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MCLEOD PHYSICIAN ASSOCIATES II: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
MCLEOD PHYSICIAN ASSOCIATES II (EIN 20-2935692)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-15
IRS object ID
201142279349301804
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-08-15T13:10:13-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1191 Peachtree Street Suite 2000AddressLine1
CityAtlantaCity
StateGAState
ZIP Code30303ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN202935692EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1McLeod Physician Associates IIBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMCLENameControl
Phone8437772256Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1555 E Cheves StreetAddressLine1
CityFlorenceCity
StateSCState
ZIP Code295020551ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameS Fulton ErvinIIIName
TitleChief Financial OfficerTitle
Phone8437772911Phone
Date Signed2011-08-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJohn W Sadoff JrName
Phone4042201500Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1McLeod Physician AssociatesBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonRobert ColonesNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1555 E Cheves StreetAddressLine1
CityFlorenceCity
StateSCState
ZIP Code29502ZIPCode
FieldValueIRS element (for citing)
Gross Receipts56941350GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.mcleodhealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2005YearFormation
State Legal DomicileSCStateLegalDomicile
Activity Or Mission DescriptionPhysician ServicesActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees537TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year32200ContributionsGrantsPriorYear
Contributions Grants Current Year37564ContributionsGrantsCurrentYear
Program Service Revenue Prior Year54758295ProgramServiceRevenuePriorYear
Program Service Revenue CY57100376ProgramServiceRevenueCY
Investment Income Prior Year-102737InvestmentIncomePriorYear
Investment Income Current Year-1115InvestmentIncomeCurrentYear
Other Revenue Prior Year384387OtherRevenuePriorYear
Other Revenue Current Year-196590OtherRevenueCurrentYear
Total Revenue Prior Year55072145TotalRevenuePriorYear
Total Revenue Current Year56940235TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year42835757SalariesEtcPriorYear
Salaries Etc Current Year45078430SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year16433618OtherExpensePriorYear
Other Expenses Current Year15904384OtherExpensesCurrentYear
Total Expenses Prior Year59269375TotalExpensesPriorYear
Total Expenses Current Year60982814TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-4197230RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-4042579RevenuesLessExpensesCY
Total Assets BOY9230166TotalAssetsBOY
Total Assets EOY8709821TotalAssetsEOY
Total Liabilities BOY20489377TotalLiabilitiesBOY
Total Liabilities EOY24011611TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-11259211NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-15301790NetAssetsOrFundBalancesEOY
Mission DescriptionTo provide physician services to the residents of the Pee Dee Region of South Carolina.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense58542921Expense
Revenue57100376Revenue
DescriptionMcLeod Physician Associates II's primary goal is to provide physician services to the residents of the Pee Dee Region of South Carolina.Description
Total Program Service Expense58542921TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109658NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees537NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form8899 Filed1Form8899Filed
Form1098 C Filed1Form1098CFiled
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Mark CameronBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8437775304TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1555 East Cheves StreetAddressLine1
CityFlorenceCity
StateSCState
ZIP Code29505ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Robert L Colones
Officer of Related Org40.00X071486271143
S Fulton Ervin III
Officer of Related Org40.00X036721755968
Michael E Payne
VP of Related Org40.00X020732946696
Dane P Ficco
Vice President40.00029699235597X
Christopher Cunningham MD
Staff Physician40.00851956049124X
Albert T Gilpin MD
Staff Physician40.00678436065245X
Charles R Tatum MD
Staff Physician40.00666040065124X
Kyle Watford MD
Staff Physician40.00606876029491X
Fred Holland MD
Staff Physician40.00588916023748X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3392224TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1586400TotalReportableCompFrmRltdOrgs
Total Other Compensation442136TotalOtherCompensation
Number Individuals GT100 K78NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Medical University Hospital
PO Box 931854AtlantaGA31193Medical Services466667
Medical Doctor Associates Inc
PO Box 277185AtlantaGA303847185Medical Services308355
Dr Gerald Atwood
2150 Lake Adeger ParkwayMill SpringNC28756Medical Services134187
Staff Care Inc
PO Box 281923AtlantaGA303841923Medical Services122278
Lab Corp
PO Box 12140BurlingtonNC272162140Medical Services101014
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Related Organizations37564RelatedOrganizations
Total Contributions37564TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Physician Services6211104703279247032792
Subsidy Fees6211101006758410067584
FieldValueIRS element (for citing)
Total Program Service Revenue57100376TotalProgramServiceRevenue

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other1115Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-1115Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-1115TotalRevenueColumn
Exclusion-$1,115ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOther RevenueDescription
Business Code900099BusinessCode
Total Revenue Column-196590TotalRevenueColumn
Exclusion-$196,590ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue-196590TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column56940235TotalRevenueColumn
Related Or Exempt Function Income57100376RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$197,705ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total395169Total
Program Services355652ProgramServices
Management And General39517ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total39170977Total
Program Services38513152ProgramServices
Management And General657825ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total216137Total
Program Services202796ProgramServices
Management And General13341ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3512880Total
Program Services3420962ProgramServices
Management And General91918ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1783267Total
Program Services1731987ProgramServices
Management And General51280ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1171830Total
Management And General1171830ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total71484Total
Program Services1100ProgramServices
Management And General70384ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2426599Total
Program Services2348928ProgramServices
Management And General77671ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total66337Total
Program Services37123ProgramServices
Management And General29214ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4076937Total
Program Services4022722ProgramServices
Management And General54215ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total260096Total
Program Services257672ProgramServices
Management And General2424ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2796350Total
Program Services2668907ProgramServices
Management And General127443ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total121438Total
Program Services116009ProgramServices
Management And General5429ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total13157Total
Program Services8008ProgramServices
Management And General5149ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total599619Total
Program Services570754ProgramServices
Management And General28865ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total624833Total
Program Services622071ProgramServices
Management And General2762ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Bad Debt34670383471838-48000
Contract Labor480674806700
Dues and Subscriptions387843419945850
Other Direct Expenses269512022267290
Licenses and Taxes13278123519270

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total81586Total
Program Services78401ProgramServices
Management And General3185ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total60982814Total
Program Services58542921ProgramServices
Management And General2439893ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY-175225BOY
EOY-626703EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5012032BOY
EOY4408418EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY330351BOY
EOY326062EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY581332BOY
EOY579827EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis10150860LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec7054941LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2405713BOY
EOY3095919EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1075963BOY
EOY926298EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY9230166BOY
EOY8709821EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5009025BOY
EOY4355388EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY15480352BOY
EOY19656223EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY20489377BOY
EOY24011611EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-11259211BOY
EOY-15301790EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-11259211BOY
EOY-15301790EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9230166BOY
EOY8709821EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis180930OtherCostOrOtherBasis
Depreciation80613Depreciation
Book Value100317BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis9969930OtherCostOrOtherBasis
Depreciation6974328Depreciation
Book Value2995602BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3095919TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
Due from Foundation66400
Other Miscellaneous22991
Due from Caresouth (Current)48446
CSV-Life Insurance607138
Other Assets Due From181323
FieldValueIRS element (for citing)
Total Book Value Other Assets926298TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Retirement Liabilities/Split Dollar Plan$919,501
Intercompany$18,736,722
FieldValueIRS element (for citing)
Total Of Amounts19656223TotalOfAmounts

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs1CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Robert L Colones
0583044098184033634031200039943078600500
S Fulton Ervin III
0295520053506018191022000033968042318500
Michael E Payne
0172462023647011220017027029669025402500
Dane P Ficco
024255004533209110014700020897033258900
Christopher Cunningham MD
829769000221870220000271240901080000
Albert T Gilpin MD
67231600061200385000267450743681000
Charles R Tatum MD
66103200050080385000266240731164000
Kyle Watford MD
6035360003340049000245910636367000
Fred Holland MD
5842510004665000237480612664000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 6ReturnReference
ExplanationPart I, Line 6a: Incentives are available to employees in leadership positions based on a combination of criteria including financial goals as well as quality initiatives. Part I, Line 6b: Incentives are available to employees in leadership positions of this and related organizations based on a combination of criteria including financial goals as well as quality initiatives.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 6McLeod Physician Associates II has a sole member which is McLeod Health.
Form 990, Part VI, Section A, line 7aThe Board of McLeod Health (sole member) has final authority as needed on the makeup and decision-making of McLeod Physician Associate II's Board.
Form 990, Part VI, Section A, line 7bThe Board of McLeod Health (sole member) has final authority as needed on the makeup and decision-making of McLeod Physician Associate II's Board.
Form 990, Part VI, Section B, line 11The process the organization uses to review the Form 990 consists of providing copies of the Form 990 to the Board of Trustees of McLeod Health (Sole Member of McLeod Physician Associates II) at the May 2011 Board meeting, along with a presentation covering the Form 990 by the preparing firm, Deloitte Tax, to allow for a thorough review by the Sole Member's Board before the filing date of August 15, 2011.
Form 990, Part VI, Section B, line 12cMcLeod Physician Associates II regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflict of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose.
Form 990, Part VI, Section B, line 15In determining compensation of McLeod Physician Associates II's top management official, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The compensation committee reviewed and approved the compensation. In the review of compensation, the top management official was compared to other similarly situated organizations and positions. He was not present when his compensation was determined.
Form 990, Part VI, Section C, line 19Governing documents, conflict of interest policy, and financial statements are available to the public upon request.
Form 990, Part VII:Robert L. Colones' compensation is paid by McLeod Health, a related organization of McLeod Physician Associates II. The compensation he receives is for his role as CEO of McLeod Health and not for his role as a Board Member, an uncompensated role, of McLeod Physician Associates II. Hours worked are not tracked on an entity by entity basis. Therefore, all hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week. S. Fulton Ervin, III's compensation is paid by McLeod Health, a related organization of McLeod Physician Associates II. The compensation he receives is for his role as CFO at McLeod Health and not for his role as a Board Member, an uncompensated role, of McLeod Physician Associates II. Hours worked are not tracked on an entity by entity basis. Therefore, all hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week. Michael Payne's compensation is paid by McLeod Health, a related organization of McLeod Physician Associates II. The compensation he receives is for his role as a Vice President at McLeod Health and not for his role as a Board Member, an uncompensated role, of McLeod Physician Associates II. Hours worked are not tracked on an entity by entity basis. Therefore, all hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week.Avg hours devoted to related org(s) when related comp is reported:
Form 990, Part III, Line 4a:The McLeod Health system (of which McLeod Physician Associates II is a part of) conducts or participates in many community programs that help further McLeod Physician Associates II's exempt purpose by promoting the health of the community. This narrative highlights just some of these programs: The Mission of McLeod Health is to improve the overall health and well being of people living within South Carolina and eastern North Carolina by providing excellence in healthcare. The medical center has championed this mission for more than a century -- celebrating 105 years of exceptional medical service to the region. McLeod Health is driven by a spirit of willing and compassionate service to others that is evident in the day-to-day hospital operations, long-range planning, and the people who are chosen to be a part of the McLeod team of professionals. This team of physicians, nurses, staff members, board members and volunteers are dedicated to providing the community with much more than medical care. Their commitment extends past the medical center's walls and into the region in an effort to build a stronger and healthier place for patients, co-workers, children and neighbors to live and work. McLeod Support to Area Organizations: McLeod Health supports more than 50 not-for-profit and local organizations by participating in events and fundraisers for these groups, providing financial contributions, and by offering the talents of McLeod staff members who serve as board members on planning committees for these organizations as well. McLeod Health annually partners with the American Heart Association for the Pee Dee Heart Walk each October. Hundreds of employees from the McLeod Cardiac and Stroke Units, Cardiac Rehabilitation Centers, Cardiac Catheterization Lab, McLeod Health & Fitness Center and other areas of McLeod Health passionately raise funds and walk in this event to reduce the prevalence of coronary heart disease and stroke in the region. For many McLeod participants, they are committed to the Heart Walk because they have been personally affected by heart disease, while others rise to the challenge in support of their patients and prevention efforts. Employees from many different areas of McLeod Health touched by cancer also join forces to take part in area American Cancer Society Relay for Life events in an effort to celebrate survivorship, prevent cancer, save lives, and diminish suffering from this disease. Each spring, walkers from the McLeod Neonatal Intensive Care Unit, McLeod Children's Hospital, Labor & Delivery and Newborn Nursery Units at McLeod Regional Medical Center and McLeod Medical Center Dillon also participate with their families in area March of Dimes' March for Babies events in hopes that someday every mom and baby will experience a healthy, full-term pregnancy. These McLeod physicians, nurses, support staff and volunteers form teams to support causes that have touched their lives in some way - - both personally and professionally-- in honor of the patients they serve and the families they have provided care. McLeod Health also works to uphold the services of the American Red Cross with financial support as well as through resources and blood donations made by employees during regular McLeod blood drives. According to the Red Cross, there is a critical need at national and state levels for blood, which is used in emergency situations as well as for people with cancer, blood disorders and other illnesses. Last year, McLeod Health collected 714 units of blood. This number is significant as one unit of blood can save up to three lives - - indicating that McLeod Health employees and community members who donated at McLeod facilities and events could potentially have saved more than 2,000 lives from one year's worth of donations. In addition, McLeod staff members dedicate invaluable time to serve on community boards including the Florence County Board of Health, Mercy Medicine, Science South, the Florence Public School District One Board and United Way, amongst others. McLeod Community Health Education Outreach Programs: McLeod Community Health Education outreach programs have provided numerous industries, school groups, churches, community festivals and countless organizations with tools to improve the health of these individuals and their loved ones. In fiscal year 2010, more than 10,000 community members were provided with information on cancer, diabetes, heart disease, diet and exercise, and safety for children, in addition to free or reduced-cost health screenings including blood pressure, blood sugar, bone density, and cholesterol screenings. Often this information can be the key to recognizing the signs and symptoms of a potentially serious health problem, allowing for more timely attention and follow up with one's physician. McLeod Resource Center: The McLeod Resource Center is a hub of information for the community with an emphasis on pregnancy, childbirth and family health. The Resource Center houses an Internet research area, which provides patients and their families with computer stations and a resource guide they can use to find reliable health information online. Patients in need of additional information about their diagnosis can visit the Resource Center to research their condition, ask questions of the clinically trained staff, or enjoy the quiet atmosphere and read educational materials provided by the American Heart Association, McLeod Diabetes Center, and the American Cancer Society as well as many others. Free childbirth and parenting magazines, baby care booklets, samples and informational literature are also available for expectant mothers who visit the Resource Center. In addition, the McLeod Resource Center offers an extensive series of free maternity education classes including Childbirth Preparation, Breastfeeding, Baby Care Postpartum, Maternity Tour, Big Sibling, and Family & Friends CPR. In addition, the Center hosts a free informal class for pregnant women called the Night for Expectant Women, or NEW. In the last year, there were more than 1,500 participants who attended the five to ten courses that are offered each month for expectant families. McLeod Safe Kids Florence: Safe Kids Florence, led by McLeod Health, works to reduce the number of unintentional childhood injuries through a multi-faceted approach combining community action, public awareness, education, technology and public policy initiatives. In the past 12 months, McLeod Safe Kids has checked more than 500 child safety seats for proper installation and trained an additional 155 caregivers on correct car seat installation techniques; attended nearly 20 area health fairs; provided more than 150 child photo ID cards; trained more than 20 teens in babysitting safety with the Safe Sitter program, and donated more than 50 helmets, and 100 smoke detectors to local children and their families. McLeod Safe Kids continues to grow and expand with the support of the McLeod Health Foundation and a grant from their community partner, Kohl's Cares for Kids.Community Benefit Report:
Form 990, Part III, Line 4a:A number of McLeod Safe Kids programs have touched many families locally helping to ensure safety for them and their community. Two ongoing examples are the Third Thursday with Kohl's Safe Seats Child Safety Seat Check program and the Photo Identification project. - The Third Thursday with Kohl's Safe Seats Child Safety Seat Check program has made a tremendous impact in the community by helping educate parents of young children that they are required by law to have their children secured in child safety seats. The Kohl's program, which originated in November of 2008, is also extremely valuable as four out of five child safety seats are installed incorrectly. Safe Kids holds a child safety seat check the third Thursday of each month from 4:00 p.m. until 6:00 p.m. in the Florence Kohl's parking lot. McLeod Safe Kids certified child safety seat technicians check for proper installation of child safety seats, correct those in need, and educate parents on proper installation and use of car seats. If the technician determines a new child safety seat is needed, the car seats are available on site. - The Photo Identification project allows parents to maintain an ID card featuring their child's up-to-date picture and accurate identification information. Safe Kids Florence recommends that children have a new photo identification card made each year. These cards provide valuable information for law enforcement such as digital fingerprint scans to assist in a missing child case. The photo identification cards are an invaluable tool for parents should anything happen to their child. Retention of Nurses and Support of Nursing Programs in the Region: As mentioned in #5, McLeod Health continues to support Florence-Darlington Technical College and Francis Marion University to help maintain and expand their nursing programs. These nursing programs are vital to the community as the medical center continues to grow and expand to meet the needs of the region's patients as well as offer enhanced services which will require need additional staffing and nurses. McLeod also serves as a learning site for more than 100 nurses a year who are students in local nursing programs. In addition, McLeod offers scholarships to eligible students to assist those who need financial aid with nursing school. McLeod scholarships are available to college students who have been accepted in an accredited allied healthcare program such as nursing. Other Notable Contributions Made by McLeod Health during Fiscal Year 2010 included: - McLeod Medical Center Darlington provided a free breast health screening for the community in October during National Breast Cancer Awareness month. The screening was held on October 6, 2009. - Free Saturday morning Injury Clinics are hosted each fall athletic season for high school athletes. The clinics are staffed by the Certified Athletic Trainers of McLeod Sports Medicine along with the physicians of McLeod Orthopedics and Pee Dee Orthopedic Associates. These healthcare professionals provide a complimentary medical assessment to evaluate the athlete's injury and make sure the injury is properly treated. They also determine if the injury requires an x-ray, if a referral is needed for physical therapy or if the athlete needs to see an orthopedic surgeon or other specialist. - For children with chronic illnesses including Asthma, Sickle Cell, and Type I Diabetes, McLeod Children's Hospital annually hosts Camp Health each summer. A free, three-day camp for children ages five to 12, Camp Health allows medical professionals to educate the pediatric participants and their caregivers on their conditions while offering fun and exciting activities such as trips to the Myrtle Beach Aquarium, Science South and the McLeod Health and Fitness Center. In Fiscal Year 2010, McLeod Health provided the region with $96.0 million dollars worth of charity care to benefit community families. McLeod Health not only provides community benefit through the services offered but also by stimulating the local economy. Last year, we contributed more than $296 million dollars in salaries and benefits, approximately $10 million dollars in sales tax, approximately $818,000 in property taxes, and more than $13.3 million dollars in hospital provider taxes to benefit the communities where its employees and patients live and work. These efforts demonstrate the spirit of willing and compassionate service that is at the heart, and the legacy, of McLeod Health.Community Benefit Report (Continued):

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatus
McLeod Regional Medical Center of Pee Dee Inc
555 East Cheves StreetFlorenceSC295020551570370242To operate a hospitalSC501(c)(3)Line 3
McLeod Health Foundation
555 East Cheves StreetFlorenceSC295020551570818672To raise money for Mcleod EntitesSC501(c)(3)Line 11 Type I
McLeod Medical Center-Dillon
555 East Cheves StreetFlorenceSC295020551510473471To operate a hospitalSC501(c)(3)Line 3
McLeod Health
555 East Cheves StreetFlorenceSC295020551510473500To operate a hospitalSC501(c)(3)Line 3

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1McLeod Medical Partners LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14401 Barclay Down Dr Ste 300AddressLine1
CityCharlotteCity
StateNCState
ZIP Code282094670ZIPCode
FieldValueIRS element (for citing)
EIN570812002EIN
Primary ActivityRentalPrimaryActivity
Legal Domicile StateSCLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1McLeod Regional Medical Center Of The Pee Dee IncBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeN/APredominantIncomeType
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1McLeod Physicians Associates IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1555 East Cheves StreetAddressLine1
CityFlorenceCity
StateSCState
ZIP Code29501ZIPCode
FieldValueIRS element (for citing)
EIN582279897EIN
Primary ActivityPhysician ServicesPrimaryActivity
Legal Domicile StateSCLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

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Business Name Line1McLeod Regional Medical Center Of The Pee Dee IncBusinessNameLine1
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Type Of EntityCTypeOfEntity
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Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
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Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

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Business Name Line1McLeod HealthBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeLTransactionType
Amount Involved1171830AmountInvolved