2024-05-15T07:19:10-05:00 2023-06-30 990 2022-07-01 562070036 DUKE UNIVERSITY HEALTH SYSTEM INC DUKE 9196841860 2200 W MAIN STREET STE 300 DURHAM NC 27705 CRAIG T ALBANESE MD CEO 9196841860 2024-04-03 CRAIG ALBANESE MD 999009999 1 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X CRAIG T ALBANESE MD 615 DOUGLAS ST STE 700 DURHAM NC 27705 6272727142 0 X WWW.DUKEHEALTH.ORG X 1998 NC SEE SCHEDULE O FOR ORGANIZATION'S MISSION STATEMENT 18 11 26017 505 0 0 65812130 17395022 4061183925 4441855976 372772809 95601985 100737132 117981685 4600505996 4672834668 2048176 2054288 0 0 2016472500 2251243997 0 0 285902 2155618846 2369918261 4174139522 4623216546 426366474 49618122 8260774039 7958888279 2800050325 2835375323 5460723714 5123512956 X SEE SCHEDULE O 0 0 3842016118 2054288 4542702009 SEE SCHEDULE O 3842016118 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 1 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 0 0 1 1 1 1 0 0 1 X 567 0 1 26017 1 0 1 1 SW DA NO MY PL UK PO GR HU IS BD 0 0 0 1 1 0 0 0 0 1 0 X 18 11 1 1 1 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 AL AR CA FL GA HI IL KS KY MD MA MI MN MS NH NJ NM NY ND OR PA RI SC TN UT VA WV WI X X X BETSY CASSIDY 9196688910 DUHS INC 615 DOUGLAS STREET SUITE DURHAM NC 27705 A EUGENE WASHINGTON MD DIRECTOR/PRESIDENT 33.00 33.20 X X 0 3142252 51351 VINCENT E PRICE DIRECTOR 3.00 48.30 X 0 1751192 55185 MARY E KLOTMAN MD DIRECTOR 11.00 44.30 X 0 1235581 51873 ERIK PAULSON DIRECTOR 1.00 61.00 X 0 456004 61515 LESLIE E BAINS DIRECTOR 2.00 0.00 X 0 0 0 GAIL BELVETT MD DDS DIRECTOR 4.00 0.00 X 990 0 0 DENISE BENNETT DIRECTOR 2.00 0.00 X 0 0 0 GERALD HASSELL DIRECTOR 2.00 4.00 X 0 0 0 WILLIAM HAWKINS DIRECTOR 4.00 6.00 X 0 0 0 ROSEMARY JACKSON MD DIRECTOR 1.00 0.00 X 0 0 0 FEDERICO MANON DIRECTOR 1.00 0.00 X 0 0 0 CARMICHAEL S ROBERTS DIRECTOR 1.00 2.10 X 0 0 0 NANCY M SCHLICHTING DIRECTOR 2.00 2.00 X 0 0 0 LAURENE SPERLING DIRECTOR 8.00 6.10 X 0 0 0 SUSAN M STALNECKER DIRECTOR 4.00 0.10 X 0 0 0 MOIRA RYNN MD DIRECTOR 2.00 40.10 X 0 483799 54853 G RICHARD WAGONER JR DIRECTOR 1.00 0.00 X 0 0 0 JIM WHITEHURST DIRECTOR 1.00 0.00 X 0 0 0 JOHN P MORDACH SVP, CFO, PART YEAR TREASURER 40.00 0.60 X 1582991 0 66153 THOMAS A OWENS MD EXECUTIVE VICE PRESIDENT, DUHS 61.00 0.70 X 1441308 0 50390 ROBERT N WILLIS VP FINANCE/CONTROLLER/CAO/INTERIM TREASURER 50.00 0.70 X 684760 0 53493 MONTE D BROWN MD VP FOR ADMINISTRATION/SECRETARY 60.00 0.10 X 781615 0 55164 CRAIG T ALBANESE MD CEO 60.00 0.70 X 1407490 0 53451 KATHLEEN GALBRAITH PART YEAR PRESIDENT, DUKE REGIONAL HOSPITAL 60.00 2.00 X 619168 0 101748 MARY K MARTIN CHIEF OPERATING OFFICER, DUH 40.00 0.00 X 679639 0 66153 MARY ANN FUCHS VP PATIENT CARE/CHIEF NURSING OFFICER 50.00 0.10 X 625223 0 44749 BARBARA M GRIFFITH MD PRESIDENT, DUKE RALEIGH HOSPITAL 40.00 0.00 X 612137 0 62567 DEVDUTTA SANGVAI MD PART YEAR PRESIDENT, DUKE REGIONAL HOSPITAL 40.00 0.20 X 539272 8564 112431 RICHARD PATRICK SHANNON CHIEF QUALITY OFFICER 40.00 0.20 X 991774 0 55032 JEFFREY M FERRANTI SENIOR VP/CHIEF DIGITAL OFFICER 40.00 0.00 X 1047207 129186 65117 KEITH STOVER VP FINANCE/COO, PRMO 40.00 0.00 X 715086 0 61821 RHONDA BRANDON CHIEF HR OFFICER 50.00 0.10 X 822395 0 64332 JOHN SMITH VP FINANCE 40.00 0.00 X 649908 0 50745 WILLIAM J FULKERSON MD FORMER OFFICER 0.00 56.00 X 0 1763663 43312 LEIGH BLEECKER FORMER KEY EMPLOYEE 65.00 0.00 X 405081 0 49609 13606044 8970241 1331044 4241 1 1 0 PRIVATE DIAGNOSTIC CLINIC PLLC PO BOX 15000 DURHAM NC 27710 MEDICAL SERVICES 208195956 AYA HEALTHCARE INC 5930 CORNERSTONE COURT W 300 SAN DIEGO CA 92121 CONTRACT NURSING 47026399 ROBINS & MORTON GROUP PO BOX 11407 DEPT 5870 BIRMINGHAM AL 35209 CONSTRUCTION SERVICES 20993669 ARAMARK SERVICES INC 1101 MARKET ST 12TH FLOOR PHILADELPHIA PA 19107 FOOD SERVICES 19982847 WHITING TURNER CONTRACTING CO 300 E JOPPA ROAD TOWSON MD 21286 CONSTRUCTION SERVICES 17907352 359 63870 9402519 7928633 37351 17395022 PATIENT REVENUE 622110 4402793657 4402793657 ANCILLARY MEDICAL SVCS 622110 39062319 39062319 4441855976 81132069 81132069 6393855 6393855 19414817 14675973 4738844 4738844 4738844 1599610713 1583575967 1564830 16034746 -1564830 14469916 14469916 133029 63870 75704 57325 57325 BILLING FEES 622110 54275159 54275159 NET BENEFIT COMPONENTS 622110 39264000 39264000 LAB SERVICES 621511 5525317 5525317 7727185 1781557 5945628 106791661 4672834668 4542702009 0 112737637 1991996 1991996 62292 62292 11626179 469442 11050578 106159 574939 149898 425041 1807462417 1412511927 394831689 118801 118482171 90788197 27687007 6967 189976645 150103147 39860343 13155 123121646 95643399 27462486 15761 21271430 21271430 10316564 4195698 6120866 648777 648777 4834779 4834779 366701076 205947314 160753762 3365439 53629 3309967 1843 37123032 22888770 14211046 23216 79200528 6153424 73047104 83220828 55011737 28209091 10386149 9492495 893654 5518743 1562714 3956029 56473509 56473509 197160687 174576539 22584148 13496274 13496274 MEDICAL SUPPLIES 1287743293 1287743293 MEDICAID ASSESSMENT 101187677 101187677 EQUIPMENT RENTAL & MAIN 96056736 64888966 31167770 INTERVIEW & RECRUITING 12567509 7581721 4985788 -17354769 57770630 -75125399 4623216546 3842016118 780914526 285902 117763 127009 472331439 484647422 882384 1591928 561593108 643735889 84177 73077 137742780 117660579 35959046 42037222 4603694420 2540939008 2165937441 2062755412 719112041 707532851 3681086884 3454131263 21965765 24168891 463961211 420426736 8260774039 7958888279 512026066 436023395 9664456 10304827 636101119 605293427 0 248385750 1642258684 1535367924 2800050325 2835375323 X 5403296138 5062532715 57427576 60980241 5460723714 5123512956 8260774039 7958888279 X 49618122 -75612199 -311216681 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 183938 0 1 237702 421640 0 PART II-B, LINE 1: DUKE UNIVERSITY HEALTH SYSTEM, INC. EMPLOYS STAFF WHO PERFORM SOME LOBBYING ACTIVITIES AS PART OF THEIR JOB RESPONSIBILITIES. THESE SAME EMPLOYEES HAVE AND SOME SENIOR LEADERS MAY HAVE DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS, AND GOVERNMENT OFFICIALS. DUKE UNIVERSITY HEALTH SYSTEM, INC. PAYS MEMBERSHIP DUES TO OTHER ORGANIZATIONS. PER THE MEMBERSHIP DUES INVOICES, SOME OF THESE ORGANIZATIONS PROVIDE A DISCLOSURE OF LOBBYING PERCENTAGE OF THE DUES RECEIVED. 57427577 10278031 -2178352 4547015 60980241 74699445 5159602 -2443178 19988293 57427577 59559614 12795429 14542065 12197663 74699445 60648900 6063715 -1163937 5989064 59559614 58627787 5694239 681288 4354414 60648900 0.67692 0.32308 0 1 1 86040386 86040386 3003270844 1291529981 1711740863 1023281885 802223912 221057973 491101305 447185115 43916190 2062755412 PRIVATE CAPITAL 1480939087 F HEDGE FUNDS 900225663 F CASH & CASH EQUIVALENTS 506857421 F NATURAL RESOURCES 280718144 F REAL ESTATE 157405009 F OTHER INVESTMENTS 127985939 F 3454131263 RIGHT-OF-USE OPERATING LEASE ASSETS 304389176 ESTIMATED THIRD PARTY PAYOR SETTLEMENT 74097222 OTHER NON-CURRENT ASSETS 41940338 420426736 TAXABLE BOND LIABILITY 882735602 RIGHT-OF-USE OPERATING LEASE LIABILITIES 331682334 FINANCE LEASE LIABILITIES 140981386 POST RETIREMENT BENEFIT OBLIGATION 108264000 457 PLAN OBLIGATIONS 25178173 DERIVATIVE INSTRUMENTS 21860199 LONG TERM DISABILITY LIABILITY 9617000 OTHER NON-CURRENT LIABILITIES 15049230 1535367924 PART V, LINE 4: THE INTENDED USE FOR THE ORGANIZATION'S ENDOWMENT: GENERATE EARNINGS AND SUBSEQUENT DISTRIBUTIONS TO SUPPORT CAPITAL PURCHASES, OFFSET OPERATING COSTS, IMPROVE PATIENT SAFETY, SUPPORT THE NEEDS OF PATIENTS AND FAMILIES, AND FUND OTHER PROGRAMS CONSISTENT WITH THE CHARITABLE MISSION OF THE INSTITUTION. PART X, LINE 2: DUKE UNIVERSITY HEALTH SYSTEM, INC. ADOPTED THE REQUIREMENTS OF FASB ASC 740 AND CONSIDERED ITS TAX POSITIONS. BASED ON THAT ANALYSIS, THE PROVISIONS OF FASB ASC 740 ARE DEEMED IMMATERIAL TO THE DUKE UNIVERSITY HEALTH SYSTEM, INC. FINANCIAL STATEMENTS AND THEREFORE NO FASB ASC 740 SPECIFIC DISCLOSURES ARE MADE IN THE AUDITED FINANCIAL STATEMENTS OF DUKE UNIVERSITY HEALTH SYSTEM, INC. AND ITS AFFILIATES FOR FISCAL YEAR ENDED JUNE 30, 2023. 1 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 318039000 CENTRAL AMERICA AND THE CARIBBEAN 0 0 SEMINAR 2000 EAST ASIA AND THE PACIFIC 0 0 SEMINAR 19000 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 SEMINAR 2000 SOUTH AMERICA 0 0 SEMINAR 2000 SUB-SAHARAN AFRICA 0 0 SEMINAR 9000 NORTH AMERICA 0 0 SEMINAR 15000 0 0 0 0 0 0 318088000 0 318088000 0 0 1 0 0 0 PART I, LINE 2: DUKE UNIVERSITY HEALTH SYSTEM, INC. PERIODICALLY APPROVES NONCASH ASSISTANCE OR TRANSFERS MEDICAL EQUIPMENT AND SUPPLIES TO ORGANIZATIONS OUTSIDE THE UNITED STATES, USUALLY IN RESPONSE TO NATURAL DISASTERS. THE ORGANIZATIONS AWARDED THE ASSISTANCE MUST MONITOR THE APPROPRIATE USE OF THE ASSISTANCE TO ENSURE COMPLIANCE WITH LAWS, REGULATIONS, AND ANY TERMS AND CONDITIONS OF THE TRANSFER. SUBRECIPIENTS ARE NOT PERMITTED UNDER THE TERMS OF THE TRANSFER. PART III ACCOUNTING METHOD: GALA 196899 63870 133029 31225 37650 3341 3488 196899 63870 133029 31225 37650 3341 3488 75704 57325 FORM 990, SCHEDULE G, PART I, LINE 2B DUKE UNIVERSITY HEALTH SYSTEM, INC. SUPPORTS THE FUNDRAISING ACTIVITIES PERFORMED BY EMPLOYEES OF DUKE UNIVERSITY. SUCH ACTIVITIES ARE DESIGNED TO DEVELOP SUPPORT FOR BOTH THE UNIVERSITY AND THE DUKE UNIVERSITY HEALTH SYSTEM, INC.'S EDUCATIONAL, RESEARCH AND HEALTHCARE PURPOSES. DUKE UNIVERSITY RECEIVES AND DIRECTS THE CONTRIBUTIONS AS APPROPRIATE TO DUKE UNIVERSITY HEALTH SYSTEM, INC. DUKE UNIVERSITY HEALTH SYSTEM, INC. HAS NOT ENTERED INTO ANY ARRANGEMENTS WITH FUNDRAISERS UNDER WHICH THE ORGANIZATION MADE PAYMENTS EXCLUSIVELY FOR SUCH EXPENSES BUT NOT FOR PROFESSIONAL FUNDRAISING SERVICES. 1 1 X 1 X 1 X 1 1 1 0 1 1 159367231 159367231 0.03450 297692860 297692860 0.06440 457060091 457060091 0.09890 2731685 2731685 0.00060 103578001 23731222 79846779 0.01730 13607100 13607100 0.00290 119916786 23731222 96185564 0.02080 576976877 23731222 553245655 0.11970 1 0 614127148 768142403 -154015255 X 1 1 3 1 DUKE UNIVERSITY HOSPITAL 2301 ERWIN ROAD PRIMARY CAMPUS DURHAM NC 27710 HTTP://WWW.DUKEHEALTH.ORG H0015 X X X X X X A 2 DUKE RALEIGH HOSPITAL 3400 WAKE FOREST ROAD PRIMARY CAMPUS RALEIGH NC 27609 HTTP://WWW.DUKEHEALTH.ORG H0238 X X X 3 DUKE REGIONAL HOSPITAL 3643 ROXBORO ROAD DURHAM NC 27704 HTTP://WWW.DUKEHEALTH.ORG H0233 X X X A DUKE UNIVERSITYDUKE REGIONAL HOSPITALS 0 0 1 X X X X X X X X X 21 1 1 1 1 X HTTP://CORPORATE.DUKEHEALTH.ORG/COMMUNITY X WWW.HEALTHYDURHAM.ORG X 1 21 1 HTTP://CORPORATE.DUKEHEALTH.ORG/COMMUNITY 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X 1 X HTTP://WWW.DUKEHEALTH.ORG X HTTP://WWW.DUKEHEALTH.ORG X HTTP://WWW.DUKEHEALTH.ORG X X X X X X X 1 X 0 X X X 1 X 0 1 DUKE RALEIGH HOSPITAL 2 0 0 1 X X X X X X X X X 22 1 1 1 1 X HTTP://CORPORATE.DUKEHEALTH.ORG/COMMUNITY X HTTP://WWW.LIVEWELLWAKE.ORG X 1 22 1 HTTP://CORPORATE.DUKEHEALTH.ORG/COMMUNITY 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X 1 X HTTP://WWW.DUKEHEALTH.ORG X HTTP://WWW.DUKEHEALTH.ORG X HTTP://WWW.DUKEHEALTH.ORG X X X X X X X 1 X 0 X X X 1 X 0 1 NOTE: THIS SCHEDULE H CONTAINS REFERENCES TO DUKE AND DUKE HEALTH WHICH ARE MEANT TO ENCOMPASS FOR THE PURPOSES OF THIS SCHEDULE DUKE UNIVERSITY HEALTH SYSTEM (DUHS), DUKE UNIVERSITY SCHOOL OF MEDICINE, AND DUKE UNIVERSITY SCHOOL OF NURSING. PART V, SECTION B:GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 5: DUKE UNIVERSITY HOSPITAL ("DUH") DUH COLLABORATES WITH THE PARTNERSHIP FOR A HEALTHY DURHAM (THE STATE CERTIFIED HEALTHY CAROLINIANS GROUP) AND THE DURHAM COUNTY HEALTH DEPARTMENT TO CONDUCT THE DURHAM COUNTY COMMUNITY HEALTH ASSESSMENT AND DEVELOPS STRATEGIES TO ADDRESS IDENTIFIED NEEDS. FACULTY AND STAFF OF THE DUKE DIVISION OF COMMUNITY HEALTH AND APPOINTED MEMBERS OF THE DUH SENIOR LEADERSHIP TEAM OFFICIALLY SERVE ON THE PARTNERSHIP FOR A HEALTHY DURHAM COMMITTEES.THE 2020 COMMUNITY HEALTH ASSESSMENT REPORT WAS PUBLISHED BY DURHAM COUNTY IN 2021. THE 2020 SURVEY WAS CONDUCTED BETWEEN MAY AND SEPTEMBER 2019, AND CARRIED OUT BY 243 COMMUNITY VOLUNTEERS, PARTNERSHIP MEMBERS, AND STAFF FROM DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH AND DUKE HEALTH. THE COUNTY WIDE SURVEY SAMPLE SIZE WAS DOUBLED IN 2019 TO ANALYZE DATA BY RACE AND ETHNICITY. THE ASSESSMENT INCLUDED 612 RESIDENT SURVEYS IN COUNTY WIDE AND HISPANIC OR LATINO NEIGHBORHOOD SAMPLES. COMMUNITY LISTENING SESSIONS WERE CONDUCTED VIA ZOOM DUE TO COVID-19 RESTRICTIONS. THE COMMUNITY HEALTH ASSESSMENT TEAM - COMPRISED OF MEMBERS REPRESENTING LOCAL GOVERNMENTS, HEALTH CARE SYSTEMS, COLLEGES & UNIVERSITIES, COMMUNITY-BASED ORGANIZATIONS AND NON-PROFITS IN SECTORS OF PHYSICAL AND MENTAL HEALTH, TRANSPORTATION, EDUCATION, HOUSING, RESEARCH, FOOD ACCESS, PLANNING ENVIRONMENT AND MORE WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT AND PROVIDE WRITTEN CONTENT AND EXPERTISE ON ISSUES OF INTEREST. THIS JOINT CHNA AND RELATED IMPLEMENTATION PLAN WAS ADOPTED BY THE DUHS BOARD OF DIRECTORS AND PUBLISHED ON THE DUKE HEALTH WEBSITE IN FISCAL YEAR 2022 (TAX YEAR 2021).GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 6A: DUKE REGIONAL HOSPITAL ("DRH")GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 6B: THE PARTNERSHIP FOR A HEALTHY DURHAM AND THE DURHAM COUNTY HEALTH DEPARTMENTGROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITALPART V, SECTION B, LINE 11: THE ASSESSMENT IDENTIFIED THE SAME FIVE HEALTH PRIORITIES FOR 2021-2023 AS THOSE OF THE PREVIOUS ASSESSMENT CYCLE: 1. AFFORDABLE HOUSING 2. ACCESS TO HEALTHCARE AND HEALTH INSURANCE3. POVERTY 4. MENTAL HEALTH 5. OBESITY, DIABETES AND FOOD ACCESS THE DUKE UNIVERSITY HOSPITAL IMPLEMENTATION PLAN CONTAINING DETAILED DESCRIPTIONS OF HOW DUKE HOSPITAL PLANS TO ADDRESS EACH PRIORITY ALONG WITH PROGRESS REPORTS CAN BE FOUND ON THE DUKEHEALTH.ORG WEBSITE. DUH CONSIDERS THE IMPLEMENTATION PLAN TO BE A "WORKING PLAN" THAT WILL CONTINUE TO EVOLVE OVER THE THREE YEAR PERIOD IN ORDER TO ENSURE THE EFFICACY OF STRATEGIES INTENDED TO MEET EXPRESSED COMMUNITY HEALTH NEEDS. THE IMPLEMENTATION PLAN MAY NOTE, BUT DOES NOT CONTAIN DETAILED DESCRIPTIONS OF, THE COMMUNITY HEALTH IMPROVEMENT WORK CARRIED OUT BY OTHER COMPONENTS OF THE LARGER DUKE HEALTH SYSTEM OR DUKE UNIVERSITY. TOGETHER WITH ITS PARTNERS, DUH ASKS ABOUT AND LISTENS TO CONCERNS, EXPLORES BARRIERS TO CARE, ANALYZES HEALTHCARE UTILIZATION AND COSTS, IDENTIFIES PARTNER NEEDS AND RESOURCES, PLANS/REDESIGNS SERVICES, TRACKS OUTCOMES, AND SHARES ACCOUNTABILITY IN ORDER TO DEVELOP EFFECTIVE PROGRAMS TO IMPROVE THE HEALTH OF THE DURHAM COMMUNITY. 1. AFFORDABLE HOUSINGAFFORDABLE HOUSING, AS DEFINED BY HUD (U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT), REQUIRES NO MORE THAN 30% OF A FAMILY'S MONTHLY INCOME. IF A FAMILY SPENDS MORE THAN 30% OF INCOME ON HOUSING, THEY ARE LESS ABLE TO PAY FOR OTHER EXPENSES, SUCH AS FOOD AND HEALTHCARE. THE INCREASED COST BURDEN OF UNAFFORDABLE HOUSING ADDS TO PSYCHOSOCIAL STRESSORS THAT CAN NEGATIVELY IMPACT A FAMILY. RENTERS MAKE UP 40% OF HOUSEHOLDS IN DURHAM, AND ALMOST HALF OF THEM ARE DEFINED AS COST-BURDENED (I.E. PAYING MORE THAN 30% OF THEIR MONTHLY INCOME FOR HOUSING).DUH HAS PARTNERED WITH HABITAT FOR HUMANITY OF DURHAM ON A NUMBER OF HOME BUILDS. ADDITIONALLY, AFFORDABLE HOUSING IS A FOCUS OF DUH AS PART OF THE LARGER DUKE UNIVERSITY. DUKE'S WORK RELATED TO AFFORDABLE HOUSING IS LED BY DUKE UNIVERSITY'S OFFICE OF DURHAM AND PUBLIC AFFAIRS. FOR INSIGHT INTO THIS AND OTHER WORK LED BY THE OFFICE OF DURHAM AND COMMUNITY AFFAIRS, SEE: HTTPS://COMMUNITY.DUKE.EDU/PROGRAMS-INITIATIVES/HOUSING-NEIGHBORHOODS/.2. ACCESS TO HEALTHCARE AND HEALTH INSURANCE:ACCESS TO HEALTHCARE IN A COMMUNITY REFERS TO THE ABILITY OF RESIDENTS TO FIND A CONSISTENT MEDICAL PROVIDER FOR THEIR PRIMARY CARE NEEDS, TO FIND A SPECIALTY PROVIDER WHEN NEEDED AND TO BE ABLE TO RECEIVE THAT CARE WITHOUT ENCOUNTERING SIGNIFICANT BARRIERS. A NUMBER OF PROGRAMS SUPPORTED BY DUH SEEK TO INCREASE ACCESS TO CARE FOR UNINSURED, UNDERINSURED, AND/OR VULNERABLE INDIVIDUALS AND FAMILIES ARE DESCRIBED BELOW:PROJECT ACCESS OF DURHAM COUNTY (PADC): LINKS ELIGIBLE LOW-INCOME, UNINSURED DURHAM COUNTY RESIDENTS TO SPECIALTY MEDICAL CARE FULLY DONATED TO THE PATIENTS BY THE PHYSICIANS, HOSPITALS INCLUDING DUH, LABS, CLINICS AND OTHER PROVIDERS PARTICIPATING IN THE PADC NETWORK.DURING FY2023, PADC SERVED 2,000 PEOPLE PROVIDING MORE THAN 3,000 EPISODES OF CARE FROM SPECIALTY PHYSICIANS AND OTHER PROVIDERS. PADC'S DURHAM HOMELESS TRANSITIONS PROGRAM WORKED WITH MORE THAN 40 UNHOUSED PERSONS AND ITS HEALTH EQUIPMENT LOAN PROGRAM PROVIDED 1,000 PIECES OF DURABLE MEDICAL EQUIPMENT TO PADC CLIENTS.LOCAL ACCESS TO COORDINATED HEALTHCARE (LATCH): AIMS TO IMPROVE HEALTH KNOWLEDGE AND SELF-CARE, ACCESS TO HEALTH CARE AND HEALTH SERVICES UTILIZATION OUTCOMES AMONG DURHAM COUNTY'S UNINSURED. THE LATCH PARTNERSHIP INCLUDES DUH (WHICH NOW PROVIDES THE MAJORITY OF OPERATING FUNDS), LINCOLN COMMUNITY HEALTH CENTER, THE DURHAM COUNTY DEPARTMENTS OF HEALTH AND SOCIAL SERVICES, EL CENTRO HISPANO, AND A NUMBER OF COMMUNITY-BASED ORGANIZATIONS (CBOS). CARE MANAGEMENT SERVICES INCLUDE HEALTH SERVICES COORDINATION AND NAVIGATION (MEDICAL, SOCIAL, BEHAVIORAL); POST-HOSPITALIZATION FOLLOW-UP; PATIENT EDUCATION; CHRONIC DISEASE MANAGEMENT; PSYCHO-SOCIAL SUPPORT; ACCESS TO BENEFITS (MEDICAID/SSI/SSDI); BILLS ASSISTANCE; INTERPRETATION TRANSLATION; AND, TRANSPORTATION COORDINATION. IN PARTNERSHIP WITH OTHER COMMUNITY STAKEHOLDERS-HEALTHCARE AND SOCIAL SERVICE PROVIDERS, LOCAL GOVERNMENT AND COMMUNITY-BASED ORGANIZATIONS-LATCH MONITORS HEALTHCARE TRENDS, IDENTIFIES BARRIERS FACING UNINSURED PATIENTS, AND, WORKING AS A CONSORTIUM, ADDRESSES AND ELIMINATES BARRIERS.DURING FISCAL YEAR 2023, LATCH CONTINUED TO SERVE UNINSURED INDIVIDUALS IN DURHAM COUNTY. THE COMPLEX CHILD PROGRAM (CCP) PROVIDES THE COORDINATION OF MEDICAL AND CO-MANAGEMENT OF MEDICAL CARE FOR CHILDREN WITH MULTIPLE MEDICALLY COMPLEX ISSUES THAT REQUIRE THE INTERACTION WITH MULTIPLE SPECIALISTS. ON AVERAGE THESE CHILDREN WORK WITH 13 SPECIALISTS. THROUGH THE CCP PARENTS HAVE DIRECT PHONE ACCESS TO A COMPLEX CARE SERVICE (CCS) PROVIDER OR RN 24/7. THE CCP TEAM WORKS WITH PARENTS TO CREATE A COMPREHENSIVE "COMPLEX CARE PLAN" THAT IS PLACED IN THE CHILD'S MEDICAL RECORD AND GIVEN TO THE PARENTS. IN ADDITION, THE CCP TEAM COORDINATES INPATIENT INTENSIVE CARE TRANSITIONS PRIOR TO DISCHARGE AND CONDUCTS INTENSIVE OUTPATIENT "BETWEEN-VISIT" CONTACTS (PHONE, CLINIC VISITS, AND IN SOME CASES, HOME VISITS). DURING FY23, THE CCP CONTINUED TO MAXIMIZE SERVICES TO CHILDREN WITH MULTIPLE MEDICALLY COMPLEX ISSUES AND THEIR FAMILIES.SOUTHERN HIGH SCHOOL (SHS) WELLNESS CENTER: PROVIDES COMPREHENSIVE PRIMARY CARE AND MENTAL HEALTH SERVICES AT SHS TO STUDENTS AT THE SCHOOL AND IS OPEN TO ALL STUDENTS AND STAFF OF DURHAM PUBLIC SCHOOLS. IT IS OPERATED BY DUKE'S DIVISION OF COMMUNITY HEALTH ON BEHALF OF DUH. JUST FOR US (JFU): PROVIDES AN IN-HOME CARE PROGRAM FOR LOW-INCOME, FRAIL ELDERLY AND DISABLED. JFU IS A COLLABORATION OF DUKE, LINCOLN COMMUNITY HEALTH CENTER, DURHAM DEPARTMENT OF SOCIAL SERVICES (DSS), THE LOCAL AREA MENTAL HEALTH ENTITY, AND THE DURHAM HOUSING AUTHORITY. DUH PROVIDES THE MAJORITY OF ONGOING SUPPORT FOR THE PROGRAM. THROUGH JFU, AN INTERDISCIPLINARY TEAM OF PROVIDERS SERVES CLIENTS IN THEIR HOMES, PROVIDING MEDICAL CARE, MANAGEMENT OF CHRONIC ILLNESSES, AND CASE MANAGEMENT. EACH PARTICIPANT RECEIVES A HOME VISIT EVERY 5 WEEKS UNLESS THERE IS AN ACUTE EPISODE OR A HOSPITAL DISCHARGE, FOR WHICH A VISIT IS SCHEDULED IMMEDIATELY. VISITS INCLUDE MEDICATION RECONCILIATION, SOCIAL ISSUES, SUPPORT SERVICES, CHRONIC DISEASE MANAGEMENT, AND POST-HOSPITAL CARE. THE HEALTH CARE TEAM CONSISTS OF A CLINICAL PROVIDER (PA, NP OR MD), OCCUPATIONAL THERAPIST, REGISTERED DIETITIAN, SOCIAL WORKER, PHLEBOTOMIST, AND COMMUNITY HEALTH WORKER. NEIGHBORHOOD/COMMUNITY CLINICS: DUH IN PARTNERSHIP WITH LINCOLN COMMUNITY HEALTH CENTER COLLABORATIVELY OPERATES THREE COMMUNITY HEALTH CLINICS: THE LYON PARK COMMUNITY CLINIC, THE WALLTOWN NEIGHBORHOOD CLINIC AND THE HOLTON WELLNESS CENTER. THE CLINICS WERE DESIGNED TO PROVIDE PRIMARY CARE, HEALTH EDUCATION, AND DISEASE PREVENTION TO THE UNDERSERVED POPULATIONS OF DURHAM. THE CLINICS PROVIDE MEDICAL CARE FOR PERSONS WITH AND WITHOUT HEALTH INSURANCE. THOSE WITHOUT INSURANCE ARE SEEN BASED ON A SLIDING FEE SCALE. NO PATIENT IS DENIED CARE BASED ON INABILITY TO PAY FOR SERVICES. CLINICS RECEIVE SIGNIFICANT SUPPORT FROM DUH. THE CLINICS OPERATE AS FAMILY MEDICINE PRACTICES AND ARE OPEN 5 DAYS A WEEK. DURING FISCAL YEAR 2023, THE SOUTHERN HIGH SCHOOL WELLNESS CENTER, THE MICRO-CLINICS AND JUST FOR US PROVIDED 10,587 IN-PERSON AND VIDEO/TELEHEALTH PATIENT VISITS. 3. POVERTY POVERTY HAS A STRONG IMPACT ON HEALTH AND IS AN IMPORTANT CONCERN FOR DURHAM RESIDENTS. RESEARCH NOW SHOWS THAT EVEN THE RISK OF AN ADVERSE CHANGE IN MATERIAL CONDITIONS, ECONOMIC AND HOUSING INSECURITY, AS WELL AS UNINSURED OR UNDERINSURED HEALTH INSURANCE COVERAGE, AFFECT HEALTH OUTCOMES. IN 2017, DUKE IMPLEMENTED A PLAN TO GRADUALLY INCREASE THE MINIMAM WAGE FOR ALL EMPLOYEES TO $15 PER HOUR, MORE THAN TWICE THE MINIMUM FEDERAL OR STATE HOURLY WAGE. THESE EFFORTS CONTINUED OVER SEVERAL YEARS, CULMINATING IN 2019 WITH A MINIMUM WAGE INCREASE TO $15 FOR ALL EMPLOYEES. ON JULY 1, 2022, DUKE UNIVERSITY, INCLUDING DUKE UNIVERSITY HEALTH SYSTEM, INCREASED THE MINIMUM WAGE TO $17 PER HOUR FOR ALL EMPLOYEES WORKING AT LEAST 20 HOURS PER WEEK AND 36 WEEKS PER YEAR. SSI/SSDI OUTREACH, ACCESS AND RECOVERY (SOAR) HELPS PATIENTS WHO ARE CHRONICALLY HOMELESS, OR AT RISK OF HOMELESSNESS ACCESS HEALTH INSURANCE, A STABLE INCOME, AND MEDICAL CARE BY ASSISTING THESE INDIVIDUALS IN APPLYING FOR SUPPLEMENTAL SECURITY INCOME (SSI) AND SOCIAL SECURITY DISABILITY INSURANCE (SSDI). THROUGH SOAR, THESE INDIVIDUALS WITH COMPLEX NEEDS ARE PROVIDED CASE MANAGEMENT FOR HOME, HOSPITAL, AND CLINIC VISITS; ARE PROVIDED WITH A STEP BY STEP EXPLANATION AND COMPLETION OF ALL APPLICATIONS FOR FEDERAL DISABILITY BENEFITS; RECEIVE EXPEDITED APPLICATIONS FOR MONTHLY INCOME AND MEDICAID/MEDICARE; AND ARE LINKED TO COMMUNITY RESOURCES. DUH FUNDS TWO SOAR CASE MANAGERS. DURING FY23, DUH CONTINUED TO ASSIST PATIENTS REFERRED TO THE SOAR PROGRAM. BENEFITS ENROLLMENT COUNSELING (BEC) HELPS SENIORS AND THOSE WITH DISABILITIES AND A LIMITED INCOME FIND AND ENROLL IN ALL THE BENEFIT PROGRAMS FOR WHICH THEY ARE ELIGIBLE. THE GOAL OF THE SERVICE IS TO ENABLE OLDER ADULTS TO ENJOY LIFE AND LIVE INDEPENDENTLY IN THEIR HOMES AND COMMUNITIES FOR AS LONG AS POSSIBLE. FOR THOSE WITH LIMITED INCOME AND RESOURCES, ADDITIONAL SUPPORT CAN BE CRITICAL IN MAINTAINING THEIR HEALTH AND AVOIDING COSTLY HOSPITALIZATIONS. THE BENEFITS PROVIDE CLIENTS SERVED WITH ACCESS TO HEALTHY FOOD, NEEDED MEDICAL CARE AND PRESCRIPTIONS, AS WELL AS OTHER SUPPORTIVE SERVICES. THE BENEFITS ALSO PROVIDE A COMMUNITY ECONOMIC STIMULUS, AS BENEFITS ARE SPENT LOCALLY IN PHARMACIES, GROCERY STORES, UTILITY COMPANIES, AND HEALTH CARE PROVIDERS. TO INCREASE THE REACH OF THE PROGRAM BEYOND GRANT FUNDING, BEC STAFF TRAIN VOLUNTEERS (FROM PARTNER COMMUNITY BASED ORGANIZATIONS AND DUKE) TO ASSIST CLIENTS IN DURHAM, GRANVILLE, AND PERSON COUNTIES. BEC WORKS WITH DUKE UNDERGRADUATES AND MEDICAL STUDENTS WHO ENGAGE IN SERVICE, OUTREACH, AND ADVOCACY EFFORTS AS WELL AS BUILD MEANINGFUL INTERGENERATIONAL RELATIONSHIPS.BEC PROGRAMS INCLUDE THE COPE INITIATIVE (COMMUNITY OUTREACH, PREVENTION AND EDUCATION), WHICH OFFERS HEALTH SCREENING AND EDUCATION IN THE COMMUNITY, AND INITIATIVES THAT DIRECTLY ADDRESS GAPS IN SENIOR HUNGER PREVENTION THROUGH TEACHING SELF-SUFFICIENT, SUSTAINABLE GARDENING PRACTICES, AND THE PROVISION OF COOKING CLASSES AT SENIOR CENTERS.BEC SAW SUBSTANTIAL GROWTH IN FY23 FROM FY22, SERVING 485 UNIQUE CLIENTS, UP FROM 350 IN FY22. THE ESTIMATED VALUE OF BENEFITS TO CLIENTS INCREASED FROM $1.2 MILLION IN FY22 TO OVER $1.5 MILLION IN FY23.4. MENTAL HEALTHDUH PARTNERS WITH AND SUPPORTS A NUMBER OF COLLABORATIVE INITIATIVES TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES AND REDUCE SUBSTANCE ABUSE. DUH SERVES AS A KEY PARTNER IN THE FOLLOWING ACTIVITES:* COMMUNITY COALITIONS: DURHAM CRISIS COLLABORATIVE; PARTNERSHIP FOR A HEALTHY DURHAM MENTAL HEALTH COMMITTEE AND DURHAM TOGETHER FOR RESILIENT YOUTH; DURHAM COUNTY LEADERSHIP FORUM ON SUBSTANCE ABUSE AND MENTAL HEALTH.* NALOXONE OUTREACH: PHARMACIES (DUKE CLINIC PHARMACY, MAIN STREET, GURLEY'S, JOSEF'S, & DUKE CANCER SPECIALTY); DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH; DURHAM MOBILE CRISIS UNIT.* PROVIDER EDUCATION: PROVIDER TOOLKITS AND CME EDUCATION; USE OF PAIN AGREEMENTS; USE OF CONTROLLED SUBSTANCE REPORTING SYSTEM (CSRS); CHRONIC PAIN PROVIDER CONSULTATION CALLS.* DIVERSION CONTROL: PERMANENT DROP BOXES IN 5 OF 6 COUNTIES (DURHAM, FRANKLIN, PERSON, GRANVILLE, & VANCE).* CHRONIC PAIN PATIENT SUPPORT: CHRONIC PAIN SELF-MANAGEMENT WORKSHOPS AT LINCOLN COMMUNITY HEALTH CENTER; CHRONIC PAIN MANAGEMENT RESOURCES; KEY COMMUNITY PRESENTATIONS.* COUNTY-WIDE ADVERSE CHILDHOOD EXPERIENCES (ACES) AND COMMUNITY RESILIENCY MODEL (CRM): ACTIVITIES AND TRAINING.DURING FISCAL YEAR 2023 DUKE CONTINUED TO WORK WITH COMMUNITY PARTNERS TO DEVELOP COMMUNITY-BASED SUPPORTIVE SERVICES FOR INDIVIDUALS LIVING WITH OPIOID USE DISORDER/SUBSTANCE USE DISORDER. DUHS SAFE OPIOID TASK FORCE: PROVIDES RECOMMENDATIONS FOR THE INITIATION AND MANAGEMENT OF OPIOID THERAPY ACROSS DUKE UNIVERSITY HEALTH SYSTEM (DUHS) TO IMPROVE PERSONAL AND COMMUNITY SAFETY AND REDUCE HARM ASSOCIATED WITH THESE HIGH RISK TREATMENTS WHILE ENGAGING PATIENTS IN THEIR OWN CARE. DUH ALONG WITH DUKE REGIONAL AND DUKE RALEIGH HOSPITALS SERVES AS A PIVOTAL PLAYER IN ALL ASPECTS OF THE WORK OF THE TASK FORCE. 5. OBESITY, DIABETES, AND FOOD ACCESS OBESITY IS A STRONG CONTRIBUTOR TO DIABETES. MANY DISEASES ARE LINKED TO NUTRITION, INCLUDING OBESITY, HYPERTENSION, HIGH CHOLESTEROL, DIABETES, AND SOME CANCERS. FOOD INSECURITY, THE STATE OF BEING WITHOUT RELIABLE ACCESS TO A SUFFICIENT QUANTITY OF AFFORDABLE, NUTRITIOUS FOOD, HAS A LARGE IMPACT ON A PERSON'S DIET. BULL CITY FIT IS A COMMUNITY-BASED WELLNESS PROGRAM AND IS PART OF THE LARGER DUKE CHILDREN'S HEALTHY LIFESTYLES PROGRAM. THE HEALTHY LIFESTYLES PROGRAM SEEKS TO ADDRESS WEIGHT-RELATED HEALTH PROBLEMS FOR CHILDREN BY OFFERING CARING PROVIDERS, FAMILY-CENTERED TREATMENT PROGRAMS, HIGHLY TRAINED EDUCATORS AND RESEARCHERS, AND STRONG COMMUNITY PARTNERSHIPS. BULL CITY FIT HELPS IN THIS EFFORT BY OFFERING FREE EVENING AND WEEKEND ACTIVITY SESSIONS FOR THE LARGER COMMUNITY. THESE SESSIONS COVER VARIOUS THEMES THAT ENCOURAGE AND PROMOTE ACTIVE LIVING, SUCH AS FITNESS GAMES, SPORT LESSONS, EXERCISE ROUTINES, SWIMMING, COOKING, AND GARDENING. EACH ACTIVITY IS FACILITATED WITH THE SUPPORT OF ENERGETIC STAFF AND VOLUNTEERS TO CREATE A POSITIVE AND FUN ENVIRONMENT FOR ALL.BULL CITY FIT EMPOWERS THE WHOLE FAMILY TO INCREASE KNOWLEDGE AND PRACTICE OF PHYSICAL ACTIVITY AND HEALTHY EATING; ADDRESS CURRENT WEIGHT-RELATED ILLNESS AND PREVENT CHRONIC DISEASE THROUGH INCREASED ACTIVITY LEVELS; IMPROVE QUALITY OF LIFE BY PROMOTING HEALTHY BEHAVIORS; INCREASE CONFIDENCE, SUPPORT POSITIVE CHANGE, AND BUILD A LIFELONG COMMITMENT TO A HEALTHY LIFESTYLE.PARTNERS OF BULL CITY FIT INCLUDE: DURHAM PARKS AND RECREATION; DURHAM CITY GOVERNMENT; DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH; EAST DURHAM CHILDREN'S INITIATIVE; LINCOLN COMMUNITY HEALTH CENTER; COMMUNITY NUTRITION PARTNERSHIP; VEGGIE VAN; BLUE POINTE YOGA; DURHAM PUBLIC SCHOOLS; PARTNERSHIP FOR A HEALTHY DURHAM; DUKE SERVICE LEARNING; DUKE FAMILY MEDICINE; DUKE CHILDREN'S HOSPITAL AND THE UNC SCHOOL OF SOCIAL WORK.DURING FY2023, DUH AND THE PARTNERSHIP SUCCESSFULLY SECURED A MULTI-YEAR IMPLEMENTATION GRANT TO CARRY OUT THE COMMUNITY-DRIVEN ACTIVITIES DEVELOPED DURING THE 2022 PLANNING GRANT PERIOD. GROUP A - FACILITY 1 - DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 16J: AS PART OF DUHS, DUKE UNIVERSITY HOSPITAL PROVIDES A BROCHURE TO ALL ADMISSIONS THAT INCLUDES A BRIEF SUMMARY OF DUHS FINANCIAL ASSISTANCE POLICIES. DUHS ALSO COMMENTS ON THE BACK OF ITS BILLING INVOICES THAT PATIENTS SHOULD CONTACT PATIENT ACCOUNT REPRESENTATIVES TO HELP THEM IF THEY CANNOT PAY THEIR BILL IN FULL. THIS COMMENT REFERENCES GOVERNMENT-SPONSORED PROGRAMS, MONTHLY PAYMENT PROGRAMS, AND OTHER FINANCIAL ASSISTANCE PROGRAMS AVAILABLE FOR PATIENTS WHO MEET CERTAIN FINANCIAL CRITERIA. DUHS ALSO PUBLICIZES ITS FINANCIAL ASSISTANCE POLICY VERBALLY THROUGH ITS FINANCIAL CARE COUNSELORS. PART V, SECTION B, LINE 24: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER ELECTIVE SERVICES, WERE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 5: DUKE RALEIGH HOSPITAL (DUKE RALEIGH OR DRAH) COLLABORATED WITH ADVANCE COMMUNITY HEALTH, ALLIANCE HEALTH, CITRIX, UNITED WAY, UNC REX HEALTHCARE, WAKE COUNTY HEALTH & HUMAN SERVICES, WAKE COUNTY MEDICAL SOCIETY COMMUNITY HEALTH FOUNDATION, WAKEMED HEALTH AND HOSPITALS, AND YOUTH THRIVE TO DEVELOP THE 2022 WAKE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE CHNA INCLUDED ANALYSIS OF EXISTING STATISTICS FROM LOCAL, COUNTY, STATE, AND NATIONAL SOURCES AS WELL AS INPUT FROM 1,073 WAKE COUNTY RESIDENTS AND ORGANIZATIONAL LEADERS. COMMUNITY INPUT WAS GATHERED THROUGH INTERNET-BASED AND TELEPHONE SURVEYS, FOCUS GROUPS, AND AN INTERNET-BASED PRIORITIZATION SURVEY. ADDITIONAL ACTION WAS TAKEN BY THE CHNA STEERING COMMITTEE MEMBERS TO PROMOTE ENGAGEMENT DURING PRIORITIZATION, THROUGH DIRECT OUTREACH TO MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY COMMUNITIES AND THOSE WHO WERE UNDERREPRESENTED. THIS JOINT CHNA AND RELATED IMPLEMENTATION PLAN WERE ADOPTED BY THE DUHS BOARD OF DIRECTORS AND PUBLISHED ON THE DUKE HEALTH WEBSITE IN FISCAL YEAR 2023.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 6A: UNC REX HEALTHCARE, WAKEMED HEALTH AND HOSPITALS.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 6B: UNITED WAY, WAKE COUNTY HEALTH & HUMAN SERVICES, ADVANCE COMMUNITY HEALTH, ALLIANCE HEALTH, CITRIX, NORTH CAROLINA INSTITUTE FOR PUBLIC HEALTH, YOUTH THRIVE, AND THE WAKE COUNTY MEDICAL SOCIETY COMMUNITY HEALTH FOUNDATION. DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 11:THE FOLLOWING THREE PRIORITY AREAS WERE IDENTIFIED FOR 2023-2025:1. AFFORDABLE HOUSING & HOMELESSNESS2. ACCESS TO HEALTHCARE3. MENTAL HEALTHTHE DUKE RALEIGH HOSPITAL IMPLEMENTATION PLAN CONTAINING DETAILED DESCRIPTIONS OF HOW DUKE RALEIGH PLANS TO ADDRESS EACH PRIORITY ALONG WITH PROGRESS REPORTS CAN BE FOUND ON THE DUKEHEALTH.ORG WEBSITE. 1. AFFORDABLE HOUSING & HOMELESSNESS THE AFFORDABLE HOUSING AND HOMELESSNESS PRIORITY INCLUDES COST OF HOUSING, HOUSING CHOICES, AND HOW MANY PEOPLE ARE HOMELESS. DUKE HEALTH ACKNOWLEDGES THAT HEALTHY HOMES PROMOTE GOOD PHYSICAL AND MENTAL HEALTH, AFFECTING THE OVERALL ABILITY OF FAMILIES TO MAKE HEALTHY CHOICES. DUKE RALEIGH PARTNERS WITH NON-PROFIT ORGANIZATIONS THAT WORK TO ENSURE THAT HOMELESSNESS IS INFREQUENT IN WAKE COUNTY BY INCREASING EFFORTS TO ADVANCE AFFORDABLE HOUSING LIKE THE WAKE COUNTY CONTINUUM OF CARE-NC 507 (COC). A DRAH REPRESENTATIVE ATTENDED THE NC 507 STRATEGIC SYSTEM DESIGN CLINIC THAT BROUGHT TOGETHER KEY STAKEHOLDERS TO UNDERSTAND AND DISCUSS ALIGNING SYSTEMS COMPONENTS WITH BEST PRACTICES, UNDERSTAND THE IMPORTANCE OF QUALITY DATA COLLECTION AND DATA-DRIVEN DECISION MAKING TO BETTER ALLOCATE FUNDS AND RESOURCES TOWARDS EFFECTIVE AND EFFICIENT INTERVENTIONS TO END HOMELESSNESS, IDENTIFY RECOMMENDATIONS TO IMPROVE THE LOCAL SYSTEMS TO END HOMELESSNESS, AND ENGAGE IN PLANNING TO DEVELOP ACTIONS TO ADDRESS RECOMMENDATIONS.DUKE RALEIGH SUPPORTS WAKE COC DURING WHITE FLAG WHICH PROVIDES TEMPORARY EMERGENCY SHELTER TO PEOPLE EXPERIENCING HOMELESSNESS DURING SEVERE WEATHER (NIGHTS WHEN THE TEMPERATURE OR WINDCHILL IS EXPECTED TO BE BELOW 35 DEGREES). DUKE RALEIGH SUPPORTS THE FOLLOWING ORGANIZATIONS FINANCIALLY AND THROUGH EMPLOYEE VOLUNTEERISM THAT WORK TOWARDS ADVANCING AFFORDABLE HOUSING AND ADDRESSING HOMELESSNESS: HEALING TRANSITIONS, TRIANGLE FAMILY SERVICES, HABITAT FOR HUMANITY, AND URBAN MINISTRIES OF WAKE COUNTY.2. ACCESS TO HEALTHCAREACCESS TO HEALTHCARE INCLUDES HOW AND WHY PEOPLE USE OR DO NOT USE HEALTHCARE, HOW MANY PEOPLE HAVE HEALTH INSURANCE, HOW MUCH HEALTHCARE THERE IS IN THE COMMUNITY, AND HOW MUCH INFORMATION THERE IS ABOUT HEALTHCARE. THE ABILITY TO ACCESS HEALTH SERVICES IS A CRITICAL PUBLIC HEALTH ISSUE, AS PRIMARY AND PREVENTATIVE SERVICES CAN HELP PREVENT OR MANAGE CHRONIC ILLNESSES AND THEREFORE IMPROVE THE HEALTH OF THE COMMUNITY. DUKE RALEIGH IS ACTIVELY ENGAGED IN IMPROVING ACCESS TO HEALTH SERVICES FOR ALL THROUGH STRATEGIC INITIATIVES AND COMMUNITY PARTNERSHIPS. THE BULLET POINTS BELOW DESCRIBE THE PROGRESS MADE BY DUKE RALEIGH DURING FY2023 ON INITIATIVES TO ADDRESS ACCESS TO HEALTHCARE:* PROVIDED APPROXIMATELY $19.8 MILLION (AT ESTIMATED COST) IN FINANCIAL ASSISTANCE TO PATIENTS. * DUKE RALEIGH ALSO SUPPORTED COMMUNITY PARTNERS WORKING TO PROVIDE CARE TO UNINSURED POPULATIONS. THESE COMMUNITY ORGANIZATIONS INCLUDE PROJECT ACCESS, URBAN MINISTRIES OF WAKE COUNTY, ALLIANCE MEDICAL MINISTRY, INTER-FAITH FOOD SHUTTLE, AND MEALS ON WHEELS. * DUKE RALEIGH PROVIDED IN-KIND LAB SERVICES TO URBAN MINISTRIES OF WAKE COUNTY'S OPEN-DOOR CLINIC AT AN ESTIMATED ANNUAL VALUE OF $2 MILLION.* DONATED AND PACKED 5,000+ POUNDS OF RICE AND BEANS FOR URBAN MINISTRIES OF WAKE COUNTY'S CLIENT CHOICE PANTRY BETWEEN FY17-FY23. * ORGANIZED TWO HEAD AND NECK CANCER SCREENING EVENTS IN FY23 RESULTING IN APPROXIMATELY 450 LIVES REACHED AND 56 SCREENING COMPLETED. * ORGANIZED A BACK-TO-SCHOOL GIVEAWAY FOR A LOCAL VULNERABLE COMMUNITY AND A LOCAL TITLE 1 SCHOOL RESULTING IN APPROXIMATELY 200 LIVES REACHED AND 100 BAGS DISTRIBUTED.* SPONSORED THE MIDTOWN FARMERS MARKET WHICH PROMOTES A HEALTHY LIFESTYLE AS WELL AS PROVIDES A VENUE FOR DUKE RALEIGH TO SHARE HEALTHY EDUCATION FROM APRIL-NOVEMBER HOSTING 4 DAYS FOCUSED ON MENTAL HEALTH, WELL-BEING AND CANCER CARE. 3. MENTAL HEALTH WAKE COUNTY HAS EXPERIENCED AN INCREASE IN THE PREVALENCE AND SEVERITY OF MENTAL HEALTH ISSUES. WHILE THE IMPACTS OF MENTAL HEALTH ARE FAR REACHING, PRIORITIZATION DISCUSSIONS HAVE PLACED SPECIAL EMPHASIS ON SEVERAL POPULATIONS SPECIFICALLY IMPACTED BY MENTAL HEALTH IDENTIFYING THE RELATIONSHIP BETWEEN DISCRIMINATION, RACISM, AND MENTAL HEALTH. DUE TO THE SCOPE AND COMPLEXITY OF MENTAL HEALTH AND ITS TIE TO PHYSICAL HEALTH, A COLLECTIVE AND COLLABORATIVE APPROACH IS NEEDED. THE BULLET POINTS BELOW DESCRIBE THE PROGRESS MADE BY DUKE RALEIGH DURING FY2023 ON INITIATIVES TO ADDRESS ACCESS TO MENTAL HEALTH SERVICES.* PROVIDED FINANCIAL SUPPORT TO TRIANGLE FAMILY SERVICES TO SUPPORT THEIR EFFORTS TO EXPAND ACCESS TO SUSTAINABLE MENTAL HEALTH SERVICES IN OUR COMMUNITY* PROVIDED SUPPORT FOR THE ADVERSE CHILDHOOD EXPERIENCES (ACES) RESILIENCE IN WAKE COUNTY INITIATIVE. THIS IS A MULTI-SECTOR, COMMUNITY-DRIVEN MOVEMENT TO ADDRESS AND PREVENT ACES AND BUILD RESILIENCE IN WAKE COUNTY.* HOSTED A MENTAL HEALTH AND WELLBEING POPUP AT THE MIDTOWN FARMERS MARKET IN JULY 2022* SPONSORED THE NATIONAL ASSOCIATION OF MENTAL ILLNESS CELEBRATION OF COURAGE WALK AS A $2,500 SPONSOR AND PRESENTER THE DAY OF IN SEPTEMBER 2022* PARTICIPATED IN THE NORTH CAROLINA BEHAVIORAL HEALTH WORKGROUP.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 16J: AS PART OF DUHS, DUKE RALEIGH HOSPITAL PROVIDES A BROCHURE TO ALL ADMISSIONS THAT INCLUDES A BRIEF SUMMARY OF DUHS FINANCIAL ASSISTANCE POLICIES. DUHS ALSO COMMENTS ON THE BACK OF ITS BILLING INVOICES THAT PATIENTS SHOULD CONTACT PATIENT ACCOUNT REPRESENTATIVES TO HELP THEM IF THEY CANNOT PAY THEIR BILL IN FULL. THIS COMMENT REFERENCES GOVERNMENT-SPONSORED PROGRAMS, MONTHLY PAYMENT PROGRAMS, AND OTHER FINANCIAL ASSISTANCE PROGRAMS AVAILABLE FOR PATIENTS WHO MEET CERTAIN FINANCIAL CRITERIA. DUHS ALSO PUBLICIZED ITS FINANCIAL ASSISTANCE POLICY VERBALLY THROUGH ITS FINANCIAL CARE COUNSELORS.DUKE RALEIGH HOSPITAL:PART V, SECTION B, LINE 24: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER ELECTIVE SERVICES, WERE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES. GROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL: PART V, SECTION B, LINE 5: AS PART OF DUKE HEALTH, DUKE REGIONAL HOSPITAL ("DRH") PARTNERED WITH DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH AND THE PARTNERSHIP FOR A HEALTHY DURHAM TO CONDUCT THE 2020 DURHAM COMMUNITY HEALTH ASSESSMENT. THE 2020 SURVEY WAS CONDUCTED BETWEEN MAY AND SEPTEMBER 2019, AND CARRIED OUT BY 243 COMMUNITY VOLUNTEERS, PARTNERSHIP MEMBERS, AND STAFF FROM DURHAM COUNTY DEPARTMENT OF PUBLIC HEALTH AND DUKE HEALTH. THE COUNTY WIDE SURVEY SAMPLE SIZE WAS DOUBLED IN 2019 TO ANALYZE DATA BY RACE AND ETHNICITY. THE ASSESSMENT INCLUDED 612 RESIDENT SURVEYS IN COUNTY WIDE AND HISPANIC OR LATINO NEIGHBORHOOD SAMPLES. COMMUNITY LISTENING SESSIONS WERE CONDUCTED VIA ZOOM DUE TO COVID-19 RESTRICTIONS. THE COMMUNITY HEALTH ASSESSMENT TEAM COMPRISED OF REPRESENTATIVES FROM LOCAL GOVERNMENTS, HEALTH CARE SYSTEMS, COLLEGES & UNIVERSITIES, COMMUNITY-BASED ORGANIZATIONS AND NON-PROFITS IN SECTORS OF PHYSICAL AND MENTAL HEALTH, TRANSPORTATION, EDUCATION, HOUSING, RESEARCH, FOOD ACCESS, PLANNING ENVIRONMENT AND MORE - WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT AND PROVIDE WRITTEN CONTENT AND EXPERTISE ON ISSUES OF INTEREST. THIS JOINT CHNA AND RELATED IMPLEMENTATION PLAN WAS ADOPTED BY THE DUHS BOARD OF DIRECTORS AND PUBLISHED ON THE DUKE HEALTH WEBSITE IN FISCAL YEAR 2022 (TAX YEAR 2021).GROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL:PART V, SECTION B, LINE 6A: DUKE UNIVERSITY HOSPITALGROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL:PART V, SECTION B, LINE 6B: THE PARTNERSHIP FOR A HEALTHY DURHAM AND THE DURHAM COUNTY HEALTH DEPARTMENTGROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL:PART V, SECTION B, LINE 11: THE ASSESSMENT IDENTIFIED FIVE HEALTH PRIORITIES FOR 2021-2023:1. AFFORDABLE HOUSING2. ACCESS TO HEALTHCARE AND HEALTH INSURANCE3. POVERTY4. MENTAL HEALTH5. OBESITY, DIABETES AND FOOD ACCESSTHE DUKE REGIONAL HOSPITAL IMPLEMENTATION PLAN CONTAINING DETAILED DESCRIPTIONS OF HOW DUKE REGIONAL PLANS TO ADDRESS EACH PRIORITY ALONG WITH PROGRESS REPORTS CAN BE FOUND ON THE DUKEHEALTH.ORG WEBSITE. DUKE REGIONAL HOSPITAL CONSIDERS THE DRH COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN DOCUMENT TO BE A "WORKING PLAN" THAT WILL CONTINUE TO EVOLVE OVER THIS THREE-YEAR PERIOD IN ORDER TO ENSURE THE EFFICACY OF STRATEGIES INTENDED TO MEET EXPRESSED COMMUNITY HEALTH NEEDS. THE IMPLEMENTATION PLAN DOES NOT CONTAIN DESCRIPTIONS OF THE COMMUNITY HEALTH IMPROVEMENT WORK CARRIED OUT BY OTHER COMPONENTS OF DUKE HEALTH OR DUKE UNIVERSITY BUT REPRESENTS ONLY DUKE REGIONAL HOSPITAL'S CONTINUALLY EVOLVING VARIETY OF PROGRAMS AND ACTIVITIES IN THE FIVE PRIORITY AREAS TO IMPROVE HEALTH WITHIN THE DURHAM COMMUNITY.1 AND 3. AFFORDABLE HOUSING AND POVERTYMINIMUM WAGE, IN 2017, DUKE IMPLEMENTED A PLAN TO GRADUALLY INCREASE THE MINIMAM WAGE FOR ALL EMPLOYEES TO $15 PER HOUR, MORE THAN TWICE THE MINIMUM FEDERAL OR STATE HOURLY WAGE. THESE EFFORTS CONTINUED OVER SEVERAL YEARS, CULMINATING IN 2019 WITH A MINIMUM WAGE INCREASE TO $15 FOR ALL EMPLOYEES. ON JULY 1, 2022, DUKE UNIVERSITY, INCLUDING DUKE UNIVERSITY HEALTH SYSTEM, INCREASED THE MINIMUM WAGE TO $17 PER HOUR FOR ALL EMPLOYEES WORKING AT LEAST 20 HOURS PER WEEK AND 36 WEEKS PER YEAR.FILL THAT BUS AND SALVATION ARMY ANGEL TREE: EMPLOYEES HAVE DONATED BINS OF SCHOOL SUPPLIES TO CRAYONS2CALCULATORS AND FILL THAT BUS! CAMPAIGN EACH YEAR SINCE 2015 TO SUPPORT DURHAM PUBLIC SCHOOLS. TEACHERS FROM THE SCHOOLS WITH THE HIGHEST POVERTY LEVELS WERE INVITED TO PICK OUT SUPPLIES NEEDED IN THEIR CLASSROOMS.EACH DECEMBER, EMPLOYEES "ADOPT" 100 CHILDREN FROM DUKE REGIONAL'S SALVATION ARMY ANGEL TREE. CHILDREN IN DURHAM HAVE RECEIVED CLOTHING, BOOKS AND TOYS THANKS TO THE GENEROUS DONATIONS. EXTRA GIFTS ARE ALSO DONATED TO THE SALVATION ARMY FOR OTHER NEEDY FAMILIES IN THE AREA.DURING FY2023, DUKE REGIONAL HOSPITAL SUPPORTED CRAYONS2CALCULATOR FILL THE BUS! CAMPAIGN, THE SALVATION ARMY TREE GIFT DRIVE AND A FOOD DRIVE FOR THE NORTH CAROLINA FOOD BANK OF CENTRAL AND EASTERN NC.EDUCATION: DUKE REGIONAL HOSPITAL HAS IDENTIFIED EDUCATION AS A PRIORITY OF ITS COMMUNITY STRATEGY TO HELP ADDRESS POVERTY. DUKE REGIONAL HOSPITAL IS COMMITTED TO HELP TRAIN THE HEALTHCARE WORKERS OF THE FUTURE. DURING FISCAL YEARS 2017 THROUGH 2020, DRH PROVIDED OPPORTUNITIES FOR 70 PRE-HEALTH UNDERGRADUATE STUDENTS FROM LOCAL COLLEGES AND UNIVERSITIES TO SHADOW AND VOLUNTEER ALONGSIDE CLINICAL AND CUSTOMER SERVICE STAFF AS AMBASSADORS IN THE EMERGENCY DEPARTMENT. DRH ALSO PROVIDED AN EIGHT-WEEK VOLUNTEER PROGRAM FOR AREA HIGH SCHOOL STUDENTS TO GAIN EXPERIENCES IN A HEALTH CARE SETTING EACH SUMMER. DUE TO COVID-19, IN-PERSON VOLUNTEER OPPORTUNITIES WERE HALTED IN MARCH 2020, BUT DRH CONTINUED TO FIND CREATIVE WAYS TO ENGAGE STUDENTS VIRTUALLY AND WELCOMED CLINICAL STUDENTS BACK TO CAMPUS USING A SLOW AND MEASURED RE-ENTRY OF STUDENTS STARTING IN THE SUMMER OF 2020. SINCE THAT TIME, CLINICAL STUDENTS AND VOLUNTEERS HAVE RETURNED TO THE HOSPITAL SETTING.DRH INVESTED $5.9 MILLION IN FISCAL YEAR 2023 TO TRAIN AND TEACH TOMORROW'S HEALTHCARE PROFESSIONALS. CITY OF MEDICINE ACADEMY: DUKE REGIONAL HOSPITAL HAS BEEN A PARTNER WITH CITY OF MEDICINE ACADEMY (CMA) AND DURHAM PUBLIC SCHOOLS SINCE THE PROGRAM'S INCEPTION AT SOUTHERN HIGH SCHOOL IN THE 1990S. IN AUGUST 2011, CMA MOVED TO A NEW FACILITY LOCATED ON THE DUKE REGIONAL CAMPUS. AS PART OF OUR PARTNERSHIP, DUKE REGIONAL HOSPITAL HOSTS STUDENTS FOR CLINICAL ROTATIONS AND INTERNSHIPS, PROVIDES CPR TRAINING AND HOSTS THE ANNUAL SENIOR AWARDS NIGHT IN THE HOSPITAL AUDITORIUM.PROJECT SEARCH: DUKE REGIONAL HOSPITAL WAS THE FIRST HOST HOSPITAL IN THE STATE FOR PROJECT SEARCH, A PARTNERSHIP WITH DURHAM PUBLIC SCHOOLS, OE ENTERPRISES, NORTH CAROLINA VOCATIONAL REHABILITATION AND ALLIANCE HEALTH THAT PROVIDES CAREER DEVELOPMENT EXPERIENCES TO SENIOR HIGH SCHOOL STUDENTS WITH DEVELOPMENTAL AND INTELLECTUAL DISABILITIES. DUKE REGIONAL HOSPITAL CONTINUED TO SERVE AS A HOST SITE FOR PROJECT SEARCH ADDING 6 NEW GRADUATES IN 2023 FOR A TOTAL OF GRADUATES TO 95 TO DATE. APPROXIMATELY HALF ARE STILL EMPLOYED IN THE COMMUNITY, WITH FOUR GRADUATES WORKING AT DUKE REGIONAL HOSPITAL. 2. ACCESS TO HEALTHCARE AND HEALTH INSURANCE LINCOLN COMMUNITY HEALTH CENTER (LCHC): IS A FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER THAT PROVIDES PRIMARY CARE SERVICES FOR ABOUT 40,000 PATIENTS EACH YEAR. APPROXIMATELY 50 PERCENT OF LCHC PATIENTS ARE UNINSURED AND 52% ARE LIVING AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL. IN ADDITION TO FINANCIAL SUPPORT, DUKE REGIONAL HOSPITAL PROVIDES ENGINEERING, ENVIRONMENTAL, LABORATORY, PHARMACY AND RADIOLOGY SERVICES. THE TOTAL DUKE REGIONAL HOSPITAL CONTRIBUTION TO LCHC IN FY 2023, INCLUDING MONETARY AND IN-KIND SERVICES, WAS $8.8 MILLION.DURHAM COUNTY EMERGENCY MEDICAL SERVICES (EMS): SERVES AS THE PRIMARY PROVIDER OF EMERGENCY AMBULANCE SERVICES AND ALTERNATIVE MEDICAL TRANSPORTATION IN DURHAM COUNTY. IN FY 2023, DUKE REGIONAL HOSPITAL CONTRIBUTED $2.8 MILLION TO THE COUNTY TO SUPPORT DURHAM EMS.PROJECT ACCESS OF DURHAM COUNTY (PADC): COORDINATES SPECIALTY CARE AT NO CHARGE TO UNINSURED AND UNDERINSURED DURHAM RESIDENTS LIVING AT OR BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. THESE RESIDENTS HAVE ACCESS TO PRIMARY HEALTH CARE THROUGH LINCOLN COMMUNITY HEALTH CENTER. IN FY2023, DUKE REGIONAL HOSPITAL PROVIDED FINANCIAL SUPPORT OF $20,000 IN LIEU OF PROVIDING SPACE AFTER PADC RELOCATED TO A NON-HOSPITAL BUILDING IN FY2021.FINANCIAL ASSISTANCE: EACH YEAR DUKE REGIONAL HOSPITAL PROVIDES NO-COST OR DISCOUNTED URGENT OR EMERGENT HEALTH CARE SERVICES TO PATIENTS WHO WERE UNABLE TO PAY. IN FY 2023 DUKE REGIONAL PROVIDED $31.9 MILLION (AT ESTIMATED COST) IN FINANCIAL ASSISTANCE.IN ADDITION, DUKE REGIONAL HOSPITAL PROVIDED $500,000 IN PATIENT SPONSORSHIP SERVICES, WHICH INCLUDES EXPENSES SUCH AS PAYMENT FOR POST-ACUTE CARE, DURABLE MEDICAL EQUIPMENT, LODGING AND MEALS BASED ON SPECIFIC INDIGENT FUNDING GUIDELINES.4. MENTAL HEALTHIN 2021, DUKE REGIONAL OPENED THE NEW BEHAVIORAL HEALTH CENTER NORTH DURHAM AND EXPANDED EMERGENCY DEPARTMENT TO PROVIDE MORE COMPREHENSIVE CARE FOR OUR BEHAVIORAL HEALTH PATIENTS. THIS $102.4 MILLION PROJECT EXPANDED THE HOSPITAL'S EMERGENCY ROOM AND CONSOLIDATED INPATIENT, OUTPATIENT, AND EMERGENCY BEHAVIORAL HEALTH SERVICES ON DUKE REGIONAL'S CAMPUS, WITH THE GOAL OF PROVIDING BETTER COORDINATION OF CARE FOR BEHAVIORAL HEALTH PATIENTS IN DURHAM AND REGIONALLY. THE CENTER INCORPORATES MEETING SPACE SPECIALLY DESIGNED TO BE USED BY COMMUNITY-BASED ORGANIZATIONS PROVIDING SERVICES FOR BEHAVIORAL HEALTH PATIENTS AND THEIR FAMILIES.5. OBESITY, DIABETES, AND FOOD ACCESSBEYOND ITS CLINICAL SERVICE LINES IN THE HOSPITAL, DRH COLLABORATES WITH NUMEROUS DURHAM NON-PROFITS AND OTHER ENTITIES WITHIN THE DUKE UNIVERSITY HEALTH SYSTEM THAT ARE SPECIFICALLY FOCUSED ON COMMUNITY-BASED MECHANISMS FOR THE PREVENTION AND TREATMENT OF OBESITY AND DIABETES AND ON ISSUES OF FOOD ACCESS.IN ADDITION TO THE ABOVE ACTIVITIES SPECIFICALLY RELATED TO THE CHNA IDENTIFIED HEALTH PRIORITIES, DUKE REGIONAL HOSPITAL SUPPORTS HEALTH NEEDS OF ITS COMMUNITY IN THE FOLLOWING WAYS:THE LOOK GOOD FEEL BETTER PROGRAM IS A NON-MEDICAL, BRAND-NEUTRAL PROGRAM THAT PROVIDES SUPPORT FOR FEMALE CANCER TREATMENT PATIENTS WHO HAVE EXPERIENCED HAIR LOSS OR OTHER PHYSICAL APPEARANCE CHANGES DUE TO CHEMOTHERAPY OR RADIATION TREATMENTS. FOR MORE THAN A DECADE, DRH HAS SUPPORTED THIS PROGRAM AS A HOST SITE. DUE TO COVID-19, DUKE REGIONAL SPONSORED THE MONTHLY WORKSHOPS IN A VIRTUAL FORMAT AND HAVE CONTINUED IN THIS FORMAT THROUGH THE PRESENT TIME.STROKE SUPPORT: DUKE REGIONAL OFFERS A MONTHLY STROKE SUPPORT GROUP THAT PROVIDES EDUCATION, SUPPORT AND RESOURCES FOR INDIVIDUALS WHO HAVE BEEN AFFECTED BY STROKE. THE SUPPORT GROUP STARTED IN 2006 AND TYPICALLY HOSTS 20-25 PARTICIPANTS A MONTH (WITH A COMBINATION OF SURVIVORS AND CARE GIVERS). DURING FISCAL YEAR 2023, DUKE REGIONAL CONTINUED THE MONTHLY STROKE SUPPORT PROGRAM AND MOVED TO HYBRID MEETINGS (PARTICIPANTS CHOSE TO ATTEND IN PERSON OR VIRTUALLY).FUNDRAISING AND OUTREACH: DUKE REGIONAL CONDUCTS A NUMBER OF FUNDRAISING AND OUTREACH ACTIVITIES IN THE DURHAM COMMUNITY AND BEYOND. DUKE REGIONAL EMPLOYEES RAISE FUNDS EACH YEAR FOR CHARITABLE ORGANIZATIONS, INCLUDING DUKE COMMUNITY GIVING (INCLUDING UNITED WAY OF THE GREATER TRIANGLE), AND THE AMERICAN HEART ASSOCIATION. IN FY2023, DUKE REGIONAL RAISED $29,857 TO SUPPORT LOCAL CHARITIES.THE HOSPITAL CONTINUES TO PARTNER WITH LOCAL NONPROFITS ON ENDEAVORS THAT EDUCATE OUR COMMUNITY ABOUT HEALTH INITIATIVES AND DISPARATIES AND PROVIDES OFFICE SPACE FOR THE DURHAM COMMUNITY HEALTH COALITION. IN FY2023, DRH PARTNERED WTH THE AMERICAN RED CROSS TO HOST 5 BLOOD DRIVES. THESE DRIVES RESULTED IN COLLECTING 103 UNITS OF BLOOD. GROUP A - FACILITY 3 - DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 16J: AS PART OF DUHS, DUKE REGIONAL HOSPITAL PROVIDES A BROCHURE TO ALL ADMISSIONS THAT INCLUDES A BRIEF SUMMARY OF DUHS FINANCIAL ASSISTANCE POLICIES. DUHS ALSO COMMENTS ON THE BACK OF ITS BILLING INVOICES THAT PATIENTS SHOULD CONTACT PATIENT ACCOUNT REPRESENTATIVES TO HELP THEM IF THEY CANNOT PAY THEIR BILL IN FULL. THIS COMMENT REFERENCES GOVERNMENT-SPONSORED PROGRAMS, MONTHLY PAYMENT PROGRAMS, AND OTHER FINANCIAL ASSISTANCE PROGRAMS AVAILABLE FOR PATIENTS WHO MEET CERTAIN FINANCIAL CRITERIA. DUHS ALSO PUBLICIZED ITS FINANCIAL ASSISTANCE POLICY VERBALLY THROUGH ITS FINANCIAL CARE COUNSELORS.GROUP A - FACILITY 3 - DUKE REGIONAL HOSPITALPART V, SECTION B, LINE 24: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER ELECTIVE SERVICES, WERE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES. 8 1 - DUKE HEALTH CENTER ARRINGDON 5601 ARRINGDON PARK DRIVE MORRISVILLE NC 27560 SPECIALTY 2 - DUKE MEADOWMONT CHAPEL HILL 802 W BARBEE CHAPEL ROAD SUITE 100 CHAPEL HILL NC 27517 SPECIALTY 3 - DUKE IMAGING SERVICES 3700 NW CARY PARKWAY SUITE 120 CARY NC 27513 INDEPENDENT DIAGNOSTIC TESTING FACILITY 4 - DUKE HEALTH IMAGING AT HERITAGE 3000 ROGERS RD WAKE FOREST NC 27587 INDEPENDENT DIAGNOSTIC TESTING FACILITY 5 - DUKE PTOT AT HILLSBOROUGH 267 SOUTH CHURTON HILLSBOROUGH NC 27278 SPECIALTY 6 - DUKE HEALTH IMAGING AT HOLLY SPRINGS 401 IRVING PKWY HOLLY SPRINGS NC 27540 INDEPENDENT DIAGNOSTIC TESTING FACILITY 7 - HOCK FAMILY PAVILION 4023 NORTH ROXBORO ROAD DURHAM NC 27704 HOSPICE 8 - DUKE IMAGING COLEY HALL 66 VILCOM CENTER DR SUITE 101 CHAPEL HILL NC 27514 INDEPENDENT DIAGNOSTIC TESTING FACILITY PART I, LINE 3C: NOT APPLICABLEPART I, LINE 6A:NOT APPLICABLEPART I, LINE 7, COLUMN F:TOTAL GROSS COMMUNITY BENEFIT EXPENSE AS A PERCENT OF TOTAL EXPENSES IS 12.5%.PART I, LINE 7:CHARITY CARE AT COST IS DETERMINED USING THE COST-TO-CHARGE CALCULATION FROM WORKSHEET 2, IN ORDER TO CALCULATE THE AMOUNTS REPORTED ON THE TABLE. UNREIMBURSED MEDICAID IS DETERMINED USING A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS.CHARITY CARE, UNREIMBURSED MEDICAID, AND COMMUNITY HEALTH IMPROVEMENT SERVICES INCLUDE FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT COSTS PROVIDED BY DUHS' SUPPORT CORPORATIONS, DUKE UNIVERSITY AFFILIATED PHYSICIANS, ASSOCIATED HEALTH SERVICES, DUKE INTEGRATED NETWORK, AND WATTS COLLEGE OF NURSING THAT FILE SEPARATE 990S BUT ARE NOT REQUIRED TO COMPLETE A SCHEDULE H SINCE NOT A HOSPITAL. TOTAL NET COMMUNITY BENEFIT EXPENSES FOR THESE ENTITIES TOTALED $25.9 MILLION IN FY2023.PART II, COMMUNITY BUILDING ACTIVITIES:THESE ACTIVITIES ARE INCLUDED IN DUKE UNIVERSITY HEALTH SYSTEM, INC.'S (DUHS) OPERATING EXPENSES AND ARE NOT TRACKED SEPARATELY FOR COMMUNITY BENEFIT REPORTING PURPOSES.PART III, LINE 1 AND LINE 2:DUHS PROVIDED UNCOMPENSATED CARE AT ESTIMATED COSTS IN THE FORM OF IMPLICIT PRICE CONCESSIONS (CONSIDERED BAD DEBT EXPENSE PRIOR TO ADOPTION OF ACCOUNTING STANDARDS UPDATE 2014-16, "REVENUE FROM CONTRACTS WITH CUSTOMERS" IN FY2019) ASSOCIATED WITH UNCOLLECTIBLE PATIENT ACCOUNTS AT AN ESTIMATED COST OF $31,791,000 IN FISCAL YEAR 2023. DUHS USED THE COST-TO-CHARGE RATIO FROM WORKSHEET 2 TO ESTIMATE COST.PART III, LINE 3:DUHS PRESUMPTIVELY SCREENS ALL UNINSURED PATIENTS AND ALL PATIENTS ENTERING THROUGH THE EMERGENCY DEPARTMENT, REGARDLESS OF INSURANCE STATUS, FOR FINANCIAL ASSISTANCE. WHILE THESE PRESUMPTIVE PROCESSES IDENTIFY A SUBSET OF PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WITHOUT NEEDING DIRECT INPUT FROM THE PATIENT, THOSE WHO DO NOT FALL UNDER THE PRESUMPTIVE SCREENING CRITERIA WILL NEED TO PROVIDE INFORMATION TO QUALIFY FOR FINANCIAL ASSISTANCE UNDER DUHS' FINANCIAL ASSISTANCE POLICY. A PORTION OF IMPLICIT PRICE CONCESSIONS (FORMERLY CONSIDERED BAD DEBT EXPENSE) SHOULD BE INCLUDED AS A COMMUNITY BENEFIT, BUT THE PORTION THAT IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY IS INDETERMINABLE BECAUSE OF THOSE PATIENTS WHO FAIL TO APPLY FOR OR PROVIDE INFORMATION NEEDED TO DETERMINE THEIR ELIGIBILITY UNDER THE DUHS FAP. DUHS, INC. FOLLOWS ITS MISSION TO THE COMMUNITY AND PROVIDES EMERGENT SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. PATIENTS WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE ARE REPORTED AS AN IMPLICIT PRICE CONCESSION INSTEAD BECAUSE OF THOSE PATIENTS' INABILITY OR UNWILLINGNESS TO PROVIDE THE NECESSARY DOCUMENTATION REQUIRED TO DETERMINE FINANCIAL ASSISTANCE CLASSIFICATION.PART III, LINE 4:PAGES 17-20 IN THE FY2023 AUDITED FINANCIAL STATEMENT FOOTNOTES DESCRIBE IMPLICIT PRICE CONCESSIONS RELATED TO UNINSURED PATIENTS.PART III, LINE 7:TOTAL UNREIMBURSED COSTS ATTRIBUTABLE TO PROVIDING SERVICES UNDER MEDICARE AS REPORTED IN THE JUNE 30, 2023 DUHS CONSOLIDATED FINANCIAL STATEMENTS ARE $502,845,000 AS COMPARED TO $154,015,255 AS REPORTED IN SECTION B, LINE 7 OF SCHEDULE H. THE DUHS TOTAL MEDICARE SHORTFALL OF $502,845,000 IS DERIVED FROM THE COST ACCOUNTING SYSTEM WHICH INCLUDES ALL PAYMENTS AND COSTS ASSOCIATED WITH MEDICARE PATIENTS, WHEREAS THE AMOUNT REPORTED IN SECTION B OF SCHEDULE H IS DERIVED BASED ON IRS INSTRUCTIONS. IRS INSTRUCTIONS SPECIFY THAT ONLY A PORTION OF COSTS ASSOCIATED WITH MEDICARE BENEFICIARIES BE REPORTED ON SCHEDULE H. SIGNIFICANT MEDICARE COSTS EXCLUDED FROM SCHEDULE H DATA INCLUDE THOSE ASSOCIATED WITH MEDICARE PATIENTS COVERED UNDER MANAGED CARE PLANS AND COSTS REIMBURSED THROUGH MEANS NOT REPORTED ON THE COST REPORT.PART III, LINE 8:MEDICARE RATES AND THE NUMBER OF MEDICARE PATIENTS DUHS TREATS ARE NOT NEGOTIATED. MEDICARE DOES NOT FULLY COMPENSATE DUHS FOR THE COST OF PROVIDING CARE TO MEDICARE BENEFICIARIES. DUHS CONTINUES TO SERVE THE MEDICARE POPULATION AS MEDICARE REIMBURSEMENT RATES DECLINE RELATIVE TO THE COST OF CARE. THEREFORE, ANY LOSS RELATED TO PROVIDING CARE FOR MEDICARE PATIENTS SHOULD BE CLASSIFIED AS A COMMUNITY BENEFIT. DUHS FOLLOWED THE MEDICARE COST REPORT RULES AND GUIDELINES IN DETERMINING THE COSTS REPORTED ON LINE 6. THESE RULES USE A VARIETY OF DIFFERENT METHODOLOGIES BASED ON THE TYPE OF SERVICE.PART III, LINE 9B:COLLECTION EFFORTS ARE IMMEDIATELY STOPPED FOR PATIENTS WHO SUBMIT A FINANCIAL ASSISTANCE APPLICATION. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT PURSUED USING ANY DEBT COLLECTION PRACTICES. NEEDS ASSESSMENT: PART VI, LINE 2:DUHS USES SEVERAL MECHANISMS TO ASSESS AND ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. DUHS IS A LEAD PARTNER ON THE DEVELOPMENT OF COMMUNITY HEALTH NEEDS ASSESSMENTS IN DURHAM COUNTY AND WAKE COUNTY. DUHS ACTIVELY VOLUNTEERS TO COLLECT DATA AND PARTICIPATE ON COMMITTEES IDENTIFYING THE PRIORITIES AND DEVELOPING STRATEGIES TO ADDRESS THE IDENTIFIED PRIORITIES. IN 2019, DUHS BEGAN A PILOT OF SCREENING ITS PATIENTS FOR UNMET SOCIAL NEEDS INCLUDING FOOD INSECURITY, HOUSING INSECURITY, TRANSPORTATION, AND MENTAL HEALTH. THE SCREENING IS MANAGED THROUGH EPIC AND WHEN PATIENTS SCREEN POSITIVE FOR A SOCIAL NEED, DUHS MAKES AN IMMEDIATE REFERRAL, THROUGH A STATEWIDE SYSTEM CALLED NCCARE360, TO COMMUNITY-BASED RESOURCES THAT PROVIDE SUPPORT SERVICES IN THE IDENTIFIED AREA(S). OVER 50 SITES ARE PARTICIPATING IN THE SCREENING OF SOCIAL NEEDS. DUKE UNIVERSITY'S BOARD OF TRUSTEES APPROVED THE STRATEGIC COMMUNITY IMPACT PLAN (SCIP) IN 2019 WHICH OUTLINES FIVE COMMUNITY FOCUS AREAS AND PRIORITIES BASED ON COMMUNITY LISTENING SESSIONS: (1) HOUSING (PRIORITY: AFFORDABLE HOUSING AND INFRASTRUCTURE; (2) EDUCATION (PRIORITY: EARLY CHILDHOOD DEVELOPMENT); (3) EMPLOYMENT (PRIORITY: COLLEGE AND CAREER READINESS); (4) HEALTH (PRIORITY: FOOD SECURITY); AND (5) COMMUNITY (PRIORITY: NONPROFIT CAPACITY). THESE FOCUS AREAS ALIGN WITH THE CHNA PRIORITIES AND PATIENT SCREENING DATA. DUHS HAS EMBRACED THE SCIP AS AN INTEGRAL PART OF ITS STRATEGIC GOAL TO ADVANCE HEALTH EQUITY. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:PART VI, LINE 3:DUHS EMPLOYS NUMEROUS MEANS TO EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE DUHS FINANCIAL ASSISTANCE POLICY. DETAILED INFORMATION IS POSTED ON WWW.DUKEHEALTH.ORG (DUHS' WEBSITE) ALONG WITH HARDCOPY BROCHURES THAT ARE AVAILABLE IN ENGLISH OR SPANISH AT ALL OF OUR PATIENT REGISTRATION LOCATIONS. ALL INPATIENTS AND EMERGENCY DEPARTMENT PATIENTS ARE ALSO PROVIDED WITH A HARDCOPY, ONE-PAGE SUMMARY OF THE WAYS DUHS CAN ASSIST PATIENTS FINANCIALLY. FOR OUTPATIENTS, THIS SAME ONE-PAGE SUMMARY IS PROVIDED ON THEIR FIRST VISIT TO THE INSTITUTION. IN ADDITION, DUHS EMPLOYS FINANCIAL CARE COUNSELORS WHO MEET INDIVIDUALLY WITH PATIENTS WHO HAVE QUESTIONS REGARDING PAYMENT FOR THEIR CARE. DUHS ALSO EMPLOYS MEDICAID ASSISTANCE COUNSELORS WHO SPECIALIZE IN ASSISTING PATIENTS TO APPLY FOR MEDICAID, DISABILITY, AND OTHER FEDERAL, STATE, AND LOCAL PROGRAMS. DUHS ASSISTS BETWEEN 12,000-15,000 PATIENTS IN APPLYING AND BECOMING ELIGIBLE FOR THESE PROGRAMS ANNUALLY. FINALLY, PATIENTS MAY ALWAYS CONTACT DUHS' TOLL FREE CUSTOMER SERVICE NUMBER TO REQUEST INFORMATION ABOUT THEIR BILL OR OBTAIN A FINANCIAL ASSISTANCE APPLICATION.COMMUNITY INFORMATION:PART VI, LINE 4:DUHS SERVES A BROAD, CULTURALLY, RACIALLY AND SOCIALLY DIVERSE GEOGRAPHIC AND DEMOGRAPHIC REGION. DUHS' HOME CITY OF DURHAM IS THE CORE, BUT DUHS' REACH EXTENDS INTO THE SURROUNDING RESEARCH TRIANGLE AREA OF NORTH CAROLINA AND THE STATE'S LARGER NORTHERN PIEDMONT REGION, AS WELL AS STATEWIDE, NATIONALLY AND GLOBALLY. DUHS' PRIMARY SERVICE AREA (PSA) IS A 7-COUNTY REGION IN NC THAT INCLUDES ALAMANCE, DURHAM, GRANVILLE, ORANGE, PERSON, VANCE AND WAKE COUNTIES. WITH A POPULATION OF ALMOST 2.1 MILLION, THIS 7-COUNTY REGION REPRESENTS APPROXIMATELY 19% OF NC'S POPULATION BASED ON FEDERAL FISCAL YEAR (FFY) 2022 DATA. THE WEIGHTED AVERAGE MEDIAN HOUSEHOLD INCOME IN ITS PSA IS $74,695. APPROXIMATELY 67% OF INPATIENT DISCHARGES FROM DUHS FACILITIES IN FFY 2022 WERE PATIENTS FROM ITS PSA. THE POPULATION IN DUHS' PSA IS EXPECTED TO GROW AT A HIGHER RATE OVER THE NEXT 5 YEARS FROM 2023 TO 2028 COMPARED TO NC'S OVERALL EXPECTED POPULATION GROWTH RATE. THE PSA 5-YEAR CAGR IS EXPECTED TO BE 1.2% COMPARED TO THE OVERALL ESTIMATED NC RATE OF 0.7%. DUHS' SECONDARY SERVICE AREA COVERS 15 COUNTIES IN NORTH CAROLINA AND SOUTHERN VIRGINIA WITH A POPULATION OF APPROXIMATELY 2 MILLION. PROMOTION OF COMMUNITY HEALTH:PART VI, LINE 5:DUHS PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH A NUMBER OF COMMUNITY BUILDING ACTIVITIES. CENTRAL TO MANY OF THE EFFORTS IS DUHS' OFFICE OF COMMUNITY HEALTH (OCH). OCH REPORTS DUALLY TO (1) THE CHANCELLOR/CEO OF THE HEALTH SYSTEM AND (2) DUKE'S VICE PRESIDENT OF COMMUNITY AFFAIRS TO FACILITATE LEVERAGING ASSETS ACROSS THE ENTIRE DUKE ENTERPRISE TO ASSESS AND ADDRESS COMMUNITY NEEDS. OCH ALSO FACILITATES THE DEVELOPMENT OF COORDINATED, SYSTEM-LEVEL INITIATIVES TO ADDRESS IDENTIFIED COMMUNITY NEEDS IN PARTNERSHIP WITH COMMUNITY-BASED ORGANIZATIONS. OCH ORGANIZES ANNUAL HEALTH SUMMITS TO BRING COMMUNITY MEMBERS, ELECTED OFFICIALS, PROVIDERS, AND OTHERS TOGETHER TO GENERATE AND SHARE INFORMATION, COLLECT ADDITIONAL DATA, AND DEVELOP STRATEGIES COLLABORATIVELY IN SOCIAL DRIVERS AREAS. DUHS' OFFICE OF COMMUNITY HEALTH ASSOCIATE VICE PRESIDENT SERVES AS A FULL-TIME LIAISON IN DURHAM AND IN DUHS' PRIMARY SERVICE AREAS. THE OFFICE SPONSORS AND FACILITATES COMMUNITY EVENTS SUCH AS THE ANNUAL COMMUNITY HEALTH SUMMIT AND SIMILAR REGIONAL AND STATE HEALTH SUMMITS THAT RAISE AWARENESS OF COMMUNITY HEALTH NEEDS, PROMOTE PREVENTION AND WELLNESS, AND CHART A COURSE FOR SOLVING HEALTH-RELATED SOCIAL NEED (HRSN) ISSUES AND DISPARITIES. IN ADDITION, THE OFFICE PROVIDES A POINT OF DIRECT CONTACT FOR COMMUNITY MEMBERS WHO HAVE QUESTIONS OR CONCERNS ABOUT COMMUNITY ISSUES OR ABOUT ACCESS TO HEALTH CARE SERVICES. THE OFFICE ALSO PROVIDES DIRECT FINANCIAL SUPPORT TO A VARIETY OF COMMUNITY GROUPS THROUGH THE BUILDING HEALTHY COMMUNITIES GRANTS PROGRAM. THE ASSOCIATE VICE-PRESIDENT AND STAFF SERVE ON A NUMBER OF COMMUNITY BOARDS AND HEALTH-RELATED COMMITTEES. STAFF FROM THE OFFICE OF COMMUNITY HEALTH AND DUHS REPRESENTATIVES IMMERSED IN COMMUNITY ENGAGEMENT ACTIVITIES CREATED FORMAL PRINCIPLES OF COMMUNITY ENGAGEMENT THAT COMMIT DUHS AND ITS COMMUNITY PARTNERS TO DEVELOPING PROPOSED PROJECTS AND INITIATIVES BASED ON TRUST, RESPECT, DIVERSITY, SAFETY AND COMMUNITY-IDENTIFIED NEEDS. THESE PRINCIPLES HAVE BEEN INCORPORATED INTO COMMUNITY-BASED HEALTHCARE PROJECTS INCLUDING COMMUNITY CLINICS, FOCUS GROUPS, CHNA IMPLEMENTATION PLANS, AND DUHS' ANNUAL HEALTH SUMMIT. IN ADDITION TO COMMUNITY BUILDING ACTIVITIES, DUHS PROMOTES THE HEALTH OF ITS COMMUNITIES IN A NUMBER OF IMPORTANT WAYS. ONE OF DUHS' THREE CONSTITUENT HOSPITALS, DUKE REGIONAL, HAS AN OPEN MEDICAL STAFF AND A HOSPITAL CORPORATION BOARD, WHICH IS A COUNTY APPOINTED BOARD RESPONSIBLE FOR HOSPITAL OVERSIGHT. IN ADDITION, APPROXIMATELY 50 LOCAL LEADERS IN THE DURHAM FAITH COMMUNITY ARE WORKING WITH DUKE HEALTH TO LOOK AT HOW TO ADDRESS THE NEEDS OF THEIR CONGREGATIONS AND COMMUNITIES BY COMBINING THE TRADITIONS OF THE FAITH COMMUNITY WITH THE KNOWLEDGE OF MODERN MEDICINE. DUHS' CEO ALSO HAS A CHANCELLOR'S COMMUNITY HEALTH ADVISORY BOARD TO PROVIDE FEEDBACK ON A VARIETY OF ISSUES, INCLUDING USE OF DUHS RESOURCES, HEALTH SERVICE DELIVERY SYSTEMS AND LONG-RANGE GOALS TO REDUCE HEALTH RISKS AND DISPARITIES IN DURHAM COUNTY. THE BOARD INCLUDES STATE AND LOCAL ELECTED OFFICIALS, NEIGHBORHOOD COUNCILS AND OTHER GRASSROOTS ORGANIZATIONS, POLITICAL GROUPS, DURHAM PUBLIC SCHOOLS, AMONG OTHERS. DUHS MAINTAINS A BUILDING HEALTHY COMMUNITIES GRANTS COMMITTEE TO REVIEW COMMUNITY REQUESTS FOR PHILANTHROPIC ASSISTANCE THAT PROMOTE HEALTH AND WELLNESS. DUHS FORMED A COMMUNITY HEALTH EXECUTIVE COUNCIL COMPRISED OF LEADERS ACROSS DUKE HEALTH TO OVERSEE STRATEGIES DESIGNED TO ADVANCE HEALTH EQUITY AND ADDRESS HEALTH-RELATED SOCIAL NEEDS. ADDITIONALLY, SEVERAL COMMITTEES/COUNCILS HAVE BEEN FORMED AROUND SPECIFIC HEALTH-RELATED SOCIAL NEEDS TO DISCUSS COMMUNITY STATUS, CAPACITY NEEDS OF COMMUNITY-BASED ORGANIZATIONS, AND TO INFORM SYSTEM-LEVEL EFFORTS.DUKE HEALTH PROVIDES VARIOUS OPPORTUNITIES FOR STUDENTS TO INTERACT WITH DIFFERENT HEALTH CARE PROFESSIONALS ACROSS THE SYSTEM. THE OFFICE OF COMMUNITY HEALTH, DRH, AND OTHER KEY COMMUNITY PARTICIPANTS ARE ACTIVE IN A WORKFORCE DEVELOPMENT PROJECT CALLED PROJECT SEARCH. THIS PROGRAM, MODELED AFTER THE PROGRAM AT CINCINNATI CHILDREN'S HOSPITAL, PROVIDES YOUTH WITH DISABILITIES EMPLOYMENT TRAINING AND CAREER OPPORTUNITIES IN DURHAM-ORANGE MEDICAL SOCIETY AND THE DURHAM ACADEMY OF MEDICINE, DENTISTRY AND PHARMACY (AN ASSOCIATION FOR AFRICAN-AMERICAN MEDICAL PROFESSIONALS) TO PROMOTE THE SUCCESS OF THE CITY OF MEDICINE ACADEMY (CMA). THE CMA IS A PUBLIC MAGNET HIGH SCHOOL DESIGNED FOR STUDENTS INTERESTED IN HEALTH CARE CAREERS. FACULTY ARE INVOLVED WITH MENTORING STUDENTS AND CLASSROOM LECTURES. DUHS IS A KEY PARTICIPANT IN THE ANNUAL BULL CITY FRESH START EVENT. STAFF FROM THE DUKE SCHOOL OF NURSING, DUKE EYE CENTER, AND STAFF AFFILIATED WITH LINCOLN COMMUNITY HEALTH CENTER HEALTHCARE FOR THE HOMELESS CLINIC VOLUNTEER TIME AND RESOURCES AT THIS IMPORTANT EVENT. STUDENTS FROM THE DUKE SCHOOLS OF MEDICINE AND NURSING ENGAGE COMMUNITIES IN DURHAM AND BEYOND IN ACTIVITIES THAT INCLUDE FREE BLOOD PRESSURE SCREENINGS FOR THE HOMELESS, AND IDENTIFYING THE HEALTH CARE NEEDS OF A LOW WEALTH COMMUNITY SCHOOL AND DEVELOPING A CURRICULUM FOR STUDENTS AND PARENTS THAT ADDRESSES THOSE NEEDS. STUDENTS HAVE ALSO FORMED FOOD SECURITY INITIATIVES INCLUDING ROOT CAUSES' FRESH PRODUCE PROGRAM THAT DISTRIBUTES FOOD TO COMMUNITY RESIDENTS BASED ON PROVIDER PRESCRIPTIONS. OCH IS ALSO AN ADVISOR TO A STUDENT-LED GROUP CALLED THE FOOD RECOVERY NETWORK THAT PACKAGES UNUSED, PREPARED MEALS FROM DINING SERVICES ACROSS THE UNIVERSITY AND DELIVERS THEM TO COMMUNITY-BASED ORGANIZATIONS FOR DISTRIBUTION TO COMMUNITY MEMBERS IN NEED.AFFILIATED HEALTH CARE SYSTEM ROLES:PART VI, LINE 6:DUHS PROVIDES VIRTUALLY ALL LEVELS OF CARE BEGINNING WITH DUKE UNIVERSITY AFFILIATED PHYSICIANS (DBA DUKE PRIMARY CARE) (DPC). DPC IS A BROAD NETWORK OF COMMUNITY-BASED SERVICES THAT INCLUDE FAMILY MEDICINE, PEDIATRICS, INTERNAL MEDICINE, AND URGENT CARE. THE HOSPITALS PROVIDE ROUTINE INPATIENT AND OUTPATIENT CARE. IN DURHAM COUNTY, DUH AND DRH WORK TOGETHER TO MAXIMIZE FACILITY UTILIZATION PROVIDING ROUTINE AND ADVANCED LEVELS OF CARE. DUH ALSO OPERATES A TRAUMA CENTER WITH AIR AMBULANCE SERVICE. DRAH SERVES THE WAKE COUNTY AREA AS A COMMUNITY HOSPITAL. THE DRAH CAMPUS HAS SEVERAL MEDICAL OFFICE BUILDINGS ENHANCING CONVENIENCE FOR THE PATIENT IN NON-EMERGENT CASES AND PROVIDES STREAMLINED ACCESS TO HIGH-DEMAND PROCEDURES SUCH AS CARDIAC CATHETERIZATION AND RADIOLOGY PROCEDURES. DUHS CONTINUES TO EXPAND ITS AMBULATORY FOOTPRINT TO PROVIDE CARE CLOSE TO PATIENTS' HOMES, EXTEND ACCESS TO NEW COMMUNITIES AND MEET GROWING POPULATION NEEDS EFFICIENTLY AND EFFECTIVELY. DUHS' POPULATION HEALTH MANAGEMENT OFFICE WITHIN DUKE INTEGRATED NETWORK, INC. IS THE CENTRAL ENTITY AT DUKE GUIDING CARE TRANSFORMATION FOR VALUE BASED CARE, INCLUDING CARE MANAGEMENT PROGRAMS AND DEPLOYMENT OF RELATED DATA AND ANALYTICS PROGRAMS, AS WELL AS FOSTERING RELATIONSHIPS WITH PAYERS, COMMUNITY RESOURCES, AND PHYSICIANS WITHIN THE SERVICE AREA. DUHS ALSO OPERATES HOME HEALTH AND HOME INFUSION SERVICES TO TREAT AND CARE FOR PATIENTS IN THE COMFORT OF THEIR HOME. THIS IS OBVIOUSLY PRACTICAL FOR PATIENTS NOT REQUIRING AN INPATIENT STAY BUT IN NEED OF ONGOING CARE AT A SUB-ACUTE LEVEL. FINALLY, HOSPICE PROVIDES PALLIATIVE CARE FOR PATIENTS NOT RESPONDING TO CURATIVE CARE. PAIN MANAGEMENT, SYMPTOM MANAGEMENT, AND PSYCHOLOGICAL AND SPIRITUAL SUPPORT PROVIDE A ROUNDED APPROACH TO COMPASSIONATELY ASSIST TERMINAL PATIENTS AND THEIR FAMILIES WITH THE PROCESS OF DYING. ALL OF THE OPERATING UNITS OF DUHS WORK TOGETHER TO PROVIDE THE RIGHT LEVEL OF CARE FOR THE PATIENT IN THE MOST BENEFICIAL MANNER. IN ADDITION TO THE REACTIVE ACTIVITIES OF DIAGNOSTIC CARE, DUHS ALSO SUPPORTS AND PROMOTES HEALTH AND WELL-BEING AT DUKE HEALTH & FITNESS CENTER, AND DUKE INTEGRATIVE MEDICINE. THESE SERVICES INCLUDE A MEDICALLY-BASED WEIGHT LOSS PROGRAM, MEDICALLY-BASED FITNESS, WELLNESS AND REHABILITATION PROGRAMS.LIST OF ALL STATES WHICH ORGANIZATION FILES A COMMUNITY BENEFIT REPORT:PART VI, LINE 7:NORTH CAROLINA 1 ALICE AYCOCK POE CTR FOR HEALTH EDUCATION 224 SUNNYBROOK RD RALEIGH NC 27610 561500678 501(C)(3) 12500 0 SPONSORSHIP ALLIANCE MEDICAL MINISTRY INC 101 DONALD ROSS DR RALEIGH NC 27610 562168673 501(C)(3) 30000 0 COMMUNITY SUPPORT AMERICAN HEART ASSOCIATION INC PO BOX 4002900 DES MOINES IA 503402900 135613797 501(C)(3) 150000 0 SPONSORSHIP BIG BROTHERS BIG SISTERS OF THE TRIANGLE 808 AVIATION PKWY SUITE 900 MORRISVILLE NC 27560 562109717 501(C)(3) 7500 0 COMMUNITY SUPPORT BOYS & GIRLS CLUBS OF DURHAM & ORANGE COUNTIES 1010 MARTIN LUTHER KING JR PKW DURHAM NC 27713 566001906 501(C)(3) 25000 0 COMMUNITY SUPPORT CAPSTONE EVENT GROUP LLC 3803-B COMPUTER DR SUITE 205 RALEIGH NC 27609 464157559 13000 0 SPONSORSHIP CARING HOUSE INC 2625 PICKETT RD DURHAM NC 277055603 561647154 501(C)(3) 43833 0 GENERAL SUPPORT CAROL EMMOTT FOUNDATION 4931 SW 76TH AVE 229 PORTLAND OR 97225 841882898 501(C)(3) 20000 0 GENERAL SUPPORT CATHOLIC CHARITIES OF THE DIOCESE OF RALEIGH 7200 STONEHENGE DR RALEIGH NC 27613 560529943 501(C)(3) 25000 0 COMMUNITY SUPPORT CENTER FOR VOLUNTEER CAREGIVING 1150 SE MAYNARD RD STE 210 CARY NC 27511 582067482 501(C)(3) 10000 0 COMMUNITY SUPPORT CHATHAM OUTREACH ALLIANCE PO BOX 1326 PITTSBORO NC 27312 561668767 501(C)(3) 12500 0 COMMUNITY SUPPORT CHILDRENS CANCER PARTNERS 900 S PINE ST STE F SPARTANBURG SC 29302 202511033 501(C)(3) 10000 0 COMMUNITY SUPPORT CHILDRENS FLIGHT OF HOPE INC 1005 DRESSER CT RALEIGH NC 27609 561762824 501(C)(3) 30000 0 COMMUNITY SUPPORT COMMUNITIES IN PARTNERSHIP PO BOX 11247 DURHAM NC 27703 475567396 501(C)(3) 60000 0 COMMUNITY SUPPORT COMMUNITY EMPOWERMENT FUND 208 N COLUMBIA ST SUITE 100 CHAPEL HILL NC 275143504 270428981 501(C)(3) 7500 0 COMMUNITY SUPPORT DURHAM CENTER FOR SENIOR LIFE 406 RIGSBEE AVE SUITE 202 DURHAM NC 27701 560886647 501(C)(3) 15000 0 COMMUNITY SUPPORT DURHAM SUCCESS SUMMIT INC 732 9TH STREET 596 DURHAM NC 27705 862985757 501(C)(3) 7500 0 COMMUNITY SUPPORT EL CENTRO HISPANO INC 2000 CHAPEL HILL RD 26A DURHAM NC 27707 562011661 501(C)(3) 10000 0 COMMUNITY SUPPORT EL FUTURO INC 2020 E CHAPEL HILL ROAD SUITE 23 DURHAM NC 27707 800122334 501(C)(3) 59000 0 COMMUNITY SUPPORT FAMILY VIOLENCE PREVENTION CENTER INC 1012 OBERLINE RD SUITE 100 RALEIGH NC 27605 581320613 501(C)(3) 62500 0 COMMUNITY SUPPORT FIGHT FOR 1 OF US INC 8024 GLENWOOD AVE SUITE 200 RALEIGH NC 27607 274754653 501(C)(3) 16750 0 SPONSORSHIP FOOD BANK OF CENTRAL AND EASTERN 1924 CAPITAL BLVD RALEIGH NC 27604 561283426 501(C)(3) 10000 0 COMMUNITY SUPPORT FRIENDS OF FREMONT PEOPLE'S FREE 106 PANAMINT DRIVE DURHAM NC 27705 920823631 501(C)(3) 15000 0 COMMUNITY SUPPORT GET HAPPY 115 WINDERMERE DRIVE 404 DURHAM NC 27712 863862455 501(C)(3) 7500 0 SPONSORSHIP GREAT 100 INC PO BOX 4875 GREENSBORO NC 274044875 561705456 501(C)(3) 30000 0 SPONSORSHIP GREATER RALEIGH CHAMBER OF COMMERCE 800 S SALISBURY ST RALEIGH NC 27601 560370850 501(C)(6) 62625 0 COMMUNITY SUPPORT/SPONSORSHIP HEALING TRANSITIONS INC 1251 GOODE STREET RALEIGH NC 27603 562135246 501(C)(3) 25000 0 COMMUNITY SUPPORT HOUSING FOR NEW HOPE INC 18 W COLONY PLACE SUITE 250 DURHAM NC 27705 582089068 501(C)(3) 25525 0 COMMUNITY SUPPORT INTER-FAITH FOOD SHUTTLE 1001 BLAIR DR RALEIGH NC 27620 561753180 501(C)(3) 20250 0 COMMUNITY SUPPORT JUSTICEMATTERS INC PO BOX 199 DURHAM NC 27702 271378558 501(C)(3) 7500 0 COMMUNITY SUPPORT LATIN 19 100 W MORGAN ST DURHAM NC 27701 872248916 501(C)(3) 12500 0 COMMUNITY SUPPORT LIFE SKILLS FOUNDATION PO BOX 51129 DURHAM NC 27712 203676000 501(C)(3) 14750 0 COMMUNITY SUPPORT MEALS ON WHEELS OF DURHAM INC 2522 ROSS RD DURHAM NC 27703 561729111 501(C)(3) 5500 0 COMMUNITY SUPPORT MIDTOWN EVENTS LLC 4321 LASSITER AT NORTH HILLS AVE ST RALEIGH NC 27609 271832351 20000 0 SPONSORSHIP MIDTOWN RALEIGH ALLIANCE 7413 SIX FORKS RD STE 259 RALEIGH NC 27615 452559048 501(C)(3) 13000 0 SPONSORSHIP MUDCATS BASEBALL LLC ONE BREWERS WAY MILWAUKEE WI 53214 274165120 6000 0 SPONSORSHIP NATIONAL INSTITUTE OF MINORITY ECON 114 PARRISH ST DURHAM NC 27702 561579041 501(C)(3) 10000 0 COMMUNITY SUPPORT NORTH CAROLINA SECRETARY OF STATE PO BOX 29622 RALEIGH NC 27626 561611340 0 7517 FMV COMMUNITY SUPPORT COMMUNITY SUPPORT NORTH CAROLINA SYMPHONY SOCIETY INC 3700 GLENWOOD AVE SUITE 130 RALEIGH NC 27612 560556755 501(C)(3) 12500 0 COMMUNITY SUPPORT NURSES ON BOARDS COALITION PO BOX 14535 MADISON WI 53708 821962611 501(C)(3) 10000 0 GENERAL SUPPORT OPEN TABLES MINISTRY PO BOX 51363 DURHAM NC 27717 270977564 501(C)(3) 10000 0 COMMUNITY SUPPORT REINVESTMENT PARTNERS PO BOX 1929 DURHAM NC 277021929 311587628 501(C)(3) 10000 0 COMMUNITY SUPPORT RESCUE MISSIONS MINISTRIES INC PO BOX 11368 DURHAM NC 27703 581482590 501(C)(3) 15000 0 COMMUNITY SUPPORT RONALD MCDONALD HOUSE OF DURHAM 506 ALEXANDER AVE DURHAM NC 27705 561220376 501(C)(3) 50000 0 SPONSORSHIP SAMARITAN HEALTH CENTER PO BOX 51339 DURHAM NC 27717 263770762 501(C)(3) 25000 0 COMMUNITY SUPPORT SENIOR PHARMASSIST INC 406 RIGSBEE AVE STE 201 DURHAM NC 277012186 562084639 501(C)(3) 11000 0 COMMUNITY SUPPORT STEPUP DURHAM 112 BROADWAY ST SUITE B DURHAM NC 27701 474578727 501(C)(3) 10000 0 COMMUNITY SUPPORT STRONGHER TOGETHER INC PO BOX 52142 DURHAM NC 27707 821595797 501(C)(3) 10000 0 COMMUNITY SUPPORT STUDENT U 600 E UMSTEAD ST DURHAM NC 27701 273460491 501(C)(3) 30000 0 COMMUNITY SUPPORT SUNRISE COMMUNITY FOR RECOVERY AND 50 S FRENCH BROAD AVE STE 246 ASHVILLE NC 28802 205775122 501(C)(3) 10000 0 COMMUNITY SUPPORT SUSAN G KOMEN BREAST CANCER FOUNDATION 13770 NOEL RD STE 801889 DALLAS TX 75380 751835298 501(C)(3) 110000 0 SPONSORSHIP TABLE MINISTRIES INC 209 E MAIN STREET CARRBORO NC 27510 261471735 501(C)(3) 17500 0 COMMUNITY SUPPORT TRIANGLE FAMILY SERVICES 3937 WESTERN BLVD RALEIGH NC 27606 560547491 501(C)(3) 15000 0 COMMUNITY SUPPORT TROSA INC 1820 JAMES ST DURHAM NC 277072024 561861158 501(C)(3) 55000 0 COMMUNITY SUPPORT UNC HEALTH FOUNDATION INC PO BOX 1050 CB 7565 CHAPEL HILL NC 27514 566057494 501(C)(3) 100000 0 COMMUNITY SUPPORT URBAN MINISTRIES OF DURHAM INC PO BOX 249 DURHAM NC 27702 581505891 501(C)(3) 12500 0 COMMUNITY SUPPORT URBAN MINISTRIES OF WAKE COUNTY 1390 CAPITAL BLVD RALEIGH NC 27603 581422700 501(C)(3) 12500 0 COMMUNITY SUPPORT WAKE COUNTY CONTINUMN OF CARE PO BOX 12044 RALEIGH NC 27605 651267717 501(C)(3) 12500 0 COMMUNITY SUPPORT WAKE COUNTY MEDICAL SOCIETY COMM 7474 CREEDMOOR ROAD 164 RALEIGH NC 27613 562205175 501(C)(3) 8333 0 SPONSORSHIP WAKE TECH COMM COLL FOUNDATION 9101 FAYETTEVILLE RD RALEIGH NC 276035696 237017752 501(C)(3) 17000 0 COMMUNITY SUPPORT WEST END COMMUNITY FOUNDATION INC PO BOX 51398 DURHAM NC 27717 561858174 501(C)(3) 6500 0 COMMUNITY SUPPORT WOMENS CENTER OF WAKE COUNTY INC 400 S WEST STREET RALEIGH NC 27601 581316004 501(C)(3) 20000 0 COMMUNITY SUPPORT YMCA OF THE TRIANGLE AREA INC 801 CORPORATE CENTER DR STE 200 RALEIGH NC 27607 560591307 501(C)(3) 15000 0 COMMUNITY SUPPORT 59 4 FINANCIAL ASSISTANCE 61 62292 0 SCHEDULE I, PART I, LINE 2 DUKE UNIVERSITY HEALTH SYSTEM, INC. PROVIDES GENERAL SUPPORT TO LOCAL ORGANIZATIONS BASED ON OUR AWARENESS OF THEIR ACTIVITIES WITHIN THE LOCAL COMMUNITY. DUKE UNIVERSITY HEALTH SYSTEM, INC. ALSO MAINTAINS A BUILDING HEALTHY COMMUNITIES GRANTS PROGRAM THAT REVIEWS COMMUNITY REQUESTS FOR PHILANTHROPIC ASSISTANCE THAT PROMOTE HEALTH AND WELLNESS. X X 1 1 X X X X X X 0 0 0 0 0 0 0 1 0 A EUGENE WASHINGTON MD DIRECTOR/PRESIDENT 0 1574285 0 1547467 0 20500 0 37164 0 19338 0 3198754 0 0 VINCENT E PRICE DIRECTOR 0 1730692 0 0 0 20500 0 37164 0 23691 0 1812047 0 0 WILLIAM J FULKERSON MD FORMER OFFICER 0 952651 0 730131 0 80881 0 37164 0 9235 0 1810062 0 0 JOHN P MORDACH SVP, CFO, PART YEAR TREASURER 890430 0 672061 0 20500 0 37164 0 31870 0 1652025 0 0 0 THOMAS A OWENS MD EXECUTIVE VICE PRESIDENT, DUHS 855279 0 505470 0 80559 0 37164 0 15990 0 1494462 0 0 0 CRAIG T ALBANESE MD CEO 1123435 0 263555 0 20500 0 37164 0 19941 0 1464595 0 0 0 MARY E KLOTMAN MD DIRECTOR 0 811689 0 403392 0 20500 0 37164 0 17328 0 1290073 0 0 JEFFREY M FERRANTI SENIOR VP/CHIEF DIGITAL OFFICER 579609 93942 447098 35244 20500 0 37164 0 30135 0 1114506 129186 0 0 RICHARD PATRICK SHANNON CHIEF QUALITY OFFICER 709932 0 261342 0 20500 0 37164 0 24508 0 1053446 0 0 0 RHONDA BRANDON CHIEF HR OFFICER 521551 0 280344 0 20500 0 37164 0 28824 0 888383 0 0 0 MONTE D BROWN MD VP FOR ADMINISTRATION/SECRETARY 445237 0 304240 0 32138 0 37164 0 19403 0 838182 0 0 0 KEITH STOVER VP FINANCE/COO, PRMO 474434 0 220075 0 20577 0 37164 0 26178 0 778428 0 0 0 MARY K MARTIN CHIEF OPERATING OFFICER, DUH 506635 0 173004 0 0 0 37164 0 30617 0 747420 0 0 0 ROBERT N WILLIS VP FINANCE/CONTROLLER/CAO/INTERIM TR 447603 0 216657 0 20500 0 37164 0 17739 0 739663 0 0 0 KATHLEEN GALBRAITH PART YEAR PRESIDENT, DUKE REGIONAL H 354308 0 249860 0 15000 0 37164 0 65700 0 722032 0 0 0 JOHN SMITH VP FINANCE 387894 0 241514 0 20500 0 37164 0 14793 0 701865 0 0 0 BARBARA M GRIFFITH MD PRESIDENT, DUKE RALEIGH HOSPITAL 498612 0 113333 0 192 0 36474 0 27673 0 676284 0 0 0 MARY ANN FUCHS VP PATIENT CARE/CHIEF NURSING OFFICE 423366 0 201857 0 0 0 37164 0 8915 0 671302 0 0 0 DEVDUTTA SANGVAI MD PART YEAR PRESIDENT, DUKE REGIONAL H 375724 8564 163548 0 0 0 36552 0 77085 0 652909 8564 0 0 MOIRA RYNN MD DIRECTOR 0 432006 0 51793 0 0 0 37164 0 19054 0 540017 0 0 ERIK PAULSON DIRECTOR 0 363084 0 72420 0 20500 0 37164 0 25508 0 518676 0 0 LEIGH BLEECKER FORMER KEY EMPLOYEE 246661 0 158279 0 141 0 37028 0 13324 0 455433 0 0 0 PART I, LINE 1A CRAIG T. ALBANESE, MD USED FIRST CLASS OR CHARTER TRAVEL SERVICES. SUCH TRAVEL WAS FOR BUSINESS PURPOSES AND NOT INCLUDED IN TAXABLE INCOME. BARBARA M GRIFFITH MD, KEITH STOVER, PRISCILLA RAMSEUR AND LEIGH BLEECKER RECEIVED A BENEFIT THAT WAS GROSSED UP TO COMPENSATE FOR WITHHOLDING OF TAXES. SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: DUHS MAINTAINS AN EXECUTIVE INCENTIVE COMPENSATION PLAN. PAYMENTS UNDER THE PLAN ARE BASED ON PRE-ESTABLISHED PERFORMANCE METRICS AND A FIXED CALCULATION METHODOLOGY APPROVED BY THE DUHS COMPENSATION COMMITTEE WITH ASSISTANCE AND INPUT FROM AN EXECUTIVE COMPENSATION CONSULTING FIRM ASSURING COMPARABILITY WITH SIMILAR SYSTEMS. THE PLAN ALLOWS FOR A MODIFICATION TO AN INDIVIDUAL'S INCENTIVE PAYMENT BASED ON LEADERSHIP COMPETENCIES AND OTHER FACTORS WITH PAYOUTS (AND MODIFICATIONS, IF ANY) APPROVED BY THE DUHS COMPENSATION COMMITTEE. A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2022-03-01 267805000 SEE PART VI 0 0 0 B NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2022-02-14 121620000 SEE PART VI 0 0 0 C NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DUD1 2016-05-26 383990154 SEE PART VI 0 0 0 D NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DVK4 2016-08-11 140200389 SEE PART VI 0 0 0 A 18650000 267805000 267805000 1 0 1 1 B 121620000 121620000 2009 1 0 1 1 C 255625000 383990154 201888819 2101335 180000000 1 1 1 1 D 140200389 139008505 1191884 0 1 1 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 0 1 1 0 0 0 1 D 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K, PART I, COLUMN F BOND ISSUE A: THE PURPOSE OF THE BONDS ISSUED 03/01/22 WAS TO CONVERT THE 2005A AND 2005B REVENUE REFUNDING BONDS TO BEAR INTEREST AT A NEW BANK-BOUGHT INDEX FLOATING RATE. THE PURPOSE OF THE BONDS ISSUED 05/30/2012 WAS TO PARTIALLY REFUND THE 2005ABC BONDS ISSUED ON 03/22/2012. THE PURPOSE OF THE BONDS ISSUED 03/22/2012 WAS TO REFUND THE 2005ABC BONDS ISSUED ON 08/21/2009, WHICH REFUNDED THE ORIGINAL 2005ABC BONDS ISSUED ON 5/19/2005. THE PURPOSE OF THE BONDS ISSUED 05/19/2005 WAS TO PARTIALLY REFUND THE 1996C BONDS ISSUED ON 10/24/1996, 1998A BONDS ISSUED ON 08/27/1998, AND THE 1998B BONDS ISSUED ON 10/13/1998. THE BONDS ISSUED 03/01/22 WERE ALSO ISSUED TO CONVERT THE 2016(B) AND 2016 (C) BONDS TO BEAR INTEREST AT A NEW BANK-BOUGHT INDEX FLOATING RATE. SEE ALSO BOND ISSUE (D) BELOW. BOND ISSUE B: THE PURPOSE OF THE BONDS ISSUED 02/14/22 WAS TO CONVERT THE 2006ABC BONDS TO BEAR INTEREST AT A NEW BANK-BOUGHT INDEX FLOATING RATE. THE PURPOSE OF THE BONDS ISSUED 3/19/2015 WAS TO REFUND THE 2006ABC BONDS ISSUED ON 10/06/2011, WHICH REFUNDED THE BONDS ISSUED 11/15/2006 FOR HOSPITAL IMPROVEMENTS INCLUDING: ROUTINE INFRASTRUCTURE, RENOVATION AND IMPROVEMENT PROJECTS AT DUKE UNIVERSITY HOSPITAL AND DUKE RALEIGH HOSPITAL, IMPROVEMENTS TO INFORMATION SYSTEMS, RENOVATION AND EXPANSION OF EMERGENCY DEPARTMENT AT DUKE UNIVERSITY HOSPITAL, HELIPORT AND NEW ROOF IMPROVEMENTS AT DUKE UNIVERSITY HOSPITAL, AND PHASES 1 AND 2 OF AN OPERATING ROOM SUITE RENOVATION AND EXPANSION AT DUKE UNIVERSITY HOSPITAL. BOND ISSUE C: THE 2016B AND 2016C REVENUE REFUNDING BONDS WERE CONVERTED TO BEAR INTEREST AT A NEW BANK BOUGHT INDEX FLOATING RATE ON 03/01/22. THE PURPOSE OF THE BONDS ISSUED 05/26/16 WAS TO REFUND THE ORIGINAL 2009A BONDS ISSUED ON 10/22/09 TO FINANCE HOSPITAL IMPROVEMENTS INCLUDING THE AMBULATORY CANCER CENTER AT DUKE UNIVERSITY HOSPITAL AND OTHER RENOVATION AND IMPROVEMENT PROJECTS AT DUKE RALEIGH HOSPITAL, AND TO REFUND THE 2005C BONDS ISSUED ON 05/30/12 AND TO PARTIALLY REFUND THE 2005B BONDS ISSUED ON 05/30/12. THE PURPOSE OF THE BONDS ISSUED 05/30/2012 WAS TO PARTIALLY REFUND THE 2005ABC BONDS ISSUED ON 03/22/12, WHICH REFUNDED THE 2005ABC BONDS ISSUED ON 08/21/2009, WHICH REFUNDED THE ORIGINAL 2005ABC BONDS ISSUED ON 5/19/2005. THE PURPOSE OF THE BONDS ISSUED 05/19/2005 WAS TO PARTIALLY REFUND THE 1996C BONDS ISSUED ON 10/24/1996, 1998A BONDS ISSUED ON 08/27/1998, AND THE 1998B BONDS ISSUED ON 10/13/1998. BOND ISSUE D: THE PURPOSE OF THE BONDS ISSUED 08/11/16 WAS TO REFUND THE ORIGINAL 2010A BONDS ISSUED ON 04/02/10 TO FINANCE HOSPITAL CAPITAL IMPROVEMENTS INCLUDING: THE CONSTRUCTION OF A MAJOR TERTIARY CARE ADDITION TO DUKE UNIVERSITY HOSPITAL REFERRED TO AS THE DUKE MEDICINE PAVILION (DMP)WHICH INCLUDED A NEW 582,000 SQUARE FOOT TERTIARY CARE ADDITION INCLUDING FOUR 24-BED INTENSIVE CARE UNITS, TWO 32 BED INTERMEDIATE /STEP-DOWN UNITS, 16 OPERATING ROOMS, EXPANDED IMAGING FACILITIES, AND PATIENT AND FAMILY ORIENTED AMENITIES; A 9,000 SQUARE FOOT SOUTH CONCOURSE CONNECTOR CORRIDOR BETWEEN THE EXISTING CANCER CENTER AND DUKE CLINICS AND THE DMP; A 46,000 SQUARE FOOT NORTH CONCOURSE CONNECTOR CORRIDOR BETWEEN THE DMP AND DUKE UNIVERSITY HOSPITAL-NORTH; RENOVATION OF APPROXIMATELY 29,000 SQUARE FEET IN DUKE UNIVERSITY HOSPITAL AND ROAD IMPROVEMENT AND VEHICLE PARKING PROJECTS REQUIRED TO COMPLETE AND OPERATE THE NEW ADDITION. BOND ISSUE A(2): DRAW-DOWN FINANCING LEASE PROGRAM WITH TD EQUIPMENT FINANCE, OTHER THAN SCHEDULE 1, IN THE MAXIMUM PRINCIPAL AMOUNT OF $38,062,676 TO FINANCE MEDICAL, COMPUTER, OFFICE, AND CAPITAL EQUIPMENT. SCHEDULE K, PART II, LINE 3, BOND ISSUES A(2): PROCEEDS REFLECT ACTUAL PRINCIPAL DRAWN DOWN UNDER DRAW DOWN FINANCING LEASE PROGRAM. SCHEDULE K, PART III, LINES 4-6, BOND ISSUE C: RESPONSES REFLECT THE COMPUTATION OF THE PORTION OF THE ISSUE ALLOCABLE TO THE REFUNDING OF THE 2009A BONDS. SCHEDULE K, PART IV, LINE 2C, BOND ISSUES (C), (D), AND A(2): BOND ISSUE (C) COMPLETED 06/01/19; AND (D) COMPLETED 08/01/21. AS TO A(2), NO ARBITRAGE COMPUTATION WAS NECESSARY BECAUSE NO PROCEEDS WERE REINVESTED. BOND ISSUES (A) AND (B): THESE PROCEEDS WERE DISBURSED OR DEEMED DISBURSED UPON ISSUANCE TO CURRENTLY REFUND THE PRIOR BONDS. BOND ISSUES A(2): SALES PROCEEDS ALLOCATED UPON ISSUANCE AND NOT INVESTED. A NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2018-05-10 38062676 SEE PART VI 0 0 0 A 18159729 22841278 22841278 2020 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 AGILITI HEALTH INC SEE PART V 779203 SEE PART V 0 GARRY BARTELS SEE PART V 73113 SEE PART V 0 XIOMARA BOYCE SEE PART V 76785 SEE PART V 0 SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF INTERESTED PERSON: AGILITY HEALTH, INC.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: AGILITY HEALTH, INC. DIRECTOR IS ALSO A DUHS, INC. DIRECTOR(C) AMOUNT OF TRANSACTION: $779,203(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR GOODS OR SERVICES(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: GARRY BARTELS(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: GARRY BARTELS IS A FAMILY MEMBER OF A DUHS, INC. DIRECTOR(C) AMOUNT OF TRANSACTION: $73,113(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR SALARY AND BENEFITS(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: XIOMARA BOYCE(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: XIOMARA BOYCE IS A FAMILY MEMBER OF A DUHS, INC. DIRECTOR(C) AMOUNT OF TRANSACTION: $76,785(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR SALARY AND BENEFITS(E) SHARING OF ORGANIZATION REVENUE? = NO X 1 1 X 6825 X 1 10000 MARKET QUOTE X ENTERTAINMENT 21 21150 VARIOUS X SPORTS 10 3250 VARIOUS 0 0 1 1 PART I, LINE 32B: DUKE UNIVERSITY HEALTH SYSTEM, INC. USES INVESTMENT BROKERS TO SELL INVESTMENTS. DUKE UNIVERSITY HEALTH SYSTEM, INC. MAY OCCASIONALLY USE THIRD PARTIES TO SELL OTHER TYPES OF NON-CASH CONTRIBUTIONS, AS THE NEED ARISES. FORM 990, PART I, LINE 1, & PART III, DESCRIPTION OF ORGANIZATION MISSION: DUHS, AS PART OF DUKE HEALTH, IS COMMITTED TO ADVANCING HEALTH TOGETHER BY DELIVERING TOMORROW'S HEALTH CARE TODAY, ACCELERATING DISCOVERY AND ITS TRANSLATION, CREATING EDUCATION THAT IS TRANSFORMING, BUILDING HEALTHY COMMUNITIES, AND CONNECTING WITH THE WORLD TO IMPROVE HEALTH GLOBALLY. FORM 990, PART III, LINE 4A STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS HISTORY AND ORGANIZATION IN 1925, JAMES B. DUKE WILLED $4 MILLION TO ESTABLISH DUKE UNIVERSITY HOSPITAL AND ITS MEDICAL SCHOOL TO IMPROVE HEALTH CARE IN THE CAROLINAS, THEN A POOR REGION LACKING HOSPITALS AND HEALTH CARE PROVIDERS. DUKE UNIVERSITY HOSPITAL HAS GROWN TO BE RECOGNIZED AS ONE OF THE WORLD'S GREAT HEALTH CARE PROVIDERS. IN 1998 AND CONCURRENT WITH ACQUIRING CONTROL OF TWO LOCAL COMMUNITY HOSPITALS, THE DUKE UNIVERSITY BOARD OF TRUSTEES ESTABLISHED DUKE UNIVERSITY HOSPITAL AS THE FLAGSHIP OF THE NEWLY INCORPORATED DUKE UNIVERSITY HEALTH SYSTEM, INC. (DUHS) TO MANAGE A WIDE RANGE OF HEALTH CARE PROGRAMS AT THE SAME HIGH LEVEL OF QUALITY THAT HAS TRADITIONALLY MADE DUKE UNIVERSITY HOSPITAL A WORLD LEADER. THIS NETWORK OF REGIONAL HEALTH CARE ORGANIZATIONS IS DEDICATED TO EMPLOYING DUKE'S STRENGTHS IN PATIENT CARE, EDUCATION, AND RESEARCH. DUHS IS A COMPONENT OF DUKE HEALTH WHICH CONCEPTUALLY INTEGRATES THE DUKE UNIVERSITY SCHOOL OF MEDICINE, DUKE-NUS MEDICAL SCHOOL, DUKE UNIVERSITY SCHOOL OF NURSING, DUKE UNIVERSITY HEALTH SYSTEM, PRIVATE DIAGNOSTIC CLINIC (DUKE PHYSICIANS PRACTICE), AND INCORPORATES THE HEALTH AND HEALTH RESEARCH PROGRAMS WITHIN THE DUKE GLOBAL HEALTH INSTITUTE AS WELL AS THOSE IN SCHOOLS AND CENTERS ACROSS DUKE UNIVERSITY, INCLUDING THE DUKE ROBERT J. MARGOLIS CENTER FOR HEALTH POLICY. THE DUKE HEALTH CLINICAL ENTERPRISE IS INTENDED TO FUNCTION AS A FULLY ALIGNED AND UNIFIED ORGANIZATION FOCUSED ON IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE, DELIVERING ADVANCED TREATMENT FOR THOSE WHO NEED IT, AND EXTENDING NEW KNOWLEDGE BEYOND OUR SYSTEMS TO THE BENEFIT OF OTHERS. LEVERAGING THE DEPTH AND BREADTH OF CAPABILITIES THAT EXIST ACROSS DUKE HEALTH AND THE ENTIRE UNIVERSITY, WE PLAN TO ACHIEVE THE VISION TO DELIVER TOMORROW'S HEALTH CARE TODAY BY LEADING IN THE DELIVERY OF HIGHEST-QUALITY, PATIENT CENTERED CARE, INTEGRATING TO OPTIMIZE COORDINATION OF CARE, GROWING AND EXTENDING OUR REACH LOCALLY, REGIONALLY, AND NATIONALLY, INVESTING IN INNOVATION TO CREATE SUSTAINABLE DIFFERENTIATION AND VALUE AND DELIVERING ON THE PROMISE OF POPULATION HEALTH. MANY PROGRAM SERVICE ACCOMPLISHMENTS ARE INCLUDED IN SCHEDULE H OF THIS FORM INCLUDING THE FINANCIAL COMMITMENT MADE TO THE COMMUNITY BY DUHS IN TERMS OF CHARITY CARE AND OTHER DIRECT AND MEASURABLE INVESTMENTS. FURTHER DETAIL OF DUHS' COMMITMENT TO PROMOTING HEALTH, WELLNESS, AND ACCESS TO QUALITY CARE FOR THE PEOPLE AND COMMUNITIES IT SERVES IS REPORTED IN DUHS' ANNUAL COMMUNITY BENEFIT REPORT. THE COMMUNITY BENEFIT REPORT IS AVAILABLE ONLINE AT HTTPS://CORPORATE.DUKEHEALTH.ORG/COMMUNITY. FORM 990, PART V, LINE 3B THE ORGANIZATION DID NOT HAVE UNRELATED BUSINESS GROSS INCOME OF $1,000 OR MORE DURING THE FISCAL YEAR ENDED JUNE 30, 2023. HOWEVER THE ORGANIZATION HAS FILED FORM 990-T FOR THE FISCAL YEAR ENDED JUNE 30, 2023 IN ORDER TO CARRY FORWARD THE NET OPERATING LOSS. FORM 990, PART VI, SECTION A, LINE 2 DIRECTORS WILLIAM HAWKINS, GERALD HASSELL, VINCENT E. PRICE, CARMICHAEL S. ROBERTS, NANCY M. SCHLICHTING, AND LAURENE M. SPERLING ARE TRUSTEES OF DUKE UNIVERSITY. DIRECTOR AND PRESIDENT, A. EUGENE WASHINGTON, MD, IS AN OFFICER OF DUKE UNIVERSITY. DIRECTOR MARY E. KLOTMAN, MD IS A KEY EMPLOYEE OF DUKE UNIVERSITY. THE FOLLOWING INDIVIDUALS ARE EMPLOYEES OF DUKE UNIVERSITY: MOIRA RYNN, MD AND ERIK PAULSON, MD. DIRECTOR AND PRESIDENT, A. EUGENE WASHINGTON, MD, OFFICERS CRAIG T. ALBANESE, MD, ROBERT N. WILLIS, JOHN P. MORDACH AND THOMAS A. OWENS, MD SERVED AS DIRECTORS AND OFFICERS OF DURHAM CASUALTY COMPANY, LTD. DURING FISCAL YEAR ENDED JUNE 30, 2023. DIRECTOR AND PRESIDENT, A. EUGENE WASHINGTON, MD, AND DIRECTORS MORIA RYNN, MD AND ERIK PAULSON SERVED AS BOARD MEMBERS OF PRIVATE DIAGNOSTIC CLINIC, PLLC. DURING FISCAL YEAR ENDED JUNE 30, 2023. OFFICERS CRAIG T. ALBANESE, MD, ROBERT N. WILLIS, JOHN P. MORDACH AND THOMAS A. OWENS, MD SERVED AS DIRECTORS AND OFFICERS OF HEALTH SYSTEM MEDICAL STRATEGIES, INC. DURING FISCAL YEAR ENDED JUNE 30, 2023. WILLIAM HAWKINS AND SUSAN STALNECKER ARE BOTH DIRECTORS OF BIOVENTUS, LLC. LAURENE SPERLING IS A DIRECTOR OF AGILITI HEALTH, INC. FORM 990, PART VI, SECTION A, LINE 3 DUHS DELEGATES CONTROL TO A SUPPORTING ORGANIZATION FOR THE MANAGEMENT OF INVESTMENTS. FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION AMENDED THE ARTICLES OF INCORPORATION EFFECTIVE JULY 1, 2023 STATING THE FOLLOWING REPORTABLE UPDATE TO ARTICLE IX: THE BOARD OF DIRECTORS SHALL INCLUDE FOUR (4) EX OFFICIO MEMBERS, WHO SHALL BE THE INDIVIDUALS SERVING AS PRESIDENT OF DUKE UNIVERSITY, THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION, THE CHAIR OF THE BOARD OF TRUSTEES OF DUKE UNIVERSITY, AND THE EXECUTIVE VICE PRESIDENT FOR HEALTH AFFAIRS/DEAN OF THE DUKE UNIVERSITY SCHOOL OF MEDICINE. THE ORGANIZATION AMENDED THE BYLAWS EFFECTIVE JULY 1, 2023 STATING THE FOLLOWING REPORTABLE UPDATES: THE BOARD OF DIRECTORS SHALL INCLUDE FOUR (4) EX OFFICIO MEMBERS, WHO SHALL BE THE INDIVIDUALS SERVING AS PRESIDENT OF DUKE UNIVERSITY, THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION, THE CHAIR OF THE BOARD OF TRUSTEES OF DUKE UNIVERSITY, AND THE EXECUTIVE VICE PRESIDENT FOR HEALTH AFFAIRS/DEAN OF THE DUKE UNIVERSITY SCHOOL OF MEDICINE. THE CEO SHALL BE NOMINATED BY THE PRESIDENT OF DUKE UNIVERSITY AND APPOINTED BY THE BOARD OF DIRECTORS OF THE CORPORATION. THE CEO SHALL REPORT TO THE PRESIDENT OF DUKE UNIVERSITY; AND TO THE BOARD OF DIRECTORS OF THE CORPORATION. ONLY THE PRESIDENT OF DUKE UNIVERSITY HAS THE POWER TO REMOVE THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION, AFTER APPROPRIATE CONSULTATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE BOARD OF DIRECTORS OF DUHS, OTHER THAN THE EX OFFICIO MEMBERS, WILL BE NOMINATED BY THE BOARD OF DIRECTORS OF DUHS, AND WILL BE APPOINTED BY THE BOARD OF TRUSTEES OF DUKE UNIVERSITY. MEMBERS OF THE BOARD OF DIRECTORS OF DUHS WILL BE SUBJECT TO REMOVAL AT THE DISCRETION OF THE BOARD OF TRUSTEES OF DUKE UNIVERSITY IN ACCORDANCE WITH THE BYLAWS OF DUHS. FORM 990, PART VI, SECTION A, LINE 7B THE DUHS BYLAWS PROVIDE THAT DUHS MUST OBTAIN DUKE UNIVERSITY BOARD OF TRUSTEES APPROVAL FOR CERTAIN SIGNIFICANT TRANSACTIONS REGARDING DEBT ISSUANCES, CAPITAL ACQUISITIONS AND TANGIBLE PERSONAL AND REAL PROPERTY SALES. FORM 990, PART VI, SECTION B, LINE 11B AFTER STAFF PREPARATION AND MANAGEMENT REVIEW, THE DUHS FORM 990 IS PRESENTED TO THE DUHS COMPLIANCE/AUDIT COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW AND DISCUSSION. DUHS BOARD LEVEL COMMENT AND DISCUSSION ARE INCORPORATED INTO THE FORM AS APPROPRIATE PRIOR TO FILING. A FINAL VERSION OF THE FORM IS MADE AVAILABLE TO THE DUHS BOARD OF DIRECTORS FOR FURTHER REVIEW AND COMMENT BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C DUHS MONITORS AND ENFORCES COMPLIANCE RELATED TO CONFLICT OF INTEREST VIA AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE DISTRIBUTED TO INDIVIDUALS INCLUDING OFFICERS, DIRECTORS, AND KEY EMPLOYEES, RELYING ON SELF DISCLOSURE OF ALL THOSE SUBJECT TO THE COI POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE DUHS COMPENSATION COMMITTEE, COMPRISED OF MEMBERS OF THE DUHS BOARD OF DIRECTORS, REVIEWS AND APPROVES ALL EXECUTIVE COMPENSATION FOR CERTAIN DISQUALIFIED PERSONS AND OTHER KEY EMPLOYEES. THE DUHS COMPENSATION COMMITTEE REVIEWS AND RECOMMENDS TO THE DUKE UNIVERSITY COMPENSATION COMMITTEE THE COMPENSATION FOR THE PRESIDENT AND CEO OF DUHS WHO IS ALSO AN OFFICER OF DUKE UNIVERSITY. DUHS HAS ADOPTED A STATEMENT OF COMPENSATION PHILOSOPHY THAT ARTICULATES BROAD OBJECTIVES TO HELP GUIDE THE DUHS COMPENSATION COMMITTEE IN ITS MISSION. THE DUHS COMPENSATION COMMITTEE ENGAGES THE SERVICES OF AN OUTSIDE EXECUTIVE COMPENSATION CONSULTING FIRM TO ESTABLISH COMPARABILITY DATA OF OTHER HEALTH CARE SYSTEMS OF SIMILAR SIZE AND COMPLEXITY AS DUHS. THE DUHS COMPENSATION COMMITTEE REVIEWS THE MARKET ANALYSIS THEN DETERMINES THE REASONABLENESS AND APPROPRIATENESS OF ALL ASPECTS OF EXECUTIVE COMPENSATION. THE DUHS COMPENSATION COMMITTEE ALSO SETS THE METRICS AND APPROVES THE PAYOUTS FOR THE DUHS INCENTIVE COMPENSATION PLANS FOR THESE INDIVIDUALS. THE DELIBERATIONS AND CONCLUSIONS OF THE DUHS COMPENSATION COMMITTEE ARE KEPT BY A RECORDING SECRETARY WHO RECORDS THE MINUTES OF THE COMMITTEE MEETINGS. FORM 990, PART VI, SECTION B, LINE 16B: DUHS FOLLOWS A WRITTEN POLICY THAT REQUIRES DUHS TO EVALUATE ITS PARTICIPATION IN JOINT VENTURE ARRANGEMENTS AND NEGOTIATE TERMS AND SAFEGUARDS TO PROTECT THE ORGANIZATION'S ASSETS AND EXEMPT STATUS. DUHS PUTS TERMS AND SAFEGUARDS IN AGREEMENTS WITH THIRD PARTIES TO PROTECT THE ASSETS AND EXEMPT STATUS OF THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 18 IN ADDITION TO PROVIDING THE ORGANIZATION'S FORM 990 UPON REQUEST, THE ORGANIZATION'S FORM 990 IS AVAILABLE TO THE PUBLIC ON SEVERAL THIRD PARTY WEBSITES. WHILE THE ORGANIZATION DOES NOT PROVIDE THE FORM 990 DIRECTLY TO THESE THIRD PARTIES, THE FORM 990 IS OBTAINED FROM THE INTERNAL REVENUE SERVICE. THE THIRD PARTIES SUBSEQUENTLY AND INDEPENDENTLY PROVIDE ACCESS TO THE FORM 990 ON THEIR PLATFORM. FORM 990, PART VI, SECTION C, LINE 19 DUKE UNIVERSITY HEALTH SYSTEM, INC.'S GOVERNING DOCUMENTS (ARTICLES OF INCORPORATION AND ANY SUBSEQUENT AMENDMENTS OR RESTATEMENTS) ARE AVAILABLE TO THE PUBLIC ON THE NORTH CAROLINA SECRETARY OF STATE WEBSITE. DUKE UNIVERSITY HEALTH SYSTEM, INC. MAKES ITS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. INDEPENDENTLY AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC AT: HTTPS://CORPORATE.DUKEHEALTH.ORG/FINANCIAL-INFORMATION FORM 990, PART XI, LINE 9: NONPERIODIC CHANGES IN DEFINED BENEFIT PLANS: -119,082,320. NET TRANSFERS TO THE UNIVERSITY AND AFFILIATES: -192,134,361. FORM 990, PART XII, LINE 3B: FEDERAL AWARDS RECEIVED BY THE ORGANIZATION ARE INCLUDED IN THE DUKE UNIVERSITY FY2023 SINGLE AUDIT. ITS AUDIT UNDER THE UNIFORM ADMINISTRATIVE REQUIREMENTS, COST PRINCIPLES, AND AUDIT REQUIREMENTS FOR FEDERAL AWARDS WAS ISSUED BY THE DUE DATE OF MARCH 31, 2024. 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