Form990
Click to see attachment
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 black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2010 and ending 06-30-2011
BCheck if applicable:
CName of organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
615 DOUGLAS STREET
 
Room/suite
City or town, state or country, and ZIP + 4
DURHAM, NC27705
D Employer identification number

56-2070036
E Telephone number

G Gross receipts $ 2,609,423,531
F Name and address of principal officer:
VICTOR J DZAU MD
615 DOUGLAS STREET STE 700
DURHAM,NC27705
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.DUKEHEALTH.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1998
M State of legal domicile: NC
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: DUHS IS COMMITTED TO EXCELLENCE, INNOVATION AND LEADERSHIP IN PROVIDING THE HEALTH CARE NEEDS OF THE PEOPLE WE SERVE, IMPROVING COMMUNITY HEALTH, AND FOSTERING THE VERY BEST MEDICAL EDUCATION.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 20
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 13
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 16,547
6 Total number of volunteers (estimate if necessary) .... 6 2,300
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 14,733,592 5,769,880
9 Program service revenue (Part VIII, line 2g) ......... 2,077,077,285 2,181,972,792
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 246,521,983 121,177,481
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 50,384,488 59,642,402
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 2,388,717,348 2,368,562,555
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 5,601,569 5,641,045
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) 1,016,995,699 1,030,668,755
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet696,773    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 935,397,822 1,062,048,680
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,957,995,090 2,098,358,480
19 Revenue less expenses. Subtract line 18 from line 12...... 430,722,258 270,204,075
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 3,155,357,986 3,519,120,113
21 Total liabilities (Part X, line 26)............ 1,582,862,863 1,472,869,787
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 1,572,495,123 2,046,250,326
Part II
Signature Block
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.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: DUHS IS COMMITTED TO EXCELLENCE, INNOVATION AND LEADERSHIP IN PROVIDING THE HEALTH CARE NEEDS OF THE PEOPLE WE SERVE, IMPROVING COMMUNITY HEALTH, AND FOSTERING THE VERY BEST MEDICAL EDUCATION.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
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? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts 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 $ 1,537,777,662 including grants of $ 5,641,045 ) (Revenue $ 2,226,773,111 )
HISTORY AND ORGANIZATION IN 1925, JAMES B. DUKE WILLED $4 MILLION TO ESTABLISH DUKE 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 TO ENHANCE AND IMPROVE HEALTH CARE THROUGHOUT NORTH CAROLINA AND SOUTHERN VIRGINIA. THE DUHS MISSION IS CLINICAL CARE AND IS ENHANCED BY THE RESEARCH AND EDUCATION MISSIONS OF DUKE UNIVERSITY (THE DUKE UNIVERSITY SCHOOL OF MEDICINE AND SCHOOL OF NURSING). TOGETHER THEY SERVE THE COMMUNITY AS DUKE MEDICINE. MANY PROGRAM SERVICE ACCOMPLISHMENTS ARE INCLUDED IN SCHEDULE H TO THIS FORM INCLUDING THE FINANCIAL COMMITMENT MADE TO THE COMMUNITY BY DUHS IN TERMS OF CHARITY CARE AND OTHER DIRECT AND MEASURABLE INVESTMENTS. BELOW ARE EXCERPTS FROM THE ANNUAL DUHS REPORT ON COMMUNITY BENEFIT. THE COST OF THESE ACTIVITIES CAN BE DIFFICULT TO MEASURE. SOMETIMES THEY INCLUDE THE PARTICIPATION OF DUKE UNIVERSITY SO REFERENCES TO "DUKE" ARE MEANT TO INCLUDE DUHS AND DUKE UNIVERSITY IN THEIR RESPECTIVE MISSION CAPACITIES. SERVING THE COMMUNITY BY PROVIDING OUTSTANDING CARE FOR EVERY PATIENT DUKE UNIVERSITY HEALTH SYSTEM'S PRIMARY COMMITMENT IS PROVIDING EXCELLENT, EFFECTIVE AND COMPASSIONATE HEALTH CARE SERVICES TO OUR PATIENTS. THE PATIENTS AND FAMILIES WE SERVE BENEFIT FROM THE HEALTH SYSTEM'S DIRECT AND IMPORTANT ASSOCIATION WITH DUKE UNIVERSITY SCHOOL OF MEDICINE, WHOSE CLINICAL FACULTY ARE RECOGNIZED LEADERS IN THEIR FIELDS. AS A LEADING ACADEMIC MEDICAL CENTER, DUKE IS UNIQUELY POSITIONED TO TRANSFORM MEDICINE AND HEALTH LOCALLY AND GLOBALLY THROUGH INNOVATIVE SCIENTIFIC RESEARCH, RAPID TRANSLATION OF BREAKTHROUGH DISCOVERIES AND EDUCATING FUTURE CLINICAL AND SCIENTIFIC LEADERS. DUKE IS A STRONG ADVOCATE OF PRACTICING EVIDENCE-BASED MEDICINE AND IS A LEADER IN EFFORTS TO ELIMINATE HEALTH INEQUALITIES. EACH YEAR, THE 15,000 PROFESSIONALS OF DUKE UNIVERSITY HEALTH SYSTEM SERVE PATIENTS THROUGH MORE THAN 60,000 HOSPITAL ADMISSIONS AND 1.9 MILLION OUTPATIENT VISITS. FOR 21 CONSECUTIVE YEARS, DUKE UNIVERSITY HOSPITAL HAS BEEN NAMED AMONG THE TOP 10 IN THE NATION BY U.S. NEWS & WORLD REPORT. IN PRIVATE AND GOVERNMENT SURVEYS, PATIENTS HAVE CONSISTENTLY RATED THEIR SATISFACTION WITH THE CARE PROVIDED AT DUKE CLINICS AND HOSPITALS ABOVE STATE AND NATIONAL AVERAGES. DUKE UNIVERSITY HEALTH SYSTEM IS A WORLD-CLASS PROVIDER OF HEALTH CARE SERVICES BASED IN DURHAM, N.C., BUT WITH AN IMPACT ACROSS NORTH CAROLINA. IT INCLUDES: DUKE UNIVERSITY HOSPITAL A TERTIARY AND QUATERNARY CARE HOSPITAL AND SPECIALTY OUTPATIENT CLINICS, LOCATED ON THE CAMPUS OF DUKE UNIVERSITY MEDICAL CENTER IN DURHAM, N.C., THAT IS CONSISTENTLY RATED AS ONE OF THE NATION'S BEST. DUKE CHILDREN'S HOSPITAL & HEALTH CENTER A PART OF DUKE UNIVERSITY HOSPITAL, DUKE CHILDREN'S IS CONSISTENTLY RANKED AMONG THE TOP PEDIATRIC SPECIALTY PROGRAMS IN THE NATION. DURHAM REGIONAL HOSPITAL A FULL-SERVICE COMMUNITY HOSPITAL IN DURHAM SERVING THE HEALTH CARE NEEDS OF DURHAM, ORANGE, PERSON AND GRANVILLE COUNTIES, AND SURROUNDING COMMUNITIES. DUKE RALEIGH HOSPITAL A COMMUNITY HOSPITAL IN RALEIGH, N.C., THAT PROVIDES AN ARRAY OF MEDICAL CARE SERVICES TO PATIENTS IN WAKE COUNTY. DUKE PRIMARY CARE A NETWORK OF COMMUNITY-BASED PRIMARY CARE PHYSICIANS, PHYSICIAN ASSISTANTS AND NURSE PRACTITIONERS SERVING PATIENTS AT TWO DOZEN LOCATIONS ACROSS EIGHT COUNTIES IN THE GREATER TRIANGLE AREA. DAVIS AMBULATORY SURGICAL CENTER A MULTI-SPECIALTY OUTPATIENT SURGICAL FACILITY IN DURHAM. DUKE HOMECARE & HOSPICE A PROVIDER OF HOSPICE SERVICES IN ORANGE, DURHAM, GRANVILLE, WAKE, PERSON, CHATHAM, ALAMANCE AND VANCE COUNTIES THAT ALSO OFFERS INFUSION SERVICES THROUGHOUT NORTH CAROLINA, SOUTH CAROLINA AND VIRGINIA. PHARMACY SERVICES ARE PROVIDED THROUGHOUT THE UNITED STATES. AFFILIATED PROGRAMS DUKE UNIVERSITY HEALTH SYSTEM MAINTAINS MANY COLLABORATIONS AND AFFILIATIONS WITH HOSPITALS AND HEALTH CARE FACILITIES ACROSS NORTH CAROLINA AND THE SOUTHEAST. AMONG THESE ARE THE DUKE HEART NETWORK AND DUKE ONCOLOGY NETWORK. CHARITY CARE AND SIMILAR COMMUNITY BENEFITS: PEOPLE WITH URGENT AND EMERGENT MEDICAL NEEDS RECEIVE MEDICAL CARE AT DUKE UNIVERSITY HEALTH SYSTEM FACILITIES REGARDLESS OF THEIR ABILITY TO PAY. IN THE FISCAL YEAR THAT ENDED JUNE 30, 2011, DUKE PROVIDED CHARITY CARE AT COST VALUED AT $65 MILLION TO PATIENTS FROM EVERY NORTH CAROLINA COUNTY. IN ADDITION TO PROVIDING PRIMARY CARE AT NO CHARGE, DUKE PHYSICIANS DONATE SPECIALTY CARE SERVICES TO ELIGIBLE UNINSURED PATIENTS THROUGH A PROGRAM CALLED PROJECT ACCESS. WE WORK WITH PATIENTS TO ACCESS THE BENEFITS TO WHICH THEY ARE ENTITLED. AND, WHEN GOVERNMENT PROGRAMS DON'T COMPLETELY COVER THE COST OF CARE, DUKE MAKES UP THE DIFFERENCE. DUKE ALSO WORKS TO CONTROL MEDICAID COSTS THROUGH ITS LEADERSHIP ROLE IN THE COMMUNITY CARE OF NORTH CAROLINA (CCNC) PROGRAM, WHICH IMPROVES THE CARE OF MORE THAN A MILLION PATIENTS WHILE REDUCING UNNECESSARY HOSPITAL AND EMERGENCY DEPARTMENT VISITS. BETWEEN 2006 AND 2010, CCNC, NOW A NATIONAL MODEL, SAVED STATE TAXPAYERS NEARLY $1 BILLION. BY THE NUMBERS " $65 MILLION - CHARITY CARE AT COST " $89 MILLION - UNREIMBURSED MEDICAID COSTS COVERED BY DUKE " $90 MILLION - UNREIMBURSED MEDICARE COSTS COVERED BY DUKE " $23 MILLION - UNRECOVERABLE PATIENT DEBT " 300,077 -- VISITS TO DUKE FROM PATIENTS WITH MEDICAID BENEFITS AID TO COMMUNITY GROUPS DUKE CONTINUES TO BUILD ON ITS LONGSTANDING PARTNERSHIPS WITH COMMUNITY GROUPS TO COLLABORATIVELY IDENTIFY AND ELIMINATE HEALTH DISPARITIES AND REMOVE OBSTACLES TO ACCESSING MEDICAL CARE. IN 2011, DUKE PROVIDED $3 MILLION IN DIRECT SUPPORT AND $4 MILLION IN IN-KIND SUPPORT FOR LINCOLN COMMUNITY HEALTH CENTER AND ITS SATELLITE COMMUNITY AND SCHOOL CLINICS, WHICH SERVE AN OVERWHELMINGLY POOR, UNINSURED PATIENT POPULATION IN DURHAM. DUKE ALSO PROVIDED $2 MILLION FOR DURHAM COUNTY'S EMERGENCY MEDICAL SERVICES OPERATION. DUKE RALEIGH HOSPITAL PROVIDED IN-KIND LAB SERVICES OF MORE THAN $1.5 MILLION IN VALUE IN 2011 TO THE OPEN DOOR CLINIC, WHICH PROVIDES NO-COST COMPREHENSIVE CARE TO UNINSURED AND INDIGENT PEOPLE IN WAKE COUNTY. BY THE NUMBERS " $10 MILLION -AID TO COMMUNITY GROUPS " 40,670 - LINCOLN COMMUNITY HEALTH CENTER (LCHC) PATIENTS " 86.6 - PERCENTAGE OF LCHC PATIENTS BELOW THE FEDERAL POVERTY LEVEL " $1.5 MILLION - VALUE OF IN-KIND LAB SERVICES PROVIDED BY DUKE RALEIGH HOSPITAL TO THE OPEN DOOR CLINIC COMMUNITY HEALTH OVER MANY YEARS, DUKE AND COMMUNITY LEADERS HAVE FORGED A CLOSE, COLLABORATIVE PARTNERSHIP TO IMPROVE THE HEALTH AND ACCESS TO HEALTH CARE OF ALL DURHAM COUNTY RESIDENTS. AN EXCELLENT EXAMPLE OF THAT VIBRANT PARTNERSHIP IS DURHAM HEALTH INNOVATIONS (DHI), WHICH IS DEVELOPING NEW WAYS TO REDUCE DEATH AND DISABILITY FROM SPECIFIC DISEASES AND DISORDERS IN THE COMMUNITY. DDC INTEGRATES INNOVATIVE APPROACHES TO COMMUNITY HEALTH, SUCH AS USE OF GEOSPATIAL TECHNOLOGY TO TRACK DISEASE, WITH TRADITIONAL GRASSROOTS, NEIGHBORHOOD-BASED EFFORTS. BY THE NUMBERS: " $6.2 MILLION - AMOUNT OF FIVE-YEAR GRANT SUPPORTING THE DURHAM DIABETES COALITION EFFORT " 12 - PERCENTAGE OF PEOPLE IN DURHAM COUNTY BELIEVED TO HAVE DIABETES " 26 MILLION - NUMBER OF AMERICANS AFFECTED BY DIABETES HEALTH PROFESSIONS EDUCATION AT THE CORE OF DUKE'S MISSION IS IMPROVING HEALTH CARE FOR PATIENTS AND COMMUNITIES BY TRAINING DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS FOR TOMORROW'S INCREASINGLY COMMUNITY-FOCUSED HEALTH CARE DELIVERY SYSTEM. THE TRAINING RECOGNIZES THAT CARE WILL BE DELIVERED IN AN EMERGING VARIETY OF NON-TRADITIONAL SETTINGS USING INNOVATIVE MODELS OF CARE. DUKE'S LEARNING TOGETHER PROGRAM IS AN EXAMPLE OF HOW HEALTH PROFESSIONS STUDENTS DEVELOP THOSE SKILLS BY TEACHING HEALTH AND WELLNESS PRACTICES TO DIVERSE COMMUNITY POPULATIONS, INCLUDING ELEMENTARY SCHOOL CHILDREN AND THE ELDERLY. IN DOING SO, THE LEARNERS GAIN SKILLS THEY CAN USE AS HEALTH PROFESSIONALS TO WORK EFFECTIVELY IN ANY COMMUNITY. BY THE NUMBERS: " $47 MILLION - INVESTMENT IN HEALTH PROFESSIONS EDUCATION " 15 - LEARNING TOGETHER PROJECTS, INCLUDING: " 1,224 - COMMUNITY CHILDREN SERVED " 239 - COMMUNITY ADULTS SERVED
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 1,537,777,662
Form 990 (2010)
Form 990 (2010)
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 AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
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 IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
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
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where 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 IClick to see attachment.......................
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 IIClick to see attachment...
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 Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; 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 IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
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, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
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.Click to see attachment
11b
Yes
 
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.Click to see attachment
11c
 
No
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.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
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.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
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, XII, and XIII is optional Click to see attachment
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, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II.. Click to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III.. Click to see attachment
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 IClick to see attachment
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.......... Click to see attachment
18
Yes
 
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................... Click to see attachment
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. ..... Click to see list of attachments
20b
Yes
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
Yes
 
23
Did the organization answer “Yes” to Part VII, Section A, questions 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................ Click to see attachment
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 questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
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
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
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................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
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 ......................... Click to see attachment
28a
Yes
 
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
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 owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
Yes
 
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I........................... Click to see attachment
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........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
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... Click to see attachment
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........... Click to see attachment
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 VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
343
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
Yes
 
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
16,547
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
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
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 or securities account)?.......................
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletBD
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
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?..........
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 and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the 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. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate 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 aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
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 to any question 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
20
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
13
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
 
No
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
Does the organization have members or stockholders? ................
6
 
No
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
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
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a 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 the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does 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 a or b, 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,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
AK , AZ , FL , GA , HI , IL , KS , KY , MD , MA , MI , MN , MS , NH , NJ , NY , NC , OH , OK , OR , PA , SC , TN , UT , WI
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 make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
MIKE LAZAR
DUKE UNIV HEALTH SYSTEM
DURHAM,NC27705
(919) 613-8997
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question 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.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet 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.

RoundBullet 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.

RoundBullet 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 organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(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
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) NANCY C ANDREWS MD
DIRECTOR
 1.0 X           0 679,311 45,100
(2) THE HONORABLE DANIEL T BLUE JR
DIRECTOR
 1.0 X           0 0 0
(3) JACK O BOVENDER JR
DIRECTOR
 1.0 X           0 0 0
(4) MARK BRANCH III MD
DIRECTOR
 1.0 X           0 20,000 1,780
(5) RICHARD H BRODHEAD
DIRECTOR
 10.0 X           0 776,073 191,410
(6) VICTOR J DZAU MD
CEO/DIRECTOR/PRESIDENT
 40.0 X   X       0 2,037,221 759,796
(7) FRANK E EMORY JR
DIRECTOR
 1.0 X           0 0 0
(8) JAMES F GOODMON
DIRECTOR
 1.0 X           0 0 0
(9) THOMAS M GORRIE
DIRECTOR
 1.0 X           0 0 0
(10) REV KENNETH R HAMMOND
DIRECTOR
 1.0 X           0 0 0
(11) DANNY O JACOBS MD
DIRECTOR
 1.0 X           0 344,165 44,706
(12) REBECCA TRENT KIRKLAND MD
DIRECTOR
 1.0 X           0 0 0
(13) RICHARD D KLAUSNER MD
DIRECTOR
 1.0 X           0 0 0
(14) HENRY C KNIGHT
DIRECTOR
 1.0 X           0 0 0
(15) JOHN H MCARTHUR
DIRECTOR
 1.0 X           0 0 0
(16) LLOYD B MORGAN
DIRECTOR
 1.0 X           0 0 0
(17) CARL E RAVIN MD
DIRECTOR
 12.0 X           0 273,090 39,574
Form 990 (2010)
Form 990 (2010)
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 (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(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
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) STEVEN SCOTT MD
DIRECTOR
 1.0 X           0 0 0
(19) SUSAN M STALNECKER
DIRECTOR
 1.0 X           0 0 0
(20) PETER VAN ETTEN
DIRECTOR
 1.0 X           0 0 0
(21) MONTE D BROWN MD
VP OF ADMINISTRATION/SECRETARY
 50.0     X       516,360 0 50,678
(22) WILLIAM J FULKERSON JR MD
CEO, DUKE HOSP/SVP, ACUTE CARE
 60.0     X       1,052,828 0 34,090
(23) KENNETH C MORRIS
SVP, CFO, TREASURER
 60.0     X       883,074 0 36,870
(24) ASIF AHMAD
VP, PDC AND CIO, DUHS
 40.0       X     589,928 0 39,290
(25) MARY ANN FUCHS
CHIEF NURSING OFFICER
 40.0       X     321,849 0 34,557
(26) PAUL R NEWMAN
CEO, ADMINISTRATIVE DIRECTOR
 0.0       X     0 315,687 60,633
(27) KEVIN W SOWERS
CHIEF OPERATING OFFICER
 60.0       X     621,977 0 36,615
(28) DOUGLAS B VINSEL
CEO, DUKE RALEIGH HOSPITAL
 60.0       X     570,032 0 46,312
(29) KERRY R WATSON
CEO, DRH CORPORATE ADMIN
 40.0       X     432,548 0 64,169
(30) MARC CALABRESE
PHYSICIAN
 40.0         X   355,936 0 47,171
(31) JOHN M KELSCH
PHYSICIAN
 40.0         X   395,043 0 43,567
(32) MOLLY K ONEILL
VP, BUSINESS DEVELOPMENT
 40.0         X   554,851 0 38,430
(33) THOMAS A OWENS
PHYSICIAN
 40.0         X   350,845 0 41,164
(34) JOSEPH G TAYLOR
PHYSICIAN
 40.0         X   395,477 0 47,417
(35) HARVEY JAY COHEN MD
FORMER DIRECTOR
 0.0           X 0 403,839 39,574
(36) KIMBERLY J JENKINS
FORMER DIRECTOR
 0.0           X 0 37,500 4,565
(37) FRANCES D MAUNEY
FORMER DIRECTOR
 0.0           X 0 127,125 20,435
(38) R SANDERS WILLIAMS MD
FORMER DIRECTOR
 0.0           X 0 245,568 30,821
(39) MICHAEL S CUFFE MD
FORMER OFFICER
 27.0           X 514,026 0 38,720
(40) MARK D GUSTAFSON
FORMER OFFICER
 0.0           X 0 273,697 42,448
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 7,554,774 5,533,276 1,879,892
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet902
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.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
BEK BUILDING GROUP INC
5400 TRINITY ROAD STE 303
RALEIGH,NC27607 		CONSTRUCTION SERVICE 58,653,963
PRIVATE DIAGNOSTIC CLINIC PLLC
DUMC 3810
DURHAM,NC27710 		PHYSICIAN SERVICES 31,608,788
ARAMARK HEALTHCARE SUPPORT SERVICES
PO BOX 651009
CHARLOTTE,NC282651009 		HEALTHCARE SERVICES 10,372,990
SKANSKA USA
PO BOX 2860
DURHAM,NC27715 		CONSTRUCTION SERVICE 5,734,272
PERKINS WILL INC
1382 PEACHTREE ST NE
ATLANTA,GA30309 		ARCHITECT SERVICES 5,714,093
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet216
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 106,688
d Related organizations...1d 16,575
e Government grants (contributions)1e 577,536
f All other contributions, gifts, grants, and
similar amounts not included above1f 		5,069,081
g Noncash contributions included in lines 1a-1f:$ 124,692
h Total. Add lines 1a-1f.......MediumBullet 5,769,880
Program Service Revenue Business Code
2a PATIENT REVENUE 621,990 2,158,359,530 2,158,359,530    
b MEDICAL SERVICES 621,990 2,511,449 2,511,449    
c ANCILLARY MEDICAL 621,990 21,101,813 21,101,813    
d SERVICES          
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 2,181,972,792
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 13,857,767     13,857,767
4 Income from investment of tax-exempt bond proceeds..MediumBullet 1,217,357     1,217,357
5 Royalties............MediumBullet 3,156,895     3,156,895
(i) Real (ii) Personal
6a Gross Rents 15,996,994  
b Less: rental expenses 15,041,637  
c Rental income or (loss) 955,357  
d Net rental income or (loss).......MediumBullet 955,357     955,357
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 331,220,664 622,471
b Less: cost or other basis and sales expenses 219,585,571 6,155,207
c Gain or (loss) 111,635,093 -5,532,736
d Net gain or (loss)..........MediumBullet 106,102,357     106,102,357
8a Gross income from fundraising events (not including
$ 106,688
of contributions reported on line 1c). See Part IV, line 18 ...
a 64,389
b Less: direct expenses ...b 78,561
c Net income or (loss) from fundraising events..MediumBullet -14,172   -14,172
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...MediumBullet 0      
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..MediumBullet 0      
Miscellaneous Revenue Business Code
11a BILLING FEES 621,990 37,657,383 37,657,383    
b TUITION REVENUE 900,099 2,024,670 2,024,670    
c DEEMED DIVIDEND REVENUE 900,003 6,667,089     6,667,089
d All other revenue .... 9,195,180 5,118,266   4,076,914
e Total. Add lines 11a–11d ......MediumBullet 55,544,322
12 Total revenue. See Instructions....MediumBullet 2,368,562,555 2,226,773,111   136,019,564
Form 990 (2010)
Form 990 (2010)
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) but are not required to complete columns (B), (C), and (D).
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 governments and organizations in the U.S. See Part IV, line 21 5,612,270 5,612,270
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 28,775 28,775
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 5,106,194 166,589 4,846,803 92,802
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 651,538 27,032 624,506  
7 Other salaries and wages 822,087,819 578,713,528 243,374,291  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 32,346,568 20,017,544 12,322,559 6,465
9 Other employee benefits ....... 114,984,120 78,096,631 36,874,791 12,698
10 Payroll taxes ........... 55,492,516 38,319,452 17,166,759 6,305
11 Fees for services (non-employees):        
a Management ...... 12,192,089 12,192,089    
b Legal ......... 1,139,896 149,213 990,683  
c Accounting ........... 503,045   503,045  
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 3,405,653   3,405,653  
g Other .......... 126,429,567 75,286,529 51,143,038  
12 Advertising and promotion .... 4,782,933 1,128,414 3,654,519  
13 Office expenses ....... 503,134,773 488,229,165 14,882,866 22,742
14 Information technology ...... 26,824,839 3,671,370 23,153,469  
15 Royalties .. 0      
16 Occupancy ........... 45,146,466 29,614,076 15,532,383 7
17 Travel ............ 6,255,991 4,372,994 1,880,411 2,586
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 2,892,090 266,840 2,623,674 1,576
20 Interest ........... 31,975,001   31,975,001  
21 Payments to affiliates ....... 46,124,561   45,574,561 550,000
22 Depreciation, depletion, and amortization ..... 87,907,593 67,327,905 20,579,688  
23 Insurance .............. 12,345,226 6,625,222 5,720,004  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a EQUIPMENT RENTAL & MAINTENANCE 67,246,889 45,747,671 21,498,413 805
b BAD DEBT 71,709,911 71,709,911    
c LAUNDRY 7,886,244 7,803,874 82,370  
d SHARED EXPENSES 558,408 558,408    
e DUES & MEMBERSHIPS 2,392,243 917,085 1,474,558 600
f All other expenses 1,195,262 1,195,075   187
25 Total functional expenses. Add lines 1 through 24f 2,098,358,480 1,537,777,662 559,884,045 696,773
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 47,438 1 49,068
2 Savings and temporary cash investments ....... 353,242,558 2 356,503,510
3 Pledges and grants receivable, net ......... 18,523,454 3 18,030,089
4 Accounts receivable, net ......... 304,383,857 4 305,877,825
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net ............. 12,811,035 7 1,394,532
8 Inventories for sale or use .............. 60,992,338 8 62,751,534
9 Prepaid expenses and deferred charges ............ 8,985,829 9 8,806,735
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,954,787,798
b Less: accumulated depreciation. ..... 10b 977,092,339 877,076,034 10c 977,695,459
11 Investments—publicly traded securities .......... 47,957,035 11 2,920,163
12 Investments—other securities. See Part IV, line 11 ...... 1,431,838,245 12 1,680,758,563
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ......... 644,069 14 644,069
15 Other assets. See Part IV, line 11 ........... 38,856,094 15 103,688,566
16 Total assets. Add lines 1 through 15 (must equal line 34)... 3,155,357,986 16 3,519,120,113
Liabilities 17 Accounts payable and accrued expenses . 260,374,010 17 283,599,625
18 Grants payable ..........   18  
19 Deferred revenue .......... 3,905,029 19 2,930,320
20 Tax-exempt bond liabilities .......... 844,462,095 20 830,779,105
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 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 ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 474,121,729 25 355,560,737
26 Total liabilities. Add lines 17 through 25..... 1,582,862,863 26 1,472,869,787
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 1,516,863,658 27 1,992,550,258
28 Temporarily restricted net assets ..... 44,864,766 28 44,049,489
29 Permanently restricted net assets ..... 10,766,699 29 9,650,579
Organizations that do not follow SFAS 117, check here MediumBullet 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 ..... 1,572,495,123 33 2,046,250,326
34 Total liabilities and net assets/fund balances ..... 3,155,357,986 34 3,519,120,113
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
2,368,562,555
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
2,098,358,480
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
270,204,075
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
1,572,495,123
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
203,551,128
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
2,046,250,326
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
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
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 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?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
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 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number

56-2070036
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number

56-2070036
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
DUKE UNIVERSITY HEALTH SYSTEM INC
  		Employer identification number

56-2070036
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
DUKE UNIVERSITY HEALTH SYSTEM INC
  		Employer identification number

56-2070036
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
DUKE UNIVERSITY HEALTH SYSTEM INC
  		Employer identification number

56-2070036
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number

56-2070036
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$ 0
3
Volunteer hours ........................................
0

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$ 0
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$ 0
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots non-taxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
199,426
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
Yes
 
119,955
j
Total. lines 1c through 1i ...................................
319,381
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
No
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
MEMBERSHIP DUES SCHEDULE C, PART II-B, LINE 1i 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.
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number

56-2070036
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 55,631,465 44,124,232 52,120,961
b Contributions ........ 5,340,437 14,138,555 5,465,898
c Investment earnings or losses ... 3,639,795 2,461,764 -6,187,893
d Grants or scholarships ..... 0 0 0
e Other expenditures for facilities
and programs ........ 		-10,911,629 -5,093,086 -7,274,733
f Administrative expenses .... 0 0 0
g End of year balance ...... 53,700,068 55,631,465 44,124,233
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet0 %
b
Permanent endowment: SchDMd Bullet18.000 %
c
Term endowment: SchDMd Bullet82.000 %
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   27,482,986 27,482,986
b Buildings ................   1,256,338,942 476,940,757 779,398,185
c Leasehold improvements ............        
d Equipment ................   441,659,757 314,983,179 126,676,578
e Other .................   229,306,113 185,168,403 44,137,710
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 977,695,459
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) POOLED INVESTMENTS 		563,376,000 F

(B) DOMESTIC BONDS & LT NOTES 		84,696,000 F

(C) DOMESTIC STOCKS 		75,750,000 F

(D) INTERNATIONAL BONDS & LT NOTES 		72,913,000 F

(E) INTERNATIONAL STOCKS 		352,547,000 F

(F) HEDGED STRATEGIES 		311,927,000 F

(G) SHORT-TERM INVESTMENTS 		180,254,000 F

(H) PRIVATE CAPITAL 		23,343,000 F

(I) REAL ESTATE 		4,776,000 F

(J) OTHER INVESTMENTS 		11,176,563 F
Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 1,680,758,563
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes 0
INTEREST PAYABLE 10,858,433
PROFESSIONAL LIABILITY COSTS 8,612,481
POST RETIREMENT BENEFIT OBLIGATION 78,733,000
CAPITAL LEASE OBLIGATION 128,116,366
DERIVATIVE INSTRUMENTS 82,698,372
OTHER NON-CURRENT LIABILITIES 42,241,583
INTERCOMPANY PAYABLE 4,300,502


Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 355,560,737
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 4 THE INTENDED USE FOR THE ORGANIZATION'S ENDOWMENT FUNDS IS SUPPORTING CAPITAL PURCHASES, OFFSETTING OPERATING COSTS, IMPROVING PATIENT SAFETY, AND SUPPORTING THE NEEDS OF PATIENTS AND FAMILIES.
LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 SCHEDULE D, PART X DUHS ADOPTED THE REQUIREMENTS OF FIN 48 AND CONSIDERED ITS TAX POSITIONS. BASED ON THAT ANALYSIS, THE PROVISIONS OF FIN 48 ARE DEEMED IMMATERIAL TO THE DUHS FINANCIAL STATEMENTS AND THEREFORE NO FIN 48 SPECIFIC DISCLOSURES ARE MADE IN THE AUDITED FINANCIAL STATEMENTS OF DUHS, INC. AND ITS AFFILIATES FOR FISCAL YEAR ENDED JUNE 30, 2011.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE F
(Form 990)

Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,
Part IV, line 14b, 15, or 16.
Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number

56-2070036
Part I
General Information on Activities Outside the United States. Complete if the organization answered
“Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of the grants or
assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award
the grants or assistance? ...................................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside the
United States.
3
Activites per Region. (Use Part V if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees or agents in region or independent contractors (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total
expenditures for region/investments
in region
Central America and the Caribbean 0 0 Send agents to seminar   10,479
East Asia and the Pacific 0 0 Send agents to seminar   26,290
Europe (Including Iceland and Greenland) 0 0 Send agents to seminar   72,555
North America 0 0 Send agents to seminar   6,353
South America 0 0 Send agents to seminar   1,110
Sub-Saharan Africa 0 0 Program Services RESEARCH 3,211
Sub-Saharan Africa 0 0 Send agents to seminar   1,081
Central America and the Caribbean 0 0 Investments   153,679,642
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 0 0 153,800,721
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b) 0 0 153,800,721
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990,
Part IV, line 15, for any recipient who received more than $5,000. Check this box if no one recipient received more than $5,000 ........ MediumBullet
Use Part V if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2
Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .....MediumBullet
 
3
Enter total number of other organizations or entities ........................MediumBullet
 
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Use Part V if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926 (see instructions for Form 926).................
2 Did the organization have an interest in a foreign trust during the tax year? If " Yes," the organization may be required to file Form 3520 and/or Form 3520-A. (see instructions for Forms 3520 and 3520-A)..........
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with respect to Certain Foreign Corporations. (see instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with respect to Certain Foreign Partnerships. (see instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see instructions for Form 5713)................................................
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 5
Part V
Supplemental Information
Complete this part to provide the information (see instructions) required in Part I, line 2, and any additional information.
Identifier ReturnReference Explanation
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2010
Additional Data


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Software Version:  



SCHEDULE G
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number

56-2070036
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
AL, AK, AZ, AR, CA, CO, CT, DC, FL, GA, HI, IL, KS, KY, LA, ME, MD, MA, MI, MN, MS, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, UT, VA, WA, WV, WI
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

GALA
(event type) 		(b) Event #2

NONE
(event type) 		(c) Other Events

0
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 171,077 0 0 171,077
2 Less: Charitable
contributions . . . 		106,688 0 0 106,688
3 Gross income (line 1
minus line 2) . . . 		64,389 0 0 64,389
VerticalDirectExpenses 4 Cash prizes . . . 0 0 0 0
5 Non-cash prizes . . 52,071 0 0 52,071
6 Rent/facility costs . . 2,777 0 0 2,777
7 Food and beverages . . 14,744 0 0 14,744
8 Entertainment . . . 2,859 0 0 2,859
9 Other direct expenses . 6,110 0 0 6,110
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 78,561
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow -14,172
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ...........................
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 2010
Additional Data


Software ID:  
Software Version:  
SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number

56-2070036
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
 
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		    64,690,025 0 64,690,025 3.190 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		    89,195,377 0 89,195,377 4.400 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....     0 0 0  
dTotal Charity Care and
Means-Tested Government Programs ..... 		    153,885,402 0 153,885,402 7.590 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    0 0 0  
f Health professions education
(from Worksheet 5) .. 		    60,632,199 13,815,057 46,817,142 2.310 %
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)     0 0 0  
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		    9,502,082 0 9,502,082 0.470 %
jTotal Other Benefits ...     70,134,281 13,815,057 56,319,224 2.780 %
kTotal. Add lines 7d and 7j. ..     224,019,683 13,815,057 210,204,626 10.370 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     0 0    
2 Economic development     0 0    
3 Community support     0 0    
4 Environmental improvements     0 0    
5 Leadership development and training for community members     0 0    
6 Coalition building     0 0    
7 Community health improvement advocacy     0 0    
8 Workforce development     0 0    
9 Other     0 0    
10 Total     0 0    
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
23,010,938
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
 
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
472,185,500
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
539,745,944
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-67,560,444
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
 
No
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1DLP HEALTHCARE LLC
  		BUILD NETWORK OF HOSPITALS 3.000 % 0 % 0 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?3
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 DUKE UNIVERSITY HOSPITAL
2301 ERWIN ROAD PRIMARY CAMPUS
DURHAM,NC27710 		X X X X   X X    
2 DUKE RALEIGH HOSPITAL
3400 WAKE FOREST ROAD
RALEIGH,NC27609 		X X         X    
3 DURHAM REGIONAL HOSPITAL
3643 ROXBORO ROAD
DURHAM,NC27704 		X X         X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:DUKE UNIVERSITY HOSPITAL
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for free care: 200.%
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.%
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14 Yes  
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16 Yes  
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21 Yes  
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:DUKE RALEIGH HOSPITAL
Line Number of Hospital Facility (from Schedule H, Part V, Section A):2

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for free care: 200.%
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.%
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14 Yes  
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16 Yes  
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21 Yes  
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:DURHAM REGIONAL HOSPITAL
Line Number of Hospital Facility (from Schedule H, Part V, Section A):3

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for free care: 200.%
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.%
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14 Yes  
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16 Yes  
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21 Yes  
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?4
Name and address Type of Facility (Describe)
1 HOSPICE OF MEADOWLANDS
1001 CORPORATE DRIVE
HILLSBOROUGH,NC27278 		HOSPICE
2 HOSPICE OF MEADOWLANDS
1001 CORPORATE DRIVE
HILLSBOROUGH,NC27278 		HOSPICE
3 HOSPICE OF MEADOWLANDS
1001 CORPORATE DRIVE
HILLSBOROUGH,NC27278 		HOSPICE
4 HOSPICE OF MEADOWLANDS
1001 CORPORATE DRIVE
HILLSBOROUGH,NC27278 		HOSPICE
5
6
7
8
9
10
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
PART I, LINE 3C   NOT APPLICABLE
PART I, LINE 6A   NOT APPLICABLE
PART I, LINE 7G   NOT APPLICABLE
PART I, LINE 7, COLUMN F   BAD DEBT EXPENSE EXCLUDED FROM DETERMINING THE PERCENT IS $71,709,910. TOTAL GROSS COMMUNITY BENEFIT EXPENSE AS A PERCENT OF TOTAL EXPENSES IS 11.05%.
PART I, LINE 7   CHARITY CARE AT COST IS DETERMINED USING THE COST-TO-CHARGE CALCULATION FROM WORKSHEET 2. UNREIMBURSED MEDICAID IS DETERMINED USING A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS.
COMMUNITY BUILDING ACTIVITIES PART II THESE ACTIVITIES ARE INCLUDED IN DUKE UNIVERSITY HEALTH SYSTEM, INC.'S OPERATING EXPENSES AND ARE NOT TRACKED SEPARATELY FOR COMMUNITY BENEFIT REPORTING PURPOSES.
PART III, LINE 4   BAD DEBT AT COST IS DETERMINED USING THE COST-TO-CHARGE RATIO CALCULATION FROM WORKSHEET 2. TEXT FROM FOOTNOTES - FOOTNOTE 3 NET PATIENT SERVICE REVENUE AND ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS: THE ALLOWANCE FOR BAD DEBTS IS THE HEALTH SYSTEM'S BEST ESTIMATE OF THE AMOUNT OF CREDIT LOSSES IN THE HEALTH SYSTEM'S PATIENT ACCOUNTS RECEIVABLE. FACTORS THAT DETERMINE THE ALLOWANCE ARE BASED PRIMARILY ON HISTORICAL COLLECTIONS AND WRITE-OFFS ADJUSTED FOR PRICE CHANGES, AGING, INSURANCE STATUS, AND OTHER MANAGEMENT ANALYSIS. FOOTNOTE 5 CHARITY CARE AND OTHER COMMUNITY BENEFITS: THE HEALTH SYSTEM PROVIDES ADDITIONAL UNCOMPENSATED CARE IN THE FORM OF BAD DEBTS. ESTIMATED UNCOMPENSATED COSTS ASSOCIATED WITH BAD DEBT ACCOUNTS WERE $23,011,000 AND $11,991,000 FOR JUNE 30, 2011 AND 2010, RESPECTIVELY.
PART III, LINE 7   TOTAL UNREIMBURSED COSTS ATTRIBUTABLE TO PROVIDING SERVICES UNDER MEDICARE AS REPORTED IN THE JUNE 30, 2011 DUHS CONSOLIDATED FINANCIAL STATEMENTS ARE $90,320,000 AS COMPARED TO $67,560,444 AS REPORTED IN SECTION B, LINE 7 OF SCHEDULE H. THE DUHS TOTAL MEDICARE SHORTFALL OF $90,320,000 IS DERIVED FROM THE COST ACCOUNTING SYSTEM WHICH INCLUDES ALL PAYMENTS AND COSTS ASSOCIATED WITH MEDICARE PATIENTS, WHEREAS THE $67,560,444 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   DUKE UNIVERSITY HEALTH SYSTEM'S COLLECTION POLICY (BAD DEBT AND AGENCY PLACEMENT POLICY) ADDRESSES, ONLY BY REFERENCE, COLLECTIONS PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. WITHIN THE BODY OF THE POLICY, THE DUKE UNIVERSITY HEALTH SYSTEM'S CHARITY CARE POLICY IS REFERENCED AS THE GUIDING POLICY FOR PATIENTS WHO FALL INTO ONE OF THESE CATEGORIES.
PART V, LINE 13G   DUHS ALSO PUBLICIZED ITS FINANCIAL ASSISTANCE POLICY VERBALLY BY OUR FINANCIAL CARE COUNSELORS.
PART V, LINE 21   CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER SERVICES NOT TYPICALLY COVERED BY INSURANCE, WILL BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES.
NEEDS ASSESSMENT PART VI, LINE 2 DUHS USES SEVERAL MECHANISMS TO ASSESS AND ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. IN DURHAM COUNTY, DUHS AND THE DUKE UNIVERSITY SCHOOL OF MEDICINE FACULTY ARE ACTIVELY INVOLVED IN THE PARTNERSHIP FOR A HEALTHY DURHAM, A COALITION OF LOCAL ORGANIZATIONS AND COMMUNITY MEMBERS WITH THE GOAL OF COLLABORATELY IMPROVING THE PHYSICAL, MENTAL, SOCIAL, HEALTH, AND WELL-BEING OF DURHAM COUNTY'S RESIDENTS. THE PARTNERSHIP IS A CERTIFIED HEALTH CAROLINIANS WORKGROUP. THE PARTNERSHIP EVALUATES COMMUNITY HEALTH CARE INFORMATION, THEN IDENTIFIES AND PRIORITIZES COMMUNITY-IDENTIFIED HEALTH CARE NEEDS AMONG SEVEN SUBCOMMITTEES THAT EACH FOCUS ON A DURHAM COUNTY HEALTH PRIORITY: MENTAL HEALTH AND SUBSTANCE ABUSE, ACCESS TO CARE, OBESITY AND CHRONIC ILLNESS, POVERTY, HIV/STI'S, AND EDUCATION. DUHS' OFFICE OF COMMUNITY RELATIONS HAS PLAYED A CENTRAL ROLE IN CONDUCTING A DURHAM HEALTH SUMMIT SINCE 2002, AN ANNUAL EVENT THAT ATTRACTS HUNDREDS OF COMMUNITY MEMBERS, HEALTH OFFICIALS, ELECTED OFFICIALS, AND DUHS EXECUTIVES AND PHYSICIANS TO RAISE AWARENESS OF KEY HEALTH ISSUES IN THE COMMUNITY AND SEEK COLLABORATIVE SOLUTIONS TO THESE ISSUES. THE SUMMIT HAS PRODUCED A NUMBER OF COMMUNITY-DRIVEN HEALTH CARE PROGRAMS AND INITIATIVES, INCLUDING MOST RECENTLY SPECIALTY PROJECT ACCESS, IN WHICH PHYSICIANS WHO PRACTICE AT DUHS FACILITIES AND OTHER DURHAM COUNTY PHYSICIANS OFFER FREE SPECIALTY CARE SERVICES TO RESIDENTS WHO OTHERWISE COULD NOT AFFORD IT. DUHS ALSO PLAYS A CENTRAL ROLE IN REGIONAL AND STATE HEALTH CARE SUMMITS USING THE SUMMITS' INFORMATION AND DATA TO ADDRESS THE HEALTH CARE NEEDS OF THOSE BROADER COMMUNITIES. DUHS ALSO USES DATA FROM THE ANNUAL DURHAM STATE OF THE COUNTY HEALTH REPORT AND THE DURHAM COUNTY HEALTH ASSESSMENT (SEE WWW.HEALTHYDURHAM.ORG) CONDUCTED EVERY 4 YEARS TO ENSURE DUHS IS ADDRESSING IMPORTANT HEALTH CARE ISSUES IDENTIFIED BY THE COMMUNITY. IN WAKE COUNTY, DUHS CONDUCTS A STUDY OF PRIMARY CARE INTAKES. DUKE RALEIGH HOSPITAL WORKED CLOSELY WITH THE WAKE COUNTY HUMAN SERVICES AGENCIES AND OTHER COMMUNITY STAKEHOLDERS ON THE 2010 WAKE COUNTY COMMUNITY HEALTH ASSESSMENT.
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 CHARITY CARE POLICY. DETAILED INFORMATION IS POSTED ON 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 APPLY AND BECOME 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 CHARITY CARE 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. DURHAM, WAKE AND ORANGE COUNTIES - WHICH FORM THE TRIANGLE - REPRESENT ABOUT TWO-THIRDS OF INPATIENT DISCHARGES FROM DUHS FACILITIES. DUHS' SECONDARY SERVICE AREA COVERS 21 COUNTIES IN NORTH CAROLINA AND SOUTHERN VIRGINIA WITH A POPULATION OVER 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 RELATIONS, WHOSE ASSOCIATE VICE PRESIDENT REPORTS DIRECTLY TO DUHS' CEO AND SERVES AS A FULL-TIME LIAISON WITH THE DURHAM COMMUNITY. THE OFFICE SPONSORS AND FACILITATES COMMUNITY EVENTS - SUCH AS THE ANNUAL DURHAM 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 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 CHARITABLE GRANTS AND GOODWILL GRANTS PROGRAM. THE ASSOCIATE VICE-PRESIDENT AND STAFF SERVE ON A NUMBER OF HEALTH CARE-RELATED COMMUNITY BOARDS AND HEALTH-RELATED COMMITTEES. STAFF FROM THE OFFICE OF COMMUNITY RELATIONS AND MEMBERS OF THE DUHS COMMUNITY HEALTH PLANNING GROUP CREATED A FORMAL PRINCIPLES OF COMMUNITY ENGAGEMENT POLICY THAT COMMITS DUHS AND ITS COMMUNITY PARTNERS TO DEVELOPING PROPOSED PROJECTS AND INITIATIVES ON TRUST, RESPECT, DIVERSITY, SAFETY AND COMMUNITY-IDENTIFIED NEEDS. THESE PRINCIPLES HAVE BEEN INCORPORATED INTO COMMUNITY-BASED HEALTH CARE PROJECTS SUCH AS THE DEVELOPMENT OF THE HOLTON WELLNESS CENTER AND DURHAM HEALTH INNOVATIONS, A MULTIDISCIPLINARY COMMUNITY BASED PARTNERSHIP BETWEEN DUKE RESEARCHERS AND MEMBERS OF THE DUKE COMMUNITY THAT FOCUSES ON IMPROVING HEALTH OUTCOMES THROUGH NEW AND CREATIVE APPROACHES TO HEALTH CARE DELIVERY. 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, DURHAM REGIONAL, HAS AN OPEN MEDICAL STAFF AND A COMMUNITY ADVISORY BOARD. DUHS ALSO HAS A COMMUNITY HEALTH PLANNING GROUP, ESTABLISHED BY THE CEO, WHOSE MISSION IS TO DEVELOP A PLAN TO COORDINATE RESOURCES WITHIN DUKE AND IN THE COMMUNITY TO IMPROVE HEALTH OUTCOMES IN DURHAM. KEY COMMUNITY PARTNERS INCLUDE THE DURHAM COUNTY HEALTH DEPARTMENT, LINCOLN COMMUNITY HEALTH CENTER AND THE DURHAM CENTER (LOCAL MENTAL HEALTH MANAGEMENT ENTITY). THE ASSOCIATE VICE-PRESIDENT OF DUHS' OFFICE OF COMMUNITY RELATIONS SERVES AS CHAIR. 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, LOCAL PHYSICIANS, THE DURHAM PUBLIC SCHOOLS, AMONG OTHERS. DUHS MAINTAINS A CHARITABLE GRANTS COMMITTEE TO REVIEW COMMUNITY REQUESTS FOR PHILANTHROPIC ASSISTANCE THAT PROMOTE HEALTH AND WELLNESS. DUKE MEDICINE PROVIDES VARIOUS OPPORTUNITIES FOR STUDENTS TO INTERACT WITH DIFFERENT HEALTH CARE PROFESSIONALS ACROSS THE SYSTEM. THE OFFICE OF COMMUNITY RELATIONS, DURHAM REGIONAL HOSPITAL, AND OTHER KEY COMMUNITY PARTNERS BEGAN PLANNING A PILOT 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 THE HEALTHCARE FIELD. PLANNING FOR THIS PROGRAM BEGAN IN EARLY FISCAL YEAR 2011 WITH A TARGET IMPLEMENTATION DATE AT DURHAM REGIONAL HOSPITAL OF OCTOBER 2011. THE OFFICE OF COMMUNITY RELATIONS WORKS WITH THE 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. THE SCOPE OF SERVICES PROVIDED BY DUKE MEDICINE STAFF AND FACULTY WILL INCREASE DURING THE NEXT YEAR. MORE FACULTY WILL BE INVOLVED WITH MENTORING STUDENTS AND CLASSROOM LECTURES. IN ADDITION, THE HEALTH SYSTEM CEO IS WORKING WITH THE NEW SCHOOLS PROJECT TO HELP THE CMA BECOME THE PREMIER HEALTH SCIENCE HIGH SCHOOL IN NORTH CAROLINA. IN 2011, CMA MOVED INTO A NEW BUILDING ON THE DURHAM REGIONAL HOSPITAL CAMPUS ON LAND DUHS RELEASED BACK TO DURHAM COUNTY. THE OCR PROGRAM MANAGER COORDINATED HEALTH CARE SERVICES AT THE ANNUAL DURHAM PROJECT HOMELESS CONNECT. DUKE UNIVERSITY HEALTH SYSTEM IS A KEY PARTNER IN THIS EVENT. 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. BEYOND DURHAM, DUKE UNIVERSITY MEDICAL AND NURSING STUDENTS ARE WORKING IN MANY NATIONS SUCH AS UGANDA, KENYA, BARBADOS AND HONDURAS.
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). THE HOSPITALS PROVIDE ROUTINE INPATIENT AND OUTPATIENT CARE. IN DURHAM COUNTY, DUKE UNIVERSITY HOSPITAL (DUH) AND DURHAM REGIONAL HOSPITAL (DRH) WORK TOGETHER TO MAXIMIZE FACILITY UTILIZATION PROVIDING ROUTINE AND ADVANCED LEVELS OF CARE. DUH ALSO OPERATES A TRAUMA CENTER WITH AIR AMBULANCE SERVICE. DUKE RALEIGH HOSPITAL (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 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 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 HEALTHY LIFESTYLES IN THE DIET & FITNESS CENTER, CENTER FOR LIVING, AND DUKE INTEGRATIVE MEDICINE. THESE OPERATIONS FOCUS LARGELY ON PREVENTION AND EDUCATION TO AVOID OR MITIGATE THE POTENTIAL FOR FUTURE ILLNESS.
LIST OF ALL STATES WHICH ORGANIZATION FILES A COMMUNITY BENEFIT REPORT:   NORTH CAROLINA
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number
56-2070036
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) DUKE UNIVERSITY324 BLACKWELL STREET
SUITE 920
DURHAM,NC27701 		56-0532129 501(C)(3) 10,000       GENERAL SUPPORT
(2) AIDS COMMUNITY RESIDENCE ASSOCIATION331 W MAIN STREET
SUITE 506
DURHAM,NC27702 		56-1609845 501(C)(3) 15,000       GENERAL SUPPORT
(3) AMERICAN CANCER SOCIETYPO BOX 10144
RALEIGH,NC27605 		58-0659875 501(C)(3) 10,000       GENERAL SUPPORT
(4) BOYS & GIRLS CLUB701 N RALEIGH BLVD
RALEIGH,NC27610 		56-0863051 501(C)(3) 17,250       GENERAL SUPPORT
(5) CHILD AND PARENT SUPPORT SERVICES411 W CHAPEL HILL STREET
SUITE 908
DURHAM,NC27701 		58-1446309 501(C)(3) 25,000       GENERAL SUPPORT
(6) DUKE SCHOOL FOR CHILDREN3716 OLD ERWIN RD
DURHAM,NC27705 		58-1521494 501(C)(3) 15,000       GENERAL SUPPORT
(7) DURHAM ACADEMY3130 PICKETT ROAD
DURHAM,NC27705 		56-0538019 501(C)(3) 25,000       GENERAL SUPPORT
(8) FOUNDATION FOR NURSING EXCELLENCEPO BOX 31824
RALEIGH,NC27622 		30-0105241 501(C)(3) 25,000       GENERAL SUPPORT
(9) GREAT 100 INCPO BOX 4875
GREENSBORO,NC27404 		56-1705456 501(C)(3) 10,000       GENERAL SUPPORT
(10) GREATER RALEIGH CHAMBER OF COMMERCEPO BOX 2978
RALEIGH,NC27602 		56-0370850 501(C)(6) 64,010       GENERAL SUPPORT
(11) HUMAN RIGHTS CAMPAIGN INC1713 PATHWAY DR
CARRBORO,NC27510 		52-1243457 501(C)(4) 6,000       GENERAL SUPPORT
(12) NORTH CAROLINA PHYSICIANS HEALTH PROGRAM220 HORIZON DRIVE
SUITE 201
RALEIGH,NC27615 		56-1846599 501(C)(3) 12,000       GENERAL SUPPORT
(13) RALEIGH RESCUE MISSIONPO BOX 27391
RALEIGH,NC27611 		56-1895093 501(C)(3) 7,500       GENERAL SUPPORT
(14) SENIOR PHARMASSIST INC406 RIGSBEE AVE
SUITE 201
DURHAM,NC27701 		56-2084639 501(C)(3) 10,000       GENERAL SUPPORT
(15) WAKE COUNTY MEDICAL SOCIETY2500 BLUE RIDGE ROAD
RALEIGH,NC27607 		56-2205175 501(C)(3) 7,500       GENERAL SUPPORT
(16) WAKE EDUCATION PARTNERSHIP706 HILLSBOROUGH STREET
SUITE A
RALEIGH,NC27603 		58-1518182 501(C)(3) 10,000       GENERAL SUPPORT
(17) BAND TOGETHERPO BOX 6445
RALEIGH,NC276286445 		56-2273756 501(C)(3) 10,000       GENERAL SUPPORT
(18) CARING HOUSE INC2625 PICKETT RD
DURHAM,NC277055603 		56-1647154 501(C)(3) 16,500       GENERAL SUPPORT
(19) CEO ROUNDTABLE ON CANCER INC940 NW CARY PKWY
SUITE 102
CARY,NC27513 		65-1230448 501(C)(3) 40,000       GENERAL SUPPORT
(20) DURHAM CHAMBER LEGACY FOUNDATIONPO BOX 3829
DURHAM,NC27702 		33-1132350 501(C)(3) 62,500       GENERAL SUPPORT
(21) EL CENTRO HISPANO INC201 W MAIN STREET
SUITE 100
DURHAM,NC27701 		56-2011661 501(C)(3) 15,000       GENERAL SUPPORT
(22) JOHN AVERY BOYS AND GIRLS CLUBPO BOX 446
DURHAM,NC27702 		56-6001906 501(C)(3) 12,500       GENERAL SUPPORT
(23) LGBT CENTER OF RALEIGH INC316 W CABARRUS ST
RALEIGH,NC27601 		26-2998186 501(C)(3) 5,500       GENERAL SUPPORT
(24) NATIONAL MEDICAL ASSOCIATION8403 COLESVILLE RD
SUITE 920
SILVER SPRING,MD20910 		53-6010805 501(C)(3) 10,000       GENERAL SUPPORT
(25) NC LUNG CANCER PARTNERSHIP INCPO BOX 14305
RTP,NC27709 		26-2300885 501(C)(3) 20,000       GENERAL SUPPORT
(26) NORTH CAROLINA SYMPHONY3700 GLENWOOD AVE
SUITE 130
RALEIGH,NC27612 		56-0556755 501(C)(3) 10,000       GENERAL SUPPORT
(27) RALEIGH SCHOOL OF NURSE ANESTHESIA3900 BARRETT DR
SUITE 200
RALEIGH,NC27609 		56-1684241 501(C)(3) 69,578       GENERAL SUPPORT
(28) WASHINGTON DUKE INN & GOLF CLUB3001 CAMERON BOULEVARD
DURHAM,NC27706 		65-1179298 N/A 29,933       DURHAM HEALTH SUMMIT
(29) CITY OF MEDICINE ACADEMY4100 N ROXBORO ST
DURHAM,NC27704 		56-6001021 501(C)(3) 32,860       GENERAL SUPPORT
(30) MIDTOWN MAGAZINE4818 SIX FORKS ROAD
SUITE 204
RALEIGH,NC27609 		20-8998537 N/A 25,000       GENERAL SUPPORT
(31) NORTH CAROLINA CHAMBER OF COMMERCE701 CORPORATE CENTER DRIVE
SUITE 40
RALEIGH,NC27607 		56-0340499 501(C)(6) 6,500       GENERAL SUPPORT
(32) NORTH CAROLINA INSTITUTE OF MEDICINE630 DAVIS DRIVE
SUITE 100
MORRISVILLE,NC27560 		56-1506066 GOVERNMENT 6,000       GENERAL SUPPORT
(33) RESEARCH AMERICAPO BOX 222451
CHINTILLY,VA201532451 		52-1609875 501(C)(3) 15,000       GENERAL SUPPORT
2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
28
3
Enter total number of other organizations ................................ . Bullet Image
5
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) DUKE CANCER SUPPORT PROGRAM 20 22,875      
(2) NANCY WALTERS SCHOLARSHIP 2 1,000      
(3) JUDY WAGONER SCHOLARSHIP 2 500      
(4) MARTHA WHITWORTH LASITER SCHOLARSHIP 2 2,000      
(5) RUBY BAILEY PIERCE SCHOLARSHIP 2 500      
(6) MEGAN WALKER SCHOLARSHIP 1 500      
(7) CHANCELLOR'S 2010 NASHER EVENT BRONZE SCHOLARSHIP 1 800      
(8) SGA AWARD 2011 4 600      

Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
PROCEDURES FOR MONITORING USE OF GRANT FUNDS SCHEDULE I, PART I, LINE 2 DUKE UNIVERSITY HEALTH SYSTEM, INC. PROVIDES GENERAL SUPPORT TO LOCAL ORGANINATIONS BASED ON OUR AWARENESS OF THEIR ACTIVITIES WITHIN THE LOCAL COMMUNITY. DUHS, INC. ALSO MAINTAINS A CHARITABLE GRANTS COMMITTEE THAT REVIEWS COMMUNITY REQUESTS FOR PHILANTHROPIC ASSISTANCE THAT PROMOTE HEALTH AND WELLNESS.
Schedule I (Form 990) 2010


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number

56-2070036
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) NANCY C ANDREWS MD (i)
(ii)		 0
446,697 		0
172,828 		0
59,786 		0
30,029 		0
16,189 		0
725,529 		0
0
(2) RICHARD H BRODHEAD (i)
(ii)		 0
753,677 		0
0 		0
22,396 		0
130,029 		0
63,292 		0
969,394 		0
0
(3) VICTOR J DZAU MD (i)
(ii)		 0
1,019,765 		0
1,006,416 		0
11,040 		0
746,258 		0
16,175 		0
2,799,654 		0
0
(4) DANNY O JACOBS MD (i)
(ii)		 0
270,090 		0
74,075 		0
0 		0
30,029 		0
15,355 		0
389,549 		0
0
(5) CARL E RAVIN MD (i)
(ii)		 0
250,590 		0
22,500 		0
0 		0
30,029 		0
10,172 		0
313,291 		0
0
(6) MONTE D BROWN MD (i)
(ii)		 301,862
0 		197,998
0 		16,500
0 		30,029
0 		21,392
0 		567,781
0 		0
0
(7) WILLIAM J FULKERSON JR MD (i)
(ii)		 652,777
0 		383,551
0 		16,500
0 		30,029
0 		5,713
0 		1,088,570
0 		0
0
(8) KENNETH C MORRIS (i)
(ii)		 615,216
0 		251,358
0 		16,500
0 		30,029
0 		8,395
0 		921,498
0 		0
0
(9) ASIF AHMAD (i)
(ii)		 271,730
0 		287,603
0 		30,595
0 		30,029
0 		9,951
0 		629,908
0 		0
0
(10) MARY ANN FUCHS (i)
(ii)		 255,600
0 		65,446
0 		803
0 		30,029
0 		5,151
0 		357,029
0 		0
0
(11) PAUL R NEWMAN (i)
(ii)		 0
207,469 		0
108,218 		0
0 		0
30,029 		0
31,147 		0
376,863 		0
0
(12) KEVIN W SOWERS (i)
(ii)		 415,415
0 		190,062
0 		16,500
0 		30,029
0 		7,637
0 		659,643
0 		0
0
(13) DOUGLAS B VINSEL (i)
(ii)		 343,228
0 		210,304
0 		16,500
0 		30,029
0 		17,133
0 		617,194
0 		0
0
(14) KERRY R WATSON (i)
(ii)		 319,858
0 		96,190
0 		16,500
0 		30,029
0 		34,929
0 		497,506
0 		0
0
(15) MARC CALABRESE (i)
(ii)		 307,265
0 		44,492
0 		4,179
0 		30,029
0 		17,913
0 		403,878
0 		0
0
(16) JOHN M KELSCH (i)
(ii)		 306,145
0 		60,683
0 		28,215
0 		30,029
0 		14,292
0 		439,364
0 		0
0
(17) MOLLY K ONEILL (i)
(ii)		 330,200
0 		208,151
0 		16,500
0 		30,029
0 		10,225
0 		595,105
0 		0
0
(18) THOMAS A OWENS (i)
(ii)		 296,045
0 		54,800
0 		0
0 		30,029
0 		11,871
0 		392,745
0 		0
0
(19) JOSEPH G TAYLOR (i)
(ii)		 253,661
0 		125,316
0 		16,500
0 		30,029
0 		18,020
0 		443,526
0 		0
0
(20) HARVEY JAY COHEN MD (i)
(ii)		 0
362,611 		0
41,228 		0
0 		0
30,029 		0
10,473 		0
444,341 		0
0
(21) KIMBERLY J JENKINS (i)
(ii)		 0
37,500 		0
0 		0
0 		0
4,565 		0
100 		0
42,165 		0
0
(22) FRANCES D MAUNEY (i)
(ii)		 0
127,125 		0
0 		0
0 		0
14,849 		0
5,876 		0
147,850 		0
0
(23) R SANDERS WILLIAMS MD (i)
(ii)		 0
93,243 		0
148,200 		0
4,125 		0
30,029 		0
1,022 		0
276,619 		0
0
(24) MICHAEL S CUFFE MD (i)
(ii)		 293,599
0 		203,927
0 		16,500
0 		30,029
0 		14,427
0 		558,482
0 		0
0
(25) MARK D GUSTAFSON (i)
(ii)		 0
254,197 		0
13,000 		0
6,500 		0
30,029 		0
13,053 		0
316,779 		0
0
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
NON-FIXED PAYMENTS SCHEDULE J, PART I, LINE 7 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.
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B VICTOR J. DZAU MD PARTICIPATES IN A PLAN DESCRIBED UNDER SECTION 457(F) OF THE INTERNAL REVENUE CODE, HOWEVER HE DID NOT RECEIVE ANY PAYMENTS DURING THE REPORTING PERIOD.
TAX INDEMNIFICATION SCHEDULE J, PART 1, LINE 1A ASIF AHMAD AND MARY ANN FUCHS RECEIVED SOME BENEFIT THAT WAS GROSSED UP TO COMPENSATE FOR WITHHOLDING OF TAXES.
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number
56-2070036
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402 657902V33 08-21-2009 322,140,000 SEE SCHEDULE O   X   X   X
B NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402 6579025S7 11-15-2006 150,715,000 SEE SCHEDULE O   X   X   X
C NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402 65821DDB4 11-10-2009 178,598,850 SEE SCHEDULE O   X   X   X
D NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402 65821DDX6 04-28-2010 120,836,075 SEE SCHEDULE O   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . . 0 5,000,000 0 0
2 Amount of bonds defeased . . . . 0 0 0 0
3 Total proceeds of issue . . . . 322,140,000 151,142,783 180,221,710 121,169,224
4 Gross proceeds in reserve funds . . 0 0 0 0
5 Capitalized interest from proceeds. 0 3,947,210 10,548,994 0
6 Proceeds in refunding escrow. . . . . 322,140,000 70,000,000 0 0
7 Issuance costs from proceeds . . . 0 682,440 2,472,104 1,460,854
8 Credit enhancement from proceeds. 0 0 0 0
9 Working capital expenditures from proceeds . . 0 0 0 0
10 Capital expenditures from proceeds . . 0 76,513,133 114,924,142 98,355,210
11 Other spent proceeds . . 0 0 0 0
12 Other unspent proceeds. . . 0 0 52,276,470 21,353,160
13 Year of substantial completion . . . 2009 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? X   X   X   X  
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . . X   X     X   X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X   X   X   X
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use? X   X   X   X  
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 . . .. . . . . . 0 % 0 % 0 % 0 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue? X   X     X   X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue? X     X   X   X
b Name of provider . CITIGROUP & DEUTSCHE
  		 
  		 
  		 
 
c Term of hedge . . 23.      
d Was the hedge superintegrated? .   X       X   X
e Was a hedge terminated? .   X       X   X
4a Were gross proceeds invested in a GIC? .   X   X   X   X
b Name of provider .  
  		 
  		 
  		 
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? .   X   X   X   X
6 Did the bond issue qualify for an exception to rebate? . . . X     X   X   X
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number

56-2070036
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) MEDTRONIC INC BOARD MEMBER IS DIRECTOR 28,857,194 PAYMENT FOR GOODS OR SERVICES   No
(2) DUKE PRIVATE DIAGNOSTIC CLINIC BD MEMBERS ARE DIRECTORS 81,568,442 PAYMENT FOR GOODS OR SERVICES   No
(3) CAPITOL BROADCASTING CO CEO IS DIRECTOR 131,000 PAYMENT FOR GOODS OR SERVICES   No
(4) THE DURHAM BULLS BASEBALL CLUB INC CEO IS DIRECTOR 95,205 PAYMENT FOR GOODS OR SERVICES   No
(5) GENESE NEWMAN FAMILY MEMBER OF KEY EMP 92,829 SALARY PAID   No
(6) TAMELA VINSEL FAMILY MEMBER OF KEY EMP 27,032 SALARY PAID   No
(7) JACQUELINE DZAU FAMILY MEMBER OF DIRECTOR 48,744 SALARY PAID   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


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SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number

56-2070036
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of Contributions or items contributed 		(c)
Contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
contribution amounts
1 Art—Works of art .... X 25 5,249 FMV
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications .. X 8 FMV
5 Clothing and household
goods ....... 		X 7,968 FMV
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 9 66,896 FMV
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles ..... X 20 4,584 FMV
19 Food inventory ... X 28 701 FMV
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( EVENT TICKETS ) X 13 2,034 FMV
26 Other Right pointing arrow large image ( GIFT CARDS/CERTIFICATES ) X 43 9,679 FMV
27 Other Right pointing arrow large image ( BEAUTY SUPPLIES ) X 77 864 FMV
28 Other Right pointing arrow large image ( JEWELRY ) X 8 5,463 FMV
Other Right pointing arrow large image ( MISCELLANEOUS ) X 56 21,248 FMV
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
0
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell non-cash
contributions? ............................
32a
Yes
 
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2010
Schedule M (Form 990) 2010
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33. Also complete this part for any additional information.
Identifier Return Reference Explanation
USE OF THIRD PARTIES TO SOLICIT, PROCESS, OR SELL NONCASH CONTRIBUTIONS SCHEDULE M, PART 1, 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.
Schedule M (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number

56-2070036
Identifier Return Reference Explanation
ORGANIZATION'S FILING OF FORM 990-T FORM 990, PART V, LINE 3B THE ORGANIZATION DID NOT HAVE ANY UNRELATED BUSINESS GROSS INCOME DURING THE FISCAL YEAR ENDING JUNE 30, 2011. AS A RESULT, FORM 990-T IS NOT REQUIRED FOR THE FISCAL YEAR ENDING JUNE 30, 2011.
BUSINESS RELATIONSHIPS OF DUHS DIRECTORS AND OFFICERS FORM 990, PART VI, SECTION A, LINE 2 DIRECTORS HONORABLE DANIEL T. BLUE, JR., JACK O. BOVENDER, JR., RICHARD H. BRODHEAD, FRANK E. EMORY, JR., SUSAN STALNECKER, AND THOMAS M. GORRIE ARE TRUSTEES OF DUKE UNIVERSITY. PRESIDENT/CEO VICTOR J. DZAU, MD IS AN OFFICER OF DUKE UNIVERSITY. THE FOLLOWING INDIVIDUALS ARE EMPLOYEES OF DUKE UNIVERSITY: DANNY O. JACOBS MD, NANCY A. ANDREWS MD, MARK BRANCH III MD, AND CARL E. RAVIN MD. OFFICER KENNETH MORRIS AND KEY EMPLOYEE PAUL NEWMAN ARE BOTH DIRECTORS AND OFFICERS OF HEALTH SYSTEM MEDICAL STRATEGIES, INC. DIRECTOR AND PRESIDENT/CEO VICTOR J. DZAU MD, OFFICERS KENNETH C. MORRIS, WILLIAM J. FULKERSON, JR. MD. , CARL E. RAVIN MD, AND KEY EMPLOYEE PAUL NEWMAN ARE DIRECTORS OF DURHAM CASUALTY COMPANY, LTD. DIRECTORS VICTOR J. DZAU MD, DANNY O. JACOBS MD, CARL E. RAVIN MD, WILLIAM J. FULKERSON MD, AND KEY EMPLOYEE PAUL NEWMAN ARE BOARD MEMBERS OF PRIVATE DIAGNOSTIC CLINIC, PLLC. DIRECTOR AND PRESIDENT/CEO VICTOR J. DZAU MD, AND OFFICER KENNETH C. MORRIS ARE DIRECTORS OF DUKE MEDICAL STRATEGIES, INC.
ELECTION OF MEMBERS OF GOVERNING BODY 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.
DECISIONS OF GOVERNING BODY FORM 990, PART VI, SECTION A, LINE 7B THE DUHS BYLAWS PROVIDE THAT DUHS MUST OBTAIN DUKE UNIVERSITY BOARD OF TRUSTEES APPROVAL FOR DEBT ISSUANCES, CAPITAL ACQUISITIONS AND TANGIBLE PERSONAL PROPERTY SALES IN EXCESS OF $50 MILLION EACH AS WELL AS REAL PROPERTY SALES IN EXCESS OF $10 MILLION EACH.
GOVERNING BODY REVIEW PROCESS OF FORM 990 FORM 990, PART VI, SECTION B, LINE 11B AFTER STAFF PREPARATION AND MANAGEMENT REVIEW, THE DUHS FORM 990 FILING IS PRESENTED TO THE DUHS COMPLIANCE/AUDIT COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW AND DISCUSSION. BOARD LEVEL COMMENT AND DISCUSSION ARE INCORPORATED INTO THE FORM AS APPROPRIATE PRIOR TO FILING. A FINAL VERSION OF THE FORM IS POSTED TO THE BOARD OF DIRECTORS COMMUNICATION PORTAL ON THE INTERNET FOR FURTHER REVIEW AND COMMENT BEFORE FILING.
CONFLICT OF INTEREST POLICY COMPLIANCE MONITORING METHOD FORM 990, PART VI, SECTION B, LINE 12c DUKE UNIVERSITY HEALTH SYSTEM MONITORS AND ENFORCES COMPLIANCE RELATED TO CONFLICT OF INTEREST VIA AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE, RELYING ON SELF DISCLOSURE OF ALL THOSE SUBJECT TO THE COI POLICY.
COMPENSATION POLICY FORM 990, PART VI, SECTION B, LINES 15A & 15B AND SCHEDULE J, LINE 3 THE DUHS COMPENSATION COMMITTEE, COMPRISED OF MEMBERS OF THE DUHS BOARD OF DIRECTORS, REVIEWS AND APPROVES ALL EXECUTIVE COMPENSATION FOR ALL 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.
GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABILITY TO THE PUBLIC FORM 990, PART VI, SECTION C, LINE 19 DUKE UNIVERSITY HEALTH SYSTEM'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 MAKES ITS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FINANCIAL STATEMENTS ARE ALSO AVAILABLE TO THE PUBLIC ON THE ELECTRONIC MUNICIPAL MARKET ACCESS WEBSITE. NAVIGATE TO HTTP://EMMA.MSRB.ORG AND ENTER "DUKE UNIVERSITY HEALTH SYSTEM" IN THE MUNI SEARCH BOX.
AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII, SECTION A, COLUMN B THE FOLLOWING INDIVIDUALS LISTED IN PART VII, SECTION A, COLUMN A DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY: HONORABLE DANIEL T. BLUE, JR., JACK O. BOVENDER, JR., FRANK E. EMORY, JR., THOMAS A. GORRIE, SUSAN M. STALNECKER, AND KIMBERLY J. JENKINS. NANCY C. ANDREWS, MD, RICHARD H. BRODHEAD, DANNY O. JACOBS, MD, AND MARK D. GUSTAFSON DEVOTED AN AVERAGE OF 50 HOURS PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY. VICTOR J. DZAU, MD, CARL E. RAVIN, MD, FRANCES D. MAUNEY, AND R. SANDERS WILLIAMS, MD DEVOTED AN AVERAGE OF 40 HOURS PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY. MONTE D. BROWN, MD DEVOTED AN AVERAGE OF 10 HOURS PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY. MARK BRANCH, III, MD AND PAUL R. NEWMAN DEVOTED AN AVERAGE OF 60 HOURS PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY. HARVEY JAY COHEN, MD DEVOTED AN AVERAGE OF 70 HOURS PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY. MICHAEL S. CUFFE, MD DEVOTED AN AVERAGE OF 13 HOURS PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY. KENNETH C. MORRIS AND PAUL R. NEWMAN DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, HEALTH SYSTEM MEDICAL STRATEGIES, INC. VICTOR J. DZAU, MD AND KENNETH C. MORRIS DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, DUKE MEDICAL STRATEGIES, INC. THE FOLLOWING INDIVIDUALS DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, DURHAM CASUALTY COMPANY, LTD: VICTOR J. DZAU, MD, CARL E. RAVIN, MD, PAUL NEWMAN, WILLIAM J. FULKERSON JR. MD, KENNETH C. MORRIS, AND MICHAEL S. CUFFE, MD . NANCY C. ANDREWS, MD AND VICTOR J. DZAU, MD DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY SCHOOL OF MEDICINE RESEARCH FOUNDATION. VICTOR J. DZAU, MD, THOMAS M. GORRIE, AND KENNETH C. MORRIS DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, DUKE MEDICINE GLOBAL SUPPORT CORPORATION. WILLIAM J. FULKERSON, MD, KENNETH C. MORRIS, AND MICHAEL S. CUFFE, MD DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY AFFILIATED PHYSICIANS, INC. KENNETH C. MORRIS AND KERRY R. WATSON DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, ASSOCIATED HEALTH SERVICES, INC. KIMBERLY J. JENKINS DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, THE LORD FOUNDATION OF NORTH CAROLINA. RICHARD H. BRODHEAD DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, DUMAC, LLC.
OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 5 NET UNREALIZED GAINS ON INVESTMENTS $ 196,332,407 NONPERIODIC CHANGES IN DEFINED BENEFIT PLANS 87,984,953 NET TRANSFERS TO THE PARENT OF PROPERTY & EQUIPMENT (10,544,987) CHANGE IN MARKET VALUE OF DERIVATIVES 22,331,886 INTEREST EARNED ON BOND PROCEEDS - CAPITALIZED FOR BOOK PURPOSES (1,217,357) REPORTING CHANGE CAPTURED ON SEPARATE RELATED ORGANIZATION'S RETURN (84,668,685) INCOME NOT REPORTED ON BOOKS, BUT INCLUDED FOR 990 REPORTING PURPOSES (6,667,089) ______________ $ 203,551,128 ==============
ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 3A DUKE UNIVERSITY HEALTH SYSTEM, INC. AND RELATED ENTITY, DUKE UNIVERSITY MANAGE THEIR INVESTMENT FUNDS IN ACCORDANCE WITH THE UNIFORM PRUDENT MANAGEMENT OF INSTITUTIONAL FUNDS ACT OF NORTH CAROLINA. THESE INVESTMENT POOLS ARE MANAGED, HELD AND ADMINISTERED BY ORGANIZATIONS THAT ARE RELATED TO DUKE UNIVERSITY.
PURPOSE OF TAX-EXEMPT BONDS SCHEDULE K, PART I, COLUMN F BOND ISSUE (A): 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 (B): HOSPITAL IMPROVEMENTS FINANCED OR REFINANCED INCLUDE: 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. TOTAL PROCEEDS OF ISSUE INCLUDE INVESTMENT EARNINGS. BOND ISSUE (C): HOSPITAL IMPROVEMENTS FINANCED INCLUDE: THE AMBULATORY CANCER CENTER AT DUKE UNIVERSITY HOSPITAL AND OTHER RENOVATION AND IMPROVEMENT PROJECTS AT DUKE UNIVERSITY HOSPITAL AND DUKE RALEIGH HOSPITAL. TOTAL PROCEEDS OF ISSUE INCLUDE INVESTMENT EARNINGS. BOND ISSUE (D): HOSPITAL IMPROVEMENTS INCLUDE THE DUKE MEDICINE PAVILION AT DUKE UNIVERSITY HOSPITAL. TOTAL PROCEEDS OF ISSUE INCLUDE INVESTMENT EARNINGS. BOND ISSUE (A)-2: DRAW-DOWN FINANCING LEASE PROGRAM WITH CITIMORTGAGE, INC. IN THE MAXIMUM PRINCIPAL AMOUNT OF $40,000,000 TO REFUND TWO LEASES UNDER A PRIOR PROGRAM ISSUED 07/09/2003 AND TO FINANCE MEDICAL, COMPUTER, OFFICE, AND CAPITAL EQUIPMENT. TOTAL PROCEEDS OF ISSUE INCLUDE INVESTMENT EARNINGS. BOND ISSUE (B)-2: DRAW-DOWN FINANCING LEASE PROGRAM WITH BANC OF AMERICA PUBLIC CAPITAL CORP. IN THE MAXIMUM PRINCIPAL AMOUNT OF $40,000,000 TO FINANCE MEDICAL, COMPUTER, OFFICE, AND CAPITAL EQUIPMENT.
SCHEDULE K, PART II, LINE 3, BOND ISSUES (B), (C), AND (D)   PROCEEDS INCLUDE INVESTMENT EARNINGS.
SCHEDULE K, PART II, LINE 3, BOND ISSUES (A)-2, AND (B)-2   PROCEEDS REFLECT ACTUAL PRINCIPAL DRAWN DOWN UNDER DRAW DOWN FINANCING LEASE PROGRAM.
SCHEDULE K, PART II, LINES 3 AND 10, BOND ISSUE (A)-2   PURSUANT TO TREAS. REG. 1.141-12(E), DISPOSITION PROCEEDS OF $5,000,000, PLUS THE INVESTMENT PROCEEDS THEREOF, HAVE BEEN EXPENDED ON ADDITIONAL CAPITAL EXPENDITURES AS A REMEDIAL ACTION FOR THE SALE OF CERTAIN BOND-FINANCED ASSETS.
SCHEDULE K, PART II, LINE 6, BOND ISSUES (A), (B), AND (A)-2   THESE PROCEEDS, PLUS ANY INVESTMENT PROCEEDS THEREOF, HAVE BEEN DISBURSED TO PAY AT MATURITY OR OPTIONALLY REDEEM THE REFUNDED BONDS.
SCHEDULE K, PART IV, QUESTION 6, BOND ISSUES (A)-2 AND (B)-2   SALES PROCEEDS ALLOCATED UPON ISSUANCE AND NOT INVESTED.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number

56-2070036
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity







(1) DUKE PRMO LLC
615 DOUGLAS STREET SUITE 700
DURHAM,NC27705
56-2070036 		MEDICAL BILLI NC 109,033,582 10,380,538 NA
 










Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) DUKE UNIVERSITY

324 BLACKWELL STREET STE 920

DURHAM,NC27701
56-0532129 		EDUCATION NC 501(C)(3) 2 NA
 
 
 
(2) AMERICAN ASSOCIATION FOR GIFTED CHILDREN

324 BLACKWELL STREET STE 920

DURHAM,NC27701
56-1686219 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(3) DUKE SCHOLARLY EXHIBITS INC

324 BLACKWELL STREET STE 920

DURHAM,NC27701
56-1701245 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(4) DUKE ALUMNI ASSOCIATION INC

614 CHAPEL DRIVE

DURHAM,NC27708
56-1594088 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(5) DUKE GIFT PROPERTIES INC

324 BLACKWELL STREET STE 920

DURHAM,NC27701
57-1211078 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(6) DUKE MANAGEMENT COMPANY

280 S MANGUM STREET STE 210

DURHAM,NC27701
56-1748858 		INVESTMENTS NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(7) DUKE GLOBAL INC

324 BLACKWELL STREET STE 920

DURHAM,NC27701
61-1588319 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(8) DUKE UNIVERSITY PHILANTHROPIES INC

324 BLACKWELL STREET STE 920

DURHAM,NC27701
57-1211099 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(9) DUKE UNIV SCH OF MED RESEARCH FOUNDATION

324 BLACKWELL STREET STE 920

DURHAM,NC27701
56-2247203 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(10) DUKE UNIV SPECIAL VENTURES FUND INC

280 S MANGUM STREET STE 210

DURHAM,NC27701
56-1465177 		INVESTMENTS NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(11) DURHAM ASSET MANAGEMENT COMPANY INC

324 BLACKWELL STREET STE 920

DURHAM,NC27701
56-1757238 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUHS INC
 
 
 
(12) DURHAM REALTY INC

324 BLACKWELL STREET STE 920

DURHAM,NC27701
56-1917936 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(13) THE FSB SUPPORT FUND

324 BLACKWELL STREET STE 920

DURHAM,NC27701
56-1849290 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(14) GOTHIC CORPORATION

280 S MANGUM STREET STE 210

DURHAM,NC27701
56-1776668 		INVESTMENTS NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(15) HIGH POINT REALTY ASSOCIATES INC

324 BLACKWELL STREET STE 920

DURHAM,NC27701
56-1917939 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(16) THE LORD FOUNDATION OF NORTH CAROLINA

305 TEER BLDG

DURHAM,NC27708
56-1415423 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(17) RUTH K BROAD BIOMEDICAL RES FOUNDATION

324 BLACKWELL STREET STE 920

DURHAM,NC27701
65-0045051 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(18) DUKE HOSPITAL AUXILIARY INC

PO BOX 2895

DURHAM,NC27710
56-1825604 		SUPPORT NC 501(C)(3) 11 TYPE III NA
 
 
 
(19) DUKE MEDICINE GLOBAL SUPPORT CORP

324 BLACKWELL ST STE 920

DURHAM,NC27701
61-1593721 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(20) THE CENTER FOR DOCUMENTARY STUDIES

1317 PETTIGREW STREET

DURHAM,NC27705
56-1655039 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(21) DUKE CORPORATE EDUCATION

310 BLACKWELL ST

DURHAM,NC27701
42-1672476 		EDUCATION NC 501(C)(3) 11 TYPE 1 DUKE UNIV
 
 
 
(22) GOTHIC HSP CORPORATION

280 S MANGUM STREET STE 210

DURHAM,NC27701
27-1325761 		INVESTMENTS NC 501(C)(3) 11 TYPE 1 DUHS INC
 
 
 
(23) DUKE UNIVERSITY AFFILIATED PHYSICIANS

615 DOUGLAS STREET SUITE 700

DURHAM,NC27705
56-1902501 		HEALTHCARE NC 501(C)(3) 11 TYPE 1 DUHS INC
 
 
 
(24) ASSOCIATED HEALTH SERVICES INC

615 DOUGLAS STREET SUITE 700

DURHAM,NC27705
56-1845329 		HEALTHCARE NC 501(C)(3) 11 TYPE 1 DUHS INC
 
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) DUMAC LLC

S MANGUM ST
DURHAM,NC27701
65-1319939 		INVESTMENTS NC NA
  		N/A                
(2) CD FUND LP

MCKINNEY AVE
DALLAS,TX75201
27-0130641 		INVESTMENTS TX NA
  		N/A                
(3) DREVER OPP FUND LP

PORTWEST DR
HOUSTON,TX77024
54-2063549 		INVESTMENTS TX NA
  		N/A                
(4) LIQUID REALTY PTR

MONTG ST
SAN FRANC,CA94104
05-0537755 		INVESTMENTS DE NA
  		N/A                
(5) BLACKWELL PTR LLC

S MANGUM ST
DURHAM,NC27701
20-8075455 		INVESTMENTS GA NA
  		N/A                
(6) GMO FORESTRY 6-B LP

ROWES WHARF
BOSTON,MA02110
48-1294791 		INVESTMENTS DE NA
  		N/A                
(7) CANYON BLUE INV FD

AVE OF STARS
LA,CA90067
27-0186996 		INVESTMENTS DE NA
  		N/A                
(8) SBER LUCKY STRIKE

BLACKWELL ST
DURHAM,NC27701
20-3891303 		REAL ESTATE NC NA
  		N/A                
(9) OCTAVIAN BLUE FD LP

650 MADISON AVE
NY,NY10022
27-2408711 		INVESTMENTS DE NA
  		N/A                
(10) TAIYO BLUE FUND LP

CARILLON
KIRKLAND,WA98033
80-0613746 		INVESTMENTS DE NA
  		N/A                
(11) LYRICAL BLUE RL PTR

N DEAN ST
ENGLEWOOD,NJ07631
27-2994514 		INVESTMENTS DE NA
  		N/A                
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) HEALTH SYSTEM MEDICAL STRATEGIES INC
615 DOUGLAS STREET SUITE 700
DURHAM,NC27705
56-2222444 		HEALTH CARE NC DUHS INC
  		C CORP 1,741,699 0 100.000 %
(2) DURHAM CASUALTY COMPANY LTD
AON HOUSE 30 WOODBOURNE AVE
PEMBROKE,BERMUDAHM 08
BD
98-0113277 		INSURANCE BD DUHS INC
  		C CORP 40,544,028 153,679,642 100.000 %
(3) GOTHIC INTERNATIONAL LTD
113 S CHURCH STREET
QUEENSGATE HOUSE,GRAND CAYMANKY1-110,
CJ
INVESTMENTS CJ NA
  		C CORP      
(4) COLCHESTER ALPHA FUND (BERMUDA) LTD
54-62 TOWNSEND ST 2
DUBLIN    
EI
INVESTMENTS BD NA
  		C CORP      
(5) COLCHESTER BETA THREE FUND LTD
CENTURY HOUSE 16 PAR-LA VILLE RD
HAMILTON   HM HX,
BD
INVESTMENTS BD NA
  		C CORP      
(6) RA CAPITAL HEALTHCARE INTERNATIONAL FUND
PO BOX 309GT UGLAND HOUSE
S CHURCH ST, GEORGETOWN,GRAND CAYMAN  
CJ
INVESTMENTS CJ NA
  		C CORP      
(7) ZAIS MATRIX VI-D LTD
PO BOX 1373GT AALL BUILDING
GEORGETOWN,GRAND CAYMAN  
CJ
INVESTMENTS CJ NA
  		C CORP      
(8) INDOCHINA LAND INVESTMENT 3 CORP
DORSET HOUSE TAIKOO PL 979 KINGS RD
HONG KONG    
HK
INVESTMENTS CJ NA
  		C CORP      
(9) DUSVF EUROPEAN LP
7 CAVENDISH SQUARE
LONDON   W1G 0PE,
UK
98-0346042 		INVESTMENTS UK NA
  		C CORP      
(10) MARATHON BLUE CAYMAN FUND
REGATTA OFFICE PARK WEST BAY RD
GRAND CAYMAN   KY1-12,
CJ
INVESTMENTS CJ NA
  		C CORP      
(11) RICHMOND PARTNERS LTD
PO BOX 309 BWI
GEORGETOWN,GRAND CAYMAN  
CJ
INVESTMENTS CJ NA
  		C CORP      
(12) DUKE MEDICAL STRATEGIES INC
324 BLACKWELL STREET STE 920
DURHAM,NC27701
56-1993799 		HEALTHCARE NC NA
  		C CORP      
(13) JOHN & PATRICIA KOSKINEN CLUT
PO BOX 185
PITTSBURGH,PA152300185
56-6532340 		INVESTMENTS PA NA
  		TRUST      
(14) DUKE UNIV QUADRANGLE FUND
PO BOX 185
PITTSBURGH,PA152300185
56-6218971 		INVESTMENTS PA NA
  		TRUST      
(15) DUKE UNIVERSITY TOWER FUND
PO BOX 185
PITTSBURGH,PA152300185
56-6147362 		INVESTMENTS PA NA
  		TRUST      
(16) DUKE CORPORATE EDUCATION LIM
165 FLEET STREET
LONDON   EC4A 2DY,
UK
42-1672476 		EDU CONSULT UK NA
  		C CORP      
(17) DUKE CORP EDU INDIA PRIVATE
ACADEMIC BLOCK NEW CAMPUS
VASTRAPUR,AHMEDABAD380015,
IN
42-1672476 		CONSULTING IN NA
  		C CORP      
(18) DUKE CORPORATE EDUCATION RSA
GROUND FLOOR TWICKEHNHAM BLDG
BRYANSTON,JOHANNESB02021,
SF
42-1672476 		CONSULTING SF NA
  		C CORP      
(19) DUKE CE LS INC
310 BLACKWELL STREET
DURHAM,NC27701
20-2004016 		REAL ESTATE NC NA
  		C CORP      
(20) DUKE GLOBAL CONSULTING (KUNSHAN)
1666 WEI CHEN NAN RD
KUNSHAN PR,KUNSHAN215300,
CH
CONSULTING CH NA
  		C CORP      
(21) DUKE MEDICINE ASIA PTE LTD
5 SHENTON WAY 07-00 UIC BLD
SING   0688,
SN
MEDICAL RESEARCH SN NA
  		C CORP      
(22) LYRICAL OPPORTUNITY PARTNERS II LTD
45 PARERAWEG PO BOX 4761
CURACAO    
NL
INVESTMENTS CJ NA
  		C CORP      
(23) INDOCHINA LAND HOLDINGS 2 LP
DORSET HOUSE TAIKOO PL 979 KINGS RD
HONG KONG    
HK
INVESTMENTS CJ NA
  		C CORP      
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) DUKE UNIVERSITY AFFILIATED PHYSICIANS INC

 B 6,032,285  
(2) ASSOCIATED HEALTH SERVICES INC

 C 4,201,721  
(3) ASSOCIATED HEALTH SERVICES INC

 N 5,099,102  
(4) DURHAM CASUALTY COMPANY INC

 Q 30,307,532  
(5) GOTHIC HSP CORPORATION

 B 270,800,341  
(6) GOTHIC HSP CORPORATION

 C 85,157,848  
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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