2022-08-10T15:28:00-05:00 2021-09-30 135565207 KPMG LLP 60 SOUTH STREET BOSTON MA 02111 990 2020-10-01 050259093 SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM ENDOWMENT SOUT 4017828000 100 KENYON AVENUE WAKEFIELD RI 028794299 THOMAS J BREEN VP AND CHIEF FINANCIAL OFFICER 4017828000 2022-08-05 1 THOMAS BREEN 999009999 TODD P TERESCO P00247720 6179881000 2022-07-26 0 AAL1 IAL1 2020 2022-09-23 18:48:47Z SYSTEM ENDOWMENT AARON S ROBINSON 100 KENYON AVENUE WAKEFIELD RI 028794299 7281314 0 X WWW.SOUTHCOUNTYHEALTH.ORG X 1989 RI PLANNING, MANAGEMENT & FUNDRAISING FOR SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM. 19 16 0 15 0 0 3260010 3623749 0 0 1461247 901369 14568 9707 4735825 4534825 0 0 0 0 441602 651509 0 0 0 206795 310364 648397 961873 4087428 3572952 39870670 47625949 267374 394059 39603296 47231890 X PLANNING, FUNDRAISING AND MANAGEMENT ACTIVITIES TO SUPPORT THE MISSION OF SOUTH COUNTY HOSPITAL AND THE VNS HOMECARE, INC. 0 0 693940 0 0 DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2021, SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM ENDOWMENT PROVIDED PLANNING, MANAGEMENT, AND FUNDRAISING ACTIVITIES FOR SOUTH COUNTY HOSPITAL AND SOUTH COUNTY HOME HEALTH. BY PROVIDING THESE SERVICES, THE HOSPITAL AND SOUTH COUNTY HOME HEALTH, WERE ABLE TO FOCUS THEIR ACTIVITIES MORE TOWARD PROVIDING HIGH-QUALITY MEDICAL SERVICES TO PERSONS IN SOUTHERN RHODE ISLAND. THE HEALTHCARE SYSTEM ENDOWMENT WAS INSTRUMENTAL IN HELPING RECRUIT NEW PHYSICIANS TO WORK FOR SOUTH COUNTY HOSPITAL, RAISE ADDITIONAL CHARITABLE DONATIONS FOR THE HOSPITAL SYSTEM AND PROMOTE THE HOSPITAL SYSTEM TO THE COMMUNITY. 132884 0 0 DURING THE FISCAL YEAR ENDED SEPTERMBER 30, 2021, SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM ENDOWMENT CONTINUED ITS COMPREHENSIVE CAMPAIGN TO RAISE MONEY FOR IMPROVEMENTS TO ITS CAMPUS, UNRESTRICTED MONEY FOR DAILY OPERATIONS AND RESTRICTED FUNDS FOR FUTURE NEEDS. THE CAPITAL NEEDS INCLUDED IN THIS CAMPAIGN ARE ADDITION OF A NEW OPERATING ROOM, ENDOSCOPY SUITE, ED IMPROVEMENTS, HEART AND VASCUALR CENTER OF EXCELLENCE, UPGRADE RADIATION THERAPY WITH A NEW LINAC, PARKING IMPROVEMENTS AND PLANS FOR A SKYBRIDGE. THE SYSTEM RECOGNIZED THESE ADDITIONS AND IMPROVEMENTS AS CRITICAL NEEDS FOR THE COMMUNITY AND THE GOAL IS FOR THE CAMPAIGN TO SUPLEMENT AT LEAST HALF THE COST OF THESE PROJECTS. AS OF SEPTEMBER 30, 2021, THE SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM ENDOWMENT HAS RAISED APPROXIMATELY XXXX OF ITS $25,000,000 GOAL. 0 826824 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 9 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 19 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 RI X MARCIA POLHEMUS 4017828000 100 KENYON AVENUE WAKEFIELD RI 02879 AARON WEISBORD MD TRUSTEE UNTIL 4/21 1.00 41.00 X 0 429511 31095 NAVEH LEVY MD PRESIDENT OF MED STAFF 1.00 2.00 X 0 28000 0 RICHARD DEL SESTO MD TRUSTEE 1.00 2.00 X 0 6000 0 DENNIS LYNCH CHAIRMAN UNTIL 4/21 1.00 2.00 X X 0 0 0 JOSEPH MATTHEWS CHAIRMAN AS OF 5/21 1.00 2.00 X X 0 0 0 JAMES FARRELL VICE CHAIRMAN 1.00 2.00 X X 0 0 0 BETTY RAMBUR PHD RN SECRETARY 1.00 2.00 X X 0 0 0 VICTORIA A WICKS TREASURER 1.00 2.00 X X 0 0 0 ROBERT BIERWIRTH MD VP OF MED STAFF 1.00 2.00 X 0 7000 0 STEVE BLAZEJEWSKI TRUSTEE 1.00 2.00 X 0 0 0 TED ALMON TRUSTEE 1.00 2.00 X 0 0 0 ROBERT BEAGLE TRUSTEE 1.00 2.00 X 0 0 0 SANDRA COLETTA TRUSTEE AS OF 5/21 1.00 2.00 X 0 0 0 ROBERT DYER MD TRUSTEE 1.00 2.00 X 0 0 0 JOHN H HOWLAND TRUSTEE 1.00 2.00 X 0 0 0 ROGEAN MAKOWSKI TRUSTEE 1.00 2.00 X 0 0 0 JASON MARSHALL TRUSTEE 1.00 2.00 X 0 0 0 DAVID ROWE MD TRUSTEE 1.00 2.00 X 0 0 0 AUSTIN C SMITH TRUSTEE 1.00 2.00 X 0 0 0 DONNA D VANDERBACK TRUSTEE 1.00 2.00 X 0 0 0 JOHN WARDLE TRUSTEE 1.00 2.00 X 0 0 0 AARON S ROBINSON PRESIDENT AND CEO 1.00 41.00 X 0 579277 30069 THOMAS J BREEN VP AND CHIEF FINANCIAL OFFICER 2.00 41.00 X 0 416269 26767 LISA RAMEAKA FORMER DIRECTOR 0.00 40.00 X 45070 406498 17115 SALVATORE ABBRUZZESE JR DO FORMER PRESIDENT MED STAFF 0.00 40.00 X 0 295822 29247 KATHLEEN CASSIN MD FORMER TRUSTEE/PHYSICIAN 0.00 40.00 X 0 163242 14133 45070 2331619 148426 0 1 1 0 0 38980 3584769 40330 3623749 698668 698668 2928619 2725918 202701 202701 202701 16370 38980 16370 0 13908 4201 9707 9707 4534825 0 0 911076 X 530879 476879 54000 120630 120630 3804 3804 1119 1119 56326 56326 110747 110747 6876 6876 57486 57486 737 737 9077 9077 1790 1790 19800 19800 DUES & LICENSES 25350 25350 CREDIT CARD FEES 7541 7541 CULTIVATION EVENTS 6567 6567 BANK SERVICE CHARGE 2217 2217 927 927 961873 826824 135049 0 376431 166834 409593 790138 192987 1155635 0 0 0 0 0 0 0 0 0 0 0 0 566962 560976 3360 5986 14192938 17026111 24695361 28481244 0 0 0 0 0 0 39870670 47625949 25233 3475 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242141 390584 267374 394059 X 28931724 33800422 10671572 13431468 39603296 47231890 39870670 47625949 X 3572952 5076783 -1021141 X X 0 1 X 1 0 X 3047601 6479069 2307783 3260010 3623749 18718212 3047601 6479069 2307783 3260010 3623749 18718212 5427723 13290489 840816 456339 330456 420523 698323 2746457 10200 10200 48830 42445 41426 14568 9707 156976 21631845 0.61440 0.63940 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 36341944 86458 6227012 10000 23583 42621831 34541444 1830565 30065 36341944 34194542 20126 330588 3812 34541444 29000372 4001736 1229738 37304 34194542 26091622 85454 2891164 67868 29000372 0.77510 0.22000 0.00490 1 0 562546 560866 1680 4416 110 4306 5986 ENDOWMENT POOLED INVESTMENTS 16009924 F ASSETS HELD IN TRUST 9533736 F DONOR RESTRICTED FUNDS 2937584 F 28481244 GIFT ANNUITY 195486 DUE TO AFFILIATES 195098 390584 X 8554712 5076783 266016 5342799 3211913 56326 1266586 1322912 4534825 926118 0 926118 56326 -20571 35755 961873 PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS ARE USED TO SUPPORT THE SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM AND ARE TO FUND CAPITAL EXPENDITURES. PART X, LINE 2: THE FOOTNOTE BELOW IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM ENDOWMENT. THE NOT-FOR-PROFIT ENTITIES (SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM ENDOWMENT, SOUTH COUNTY HOSPITAL AND SOUTH COUNTY HOME HEALTH) OPERATE AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE TAX PROVISIONS AND RELATED LIABILITIES FOR SILVER SPRING HEALTH CARE MANAGEMENT WHICH IS A TAXABLE ENTITY CONROLLED BY THE HOSPITAL ARE NOT SIGNIFICANT. THE HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY TO BE REALIZED UPON SETTLEMENT. CHANGES IN RECOGNITION IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. THE HOSPITAL DID NOT RECOGNIZE THE EFFECT OF ANY INCOME TAX PROVISIONS IN EITHER 2021 OR 2020. PART XI, LINE 2D - OTHER ADJUSTMENTS: UNREALIZED CHANGE IN EQUITY INTERESTS IN LP 296,016. NET ASSETS RELEASED FOR CAPITAL EXPENDITURES -30,000. PART XI, LINE 4B - OTHER ADJUSTMENTS: TRANSFER FROM TRNA FOR CAPITAL EXPENDITURES 1,287,157. FUNDRAISING EXPENSES -16,370. COST OF GOODS SOLD -4,201. PART XII, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES -16,370. COST OF GOODS SOLD -4,201. PART-V LINE-2 SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM ENDOWMENT HAS ADOPTED FASB ASU 2016-14, PRESENTATION OF THE FINANCIAL STATEMENTS OF NOT-FOR PROFIT ENTITIES. AS A RESULT, THE SEPTEMBER 20, 2021 AUDITED FINANCIAL STATEMENTS CLASSIFY THE NET ASSETS AS EITHER NET ASSETS WITHOUT DONOR RESTRICTION, OR NET ASSETS WITH DONOR RESTRICTIONS. FOR PURPOSES OF PART V, LINE 2, SOUTH COUNTY HOME HEALTH HAS REPORTED ITS YEAR END ENDOWMENT BALANCE SHEET WITHOUT DONOR RESTRICTIONS AS QUASI ENDOWMENT AND ITS YEAR END BALANCE WITH DONOR RESTRICTIONS AS PERMANENT ENDOWMENT AND TERM RESTRICTED ENDOWMENT, RESPECTIVELY. INVITATIONAL 55350 38980 16370 0 0 15680 0 0 690 55350 38980 16370 15680 690 16370 0 1 0 0 0 0 0 0 0 0 AARON S ROBINSON PRESIDENT AND CEO 0 465606 0 102689 0 10982 0 9975 0 20094 0 609346 0 0 LISA RAMEAKA FORMER DIRECTOR 0 206690 0 0 45070 199808 0 7309 0 9806 45070 423613 0 0 AARON WEISBORD MD TRUSTEE UNTIL 4/21 0 228420 0 195658 0 5433 0 9975 0 21120 0 460606 0 0 THOMAS J BREEN VP AND CHIEF FINANCIAL OFFICER 0 412674 0 500 0 3095 0 9975 0 16792 0 443036 0 0 SALVATORE ABBRUZZESE JR DO FORMER PRESIDENT MED STAFF 0 274233 0 20290 0 1299 0 9975 0 19272 0 325069 0 0 KATHLEEN CASSIN MD FORMER TRUSTEE/PHYSICIAN 0 127068 0 35361 0 813 0 5724 0 8409 0 177375 0 0 PART I, LINE 3 THE COMPENSATION OF THE CEO IS DETERMINED BY SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM WHICH USES THE FORM 990 OF OTHER ORGANIZATIONS, A COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO DETERMINE COMPENSATION. PART I, LINE 4A LISA RAMEAKA RECEIVED SEVERANCE IN THE AMOUNT OF 199,500 DURING THE CALENDAR YEAR 2020 FROM SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM. UNDER THE TERMS OF HER AGREEMENT, SEVERANCE WAS PAID IN ONE LUMP SUM FOLLOWING HER TERMINATION IN JUNE 2020. X 3 40330 FAIR MARKET VALUE 0 1 0 PART I, COLUMN (B) THE AMOUNT REPORTED IN PART I, COLUMN (B) REPRESENTS THE NUMBER OF CONTRIBUTIONS. FORM 990, PART VI, SECTION B, LINE 11B SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM AND ITS AFFILIATES (KNOWN AS SOUTH COUNTY HEALTH (SCH)) HAS POLICIES AND PROCEDURES ADOPTED BY ALL ENTITIES IN THE SYSTEM. ALL ENTITIES HAVE MIRROR BOARDS. THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S AUDIT COMMITTEE APPROXIMATELY 30 DAYS PRIOR TO THE FILING DEADLINE. THE AUDIT COMMITTEE THEN REVIEWS THE FORM 990 AND PROVIDES QUESTIONS AND COMMENTS TO THE ORGANIZATION'S ACCOUNTING DEPARTMENT. BEFORE IT IS FILED, A COPY OF THE FINAL FORM 990, INCLUDING REQUIRED SCHEDULES, IS PROVIDED TO THE MEMBERS OF THE BOARD OF TRUSTEES FOR REVIEW AND DISCUSSION WITH THE CHAIRMAN OF THE AUDIT COMMITTEE AT A BOARD MEETING PRIOR TO THE FILING DEADLINE. FORM 990, PART VI, SECTION B, LINE 12C SCH HAS POLICIES AND PROCEDURES ADOPTED BY ALL ENTITIES IN THE SYSTEM. MEMBERS OF THE GOVERNING BODY, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. IT IS PERIODICALLY REVIEWED AND DISCUSSED AT BOARD MEETINGS. IF A POTENTIAL CONFLICT IS IDENTIFIED, THE BOARD WOULD DISCUSS THE ITEM TO DETERMINE IF A CONFLICT EXIST. IF A CONFLICT EXISTS, THE INDIVIDUAL WOULD RECUSE THEMSELVES FROM THE DISCUSSIONS. ALL DISCUSSIONS ARE CONTEMPORANEOUSLY DOCUMENTED. FORM 990, PART VI, SECTION B, LINE 15A SCH HAS POLICIES AND PROCEDURES ADOPTED BY ALL ENTITIES IN THE SYSTEM. THE BOARD OF TRUSTEES HAS THE ULTIMATE RESPONSIBILITY TO ENSURE THAT COMPENSATION OF THE EXECUTIVE LEADERSHIP OF SCH REFLECTS THE NORMS ESTABLISHED IN THE INDUSTRY, REWARDS AND REINFORCES THE VALUES AND LONG-RANGE GOALS OF THE SYSTEM, AND UPHOLDS THE BOARD'S RESPONSIBILITY TO THE COMMUNITY IT STEWARDS OF THE COMMUNITY'S ASSETS. ON AN ANNUAL BASIS, THE EXECUTIVE COMMITTEE PERFORMS A COMPENSATION REVIEW FOR THE CEO. THE VICE PRESIDENT OF HUMAN RESOURCES DOES A MARKET ANALYSIS OF DATA OF CEO POSITIONS IN COMPARABLE HOSPITALS INCLUDING THE USE OF FORM 990 OF OTHER ORGANIZATIONS AND COMPENSATION SURVEYS. THE EXECUTIVE COMMITTEE REVIEWS THE PACKET OF MATERIALS INCLUDING THE MARKET REVIEW OF COMPENSATION, A REVIEW OF CEO GOALS ATTAINMENT AND OTHER MATERIALS RELEVANT TO HIS OR HER PERFORMANCE. THE CEO PROVIDES THE EXECUTIVE COMMITTEE SUGGESTED COMPENSATION FOR THE CMO, CNO, AND CFO. THE EXECUTIVE COMMITTEE APPROVES ALL COMPENSATION DECISIONS AND CONTEMPOROUSLY DOCUMENTS THE DISCUSSION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONSULTING: PROGRAM SERVICE EXPENSES 109,247. TOTAL EXPENSES 109,247. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,500. TOTAL EXPENSES 1,500. FORM 990, PART XI, LINE 9: UNREALIZED CHANGE IN EQUITY INTERESTS IN LP 296,016. NET ASSETS RELEASED FROM RESTRICTION FOR CAPITAL EXPENDITURES -30,000. TRANSFER FROM TRNA TO UNRESTRICTED FUND EXPENDITURES -1,287,157. FORM 990, PART XII, LINE 2C FINANCIAL STATEMENTS AND REPORTING THE ORGANIZATION'S AUDIT COMMITTEE IS RESPONSIBLE FOR SELECTING AN INDEPENDENT ACCOUNTANT TO AUDIT THE ORGANIZATION'S FINANCIAL STATEMENTS AND FOR OVERSEEING THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS. OCEAN VIEW HEALTH VENTURE 100 KENYON AVENUE WAKEFIELD RI 02879 853789537 LEASE OFFICE BUILDING/PROVIDE MEDICAL ACCESS RI 0 5505657 SC HOSPITAL SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM 100 KENYON AVENUE WAKEFIELD RI 02879 050445136 HOSPITAL RI 501(C)(3) 3 SCH ENDOWMNT 1 SOUTH COUNTY HOME HEALTH 14 WOODRUFF AVENUE NARRAGANSETT RI 02882 056033975 HEALTHCARE RI 501(C)(3) 10 SC HOSPITAL 1 SILVER SPRING HEALTH CARE MANAGEMENT 100 KENYON AVENUE WAKEFIELD RI 02879 050459095 HOLDING COMPANY RI SCH HEALTHCARE C 1.00000 1 SOUTH COUNTY QUALITY CARE 100 KENYON AVENUE WAKEFIELD RI 02879 050491313 PERSONAL CARE RI SSHC MANAGEMENT C 1.00000 1 SSHM SURGICAL SUPPLY INC 100 KENYON AVENUE WAKEFIELD RI 02879 050478937 MEDICAL EQUIPMENT RI SSHC MANAGEMENT C 1.00000 1 CHARITABLE REMAINDER TRUSTS (3) RI N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0 SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM B 1317158 FMV SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM O 651509 FMV SOUTH COUNTY HOME HEALTH B 60000 FMV