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Novant Health.

Another sharp climb in investment income for Novant Health Inc. contributed to $278.2 million in excess revenue for the second quarter, the not-for-profit health system reported Friday.

Excess revenue over expenses in a not-for-profit organization, such as Novant, equates to profit in a for-profit business.

By comparison, Novant had excess revenue of $124.5 million in the second quarter of fiscal 2018.

Core operating income fell 46% to $58.6 million compared with last year.

However, the not-for-profit health system had a $221.3 million investment gain, compared with a $17.5 million gain a year ago. Not-for-profit hospitals depend on investment income to increase their bottom lines and to help pay for capital projects.

Novant reported $2.66 billion in core operating revenue, up 11.2%. Novant reported $169.2 million in “other income,” compared with $123.9 million a year ago.

Operating expenses rose 14.2% to $2.43 billion.

In the Triad, Novant Health owns and manages Forsyth, Clemmons, Kernersville and Thomasville medical centers as well as Medical Park Hospital in Winston-Salem.

The system has 28,092 employees overall in its four-state network, including about 8,145 in Forsyth County.

It spent $186.6 million on capital projects during the quarter, compared with $169.1 million a year ago.

The system did not list a provision for bad debt for the sixth consecutive quarter. For fiscal 2017, the provision for bad debt was at $212.9 million, up from $204.5 million a year earlier.

According to the American Hospital Association, bad debt is defined as services for which hospitals anticipated, but did not receive, payment from patients who had the financial means to pay.

Novant’s report was listed — as usual, without management commentary — at the Municipal Securities Rulemaking Board’s website,

The reports are aimed primarily at bondholders and ratings agencies, and typically are submitted about two months after the end of a quarter.

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