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.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CARENET INC
Employer identification number
56-1977341
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
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(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)
No
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
h
Provide the following information about the supported organization(s).
(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
(1)
NORTH CAROLINA BAPTIST HOSPITAL
560552787
3
Yes
Yes
Yes
0
Total
0
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
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
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
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
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:
-
TIN:
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.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CARENET INC
Employer identification number
56-1977341
Identifier
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 6
NORTH CAROLINA BAPTIST HOSPITAL IS THE SOLE MEMBER OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7A
THE NUMBER OF TRUSTEES OF THE CORPORATION SHALL BE NOT LESS THAN THREE NOR MORE THAN TEN. THE SOLE MEMBER AT ANY ANNUAL MEETING MAY BY RESOLUTION FIX THE NUMBER OF TRUSTEES TO BE ELECTED AT THE MEETING, WHICH SHALL CONSTITUTE THE NUMBER OF TRUSTEES OF THE CORPORATION UNTIL THE NEXT ANNUAL MEETING OF THE SOLE MEMBER UNLESS THE NUMBER IS CHANGED BY ACTION OF THE SOLE MEMBER OR THE TRUSTEES. THE TRUSTEES SHALL BE ELECTED BY THE SOLE MEMBER AT ANY ANNUAL MEETING OF THE SOLE MEMBER OR AT A SPECIAL MEETING OF THE SOLE MEMBER OF WHICH NOTICE OF THE PURPOSE TO ELECT ONE OR MORE TRUSTEES HAS BEEN GIVEN. THE ELECTION OF TRUSTEES SHALL BE A PART OF THE ORDER OF BUSINESS OF EACH ANNUAL MEETING OF THE SOLE MEMBER. TRUSTEES MAY BE REMOVED FROM OFFICE AT ANY TIME WITH OR WITHOUT CAUSE BY THE SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7B
SEE RESPONSE TO LINE 7A.
FORM 990, PART VI, SECTION B, LINE 11
THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVES COPIES OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. THE AUDIT AND COMPLIANCE COMMITTEES OF THE GOVERNING BOARDS OF WFUHS AND NCBH REVIEW IN ADDITIONAL DETAIL THE FILING ORGANIZATION'S FORM 990 WITH THE ORGANIZATION'S CHIEF FINANCIAL OFFICER OR HIS DESIGNEE, WHO ANSWERS QUESTIONS AND ADDRESSES CONCERNS RAISED BY SUCH COMMITTEE MEMBERS OR OTHER FILING ORGANIZATION DIRECTORS. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL DIRECTORS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS.
FORM 990, PART VI, SECTION B, LINE 12C
CARENET, INC. IS A SUBSIDIARY OF NORTH CAROLINA BAPTIST HOSPITAL (NCBH) WHICH IS OPERATED BY WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER (WFUBMC). POLICIES APPLICABLE TO WFUBMC ARE ALSO APPLICABLE TO CARENET, INC. TO PROMOTE REGULATORY COMPLIANCE, INCLUDING THE AVOIDANCE OF IMPERMISSIBLE PRIVATE BENEFIT, PRIVATE INUREMENT, OR EXCESS BENEFIT TO PERSONS POSSESSING SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF NCBH, THE EXECUTIVE COMMITTEE OF THE WFUBMC BOARD WILL CONDUCT OR INITIATE REVIEWS AS IT DEEMS APPROPRIATE OR NECESSARY OF: (I) COMPENSATION ARRANGEMENTS; (II) ACQUISITIONS OF PHYSICIAN PRACTICES AND OTHER PROVIDER SERVICES; (III) PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICES ORGANIZATIONS AND PHYSICIAN HOSPITAL ORGANIZATIONS; AND (IV) AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES, AND THIRD-PARTY PAYERS.
FORM 990, PART VI, SECTION B, LINE 15A
CARENET, INC. HAS NO DIRECT EMPLOYEES -- ALL CLINICIANS AND OFFICE STAFF ARE EMPLOYED BY NORTH CAROLINA BAPTIST HOSPITAL (NCBH) OR ARE INDEPENDENT CONTRACTORS. THE SALARIES OF THE TOP EXECUTIVE DIRECTOR OR OTHER OFFICERS ARE DETERMINED BY WFUBMC AND DETAILED IN THE WFUBMC EXECUTIVE COMPENSATION POLICY. THE CARENET, INC. BOARD OF TRUSTEES REVIEWS THE SALARY OF THE EXECUTIVE DIRECTOR ANNUALLY. THE ORGANIZATION HAD NO OTHER OFFICERS OR KEY EMPLOYEES TO WHOM THE POLICY WOULD APPLY.
FORM 990, PART VI, SECTION C, LINE 18
PHOTOCOPIES OF THE FORM 1023 AND RECENT FILINGS OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE.
FORM 990, PART VI, SECTION C, LINE 19
PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE.
AVERAGE HOURS FOR RELATED ORGANIZATIONS:
FORM 990, PART VII, LINE 1, COLUMN (B):
THE FOLLOWING PERSONS WERE COMPENSATED DIRECTLY BY NORTH CAROLINA BAPTIST HOSPITAL, A RELATED ORGANIZATION, FOR SERVICES PERFORMED FOR THE FILING ORGANIZATION. EACH PERSON'S POSITION IN EACH ORGANIZATION, AND THE AVERAGE HOURS PER WEEK THAT THEY DEVOTE TO EACH ENTITY, ARE SHOWN BELOW. - H. GREG BRAY - TRUSTEE, FILING ORGANIZATION 0.1 HOURS PER WEEK ASSISTANT TREASURER/ASSISTANT SECRETARY, NCBH 38.7 HOURS PER WEEK SECRETARY, THE NURSING CENTER AT OAK SUMMIT (1/1 - 6/30) 0.1 HOURS PER WEEK SECRETARY, NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION (1/1 - 6/30) 0.1 HOURS PER WEEK TREASURER, HAWTHORNE INN & CONFERENCE CENTER 1 HOURS PER WEEK - DONNY LAMBETH - TRUSTEE, FILING ORGANIZATION 0.1 HOURS PER WEEK PRESIDENT, NCBH 36 HOURS PER WEEK PRESIDENT, WFUBMC COMMUNITY PHYSICIANS 1 HOUR PER WEEK DIRECTOR, DAVIDSON HEALTHCARE, INC. 1 HOUR PER WEEK DIRECTOR, LEXINGTON MEMORIAL HOSPITAL, INC. 1 HOUR PER WEEK DIRECTOR, LEXMEDICAL, INC. 1 HOUR PER WEEK CHAIRMAN, HAWTHORNE INN & CONFERENCE CENTER 0.1 HOURS PER WEEK SECRETARY, THE NURSING CENTER AT OAK SUMMIT (7/1 - 12/31) 0.1 HOURS PER WEEK SECRETARY, NORTH CAROLINA BAPTIST HOSPITAL FOUNDATION (7/1 - 12/31) 0.1 HOURS PER WEEK MEMBER, NORTHWEST COMMUNITY CARE NETWORK, INC. 0.1 HOURS PER WEEK TRUSTEE, SECRETARY, TREASURER, THE MEDICAL FOUNDATION OF WFUHS AND NCBH 0.1 HOURS PER WEEK - MAUREEN E. SINTICH - TRUSTEE, FILING ORGANIZATION 0.1 HOURS PER WEEK VP OPERATIONS/CNO, NCBH 39.8 HOURS PER WEEK TRUSTEE, HAWTHORNE INN & CONFERENCE CENTER 0.1 HOURS PER WEEK - LINDA SCHROEDER - TRUSTEE, FILING ORGANIZATION 0.1 HOURS PER WEEK - STEVEN N. SCOGGIN - PRESIDENT, FILING ORGANIZATION 40 HOURS PER WEEK
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
NET UNREALIZED GAINS ON INVESTMENTS: 7,690.
FORM 990, PART XII, LINE 2C:
THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
NUMBER OF INDEPENDENT BOARD MEMBERS:
FORM 990, PART VI, SECTION A, LINE 1B
CARENET OPERATES UNDER THE DIRECT CONTROL OF ITS SOLE MEMBER, NORTH CAROLINA BAPTIST HOSPITAL, A 501(C)(3) ORGANIZATION. MEMBERS OF THE BOARD OF DIRECTORS OF CARENET ARE NOMINATED BY THE SOLE MEMBER, TYPICALLY FROM ITS MANAGEMENT STAFF, AND IS SUPERVISED BY THE BOARD OF DIRECTORS OF THE SOLE MEMBER. A MAJORITY OF THE BOARD OF DIRECTORS OF THE SOLE MEMBER IS INDEPENDENT.
FORM 990, PART VI, SECTION A, LINE 3:
EFFECTIVE JULY 1, 2010, THE GOVERNING BOARDS OF FOUR NORTH CAROLINA NONPROFIT CORPORATIONS (WAKE FOREST UNIVERSITY, NORTH CAROLINA BAPTIST HOSPITAL, WAKE FOREST UNIVERSITY HEALTH SCIENCES, AND WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER) ENTERED INTO AN AGREEMENT (THE "MEDICAL CENTER INTEGRATION AGREEMENT" OR "MCIA") UNDER WHICH THE POWER TO OPERATE EACH OF NORTH CAROLINA BAPTIST HOSPITAL ("NCBH") AND WAKE FOREST UNIVERSITY HEALTH SCIENCES ("WFUHS"), INCLUDING THEIR RESPECTIVE "SUBSIDIARIES, AFFILIATES, AND JOINT VENTURES", WAS DELEGATED TO WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER ("WFUBMC"). WFUHS IS A WHOLLY-CONTROLLED SUBSIDIARY OF WAKE FOREST UNIVERSITY ("WFU"). WFUBMC IS NOW A MEMBERSHIP NONPROFIT CORPORATION WHOSE TWO EQUAL MEMBERS ARE NCBH (WHICH ENTITY IS UNRELATED TO WFU) AND WFU. THIS CONSOLIDATION OF MANAGEMENT IN WFUBMC OF THE VARIOUS ACADEMIC MEDICAL CENTER OPERATIONS, SUBJECT TO SUBSTANTIAL RESERVED POWERS IN EACH OF THE WFU AND NCBH CONSTITUENT MEMBERS' (OR IN WFUHS') BOARDS, MANDATED CHANGES IN THE GOVERNANCE DOCUMENTS OF EACH ORGANIZATION (WFUHS, NCBH, AND WFU), WHICH CHANGES WERE MADE DURING THE TAX YEAR. THE FILING ORGANIZATION [CARENET, INC.] IS A WHOLLY-OWNED SUBSIDIARY OF NCBH. WHILE NO CONFORMING CHANGES TO THE FILING ORGANIZATION'S GOVERNANCE DOCUMENTS WERE MADE DURING THE TAX YEAR, THE FILING ORGANIZATION'S MANAGEMENT HAS BEEN DIRECTLY IMPACTED BY THE MCIA, AS REFLECTED IN THE CHANGES MADE TO THE GOVERNANCE DOCUMENTS OF WFUBMC, WFUHS, AND NCBH.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.