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
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2011 and ending 06-30-2012
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 NO 700
 
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 $ 3,631,677,412
F Name and address of principal officer:
VICTOR J DZAU MD
615 DOUGLAS ST 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: SEE SCHEDULE O FOR ORGANIZATION'S MISSION STATEMENT
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 21
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 14
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 17,055
6 Total number of volunteers (estimate if necessary) .... 6 2,400
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) ......... 5,769,880 11,631,914
9 Program service revenue (Part VIII, line 2g) ......... 2,181,972,792 2,304,899,882
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 121,177,481 19,726,188
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 59,642,402 66,110,800
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 2,368,562,555 2,402,368,784
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 5,641,045 2,065,384
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) 1,030,668,755 1,075,745,136
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet150,531    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 1,062,048,680 1,066,984,072
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 2,098,358,480 2,144,794,592
19 Revenue less expenses. Subtract line 18 from line 12....... 270,204,075 257,574,192
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 3,519,120,113 3,972,574,812
21 Total liabilities (Part X, line 26)............. 1,472,869,787 2,025,063,125
22 Net assets or fund balances. Subtract line 21 from line 20..... 2,046,250,326 1,947,511,687
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 use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
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 organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations 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 $ 1,561,649,863 including grants of $ 2,065,384 ) (Revenue $ 2,351,502,636 )
SEE SCHEDULE O
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$ 1,561,649,863
Form 990 (2011)
Form 990 (2011)
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 IIIClick to see attachment........................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part 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 temporarily restricted endowments, permanent endowments, 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, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? 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
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements. Click to see attachment
20b
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization 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 list of attachments
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 employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... 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...........................
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
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... 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 (2011)
Form 990 (2011)
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
345
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
17,055
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 (2011)
Form 990 (2011)
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
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
21
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
14
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
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ..........
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
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 , OK , OR , PA , SC , TN , UT , WI , ND
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
MIKE LAZAR
DUKE UNIVERSITY HEALTH SYSTEM INC
DURHAM,NC27705
(919) 613-8997
Form 990 (2011)
Form 990 (2011)
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 (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) NANCY C ANDREWS MD
DIRECTOR
 1.00 X           0 743,157 46,514
(2) THE HON DANIEL T BLUE JR
DIRECTOR
 1.00 X           0 0 0
(3) JACK O BOVENDER JR
DIRECTOR
 1.00 X           0 0 0
(4) RICHARD H BRODHEAD
DIRECTOR
 10.00 X           0 985,763 191,905
(5) VICTOR J DZAU MD
CEO/DIRECTOR/PRESIDENT
 40.00 X   X       0 2,060,599 711,844
(6) FRANK E EMORY JR
DIRECTOR
 1.00 X           0 0 0
(7) JAMES F GOODMON
DIRECTOR
 1.00 X           0 0 0
(8) THOMAS M GORRIE
DIRECTOR
 2.00 X           0 0 0
(9) CAROLYN E HENDERSON
DIRECTOR
 1.00 X           0 0 0
(10) DANNY O JACOBS MD
DIRECTOR
 1.00 X           0 325,811 49,420
(11) REBECCA TRENT KIRKLAND MD
DIRECTOR
 1.00 X           0 0 0
(12) RICHARD D KLAUSNER MD
DIRECTOR
 1.00 X           0 0 0
(13) JOHN H MCARTHUR
DIRECTOR
 1.00 X           0 0 0
(14) LLOYD B MORGAN
DIRECTOR
 1.00 X           0 0 0
(15) THEODORE N PAPPAS MD
DIRECTOR
 1.00 X           0 109,591 36,123
(16) CARL E RAVIN MD
DIRECTOR
 1.00 X           0 250,407 40,021
(17) STEVEN SCOTT MD
DIRECTOR
 1.70 X           0 0 0
Form 990 (2011)
Form 990 (2011)
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 (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) SUSAN M STALNECKER
DIRECTOR
 1.00 X           0 0 0
(19) KATHERINE KEITH THOMAS
DIRECTOR
 1.00 X           0 0 0
(20) PETER VAN ETTEN
DIRECTOR
 1.00 X           0 0 0
(21) G RICHARD WAGONER JR
DIRECTOR
 1.00 X           0 0 0
(22) MONTE D BROWN MD
VP OF ADMINISTRATION/SECRETARY
 50.00     X       534,954 0 51,520
(23) WILLIAM J FULKERSON MD
CEO, DUKE HOSP/SVP, ACUTE CARE
 60.00     X       1,171,458 0 34,245
(24) KENNETH C MORRIS
SVP, CFO, TREASURER
 40.00     X       1,053,572 0 37,180
(25) MARY ANN FUCHS
CHIEF NURSING OFFICER
 40.00       X     355,002 0 34,719
(26) ARTHUR L GLASGOW
VP/CIO, DHTS
 40.00       X     531,650 0 39,181
(27) KEVIN W SOWERS
PRESIDENT, DUKE UNIVERSITY HOSPITAL
 62.00       X     640,717 0 36,201
(28) DOUGLAS B VINSEL
CEO, DUKE RALEIGH HOSPITAL
 60.00       X     548,910 0 46,759
(29) KERRY R WATSON
PRESIDENT, DURHAM REGIONAL HOSPITAL
 40.00       X     508,442 0 88,590
(30) MARC CALABRESE
PHYSICIAN
 40.00         X   395,114 0 48,159
(31) JOHN M KELSCH
PHYSICIAN
 40.00         X   373,710 0 44,240
(32) MOLLY K ONEILL
VP, BUSINESS DEVELOPMENT
 40.00         X   591,569 0 39,058
(33) THOMAS A OWENS
PHYSICIAN
 40.00         X   389,210 0 42,886
(34) JOSEPH G TAYLOR
PHYSICIAN
 40.00         X   453,523 0 48,629
(35) MARK D GUSTAFSON
FORMER OFFICER
 55.00           X 0 275,898 44,743
(36) PAUL R NEWMAN
FORMER KEY EMPLOYEE
 0.00           X 0 245,805 67,032
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 7,547,831 4,997,031 1,778,969
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet1,042
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
KBR BUILDING GROUP INC
5605 CARNEGIE BLVD
CHARLOTTE,NC28209 		CONSTRUCTION SERVICE 178,861,238
PRIVATE DIAGNOSTIC CLINIC PLLC
DUMC 3070
DURHAM,NC27710 		PHYSICIAN SERVICES 69,112,094
ARAMARK HEALTHCARE SUPPORT SERVICES
PO BOX 651009
CHARLOTTE,NC282651009 		HEALTHCARE SERVICES 10,464,137
GE MEDICAL SYSTEMS INC
PO BOX 402076
ATLANTA,GA303842076 		CONTRACT SERVICES 4,624,589
PERKINS & WILL INC
1382 PEACHTREE ST NE
ATLANTA,GA30309 		ARCHITECT SERVICES 4,313,836
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet255
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 131,288
d Related organizations...1d 29,751
e Government grants (contributions)1e 591,084
f All other contributions, gifts, grants, and
similar amounts not included above1f 		10,879,791
g Noncash contributions included in lines 1a-1f:$ 202,422
h Total. Add lines 1a-1f.......MediumBullet 11,631,914
Program Service Revenue Business Code
2a PATIENT REVENUE 621,990 2,279,086,228 2,279,086,228    
b ANCILLARY MEDICAL 621,990 23,103,169 23,103,169    
c MEDICAL SERVICES 621,990 2,710,485 2,710,485    
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 2,304,899,882
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 11,691,822     11,691,822
4 Income from investment of tax-exempt bond proceeds..MediumBullet 775,200     775,200
5 Royalties............MediumBullet 2,335,261     2,335,261
(i) Real (ii) Personal
6a Gross rents 15,390,286  
b Less: rental expenses 14,964,762  
c Rental income or (loss) 425,524  
d Net rental income or (loss).......MediumBullet 425,524     425,524
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 1,221,326,398 165,462
b Less: cost or other basis and sales expenses 1,214,140,468 92,226
c Gain or (loss) 7,185,930 73,236
d Net gain or (loss)..........MediumBullet 7,259,166     7,259,166
8a Gross income from fundraising events (not including
$ 131,288
of contributions reported on line 1c). See Part IV, line 18 ...
a 90,644
b Less: direct expenses ...b 111,172
c Net income or (loss) from fundraising events..MediumBullet -20,528   -20,528
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        
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        
Miscellaneous Revenue Business Code
11a BILLING FEES 621,990 39,580,345 39,580,345    
b DEEMED DIVIDEND 900,003 12,642,049     12,642,049
c TUITION 900,099 1,917,192 1,917,192    
d All other revenue .... 9,230,957 4,946,060   4,284,897
e Total. Add lines 11a–11d ......MediumBullet 63,370,543
12 Total revenue. See Instructions....MediumBullet 2,402,368,784 2,351,343,479 0 39,393,391
Form 990 (2011)
Form 990 (2011)
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).
Check if Schedule O contains a response to any question in this Part IX. .........
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 2,007,023 2,007,023
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 58,361 58,361
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 5,673,191 541,576 5,086,916 44,699
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 186,192 80,376 105,816  
7 Other salaries and wages 859,604,127 602,769,399 256,776,004 58,724
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 37,865,766 23,871,267 13,989,865 4,634
9 Other employee benefits ....... 110,138,361 81,143,753 28,984,124 10,484
10 Payroll taxes ........... 62,277,499 42,354,927 19,916,344 6,228
11 Fees for services (non-employees):        
a Management ...... 13,329,752 12,310,350 1,019,402  
b Legal ......... 1,432,149 109,374 1,322,775  
c Accounting ........... 476,500   476,500  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ...... 3,214,538   3,214,538  
g Other .......... 146,215,135 90,100,726 56,114,409  
12 Advertising and promotion .... 4,554,617 1,180,242 3,374,375  
13 Office expenses ....... 532,476,603 517,800,172 14,656,549 19,882
14 Information technology ...... 30,673,109 3,675,419 26,997,690  
15 Royalties ..        
16 Occupancy ........... 47,577,024 31,764,742 15,812,244 38
17 Travel ............ 6,255,504 4,299,468 1,952,831 3,205
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 3,440,775 102,100 3,338,076 599
20 Interest ........... 36,084,598 538,719 35,545,879  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 91,892,122 73,665,381 18,226,741  
23 Insurance .............. 10,568,711 5,781,226 4,787,485  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a EQUIPMENT RENTAL & MAIN 59,973,124 45,885,932 14,086,886 306
b LAUNDRY 7,969,578 7,903,216 66,362  
c DUES & MEMBERSHIPS 2,312,195 877,058 1,434,355 782
d CONTINUING EDUCATION 1,586,997 465,688 1,120,359 950
e
f All other expenses 66,951,041 12,363,368 54,587,673  
25 Total functional expenses. Add lines 1 through 24f 2,144,794,592 1,561,649,863 582,994,198 150,531
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 49,068 1 49,073
2 Savings and temporary cash investments ....... 356,503,510 2 586,721,228
3 Pledges and grants receivable, net ......... 18,030,089 3 22,132,059
4 Accounts receivable, net ......... 305,877,825 4 323,603,278
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 ............. 1,394,532 7 1,242,411
8 Inventories for sale or use .............. 62,751,534 8 66,770,331
9 Prepaid expenses and deferred charges ............ 8,806,735 9 14,264,968
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 2,318,578,316
b Less: accumulated depreciation. ..... 10b 1,056,312,210 977,695,459 10c 1,262,266,106
11 Investments—publicly traded securities .......... 2,920,163 11 2,778,265
12 Investments—other securities. See Part IV, line 11 ...... 1,680,758,563 12 1,674,659,624
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 ........... 103,688,566 15 17,443,400
16 Total assets. Add lines 1 through 15 (must equal line 34)... 3,519,120,113 16 3,972,574,812
Liabilities 17 Accounts payable and accrued expenses . 283,599,625 17 318,183,821
18 Grants payable ..........   18  
19 Deferred revenue .......... 2,930,320 19 9,272,886
20 Tax-exempt bond liabilities .......... 830,779,105 20 1,136,143,590
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 (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D..... 355,560,737 25 561,462,828
26 Total liabilities. Add lines 17 through 25..... 1,472,869,787 26 2,025,063,125
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 ..... 1,992,550,258 27 1,897,474,906
28 Temporarily restricted net assets ..... 44,049,489 28 40,757,961
29 Permanently restricted net assets ..... 9,650,579 29 9,278,820
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 ..... 2,046,250,326 33 1,947,511,687
34 Total liabilities and net assets/fund balances ..... 3,519,120,113 34 3,972,574,812
Form 990 (2011)
Form 990 (2011)
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
2,402,368,784
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
2,144,794,592
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
257,574,192
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
2,046,250,326
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
-356,312,831
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
1,947,511,687
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 (2011)
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
2011
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2011

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
2011
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 on line H of its
Form 990-EZ or on Part I, 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) (2011)

Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
DUKE UNIVERSITY HEALTH SYSTEM INC
  		Employer identification number

56-2070036
Part I
Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total 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)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
DUKE UNIVERSITY HEALTH SYSTEM INC
  		Employer identification number

56-2070036
Part II
Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
     
(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) (2011)

Page 4
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
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
that total 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 $  
Use duplicate copies of Part III if additional space is needed
(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) (2011)

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
2011
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, line 35c (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 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 function 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) 2011

Schedule C (Form 990 or 990-EZ) 2011
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 expenses, and share of excess lobbying expenditures).
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) 2008 (b) 2009 (c) 2010 (d) 2011 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots nontaxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2011


Schedule C (Form 990 or 990-EZ) 2011
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)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(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
 
306,611
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
69,596
j
Total. Add lines 1c through 1i ...............................
376,207
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 carry over 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) and if either (a) BOTH Part III-A, lines 1 and 2 are answered “No” OR (b) Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible 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, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: DUKE UNIVERSITY HEALTH SYSTEM, INC. EMPLOYS STAFF WHO PERFORM SOME LOBBYING ACTIVITIES AS PART OF THEIR JOB RESPONSIBILITIES. THESE SAME EMPLOYEES AND SOME SENIOR LEADERS OF THE ORGANIZATION MAY HAVE DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS, AND GOVERNMENT OFFICIALS. DUKE UNIVERSITY HEALTH SYSTEM, INC. PAYS MEMBERSHIP DUES TO OTHER ORGANIZATIONS. PER THE MEMBERSHIP DUES INVOICES, SOME OF THESE ORGANIZATIONS PROVIDE A DISCLOSURE OF LOBBYING PERCENTAGE OF THE DUES RECEIVED.
Schedule C (Form 990 or 990EZ) 2011

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, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2011
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 can 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 through 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, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax 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 (ASC 958), 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 (ASC 958), 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 (ASC 958), 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) 2011

Schedule D (Form 990) 2011
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 .... 53,700,068 55,631,465 44,124,232 52,120,961
b Contributions ........ 11,126,530 5,340,437 14,138,555 5,465,898
c Net investment earnings, gains, and losses ... -758,496 3,639,795 2,461,764 -6,187,893
d Grants or scholarships .....        
e Other expenditures for facilities
and programs ........ 		14,031,321 10,911,629 5,093,086 7,274,733
f Administrative expenses ....        
g End of year balance ...... 50,036,781 53,700,068 55,631,465 44,124,233
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet36.000 %
c
Temporarily restricted endowment SchDMd Bullet64.000 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
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
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (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 ................   1,481,891,386 522,004,548 959,886,838
c Leasehold improvements ............        
d Equipment ................   519,211,616 338,651,555 180,560,061
e Other .................   289,992,328 195,656,107 94,336,221
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 1,262,266,106
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
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 		550,171,000 F

(B) DOMESTIC BONDS & LT NOTES 		133,799,000 F

(C) DOMESTIC STOCKS 		83,087,000 F

(D) INTERNAT'L BONDS/LT NOTES 		42,493,000 F

(E) INTERNATIONAL STOCKS 		306,867,000 F

(F) HEDGED STRATEGIES 		317,490,000 F

(G) SHORT-TERM INVESTMENTS 		162,041,000 F

(H) PRIVATE CAPITAL 		43,992,000 F

(I) REAL ESTATE 		18,108,000 F

(J) OTHER INVESTMENTS 		16,611,624 F
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 1,674,659,624
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) must 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) must 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) Book value
Federal Income Taxes  
INTEREST PAYABLE 11,102,230
PROFESSIONAL LIABILITY COSTS 9,017,601
POST RETIREMENT BENEFIT OBLIGATION 213,700,000
CAPITAL LEASE OBLIGATION 127,576,266
DERIVATIVE INSTRUMENTS 139,026,628
OTHER NON-CURRENT LIABILITIES 61,040,103



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 561,462,828
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) 2011

Schedule D (Form 990) 2011
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 through 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 must 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 must 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
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: 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.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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, 2012.
Schedule D (Form 990) 2011

Additional Data


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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
2011
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 its grants
and other 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 its grants and other
assistance 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   9,999
CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES RECRUITMENT 1,240
EAST ASIA AND THE PACIFIC 0 0 SEND AGENTS TO SEMINAR   10,089
EUROPE 0 0 SEND AGENTS TO SEMINAR   42,596
MIDDLE EAST AND NORTH AFRICA 0 0 SEND AGENTS TO SEMINAR   12,803
NORTH AMERICA 0 0 SEND AGENTS TO SEMINAR   372
SOUTH AMERICA 0 0 SEND AGENTS TO SEMINAR   495
CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS   160,542,221
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 0 0 160,619,815
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 0 160,619,815
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2011
Schedule F (Form 990) 2011
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) 2011
Schedule F (Form 990) 2011Page 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) 2011
Schedule F (Form 990) 2011
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) 2011
Schedule F (Form 990) 2011
Page 5
Part V
Supplemental Information
Complete this part to provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
Identifier ReturnReference Explanation
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2011
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 arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
OMB No. 1545-0047
2011
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
 
DUKE UNIVERSITY
BLACKWELL ST
 
DURHAM, NC27701 		SHARED FUNDRAISING Yes   0 700,000 0
Total .................right arrow   700,000  
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, 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) 2011
Schedule G (Form 990 or 990-EZ) 2011
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

  
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 221,932     221,932
2 Less: Charitable
contributions . . . 		131,288     131,288
3 Gross income (line 1
minus line 2) . . . 		90,644     90,644
VerticalDirectExpenses 4 Cash prizes . . . 0      
5 Non-cash prizes . . 70,633     70,633
6 Rent/facility costs . . 1,816     1,816
7 Food and beverages . . 27,227     27,227
8 Entertainment . . . 4,848     4,848
9 Other direct expenses . 6,648     6,648
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 111,172
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow -20,528
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) 2011
Schedule G (Form 990 or 990-EZ) 2011
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
  FORM 990, SCHEDULE G, PART I, LINE 2B DUKE UNIVERSITY HEALTH SYSTEM SUPPORTS THE FUNDRAISING ACTIVITIES PERFORMED BY EMPLOYEES OF DUKE UNIVERSITY. SUCH ACTIVITIES ARE DESIGNED TO DEVELOP SUPPORT FOR BOTH THE UNIVERSITY AND THE DUKE UNIVERSITY HEALTH SYSTEM'S EDUCATIONAL, RESEARCH AND HEALTHCARE PURPOSES. DUKE UNIVERSITY RECEIVES AND DIRECTS THE CONTRIBUTIONS AS APPROPRIATE TO THE HEALTH SYSTEM. THE AGREEMENT BETWEEN DUKE UNIVERSITY AND DUKE UNIVERSITY HEALTH SYSTEM DOES NOT DISTINGUISH BETWEEN PAYMENTS FOR PROFESSIONAL FUNDRAISING SERVICES AND EXPENSE PAYMENTS OR REIMBURSEMENTS.
Schedule G (Form 990 or 990-EZ) 2011
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
2011
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
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the
following was the family income limit for eligibility for discounted care: ............
3b
Yes
 
c
If the organization did 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 used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance 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 discountedcare to a patient who was eligibile for free or discounted care?...............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year?...........
6a
Yes
 
b
If "Yes," did 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
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance
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 Financial Assistance at cost
(from Worksheet 1) .. 		    69,096,659 0 69,096,659 3.220 %
b Medicaid (from Worksheet 3, column a) .....     33,917,268 0 33,917,268 1.580 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .     348 0 348 0 %
dTotal Financial Assistance and
Means-Tested Government Programs ..... 		    103,014,275   103,014,275 4.800 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    718 0 718 0 %
f Health professions education
(from Worksheet 5) .. 		    70,345,378 14,540,320 55,805,058 2.600 %
g Subsidized health services
(from Worksheet 6) .. 		    747 0 747 0 %
h Research (from Worksheet 7)     0 0    
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....     11,283,213 0 11,283,213 0.530 %
jTotal Other Benefits ...     81,630,056 14,540,320 67,089,736 3.130 %
kTotal. Add lines 7d and 7j. ..     184,644,331 14,540,320 170,104,011 7.930 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(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            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did 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........
2
24,618,001
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance 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
487,029,763
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
556,125,815
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-69,096,052
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
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

 

No
Part IV
Management Companies and Joint Ventures
(see instructions)
(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 %
11 DLP 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) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest)
How many hospital facilities did the organization operate during the tax year?5
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 DURHAM REGIONAL HOSPITAL
3643 ROXBORO ROAD
DURHAM,NC27704 		X X         X    
3 DUKE RALEIGH HOSPITAL
3400 WAKE FOREST ROAD
RALEIGH,NC27609 		X X         X    
4 MARIA PARHAM MEDICAL CENTER
566 RUIN CREEK ROAD
HENDERSON,NC27536 		X X         X   3% OWNERSHIP IN JOINT VENTURE
5 PERSON MEMORIAL HOSPITAL
615 RIDGE ROAD
ROXBORO,NC27573 		X X         X   3% OWNERSHIP IN JOINT VENTURE
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
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)
DUKE UNIVERSITY HOSPITAL
Name of Hospital Facility:  
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 2011)
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 the community health 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 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 Participation in the development of a community-wide community benefit plan
d Participation in the execution of a 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 Needs Assessment
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 and 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 Explained 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?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
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 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 (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 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 patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
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 why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
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)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
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 FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21 Yes  
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
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)
DURHAM REGIONAL HOSPITAL
Name of Hospital Facility:  
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 2011)
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 the community health 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 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 Participation in the development of a community-wide community benefit plan
d Participation in the execution of a 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 Needs Assessment
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 and 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 Explained 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?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
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 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 (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 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 patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
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 why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
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)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
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 FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21 Yes  
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
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)
DUKE RALEIGH HOSPITAL
Name of Hospital Facility:  
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 2011)
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 the community health 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 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 Participation in the development of a community-wide community benefit plan
d Participation in the execution of a 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 Needs Assessment
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 and 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 Explained 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?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
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 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 (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 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 patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
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 why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
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)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
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 FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21 Yes  
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
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)
MARIA PARHAM MEDICAL CENTER
Name of Hospital Facility:  
Line Number of Hospital Facility (from Schedule H, Part V, Section A):4

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
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 the community health 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 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 Participation in the development of a community-wide community benefit plan
d Participation in the execution of a 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 Needs Assessment
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 and 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 Explained 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?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 180.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
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 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 (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 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 patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
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 why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
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)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
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 FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
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)
PERSON MEMORIAL HOSPITAL
Name of Hospital Facility:  
Line Number of Hospital Facility (from Schedule H, Part V, Section A):5

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
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 the community health 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 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 Participation in the development of a community-wide community benefit plan
d Participation in the execution of a 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 Needs Assessment
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 and 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 Explained 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?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 180.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 200.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
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 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 (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16 Yes  
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 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 patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
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 why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
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)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
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 FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?12
Name and address Type of Facility (describe)
1 HOSPICE OF MEADOWLANDS
1001 CORPORATE DRIVE
HILLSBOROUGH,NC27278 		HOSPICE
2 HOCK FAMILY PAVILION
4023 NORTH ROXBORO ROAD
DURHAM,NC27704 		HOSPICE
3 DIET & FITNESS CENTER
501 DOUGLAS STREET
DURHAM,NC27705 		HEALTHY WEIGHT LOSS TREATMENT CENTER
4 DUKE INTEGRATIVE MEDICINE
3475 ERWIN ROAD
DURHAM,NC27705 		CLINICAL AND THERAPEUTIC SERVICES CENTER
5 NORTHERN CAROLINA SURGICAL ASSOCIATES
120 CHARLES ROLLINS ROAD SUITE 206
HENDERSON,NC27536 		GENERAL SURGICAL PRACTICE - 3% OWNERSHIP IN JOINT VENTURE
6 MARIA PARHAM ANESTHESIA & PHYSIATRY
568 RUIN CREEK ROAD SUITE 128
HENDERSON,NC27536 		PHYSICIAN PRACTICE (ANESTHESIA & PHYSIATRY) - 3% OWNERSHIP IN JOINT VENTURE
7 MARIA PARHAM NEPHROLOGY & HYPERTENSION
568 RUIN CREEK ROAD SUITE 006
HENDERSON,NC27536 		PHYSICIAN PRACTICE (NEPHROLOGY/HYPERTENSION)-3% OWNERSHIP IN JOINT VENTU
8 KERR LAKE ORTHOPAEDICS
120 CHARLES ROLLINS ROAD SUITE 205
HENDERSON,NC27536 		PHYSICIAN PRACTICE (ORTHOPAEDICS) - 3% OWNERSHIP IN JOINT VENTURE
9 FOUR COUNTY PRIMARY CARE
120 CHARLES ROLLINS ROAD SUITE 102
HENDERSON,NC27536 		PHYSICIAN PRACTICE - 3% OWNERSHIP IN JOINT VENTURE
10 MARIA PARHAM REGIONAL HOME HEALTH
566 RUIN CREEK ROAD
HENDERSON,NC27536 		HOME HEALTH PRACTICE - 3% OWNERSHIP IN JOINT VENTURE
11 NORTHERN CAROLINA CARDIOLOGY
568 RUIN CREEK ROAD SUITE 102
HENDERSON,NC27536 		PHYSICIAN PRACTICE (CARDIOLOGY) - 3% OWNERSHIP IN JOINT VENTURE
12 MARIA PARHAM ENDOCRINOLOGY
120 CHARLES ROLLINS ROAD SUITE 206
HENDERSON,NC27536 		PHYSICIAN PRACTICE (ENDOCRINOLOGY) - 3% OWNERSHIP IN JOINT VENTURE
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions 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, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any 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 APPLICABLEPART I, LINE 6A:NOT APPLICABLEPART I, LINE 7G:NOT APPLICABLEPART I, LINE 7, COLUMN F:TOTAL GROSS COMMUNITY BENEFIT EXPENSE AS A PERCENT OF TOTAL EXPENSES IS 8.6%.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 (DUHS) OPERATING EXPENSES AND ARE NOT TRACKED SEPARATELY FOR COMMUNITY BENEFIT REPORTING PURPOSES. PART III, LINE 4:METHODOLOGY FOR DETERMINING BAD DEBT AMOUNT REPORTED ON LINE 2:BAD DEBT AT COST IS DETERMINED USING THE COST-TO-CHARGE RATIO CALCULATION FROM WORKSHEET 2.DESCRIPTION OF HOW DUHS ACCOUNTS FOR DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS IN DETERMINING BAD DEBT EXPENSE:DISCOUNTS AND PAYMENTS ARE TREATED AS A REDUCTION ON THE PATIENT'S ACCOUNT. THEREFORE, THE AMOUNT REPORTED AS BAD DEBT EXPENSE IS REDUCED BY THE AMOUNT OF ANY PAYMENTS OR DISCOUNTS APPLIED. RATIONALE FOR INCLUDING PORTION OF BAD DEBT AS COMMUNITY BENEFIT:BAD DEBT EXPENSE SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. DUKE UNIVERSITY HEALTH SYSTEM, INC. FOLLOWS ITS MISSION TO THE COMMUNITY AND PROVIDES EMERGENT SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, SOME PATIENTS WHO MAY QUALIFY FOR CHARITY CARE ARE REPORTED AS BAD DEBT EXPENSE INSTEAD DUE TO PATIENTS' INABILITY OR UNWILLINGNESS TO PROVIDE THE NECESSARY DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE.TEXT FROM FOOTNOTES:FOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE, THE HEALTH SYSTEM RECOGNIZES REVENUE ON THE BASIS OF ITS DISCOUNTED RATES. UNINSURED PATIENTS RECEIVE A DISCOUNT FROM BILLED CHARGES (EXCLUDING COSMETIC SERVICES). ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE HEALTH SYSTEM'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE HEALTH SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR BAD DEBTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HEALTH SYSTEM ANALYZES HISTORICAL COLLECTIONS AND WRITE-OFFS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR BAD DEBTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HEALTH SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR BAD DEBTS, ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS, PROVISION FOR BAD DEBTS, AND CONTRACTUAL ADJUSTMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS OR WITH BALANCES REMAINING AFTER THE THIRD-PARTY COVERAGE HAS ALREADY PAID, THE HEALTH SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS HISTORICAL COLLECTIONS, WHICH INDICATES THAT MANY PATIENTS DECLINE TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE DISCOUNTED RATES AND THE AMOUNTS COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR BAD DEBTS.PART III, LINE 7:TOTAL UNREIMBURSED COSTS ATTRIBUTABLE TO PROVIDING SERVICES UNDER MEDICARE AS REPORTED IN THE JUNE 30, 2012 DUHS CONSOLIDATED FINANCIAL STATEMENTS ARE $96,038,000 AS COMPARED TO $69,096,052 AS REPORTED IN SECTION B, LINE 7 OF SCHEDULE H. THE DUHS TOTAL MEDICARE SHORTFALL OF $96,038,000 IS DERIVED FROM THE COST ACCOUNTING SYSTEM WHICH INCLUDES ALL PAYMENTS AND COSTS ASSOCIATED WITH MEDICARE PATIENTS, WHEREAS THE $69,096,052 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. UNREIMBURSED MEDICARE COSTS REPORTED ON SCHEDULE H IS UNDERSTATED DUE TO EXCLUDING THOSE COSTS 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 V, SECTION A:FACILITIES NUMBERED 4 AND 5 ARE INCLUDED AS A RESULT OF DUHS' 3% OWNERSHIP IN A JOINT VENTURE.PART V, LINE 13G:DUHS PROVIDES A BROCHURE TO ALL ADMISSIONS THAT INCLUDES A BRIEF SUMMARY OF DUHS FINANCIAL ASSISTANCE POLICIES. DUHS ALSO COMMENTS ON THE BACK OF ITS BILLING INVOICES THAT PATIENTS SHOULD CONTACT PATIENT ACCOUNT REPRESENTATIVES TO HELP THEM IF THEY CANNOT PAY THEIR BILL IN FULL. THIS COMMENT REFERENCES GOVERNMENT-SPONSORED PROGRAMS, MONTHLY PAYMENT PROGRAMS, AND OTHER FINANCIAL ASSISTANCE PROGRAMS AVAILABLE FOR PATIENTS WHO MEET CERTAIN FINANCIAL CRITERIA. DUHS ALSO PUBLICIZED ITS FINANCIAL ASSISTANCE POLICY VERBALLY 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.PART V, SECTION C:FACILITIES NUMBERED 5 THROUGH 12 ARE INCLUDED AS A RESULT OF DUHS' 3% OWNERSHIP IN A JOINT VENTURE.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 STATE-WIDE NETWORK 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 NETWORK IS A CERTIFIED HEALTHY CAROLINIAN'S WORKGROUP. THE NETWORK 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, EDUCATION, AND HOMELESSNESS. 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 12,000-20,000 PATIENTS IN APPLYING AND BECOMING ELIGIBLE FOR THESE PROGRAMS ANNUALLY. FINALLY, PATIENTS MAY ALWAYS CONTACT DUHS' TOLL FREE CUSTOMER SERVICE NUMBER TO REQUEST INFORMATION ABOUT THEIR BILL OR OBTAIN A 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 NUMBEROF 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 HEALTHOF 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 AND THE DUKE UNIVERSITY SCHOOL OF MEDICINE AND SCHOOL OF NURSING (COMMONLY REFERRED TO AS DUKE MEDICINE) RECENTLY LAUNCHED A NEW INITIATIVE WITH MEMBERS OF THE DURHAM FAITH COMMUNITY. APPROXIMATELY 50 LOCAL LEADERS IN THE FAITH COMMUNITY ARE WORKING WITH DUKE MEDICINE TO LOOK AT HOW TO ADDRESS THE NEEDS OF THEIR CONGREGATIONS AND COMMUNITIES BY COMBINING THE TRADITIONS OF THE FAITH COMMUNITY WITH THE KNOWLEDGE OF MODERN MEDICINE. A SERIES OF MEETINGS HAVE BEEN HELD TO DETERMINE HOW DUKE MEDICINE CAN PARTNER WITH THE FAITH COMMUNITY TO SUPPORT HEALTH MINISTRY ACTIVITIES IN THEIR COMMUNITY AND PLACES OF WORSHIP.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 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. 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. FACULTY ARE 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 TRANSFERRED 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.
    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:PART VI, LINE 7:NORTH CAROLINA.
PERSON MEMORIAL HOSPITAL   PART V, SECTION B, LINE 17E: APPLICABLE PATIENTS WERE NOTIFIED AT THE TIME OF UP-FRONT COLLECTION EFFORTS; THOSE PATIENTS WHO PRESENTED BILLING QUESTIONS AND CONCERNS WERE NOTIFIED AT THAT TIME.
MARIA PARHAM MEDICAL CENTER   PART V, SECTION B, LINE 19D: THE HOSPITAL FACILITY FOLLOWS ITS ESTABLISHED CHARITY CARE POLICY IN DETERMINING THE APPROPRIATE MAXIMUM AMOUNT TO CHARGE FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE.
PERSON MEMORIAL HOSPITAL   PART V, SECTION B, LINE 19D: THE MAXIMUM AMOUNT WAS DETERMINED BY APPLYING A SELF-PAY DISCOUNT AS A FLAT PERCENTAGE OF CHARGES.
Schedule H (Form 990) 2011
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
2011
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) 1 IN 8K RALLY FOR THE CURE30 MEMORIAL DR
PINEHURST,NC28374 		45-2871984 501(C)(3) 16,000       GENERAL SUPPORT
(2) ALLIANCE MEDICAL MINISTRY INC101 DONALD ROSS DRIVE
RALEIGH,NC27610 		56-2168673 501(C)(3) 27,500       GENERAL SUPPORT
(3) CARING HOUSE INC2625 PICKETT RD
DURHAM,NC277055603 		56-1647154 501(C)(3) 7,917       GENERAL SUPPORT
(4) CEO ROUNDTABLE ON CANCER INC940 NW CARY PKWY SUITE 102
CARY,NC27513 		65-1230448 501(C)(3) 40,000       GENERAL SUPPORT
(5) CHILD AND PARENT SUPPORT SERVICES411 W CHAPEL HILL ST SUITE 908
DURHAM,NC27701 		58-1446309 501(C)(3) 31,000       GENERAL SUPPORT
(6) COUNCIL FOR ENTREPRENEURIAL DEVELOPMENTPO BOX 13353
RTP,NC277093353 		56-1399587 501(C)(3) 7,500       GENERAL SUPPORT
(7) DUKE HEALTH RALEIGH HOSPITAL GUILD3400 WAKE FOREST RD
RALEIGH,NC27609 		20-2942711 501(C)(3) 29,800       GUILD BIRDWOOD PROJECT CONTRIBUTION
(8) DUKE SCHOOL FOR CHILDREN3716 OLD ERWIN RD
DURHAM,NC27705 		58-1521494 501(C)(3) 25,000       GENERAL SUPPORT
(9) DURHAM ACADEMY DEVELOPMENT OFFICE3601 RIDGE ROAD
DURHAM,NC277055599 		56-0538019 501(C)(3) 25,000       GENERAL SUPPORT
(10) DURHAM CHAMBER LEGACY FOUNDATIONPO BOX 3829
DURHAM,NC27702 		13-1132350 501(C)(3) 31,250       GENERAL SUPPORT
(11) DURHAM CHAMBER OF COMMERCEPO BOX 3829
DURHAM,NC27702 		56-0207530 501(C)(6) 30,000       GENERAL SUPPORT
(12) EL CENTRO HISPANO INC600 E MAIN STREET
DURHAM,NC27701 		56-2011661 501(C)(3) 8,500       GENERAL SUPPORT
(13) FOUNDATION FOR NURSING EXCELLENCEPO BOX 31824
RALEIGH,NC27622 		30-0105241 501(C)(3) 20,000       GENERAL SUPPORT
(14) GREATER RALEIGH CHAMBER OF COMMERCEPO BOX 2978
RALEIGH,NC276022978 		56-0370850 501(C)(6) 25,000       GENERAL SUPPORT
(15) HEALING WITH CAARE INC214 BROADWAY ST
DURHAM,NC27701 		56-1963988 501(C)(3) 10,000       GENERAL SUPPORT
(16) HUMAN RIGHTS CAMPAIGN INC1640 RHODE ISLAND AVE NW
WASHINGTON,DC20036 		52-1243457 501(C)(4) 12,000       GENERAL SUPPORT
(17) INTERACT1012 OBERLINE RD SUITE 100
RALEIGH,NC27605 		58-1320613 501(C)(3) 15,000       GENERAL SUPPORT
(18) JOHN AVERY BOYS AND GIRLS CLUBPO BOX 446
DURHAM,NC27702 		56-6001906 501(C)(3) 11,000       GENERAL SUPPORT
(19) LGBT CENTER OF RALEIGH INC411 HILLSBOROUGH ST
RALEIGH,NC276031727 		26-2998186 501(C)(3) 10,000       GENERAL SUPPORT
(20) NORTH CAROLINA INSTITUTE OF MEDICINE630 DAVIS DR STE 100
MORRISVILLE,NC27560 		56-1506066 NC GOVERNMENT 6,000       GENERAL SUPPORT
(21) NORTH CAROLINA PHYSICIANS HEALTH PROGRAM220 HORIZON DRIVE 201
RALEIGH,NC27615 		56-1846599 501(C)(3) 36,000       GENERAL SUPPORT
(22) RALEIGH SCHOOL OF NURSE ANESTHESIA3900 BARRETT DR SUITE 200
RALEIGH,NC27609 		56-1684241 501(C)(3) 17,731       GENERAL SUPPORT
(23) RESEARCH AMERICAPO BOX 222451
CHINTILLY,VA201532451 		52-1609875 501(C)(3) 20,000       GENERAL SUPPORT
(24) RONALD MCDONALD HOUSE506 ALEXANDER AVENUE
DURHAM,NC27705 		56-1220376 501(C)(3) 1,200,000       GENERAL SUPPORT
(25) SAMARITAN HEALTH CENTER507 E KNOX ST
DURHAM,NC27701 		26-3770762 501(C)(3) 20,000       GENERAL SUPPORT
(26) SENIOR PHARMASSIST INC406 RIGSBEE AVE STE 201
DURHAM,NC277012186 		56-2084639 501(C)(3) 15,000       GENERAL SUPPORT
(27) TRIANGLE UNITED WAY INC2400 PERIMETER PARK DRIVE STE 150
MORRISVILLE,NC27560 		56-1949103 501(C)(3) 5,788       GENERAL SUPPORT
(28) WAKE TECHNICAL COMMUNITY COLLEGE9101 FAYETTEVILLE ROAD
RALEIGH,NC276035696 		23-7017752 501(C)(3) 10,000       GENERAL SUPPORT
(29) DUKE UNIVERSITY324 BLACKWELL ST STE 850
DURHAM,NC27701 		56-0532129 501(C)(3) 0 34,665 FMV DONATION OF MEDICAL EQUIPMENT GENERAL SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
26
3
Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image
3
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2011

Schedule I (Form 990) 2011
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) ANDES SCHOLARSHIP 1 1,000      
(2) FINANCIAL ASSISTANCE 39 45,111      
(3) JUDY WAGONER SCHOLARSHIP 2 500      
(4) KINGS DAUGHTERS SCHOLARSHIP FALL 2011 1 500      
(5) MARTHA WHITWORTH LASATER AWARD 2 2,000      
(6) MEGAN WALKER SCHOLARSHIP 2 1,000      
(7) MELANIE TAYLOR SCHOLARSHIP 4 3,500      
(8) NANCY WALTERS SCHOLARSHIP 2 1,000      
(9) NAP PRIZE 2 150      
(10) RUBY BAILEY PIERCE SCHOLARSHIP 2 500      
(11) SGA AWARD 4 600      
(12) SHELTERING HOME CIRCLE OF THE KINGS DAUGHTERS AWARD 1 2,500      

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
SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING USE OF GRANT FUNDS DUKE UNIVERSITY HEALTH SYSTEM, INC. PROVIDES GENERAL SUPPORT TO LOCAL ORGANIZATIONS 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) 2011


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
2011
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 or provision 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. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
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 Regulations 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) 2011

Schedule J (Form 990) 2011
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.
(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 as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) NANCY C ANDREWS MD (i)
(ii)		 0
469,490 		0
211,951 		0
61,716 		0
29,975 		0
17,967 		0
791,099 		0
0
(2) RICHARD H BRODHEAD (i)
(ii)		 0
765,292 		0
0 		0
220,471 		0
129,975 		0
64,289 		0
1,180,027 		0
100,000
(3) VICTOR J DZAU MD (i)
(ii)		 0
1,035,303 		0
1,013,580 		0
11,716 		0
697,579 		0
17,515 		0
2,775,693 		0
0
(4) DANNY O JACOBS MD (i)
(ii)		 0
269,944 		0
55,867 		0
0 		0
29,975 		0
20,123 		0
375,909 		0
0
(5) CARL E RAVIN MD (i)
(ii)		 0
250,407 		0
0 		0
0 		0
29,975 		0
10,673 		0
291,055 		0
0
(6) MONTE D BROWN MD (i)
(ii)		 310,307
0 		208,147
0 		16,500
0 		29,975
0 		22,310
0 		587,239
0 		0
0
(7) WILLIAM J FULKERSON MD (i)
(ii)		 712,490
0 		442,468
0 		16,500
0 		29,975
0 		6,076
0 		1,207,509
0 		0
0
(8) KENNETH C MORRIS (i)
(ii)		 649,680
0 		375,176
0 		28,716
0 		29,975
0 		8,849
0 		1,092,396
0 		0
0
(9) MARY ANN FUCHS (i)
(ii)		 276,714
0 		68,064
0 		10,224
0 		29,975
0 		5,422
0 		390,399
0 		0
0
(10) ARTHUR L GLASGOW (i)
(ii)		 306,014
0 		222,136
0 		3,500
0 		29,975
0 		9,986
0 		571,611
0 		0
0
(11) KEVIN W SOWERS (i)
(ii)		 427,603
0 		196,614
0 		16,500
0 		29,975
0 		7,295
0 		677,987
0 		0
0
(12) DOUGLAS B VINSEL (i)
(ii)		 353,714
0 		178,696
0 		16,500
0 		29,975
0 		17,661
0 		596,546
0 		0
0
(13) KERRY R WATSON (i)
(ii)		 327,239
0 		156,370
0 		24,833
0 		29,975
0 		59,424
0 		597,841
0 		0
0
(14) MARC CALABRESE (i)
(ii)		 339,119
0 		54,795
0 		1,200
0 		29,975
0 		19,038
0 		444,127
0 		0
0
(15) JOHN M KELSCH (i)
(ii)		 317,343
0 		39,867
0 		16,500
0 		29,975
0 		15,048
0 		418,733
0 		0
0
(16) MOLLY K ONEILL (i)
(ii)		 340,079
0 		234,990
0 		16,500
0 		29,975
0 		10,332
0 		631,876
0 		0
0
(17) THOMAS A OWENS (i)
(ii)		 323,943
0 		65,267
0 		0
0 		29,975
0 		13,719
0 		432,904
0 		0
0
(18) JOSEPH G TAYLOR (i)
(ii)		 263,558
0 		173,465
0 		16,500
0 		29,975
0 		19,312
0 		502,810
0 		0
0
(19) MARK D GUSTAFSON (i)
(ii)		 0
266,898 		0
0 		0
9,000 		0
29,975 		0
15,420 		0
321,293 		0
0
(20) PAUL R NEWMAN (i)
(ii)		 0
216,005 		0
29,800 		0
0 		0
29,975 		0
37,622 		0
313,402 		0
0
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
SUPPLEMENTAL INFORMATION PART III 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. 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.
Schedule J (Form 990) 2011

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 Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2011
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   03-22-2012 322,140,000 SEE PART VI   X   X   X
B NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402   05-30-2012 214,598,930 SEE PART VI   X   X   X
C NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402   10-06-2011 145,715,000 SEE PART VI   X   X   X
D NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402 65821DDB4 11-10-2009 178,598,850 SEE PART VI   X   X   X
NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402 65821DDX6 04-28-2010 120,836,075 SEE PART VI   X   X   X
NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402 65821DLJ8 06-28-2012 326,853,753 SEE PART VI   X   X   X
NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402   11-01-2005 40,000,000 SEE PART VI   X   X   X
NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402   12-04-2008 40,000,000 SEE PART VI   X   X   X
NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402   03-06-2012 40,000,000 SEE PART VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . 214,760,000   5,200,000  
2 Amount of bonds legally defeased . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . 322,140,000 214,760,000 145,715,000 179,713,706
4 Gross proceeds in reserve funds . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . . 15,924,326     15,924,326
6 Proceeds in refunding escrows . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . 2,472,104 2,840,876   2,472,104
8 Credit enhancement from proceeds . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . 161,317,276 110,366,615 26,439,498 161,317,276
11 Other spent proceeds . . . . . . . . . . . 322,140,000 214,760,000 145,715,000  
12 Other unspent proceeds . . . . . . . . . . . 213,647,545 213,647,545    
13 Year of substantial completion . . . . . . . . . . . 2009 2009 2012
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) 2011
Schedule K (Form 990) 2011
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 of bond-financed property? . . . . . . . . .   X   X X   X  
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . .   X   X   X   X
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .                
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 0.00000% 0.00000% 0.00000% 0.00000%
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 0.00000% 0.00000% 0.00000% 0.00000%
6 Total of lines 4 and 5 . . .. . . . . . . . . 0.00000% 0.00000% 0.00000% 0.00000%
7 Does the bond issue meet the private security or payment test? . . . X   X   X   X  
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
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 qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . .  
  		 
  		 
  		 
 
c Term of hedge . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was a hedge terminated? . . . . .                
4a Were gross proceeds invested in a guaranteed investment contract (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
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X     X
Schedule K (Form 990) 2011

Schedule K (Form 990) 2011
Page 3
Part V
Procedures To Undertake Corrective Action
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . .
Part VI
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
SCHEDULE K, PART I, COLUMN F PURPOSE OF TAX-EXEMPT BONDS BOND ISSUE (A): THE PURPOSE OF THE BONDS ISSUED 03/22/2012 WAS TO REFUND THE 2005ABC BONDS ISSUED ON 08/21/2009, WHICH REFUNDED THE ORIGINAL 2005ABC BONDS ISSUED ON 5/19/2005. THE PURPOSE OF THE BONDS ISSUED 05/19/2005 WAS TO PARTIALLY REFUND THE 1996C BONDS ISSUED ON 10/24/1996, 1998A BONDS ISSUED ON 08/27/1998, AND THE 1998B BONDS ISSUED ON 10/13/1998. BOND ISSUE (B): THE PURPOSE OF THE BONDS ISSUED 05/30/2012 WAS TO PARTIALLY REFUND THE 2005ABC BONDS ISSUED ON 03/22/12, WHICH REFUNDED THE 2005ABC BONDS ISSUED ON 08/21/2009, WHICH REFUNDED THE ORIGINAL 2005ABC BONDS ISSUED ON 5/19/2005. THE PURPOSE OF THE BONDS ISSUED 05/19/2005 WAS TO PARTIALLY REFUND THE 1996C BONDS ISSUED ON 10/24/1996, 1998A BONDS ISSUED ON 08/27/1998,AND THE 1998B BONDS ISSUED ON 10/13/1998. BOND ISSUE (C): THE PURPOSE OF THE BONDS ISSUED 10/06/2011 WAS TO REFUND THE ORIGINAL 2006ABC BONDS ISSUED ON 11/15/2006 FOR HOSPITAL IMPROVEMENTS FINANCED OR REFINANCED INCLUDING: ROUTINE INFRASTRUCTURE, RENOVATION AND IMPROVEMENT PROJECTS AT DUKE UNIVERSITY HOSPITAL AND DUKE RALEIGH HOSPITAL, IMPROVEMENTS TO INFORMATION SYSTEMS, RENOVATION AND EXPANSION OF EMERGENCY DEPARTMENT AT DUKE UNIVERSITY HOSPITAL, HELIPORT AND NEW ROOF IMPROVEMENTS AT DUKE UNIVERSITY HOSPITAL, AND PHASES 1 AND 2 OF AN OPERATING ROOM SUITE RENOVATION AND EXPANSION AT DUKE UNIVERSITY HOSPITAL. BOND ISSUE (D): 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. BOND ISSUE (A-2): HOSPITAL IMPROVEMENTS INCLUDE THE DUKE MEDICINE PAVILION AT DUKE UNIVERSITY HOSPITAL. BOND ISSUE (B-2): HOSPITAL IMPROVEMENTS INCLUDE THE DUKE MEDICINE PAVILION AND THE DUKE NORTH CONCOURSE AT DUKE UNIVERSITY HOSPITAL . BOND ISSUE (C-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. BOND ISSUE (D-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. BOND ISSUE (A-3): 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   NOTE FOR BOND ISSUE (B): PROCEEDS INCLUDE ISSUE PRICE PLUS ORIGINAL ISSUE DISCOUNT / UPFRONT FEE PAID DIRECTLY BY DUHS TO THE BANK UPON ISSUANCE NOTE FOR BOND ISSUES (D), (A-2), AND (B-2): PROCEEDS INCLUDE INVESTMENT EARNINGS. NOTE FOR BOND ISSUES (C-2), (D-2), AND (A-3): PROCEEDS REFLECT ACTUAL PRINCIPAL DRAWN DOWN UNDER DRAW DOWN FINANCING LEASE PROGRAM.
SCHEDULE K, PART II, LINES 3 AND 10   NOTE FOR BOND ISSUE (C-2): PURSUANT TO TREASURY REGULATION 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 11   NOTE FOR BOND ISSUES (A), (B), (C), AND (C-2): THESE PROCEEDS WERE DISBURSED OR DEEMED DISBURSED UPON ISSUANCE TO CURRENTLY REFUND THE PRIOR BONDS.
SCHEDULE K, PART IV, QUESTION 6   NOTE FOR BOND ISSUES (C-2), (D-2), AND (A-3): SALES PROCEEDS ALLOCATED UPON ISSUANCE AND NOT INVESTED.
Schedule K (Form 990) 2011

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 Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2011
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   03-22-2012 322,140,000 SEE PART VI   X   X   X
B NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402   05-30-2012 214,598,930 SEE PART VI   X   X   X
C NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402   10-06-2011 145,715,000 SEE PART VI   X   X   X
D NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402 65821DDB4 11-10-2009 178,598,850 SEE PART VI   X   X   X
NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402 65821DDX6 04-28-2010 120,836,075 SEE PART VI   X   X   X
NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402 65821DLJ8 06-28-2012 326,853,753 SEE PART VI   X   X   X
NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402   11-01-2005 40,000,000 SEE PART VI   X   X   X
NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402   12-04-2008 40,000,000 SEE PART VI   X   X   X
NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402   03-06-2012 40,000,000 SEE PART VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . 214,760,000   5,200,000  
2 Amount of bonds legally defeased . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . 322,140,000 214,760,000 145,715,000 179,713,706
4 Gross proceeds in reserve funds . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . . 15,924,326     15,924,326
6 Proceeds in refunding escrows . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . 2,472,104 2,840,876   2,472,104
8 Credit enhancement from proceeds . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . 161,317,276 110,366,615 26,439,498 161,317,276
11 Other spent proceeds . . . . . . . . . . . 322,140,000 214,760,000 145,715,000  
12 Other unspent proceeds . . . . . . . . . . . 213,647,545 213,647,545    
13 Year of substantial completion . . . . . . . . . . . 2009 2009 2012
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) 2011
Schedule K (Form 990) 2011
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 of bond-financed property? . . . . . . . . .   X   X X   X  
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . .   X   X   X   X
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .                
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 0.00000% 0.00000% 0.00000% 0.00000%
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 0.00000% 0.00000% 0.00000% 0.00000%
6 Total of lines 4 and 5 . . .. . . . . . . . . 0.00000% 0.00000% 0.00000% 0.00000%
7 Does the bond issue meet the private security or payment test? . . . X   X   X   X  
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
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 qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . .  
  		 
  		 
  		 
 
c Term of hedge . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was a hedge terminated? . . . . .                
4a Were gross proceeds invested in a guaranteed investment contract (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
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X     X
Schedule K (Form 990) 2011

Schedule K (Form 990) 2011
Page 3
Part V
Procedures To Undertake Corrective Action
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . .
Part VI
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
SCHEDULE K, PART I, COLUMN F PURPOSE OF TAX-EXEMPT BONDS BOND ISSUE (A): THE PURPOSE OF THE BONDS ISSUED 03/22/2012 WAS TO REFUND THE 2005ABC BONDS ISSUED ON 08/21/2009, WHICH REFUNDED THE ORIGINAL 2005ABC BONDS ISSUED ON 5/19/2005. THE PURPOSE OF THE BONDS ISSUED 05/19/2005 WAS TO PARTIALLY REFUND THE 1996C BONDS ISSUED ON 10/24/1996, 1998A BONDS ISSUED ON 08/27/1998, AND THE 1998B BONDS ISSUED ON 10/13/1998. BOND ISSUE (B): THE PURPOSE OF THE BONDS ISSUED 05/30/2012 WAS TO PARTIALLY REFUND THE 2005ABC BONDS ISSUED ON 03/22/12, WHICH REFUNDED THE 2005ABC BONDS ISSUED ON 08/21/2009, WHICH REFUNDED THE ORIGINAL 2005ABC BONDS ISSUED ON 5/19/2005. THE PURPOSE OF THE BONDS ISSUED 05/19/2005 WAS TO PARTIALLY REFUND THE 1996C BONDS ISSUED ON 10/24/1996, 1998A BONDS ISSUED ON 08/27/1998,AND THE 1998B BONDS ISSUED ON 10/13/1998. BOND ISSUE (C): THE PURPOSE OF THE BONDS ISSUED 10/06/2011 WAS TO REFUND THE ORIGINAL 2006ABC BONDS ISSUED ON 11/15/2006 FOR HOSPITAL IMPROVEMENTS FINANCED OR REFINANCED INCLUDING: ROUTINE INFRASTRUCTURE, RENOVATION AND IMPROVEMENT PROJECTS AT DUKE UNIVERSITY HOSPITAL AND DUKE RALEIGH HOSPITAL, IMPROVEMENTS TO INFORMATION SYSTEMS, RENOVATION AND EXPANSION OF EMERGENCY DEPARTMENT AT DUKE UNIVERSITY HOSPITAL, HELIPORT AND NEW ROOF IMPROVEMENTS AT DUKE UNIVERSITY HOSPITAL, AND PHASES 1 AND 2 OF AN OPERATING ROOM SUITE RENOVATION AND EXPANSION AT DUKE UNIVERSITY HOSPITAL. BOND ISSUE (D): 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. BOND ISSUE (A-2): HOSPITAL IMPROVEMENTS INCLUDE THE DUKE MEDICINE PAVILION AT DUKE UNIVERSITY HOSPITAL. BOND ISSUE (B-2): HOSPITAL IMPROVEMENTS INCLUDE THE DUKE MEDICINE PAVILION AND THE DUKE NORTH CONCOURSE AT DUKE UNIVERSITY HOSPITAL . BOND ISSUE (C-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. BOND ISSUE (D-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. BOND ISSUE (A-3): 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   NOTE FOR BOND ISSUE (B): PROCEEDS INCLUDE ISSUE PRICE PLUS ORIGINAL ISSUE DISCOUNT / UPFRONT FEE PAID DIRECTLY BY DUHS TO THE BANK UPON ISSUANCE NOTE FOR BOND ISSUES (D), (A-2), AND (B-2): PROCEEDS INCLUDE INVESTMENT EARNINGS. NOTE FOR BOND ISSUES (C-2), (D-2), AND (A-3): PROCEEDS REFLECT ACTUAL PRINCIPAL DRAWN DOWN UNDER DRAW DOWN FINANCING LEASE PROGRAM.
SCHEDULE K, PART II, LINES 3 AND 10   NOTE FOR BOND ISSUE (C-2): PURSUANT TO TREASURY REGULATION 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 11   NOTE FOR BOND ISSUES (A), (B), (C), AND (C-2): THESE PROCEEDS WERE DISBURSED OR DEEMED DISBURSED UPON ISSUANCE TO CURRENTLY REFUND THE PRIOR BONDS.
SCHEDULE K, PART IV, QUESTION 6   NOTE FOR BOND ISSUES (C-2), (D-2), AND (A-3): SALES PROCEEDS ALLOCATED UPON ISSUANCE AND NOT INVESTED.
Schedule K (Form 990) 2011

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 Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2011
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   03-22-2012 322,140,000 SEE PART VI   X   X   X
B NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402   05-30-2012 214,598,930 SEE PART VI   X   X   X
C NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402   10-06-2011 145,715,000 SEE PART VI   X   X   X
D NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402 65821DDB4 11-10-2009 178,598,850 SEE PART VI   X   X   X
NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402 65821DDX6 04-28-2010 120,836,075 SEE PART VI   X   X   X
NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402 65821DLJ8 06-28-2012 326,853,753 SEE PART VI   X   X   X
NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402   11-01-2005 40,000,000 SEE PART VI   X   X   X
NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402   12-04-2008 40,000,000 SEE PART VI   X   X   X
NORTH CAROLINA MEDICAL CARE COMMISSION
  		52-1309402   03-06-2012 40,000,000 SEE PART VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . 214,760,000   5,200,000  
2 Amount of bonds legally defeased . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . 322,140,000 214,760,000 145,715,000 179,713,706
4 Gross proceeds in reserve funds . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . . 15,924,326     15,924,326
6 Proceeds in refunding escrows . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . 2,472,104 2,840,876   2,472,104
8 Credit enhancement from proceeds . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . 161,317,276 110,366,615 26,439,498 161,317,276
11 Other spent proceeds . . . . . . . . . . . 322,140,000 214,760,000 145,715,000  
12 Other unspent proceeds . . . . . . . . . . . 213,647,545 213,647,545    
13 Year of substantial completion . . . . . . . . . . . 2009 2009 2012
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) 2011
Schedule K (Form 990) 2011
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 of bond-financed property? . . . . . . . . .   X   X X   X  
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . .   X   X   X   X
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .                
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 0.00000% 0.00000% 0.00000% 0.00000%
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 0.00000% 0.00000% 0.00000% 0.00000%
6 Total of lines 4 and 5 . . .. . . . . . . . . 0.00000% 0.00000% 0.00000% 0.00000%
7 Does the bond issue meet the private security or payment test? . . . X   X   X   X  
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
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 qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . .  
  		 
  		 
  		 
 
c Term of hedge . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was a hedge terminated? . . . . .                
4a Were gross proceeds invested in a guaranteed investment contract (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
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X     X
Schedule K (Form 990) 2011

Schedule K (Form 990) 2011
Page 3
Part V
Procedures To Undertake Corrective Action
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . .
Part VI
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
SCHEDULE K, PART I, COLUMN F PURPOSE OF TAX-EXEMPT BONDS BOND ISSUE (A): THE PURPOSE OF THE BONDS ISSUED 03/22/2012 WAS TO REFUND THE 2005ABC BONDS ISSUED ON 08/21/2009, WHICH REFUNDED THE ORIGINAL 2005ABC BONDS ISSUED ON 5/19/2005. THE PURPOSE OF THE BONDS ISSUED 05/19/2005 WAS TO PARTIALLY REFUND THE 1996C BONDS ISSUED ON 10/24/1996, 1998A BONDS ISSUED ON 08/27/1998, AND THE 1998B BONDS ISSUED ON 10/13/1998. BOND ISSUE (B): THE PURPOSE OF THE BONDS ISSUED 05/30/2012 WAS TO PARTIALLY REFUND THE 2005ABC BONDS ISSUED ON 03/22/12, WHICH REFUNDED THE 2005ABC BONDS ISSUED ON 08/21/2009, WHICH REFUNDED THE ORIGINAL 2005ABC BONDS ISSUED ON 5/19/2005. THE PURPOSE OF THE BONDS ISSUED 05/19/2005 WAS TO PARTIALLY REFUND THE 1996C BONDS ISSUED ON 10/24/1996, 1998A BONDS ISSUED ON 08/27/1998,AND THE 1998B BONDS ISSUED ON 10/13/1998. BOND ISSUE (C): THE PURPOSE OF THE BONDS ISSUED 10/06/2011 WAS TO REFUND THE ORIGINAL 2006ABC BONDS ISSUED ON 11/15/2006 FOR HOSPITAL IMPROVEMENTS FINANCED OR REFINANCED INCLUDING: ROUTINE INFRASTRUCTURE, RENOVATION AND IMPROVEMENT PROJECTS AT DUKE UNIVERSITY HOSPITAL AND DUKE RALEIGH HOSPITAL, IMPROVEMENTS TO INFORMATION SYSTEMS, RENOVATION AND EXPANSION OF EMERGENCY DEPARTMENT AT DUKE UNIVERSITY HOSPITAL, HELIPORT AND NEW ROOF IMPROVEMENTS AT DUKE UNIVERSITY HOSPITAL, AND PHASES 1 AND 2 OF AN OPERATING ROOM SUITE RENOVATION AND EXPANSION AT DUKE UNIVERSITY HOSPITAL. BOND ISSUE (D): 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. BOND ISSUE (A-2): HOSPITAL IMPROVEMENTS INCLUDE THE DUKE MEDICINE PAVILION AT DUKE UNIVERSITY HOSPITAL. BOND ISSUE (B-2): HOSPITAL IMPROVEMENTS INCLUDE THE DUKE MEDICINE PAVILION AND THE DUKE NORTH CONCOURSE AT DUKE UNIVERSITY HOSPITAL . BOND ISSUE (C-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. BOND ISSUE (D-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. BOND ISSUE (A-3): 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   NOTE FOR BOND ISSUE (B): PROCEEDS INCLUDE ISSUE PRICE PLUS ORIGINAL ISSUE DISCOUNT / UPFRONT FEE PAID DIRECTLY BY DUHS TO THE BANK UPON ISSUANCE NOTE FOR BOND ISSUES (D), (A-2), AND (B-2): PROCEEDS INCLUDE INVESTMENT EARNINGS. NOTE FOR BOND ISSUES (C-2), (D-2), AND (A-3): PROCEEDS REFLECT ACTUAL PRINCIPAL DRAWN DOWN UNDER DRAW DOWN FINANCING LEASE PROGRAM.
SCHEDULE K, PART II, LINES 3 AND 10   NOTE FOR BOND ISSUE (C-2): PURSUANT TO TREASURY REGULATION 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 11   NOTE FOR BOND ISSUES (A), (B), (C), AND (C-2): THESE PROCEEDS WERE DISBURSED OR DEEMED DISBURSED UPON ISSUANCE TO CURRENTLY REFUND THE PRIOR BONDS.
SCHEDULE K, PART IV, QUESTION 6   NOTE FOR BOND ISSUES (C-2), (D-2), AND (A-3): SALES PROCEEDS ALLOCATED UPON ISSUANCE AND NOT INVESTED.
Schedule K (Form 990) 2011

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
2011
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) 2011
Schedule L (Form 990 or 990-EZ) 2011
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
  		BOARD MEMBER IS DIRECTOR 26,777,547 PAYMENT FOR GOODS AND SERVICES   No
(2) PRIVATE DIAGNOSTIC CLINIC
  		BOARD MEMBERS ARE DIRECTOR AND FORMER KEY EMPLOYEE 105,620,512 PAYMENT FOR GOODS AND SERVICES   No
(3) CBC NEW MEDIA GROUP LLC
  		CEO IS DIRECTOR 143,000 PAYMENT FOR GOODS AND SERVICES   No
(4) THE DURHAM BULLS BASEBALL CLUB INC
  		CEO IS DIRECTOR 47,845 PAYMENT FOR GOODS AND SERVICES   No
(5) GENESE NEWMAN FAMILY MEMBER OF FORMER OFFICER 105,815 SALARY PAID/CONTRIBUTION TO 403(B) PLAN   No
(6) TAMELA VINSEL FAMILY MEMBER OF KEY EMPLOYEE 28,740 SALARY PAID   No
(7) JACQUELINE DZAU FAMILY MEMBER OF DIRECTOR/OFFICER 51,636 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) 2011

Additional Data


Software ID:  
Software Version:  




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
2011
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)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art .... X 25 7,998 VARIOUS
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		X 3,387 VARIOUS
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 12 120,226 MARKET QUOTE
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 50 5,664 VARIOUS
19 Food inventory ... X 20 135 VARIOUS
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 23 2,588 VARIOUS
26 Other Right pointing arrow large image ( GIFT CARDS ) X 90 10,272 VARIOUS
27 Other Right pointing arrow large image ( JEWELRY ) X 25 12,491 VARIOUS
28 Other Right pointing arrow large image ( MISCELLANEOUS ) X 175 39,661 VARIOUS
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
1
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 noncash
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) 2011
Schedule M (Form 990) 2011
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33 and whether the organization is reporting in Part I, column (b) the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Identifier Return Reference Explanation
THIRD PARTY USE: PART I, LINE 32B: DUKE UNIVERSITY HEALTH SYSTEM, INC. USES INVESTMENT BROKERS TO SELL INVESTMENTS. DUKE UNIVERSITY HEALTH SYSTEM, INC. MAY OCCASIONALLY USE THIRD PARTIES TO SELL OTHER TYPES OF NON-CASH CONTRIBUTIONS, AS THE NEED ARISES.
Schedule M (Form 990) 2011
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
2011
Open to Public
Inspection
Name of the organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number

56-2070036
Identifier Return Reference Explanation
ORGANIZATION MISSION STATEMENT FORM 990, PART I, LINE 1 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.
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A 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. COMMUNITY HEALTH DUKE UNIVERSITY HEALTH SYSTEM REMAINS FIRMLY COMMITTED TO WORKING COLLABORATIVELY WITH ITS COMMUNITY PARTNERS TO IDENTIFY, UNDERSTAND AND ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. FOR YEARS THROUGH ITS TWO HOSPITALS IN DURHAM AND ONE IN RALEIGH, DUKE HAS WORKED WITH THE HEALTH DEPARTMENTS IN DURHAM AND WAKE COUNTIES, COMMUNITY MEMBERS, AND NUMEROUS COMMUNITY PARTNER ORGANIZATIONS TO CONDUCT REGULAR COMMUNITY HEALTH NEEDS ASSESSMENTS. NEW FEDERAL REQUIREMENTS EFFECTIVE IN THE 2013 FISCAL YEAR FORMALIZE THE ASSESSMENT, REPORTING AND IMPLEMENTATION PLANNING PROCESS. LINKS TO THE DURHAM AND WAKE COUNTY COMMUNITY HEALTH ASSESSMENTS AND TO EACH HOSPITAL'S REPORT WILL BE POSTED TO WWW.DUKEMEDICINE.ORG. $11.28 MILLION COMMUNITY GROUPS OVER MANY YEARS, DUKE HAS DEVELOPED PRODUCTIVE PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS WORKING TOWARD THE COMMON GOAL OF ELIMINATING HEALTH DISPARITIES AND IMPROVING RESIDENTS' ACCESS TO HIGH QUALITY MEDICAL CARE. IN THE 2012 FISCAL YEAR, DUKE PROVIDED A TOTAL OF $11.28 MILLION IN CASH AND IN-KIND SUPPORT FOR COMMUNITY GROUPS, INCLUDING $6.89 MILLION FOR LINCOLN COMMUNITY HEALTH CENTER IN DURHAM AND ITS SATELLITE COMMUNITY CLINICS, WHICH SERVE AN OVERWHELMINGLY POOR AND UNINSURED POPULATION; MORE THAN $2.22 MILLION FOR DURHAM COUNTY'S EMERGENCY MEDICAL SERVICES OPERATION; AND NEARLY $2.22 MILLION IN CASH CONTRIBUTIONS TO OTHER ORGANIZATIONS. $55.8 MILLION HEALTH PROFESSIONS EDUCATION DUKE'S HEALTH PROFESSIONS EDUCATION PROGRAMS ARE RECOGNIZED AMONG THE BEST, MOST INNOVATIVE IN THE UNITED STATES. DUKE REQUIRES THAT ITS HEALTH PROFESSIONS STUDENTS PARTICIPATE IN ROTATIONS IN COMMUNITY CLINICS, SCHOOL WELLNESS CENTERS AND IN-HOME CARE PROGRAMS FOR ELDERLY OR HOME-BOUND PEOPLE. IN ADDITION TO THE VALUABLE EXPERIENCE HEALTH PROFESSIONS STUDENTS GAIN IN ITS THREE HOSPITALS, THIS COMMUNITY OUTREACH PREPARES DOCTORS, NURSES, ADVANCED PRACTICE PROVIDERS, PHYSICAL THERAPISTS, AND OTHER HEALTH PROFESSIONALS TO WORK AND LEAD IN AN INCREASINGLY COMMUNITY-FOCUSED HEALTH CARE DELIVERY SYSTEM. IN THE 2012 FISCAL YEAR, DUKE INVESTED $55.8 MILLION IN ITS HEALTH PROFESSIONS EDUCATION PROGRAMS. CHARITY CARE AND OTHER UNREIMBURSED EXPENSES PROVIDING QUALITY CARE REGARDLESS OF A PATIENT'S ABILITY TO PAY DUKE'S COMMITMENT IS TO PROVIDE HIGH QUALITY, EFFECTIVE CARE WITH A CONSISTENTLY HIGH LEVEL OF DIGNITY, RESPECT AND SKILL TO EACH OF OUR PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. IN THE FISCAL YEAR THAT ENDED JUNE 30, 2012, DUKE PROVIDED CHARITY CARE AT COST OF $69 MILLION. OF THIS AMOUNT, DUKE PROVIDED CHARITY CARE OF $65 MILLION TO 168,158 PATIENTS FROM 96 NORTH CAROLINA COUNTIES. ALL PATIENTS WHO DO NOT HAVE INSURANCE, OR WHO BECAUSE OF FINANCIAL HARDSHIP CANNOT PAY FOR THE URGENT OR EMERGENT MEDICAL CARE THEY RECEIVE, ARE ELIGIBLE UNDER DUKE POLICIES TO RECEIVE CARE AT A DISCOUNT OR WITHOUT CHARGE. 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. NEARLY 12 PERCENT OF ALL DISCHARGED ADULT PATIENTS, 6 PERCENT OF HOSPITAL OUTPATIENT SURGERY AND CLINIC VISITS, AND NEARLY 71 PERCENT OF ALL VISITS TO DUKE EMERGENCY DEPARTMENT RECEIVED SOME LEVEL OF CHARITY CARE. DUKE WORKS WITH PATIENTS BY INFORMING THEM ABOUT AND HELPING THEM ACCESS THE FINANCIAL ASSISTANCE TO WHICH THEY ARE ENTITLED. AND WHEN GOVERNMENT PROGRAMS DO NOT COMPLETELY COVER THE COST OF THEIR CARE, DUKE MAKES UP SOME OR ALL OF THE DIFFERENCE. BY THE NUMBERS $69 MILLION - CHARITY CARE AT COST $34 MILLION - UNREIMBURSED MEDICAID COSTS COVERED BY DUKE $96 MILLION - UNREIMBURSED MEDICARE COSTS COVERED BY DUKE $25 MILLION - UNRECOVERABLE PATIENT DEBT CHARITY CARE NORTH CAROLINA (168,158 PATIENTS, $65 MILLION, INCLUSIVE OF DURHAM COUNTY AND WAKE COUNTY) DURHAM COUNTY (79,217 PATIENTS, $35 MILLION) WAKE COUNTY (50,770 PATIENTS, $14 MILLION) HIGHLIGHTS OF DUKE'S CHARITY CARE AND DISCOUNTED CARE POLICES * DUKE'S COMMITMENT IS TO CARE FOR ALL PATIENTS WITH A HIGH LEVEL OF DIGNITY, RESPECT, AND SKILL. * DUKE PROVIDES A DISCOUNT TO ALL PATIENTS OF LIMITED MEANS WHO DO NOT HAVE HEALTH INSURANCE FOR EVERY MEDICAL SERVICE EXCEPT COSMETIC PROCEDURES. * DUKE PROVIDES ASSISTANCE TO PATIENTS WHOSE MEDICAL HARDSHIP MAKES IT DIFFICULT FOR THEM TO PAY BASIC LIVING EXPENSES. * DUKE ASSISTS PATIENTS IN APPLYING FOR ANY ADDITIONAL FINANCIAL PROGRAMS FOR WHICH THEY MAY QUALIFY. * DUKE'S COMPLETE CHARITY CARE AND UNINSURED DISCOUNTED CARE POLICIES ARE AVAILABLE AT WWW.DUKEHEALTH.ORG DUKE UNIVERSITY HEALTH SYSTEM - AN OVERVIEW DUKE UNIVERSITY HEALTH SYSTEM IS A WORLD-CLASS PROVIDER OF HEALTH CARE SERVICES BASED IN DURHAM, N.C., THAT SERVICES MILLIONS OF PATIENTS AND THEIR FAMILIES EACH YEAR. AS AN INTEGRATED HEALTH CARE SYSTEM, DUKE OPERATES DUKE UNIVERSITY HOSPITAL, DURHAM REGIONAL HOSPITAL AND DUKE RALEIGH HOSPITAL, AS WELL AS AN EXTENSIVE NETWORK OF PRIMARY CARE CLINICS AND AMBULATORY CARE CENTERS, AND A STATEWIDE HOMECARE AND HOSPICE SERVICE. ADULT INPATIENT DISCHARGES, FISCAL YEAR ENDED JUNE 30, 2012 DUKE UNIVERSITY HEALTH SYSTEM PROVIDED CARE FOR 60,758 ADULT INPATIENT DISCHARGES IN 2012, MORE THAN 90 PERCENT INVOLVING NORTH CAROLINA RESIDENTS. TOP 3 NORTH CAROLINA COUNTIES BY VOLUME WERE: * DURHAM (19,647) * WAKE (10,023) * ORANGE (2,577) OUTPATIENT VISITS, FISCAL YEAR ENDED JUNE 30, 2012 DUKE UNIVERSITY HEALTH SYSTEM PROVIDED CARE DURING 2,016,470 OUTPATIENT VISITS IN 2012; AND NEARLY 91 PERCENT WERE FROM NORTH CAROLINA RESIDENTS. TOP 3 NORTH CAROLINA COUNTIES BY VOLUME WERE: * DURHAM (724,194) * WAKE (426,118) * ORANGE (124,511) DUKE-TRAINED HEALTH CARE PROFESSIONALS IN NORTH CAROLINA NEARLY 6,000 DUKE-TRAINED HEALTH CARE PROFESSIONALS LIVE IN NORTH CAROLINA. PHYSICIANS: 2,880 NURSES: 2,106 PHYSICIAN ASSISTANTS: 601 PHYSICAL THERAPISTS: 234 PATHOLOGY ASSISTANTS: 28 TOTAL: 5,849
EXPLANATION FOR NOT FILING FORM 990-T FORM 990, PART V, LINE 3B THE ORGANIZATION DID NOT HAVE ANY UNRELATED BUSINESS GROSS INCOME DURING THE FISCAL YEAR ENDED JUNE 30, 2012. AS A RESULT, FORM 990-T IS NOT REQUIRED FOR THE FISCAL YEAR ENDED JUNE 30, 2012.
  FORM 990, PART VI, SECTION A, LINE 2 DIRECTORS JACK O. BOVENDER, JR., RICHARD H. BRODHEAD, FRANK E. EMORY, JR., SUSAN STALNECKER, THOMAS M. GORRIE, AND G. RICHARD WAGONER 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: NANCY A. ANDREWS MD, DANNY O. JACOBS MD, THEODORE N. PAPPAS, MD, AND CARL E. RAVIN MD. DIRECTOR AND PRESIDENT/CEO VICTOR J. DZAU MD, DIRECTOR CARL E. RAVIN, MD, AND OFFICERS WILLIAM J. FULKERSON, JR. MD AND KENNETH C. MORRIS ARE DIRECTORS OF DURHAM CASUALTY COMPANY, LTD. DIRECTOR AND PRESIDENT/CEO VICTOR J. DZAU MD, DIRECTORS DANNY O. JACOBS MD, CARL E. RAVIN MD, AND OFFICER WILLIAM J. FULKERSON MD ARE BOARD MEMBERS OF PRIVATE DIAGNOSTIC CLINIC, PLLC. AND THEODORE N. PAPPAS, MD IS ASSISTANT MEDICAL DIRECTOR FOR PRIVATE DIAGNOSTIC CLINIC, PLLC. DIRECTOR AND PRESIDENT/CEO VICTOR J. DZAU MD AND OFFICER KENNETH C. MORRIS ARE DIRECTORS OF DUKE MEDICAL STRATEGIES, INC. OFFICERS WILLIAM J. FULKERSON MD AND KENNETH C. MORRIS ARE BOTH DIRECTORS AND OFFICERS OF HEALTH SYSTEM MEDICAL STRATEGIES, INC.
  FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE BOARD OF DIRECTORS OF DUHS, OTHER THAN THE EX OFFICIO MEMBERS, WILL BE NOMINATED BY THE BOARD OF DIRECTORS OF DUHS, AND WILL BE APPOINTED BY THE BOARD OF TRUSTEES OF DUKE UNIVERSITY. MEMBERS OF THE BOARD OF DIRECTORS OF DUHS WILL BE SUBJECT TO REMOVAL AT THE DISCRETION OF THE BOARD OF TRUSTEES OF DUKE UNIVERSITY IN ACCORDANCE WITH THE BYLAWS OF DUHS.
  FORM 990, PART VI, SECTION A, LINE 7B THE DUHS BYLAWS PROVIDE THAT DUHS MUST OBTAIN DUKE UNIVERSITY BOARD OF TRUSTEES APPROVAL FOR CERTAIN SIGNIFICANT TRANSACTIONS REGARDING DEBT ISSUANCES, CAPITAL ACQUISITIONS AND TANGIBLE PERSONAL AND REAL PROPERTY SALES.
  FORM 990, PART VI, SECTION B, LINE 11 AFTER STAFF PREPARATION AND MANAGEMENT REVIEW, THE DUHS FORM 990 IS PRESENTED TO THE DUHS COMPLIANCE/AUDIT COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW AND DISCUSSION. 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.
  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.
  FORM 990, PART VI, SECTION B, LINE 15 THE DUHS COMPENSATION COMMITTEE, COMPRISED OF MEMBERS OF THE DUHS BOARD OF DIRECTORS, REVIEWS AND APPROVES ALL EXECUTIVE COMPENSATION FOR 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.
  FORM 990, PART VI, SECTION C, LINE 19 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.
ESTIMATED 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: JACK O. BOVENDER, JR., FRANK E. EMORY, JR., SUSAN M. STALNECKER, AND G. RICHARD WAGONER, JR. THOMAS M. GORRIE DEVOTED AN AVERAGE OF 2 HOURS PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY. VICTOR J. DZAU, MD, DANNY O. JACOBS, MD, THEODORE N. PAPPAS, MD, AND PAUL R. NEWMAN DEVOTED AN AVERAGE OF 40 HOURS PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY. RICHARD H. BRODHEAD DEVOTED AN AVERAGE OF 50 HOURS PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY. MARK D. GUSTAFSON DEVOTED AN AVERAGE OF 55 HOURS PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY. NANCY C. ANDREWS, MD AND CARL E. RAVIN, MD DEVOTED AN AVERAGE OF 60 HOURS PER WEEK TO RELATED ORGANIZATION, DUKE UNIVERSITY. KENNETH C. MORRIS, WILLIAM J. FULKERSON, MD, 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, WILLIAM J. FULKERSON JR., MD, KENNETH C. MORRIS, AND PAUL R. NEWMAN. 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 THOMAS A. OWENS 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. RICHARD H. BRODHEAD AND G. RICHARD WAGONER, JR. DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, DUMAC, INC. VICTOR J. DZAU, MD DEVOTED AN AVERAGE OF 1 HOUR PER WEEK TO RELATED ORGANIZATION, INTERNATIONAL PARTNERSHIP FOR INNOVATIVE HEALTHCARE DELIVERY, INC.
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -20,608,675. NONPERIODIC CHANGES IN DEFINED BENEFIT PLANS: -212,373,811. NET TRANSFERS TO PARENT & AFFILIATES: -48,231,281. NET TRANSFERS TO PARENT & AFFILIATES OF PROPERTY & EQUIPMENT: -4,145,777. CUMULATIVE EFFECT OF CHANGE IN ACCOUNTING PRINCIPLE: -1,207,782. CHANGE IN MARKET VALUE OF DERIVATIVES: -56,328,256. INTEREST EARNED ON BOND PROCEEDS - CAPITALIZED FOR BOOK PURPOSES: -775,200. INCOME NOT REPORTED ON BOOKS, BUT INCLUDED FOR 990 REPORTING PURPOSES: DEEMED DIVIDEND: -12,642,049. TOTAL TO FORM 990, PART XI, LINE 5: -356,312,831.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

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
2011
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 BILLING NC 123,449,070 20,129,706 DUKE UNIVERSITY HEALTH SYSTEM INC
 










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) AMER ASSOC FOR GIFTED CHILDREN - 56-1686219

324 BLACKWELL STREET STE 850

DURHAM,NC27701
 SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(2) ASSOCIATED HEALTH SVCS INC

615 DOUGLAS STREET SUITE 700

DURHAM,NC27705
56-1845329 		HEALTHCARE NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY HEALTH SYSTEM INC
 
Yes
 
(3) DU SPECIAL VENTURES FUND INC

280 S MANGUM STREET STE 210

DURHAM,NC27701
56-1465177 		INVESTMENTS NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(4) DUKE ALUMNI ASSOCIATION INC

614 CHAPEL DRIVE

DURHAM,NC27708
56-1594088 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(5) DUKE CORPORATE EDUCATION

310 BLACKWELL ST

DURHAM,NC27701
42-1672476 		EDUCATION NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(6) DUKE GIFT PROPERTIES INC

324 BLACKWELL STREET STE 850

DURHAM,NC27701
57-1211078 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(7) DUKE GLOBAL INC

324 BLACKWELL STREET STE 850

DURHAM,NC27701
61-1588319 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(8) DUKE HOSPITAL AUXILIARY INC

PO BOX 2895

DURHAM,NC27710
56-1825604 		SUPPORT NC 501(C)(3) 11 TYPE III N/A
 
No
(9) DUKE MANAGEMENT COMPANY

280 S MANGUM STREET STE 210

DURHAM,NC27701
56-1748858 		INVESTMENTS NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(10) DUKE MEDICINE GLOBAL SUPP CORP- 61-1593721

324 BLACKWELL STREET STE 850

DURHAM,NC27701
 SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(11) DUKE SCHOLARLY EXHIBITS INC

324 BLACKWELL STREET STE 850

DURHAM,NC27701
56-1701245 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(12) DUKE UNIV AFFILIATED PHYSICIANS

615 DOUGLAS STREET SUITE 700

DURHAM,NC27705
56-1902501 		HEALTHCARE NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY HEALTH SYSTEM INC
 
Yes
 
(13) DUKE UNIV PHILANTHROPIES INC

324 BLACKWELL STREET STE 850

DURHAM,NC27701
57-1211099 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(14) DUKE UNIV SCH OF MED RESEARCH FDN 56-2247203

324 BLACKWELL STREET STE 850

DURHAM,NC27701
 SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(15) DUKE UNIVERSITY

324 BLACKWELL STREET STE 850

DURHAM,NC27701
56-0532129 		EDUCATION NC 501(C)(3) LINE 2 N/A
 
No
(16) DUMAC INC

280 S MANGUM STREET STE 210

DURHAM,NC27701
90-0754895 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(17) DURHAM ASSET MGMT COMPANY INC

324 BLACKWELL STREET STE 850

DURHAM,NC27701
56-1757238 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(18) DURHAM REALTY INC

324 BLACKWELL STREET STE 850

DURHAM,NC27701
56-1917936 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(19) GOTHIC CORPORATION

280 S MANGUM STREET STE 210

DURHAM,NC27701
56-1776668 		INVESTMENTS NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(20) GOTHIC HSP CORPORATION

280 S MANGUM STREET STE 210

DURHAM,NC27701
27-1325761 		INVESTMENTS NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY HEALTH SYSTEM INC
 
Yes
 
(21) HIGH POINT REALTY ASSOCIATES INC

324 BLACKWELL STREET STE 850

DURHAM,NC27701
56-1917939 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(22) IPIHD INC

310 BLACKWELL ST

DURHAM,NC27710
32-0358709 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(23) RUTH K BROAD BIOMED RES FDN

324 BLACKWELL STREET STE 850

DURHAM,NC27701
65-0045051 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(24) THE CTR FOR DOCUMENTARY STUDIES

1317 PETTIGREW STREET

DURHAM,NC27705
56-1655039 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(25) THE FSB SUPPORT FUND

324 BLACKWELL STREET STE 850

DURHAM,NC27701
56-1849290 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(26) THE LORD FDN OF NORTH CAROLINA

305 TEER BLDG

DURHAM,NC27708
56-1415423 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
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) AVENUE BLUE TC FD 27-4011571

PARK AVENUE
NEW YORK,NY10022
 INVESTMENTS DE N/A
 N/A       No     No  
(2) BLACKWELL PTR LLC 20-8075455

280 S MANGUM STREET STE 210
DURHAM,NC27701
 INVESTMENTS GA N/A
 N/A       No     No  
(3) CANYON BLUE INV FD 27-0186996

AVE OF STARS
LA,CA90067
 INVESTMENTS DE N/A
 N/A       No     No  
(4) CD FUND LP - 27-0130641

MCKINNEY AVE
DALLAS,TX75201
 INVESTMENTS TX N/A
 N/A       No     No  
(5) DUMAC LLC - 65-1319939

280 S MANGUM STREET STE 210
DURHAM,NC27701
 INVESTMENTS NC N/A
 N/A       No     No  
(6) GMO FORESTRY 6B LP 48-1294791

FRANKLIN STREET
BOSTON,MA02110
 INVESTMENTS DE N/A
 N/A       No     No  
(7) LIQUID REALTY PTR 05-0537755

LINDA MESA
DANVILLE,CA94526
 INVESTMENTS DE N/A
 N/A       No     No  
(8) LYRICAL BLUE RL PT 27-2994514

32 N DEAN ST
ENGLEWOOD,NJ07631
 INVESTMENTS DE N/A
 N/A       No     No  
(9) LYRICAL-BLUE RGNT 45-3626577

32 N DEAN ST
ENGLEWOOD,NJ07631
 INVESTMENTS DE N/A
 N/A       No     No  
(10) OCTAVIAN BLUE FD 27-2408711

5TH AVENUE
NY,NY10151
 INVESTMENTS DE N/A
 N/A       No     No  
(11) SBER LUCKY STRIKE 20-3891303

310 BLACKWELL ST
DURHAM,NC27701
 REAL ESTATE NC N/A
 N/A       No     No  
(12) TAIYO BLUE FUND LP 80-0613746

5300 CARILLON POINT
KIRKLAND,WA98033
 INVESTMENTS DE N/A
 N/A       No     No  
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) COLCHESTER ALPHA FUND (BERMUDA) LTD
59-62 TOWNSEND ST 2
DUBLIN    
EI
INVESTMENTS BD N/A
 C      
(2) COLCHESTER BETA THREE FUND LTD
CENTURY HOUSE 16 PAR-LA VILLE RD
HAMILTON   HM HX
BD
INVESTMENTS BD N/A
 C      
(3) DUKE CE LS INC
310 BLACKWELL STREET
DURHAM,NC27701
20-2004016 		REAL ESTATE NC N/A
 C      
(4) DUKE CORP EDU INDIA PRIVATE
ACADEMIC BLOCK NEW CAMPUS
VASTRAPUR,AHMEDABAD380015
IN
42-1672476 		CONSULTING IN N/A
 C      
(5) DUKE CORPORATE EDUCATION LIM
165 FLEET STREET
LONDON   EC4A 2DY
UK
42-1672476 		EDUCATION CONSULTING UK N/A
 C      
(6) DUKE CORPORATE EDUCATION RSA
GROUND FLOOR TWICKEHNHAM BLDG
BRYANSTON,JOHANNESBURG02021
SF
42-1672476 		CONSULTING SF N/A
 C      
(7) DUKE GLOBAL CONSULTING (KUNSHAN)
1666 WEI CHEN NAN RD
KUNSHAN PR,KUNSHAN215300
CH
CONSULTING CH N/A
 C      
(8) DUKE MEDICAL STRATEGIES INC
2200 WEST MAIN STREET STE 920
DURHAM,NC27705
56-1993799 		HEALTHCARE NC N/A
 C      
(9) DUKE MEDICINE ASIA PTE LTD
5 SHENTON WAY 07-00 UIC BLD
SING   0688
SN
MEDICAL RESEARCH SN N/A
 C      
(10) DUKE UNIV QUADRANGLE FUND
PO BOX 185
PITTSBURGH,PA152300185
56-6218971 		INVESTMENTS PA N/A
 T      
(11) DUKE UNIVERSITY TOWER FUND
PO BOX 185
PITTSBURGH,PA152300185
56-6147362 		INVESTMENTS PA N/A
 T      
(12) DURHAM CASUALTY COMPANY LTD
AON HOUSE 30 WOODBOURNE AVE
PEMBROKE   HM 08
BD
98-0113277 		INSURANCE BD DUHS INC
  		C 19,164,938 160,542,221 100.000 %
(13) DUSVF EUROPEAN LP
7 CAVENDISH SQUARE
LONDON   W1G 0PE
UK
98-0346042 		INVESTMENTS UK N/A
 C      
(14) GOTHIC INTERNATIONAL LTD
113 S CHURCH STREET QUEENSGATE HOU
GRAND CAYMAN   KY1-1108
CJ
INVESTMENTS CJ N/A
 C      
(15) HEALTH SYSTEM MEDICAL STRATEGIES INC
615 DOUGLAS STREET SUITE 700
DURHAM,NC27705
56-2222444 		HEALTH CARE NC DUHS INC
  		C 172,945   100.000 %
(16) INDOCHINA LAND HOLDINGS 2 LP
SCOTIA CENTRE 4TH FL PO BOX 2804
GRAND CAYMAN    
CJ
INVESTMENTS CJ N/A
 C      
(17) INDOCHINA LAND HOLDINGS III
11F CHINA HONG KONG TOWER 8 HENNE
HONG KONG    
HK
INVESTMENTS CJ N/A
 C      
(18) JOHN & PATRICIA KOSKINEN CLUT
PO BOX 185
PITTSBURGH,PA152300185
56-6532340 		INVESTMENTS PA N/A
 T      
(19) MARATHON BLUE CAYMAN FUND
89 NEXUS WAY PO BOX 31106
GRAND CAYMAN   KY1-1205
CJ
INVESTMENTS CJ N/A
 C      
(20) GHI HOLDINGS MAURITIUS
9TH FL ORANGE TOWER CYBERCITY
EBENE    
MP
INVESTMENTS MP N/A
 C      
(21) GHI ERP LTD
9TH FL ORANGE TOWER CYBERCITY
EBENE    
MP
INVESTMENTS MP N/A
 C      
(22) GHI HSP LTD
9TH FL ORANGE TOWER CYBERCITY
EBENE    
MP
INVESTMENTS MP N/A
 C      
(23) GHI JBD LTD
9TH FL ORANGE TOWER CYBERCITY
EBENE    
MP
INVESTMENTS MP N/A
 C      
(24) GHI LTP LTD
9TH FL ORANGE TOWER CYBERCITY
EBENE    
MP
INVESTMENTS MP N/A
 C      
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
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 related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
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

 Q 12,464,833 FMV
(2) ASSOCIATED HEALTH SERVICES INC

 R 3,957,378 FMV
(3) ASSOCIATED HEALTH SERVICES INC

 N 5,099,102 FMV
(4) DURHAM CASUALTY COMPANYINC

 Q 29,745,950 FMV
(5) GOTHIC HSP CORPORATION

 B 93,397,565 FMV
(6) GOTHIC HSP CORPORATION

 C 114,890,494 FMV
(7) DUKE UNIVERSITY AFFILIATED PHYSICIANS INC

 R 407,616 FMV
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
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)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(e)
Are all
partners
section
501(c)(3)
organizations? 		(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 Yes No






























Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
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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