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        <ReturnReference>Part I, Line 4a:</ReturnReference>
        <Explanation>severance paid to 1 executive - Miles $41,779</Explanation>
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        <Identifier>Supplemental Information</Identifier>
        <ReturnReference>Part III</ReturnReference>
        <Explanation>The compensation of these individuals is determined by WakeMed. WakeMed regularly uses an independent consulting firm as a source of compensation information, benchmarking and review to ensure consistent and fair compensation practices.</Explanation>
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      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section A, line 7a</Identifier>
        <Explanation>8 members of the board are appointed to the board of directors by wake county.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section A, line 7b</Identifier>
        <Explanation>The wake county board of commissioners holds limited approval over some governing body decisions pertaining to articles v, vi, vii and ix in the articles of incorporation. The transfer agreement with wake county indicates approval/consent for transactions pertaining to substantial disposition of assets and covenants on liens.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section B, line 11</Identifier>
        <Explanation>the entire 990 and associated schedules are reviewed over a period of months by the finance committee of the board of directors to acknowledge they have reviewed forms and schedules and then recommend approval to the board. A final copy is provided to the board before filing.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section B, line 12c</Identifier>
        <Explanation>the organization monitors and enforces the conflict of interest policy in various ways. each year, members of the board, committees with board delegated powers, the ceo, corporate staff, executive staff, directors, and managers are required to complete and submit a conflict of interest questionnaire. those individuals are required to provide written documentation of any potential conflicts of interest, identifying material financial interest and personal conflicts of interest. remedial measures implemented to address conflicts of interest include abstention from voting on certain issues as well as recusal from the decision-making process and participation involving the identified issue/area. the code of conduct provides guidance on gifts and travel. gifts should not be accepted and prior to any travel/lodging paid for by a third party, written approval must be obtained from an executive vice president. also, employees who own or work in a private business outside of wakemed are not allowed to recruit or promote their products and services during work hours or through wakemed printed materials.</Explanation>
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      <GeneralExplanation>
        <Explanation>The compensation of these individuals is determined by WakeMed. WakeMed regularly uses an independent consulting firm as a source of compensation information, benchmarking and review to ensure consistent and fair compensation practices.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section C, line 19</Identifier>
        <Explanation>the 990 is available by request and is published on guidestar. Financial statements are publically available through the medical care commission as it relates to tax exempt debt. The annual audited financial statements and transfer agreement are provided each year to wake county commissioners and become public information. Articles of incorporation are available on NC secretary of state website.</Explanation>
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      <GeneralExplanation>
        <Identifier>form 990, part xi, line 2c:</Identifier>
        <Explanation>the financial statements are included in the combined audited financial statements of wakemed.</Explanation>
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      <GeneralExplanation>
        <Explanation>From 990, Page 1, Box C: Doing business as: Assumed names include Wake Professional Associates and East Square Medical Plaza.</Explanation>
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