2020-08-14T13:39:45-05:00 2019-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2018-10-01 811723202 PRISMA HEALTH-UPSTATE PRIS 8647977611 300 EAST MCBEE AVENUE NO 302 GREENVILLE SC 29601 MICHAEL BURKE EVP-CHIEF FINANCIAL OFFICER 8647977611 2020-08-14 1 AMY BIBBY P00445891 8282542254 2020-08-14 99.47.28.203 2020-08-14 13:28:14 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 48FB394F9AA065459641371F168D9F2AFFFBB473 2018 2020-09-23 17:36:50Z MARK S O'HALLA 300 EAST MCBEE AVENUE NO 302 GREENVILLE SC 29601 2345802498 0 X WWW.GHS.ORG X 2016 SC INSPIRE HEALTH. SERVE WITH COMPASSION. BE THE DIFFERENCE. 17 17 13771 0 876321 0 10618761 10483239 2007036942 2274714901 12341646 5368759 3626001 53717220 2033623350 2344284119 72496162 19402013 0 0 806910153 861556533 0 0 0 999110733 1145141169 1878517048 2026099715 155106302 318184404 2187104766 1196689439 1245838395 804820694 941266371 391868745 INSPIRE HEALTH. SERVE WITH COMPASSION. BE THE DIFFERENCE. 0 0 1686474353 19402013 2327555800 PLEASE READ THE ANNUAL REPORT FOR MORE DETAIL ABOUT NEW AND EXPANDED SERVICES AND INNOVATIVE COLLABORATIONS AT THIS WEBSITE: HTTPS://WWW.PRISMAHEALTH.ORG/STATISTICAL-PROFILE-2019 1686474353 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 1 0 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 1 1022 0 1 13771 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 SC X KEVIN HODGE 8647977611 300 EAST MCBEE AVE STE 302 GREENVILLE SC 29601 ANDREW J WHITE JR BOARD MEMBER 1.00 X 0 0 0 ANNA KATE HIPP BOARD MEMBER 1.00 X 0 0 0 ANNMARIE HIGGINS BOARD MEMBER 1.00 X 0 0 0 WILLIAM M WEBSTER IV BOARD MEMBER 1.00 X 0 0 0 ROBERT T NITTO VICE CHAIR 1.00 X 0 0 0 BENJAMIN B WATERS III BOARD MEMBER 1.00 X 0 0 0 CHARLES E DALTON BOARD MEMBER 1.00 X 0 0 0 DAVID M LOMINACK BOARD MEMBER 1.00 X 0 0 0 MARGARET L JENKINS CHAIR 1.00 X 0 0 0 MARGUERITE R WYCHE BOARD MEMBER 1.00 X 0 0 0 MICHAEL CUMBY BOARD MEMBER 1.00 X 0 0 0 C MICHAEL SMITH BOARD MEMBER 1.00 X 0 0 0 W MICHAEL ELLISON BOARD MEMBER 1.00 X 0 0 0 PRASHANT PRABHU BOARD MEMBER 1.00 X 0 0 0 RICHARD A PHILLIPS BOARD MEMBER 1.00 X 0 0 0 RUTH M RICHBURG BOARD MEMBER 1.00 X 0 0 0 TIMOTHY J REED BOARD MEMBER 1.00 X 0 0 0 SPENCE M TAYLOR MD PRESIDENT, UPSTATE AFF'L (UNTIL 9/19) 40.00 1.00 X 53815 874624 160229 T CHAD MOSES VP AND CHIEF FINANCIAL EXECUTIVE 40.00 1.00 X 250799 0 65640 JOSEPH J BLAKE JR SECRETARY 1.00 40.00 X 29929 432135 37297 CHARLES D BEAMAN JR CO-CEO OF PRISMA HEALTH (UNTIL 7/19) 1.00 40.00 X 0 1402521 91282 MALCOLM W ISLEY CHIEF STRATEGY OFFICER 1.00 40.00 X 36356 761524 144512 ANGELO SINOPOLI MD CHIEF CLINICAL OFFICER 1.00 40.00 X 46751 1279480 167693 GREGORY J RUSNAK CHIEF ADMINISTRATIVE OFFIC 1.00 40.00 X 45138 1070183 164976 HOWARD P WEST GENERAL COUNSEL 1.00 40.00 X 0 463766 86144 TERRI T NEWSOM CHIEF FINANCIAL OFFICER 1.00 40.00 X 40574 1000448 160925 MICHAEL C RIORDAN CO-CEO OF PRISMA HEALTH (UNTIL 5/19) 1.00 40.00 X 0 1430294 87707 RICH ROGERS CHIEF INFORMATION OFFICER 40.00 1.00 X 415459 0 139718 CAROLYN SWINTON MN CHIEF NURSING OFFICER 1.00 40.00 X 0 362574 75775 DOUGLAS D DORMAN VP OF HUMAN RESOURCES 40.00 X 493162 0 4882 JAMES M ELLIS JR VP CLINICAL AFFAIRS 40.00 X 489436 0 162342 PAUL F JOHNSON VP CHIEF OPERATIONS EXECUTIVE 40.00 X 439482 0 155109 MICHELLE A SMITH CHIEF NURSING OFFICER 40.00 X 569663 0 45137 CHRISTOPHER C WRIGHT CHIEF MEDICAL STAFF 40.00 X 657009 0 55371 3567573 9077549 1804739 764 0 1 0 HEALTHCARE STAFFING SERVICES 1000 CENTER POINT ROAD COLUMBIA SC 29210 STAFFING SERVICES 25171442 EPIC SYSTEMS CORPORATION 1979 MILKY WAY VERONA WI 53593 EPIC SERVICES 19775320 INTERNAL MEDICINE ASSOCIATES 1025 VERDAE BLVD STE A GREENVILLE SC 29607 MANAGEMENT CONTRACT FEES 16181895 INTERNETWORK ENGINEERING INC 13777 BALLANTYNE CORPORATE PLACE S CHARLOTTE NC 28277 IT SERVICES 7425495 AMERICAN SECURITY OF GREENVILLE LLC PO BOX 486 GREENVILLE SC 29602 SECURITY SERVICES 6426814 743 36543 580967 9865729 75517 10483239 NET PATIENT SERVICE 621400 2170121768 2169490674 631094 OTHER REVENUE 900099 50803355 50558128 245227 PHARMACY SALES 446110 36516001 36516001 BAD DEBT RECOVERIES 900099 17308405 17308405 MEDICARE SHARED SAVING 900099 -34628 -34628 2274714901 6887138 6887138 3415488 0 3415488 3415488 3415488 599803 918576 -599803 -918576 -1518379 -1518379 NON-OPERATING INCOME 900099 50301732 50301732 50301732 2344284119 2327555800 876321 5368759 X 19402013 19402013 918821 918821 663132662 419872046 243260616 14365267 9082992 5282275 135883597 85917621 49965976 47256186 29879538 17376648 22757742 22757742 62947 62947 203531586 203531586 337 337 44713576 44713576 39509018 39509018 59127379 59127379 3385357 3385357 587530 587530 23413909 23413909 107466387 107466387 5137283 5137283 MEDICAL SUPPLIES 395806679 395806679 BAD DEBT EXPENSE 196753019 196753019 MEDICAID TAX 29752373 29752373 MIAP ASSESSMENT 6874824 6874824 6261223 6261223 2026099715 1686474353 339625362 0 84176530 -14737629 1816857 -883253 229457742 256936660 6148771 148375 200179 35474823 43594778 6818019 10389207 2226666866 1398287510 836856429 828379356 835474672 236000 13037724 12342763 10962309 10787541 126732515 49443837 2187104766 1196689439 227342809 251751697 98015615 96791398 35874283 32711065 593562728 352570848 291042960 70995686 1245838395 804820694 X 912369468 362525717 28896903 29343028 941266371 391868745 2187104766 1196689439 X 318184404 -31658500 -835923530 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 148947 148947 0 PART II-B, LINE 1: PRISMA HEALTH-UPSTATE PAYS ANNUAL MEMBERSHIP DUES AS PART OF ITS MEMBERSHIP WITH THE SC HOSPITAL ASSOCIATION AND 10.88% ($41,901) OF THESE DUES ARE USED FOR LOBBYING ACTIVITIES. THE ORGANIZATION ALSO PAID LOBBYING COSTS OF $98,115 TO PUBLIC STRATEGY. PAGE 3, PART II-B, LINE I, COLUMN (B) PRISMA HEALTH-UPSTATE ALSO PAYS THE SOUTH CAROLINA HOSPITAL ASSOCIATION DUES FOR BAPTIST EASLEY HOSPITAL. 10.88% ($2,933) OF THE SOUTH CAROLINA HOSPITAL ASSOCIATION DUES ARE RELATED TO LOBBYING ACTIVITIES. PRISMA HEALTH-UPSTATE PAID THE AMERICAN HOSPITAL ASSOCIATION DUES FOR BAPTIST EASLEY HOSPITAL. 23.32% ($5,998) OF THE AMERICAN HOSPITAL ASSOCIATION DUES ARE RELATED TO LOBBYING ACTIVITIES. 51553290 51553290 821984885 387090432 434894453 1285529388 975264780 310264608 67599303 35932298 31667005 828379356 STUDIES 2286612 OTHER LIABILITIES 68709074 70995686 X PART X, LINE 2: PRISMA HEALTH-UPSTATE IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF PRISMA HEALTH AND SUBSIDIARIES. PRISMA HEALTH QUALIFIES AS AN ORGANIZATION EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). AS OF SEPTEMBER 30, 2019, PRISMA HEALTH HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS. 1 1 X 1 X 1 X 1 1 1 0 1 1 91088694 33130914 57957780 0.03170 261653195 260978894 674301 0.00040 352741889 294109808 58632081 0.03210 6109633 330971 5778662 0.00320 73942887 52356579 21586308 0.01180 71715161 47857220 23857941 0.01300 896656 896656 0.00050 10283823 10283823 0.00560 162948160 100544770 62403390 0.03410 515690049 394654578 121035471 0.06620 1 37561547 5205676 303134842 421415587 -118280745 X 1 1 8 1 GREENVILLE MEMORIAL HOSPITAL 701 GROVE ROAD GREENVILLE SC 29605 WWW.GHS.ORG HTL0936 X X X X X A 2 GREER MEMORIAL HOSPITAL 830 S BUNCOMBE RD GREER SC 29650 WWW.GHS.ORG HTL0934 X X X A 3 HILLCREST MEMORIAL HOSPITAL 729 SE MAIN ST SIMPSONVILLE SC 29681 WWW.GHS.ORG HTL0931 X X X X A 4 LAURENS COUNTY MEMORIAL HOSPITAL 22725 HWY 76 EAST CLINTON SC 29325 WWW.GHS.ORG HTL0932 X X X A 5 NORTH GREENVILLE HOSPITAL 807 N MAIN ST TRAVELERS REST SC 29690 WWW.GHS.ORG HTL0935 X X X A 6 OCONEE MEMORIAL HOSPITAL 298 MEMORIAL DRIVE SENECA SC 29672 WWW.GHS.ORG HTL0937 X X X A 7 PATEWOOD MEMORIAL HOSPITAL 175 PATEWOOD DRIVE GREENVILLE SC 29615 WWW.GHS.ORG HTL0933 X X X X A 8 BAPTIST EASLEY HOSPITAL 200 FLEETWOOD DR EASLEY SC 29640 WWW.GHS.ORG HTL0945 X X X A FACILITY REPORTING GROUP A 0 0 1 X X X X X X X X X 18 1 1 0 1 X SEE DISCLOSURE X 1 18 1 SEE DISCLOSURE 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X SEE DISCLOSURE X SEE DISCLOSURE X SEE DISCLOSURE X X X X X X X 1 X 0 X X X X X 1 X 0 0 PART V, SECTION B, LINE 16A HTTPS://WWW.GHS.ORG/PATIENTS-VISITORS/PATIENT-INFO/PAYMENT/FINANCIAL-ASSISTANCE/ PART V, SECTION B, LINE 16B HTTPS://WWW.GHS.ORG/PATIENTS-VISITORS/PATIENT-INFO/PAYMENT/FINANCIAL-ASSISTANCE/ PART V, SECTION B, LINE 16C HTTPS://WWW.GHS.ORG/PATIENTS-VISITORS/PATIENT-INFO/PAYMENT/FINANCIAL-ASSISTANCE/ PART V, SECTION B, LINE 7A AND 10A: WEBSITE FOR COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY:HTTPS://WWW.PRISMAHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: GREENVILLE MEMORIAL HOSPITAL, - FACILITY 2: GREER MEMORIAL HOSPITAL, - FACILITY 3: HILLCREST MEMORIAL HOSPITAL, - FACILITY 4: LAURENS COUNTY MEMORIAL HOSPITAL, - FACILITY 5: NORTH GREENVILLE HOSPITAL, - FACILITY 6: OCONEE MEMORIAL HOSPITAL, - FACILITY 7: PATEWOOD MEMORIAL HOSPITAL, - FACILITY 8: BAPTIST EASLEY HOSPITAL FACILITY REPORTING GROUP A PART V, SECTION B, LINE 5: PRISMA HEALTH FORMED A MULTI-STAKEHOLDER TEAM TO CARRY OUT THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT. TOGETHER, THE TEAM IDENTIFIED SEVEN COUNTIES TO FOCUS ON IN COLLECTING DATA FOR PRISMA HEALTH'S 2019 CHNA. THESE COUNTIES WERE: GREENVILLE, LAURENS, LEXINGTON, OCONEE, PICKENS, RICHLAND AND SUMTER.A TOTAL OF 5,572 SURVEYS WERE COMPLETED ACROSS THE SEVEN COUNTIES. DATA AND INFORMATION GATHERING USED BOTH QUALITATIVE AND QUANTITATIVE METHODS. PRIMARY RESEARCH-QUALITATIVE AND QUANTITATIVE- WAS COLLECTED THROUGH INTERNAL DATA SOURCES, FOCUS GROUPS, COMMUNITY STAKEHOLDER INTERVIEWS AND COMMUNITY MEMBER SURVEYS. COMMUNITY AGENCIES PROVIDED SECONDARY RESEARCH.PUBLIC HEALTH EXPERTS GUIDED THE TEAM'S OBJECTIVES IN DEVELOPING TOOLS, ANALYZING DATA AND PRIORITIZING NEEDS. FACILITY REPORTING GROUP A PART V, SECTION B, LINE 6A: PRISMA HEALTH-MIDLANDS, PRISMA HEALTH-UPSTATE, PRISMA HEALTH TUOMEY, AND THE SHRINER'S HOSPITAL OF GREENVILLE ALL CONDUCTED THE CHNA JOINTLY FACILITY REPORTING GROUP A PART V, SECTION B, LINE 11: THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT RESULTS INDICATED THREE DISTINCTIVE HEALTH ISSUES AND PRIORITY AREAS FOR INTERVENTION IN LEXINGTON, RICHLAND, SUMTER, GREENVILLE, OCONEE, PICKENS AND LAURENS COUNTY. THOSE NEEDS ARE:1. MENTAL HEALTH2. OBESITY3. DRUG USEDURING THE NEXT THREE YEARS, PRISMA HEALTH IS COMMITTED TO PARTNERING WITH HEALTH CARE AND COMMUNITY LEADERS TO PRIORITIZE AND SELECT CRITICAL AREAS FOR INTERVENTION AND ACTION PLANNING. WE HAVE OUTLINED STRATEGIES FOR PRIORITY AREAS IN PARTNERSHIP WITH VARIOUS COMMUNITY PARTNERS. FACILITY REPORTING GROUP A PART V, SECTION B, LINE 13H: THERE IS A CATASTROPHIC CLAUSE WHICH ALLOWS FOR AN ALTERNATIVE MEANS OF QUALIFYING BASED A SIGNIFICANT FINANCIAL HARDSHIP. FACILITY REPORTING GROUP A PART V, SECTION B, LINE 15E: THE FINANCIAL ASSISTANCE POLICY EXPLAINS DIFFERENT METHODS FOR APPLYING FOR FINANCIAL ASSISTANCE BY: VISITING PRISMA HEALTH WEBSITE WITH ADDRESS LISTED, CONTACTING PRISMA HEALTH PATIENT FINANCIAL SERVICES WITH PHONE NUMBERS LISTED, MAILING A REQUEST WITH ADDRESSES LISTED OR VISITING A PRISMA HEALTH FACILITY FACILITY REPORTING GROUP A PART V, SECTION B, LINE 16J: COMMUNITY CLINICS ARE AWARE OF AND HAVE ACCESS TO THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATIONS. FACILITY REPORTING GROUP A PART V, SECTION B, LINE 20E: THE ORGANIZATION WIDELY PUBLICIZES THE FINANCIAL ASSISTANCE POLICY. 59 1 - PRISMA HEALTH CANCER INSTITUTE - FARIS 900 W FARIS ROAD GREENVILLE SC 29605 OUTPATIENT CANCER TREATMENT 2 - PRISMA HEALTH PATEWOOD OUTPATIENT CENTER 200 PATEWOOD DRIVE BLDG A GREENVILLE SC 296153593 OUTPATIENT SURGERY AND DIAGNOSTIC 3 - PRISMA HEALTH CANCER INSTITUTE - SENECA 132 LILA DOYLE DRIVE SENECA SC 29672 OUTPATIENT CANCER TREATMENT 4 - PRISMA HEALTH CANCER INSTITUTE - GROVE 3 BUTTERNUT DRIVE SUITE B GREENVILLE SC 29605 OUTPATIENT CANCER TREATMENT 5 - PRISMA HEALTH CANCER INSTITUTE - SPARTAN 120 DILLON DRIVE SPARTANBURG SC 29307 OUTPATIENT CANCER TREATMENT 6 - PRISMA HEALTH OUTPATIENT RADIOLOGY 701 GROVE ROAD GREENVILLE SC 296054210 OUTPATIENT IMAGING 7 - PRISMA HEALTH CROSS CREEK SURGERY CENTER 9 DOCTORS DRIVE GREENVILLE SC 296054266 AMBULATORY SURGERY 8 - PRISMA HEALTH CANCER INSTITUTE - GREER 340 MEDICAL PARKWAYSUITE 100 GREER SC 29650 OUTPATIENT CANCER TREATMENT 9 - PRISMA HEALTH MARSHALL I PICKENS HOSPIT 701 GROVE ROAD GREENVILLE SC 296054210 INPATIENT PSYCHIATRIC 10 - PRISMA HEALTH ROGER C PEACE REHABILITAT 701 GROVE ROAD GREENVILLE SC 296054210 INPATIENT REHABILITATION 11 - PRISMA HEALTH CARDIOVASCULAR SERVICES - 3 BUTTERNUT DRIVE GREENVILLE SC 29605 CARDIOVASCULAR DIAGNOSTIC 12 - PRISMA HEALTH VASCULAR HEALTH ALLIANCE 200 PATEWOOD ROAD SUITE 300-C GREENVILLE SC 296153593 OUTPATIENT DIAGNOSTIC SERVICES; WOUND CARE; VENOUS 13 - PRISMA HEALTH KIDNETICS 29 NORTH ACADEMY ST GREENVILLE SC 296012629 PEDIATRIC OCCUPATIONAL, PHYSICAL AND SPEECH THERAPIES 14 - PRISMA HEALTH LILA DOYLE 101 LILA DOYLE DRIVE SENECA SC 296729495 SKILLED NURSING 15 - PRISMA HEALTH CENTER FOR PEDIATRIC MEDIC 20 MEDICAL RIDGE DRIVE GREENVILLE SC 29605 PEDIATRIC PRIMARY CARE 16 - PRISMA HEALTH GREENVILLE MEMORIAL SUB-AC 701 GROVE ROAD GREENVILLE SC 296054210 SKILLED NURSING 17 - PRISMA HEALTH OBGYN CLINIC 1120 GROVE ROAD GREENVILLE SC 296054652 PRIMARY CARE - OB/GYN 18 - PRISMA HEALTH EMS 1315 GROVE ROAD GREENVILLE SC 296054717 AMBULANCE SERVICE 19 - PRISMA HEALTH OCONEE MEMORIAL HOSPITAL E 298 MEMORIAL DRIVE SENECA SC 296729443 EMERGENCY SERVICES AND TRANSPORTATION 20 - PRISMA HEALTH HOME HEALTH UPSTATE 440 ROPER MOUNTAIN ROAD SUITE C GREENVILLE SC 296154235 HOME HEALTH AGENCY 21 - PRISMA HEALTH PEDIATRIC HEMATOLOGYONCOL 900 W FARIS ROAD GREENVILLE SC 296054255 DIAGNOSTIC SERVICES AND TREATMENTS FOR CHILDREN 22 - PRISMA HEALTH ROGER C PEACE OUTPATIENT 701 GROVE ROAD GREENVILLE SC 296054210 OUTPATIENT REHABILITATION 23 - PRISMA HEALTH CANCER INSTITUTE - EASLEY 109 FLEETWOOD DRIVE SUITE A EASLEY SC 29640 OUTPATIENT CANCER TREATMENT 24 - PRISMA HEALTH LAURENS FAMILY MEDICINE - 106 PARKVIEW DRIVE LAURENS SC 293602652 PRIMARY CARE 25 - PRISMA HEALTH ROGER C PEACE TBI 100 AUGUSTA STREET GREENVILLE SC 296013504 OUTPATIENT BRAIN INJURY REHABILITATION 26 - PRISMA HEALTH SURGERYORTHOPEDICS CLINI 13 EDGEWOOD DRIVE GREENVILLE SC 296054235 OUTPATIENT ORTHOPEDIC/SURGERY DIAGNOSTIC, REFERRAL 27 - PRISMA HEALTH SURGERY CENTER - SPARTANBU 1413 JOHN B WHITE SR BLVD SUITE D SPARTANBURG SC 293063995 AMBULATORY SURGERY 28 - PRISMA HEALTH OCONEE PAIN MANAGEMENT 102 B OMNI DRIVE SENECA SC 296729448 PAIN MANAGEMENT 29 - PRISMA HEALTH SENIOR CARE 32 CENTENNIAL DRIVE GREENVILLE SC 29605 GERIATRIC OUTPATIENT PRIMARY AND SPECIALTY CARE 30 - PRISMA HEALTH INTERNAL MEDICINESUBSPECI 876 W FARIS ROAD GREENVILLE SC 296054210 PRIMARY CARE 31 - PRISMA HEALTH ADVANCED FAMILY MEDICINE 210 SOUTH BROAD STREET CLINTON SC 29325 PRIMARY CARE 32 - PRISMA HEALTH CENTER FOR FAMILY MEDICINE 877 W FARIS RD GREENVILLE SC 296054289 PRIMARY CARE 33 - PRISMA HEALTH HOSPICE OF THE FOOTHILLS 390 KEOWEE SCHOOL ROAD SENECA SC 296726743 HOSPICE - OUTPATIENT 34 - PRISMA HEALTH CLEMSONSENECA PEDS - CLEM 450 OLD GREENVILLE HIGHWAY CLEMSON SC 296311671 PRIMARY CARE PEDIATRIC 35 - PRISMA HEALTH MARSHALL I PICKENS CHILDR 701 GROVE ROAD GREENVILLE SC 296054210 CHILD AND ADOLESCENT RESIDENTIAL TREATMENT CENTER 36 - PRISMA HEALTH CLEMSONSENECA PEDS - SENE 109 OMNI DRIVE B SENECA SC 296729448 PRIMARY CARE PEDIATRIC 37 - PRISMA HEALTH LAURENS FAMILY MEDICINE - 9100 HWY14 GRAY COURT SC 296454152 PRIMARY CARE 38 - PRISMA HEALTH SLEEP DISORDERS CENTER - V 1025 VERDAE BLVD SUITE D GREENVILLE SC 296074032 SLEEP STUDIES/DIAGNOSTIC 39 - PRISMA HEALTH MARSHALL I PICKENS OUTPAT 701 GROVE ROAD GREENVILLE SC 296054210 OUTPATIENT PSYCHIATRIC 40 - PRISMA HEALTH DIABETES SELF-CARE MGMT P 875 WEST FARIS ROAD GREENVILLE SC 296054254 OUTPATIENT DIABETES CARE 41 - PRISMA HEALTH CARDIOVASCULAR SERVICES SI 719 SE MAIN STREET SIMPSONVILLE SC 29681 CARDIOVASCULAR DIAGNOSTIC 42 - PRISMA HEALTH CANCER INSTITUTE - LAURENS 22725 HWY 76 EAST THIRD FLOOR CLINTON SC 293257527 OUTPATIENT CANCER TREATMENT 43 - PRISMA HEALTH SLEEP DISORDERS CENTER - H 741 SOUTHEAST MAIN ST SIMPSONVILLE SC 296813237 SLEEP STUDIES/DIAGNOSTIC 44 - PRISMA HEALTH CANCER INSTITUTE - EASTSID 65 INTERNATIONAL DRIVE GREENVILLE SC 29615 OUTPATIENT CANCER TREATMENT 45 - PRISMA HEALTH SLEEP DISORDERS CENTER - F 890 WEST FARIS ROAD SUITE 560 GREENVILLE SC 296054253 SLEEP STUDIES/DIAGNOSTIC 46 - PRISMA HEALTH WONDER CENTER 29 NORTH ACADEMY STREET GREENVILLE SC 296012629 DAY TREATMENT CENTER FOR MEDICALLY FRAGILE CHILDREN 47 - PRISMA HEALTH CENTER FOR PEDIATRIC MEDIC 5 WEST MAIN STREET GREENVILLE SC 29611 PRIMARY CARE PEDIATRIC 48 - PRISMA HEALTH INFUSION CENTER 701 GROVE ROAD GREENVILLE SC 296054210 OUTPATIENT CANCER TREATMENT 49 - PRISMA HEALTH WOMEN'S AND CHILDREN'S PRO 701 GROVE ROAD GREENVILLE SC 296054210 CHILDBIRTH EDUCATION 50 - PRISMA HEALTH CENTER FOR FAMILY MEDICINE 109 PHYSICIANS DRIVE SUITE A GREER SC 296504450 PRIMARY CARE 51 - PRISMA HEALTH CENTER FOR FAMILY MEDICINE 139 LILA DOYLE DRIVE SENECA SC 29672 PRIMARY CARE 52 - PRISMA HEALTH CENTER FOR PERIOPERATIVE O 905 VERDAE BLVD SUITE 102 GREENVILLE SC 296074029 SURGICAL PREASSESSMENT 53 - PRISMA HEALTH KIDNETICS - MEDICAID 29 NORTH ACADEMY STREET GREENVILLE SC 296012629 PEDIATRIC OCCUPATIONAL, PHYSICAL AND SPEECH THERAPIES 54 - PRISMA HEALTH WONDER CENTER - NON MEDICA 29 NORTH ACADEMY STREET GREENVILLE SC 296012629 DAY TREATMENT CENTER FOR MEDICALLY FRAGILE CHILDREN 55 - PRISMA HEALTH BAPTIST EASLEY OP SERVICES 1807-A EAST MAIN STREET EASLEY SC 29640 OUTPATIENT SURGERY AND DIAGNOSTIC 56 - PRISMA HEALTH BAPTIST EASLEY OP POWDERSV 11404 ANDERSON ROAD GREENVILLE SC 29611 OUTPATIENT SURGERY AND DIAGNOSTIC 57 - PRISMA HEALTH BAPTIST EASLEY THERAPY SVS 11404 ANDERSON ROAD GREENVILLE SC 29611 OUTPATIENT THERAPY 58 - PRISMA HEALTH BAPTIST EASLEY THERAPY SVS 112 JOHN STREET STE 104 EASLEY SC 29640 OUTPATIENT THERAPY 59 - PRISMA HEALTH HILLCREST HOSP VASCULAR LA 729 SE MAIN ST SIMPSONVILLE SC 296813218 LAB PART I, LINE 3C: FPG IS USED BUT IN ADDITION, THERE IS CONSIDERATION FOR CATASTROPHIC EVENTS:WHEN THE PATIENT'S HOSPITAL ACCOUNT(S) EXCEED TWO (2) TIMES THE HOUSEHOLD ANNUAL GROSS INCOME THE FOLLOWING CRITERIA WILL BE CONSIDERED WHEN DETERMINING SPONSORSHIP ELIGIBILITY:THE TAX APPRAISED VALUE OF THE PRIMARY PLACE OF RESIDENCE MAY EXCEED THE TWO HUNDRED THOUSAND DOLLARS ($200,000).EQUITY VALUE OF THE PRIMARY PLACE OF RESIDENCE MAY EXCEED THIRTY-FIVE THOUSAND ($35,000) DOLLARS.LIQUID ASSETS MAY BE CONSIDERED WHEN DETERMINING SPONSORSHIP.SPONSORSHIP FOR A CATASTROPHIC EVENT MAY BE APPROVED FOR OUTSTANDING ACCOUNTS FOR DATES OF SERVICE WITHIN EIGHT (8) MONTHS FROM THE DATE OF APPLICATION. CHARITY/SPONSORSHIP WILL NOT BE ADDED TO THE PATIENT'S RECORD FOR FUTURE DATES OF SERVICE BUT MAY REAPPLY WHEN ADDITIONAL SERVICES ARE RECEIVED. PART I, LINE 7G: THE SUBSIDIZED HEALTH SERVICES INCLUDE:1. CENTER FOR FAMILY MEDICINE2. MEDICAL CENTER CLINICS3. HOSPICE SERVICES4. HOSPICE OF THE FOOTHILLS5. MARSHALL I. PICKENS HOSPITAL6. HOME HEALTH7. LILA DOYLE NURSING CARE8. GMMC SUBACUTE9. ROGER C. PEACE REHABILITATION10. MOBILE CARE AMBULANCE SERVICE11. DIABETES SELF MANAGEMENT PROGRAM12. LAURENS SKILLED NURSING13. PALLATIVE CARE PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 196,753,019. PART III, LINE 2: BAD DEBT EXPENSE IS CALCULATED BY APPLYING THE ORGANIZATION'S COST-TO-CHARGE RATIO TO THE BAD DEBT WRITE-OFFS AS PRESENTED IN THE AUDITED FINANCIAL STATEMENTS. THIS AMOUNT IS THEN REDUCED BY A PORTION OF THE NET MEDICAID DSH REVENUE. PART III, LINE 3: OF THE ACCOUNTS IN BAD DEBT, AN INTERNAL REVIEW SHOWED THAT 20.5% WERE SELF-PAY WITH LOW PROPENSITY TO PAY SCORES. OF THESE, OUR ESTIMATE IS THAT 67.5% OF THESE WOULD QUALIFY FOR CHARITY. PART III, LINE 4: SEE THE FY2019 FINANCIALS, NOTE 2 - NET PATIENT SERVICE REVENUE AND PATIENT ACCOUNTS RECEIVABLE. PART III, LINE 8: ONE CRITERION FOR QUALIFIYING AS A COMMUNITY BENEFIT IS THAT THE SERVICE, IF NOT PROVIDED BY THE HOSPITAL, WOULD OTHERWISE BE PROVIDED BY THE GOVERNMENT. PRISMA HEALTH IS REQUIRED TO PROVIDE CARE TO ALL, REGARDLESS OF ABILITY TO PAY. A FOR-PROFIT ENTITY WOULD NOT KNOWINGLY OFFER A PROGRAM THAT GENERATES A LOSS OF THIS MAGNITUDE. PART III, LINE 9B: IF IT IS DETERMINED THAT A PATIENT HAS NO AVAILABLE MEANS TO PAY FOR SERVICES AND IS DECLARED ELIGIBLE FOR HOSPITAL CHARITY OR HOSPITAL SPONSORSHIP, CHARGES WILL BE ADJUSTED ACCORDING TO THE LEVEL OF CHARITY OR SPONSORSHIP DOCUMENTED ON THE PATIENT'S ACCOUNT. SPECIFIC TO PATIENTS SEEN AT COMPONENTS OF THE GREENVILLE MEMORIAL HOSPITAL PROVIDER, AND FOR PURPOSES OF THE 340B DRUG PROGRAM, THE CONTRACT PHARMACIES WILL EXTEND DISCOUNTS TO PATIENTS UNDER THE HOSPITAL SPONSORSHIP PROGRAM. HOSPITAL CHARITY AND HOSPITAL SPONSORSHIP CONSTITUTES A SATISFACTORY FINANCIAL ARRANGEMENT. PART VI, LINE 2: A DESCRIPTION OF HOW PRISMA HEALTH-UPSTATE CONDUCTS ITS NEEDS ASSESSMENT CAN BE FOUND AT THE FOLLOWING LINK: HTTPS://WWW.PRISMAHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ PART VI, LINE 3: THE ORGANIZATION INFORMS AND EDUCATES PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY BY:- POSTING THE HOSPITALS FINANCIAL ASSISTANCE POLICY ON THEIR WEBSITE- POSTING AN APPLICATION FOR FINANCIAL ASSISTANCE ON THEIR WEBSITE- POSTING A PLAIN LANGUAGE SUMMARY ON THEIR WEBSITE- THE FINANCIAL ASSISTANCE IS MADE AVAILABLE UPON REQUEST AND WITHOUT CHARGE- THE FINANCIAL ASSISTANCE APPLICATION IS MADE AVAILABLE UPON REQUEST AND WITHOUT CHARGE- THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS MADE AVAILABLE UPON REQUEST AND WITHOUT CHARGE- THE ORGANIZATION NOTIFIES MEMBERS OF THE COMMUNITY WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE OF THE FINANCIAL ASSISTANCE POLICY- THE FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY WERE TRANSLATED INTO THE PRIMARY LANGUAGES SPOKEN BY LEP POPULATION PART VI, LINE 4: ALTHOUGH PRISMA HEALTH-UPSTATE SERVES PATIENTS FROM THE ENTIRE 10-COUNTY UPSTATE AREA OF SOUTH CAROLINA, FOR THE PURPOSE OF THIS COMMUNITY HEALTH NEEDS ASSESSMENT, WE CHOSE THE COMMUNITIES WITH THE CLOSEST PROXIMITY TO A PRISMA HEALTH-UPSTATE FACILITY. THESE COMMUNITIES LIE WITHIN FOUR COUNTIES: GREENVILLE COUNTY, LAURENS COUNTY, OCONEE COUNTY, AND PICKENS COUNTY. PART VI, LINE 5: INFORMATION ON WAYS PRISMA HEALTH-UPSTATE PROMOTES COMMUNITY HEALTH CAN BE FOUND AT THE FOLLOWING LINK: HTTPS://WWW.PRISMAHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ PART VI, LINE 6: THE ORGANIZATION IS A COMPONENT OF AN AFFILIATED HEALTH CARE SYSTEM IN THE STATE OF SOUTH CAROLINA. THE SYSTEM HAS MULTIPLE HOSPITAL SYSTEMS THAT PROVIDE HOSPITALS SERVICES TO THE RESPECTIVE COMMUNITIES. 1 A CHILD'S HAVEN 20 MARTIN DRIVE GREENVILLE SC 29617 570893712 509(A)(1) 5000 OPERATIONAL/COMMUNITY ENGAGEMENT AMERICAN CANCER SOCIETY 154 MILESTONE WAY GREENVILLE SC 29615 131788491 501(C)(3) 38400 OPERATIONAL/COMMUNITY ENGAGEMENT AMERICAN DIABETES ASSOCIATION 107 WESTPARK BLVD 220 COLUMBIA SC 29210 131623888 509(A)(1) 5000 OPERATIONAL/COMMUNITY ENGAGEMENT AMERICAN HEART ASSOCIATION 3535 PELHAM ROAD GREENVILLE SC 29615 135613797 501(C)(3) 10000 OPERATIONAL/COMMUNITY ENGAGEMENT AMERICAN RED CROSS 940 GROVE ROAD GREENVILLE SC 29605 530196605 509(A)(1) 7500 OPERATIONAL/COMMUNITY ENGAGEMENT ARTISPHERE 101B AUGUSTA STREET GREENVILLE SC 29601 582676608 509(A)(1) 13000 OPERATIONAL/COMMUNITY ENGAGEMENT BELL FEDERATION CENTER FOR THE 1103 NORTH HARPER STREET LAURENS SC 29360 570958254 501(C)(3) 5000 OPERATIONAL/COMMUNITY ENGAGEMENT BLUE RIDGE COUNCIL BSA 1 PARK PLAZA GREENVILLE SC 29607 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PRISMA HEALTH-UPSTATE HAS A FORMAL ONLINE SUBMISSION PROCESS. VARIOUS LEADERS IN THE ORGANIZATION PROVIDE INPUT AND DECISIONS ARE MADE BASED ON ALL INFORMATION RECEIVED. X X X X 0 1 0 0 0 0 0 0 0 SPENCE M TAYLOR MD PRESIDENT, UPSTATE AFF'L (UNTIL 9/19 53267 797399 0 40781 548 36444 0 115635 3549 41045 57364 1031304 0 0 T CHAD MOSES VP AND CHIEF FINANCIAL EXECUTIVE 250375 0 0 0 424 0 29962 0 35678 0 316439 0 0 0 JOSEPH J BLAKE JR SECRETARY 29418 397984 0 23161 511 10990 4723 0 2778 29796 37430 461931 0 0 CHARLES D BEAMAN JR CO-CEO OF PRISMA HEALTH (UNTIL 7/19) 0 1356844 0 0 0 45677 0 49603 0 41679 0 1493803 0 0 MALCOLM W ISLEY CHIEF STRATEGY OFFICER 35810 513363 0 236848 546 11313 1385 99817 3422 39888 41163 901229 0 0 ANGELO SINOPOLI MD CHIEF CLINICAL OFFICER 46261 841577 0 417253 490 20650 4079 136543 2178 24893 53008 1440916 0 0 GREGORY J RUSNAK CHIEF ADMINISTRATIVE OFFIC 44598 684590 0 351561 540 34032 3974 118289 3381 39332 52493 1227804 0 0 HOWARD P WEST GENERAL COUNSEL 0 463766 0 0 0 0 0 58707 0 27437 0 549910 0 0 TERRI T NEWSOM CHIEF FINANCIAL OFFICER 40040 645243 0 343898 534 11307 1274 115779 3326 40546 45174 1156773 0 0 MICHAEL C RIORDAN CO-CEO OF PRISMA HEALTH (UNTIL 5/19) 0 1195879 0 56779 0 177636 0 45100 0 42607 0 1518001 0 0 RICH ROGERS CHIEF INFORMATION OFFICER 382767 0 20946 0 11746 0 106019 0 33699 0 555177 0 0 0 CAROLYN SWINTON MN CHIEF NURSING OFFICER 0 324208 0 0 0 38366 0 40609 0 35166 0 438349 0 0 DOUGLAS D DORMAN VP OF HUMAN RESOURCES 93635 0 21587 0 377940 0 0 0 4882 0 498044 0 0 0 JAMES M ELLIS JR VP CLINICAL AFFAIRS 460747 0 24599 0 4090 0 119253 0 43089 0 651778 0 0 0 PAUL F JOHNSON VP CHIEF OPERATIONS EXECUTIVE 405517 0 21732 0 12233 0 117837 0 37272 0 594591 0 0 0 MICHELLE A SMITH CHIEF NURSING OFFICER 178871 0 18264 0 372528 0 30200 0 14937 0 614800 0 0 0 CHRISTOPHER C WRIGHT CHIEF MEDICAL STAFF 653574 0 0 0 3435 0 26600 0 28771 0 712380 0 0 0 PART I, LINE 4B THE 457(F) PLAN IS PROVIDED TO A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES (WITHIN THE MEANING OF SECTIONS 201(2), 301(A)(3) AND 401(A)(1) OF ERISA) OF PRISMA HEALTH AND SUBSIDIARIES WHO CONTRIBUTE SIGNIFICANTLY TO THE FUTURE BUSINESS SUCCESS OF THE COMPANY WITH SUPPLEMENTAL RETIREMENT INCOME THROUGH COMPANY CONTRIBUTIONS. EMPLOYEES ELIGIBLE FOR THE PROGRAM ARE APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. THOSE ELIGIBLE RECEIVE A 10 OR 15 PERCENT ON AN ANNUAL BASIS BASED ON PRIOR FISCAL YEAR BASE COMPENSATION. A SEE PART VI 576007863 396481AA1 2016-10-01 601263556 SEE PART VI 0 0 0 B LAURENS COUNTY HEALTH CARE SYSTEM 570823499 519071CY8 2016-10-01 3880768 SEE PART VI 0 0 0 C GREENVILLE HEALTH AUTHORITY 576007863 396481AA1 2019-05-01 68360000 SEE PART VI 0 0 0 A 326865000 601263556 601263556 1 0 1 1 B 1845000 3880768 3880768 1 0 1 1 C 68360000 68360000 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 0 0 0.00000 0.00010 0.00010 0 0 1 C 0 0 0 0 0.00000 0.00010 0.00010 0 0 1 A 0 0 1 1 1 0 0 0 1 B 0 0 1 1 0 0 0 0 1 C 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 SCHEDULE K, PART I, LINE A, COLUMN A: ISSUER NAME: GREENVILLE HEALTH AUTHORITY, F/K/A GREENVILLE HOSPITAL SYSTEM. SCHEDULE K, PART I, LINE A, COLUMN (F): DESCRIPTION OF PURPOSE: ON 10/1/2016, PRISMA HEALTH - UPSTATE, F/K/A UPSTATE AFFILIATE ORGANIZATION, ("UPSTATE") ENTERED INTO A LEASE AND CONTRIBUTION AGREEMENT WITH GREENVILLE HEALTH AUTHORITY F/K/A GREENVILLE HOSPITAL SYSTEM (THE "ISSUER"), PURSUANT TO WHICH UPSTATE WOULD UNDERTAKE THE OPERATIONS OF ISSUER'S HOSPITAL FACILITIES. AT THE TIME OF THE AGREEMENT, THE ISSUER TIMELY UNDERTOOK REMEDIAL ACTION UNDER SECTION 1.141-12(F) OF THE TREASURY REGULATIONS TO CAUSE THE ISSUER BONDS TO BE RE-ISSUED ON 10/01/2016 AS QUALIFIED 501(C)3 BONDS. THE BOND BEING REPORTED ON THIS SCHEDULE K IS THAT RE-ISSUANCE BOND. AS FILED ON FORM 8038, THE RE-ISSUANCE WAS CONSIDERED A CURRENT REFUNDING OF THE ISSUER'S PREVIOUS BONDS WHICH WERE ISSUED ON 06/1/1990 (SERIES 1990); 07/01/2008 (SERIES 2008A); 08/19/2008 (SERIES 2008B); 08/9/2012 (REISSUANCE OF SERIES 2008C); 04/20/2015 (REISSUANCE OF SERIES 2008D); 04/20/2015 (REISSUANCE OF SERIES 2008E); 06/07/2012 (SERIES 2012); 04/01/2014 (SERIES 2014A); 09/23/2014 (SERIES 2014B) SCHEDULE K, PART I, LINE B, COLUMN (F): DESCRIPTION OF PURPOSE: ON 7/1/2013, LAURENS COUNTY HEALTH CARE SYSTEM (THE "ISSUER") ENTERED INTO A LEASE AND CONTRIBUTION AGREEMENT (THE "2013 AGREEMENT") WITH GREENVILLE HEALTH AUTHORITY F/K/A GREENVILLE HOSPITAL SYSTEM ("GHA OR THE "LESSEE"). THE 2013 AGREEMENT TRANSFERRED THE OPERATIONS OF THE LAURENS HOSPITAL TO GHA AS LESSEE. ON 0/1/2016, PRISMA HEALTH - UPSTATE, F/K/A UPSTATE AFFILIATE ORGANIZATION ("UPSTATE") ENTERED INTO A LEASE AND CONTRIBUTION AGREEMENT (THE "2016 AGREEMENT") WITH GHA. UNDER THE TERMS OF THE 2016 AGREEMENT, UPSTATE BECAME A SUBLESSEE UNDER THE 2013 AGREEMENT AND ASSUMED OPERATIONS OF THE LAURENS HOSPITAL. AT THE TIME OF THE 2016 AGREEMENT, THE ISSUER TIMELY UNDERTOOK REMEDIAL ACTION UNDER SECTION 1.141-12(F) OF THE TREASURY REGULATIONS TO CAUSE THE ISSUER BONDS TO BE RE-ISSUED ON 10/01/2016 AS QUALIFIED 501(C)3 BONDS. THE BOND BEING REPORTED ON THIS SCHEDULE K IS THAT RE-ISSUANCE BOND. AS FILED ON FORM 8038, THE RE-ISSUANCE WAS CONSIDERED A CURRENT REFUNDING OF THE ISSUER'S PREVIOUS BONDS WHICH WERE ISSUED ON 2/29/2012. SCHEDULE K, PART II, COLUMN A, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE DEEMED EXPENDED ON THE REISSUANCE DATE. SCHEDULE K, PART II, COLUMN B, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE DEEMED EXPENDED ON THE REISSUANCE DATE. SCHEDULE K, PART II, COLUMN C, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE DEEMED EXPENDED ON THE REISSUANCE DATE. SCHEDULE K, PART III, COLUMN A, LINE 3A: ALL OF THESE CONTRACTS MEET SAFE HARBOR PROVISIONS. SCHEDULE K, PART IV, COLUMN A, LINE 2(A-C) : (1) SERIES 1990 - COMPUTATION DATE 7/1/2015 (NO REBATE DUE); (2) SERIES 2008A - FINAL COMPUTATION DATE 12/5/2018 (NO REBATE DUE); (3) SERIES 2008B, REISSUED SERIES 2008D AND REISSUED SERIES 2008E - FINAL COMPUTATION DATE 12/5/2018 (NO REBATE DUE); (4) REISSUED SERIES 2008C - COMPUTATION DATE 8/9/2017 (NO REBATE DUE); (5) SERIES 2012 - COMPUTATION DATE 6/7/2017 (EXCEPTION TO REBATE); (6) SERIES 2014A - COMPUTATION DATE 4/1/2019 (EXCEPTION TO REBATE): (7) SERIES 2014B - COMPUTATION DATE 9/23/2019 (EXCEPTION TO REBATE); (8) SERIES 2015 - COMPUTATION DATE 5/1/2019 (EXCEPTION TO REBATE) SCHEDULE K, PART IV, COLUMN B, LINE 2(A-C) : (1) SERIES 2015 - COMPUTATION DATE 2/29/2017 (EXCEPTION TO REBATE). FRANCES M TAYLOR FAMILY MEMBER OF DR. SPENCE TAYLOR 73018 COMPENSATED AS EMPLOYEE 0 LAURA T WARMAN FAMILY MEMBER OF DR. SPENCE TAYLOR 71400 COMPENSATED AS EMPLOYEE 0 X 15523 COST X 4 75517 FMV 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER IS PRISMA HEALTH. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER, PRISMA HEALTH, SELECTS THE BOARD MEMBERS AND HAS THE POWER TO REMOVE ANY DIRECTOR AT ANY TIME. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER, PRISMA HEALTH, HAS THE AUTHORITY WITH RESPECT TO THE FOLLOWING MATTERS: 1. APPROVE ANY AMENDMENT OR CHANGE TO THE ARTICLES OF INCORPORATION OR ANY CORRELATIVE DOCUMENT OF THE CORPORATION AS TO WHICH THE APPROVAL OF THE CORPORATION IS REQUIRED IN CONNECTION WITH SUCH AMENDMENT OR CHANGE, IN EACH CASE ABOVE TO THE EXTENT SUCH AMENDMENT OR CHANGE IS INTENDED TO OR WOULD ABROGATE OR DIMINISH IN ANY WAY OR OTHERWISE ELIMINATE THE RIGHTS AND PRIVILEGES OF PRISMA HEALTH; 2. APPROVE ANY AMENDMENT OR CHANGE TO, OR THE REPEAL OF, THE BYLAWS OF THE CORPORATION IS REQUIRED IN CONNECTION WITH SUCH AMENDMENT, CHANGE, OR REPEAL, IN EACH CASE ABOVE TO THE EXTENT SUCH AMENDMENT OR CHANGE IS INTENDED TO OR WOULD ABROGATE OR DIMINISH IN ANY WAY OR OTHERWISE ELIMINATE THE RIGHTS AND PRIVILEGES OF PRISMA HEALTH 3. INITIATE ANY MERGER OR CONSOLIDATION, OR THE DISSOLUTION, CONVERSION, OR LIQUIDATION OF (INCLUDING ANY BANKRUPTCY FILING OR INSOLVENCY PROCEEDING BY) THE CORPORATION; 4. INITIATE THE DISSOLUTION, CONVERSION, OR LIQUIDATION OF (INCLUDING ANY BANKRUPTCY FILING OR INSOLVENCY PROCEEDING BY) THE CORPORATION; 5. APPOINT OR REMOVE THE POST-CLOSING CORPORATION DIRECTORS, WITH OR WITHOUT CAUSE; 6. INITIATE THE ESTABLISHMENT OF ANY NEW MATERIAL ACADEMIC AFFILIATION BY THE CORPORATION; 7. INITIATE THE PARTICIPATION, DIRECTLY OR INDIRECTLY, IN ANY JOINT VENTURE OR JOINT ENTERPRISE WITH ONE OR MORE THIRD PARTIES, OR APPROVE THE PARTICIPATION, DIRECTLY OR INDIRECTLY, IN SUCH A TRANSACTION TO THE EXTENT IT MAY FALL OUTSIDE THE PARAMETERS FOR ENTRY INTO SUCH TRANSACTIONS ESTABLISHED BY PRISMA HEALTH; 8. ON CONSULTATION WITH THE CORPORATION, DEVELOP THE OPERATING AND CAPITAL BUDGETS AND FORECASTS APPLICABLE TO THE CORPORATION, AND MONITOR THE STATUS OF, AND HOLD IT ACCOUNTABLE FOR ITS PERFORMANCE RELATIVE TO, ITS BUDGET OR FORECAST, AS APPLICABLE; 9. ON CONSULTATION WITH THE CORPORATION, DEVELOP THE STRATEGIC, FINANCIAL, CAPITAL, AND OPERATING PLANS APPLICABLE TO THE CORPORATION AND MONITOR THE STATUS OF, AND HOLD IT ACCOUNTABLE FOR ITS PERFORMANCE RELATIVE TO, ITS STRATEGIC, FINANCIAL, CAPITAL, AND OPERATING PLANS; 10. EXERCISE OVERSIGHT OVER MANAGEMENT OF AND POLICIES WITH RESPECT TO, AND INITIATE THE SALE OF OR ANY LIEN ON, THE REAL OR PERSONAL PROPERTY ASSETS (OR ANY INTEREST THEREIN) OF THE CORPORATION; 11. APPROVE THE PARTICIPATION, DIRECTLY OR INDIRECTLY, BY THE CORPORATION IN A SALE OR LIEN TRANSACTION, TO THE EXTENT SUCH TRANSACTION MAY FALL OUTSIDE THE PARAMETERS FOR ENTRY INTO SUCH TRANSACTIONS WITHOUT THE PRIOR APPROVAL PRISMA HEALTH; 12. INITIATE THE INCURRENCE OF ANY INDEBTEDNESS, ANY OPERATING OR CAPITAL EXPENDITURE, OR ANY INVESTMENT IN (INCLUDING ANY LOAN TO) ANY THIRD PARTY, BY THE CORPORATION, IN EACH CASE TO THE EXTENT THE SAME IS NOT INCLUDED IN AN APPROVED BUDGET OR FORECAST OR OTHER ACTION TAKEN BY PRISMA HEALTH APPLICABLE TO THE CORPORATION; 13. CAUSE OR DIRECT THE PAYMENT, LOAN OR TRANSFER TO PRISMA HEALTH OF SUCH FUNDS, AND IN SUCH AMOUNTS, AS PRISMA HEALTH SHALL DETERMINE FROM TIME TO TIME, FROM THE CORPORATION; AND 14. TO THE EXTENT NOT EXPRESSLY SET FORTH ABOVE, DIRECT OR REQUIRE THAT THE CORPORATION TAKE ANY OTHER LAWFUL ACTS OR ACTIONS WITH RESPECT TO SUCH ENTITY'S BUSINESS, AFFAIRS, MANAGEMENT, PROPERTIES, OR ACTIVITIES AS PRISMA HEALTH SHALL DETERMINE FROM TIME TO TIME. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. THE RETURN WAS REVIEWED BY MANAGEMENT AND IN-HOUSE LEGAL COUNSEL PRIOR TO FILING WITH THE IRS. IN ADDITION, A COPY OF THE RETURN WAS PROVIDED TO THE PRISMA HEALTH-UPSTATE BOARD OF DIRECTORS AND THE PRISMA HEALTH BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE DIRECTORS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ON AN ANNUAL BASIS ANY CONFLICTS OF INTEREST. THESE ARE REVIEWED BY THE CORPORATE COMPLIANCE AND LEGAL DEPARTMENTS OF PRISMA HEALTH. ADDITIONALLY, CORPORATE COMPLIANCE COMPARES ANNUAL DISCLOSURES BY EMPLOYED PHYSICIANS TO THOSE DISCLOSED BY VENDORS THROUGH THE OPEN PAYMENTS SYSTEMS. ANY EXCEPTIONS ARE REVIEWED AND COMMUNICATED TO THE CONFLICT OF INTEREST COMMITTEE AND THE DEPARTMENT CHAIRPERSON. FORM 990, PART VI, SECTION B, LINE 15 PRISMA HEALTH IS RESPONSIBLE FOR ESTABLISHING THE COMPENSATION PHILOSOPHY. AS PART OF THIS UNDERTAKING, THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF PRISMA HEALTH, WHICH IS COMPOSED SOLELY OF INDEPENDENT DIRECTORS OF PRISMA HEALTH, SETS THE COMPENSATION PAYABLE TO THE EXECUTIVES AND MANAGEMENT LEADERS EMPLOYED BY PRISMA HEALTH AND ITS RELATED ORGANIZATIONS WHO ARE CONSIDERED AS DISQUALIFIED PERSONS IN ACCORDANCE WITH SECTION 4958 OF THE CODE AND THE APPLICABLE COMPENSATION PHILOSOPHY TO MANAGERS, DIRECTORS, AND EMPLOYEES. THIS PROCESS OF INDEPENDENT ESTABLISHMENT AND REVIEW OF COMPENSATION BY THE PARENT ORGANIZATION OR THE SYSTEM IS CONSISTENT WITH THAT UTILIZED BY THE MAJORITY OF LARGE, MULTI-INSTITUTIONAL HEALTHCARE SYSTEMS. THE EXECUTIVE COMPENSATION COMMITTEE UTILIZES AN EXPERT INDEPENDENT COMPENSATION CONSULTANT RETAINED BY THE COMMITTEE TO PROVIDE AND EVALUATE COMPENSATION BASED ON COMPARABILITY DATA, MARKET CONDITIONS, COMPETITION FOR TALENT, AND OTHER SIGNIFICANT FACTORS. BASE COMPENSATION, VARIABLE INCENTIVE COMPENSATION, AND BENEFITS ARE ALL ESTABLISHED AND SET AFTER REVIEW BY THE COMMITTEE OF THIS DATA AND THE PERFORMANCE OF THE ORGANIZATION, AND REPORTS FROM THE INDEPENDENT CONSULTANT ARE INCLUDED IN THE MINUTES OF THE DELIBERATION BY THE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES ITS FORM 990 AND FORM 1023 AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 6,170,930. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,170,930. MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 80,688,073. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 80,688,073. TEACHING SERVICES: PROGRAM SERVICE EXPENSES 4,177,373. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,177,373. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 1,141,588. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,141,588. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 102,360,870. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 102,360,870. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 8,992,752. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,992,752. FORM 990, PART XI, LINE 9: EQUITY TRANSFERS -836,572,992. OTHER CHANGES IN NET ASSETS 649,462. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART VII, SECTION B: THE IMAG MANAGEMENT SERVICE AGREEMENT (MSO) IS AN INDEPENDENT CONTRACTOR RELATIONSHIP WHERE PRISMA HEALTH-UNIVERSITY MEDICAL GROUP PURCHASES ALL NON-MD STAFFING THAT SUPPORTS IMA PROVIDERS. BECAUSE IMA DOES HAVE MD SPECIALISTS AS WELL, IT ALSO HAS BEEN ALLOWED TO PURCHASE ITS PRACTICE PLAN SUPPLIES NEEDED FOR ITS RHEUMATOLOGY PATIENTS. THERE IS ALSO AN ADMINISTRATIVE DOLLAR AMOUNT PER YEAR THAT IS PROVIDED TO IMAG AS THE MANAGEMENT FEE TO OVERSEE ITS NON-MD PORTION OF PRACTICE. PRISMA HEALTH-UNIVERSITY MEDICAL GROUP DOES NOT HAVE ITS OWN DISBURSEMENT CASH ACCOUNT; THEREFORE, ALL PAYMENTS TO IMA ARE MADE BY PRISMA HEALTH-UPSTATE. 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