efile Public Visual Render
ObjectId: 201821349349302107 - Submission: 2018-05-14
TIN: 51-0190238
Form
990
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
Do not enter social security numbers on this form as it may be made public.
Information about Form 990 and its instructions is at
www.IRS.gov/form990
.
OMB No. 1545-0047
20
16
Open to Public Inspection
A
For the 2016 calendar year, or tax year beginning
07-01-2016
, and ending
06-30-2017
B
Check if applicable:
Address change
Name change
Initial return
Final return/terminated
Amended return
Application pending
C
Name of organization
Wake Forest University Baptist Medical
Center
Doing business as
Number and street (or P.O. box if mail is not delivered to street address)
Medical Center Blvd
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
WinstonSalem
,
NC
27157
D Employer identification number
51-0190238
E Telephone number
(336) 716-4445
G
Gross receipts $
145,040,868
F
Name and address of principal officer:
Julie A Freischlag MD
Medical Center Blvd
WinstonSalem
,
NC
27157
I
Tax-exempt status:
501(c)(3)
501(c)
(
)
(insert no.)
4947(a)(1)
or
527
J
Website:
wakehealth.edu
H(a)
Is this a group return for
subordinates?
Yes
No
H(b)
Are all subordinates
included?
Yes
No
If "No," attach a list. (see instructions)
H(c)
Group exemption number
K
Form of organization:
Corporation
Trust
Association
Other
L
Year of formation:
1975
M
State of legal domicile:
NC
Part I
Summary
1
Briefly describe the organization’s mission or most significant activities:
Improving the health of our region, state and nation
2
Check this box
3
Number of voting members of the governing body (Part VI, line 1a)
........
3
13
4
Number of independent voting members of the governing body (Part VI, line 1b)
.....
4
12
5
Total number of individuals employed in calendar year 2016 (Part V, line 2a)
......
5
14,695
6
Total number of volunteers (estimate if necessary)
.............
6
1,953
7a
Total unrelated business revenue from Part VIII, column (C), line 12
........
7a
-178,665
b
Net unrelated business taxable income from Form 990-T, line 34
.........
7b
-178,665
Prior Year
Current Year
8
Contributions and grants (Part VIII, line 1h)
.........
3,625,492
1,017,776
9
Program service revenue (Part VIII, line 2g)
.........
20,667,577
141,957,380
10
Investment income (Part VIII, column (A), lines 3, 4, and 7d )
....
37,258
195,454
11
Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)
1,598,860
-9,941
12
Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)
25,929,187
143,160,669
13
Grants and similar amounts paid (Part IX, column (A), lines 1–3 )
...
6,020
95,150
14
Benefits paid to or for members (Part IX, column (A), line 4)
.....
0
0
15
Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)
17,277,420
94,173,734
16a
Professional fundraising fees (Part IX, column (A), line 11e)
.....
0
0
b
Total fundraising expenses (Part IX, column (D), line 25)
0
17
Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)
....
14,821,950
62,347,821
18
Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)
32,105,390
156,616,705
19
Revenue less expenses. Subtract line 18 from line 12
.......
-6,176,203
-13,456,036
Beginning of Current Year
End of Year
20
Total assets (Part X, line 16)
.............
259,528,515
388,126,708
21
Total liabilities (Part X, line 26)
.............
131,023,426
289,216,510
22
Net assets or fund balances. Subtract line 21 from line 20
.....
128,505,089
98,910,198
Part II
Signature Block
Sign Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
2018-05-08
Signature of officer
Date
Bradley A Clark
Treasurer
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
Check
if
self-employed
PTIN
Firm's name
Firm's EIN
Firm's address
Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions)
..........
Yes
No
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form
990
(2016)
Page 2
Form 990 (2016)
Page
2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III
..............
1
Briefly describe the organization’s mission:
See Schedule OTHE ORGANIZATION IS PART OF WAKE FOREST BAPTIST MEDICAL CENTER, A PREEMINENT, INTERNATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER OF THE HIGHEST QUALITY WITH BALANCED EXCELLENCE IN PATIENT CARE, RESEARCH AND EDUCATION. OUR MISSION IS TO IMPROVE THE HEALTH OF OUR REGION, STATE AND NATION BY: GENERATING AND TRANSLATING KNOWLEDGE TO PREVENT, DIAGNOSE AND TREAT DISEASE; TRAINING LEADERS IN HEALTH CARE AND BIOMEDICAL SCIENCE; AND SERVING AS THE PREMIER HEALTH SYSTEM IN OUR REGION, WITH SPECIFIC CENTERS OF EXCELLENCE RECOGNIZED AS NATIONAL AND INTERNATIONAL CARE DESTINATIONS.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ?
.....................
Yes
No
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services?
...........................
Yes
No
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a
(Code:
) (Expenses $
3,452,250
including grants of $
7,300
) (Revenue $
)
Wake Forest University Baptist Medical Center is an integral part of Wake Forest Baptist Medical Center, a preeminent, internationally recognized academic medical center of the highest quality with balanced excellence in patient care, research and education. The following paragraphs are provided to explain the relationship of the filing organization with other organizations which together comprise "Wake Forest Baptist Medical Center," the name not of any one corporate entity, but used generically to describe a large group of mostly tax-exempt 501 (c)(3) organizations performing various academic medical center activities in northwest North Carolina, including patient care, medical research, technology transfer and medical education. Because these activities are not all performed by each organization, the narrative that follows will include descriptions of activities that are performed by the filing organization and by a related (or unrelated but affiliated) organization; they are again provided to illustrate a complete picture of the filing organization's role in this integrated academic medical center's comprehensive activities. Wake Forest Baptist Medical Center is northwest North Carolina's sole academic medical center, bringing to the region the resources of one of America's top hospitals and innovative research centers and a premier medical school. Wake Forest University Baptist Medical Center (WFUBMC) is a corporation whose two equal members are Wake Forest University and North Carolina Baptist Hospital. The Medical Center operates Wake Forest University School of Medicine, which has a faculty of 1,247, including physicians and basic scientists. The medical center has 1,029 acute care and rehabilitation beds operative across the system, which encompasses its main campus (885 beds), Wake Forest Baptist Health Lexington Medical Center (94 beds) and Wake Forest Baptist Health Davie Medical Center (50 beds). The medical center opened a $47 million, 50-bed inpatient facility at Davie Medical Center in the spring of 2017. Overall, Wake Forest Baptist Medical Center serves a 24-county region in northwestern North Carolina and southwestern Virginia and draws patients from across the nation for select services.The medical center is the driving force behind the establishment of Wake Forest Innovation Quarter, a growing urban-based district for research, business and education in biomedical science, information technology, clinical services and advanced materials in downtown Winston-Salem. Home to more than 152 companies, four leading institutions, more than 3,600 workers, 1,522 students and 8,000 workforce trainee participants, the Innovation Quarter currently comprises 1.9 million square feet of office, laboratory and educational space on its 200+ developable acres. In July 2016, Wake Forest University School of Medicine students began their medical careers in the Bowman Gray Center for Medical Education in the Innovation Quarter. The $60 million building was designed with the next generation of physician-leaders in mind. It includes the latest technologies and simulation labs that allow students to prepare for real-life experiences. The opening of the Bowman Gray Center coincided with the adoption of a new medical school curriculum that is one of the most advanced in the country.In November 2016, Wake Forest Baptist Medical Center was awarded a five-year, $8.7 million grant from the National Institutes of Health for the establishment of a new center for research into Alzheimer's disease. The Alzheimer's Disease Core Center at Wake Forest Baptist is among 31 NIH-funded Alzheimer's research centers in the country and the only one in North Carolina. The center will provide training in translational research to new investigators and develop educational programs about Alzheimer's and dementia for health care professionals, patients and family members, and the community at large. The center already is offering groundbreaking clinical trials, including studies that examine how exercise, diet and new drugs may affect the development or progress of Alzheimer's and dementia.1. CLINICAL SERVICES Wake Forest Baptist Medical Center is nationally recognized for clinical excellence and internationally known for pioneering research and clinical innovation. Its clinical enterprise, Wake Forest Baptist Health, offers expertise in more than 100 areas of medicine, encompassing comprehensive preventive and highly specialized care for all ages. The medical center network includes the 167-bed Comprehensive Cancer Center and the 144-bed Brenner Children's Hospital, both of which are on the main campus in Winston-Salem, as well as community hospitals in neighboring Davidson and Davie counties. Across its service area of northwest North Carolina and southwest Virginia, Wake Forest Baptist has 3 emergency departments, 3 urgent care centers, 72 primary care clinics, 265 specialty clinics, 18 out-patient dialysis centers, 1 free-standing dialysis access-center, and freestanding imaging and endoscopy centers. The medical center employs 1,865 physicians, 3,184 registered nurses, and 716 residents and fellows. It has a total staff of 16,157. Overall in FY 2017, Wake Forest Baptist had 55,568 inpatient admissions, 158,344 Emergency Department visits and 1,868,802 outpatient encounters (ambulatory visits and outpatient encounters).2. OUTREACHWake Forest Baptist Medical Center continues a broad-based effort to reach underserved populations across its service area. The Medical Center's annual Community Benefits report reflects this commitment. In fiscal 2017, the Medical Center spent $374 million to support these areas: Subsidized health costs Community health outreach Charity care Research EducationOne anchor of outreach for the Medical Center is its Downtown Health Plaza, a full-service, outpatient medical clinic that serves many of Forsyth County's uninsured and underinsured residents with a state-of-the-art medical home. In addition to clinical care, the Downtown Health Plaza offers community health fairs, diabetes education and a Centering Pregnancy Program that is reducing the incidence of low birth weight babies. Altogether, 64,768 patient visits were recorded at the Downtown Health Plaza in the 2017 fiscal year, and another 13,348 visits were recorded at Winston East Pediatrics, a nearby Wake Forest Baptist care facility serving the uninsured and underinsured.The Medical Center's programs and partnerships reflect innovative efforts to reach underserved populations. They include:-- Regular community-based health clinics, including: the weekly Delivering Equal Access to Care (DEAC) Clinic at the Community Care Center in Winston-Salem, the monthly Triad Free Health Clinic at Community Mosque in Winston-Salem, the monthly Grace Clinic at New Light Missionary Baptist Church in Winston-Salem and the annual Share the Health Fair at the Downtown Health Plaza in Winston-Salem. These clinics, sponsored by private organizations and churches with volunteer assistance from Wake Forest Baptist physicians, nurses, medical students and others, attract thousands of people to screenings for acute and chronic conditions. -- The School of Medicine's Physician Assistant (PA) program, which is increasing the number of PA's working in primary care in North Carolina's rural Appalachian counties through its second campus at Appalachian State University in Boone. -- FaithHealthNC, an initiative that connects the caring strengths of congregations, the clinical expertise of providers and a network of community resources to ease those on the journey to health and healing, strengthening communities in the process. One example of this work is a FaithHealth program in which workers known as Supporters of Health connect patients with resources they need after a health incident or hospitalization. The goal is to help these patients avoid readmission, in particular to the emergency department. 3. EDUCATIONAL MISSION AND ACCOMPLISHMENTS The constituent organizations of Wake Forest Baptist Medical Center operate a broad range of educational programs, graduating skilled practitioners. It attracts some of the world's most competitive medical students, residents and fellows, as well as students in clinical pastoral care, nurse anesthesia and other areas. In the most recent reporting period, Wake Forest Baptist invested more than $107.3 million in the education of tomorrow's health care and biomedical leaders and in research funding not covered by outside sources. That investment supported training of 491 medical students, 716 physician residents and fellows, 267 graduate students and 175 physician assistants. In addition, the Northwest Area Health Education Center, part of Wake Forest University School of Medicine, offered 1,935 continuing medical education activities that drew 35,019 participants from throughout the region.
4b
(Code:
) (Expenses $
144,599,090
including grants of $
87,850
) (Revenue $
141,957,380
)
Cornerstone Health Care is a multi-disciplinary medical practice with more than 80 locations in communities throughout central north carolina. Cornerstone provided medical outpatient care services to approximately 562,000 patients during the fiscal year. Cornerstone Health Care is the recipient of the 2015 American Medical Group Association Acclaim Award, a national recognition for success in improving the quality and lowering the cost of services offered. Cornerstone has transitioned from the traditional "fee-for-service" model to a patient-centered medical home system providing expanded access, increased coordination of care, enhanced patient education for prevention and treatment of chronic disease, and sophisticated technological support. Cornerstone Health Care was selected to participate in the Medicare Shared Savings Program Accountable Care Organization ("ACO") sponsored by the Centers for Medicare and Medicaid Services ("CMS"). Through the Shared Savings Program, Cornerstone works with CMS to provide Medicare Fee-For-Service beneficiaries with high quality service and care, while reducing the growth in medicare expenditures through enhanced care coordination. In 2016, Cornerstone was one of only 21 ACO's in the United States invited to particpate in phase two of the ACO process called the Next Generation ACO. This recognizes Cornerstone's advanced readiness and committment to providing the highest quality care at the best cost possible.
4c
(Code:
) (Expenses $
including grants of $
) (Revenue $
)
4d
Other program services (Describe in Schedule O.)
(Expenses $
including grants of $
) (Revenue $
)
4e
Total program service expenses
148,051,340
Form
990
(2016)
Page 3
Form 990 (2016)
Page
3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?
If "Yes," complete Schedule A
.....................
1
Yes
2
Is the organization required to complete
Schedule B, Schedule of Contributors
(see instructions)?
...
2
Yes
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office?
If "Yes," complete Schedule C, Part I
.............
3
No
4
Section 501(c)(3) organizations.
Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year?
If "Yes," complete Schedule C, Part II
..............
4
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19?
If "Yes," complete Schedule C, Part III
.................
5
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts?
If "Yes," complete Schedule D, Part I
..................
6
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures?
If "Yes," complete Schedule D, Part II
...
7
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets?
If "Yes," complete Schedule D, Part III
.............
8
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services?
If "Yes," complete Schedule D, Part IV
..............
9
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments?
If "Yes," complete Schedule D, Part V
......
10
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.
...................
11a
Yes
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16?
If "Yes," complete Schedule D, Part VII
.......
11b
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16?
If "Yes," complete Schedule D, Part VIII
.......
11c
Yes
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16?
If "Yes," complete Schedule D, Part IX
............
11d
Yes
e
Did the organization report an amount for other liabilities in Part X, line 25?
If "Yes," complete Schedule D, Part X
11e
Yes
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)?
If "Yes," complete Schedule D, Part X
11f
Yes
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII
.................
12a
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year?
If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional
12b
Yes
13
Is the organization a school described in section 170(b)(1)(A)(ii)?
If "Yes," complete Schedule E
13
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?
.....
14a
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more?
If "Yes," complete Schedule F, Parts I and IV
.........
14b
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization?
If “Yes,” complete Schedule F, Parts II and IV
.....
15
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals?
If “Yes,” complete Schedule F, Parts III and IV
...
16
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e?
If "Yes," complete Schedule G, Part I
(see instructions)
....
17
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a?
If "Yes," complete Schedule G, Part II
............
18
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a?
If "Yes," complete Schedule G, Part III
...................
19
No
Form
990
(2016)
Page 4
Form 990 (2016)
Page
4
Part IV
Checklist of Required Schedules
(continued)
Yes
No
20a
Did the organization operate one or more hospital facilities?
If "Yes," complete Schedule H
....
20a
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1?
If “Yes,” complete Schedule I, Parts I and II
.....
21
Yes
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2?
If “Yes,” complete Schedule I, Parts I and III
........
22
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees?
If "Yes," complete Schedule J
.......................
23
Yes
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002?
If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a
...............
24a
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?
...
24b
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
...............
24c
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?
...
24d
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations.
Did the organization engage in an excess benefit transaction with a disqualified person during the year?
If "Yes," complete Schedule L, Part I
............
25a
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ?
If "Yes," complete Schedule L, Part I
...................
25b
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons?
If "Yes," complete Schedule L, Part II
................
26
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons?
If "Yes," complete Schedule L, Part III
.........
27
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee?
If "Yes," complete Schedule L,
Part IV
........................
28a
No
b
A family member of a current or former officer, director, trustee, or key employee?
If "Yes," complete Schedule L, Part IV
.....................
28b
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner?
If "Yes," complete Schedule L, Part IV
...
28c
No
29
Did the organization receive more than $25,000 in non-cash contributions?
If "Yes," complete Schedule M
..
29
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions?
If "Yes," complete Schedule M
.............
30
Yes
31
Did the organization liquidate, terminate, or dissolve and cease operations?
If "Yes," complete Schedule N, Part I
.
31
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?
If "Yes," complete Schedule N, Part II
...........
32
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3?
If "Yes," complete Schedule R, Part I
........
33
Yes
34
Was the organization related to any tax-exempt or taxable entity?
If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1
.........................
34
Yes
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)?
If "Yes," complete Schedule R, Part V, line 2
...
35b
Yes
36
Section 501(c)(3) organizations.
Did the organization make any transfers to an exempt non-charitable related organization?
If "Yes," complete Schedule R, Part V, line 2
.............
36
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes?
If "Yes," complete Schedule R, Part VI
37
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19?
Note.
All Form 990 filers are required to complete Schedule O.
............
38
Yes
Form
990
(2016)
Page 5
Form 990 (2016)
Page
5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V
...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable
..
1a
0
b
Enter the number of Forms W-2G included in line 1a.
Enter -0-
if not applicable
.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners?
..................
1c
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return
..................
2a
14,695
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note.
If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?
...
3a
Yes
b
If “Yes,” has it filed a Form 990-T for this year?
If “No” to line 3b, provide an explanation in Schedule O
...
3b
Yes
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?
..
4a
No
b
If "Yes," enter the name of the foreign country:
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?
..
5a
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T?
............
5c
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?
...
6a
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?
......................
6b
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?
....................
7a
Yes
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?
.....
7b
Yes
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?
.........................
7c
No
d
If "Yes," indicate the number of Forms 8282 filed during the year
....
7d
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
..
7f
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?
......................
7g
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?
..........................
7h
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?
.........................
8
9a
Did the sponsoring organization make any taxable distributions under section 4966?
...
9a
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?
...
9b
10
Section 501(c)(7) organizations.
Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12
...
10a
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
11
Section 501(c)(12) organizations.
Enter:
a
Gross income from members or shareholders
.........
11a
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.)
..........
11b
12a
Section 4947(a)(1) non-exempt charitable trusts.
Is the organization filing Form 990 in lieu of Form 1041?
12a
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans
....
13b
c
Enter the amount of reserves on hand
............
13c
14a
Did the organization receive any payments for indoor tanning services during the tax year?
.....
14a
No
b
If "Yes," has it filed a Form 720 to report these payments?
If "No," provide an explanation in Schedule O
..
14b
Form
990
(2016)
Page 6
Form 990 (2016)
Page
6
Part VI
Governance, Management, and Disclosure
For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines
8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI
..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
13
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
12
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee?
.................
2
Yes
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person?
.
3
Yes
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
...........................
4
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets?
.
5
No
6
Did the organization have members or stockholders?
................
6
Yes
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body?
....................
7a
Yes
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body?
...................
7b
Yes
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body?
.......................
8a
Yes
b
Each committee with authority to act on behalf of the governing body?
............
8b
Yes
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address?
If "Yes," provide the names and addresses in Schedule O
.......
9
No
Section B. Policies
(
This Section B requests information about policies not required by the Internal Revenue Code.
)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates?
............
10a
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
............................
11a
Yes
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990.
.....
12a
Did the organization have a written conflict of interest policy?
If "No," go to line 13
.......
12a
Yes
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts?
..........................
12b
Yes
c
Did the organization regularly and consistently monitor and enforce compliance with the policy?
If "Yes," describe in Schedule O how this was done
...................
12c
Yes
13
Did the organization have a written whistleblower policy?
...............
13
Yes
14
Did the organization have a written document retention and destruction policy?
.........
14
Yes
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official
...........
15a
Yes
b
Other officers or key employees of the organization
................
15b
Yes
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year?
......................
16a
Yes
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements?
............
16b
Yes
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filed
NC
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
Own website
Another's website
Upon request
Other (explain in Schedule O)
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
Joseph Dolan
Medical Center Blvd
WinstonSalem
,
NC
27157
(336) 716-4445
Form
990
(2016)
Page 7
Form 990 (2016)
Page
7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII
..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a
Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
List all of the organization’s
current
officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.
List all of the organization’s
current
key employees, if any. See instructions for definition of "key employee."
List the organization’s five
current
highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.
List all of the organization’s
former
officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.
List all of the organization’s
former directors or trustees
that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.
List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
(1)
Stephen L Robertson
......................................................................
Chair & director
4.00
.................
4.00
X
X
0
0
0
(2)
Arthur A Gibel
......................................................................
Director
4.00
.................
2.00
X
0
0
0
(3)
A LEE HERRING
......................................................................
Director
4.00
.................
2.00
X
0
0
0
(4)
George D Renfro
......................................................................
Director
4.00
.................
2.00
X
0
0
0
(5)
William C Warden Jr
......................................................................
Director
4.00
.................
2.00
X
0
0
0
(6)
Sheree B Watson
......................................................................
Director
4.00
.................
4.00
X
0
0
0
(7)
Donna A Boswell PhD
......................................................................
Director
4.00
.................
17.00
X
0
0
0
(8)
Donald E Flow
......................................................................
Vice Chair & director
4.00
.................
9.00
X
X
0
0
0
(9)
Nathan O Hatch PhD
......................................................................
Director
5.80
.................
34.20
X
0
1,023,612
662,475
(10)
James R Helvey III
......................................................................
Director
4.00
.................
8.60
X
0
0
0
(11)
james j marino
......................................................................
director
4.00
.................
6.00
X
0
0
0
(12)
Andrew J Schindler
......................................................................
Director
4.00
.................
7.60
X
0
0
0
(13)
John H McConnell MD
......................................................................
Director (ex-off) & CEO (to 4-26-17)
5.00
.................
35.00
X
X
0
2,031,055
266,426
(14)
Julie A Freischlag MD
......................................................................
Director (ex-off) & CEO (eff 4-27-17)
5.00
.................
35.00
X
X
0
0
0
(15)
Kevin P High MD
......................................................................
EVP, Health System Affairs
5.00
.................
35.00
X
0
817,847
186,831
(16)
Edward Abraham MD
......................................................................
Dean, School of Med
5.00
.................
35.00
X
0
934,669
179,169
(17)
Eric Tomlinson DCs PhD
......................................................................
President, WFIQ
5.00
.................
35.00
X
0
799,427
111,994
Form
990
(2016)
Page 8
Form 990 (2016)
Page
8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
(continued)
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
(18)
Chad A Eckes
........................................................................
EVP Crp Svc, CFO, Asst Trs (to 6-11-17)
5.00
.......................
35.00
X
984,048
0
231,334
(19)
Terry G Williams
........................................................................
EVP, Chief Strategy Officer
5.00
.......................
35.00
X
725,787
0
170,369
(20)
ROBERT GFELLER
........................................................................
VP, External Relations & Chief Mktg Offi
5.00
.......................
35.00
X
582,269
0
144,136
(21)
Lilicia Bailey
........................................................................
VP, Chief Human Resources (eff 8-23-16)
5.00
.......................
35.00
X
169,508
0
24,137
(22)
Steve Bloom
........................................................................
VP, Chief Human Resources (to 8-22-16)
5.00
.......................
35.00
X
0
0
0
(23)
Deette M Emon
........................................................................
VP, CIO
5.00
.......................
35.00
X
515,506
0
108,015
(24)
Norman B Potter Jr to 2-28-17
........................................................................
VP, Development
5.00
.......................
35.00
X
0
426,485
101,230
(25)
Karen H Huey
........................................................................
VP, Facilities
5.00
.......................
35.00
X
369,171
0
88,059
(26)
J Mclain wallace Jr
........................................................................
VP, Gen Counsel & Sec
5.00
.......................
35.00
X
583,744
0
151,020
(27)
J Reid Morgan
........................................................................
Assistant Secretary
6.00
.......................
34.00
X
0
560,584
142,553
(28)
Bradley A Clark
........................................................................
Treasurer
5.00
.......................
35.00
X
355,369
0
77,288
(29)
Michael T Waid
........................................................................
Sr. VP Hlth sys ops
40.00
.......................
0.00
X
490,192
0
121,840
(30)
Cathleen Wheatley
........................................................................
VP clinical op, chief nurs
40.00
.......................
0.00
X
523,022
0
110,457
(31)
Dan Squires
........................................................................
Dir Fin Affilates - Op Finance
40.00
.......................
0.00
X
486,191
0
30,891
(32)
Conrad Emmerich
........................................................................
Sr. VP Business Svc, Exec VP Hlth Sys Aff
40.00
.......................
0.00
X
426,433
0
100,951
(33)
Victoria Russell
........................................................................
VP Clinical op, Ex Adm Dir
40.00
.......................
0.00
X
534,378
0
37,176
(34)
Cheryl E H Locke
........................................................................
Former Officer
5.00
.......................
35.00
X
535,148
0
101,973
(35)
Lisa M Wyatt
........................................................................
Former Officer
0.00
.......................
0.00
X
0
104,500
122
(36)
Joanne C Ruhland
........................................................................
Former Officer
5.00
.......................
35.00
X
320,824
0
85,064
(37)
K Barbara Carbone MD
........................................................................
Former Officer
0.00
.......................
0.00
X
0
395,567
122
(38)
Russell M Howerton MD
........................................................................
Former Officer
0.00
.......................
40.00
X
0
698,389
177,305
1b
Sub-Total
................
c
Total from continuation sheets to Part VII, Section A
....
d
Total (add lines 1b and 1c)
...........
7,601,590
7,792,135
3,410,937
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization
720
Yes
No
3
Did the organization list any
former
officer, director or trustee, key employee, or highest compensated employee on line 1a?
If "Yes," complete Schedule J for such individual
..............
3
Yes
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000?
If "Yes," complete Schedule J for such
individual
...........................
4
Yes
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization?
If "Yes," complete Schedule J for such person
........
5
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization
0
Form
990
(2016)
Page 9
Form 990 (2016)
Page
9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII
.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
1a
Federated campaigns
..
1a
b
Membership dues
..
1b
c
Fundraising events
..
1c
d
Related organizations
1d
e
Government grants (contributions)
1e
f
All other contributions, gifts, grants, and similar amounts not included above
1f
1,017,776
g
Noncash contributions included
in lines 1a-1f:$
15,000
h Total.
Add lines 1a-1f
.......
1,017,776
Business Code
2a
Net Patient Service
621990
141,957,380
141,957,380
b
c
d
e
f
All other program service revenue .
g
Total.
Add lines 2a–2f
....
141,957,380
3
Investment income (including dividends, interest, and other
similar amounts)
......
585,639
-178,665
764,304
4
Income from investment of tax-exempt bond proceeds
5
Royalties
...........
(ii) Personal
(i) Real
6a
Gross rents
1,472,273
b
Less: rental expenses
1,485,674
c
Rental income or (loss)
-13,401
d
Net rental income or (loss)
......
-13,401
-13,401
(ii) Other
(i) Securities
7a
Gross amount from sales of assets other than inventory
b
Less: cost or other basis and sales expenses
320,151
70,034
c
Gain or (loss)
-320,151
-70,034
d
Net gain or (loss)
.....
-390,185
-390,185
8a
Gross income from fundraising events (not including $
of contributions reported on line 1c).
See Part IV, line 18
....
a
7,800
b
Less: direct expenses
...
b
4,340
c
Net income or (loss) from fundraising events
..
3,460
3,460
9a
Gross income from gaming activities.
See Part IV, line 19
...
a
b
Less: direct expenses
...
b
c
Net income or (loss) from gaming activities
..
10a
Gross sales of inventory, less
returns and allowances
..
a
b
Less: cost of goods sold
..
b
c
Net income or (loss) from sales of inventory
..
Business Code
Miscellaneous Revenue
11a
b
c
d
All other revenue
....
e
Total.
Add lines 11a–11d
......
12
Total revenue.
See Instructions.
.....
143,160,669
141,957,380
-178,665
364,178
Form
990
(2016)
Page 10
Form 990 (2016)
Page
10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).
Check if Schedule O contains a response or note to any line in this Part IX
..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service
expenses
(C)
Management and
general expenses
(D)
Fundraising
expenses
1
Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21
95,150
95,150
2
Grants and other assistance to domestic individuals. See Part IV, line 22
3
Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4
Benefits paid to or for members
5
Compensation of current officers, directors, trustees, and key employees
....
6
Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)
....
7
Other salaries and wages
78,212,473
77,485,228
727,245
8
Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions)
....
923,068
914,485
8,583
9
Other employee benefits
.......
12,366,383
12,182,481
183,902
10
Payroll taxes
...........
2,671,810
2,646,967
24,843
11
Fees for services (non-employees):
a
Management
......
b
Legal
.........
130,820
65,410
65,410
c
Accounting
...........
d
Lobbying
...........
e
Professional fundraising services.
See Part IV, line 17
f
Investment management fees
......
g
Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)
12,305,149
8,581,856
3,723,293
12
Advertising and promotion
....
302,738
302,738
13
Office expenses
.......
1,923,870
1,545,584
378,286
14
Information technology
......
3,016,911
2,228,905
788,006
15
Royalties
..
16
Occupancy
...........
1,516,845
1,230,684
286,161
17
Travel
............
262,779
237,749
25,030
18
Payments of travel or entertainment expenses for any federal, state, or local public officials
.
19
Conferences, conventions, and meetings
....
205,489
171,190
34,299
20
Interest
...........
3,770,786
3,707,250
63,536
21
Payments to affiliates
.......
22
Depreciation, depletion, and amortization
..
2,815,197
2,051,799
763,398
23
Insurance
...
580,553
476,053
104,500
24
Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a
Clinical Supplies
15,310,599
15,310,599
0
b
Equipment Rental & Main
15,246,687
13,861,624
1,385,063
c
Bad Debt
4,955,588
4,955,588
0
d
Unrelated Business Inco
3,810
0
3,810
e
All other expenses
25
Total functional expenses.
Add lines 1 through 24e
156,616,705
148,051,340
8,565,365
0
26
Joint costs.
Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation.
Check here
if following SOP 98-2 (ASC 958-720).
Form
990
(2016)
Page 11
Form 990 (2016)
Page
11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX
..............
(A)
Beginning of year
(B)
End of year
1
Cash–non-interest-bearing
........
6,409,274
1
8,559,246
2
Savings and temporary cash investments
.........
60,276,683
2
148,937,618
3
Pledges and grants receivable, net
......
4,206,173
3
1,287,507
4
Accounts receivable, net
.............
17,276,550
4
20,452,078
5
Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
.............
5
6
Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
..............
6
7
Notes and loans receivable, net
....
792,931
7
0
8
Inventories for sale or use
........
560,159
8
0
9
Prepaid expenses and deferred charges
......
902,079
9
21,188,527
10a
Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D
10a
44,731,500
b
Less: accumulated depreciation
10b
10,414,156
39,792,904
10c
34,317,344
11
Investments—publicly traded securities
.
11
12
Investments—other securities. See Part IV, line 11
.....
12
13
Investments—program-related. See Part IV, line 11
..
112,217,879
13
109,889,779
14
Intangible assets
...............
15,952,372
14
15,952,372
15
Other assets. See Part IV, line 11
...........
1,141,511
15
27,542,237
16
Total assets.
Add lines 1 through 15 (must equal line 34)
...
259,528,515
16
388,126,708
17
Accounts payable and accrued expenses
.....
26,570,570
17
89,568,021
18
Grants payable
...
18
19
Deferred revenue
.........
19
20
Tax-exempt bond liabilities
.........
20
21
Escrow or custodial account liability.
Complete Part IV of Schedule D
21
22
Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons.
Complete Part II of Schedule L
..
22
23
Secured mortgages and notes payable to unrelated third parties
..
54,000,000
23
196,580,056
24
Unsecured notes and loans payable to unrelated third parties
..
24
25
Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24).
Complete Part X of Schedule D
50,452,856
25
3,068,433
26
Total liabilities.
Add lines 17 through 25
..
131,023,426
26
289,216,510
Organizations that follow SFAS 117 (ASC 958),
check here
and complete lines 27 through 29, and lines 33 and 34.
27
Unrestricted net assets
122,672,996
27
95,969,032
28
Temporarily restricted net assets
...........
5,832,093
28
2,941,166
29
Permanently restricted net assets
29
Organizations that do not follow SFAS 117 (ASC 958),
check here
and complete lines 30 through 34.
30
Capital stock or trust principal, or current funds
.....
30
31
Paid-in or capital surplus, or land, building or equipment fund
...
31
32
Retained earnings, endowment, accumulated income, or other funds
32
33
Total net assets or fund balances
...........
128,505,089
33
98,910,198
34
Total liabilities and net assets/fund balances
........
259,528,515
34
388,126,708
Form
990
(2016)
Page 12
Form 990 (2016)
Page
12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI
..............
1
Total revenue (must equal Part VIII, column (A), line 12)
............
1
143,160,669
2
Total expenses (must equal Part IX, column (A), line 25)
............
2
156,616,705
3
Revenue less expenses. Subtract line 2 from line 1
..............
3
-13,456,036
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A))
..
4
128,505,089
5
Net unrealized gains (losses) on investments
...............
5
-7,862
6
Donated services and use of facilities
.................
6
7
Investment expenses
.....................
7
8
Prior period adjustments
.....................
8
9
Other changes in net assets or fund balances (explain in Schedule O)
........
9
-16,130,993
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
98,910,198
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII
.............
Yes
No
1
Accounting method used to prepare the Form 990:
Cash
Accrual
Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
Separate basis
Consolidated basis
Both consolidated and separate basis
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
Separate basis
Consolidated basis
Both consolidated and separate basis
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight
of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
No
b
If "Yes," did the organization undergo the required audit or audits?
If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Form
990
(2016)
Form 990 (2016)
Additional Data
Software ID:
Software Version:
Form 990, Special Condition Description:
Special Condition Description