Forsyth Community Pcc LLC

“Form 990, part vi, section a, line 2: family and/or business relationships business relationship richard lord chris prouty steven scoggins”

“Forsyth community pcc, llc ("fcpcc") has delegated management of administrative support services. The manager is responsible for certain management and administrative services including 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 current or former officers, directors, trustees, key employees or highest compensated employees were compensated by the management company for any services provided to fcpcc during the year.”

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

“The limited liability company's members, forsyth memorial hospital, inc. And and wake forest university baptist medical center, each appoint 1/2 of the board.”

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

“The return will be reviewed by the board prior to filing.”

“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 conflict of interest policy would be followed. The potential conflict of interest would be disclosed by the board member before a vote on the transaction and the rest of the board would determine whether a conflict of interest exists. If the rest of the board determined that a conflict of interest existed then the board member with the conflict of interest would not participate in the deliberations and vote.”

“Form 990, part vi, section c, line 19: governing documents disclosure no documents available to the public.”

“The filing entity's accounts payable function is managed by their support services provider, novant medical group, inc. (nmg) and as such, they do not issue 1099s directly. Information reported in part vii, section b represents the expenses paid on behalf of the filing entity to independent contractors over $100,000.”

“The promotion of health for the benefit of the community is a charitable purpose. Federal health care reform and other changes relating to the provision of health care services have made it increasingly critical for hospital systems and their constituent hospitals to be able effectively to align with other health care providers and physicians as they assume a greater role in providing care for identified at-risk populations. Forsyth community pcc, llc is a joint venture formed in 2018 between forsyth memorial hospital, inc. ("fmh") and wake forest university baptist medical center ("wake") to provide healthcare services in forsyth county, nc. Access to care is regularly identified as a significant and critical need in our community health needs assessments and addressing it is critical to sustaining a healthy community. The same can be said for affordability. After extensive due diligence and in light of their complementary mission and values, fmh and wake determined that they could work together to address these issues by creating this joint community care clinic, locating it in a historically underserved community, and providing healthcare services at nominal fees. The clinic is committed to ensuring access to high-quality, affordable, comprehensive healthcare for all residents of forsyth county, regardless of their insurance status or their ability to pay.”

“Outside services: program service expenses 28,230. Management and general expenses 804. Fundraising expenses 0. Total expenses 29,034. Contracted services: program service expenses 378,504. Management and general expenses 0. Fundraising expenses 0. Total expenses 378,504. Recruitment: program service expenses 1,909. Management and general expenses 39. Fundraising expenses 0. Total expenses 1,948. Professional physician services: program service expenses 681,698. Management and general expenses 0. Fundraising expenses 0. Total expenses 681,698.”