2026-08-10T15:17:22+00:00 2025-09-30 135381590 BDO USA 421 FAYETTEVILLE ST STE 300 RALEIGH NC 276011776 990 2024-10-01 562112733 THE OUTER BANKS HOSPITAL INC OUTE 2528475129 2100 STANTONSBURG ROAD GREENVILLE NC 27835 CATHY YABLONSKI PRESIDENT 2528475129 2026-08-10 true SANDRA L FEINSMITH P01064157 9197549370 2026-08-10 2024 2025-03-06 01:10:19Z OUTER BANKS HEALTH CATHY YABLONSKI 2100 STANTONSBURG ROAD GREENVILLE NC 27835 154950522 false X WWW.OUTERBANKSHEALTH.ORG X 2002 NC TO ADVANCE AND SUPPORT THE HEALTHCARE NEEDS OF THE COMMUNITIES OF EASTERN NORTH CAROLINA. 10 7 0 76 0 3165116 997047 136581520 147692925 2199187 2238831 4686577 4021719 146632400 154950522 233693 271327 0 0 60060423 68261573 0 0 0 75442586 69105441 135736702 137638341 10895698 17312181 144937932 152666321 28460038 29876246 116477894 122790075 TO ENHANCE THE QUALITY OF LIFE FOR THE RESIDENTS AND VISITORS OF DARE COUNTY AND THE SURROUNDING REGION BY PROMOTING WELLNESS AND PROVIDING THE HIGHEST QUALITY HEALTHCARE SERVICES. false false 125799806 271327 125836894 OUTPATIENT AND EMERGENCY SERVICES: PROVIDED EMERGENCY SERVICES TO 20,276 PATIENTS 24 HOURS A DAY FOR 365 DAYS. PROVIDED OUTPATIENT DIAGNOSTIC AND THERAPEUTIC SERVICES TO 36,182 PATIENTS. PERFORMED 2,096 OUTPATIENT SURGICAL PROCEDURES. 0 0 21856031 INPATIENT SERVICES: PROVIDED INPATIENT CARE 24 HOURS A DAY FOR 365 DAYS TO 1,699 PATIENTS. DELIVERED 273 BABIES. PERFORMED 157 INPATIENT SURGICAL PROCEDURES. 125799806 true true false true false false false false false false true false false false true true true true false false false false false false false false true true true false true false false false false false false false false false false false false false false true true false false false false true 0 0 0 false false false false false false false false false false false false X 10 7 false false false false true true true true true false false false true true true true true true true true false false X X JENNIFER WORSLEY 2528472254 2100 STANTONSBURG ROAD GREENVILLE NC 27834 JAMIE FOUNTAIN MD BOARD MEMBER 40.0 0 X 443545 0 78756 JASON HIGGINSON MD BOARD MEMBER 2.0 2.0 X 0 0 0 JASON WAUGHTEL VICE CHAIR 2.0 0 X 0 0 0 MYRA BOWEN BOARD MEMBER 2.0 0 X 0 0 0 MYRA LADD-BONE CHAIR 2.0 0 X 0 0 0 PETE BURKHIMER BOARD MEMBER 2.0 0 X 0 0 0 REESE JACKSON BOARD MEMBER 2.0 0 X 0 0 0 ROBERT TULL BOARD MEMBER (THRU 03/25) 2.0 0 X 0 0 0 SANDRA BAYNES BOARD MEMBER (AS OF 06/25) 2.0 0 X 0 0 0 SANDY MARTIN BOARD MEMBER (AS OF 06/25) 2.0 0 X 0 0 0 TESS JUDGE BOARD MEMBER (THRU 03/25) 2.0 0 X 0 0 0 VAN SMITH BOARD MEMBER 2.0 46.0 X 0 527546 205074 AMY MONTGOMERY SECRETARY 40.0 0 X 176671 0 36864 RONALD SLOAN PRESIDENT 40.0 0 X 409121 0 145578 MARCELLA BRYANT VP, CLINICAL OPERATIONS 40.0 0 X 245355 0 66791 TODD WARLITNER VP FINANCE-CRITICAL ACCESS HOSPITALS 16.0 24.0 X 89625 134438 63491 CHARLES SHELTON PHYSICIAN 40.0 0 X 573281 0 52046 CHRISTOPHER MANN PHYSICIAN 40.0 0 X 715883 0 54467 GARY HUNTER ANESTHESIOLOGIST 40.0 0 X 564707 0 33732 JEFFREY CHASE PHYSICIAN 40.0 0 X 574975 0 50538 MATTHEW MCKENNA PHYSICIAN 40.0 0 X 609482 0 56231 4402645 661984 843568 135 false true false AMN HEALTHCARE PO BOX 281923 ATLANTA GA 30384 TEMP LABOR SERVICES 3880296 SODEXO INC & AFFILIATES PO BOX 905374 CHARLOTTE NC 28290 CONTRACT LABOR & MGT 1020805 MEDICAL SOLUTIONS LLC 1010 N 102ND STREET OMAHA NE 68114 LOCUMS/TEMP LABOR 867262 CHESAPEAKE REGIONAL MEDICAL GROUP 667 KINGSBOROUGH SQUARE CHESAPEAKE VA 23320 HOSP/MEDICAL GROUP 802694 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 LOCUMS/TEMP LABOR 656676 23 997047 997047 OUTPATIENT SERVICES 621110 125836894 125836894 INPATIENT SERVICES 621110 21856031 21856031 0 0 0 0 147692925 2223612 2223612 263413 263413 0 263413 263413 15219 0 15219 15219 15219 OTHER REVENUE 900099 3444640 3444640 CAFETERIA MEALS 722514 228973 228973 REBATES 900099 52666 52666 32027 0 0 32027 3758306 154950522 147692925 0 6260550 X 271327 271327 0 0 1899545 1899545 54506410 53288924 1217486 1421821 1350730 71091 6573872 6541912 31960 3859925 3666929 192996 48172 38537 9635 1805 0 1805 47161 0 47161 2598 0 2598 33323712 26658969 6664743 0 659514 527611 131903 440408 396367 44041 67624 13525 54099 1138919 911135 227784 266756 213405 53351 334050 334050 4960392 4960392 774207 154841 619366 MEDICAL SUPPLIES 23702354 23702354 BAD DEBT 2163162 2163162 ALL OTHER EXPENSES 1174607 939686 234921 0 0 0 0 137638341 125799806 11838535 0 0 0 28499435 18895272 0 0 18353363 21677614 0 0 0 0 0 0 2094352 2071000 230410 182752 123454747 61239134 57042002 62215613 31854989 41101841 0 0 0 0 6863381 6522229 144937932 152666321 25004588 27480069 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3455450 2396177 28460038 29876246 X 116477894 122790075 0 0 116477894 122790075 144937932 152666321 X 17312181 -11000000 X X false true true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 2598 2598 false SCHEDULE C, PART II-B, LINE 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY 18.81% OF DUES TO NCHA ARE ALLOCATED TO LOBBYING. 5525175 5525175 72808662 34043971 38764691 464435 464435 0 31728285 22491035 9237250 12928190 4239693 8688497 62215613 FEDERAL INCOME TAXES DUE TO THIRD PARTY PAYORS 2124177 RESERVE FOR PROFESSIONAL LIABILITY 272000 2396177 X 152787360 0 0 152787360 2163162 2163162 154950522 135475179 0 0 135475179 2163162 2163162 137638341 SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE THE OUTER BANKS HOSPITAL, INC. HAS BEEN DETERMINED TO QUALIFY AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE OUTER BANKS HOSPITAL, INC. HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN YEARS AND HAS CONCLUDED THAT NO MATERIAL LIABILITIES EXIST AS OF SEPTEMBER 30, 2025 AND 2024. THE OUTER BANKS HOSPITAL, INC. FILES TAX RETURNS WITH THE U.S. FEDERAL AND STATE OF NORTH CAROLINA JURISDICTIONS. WITH FEW EXCEPTIONS, THE OUTER BANKS HOSPITAL, INC. IS NO LONGER SUBJECT TO U.S. FEDERAL EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2022. SCHEDULE D, PART XI, LINE 4(B) OTHER REVENUES IN FORM 990 NOT IN AUDITED FINANCIAL STATEMENTS BAD DEBT - 2163162 SCHEDULE D, PART XII, LINE 4(B) OTHER EXPENSES IN FORM 990 NOT IN AUDITED FINANCIAL STATEMENTS BAD DEBT - 2163162 true true X true X true X true true true false true true 5477984 0 5477984 0.04044 8807956 17322761 0 0.0 0 0 0 0.0 0 0 14285940 17322761 5477984 0.04044 12 4461 639458 0 639458 0.00472 3 113 213176 0 213176 0.00157 0 0 0 0.0 0 0 0 0.0 5 37057 263411 0 263411 0.00194 20 41631 1116045 0 1116045 0.00824 20 41631 15401985 17322761 6594029 0.04867 1 32797 32797 0.00024 1 11817 11817 0.00009 1 51942 51942 0.00038 0 0.0 1 15 1537 1537 0.00001 1 8317 8317 0.00006 0 0.0 1 47 14021 14021 0.00010 0 0.0 6 62 120431 0 120431 0.00089 true 993797 31248324 31569561 -321237 X true true 1 1 THE OUTER BANKS HOSPITAL INC 4800 SOUTH CROATAN HIGHWAY NAGS HEAD NC 27959 H0273 X X X X X THE OUTER BANKS HOSPITAL INC 1 false false true X X X X X X X X X 24 true false true true X THE HOSPITAL MAKES ITS COMMUNITY HEALTH NEEDS ASSESSMENT AND MOST RECENTLY ADOPTED IMPLEMENTATION ST X true 24 true THE HOSPITAL MAKES ITS COMMUNITY HEALTH NEEDS ASSESSMENT AND MOST RECENTLY ADOPTED IMPLEMENTATION ST false true X 200.0 300.0 X X true true X X X true X HTTPS://WWW.ECUHEALTH.ORG/PATIENTS-AND-FAMILIES/YOUR-BILL/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.ECUHEALTH.ORG/PATIENTS-AND-FAMILIES/YOUR-BILL/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.ECUHEALTH.ORG/PATIENTS-AND-FAMILIES/YOUR-BILL/FINANCIAL-ASSISTANCE/ X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 FACILITY , 1 FACILITY , 1 - THE OUTER BANKS HOSPITAL, INC.. INPUT WAS GATHERED FROM A BROAD RANGE OF REMARKABLE LEADERS AND STAKEHOLDERS ACROSS DARE COUNTY WHO ARE PASSIONATE ABOUT THE HEALTH AND WELLBEING OF THE RESIDENTS. THE OUTER BANKS HOSPITAL DIRECTLY COLLABORATED WITH DARE COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT. ADDITIONAL PARTNERS PARTICIPATING IN THE PLANNING, DATA REVIEW, AND PRIORITIZATION PROCESS FOR THE MOST RECENT DARE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDED: COMMUNITY CARE CLINIC OF DARE, DARE COUNTY EMERGENCY MEDICAL SERVICES, DARE COUNTY HEALTH & HUMAN SERVICES, DARE COUNTY SHERIFF'S OFFICE, GEM ADULT DAY SERVICES, INTERFAITH COMMUNITY OUTREACH, INC., OUTER BANKS COMMUNITY FOUNDATION, OUTER BANKS DEMENTIA TASK FORCE, AND OUTER BANKS RELIEF FOUNDATION. THESE STAKEHOLDERS REPRESENT HEALTHCARE DELIVERY, PUBLIC HEALTH, EMERGENCY SERVICES, SOCIAL SERVICES, NONPROFIT COMMUNITY ASSISTANCE, AGING SERVICES, AND DIRECT COMMUNITY REPRESENTATION, REFLECTING A BROAD CROSS-SECTION OF COMMUNITY INTERESTS. PRIMARY AND SECONDARY DATA WERE COLLECTED AND REVIEWED BETWEEN FEBRUARY AND JULY 2024. PRIMARY DATA WAS COLLECTED THROUGH A COMMUNITY OPINION SURVEY, THREE FOCUS GROUPS, AND 15 KEY INFORMANT INTERVIEWS. THE LEADERSHIP TEAM USED GRASS ROOT EFFORTS TO DISTRIBUTE THE COMMUNITY HEALTH OPINION SURVEY TO A BROAD RANGE OF PEOPLE IN THE COMMUNITY, TARGETING DIFFERENT INCOME LEVELS, INCLUDING UNDERSERVED MEMBERS OF THE COMMUNITY, THE ELDERLY, AND THE GENERAL POPULATION. MORE THAN 1,200 SURVEYS WERE COMPLETED BY INDIVIDUALS LIVING, WORKING OR RECEIVING HEALTHCARE IN THE COMMUNITY. THE SURVEY WAS AVAILABLE IN BOTH ENGLISH AND SPANISH. THE THREE FOCUS GROUPS CONDUCTED CONNECTED WITH OVER 25 COMMUNITY MEMBERS. SECONDARY DATA PROVIDED OBJECTIVE MEASURES OF HEALTH STATUS AND DISPARITIES. THIS DATA INCLUDED DEMOGRAPHIC, SOCIOECONOMIC, HEALTH BEHAVIOR, DISEASE PREVALENCE, AND HEALTH CARE ACCESS INDICATORS DERIVED FROM PUBLICLY AVAILABLE SOURCES SUCH AS THE NORTH CAROLINA DATA PORTAL, COUNTY HEALTH RANKINGS, THE AMERICAN COMMUNITY SURVEY, AND OTHER STATE AND FEDERAL DATASETS. THESE INDICATORS ALLOWED THE HOSPITAL AND COLLABORATING PARTNERS TO CONTEXTUALIZE COMMUNITY REPORTED NEEDS WITHIN BROADER POPULATION LEVEL TRENDS. ADDITIONALLY, THE COUNTY CHNA'S WERE PART OF THE HEALTH ENC COLLABORATIVE ALIGNING THE CHNA CYCLE WITH 34 ADDITIONAL COUNTIES IN EASTERN NC. THIS ALIGNMENT PLANS TO PROMOTE COMMUNITY HEALTH IMPROVEMENT ACTIVITIES ACROSS COUNTY LINES. SCHEDULE H, PART V, SECTION B, LINE 6B FACILITY , 1 FACILITY , 1 - THE OUTER BANKS HOSPITAL, INC.. OUTER BANKS HOSPITAL COLLABORATED WITH DARE COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT. SCHEDULE H, PART V, SECTION B, LINE 11 FACILITY , 1 FACILITY , 1 - THE OUTER BANKS HOSPITAL, INC.. THE LEADERSHIP AND PARTNERSHIP GROUP MENTIONED IN PART V SECTION B LINE 5 HAVE A LONG HISTORY OF WORKING TOGETHER ON COMMUNITY NEEDS. TOGETHER, BASED ON THE DATA, THE GROUP DISCUSSED RESOURCES AVAILABLE AND THE ROLES OF THE PARTNERS, AS NO ONE ORGANIZATION CAN ADDRESS THE COMMUNITY HEALTH NEEDS ALONE, WHEN THEY CHOSE THE PRIORITIES FOR THE OUTER BANKS HOSPITAL. THE PRIORITIES APPROVED BY THE OUTER BANKS BOARD OF DIRECTORS WERE ACCESS TO CARE, MENTAL HEALTH, AND SUBSTANCE ABUSE. THE OUTER BANKS BOARD OF DIRECTORS ALSO APPROVED AN "ON-GOING" SET OF IMPLEMENTATION STRATEGIES FOR THE HOSPITAL TO ADDRESS FOR THE THREE-YEAR CYCLE. KEY INITIATIVES INCLUDE: ACCESS TO CARE: PREVENTIVE SERVICES AND SCREENINGS: DELIVER COMMUNITY-BASED HEALTH EDUCATION AND SCREENINGS, INCLUDING CANCER SCREENINGS, CHRONIC DISEASE SCREENING, BLOOD PRESSURE MONITORING, AND WELLNESS EDUCATION IN COMMUNITY SETTINGS. WORKFORCE DEVELOPMENT AND CAREER PROMOTION: PROMOTE HEALTHCARE CAREERS THROUGH STUDENT PROGRAMS, CAREER FAIRS, VOLUNTEER OPPORTUNITIES, AND PARTNERSHIPS WITH LOCAL SCHOOLS AND COLLEGES. COMMUNITY EDUCATION AND ENGAGEMENT: PROVIDE CPR AND AED TRAINING, ADVANCE CARE PLANNING EDUCATION, MATERNAL AND CHILD HEALTH CLASSES, STROKE EDUCATION, AND COMMUNITY WELLNESS PROGRAMS. EXPANDED PRIMARY AND SPECIALTY CARE ACCESS: ENHANCE ACCESS THROUGH PARTNERSHIPS WITH PRIMARY AND SPECIALTY CARE PRACTICES, TELEHEALTH SERVICES, EXTENDED APPOINTMENT AVAILABILITY, AND PROVIDER RECRUITMENT AND RETENTION INITIATIVES. MENTAL HEALTH: COMMUNITY-BASED EDUCATION AND TRAINING: OFFER MENTAL HEALTH FIRST AID TRAINING AND MENTAL HEALTH AWARENESS INITIATIVES TO REDUCE STIGMA AND IMPROVE RECOGNITION OF WARNING SIGNS. TELEHEALTH MENTAL HEALTH SERVICES: EXPAND ACCESS TO THERAPY AND PSYCHIATRIC SUPPORT THROUGH VIRTUAL VISITS INTEGRATED INTO PRIMARY CARE AND OUTPATIENT SETTINGS. COMMUNITY BENEFIT GRANT INVESTMENTS: SUPPORT LOCAL ORGANIZATIONS DELIVERING MENTAL HEALTH PREVENTION, EARLY INTERVENTION, AND RESILIENCE-BUILDING PROGRAMS THROUGH COMMUNITY BENEFIT GRANTS. WELLNESS AND SUPPORTIVE PROGRAMS: IMPLEMENT GROUP-BASED AND WELLNESS-ORIENTED PROGRAMS THAT SUPPORT EMOTIONAL WELL-BEING, STRESS REDUCTION, SOCIAL CONNECTION, AND QUALITY OF LIFE. COMMUNITY COLLABORATION: PARTICIPATE IN LOCAL COALITIONS FOCUSED ON MENTAL HEALTH AWARENESS, SUICIDE PREVENTION, AND SYSTEM IMPROVEMENT. SUBSTANCE USE: PREVENTION AND HARM REDUCTION: CONDUCT MEDICATION COLLECTION EVENTS TO SAFELY DISPOSE OF UNUSED MEDICATIONS AND REDUCE MISUSE RISK. COMMUNITY BENEFIT GRANT INVESTMENTS: FUND LOCAL PREVENTION, EARLY INTERVENTION, AND TREATMENT PROGRAMS ADDRESSING SUBSTANCE USE THROUGH COMMUNITY BENEFIT GRANTS. TOBACCO AND ALCOHOL USE REDUCTION: OFFER EVIDENCE-BASED TOBACCO CESSATION SERVICES AND ALCOHOL USE REDUCTION COACHING INTEGRATED INTO CLINICAL AND WELLNESS SERVICES. COMMUNITY COALITION PARTICIPATION: COLLABORATE WITH LOCAL PARTNERS AND TASK FORCES FOCUSED ON OPIOID MISUSE PREVENTION, RECOVERY SUPPORT, AND BEHAVIORAL HEALTH SYSTEM IMPROVEMENT. HOLISTIC WELLNESS PROMOTION: INTEGRATE SUBSTANCE USE PREVENTION MESSAGING AND SUPPORTS INTO BROADER COMMUNITY WELLNESS AND LIFESTYLE INITIATIVES. 0 SCHEDULE H, PART I, LINE 7 FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFITS AT COST COSTS WERE CALCULATED USING THE ESTIMATED COST TO CHARGE RATIO FROM THE NORTH CAROLINA HOSPITAL ASSOCIATION'S ADVOCACY NEEDS DATA INITIATIVE WHICH IS THE STANDARD FOR REPORTING COMMUNITY BENEFITS IN NORTH CAROLINA. DURING MARCH 2023, THE HEALTHCARE ACCESS AND STABILIZATION PROGRAM (HASP) WAS ENACTED BY THE STATE OF NORTH CAROLINA AND IS A FEDERALLY FUNDED PROGRAM THROUGH THE CENTER FOR MEDICARE & MEDICAID SERVICES (CMS) TO ENHANCE MEDICAID REIMBURSEMENT. HASP WAS SPECIFICALLY DESIGNED TO STRENGTHEN VULNERABLE RURAL HOSPITALS, SUCH AS THOSE IN THE ECU HEALTH SYSTEM, AND PROVIDE THEM FINANCIAL STABILITY TO CARE FOR ALL MEMBERS OF THEIR COMMUNITY. FOR THE YEAR ENDED SEPTEMBER 30, 2025, ECU HEALTH RECOGNIZED $401.9 MILLION, NET OF ASSESSMENTS OF APPROXIMATELY $102.7 MILLION, AS NET PATIENT SERVICE REVENUE OF $299.2 MILLION. THE HASP PROGRAM BRINGS REIMBURSEMENTS IN LINE MORE CLOSELY WITH THE ACTUAL COST OF CARE, HELPING TO STABILIZE OUR HEALTHCARE SAFETY NET. THESE FUNDS PLAY A CRITICAL ROLE IN ALLOWING ECU HEALTH TO FULFIL ITS COMMITMENT TO THE CARE AND WELL-BEING OF THE PATIENTS WE SERVE AND ALLOWS US TO FOCUS ON PROVIDING SAFE, HIGH-QUALITY CARE TO ALL, REGARDLESS OF A PATIENT'S ABILITY TO PAY. MEDICAID EXPANSION BROUGHT HEALTHCARE COVERAGE TO PATIENTS IN OUR ECU HEALTH SERVICE AREA WHO WERE PREVIOUSLY UNINSURED, THEREBY IMPROVING HEALTH OUTCOMES AND FINANCIAL SECURITY FOR MANY FAMILIES. GOING FORWARD, HASP PAYMENTS, AND A HIGHER HOSPITAL TAX, ALSO HAS A NEW REQUIREMENT THAT HOSPITALS AGREE TO A MEDICAL DEBT INCENTIVE PROGRAM. HOSPITALS ARE NOT RECEIVING NEW MONEY TO IMPLEMENT THE MEDICAL DEBT MITIGATION PLAN, RATHER, HOSPITALS LIKE ECU HEALTH ARE RECEIVING THE FULL AMOUNT OF REIMBURSEMENT OWED TO THEM BY PARTICIPATING IN THE PLAN. MEDICAL DEBT IS A COMPLEX ISSUE AND CAN NOT BE SOLVED SOLELY BY HOSPITALS AND HEALTHCARE PROVIDERS. THERE IS SIGNIFICANT WORK TO BE DONE TO DEVELOP FINANCIALLY SUSTAINABLE SOLUTIONS TO ADDRESS MEDICAL DEBT THAT INCLUDES HEALTH INSURANCE PLANS, PROVIDERS, EMPLOYERS, BUSINESS LEADERS AND GOVERNMENT PARTNERS. NORTH CAROLINA HOSPITALS MAY CHOOSE TO IMPLEMENT A MEDICAL DEBT RELIEF PROGRAM TO MAXIMIZE MEDICAID REIMBURSEMENT UNDER HASP. UNDER THE PROGRAM, HOSPITALS MUST RELIEVE ALL MEDICAL DEBT DEEMED UNCOLLECTIBLE DATING BACK TO JANUARY 1, 2024, WITH A TEN YEAR LOOK BACK PERIOD, FOR ANY PATIENTS WHO ARE NORTH CAROLINA RESIDENTS ACTIVELY ENROLLED IN MEDICAID OR MANAGED MEDICAID, ARE BELOW CERTAIN FEDERAL POVERTY LEVELS, OR MEET OTHER CRITERIA. DURING THE YEAR ENDED SEPTEMBER 30, 2025, ECU HEALTH AMENDED ITS PATIENT FINANCIAL ASSISTANCE POLICIES TO ADHERE TO THE REQUIRED ELIGIBILITY REQUIREMENTS OF THE PROGRAM. MOST PEOPLE STRUGGLING WITH MEDICAL DEBT ARE INSURED. NO MATTER HOW GENEROUS, HOSPITAL FINANCIAL ASSISTANCE WILL NEVER BE A SUBSTITUTE FOR A HEALTH INSURANCE PLAN THAT COVERS PREVENTIVE AND NECESSARY CARE AT AN AFFORDABLE PRICE ON THE FRONT AND BACK END OF COVERAGE. ECU HEALTH PROVIDES HIGH-QUALITY CARE FOR EVERYONE WHO WALKS THROUGH OUR DOORS, REGARDLESS OF THEIR ABILITY TO PAY. INABILITY TO PAY FOR SERVICES SHOULD NOT DETER ANYONE FROM SEEKING NEEDED MEDICAL CARE. THAT IS WHY ECU HEALTH HAS DEVELOPED AND COMMITTED TO PRINCIPLES AND GUIDELINES FOR ASSISTING UNINSURED PATIENTS, AS WELL AS UNDERINSURED PATIENTS, AND GUIDELINES FOR DEBT COLLECTION, THAT PROVIDE SIGNIFICANT PATIENT ASSISTANCE AND PROTECTION. ECU HEALTH IS COMMITTED TO HELPING PATIENTS PLAN FOR MEDICAL BILLS BY OFFERING FINANCIAL COUNSELING AND FINANCIAL ASSISTANCE PROGRAMS AND WORK HARD TO INFORM PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICIES. IN 2025, ECU HEALTH PROVIDED $98.4 MILLION IN CHARITY CARE AND FORGAVE $8.3 MILLION IN BAD DEBT. SCHEDULE H, PART I, LINE 7 OTHER BENEFITS COMMUNITY HEALTH IMPROVEMENT SERVICES & COMMUNITY BENEFIT OPERATIONS (E) OUTER BANKS HOSPITAL COMMUNITY HEALTH IMPROVEMENT SERVICES TOTALED $148,123 IN REPORTED EXPENSE AND SERVED 4,461 INDIVIDUALS. KEY COST COMPONENTS INCLUDED ADVANCE CARE PLANNING OF $34,831 , COMMUNITY HEALTH IMPROVEMENT OF $104,713, AND HEALTH EDUCATION - COMMUNITY OF $8,579. TO ILLUSTRATE THE COMMUNITY HEALTH IMPROVEMENT EXPENSE, A CHRONIC CARE NURSE NAVIGATOR HAD 516.0 STAFF HOURS, $37,689 IN EXPENSE, AND 181 PERSONS SERVED; THIS WORK INCLUDED DIABETES EDUCATION, STROKE RISK REDUCTION EDUCATION, COMMUNITY PRESENTATIONS, AND SUPPORT PROGRAMMING (INCLUDING A MONTHLY STROKE SUPPORT NETWORK). COMMUNITY HEALTH IMPROVEMENT INCLUDED $59,308 IN EXPENSE CAPTURED FOR "COMMUNITY HEALTH IMPROVEMENT FY 24-25 $7,716 FOR THE UNITE US PLATFORM THAT SUPPORTS SCREENING FOR HEALTH-RELATED SOCIAL NEEDS AND SOCIAL CARE REFERRALS (NC CARE360/UNITE US), WITH THE PLATFORM NOTED AS A SHARED ANNUAL COST ALLOCATION ACROSS ENTITIES. HEALTH EDUCATION FOR THE COMMUNITY TOTALED $8,579 AND SERVED 3,486 INDIVIDUALS, WITH 174.0 STAFF HOURS REPORTED IN THE EXTENDED REPORT'S PROGRAM TOTALS. EXAMPLES INCLUDE RECURRING "EAT THE RAINBOW" COMMUNITY NUTRITION EDUCATION AT LOCAL FARMERS MARKETS (E.G., $418 EXPENSES WITH 100 PERSONS SERVED AT ONE EVENT, AND $418 EXPENSES WITH 176 PERSONS SERVED AT ANOTHER EVENT), AND A STROKE AWARENESS WALK WITH $220 IN EXPENSE AND 75 PERSONS SERVED. THESE EXAMPLES DEMONSTRATE HOW REPORTED HEALTH EDUCATION DOLLARS SUPPORTED COMMUNITY-BASED PREVENTION EDUCATION AND ENGAGEMENT OPPORTUNITIES OFFERED AT NO OR NOMINAL COST TO PARTICIPANTS, CONSISTENT WITH COMMUNITY HEALTH IMPROVEMENT INTENT. THE COMMUNITY BENEFIT OPERATIONS COST OF $491,335 PAYS FOR FIVE STAFF MEMBERS WHO SPENT 5,928 HOURS PLANNING, COORDINATING, AND PROMOTING COMMUNITY HEALTH PROGRAMS ACROSS DARE COUNTY, PLUS THE SUPPLIES, SOFTWARE, AND MATERIALS THEY NEED TO DO THAT WORK. THE COMMUNITY HEALTH IMPROVEMENT SERVICES COST OF $148,123, ON THE OTHER HAND, ONLY COVERS THE ACTUAL PROGRAM COSTS, FOR EXAMPLE, THE NURSE WHO DOES DIABETES EDUCATION AND STROKE PREVENTION. THE STAFF AND OVERHEAD COSTS THAT MAKE THOSE PROGRAMS HAPPEN ARE COUNTED SEPARATELY UNDER OPERATIONS. OUTER BANKS HOSPITAL PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS, REPORTING 12 ACTIVITIES THAT SERVED 4,461 INDIVIDUALS, WITH A TOTAL COMMUNITY BENEFIT EXPENSE OF $639,458, NO OFFSETTING REVENUE, AND A NET COMMUNITY BENEFIT EXPENSE OF $639,458. HEALTH PROFESSIONS EDUCATION (F) OUTER BANKS HOSPITAL SUPPORTED HEALTH PROFESSIONS EDUCATION BY PROVIDING CLINICAL TRAINING SETTINGS, PRECEPTORSHIPS, AND EDUCATIONAL SUPPORT FOR FUTURE HEALTHCARE PROFESSIONALS. THE HOSPITAL REPORTED 3 ACTIVITIES, SERVING 113 INDIVIDUALS, WITH A TOTAL COMMUNITY BENEFIT EXPENSE OF $213,176 AND NET COMMUNITY BENEFIT EXPENSE OF $213,176. REPORTED HEALTH PROFESSIONS EDUCATION EXPENSE INCLUDES NURSING INTERNSHIPS/PRECEPTORSHIPS OF $75,287, OTHER ALLIED HEALTH PROFESSIONS EDUCATION OF $106,814, AND HEALTH PROFESSIONS EDUCATION SCHOLARSHIPS/TUITION ASSISTANCE OF $31,075. NURSING CLINICAL ROTATIONS TOTALED 1,030 STAFF HOURS (44 LEARNERS SERVED; $75,287 TOTAL EXPENSE) AND 1,456.1 STAFF HOURS FOR ALLIED HEALTH CLINICAL ROTATIONS (46 LEARNERS SERVED; $106,814 TOTAL EXPENSE). EXAMPLES OF NURSING TRAINING INCLUDE COLLEGE OF THE ALBEMARLE NURSING STUDENT ROTATIONS (E.G., $25,243 EXPENSE SUPPORTING 8 STUDENTS IN ONE ROTATION WITH 345.6 STAFF HOURS). EXAMPLES OF ALLIED HEALTH TRAINING INCLUDE CLINICAL ROTATIONS FOR SURGICAL TECHNOLOGISTS ($8,450 EXPENSE SUPPORTING 2 LEARNERS WITH 115.2 STAFF HOURS) AND PHYSICAL THERAPY STUDENTS (E.G., $10,563 EXPENSE SUPPORTING 2 LEARNERS WITH 144 STAFF HOURS). TUITION ASSISTANCE AND SCHOLARSHIPS TOTALED $31,075, AND THE EXTENDED REPORT DOCUMENTS SUPPORT FOR 23 HIGH SCHOOL STUDENTS WITH A STATED $23,000 SCHOLARSHIP AMOUNT TOWARD HEALTHCARE-FOCUSED COLLEGE TUITION, WITH THE PROGRAM OVERSEEN BY A NURSE EDUCATOR. CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT (I) THE OUTER BANKS HOSPITAL REPORTED $263,411 IN TOTAL CASH AND IN KIND CONTRIBUTIONS, BENEFITING 37,057 PERSONS, WITH DOCUMENTED EXAMPLES INCLUDING COMMUNITY BENEFIT GRANT FUNDING OF $155,500 SUPPORTING COMMUNITY HEALTH INITIATIVES AND PROGRAMS ALIGNED WITH IDENTIFIED COMMUNITY NEEDS. ADDITIONAL DOCUMENTED CASH CONTRIBUTIONS INCLUDE A $64,000 DONATION SUPPORTING THE COMMUNITY CARE CLINIC, DOCUMENTED AS SALARY SUPPORT TO EXPAND ACCESS TO CARE FOR UNDERSERVED POPULATIONS. IN KIND CONTRIBUTIONS TOTALED $43,911 AND REFLECT BENEVOLENT CASE MANAGEMENT ASSISTANCE, PROVIDING DIRECT SUPPORT TO INDIVIDUALS EXPERIENCING FINANCIAL HARDSHIP. DOCUMENTED BLOOD DRIVE ACTIVITY TOTALED $6,636 IN EXPENSE, SUPPORTING COMMUNITY BLOOD COLLECTION EFFORTS DURING MULTIPLE BLOOD DRIVE EVENTS HOSTED THROUGHOUT THE FISCAL YEAR. SCHEDULE H, PART I, LINE 6A COMMUNITY BENEFIT REPORT PREPARED BY RELATED ORGANIZATION ECU HEALTH PREPARES THE COMMUNITY BENEFIT REPORT. THE NUMERIC DATA IN THIS REPORT IS BASED ON THE FORM 990, SCHEDULE H CRITERIA. SCHEDULE H, PART I, LINE 7 BAD DEBT EXPENSE EXCLUDED FROM FINANCIAL ASSISTANCE CALCULATION 2163162 SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES DURING THE REPORTING PERIOD, OUTER BANKS HOSPITAL REPORTED SIX COMMUNITY BUILDING ACTIVITIES UNDER SCHEDULE H, PART II, SERVING 62 PERSONS, WITH A TOTAL COMMUNITY BENEFIT EXPENSE OF $120,431, NO DIRECT OFFSETTING REVENUE AND NET COMMUNITY BENEFIT EXPENSE OF $120,431. THESE ACTIVITIES WERE REPORTED ACROSS SIX CATEGORIES: COMMUNITY SUPPORT OF $51,942, PHYSICAL IMPROVEMENTS/HOUSING OF $32,797, WORKFORCE DEVELOPMENT OF $14,021, ECONOMIC DEVELOPMENT OF $11,817, COALITION BUILDING OF $8,317, AND LEADERSHIP DEVELOPMENT AND TRAINING OF $1,537. FIVE OF THESE ACTIVITIES REFLECTED DEDICATED STAFF AND LEADERSHIP TIME SERVING ON COMMUNITY BOARDS, COMMITTEES, AND TASK FORCES THAT ADDRESS THE SOCIAL AND ECONOMIC CONDITIONS UNDERLYING COMMUNITY HEALTH IN DARE COUNTY. THIS INCLUDED PARTICIPATION ON HOUSING-RELATED BOARDS AND COMMITTEES FOR $32,797; BROAD COMMUNITY SUPPORT PARTNERSHIPS FOR $51,942; LOCAL ECONOMIC DEVELOPMENT ENGAGEMENT FOR $11,817; HEALTH-FOCUSED COALITION BUILDING FOR $8,317; AND LEADERSHIP DEVELOPMENT AND TRAINING FOR $1,537, WHICH SERVED 15 INDIVIDUALS. ALTHOUGH THESE ENGAGEMENTS ARE NOT DIRECT CLINICAL SERVICES, THEY STRENGTHEN COMMUNITY INFRASTRUCTURE AND THE LOCAL SYSTEMS THAT SUPPORT ACCESS TO CARE AND SERVICES IN A RURAL COASTAL COMMUNITY. THE HOSPITAL'S REMAINING COMMUNITY BUILDING ACTIVITY FOCUSED ON WORKFORCE DEVELOPMENT THROUGH HEALTH CAREERS PROMOTION OF $14,021, SERVING 47 PERSONS, DESIGNED TO STRENGTHEN THE HEALTHCARE WORKFORCE PIPELINE IN A RURAL COASTAL COMMUNITY. SUPPORTING DETAIL INCLUDES A HEALTHCARE CAREERS EXPLORATION PROGRAM WITH ONE-DAY STUDENT EXPERIENCES (E.G., $1,445 IN EXPENSE SUPPORTING 20 STUDENTS AND 33 STAFF HOURS) AND STUDENT INTERN/SHADOWING EXPERIENCES (E.G., $7,096 SUPPORTING 5 STUDENTS AND 162 STAFF HOURS; AND $5,480 SUPPORTING 7 STUDENTS AND 125.1 STAFF HOURS), WITH PROGRAM TOTALS OF $14,021 AND 47 PERSONS SERVED. THESE ACTIVITIES PROMOTE COMMUNITY HEALTH BY INCREASING AWARENESS OF HEALTHCARE CAREER PATHWAYS AND BUILDING LONGER-TERM CAPACITY TO SUPPORT ACCESS TO CARE IN REGIONS FACING PERSISTENT STAFFING CONSTRAINTS. SCHEDULE H, PART III, LINE 2 BAD DEBT EXPENSE - METHODOLOGY USED TO ESTIMATE AMOUNT BAD DEBT IS BASED ON AGING CATEGORIES, CURRENT ECONOMIC CONDITIONS AND HISTORICAL COLLECTION EXPERIENCE; AND IS RECORDED IN THE PERIOD IN WHICH COLLECTION IS CONSIDERED DOUBTFUL. SCHEDULE H, PART III, LINE 3 BAD DEBT EXPENSE METHODOLOGY IN CONNECTION WITH THE PRESUMPTIVE ELIGIBILITY CONSIDERATION OF THE AFFORDABLE CARE ACT, THE OUTER BANKS HOSPITAL DOES NOT REFLECT ANY BAD DEBT IN CONNECTION WITH FAP-ELIGIBLE PATIENTS. THESE PATIENTS ARE PRESUMED TO BE PART OF THE MEDICAID POPULATION AND AFFORDED COVERAGE AS SUCH. SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE - FINANCIAL STATEMENT FOOTNOTE THE FINANCIAL STATEMENTS OF THE OUTER BANKS HOSPITAL ARE PRESENTED ON A STAND ALONE BASIS; THE TEXT OF THE FOOTNOTE FROM PAGE 20 IS PRESENTED BELOW: PATIENT ACCOUNTS RECEIVABLE, NET PATIENT ACCOUNTS RECEIVABLES ARE REPORTED NET OF ESTIMATED ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS AND ALLOWANCES FOR BAD DEBTS AND ARE RECORDED IN THE PERIOD IN WHICH COLLECTION IS CONSIDERED DOUBTFUL. ESTIMATED ALLOWANCES FOR BAD DEBTS ARE APPROXIMATELY $8.3 MILLION AS OF SEPTEMBER 30, 2025. SCHEDULE H, PART III, LINE 8 COMMUNITY BENEFIT & METHODOLOGY FOR DETERMINING MEDICARE COSTS THE SHORTFALL OF MEDICARE REVENUE TO MEDICARE WAS CALCULATED ACCORDING TO THE COST TO CHARGE RATIO. ALLOWABLE COSTS OF CARE SHOULD BE CONSIDERED COMMUNITY BENEFIT BECAUSE IN THE AREA SERVED BY THE OUTER BANKS HOSPITAL, THERE ARE NO OTHER PROVIDERS AVAILABLE TO PROVIDE THE REQUIRED SERVICES. THEREFORE, THE CARE WOULD BECOME A GOVERNMENT OBLIGATION AND IS TREATED AS A COMMUNITY BENEFIT PROVIDED BY THE OUTER BANKS HOSPITAL. SCHEDULE H, PART III, LINE 9B COLLECTION PRACTICES FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE RECOMMENDED PATIENT ACCOUNTS WILL CONTINUE TO GO THROUGH THE ACCOUNTS RECEIVABLE BILLING CYCLE AS NORMAL. WHEN THE ACCOUNT REACHES THE CUSTOMER SERVICE/COLLECTIONS MANAGER, FINANCIAL COUNSELING SUPERVISOR OR PATIENT ACCOUNTS SUPERVISOR, BASED ON THE INFORMATION GIVEN, A DECISION WILL BE MADE WHETHER TO PROCEED WITH COLLECTION OR REFER THE ACCOUNT FOR APPROVAL OF CHARITY CARE. THE PROCESS WILL OCCUR AS FOLLOWS: I. FINANCIAL COUNSELORS WILL TRY TO LOCATE THIRD PARTY PAYORS. IF NOT ELIGIBLE FOR ANY THIRD-PARTY COVERAGE (INCLUDING CHARITIES), THEY MAY, BASED UPON THE FINANCIAL INFORMATION RECEIVED, RECOMMEND THE PATIENT FOR CHARITY CARE. II. PATIENT COUNSELORS WILL REVIEW FOR ANY THIRD-PARTY PAYORS AND VERIFY EMPLOYMENT AND ASSETS. A CHARITY CARE APPLICATION WILL NEED TO BE COMPLETED ALONG WITH TAX RETURN, PAY STUBS, SOCIAL SECURITY AWARD LETTER AND OTHER FINANCIAL INFORMATION AS MAY BE REQUIRED. III. THE PATIENT ACCOUNTS SUPERVISOR, FINANCIAL COUNSELING SUPERVISOR OR CUSTOMER SERVICE/COLLECTIONS MANAGER, BASED UPON ACCOUNT BALANCE AND THE INFORMATION GIVEN, WILL MAKE A DECISION WHETHER TO PROCEED WITH COLLECTION OR REFER THE PATIENT ACCOUNT FOR APPROVAL FOR CHARITY CARE. PRESUMPTIVE ELIGIBILITY FOR CHARITY CARE - THERE ARE OCCASIONS IN WHICH A PATIENT MAY APPEAR ELIGIBLE FOR A CHARITY CARE DISCOUNT, BUT THERE IS NO FINANCIAL ASSISTANCE INFORMATION AVAILABLE TO SUPPORT FINANCIAL AID. A. SOME PATIENTS ARE PRESUMED TO BE ELIGIBLE FOR CHARITY CARE DISCOUNTS ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES (E.G., HOMELESSNESS PATIENTS WITH NO INCOME, BANKRUPTCY, DECEASED PATIENTS WITH NO ESTATE OR SPOUSE, ETC.) B. THROUGH THE ASSISTANCE OF A THIRD-PARTY VENDOR AND CERTAIN ALGORITHMS, IN CONJUNCTION WITH OUR CHARITY POLICY GUIDELINES, ALL ACCOUNTS, PRIOR TO OUTSIDE COLLECTION AGENCY REFERRAL, WILL BE TESTED FOR PRESUMPTIVE CHARITY. C. THE ACCOUNTS DEEMED CHARITY WILL BE ADJUSTED OFF AND THE REMAINING ACCOUNTS WILL BE REFERRED TO AN OUTSIDE COLLECTION AGENCY. D. ONCE THE AGENCY HAS HAD THE ACCOUNTS FOR SIX MONTHS AND HAS DEEMED THEM UNCOLLECTIBLE, THE ACCOUNTS WITH BALANCES OF $1,580 OR GREATER WILL REMAIN WITH THE AGENCY AND BE KEPT ON THE PATIENT'S CREDIT FILE. E. THE ACCOUNTS RETURNED TO THE HOSPITAL WILL BE PLACED IN A UNIQUE FINANCIAL CLASS AND WILL NOT BE PURSUED FOR COLLECTIONS. SCHEDULE H, PART V, SECTION B, LINE 16A FAP WEBSITE - THE OUTER BANKS HOSPITAL, INC.: LINE 16A URL: HTTPS://WWW.ECUHEALTH.ORG/PATIENTS-AND-FAMILIES/YOUR-BILL/FINANCIAL-ASSISTANCE/; SCHEDULE H, PART V, SECTION B, LINE 16B FAP APPLICATION WEBSITE - THE OUTER BANKS HOSPITAL, INC.: LINE 16B URL: HTTPS://WWW.ECUHEALTH.ORG/PATIENTS-AND-FAMILIES/YOUR-BILL/FINANCIAL-ASSISTANCE/; SCHEDULE H, PART V, SECTION B, LINE 16C FAP PLAIN LANGUAGE SUMMARY WEBSITE - THE OUTER BANKS HOSPITAL, INC.: LINE 16C URL: HTTPS://WWW.ECUHEALTH.ORG/PATIENTS-AND-FAMILIES/YOUR-BILL/FINANCIAL-ASSISTANCE/; SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT THE ORGANIZATION ASSESSES COMMUNITY NEED IN CONJUNCTION WITH THE STATE AFFILIATED COUNTY HEALTH DEPARTMENTS AND OTHER LOCAL HEALTH CARE ORGANIZATIONS. THIS HAS BEEN DESCRIBED IN DETAIL IN SCHEDULE H, PART V, SECTION C, LINES 5 AND 11. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE INFORMATION IS AVAILABLE ON THE ORGANIZATION'S WEBSITE AND AT REGISTRATION FOR PATIENTS. IN ADDITION, FACE TO FACE FINANCIAL COUNSELING IS AVAILABLE TO PATIENTS AND THEIR FAMILIES IN THE CENTRAL BUSINESS OFFICE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION THE PRIMARY SERVICE AREA FOR THE OUTER BANKS HOSPITAL ENCOMPASSES DARE COUNTY. DARE COUNTY IS LOCATED ALONG THE COAST IN NORTHEASTERN NORTH CAROLINA. THE SIX MUNICIPALITIES WITHIN DARE COUNTY INCLUDE DUCK, SOUTHERN SHORES, KITTY HAWK, KILL DEVIL HILLS, NAGS HEAD, AND MANTEO. ADDITIONAL COMMUNITIES INCLUDE AVON, BUXTON, FRISCO, HATTERAS, MANNS HARBOR, RODANTHE, AND WANCHESE. THE MOST RECENT CHNA INDICATES: DARE COUNTY HAS A POPULATION OF 38,482 MAKING UP LESS THAN 1% OF NORTH CAROLINA'S TOTAL POPULATION. THE POPULATION OF THE COUNTY IS PROJECTED TO GROW 0.56% ANNUALLY BETWEEN NOW AND 2029. RACE AND ETHNICITY: DARE COUNTY'S RACIAL COMPOSITION DIFFERS SIGNIFICANTLY FROM STATE AND NATIONAL AVERAGES. NON-HISPANIC WHITE RESIDENTS MAKE UP THE LARGEST RACIAL GROUP AT 84.4%, WHICH IS NOTABLY HIGHER THAN BOTH NORTH CAROLINA (61.2%) AND UNITED STATES (60.6%) FIGURES. NON-HISPANIC BLACK RESIDENTS COMPRISE JUST 1.9% OF THE POPULATION, CONSIDERABLY LOWER THAN STATE (20.4%) AND NATIONAL (12.5%) AVERAGES. THE COUNTY HAS LOWER PERCENTAGES OF ASIAN (0.8%), AMERICAN INDIAN ALASKA NATIVE (0.5%), AND NATIVE HAWAIIAN PACIFIC ISLANDER (0.0%) POPULATIONS COMPARED TO STATE AND NATIONAL FIGURES. THE PERCENTAGE OF RESIDENTS IDENTIFYING AS TWO OR MORE RACES (6.2%) IS LOWER THAN THE STATE AVERAGE (7.2%). BY ETHNICITY, 7.4% OF DARE COUNTY'S POPULATION IS HISPANIC. THIS IS LOWER THAN THE STATE PROPORTION (11.4%). AGE AND SEX: THE AGE DISTRIBUTION OF DARE COUNTY SKEWS OLDER COMPARED TO STATE AND NATIONAL AVERAGES. DARE HAS A LOWER PERCENTAGE OF RESIDENTS BELOW AGE 15 (14.9%) COMPARED TO NORTH CAROLINA (17.9%) AND THE UNITED STATES (18.1%). THE PERCENTAGE OF RESIDENTS BETWEEN 15 AND 44 (33.0%) IS ALSO LOWER THAN STATE (39.3%) AND NATIONAL (39.5%) FIGURES. HOWEVER, DARE COUNTY HAS HIGHER PERCENTAGES OF RESIDENTS AGED 45-64 (29.6%) AND 65 AND OLDER (22.5%) COMPARED TO BOTH STATE AND NATIONAL AVERAGES. THE SEX DISTRIBUTION IN DARE COUNTY IS NEARLY BALANCED, WITH FEMALES MAKING UP 49.9% AND MALES 50.1% OF THE POPULATION. LANGUAGE: APPROXIMATELY 8.1% OF DARE COUNTY RESIDENTS SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME, COMPARED TO AROUND 12.7% OF NORTH CAROLINA RESIDENTS. APPROXIMATELY 7.0% OF COUNTY RESIDENTS SPEAK SPANISH AT HOME, SUGGESTING A PREDOMINANCE OF ENGLISH SPEAKERS. DISABILITY STATUS: IN DARE COUNTY THE DISABILITY RATE (11%) IS LOWER THAN THE STATE AVERAGE OF 13.3%. VETERAN STATUS: VETERANS MAKE UP NEARLY 9% OF DARE COUNTY'S POPULATION, A SLIGHTLY HIGHER PROPORTION COMPARED TO NORTH CAROLINA (7.8%). ECONOMIC INDICATORS: DARE COUNTY IS RANKED AS A TIER 2 COUNTY BY THE NC DEPARTMENT OF COMMERCE. DARE COUNTY'S MEDIAN HOUSEHOLD INCOME OF $73,526 WAS HIGHER THAN THE MEDIAN HOUSEHOLD INCOME IN NORTH CAROLINA OF $64,316. THE OVERALL UNEMPLOYMENT RATE IN DARE COUNTY (5.1%) MATCHES THE STATE AVERAGE (5.1%) AND IS HIGHER THAN THE NATIONAL AVERAGE (3.9%). IN DARE COUNTY 5.4% OF HOUSEHOLDS WERE BELOW THE FEDERAL POVERTY LEVEL (FPL) - ROUGHLY HALF THE PROPORTION IN THE STATE (10.1%) AND NATION (9.5%). DARE COUNTY HAS A SMALLER PROPORTION OF RESIDENTS RECEIVING FOOD STAMPS/SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (8%) COMPARED TO NORTH CAROLINA (13.4%) INDICATING A LOWER LEVEL OF FOOD INSECURITY AMONG COUNTY HOUSEHOLDS. ADDITIONALLY, SEE INFORMATION POSTED AT HTTPS://WWW.ECUHEALTH.ORG/ABOUT-US/COMMUNITY/HEALTH-NEEDS-ASSESSMENT/ SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH THIS HAS BEEN DESCRIBED IN DETAIL IN SCHEDULE H, PART V, SECTION C, LINES 5 AND 11. ADDITIONALLY, SEE INFORMATION POSTED AT HTTPS://WWW.ECUHEALTH.ORG/ABOUT-US/COMMUNITY/HEALTH-NEEDS-ASSESSMENT/ SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM OUR MISSION AT ECU HEALTH IS TO IMPROVE THE HEALTH AND WELL-BEING OF EASTERN NORTH CAROLINA. OUR VISION IS TO BECOME THE NATIONAL MODEL FOR RURAL HEALTH AND WELLNESS BY CREATING A PREMIER, TRUSTED HEALTH CARE DELIVERY SYSTEM WHILE REMAINING TRUE TO OUR VALUES OF INTEGRITY, COMPASSION, EDUCATION, ACCOUNTABILITY, SAFETY AND TEAMWORK. OUR OPERATIONAL IMPERATIVES DRIVE ECU HEALTH PERFORMANCE AND OUTCOMES. THESE IMPERATIVES ARE EXPERIENCE, FINANCE, QUALITY, WELL-BRING, EQUITY & INCLUSION. WE KEEP PATIENTS, FAMILIES, TEAM MEMBERS AND COMMUNITIES AT THE CENTER OF EVERYTHING THAT WE DO. WE ARE MANAGING LIVES THROUGH A MODERN DELIVERY SYSTEM OF HEALTH CARE IN AN ACADEMIC AND RURAL SETTING TO DELIVER SAFE, HIGHLY RELIABLE HUMAN CENTERED CARE. ECU HEALTH IS A NORTH CAROLINA NON-PROFIT CORPORATION WITH HEADQUARTERS IN GREENVILLE, NORTH CAROLINA. ECU HEALTH AND ITS AFFILIATES OPERATE AN INTEGRATED HEALTH CARE DELIVERY SYSTEM THAT SERVES A TOTAL MARKET OF APPROXIMATELY 1.4 MILLION PEOPLE IN 29 CONTIGUOUS COUNTIES IN EASTERN NORTH CAROLINA. THE HEALTH SYSTEM INCLUDES HOSPITALS, PHYSICIAN PRACTICES, OUTPATIENT SERVICES, HOME HEALTH, HOSPICE, AND WELLNESS SERVICES. THE HEALTH SYSTEM'S OWNED HOSPITALS ARE ECU HEALTH MEDICAL CENTER, WHICH IS A TERTIARY CARE HOSPITAL AND AN ACADEMIC MEDICAL CENTER, THAT INCLUDES THE ECU HEALTH BEAUFORT HOSPITAL AS A DEPARTMENT OPERATING AS A CAMPUS OF ECU HEALTH MEDICAL CENTER AND SEVEN OTHER ACUTE CARE HOSPITALS: ECU HEALTH ROANOKE-CHOWAN HOSPITAL, ECU HEALTH EDGECOMBE HOSPITAL, ECU HEALTH CHOWAN HOSPITAL, ECU HEALTH BERTIE HOSPITAL, ECU HEALTH DUPLIN HOSPITAL, ECU HEALTH NORTH HOSPITAL, AND THE OUTER BANKS HOSPITAL. ECU HEALTH MEDICAL CENTER SERVES AS THE TEACHING HOSPITAL FOR THE BRODY SCHOOL OF MEDICINE, EAST CAROLINA SCHOOLS OF NURSING AND ALLIED HEALTH, PITT COMMUNITY COLLEGE AND BEAUFORT COMMUNITY COLLEGE. THE SYSTEM ALSO SERVES AS A REGIONAL REFERRAL CENTER FOR EASTERN NORTH CAROLINA. IN OUR RURAL HEALTH CARE SETTING, WE ARE FACED WITH UNIQUE CHALLENGES. ONE OF THE CHALLENGES IS ACCESS TO CARE. FACTORS INFLUENCING ACCESS INCLUDE PATIENT FACTORS SUCH AS TRANSPORTATION NEEDS AS WELL AS PROVIDER AND STAFFING SHORTAGES. SHORTAGES IN STAFFING INFLATE THE COST OF PROVIDING CARE THROUGH THE USE OF LOCUM AND TEMPORARY LABOR AND CAUSE ADDITIONAL FINANCIAL STRAINS RELATED TO THE HIGH PERCENTAGE OF GOVERNMENT PAYORS AS WELL AS THE UNINSURED POPULATION IN OUR REGION. ALL COUNTIES IN WHICH ECU HEALTH OPERATES ARE DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). AS A RESULT, OUR EMERGENCY DEPARTMENTS BECOME A PRIMARY CARE ACCESS POINT AND CAUSE OVERLOAD ON THE SYSTEM WHICH RESULT IN CAPACITY CONSTRAINTS FOR BEDS NEEDED FOR ADMISSIONS AND BOARDERS WAITING FOR TRANSFERS TO BEHAVIORAL HEALTH FACILITIES. ECU HEALTH HAS MADE A CONSCIOUS DECISION TO PROVIDE CERTAIN SERVICES FOR THE BENEFIT OF THE COMMUNITY ALTHOUGH VOLUMES ARE NOT LARGE ENOUGH TO GENERATE A PROFIT. ONE EXAMPLE OF THESE SERVICES ARE OB SERVICES WHERE LESS THAN 1 BABY IS BORN A DAY IN SOME OF OUR REGIONAL HOSPITALS; HOWEVER, DUE TO OUR RURAL NATURE WE BELIEVE IT WOULD BE DETRIMENTAL TO OUR COMMUNITY TO NOT MAINTAIN THESE SERVICES. ECU HEALTH IS CONTINUOUSLY COLLABORATING ON WAYS TO INCREASE ACCESS SUCH AS THROUGH USE OF TELEMEDICINE TO PROVIDE HIGH LEVEL CARE TO OUR REGIONAL HOSPITALS BY USING RESOURCES AT OUR ACADEMIC MEDICAL CENTER TO KEEP PATIENTS CLOSE TO HOME WHEN POSSIBLE. ADDITIONALLY. SEE INFORMATION POSTED AT HTTPS://WWW.ECUHEALTH.ORG/ABOUT-US/COMMUNITY/HEALTH-NEEDS-ASSESSMENT/ SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT NC true COMMUNITY CARE CLINIC OF DARE PO BOX 1000 MANTEO NC 27954 202230717 501 (C) (3) 85000 SUPPORT IN HIRING EXECUTIVE DIRECTOR COLLEGE OF THE ALBEMARLE FOUNDATION PO BOX 2327 ELIZABETH CITY NC 27906 581399254 501 (C) (3) 23000 COMMUNITY OUTREACH INTERFAITH COMMUNITY PO BOX 87 NAGS HEAD NC 27959 223902355 501 (C) (3) 20000 COMMUNITY BENEFIT GRANT PROGRAM OUTER BANKS COMMUNITY FOUNDATION PO BOX 1100 KILL DEVIL HILLS NC 27948 581516313 501(C) (3) 15000 COMMUNITY BENEFIT GRANT PROGRAM CAPE HATTERAS UNITED METHODIST MEN PO BOX 672 BUXTON NC 27920 561215425 501(C) (3) 10000 COMMUNITY BENEFIT GRANT PROGRAM DARE COUNTY HEALTH DEPARTMENT 109 EXETER ST MANTEO NC 27954 566000293 GOVT ENTITY 8500 COMMUNITY BENEFIT GRANT PROGRAM CHILDREN & YOUTH PARTNERSHIP PO BOX 2539 KILL DEVIL HILLS NC 27948 561885539 501(C) (3) 8000 COMMUNITY BENEFIT GRANT PROGRAM OUTER BANKS DEMENTIA FRIENDLY COALITION PO BOX 752 KITTY HAWK NC 27949 850522723 501(C) (3) 7550 EVENT SPONSORSHIP DARE COUNTY TRANSPORTATION 954 MARSHALL C COLLINS DR MANTEO NC 27954 566000293 GOVT ENTITY 7500 COMMUNITY BENEFIT GRANT PROGRAM CROSS ROADS OBX ASSOCIATION 111 W CARLTON AVE KILL DEVIL HILLS NC 27948 372004420 501(C) (3) 7500 COMMUNITY BENEFIT GRANT PROGRAM OUTER BANKS CHAMBER OF COMMERCE PO BOX 1757 KILL DEVIL HILLS NC 27948 560899110 501(C) (3) 7500 EVENT SPONSORSHIP NC AQUARIUM SOCIETY 3125 POPLARWOOD CT STE 160 RALEIGH NC 27604 561512990 501(C) (3) 7500 COMMUNITY BENEFIT GRANT PROGRAM OBX ROOM IN THE INN PO BOX 2786 KILL DEVIL HILLS NC 27948 455030512 501(C) (3) 7500 COMMUNITY BENEFIT GRANT PROGRAM 13 0 SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING USE OF GRANT FUNDS TOBH MAINTAINS RECORDS TO SUBSTANTIATE ALL DISBURSEMENTS MADE IN ACCORDANCE WITH ITS DOCUMENT RETENTION POLICY. ALL GRANTS AND ASSISTANCE ARE APPROVED AT THE APPROPRIATE LEVEL OUTLINED IN ITS POLICY AND PROCEDURES. X X X X false false false false false false false false false VAN SMITH BOARD MEMBER 0 415805 0 111741 0 0 0 158352 0 46722 0 732620 0 0 JAMIE FOUNTAIN MD BOARD MEMBER 320994 0 122551 0 0 0 29948 0 48808 0 522301 0 0 0 AMY MONTGOMERY SECRETARY 175171 0 1500 0 0 0 0 0 36864 0 213535 0 0 0 RONALD SLOAN PRESIDENT 317063 0 92058 0 0 0 88174 0 57404 0 554699 0 0 0 TODD WARLITNER VP FINANCE-CRITICAL ACCESS HOSPITALS 72632 108949 16993 25489 0 0 9444 14165 15953 23929 115022 172532 0 0 MARCELLA BRYANT VP, CLINICAL OPERATIONS 197276 0 48079 0 0 0 25899 0 40892 0 312146 0 0 0 JEFFREY CHASE PHYSICIAN 566642 0 8333 0 0 0 0 0 50538 0 625513 0 0 0 GARY HUNTER ANESTHESIOLOGIST 564707 0 0 0 0 0 0 0 33732 0 598439 0 0 0 CHRISTOPHER MANN PHYSICIAN 540351 0 175532 0 0 0 0 0 54467 0 770350 0 0 0 MATTHEW MCKENNA PHYSICIAN 546091 0 63391 0 0 0 0 0 56231 0 665713 0 0 0 CHARLES SHELTON PHYSICIAN 539085 0 34196 0 0 0 0 0 52046 0 625327 0 0 0 SCHEDULE J, PART I, LINE 3 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION THE TOP MANAGEMENT OFFICIAL IS THE PRESIDENT WHO IS AN EMPLOYEE OF TOBH. THE COMPENSATION IS DETERMINED BY THE COMPENSATION AND BENEFITS COMMITTEE OF THE ECU HEALTH BOARD USING COMPARATIVE DATA FROM LIKE ORGANIZATIONS AND INPUT FROM CONSULTANTS. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS ALSO DETERMINED BY THE COMPENSATION AND BENEFITS COMMITTEE OF THE ECU HEALTH BOARD USING COMPARATIVE DATA FROM LIKE ORGANIZATIONS AND INPUT FROM CONSULTANTS. ALL COMPENSATION DISCUSSIONS AND ACTIONS ARE DOCUMENTED AND APPROVED IN THE MINUTES OF THE COMMITTEE. FORM 990, PART III, LINE 4A PROGRAM SERVICE DESCRIPTION OVERVIEW OF UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA: OUR MISSION AT ECU HEALTH IS TO IMPROVE THE HEALTH AND WELL-BEING OF EASTERN NORTH CAROLINA. OUR MISSION, VISION AND VALUES CONTINUE TO LEAD US ON A VOYAGE TO EXCELLENCE. BECAUSE THE PEOPLE WE TAKE CARE OF ARE OUR NEIGHBORS, FRIENDS AND FAMILY THEY DESERVE THE BEST. ECU HEALTH IS A NORTH CAROLINA NON-PROFIT CORPORATION WITH HEADQUARTERS IN GREENVILLE, NORTH CAROLINA. ECU HEALTH AND ITS AFFILIATES OPERATE AN INTEGRATED HEALTH CARE DELIVERY SYSTEM THAT SERVES A TOTAL MARKET OF APPROXIMATELY 1.4 MILLION PEOPLE IN 29 CONTIGUOUS COUNTIES IN EASTERN NORTH CAROLINA. THE HEALTH SYSTEM INCLUDES HOSPITALS, PHYSICIAN PRACTICES, OUTPATIENT SERVICES, HOME HEALTH, HOSPICE, AND WELLNESS SERVICES. THE HEALTH SYSTEM'S OWNED HOSPITALS ARE ECU HEALTH MEDICAL CENTER, WHICH IS A TERTIARY CARE HOSPITAL AND AN ACADEMIC MEDICAL CENTER, THAT INCLUDES THE ECU HEALTH BEAUFORT HOSPITAL AS A DEPARTMENT OPERATING AS A CAMPUS OF ECU HEALTH MEDICAL CENTER AND SEVEN OTHER ACUTE CARE HOSPITALS: ECU HEALTH ROANOKE-CHOWAN HOSPITAL, ECU HEALTH EDGECOMBE HOSPITAL, ECU HEALTH CHOWAN HOSPITAL, ECU HEALTH BERTIE HOSPITAL, ECU HEALTH DUPLIN HOSPITAL, ECU HEALTH NORTH HOSPITAL, AND THE OUTER BANKS HOSPITAL. ECU HEALTH MEDICAL CENTER SERVES AS THE TEACHING HOSPITAL FOR THE BRODY SCHOOL OF MEDICINE, EAST CAROLINA SCHOOLS OF NURSING AND ALLIED HEALTH, PITT COMMUNITY COLLEGE AND BEAUFORT COMMUNITY COLLEGE. THE SYSTEM ALSO SERVES AS A REGIONAL REFERRAL CENTER FOR EASTERN NORTH CAROLINA. THE SYSTEM'S NINE OWNED HOSPITALS ARE LICENSED TO OPERATE 1,708 BEDS. EACH HOSPITAL IS LICENSED BY THE DIVISION OF FACILITY SERVICES OF THE NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES AND APPROVED AS A PROVIDER BY THE MEDICARE AND MEDICAID PROGRAMS. ECU HEALTH AND ITS HOSPITALS AND AFFILIATE ORGANIZATIONS PROVIDE SERVICES TO PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. IN FISCAL YEAR 2025 ECU HEALTH'S COMBINED PATIENT CARE STATISTICS WERE: INPATIENT ADMISSIONS, 68,570; INPATIENT DAYS OF CARE, 385,908; SURGERIES, 54,577; BIRTHS, 6,394; AND OUTPATIENT VISITS, 482,146. OUR SYSTEM'S WORKFORCE INCLUDED 13,578 EMPLOYEES. EACH OF ECU HEALTH'S HOSPITALS OPERATES AN EMERGENCY ROOM, WHICH IS OPEN 24 HOURS A DAY. ECU HEALTH MEDICAL CENTER ALSO OFFERS A FULL SPECTRUM OF TRAUMA SERVICES. EMERGENCY AND TRAUMA SERVICES ARE PROVIDED TO PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. IN FISCAL YEAR 2025 ECU HEALTH PROVIDED CARE TO 277,498 EMERGENCY ROOM PATIENTS. ECU HEALTH'S BOARD OF DIRECTORS CONSISTS OF 11 VOTING MEMBERS, SIX OF WHOM MUST BE CURRENT OR FORMER PITT COUNTY, NORTH CAROLINA APPOINTEES OF ECU HEALTH MEDICAL CENTER'S BOARD OF TRUSTEES AND FIVE OF WHOM MUST BE CURRENT OR FORMER BOARD OF GOVERNORS OF THE UNIVERSITY OF NORTH CAROLINA APPOINTEES OF ECU HEALTH MEDICAL CENTER'S BOARD OF TRUSTEES. ECU HEALTH MEDICAL CENTER, IN AFFILIATION WITH THE BRODY SCHOOL OF MEDICINE, WHICH IS OWNED BY THE STATE OF NORTH CAROLINA, OPERATES 30 RESIDENT-TRAINING PROGRAMS WITH OVER 400 MEDICAL RESIDENTS. THIS RELATIONSHIP ENABLES ECU HEALTH MEDICAL CENTER AND THE BRODY SCHOOL OF MEDICINE TO COMBINE THEIR RESOURCES FOR THE PROVISION OF QUALITY PATIENT CARE, MEDICAL EDUCATION AND RESEARCH FOR THE RESIDENTS OF EASTERN NORTH CAROLINA. THE BRODY SCHOOL OF MEDICINE HAS THREE IMPORTANT GOALS: EDUCATING PRIMARY CARE PHYSICIANS, MAKING MEDICAL CARE MORE READILY AVAILABLE TO THE PEOPLE OF EASTERN NORTH CAROLINA, AND PROVIDING OPPORTUNITIES TO MINORITY AND DISADVANTAGED STUDENTS. AS A NON-PROFIT ORGANIZATION, ECU HEALTH REINVESTS ALL EXCESS OF REVENUES OVER EXPENSES IN PROGRAMS, SERVICES, AND FACILITIES THAT PROVIDE ACCESS TO PATIENT CARE AND HEALTH SERVICES TO THE CITIZENS OF EASTERN CAROLINA. OVERVIEW OF ECU HEALTH COMMUNITY BENEFIT PROGRAMS 1. EASTERN NORTH CAROLINA IS COMPRISED OF 1.4 MILLION PEOPLE LIVING IN 14,000 SQUARE MILES. BOUNDARIES ARE FROM I-95 EAST TO THE COAST, AND FROM THE VIRGINIA LINE DOWN TO AND INCLUDING ONSLOW COUNTY. THE AREA IS LARGELY RURAL AND LARGELY POOR, WITH HIGHER THAN STATE OR NATIONAL AVERAGE RATES FOR POVERTY AND UNINSURED. HEALTH STATUS INDICATORS SHOW INCREASED INCIDENCE OF DISEASE IN THE REGION, ESPECIALLY CANCER, HEART DISEASE AND STROKE. ECU HEALTH DETERMINES PRIORITIES FOR TARGET POPULATIONS BY WORKING IN CONCERT WITH MEDICAL AND COMMUNITY AGENCY PARTNERS IN ONGOING ASSESSMENT OF THE MOST PRESSING HEALTH CARE NEEDS. MANY EFFORTS OVER THE PAST DECADE HAVE FOCUSED ON DIABETES, PEDIATRIC ASTHMA, SCHOOL HEALTH, INJURY PREVENTION, ACCESS TO CARE, NUTRITION ENHANCEMENT, PHYSICAL ACTIVITIES AND CHRONIC DISEASE SCREENINGS. ALSO, SPECIAL PROGRAMS TO MANAGE THE CARE OF MEDICAID ENROLLEES, ADDRESS ACCESS TO BOTH MEDICAL CARE AND MEDICATIONS FOR THE UNINSURED, AND COORDINATION OF SERVICES FOR CHILDREN WITH OBESITY HAVE BEEN UNDERTAKEN. THE POPULATIONS THAT ARE SERVED BY ADDRESSING THESE ISSUES ARE LARGELY THE POOR, THE UNDERSERVED, AND MINORITIES. DETERMINATION OF SPECIFIC POPULATIONS TO ADDRESS OCCURS WHEN PARTNERS SUCH AS THE NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES, LOCAL HEALTH DEPARTMENTS, COUNTY COALITIONS, TASK FORCES, AND PHYSICIANS IDENTIFY A QUANTIFIABLE NEED, AND COMMUNITY PARTNERS ARE ENGAGED TO WORK TOGETHER WITH THE HEALTH SYSTEM. 2. FUNDING FOR COMMUNITY HEALTH PROGRAMS IS OBTAINED FROM BOTH THE OPERATING FUNDS OF ECU HEALTH ENTITIES AND EXTERNAL GRANT-AWARDING ORGANIZATIONS. THE ECU HEALTH BOARD ANNUALLY PROVIDES FINANCIAL SUPPORT FOR THE COMMUNITY BENEFIT INITIATIVES PROGRAM BASED WITHIN EACH ECU HEALTH HOSPITAL. FUNDS ARE AWARDED TO COMMUNITY AGENCIES THAT SUCCESSFULLY DEMONSTRATE BOTH NEED AND A WELL-DESIGNED PLAN TO ADDRESS ONE OF THE HEALTH PRIORITIES IDENTIFIED IN THE COMMUNITY HEALTH ASSESSMENT PROCESS. THESE FUNDS ARE THEN AWARDED TO COMMUNITY AGENCIES THAT SUCCESSFULLY DEMONSTRATE BOTH NEED AND A WELL-DESIGNED PLAN TO ADDRESS ONE OF THE FOUNDATION'S PRIORITY CATEGORIES. IN ADDITION, EACH ECU HEALTH HOSPITAL FINANCIALLY SUPPORTS COMMUNITY HEALTH RESOURCES WITHIN ITS OPERATING BUDGET. PROGRAMS VARY ACCORDING TO THE HOSPITAL'S FINANCIAL ABILITY AND COMMUNITY NEED, BUT ALL INCLUDE COLLABORATIVE EFFORTS WITH LOCAL HEALTH DEPARTMENTS, INCLUDING HEALTH SCREENINGS AND EDUCATION TO TARGETED POPULATIONS. ECU HEALTH ALSO HAS A SUCCESSFUL TRACK RECORD OF OBTAINING COMMUNITY HEALTH PROGRAM SUPPORT FROM EXTERNAL AGENCIES THAT AWARD GRANT FUNDING TO APPROVE PROJECTS. THE ECU HEALTH GRANTS OFFICE WAS ESTABLISHED IN 2008 AND SERVES AS THE CENTRAL POINT FOR GRANT MINING, ACQUISITION AND MANAGEMENT OF GRANTS AWARDED TO ECU HEALTH HOSPITALS FOR COMMUNITY-BASED PROGRAMS. GRANT FUNDS ARE UTILIZED TO DEMONSTRATE THE EFFECTIVENESS OF A PROPOSED COMMUNITY PROGRAM, MEASURE THE OUTCOMES ACHIEVED, AND GARNER LONG-TERM SUSTAINABILITY FROM EITHER THE HEALTH SYSTEM, OTHER COMMUNITY AGENCIES OR AS A COLLABORATIVE PROGRAM. MANY COMMUNITY HEALTH PROGRAMS ARE COLLABORATIVE IN NATURE WITH LOCAL SERVICE AGENCIES, AND OFTEN A PORTION OF THE GRANT FUNDS ARE USED TO SUPPORT RESOURCES OR SERVICES IN THESE AGENCIES 3. COMMUNITY HEALTH PRIORITIES ARE DETERMINED FOLLOWING THE COMPLETION OF A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS. THE COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDES INPUT FROM COMMUNITY MEMBERS RECEIVED THROUGH COMMUNITY SURVEYS AND FOCUS GROUP DISCUSSIONS, AS WELL AS A REVIEW OF SECONDARY HEALTH DATA. COMMUNITY ALLIANCES, PARTNERS AND ORGANIZATIONS, INCLUDING LOCAL HEALTH DEPARTMENTS, PARTICIPATE IN THIS REVIEW. A LIST OF THE MOST PRESSING HEALTH ISSUES ARE COMPILED FOR EACH COMMUNITY AND THEN PRIORITIZED FOLLOWING AN ASSESSMENT OF CURRENT HEALTH RESOURCES TO ADDRESS THE IDENTIFIED HEALTH ISSUES. ESTABLISHED RESOURCES/COALITIONS AND NEW PARTNERSHIPS ARE FORMED TO ADDRESS THE IDENTIFIED HEALTH PRIORITIES 4. COMMUNITY HEALTH PRIORITIES ARE ALSO ESTABLISHED IN RESPONSE TO A COMPELLING NEED IDENTIFIED BY HEALTH PRACTITIONERS OR COMMUNITY GROUPS. ECU HEALTH IS FORTUNATE TO HAVE A STRONG COLLABORATIVE PARTNERSHIP WITH EAST CAROLINA UNIVERSITY AND WORKS CLOSELY WITH THE SCHOOLS WITHIN THE HEALTH SCIENCES DIVISION, ESPECIALLY THE BRODY SCHOOL OF MEDICINE. PROVIDED BELOW ARE A FEW HIGHLIGHTS OF THE COMMUNITY BENEFIT AND EDUCATION ACTIVITIES: COMMUNITY HEALTH IMPROVEMENT SERVICES: COMMUNITY HEALTH IMPROVEMENT SERVICES ARE PROGRAMS AND SERVICES THAT MEET AN IDENTIFIED NEED AND ARE OFFERED TO THE COMMUNITY AT LITTLE OR NO CHARGE. ECU HEALTH HOSPITALS SPONSOR PROGRAMS THAT IMPROVE ACCESS TO HEALTH CARE FOR THE UNDERSERVED AND ENHANCE THE IDENTIFICATION AND MANAGEMENT OF CHRONIC DISEASES, SUCH AS CANCER, DIABETES AND HEART DISEASE. HERE ARE A FEW EXAMPLES OF THESE PROGRAMS: - MEDICAL ASSISTANCE PROGRAMS FOR UNINSURED PATIENTS - SUPPORT FOR COMMUNITY COALITIONS FOCUSED ON HEALTH - SUPPORT OF LOCAL FEDERALLY QUALIFIED HEALTH CENTER - SUPPORT FOR HEALTHY NEIGHBORS FAITH HEALTH PARTNERSHIP - SUPPORT FOR SCHOOL HEALTH PARTNERSHIP FORM 990, PART III, LINE 4A PROGRAM SERVICE DESCRIPTION (CONTINUATION) HEALTH PROFESSIONAL EDUCATION: PREPARING FUTURE HEALTH CARE PROFESSIONALS IS IMPORTANT TO US. OUR HOSPITALS PROVIDE CLINICAL SETTINGS FOR STUDENTS OF HEALTH PROFESSIONS, SUCH AS FUTURE PHYSICIANS, NURSES AND OTHER ALLIED HEALTH PROFESSIONALS. WE ALSO SUPPORT STUDENTS THROUGH DEFERRED FORGIVABLE LOANS AND INTERNSHIPS INCLUDING RESIDENT TRAINING, NURSING CLINIC SITES, ALLIED HEALTH PROFESSIONALS, AND FINANCIAL SUPPORT OF NURSING PROGRAMS. RESEARCH: EAST CAROLINA UNIVERSITY (ECU) CONDUCTS RESEARCH TO EVALUATE NEW TREATMENTS AND PROTOCOLS. THESE STUDIES HELP HEALTH PROFESSIONALS EVERYWHERE PROVIDE QUALITY CARE TO PATIENTS. ECU HEALTH SUPPORTS THIS THROUGH VARIOUS MEANS INCLUDING SUPPORTING THE INSTITUTIONAL REVIEW BOARD AT ECU AND PROVIDING STUDY SITES. FINANCIAL AND IN-KIND CONTRIBUTIONS: ECU HEALTH DONATES MONEY AND IN-KIND SERVICES TO COMMUNITY GROUPS AND ACTIVITIES THAT SHARE OUR MISSION OF IMPROVING HEALTH. THEY INCLUDE MEALS ON WHEELS, THE BLOOD CONNECTION BLOOD DRIVES, MEDICAL SUPPLIES TO EMERGENCY MEDICAL SERVICES, FREE MEDICATIONS TO QUALIFYING PATIENTS, AND LOCAL HIGH SCHOOL AND COMMUNITY COLLEGE ALLIED HEALTH PROGRAMS. ECU HEALTH HOSPITALS ARE KEY PARTNERS IN FUNDRAISING FOR ORGANIZATIONS SUCH AS THE UNITED WAY, AMERICAN HEART ASSOCIATION, AND THE AMERICAN CANCER SOCIETY. COMMUNITY BUILDING: COMMUNITY-BUILDING ACTIVITIES INCLUDE PROGRAM THAT ARE NOT DIRECTLY RELATED TO HEALTH CARE BUT ADDRESS UNDERLYING ISSUES THAT IMPACT THE HEALTH OF COMMUNITIES. POVERTY, CRIME, HOMELESSNESS, WORKFORCE DEVELOPMENT AND ECONOMIC DEVELOPMENT ALL AFFECT THE OVERALL HEALTH OF COMMUNITIES. ECU HEALTH HAS PROVIDED SUPPORT FOR OUR LOCAL CHAMBERS OF COMMERCE, INVESTMENTS IN COMMUNICATION INFRASTRUCTURE VIA INFORMATION TECHNOLOGY CONNECTIONS, SUPPORT FOR THE TEEN LEADERSHIP ACADEMY, RECRUITMENT OF PHYSICIANS TO OUR RURAL COMMUNITIES, AND PROGRAMS THAT ENCOURAGE STUDENTS TO PURSUE HEALTH CAREERS. FORM 990, PART VI, LINE 15 PROCESS TO ESTABLISH COMPENSATION THE COMPENSATION IS DETERMINED BY THE COMPENSATION AND BENEFITS COMMITTEE OF THE ECU HEALTH BOARD USING COMPARATIVE DATA FROM LIKE ORGANIZATIONS AND INPUT FROM CONSULTANTS. THIS PROCESS IS PERFORMED EVERY YEAR. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS ALSO DETERMINED BY THE COMPENSATION AND BENEFITS COMMITTEE OF THE ECU HEALTH BOARD USING COMPARATIVE DATA FROM LIKE ORGANIZATIONS AND INPUT FROM CONSULTANTS. THIS PROCESS IS PERFORMED EVERY YEAR. ALL COMPENSATION DISCUSSIONS AND ACTIONS ARE DOCUMENTED AND APPROVED IN THE MINUTES OF THE COMMITTEE. FORM 990, PART VI, LINE 1A DELEGATE BROAD AUTHORITY TO A COMMITTEE THE BOARD OF DIRECTORS MAY CREATE AN EXECUTIVE COMMITTEE CONSISTING OF TWO OR MORE VOTING MEMBERS. THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE, IN THE INTERIM BETWEEN MEETINGS OF THE BOARD OF DIRECTORS, AND EXCEPT AS OTHER PROVIDED IN SECTION 8 OF THE BYLAWS, ALL THE POWERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS ACCORDING TO THE ORGANIZATION'S AMENDED AND RESTATED BYLAWS, ARTICLE II, THE ORGANIZATION HAS TWO MEMBERS, EAST CAROLINA HEALTH AND CHESAPEAKE HOSPITAL AUTHORITY. FORM 990, PART VI, LINE 7A MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY EACH MEMBER HAS THE RIGHT TO APPOINT BOARD MEMBERS. EAST CAROLINA HEALTH APPOINTS 6 BOARD MEMBERS AND CHESAPEAKE HOSPITAL AUTHORITY APPOINTS 4 BOARD MEMBERS. FORM 990, PART VI, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS THE FOLLOWING ACTIONS SHALL NOT BE TAKEN WITHOUT UNANIMOUS CONSENT OF THE MEMBERS: (A) POSSESS PROPERTY. POSSESS CORPORATION PROPERTY FOR OTHER THAN A PURPOSE OF THE CORPORATION; OR ASSIGN, TRANSFER, OR PLEDGE THE RIGHTS OF THE CORPORATION IN SPECIFIC PROPERTY, FOR OTHER THAN THE EXCLUSIVE BENEFIT OF THE CORPORATION. (B) INVEST FUNDS. EMPLOY, OR PERMIT TO BE EMPLOYED, THE FUNDS OR ASSETS OF THE CORPORATION IN ANY MANNER EXCEPT FOR THE EXCLUSIVE BENEFIT OF THE CORPORATION; OR COMMINGLE THE CORPORATION'S FUNDS WITH ITS OWN OR ANY OTHER PERSON'S FUNDS; (C) ADDITIONAL CAPITAL CONTRIBUTIONS. CAUSE THE CORPORATION TO REQUIRE ADDITIONAL CAPITAL CONTRIBUTIONS BEYOND THE AMOUNTS NECESSARY TO COVER THE COST OF THE CORPORATION'S CERTIFICATE OF NEED PROJECT FOR THE DEVELOPMENT OF AN ACUTE CARE HOSPITAL IN DARE COUNTY, INCLUDING THE ACQUISITION OF REAL PROPERTY AND WORKING CAPITAL, WHICH THE MEMBERS HAVE ALREADY SPECIFICALLY COMMITTED; (D) ADMIT MEMBERS. CAUSE THE CORPORATION TO ADMIT NEW MEMBERS; (E) MERGE OR DISSOLUTION. CAUSE THE CORPORATION TO MERGE WITH OR INTO ANY OTHER ENTITY OR ANY ENTITY TO MERGE WITH OR INTO THE CORPORATION OR CAUSE THE CORPORATION TO DISSOLVE; (F) AMENDMENT. AMEND THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS. (G) CON LITIGATION. COMMENCE OR SETTLE ANY LITIGATION ASSOCIATED WITH THE ISSUANCE OF A CERTIFICATE OF NEED FOR AN ACUTE CARE HOSPITAL IN DARE COUNTY; (H) SALE OF ASSETS. SELL ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; OR (I) BUSINESS OF CORPORATION. CHANGE THE TYPE OF BUSINESS IN WHICH THE CORPORATION IS ENGAGED FROM THE OPERATION OF AN ACUTE CARE HOSPITAL AND THE PROVISION OF RELATED MEDICAL SERVICES IN DARE COUNTY, NORTH CAROLINA. FORM 990, PART VI, LINE 11B REVIEW OF FORM 990 BY GOVERNING BODY FORM 990 IS MADE AVAILABLE TO BOARD MEMBERS BY POSTING TO A BOARD MEMBER'S WEBSITE. ANY BOARD MEMBER WHO DOES NOT HAVE THE ABILITY TO ACCESS THE RETURN IN THIS MANNER WILL RECEIVE A COPY VIA ELECTRONIC OR REGULAR MAIL. THE RETURN IS ALSO REVIEWED BY THE CHIEF FINANCIAL OFFICER, CHIEF GENERAL COUNSEL AND THE CHIEF AUDIT AND COMPLIANCE OFFICER OF ECU HEALTH PRIOR TO FILING. FORM 990, PART VI, LINE 12C CONFLICT OF INTEREST POLICY ALL OFFICERS, BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A YEARLY COMPREHENSIVE CONFLICT OF INTEREST QUESTIONNAIRE. THESE RESPONSES ARE REVIEWED BY LEGAL COUNSEL AND ANY POTENTIAL OR ACTUAL CONFLICTS ARE BROUGHT TO THE BOARD FOR DISPOSITION. BOARD MEMBERS ARE INSTRUCTED TO REPORT ANY POTENTIAL CONFLICTS ARISING DURING THE YEAR FOR REVIEW. BOARD MEMBERS ARE REQUIRED TO RECUSE THEMSELVES FROM VOTING ON ISSUES IN WHICH THEY ARE DEEMED TO HAVE A CONFLICT. FORM 990, PART VI, LINE 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN IRC SECTION 6104(D). FORM 990, PART VIII, LINE 11D OTHER MISCELLANEOUS REVENUE ALL OTHER REVENUE - TOTAL REVENUE: 32027, RELATED OR EXEMPT FUNCTION REVENUE: , UNRELATED BUSINESS REVENUE: , REVENUE EXCLUDED FROM TAX UNDER SECTIONS 512, 513, OR 514: 32027; FORM 990, PART IX, LINE 11G OTHER FEES CONTRACTED SERVICES - TOTAL EXPENSE: 33323712, PROGRAM SERVICE EXPENSE: 26658969, MANAGEMENT AND GENERAL EXPENSES: 6664743, FUNDRAISING EXPENSES: 0; FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES NET ASSET TRANSFER - -11000000; TOTAL - -11000000; FORM 990, PART XII, LINE 2C CHANGE OF OVERSIGHT PROCESS OR SELECTION PROCESS THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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