TY 2018 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)
(1) HENRY L DARNELL...................................................................... BOARD MEMBER	2.25 ................. 0.0	X
(2) BRENDA C GIBSON...................................................................... BOARD OF DIR. (END 5/25/19)	3.25 ................. 0.0	X
(3) JERRY C BERNSTEIN MD...................................................................... BOARD MEMBER (END 10/2/18)	0.0 ................. 0.0	X
(4) ROBERT A CERWIN...................................................................... BOARD MEMBER	2.5 ................. 0.0	X
(5) A BLANTON GODFREY PHD...................................................................... BOARD MEMBER	3.0 ................. 0.0	X
(6) VERN DAVENPORT...................................................................... BOARD MEMBER	1.5 ................. 0.0	X
(7) ROBERT C RICE JR...................................................................... SECRETARY - BOARD MEMBER	2.5 ................. 0.0	X
(8) WILLY E STEWART...................................................................... CHAIR, BOARD OF DIRECTORS	3.0 ................. 0.0	X
(9) DAN BLUE III...................................................................... BOARD MEMBER	2.25 ................. 0.0	X
(10) CHRISTINA ALVARADO SHANAHAN...................................................................... VICE CHAIR, BOARD OF DIRECTORS	3.0 ................. 0.0	X
(11) James Anthony Penry...................................................................... BOARD MEMBER	2.5 ................. 0.0	X
(12) R DONOVAN MUNFORD...................................................................... BOARD MEMBER (END 5/25/19)	1.5 ................. 0.0	X
(13) Sonia Barnes...................................................................... BOARD MEMBER	2.75 ................. 0.0	X
(14) LARRY BARBOUR...................................................................... BOARD MEMBER (BEG. 5/25/19)	1.75 ................. 0.0	X
(15) THAD L MCDONALD MD...................................................................... BOARD OF DIR. (BEG. 10/2/18)	2.75 ................. 0.0	X
(16) MARY NASH RUSHER...................................................................... BOARD OF DIR. (BEG. 5/25/19)	1.5 ................. 0.0	X
(17) BLOUNT WILLIAMS...................................................................... BOARD OF DIR. (BEG. 5/25/19)	2.0 ................. 0.0	X

(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)	(F) Estimated amount of other compensation from the organization and related organizations
(18) STEPHEN M SMITH........................................................................ BOARD MEMBER (END 5/25/19)	3.5 .......................0.0	X					0	0
(19) DONALD R GINTZIG........................................................................ President & CEO	75.0 .......................0.0		X				1,699,607	41,595
(20) DENISE WARREN........................................................................ Exec VP & COO	65.0 .......................0.0		X				769,338	36,366
(21) Rick Carrico........................................................................ CFO	70.0 .......................0.0		X				766,824	43,519
(22) ROYLYN JOHNSON........................................................................ OFFICER - SECRETARY	50.0 .......................0.0		X				109,992	16,304
(23) THEODORE LOTCHIN........................................................................ VP - CHIEF COMPL. & PRIVACY	60.0 .......................0.0		X				335,113	39,066
(24) CHARLES HARR........................................................................ Chief Medical Officer, Raleigh	60.0 .......................0.0			X			482,523	19,000
(25) Christine Craig........................................................................ VP, Governmental Affairs	55.0 .......................0.0			X			286,505	32,862
(26) J WEST PAUL END 42619........................................................................ SVP & CH QUALITY/MED STAFF OFC	60.0 .......................0.0			X			499,909	43,519
(27) Rebecca Andrews........................................................................ SVP & ADMIN RALEIGH	65.0 .......................0.0			X			438,286	30,351
(28) Seth Brody........................................................................ Chief Medical Officer, Cary	60.0 .......................0.0			X			402,090	17,500
(29) Stephanie Sessoms........................................................................ VP FINANCE	60.0 .......................0.0			X			266,662	35,309
(30) Susan James........................................................................ VP & Chief Legal Officer	60.0 .......................0.0			X			407,819	40,606
(31) Thomas Gough........................................................................ SVP - Administrator Cary	60.0 .......................0.0			X			396,792	19,276
(32) SHERI D DESHAZO........................................................................ SR VP ADMIN-NORTH (END 8/9/19)	65.0 .......................0.0			X			295,042	42,939
(33) Debra Laughery........................................................................ VP - Public Relations	60.0 .......................0.0			X			299,328	16,610
(34) MATTHEW NATHAN........................................................................ SENIOR VP - PHYSICIAN SERVICES	65.0 .......................0.0			X			553,901	20,895
(35) KAREN BASH........................................................................ CMO, NORTH HOSPITAL	60.0 .......................0.0			X			361,906	31,233
(36) RICK SHRUM........................................................................ VP & CHIEF STRATEGY OFFICER	60.0 .......................0.0			X			350,211	46,129
(37) JOHN PERRY........................................................................ VP MEDICAL EDUCATION	55.0 .......................0.0			X			365,903	40,879
(38) CHANTAL HOWARD END 4119........................................................................ VP NURSING, RALEIGH	60.0 .......................0.0			X			221,413	24,026
(39) PETER MARKS........................................................................ VP & CIO	60.0 .......................0.0			X			428,256	20,786
(40) JEANENE R MARTIN........................................................................ SENIOR VP-HUMAN RESOURCES	55.0 .......................0.0			X			411,714	35,663
(41) THOMAS G CAVENDER........................................................................ VP FACILITIES & CONSTRUCTION	50.0 .......................0.0			X			342,441	28,186
(42) CAROLYN KNAUP........................................................................ SENIOR VP-AMBULATORY SERVICES	60.0 .......................0.0			X			379,541	37,831
(43) CYNTHIA ALNESS-BOILY........................................................................ SENIOR VP-OPERATIONS & CNO	60.0 .......................0.0			X			433,108	34,090
(44) GURVINDER S DEOL........................................................................ PHYSICIAN	65.0 .......................0.0				X		1,239,647	36,038
(45) JONATHAN D CHAPPELL........................................................................ PHYSICIAN	60.0 .......................0.0				X		968,045	30,678
(46) TIMOTHY E HARRIS........................................................................ PHYSICIAN	60.0 .......................0.0				X		883,182	38,242
(47) Conor Regan........................................................................ Physician	55.0 .......................0.0				X		991,292	23,260
(48) BRYON BOULTON........................................................................ PHYSICIAN	61.0 .......................0.0				X		1,043,291	35,394
(49) GEORGIA C HARRINGTON........................................................................ VP-OPS (END 4/6/18)	55.0 .......................0.0					X	105,617	11,300
(50) BETSY GASKINS-MCCLAINE........................................................................ VP HEART & VASCULAR	65.0 .......................0.0					X	240,997	23,234

(A) Name and business address	(B) Description of services	(C) Compensation
UNIVERSITY OF NC HOSPITALS, 211 FRIDAY CENTER DRIVE STE 2033 CHAPEL HILL,NC27517	HEALTH CARE SYSTEM	4,168,148
LABORATORY CORPORATION OF AMERICA, PO BOX 12140 BURLINGTON,NC27216	DIAGNOSTIC TESTING	3,125,207
AMCOL SYSTEMS, PO BOX 21625 COLUMBIA,SC29221	COLLECTION SERVICES	2,928,447
FRESENIUS MEDICAL CARE BMA WAKE, 16343 COLLECTION CENTER DRIVE CHICAGO,IL60693	HEMODIALYSIS TRMNT.	2,314,848
WAKE EMERGENCY PHYSICIANS, 210 TOWNE VILLAGE DRIVE CARY,NC27513	PHYSICIAN SERVICES	2,165,227
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 90

- 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 the latest information.

OMB No. 1545-0047

2018

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) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 2018 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. 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—2017. 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—2018. 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—2017. 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) 2018

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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. 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—2017. 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) 2018

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) 2018

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) 2018

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) 2018

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 2018 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-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, 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 2018. 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 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

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) 2018

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

2018

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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization WakeMed

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

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) (2018)

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

2018

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) 2018

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) 2015	(b) 2016	(c) 2017	(d) 2018	(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) 2018

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

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

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

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

559,067

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

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

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

559,067

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) 2018

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 the latest information.

OMB No. 1545-0047

2018

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 SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

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

(ii)

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

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2018

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 ....	335,506	336,449	337,353	335,518	332,541
b	Contributions ...
c	Net investment earnings, gains, and losses	5,026	4,238	3,448	3,601	4,776
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....	5,210	5,181	4,352	1,766	1,799
g	End of year balance ......	335,322	335,506	336,449	337,353	335,518

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 %

Temporarily restricted 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 .....	0	3,864,369		3,864,369
b	Buildings ....	0	634,511,414	354,025,544	280,485,870
c	Leasehold improvements	0	37,065,098	21,360,757	15,704,341
d	Equipment ....	0	895,807,338	727,800,992	168,006,346
e	Other .....	0	49,451,711	18,982,905	30,468,806
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..					498,529,732

Schedule D (Form 990) 2018

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

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

Part IX

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

(a) Description				(b) Book value
(1) RESTRICTED FUNDS				41,031,604
(2) DESIGNATED FUNDS				106,454,749
(3) OTHER EQUITY INVESTMENTS				36,151,808
(4) PREPAID PENSION				14,358,699
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				197,996,860

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
TOTAL DUE TO THIRD PARTY PAYOR	3,366,204
ACCRUED CLAIMS PAYABLE	20,255,785
PENSION - DEFERRED INFLOW	3,056,245
DEFERRED LANDLORD INCENTIVES & RENTS	1,574,398
OTHER DEFERRED INFLOWS OF RESOURCES	896,249
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	29,148,881
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) 2018

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
SCHEDULE D, PART V, LINE 4	Intended use of endowment funds 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) 2018

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

2018

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" to 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		(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in region	(f) Total expenditures for and investments in region
	Central America and the Caribbean	CAPTIVE INSURANCE	INSURANCE PREMIUMS/EXP	6,676,845
















3a	Sub-total .....			6,676,845
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)			6,676,845

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2018

Schedule F (Form 990) 2018

Page 2

Part II

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

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

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

Schedule F (Form 990) 2018

Schedule F (Form 990) 2018Page 3

Part III

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

Part III can be duplicated if additional space is needed.

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

Schedule F (Form 990) 2018

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2018

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
FORM 990, SCHEDULE F, PART I	PROCEDURES FOR MONITORING USE OF GRANTS THE METHOD USED TO ACCOUNT FOR EXPENDITURES ON THE ORGANIZATION'S FINANCIAL STATEMENTS IS THE ACCRUAL METHOD.

Schedule F (Form 990) 2018

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

2018

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) . . .	107,308,828		107,308,828	7.750 %
b	Medicaid (from Worksheet 3, column a) . . . . .	205,286,714	174,830,814	30,455,900	2.200 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	1,985,055	1,952,817	32,238	0.010 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	314,580,597	176,783,631	137,796,966	9.960 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	5,424,896	250,000	5,174,896	0.370 %
f	Health professions education (from Worksheet 5) . . .	15,652,449	10,551,965	5,100,484	0.370 %
g	Subsidized health services (from Worksheet 6) . . . .	0	0	0	0 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	1,136,007		1,136,007	0.080 %
j	Total. Other Benefits . .	22,213,352	10,801,965	11,411,387	0.820 %
k	Total. Add lines 7d and 7j .	336,793,949	187,585,596	149,208,353	10.780 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

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	130,075		130,075	0.010 %
3	Community support	694,955		694,955	0.050 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	4,133,428	47,405	4,086,023	0.290 %
9	Other
10	Total	4,958,458	47,405	4,911,053	0.350 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

25,313,113

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).....

389,563,002

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

499,661,239

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

-110,098,237

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 %	(e) Physicians' profit % or stock ownership %
1CAPITAL CITY SURGERY	SURGERY	51 %	21.39 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

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) 2018

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 19

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 19

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) 2018

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) 2018

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

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

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) 2018

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) 2018

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, 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, SECTION B, LINE 3E THE SIGNIFICANT HEALTH NEEDS OF WAKE COUNTY WERE IDENTIFIED IN THE 2019 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 PRIORITY AREAS FOR WAKE COUNTY ARE: TRANSPORTATION & TRANSIT, ACCESS TO HEALTH SERVICES, MENTAL HEALTH AND SUBSTANCE ABUSE, EMPLOYMENT, AND HOUSING & HOMELESSNESS. 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 DEALTHS, PERCENTAGE OF PEOPLE EXPOSED TO SECONDHAND SMOKE, PERSONS SERVED IN NC STATE ALCOHOL AND DRUG TREATMENT CENTERS. THE EMPLOYMENT PRIORITY INCLUDES INFORMATION RELATED TO HOW MANY PEOPLE HAVE JOBS, WHAT TYPES OF JOBS THEY HAVE, AND WHETHER PEOPLE FEEL THEY CAN GET A GOOD JOB IN WAKE COUNTY. THE HOUSING AND HOMELESSNESS PRIORITY CONTAINS INFORMATION RELATED TO THE COST OF HOUSING, HOUSING CHOICES, AND NUMBER OF PERSONS EXPERIENCING HOMELESSNESS.
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 THE FULL 2019 CHNA REPORT, WAKEMED PARTNERED WITH OVER 100 AGENCY AND COMMUNITY PARTNERS IN WAKE COUNTY TO CONDUCT THE COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT IN LATE 2018 THROUGH EARLY 2019. THE NEXT CHNA WILL BE COMPLETED IN 2021. THE PURPOSE OF WAKE COUNTYS CHNA IS TO IDENTIFY HEALTH STATUS CONCERNS AND RESOURCES IN WAKE COUNTY, REPORT FINDINGS, WORK WITH THE COMMUNITY TO DETERMINE PRIORITY ISSUES TO BE ADDRESSED, AND DEVELOP A COMMUNITY-BASED ACTION PLAN TO ADDRESS IDENTIFIED CONCERNS. THE 2019 STUDY REPORT IS 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 IMPUT AND PRIORTIZATION SESSIONS WERE HELD. IN TOTAL MORE THAN 5,900 PEOPLE PARTICIPATED IN THE PROCESS. TIME PERIOD FOR INPUT: THE COLLECTION PERIOD BEGAN IN MAY 2018 DATA WAS GATHERED THROUGH OCTOBER 2018. 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 MINISRTY. 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 UNDERSERVED, 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 2019 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, ADVANCE COMMUNITY HEALTH (FORMERLY 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, YOUTH THRIVE, AND TRIANGLE UNITED WAY
SCHEDULE H, PART V, SECTION B, LINE 7A	HTTP://WWW.WAKEMED.ORG/DOCUMENTS/COMMUNITY/2019-WAKE-COUNTY-CHNA-REPORT-FI NAL.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/2019-CHNA-initiatives.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 FIVE PRIORITY AREAS FOR WAKE COUNTY THAT WILL BE ADDRESSED OVER THE NEXT THREE YEARS: - TRANSPORTATION & TRANSIT OPTIONS; - ACCESS TO HEALTH SERVICES; - MENTAL HEALTH AND SUBSTANCE ABUSE; - EMPLOYMENT; AND - HOUSING & HOMELESSNESS WAKEMED'S IMPLEMENTATION PLAN ADDRESSES EACH PRIORITY AREA. (HTTPS://WWW.WAKEMED.ORG/DOCUMENTS/COMMUNITY/2019-CHNA-PLAN.PDF) THE IMPLEMENTATION PLAN DETAILS THE SERVICES AND PROGRAMS WAKEMED OFFERS OR IS PARTNERING WITH OTHER ORGANIZATIONS TO PROVIDE TO THE COMMUNITY.
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) 2018

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?11
Name and address		Type of Facility (describe)
1	WAKE SPECIALTY PHYSICIANS LLC 3000 NEW BERN AVENUE RALEIGH,NC27610	MEDICAL PRACTICE
2	WAKEMED NORTH 10000 FALLS OF THE NEUSE ROAD RALEIGH,NC27614	SURG., PREGNANCY, CHILDBIRTH, OP/AMB SURG. CENTER
3	WAKEMED REHAB HOSPITAL 3000 NEW BERN AVENUE RALEIGH,NC27610	PHYS MED/REHAB HOSP., PHYS SPCH/OCCUP THERAPY
4	WAKEMED GARNER HEALTHPLEX 400 US 70 EAST GARNER,NC27529	EMERG. DEPT., LABORATORY, RADIOLOGY
5	WAKEMED SPECIALISTS GROUP 3000 NEW BERN AVENUE RALEIGH,NC27610	MEDICAL PRACTICES
6	WAKEMED APEX HEALTHPLEX 120 HEALTHPLEX WAY APEX,NC27502	EMERG. DEPT., LABORATORY, RADIOLOGY
7	WAKEMED BRIER CREEK HEALTHPLEX 8001 TW ALEXANDER DRIVE RALEIGH,NC27617	EMERG. DEPT., LABORATORY, RADIOLOGY
8	WAKEMED HOME HEALTH 2920 HIGHWOODS BOULEVARD SUITE 200 RALEIGH,NC27604	HOME HEALTH, HOME IV THERAPY, PRIVATE DUTY NURSING
9	WAKEMED MEDICAL PARK 23 SUNNYBROOK ROAD RALEIGH,NC27610	LABORATORY, RADIOLOGY
10	WAKEMED CLAYTON MEDICAL PARK 555 MEDICAL PARK CLAYTON,NC27520	REHAB THERAPY
11	WAKEMED WAKE FOREST ROAD 3701 WAKE FOREST ROAD RALEIGH,NC27609	PHYS, OCCUP, SPCH/PEDS SPCH THERAPY

Schedule H (Form 990) 2018

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	Criteria for Determining eligibility for free or discounted care DISCOUNTED CARE IS AVAILABLE FOR THOSE AT THE 300% OF THE FPG. FURTHER, ALL PATIENTS WITHOUT INSURANCE QUALIFY FOR AN AUTOMATIC 50% DISCOUNT WITHOUT CONSIDERATION OF 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 COMMUNITY BUILDING ACTIVITIES 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, WHILE ALSO HELPS TO ATTRACT NEW TALENT TO THE AREA FOR GROWING BUSINESSES WITH A FOCUS ON INCLUSION. 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, AS WELL AS OTHER COMMUNITY-BASED ORGANIZATIONS 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 UNCOLLECTABLE 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 UNCOLLECTABLE ACCOUNTS AS A COMPONENT OF NET PATIENT SERVICE REVENUE RATHER THAN WITHIN OPERATING EXPENSES". SCHEDULE H, PART III, LINE 8A TREATMENT OF MEDICARE SHORTFALL AS COMMUNITY BENEFIT WAKEMED BELIEVES THAT ALL OF THE $110,098,237 MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITTY 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 38.8% 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 WERE TREATED AS COMMUNITY BENEFIT, THE PERCENT OF TOTAL EXPENSES ATTRIBUTABLE TO COMMUNITY BENEFIT WOULD INCREASE FROM 10.78% TO 18.72%. SCHEDULE H, PART III, LINE 8B MEDICARE COSTING METHODOLOGY THE MEDICARE ALLOWABLE COSTS WERE DETERMINED FROM THE MEDICARE COST REPORT, AS SPECIFIED IN THE PROVIDER REIMBURSEMENT MANUAL. SCHEDULE H, PART III, LINE 9B APPLICATION OF COLLECTION PRACTICES TO THOSE QUALIFYING FOR FINANCIAL ASSISTANCE 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. PRIOR TO SENDING TO COLLECTIONS, ALL PATIENT ACCOUNTS ARE ROUTED THRU A PRESUMPTIVE CHARITY PROCESS WHERE THEY ARE AUTOMATICALLY SCREENED FOR ASSISTANCE. 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.
SCHEDULE H, PART VI, LINE 2	NEEDS ASSESSMENT 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 2018 AND EARLY 2019, WAKEMED HEALTH & HOSPITALS JOINED WITH DUKE HEALTH RALEIGH, UNC REX HEALTHCARE, ADVANCE COMMUNITY , TRIANGLE UNITED WAY, WAKE COUNTY HUMAN SERVICES, YOUTH THRIVE, AND OTHERS TO JOINTLY CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE ASSESSMENT WAS COMPLETED IN JUNE OF 2019. 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: https://www.wakemed.org/documents/community/2019-Wake-County-CHNA-Report-F inal.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. IN 2017, THE WAKE COUNTY BOARD OF COMMISSIONERS APPOINTED A POPULATION HEALTH TASK FORCE. THE TASK FORCE CONSIDERED A WEALTH OF DATA, RESEARCH, COMMUNITY FEEDBACK, AND NATIONAL BEST PRACTICES. AS A CONCEPT OF HEALTH, "POPULATION HEALTH" IS DEFINED AS 'THE HEALTH OUTCOMES OF A GROUP OF INDIVIDUALS, INCLUDING THE DISTRIBUTION OF SUCH OUTCOMES WITHIN THE GROUP.' IT IS AN APPROACH THAT CONSIDERS BOTH HEALTH OUTCOMES AND THE DETERMINANTS OF THOSE OUTCOMES. OUR GOAL IS TO EMPLOY A BROAD DEFINITION OF "HEALTH" WHICH IS A STATE OF COMPLETE PHYSICAL, MENTAL, AND SOCIAL WELL-BEING NOT MERELY THE ABSENCE OF DISEASE OR INFIRMITY. STUDIES SHOW THAT ONLY 20 PERCENT OF HEALTH OUTCOMES ARE ACHIEVED THROUGH THE PROVISION OF MEDICAL CARE THE REST IS A COMBINATION OF A PERSONS GENETICS, HEALTHY BEHAVIORS, SOCIAL AND ECONOMIC FACTORS, AND THE PHYSICAL ENVIRONMENT. THIS BROAD DEFINITION OF "HEALTH" CANNOT BE ACHIEVED SOLELY BY THE PROVISION OF AFFORDABLE, ACCESSIBLE, AND QUALITY HEALTHCARE. IT CAN ONLY BE ACHIEVED BY ALIGNING MEDICAL CARE WITH "SOCIAL DETERMINATIONS OF HEALTH" TO MAKE PREVENTION AND WELLNESS ACTIVITIES THE EASY CHOICE AND IMPROVE HEALTH THROUGHOUT ALL STAGES OF LIFE. UNDERSTANDING THAT HEALTH IS IMPACTED BY MORE THAN MEDICAL CARE INCLUDING SUCH THINGS AS ACCESS TO FOOD, HOUSING, EMPLOYMENT, EDUCATION, SOCIAL SUPPORT, AND A CLEAN ENVIRONMENT LIVE WELL WAKE STRIVES TO MAKE WAKE COUNTY A HEALTHIER PLACE TO LIVE FOR EVERYONE. LIVE WELL WAKE HAS EMERGED FROM THE WORK OF TWO PRE-EXISTING EFFORTS. THE WAKE COUNTY POPULATION HEALTH TASK FORCE, INITIATED BY THE BOARD OF COMMISSIONERS IN 2018, IDENTIFIED THE NEED FOR A STRUCTURED APPROACH TO CONVENING PARTNERS IN ORDER TO REALIZE THE TASK FORCES RECOMMENDATIONS. THIS STRUCTURE ALSO ENSURES ALIGNMENT WITH THE ONGOING COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, WHICH IDENTIFIES THE HEALTH AND RESOURCE NEEDS OF WAKE COUNTY. THROUGH BRINGING TOGETHER STAKEHOLDERS IN THE BROADER COMMUNITY, GOVERNMENT, HEALTHCARE, AND BUSINESS, LIVE WELL WAKE AIMS TO ADDRESS WAKE COUNTYS BIGGEST CHALLENGES AS OUTLINED BY THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. WORKING GROUPS HAVE BEEN FORMED TO ADDRESS THOSE SEVEN AREAS AND, USING A RESULTS-BASED ACCOUNTIBILITY FRAMEWORK, WILL AIM TO ACCELERATE PROGRESS TOWARDS MAKING THE LIVES OF ALL PEOPLE IN WAKE COUNTY BETTER.
SCHEDULE H , PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PATIENTS ARE PROVIDED WITH INFORMATION ABOUT FINANCIAL ASSISTANCE AT REGISTRATION, DISCHARGE, PHONE CALLS, AND A PLAIN 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 CONSELOR 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 UNISURED 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.
SCHEDULE H, PART VI, LINE 4	COMMUNITY INFORMATION WHILE WAKEMED SERVES PATIENTS FROM ALL OF NORTH CAROLINA'S 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 IN WAKE COUNTY. 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 EXCESSS 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)
SCHEDULE H, PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH 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 COUNTY'S 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 370 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 PROVIDERS 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 MAINTANING 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 INSURES 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.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM N/A
SCHEDULE H, PART VI, LINE 7	STATE FILING OF COMMUNITY BENEFIT REPORT 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) 2018

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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

2018

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) WAKE TECH COLLEGE FOUNDATION 9101 FAYETTEVILLE ROAD RALEIGH,NC27603	23-7017752	501(c)(3)	60,000	0			GENERAL SUPPORT
(2) WAKEMED FOUNDATION 3000 NEW BERN AVENUE RALEIGH,NC27610	56-1916549	501(c)(3)	57,077	0			GENERAL SUPPORT
(3) MARBLES KIDS MUSEUM 201 EAST HARGETT STREET RALEIGH,NC27601	58-1647538	501(c)(3)	40,000	0			GENERAL SUPPORT
(4) INTERACT 191 HIGH HOUSE ROAD CARY,NC27511	27-1771636	501(c)(3)	30,000	0			GENERAL SUPPORT
(5) INTERFAITH FOOD SHUTTLE 201 EAST HARGETT STREET RALEIGH,NC27601	56-1647538	501(c)(3)	25,000	11,661	FMV	FOOD DONATIONS	GENERAL SUPPORT
(6) NC SYMPHONY INC 3700 GLENWOOD AVENUE SUITE 13 RALEIGH,NC27612	56-0556755	501(c)(3)	18,000	0			General SupporT
(7) URBAN MINISTRIES OF WAKE COUNTY 1390 CAPITAL BOULEVARD RALEIGH,NC27603	58-1422700	501(c)(3)	12,500	0			General Support
(8) ALLIANCE MEDICAL MINISTRY 101 DONALD ROSS DRIVE RALEIGH,NC27610	56-2168673	501(c)(3)	10,000	0			GENERAL SUPPORT
(9) LINKNICA 7028 RAINWATER ROAD RALEIGH,NC27615	81-0893209	501(c)(3)	10,000	0			General Support
(10) MARCH OF DIMES 1275 MAMARONECK AVENUE WHITE PLAINS,NY10605	13-1846366	501(c)(3)	10,000	0			General Support
(11) ME FINE FOUNDATION 5100 US HIGHWAY 70 EAST PRINCETON,NC27569	20-1819368	501(c)(3)	10,000	0			General Support
(12) NC MUSEUM OF ART FOUNDATION 4630 MAIL SERVICE CENTER RALEIGH,NC276994630	23-7071511	501(c)(3)	10,000	0			General Support
(13) NC SPINAL CORD INJURY ASSOCIATION 7980 CHAPEL HILL ROAD SUITE 101 CARY,NC27513	51-0491208	501(c)(3)	10,000	0			GENERAL SUPPORT
(14) YMCA OF THE TRIANGLE 801 CORPORATE CENTER DRIVE 200 RALEIGH,NC27607	56-0591307	501(c)(3)	10,000	0			GENERAL SUPPORT
(15) AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVENUE DALLAS,TX75231	13-5613797	501(c)(3)	7,500	0			GENERAL SUPPORT
(16) GIRL SCOUTS OF NC COASTAL PINES INC 6901 PINECREST ROAD RALEIGH,NC27613	56-1791500	501(c)(3)	7,500	0			GENERAL SUPPORT
(17) LUNG CANCER INITIATIVE OF NC 4000 BLUE RIDGE ROAD SUITE 170 RALEIGH,NC27612	26-2300885	501(c)(3)	6,500	0			GENERAL SUPPORT
(18) RONALD MCDONALD HOUSE 506 ALEXANDER AVENUE DURHAM,NC27705	56-1220376	501(c)(3)	6,000	0			GENERAL SUPPORT
(19) ALLIANCE MEDICAL 101 DONALD ROSS DRIVE RALEIGH,NC27610	56-2168673	501(c)(3)	375,000	0			MEDICAL CARE
(20) CAPITAL CARE COLLABORATIVE 2500 BLUE RIDGE ROAD RALEIGH,NC27607	56-1150521	501(c)(6)	250,000	0			MEDICAL CARE
(21) DEBNAM CLINIC 1501 POOLE ROAD RALEIGH,NC27610	56-1977593		216,000	0			MEDICAL CARE
(22) RALEIGH SCHOOL OF NURSE ANESTHESIA 3900 BARRETT DRIVE RALEIGH,NC27609	56-1684241	501(c)(3)	47,405	0			GENERAL SUPPORT
(23) WAKE COUNTY HUMAN SERVICES PO BOX 46833 RALEIGH,NC27620	56-6000376		607,307	0			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) 2018

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	1299	91,548	FMV	HOUSE USAGE
(2) PRESCRIPTION DRUGS	7211	149,677	FMV	RX- INDIGENT PATIENT
(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

SCHEDULE I, PART I, LINE 2

PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS ALL GRANT/FUNDRAISING 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) 2018

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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

2018

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 in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

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) 2018

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)
1GEORGIA C HARRINGTON VP-OPS (END 4/6/18)	(i) (ii)	87,532 ------------- 0	0 ------------- 0	18,085 ------------- 0	6,240 ------------- 0	5,060 ------------- 0	116,917 ------------- 0	0 ------------- 0
2GURVINDER S DEOL PHYSICIAN	(i) (ii)	1,034,148 ------------- 0	181,791 ------------- 0	23,708 ------------- 0	9,019 ------------- 0	27,019 ------------- 0	1,275,685 ------------- 0	0 ------------- 0
3JONATHAN D CHAPPELL PHYSICIAN	(i) (ii)	844,510 ------------- 0	110,760 ------------- 0	12,775 ------------- 0	8,895 ------------- 0	21,783 ------------- 0	998,723 ------------- 0	0 ------------- 0
4DONALD R GINTZIG President & CEO	(i) (ii)	1,055,945 ------------- 0	580,676 ------------- 0	62,986 ------------- 0	17,489 ------------- 0	24,106 ------------- 0	1,741,202 ------------- 0	0 ------------- 0
5TIMOTHY E HARRIS PHYSICIAN	(i) (ii)	678,247 ------------- 0	188,818 ------------- 0	16,117 ------------- 0	8,911 ------------- 0	29,331 ------------- 0	921,424 ------------- 0	0 ------------- 0
6DENISE WARREN Exec VP & COO	(i) (ii)	595,947 ------------- 0	155,215 ------------- 0	18,176 ------------- 0	11,987 ------------- 0	24,379 ------------- 0	805,704 ------------- 0	0 ------------- 0
7CHARLES HARR Chief Medical Officer, Raleigh	(i) (ii)	425,190 ------------- 0	15,996 ------------- 0	41,337 ------------- 0	16,500 ------------- 0	2,500 ------------- 0	501,523 ------------- 0	0 ------------- 0
8Christine Craig VP, Governmental Affairs	(i) (ii)	234,697 ------------- 0	36,227 ------------- 0	15,581 ------------- 0	15,250 ------------- 0	17,612 ------------- 0	319,367 ------------- 0	0 ------------- 0
9J WEST PAUL END 42619 SVP & CH QUALITY/MED STAFF OFC	(i) (ii)	401,835 ------------- 0	75,701 ------------- 0	22,373 ------------- 0	16,500 ------------- 0	27,019 ------------- 0	543,428 ------------- 0	0 ------------- 0
10Rebecca Andrews SVP & ADMIN RALEIGH	(i) (ii)	352,798 ------------- 0	64,820 ------------- 0	20,668 ------------- 0	16,500 ------------- 0	13,851 ------------- 0	468,637 ------------- 0	0 ------------- 0
11Rick Carrico CFO	(i) (ii)	518,742 ------------- 0	135,948 ------------- 0	112,134 ------------- 0	16,500 ------------- 0	27,019 ------------- 0	810,343 ------------- 0	0 ------------- 0
12Seth Brody Chief Medical Officer, Cary	(i) (ii)	363,493 ------------- 0	18,552 ------------- 0	20,045 ------------- 0	16,500 ------------- 0	1,000 ------------- 0	419,590 ------------- 0	0 ------------- 0
13Stephanie Sessoms VP FINANCE	(i) (ii)	230,175 ------------- 0	35,364 ------------- 0	1,123 ------------- 0	13,789 ------------- 0	21,520 ------------- 0	301,971 ------------- 0	0 ------------- 0
14Susan James VP & Chief Legal Officer	(i) (ii)	352,992 ------------- 0	54,013 ------------- 0	814 ------------- 0	16,500 ------------- 0	24,106 ------------- 0	448,425 ------------- 0	0 ------------- 0
15Thomas Gough SVP - Administrator Cary	(i) (ii)	326,534 ------------- 0	54,122 ------------- 0	16,136 ------------- 0	16,500 ------------- 0	2,776 ------------- 0	416,068 ------------- 0	0 ------------- 0
16Conor Regan Physician	(i) (ii)	695,002 ------------- 0	280,751 ------------- 0	15,539 ------------- 0	8,560 ------------- 0	14,700 ------------- 0	1,014,552 ------------- 0	0 ------------- 0
17SHERI D DESHAZO SR VP ADMIN-NORTH (END 8/9/19)	(i) (ii)	229,865 ------------- 0	46,603 ------------- 0	18,574 ------------- 0	15,996 ------------- 0	26,943 ------------- 0	337,981 ------------- 0	0 ------------- 0
18Debra Laughery VP - Public Relations	(i) (ii)	245,390 ------------- 0	36,032 ------------- 0	17,906 ------------- 0	15,973 ------------- 0	637 ------------- 0	315,938 ------------- 0	0 ------------- 0
19THEODORE LOTCHIN VP - CHIEF COMPL. & PRIVACY	(i) (ii)	291,415 ------------- 0	43,398 ------------- 0	300 ------------- 0	16,500 ------------- 0	22,566 ------------- 0	374,179 ------------- 0	0 ------------- 0
20MATTHEW NATHAN SENIOR VP - PHYSICIAN SERVICES	(i) (ii)	430,774 ------------- 0	80,123 ------------- 0	43,004 ------------- 0	16,500 ------------- 0	4,395 ------------- 0	574,796 ------------- 0	0 ------------- 0
21KAREN BASH CMO, NORTH HOSPITAL	(i) (ii)	323,670 ------------- 0	18,981 ------------- 0	19,255 ------------- 0	16,500 ------------- 0	14,733 ------------- 0	393,139 ------------- 0	0 ------------- 0
22RICK SHRUM VP & CHIEF STRATEGY OFFICER	(i) (ii)	300,778 ------------- 0	46,473 ------------- 0	2,960 ------------- 0	16,500 ------------- 0	29,629 ------------- 0	396,340 ------------- 0	0 ------------- 0
23JOHN PERRY VP MEDICAL EDUCATION	(i) (ii)	317,935 ------------- 0	46,560 ------------- 0	1,408 ------------- 0	16,500 ------------- 0	24,379 ------------- 0	406,782 ------------- 0	0 ------------- 0
24CHANTAL HOWARD END 4119 VP NURSING, RALEIGH	(i) (ii)	188,947 ------------- 0	27,881 ------------- 0	4,585 ------------- 0	12,593 ------------- 0	11,433 ------------- 0	245,439 ------------- 0	0 ------------- 0
25PETER MARKS VP & CIO	(i) (ii)	332,860 ------------- 0	49,190 ------------- 0	46,206 ------------- 0	16,370 ------------- 0	4,416 ------------- 0	449,042 ------------- 0	0 ------------- 0
26JEANENE R MARTIN SENIOR VP-HUMAN RESOURCES	(i) (ii)	332,262 ------------- 0	62,319 ------------- 0	17,133 ------------- 0	16,500 ------------- 0	19,163 ------------- 0	447,377 ------------- 0	0 ------------- 0
27THOMAS G CAVENDER VP FACILITIES & CONSTRUCTION	(i) (ii)	277,369 ------------- 0	41,171 ------------- 0	23,901 ------------- 0	16,500 ------------- 0	11,686 ------------- 0	370,627 ------------- 0	0 ------------- 0
28CAROLYN KNAUP SENIOR VP-AMBULATORY SERVICES	(i) (ii)	305,547 ------------- 0	57,911 ------------- 0	16,083 ------------- 0	16,500 ------------- 0	21,331 ------------- 0	417,372 ------------- 0	0 ------------- 0
29BETSY GASKINS-MCCLAINE VP HEART & VASCULAR	(i) (ii)	201,782 ------------- 0	22,292 ------------- 0	16,923 ------------- 0	13,876 ------------- 0	9,358 ------------- 0	264,231 ------------- 0	0 ------------- 0
30CYNTHIA ALNESS-BOILY SENIOR VP-OPERATIONS & CNO	(i) (ii)	343,964 ------------- 0	64,041 ------------- 0	25,103 ------------- 0	16,500 ------------- 0	17,590 ------------- 0	467,198 ------------- 0	0 ------------- 0
31BRYON BOULTON PHYSICIAN	(i) (ii)	902,682 ------------- 0	126,433 ------------- 0	14,176 ------------- 0	8,694 ------------- 0	26,700 ------------- 0	1,078,685 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2018

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 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) 2018

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 the latest information.

OMB No. 1545-0047

2018

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	65821DLY5	07-11-2012	315,717,962	SEE PART VI		X		X		X
B	PUBLIC FINANCE AUTHORITY	27-3866124	74442CBZ6	04-10-2019	379,665,283	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	64,650,000		0
2 Amount of bonds legally defeased ..............	0		0
3 Total proceeds of issue ..................	315,730,875		380,380,702
4 Gross proceeds in reserve funds .............	0		0
5 Capitalized interest from proceeds .............	0		0
6 Proceeds in refunding escrows ...............	0		157,000,000
7 Issuance costs from proceeds ...............	2,994,195		2,897,263
8 Credit enhancement from proceeds .............	0		0
9 Working capital expenditures from proceeds .............	0		0
10 Capital expenditures from proceeds .............	0		0
11 Other spent proceeds .............	312,736,680		139,755,000
12 Other unspent proceeds .............	0		80,728,439
13 Year of substantial completion .............	2012
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X		X
15 Were the bonds issued as part of an advance refunding issue? .....	X		X
16 Has the final allocation of proceeds been made? ..........	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X

Part Ⅲ

Private Business Use

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

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

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	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
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		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

Part Ⅳ

Arbitrage

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

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

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

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference	Explanation
SCHEDULE K, PART I, A(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 CORPORATION'S HEALTHCARE FACILITIES. SCHEDULE K, PART I, B(F) EFFECTIVE APRIL 1, 2019, WAKEMED, THROUGH THE PUBLIC FINANCE AUTHORITY (THE "AUTHORITY"), ISSUED $207,650 OF HOSPITAL REVENUE BONDS, SERIES 2019A ("SERIES 2019A BONDS"), $79,045 OF HOSPITAL REVENUE BONDS, SERIES 2019B ("SERIES 2019B BONDS"), AND $79,045 OF HOSPITAL REVENUE BONDS, SERIES 2019C ("SERIES 2019C BONDS"). A PORTION OF THE SERIES 2019A BONDS PROCEEDS WERE USED TO REFUND THE OUTSTANDING SERIES 2009B AND 2009C BONDS AS WELL AS PARTIALLY REFUND THE OUTSTANDING SERIES 2012A BONDS. THE REMAINING PROCEEDS OF THE SERIES 2019A BONDS WILL BE USED TO PAY FOR THE EXPANSION OF WAKEMED CARY HOSPITAL AND FUND CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES AT WAKEMED'S VARIOUS HOSPITALS. THE PROCEEDS OF THE SERIES 2019B AND 2019C BONDS WERE USED TO REFINANCE TWO OUTSTANDING TAXABLE TERM LOANS. THE LOANS WERE TO FINANCE COSTS ASSOCIATED WITH NORTH HOSPITAL AND INFORMATION TECHNOLOGY IMPLEMENTATION PROJECTS. THEY WERE ALSO USED TO PURCHASE TWO PREVIOUSLY LEASED BUILDINGS, RALEIGH MEDICAL PARK AND BRIER CREEK HEALTHPLEX.
PRICE VARIANCE	SCHEDULE K, PART I, ROW B, COL E $13,925,283 ISSUE PRICE VARIANCE IS PREMIUM PAID AT 2019A ISSUANCE
TOTAL PROCEEDS OF ISSUE	SCHEDULE K, PART II, 3, COLUMNS A & B TOTAL PROCEEDS INCLUDE INVESTMENT EARNINGS.
PROCEEDS	SCHEDULE K, PART II, LINE 7, COLUMN B 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.
ARBITRAGE REBATE	SCHEDULE K, PART IV, 2C

Schedule K (Form 990) 2018

Additional Data

Software ID:
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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

2018

Open to Public
Inspection

Name of the organization

WakeMed

Employer identification number

56-6017737

Return Reference	Explanation
FORM 990, HEADER C, DBA	1. WAKEMED HEALTH & HOSPITALS 2. WAKEMED RALEIGH CAMPUS 3. WAKEMED CARY HOSPITAL 4. WAKEMED APEX HEALTHPLEX 5. WAKEMED NEW BERN AVENUE CAMPUS 6. WAKEMED REHAB 7. WAKE MEDICAL CENTER 8. WESTERN WAKE HOSPITAL 9. WAKE HEART CENTER 10. WESTERN WAKE MEDICAL CENTER 11. WAKE REHABILITATION HOSPITAL 12. WAKE AREA HEALTH EDUCATION CENTER 13. WAKE AHEC 14. WAKEMED HOME CARE 15. WAKEMED WESTERN WAKE MEDICAL CENTER 16. WAKEMED NORTH HEALTHPLEX 17. WAKEMED CLAYTON MEDICAL PARK 18. WAKEMED CARY OUTPATIENT REHAB CENTER 19. WAKEMED WAKE FOREST ROAD OUTPATIENT REHAB CENTER 20. WAKEMED HOME HEALTH 21. WAKEMED EMERGENCY SERVICES INSTITUTE 22. WAKEMED MOBILE CRITICAL CARE SERVICES 23. WAKEMED BRIER CREEK HEALTHPLEX 24. WAKEMED OUTPATIENT PHARMACY 25. WAKEMED GARNER HEALTHPLEX 26. WAKEMED CHILDRENS HOSPITAL 27. WAKEMED PROFESSIONAL STAFF 28. WAKEMED CHILDRENS 29. WAKEMED NORTH HOSPITAL 30. WAKEMED CENTER FOR PATIENT SAFETY 31. WAKEMED CENTER FOR INNOVATIVE LEARNING 32. WAKEMED REHABILITATION HOSPITAL 33. WAKEMED PRIMARY CARE-KNIGHTDALE 34. WAKEMED PRIMARY CARE-NORTH RALEIGH 35. WAKEMED PRIMARY CARE-WAKE FOREST 36. WAKEMED PRIMARY CARE-WEST CARY PARK 37. WAKEMED PRIMARY CARE-FUQUAY VARINA 38. WAKEMED PRIMARY CARE-GARNER 39. WAKEMED PRIMARY CARE-HOLLY SPRINGS 40. WAKEMED PRIMARY CARE-KILDAIRE FARM ROAD 41. WAKEMED CHILDRENS-PEDIATRICS 42. WAKEMED PRIMARY CARE-APEX 43. WAKEMED PHYSICIAN PRACTICES 44. WAKEMED PRIMARY CARE-BRIER CREEK 45. WAKEMED PRIMARY CARE-CAMERON VILLAGE 46. WAKEMED PRIMARY CARE-CARY PARKWAY 47. WAKEMED PRIMARY CARE-DOWNTOWN RALEIGH 48. WAKEMED PRIMARY CARE-EMPLOYEE HEALTH 49. WAKEMED PRIMARY CARE-FORESTVILLE CROSSING 50. WAKEMED PEDIATRICS-CLAYTON 51. WAKEMED PHYSICIAN PRACTICES 52. WAKEMED URGENT CARE 53. TRIANGLE SINUS CENTER 54. WAKEMED UROLOGY 55. WAKEMED BARIATRICS SURGERY & MEDICAL WEIGHT LOSS 56. WAKEMED WAKE ORTHOPAEDICS 57. WAKEMED CHILDRENS-PEDIATRIC MINOR PROCEDURES 58. WAKEMED CHILDRENS-PEDIATRIC PULMONOLOGY 59. WAKEMED CHILDRENS-PEDIATRIC SURGERY 60. WAKEMED CHILDRENS-PEDIATRIC WEIGHT MANAGEMENT 61. WAKEMED CHILDRENS-PEDIATRIC BEHAVIORAL HEALTH 62. WAKEMED CHILDRENS-PEDIATRIC CARDIOLOGY 63. WAKEMED CHILDRENS-PEDIATRIC ENDOCRINOLOGY 64. WAKEMED CHILDRENS-GASTROENTEROLOGY 65. WAKEMED CHILDRENS-PEDIATRIC INTENSIVIST 66. WAKEMED CHILDRENS-SPECIAL INFANT CARE 67. WAKEMED CORPORATE HEALTH SERVICES 68. WAKEMED CRITICAL CARE MEDICINE 69. WAKEMED DENTAL SERVICE 70. WAKEMED ENT-HEAD & NECK SURGERY 71. WAKEMED GASTROENTEROLOGY 72. WAKEMED GENERAL SURGERY 73. WAKEMED HEART & VASCULAR-ADVANCED HEART FAILURE 74. WAKEMED HEART & VASCULAR-CARDIOLOGY 75. WAKEMED HEART & VASCULAR-CARDIOVASCULAR & THORACIC SURGERY 76. WAKEMED VASCULAR SURGERY 77. WAKEMED HEART & VASCULAR-COMPLEX ARRHYTHMIA 78. WAKEMED HEART & VASCULAR-STRUCTURAL HEART 79. WAKEMED HOSPITALIST 80. WAKEMED HOSPITALIST-GROUP HOME 81. WAKEMED MATERNAL FETAL MEDICINE 82. WAKEMED MOBILE WELLNESS 83. WAKEMED NEONATOLOGY 84. WAKEMED OBSTETRICS & GYNECOLOGY 85. WAKEMED PEDIATRIC HOSPITAL MEDICINE-SANFORD 86. WAKEMED PHYSICAL THERAPY 87. WAKEMED PSYCHIATRY-HOSPITAL BASED 88. WAKEMED PULMONOLOGY-HOSPITAL BASED 89. WAKEMED PULMONOLOGY 90. WAKEMED TRANSITIONAL HEALTH 91. WAKEMED RHEUMATOLOGY 92. WAKEMED UROGYNECOLOGY 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 to review the 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 and enforcement of compliance with 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 MATERIALS.
FORM 990, PART VI, SECTION B, LINE 15A & 15B	Process for determining compensation OF CEO, EXEC. DIR., OR Top mgt official REVIEW OF COMPENSATION IS PERFORMED BY AN INDEPENDENT FIRM. CEO COMPENSATION IS REVIEWED WITH AN OUTSIDE FIRM EVERY YEAR. 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 (1,127,524) TRANSFER OF FIXED ASSETS (194,889) DONATED CAPITAL TO FINANCE PPE 514,671 GIFTS/GRANTS/BEQUESTS/PLEDGES 95,624 FOUNDATION TO WAKEMED 909,125 INTERCO CASH TRANSFERS 1,366,016 PET (2,031,162) -------------------------------------------------- TOTAL (468,139)

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

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

2018

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 3000 NEW BERN AVENUE RALEIGH,NC27610 26-4169156	MEDICAL OFFIC	NC	146,594,879	-102,513,987	NA
(2) CSAMS NEW BERN AVENUE LLC 3000 NEW BERN AVENUE RALEIGH,NC27610 26-0554927	HEALTHCARE	NC	0	237,298	NA
(3) WAKEMED SPECIALISTS GROUP LLC 3000 NEW BERN AVENUE RALEIGH,NC27610 83-4333066	MEDICAL OFFIC	NC	20,668,852	27,828,986	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)WAKEMED PROPERTY SERVICES 3000 NEW BERN AVENUE RALEIGH,NC27610 56-1133894	LEASING	NC	501(c)(3)	12B	NA		No
(2)WAKEMED 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) 2018

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) CAPITAL CITY SURGERY CENTER LLC 3000 NEW BERN AVENUE RALEIGH,NC27610 26-0804803	HEALTHCARE	NC	NA	Related	6,128,083	5,754,053		No	0		No	51.000 %
(2) HOLLY SPRINGS SURGICAL VENTURES LLC 3000 NEW BERN AVENUE RALEIGH,NC27610 47-3753856	HEALTHCARE	NC	NA	Related	-98,729	870,704		No	0		No	42.500 %
(3) WAKE PET SERVICES LLC 3000 NEW BERN AVENUE RALEIGH,NC27610 26-3108205	EQUIPMENT LEASING	NC	WAKEMED	Related				No	0	Yes		100.000 %

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	COMMUNITY HEALTH	NC	NA	C Corp	-537,700	12,089,931	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	CJ	NA	C Corp	8,372,861	38,502,408	100.000 %	Yes
(3) QUALITY TEXTILE SERVICES 313 SOUTH ROGERS LANE RALEIGH,NC27610 56-1943802	TEXTILE SERVICES	NC	NA	C Corp	0	0			No

Schedule R (Form 990) 2018

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

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	b	7,429,788	CASH-FMV
(2) WAKEMED FOUNDATION	c	1,494,929	CASH-FMV
(3) WAKEMED PROPERTY SERVICES	j	1,063,490	CASH-FMV
(4) WAKEMED PROPERTY SERVICES	k	18,002,178	CASH-FMV
(5) WAKEMED PROPERTY SERVICES	q	426,783	CASH-FMV
(6) QUALITY TEXTILE SERVICES	l	2,261,386	CASH-FMV

Schedule R (Form 990) 2018

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) 2018

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) 2018

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 OUTSTANDING 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 2018 (Part V, line 2a) ......	5	10,931
6	Total number of volunteers (estimate if necessary) .............	6	1,569
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	10,716,940
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	5,294,202	5,323,902
9	Program service revenue (Part VIII, line 2g) .........	1,290,894,742	1,391,926,204
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	10,719,313	15,300,018
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-2,874,782	865,519
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,304,033,475	1,413,415,643
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	2,120,826	2,132,061
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)	760,513,477	812,524,448
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)....	505,807,395	570,798,572
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,268,441,698	1,385,455,081
19	Revenue less expenses. Subtract line 18 from line 12.......	35,591,777	27,960,562
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,508,036,898	1,655,160,684
21	Total liabilities (Part X, line 26).............	745,412,788	845,671,109
22	Net assets or fund balances. Subtract line 21 from line 20.....	762,624,110	809,489,575

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 297,890,968 including grants of $ 0 ) (Revenue $ 367,221,011 )
	SURGICAL SERVICES - WAKEMED PROVIDES SURGICAL SERVICES IN FIVE LOCATIONS THROUGHOUT THE COUNTY: WAKEMED RALEIGH CAMPUS, WAKEMED CARY HOSPITAL, WAKEMED NORTH, HOLLY SPRINGS SURGICAL VENTURES, AND CAPITAL CITY SURGERY CENTER 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. WAKEMED'S 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 COUNTY'S 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 2019, OUR SURGICAL PATIENTS INCLUDED 34.0% WHO WERE INSURED UNDER MEDICARE, 14.1% WHO WERE INSURED UNDER MEDICAID, AND 5.5% WHO WERE UNINSURED (OR "SELF-PAY OR CHARITY CARE").

4b	(Code: ) (Expenses $ 149,114,123 including grants of $ 0 ) (Revenue $ 196,323,469 )
	EMERGENCY SERVICES 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. WAKEMED CARY HOSPITAL EMERGENCY DEPARTMENT IS A LEVEL III TRAUMA CANTER. OUR TRAUMA SERVICES INCLUDE 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 2019, 19.0% OF OUR TOTAL EMERGENCY PATIENTS WERE INSURED UNDER MEDICARE; 26.4% WERE INSURED UNDER MEDICAID; AND 17.9% WERE UNINSURED SELF-PAY/CHARITY CARE. OVER 44% OF ALL PATIENTS SEEN IN OUR EMERGENCY DEPARTMENTS ARE EITHER MEDICAID OR UNINSURED PATIENT, RESULTING IN WAKEMED PROVIDING CARE OF AN ESTIMATED 68% OF WAKE COUNTYS UNINSURED AND MEDICAID PATIENTS. ALL STAND - ALONE LOCATIONS SERVE AREAS WHICH ARE OTHERWISE UNDERSERVED BY DEDICATED MEDICAL SERVICES.

4c	(Code: ) (Expenses $ 128,713,777 including grants of $ 0 ) (Revenue $ 138,074,049 )
	HEART CENTER WAKEMEDS HEART AND VASCULAR PROGRAM IS ONE OF THE LARGEST AND MOST COMPREHENSIVE CARDIOVASCULAR PROGRAMS IN THE STATE OF NORTH CAROLINA. THIS YEAR, 18,414 CARDIOVASCULAR PROCEDURES WERE PERFORMED INCLUDING SURGERY, DIAGNOSTIC AND INTERVENTIONAL CARDIAC CATHETERIZATIONS AND ELECTROPHYSIOLOGY STUDIES. THOUSANDS MORE PATIENTS WERE TREATED MEDICALLY AS IN- AND OUTPATIENTS THROUGHOUT THE SYSTEM. IN FISCAL YEAR 2019, OUR CARDIAC PATIENTS INCLUDED 40.0% WHO WERE INSURED UNDER MEDICARE, 10.1% WHO WERE INSURED UNDER MEDICAID, AND 12.7% WHO WERE UNINSURED (OR "SELF-PAY OR CHARITY CARE"). 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 2019, THE TEAM TRANSPORTED 19,723 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 ONGOING 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 OUTCOMES, 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 COMMUITY. 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 $ 666,526,069 including grants of $ 2,132,061 ) (Revenue $ 690,100,872 )
4e	Total program service expenses1,242,244,937

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	16,776,295	0	992,686

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	4,790,351

f	All other contributions, gifts, grants, and similar amounts not included above		1f	533,551

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		5,323,902

		Business Code
2a	PATIENT SERVICES	621511	1,337,958,074	1,337,958,074	0	0
b	NON - PATIENT SERVICES	621500	9,189,867	0	9,189,867	0
c	CAFETERIA	722210	5,811,367	0	0	5,811,367
d	PURCH DISC/REBATE/VHA	900099	2,192,166	2,192,166	0	0
e	OTHER OPERATING REVENUE	900099	32,760,823	12,572,628	1,527,073	18,661,122
f	All other program service revenue.		4,013,907	4,013,907
g	Total. Add lines 2a–2f ....		1,391,926,204

3 Investment income (including dividends, interest, and othersimilar amounts) ......			15,433,508			15,433,508
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		1,202,587
b	Less: rental expenses		130,265
c	Rental income or (loss)	0	1,072,322
d	Net rental income or (loss)......			1,072,322			1,072,322
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	1,250,213	1,155,723
b	Less: cost or other basis and sales expenses	2,650,063	-110,637
c	Gain or (loss)	-1,399,850	1,266,360
d	Net gain or (loss).....			-133,490			-133,490
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a		0
b	Less: direct expenses ...b		0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		0
b	Less: direct expenses ...b		0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
	a		0
b	Less: cost of goods sold ..b		0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	LOSS FROM JOINT VENTURES		900099	-206,803	-206,803	0	0
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			-206,803
12	Total revenue. See Instructions......			1,413,415,643	1,356,529,972	10,716,940	40,844,829

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	1,890,836	1,890,836
2	Grants and other assistance to domestic individuals. See Part IV, line 22	241,225	241,225
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.	0	0
4	Benefits paid to or for members	0	0
5	Compensation of current officers, directors, trustees, and key employees ....	11,593,905	9,275,124	2,318,781	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	668,524,559	568,245,875	100,278,684	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	31,341,875	26,640,594	4,701,281	0
9	Other employee benefits .......	57,996,703	49,297,198	8,699,505	0
10	Payroll taxes ...........	43,067,406	36,607,295	6,460,111	0
11	Fees for services (non-employees):
a	Management ......	0	0	0	0
b	Legal .........	804,628	756,350	48,278	0
c	Accounting ...........	305,122	279,339	25,783	0
d	Lobbying ...........	411,497	386,807	24,690	0
e	Professional fundraising services. See Part IV, line 17	0			0
f	Investment management fees ......	1,113,183	1,046,392	66,791	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	78,647,972	73,929,094	4,718,878	0
12	Advertising and promotion ....	5,915,654	5,560,715	354,939	0
13	Office expenses .......	36,586,115	34,390,948	2,195,167	0
14	Information technology ......	20,687,662	19,446,402	1,241,260	0
15	Royalties ..	0	0	0	0
16	Occupancy ...........	27,997,689	26,317,828	1,679,861	0
17	Travel ............	1,393,033	1,309,451	83,582	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 ....	1,038,965	976,627	62,338	0
20	Interest ...........	19,851,880	19,851,880	0	0
21	Payments to affiliates .......	0	0	0	0
22	Depreciation, depletion, and amortization ..	70,627,254	70,627,254	0	0
23	Insurance ...	9,486,462	8,917,274	569,188	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	197,195,304	197,195,304	0	0
b	GAP ASSESSMENT	31,378,870	29,496,138	1,882,732	0
c	REPAIRS AND MAINTENANCE	26,834,700	21,467,760	5,366,940	0
d	MINOR EQUIPMENT	11,541,605	10,849,109	692,496	0
e	All other expenses	28,980,977	27,242,118	1,738,859
25	Total functional expenses. Add lines 1 through 24e	1,385,455,081	1,242,244,937	143,210,144	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).	0

1	Cash–non-interest-bearing ........			53,965	1	55,505
2	Savings and temporary cash investments .........			549,422,956	2	577,882,186
3	Pledges and grants receivable, net ......			228,162	3	248,629
4	Accounts receivable, net .............			148,500,485	4	179,030,295
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
				0	6	0
7	Notes and loans receivable, net ....			1,836,063	7	1,065,625
8	Inventories for sale or use ........			20,962,630	8	20,519,374
9	Prepaid expenses and deferred charges ......			11,609,110	9	16,130,549
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,620,699,930
b	Less: accumulated depreciation	10b	1,122,170,198	504,057,180	10c	498,529,732
11	Investments—publicly traded securities .			156,200,777	11	163,341,458
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 ...............			566,301	14	360,471
15	Other assets. See Part IV, line 11 ...........			114,599,269	15	197,996,860
16	Total assets. Add lines 1 through 15 (must equal line 34)...			1,508,036,898	16	1,655,160,684

17	Accounts payable and accrued expenses .....	163,132,447	17	191,195,940
18	Grants payable ...	0	18	0
19	Deferred revenue .........	619,450	19	347,279
20	Tax-exempt bond liabilities .........	397,702,019	20	624,979,009
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	157,000,000	23	0
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	26,958,872	25	29,148,881
26	Total liabilities. Add lines 17 through 25..	745,412,788	26	845,671,109

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	761,814,832	27	808,720,078
28	Temporarily restricted net assets ...........	473,772	28	434,174
29	Permanently restricted net assets	335,506	29	335,323
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	762,624,110	33	809,489,575
34	Total liabilities and net assets/fund balances ........	1,508,036,898	34	1,655,160,684

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