TY 2023 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) MICHAEL WALDRUM MD...................................................................... CHAIRMAN	2.0 ................. 52.0	X					0	1,377,781	368,120
(2) ANDREW ZUKOWSKI...................................................................... SECRETARY/TREASURER	2.0 ................. 48.0		X				0	747,262	158,895
(3) JAY BRILEY THRU 1223...................................................................... PRESIDENT, ECUH CMNTY HOSP.	2.0 ................. 50.0		X				0	512,320	175,853
(4) VAN SMITH As of 0124...................................................................... PRESIDENT, ECUH CMNTY HOSP.	2.0 ................. 50.0		X				0	397,137	180,449
(5) TAMMI ROOS...................................................................... ANESTHESIOLOGIST	40.0 ................. 0.0				X		475,865	0	63,707
(6) PATRICK HEINS...................................................................... PRESIDENT, ECUH EDGECOMBE	40.0 ................. 0.0			X			359,046	0	179,742
(7) SUSAN SUITER THRU 0723...................................................................... VP, PATIENT CARE SVCS NORTH	40.0 ................. 0.0			X			232,965	0	291,059
(8) ANTHONY CHUNG...................................................................... ANESTHESIOLOGIST	40.0 ................. 0.0				X		424,946	0	49,171
(9) BRIAN HARVILL...................................................................... PRES, ECUH CHOWAN&ECUH BERTIE	40.0 ................. 0.0			X			352,297	0	114,946
(10) SUE TAYLOR As of 0723...................................................................... VP, PATIENT CARE SVCS NORTH	40.0 ................. 0.0			X			320,087	0	140,813
(11) JEFFERY DIAL...................................................................... PRESIDENT, ECUH DUPLIN	40.0 ................. 0.0			X			290,709	0	154,758
(12) DEBRA HERNANDEZ...................................................................... SVP, SYSTEM EMERGENCY SERVICES	0.0 ................. 40.0					X	0	338,593	95,506
(13) MICHELLE TAYLOR...................................................................... VP OF FINANCE & OPERATIONS	40.0 ................. 0.0		X				0	295,156	137,116
(14) JASON HARRELL...................................................................... PRESIDENT, ECUH NORTH	40.0 ................. 0.0			X			315,046	0	103,629
(15) JUDY BRUNO...................................................................... PRESIDENT, ECUH ROANOKE CHOWAN	40.0 ................. 0.0			X			300,927	0	45,895
(16) KELLY SEXTON...................................................................... MGR, PHARMACY	40.0 ................. 0.0				X		208,052	0	90,216
(17) CHARLES ALFORD...................................................................... VP, FIN. SVCS (EDGE & RCH)	40.0 ................. 0.0			X			207,348	0	79,412

(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)	(F) Estimated amount of other compensation from the organization and related organizations
(18) SHELLI SIMMONS........................................................................ MGR, PHARMACY	40.0 .......................0.0			X		225,771	0	58,253
(19) LEIGH GURLEY........................................................................ MGR, PHARMACY	40.0 .......................0.0			X		213,690	0	67,634
(20) DENNIS CAMPBELL........................................................................ PRESIDENT ECUH BEAUFORT/ECUHMC	0.0 .......................40.0		X			0	211,684	65,888
(21) DAVID S HUGHES........................................................................ FORMER SECRETARY/TREASURER	0.0 .......................0.0				X	0	267,387	7,799
(22) CYNTHIA MAYO........................................................................ VP, PATIENT CARE SVCS EDGE	40.0 .......................0.0		X			173,380	0	87,190
(23) LUCINDA CRAWFORD........................................................................ VP, FINANCIAL SERVICES DUPLIN	40.0 .......................0.0		X			170,784	0	76,905
(24) TODD WARLITNER........................................................................ VP, FIN.-CRITICAL ACCESS HOSP.	24.0 .......................16.0		X			114,696	76,464	56,198
(25) DELORES MORRIS........................................................................ VP, PATIENT CARE SERVICES-VROA	40.0 .......................0.0		X			172,124	0	69,556
(26) DANA BYRUM........................................................................ VP, PT CARE SERVICES CHO	40.0 .......................0.0		X			177,091	0	56,019
(27) CHRISTINA MILLER........................................................................ VP, PATIENT CARE SVCS DUPLIN	40.0 .......................0.0		X			170,016	0	24,461
(28) Angela Allen As of 0324........................................................................ BOARD MEMBER	2.0 .......................2.0	X				0	0	0
(29) MARCUS ALBERNAZ MD........................................................................ BOARD MEMBER	2.0 .......................2.0	X				0	0	0
(30) ERNIE EVANS........................................................................ BOARD MEMBER	2.0 .......................2.0	X				0	0	0
(31) JIMMY GARRIS........................................................................ BOARD MEMBER	2.0 .......................2.0	X				0	0	0
(32) POLLY JOHNSON THRU 1223........................................................................ BOARD MEMBER	2.0 .......................0.0	X				0	0	0
(33) JAMES PIERCE........................................................................ BOARD MEMBER	2.0 .......................0.0	X				0	0	0
(34) DIANE TAYLOR........................................................................ BOARD MEMBER	2.0 .......................4.0	X				0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
AMN HEALTHCARE INC, 2735 COLLECTION CENTER DRIVE CHICAGO,IL60693	Temporary Labor SVCS	15,933,191
SODEXO INC AFFILIATES, PO BOX 905374 CHARLOTTE,NC28290	CONTRACT LABOR&MGMT	7,903,403
MEDICAL SOLUTIONS LLC, 9101 WESTERN AVENUE SUITE 101 OMAHA,NE68114	Temporary Labor Svcs	4,740,863
AMERICAN BUILDERS INC, PO Box 2553 WINTERVILLE,NC28590	CONTRACTED SERVICES	3,832,889
SERVPRO OF BATH, 6045 US 264 Highway E WASHINGTON,NC27889	CONTRACTED SERVICES	2,525,531
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 60

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

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

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

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

East Carolina Health

Employer identification number

91-1997979

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).)

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 33 1/3% 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 33 1/3% 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 on 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) 2023

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 5 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 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. 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—2022. 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—2023. 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—2022. 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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 on 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 5 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 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. 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—2022. 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) 2023

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) .

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

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 on 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 on 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) 2023

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 on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2023

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	0
2	Recoveries of prior-year distributions	2	0
3	Other gross income (see instructions)	3	0
4	Add lines 1 through 3	4	0
5	Depreciation and depletion	5	0
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	0
7	Other expenses (see instructions)	7	0
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8	0

	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	0
b	Average monthly cash balances	1b	0
c	Fair market value of other non-exempt-use assets	1c	0
d	Total (add lines 1a, 1b, and 1c)	1d	0
e	Discount claimed for blockage or other factors (explain in detail in Part VI): 0
2	Acquisition indebtedness applicable to non-exempt use assets	2	0
3	Subtract line 2 from line 1d	3	0
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4	0
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5	0
6	Multiply line 5 by 0.035	6	0
7	Recoveries of prior-year distributions	7	0
8	Minimum Asset Amount (add line 7 to line 6)	8	0

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1	0
2	Enter 85% of line 1	2	0
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3	0
4	Enter greater of line 2 or line 3	4	0
5	Income tax imposed in prior year	5	0
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6	0

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) 2023

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	1	0
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2	0
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3	0
4 Amounts paid to acquire exempt-use assets	4	0
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5	0
6 Other distributions (describe in Part VI). See instructions	6	0
7Total annual distributions. Add lines 1 through 6.	7	0
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8	0
9 Distributable amount for 2023 from Section C, line 6	9	0
10 Line 8 amount divided by Line 9 amount	10	0 %

Section E - Distribution Allocations (see instructions)	(i) Excess Distributions	(ii) Underdistributions Pre-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6			0
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.		0
3 Excess distributions carryover, if any, to 2023:
a From 2018.......0
b From 2019.......0
c From 2020.......0
d From 2021.......0
e From 2022.......0
fTotal of lines 3a through e	0
g Applied to underdistributions of prior years		0
h Applied to 2023 distributable amount			0
i Carryover from 2018 not applied (see instructions)	0
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.	0
4Distributions for 2023 from Section D, line 7:
$ 0
a Applied to underdistributions of prior years		0
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.	0
5 Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.		0
6 Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.			0
7 Excess distributions carryover to 2024. Add lines 3j and 4c.	0
8 Breakdown of line 7:
a Excess from 2019.....0
b Excess from 2020.....0
c Excess from 2021.....0
d Excess from 2022.....0
e Excess from 2023.....0

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

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) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

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

2023

Name of the organization

East Carolina Health

Employer identification number

91-1997979

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) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization East Carolina Health

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
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) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization East Carolina Health		Employer identification number 91-1997979

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) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization East Carolina Health			Employer identification number 91-1997979
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) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

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

right arrow

Complete if the organization is described below. right arrow

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

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

OMB No. 1545-0047

2022

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

East Carolina Health

Employer identification number

91-1997979

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 .................................................................... right arrow

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 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

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 ..... right arrow

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

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

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.

Cat. No. 50084S

Schedule C (Form 990) 2022

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 right arrow

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 right arrow

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) 2019	(b) 2020	(c) 2021	(d) 2022	(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) 2022

Page 3

Part II-B

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

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

(a)

Yes|No

(b)

Amount

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

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

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

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

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

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

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

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

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

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

Yes

21,214

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

21,214

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, LOBBYING ACTIVITIES:	25.93% OF DUES TO NCHA ARE ALLOCATED TO LOBBYING.

Schedule C (Form 990) 2022

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.
right arrow

Attach to Form 990.
right arrow

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

East Carolina Health

Employer identification number

91-1997979

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 July 25, 2006, 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 right arrow

Number of states where property subject to conservation easement is located right arrow

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
right arrow

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

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

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

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

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

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

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

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

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

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

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

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

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

Term endowment right arrow

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 .....	2,676,404		2,676,404
b	Buildings ....	245,053,059	160,927,193	84,125,866
c	Leasehold improvements	6,782,507	6,214,465	568,042
d	Equipment ....	147,470,336	122,855,977	24,614,359
e	Other .....	11,820,663	3,262,071	8,558,592
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				120,543,263

Schedule D (Form 990) 2022

Page 3

Part VII

Investments - Other 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

Investments - Program 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)DUE FROM THIRD PARTY PAYORS				37,248,113
(2)DEFERRED OUTFLOWS				28,087,725
(3)OTHER RECEIVABLES				4,573,607
(4)INVESTMENTS IN SUBSIDIARIES				1,481,325
(5)OTHER ASSETS				505,559
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				71,896,329

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
NET PENSION LIABILITY	39,466,731
DUE TO THIRD PARTY PAYORS	20,638,670
DEFERRED INFLOW	7,216,205
OTHER LIABILITIES	1,714,765





Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	69,036,371
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) 2022

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 X, LINE 2:

EAST CAROLINA HEALTH, INC. HAS BEEN DETERMINED TO QUALIFY AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. EAST CAROLINA HEALTH, INC. HAS REVIEWED ITS TAX POSITIONS FOR ALL OPEN YEARS AND HAS CONCLUDED THAT NO MATERIAL LIABILITIES EXIST AS OF SEPTEMBER 30, 2024, AND 2023. EAST CAROLINA HEALTH FILES TAX RETURNS WITH THE U.S. FEDERAL AND STATE OF NORTH CAROLINA JURISDICTIONS. WITH FEW EXCEPTIONS, EAST CAROLINA HEALTH IS NO LONGER SUBJECT TO U.S. FEDERAL EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2021.

Schedule D (Form 990) 2022

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 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

East Carolina Health

Employer identification number

91-1997979

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 %

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		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			14,120,247		14,120,247	2.710 %
b	Medicaid (from Worksheet 3, column a) . . . . .			118,620,373	152,238,617	0	0 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			132,740,620	152,238,617	14,120,247	2.710 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	54	14,051	2,140,503		2,140,503	0.410 %
f	Health professions education (from Worksheet 5) . . .	13	900	1,474,083		1,474,083	0.280 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	31	142,934	1,101,484		1,101,484	0.210 %
j	Total. Other Benefits . .	98	157,885	4,716,070		4,716,070	0.900 %
k	Total. Add lines 7d and 7j .	98	157,885	137,456,690	152,238,617	18,836,317	3.610 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	4		22,058		22,058	0 %
3	Community support	6	20	42,507		42,507	0.010 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	2	143	35,830		35,830	0.010 %
7	Community health improvement advocacy
8	Workforce development	9	1,699	33,142		33,142	0.010 %
9	Other
10	Total	21	1,862	133,537		133,537	0.030 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

12,244,727

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).....

82,375,187

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

97,408,222

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

-15,033,035

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

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?6Name, 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)									Other (describe)	Facility reporting group
1	EAST CAROLINA HEALTH - HERITAGE INC 111 HOSPITAL DRIVE TARBORO,NC27886 H0258	X	X	X		X	X			A
2	EAST CAROLINA HEALTH - ROANOKE-CHOWAN 500 ACADEMY STREET AHOSKIE,NC27910 H0001	X	X	X			X	X	BEHAVIORAL HEALTH	A
3	EAST CAROLINA HEALTH - CHOWAN INC 211 VIRGINIA ROAD EDENTON,NC27932 H0063	X	X	X	X		X			A
4	DUPLIN GENERAL HOSPITAL INC 401 NORTH MAIN STREET KENANSVILLE,NC28349 H0166	X	X	X			X			A
5	EAST CAROLINA HEALTH - BERTIE 1403 SOUTH KING STREET WINDSOR,NC27983 H0268	X	X	X	X		X			A
6	HALIFAX REGIONAL MEDICAL CENTER INC 250 SMITH CHURCH ROAD ROANOKE RAPIDS,NC27870 H0230	X	X	X			X			B

Schedule H (Form 990) 2023

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)

	FACILITY REPORT GROUP A (12345)
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 21

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

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

Yes

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

Yes

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

Yes

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

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

Other website (list url):

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 21

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

Yes

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

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) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	FACILITY REPORT GROUP A (12345)
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 200.%
and FPG family income limit for eligibility for discounted care of 200.%

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 PART V DISCLOSURE

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

SEE PART V DISCLOSURE

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

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) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	FACILITY REPORT GROUP A (12345)
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

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

	FACILITY REPORT GROUP A (12345)
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) 2023

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)

	FACILITY REPORT GROUP B (6)
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?........................

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 21

Yes

6 a

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

Yes

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

Yes

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

Yes

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

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

Other website (list url):

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 21

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

Yes

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

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

10b

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) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	FACILITY REPORT GROUP B (6)
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 200.%
and FPG family income limit for eligibility for discounted care of 250.%

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

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 PART V DISCLOSURE

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

SEE PART V DISCLOSURE

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

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)

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) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	FACILITY REPORT GROUP B (6)
Name of hospital facility or letter of facility reporting group

Yes

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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) 2023

Page 7

Part VFacility Information (continued)

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

	FACILITY REPORT GROUP B (6)
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 prospective Medicare or Medicaid method

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) 2023

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
SCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP A	FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: EAST CAROLINA HEALTH - HERITAGE, INC. - FACILITY 2: EAST CAROLINA HEALTH - ROANOKE-CHOWAN - FACILITY 3: EAST CAROLINA HEALTH - CHOWAN, INC. - FACILITY 4: DUPLIN GENERAL HOSPITAL, INC. - FACILITY 5: EAST CAROLINA HEALTH - BERTIE
FACILITY REPORT GROUP A	PART V, SECTION B, LINE 5: ECU Health Bertie Hospital & ECU Health Chowan Hospital: Input was gathered from a broad range of remarkable leaders and stakeholders who are passionate about the health and wellbeing of the residents of Bertie and Chowan counties. ECU Health Bertie Hospital and ECU Health Chowan Hospital directly collaborated with Albemarle Regional Health Services (the local public health department) and community members involved in the Healthy Carolinians of the Albemarle and Three Rivers Healthy Carolinians partnership groups to complete the 2022 Bertie County Community Health Needs Assessment and the 2022 Chowan County Community Health Needs Assessment. ECU Health Bertie Hospital and Chowan Hospital and Albemarle Regional Health Services developed a CHNA Leaders Team to help lead the process. The CHNA Leadership Team included county residents as well as representatives from various local agencies and organizations mentioned above. The leadership team used grass root efforts to ensure community citizen's opinions were heard and demographic characteristics of participants were considered to ensure that results portrayed an accurate representation of each county. Primary and Secondary data was collected and reviewed between April 1 and June 30, 2021. Primary data included a community opinion survey available in paper and an electronic version. Community locations for survey distribution were selected to enrich participation representation by historically underrepresented subgroups including minority populations, low income and elderly residents. In Bertie County a total of 393 survey responses were received: 372 in English and 21 in Spanish. In Chowan County as total of 396 survey responses were received, all were English. Due to the COVID-19 pandemic the counties did not offer focus groups for the 2022 CHNA as it had in previous years. The CHNA Leadership team led a Priority Setting meeting that included staff from Albemarle Alliance for Children and Families, ECU Health Behavioral Health, Board of Education/School System, City Government, the Community College, Community Health Centers, Cooperative Extension, County Government, County Commissioners, ECU Health Hospital Foundation, Law Enforcement, Local Treatment Centers, NC Partnership for Public Health, Rescue/Emergency Management Services, Chowan/Perquimans Smart Start, and United Way. These partners represented health and non-health professionals who serve the community at large, vulnerable populations, and populations with unmet health needs. Key findings included: Access to Health Services; Cancer; Diabetes; Economy; Exercise, Nutrition & Weight; Heart Disease & Stroke; and Behavioral Health Substance Abuse. The group discussed resources available and the roles of the partners, as no one organization can address the community health needs alone, when they chose the priorities for the hospitals. The priorities for ECU Health Bertie and ECU Health Chowan Hospitals were Chronic Disease, Healthy Lifestyles, and Substance Abuse. All priorities would have an emphasis on Access to Care. ECU Health Duplin Hospital: Input was gathered from a broad range of remarkable leaders and stakeholders across Duplin County who are passionate about the health and wellbeing of the residents. ECU Health Duplin Hospital directly collaborated with Duplin County Health Department and several partners including: Duplin County 4-H, Prevention Services, Duplin County Board of Health, Duplin County Commissioners, Duplin County Public Libraries, Duplin County Public Schools, Health Access & Equity at NC FIELD, Shackle-Free Community Outreach, Mediation Center of Eastern Carolina, Duplin Christian Outreach Ministries, NC Cooperative Extension Office, ECU Health Duplin Foundation, and ECU Health Medical Group in the planning, data review, and prioritization process to complete the 2022 Duplin County Community Health Needs Assessment. The leadership team used grass root efforts to ensure community citizen's opinions were heard and demographic characteristics of participants were considered to ensure that results portrayed an accurate representation of each county. Primary and Secondary data was collected and reviewed between April 1 and June 30, 2021. Primary data included a community opinion survey available in paper and an electronic version. Community locations for survey distribution were selected to enrich participation representation by historically underrepresented subgroups including minority populations, low income and elderly residents. In Duplin County a total of 447 survey responses were received: 407 in English and 40 in Spanish. Due to the COVID-19 pandemic the counties did not offer focus groups for the 2022 CHNA as it had in previous years. ECU Health Edgecombe Hospital: Input was gathered from a broad range of remarkable leaders and stakeholders across Edgecombe County who are passionate about the health and wellbeing of the residents. ECU Health Edgecombe directly collaborated with Edgecombe County Health Department and several partners including: Access East, Carolina Family Health Centers, Inc. (Federally Qualified Health Center), Conetoe Family Life Center, Edgecombe County EMS, EastPointe Human Services, Opportunities Industrialization Center - Health (Federally Qualified Health Center), Project Momentum, Inc, Rural Health Group (FQHC), and Trillium Health Services in the planning, data review, and prioritization process to complete the 2022 Edgecombe County Community Health Needs Assessment. The leadership team used grass root efforts to ensure community citizen's opinions were heard and demographic characteristics of participants were considered to ensure that results portrayed an accurate representation of each county. Primary and Secondary data was collected and reviewed between April 1 and June 30, 2021. Primary data included a community opinion survey available in paper and an electronic version. Community locations for survey distribution were selected to enrich participation representation by historically underrepresented subgroups including minority populations, low income and elderly residents. A total of 385 survey responses were received. Due to the COVID-19 pandemic the counties did not offer focus groups for the 2022 CHNA as it had in previous years. ECU Health Roanoke-Chowan Hospital: Input was gathered from a broad range of remarkable leaders and stakeholders across Hertford County who are passionate about the health and wellbeing of the residents. ECU Health Roanoke Chowan Hospital collaborated with Albemarle Regional Health Services and the following partners: Gates Partners for Health, Healthy Carolinians of the Albemarle, Sentara Albemarle Medical Center, Three Rivers Healthy Carolinians, and Hertford Health Maintenance Alliance in the planning, data review, and prioritization process to complete the 2022 Hertford County Community Health Needs Assessment. The leadership team used grass root efforts to ensure community citizen's opinions were heard and demographic characteristics of participants were considered to ensure that results portrayed an accurate representation of each county. Primary and Secondary data was collected and reviewed between April 1 and June 30, 2021. Primary data included a community opinion survey available in paper and an electronic version. Community locations for survey distribution were selected to enrich participation representation by historically underrepresented subgroups including minority populations, low income and elderly residents. In Hertford County a total of 374 survey responses were received: 365 in English and 9 in Spanish. Due to the COVID-19 pandemic the counties did not offer focus groups for the 2022 CHNA as it had in previous years. Additionally, for all hospitals in the ECU Health Community Hospitals Group noted above, the county's CHNA was part of the Health ENC collaborative aligning the CHNA cycle with 35 additional counties in Eastern NC. This alignment will promote community health improvement activities across county lines.
FACILITY REPORT GROUP A	PART V, SECTION B, LINE 6A: THE COMMUNITY HEALTH NEEDS ASSESMENT WAS CONDUCTED WITH THE FOLLOWING HOSPITALS: EAST CAROLINA HEALTH - HERITAGE, INC. DBA ECU HEALTH EDGECOMBE HOSPITAL EAST CAROLINA HEALTH DBA ECU HEALTH ROANOKE-CHOWAN HOSPITAL EAST CAROLINA HEALTH - CHOWAN, INC. DBA ECU HEALTH CHOWAN HOSPITAL DUPLIN GENERAL HOSPITAL, INC. DBA ECU HEALTH DUPLIN HOSPITAL EAST CAROLINA HEALTH - BERTIE DBA ECU HEALTH BERTIE HOSPITAL HALIFAX REGIONAL MEDICAL CENTER, INC. DBA ECU HEALTH NORTH
FACILITY REPORT GROUP A	PART V, SECTION B, LINE 6B: ECU Health Bertie Hospital and ECU Health Chowan Hospital collaborated with Albemarle Regional Health Services (the local public health department). ECU Health Duplin Hospital collaborated with Duplin County Health Department. ECU Health Edgecombe Hospital collaborated with Edgecombe County Health Department. ECU Health Roanoke-Chowan Hospital collaborated with Albemarle Regional Health Services.
FACILITY REPORT GROUP A	PART V, SECTION B, LINE 7A AND 10A: THE HOSPITAL MAKES ITS COMMUNITY HEALTH NEEDS ASSESSMENT AND MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY AVAILABLE TO THE PUBLIC ON THE HOSPITAL'S WEBSITE: HTTPS://WWW.ECUHEALTH.ORG/ABOUT-US/COMMUNITY/HEALTH-NEEDS-ASSESSMENT/
FACILITY REPORT GROUP A	PART V, SECTION B, LINE 11: ECU Health Bertie Hospital: The leadership and partnership group mentioned in Part V Section B Line 5 have a long history of working together on the community needs. The group discussed resources available and the roles of the partners, as no one organization can address the community health needs alone, when they chose the priorities for the hospitals. The priorities for ECU Health Bertie and ECU Health Chowan Hospitals were Chronic Disease, Healthy Lifestyles; and Substance Abuse. All priorities would have an emphasis on Access to Care. ECU Health Community Hospitals' Board of Directors approved the priorities and an "on-going" set of Implementation Strategies for the ECU Health Bertie hospital to address for the three-year cycle. Chronic Disease: The hospital promotes preventative health education and screening events to churches, schools, and community partners. The team provided 20 chronic disease related education & screening sessions across the county impacting 463 people. The hospital added specialty health care services at the ECU Health Bertie Hospital Outpatient Services Center to reduce travel needs for community members. The clinics provided 7,965 clinic visits. The hospital partners with the advance care planning team which offers advance care planning and psychiatric advanced directives education to assist community members with proactive end-of-life care planning. The hospital also partners with the American Cancer Society to support the Bertie Relay for Life. Healthy Lifestyles: The Hospital promotes lifestyle behaviors and overall community health by being an active partner in Three Rivers Healthy Carolinians, providing an Athletic Trainer at the High School, promoting access to social determinants of health resources through the NCCARE360 platform, promoting immunizations, partnering with Good Shepherd Food Pantry, offering Teddy Bear Fairs for elementary students, and offering child safety education and car seat safety checks. Substance Abuse: The hospital is active member of the Bertie County Networking Council focused on reducing the stigma and education around substance misuse. The hospital offers Pain Management, providing 1,154 treatments. The hospital partners with local law enforcement on how to access drug disposal boxes and the school system to offer programs such as Catch My Breath. Additionally, the hospital provides Community Health Grants to non-profit organizations that concentrate on these three priorities. So far in this three-cycle $190,000 was distributed. See Part VI Line 1, Part 1, line 7, i for more details. ECU Health Chowan Hospital: ECU Health Community Hospitals' Board of Directors approved the priorities and an "on-going" set of Implementation Strategies for ECU Health Chowan hospital to address for the three-year cycle. Chronic Disease: The hospital promotes preventative health education and screening events to churches, schools, and community partners. The team provided 104 chronic disease screening events serving 836 participants and two prostate screening events serving 23 participants. The hospital added specialty health care services at the ECU Health Chowan Hospital Outpatient Services Center to reduce travel needs for community members. These clinics provided 9,657 clinic visits. The hospital partners with the advance care planning team which offers advance care planning and psychiatric advanced directives education to assist community members with proactive end-of-life care planning. The hospital also partners with the American Cancer Society to support the Chowan/Perquimans Relay for Life. Healthy Lifestyles: The Hospital promotes lifestyle behaviors and overall community health by being an active partner in Three Rivers Healthy Carolinians, providing an Athletic Trainer at the High School, promoting access to social determinants of health resources through the NCCARE360 platform, promoting immunizations (63 provided), providing Prenatal childbirth classes (51 participants), partnering with Edenton Food Pantry to offer Book Bag Buddies (382 children served), offering Teddy Bear Fairs for 851 elementary students, and offering child safety education and car seat safety checks. Substance Abuse: The hospital partners with ARHS on Tobacco Free initiatives, educates community on appropriate ways to dispose of medication, and partners with local law enforcement on how to access drug disposal boxes. Additionally, the hospital provides Community Health Grants to non-profit organizations that concentrate on these three priorities. So far in this three-year cycle $191,250 was distributed. See Part VI Line 1, Part 1, line 7, i for more details. ECU Health Duplin: The leadership and partnership group mentioned in Part V Section B Line 5 have a history of working together on community needs. Together, based on the data, resources available, and existing work among the partners, as no one organization can address all the community health needs alone, the following priorities were chosen for ECU Health Duplin: Chronic Disease Prevention, Access to Care, and Mental Health/Illness. ECU Health Community Hospitals' Board of Directors approved the priorities and an "on-going" set of Implementation Strategies for the hospital to address for the three-year cycle. Chronic Disease Prevention: The hospital partnered with the health department to create a Duplin Coalition for Health (44 current organization participating); offered health screenings and educational opportunities (1,900 screening offered); maintains the "Get With The Guidelines- Stroke" certification standards; offered Stroke education program for elementary students called SAM (1,382 students educated), offered Breast Feeding Education for 75 mothers. Access to Care: The Hospital partnered with Duplin Health Sciences Academy and James Sprunt community college to educate and train future health care providers (543 students impacted); and participated in the Rural Family Medicine Residency Program (2 residents completed). Mental Health/Illness: The hospital provided mental health assessments and care coordination in the emergency room (916 visits); and collaborated with the county mental health services team to improved continuity of services. Additionally, the hospital provides Community Health Grants to non-profit organizations that concentrate on these three priorities. So far in this three-year cycle $175,900 was distributed. See Part VI Line 1, Part 1, line 7, i for more details. ECU Health Edgecombe Hospital: The leadership and partnership group mentioned in Part V Section B Line 5 have a long history of working together on the community needs. Together, based on the data, resources available, and existing work among the partners, as no one organization can address the community health needs alone, they determined Edgecombe County's community health priorities. Key findings included: Health Equity and Health Disparities; Substance Use, Mental Health, and Overdose; and Social Determinants of Health. ECU Health Community Hospitals' Board of Directors approved the priorities and an "on-going" set of Implementation Strategies for the hospital to address for the three-year cycle. Health Equity and Health Disparities: To address differences in health needs based on race, age, income, and other vulnerable populations, the hospital provided community-based health screenings and education for conditions like heart disease, stroke, diabetes, and cancer (268 served); offered charity care to patients facing financial hardships; lead Edgecombe County Rural Health Network-comprising nine health and human services organizations-facilitates multidisciplinary collaboration to address health disparities; worked with the federally qualified health centers (FQHCs) and the local health department to enhance referrals to primary care and provide education about available services and public health initiatives; contracted with Vanguard to help increase those with insurance (366 people); created Edgecombe County Barbershop Partnership and involved 11 local barbers in tackling health disparities among African American men. Substance Use, Mental Health, and Overdose: The hospital served and continues to serve on multi-disciplinary Coordinated Opiate Recovery Effort (CORE) collaborative team focused on the opioid crisis; and refers patients to the Medication-Assisted Treatment (MAT) program at Freedom Hill Community Health Center. Social Determinants of Health: The hospital uses the NCCare360 platform to provided information for SDOH referrals. Additionally, the hospital provides Community Health Grants to non-profit organizations that concentrate on these three priorities. So far in this three-year cycle $190,000 was distributed. See Part VI Line 1, Part 1, line 7, i for more details. ECU Health Roanoke-Chowan Hospital: The leadership and partnership group mentioned in Part V Section B Line 5 have a long history of working toget
FACILITY REPORT GROUP A	PART V, SECTION B, LINE 16A, 16B, AND 16C: THE HOSPITAL MAKES ITS FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY AVAILABLE AT THE FOLLOWING WEBSITE: HTTPS://WWW.ECUHEALTH.ORG/PATIENTS-AND-FAMILIES/YOUR-BILL/FINANCIAL-ASSIST ANCE/
SCHEDULE H, PART V, SECTION B. FACILITY REPORTING GROUP B	FACILITY REPORT GROUP B CONSISTS OF: - FACILITY 6: HALIFAX REGIONAL MEDICAL CENTER, INC. - ECU HEALTH NORTH HOSPITAL
FACILITY REPORT GROUP B	PART V, SECTION B, LINE 5: ECU Health North: Input was gathered from a broad range of remarkable leaders and stakeholders across Halifax County who are passionate about the health and wellbeing of the residents. ECU Health North collaborated with Halifax County Health Department and several partners including: Healthy Halifax Partners; Roanoke Valley Community Health Initiative; Halifax County Board of Health; ECU Health North Board; Smart Start; Colleges; School System; and Behavioral, Dental and Health Care Providers in the planning, data review, and prioritization process to complete the 2022 Halifax County Community Health Needs Assessment. The leadership team used grass root efforts to ensure community citizen's opinions were heard and demographic characteristics of participants were considered to ensure that results portrayed an accurate representation of the county. Primary and Secondary data was collected and reviewed between April 1 and June 30, 2021. Primary data included a community opinion survey available in paper and an electronic version. Community locations for survey distribution were selected to enrich participation representation by historically underrepresented subgroups including minority populations, low income and elderly residents. A total of 399 survey responses were received. Due to the COVID-19 pandemic the county did not offer focus groups for the 2022 CHNA as it had in previous years. Additionally, for all hospitals in the ECU Health Community Hospitals Group noted above, the county's CHNA was part of the Health ENC collaborative aligning the CHNA cycle with 35 additional counties in Eastern NC. This alignment will promote community health improvement activities across county lines.
FACILITY REPORT GROUP B	PART V, SECTION B, LINE 6A: THE COMMUNITY HEALTH NEEDS ASSESMENT WAS CONDUCTED WITH THE FOLLOWING HOSPITALS: EAST CAROLINA HEALTH - HERITAGE, INC. DBA ECU HEALTH EDGECOMBE HOSPITAL EAST CAROLINA HEALTH DBA ECU HEALTH ROANOKE-CHOWAN HOSPITAL EAST CAROLINA HEALTH - CHOWAN, INC. DBA ECU HEALTH CHOWAN HOSPITAL DUPLIN GENERAL HOSPITAL, INC. DBA ECU HEALTH DUPLIN HOSPITAL EAST CAROLINA HEALTH - BERTIE DBA ECU HEALTH BERTIE HOSPITAL HALIFAX REGIONAL MEDICAL CENTER, INC. DBA ECU HEALTH NORTH
FACILITY REPORT GROUP B	PART V, SECTION B, LINE 6B: ECU Health North collaborated with Halifax County Health Department.
FACILITY REPORT GROUP B	PART V, SECTION B, LINE 7A AND 10A: THE HOSPITAL MAKES ITS COMMUNITY HEALTH NEEDS ASSESSMENT AND MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY AVAILABLE TO THE PUBLIC ON THE HOSPITAL'S WEBSITE: HTTPS://WWW.ECUHEALTH.ORG/ABOUT-US/COMMUNITY/HEALTH-NEEDS-ASSESSMENT/
FACILITY REPORT GROUP B	PART V, SECTION B, LINE 11: ECU Health North: The leadership and partnership group mentioned in Part V Section B Line 5 have a long history of working together on the community needs. Together, based on the data and existing work among the partners, they determined that Employment (Economy); Obesity; Maternal Fetal & Infant Health; Teen Pregnancy; Mental Health (Crisis Intervention); Substance Abuse; Tobacco Use; and Transportation as the significant health needs. The group discussed resources available and the roles of the partners, as no one organization can address the community health needs alone, when they chose the priorities for the three health priorities for ECU Health North. The priorities were Obesity; Substance Abuse/ (Mental Health Crisis Intervention); and Maternal, Fetal, and Infant Health. ECU Health Community Hospitals' Board of Directors approved the priorities and an "on-going" set of Implementation Strategies for the hospital to address for the three-year cycle. Obesity: The hospital received grant dollars to lead efforts for physical activity, healthy eating, and coalition building (94 events); provided education to the faith-based community through a Faithful Families program; offered cholesterol, glucose, and blood pressure screenings (123 screened); and promoted education around the obesity epidemic throughout the county. Substance Abuse/(Mental Health Crisis Intervention): The hospital partnered with Trillium Health to facilitate monthly collaboration meetings; and referred patients to Morse Clinic and Crisis Intervention. Maternal, Fetal, and Infant Health: The hospital uses the NCCare360 platform to provide information for SDOH needs of high-risk mothers. Additionally, the hospital's key strategies in the first two years of this three-year cycle were providing Community Health Grants to non-profit organizations that concentrate on these three priorities. So far in this three-year cycle $190,000 was distributed. See Part VI Line 1, Part 1, line 7, i for more details.
FACILITY REPORT GROUP B	PART V, SECTION B, LINE 16A, 16B, AND 16C: THE HOSPITAL MAKES ITS FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY AVAILABLE AT THE FOLLOWING WEBSITE: HTTPS://WWW.ECUHEALTH.ORG/PATIENTS-AND-FAMILIES/YOUR-BILL/FINANCIAL-ASSIST ANCE/

Schedule H (Form 990) 2023

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?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2023

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
PART I, LINE 6A:	ECU Health prepares the community benefit report. The numeric data in this report is based on the form 990, Schedule H criteria.
PART I, LINE 7, FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS:	COSTS WERE CALCULATED USING THE ESTIMATED COST TO CHARGE RATIO FROM THE NORTH CAROLINA HOSPITAL ASSOCIATION'S ADVOCACY NEEDS DATA INITIATIVE WHICH IS THE STANDARD FOR REPORTING COMMUNITY BENEFITS IN NORTH CAROLINA. DURING MARCH 2023, THE HEALTHCARE ACCESS AND STABILIZATION PROGRAM (HASP) WAS ENACTED BY THE STATE OF NORTH CAROLINA AND IS A FEDERALLY FUNDED PROGRAM THROUGH THE CENTER FOR MEDICARE & MEDICAID SERVICES (CMS) TO ENHANCE MEDICAID REIMBURSEMENT. HASP WAS SPECIFICALLY DESIGNED TO STRENGTHEN VULNERABLE RURAL HOSPITALS, SUCH AS THOSE IN THE ECU HEALTH SYSTEM, AND PROVIDE THEM FINANCIAL STABILITY TO CARE FOR ALL MEMBERS OF THEIR COMMUNITY. DURING SEPTEMBER 2023, CMS APPROVED HASP AND THE INCREASED REIMBURSEMENTS TO BE MADE FOR SERVICES PROVIDED FOR THE PERIOD JULY 1, 2023 TO JUNE 30, 2025. FOR THE YEAR ENDED SEPTEMBER 30, 2024, ECU HEALTH RECOGNIZED $261.7 MILLION AS NET PATIENT SERVICE REVENUE, NET OF ASSESSMENTS OF APPROXIMATELY $86.3 MILLION. INCLUDED IN THESE 2024 HASP REVENUE IS 3 MONTHS RELATED TO THE 2023 FISCAL YEAR TOTALING $42.1 MILLION, NET OF ASSESSMENTS. THE HASP PROGRAM BRINGS REIMBURSEMENTS IN LINE MORE CLOSELY WITH THE ACTUAL COST OF CARE, HELPING TO STABILIZE OUR HEALTHCARE SAFETY NET. THESE FUNDS PLAY A CRITICAL ROLE IN ALLOWING ECU HEALTH TO FULFIL ITS COMMITMENT TO THE CARE AND WELL-BEING OF THE PATIENTS WE SERVE AND ALLOWS US TO FOCUS ON PROVIDING SAFE, HIGH-QUALITY CARE TO ALL, REGARDLESS OF A PATIENT'S ABILITY TO PAY. MEDICAID EXPANSION BROUGHT HEALTHCARE COVERAGE TO APPROX 34,000 IN OUR ECU HEALTH SERVICE AREA WHO WERE PREVIOUSLY UNINSURED, THEREBY IMPROVING HEALTH OUTCOMES AND FINANCIAL SECURITY FOR MANY FAMILIES. GOING FORWARD, HASP PAYMENTS, AND A HIGHER HOSPITAL TAX, ALSO HAS A NEW REQUIREMENT THAT HOSPITALS AGREE TO A MEDICAL DEBT INCENTIVE PROGRAM. HOSPITALS ARE NOT RECEIVING NEW MONEY TO IMPLEMENT THE MEDICAL DEBT MITIGATION PLAN, RATHER, HOSPITALS LIKE ECU HEALTH ARE RECEIVING THE FULL AMOUNT OF REIMBURSEMENT OWED TO THEM BY PARTICIPATING IN THE PLAN. MEDICAL DEBT IS A COMPLEX ISSUE AND CAN NOT BE SOLVED SOLELY BY HOSPITALS AND HEALTHCARE PROVIDERS. THERE IS SIGNIFICANT WORK TO BE DONE TO DEVELOP FINANCIALLY SUSTAINABLE SOLUTIONS TO ADDRESS MEDICAL DEBT THAT INCLUDES HEALTH INSURANCE PLANS, PROVIDERS, EMPLOYERS, BUSINESS LEADERS AND GOVERNMENT PARTNERS. Most people struggling with medical debt are insured. No matter how generous, hospital financial assistance will never be a substitute for a health insurance plan that covers preventive and necessary care at an affordable price on the front and back end of coverage. ECU HEALTH provides high-quality care for everyone who walks through our doors, regardless of their ability to pay. Inability to pay for services should not deter anyone from seeking needed medical care. That is why ECU Health has developed and committed to principles and guidelines for assisting uninsured patients, as well as underinsured patients, and guidelines for debt collection, that provide significant patient assistance and protection. ECU HEALTH is committed to helping patients plan for medical bills by offering financial counseling and financial assistance programs and work hard to inform patients about the financial assistance policies. In 2024, ECU Health provided $54.0 million in charity care and forgave $33.7 million in bad debt.
PART I, LINE 7, OTHER BENEFITS:	Community Health Improvement Services & Community Benefit Operations (e) ECU Health Bertie Hospital ECU Health Bertie dedicated 132 hours of staff time to Community Health Improvement Services, serving 504 individuals with a total community benefit expense of $139,961. These services included community outreach initiatives such as offering advance care planning at no charge to assist with completing advance directives, flu clinics, health education classes on topics like colorectal cancer awareness and mental health, and free wellness screenings that measured blood pressure, blood sugar, weight, BMI, and cholesterol. These initiatives have significantly contributed to the overall health and well-being of the community by providing essential health services and education. The advance care planning sessions have empowered individuals to make informed decisions about their healthcare, while the flu clinics and health education classes have raised awareness about important health issues. The free wellness screenings have helped identify and manage health risks, leading to improved health outcomes for the community. For community benefit operations, 70 hours of staff time were utilized, with a total community benefit expense of $6,214. The combined total community benefit expense for community health improvement services and community benefit operations amounted to $146,175. ECU Health Chowan Hospital ECU Health Chowan dedicated 377 hours of staff time to Community Health Improvement Services, serving 2,352 individuals with a total community benefit expense of $407,589. These services included community outreach initiatives such as offering advance care planning at no charge to assist with completing advance directives, flu clinics, health education classes on topics like Medic Alert awareness, foot health for senior citizens, heart health at Perquimans County Center for Active Living, support groups focused on childbirth and breastfeeding, and free wellness screenings that measured blood pressure, blood sugar, weight, BMI, and cholesterol. These initiatives have significantly contributed to the overall health and well-being of the community by providing essential health services and education. The advance care planning sessions have empowered individuals to make informed decisions about their healthcare, while the flu clinics and health education classes have raised awareness about important health issues. The free wellness screenings have helped identify and manage health risks, leading to improved health outcomes for the community. For community benefit operations, 129 hours of staff time were utilized, with a total community benefit expense of $8,860. The combined total community benefit expense for community health improvement services and community benefit operations amounted to $416,449. ECU Health Duplin Hospital ECU Health Duplin dedicated 3,530 hours of staff time to Community Health Improvement Services, serving 4,970 individuals with a total community benefit expense of $519,621. These services included community outreach initiatives such as offering advance care planning at no charge to assist with completing advance directives, flu clinics, health education classes on topics like nutrition and falls awareness for senior citizens, skin cancer awareness, and free wellness screenings that measured blood pressure, blood sugar, weight, BMI, and cholesterol. An example of an educational session is "Your Prostate Cancer Awareness," which saw an attendance of over 100 participants from July through September. Moreover, Breast Cancer Screenings were conducted at Brewed on Broadway, with an expense of $1,000. Blood Pressure, Glucose, and Cholesterol Screenings were also held at Brewed on Broadway Coffee Shop in Pink Hill, NC, with an expense of $1,000. Additionally, the Public Program Enrollment Assistance saw 444 occurrences with an expense of $8,880. For community benefit operations, 84 hours of staff time were utilized, with a total community benefit expense of $5,061. The combined total community benefit expense for community health improvement services and community benefit operations amounted to $524,682. ECU Health Edgecombe Hospital ECU Health Edgecombe dedicated 486 hours of staff time to Community Health Improvement Services, serving 2,349 individuals with a total community benefit expense of $385,990. These services included community outreach initiatives such as offering advance care planning at no charge to assist with completing advance directives, prostate cancer screening (with a total expense of $1,000 and serving 10 individuals), health education classes on topics like strokes and CPR, and free wellness screenings that measured blood pressure, blood sugar, weight, BMI, and cholesterol. Additionally, the Public Program Enrollment Assistance assisted 366 persons with enrollment for health insurance through the health insurance market for an expense of $221,460. For community benefit operations, 40 hours of staff time were utilized, with a total community benefit expense of $1,384. The combined total community benefit expense for community health improvement services and community benefit operations amounted to $387,374. ECU Health North ECU Health North dedicated 41 hours of staff time to Community Health Improvement Services, serving 680 individuals with a total community benefit expense of $372,592. These services included community outreach initiatives such as offering advance care planning at no charge to assist with completing advance directives, diabetes education support groups, health education classes on heart health, and women's heart health events. Additionally, the Public Program Enrollment Assistance assisted 410 persons with enrollment for health insurance through the health insurance market for an expense of $241,167. These efforts reflect ECU Health North's commitment to fostering community engagement and support through continuous involvement in local and regional initiatives. For community benefit operations, 10 hours of staff time were utilized, with a total community benefit expense of $666. The combined total community benefit expense for community health improvement services and community benefit operations amounted to $373,258. ECU Health Roanoke-Chowan Hospital ECU Health Roanoke Chowan dedicated 310 hours of staff time to Community Health Improvement Services, serving 3,196 individuals with a total community benefit expense of $282,520. These services included community outreach initiatives such as offering advance care planning at no charge to assist with completing advance directives, flu clinics, health education classes on topics like stroke prevention and diabetes, and free wellness screenings that measured blood pressure, blood sugar, and cholesterol. Additionally, the organization participated in various community events such as the American Heart Month in Hertford County and the Diabetes Prevention Program in Bertie County. They also provided informational handouts for heart health awareness and distributed pre-diabetes risk assessments during these events. Furthermore, ECU Health Roanoke Chowan collaborated with local schools to offer educational sessions on nutrition and physical activity for children. The organization also facilitated diabetes support groups for the Roanoke-Chowan area, bringing people together to discuss education, prevention, self-management, nutrition, and exercise. Additionally, the Public Program Enrollment Assistance assisted 240 persons with enrollment for health insurance through the health insurance market for an expense of $110,895. For community benefit operations, 77 hours of staff time were utilized, with a total community benefit expense of $10,045. The combined total community benefit expense for community health improvement services and community benefit operations amounted to $292,565. Health Professional Education (f) ECU Health Bertie Hospital ECU Health Bertie dedicated 421 hours of staff time to Health Professions Education, serving 18 individuals with a total community benefit expense of $26,897. This included $2,695 for nursing internships/preceptorships and $24,202 for other health professions such as social work, EMS, phlebotomy, and radiology. The nursing internship/preceptorship program provided valuable firsthand experience in nursing, while other health professions programs involved significant staff time and resources to support students in EMS, phlebotomy, and radiology. These programs collectively served 18 individuals, offering essential training and experience. These educational initiatives have a significant impact on the community by enhancing the skills and knowledge of future healthcare professionals. By investing in the education of these professionals, ECU Health Bertie is helping to ensure a well-prepared and competent workforce that can meet the healthcare needs of the community. ECU Health Chowan Hospital ECU Health Cho
PART II, COMMUNITY BUILDING ACTIVITIES:	ECU Health Bertie Hospital ECU Health Bertie dedicated 18 hours of staff time to community building activities, with a total community benefit expense of $3,695. These activities included $616 for economic development, $2,668 for community support, and $411 for workforce development. Specific initiatives included presenting at Chamber of Commerce meetings and executive leadership attending Medicaid expansion events. Additionally, community building activities included participation in the Bertie County Medicaid Despair Event, where staff spent 2 hours addressing Medicaid despair issues. The Windsor/Bertie Chamber of Commerce also benefited from 2 hours of staff time dedicated to economic development efforts. These activities demonstrate ECU Health Bertie's commitment to fostering economic growth, supporting local organizations, and developing a skilled workforce. By investing in these initiatives, ECU Health Bertie is helping to strengthen the community and improve overall health and well-being. These contributions provide essential resources and support to individuals and organizations in need, ensuring a positive impact on the community. ECU Health Chowan Hospital ECU Health Chowan dedicated 465 hours of staff time to community building activities, with a total community benefit expense of $77,847. These activities included $15,118 for economic development, $24,667 for community support, $34,242 for coalition building, and $3,820 for workforce development. Coalition building activities included attending SECU advisory board meetings and United Way NC Board of Directors meetings. Staff also participated in various boards and committees such as the Lion's Club, Edenton Chowan Education Foundation, and Tyrrell County Schools. Additionally, the Eastern Healthcare Preparedness Coalition, which is part of disaster preparedness, benefited from these efforts. ECU Health Duplin Hospital ECU Health Duplin dedicated 114 hours of staff time to community building activities, with a total community benefit expense of $12,303. These activities included $5,625 for economic development, $3,540 for community support, and $3,138 for workforce development. Specific initiatives included presenting at a chamber of commerce meeting and executive leadership attending a Medicaid expansion event. Additionally, community building activities included participation in quarterly meetings for community resources coordinated by Duplin County Services. The Executive Director attended these meetings, making presentations and informing attendees of available services, dedicating a total of 8 hours per year. The Executive Director also participated in monthly meetings for the regional healthcare coalition (southeastern) every quarter, dedicating 48 hours per year. The Hospital President contributed by serving on the Duplin County Career Partnership's Business and Jobs Annual Summit Community College Advisory Committee for 2 hours and speaking at the Duplin County Municipal Association Luncheon and Wallace Rotary Club Meeting. These efforts reflect ECU Health Duplin's commitment to fostering community engagement and support. ECU Health Edgecombe Hospital ECU Health Edgecombe dedicated 237 hours of staff time to community building activities, with a total community benefit expense of $30,890. These activities included $9,724 for community support and $21,166 for workforce development. Specific community support activities involved participation in AHEC Board/Committee meetings with 12 hours of staff time and an expense of $1,200. Contributions to the Edgecombe Community College Advisory Board meetings totaled 15 hours and $1,500. The hospital also supported local events like the Tarboro-Edgecombe Chamber of Commerce Annual Banquet with 10 hours dedicated and an expense of $1,000. ECU Health North ECU Health North dedicated 5 hours of staff time to community building activities, with a total community benefit expense of $1,602, serving 416 persons. These activities focused on Health Careers Promotion and included the Center for Learning & Performance. Specific engagements involved a Radiology Technician, a Diabetes Nurse Specialist, and 10 students from Northeast Academy High School visiting ECU Health North. Various areas of the hospital were toured, and discussions were held about the functions of each area. ECU Health Roanoke-Chowan Hospital ECU Health Roanoke Chowan dedicated 62 hours of staff time to community building activities, with a total community benefit expense of $7,200. These activities included $699 for economic development, $1,908 for community support, $1,588 for coalition building, and $3,005 for workforce development. Specific initiatives included presenting at a chamber of commerce meeting and executive leadership attending a Medicaid expansion event. Additionally, community building activities included participation in the Bertie County Medicaid Despair Event, where staff spent 2 hours addressing Medicaid despair issues. The Windsor/Bertie Chamber of Commerce also benefited from 2 hours of staff time dedicated to economic development efforts. These activities demonstrate ECU Health Roanoke Chowan's commitment to fostering economic growth, supporting local organizations, and developing a skilled workforce. By investing in these initiatives, ECU Health Roanoke Chowan is helping to strengthen the community and improve overall health and well-being. These contributions provide essential resources and support to individuals and organizations in need, ensuring a positive impact on the community.
PART III, LINE 2:	Bad debt is based on aging categories, current economic conditions and historical collection experience; and is recorded in the period in which collection is considered doubtful.
PART III, LINE 3:	IN CONNECTION WITH THE PRESUMPTIVE ELIGIBILITY CONSIDERATION OF THE AFFORDABLE CARE ACT, ECU HEALTH ENTITIES DO NOT REFLECT ANY BAD DEBT IN CONNECTION WITH FAP-ELIGIBLE PATIENTS. THESE PATIENTS ARE PRESUMED TO BE PART OF THE MEDICAID POPULATION AND AFFORDED COVERAGE AS SUCH.
PART III, LINE 4:	THE FINANCIAL STATEMENTS OF ECU HEALTH ARE PRESENTED ON A CONSOLIDATED BASIS; THE TEXT OF THE FOOTNOTE FROM PAGE 30 IS PRESENTED BELOW: PATIENT ACCOUNTS RECEIVABLE, NET PATIENT ACCOUNTS RECEIVABLES ARE REPORTED NET OF ESTIMATED ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS AND ALLOWANCES FOR BAD DEBTS AND ARE RECORDED IN THE PERIOD IN WHICH COLLECTION IS CONSIDERED DOUBTFUL. ESTIMATED ALLOWANCES FOR BAD DEBTS ARE APPROXIMATELY $118.3 MILLION AS OF SEPTEMBER 30, 2024.
PART III, LINE 8:	THE SHORTFALL OF MEDICARE REVENUE TO MEDICARE WAS CALCULATED ACCORDING TO THE COST TO CHARGE RATIO. ALLOWABLE COSTS OF CARE SHOULD BE CONSIDERED COMMUNITY BENEFIT BECAUSE IN THE AREA SERVED BY ECU HEALTH, THERE ARE NO OTHER PROVIDERS AVAILABLE TO PROVIDE THE REQUIRED SERVICES. THEREFORE, THE CARE WOULD BECOME A GOVERNMENT OBLIGATION AND IS TREATED AS A COMMUNITY BENEFIT PROVIDED BY ECU HEALTH.
PART III, LINE 9B:	RECOMMENDED PATIENT ACCOUNTS WILL CONTINUE TO GO THROUGH THE ACCOUNTS RECEIVABLE BILLING CYCLE AS NORMAL. WHEN THE ACCOUNT REACHES THE CUSTOMER SERVICE/COLLECTIONS MANAGER, FINANCIAL COUNSELING SUPERVISOR OR PATIENT ACCOUNTS SUPERVISOR, BASED ON THE INFORMATION GIVEN, A DECISION WILL BE MADE WHETHER TO PROCEED WITH COLLECTION OR REFER THE ACCOUNT FOR APPROVAL OF CHARITY CARE. THE PROCESS WILL OCCUR AS FOLLOWS: I. FINANCIAL COUNSELORS WILL TRY TO LOCATE THIRD PARTY PAYORS. IF NOT ELIGIBLE FOR ANY THIRD-PARTY COVERAGE (INCLUDING CHARITIES), THEY MAY, BASED UPON THE FINANCIAL INFORMATION RECEIVED, RECOMMEND THE PATIENT FOR CHARITY CARE. II. PATIENT COUNSELORS WILL REVIEW FOR ANY THIRD-PARTY PAYORS AND VERIFY EMPLOYMENT AND ASSETS. A CHARITY CARE APPLICATION WILL NEED TO BE COMPLETED ALONG WITH TAX RETURN, PAY STUBS, SOCIAL SECURITY AWARD LETTER AND OTHER FINANCIAL INFORMATION AS MAY BE REQUIRED. III. THE PATIENT ACCOUNTS SUPERVISOR, FINANCIAL COUNSELING SUPERVISOR OR CUSTOMER SERVICE/COLLECTIONS MANAGER, BASED UPON ACCOUNT BALANCE AND THE INFORMATION GIVEN, WILL MAKE A DECISION WHETHER TO PROCEED WITH COLLECTION OR REFER THE PATIENT ACCOUNT FOR APPROVAL FOR CHARITY CARE. PRESUMPTIVE ELIGIBILITY FOR CHARITY CARE - THERE ARE OCCASIONS IN WHICH A PATIENT MAY APPEAR ELIGIBLE FOR A CHARITY CARE DISCOUNT, BUT THERE IS NO FINANCIAL ASSISTANCE INFORMATION AVAILABLE TO SUPPORT FINANCIAL AID. A. SOME PATIENTS ARE PRESUMED TO BE ELIGIBLE FOR CHARITY CARE DISCOUNTS ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES (E.G., HOMELESSNESS PATIENTS WITH NO INCOME, BANKRUPTCY, DECEASED PATIENTS WITH NO ESTATE OR SPOUSE, ETC.) B. THROUGH THE ASSISTANCE OF A THIRD-PARTY VENDOR AND CERTAIN ALGORITHMS, IN CONJUNCTION WITH OUR CHARITY POLICY GUIDELINES, ALL ACCOUNTS, PRIOR TO OUTSIDE COLLECTION AGENCY REFERRAL, WILL BE TESTED FOR PRESUMPTIVE CHARITY. C. THE ACCOUNTS DEEMED CHARITY WILL BE ADJUSTED OFF AND THE REMAINING ACCOUNTS WILL BE REFERRED TO AN OUTSIDE COLLECTION AGENCY. D. ONCE THE AGENCY HAS HAD THE ACCOUNTS FOR SIX MONTHS AND HAS DEEMED THEM UNCOLLECTIBLE, THE ACCOUNTS WITH BALANCES OF $1,580 OR GREATER WILL REMAIN WITH THE AGENCY AND BE KEPT ON THE PATIENT'S CREDIT FILE. E. THE ACCOUNTS RETURNED TO THE HOSPITAL WILL BE PLACED IN A UNIQUE FINANCIAL CLASS AND WILL NOT BE PURSUED FOR COLLECTIONS.
PART VI, LINE 2:	THE ORGANIZATION ASSESSES COMMUNITY NEED IN CONJUNCTION WITH THE STATE AFFILIATED COUNTY HEALTH DEPARTMENTS AND OTHER LOCAL HEALTH CARE ORGANIZATIONS. THIS HAS BEEN DESCRIBED IN DETAIL IN SCHEDULE H, PART V, SECTION C, LINES 5 AND 11.
PART VI, LINE 3:	INFORMATION IS AVAILABLE ON THE ORGANIZATION'S WEBSITE AND AT REGISTRATION FOR PATIENTS. IN ADDITION, FACE TO FACE FINANCIAL COUNSELING IS AVAILABLE TO PATIENTS AND THEIR FAMILIES IN THE CENTRAL BUSINESS OFFICE.
PART VI, LINE 4:	ECU Health Bertie Hospital The primary service area for ECU Health Bertie Hospital is Bertie County. Bertie County encompasses 741 square miles, 42 square miles of which are water. The major town in Bertie County is Windsor, the county seat. Other Bertie County communities include Askewville, Aulander, Colerain, Kelford, Merry Hill, Lewiston-Woodville, Powellsville and Roxobel. The following data was collected as part of the 2022 CHNA: As of 2019, the population of Bertie County was 18,947, evenly divided between males and females. Whites composed 35.2% of the total population; Blacks/African Americans 61.6%; and Hispanic or Latino of any race at 2.1%. Approximately 13% of county residents did not have health insurance. Almost 19% of residents were Medicaid eligible. Bertie County was and remains a Tier 1 county, meaning it is one of the 40 most economically distressed counties in the state. Bertie County's median income per household was $35,527, which is below the North Carolina median of $54,602. Additionally, the poverty rate in Bertie County for 2015-2019 was 23%, well above the state rate of 15%. Approximately 78.4% of Bertie County's residents over the age of 25 years had a high school degree or higher, compared to the state rate of 87.8%. These factors contribute to the health challenges identified in the 2022 Community Health Needs Assessment. ECU Health Chowan Hospital The primary service area for ECU Health Chowan is Chowan County. Chowan County encompasses 233 square miles, 61 of which are water. The major town in Chowan County is Edenton, the county seat. Other Chowan County communities include Tyner, Rocky Hock, and Yeopim. The following data was collected as part of the 2022 CHNA: As of 2019, the population of Chowan County was 13,943, nearly evenly divided by gender. Whites composed 61.1 percent of the total population; Blacks/African Americans 35.2 percent; and Hispanics/Latinos of any race 3.7 percent. Approximately 12% of county residents do not have health insurance. Just over 18% of residents are Medicaid eligible. Chowan County was and remains a Tier 2 county, meaning while it is not one of the 40 most economically distressed counties in North Carolina, it is in the next 40 counties designation for economically distressed in North Carolina. Chowan County's median household income is $46,519, which is lower than the state median of $54,602. Additionally, the poverty rate in Chowan County for 2015-2019 is 16%, just above the state rate of 15%. Approximately 86.8% of Chowan County's residents over the age of 25 years have a high school degree or higher, compared to the state rate of 87.8%. These factors contribute to the health challenges identified in the 2022 Community Health Needs Assessment. ECU Health Duplin Hospital The primary service area for ECU Health Duplin Hospital is Duplin County, North Carolina. Towns that make up the county include Beulaville, Calypso, Faison, Greenevers, Kenansville, Magnolia, Rose Hill, Teachey, Wallace and Warsaw. The following data was collected as part of the 2022 CHNA: As of 2019, the county's population was 59,741. The White population accounts for 71.2% of the total population in Duplin County, with the Black or African American population accounting for 23.8% of the total population. The Hispanic/Latino population comprises 22.2% of Duplin County, which is significantly higher than North Carolina (9.2%). The population under the age of 25 years is 32.3% and 18% are over the age of 65 years. Duplin County was designated as one of the 40 Tier 1 counties during 2022, meaning it is one of the most economically distressed counties in the state. (It is now a Tier 2 county) The rate of individuals aged 0-64 years old that have health insurance coverage in Duplin County is 79.3%, which is lower than the rate for North Carolina (87.3%). In addition, 21% of all people in Duplin County live in poverty, with 34% of Duplin County children living in poverty. These factors contribute to the health challenges identified in the 2022 Community Health Needs Assessment. ECU Health Edgecombe Hospital The primary service area for ECU Health Edgecombe Hospital encompasses Edgecombe County, North Carolina which is located just east of the I-95 corridor in eastern North Carolina. Municipalities within Edgecombe County include Rocky Mount, Pinetops, Conetoe, Whitakers, Macclesfield, Leggett, Sharpsburg, Princeville and Tarboro. The following data was collected as part of the 2022 CHNA: As of 2019, the estimated population of Edgecombe County was down to 51,472 from the 2016 population count of 53,318. According to 2019 data from the U.S. Census bureau, the majority of Edgecombe County citizens are African-American (57.6 percent), whereas Caucasians represent 39.4 percent of the population. U.S. Census data also shows the Hispanic population in Edgecombe County has grown from 4.3 percent to 4.6 percent in 2019. American Indian, Alaskan Native, Asian, Pacific Islander or persons reporting two or more races represent the remaining Edgecombe County population. Overall, the race distribution in Edgecombe County is quite different from that of North Carolina. In North Carolina, 68.7 percent of the population is Caucasian, and 21.4 percent is African- American. As of 2019, the median household income of Edgecombe County was $36,866 compared to the state median household income of $54,602. Edgecombe County's poverty rate of 24.0% was higher than the state rate of 15.0%. Edgecombe County was designated as one of the 40 Tier 1 counties during 2022 and remains a Tier 1 county, meaning it is one of the most economically distressed counties in the state. The rate of individuals aged 0-64 years old that have health insurance coverage in Edgecombe County was 87.3%, which is the same for North Carolina (87.3%). In addition, 24% of all people in Edgecombe County live in poverty, with 37% of Edgecombe County children living in poverty. These factors contribute to the health challenges identified in the 2022 Community Health Needs Assessment. ECU Health Roanoke-Chowan Hospital The primary service area for ECU Health Roanoke Chowan Hospital is Hertford County. The hospital also serves portions of Bertie, Gates, and Northampton Counties. The following data was collected as part of the 2022 CHNA: As of 2019, the population of Hertford County was 23,667, nearly evenly divided by gender. Whites composed 35.1% of the total population; Blacks/African Americans 59.4%; and Hispanic or Latino of any race at 3.8%. Approximately 13% of county residents do not have health insurance. Almost 19% of residents are Medicaid eligible. Hertford County is designated as a Tier 1 county, meaning it is one of the 40 most economically distressed counties in the state. Hertford County's median income per household is $41,028, which is below the North Carolina median of $54,602. Poverty levels in Hertford County for 2015 - 2019 are higher than the surrounding region with 22% of the population living below the poverty level. Approximately 80.8% of Bertie County's residents over the age of 25 years have a high school degree or higher, compared to the state rate of 87.8%. These factors contributed to the health challenges identified in the 2022 Community Health Needs Assessment. ECU Health North The primary service area for ECU Health North is Halifax County. It also serves Northampton. The following data was collected as part of the 2022 CHNA: In 2019, Halifax County had an estimate population of 50,010. This is a 8.4% decrease in the population over the past 10 years. African Americans represent the majority of the population in Halifax County at 52.8%. White Americans represent 40.5% of the county's population, with the Hispanic population considerably less than the state at 2.9% and an American Indian population that is notably higher than the state average at 3.8%. It's important to note the make-up of Halifax County reflects differently from the state demographics because often times the health disparities can be exaggerated in comparison to the state because they affect the majority of the county population. Halifax County is designated as a Tier 1 county, meaning it is one of the 40 most economically distressed counties in the state. Halifax County's median income per household is $32,502, which is below the North Carolina median of $54,602. Poverty levels in Halifax County are higher than the surrounding region with almost 26% of the population living below the poverty level. 79.1% of Halifax County's residents over the age of 25 years have a high school degree or higher, compared to the state rate of 86.6%. These factors contribute to the health challenges identified in the 2022 Community Health Needs Assessment. ADDITIONALLY, SEE INFORMATION POSTED AT HTTPS://WWW.ECUHEALTH.ORG/ABOUT-US/COMMUNITY/HEALTH-NEEDS-ASSESSMENT/
PART VI, LINE 5:	THIS HAS BEEN DESCRIBED IN DETAIL IN SCHEDULE H, PART V, SECTION C, LINES 5 AND 11. ADDITIONALLY, SEE INFORMATION POSTED AT HTTPS://WWW.ECUHEALTH.ORG/ABOUT-US/COMMUNITY/HEALTH-NEEDS-ASSESSMENT/
PART VI, LINE 6:	OUR MISSION AT ECU HEALTH IS TO IMPROVE THE HEALTH AND WELL-BEING OF EASTERN NORTH CAROLINA. OUR VISION IS TO BECOME THE NATIONAL MODEL FOR RURAL HEALTH AND WELLNESS BY CREATING A PREMIER, TRUSTED HEALTH CARE DELIVERY SYSTEM WHILE REMAINING TRUE TO OUR VALUES OF INTEGRITY, COMPASSION, EDUCATION, ACCOUNTABILITY, SAFETY AND TEAMWORK. OUR OPERATIONAL IMPERATIVES DRIVE ECU HEALTH PERFORMANCE AND OUTCOMES. THESE IMPERATIVES ARE EXPERIENCE, FINANCE, QUALITY, WELL-BEING, EQUITY & INCLUSION. WE KEEP PATIENTS, FAMILIES, TEAM MEMBERS AND COMMUNITIES AT THE CENTER OF EVERYTHING THAT WE DO. WE ARE MANAGING LIVES THROUGH A MODERN DELIVERY SYSTEM OF HEALTH CARE IN AN ACADEMIC AND RURAL SETTING TO DELIVERY SAFE, HIGHLY RELIABLE HUMAN CENTERED CARE. ECU HEALTH IS A NORTH CAROLINA NON-PROFIT CORPORATION WITH HEADQUARTERS IN GREENVILLE, NORTH CAROLINA. ECU HEALTH AND ITS AFFILIATES OPERATE AN INTEGRATED HEALTH CARE DELIVERY SYSTEM THAT SERVES A TOTAL MARKET OF APPROXIMATELY 1.4 MILLION PEOPLE IN 29 CONTIGUOUS COUNTIES IN EASTERN NORTH CAROLINA. THE HEALTH SYSTEM INCLUDES HOSPITALS, PHYSICIAN PRACTICES, OUTPATIENT SERVICES, HOME HEALTH, HOSPICE, AND WELLNESS SERVICES. THE HEALTH SYSTEM'S OWNED HOSPITALS ARE ECU HEALTH MEDICAL CENTER, WHICH IS A TERTIARY CARE HOSPITAL AND AN ACADEMIC MEDICAL CENTER, THAT INCLUDES THE ECU HEALTH BEAUFORT HOSPITAL AS A DEPARTMENT OPERATING AS A CAMPUS OF ECU HEALTH MEDICAL CENTER AND SEVEN OTHER ACUTE CARE HOSPITALS: ECU HEALTH ROANOKE-CHOWAN HOSPITAL, ECU HEALTH EDGECOMBE HOSPITAL, ECU HEALTH CHOWAN HOSPITAL, ECU HEALTH BERTIE HOSPITAL, ECU HEALTH DUPLIN HOSPITAL, ECU HEALTH NORTH HOSPITAL, AND THE OUTER BANKS HOSPITAL. ECU HEALTH MEDICAL CENTER SERVES AS THE TEACHING HOSPITAL FOR THE BRODY SCHOOL OF MEDICINE, EAST CAROLINA SCHOOLS OF NURSING AND ALLIED HEALTH, PITT COMMUNITY COLLEGE AND BEAUFORT COMMUNITY COLLEGE. THE SYSTEM ALSO SERVES AS A REGIONAL REFERRAL CENTER FOR EASTERN NORTH CAROLINA. IN OUR RURAL HEALTH CARE SETTING, WE ARE FACED WITH UNIQUE CHALLENGES. ONE OF THE CHALLENGES IS ACCESS TO CARE. FACTORS INFLUENCING ACCESS INCLUDE PATIENT FACTORS SUCH AS TRANSPORTATION NEEDS AS WELL AS PROVIDER AND STAFFING SHORTAGES. SHORTAGES IN STAFFING INFLATE THE COST OF PROVIDING CARE THROUGH THE USE OF LOCCUM AND TEMPORARY LABOR AND CAUSE ADDITIONAL FINANCIAL STRAINS RELATED TO THE HIGH PERCENTAGE OF GOVERNMENT PAYORS AS WELL AS THE UNINSURED POPULATION IN OUR REGION. MANY COUNTIES IN WHICH ECU HEALTH OPERATES ARE DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). AS A RESULT, OUR EMERGENCY DEPARTMENTS BECOME A PRIMARY CARE ACCESS POINT AND CAUSE OVERLOAD ON THE SYSTEM WHICH RESULT IN CAPACITY CONSTRAINTS FOR BEDS NEEDED FOR ADMISSIONS AND BOARDERS WAITING FOR TRANSFERS TO BEHAVIORAL HEALTH FACILITIES. ECU HEALTH HAS MADE A CONSCIOUS DECISION TO PROVIDE CERTAIN SERVICES FOR THE BENEFIT OF THE COMMUNITY ALTHOUGH VOLUMES ARE NOT LARGE ENOUGH TO GENERATE A PROFIT. ONE EXAMPLE OF THESE SERVICES ARE OB SERVICES WHERE LESS THAN 1 BABY IS BORN A DAY IN SOME OF OUR REGIONAL HOSPITALS; HOWEVER, DUE TO OUR RURAL NATURE WE BELIEVE IT WOULD BE DETRIMENTAL TO OUR COMMUNITY TO NOT MAINTAIN THESE SERVICES. ECU HEALTH IS CONTINUOUSLY COLLABORATING ON WAYS TO INCREASE ACCESS SUCH AS THROUGH USE OF TELEMEDICINE TO PROVIDE HIGH LEVEL CARE TO OUR REGIONAL HOSPITALS BY USING RESOURCED AT OUR ACADEMIC MEDICAL CENTER TO KEEP PATIENTS CLOSE TO HOME WHEN POSSIBLE. ADDITIONALLY. SEE INFORMATION POSTED AT HTTPS://WWW.ECUHEALTH.ORG/ABOUT-US/COMMUNITY/HEALTH-NEEDS-ASSESSMENT/
PART VI, LINE 7, LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT:	NC

Schedule H (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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

2023

Open to Public
Inspection

Name of the organization
East Carolina Health

Employer identification number
91-1997979

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	(h) Purpose of grant or assistance
(1) KRISTI OVERTON JOHNSON MINISTRIES 101 W 14TH STSTE 110 GREENVILLE,NC27858	26-4307444	501(C)(3)	5,500	SEE PART IV
(2) PERQUIMANS COUNTY EMERGENCY SERVICES PO BOX 563 HERTFORD,NC27944	56-6000330	GOVT ENTITY	5,750	SEE PART IV
(3) BERTIE COUNTY PO BOX 530 WINDSOR,NC27983	56-6000273	GOVT ENTITY	6,000	SEE PART IV
(4) TOWN OF MURFREESBORO PO BOX 628 MURFREESBORO,NC27855	56-6001298	GOVT ENTITY	6,700	SEE PART IV
(5) ROCKY MOUNT FAMILY YMCA INC PO BOX 4063 ROCKY MOUNT,NC27803	56-0543251	501(C)(3)	6,750	SEE PART IV
(6) ALBEMARLE AREA UNITED WAY PO BOX 293 ELIZABETH CITY,NC27907	23-7123601	501(C)(3)	7,000	SEE PART IV
(7) AHOSKIE FOOD PANTRY PO BOX 159 AHOSKIE,NC27910	47-5312847	501(C)(3)	7,000	SEE PART IV
(8) PERQUIMANS COUNTY SCHOOLS FOUNDATION INC 411 EDENTON ROAD STREET HERTFORD,NC27944	55-0788873	501(C)(3)	7,000	SEE PART IV
(9) THE LIGHTHOUSE HOME PO BOX 636 ROCKY MOUNT,NC27801	30-0538794	501(C)(3)	7,000	SEE PART IV
(10) NC COOPERATIVE EXTENSION-CHOWAN COUNTY CNTR 730 N GRANVILLE ST STE A EDENTON,NC27932	56-6000286	GOVT ENTITY	7,250	SEE PART IV
(11) DOWN EAST PARTNERSHIP FOR CHILDREN 215 LEXINGTON STREET ROCKY MOUNT,NC27802	56-1859313	501(C)(3)	7,500	SEE PART IV
(12) SNOW HILL COMMUNITY OUTREACH 1571 RED HILL ROAD MOUNT OLIVE,NC28365	83-2285894	501(C)(3)	8,500	SEE PART IV
(13) RURAL OPPORTUNITIES INSTITUTE 3361 SUNSET AVE 5061 ROCKY MOUNT,NC27804	99-1735506	501(C)(3)	8,500	SEE PART IV
(14) ROANOKE RAPIDS FIRE DEPARTMENT 643 ROANOKE AVENUE ROANOKE RAPIDS,NC27870	56-6001319	GOVT ENTITY	9,000	SEE PART IV
(15) BERTIE COUNTY RURAL HEALTH ASSOCIATION PO BOX 628 WINDSOR,NC27983	56-1420061	501(C)(3)	10,000	SEE PART IV
(16) WILMINGTON AREA REBUILDING MINISTRY INC 5058 WRIGHTSVILLE AVE WILMINGTON,NC28403	56-2076795	501(C)(3)	10,000	SEE PART IV
(17) VOICE COMMUNITY MEDICINE FOUNDATION PO BOX 100 TARBORO,NC27886	56-1222730	501(C)(3)	10,000	SEE PART IV
(18) CENTER FOR ENERGY EDUCATION 460 AIRPORT ROAD ROANOKE RAPIDS,NC27870	47-2079791	501(C)(3)	10,000	SEE PART IV
(19) ALBEMARLE DEVELOPMENT CORPORATION 512 SOUTH CHURCH STREET HERTFORD,NC27944	26-2495965	501(C)(3)	11,000	SEE PART IV
(20) UNION MISSION OF ROANOKE RAPIDS INC 1310 ROANOKE AVE ROANOKE RAPIDS,NC27870	56-0649264	501(C)(3)	12,500	SEE PART IV
(21) DUPLIN COUNTY HEALTH DEPARTMENT PO BOX 948 KENANSVILLE,NC28349	56-6000296	GOVT ENTITY	15,000	SEE PART IV
(22) CARENET COUNSELING EAST 108 OAKMONT DRIVE GREENVILLE,NC27858	56-2189431	501(C)(3)	16,500	SEE PART IV
(23) LAKE GASTON RETIREMENT VILLAGE FDN INC 2357 EATON FERRY ROAD LITTLETON,NC27850	26-0804984	501(C)(3)	17,000	SEE PART IV
(24) NC COOPERATIVE EXTENSION - BERTIE COUNTY PO BOX 280 WINDSOR,NC27983	56-6000276	GOVT ENTITY	18,900	SEE PART IV
(25) HERTFORD COUNTY PO BOX 188 WINTON,NC27986	56-6001523	GOVT ENTITY	22,000	SEE PART IV
(26) FOOD BANK OF CENTRAL & EASTERN NC 1924 CAPITAL BOULEVARD RALEIGH,NC27604	56-1283426	501(C)(3)	24,500	SEE PART IV
(27) RIPE FOR REVIVAL 161 ENGLISH ROAD ROCKY MOUNT,NC27804	85-2733560	501(C)(3)	27,600	SEE PART IV
(28) ROANOKE-CHOWAN CMNTY HEALTH CENTER (RCCHC) 120 HEALTH CENTER DRIVE AHOSKIE,NC27910	42-1638714	501(C)(3)	32,000	SEE PART IV
(29) NC MEDASSIST 4428 TAGGART CREEK ROAD CHARLOTTE,NC28208	56-2018957	501(C)(3)	40,500	SEE PART IV
(30) FOOD BANK OF THE ALBEMARLE PO BOX 1704 ELIZABETH CITY,NC27906	56-1341658	501(C)(3)	51,700	SEE PART IV

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) 2023

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)
(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:

THE ORGANIZATION MAINTAINS RECORDS TO SUBSTANTIATE ALL DISBURSEMENTS MADE IN ACCORDANCE WITH ITS DOCUMENT RETENTION POLICY. ALL GRANTS AND ASSISTANCE ARE APPROVED AT THE APPROPRIATE LEVEL OUTLINED IN ITS POLICY AND PROCEDURES.

SCHEDULE I, PART II, LINE 1(H) PURPOSE OF GRANT:

1. KRISTI OVERTON JOHNSON MINISTRIES: VICTORIOUS LIVING PRISON OUTREACH 2. PERQUIMANS COUNTY EMERGENCY SERVICES: MOBILE INTEGRATED HEALTHCARE SERVICES/COMMUNITY PARAMEDICINE 3. BERTIE COUNTY: VETERANS TRANSPORTATION ASSISTANCE PROGRAM 4. TOWN OF MURFREESBORO: MURFREESBORO RECREATION AND COMMUNITY HEALTH 5. ROCKY MOUNT FAMILY YMCA, INC.: LONGER LIFE PROJECT 6. ALBEMARLE AREA UNITED WAY: HEALTH EQUITY ACCESS VIA NC 2-1-1 7. AHOSKIE FOOD PANTRY: FOOD PANTRY SERVICES 8. PERQUIMANS COUNTY SCHOOLS FOUNDATION, INC.: WATER TURTLES PROGRAM 9. THE LIGHTHOUSE HOME: OPIATE CRISIS PEER SUPPORT SPECIALIST 10. NC COOPERATIVE EXTENSION-CHOWAN COUNTY CNTR: EDUCATION & 4-H JR. CHEF'S SUMMER PROGRAM 11. DOWN EAST PARTNERSHIP FOR CHILDREN: ENGAGING COMMUNITY PARTNERS TO SUSTAIN A HEALTH COMMUNITY 12. SNOW HILL COMMUNITY OUTREACH: ENCLOSED TRANSPORT TRAILER 13. RURAL OPPORTUNITIES INSTITUTE: TRAUMA-INFORMED & RESILIENCE FOCUSED TRAINING AND SUPPORT 14. ROANOKE RAPIDS FIRE DEPARTMENT: PROJECT SAFE FIREFIGHTER 15. BERTIE COUNTY RURAL HEALTH ASSOCIATION: BCRHA MEDICAL TRANSPORTATION 16. WILMINGTON AREA REBUILDING MINISTRY, INC.: WARM HELPS DUPLIN COUNTY WEATHER THE NEXT STORM 17. VOICE / COMMUNITY MEDICINE FOUNDATION: MEDICAL AND ESSENTIAL TRANSPORTATION FOR SENIORS 18. CENTER FOR ENERGY EDUCATION: HEALTH AND WELLNESS LEARNING SERIES FOR RESIDENTS AND STUDENTS 19. ALBEMARLE DEVELOPMENT CORPORATION: MEALS ON WHEELS 20. UNION MISSION OF ROANOKE RAPIDS INC: COMMUNITY SUPPORT 21. DUPLIN COUNTY HEALTH DEPARTMENT: PREDIABETES AND DIABETES MANAGEMENT 22. CARENET COUNSELING EAST: ACCESS TO BEHAVIORAL HEALTH CARE 23. LAKE GASTON RETIREMENT VILLAGE FDN, INC.: HELPFUL HANDS AND HEARTS RAMPS IT UP 24. NC COOPERATIVE EXTENSION - BERTIE COUNTY: HANDS ON NUTRITION EDUCATION AND PHYSICAL ACTIVITY FOR THE COMMUNITY 25. HERTFORD COUNTY: SENIOR PREVENTION INFORMATION & COMMUNITY EDUCATION 26. FOOD BANK OF CENTRAL & EASTERN NC: NOURISHING FAMILIES 27. RIPE FOR REVIVAL: PAY WHAT YOU CAN MOBILE MARKET BUS 28. ROANOKE-CHOWAN CMNTY HEALTH CENTER (RCCHC): PRESCRIPTION ASSISTANCE PROGRAM AND DIABETES SELF-MANAGEMENT EDUCATION 29. NC MEDASSIST: MEDICATION ASSISTANCE PROGRAM (PRESCRIPTION AND OTC) 30. FOOD BANK OF THE ALBEMARLE: SUPPLEMENTAL FOOD PROGRAMS

Schedule I (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

East Carolina Health

Employer identification number

91-1997979

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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

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) 2023

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, 1099-MISC compensation, and/or 1099-NEC			(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)
1MICHAEL WALDRUM MD CHAIRMAN	(i) (ii)	0 ------------- 960,564	0 ------------- 404,165	0 ------------- 13,052	0 ------------- 313,500	0 ------------- 54,620	0 ------------- 1,745,901	0 ------------- 0
2ANDREW ZUKOWSKI SECRETARY/TREASURER	(i) (ii)	0 ------------- 653,260	0 ------------- 74,002	0 ------------- 20,000	0 ------------- 122,932	0 ------------- 35,963	0 ------------- 906,157	0 ------------- 0
3JAY BRILEY THRU 1223 PRESIDENT, ECUH CMNTY HOSP.	(i) (ii)	0 ------------- 455,176	0 ------------- 57,144	0 ------------- 0	0 ------------- 131,913	0 ------------- 43,940	0 ------------- 688,173	0 ------------- 0
4VAN SMITH As of 0124 PRESIDENT, ECUH CMNTY HOSP.	(i) (ii)	0 ------------- 377,403	0 ------------- 19,734	0 ------------- 0	0 ------------- 135,942	0 ------------- 44,507	0 ------------- 577,586	0 ------------- 0
5TAMMI ROOS ANESTHESIOLOGIST	(i) (ii)	475,865 ------------- 0	0 ------------- 0	0 ------------- 0	42,878 ------------- 0	20,829 ------------- 0	539,572 ------------- 0	0 ------------- 0
6PATRICK HEINS PRESIDENT, ECUH EDGECOMBE	(i) (ii)	320,684 ------------- 0	38,362 ------------- 0	0 ------------- 0	161,018 ------------- 0	18,724 ------------- 0	538,788 ------------- 0	0 ------------- 0
7SUSAN SUITER THRU 0723 VP, PATIENT CARE SVCS NORTH	(i) (ii)	150,069 ------------- 0	0 ------------- 0	82,896 ------------- 0	280,140 ------------- 0	10,919 ------------- 0	524,024 ------------- 0	0 ------------- 0
8ANTHONY CHUNG ANESTHESIOLOGIST	(i) (ii)	424,746 ------------- 0	200 ------------- 0	0 ------------- 0	8,531 ------------- 0	40,640 ------------- 0	474,117 ------------- 0	0 ------------- 0
9BRIAN HARVILL PRES, ECUH CHOWAN&ECUH BERTIE	(i) (ii)	307,922 ------------- 0	44,375 ------------- 0	0 ------------- 0	66,320 ------------- 0	48,626 ------------- 0	467,243 ------------- 0	0 ------------- 0
10SUE TAYLOR As of 0723 VP, PATIENT CARE SVCS NORTH	(i) (ii)	280,923 ------------- 0	39,164 ------------- 0	0 ------------- 0	99,830 ------------- 0	40,983 ------------- 0	460,900 ------------- 0	0 ------------- 0
11JEFFERY DIAL PRESIDENT, ECUH DUPLIN	(i) (ii)	249,714 ------------- 0	34,745 ------------- 0	6,250 ------------- 0	108,015 ------------- 0	46,743 ------------- 0	445,467 ------------- 0	0 ------------- 0
12DEBRA HERNANDEZ SVP, SYSTEM EMERGENCY SERVICES	(i) (ii)	0 ------------- 322,845	0 ------------- 15,748	0 ------------- 0	0 ------------- 74,642	0 ------------- 20,864	0 ------------- 434,099	0 ------------- 0
13MICHELLE TAYLOR VP OF FINANCE & OPERATIONS	(i) (ii)	0 ------------- 281,156	0 ------------- 14,000	0 ------------- 0	0 ------------- 92,751	0 ------------- 44,365	0 ------------- 432,272	0 ------------- 0
14JASON HARRELL PRESIDENT, ECUH NORTH	(i) (ii)	279,218 ------------- 0	35,828 ------------- 0	0 ------------- 0	64,165 ------------- 0	39,464 ------------- 0	418,675 ------------- 0	0 ------------- 0
15JUDY BRUNO PRESIDENT, ECUH ROANOKE CHOWAN	(i) (ii)	101,783 ------------- 0	0 ------------- 0	199,144 ------------- 0	34,415 ------------- 0	11,480 ------------- 0	346,822 ------------- 0	0 ------------- 0
16KELLY SEXTON MGR, PHARMACY	(i) (ii)	207,385 ------------- 0	667 ------------- 0	0 ------------- 0	45,131 ------------- 0	45,085 ------------- 0	298,268 ------------- 0	0 ------------- 0
17CHARLES ALFORD VP, FIN. SVCS (EDGE & RCH)	(i) (ii)	198,064 ------------- 0	9,284 ------------- 0	0 ------------- 0	73,322 ------------- 0	6,090 ------------- 0	286,760 ------------- 0	0 ------------- 0
18SHELLI SIMMONS MGR, PHARMACY	(i) (ii)	224,954 ------------- 0	817 ------------- 0	0 ------------- 0	41,664 ------------- 0	16,589 ------------- 0	284,024 ------------- 0	0 ------------- 0
19LEIGH GURLEY MGR, PHARMACY	(i) (ii)	213,023 ------------- 0	667 ------------- 0	0 ------------- 0	51,212 ------------- 0	16,422 ------------- 0	281,324 ------------- 0	0 ------------- 0
20DENNIS CAMPBELL PRESIDENT ECUH BEAUFORT/ECUHMC	(i) (ii)	0 ------------- 200,267	0 ------------- 11,417	0 ------------- 0	0 ------------- 27,208	0 ------------- 38,680	0 ------------- 277,572	0 ------------- 0
21DAVID S HUGHES FORMER SECRETARY/TREASURER	(i) (ii)	0 ------------- 267,387	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 7,799	0 ------------- 275,186	0 ------------- 0
22CYNTHIA MAYO VP, PATIENT CARE SVCS EDGE	(i) (ii)	164,630 ------------- 0	8,750 ------------- 0	0 ------------- 0	44,689 ------------- 0	42,501 ------------- 0	260,570 ------------- 0	0 ------------- 0
23LUCINDA CRAWFORD VP, FINANCIAL SERVICES DUPLIN	(i) (ii)	162,683 ------------- 0	8,101 ------------- 0	0 ------------- 0	56,690 ------------- 0	20,215 ------------- 0	247,689 ------------- 0	0 ------------- 0
24TODD WARLITNER VP, FIN.-CRITICAL ACCESS HOSP.	(i) (ii)	109,208 ------------- 72,806	5,488 ------------- 3,658	0 ------------- 0	12,148 ------------- 8,099	21,571 ------------- 14,380	148,415 ------------- 98,943	0 ------------- 0
25DELORES MORRIS VP, PATIENT CARE SERVICES-VROA	(i) (ii)	168,591 ------------- 0	3,533 ------------- 0	0 ------------- 0	44,429 ------------- 0	25,127 ------------- 0	241,680 ------------- 0	0 ------------- 0
26DANA BYRUM VP, PT CARE SERVICES CHO	(i) (ii)	168,192 ------------- 0	8,899 ------------- 0	0 ------------- 0	48,775 ------------- 0	7,244 ------------- 0	233,110 ------------- 0	0 ------------- 0
27CHRISTINA MILLER VP, PATIENT CARE SVCS DUPLIN	(i) (ii)	167,766 ------------- 0	2,250 ------------- 0	0 ------------- 0	10,467 ------------- 0	13,994 ------------- 0	194,477 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

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 3:

THE TOP MANAGEMENT OFFICIAL IS THE PRESIDENT WHO IS AN EMPLOYEE OF EAST CAROLINA HEALTH. THE COMPENSATION IS DETERMINED BY THE COMPENSATION AND BENEFITS COMMITTEE OF THE ECU HEALTH BOARD USING COMPARATIVE DATA FROM LIKE ORGANIZATIONS AND INPUT FROM CONSULTANTS. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS ALSO DETERMINED BY THE COMPENSATION AND BENEFITS COMMITTEE OF THE ECU HEALTH BOARD USING COMPARATIVE DATA FROM LIKE ORGANIZATIONS AND INPUT FROM CONSULTANTS. ALL COMPENSATION DISCUSSIONS AND ACTIONS ARE DOCUMENTED AND APPROVED IN THE MINUTES OF THE COMMITTEE.

Schedule J (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

East Carolina Health

Employer identification number

91-1997979

Return Reference	Explanation
FORM 990, PART III, LINE 4A:	OVERVIEW OF UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA: OUR MISSION AT ECU HEALTH IS TO IMPROVE THE HEALTH AND WELL-BEING OF EASTERN NORTH CAROLINA. OUR MISSION, VISION AND VALUES CONTINUE TO LEAD US ON A VOYAGE TO EXCELLENCE. BECAUSE THE PEOPLE WE TAKE CARE OF ARE OUR NEIGHBORS, FRIENDS AND FAMILY THEY DESERVE THE BEST. ECU HEALTH IS A NORTH CAROLINA NON-PROFIT CORPORATION WITH HEADQUARTERS IN GREENVILLE, NORTH CAROLINA. ECU HEALTH AND ITS AFFILIATES OPERATE AN INTEGRATED HEALTH CARE DELIVERY SYSTEM THAT SERVES A TOTAL MARKET OF APPROXIMATELY 1.4 MILLION PEOPLE IN 29 CONTIGUOUS COUNTIES IN EASTERN NORTH CAROLINA. THE HEALTH SYSTEM INCLUDES HOSPITALS, PHYSICIAN PRACTICES, OUTPATIENT SERVICES, HOME HEALTH, HOSPICE, AND WELLNESS SERVICES. THE HEALTH SYSTEM'S OWNED HOSPITALS ARE ECU HEALTH MEDICAL CENTER, WHICH IS A TERTIARY CARE HOSPITAL AND AN ACADEMIC MEDICAL CENTER, THAT INCLUDES THE ECU HEALTH BEAUFORT HOSPITAL AS A DEPARTMENT OPERATING AS A CAMPUS OF ECU HEALTH MEDICAL CENTER AND SEVEN OTHER ACUTE CARE HOSPITALS: ECU HEALTH ROANOKE-CHOWAN HOSPITAL, ECU HEALTH EDGECOMBE HOSPITAL, ECU HEALTH CHOWAN HOSPITAL, ECU HEALTH BERTIE HOSPITAL, ECU HEALTH DUPLIN HOSPITAL, ECU HEALTH NORTH HOSPITAL, AND THE OUTER BANKS HOSPITAL. ECU HEALTH MEDICAL CENTER SERVES AS THE TEACHING HOSPITAL FOR THE BRODY SCHOOL OF MEDICINE, EAST CAROLINA SCHOOLS OF NURSING AND ALLIED HEALTH, PITT COMMUNITY COLLEGE AND BEAUFORT COMMUNITY COLLEGE. THE SYSTEM ALSO SERVES AS A REGIONAL REFERRAL CENTER FOR EASTERN NORTH CAROLINA. THE SYSTEM'S NINE OWNED HOSPITALS ARE LICENSED TO OPERATE 1,708 BEDS. EACH HOSPITAL IS LICENSED BY THE DIVISION OF FACILITY SERVICES OF THE NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES AND APPROVED AS A PROVIDER BY THE MEDICARE AND MEDICAID PROGRAMS. ECU HEALTH AND ITS HOSPITALS AND AFFILIATE ORGANIZATIONS PROVIDE SERVICES TO PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. IN FISCAL YEAR 2024 ECU HEALTH'S COMBINED PATIENT CARE STATISTICS WERE: INPATIENT ADMISSIONS, 68,152; INPATIENT DAYS OF CARE, 385,435; SURGERIES, 56,012; BIRTHS, 6,690; AND OUTPATIENT VISITS, 450,414. OUR SYSTEM'S WORKFORCE INCLUDED 13,090 EMPLOYEES. EACH OF ECU HEALTH'S HOSPITALS OPERATES AN EMERGENCY ROOM, WHICH IS OPEN 24 HOURS A DAY. ECU HEALTH MEDICAL CENTER ALSO OFFERS A FULL SPECTRUM OF TRAUMA SERVICES. EMERGENCY AND TRAUMA SERVICES ARE PROVIDED TO PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. IN FISCAL YEAR 2024 ECU HEALTH PROVIDED CARE TO 274,505 EMERGENCY ROOM PATIENTS. ECU HEALTH'S BOARD OF DIRECTORS CONSISTS OF 11 VOTING MEMBERS, SIX OF WHOM MUST BE CURRENT OR FORMER PITT COUNTY, NORTH CAROLINA APPOINTEES OF ECU HEALTH MEDICAL CENTER'S BOARD OF TRUSTEES AND FIVE OF WHOM MUST BE CURRENT OR FORMER BOARD OF GOVERNORS OF THE UNIVERSITY OF NORTH CAROLINA APPOINTEES OF ECU HEALTH MEDICAL CENTER'S BOARD OF TRUSTEES. ECU HEALTH MEDICAL CENTER, IN AFFILIATION WITH THE BRODY SCHOOL OF MEDICINE, WHICH IS OWNED BY THE STATE OF NORTH CAROLINA, OPERATES 30 RESIDENT-TRAINING PROGRAMS WITH OVER 400 MEDICAL RESIDENTS. THIS RELATIONSHIP ENABLES ECU HEALTH MEDICAL CENTER AND THE BRODY SCHOOL OF MEDICINE TO COMBINE THEIR RESOURCES FOR THE PROVISION OF QUALITY PATIENT CARE, MEDICAL EDUCATION AND RESEARCH FOR THE RESIDENTS OF EASTERN NORTH CAROLINA. THE BRODY SCHOOL OF MEDICINE HAS THREE IMPORTANT GOALS: EDUCATING PRIMARY CARE PHYSICIANS, MAKING MEDICAL CARE MORE READILY AVAILABLE TO THE PEOPLE OF EASTERN NORTH CAROLINA, AND PROVIDING OPPORTUNITIES TO MINORITY AND DISADVANTAGED STUDENTS. AS A NON-PROFIT ORGANIZATION, ECU HEALTH REINVESTS ALL EXCESS OF REVENUES OVER EXPENSES IN PROGRAMS, SERVICES, AND FACILITIES THAT PROVIDE ACCESS TO PATIENT CARE AND HEALTH SERVICES TO THE CITIZENS OF EASTERN CAROLINA. OVERVIEW OF ECU HEALTH COMMUNITY BENEFIT PROGRAMS 1. EASTERN NORTH CAROLINA IS COMPRISED OF 1.4 MILLION PEOPLE LIVING IN 14,000 SQUARE MILES. BOUNDARIES ARE FROM I-95 EAST TO THE COAST, AND FROM THE VIRGINIA LINE DOWN TO AND INCLUDING ONSLOW COUNTY. THE AREA IS LARGELY RURAL AND LARGELY POOR, WITH HIGHER THAN STATE OR NATIONAL AVERAGE RATES FOR POVERTY AND UNINSURED. HEALTH STATUS INDICATORS SHOW INCREASED INCIDENCE OF DISEASE IN THE REGION, ESPECIALLY CANCER, HEART DISEASE AND STROKE. ECU HEALTH DETERMINES PRIORITIES FOR TARGET POPULATIONS BY WORKING IN CONCERT WITH MEDICAL AND COMMUNITY AGENCY PARTNERS IN ONGOING ASSESSMENT OF THE MOST PRESSING HEALTH CARE NEEDS. MANY EFFORTS OVER THE PAST DECADE HAVE FOCUSED ON DIABETES, PEDIATRIC ASTHMA, SCHOOL HEALTH, INJURY PREVENTION, ACCESS TO CARE, NUTRITION ENHANCEMENT, PHYSICAL ACTIVITIES AND CHRONIC DISEASE SCREENINGS. ALSO, SPECIAL PROGRAMS TO MANAGE THE CARE OF MEDICAID ENROLLEES, ADDRESS ACCESS TO BOTH MEDICAL CARE AND MEDICATIONS FOR THE UNINSURED, AND COORDINATION OF SERVICES FOR CHILDREN WITH OBESITY HAVE BEEN UNDERTAKEN. THE POPULATIONS THAT ARE SERVED BY ADDRESSING THESE ISSUES ARE LARGELY THE POOR, THE UNDERSERVED, AND MINORITIES. DETERMINATION OF SPECIFIC POPULATIONS TO ADDRESS OCCURS WHEN PARTNERS SUCH AS THE NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES, LOCAL HEALTH DEPARTMENTS, COUNTY COALITIONS, TASK FORCES, AND PHYSICIANS IDENTIFY A QUANTIFIABLE NEED, AND COMMUNITY PARTNERS ARE ENGAGED TO WORK TOGETHER WITH THE HEALTH SYSTEM. 2. FUNDING FOR COMMUNITY HEALTH PROGRAMS IS OBTAINED FROM BOTH THE OPERATING FUNDS OF ECU HEALTH ENTITIES AND EXTERNAL GRANT-AWARDING ORGANIZATIONS. THE ECU HEALTH BOARD ANNUALLY PROVIDES FINANCIAL SUPPORT FOR THE COMMUNITY BENEFIT INITIATIVES PROGRAM BASED WITHIN EACH ECU HEALTH HOSPITAL. FUNDS ARE AWARDED TO COMMUNITY AGENCIES THAT SUCCESSFULLY DEMONSTRATE BOTH NEED AND A WELL-DESIGNED PLAN TO ADDRESS ONE OF THE HEALTH PRIORITIES IDENTIFIED IN THE COMMUNITY HEALTH ASSESSMENT PROCESS. THESE FUNDS ARE THEN AWARDED TO COMMUNITY AGENCIES THAT SUCCESSFULLY DEMONSTRATE BOTH NEED AND A WELL-DESIGNED PLAN TO ADDRESS ONE OF THE FOUNDATION'S PRIORITY CATEGORIES. IN ADDITION, EACH ECU HEALTH HOSPITAL FINANCIALLY SUPPORTS COMMUNITY HEALTH RESOURCES WITHIN ITS OPERATING BUDGET. PROGRAMS VARY ACCORDING TO THE HOSPITAL'S FINANCIAL ABILITY AND COMMUNITY NEED, BUT ALL INCLUDE COLLABORATIVE EFFORTS WITH LOCAL HEALTH DEPARTMENTS, INCLUDING HEALTH SCREENINGS AND EDUCATION TO TARGETED POPULATIONS. ECU HEALTH ALSO HAS A SUCCESSFUL TRACK RECORD OF OBTAINING COMMUNITY HEALTH PROGRAM SUPPORT FROM EXTERNAL AGENCIES THAT AWARD GRANT FUNDING TO APPROVE PROJECTS. THE ECU HEALTH GRANTS OFFICE WAS ESTABLISHED IN 2008 AND SERVES AS THE CENTRAL POINT FOR GRANT MINING, ACQUISITION AND MANAGEMENT OF GRANTS AWARDED TO ECU HEALTH HOSPITALS FOR COMMUNITY-BASED PROGRAMS. GRANT FUNDS ARE UTILIZED TO DEMONSTRATE THE EFFECTIVENESS OF A PROPOSED COMMUNITY PROGRAM, MEASURE THE OUTCOMES ACHIEVED, AND GARNER LONG-TERM SUSTAINABILITY FROM EITHER THE HEALTH SYSTEM, OTHER COMMUNITY AGENCIES OR AS A COLLABORATIVE PROGRAM. MANY COMMUNITY HEALTH PROGRAMS ARE COLLABORATIVE IN NATURE WITH LOCAL SERVICE AGENCIES, AND OFTEN A PORTION OF THE GRANT FUNDS ARE USED TO SUPPORT RESOURCES OR SERVICES IN THESE AGENCIES 3. COMMUNITY HEALTH PRIORITIES ARE DETERMINED FOLLOWING THE COMPLETION OF A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS. THE COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDES INPUT FROM COMMUNITY MEMBERS RECEIVED THROUGH COMMUNITY SURVEYS AND FOCUS GROUP DISCUSSIONS, AS WELL AS A REVIEW OF SECONDARY HEALTH DATA. COMMUNITY ALLIANCES, PARTNERS AND ORGANIZATIONS, INCLUDING LOCAL HEALTH DEPARTMENTS, PARTICIPATE IN THIS REVIEW. A LIST OF THE MOST PRESSING HEALTH ISSUES ARE COMPILED FOR EACH COMMUNITY AND THEN PRIORITIZED FOLLOWING AN ASSESSMENT OF CURRENT HEALTH RESOURCES TO ADDRESS THE IDENTIFIED HEALTH ISSUES. ESTABLISHED RESOURCES/COALITIONS AND NEW PARTNERSHIPS ARE FORMED TO ADDRESS THE IDENTIFIED HEALTH PRIORITIES 4. COMMUNITY HEALTH PRIORITIES ARE ALSO ESTABLISHED IN RESPONSE TO A COMPELLING NEED IDENTIFIED BY HEALTH PRACTITIONERS OR COMMUNITY GROUPS. ECU HEALTH IS FORTUNATE TO HAVE A STRONG COLLABORATIVE PARTNERSHIP WITH EAST CAROLINA UNIVERSITY AND WORKS CLOSELY WITH THE SCHOOLS WITHIN THE HEALTH SCIENCES DIVISION, ESPECIALLY THE BRODY SCHOOL OF MEDICINE.
FORM 990, PART III, LINE 4A (CONTINUATION):	PROVIDED BELOW ARE A FEW HIGHLIGHTS OF THE COMMUNITY BENEFIT AND EDUCATION ACTIVITIES: COMMUNITY HEALTH IMPROVEMENT SERVICES: COMMUNITY HEALTH IMPROVEMENT SERVICES ARE PROGRAMS AND SERVICES THAT MEET AN IDENTIFIED NEED AND ARE OFFERED TO THE COMMUNITY AT LITTLE OR NO CHARGE. ECU HEALTH HOSPITALS SPONSOR PROGRAMS THAT IMPROVE ACCESS TO HEALTH CARE FOR THE UNDERSERVED AND ENHANCE THE IDENTIFICATION AND MANAGEMENT OF CHRONIC DISEASES, SUCH AS CANCER, DIABETES AND HEART DISEASE. HERE ARE A FEW EXAMPLES OF THESE PROGRAMS: - MEDICAL ASSISTANCE PROGRAMS FOR UNINSURED PATIENTS - SUPPORT FOR COMMUNITY COALITIONS FOCUSED ON HEALTH - SUPPORT OF LOCAL FEDERALLY QUALIFIED HEALTH CENTER - SUPPORT FOR HEALTHY NEIGHBORS FAITH HEALTH PARTNERSHIP - SUPPORT FOR SCHOOL HEALTH PARTNERSHIP HEALTH PROFESSIONAL EDUCATION: PREPARING FUTURE HEALTH CARE PROFESSIONALS IS IMPORTANT TO US. OUR HOSPITALS PROVIDE CLINICAL SETTINGS FOR STUDENTS OF HEALTH PROFESSIONS, SUCH AS FUTURE PHYSICIANS, NURSES AND OTHER ALLIED HEALTH PROFESSIONALS. WE ALSO SUPPORT STUDENTS THROUGH DEFERRED FORGIVABLE LOANS AND INTERNSHIPS INCLUDING RESIDENT TRAINING, NURSING CLINIC SITES, ALLIED HEALTH PROFESSIONALS, AND FINANCIAL SUPPORT OF NURSING PROGRAMS. RESEARCH: EAST CAROLINA UNIVERSITY (ECU) CONDUCTS RESEARCH TO EVALUATE NEW TREATMENTS AND PROTOCOLS. THESE STUDIES HELP HEALTH PROFESSIONALS EVERYWHERE PROVIDE QUALITY CARE TO PATIENTS. ECU HEALTH SUPPORTS THIS THROUGH VARIOUS MEANS INCLUDING SUPPORTING THE INSTITUTIONAL REVIEW BOARD AT ECU AND PROVIDING STUDY SITES. FINANCIAL AND IN-KIND CONTRIBUTIONS: ECU HEALTH DONATES MONEY AND IN-KIND SERVICES TO COMMUNITY GROUPS AND ACTIVITIES THAT SHARE OUR MISSION OF IMPROVING HEALTH. THEY INCLUDE MEALS ON WHEELS, THE BLOOD CONNECTION BLOOD DRIVES, MEDICAL SUPPLIES TO EMERGENCY MEDICAL SERVICES, FREE MEDICATIONS TO QUALIFYING PATIENTS, AND LOCAL HIGH SCHOOL AND COMMUNITY COLLEGE ALLIED HEALTH PROGRAMS. ECU HEALTH HOSPITALS ARE KEY PARTNERS IN FUNDRAISING FOR ORGANIZATIONS SUCH AS THE UNITED WAY, AMERICAN HEART ASSOCIATION, AND THE AMERICAN CANCER SOCIETY. COMMUNITY BUILDING: COMMUNITY-BUILDING ACTIVITIES INCLUDE PROGRAMS THAT ARE NOT DIRECTLY RELATED TO HEALTH CARE BUT ADDRESS UNDERLYING ISSUES THAT IMPACT THE HEALTH OF COMMUNITIES. POVERTY, CRIME, HOMELESSNESS, WORKFORCE DEVELOPMENT AND ECONOMIC DEVELOPMENT ALL AFFECT THE OVERALL HEALTH OF COMMUNITIES. ECU HEALTH HAS PROVIDED SUPPORT FOR OUR LOCAL CHAMBERS OF COMMERCE, INVESTMENTS IN COMMUNICATION INFRASTRUCTURE VIA INFORMATION TECHNOLOGY CONNECTIONS, SUPPORT FOR THE TEEN LEADERSHIP ACADEMY, RECRUITMENT OF PHYSICIANS TO OUR RURAL COMMUNITIES, AND PROGRAMS THAT ENCOURAGE STUDENTS TO PURSUE HEALTH CAREERS.
FORM 990, PART VI, SECTION B, LINE 11B:	THE 990 IS MADE AVAILABLE TO BOARD MEMBERS BY POSTING TO A BOARD MEMBER'S WEBSITE. ANY BOARD MEMBER WHO DOES NOT HAVE THE ABILITY TO ACCESS THE RETURN IN THIS MANNER WILL RECEIVE A COPY VIA ELECTRONIC OR REGULAR MAIL. THE RETURN IS ALSO REVIEWED BY THE CHIEF FINANCIAL OFFICER, CHIEF GENERAL COUNSEL AND THE CHIEF AUDIT AND COMPLIANCE OFFICER OF ECU HEALTH PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C:	ALL OFFICERS, BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A YEARLY COMPREHENSIVE CONFLICT OF INTEREST QUESTIONNAIRE. THESE ARE REVIEWED BY LEGAL COUNSEL AND ANY POTENTIAL OR ACTUAL CONFLICTS ARE BROUGHT TO THE BOARD FOR DISPOSITION. BOARD MEMBERS ARE INSTRUCTED TO REPORT ANY POTENTIAL CONFLICTS ARISING DURING THE YEAR FOR REVIEW. BOARD MEMBERS ARE REQUIRED TO RECUSE THEMSELVES FROM VOTING ON ISSUES IN WHICH THEY ARE DEEMED TO HAVE A CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15:	THE COMPENSATION IS DETERMINED BY THE COMPENSATION AND BENEFITS COMMITTEE OF THE ECU HEALTH BOARD USING COMPARATIVE DATA FROM LIKE ORGANIZATIONS AND INPUT FROM CONSULTANTS. THIS PROCESS IS PERFORMED EVERY YEAR. COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS ALSO DETERMINED BY THE COMPENSATION AND BENEFITS COMMITTEE OF THE ECU HEALTH BOARD USING COMPARATIVE DATA FROM LIKE ORGANIZATIONS AND INPUT FROM CONSULTANTS. THIS PROCESS IS PERFORMED EVERY YEAR. ALL COMPENSATION DISCUSSIONS AND ACTIONS ARE DOCUMENTED AND APPROVED IN THE MINUTES OF THE COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19:	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND COMBINED FINANCIAL STATEMENTS AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN IRC SECTION 6104(D).
FORM 990, PART XI, LINE 9:	OTHER CHANGES IN NET ASSETS: NET ASSET TRANSFER $274,698.
FORM 990, PART XII, LINE 2C:	THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACTED SERVICES TOTAL FEES:XXX-XX-XXXX

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

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

East Carolina Health

Employer identification number

91-1997979

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) DUPLIN HEALTH CARE SERVICES LLC 401 N MAIN STREET KENANSVILLE,NC28439 56-6011594	HEALTHCARE	NC	0	0	DUPLIN GENH

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)UNIV HEALTH SYSTEMS OF EASTERN CAROLINA 2100 STANTONSBURG ROAD GREENVILLE,NC27835 56-2141073	HEALTHCARE	NC	501(C)(3)	12C-III FI	NA		No
(2)PITT COUNTY MEMORIAL HOSPITAL INC 2100 STANTONSBURG ROAD GREENVILLE,NC27835 56-0585243	HOSPITAL	NC	501(C)(3)	LINE 3	ECU HEALTH		No
(3)VIDANT MEDICAL GROUP LLC 2100 STANTONSBURG ROAD GREENVILLE,NC27835 38-3740839	HEALTHCARE	NC	501(C)(3)	LINE 10	ECU HEALTH		No
(4)EAST CAROLINA HEALTH 2100 STANTONSBURG ROAD GREENVILLE,NC27835 56-2003393	HOSPITAL	NC	501(C)(3)	LINE 3	ECU HEALTH		No
(5)PCMH MANAGEMENT INC 2100 STANTONSBURG ROAD GREENVILLE,NC27835 56-1690740	MEDICAL PROP.	NC	501(C)(2)	N/A	ECU HEALTH		No
(6)HEALTHACCESS INC 2100 STANTONSBURG ROAD GREENVILLE,NC27835 56-1396133	HEALTHCARE	NC	501(C)(3)	LINE 12B,II	ECU HEALTH		No
(7)THE OUTER BANKS HOSPITAL INC 2100 STANTONSBURG ROAD GREENVILLE,NC27835 56-2112733	HOSPITAL	NC	501(C)(3)	LINE 3	EC Health		No
(8)ACCESS EAST INC 2410 STANTONSBURG RD STANTON SQUA GREENVILLE,NC27834 56-1949493	HEALTHCARE	NC	501(C)(3)	LINE 10	ECU HEALTH		No
(9)ROANOKE VALLEY HEALTH SERVICES 2100 STANTONSBURG ROAD GREENVILLE,NC27835 56-1925492	HEALTHCARE	NC	501(C)(3)	LINE 3	ECU HEALTH		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2023

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	(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	(k) Percentage ownership

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	(h) Percentage ownership	Yes	No

Schedule R (Form 990) 2023

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

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

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

Yes

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

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

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

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

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

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

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

Yes

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

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

Schedule R (Form 990) 2023

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2023

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference

Explanation

SCHEDULE R, PART II, IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS:

FULL NAME, EIN, AND ADDRESS OF RELATED ORGANIZATIONS: NAME: UNIVERSITY HEALTH SYSTEMS OF EASTERN CAROLINA D/B/A ECU HEALTH EIN: 56-2141073 ADDRESS: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 NAME: PITT COUNTY MEMORIAL HOSPITAL, INC. D/B/A ECU HEALTH MEDICAL CENTER EIN: 56-0585243 ADDRESS: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 NAME: VIDANT MEDICAL GROUP, LLC. D/B/A ECU HEALTH PHYSICIANS EIN: 38-3740839 ADDRESS: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 NAME: EAST CAROLINA HEALTH D/B/A ECU HEALTH COMMUNITY HOSPITALS EIN: 56-2003393 ADDRESS: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 NAME: PCMH MANAGEMENT, INC. D/B/A ECU HEALTH PROPERTIES EIN: 56-1690740 ADDRESS: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835 NAME: THE OUTER BANKS HOSPITAL, INC. D/B/A OUTER BANKS HEALTH EIN: 56-2112733 ADDRESS: 2100 STANTONSBURG ROAD, GREENVILLE, NC 27835

Schedule R (Form 990) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO ADVANCE AND SUPPORT THE HEALTHCARE NEEDS OF THE COMMUNITIES OF EASTERN NORTH CAROLINA.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	7
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	4
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	193
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,659,926	1,310,649
9	Program service revenue (Part VIII, line 2g) .........	488,729,965	578,449,263
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	392,031	121,683
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	13,292,877	16,962,832
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	504,074,799	596,844,427
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	766,950	616,654
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)	194,467,220	218,006,888
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)....	306,102,563	344,085,727
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	501,336,733	562,709,269
19	Revenue less expenses. Subtract line 18 from line 12.......	2,738,066	34,135,158
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	344,527,899	383,739,575
21	Total liabilities (Part X, line 26).............	131,560,387	136,431,000
22	Net assets or fund balances. Subtract line 21 from line 20.....	212,967,512	247,308,575

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 115,565,071 including grants of $ 95,000 ) (Revenue $ 130,427,521 )
	ECU HEALTH EDGECOMBE HOSPITAL ECU HEALTH EDGECOMBE HOSPITAL, FORMERLY HERITAGE HOSPITAL, IS A 117-BED FACILITY LOCATED IN TARBORO, NORTH CAROLINA. SERVICES AT ECU HEALTH EDGECOMBE INCLUDE ACUTE CARE, INPATIENT AND SAME DAY SURGERY, EMERGENCY, CRITICAL CARE, OBSTETRICS/GYNECOLOGY, AND ONCOLOGY SERVICES. IT ALSO OPERATES A RURAL HEALTH CENTER, WHICH PROVIDES GENERAL, PEDIATRIC, WOMEN'S AND OCCUPATIONAL HEALTH SERVICES.

4b	(Code: ) (Expenses $ 102,373,473 including grants of $ 95,000 ) (Revenue $ 107,269,260 )
	ECU HEALTH ROANOKE-CHOWAN HOSPITAL ECU HEALTH ROANOKE-CHOWAN HOSPITAL IS AN 86-BED HOSPITAL LOCATED IN AHOSKIE, NORTH CAROLINA, THAT IS ALSO LICENSED FOR 28 INPATIENT PSYCHIATRIC BEDS. SERVICES AT ROANOKE-CHOWAN HOSPITAL INCLUDE ACUTE CARE, OBSTETRICS/GYNECOLOGY, EMERGENCY, SUB-ACUTE CARE, SPECIALTY CLINICS AND BEHAVIORAL HEALTH. THE HOSPITAL ALSO OPERATES A WELLNESS CENTER FOR THE COMMUNITY.

4c	(Code: ) (Expenses $ 128,995,756 including grants of $ 95,000 ) (Revenue $ 123,265,235 )
	ECU HEALTH NORTH, FORMERLY HALIFAX REGIONAL MEDICAL CENTER ECU HEALTH NORTH, FORMERLY HALIFAX REGIONAL MEDICAL CENTER IS A 204-BED HOSPITAL LOCATED IN ROANOKE RAPIDS, NORTH CAROLINA. SERVICES AT ECU HEALTH NORTH INCLUDE ACUTE CARE, OBSTETRICS/GYNECOLOGY, CRITICAL CARE UNIT, IP AND SAME DAY SURGERY, 24-HOUR EMERGENCY, ONCOLOGY, CARDIAC CATH LAB, ENDOSCOPY SERVICES, REHAB SERVICES, AND WOUND CARE SERVICES.

	(Code: ) (Expenses $ 161,414,163 including grants of $ 331,654 ) (Revenue $ 217,487,247 )
	HOSP. SVCS PROVIDED AT ADD. FACILITIES

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 161,414,163 including grants of $ 331,654 ) (Revenue $ 217,487,247 )
4e	Total program service expenses508,348,463

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	4,557,733	4,223,784	2,918,710

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

f	All other contributions, gifts, grants, and similar amounts not included above		1f	1,310,649

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

h Total. Add lines 1a-1f.......		1,310,649

		Business Code
2a	OUTPATIENT SERVICES	621110	358,870,059	358,870,059
b	INPATIENT SERVICES	621400	219,579,204	219,579,204
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		578,449,263

3 Investment income (including dividends, interest, and othersimilar amounts) ......			614,872		0	614,872
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
			(i) Real	(ii) Personal
6a	Gross rents	6a	54,719
b	Less: rental expenses	6b
c	Rental income or (loss)	6c	54,719	0
d	Net rental income or (loss).......			54,719			54,719
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a
b	Less: cost or other basis and sales expenses	7b		493,189
c	Gain or (loss)	7c		-493,189
d	Net gain or (loss).........			-493,189			-493,189
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a	0
b	Less: direct expenses ...		8b	0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	0
b	Less: cost of goods sold ..		10b	0
c	Net income or (loss) from sales of inventory..			0

Business Code
11a	ALL OTHER		900099	14,218,307			14,218,307
b	CAFETERIA MEALS		722514	1,919,063			1,919,063
c	REBATES		900099	617,381			617,381
d	All other revenue ....			153,362			153,362
e	Total. Add lines 11a–11d ......			16,908,113
12	Total revenue. See instructions.....			596,844,427	578,449,263	0	17,084,515

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	616,654	616,654
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0
4	Benefits paid to or for members .......	0
5	Compensation of current officers, directors, trustees, and key employees ...........	3,291,777		3,291,777
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
7	Other salaries and wages........	164,725,230	159,270,518	5,454,712
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	10,916,947	10,371,100	545,847
9	Other employee benefits .......	26,723,863	23,403,309	3,320,554
10	Payroll taxes ...........	12,349,071	11,731,617	617,454
11	Fees for services (non-employees):
a	Management ......	522,707	416,374	106,333
b	Legal .........	8,311		8,311
c	Accounting ...........	236,245		236,245
d	Lobbying ...........	21,214		21,214
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	150,210,504	118,697,069	31,513,435	0
12	Advertising and promotion ....	194,488		194,488
13	Office expenses .......	1,405,007	1,108,189	296,818
14	Information technology ......	757,929	235,705	522,224
15	Royalties ..	0
16	Occupancy ...........	5,586,415	4,259,976	1,326,439
17	Travel ............	386,555	309,244	77,311
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	3,087,013		3,087,013
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	14,136,961	14,136,961
23	Insurance ...	3,797,769	759,554	3,038,215
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	82,684,822	82,684,822
b	BAD DEBT	41,827,636	41,827,636
c	MEDICAID ASSESSMENTS	35,710,073	35,710,073
d	OTHER EXPENSES	3,512,078	2,809,662	702,416
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	562,709,269	508,348,463	54,360,806	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			0	1	0
2	Savings and temporary cash investments .........			25,477,442	2	97,142,792
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			88,799,999	4	78,672,569
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			0	7	0
8	Inventories for sale or use ............			11,696,951	8	12,482,277
9	Prepaid expenses and deferred charges ......			2,323,055	9	3,002,345
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	413,802,969
b	Less: accumulated depreciation	10b	293,259,706	117,593,284	10c	120,543,263
11	Investments—publicly traded securities .			0	11	0
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 ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			98,637,168	15	71,896,329
16	Total assets. Add lines 1 through 15 (must equal line 33)...			344,527,899	16	383,739,575

17	Accounts payable and accrued expenses .....	58,126,969	17	64,870,171
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	314,827	23	2,524,458
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	73,118,591	25	69,036,371
26	Total liabilities. Add lines 17 through 25..	131,560,387	26	136,431,000

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	209,807,213	27	244,148,276
28	Net assets with donor restrictions ...........	3,160,299	28	3,160,299
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	212,967,512	32	247,308,575
33	Total liabilities and net assets/fund balances ........	344,527,899	33	383,739,575