2023-08-07T07:14:24-05:00 2022-09-30 440160260 FORVIS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2021-10-01 043633263 WACCAMAW COMMUNITY HOSPITAL WACC 8435277102 PO BOX 421718 GEORGETOWN SC 29442 ELIZABETH WARD EVP & CFO 8435277102 2023-08-07 1 ELIZABETH WARD 999009999 AMY BIBBY P00445891 8282542254 2023-08-07 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z TIDELANDS WACCAMAW COMMUNITY HOSPITAL BRUCE P BAILEY PO BOX 421718 GEORGETOWN SC 29442 210285970 0 X WWW.TIDELANDSHEALTH.ORG X 2002 SC TO PROVIDE HIGH QUALITY HEALTHCARE TO THE CITIZENS OF GEORGETOWN CO. AND SURROUNDING AREAS. 15 10 0 73 0 0 2251986 200633 200614391 204240364 374625 9497 5184563 5829170 208425565 210279664 0 0 0 0 50578983 60509025 0 0 0 122586173 132837513 173165156 193346538 35260409 16933126 320687965 326122356 120687431 109188696 200000534 216933660 X WE HELP PEOPLE LIVE BETTER LIVES THROUGH BETTER HEALTH. 0 0 167959460 204240364 WACCAMAW COMMUNITY HOSPITAL PROVIDES QUALITY HEALTH CARE AND PROMOTES HEALTH AND WELLNESS TO THE RESIDENTS OF GEORGETOWN COUNTY AND SURROUNDING AREAS. WACCAMAW COMMUNITY HOSPITAL IS A 124 BED ACUTE CARE FACILITY LOCATED IN MURRELLS INLET, SOUTH CAROLINA. THE HOSPITAL WAS ORGANIZED UNDER THE LAWS OF THE STATE OF SOUTH CAROLINA IN 2002 FOR THE PURPOSE OF OPERATING A COMMUNITY SATELLITE HOSPITAL IN THE NORTHERN PART OF GEORGETOWN COUNTY. PLEASE SEE SCHEDULE O FOR A CONTINUATION OF PROGRAM SERVICE ACCOMPLISHMENTS.THE HOSPITAL WAS CREATED FOR THE PURPOSE OF PROMOTING HEALTH FOR ALL RESIDENTS OF GEORGETOWN COUNTY AND ITS OUTLYING AREAS. THE PROMOTION OF HEALTH HAS BEEN ESTABLISHED AS A CHARITABLE PURPOSE UNDER INTERNAL REVENUE CODE (IRC) SECTION 501 (C)(3). REVENUE RULE 69-545, 1969-2 C.B. 117, AS MODIFIED BY REC. RUL. 83-157, 1983-2 C.B. 94, SETS FORTH THE FACTORS THE INTERNAL REVENUE SERVICES WILL CONSIDER IN DETERMINING WHETHER A NONPROFIT HOSPITAL QUALIFIES FOR TAX EXEMPT STATUS.THE HOSPITAL OPERATES ITS FACILITIES IN A MANNER DESCRIBED IN REV. RULING 69-545, SUPRA. THE HOSPITAL HAS A BOARD OF TRUSTEES COMPOSED OF INDEPENDENT CIVIC LEADERS AND PHYSICIANS. AN OPEN MEDICAL STAFF IS MAINTAINED BY THE HOSPITAL, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS. ALSO, THE HOSPITAL PROVIDES EMERGENCY AND NON-EMERGENCY CARE TO ANYONE REGARDLESS OF THEIR ABILITY TO PAY, EITHER DIRECTLY OR THROUGH THIRD PARTY REIMBURSEMENT, INCLUDING MEDICARE AND MEDICAID.DURING THE YEAR ENDED SEPTEMBER 30, 2022, THE HOSPITAL FURNISHED CHARITY CARE IN THE AMOUNT OF $22,125,976. IN ADDITION TO PROVIDING PATIENT CHARITY CARE, AND IN FURTHERANCE OF ITS EXEMPT PURPOSE TO BENEFIT THE COMMUNITY, THE HOSPITAL PROVIDES CAR SEATS TO FAMILIES AND NEWBORN INFANTS WHO DO NOT PRESENTLY HAVE OR CANNOT AFFORD TO PURCHASE ONE. IN ADDITION, THE HOSPITAL PROVIDES FREE TAXI SERVICE THROUGH AN AUXILIARY ORGANIZATION FOR INDIVIDUALS THAT CANNOT AFFORD OR ARRANGE FOR TRANSPORTION TO THEIR RESIDENCE OR HEALTHCARE SERVICE. THE HOSPITAL ALSO PARTICIPATES IN STATE PROGRAMS SUCH AS THE BEST CHANCE NETWORK, WHICH TARGETS LOW-INCOME WOMEN FOR PREVENTATIVE HEALTHCARE TESTING.THE HOSPITAL IS PART OF THE GEORGETOWN HOSPITAL SYSTEM WHICH PERIODICALLY CONDUCTS VARIOUS COMMUNITY OUTREACH, SCREENING, AND EDUCATIONAL PROGRAMS. AMONG THESE ARE CHOLESTEROL AND BLOOD PRESSURE SCREENINGS, PERIODIC HEALTH FAIRS HELD THROUGHOUT THE SERVICE AREA WHICH OFFER A VARIETY OF HEALTH-RELATED INFORMATION AND SCREENINGS, SUCH AS GLUCOSE, CHOLESTEROL, BLOOD PRESSURE, BODY FAT ANALYSIS, AND A LABORATORY BLOOD PROFILE. THE HOSPITAL SYSTEM'S COMMUNITY EDUCATION PROGRAM CONDUCTS A VARIETY OF CLASSES AND LECTURE SERIES OPEN TO THE PUBLIC, INCLUDING CPR, WEIGHT CONTROL, SMOKING CESSATION, CHILDBIRTH EDUCATION, PRE-NATAL AND INFANT NUTRITION, AND OTHERS. 167959460 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 1 X 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 SC X X ELIZABETH S WARD EVP & CFO 8435277102 606 BLACK RIVER ROAD GEORGETOWN SC 29440 MR J EDWARD NORRIS III TRUSTEE 1.00 2.00 X 0 0 0 MR DANIEL SCHEFFING TRUSTEE 1.00 2.00 X 0 0 0 MR JULIAN A REYNOLDS JR CHAIRMAN 1.00 2.00 X X 0 0 0 MR FRANCIS B FORD JR TRUSTEE 1.00 2.00 X 0 0 0 MR ROBERT L JONES VICE CHAIRMAN 1.00 2.00 X X 0 0 0 MS JUDITH K INGLE SECRETARY/TREASURER 1.00 2.00 X X 0 0 0 MR TONY JORDAN TRUSTEE 1.00 2.00 X 0 0 0 DR MARTHENA MORANT TRUSTEE 1.00 2.00 X 0 0 0 MR WILLIE SHELLEY JR TRUSTEE 1.00 2.00 X 0 0 0 MR MARK NASH TRUSTEE 1.00 2.00 X 0 0 0 MR DAN STACY JR TRUSTEE 1.00 2.00 X 0 0 0 DR CHRISTINE GERBER TRUSTEE & PHYSICIAN 1.00 2.00 X 6325 6325 0 DR WILLIAM GREER TRUSTEE & PHYSICIAN 1.00 42.00 X 34213 948958 33389 DR J MICHAEL RATLIFFE VICE CHIEF OF STAFF & PHYSICIAN 1.00 2.00 X 613 613 0 DR THOMAS CHANDLER CHIEF OF STAFF & PHYSICIAN 1.00 2.00 X 11757 11757 0 BRUCE BAILEY PRESIDENT & CEO 21.00 19.00 X 433411 383420 37303 GAYLE RESETAR EXECUTIVE VICE PRESIDENT & COO 21.00 19.00 X 298371 263955 25152 ELIZABETH WARD EXECUTIVE VICE PRESIDENT & CFO 21.00 19.00 X 324547 287110 33784 PHILIP DULBERGER EXECUTIVE VICE PRESIDENT & CHIEF PHYSICIAN EXECUTI 21.00 19.00 X 356794 315640 30306 JAMES F HARPER CHIEF HUMAN RESOURCE OFFICER/EVP 21.00 19.00 X 208794 184710 39394 GERALD HARMON VP MEDICAL AFFAIRS 21.00 19.00 X 238756 211216 14267 GARY METCALFE VP SUPPLY CHAIN & SUPPORT SERVICES 21.00 19.00 X 148661 131512 22271 JOHN LAROCHELLE VP OPERATIONS 21.00 19.00 X 132770 117454 37992 MICAH NAUS VP / CHIEF INFORMATION OFFICER 21.00 19.00 X 143620 127054 26151 2338632 2989724 300009 136 0 1 1 SODEXO INC PO BOX 360170 PITTSBURGH PA 15251 DIETARY & HOUSEKEEPING 4611444 PALMETTO EMERGENCY PHYSICIANS 86 SHOREBIRD LOOP PAWLEYS ISLAND SC 29585 EMERGENCY PHYSICIAN SERVICES 3912208 AYA HEALTHCARE 5930 CORNERSTONE COURT WEST 300 SAN DIEGO CA 92121 CONTRACT CLINICAL STAFF 3776457 INLET ANESTHESIA CONSULTANTS 130 PRESERVATION CIRCLE PAWLEYS ISLAND SC 29585 ANESTHESIA SERVICES 2837072 COASTAL STRUCTURES CORPORATION PO BOX 937 GEORGETOWN SC 29442 CONSTRUCTION 2451112 55 79645 120988 200633 NET PATIENT SERVICE REVENUE 621400 198331562 198331562 OTHER RELATED SERVICES 900099 3575676 3575676 PHARMACY 446110 1994798 1994798 CAFETERIA 722514 338328 338328 204240364 6405 6405 5761716 0 5761716 5761716 5761716 3092 0 3092 3092 3092 22748 6306 16442 16442 PENSION TERMINATION REVENUE 900099 51012 51012 51012 210279664 204240364 0 5838667 X 1466031 52908 1413123 4207539 4207539 44545068 44545068 1048835 1048835 6068333 6068333 3173219 3173219 431115 431115 2723161 2723161 64930 64930 140189 140189 57033438 37279150 19754288 401753 238 401515 2506382 2379101 127281 2592576 2521200 71376 110063 109453 610 1806540 1806540 8697532 8280436 417096 918095 844177 73918 MEDICAL SUPPLIES 39178531 39178531 BAD DEBT EXPENSE 15575517 15575517 MISCELLANEOUS EXPENSE 429606 429606 RECRUITMENT 228085 28494 199591 193346538 167959460 25387078 0 3500 3500 28953 30942 40341612 32378681 2803330 3440190 2852195 2818435 293076937 121292895 139382496 171784042 1000000 1000000 134275879 114666566 320687965 326122356 9212596 13330952 94106090 91280744 17368745 4577000 120687431 109188696 X 199655846 216902172 344688 31488 200000534 216933660 320687965 326122356 16933126 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 146417 146417 0 PART II-B, LINE 1: THE HOSPITAL IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE SOUTH CAROLINA HOSPITAL ASSOCIATION (SCHA). NELSON MULLINS RILEY SCARBOROUGH, LLP IS ALSO ENGAGED TO PROVIDE VARIOUS PROFESSIONAL SERVICES. THESE ORGANIZATIONS ENGAGE IN LOBBYING ACTIVIES FOR THE BENEFIT OF MEMBERS AND CLIENTS AND A PORTION OF THE EXPENSE PAID IS ATTRIBUTABLE TO LOBBYING EXPENDITURES. FOR THE YEAR, THE PORTION OF THE EXPENSES ATTRIBUTATE TO LOBBYING EXPENDITURES WAS $2,724 FOR AHA, $3,504 FOR SCHA AND $140,189 FOR NELSON MULLINS RILEY SCARBOROUGH LLP. 21715564 21715564 173167692 53174802 119992890 2680470 1832790 847680 80477152 66285303 14191849 15036059 15036059 171784042 OTHER RECEIVABLES 98122 DUE FROM AFFILIATES 114568444 114666566 ESTIMATED THIRD-PARTY SETTLEMENTS 4577000 4577000 X 194710453 -15575517 -15575517 210285970 -6306 -6306 210279664 177777327 -15575517 -15575517 193352844 -6306 -6306 193346538 PART X, LINE 2: WACCAMAW COMMUNITY HOSPITAL HAS BEEN GRANTED EXEMPTION FROM INCOME TAXES AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. ACCORDINGLY, THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A PROVISION FOR INCOME TAXES. THE HOSPITAL HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2022. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT NET WITH REVENUE -15,575,517. PART XI, LINE 4B - OTHER ADJUSTMENTS: COST OF GOODS SOLD NET WITH REVENUE -6,306. PART XII, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT NET WITH REVENUE -15,575,517. PART XII, LINE 4B - OTHER ADJUSTMENTS: COST OF GOODS SOLD NET WITH REVENUE -6,306. 1 1 X 1 X 0 1 1 0 1 1 2993984 70123 2923861 0.01640 13660036 12912692 747344 0.00420 16654020 12982815 3671205 0.02060 2115249 2115249 0.01190 7025455 2261711 4763744 0.02680 265550 76275 189275 0.00110 9406254 2337986 7068268 0.03980 26060274 15320801 10739473 0.06040 2357 2357 0.00000 14296 14296 0.00010 589 589 0.00000 511846 511846 0.00290 529088 529088 0.00300 0 5637709 2094333 79324525 91793262 -12468737 X 1 1 1 1 WACCAMAW COMMUNITY HOSPITAL 4070 HIGHWAY 17 BYPASS MURRELLS INLET SC 29576 X X X X DISPROPORTIONATE SHARE HOSPITAL WACCAMAW COMMUNITY HOSPITAL 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X SEE PART V, SECTION C X X 1 21 1 SEE PART V, SECTION C 0 1 X 200.000000000000 X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X 1 X 0 0 WACCAMAW COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: THE 2022 TIDELANDS HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY WAS DESIGNED IN CONJUNCTION WITH GEORGETOWN AND HORRY COUNTY PARTNERS AND UTILIZED METHODOLOGY AND BEST PRACTICES IDENTIFIED BY LEADING NATIONAL RESEARCH HOSPITALS. SURVEYS WERE SENT OUT ELECTRONICALLY AND BY PAPER TO COMMUNITY NONPROFIT LEADERS, GOVERNMENT OFFICIALS, SCHOOL DISTRICTS, MEDICAL FACILITIES, FAITH LEADERS, BUSINESS LEADERS, KEY TIDELANDS HEALTH STAFF MEMBERS, AND THE COMMUNITY AT LARGE. TIDELANDS HELD TWO EVENTS TO SELECT THE MOST SIGNIFICANT NEEDS BASED ON THE 2019 CHNA SURVEY. WACCAMAW COMMUNITY HOSPITAL PART V, SECTION B, LINE 6A: GEORGETOWN MEMORIAL HOSPITAL WACCAMAW COMMUNITY HOSPITAL PART V, SECTION B, LINE 6B: QUORUM HEALTH RESOURCES PROVIDED THE EXPERTISE TO COMPLETE THE CHNA IN PARTNERSHIP WITH TIDELANDS HEALTH REPRESENTATIVES. WACCAMAW COMMUNITY HOSPITAL PART V, SECTION B, LINE 7D: ALL TCCN PARTNERS WERE SENT AN ELECTONIC COPY. WACCAMAW COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: THE SIGNIFICANT NEEDS IDENTIFIED AND SELECTED ARE HEALTH CARE AFFORDABILITY AND ACCESS, CANCER, HEART DISEASE, MENTAL HEALTH, DIABETES, WOMEN'S HEALTH. PART V, LINE 7A, CHNA WEBSITE: HTTPS://WWW.TIDELANDSHEALTH.ORG/DISCOVER/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, LINE 10A: IMPLEMENTATION STRATEGY WEBSITE: HTTPS://WWW.TIDELANDSHEALTH.ORG/DISCOVER/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, LINE 16B & C, FAP, FAP APPLICATION & PLAIN LANGUAGE SUMMARY: HTTP://WWW.TIDELANDSHEALTH.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/ 9 1 - TIDELANDS HEALTH IMAGING AT MURRELLS INL 4181 HIGHWAY 17 MURRELLS INLET SC 295765019 IMAGING CENTER 2 - TIDELANDS HEALTH PAIN MANAGEMENT SERVICE 4040 HIGHWAY 17 UNIT 206 MURRELLS INLET SC 295765098 PAIN MANAGEMENT 3 - TIDELANDS HEALTH ENDOSCOPY CENTER AT MUR 4040 HIGHWAY 17 UNIT 102 MURRELLS INLET SC 295765098 ENDOSCOPY 4 - TIDELANDS HEALTH IMAGING AT WACCAMAW MED 4040 HIGHWAY 17 UNIT 103 MURRELLS INLET SC 295765098 IMAGING CENTER 5 - TIDELANDS HEALTH REHABILITATION SERVICES 198 VILLAGE CENTER BLVD MYRTLE BEACH SC 295796618 ADULT REHABILITATION 6 - TIDELANDS HEALTH REHABILITATION SERVICES 543 HIGHWAY 17 N NORTH MYRTLE BEACH SC 295822903 ADULT REHABILITATION 7 - TIDELANDS HEALTH WOMEN'S IMAGING 4017 HIGHWAY 17 MURRELLS INLET SC 295765032 IMAGING CENTER 8 - TIDELANDS HEALTH LAB AT THE MARKET COMMO 2200 CROWE LN MYRTLE BEACH SC 295771663 LABORATORY SERVICES 9 - TIDELANDS HEALTH CARDIAC REHABILIATION S 4040 HIGHWAY 17 UNIT 203 MYRTLE BEACH SC 295765098 ADULT REHABILITATION PART I, LINE 7: THE ORGANIZATION USED WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS TO COMPUTE A COST-TO-CHARGE RATIO USED TO CALCULATE CHARITY CARE AND UNREIMBURSED MEDICAID AT COST. PART I, LN 7 COL(F): TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25 CONTAINS A BAD DEBT EXPENSE OF $15,575,517 THAT HAS BEEN REMOVED FOR PURPOSES OF COMPUTING PERCENTAGE OF TOTAL EXPENSE ON COLUMN (F). PART II, COMMUNITY BUILDING ACTIVITIES: $511,846 WAS SPENT TO RECRUIT PHYSICIANS WITH THE SKILLS AND TRAINING NECESSARY TO BEST SERVE THE NEEDS OF THE COMMUNITY IN AREAS SUCH AS OBSTETRICS/GYNECOLOGY AND PULMONOLOGY. THE COVID 19 PANDEMIC HAS CAUSED SIGNIFICANT TURNOVER IN HEALTHCARE AND WE HAVE BEEN FORCED TO DEDICATE MATERIAL RESOURCES TO THE RECRUITMENT AND REPLACEMENT OF CLINICAL STAFF TO PROVIDE MUCH NEEDED PATIENT CARE. THE WORKFORCE MARKET HAS BECOME INCREDIBLY COMPETITIVE AND WE HAVE THE NEED TO BE CREATIVE IN PROVIDING INCENTIVES FOR HEALTHCARE PROFESSIONALS TO COME TO OUR SYSTEM. PART III, LINE 3: FOR AUDITED FINANCIAL STATEMENT PURPOSES, IN 2022, THE ORGANIZATION ASSESSED THE POPULATION OF PATIENTS UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE RESPONSIBLE IN CONJUNCTION WITH STATISTICS OF THE LOCAL POPULATION FALLING BELOW FEDERAL POVERTY LIMITS. THE ORGANIZATION BELIEVES A SIGNIFICANT PORTION OF THE UNPAID PATIENT SERVICES WOULD QUALIFY FOR CHARITY CARE IF THE PATIENT WERE TO APPLY IN ACCORDANCE WITH THE CURRENT POLICY. AS A RESULT, CHARITY CARE, AT CHARGES RECLASSIFIED FROM BAD DEBT TOTALED $ 9,206,000. THE IMPACT OF THIS RECLASSIFICATION HAS BEEN REMOVED FOR SCHEDULE H PRESENTATION PURPOSES. PART III, LINE 4: THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE ON BAD DEBT EXPENSE.WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS WAS USED TO COMPUTE A COST-TO-CHARGE RATIO USED TO CALCULATE BAD DEBT EXPENSE AT COST FOR PURPOSES OF LINE PART III, LINES 2 AND 3.THE PERCENTAGE OF FAMILIES BELOW THE POVERTY LEVEL IN THE AREA SERVED IS USED TO ESTIMATE THE PERCENTAGE OF NET REVENUE EXPECTED TO BE AWARDED CHARITY CARE. THE VARIANCE WITH ACTUAL CHARITY CARE ADJUSTMENTS IS THE AMOUNT OF THE ORGANIZATION'S BAD DEBT ATTRIBUTED TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. PART III, LINE 8: THE MEDICARE COST REPORT WAS USED TO CALCULATE THE OVERALL SHORTFALL. THE ORGANIZATION BELIEVES THE ENTIRE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT. APPROXIMATELY 60% OF THE ORGANIZATION'S PAYER MIX IS DEVOTED TO MEDICARE. PART III, LINE 9B: GEORGETOWN HOSPITAL SYSTEM HAS A PROCESS IN PLACE TO ASSIST PATIENTS IN UNDERSTANDING THEIR FINANCIAL RESPONSIBILITY, BEGINNING WITH SCHEDULING AND REGISTRATION. SIGNAGE AND FINANCIAL RESPONSIBILITY BROCHURES ARE CLEARLY DISPLAYED THROUGHOUT THE REGISTRATION AREAS OF THE SYSTEM. THIS INFORMATION DETAILS THE POTENTIAL PATIENT RESPONSIBILITY AND ALSO PROVIDES INFORMATION ON THE AVAILABLE PROGRAMS IN THE EVENT THE PATIENT CAN NOT PAY THE BILL. IF THE PATIENT COMMUNICATES THEIR INABILITY TO PAY, THE FINANCIAL ASSISTANCE PROGRAM IS REVIEWED AND THE PATIENT IS DIRECTED TO THE FINANCIAL ASSISTANCE DEPARTMENT. UPON APPLICATION FOR FINANCIAL ASSISTANCE, COLLECTION PRACTICES ARE HALTED UNTIL THE APPLICATION HAS BEEN REVIEWED AND PROCESSED. IF FINANCIAL ASSISTANCE IS APPROVED, COLLECTION PRACTICES WILL CEASE. IF FINANCIAL ASSISTANCE IS DENIED, COLLECTION PRACTICES WILL CONTINUE. PART VI, LINE 2: THE ORGANIZATION ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY WITH THE ASSISTANCE OF STATE AND INTERNAL REPORTING INFORMATION. THE INFORMATION IS INTERPRETED, REVIEWED AND ANALYZED. IF A NEED IS PRESENT, A STRATEGIC PLAN IS DEVELOPED, WITH THE GOAL OF PROVIDING AS MANY LOCAL SERVICES AS POSSIBLE. THE PLAN IS THEN PRESENTED TO THE BOARD FOR APPROVAL. ONCE BOARD APPROVAL IS RECEIVED, THE IMPLEMENTATION PROCESS BEGINS. THE ORGANIZATION'S COMMUNITY HEALTH PROGRAM'S OBJECTIVE IS TO ENHANCE THE HEALTH CARE STATUS OF THE COMMUNITY, PROVIDING EDUCATION, SCREENINGS, AND REGULAR FOLLOW UP TO ENSURE READY ACCESS TO QUALITY HEALTHCARE. PART VI, LINE 3: THE ORGANIZATION REGULARLY ADVERTISES THE AVAILABLE STATE, FEDERAL, AND LOCAL FINANCIAL ASSISTANCE PROGRAMS. ALL PATIENTS WITHOUT INSURANCE ARE SCREENED FOR AVAILABLE STATE AND FEDERAL PROGRAMS. PATIENTS NOT MEETING STATE AND FEDERAL PROGRAM GUIDELINES ARE PROVIDED A ONE ON ONE CONSULTATION FOR LOCAL FINANCIAL ASSISTANCE, IF DESIRED. THE HOSPITAL FEATURES SIGNAGE AND BROCHURES THROUGHOUT THE REGISTRATION AREAS THAT OUTLINE RESPONSIBILITIES AND OPTIONS. PART VI, LINE 4: THE ORGANIZATION SERVES THE SOUTH CAROLINA COUNTIES OF HORRY AND GEORGETOWN, AS WELL AS OUTLYING AREAS. HORRY COUNTY (1,100 SQ. MILES) HAS AN ESTIMATED 2022 POPULATION OF 383,000. 26% OF THE POPULATION IS OVER THE AGE OF 65 AND THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $54,000. IN ADDITION, AN ESTIMATED 13% OF THE POPULATION IS BELOW THE POVERTY LEVEL. FINALLY, 16% OF THE POPULATION UNDER THE AGE OF 65 IS ESTIMATED TO BE WITHOUT HEALTH INSURANCE. GEORGETOWN COUNTY (815 SQ. MILES) HAS A POPULATION OF APPROXIMATELY 64,000 PEOPLE AND AN ESTIMATED 30% OF THE POPULATION IS OVER THE AGE OF 65. THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $56,000 AND AN ESTIMATED 15% OF THE POPULATION IS BELOW THE POVERTY LEVEL. FINALLY, 15% OF THE POPULATION UNDER THE AGE OF 65 IS ESTIMATED TO BE WITHOUT HEALTH INSURANCE. COMPETING HOSPITALS ARE LOCATED APPROXIMATELY 40-45 MILES NORTH AND NORTHWEST AND 60 MILES SOUTH. MAJOR SURROUNDING CITIES INCLUDE: CHARLESTON, SC (60 MILES), COLUMBIA, SC (150 MILES) AND CHARLOTTE, NC (215 MILES). PART VI, LINE 5: A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR MANY OF ITS DEPARTMENTS.USAGE OF THE ORGANIZATION'S SURPLUS OF FUNDS IS DESCRIBED ON FORM 990, PART III; HOWEVER IN GENERAL, A SURPLUS OF FUNDS IS USED TO REINVEST IN PROPERTY AND EQUIPMENT IN ORDER TO CONTINUE PROVIDING TO THE PUBLIC THE BEST IN PATIENT CARE AND TECHNOLOGY. PART VI, LINE 6: WACCAMAW COMMUNITY HOSPITAL IS PART OF GEORGETOWN HOSPITAL SYSTEM. GEORGETOWN HOSPITAL SYSTEM IS A RELATED 501(C)(3) HEALTHCARE ORGANIZATION. PART VI, LINE 7, REPORTS FILED WITH STATES SC X X X X 0 1 0 1 1 1 1 0 0 DR WILLIAM GREER TRUSTEE & PHYSICIAN 34213 654576 0 254653 0 39729 0 6322 0 27067 34213 982347 0 0 BRUCE BAILEY PRESIDENT & CEO 311997 276011 79628 70443 41786 36966 5386 4764 14407 12746 453204 400930 0 0 PHILIP DULBERGER EXECUTIVE VICE PRESIDENT & CHIEF PHY 263774 233350 68343 60461 24677 21829 5386 4764 10695 9461 372875 329865 0 0 ELIZABETH WARD EXECUTIVE VICE PRESIDENT & CFO 223457 197683 59208 52378 41882 37049 5468 4837 12458 11021 342473 302968 0 0 GAYLE RESETAR EXECUTIVE VICE PRESIDENT & COO 198417 175531 53330 47178 46624 41246 5655 5003 7691 6803 311717 275761 0 0 GERALD HARMON VP MEDICAL AFFAIRS 169778 150196 41710 36899 27268 24121 6374 5638 1196 1059 246326 217913 0 0 JAMES F HARPER CHIEF HUMAN RESOURCE OFFICER/EVP 123125 108923 51247 45336 34422 30451 6133 5426 14769 13066 229696 203202 0 0 GARY METCALFE VP SUPPLY CHAIN & SUPPORT SERVICES 97865 86577 19209 16994 31587 27941 6214 5498 5604 4955 160479 141965 0 0 MICAH NAUS VP / CHIEF INFORMATION OFFICER 123809 109529 13743 12158 6068 5367 0 0 13875 12276 157495 139330 0 0 JOHN LAROCHELLE VP OPERATIONS 93915 83082 17468 15453 21387 18919 5666 5013 14492 12821 152928 135288 0 0 PART I, LINE 4B ALL ELC MEMBERS (BRUCE BAILEY, GAYLE RESETAR, ELIZABETH WARD, PHILIP DULBERGER, JAN HARPER (THRU HIS DEPARTURE ON 3/1/2022) & GERALD HARMON) WERE ENROLLED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN BEGINNING 10/1/2018. BRUCE, ELIZABETH, GAYLE & PHIL ARE ENROLLED IN A SPLIT DOLLAR LIFE INSURANCE PLAN. DR. HARMON & JAN RECEIVE A RETENTION BONUS EACH YEAR (INCLUDED IN COMPENSATION). THE ORGANIZATION DEPOSITED FUNDS INTO A LIFE INSURANCE POLICY ON THE PARTICIPANT'S LIFE. DURING LIFE, AND SUBJECT TO THE POLICY GENERATING SUFFICIENT VALUES, THE PARTICIPANT CAN BORROW FROM THE POLICY. AT DEATH, THE ORGANIZATION RECOVERS ITS PREMIUMS PLUS INTEREST PLUS ADDITIONAL KEY-PERSON INSURANCE PROCEEDS. PART I, LINE 5 INCENTIVE COMPENSATION PAID TO NON-PHYSICIAN LEADERSHIP/EXECUTIVES IS CONTINGENT UPON QUALITY INDICATORS, NET REVENUES, AND THE OVERALL PROFITABILITY OF THE ORGANIZATION. INCENTIVE COMPENSATION PAID TO PHYSICIANS AND PHYSICIAN LEADERSHIP IS BASED ON PRODUCTION AND QUALITY INDICATORS. PHYSICIAN INCENTIVE COMPENSATION DOES NOT INCLUDE INCOME RELATED METRICS. IF PREDETERMINED GOALS ARE MET, INCENTIVE COMPENSATION IS PAID IN ACCORDANCE WITH AN INCENTIVE COMPENSATION PROGRAM. SEE PART II, COLUMN (B)(II). PART I, LINE 6 SEE THE RESPONSE TO LINE 5A AND 5B. PART I, LINE 3 THE ORGANIZATION RELIES ON THE BOARD OF ITS SOLE MEMBER ORGANIZATION TO NEGOTIATE AND ESTABLISH THE COMPENSATION AGREEMENTS FOR ITS CEO AND OTHER OFFICERS. THE BOARD OF GEORGETOWN HOSPITAL SYSTEM USES THE FOLLOWING METHODS TO DETERMINE COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANTS - COMPENSATION STUDY/SURVEY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE BOARD OF GEORGETOWN HOSPITAL SYSTEM IS A MAJORITY INDEPENDENT. PART II THE ORGANIZATION UTILIZES A COMMON PAYING AGENT FOR SERVICES PERFORMED FOR BOTH WACCAMAW COMMUNITY HOSPITAL AND A RELATED ORGANIZATION. COMPENSATION FOR THESE INDIVIDUALS IS PRESENTED TO REFLECT AN ALLOCATION OF SERVICES PERFORMED FOR THESE ORGANIZATIONS. A SC JOBS - ECONOMIC DEVELOPMENT AUTHORITY 570960018 NONEAVAIL 2012-02-23 30850000 CAPITAL ACQUISITION 0 0 0 B SC JOBS - ECONOMIC DEVELOPMENT AUTHORITY 570960018 NONEAVAIL 2016-09-09 87890000 REFUND PRIOR ISSUE 0 0 0 C SC JOBS - ECONOMIC DEVELOPMENT AUTHORITY 570960018 NONEAVAIL 2016-11-03 35050000 CURRENT REFUNDING 0 0 0 D SOUTH CAROLINA JOBS-ECONOMIC DEVELOPMENT AUTHORITY 570960018 NONEAVAIL 2017-11-01 45295000 CONSTRUCTION 0 0 0 A 8792837 30850000 172596 30614582 62822 2012 0 0 1 1 B 5612805 16925130 16925130 1 0 1 1 C 1293097 20233524 97411 20136113 1 0 1 1 D 31728 45295000 305281 38906877 6082842 0 0 0 0 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 D 0 0 0 0 0 0 0 A 0 0 1 0 1 0 0 0 0 B 0 1 1 0 1 0 0 0 0 C 0 0 1 0 0 0 0 0 0 D 0 1 0 0 1 0 0 0 0 A 0 B 0 C 0 D 0 FORM 990, SCH K, PART II, LINE 11 THE AMOUNTS ON THIS LINE WERE USED TO REFUND PRIOR ISSUE BONDS. THE AMOUNTS IN COLUMN B (ENTITY 1) WERE USED TO REFUND BONDS THAT WERE ISSUED ON 12/22/2010. THE AMOUNTS IN COLUMN C (ENTITY 1) WERE USED TO REFUND BONDS THAT WERE ISSUED ON 5/30/2012. CASEY MAIER FAMILY MEMBER OF BOARD MEMBER WILLIE SHELLEY 38197 RADIOLOGIC TECHNOLOGIST 0 COASTAL CRITICAL CARE CONSULTANTS PARTIALLY OWNED BY BOARD MEMBER DR. THOMAS CHANDLER 257134 CONTRACTED PHYSICIAN SERVICES 0 PALMETTO EMERGENCY PHYSICIANS OWNED IN PART BY BOARD MEMBER DR. MICHAEL RATLIFFE 3912208 CONTRACTED PHYSICIAN SERVICES 0 FORM 990, PART V, LINE 2A: THE ORGANIZATION HAS NO DIRECT EMPLOYEES. GEORGETOWN HOSPITAL SYSTEM, A RELATED ORGANIZATION, FILES PAYROLL FOR THE ORGANIZATION. THE NUMBER OF EMPLOYEES REPORTED BY GEORGETOWN HOSPITAL SYSTEM THAT ARE RELATED TO THE ORGANIZATION IS 1,281. FORM 990, PART VI, SECTION A, LINE 1A THE ORGANIZATION HAS AN EXECUTIVE COMMITTEE, FINANCE COMMITTEE, AND COMPENSATION COMMITTEE THAT HAVE LIMITED POWERS DELEGATED FROM THE FULL VOTING BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE IS COMPRISED OF FIVE OR MORE MEMBERS, INCLUDING FOUR WHO ARE ALSO MEMBERS OF THE MEMBER ORGANIZATION'S BOARD OF DIRECTORS. THE FINANCE COMMITTEE CONTAINS FOUR OR MORE MEMBERS INCLUDING THE TREASURER OF THE MEMBER ORGANIZATION. THE COMPENSATION COMMITTEE IS AS APPOINTED BY THE CHAIRMAN OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A MEMBER ORGANIZATION WITHIN THE MEANING OF THE SOUTH CAROLINA NONPROFIT CORPORATION ACT OF 1994. THE SOLE MEMBER OF THE CORPORATION IS GEORGETOWN HOSPITAL SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS THE SOLE AUTHORITY TO APPOINT OR REMOVE A TRUSTEE OR THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS THE SOLE AUTHORITY TO (1) DIRECT HEALTHCARE SERVICES UNDERTAKEN BY THE ORGANIZATION, INCLUDING THE ADDITION OR DELETION OF CLINICAL SERVICE LINES, AND AUDIT COMPLIANCE WITH SUCH DIRECTIVES, (2) VETO POLICIES AND PROCEDURES, (3) REQUIRE DISTRIBUTION OF INCOME, ASSETS, OR OTHER PROPERTY FROM, OR MAKE CONTRIBUTIONS TO THE ORGANIZATION TO ACHIEVE THE MUTUAL OBJECTIVES OF THE ORGANIZATION AND THE SOLE MEMBER, (4) APPROVE BUDGETS, (5) AUTHORIZE CAPITAL TRANSACTIONS, (6) ADOPT A PLAN OF DISSOLUTION, (7) ADMIT NEW MEMBERS TO THE ORGANIZATION, (8) AMEND THE ARTICLES OF THE ORGANIZATION, AND (9) NEGOTIATE AND AUTHORIZE MANAGEMENT AGREEMENTS WITH THIRD PARTIES. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WAS PREPARED BY AN OUTSIDE ACCOUNTING FIRM WITH THE ASSISTANCE AND OVERSIGHT OF MANAGEMENT. A COPY OF THE RETURN WAS PROVIDED TO EACH VOTING BOARD MEMBER. EACH MEMBER WAS PROVIDED THE OPPORTUNITY TO ASK QUESTIONS OF THE EVP & CFO PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY WHICH IS REVIEWED, ACCEPTED, AND SIGNED BY EACH OFFICER AND VOTING BOARD MEMBER ON AN ANNUAL BASIS. PURSUANT TO THIS POLICY, EACH OFFICER AND BOARD MEMBER WILL RECUSE HIMSELF OR HERSELF FROM ANY DISCUSSIONS AND VOTES FOR WHICH A CONFLICT EXISTS. DETERMINATION OF WHETHER A CONFLICT EXISTS IS MADE AT A MANAGEMENT, BOARD MEMBER, OFFICER, AND INDIVIDUAL LEVEL. ACTUAL CONFLICTS ARE REVIEWED BY MANAGEMENT AND THE BOARD WITHOUT THE PRESENCE OF THE INTERESTED PARTY. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USES OUTSIDE AGENCIES TO ESTABLISH, ASSESS THE REASONABLENESS OF, REVIEW, AND APPROVE THE COMPENSATION OF DIRECTORS, SENIOR MANAGEMENT & PHYSICIANS. SENIOR MANAGEMENT PROVIDES OVERSIGHT ON DIRECTOR COMPENSATION, THE BOARD COMPENSATION COMMITTEE PROVIDES OVERSIGHT ON PHYSICIAN COMPENSATION AND THE CEO PROVIDES OVERSIGHT (WITH THE ASSISTANCE OF THE CFO AND CHRO) ON SENIOR MANAGEMENT COMPENSATION. CEO COMPENSATION IS EVALUATED AND APPROVED BY THE FULL BOARD AND BOARD COMPENSATION COMMITTEE. FAIR MARKET VALUATIONS ARE COMPLETED FOR ALL COMPENSATION AT LEAST ANNUALLY AND MONTHLY COMPENSATION MEETINGS ARE HELD TO REVIEW ANY AND ALL COMPENSATION RELATED ACTIVITIES. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 37,279,150. MANAGEMENT AND GENERAL EXPENSES 19,754,288. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 57,033,438. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART V, LINE 1A: THE ORGANIZATION DID NOT DIRECTLY ISSUE ANY 1099'S DURING THE TAX PERIOD. GEORGETOWN MEMORIAL HOSPITAL, A RELATED ORGANIZATION, FILES THE FORMS 1099'S FOR THE ORGANIZATION. THE NUMBER OF 1099'S REPORTED BY GEORGETOWN MEMORIAL HOSPITAL THAT ARE RELATED TO THE ORGANIZATION IS 77. GEORGETOWN HOSPITAL SYSTEM PO BOX 421718 GEORGETOWN SC 29442 020598440 HEALTHCARE SC 501(C)(3) LINE 12B, II N/A 0 GEORGETOWN MEMORIAL HOSPITAL PO BOX 421718 GEORGETOWN SC 29442 570341194 HEALTHCARE SC 501(C)(3) LINE 3 GEORGETOWN HOSPITAL SYSTEM 0 TIDELANDS HEALTH HOLDINGS PO BOX 421718 GEORGETOWN SC 29442 850532826 HEALTHCARE SC 501(C)(3) LINE 12B, II GEORGETOWN HOSPITAL SYSTEM 0 GEORGETOWN RADIATION THERAPY CENTER 4033 HIGHWAY 17 MURRELLS INLET SC 29576 200131459 HEALTHCARE SC N/A 0 0 TIDELANDS AND MEDQUEST JOINT VENTURE LLC 606 BLACK RIVER RD GEORGETOWN SC 29440 841945687 IMAGING SC N/A 0 0 0 0 0 1 0 0 0 0 1 1 1 0 1 1 1 1 1 0 0