Return of Organization Exempt from Income
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North Carolina Hospital Association
Alamance Regional Medical Center • Albemarle Health • Alleghany Memorial Hospital • Angel Medical Center • Annie Penn Hospital • Anson Community Hospital • Ashe Memorial Hospital, Inc. • Betsy Johnson Regional Hospital • Blowing Rock Hospital • Blue Ridge Regional Hospital • Broughton Hospital • Brunswick Community Hospital • Caldwell Memorial Hospital, Inc. • Cape Fear Valley - Bladen County Hospital • Cape Fear Valley Health System • CarePartners Rehabilitation Hospital • CarolinaEast Health System • Carolinas Medical Center • Carolinas Medical Center - Lincoln • Carolinas Medical Center - Mercy • Carolinas Medical Center - Northeast • Carolinas Medical Center - Pineville • Carolinas Medical Center - Union • Carolinas Medical Center - University • Carolinas Rehabilitation • Carteret County General Hospital • CaroMont Health, Inc. • Catawba Valley Medical Center • Central Carolina Hospital • Central Regional Hospital • Charles A Cannon, Jr. Memorial Hospital • Chatham Hospital • Cherokee Indian Hospital • Cherry Hospital • Cleveland Regional Medical Center • Coastal Plain Hospital • Columbus Regional Healthcare System • Cone Health Behavioral Health • Davie County Hospital • Davis Regional Medical Center • Department of Veterans Affairs Medical Center Asheville • Department of Veterans Affairs Medical Center Durham • Duke Raleigh Hospital • Duke University Hospital • Durham Regional Hospital • FirstHealth Montgomery Memorial Hospital • FirstHealth Moore Regional Hospital • FirstHealth Richmond Memorial Hospital • Forsyth Medical Center -
Vidant Bertie Hospital's 2013 Community Health Needs Assessment
Vidant Bertie Hospital’s 2013 Community Health Needs Assessment Community Health Assessment funding provided by: Albemarle Regional Health Services Albemarle Health The Outer Banks Hospital Vidant Bertie Hospital Vidant Chowan Hospital May 2013 Dear Community Member, Thank you for taking the time to review the 2013 Community Health Assessment for our area. Albemarle Regional Health Services and Vidant Bertie Hospital are proud to partner and provide this comprehensive report which illustrates the health status,health needs and improvements,as well as health resources in our community. This document represents months of diligent work by health department staff, hospital staff, and community members like you. We have continued to work together throughout the past several years to develop and implement strategies to target needs identified in the 2010 CHA process. These efforts have resulted in more positive health outcomes in our communities and we are pleased to include areas of improvement in this report. Moving forward,we will use this report to guide us in developing and implementing strategies and engaging partners to address the current needs identified in the 2013 process. We would like to thank each person,organization,and agency that has helped with this process. The health of a community starts with you. Best of health, rry L. Parks,MPH Health Director President Albemarle Regional Health Services Vidant Bertie Hospital ACKNOWLEDGMENTS The Community Health Assessment (CHA) process requires much work and dedication from those who are committed to identifying and solving health problems within our communities to improve the quality of life for our residents. The first phase of this process is forming a CHA Leadership Team. -
Return of Organization Exempt from Income
efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493224010375 Return of Organization Exempt From Income Tax OMB No 1545-0047 Form 990 Under section 501 ( c), 527, or 4947 ( a)(1) of the Internal Revenue Code ( except private foundations) 2O1 3 Do not enter Social Security numbers on this form as it may be made public By law, the IRS Department of the Treasury Open generally cannot redact the information on the form Internal Revenue Service Inspection - Information about Form 990 and its instructions is at www.IRS.gov/form990 For the 2013 calendar year, or tax year beginning 10-01-2013 , 2013, and ending 09-30-2014 C Name of organization B Check if applicable D Employer identification number University Health Systems of Eastern F Address change Carolina Inc 56-2141073 Doing Business As F Name change Vidant Health 1 Initial return Number and street (or P 0 box if mail is not delivered to street address) Room/suite E Telephone number 2100 Stantonsburg Road p Terminated (252)847-5129 (- Amended return City or town, state or province, country, and ZIP or foreign postal code Greenville, NC 27835 1 Application pending G Gross receipts $ 143,238,746 F Name and address of principal officer H(a) Is this a group return for David Herman subordinates? fl Yes F No 2100 Stantonsburg Road Greenville, NC 27835 H(b) Are a l l subordinates 1 Yes 1 No included? I Tax-exempt status F 501(c)(3) 1 501(c) ( ) I (insert no (- 4947(a)(1) or F_ 527 If "No," attach a list (see instructions) J Website : - www vidanthealth com H(c) Group exemption number 0- K Form of organization F Corporation 1 Trust F_ Association (- Other 0- L Year of formation 1998 M State of legal domicile NC Summary 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 w 2 Check this box if the organization discontinued its operations or disposed of more than 25% of its net assets 3 Number of voting members of the governing body (Part VI, line 1a) . -
Return of Organization Exempt from Income
l efile GRAPHIC p rint - DO NOT PROCESS As Filed Data - DLN: 93493134006193 Return of Organization Exempt From Income Tax OMB No 1545-0047 Form 990 Under section 501 (c), 527, or 4947 ( a)(1) of the Internal Revenue Code ( except black lung benefit trust or private foundation) 2011 Department of the Treasury Internal Revenue Service 1-The organization may have to use a copy of this return to satisfy state reporting requirements MEMO A For the 2011 calendar year, or tax year beginning 10-01-2011 and ending 09-30-2012 C Name of organization D Employer identification number B Check if applicable PITT COUNTY MEMORIAL HOSPITAL INC F Address change 56-0585243 Doing Business As E Telephone number F N ame c hange VIDANT MEDICAL CENTER (252) 847-5129 F Initial return Number and street (or P 0 box if mail is not delivered to street address ) Room/suite 2100 STANTONSBURG ROAD G Gross receipts $ 1,104,838,649 F_ Terminated 1 Amended return City or town, state or country, and ZIP + 4 GREENVILLE, NC 27835 I Application pending F Name and address of principal officer H(a) Is this a group return for STEVE LAWLER affiliates? fl Yes F No 2100 STANTONSBURG ROAD GREENVILLE,NC 27835 H(b) Are all affiliates included ? fl Yes F_ No If "No," attach a list (see instructions) I Tax - exempt status F 501(c)(3) 1 501( c) ( ) -4 (insert no ) 1 4947(a)(1) or F_ 527 H(c) Group exemption number 0- J Website :1- WWW VIDANTHEALTH COM K Form of organization F Corporation 1 Trust F_ Association 1 Other 0- L Year of formation 1953 M State of legal domicile NC Summary 1 Briefly describe the organization's mission or most significant activities TO PROVIDE ACCESS TO QUALITY MEDICAL SERVICE TO ALL CITIZENS OF PITT COUNTY AND EASTERN NC W 2 Check this box 1ii if the organization discontinued its operations or disposed of more than 25% of its net assets 3 Number of voting members of the governing body (Part VI, line 1a) . -
Bertie County
Bertie County 2019 Community Health Needs Assessment 1 Acknowledgements This report is the culmination of significant work led by Albemarle Regional Health Services and Vidant Bertie Hospital / Vidant Health, in conjunction with key stakeholders from the community: Teresa Beardsley Amanda Betts Kia Boone Erin Brabble Dana Byrum Allen Castelloe Kathy Copeland Sara Davidson Crystal Dempsey Dr. Catherine Edmonds Caroline Edwards Judith Garrett Brian Harvill Kelly Herr Lewis Hoggard LuAnn Joyner Liza Layton Tammy Lee Melissa Roupe Scott Sauer Wanda Stallings Amy Underhill Ron Wesson Brian White Support of this document was also provided by many other entities. Albemarle Regional Health Services and Vidant Bertie Hospital / Vidant Health greatly appreciates the help of our vital community stakeholders. 2 Table of Contents List of Figures ................................................................................................................................ 7 List of Tables ................................................................................................................................. 9 Executive Summary .................................................................................................................... 10 Service Area ............................................................................................................................. 10 Methods for Identifying Community Health Needs ............................................................ 10 Secondary Data .................................................................................................................. -
Available ICU Bed Capacity for All NC Hsas, FY18
Available ICU Bed Capacity for all NC HSAs, FY18 Source: NC DHSR per 2019 Hospital License Renewal Applications Licensed ICU Bed Capacity for All HSAs, FY2018 Licensed ICU Licensed Total Actual Possible ICU Beds Bed ICU Bed ICU Beds Total Facility Name County Licensed ICU Bed ICU Bed Available per Capacity Capacity Available Population ICU Beds Days Days 10,000 Pop Used Unused Notes: a b c d e f g h State Total 3,431 827,071 1,252,315 66% 34% 1,165 10,630,691 1.10 Source: NC DHSR Hospital Access Database per 2019 License Renewal Applications Notes: * Hospitals are closed and no longer in operation ** Some hospitals with ICU beds did not report ICU bed days Numbers may not foot in table due to rounding a: Total licensed ICU beds from NC DHSR Hospital Access Database per 2019 NC DHSR Hospital License Renewal Applications b: Total ICU bed days from NC DHSR Hospital Access Database per 2019 NC DHSR Hospital License Renewal Applications c: b * 365 days d: b / c e: (1‐d) f: a * e g: NCOSBM 2020 population estimate h: f/g *10,000 Available ICU Bed Capacity in HSA 1, FY18 Source: NC DHSR per 2019 Hospital License Renewal Applications *Codes on map match Facility ID in tables Licensed ICU Bed Capacity for HSA 1, FY2018 Licensed Total Possible Licensed ICU ICU Beds Actual ICU ICU Bed ICU Beds Total 2020 FacilityID Facility Name County HSA Licensed ICU Bed Bed Capacity Available per Bed Days Capacity Available Population ICU Beds Days Unused 10,000 Pop Used Notes: Notes: a b c d e f g h W Alexander Hospital (closed)* Alexander I ‐ ‐ ‐ 0% 0% ‐ Alexander Total I ‐ ‐ ‐ 0% 0% ‐ 38,755 0.00 B Alleghany Memorial Hospital Alleghany I 41 1,174 14,965 8% 92% 38 Alleghany Total I 41 1,174 14,965 0% 0% 38 11,510 32.83 Ashe Total I ‐ ‐ ‐ 0% 0% ‐ 28,150 0.00 Charles A. -
2020 Dsh and Fqhc Locations
2020 DSH AND FQHC LOCATIONS COUNTY NAME LOCATION FACILITY TYPE ALAMANCE Alamance Regional Medical Center Burlington DSH ALAMANCE Piedmont Health Services Burlington FQHC ALAMANCE Piedmont Health Services/ Scott Clinic Burlington FQHC ALAMANCE Piedmont Health Services/Sylvan Community Health Center Snow Camp FQHC ALAMANCE Piedmont Health/Charles Drew Community Health Center Burlington FQHC ALAMANCE Piedmont Health/Scott Community Health Center Pharmacy Burlington FQHC ALAMANCE Piedmont Health Services Inc Chapel Hill FQCH ALEXANDER Gaston Family Health Services Inc. Taylorsville FQCH ALLEGHANY Alleghany Memorial Hospital Sparta DSH ANSON Anson Regional Medical Services Wadesboro FQHC ANSON Atrium Health Anson Wadesboro DSH ASHE Ashe Memorial Hospital Jefferson DSH AVERY High Country Community Health Newland FQHC AVERY Charles A Cannon Jr Memorial Hospital Boone DSH BEAUFORT Vidant Beaufort Hospital Washington DSH BEAUFORT Metropolitan Community Health /Agape Community Health Clinic Washington FQHC BERTIE Vidant Bertie Hospital Windsor DSH BERTIE Bertie County Rural Health Association/Lewiston CHC Windsor FQHC BERTIE Roanoke Chowan Community Health/Colerain Primary Care Colerain FQHC BLADEN Cape Fear Valley Bladen County Hospital Elizabethtown DSH BLADEN Goshen Medical Center Garland FQHC BLADEN Tri County/ Commwell Health of Tar heel Tar Heel FQHC BRUNSWICK J Arthur Dosher Memorial Hospital Southport DSH BRUNSWICK Goshen Medical Center Southport FQHC BRUNSWICK Tri County Community Health Council Shallotte FQCH BRUNSWICK Tri County Community -
REGISTRATION FORM Return to KHES Main Office Between Hours of 8:30 AM – 4:00 PM
OFFICE USE ONLY RECEIVED Date: ____________ Time: ________ SAFE ROUTES TO SCHOOL CAMP AT KHES AUGUST 8 - AUGUST 11, 2016 REGISTRATION FORM Return to KHES main office between hours of 8:30 AM – 4:00 PM. You will be notified by of your child’s acceptance on or before June 16. CHILD’S INFORMATION CHILD’S NAME: BIRTH DATE: GENDER: MALE FEMALE ADDRESS: CITY: ZIP: SCHOOL: GRADE (ENTERING 8/2016): FAMILY INFORMATION (CHILD WILL BE RELEASED TO PARENTS/GUARDIANS LISTED BELOW) MOTHER/GUARDIAN’S NAME: HOME #: WORK #: MOBILE #: PAGER #: E-MAIL ADDRESS: FATHER/GUARDIAN’S NAME: HOME #: WORK #: MOBILE #: PAGER #: E-MAIL ADDRESS: EMERGENCY INFORMATION EMERGENCY CONTACT AND THOSE APPROVED TO PICKUP (WRITTEN NOTICE MUST BE PROVIDED BY PARENT/GUARDIAN IN ORDER FOR CHILD TO BE RELEASED TO SOMEONE OTHER THAN PARENT/GUARDIAN): NAME: RELATIONSHIP TO CHILD: HOME #: WORK #: MOBILE #: PAGER #: OTHERS APPROVED TO PICK UP CHILD: _________________________________________________________ CHECK ALL THAT APPLY AND PROVIDE DETAIL WHERE NECESSARY: ALLERGIES (TYPE): MEDICATIONS: YES NO ________________________________________________________________ SPECIAL CIRCUMSTANCES: ___________________________________________________________________ Page 1 of 3 GENERAL CHILD WAIVER AND RELEASE I, the undersigned, for and in consideration of the privilege of having my child participate in the Safe Routes to School Camp do voluntarily waive and release Vidant Health and The Outer Banks Hospital, each of its successors, assigns, affiliates, each of its officers, directors, agents and employees from any liability for any and all claims or causes of action I, my heirs, executors and administrators might now or hereafter have for injury, loss, damages, or death arising out of or as a consequence of or incident to his/her involvement, or as a result of the ordinary negligence of any party. -
About This About This Guide
About this About this guide This is the fourth edition of Albemarle Smart Start Partnership’s Community Resource Guide, designed to help parents with young children learn more about the region’s resources for families. This guide includes information about the counties we serve – Bertie, Camden, Currituck, Gates and Pasquotank. We worked hard to make this edition as accurate and up-to-date as possible, but it’s always a good idea to call before making plans, as times, locations and other information may have changed. We appreciate the help and cooperation we received while putting this updated edition together. We hope our readers will find valuable information and learn more about the resources that serve our region’s children and families. For additional copies, stop by the offices of Albemarle Smart Start Partnership, 1403 Parkview Drive in Elizabeth City. You may also call (252) 333-1233, (Elizabeth City) or (800) 262-8314 (toll free). The guide may also be viewed and downloaded from www.albemarlessp.org. Visit us on Facebook for up-to-date information on programs, services and local events - www.facebook.com/albemarlesmartstart Albemarle Smart Start Partnership Albemarle Smart Start Partnership is part of North Carolina’s statewide Smart Start initiative, which has the goal of making sure every child in North Carolina enters school healthy and ready to succeed. In northeastern North Carolina, Smart Start funds support programs for children between birth and age five, their families and child care providers. The Partnership offers a variety of programs, and supports programs offered by other agencies. These programs are accompanied by the Smart Start logo. -
Physician Employed Personnel (PEP) Initial Application
Physician Employed Personnel (PEP) Initial Application PHYSICIAN EMPLOYED PERSONNEL INITIAL APPLICATION NAME LAST FIRST M.I. □ THE OUTER BANKS HOSPITAL □ VIDANT DUPLIN HOSPITAL □ VIDANT BEAUFORT HOSPITAL □ VIDANT EDGECOMBE HOSPITAL □ VIDANT BERTIE HOSPITAL □ VIDANT MEDICAL CENTER □ VIDANT CHOWAN HOSPITAL □ VIDANT ROANOKE CHOWAN Page 1 of 5 Physician Employed Personnel (PEP) Initial Application Physician Employed Applicant Information □ Initial Appointment Please check appropriate category: □ RN □ LPN □ Dental Assistant □ Surgical Assistant □ Office Assistant □ Researcher □ Medical Physicist □ Lithotripsy □ Radiology Coordinator □ Other: _______________________________ Please specify the Vidant Health Department you will be working in: __________________________________ Please provide estimated percent of time spent at above designated Vidant Health entity:________________ (10%, 50%, 90%, etc.) __________________________________________________________________________________________________ New Applicant’s Full Legal Name: ______________________________________________________ Applicant’s Social Security #: ______/_____/_______ Date of Birth ______________ Home Address: ___________________________________________________________________________ (Street) ___________________________________________________________________________ (City) (State) (Zip) Telephone #: ___________________________ Email: ____________________________________ Employer and Sponsoring Physician Information Employer Practice/Group Name: __________________________________________________________ -
Annual Report Dear Friends
ANNUAL REPORT DEAR FRIENDS, We are pleased to present the Vidant Health Foundation annual report for 2018, a year marked by great successes throughout the organization. We are seeing firsthand how your gifts are transforming lives and giving new hope to families, neighbors and friends. Together, we are helping to bring better health to thousands of people and making our communities and region an even better place to live and work. In the pages that follow, you will learn more about what made 2018 such a spectacular year – from a $10 million gift from the Eddie and Jo Allison Smith Family Foundation to celebrating 20 years of Community Benefit Grants and everything in between. We are grateful for you, our partners, for choosing to support Vidant Health and working together to improve the health and well-being of eastern North Carolina every day. VIDANT CANCER CARE Scott Senatore President, Vidant Health Foundation 2018 marked the opening of Vidant Cancer Care at the Eddie and Jo Allison Smith Tower on the Vidant Medical Center campus in Greenville. This six-story, 418,000-square-foot facility is home to both inpatient and outpatient services, allowing patients to receive all of their care in one convenient place. Together, with generous gifts from the Golden LEAF Foundation and the Eddie and Jo Allison Smith Family Foundation along with thousands of other donors, we are inspired by a commitment to provide unsurpassed care close to home, prevent cancer whenever possible and diagnose the disease in the earliest stages. BOARD OF TRUSTEES EXECUTIVE COMMITTEE (L to R, back row): Spence Cosby; J. -
Member Questions Regarding Network Coverage
Member Questions Regarding Network Coverage Board of Trustees Meeting September 27, 2013 Most Frequently Asked Questions While there have been many interesting questions posed throughout the HBR and Member meetings, the most consistently expressed questions and concerns relate to network coverage and provider accessibility Actives/Non-Medicare Primary • Concern with the lack of Blue Options Designated facilities in the eastern portion of the state • Misconception that members can only use Blue Options Designated facilities Medicare Primary • Concern that their provider is not in either the Humana or UHC network • Lack of understanding regarding Passive PPO Network • Lack of clarity regarding whether their provider will accept Medicare and file claims for SHP members 2 Network Coverage Concerns We have asked representatives from BCBSNC, Humana and UHC to address these concerns. Blue Options Designated Providers • BCBSNC: Jack Kenley, Vice President Sales & Marketing, SHP Executive Medicare Advantage Networks • Humana: Christa Klein, Group Medicare Business Executive • UHC: John Thompson, Vice President, Client Development, UHC Retiree Solutions 3 Blue Options Designated Providers Wellness Incentives Members enrolled in the Enhanced 80/20 Plan and CDHP can reduce their out of pocket costs when visiting a Blue Options Designated Provider: Designated Specialists Designated Hospitals • General Surgery • Quality Outcomes • Ob-Gyn • Cost Efficiency • Gastroenterology • Accessibility • Orthopedics • Cardiology • Neurology 4 State Health Plan Designated