2012-11-15T05:42:33-06:00 2011-09-30 CLIFTONLARSONALLEN LLP 101 N TRYON STREET SUITE 1000 CHARLOTTE NC 28246 990 2010-10-01 566017737 WAKEMED WAKE 9193500522 3000 NEW BERN AVE RALEIGH NC 27610 MICHAEL DEVAUGHN 9193500522 2012-11-15 1 GREGORY W JOHNS 7049985200 2010 2016-02-24 21:20:13Z X SEE SCHEDULE O WILLIAM K ATKINSON PHD 3000 NEW BERN AVE RALEIGH NC 27610 1316811525 0 X WWW.WAKEMED.ORG X 1965 NC WAKEMED IS A MULTI-FACILITY HEALTH SYSTEM, PROVIDING STATE OF THE ART, HIGH QUALITY CARE. 14 14 8770 1627 2441478 0 5965412 5720938 877653989 920937695 11942993 15487893 1013153 928079 896575547 943074605 1217664 1667290 0 0 475390247 494163620 0 0 0 416779932 441394424 893387843 937225334 3187704 5849271 1335640583 1362673830 663145048 654720444 672495535 707953386 X WAKEMED PROVIDES OUTSTANDING AND COMPASSIONATE CARE TO ALL WHO SEEK OUR SERVICES. WE ARE COMMITTED TO THE HEALTH & WELLNESS OF THE COMMUNITIES WE SERVE BY PROVIDING PREVENTIVE, DIAGNOSTIC, IN/OUT PATIENT, REHABILITATIVE AND SKILLED NURSING CARE TO ALL REGARDLESS OF ABILITY TO PAY. WE ALSO COLLABORATE WITH OTHER COMMUNITY ORGANIZATIONS TO IMPROVE HEALTH STATUS & ACCESS. 0 0 235504683 229227372 SURGICAL SERVICES - WAKEMED OFFERS SURGICAL SERVICES IN FOUR LOCATIONS; WAKEMED RALEIGH CAMPUS, WAKEMED CARY HOSPITAL, WAKEMED NORTH HEALTHPLEX AND BLUE RIDGE SURGERY CENTER. ALL OF THESE FACILITIES PROVIDE SURGICAL SERVICES TO ALL WHO SEEK CARE REGARDLESS OF THEIR ABILITY TO PAY. BY HAVING IN AND OUT PATIENT SERVICES IN FOUR DISTINCT LOCATIONS THROUGHOUT THE COUNTY, WAKEMED HAS IMPROVED ACCESS TO THESE NEEDED SERVICES. IN JUNE OF 2012 AN ADDITIONAL DAY SURGERY LOCATION WILL OPEN IN EAST RALEIGH. ACCESS TO SPECIALTY CARE CONTINUES TO BE ONE OF THE KEY HEALTH CONCERNS FACING OUR COMMUNITY. WAKEMED HAS EXPANDED ITS NETWORK OF SPECIALISTS AND WAKEMED FACULTY PHYSICIANS IS ONE OF THE KEY GROUPS OF PHYSICIANS WHO PROVIDE SUBSPECIALITY CARE TO THE UNDERINSURED AND WORK WITH THE PATIENT TO PROVIDE DISCOUNTED FEES BASED ON INCOME AND NEED. MANY PHYSICIANS ON THE MEDICAL STAFF CONTINUE THIS PRACTICE OF PROVDING QUALITY CARE TO PATIENTS REGARDLESS OF ABILITY TO PAY. LAST YEAR, SURGERIES WERE PERFORMED ON 29,085 PATIENTS (AN INCREASE OF 3.5% OVER 2010) IN THE WAKEMED SYSTEM. OF THESE SURGERIES, 7,855 (27%) WERE INSURED UNDER MEDICARE, 4,404 (15%) WERE INSURED UNDER MEDICAID AND 1,499 (5.2%) WERE UNINSURED (OR SELF PAY OR CHARITY CARE). 224900878 242850442 HEART SERVICES - WAKEMED'S HEART AND VASCULAR PROGRAM IS NOT ONLY THE LARGEST, BUT ONE OF THE MOST WELL RESPECTED IN CARDIOVASCULAR PROGRAMS IN NORTH CAROLINA. LAST YEAR, MORE THAN 25,000 CARDIOVASCULAR PROCEDURES WERE CONDUCTED FOR NEARLY 13,536 IN AND OUT PATIENTS CASES IN THE WAKEMED SYSTEM. PROCEDURES INCLUDED SURGERY, CARDIAC CATHERIZATIONS AND ELECTROPHYSIOLOGY AND THOUSANDS OF OTHERS WERE TREATED MEDICALLY AS IN AND OUTPATIENTS THROUGHOUT THE SYSTEM. HEART DISEASE REMAINS THE SECOND LEADING CAUSE OF DEATH IN WAKE COUNTY. ADDITIONALLY, THE COUNTY'S 2010 HEALTH ASSESSMENT IDENTIFIES MANAGEMENT OF CHRONIC DISEASE OF PARAMOUNT IMPORTANCE TO WAKE COUNTY RESIDENTS' OVERALL HEALTH. WAKEMED'S HEART CENTER HAS MADE SIGNIFICANT STRIDES IN PROGRAMS AND SERVICES AIMING TO REDUCE HEART DISEASE AND DIABETES AND IMPROVE PATIENTS' UNDERSTANDING OF DISEASE MANAGEMENT. THE WAKEMED HEART CENTER PROVIDES A COMPREHENSIVE CONTINUUM OF CARE FOR THE CARDIAC PATIENT FROM EDUCATION AND PREVENTION TO DIAGNOSIS, INTERVENTION, SURGERY, CARDIAC REHABILITATION AND ON-GOING DISEASE MANAGEMENT FOR HEART FAILURE. FREE EDUCATION PROGRAMS ARE OFFERED REGULARLY FOR OUR PATIENTS, THEIR FAMILY MEMBERS AND THE COMMUNITY TO COMPLEMENT OUR COMPREHENSIVE CARE SERVICES. OUR INTENTIONS ARE TO TEACH PATIENTS ABOUT THEIR RISK FACTORS FOR HEART DISEASE AND ENCOURAGE HEALTHY BEHAVIORS THROUGH LIFESTYLE CHANGES, THUS BUILDING A FOUNDATION FOR A HEALTHIER POPULATION. WAKEMED MOBILE CRITICAL CARE SERVICES PROVIDES CRITICAL CARE TRANSPORT VIA GROUND AND AIR SERVICING. SERVING APPROXIMATELY 1,300 CRITICALLY ILL PATIENTS EACH MONTH, IT IS THE BUSIEST INTER-FACILITY GROUND TRANSPORT SERVICE IN THE STATE. EACH YEAR, WAKEMED'S HEART CENTER PROVIDES FREE HEALTH SCREENINGS INCLUDING CHOLESTEROL SCREENINGS, BLOOD PRESSURE CHECKS, VASCULAR SCREENINGS AND STROKE ASSESSMENTS THROUGHOUT THE COMMUNITY. THESE SCREENINGS ARE DESIGNED TO BE A SECONDARY PREVENTION ACTIVITY TO DETECT EARLY ONSET OF DISEASE AND ILLNESS. WAKEMED CONDUCTS TRAINING FOR THE PROGRAM CPR ANYTIME AT MULTIPLE LOCATIONS IN WAKE COUNTY, AND PROVIDES CPR ANYTIME KITS THROUGHOUT THE COMMUNITY AT MORE THAN A 70 PERCENT DISCOUNTED COST. LAST FISCAL YEAR, WAKEMED PERFORMED 25,742 PROCEDURES IN THE HEART CENTER; OF THESE 15,210 (60%) WERE INSURED UNDER MEDICARE, 1,700 (6.6%) WERE INSURED UNDER MEDICAID AND 444 (4.2%) OF THESE PATIENTS WERE UNINSURED. 76718474 115446336 EMERGENCY SERVICES - ACCESS TO AFFORDABLE HEALTH CARE CONTINUES TO BE A CRITICAL CHALLENGE FACING WAKE COUNTY'S RESIDENTS. ONE OF THE MANY WAYS WAKEMED HAS IMPROVED ACCESS FOR WAKE COUNTY RESIDENTS IS THROUGH OUR MULTIPLE LOCATIONS AND PHYSICIANS OFFICES THROUGHOUT THE COMMUNITY. OVER THE PAST COUPLE OF YEARS, WAKEMED HAS OPENED FULL SERVICE, STAND ALONE EMERGENCY DEPARTMENTS, WHICH ARE GEOGRAPHICALLY SPREAD THROUGHOUT THE COUNTY, INCREASING CONVENIENT ACCESS TO EMERGENCY CARE FOR PATIENTS. WAKEMED IS AMONG THE TOP THREE VOLUME PROVIDERS OF EMERGENCY CARE IN NC. ITS FIVE ADULT EMERGENCY DEPARTMENTS ARE LOCATED THROUGHOUT WAKE COUNTY. OUR CHILDREN'S EMERGENCY DEPARTMENT IN RALEIGH IS THE ONLY CHILDREN'S ED IN THE COUNTY. WAKEMED'S RALEIGH CAMPUS IS ALSO HOME TO WAKE COUNTY'S ONLY LEVEL I TRAUMA CENTER, THE HIGHEST DESIGNATION AWARDED TO TRAUMA CENTERS IN NORTH CAROLINA. OUR TRAUMA SERVICE INCLUDES FIVE ADULT INTENSIVE CARE UNITS AND A PEDIATRIC INTENSIVE CARE UNIT AS WELL AS A COMPREHENSIVE ACUTE, INPATIENT AND OUTPATIENT PHYSICAL REHABILITATION PROGRAM. WAKEMED'S EMERGENCY AND TRAUMA SERVICES TREAT ALL PATIENTS WHO PRESENT SEEKING MEDICAL CARE, REGARDLESS OF THEIR ABILITY TO PAY. IN FY11, 210,030 PATIENTS WERE TREATED IN WAKEMED'S EMERGENCY DEPARTMENTS; OF THESE PATIENTS 34,438 (16.4%) WERE INSURED UNDER MEDICARE; 50,827 (26%) WERE INSURED UNDER MEDICAID; AND 45,796 (22%) WERE UNINSURED. OVER 48% OF ALL PATIENTS SEEN IN OUR EDS ARE EITHER MEDICAID OR UNINSURED RESULTING IN WAKEMED PROVIDING CARE FOR MORE THAN 80 PERCENT OF THE COUNTY'S UNINSURED AND MEDICAID PATIENTS. A SIXTH EMERGENCY DEPARTMENT OPENED JANUARY 9, 2012 WHICH WILL SERVE THE GROWING NORTH WESTERN PORTION OF WAKE COUNTY AS WELL AS EASTERN DURHAM COUNTY. ALL OF THE STAND ALONE LOCATIONS SERVE AREAS WHICH ARE OTHERWISE UNDERSERVED BY DEDICATED MEDICAL SERVICES. 291911137 1614817 329018852 291911137 1614817 329018852 829035172 1 1 0 1 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 600 0 1 8770 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 0 1 1 NC X MICHAEL DEVAUGHN CFO 9193500522 3000 NEW BERN AVE RALEIGH NC 27610 THOMAS B OXHOLM 10.00 X 0 0 0 WILLIAM H MCBRIDE 7.30 X 0 0 0 JERRY C BERNSTEIN MD 6.30 X 0 0 0 RICHARD F BAKER 7.80 X 0 0 0 LARRY D BARBOUR 7.00 X 0 0 0 ROBERT A CERWIN MD 4.00 X 0 0 0 DANA D COPELAND MD 5.00 X 0 0 0 BRENDA C GIBSON 8.00 X 0 0 0 M JACKSON NICHOLS 5.00 X 0 0 0 WILLIAM R MCNEAL 4.00 X 0 0 0 LESLIE MERRITT 4.30 X 0 0 0 CHRISTINA ALVARADO SHANAHAN 5.50 X 0 0 0 LORRAINE M WRIGHT PHD 8.30 X 0 0 0 LLOYD M YATES 5.00 X 0 0 0 WILLIAM K ATKINSON PHD 80.00 X 1606033 0 27336 MICHAEL DEVAUGHN 60.00 X 475057 0 20031 THOMAS GETTINGER 60.00 X 396574 0 8358 ROYLYN JOHNSON 40.00 X 85686 0 8901 KATHLEEN K GORMLEY 55.00 X 559149 0 25168 DAVID C COULTER 55.00 X 428128 0 25556 MARY A WILCOX 50.00 X 311222 0 25662 JEANENE R MARTIN 65.00 X 302055 0 28375 EVIN D ARLEDGE 55.00 X 286413 0 27240 THOMAS G CAVENDER 60.00 X 262653 0 22855 CAROLYN KNAUP 60.00 X 217791 0 27309 BETSY GASKINS-MCCLAINE 60.00 X 243295 0 26436 GEORGIA C SUMIEL 48.00 X 206445 0 18925 TIMOTHY E HARRIS 40.00 X 818692 0 25058 MARK L WOOD 40.00 X 737264 0 30933 JOHNATHAN D CHAPPELL 40.00 X 712705 0 23198 GURVINDER S DEOL 40.00 X 799175 0 29683 ROBERT G HOWARD JR MD 40.00 X 572034 0 25429 9020371 0 426453 359 0 1 0 OWENS & MINOR 4200 GLOBAL ST RALEIGH NC 27610 MEDICAL PRODUCTS 32226562 AMERISOURCEBERGEN PO BOX 530494 ATLANTA GA 303530494 PHARMACEUTICALS 24589360 BRASFIELD & GORRIE LLC 8521 SIX FORKS RD 110 RALEIGH NC 27615 CONSTRUCTION 19922417 BOSTON SCIENTIFIC PO BOX 8500-6205 PHILADELPHIA PA 191786205 MEDICAL DEVICES 15763684 MEDTRONIC PO BOX 409201 ATLANTA GA 303849201 MEDICAL DEVICES 14302017 378 5069909 651029 5720938 PATIENT SERVICES 621500 902196746 901595698 601048 18740949 14710090 1840430 2190429 920937695 14053028 14053028 769567 78702 690865 690865 690865 374265599 827484 373085715 572503 1179884 254981 1434865 1434865 INVESTMENT IN SUBS 621610 237214 237214 237214 943074605 916543002 2441478 18369187 1614817 1614817 52473 52473 5712448 5712448 406708827 342333091 64375736 17650674 15003073 2647601 36596509 31107033 5489476 27495162 23370888 4124274 1774126 1667679 106447 213831 195762 18069 475457 446930 28527 1514869 1514869 108922128 102386800 6535328 5083575 4778561 305014 178519184 167808033 10711151 10662337 10022597 639740 17816425 16747440 1068985 760384 714761 45623 1165604 1095668 69936 15625934 15625934 61338553 61338553 5985871 5626719 359152 REPAIRS/MAINT 18160496 14528397 3632099 MINOR EQUIPMENT 3851623 3620526 231097 LAUNDRY 2205807 2205807 PATIENT TRANSPORT 1595694 1595694 5722526 5147936 574590 937225334 829035172 108190162 0 47880 54892 526517265 567398778 668736 380053 116153089 122045084 19481828 18983249 9621002 7164240 1213074735 693727810 526315095 519346925 48902633 49468660 87933055 77831949 1335640583 1362673830 128040889 132227054 1351501 1088448 463845902 455346622 69906756 66058320 663145048 654720444 X 671933552 707401312 561983 552074 672495535 707953386 1335640583 1362673830 5849271 29608580 X X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 475457 0 0 475457 0 322669 5980 1114 327535 316547 7328 1206 322669 350781 9625 42650 1209 316547 1.00000 0 0 3889817 3889817 563810148 190826143 372984005 8791173 4912043 3879130 593322235 482804845 110517390 43261362 15184779 28076583 519346925 ASSETS WHOSE LIFE IS LIMITED 6924875 PREPAID PENSION OBLIGATION 923658 DEFERRED BOND FINANCING COSTS 10877786 OTHER EQUITY INVESTMENTS 751225 RESTRICTED FUNDS 33002690 DESIGNATED FUNDS 25351715 77831949 CAPITAL LEASES 183479 MISC LEASES - LT 2237266 DUE TO 3RD PARTIES 42917635 ESTIMATED MALPRACTICE 20577515 ACCRUED INTEREST 142425 66058320 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ALLEN TRUST ENDOWMENT FUNDS ARE USED TO PROVIDE POOR AND INDIGENT PATIENTS WITH PRIVATE DUTY NURSING CARE. WAKEMED DEFINES POOR AND INDIGENT PATIENTS AS THOSE WITH A FINANCIAL CLASS OF SELF-PAY OR MEDICAID. A SITTER CAN BE IN EITHER THE HOSPITAL OR HOMECARE SETTING. EAST ASIA 0 0 PROGRAM SERVICE PATIENT TRANSPORT 16990 CARIBBEAN 0 0 CONFERENCE 4784 EUROPE 0 0 CONFERENCE 1442 NORTH AMERICA 0 0 CONFERENCE 10110 CARIBBEAN 0 0 INVESTMENT 60000 0 0 0 0 0 0 93326 0 93326 0 0 1 0 0 0 1 1 X 1 X 1 X 1 1 1 0 1 1 71449504 71449504 0.07620 157047071 109772833 47274238 0.05040 228496575 109772833 118723742 0.12660 2541573 381958 2159615 0.00230 15610469 9423152 6187317 0.00660 621258 621258 0.00070 18773300 9805110 8968190 0.00960 247269875 119577943 127691932 0.13620 50177 50177 0.00010 259501 259501 0.00030 583751 583751 0.00060 2657 2657 0.00000 989575 989575 0.00110 1885661 1885661 0.00210 1 11068891 0 263148250 266968702 -3820452 X 1 1 2 WAKE PET SERVICES LLC EQUIPMENT LEASING 0.50000 0.00000 0.50000 3 CARDIAC INNOVATIONS LLC EQUIPMENT LEASING 1.00000 0.00000 0.00000 4 WAKE ORTHOPEADICS LLC MEDICAL PRACTICE 1.00000 0.00000 0.00000 5 WAKE SPECIALTY PHYSICIANS LLC MEDICAL PRACTICE 1.00000 0.00000 0.00000 6 BLUE RIDGE GP LLC MEDICAL PRACTICE 0.51000 0.00000 0.00000 7 PARTNERS IN PRACTICE LLC MEDICAL PRACTICE 1.00000 0.00000 0.00000 2 1 WAKEMED - RALEIGH CAMPUS

3000 NEW BERN AVE RALEIGH NC 27610

X X X X 2 WAKEMED - CARY HOSPITAL

1900 KILDARE ROAD CARY NC 27518

X X X WAKEMED - RALEIGH CAMPUS 1 1 X X X X X X X X 10 1 0 1 X X X X X X X 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X X 1 1 X X X X 1 X X 1 X X X X X X 1 X 0 1 WAKEMED - CARY HOSPITAL 2 1 X X X X X X X X 10 1 0 1 X X X X X X X 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X X 1 1 X X X X 1 X X 1 X X X X X X 1 X 0 1 18 WAKEMED NORTH HEALTHPLEX EMERGENCY DPT

10000 FALLS OF THE NEUSE RD RALEIGH NC 27614

O/P AMBULATORY SURGERY CENTER WAKE FACULTY PHYSICIANS LLC

3024 NEW BERN AVENUE RALEIGH NC 27610

MEDICAL PRACTICE WAKEMED REHAB HOSPITAL

3000 NEW BERN AVENUE RALEIGH NC 27610

PHYSICAL MEDICINE & REHABILITATION HOSPITAL WAKEMED APEX HEALTHPLEX

120 HEALTHPLEX WAY APEX NC 27502

EMERGENCY DEPARTMENT WAKE ORTHOPEDICS LLC

3009 NEW BERN AVE RALEIGH NC 27610

MEDICAL PRACTICE WAKE SPECIALTY PHYSICIANS LLC

3024 NEW BERN AVENUE RALEIGH NC 27610

MEDICAL PRACTICE BLUE RIDGE SURGERY CENTER

2308 WESVILL COURT RALEIGH NC 27607

AMBULATORY SURGERY WAKEMED HOME HEALTH

2920 HIGHWOODS BLVD SUITE 200 RALEIGH NC 27604

HOME HEALTH WAKEMED FUQUAY-VARINA OUTPATIENT & SNF

400 RANSOM ST FUQUAYVARINA NC 27526

SKILLED NURSING FACILITY WAKEMED CLAYTON MEDICAL PARK

555 MEDICAL PARK PLACE CLAYTON NC 27520

LABORATORY, RADIOLOGY, PT, OT, & ST WAKEMED ZEBULON OUTPATIENT & SNF

535 W GANNON WAY ZEBULON NC 27597

SNF, PT, OT, ST, RADIOLOGY, LABORATORY WAKEMED WAKE FOREST RD OUTPATIENT REHAB

3701 WAKE FOREST RD RALEIGH NC 27609

PT, OT, ST, REHABILITATION DAY TREATMENT PROGRAM WAKEMED ALEXANDER YMCA

1603 HILLSBOROUGH ST RALEIGH NC 27605

PHYSICAL THERAPY WAKEMED BRIER CREEK MEDICAL PARK

10208 CERNY ST RALEIGH NC 27617

LABORATORY, RADIOLOGY WAKEMED KRAFT FAMILY YMCA

8921 HOLLY SPRINGS RD APEX NC 27539

PT, OT, CARDIAC REHABILITATION, NUTRITIONAL COUNSELING WAKEMED KERR FAMILTY YMCA

2500 WAKEFIELD PINES DR RALEIGH NC 27614

PHYSICAL THERAPY WAKEMED CARY FAMILY YMCA

101 YMCA DRIVE CARY NC 27513

PHYSICAL THERAPY PARNTERS IN PRACTICE LLC

3024 NEW BERN AVENUE RALEIGH NC 27610

MEDICAL PRACTICE PART I, LINE 7: CHARITY CARE IS REPORTED AS THE SYSTEM'S CHARITY CARE AT COST. MEDICAID COSTS ARE DERIVED FROM OUR COST ACCOUNTING SYSTEM, WHICH ADDRESSES ALL PATIENT SEGMENTS. PART II: WAKEMED IS ACTIVELY INVOLVED IN MAKING OUR COMMUNITY A HEALTHIER PLACE TO LIVE AND WORK. OUR WORKFORCE DEVELOPMENT PROGRAM WORKS WITH YOUTH, HEALTH SCIENCE STUDENTS AND THOSE IN A VARIETY OF HEALTH PROFESSIONS PROGRAMS WITH MENTORING, RESIDENCIES, CLINICAL ROTATIONS, AND EDUCATION ALL WITH THE PURPOSE OF PREPARING FOR THE WORKFORCE OF TOMORROW. WE PARTNER WITH NUMEROUS COLLEGES, COMMUNITY COLLEGES AND HIGH SCHOOLS THROUGHOUT THE REGION AND OUR CAMPUS IS HOME TO THE WAKE EARLY COLLEGE HIGH SCHOOL. WAKEMED IS ALSO HOME TO WAKE AREA HEALTH EDUCATION CENTER, A PROGRAM OF THE UNIVERSITY OF NORTH CAROLINA. WAKEMED ALSO WORKS CLOSELY WITH THE 8 MUNICIPALITIES IN OUR COUNTY AND THE WAKE COUNTY ECONOMIC DEVELOPMENT COUNCIL TO ATTRACT NEW JOBS AND GROW INDUSTRY AND BUSINESS. A HEALTHY ECONOMY ULTIMATELY LEADS TO THE HEALTHIER COMMUNITY. IN ADDITION, WAKEMED HAS BEGUN EFFORTS TO IMPROVE THE NEIGHBORHOOD AROUND THE HOSPITAL. WE ARE WORKING CLOSELY WITH THE CITIZEN'S ADVISORY COUNCILS AND ARE BUILDING A COALITION TO REDUCE CRIME, BEAUTIFY THE AREA, ATTRACT RETAIL BUSINESSES AND RESTAURANTS AND FOSTER NEW MEDICAL DEVELOPMENT. OUR COMMUNITY HEALTH IMPROVEMENT ACTIVITIES ARE NUMEROUS AND INCLUDE BEING THE LEAD AGENCY FOR SAFEKIDS, ADVOCATES FOR HEALTH IN ACTION, ENERGIZE, ASTHMA COALITION, ACTION FOR CHILDREN, CAPITAL CARE COLLABORATIVE AND MORE. EACH IS WORKING TO SUPPORT PROGRAMS AND POLICIES THAT IMPROVE PUBLIC HEALTH AND ACCESS TO HEALTH CARE. PART III, LINE 4: THE AMOUNT REPORTED IN PART III, LINE 2 IS THE SYSTEM BAD DEBT AT COST. CHARITY AND BAD DEBT ACCOUNTS ARE RECORDED AT CURRENT ACCOUNT BALANCE LEVELS. THE BALANCE MAY BE NET OF CONTRACTUAL ALLOWANCES AND/OR PAYMENTS RECEIVED. FOR EXAMPLE, BAD DEBT OR CHARITY RESULTING FROM AN UNPAID PATIENT LIABILITY AFTER INSURANCE IS RECORDED AT THE AMOUNT UNPAID BY THE PATIENT. THE TEXT OF THE FOOTNOTE TO WAKEMED'S FINANCIAL STATEMENTS REGARDING BAD DEBT EXPENSE IS AS FOLLOWS: "WAKEMED HAS PRESENTED ITS PROVISION FOR UNCOLLECTIBLE ACCOUNTS AS A DIRECT REDUCTION OF PATIENT SERVICE REVENUE IN ACCORDANCE WITH THE AICPA AUDIT GUIDE FOR HEALTH CARE ORGANIZATIONS. BASED ON THE MOST RECENT UPDATE OF THE AUDIT GUIDE'S INTERPRETATIONS OF THE REQUIREMENTS OF GASB STATEMENT NO. 34, GOVERNMENTAL HEALTH CARE ORGANIZATIONS ARE REQUIRED TO PRESENT UNCOLLECTIBLE ACCOUNTS AS A COMPONENT OF NET PATIENT SERVICE REVENUE RATHER THAN WITHIN OPERATING EXPENSES." PART III, LINE 8: THE MEDICARE ALLOWABLE COSTS WERE DETERMINED FROM THE MEDICARE COST REPORT, AS SPECIFIED IN THE PROVIDER REIMBURSEMENT MANUAL. WAKEMED BELIEVES THAT ALL OF THE $3,003,436 MEDICARE SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE WAKEMED HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THIS YEAR, MEDICARE ACCOUNTED FOR 42% OF HOSPITAL REVENUES. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. PART III, LINE 9B: THE WAKEMED COLLECTIONS POLICY APPLIES TO ALL PATIENTS. ONCE AN ACCOUNT BALANCE IS DETERMINED TO BE PATIENT LIABILITY, A LETTER IS SENT TO THE PATIENT REQUESTING PAYMENT ON THE BALANCE OF THE ACCOUNT. IF NO PAYMENT OR RESPONSE IS RECEIVED WITHIN 30 DAYS, A SECOND NOTICE IS MAILED REQUESTING PAYMENT. AT DAY 60, THE PATIENT IS SENT A THIRD LETTER INSTRUCTING THEM TO SETTLE THE ACCOUNT WITHIN 10 DAYS. AT DAY 75, THE PATIENT IS SENT A FINAL NOTICE REQUESTING PAYMENT WITHIN 10 DAYS OR THE ACCOUNT WILL BE MOVED TO A COLLECTION AGENCY. WHILE THE LETTER STATES 10 DAYS TO RECEIVE THIS PAYMENT, WAKEMED ALLOWS 30 DAYS FOR PAYMENT TO BE RECEIVED AND POSTED TO THE ACCOUNT BEFORE THE ACCOUNT IS SENT TO THE COLLECTION AGENCY ON DAY 105. NOTE, DUE TO MEDICARE REGULATIONS, MEDICARE PATIENT ACCOUNTS DO NOT MOVE TO THE COLLECTION AGENCY UNTIL DAY 125. WAKEMED - RALEIGH CAMPUS PART V, SECTION B, LINE 3: WAKEMED PARTICIPATED IN WAKE COUNTY'S COMMUNITY HEALTH NEEDS ASSESSMENT. WAKEMED - CARY HOSPITAL PART V, SECTION B, LINE 3: WAKEMED PARTICIPATED IN WAKE COUNTY'S COMMUNITY HEALTH NEEDS ASSESSMENT. WAKEMED - RALEIGH CAMPUS PART V, SECTION B, LINE 5C: THE ASSESSMENT IS ALSO AVAILABLE THROUGH WAKE COUNTY. WAKEMED - CARY HOSPITAL PART V, SECTION B, LINE 5C: THE ASSESSMENT IS ALSO AVAILABLE THROUGH WAKE COUNTY. WAKEMED - RALEIGH CAMPUS PART V, SECTION B, LINE 15E: OTHER ACTIONS - WAKEMED UTILIZES A THIRD PARTY COLLECTION AGENCY AS DESCRIBED IN PART III, LINE 9B. WAKEMED - CARY HOSPITAL PART V, SECTION B, LINE 15E: OTHER ACTIONS - WAKEMED UTILIZES A THIRD PARTY COLLECTION AGENCY AS DESCRIBED IN PART III, LINE 9B. WAKEMED - RALEIGH CAMPUS PART V, SECTION B, LINE 16E: OTHER ACTIONS - PRIOR TO REPORTING TO A CREDIT AGENCY, WAKEMED AND ITS THIRD PARTY COLLECTION AGENCY ATTEMPT COLLECTION OF PATIENT LIABILITY AMOUNTS THROUGH THE USE OF PHONE CALLS AND A SERIES OF STATEMENT LETTERS TO THE GUARANTOR. WAKEMED - CARY HOSPITAL PART V, SECTION B, LINE 16E: OTHER ACTIONS - PRIOR TO REPORTING TO A CREDIT AGENCY, WAKEMED AND ITS THIRD PARTY COLLECTION AGENCY ATTEMPT COLLECTION OF PATIENT LIABILITY AMOUNTS THROUGH THE USE OF PHONE CALLS AND A SERIES OF STATEMENT LETTERS TO THE GUARANTOR. WAKEMED - RALEIGH CAMPUS PART V, SECTION B, LINE 17E: N/A WAKEMED - RALEIGH CAMPUS PART V, SECTION B, LINE 18C: N/A WAKEMED - RALEIGH CAMPUS PART V, SECTION B, LINE 18D: N/A WAKEMED - RALEIGH CAMPUS PART V, SECTION B, LINE 19D: OTHER - WAKEMED BILLS ALL PATIENTS FROM THE SAME CHARGE MASTER OR FEE SCHEDULE WHETHER THE PATIENT HAS INSURANCE OR NO INSURANCE. WE ARE TRANSITIONING TO A POLICY EFFECTIVE OCTOBER 1, 2011, IN WHICH PERSONS AT OR BELOW 250% OF FPG AND DETERMINED TO BE ELIGIBLE FOR OUR CHARITY CARE POLICY WILL BE RESPONSIBLE FOR ONLY NOMINAL CO-PAYS. WAKEMED - CARY HOSPITAL PART V, SECTION B, LINE 19D: OTHER - WAKEMED BILLS ALL PATIENTS FROM THE SAME CHARGE MASTER OR FEE SCHEDULE WHETHER THE PATIENT HAS INSURANCE OR NO INSURANCE. WE ARE TRANSITIONING TO A POLICY EFFECTIVE OCTOBER 1, 2011, IN WHICH PERSONS AT OR BELOW 250% OF FPG AND DETERMINED TO BE ELIGIBLE FOR OUR CHARITY CARE POLICY WILL BE RESPONSIBLE FOR ONLY NOMINAL CO-PAYS. WAKEMED - RALEIGH CAMPUS PART V, SECTION B, LINE 20: N/A WAKEMED - CARY HOSPITAL PART V, SECTION B, LINE 20: N/A WAKEMED - RALEIGH CAMPUS PART V, SECTION B, LINE 21: WAKEMED BILLS ALL PATIENTS FROM THE SAME CHARGE MASTER OR FEE SCHEDULE WHETHER THE PATIENT HAS INSURANCE OR NO INSURANCE. WAKEMED - CARY HOSPITAL PART V, SECTION B, LINE 21: WAKEMED BILLS ALL PATIENTS FROM THE SAME CHARGE MASTER OR FEE SCHEDULE WHETHER THE PATIENT HAS INSURANCE OR NO INSURANCE. PART VI, LINE 2: THE COMMUNITY NEEDS ASSESSMENT IS A PROCESS THAT HELPS TO IDENTIFY FACTORS AFFECTING OUR COUNTY, DETERMINE RESOURCES NEEDED TO ADDRESS THESE FACTORS, AND DEVELOP A PLAN OF ACTION TO ADDRESS COMMUNITY NEEDS. COMMUNITY ASSESSMENTS ARE REQUIRED OF LOCAL HEALTH DEPARTMENTS BY THE STATE OF NORTH CAROLINA EVERY FOUR YEARS. WAKE COUNTY COMPLETED ITS MOST RECENT ASSESSMENT IN DECEMBER 2010. WAKEMED USED THIS INFORMATION AS WELL AS MULTIPLE OTHER SOURCES OF SECONDARY DATA COMPILED BY THE WAKEMED PLANNING DEPARTMENT FOR THE NEEDS ASSESSMENT. THE ASSESSMENT DATA IS COLLECTED VIA PAPER SURVEY, DOOR TO DOOR VISITS, AND FOCUS GROUPS. WAKE COUNTY WORKED WITH THE NORTH CAROLINA INSTITUTE FOR PUBLIC HEALTH IN THE GILLINGS SCHOOL OF GLOBAL PUBLIC HEALTH TO COLLECT AND ANALYZE DATA. WAKEMED HAD REPRESENTATION ON THE STEERING COMMITTEE AND USED THE RESULTS TO GUIDE THE COMMUNITY BENEFIT PLANNING PROCESS. THE EXECUTIVE SUMMARY IS INCLUDED. PART VI, LINE 3: WAKEMED POSTS THE REQUIRED EMTALA NOTICE AT ALL PORTALS OF ENTRY, INCLUDING EMERGENCY DEPARTMENTS. THE SIGNAGE NOTES THAT WAKEMED PARTICIPATES IN THE MEDICAID PROGRAM. THE WAKEMED WEBSITE PROVIDES DETAILED INFORMATION REGARDING FINANCIAL ASSISTANCE AND CHARITY CARE. IN ADDITION, THE FINANCIAL ASSISTANCE FORM IS LOCATED ON THE WEBSITE FOR ANY PATIENT TO COMPLETE AND SUBMIT. AS PART OF THE INTAKE PROCESS/REGISTRATION FOR ALL PATIENTS, WAKEMED PROVIDES A COPY OF THE FINANCIAL AND BILLING POLICY, WHICH REFERS PATIENTS TO PATIENT FINANCIAL SERVICES IF THEY HAVE CONCERNS REGARDING THEIR ABILITY TO PAY THE BILL. ALL INPATIENTS AND PATIENTS SCHEDULED FOR SELECTED OUTPATIENT PROCEDURES, AND WHO ARE DESIGNATED "UNINSURED" AT THE TIME OF ADMISSION, ARE CONTACTED PERSONALLY BY A FINANCIAL COUNSELOR. IN ADDITION, ANY PATIENT, REGARDLESS OF INSURANCE COVERAGE, MAY REQUEST TO SEE A FINANCIAL COUNSELOR. THE FINANCIAL COUNSELOR WILL ASSESS POSSIBLE MEDICAID ELIGILBILTY AND PROVIDE AN APPLICATION/FINANCIAL STATEMENT THAT IS SUBMITTED TO PATIENT FINANCIAL SERVICES TO REQUEST ASSISTANCE WITH MEDICAL EXPENSES. WAKEMED ALSO HAS ON-SITE EMPLOYEES FROM WAKE COUNTY HUMAN SERVICES TO PROCESS MEDICAID APPLICATIONS FOR RESIDENTS OF WAKE COUNTY. ANY PATIENT WHO IS UNINSURED AND MAY BE ELIBIBLE FOR DISABILTY IS REFERRED TO A WAKEMED DISABILTY SPECIALIST WHO WILL ASSIST WITH THE APPLICATION. WAKEMED INCLUDES INFORMATION REGARDING THE FINANCIAL ASSISTANCE POLICY IN ALL PATIENT BILLING STATEMENTS. PART VI, LINE 4: ALTHOUGH WAKEMED SERVES PATIENTS FROM ALL OF NORTH CAROLINAS 100 COUNTIES AND BEYOND, ITS PRIMARY SERVICE AREA CAN BEST BE DESCRIBED AS THE CONTIGUOUS ZONE INCLUDING WAKE COUNTY AND JOHNSTON COUNTY IN CENTRAL NORTH CAROLINA. BOTH COUNTIES ARE GROWING AREAS CONSISTING OF A CENTRAL CITY CORE IN RALEIGH AND DOZENS OF SMALLER COMMUNITIES THAT VIEW RALEIGH AS THEIR PRIMARY SOURCE FOR TERTIARY LEVEL CARE. THE MARKET ITSELF IS FIERCELY COMPETITIVE THE ONLY MARKET IN THE STATE WITH THREE MAJOR HEALTH SYSTEMS COMPETING AGAINST ONE ANOTHER WAKEMED SHOULDERS THE VAST MAJORITY OF THE CHARITY CARE IN THE MARKET, OFTEN EXCEEDING 80% OF THE BURDEN. THE GROWTH OF THE POPULATION BASE AND THE GRADUAL AGING OF THE POPULATION ARE INDICATING AN EXTENSIVE NEED FOR MORE CAPACITY TO SERVE THE COMMUNITY OVER THE FEW NEXT DECADES. PART VI, LINE 6: WHEN WAKEMED HEALTH & HOSPITALS OPENED ITS DOORS IN 1961 AS THE MEMORIAL HOSPITAL OF WAKE COUNTY, ONE THING WAS CERTAIN - IT WOULD BE AN INSTITUTION WITH AN UNWAVERING COMMITMENT TO THE COMMUNITIES IT SERVES. SINCE THEN, WAKEMED HAS GROWN FROM A RELATIVELY SMALL FACILITY WITH FOUR SATELITE HOSPITALS SERVING THE LOCAL HEALTH CARE NEEDS OF WAKE COUNTY RESIDENTS TO A TRULY INTEGRATED HEALTH CARE SYSTEM AND MAJOR REFERRAL CENTER SERVING OUR REGION AND STATE. WHILE MUCH HAS CHANGED, THE COMMITMENT TO IMPROVING THE HEALTH OF THE INDIVIDUALS AND FAMILIES WE SERVE HAS REMAINED CONSTANT.TODAY, WAKEMED IS A LOCALLY OWNED AND OPERATED, 870-BED NOT-FOR-PROFIT HEALTH SYSTEM OFFERING A BROAD RANGE OF PREVENTIVE, PRIMARY, ACUTE AND TERTIARY SERVICES. AS WAKE COUNTY'S LARGEST PRIVATE EMPLOYER AND A CORNERSTONE OF THE COMMUNITY, WAKEMED IS AN ASSET RESIDENTS CAN DEPEND ON NOT ONLY FOR THE HIGHEST QUALITY OF HEALTH CARE BUT FOR COMMUNITY OUTREACH IN THE FORM OF SCREENINGS, CLASSES, SEMINARS, HEALTH FAIRS, PREVENTIVE PROGRAMS, SUPPORT GROUPS AND OTHER OUTREACH INITIATIVES. THE MAJORITY OF THE PROGRAMS ARE FREE AND ALL ARE DESIGNED TO IMPROVE HEALTH, EDUCATE AND ENLIGHTEN BY OFFERING ACCESS TO EXPERTS, RESOURCES, AND HEALTH INFORMATION. IN ADDITION, OUR 1,000 PERSON MEDICAL STAFF IS OPEN AND COMPRISED PRIMARILY OF INDEPENDENT PRACTITIONERS, ALTHOUGH THE NUMBER OF EMPLOYED PHYSICIANS IS GROWING AND NOW TOTALS NEARLY 200 PHYSICIANS.EACH YEAR WE SERVE, SUPPORT AND WORK CLOSELY WITH THE COMMUNITY IN MANY WAYS. WE ABSORB THE HEALTH CARE COSTS OF THOSE WHO COME TO US UNABLE TO PAY FOR THEIR CARE. WE EDUCATE AND TRAIN PHYSICIANS AND CAREGIVERS. WE DEVELOP NEW SERVICES AND INITIATIVES TO ENHANCE ACCESS AND MEET THE NEEDS OF THE UNDERSERVED. WE PARTNER WITH A VARIETY OF COMMUNITY-BASED ORGANIZATIONS TO DEVELOP PROGRAMS THAT ANSWER A NEED. WE PROVIDE DONATIONS TO COMMUNITY CHARITIES AND ORGANIZATIONS WHOSE GOALS SUPPORT OUR MISSION. AND, WE OFFER A HOST OF COMMUNITY OUTREACH AND EDUCATION PROGRAMS. OUR HOSPITAL BOARD AND FOUNDATION BOARD REPRESENT A BROAD SECTION OF THE COMMUNITY AND SERVE IN A VOLUNTARY ROLE OFTEN GIVING NUMEROUS HOURS EACH WEEK. PART VI, LINE 7: BEYOND THE CARE CURRENTLY PROVIDED WITHIN OUR FACILITIES, WAKEMED CONTINUES TO DEVELOP PROGRAMS AND SERVICES IN THOSE AREAS WHICH ARE UNDERSERVED AND ARE GROWING. ACCESS TO PRIMARY CARE PROVIDERS IS A CRITICAL NEED. AS A RESULT, WE ARE EXPANDING OUR NETWORK OF PRIMARY CARE PROVIDERS WHO SERVE COMMUNITY RESIDENTS, REGARDLESS OF THEIR ABILITY TO PAY. WAKEMED HELPS IMPROVE THE HEALTH OF THE COMMUNITY BY OUTREACH THAT TAKES ON MANY FORMS FROM THE DIRECT PROVISION OF CARE TO MENTORING AT-RISK YOUTH. THE 14-MEMBER, VOLUNTEER, WAKEMED BOARD OF DIRECTORS, IS A TRUE CROSS SECTION OF THE COMMUNITIES WE SERVE. THEY ARE CORPORATE/BUSINESS LEADERS, COMMUNITY AND VOLUNTEER LEADERS AND COMMUNITY PHYSICIANS. EIGHT OF THE 14 MEMBERS ARE APPOINTED BY THE WAKE COUNTY COMMISSIONERS AND THERE ARE NO EMPLOYEES OR VENDORS. EACH BOARD MEMBER COMPLETES A CONFLICT OF INTEREST STATEMENT TO ENSURE THEY REPRESENT THE BEST INTEREST OF THE COMMUNITY. IN ADDITION, THE BOARD HAS APPOINTED A COMMUNITY BENEFIT TASK FORCE, WHICH ALSO REPRESENTS THE BROADER COMMUNITY TO HELP DETERMINE WHERE THE NEED IS THE GREATEST AND PROVIDE ADVICE AND RECOMMENDATIONS TO THE BOARD WITH REGARD TO WAKEMEDS ROLE AND BENEFIT TO THE COMMUNITY. THE MEDICAL STAFFS ARE OPEN TO ALL COMMUNITY PHYSICIANS AND PRIVILEGES ARE EXTENDED TO THOSE WHO APPLY AND MEET THE CREDENTIALS AS ESTABLISHED BY THE BY-LAWS. THERE ARE CURRENTLY NEARLY 1,000 PHYSICIANS ON THE MEDICAL STAFFS FROM ALL SPECIALTIES AND SEGMENTS OF THE COMMUNITY. AS A PRIVATE, NOT-FOR-PROFIT ORGANIZATION, NET INCOME IS REINVESTED IN THE ORGANIZATION FOR CAPITAL EQUIPMENT, FACILITY IMPROVEMENTS OR EXPANSION, NEW SERVICES AND SERVICE LOCATIONS, THE EDUCATION OF HEALTH PROFESSIONALS, RESEARCH AS IT RELATES TO THE IMPROVEMENT OF CARE AND OUTCOMES, AND EFFORTS TO CONTINUALLY IMPROVE THE QUALITY AND SAFETY OF PATIENT CARE. REPORTS FILED WITH STATES PART VI, LINE 7 NC STATE FILING OF COMMUNITY BENEFIT REPORT: SCHEDULE H, PART VI, LINE 7: WAKEMED PUBLISHES A COMMUNITY BENEFIT REPORT EACH YEAR. IT IS AVAILABLE IN PRINT FORM AS WELL AS ON THE WAKEMED WEBSITE. WAKEMED ALSO VOLUNTARILY FILES A COMMUNITY BENEFIT REPORT WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION. 1 ALLIANCE MEDICAL MINISTRY 101 DONALD ROSS DR RALEIGH NC 27610 562168673 501(C)(3) 372125 MEDICAL CARE DEBNAM CLINIC 524 BLOUNT ST RALEIGH NC 27601 561977593 300000 MEDICAL CARE TRIANGLE DISABILITY ADVOCATES 206 NEW BERN PL RALEIGH NC 27601 562232698 501(C)(3) 60165 MEDICAL CARE DOCTOR'S MAKING HOUSE CALLS 4220 APEX HWY DURHAM NC 27713 010691134 4275 MEDICAL CARE WAKE COUNTY HUMAN SERVICES 2500 BLUE RIDGE RD RALEIGH NC 27607 GOV'T 227712 MEDICAL CARE HILLTOP HOME 3006 NEW BERN AVE RALEIGH NC 27610 560727843 501(C)(3) 50000 2750 FMV VEHICLE GENERAL SUPPORT AMERICAN DIABETES ASSOCIATION 2418 BLUE RIDGE RD RALEIGH NC 27607 131623888 501(C)(3) 5000 GENERAL SUPPORT AMERICAN HEART ASSOCIATION 4217 PARK PL CT GLEN ALLEN VA 23060 135613797 501(C)(3) 17500 GENERAL SUPPORT AMERICAN RED CROSS 100 N PEARTREE LN RALEIGH NC 27610 530196605 501(C)(3) 5000 GENERAL SUPPORT ARTSPLOSURE 313 S BLOUNT ST RALEIGH NC 27601 581387567 501(C)(3) 5000 GENERAL SUPPORT BOYS & GIRLS CLUB 701 N RALEIGH BLVD RALEIGH NC 27610 560863051 501(C)(3) 5000 GENERAL SUPPORT INTERACT 1012 OBERLIN RD 100 RALEIGH NC 27605 581320613 501(C)(3) 10000 GENERAL SUPPORT INTERFAITH FOOD SHUTTLE PO BOX 40156 RALEIGH NC 27629 561753180 501(C)(3) 4500 12114 BOOK FOOD GENERAL SUPPORT JUNIOR LEAGUE OF RALEIGH INC PO BOX 26821 RALEIGH NC 27603 560562849 501(C)(3) 8333 GENERAL SUPPORT MARBLES KIDS MUSEUM 201 EAST HARGETT ST RALEIGH NC 27601 581647538 501(C)(3) 8000 990 FMV MONITOR GENERAL SUPPORT NC MUSEUM OF HISTORY 5 E EDENTON ST RALEIGH NC 27601 GOV'T 5000 GENERAL SUPPORT NC PHYSICIANS HEALTH PROGRAM INC 200 HORIZON DR 201 RALEIGH NC 27615 561846599 501(C)(3) 13200 GENERAL SUPPORT NC SPINAL CORD INJURY ASSOCIATION 2039 ROYCE DR MEBANE NC 27302 510491208 501(C)(3) 5000 GENERAL SUPPORT OCCONEECHEE COUNCIL 3231 ATLANTIC ST RALEIGH NC 27629 560529984 501(C)(3) 5000 GENERAL SUPPORT UNC PUBLIC HEALTH FOUNDATION CAMPUS BOX 7400 CHAPEL HILL NC 27599 GOV'T 5000 GENERAL SUPPORT READ AND FEED 5448 APEX PEAKWAY APEX NC 27502 203246207 501(C)(3) 5000 GENERAL SUPPORT RONALD MCDONALD HOUSE 506 ALEXANDER DR DURHAM NC 27705 561220376 501(C)(3) 5000 GENERAL SUPPORT THE HEALING PLACE 1251 GOODE ST RALEIGH NC 27603 562135246 501(C)(3) 5500 GENERAL SUPPORT UNC CENTER FOR PUBLIC TV PO BOX 14900 RTP NC 27709 GOV'T 55000 GENERAL SUPPORT NC MUSEUM OF ART FOUNDATION 4630 MAIL SERVICE CNTR RALEIGH NC 27699 237071511 501(C)(3) 10000 GENERAL SUPPORT UNITED ART COUNCIL 101 S BLOUNT ST RALEIGH NC 27601 560770175 501(C)(3) 5000 GENERAL SUPPORT COMMUNITY HEALTH FOUNDATION 2500 BLUE RIDGE RD 330 RALEIGH NC 27607 562205175 501(C)(3) 75000 GENERAL SUPPORT WAKE EARLY COLLEGE HEALTHSCIENCE 4901 LEIGH RD RALEIGH NC 27616 562258278 501(C)(3) 7022 37475 FMV DENTAL EQUIPMENT GENERAL SUPPORT WAKE EDUCATIONAL PARTNERSHIP 706 HILLSBOROUGH ST RALEIGH NC 27603 581518182 501(C)(3) 5000 GENERAL SUPPORT 27 2 PRESCRIPTION DRUGS 709 52473 COST PRESCRIPTION DRUGS TO INDIGENT PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ALL REQUESTS MUST BE IN WRITING. THEY ARE REVIEWED ACCORDING TO OUR DONATIONS/SPONSORSHIP GUIDELINES AS IT RELATES TO COMMUNITY NEED AND TIES TO WAKEMED'S MISSION AND DESIGNATION AS A 501(C)(3) ORGANIZATION. ALL DONATIONS ARE LOGGED ON A SPREADSHEET WITH THE REASON FOR THE GIFT. WE ALSO KEEP A FILE ON EACH ORGANIZATION AND ALL ASSOCIATED PAPERWORK. IN MANY CASES WE ALSO TRACK HOW THE GIFT IS USED AND THE BENEFITS. IN THE CASE OF A LARGE GRANT, THE ORGANIZATION IS ALSO ASKED FOR A REPORT ON RESULTS. X X X 0 1 X X X X X 0 0 0 0 0 0 0 1 0 WILLIAM K ATKINSON PHD 763876 0 833501 0 8656 0 9800 0 17536 0 1633369 0 549080 0 MICHAEL DEVAUGHN 345255 0 114003 0 15799 0 12250 0 7781 0 495088 0 0 0 THOMAS GETTINGER 201469 0 145203 0 49902 0 0 0 8358 0 404932 0 0 0 KATHLEEN K GORMLEY 410257 0 133265 0 15627 0 8575 0 16593 0 584317 0 0 0 DAVID C COULTER 342549 0 60623 0 24956 0 8575 0 16981 0 453684 0 0 0 MARY A WILCOX 251582 0 44369 0 15271 0 8575 0 17087 0 336884 0 0 0 JEANENE R MARTIN 244569 0 43200 0 14286 0 11025 0 17350 0 330430 0 0 0 EVIN D ARLEDGE 263316 0 19158 0 3939 0 8575 0 18665 0 313653 0 0 0 THOMAS G CAVENDER 229072 0 16895 0 16686 0 9800 0 13055 0 285508 0 0 0 CAROLYN KNAUP 189542 0 14095 0 14154 0 10064 0 17245 0 245100 0 0 0 BETSY GASKINS-MCCLAINE 224640 0 16332 0 2323 0 12250 0 14186 0 269731 0 0 0 GEORGIA C SUMIEL 192010 0 13820 0 615 0 6296 0 12629 0 225370 0 0 0 TIMOTHY E HARRIS 394352 0 423928 0 412 0 8575 0 16483 0 843750 0 0 0 MARK L WOOD 331038 0 405248 0 978 0 8575 0 22358 0 768197 0 0 0 JOHNATHAN D CHAPPELL 245034 0 467457 0 214 0 7350 0 15848 0 735903 0 0 0 GURVINDER S DEOL 288798 0 509366 0 1011 0 7350 0 22333 0 828858 0 0 0 ROBERT G HOWARD JR MD 293052 0 278386 0 596 0 7350 0 18079 0 597463 0 0 0 PART I, LINE 1A TAX INDEMNIFICATION, GROSS-UP, TRAVEL FOR COMPANIONS AND HOUSING ALLOWANCE ARE PAID TO SOME KEY EMPLOYEES. GROSS-UP AND HOUSING ALLOWANCE ARE INCLUDED IN TAXABLE COMPENSATION. PART I, LINE 1B CEO BENEFITS REQUIRING GROSS-UP ARE COVERED BY HIS EMPLOYMENT AGREEMENT; ANY ADDITIONAL ONES ARE APPROVED BY THE BOARD OF DIRECTORS. OTHER STAFF GROSS-UPS OCCUR FOR SERVICE AWARD GIFT CHECKS. CEO TRAVEL FOR SPOUSE IS INCLUDED IN HIS EMPLOYMENT CONTRACT. PART I, LINE 7 THE ORGANIZATION HAS INCENTIVE BASED PROGRAMS THAT ARE DRIVEN BY ACCOMPLISHING TARGETS ASSOCIATED WITH QUALITY OF CARE, HAND HYGIENE, WORKFORCE EXCELLENCE, PATIENT SATISFACTION, AND A MINIMUM OPERATING MARGIN. NC MEDICAL CARE COMMISSION 521309402 65821DCR0 2009-02-10 169225082 SEE SCHEDULE O 0 0 0 NC MEDICAL CARE COMMISSION 521309402 65821DCS8 2009-02-26 75000000 SEE SCHEDULE O 0 0 0 NC MEDICAL CARE COMMISSION 521309402 65821DCW9 2009-07-16 81780000 SEE SCHEDULE O 0 0 0 2900000 169506279 11946013 32422 3346768 2993480 151187596 2010 0 0 1 1 75249667 835544 37919 74376204 2010 0 0 1 1 3540000 81780000 80914700 817125 41347 6828 1 0 1 1 0 0 1 0 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 1 FORM 990, PART VI, SECTION A, LINE 7A EIGHT MEMBERS OF THE BOARD ARE APPOINTED TO THE BOARD OF DIRECTORS BY WAKE COUNTY. FORM 990, PART VI, SECTION A, LINE 7B 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. FORM 990, PART VI, SECTION B, LINE 11 THE ENTIRE 990 AND ASSOCIATED SCHEDULES ARE REVIEWED 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. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES THE CONFLICT OF INTEREST POLICY IN VARIOUS WAYS. EACH YEAR, MEMBERS OF THE BOARD, COMMITTEES WITH BOARD DELEGATED POWERS, CEO, CORPORATE STAFF, EXECUTIVE STAFF, DIRECTORS, MANAGERS ARE REQUIRED TO COMPLETE AND SUBMIT A CONFLICT OF INTEREST QUESTIONNAIRE. THOSE INDIVIDUALS ARE REQUIRED TO PROVIDE WRITTEN DOCUMENTATION OF ANY POTENTIAL CONFLICT OF INTEREST, IDENTIFYING MATERIAL FINANCIAL INTEREST/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. FORM 990, PART VI, SECTION B, LINE 15A REVIEW OF THE COMPENSATION FOR THE CEO, OFFICERS AND KEY EMPLOYEES IS DONE REGULARLY BY THE HUMAN RESOURCE DEPARTMENT. THE FACILITY REGULARLY USES AN INDEPENDENT CONSULTING FIRM AS A SOURCE OF COMPENSATION INFORMATION, BENCHMARKING AND REVIEW TO ENSURE CONSISTENT AND FAIR COMPENSATION PRACTICES. THE CEO'S COMPENSATION IS APPROVED BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 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. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. FACILITY INFORMATION: SCHEDULE H, PAGE 3, PART V: PART V LISTS THOSE FACILITIES SEPARATELY LICENSED AND/OR REGISTERED UNDER STATE LAW. IT IS NOT A COMPLETE LISTING OF ALL SITES WHERE SERVICES ARE PROVIDED. THE COMPLETE LISTING CAN BE FOUND ON WAKEMED.ORG. DOING BUSINESS AS: FORM 990, PAGE 1, BOX C: LEGAL ENTITY NAME WAKEMED LEGAL ENTIY EIN 56-6017737 DBA NAME(S): 1. WAKE MEDICAL CENTER 2. WESTERN WAKE HOSPITAL 3. NORTHERN WAKE HOSPITAL 4. WAKE HEART CENTER 5. WESTERN WAKE MEDICAL CENTER 6. WAKE REHABILITATION HOSPITAL 7. WAKE AREA HEALTH EDUCATION CENTER 8. WAKE AHEC 9. EASTERN WAKE DAY HOSPITAL AND SKILLED NURSING FACILITY 10. WAKEMED HOME CARE 11. WAKEMED - NEW BERN AVENUE CAMPUS 12. WAKEMED - WESTERN WAKE MED. CENTER 13. WAKEMED - REHAB 14. WAKEMED - FUQUAY-VARINA 15. WAKEMED - ZEBULON-WENDELL 16. WAKEMED RALEIGH CAMPUS 17. WAKEMED CARY HOSPITAL 18. WAKEMED NORTH HEALTHPLEX 19. WAKEMED CLAYTON MEDICAL PARK 20. WAKEMED CARY OUTPATIENT REHAB CENTER 21. WAKEMED FUQUAY-VARINA OUTPATIENT & SKILLED NURSING FACILITY 22. WAKEMED ZEBULON/WENDELL OUTPATIENT & SKILLED NURSING FACILITY 23. WAKEMED WAKE FOREST ROAD OUTPATIENT REHAB CENTER 24. WAKEMED HOME HEALTH 25. WAKEMED HEALTH & HOSPITALS 26. WAKEMED EMERGENCY SERVICES INSTITUTE 27. WAKEMED CENTER FOR PATIENT SAFETY 28. WAKEMED APEX HEALTHPLEX 29. WAKEMED PROFESSIONAL STAFF 30. WAKEMED MOBILE CRITICAL CARE SERVICES 31.WAKEMED CENTER FOR INNOVATIVE LEARNING VOLUNTEERS: FORM 990, PART I, LINE 6: WAKEMED HAS APPROXIMATELY 1,627 VOLUNTEERS. THEY ARE TECHNICALLY CLASSIFIED AS VOLUNTEERS OF THE ORGANIZATIONS; "THE VOLUNTEERS AT WAKEMED RALEIGH CAMPUS" AND "THE VOLUNTEERS AT WAKEMED CARY HOSPITAL" BUT WE LIST THEM HERE FOR INFORMATIONAL PURPOSES. DESCRIPTION OF PURPOSE: SCHEDULE K, PAGE 1, ROW A, COLUMN F: FINANCING (A) COSTS OF CONSTRUCTING, EXPANDING, RENOVATING AND EQUIPPING CERTAIN HOSPITAL FACILITIES, INCLUDING WAKEMED CARY 2-STORY VERTICAL EXPANSION, 10-BED LABOR AND DELIVERY UNIT EXPANSION AND PARKING DECK, WAKEMED RALEIGH 4-STORY PATIENT TOWER, PARKING DECK FOR VISITORS AND PATIENTS, EMPLOYEE PARKING DECK, PORTION OF REHABILITATION HOSPITAL FOR INPATIENT BEDS, THE FIRST FLOOR OF MAIN HOSPITAL FOR 25 OBSERVATION BED UNIT AND RELATED AND OTHER EQUIPMENT; (B) A DEBT SERVICE RESERVE FUND; (C) THE PREMIUM FOR A FINANCIAL GUARANTY INSURANCE POLICY; AND (D) ISSUANCE COSTS. DESCRIPTION OF PURPOSE: SCHEDULE K, PAGE 1, ROW B, COLUMN F: FINANCING (A) COSTS OF CONSTRUCTING, EXPANDING, RENOVATING AND EQUIPPING CERTAIN HOSPITAL FACILITIES, INCLUDING WAKEMED CARY 2-STORY VERTICAL EXPANSION, 10-BED LABOR AND DELIVERY UNIT EXPANSION AND PARKING DECK, WAKEMED RALEIGH 4-STORY PATIENT TOWER, PARKING DECK FOR VISITORS AND PATIENTS, EMPLOYEE PARKING DECK, PORTION OF REHABILITATION HOSPITAL FOR INPATIENT BEDS, THE FIRST FLOOR OF MAIN HOSPITAL FOR 25 OBSERVATION BED UNIT AND RELATED AND OTHER EQUIPMENT; (B) INITIAL COSTS FOR A CREDIT FACILITY FOR THE BONDS; AND (C) ISSUANCE COSTS. DESCRIPTION OF PURPOSE: SCHEDULE K, PAGE 1, ROW C, COLUMN F: FINANCING (A) COSTS OF CURRENTLY REFUNDING ALL OUTSTANDING SERIES 1997 BONDS ISSUED ON APRIL 1, 1997. THE SERIES 1997 BONDS WERE ISSUED TO REFUND ALL OF SERIES 1993 AND 1988 BONDS WHICH WERE ISSUED TO FINANCE COSTS OF CONSTRUCTING, EXPANDING, RENOVATING AND EQUIPPING CERTAIN HOSPITAL FACILITIES, INCLUDING CONSTRUCTION OF WAKEMED CARY HOSPITAL, TWO-STORY ADDITION TO THE WAKEMED MAIN CAMPUS, 45-BED REHABILITATION HOSPITAL AND RELATED AND OTHER EQUIPMENT; AND (B) ISSUANCE COSTS. FORM 990, PAGE 6, PART VI, SECTION A, LINE 8A AND 8B: WAKEMED DOCUMENTS ALL MEETINGS HELD BY THE GOVERNING BODY AND EACH COMMITTEE MEETINGS IN THE FORM OF "MINUTES OF THE MEETINGS." THESE MINUTES ARE KEPT IN 2 FORMATS; PAPER AND DISKS WHICH ARE STORED AT SEPARATE LOCATIONS. FORM 990, PAGE 12, PART XI, LINE 5: IN 2011, NET ASSETS INCREASED PRIMARILY DUE TO CURRENT YEAR INCOME AND REIMBURSED CONSTRUCTION AND EQUIPMENT COSTS FROM BOND PROCEEDS. 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