2021-08-12T11:14:39-05:00 2020-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2019-10-01 570341194 GEORGETOWN MEMORIAL HOSPITAL GEOR 8435277102 PO BOX 421718 GEORGETOWN SC 29442 ELIZABETH WARD EVP & CFO 8435277102 2021-08-12 1 AMY BIBBY P00445891 8282542254 2021-08-12 2019 2022-09-23 18:48:47Z TIDELANDS GEORGETOWN MEMORIAL HOSPITAL BRUCE P BAILEY PO BOX 421718 GEORGETOWN SC 29442 187222049 0 X WWW.TIDELANDSHEALTH.ORG X 1946 SC TO PROVIDE HIGH QUALITY HEALTHCARE TO THE CITIZENS OF GEORGETOWN CO. AND SURROUNDING AREAS. 8 6 0 59 0 0 2771825 4070586 170932210 177614358 6819422 -13764723 1459613 1856078 181983070 169776299 353012 519844 0 0 72111439 75352997 62400 35400 430622 90883153 94850490 163410004 170758731 18573066 -982432 401767363 444383449 188006002 267851394 213761361 176532055 X WE HELP PEOPLE LIVE BETTER LIVES THROUGH BETTER HEALTH. 0 0 129663792 519844 177614358 GEORGETOWN MEMORIAL HOSPITAL PROVIDES QUALITY HEALTH CARE AND PROMOTES HEALTH AND WELLNESS TO GEORGETOWN COUNTY AND SURROUNDING AREAS. GEORGETOWN MEMORIAL HOSPITAL IS A 131 BED ACUTE FACILITY LOCATED IN THE CITY OF GEORGETOWN, SOUTH CAROLINA. THE HOSPITAL WAS ORGANIZED UNDER THE LAWS OF THE STATE OF SOUTH CAROLINA IN 1946 FOR THE PURPOSE OF OPERATING A COMMUNITY HOSPITAL IN 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 RULING 69-545, 1969-2 C.B. 117, AS MODIFIED BY REV. RUL. 83-157, 1983-2 C.B. 94, SETS FORTH THE FACTORS THE INTERNAL REVENUE SERVICES WILL CONSIDER IN DETERMINING WHETHER A NONPROFIT HOSPITAL QUALIFIED FOR TAX EXEMPT STATUS.THE HOSPITAL OPERATES ITS FACILITIES IN A MANNER DESCRIBED IN REV. RUL. 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, 2020, THE HOSPITAL FURNISHED CHARITY CARE IN THE AMOUNT OF $26,356,926. 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 OPEN TO THE PUBLIC, INCLUDING CPR, WEIGHT CONTROL, SMOKING CESSATION, CHILDBIRTH EDUCATION, PRE-NATAL AND INFANT NUTRITION, AND OTHERS. 129663792 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 1 1 0 1 1 1 0 1 1 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 1 0 0 0 1 X 417 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 8 6 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 DANIEL SCHEFFING CHAIRMAN 1.00 2.00 X X 1000 0 0 MR FRANCIS B FORD JR VICE CHAIRMAN 1.00 2.00 X X 600 0 0 DR MARTHENA MORANT SECRETARY/TREASURER 1.00 2.00 X X 650 0 0 MR TONY JORDAN TRUSTEE 1.00 2.00 X 650 0 0 MR MARK NASH TRUSTEE 1.00 2.00 X 450 0 0 MR DAN STACY TRUSTEE 1.00 2.00 X 0 0 0 DR CHRISTINE GERBER TRUSTEE & PHYSICIAN 1.00 2.00 X 36513 0 0 DR MICHAEL RATZ CHIEF OF STAFF & PHYSICIAN 1.00 42.00 X 6938 366735 38357 BRUCE BAILEY PRESIDENT & CEO 20.00 20.00 X 298730 306476 42389 GAYLE RESETAR EXECUTIVE VICE PRESIDENT & COO 20.00 20.00 X 206678 212038 33907 ELIZABETH WARD EXECUTIVE VICE PRESIDENT & CFO 20.00 20.00 X 221560 227306 36431 RICK KAYLOR SENIOR VICE PRESIDENT SYSTEM DEVELOPMENT & STRATEG 20.00 20.00 X 184382 189165 22806 PHILIP DULBERGER EXECUTIVE VICE PRESIDENT & CHIEF PHYSICIAN EXECUTI 20.00 20.00 X 255583 262211 40114 JAMES F HARPER SENIOR VICE PRESIDENT & CHIEF HUMAN RESOURCE OFFIC 20.00 20.00 X 152212 156159 42994 PAM MAXWELL SENIOR VICE PRESIDENT & CHIEF NURSING OFFICER 20.00 20.00 X 137085 140640 31216 FLORIAN ANZEVENO INTERIM CIO/ADVISER 20.00 20.00 X 135406 138917 5022 GERALD HARMON VP MEDICAL AFFAIRS 20.00 20.00 X 193569 198588 7155 1832006 2198235 300391 74 0 1 1 COASTAL STRUCTURES CORPORATION PO BOX 937 GEORGETOWN SC 29442 CONSTRUCTION 4215154 SODEXO INC PO BOX 360170 PITTSBURGH PA 15251 FOOD & HOUSEKEEPING 3928916 PALMETTO EMERGENCY PHYSICIANS 86 SHOREBIRD LOOP PAWLEYS ISLAND SC 29585 EMERGENCY PHYSICIAN SERVICES 3463486 NELSON MULLINS RILEY & SCARBOROUGH PO BOX 11070 COLUMBIA SC 29211 LEGAL SERVICES 2190702 GEORGETOWN ANESTHESIA CONSULTANTS 130 PRESERVATION CIRCLE PAWLEYS ISLAND SC 29585 ANESTHESIA SERVICES 1494809 73 127301 3943285 37520 4070586 NET PATIENT SERVICE REVENUE 621400 168702039 168702039 OTHER RELATED SERVICES 900099 6274686 6274686 PHARMACY 446110 1146909 1146909 FITNESS CENTER 900099 1089102 1089102 MEALS 722210 282679 282679 118943 118943 177614358 3599019 3599019 1888636 0 1888636 1888636 1888636 17363742 -17363742 -17363742 -17363742 0 127301 52854 -52854 -52854 28621 29154 -533 -533 DISCOUNTS/REBATES 900099 20829 20829 20829 169776299 177614358 0 -11908645 519844 519844 1025051 43451 981600 31403 31403 58676433 42464456 15982462 229515 1428120 1016055 406573 5492 10052270 7151820 2861795 38655 4139720 2945258 1178543 15919 385635 385635 3738207 3738207 49706 49706 35400 35400 2000 2000 215704 307 215397 8486666 3780762 4619140 86764 1950855 1859119 91736 323722 237064 78563 8095 1835595 1835595 16728987 7553138 9167485 8364 836367 377620 458329 418 MEDICAL SUPPLIES 49006914 49006914 BAD DEBT EXPENSE 10494226 10494226 MISCELLANEOUS EXPENSE 551244 378163 173081 RECRUITMENT 244662 244662 170758731 129663792 40664317 430622 4190 4140 37561773 44013798 22461892 23860797 3500000 3509785 5461112 6890316 5121988 5646762 370563742 196397289 177163582 174166453 147473524 183996918 533838 533838 2485464 1760642 401767363 444383449 25134874 34510815 96369199 93873349 66501929 139467230 188006002 267851394 X 212091476 174987573 1669885 1544482 213761361 176532055 401767363 444383449 X -982432 1829190 -38076064 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5606 5606 0 PART II-B, LINE 1: THE HOSPITAL IS A MEMBER OF BOTH THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE SOUTH CAROLINA HOSPITAL ASSOCIATION (SCHA). THESE ORGANIZATIONS ENGAGE IN LOBBYING FOR THE BENEFIT OF THEIR MEMBERSHIP BODIES, AND A PORTION OF THE MEMBERSHIP DUES PAID TO THE ORGANIZATIONS IS ATTRIBUTABLE TO LOBBYING EXPENDITURES. FOR THE YEAR, THE PORTION OF DUES ATTRIBUTABLE TO LOBBYING EXPENDITURES WAS $2,297 FOR AHA AND $3,309 FOR SCHA. 24209677 24209677 178198941 78032464 100166477 5847045 3611322 2235723 152898402 114753503 38144899 9409677 9409677 174166453 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 1356830 DUE TO AFFILIATE 120480916 PROVIDER RELEIF FUNDS LIABILITY 3330619 MEDICARE ADVANCE CONTRACT LIABILITY 14298865 139467230 X 160836246 1829190 1829190 159007056 10769243 10769243 169776299 159989488 0 159989488 10769243 10769243 170758731 PART X, LINE 2: GEORGETOWN MEMORIAL 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, 2020. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET WITH REVENUE 10,494,226. INTEREST AND DIVIDEND OVERHEAD FEES 275,017. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET WITH REVENUE 10,494,226. INTEREST AND DIVIDEND OVERHEAD FEES 275,017. X X X 1 PRIDE PHILANTHROPY 885 WOODSTOCK RD STE 430 ROSWELL GA 300752374 CAPITAL CAMPAIGN 0 3495109 35400 3459709 3495109 35400 3459709 2019 IN THE PINK BREAST CANCER WALK 86141 86141 854 4244 250 23333 GOLF TOURNAMENT 41160 41160 7079 15281 1813 127301 127301 7933 19525 250 25146 52854 -52854 1 1 X 1 X 0 1 1 0 1 1 4101859 994920 3106939 0.01820 16291792 14538984 1752808 0.01030 20393651 15533904 4859747 0.02850 1696197 1696197 0.00990 251238 37948 213290 0.00120 456112 58710 397402 0.00230 2403547 96658 2306889 0.01340 22797198 15630562 7166636 0.04190 277 277 0.00000 2098 2098 0.00000 2035 2035 0.00000 2236 2236 0.00000 84096 84096 0.00050 90742 90742 0.00050 0 6126269 3419670 72722787 80464236 -7741449 X 1 1 1 1 GEORGETOWN MEMORIAL HOSPITAL 606 BLACK RIVER ROAD GEORGETOWN SC 29440 X X X X MEDICARE DISPROPORTIONATE SHARE HOSPITAL GEORGETOWN MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X SEE PART V, SECTION C X X 1 18 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 X 1 X 0 0 GEORGETOWN MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: THE 2019 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. GEORGETOWN MEMORIAL HOSPITAL PART V, SECTION B, LINE 6A: WACCAMAW COMMUNITY HOSPITAL GEORGETOWN MEMORIAL HOSPITAL PART V, SECTION B, LINE 6B: QUORUM HEALTH RESOURCES PROVIDED THE EXPERTISE TO COMPLETE THE CHNA IN PARTNERSHIP WITH TIDELANDS HEALTH REPRESENTATIVES. GEORGETOWN MEMORIAL HOSPITAL PART V, SECTION B, LINE 7D: ALL TCCN PARTNERS WERE SENT AN ELECTONIC COPY. GEORGETOWN MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: THE SIGNIFICANT NEEDS IDENTIFIED AND SELECTED ARE MENTAL HEALTH, ALCOHOL AND SUBSTANCE USE, OBESITY, DIABETES, AND CANCER. AN IMPLEMENTATION PLAN HAS BEEN ESTABLISHED THAT IDENTIFIES KEY INDICATORS FOR EACH SELECTED HEALTH NEED. A DASHBOARD WILL BE MAINTAINED AND REGULARLY REVIEWED THAT TRACKS METRICS. WHILE SEXUALLY TRANSMITTED ILLNESSES WAS IDENTIFIED AS A NEED IN BOTH THE SURVEY AND THROUGH DATA WALK VOTING, TIDELANDS HEALTH DOES NOT HAVE THE PARTNERSHIPS IN PLACE TO ELEVATE THIS AREA OF NEED. TIDELANDS HEALTH WILL SEEK TO ENHANCE RELATIONSHIPS WITH PARTNERS THAT WOULD BE VITAL TO SEXUAL EDUCATION, PREVENTION, SCREENING, AND TREATMENT OF SEXUALLY TRANSMITTED ILLNESSES. TIDELANDS HEALTH WILL WORK IN CONJUNCTION WITH COMMUNITY PARTNERS AND ORGANIZATIONS ALIKE, THESE GROUPS WILL TAKE PART IN COMMUNITY EVENTS TO BRING AWARENESS TO THESE AREAS OF NEED. THE COMMUNITY BENEFIT REPORTING METHOD IS USED TO ORGANIZE FUNCTIONS AND EVENTS TO BETTER SERVE THE POPULATION WHICH OUR HEALTH SYSTEMS OPERATE. THE HEALTH SYSTEM UTILIZES THEIR COMMUNITY RESOURCE DEPARTMENT TO SERVICE OUR DEMOGRAPHIC. TIDELANDS COMMUNITY CARE NETWORK OPERATES TO ASSIST THOSE PATIENTS IN NEED TO HAVE ACCESS TO HEALTH CARE AND OTHER SOCIAL DETERMINATES TO HELP LEAD THEM TO HEALTHIER LIVES. TIDELANDS HEALTH UTILIZES AVAILABLE GRANT OPPORTUNITIES TO ENSURE THAT ADDITIONAL FUNDING IS PROVIDED TO BETTER MEET THE NEEDS ADDRESSED. PART V, LINE 7A, CHNA WEBSITE: HTTPS://WWW.TIDELANDSHEALTH.ORG/DISCOVER/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, LINE 10B, IMPLEMENTATION STRATEGY WEBSITE: HTTPS://WWW.TIDELANDSHEALTH.ORG/DISCOVER/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, LINE 16B & C, FAP, FAP APPLICATION & PLAIN LANGUAGE SUMMARY WEBSITE: HTTP://WWW.TIDELANDSHEALTH.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/ 13 1 - HEALTHPOINT CENTER FOR HEALTH & FITNESS 12965 OCEAN HIGHWAY PAWLEYS ISLAND SC 29585 FITNESS CLUB/ADULT REHAB 2 - REHABILITATION SERVICES 4040 HWY 17 SUITE 201 MURRELLS INLET SC 29576 ADULT REHABILITATION 3 - REHABILITATION & PAIN MANAGEMEN 219 CHURCH STREET GEORGETOWN SC 29440 ADULT REHAB/PAIN MGMT 4 - REHABILITATION SERVICES 3650 COALITION DRIVE MYRTLE BEACH SC 29588 ADULT REHABILITATION 5 - WOUND & INFUSION CENTER 4367 RIVERWOOD DRIVE SUITE 140 MURRELLS INLET SC 29576 INFUSION SERVICES & WOUND CLINIC 6 - REHABILITATION SERVICES 3515 CADUCEUS DRIVE MYRTLE BEACH SC 29588 PEDIATRIC REHAB 7 - INFUSION SERVICES MURRELLS 4181 HIGHWAY 17 BYPASS MURRELLS INLET SC 29576 INFUSION SERVICES 8 - REHABILITATION SERVICES 4033 HWY 17 SUITE 102 MURRELLS INLET SC 29576 NEUROLOGICAL REHABILITATION 9 - REHABILITATION SERVICES 2361 NORTH FRASER ST GEORGETOWN SC 29440 PEDIATRIC REHABILITATION 10 - REHABILITATION SERVICES 106 WACCAMAW MEDICAL PARK COURT CONWAY SC 29526 ADULT REHABILITATION 11 - INFUSION SERVICES GEORGETOWN 2405 NORTH FRASER ST GEORGETOWN SC 29440 INFUSION SERVICES 12 - INFUSION SERVICES MYRTLE BEACH 1220 21ST AVENUE NORTH MYRTLE BEACH SC 29577 INFUSION SERVICES 13 - REHABILITATION SERVICES 701 S MORGAN AVE ANDREWS SC 29510 ADULT REHABILITATION PART I, LINE 7: THE ORGANIZATION USED WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS TO COMPUTE A COST-TO-CHARGES 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 $10,494,226 THAT HAS BEEN REMOVED FOR PURPOSES OF COMPUTING PERCENTAGE OF TOTAL EXPENSE ON COLUMN (F). PART II, COMMUNITY BUILDING ACTIVITIES: IN ADDITION, $84,096 WAS SPENT TO RECRUIT PHYSICIANS WITH THE SKILLS AND TRAINING NECESSARY TO BEST SERVE THE NEEDS OF THE COMMUNITY IN AREAS SUCH AS OBSTETRICS/PULMONOLOGY. PART III, LINE 2: FOR AUDITED FINANCIAL STATEMENT PURPOSES, IN 2020, 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 $13,259,000. 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-CHARGES RATIO USED TO CALCULATE BAD DEBT EXPENSE AT COST FOR PURPOSES OF 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 2019 POPULATION OF 354,000. 25% OF THE POPULATION IS OVER THE AGE OF 65 AND THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $51,000. IN ADDITION, AN ESTIMATED 13% OF THE POPULATION IS BELOW THE POVERTY LEVEL. FINALLY, 17% 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 63,000 PEOPLE AND AN ESTIMATED 29% OF THE POPULATION IS OVER THE AGE OF 65. THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $48,000 AND AN ESTIMATED 18% OF THE POPULATION IS BELOW THE POVERTY LEVEL. FINALLY, 14% 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: GEORGETOWN MEMORIAL 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 1 COASTAL CAROLINA UNIVERSITY PO BOX 261954 CONWAY SC 29528 570977955 501C3 150000 OPERATIONAL ASSISTANCE MYRTLE BEACH SPORT CENTER 2115 FARLOW STREET MYRTLE BEACH SC 29577 364802450 75500 OPERATIONAL ASSISTANCE CAROLINA COUNTRY MUSIC FESTIVAL LLC 6300 CARMEL RD SUITE 110C CHARLOTTE NC 28226 472607324 30000 OPERATIONAL ASSISTANCE HELPING HANDS OF GEORGETOWN 1813 HIGHMARKET STREET GEORGETOWN SC 29440 570883461 501C3 20000 OPERATIONAL ASSISTANCE HORRY-GEORGETOWN TECHNICAL COLLEGE FOUNDATION 743 HEMLOCK AVENUE MYRTLE BEACH SC 29577 570671224 25000 OPERATIONAL ASSISTANCE BROOKGREEN GARDENS PO BOX 3368 PAWLEYS ISLAND SC 29585 570380356 501C3 25000 OPERATIONAL ASSISTANCE SMITH MEDICAL CLINIC PO BOX 1740 PAWLEYS ISLAND SC 29585 570786699 501C3 25000 OPERATIONAL ASSISTANCE BLACK RIVER UNITED WAY 515 FRONT STREET GEORGETOWN SC 29440 570526145 501C3 82000 OPERATIONAL ASSISTANCE HEALTHY LEARNERS 2749 LAUREL STREET COLUMBIA SC 29204 571127197 501C3 20000 OPERATIONAL ASSISTANCE MARCH OF DIMES PO BOX 673667 MARIETTA GA 30006 131846366 501C3 15000 OPERATIONAL ASSISTANCE FAVOR GRAND STRAND PO BOX 15874 SURFSIDE BEACH SC 295875874 461206306 12500 OPERATIONAL ASSISTANCE THE LONG BAY SYMPHONY 1107 48TH AVE N SUITE 310-E MYRTLE BEACH SC 29577 570854961 7500 OPERATIONAL ASSISTANCE BRIDGE TO BRIDGE RUN- GEORGETOWN PO BOX 556 GEORGETOWN SC 29442 6000 OPERATIONAL ASSISTANCE GROUND ZERO MINISTRIES INC PO BOX 8279 MYRTLE BEACH SC 29578 621751085 501C3 5000 OPERATIONAL ASSISTANCE GEORGETOWN ECONOMIC DEVELOPMENT ALLIANCE PO BOX 1515 GEORGETOWN SC 29442 570670769 501C3 5000 OPERATIONAL ASSISTANCE 9 6 PART I, LINE 2: TIDELANDS HEALTH HAS A STRONG PHILANTHROPIC HISTORY AND COMMITMENT TO COMMUNITY GIVING. THE ORGANIZATION PROVIDES FINANCIAL AND IN-KIND SUPPORT FOR LOCAL ORGANIZATIONS THAT ALIGN WITH ITS MISSION OF HEALTH AND WELLNESS. SPONSORSHIPS GRANTED BY TIDELANDS HEALTH SHOULD PROMOTE HEALTH AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS IN GEORGETOWN, HORRY AND WILLIAMSBURG COUNTIES. PRIORITY FUNDING AND CONSIDERATION ARE GIVEN TO PROGRAMS AND ACTIVITIES THAT FOCUS ON THE FOLLOWING AREAS: HEALTH DISPARITIES; DISEASE MANAGEMENT; WELLNESS; DISEASE PREVENTION AND HEALTH PROMOTION; AND COORDINATION OF CARE. ALL SPONSORSHIP APPLICATIONS ARE REVIEWED BY THE TIDELANDS HEALTH COMMUNITY GIVING COMMITTEE, WHICH MAKES FUNDING DECISIONS BASED ON ESTABLISHED GUIDELINES AND CRITERIA. FUNDING IS DIRECTED TO THOSE EVENTS AND ORGANIZATIONS THAT MOST CLOSELY ALIGN WITH TIDELANDS HEALTH'S HEALTH CARE MISSION. X X X X 0 1 0 1 1 1 1 0 0 DR MICHAEL RATZ CHIEF OF STAFF & PHYSICIAN 6938 296667 0 32969 0 37099 0 6942 0 31415 6938 405092 0 0 BRUCE BAILEY PRESIDENT & CEO 263395 270225 0 0 35335 36251 4837 4963 16086 16503 319653 327942 0 0 GAYLE RESETAR EXECUTIVE VICE PRESIDENT & COO 182699 187437 0 0 23979 24601 4837 4963 11899 12208 223414 229209 0 0 ELIZABETH WARD EXECUTIVE VICE PRESIDENT & CFO 196545 201642 0 0 25015 25664 4376 4490 13606 13959 239542 245755 0 0 RICK KAYLOR SENIOR VICE PRESIDENT SYSTEM DEVELOP 148166 152009 16763 17198 19453 19958 4487 4603 6770 6946 195639 200714 0 0 PHILIP DULBERGER EXECUTIVE VICE PRESIDENT & CHIEF PHY 232923 238963 0 0 22660 23248 4837 4963 14963 15351 275383 282525 0 0 JAMES F HARPER SENIOR VICE PRESIDENT & CHIEF HUMAN 107315 110098 13645 13998 31252 32063 4547 4665 16675 17107 173434 177931 0 0 PAM MAXWELL SENIOR VICE PRESIDENT & CHIEF NURSIN 100119 102715 12877 13211 24089 24714 3369 3457 12039 12351 152493 156448 0 0 FLORIAN ANZEVENO INTERIM CIO/ADVISER 107069 109845 0 0 28337 29072 2479 2543 0 0 137885 141460 0 0 GERALD HARMON VP MEDICAL AFFAIRS 152129 156074 17136 17580 24304 24934 2419 2481 1113 1142 197101 202211 0 0 PART I, LINE 4B ALL SENIOR CABINET MEMBERS (BRUCE BAILEY, GAYLE RESETAR, BETH WARD, PHILIP DULBERGER, PAM MAXWELL, RICK KAYLOR, JAN HARPER & GERALD HARMON) WERE ENROLLED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN BEGINNING 10/1/2018. BRUCE, BETH, GAYLE & PHIL ARE ENROLLED IN A SPLIT DOLLAR LIFE INSURANCE PLAN. 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. DR. HARMON, PAM, RICK & JAN RECEIVE A RETENTION BONUS EACH YEAR (INCLUDED IN COMPENSATION). 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 GEORGETOWN MEMORIAL 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 2011-09-22 25565000 CURRENT REFUNDING 0 0 0 B SC JOBS - ECONOMIC DEVELOPMENT AUTHORITY 570960018 NONEAVAIL 2011-12-22 12165620 CURRENT REFUNDING 0 0 0 C SC JOBS - ECONOMIC DEVELOPMENT AUTHORITY 570960018 NONEAVAIL 2016-09-09 87890000 REFUND PRIOR ISSUE AND CONSTRUCT 0 0 0 D SC JOBS - ECONOMIC DEVELOPMENT AUTHORITY 570960018 NONEAVAIL 2016-11-03 35050000 CURRENT REFUNDING 0 0 0 A 8736575 9350748 94698 9256050 2001 1 0 1 1 B 2530000 12190000 123522 12066478 1999 1 0 1 1 C 1793205 70964870 62500000 8464870 1 0 0 0 D 80318 14816476 71332 14745144 1 0 1 1 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 0 0 0 0 0 B 0 0 1 0 1 0 0 0 0 C 0 1 0 0 1 0 0 0 0 D 0 1 0 0 0 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 A WERE USED TO REFUND BONDS THAT WERE ISSUED ON 8/15/1999 AND 8/1/2001. THE AMOUNTS IN COLUMN B WERE USED TO REFUND BONDS THAT WERE ISSUED ON 3/15/1998 AND 8/15/1999. THE AMOUNTS IN COLUMN C WERE USED TO REFUND BONDS THAT WERE ISSUED ON 12/22/2010. THE AMOUNTS IN COLUMN D WERE USED TO REFUND BONDS THAT WERE ISSUED ON 5/30/2012. BRUCE BAILEY PRESIDENT & CEO FUND PURCHASE OF CASH VALUE LIFE INSURANCE POLICIES. X 1245763 1249246 0 1 1 GAYLE RESETAR EVP & COO FUND PURCHASE OF CASH VALUE LIFE INSURANCE POLICIES. X 652542 654372 0 1 1 ELIZABETH S WARD EVP & CFO FUND PURCHASE OF CASH VALUE LIFE INSURANCE POLICIES. X 771186 773338 0 1 1 PHILIP DULBERGER VP & CPE FUND PURCHASE OF CASH VALUE LIFE INSURANCE POLICIES. X 830509 832829 0 1 1 3509785 BECCA KAYLOR FAMILY MEMBER OF OFFICER RICK KAYLOR 31403 COMPENSATION AS EMPLOYEE OF ORGANIZATION. AMOUNT SHOWN ON SCHEDULE L REPRESENTS GMH'S ALLOCATED PORTION OF TOTAL SALARY PAID FROM A RELATED ORGANIZATION. THE INDIVIDUAL RECEIVED $63,620 IN TOTAL FOR SERVICES RENDERED TO ALL RELATED ORGANIZATIONS. 0 SCHEDULE L PART II THE EO PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS THROUGH AN ARRANGEMENT THE IRS REFERS TO AS "COLLATERAL ASSIGNMENT SPLIT DOLLAR" (CASD). ALTHOUGH THE IRS REQUIRES REPORTING IN PART II, ABOVE, FOR LOANS TO INTERESTED PERSONS, CASD IS NOT AN ACTUAL LOAN. THERE IS NEITHER A TRANSFER OF FUNDS TO THE PARTICIPANT NOR AN OBLIGATION FOR THE PARTICIPANT TO PAY THOSE FUNDS BACK. INSTEAD, THE EO RECOVERS ITS OUTLAYS PLUS INTEREST FROM THE UNDERLYING POLICY.THE RECOVERY RIGHT IS A KEY ADVANTAGE OF CASD. WITH TRADITIONAL DEFERRED COMPENSATION, THE EO PAYS THE BENEFIT FROM CORPORATE ASSETS, NEVER TO RECOVER THOSE DOLLARS. WITH CASD, THE EO RECOVERS NOT ONLY ITS OUTLAYS, BUT ALSO INTEREST THAT TAKES INTO ACCOUNT THE TIME VALUE OF MONEY.IN CASD, THE EO DEPOSITS DOLLARS DIRECTLY INTO A LIFE INSURANCE POLICY, WITH THE EO HOLDING A LIEN ON THE POLICY TO ENSURE REPAYMENT. AT SPECIFIED TIMES AND SUBJECT TO VESTING REQUIREMENTS, THE PARTICIPANT MAY BORROW FROM THE CASH VALUE OF THE POLICY TO SUPPLEMENT RETIREMENT INCOME (PROVIDED THERE ARE SUFFICIENT POLICY VALUES). BORROWING IS CAREFULLY MONITORED AND LIMITED TO ASSURE THAT THE POLICY WILL REMAIN IN EFFECT UNTIL THE PARTICIPANT'S DEATH AND WILL PAY A DEATH BENEFIT AT LEAST SUFFICIENT TO REPAY THE EO'S OUTLAYS PLUS INTEREST. ANY REMAINING DEATH PROCEEDS ARE DIVIDED BETWEEN THE EO AND THE EXECUTIVE'S BENEFICIARY AS AGREED UPON BY THE PARTIES.LOAN BALANCETHE CORE FORM, PART X, LINE 5 AND SCHEDULE L, PART II INDICATES LOANS AND OTHER RECEIVABLES OF $3,509,785. THE CUMULATIVE BALANCE DUE FROM EXECUTIVES IS $3,703,447. PLEASE NOTE THE VARIANCE BETWEEN THE TWO FIELDS IS A RESULT OF THE DIFFERENCE BETWEEN THE CASH VALUE OF THE LIFE INSURANCE AND THE PRINCIPAL PLUS ACCRUED INTEREST. X 1,452 DR. SCHOLL'S COMFORT INSOLES 1452 14520 COST X 10,000 FACE SHIELDS 10000 14000 COST X 3 PALLETS OF CANDY BARS 3 9000 COST 0 0 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 1,177. FORM 990, PART VI, SECTION A, LINE 1 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 REPRESENTATIVE OF THE ACCOUNTING FIRM PRESENTED THE RETURN TO THE FINANCE COMMITTEE WITH MANAGEMENT AND ANSWERED QUESTIONS FROM BOARD MEMBERS. THE CFO THEN REVIEWED THE FORM WITH ALL BOARD MEMBERS, AS EVIDENCED IN THE BOARD MINUTES. A COPY OF THE RETURN WAS PROVIDED TO EACH VOTING BOARD MEMBER. AFTER A DISCUSSION PERIOD, THE BOARD VOTED TO APPROVE THE FILING OF THE FORM 990 WITH THE IRS AS PRESENTED. THE CFO/CEO MET IN PERSON WITH ANY MEMBERS ABSENT FROM THE MEETING TO DISCUSS THE RETURN. 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) 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 XI, LINE 9: EQUITY TRANSFER -38,076,064. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. PART XI LN 5: THE CORE FORM, PART X, LINE 5 AND SCHEDULE L, PART II INDICATES LOANS AND OTHER RECEIVABLES OF $3,509,785. THE CUMULATIVE BALANCE DUE FROM EXECUTIVES IS $3,703,447. PLEASE NOTE THE VARIANCE BETWEEN THE TWO FIELDS IS A RESULT OF THE DIFFERENCE BETWEEN THE CASH VALUE OF THE LIFE INSURANCE AND THE PRINCIPAL PLUS ACCRUED INTEREST. FORM 990, PART V, LINE 1A: GEORGETOWN MEMORIAL HOSPITAL, FILES THE 1099'S FOR ITSELF AND TWO RELATED ORGANIZATIONS (GEORGETOWN HOSPITAL SYSTEM AND WACCAMAW COMMUNITY HOSPITAL). THE NUMBER OF 1099'S RELATED TO THE FILING ORGANIZATION IS 202. GEORGETOWN HOSPITAL SYSTEM PO BOX 421718 GEORGETOWN SC 29442 020598440 HEALTHCARE SC 501(C)(3) LINE 12B, II N/A 0 WACCAMAW COMMUNITY HOSPITAL PO BOX 421718 GEORGETOWN SC 29442 043633263 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 BYPASS MURRELLS INLET SC 29576 200131459 HEALTHCARE SC N/A TIDELANDS AND MEDQUEST JOINT VENTURE LLC 606 BLACK RIVER RD GEORGETOWN SC 29440 841945687 IMAGING SC N/A 0 0 0 0 1 0 0 0 1 1 1 1 0 1 1 1 1 0 0