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 private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 07-01-2013 , 2013, and ending 06-30-2014
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 province, country, and ZIP or foreign postal code
DURHAM, NC27705
D Employer identification number

56-2070036
E Telephone number

G Gross receipts $ 3,498,473,549
F Name and address of principal officer:
WILLIAM J FULKERSON 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
subordinates?
H(b)
Are all subordinates
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 12
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 18,169
6 Total number of volunteers (estimate if necessary) ............. 6 2,291
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) ......... 8,798,192 14,054,772
9 Program service revenue (Part VIII, line 2g) ......... 2,361,852,708 2,396,909,183
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 87,946,275 198,777,380
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 76,648,843 83,624,506
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 2,535,246,018 2,693,365,841
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 937,726 911,323
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) 1,151,447,618 1,173,834,491
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet101,050    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 1,087,556,573 1,215,706,033
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 2,239,941,917 2,390,451,847
19 Revenue less expenses. Subtract line 18 from line 12....... 295,304,101 302,913,994
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 4,327,827,970 4,643,137,100
21 Total liabilities (Part X, line 26)............. 1,882,057,686 1,802,551,366
22 Net assets or fund balances. Subtract line 21 from line 20..... 2,445,770,284 2,840,585,734
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 MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: 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 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 $ 1,748,613,331 including grants of $ 911,323 ) (Revenue $ 2,462,293,535 )
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 expensesMediumBullet1,748,613,331
Form 990 (2013)
Form 990 (2013)
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 (see instructions)? 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, or have a section 501(h) election in effect during the tax year? 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 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part 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, line 10?
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 VIIClick 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 VIIIClick 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 IXClick 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 XClick 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 XClick 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 and XII 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 and XII 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, Parts I and IV......... 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 other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IVClick 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 other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV... 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 I (see instructions).... Click 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 hospital facilities? 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 statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government 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 or 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, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... 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 lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ 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
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, 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
 
No
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 direct or indirect 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 M..Click 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, Part II, III, or IV, and Part 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 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
492
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
18,169
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” to line 3b, 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, securities account, or other financial 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 as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds 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. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2013)
Form 990 (2013)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
21
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
12
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
Yes
 
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 this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
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
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
AK , FL , GA , HI , IL , KS , KY , MD , MA , MI , MN , MS , NH , NJ , NY , OK , OR , PA , SC , TN , UT , WI
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you 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:
MediumBulletLAURA ALVISDUHS INC 615 DOUGLAS STREET SUITEDURHAMNC27705 (919) 613-8993
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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 organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) NANCY CATHERINE ANDREWS MD........................................................................
DIRECTOR
 4.00
.......................41.00 		X           0 742,900 82,236
(2) DANIEL T BLUE JR........................................................................
DIRECTOR
 6.00
.......................0.00 		X           0 0 0
(3) JACK O BOVENDER JR........................................................................
DIRECTOR
 2.00
.......................6.00 		X           0 0 0
(4) RICHARD H BRODHEAD........................................................................
DIRECTOR
 10.00
.......................52.00 		X           0 1,093,650 194,315
(5) VICTOR J DZAU MD........................................................................
PRESIDENT & CEO, DUHS/DIRECTOR
 40.00
.......................48.00 		X   X       0 2,040,018 732,795
(6) JAMES F GOODMON........................................................................
DIRECTOR
 1.50
.......................0.00 		X           0 0 0
(7) THOMAS M GORRIE........................................................................
DIRECTOR
 7.00
.......................18.00 		X           0 0 0
(8) WILLIAM HAWKINS........................................................................
DIRECTOR
 2.00
.......................4.00 		X           0 0 0
(9) CAROLYN E HENDERSON........................................................................
DIRECTOR
 1.00
.......................0.00 		X           0 0 0
(10) MARY E KLOTMAN MD........................................................................
DIRECTOR
 5.00
.......................41.00 		X           0 397,320 42,008
(11) MICHAEL MARSICANO........................................................................
DIRECTOR
 1.00
.......................6.00 		X           0 0 0
(12) JOHN MCARTHUR........................................................................
DIRECTOR
 1.00
.......................0.00 		X           0 0 0
(13) LLOYD B MORGAN........................................................................
DIRECTOR
 2.00
.......................0.00 		X           0 0 0
(14) THEODORE NICK PAPPAS MD........................................................................
DIRECTOR
 2.00
.......................40.00 		X           0 423,812 44,229
(15) CARL E RAVIN MD........................................................................
DIRECTOR
 15.00
.......................41.00 		X           0 249,929 42,341
(16) DAVID M RUBENSTEIN........................................................................
DIRECTOR
 1.00
.......................7.00 		X           0 0 0
(17) STEVEN M SCOTT MD........................................................................
DIRECTOR
 2.50
.......................0.00 		X           0 0 0
Form 990 (2013)
Form 990 (2013)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) SUSAN M STALNECKER........................................................................
DIRECTOR
 2.00
.......................6.00 		X           0 0 0
(19) KATHERINE KEITH THOMAS........................................................................
DIRECTOR
 1.00
.......................0.00 		X           0 0 0
(20) PETER VAN ETTEN........................................................................
DIRECTOR
 1.00
.......................0.00 		X           0 0 0
(21) JAMES MOON WHITEHURST........................................................................
DIRECTOR
 1.00
.......................0.00 		X           0 0 0
(22) MONTE D BROWN MD........................................................................
VP OF ADMINISTRATION/SECRETARY
 60.00
.......................0.00 		    X       600,069 0 47,520
(23) WILLIAM J FULKERSON MD........................................................................
EXECUTIVE VP, DUHS
 60.00
.......................5.00 		    X       1,209,478 0 36,003
(24) KENNETH C MORRIS........................................................................
SVP, CFO, TREASURER
 60.00
.......................5.00 		    X       1,051,238 0 39,631
(25) MARY ANN FUCHS........................................................................
VP-PATIENT CARE/CHIEF NURSE EXEC
 60.00
.......................0.00 		      X     405,639 0 36,476
(26) RICHARD GANNOTTA........................................................................
PRESIDENT, DUKE RALEIGH HOSPITAL
 40.00
.......................0.00 		      X     442,125 0 50,701
(27) KATHLEEN GALBRAITH........................................................................
PRESIDENT, DUKE REGIONAL HOSPITAL
 60.00
.......................1.00 		      X     199,318 0 40,117
(28) JEFFREY FERRANTI........................................................................
VP, CIO, DHTS ADMINISTRATION
 60.00
.......................0.00 		      X     402,031 74,844 44,229
(29) CARLA PARKER-HOLLIS........................................................................
VP, DUKE RALEIGH HOSPITAL
 60.00
.......................0.00 		      X     191,404 0 40,216
(30) KEVIN W SOWERS........................................................................
PRESIDENT, DUKE UNIVERSITY HOSPITAL
 70.00
.......................0.00 		      X     676,744 0 41,744
(31) DOUGLAS B VINSEL........................................................................
PRESIDENT, DUKE RALEIGH HOSPITAL
 60.00
.......................0.00 		      X     277,045 0 31,276
(32) KERRY R WATSON........................................................................
PRESIDENT, DUKE REGIONAL HOSPITAL
 40.00
.......................1.00 		      X     497,372 0 81,510
(33) MARC CALABRESE........................................................................
PHYSICIAN
 40.00
.......................0.00 		        X   420,430 0 51,901
(34) SANDRA DANOFF........................................................................
SVP, STRATEGIC PLANNING, BD, NS
 40.00
.......................0.00 		        X   690,358 0 42,881
(35) JOHN M KELSCH........................................................................
PHYSICIAN
 40.00
.......................0.00 		        X   410,875 0 47,768
(36) THOMAS OWENS MD........................................................................
CHIEF MEDICAL OFFICER
 55.00
.......................5.00 		        X   576,728 0 43,875
(37) JOSEPH G TAYLOR........................................................................
PHYSICIAN
 40.00
.......................0.00 		        X   435,862 0 52,647
(38) PAUL NEWMAN........................................................................
FORMER KEY EMPLOYEE
 0.00
.......................41.00 		          X 0 244,434 34,813
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 8,486,716 5,266,907 1,901,232
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet1,267
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
PRIVATE DIAGNOSTIC CLINIC PLLCDUMC 3070DURHAMNC27710 PHYSICIAN SERVICES 83,523,514
KBR BUILDING GROUP INC5605 CARNEGIE BLVDCHARLOTTENC28209 CONSTRUCTION SERVICE 52,400,981
OPTIMUM HEALTHCARE IT LLCPO BOX 741383ATLANTAGA303841383 IT CONSULTING SERVICES 12,303,119
ARAMARK HEALTHCARE SUPPORT SERVICES25271 NETWORK PLACECHICAGOIL606731252 HEALTHCARE SERVICES 10,468,540
BALFOUR BEATTY CONSTRUCTION LLC5420 WADE PARK BLVDRALEIGHNC27607 CONSTRUCTION SERVICE 10,053,299
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet285
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 43,181
d Related organizations...1d 34,560
e Government grants (contributions)1e 582,207
f All other contributions, gifts, grants, and
similar amounts not included above1f 		13,394,824
g Noncash contributions included in lines
1a-1f:$ 		1,757,967
h Total. Add lines 1a-1f.......MediumBullet 14,054,772
Program Service RevenueAmt Business Code
2a PATIENT REVENUE 621990 2,377,495,539 2,377,495,539    
b ANCILLARY MEDICAL 621990 16,536,909 16,536,909    
c MEDICAL SERVICES 621990 2,876,735 2,876,735    
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 2,396,909,183
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 7,449,744     7,449,744
4 Income from investment of tax-exempt bond proceeds..MediumBullet 613     613
5 Royalties...........MediumBullet 6,138,372     6,138,372
(i) Real (ii) Personal
6a Gross rents 14,236,294  
b Less: rental expenses 13,295,115  
c Rental income or (loss) 941,179  
d Net rental income or (loss).......MediumBullet 941,179     941,179
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 982,477,333 615,687
b Less: cost or other basis and sales expenses 791,340,047 425,950
c Gain or (loss) 191,137,286 189,737
d Net gain or (loss)..........MediumBullet 191,327,023     191,327,023
8a Gross income from fundraising events (not including
$ 43,181
of contributions reported on line 1c). See Part IV, line 18 ..
a 69,373
b Less: direct expenses ...b 46,596
c Net income or (loss) from fundraising events..MediumBullet 22,777   22,777
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 621990 42,158,020 42,158,020    
b DEEMED DIVIDEND 900003 7,646,449     7,646,449
c PROGRAM DEV. & SUPPORT 900099 6,674,723 6,674,723    
d All other revenue .... 20,042,986 16,551,609   3,491,377
e Total. Add lines 11a–11d ...... MediumBullet 76,522,178
12 Total revenue. See Instructions......MediumBullet 2,693,365,841 2,462,293,535 0 217,017,534
Form 990 (2013)
Form 990 (2013)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 874,823 874,823
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 36,500 36,500
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 .... 6,194,307 273,940 5,916,176 4,191
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 186,494 66,701 119,793  
7 Other salaries and wages 934,725,066 645,285,829 289,393,223 46,014
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 47,898,417 30,302,134 17,592,569 3,714
9 Other employee benefits ....... 119,072,273 83,271,771 35,794,920 5,582
10 Payroll taxes ........... 65,757,934 45,128,979 20,625,461 3,494
11 Fees for services (non-employees):        
a Management ...... 11,280,676 10,622,143 658,533  
b Legal ......... 1,417,744 74,671 1,343,073  
c Accounting ........... 567,415   567,415  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 2,960,218   2,960,218  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 167,859,442 96,083,485 71,773,643 2,314
12 Advertising and promotion .... 2,011,021 603,393 1,407,298 330
13 Office expenses ....... 31,540,764 19,165,643 12,341,848 33,273
14 Information technology ...... 65,729,066 2,929,687 62,799,379  
15 Royalties ..        
16 Occupancy ........... 57,512,384 46,914,134 10,598,250  
17 Travel ............ 6,090,092 3,807,362 2,281,901 829
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 3,948,007 455,384 3,492,623  
20 Interest ........... 40,175,395 223,711 39,951,684  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 140,302,972 105,010,014 35,292,958  
23 Insurance .............. 8,258,313 4,414,657 3,843,656  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 548,196,011 548,196,011 0  
b EQUIPMENT RENTAL & MAIN 62,795,725 42,120,409 20,675,230 86
c MEDICAID ASSESSMENT 54,141,735 54,141,735 0  
d LAUNDRY 10,355,305 10,314,319 40,986  
e All other expenses 563,748 -1,704,104 2,266,629 1,223
25 Total functional expenses. Add lines 1 through 24e 2,390,451,847 1,748,613,331 641,737,466 101,050
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 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 76,597 1 79,127
2 Savings and temporary cash investments ......... 282,318,458 2 205,430,693
3 Pledges and grants receivable, net ........... 11,269,708 3 5,801,289
4 Accounts receivable, net ............. 331,741,223 4 389,980,571
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net ............. 1,092,758 7 941,907
8 Inventories for sale or use .............. 68,717,773 8 72,410,897
9 Prepaid expenses and deferred charges .......... 15,394,082 9 16,057,510
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 2,764,598,998
b Less: accumulated depreciation ..... 10b 1,276,437,440 1,491,072,128 10c 1,488,161,558
11 Investments—publicly traded securities .......... 2,816,358 11 2,997,068
12 Investments—other securities. See Part IV, line 11 ..... 2,074,420,736 12 2,440,754,778
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ............... 644,069 14 3,944,084
15 Other assets. See Part IV, line 11 ........... 48,264,080 15 16,577,618
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 4,327,827,970 16 4,643,137,100
Liabilities 17 Accounts payable and accrued expenses ......... 362,936,700 17 277,431,401
18 Grants payable .................   18  
19 Deferred revenue ................ 3,703,031 19 5,934,683
20 Tax-exempt bond liabilities ............. 1,107,827,649 20 1,086,392,745
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   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.................... 407,590,306 25 432,792,537
26 Total liabilities. Add lines 17 through 25......... 1,882,057,686 26 1,802,551,366
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 2,398,823,195 27 2,781,502,537
28 Temporarily restricted net assets ........... 36,082,851 28 47,826,350
29 Permanently restricted net assets ........... 10,864,238 29 11,256,847
Organizations that do not follow SFAS 117 (ASC 958), 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 ........... 2,445,770,284 33 2,840,585,734
34 Total liabilities and net assets/fund balances ........ 4,327,827,970 34 4,643,137,100
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
2,693,365,841
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
2,390,451,847
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
302,913,994
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
2,445,770,284
5
Net unrealized gains (losses) on investments ...............
5
173,574,633
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-81,673,177
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
2,840,585,734
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
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.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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 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
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
Total  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here.................................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2013

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.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Name of the 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 its Form 990PF, Part I, line 2, 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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 2
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, RESTRICTEDRESTRICTED

$RESTRICTED


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 3
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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 4
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) (2013)

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.SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 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 Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2013

Schedule C (Form 990 or 990-EZ) 2013
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 SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) Total
2a Lobbying nontaxable 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) 2013


Schedule C (Form 990 or 990-EZ) 2013
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)
No
Yes
(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
 
192,041
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
65,551
j
Total. Add lines 1c through 1i ...............................
257,592
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? .......
 
 
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
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
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) 2013

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. SchDMd Bullet Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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 section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, 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 XIII, 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, 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 XIII.
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 XIII 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 XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 46,947,089 50,036,781 53,700,068 55,631,465 44,124,232
b Contributions ........ 13,413,723 8,190,873 11,126,530 5,340,437 14,138,555
c Net investment earnings, gains, and losses 2,988,057 1,409,233 -758,496 3,639,795 2,461,764
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		4,265,674 12,689,798 14,031,321 10,911,629 5,093,086
f Administrative expenses ....          
g End of year balance ...... 59,083,195 46,947,089 50,036,781 53,700,068 55,631,465
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet41.240 %
c
Temporarily restricted endowment SchDMd Bullet58.760 %
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 XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. 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 .................   27,304,086 27,304,086
b Buildings ................   1,656,274,789 627,485,387 1,028,789,402
c Leasehold improvements ............        
d Equipment ................   648,470,163 414,987,026 233,483,137
e Other .................   432,549,960 233,965,027 198,584,933
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 1,488,161,558
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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) HEDGED STRATEGIES 		531,286,000 F

(B) SHORT-TERM INVESTMENTS 		178,848,000 F

(C) PRIVATE CAPITAL 		321,707,000 F

(D) REAL ASSETS 		306,549,000 F

(E) FIXED INCOME 		386,194,000 F

(F) EQUITIES 		602,304,000 F

(G) OTHER INVESTMENTS 		113,866,778 F


Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 2,440,754,778
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. 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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
INTERCOMPANY PAYABLE 23,990,363
INTEREST PAYABLE 11,122,498
PROFESSIONAL LIABILITY COSTS 8,590,420
POST RETIREMENT BENEFIT OBLIGATION 120,209,000
CAPITAL LEASE OBLIGATION 125,986,871
DERIVATIVE INSTRUMENTS 90,011,951
OTHER NON-CURRENT LIABILITIES 52,881,434


Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 432,792,537
2. Liability for uncertain tax positions In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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 XIII.) ............ 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 XIII.) ........... 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 XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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 XIII.) ............ 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 XIII.) ............ 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 XIII
Supplemental Information
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART V, LINE 4: THE INTENDED USE FOR THE ORGANIZATION'S ENDOWMENT: FUNDS SUPPORT CAPITAL PURCHASES, OFFSET OPERATING COSTS, IMPROVE PATIENT SAFETY, AND SUPPORT THE NEEDS OF PATIENTS AND FAMILIES.
PART X, LINE 2: DUKE UNIVERSITY HEALTH SYSTEM, INC. 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 DUKE UNIVERSITY HEALTH SYSTEM, INC. FINANCIAL STATEMENTS AND THEREFORE NO FIN 48 SPECIFIC DISCLOSURES ARE MADE IN THE AUDITED FINANCIAL STATEMENTS OF DUKE UNIVERSITY HEALTH SYSTEM, INC. AND ITS AFFILIATES FOR FISCAL YEAR ENDED JUNE 30, 2014.
Schedule D (Form 990) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.Right pointing arrow large image Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (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 and investments
in region
CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES EDUCATION 2,618
CENTRAL AMERICA AND THE CARIBBEAN 0 0 SEMINAR   5,246
CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS   197,259,834
EAST ASIA AND THE PACIFIC 0 0 SEMINAR   840
EUROPE 0 0 SEMINAR   35,544
MIDDLE EAST AND NORTH AFRICA 0 0 PROGRAM SERVICES EDUCATION 717
MIDDLE EAST AND NORTH AFRICA 0 0 SEMINAR   21,962
SOUTH AMERICA 0 0 SEMINAR   7,470
SOUTH ASIA 0 0 PROGRAM SERVICES EDUCATION 16,844
SOUTH ASIA 0 0 SEMINAR   1,325
SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES EDUCATION 12,255
SUB-SAHARAN AFRICA 0 0 SEMINAR   1,887
           
           
           
           
           
3a Sub-total ..... 0 0 197,334,231
b Total from continuation sheets to Part I ... 0 0 32,311
c Totals (add lines 3a and 3b) 0 0 197,366,542
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
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. Part II can be duplicated 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 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) 2013
Schedule F (Form 990) 2013Page 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.
Part III can be duplicated 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) 2013
Schedule F (Form 990) 2013
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, Return by a U.S. Transferor of Property to a Foreign Corporation (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, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (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, Information 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) 2013
Schedule F (Form 990) 2013
Page 5
Part V
Supplemental Information
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).
ReturnReference Explanation
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2013
Additional Data


Software ID:  
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.
right arrowInformation about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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.
Form 990-EZ filers are not required to complete this part.
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.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
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 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. 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 . . . 112,554     112,554
2 Less: Contributions . . 43,181     43,181
3 Gross income (line 1
minus line 2) . . . 		69,373     69,373
VerticalDirectExpenses 4 Cash prizes . . . 0      
5 Noncash prizes . . 25,895     25,895
6 Rent/facility costs . . 0      
7 Food and beverages . 10,890     10,890
8 Entertainment . . . 4,400     4,400
9 Other direct expenses . 5,411     5,411
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 46,596
11 Net income summary. Subtract line 10 from line 3, column (d)........... right arrow 22,777
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. Subtract line 7 from line 1, 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:
 
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
Page 3
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? ..........................
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
%
b
An outside facility ........................
13b
%
14
Enter 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 of the third party:
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
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Return Reference Explanation
FORM 990, SCHEDULE G, PART I, LINE 2B DUKE UNIVERSITY HEALTH SYSTEM, INC. SUPPORTS THE FUNDRAISING ACTIVITIES PERFORMED BY EMPLOYEES OF DUKE UNIVERSITY. SUCH ACTIVITIES ARE DESIGNED TO DEVELOP SUPPORT FOR BOTH THE UNIVERSITY AND THE DUKE UNIVERSITY HEALTH SYSTEM, INC.'S EDUCATIONAL, RESEARCH AND HEALTHCARE PURPOSES. DUKE UNIVERSITY RECEIVES AND DIRECTS THE CONTRIBUTIONS AS APPROPRIATE TO DUKE UNIVERSITY HEALTH SYSTEM, INC. THE AGREEMENT BETWEEN DUKE UNIVERSITY AND DUKE UNIVERSITY HEALTH SYSTEM, INC. DOES NOT DISTINGUISH BETWEEN PAYMENTS FOR PROFESSIONAL FUNDRAISING SERVICES AND EXPENSE PAYMENTS OR REIMBURSEMENTS.
Schedule G (Form 990 or 990-EZ) 2013
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.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number

56-2070036
Part I
Financial Assistance 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) as a factor in determining 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 as a factor in determining 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 used factors other than FPG in determining 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, as a factor in determining 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
Yes
 
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
 
No
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) .. 		    92,698,626   92,698,626 3.880 %
b Medicaid (from Worksheet 3,
column a) .... 		    90,137,354   90,137,354 3.770 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    182,835,980   182,835,980 7.650 %
Other Benefits
            
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		    74,510,623 14,661,744 59,848,879 2.500 %
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		    10,666,224   10,666,224 0.450 %
j Total. Other Benefits ..     85,176,847 14,661,744 70,515,103 2.950 %
k Total. Add lines 7d and 7j .     268,012,827 14,661,744 253,351,083 10.600 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
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. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
21,652,702
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
460,302,175
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
585,615,880
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-125,313,705
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(owned 10% or more by officers, directors, trustees, key employees, and physicians—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 %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?3
Name, address, primary website address, and state license number 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 DUKE UNIVERSITY HOSPITAL
2301 ERWIN ROAD PRIMARY CAMPUS
DURHAM,NC27710
WWW.DUKEMEDICINE.ORG 		X X X X   X X     A
2 DUKE RALEIGH HOSPITAL
3400 WAKE FOREST ROAD
RALEIGH,NC27609
WWW.DUKEMEDICINE.ORG 		X X         X      
3 DUKE REGIONAL HOSPITAL
3643 ROXBORO ROAD
DURHAM,NC27704
WWW.DUKEMEDICINE.ORG 		X X         X     A
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
DUKE UNIVERSITYDUKE REGIONAL HOSPITALS
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		 
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 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.
11 Used FPG to determine eligibility for providing discounted care?................. 11 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.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 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?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 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 individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 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?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 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
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22 Yes  
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
DUKE RALEIGH HOSPITAL
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		2
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 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.
11 Used FPG to determine eligibility for providing discounted care?................. 11 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.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 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?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 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 individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 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?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 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
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22 Yes  
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference Explanation
DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 3: DUKE RALEIGH HOSPITAL ("DRAH") USED THE 2010 WAKE COUNTY COMMUNITY ASSESSMENT IN DEVELOPING ITS CHNA AND IMPLEMENTATION PLAN. THE WAKE COUNTY ASSESSMENT INCLUDED INPUT FROM 1,349 CITIZEN SURVEYS, 34 FOCUS GROUPS, 8 WORKGROUPS, AND 3 COMMUNITY MEETINGS. A STEERING COMMITTEE, CO-CHAIRED BY DRAH'S PRESIDENT, COMPRISED OF 50 MEMBERS FROM HOSPITALS, LOCAL GOVERNMENTS, FAITH-BASED ORGANIZATIONS, SCHOOLS, MEDIA, NON-PROFIT ORGANIZATIONS, AND BUSINESSES WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT PROCESS AND PROVIDE INPUT.
DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 4: REX HEALTHCARE, HOLLY HILL HOSPITAL, WAKEMED HEALTH AND HOSPITALS
DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 5D: THE CHNA IS AVAILABLE ON THE WEBSITE BY NAVIGATING TO WWW.DUKEMEDICINE.ORG, CLICKING ON "PATIENTS & VISITORS", THEN "FINANCIAL ASSISTANCE", THEN "COMMUNITY HEALTH NEEDS ASSESSMENT AND CHARITY CARE".
DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 6I: REFER TO HTTP://WWW.DUKEMEDICINE.ORG/PATIENTS-AND-VISITORS/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT AND CLICK ON THE LINK FOR THE DUKE RALEIGH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSSMENT REPORT. THIS REPORT DESCRIBES ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA.
DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 7: DRAH DID NOT ADDRESS DENTAL CARE AS DENTAL CARE IS NOT OFFERED AS PART OF DRAH'S CONTINUUM OF SERVICES.
DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 14G: 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.
DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 20D: DUHS USED THE LOOK BACK METHOD AND TOOK THE SUM OF ALL CLAIMS THAT HAVE BEEN SUBMITTED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS DURING THE PRIOR 12 MONTH PERIOD DIVIDED BY THE SUM OF THE ASSOCIATED GROSS CHARGES RELATED TO THOSE CLAIMS.
DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 22: 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 B FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: DUKE UNIVERSITY HOSPITAL, - FACILITY 3: DUKE REGIONAL HOSPITAL
FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 3: DUKE REGIONAL HOSPITAL ("DRH") COLLABORATED WITH THE PARTNERSHIP FOR A HEALTHY DURHAM AND THE DURHAM COUNTY HEALTH DEPARTMENT ON THE 2011 DURHAM COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE ASSESSMENT PROCESS INCLUDED 207 CITIZEN SURVEYS FROM RANDOMLY SELECTED HOUSEHOLDS AND 10 COMMUNITY LISTENING SESSIONS WITH 283 COMMUNITY MEMBERS. REPRESENTATIVES FROM DUH AND DRH PARTICIPATED AS MEMBERS ON THE COMMUNITY HEALTH ASSESSMENT TEAM ALONG WITH REPRESENTATIVES FROM OTHER UNIVERSITIES, LOCAL GOVERNMENT, SCHOOLS, NON-PROFIT ORGANIZATIONS, AND BUSINESSES. THE COMMUNITY HEALTH ASSESSMENT TEAM WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT AND PROVIDE WRITTEN CONTENT AND EXPERTISE ON ISSUES OF INTEREST.
FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 4: DUKE UNIVERSITY HOSPITAL ("DUH")
FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 5D: THE CHNA IS AVAILABLE ON THE WEBSITE BY NAVIGATING TO WWW.DUKEMEDICINE.ORG, CLICKING ON "PATIENTS & VISITORS", THEN "FINANCIAL ASSISTANCE", THEN "COMMUNITY HEALTH NEEDS ASSESSMENT AND CHARITY CARE".
FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 6I: REFER TO HTTP://WWW.DUKEMEDICINE.ORG/PATIENTS-AND-VISITORS/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT AND CLICK ON THE LINK FOR THE DUKE REGIONAL HOSPITAL COMMUNITY HEALTH NEEDS ASSESSSMENT REPORT. THIS REPORT DESCRIBES ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA.
FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 7: DRH DID NOT SPECIFICALLY ADDRESS THE HIV AND SEXUALLY TRANSMITTED INFECTIONS NEED IDENTIFIED IN THE CHNA BECAUSE CONSIDERABLE WORK IS ALREADY BEING DONE THROUGH OTHER ORGANIZATIONS WITHIN THE COMMUNITY. THROUGH THE PARTNERSHIP FOR A HEALTHY DURHAM, THE HIV/STI COMMITTEE BRINGS TOGETHER COMMUNITY MEMBERS AND AGENCIES TO FOCUS ON STRATEGIES TO PREVENT THE SPREAD OF SYPHILIS AND HIV/AIDS. IN ADDITION, LINCOLN COMMUNITY HEALTH CENTER, WHICH DRH SUPPORTS, OPERATES AN EARLY INTERVENTION CLINIC FOR PATIENTS WITH HIV/AIDS AT THE DURHAM COUNTY HEALTH DEPARTMENT.
FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 14G: 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.
FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 20D: DUHS USED THE LOOK BACK METHOD AND TOOK THE SUM OF ALL CLAIMS THAT HAVE BEEN SUBMITTED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS DURING THE PRIOR 12 MONTH PERIOD DIVIDED BY THE SUM OF THE ASSOCIATED GROSS CHARGES RELATED TO THOSE CLAIMS.
FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 22: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER SERVICES NOT TYPICALLY COVERED BY INSURANCE, WILL BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES.
FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 3: DUKE UNIVERSITY HOSPITAL ("DUH") COLLABORATED WITH THE PARTNERSHIP FOR A HEALTHY DURHAM AND THE DURHAM COUNTY HEALTH DEPARTMENT ON THE 2011 DURHAM COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE ASSESSMENT PROCESS INCLUDED 207 CITIZEN SURVEYS FROM RANDOMLY SELECTED HOUSEHOLDS AND 10 COMMUNITY LISTENING SESSIONS WITH 283 COMMUNITY MEMBERS. REPRESENTATIVES FROM DUH AND DRH PARTICIPATED AS MEMBERS ON THE COMMUNITY HEALTH ASSESSMENT TEAM ALONG WITH REPRESENTATIVES FROM OTHER UNIVERSITIES, LOCAL GOVERNMENT, SCHOOLS, NON-PROFIT ORGANIZATIONS, AND BUSINESSES. THE COMMUNITY HEALTH ASSESSMENT TEAM WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT AND PROVIDE WRITTEN CONTENT AND EXPERTISE ON ISSUES OF INTEREST.
FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 4: DUKE REGIONAL HOSPITAL ("DRH")
FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 5D: THE CHNA IS AVAILABLE ON THE WEBSITE BY NAVIGATING TO WWW.DUKEMEDICINE.ORG, CLICKING ON "PATIENTS & VISITORS", THEN "FINANCIAL ASSISTANCE", THEN "COMMUNITY HEALTH NEEDS ASSESSMENT AND CHARITY CARE".
FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 6I: REFER TO HTTP://WWW.DUKEMEDICINE.ORG/PATIENTS-AND-VISITORS/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT AND CLICK ON THE LINK FOR THE DUKE UNIVERSITY HOSPITAL COMMUNITY HEALTH NEEDS ASSESSSMENT REPORT. THIS REPORT DESCRIBES ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA.
FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 7: DUH DID NOT SPECIFICALLY ADDRESS THE HIV AND SEXUALLY TRANSMITTED INFECTIONS NEED IDENTIFIED IN THE CHNA BECAUSE CONSIDERABLE WORK IS ALREADY BEING DONE THROUGH OTHER ORGANIZATIONS WITHIN THE COMMUNITY. THROUGH THE PARTNERSHIP FOR A HEALTHY DURHAM, THE HIV/STI COMMITTEE BRINGS TOGETHER COMMUNITY MEMBERS AND AGENCIES TO FOCUS ON STRATEGIES TO PREVENT THE SPREAD OF SYPHILIS AND HIV/AIDS.
FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 14G: 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.
FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 20D: DUHS USED THE LOOK BACK METHOD AND TOOK THE SUM OF ALL CLAIMS THAT HAVE BEEN SUBMITTED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS DURING THE PRIOR 12 MONTH PERIOD DIVIDED BY THE SUM OF THE ASSOCIATED GROSS CHARGES RELATED TO THOSE CLAIMS.
FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 22: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER SERVICES NOT TYPICALLY COVERED BY INSURANCE, WILL BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES.
   
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section D. 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?4
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
6
7
8
9
10
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 3: DUKE RALEIGH HOSPITAL ("DRAH") USED THE 2010 WAKE COUNTY COMMUNITY ASSESSMENT IN DEVELOPING ITS CHNA AND IMPLEMENTATION PLAN. THE WAKE COUNTY ASSESSMENT INCLUDED INPUT FROM 1,349 CITIZEN SURVEYS, 34 FOCUS GROUPS, 8 WORKGROUPS, AND 3 COMMUNITY MEETINGS. A STEERING COMMITTEE, CO-CHAIRED BY DRAH'S PRESIDENT, COMPRISED OF 50 MEMBERS FROM HOSPITALS, LOCAL GOVERNMENTS, FAITH-BASED ORGANIZATIONS, SCHOOLS, MEDIA, NON-PROFIT ORGANIZATIONS, AND BUSINESSES WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT PROCESS AND PROVIDE INPUT.
DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 4: REX HEALTHCARE, HOLLY HILL HOSPITAL, WAKEMED HEALTH AND HOSPITALS
DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 5D: THE CHNA IS AVAILABLE ON THE WEBSITE BY NAVIGATING TO WWW.DUKEMEDICINE.ORG, CLICKING ON "PATIENTS & VISITORS", THEN "FINANCIAL ASSISTANCE", THEN "COMMUNITY HEALTH NEEDS ASSESSMENT AND CHARITY CARE".
DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 6I: REFER TO HTTP://WWW.DUKEMEDICINE.ORG/PATIENTS-AND-VISITORS/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT AND CLICK ON THE LINK FOR THE DUKE RALEIGH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSSMENT REPORT. THIS REPORT DESCRIBES ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA.
DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 7: DRAH DID NOT ADDRESS DENTAL CARE AS DENTAL CARE IS NOT OFFERED AS PART OF DRAH'S CONTINUUM OF SERVICES.
DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 14G: 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.
DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 20D: DUHS USED THE LOOK BACK METHOD AND TOOK THE SUM OF ALL CLAIMS THAT HAVE BEEN SUBMITTED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS DURING THE PRIOR 12 MONTH PERIOD DIVIDED BY THE SUM OF THE ASSOCIATED GROSS CHARGES RELATED TO THOSE CLAIMS.
DUKE RALEIGH HOSPITAL PART V, SECTION B, LINE 22: 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 B FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: DUKE UNIVERSITY HOSPITAL, - FACILITY 3: DUKE REGIONAL HOSPITAL
FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 3: DUKE REGIONAL HOSPITAL ("DRH") COLLABORATED WITH THE PARTNERSHIP FOR A HEALTHY DURHAM AND THE DURHAM COUNTY HEALTH DEPARTMENT ON THE 2011 DURHAM COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE ASSESSMENT PROCESS INCLUDED 207 CITIZEN SURVEYS FROM RANDOMLY SELECTED HOUSEHOLDS AND 10 COMMUNITY LISTENING SESSIONS WITH 283 COMMUNITY MEMBERS. REPRESENTATIVES FROM DUH AND DRH PARTICIPATED AS MEMBERS ON THE COMMUNITY HEALTH ASSESSMENT TEAM ALONG WITH REPRESENTATIVES FROM OTHER UNIVERSITIES, LOCAL GOVERNMENT, SCHOOLS, NON-PROFIT ORGANIZATIONS, AND BUSINESSES. THE COMMUNITY HEALTH ASSESSMENT TEAM WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT AND PROVIDE WRITTEN CONTENT AND EXPERTISE ON ISSUES OF INTEREST.
FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 4: DUKE UNIVERSITY HOSPITAL ("DUH")
FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 5D: THE CHNA IS AVAILABLE ON THE WEBSITE BY NAVIGATING TO WWW.DUKEMEDICINE.ORG, CLICKING ON "PATIENTS & VISITORS", THEN "FINANCIAL ASSISTANCE", THEN "COMMUNITY HEALTH NEEDS ASSESSMENT AND CHARITY CARE".
FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 6I: REFER TO HTTP://WWW.DUKEMEDICINE.ORG/PATIENTS-AND-VISITORS/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT AND CLICK ON THE LINK FOR THE DUKE REGIONAL HOSPITAL COMMUNITY HEALTH NEEDS ASSESSSMENT REPORT. THIS REPORT DESCRIBES ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA.
FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 7: DRH DID NOT SPECIFICALLY ADDRESS THE HIV AND SEXUALLY TRANSMITTED INFECTIONS NEED IDENTIFIED IN THE CHNA BECAUSE CONSIDERABLE WORK IS ALREADY BEING DONE THROUGH OTHER ORGANIZATIONS WITHIN THE COMMUNITY. THROUGH THE PARTNERSHIP FOR A HEALTHY DURHAM, THE HIV/STI COMMITTEE BRINGS TOGETHER COMMUNITY MEMBERS AND AGENCIES TO FOCUS ON STRATEGIES TO PREVENT THE SPREAD OF SYPHILIS AND HIV/AIDS. IN ADDITION, LINCOLN COMMUNITY HEALTH CENTER, WHICH DRH SUPPORTS, OPERATES AN EARLY INTERVENTION CLINIC FOR PATIENTS WITH HIV/AIDS AT THE DURHAM COUNTY HEALTH DEPARTMENT.
FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 14G: 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.
FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 20D: DUHS USED THE LOOK BACK METHOD AND TOOK THE SUM OF ALL CLAIMS THAT HAVE BEEN SUBMITTED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS DURING THE PRIOR 12 MONTH PERIOD DIVIDED BY THE SUM OF THE ASSOCIATED GROSS CHARGES RELATED TO THOSE CLAIMS.
FACILITY 3 -- DUKE REGIONAL HOSPITAL PART V, SECTION B, LINE 22: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER SERVICES NOT TYPICALLY COVERED BY INSURANCE, WILL BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES.
FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 3: DUKE UNIVERSITY HOSPITAL ("DUH") COLLABORATED WITH THE PARTNERSHIP FOR A HEALTHY DURHAM AND THE DURHAM COUNTY HEALTH DEPARTMENT ON THE 2011 DURHAM COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE ASSESSMENT PROCESS INCLUDED 207 CITIZEN SURVEYS FROM RANDOMLY SELECTED HOUSEHOLDS AND 10 COMMUNITY LISTENING SESSIONS WITH 283 COMMUNITY MEMBERS. REPRESENTATIVES FROM DUH AND DRH PARTICIPATED AS MEMBERS ON THE COMMUNITY HEALTH ASSESSMENT TEAM ALONG WITH REPRESENTATIVES FROM OTHER UNIVERSITIES, LOCAL GOVERNMENT, SCHOOLS, NON-PROFIT ORGANIZATIONS, AND BUSINESSES. THE COMMUNITY HEALTH ASSESSMENT TEAM WORKED TO DIRECT THE ACTIVITIES OF THE ASSESSMENT AND PROVIDE WRITTEN CONTENT AND EXPERTISE ON ISSUES OF INTEREST.
FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 4: DUKE REGIONAL HOSPITAL ("DRH")
FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 5D: THE CHNA IS AVAILABLE ON THE WEBSITE BY NAVIGATING TO WWW.DUKEMEDICINE.ORG, CLICKING ON "PATIENTS & VISITORS", THEN "FINANCIAL ASSISTANCE", THEN "COMMUNITY HEALTH NEEDS ASSESSMENT AND CHARITY CARE".
FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 6I: REFER TO HTTP://WWW.DUKEMEDICINE.ORG/PATIENTS-AND-VISITORS/GENERAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT AND CLICK ON THE LINK FOR THE DUKE UNIVERSITY HOSPITAL COMMUNITY HEALTH NEEDS ASSESSSMENT REPORT. THIS REPORT DESCRIBES ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA.
FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 7: DUH DID NOT SPECIFICALLY ADDRESS THE HIV AND SEXUALLY TRANSMITTED INFECTIONS NEED IDENTIFIED IN THE CHNA BECAUSE CONSIDERABLE WORK IS ALREADY BEING DONE THROUGH OTHER ORGANIZATIONS WITHIN THE COMMUNITY. THROUGH THE PARTNERSHIP FOR A HEALTHY DURHAM, THE HIV/STI COMMITTEE BRINGS TOGETHER COMMUNITY MEMBERS AND AGENCIES TO FOCUS ON STRATEGIES TO PREVENT THE SPREAD OF SYPHILIS AND HIV/AIDS.
FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 14G: 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.
FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 20D: DUHS USED THE LOOK BACK METHOD AND TOOK THE SUM OF ALL CLAIMS THAT HAVE BEEN SUBMITTED TO MEDICARE AND ALL PRIVATE HEALTH INSURERS DURING THE PRIOR 12 MONTH PERIOD DIVIDED BY THE SUM OF THE ASSOCIATED GROSS CHARGES RELATED TO THOSE CLAIMS.
FACILITY 1 -- DUKE UNIVERSITY HOSPITAL PART V, SECTION B, LINE 22: CERTAIN ELECTIVE COSMETIC/AESTHETIC SERVICES, AND OTHER SERVICES NOT TYPICALLY COVERED BY INSURANCE, WILL BE BILLED AT AN AMOUNT EQUAL TO GROSS CHARGES.
Schedule H (Form 990) 2013
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
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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. Part II can be duplicated if additional space is needed.
(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 CURE
30 MEMORIAL DR
PINEHURST,NC28374 		45-2871984 - 5,800       GENERAL SUPPORT
(2) ALLIANCE MEDICAL MINISTRY INC
101 DONALD ROSS DRIVE
RALEIGH,NC27610 		56-2168673 501(C)(3) 42,500       GENERAL SUPPORT
(3) THE AMERICAN SOCIETY OF GENE & CELL THERAPY
555 EAST WELLS ST SUITE 1100
MILWAUKEE,WI53202 		91-1766321 501(C)(3) 25,000       GENERAL SUPPORT
(4) BOYS & GIRLS CLUB
701 N RALEIGH BLVD
RALEIGH,NC27610 		56-0863051 501(C)(3) 17,500       GENERAL SUPPORT
(5) CEO ROUNDTABLE ON CANCER INC
940 NW CARY PKWY SUITE 102
CARY,NC27513 		65-1230448 501(C)(3) 40,000       GENERAL SUPPORT
(6) CITY OF MEDICINE ACADEMY
301 CRUTCHFIELD ST
DURHAM,NC27704 		56-6001021 NC GOVERNMENT 20,451       GENERAL SUPPORT
(7) DUKE SCHOOL FOR CHILDREN
3716 OLD ERWIN RD
DURHAM,NC27705 		58-1521494 501(C)(3) 25,000       GENERAL SUPPORT
(8) DURHAM AT RISK YOUTH COLLABORATIVE
107 N DIVER ST
DURHAM,NC27703 		32-0263133 501(C)(3) 15,000       GENERAL SUPPORT
(9) DURHAM COUNTY
414 E MAIN ST
DURHAM,NC27701 		56-6000297 LOCAL GOVERNMENT 25,000       GENERAL SUPPORT
(10) FAMILY VIOLENCE PREVENTION CENTER
1012 OBERLINE RD SUITE 100
RALEIGH,NC27605 		58-1320613 501(C)(3) 40,000       GENERAL SUPPORT
(11) FOUNDATION FOR NURSING EXCELLENCE
PO BOX 31824
RALEIGH,NC27622 		30-0105241 501(C)(3) 20,000       GENERAL SUPPORT
(12) GREAT 100 INC
PO BOX 4875
GREENSBORO,NC274044875 		56-1705456 501(C)(3) 15,000       GENERAL SUPPORT
(13) GREATER RALEIGH CHAMBER OF COMMERCE
PO BOX 2978
RALEIGH,NC276022978 		56-0370850 501(C)(6) 45,910       GENERAL SUPPORT
(14) HUMAN RIGHTS CAMPAIGN
1640 RHODE ISLAND AVE NW
WASHINGTON,DC20036 		52-1243458 501(C)(4) 15,000       GENERAL SUPPORT
(15) KNIGHTDALE CHAMBER OF COMMERCE
207 MAIN STREET
KNIGHTDALE,NC27545 		56-1325118 501(C)(6) 5,500       GENERAL SUPPORT
(16) LGBT CENTER OF RALEIGH INC
411 HILLSBOROUGH ST
RALEIGH,NC276031727 		26-2998186 501(C)(3) 10,000       GENERAL SUPPORT
(17) MEDICAL FOUNDATION OF NC INC
CB7120
CHAPEL HILL,NC275997120 		56-6001393 501(C)(3) 50,000       GENERAL SUPPORT
(18) MIDTOWN EVENTS LLC
4321 LASSITER AT NORTH HILLS
RALEIGH,NC27609 		27-1832351 - 40,000       GENERAL SUPPORT FOR ART WEEK
(19) MIDTOWN EVENTS
4818 SIX FORKS ROAD SUITE 204
RALEIGH,NC27609 		20-8998537 - 80,000       GENERAL SUPPORT FOR LOCAL FARMER'S MARKET
(20) NC CENTER FOR NON PROFITS
1110 NAVAHO DRIVE SUITE 200
RALEIGH,NC27609 		56-1729407 501(C)(3) 10,000       GENERAL SUPPORT
(21) NC LUNG CANCER PARTNERSHIP
4000 BLUE RIDGE RD SUITE 170
RALEIGH,NC27612 		26-2300885 501(C)(3) 15,000       GENERAL SUPPORT
(22) NORTH CAROLINA HOSPITAL ASSOCIATION
PO BOX 4449
CARY,NC275194449 		56-0641290 501(C)(6) 27,312       GENERAL SUPPORT
(23) NORTH CAROLINA INSTITUTE OF MEDICINE
630 DAVIS DR STE 100
MORRISVILLE,NC27560 		56-1506066 NC GOVERNMENT 6,000       GENERAL SUPPORT
(24) NORTH CAROLINA PHYSICIANS HEALTH
220 HORIZON DRIVE 201
RALEIGH,NC27615 		56-1846599 501(C)(3) 12,000       GENERAL SUPPORT
(25) RALEIGH SCHOOL OF NURSE ANESTHESIA
3900 BARRETT DR SUITE 200
RALEIGH,NC27609 		56-1684241 501(C)(3) 72,606       GENERAL SUPPORT
(26) RESEARCH AMERICA
PO BOX 222451
CHINTILLY,VA201532451 		52-1609875 501(C)(3) 20,000       GENERAL SUPPORT
(27) SAMARITAN HEALTH CENTER
PO BOX 51339
DURHAM,NC27717 		26-3770762 501(C)(3) 20,000       GENERAL SUPPORT
(28) SUSAN G KOMEN FOR THE CURE NORTH
600 AIRPORT BLVD SUITE 100
MORRISVILLE,NC27560 		75-2845066 501(C)(3) 10,000       GENERAL SUPPORT
(29) TRIANGLE BUSINESS JOURNAL
1305 NAVAHO DR SUITE 100
RALEIGH,NC27609 		43-1366184 - 16,100       GENERAL SUPPORT
(30) WAKE COUNTY MEDICAL SOCIETY
2500 BLUE RIDGE RD STE 330
RALEIGH,NC27616 		56-2205175 501(C)(3) 95,000       GENERAL SUPPORT
(31) WAKE TECHNICAL COMMUNITY COLLEGE
9101 FAYETTEVILLE ROAD
RALEIGH,NC276035696 		23-7017752 501(C)(3) 15,000       GENERAL SUPPORT
(32) DUKE UNIVERSITY
324 BLACKWELL ST STE 850
DURHAM,NC27701 		56-0532129 501(C)(3)   66,248 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
24
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
8
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2013

Schedule I (Form 990) 2013
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.
Part III can be duplicated 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) BILL BAKER SCHOLARSHIP AWARD 1 500      
(2) FINANCIAL ASSISTANCE 13 13,700      
(3) FRIENDS OF EVAN SCHOLARSHIP 5 5,250      
(4) MARY EMMA FARMER JONES SCHOLARSHIP AWARD 1 1,050      
(5) MELANIE TAYLOR SCHOLARSHIP AWARD 1 2,500      
(6) STUDENT SCHOLARSHIP 12 13,500      


Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
SCHEDULE I, PART I, LINE 2 DUKE UNIVERSITY HEALTH SYSTEM, INC. PROVIDES GENERAL SUPPORT TO LOCAL ORGANIZATIONS BASED ON OUR AWARENESS OF THEIR ACTIVITIES WITHIN THE LOCAL COMMUNITY. DUKE UNIVERSITY HEALTH SYSTEM, INC. ALSO MAINTAINS A CHARITABLE GRANTS COMMITTEE THAT REVIEWS COMMUNITY REQUESTS FOR PHILANTHROPIC ASSISTANCE THAT PROMOTE HEALTH AND WELLNESS.
Schedule I (Form 990) 2013


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, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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 of the expenses described above? If "No," complete Part III to explain....
1b
 
No
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
No
3
Indicate which, if any, of the following the filing organization used 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
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 (E) amounts for that individual.
(A) Name and Title (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 CATHERINE ANDREWS MDDIRECTOR (i)
(ii)		 0
511,948 		0
213,452 		0
17,500 		0
31,276 		0
52,787 		0
826,963 		0
0
(2)RICHARD H BRODHEADDIRECTOR (i)
(ii)		 0
873,792 		0
0 		0
219,858 		0
131,276 		0
66,205 		0
1,291,131 		0
100,000
(3)VICTOR J DZAU MDPRESIDENT & CEO, DUHS/DIRECTOR (i)
(ii)		 0
1,094,130 		0
933,638 		0
12,250 		0
716,303 		0
20,526 		0
2,776,847 		0
0
(4)MARY E KLOTMAN MDDIRECTOR (i)
(ii)		 0
279,856 		0
63,876 		0
53,588 		0
31,276 		0
11,700 		0
440,296 		0
0
(5)THEODORE NICK PAPPAS MDDIRECTOR (i)
(ii)		 0
351,902 		0
71,779 		0
131 		0
31,276 		0
14,272 		0
469,360 		0
0
(6)CARL E RAVIN MDDIRECTOR (i)
(ii)		 0
249,929 		0
0 		0
0 		0
31,252 		0
12,030 		0
293,211 		0
0
(7)MONTE D BROWN MDVP OF ADMINISTRATION/SECRETARY (i)
(ii)		 343,847
0 		238,722
0 		17,500
0 		31,276
0 		17,448
0 		648,793
0 		0
0
(8)WILLIAM J FULKERSON MDEXECUTIVE VP, DUHS (i)
(ii)		 749,060
0 		442,918
0 		17,500
0 		31,276
0 		7,432
0 		1,248,186
0 		0
0
(9)KENNETH C MORRISSVP, CFO, TREASURER (i)
(ii)		 681,012
0 		352,726
0 		17,500
0 		31,276
0 		10,808
0 		1,093,322
0 		0
0
(10)MARY ANN FUCHSVP-PATIENT CARE/CHIEF NURSE EXEC (i)
(ii)		 290,352
0 		97,044
0 		18,243
0 		31,276
0 		6,207
0 		443,122
0 		0
0
(11)RICHARD GANNOTTAPRESIDENT, DUKE RALEIGH HOSPITAL (i)
(ii)		 325,447
0 		111,684
0 		4,994
0 		31,276
0 		20,562
0 		493,963
0 		0
0
(12)KATHLEEN GALBRAITHPRESIDENT, DUKE REGIONAL HOSPITAL (i)
(ii)		 173,074
0 		20,000
0 		6,244
0 		24,708
0 		16,043
0 		240,069
0 		0
0
(13)JEFFREY FERRANTIVP, CIO, DHTS ADMINISTRATION (i)
(ii)		 331,172
14,844 		62,109
60,000 		8,750
0 		9,054
22,222 		8,773
5,413 		419,858
102,479 		0
0
(14)CARLA PARKER-HOLLISVP, DUKE RALEIGH HOSPITAL (i)
(ii)		 174,158
0 		0
0 		17,246
0 		23,709
0 		17,131
0 		232,244
0 		0
0
(15)KEVIN W SOWERSPRESIDENT, DUKE UNIVERSITY HOSPITAL (i)
(ii)		 446,934
0 		195,539
0 		34,271
0 		31,276
0 		12,055
0 		720,075
0 		0
0
(16)DOUGLAS B VINSELPRESIDENT, DUKE RALEIGH HOSPITAL (i)
(ii)		 266,836
0 		0
0 		10,209
0 		31,276
0 		919
0 		309,240
0 		0
0
(17)KERRY R WATSONPRESIDENT, DUKE REGIONAL HOSPITAL (i)
(ii)		 343,689
0 		136,183
0 		17,500
0 		31,276
0 		51,439
0 		580,087
0 		0
0
(18)MARC CALABRESEPHYSICIAN (i)
(ii)		 350,548
0 		55,804
0 		14,078
0 		31,276
0 		21,875
0 		473,581
0 		0
0
(19)SANDRA DANOFFSVP, STRATEGIC PLANNING, BD, NS (i)
(ii)		 431,003
0 		237,526
0 		21,829
0 		31,276
0 		13,133
0 		734,767
0 		0
0
(20)JOHN M KELSCHPHYSICIAN (i)
(ii)		 335,353
0 		58,022
0 		17,500
0 		31,276
0 		17,665
0 		459,816
0 		0
0
(21)THOMAS OWENS MDCHIEF MEDICAL OFFICER (i)
(ii)		 419,281
0 		106,887
0 		50,560
0 		31,276
0 		14,095
0 		622,099
0 		0
0
(22)JOSEPH G TAYLORPHYSICIAN (i)
(ii)		 278,348
0 		140,014
0 		17,500
0 		31,276
0 		22,354
0 		489,492
0 		0
0
(23)PAUL NEWMANFORMER KEY EMPLOYEE (i)
(ii)		 0
244,434 		0
0 		0
0 		0
30,086 		0
14,504 		0
289,024 		0
0
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
SCHEDULE J, PART I, LINE 1A JOHN MCARTHUR TRAVELED FIRST CLASS FOR BUSINESS PURPOSES WHEN LOWER LEVEL CLASSES WERE NOT AVAILABLE. THIS TRAVEL WAS FOR NECESSARY BUSINESS PURPOSES. 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. RICHARD H. BRODHEAD PARTICIPATED IN AND RECEIVED PAYMENTS OF $200,000 UNDER A DEFERRED COMPENSATION PLAN DESCRIBED UNDER SECTION 457(F) OF THE INTERNAL REVENUE CODE. SUCH AMOUNTS WERE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE AS DEFINED UNDER IRC SECTION 457(F). 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) 2013

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.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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   08-28-2012 48,225,000 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 12,420,000 17,290,000  
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 14,871,185   15,924,326
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 2,472,104 2,737,864   2,472,104
8 Credit enhancement from proceeds . . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 161,317,276 309,386,345   161,317,276
11 Other spent proceeds . . . . . . . . . . . . . . 322,140,000 214,760,000 145,715,000  
12 Other unspent proceeds . . . . . . . . . . . . . .        
13 Year of substantial completion . . . . . . . . . . . . 2009 2013 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    
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X    
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
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      
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      
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   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 % 0 % 0 %  
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 % 0 % 0 %  
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0 % 0 % 0 %  
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X    
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . . X     X X      
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. 0.070 %   4.330 %  
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X     X      
9 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      
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . . X   X   X     X
c No rebate due? . . . . . . . . X   X   X   X  
If you checked "No rebate due" in line 2c, provide in
Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . . X   X   X     X
4a 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 . . . . . . . . . NA
  		NA
  		NA
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .   X   X   X   X
e Was the hedge terminated? . . . . . .   X   X   X   X
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . . NA
  		NA
  		NA
  		NA
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .   X   X   X   X
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
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? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K, PART I, COLUMN F 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): THE PURPOSE OF THE BONDS ISSUED 08/28/2012 WAS TO REFUND THE ORIGINAL 1985B BONDS ISSUED ON 10/02/1985 FOR THE ACQUISITION OF A MAINTENANCE BUILDING, PARKING, AND A DEBT SERVICE FUND; AND TO REFUND THE ORIGINAL 1993A BONDS ISSUED ON 08/12/1993. THE PURPOSE OF THE BONDS ISSUED 08/12/1993 WAS TO PARTIALLY REFUND THE 1991D BONDS ISSUED ON 7/1/1991 AND THE 1985A BONDS ISSUED ON 10/02/1985. 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 BOND ISSUE (B): PROCEEDS INCLUDE ISSUE PRICE PLUS ORIGINAL ISSUE DISCOUNT / UPFRONT FEE PAID DIRECTLY BY DUHS TO THE BANK UPON ISSUANCE. BOND ISSUES (D), A (2), AND B (2): PROCEEDS INCLUDE INVESTMENT EARNINGS. BOND ISSUES D (2) AND A (3): PROCEEDS REFLECT ACTUAL PRINCIPAL DRAWN DOWN UNDER DRAW DOWN FINANCING LEASE PROGRAM. SCHEDULE K, PART IV, LINE 2C BOND ISSUES (A), (B), (C), (D), A (2) AND B (2): BOND ISSUE (A/B) ARBITRAGE REPORT COMPLETED 3/22/13, (C) COMPLETED 9/30/2013, (D) COMPLETED 11/1/2013, A (2) COMPLETED 4/1/13, B (2) COMPLETED 5/31/2014. BOND ISSUES (A), (B), (C) AND C (2): THESE PROCEEDS WERE DISBURSED OR DEEMED DISBURSED UPON ISSUANCE TO CURRENTLY REFUND THE PRIOR BONDS. BOND ISSUES D (2), AND A (3): SALES PROCEEDS ALLOCATED UPON ISSUANCE AND NOT INVESTED. SCHEDULE K, PART III, LINE 8C, BOND ISSUE (C): DISPOSITION IS THE SUBJECT OF A CLOSING AGREEMENT ENTERED INTO WITH THE IRS IN OCTOBER 2014 THROUGH THE TAX EXEMPT BONDS VOLUNTARY CLOSING AGREEMENT PROGRAM.
Schedule K (Form 990) 2013

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.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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   08-28-2012 48,225,000 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 12,420,000 17,290,000  
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 14,871,185   15,924,326
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 2,472,104 2,737,864   2,472,104
8 Credit enhancement from proceeds . . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 161,317,276 309,386,345   161,317,276
11 Other spent proceeds . . . . . . . . . . . . . . 322,140,000 214,760,000 145,715,000  
12 Other unspent proceeds . . . . . . . . . . . . . .        
13 Year of substantial completion . . . . . . . . . . . . 2009 2013 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    
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X    
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
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      
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      
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   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 % 0 % 0 %  
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 % 0 % 0 %  
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0 % 0 % 0 %  
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X    
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . . X     X X      
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. 0.070 %   4.330 %  
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X     X      
9 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      
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . . X   X   X     X
c No rebate due? . . . . . . . . X   X   X   X  
If you checked "No rebate due" in line 2c, provide in
Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . . X   X   X     X
4a 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 . . . . . . . . . NA
  		NA
  		NA
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .   X   X   X   X
e Was the hedge terminated? . . . . . .   X   X   X   X
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . . NA
  		NA
  		NA
  		NA
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .   X   X   X   X
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
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? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K, PART I, COLUMN F 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): THE PURPOSE OF THE BONDS ISSUED 08/28/2012 WAS TO REFUND THE ORIGINAL 1985B BONDS ISSUED ON 10/02/1985 FOR THE ACQUISITION OF A MAINTENANCE BUILDING, PARKING, AND A DEBT SERVICE FUND; AND TO REFUND THE ORIGINAL 1993A BONDS ISSUED ON 08/12/1993. THE PURPOSE OF THE BONDS ISSUED 08/12/1993 WAS TO PARTIALLY REFUND THE 1991D BONDS ISSUED ON 7/1/1991 AND THE 1985A BONDS ISSUED ON 10/02/1985. 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 BOND ISSUE (B): PROCEEDS INCLUDE ISSUE PRICE PLUS ORIGINAL ISSUE DISCOUNT / UPFRONT FEE PAID DIRECTLY BY DUHS TO THE BANK UPON ISSUANCE. BOND ISSUES (D), A (2), AND B (2): PROCEEDS INCLUDE INVESTMENT EARNINGS. BOND ISSUES D (2) AND A (3): PROCEEDS REFLECT ACTUAL PRINCIPAL DRAWN DOWN UNDER DRAW DOWN FINANCING LEASE PROGRAM. SCHEDULE K, PART IV, LINE 2C BOND ISSUES (A), (B), (C), (D), A (2) AND B (2): BOND ISSUE (A/B) ARBITRAGE REPORT COMPLETED 3/22/13, (C) COMPLETED 9/30/2013, (D) COMPLETED 11/1/2013, A (2) COMPLETED 4/1/13, B (2) COMPLETED 5/31/2014. BOND ISSUES (A), (B), (C) AND C (2): THESE PROCEEDS WERE DISBURSED OR DEEMED DISBURSED UPON ISSUANCE TO CURRENTLY REFUND THE PRIOR BONDS. BOND ISSUES D (2), AND A (3): SALES PROCEEDS ALLOCATED UPON ISSUANCE AND NOT INVESTED. SCHEDULE K, PART III, LINE 8C, BOND ISSUE (C): DISPOSITION IS THE SUBJECT OF A CLOSING AGREEMENT ENTERED INTO WITH THE IRS IN OCTOBER 2014 THROUGH THE TAX EXEMPT BONDS VOLUNTARY CLOSING AGREEMENT PROGRAM.
Schedule K (Form 990) 2013

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.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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   08-28-2012 48,225,000 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 12,420,000 17,290,000  
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 14,871,185   15,924,326
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 2,472,104 2,737,864   2,472,104
8 Credit enhancement from proceeds . . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 161,317,276 309,386,345   161,317,276
11 Other spent proceeds . . . . . . . . . . . . . . 322,140,000 214,760,000 145,715,000  
12 Other unspent proceeds . . . . . . . . . . . . . .        
13 Year of substantial completion . . . . . . . . . . . . 2009 2013 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    
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X    
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
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      
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      
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   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 % 0 % 0 %  
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 % 0 % 0 %  
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0 % 0 % 0 %  
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X    
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . . X     X X      
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. 0.070 %   4.330 %  
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X     X      
9 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      
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . . X   X   X     X
c No rebate due? . . . . . . . . X   X   X   X  
If you checked "No rebate due" in line 2c, provide in
Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . . X   X   X     X
4a 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 . . . . . . . . . NA
  		NA
  		NA
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .   X   X   X   X
e Was the hedge terminated? . . . . . .   X   X   X   X
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . . NA
  		NA
  		NA
  		NA
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .   X   X   X   X
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
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? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K, PART I, COLUMN F 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): THE PURPOSE OF THE BONDS ISSUED 08/28/2012 WAS TO REFUND THE ORIGINAL 1985B BONDS ISSUED ON 10/02/1985 FOR THE ACQUISITION OF A MAINTENANCE BUILDING, PARKING, AND A DEBT SERVICE FUND; AND TO REFUND THE ORIGINAL 1993A BONDS ISSUED ON 08/12/1993. THE PURPOSE OF THE BONDS ISSUED 08/12/1993 WAS TO PARTIALLY REFUND THE 1991D BONDS ISSUED ON 7/1/1991 AND THE 1985A BONDS ISSUED ON 10/02/1985. 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 BOND ISSUE (B): PROCEEDS INCLUDE ISSUE PRICE PLUS ORIGINAL ISSUE DISCOUNT / UPFRONT FEE PAID DIRECTLY BY DUHS TO THE BANK UPON ISSUANCE. BOND ISSUES (D), A (2), AND B (2): PROCEEDS INCLUDE INVESTMENT EARNINGS. BOND ISSUES D (2) AND A (3): PROCEEDS REFLECT ACTUAL PRINCIPAL DRAWN DOWN UNDER DRAW DOWN FINANCING LEASE PROGRAM. SCHEDULE K, PART IV, LINE 2C BOND ISSUES (A), (B), (C), (D), A (2) AND B (2): BOND ISSUE (A/B) ARBITRAGE REPORT COMPLETED 3/22/13, (C) COMPLETED 9/30/2013, (D) COMPLETED 11/1/2013, A (2) COMPLETED 4/1/13, B (2) COMPLETED 5/31/2014. BOND ISSUES (A), (B), (C) AND C (2): THESE PROCEEDS WERE DISBURSED OR DEEMED DISBURSED UPON ISSUANCE TO CURRENTLY REFUND THE PRIOR BONDS. BOND ISSUES D (2), AND A (3): SALES PROCEEDS ALLOCATED UPON ISSUANCE AND NOT INVESTED. SCHEDULE K, PART III, LINE 8C, BOND ISSUE (C): DISPOSITION IS THE SUBJECT OF A CLOSING AGREEMENT ENTERED INTO WITH THE IRS IN OCTOBER 2014 THROUGH THE TAX EXEMPT BONDS VOLUNTARY CLOSING AGREEMENT PROGRAM.
Schedule K (Form 990) 2013

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, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by 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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)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 assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2013
Schedule L (Form 990 or 990-EZ) 2013
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
  		SEE PART V 30,512,750 SEE PART V   No
(2) PRIVATE DIAGNOSTIC CLINIC
  		SEE PART V 132,913,268 SEE PART V   No
(3) CBC NEW MEDIA GROUP LLC
  		SEE PART V 31,000 SEE PART V   No
(4) THE DURHAM BULLS BASEBALL CLUB INC
  		SEE PART V 36,970 SEE PART V   No
(5) IMMUCOR INC
  		SEE PART V 696,144 SEE PART V   No
(6) THORATEC CORPORATION
  		SEE PART V 9,423,059 SEE PART V   No
(7) ALFRED WILLIAMS & COMPANY
  		SEE PART V 1,642,794 SEE PART V   No
(8) GENESE NEWMAN SEE PART V 119,793 SEE PART V   No
(9) TAMELA VINSEL SEE PART V 66,701 SEE PART V   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (A) NAME OF INTERESTED PERSON: MEDTRONIC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: MEDTRONIC BOARD MEMBER IS DUHS, INC. DIRECTOR.(C) AMOUNT OF TRANSACTION: $30,512,750(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR GOODS OR SERVICES(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: PRIVATE DIAGNOSTIC CLINIC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: PRIVATE DIAGNOSTIC CLINIC BOARD MEMBER IS DUHS, INC. FORMER KEY EMPLOYEE.(C) AMOUNT OF TRANSACTION: $132,913,268(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR GOODS OR SERVICES(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: CBC NEW MEDIA GROUP, LLC(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: CBC NEW MEDIA GROUP, LLC. CEO IS DUHS, INC. DIRECTOR.(C) AMOUNT OF TRANSACTION: $31,000(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR GOODS OR SERVICES(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: THE DURHAM BULLS BASEBALL CLUB, INC.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: THE DURHAM BULLS BASEBALL CLUB, INC. CEO IS DUHS, INC. DIRECTOR.(C) AMOUNT OF TRANSACTION: $36,970(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR GOODS OR SERVICES(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: IMMUCOR, INC.(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: IMMUCOR, INC. CEO IS DUHS, INC. DIRECTOR.(C) AMOUNT OF TRANSACTION: $696,144(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR GOODS OR SERVICES(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: THORATEC CORPORATION(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: THORATEC CORPORATION BOARD MEMBER IS DUHS, INC. DIRECTOR.(C) AMOUNT OF TRANSACTION: $9,423,059(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR GOODS OR SERVICES(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: ALFRED WILLIAMS & COMPANY(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: ALFRED WILLIAMS & COMPANY MARKET PRESIDENT IS DUHS, INC. DIRECTOR.(C) AMOUNT OF TRANSACTION: $1,642,794(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR GOODS OR SERVICES(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: GENESE NEWMAN(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: GENESE NEWMAN IS A FAMILY MEMBER OF DUHS, INC. FORMER KEY EMPLOYEE(C) AMOUNT OF TRANSACTION: $119,793(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR SALARY AND BENEFITS(E) SHARING OF ORGANIZATION REVENUE? = NO(A) NAME OF INTERESTED PERSON: TAMELA VINSEL(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: TAMELA VINSEL IS A FAMILY MEMBER OF DUHS, INC. KEY EMPLOYEE(C) AMOUNT OF TRANSACTION: $66,701(D) DESCRIPTION OF TRANSACTION: PAYMENT FOR SALARY AND BENEFITS(E) SHARING OF ORGANIZATION REVENUE? = NO
Schedule L (Form 990 or 990-EZ) 2013

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 organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageInformation about Schedule M (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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 14 213 VARIOUS
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications .. X 121 VARIOUS
5 Clothing and household
goods ....... 		X 246 VARIOUS
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 17 1,729,743 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 1 770 VARIOUS
19 Food inventory ... X 13 36 VARIOUS
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( GIFT CARDS ) X 57 15,692 VARIOUS
26 Other Right pointing arrow large image ( JEWELRY ) X 8 6,448 VARIOUS
27 Other Right pointing arrow large image ( MISCELLANEOUS ) X 92 3,889 VARIOUS
28 Other Right pointing arrow large image ( EVENT TICKETS ) X 5 809 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
0
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 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 an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2013)
Schedule M (Form 990) (2013)
Page 2
Part II
Supplemental Information. 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.
Return Reference Explanation
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) (2013)
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.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
DUKE UNIVERSITY HEALTH SYSTEM INC
 
Employer identification number

56-2070036
Return Reference Explanation
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.
FORM 990, PART III, LINE 4A STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS HISTORY AND ORGANIZATION IN 1925, JAMES B. DUKE WILLED $4 MILLION TO ESTABLISH DUKE 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. DUKE UNDERSTANDS THAT HEALTHCARE MEANS FAR MORE THAN TAKING CARE OF PEOPLE IN A HOSPITAL SETTING. AS THIS REPORT REFLECTS, IT ALSO MEANS INVESTING IN THE COMMUNITIES DUKE SERVES TO INCREASE ACCESS TO HEALTHCARE, ALLEVIATE HEALTH DISPARITIES, AND IMPROVE COMMUNITIES' OVERALL WELLNESS BY IDENTIFYING AND ADDRESSING HEALTHCARE NEEDS. WE ARE PROUD TO REPORT THAT FOR THE FISCAL YEAR THAT ENDED JUNE 30, 2014, DUKE PROVIDED A TOTAL COMMUNITY BENEFIT AND INVESTMENT OF $448 MILLION. OF THAT FIGURE, $253.3 MILLION REPRESENTED THE COMMUNITY BENEFIT CATEGORIES RECOGNIZED BY THE U.S. INTERNAL REVENUE SERVICE INCLUDING $92.7 MILLION IN CHARITY CARE AT ESTIMATED COST TO PATIENTS FROM EVERY CORNER OF NORTH CAROLINA WHO ARE UNINSURED OR WHO CANNOT PAY FOR CARE BECAUSE OF FINANCIAL HARDSHIP. DUKE CONTINUES TO VALUE ITS LONGSTANDING COLLABORATIONS WITH ITS MANY COMMUNITY AND GOVERNMENT PARTNERS, AND TO HONOR ITS FOUNDATIONAL COMMITMENT TO PROVIDE HIGH-QUALITY, COMPASSIONATE, AND SAFE MEDICAL CARE TO THE PEOPLE IT SERVES ACROSS NORTH CAROLINA. THE 2015 REPORT ON COMMUNITY BENEFIT ALSO IS AVAILABLE ONLINE AT HTTP://DUKEMEDICINE.ORG/ABOUTUS. CLICK ON "COMMUNITY HEALTH & BENEFITS." DUKE PROVIDES HIGH-QUALITY CARE REGARDLESS OF A PATIENT'S ABILITY TO PAY DUKE PROVIDED CHARITY CARE AT ESTIMATED COST TOTALING $92.7 MILLION TO 164,649 PATIENTS DURING THE FISCAL YEAR THAT ENDED ON JUNE 30, 2014. NEARLY 94 PERCENT OF THE PATIENTS WERE FROM NORTH CAROLINA. DUKE PROVIDES ELIGIBLE CARE AT A DISCOUNT OR WITHOUT CHARGE TO ALL QUALIFYING PATIENTS WHO DO NOT HAVE INSURANCE, OR WHO BECAUSE OF FINANCIAL HARDSHIP CANNOT PAY FOR THE MEDICAL CARE THEY RECEIVE. IN ADDITION TO PROVIDING PRIMARY CARE AT NO CHARGE, DUKE PHYSICIANS DONATE SPECIALTY CARE SERVICES TO ELIGIBLE UNINSURED PATIENTS THROUGH A PROGRAM IN DURHAM AND WAKE COUNTIES CALLED PROJECT ACCESS. DUKE IS COMMITTED TO PROVIDING HIGH-QUALITY, EFFECTIVE CARE WITH A CONSISTENTLY HIGH LEVEL OF DIGNITY, RESPECT AND SKILL TO ALL PATIENTS IT SERVES, REGARDLESS OF THEIR ABILITY TO PAY. DUKE WORKS WITH PATIENTS BY NAVIGATING THEM THROUGH THE FINANCIAL ASSISTANCE PROGRAMS TO WHICH THEY ARE ENTITLED. WHEN GOVERNMENT PROGRAMS SUCH AS MEDICAID DO NOT COMPLETELY COVER DUKE'S COST OF CARE, DUKE ABSORBS THE DIFFERENCE IN ACCORDANCE WITH ITS POLICIES. HIGHLIGHTS OF DUKE'S CHARITY CARE AND DISCOUNTED CARE POLICIES * DUKE PROVIDES A DISCOUNT TO UNINSURED PATIENTS OF LIMITED MEANS FOR SUBSTANTIALLY ALL MEDICAL SERVICES EXCEPT COSMETIC PROCEDURES. * DUKE ASSISTS PATIENTS WHOSE MEDICAL HARDSHIP MAKES IT DIFFICULT FOR THEM TO PAY BASIC LIVING EXPENSES. * DUKE HELPS PATIENTS NAVIGATE THROUGH ADDITIONAL FINANCIAL PROGRAMS FOR WHICH THEY MAY QUALIFY. DUKE'S COMPLETE CHARITY CARE AND UNINSURED DISCOUNTED CARE POLICIES ARE AVAILABLE AT WWW.DUKEMEDICINE.ORG. CLICK ON "PATIENTS & VISITORS," THEN "FINANCIAL ASSISTANCE." COSTS DUKE COVERS FOR CHARITY CARE AND OTHER UNREIMBURSED EXPENSES: $92.7 MILLION CHARITY CARE $90.1 MILLION UNREIMBURSED MEDICAID $172.8 MILLION UNREIMBURSED MEDICARE $21.7 MILLION UNRECOVERABLE PATIENT DEBT DUKE WORKS WITH ITS COMMUNITY PARTNERS TO PROMOTE WELLNESS, CARE ACCESS: DUKE UNIVERSITY HEALTH SYSTEM REMAINS FIRMLY COMMITTED TO WORKING COLLABORATIVELY WITH ITS MANY COMMUNITY PARTNERS TO IDENTIFY, UNDERSTAND, AND ADDRESS THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES. THROUGH ITS TWO HOSPITALS IN DURHAM AND ONE IN RALEIGH, DUKE WORKS WITH THE HEALTH DEPARTMENTS IN DURHAM AND WAKE COUNTIES, COMMUNITY MEMBERS, AND NUMEROUS COMMUNITY PARTNER ORGANIZATIONS TO CONDUCT REGULAR COMMUNITY HEALTH NEEDS ASSESSMENTS. IN COMPLIANCE WITH FEDERAL REQUIREMENTS, LINKS TO THE COMMUNITY HEALTH NEEDS ASSESSMENTS FOR DURHAM AND WAKE COUNTIES, AND TO EACH OF THE DUKE HOSPITALS' REPORTS, ARE POSTED ON HTTP://DUKEMEDICINE.ORG/ABOUTUS. CLICK ON "COMMUNITY HEALTH NEEDS ASSESSMENT." CONTRIBUTIONS TO COMMUNITY GROUPS: OVER MANY YEARS, DUKE AND COMMUNITY ORGANIZATIONS HAVE DEVELOPED PRODUCTIVE PARTNERSHIPS TO WORK TOWARD THE COMMON GOAL OF ELIMINATING HEALTHCARE DISPARITIES AND IMPROVING RESIDENTS' ACCESS TO HIGH-QUALITY MEDICAL CARE. IN THE 2014 FISCAL YEAR, DUKE PROVIDED A TOTAL OF $10.7 MILLION IN CASH AND IN-KIND SUPPORT FOR COMMUNITY GROUPS. THAT INCLUDES MORE THAN $7.3 MILLION FOR LINCOLN COMMUNITY HEALTH CENTER IN DURHAM AND ITS SATELLITE COMMUNITY CLINICS, WHICH SERVE AN OVERWHELMINGLY POOR AND UNINSURED POPULATION; NEARLY $2.35 MILLION FOR DURHAM COUNTY'S EMERGENCY MEDICAL SERVICES OPERATION; AND MORE THAN $1 MILLION IN CASH CONTRIBUTIONS TO OTHER ORGANIZATIONS. HEALTH PROFESSIONS EDUCATION: EDUCATING THE NEXT GENERATION OF HEALTHCARE PROFESSIONALS IS AT THE HEART OF DUKE'S MISSION TO IMPROVE HEALTHCARE FOR OUR PATIENTS AND THE COMMUNITY. DUKE REMAINS COMMITTED TO OFFERING CHALLENGING, INNOVATIVE PROGRAMS THAT PREPARE MEDICAL STUDENTS, NURSES, NURSE PRACTITIONERS, PHYSICIAN ASSISTANTS, AND PHYSICAL THERAPISTS FOR TOMORROW'S INCREASINGLY COMMUNITY-FOCUSED HEALTHCARE DELIVERY SYSTEM. THE TRAINING RECOGNIZES THAT HEALTHCARE PROFESSIONALS WILL PROVIDE PATIENT CARE IN AN EMERGING VARIETY OF NON-TRADITIONAL SETTINGS USING INNOVATIVE MODELS OF CARE THAT PROMOTE HEALTH, WELLNESS, AND INDIVIDUAL SELF-CARE. IN ADDITION TO THE IMPORTANT EXPERIENCE THAT DUKE HEALTH PROFESSIONS STUDENTS GAIN IN ITS THREE HOSPITALS, DUKE EMPHASIZES THE VALUE OF COMMUNITY OUTREACH BY REQUIRING THAT THE STUDENTS PARTICIPATE IN ROTATIONS IN COMMUNITY CLINICS, SCHOOL WELLNESS CENTERS, AND IN-HOME CARE PROGRAMS FOR ELDERLY OR HOME-BOUND PEOPLE. IN THE 2014 FISCAL YEAR, DUKE INVESTED $59.8 MILLION IN ITS HEALTH PROFESSIONS EDUCATION PROGRAMS.
FORM 990, PART V, LINE 3B THE ORGANIZATION DID NOT HAVE ANY UNRELATED BUSINESS GROSS INCOME DURING THE FISCAL YEAR ENDED JUNE 30, 2014. AS A RESULT, FORM 990-T IS NOT REQUIRED FOR THE FISCAL YEAR ENDED JUNE 30, 2014.
FORM 990, PART VI, SECTION A, LINE 2 DIRECTORS JACK O. BOVENDER, JR., RICHARD H. BRODHEAD, THOMAS M. GORRIE, WILLIAM HAWKINS, MICHAEL MARSICANO, DAVID M. RUBENSTEIN, AND SUSAN M. STALNECKER ARE TRUSTEES OF DUKE UNIVERSITY. DIRECTOR AND PRESIDENT/CEO VICTOR J. DZAU, MD IS AN OFFICER OF DUKE UNIVERSITY. THE FOLLOWING INDIVIDUALS ARE EMPLOYEES OF DUKE UNIVERSITY: NANCY CATHERINE ANDREWS, MD, MARY E. KLOTMAN, MD, THEODORE NICK 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, MD AND KENNETH C. MORRIS ARE DIRECTORS OF DURHAM CASUALTY COMPANY, LTD. DIRECTOR AND PRESIDENT/CEO VICTOR J. DZAU, MD, DIRECTORS CARL E. RAVIN, MD, MARY E. KLOTMAN, MD, THEODORE NICK PAPPAS, MD, AND OFFICER WILLIAM J. FULKERSON, MD ARE BOARD MEMBERS OF PRIVATE DIAGNOSTIC CLINIC, PLLC. DIRECTOR AND PRESIDENT/CEO VICTOR J. DZAU, MD AND OFFICER KENNETH C. MORRIS ARE DIRECTORS OF DUKE MEDICAL STRATEGIES, INC. 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 3 DUHS DELEGATES CONTROL TO A SUPPORTING ORGANIZATION FOR THE MANAGEMENT OF INVESTMENTS.
FORM 990, PART VI, SECTION A, LINE 4 DUHS AND ITS BOARD OF DIRECTORS HAVE REVISED AND APPROVED THE AMENDMENT OF DUKE UNIVERSITY HEALTH SYSTEM, INC. ARTICLES OF INCORPORATION AND ITS BYLAWS. SIGNIFICANT CHANGES ARE SUMMARIZED AS FOLLOWS: THE AMENDED AND RESTATED DUHS ARTICLES OF INCORPORATION AND BYLAWS INCREASED THE NUMBER OF BOARD MEMBERS FROM TWENTY ONE (21) TO TWENTY TWO (22). THE AFFAIRS OF DUHS SHALL BE MANAGED BY A BOARD OF DIRECTORS CONSISTING OF AT LEAST THIRTEEN (13), BUT NO MORE THAN TWENTY TWO (22) VOTING MEMBERS. THE AMENDED AND RESTATED DUHS ARTICLES OF INCORPORATION AND BYLAWS STATE A MINIMUM OF EIGHT (8) MEMBERS OF THE BOARD OF DIRECTORS SHALL BE CURRENT OR FORMER DUKE UNIVERSITY TRUSTEES.
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 EMAILED TO THE BOARD OF DIRECTORS FOR FURTHER REVIEW AND COMMENT BEFORE FILING.
FORM 990, PART VI, SECTION B, LINE 12C DUHS MONITORS AND ENFORCES COMPLIANCE RELATED TO CONFLICT OF INTEREST VIA AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE, 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 18 DUKE UNIVERSITY HEALTH SYSTEM, INC.'S FORM 990 IS AVAILABLE TO THE PUBLIC ON WWW.GUIDESTAR.ORG. GUIDESTAR INDEPENDENTLY POSTS TAX-EXEMPT ORGANIZATIONS' FORM 990'S ON THEIR WEBSITE, OBTAINED FROM THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION C, LINE 19 DUKE UNIVERSITY HEALTH SYSTEM, INC.'S GOVERNING DOCUMENTS (ARTICLES OF INCORPORATION AND ANY SUBSEQUENT AMENDMENTS OR RESTATEMENTS) ARE AVAILABLE TO THE PUBLIC ON THE NORTH CAROLINA SECRETARY OF STATE WEBSITE. DUKE UNIVERSITY HEALTH SYSTEM, INC. MAKES ITS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. 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 SEARCH BOX, CHOOSE ANY "ISSUE DESCRIPTION" WITH A "DATED DATE", ACCEPT THE TERMS OF THE WEBSITE, AND CLICK ON "CONTINUING DISCLOSURE".
FORM 990, PART XI, LINE 9: NONPERIODIC CHANGES IN DEFINED BENEFIT PLANS: -2,249,618. NET TRANSFERS TO PARENT & AFFILIATES: -75,213,302. CHANGE IN MARKET VALUE OF DERIVATIVES: 3,436,805. INTEREST EARNED ON BOND PROCEEDS - CAPITALIZED FOR BOOK PURPOSES: -613. INCOME NOT REPORTED ON BOOKS, BUT INCLUDED FOR 990 REPORTING PURPOSES: DEEMED DIVIDEND: -7,646,449.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

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" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2013
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 (if applicable) 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
 MEDICAL BILLING NC 133,655,403 5,683,288 DUKE UNIVERSITY HEALTH SYSTEM INC
 
(2) DUHS GLOBAL LLC
310 BLACKWELL STREET 4TH FLOOR BOX
DURHAM,NC27710
 SUPPORT NC 0 0 DUKE UNIVERSITY HEALTH SYSTEM INC
 
(3) HSPPMCO LLC
280 S MANGUM STREET STE 210
DURHAM,NC27701
 INVESTMENTS NC 5,035,257 125,249,714 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 entity?
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-O N/A
 
No
(9) DUKE INTEGRATED NETWORK INC

615 DOUGLAS STREET SUITE 700

DURHAM,NC27705
46-3129771 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY HEALTH SYSTEM INC
 
Yes
 
(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 QUALITY NETWORK INC

615 DOUGLAS STREET SUITE 700

DURHAM,NC27705
46-1340679 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY HEALTH SYSTEM INC
 
Yes
 
(12) DUKE SCHOLARLY EXHIBITS INC

324 BLACKWELL STREET STE 850

DURHAM,NC27701
56-1701245 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(13) 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
 
(14) DUKE UNIV PHILANTHROPIES INC

324 BLACKWELL STREET STE 850

DURHAM,NC27701
57-1211099 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(15) 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
(16) DUKE UNIVERSITY

324 BLACKWELL STREET STE 850

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

280 S MANGUM STREET STE 210

DURHAM,NC27701
90-0754895 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(18) 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
(19) DURHAM REALTY INC

324 BLACKWELL STREET STE 850

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

280 S MANGUM STREET STE 210

DURHAM,NC27701
56-1776668 		INVESTMENTS NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(21) 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
 
(22) 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
(23) IPIHD INC

324 BLACKWELL STREET STE 850

DURHAM,NC27701
32-0358709 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(24) 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
(25) THE CTR FOR DOCUMENTARY STUDIES

1317 PETTIGREW STREET

DURHAM,NC27705
56-1655039 		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
(27) DUKE JANJUN SERVICES INC

324 BLACKWELL STREET STE 850

DURHAM,NC27701
47-1150667 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(28) DUKE JULDEC SERVICES INC

324 BLACKWELL STREET STE 850

DURHAM,NC27701
47-1143245 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(29) DUKE ALLMO SERVICES INC

324 BLACKWELL STREET STE 850

DURHAM,NC27701
47-1133466 		SUPPORT NC 501(C)(3) 11 TYPE 1 DUKE UNIVERSITY
 
 
No
(30) DUKE UNIVERSITY FEDERAL CREDIT UNION

2200 WEST MAIN ST STE L100

DURHAM,NC27705
56-1632379 		BANKING NC 501(C)(1)   DUKE UNIVERSITY HEALTH SYSTEM INC
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
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) LIQUID REALTY PTR 05-0537755

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

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

32 N DEAN ST
ENGLEWOOD,NJ07631
 INVESTMENTS DE N/A
 N/A       No     No  
(8) MANGUM LLC - 46-1275587

280 S MANGUM STREET STE 210
DURHAM,NC27701
 INVESTMENTS DE N/A
 N/A       No     No  
(9) OCTAVIAN BLUE FD 27-2408711

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

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

5300 CARILLON POINT
KIRKLAND,WA98033
 INVESTMENTS DE N/A
 N/A       No     No  
(12) TVV CAPITAL III-A 90-0909850

4TH AVE
NASHVILLE,TN37219
 INVESTMENTS DE N/A
 N/A       No     No  
(13) MANGUM II LLC - 46-5135858

280 S MANGUM STREET STE 210
DURHAM,NC27701
 INVESTMENTS NC 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
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) COLCHESTER ALPHA FUND (BERMUDA) LTD

59-62 TOWNSEND ST 2
DUBLIN    
EI
INVESTMENTS BD N/A
 C         No
(2) COLCHESTER BETA THREE FUND LTD

CENTURY HOUSE 16 PAR-LA VILLE RD
HAMILTON   HM HX
BD
INVESTMENTS BD N/A
 C         No
(3) DUKE CE LS INC

310 BLACKWELL STREET
DURHAM,NC27701
20-2004016 		REAL ESTATE NC N/A
 C         No
(4) DUKE CE (SEA) PRIVATE LIMITED

1 RAFFLES PLACE TOWER 2
SINGAPORE   048616
SN
SUPPORT SN N/A
 C         No
(5) DUKE CORP EDU INDIA PRIVATE

ACADEMIC BLOCK NEW CAMPUS
VASTRAPUR,AHMEDABAD380015
IN
42-1672476 		CONSULTING IN N/A
 C         No
(6) DUKE CORPORATE EDUCATION LIM

165 FLEET STREET
LONDON   EC4A 2DY
UK
42-1672476 		EDUCATION CONSULTING UK N/A
 C         No
(7) DUKE CORPORATE EDUCATION RSA

GROUND FLOOR TWICKEHNHAM BLDG
BRYANSTON,JOHANNESBURG02021
SF
42-1672476 		CONSULTING SF N/A
 C         No
(8) DUKE GLOBAL CONSULTING (KUNSHAN)

1666 WEI CHEN NAN RD
KUNSHAN PR,KUNSHAN215300
CH
CONSULTING CH N/A
 C         No
(9) DUKE MEDICAL STRATEGIES INC

2200 WEST MAIN STREET STE 920
DURHAM,NC27705
56-1993799 		HEALTHCARE NC N/A
 C         No
(10) DUKE MEDICINE ASIA PTE LTD

5 SHENTON WAY 07-00 UIC BLD
SING   0688
SN
MEDICAL RESEARCH SN N/A
 C         No
(11) DUKE UNIV QUADRANGLE FUND

PO BOX 185
PITTSBURGH,PA152300185
56-6218971 		INVESTMENTS PA N/A
 T         No
(12) DUKE UNIVERSITY TOWER FUND

PO BOX 185
PITTSBURGH,PA152300185
56-6147362 		INVESTMENTS PA N/A
 T         No
(13) DURHAM CASUALTY COMPANY LTD

AON HOUSE 30 WOODBOURNE AVE
PEMBROKE   HM 08
BD
98-0113277 		INSURANCE BD DUHS INC
  		C 35,049,541 197,259,834 100.000 % Yes  
(14) DUSVF EUROPEAN LP

7 CAVENDISH SQUARE
LONDON   W1G 0PE
UK
98-0346042 		INVESTMENTS UK N/A
 C         No
(15) GOTHIC INTERNATIONAL LTD

113 S CHURCH STREET QUEENSGATE HOU
GRAND CAYMAN   KY1-1108
CJ
INVESTMENTS CJ N/A
 C         No
(16) HEALTH SYSTEM MEDICAL STRATEGIES INC

615 DOUGLAS STREET SUITE 700
DURHAM,NC27705
56-2222444 		HEALTH CARE NC DUHS INC
  		C 182,434 95,004 100.000 % Yes  
(17) JOHN & PATRICIA KOSKINEN CLUT

PO BOX 185
PITTSBURGH,PA152300185
56-6532340 		INVESTMENTS PA N/A
 T         No
(18) MARATHON BLUE CAYMAN FUND

89 NEXUS WAY PO BOX 31106
GRAND CAYMAN   KY1-1205
CJ
INVESTMENTS CJ N/A
 C         No
(19) GHI HOLDINGS MAURITIUS

9TH FL ORANGE TOWER CYBERCITY
EBENE    
MP
INVESTMENTS MP N/A
 C         No
(20) GHI ERP LTD

9TH FL ORANGE TOWER CYBERCITY
EBENE    
MP
INVESTMENTS MP N/A
 C         No
(21) GHI HSP LTD

9TH FL ORANGE TOWER CYBERCITY
EBENE    
MP
INVESTMENTS MP N/A
 C         No
(22) GHI JBD LTD

9TH FL ORANGE TOWER CYBERCITY
EBENE    
MP
INVESTMENTS MP N/A
 C         No
(23) GHI LTP LTD

9TH FL ORANGE TOWER CYBERCITY
EBENE    
MP
INVESTMENTS MP N/A
 C         No
(24) QUORUM FUND LIMITED

PO BOX 1043 GEORGE TOWN
GRAND CAYMAN   KY1-1102
CJ
INVESTMENTS CJ N/A
 C         No
(25) MCP PRIVATE CAPITAL (FEEDER) FUND I LP

6 RUE GABRIEL LIPPMAN
LUXEMBOURG   L-5365
LU
INVESTMENTS LU N/A
 C         No
(26) DUKE INDIA SERVICES PRIVATE LIMITED

302 PRIDE ELITE 10 MUSEUM ROAD
BANGALORE,KARNATAKA560001
IN
MEDICAL RESEARCH IN N/A
 C         No
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
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 or (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 Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
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 related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) DUKE UNIVERSITY AFFILIATED PHYSICIANS INC

 R 8,107,993 FMV
(2) DUKE UNIVERSITY AFFILIATED PHYSICIANS INC

 S 536,244 FMV
(3) ASSOCIATED HEALTH SERVICES INC

 S 1,988,797 FMV
(4) ASSOCIATED HEALTH SERVICES INC

 O 4,503,276 FMV
(5) DURHAM CASUALTY COMPANYINC

 R 12,413,021 FMV
(6) DURHAM CASUALTY COMPANYINC

 S 7,101,737 FMV
(7) GOTHIC HSP CORPORATION

 B 136,346,441 FMV
(8) GOTHIC HSP CORPORATION

 C 164,016,344 FMV
(9) HEALTH SYSTEM MEDICAL STRATEGIES INC

 R 113,909 FMV
(10) DUKE INTEGRATED NETWORK INC

 R 483,203 FMV
(11) DUKE INTEGRATED NETWORK INC

 O 379,636 FMV
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
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) 2013
Schedule R (Form 990) 2013
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2013
Additional Data


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