TY 2017 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) HENRY DARNELL...................................................................... BOARD MEMBER	3.0 ................. 0.0	X		0	0
(2) STEPHEN M SMITH...................................................................... BOARD MEMBER	3.0 ................. 0.0	X		0	0
(3) BRENDA C GIBSON...................................................................... CHAIR - BOARD OF DIRECTORS	6.25 ................. 0.0	X		0	0
(4) JERRY C BERNSTEIN MD...................................................................... BOARD MEMBER	3.0 ................. 0.0	X		0	0
(5) ROBERT A CERWIN...................................................................... BOARD MEMBER	2.75 ................. 0.0	X		0	0
(6) A BLANTON GODFREY PHD...................................................................... BOARD MEMBER	2.75 ................. 0.0	X		0	0
(7) VERN DAVENPORT...................................................................... BOARD MEMBER	2.75 ................. 0.0	X		0	0
(8) ROBERT C RICE JR...................................................................... BOARD MEMBER	3.25 ................. 0.0	X		0	0
(9) WILLY E STEWART...................................................................... SECRETARY, BOARD OF DIRECTORS	2.75 ................. 0.0	X		0	0
(10) DAN BLUE III...................................................................... BOARD MEMBER	2.75 ................. 0.0	X		0	0
(11) CHRISTINA ALVARADO SHANAHAN...................................................................... VICE CHAIR, BOARD OF DIRECTORS	2.5 ................. 0.0	X		0	0
(12) James Anthony Penry...................................................................... BOARD MEMBER	2.75 ................. 0.0	X		0	0
(13) R Donovan Munford...................................................................... BOARD MEMBER	1.75 ................. 0.0	X		0	0
(14) Sonia Barnes...................................................................... BOARD MEMBER	2.0 ................. 0.0	X		0	0
(15) DONALD R GINTZIG...................................................................... President & CEO	75.0 ................. 0.0		X	1,509,505	41,299
(16) DENISE WARREN...................................................................... Exec VP & COO	65.0 ................. 0.0		X	777,166	35,354
(17) Rick Carrico...................................................................... CFO	60.0 ................. 0.0		X	384,033	31,624

(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)	(F) Estimated amount of other compensation from the organization and related organizations
(18) ROYLYN JOHNSON........................................................................ OFFICER - SECRETARY	50.0 .......................0.0	X				108,334	15,368
(19) THEODORE LOTCHIN........................................................................ VP - CHIEF COMPL. & PRIVACy	60.0 .......................0.0	X				61,796	4,712
(20) CAROLYN KNAUP........................................................................ SENIOR VP-AMBULATORY SERVICES	62.0 .......................0.0		X			371,369	37,587
(21) CYNTHIA ALNESS-BOILY........................................................................ SENIOR VP-OPERATIONS & CNO	60.0 .......................0.0		X			451,985	33,879
(22) GEORGIA C HARRINGTON........................................................................ VP-OPS (END 4/6/18)	55.0 .......................0.0		X			317,168	31,332
(23) Charles Harr........................................................................ Chief Medical Officer, Raleigh	60.0 .......................0.0		X			527,170	18,700
(24) Christine Craig........................................................................ VP, Governmental Affairs	55.0 .......................0.0		X			268,110	31,789
(25) J West Paul........................................................................ SVP & Ch Quality/Med Staff Ofc	60.0 .......................0.0		X			507,418	42,410
(26) Rebecca Andrews........................................................................ SVP & ADMIN RALEIGH	63.0 .......................0.0		X			477,588	27,857
(27) Seth Brody........................................................................ Chief Medical Officer, Cary	60.0 .......................0.0		X			471,716	17,200
(28) Stephanie Sessoms........................................................................ VP FINANCE	60.0 .......................0.0		X			358,333	37,924
(29) Susan James........................................................................ VP & Chief Legal Officer	55.0 .......................0.0		X			374,255	39,830
(30) Thomas Gough........................................................................ SVP - Administrator Cary	60.0 .......................0.0		X			393,045	39,603
(31) SHERI D DESHAZO........................................................................ SR VP ADMINISTRATION-NORTH	65.0 .......................0.0		X			286,419	40,438
(32) Debra Laughery........................................................................ VP - Public Relations	60.0 .......................0.0		X			308,471	16,300
(33) MATTHEW NATHAN BEG 9262016........................................................................ SENIOR VP - PHYSICIAN SERVICES	65.0 .......................0.0		X			533,752	20,039
(34) KAREN BASH........................................................................ CMO, NORTH HOSPITAL	60.0 .......................0.0		X			411,572	32,028
(35) RICK SHRUM beg 1117........................................................................ VP & CHIEF STRATEGY OFFICER	60.0 .......................0.0		X			354,099	42,857
(36) JOHN PERRY........................................................................ VP MEDICAL EDUCATION	60.0 .......................0.0		X			339,795	40,603
(37) CHANTAL HOWARD........................................................................ VP NURSING, RALEIGH	60.0 .......................0.0		X			222,754	23,737
(38) PETER MARKS........................................................................ VP & CIO (beg 6/26/17)	60.0 .......................0.0		X			172,517	9,711
(39) JEANENE R MARTIN........................................................................ SENIOR VP-HUMAN RESOURCES	60.0 .......................0.0		X			420,007	35,477
(40) THOMAS G CAVENDER........................................................................ VP FACILITIES & CONSTRUCTION	50.0 .......................0.0		X			359,580	21,126
(41) GURVINDER S DEOL........................................................................ PHYSICIAN	65.0 .......................0.0			X		1,336,445	36,015
(42) JONATHAN D CHAPPELL........................................................................ PHYSICIAN	60.0 .......................0.0			X		1,031,691	33,333
(43) Bryon Boulton........................................................................ Physician	61.0 .......................0.0			X		1,248,510	30,351
(44) Conor Regan........................................................................ Physician	60.0 .......................0.0			X		953,012	24,742
(45) OKECHUKWU NWOKO........................................................................ PHYSICIAN	60.0 .......................0.0			X		952,458	17,871
(46) JOHN R FINLEY END 81817........................................................................ CHIEF COMPLIANCE OFFICER	0.0 .......................0.0				X	186,588	0
(47) BETSY GASKINS-MCCLAINE........................................................................ VP HEART & VASCULAR	65.0 .......................0.0				X	322,791	25,015
(48) VICKI BLOCK........................................................................ Former SR VP & ADMIN. RALEIGH	0.0 .......................0.0				X	190,384	0
(49) JOHN S PIATKOWSKIEND 1216........................................................................ FORMER SR VP AMB & PHYS OP	0.0 .......................0.0				X	463,407	850
(50) E DENTON ARLEDGE........................................................................ FORMER VP & CIO (end 8/18/17)	0.0 .......................0.0				X	359,510	23,828

(A) Name and business address	(B) Description of services	(C) Compensation
UNIVERSITY OF NC HOSPITALS, 211 FRIDAY CENTER DRIVE SUITE 2033 CHAPEL HILL,NC27517	HEALTH CARE SYSTEM	4,104,724
AMCOL SYSTEMS, PO BOX 21625 COLUMBIA,SC29221	COLLECTION SERVICES	3,052,349
LABORATORY CORPORATION OF AMERICA, PO BOX 12140 BURLINGTON,NC27216	DIAGNOSTIC TESTING	2,796,388
NAVIGANT CONSULTING INC, 4511 PAYSPHERE CIRCLE CHICAGO,IL60674	CONSULTING SERVICES	2,012,952
WAKE MEDICAL LABORATORY CONSULTANTS, PO BOX 14004 RALEIGH,NC27620	PATHOLOGY SERVICES	1,897,087
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 93

- 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.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

Wakemed

Employer identification number

56-6017737

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, 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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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) 2019

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. 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—2018. 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—2019. 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—2018. 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) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. 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—2018. 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) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d 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 12a or 12b 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) 2019

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) 2019

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 (explain in Part VI). 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) 2019

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

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) 2019

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.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

Wakemed

Employer identification number

56-6017737

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. Don't 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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization Wakemed

Part I Contributors	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
		$	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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization Wakemed		Employer identification number 56-6017737

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization Wakemed			Employer identification number 56-6017737
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) (2019)

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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

Wakemed

Employer identification number

56-6017737

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 (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

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) 2019

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) 2016	(b) 2017	(c) 2018	(d) 2019	(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) 2019

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|No

(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)? ........

Yes

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

Yes

544,585

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

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

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

544,585

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
SCHEDULE C, PART II-B, LINE 1	WAKEMED AND ITS OFFICE OF GOVERNMENT AFFAIRS WORK TO MAINTAIN AND STRENGTHEN EFFECTIVE RELATIONSHIPS WITH LEGISLATORS AND POLICY MAKERS AT THE STATE, LOCAL, AND NATIONAL LEVELS. THE OBJECTIVE IS TO ENSURE THAT WAKEMED'S POINT OF VIEW IS CONSISTENTLY AND CONTINUALLY HEARD SO THAT LEGISLATION, REGULATIONS, AND THE SETTING OF HEALTH POLICY SUPPORT THE ORGANIZATION'S ABILITY TO FULFILL ITS MISSION OF CARE FOR ALL, REGARDLESS OF THE ABILITY TO PAY. IN ADDITION, WAKEMED PAID ANNUAL DUES TO VARIOUS HOSPITAL ASSOCIATIONS. THESE HOSPITAL ASSOCIATIONS CONDUCT LOBBYING ACTIVITIES ON BEHALF OF ITS MEMBERS, AND AS SUCH, A PORTION OF THE HOSPITAL DUES ARE ALLOCATED TO LOBBYING.

Return Reference

Explanation

SCHEDULE C, PART II-B, LINE 1

WAKEMED AND ITS OFFICE OF GOVERNMENT AFFAIRS WORK TO MAINTAIN AND STRENGTHEN EFFECTIVE RELATIONSHIPS WITH LEGISLATORS AND POLICY MAKERS AT THE STATE, LOCAL, AND NATIONAL LEVELS. THE OBJECTIVE IS TO ENSURE THAT WAKEMED'S POINT OF VIEW IS CONSISTENTLY AND CONTINUALLY HEARD SO THAT LEGISLATION, REGULATIONS, AND THE SETTING OF HEALTH POLICY SUPPORT THE ORGANIZATION'S ABILITY TO FULFILL ITS MISSION OF CARE FOR ALL, REGARDLESS OF THE ABILITY TO PAY. IN ADDITION, WAKEMED PAID ANNUAL DUES TO VARIOUS HOSPITAL ASSOCIATIONS. THESE HOSPITAL ASSOCIATIONS CONDUCT LOBBYING ACTIVITIES ON BEHALF OF ITS MEMBERS, AND AS SUCH, A PORTION OF THE HOSPITAL DUES ARE ALLOCATED TO LOBBYING.

Schedule C (Form 990 or 990EZ) 2019

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.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Wakemed

Employer identification number

56-6017737

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 7/25/06, 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 FASB 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 FASB 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 FASB 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) 2019

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 ....	336,449	337,353	335,518	332,541	329,232
b	Contributions ...
c	Net investment earnings, gains, and losses	4,238	3,448	3,601	4,776	5,081
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....	5,181	4,352	1,766	1,799	1,772
g	End of year balance ......	335,506	336,449	337,353	335,518	332,541

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

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100.000 %

Term endowment SchDMd Bullet

0 %

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 .....	3,864,369		3,864,369
b	Buildings ....	628,355,087	332,033,824	296,321,263
c	Leasehold improvements	31,046,486	18,334,749	12,711,737
d	Equipment ....	864,823,906	693,912,817	170,911,089
e	Other .....	38,325,324	18,076,602	20,248,722
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				504,057,180

Schedule D (Form 990) 2019

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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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)RESTRICTED FUNDS				37,507,730
(2)DESIGNATED FUNDS				31,379,926
(3)OTHER EQUITY INVESTMENTS				31,845,909
(4)PREPAID PENSION				13,865,704
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				114,599,269

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	0
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	26,958,872
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) 2019

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
Intended use of endowment funds	SCHEDULE D, PART V, LINE 4 THE ALLEN TRUST ENDOWMENT FUNDS ARE USED TO PROVIDE POOR AND INDIGENT PATIENTS WITH NEEDED PRIVATE NURSING CARE. WAKEMED DEFINES "POOR AND INDIGENT" AS THOSE WITH A FINANCIAL CLASS OF SELF-PAY OR MEDICAID. THE SITTER PROVIDING PRIVATE NURSING CARE MAY BE EITHER IN THE HOSPITAL OR IN A HOME SETTING.

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization
Wakemed

Employer identification number

56-6017737

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in the region	(e) If activity listed in (d) is a program service, describe specific type of service(s) in the region	(f) Total expenditures for and investments in the region
	Central America and the Caribbean	0	0	INSURANCE PREMIUMS/EXP	6,483,665
















3a	Sub-total ....	0	0		6,483,665
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)	0	0		6,483,665

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2019

Schedule F (Form 990) 2019

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of noncash assistance	(h) Description of noncash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2019

Schedule F (Form 990) 2019Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of noncash assistance	(g) Description of noncash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2019

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2019

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.

ReturnReference	Explanation

Schedule F (Form 990) 2019

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

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Wakemed

Employer identification number

56-6017737

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 250 %

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: . . . . . . . .

Yes

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) . . .	89,399,139		89,399,139	7.050 %
b	Medicaid (from Worksheet 3, column a) . . . . .	207,935,067	180,589,599	27,345,468	2.160 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	1,491,502	1,427,254	64,248	0.010 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	298,825,708	182,016,853	116,808,855	9.220 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	4,764,335	250,000	4,514,335	0.360 %
f	Health professions education (from Worksheet 5) . . .	12,120,532	10,392,538	1,727,994	0.140 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	1,152,297		1,152,297	0.090 %
j	Total. Other Benefits . .	18,037,164	10,642,538	7,394,626	0.590 %
k	Total. Add lines 7d and 7j .	316,862,872	192,659,391	124,203,481	9.810 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

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.

		(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	125,142		125,142	0.010 %
3	Community support	678,378		678,378	0.050 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	4,700,997	47,405	4,653,592	0.370 %
9	Other
10	Total	5,504,517	47,405	5,457,112	0.430 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare 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. ......

23,184,589

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).....

361,534,764

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

457,054,495

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

-95,519,731

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 %
1CAPITAL CITY SURGERY	SURGERY	51 %	0 %	22.19 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2019

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?2Name, 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)						Facility reporting group
1	WAKEMED CARY HOSPITAL 1900 KILDARE FARM ROAD CARY,NC27518 WWW.WAKEMED.ORG H0276	X	X		X	A
2	WakeMed Raleigh Campus 3000 New Bern Avenue RALEIGH,NC27610 WWW.WAKEMED.ORG H0199	X	X	X	X	A

Schedule H (Form 990) 2019

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)

	A
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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

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 SECTION C

Other website (list url): SEE SECTION C

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 16

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

Yes

If "Yes" (list url): SEE SECTION C

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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	A
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.%
and FPG family income limit for eligibility for discounted care of 300.%

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

Yes

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)

Was widely publicized 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 SECTION C

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

SEE SECTION C

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

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)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	A
Name of hospital facility or letter of facility reporting group

Yes

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 nonpayment?..................................

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

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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

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

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

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)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

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

	A
Name of hospital facility or letter of facility reporting group

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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) 2019

Page 8

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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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
FACILITY GROUP A	ALL ANSWERS PROVIDED IN PART V, SECTION B & C PERTAIN TO FACILITY GROUP A, WHICH INCLUDES WAKEMED RALEIGH CAMPUS AND WAKEMED CARY HOSPITAL AS IDENTIFIED ON SCHEDULE H, PART V, SECTION A, LINES 1-2. Schedule H, Part V, Sec B. Line 3e The significant health needs of Wake County were identified in the 2016 Community Health Needs Assessment, which was conducted in collaboration with the areas other health systems, Wake County Human Services and other community agencies. While there was not a focus on specific health conditions, the perceived needs were prioritized based on the research data. The four priority areas for Wake County are: health insurance coverage, transportation, access to health services and mental health and substance abuse. Those without health insurance are less likely to receive medical care, are more likely to have poor health status and are more likely to die early. Although the Affordable Care Act did result in an increase in the availability of insurance to more residents, the lack of Medicaid expansion in North Carolina has left many low-income residents without insurance. The level and type of insurance held by individuals can significantly impact their ability to obtain healthcare services, and more specifically to obtain services in the most appropriate healthcare setting. While transportation may not seem related to health needs, many aspects of daily life require use of transportation, including employment, education, access to nutritional foods, and access to healthcare services, and all of these factor into ones overall health. Further, transportation also impacts physical activity. The transportation infrastructures in Wake County have struggled to keep up with the population growth experienced within the county over recent years. The ability to access health services is a critical public health issue, as primary and preventative services can help to prevent or manage chronic illnesses thus improving the health of the community. A lack of facilities and specialists in local communities across the county were noted as being barriers to accessing care as were the need for more sliding scale providers. The traditional hours offered by many healthcare providers also create a barrier to accessing care for many individuals and families who are forced to miss an entire or partial day of work in order to go to the doctor. Wake County has experienced an increase in the prevalence and severity of mental health and substance abuse problems over recent years. At the same time, the availability of resources and access to services for people suffering with these problems has declined. Mental health and substance abuse were identified as priority areas in seven of the eight service zones and Wake County overall. Reasons that mental health and substance use were identified include high: suicide rates, smoking, number of people reporting poor mental health days, rate of mental health emergency department, alcohol-impaired driving deaths, percentage of people exposed to secondhand smoke, persons served in NC State Alcohol and Drug Treatment Centers.
SCHEDULE H, PART V, SECTION B, LINE 5	THE FOLLOWING RESPONSES APPLY TO ALL FACILITIES WITHIN THE GROUP, UNLESS OTHERWISE NOTED. AS INDICATED IN THE EXECUTIVE SUMMARY AND CHAPTER 1 OF THE CHNA REPORT, WAKEMED PARTNERED WITH OVER 60 AGENCY AND COMMUNITY PARTNERS IN WAKE COUNTY TO CONDUCT THE COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT IN LATE 2015 THROUGH EARLY 2016. THE CHNA IS BEING UPDATED IN 2019 AND WILL BE AVAILABLE IN LATE JUNE. (HTTP://WWW.WAKEMED.ORG/DOCUMENTS/WAKE-COUNTY-COMMUNITY-HEALTH-NEEDS-ASSES SMENT.PDF) THE PURPOSE OF THE PROJECT WAS TO IDENTIFY HEALTH STATUS CONCERNS AND RESOURCES IN WAKE COUNTY, REPORT FINDINGS, WORK WITH COMMUNITY, DETERMINE PRIORITY ISSUES TO BE ADDRESSED AND DEVELOP A COMMUNITY-BASED ACTION PLAN TO ADDRESS IDENTIFIED CONCERNS. THE STUDY REPORT, WHICH BECAME AVAILABLE IN JUNE 2016, WAS THE BASIS OF THE IMPLEMENTATION PLAN. A MULTI-STEP PROCESS WAS USED TO ASSESS THE COMMUNITY HEALTH NEEDS, CHALLENGES, AND OPPORTUNITIES OF WAKE COUNTY. MULTIPLE SOURCES OF PUBLICLY AVAILABLE INFORMATION, ALONG WITH DIVERSE COMMUNITY INPUT, WERE INCORPORATED IN THE STUDY IN ORDER TO PAINT A MORE COMPLETE PICTURE OF WAKE COUNTYS HEALTH NEEDS. PRIMARY RESEARCH DATA WAS COLLECTED VIA TELEPHONE SURVEYS, INTERNET SURVEYS, AND FOCUS GROUPS. IN ADDITION, COMMUNITY INPUT AND PRIORTIZATION SESSIONS WERE HELD. IN TOTAL MORE THAN 1,500 PEOPLE PARTICIPATED IN THE PROCESS. TIME PERIOD FOR INPUT: THE COLLECTION PERIOD BEGAN IN SEPTEMBER 2015; DATA WAS GATHERED THROUGH MARCH 2016. DESCRIPTION OF MEDICALLY UNDERSERVED, LOW-INCOME OR MINORITY POPULATIONS THAT PROVIDED INPUT: MEDICALLY UNDERSERVED INCLUDE THOSE WITHOUT MEDICAL INSURANCE OR ACCESS TO MEDICAL CARE. DATA SUCH AS RATES OF FREE AND REDUCED LUNCH, FOOD INSECURITY, HOMELESSNESS, POVERTY RATES / MEDIAN INCOME DESCRIBED LOW-INCOME RESIDENTS IN THE COUNTY. RACIAL AND ETHNIC MINORITY POPULATIONS, THE HOMELESS POPULATION, LIMITED ENGLISH-SPEAKING HOUSEHOLDS, AND SPANISH-SPEAKING RESIDENTS DESCRIBE THE MINORITY POPULATIONS FROM WHOM DATA WAS GATHERED. INPUT BY MEDICALLY UNDERSERVED, LOW-INCOME OR MINORITY POPULATIONS: SIGNIFICANT EFFORT WAS PUT INTO UNDERSTANDING THE EXISTING RACIAL/ETHNIC, UNDERSERVED, MEDIAN INCOME/POVERTY LEVEL MAKE-UP OF THE COUNTY. LIMITATIONS ON THE GATHERING OF DATA FOR THE MEDICALLY UNDERSERVED, LOW-INCOME OR MINORITY POPULATIONS WERE RECOGNIZED. SUCH LIMITATIONS INCLUDE ZIP CODE / CENSUS TRACT ISSUES AND LEGAL AND PRACTICAL ISSUES GATHERING DATA FOR CHILDREN, 'STALE' DATA, AND ACCESS TO THESE POPULATIONS. UNDERSTANDING THE LIMITATIONS AND TACKLING THE CHALLENGES POSED BY THESE LIMITATIONS WERE KEY IN GATHERING THE NECESSARY INPUT FROM THESE POPULATIONS. IT WAS RECOGNIZED THAT PARTNERING WITH LOCAL ORGANIZATIONS THAT HAVE ACCESS TO THESE POPULATIONS LED TO NUMEROUS PARTNERSHIPS IN THE PROCESS. THE METHODOLOGY WAS DEVELOPED WITH SPECIAL ATTENTION GIVEN TO THE GATHERING OF DATA FROM THESE SUB-POPULATIONS SINCE IT WAS DETERMINED THAT THE 2013 CHNA DATA-GATHERING FELL SHORT IN THIS AREA. BOTH PRIMARY AND SECONDARY DATA WAS GATHERED. PRIMARY DATA COLLECTED INCLUDED DATA GATHERED THROUGH A TELEPHONE SURVEY (WHICH WAS STATISTICALLY REPRESENTATIVE OF THE COUNTY AS A WHOLE) AS WELL AS A WEB-BASED SURVEY WHICH ALLOWED FOR ADDITIONAL COMMUNITY INPUT. FOCUS GROUPS WERE ALSO CONDUCTED AT NUMEROUS LOCATIONS THROUGHOUT THE COUNTY TO ENSURE GEOGRAPHIC REPRESENTATION OF THE ENTIRE COUNTY. SPECIAL FOCUS GROUPS DEDICATED TO OBTAINING INPUT FROM THE SPANISH-SPEAKING AND HOMELESS POPULATIONS WERE ALSO HELD. A SPECIFIC EXAMPLE OF PRIMARY DATA GATHERED FOR LOW-INCOME RESIDENTS WAS A FOCUS GROUP MADE UP OF HOMELESS INDIVIDUALS COORDINATED THROUGH LOVE WINS MINISTRY. LASTLY, THE PRIORITIZATION PROCESS WHICH CONCLUDED THE DATA COLLECTION PERIOD PROVIDED THE ENTIRE COMMUNITY OF WAKE COUNTY WITH THE OPPORTUNITY TO DECIDE WHICH ISSUES SHOULD BE THE FOCUS OF CHNA ACTION PLANS FOR THE NEXT THREE YEARS. SECONDARY DATA RELATED TO THE MEDICALLY UNSERVED, LOW-INCOME, AND MINORITY POPULATIONS WERE ALSO GATHERED THROUGHOUT THE PROCESS FROM EXISTING SOURCES. IN ADDITION, INPUT FROM NUMEROUS COMMUNITY ORGANIZATIONS WITH KNOWLEDGE OF THE ISSUES THAT NEED TO BE ADDRESSED WITHIN WAKE COUNTY WAS GATHERED THROUGHOUT THE ENTIRE PROCESS. FOR EXAMPLE, ADVANCE COMMUNITY HEALTH, A FEDERALLY-QUALIFIED HEALTH CENTER (FQHC), WHICH SERVES A SIGNIFICANT PORTION OF MEDICALLY UNDERSERVED AND LOW-INCOME RESIDENTS WITHIN WAKE COUNTY, WAS A PARTICIPATING ORGANIZATION THROUGHOUT THE PROCESS. WAKEMED MANAGEMENT BELIEVES THAT THE 2016 CHNA ADEQUATELY INCORPORATES INPUT FROM THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS.
SCHEDULE H, PART V, SECTION B, LINE 6A	The following responses apply to all facilities within the group, unless otherwise noted. Wake County Human Services, Duke Health Raleigh, Rex Healthcare, Wake Health Services, and WakeMed in addition to numerous other non-profit organizations.
SCHEDULE H, PART V, SECTION B, LINE 6B	Wake County Human Services and Triangle United Way.
SCHEDULE H, PART V, SECTION B, LINE 7A	HTTP://WWW.WAKEMED.ORG/DOCUMENTS/WAKE-COUNTY-COMMUNITY-HEALTH-NEEDS-ASSESS MENT.PDF SCHEDULE H, PART V, SECTION B, LINE 7B http://www.wakegov.com/humanservices/data/Documents/2016%20Wake%20County%2 0CHNA%20Full%20Document%20Final.pdf
SCHEDULE H, PART V, SECTION B, LINE 10A	http://www.wakemed.org/documents/community-health-needs-assessment-impleme ntation-plan.pdf
SCHEDULE H, PART V, SECTION B, LINE 11	Our CHNA prioritization process resulted in 21 key areas of focus, some of which apply more to hospitals than others. From the list of 21 identified needs, the following categories were identified as the four priority areas for Wake County that will be addressed over the next three years: --health insurance coverage; --transportation; --access to health services; and --mental health and substance abuse. WakeMed's implementation plan addresses each priority area. (http://www.wakemed.org/documents/community-health-needs-assessment-implem entation-plan.pdf) The implementation plan details the services and programs WakeMed offers or is partnering with other organizations to provide to the other community. THIS WORK CONTINUED IN 2018 BASED ON THE 2016 IMPLEMENTATION PLAN.
SCHEDULE H, PART V, SECTION B, LINE 16A	HTTP://WWW.WAKEMED.ORG/WORKFILES/REGULATORY/CHARITY-CARE-POLICY.PDF https://www.wakemed.org/workfiles/Regulatory/Charity-Care-Policy-SPANISH.p df
SCHEDULE H, PART V, SECTION B, LINE 16B	HTTP://WWW.WAKEMED.ORG/WORKFILES/REGULATORY/FINANCIAL-ASSISTANCE-APPLICATI ON-ENGLISH.PDF HTTP://WWW.WAKEMED.ORG/WORKFILES/REGULATORY/FINANCIAL-ASSISTANCE-APPLICATI ON-SPANISH.PDF
SCHEDULE H, PART V, SECTION B, LINE 16C	HTTP://WWW.WAKEMED.ORG/WORKFILES/REGULATORY/FINANCIAL-ASSISTANCE-POLICY-SU MMARY-ENGLISH.PDF HTTP://WWW.WAKEMED.ORG/WORKFILES/REGULATORY/FINANCIAL-ASSISTANCE-POLICY-SU MMARY-SPANISH.PDF
SCHEDULE H, PART V, SECTION B, LINE 20E	WakeMed also notified patients at admission and discharge of services about the financial assistance policy and provided documentation as requested.

Schedule H (Form 990) 2019

Page 9

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?10
Name and address		Type of Facility (describe)
1	WAKE SPECIALTY PHYSICIANS LLC 3024 NEW BERN AVENUE RALEIGH,NC27610	MEDICAL PRACTICE
2	WAKEMED NORTH 10000 FALLS OF THE NEUSE ROAD RALEIGH,NC27614	SURGERY, PREGNANCY, CHILDBIRTH, OP/AMB SURGERY CENTER
3	WAKEMED REHAB HOSPITAL 3000 NEW BERN AVENUE RALEIGH,NC27610	PHYS MED & REHAB HOSPITAL, PHYS, SPEECH & OCCUP THERAPY CARDIAC REHAB, FITNESS CENTER
4	WAKEMED GARNER HEALTHPLEX 400 US 70 EAST GARNER,NC27529	EMERG. DEPT., LABORATORY, RADIOLOGY
5	WAKEMED APEX HEALTHPLEX 120 HEALTHPLEX WAY APEX,NC27502	EMERG. DEPT., LABORATORY, RADIOLOGY
6	WAKEMED BRIER CREEK HEALTHPLEX 8001 TW ALEXANDER DRIVE RALEIGH,NC27617	EMERG. DEPT., LABORATORY, RADIOLOGY
7	WAKEMED MEDICAL PARK 23 SUNNYBROOK ROAD RALEIGH,NC27610	LABORATORY, RADIOLOGY
8	WAKEMED CLAYTON MEDICAL PARK 555 MEDICAL PARK CLAYTON,NC27520	REHAB THERAPY
9	WAKEMED HOME HEALTH 2920 HIGHWOODS BOULEVARD SUITE 200 RALEIGH,NC27604	HOME HEALTH, HOME IV THERAPY, PRIVATE DUTY NURSING
10	WAKEMED WAKE FOREST ROAD 3701 WAKE FOREST ROAD RALEIGH,NC27609	PHYS, OCCUP, SPEECH & PEDIATRIC SPEECH THERAPY

Schedule H (Form 990) 2019

Page 10

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
SCHEDULE H, PART I, LINE 3B	DISCOUNTED CARE IS AVAILABLE FOR THOSE AT 300% OF THE FPG. FURTHER, ALL PATIENTS WITHOUT INSURANCE QUALIFY FOR AN AUTOMATIC 50% DISCOUNT WITHOUT CONSIDERATION OF THE FPG. SCHEDULE H, PART I, LINE 7A CHARITY CARE IS REPORTED AS THE SYSTEM'S CHARITY CARE AT COST, USING A COST TO CHARGE RATION CALCULATED AS IN WORKSHEET 2. SCHEDULE H, PART I, LINE 7B MEDICAID COSTS ARE DERIVED FROM OUR COST ACCOUNTING SYSTEM, WHICH ADDRESSES ALL PATIENT SEGMENTS. SCHEDULE H, PART I, LINE 7C COSTS OF OTHER GOVERNMENT PROGRAMS ARE DERIVED FROM OUR COST ACCOUNTING SYSTEM, WHICH ADDRESSES ALL PATIENT SEGMENTS. SCHEDULE H, PART I, LINE 7F PER MEDICARE COST REPORT SCHEDULE H, PART II WAKEMED IS ACTIVELY INVOLVED IN NOT ONLY IMPROVING THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE, BUT IS ALSO SUPPORTIVE OF COMMUNITY BUILDING ACTIVITIES. WAKEMED HAS BEGUN EFFORTS TO IMPROVE THE NEIGHBORHOOD AROUND THE HOSPITAL AND ENCOURAGE REDEVELOPMENT AND PHYSICAL IMPROVEMENTS. A COALITION OF LOCAL BUSINESS AND COMMUNITY LEADERS ARE WORKING TO REDUCE CRIME, BEAUTIFY THE AREA, ATTRACT RETAIL BUSINESSES AND RESTAURANTS, AND FOSTER NEW MEDICAL DEVELOPMENT AROUND THE MAIN HOSPITAL CAMPUS IN DOWNTOWN RALEIGH, WHICH IS AN ECONOMICALLY DEPRESSED AREA. WE HAVE ALSO INVESTED IN THE WAKE TECHNICAL COMMUNITY COLLEGE FACILITY GROWTH WHICH IS VITAL TO EDUCATING FUTURE NURSES, RADIOLOGY TECHS, EMERGENCY RESPONSE PERSONNEL AND OTHERS. OUR WORKFORCE DEVELOPMENT PROGRAM WORKS WITH YOUTH, HEALTH SCIENCE STUDENTS AND THOSE IN A VARIETY OF HEALTH PROFESSIONS PROGRAMS WITH MENTORING, RESIDENCIES, CLINICAL ROTATIONS, AND EDUCATION ALL WITH THE PURPOSE OF PREPARING FOR THE WORKFORCE OF TOMORROW. WE PARTNER WITH NUMEROUS COLLEGES, UNIVERSITIES, COMMUNITY COLLEGES AND HIGH SCHOOLS THROUGHOUT THE REGION AND OUR CAMPUS IS HOME TO THE WAKE EARLY COLLEGE HIGH SCHOOL. WAKEMED IS ALSO HOME TO WAKE AREA HEALTH EDUCATION CENTER, A PROGRAM OF THE UNIVERSITY OF NORTH CAROLINA WHICH PROVIDES ACCREDITED EDUCATION PROGRAMS TO NURSES, ALLIED HEALTH PROFESSIONALS AND PHYSICIANS THROUGHOUT THE REGION. WAKEMED ALSO WORKS CLOSELY WITH THE INVESTMENT OF CASH AND EXPERTISE FOR THE EIGHT MUNICIPALITIES IN OUR COUNTY AND THE WAKE COUNTY ECONOMIC DEVELOPMENT COUNCIL TO ATTRACT NEW JOBS AND GROW INDUSTRY AND BUSINESS. A HEALTHY ECONOMY ULTIMATELY LEADS TO THE HEALTHIER COMMUNITY. OUR COMMUNITY HEALTH IMPROVEMENT ACTIVITIES ARE NUMEROUS AND INCLUDE BEING THE LEAD AGENCY FOR SAFEKIDS, ENERGIZE, ASTHMA COALITION, COMMUNITY HEALTH PROJECT AND MORE. EACH IS WORKING TO SUPPORT PROGRAMS AND POLICIES THAT IMPROVE PUBLIC HEALTH AND ACCESS TO HEALTH CARE. WE ARE ALSO PARTNERING WITH COUNTY AND OTHER OFFICIALS ON INITIATIVES THAT WILL IMPROVE ACCESS TO MENTAL HEALTH SERVICES, A GROWING CRISIS IN OUR COMMUNITY. THE OVERALL GOAL IS TO MAKE OUR COMMUNITY A HEALTHIER PLACE TO LIVE AND WORK. SCHEDULE H, PART III, LINE 2 THE AMOUNT REPORTED IN PART III, LINE 2 IS THE SYSTEM BAD DEBT AT COST. CHARITY AND BAD DEBT ACCOUNTS ARE RECORDED AT CURRENT ACCOUNT BALANCE LEVELS. THE BALANCE MAY BE NET OF CONTRACTUAL ALLOWANCES AND/OR PAYMENTS RECEIVED. FOR EXAMPLE, BAD DEBT OR CHARITY RESULTING FROM AN UNPAID PATIENT LIABILITY AFTER INSURANCE IS RECORDED AT THE AMOUNT UNPAID BY THE PATIENT. SCHEDULE H, PART III, LINE 3 PATIENTS ARE PROVIDED WITH INFORMATION ABOUT FINANCIAL ASSISTANCE AT REGISTRATION, DISCHARGE, PHONE CALLS, ON THE WEBSITE, AND A PLAIN LANGUAGE SUMMARY OF FINANCIAL ASSISTANCE IS SENT WITH EVERY STATEMENT. IN ORDER TO QUALIFY, A PATIENT MUST APPLY AND MEET FINANCIAL ASSISTANCE POLICY (FAP) REQUIREMENTS. SCHEDULE H, PART III, LINE 4 THE TEXT OF THE FOOTNOTE TO WAKEMED'S FINANCIAL STATEMENTS REGARDING BAD DEBT EXPENSE IS AS FOLLOWS: "WAKEMED HAS PRESENTED ITS PROVISION FOR UNCOLLECTIBLE ACCOUNTS AS A DIRECT REDUCTION OF PATIENT SERVICE REVENUE. BASED ON MANAGEMENT'S INTERPRETATION OF THE REQUIREMENTS OF GASB STATEMENT NO. 34, GOVERNMENTAL HEALTH CARE ORGANIZATIONS ARE REQUIRED TO PRESENT UNCOLLECTIBLE ACCOUNTS AS A COMPONENT OF NET PATIENT SERVICE REVENUE RATHER THAN WITHIN OPERATING EXPENSES. SCHEDULE H, PART III, LINE 8 WAKEMED BELIEVES THAT ALL OF THE $95,519,731 MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE WAKEMED HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THIS YEAR, MEDICARE ACCOUNTED FOR 28.0% OF HOSPITAL REVENUE. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. IF THE WAKEMED MEDICARE SHORTFALL WERE TREATED AS COMMUNITY BENEFIT, THE PERCENT OF TOTAL EXPENSES ATTRIBUTABLE TO COMMUNITY BENEFIT WOULD INCREASE FROM 9.81% TO 17.32%. MEDICARE COSTING METHODOLOGY THE MEDICARE ALLOWABLE COSTS WERE DETERMINED FROM THE MEDICARE COST REPORT, AS SPECIFIED IN THE PROVIDER REIMBURSEMENT MANUAL. APPLICATION OF COLLECTION PRACTICES TO THOSE QUALIFYING FOR FINANCIAL ASSISTANCE SCHEDULE H, PART III, LINE 9B WAKEMED PROVIDES MANY OPPORTUNITIES TO EDUCATE PATIENTS ON OUR FINANCIAL ASSISTANCE PROGRAM PRIOR TO DISCHARGE AND AGAIN WHEN THE FIRST BILL IS RECEIVED. IN ORDER TO MAKE SURE WE REACH OUT TO OUR PATIENTS, WE SEND AT LEAST FOUR STATEMENTS AND ALSO MAKE FOLLOW-UP CALLS. EACH STATEMENT REFERENCES THE FINANCIAL ASSISTANCE PROGRAM AND INCLUDES A PLAIN LANGUAGE SUMMARY OF OUR FINANCIAL ASSISTANCE PROGRAM. PATIENTS ARE SCREENED FOR FINANCIAL ASSISTANCE AND ARE GIVEN OPPORTUNITIES TO APPLY. IF A PATIENT CHOOSES NOT TO APPLY, OR DOES NOT QUALIFY, THEY ARE GIVEN THE OPPORTUNITY FOR OTHER PAYMENT ARRANGEMENTS. IF THE PATIENT DID NOT APPLY FOR FINANCIAL ASSISTANCE AND ENDS UP IN COLLECTIONS, AN APPLICATION FOR FINANCIAL ASSISTANCE IS PROVIDED. THE PATIENT AT THAT POINT HAS THE OPPORTUNITY TO APPLY; ALL COLLECTION EFFORTS CEASE ONCE THE APPLICATION IS RECEIVED, EVEN IF THE APPLICATION IS MISSING DOCUMENTATION.
NEEDS ASSESSMENT	SCHEDULE H, PART VI, LINE 2 THE COMMUNITY NEEDS ASSESSMENT IS A PROCESS THAT HELPS TO IDENTIFY FACTORS AFFECTING OUR COUNTY, DETERMINE RESOURCES NEEDED TO ADDRESS THESE FACTORS, AND DEVELOP A PLAN OF ACTION TO ADDRESS THE NEEDS OF THE COMMUNITY WE SERVE. DURING LATE 2015 AND EARLY 2016, WAKEMED HEALTH & HOSPITALS JOINED WITH DUKE RALEIGH, REX HEALTHCARE, ADVANCE HEALTH SERVICES, TRIANGLE UNITED WAY, WAKE COUNTY HUMAN SERVICES, AND OTHERS TO JOINTLY CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE ASSESSMENT WAS COMPLETED IN JUNE OF 2016. THE ASSESSMENT INVOLVED INPUT FROM HUNDREDS OF WAKE COUNTY RESIDENTS AND PUBLIC HEALTH LEADERS THROUGH SURVEYS, FOCUS GROUPS, AND STEERING COMMITTEE MEMBERS. IN ADDITION, SECONDARY RESEARCH WAS COMPLETED TO COMPARE INFORMATION WE RECEIVED FROM OTHER NATIONAL STUDIES. THE CHNA CAN BE FOUND ON THE WAKEMED WEBSITE: HTTP://WWW.WAKEMED.ORG/DOCUMENTS/WAKE-COUNTY-COMMUNITY-HEALH-NEEDS-ASSESSM ENT.PDF IN ADDITION TO THIS PRIMARY DATA, WAKEMEDS CORPORATE PLANNING DEPARTMENT COLLECTS AND ANALYZES MULTIPLE OTHER SOURCES OF SECONDARY DATA WHICH HELPS US UNDERSTAND DEMOGRAPHIC, SOCIOGRAPHIC, AND HEALTH TRENDS. WITH THE GOAL OF ENHANCING ACCESS, THE STAFF IS ALSO CHARGED WITH FORECASTING FUTURE NEEDS AND PLANNING TO MEET THOSE NEEDS. THIS PROCESS INCLUDES A CAREFUL ANALYSIS OF CURRENT SYSTEM CAPACITIES AND PROJECTS FUTURE NEEDED CAPACITY TO MEET POPULATION GROWTH AND DEMOGRAPHIC CHANGES.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	SCHEDULE H, PART VI, LINE 3 PATIENTS ARE PROVIDED WITH INFORMATION ABOUT FINANCIAL ASSISTANCE AT REGISTRATION, DISCHARGE, PHONE CALLS, AND A PLAN LANGUAGE SUMMARY OF FINANCIAL ASSISTANCE IS SENT WITH EVERY STATEMENT. THIS INFORMATION IS ALSO AVAILABLE ON THE WEBSITE. IN ORDER TO QUALIFY, A PATIENT MUST APPLY AND MEET THE FAP REQUIREMENTS. WAKEMED POSTS THE REQUIRED EMTALA NOTICE AT ALL PORTALS OF ENTRY WHERE AN EMERGENCY DEPARTMENT IS PRESENT. THE SIGNAGE NOTES THAT WAKEMED PARTICIPATES IN THE MEDICARE PROGRAM. THE WAKEMED WEBSITE PROVIDES DETAILED INFORMATION REGARDING FINANCIAL ASSISTANCE AND CHARITY CARE. THE PATIENT BILLING AND FINANCIAL INFORMATION POLICY IS INCLUDED IN ALL INPATIENTS "MY IMPORTANT PAPERS" FOLDER AND IS ADDRESSED IN THE PATIENT INFORMATION GUIDE AVAILABLE IN ALL INPATIENT ROOMS. IN ADDITION, THE FINANCIAL ASSISTANCE FORM IS LOCATED ON THE WEBSITE FOR ANY PATIENT TO COMPLETE AND SUBMIT. AS PART OF THE INTAKE PROCESS/REGISTRATION FOR ALL PATIENTS, WAKEMED PROVIDES A COPY OF THE PATIENT BILLING AND FINANCIAL INFORMATION POLICY, WHICH REFERS PATIENTS TO PATIENT FINANCIAL SERVICES IF THEY HAVE CONCERNS REGARDING THEIR ABILITY TO PAY THE BILL. ALL INPATIENTS AND PATIENTS SCHEDULED FOR OUTPATIENT PROCEDURES, AND WHO ARE DESIGNATED "UNINSURED" AT THE TIME OF ADMISSION, ARE CONTACTED PERSONALLY BY A FINANCIAL COUNSELOR. IN ADDITION, ANY PATIENT, REGARDLESS OF INSURANCE COVERAGE, MAY REQUEST TO SEE A FINANCIAL COUNSELOR. THE FINANCIAL COUNSELOR WILL ASSESS POSSIBLE MEDICAID ELIGIBILITY AND PROVIDE AN APPLICATION/FINANCIAL STATEMENT THAT IS SUBMITTED TO PATIENT FINANCIAL SERVICES TO REQUEST ASSISTANCE WITH MEDICAL EXPENSES. WAKEMED ALSO HAS ON-SITE EMPLOYEES FROM WAKE COUNTY HUMAN SERVICES TO PROCESS MEDICAID APPLICATIONS FOR RESIDENTS OF WAKE COUNTY. ANY PATIENT WHO IS UNINSURED AND MAY BE ELIGIBLE FOR DISABILITY IS REFERRED TO A WAKEMED DISABILITY SPECIALIST WHO ASSISTS WITH THE APPLICATION. WAKEMED INCLUDES INFORMATION REGARDING FINANCIAL ASSISTANCE TO ALL PATIENT BILLING STATEMENTS.
COMMUNITY INFORMATION	SCHEDULE H, PART VI, LINE 4 WHILE WAKEMED SERVES PATIENTS FROM ALL OF NORTH CAROLINAS 100 COUNTIES AND BEYOND, ITS PRIMARY SERVICE AREA CAN BEST BE DESCRIBED AS THE COUNTIES CONTIGUOUS TO WAKE COUNTY. THE VAST MAJORITY OF PATIENTS COME FROM WAKE AND JOHNSTON COUNTIES. BOTH COUNTIES HAVE RAPIDLY GROWING SMALLER/SUBURBAN COMMUNITIES CENTERED AROUND THE CAPITAL CITY OF RALEIGH. THESE COMMUNITIES LOOK TO RALEIGH AS THEIR PRIMARY SOURCE FOR TERTIARY LEVEL CARE. THE MARKET IS DEMOGRAPHICALLY DIVERSE AND FIERCELY COMPETITIVE WITH THREE MAJOR HEALTH SYSTEMS COMPETING AGAINST ONE ANOTHER. WAKEMED SHOULDERS THE VAST MAJORITY OF CARE FOR THE UNINSURED AND UNDERINSURED, OFTEN EXCEEDING 80% OF THE BURDEN. WAKE COUNTY WAS FOUNDED IN 1771 AND OCCUPIES APPROXIMATELY 860 SQUARE MILES IN THE PIEDMONT REGION OF NORTH CAROLINA. IN 1792, THE CITY OF RALEIGH WAS NAMED THE CAPITAL OF NORTH CAROLINA AND IT REMAINS THE MOST POPULOUS MUNICIPALITY IN WAKE COUNTY. WITH A POPULATION IN EXCESS OF 1,000,000 PERSONS, THE COUNTY IS THE SECOND MOST POPULOUS COUNTY IN THE STATE. WAKE COUNTY IS HOME TO 12 MUNICIPALITIES. WAKE COUNTY HAS EXPERIENCED POPULATION GROWTH OVER RECENT YEARS; THIS GROWTH IS EXPECTED TO CONTINUE ACCORDING TO DATA FROM THE N.C. OFFICE OF STATE BUDGET AND MANAGEMENT, WAKE COUNTY IS PROJECTED TO GROW AT A HIGHER ANNUAL RATE THAN ITS PEER GEOGRAPHIES AT 2.1 PERCENT ANNUALLY FROM 2015 TO 2025 WITH THE ADDITION OF OVER 226,000 PEOPLE. AS SHOWN IN THE TABLE BELOW, RESIDENTS OF THESE TWO COUNTIES CURRENTLY EXCEED ONE MILLION IN POPULATION, AND THAT POPULATION HAS CONTINUED TO GROW EVEN AMIDST THE WORST ECONOMIC RECESSION IN MANY DECADES. THE POPULATION IS FAIRLY DIVERSE. RACE AND ETHNICITY INFORMATION ARE ALSO PRESENTED IN THE TABLE. WAKE COUNTY JOHNSTON COUNTY TOTAL 2015 1,006,053 184,322 1,190,375 2020 1,116,912 210,948 1,327,860 % CHANGE 11.0% (2.1%/ANNUM) 14.4% (2.7%/ANNUM) 11.5%(2.2%/ANNUM) RACE AND ETHNICITY 2015 WHITE 68% 81% 70% BLACK 22% 15% 21% ASIAN 6% 1% 6% OTHER/UNKNOWN 4% 3% 3% HISPANIC* 11% 15% 12% *(NOT CONSIDERED A RACE, INCLUDED IN TOTALS ABOVE)
PROMOTION OF COMMUNITY HEALTH	SCHEDULE H, PART VI, LINE 5 SINCE OPENING IN 1961, WAKEMED HAS BEEN AN INSTITUTION WITH AN UNWAVERING COMMITMENT TO THE COMMUNITIES IT SERVES BY IMPROVING THE HEALTH OF THE INDIVIDUALS AND FAMILIES WE SERVE. TODAY, WAKEMED OFFERS A BROAD RANGE OF PREVENTIVE, PRIMARY, ACUTE, AND TERTIARY SERVICES. AS WAKE COUNTYS LARGEST PRIVATE EMPLOYER AND A CORNERSTONE OF THE COMMUNITY, WAKEMED IS AN ASSET RESIDENTS CAN DEPEND ON NOT ONLY FOR THE HIGHEST QUALITY OF HEALTH CARE INSIDE THE HOSPITAL AND OUTPATIENT FACILITIES, BUT FOR COMMUNITY OUTREACH IN THE FORM OF SCREENINGS, CLASSES, SEMINARS, HEALTH FAIRS, PREVENTIVE PROGRAMS, SUPPORT GROUPS, AND OTHER OUTREACH INITIATIVES. THE MAJORITY OF THE PROGRAMS ARE FREE AND ALL ARE DESIGNED TO IMPROVE HEALTH, EDUCATE, AND ENLIGHTEN BY OFFERING ACCESS TO EXPERTS, RESOURCES, AND HEALTH INFORMATION. IN ADDITION, OUR 1,200+ PERSON MEDICAL STAFF IS OPEN AND COMPRISED PRIMARILY OF INDEPENDENT PRACTITIONERS, ALTHOUGH THE NUMBER OF EMPLOYED PHYSICIANS IS GROWING AND NOW TOTALS MORE THAN 340 PHYSICIANS. EACH YEAR WE SERVE, SUPPORT AND WORK CLOSELY WITH THE COMMUNITY IN MANY WAYS. WE ABSORB THE HEALTH CARE COSTS OF THOSE WHO COME TO US UNABLE TO PAY FOR THEIR CARE. WE EDUCATE AND TRAIN PHYSICIANS AND CAREGIVERS. WE DEVELOP NEW SERVICES AND INITIATIVES TO ENHANCE ACCESS AND MEET THE NEEDS OF THE UNDERSERVED. WE PARTNER WITH A VARIETY OF COMMUNITY-BASED ORGANIZATIONS TO DEVELOP PROGRAMS THAT ANSWER A SPECIFIC COMMUNITY HEALTH NEED. WE PROVIDE DONATIONS TO COMMUNITY CHARITIES AND ORGANIZATIONS WHOSE GOALS SUPPORT OUR MISSION. AND WE OFFER A HOST OF COMMUNITY OUTREACH AND EDUCATION PROGRAMS TARGETED TO THE UNDERSERVED AND AT-RISK POPULATIONS FOR CARDIOVASCULAR DISEASE, DIABETES, STROKE, AND AVOIDABLE INJURIES, AMONG OTHERS. BEYOND THE CARE CURRENTLY PROVIDED WITHIN OUR FACILITIES, WAKEMED CONTINUES TO DEVELOP PROGRAMS AND SERVICES IN THOSE AREAS WHICH ARE UNDERSERVED AND ARE GROWING. ACCESS TO PRIMARY CARE PROVIDES IS A CRITICAL NEED. AS A RESULT, WE CONTINUE TO EXPAND OUR NETWORK OF PRIMARY CARE PROVIDERS WHO SERVE COMMUNITY RESIDENTS, REGARDLESS OF THEIR ABILITY TO PAY. WAKEMED HELPS IMPROVE THE HEALTH OF THE COMMUNITY BY OUTREACH THAT TAKES ON MANY FORMS FROM THE DIRECT PROVISION OF CARE TO MENTORING AT-RISK YOUTH. AREAS OF FOCUS FOR THE SYSTEM ARE CENTERED ON: --IMPROVED ACCESS TO CARE THROUGH GEOGRAPHICALLY DISPERSED OUTPATIENT FACILITIES, PRIMARY CARE PHYSICIANS, EMERGENCY DEPARTMENTS, AND NOW VIRTUAL CARE OPTIONS. WE ALSO WORK CLOSELY WITH THE COMMUNITY TO IMPROVE ACCESS AND AFFORDABILITY FOR THE UNDERSERVED POPULATIONS OF THE COMMUNITY. THIS IS DONE IN PART BY COLLABORATING WITH COMMUNITY PARTNERS SO THAT HEALTH CARE GAPS ARE ADDRESSED. --WORKING CLOSELY WITH PATIENTS AND THE COMMUNITY TO PROMOTE AND SUPPORT THE OPTIMAL PREVENTION AND MANAGEMENT OF CHRONIC DISEASES, INJURIES AND ILLNESS IN OUR MOST VULNERABLE POPULATIONS, ESPECIALLY CHILDREN. WE ALSO HAVE AN INCREASED FOCUS ON IMPROVING AND MAINTAINING CARDIOVASCULAR HEALTH, WITH AN EMPHASIS ON ADDRESSING HEART DISEASE, STROKE, AND DIABETES PERTINENT TO BUILDING A HEALTHIER COMMUNITY. --DEVELOPMENT OF A COMPREHENSIVE POPULATION HEALTH PROGRAM ANCHORED BY AN ACCOUNTABLE CARE ORGANIZATION WITH OVER 200,000 COVERED LIVES FROM PARTNERING WITH CMS AND THE MAJOR INSURERS WITHIN THE MARKET. WITH A FOCUS ON QUALITY AND COORDINATION OF CARE, PATIENTS ARE RECEIVING VALUE AND IMPROVING THEIR HEALTH. --DEVELOPMENT OF A COMMUNITY HEALTH POPULATION PROGRAM THAT WORKS WITH OUR MOST VULNERABLE POPULATIONS TO ADDRESS BOTH THEIR HEALTH AND SOCIAL NEEDS SUCH AS A MEDICAL HOME, MEDICATION, HOUSING, AND MORE. IT IS MADE POSSIBLE BY GRANTS AND PARTNERING WITH OTHER COMMUNITY-BASED ORGANIZATIONS. --CONTINUING EFFORTS TO EDUCATE HEALTHCARE PROVIDERS OF TODAY AND TOMORROW RECOGNIZING THAT THESE EFFORTS WILL ENSURE A SKILLED WORKFORCE WHICH ULTIMATELY BUILDS A HEATHIER AND STRONGER COMMUNITY. --PROVIDING SUPPORT AND LEADERSHIP IN COMMUNITY BUILDING ACTIVITIES THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS. WE ALSO ENCOURAGE EMPLOYEE, VOLUNTEER AND PHYSICIAN PARTICIPATION, PHILANTHROPIC SUPPORT, AND VOLUNTEERISM IN THE COMMUNITY.
AFFILIATED HEALTH CARE SYSTEM	SCHEDULE H, PART VI, LINE 6 N/A
STATE FILING OF COMMUNITY BENEFIT REPORT	SCHEDULE H, PART VI, LINE 7 WAKEMED PUBLISHES A COMMUNITY BENEFIT REPORT EACH YEAR WHICH HIGHLIGHTS THE FINANCIAL IMPACT ON THE COMMUNITY. IT IS AVAILABLE IN PRINT FORM AS WELL AS ON THE WAKEMED WEBSITE. WAKEMED ALSO VOLUNTARILY FILES A SIMILAR COMMUNITY BENEFIT REPORT WITH THE NORTH CAROLINA HOSPITAL ASSOCIATION.

Schedule H (Form 990) 2019

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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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
Wakemed

Employer identification number
56-6017737

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 noncash assistance	(h) Purpose of grant or assistance
(1) ALLIANCE MEDICAL MINISTRY 101 DONALD ROSS DRIVE RALEIGH,NC27610	56-2168673	501(c)(3)	384,804				MEDICAL CARE
(2) AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVENUE DALLAS,TX75231	13-5613797	501(C)(3)	25,000				GENERAL SUPPORT
(3) CAPITAL CARE COLLABORATIVE 2500 BLUE RIDGE ROAD RALEIGH,NC27607	56-1150521	501(C)(6)	250,000				MEDICAL CARE
(4) DEBNAM CLINIC 1501 POOLE ROAD RALEIGH,NC27610	56-1977593		216,000				MEDICAL CARE
(5) FOOD BANK OF CENTRAL & EASTERN NC 1924 CAPITAL BOULEVARD RALEIGH,NC27604	56-1283426	501(C)(3)	7,500				HURRICANE FLORENCE RELIEF EFFORT
(6) GIRL SCOUTS OF NC COASTAL PINES 6901 PINECREST ROAD RALEIGH,NC27613	56-1791500	501(C)(3)	7,500				General SupporT
(7) INTERACT 191 HIGH HOUSE ROAD CARY,NC27511	27-1771636	501(C)(3)	30,000				General Support
(8) INTERFAITH FOOD SHUTTLE 201 EAST HARGETT STREET RALEIGH,NC27601	56-1647538	501(C)(3)	5,500	14,739	FMV	FOOD DONATIONS	GENERAL SUPPORT
(9) LINKNICA 7028 RAINWATER ROAD RALEIGH,NC27615	81-0893209	501(C)(3)	10,000				General Support
(10) MARCH OF DIMES 1275 MAMARONECK AVENUE WHITEPLAINS,NY10605	13-1846366	501(C)(3)	10,000				General Support
(11) NC MUSEUM OF ART FOUNDATION 4630 MAIL SERVICE CENTER RALEIGH,NC276994630	23-7071511	501(C)(3)	10,000				General Support
(12) NC PHYSICIANS HEALTH PROGRAM 220 HORIZON DRIVE NO 201 RALEIGH,NC27615	56-1846599	501(C)(3)	10,000				General Support
(13) NC SYMPHONY INC 3700 GLENWOOD AVE SUITE 13 RALEIGH,NC27612	56-0556755	501(C)(3)	15,000				GENERAL SUPPORT
(14) RALEIGH SCHOOL OF NURSE ANETHESIA 3900 BARRETT DRIVE RALEIGH,NC27609	56-1684241	501(C)(3)	47,405				GENERAL SUPPORT
(15) URBAN MINISTRIES OF WAKE COUNTY 1390 CAPITAL BOULEVARD RALEIGH,NC27603	58-1422700	501(C)(3)	10,000				GENERAL SUPPORT
(16) WAKE COUNTY HUMAN SERVICES PO BOX 46833 RALEIGH,NC27620	56-6000376		575,558				GENERAL SUPPORT
(17) WAKE TECH COLLEGE FOUNDATION 9101 FAYETTEVILLE ROAD RALEIGH,NC27603	23-7017752	501(C)(3)	61,500				GENERAL SUPPORT
(18) WAKEMED FOUNDATION 3000 NEW BERN AVENUE RALEIGH,NC27610	56-1916549	501(C)(3)	49,564				GENERAL SUPPORT
(19) YMCA OF THE TRIANGLE AREA 801 CORPORATE CENTER DRIVE 200 RALEIGH,NC27607	56-0591307	501(C)(3)	10,000				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) 2019

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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) HEART CENTER - RONALD MCDONALD	1334	83,780	COST	RON. MC. HOUSE USAGE
(2) PRESCRIPTION DRUGS	5934	149,791	COST	RX-INDIGENT PATIENTS
(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

PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS

SCHEDULE I, PART I, LINE 2 ALL GRANT/FUNDING REQUESTS MUST BE MADE IN WRITING. FREQUENTLY, MEETINGS ARE HELD WITH REQUESTING ORGANIZATIONS TO ENSURE THE REQUESTS ARE IN ACCORDANCE WITH OUR GOALS AND GUIDELINES RELATED TO DONATIONS AND SPONSORSHIPS. ALL DONATIONS ARE COORDINATED THROUGH ONE DEPARTMENT AND ARE TRACKED AND LOGGED ON A SPREADSHEET WITH A QUICK REFERENCE TO THE REASON FOR THE GIFT. IN MOST CASES, WAKEMED TRACKS HOW THE GIFT WAS USED, THE OUTCOMES, AND THE BENEFITS TO THE COMMUNITY. IN THE CASE OF LARGE GRANTS, THE ORGANIZATION IS ALSO ASKED FOR A REPORT OF THE RESULTS AND THE IMPACT.

Schedule I (Form 990) 2019

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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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Wakemed

Employer identification number

56-6017737

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 on 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 .........

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 on 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? .............

Yes

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

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

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 nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

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) 2019

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)
1CAROLYN KNAUP SENIOR VP-AMBULATORY SERVICES	(i) (ii)	293,567 ------------- 0	41,109 ------------- 0	36,693 ------------- 0	16,237 ------------- 0	21,350 ------------- 0	408,956 ------------- 0	0 ------------- 0
2BETSY GASKINS-MCCLAINE VP HEART & VASCULAR	(i) (ii)	245,738 ------------- 0	45,865 ------------- 0	31,188 ------------- 0	15,581 ------------- 0	9,434 ------------- 0	347,806 ------------- 0	0 ------------- 0
3CYNTHIA ALNESS-BOILY SENIOR VP-OPERATIONS & CNO	(i) (ii)	331,740 ------------- 0	74,086 ------------- 0	46,159 ------------- 0	16,251 ------------- 0	17,628 ------------- 0	485,864 ------------- 0	0 ------------- 0
4VICKI BLOCK Former SR VP & ADMIN. RALEIGH	(i) (ii)	0 ------------- 0	7,381 ------------- 0	183,003 ------------- 0	0 ------------- 0	0 ------------- 0	190,384 ------------- 0	0 ------------- 0
5GEORGIA C HARRINGTON VP-OPS (END 4/6/18)	(i) (ii)	254,898 ------------- 0	44,768 ------------- 0	17,502 ------------- 0	15,942 ------------- 0	15,390 ------------- 0	348,500 ------------- 0	0 ------------- 0
6GURVINDER S DEOL PHYSICIAN	(i) (ii)	943,732 ------------- 0	347,364 ------------- 0	45,349 ------------- 0	8,972 ------------- 0	27,043 ------------- 0	1,372,460 ------------- 0	0 ------------- 0
7JONATHAN D CHAPPELL PHYSICIAN	(i) (ii)	719,064 ------------- 0	278,006 ------------- 0	34,621 ------------- 0	8,827 ------------- 0	24,506 ------------- 0	1,065,024 ------------- 0	0 ------------- 0
8DONALD R GINTZIG President & CEO	(i) (ii)	989,586 ------------- 0	461,898 ------------- 0	58,021 ------------- 0	17,169 ------------- 0	24,130 ------------- 0	1,550,804 ------------- 0	0 ------------- 0
9DENISE WARREN Exec VP & COO	(i) (ii)	571,355 ------------- 0	177,702 ------------- 0	28,109 ------------- 0	11,451 ------------- 0	23,903 ------------- 0	812,520 ------------- 0	0 ------------- 0
10JOHN S PIATKOWSKIEND 1216 FORMER SR VP AMB & PHYS OP	(i) (ii)	24,230 ------------- 0	0 ------------- 0	439,177 ------------- 0	850 ------------- 0	0 ------------- 0	464,257 ------------- 0	0 ------------- 0
11Charles Harr Chief Medical Officer, Raleigh	(i) (ii)	427,055 ------------- 0	97,097 ------------- 0	3,018 ------------- 0	16,200 ------------- 0	2,500 ------------- 0	545,870 ------------- 0	0 ------------- 0
12Christine Craig VP, Governmental Affairs	(i) (ii)	202,872 ------------- 0	35,761 ------------- 0	29,477 ------------- 0	14,239 ------------- 0	17,550 ------------- 0	299,899 ------------- 0	0 ------------- 0
13J West Paul SVP & Ch Quality/Med Staff Ofc	(i) (ii)	389,712 ------------- 0	87,996 ------------- 0	29,710 ------------- 0	16,200 ------------- 0	26,210 ------------- 0	549,828 ------------- 0	0 ------------- 0
14Rebecca Andrews SVP & ADMIN RALEIGH	(i) (ii)	319,611 ------------- 0	119,719 ------------- 0	38,258 ------------- 0	16,200 ------------- 0	11,657 ------------- 0	505,445 ------------- 0	0 ------------- 0
15Rick Carrico CFO	(i) (ii)	311,362 ------------- 0	16,070 ------------- 0	56,601 ------------- 0	13,128 ------------- 0	18,496 ------------- 0	415,657 ------------- 0	0 ------------- 0
16Seth Brody Chief Medical Officer, Cary	(i) (ii)	369,939 ------------- 0	100,911 ------------- 0	866 ------------- 0	16,200 ------------- 0	1,000 ------------- 0	488,916 ------------- 0	0 ------------- 0
17Stephanie Sessoms VP FINANCE	(i) (ii)	188,273 ------------- 0	118,845 ------------- 0	51,215 ------------- 0	14,788 ------------- 0	23,136 ------------- 0	396,257 ------------- 0	0 ------------- 0
18Susan James VP & Chief Legal Officer	(i) (ii)	313,271 ------------- 0	55,239 ------------- 0	5,745 ------------- 0	16,200 ------------- 0	23,630 ------------- 0	414,085 ------------- 0	0 ------------- 0
19Thomas Gough SVP - Administrator Cary	(i) (ii)	296,808 ------------- 0	72,663 ------------- 0	23,574 ------------- 0	16,200 ------------- 0	23,403 ------------- 0	432,648 ------------- 0	0 ------------- 0
20Bryon Boulton Physician	(i) (ii)	850,015 ------------- 0	397,580 ------------- 0	915 ------------- 0	8,535 ------------- 0	21,816 ------------- 0	1,278,861 ------------- 0	0 ------------- 0
21Conor Regan Physician	(i) (ii)	722,107 ------------- 0	230,175 ------------- 0	730 ------------- 0	8,404 ------------- 0	16,338 ------------- 0	977,754 ------------- 0	0 ------------- 0
22SHERI D DESHAZO SR VP ADMINISTRATION-NORTH	(i) (ii)	222,618 ------------- 0	37,827 ------------- 0	25,974 ------------- 0	13,551 ------------- 0	26,887 ------------- 0	326,857 ------------- 0	0 ------------- 0
23Debra Laughery VP - Public Relations	(i) (ii)	235,711 ------------- 0	41,359 ------------- 0	31,401 ------------- 0	15,676 ------------- 0	624 ------------- 0	324,771 ------------- 0	0 ------------- 0
24MATTHEW NATHAN BEG 9262016 SENIOR VP - PHYSICIAN SERVICES	(i) (ii)	395,266 ------------- 0	72,035 ------------- 0	66,451 ------------- 0	16,170 ------------- 0	3,869 ------------- 0	553,791 ------------- 0	0 ------------- 0
25KAREN BASH CMO, NORTH HOSPITAL	(i) (ii)	346,463 ------------- 0	63,712 ------------- 0	1,397 ------------- 0	16,200 ------------- 0	15,828 ------------- 0	443,600 ------------- 0	0 ------------- 0
26RICK SHRUM beg 1117 VP & CHIEF STRATEGY OFFICER	(i) (ii)	277,044 ------------- 0	39,525 ------------- 0	37,530 ------------- 0	15,433 ------------- 0	27,424 ------------- 0	396,956 ------------- 0	0 ------------- 0
27JOHN PERRY VP MEDICAL EDUCATION	(i) (ii)	299,978 ------------- 0	33,499 ------------- 0	6,318 ------------- 0	16,200 ------------- 0	24,403 ------------- 0	380,398 ------------- 0	0 ------------- 0
28CHANTAL HOWARD VP NURSING, RALEIGH	(i) (ii)	170,838 ------------- 0	30,039 ------------- 0	21,877 ------------- 0	12,198 ------------- 0	11,539 ------------- 0	246,491 ------------- 0	0 ------------- 0
29PETER MARKS VP & CIO (beg 6/26/17)	(i) (ii)	118,025 ------------- 0	8,714 ------------- 0	45,778 ------------- 0	8,313 ------------- 0	1,398 ------------- 0	182,228 ------------- 0	0 ------------- 0
30OKECHUKWU NWOKO PHYSICIAN	(i) (ii)	632,880 ------------- 0	303,894 ------------- 0	15,684 ------------- 0	8,810 ------------- 0	9,061 ------------- 0	970,329 ------------- 0	0 ------------- 0
31JEANENE R MARTIN SENIOR VP-HUMAN RESOURCES	(i) (ii)	311,493 ------------- 0	69,087 ------------- 0	39,427 ------------- 0	16,243 ------------- 0	19,234 ------------- 0	455,484 ------------- 0	0 ------------- 0
32E DENTON ARLEDGE FORMER VP & CIO (end 8/18/17)	(i) (ii)	215,815 ------------- 0	9,212 ------------- 0	134,483 ------------- 0	10,986 ------------- 0	12,842 ------------- 0	383,338 ------------- 0	0 ------------- 0
33THOMAS G CAVENDER VP FACILITIES & CONSTRUCTION	(i) (ii)	269,370 ------------- 0	48,103 ------------- 0	42,107 ------------- 0	16,238 ------------- 0	4,888 ------------- 0	380,706 ------------- 0	0 ------------- 0
34JOHN R FINLEY END 81817 CHIEF COMPLIANCE OFFICER	(i) (ii)	186,588 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	186,588 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
SCHEDULE J, PART I, LINE 1A	TAX INDEMNIFICATION AND GROSS-UP PAYMENTS ARE PAID TO SOME KEY EMPLOYEES. THEY ARE INCLUDED IN TAXABLE INCOME.
SCHEDULE J, PART I, LINE 1B	TAX GROSS-UPS FOR KEY EMPLOYEES ARE COVERED BY THE EMPLOYEE AGREEMENT OR ARE APPROVED BY THE BOARD OF DIRECTORS.
SCHEDULE J, PART I, LINE 4A	EVIN DENTON ARLEDGE RECEIVED $98,2201 IN SEVERANCE PAYMENTS. VICKI BLOCK RECEIVED $183,003 IN SEVERANCE PAYMENTS. JOHN PIATKOWSKI RECEIVED $395,763 IN SEVERANCE PAYMENTS.
SCHEDULE J, PART I, LINE 4B	WAKEMED MAINTAINED A 457F PLAN FOR CERTAIN INDIVIDUALS. THERE WERE NO CONTRIBUTIONS MADE DURING THE YEAR. THE FOLLOWING INDIVIDUALS RECEIVED VESTED PAY-OUTS DURING THE CALENDAR YEAR 2017. CYNTHIA ALNESS-BOILY $18,122 REBECCA ANDREWS $13,268 THOMAS CAVENDER $13,444 JONATHAN CHAPPELL $33,824 CHRISTINE CRAIG $ 8,918 GURVINDER DEOL $41,935 GEORGIA HARINGTON $10,483 CAROLYN KNAUP $13,125 DEBRA LAUGHERY $ 8,856 JEANENE MARTIN $15,171 BETSY MCCLAINE $12,200 OKECHUKWUE NWOKO $14,562
SCHEDULE J, PART I, LINE 7	WAKEMED HAS INCENTIVE-BASED PROGRAMS THAT ARE DRIVEN BY ACCOMPLISHING TARGETS ASSOCIATED WITH QUALITY OF CARE FOR DISCHARGE INSTRUCTIONS, PATIENT SATISFACTION, AND MINIMUM OPERATING BENEFITS.

Schedule J (Form 990) 2019

Additional Data

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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 Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
Wakemed

Employer identification number
56-6017737

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 COMMISSION	52-1309402	65821DCW9	07-16-2009	81,780,000	SEE PART VI		X		X		X
B	NORTH CAROLINA MEDICAL CARE COMMISSION	52-1309402	65821DCS8	02-26-2009	75,000,000	SEE PART VI		X		X		X
C	NORTH CAROLINA MEDICAL CARE COMMISSION	52-1309402	65821DLY5	07-11-2012	315,717,962	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	32,390,000		0		37,435,000
2 Amount of bonds legally defeased ..............	0		0		0
3 Total proceeds of issue ..................	81,780,000		75,249,667		315,725,134
4 Gross proceeds in reserve funds .............	0		0		0
5 Capitalized interest from proceeds .............	0		0		0
6 Proceeds in refunding escrows ...............	0		0		172,556,427
7 Issuance costs from proceeds ...............	817,125		835,544		2,994,195
8 Credit enhancement from proceeds .............	41,347		37,919		0
9 Working capital expenditures from proceeds .............	0		0		0
10 Capital expenditures from proceeds .............	0		74,376,204		0
11 Other spent proceeds .............	80,921,528		0		140,174,512
12 Other unspent proceeds .............	0		0		0
13 Year of substantial completion .............	2012		2010		2012
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2018, a current refunding issue)? ........
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2018, an advance refunding issue)? ........
16 Has the final allocation of proceeds been made? ..........	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X	X

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

Cat. No. 50193E

Schedule K (Form 990) 2019

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X	X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?			X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X
b Exception to rebate? ........		X		X		X
c No rebate due? .........	X		X		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			X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X
b Name of provider ..........	0		0		0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2019

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X
b Name of provider ..........	0		0		0
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		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X

Part Ⅵ

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

Return Reference	Explanation
PURPOSE	SCHEDULE K, PART I, A(F) FINANCING (A) COSTS OF CURRENTLY REFUNDING ALL OUTSTANDING SERIES 1997 BONDS ISSUED APRIL 1, 1997. THE SERIES 1997 BONDS WERE ISSUED TO REFUND ALL OF SERIES 1993 AND 1988 BONDS, WHICH WERE ISSUED TO FINANCE COSTS OF CONSTRUCTING, EXPANDING, RENOVATING, AND EQUIPPING CERTAIN HOSPITAL FACILITIES, INCLUDING CONSTRUCTION OF WAKEMED CARY HOSPITAL, A 2-STORY ADDITION OF THE WAKEMED MAIN CAMPUS, A 45-BED REHABILITATION HOSPITAL AND RELATED, AND OTHER EQUIPMENT; AND (B) ISSUANCE COSTS. SCHEDULE K, PART I, B(F) FINANCING (A) COSTS OF CONSTRUCTION, RENOVATING AND EQUIPPING CERTAIN HOSPITAL FACILITIES, INCLUDING WAKEMED CARY 2-STORY VERTICAL EXPANSION, 10-BED LABOR AND DELIVERY UNIT EXPANSION AND PARKING DECK, WAKEMED RALEIGH 4-STORY PATIENT TOWER, PARKING DECK FOR VISITORS AND PATIENTS, EMPLOYEE PARKING DECK, PORTIONS OF REHABILITATION HOSPITAL FOR INPATIENT BEDS, THE FIRST FLOOR OF THE MAIN HOSPITAL FOR A 25-BED OBSERVATION UNIT AND RELATED, AND OTHER EQUIPMENT; (B) INITIAL COSTS FOR CREDIT FACILITY FOR THE BONDS; AND (C) ISSUANCE COSTS. SCHEDULE K, PART I, C(F) THE SERIES 2012A BONDS WERE ISSUED TO REFUND ALL THE SERIES 2001 AND THE 2009A BONDS AND PAY CERTAIN EXPENSES INCURRED IN THE CONNECTION WITH THE ISSUANCE AND SALE OF THE 2012A BONDS. THE PROCEEDS OF THE REFUNDED 2001 BONDS AND THE REFUNDED 2009A BONDS WERE USED TO FINANCE THE COSTS OF VARIOUS IMPROVEMENTS TO THE CORPORATIONS HEALTHCARE FACILITIES.
TOTAL PROCEEDS OF ISSUE	SCHEDULE K, PART II, 3, COLUMNS B & C TOTAL PROCEEDS INCLUDE INVESTMENT EARNINGS.
ISSUANCE COSTS FROM PROCEEDS	SCHEDULE K, PART II, LINE 7, COLUMNS A, B, & C THE AMOUNTS REPORTED ON FORM 8038 AS PROCEEDS USED FOR BOND ISSUANCE COSTS WERE ESTIMATES. THE AMOUNTS REPORTED ON SCHEDULE K REPRESENT THE ACTUAL USE OF PROCEEDS. SCHEDULE K CREDIT ENHANCEMENT REPORTED WAS FROM THE INITIAL LETTER OF CREDIT FEE PAID FROM BOND PROCEEDS. THIS AMOUNT WAS UNKNOWN AT THE TIME OF THE FORM 8038 PREPARATION.
ARBITRAGE REBATE	SCHEDULE K, PART IV, 2C

Schedule K (Form 990) 2019

Additional Data

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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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

Wakemed

Employer identification number

56-6017737

Return Reference	Explanation
DBAS FOR WAKEMED	FORM 990, HEADER C, DBA 1 Wake Medical Center 2 Western Wake Hospital 3 Northern Wake Hospital 4 Wake Heart Center 5 Western Wake Medical Center 6 Wake Rehabilitation Hospital 7 Wake Area Health Education Center 8 Wake AHEC 9 Eastern Wake Day Hospital and Skilled Nursing Facility 10 WakeMed Home Care 11 WakeMed - New Bern Avenue Campus 12 WakeMed - Western Wake Medical Center 13 WakeMed - Rehab 14 WakeMed - Fuquay-Varina 15 WakeMed Raleigh Campus 16 WakeMed Cary Hospital 17 WakeMed North Healthplex 18 WakeMed Clayton Medical Park 19 WakeMed Cary Outpatient Rehab Center 20 WakeMed Fuquay-Varina Outpatient & Skilled Nursing Facility 21 WakeMed Zebulon/Wendell Outpatient & Skilled Nursing Facility 22 WakeMed Wake Forest Road Outpatient Rehab Center 23 WakeMed Home Health 24 WakeMed Health & Hospitals 25 WakeMed Emergency Services Institute 26 WakeMed Center for Patient Safety 27 WakeMed Apex Healthplex 28 WakeMed Apex Day Surgery Center, LLC 29 WakeMed Professional Staff 30 WakeMed Mobile Critical Care Services 31 WakeMed Center for Innovative Learning 32 WakeMed Brier Creek Healthplex 33 WakeMed Outpatient Pharmacy 34 WakeMed Garner Healthplex 35 WakeMed Children's Hospital 36 WakeMed Children's 37 WakeMed North 38 WakeMed Rehabilitation Hospital 39 WakeMed Raleigh Medical Park 40 WakeMed Employee Pharmacy 41 WakeMed OP Rehab - 300 Ashville Avenue, Suite 220 Cary, NC 42 WakeMed Cary Hospital Sleep Center - MacGregor Pines Drive 43 Wake Specialty Brier Creek Internal Medicine 44 Wake Specialty ENT - Head & Neck Surgery 45 Wake Specialty Facial Plastics 46 Wake Specialty Gastroenterology & Hepatology 47 Wake Specialty General Surgery 48 Wake Specialty OB/GYN 49 Wake Specialty Physicians ENT - Head & Neck Surgery 50 Wake Specialty Physicians Facial Plastics 51 Wake Specialty Physicians Gastroenterology & Hepatology 52 Wake Specialty Physicians General Surgery 53 Wake Specialty Physicians Internal Medicine Brier Creek 54 Wake Specialty Physicians OB/GYN 55 Wake Specialty Physicians Urology 56 Wake Specialty Physicians Women's Center 57 Wake Specialty Urology 58 Wake Specialty Women's Center 59 Wake Specialty Physicians Maternal Fetal Medicine 60 Wake Specialty Physicians Employee Health 61 Falls Pointe Medical Group 62 Wake Specialty Physicians - City Center Medical Group 63 Wake Specialty Physicians - Carolina Cardiology 64 Wake Specialty Physicians - Concussion Clinic 65 Wake Specialty Physicians - Apex Medical Group 66 Wake Specialty Physicians - Accent Urgent Care 67 Wake Specialty Physicians - Wake Orthopaedics 68 Wake Specialty Physicians - North Wake Internal Medicine 69 Wake Specialty Physicians Pulmonology 70 Wake Specialty Physicians - Knightdale Family Practice 71 Wake Specialty Physicians - Carolina Cardiovascular Surgical Associates 72 Wake Specialty Physicians - Capital Urology 73 Wake Specialty Physicians - Morrisville Primary Care 74 Wake Specialty Physicians - Garner Primary Care 75 Wake Specialty Physicians Fuquay-Varina Primary Care 76 Wake Specialty Physicians - Structural Heart 77 Wake Specialty Physicians - Raleigh Cardiology 78 Wake Specialty Physicians - Raleigh Cardiology Associates 79 Wake Specialty Physicians - Cardiovascular 80 Wake Specialty Physicians - Parkway Primary Care 81 WakeMed Physician Practices Physical Therapy 82 Wake Orthopaedics 83 WakeMed Urgent Care 84 WakeMed Heart and Vascular Physicians DESCRIPTION OF NEW SERVICES FORM 990, PART III, LINE 2 IN FEBRUARY 2017, WAKEMED ENTERED INTO AN AGREEMENT WITH DUKE HEALTH TO ESTABLISH HEART CARE PLUS+, AN INNOVATIVE COLLABORATION IN THE AREA OF CARDIOVASCULAR DISEASE. IN APRIL 2017, WAKEMED ENTERED INTO AN AGREEMENT WITH DUKE HEALTH TO ESTABLISH CANCER CARE PLUS+, AN INNOVATIVE COLLABORATION IN THE AREA OF ONCOLOGY/CANCER SERVICES. THE PRIMARY GOAL OF THE COLLABORATIVES IS TO DELIVER HIGHLY COORDINATED CARE, A BROADER SCOPE OF SERVICES, AND GREATER VALUE AND AFFORDABILITY TO CITIZENS OF WAKE COUNTY. BOTH ORGANIZATIONS REMAIN INDEPENDENT BUT ARE FOCUSED ON WORKING TOGETHER TO IMPROVE THESE HEALTHCARE SERVICES IN WAKE COUNTY. OTHER PROGRAM SERVICES FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICES INCLUDE HOSPITAL IN AND OUTPATIENT ANCILLARY CARE SERVICES IN OTHER SPECIALTY AREAS NOT LISTED ABOVE.
MEMBERS, STOCKHOLDERS, OR OTHER PERSONS W/ POWER TO APPOINT	GOVERNING BODY FORM 990, PART VI, SECTION A, LINE 7A EIGHT MEMBERS OF THE BOARD ARE APPOINTED TO THE BOARD OF DIRECTORS BY WAKE COUNTY.
GOVERNANCE DECISIONS RESERVED TO MEMBERS, STOCKHOLDERS, OR	PERSONS OTHER THAN THE GOVERNING BODY FORM 990, PART VI, SECTION A, LINE 7B THE WAKE COUNTY BOARD OF COMMISSIONERS HOLDS LIMITED APPROVAL OVER SOME GOVERNING BODY DECISIONS PERTAINING TO ARTICLES V, VI,VII, AND IX IN THE ARTICLES OF INCORPORATION. THE TRANSFER AGREEMENT WITH WAKE COUNTY INDICATES APPROVAL/CONSENT FOR TRANSACTIONS PERTAINING TO SUBSTANTIAL DISPOSITION OF ASSETS AND COVENANTS ON LIENS.
PROCESS USED BY THE ORGANIZATION TO REVIEW FORM 990	FORM 990, PART VI, SECTION B, LINE 11B THE ENTIRE 990 AND ASSOCIATED SCHEDULES ARE REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS WHO ACKNOWLEDGE THEY HAVE REVIEWED FORMS AND SCHEDULES AND THEN RECOMMEND APPROVAL TO THE BOARD. A FINAL COPY IS PROVIDED TO THE BOARD BEFORE FILING.
MONITORING WRITTEN CONFLICT OF INTEREST POLICY	FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MONITORS AND ENFORCES THE CONFLICT OF INTEREST POLICY IN VARIOUS WAYS. EACH YEAR, MEMBERS OF THE BOARD, COMMITTEES WITH BOARD DELEGATE POWERS, CEO, CORPORATE STAFF, EXECUTIVE STAFF, DIRECTORS, AND MANAGERS ARE REQUIRED TO COMPLETE AND SUBMIT A CONFLICT OF INTEREST QUESTIONNAIRE. THOSE INDIVIDUALS ARE REQUIRED TO PROVIDE WRITTEN DOCUMENTATION OF ANY POTENTIAL CONFLICT OF INTEREST, IDENTIFYING MATERIAL FINANCIAL INTEREST/PERSONAL CONFLICTS OF INTEREST. REMEDIAL MEASURES IMPLEMENTED TO ADDRESS CONFLICTS OF INTEREST INCLUDE ABSTENTION FROM VOTING ON CERTAIN ISSUES AS WELL AS RECUSAL FROM THE DECISION MAKING PROCESS AND PARTICIPATION INVOLVING THE IDENTIFIED ISSUE/AREA. THE CODE OF CONDUCT PROVIDES GUIDANCE ON GIFTS AND TRAVEL. GIFTS SHOULD NOT BE ACCEPTED AND PRIOR TO ANY TRAVEL/LODGING PAID FOR BY A THIRD PARTY, WRITTEN APPROVAL MUST BE OBTAINED FROM AN EXECUTIVE VICE PRESIDENT. ALSO, EMPLOYEES WHO OWN OR WORK IN A PRIVATE BUSINESS OUTSIDE OF WAKEMED ARE NOT ALLOWED TO RECRUIT OR PROMOTE THEIR PRODUCTS AND SERVICES DURING WORK HOURS OR THROUGH WAKEMED PRINTED HOURS OR THROUGH WAKEMED PRINTED MATERIALS.
PROCESS FOR DETERMINING COMPENSATION OF CEO, EXEC. DIR., OR TOP	MGT OFFICIAL FORM 990, PART VI, SECTION B, LINES 15A & 15B REVIEW OF COMPENSATION IS PERFORMED BY AN INDEPENDENT FIRM. EVERY THREE YEARS AN EXECUTIVE COMPETITIVE COMPENSATION REVIEW IS PERFORMED. ON ALTERNATE YEARS, THE SVP/HR PRESENTS MARKET DATA COMPARISONS TO A BOARD OF DIRECTOR'S COMMITTEE FOR REVIEW.
AVAILABILITY OF FINANCIAL STMT, CONFLICT OF INTEREST, ORGANIZING	DOCS FORM 990, PART VI, SECTION C, LINE 19 THE 990 IS AVAILABLE BY REQUEST AND IS PUBLISHED ON GUIDESTAR. FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE THROUGH THE NC MEDICAL CARE COMMISSION AS IT RELATES TO TAX EXEMPT DEBT. THE ANNUAL AUDITED FINANCIAL STATEMENTS AND TRANSFER AGREEMENT ARE PROVIDED EACH YEAR TO WAKE COUNTY COMMISSIONERS AND BECOME PUBLIC INFORMATION. ARTICLES OF INCORPORATION ARE AVAILABLE ON THE NC SECRETARY OF STATE WEBSITE.
OTHER CHANGES IN NET ASSETS	FORM 990, PART XI, LINE 9 TRANSFERS BETWEEN AFFILIATES (1,264,482) TRANSFER OF FIXED ASSETS (569,907) DONATED CAPITAL TO FINANCE PPE 565,613 GIFTS/GRANTS/BEQUESTS/PLEDGES 183,788 FOUNDATION TO WAKEMED 471,940 INTERCO CASH TRANSFERS (2,677,808) ROUNDING (1) -------------- TOTAL (3,290,857)

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

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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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Wakemed

Employer identification number

56-6017737

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) WAKE SPECIALTY PHYSICIANS LLC 2009 NEW BERN AVENUE RALEIGH,NC27610 26-4169156	MEDICAL OFFIC	NC	146,465,175	74,059,528	NA
(2) CSAMS NEW BERN AVENUE LLC 3000 NEW BERN AVENUE RALEIGH,NC27610 26-0554927	HEALTHCARE	NC	0	345,482	NA
(3) WAKE ORTHOPAEDICS LLC 3009 NEW BERN AVENUE RALEIGH,NC27610 04-3750760	MEDICAL OFFIC	NC	0	0	NA

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)WAKE PROPERTY SERVICES 3000 NEW BERN AVENUE RALEIGH,NC27610 56-1133894	LEASING	NC	501(c)(3)	12B	NA		No
(2)WAKE FACULTY PRACTICE PLAN 3000 NEW BERN AVENUE RALEIGH,NC27610 23-7169178	MEDICAL	NC	501(c)(3)	12b	NA		No
(3)THE VOLUNTEERS AT CARY CAMPUS 3000 NEW BERN AVENUE RALEIGH,NC27610 56-1798031	VOLUNTEERS	NC	501(c)(3)	12b	NA		No
(4)WAKEMED FOUNDATION 3000 NEW BERN AVENUE RALEIGH,NC27610 56-1916549	SUPPORT	NC	501(c)(3)	7	NA		No
(5)THE VOLUNTEERS AT RALEIGH CAMPUS 3000 NEW BERN AVENUE RALEIGH,NC27610 56-0749114	VOLUNTEERS	NC	501(c)(3)	12b	NA		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2019

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) CAP CITY SURG CNTR 3000 NEW BERN AVE RALEIGH,NC27610 26-0804803	HEALTHCARE	NC	NA	Related	7,497,581	7,235,983		No	0		No	51.000 %
(2) HOLLY SPRINGS SURGICAL VENTURE 9131 ANSON WAY 304 RALEIGH,NC27540 47-3753856	HEALTHCARE	NC	NA	Related	-594,438	1,120,561		No	0		No	42.500 %
(3) WAKE PET SERVICES 3000 NEW BERN AVE RALEIGH,NC27610 26-3108205	EQUIPMENT LEASING	NC	NA	Related	181,642	59,160		No	0	Yes		50.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(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) WAKEMED KEY COMMUNITY CARE LLC 3000 NEW BERN AVENUE RALEIGH,NC27610 46-2853835		NC	NA	C Corp	-1,481,326	5,555,718	50.000 %	Yes
(2) ROCKROOM INSURANCE COMPANY (SPC) LTD 62 FORUM LANE 3 FLOOR PO BOX 30600 CAYMAN JY1-1203 CJ 56-6017737	CAPTIVE INSURANCE	NC	NA	C Corp	8,197,851	33,122,286	100.000 %	Yes
(3) QUALITY TEXTILE SERVICES 313 SOUTH ROGERS LANE RALEIGH,NC27610 56-1943802	TEXTILE SERVICES	NC	NA	C CORP	0	0	0 %		No

Schedule R (Form 990) 2019

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) ............................

Yes

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) .......................

Yes

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

Yes

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

Yes

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) ...................

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

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

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

Yes

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

Yes

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) ROCKROOM INSURANCE COMPANY (SPC) LTD	b	6,483,668	CASH-FMV
(2) WAKEMED FOUNDATION	c	1,667,154	CASH-FMV
(3) WAKEMED PROPERTY SERVICES	j	716,166	CASH-FMV
(4) WAKEMED PROPERTY SERVICES	k	14,817,771	CASH-FMV
(5) WAKEMED PROPERTY SERVICES	q	598,263	CASH-FMV
(6) WAKEMED PROPERTY SERVICES	r	4,470,025	CASH-FMV
(7) QUALITY TEXTILE SERVICES	L	2,247,072	CASH-FMV

Schedule R (Form 990) 2019

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) 2019

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) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: THE MISSION OF WAKEMED IS TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY WITH OUSTANDING AND COMPASSIONATE CARE TO ALL.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	14
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	10,580
6	Total number of volunteers (estimate if necessary) .............	6	2,021
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	9,698,130
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	-806,870

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,576,752	5,294,202
9	Program service revenue (Part VIII, line 2g) .........	1,231,241,669	1,290,894,742
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	9,429,305	10,719,313
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-1,576,924	-2,874,782
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,243,670,802	1,304,033,475
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	2,207,049	2,120,826
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)	706,540,835	760,513,477
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)....	484,303,264	505,807,395
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,193,051,148	1,268,441,698
19	Revenue less expenses. Subtract line 18 from line 12.......	50,619,654	35,591,777
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,470,677,957	1,508,036,898
21	Total liabilities (Part X, line 26).............	755,793,187	745,412,788
22	Net assets or fund balances. Subtract line 21 from line 20.....	714,884,770	762,624,110

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 287,061,714 including grants of $ 0 ) (Revenue $ 344,329,046 )
	SURGICAL SERVICES WAKEMED PROVIDES SURGICAL SERVICES IN FOUR LOCATIONS THROUGHOUT THE COUNTY: WAKEMED RALEIGH CAMPUS, WAKEMED CARY HOSPITAL, WAKEMED NORTH, AND CAPITAL CITY SURGERY, OF WHICH WAKEMED IS A MAJORITY INVESTOR. BY DELIVERING SURGICAL SERVICES TO ALL WHO SEEK CARE REGARDLESS OF THEIR ABILITY TO PAY AND BY HAVING INPATIENT SERVICES IN THREE DISTINCT LOCATIONS THROUGHOUT THE COUNTY, WAKEMED HAS IMPROVED ACCESS TO THESE NEEDED SERVICES. WAKEMEDS WIDE RANGE OF SURGICAL SPECIALTIES INCLUDE BARIATRIC, CARDIOVASCULAR AND THORACIC, ENT, HEAD AND NECK, ADULT AND PEDIATRIC GASTROINTESTINAL, GENERAL, NEUROSURGERY, OBSTETRICS AND GYNECOLOGY, ORTHOPEDICS, PEDIATRIC, UROLOGY, AND VASCULAR. AS WAKE COUNTYS ONLY STATE DESIGNATED LEVEL 1 TRAUMA CENTER, WAKEMED PROVIDES COMPREHENSIVE TRAUMA SURGERY FOR GENERAL, ORTHOPEDIC, NEUROSURGERY, AND VASCULAR TRAUMA PATIENTS. BECAUSE ACCESS TO SPECIALTY CARE CONTINUES TO BE A KEY HEALTH CONCERN FACING OUR COMMUNITY, WAKEMED HAS EXPANDED ITS NETWORK OF SPECIALISTS THROUGH WAKEMED PHYSICIANS WHO PROVIDE SUBSPECIALTY CARE TO THE UNINSURED AND UNDERINSURED IN OUR COMMUNITY. OUR STAFF WORKS WITH THE PATIENT TO DISCOUNT THEIR FEES BASED ON INDIVIDUAL INCOME AND NEED. MANY PHYSICIANS ON THE MEDICAL STAFF CONTINUE THIS PRACTICE OF PROVIDING QUALITY CARE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN FISCAL YEAR 2018, OUR SURGICAL PATIENTS INCLUDED 32.7% WHO WERE INSURED UNDER MEDICARE, 14.7% WHO WERE INSURED UNDER MEDICAID, AND 5.4% WHO WERE UNINSURED (OR "SELF-PAY OR CHARITY CARE").

4b	(Code: ) (Expenses $ 141,237,335 including grants of $ 0 ) (Revenue $ 192,425,740 )
	EMERGENCY A CRITICAL ISSUE FACING WAKE COUNTY RESIDENTS CONTINUES TO BE ACCESS TO AFFORDABLE HEALTH CARE. TO ADDRESS THIS CHALLENGE, WAKEMED HAS STRATEGICALLY PLACED SIX FULL-SERVICE, EMERGENCY DEPARTMENTS IN KEY GEOGRAPHIC AREAS THROUGHOUT THE COUNTY IN RALEIGH, CARY, NORTH RALEIGH, APEX, BRIER CREEK, AND GARNER. LOCATED IN RALEIGH, WAKEMED ALSO OPERATES THE ONLY CHILDRENS EMERGENCY DEPARTMENT IN THE COUNTY. BECAUSE PHYSICIAN AVAILABILITY IS KEY TO OPENING ACCESS TO CARE, WAKEMEDS PHYSICIAN PRACTICES, HEALTHPLEXES, AND OUTPATIENT SERVICES ARE CONVENIENTLY POSITIONED THROUGH THE AREA. WAKEMED IS AMONG THE TOP THREE VOLUME PROVIDERS OF EMERGENCY CARE IN NORTH CAROLINA. WAKEMEDS RALEIGH CAMPUS IS ALSO HOME TO WAKE COUNTYS ONLY LEVEL 1 TRAUMA CENTER, THE HIGHEST DESIGNATION AWARDED TO TRAUMA CENTERS IN NORTH CAROLINA. OUR TRAUMA SERVICE INCLUDES A COMPREHENSIVE RESEARCH PROGRAM, INJURY PREVENTION PROGRAMS, FELLOWSHIP TRAINED TRAUMA SURGEONS ON-SITE 24/7, A MULTI-DISCIPLINARY TEAM OF PROFESSIONALS, THE CLINICAL SUPPORT OF SIX ADULT INTENSIVE CARE UNITS AND A PEDIATRIC INTENSIVE CARE UNIT, AS WELL AS A COMPREHENSIVE ACUTE, INPATIENT AND OUTPATIENT PHYSICAL REHABILITATION PROGRAM. WAKEMEDS EMERGENCY AND TRAUMA SERVICES TREAT ALL PATIENTS WHO PRESENT SEEKING MEDICAL CARE, REGARDLESS OF THEIR ABILITY TO PAY. IN FY 2018, 18.8% OF OUR TOTAL EMERGENCY PATIENTS WERE INSURED UNDER MEDICARE; 27.2% WERE INSURED UNDER MEDICAID; AND 17.4% WERE UNINSURED SELF-PAY/CHARITY CARE. OVER 47% OF ALL PATIENTS SEEN IN OUR EMERGENCY DEPARTMENTS ARE EITHER MEDICAID OR UNINSURED PATIENT, RESULTING IN WAKEMED PROVIDING CARE TO AN ESTIMATED 69% OF WAKE COUNTYS UNINSURED AND MEDICAID PATIENTS. ALL STAND-ALONE LOCATIONS SERVE AREAS WHICH ARE OTHERWISE UNDERSERVED BY DEDICATED MEDICAL SERVICES.

4c	(Code: ) (Expenses $ 127,853,647 including grants of $ 0 ) (Revenue $ 137,360,246 )
	HEART CENTER WAKEMEDS HEART AND VASCULAR PROGRAM IS ONE OF THE LARGEST AND MOST COMPREHENSIVE CARDIOVASCULAR PROGRAMS IN THE STATE OF NORTH CAROLINA. LAST YEAR, 17,281 CARDIOVASCULAR PROCEDURES WERE PERFORMED INCLUDING SURGERY, DIAGNOSTIC AND INTERVENTIONAL CARDIAC CATHETERIZATIONS AND ELECTROPHSIOLOGY STUDIES. THOUSANDS MORE PATIENTS WERE TREATED MEDICALLY AS IN- AND OUTPATIENT THROUGHOUT THE SYSTEM. WAKEMED HEALTH & HOSPITALS HAS CONSISTENTLY BEEN NATIONALLY RECOGNIZED FOR EXCELLENCE IN BOTH STROKE AND HEART CARE. WAKEMED RALEIGH CAMPUS AND WAKEMED CARY HOSPITAL RECEIVED RECOGNITION FROM THE AMERICAN HEART ASSOCIATION AND THE AMERICAN STROKE ASSOCIATION THROUGH THEIR GET WITH THE GUIDELINES (GWTG) AWARDS, EACH EARNING GOLD PLUS ACHIEVEMENT AWARDS FOR BOTH STROKE CARE AND FOR HEART FAILURE CARE. THESE RECOGNITIONS SIGNIFY THAT WAKEMED HAS REACHED AN AGGRESSIVE GOAL OF TREATING BOTH STROKE AND HEART FAILURE PATIENTS ACCORDING TO THE GUIDELINES OF CARE RECOMMENDED BY THE AMERICAN STROKE ASSOCIATION, AMERICAN HEART ASSOCIATION, AND AMERICAN COLLEGE OF CARDIOLOGY. BOTH WAKEMED CARY HOSPITAL AND WAKEMED RALEIGH CAMPUS RECEIVED CHEST PAIN CENTER ACCREDITATION BY THE SOCIETY OF CARDIOVASCULAR PATIENT CARE, AND BOTH RECEIVED THE JOINT COMMISSION ADVANCED CERTIFICATION FOR PRIMARY STROKE CENTER. IN ADDITION, WAKEMED RALEIGH CAMPUS RECEIVED THE SILVER LEVEL AWARD AS A REFERRING HOSPITAL FROM THE AMERICAN HEART ASSOCIATIONS MISSION LIFELINE. WAKEMED HEALTH & HOSPITALS WAS ALSO DESIGNATED A BLUE DISTINCTION CENTER FOR CARDIAC CARE BY BLUECROSS BLUESHIELD OF NC. A KEY SUPPORT SERVICE FOR OUR COMMUNITY, WAKEMED MOBILE CRITICAL CARE SERVICES IS A COMPREHENSIVE MEDICAL TRANSPORT PROGRAM THAT IMPROVES ACCESS TO ACUTE CARE AND FACILITATES TRANSPORT INTO, OUT OF, AND ACROSS THE HEALTH CARE SYSTEM. WAKEMED MOBILE CRITICAL CARE SERVICES TRANSPORTS PATIENTS THROUGHOUT THE REGION AND STATE. IN 2018, THE TEAM TRANSPORTED 18,514 PATIENTS. WAKEMEDS HEART CENTER HAS MADE SIGNIFICANT STRIDES IN PROGRAMS AND SERVICES AIMING TO REDUCE HEART DISEASE AND DIABETES, IMPROVE STROKE OUTCOMES AND IMPROVE PATIENTS UNDERSTANDING OF DISEASE MANAGEMENT. WE KNOW THAT TEACHING PATIENTS ABOUT THEIR RISK FACTORS FOR HEART DISEASE AND ENCOURAGING HEALTHY BEHAVIORS THROUGH LIFESTYLE CHANGES BUILDS A FOUNDATION FOR A HEALTHIER POPULATION. THUS, THE WAKEMED HEART CENTER PROVIDES A COMPREHENSIVE CONTINUUM OF CARE FOR THE CARDIAC PATIENT FROM OUTREACH EDUCATION AND PREVENTION TO DIAGNOSIS, INTERVENTION, SURGERY, CARDIAC REHABILITATION AND OUTGOING DISEASE MANAGEMENT FOR HEART FAILURE DIABETES. FREE EDUCATION PROGRAMS ARE OFFERED REGULARLY FOR OUR PATIENTS, THEIR FAMILY MEMBERS AND THE COMMUNITY TO COMPLEMENT OUR COMPREHENSIVE CARE SERVICES. BECAUSE THE FASTEST INTERVENTION PROVIDES THE BEST INCOMES, ALL OF WAKEMEDS EMERGENCY DEPARTMENTS ARE CERTIFIED CHEST PAIN CENTERS. WAKEMED RALEIGH CAMPUS AND CARY HOSPITAL ARE DESIGNATED PRIMARY STROKE CENTERS. ADDITIONALLY, WAKEMEDS HEART CENTER PROVIDES FREE HEALTH SCREENINGS THROUGHOUT THE COMMUNITY INCLUDING CHOLESTEROL SCREENINGS, BLOOD PRESSURE CHECKS, VASCULAR SCREENINGS, AND STROKE ASSESSMENTS. THESE SCREENINGS ARE DESIGNED TO BE A SECONDARY PREVENTION ACTIVITY TO DETECT EARLY ONSET OF DISEASE OR ILLNESS. WAKEMED HEART & VASCULAR PROVIDES NUMEROUS OPPORTUNITIES FOR HEART HEALTH EDUCATION AND CPR TRAINING IN THE COMMUNITY. ONE OF OUR KEY OUTREACH PROGRAMS IS CPR ANYTIME. THIS PROGRAM IS PROVIDED AT MULTIPLE LOCATIONS IN WAKE COUNTY THROUGHOUT THE YEAR AND THE CPR ANYTIME KITS ARE PROVIDED AT NO COST TO PARTICIPANTS. WAKEMED DOES MAKE THE OPPORTUNITY FOR DONATIONS AVAILABLE TO HELP UNDERWRITE SOME OF THE COST AND ALLOW THE PROGRAM TO CONTINUE TO GROW. DONATIONS COVER LESS THAN 10% OF THE OVERALL COST.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 579,485,973 including grants of $ 2,120,826 ) (Revenue $ 613,175,302 )
4e	Total program service expenses1,135,638,669

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	17,812,753	0	960,789

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	0
d	Related organizations		1d	0
e	Government grants (contributions)		1e	4,704,737

f	All other contributions, gifts, grants, and similar amounts not included above		1f	589,465

g	Noncash contributions included in lines 1a - 1f:$		1g	0

h Total. Add lines 1a-1f.......		5,294,202

		Business Code
2a	PATIENT SERVICES	621511	1,240,299,447	1,240,299,447	0	0
b	NON-PATIENT SERVICES	621500	8,395,650	0	8,395,650	0
c	CAFETERIA	722210	5,269,207	0	0	5,269,207
d	PURCH DISCNTS/REBATES/VHA	900099	4,601,640	4,601,640	0	0
e	OTHER OPERATING REVENUE	900099	28,468,287	17,190,755	1,302,480	9,975,052
f	All other program service revenue.		3,860,511	3,860,511
g	Total. Add lines 2a–2f .....		1,290,894,742

3 Investment income (including dividends, interest, and othersimilar amounts) ......			11,640,071			11,640,071
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		853,333	6a
b	Less: rental expenses		123,707	6b
c	Rental income or (loss)	0	729,626	6c
d	Net rental income or (loss).......			729,626			729,626
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	1,622,762	396,207,101	7a
b	Less: cost or other basis and sales expenses	648,923	398,101,698	7b
c	Gain or (loss)	973,839	-1,894,597	7c
d	Net gain or (loss).........			-920,758			-920,758
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a	0
b	Less: direct expenses ...		8b	0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	0
b	Less: cost of goods sold ..		10b	0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	LOSS FROM JOINT VENTURES		900099	-3,604,408	-3,604,408
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			-3,604,408
12	Total revenue. See instructions.....			1,304,033,475	1,262,347,945	9,698,130	26,693,198

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	1,887,255	1,887,255
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	233,571	233,571
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0	0
4	Benefits paid to or for members .......	0	0
5	Compensation of current officers, directors, trustees, and key employees ...........	11,252,614	9,002,091	2,250,523	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	0	0	0	0
7	Other salaries and wages........	623,381,262	529,874,073	93,507,189	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	29,958,578	25,464,791	4,493,787	0
9	Other employee benefits .......	55,649,436	47,302,021	8,347,415	0
10	Payroll taxes ...........	40,271,587	34,230,849	6,040,738	0
11	Fees for services (non-employees):
a	Management ......	0	0	0	0
b	Legal .........	681,216	640,343	40,873	0
c	Accounting ...........	337,584	309,058	28,526	0
d	Lobbying ...........	406,383	382,000	24,383	0
e	Professional fundraising services. See Part IV, line 17	0			0
f	Investment management fees ......	0	0	0	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	71,143,668	66,875,048	4,268,620	0
12	Advertising and promotion ....	5,694,895	5,353,201	341,694	0
13	Office expenses .......	41,152,579	38,683,424	2,469,155	0
14	Information technology ......	19,160,147	18,010,538	1,149,609	0
15	Royalties ..	0	0	0	0
16	Occupancy ...........	24,643,304	23,164,706	1,478,598	0
17	Travel ............	1,221,066	1,147,802	73,264	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0	0	0	0
19	Conferences, conventions, and meetings ....	1,088,231	1,022,937	65,294	0
20	Interest ...........	16,803,625	16,803,625	0	0
21	Payments to affiliates .......	0	0	0	0
22	Depreciation, depletion, and amortization ..	70,168,694	70,168,694	0	0
23	Insurance ...	5,342,687	5,022,126	320,561	0
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	174,737,061	174,737,061	0	0
b	GAP ASSESSMENT	27,635,667	25,977,527	1,658,140	0
c	REPAIRS AND MAINTENANCE	25,065,893	20,052,714	5,013,179	0
d	MINOR EQUIPMENT	3,953,240	3,716,046	237,194	0
e	All other expenses	16,571,455	15,577,168	994,287
25	Total functional expenses. Add lines 1 through 24e	1,268,441,698	1,135,638,669	132,803,029	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 ........			56,898	1	53,965
2	Savings and temporary cash investments .........			540,650,124	2	549,422,956
3	Pledges and grants receivable, net ......			219,507	3	228,162
4	Accounts receivable, net .............			156,410,612	4	148,500,485
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			1,881,875	7	1,836,063
8	Inventories for sale or use ............			19,416,868	8	20,962,630
9	Prepaid expenses and deferred charges ......			10,907,317	9	11,609,110
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,566,415,172
b	Less: accumulated depreciation	10b	1,062,357,992	511,584,721	10c	504,057,180
11	Investments—publicly traded securities .			98,701,773	11	156,200,777
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			265,290	14	566,301
15	Other assets. See Part IV, line 11 ...........			130,582,972	15	114,599,269
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,470,677,957	16	1,508,036,898

17	Accounts payable and accrued expenses .....	159,909,506	17	163,132,447
18	Grants payable ...	0	18	0
19	Deferred revenue .........	309,201	19	619,450
20	Tax-exempt bond liabilities .........	409,952,370	20	397,702,019
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	157,000,000	23	157,000,000
24	Unsecured notes and loans payable to unrelated third parties ..	0	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	28,622,110	25	26,958,872
26	Total liabilities. Add lines 17 through 25..	755,793,187	26	745,412,788

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	714,884,770	32	762,624,110
33	Total liabilities and net assets/fund balances ........	1,470,677,957	33	1,508,036,898

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No