER THE MEMBERSHIP DUES INVOICES, SOME OF THESE ORGANIZATIONS PROVIDE A DISCLOSURE OF LOBBYING PERCENTAGE OF THE DUES RECEIVED. 55631465 5340437 3639795 0 -10911629 0 53700068 44124232 14138555 2461764 0 -5093086 0 55631465 52120961 5465898 -6187893 0 -7274733 0 44124233 0.00000 0.18000 0.82000 false true true 27482986 27482986 1256338942 476940757 779398185 441659757 314983179 126676578 229306113 185168403 44137710 977695459 POOLED INVESTMENTS 563376000 F DOMESTIC BONDS & LT NOTES 84696000 F DOMESTIC STOCKS 75750000 F INTERNATIONAL BONDS & LT NOTES 72913000 F INTERNATIONAL STOCKS 352547000 F HEDGED STRATEGIES 311927000 F SHORT-TERM INVESTMENTS 180254000 F PRIVATE CAPITAL 23343000 F REAL ESTATE 4776000 F OTHER INVESTMENTS 11176563 F 1680758563 0 INTEREST PAYABLE 10858433 PROFESSIONAL LIABILITY COSTS 8612481 POST RETIREMENT BENEFIT OBLIGATION 78733000 CAPITAL LEASE OBLIGATION 128116366 DERIVATIVE INSTRUMENTS 82698372 OTHER NON-CURRENT LIABILITIES 42241583 INTERCOMPANY PAYABLE 4300502 355560737 ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 4 THE INTENDED USE FOR THE ORGANIZATION'S ENDOWMENT FUNDS IS SUPPORTING CAPITAL PURCHASES, OFFSETTING OPERATING COSTS, IMPROVING PATIENT SAFETY, AND SUPPORTING THE NEEDS OF PATIENTS AND FAMILIES. LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 SCHEDULE D, PART X DUHS ADOPTED THE REQUIREMENTS OF FIN 48 AND CONSIDERED ITS TAX POSITIONS. BASED ON THAT ANALYSIS, THE PROVISIONS OF FIN 48 ARE DEEMED IMMATERIAL TO THE DUHS FINANCIAL STATEMENTS AND THEREFORE NO FIN 48 SPECIFIC DISCLOSURES ARE MADE IN THE AUDITED FINANCIAL STATEMENTS OF DUHS, INC. AND ITS AFFILIATES FOR FISCAL YEAR ENDED JUNE 30, 2011. 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HEALTHY WEIGHT LOSS TREATMENT CENTER DUKE INTEGRATIVE MEDICINE

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CLINICAL AND THERAPEUTIC SERVICES CENTER PART I, LINE 3C NOT APPLICABLE PART I, LINE 6A NOT APPLICABLE PART I, LINE 7G NOT APPLICABLE PART I, LINE 7, COLUMN F BAD DEBT EXPENSE EXCLUDED FROM DETERMINING THE PERCENT IS $71,709,910. TOTAL GROSS COMMUNITY BENEFIT EXPENSE AS A PERCENT OF TOTAL EXPENSES IS 11.05%. PART I, LINE 7 CHARITY CARE AT COST IS DETERMINED USING THE COST-TO-CHARGE CALCULATION FROM WORKSHEET 2. UNREIMBURSED MEDICAID IS DETERMINED USING A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS. COMMUNITY BUILDING ACTIVITIES PART II THESE ACTIVITIES ARE INCLUDED IN DUKE UNIVERSITY HEALTH SYSTEM, INC.'S OPERATING EXPENSES AND ARE NOT TRACKED SEPARATELY FOR COMMUNITY BENEFIT REPORTING PURPOSES. PART III, LINE 4 BAD DEBT AT COST IS DETERMINED USING THE COST-TO-CHARGE RATIO CALCULATION FROM WORKSHEET 2. TEXT FROM FOOTNOTES - FOOTNOTE 3 NET PATIENT SERVICE REVENUE AND ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS: THE ALLOWANCE FOR BAD DEBTS IS THE HEALTH SYSTEM'S BEST ESTIMATE OF THE AMOUNT OF CREDIT LOSSES IN THE HEALTH SYSTEM'S PATIENT ACCOUNTS RECEIVABLE. FACTORS THAT DETERMINE THE ALLOWANCE ARE BASED PRIMARILY ON HISTORICAL COLLECTIONS AND WRITE-OFFS ADJUSTED FOR PRICE CHANGES, AGING, INSURANCE STATUS, AND OTHER MANAGEMENT ANALYSIS. FOOTNOTE 5 CHARITY CARE AND OTHER COMMUNITY BENEFITS: THE HEALTH SYSTEM PROVIDES ADDITIONAL UNCOMPENSATED CARE IN THE FORM OF BAD DEBTS. ESTIMATED UNCOMPENSATED COSTS ASSOCIATED WITH BAD DEBT ACCOUNTS WERE $23,011,000 AND $11,991,000 FOR JUNE 30, 2011 AND 2010, RESPECTIVELY. PART III, LINE 7 TOTAL UNREIMBURSED COSTS ATTRIBUTABLE TO PROVIDING SERVICES UNDER MEDICARE AS REPORTED IN THE JUNE 30, 2011 DUHS CONSOLIDATED FINANCIAL STATEMENTS ARE $90,320,000 AS COMPARED TO $67,560,444 AS REPORTED IN SECTION B, LINE 7 OF SCHEDULE H. THE DUHS TOTAL MEDICARE SHORTFALL OF $90,320,000 IS DERIVED FROM THE COST ACCOUNTING SYSTEM WHICH INCLUDES ALL PAYMENTS AND COSTS ASSOCIATED WITH MEDICARE PATIENTS, WHEREAS THE $67,560,444 REPORTED IN SECTION B OF SCHEDULE H IS DERIVED BASED ON IRS INSTRUCTIONS. IRS INSTRUCTIONS SPECIFY THAT ONLY A PORTION OF COSTS ASSOCIATED WITH MEDICARE BENEFICIARIES BE REPORTED ON SCHEDULE H. SIGNIFICANT MEDICARE COSTS EXCLUDED FROM SCHEDULE H DATA INCLUDE THOSE ASSOCIATED WITH MEDICARE PATIENTS COVERED UNDER MANAGED CARE PLANS AND COSTS REIMBURSED THROUGH MEANS NOT REPORTED ON THE COST REPORT. PART III, LINE 8 MEDICARE RATES AND THE NUMBER OF MEDICARE PATIENTS DUHS TREATS ARE NOT NEGOTIATED. MEDICARE DOES NOT FULLY COMPENSATE DUHS FOR THE COST OF PROVIDING CARE TO MEDICARE BENEFICIARIES. DUHS CONTINUES TO SERVE THE MEDICARE POPULATION AS MEDICARE REIMBURSEMENT RATES DECLINE RELATIVE TO THE COST OF CARE. THEREFORE, ANY LOSS RELATED TO PROVIDING CARE FOR MEDICARE PATIENTS SHOULD BE CLASSIFIED AS A COMMUNITY BENEFIT. DUHS FOLLOWED THE MEDICARE COST REPORT RULES AND GUIDELINES IN DETERMINING THE COSTS REPORTED ON LINE 6. THESE RULES USE A VARIETY OF DIFFERENT METHODOLOGIES BASED ON THE TYPE OF SERVICE. PART III, LINE 9B DUKE UNIVERSITY HEALTH SYSTEM'S COLLECTION POLICY (BAD DEBT AND AGENCY PLACEMENT POLICY) ADDRESSES, ONLY BY REFERENCE, COLLECTIONS PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. WITHIN THE BODY OF THE POLICY, THE DUKE UNIVERSITY HEALTH SYSTEM'S CHARITY CARE POLICY IS REFERENCED AS THE GUIDING POLICY FOR PATIENTS WHO FALL INTO ONE OF THESE CATEGORIES. PART V, LINE 13G DUHS ALSO PUBLICIZED ITS FINANCIAL ASSISTANCE POLICY VERBALLY BY OUR FINANCIAL CARE COUNSELORS. PART V, LINE 21 CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER SERVICES NOT TYPICALLY COVERED BY INSURANCE, WILL BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES. NEEDS ASSESSMENT PART VI, LINE 2 DUHS USES SEVERAL MECHANISMS TO ASSESS AND ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. IN DURHAM COUNTY, DUHS AND THE DUKE UNIVERSITY SCHOOL OF MEDICINE FACULTY ARE ACTIVELY INVOLVED IN THE PARTNERSHIP FOR A HEALTHY DURHAM, A COALITION OF LOCAL ORGANIZATIONS AND COMMUNITY MEMBERS WITH THE GOAL OF COLLABORATELY IMPROVING THE PHYSICAL, MENTAL, SOCIAL, HEALTH, AND WELL-BEING OF DURHAM COUNTY'S RESIDENTS. THE PARTNERSHIP IS A CERTIFIED HEALTH CAROLINIANS WORKGROUP. THE PARTNERSHIP EVALUATES COMMUNITY HEALTH CARE INFORMATION, THEN IDENTIFIES AND PRIORITIZES COMMUNITY-IDENTIFIED HEALTH CARE NEEDS AMONG SEVEN SUBCOMMITTEES THAT EACH FOCUS ON A DURHAM COUNTY HEALTH PRIORITY: MENTAL HEALTH AND SUBSTANCE ABUSE, ACCESS TO CARE, OBESITY AND CHRONIC ILLNESS, POVERTY, HIV/STI'S, AND EDUCATION. DUHS' OFFICE OF COMMUNITY RELATIONS HAS PLAYED A CENTRAL ROLE IN CONDUCTING A DURHAM HEALTH SUMMIT SINCE 2002, AN ANNUAL EVENT THAT ATTRACTS HUNDREDS OF COMMUNITY MEMBERS, HEALTH OFFICIALS, ELECTED OFFICIALS, AND DUHS EXECUTIVES AND PHYSICIANS TO RAISE AWARENESS OF KEY HEALTH ISSUES IN THE COMMUNITY AND SEEK COLLABORATIVE SOLUTIONS TO THESE ISSUES. THE SUMMIT HAS PRODUCED A NUMBER OF COMMUNITY-DRIVEN HEALTH CARE PROGRAMS AND INITIATIVES, INCLUDING MOST RECENTLY SPECIALTY PROJECT ACCESS, IN WHICH PHYSICIANS WHO PRACTICE AT DUHS FACILITIES AND OTHER DURHAM COUNTY PHYSICIANS OFFER FREE SPECIALTY CARE SERVICES TO RESIDENTS WHO OTHERWISE COULD NOT AFFORD IT. DUHS ALSO PLAYS A CENTRAL ROLE IN REGIONAL AND STATE HEALTH CARE SUMMITS USING THE SUMMITS' INFORMATION AND DATA TO ADDRESS THE HEALTH CARE NEEDS OF THOSE BROADER COMMUNITIES. DUHS ALSO USES DATA FROM THE ANNUAL DURHAM STATE OF THE COUNTY HEALTH REPORT AND THE DURHAM COUNTY HEALTH ASSESSMENT (SEE WWW.HEALTHYDURHAM.ORG) CONDUCTED EVERY 4 YEARS TO ENSURE DUHS IS ADDRESSING IMPORTANT HEALTH CARE ISSUES IDENTIFIED BY THE COMMUNITY. IN WAKE COUNTY, DUHS CONDUCTS A STUDY OF PRIMARY CARE INTAKES. DUKE RALEIGH HOSPITAL WORKED CLOSELY WITH THE WAKE COUNTY HUMAN SERVICES AGENCIES AND OTHER COMMUNITY STAKEHOLDERS ON THE 2010 WAKE COUNTY COMMUNITY HEALTH ASSESSMENT. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3 DUHS EMPLOYS NUMEROUS MEANS TO EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE DUHS CHARITY CARE POLICY. DETAILED INFORMATION IS POSTED ON DUKEHEALTH.ORG (DUHS' WEBSITE) ALONG WITH HARDCOPY BROCHURES THAT ARE AVAILABLE IN ENGLISH OR SPANISH AT ALL OF OUR PATIENT REGISTRATION LOCATIONS. ALL INPATIENTS AND EMERGENCY DEPARTMENT PATIENTS ARE ALSO PROVIDED WITH A HARDCOPY, ONE-PAGE SUMMARY OF THE WAYS DUHS CAN ASSIST PATIENTS FINANCIALLY. FOR OUTPATIENTS, THIS SAME ONE-PAGE SUMMARY IS PROVIDED ON THEIR FIRST VISIT TO THE INSTITUTION. IN ADDITION, DUHS EMPLOYS FINANCIAL CARE COUNSELORS WHO MEET INDIVIDUALLY WITH PATIENTS WHO HAVE QUESTIONS REGARDING PAYMENT FOR THEIR CARE. DUHS ALSO EMPLOYS MEDICAID ASSISTANCE COUNSELORS WHO SPECIALIZE IN ASSISTING PATIENTS TO APPLY FOR MEDICAID, DISABILITY, AND OTHER FEDERAL, STATE, AND LOCAL PROGRAMS. DUHS ASSISTS BETWEEN 12,000-15,000 PATIENTS APPLY AND BECOME ELIGIBLE FOR THESE PROGRAMS ANNUALLY. FINALLY, PATIENTS MAY ALWAYS CONTACT DUHS' TOLL FREE CUSTOMER SERVICE NUMBER TO REQUEST INFORMATION ABOUT THEIR BILL OR OBTAIN A CHARITY CARE APPLICATION. COMMUNITY INFORMATION PART VI, LINE 4 DUHS SERVES A BROAD, CULTURALLY, RACIALLY AND SOCIALLY DIVERSE GEOGRAPHIC AND DEMOGRAPHIC REGION. DUHS' HOME CITY OF DURHAM IS THE CORE, BUT DUHS' REACH EXTENDS INTO THE SURROUNDING RESEARCH TRIANGLE AREA OF NORTH CAROLINA AND THE STATE'S LARGER NORTHERN PIEDMONT REGION, AS WELL AS STATEWIDE, NATIONALLY AND GLOBALLY. DURHAM, WAKE AND ORANGE COUNTIES - WHICH FORM THE TRIANGLE - REPRESENT ABOUT TWO-THIRDS OF INPATIENT DISCHARGES FROM DUHS FACILITIES. DUHS' SECONDARY SERVICE AREA COVERS 21 COUNTIES IN NORTH CAROLINA AND SOUTHERN VIRGINIA WITH A POPULATION OVER 2 MILLION. PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 DUHS PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH A NUMBER OF COMMUNITY BUILDING ACTIVITIES. CENTRAL TO MANY OF THE EFFORTS IS DUHS' OFFICE OF COMMUNITY RELATIONS, WHOSE ASSOCIATE VICE PRESIDENT REPORTS DIRECTLY TO DUHS' CEO AND SERVES AS A FULL-TIME LIAISON WITH THE DURHAM COMMUNITY. THE OFFICE SPONSORS AND FACILITATES COMMUNITY EVENTS - SUCH AS THE ANNUAL DURHAM HEALTH SUMMIT AND SIMILAR REGIONAL AND STATE HEALTH SUMMITS -- THAT RAISE AWARENESS OF COMMUNITY HEALTH NEEDS, PROMOTE PREVENTION AND WELLNESS, AND CHART A COURSE FOR SOLVING HEALTH ISSUES AND DISPARITIES. IN ADDITION, THE OFFICE PROVIDES A POINT OF DIRECT CONTACT FOR COMMUNITY MEMBERS WHO HAVE QUESTIONS OR CONCERNS ABOUT COMMUNITY ISSUES OR ABOUT ACCESS TO HEALTH CARE SERVICES. THE OFFICE ALSO PROVIDES DIRECT FINANCIAL SUPPORT TO A VARIETY OF COMMUNITY GROUPS THROUGH THE CHARITABLE GRANTS AND GOODWILL GRANTS PROGRAM. THE ASSOCIATE VICE-PRESIDENT AND STAFF SERVE ON A NUMBER OF HEALTH CARE-RELATED COMMUNITY BOARDS AND HEALTH-RELATED COMMITTEES. STAFF FROM THE OFFICE OF COMMUNITY RELATIONS AND MEMBERS OF THE DUHS COMMUNITY HEALTH PLANNING GROUP CREATED A FORMAL PRINCIPLES OF COMMUNITY ENGAGEMENT POLICY THAT COMMITS DUHS AND ITS COMMUNITY PARTNERS TO DEVELOPING PROPOSED PROJECTS AND INITIATIVES ON TRUST, RESPECT, DIVERSITY, SAFETY AND COMMUNITY-IDENTIFIED NEEDS. THESE PRINCIPLES HAVE BEEN INCORPORATED INTO COMMUNITY-BASED HEALTH CARE PROJECTS SUCH AS THE DEVELOPMENT OF THE HOLTON WELLNESS CENTER AND DURHAM HEALTH INNOVATIONS, A MULTIDISCIPLINARY COMMUNITY BASED PARTNERSHIP BETWEEN DUKE RESEARCHERS AND MEMBERS OF THE DUKE COMMUNITY THAT FOCUSES ON IMPROVING HEALTH OUTCOMES THROUGH NEW AND CREATIVE APPROACHES TO HEALTH CARE DELIVERY. IN ADDITION TO COMMUNITY BUILDING ACTIVITIES, DUHS PROMOTES THE HEALTH OF ITS COMMUNITIES IN A NUMBER OF IMPORTANT WAYS. ONE OF DUHS' THREE CONSTITUENT HOSPITALS, DURHAM REGIONAL, HAS AN OPEN MEDICAL STAFF AND A COMMUNITY ADVISORY BOARD. DUHS ALSO HAS A COMMUNITY HEALTH PLANNING GROUP, ESTABLISHED BY THE CEO, WHOSE MISSION IS TO DEVELOP A PLAN TO COORDINATE RESOURCES WITHIN DUKE AND IN THE COMMUNITY TO IMPROVE HEALTH OUTCOMES IN DURHAM. KEY COMMUNITY PARTNERS INCLUDE THE DURHAM COUNTY HEALTH DEPARTMENT, LINCOLN COMMUNITY HEALTH CENTER AND THE DURHAM CENTER (LOCAL MENTAL HEALTH MANAGEMENT ENTITY). THE ASSOCIATE VICE-PRESIDENT OF DUHS' OFFICE OF COMMUNITY RELATIONS SERVES AS CHAIR. DUHS' CEO ALSO HAS A CHANCELLOR'S COMMUNITY HEALTH ADVISORY BOARD TO PROVIDE FEEDBACK ON A VARIETY OF ISSUES, INCLUDING USE OF DUHS RESOURCES, HEALTH SERVICE DELIVERY SYSTEMS AND LONG-RANGE GOALS TO REDUCE HEALTH RISKS AND DISPARITIES IN DURHAM COUNTY. THE BOARD INCLUDES STATE AND LOCAL ELECTED OFFICIALS, NEIGHBORHOOD COUNCILS AND OTHER GRASSROOTS ORGANIZATIONS, POLITICAL GROUPS, LOCAL PHYSICIANS, THE DURHAM PUBLIC SCHOOLS, AMONG OTHERS. DUHS MAINTAINS A CHARITABLE GRANTS COMMITTEE TO REVIEW COMMUNITY REQUESTS FOR PHILANTHROPIC ASSISTANCE THAT PROMOTE HEALTH AND WELLNESS. DUKE MEDICINE PROVIDES VARIOUS OPPORTUNITIES FOR STUDENTS TO INTERACT WITH DIFFERENT HEALTH CARE PROFESSIONALS ACROSS THE SYSTEM. THE OFFICE OF COMMUNITY RELATIONS, DURHAM REGIONAL HOSPITAL, AND OTHER KEY COMMUNITY PARTNERS BEGAN PLANNING A PILOT WORKFORCE DEVELOPMENT PROJECT CALLED PROJECT SEARCH. THIS PROGRAM, MODELED AFTER THE PROGRAM AT CINCINNATI CHILDREN'S HOSPITAL, PROVIDES YOUTH WITH DISABILITIES EMPLOYMENT TRAINING AND CAREER OPPORTUNITIES IN THE HEALTHCARE FIELD. PLANNING FOR THIS PROGRAM BEGAN IN EARLY FISCAL YEAR 2011 WITH A TARGET IMPLEMENTATION DATE AT DURHAM REGIONAL HOSPITAL OF OCTOBER 2011. THE OFFICE OF COMMUNITY RELATIONS WORKS WITH THE DURHAM-ORANGE MEDICAL SOCIETY AND THE DURHAM ACADEMY OF MEDICINE, DENTISTRY AND PHARMACY (AN ASSOCIATION FOR AFRICAN-AMERICAN MEDICAL PROFESSIONALS) TO PROMOTE THE SUCCESS OF THE CITY OF MEDICINE ACADEMY (CMA). THE CMA IS A PUBLIC MAGNET HIGH SCHOOL DESIGNED FOR STUDENTS INTERESTED IN HEALTH CARE CAREERS. THE SCOPE OF SERVICES PROVIDED BY DUKE MEDICINE STAFF AND FACULTY WILL INCREASE DURING THE NEXT YEAR. MORE FACULTY WILL BE INVOLVED WITH MENTORING STUDENTS AND CLASSROOM LECTURES. IN ADDITION, THE HEALTH SYSTEM CEO IS WORKING WITH THE NEW SCHOOLS PROJECT TO HELP THE CMA BECOME THE PREMIER HEALTH SCIENCE HIGH SCHOOL IN NORTH CAROLINA. IN 2011, CMA MOVED INTO A NEW BUILDING ON THE DURHAM REGIONAL HOSPITAL CAMPUS ON LAND DUHS RELEASED BACK TO DURHAM COUNTY. THE OCR PROGRAM MANAGER COORDINATED HEALTH CARE SERVICES AT THE ANNUAL DURHAM PROJECT HOMELESS CONNECT. DUKE UNIVERSITY HEALTH SYSTEM IS A KEY PARTNER IN THIS EVENT. DUKE SCHOOL OF NURSING, DUKE EYE CENTER, AND STAFF AFFILIATED WITH LINCOLN COMMUNITY HEALTH CENTER HEALTHCARE FOR THE HOMELESS CLINIC VOLUNTEER TIME AND RESOURCES AT THIS IMPORTANT EVENT. STUDENTS FROM THE DUKE SCHOOLS OF MEDICINE AND NURSING ENGAGE COMMUNITIES IN DURHAM AND BEYOND IN ACTIVITIES THAT INCLUDE FREE BLOOD PRESSURE SCREENINGS FOR THE HOMELESS, AND IDENTIFYING THE HEALTH CARE NEEDS OF A LOW WEALTH COMMUNITY SCHOOL AND DEVELOPING A CURRICULUM FOR STUDENTS AND PARENTS THAT ADDRESSES THOSE NEEDS. BEYOND DURHAM, DUKE UNIVERSITY MEDICAL AND NURSING STUDENTS ARE WORKING IN MANY NATIONS SUCH AS UGANDA, KENYA, BARBADOS AND HONDURAS. AFFILIATED HEALTH CARE SYSTEM ROLES PART VI, LINE 6 DUHS PROVIDES VIRTUALLY ALL LEVELS OF CARE BEGINNING WITH DUKE UNIVERSITY AFFILIATED PHYSICIANS (DBA DUKE PRIMARY CARE) (DPC). THE HOSPITALS PROVIDE ROUTINE INPATIENT AND OUTPATIENT CARE. IN DURHAM COUNTY, DUKE UNIVERSITY HOSPITAL (DUH) AND DURHAM REGIONAL HOSPITAL (DRH) WORK TOGETHER TO MAXIMIZE FACILITY UTILIZATION PROVIDING ROUTINE AND ADVANCED LEVELS OF CARE. DUH ALSO OPERATES A TRAUMA CENTER WITH AIR AMBULANCE SERVICE. DUKE RALEIGH HOSPITAL (DRAH) SERVES THE WAKE COUNTY AREA AS A COMMUNITY HOSPITAL. THE DRAH CAMPUS HAS SEVERAL MEDICAL OFFICE BUILDINGS ENHANCING CONVENIENCE FOR THE PATIENT IN NON-EMERGENT CASES AND PROVIDES STREAMLINED ACCESS TO HIGH-DEMAND PROCEDURES SUCH AS CARDIAC CATHETERIZATION AND RADIOLOGY PROCEDURES. DUHS ALSO OPERATES HOME HEALTH AND HOME INFUSION SERVICES TO TREAT AND CARE FOR PATIENTS IN THE COMFORT OF THEIR HOME. THIS IS OBVIOUSLY PRACTICAL FOR PATIENTS NOT REQUIRING INPATIENT STAY BUT IN NEED OF ONGOING CARE AT A SUB-ACUTE LEVEL. FINALLY, HOSPICE PROVIDES PALLIATIVE CARE FOR PATIENTS NOT RESPONDING TO CURATIVE CARE. PAIN MANAGEMENT, SYMPTOM MANAGEMENT, AND PSYCHOLOGICAL AND SPIRITUAL SUPPORT PROVIDE A ROUNDED APPROACH TO COMPASSIONATELY ASSIST TERMINAL PATIENTS AND THEIR FAMILIES WITH THE PROCESS OF DYING. ALL OF THE OPERATING UNITS OF DUHS WORK TOGETHER TO PROVIDE THE RIGHT LEVEL OF CARE FOR THE PATIENT IN THE MOST BENEFICIAL MANNER. IN ADDITION TO THE REACTIVE ACTIVITIES OF DIAGNOSTIC CARE, DUHS ALSO SUPPORTS AND PROMOTES HEALTHY LIFESTYLES IN THE DIET & FITNESS CENTER, CENTER FOR LIVING, AND DUKE INTEGRATIVE MEDICINE. THESE OPERATIONS FOCUS LARGELY ON PREVENTION AND EDUCATION TO AVOID OR MITIGATE THE POTENTIAL FOR FUTURE ILLNESS. LIST OF ALL STATES WHICH ORGANIZATION FILES A COMMUNITY BENEFIT REPORT: NORTH CAROLINA true DUKE UNIVERSITY 324 BLACKWELL STREET SUITE 920 DURHAM NC 27701 560532129 501(C)(3) 10000 GENERAL SUPPORT AIDS COMMUNITY RESIDENCE ASSOCIATION 331 W MAIN STREET SUITE 506 DURHAM NC 27702 561609845 501(C)(3) 15000 GENERAL SUPPORT AMERICAN CANCER SOCIETY PO BOX 10144 RALEIGH NC 27605 580659875 501(C)(3) 10000 GENERAL SUPPORT BOYS & GIRLS CLUB 701 N RALEIGH BLVD RALEIGH NC 27610 560863051 501(C)(3) 17250 GENERAL SUPPORT CHILD AND PARENT SUPPORT SERVICES 411 W CHAPEL HILL STREET SUITE 908 DURHAM NC 27701 581446309 501(C)(3) 25000 GENERAL SUPPORT DUKE SCHOOL FOR CHILDREN 3716 OLD ERWIN RD DURHAM NC 27705 581521494 501(C)(3) 15000 GENERAL SUPPORT DURHAM ACADEMY 3130 PICKETT ROAD DURHAM NC 27705 560538019 501(C)(3) 25000 GENERAL SUPPORT FOUNDATION FOR NURSING EXCELLENCE PO BOX 31824 RALEIGH NC 27622 300105241 501(C)(3) 25000 GENERAL SUPPORT GREAT 100 INC PO BOX 4875 GREENSBORO NC 27404 561705456 501(C)(3) 10000 GENERAL SUPPORT GREATER RALEIGH CHAMBER OF COMMERCE PO BOX 2978 RALEIGH NC 27602 560370850 501(C)(6) 64010 GENERAL SUPPORT HUMAN RIGHTS CAMPAIGN INC 1713 PATHWAY DR CARRBORO NC 27510 521243457 501(C)(4) 6000 GENERAL SUPPORT NORTH CAROLINA PHYSICIANS HEALTH PROGRAM 220 HORIZON DRIVE SUITE 201 RALEIGH NC 27615 561846599 501(C)(3) 12000 GENERAL SUPPORT RALEIGH RESCUE MISSION PO BOX 27391 RALEIGH NC 27611 561895093 501(C)(3) 7500 GENERAL SUPPORT SENIOR PHARMASSIST INC 406 RIGSBEE AVE SUITE 201 DURHAM NC 27701 562084639 501(C)(3) 10000 GENERAL SUPPORT WAKE COUNTY MEDICAL SOCIETY 2500 BLUE RIDGE ROAD RALEIGH NC 27607 562205175 501(C)(3) 7500 GENERAL SUPPORT WAKE EDUCATION PARTNERSHIP 706 HILLSBOROUGH STREET SUITE A RALEIGH NC 27603 581518182 501(C)(3) 10000 GENERAL SUPPORT BAND TOGETHER PO BOX 6445 RALEIGH NC 276286445 562273756 501(C)(3) 10000 GENERAL SUPPORT CARING HOUSE INC 2625 PICKETT RD DURHAM NC 277055603 561647154 501(C)(3) 16500 GENERAL SUPPORT CEO ROUNDTABLE ON CANCER INC 940 NW CARY PKWY SUITE 102 CARY NC 27513 651230448 501(C)(3) 40000 GENERAL SUPPORT DURHAM CHAMBER LEGACY FOUNDATION PO BOX 3829 DURHAM NC 27702 331132350 501(C)(3) 62500 GENERAL SUPPORT EL CENTRO HISPANO INC 201 W MAIN STREET SUITE 100 DURHAM NC 27701 562011661 501(C)(3) 15000 GENERAL SUPPORT JOHN AVERY BOYS AND GIRLS CLUB PO BOX 446 DURHAM NC 27702 566001906 501(C)(3) 12500 GENERAL SUPPORT LGBT CENTER OF RALEIGH INC 316 W CABARRUS ST RALEIGH NC 27601 262998186 501(C)(3) 5500 GENERAL SUPPORT NATIONAL MEDICAL ASSOCIATION 8403 COLESVILLE RD SUITE 920 SILVER SPRING MD 20910 536010805 501(C)(3) 10000 GENERAL SUPPORT NC LUNG CANCER PARTNERSHIP INC PO BOX 14305 RTP NC 27709 262300885 501(C)(3) 20000 GENERAL SUPPORT NORTH CAROLINA SYMPHONY 3700 GLENWOOD AVE SUITE 130 RALEIGH NC 27612 560556755 501(C)(3) 10000 GENERAL SUPPORT RALEIGH SCHOOL OF NURSE ANESTHESIA 3900 BARRETT DR SUITE 200 RALEIGH NC 27609 561684241 501(C)(3) 69578 GENERAL SUPPORT WASHINGTON DUKE INN & GOLF CLUB 3001 CAMERON BOULEVARD DURHAM NC 27706 651179298 N/A 29933 DURHAM HEALTH SUMMIT CITY OF MEDICINE ACADEMY 4100 N ROXBORO ST DURHAM NC 27704 566001021 501(C)(3) 32860 GENERAL SUPPORT MIDTOWN MAGAZINE 4818 SIX FORKS ROAD SUITE 204 RALEIGH NC 27609 208998537 N/A 25000 GENERAL SUPPORT NORTH CAROLINA CHAMBER OF COMMERCE 701 CORPORATE CENTER DRIVE SUITE 40 RALEIGH NC 27607 560340499 501(C)(6) 6500 GENERAL SUPPORT NORTH CAROLINA INSTITUTE OF MEDICINE 630 DAVIS DRIVE SUITE 100 MORRISVILLE NC 27560 561506066 GOVERNMENT 6000 GENERAL SUPPORT RESEARCH AMERICA PO BOX 222451 CHINTILLY VA 201532451 521609875 501(C)(3) 15000 GENERAL SUPPORT 28 5 DUKE CANCER SUPPORT PROGRAM 20 22875 NANCY WALTERS SCHOLARSHIP 2 1000 JUDY WAGONER SCHOLARSHIP 2 500 MARTHA WHITWORTH LASITER SCHOLARSHIP 2 2000 RUBY BAILEY PIERCE SCHOLARSHIP 2 500 MEGAN WALKER SCHOLARSHIP 1 500 CHANCELLOR'S 2010 NASHER EVENT BRONZE SCHOLARSHIP 1 800 SGA AWARD 2011 4 600 PROCEDURES FOR MONITORING USE OF GRANT FUNDS SCHEDULE I, PART I, LINE 2 DUKE UNIVERSITY HEALTH SYSTEM, INC. PROVIDES GENERAL SUPPORT TO LOCAL ORGANINATIONS BASED ON OUR AWARENESS OF THEIR ACTIVITIES WITHIN THE LOCAL COMMUNITY. DUHS, INC. ALSO MAINTAINS A CHARITABLE GRANTS COMMITTEE THAT REVIEWS COMMUNITY REQUESTS FOR PHILANTHROPIC ASSISTANCE THAT PROMOTE HEALTH AND WELLNESS. X X X X X X false true false false false false false true false NANCY C ANDREWS MD 0 446697 0 172828 0 59786 0 30029 0 16189 0 725529 0 0 RICHARD H BRODHEAD 0 753677 0 0 0 22396 0 130029 0 63292 0 969394 0 0 VICTOR J DZAU MD 0 1019765 0 1006416 0 11040 0 746258 0 16175 0 2799654 0 0 DANNY O JACOBS MD 0 270090 0 74075 0 0 0 30029 0 15355 0 389549 0 0 CARL E RAVIN MD 0 250590 0 22500 0 0 0 30029 0 10172 0 313291 0 0 MONTE D BROWN MD 301862 0 197998 0 16500 0 30029 0 21392 0 567781 0 0 0 WILLIAM J FULKERSON JR MD 652777 0 383551 0 16500 0 30029 0 5713 0 1088570 0 0 0 KENNETH C MORRIS 615216 0 251358 0 16500 0 30029 0 8395 0 921498 0 0 0 ASIF AHMAD 271730 0 287603 0 30595 0 30029 0 9951 0 629908 0 0 0 MARY ANN FUCHS 255600 0 65446 0 803 0 30029 0 5151 0 357029 0 0 0 PAUL R NEWMAN 0 207469 0 108218 0 0 0 30029 0 31147 0 376863 0 0 KEVIN W SOWERS 415415 0 190062 0 16500 0 30029 0 7637 0 659643 0 0 0 DOUGLAS B VINSEL 343228 0 210304 0 16500 0 30029 0 17133 0 617194 0 0 0 KERRY R WATSON 319858 0 96190 0 16500 0 30029 0 34929 0 497506 0 0 0 MARC CALABRESE 307265 0 44492 0 4179 0 30029 0 17913 0 403878 0 0 0 JOHN M KELSCH 306145 0 60683 0 28215 0 30029 0 14292 0 439364 0 0 0 MOLLY K ONEILL 330200 0 208151 0 16500 0 30029 0 10225 0 595105 0 0 0 THOMAS A OWENS 296045 0 54800 0 0 0 30029 0 11871 0 392745 0 0 0 JOSEPH G TAYLOR 253661 0 125316 0 16500 0 30029 0 18020 0 443526 0 0 0 HARVEY JAY COHEN MD 0 362611 0 41228 0 0 0 30029 0 10473 0 444341 0 0 KIMBERLY J JENKINS 0 37500 0 0 0 0 0 4565 0 100 0 42165 0 0 FRANCES D MAUNEY 0 127125 0 0 0 0 0 14849 0 5876 0 147850 0 0 R SANDERS WILLIAMS MD 0 93243 0 148200 0 4125 0 30029 0 1022 0 276619 0 0 MICHAEL S CUFFE MD 293599 0 203927 0 16500 0 30029 0 14427 0 558482 0 0 0 MARK D GUSTAFSON 0 254197 0 13000 0 6500 0 30029 0 13053 0 316779 0 0 NON-FIXED PAYMENTS SCHEDULE J, PART I, LINE 7 DUHS MAINTAINS AN EXECUTIVE INCENTIVE COMPENSATION PLAN. PAYMENTS UNDER THE PLAN ARE BASED ON PRE-ESTABLISHED PERFORMANCE METRICS AND A FIXED CALCULATION METHODOLOGY APPROVED BY THE DUHS COMPENSATION COMMITTEE WITH ASSISTANCE AND INPUT FROM AN EXECUTIVE COMPENSATION CONSULTING FIRM ASSURING COMPARABILITY WITH SIMILAR SYSTEMS. THE PLAN ALLOWS FOR A MODIFICATION TO AN INDIVIDUAL'S INCENTIVE PAYMENT BASED ON LEADERSHIP COMPETENCIES AND OTHER FACTORS WITH PAYOUTS (AND MODIFICATIONS, IF ANY) APPROVED BY THE DUHS COMPENSATION COMMITTEE. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B VICTOR J. DZAU MD PARTICIPATES IN A PLAN DESCRIBED UNDER SECTION 457(F) OF THE INTERNAL REVENUE CODE, HOWEVER HE DID NOT RECEIVE ANY PAYMENTS DURING THE REPORTING PERIOD. TAX INDEMNIFICATION SCHEDULE J, PART 1, LINE 1A ASIF AHMAD AND MARY ANN FUCHS RECEIVED SOME BENEFIT THAT WAS GROSSED UP TO COMPENSATE FOR WITHHOLDING OF TAXES. NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 657902V33 2009-08-21 322140000 SEE SCHEDULE O false false false NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 6579025S7 2006-11-15 150715000 SEE SCHEDULE O false false false NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DDB4 2009-11-10 178598850 SEE SCHEDULE O false false false NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DDX6 2010-04-28 120836075 SEE SCHEDULE O false false false 0 0 322140000 0 0 322140000 0 0 0 0 0 0 true false true true 5000000 0 151142783 0 3947210 70000000 682440 0 0 76513133 0 0 2009 true false true true 0 0 180221710 0 10548994 0 2472104 0 0 114924142 0 52276470 false false false true 0 0 121169224 0 0 0 1460854 0 0 98355210 0 21353160 false false false true false false true false true 0.00000 0.00000 0.00000 true false false true false true 0.00000 0.00000 0.00000 true false false true false true 0.00000 0.00000 0.00000 true false false true false true 0.00000 0.00000 0.00000 true false true true CITIGROUP & DEUTSCHE 23. false false false false true false true false false false false false false false false false false false false false false false false false false false false MEDTRONIC INC BOARD MEMBER IS DIRECTOR 28857194 PAYMENT FOR GOODS OR SERVICES false DUKE PRIVATE DIAGNOSTIC CLINIC BD MEMBERS ARE DIRECTORS 81568442 PAYMENT FOR GOODS OR SERVICES false CAPITOL BROADCASTING CO CEO IS DIRECTOR 131000 PAYMENT FOR GOODS OR SERVICES false THE DURHAM BULLS BASEBALL CLUB INC CEO IS DIRECTOR 95205 PAYMENT FOR GOODS OR SERVICES false GENESE NEWMAN FAMILY MEMBER OF KEY EMP 92829 SALARY PAID false TAMELA VINSEL FAMILY MEMBER OF KEY EMP 27032 SALARY PAID false JACQUELINE DZAU FAMILY MEMBER OF DIRECTOR 48744 SALARY PAID false X 25 5249 FMV X 8 FMV X 7968 FMV X 9 66896 FMV X 20 4584 FMV X 28 701 FMV X EVENT TICKETS 13 2034 FMV X GIFT CARDS/CERTIFICATES 43 9679 FMV X BEAUTY SUPPLIES 77 864 FMV X JEWELRY 8 5463 FMV X MISCELLANEOUS 56 21248 FMV 0 false true true USE OF THIRD PARTIES TO SOLICIT, PROCESS, OR SELL NONCASH CONTRIBUTIONS SCHEDULE M, PART 1, LINE 32B DUKE UNIVERSITY HEALTH SYSTEM, INC. USES INVESTMENT BROKERS TO SELL INVESTMENTS. DUKE UNIVERSITY HEALTH SYSTEM, INC. MAY OCCASIONALLY USE THIRD PARTIES TO SELL OTHER TYPES OF NON-CASH CONTRIBUTIONS, AS THE NEED ARISES. ORGANIZATION'S FILING OF FORM 990-T FORM 990, PART V, LINE 3B THE ORGANIZATION DID NOT HAVE ANY UNRELATED BUSINESS GROSS INCOME DURING THE FISCAL YEAR ENDING JUNE 30, 2011. AS A RESULT, FORM 990-T IS NOT REQUIRED FOR THE FISCAL YEAR ENDING JUNE 30, 2011. BUSINESS RELATIONSHIPS OF DUHS DIRECTORS AND OFFICERS FORM 990, PART VI, SECTION A, LINE 2 DIRECTORS HONORABLE DANIEL T. BLUE, JR., JACK O. BOVENDER, JR., RICHARD H. BRODHEAD, FRANK E. EMORY, JR., SUSAN STALNECKER, AND THOMAS M. GORRIE ARE TRUSTEES OF DUKE UNIVERSITY. PRESIDENT/CEO VICTOR J. DZAU, MD IS AN OFFICER OF DUKE UNIVERSITY. THE FOLLOWING INDIVIDUALS ARE EMPLOYEES OF DUKE UNIVERSITY: DANNY O. JACOBS MD, NANCY A. ANDREWS MD, MARK BRANCH III MD, AND CARL E. RAVIN MD. OFFICER KENNETH MORRIS AND KEY EMPLOYEE PAUL NEWMAN ARE BOTH DIRECTORS AND OFFICERS OF HEALTH SYSTEM MEDICAL STRATEGIES, INC. DIRECTOR AND PRESIDENT/CEO VICTOR J. DZAU MD, OFFICERS KENNETH C. MORRIS, WILLIAM J. FULKERSON, JR. MD. , CARL E. RAVIN MD, AND KEY EMPLOYEE PAUL NEWMAN ARE DIRECTORS OF DURHAM CASUALTY COMPANY, LTD. DIRECTORS VICTOR J. DZAU MD, DANNY O. JACOBS MD, CARL E. RAVIN MD, WILLIAM J. FULKERSON MD, AND KEY EMPLOYEE PAUL NEWMAN ARE BOARD MEMBERS OF PRIVATE DIAGNOSTIC CLINIC, PLLC. DIRECTOR AND PRESIDENT/CEO VICTOR J. DZAU MD, AND OFFICER KENNETH C. MORRIS ARE DIRECTORS OF DUKE MEDICAL STRATEGIES, INC. ELECTION OF MEMBERS OF GOVERNING BODY FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE BOARD OF DIRECTORS OF DUHS, OTHER THAN THE EX OFFICIO MEMBERS, WILL BE NOMINATED BY THE BOARD OF DIRECTORS OF DUHS, AND WILL BE APPOINTED BY THE BOARD OF TRUSTEES OF DUKE UNIVERSITY. MEMBERS OF THE BOARD OF DIRECTORS OF DUHS WILL BE SUBJECT TO REMOVAL AT THE DISCRETION OF THE BOARD OF TRUSTEES OF DUKE UNIVERSITY IN ACCORDANCE WITH THE BYLAWS OF DUHS. DECISIONS OF GOVERNING BODY FORM 990, PART VI, SECTION A, LINE 7B THE DUHS BYLAWS PROVIDE THAT DUHS MUST OBTAIN DUKE UNIVERSITY BOARD OF TRUSTEES APPROVAL FOR DEBT ISSUANCES, CAPITAL ACQUISITIONS AND TANGIBLE PERSONAL PROPERTY SALES IN EXCESS OF $50 MILLION EACH AS WELL AS REAL PROPERTY SALES IN EXCESS OF $10 MILLION EACH. GOVERNING BODY REVIEW PROCESS OF FORM 990 FORM 990, PART VI, SECTION B, LINE 11B AFTER STAFF PREPARATION AND MANAGEMENT REVIEW, THE DUHS FORM 990 FILING IS PRESENTED TO THE DUHS COMPLIANCE/AUDIT COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW AND DISCUSSION. BOARD LEVEL COMMENT AND DISCUSSION ARE INCORPORATED INTO THE FORM AS APPROPRIATE PRIOR TO FILING. A FINAL VERSION OF THE FORM IS POSTED TO THE BOARD OF DIRECTORS COMMUNICATION PORTAL ON THE INTERNET FOR FURTHER REVIEW AND COMMENT BEFORE FILING. CONFLICT OF INTEREST POLICY COMPLIANCE MONITORING METHOD FORM 990, PART VI, SECTION B, LINE 12c DUKE UNIVERSITY HEALTH SYSTEM MONITORS AND ENFORCES COMPLIANCE RELATED TO CONFLICT OF INTEREST VIA AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE, RELYING ON SELF DISCLOSURE OF ALL THOSE SUBJECT TO THE COI POLICY. COMPENSATION POLICY FORM 990, PART VI, SECTION B, LINES 15A & 15B AND SCHEDULE J, LINE 3 THE DUHS COMPENSATION COMMITTEE, COMPRISED OF MEMBERS OF THE DUHS BOARD OF DIRECTORS, REVIEWS AND APPROVES ALL EXECUTIVE COMPENSATION FOR ALL DISQUALIFIED PERSONS AND OTHER KEY EMPLOYEES. THE DUHS COMPENSATION COMMITTEE REVIEWS AND RECOMMENDS TO THE DUKE UNIVERSITY COMPENSATION COMMITTEE THE COMPENSATION FOR THE PRESIDENT AND CEO OF DUHS WHO IS ALSO AN OFFICER OF DUKE UNIVERSITY. DUHS HAS ADOPTED A STATEMENT OF COMPENSATION PHILOSOPHY THAT ARTICULATES BROAD OBJECTIVES TO HELP GUIDE THE DUHS COMPENSATION COMMITTEE IN ITS MISSION. THE DUHS COMPENSATION COMMITTEE ENGAGES THE SERVICES OF AN OUTSIDE EXECUTIVE COMPENSATION CONSULTING FIRM TO ESTABLISH COMPARABILITY DATA OF OTHER HEALTH CARE SYSTEMS OF SIMILAR SIZE AND COMPLEXITY AS DUHS. THE DUHS COMPENSATION COMMITTEE REVIEWS THE MARKET ANALYSIS THEN DETERMINES THE REASONABLENESS AND APPROPRIATENESS OF ALL ASPECTS OF EXECUTIVE COMPENSATION. THE DUHS COMPENSATION COMMITTEE ALSO SETS THE METRICS AND APPROVES THE PAYOUTS FOR THE DUHS INCENTIVE COMPENSATION PLANS FOR THESE INDIVIDUALS. THE DELIBERATIONS AND CONCLUSIONS OF THE DUHS COMPENSATION COMMITTEE ARE KEPT BY A RECORDING SECRETARY WHO RECORDS THE MINUTES OF THE COMMITTEE MEETINGS. GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABILITY TO THE PUBLIC FORM 990, PART VI, SECTION C, LINE 19 DUKE UNIVERSITY HEALTH SYSTEM'S GOVERNING DOCUMENTS (ARTICLES OF INCORPORATION AND ANY SUBSEQUENT AMENDMENTS OR RESTATEMENTS) ARE AVAILABLE TO THE PUBLIC ON THE NORTH CAROLINA SECRETARY OF STATE WEBSITE. DUKE UNIVERSITY HEALTH SYSTEM MAKES ITS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FINANCIAL STATEMENTS ARE ALSO AVAILABLE TO THE PUBLIC ON THE ELECTRONIC MUNICIPAL MARKET ACCESS WEBSITE. NAVIGATE TO HTTP://EMMA.MSRB.ORG AND ENTER "DUKE UNIVERSITY HEALTH SYSTEM" IN THE MUNI SEARCH BOX. AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII, SECTION A, COLUMN B THE FOLLOWING INDIVIDUALS LISTED IN PART VII, SECTION A, COLUMN A DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY: HONORABLE DANIEL T. BLUE, JR., JACK O. BOVENDER, JR., FRANK E. EMORY, JR., THOMAS A. GORRIE, SUSAN M. STALNECKER, AND KIMBERLY J. JENKINS. NANCY C. ANDREWS, MD, RICHARD H. BRODHEAD, DANNY O. JACOBS, MD, AND MARK D. GUSTAFSON DEVOTED AN AVERAGE OF 50 HOURS PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY. VICTOR J. DZAU, MD, CARL E. RAVIN, MD, FRANCES D. MAUNEY, AND R. SANDERS WILLIAMS, MD DEVOTED AN AVERAGE OF 40 HOURS PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY. MONTE D. BROWN, MD DEVOTED AN AVERAGE OF 10 HOURS PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY. MARK BRANCH, III, MD AND PAUL R. NEWMAN DEVOTED AN AVERAGE OF 60 HOURS PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY. HARVEY JAY COHEN, MD DEVOTED AN AVERAGE OF 70 HOURS PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY. MICHAEL S. CUFFE, MD DEVOTED AN AVERAGE OF 13 HOURS PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY. KENNETH C. MORRIS AND PAUL R. NEWMAN DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, HEALTH SYSTEM MEDICAL STRATEGIES, INC. VICTOR J. DZAU, MD AND KENNETH C. MORRIS DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, DUKE MEDICAL STRATEGIES, INC. THE FOLLOWING INDIVIDUALS DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, DURHAM CASUALTY COMPANY, LTD: VICTOR J. DZAU, MD, CARL E. RAVIN, MD, PAUL NEWMAN, WILLIAM J. FULKERSON JR. MD, KENNETH C. MORRIS, AND MICHAEL S. CUFFE, MD . NANCY C. ANDREWS, MD AND VICTOR J. DZAU, MD DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY SCHOOL OF MEDICINE RESEARCH FOUNDATION. VICTOR J. DZAU, MD, THOMAS M. GORRIE, AND KENNETH C. MORRIS DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, DUKE MEDICINE GLOBAL SUPPORT CORPORATION. WILLIAM J. FULKERSON, MD, KENNETH C. MORRIS, AND MICHAEL S. CUFFE, MD DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY AFFILIATED PHYSICIANS, INC. KENNETH C. MORRIS AND KERRY R. WATSON DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, ASSOCIATED HEALTH SERVICES, INC. KIMBERLY J. JENKINS DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, THE LORD FOUNDATION OF NORTH CAROLINA. RICHARD H. BRODHEAD DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, DUMAC, LLC. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 5 NET UNREALIZED GAINS ON INVESTMENTS $ 196,332,407 NONPERIODIC CHANGES IN DEFINED BENEFIT PLANS 87,984,953 NET TRANSFERS TO THE PARENT OF PROPERTY & EQUIPMENT (10,544,987) CHANGE IN MARKET VALUE OF DERIVATIVES 22,331,886 INTEREST EARNED ON BOND PROCEEDS - CAPITALIZED FOR BOOK PURPOSES (1,217,357) REPORTING CHANGE CAPTURED ON SEPARATE RELATED ORGANIZATION'S RETURN (84,668,685) INCOME NOT REPORTED ON BOOKS, BUT INCLUDED FOR 990 REPORTING PURPOSES (6,667,089) ______________ $ 203,551,128 ============== ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 3A DUKE UNIVERSITY HEALTH SYSTEM, INC. AND RELATED ENTITY, DUKE UNIVERSITY MANAGE THEIR INVESTMENT FUNDS IN ACCORDANCE WITH THE UNIFORM PRUDENT MANAGEMENT OF INSTITUTIONAL FUNDS ACT OF NORTH CAROLINA. THESE INVESTMENT POOLS ARE MANAGED, HELD AND ADMINISTERED BY ORGANIZATIONS THAT ARE RELATED TO DUKE UNIVERSITY. PURPOSE OF TAX-EXEMPT BONDS SCHEDULE K, PART I, COLUMN F BOND ISSUE (A): THE PURPOSE OF THE BONDS ISSUED 05/19/2005 WAS TO PARTIALLY REFUND THE 1996C BONDS ISSUED ON 10/24/1996, 1998A BONDS ISSUED ON 08/27/1998, AND THE 1998B BONDS ISSUED ON 10/13/1998. BOND ISSUE (B): HOSPITAL IMPROVEMENTS FINANCED OR REFINANCED INCLUDE: ROUTINE INFRASTRUCTURE, RENOVATION AND IMPROVEMENT PROJECTS AT DUKE UNIVERSITY HOSPITAL AND DUKE RALEIGH HOSPITAL, IMPROVEMENTS TO INFORMATION SYSTEMS, RENOVATION AND EXPANSION OF EMERGENCY DEPARTMENT AT DUKE UNIVERSITY HOSPITAL, HELIPORT AND NEW ROOF IMPROVEMENTS AT DUKE UNIVERSITY HOSPITAL, AND PHASES 1 AND 2 OF AN OPERATING ROOM SUITE RENOVATION AND EXPANSION AT DUKE UNIVERSITY HOSPITAL. TOTAL PROCEEDS OF ISSUE INCLUDE INVESTMENT EARNINGS. BOND ISSUE (C): HOSPITAL IMPROVEMENTS FINANCED INCLUDE: THE AMBULATORY CANCER CENTER AT DUKE UNIVERSITY HOSPITAL AND OTHER RENOVATION AND IMPROVEMENT PROJECTS AT DUKE UNIVERSITY HOSPITAL AND DUKE RALEIGH HOSPITAL. TOTAL PROCEEDS OF ISSUE INCLUDE INVESTMENT EARNINGS. BOND ISSUE (D): HOSPITAL IMPROVEMENTS INCLUDE THE DUKE MEDICINE PAVILION AT DUKE UNIVERSITY HOSPITAL. TOTAL PROCEEDS OF ISSUE INCLUDE INVESTMENT EARNINGS. BOND ISSUE (A)-2: DRAW-DOWN FINANCING LEASE PROGRAM WITH CITIMORTGAGE, INC. IN THE MAXIMUM PRINCIPAL AMOUNT OF $40,000,000 TO REFUND TWO LEASES UNDER A PRIOR PROGRAM ISSUED 07/09/2003 AND TO FINANCE MEDICAL, COMPUTER, OFFICE, AND CAPITAL EQUIPMENT. TOTAL PROCEEDS OF ISSUE INCLUDE INVESTMENT EARNINGS. BOND ISSUE (B)-2: DRAW-DOWN FINANCING LEASE PROGRAM WITH BANC OF AMERICA PUBLIC CAPITAL CORP. IN THE MAXIMUM PRINCIPAL AMOUNT OF $40,000,000 TO FINANCE MEDICAL, COMPUTER, OFFICE, AND CAPITAL EQUIPMENT. SCHEDULE K, PART II, LINE 3, BOND ISSUES (B), (C), AND (D) PROCEEDS INCLUDE INVESTMENT EARNINGS. SCHEDULE K, PART II, LINE 3, BOND ISSUES (A)-2, AND (B)-2 PROCEEDS REFLECT ACTUAL PRINCIPAL DRAWN DOWN UNDER DRAW DOWN FINANCING LEASE PROGRAM. SCHEDULE K, PART II, LINES 3 AND 10, BOND ISSUE (A)-2 PURSUANT TO TREAS. REG. 1.141-12(E), DISPOSITION PROCEEDS OF $5,000,000, PLUS THE INVESTMENT PROCEEDS THEREOF, HAVE BEEN EXPENDED ON ADDITIONAL CAPITAL EXPENDITURES AS A REMEDIAL ACTION FOR THE SALE OF CERTAIN BOND-FINANCED ASSETS. SCHEDULE K, PART II, LINE 6, BOND ISSUES (A), (B), AND (A)-2 THESE PROCEEDS, PLUS ANY INVESTMENT PROCEEDS THEREOF, HAVE BEEN DISBURSED TO PAY AT MATURITY OR OPTIONALLY REDEEM THE REFUNDED BONDS. SCHEDULE K, PART IV, QUESTION 6, BOND ISSUES (A)-2 AND (B)-2 SALES PROCEEDS ALLOCATED UPON ISSUANCE AND NOT INVESTED. 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