Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions. 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
WakeMed
Employer identification number
56-6017737
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the 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)
(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)
(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
Gross receipts from related activities, etc. (see instructions)
..................
12
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.................................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2013.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2012.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2013.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 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)
(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)
(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
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2012.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 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:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
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
WakeMed
Employer identification number
56-6017737
Return Reference
Explanation
DBA'S FOR WAKEMED
FORM 990, HEADER C, DBA 1 Wake Medical Center 2 Western Wake Hospital 3 Northern Wake Hospital 4 Wake Heart Center 5 Western Wake Medical Center 6 Wake Rehabilitation Hospital 7 Wake Area Health Education Center 8 Wake AHEC 9 Eastern Wake Day Hospital and Skilled Nursing Facility 10 WakeMed Home Care 11 WakeMed - New Bern Avenue Campus 12 WakeMed - Western Wake Medical Center 13 WakeMed - Rehab 14 WakeMed - Fuquay-Varina 15 WakeMed - Zebulon-Wendell 16 WakeMed Raleigh Campus 17 WakeMed Cary Hospital 18 WakeMed North Healthplex 19 WakeMed Clayton Medical Park 20 WakeMed Cary Outpatient Rehab Center 21 WakeMed Fuquay-Varina Outpatient & Skilled Nursing Facility 22 WakeMed Zebulon/Wendell Outpatient & Skilled Nursing Facility 23 WakeMed Wake Forest Road Outpatient Rehab Center 24 WakeMed Home Health 25 WakeMed Health & Hospitals 26 WakeMed Emergency Services Institute 27 WakeMed Center for Patient Safety 28 WakeMed Apex Healthplex 29 WakeMed Apex Day Surgery Center, LLC 30 WakeMed Professional Staff 31 WakeMed Mobile Critical Care Services 32 WakeMed Center for Innovative Learning 33 WakeMed Brier Creek Healthplex 34 WakeMed Outpatient Pharmacy 35 WakeMed Garner Healthplex 36 WakeMed Zebulon/Wendell Outpatient Rehabilitation 39 WakeMed Brier Creek Medical Park 40 WakeMed Raleigh Medical Park 41 WakeMed OP Rehab - Banks D Kerr Family YMCA Raleigh, NC 42 WakeMed OP Rehab - Cary Family YMCA Cary, NC 43 WakeMed OP Rehab - Kraft Family YMCA Apex, NC 44 WakeMed OP Rehab - Alexander Family YMCA Raleigh, NC 45 Wake Specialty Brier Creek Internal Medicine 46 Wake Specialty ENT - Head & Neck Surgery 47 Wake Specialty Facial Plastics 48 Wake Specialty Gastroenterology & Hepatology 49 Wake Specialty General Surgery 50 Wake Specialty OB/GYN 51 Wake Specialty Physicians ENT - Head & Neck Surgery 52 Wake Specialty Physicians Facial Plastics 53 Wake Specialty Physicians Gastroenterology & Hepatology 54 Wake Specialty Physicians General Surgery 55 Wake Specialty Physicians Internal Medicine Brier Creek 56 Wake Specialty Physicians OB/GYN 57 Wake Specialty Physicians Urology 58 Wake Specialty Physicians Women's Center 59 Wake Specialty Urology 60 Wake Specialty Women's Center 61 Wake Specialty Physicians Maternal Fetal Medicine 62 Wake Specialty Physicians Employee Health 63 Falls Pointe Medical Group 64 Wake Specialty Physicians - City Center Medical Group 65 Wake Specialty Physicians - Carolina Cardiology 66 Wake Specialty Physicians - Concussion Clinic 67 Wake Specialty Physicians - Apex Medical Group 68 Wake Specialty Physicians - Holly Springs Medical Group 69 Wake Specialty Physicians - Accent Urgent Care 70 Wake Specialty Physicians - Wake Orthopaedics 71 Wake Specialty Physicians - North Wake Internal Medicine 72 Wake Specialty Physicians Pulmonology 73 Wake Specialty Physicians - Knightdale Family Practice 74 Wake Specialty Physicians - Carolina Cardiovascular Surgical Associates 75 Wake Specialty Physicians - Cary Cardiology 76 Wake Specialty Physicians - Capital Urology 77 Wake Specialty Physicians - Harnett Surgical Associates 78 Wake Specialty Physicians - Morrisville Primary Care 79 Wake Specialty Physicians - Garner Primary Care 80 Wake Specialty Physicians - Fuquay Varina Primary Care 81 Wake Specialty Physicians - Wellness Family Practice 82 Wake Specialty Physicians - Structural Heart 83 Wake Specialty Physicians - Raleigh Cardiology 84 Wake Specialty Physicians - Raleigh Cardiology Associates 85 Wake Specialty Physicians - Cardiovascular 86 Wake Specialty Physicians - Parkway Primary Care
OTHER PROGRAM SERVICES
FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICES INCLUDE HOSPITAL IN AND OUTPATIENT ANCILLARY CARE SERVICES IN OTHER SPECIALTY AREAS NOT LISTED ABOVE.
MEMBERS, STOCKHOLDERS, OR OTHER PERSONS W/ POWER TO APPOINT GOVERNING BODY
FORM 990, PART VI, SECTION A, LINE 7A EIGHT MEMBERS OF THE BOARD ARE APPOINTED TO THE BOARD OF DIRECTORS BY WAKE COUNTY.
GOVERNANCE DECISIONS RESERVED TO MEMBERS, STOCKHOLDERS, OR PERSONS OTHER
THAN THE GOVERNING BODY FORM 990, PART VI, SECTION A, LINE 7B THE WAKE COUNTY BOARD OF COMMISSIONERS HOLDS LIMITED APPROVAL OVER SOME GOVERNING BODY DECISIONS PERTAINING TO ARTICLES V, VI, VII AND IX IN THE ARTICLES OF INCORPORATION. THE TRANSFER AGREEMENT WITH WAKE COUNTY INDICATES APPROVAL/CONSENT FOR TRANSACTIONS PERTAINING TO SUBSTANTIAL DISPOSITION OF ASSETS AND COVENANTS ON LIENS.
PROCESS USED BY THE ORGANIZATION TO REVIEW FORM 990
FORM 990, PART VI, SECTION B, LINE 11B THE ENTIRE 990 AND ASSOCIATED SCHEDULES ARE REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS TO ACKNOWLEDGE THEY HAVE REVIEWED FORMS AND SCHEDULES AND THEN RECOMMEND APPROVAL TO THE BOARD. A FINAL COPY IS PROVIDED TO THE BOARD BEFORE FILING.
MONITORING WRITTEN CONFLICT OF INTEREST POLICY
FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES THE CONFLICT OF INTEREST POLICY IN VARIOUS WAYS. EACH YEAR, MEMBERS OF THE BOARD, COMMITTEES WITH BOARD DELEGATED POWERS, CEO, CORPORATE STAFF, EXECUTIVE STAFF, DIRECTORS AND MANAGERS ARE REQUIRED TO COMPLETE AND SUBMIT A CONFLICT OF INTEREST QUESTIONNAIRE. THOSE INDIVIDUALS ARE REQUIRED TO PROVIDE WRITTEN DOCUMENTATION OF ANY POTENTIAL CONFLICT OF INTEREST, IDENTIFYING MATERIAL FINANCIAL INTEREST/PERSONAL CONFLICTS OF INTEREST. REMEDIAL MEASURES IMPLEMENTED TO ADDRESS CONFLICTS OF INTEREST INCLUDE ABSTENTION FROM VOTING ON CERTAIN ISSUES AS WELL AS RECUSAL FROM THE DECISION MAKING PROCESS AND PARTICIPATION INVOLVING THE IDENTIFIED ISSUE/AREA. THE CODE OF CONDUCT PROVIDES GUIDANCE ON GIFTS AND TRAVEL. GIFTS SHOULD NOT BE ACCEPTED AND PRIOR TO ANY TRAVEL/LODGING THAT IS PAID FOR BY A THIRD PARTY WRITTEN APPROVAL MUST BE OBTAINED FROM AN EXECUTIVE VICE PRESIDENT. ALSO, EMPLOYEES WHO OWN OR WORK IN A PRIVATE BUSINESS OUTSIDE OF WAKEMED ARE NOT ALLOWED TO RECRUIT OR PROMOTE THEIR PRODUCTS AND SERVICES DURING WORK HOURS OR THROUGH WAKEMED PRINTED MATERIALS.
PROCESS FOR DETERMINING COMPENSATION OF CEO, EXEC. DIR., OR TOP MGMT
OFFICIAL FORM 990, PART VI, SECTION B, LINES 15A & 15B REVIEW OF COMPENSATION IS PERFORMED BY AN INDEPENDENT FIRM. EVERY THREE YEARS THEY PERFORM AN EXECUTIVE COMPETITIVE COMPENSATION REVIEW. ON ALTERNATE YEARS THE SVP/HR PRESENTS MARKET DATA COMPARISONS TO A BOARD OF DIRECTOR'S COMMITTEE FOR REVIEW.
AVAILABILITY OF FINANCIAL STMTS, CONFLICT OF INTEREST, ORGANIZING DOCS
FORM 990, PART VI, SECTION C, LINE 19 THE 990 IS AVAILABLE BY REQUEST AND IS PUBLISHED ON GUIDESTAR. FINANCIAL STATEMENTS ARE PUBLICALLY AVAILABLE THROUGH THE MEDICAL CARE COMMISSION AS IT RELATES TO TAX EXEMPT DEBT. THE ANNUAL AUDITED FINANCIAL STATEMENTS AND TRANSFER AGREEMENT ARE PROVIDED EACH YEAR TO WAKE COUNTY COMMISSIONERS AND BECOME PUBLIC INFORMATION. ARTICLES OF INCORPORATION ARE AVAILABLE ON NC SECRETARY OF STATE WEBSITE.
OTHER CHANGES IN NET ASSETS
FORM 990, PART XI, LINE 9 CHANGES IN NET ASSETS DURING THE YEAR INCLUDED CAPITAL ASSET RENOVATIONS TO THE NEONATAL ICU, THE EXPANSION OF THE NORTH HEALTHPLEX, CENTRAL PLANT IMPROVEMENTS, AND THE PURCHASE AND IMPLEMENTATION OF EPIC SYSTEMS. - $27,028,703.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.