Forsyth Community Pcc LLC

“Form 990, part vi, section a, line 2: family and/or business relationships business relationship richard lord amanda burton steven scoggin”

“The organization has delegated management of its administrative support services. The manager is responsible for non-clinical operational oversight, utilization review and quality assurance, marketing and branding, financial management including accounting, budget preparation, billing and collections, provider contracting and credentialing, facilities and information technology management, regulatory and risk management, contracting/purchasing services, and recruitment/personnel staffing services. No trustees and/or officers are compensated by the management company for services rendered to the organization during the year.”

“Form 990, part vi, section a, line 6: classes of members or stockholders the organization is a north carolina limited liability company with members.”

“The limited liability company's members, forsyth memorial hospital, inc. And wake forest university baptist medical center, each appoint one half of the board.”

“The limited liability company's members, forsyth memorial hospital, inc. And wake forest university baptist medical center, approve certain transactions and changes to the operating agreement.”

“The organization's board of trustees receives a copy of form 990 with sufficient time to review and comment prior to filing. If material revisions are required following the board review period, a revised form 990 is redistributed to the board trustees prior to filing with the irs.”

“The organization's conflict of interest policy applies to all trustees including members of a committee with board delegated powers. With respect to particular transactions that come before the board, the potential conflict of interest would be disclosed by the board trustee before a vote on the transaction. The remaining trustees would determine whether or not a conflict of interest exists. If it is determined that a conflict of interest exists, then the board trustee with the conflict of interest would not particpate in the deliberations and vote for that particular transaction.”

“Form 990, part vi, section c, line 19: governing documents disclosure the organization's articles of organization are available to the public on request and are available on the website of the north carolina secretary of state. The operating agreement is not published or available to the public.”

“The organization's accounts payable function is managed by their management/administrative service provider, novant medical group, inc., an organization affiliated with novant health, inc. The organization does not issue forms 1099 directly. The information reported in part vii section b represents expenses paid on behalf of the filing organization by novant health, inc.”

“Forsyth community pcc, llc, doing business as highland avenue primary care clinic, is a joint venture health care clinic formed in 2018 between forsyth memorial hospital, inc. And wake forest university baptist medical center to provide healthcare services in forsyth county, nc. This joint community care clinic, located in a historically underserved community and providing healthcare services at nominal fees, is committed to ensuring access to high-quality, affordable, comprehensive healthcare for all residents of forsyth county, regardless of their insurance status or ability to pay.”

“Outside services: program service expenses 11,349. Management and general expenses 529. Fundraising expenses 0. Total expenses 11,878. Contracted services: program service expenses 317,504. Management and general expenses 0. Fundraising expenses 0. Total expenses 317,504. Professional physician services: program service expenses 403,218. Management and general expenses 0. Fundraising expenses 0. Total expenses 403,218.”

“Capital contributions 1,000,000.”