2020-08-03T14:50:07-05:00 2019-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2018-10-01 814193950 APELLA HEALTH MANAGEMENT INC APEL 8645605010 700 N PINE STREET SPARTANBURG SC 29303 KENNETH J MEINKE VP - FINANCE /CHIEF ADMINIST 8645605010 2020-08-03 1 AMY BIBBY P00445891 8282542254 99.47.28.203 2020-08-03 14:49:13 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 48FB394F9AA065459641371F168D9F2AFFFBB473 2018 2020-09-23 17:36:50Z BRUCE HOLSTIEN 700 N PINE STREET SPARTANBURG SC 29303 179171179 0 X WWW.APELLAHEALTH.COM X 2016 SC APELLA HEALTH MANAGEMENT WAS FORMED TO PROVIDE CERTAIN CHARITABLE AND HEALTH CARE SERVICES TO THE BENEFIT OF SPARTANBURG REGIONAL HEALTH SERIVCES DISTRICT, INC., A PUBLIC HOSPITAL CORPORATION AND POLITICAL SUBDIVISION OF THE STATE OF SOUTH CAROLINA, IN FURTHERANCE OF SERVING THE HEALTH CARE NEEDS OF SPARTANBURG COUNTY COMMUNITIES IN SOUTH CAROLINA AND OTHER SURROUNDING COMMUNITIES. 8 7 2610 0 0 0 0 0 72375249 179255518 0 24744 -26618 -109083 72348631 179171179 0 0 0 0 68852378 172412472 0 0 0 1740511 3193185 70592889 175605657 1755742 3565522 10970363 24957794 8226695 18648604 2743668 6309190 X APELLA HEALTH MANAGEMENT WAS FORMED TO PROVIDE CERTAIN CHARITABLE AND HEALTH CARE SERVICES TO THE BENEFIT OF SPARTANBURG REGIONAL HEALTH SERIVCES DISTRICT, INC., A PUBLIC HOSPITAL CORPORATION AND POLITICAL SUBDIVISION OF THE STATE OF SOUTH CAROLINA, IN FURTHERANCE OF SERVING THE HEALTH CARE NEEDS OF SPARTANBURG COUNTY COMMUNITIES IN SOUTH CAROLINA AND OTHER SURROUNDING COMMUNITIES. 0 0 167233605 179255518 THE ORGANIZATION WAS FORMED TO PROMOTE HEALTH FOR THE BENEFIT OF THE COMMUNITY AND LESSEN THE BURDENS OF GOVERNMENT BOTH WITHIN THE MEANING OF SECTION 501(C)(3) OF THE CODE BY PROVIDING CERTAIN ESSENTIAL CHARITABLE AND HEALTH CARE SERVICES, INCLUDING MANAGEMENT SERVICES TO THE SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, A STATE INSTRUMENTALITY OF SOUTH CAROLINA (THE "DISTRICT").SUCH SERVICES ARE ESSENTIAL IN FURTHERANCE OF SERVING THE HEALTH CARE NEEDS OF THE COMMUNITIES IN AND SURROUNDING SPARTANBURG. THE DISTRICT'S HEALTH CARE FACILITIES, INCLUDE FIVE (5) ACUTE-CARE HOSPITALS; A LONG TERM ACUTE CARE HOSPITAL; TWO LONG-TERM CARE FACILITIES; A HOSPICE HOME AND IN-HOME HOSPICE SERVICES; A PHYSICIAN GROUP CONSISTING OF OVER 450 PHYSICIANS LOCATED THROUGHOUT THE DISTRICT'S SERVICE AREA; AND OTHER RELATED ENTITIES. PROVIDING THESE SERVICES, THE ORGANIZATION'S ACTIVITIES ALLOW THE DISTRICT TO BETTER ACHIEVE ITS CHARITABLE AND GOVERNMENTAL PURPOSES. 167233605 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 5 0 1 2610 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 SC X KENNETH J MEINKE 8645606103 700 N PINE STREET SPARTANBURG SC 29303 X ROBERT GREGORY JR CHAIRPERSON 1.00 X X 0 0 0 KATHERINE DUNLEAVY VICE CHAIRPERSON 1.00 X X 0 0 0 HOMER MCABEE JR TREASURER 1.00 X X 0 0 0 MARY THOMAS SECRETARY 1.00 X X 0 0 0 WILSON SMITH BOARD MEMBER 1.00 X 0 100000 0 NALIN SRIVASTAVA BOARD MEMBER 1.00 X 0 16125 0 TERRY CASH BOARD MEMBER 1.00 X 0 0 0 ASHLEY ALLEN BOARD MEMBER 1.00 X 0 0 0 BRUCE HOLSTIEN PRESIDENT 40.00 X 989799 0 303452 KENNETH MEINKE VP - FINANCE/CHIEF ADMIN. 40.00 X 1002845 0 192281 MARK AYCOCK VP - OPERATIONS 40.00 X 908099 0 206130 MARIA WILLIAMSON VP - MARKETING 40.00 X 386365 0 8850 PAUL NEWHOUSE PRESIDENT - UMC 40.00 X 256863 0 24611 RALPH PETTINGELL VP - PAYER STRATEGY 40.00 X 295283 0 14269 YASSER OMAR MAHMOUD PHYSICAL THERAPIST 40.00 X 217091 0 19011 MARY JANE HARDY SYSTEM CONTROLLER 40.00 X 165100 0 15167 4221445 116125 783771 8 0 1 0 KAUFMAN HALL & ASSOCIATES LLC 10 S WACKER STREET STE 3375 CHICAGO IL 60606 CONSULTING 165680 1 LEASED STAFFING REVENUE 541900 167191180 167191180 MANAGEMENT FEE REVENUE 541900 8970006 8970006 ADMINISTRATIVE FEE REVENUE 541900 3094332 3094332 179255518 24744 24744 JOINT VENTURE REVENUE 900099 -109083 -109083 -109083 179171179 179255518 0 -84339 2984334 2984334 137685895 136548249 1137646 4027402 3799728 227674 17345431 16587332 758099 10369410 10287189 82221 185793 185793 19984 19984 2825857 2825857 28930 6610 22320 28653 28653 99471 99471 OTHER EXPENSES 4497 4497 175605657 167233605 8372052 0 4173250 7090447 51281 77843 114613 28653 0 85960 1813382 176762 4932450 17526782 10970363 24957794 8215559 18648604 11136 8226695 18648604 X 2743668 6309190 2743668 6309190 10970363 24957794 3565522 0 X X 0 1 X 1 0 X X 1 SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT 571075649 6 1 0 167233605 1 0 167233605 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 X PART IV SECTION E LN 1C THE ORGANIZATION SUPPORTS SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT WHICH IS A GOVERNMENTAL ENTITY. THE ORGANIZATION LESSENS THE BURDENS OF THE GOVERNMENTAL ENTITY BY PROVIDING CERTAIN ESSENTIAL CHARITABLE AND HEALTH CARE SERVICES. PART IV SECTION D LINE 1 THE ORGANIZATION SUBMITS TO THE SUPPORTED ORGANIZATION A COPY OF ITS FORM 990 UPON SUBMISSION. PART IV SECTION D LINE 3 THE CHIEF EXECUTIVE OFFICER PERFORMS THE SAME FUNCTIONS FOR BOTH THE FILING ORGANIZATION AND SUPPORTED ORGANIZATION, AS A RESULT THE SUPPORTED ORGANIZATION HAD A DIRECT SIGNIFICANT VOICE IN TO THE USE OF THE INCOME AND THE ASSETS OF THE ORGANIZATION. 114613 28653 85960 85960 DUE FROM RELATED ORGANIZATION 17526782 17526782 X 179171179 0 179171179 0 179171179 175605657 0 175605657 0 175605657 PART X, LINE 2: THE COMPANY HAS BEEN GRANTED EXEMPTION FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND, ACCORDINGLY, NO PROVISION FOR INCOME TAX IS RECORDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE COMPANY HAS DETERMINED THAT IT DOES NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2019. X X X X X 0 1 0 0 0 0 0 0 0 BRUCE HOLSTIEN PRESIDENT 850013 0 0 0 139786 0 286399 0 17053 0 1293251 0 0 0 KENNETH MEINKE VP - FINANCE/CHIEF ADMIN. 538771 0 300100 0 163974 0 180106 0 12175 0 1195126 0 0 0 MARK AYCOCK VP - OPERATIONS 530243 0 287901 0 89955 0 194783 0 11347 0 1114229 0 0 0 MARIA WILLIAMSON VP - MARKETING 301692 0 78710 0 5963 0 0 0 8850 0 395215 0 0 0 PAUL NEWHOUSE PRESIDENT - UMC 211250 0 30150 0 15463 0 8107 0 16504 0 281474 0 0 0 RALPH PETTINGELL VP - PAYER STRATEGY 215010 0 58480 0 21793 0 0 0 14269 0 309552 0 0 0 YASSER OMAR MAHMOUD PHYSICAL THERAPIST 128960 0 87245 0 886 0 5096 0 13915 0 236102 0 0 0 MARY JANE HARDY SYSTEM CONTROLLER 159534 0 5000 0 566 0 5247 0 9920 0 180267 0 0 0 PART I, LINE 4B EXECUTIVES OF THE ORGANIZATION PARTICIPATE IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. DURING THE YEAR THE EXECUTIVES ACCRUED THE FOLLOWING AMOUNTS UNDER THE TERMS OF THE PLAN. BRUCE HOLSTIEN - $268,492 KENNETH MEINKE - $170,782 MARK AYCOCK - $169,338 SCHEDULE J PART I LN 3 SRHS (A RELATED ORGANIZATION) UTILIZED A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION STUDY/SURVEY, AND A COMPENSATION COMMITTEE TO ASSIST IN ESTABLISHING COMPENSATION FOR EXECUTIVES OF APELLA HEALTH MANAGEMENT, INC. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WAS REVIEWED WITH THE AUDIT COMMITTEE CHAIR IN DETAIL. RETURN WAS REVIEWED AT THE BOARD OF DIRECTORS MEETING, PRIOR TO ISSUANCE. ALL QUESTIONS/COMMENTS WERE APPROPRIATELY ADDRESSED. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS MUST DISCLOSE TO THE BOARD ALL APPLICABLE FINANCIAL INTERESTS, BOARD MEMBERSHIPS, AND OTHER INTERESTS, AND ALL MATERIAL FACTS RELATING TO ANY ORGANIZATION ENTERING INTO A TRANSACTION OR ARRANGEMENT WITH THE CORPORATION THAT MAY RESULT IN A CONFLICT OF INTEREST. BOARD MEMBERS ARE RESPONSIBLE FOR IDENTIFYING POTENTIAL CONFLICTS AS ITEMS ARE DISCUSSED. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION UTILIZES SEVERAL SOURCES OF COMPARIBILITY DATA DURING ITS COMPENSATION REVIEW PROCESS INCLUDING: WILLIS TOWERS WATSON CONDUCTS AN ANNUAL EXECUTIVE MARKET COMPENSATION ASSESSMENT. THE DATA IS PROVIDED FROM NATIONAL SURVEYS: TOWER DATA SERVICES, MERCER, INC., INTEGRATED HEALTHCARE STRATEGIES, AND SULLIVAN COTTER AND ASSOCIATES. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES ITS FORM 1023, AND FORM 990 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 VII & PART IX COMPENSATION REPORTED IN PART VII OF THE RETURN IS REPORTED ON A CALENDAR YEAR BASIS AS REQUIRED BY THE FORM 990 INSTRUCTIONS. COMPENSATION REPORTED IN PART PART IX LN 5 OF THE RETURN IS REPORTED ON THE FISCAL YEAR BASIS. THIS DIFFERENCE RESULTS IN A DISCREPANCY BETWEEN THE AMOUNTS ILLUSTRATED IN EACH SECTION. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT 101 EAST WOOD STREET SPARTANBURG SC 29303 571075649 HEALTHCARE SERVICES SC GOVERNMENT N/A N/A 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0