2021-05-14T07:04:47-05:00 2020-06-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2019-07-01 621113169 SHELBY COUNTY HEALTH CARE CORPORATION SHEL 9015457928 877 JEFFERSON AVENUE MEMPHIS TN 38103 J RICHARD WAGERS JR CFO 9015457928 2021-05-14 1 AMY BIBBY P00445891 8282542254 2021-05-12 2019 2022-09-23 18:48:47Z REGIONAL ONE HEALTH J RICHARD WAGERS JR 877 JEFFERSON AVENUE MEMPHIS TN 38103 535950991 0 X WWW.REGIONALONEHEALTH.ORG X 1981 TN HEALTHCARE DELIVERY OPERATING A PUBLIC CHARITY HOSPITAL PROVIDING INPATIENT AND OUTPATIENT SERVICES. 14 14 4208 10 0 0 40164970 72345488 384873499 367331276 586412 -606591 68787912 94645152 494412793 533715325 0 0 0 0 205403731 204758117 0 0 895867 299206300 325045768 504610031 529803885 -10197238 3911440 333807579 338180767 102336307 115244390 231471272 222936377 X REGIONAL ONE HEALTH'S MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE WE SERVE BY PROVIDING COMPASSIONATE CARE AND EXCEPTIONAL SERVICES. 0 0 496707929 461976428 SHELBY COUNTY HEALTH CARE CORPORATION, DBA REGIONAL ONE HEALTH, IS A HEALTHCARE ORGANIZATION PROVIDING ACCESSIBLE, EFFICIENT QUALITY HEALTHCARE TO INDIVIDUALS FROM A FIVE-STATE REGION WITHIN 150 MILES OF THE MEMPHIS AREA. REGIONAL ONE HEALTH PROVIDES ACCESS TO THE ONLY LEVEL I TRAUMA CENTER TO PATIENTS WITHIN 150 MILES OF MEMPHIS, AND IS THE SAFETY NET TO THE REGION. PROVIDING INPATIENT AND OUTPATIENT SERVICES, REGIONAL ONE HEALTH IS ANCHORED BY FIVE HIGHLY RESPECTED CENTERS OF EXCELLENCE: TRAUMA, BURN, WOUND CARE, NEONATAL/PERINATAL AND HIGH RISK OBSTETRICS. REGIONAL ONE HEALTH IS A MAJOR TEACHING SITE FOR THE UNIVERSITY OF TENNESSEE HEALTH SCIENCES CENTER, TRAINING MORE THAN HALF OF THE DOCTORS IN TENNESSEE. IN FISCAL YEAR 2020, THERE WERE: 13,162 DISCHARGES; 2,045 NORMAL NEWBORN DISCHARGES; 892 HIGH RISK NEWBORN DISCHARGES; 173,284 OUTPATIENT VISITS; 10,824 TRAUMA VISITS; AND 42,051 OTHER EMERGENCY ROOM VISITS. 496707929 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 1 274 0 1 4208 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X WILLIAM BROOKS CHAMPION 9015458244 877 JEFFERSON AVENUE MEMPHIS TN 38103 DAVID T POPWELL CHAIRMAN 1.00 X X 0 0 0 RONALD COLEMAN VICE CHAIR 1.00 X X 0 0 0 BRENDA HARDY MD SECRETARY 1.00 X X 0 0 0 SCOT LENOIR DIRECTOR 1.00 X 0 0 0 KENNARD BROWN DIRECTOR 1.00 X 0 0 0 COMMISSIONER VAN TURNER DIRECTOR 1.00 X 0 0 0 JUDY EDGE DIRECTOR 1.00 X 0 0 0 JAMES FREEMAN MD DIRECTOR 1.00 X 0 0 0 PAUL MORRIS DIRECTOR 1.00 X 0 0 0 EPHIE JOHNSON DIRECTOR 1.00 X 0 0 0 TIMOTHY FABIAN MD DIRECTOR 1.00 X 0 0 0 JOSHUA LIPMAN DIRECTOR 1.00 X 0 0 0 CLAUDETTE SHEPHARD MD DIRECTOR 1.00 X 0 0 0 JULIA KAVANAGH DIRECTOR 1.00 X 0 0 0 PHIL SHANNON DIRECTOR 0.00 X 0 0 0 MRS PAM BROWN DIRECTOR 1.00 X 0 0 0 DAVID T POPWELL DIRECTOR 1.00 X 0 0 0 COOPWOOD REGINALD PRESIDENT AND CEO 40.00 9.00 X 868036 0 159176 WAGERS JR JAMES EXECUTIVE VP AND CFO 40.00 5.00 X 533936 0 308062 SCHAFER LISA EXECUTIVE VP/COO/CNO 44.00 X 332156 0 52304 TOWNS LETICIA CHIEF ADMINISTRATIVE OFFICER 40.00 X 324214 0 58556 ABDULLAH IMAD SENIOR VP/CHIEF LEGAL COUNSEL 40.00 X 328053 0 56652 PERISHO BRET SR VP. CHIEF STRATEGY OFFICER 40.00 X 443172 0 116798 CROCE MARTIN SR VP. CHIEF MEDICAL OFFICER 40.00 X 454981 0 92656 COOPER SUSAN SENIOR VP/CIO 40.00 X 296697 0 44464 KIM WILLIAM SENIOR VP/CIO 40.00 X 267596 0 42524 3848841 0 931192 207 0 1 0 EMPLOYEE HEALTH NETWORK HOLDING LLC PO BOX 896599 CHARLOTTE NC 28289 HEALTHCARE SERVICES 7450420 UNIVERSITY CLINICAL HEALTH FINANCE AND A 1407 UNION AVE STE 720 MEMPHIS TN 38104 PHYSICIAN SERVICES 5843268 AGILITI HEALTH LLC 6625 WEST 78TH STREET STE 300 MINNEAPOLIS MN 55439 MANAGEMENT SERVICES 3856661 VENTURE TECHNOLOGIES CONVERGEONE INC PO BOX 11407 BIRMINGHAM AL 35246 IT SERVICES 3724731 DATA BLUE LLC PO BOX 281274 NASHVILLE TN 37228 IT SERVICES 2391237 49 446176 71899312 72345488 NET PATIENT SERVICE RE 900099 367331276 367331276 367331276 1629075 1629075 2235666 -2235666 -2235666 -2235666 OUTPATIENT PHARMACY 900099 92025111 92025111 2620041 2620041 94645152 533715325 461976428 0 -606591 X 2058342 725500 1332842 172570408 155614129 16338576 617703 2865391 2565294 289961 10136 15352448 13744564 1553579 54305 11911528 10664016 1205378 42134 11975505 826774 10977142 171589 360607 292732 67875 434736 434736 224300 224300 105269244 105269244 691415 691415 563035 563035 12514624 12514624 17148459 17148459 262396 262396 112300 112300 37080 37080 10482000 10482000 2323735 2323735 MEDICAL SUPPLIES 131612049 131612049 31034283 31034283 529803885 496707929 32200089 895867 14986656 17881361 340004 341105 918135 1247080 172851493 103343935 19221600 19221600 6749129 6199080 4424031 4360684 403886228 342174454 65360152 61711774 36020380 113173815 12935999 10700333 333807579 338180767 79348782 79565899 1670358 10047742 21317167 25630749 102336307 115244390 X 19999590 19999590 0 0 211471682 202936787 231471272 222936377 333807579 338180767 X 3911440 1226301 -13672636 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 49014 49014 0 PART II-B, LINE 1: LOBBYING SUPPORT PAID DIRECTLY TO VARIOUS VENDORS AND INDIRECTLY THROUGH DUES PAID TO INDUSTRY ASSOCIATIONS AND CONTRACTORS. 815382 815382 49097838 46851244 2246594 6493711 5925863 567848 264649734 241909810 22739924 82829563 47487537 35342026 61711774 RESERVES 7617538 COMPENSATED ABSENCES 18013211 25630749 X PART X, LINE 2: REGIONAL ONE HEALTH IS A NOT-FOR-PROFIT CORPORATION ORGANIZED BY THE APPROVAL OF THE BOARD OF COUNTY COMMISSIONERS OF THE COUNTY AND QUALIFIES AS A GOVERNMENTAL ENTITY NOT SUBJECT TO FEDERAL INCOME TAX, BY REASON OF BEING INTEGRAL PARTS OF A STATE OR POLITICAL SUBDIVISION. REGIONAL ONE HEALTH ALSO QUALIFIES AS A TAX-EXEMPT ENTITY UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN IRC SECTION 501(C)(3) (DUAL TAX-EXEMPT STATUS). THEREFORE, RELATED INCOME IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES, EXCEPT FOR TAX ON INCOME FROM ACTIVITIES UNRELATED TO ITS EXEMPT PURPOSE, AS DESCRIBED IN IRC SECTION 512(A). THUS, NO PROVISION FOR INCOME TAXES HAS BEEN RECORDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. 1 1 X 1 X 1 X 1 1 1 0 1 1 48292605 12119 48280486 0.09110 86945592 65480277 21465315 0.04050 135238197 65492396 69745801 0.13160 24351470 15259137 9092333 0.01720 456718 456718 0.00090 24808188 15259137 9549051 0.01810 160046385 80751533 79294852 0.14970 1 49992147 46122770 31382586 14740184 X 1 1 2 1 REGIONAL ONE HEALTH 877 JEFFERSON AVENUE MEMPHIS TN 38103 WWW.REGIONALONEHEALTH.ORG 00000110 X X X X INPATIENT REHABILITATION FACILITY, OUTPATIENT PRIMARY CARE CLINICS, NURSERY A 2 REGIONAL MEDICAL EXTENDED CARE HOSPITAL 890 MADISON AVENUE MEMPHIS TN 38103 WWW.REGIONALONEHEALTH.ORG/EXTENDED-CAR 00000186 X A REGIONAL ONE HEALTHREGIONAL MED EXTENDE 0 0 1 X X X X X X X X 19 1 0 0 1 X WWW.REGIONALONEHEALTH.ORG 1 19 1 WWW.REGIONALONEHEALTH.ORG 0 1 X 1 1 X X X X 1 X HTTPS://WWW.REGIONALONEHEALTH.ORG/FINANCIAL-ASSISTANCE-POLICY/ X HTTPS://WWW.REGIONALONEHEALTH.ORG/FINANCIAL-ASSISTANCE-POLICY/ X HTTPS://WWW.REGIONALONEHEALTH.ORG/FINANCIAL-ASSISTANCE-POLICY/ X X X X X 1 X 0 X X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: REGIONAL ONE HEALTH, - FACILITY 2: REGIONAL MEDICAL EXTENDED CARE HOSPITAL REGIONAL ONE HEALTH/REGIONAL MED EXTENDE PART V, SECTION B, LINE 5: THE DEVELOPMENT OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) INCLUDED BOTH QUANTITATIVE AND QUALITATIVE RESEARCH COMPONENTS. TO OBTAIN BROAD INPUT FROM THE COMMUNITY, THE CHNA DEVELOPMENT PROCESS INCLUDED DATA GATHERING UTILIZING AN ONLINE COMMUNITY SURVEY, KEY INFORMANT SURVEYS AND COMMUNITY REPRESENTATION ON THE STEERING COMMITTEE AND IN THE CHNA DEVELOPMENT PRIORITIZATION SESSION. APPROXIMATELY 936 ONLINE COMMUNITY SURVEYS WERE COMPLETED BY INDIVIDUALS FROM VARIED DEMOGRAPHIC AND SOCIOECONOMIC BACKGROUNDS. INDIVIDUALS COMPLETING THE KEY INFORMANT SURVEY WERE IDENTIFIED AS INDIVIDUAL MOST LIKELY AWARE OF, AND OR INVOLVED IN ADDRESSING COMMUNITY HEALTH NEEDS. APPROXIMATELY 55 INDIVIDUALS, "KEY INFORMANTS", COMPLETED THE KEY INFORMANTS' SURVEY. THESE INDIVIDUALS INCLUDED REPRESENTATIVES FROM SOCIAL SERVICES AGENCIES; RELIGIOUS AND FAITH-BASED ORGANIZATIONS; PUBLIC HEALTH AND HEALTHCARE ORGANIZATIONS; ELECTED OFFICIALS; EDUCATIONAL INSTITUTIONS OR SYSTEM AND OTHER COMMUNITY LEADERS. COMMUNITY MEMBERS PARTICIPATING IN THE PRIORITIZATION SESSION INCLUDED REPRESENTATIVE FROM THE LOCAL HEALTH DEPARTMENT, LOCAL UNIVERSITY SCHOOLS OF PUBLIC HEALTH AND NURSING, ELECTED OFFICIALS, HEALTH SYSTEM'S FOUNDATION BOARD, RELIGIOUS LEADERS AND SENIOR STAFF FROM THE ORGANIZATION. REGIONAL ONE HEALTH/REGIONAL MED EXTENDE PART V, SECTION B, LINE 11: IN THE MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), NINE COMMUNITY HEALTH NEEDS WERE IDENTIFIED AND PRIORITIZED IN A PRIORITIZATION SESSION WHICH INCLUDED 16 COMMUNITY REPRESENTATIVES. FOLLOWING THE PRIORITIZATION SESSION, AND IN ADVANCE OF SUBMITTING THE RECOMMENDED IMPLEMENTATION PLAN TO THE BOARD FOR APPROVAL, THE ORGANIZATION IDENTIFIED WHICH PRIORITIZED NEEDS WOULD BE ADDRESSED. THE CRITERIA USED TO DETERMINE THE NEEDS TO ADDRESS INCLUDED THE ABILITY TO: 1. SUSTAIN AND LEVERAGE EXISTING EFFORTS ALIGNED WITH THE CHNA, CURRENT AND MOST RECENT, AND PRIORITIZED NEEDS; 2. DEVELOP AND/OR SUPPORT ADDITIONAL PARTNERSHIPS, PROGRAMS AND INITIATIVES TO ADDRESS THE NEEDS; AND 3. ACCOUNT FOR THE HEALTH SYSTEM'S RESOURCES AND EXPERTISE, MISSION AND STRATEGIC GOALS. THE CHOSEN COMMUNITY HEALTH NEEDS TO BE ADDRESSED WILL BE ADDRESSED BASED ON THESE CRITERIA. IN ADDITION, ADDRESSING THESE NEEDS WILL INCLUDE: CONTINUATION OF CURRENT PROGRAMS AND EFFORTS; COLLABORATIVE WORK WITH OTHER COMMUNITY PARTNERS AND SUPPORT OF NEW AND EXISTING COMMUNITY WIDE EFFORTS. AS OUTLINED IN THE APPROVED IMPLEMENTATION PLAN, REGIONAL ONE HEALTH WILL NOT ADDRESS THE FOLLOWING COMMUNITY HEALTH NEEDS: DRUG ABUSE, MENTAL HEALTHCARE, TB OR POVERTY. REGIONAL ONE HEALTH DOES NOT POSSESS THE SUBJECT MATTER EXPERTISE TO ADDRESS THESE NEEDS. IN ADDITION, THE UNADDRESSED NEEDS ARE BEYOND THE HEALTH SYSTEM'S ABILITY TO HAVE A DIRECT IMPACT, I.E. POVERTY. THERE ARE NUMEROUS COMMUNITY, GOVERNMENT AND SOCIAL SERVICE ORGANIZATIONS, AS WELL AS SPECIALTY HEALTHCARE PROVIDERS MORE CAPABLE AND EXPERIENCED IN ADDRESSING THESE NEEDS. REGIONAL ONE HEALTH/REGIONAL MED EXTENDE PART V, SECTION B, LINE 13H: OTHER ADDITIONAL METHOD ADDED TO DETERMINING FINANCIAL ASSISTANCE IS THE ACCEPTED USE OF PARD (PAYMENT ASSISTANCE RANK ORDER) BY SCORING PATIENTS BASED ON VARIOUS SOCIO-ECONOMIC FACTORS AVAILABLE. REGIONAL ONE HEALTH/REGIONAL MED EXTENDE PART V, SECTION B, LINE 20E: USE OF PAYMENT ASSISTANCE RANK ORDER (PARD) SCORING IS USED IN ADDITIONAL TO OTHER AVAILABLE PATIENT DATA. SCHEDULE H, PART V, SECTION B, LINE 5-GROUP A REGIONAL ONE HEALTH - THE DEVELOPMENT OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) INCLUDED BOTH QUANTITATIVE AND QUALITATIVE RESEARCH COMPONENTS. TO OBTAIN BROAD INPUT FROM THE COMMUNITY, THE CHNA DEVELOPMENT PROCESS INCLUDED DATA GATHERING UTILIZING AN ONLINE COMMUNITY SURVEY, KEY INFORMANT SURVEYS AND COMMUNITY REPRESENTATION ON THE STEERING COMMITTEE AND IN THE CHNA DEVELOPMENT PRIORITIZATION SESSION. APPROXIMATELY 936 ONLINE COMMUNITY SURVEYS WERE COMPLETED BY INDIVIDUALS FROM VARIED DEMOGRAPHIC AND SOCIOECONOMIC BACKGROUNDS. INDIVIDUALS COMPLETING THE KEY INFORMANT SURVEY WERE IDENTIFIED AS INDIVIDUAL MOST LIKELY AWARE OF, AND OR INVOLVED IN ADDRESSING COMMUNITY HEALTH NEEDS. APPROXIMATELY 55 INDIVIDUALS, "KEY INFORMANTS", COMPLETED THE KEY INFORMANTS' SURVEY. THESE INDIVIDUALS INCLUDED REPRESENTATIVES FROM SOCIAL SERVICES AGENCIES; RELIGIOUS AND FAITH-BASED ORGANIZATIONS; PUBLIC HEALTH AND HEALTHCARE ORGANIZATIONS; ELECTED OFFICIALS; EDUCATIONAL INSTITUTIONS OR SYSTEM AND OTHER COMMUNITY LEADERS. COMMUNITY MEMBERS PARTICIPATING IN THE PRIORITIZATION SESSION INCLUDED REPRESENTATIVE FROM THE LOCAL HEALTH DEPARTMENT, LOCAL UNIVERSITY SCHOOLS OF PUBLIC HEALTH AND NURSING, ELECTED OFFICIALS, HEALTH SYSTEM'S FOUNDATION BOARD, RELIGIOUS LEADERS AND SENIOR STAFF FROM THE ORGANIZATION. SCHEDULE H, PART V, SECTION B, LINE 11-GROUP A REGIONAL ONE HEALTH -IN THE MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), NINE COMMUNITY HEALTH NEEDS WERE IDENTIFIED AND PRIORITIZED IN A PRIORITIZATION SESSION WHICH INCLUDED 16 COMMUNITY REPRESENTATIVES. FOLLOWING THE PRIORITIZATION SESSION, AND IN ADVANCE OF SUBMITTING THE RECOMMENDED IMPLEMENTATION PLAN TO THE BOARD FOR APPROVAL, THE ORGANIZATION IDENTIFIED WHICH PRIORITIZED NEEDS WOULD BE ADDRESSED. THE CRITERIA USED TO DETERMINE THE NEEDS TO ADDRESS INCLUDED THE ABILITY TO: 1. SUSTAIN AND LEVERAGE EXISTING EFFORTS ALIGNED WITH THE CHNA, CURRENT AND MOST RECENT, AND PRIORITIZED NEEDS; 2. DEVELOP AND/OR SUPPORT ADDITIONAL PARTNERSHIPS, PROGRAMS AND INITIATIVES TO ADDRESS THE NEEDS; AND 3. ACCOUNT FOR THE HEALTH SYSTEM'S RESOURCES AND EXPERTISE, MISSION AND STRATEGIC GOALS. THE CHOSEN COMMUNITY HEALTH NEEDS TO BE ADDRESSED WILL BE ADDRESSED BASED ON THESE CRITERIA. IN ADDITION, ADDRESSING THESE NEEDS WILL INCLUDE: CONTINUATION OF CURRENT PROGRAMS AND EFFORTS; COLLABORATIVE WORK WITH OTHER COMMUNITY PARTNERS AND SUPPORT OF NEW AND EXISTING COMMUNITY WIDE EFFORTS. AS OUTLINED IN THE APPROVED IMPLEMENTATION PLAN, REGIONAL ONE HEALTH WILL NOT ADDRESS THE FOLLOWING COMMUNITY HEALTH NEEDS: DRUG ABUSE, MENTAL HEALTHCARE, TB OR POVERTY. REGIONAL ONE HEALTH DOES NOT POSSESS THE SUBJECT MATTER EXPERTISE TO ADDRESS THESE NEEDS. IN ADDITION, THE UNADDRESSED NEEDS ARE BEYOND THE HEALTH SYSTEM'S ABILITY TO HAVE A DIRECT IMPACT, I.E. POVERTY. THERE ARE NUMEROUS COMMUNITY, GOVERNMENT AND SOCIAL SERVICE ORGANIZATIONS, AS WELL AS SPECIALTY HEALTHCARE PROVIDERS MORE CAPABLE AND EXPERIENCED IN ADDRESSING THESE NEEDS. SCHEDULE H, PART V, SECTION B, LINE 13HGROUP A OTHER ADDITIONAL METHOD ADDED TO DETERMINING FINANCIAL ASSISTANCE IS THE ACCEPTED USE OF PARD (PAYMENT ASSISTANCE RANK ORDER) BY SCORING PATIENTS BASED ON VARIOUS SOCIO-ECONOMIC FACTORS AVAILABLE. SCHEDULE H, PART V, SECTION B, LINE 20E-GROUP A USE OF PAYMENT ASSISTANCE RANK ORDER (PARD) SCORING IS USED IN ADDITIONAL TO OTHER AVAILABLE PATIENT DATA. SCHEDULE H, PART V, SECTION B, LINE 22D-GROUP A THE ORGANIZATION DISCOUNTS SELF-PAY CHARGES USING JAR (TENNESSEE JOINT ANNUAL REPORT) COST TO CHARGE RATIO TIMES 175%. FINANCIAL ASSISTANCE IS GRANTED, THEN CHARGES ARE WRITTEN OFF AT 100%. 1 1 - REGIONAL ONE HEALTH SUBACUTE CARE 877 JEFFERSON AVE ADAMS PAVILION 3RD FL MEMPHIS TN 38103 20-BED SKILLED NURSING FACILITY UNIT IN THE HOSPITAL, EFFECTIVE DEC 16, 2015 PART I, LINE 7: AMOUNTS REPORTED WERE CALCULATED USING A COST-TO-CHARGE RATIO AND FOLLOWING THE EXAMPLES OF WORKSHEETS 1-5 IN THE PUBLISHED 990 INSTRUCTIONS. PART II, COMMUNITY BUILDING ACTIVITIES: CONCENTRATED ON POPULATION HEALTH MANAGEMENT TO PROMOTE HEALTH EDUCATION AWARENESS IN THE COMMUNITY. PART III, LINE 2: BAD DEBT EXPENSE (COST) WAS ESTIMATED USING A COST-TO-CHARGE RATIO. PART III, LINE 8: COST OF MEDICARE SERVICES BASED ON COST TO CHARGE RATIO. PART III, LINE 9B: ORGANIZATION CONTRACTS WITH AN AGENCY TO ASSIST PATIENTS WITH COMPLETING APPLICATIONS FOR ELIGIBILITY UNDER FEDERAL AND STATE GOVERNMENT PROGRAMS AND PROVIDE CHARITY CARE APPLICATIONS. PART VI, LINE 2: DURING TAX YEAR 2018 AND FISCAL YEAR 2019, REGIONAL ONE HEALTH BEGAN EXECUTING ITS TRIENNIAL IMPLEMENTATION PLAN 2019-2021 THAT WAS RECOMMENDED TO AND APPROVED BY THE BOARD. REGIONAL ONE HEALTH USES MULTIPLE SOURCES TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED. THESE SOURCES INCLUDE PUBLICLY REPORTED HEALTH STATISTICS AND VITAL RECORDS, COMMISSIONED RESEARCH AND REPORTS BY NON-PROFIT ORGANIZATIONS (I.E., URBAN CHILD INSTITUTE) IN THE LOCAL COMMUNITY AND ACROSS THE STATE, AND OUR COMMUNITY HEALTH NEEDS ASSESSMENT. THE ORGANIZATION SENDS UNCOMPENSATED CARE APPLICATIONS TO PATIENTS FOR COMPLETION AND SUBMISSION OF INCOME PROOF TO DETERMINE ELIGIBILITY FOR THE UNCOMPENSATED CARE PROGRAM. PART VI, LINE 3: ORGANIZATION SENDS UNCOMPENSATED CARE APPLICATIONS TO PATIENTS FOR COMPLETION AND SUBMISSION OF INCOME PROOF TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PART VI, LINE 4: REGIONAL ONE HEALTH IS LOCATED IN MEMPHIS, TENNESSEE. MEMPHIS IS IN SHELBY COUNTY AND PART OF THE MEMPHIS TENNESSEE, METROPOLITAN MISSISSIPPI AND ARKANSAS MSA. THE TOTAL POPULATION OF MEMPHIS IS APPROXIMATELY 650,000 AND THE APPROXIMATE POPULATION OF SHELBY COUNTY IS 935,000. MORE THAN TWO-THIRDS OF THE COUNTY'S POPULATION RESIDES IN MEMPHIS. IN MEMPHIS, 63.3 PERCENT OF THE POPULATION IS BLACK AND 29.4 PERCENT IS WHITE, COMPARED TO A 52.3 PERCENT BLACK POPULATION AND 43.6 PERCENT WHITE POPULATION IN SHELBY COUNTY. TWENTY-SIX PERCENT OF THE POPULATION IN MEMPHIS LIVES BELOW THE POVERTY LEVEL. THE MEDIAN EARNINGS FOR WORKERS IN MEMPHIS IS $24,882, AND THE MEDIAN HOUSEHOLD INCOME IS $37,000. TWENTY-THREE PERCENT OF MEMPHIS POPULATION OVER THE AGE OF 25 HAS A BACHELOR'S DEGREE. PART VI, LINE 5: REGIONAL ONE HEALTH PARTNERED WITH AND/OR SUPPORTED NUMEROUS ORGANIZATIONS AND INITIATIVES AIMED AT REGIONAL ONE HEALTH PARTNERED WITH AND,OR SUPPORTED NUMEROUS ORGANIZATIONS AND INITIATIVES AIMED AT TOMORROW, HEALTHY MEMPHIS COMMON TABLE, MEMPHIS MEDICAL DISTRICT, MEMPHIS AREA CHAMBER OF COMMERCE, CITY OF MEMPHIS INNOVATION DELIVERY TEAM, AND THE DOWNTOWN COMMISSION. REGIONAL ONE HEALTH'S AFFILIATIONS WITH THESE & OTHER GROUPS ARE VARIED, AND INCLUDE BEING PAID MEMBERS OR SPONSORS AS WELL AS IN-KIND SUPPORT. MEMBERS OF REGIONAL ONE HEALTH STAFF SERVE AS VOLUNTEER BOARD MEMBERS OR IN LEADERSHIP CAPACITIES WITH SEVERAL COMMUNITY ORGANIZATIONS. THE AFOREMENTIONED ORGANIZATIONS AND OTHERS HAVE A PRIMARY FOCUS ON IMPROVING THE QUALITY OF LIFE IN THE COMMUNITY THROUGH HEALTH IMPROVEMENT INITIATIVES, ENVIRONMENTAL ISSUES, AND ECONOMIC DEVELOPMENT-COMMUNITY BUILDING ACTIVITIES ARE PLANNED, AND NECESSARY PARTNERSHIPS FORMED TO IMPROVE THE QUALITY OF LIFE AND HEALTH IN OUR COMMUNITY BASED ON NEEDS IDENTIFIED BY OUR STAFF, THROUGH OUR PLANNING PROCESS, COMMUNITY REQUESTS AND OUR RESOURCE CAPACITY. OUR COMMUNITY BUILDING ACTIVITIES ARE ALSO PLANNED-BASED NEEDS IDENTIFIED AND REPORTED BY OTHER ORGANIZATIONS. IN ADDITION TO THE PREVIOUSLY MENTIONED AFFILIATIONS, REGIONAL ONE HEALTH SUPPORTS AND PARTNERS WITH MARCH OF DIMES, LOCAL COLLEGES AND UNIVERSITIES, SUSAN G. KOMEN, AMERICAN HEART ASSOCIATION, UNITED WAY OF THE MID-SOUTH, ALONG WITH A MYRIAD OF OTHER SOCIAL AND CIVIC ORGANIZATIONS TO RESPOND TO IDENTIFIED COMMUNITY HEALTH IMPROVEMENT NEEDS. X X X X X 1 1 0 0 0 0 0 0 0 COOPWOOD REGINALD PRESIDENT AND CEO 829238 0 0 0 38798 0 151544 0 7632 0 1027212 0 108891 0 WAGERS JR JAMES EXECUTIVE VP AND CFO 525411 0 0 0 8525 0 299964 0 8098 0 841998 0 0 0 SCHAFER LISA EXECUTIVE VP/COO/CNO 327696 0 0 0 4460 0 50000 0 2304 0 384460 0 0 0 TOWNS LETICIA CHIEF ADMINISTRATIVE OFFICER 309624 0 0 0 14590 0 55552 0 3004 0 382770 0 0 0 ABDULLAH IMAD SENIOR VP/CHIEF LEGAL COUNSEL 315196 0 0 0 12857 0 50847 0 5805 0 384705 0 0 0 PERISHO BRET SR VP. CHIEF STRATEGY OFFICER 214091 0 0 0 229081 0 108088 0 8710 0 559970 0 66953 0 CROCE MARTIN SR VP. CHIEF MEDICAL OFFICER 408344 0 41000 0 5637 0 91000 0 1656 0 547637 0 0 0 COOPER SUSAN SENIOR VP/CIO 282139 0 0 0 14558 0 42304 0 2160 0 341161 0 0 0 KIM WILLIAM SENIOR VP/CIO 266322 0 0 0 1274 0 33846 0 8678 0 310120 0 0 0 PART I, LINES 4A-B BRET PERISHO RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $124,731. A NUMBER OF INDIVIDUALS LISTED IN SCHEDULE J PARTICIPATED IN A SERP PLAN DURING THE YEAR AND RECEIVED SERP BENEFITS AS FOLLOWS: REGINALD COOPWOOD RECEIVED $126,557; J. RICHARD WAGERS RECEIVED $249,964; MARTIN CROCE RECEIVED $41,000; LETICIA TOWNS RECEIVED $30,832; IMAD ABDULLAH RECEIVED $32,075; BRET PERISHO RECEIVED 66,953; BILL KIM RECEIVED $27,500; AND SUSAN COOPER RECEIVED $28,254. X PPE EQUIPMENT 1 148165 FMV 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS WERE GIVEN ACCESS TO A DRAFT COPY OF THE FORM 990 THROUGH A SECURED INTERNET PORTAL. FORM 990, PART VI, SECTION B, LINE 12C LEGAL AND COMPLIANCE CONDUCTS AN ONGOING ANNUAL REQUEST FOR SUBMISSION OF CONFLICT OF INTEREST FORMS. PROCESS IS MONITORED BY CORPORATE COMPLIANCE TO ENSURE THAT ALL FORMS ARE COMPLETED. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE EXECUTIVE MANAGEMENT TEAM WAS APPROVED BY THE HUMAN RESOURCE COMMITTEE AND WAS DEEMED TO BE COMPETITIVE BASED ON BUSINESS CIRCUMSTANCES AND PREVAILING MARKET CONDITIONS. THE ORGANIZATION PURCHASES COMPENSATION/SALARY INFORMATION ANNUALLY FROM THREE NATIONAL CONSULTING GROUPS AND THE STATE HOSPITAL ASSOCIATION AND HAS A COMPENSATION CONSULTANT PROVIDE PERIODIC REVIEWS. THE INFORMATION IS USED AS A REFERENCE IN DETERMINING LEVELS FOR INTERNAL AND EXTERNAL EQUITY. THE LAST PERIODIC REVIEW FOR ALL OF THE POSITIONS WAS FINALIZED IN SEPTEMBER 2020. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G MEDICAL AND PROFESSIONAL SERVICES : PROGRAM SERVICE EXPENSES 105,269,244. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 105,269,244. FORM 990, PART XI, LINE 9: ADJUSTMENT TO VALUATION OF INVESTMENTS -13,672,636. REGIONAL MED EXTENDED CARE HOSPITAL LLC 890 MADISON AVENUE 4TH FLOOR MEMPHIS TN 38103 208930584 LONG TERM ACUTE CARE HOSPITAL TN 15847134 12004999 SHELBY COUNTY HEALTH CARE CORPORATION REGIONAL ONE HEALTH RESEARCH INSTITUTE LLC 877 JEFFERSON AVE SUITE 110 MEMPHIS TN 38103 843106301 RESEARCH TN 14206 14206 SHELBY COUNTY HEALTH CARE CORPORATION REGIONAL MEDICAL CENTER AT MEMPHIS FOUNDATION 877 JEFFERSON AVENUE MEMPHIS TN 38103 581737037 FOUNDATION RAISES FUNDS TO SUPPORT TN 501(C)(3) LINE 12B, II SHELBY COUNTY HEALTH CARE CORPORATION 1 SHELBY COUNTY HEALTH CARE PROPERTIES INC 877 JEFFERSON AVENUE MEMPHIS TN 38103 463479985 HOLDS TITLE TO AND LEASES THE REAL TN 501(C)(2) SHELBY COUNTY HEALTH CARE CORPORATION 1 MEMPHIS MEDICAL CENTER AIR AMBULANCE SERVICES INC 1080 EASTMORELAND AVENUE MEMPHIS TN 38104 621280261 OPERATES AIR AMBULANCE SERVICE TN 501(C)(3) LINE 12A, I N/A 0 REGIONAL ONE IMAGING CENTER 877 JEFFERSON AVE SUITE 110 MEMPHIS TN 38103 474626157 HEALTH CARE TN SHELBY COUNTY HEALTH CARE CORPORATION 143269 0 0 0.70000 REGIONAL ONE PROPERTIES INC 877 JEFFERSON AVENUE MEMPHIS TN 38103 464971777 HOLDS TITLE TO AND LEASES PROPERTY TN SHELBY COUNTY HEALTH CARE CORPORATION C 3497896 1.00000 0 REGIONAL ONE HEALTH INNOVATIONS INC 877 JEFFERSON AVENUE MEMPHIS TN 38103 822356548 MARKETING AND INVESTING TN SHELBY COUNTY HEALTH CARE CORPORATION C 1.00000 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0