2019-08-22T06:27:00-07:00 2019-05-31 Terry Horne CPA Inc 732 West Main Street Lebanon TN 37087 990 2018-06-01 570672117 LITTLE RIVER MEDICAL CENTER INC LITT 8436638000 PO BOX 547 LITTLE RIVER SC 29566 PAMELA DAVIS CHIEF EXECUTIVE OFFICER 8436638000 2019-07-16 true Terry Horne CPA P00120946 6154447293 2019-08-22 96.38.81.69 2019-08-22 06:26:04 PD P 03245427EFB77A9D91A2A51551C39050C68870D0 03245427EFB77A9D91A2A51551C39050C68870D0 2018 2019-02-21 02:37:17Z PAMELA DAVIS PO BOX 547 LITTLE RIVER SC 29566 31311083 false X N/A X 1978 SC THE ORGANIZATION PROVIDES HEALTH CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. 13 13 427 0 0 0 12171713 9347909 15782290 21869799 -2156 93375 0 27951847 31311083 0 0 19210451 20631233 0 0 7971294 10504565 27181745 31135798 770102 175285 22076588 23353380 9825727 10922568 12250861 12430812 THE ORGANIZATION PROVIDES HEALTH CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. false false 26251505 0 21869799 THE ORGANIZATION PROVIDES HEALTH CARE REGARDLESS OF INDIVIDUALS ABILITY TO PAY. THESE MEDICAL SERVICES ARE PROVIDED IN AREAS THAT HAVE A SHORTAGE OF HEALTH CARE PROVIDERS. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. OVER 117,900 VISITS WERE PROVIDED DURING THE YEAR. 26251505 true false false false false false false false false false true false false false false false true false false false false false false false false false false false false true false false false false false false false false true false false false false true false false false false true 33 0 true 427 true false false false false false false false false false false false false false X 13 13 true false false false false false false true true false false false true true true true true true true false SC X CHARLES EASON 8436631013 4303 LIVE OAK DRIVE LITTLE RIVER SC 29566 WILLIE ANN HUCKS SECRETARY 1.00 X 0 0 0 HOWARD GARRISON CHAIR 1.00 X 0 0 0 LYNN KORNITA BOARD MEMBER 1.00 X 0 0 0 ELOUISE YOUNG BOARD MEMBER 1.00 X 0 0 0 COLEEN RENEE KENNEDY BOARD MEMBER 1.00 X 0 0 0 LUZ ELENA KUHLER BOARD MEMBER 1.00 X 0 0 0 MAURICE JONES VICE CHAIR 1.00 X 0 0 0 DANA BLACK BOARD MEMBER 1.00 X 0 0 0 JACK FIELDS BOARD MEMBER 1.00 X 0 0 0 KIMBERLEE MASSON TREASURER 1.00 X 0 0 0 CYNTHIA GAUSE BOARD MEMBER 1.00 X 0 0 0 JOAN VAITIS BOARD MEMBER 1.00 X 0 0 0 GREGORY THOMPSON BOARD MEMBER 1.00 X 0 0 0 PAM DAVIS CHIEF EXECUTIVE OFFICER 40.00 X 231137 0 44124 CHARLES EASON CHIEF FINANCIAL OFFICER 40.00 X 166197 0 44434 KAREN CAGLE CHIEF OPERATIONAL OFFICER 40.00 X 109171 0 21242 MARK MANCINI CHIEF INFORMATION OFFICER 40.00 X 91713 0 33798 WILLIAM J O'CONNOR CHIEF MEDICAL OFFICER 40.00 X 222159 0 29916 MARK JANOSKY CHIEF DENTAL OFFICER 40.00 X 164817 0 22307 KRISTOPHER L CHIPLINSKI DIRECTOR OF PHARMACY 40.00 X 140059 0 57735 LUIS INSIGNARES PHYSICIAN 40.00 X 190154 0 39982 DANNY KASS PHYSICIAN 40.00 X 217333 0 5007 EUNICE GUZMAN PHYSICIAN 40.00 X 214868 0 4376 CHRISTINE MCGINLEY PHYSICIAN 40.00 X 191974 0 21558 ROMEO NILLAS PHYSICIAN 40.00 X 187138 0 24682 MICHELE HROMYAK PHARMACIST 40.00 X 122329 0 28629 LATISHA KEARSLEY DENTIST 40.00 X 143803 0 18124 BRENT ALAN BAUER DENTIST 40.00 X 136781 0 39406 PEGGY BOURGUILLON PHYSICIAN 40.00 X 182515 0 9373 MARISTELA NABONG-NILLAS PHYSICIAN 40.00 X 170074 0 33543 SHERRY NWANEGWO PHYSICIAN 40.00 X 185838 0 18398 RAYMOND REISER PHYSICIAN 40.00 X 174466 0 17116 ALEENA SABZWARI DENTIST 40.00 X 154142 0 17264 ORLANDO VALDEZ PHYSICIAN 40.00 X 169352 0 14700 SHAUNA WALTERS PHYSICIAN 40.00 X 168502 0 11057 MERIANA MARTIN DENTIST 40.00 X 140393 0 7510 BERNICE LIM PHYSICIAN 40.00 X 123488 0 18900 ANGELA WALLS DANIELS PHARMACIST 40.00 X 123750 0 21212 VIKI LAMBERTUS NURSE PRACTITIONER 40.00 X 114653 0 16133 BEVERLY ELAINE MILLER NURSE PRACTITIONER 40.00 X 120689 0 1341 4357495 0 621867 26 false true false CHARTSPAN MEDICAL TECHNOLOGIES INC 2 N MAIN ST GREENVILLE SC 29601 CARE COORDINATION SERVICES 323459 GREENWAY PO BOX 203658 DALLAS TX 75320 MEDICAL BILLING/CODING SERVICES 418852 WACCAMAW CENTER FOR MENTAL HEALTH 164 WACCAMAW MEDICAL PARK CONWAY SC 29526 CONTRACT MENTAL HEALTH SERVICES 131474 LABCORP PO BOX 921140 BURLINGTON NC 27216 LAB SERVICES 203854 4 8845791 502118 24000 9347909 PATIENT FEES 621111 18926113 0 0 340B & OTHER CONTRACT SERVICES 621111 2943686 0 0 21869799 93711 0 93711 -336 -336 -336 0 0 -336 31311083 21869799 0 93375 1125253 527035 598218 0 15771440 14090110 1681330 0 358610 311991 46619 0 2272954 1959130 313824 0 1102976 959589 143387 0 3179825 2543860 635965 0 4623905 3699123 924782 0 1415160 1132127 283033 0 446780 357424 89356 0 414331 331465 82866 0 424564 339651 84913 0 31135798 26251505 4884293 0 119721 142111 3627199 3756470 1814691 2548468 327493 389166 355712 412132 22715241 6655532 15829272 16059709 2500 45324 22076588 23353380 1272691 2627764 113951 214029 8439085 8080775 9825727 10922568 X 12213472 12388757 37389 42055 12250861 12430812 22076588 23353380 X 175285 4666 X X false true X true true true X 0 5998155 8307426 9586181 12171713 9347909 45411384 0 0 5998155 8307426 9586181 12171713 9347909 45411384 0 45411384 2095 2375 2462 6643 93375 106950 0 0 45518334 77835324 0.99770 0.99960 X 0 0 0 2640472 2640472 15626938 3194655 12432283 4447831 3460877 986954 16059709 31311083 31311083 31311083 31135798 31135798 31135798 X X false false false false false false false false false PAM DAVIS 231137 0 0 0 0 0 9995 0 34130 0 275262 0 0 0 CHARLES EASON 166197 0 0 0 0 0 6804 0 37630 0 210631 0 0 0 WILLIAM J O'CONNOR 222159 0 0 0 0 0 9377 0 20539 0 252075 0 0 0 MARK JANOSKY 164817 0 0 0 0 0 6645 0 15662 0 187124 0 0 0 KRISTOPHER L CHIPLINSKI 140059 0 0 0 0 0 6469 0 51266 0 197794 0 0 0 LUIS INSIGNARES 190154 0 0 0 0 0 8470 0 31512 0 230136 0 0 0 DANNY KASS 217333 0 0 0 0 0 3260 0 1747 0 222340 0 0 0 EUNICE GUZMAN 214868 0 0 0 0 0 2482 0 1894 0 219244 0 0 0 CHRISTINE MCGINLEY 191974 0 0 0 0 0 3964 0 17594 0 213532 0 0 0 ROMEO NILLAS 187138 0 0 0 0 0 7749 0 16933 0 211820 0 0 0 MICHELE HROMYAK 122329 0 0 0 0 0 4097 0 24532 0 150958 0 0 0 LATISHA KEARSLEY 143803 0 0 0 0 0 4425 0 13699 0 161927 0 0 0 BRENT ALAN BAUER 136781 0 0 0 0 0 6229 0 33177 0 176187 0 0 0 PEGGY BOURGUILLON 182515 0 0 0 0 0 2874 0 6499 0 191888 0 0 0 MARISTELA NABONG-NILLAS 170074 0 0 0 0 0 7426 0 26117 0 203617 0 0 0 SHERRY NWANEGWO 185838 0 0 0 0 0 2738 0 15660 0 204236 0 0 0 RAYMOND REISER 174466 0 0 0 0 0 1747 0 15369 0 191582 0 0 0 ALEENA SABZWARI 154142 0 0 0 0 0 6229 0 11035 0 171406 0 0 0 ORLANDO VALDEZ 169352 0 0 0 0 0 0 0 14700 0 184052 0 0 0 SHAUNA WALTERS 168502 0 0 0 0 0 0 0 11057 0 179559 0 0 0 false false false Pt VI, Line 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY Pt VI, Line 19 AND FORM 990 AVAILABLE UPON WRITTEN REQUEST. Pt VI, Line 11b THE FORM 990 IS PREPARED BY THE CENTER'S INDEPENDENT AUDITOR WITH REVIEW AND Pt VI, Line 11b INFORMATION PROVIDED BY THE CEO & CFO. A COPY OF THE FORM 990 WILL BE GIVEN Pt VI, Line 11b AND REVIEWED WITH THE BOARD AFTER COMPLETION AND SUBMISSION BY THE AUDITOR. Pt VI, Line 12c ANNUALLY THE CONFLICT OF INTEREST STATEMENT IS SIGNED BY BOARD MEMBERS AND Pt VI, Line 12c REVIEWED THE ENTIRE BOARD. BOARD MEMBERS SHALL EXCUSE THEMSELVES FROM Pt VI, Line 12c ISSUES THAT ENHANCE THE PROBABILITY OF THEIR OWN PERSONAL AND PRIVATE GAIN. Pt VI, Line 15a STATE AND NATIONAL SALARY COMPARISONS ARE USED TO ESTABLISH SALARY LIMITS Pt VI, Line 15b FOR TOP MANAGEMENT OFFICIALS. PERFORMANCE EVALUATIONS ARE PERFORMED ANNUALLY Pt VI, Line 15b AND CEO SALARY INCREASES ARE BOARD APPROVED. Pt XII, Line 2c THE CEO & CFO OVERSEE FINANCIAL STATEMENT PREPARATION AND AUDIT ENGAGEMENT. Pt XI PART XI LINE 9- CHANGE IN NET ASSETS DUE TO DECREASE IN TEMPORARILY Pt XI RESTRICTED NET ASSETS RELATED TO DONATED PHARMACEUTICALS. Pt VI, Line 2 MS. WILLIE ANN HUCKS AND MR. ROBERT HUCKS ARE BOTH ON THE BOARD Pt VI, Line 2 AND HAVE A MOTHER/SON RELATIONSHIP. Pt XI INCREASE IN NET ASSETS DUE TO CHANGE IN TEMPORARILY RESTRICTED CASH. false false false false false false false false false false false false false false false false false false false