2023-11-14T11:01:41-06:00 2022-12-31 990 2022-01-01 561685120 NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION NORT 3367164445 MEDICAL CENTER BOULEVARD WINSTON SALEM NC 27157 BRADLEY A CLARK TREASURER 3367164445 2023-11-14 BRADLEY CLARK 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z BRADLEY A CLARK MEDICAL CENTER BOULEVARD WINSTON SALEM NC 27157 1445824 0 X N/A X 1986 NC TO OPERATE AND CARRY OUT THE FUNCTIONS AND PURPOSES OF NORTH CAROLINA BAPTIST HOSPITAL AND TO MAKE CHARITABLE DONATIONS 6 6 0 6 0 0 1518 1293 0 0 15765238 1414170 450871 30361 16217627 1445824 300000 1040000 0 0 0 0 0 0 0 17176 40830 317176 1080830 15900451 364994 61922470 53724183 10549 10548 61911921 53713635 TO OPERATE AS A CHARITABLE ORGANIZATION, TO MAKE CHARITABLE DONATIONS AND FURTHER TO OPERATE AND CARRY OUT THE FUNCTIONS AND PURPOSES OF NORTH CAROLINA BAPTIST HOSPITAL. 0 0 1068362 1040000 30361 THE FOUNDATION WAS ESTABLISHED TO PROVIDE CHARITABLE FUNDING TO HELP MAINTAIN THE MISSION OF THE ORGANIZATION AND TO SUPPORT, PROMOTE, AND GENERALLY ADVANCE THE INTERESTS OF NORTH CAROLINA BAPTIST HOSPITAL IN THE PURSUIT OF ITS MINISTRIES OF HEALING. THE FOUNDATION PROVIDES SUPPORT TO THE HOSPITAL'S DIVISION OF FAITH AND HEALTH MINISTRIES AND ITS FAITHHEALTHNC INITIATIVE TO IMPROVE HEALTH WITHIN THE COMMUNITY AND BETTER ACCESS TO CARE. 1068362 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X ERIN KOEWING 3367164445 MEDICAL CENTER BLVD WINSTONSALEM NC 27157 A LEE HERRING BOARD MEMBER 2.00 2.00 X 0 0 0 ARTHUR A GIBEL BOARD MEMBER 2.00 2.00 X 0 0 0 SHEREE B WATSON BOARD MEMBER 2.00 2.00 X 0 0 0 STEPHEN L ROBERTSON BOARD MEMBER 2.00 2.00 X 0 0 0 WILLIAM C WARDEN JR BOARD MEMBER 2.00 2.00 X 0 0 0 EDWIN L WELCH JR CHAIR (FR 1/1/22) 3.00 2.00 X X 0 0 0 BRADLEY A CLARK TREASURER 0.50 39.50 X 1335054 0 135513 J MCLAIN WALLACE JR SECRETARY 2.00 38.00 X 984139 0 159721 2319193 0 295234 0 0 1 1 0 1293 1293 1118806 1118806 295364 0 295364 295364 295364 OTHER INCOME 621990 30361 30361 30361 1445824 30361 0 1414170 1040000 1040000 38402 25934 12468 2428 2428 1080830 1068362 12468 0 20962051 6966156 539593 541994 60924 7050094 40359902 39165939 61922470 53724183 10549 10548 10549 10548 X 61911921 53713635 61911921 53713635 61922470 53724183 364994 -8563280 0 X 0 1 X 1 0 X X 1 NORTH CAROLINA BAPTIST HOSPITAL 560552787 3 1 985236 0 1 985236 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 PUBLICLY TRADED SECURITIES > %5 OF ASSETS 39165939 F 39165939 X PART X, LINE 2: THE ORGANIZATION HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS CALENDAR YEAR ENDED DECEMBER 31, 2022 AND SHORT PERIOD ENDED DECEMBER 31, 2021, INCLUDING A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF ITS JOINT VENTURES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS FOR THE CALENDAR YEAR ENDED DECEMBER 31, 2022 AND SHORT PERIOD ENDED DECEMBER 31, 2021. 1 NORTH CAROLINA BAPTIST HOSPITAL MEDICAL CENTER BOULEVARD WINSTON SALEM NC 27157 560552787 501(C)(3) 985236 0 SUPPORT OF FAITHHEALTH NC, EE EMERGENCY FD, AND OTHER PROGRAMS FAITHHEALTH INNOVATIONS MEDICAL CENTER BOULEVARD WINSTON SALEM NC 27157 237426944 501(C)(3) 54764 0 SUPPORT OF WILKES PATIENT FUND AND OTHER FAITHHEALTH INITIATIVES 2 0 PART I, LINE 2: THE ORGANIZATION FOLLOWS THE POLICY USED BY WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER (TO WHICH ENTITY THE OPERATION OF THE SUBSIDIARIES OF ITS TWO MEMBERS, WAKE FOREST UNIVERSITY HEALTH SCIENCES AND NORTH CAROLINA BAPTIST HOSPITAL, - INCLUDING THE FILING ORGANIZATION - HAS BEEN DELEGATED) IN REVIEWING ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE ORGANIZATION MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF AMOUNTS DISBURSED. 0 1 0 0 0 0 0 0 0 BRADLEY A CLARK TREASURER 790574 0 506925 0 37555 0 100623 0 34890 0 1470567 0 34657 0 J MCLAIN WALLACE JR SECRETARY 590200 0 252513 0 141426 0 144251 0 15470 0 1143860 0 116382 0 PART I, LINE 4B CERTAIN OFFICERS OF THE FILING ORGANIZATION PARTICIPATED IN AND/OR RECEIVED PAYMENTS FROM A NON-QUALIFIED DEFERRED COMPENSATION PLAN (RESTORATION OR SERP). THE DETERMINATION OF THE PAYMENT AMOUNT FROM THE NON-QUALIFIED DEFERRED COMPENSATION PLANS FOLLOWED THE EMPLOYMENT ORGANIZATION'S COMPENSATION PROCEDURES. THE FOLLOWING OFFICERS RECEIVED PAYMENTS FROM NON-QUALIFIED DEFERRED COMPENSATION PLANS DURING THE CURRENT TAX YEAR: BRADLEY A. CLARK $34,775 J. MCLAIN WALLACE, JR. $116,382 FORM 990, PART VII, LINE 5 - COMPENSATION FROM UNRELATED ORGANIZATION BRADLEY A. CLARK WAS COMPENSATED BY THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY ("CMHA", DOING BUSINESS AS ATRIUM HEALTH), AN AFFILIATED BUT UNRELATED ORGANIZATION, FOR SERVICES RENDERED TO THE ORGANIZATION. SEE PART VII AND SCHEDULE J FOR HIS COMPENSATION. J. MCLAIN WALLACE, JR. WAS COMPENSATED BY WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC"), AN AFFILIATED BUT UNRELATED ORGANIZATION, FOR SERVICES RENDERED TO THE ORGANIZATION. SEE PART VII AND SCHEDULE J FOR HIS COMPENSATION. FORM 990, PART VI, SECTION A, LINE 4 EFFECTIVE JUNE 16, 2022, NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION AMENDED AND RESTATED ITS BYLAWS AND FILED ARTICLES OF RESTATEMENT WITH THE NORTH CAROLINA SECRETARY OF STATE. THE GOVERNING DOCUMENTS WERE AMENDED AND RESTATED TO STATE THAT THE PURPOSE OF THE FILING ORGANIZATION IS TO BE ORGANIZED AND OPERATE EXCLUSIVELY FOR NON-PROFIT PURPOSES INCLUDING MAKING GIFTS AND CONTRIBUTIONS TO CHARITABLE ORGANIZATIONS AND FURTHER TO OPERATE AND CARRY OUT THE FUNCTIONS AND PURPOSES OF ITS SOLE MEMBER, NORTH CAROLINA BAPTIST HOSPITAL. THE BYLAWS WERE ALSO AMENDED TO PROVIDE THAT THE NUMBER OF TRUSTEES OF THE FILING ORGANIZATION SHALL BE BETWEEN THREE AND TWENTY AND THAT THE FILING ORGANIZATION'S SOLE MEMBER SHALL APPOINT THE TRUSTEES FOR TERMS UP TO THREE YEARS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS NORTH CAROLINA BAPTIST HOSPITAL, A NORTH CAROLINA NONPROFIT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE NUMBER OF TRUSTEES OF THE CORPORATION SHALL BE BETWEEN THREE AND TWENTY. THE SOLE MEMBER, NORTH CAROLINA BAPTIST HOSPITAL, SHALL APPOINT THE TRUSTEES FOR TERMS UP TO THREE YEARS. FORM 990, PART VI, SECTION A, LINE 7B THE FILING ORGANIZATION'S SOLE MEMBER, NORTH CAROLINA BAPTIST HOSPITAL, SHALL APPOINT THE TRUSTEES FOR TERMS OF UP TO THREE YEARS. ADDITIONALLY, ANY BYLAW AMENDMENT OR REPEAL AND NEW BYLAWS MUST BE APPROVED BY THE FILING ORGANIZATION'S SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVES COPIES OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL DIRECTORS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES ITS OFFICERS, DIRECTORS AND ANY KEY EMPLOYEES TO REVIEW THE CONFLICT OF INTEREST POLICY AND DISCLOSE ANY POTENTIAL CONFLICTS OF INTERESTS ANNUALLY AND AS THEY ARISE. ANY ITEMS DISCLOSED ARE REVIEWED AND MANAGED IN ACCORDANCE WITH THE ORGANIZATION'S POLICY ON CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION PAYS NO COMPENSATION TO DIRECTORS. COMPENSATION PAID TO OFFICERS WAS PAID BY UNRELATED ORGANIZATIONS, WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC"), OR CHARLOTTE MECKLENBURG HOSPITAL AUTHORITY ("CMHA", DBA ATRIUM HEALTH) AND THE DETERMINATION OF THE COMPENSATION OF SUCH INDIVIDUALS IS CONDUCTED VIA THE PROCESS UTILIZED BY THE WFUBMC BOARD, AS FOLLOWS: THE DIVERSITY, INCLUSION, & COMPENSATION COMMITTEE (THE "COMMITTEE") OF THE ATRIUM HEALTH, INC. BOARD OF DIRECTORS HAS AUTHORITY AS THE WFUBMC BOARD DELEGATES TO IT, FOR THE REVIEW AND APPROVAL OF SENIOR EXECUTIVE COMPENSATION, INCLUDING SENIOR EXECUTIVE INCENTIVE PLANS. NO MEMBER OF THE COMMITTEE IS AN EMPLOYEE OF WFUBMC OR OF THE FILING ORGANIZATION. THE COMMITTEE RELIES UPON AN EXTERNAL, INDEPENDENT COMPENSATION CONSULTANT EXPERIENCED IN HEALTHCARE TO PROVIDE THE COMMITTEE WITH COMPENSATION COMPARABILITY DATA FOR NEW EXECUTIVE POSITION APPOINTMENTS AND FOR COMPENSATION REVIEWS FOR EXISTING EXECUTIVES. THE CONSULTANT, WHICH IS RETAINED DIRECTLY BY THE COMMITTEE, PROVIDES THIRD-PARTY INFORMATION AND EVALUATES THE COMPETITIVENESS AND REASONABLENESS OF EXECUTIVE COMPENSATION AND BENEFITS PROGRAMS IN RELATION TO MARKET PRACTICES FOR SIMILARLY SITUATED HEALTHCARE ORGANIZATIONS. THE COMMITTEE MAKES ITS DECISIONS WITH RESPECT TO EXECUTIVE COMPENSATION IN ACCORDANCE WITH WFUBMC AND FILING ORGANIZATION POLICIES, IRS REGULATIONS, AND STANDARD CORPORATE GOVERNANCE PRACTICES. SUCH POLICIES INCLUDE ADHERENCE TO EXECUTIVE COMPENSATION PHILOSOPHY AND REVIEW PROCESSES; PROCESSES ENSURING COMMITTEE MEMBER AND COMPENSATION CONSULTANT INDEPENDENCE; USE OF VALID MARKET COMPARISONS OF DATA FROM HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE, STRUCTURE, AND COMPLEXITY AND ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS, PER IRS GUIDELINES. MINUTES OF THE DELIBERATIONS OF THE COMMITTEE ARE MAINTAINED IN THE ATRIUM HEALTH, INC. LEGAL DEPARTMENT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST AND ARE AVAILABLE ON THE WEBSITE OF THE NORTH CAROLINA SECRETARY OF STATE. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES, AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON REQUEST. NORTH CAROLINA BAPTIST HOSPITAL MEDICAL CENTER BOULEVARD WINSTON SALEM NC 27157 560552787 HEALTHCARE NC 501(C)(3) LINE 3 0 CARENET INC 2000 WEST FIRST STREET SUITE 410 WINSTON SALEM NC 27104 561977341 HEALTHCARE NC 501(C)(3) LINE 12B, II NORTH CAROLINA BAPTIST HOSPITAL 0 CORNERSTONE HEALTH ENABLEMENT STRATEGIC SOLUTIONS LLC 165 KIMEL PARK DRIVE STE B WINSTONSALEM NC 27103 461314057 MGMT & TRANSFORM. SVC. - MEDICAL ORGS NC N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0