THE REX HEALTHCARE FOUNDATION INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
THE REX HEALTHCARE FOUNDATION INC (EIN 56-6052117)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-15
IRS object ID
201241369349304674
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-05-15T12:58:17-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1101 N TRYON STREET SUITE 1000AddressLine1
CityCHARLOTTECity
StateNCState
ZIP Code28246ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN566052117EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1THE REX HEALTHCARE FOUNDATION INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlREXHNameControl
Phone9197844424Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line14420 LAKE BOONE TRAILAddressLine1
CityRALEIGHCity
StateNCState
ZIP Code27607ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBERNADETTE SPONGName
TitleCFOTitle
Phone9197843100Phone
Date Signed2012-05-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameGREGORY W JOHNSName
Phone7049985200Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDAVID STRONGNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line14420 LAKE BOONE TRAILAddressLine1
CityRALEIGHCity
StateNCState
ZIP Code27607ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6096412GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.REXHEALTH.COM/FOUNDATIONWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1958YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE OPPORTUNITIES FOR OUR COMMUNITY TO INVEST RESOURCES IN THE EXCELLENT WORK OF REX HEALTHCARE.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1617600ContributionsGrantsPriorYear
Contributions Grants Current Year1243136ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year59981InvestmentIncomePriorYear
Investment Income Current Year319099InvestmentIncomeCurrentYear
Other Revenue Prior Year449965OtherRevenuePriorYear
Other Revenue Current Year661108OtherRevenueCurrentYear
Total Revenue Prior Year2127546TotalRevenuePriorYear
Total Revenue Current Year2223343TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1130581GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1225046GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year723710SalariesEtcPriorYear
Salaries Etc Current Year606149SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year37405TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY34683TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year750641TotalFundrsngExpCurrentYear
Other Expense Prior Year409214OtherExpensePriorYear
Other Expenses Current Year231125OtherExpensesCurrentYear
Total Expenses Prior Year2300910TotalExpensesPriorYear
Total Expenses Current Year2097003TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-173364RevenuesLessExpensesPriorYear
Revenues Less Expenses CY126340RevenuesLessExpensesCY
Total Assets BOY4516342TotalAssetsBOY
Total Assets EOY5166927TotalAssetsEOY
Total Liabilities BOY101004TotalLiabilitiesBOY
Total Liabilities EOY159429TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4415338NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5007498NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE OPPORTUNITIES FOR OUR COMMUNITY TO INVEST RESOURCES IN THE EXCELLENT WORK OF REX HEALTHCARE.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense1225046Expense
Grants1225046Grants
Revenue1243136Revenue
DescriptionSUPPORT, BY FINANCIAL ASSISTANCE, THE EXCELLENT WORK OF REX HEALTHCARE, INC.Description
Total Program Service Expense1225046TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
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 Invest1ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
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 Fundraising1ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109612NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonBERNADETTE SPONGNamePerson
Telephone Number9197843100TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14420 LAKE BOONE TRAILAddressLine1
CityRALEIGHCity
StateNCState
ZIP Code27607ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
A DALE JENKINS
DIRECTOR5.00X000
JEAN W CARTER MD
DIRECTOR2.00X000
VINCENT L HOELLERICH MD
DIRECTOR2.00X000
JAMES B HYLER
DIRECTOR2.00X000
DARLEEN M JOHNS
DIRECTOR2.00X000
JEFFREY J LYASH
DIRECTOR2.00X000
GARY L PARK
DIRECTOR2.00X0662552196256
ORAGE QUARLES III
DIRECTOR2.00X000
WILLIAM ROPER MD
DIRECTOR2.00X0728809155179
MARK A STRIEBEL
DIRECTOR2.00X000
ROBERT S THOMAS
DIRECTOR2.00X000
TERESA ARTIS
DIRECTOR2.00X000
DAVID STRONG
PRESIDENT40.00X0724732203123X
BERNADETTE SPONG
SVP/FINANCE AND CFO, TREASURER40.00034322641217X
SYLVIA HACKETT
VP/HR AND DEVELOPMENT40.00022907053043X
ROBERT B LIVERMAN JR
ASSISTANT TREASURER40.00014806326122X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2836452TotalReportableCompFrmRltdOrgs
Total Other Compensation674940TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Related Organizations671042RelatedOrganizations
All Other Contributions572094AllOtherContributions
Total Contributions1243136TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column116460TotalRevenueColumn
Exclusion$116,460ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities3698812Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities3496173Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities202639Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column202639TotalRevenueColumn
Exclusion$202,639ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events1038004GrossIncomeFundraisingEvents
Fundraising Direct Expenses376896FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column661108TotalRevenueColumn
Exclusion$661,108ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column2223343TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$980,207ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1225046Total
Program Services1225046ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total510486Total
Management And General51049ManagementAndGeneral
Fundraising459437Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total13020Total
Management And General1302ManagementAndGeneral
Fundraising11718Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total48487Total
Management And General4849ManagementAndGeneral
Fundraising43638Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total34156Total
Management And General3415ManagementAndGeneral
Fundraising30741Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total8568Total
Management And General8568ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total34683Total
Fundraising34683Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total33197Total
Management And General33197ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total63067Total
Management And General6307ManagementAndGeneral
Fundraising56760Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total3601Total
Management And General360ManagementAndGeneral
Fundraising3241Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total51722Total
Management And General5172ManagementAndGeneral
Fundraising46550Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total44702Total
Management And General4470ManagementAndGeneral
Fundraising40232Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total10329Total
Management And General1033ManagementAndGeneral
Fundraising9296Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1524Total
Management And General152ManagementAndGeneral
Fundraising1372Fundraising

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total14415Total
Management And General1442ManagementAndGeneral
Fundraising12973Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2097003Total
Program Services1225046ProgramServices
Management And General121316ManagementAndGeneral
Fundraising750641Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY663697BOY
EOY608744EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY184195BOY
EOY128930EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1000BOY
EOY14595EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis15226LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec9405LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY7346BOY
EOY5821EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY3660104BOY
EOY4408837EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY4516342BOY
EOY5166927EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY101004BOY
EOY159429EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY101004BOY
EOY159429EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4415338BOY
EOY5007498EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4415338BOY
EOY5007498EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4516342BOY
EOY5166927EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses126340ReconcilationRevenueExpenses
Reconcilation Other Changes465820ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
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)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1REX HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
EIN561509260EIN
Type Of Organization3TypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$1,225,046Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts1225046SumOfAmounts

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 D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance330250BeginningOfYearBalance
Contributions1790Contributions
End Of Year Balance332040EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Buildings Buildings

FieldValueIRS element (for citing)
Book Value0BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis15226OtherCostOrOtherBasis
Depreciation9405Depreciation
Book Value5821BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Book Value0BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5821TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
DescriptionINVESTMENTSDescription
Book Value4408837BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Program Related4408837TotalOfBookValueProgramRelated

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO FURTHER THE MISSION OF REX HEALTHCARE FOUNDATION.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:REX HEALTHCARE FOUNDATION, INC. IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsXMailSolicitations
Email SolicitationsXEmailSolicitations
Phone SolicitationsXPhoneSolicitations
In Person SolicitationsXInPersonSolicitations
Solicitation Of Non Govt GrantsXSolicitationOfNonGovtGrants
Special Fundraising EventsXSpecialFundraisingEvents
Agreement Ref Fundraising1AgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation

Name Of Organization NameOfOrganization

FieldValueIRS element (for citing)
Business Name Line1WITZLEBEN ASSOCIATESBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1610 WEST MAIN STREET LOFT 207AddressLine1
CityDURHAMCity
StateNCState
ZIP Code27701ZIPCode
FieldValueIRS element (for citing)
ActivityCONSULTINGActivity
Fundraiser Control Of Funds0FundraiserControlOfFunds
Gross Receipts0GrossReceipts
Amount Retained By Contractor0AmountRetainedByContractor
Net To Organization0NetToOrganization
FieldValueIRS element (for citing)
Licensed StatesNCLicensedStates

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF TOURNAMENTNameOfEvent1
Gross Receipts Event1587509GrossReceiptsEvent1
Gross Revenue Event1587509GrossRevenueEvent1
Other Direct Expenses Event1175801OtherDirectExpensesEvent1
Name Of Event2GALANameOfEvent2
Gross Receipts Event2235953GrossReceiptsEvent2
Gross Revenue Event2235953GrossRevenueEvent2
Other Direct Expenses Event2140594OtherDirectExpensesEvent2
Total Number Of Other Events4TotalNumberOfOtherEvents
Gross Receipts Other Events214542GrossReceiptsOtherEvents
Gross Revenue Other Events214542GrossRevenueOtherEvents
Other Direct Expenses Other Events60501OtherDirectExpensesOtherEvents
Gross Receipts Total1038004GrossReceiptsTotal
Gross Revenue Total Events1038004GrossRevenueTotalEvents
Other Direct Expenses Total Events376896OtherDirectExpensesTotalEvents
Direct Expense Summary Events376896DirectExpenseSummaryEvents
Net Income Summary661108NetIncomeSummary

Form990 Schedule G Part IV Form990ScheduleGPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF FUNDRAISING PAYMENTSIdentifier
Return ReferenceSCHEDULE G, PART I, LINE 2B, COLUMN (V)ReturnReference
ExplanationPAID FOR CONSULTINGExplanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained0RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1REX HOSPITAL INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14420 LAKE BOONE TRAILAddressLine1
CityRALEIGHCity
StateNCState
ZIP Code27607ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient561509260EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant1225046AmountOfCashGrant
Purpose Of GrantGENERAL SUPPORTPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: REX HEALTHCARE FOUNDATION'S SOLE RECIPIENT OF ASSISTANCE IS REX HOSPITAL, INC. THE TWO ORGANIZATIONS WORK CLOSELY TOGETHER, SO THEREFORE MONITORING IS REAL-TIME AND CONSISTENT.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
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 (6 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
GARY L PARK
06551410007411018899407262085880800
WILLIAM ROPER MD
071575900013050015041704762088398800
DAVID STRONG
042575901217650177208018861701450609278550151304
BERNADETTE SPONG
0260143069962013121027911013306038444300
SYLVIA HACKETT
01747350487340560104443008613028211300
ROBERT B LIVERMAN JR
01262450129650885302126304859017418500

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1ATHE ORGANIZATION OFFERS COMPLIMENTARY MEMBERSHIPS TO REX WELLNESS CENTERS FOR THE EXECUTIVE STAFF, BOTH ACTIVE AND RETIRED BOARD MEMBERS AND MEDICAL DIRECTORS. ALL MEMBERS RECEIVING COMPLIMENTARY MEMBERSHIPS ARE REQUIRED TO COMPLETE THE SAME APPLICATION AND TESTING PROCEDURES AS OTHER MEMBERS. CURRENTLY, THERE ARE 10 INDIVIDUALS LISTED THAT RECEIVE COMPLIMENTARY MEMBERSHIPS. THE VALUE OF THE COMPLIMENTARY MEMBERSHIPS IS TREATED AS TAXABLE COMPENSATION AND IS REPORTED ON THE INDIVIDUALS W-2.
PART I, LINES 4A-BPART I, LINE 4A, DURING CALENDAR YEAR 2010, EMILY BARBOUR RECEIVED SEVERANCE PAYMENTS TOTALING $115,444, WHICH IS REPORTED IN PART II, LINE 7, COLUMN B(III). PART I, LINE 4B, DURING CALENDAR YEAR 2010, DAVID STRONG PARTICIPATED IN A NON QUALIFIED SUPPLEMENTAL RETIREMENT PLAN AND RECEIVED PAYMENTS TOTALING $154,568, WHICH IS REPORTED IN PART II, LINE 3, COLUMN B(III). HE ALSO EARNED COMPENSATION UNDER THIS PLAN TOTALING $166,853, WHICH IS REPORTED IN PART II, LINE 3, COLUMN C. THE CURRENT YEAR EARNINGS ARE PAYABLE IN THE FUTURE.
PART I, LINE 5EMPLOYEES IN MANAGERIAL ROLES PARTICIPATE IN AN ANNUAL INCENTIVE COMPENSATION PLAN. THE COMPENSATION EARNED UNDER THIS PLAN IS BASED PARTLY ON THE COMBINED EARNINGS OF REX HEALTHCARE, INC. AND ITS SUBSIDIARIES. ADDITIONALLY, THE INCENTIVE COMPENSATION OF THE PRESIDENT AND CFO IS BASED PARTLY ON THE EARNINGS OF THE UNC HEALTH CARE SYSTEM. OTHER PERFORMANCE MEASURES USED TO DETERMINE INCENTIVE COMPENSATION ARE PHYSICIAN SATISFACTION, PATIENT CARE QUALITY OUTCOMES, EFFECTIVE USE OF TECHNOLOGY AND INDIVIDUAL GOALS.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 7ATHE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM APPOINTS ALL OF THE THIRTEEN SEATS ON THE ORGANIZATION'S BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7BTHE ORGANIZATION'S BOARD REQUIRES PRIOR APPROVAL OF THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM FOR CERTAIN POWERS, INCLUDING BUT NOT LIMITED TO ADDITION OR DELETION OF A HEALTH CARE SERVICE, PARTICIPATION, DIRECTLY OR INDIRECTLY, IN A JOINT VENTURE, INDEBTEDNESS AND CAPITAL BUDGETS, OPERATING BUDGETS AND NON-BUDGETED MATERIAL EXPENDITURES.
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION'S EXECUTIVE TEAM DISCUSSES AND REVIEWS THE FORM 990 AND ALL ASSOCIATED SCHEDULES THROUGHOUT THE INFORMATION GATHERING STAGE. THE FORM 990 AND ASSOCIATED SCHEDULES ARE THEN REVIEWED AND APPROVED BY THE BOARD AS A WHOLE. A COPY OF THE APPROVED FORM 990 ALONG WITH THE ASSOCIATED SCHEDULES IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING.
THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REQUIRING ALL BOARD MEMBERS TO ANNUALLY COMPLETE AND SIGN A QUESTIONNAIRE DOCUMENTING ANY AREA OF CONFLICT OF INTEREST. THE BOARD MEMBERS ARE REQUIRED TO REPORT AND DOCUMENT ANY NEW AREAS OF CONFLICT OF INTEREST AS THEY ARISE.FORM 990, PART VI, SECTION B, LINE 12C
THE ORGANIZATION USES AN INDEPENDENT CONSULTANT TO MEASURE FAIR VALUE OF COMPENSATION FOR THE ORGANIZATION'S PRESIDENT AND OTHER TOP MANAGEMENT. THE ORGANIZATION'S BOARD REVIEWS AND APPROVES THE COMPENSATION FOR ALL OFFICERS EXCEPT THE ASSISTANT TREASURER AND ASSISTANT SECRETARY.FORM 990, PART VI, SECTION B, LINE 15
THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST AND ON GUIDESTAR'S WEBSITE AND THE FINANCIAL STATEMENTS ARE AVAILABLE ON MUNICIPAL SECURITIES RULEMAKING BOARD'S WEBSITE. THE ORGANIZATION DOES NOT MAKE OTHER GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC.FORM 990, PART VI, SECTION C, LINE 19
DUE TO THE TREMENDOUS OVERLAP OF DIRECTORS BETWEEN THE ORGANIZATION AND ALL RELATED ORGANIZATIONS, THE RELATED ORGANIZATIONS' HOURS ARE INCLUDED IN THE HOURS LISTED.PART VII, SECTION A, COLUMN B:
CHANGES IN NET ASSETS OR FUND BALANCES:CHANGE IN UNRESTRICTED FUNDS 465,820. TOTAL TO FORM 990, PART XI, LINE 5: 465,820.FORM 990, PART XI, LINE 5:
THE AUDIT COMMITTEE'S PROCESS FOR OVERSIGHT OF THE AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANTS HAS NOT CHANGED FROM THE PRIOR YEAR.FORM 990, PART XII, LINE 2C:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
SMITHFIELD RADIATION ONCOLOGY LLC
4420 LAKE BOONE TRAILRALEIGHNC27607200338181RADIATION THERAPYNC00REX HOSPITAL INC
REX HOLDINGS LLC
4420 LAKE BOONE TRAILRALEIGHNC27607273434791HOLDING COMPANYNC00REX HEALTHCARE INC
REX ORTHOPEDIC VENTURES LLC
4420 LAKE BOONE TRAILRALEIGHNC27607273434805ORTHOPEDIC SERVICESNC00REX HOLDINGS LLC
REX CDP VENTURES LLC
4420 LAKE BOONE TRAILRALEIGHNC27607204957241MEDICAL CAMPUS DEVELOPMENTNC00REX ENTERPRISES COMPANY INC
REX WAKEFIELD WELLNESS LLC
4420 LAKE BOONE TRAILRALEIGHNC27607561533957MEDICAL CAMPUS DEVELOPMENTNC00REX CDP VENTURES LLC
REX CDP VENTURES - RETAIL LLC
4420 LAKE BOONE TRAILRALEIGHNC27607273205784REAL ESTATE DVLPMNTNC00REX CDP VENTURES LLC
REX CDP VENTURES - HT LLC
4420 LAKE BOONE TRAILRALEIGHNC27607204957241REAL ESTATE DVLPMNTNC00REX CDP VENTURES LLC
WAKEFIELD REX INVESTORS MOB LLC
4420 LAKE BOONE TRAILRALEIGHNC27607REAL ESTATE DVLPMNTNC00REX CDP VENTURES LLC

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
REX HEALTHCARE INC
4420 LAKE BOONE TRAILRALEIGHNC27607561509129HEALTHCARENC501(C)(3)LINE 11A, IUNC HEALTHCARE0
REX HOME SERVICES INC
4420 LAKE BOONE TRAILRALEIGHNC27607561636242HEALTHCARENC501(C)(3)LINE 3REX HOSPITAL0
UNC HEALTH CARE SYSTEM
101 MANNING DRIVECHAPEL HILLNC27514562206970HEALTHCARENC501(C)(3)LINE 3UNC HEALTHCARE0
REX HOSPITAL INC
4420 LAKE BOONE TRAILRALEIGHNC27607561509260HOSPITALNC501(C)(3)LINE 3REX HEALTHCARE0

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
REX SURGERY CENTER OF CARY LLC
4420 LAKE BOONE TRAILRALEIGHNC27607273684056ASCNCREX HOSPITAL INCRELATED000.00000
JRH VENTURES LLC
4420 LAKE BOONE TRAILRALEIGHNC27607274092967MED CAMPUS DVLTNCREX HOSPITAL INCRELATED000.00000

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
REX ENTERPRISES COMPANY INC
4420 LAKE BOONE TRAILRALEIGHNC27607561553957OPERATIONS SUPNCREX HEALTHCAREC
REX PHYSICIANS LLC
4420 LAKE BOONE TRAILRALEIGHNC27607264594963HEALTHCARENCREX HOLDINGSC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
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 Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
REX HOSPITAL INC
B1225046FMV
REX HOSPITAL INC
J44702FMV
REX HOSPITAL INC
O606509FMV

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