TY 2015 Form 990

(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)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) CATHARINE B ARROWOOD...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(2) TERESA C ARTIS...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(3) ANN S COLLINS MD...................................................................... DIRECTOR (AS OF 5/1/16)	1.00 ................. 1.00	X		0	0	0
(4) COURTNEY A CROWDER...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(5) PETER D HANS...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(6) VINCENT D HOELLERICH MD...................................................................... DIRECTOR (LEFT 12/31/15)	1.00 ................. 1.00	X		0	0	0
(7) STEVEN C LILLY...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(8) C HOWARD NYE...................................................................... DIRECTOR/VICE CHAIRMAN	2.00 ................. 2.00	X		0	0	0
(9) BOBBY T PARKER...................................................................... DIRECTOR (AS OF 5/1/16)	1.00 ................. 1.00	X		0	0	0
(10) RIG S PATEL MD...................................................................... DIRECTOR	1.00 ................. 1.00	X		63,450	0	0
(11) WILLIAM L ROPER...................................................................... DIRECTOR	1.00 ................. 59.00	X		0	944,620	334,530
(12) ROBERT S THOMAS...................................................................... DIRECTOR/CHAIRMAN	2.00 ................. 2.00	X		0	0	0
(13) GARY L PARK...................................................................... CEO	1.00 ................. 59.00	X	X	0	935,313	515,089
(14) STEPHEN W BURRISS...................................................................... PRESIDENT	59.00 ................. 1.00	X	X	530,972	0	120,830
(15) SUSAN M SANDBERG...................................................................... COO (AS OF 2/1/16)	59.00 ................. 1.00		X	0	0	0
(16) BERNADETTE M SPONG...................................................................... SVP/FINANCE & CFO (LEFT 7/31/15)	59.00 ................. 1.00		X	298,377	0	45,485
(17) LINDA H BUTLER MD...................................................................... VP/MEDICAL AFFAIRS, CMO & CMIO	59.00 ................. 1.00		X	364,693	0	50,759

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(18) JAYNE R BYRD........................................................................ VP/SURGICAL SERVICES	59.00 .......................1.00	X			246,552	0	108,550
(19) DONALD R ESPOSITO JR........................................................................ VP/GENERAL COUNSEL	59.00 .......................1.00	X			358,292	0	29,538
(20) MICHELLE L GRAY........................................................................ VP & REGIONAL CIO (LEFT 10/31/15)	59.00 .......................1.00	X			252,477	0	20,028
(21) SYLVIA D HACKETT........................................................................ VP/REX HEALTHCARE FOUNDATION	59.00 .......................1.00	X			338,014	0	39,814
(22) R ERICK HAWKINS LEFT 121815........................................................................ VP/H&V SERVICES, CFO & TREASURER	59.00 .......................1.00	X			350,297	0	25,120
(23) CHAD T LEFTERIS........................................................................ VP/OPERATIONS	59.00 .......................1.00	X			267,824	0	16,776
(24) JOEL D RAY........................................................................ VP/PATIENT CARE SVCS & CNO	59.00 .......................1.00	X			269,783	0	7,571
(25) ROBERT D RICKER........................................................................ VP/PHYSICIAN SERVICES	59.00 .......................1.00	X			285,718	0	50,941
(26) KIRSTEN RIGGS........................................................................ VP (AS OF 3/15/16)	59.00 .......................1.00	X			180,007	0	27,827
(27) LISA R SCHILLER........................................................................ VP/MKTG, PR, COMM & GOVT AFFAIRS	59.00 .......................1.00	X			257,092	0	30,645
(28) TAMMIE T STANTON........................................................................ VP/POST ACUTE SERVICES	59.00 .......................1.00	X			0	305,439	85,066
(29) SEAN T TEHRANI MD........................................................................ VP/REGIONAL HOSPITALISTS SERVICES	59.00 .......................1.00	X			639,916	0	28,220
(30) TOM G WILLIAMS........................................................................ VP/AMBULATORY SERVICES	59.00 .......................1.00	X			255,215	0	32,514
(31) JOHN E MILLER LEFT 32516........................................................................ ASST TREASURER & ASST SEC	59.00 .......................1.00	X			0	255,878	49,114
(32) ERIC JANIS........................................................................ PHYSICIAN	0.00 .......................60.00		X		1,541,045	0	47,302
(33) RAVISH SACHAR........................................................................ PHYSICIAN	0.00 .......................60.00		X		1,535,880	0	48,451
(34) MATTHEW HOOK........................................................................ PHYSICIAN	0.00 .......................60.00		X		1,510,728	0	50,481
(35) MATEEN AKHTAR........................................................................ PHYSICIAN	0.00 .......................60.00		X		1,365,455	0	50,481
(36) JOEL SCHNEIDER........................................................................ PHYSICIAN	0.00 .......................60.00		X		1,346,026	0	47,117
(37) DAVID W STRONG........................................................................ FORMER PRESIDENT (LEFT 3/31/15)	0.00 .......................0.00			X	1,226,662	0	16,758

(A) Name and business address	(B) Description of services	(C) Compensation
SKANSKA USA BUILDING INC 4309 EMPEROR BLVD STE 200 DURHAM,NC27703	CONSTRUCTION	76,284,859
WEATHERSPOON AND VOLTZ LLP 3605 GLENWOOD AVE SUITE 480 RALEIGH,NC27612	ATTORNEYS	4,269,788
CORE BUILDING COMPANY INC 3709 AUBURN CHURCH RD GARNER,NC27529	CONSTRUCTION	2,442,795
MAYO MEDICAL LABORATORIES 200 SW 1ST STREET ROCHESTER,MN55095	LAB SERVICES	2,416,768
WHR ARCHITECTS INC 1111 LOUISIANA 26TH FLOOR HOUSTON,TX77002	ARCHTECTURAL	2,033,659
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 78

- TIN:

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.
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Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

REX HOSPITAL INC

Employer identification number

56-1509260

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 VI.)..
11	Total support. Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. 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 ....................... right arrow

33 1/3% support test—2014. 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 ..................... right arrow

17a

10%-facts-and-circumstances test—2015. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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) 2015

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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. 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 ....... right arrow

33 1/3% support tests—2014. 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 .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Name of the organization

REX HOSPITAL INC

Employer identification number

56-1509260

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... 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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization REX HOSPITAL INC

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization REX HOSPITAL INC		Employer identification number 56-1509260

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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization REX HOSPITAL INC			Employer identification number 56-1509260
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No.from Part I

(b) Purpose 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

(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

(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

(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) (2015)

Additional Data

Software ID:
Software Version:

- TIN:

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

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

REX HOSPITAL INC

Employer identification number

56-1509260

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures ...................................................................................................................... SchCMd Bullet

Volunteer hours .............................................................................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ..............................................................................................................	Yes No

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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2012	(b) 2013	(c) 2014	(d) 2015	(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) 2015

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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

26,783

Total. Add lines 1c through 1i ....................................................................................................

26,783

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	REX HOSPITAL BELIEVES IN MAINTAINING STRONG, OPEN AND EFFECTIVE RELATIONSHIPS WITH ELECTED OFFICIALS AND POLICY MAKERS AT THE LOCAL, STATE AND NATIONAL LEVELS. THE OBJECTIVE IS TO EDUCATE THESE GROUPS ON HEALTHCARE ISSUES, TO SERVE AS A RESOURCE, AND TO COMMUNICATE THE ORGANIZATION'S POSITION IN SUPPORT OF ITS MISSION. AS A MEMBER OF THE NCHA, A PERCENTAGE OF THE ORGANIZATION'S MEMBERSHIP DUES ARE ATTRIBUTED TO LOBBYING ACTIVITIES.

Return Reference

Explanation

PART II-B, LINE 1:

REX HOSPITAL BELIEVES IN MAINTAINING STRONG, OPEN AND EFFECTIVE RELATIONSHIPS WITH ELECTED OFFICIALS AND POLICY MAKERS AT THE LOCAL, STATE AND NATIONAL LEVELS. THE OBJECTIVE IS TO EDUCATE THESE GROUPS ON HEALTHCARE ISSUES, TO SERVE AS A RESOURCE, AND TO COMMUNICATE THE ORGANIZATION'S POSITION IN SUPPORT OF ITS MISSION. AS A MEMBER OF THE NCHA, A PERCENTAGE OF THE ORGANIZATION'S MEMBERSHIP DUES ARE ATTRIBUTED TO LOBBYING ACTIVITIES.

Schedule C (Form 990 or 990EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on 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.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

REX HOSPITAL INC

Employer identification number

56-1509260

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

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? ...........

Yes No

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? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

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)? .............................

Yes No

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" on Form 990, Part IV, line 8.

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.

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)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

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:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2015

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

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" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

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' on 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 ...	25,788,330		25,788,330
b	Buildings	188,079,733	107,213,980	80,865,753
c	Leasehold improvements	20,787,622	7,714,881	13,072,741
d	Equipment ...	365,895,536	316,442,135	49,453,401
e	Other ...	267,836,952	67,400,598	200,436,354
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				369,616,579

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on 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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
CAPITAL LEASE	747,827
PAYABLE TO RELATED PARTY	10,736,050
PENSION LIABILITY	114,399,630
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	125,883,507
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) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on 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 (losses) 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' on 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 IV, LINE 2B:

THE ORGANIZATION HOLDS CASH IN TRUST FOR THE RESIDENTS OF THE NURSING HOME FACILITIES.

PART X, LINE 2:

THE FOLLOWING FOOTNOTE COMES FROM THE CONSOLIDATED FINANCIAL STATEMENTS OF REX HOSPITAL, INC. D/B/A REX HEALTHCARE. THE FOOTNOTE REFERENCES OTHER MEMBERS OF THE AUDIT CONSOLIDATED GROUP THAT ARE NOT PART OF THIS TAX RETURN: REX, THE HOSPITAL, THE FOUNDATION, AND HOME SERVICES ARE EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ENTERPRISES IS A TAXABLE CORPORATION THAT PREVIOUSLY HAD NET OPERATING LOSS CARRYFORWARDS WHICH EXPIRED IN 2012. PHYSICIANS IS A SINGLE MEMBER LIMITED LIABILITY COMPANY THAT HAS ELECTED TO BE TAXED AS A FOR-PROFIT CORPORATION. PHYSICIANS HAD A NET OPERATING LOSS IN 2013 AND 2012. THE HOSPITAL IS THE SOLE MEMBER OF ROV AND RSCW, AND ENTERPRISES IS THE SOLE MEMBER OF RWE, AND RWE IS THE SOLE MEMBER OF WELLNESS, MOB AND RHVLLC. AS SUCH, THESE ENTITIES ARE CONSIDERED DISREGARDED ENTITIES FOR TAX PURPOSES.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

REX HOSPITAL INC

Employer identification number

56-1509260

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other 25000.0000000000 %

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: . . . . . . . .

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	22,322,268		22,322,268	2.380 %
b	Medicaid (from Worksheet 3, column a) . . . . .	41,142,474	36,348,563	4,793,911	0.510 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	63,464,742	36,348,563	27,116,179	2.890 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).
f	Health professions education (from Worksheet 5) . . .	949,676		949,676	0.100 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .	345,803		345,803	0.040 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	973,129		973,129	0.100 %
j	Total. Other Benefits . .	2,268,608		2,268,608	0.240 %
k	Total. Add lines 7d and 7j .	65,733,350	36,348,563	29,384,787	3.130 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

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

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

9,521,111

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. ......

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

Enter total revenue received from Medicare (including DSH and IME).....

322,897,247

Enter Medicare allowable costs of care relating to payments on line 5.....

415,007,649

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-92,110,402

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

Yes

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 %
11 REX SURGERY CENTER OF CARY LLC	AMBULATORY SURGICAL CENTER	55.000 %	0 %	45.000 %
22 ORTHOPAEDIC SURGERY CENTER OF RALEIGH LLC	SURGERY CENTER	51.000 %	0 %	49.000 %
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2015

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?1 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	REX HOSPITAL INC 4420 LAKE BOONE TRAIL RALEIGH,NC27607 WWW.REXHEALTH.COM H0065	X	X	X

Schedule H (Form 990) 2015

Page 4

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)

	REX HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

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 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE PART V

Other website (list url): SEE PART V

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE PART V

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

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)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, 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) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	REX HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

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 included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 250.000000000000% and FPG family income limit for eligibility for discounted care of %

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART V

The FAP application form was widely available on a website (list url):

SEE PART V

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

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 all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	REX HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized 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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that
can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 7

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
REX HOSPITAL, INC.	PART V, SECTION B, LINE 5: THE ORGANIZATION TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE COMMUNITY THROUGH PARTICIPATION IN BOTH A COMMUNITY WIDE HEALTH OPINION SURVEY AND FOCUS GROUPS. THE HEALTH OPINION SURVEY WAS INTERNET BASED AND TELEPHONE SURVEYS OF RANDOMLY SELECTED HOUSEHOLDS. THE NINE FOCUS GROUPS, INCLUDING TWO IN SPANISH, CONSISTED OF RECRUITED PARTICIPANTS REPRESENTING SPECIFIC GROUPS.
REX HOSPITAL, INC.	PART V, SECTION B, LINE 6A: THE ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES: WAKEMED HEALTH AND HOSPITALS AND DUKE RALEIGH HOSPITAL.
REX HOSPITAL, INC.	PART V, SECTION B, LINE 6B: THE ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: WAKE COUNTY HUMAN SERVICES, ADVANCE COMMUNITY HEALTH, UNITED WAY OF THE GREATER TRIANGLE AND WAKE COUNTY MEDICAL SOCIETY COMMUNITY HEALTH FOUNDATION.
REX HOSPITAL, INC.	PART V, SECTION B, LINE 11: THE ORGANIZATION IS ADDRESSING THE FOLLOWING TOP IDENTIFIED AREAS:HEALTH INSURANCE COVERAGE: WHILE THIS CONCERN CERTAINLY RELATES TO THOSE NOT HAVING COVERAGE AT ALL, MORE FREQUENTLY THAN EVER CONCERNS ARE BEING RAISED BY THOSE WHO HAVE INSURANCE REGARDING OTHER CRITICAL ISSUES; SUCH AS, LIMITATIONS ON WHAT INSURANCE DOES OR DOES NOT COVER, COMPLEXITY OF THE SYSTEM AND THE NEED FOR EDUCATION RELATED TO HOW INSURANCE WORKS AND HOW TO USE IT, ABILITY TO AFFORD POST-INSURANCE FINANCIAL OBLIGATIONS RELATED TO VISITS AND PRESCRIPTIONS AND REMAINING BARRIERS TO ACCESS FOR CERTAIN INSURANCE TYPES, NAMELY MEDICARE AND MEDICAID, AS SOME PHYSICIANS AND PROVIDERS HAVE LIMITED OR SUSPENDED THEIR ACCEPTANCE OF THOSE INSURANCE TYPES. UNC REX WILL FOCUS ON EDUCATION TO INTERNAL AUDIENCES, MOST SPECIFICALLY PATIENT FINANCIAL SERVICES AND NURSE NAVIGATORS, TO ALLOW FOR EXPANDED CONVERSATIONS REGARDING HEALTH INSURANCE COVERAGE, OPTIONS, AND MEANS OF OBTAINING THEM. UNC REX WILL FORM A STRONGER PARTNERSHIP WITH ENROLL AMERICA, THE NATION'S LEADING HEALTH CARE ENROLLMENT COALITION. IN ADDITION, CHANGES TO THE UNC REX CO-WORKER BENEFITS STRUCTURE WILL INCREASE THE NUMBER OF CO-WORKERS WHO CAN AFFORD COVERAGE; THIS IS KEY AS ONE OF THE LARGEST WAKE COUNTY EMPLOYERS. UNC REX WILL EVALUATE ITS SUPPORT OF THE TRIANGLE UNITED WAY ACA PROGRAM TO FUND PREMIUMS OF THOSE WHO CANNOT AFFORD THEM AND THE EXPANSION OF THE UNC REX ANGEL FUND, WHICH SUPPORTS PATIENTS UNDERGOING CANCER TREATMENT.TRANSPORTATION: ACCESS TO AND COST OF TRANSPORTATION IS AN ISSUE THAT IMPACTS EVERY RESIDENT OF WAKE COUNTY, REGARDLESS OF THEIR BACKGROUND OR SOCIAL STATUS AND CAN HAVE MULTIPLE IMPLICATIONS ON HEALTH. UNC REX HAS INITIATED A NEW INTERNAL EFFORT TO COORDINATE APPOINTMENTS FOR PATIENTS WITH CHRONIC CONDITIONS TO REDUCE TRAVEL, WHICH WILL ASSIST IN EFFICIENCIES FOR BOTH PATIENTS AND PROVIDERS. EXPANSION OF MOBILE HEALTH OUTREACH, MAMMOGRAPHY AND HEART & VASCULAR SCREENINGS, INCLUDING POTENTIAL NEW OPTIONS TO REACH PEOPLE CLOSER TO WHERE THEY LIVE AND WORK, ESPECIALLY IN UNDERSERVED AREAS IS IN REVIEW. IN ADDITION, ADVANCEMENTS IN TELEMEDICINE ALTERNATIVES WILL REDUCE A PATIENT'S RELIANCE ON TRANSPORTATION TO RECEIVE CARE.ACCESS TO HEALTH SERVICES: FROM A HEALTH NEED PERSPECTIVE FOR WAKE COUNTY, ACCESS TO HEALTH SERVICES ENCOMPASSES THOSE AREAS OR ITEMS THAT PRESENT A BARRIER TO RESIDENTS RECEIVING THE CARE THEY NEED; AS SUCH, THIS NEED CAN BE FAIRLY BROAD. HOWEVER, THE KEY AREAS ARE SYSTEM COMPLEXITY, AFFORDABILITY, PROVIDER AVAILABILITY AND PRIMARY CARE ACCESS. FOCUSED EFFORTS ON POPULATION HEALTH WILL REDUCE COSTS AND IMPROVE MEDICAL CARE AND PREVENTION ACROSS THE COMMUNITY. UNC REX'S EDUCATION TO ADDRESS PROPER UTILIZATION OF EMERGENCY DEPARTMENTS, URGENT CARE CENTERS AND PRIMARY CARE FACILITIES IS ONGOING. FURTHER EXPANSION OF THE UNC HEALTH ALLIANCE CLINICALLY INTEGRATED NETWORK WILL ENGAGE PHYSICIANS ACROSS THE COUNTY AND BEYOND IN THE TRANSFORMATION OF PATIENT CARE. ADDING PRIMARY CARE AND SPECIALTY PROVIDERS ACROSS THE TRIANGLE AS WELL AS HEART & VASCULAR, SURGICAL AND HOSPITALIST PROGRAMS IN JOHNSTON COUNTY HAS PROVIDED RESIDENTS WITH GREATER ACCESS TO QUALITY HEALTHCARE OPTIONS. IN ADDITION, EXPANSION OF SERVICES IN HOLLY SPRINGS, INCLUDING FUTURE HOLLY SPRINGS HOSPITAL, WILL PROVIDE RESIDENTS OF SOUTHERN WAKE COUNTY GREATER ACCESS TO QUALITY HEALTHCARE AND ADDITION JOB OPPORTUNITIES. UNC REX WILL EXPLORE NEW AND INTERACTIVE WAYS TO REACH PEOPLE, THROUGH COMMUNITY OUTREACH, TELEHEALTH OR OTHER ALTERNATIVES. THE FIVE REX WELLNESS CENTERS GEOGRAPHICALLY SPREAD ACROSS THE COUNTY WILL CONTINUE TO BE AN INTEGRAL PART OF IMPROVING FITNESS AND NUTRITION, SUPPORTING COMMUNITY ACTIVITIES, PROVIDING EDUCATION AND ACCESS TO MOBILE HEART AND VASCULAR SCREENINGS. OTHER ACTIVITIES THAT UNC REX HAVE IMPLEMENTED OR ARE PURSUING INCLUDE A DEMONSTRATION KITCHEN IN THE NEW HEART & VASCULAR HOSPITAL, EXPANSION OF FREE ONLINE TOOLS FOR HEALTH ASSESSMENT AND INCREASING THE NUMBER OF NAVIGATORS TO ASSIST PATIENTS FROM POINT OF DIAGNOSIS THROUGH REFERRAL VISITS AND SURGICAL PROCEDURES WILL BE REVIEWED MAKING IT EASIER FOR PATIENTS TO NAVIGATE THE HEALTHCARE LANDSCAPE.MENTAL HEALTH AND SUBSTANCE ABUSE: PATIENTS WILL HAVE MUCH-NEEDED ACCESS TO HIGHER LEVELS OF SPECIALIZED BEHAVIORAL HEALTH AND MEDICAL CARE AT UNC WAKEBROOK, WHICH RECEIVES ANNUAL FINANCIAL SUPPORT FROM UNC REX. IN ADDITION, AT UNC REX HOSPITAL EMERGENCY DEPARTMENT (ED), A NEW BEHAVIORAL HEALTH HOLDING AREA IN IN PROCESS, WHICH WILL POSITIVELY IMPACT ACCESS TO THE ED AND ALLOW FOR PATIENTS TO BE CARED FOR IN A BETTER LOCATION. MORE TRAINING FOR CORE STAFF WITH BACKGROUNDS IN MENTAL AND BEHAVIORAL HEALTH WILL EXPAND THE CAREGIVER POOL. UNC REX WILL CONTINUE COLLABORATIONS WITH OTHER COMMUNITY PROVIDERS TO BEST MEET THE NEEDS OF THIS SPECIAL PATIENT POPULATION. EFFORTS WITH THE UNC REX PAIN MANAGEMENT DEPARTMENT AND THE COMMUNITY CARE OF NORTH CAROLINA TO EXPAND ITS COLLABORATIVE, PROACTIVE APPROACH FOR ASSISTING PATIENTS WITH CHRONIC PAIN ISSUES WILL CONTINUE TO REDUCE THE INCIDENCE OF OVERDOSE AND DEATH DUE TO SUBSTANCE ABUSE. UNC REX WILL CONTINUE THROUGH PARTNERSHIPS TO BUILD AWARENESS AROUND REDUCING THE STIGMAS SURROUNDING MENTAL HEALTH.THE ORGANIZATION DID NOT ADDRESS THE FOLLOWING FOCUS AREAS IDENTIFIED IN THE CHNA: INCOME AND POVERTY, EMPLOYMENT, HEALTH PROFESSIONALS, PHYSICAL ACTIVITY, NUTRITION AND OBESITY, HOUSING AND HOMELESSNESS, COMMUNITY ENGAGEMENT, CAREGIVING, ENVIRONMENTAL HEALTH, EDUCATION AND LIFELONG LEARNING, CHILD WELFARE AND FINANCIAL ASSISTANCE, HEALTH STATUS, INJURY AND VIOLENCE, MATERNAL AND INFANT HEALTH, ORAL HEALTH, CRIME AND SAFETY, DISABILITIES AND CULTURAL AND/OR LANGUAGE BARRIERS. AS A HEALTHCARE ORGANIZATION, UNC REX'S RESOURCES ARE MORE READILY AVAILABLE TO ADDRESS THE AREAS IDENTIFIED ABOVE.
REX HOSPITAL, INC.	PART V, SECTION B, LINE 22D: PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE RECEIVE THE BENEFIT OF 100% ADJUSTMENT OF ELIGIBLE CHARGES, INCLUDING EMERGENCY CARE, MINUS A SMALL COPAYMENT DEPENDING ON THE TYPE OF SERVICE RECEIVED. AMOUNTS GENERALLY BILLED BASED ON MANAGED CARE CONTRACTED AMOUNTS ARE USED TO DETERMINE THE UNINSURED DISCOUNT WHICH IS AUTOMATICALLY APPLIED TO ALL SELF PAY BALANCES REGARDLESS OF ELIGIBILITY FOR FINANCIAL ASSISTANCE.
PART VI LINE 2	AS THE COUNTY CONTINUES TO GROW, NECESSARY STEPS MUST BE TAKEN TO ENSURE THAT THE NEEDS OF ALL OF OUR CITIZENS ARE BEING MONITORED AND EVALUATED. WAKE COUNTY HUMAN SERVICES WORKS WITH ALL LOCAL HOSPITALS, INCLUDING UNC REX, TO CONDUCT A COMMUNITY-WIDE HEALTH ASSESSMENT. THIS ASSESSMENT, CONDUCTED EVERY THREE TO FOUR YEARS, IDENTIFIES OPPORTUNITIES AND CHALLENGES IN THE MARKET. UNC REX COLLABORATES WITH COMMUNITY PARTNERS REGULARLY TO ENSURE OUR EFFORTS ARE PROPERLY ALIGNED BASED ON WAKE COUNTY'S SOCIOECONOMIC AND DEMOGRAPHIC INFORMATION. UNC REX ALSO RELIES ON INPUT FROM OUR PHYSICIANS AND CLINICAL STAFF, PATIENT OUTCOMES AS WELL AS QUALITATIVE AND QUANTITATIVE RESEARCH TO IDENTIFY AREAS OF OPPORTUNITY TO IMPROVE THE HEALTH OF OUR COMMUNITY.
PART VI LINE 3	UNC REX PROVIDES A WIDE RANGE OF TOOLS AND EDUCATION TO HELP PATIENTS WHO NEED FINANCIAL ASSISTANCE AND THE PROGRAM IS DESIGNED TO MAKE IT EASY FOR PATIENTS TO APPLY FOR FINANCIAL ASSISTANCE, CHARITY CARE AND OTHER AID PROGRAMS. UNC REX POSTS DETAILED INFORMATION ABOUT ITS GENEROUS CHARITY CARE POLICY AND OTHER FINANCIAL AID INFORMATION AT VARIOUS POINTS IN THE HOSPITAL AND ON ITS WEBSITE. DURING PATIENT REGISTRATION, STAFF WILL DISTRIBUTE A COPY OF THE UNC HEALTHCARE FINANCIAL ASSISTANCE POLICY, WHICH INCLUDES USEFUL INFORMATION AND HELPFUL RESOURCES, TO ANYONE WHO DOES NOT HAVE INSURANCE OR ASKS FOR ASSISTANCE. UNC REX FINANCIAL COUNSELORS WILL BEGIN WORKING WITH PATIENTS NEEDING ASSISTANCE AT REGISTRATION OR VISIT THE ROOMS OF PATIENTS WHO ASK FOR HELP. THE COUNSELORS WILL ASSIST WITH DETERMINING MEDICAID ELIGIBILITY AND WITH FILLING OUT A UNC REX ASSIST APPLICATION. FINALLY, UNC REX ALSO WORKS WITH VARIOUS COMMUNITY GROUPS THAT HELP PROVIDE ASSISTANCE TO THE UNINSURED OR UNDERINSURED, INCLUDING PROJECT ACCESS, PRETTY IN PINK AND OTHERS. THE ANGEL FUND OF THE REX HEALTHCARE FOUNDATION ALSO SUPPORTS CANCER PATIENTS WITH UNIQUE FINANCIAL NEEDS, INCLUDING TRANSPORTATION, LIVING EXPENSES AND PRESCRIPTIONS.
PART VI LINE 4	THE ORGANIZATION SERVES AN AREA THAT ENCOMPASSES A FOUR-COUNTY AREA CONSISTING OF WAKE COUNTY AS THE PRIMARY SERVICE AREA WITH HARNETT, FRANKLIN AND JOHNSTON COUNTIES, COMPRISING THE SECONDARY SERVICE AREA. WAKE COUNTY AND ITS SURROUNDING COMMUNITIES ARE AMONG THE FASTEST GROWING REGIONS IN THE NATION. UNEMPLOYMENT RATES IN THE PRIMARY SERVICE AREA ARE LESS THAN THE UNEMPLOYMENT RATES FOR THE NATION AND THE STATE. AVERAGE HOUSEHOLD INCOME AND EDUCATION LEVEL ALSO COMPARE FAVORABLY WITH BOTH THE NATION AND THE STATE.
PART VI LINE 5	THERE ARE MANY WAYS UNC REX WORKS WITH COMMUNITY PARTNERS TO ADDRESS HEALTH ISSUES AND CONCERNS IDENTIFIED WITHIN THE COMMUNITY. THROUGH BOTH FINANCIAL, IN-KIND AND STAFF SUPPORT, UNC REX PROVIDES ASSISTANCE IN HOSTING COMMUNITY HEALTH SCREENINGS, MOBILE MAMMOGRAPHY SCREENINGS AND ON-SITE MEDICAL CARE THROUGH THE UNC REX EMERGENCY RESPONSE TEAM. ADDITIONALLY, COMMUNITY RELATIONS ACTIVITIES REGULARLY DEMONSTRATE PROMOTING HEALTH AND WELLNESS INITIATIVES. "ASK THE EXPERT" FORUMS ARE FREE AND OFFERED THROUGHOUT WAKE COUNTY BY PHYSICIANS AND STAFF. UNC REX HAS BEEN DILIGENT IN AWARDING GRANTS TO COMMUNITY GROUPS TO ASSIST THEM WHERE NEEDS ARE GREATEST. TWICE A YEAR WE HOST A COLLABORATIVE BREAKFAST INVITING COMMUNITY PARTNERS, ORGANIZATIONS AND HEALTHCARE PROVIDERS WHO WORK WITH UNINSURED WOMEN TO DISCUSS AND ADDRESS CURRENT HARDSHIPS AND RESOURCES - TRULY A COMMITMENT TO THE NONPROFIT COMMUNITY.
PART VI LINE 6	UNC REX HEALTHCARE IS A SUBSIDIARY OF THE UNC HEALTH CARE SYSTEM IN CHAPEL HILL. THAT SYSTEM SERVES PATIENTS FROM ALL 100 COUNTIES, REGARDLESS OF THEIR ABILITY TO PAY, PROVIDING MORE THAN $300 MILLION A YEAR IN UNCOMPENSATED CARE. AS PART OF THE INTEGRATED SYSTEM, UNC REX STRIVES TO IMPROVE ACCESS AND SERVICES IN WAKE COUNTY'S GROWING AND UNDERSERVED AREAS. UNC REX CAREGIVERS ALSO WORK CLOSELY WITH THEIR COUNTERPARTS AT UNC HEALTH CARE TO FIND MORE WAYS TO IMPROVE CARE AND QUALITY, REACH MORE UNINSURED PATIENTS AND MORE. UNC REX'S BOARD REPRESENTS A CROSS-SECTION OF THE COMMUNITY, WITH VOLUNTEERS THAT INCLUDE BUSINESS LEADERS, COMMUNITY PHYSICIANS AND OTHERS. THAT BOARD WORKS CLOSELY WITH THE BOARD AT UNC HEALTH CARE TO DETERMINE THE BEST WAYS TO PLAY A LARGER ROLE IN IMPROVING THE COMMUNITY'S HEALTH, AND UNC REX'S ROLE IN THE BIGGER SYSTEM'S MISSION.
PART VI LINE 7	THE ORGANIZATION SUBMITS AN ANNUAL COMMUNITY BENEFIT REPORT TO THE NORTH CAROLINA HOSPITAL ASSOCIATION AND THE NORTH CAROLINA MEDICAL CARE COMMISSION.
SCHEDULE H, PART V, SECTION B, LINES 7A AND 10A	WWW.REXHEALTH.COM/RH/ABOUT/COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
SCHEDULE H, PART V, SECTION B, LINE 7B	WWW.WAKEGOV.COM/HUMANSERVICES/DATA
SCHEDULE H, PART V, SECTION B, LINES 16A, 16B AND 16C	HTTP://WWW.UNCMEDICALCENTER.ORG/UNCMC/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE-PROGRAMS/

Schedule H (Form 990) 2015

Page 8

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?50
Name and address		Type of Facility (describe)
1	1 - REX HEALTHCARE OF WAKEFIELD 11200 GOVERNOR MANLY WAY RALEIGH,NC27614	HEALTHCARE
2	2 - REX HEALTHCARE OF CARY 1505 1515 SW CARY PARKWAY CARY,NC27511	HEALTHCARE
3	3 - UNC REX HEALTHCARE OF GARNER 300 HEALTH PARK DRIVE GARNER,NC27529	HEALTHCARE
4	4 - UNC REX NURSING CARE & REHABILITATION CE 4210 LAKE BOONE TRAIL RALEIGH,NC27607	NURSING FACILITY
5	5 - REX MEDICAL PLAZA 4414 LAKE BOONE TRAIL RALEIGH,NC27607	HEALTHCARE
6	6 - UNC REX NURSING CARE & REHABILITATION CE 911 S HUGHES SREET APEX,NC27502	NURSING FACILITY
7	7 - REX HEALTHCARE OF KNIGHTDALE 6602 KNIGHTDALE BOULEVARD KNIGHTDALE,NC27545	HEALTHCARE
8	8 - REX NEUROSURGERY AND SPINE SPECIALISTS ( 4207 LAKE BOONE TRAIL SUITE 220 RALEIGH,NC27607	NEUROSURGERY
9	9 - SMITHFIELD RADIATION ONCOLOGY 514 N BRIGHT LEAF BOULEVARD SUITE 1200 SMITHFIELD,NC27577	ONCOLOGY
10	10 - NORTH CAROLINA HEART AND VASCULAR (GOLDS 2615 HOSPITAL ROAD SUITE 300 GOLDSBORO,NC27534	HEART & VASCULAR
11	11 - UNC NEUROSURGERY AT NASH (ROCKY MOUNT) 45 GUARDIAN COURT ROCKY MOUNT,NC27804	NEUROSURGERY
12	12 - REX HEALTHCARE OF HOLLY SPRINGS 781 AVENT FERRY ROAD HOLLY SPRINGS,NC27540	HEALTHCARE
13	13 - UNC REX HEALTHCARE OF EAST RALEIGH 117 SUNNYBROOK ROAD RALEIGH,NC27610	HEALTHCARE
14	14 - REX WOUND HEALING CENTER - RALEIGH 2916 BLUE RIDGE ROAD RALEIGH,NC27612	WOUND CARE
15	15 - REX SURGICAL SPECIALISTS BARIATRIC SPECI 4207 LAKE BOONE TRAIL SUITE 210 RALEIGH,NC27607	BARIATRIC
16	16 - REX THORACIC SURGICAL SPECIALISTS OF CAR 150 PARKWAY OFFICE COURT SUITE 200 CARY,NC27518	THORACIC SURGERY
17	17 - REX WELLNESS CENTER OF WAKEFIELD 11200 GALLERIA AVENUE RALEIGH,NC27614	WELLNESS AND REHABILITATION
18	18 - NORTH CAROLINA HEART AND VASCULAR (CLINT 603 BEAMAN STREET SUITE 5 CLINTON,NC28328	HEART & VASCULAR
19	19 - REX BREAST CARE SPECIALISTS (CARY) 300 ASHEVILLE AVENUE SUITE 240 CARY,NC27518	BREAST CARE
20	20 - REX HEMATOLOGY ONCOLOGY ASSOCIATES - BLU 2605 BLUE RIDGE ROAD SUITE 190 RALEIGH,NC27607	ONCOLOGY
21	21 - REX WELLNESS CENTER OF RALEIGH 4200 LAKE BOONE TRAIL RALEIGH,NC27607	WELLNESS
22	22 - REX WELLNESS CENTER OF CARY 1515 SW CARY PARKWAY CARY,NC27511	WELLNESS AND REHABILITATION
23	23 - NORTH CAROLINA HEART AND VASCULAR (LOUIS 500 REDWOOD LANE LOUISBURG,NC27549	HEART & VASCULAR
24	24 - REX WELLNESS CENTER OF GARNER 1400 TIMBER DRIVE EAST GARNER,NC27529	WELLNESS AND REHABILITATION
25	25 - REX HEMATOLOGY ONCOLOGY ASSOCIATES - CAR 150 PARKWAY OFFICE COURT SUITE 200 CARY,NC27518	ONCOLOGY
26	26 - NORTH CAROLINA HEART AND VASCULAR (SMITH 910 BERKSHIRE ROAD SMITHFIELD,NC27577	HEART & VASCULAR
27	27 - JOHNSTON PROFESSIONAL PLAZA 2076 NC HIGHWAY 42W CLAYTON,NC27520	HEALTHCARE
28	28 - UNC REX REHABILITATION SERVICES - RALEIG 2709 BLUE RIDGE ROAD SUITE 200 RALEIGH,NC27607	REHABILITATION
29	29 - REX PULMONARY SPECIALISTS (CARY) 300 ASHEVILLE AVENUE SUITE 301 CARY,NC27518	PULMONARY HEALTH
30	30 - NORTH CAROLINA HEART AND VASCULAR (LILLI 701 S MAIN STREET LILLINGTON,NC27546	HEART & VASCULAR
31	31 - REX WELLNESS CENTER OF KNIGHTDALE 6602 KNIGHTDALE BOULEVARD KNIGHTDALE,NC27545	WELLNESS
32	32 - REX DIGESTIVE HEALTHCARE (WAKEFIELD) 11211 GALLERIA AVE SUITE 101 RALEIGH,NC27614	DIGESTIVE HEALTHCARE
33	33 - REX HOME SERVICES 1500 SUNDAY DRIVE SUITE 113 RALEIGH,NC27607	HOME HEALTHCARE AND REHABILITATION
34	34 - NORTH CAROLINA HEART AND VASCULAR (OXFOR 102 PROFESSIONAL PARK DRIVE SUITE C OXFORD,NC27656	HEART & VASCULAR
35	35 - NORTH CAROLINA HEART AND VASCULAR (WILSO 2605 FOREST HILLS ROAD SW WILSON,NC27893	HEART & VASCULAR
36	36 - UNC FAMILY MEDICINE AT NORTH RALEIGH 7100 SIX FORKS ROAD SUITE 101 RALEIGH,NC27615	FAMILY HEALTHCARE
37	37 - REX EAR NOSE AND THROAT SPECIALISTS (CA 790 SE CARY PARKWAY SUITE 110 CARY,NC27511	ENT HEALTHCARE
38	38 - REXUNC FAMILY PRACTICE OF PANTHER CREEK 10030 GREEN LEVEL CHURCH ROAD SUITE 808 CARY,NC27519	FAMILY HEALTHCARE
39	39 - REX DIGESTIVE HEALTHCARE (NORTH RALEIGH) 8300 HEALTH PARK SUITE 209 RALEIGH,NC27615	DIGESTIVE HEALTHCARE
40	40 - REX SLEEP LAB OF RALEIGH 4210 LAKE BOONE TRAIL RALEIGH,NC27607	SLEEP LAB
41	41 - TRIANGLE EAST SURGERY - SMITHFIELD 131 EAST MARKET STREET SMITHFIELD,NC27520	GENERAL SURGERY
42	42 - REX HOSPITAL DIAGNOSTIC IMAGING OF DURAL 3050 DURALEIGH ROAD SUITE 121 RALEIGH,NC27612	DIAGNOSTIC IMAGING
43	43 - REX EXPRESS CARE OF RALEIGH 3050 DURALEIGH ROAD SUITE 111 RALEIGH,NC27612	EXPRESS HEALTHCARE
44	44 - REX DIGESTIVE HEALTHCARE (RALEIGH) 2417 ATRIUM DRIVE SUITE 150 RALEIGH,NC27607	DIGESTIVE HEALTHCARE
45	45 - REX PAIN MANAGEMENT CENTER 3050 DURALEIGH ROAD SUITE 201 RALEIGH,NC27612	PAIN MANAGEMENT
46	46 - REX SLEEP LAB OF CARY 790 SE CARY PARKWAY SUITE 105 CARY,NC27511	SLEEP LAB
47	47 - REX BREAST CARE SPECIALISTS (RALEIGH) 3100 DURALEIGH ROAD SUITE 205 RALEIGH,NC27612	BREAST CARE CENTER
48	48 - REX CHILD DEVELOPMENT CENTER 3116 BLUE RIDGE ROAD RALEIGH,NC27612	CHILD DEVELOPMENT
49	49 - UNIVERSITY ORTHOPAEDICS AND SPORTS MEDIC 166 SPRINGBROOK AVENUE SUITE 101 CLAYTON,NC27520	ORTHOPAEDICS
50	50 - UNC REX MEDICAL OFFICE BUILDING 2800 BLUE RIDGE ROAD SUITE 204 RALEIGH,NC27607	OFFICE BUILDING

Schedule H (Form 990) 2015

Page 9

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
PART III, LINE 4:	NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEWS AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, AND INVESTIGATIONS.
PART III, LINE 8:	HOSPITALS TREAT PATIENTS COVERED BY MEDICARE, JUST AS THEY DO ANY PATIENT. AMOUNTS THAT HOSPITALS ARE ELIGIBLE TO RECEIVE IN PAYMENT FOR SERVICES PROVIDED TO PATIENTS COVERED BY MEDICARE ARE NOT NEGOTIABLE. AS MEDICARE REIMBURSEMENT RATES DECLINE RELATIVE TO THE COSTS OF PROVIDING CARE, HOSPITALS CONTINUE TO SERVE THE MEDICARE POPULATION. WITHOUT THE SERVICES PROVIDED BY HOSPITALS, THE GOVERNMENT WOULD BECOME OBLIGATED FOR THE SERVICES REQUIRED BY THESE PATIENTS. THEREFORE, WE BELIEVE THAT ANY UNREIMBURSED COSTS OF PROVIDING THIS CARE ARE A BENEFIT PROVIDED BY THE HOSPITAL TO THE COMMUNITY AND GOVERNMENT.
PART III, LINE 9B:	PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE APPROVED FOR 100% ADJUSTMENT OF ELIGIBLE CHARGES MINUS A COPAYMENT. COPAYMENTS ACCRUE AND ARE NOT ELIGIBLE FOR COLLECTIONS PROCESSES.
PART III SECTION A LINE 2	THE COSTING METHODOLOGY USED TO DETERMINE PAYER COSTS IS THE ANDI METHODOLOGY, WHICH USES A FACILITY-WIDE RATIO OF COST TO CHARGES AS DESCRIBED IN THE NCHA COMMUNITY BENEFITS GUIDELINES
PART III SECTION A LINE 3	WHILE THE COSTS OF BAD DEBTS ARE PRESENT FOR ESSENTIALLY EVERY BUSINESS ORGANIZATION, FEW OTHER THAN HOSPITALS ARE EXPECTED TO CONTINUE TO PROVIDE SERVICES TO THOSE WITH MEANS WHO HAVE PREVIOUSLY FAILED TO PAY. CONTINUATION OF SERVICE TO PATIENTS WITH THE MEANS TO PAY BUT WHO HAVE FAILED TO DO SO IS A FURTHER COMMUNITY BENEFIT RELATED TO THE ORGANIZATION'S MISSION. THEREFORE, WE BELIEVE THAT THE COST OF BAD DEBTS SHOULD BE CONSIDERED A COMMUNITY BENEFIT.
PART III SECTION A LINE 4	NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEWS AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, AND INVESTIGATIONS.
PART III SECTION B LINE 8	HOSPITALS TREAT PATIENTS COVERED BY MEDICARE, JUST AS THEY DO ANY PATIENT. AMOUNTS THAT HOSPITALS ARE ELIGIBLE TO RECEIVE IN PAYMENT FOR SERVICES PROVIDED TO PATIENTS COVERED BY MEDICARE ARE NOT NEGOTIABLE. AS MEDICARE REIMBURSEMENT RATES DECLINE RELATIVE TO THE COSTS OF PROVIDING CARE, HOSPITALS CONTINUE TO SERVE THE MEDICARE POPULATION. WITHOUT THE SERVICES PROVIDED BY HOSPITALS, THE GOVERNMENT WOULD BECOME OBLIGATED FOR THE SERVICES REQUIRED BY THESE PATIENTS. THEREFORE, WE BELIEVE THAT ANY UNREIMBURSED COSTS OF PROVIDING THIS CARE ARE A BENEFIT PROVIDED BY THE HOSPITAL TO THE COMMUNITY AND GOVERNMENT.
PART III SECTION C LINE 9B	PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE APPROVED FOR 100% ADJUSTMENT OF ELIGIBLE CHARGES MINUS A COPAYMENT. COPAYMENTS ACCRUE AND ARE NOT ELIGIBLE FOR COLLECTIONS PROCESSES.
PART VI, LINE 2:	AS THE COUNTY CONTINUES TO GROW, NECESSARY STEPS MUST BE TAKEN TO ENSURE THAT THE NEEDS OF ALL OF OUR CITIZENS ARE BEING MONITORED AND EVALUATED. WAKE COUNTY HUMAN SERVICES WORKS WITH ALL LOCAL HOSPITALS, INCLUDING REX, TO CONDUCT A COMMUNITY-WIDE HEALTH ASSESSMENT. THIS ASSESSMENT, CONDUCTED EVERY THREE TO FOUR YEARS, IDENTIFIES OPPORTUNITIES AND CHALLENGES IN THE MARKET. REX COLLABORATES WITH COMMUNITY PARTNERS REGULARLY TO ENSURE OUR EFFORTS ARE PROPERLY ALIGNED BASED ON WAKE COUNTY'S SOCIOECONOMIC AND DEMOGRAPHIC INFORMATION. REX ALSO RELIES ON INPUT FROM OUR PHYSICIANS AND CLINICAL STAFF, PATIENT OUTCOMES AS WELL AS QUALITATIVE AND QUANTITATIVE RESEARCH TO IDENTIFY AREAS OF OPPORTUNITY TO IMPROVE THE HEALTH OF OUR COMMUNITY.
PART VI, LINE 3:	REX PROVIDES A WIDE RANGE OF TOOLS AND EDUCATION TO HELP PATIENTS WHO NEED FINANCIAL ASSISTANCE. THE REX ASSIST PROGRAM IS DESIGNED TO MAKE IT EASY FOR PATIENTS TO APPLY FOR FINANCIAL ASSISTANCE, CHARITY CARE AND OTHER AID PROGRAMS. REX POSTS DETAILED INFORMATION ABOUT ITS GENEROUS CHARITY CARE POLICY, THE REX ASSIST PROGRAM AND OTHER FINANCIAL AID INFORMATION AT VARIOUS POINTS IN THE HOSPITAL AND ON ITS WEBSITE. DURING PATIENT REGISTRATION, STAFF WILL DISTRIBUTE THE "YOUR REX HOSPITAL BILL" FLYER TO ANYONE WHO DOES NOT HAVE INSURANCE OR ASKS FOR ASSISTANCE. THAT FLYER INCLUDES USEFUL INFORMATION AND HELPFUL RESOURCES. REX FINANCIAL COUNSELORS WILL BEGIN WORKING WITH PATIENTS NEEDING ASSISTANCE AT REGISTRATION OR VISIT THE ROOMS OF PATIENTS WHO ASK FOR HELP. THE COUNSELORS WILL ASSIST WITH DETERMINING MEDICAID ELIGIBILITY AND WITH FILLING OUT A REX ASSIST APPLICATION. FINALLY, REX ALSO WORKS WITH VARIOUS COMMUNITY GROUPS THAT HELP PROVIDE ASSISTANCE TO THE UNINSURED OR UNDERINSURED, INCLUDING PROJECT ACCESS, PRETTY IN PINK AND OTHERS. THE ANGEL FUND OF THE REX HEALTHCARE FOUNDATION ALSO SUPPORTS CANCER PATIENTS WITH UNIQUE FINANCIAL NEEDS, INCLUDING TRANSPORTATION, LIVING EXPENSES AND PRESCRIPTIONS.
PART VI, LINE 4:	THE ORGANIZATION SERVES AN AREA THAT ENCOMPASSES A FOUR-COUNTY AREA CONSISTING OF WAKE COUNTY AS THE PRIMARY SERVICE AREA WITH HARNETT, FRANKLIN AND JOHNSTON COUNTIES, COMPRISING THE SECONDARY SERVICE AREA. WAKE COUNTY AND ITS SURROUNDING COMMUNITIES ARE AMONG THE FASTEST GROWING REGIONS IN THE NATION. UNEMPLOYMENT RATES IN THE PRIMARY SERVICE AREA ARE LESS THAN THE UNEMPLOYMENT RATES FOR THE NATION AND THE STATE. AVERAGE HOUSEHOLD INCOME AND EDUCATION LEVEL ALSO COMPARE FAVORABLY WITH BOTH THE NATION AND THE STATE.
PART VI, LINE 5:	THERE ARE MANY WAYS REX WORKS WITH COMMUNITY PARTNERS TO ADDRESS HEALTH ISSUES AND CONCERNS IDENTIFIED WITHIN THE COMMUNITY. THROUGH BOTH FINANCIAL, IN-KIND AND STAFF SUPPORT, REX PROVIDES ASSISTANCE IN HOSTING COMMUNITY HEALTH SCREENINGS, MOBILE MAMMOGRAPHY SCREENINGS AND ON-SITE MEDICAL CARE THROUGH THE REX EMERGENCY RESPONSE TEAM. ADDITIONALLY, COMMUNITY RELATIONS ACTIVITIES REGULARLY DEMONSTRATE PROMOTING HEALTH AND WELLNESS INITIATIVES. "ASK THE EXPERT" FORUMS ARE FREE AND OFFERED THROUGHOUT WAKE COUNTY BY PHYSICIANS AND STAFF. REX HAS BEEN DILIGENT IN AWARDING GRANTS TO COMMUNITY GROUPS TO ASSIST THEM WHERE NEEDS ARE GREATEST. TWICE A YEAR WE HOST A COLLABORATIVE BREAKFAST INVITING COMMUNITY PARTNERS, ORGANIZATIONS AND HEALTHCARE PROVIDERS WHO WORK WITH UNINSURED WOMEN TO DISCUSS AND ADDRESS CURRENT HARDSHIPS AND RESOURCES - TRULY A COMMITMENT TO THE NONPROFIT COMMUNITY.
PART VI, LINE 6:	REX HEALTHCARE IS A SUBSIDIARY OF THE UNC HEALTH CARE SYSTEM IN CHAPEL HILL. THAT SYSTEM SERVES PATIENTS FROM ALL 100 COUNTIES, REGARDLESS OF THEIR ABILITY TO PAY, PROVIDING MORE THAN $300 MILLION A YEAR IN UNCOMPENSATED CARE. AS PART OF THE INTEGRATED SYSTEM, REX STRIVES TO IMPROVE ACCESS AND SERVICES IN WAKE COUNTY'S GROWING AND UNDERSERVED AREAS. REX CAREGIVERS ALSO WORK CLOSELY WITH THEIR COUNTERPARTS AT UNC HEALTH CARE TO FIND MORE WAYS TO IMPROVE CARE AND QUALITY, REACH MORE UNINSURED PATIENTS AND MORE. REX'S BOARD REPRESENTS A CROSS-SECTION OF THE COMMUNITY, WITH VOLUNTEERS THAT INCLUDE BUSINESS LEADERS, COMMUNITY PHYSICIANS AND OTHERS. THAT BOARD WORKS CLOSELY WITH THE BOARD AT UNC HEALTH CARE TO DETERMINE THE BEST WAYS TO PLAY A LARGER ROLE IN IMPROVING THE COMMUNITY'S HEALTH, AND REX'S ROLE IN THE BIGGER SYSTEM'S MISSION.

Schedule H (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

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," on 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

2015

Open to Public
Inspection

Name of the organization
REX HOSPITAL INC

Employer identification number
56-1509260

Part I

General Information on Grants and Assistance

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? ........................

Yes No

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 Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on 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 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) UNC HOSPITALS VOLUNTEER ASSOC 101 MANNING DRIVE CHAPEL HILL,NC27514	56-1118388	115	100,000	GENERAL SUPPORT
(2) UNITED WAY OF THE GREATER TRIANGLE 2400 PERIMETER PARK DRIVE STE 150 CHAPEL HILL,NC27560	56-1949103	501(C)(3)	100,000	GENERAL SUPPORT
(3) AMERICAN HEART ASSOCIATION 3901 COMPUTER DRIVE STE 110 RALEIGH,NC27609	56-0529996	501(C)(3)	65,000	GENERAL SUPPORT/EDUCATION SUPPORT
(4) GREATER RALEIGH CHAMBER PO BOX 2978 RALEIGH,NC27602	56-0370850	501(C)(6)	58,027	GENERAL SUPPORT
(5) NORTH CAROLINA SYMPHONY 4350 LASSITER STE 250 RALEIGH,NC27609	56-0556755	501(C)(3)	55,000	GENERAL SUPPORT
(6) FRIENDS OF THE NC MUSEUM OF NATURAL SCIENCE PO BOX 26928 RALEIGH,NC27611	56-1240806	501(C)(3)	50,000	GENERAL SUPPORT
(7) LEUKEMIA & LYMPHOMA SOCIETY 401 HARRISON OAKS BLVD SUITE 200 CARY,NC27513	13-5644916	501(C)(3)	40,000	GENERAL SUPPORT
(8) SUSAN G KOMEN NC TRIANGLE 600 AIRPORT BLVD SUITE 100 MORRISVILLE,NC27560	75-2845066	501(C)(3)	25,250	GENERAL SUPPORT
(9) ALICE AYCOCK POE CENTER FOR HEALTH EDUCATION 224 SUNNYBROOK ROAD RALEIGH,NC27610	56-1500678	501(C)(3)	21,500	GENERAL SUPPORT
(10) URBAN MINISTRIES OF WAKE COUNTY 1390 CAPITAL BLVD RALEIGH,NC27603	58-1422700	501(C)(3)	20,100	GENERAL SUPPORT
(11) WAKE EDUCATION PARTNERSHIP 706 HILLSBOURGH STREET SUITE A RALEIGH,NC27603	58-1518182	501(C)(3)	20,000	GENERAL SUPPORT
(12) WAKE TECH FOUNDATION 9101 FAYETTEVILLE ROAD RALEIGH,NC27511	23-7017752	501(C)(3)	15,000	GENERAL SUPPORT
(13) CARY CHAMBER OF COMMERCE 307 NORTH ACADEMY STREET CARY,NC27519	56-0989726	501(C)(3)	12,025	GENERAL SUPPORT
(14) NC MUSEUM OF ART 4630 MAIL SERVICE CENTER RALEIGH,NC27699	23-7071511	501(C)(3)	11,000	GENERAL SUPPORT
(15) LUNG CANCER INITIATIVE OF NC 4000 BLUE RIDGE ROAD SUITE 170 RALEIGH,NC27612	26-2300885	501(C)(3)	10,250	GENERAL SUPPORT
(16) AFRICAN AMERICAN CULTURAL FESTIVAL PO BOX 46595 RALEIGH,NC27620	90-0636941	501(C)(3)	10,000	GENERAL SUPPORT
(17) BLUE RIDGE ALLIANCE CORRIDOR 2416 HILLSBOROUGH STREET RALEIGH,NC27607	47-1697576	501(C)(3)	10,000	GENERAL SUPPORT
(18) INNOVATE RALEIGH 310 S HARRINGTON STREET RALEIGH,NC27603	26-2891963	501(C)(3)	10,000	GENERAL SUPPORT
(19) MARCH OF DIMES NORTH CAROLINA CHAPTER 6504 FALLS OF NEUSE RD SUITE 100 RALEIGH,NC27615	13-1846366	501(C)(3)	10,000	GENERAL SUPPORT
(20) RALEIGH CIVIC VENTURES DOWNTOWN RALEIGH ALLIANCE 120 S WILMINGTON STREET SUITE 103 RALEIGH,NC27601	56-2095185	501(C)(3)	10,000	GENERAL SUPPORT
(21) GIRLS SCOUTS NC COASTAL PINES 6901 PINECREST ROAD RALEIGH,NC27613	56-0791500	501(C)(3)	8,000	GENERAL SUPPORT
(22) ALLIANCE MEDICAL MINISTRY 101 DONALD ROSS DRIVE RALEIGH,NC27610	56-2168673	501(C)(3)	7,500	GENERAL SUPPORT
(23) DOWNTOWN RALEIGH ALLIANCE 120 SOUTH WILMINGTON STREET SUITE 103 RALEIGH,NC27601	56-1994005	501(C)(6)	6,050	GENERAL SUPPORT
(24) HOLLY SPRINGS CHAMBER OF COMMERCE 344 RALEIGH STREET SUITE 100 HOLLY SPRINGS,NC27540	56-1875144	501(C)(6)	6,000	GENERAL SUPPORT
(25) LUCY DANIELS CENTER 9003 WESTON PARKWAY CARY,NC27513	58-1863104	501(C)(3)	6,000	GENERAL SUPPORT
(26) KNIGHTDALE CHAMBER OF COMMERCE 207 MAIN STREET KNIGHTDALE,NC27545	56-1325118	501(C)(6)	5,599	GENERAL SUPPORT
(27) WAKE FOREST AREA CHAMBER OF COMMERCE 350 S WHITE STREET WAKE FOREST,NC27587	56-1122169	501(C)(6)	5,500	GENERAL SUPPORT
(28) FOUNDATION OF HOPE 9401 GLENWOOD AVENUE RALEIGH,NC27617	56-6246626	501(C)(3)	5,000	GENERAL SUPPORT
(29) HOLT BROTHERS FOUNDATION 8801 FAST PARK DRIVE SUITE 105 107 RALEIGH,NC27617	56-6570426	501(C)(3)	5,000	GENERAL SUPPORT
(30) KAY YOW CANCER FOUNDATION 5121 KINGDOM WAY SUITE 305 RALEIGH,NC27607	26-1789695	501(C)(3)	5,000	GENERAL SUPPORT
(31) NAMI WAKE COUNTY PO BOX 12562 RALEIGH,NC27605	56-1552949	501(C)(3)	5,000	GENERAL SUPPORT
(32) NC PREVENTION PARTNERS 88 VILCOM CENTER DRIVE SUITE 110 CHAPEL HILL,NC27514	31-1722051	501(C)(3)	5,000	GENERAL SUPPORT
(33) REX HEALTHCARE FOUNDATION 2500 BLUE RIDGE ROAD SUITE 325 RALEIGH,NC27607	56-6052117	501(C)(3)	5,000	GENERAL SUPPORT
(34) THE FIRST TEE OF THE TRIANGLE 8800 WESTGATEPARK DRIVE SUITE104 RALEIGH,NC27617	56-2266025	501(C)(3)	5,000	GENERAL SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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)
(2)
(3)
(4)
(5)
(6)
(7)

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

PART I, LINE 2:

REX REQUIRES ALL REQUESTS FOR GRANTS OR OTHER ASSISTANCE TO BE IN WRITING. SUCH REQUESTS ARE TYPICALLY REVIEWED ON AN ANNUAL BASIS FOLLOWING GUIDELINES RELATED TO COMMUNITY NEED AND REX'S MISSION. REX'S PRIORITIES INCLUDE SUPPORTING HEALTH, HUMAN SERVICES, EDUCATION AND ARTS IN THE COMMUNITIES IT SERVES. REX HAS VARIOUS WAYS OF TRACKING THE RESULTS OF ITS CONTRIBUTIONS. BECAUSE REX OFTEN WORKS CLOSELY WITH THE COMMUNITY GROUPS IT SUPPORTS, THE ORGANIZATION RECEIVES FREQUENT UPDATES ON THEIR WORK AND PROGRESS. FOR LARGER GRANTS, REX ALSO RECEIVES ANNUAL OR QUARTERLY REPORTS ON RESULTS.

Schedule I (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

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" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

REX HOSPITAL INC

Employer identification number

56-1509260

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

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 .........

Yes

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? ..

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization?

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

Yes

Any related organization? .........................

Yes

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on 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 ............

Were any amounts reported on 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 .............................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2015

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 on 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 in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1WILLIAM L ROPERDIRECTOR	(i) (ii)	0 ------------- 772,345	0 ------------- 140,416	0 ------------- 31,859	0 ------------- 315,353	0 ------------- 19,177	0 ------------- 1,279,150	0 ------------- 0
2GARY L PARKCEO	(i) (ii)	0 ------------- 768,891	0 ------------- 142,263	0 ------------- 24,159	0 ------------- 496,220	0 ------------- 18,869	0 ------------- 1,450,402	0 ------------- 0
3STEPHEN W BURRISSPRESIDENT	(i) (ii)	387,941 ------------- 0	101,197 ------------- 0	41,834 ------------- 0	105,286 ------------- 0	15,544 ------------- 0	651,802 ------------- 0	0 ------------- 0
4BERNADETTE M SPONGSVP/FINANCE & CFO (LEFT 7/31/15)	(i) (ii)	239,842 ------------- 0	0 ------------- 0	58,535 ------------- 0	39,295 ------------- 0	6,190 ------------- 0	343,862 ------------- 0	0 ------------- 0
5LINDA H BUTLER MDVP/MEDICAL AFFAIRS, CMO & CMIO	(i) (ii)	258,113 ------------- 0	77,227 ------------- 0	29,353 ------------- 0	35,215 ------------- 0	15,544 ------------- 0	415,452 ------------- 0	0 ------------- 0
6JAYNE R BYRDVP/SURGICAL SERVICES	(i) (ii)	189,530 ------------- 0	55,115 ------------- 0	1,907 ------------- 0	103,224 ------------- 0	5,326 ------------- 0	355,102 ------------- 0	0 ------------- 0
7DONALD R ESPOSITO JRVP/GENERAL COUNSEL	(i) (ii)	261,792 ------------- 0	71,673 ------------- 0	24,827 ------------- 0	14,057 ------------- 0	15,481 ------------- 0	387,830 ------------- 0	0 ------------- 0
8MICHELLE L GRAYVP & REGIONAL CIO (LEFT 10/31/15)	(i) (ii)	183,352 ------------- 0	56,207 ------------- 0	12,918 ------------- 0	16,980 ------------- 0	3,048 ------------- 0	272,505 ------------- 0	0 ------------- 0
9SYLVIA D HACKETTVP/REX HEALTHCARE FOUNDATION	(i) (ii)	228,607 ------------- 0	73,234 ------------- 0	36,173 ------------- 0	30,697 ------------- 0	9,117 ------------- 0	377,828 ------------- 0	0 ------------- 0
10R ERICK HAWKINS LEFT 121815VP/H&V SERVICES, CFO & TREASURER	(i) (ii)	260,075 ------------- 0	66,635 ------------- 0	23,587 ------------- 0	15,253 ------------- 0	9,867 ------------- 0	375,417 ------------- 0	0 ------------- 0
11CHAD T LEFTERISVP/OPERATIONS	(i) (ii)	184,997 ------------- 0	57,662 ------------- 0	25,165 ------------- 0	11,943 ------------- 0	4,833 ------------- 0	284,600 ------------- 0	0 ------------- 0
12JOEL D RAYVP/PATIENT CARE SVCS & CNO	(i) (ii)	210,195 ------------- 0	57,572 ------------- 0	2,016 ------------- 0	7,325 ------------- 0	246 ------------- 0	277,354 ------------- 0	0 ------------- 0
13ROBERT D RICKERVP/PHYSICIAN SERVICES	(i) (ii)	214,443 ------------- 0	62,230 ------------- 0	9,045 ------------- 0	43,855 ------------- 0	7,086 ------------- 0	336,659 ------------- 0	0 ------------- 0
14KIRSTEN RIGGSVP (AS OF 3/15/16)	(i) (ii)	157,190 ------------- 0	16,659 ------------- 0	6,158 ------------- 0	12,346 ------------- 0	15,481 ------------- 0	207,834 ------------- 0	0 ------------- 0
15LISA R SCHILLERVP/MKTG, PR, COMM & GOVT AFFAIRS	(i) (ii)	189,238 ------------- 0	51,690 ------------- 0	16,164 ------------- 0	16,054 ------------- 0	14,591 ------------- 0	287,737 ------------- 0	0 ------------- 0
16TAMMIE T STANTONVP/POST ACUTE SERVICES	(i) (ii)	0 ------------- 249,812	0 ------------- 45,415	0 ------------- 10,212	0 ------------- 65,472	0 ------------- 19,594	0 ------------- 390,505	0 ------------- 0
17SEAN T TEHRANI MDVP/REGIONAL HOSPITALISTS SERVICES	(i) (ii)	480,277 ------------- 0	97,957 ------------- 0	61,682 ------------- 0	14,769 ------------- 0	13,451 ------------- 0	668,136 ------------- 0	0 ------------- 0
18TOM G WILLIAMSVP/AMBULATORY SERVICES	(i) (ii)	189,881 ------------- 0	55,465 ------------- 0	9,869 ------------- 0	17,923 ------------- 0	14,591 ------------- 0	287,729 ------------- 0	0 ------------- 0
19JOHN E MILLER LEFT 32516ASST TREASURER & ASST SEC	(i) (ii)	0 ------------- 209,357	0 ------------- 19,394	0 ------------- 27,127	0 ------------- 43,721	0 ------------- 5,393	0 ------------- 304,992	0 ------------- 0
20ERIC JANISPHYSICIAN	(i) (ii)	1,482,912 ------------- 0	32,275 ------------- 0	25,858 ------------- 0	35,000 ------------- 0	12,302 ------------- 0	1,588,347 ------------- 0	0 ------------- 0
21RAVISH SACHARPHYSICIAN	(i) (ii)	1,502,393 ------------- 0	32,275 ------------- 0	1,212 ------------- 0	35,000 ------------- 0	13,451 ------------- 0	1,584,331 ------------- 0	0 ------------- 0
22MATTHEW HOOKPHYSICIAN	(i) (ii)	1,459,241 ------------- 0	32,275 ------------- 0	19,212 ------------- 0	35,000 ------------- 0	15,481 ------------- 0	1,561,209 ------------- 0	0 ------------- 0
23MATEEN AKHTARPHYSICIAN	(i) (ii)	1,312,662 ------------- 0	32,275 ------------- 0	20,518 ------------- 0	35,000 ------------- 0	15,481 ------------- 0	1,415,936 ------------- 0	0 ------------- 0
24JOEL SCHNEIDERPHYSICIAN	(i) (ii)	1,310,278 ------------- 0	32,275 ------------- 0	3,473 ------------- 0	35,000 ------------- 0	12,117 ------------- 0	1,393,143 ------------- 0	0 ------------- 0
25DAVID W STRONGFORMER PRESIDENT (LEFT 3/31/15)	(i) (ii)	153,361 ------------- 0	0 ------------- 0	1,073,301 ------------- 0	13,919 ------------- 0	2,839 ------------- 0	1,243,420 ------------- 0	246,929 ------------- 0

Schedule J (Form 990) 2015

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
PART I, LINE 1A	THE ORGANIZATION OFFERS COMPLIMENTARY MEMBERSHIPS TO REX WELLNESS CENTERS FOR THE EXECUTIVE STAFF, BOTH ACTIVE AND RETIRED BOARD MEMBERS AND MEDICAL DIRECTORS. ALL MEMBERS RECEIVING COMPLIMENTARY MEMBERSHIPS ARE REQUIRED TO COMPLETE THE SAME APPLICATION AND TESTING PROCEDURES AS OTHER MEMBERS. CURRENTLY, THERE ARE 7 INDIVIDUALS LISTED THAT RECEIVE COMPLIMENTARY MEMBERSHIPS. THE VALUE OF THE COMPLIMENTARY MEMBERSHIP IS TREATED AS TAXABLE COMPENSATION AND IS REPORTED ON THE INDIVIDUAL'S W-2.
PART I, LINE 4B	DURING THE CALENDAR YEAR 2015, DAVID STRONG, FORMER PRESIDENT, RECEIVED DISTRIBUTIONS FROM A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN TOTALING $246,929. DURING THE CALENDAR YEAR 2015, STEVE BURRISS PARTICIPATED IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN FUNDED AND CONTROLLED BY A RELATED ORGANIZATION, UNC HEALTH CARE SYSTEM. HE EARNED COMPENSATION UNDER THIS PLAN TOTALING $47,346. THE CURRENT YEAR EARNINGS ARE PAYABLE IN THE FUTURE. DURING THE CALENDAR YEAR 2015, GARY PARK PARTICIPATED IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN FUNDED AND CONTROLLED BY A RELATED ORGANIZATION, UNC HEALTH CARE SYSTEM. HE EARNED COMPENSATION UNDER THIS PLAN TOTALING $350,913. THE CURRENT YEAR EARNINGS ARE PAYABLE IN THE FUTURE. DURING THE CALENDAR YEAR 2015, WILLIAM ROPER PARTICIPATED IN A NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN FUNDED AND CONTROLLED BY A RELATED ORGANIZATION, UNC HEALTH CARE SYSTEM. HE EARNED COMPENSATION UNDER THIS PLAN TOTALING $191,592. THE CURRENT YEAR EARNINGS ARE PAYABLE IN THE FUTURE.
PART I, LINE 6	EMPLOYEES IN MANAGERIAL ROLES PARTICIPATE IN AN ANNUAL INCENTIVE COMPENSATION PLAN. THE COMPENSATION EARNED UNDER THIS PLAN IS BASED PARTLY ON THE COMBINED EARNINGS OF REX HEALTHCARE, INC. AND ITS SUBSIDIARIES. ADDITIONALLY, THE INCENTIVE COMPENSATION OF THE PRESIDENT AND CFO IS BASED PARTLY ON THE EARNINGS OF THE UNC HEALTH CARE SYSTEM. OTHER PERFORMANCE MEASURES USED TO DETERMINE INCENTIVE COMPENSATION ARE PHYSICIAN SATISFACTION, PATIENT CARE QUALITY OUTCOMES, EFFECTIVE USE OF TECHNOLOGY AND INDIVIDUAL GOALS.

Schedule J (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

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

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
REX HOSPITAL INC

Employer identification number
56-1509260

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
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	NORTH CAROLINA MEDICAL CARE COMMISSIONS	52-1309402	65821DFJ5	10-26-2010	127,456,150	SEE PART VI		X		X		X
B	NORTH CAROLINA MEDICAL CARE COMMISSIONS	52-1309402	65821DTR2	05-21-2015	150,167,728	SEE PART VI		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	22,755,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	127,456,150		150,167,728
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............	2,184,840		4,130,000
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	1,628,054		1,051,300
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	47,608,529		144,986,428
11 Other spent proceeds .............	76,034,727
12 Other unspent proceeds .............
13 Year of substantial completion .............	2013
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X			X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X
16 Has the final allocation of proceeds been made? ..........	X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	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
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2015

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
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
c Are there any research agreements that may result in private business use of bond-financed property? .............		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 ....
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 .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		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
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
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

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...	X			X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......			X
b Exception to rebate? ........				X
c No rebate due? .........				X
If "Yes" to line 2c, provide in Part VI the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X	X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2015

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
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	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

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
PART I. LINE A, COLUMN (F)	CONSTRUCTION OF CENTRAL ENERGY PLANT, PURCHASE ROUTINE CAPITAL EQUIPMENT AND REFUND SERIES 1998 BONDS.
PART I, LINE B, COLUMN (F)	CONSTRUCTION OF NORTH CAROLINA HEART & VASCULAR HOSPITAL AND PARKING DECK, PURCHASE EQUIPMENT FOR NORTH CAROLINA HEART & VASCULAR HOSPITAL AND FUND CAPITALIZED INTEREST.
PART IV, LINE 2C	THE REBATE COMPUTATION WAS PERFORMED FOR PERIOD ENDING SEPTEMBER 30, 2015.

Schedule K (Form 990) 2015

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 990-EZ 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

2015

Open to Public
Inspection

Name of the organization

REX HOSPITAL INC

Employer identification number

56-1509260

Return Reference	Explanation
FORM 990, PART III, LINE 4A (CONTINUED)	REX EXPRESS CARES (CARY, HOLLY SPRINGS, KNIGHTDALE, RALEIGH AND WAKEFIELD) PROVIDE A CONVENIENT, LOWER-COST ALTERNATIVE TO THE HOSPITAL EMERGENCY DEPARTMENT FOR PATIENTS WHO NEED URGENT MEDICAL TREATMENT BECAUSE OF AN ACCIDENT OR ILLNESS. DURING FY16, REX EXPRESS CARES TREATED MORE THAN 46,000 PATIENTS. DURING 2016, REX EXPRESS CARE OPENED ITS FIFTH LOCATION, JUST DOWN THE STREET FROM OUR MAIN RALEIGH HOSPITAL, TO PROVIDE A NEW OPTION FOR PATIENTS WHO DON'T NEED THE EMERGENCY DEPARTMENT. IN ADDITION, REX EXPRESS CARE INTRODUCED AN ONLINE RESERVATION SYSTEM AT ALL FIVE LOCATIONS ACROSS WAKE COUNTY, MAKING IT EASIER FOR PATIENTS TO SCHEDULE THEIR URGENT CARE VISITS.
FORM 990, PART VI, SECTION A, LINE 6	THE ORGANIZATION'S SOLE MEMBER IS REX HEALTHCARE, INC.
FORM 990, PART VI, SECTION A, LINE 7A	THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM APPOINTS ALL OF THE THIRTEEN SEATS ON THE ORGANIZATION'S BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7B	THE ORGANIZATION'S BOARD REQUIRES PRIOR APPROVAL OF THE UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM FOR CERTAIN POWERS, INCLUDING BUT NOT LIMITED TO ADDITION OR DELETION OF A HEALTH CARE SERVICE, PARTICIPATION, DIRECTLY OR INDIRECTLY, IN A JOINT VENTURE, INDEBTEDNESS AND CAPITAL BUDGETS, OPERATING BUDGETS AND NON-BUDGETED MATERIAL EXPENDITURES.
FORM 990, PART VI, SECTION B, LINE 11	THE ORGANIZATION'S EXECUTIVE TEAM DISCUSSES AND REVIEWS THE FORM 990 AND ALL ASSOCIATED SCHEDULES THROUGHOUT THE INFORMATION GATHERING STAGE. THE FORM 990 AND ASSOCIATED SCHEDULES ARE THEN REVIEWED AND APPROVED BY THE BOARD AS A WHOLE. A COPY OF THE APPROVED FORM 990 ALONG WITH THE ASSOCIATED SCHEDULES IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REQUIRING ALL BOARD MEMBERS TO ANNUALLY COMPLETE AND SIGN A QUESTIONNAIRE DOCUMENTING ANY AREA OF CONFLICT OF INTEREST. THE BOARD MEMBERS ARE REQUIRED TO REPORT AND DOCUMENT ANY NEW AREAS OF CONFLICT OF INTEREST AS THEY ARISE.
FORM 990, PART VI, SECTION B, LINE 15	THE ORGANIZATION USES AN INDEPENDENT CONSULTANT TO MEASURE FAIR VALUE OF COMPENSATION FOR THE ORGANIZATION'S PRESIDENT AND OTHER TOP MANAGEMENT. THE ORGANIZATION'S BOARD REVIEWS AND APPROVES THE COMPENSATION FOR ALL OFFICERS EXCEPT THE ASSISTANT TREASURER AND ASSISTANT SECRETARY.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST AND ON GUIDESTAR'S WEBSITE AND THE FINANCIAL STATEMENTS ARE AVAILABLE ON MUNICIPAL SECURITIES RULEMAKING BOARD'S WEBSITE. THE ORGANIZATION DOES NOT MAKE OTHER GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC.
FORM 990, PART XII, LINE 2C	THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
FORM 990, PART I, DOING BUSINESS AS:	NORTH CAROLINA HEART & VASCULAR REX BLOOD PLAN REX BREAST CARE CENTER REX CANCER CENTER REX CANCER SPECIALTY CENTER REX CARDIAC SURGICAL SPECIALISTS REX COMPREHENSIVE VEIN CENTER REX CRITICAL CARE TRANSPORT REX DIGESTIVE HEALTHCARE REX EAR NOSE & THROAT SPECIALISTS REX EAR NOSE & THROAT SPECIALISTS AT WAKEFIELD REX EXPRESS CARE OF CARY REX EXPRESS CARE OF HOLLY SPRINGS REX EXPRESS CARE OF KNIGHTDALE REX EXPRESS CARE OF RALEIGH REX EXPRESS CARE OF WAKEFIELD REX FAMILY BIRTH CENTER REX FAMILY PRACTICE OF KNIGHTDALE REX FAMILY PRACTICE OF WAKEFIELD REX HEALTHCARE REX HEALTHCARE OF CARY REX HEALTHCARE OF GARNER REX HEALTHCARE OF HOLLY SPRINGS REX HEALTHCARE OF KNIGHTDALE REX HEALTHCARE OF WAKEFIELD REX HEART CENTER REX HEART FAILURE REX HEMATOLOGY ONCOLOGY ASSOCIATES REX HOME SERVICES REX HOSPITAL REX HOSPITAL PELVIC HEALTH CENTER REX HOSPITAL TRANSPORT REX INTERNAL MEDICINE OF CARY REX LABORATORY SERVICES OF CARY REX MOBILE MAMMOGRAPHY REX NEUROSURGERY & SPINE SPECIALISTS REX NUTRITION SERVICES REX OUTREACH REX PAIN CENTER REX PALLIATIVE CARE SPECIALISTS REX PEDIATRICS OF CARY REX PEDIATRICS OF HOLLY SPRINGS REX PHARMACY OF RALEIGH REX PRIMARY CARE OF CARY REX PRIMARY CARE OF CARY REX PULMONARY SPECIALISTS REX RADIOLOGY SERVICES OF CARY REX REHABILITATION AND NURSING CARE CENTER OF APEX REX REHABILITATION SERVICES OF CARY REX SAME DAY SURGERY REX SENIOR HEALTH CENTER REX STRATEGIC INNOVATIONS REX STRUCTURAL HEART REX SURGICAL SPECIALISTS REX THORACIC SPECIALISTS REX THORACIC SURGICAL SPECIALISTS REX UNC HEALTH CARE REX VASCULAR SPECIALISTS REX VASCULAR SURGICAL SPECIALISTS REX WELLNESS CENTER OF CARY REX WELLNESS CENTER OF GARNER REX WELLNESS CENTER OF KNIGHTDALE REX WELLNESS CENTER OF WAKEFIELD REX WOUND HEALING CENTER UNC REX CANCER CENTER UNC REX HEALTHCARE UNC REX HOME SERVICES UNC REX HOSPITAL UNC REX HOSPITAL TRANSPORT UNC REX PHARMACY OF RALEIGH UNC REX REHABILITATION & NURSING CARE CENTER OF APEX UNC REX REHABILITATION & NURSING CARE CENTER OF RALEIGH
FORM 990, PART I, LINE6	THE ORGANIZATION'S VOLUNTEER SERVICES DEPARTMENT MAINTAINS A LARGE STAFF OF COMPETENT AND COMPASSIONATE VOLUNTEERS WHO ENHANCE AND EXTEND SERVICES PROVIDED TO PATIENTS, FAMILY MEMBERS, CLIENTS AND RESIDENTS. THE 1,300 VOLUNTEERS PROVIDED APPROXIMATELY 149,000 SERVICE HOURS TO THE ORGANIZATION. THE ANIMAL ASSISTED THERAPY PROGRAM AT REX HOSPITAL HAS 9 CANINE VOLUNTEERS. THE CANINES AND THEIR HANDLERS VISITED NUMEROUS PATIENTS OFFERING COMFORT AND SUPPORT. THE PATIENT COMPANION PROGRAM CONTINUED THIS YEAR INSIDE REX HOSPITAL WHICH OFFERS A VISIT TO PATIENTS WHO ARE LONELY OR NEED TO TALK TO SOMEONE. VOLUNTEERS ALSO VISITED PATIENTS, CONDUCTED HEARING TESTS FOR NEWBORN BABIES, GREETED GUESTS AND DELIVERED FLOWER ARRANGEMENTS AND CARDS. THEY MANNED WAITING ROOMS, ESCORTED PATIENTS, MADE BEDS, DISCHARGED PATIENTS AND SO MUCH MORE TO PROVIDE COMFORT TO OUR COMMUNITY.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

REX HOSPITAL INC

Employer identification number

56-1509260

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) REX HEALTH VENTURES GP I LLC 4420 LAKE BOONE TRAIL RALEIGH,NC27607 45-5070550	VENTURE CAPITAL INVESTMENT	NC	0	10,046,659	REX HOSPITAL INC
(2) REX ORTHOPEDIC VENTURES LLC 4420 LAKE BOONE TRAIL RALEIGH,NC27607 27-3434805	ORTHOPEDIC PRACTICE VENTU	NC	3,904,532	0	REX HOSPITAL INC
(3) REX SURGERY CENTER OF WAKEFIELD LLC 4420 LAKE BOONE TRAIL RALEIGH,NC27607 46-5511168	ASC	NC	0	0	REX HOSPITAL INC
(4) REX RADIATION ONCOLOGY LLC 4420 LAKE BOONE TRAIL RALEIGH,NC27607 81-1078226	ONCOLOGY PRACTICE	NC	509,196	9,219,869	REX HOSPITAL 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?
(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	Yes	No
(1)UNC HEALTH CARE SYSTEM 101 MANNING DRIVE CHAPEL HILL,NC27514 56-2206970	HEALTHCARE	NC	SECTION 115		UNC HEALTHCARE		No
(2)UNC HOSPITALS 211 FRIDAY CENTER DR SUITE 2029 CHAPEL HILL,NC27517 56-1118388	HEALTHCARE	NC	SECTION 115		UNC HEALTHCARE		No
(3)CALDWELL MEMORIAL HOSPITAL PO BOX 1890 LENIOR,NC28645 56-0554204	HEALTHCARE	NC	501(C)(3)	LINE 3	UNC HEALTHCARE		No
(4)CALDWELL MEMORIAL HOSPITAL FOUNDATION INC PO BOX 1890 LENIOR,NC28645 58-1935514	SUPPORT OF CALDWELL	NC	501(C)(3)	LINE 7	CALDWELL MEMORIAL HOSPITAL		No
(5)CHATHAM HOSPITAL INC PO BOX 649 SILVER CITY,NC27344 56-0611546	HEALTHCARE	NC	501(C)(3)	LINE 3	UNC HEALTHCARE		No
(6)HIGH POINT REGIONAL HEALTH 601 N ELM STREET HIGH POINT,NC27261 56-0532309	HEALTHCARE	NC	501(C)(3)	LINE 3	UNC HEALTHCARE		No
(7)HIGH POINT REGIONAL HEALTH SERVICES INC 601 N ELM STREET HIGH POINT,NC27261 56-1497163	HEALTHCARE	NC	501(C)(3)	509(A)(3) TYPE 2	UNC HEALTHCARE		No
(8)HIGH POINT REGIONAL HEALTH FOUNDATION INC 601 N ELM STREET HIGH POINT,NC27261 27-2854711	SUPPORT OF HIGH POINT	NC	501(C)(3)	509(A)(3) TYPE 1	HIGH POINT REGIONAL HEALTH		No
(9)REX HEALTHCARE INC 4420 LAKE BOONE TRAIL RALEIGH,NC27607 56-1509129	HEALTHCARE	NC	501(C)(3)	509(A)(3) TYPE 2	UNC HEALTHCARE		No
(10)THE REX HEALTHCARE FOUNDATION INC 4420 LAKE BOONE TRAIL RALEIGH,NC27607 56-6052117	SUPPORT OF REX HOSPITAL	NC	501(C)(3)	509(A)(3) TYPE 2	REX HEALTHCARE		No
(11)UNC PHYSICIANS NETWORK 1600 PERIMETER PARK DRIVE SUITE 225 MORRISVILLE,NC27560 27-1081647	HEALTHCARE	NC	501(C)(3)	LINE 9	UNC HEALTHCARE		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2015

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) REX SURGERY CENTER OF CARY LLC 4420 LAKE BOONE TRAIL RALEIGH,NC27607 27-3684056	ASC	NC	REX HOSPITAL INC	RELATED				No			No	55.000 %
(2) JRH VENTURES LLC 4420 LAKE BOONE TRAIL RALEIGH,NC27607 27-4092967	MED CAMPUS DVLT	NC	REX HOSPITAL INC	RELATED				No			No	50.000 %
(3) REX HEALTH VENTURES I LP 4420 LAKE BOONE TRAIL RALEIGH,NC27607 37-1690478	VENTURE CAPITAL INVESTMENT	NC	REX HEALTH VENTURES	RELATED				No			No	100.000 %
(4) ORTHOPAEDIC SURGERY CENTER OF RALEIGH LLC 4420 LAKE BOONE TRAIL RALEIGH,NC27607 27-1740526	ORTHOPAEDIC SURGERY	NC	REX HOSPITAL INC	RELATED				No			No	51.000 %
(5) HIGH POINT SURGERY CENTER 600 NORTH LINDSAY STREET HIGH POINT,NC27260 56-1867005	HEALTHCARE	NC	N/A
(6) REGIONAL WELLNESS LLC 861 OLD WINSTON ROAD KERNERSVILLE,NC27284 20-4475769	HEALTHCARE	NC		RELATED				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	(i) Section 512(b)(13) controlled entity?
(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	Yes	No
(1) REX ENTERPRISES COMPANY INC 4420 LAKE BOONE TRAIL RALEIGH,NC27607 56-1553957	OPERATIONS SUPPORT	NC	REX HEALTHCARE	C				No
(2) HIGH POINT HEALTHCARE VENTURES INC 601 N ELM STREET HIGH POINT,NC27261 56-1343468	HOLDING COMPANY	NC	N/A	C				No
(3) UNC PHYSICIANS NETWORK GROUP PRACTICES LLC 1600 PERIMETER PARK DRIVE SUITE 225 MORRISVILLE,NC27560 46-1416986	HEALTHCARE	NC	N/A	C				No

Schedule R (Form 990) 2015

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

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) THE REX HEALTHCARE FOUNDATION INC	C	1,806,619	FMV
(2) THE REX HEALTHCARE FOUNDATION INC	P	755,662	FMV

Schedule R (Form 990) 2015

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

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) 2015

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE THE BEST IN HEALTH SERVICES THROUGH COMPASSIONATE CARE AND LEADING-EDGE TECHNOLOGY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	6,611
6	Total number of volunteers (estimate if necessary) .............	6	1,300
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	4,285,156
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,821,489	1,979,704
9	Program service revenue (Part VIII, line 2g) .........	848,124,162	978,292,468
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	18,255,619	7,488,752
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-2,663,001	76,586,843
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	868,538,269	1,064,347,767
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	153,000	969,415
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)	409,811,079	425,922,352
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	352,407,953	512,619,174
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	762,372,032	939,510,941
19	Revenue less expenses. Subtract line 18 from line 12.......	106,166,237	124,836,826
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	835,747,955	929,466,692
21	Total liabilities (Part X, line 26).............	537,080,157	524,751,693
22	Net assets or fund balances. Subtract line 21 from line 20.....	298,667,798	404,714,999

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 779,092,089 including grants of $ 969,415 ) (Revenue $ 966,327,056 )
	UNC REX IS THE ONLY HOSPITAL IN NORTH CAROLINA TO RECEIVE STRAIGHT "A" GRADES SINCE THE LEAPFROG GROUP BEGAN A NATIONAL HOSPITAL SAFETY SCORECARD IN 2012. IN 2016, LEAPFROG NAMED UNC REX TO ITS LIST OF TOP HOSPITALS IN THE COUNTRY -- THE ONLY NORTH CAROLINA HOSPITAL TO RECEIVE THAT RECOGNITION.MORE THAN 10 YEARS AGO, UNC REX BECAME THE FIRST HOSPITAL IN THE TRIANGLE TO BE AWARDED MAGNET STATUS BY THE AMERICAN NURSES CREDENTIALING CENTER. IN 2015, UNC REX WAS RE-DESIGNATED MAGNET STATUS FOR THE THIRD CONSECUTIVE TIME. THE MAGNET RECOGNITION PROGRAM RECOGNIZES HEALTH CARE ORGANIZATIONS FOR EXCELLENCE IN NURSING CARE. THIS AWARD PUTS UNC REX'S NURSES IN AN ELITE GROUP OF THE TOP 2 PERCENT OF NURSES IN THE NATION.UNC REX IS ONE OF THE LARGEST EMPLOYERS IN WAKE COUNTY, WITH MORE THAN 6,400 CO-WORKERS. UNC REX IS KNOWN FOR ITS EXCELLENT BENEFITS AND IS ROUTINELY RECOGNIZED BY LOCAL AND NATIONAL PUBLICATIONS AS A "BEST PLACE TO WORK."UNC REX'S CULINARY TEAM HAS CREATED A CHEF-BASED PROGRAM THAT IS GAINING INTERNATIONAL RECOGNITION AND REINVENTING TRADITIONAL "HOSPITAL FOOD." THEY TEND AN HERB AND VEGETABLE GARDEN AT UNC REX, AND USE LOCAL AND FRESH INGREDIENTS AS MUCH AS POSSIBLE. UNC REX WAS THE FIRST HOSPITAL IN THE SOUTHEAST TO GET RID OF DEEP FRYERS AND THE CHEFS CONTINUE TO EXPLORE NEW WAYS TO COOK AND SERVE OUR CUISINE. IN EARLY 2017, THE UNC REX CHEFS OPENED A NEW MEDITERRANEAN -THEMED, HEART HEALTHY RESTAURANT CALLED KARDIA IN THE NEW NORTH CAROLINA HEART & VASCULAR HOSPITAL. IN ADDITION, THE CHEFS BEGAN OFFERING CLASSES ON HEALTHY COOKING AND EATING TO PATIENTS, THEIR FAMILIES AND MEMBERS OF THE COMMUNITY IN A NEW DEMONSTRATION KITCHEN. UNC REX PERFORMS MORE THAN 32,000 HEART AND VASCULAR PROCEDURES A YEAR, INCLUDING CORONARY ARTERY BYPASS GRAFTING, ENDOVASCULAR AAA REPAIR, ECHOCARDIOGRAPHY, PERIPHERAL VASCULAR ULTRASOUND, VALVE REPLACEMENT AND REPAIR, ANGIOPLASTY, CARDIAC CATHETERIZATION, MINIMALLY INVASIVE STRUCTURAL HEART PROCEDURES, INVASIVE PERIPHERAL VASCULAR INTERVENTIONS, INCLUDING CRITICAL LIMB ISCHEMIA PROCEDURES, ELECTROPHYSIOLOGY PROCEDURES AND STENT PLACEMENT, REGARDLESS OF PATIENTS' ABILITY TO PAY. UNC REX HAS BEEN A CHEST PAIN ACCREDITED HOSPITAL FOR MORE THAN A DECADE, REINFORCING THE ORGANIZATION'S DEDICATION TO COMMUNITY OUTREACH AND INNOVATION IN THE CARE OF CHEST PAIN PATIENTS. THE SERVICE LINE ALSO INCLUDES OPEN HEART SURGICAL SUITES WHERE PHYSICIANS PERFORM PROCEDURES SUCH AS CORONARY ARTERY BYPASS GRAFTING, MITRAL VALVE REPLACEMENT AND REPAIR, AND AORTIC VALVE AND AORTIC ARCH REPLACEMENTS. UNC REX ALSO PROVIDES A FULL RANGE OF INVASIVE CATHETER BASED CARDIAC, VASCULAR AND ELECTROPHYSIOLOGY PROCEDURES. ALL OF THE EXISTING HEART AND VASCULAR SERVICES AND CARE, WHICH WERE PROVIDED AT MORE THAN SEVEN LOCATIONS ACROSS THE MAIN HOSPITAL IN RALEIGH, WERE CONSOLIDATED INTO A MODERN, MORE EFFICIENT AND MORE CONVENIENT FACILITY WITH THE MARCH 2017 OPENING OF THE NORTH CAROLINA HEART AND VASCULAR HOSPITAL ON UNC REX'S MAIN RALEIGH CAMPUS. THE NEW EIGHT-STORY, 306,000-SQUARE-FOOT HOSPITAL PROVIDES EASIER AND MORE COMFORTABLE ACCESS FOR PATIENTS AND THEIR FAMILIES, PHYSICIANS AND STAFF, IN A FACILITY THAT'S DESIGNED TO PROMOTE HEALING, PREVENTION, EDUCATION, INNOVATION AND WELLNESS. UNC REX SURGERY CENTERS IN RALEIGH, CARY AND WAKEFIELD WERE USED BY HUNDREDS OF PHYSICIANS TO PROVIDE MORE THAN 36,000 IN- AND OUT-PATIENT SURGERIES AND PROCEDURES IN FY16. THE THREE LOCATIONS HAVE IMPROVED ACCESS TO SPECIALIZED CARE FOR PATIENTS ACROSS THE REGION. SURGEONS MAKE SUBSTANTIAL USE OF MINIMALLY INVASIVE TECHNOLOGY AND INNOVATION FOR DIAGNOSIS AND TREATMENT, REDUCING PATIENTS' RECOVERY TIME AND HOSPITAL STAY AND SUPPORTING QUALITY CARE. THE CENTERS INCLUDE 38 OPERATING SUITES, 11 MINOR PROCEDURE ROOMS, AND VARIOUS PERIOPERATIVE AND ANCILLARY SUPPORT SPACES. UNC REX IS INCREASINGLY PERFORMING SURGERIES ON AN OUTPATIENT BASIS, AND CONTINUING TO LOOK FOR OTHER WAYS TO REDUCE OVERALL COSTS FOR PATIENTS. SOME OF THE TOP PROCEDURES INCLUDE GENERAL, ORTHOPEDIC, GYNECOLOGIC AND OPHTHALMIC SURGERIES. DURING THE YEAR, NEARLY 4,300 OUTPATIENT ORTHOPEDIC PROCEDURES WERE PERFORMED AT RALEIGH ORTHOPEDIC SURGERY CENTER, UNC REX'S JOINT VENTURE WITH RALEIGH ORTHOPAEDIC CLINIC LOCATED ABOUT A MILE FROM UNC REX'S MAIN RALEIGH CAMPUS. UNC REX PROVIDES A FULL RANGE OF SPECIALIZED, MULTI-DISCIPLINARY ONCOLOGY THERAPY AND SUPPORT SERVICES TO PATIENTS IN WAKE COUNTY AND BEYOND INCLUDING MEDICAL, RADIATION AND SURGICAL ONCOLOGY. DURING FISCAL YEAR 2016, UNC REX CANCER CENTER PROVIDED MORE THAN 30,000 RADIATION ONCOLOGY TREATMENTS, AND NEARLY 50,000 HEMATOLOGY/ONCOLOGY CHEMOTHERAPY TREATMENTS AND INFUSIONS AT FIVE LOCATIONS IN WAKE COUNTY. IN ADDITION TO CANCER TREATMENTS AND THERAPIES, THE CENTERS PROVIDE OUTREACH AND SUPPORT SERVICES INCLUDING NUTRITIONAL SERVICES, NURSE NAVIGATION, SOCIAL WORK, REHABILITATION SERVICES AND SURVIVORSHIP OR END OF LIFE CARE. UNC REX CANCER CENTER ALSO PROVIDES ONCOLOGIC SURGICAL SERVICES TO CANCER PATIENTS THROUGH ACCESS TO UNC REX HOSPITAL. UNC REX CANCER CENTER IS ACCREDITED BY THE COMMISSION ON CANCER AS A COMPREHENSIVE COMMUNITY CANCER CENTER AND WORKS CLOSELY WITH THE NATIONALLY RECOGNIZED N.C. CANCER HOSPITAL AND THE UNC LINEBERGER COMPREHENSIVE CANCER CENTER IN CHAPEL HILL TO EXTEND SPECIALTY ONCOLOGY SERVICES AND CLINICAL TRIALS TO PATIENTS IN RALEIGH. DURING 2016, UNC REX CANCER CARE OPENED ITS NEWS CANCER CENTER IN EAST RALEIGH, PROVIDING STATE-OF-THE-ART RADIATION ONCOLOGY SERVICES TO PATIENTS IN THAT AREA.AT UNC REX'S WOMEN'S CENTER, CAREGIVERS SEEK TO PROVIDE FAMILY-CENTERED CARE TO THE NEW MOTHER, BABY AND EXTENDED FAMILY. DURING FISCAL YEAR 2016, 5,650 BABIES WERE BORN IN THE REX WOMEN'S CENTER. THESE BIRTHS ARE SUPPORTED BY 24/7 ANESTHESIOLOGY AND NEONATOLOGY SERVICES, HIGH RISK OBSTETRICS PROVIDED BY UNC MATERNAL FETAL MEDICINE, LACTATION SUPPORT SERVICES PROVIDED BY A TEAM OF CERTIFIED LACTATION CONSULTANTS AND AN IN-HOUSE RETAIL CENTER FOR INFANT NUTRITION. UNC REX ALSO OFFERS A WIDE VARIETY OF PRE- AND POST-NATAL CLASSES, SCREENING FOR POSTPARTUM DEPRESSION AND PSYCHOLOGICAL SERVICES. THERE ARE THREE OPERATING SUITES FOR CESAREAN BIRTHS AND 70 PRIVATE ROOMS IN WHICH LABOR, DELIVERY, RECOVERY, AND POSTPARTUM CARE OF THE MOTHER AND CHILD NORMALLY OCCUR. IN 2015, UNC REX'S NEONATAL INTENSIVE CARE UNIT WAS GRANTED A LEVEL IV DESIGNATION, ALLOWING UNC REX'S TEAM OF BOARD CERTIFIED NEONATOLOGISTS, NURSES, RESPIRATORY THERAPISTS, DEVELOPMENTAL CARE TEAM AND OTHERS TO CARE FOR EVEN MORE PREMATURE AND MEDICALLY FRAGILE BABIES. UNC REX'S NICU WAS PREVIOUSLY DESIGNATED LEVEL III. IN 2016, REX ALSO ADDED AN OBSTETRIC EMERGENCY DEPARTMENT. THE OB ED IS STAFFED 24/7 WITH A TEAM OF OB HOSPITALISTS, NURSES AND TECHNICIANS WHO PROVIDE OBSTETRIC EMERGENCY CARE IN PARTNERSHIP WITH OUR COMMUNITY OBSTETRICIANS. THIS ASSURES OUR PATIENTS ALWAYS RECEIVE TIMELY OBSTETRIC CARE, NOT TO MENTION AN EXTRA PAIR OF HANDS WHEN AN OBSTETRICIAN HAS TWO DELIVERIES AT ONE TIME OR IS MANAGING OTHER URGENT PATIENT CARE NEEDS.UNC REX PROVIDED MORE THAN 4,700 SCREENING MAMMOGRAMS TO WOMEN ACROSS A 17-COUNTY REGION, INCLUDING MANY WITH NO INSURANCE OR WHO ARE UNDERINSURED. UNC REX'S TWO MOBILE MAMMOGRAPHY VEHICLES (NICKNAMED BETTY AND WILMA) PROVIDE A CONVENIENT OPTION FOR BUSINESS AND OTHER ORGANIZATIONS SO THAT ALL WOMEN MAY BENEFIT FROM MAMMOGRAPHY'S EARLY DETECTION CAPABILITIES. MOBILE MAMMOGRAPHY IS MADE POSSIBLE THROUGH GENEROUS FUNDING FROM REVLON INC., THE KAY YOW CANCER FUND, THE UNC REX HOSPITAL OPEN, AND THE REX HEALTHCARE FOUNDATION. MAMMOGRAPHY SERVICES FUNDING IS AVAILABLE FOR QUALIFIED WOMEN UTILIZING THE MOBILE MAMMOGRAPHY UNIT THROUGH GENEROUS FUNDING FROM SUSAN G. KOMEN FOR THE CURE, NC TRIANGLE AFFILIATE.UNC REX BLOOD SERVICES RUNS TWO BLOODMOBILES (NICKNAMED FRED AND BARNEY) THAT TRAVEL TO SCHOOLS, CHURCHES, EMPLOYERS AND OTHER ORGANIZATIONS THAT WANT TO HOST BLOOD DRIVES. THE UNC REX DONOR CENTER WAS FOUNDED IN 1962 BY A CONCERNED GROUP OF PHYSICIANS AND COMMUNITY LEADERS WHO WANTED TO ENSURE THAT THERE WOULD ALWAYS BE A SAFE AND ADEQUATE BLOOD SUPPLY TO MEET THE NEEDS OF LOCAL PATIENTS. THIS NOT-FOR-PROFIT, COMMUNITY BLOOD BANK EXCEEDS THE SAFETY STANDARDS SET BY THE BLOOD BANKING INDUSTRY AND IS ACCREDITED BY THE AMERICAN ASSOCIATION OF BLOOD BANKS, COLLEGE OF AMERICAN PATHOLOGY AND THE FOOD AND DRUG ADMINISTRATION.UNC REX IS A LEADER IN WELLNESS, PREVENTION AND EDUCATION IN OUR COMMUNITY. WE WORK WITH VARIOUS COMMUNITY PARTNERS TO IMPROVE THE OVERALL HEALTH OF RESIDENTS OF ALL AGES. UNC REX WELLNESS CENTERS IN RALEIGH, CARY, WAKEFIELD, GARNER AND KNIGHTDALE PROVIDE A WIDE RANGE OF FITNESS, DIET, REHAB AND OTHER SERVICES FOR MORE THAN 15,000 MEMBERS.

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 expenses779,092,089

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	13,484,475	2,441,250	1,879,007

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	1,979,704
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		1,979,704

			Business Code
2a	PATIENT SERVICE REVENUE	625100	933,234,738	933,234,738
b
c
d
e
f	All other program service revenue.			45,057,730	35,163,157	4,285,156	5,609,417
g Total.Add lines 2a–2f.....			978,292,468

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			3,858,299			3,858,299
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		1,146,655
b	Less: rental expenses		301,276
c	Rental income or (loss)		845,379
d	Net rental income or (loss)......			845,379			845,379
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		147,331,024
b	Less: cost or other basis and sales expenses	31,597	143,668,974
c	Gain or (loss)	-31,597	3,662,050
d	Net gain or (loss).....			3,630,453			3,630,453
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
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..
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..
Business Code			Miscellaneous Revenue
11a	GAIN ON CHANGE IN PENSION PLAN		621990	75,741,464			75,741,464
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			75,741,464
12	Total revenue. See Instructions......			1,064,347,767	968,397,895	4,285,156	89,685,012

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	969,415	969,415
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	5,856,425		5,856,425
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	346,425,455	314,048,389	32,377,066
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	20,675,944	19,656,755	1,019,189
9	Other employee benefits .......	29,718,718	26,385,564	3,333,154
10	Payroll taxes ...........	23,245,810	20,457,565	2,788,245
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	809,289		809,289
c	Accounting ...........	137,412		137,412
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	989,543		989,543
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	29,469,013	26,816,802	2,652,211
12	Advertising and promotion ....	3,287,319	2,991,460	295,859
13	Office expenses .......	7,548,958	6,869,552	679,406
14	Information technology ......	18,964,762	17,257,933	1,706,829
15	Royalties ..
16	Occupancy ...........	22,944,792	20,879,761	2,065,031
17	Travel ............	1,550,798	1,411,226	139,572
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	259,545	236,186	23,359
20	Interest ...........	4,535,751	4,127,533	408,218
21	Payments to affiliates .......	31,447,522	31,447,522
22	Depreciation, depletion, and amortization ..	34,081,743	31,014,386	3,067,357
23	Insurance ...	5,218,333	4,748,683	469,650
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	PATIENT SUPPLIES & SERV	199,260,045	199,260,045
b	HOME OFFICE ALLOCATION	99,455,508		99,455,508
c	BAD DEBT EXPENSE	28,819,623	28,819,623
d	MINOR EQUIPMENT AND R &	15,500,148	14,105,135	1,395,013
e	All other expenses	8,339,070	7,588,554	750,516
25	Total functional expenses. Add lines 1 through 24e	939,510,941	779,092,089	160,418,852	0
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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			56,816,976	1	57,092,540
2	Savings and temporary cash investments .........			10,444,174	2	30,453,969
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			109,014,543	4	116,946,132
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 ....				7
8	Inventories for sale or use ........			17,855,038	8	17,225,654
9	Prepaid expenses and deferred charges ......			34,656,167	9	32,884,632
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	868,388,173
b	Less: accumulated depreciation	10b	498,771,594	303,786,859	10c	369,616,579
11	Investments—publicly traded securities .			268,140,687	11	254,570,720
12	Investments—other securities. See Part IV, line 11 .....			14,404,566	12	18,763,500
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			20,628,945	15	31,912,966
16	Total assets. Add lines 1 through 15 (must equal line 34)...			835,747,955	16	929,466,692

17	Accounts payable and accrued expenses .....	155,980,594	17	145,940,653
18	Grants payable ...		18
19	Deferred revenue .........	721,886	19	405,419
20	Tax-exempt bond liabilities .........	169,337,941	20	252,507,516
21	Escrow or custodial account liability. Complete Part IV of Schedule D	12,345	21	14,598
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 ..	15,000,000	24	0
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	196,027,391	25	125,883,507
26	Total liabilities. Add lines 17 through 25..	537,080,157	26	524,751,693

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	294,891,843	27	297,882,177
28	Temporarily restricted net assets ...........	3,775,955	28	106,832,822
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........	298,667,798	33	404,714,999
34	Total liabilities and net assets/fund balances ........	835,747,955	34	929,466,692