4A (Expenses $ 1228414797 including grants of $ 2399) (Revenue $ 1475918334)
"UNC REX IS FREQUENTLY RECOGNIZED AS ONE OF THE TOP HOSPITALS IN NORTH CAROLINA AND THE NATION. UNC REX IS THE ONLY HOSPITAL IN NORTH CAROLINA TO RECEIVE STRAIGHT ""A"" GRADES SINCE THE LEAPFROG GROUP BEGAN A NATIONAL HOSPITAL SAFETY SCORECARD IN 2012 - AND ONE OF ONLY 23 NATIONWIDE. BUSINESS NORTH CAROLINA MAGAZINE NAMED UNC REX AS THE STATE'S TOP HOSPITAL IN ITS 2021 LIST. NEWSWEEK MAGAZINE INCLUDED UNC REX ON ITS RANKING OF THE ""WORLD'S BEST HOSPITALS"". FOR 2021. UNC REX WAS ONE OF ONLY 330 HOSPITALS NATIONWIDE TO MAKE THE LIST. NEWSWEEK ALSO INCLUDED UNC REX ON ITS 2021 LIST OF THE ""BEST MATERNITY CARE HOSPITALS."" UNC REX ACHIEVED A FIVE-STAR RATING FOR QUALITY OF CARE FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS). THAT PUTS UNC REX IN THE TOP NINE PERCENT OF HOSPITALS NATIONWIDE. UNC REX IS ONE OF 13 HOSPITALS IN NORTH CAROLINA TO RECEIVE FIVE STARS FROM CMS. MORE THAN 10 YEARS AGO, UNC REX BECAME THE FIRST HOSPITAL IN THE TRIANGLE TO BE AWARDED MAGNET STATUS BY THE AMERICAN NURSES CREDENTIALING CENTER. IN 2020, UNC REX WAS RE-DESIGNATED MAGNET STATUS FOR THE FOURTH CONSECUTIVE TIME. THE MAGNET RECOGNITION PROGRAM RECOGNIZES HEALTH CARE ORGANIZATIONS FOR EXCELLENCE IN NURSING CARE. THIS AWARD PUTS UNC REX'S NURSES IN AN ELITE GROUP OF THE TOP 2 PERCENT OF NURSES IN THE NATION. UNC REX IS ONE OF THE LARGEST EMPLOYERS IN WAKE COUNTY, WITH MORE THAN 8,000 CO-WORKERS. UNC REX IS KNOWN FOR ITS EXCELLENT BENEFITS AND IS ROUTINELY RECOGNIZED BY LOCAL AND NATIONAL PUBLICATIONS AS A ""BEST PLACE TO WORK."" DURING THE PANDEMIC, UNC REX TEAMMATES HAVE WORKED TIRELESSLY TO CARE FOR THOUSANDS OF COVID PATIENTS. IN EARLY 2020, UNC REX OPENED A SPECIAL RESPIRATORY ISOLATION UNIT TO TREAT SEVERE COVID, AND HAS CONTINUED TO ADAPT OPERATIONS AS NECESSARY. UNC REX ALSO ORCHESTRATED A MASSIVE VACCINATION EFFORT TO HELP INOCULATE OUR TEAMMATES AND MEMBERS OF OUR COMMUNITY, AS WELL AS AN ONGOING COVID TESTING PROCESS. IN LATE 2021, UNC REX OPENED A NEW, 50-BED COMMUNITY HOSPITAL IN HOLLY SPRINGS. THE UNC REX HOLLY SPRINGS HOSPITAL OFFERS MUCH-NEEDED MEDICAL CARE AND SERVICES TO ALL RESIDENTS OF ONE OF THE TRIANGLE'S FASTEST-GROWING REGIONS, CLOSER TO HOME. UNC REX BEGAN EFFORTS MORE THAN A DECADE AGO TO EXPAND MEDICAL CARE IN THAT AREA, WHICH CONTINUES TO ATTRACT NEW RESIDENTS, FROM YOUNG FAMILIES TO RETIREES. THE 242,000 SQUARE-FOOT, EIGHT-STORY COMMUNITY HOSPITAL INCLUDES 50 INPATIENT BEDS, OPERATING ROOMS FOR A WIDE RANGE OF SURGERIES, A FULL-SERVICE EMERGENCY DEPARTMENT, MRI, RADIOLOGY, LABORATORY, PHARMACY AND MUCH MORE. THE HOSPITAL WILL DELIVER BABIES WITH SEVEN LABOR AND DELIVERY ROOMS, A C-SECTION OPERATING SUITE AND OB EMERGENCY BAYS. EVENTUALLY, THE HOSPITAL WILL EMPLOY MORE THAN 400 PEOPLE. ALSO IN LATE 2018, UNC REX OPENED A NEW FOOD PANTRY TO SUPPORT PATIENTS AND THEIR FAMILIES WHO STRUGGLE WITH ACCESS TO HEALTHY FOOD. THE PANTRY IS A PARTNERSHIP BETWEEN UNC REX, FOOD LION AND THE FOOD BANK OF CENTRAL & EASTERN NORTH CAROLINA. IT'S ONE OF THE FIRST FOOD PANTRIES OPERATED BY A COMMUNITY HOSPITAL IN NORTH CAROLINA, AND ONE OF ONLY A HANDFUL ACROSS THE COUNTRY. PATIENTS AT UNC REX WHO INDICATE THAT THEY HAVE RECENTLY STRUGGLED WITH FOOD ACCESS, OR WHO ARE CONSIDERED FOOD INSECURE, ARE PRESCRIBED A VISIT TO THE FOOD PANTRY WITH THEIR HOSPITAL DISCHARGE PAPERWORK. THEY WILL RECEIVE A THREE-DAY SUPPLY OF HEALTHY FOOD, ENOUGH FOR A FAMILY OF FOUR, INCLUDING FRESH PRODUCE, STAPLE ITEMS AND HEALTHY SNACKS. THE UNC REX FOOD PANTRY WILL ALSO PROVIDE NUTRITIONAL INFORMATION, HEALTHY RECIPES FROM UNC REX'S AWARD-WINNING CHEFS AND DIETITIANS, AND A COMPREHENSIVE LIST OF FOOD BANKS AND OTHER COMMUNITY RESOURCES. A SECOND FOOD PANTRY OPENED MARCH 1, 2022, AT THE UNC REX HOLLY SPRINGS HOSPITAL. UNC REX'S CULINARY TEAM HAS CREATED A CHEF-BASED PROGRAM THAT HAS ATTRACTED INTERNATIONAL RECOGNITION AND REINVENTING TRADITIONAL ""HOSPITAL FOOD."" THEY TEND AN HERB AND VEGETABLE GARDEN AT UNC REX, AND USE LOCAL AND FRESH INGREDIENTS AS MUCH AS POSSIBLE. UNC REX WAS THE FIRST HOSPITAL IN THE SOUTHEAST TO GET RID OF DEEP FRYERS AND THE CHEFS CONTINUE TO EXPLORE NEW WAYS TO COOK AND SERVE OUR CUISINE. IN MARCH 2017, THE UNC REX CHEFS OPENED A NEW MEDITERREAN-THEMED, HEART HEALTHY RESTAURANT CALLED KARDIA IN THE NEW NORTH CAROLINA HEART & VASCULAR HOSPITAL. IN ADDITION, THE CHEFS BEGAN OFFERING CLASSES ON HEALTHY COOKING AND EATING TO PATIENTS, THEIR FAMILIES AND MEMBERS OF THE COMMUNITY IN A NEW DEMONSTRATION KITCHEN. UNC REX PERFORMS THOUSANDS OF HEART AND VASCULAR PROCEDURES A YEAR, INCLUDING CORONARY ARTERY BYPASS GRAFTING, ENDOVASCULAR AAA REPAIR, ECHOCARDIOGRAPHY, PERIPHERAL VASCULAR ULTRASOUND, VALVE REPLACEMENT AND REPAIR, ANGIOPLASTY, CARDIAC CATHETERIZATION, MINIMALLY INVASIVE STRUCTURAL HEART PROCEDURES, INVASIVE PERIPHERAL VASCULAR INTERVENTIONS, INCLUDING CRITICAL LIMB ISCHEMIA PROCEDURES, ELECTROPHYSIOLOGY PROCEDURES AND STENT PLACEMENT, REGARDLESS OF PATIENTS' ABILITY TO PAY. UNC REX HAS BEEN A CHEST PAIN ACCREDITED HOSPITAL FOR MORE THAN A DECADE, REINFORCING THE ORGANIZATION'S DEDICATION TO COMMUNITY OUTREACH AND INNOVATION IN THE CARE OF CHEST PAIN PATIENTS. THE SERVICE LINE ALSO INCLUDES OPEN HEART SURGICAL SUITES WHERE PHYSICIANS PERFORM PROCEDURES SUCH AS CORONARY ARTERY BYPASS GRAFTING, MITRAL VALVE REPLACEMENT AND REPAIR, AND AORTIC VALVE AND AORTIC ARCH REPLACEMENTS. UNC REX ALSO PROVIDES A FULL RANGE OF INVASIVE CATHETER BASED CARDIAC, VASCULAR AND ELECTROPHYSIOLOGY PROCEDURES. ALL OF THE EXISTING HEART AND VASCULAR SERVICES AND CARE, WHICH WERE PROVIDED AT MORE THAN SEVEN LOCATIONS ACROSS THE MAIN HOSPITAL IN RALEIGH, WERE CONSOLIDATED INTO A MODERN, MORE EFFICIENT AND MORE CONVENIENT FACILITY WITH THE MARCH 2017 OPENING OF THE NORTH CAROLINA HEART AND VASCULAR HOSPITAL ON UNC REX'S MAIN RALEIGH CAMPUS. THIS EIGHT-STORY, 306,000-SQUARE-FOOT HOSPITAL PROVIDES EASIER AND MORE COMFORTABLE ACCESS FOR PATIENTS AND THEIR FAMILIES, PHYSICIANS AND STAFF, IN A FACILITY THAT'S DESIGNED TO PROMOTE HEALING, PREVENTION, EDUCATION, INNOVATION AND WELLNESS. OUR CHEFS AND DIETITIANS REGULARLY HOLD COMMUNITY HEALTHY COOKING DEMONSTRATIONS IN A CONFERENCE SPACE THAT INCLUDES A DEMONSTRATION KITCHEN, AND HAVE HOSTED HUNDREDS OF PARTICIPANTS, INCLUDING PATIENTS AND THEIR FAMILIES. UNC REX SURGERY CENTERS IN RALEIGH, CARY AND WAKEFIELD WERE USED BY HUNDREDS OF PHYSICIANS TO PROVIDE THOUSANDS OF IN- AND OUT-PATIENT SURGERIES AND PROCEDURES IN FY21. THE THREE LOCATIONS HAVE IMPROVED ACCESS TO SPECIALIZED CARE FOR PATIENTS ACROSS THE REGION. SURGEONS MAKE SUBSTANTIAL USE OF MINIMALLY INVASIVE TECHNOLOGY AND INNOVATION FOR DIAGNOSIS AND TREATMENT, REDUCING PATIENTS' RECOVERY TIME AND HOSPITAL STAY AND SUPPORTING QUALITY CARE. THE CENTERS INCLUDE 38 OPERATING SUITES, 11 MINOR PROCEDURE ROOMS, AND VARIOUS PERIOPERATIVE AND ANCILLARY SUPPORT SPACES. UNC REX IS INCREASINGLY PERFORMING SURGERIES ON AN OUTPATIENT BASIS, AND CONTINUING TO LOOK FOR OTHER WAYS TO REDUCE OVERALL COSTS FOR PATIENTS. SOME OF THE TOP PROCEDURES INCLUDE GENERAL, ORTHOPEDIC, GYNECOLOGIC AND OPHTHALMIC SURGERIES. DURING THE YEAR, THOUSANDS OF OUTPATIENT ORTHOPEDIC PROCEDURES WERE PERFORMED AT RALEIGH ORTHOPAEDIC SURGERY CENTER, UNC REX'S JOINT VENTURE WITH RALEIGH ORTHOPAEDIC CLINIC LOCATED ABOUT A MILE FROM UNC REX'S MAIN RALEIGH CAMPUS. UNC REX PROVIDES A FULL RANGE OF SPECIALIZED, MULTI-DISCIPLINARY ONCOLOGY THERAPY AND SUPPORT SERVICES TO PATIENTS IN WAKE COUNTY AND BEYOND INCLUDING MEDICAL, RADIATION AND SURGICAL ONCOLOGY. IN ADDITION TO PROVIDING CANCER TREATMENTS AND THERAPIES AT FIVE LOCATIONS IN WAKE COUNTY, THE CENTERS OFFER OUTREACH AND SUPPORT SERVICES INCLUDING NUTRITIONAL SERVICES, NURSE NAVIGATION, SOCIAL WORK, REHABILITATION SERVICES AND SURVIVORSHIP OR END OF LIFE CARE. UNC REX CANCER CENTER ALSO PROVIDES ONCOLOGIC SURGICAL SERVICES TO CANCER PATIENTS THROUGH ACCESS TO UNC REX HOSPITAL. UNC REX CANCER CENTER IS ACCREDITED BY THE COMMISSION ON CANCER AS A COMPREHENSIVE COMMUNITY CANCER CENTER AND WORKS CLOSELY WITH THE NATIONALLY RECOGNIZED N.C. CANCER HOSPITAL AND THE UNC LINEBERGER COMPREHENSIVE CANCER CENTER IN CHAPEL HILL TO EXTEND SPECIALTY ONCOLOGY SERVICES AND CLINICAL TRIALS TO PATIENTS IN RALEIGH. IN EARLY 2017, UNC REX CANCER CARE BEGAN A PATIENT & FAMILY ADVISORY COUNCIL. IT'S A GROUP OF SURVIVORS AND OTHER VOLUNTEERS WHO VISIT WITH CANCER PATIENTS AND FAMILIES GOING THROUGH TREATMENT TO OFFER SUPPORT, GATHER FEEDBACK, AND DEVELOP NEW PROGRAMS AND ACTIVITIES, AND MORE. THE GOAL IS TO HELP STAFF UNDERSTAND WAYS THEY COULD IMPROVE THE OVERALL PATIENT EXPERIENCE. IN LATE 2018, UNC REX ANNOUNCED PLANS TO BUILD A NEW, $65 MILLION CANCER CENTER ACROSS THE STREET FROM OUR MAIN RALEIGH CAMPUS. THAT FACILITY OPENED FOR PATIENTS IN EARLY MARCH, 2022. AT UNC REX'S WOMEN'S CENTER, CAREGIVERS SEEK TO PROVIDE FAMILY-CENTERED CARE TO THE NEW MOTHER, BABY AND EXTENDED FAMILY. EVERY YEAR, THOUSANDS OF BABIES ARE BORN AT THE WOMEN'S CENTER. THESE BIRTHS ARE SUPPORTED BY 24/7 A"

PART V, SECTION B, LINE 5:
THE 2022 WAKE CHNA FOLLOWED AN EIGHT-PHASE PROCESS DEVELOPED BY NORTH CAROLINA INSTITUTE OF PUBLIC HEALTH (NCIPH) AND INFORMED BY THE COUNTY HEALTH RANKINGS MODEL, EMPHASIZING HOW POLICIES AND PROGRAMS INFLUENCE A VARIETY OF HEALTH FACTORS WHICH LEAD TO HEALTH OUTCOMES. THE PROCESS INCLUDED COLLECTING NEW DATA THROUGH A COMMUNITY HEALTH OPINION SURVEY AND FOCUS GROUPS, AND REVIEWING EXISTING, SECONDARY DATA. SECONDARY DATA WAS COLLECTED ON NATIONAL (U.S. CENSUS BUREAUS) AND STATE (NC CENTER FOR HEALTH STATISTICS) LEVELS. THE COVID-19 PANDEMIC REQUIRED SOME DATA COLLECTION METHODS TO BE ADAPTED. COMMUNITY ENGAGEMENT IN THE ASSESSMENT PROCESS IS ESSENTIAL TO ENSURE THAT THE IDENTIFIED PRIORITIES ARE REPRESENTATIVE OF COMMUNITY NEED. COMMUNITY INPUT WAS SOLICITED IN SEVERAL WAYS: THE COMMUNITY HEALTH OPINION SURVEY (CHOS) CAPTURED THE INPUT OF 1073 WAKE COUNTY RESIDENTS. IN ADDITION, 6 FOCUS GROUPS WERE CONDUCTED WITH RESIDENTS TO GAIN AN UNDERSTANDING OF THE STORIES AND EXPERIENCES OF COUNTY RESIDENTS IN SPECIFIC GEOGRAPHIC AREAS AND ON SPECIFIC TOPICS OF INTEREST DETERMINED BY THE STEERING COMMITTEE AND INFORMED BY THE PREVIOUS HEALTH ASSESSMENT. TWO KEY INFORMANT INTERVIEWS WERE ATTEMPTED BUT WERE UNSUCCESSFUL DUE TO SCHEDULING ISSUES. AFTER INITIAL DATA COLLECTION AND ANALYSIS, COMMUNITY MEMBERS WERE INVITED TO PARTICIPATE IN A PRIORITIZATION SURVEY WHERE THEY WERE ASKED TO SELECT THE MOST PRESSING CHALLENGE FROM A SET OF DATA-INFORMED OPTIONS. FINALLY, THE LIVE WELL WAKE STEERING COMMITTEE PARTICIPATED IN A DATA WALK AND PRIORITIZATION VOTING ACTIVITY TO DETERMINE THE FINAL PRIORITIES FOR THIS COMMUNITY HEALTH NEEDS ASSESSMENT.

PART V, SECTION B, LINE 6A:
THE ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES: DUKE RALEIGH HOSPITAL AND WAKEMED HEALTH AND HOSPITALS.

PART V, SECTION B, LINE 6B:
THE ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED WITH THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: ADVANCE COMMUNITY HEALTH, ALLIANCE HEALTH, CITRIX, WAKE COUNTY HEALTH AND HUMAN SERVICES, WAKE COUNTY MEDICAL SOCIETY COMMUNITY HEALTH FOUNDATION.

PART V, SECTION B, LINE 7A:
WWW.REXHEALTH.COM/RH/ABOUT/COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT

PART V, SECTION B, LINE 7B:
WWW.WAKEGOV.COM/WELLBEING

PART V, SECTION B, LINE 10A:
WWW.REXHEALTH.COM/RH/ABOUT/COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT

PART V, SECTION B, LINE 11:
THE HOSPITAL HAS IDENTIFIED THE FOLLOWING THREE HEALTH PRIORITIES: AFFORDABLE HOUSING & HOMELESSNESS UNC HEALTH REX IS ONE OF THE LARGEST EMPLOYERS IN WAKE COUNTY. IT IS A PRIORITY TO ENSURE OUR TEAMMATES HAVE THE ABILITY TO ACCESS AFFORDABLE HOUSING IN WAKE COUNTY, SHOULD THEY CHOOSE. OUR COMMUNITY ENGAGEMENT PARTNERSHIPS WILL INCLUDE THOSE WHO SPECIALIZE IN ADDRESSING HOUSING DEVELOPMENT AND SUSTAINABILITY. ACTIONABLE ITEMS: INVEST IN THE U3 UNIVERSITY EMPLOYEE STUDY IN PARTNERSHIP WITH UNC CH TO EVALUATE HOUSING THROUGHOUT THE COUNTY. UTILIZE A NEWLY DEVELOPED SOCIAL DETERMINANTS OF HEALTH EPIC DASHBOARD TO CONNECT PATIENTS WITH COMMUNITY RESOURCES AND ANALYZE DATA TO EVALUATE EFFECTIVENESS. EXPLORE STRATEGIES WITH THE HEALTH ANCHOR NETWORK AND COMMIT TO SUPPORT LOCAL, NON-PROFIT, COMMUNITY, BUSINESS AND GOVERNMENT PARTNERSHIPS WITH A FOCUS ON ADDRESSING HOUSING AND OTHER SOCIAL DETERMINANTS OF HEALTH THAT IMPACT AFFORDABLE HOUSING. ACCESS TO HEALTH CARE IT IS UNC HEALTH REX'S MISSION TO CARE FOR ALL, REGARDLESS OF THEIR ABILITY TO PAY. INVESTING IN EDUCATION, EXPANSION PROJECTS AND INNOVATIVE STRATEGIES ACROSS WAKE COUNTY IS ESSENTIAL TO ACCOMMODATE FOR OUR GROWING, AGING POPULATION. ACTIONABLE ITEMS: CONDUCT STRATEGIC PLANNING FOR EXPANSION OF SERVICES ACROSS WAKE COUNTY THAT IMPROVE ACCESS. INCREASE CAPACITY OF CARE FOR OUTPATIENT SERVICES THROUGH EXPANDED HOURS OF OPERATION AND VIRTUAL CARE OPTIONS AT UNCPN CARE SITES. EVALUATE MOBILE HEALTH OUTREACH STRATEGY POST COVID-19 AND DEVELOP PLAN FOR INCREASED ACCESS. INVEST IN EDUCATION, GUIDED ASSISTANCE AND FINANCIAL NAVIGATION RESOURCES TO SUPPORT THE MEDICAID ELIGIBLE, BUT NOT YET ENLISTED, POPULATION. INVEST IN DIGITAL ENHANCEMENTS THAT EDUCATE AND IMPROVE EASE-OF-USE. MENTAL HEALTH WITH MENTAL HEALTH CHALLENGES CONTINUING TO RISE ACROSS ALL DEMOGRAPHICS, WE COMMIT TO ADVOCACY, SYSTEM IMPROVEMENTS AND DEEP INVESTMENTS THAT ALLOW FOR GREATER ACCESS TO MENTAL AND BEHAVIORAL HEALTH PROVIDERS, EDUCATION AND RESOURCES. WE WILL CONTINUE TO ENCOURAGE COLLABORATION AND COMPASSIONATE CARE AND OUTREACH TO THOSE WHO STRUGGLE. ACTIONABLE ITEMS: DEVELOP NEW GOALS AND PATHWAYS FOR STANDARDIZED OPIOID PRESCRIBING SCHEDULES (SOPS) AND ENHANCED RECOVERY AFTER SURGERY PROGRAMS (ERAS) TO REDUCE THE NUMBER OF OPIOIDS PRESCRIBED. EXPAND BEHAVIORAL HEALTH SERVICES OF UNC PEDIATRICS AND ADOLESCENT PSYCHIATRY TO UNC REX MAIN AND UNC REX HOLLY SPRINGS EMERGENCY DEPARTMENTS. EXPAND UTILIZATION OF PROJECT ECHO AND COLLABORATION WITH UNCPN PRIMARY CARE SITES. INCREASE INVESTMENT IN TEAMMATE MENTAL HEALTH RESOURCES TO ENCOURAGE WELL-BEING AND LIMIT BURNOUT.

PART V, SECTION B, LINE 15E:
PROVIDED SEVERAL WAYS TO RETURN THE COMPLETED APPLICATION, SUCH AS, IN THE ENVELOPE PROVIDED, UPLOAD TO PROVIDED WEBSITE AND FAX NUMBER.

PART V, SECTION B, LINES 16A, 16B AND 16C:
WWW.REXHEALTH.COM/RH/PATIENTS-VISITORS/BILLING

PART V, SECTION B, LINE 20D:
TO ASSIST PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE, BUT CIRCUMSTANCES PREVENT COMPLETION OF A FULL APPLICATION, A PRESUMPTIVE DETERMINATION MAY BE UTILIZED.

PART I, LINE 7, COLUMN (F)
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24(c), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $64,081,927. PART III, SECTION A, LINE 2: THE ORGANIZATION'S BAD DEBT EXPENSE AS REPORTED ON THE AUDITED FINANCIAL STATEMENTS AND FORM 990 PART IX. THE COST-TO-CHARGE RATIO FOR THE YEAR WAS APPLIED TO THE GROSS BAD DEBT CHARGES FOR THE YEAR. PART III, SECTION A, LINE 3: THE ORGANIZATION'S BAD DEBT DOES NOT INCLUDE ANY AMOUNTS ATTRIBUTABLE TO THOSE PATIENTS WHO APPLIED FOR AND RECEIVED FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PART III, SECTION A, LINE 4: NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEWS, AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS AND INVESTIGATIONS. PART III, SECTION B, LINE 8: HOSPITALS TREAT PATIENTS COVERED BY MEDICARE, JUST AS THEY DO ANY PATIENT. AMOUNTS THAT HOSPITALS ARE ELIGIBLE TO RECEIVE IN PAYMENT FOR SERVICES PROVIDED TO PATIENTS COVERED BY MEDICARE ARE NOT NEGOTIABLE. AS MEDICARE REIMBURSEMENT RATES DECLINE RELATIVE TO THE COSTS OF PROVIDING CARE, HOSPITALS CONTINUE TO SERVE THE MEDICARE POPULATION. WITHOUT THE SERVICES PROVIDED BY HOSPITALS, THE GOVERNMENT WOULD BECOME OBLIGATED FOR THE SERVICES REQUIRED BY THESE PATIENTS. THEREFORE, WE BELIEVE THAT ANY UNREIMBURSED COSTS OF PROVIDING THIS CARE ARE A BENEFIT PROVIDED BY THE HOSPITAL TO THE COMMUNITY AND GOVERNMENT. PART III, SECTION C, LINE 9B: PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE APPROVED FOR 100 PERCENT ADJUSTMENT OF ELIGIBLE CHARGES MINUS A COPAYMENT. COPAYMENTS ACCRUE AND ARE NOT ELIGIBLE FOR COLLECTIONS PROCESSES.

PART VI, LINE 2:
AS THE COUNTY CONTINUES TO GROW, NECESSARY STEPS MUST BE TAKEN TO ENSURE THAT THE NEEDS OF ALL OF OUR CITIZENS ARE BEING MONITORED AND EVALUATED. WAKE COUNTY HUMAN SERVICES WORKS WITH ALL LOCAL HOSPITALS, INCLUDING REX, TO CONDUCT A COMMUNITY-WIDE HEALTH ASSESSMENT. THIS ASSESSMENT, CONDUCTED EVERY THREE TO FOUR YEARS, IDENTIFIES OPPORTUNITIES AND CHALLENGES IN THE MARKET. REX COLLABORATES WITH COMMUNITY PARTNERS REGULARLY TO ENSURE OUR EFFORTS ARE PROPERLY ALIGNED BASED ON WAKE COUNTY'S SOCIOECONOMIC AND DEMOGRAPHIC INFORMATION. REX ALSO RELIES ON INPUT FROM OUR PHYSICIANS AND CLINICAL STAFF, PATIENT OUTCOMES AS WELL AS QUALITATIVE AND QUANTITATIVE RESEARCH TO IDENTIFY AREAS OF OPPORTUNITY TO IMPROVE THE HEALTH OF OUR COMMUNITY.

PART VI, LINE 3
"REX PROVIDES A WIDE RANGE OF TOOLS AND EDUCATION TO HELP PATIENTS WHO NEED FINANCIAL ASSISTANCE. THE REX ASSIST PROGRAM IS DESIGNED TO MAKE IT EASY FOR PATIENTS TO APPLY FOR FINANCIAL ASSISTANCE, CHARITY CARE AND OTHER AID PROGRAMS. REX POSTS DETAILED INFORMATION ABOUT ITS GENEROUS CHARITY CARE POLICY, THE REX ASSIST PROGRAM AND OTHER FINANCIAL AID INFORMATION AT VARIOUS POINTS IN THE HOSPITAL AND ON ITS WEBSITE. DURING PATIENT REGISTRATION, STAFF WILL DISTRIBUTE THE ""YOUR REX HOSPITAL BILL"" FLYER TO ANYONE WHO DOES NOT HAVE INSURANCE OR ASKS FOR ASSISTANCE. THAT FLYER INCLUDES USEFUL INFORMATION AND HELPFUL RESOURCES. REX FINANCIAL COUNSELORS WILL BEGIN WORKING WITH PATIENTS NEEDING ASSISTANCE AT REGISTRATION OR VISIT THE ROOMS OF PATIENTS WHO ASK FOR HELP. THE COUNSELORS WILL ASSIST WITH DETERMINING MEDICAID ELIGIBILITY AND WITH FILLING OUT A REX ASSIST APPLICATION. FINALLY, REX ALSO WORKS WITH VARIOUS COMMUNITY GROUPS THAT HELP PROVIDE ASSISTANCE TO THE UNINSURED OR UNDERINSURED, INCLUDING PROJECT ACCESS, PRETTY IN PINK AND OTHERS. THE ANGEL FUND OF THE REX HEALTHCARE FOUNDATION ALSO SUPPORTS CANCER PATIENTS WITH UNIQUE FINANCIAL NEEDS, INCLUDING TRANSPORTATION, LIVING EXPENSES AND PRESCRIPTIONS."

PART VI, LINE 4:
THE ORGANIZATION SERVES AN AREA THAT ENCOMPASSES A FOUR-COUNTY AREA CONSISTING OF WAKE COUNTY AS THE PRIMARY SERVICE AREA WITH HARNETT, FRANKLIN AND JOHNSTON COUNTIES, COMPRISING THE SECONDARY SERVICE AREA. THE POPULATION OF WAKE COUNTY ACCORDING TO THE 2020 U.S. CENSUS IS 1,129,410. WAKE COUNTY IS THE MOST POPULOUS COUNTY IN NORTH CAROLINA. THE POPULATION OF WAKE COUNTY IS GROWING RAPIDLY, WITH A POPULATION OF 633,333 IN 2000 AND A PROJECTED POPULATION OF 1,730,067 PROJECTED FOR 2050. IN WAKE COUNTY, THE PERCENTAGE OF THE TOTAL POPULATION REPRESENTED BY THE URBAN POPULATION IS 93.9% AS OF 2010 DECENNIAL CENSUS, WITH ONLY 6.1% REPRESENTED BY THE RURAL POPULATION. THE POPULATION DENSITY IN WAKE COUNTY HAS INCREASED FROM 1,078 PERSONS PER SQUARE MILE IN 2010 TO 1,352 PERSONS PER SQUARE MILE IN 2020. THERE ARE A HIGHER PERCENTAGE OF FEMALES (51.4%) LIVING IN WAKE COUNTY THAN MALES (48.6%). MOST OF THE POPULATION IN WAKE COUNTY IS BETWEEN THE AGES OF 25-64 WITH 29.6% OF THE POPULATION BEING BETWEEN THE AGES OF 25 TO 44 AND 25.9% BETWEEN THE AGES OF 45-64. 23.6% OF THE POPULATION IS UNDER THE AGE OF 18 YEARS AND 12.0% OF THE POPULATION IS 65 YEARS OF AGE OR OLDER. THE WAKE COUNTY POPULATION 65 YEARS OF AGE OR OLDER IS PROJECTED TO GROW TO 20.9% BY 2050. IN TERMS OF RACIAL AND ETHNIC DIVERSITY, 57.1% OF THE POPULATION IDENTIFIES AS WHITE NON-HISPANIC, 18.1% AS BLACK OR AFRICAN AMERICAN NON-HISPANIC, 11.4% AS HISPANIC OR LATINO, 8.6% AS ASIAN NON-HISPANIC, 4.0% AS TWO OR MORE RACES AND NON-HISPANIC, 0.5% AS SOME OTHER RACE AND NON-HISPANIC, AND 0.2% AMERICAN INDIAN AND ALASKAN NATIVES NON-HISPANIC. WAKE COUNTY'S MEDIAN HOUSEHOLD INCOME WAS $80,591 BETWEEN 2015-2019, AMONG THE HIGHEST IN THE STATE. WAKE COUNTY'S PER CAPITA INCOME WAS $40,982 DURING THE SAME TIME PERIOD.

PART VI, LINE 5:
"THERE ARE MANY WAYS REX WORKS WITH COMMUNITY PARTNERS TO ADDRESS HEALTH ISSUES AND CONCERNS IDENTIFIED WITHIN THE COMMUNITY. THROUGH BOTH FINANCIAL, IN-KIND AND STAFF SUPPORT, REX PROVIDES ASSISTANCE IN HOSTING COMMUNITY HEALTH SCREENINGS, MOBILE MAMMOGRAPHY SCREENINGS AND ON-SITE MEDICAL CARE THROUGH THE REX EMERGENCY RESPONSE TEAM. ADDITIONALLY, COMMUNITY RELATIONS ACTIVITIES REGULARLY DEMONSTRATE PROMOTING HEALTH AND WELLNESS INITIATIVES. ""ASK THE EXPERT"" FORUMS ARE FREE AND OFFERED THROUGHOUT WAKE COUNTY BY PHYSICIANS AND STAFF. REX HAS BEEN DILIGENT IN AWARDING GRANTS TO COMMUNITY GROUPS TO ASSIST THEM WHERE NEEDS ARE GREATEST. TWICE A YEAR WE HOST A COLLABORATIVE BREAKFAST INVITING COMMUNITY PARTNERS, ORGANIZATIONS AND HEALTHCARE PROVIDERS WHO WORK WITH UNINSURED WOMEN TO DISCUSS AND ADDRESS CURRENT HARDSHIPS AND RESOURCES - TRULY A COMMITMENT TO THE NONPROFIT COMMUNITY."

PART VI, LINE 6:
REX HEALTHCARE IS A SUBSIDIARY OF THE UNC HEALTH CARE SYSTEM IN CHAPEL HILL. THAT SYSTEM SERVES PATIENTS FROM ALL 100 COUNTIES, REGARDLESS OF THEIR ABILITY TO PAY, PROVIDING MORE THAN $200 MILLION A YEAR IN UNCOMPENSATED CARE. AS PART OF THE INTEGRATED SYSTEM, REX STRIVES TO IMPROVE ACCESS AND SERVICES IN WAKE COUNTY'S GROWING AND UNDERSERVED AREAS. REX CAREGIVERS ALSO WORK CLOSELY WITH THEIR COUNTERPARTS AT UNC HEALTH CARE TO FIND MORE WAYS TO IMPROVE CARE AND QUALITY, REACH MORE UNINSURED PATIENTS AND MORE. REX'S BOARD REPRESENTS A CROSS-SECTION OF THE COMMUNITY, WITH VOLUNTEERS THAT INCLUDE BUSINESS LEADERS, COMMUNITY PHYSICIANS AND OTHERS. THAT BOARD WORKS CLOSELY WITH THE BOARD AT UNC HEALTH CARE TO DETERMINE THE BEST WAYS TO PLAY A LARGER ROLE IN IMPROVING THE COMMUNITY'S HEALTH, AND REX'S ROLE IN THE BIGGER SYSTEM'S MISSION.