Duke University Health System Inc in Durham, North Carolina (NC)

Duke University Health System Inc
Employer Identification Number (EIN)	562070036
Name of Organization	Duke University Health System Inc
Address	615 Douglas St Ste 700, Durham, NC 27705-6616
Activities	Hospital, Health clinic, In faculty group practice association
Subsection	Charitable Organization
Ruling Date	06/1998
Deductibility	Contributions are deductible
Foundation	Hospital or medical research organization
Organization	Corporation
Exempt Organization Status	Unconditional Exemption
Tax Period	06/2013
Assets	$50,000,000 to greater
Income	$50,000,000 to greater
Filing Requirement	990 (all other) or 990EZ return
Asset Amount	$4,327,827,970
Amount of Income	$3,462,865,893
Form 990 Revenue Amount	$2,535,246,018
National Taxonomy of Exempt Entities (NTEE)	Health - General and Rehabilitative: Community Health Systems

Non-representatives - add comments:

Amount of income in 2013: $3,462,865,893

Duke University Health System Inc:	$3,462,865,893
Other organizations performing similar types of work:	$58,371,666

Assets in 2013: $4,327,827,970

Duke University Health System Inc:	$4,327,827,970
Other organizations performing similar types of work:	$115,495,398

Expenses in 2013: $2,239,941,917

Duke University Health System Inc:	$2,239,941,917
Other organizations performing similar types of work:	$46,510,321

Income to expenses ratio in 2013: 1.5

Duke University Health System Inc:	1.5
Other organizations performing similar types of work:	1.0

Expenses allocated to program services in 2007: 75.0%

This organization:	75.0%
Other organizations performing similar types of work:	86.6%

Number of employees in 2013: 17,633

Duke University Health System Inc:	17,633
Other organizations performing similar types of work:	360

Employees paid over $100,000 in 2013: 8.1%

Duke University Health System Inc:	8.1%
Other organizations performing similar types of work:	0.0%

Grants share in income in 2013: 0.3%

Duke University Health System Inc:	0.3%
Other organizations performing similar types of work:	0.0%

Financial snapshot ($)

Revenue for 2013

Assets at the end of 2013

Functional expenses for 2013

	2012	2013
Checklist
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?	Yes	Yes
Is the organization required to complete Schedule B, Schedule of Contributors?	Yes	Yes
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office?	No	No
Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year?	Yes	Yes
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19?	No	No
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts?	No	No
Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures?	No	No
Did the organization maintain collections of works of art, historical treasures, or other similar assets?	No	No
Did the organization report an amount for escrow or custodial account liability; serve as a custodian or provide credit counseling, debt management, credit repair, or debt negotiation services?	No	No
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments?	Yes	Yes
Did the organization report an amount for land, buildings, and equipment?	Yes	Yes
Did the organization report an amount for investments-other securities that is 5% or more of its total assets?	Yes	Yes
Did the organization report an amount for investments-program related that is 5% or more of its total assets?	No	No
Did the organization report an amount for other assets that is 5% or more of its total assets?	No	No
Did the organization report an amount for other liabilities?	Yes	Yes
Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)?	No	No
Did the organization obtain separate, independent audited financial statements for the tax year?	No	No
Was the organization included in consolidated, independent audited financial statements for the tax year?	Yes	Yes
Is the organization a school described in section 170(b)(1)(A)(ii)?	No	No
Did the organization maintain an office, employees, or agents outside of the United States?	No	No
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more?	Yes	Yes
Did the organization report more than $5,000 of grants or other assistance to or for any foreign organization?	No	No
Did the organization report more than $5,000 of aggregate grants or other assistance to or for foreign individuals?	No	No
Did the organization report a total of more than $15,000 of expenses for professional fundraising services?	No	No
Did the organization report more than $15,000 total of fundraising event gross income and contributions?	Yes	Yes
Did the organization report more than $15,000 of gross income from gaming activities?	No	No
Did the organization operate one or more hospital facilities?	Yes	Yes
Did the organization attach a copy of its audited financial statements?	Yes	Yes
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government?	Yes	Yes
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals?	Yes	Yes
Did the organization answer 'Yes' about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees?	Yes	Yes
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002?	Yes	Yes
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?	No	No
Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds?	No	No
Did the organization act as an 'on behalf of' issuer for bonds outstanding at any time during the year?	No	No
Did the organization engage in an excess benefit transaction with a disqualified person during the year?	No	No
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?	No	No
Did the organization report any amount for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons?	No	No
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons?	No	No
Was the organization a party to a business transaction with one of the following parties
A current or former officer, director, trustee, or key employee?	Yes	No
A family member of a current or former officer, director, trustee, or key employee?	Yes	Yes
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner?	Yes	Yes
Did the organization receive more than $25,000 in non-cash contributions?	Yes	Yes
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions?	Yes	Yes
Did the organization liquidate, terminate, or dissolve and cease operations?	No	No
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?	No	No
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3?	Yes	Yes
Was the organization related to any tax-exempt or taxable entity?	Yes	Yes
Did the organization have a controlled entity within the meaning of section 512(b)(13)?	Yes	Yes
Did the organization make any transfers to an exempt non-charitable related organization?	No	No
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes?	No	No

	2011	2012	2013
Statements Regarding Other IRS Filings and Tax Compliance
The number reported in Box 3 of Form 1096		345	578
The number of Forms W-2G		0	0
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners?		Yes	Yes
The number of employees reported on Form W-3, Transmittal of Wage and Tax Statements, filed for the calendar year ending with or within the year covered by this return		17,055	17,633
Did the organization file all required federal employment tax returns?		Yes	Yes
Did the organization have unrelated business gross income of $1,000 or more during the year?	No	No	No
Has it filed a Form 990-T for this year?		No	No
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?		Yes	Yes
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?		No	No
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?		No	No
Did the organization file Form 8886-T?		No	No
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?		No	No
Did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?		No	No
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?		Yes	Yes
Did the organization notify the donor of the value of the goods or services provided?		Yes	Yes
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?		No	No
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?		No	No
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?		No	No
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?		No	No
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?		No	No
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?		No	No
Did the sponsoring organization make any taxable distributions under section 4966?		No	No
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?		No	No
Initiation fees and capital contributions	$0	$0	$0
Gross receipts for public use of club facilities	$0	$0	$0
Gross income from members or shareholders	$0	$0	$0
Gross income from other sources	$0	$0	$0
Is the organization filing Form 990 in lieu of Form 1041?		No	No
The amount of tax-exempt interest received or accrued during the year		$0	$0
Is the organization licensed to issue qualified health plans in more than one state?		No	No
The amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans		$0	$0
The amount of reserves on hand		$0	$0
Did the organization receive any payments for indoor tanning services during the tax year?		No	No
Has it filed a Form 720 to report these payments?		No	No

	2012	2013
Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
Total reportable compensation from the organization	$7,547,831	$8,041,771
Total reportable compensation from related organizations	$4,997,031	$5,767,955
Total estimated amount of other compensation from the organization and related organizations	$1,778,969	$1,906,788
Total number of individuals who received more than $100,000 of reportable compensation from the organization	1,042	1,169
Total number of independent contractors who received more than $100,000 of compensation from the organization	255	253

	2011	2012	2013
Statement of Revenue
Total revenue	$2,368,562,555	$2,402,368,784	$2,535,246,018
Contributions, Gifts, Grants and Other Similar Amounts	$5,769,880	$11,631,914	$8,798,192
Program Service Revenue	$2,181,972,792	$2,304,899,882	$2,361,852,708
621990		$2,279,086,228	$2,334,666,124
621990		$23,103,169	$24,539,879
621990		$2,710,485	$2,646,705
All other program service revenue		$0	$0
Other Revenue
Investment income (including dividends, interest, and other similar amounts)	$13,857,767	$11,691,822	$-6,793,436
Income from investment of tax-exempt bond proceeds	$1,217,357	$775,200	$138,100
Royalties	$3,156,895	$2,335,261	$2,581,544
Net rental income	$955,357	$425,524	$1,128,523
Gross rents (Real / Personal)	$15,996,994 / $0	$15,390,286 / $0	$15,813,557 / $0
Less: rental expenses (Real / Personal)	$15,041,637 / $0	$14,964,762 / $0	$14,685,034 / $0
Rental income or (loss) (Real / Personal)	$955,357 / $0	$425,524 / $0	$1,128,523 / $0
Net gain/loss from sales of assets other than inventory	$106,102,357	$7,259,166	$94,601,611
Gross amount from sales of assets other than inventory (Securities / Other)	$331,220,664 / $622,471	$1,221,326,398 / $165,462	$1,007,370,832 / $86,146
Less: cost or other basis and sales expenses (Securities / Other)	$219,585,571 / $6,155,207	$1,214,140,468 / $92,226	$912,345,838 / $509,529
Gain or (loss) (Securities / Other)	$111,635,093 / $-5,532,736	$7,185,930 / $73,236	$95,024,994 / $-423,383
Net income/loss from fundraising events	$-14,172	$-20,528	$-29,758
Gross income from fundraising events	$64,389	$90,644	$49,716
Less: direct expenses	$78,561	$111,172	$79,474
Net income/loss from gaming activities	$0	$0	$0
Net income/loss from sales of inventory	$0	$0	$0
Miscellaneous Revenue	$55,544,322	$63,370,543	$72,968,534
621990		$39,580,345	$40,823,754
900003		$12,642,049	$19,440,994
900099		$1,917,192	$1,728,191
All other revenue		$9,230,957	$10,975,595

	2011	2012	2013
Statement of Functional Expenses
Total functional expenses	$2,098,358,480	$2,144,794,592	$2,239,941,917
Grants and other assistance to domestic organizations and domestic governments		$2,007,023	$884,701
Grants and other assistance to domestic individuals		$58,361	$53,025
Grants and other assistance to foreign organizations, foreign governments, and foreign individuals		$0	$0
Benefits paid to or for members		$0	$0
Compensation of current officers, directors, trustees, and key employees	$5,106,194	$5,673,191	$6,215,349
Compensation not included above, to disqualified persons		$186,192	$240,619
Other salaries and wages	$822,087,819	$859,604,127	$902,895,312
Pension plan accruals and contributions		$37,865,766	$46,049,521
Other employee benefits		$110,138,361	$128,690,800
Payroll taxes	$55,492,516	$62,277,499	$67,356,017
Fees for services (non-employees)
Management		$13,329,752	$13,444,312
Legal		$1,432,149	$231,801
Accounting		$476,500	$477,815
Lobbying		$0	$0
Professional fundraising services	$0	$0	$0
Investment management fees		$3,214,538	$2,610,734
Other		$146,215,135	$157,657,402
Advertising and promotion		$4,554,617	$4,705,831
Office expenses		$532,476,603	$539,900,189
Information technology		$30,673,109	$59,086,312
Royalties		$0	$0
Occupancy		$47,577,024	$51,617,168
Travel		$6,255,504	$6,179,720
Payments of travel or entertainment expenses for any federal, state, or local public officials		$0	$0
Conferences, conventions, and meetings		$3,440,775	$3,219,883
Interest		$36,084,598	$22,713,955
Payments to affiliates		$0	$0
Depreciation, depletion, and amortization		$91,892,122	$102,340,454
Insurance		$10,568,711	$7,840,244
Other expenses		$59,973,124	$50,919,306
Other expenses		$7,969,578	$47,796,902
Other expenses		$2,312,195	$8,863,759
Other expenses		$1,586,997	$2,633,019
Other expenses		$66,951,041	$5,317,767

	2011	2012	2013
Balance Sheet
Total assets	$3,519,120,113	$3,972,574,812	$4,327,827,970
Cash - non-interest-bearing		$49,073	$76,597
Savings and temporary cash investments		$586,721,228	$282,318,458
Pledges and grants receivable, net		$22,132,059	$11,269,708
Accounts receivable, net		$323,603,278	$331,741,223
Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees		$0	$0
Loans and other receivables from other disqualified persons, persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations		$0	$0
Notes and loans receivable, net		$1,242,411	$1,092,758
Inventories for sale or use		$66,770,331	$68,717,773
Prepaid expenses and deferred charges		$14,264,968	$15,394,082
Land, buildings, and equipment: cost or other basis		$1,262,266,106	$1,491,072,128
Investments - publicly traded securities		$2,778,265	$2,816,358
Investments - other securities		$1,674,659,624	$2,074,420,736
Investments - program-related		$0	$0
Intangible assets		$644,069	$644,069
Other assets		$17,443,400	$48,264,080
Total liabilities	$1,472,869,787	$2,025,063,125	$1,882,057,686
Accounts payable and accrued expenses		$318,183,821	$362,936,700
Grants payable		$0	$0
Deferred revenue		$9,272,886	$3,703,031
Tax-exempt bond liabilities	$830,779,105	$1,136,143,590	$1,107,827,649
Escrow or custodial account liability		$0	$0
Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons		$0	$0
Secured mortgages and notes payable to unrelated third parties	$0	$0	$0
Unsecured notes and loans payable to unrelated third parties	$0	$0	$0
Other liabilities (including federal income tax, payables to related third parties, and other liabilities)		$561,462,828	$407,590,306
Total net assets or fund balances	$2,046,250,326	$1,947,511,687	$2,445,770,284
Unrestricted net assets		$1,897,474,906	$2,398,823,195
Temporarily restricted net assets		$40,757,961	$36,082,851
Permanently restricted net assets		$9,278,820	$10,864,238
Capital stock or trust principal, or current funds		$0	$0
Paid-in or capital surplus, or land, building, or equipment fund		$0	$0
Retained earnings, endowment, accumulated income, or other funds	$0	$0	$0

Reason for Public Charity Status (for 2013)
The organization is not a private foundation because it is:	A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii)
Number of organizations supported	0
Sum of amounts of support	$0

	2000	2001	2002	2003	2004	2005	2006	2007
Revenue, Expenses, and Changes in Net Assets or Fund Balances
Total revenue	$1,227,614,069	$1,305,762,895	$1,367,133,655	$1,475,595,323	$1,666,993,115	$1,766,824,562	$1,829,091,209	$1,961,975,473
Contributions, gifts, grants, and similar amounts received	$2,274,308	$5,699,520	$3,414,956	$3,161,579	$13,317,058	$5,374,449	$8,144,978	$23,025,771
Contributions to donor advised funds							$0	$0
Direct public support	$2,274,308	$5,542,632	$2,783,980	$3,029,884	$12,921,675	$5,168,946	$7,819,569	$22,253,077
Indirect public support	$0	$0	$0	$0	$0	$0	$0	$0
Government contributions (grants)	$0	$156,888	$630,976	$131,695	$395,383	$205,503	$325,409	$772,694
Program service revenue including government fees and contracts	$1,135,642,571	$1,193,799,800	$1,261,317,152	$1,386,940,902	$1,602,772,420	$1,676,263,582	$1,739,374,786	$1,827,733,958
Membership dues and assessments	$0	$0	$0	$0	$0	$0	$0	$0
Interest on savings and temporary cash investments	$0	$0	$0	$0	$0	$0	$0	$0
Dividends and interest from securities	$0	$0	$5,866,679	$6,414,444	$6,361,206	$3,949,278	$5,676,899	$3,861,752
Net rental income or (loss)	$0	$2,297,491	$2,289,562	$17,318,960	$4,960,116	$3,795,442	$1,074,123	$1,976,027
Gross rents	$0	$2,297,491	$2,289,562	$17,318,960	$17,576,852	$17,925,524	$16,371,669	$17,575,603
Less: rental expenses	$0	$0	$0	$0	$12,616,736	$14,130,082	$15,297,546	$15,599,576
Other investment income	$0	$0	$0	$0	$0	$39,522,560	$35,167,373	$51,853,208
Gain or (loss) from sales of assets other than inventory	$28,884,297	$30,600,684	$18,436,227	$33,832,562	$6,308,366	$215,345	$-2,668,159	$9,949,264
Gross amount from sales of assets other than inventory	$28,884,297	$30,600,684	$20,495,856	$39,636,179	$33,630,497	$6,621,023	$2,295,577	$37,625,182
Less: cost or other basis and sales expenses	$0	$0	$2,059,629	$5,803,617	$27,322,131	$6,405,678	$4,963,736	$27,675,918
Net income or (loss) from special events and activities	$0	$0	$0	$0	$0	$0	$0	$0
Gross revenue	$0	$0	$0	$0	$0	$0	$0	$0
Less: direct expenses other than fundraising expenses	$0	$0	$0	$0	$0	$0	$0	$0
Gross profit or (loss) from sales of inventory	$0	$0	$0	$0	$0	$0	$0	$0
Gross sales of inventory, less returns and allowances	$0	$0	$0	$0	$0	$0	$0	$0
Less: cost of goods sold	$0	$0	$0	$0	$0	$0	$0	$0
Other revenue	$60,812,893	$73,365,400	$75,809,079	$27,926,876	$33,273,949	$37,703,906	$42,321,209	$43,575,493
Total expenses	$1,245,624,321	$1,262,781,906	$1,300,752,419	$1,376,758,208	$1,588,238,429	$1,676,173,768	$1,682,716,454	$1,771,486,703
Program services	$1,028,587,936	$833,939,254	$925,338,903	$1,022,487,207	$1,204,140,459	$1,181,338,135	$1,250,958,467	$1,328,362,302
Management and general	$217,036,385	$428,842,652	$375,413,516	$354,271,001	$384,097,970	$494,835,633	$431,630,372	$442,992,594
Fundraising	$0	$0	$0	$0	$0	$0	$127,615	$131,807
Payments to affiliates	$0	$0	$0	$0	$0	$0	$0	$0
Net assets or fund balances at end of year	$852,525,744	$788,465,710	$827,046,840	$970,707,222	$1,092,864,468	$1,078,724,859	$1,695,755,659	$1,892,598,361
Excess or (deficit) for the year	$-18,010,252	$42,980,989	$66,381,236	$98,837,115	$78,754,686	$90,650,794	$146,374,755	$190,488,770
Net assets or fund balances at beginning of year	$945,199,196	$852,525,744	$788,465,710	$827,046,840	$970,707,222	$1,092,864,468	$1,078,724,859	$1,695,755,659
Other changes in net assets or fund balances	$-74,663,200	$-107,041,023	$-27,800,106	$44,823,267	$43,402,560	$-104,790,403	$470,656,045	$6,353,932

	Total	Program services	Management and general	Fundraising
Statement of Functional Expenses (for 2007)
Total functional expenses	$1,771,486,703	$1,328,362,302	$442,992,594	$131,807
Grants paid from donor advised funds		$0
Other grants and allocations		$140,992,685
Specific assistance to individuals		$0
Benefits paid to or for members		$0
Compensation of current officers, directors, key employees, etc.	$2,050,811	$703,547	$1,347,264	$0
Compensation of former officers, directors, key employees, etc.	$46,650	$0	$46,650	$0
Compensation and other distributions, not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)	$0	$0	$0	$0
Salaries and wages of employees not included above	$682,986,589	$471,825,673	$211,085,608	$75,308
Pension plan contributions not included above	$20,624,728	$12,439,833	$8,180,378	$4,517
Employee benefits not included above	$69,621,063	$42,842,555	$26,776,457	$2,051
Payroll taxes	$45,521,216	$31,717,974	$13,798,171	$5,071
Professional fundraising fees	$0	$0	$0	$0
Accounting fees	$545,809	$3,421	$542,388	$0
Legal fees	$3,097,492	$107,285	$2,990,207	$0
Supplies	$350,199,474	$343,734,372	$6,462,240	$2,862
Telephone	$6,890,935	$3,241,306	$3,648,301	$1,328
Postage and shipping	$2,725,128	$937,034	$1,782,908	$5,186
Occupancy	$19,941,554	$19,941,554	$0	$0
Equipment rental and maintenance	$80,553,562	$42,232,887	$38,320,675	$0
Printing and publications	$3,958,063	$945,493	$3,002,117	$10,453
Travel	$5,969,625	$3,889,426	$2,079,694	$505
Conferences, conventions, and meetings	$3,267,258	$587,327	$2,659,465	$20,466
Interest	$20,387,249	$0	$20,387,249	$0
Depreciation, depletion, etc.	$68,922,584	$50,692,265	$18,230,319	$0
Other expenses not covered above	$243,184,228	$161,527,665	$81,652,503	$4,060

	2000	2001	2002	2003	2004	2005	2006	2007
Balance Sheets
Total assets	$1,709,811,216	$1,639,817,376	$1,690,329,412	$1,845,143,569	$2,044,250,902	$2,029,206,446	$2,694,990,252	$2,930,050,297
Cash - non-interest-bearing	$39,439,094	$48,875,056	$38,153,616	$47,677,867	$3,776,979	$54,637,373	$76,709,759	$98,114,735
Savings and temporary cash investments	$0	$0	$0	$0	$0	$0	$0	$0
Accounts receivable less allowance for doubtful accounts	$261,869,045	$255,313,016	$231,986,001	$264,281,717	$278,960,235	$282,248,027	$289,733,573	$278,122,801
Pledges receivable less allowance for doubtful accounts	$0	$0	$0	$0	$0	$0	$0	$16,000,000
Grants receivable	$0	$0	$0	$0	$0	$0	$0	$0
Receivables from current and former officers, directors, trustees, and key employees	$0	$0	$0	$0	$0	$0	$0	$0
Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)							$0	$0
Other notes and loans receivable less allowance for doubtful accounts	$0	$0	$0	$0	$0	$0	$0	$0
Inventories for sale or use	$21,045,371	$24,567,602	$28,678,490	$31,472,531	$34,217,972	$37,877,656	$42,610,859	$48,957,236
Prepaid expenses and deferred charges	$21,039,505	$18,568,981	$14,906,547	$43,098,972	$32,976,266	$30,267,561	$268,695,910	$321,323,676
Investments - publicly-traded securities							$33,603,277	$37,449,540
Investments - other securities	$587,022,459	$561,456,616	$640,415,351	$748,149,768	$966,067,545	$43,055,703	$0	$0
Investments - land, buildings, and equipment less accumulated depreciation	$0	$521,452	$521,452	$553,286	$546,144	$521,453	$521,453	$0
Investments - other	$2,047,772	$0	$0	$0	$0	$905,642,000	$1,198,832,051	$1,322,869,564
Land, buildings, and equipment less accumulated depreciation	$516,393,012	$505,902,331	$519,160,496	$505,926,240	$513,088,785	$561,992,565	$596,847,902	$645,594,567
Other assets, including program-related investments	$260,954,958	$224,612,322	$216,507,459	$203,983,188	$214,616,976	$112,964,108	$187,435,468	$161,618,178
Total liabilities	$857,285,472	$851,351,666	$863,282,572	$874,436,347	$951,386,434	$950,481,587	$999,234,593	$1,037,451,936
Accounts payable and accrued expenses	$119,959,444	$112,910,003	$145,623,980	$182,678,073	$164,094,485	$187,032,490	$185,420,493	$217,678,116
Grants payable	$0	$0	$0	$0	$0	$0	$0	$0
Deferred revenue	$15,928,182	$20,716,240	$5,851,214	$673,361	$8,818,059	$11,394,592	$997,967	$1,353,601
Loans from officers, directors, trustees, and key employees	$0	$0	$0	$0	$0	$0	$0	$0
Tax-exempt bond liabilities	$486,739,028	$479,267,241	$471,315,455	$433,263,668	$446,482,005	$435,098,249	$575,591,829	$565,711,867
Mortgages and other notes payable	$51,121,391	$27,141,391	$6,720,000	$0	$0	$0	$0	$0
Other liabilities	$183,537,427	$211,316,791	$233,771,923	$257,821,245	$331,991,885	$316,956,256	$237,224,304	$252,708,352
Total liabilities and net assets/fund balances	$1,709,811,216	$1,639,817,376	$1,690,329,412	$1,845,143,569	$2,044,250,902	$2,029,206,446	$2,694,990,252	$2,930,050,297
Total net assets or fund balances	$852,525,744	$788,465,710	$827,046,840	$970,707,222	$1,092,864,468	$1,078,724,859	$1,695,755,659	$1,892,598,361

	2000	2001	2002	2003	2004	2005	2006	2007
Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
Total revenue	$1,227,614,069	$1,305,762,895	$1,367,133,655	$1,475,595,323	$1,666,993,115	$1,766,824,562	$1,829,091,209	$1,961,975,473
Total revenue, gains, and other support per audited financial statements	$1,161,464,670	$1,233,084,413	$1,370,792,278	$1,563,493,801	$1,657,136,972	$1,933,467,432	$2,028,631,676	$1,903,386,874
Other expenses	$-66,149,399	$-72,678,482	$3,658,623	$87,898,478	$-22,552,831	$152,363,501	$185,642,218	$-70,750,261
Net unrealized gains on investments	$-66,149,399	$-72,678,482	$3,658,623	$87,898,478	$102,583,560	$196,410,504	$228,176,823	$-25,659,136
Donated services and use of facilities	$0	$0	$0	$0	$0	$0	$0	$0
Recoveries of prior year grants	$0	$0	$0	$0	$0	$0	$0	$0
Other	$0	$0	$0	$0	$-125,136,391	$-44,047,003	$-42,534,605	$-45,091,125
Other revenue	$0	$0	$0	$0	$-12,696,688	$-14,279,369	$-13,898,249	$-12,161,662
Investment expenses	$0	$0	$0	$0	$0	$0	$0	$0
Other	$0	$0	$0	$0	$-12,696,688	$-14,279,369	$-13,898,249	$-12,161,662

	2000	2001	2002	2003	2004	2005	2006	2007
Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
Total expenses	$1,245,624,321	$1,262,781,906	$1,300,752,419	$1,376,758,208	$1,588,238,429	$1,676,173,768	$1,682,716,454	$1,771,486,703
Total expenses and losses per audited financial statements	$1,245,624,321	$1,262,781,906	$1,300,752,419	$1,376,758,208	$1,475,798,726	$1,646,406,134	$1,654,080,098	$1,738,557,240
Other revenue	$0	$0	$0	$0	$12,696,688	$14,279,369	$13,898,249	$12,161,662
Donated services and use of facilities	$0	$0	$0	$0	$0	$0	$0	$0
Prior year adjustments	$0	$0	$0	$0	$0	$0	$0	$0
Losses	$0	$0	$0	$0	$0	$0	$0	$0
Other	$0	$0	$0	$0	$12,696,688	$14,279,369	$13,898,249	$12,161,662
Other expenses	$0	$0	$0	$0	$125,136,391	$44,047,003	$42,534,605	$45,091,125
Investment expenses	$0	$0	$0	$0	$0	$0	$0	$0
Other	$0	$0	$0	$0	$125,136,391	$44,047,003	$42,534,605	$45,091,125

Average hours per week devoted to position	Compensation	Contributions to employee benefit plans & deferred compensation plans	Expense account and other allowances
Current Officers, Directors, Trustees, and Key Employees
40	$408,268	$38,145	$0
40	$670,383	$33,164	$0
40	$823,954	$35,830	$41,067

Total number of officers, directors, and trustees permitted to vote on organization business at board meetings	19
Are any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, related to each other through family or business relationships?	Yes
Do any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, receive compensation from any other organizations, whether tax exempt or taxable, that are related to the organization?	Yes
Does the organization have a written conflict of interest policy?	Yes

Loans and Advances	Compensation	Contributions to employee benefit plans & deferred compensation plans	Expense account and other allowances
Former Officers, Directors, Trustees, and Key Employees That Received Compensation or Other Benefits
$0	$38,791	$7,859	$0

Other Information
Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return, and has it filed a tax return on Form 990-T for this year?	No
Was there a liquidation, dissolution, termination, or substantial contraction during the year?	No
Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization?	Yes
Direct and indirect political expenditures	$0
Did the organization file Form 1120-POL for this year?	No
Were substantially all dues nondeductible by members?
Did the organization make only in-house lobbying expenditures of $2,000 or less?
Dues, assessments, and similar amounts from members	$0
Section 162(e) lobbying and political expenditures	$0
Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices	$0
Taxable amount of lobbying and political expenditures	$0
Does the organization elect to pay the section 6033(e) tax on the amount above?
If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount above to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year?
Initiation fees and capital contributions	$0
Gross receipts for public use of club facilities	$0
At any time during the year, did the organization, directly or indirectly, own a controlled entity within the meaning of section 512(b)(13)?	Yes
Amount of tax imposed on the organization during the year under: section 4911	$0
Amount of tax imposed on the organization during the year under: section 4912	$0
Amount of tax imposed on the organization during the year under: section 4955	$0
Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year?	No
Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958	$0
Amount of tax above, reimbursed by the organization	$0
At any time during the tax year, was the organization a party to a prohibited tax shelter transaction?	No
Did the organization acquire a direct or indirect interest in any applicable insurance contract?	No
Did the supporting organization, or a fund maintained by a sponsoring organization, have excess business holdings at any time during the year?	No
Number of employees employed in the pay period that includes March 12, 2006	10,954

	Unrelated business income		Excluded by section 512, 513, or 514		Related or exempt function income
Analysis of Income-Producing Activities (for 2007)
	Business code	Amount	Exclusion code	Amount	Related or exempt function income
Total		$0		$71,911,573	$1,867,038,129
Program service revenue
Program service revenue 1	000000	$0	00	$0	$1,173,839,083
Program service revenue 2	000000	$0	00	$0	$27,106,283
Program service revenue 3	000000	$0	00	$0	$5,935,592
Program service revenue 4	000000	$0	00	$0	$0
Program service revenue 5	000000	$0	00	$0	$0
Medicare/Medicaid payments	000000	$0	00	$0	$620,853,000
Fees and contracts from government agencies	000000	$0	00	$0	$0
Membership dues and assessments	000000	$0	00	$0	$0
Interest on savings and temporary cash investments	000000	$0	00	$0	$0
Dividends and interest from securities	000000	$0	Dividends, interest, payments with respect to securities loans, annuities, income from notional principal contracts, loan commitment fees, and other substantially similar income from ordinary and routine investments excluded by section 512(b)(1)	$3,861,752	$0
Net rental income or (loss) from real estate
debt-financed property	000000	$0	00	$0	$0
not debt-financed property	000000	$0	Real property rental income that does not depend on the income or profits derived by the person leasing the property and is excluded by section 512(b)(3)	$1,976,027	$0
Net rental income or (loss) from personal property	000000	$0	00	$0	$0
Other investment income	000000	$0	Gain (or loss, to the extent allowed) from the sale of investments and other non-inventory property and from certain property acquired from financial institutions that are in conservatorship or receivership (sections 512(b)(5) and 512(b)(16)(A))	$51,853,208	$0
Gain or (loss) from sales of assets other than inventory	000000	$0	Gain (or loss, to the extent allowed) from the sale of investments and other non-inventory property and from certain property acquired from financial institutions that are in conservatorship or receivership (sections 512(b)(5) and 512(b)(16)(A))	$9,949,264	$0
Net income or (loss) from special events	000000	$0	00	$0	$0
Gross profit or (loss) from sales of inventory	000000	$0	00	$0	$0
Other revenue	000000	$0	Royalty income excluded by section 512(b)(2)	$4,271,322	$39,304,171

EIN of corporation, partnership, or disregarded entity	Percentage of ownership interest	Total income	End-of-year assets
Information Regarding Taxable Subsidiaries and Disregarded Entities (for 2007)
562070036	100%	$97,119,525	$16,292,634
562222444	100%	$108,755	$40,156
000000000	0%	$0	$0
000000000	0%	$0	$0

Compensation	Contributions to employee benefit plans & deferred compensation	Expense account and other allowances
Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (for 2007)
$499,623	$35,864	$11,369
$493,477	$38,324	$0
$483,969	$35,831	$0
$445,336	$32,691	$0
$386,867	$37,931	$7,987

Total number of other employees paid over $50,000	5,084

Total number of other employees paid over $50,000

5,084

Statements About Activities (for 2007)
Expenses paid or incurred in connection with the lobbying activities	$251,744
Did the organization receive or hold an easement for conservation purposes, including easements to preserve open space, the environment, historic land areas or historic structures?	No
Did the organization provide credit counseling, debt management, credit repair, or debt negotiation services?	No
Did the organization maintain any donor advised funds?	No
Did the organization make any taxable distributions under section 4966?	No
Did the organization make a distribution to a donor, donor advisor, or related person?	No
The total number of donor advised funds owned at the end of the tax year	$0
The aggregate value of assets held in all donor advised funds owned at the end of the tax year	$0
The total number of separate funds or accounts owned at the end of the tax year (excluding donor advised funds included above) where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts	$0
The aggregate value of assets held in all funds or accounts included above at the end of the tax year	$0

Reason for Non-Private Foundation Status
The organization is not a private foundation because it is	Hospital, or a cooperative hospital service organization

	1999	2000	2001	2002	2003	2004	2005	2006
Support Schedule
Total	$0	$0	$0	$0	$0	$0	$0	$0
Gifts, grants, and contributions received	$0	$0	$0	$0	$0	$0	$0	$0
Membership fees received	$0	$0	$0	$0	$0	$0	$0	$0
Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is related to the organization's charitable, etc., purpose	$0	$0	$0	$0	$0	$0	$0	$0
Gross income from interest, dividends, amounts received from payments on securities loans (section 512(a)(5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organization after June 30, 1975	$0	$0	$0	$0	$0	$0	$0	$0
Net income from unrelated business activities not included above	$0	$0	$0	$0	$0	$0	$0	$0
Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf	$0	$0	$0	$0	$0	$0	$0	$0
The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge	$0	$0	$0	$0	$0	$0	$0	$0
Other income	$0	$0	$0	$0	$0	$0	$0	$0

Lobbying Expenditures by Electing Public Charities (for 2007)
Total exempt purpose expenditures	$0
Total lobbying expenditures	$0
Total lobbying expenditures to influence public opinion (grassroots lobbying)	$0
Total lobbying expenditures to influence a legislative body (direct lobbying)	$0
Other exempt purpose expenditures	$0
Lobbying nontaxable amount	$0
Grassroots nontaxable amount	$0

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Id	Name	Address	State	Established	Total Income
Organizations performing similar types of work
1	Duke University Health System Inc	615 Douglas St Ste 700, Durham, NC 27705-6616	NC	1998-06	$3,462,865,893
2	Mission Health System Inc	Mission Finance Dept 400 Ridgefield, Asheville, NC 28806	NC	1982-03	$176,581,817
3	Foundation Health Systems Corp, Hawthorne Surgical Center	2085 Frontis Plaza Bld, Winston Salem, NC 27103	NC	1991-08	$57,783,600
4	Associated Health Services Inc	615 Douglas St Ste 700, Durham, NC 27705-6616	NC	1997-01	$12,538,694
5	Sisters Of Mercy Services Corporation	PO BOX 16367, Asheville, NC 28816-0367	NC	1982-07	$3,891,557
6	Wayne Health Corporation	PO BOX 8001, Goldsboro, NC 27533-8001	NC	1991-06	$363,278
7	St Vincents Health System Inc	4205 Belfort Rd Ste 4015, Jacksonville, FL 32216-3623	FL	1946-03	$66,865,460
8	Health Quest Medical Practice P C	1351 Route 55 Ste 200, Lagrangeville, NY 12540-5128	NY	2011-03	$60,477,199
9	Mercy Hospital Cassville	645 Maryville Centre Dr Ste 100, Saint Louis, MO 63141-5846	MO	1946-03	$20,740,287
10	Mount Nittany Health System	1800 E Park Ave, State College, PA 16803-6709	PA	2012-06	$11,322,798
11	Atenas Community Health Center Achc Inc	PO BOX 455, Manati	international	2014-11	$9,883,196
12	Triad Health Systems Inc, Triad Medical Clinic	PO BOX 845, Warsaw, KY 41095-0845	KY	2008-01	$2,034,457
13	Advanced Primary Care Physicians	501 Bath Rd, Bristol, PA 19007-3101	PA	2012-02	$694,036
14	Susquehanna Health Systems Inc	401 Broad Ave, Susquehanna, PA 18847-1611	PA	1998-02	$16,150
15	St Lukes Community Development Corporation - Pmc	6624 Fannin St, Houston, TX 77030-2312	TX	2014-01	$419
16	Lexhealth Inc	Po 1817 250 Hospital Drive, Lexington, NC 27293	NC	1986-08	$5
17	Bemc Med Pro Fees, Banner Health	1441 N 12th Street, Phoenix, AZ 85006	AZ		$0
18	Citizens Homeless Care Corporation	88 Black Falcon Ave Suite 342, Boston, MA 02210	MA	2002-09	$0
19	Cwh An Alliance Of Childrens Health System And Uab Health System	1600 7th Ave S, Birmingham, AL 35233-1711	AL	2002-06	$0
20	Ozarks Health Services Inc	1235 E Cherokee St, Springfield, MO 65804-2203	MO	1946-03	$0

Number of organizations performing similar types of work

Alaska	1
Alabama	5
Arizona	8
California	23
Colorado	15
Connecticut	6
Florida	22
Georgia	16
Hawaii	2
Iowa	3
Illinois	19
Indiana	7
Kansas	2
Kentucky	6
Louisiana	3
Massachusetts	15
Maryland	13
Maine	3
Michigan	15
Minnesota	9
Missouri	12
Mississippi	2
Montana	1

North Carolina	7
North Dakota	1
Nebraska	7
New Hampshire	3
New Jersey	8
New Mexico	1
Nevada	2
New York	12
Ohio	26
Oklahoma	6
Oregon	2
Pennsylvania	32
Rhode Island	4
South Carolina	7
Tennessee	10
Texas	20
Utah	1
Virginia	10
Vermont	3
Washington	4
Wisconsin	6
West Virginia	6
International	2

Total

388

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