PRESBYTERIAN HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
PRESBYTERIAN HOSPITAL (EIN 56-0554230)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-13
IRS object ID
201233189349302923
Schema version
2011v1.2
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)
Timestamp2012-11-13T13:42:23-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN560554230EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PRESBYTERIAN HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPRESNameControl
Phone3367182803Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12085 FRONTIS PLAZA BLVDAddressLine1
CityWINSTON SALEMCity
StateNCState
ZIP Code27103ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameFRED HARGETTName
TitleEVP & CFOTitle
Phone3367182003Phone
Date Signed2012-11-13DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARK BILLINGSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12085 FRONTIS PLAZA BLVDAddressLine1
CityWINSTON SALEMCity
StateNCState
ZIP Code27103ZIPCode
FieldValueIRS element (for citing)
Gross Receipts731668457GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.PRESBYTERIAN.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1903YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionSEE SCHEDULE OActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees5417TotalNbrEmployees
Total Nbr Volunteers839TotalNbrVolunteers
Total Gross UBI337124TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2808695ContributionsGrantsPriorYear
Contributions Grants Current Year2423359ContributionsGrantsCurrentYear
Program Service Revenue Prior Year715378410ProgramServiceRevenuePriorYear
Program Service Revenue CY712435806ProgramServiceRevenueCY
Investment Income Prior Year-202611InvestmentIncomePriorYear
Investment Income Current Year-400702InvestmentIncomeCurrentYear
Other Revenue Prior Year19488890OtherRevenuePriorYear
Other Revenue Current Year16410168OtherRevenueCurrentYear
Total Revenue Prior Year737473384TotalRevenuePriorYear
Total Revenue Current Year730868631TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1064408GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1061192GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year269638886SalariesEtcPriorYear
Salaries Etc Current Year274012923SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year358562204OtherExpensePriorYear
Other Expenses Current Year374431342OtherExpensesCurrentYear
Total Expenses Prior Year629265498TotalExpensesPriorYear
Total Expenses Current Year649505457TotalExpensesCurrentYear
Revenues Less Expenses Prior Year108207886RevenuesLessExpensesPriorYear
Revenues Less Expenses CY81363174RevenuesLessExpensesCY
Total Assets BOY598721752TotalAssetsBOY
Total Assets EOY667273513TotalAssetsEOY
Total Liabilities BOY44412397TotalLiabilitiesBOY
Total Liabilities EOY37574082TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY554309355NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY629699431NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSEE SCHEDULE OMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense532284327Expense
Grants1061192Grants
Revenue723785301Revenue
DescriptionTHE PRESBYTERIAN HOSPITAL (PH) AND PRESBYTERIAN HOSPITAL HUNTERSVILLE (PHH) EXIST TO PROMOTE THE HEALTH OF THE INHABITANTS OF THE CHARLOTTE-MECKLENBURG COUNTY AREA REGARDLESS OF THE PATIENT'S ABILITY TO PAY. DURING 2011, PH HAD 607 LICENSED BEDS. THERE WERE 165,173 PATIENT DAYS, WITH AN AVERAGE LENGTH OF STAY OF 5.57 DAYS, AND AN AVERAGE DAILY CENSUS OF 453. THERE WERE 29,082 DISCHARGES, 21,666 INPATIENT AND OUTPATIENT SURGERIES, 148,236 OUTPATIENT ENCOUNTERS AND 83,433 EMERGENCY DEPARTMENT VISITS. (CONTINUED ON SCHEDULE O)Description
Total Program Service Expense532284327TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
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 Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees5417NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs1ChangesToOrganizingDocs
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 Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
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 Line1KAREN DAUGHERTYBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3367182803TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12085 FRONTIS PLAZA BLVDAddressLine1
CityWINSTON SALEMCity
StateNCState
ZIP Code27103ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
BILLINGSDERRICK MARK
PRES-PRESBY/COO-CHLT / TRUSTEE60.00XX8235320288038
CURETONJESSE
TREASURER2.00XX000
FLETCHERSIDNEY
TRUSTEE2.00X0161320
FOXANTHONY
TRUSTEE2.00X000
GALLAGHERARTHUR
SEC2.00XX000
GARNERSTUART J
TRUSTEE2.00X039882844073
JONESBRUCE
TRUSTEE2.00X000
LYLESVIOLA
CHAIR2.00XX000
MYERSLEE
TRUSTEE2.00X000
PALERMOJAMES
VICE CHAIR2.00XX000
PHILLIPSG PATRICK
TRUSTEE2.00X000
POSTONWILLIAM
TRUSTEE2.00X000
STONELARRY
TRUSTEE2.00X000
STROUP IIIPAUL
TRUSTEE2.00X000
WILLIAMSDAN
TRUSTEE2.00X000
WALSHBETSY JEAN
ASST SEC2.00X026882146848
STILLERMANSHELLI STOKER
ASST SEC2.00X021673531463
VANCEAMY SUSAN
SVP & COO PHC60.00466336041558X
VINCENTPAULA ROLLINS
SVP CENTER CITY MKT60.005434010155414X
BLACKMONTANYA S
PRESIDENT PHH60.00273128026447X
JONESVELVETTE LAJEUNE
VP & COO PHH60.00169533020195X
MCADAMSSTEPHEN
VP & SR MED DIR SPECIALTY SERV60.0017104909780X
ZWENGTHOMAS NELSON
SVP MEDICAL AFFAIRS60.00664930054818X
JOHNSONWALTER W
INTERNIST40.00268002035002X
REILINGRICHARD B
VP MAJOR GIFTS40.00298090032620X
SHOAF JREDWIN H
INTERNIST40.00291907030030X
STEGERELIZABETH ANN
VP NURSING40.00267093033363X
WISEJAIME
FAMILY PRACTITIONER40.002406526028725895X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4261066TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1160803TotalReportableCompFrmRltdOrgs
Total Other Compensation875544TotalOtherCompensation
Number Individuals GT100 K174NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
RODGERS BUILDERS INC
PO BOX 18446CHARLOTTENC28218CONTRACTORS17680629
MORRISON MANAGEMENT SPECIALISTS
PO BOX 102289ATLANTAGA30368FOOD SERVICES8025779
JAMES R VANNOY & SONS CON
PO BOX 635JEFFERSONNC28640CONTRACTORS5562781
AMERICAN RED CROSS
PO 905890CHARLOTTENC28290BLOOD PROCESSING5446711
LUQUIRE GEORGE ANDREWS
4201 CONGRESS STREET SUITCHARLOTTENC28209ADVERTISING1969290
FieldValueIRS element (for citing)
Number Of Contractors GT100 K73NumberOfContractorsGT100K
Related Organizations2230962RelatedOrganizations
All Other Contributions192397AllOtherContributions
Total Contributions2423359TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT REVENUE621990711519766711519766
SOUTHPARK SURGERY CTR621110916040916040
FieldValueIRS element (for citing)
Total Program Service Revenue712435806TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column14309TotalRevenueColumn
Exclusion$14,309ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real19013Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real19013Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column19013TotalRevenueColumn
Exclusion$19,013ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other31916Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other446927Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-415011Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-415011TotalRevenueColumn
Exclusion-$415,011ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events430015GrossIncomeFundraisingEvents
Fundraising Direct Expenses352899FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column77116TotalRevenueColumn
Exclusion$77,116ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
MISCELLANEOUS9000999220592914246078132
CAFETERIA7222103118597$3,118,597
PHARMACY4461102229328220703522293

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column1745522TotalRevenueColumn
Unrelated Business Revenue236699UnrelatedBusinessRevenue
Exclusion$1,508,823ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue16314039TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column730868631TotalRevenueColumn
Related Or Exempt Function Income723785301RelatedOrExemptFunctionIncome
Unrelated Business Revenue337124UnrelatedBusinessRevenue
Exclusion$4,322,847ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1031192Total
Program Services1031192ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total30000Total
Program Services30000ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3708158Total
Management And General3708158ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total217278627Total
Program Services208066013ProgramServices
Management And General9212614ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total7640190Total
Program Services7316246ProgramServices
Management And General323944ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total28977686Total
Program Services27749032ProgramServices
Management And General1228654ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total16408262Total
Program Services15712552ProgramServices
Management And General695710ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total29697319Total
Program Services20434127ProgramServices
Management And General9263192ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total6208060Total
Program Services5944838ProgramServices
Management And General263222ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3334234Total
Program Services3192862ProgramServices
Management And General141372ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total5180302Total
Program Services4960657ProgramServices
Management And General219645ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total19617170Total
Program Services18785402ProgramServices
Management And General831768ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total317286Total
Program Services303833ProgramServices
Management And General13453ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total246492Total
Program Services236041ProgramServices
Management And General10451ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total10517666Total
Program Services10071717ProgramServices
Management And General445949ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total27735921Total
Program Services26559918ProgramServices
Management And General1176003ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total787624Total
Program Services754229ProgramServices
Management And General33395ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
CORPORATE ALLOCATION8892699688926996
MEDICAL SUPPLIES8567222685672226
DRUGS3070740730707407
BAD DEBT2909490629094906

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total36387733Total
Program Services35661129ProgramServices
Management And General726604ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total649505457Total
Program Services532284327ProgramServices
Management And General117221130ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY994438BOY
EOY2730064EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY79964548BOY
EOY85954942EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY9526433BOY
EOY11122291EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY10147958BOY
EOY10029252EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1084813BOY
EOY1001364EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis681977089LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec372659033LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY289968887BOY
EOY309318056EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY2354310BOY
EOY1874881EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY27017EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY204680365BOY
EOY245215646EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY598721752BOY
EOY667273513EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY36305461BOY
EOY31131742EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY5596706BOY
EOY987615EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2510230BOY
EOY5454725EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY44412397BOY
EOY37574082EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY554298624BOY
EOY629688700EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY10731BOY
EOY10731EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY554309355BOY
EOY629699431EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY598721752BOY
EOY667273513EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses81363174ReconcilationRevenueExpenses
Reconcilation Other Changes-5973098ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$52,255OtherActivitiesAmount
Total Lobbying Expenditures IIB52255TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationDUES PAID TO CERTAIN ORGANIZATIONS WHICH INCLUDE A PORTION RELATED TO LOBBYING ACTIVITIES.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance10731BeginningOfYearBalance
End Of Year Balance10731EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance10731BeginningOfYearBalance
End Of Year Balance10731EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance10731BeginningOfYearBalance
End Of Year Balance10731EndOfYearBalance
FieldValueIRS element (for citing)
Term Endowment EOY Balance1.00000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis7138673OtherCostOrOtherBasis
Book Value7138673BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis382066638OtherCostOrOtherBasis
Depreciation174547285Depreciation
Book Value207519353BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2718973OtherCostOrOtherBasis
Depreciation1766741Depreciation
Book Value952232BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis254398772OtherCostOrOtherBasis
Depreciation192231114Depreciation
Book Value62167658BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis35654033OtherCostOrOtherBasis
Depreciation4113893Depreciation
Book Value31540140BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings309318056TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM AFFILIATES192191030
INVESTMENT IN AFFILIATES53024616
FieldValueIRS element (for citing)
Total Book Value Other Assets245215646TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionTHIRD PARTY PAYMENT ADJUSTMENTDescription
Amount$5,454,725Amount
FieldValueIRS element (for citing)
Total Of Amounts5454725TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:INTENDED USES FOR ENDOWMENT FUNDS THE ENDOWMENT FUNDS INTENDED USE IS FOR EQUIPMENT AND PROGRAMS TO BETTER SERVE THE HOSPITAL'S PATIENTS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X: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, 2011 AND 2010.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1FUNDRAISERSNameOfEvent1
Gross Receipts Event1430015GrossReceiptsEvent1
Gross Revenue Event1430015GrossRevenueEvent1
Other Direct Expenses Event1352899OtherDirectExpensesEvent1
Gross Receipts Total430015GrossReceiptsTotal
Gross Revenue Total Events430015GrossRevenueTotalEvents
Other Direct Expenses Total Events352899OtherDirectExpensesTotalEvents
Direct Expense Summary Events352899DirectExpenseSummaryEvents
Net Income Summary77116NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To Most HospitalsXPolicyAppliedToMostHospitals
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage300.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care0FPGReferenceDiscountedCare
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense32510637TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense32510637NetCommunityBenefitExpense
Percent Of Total Expense0.05010PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense86997956TotalCommunityBenefitExpense
Direct Offsetting Revenue58403529DirectOffsettingRevenue
Net Community Benefit Expense28594427NetCommunityBenefitExpense
Percent Of Total Expense0.04400PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense10089103TotalCommunityBenefitExpense
Direct Offsetting Revenue6519226DirectOffsettingRevenue
Net Community Benefit Expense3569877NetCommunityBenefitExpense
Percent Of Total Expense0.00550PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense129597696TotalCommunityBenefitExpense
Direct Offsetting Revenue64922755DirectOffsettingRevenue
Net Community Benefit Expense64674941NetCommunityBenefitExpense
Percent Of Total Expense0.09960PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense18072873TotalCommunityBenefitExpense
Direct Offsetting Revenue2456302DirectOffsettingRevenue
Net Community Benefit Expense15616571NetCommunityBenefitExpense
Percent Of Total Expense0.02400PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense28610232TotalCommunityBenefitExpense
Direct Offsetting Revenue18123861DirectOffsettingRevenue
Net Community Benefit Expense10486371NetCommunityBenefitExpense
Percent Of Total Expense0.01610PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense1070958TotalCommunityBenefitExpense
Direct Offsetting Revenue427650DirectOffsettingRevenue
Net Community Benefit Expense643308NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense1061192TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense1061192NetCommunityBenefitExpense
Percent Of Total Expense0.00160PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense48815255TotalCommunityBenefitExpense
Direct Offsetting Revenue21007813DirectOffsettingRevenue
Net Community Benefit Expense27807442NetCommunityBenefitExpense
Percent Of Total Expense0.04270PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense178412951TotalCommunityBenefitExpense
Direct Offsetting Revenue85930568DirectOffsettingRevenue
Net Community Benefit Expense92482383NetCommunityBenefitExpense
Percent Of Total Expense0.14230PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$29,094,906BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare142788577AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare158331632CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-15543055MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line11 SOUTHPARK SURGERY CENTER LLCBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityHEALTHCAREDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.60000OrganizationProfitOrOwnership
Physicans Profit Or Ownership0.40000PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalChildrens HospitalChildrensHospitalEr24 HoursEr24Hours
PRESBYTERIAN HOSPITAL
1200 HAWTHORNE LANECHARLOTTENC28204XXXX
PRESBYTERIAN HOSPITAL HUNTERSVILLE
210030 GILEAD RDHUNTERSVILLENC28078XXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)

Hospital Facility NumberHospitalFacilityNumberEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedExplains BasisExplainsBasisExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresPosted On WebsitePostedOnWebsiteAttached To InvoicesAttachedToInvoicesPosted In Emergency RoomPostedInEmergencyRoomPosted In Admission OfficePostedInAdmissionOfficeProvided On AdmissionProvidedOnAdmissionAvailable On RequestAvailableOnRequestActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
PRESBYTERIAN HOSPITAL
111300.0000000000000011XXXXXX101X00
PRESBYTERIAN HOSPITAL HUNTERSVILLE
211300.0000000000000011XXXXXX101X00

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities5NumberOfOtherFacilities

Other Facilities OtherFacilities (5 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
MIDTOWN SURGERY CENTER
1918 RANDOLPH ROADCHARLOTTENC28207AMBULATORY SURGERY CENTER
PRESBYTERIAN INTERNAL MEDICINE CLINIC
1918 RANDOLPH ROAD SUITE 350CHARLOTTENC28207PHYSICIAN CLINIC
MCKEE INTERNAL MEDICINE
3330 SISKEY PARKWAYMATTHEWSNC28105PHYSICIAN CLINIC
CHARLOTTE INTERNAL MEDICINE
1701 ABBEY PLACECHARLOTTENC28209PHYSICIAN CLINIC
PRESBYTERIAN PULMONARY & CRITICAL CARE
1900 RANDOLPH ROAD SUITE 216CHARLOTTENC28207PHYSICIAN CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (19 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 3C: 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). OTHER PATIENTS MAY ALSO BE ELIGIBLE FOR DISCOUNTS FOR BALANCES ABOVE $5,000 (CATASTROPHIC DISCOUNT).
PART I, LINE 6A: THE ORGANIZATION IS PART OF THE NOVANT HEALTH CARE 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 $29,094,906.
PART II: ALTHOUGH PART II FOR SCHEDULE H HAS BEEN LEFT BLANK, THE ORGANIZATION DOES ENGAGE IN MANY COMMUNITY BUILDING ACTIVITIES, WHICH SUPPORT AND STRENGTHEN THE COMMUNITY IT SERVES. THESE ACTIVITIES ARE IMPORTANT TO THE ORGANIZATION'S MISSION TO IMPROVE THE HEALTH OF THE COMMUNITY. HOWEVER, THE ORGANIZATION HAS NOT TRADITIONALLY MAINTAINED AN INFRASTRUCTURE TO TRACK, MONITOR AND REPORT THESE ACTIVITIES. THE ORGANIZATION IS PART OF THE NOVANT HEALTH CARE SYSTEM, WHICH HAS A COMMUNITY BENEFIT COMMITTEE. THE COMMUNITY BENEFIT COMMITTEE IS CURRENTLY IN THE PROCESS OF ESTABLISHING THE APPROPRIATE INTERNAL MECHANISMS TO TRACK, MONITOR AND REPORT THESE ACTIVITIES. THE ORGANIZATION IS COMMITTED TO CONTINUING TO PROVIDE THE COMMUNITY BUILDING ACTIVITIES NECESSARY TO MAINTAIN A HEALTHY, PRODUCTIVE AND VIABLE COMMUNITY.
PART III, LINE 4: THE ORGANIZATION'S BAD DEBT EXPENSE (AT COST) ON LINE 2 IS CALCULATED USING THE SAME METHODOLOGY AS CHARITY CARE AND OTHER COMMUNITY BENEFITS USING AN ENTITY SPECIFIC COST TO CHARGE RATIO (RCC).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 V, SECTION B, LINE 10: 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). OTHER PATIENTS MAY ALSO BE ELIGIBLE FOR DISCOUNTS FOR BALANCES ABOVE $5,000 (CATASTROPHIC DISCOUNT).PRESBYTERIAN HOSPITAL
PART V, SECTION B, LINE 10: 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). OTHER PATIENTS MAY ALSO BE ELIGIBLE FOR DISCOUNTS FOR BALANCES ABOVE $5,000 (CATASTROPHIC DISCOUNT).PRESBYTERIAN HOSPITAL HUNTERSVILLE
PART V, SECTION B, LINE 17E: PRESBYTERIAN HOSPITAL:PART V, SECTION B, LINES 15, 16, AND 17:WE DID NOT CHECK ANYTHING FOR QUESTION 15, 16 AND 17 BECAUSE WE PROCEED WITH ALL REASONABLE EFFORTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE PRIOR TO INITIATING ANY COLLECTION ACTIONS.PRESBYTERIAN HOSPITAL
PART V, SECTION B, LINE 17E: PRESBYTERIAN HOSPITAL HUNTERSVILLE:PART V, SECTION B, LINES 15, 16, AND 17:WE DID NOT CHECK ANYTHING FOR QUESTION 15, 16 AND 17 BECAUSE WE PROCEED WITH ALL REASONABLE EFFORTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE PRIOR TO INITIATING ANY COLLECTION ACTIONS.PRESBYTERIAN HOSPITAL HUNTERSVILLE
PART V, SECTION B, LINE 19D: THE HOSPITAL FACILITY USED THE AVERAGE OF ITS NEGOTIATED COMMERCIAL INSURANCE RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED.PRESBYTERIAN HOSPITAL
PART V, SECTION B, LINE 19D: THE HOSPITAL FACILITY USED THE AVERAGE OF ITS NEGOTIATED COMMERCIAL INSURANCE RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED.PRESBYTERIAN HOSPITAL HUNTERSVILLE
PART VI, LINE 2: NEEDS ASSESSMENTTHE ORGANIZATION IS PART OF THE NOVANT HEALTH CARE SYSTEM, WHICH HAS A COMMUNITY BENEFIT COMMITTEE. THE COMMUNITY BENEFIT COMMITTEE IS RESPONSIBLE FOR ASSISTING THE HOSPITALS WITHIN THE HEALTH CARE 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 HEALTH CARE 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 HEALTH CARE 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. - UNINSURED PATIENTS WITH INCOMES OF UP TO 300% OF THE FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR 100% WRITE-OFF. - UNINSURED PATIENTS WITH INCOME OVER 300% OF THE FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR SELF-PAY DISCOUNTS BASED ON THE PATIENT'S ANNUAL INCOME AND OUTSTANDING MEDICAL BILLS / COSTS. - ANY PATIENT (EVEN WITH HEALTH INSURANCE) WITH A BALANCE OVER $5,000 AND / OR INCOME OVER 300% OF THE FEDERAL POVERTY LEVEL IS ELIGIBLE FOR A CATASTROPHIC DISCOUNT. OUR CATASTROPHIC DISCOUNTS ARE ALSO BASED ON THE PATIENT'S ANNUAL INCOME AND OUTSTANDING MEDICAL BILLS / COSTS.- ANY PATIENT IS ELIGIBLE FOR AN INDIVIDUALIZED PAYMENT PLAN BASED ON THE AMOUNT DUE AND THE PATIENT'S FINANCIAL STATUS, WITH TERMS EXTENDING UP TO FIVE YEARS. NO INTEREST IS CHARGED, UNLESS APPROPRIATE. 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 SELF-PAY PATIENTS AND INSURED PATIENTS WITH HIGH DEDUCTIBLES 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 PRESBYTERIAN HOSPITAL, INC. FORM 990 INCLUDES THE OPERATIONS OF TWO HOSPITALS. PRESBYTERIAN HOSPITAL THE ORGANIZATION DEFINES ITS COMMUNITY BY ITS PRIMARY SERVICE AREA, WHICH IS MECKLENBURG COUNTY, NORTH CAROLINA.THERE ARE FOUR NONPROFIT HOSPITALS IN THE COMMUNITY, ONE OF WHICH IS THE ORGANIZATION AND ALL OF WHICH ARE PART OF THE NOVANT HEALTH CARE SYSTEM. THERE ARE ALSO FOUR GOVERNMENTAL HOSPITALS, WHICH ARE ALL PART OF THE SAME HEALTH CARE SYSTEM. ACCORDING TO TRUVEN HEALTH DATA, THE SPECIFIC POPULATION GROUPS (ETHNIC AND CULTURAL) ARE AS FOLLOWS: WHITE NON-HISPANIC (475,012) 49.1%; BLACK NON-HISPANIC (294,616) 30.5%; HISPANIC (126,051) 13.0%; OTHERS (24,126) 2.5%; ASIAN AND PACIFIC ISLAND (47,062) 4.9%; FOR A TOTAL POPULATION OF 966,867. ACCORDING TO TRUVEN HEALTH DATA, THE MEDIAN HOUSEHOLD INCOME LEVEL WAS $56,825.ACCORDING TO TRUVEN HEALTH DATA, THE AGE BREAKDOWN IS AS FOLLOWS: 0-17 YEARS (253,670) 26.2%; 18-64 YEARS (631,107) 65.3%; 65+ YEARS (82,090) 8.5%PRESBYTERIAN HOSPITAL HUNTERSVILLE THE ORGANIZATION DEFINES ITS COMMUNITY BY ITS PRIMARY SERVICE AREA, WHICH IS COMPRISED OF THE FOLLOWING FOUR ZIP CODES: 28031 (CORNELIUS, NORTH CAROLINA); 28078 (HUNTERSVILLE, NORTH CAROLINA); 28216 (CHARLOTTE, NORTH CAROLINA) AND 28269 (CHARLOTTE, NORTH CAROLINA).THERE IS ONE NONPROFIT HOSPITAL IN THE COMMUNITY, WHICH IS THE ORGANIZATION. THERE IS ALSO ONE GOVERNMENTAL HOSPITAL AND ONE FOR PROFIT HOSPITAL. ACCORDING TO TRUVEN HEALTH DATA, THE SPECIFIC POPULATION GROUPS (ETHNIC AND CULTURAL) ARE AS FOLLOWS: WHITE NON-HISPANIC (102,138) 49.9%; BLACK NON-HISPANIC (71,377) 34.9%; HISPANIC (17,690) 8.6%; OTHERS (5,204) 2.5%; ASIAN AND PACIFIC ISLAND (8,243) 4.0%; FOR A TOTAL POPULATION OF 204,652. ACCORDING TO TRUVEN HEALTH DATA, THE MEDIAN HOUSEHOLD INCOME LEVEL WAS $65,764. ACCORDING TO TRUVEN HEALTH DATA, THE AGE BREAKDOWN IS AS FOLLOWS: 0-17 YEARS (57,791) 28.2%; 18-64 YEARS (131,113) 64.1%; 65+ YEARS (15,748) 7.7%
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 A FULL-TIME EMERGENCY ROOM WHICH IS OPEN TO AND ACCEPTS 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 HEALTH CARE 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 HEALTH CARE ORGANIZATIONS IN THE COMMUNITIES IT SERVES; AND14. GENERALLY PROMOTING THE HEALTH, WELLNESS, AND WELFARE OF THE COMMUNITIES IT SERVES BY PROVIDING QUALITY HEALTH CARE 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 HEALTH CARE FACILITIES IN THE SAME HEALTH CARE 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 ONE OF TEN TAX-EXEMPT HOSPITALS IN THE NOVANT HEALTH CARE SYSTEM IN NORTH CAROLINA AND VIRGINIA. 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 HEALTH CARE 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 HEALTH CARE 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 HEALTH CARE 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 HEALTH CARE SYSTEM HAS A COMMUNITY BENEFIT COMMITTEE, WHICH WILL OVERSEE AND ASSIST ALL TAX-EXEMPT HOSPITALS WITHIN NOVANT 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 HEALTH CARE 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

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (30 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
AMERICAN CANCER SOCIETY
6000 FAIRVIEW RD STE 200CHARLOTTENC28210580659875501(C)(3)11500CANCER AWARENESS
AMERICAN HEART ASSOCIATION
222 SOUTH CHURCH ST STE 303CHARLOTTENC28202135613797501(C)(3)65000COMMUNITY OUTREACH
BRAIN TUMOR FOR THE CAROLINAS
PO BOX 5627CHARLOTTENC28299208208247501(C)(3)210250COMMUNITY OUTREACH
CATAWBA RIVER DISTRICT
1904 STONEYRIDGE DRCHARLOTTENC28214270176418501(C)(3)7500COMMUNITY OUTREACH
CHARLOTTE CENTER CITY PARTNERS
200 S TRYON ST STE 1600CHARLOTTENC28202561247787501(C)(4)115000COMMUNITY OUTREACH
CHARLOTTE CHAMBER OF COMMERCE
PO BOX 32785CHARLOTTENC28232560173610501(C)(6)22300COMMUNITY OUTREACH
COLON CANCER COALITION
8009 34TH AVENUE STE 360BLOOMINGTONMN55425300377727501(C)(3)10000CANCER AWARENESS
COMMUNITY BUILDING INITIATIVE
217 SOUTH TRYON STREETCHARLOTTENC28202202892726501(C)(3)10000COMMUNITY OUTREACH
CULTURE & HERITAGE COMMISSION
4621 MT GALLANT RDROCK HILLSC29732237257020501(C)(3)7500COMMUNITY OUTREACH
DANIEL STOWE BOTANICAL GARDEN
6500 SOUTH NEW HOPE RDBELMONTNC28012208362933501(C)(3)10000COMMUNITY OUTREACH
DISCOVERY PLACE KIDS
PO BOX 237HUNTERSVILLENC28078560529944501(C)(3)113095COMMUNITY OUTREACH
GANTT CENTER
551 SOUTH TRYON STREETCHARLOTTENC28202561152286501(C)(3)50000COMMUNITY OUTREACH
HEARTBRIGHT FOUNDATION
2923 SOUTH TRYON SUITE 200CHARLOTTENC28203450496759501(C)(3)20000COMMUNITY OUTREACH
JUVENILE DIABETES FOUNDATION
1401-B OLD MILL CIRCLEWINSTONSALEMNC27103231907729501(C)(3)18000COMMUNITY OUTREACH
LAKE NORMAN COMMUNITY HEALTH CLINIC
14230 HUNTERS ROADHUNTERSVILLENC28078043723062501(C)(3)57160COMMUNITY HEALTH
LAKE NORMAN REGIONAL ECONOMIC DEVELOPMENT CORP
13801 REESE BLVD W STE 200-AHUNTERSVILLENC28078510463069501(C)(3)9500COMMUNITY OUTREACH
LEADERSHIP CHARLOTTE
PO BOX 11757CHARLOTTENC28220561684782501(C)(3)5500COMMUNITY OUTREACH
LEUKEMIA & LYMPHOMA SOCIETY
1577 NEW GARDEN RD STE DGREENSBORONC27410135644916501(C)(3)17302CANCER AWARENESS
LUNG STRONG 15K 5K
3915 AUTUMN HARVEST LANECHARLOTTENC28269263677470501(C)(3)10000COMMUNITY HEALTH
MARCH OF DIMES
410 BROOKSTOWN AVEWINSTONSALEMNC27101131846366501(C)(3)12500COMMUNITY OUTREACH
MECKLENBURG AQUATIC CLUB
9850 PROVIDENCE RDCHARLOTTENC28277591769720501(C)(3)30000COMMUNITY OUTREACH
MECKLENBURG CITIZENS FOR PUBLIC EDUCATION
129 W TRADE ST STE 1555CHARLOTTENC28202561752043501(C)(3)15000COMMUNITY OUTREACH
MECKLENBURG COUNCIL OF NURSING
PO BOX 37402CHARLOTTENC28237561848870501(C)(6)6750COMMUNITY OUTREACH
MINT HILL CHAMBER OF COMMERCE
PO BOX 23223MINT HILLNC28227208311079501(C)(6)7500SCHOLARSHIP FUND
NC PHYSICIANS HEALTH PROGRAM
220 HORIZON DRIVE SUITE 201RALEIGHNC27615561846599501(C)(3)12000PHYSICIAN OUTREACH
NORTH MECK SOCCER CLUB
11138 TREYNORTH DR STE BCORNELIUSNC28031611556757501(C)(3)10000COMMUNITY OUTREACH
ROTARY CLUB OF LAKE NORMAN HUNTERSVILLE INC
PO BOX 2306HUNTERSVILLENC28070262902286501(C)(3)12000COMMUNITY OUTREACH
SUSAN G KOMEN FOUNDATION
5005 LBJ FREEWAY STE 250DALLASTX75244751835298501(C)(3)50000COMMUNITY OUTREACH
TOWN OF MATTHEWS
100 MCDOWELL STREETMATTHEWSNC28105566001283TOWN OF MATTHEWS7000COMMUNITY OUTREACH
GREATER WINSTON SALEM CHAMBER OF COMMERCE
601 WEST 4TH STWINSTONSALEMNC27101560459820501(C)(6)20680COMMUNITY OUTREACH
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants25TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations5TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantEDUCATIONAL SCHOLARSHIPSTypeOfGrant
Number Of Recipients10NumberOfRecipients
Amount Of Cash Grant30000AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
ExplanationPART I, LINE 2 - PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS THE ORGANIZATION IS AN AFFILIATE IN AN INTEGRATED HEALTH CARE 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

FieldValueIRS element (for citing)
First Class Or Charter TravelXFirstClassOrCharterTravel
Travel For CompanionsXTravelForCompanions
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Discretionary Spending AccountXDiscretionarySpendingAccount
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Severance Payment1SeverancePayment
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 (15 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
BILLINGSDERRICK MARK
52142102799750221360279858081800111157002799750
GARNERSTUART J
0354664031749012415022200021873044290100
WALSHBETSY JEAN
0219206044265053500211500256980315669044265
STILLERMANSHELLI STOKER
0182605026180079500112200202430248198026180
VANCEAMY SUSAN
2789630175560011813022200019358050789401755600
VINCENTPAULA ROLLINS
30233401979900430770141875013539069881501949900
BLACKMONTANYA S
2127540498000105740780001864702995750498000
JONESVELVETTE LAJEUNE
288890243000116344020080181870189728000
MCADAMSSTEPHEN
1342040350000184508077017030180829000
ZWENGTHOMAS NELSON
3781930263460023277022200032618071974802634600
JOHNSONWALTER W
19699607023707690100000250020303004000
REILINGRICHARD B
2234990652500934101143002119003307100652500
SHOAF JREDWIN H
1956910939830223301212001791003219370224510
STEGERELIZABETH ANN
218817036938011338098980234660300457000
WISEJAIME
2406517188208751508900105170153782406528618200

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 1AFRINGE 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 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. THE ORGANIZATION PROVIDES A TEMPORARY RESIDENCE FOR LIMITED EXECUTIVE USE THAT AT TIMES MAY INCLUDE INCIDENTAL PERSONAL USE. IN THAT CASE, THE VALUE IS CALCULATED UNDER APPLICABLE TAX LAWS AND THAT AMOUNT IS INCLUDED IN THE EXECUTIVE'S TAXABLE 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 3THE 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-BSEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE NONQUALIFIED EQUITY-BASED JONES, VELVETTE LAJEUNE 63,154 0 0
PART IIIPART 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 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). A MINIMUM LEVEL OF COMMUNITY BENEFIT AND CHARITY CARE, AS WELL AS A MINIMUM LEVEL OF FINANCIAL PERFORMANCE, IS REQUIRED BEFORE ANY AWARD CAN BE PAID UNDER THE PLAN. 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 THIS LONG-TERM INCENTIVE 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: SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN: 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 RETIREMENT PLAN.SUPPLEMENTAL INFORMATION

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (15 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ACTIVITIESFORM 990, PART I, LINE 1: ORGANIZATION'S MISSION OR MOST SIGNIFICANTPRESBYTERIAN HOSPITAL AND PRESBYTERIAN HOSPITAL HUNTERSVILLE ARE INTEGRAL PARTS OF THE NOVANT HEALTH SYSTEM (COLLECTIVELY KNOWN AS "NOVANT"), A NOT-FOR-PROFIT INTEGRATED GROUP OF HOSPITALS, PHYSICIAN CLINICS, OUTPATIENT CENTERS AND OTHER HEALTHCARE SERVICE PROVIDERS. NOVANT IS RANKED AS ONE OF OUR NATION'S TOP 25 HEALTHCARE SYSTEMS - CARING FOR PATIENTS AND COMMUNITIES IN NORTH CAROLINA, VIRGINIA AND SOUTH CAROLINA. NOVANT HEALTH REPORTED $3.453 BILLION IN REVENUES IN 2011. PRESBYTERIAN HOSPITAL AND PRESBYTERIAN HOSPITAL HUNTERSVILLE EXIST TO IMPROVE THE HEALTH OF THE COMMUNITIES THEY SERVE WITH A VISION OF PROVIDING A REMARKABLE PATIENT EXPERIENCE IN EVERY DIMENSION, EVERY TIME. THEY ACCOMPLISH THAT MISSION BY PROVIDING HEALTHCARE SERVICES TO ALL WHO ENTRUST THEIR CARE TO THEM AND BY SUPPORTING THE GREATER CHARLOTTE COMMUNITY THROUGH PARTNERSHIPS AND OUTREACH. THE HOSPITALS' SUPPORT ORGANIZATIONS THAT PROVIDE HEALTH SERVICES, EDUCATION AND ASSISTANCE TO THE UNINSURED AND OVERALL COMMUNITY. IN ADDITION TO OUR QUALITY OF SERVICES, WE'RE VERY PROUD OF OUR PATIENT FINANCIAL ASSISTANCE PROGRAM. WE WORK WITH INDIVIDUALS TO HELP QUALIFY THEM FOR PUBLIC ASSISTANCE, ESTABLISH A REASONABLE PAYMENT PLAN, DISCOUNT THEIR BILL TO REFLECT THEIR PERSONAL RESOURCES OR PROVIDE THEM WITH FREE CHARITY CARE. COMMUNITY OUTREACH THE HOSPITALS ARE PROUD OF THEIR OUTREACH EFFORTS, SUCH AS THE PRESBYTERIAN HOSPITAL COMMUNITY CARE CRUISER, SUPPORTED ENTIRELY BY DONATIONS SECURED THROUGH THE PRESBYTERIAN HOSPITAL FOUNDATION. THE CRUISER IS A 38-FOOT MEDICAL CLINIC-ON-WHEELS. THE CLINICAL STAFF ON THE CRUISER PROVIDES PRIMARY AND PREVENTIVE PEDIATRIC MEDICAL CARE TO UNDERSERVED CHILDREN IN CHARLOTTE AND SURROUNDING AREAS. THE CRUISER HAS JOURNEYED INTO AT-RISK NEIGHBORHOODS, TREATED MORE THAN 6,700 PATIENTS AND PROVIDED MORE THAN 9,600 IMMUNIZATIONS SINCE ITS LAUNCH IN 2007. IN 2011, PRESBYTERIAN HOSPITAL LAUNCHED THE VITALITY CHALLENGE, A PROGRAM TO ENCOURAGE THE COMMUNITY TO ADOPT HEALTH HABITS FOR WEIGHT LOSS. A COMMUNITY HEALTH DAY WAS HELD AT A LOCAL COLLEGE AND PROVIDED FREE HEALTH SCREENINGS AND EDUCATIONAL SEMINARS TO OVER 150 PEOPLE. PRESBYTERIAN HOSPITAL HUNTERSVILLE'S CARDIAC NURSE NAVIGATOR PROVIDED BLOOD PRESSURE SCREENINGS IN LOCAL BARBERSHOPS, EDUCATING MEN ABOUT HEART DISEASE WHO MIGHT NOT OTHERWISE SEEK CARE FROM A PHYSICIAN. PRESBYTERIAN HOSPITAL HUNTERSVILLE ALSO HOSTED FREE COMMUNITY PROSTATE CANCER SCREENINGS TO MEN IN THE AREA IN 2011. NEW TECHNOLOGY & SERVICES PRESBYTERIAN HOSPITAL AND PRESBYTERIAN HOSPITAL HUNTERSVILLE ARE CONTINUALLY ANALYZING OUR HEALTHCARE OFFERINGS TO DETERMINE WHAT NEW TECHNOLOGY AND SERVICES SHOULD BE PROVIDED FOR OUR PATIENTS. IN 2011, PRESBYTERIAN HOSPITAL INTRODUCED THE FOLLOWING NEW SERVICES: - PRESBYTERIAN SPINE FRACTURE CLINIC - A CLINIC TO FACILITATE TIMELY, APPROPRIATE TREATMENT FOR VERTEBRAL COMPRESSION FRACTURES. WHEN LEFT UNTREATED, THESE FRACTURES HEAL SLOWLY OR NOT AT ALL AND CAN LEAD TO PERMANENT PROBLEMS. THE NEW SPINE FRACTURE CLINIC PROVIDES PATIENTS AND REFERRING PHYSICIANS A SEAMLESS PROCESS FOR FURTHER EVALUATION ONCE A FRACTURE HAS BEEN DETECTED, FOLLOWED BY MINIMALLY INVASIVE THERAPY DESIGNED TO RAPIDLY REDUCE PAIN AND STABILIZE THE SPINE TO FOSTER HEALING. - PRESBYTERIAN ANEURYSM CLINIC - IN DECEMBER 2011, THE PRESBYTERIAN ANEURYSM CLINIC WAS CREATED TO ADDRESS THE DANGER OF INTRACRANIAL ANEURYSMS. WHILE MANY INDIVIDUALS LIVE WITH UNDETECTED INTRACRANIAL ANEURYSMS FOR YEARS, AN ANEURYSM BECOMES LIFE-THREATENING THE MOMENT IT RUPTURES. 20 PERCENT RESULT IN DEATH WITHIN THE FIRST 24 HOURS. OF THE REMAINING 80 PERCENT, ONE-THIRD DIE IN THE HOSPITAL, ONE-THIRD SUFFER SIGNIFICANT, LONG-TERM NEUROLOGICAL SYMPTOMS, AND ONE-THIRD WILL RETURN TO INDEPENDENT LIVING BUT WITH SIDE EFFECTS. WHEN AN ANEURYSM IS DETECTED, THE TEAM EVALUATES AND WEIGHS ALL OF THESE FACTORS AND RECOMMENDATION FOLLOW-UP OR TREATMENT TO REDUCE THE RISK OF RUPTURE. - NEW HOSPITAL WING AND CHILDREN'S EMERGENCY DEPARTMENT - IN 2011, PRESBYTERIAN HOSPITAL OPENED TWO NEW WINGS TO THE HOSPITAL. ONE IS A 100,000-SQUARE-FOOT, FOUR-STORY VERTICAL EXPANSION WHICH INCLUDES 90 NEW STATE-OF-THE-ART PATIENT ROOMS, A 20-BED CARDIAC TRIAGE UNIT, NEW PUBLIC SAFETY/EMERGENCY MANAGEMENT OFFICE AND 5,000 SQUARE FEET OF ADDITIONAL EDUCATIONAL CLASSROOMS. THE SECOND WING HOUSES NEW OPERATING ROOM SUITES, A NEW PHARMACY AS WELL AS AN EXPANDED CHILDREN'S EMERGENCY DEPARTMENT WHICH TRIPLED ITS SIZE. THE CHILD-FRIENDLY SPACE WAS DESIGNED WITH A SEPARATE ENTRANCE AND WAITING ROOM, 14 EXAM ROOMS AND TWO TRIAGE ROOMS, AS WELL AS TWO CRITICAL CARE ROOMS SPECIALLY DESIGNED FOR PEDIATRICS. - LUNG NODULE EVALUATION PROGRAM - THROUGH A PARTNERSHIP BETWEEN RADIOLOGY, PULMONOLOGY, THORACIC SURGERY AND ONCOLOGY, THIS PROGRAM PROVIDES A CLEAR PATH OF CARE FOR PATIENTS WHO ARE FOUND TO HAVE INCIDENTAL LUNG NODULES DURING A CT SCAN. ONCE THESE NODULES ARE IDENTIFIED, EACH CASE IS ASSESSED AND TREATMENT OR FOLLOW-UP CARE IS PROVIDED. - VASCULAR SCREENING PROGRAM - PRESBYTERIAN HOSPITAL HUNTERSVILLE LAUNCHED THIS PROGRAM IN LATE 2011 WHICH PROVIDES PATIENTS ACCESS TO DIAGNOSTIC TESTS TO DETERMINE THEIR RISK FOR VASCULAR DISEASE, FOLLOWED BY EDUCATION AND RECOMMENDATIONS FOR CARE. - CANCER PATIENT NAVIGATOR - PRESBYTERIAN HOSPITAL HUNTERSVILLE ADDED ITS FIRST CANCER PATIENT NAVIGATOR, A REGISTERED NURSE WITH SPECIAL TRAINING IN ONCOLOGY. THE NAVIGATOR'S PRIMARY FUNCTION IS TO MAKE THE CANCER JOURNEY AS SEAMLESS AS POSSIBLE FOR PATIENTS. SHORTLY AFTER DIAGNOSIS, THE NAVIGATOR CONSULTS WITH THE PATIENT AND PROVIDES INFORMATION ON AVAILABLE PROGRAMS SUCH AS SUPPORT GROUPS, COUNSELING, SYMPTOM MANAGEMENT AND THE SECOND OPINION CANCER CLINIC. THE NAVIGATOR ALSO COORDINATES PHYSICIAN APPOINTMENTS, PROVIDES A FAMILIAR FACE AT PRE-SURGERY/SURGERY, AND ANSWERS QUESTIONS AND OFFERS SUPPORT. AWARDS, RECOGNITIONS & RE-CERTIFICATIONS PRESBYTERIAN HOSPITAL AND PRESBYTERIAN HOSPITAL HUNTERSVILLE WERE THE RECIPIENTS OF SEVERAL NATIONAL AWARDS IN 2011: - BEST HOSPITALS IN AMERICA - PRESBYTERIAN HOSPITAL WAS NAMED ONE OF THE 50 BEST HOSPITALS IN AMERICA BY BECKER'S HOSPITAL REVIEW IN 2011. THE HOSPITAL RECEIVED THIS RECOGNITION FOR ITS QUALITY CARE, PUTTING PATIENTS' NEEDS FIRST AND USING INNOVATION IN HEALTHCARE. - MISSION: LIFELINE SILVER AND BRONZE PERFORMANCE ACHIEVEMENT AWARD - PRESBYTERIAN HOSPITAL RECEIVED THE SILVER AWARD FROM THE AMERICAN HEART ASSOCIATION AND PRESBYTERIAN HOSPITAL HUNTERSVILLE RECEIVED THE BRONZE AWARD. THE AWARDS RECOGNIZE PRESBYTERIAN'S COMMITMENT AND SUCCESS IN IMPLEMENTING A HIGHER STANDARD OF CARE FOR HEART ATTACK PATIENTS THAT EFFECTIVELY IMPROVES THE SURVIVAL AND CARE OF STEMI (ST ELEVATION MYOCARDIAL INFARCTION) PATIENTS. HOSPITALS INVOLVED IN MISSION: LIFELINE STRIVE TO IMPROVE CARE IN BOTH ACUTE TREATMENT MEASURES AND DISCHARGE MEASURES. - VHA LEADERSHIP AWARD FOR CLINICAL EXCELLENCE - VHA INC., A NATIONAL HEALTHCARE NETWORK OF NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS, RECENTLY PRESENTED PRESBYTERIAN HOSPITAL WITH ITS 2011 VHA LEADERSHIP AWARD FOR CLINICAL EXCELLENCE, AN HONOR FOR EXCEEDING NATIONAL PERFORMANCE STANDARDS FOR CLINICAL CARE AND IMPROVING THE PATIENT EXPERIENCE. PRESBYTERIAN HOSPITAL IS AMONG ONLY 28 HOSPITALS NATIONWIDE, AND THE ONE OF ONLY THREE HOSPITALS IN THE CAROLINAS, RECOGNIZED BY VHA FOR ACHIEVING TOP PERFORMANCE IN CENTERS FOR MEDICARE AND MEDICAID SERVICES' CLINICAL CORE MEASURES AND HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS). - 60 HOSPITALS WITH GREAT ORTHOPEDIC PROGRAMS - PRESBYTERIAN ORTHOPAEDIC HOSPITAL (POH), A RELATED HOSPITAL CLOSELY ALIGNED WITH PRESBYTERIAN HOSPITAL, WAS ONE OF ONLY FOUR HOSPITALS IN THE CAROLINAS NAMED TO THE "60 HOSPITALS WITH GREAT ORTHOPEDIC PROGRAMS" LIST FOR 2011 BY BECKER'S HOSPITAL REVIEW. HOSPITALS WERE INCLUDED ON THIS LIST BASED ON EXHIBITING EXCELLENCE IN ORTHOPEDICS, QUALITY OF SERVICE, OUTSTANDING LOCAL AND NATIONAL REPUTATIONS AND HIGH VOLUME OF ORTHOPEDIC CASES. - PRC "TOP PERFORMER" PATIENT SATISFACTION AWARD - PRESBYTERIAN HOSPITAL'S OUTPATIENT RADIATION ONCOLOGY DEPARTMENT RECEIVED A "TOP PERFORMER" AWARD FROM PROFESSIONAL RESEARCH CONSULTANTS (PRC), A NATIONAL HEALTHCARE MARKETING ORGANIZATION THAT CONDUCTS SATISFACTION SURVEYS FOR THE HOSPITAL. THE TOP PERFORMER AWARD INDICATES THAT FACILITIES ARE AT OR ABOVE THE 100TH PERCENTILE FOR THE OVERALL QUALITY OF CARE PERCENT "EXCELLENT" SCORE FROM THE NATIONAL CLIENT DATABASE.
FORM 990, PART III, LINE 1: MISSION, VISION, AND VALUESMISSION: 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.
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 $567,000,000 IN 2011. 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 4A: PROGRAM SERVICE ACCOMPLISHMENTSPHH HAD 60 LICENSED BEDS. THERE WERE 20,340 PATIENT DAYS, WITH AN AVERAGE LENGTH OF STAY OF 3.6 DAYS AND AN AVERAGE DAILY CENSUS OF 56. THERE WERE 5,598 DISCHARGES, 4,680 INPATIENT AND OUTPATIENT SURGERIES, 58,018 OUTPATIENT ENCOUNTERS AND 34,611 EMERGENCY DEPARTMENT VISITS.
FORM 990, PART VI, SECTION A, LINE 4SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS THE BYLAWS WERE REVISED TO CHANGE AND/OR ADD OFFICER TITLES.
FORM 990, PART VI, SECTION A, LINE 6CLASSES OF MEMBERS OR STOCKHOLDERS THE CORPORATION IS A NONPROFIT CORPORATION WITH MEMBERS (OR A MEMBER).
FORM 990, PART VI, SECTION A, LINE 7AELECTION OF MEMBERS AND THEIR RIGHTS THE BOARD MEMBERS OF THE GOVERNING BODY OF PRESBYTERIAN HOSPITAL ARE THE SAME AS THOSE OF THE NOVANT HEALTH SOUTHERN PIEDMONT REGION, LLC, A RELATED ENTITY.
FORM 990, PART VI, SECTION A, LINE 7BDECISIONS SUBJECT TO APPROVAL OF MEMBERS THE BOARD OF NOVANT HEALTH, INC. APPROVES CHANGES MADE TO THE PRESYTERIAN HOSPITAL BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11ORGANIZATION'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 12CMONITORING 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 POTENTIAL CONFLICT OF INTEREST IS DISCLOSED BY THE BOARD MEMBER, GENERALLY IN ADVANCE OF THE MEETING AT WHICH A VOTE IS TO TAKE PLACE, AND LEGAL COUNSEL DISCUSSES THE POTENTIAL CONFLICT OF INTEREST WITH THE BOARD MEMBER. THE BOARD MEMBER IS INSTRUCTED IN ACCORDANCE WITH THE TRUSTEE CONFLICT OF INTEREST POLICY. IF A CONFLICT OF INTEREST IS FOUND TO EXIST, THEN THE BOARD MEMBER WITH THE CONFLICT REFRAINS FROM PARTICIPATION IN THE BOARD'S DELIBERATIONS AND VOTE ON THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 13: WRITTEN WHISTLEBLOWER POLICY THE ORGANIZATION IS PART OF THE INTEGRATED HEALTHCARE SYSTEM OPERATED BY NOVANT HEALTH, INC. ("NOVANT HEALTH"), THE PARENT ORGANIZATION. NOVANT HEALTH'S BYLAWS AUTHORIZE IT TO ESTABLISH CERTAIN POLICIES FOR ALL OF ITS SUBSIDIARIES WITHIN THE SYSTEM. ALL SUBSIDIARY ORGANIZATIONS FOLLOW ALL APPLICABLE NOVANT HEALTH CORPORATE POLICIES IN THEIR OPERATIONS. NOVANT HEALTH HAS ESTABLISHED A WHISTLEBLOWER POLICY, WHICH ALL SUBSIDIARY ORGANIZATIONS IN THE SYSTEM FOLLOW. THE INDIVIDUAL SUBSIDIARY ORGANIZATION'S BOARD OF TRUSTEES DO NOT SPECIFICALLY ADOPT OR APPROVE EACH OPERATING POLICY, AS THERE ARE HUNDREDS OF POLICIES THAT APPLY TO ALL SUBSIDIARY ORGANIZATIONS AND THEY CANNOT PRACTICABLY BE APPROVED BY ALL OF THE INDIVIDUAL BOARDS. FORM 990, PART VI, SECTION B, LINE 14: WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY THE ORGANIZATION IS PART OF THE INTEGRATED HEALTHCARE SYSTEM OPERATED BY NOVANT HEALTH, INC. ("NOVANT HEALTH"), THE PARENT ORGANIZATION. NOVANT HEALTH'S BYLAWS AUTHORIZE IT TO ESTABLISH CERTAIN POLICIES FOR ALL OF ITS SUBSIDIARIES WITHIN THE SYSTEM. ALL SUBSIDIARY ORGANIZATIONS FOLLOW ALL APPLICABLE NOVANT HEALTH CORPORATE POLICIES IN THEIR OPERATIONS. NOVANT HEALTH HAS ESTABLISHED A DOCUMENT RETENTION AND DESTRUCTION POLICY, WHICH ALL SUBSIDIARY ORGANIZATIONS IN THE SYSTEM FOLLOW. THE INDIVIDUAL SUBSIDIARY ORGANIZATION'S BOARD OF TRUSTEES DO NOT SPECIFICALLY ADOPT OR APPROVE EACH OPERATING POLICY, AS THERE ARE HUNDREDS OF POLICIES THAT APPLY TO ALL SUBSIDIARY ORGANIZATIONS AND THEY CANNOT PRACTICABLY BE APPROVED BY ALL OF THE INDIVIDUAL BOARDS.
FORM 990, PART VI, SECTION B, LINE 15FORM 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 19GOVERNING 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 ORGANIZATIONSTHE 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 HEALTH CARE 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 5:AFFILIATE TRANSFERS: -1,623,219. MALPRACTICE INSURANCE ADJUSTMENT: -3,432,914. K-1 ADJUSTMENTS: -916,965. TOTAL TO FORM 990, PART XI, LINE 5: -5,973,098.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (24 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
AUXILIARY OF FORSYTH MEMORIAL HOSPITAL
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560862112HEALTHCARENC501(C)(3)LINE 9FORSYTH MEMORIAL HOSPITAL0
BRUNSWICK NOVANT MEDICAL CENTER FOUNDATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103274616751HEALTHCARENC501(C)(3)LINE 7BRUNSWICK COMMUNITY HOSPITAL LLC0
CAROLINA MEDICORP ENTERPRISES
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103581466368HEALTHCARENC501(C)(3)LINE 11B, IINOVANT MEDICAL GROUP0
COMMUNITY GENERAL HEALTH PARTNERS
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560636250HEALTHCARENC501(C)(3)LINE 3NOVANT HEALTH TRIAD REGION0
COMMUNITY GENERAL HOSPITAL FOUNDATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561828629HEALTHCARENC501(C)(3)LINE 7COMMUNITY GENERAL HEALTH PARTNERS0
CONTINUING CARE SERVICES
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103541288473HEALTHCAREVA501(C)(3)LINE 9PRINCE WILLIAM HEALTH SYSTEM0
FORSYTH MEDICAL CENTER FOUNDATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103562120959HEALTHCARENC501(C)(3)LINE 7FORSYTH MEMORIAL HOSPITAL0
FORSYTH MEMORIAL HOSPITAL
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560928089HEALTHCARENC501(C)(3)LINE 3NOVANT HEALTH TRIAD REGION0
FOUNDATION HEALTH SYSTEMS CORP
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561373175HEALTHCARENC501(C)(3)LINE 9NOVANT HEALTH TRIAD REGION0
MEDICAL PARK HOSPITAL
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561340424HEALTHCARENC501(C)(3)LINE 3NOVANT HEALTH TRIAD REGION0
NOVANT HEALTH INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561376950HEALTHCARENC501(C)(3)LINE 11C, III-FI0N/A
NOVANT MEDICAL GROUP
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103581728803HEALTHCARENC501(C)(3)LINE 3NMG SERVICES INC0
PERSONAL CARE SERVICES
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103541291284HEALTHCAREVA501(C)(3)LINE 9PRINCE WILLIAM HEALTH SYSTEM0
PRESBYTERIAN HOSPITAL FOUNDATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103581413074HEALTHCARENC501(C)(3)LINE 7NOVANT HEALTH SOUTHERN PIEDMONT REGION0
PRESBYTERIAN MEDICAL CARE CORPORATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561376368HEALTHCARENC501(C)(3)LINE 3NOVANT HEALTH SOUTHERN PIEDMONT REGION0
PRINCE WILLIAM HEALTH SYSTEM
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103541278944HEALTHCAREVA501(C)(3)LINE 11C, III-FINOVANT HEALTH0
PRINCE WILLIAM HEALTH SYSTEM FOUNDATION
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103541307595HEALTHCAREVA501(C)(3)LINE 11A, IPRINCE WILLIAM HEALTH SYSTEM0
PRINCE WILLIAM HOSPITAL
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103540696355HEALTHCAREVA501(C)(3)LINE 3PRINCE WILLIAM HEALTH SYSTEM0
ROWAN HEALTH SERVICES CORP
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561424814HEALTHCARENC501(C)(3)LINE 11C, III-FINOVANT HEALTH0
NMG SERVICES INC (FKA ROWAN MEDICAL PRACTICES)
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103562098809HEALTHCARENC501(C)(3)LINE 9NOVANT HEALTH0
ROWAN REGIONAL MEDICAL CENTER AUXILIARY
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103237022472HEALTHCARENC501(C)(3)LINE 9ROWAN REGIONAL MEDICAL CENTER0
ROWAN REGIONAL MEDICAL CENTER FOUNDATION INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103561424818HEALTHCARENC501(C)(3)LINE 7ROWAN REGIONAL MEDICAL CENTER0
ROWAN REGIONAL MEDICAL CENTER INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103560547479HEALTHCARENC501(C)(3)LINE 3ROWAN HEALTH SERVICES CORP0
SELF INSURANCE FUND - NOVANT HEALTH INC
2085 FRONTIS PLAZA BLVDWINSTON SALEMNC27103581867242HEALTHCARENC501(C)(3)LINE 11C, III-FINOVANT HEALTH0

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1SOUTHPARK SURGERY CENTER LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12085 FRONTIS PLAZA BLVDAddressLine1
CityWINSTON SALEMCity
StateNCState
ZIP Code27103ZIPCode
FieldValueIRS element (for citing)
EIN870714098EIN
Primary ActivityHEALTHCAREPrimaryActivity
Legal Domicile StateNCLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1PRESBYTERIAN HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeType
Share Of Total Income916965ShareOfTotalIncome
Share Of EOY Assets4019278ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner
Percentage Ownership0.60000PercentageOwnership
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 Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
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 Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
SOUTH PARK SURGERY CENTER
P4189130COST
SOUTH PARK SURGERY CENTER
R1099900CASH

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