2019-06-25T07:45:20-05:00 2018-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2017-10-01 560583151 SCOTLAND MEMORIAL HOSPITAL INC SCOT 9102917920 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 MATT PRACHT CFO 9102917920 2019-06-25 1 AMY BIBBY P00445891 8282542254 2019-06-25 24.241.144.70 2019-06-25 07:41:29 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 3C4A73C7F70BFF54BAAC11A85090BDFB39FC8B01 2017 2019-02-21 02:37:17Z MATT PRACHT 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 180191486 0 X WWW.SCOTLANDHEALTH.ORG X 1945 NC TO OFFER A FULL RANGE OF ACUTE CARE AND INPATIENT SERVICES TO THE RESIDENTS OF SCOTLAND COUNTY, NORTH CAROLINA AND THE SURROUNDING AREA. 18 13 1251 115 84574 0 907460 949453 168117662 175385121 1616056 2905427 983966 951485 171625144 180191486 46908 190762 0 0 70688981 76015671 0 0 0 79969431 86778492 150705320 162984925 20919824 17206561 187772277 196786140 60921968 55794865 126850309 140991275 TO PROVIDE HIGH QUALITY, COMPASSIONATE HEALTH CARE. 0 0 142154572 190762 175300547 SEE SCHEDULE O 142154572 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 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 189 0 1 1251 1 1 1 0 0 0 0 0 0 0 0 0 X 18 13 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NC X MELINDA BRISSON 9102917393 500 LAUCHWOOD DR LAURINBURG NC 28352 X GREGORY C WOOD CEO/PRESIDENT 37.00 3.00 X X 450193 0 69909 JANE ROGERS CHAIR 2.00 3.00 X X 0 0 0 DAVID HARLING VICE CHAIR 2.00 X X 0 0 0 CHIP SHYTLE TREASURER 2.00 2.00 X X 0 0 0 STEPHEN LANUTI MD TRUSTEE/PHYSICIAN 40.00 2.00 X 609749 0 85760 DOUG NEDEROSTEK MD TRUSTEE/PHYSICIAN 40.00 2.00 X 46005 0 0 GLENN HARRIS MD TRUSTEE/PHYSICIAN 40.00 2.00 X 238500 0 72297 TIM BROOKS TRUSTEE 1.00 2.00 X 0 0 0 KYLE CHAVIS TRUSTEE 1.00 3.00 X 0 0 0 BRAD FAULKENBERRY MD TRUSTEE 1.00 2.00 X 0 0 0 BETTY HASTY TRUSTEE 1.00 3.00 X 0 0 0 BOBBY HINSON TRUSTEE 1.00 2.00 X 0 0 0 BECCA HUGHES TRUSTEE 1.00 3.00 X 0 0 0 JOSHUA MALCOLM TRUSTEE 1.00 2.00 X 0 0 0 ALLEN MCLAURIN TRUSTEE 1.00 2.00 X 0 0 0 KEN NICHOLS TRUSTEE 1.00 8.00 X 0 0 0 JOHN NOBLES MD TRUSTEE/PHYSICIAN 40.00 2.00 X 287739 0 15185 MIKE VINSON TRUSTEE 1.00 1.00 X 0 0 0 MATTHEW D PRACHT CFO/VP FINANCE/ASST. TREAS 35.00 5.00 X 244352 0 64005 LYNN THOMPSON SECRETARY 1.00 2.00 X 46249 0 5706 PAULA MCKINNEY VP CNO 40.00 X 172159 0 5500 PAT PHILLIPS SVP OPERATIONS 40.00 X 257893 0 25296 GRAY MILLS VP STRATEGIC DEVELOPMENT 40.00 X 194483 0 28039 CHERYL DAVIS MD VP MEDIAL AFFAIRS 40.00 X 261726 0 44663 ANN LOCKLEAR VP STRATEGIC DEVELOPMENT 40.00 X 185923 0 12391 LINDA MITCHELL-FRYE MD PHYSICIAN 40.00 X 530356 0 27326 CHI-DAI CHEN MD PHYSICIAN 40.00 X 345683 0 23946 PATRICIA MIDDLETON MD PHYSICIAN 40.00 X 297711 0 20692 JONATHAN ROWSON MD PHYSICIAN 40.00 X 222964 0 20440 4391685 0 521155 43 0 1 0 LIBERTY ANESTHESIA PLLC 16101 CADDIE COURT WAGRAM NC 28396 MEDICAL SERVICES 2365176 JEROME V PONDER MD 3461 THAMESFORD ROAD FAYETTEVILLE NC 28311 MEDICAL SERVICES 426662 FUSION MEDICAL STAFFING LLC PO BOX 82674 LINCOLN NE 685012674 MEDICAL SERVICES 352138 ARMSTRONG & WEINSTEIN LLC ONE DUNWOODY PARK ATLANTA GA 30338 BILLING/COLLECTION SERVICES 306285 QUENE LLC 161 PILGRIM POINT LEXINGTON SC 29072 FUNDRAISING SERVICES 295083 15 835457 113996 949453 NET PATIENT SERVICE REVENUE 621500 170379571 170379571 OTHER OPERATING REVENUE 624100 4541545 4456971 84574 MOB 900099 273003 273003 MEANINGFUL USE REVENUE 900099 188142 188142 HOSPICE IT CONTRACT 624100 2860 2860 175385121 2611635 2611635 350803 0 350803 350803 350803 272301 21491 0 0 272301 21491 293792 293792 CAFETERIA 722210 600266 600266 PURCHASE DISCOUNTS 900099 416 416 600682 180191486 175300547 84574 3856912 X 162862 162862 27900 27900 3225405 1355235 1870170 54945435 50856750 4088685 4217523 3785492 432031 10092627 9058767 1033860 3534681 3172598 362083 1764110 1764110 363536 363536 176385 176385 103070 103070 19716512 15635977 4080535 788588 33520 755068 6050664 4826435 1224229 392007 392007 1942929 1841126 101803 607863 505757 102106 10482 2231 8251 377607 377607 7388149 7388149 777319 777319 BAD DEBT 22190537 22190537 MEDICAL SUPPLIES 19744390 19744390 PROVIDER TAX 3587112 3587112 MISCELLANEOUS EXPENSE 521734 521734 275498 275498 162984925 142154572 20830353 0 46572 139960 60552845 45873491 10042681 11309421 1676885 1354084 1617987 2528119 177503631 111370256 54450845 66133375 56406997 62125388 575018 733510 600262 3953892 1802185 2634900 187772277 196786140 17072248 18955799 5573939 5280564 38275781 31558502 60921968 55794865 X 125732833 140111666 1117476 879609 126850309 140991275 187772277 196786140 X 17206561 19074 -3084669 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 10019 10019 0 PART II-B, LINE 1: SCOTLAND MEMORIAL HOSPITAL IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND NORTH CAROLINA HOSPITAL ASSOCIATION. A PORTION OF MEMBERSHIP DUES PAID TO THESE ASSOCIATIONS IS ALLOCATED TO LOBBYING EXPENSES. 1825397 1825397 96856016 64806230 32049786 65056300 43529083 21527217 13765918 3034943 10730975 66133375 CAPITAL LEASE OBLIGATIONS 1354252 ACCRUED INTEREST PAYABLE 153175 ESTIMATED 3RD PARTY SETTLEMENTS 12575196 PENSION PLAN LIABILITY 17475879 31558502 X 154638829 19074 852279 871353 153767476 103070 26320940 26424010 180191486 140497863 0 140497863 103070 22383992 22487062 162984925 PART X, LINE 2: THE CORPORATION AND ITS NONPROFIT AFFILIATES ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE LLC IS TREATED AS A PARTNERSHIP AND AS SUCH, THE INCOME FLOWS THROUGH TO THE OWNERS OF THE LLC. THE CORPORATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2018. PART XI, LINE 2D - OTHER ADJUSTMENTS: PENSION PLAN ADJUSTMENT 852,279. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 22,190,537. TRANSFER OF EQUITY 3,690,747. DISSOLUTION OF NONCONTROLLING INTEREST 246,201. GAIN ON SALE OF ASSETS 21,491. GRANTS INCLUDED IN REVENUE 163,062. EXPENSE INCLUDED IN REVENUE 8,902. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 22,190,537. GAIN ON SALE OF ASSETS 21,491. GRANTS INCLUDED IN REVENUE 163,062. EXPENSE INCLUDED IN REVEUNE 8,902. 1 1 1 X 1 X 1 1 1 0 1 1 3582321 3582321 0.02200 26059670 24922536 1137134 0.00700 29641991 24922536 4719455 0.02900 121305 462661 0 0.00000 121305 462661 0 0.00000 29763296 25385197 4719455 0.02900 1 5477581 4272513 57643406 47595632 10047774 X 1 1 1 SCOTLAND MOB INC MEDICAL OFFICE BUILDING 0.73170 0.26830 1 1 SCOTLAND MEMORIAL HOSPITAL INC 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 X X X DISPROPORTIONATE SHARE HOSPITAL SCOTLAND MEMORIAL HOSPITAL INC 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X SEE DISCLOSURE X 1 16 1 SEE DISCLOSURE 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X 1 X SEE PART V X SEE PART V X HTTP://WWW.SCOTLANDHEALTH.ORG/FINANCIAL-ASSISTANCE-148 X X X X X 1 X 0 X X X 1 X 0 0 SCOTLAND MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 5: IDENTIFIED PUBLIC HEALTH OFFICIALS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, AND COMMUNITY MEMBERS WITH KNOWLEDGE AND INTEREST IN ASSESSING AND IMPROVING THE HEALTH OF SCOTLAND COUNTY RESIDENTS. THESE INCLUDED: SCOTLAND HEALTH CARE SYSTEM BOARD OF TRUSTEES, SCOTLAND COUNTY HEALTH DEPARTMENT HEALTH EDUCATOR, ENVIRONMENTAL HEALTH COORDINATOR, BREASTFEEDING PROGRAMS MANAGER, QUALITY ASSURANCE COORDINATOR, DIRECTOR OF NURSING, AND HEALTH DIRECTOR. SCOTLAND HEALTH CARE SYSTEM COORDINATOR OF MOBILE SERVICES, INDUSTRIAL BUSINESS RN, DIRECTOR OF SCOTLAND PHYSICIANS NETWORK, ASST. DIRECTOR OF ASSOCIATE HEALTH, SCOTLAND MEMORIAL FOUNDATION GRANT WRITER, SCOTLAND MEMORIAL FOUNDATION DIRECTOR, MARKETING COORDINATOR; SCOTLAND COUNTY SCHOOL SYSTEM SOCIAL WORK/FACILITATOR, RN LEAD NURSE; SCOTLAND COMMNITY HEALTH CLINIC DIRECTOR; SCOTLAND COUNTY PARKS AND RECREATION DIRECTOR; 2 COMMUNITY MEMBERS. SCOTLAND MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 11: THE TOP PRIORITY ADDRESSED IN THIS CHNA WAS IDENTIFIED AS HYPERTENSION. THE OBJECTIVES TO ADDRESSING THIS NEED INCLUDE: INCREASING PUBLIC EDUCATION, IMPLEMENTING BLOOD PRESSURE SCREENING AND CARE PROTOCOLS INTO CURRENT COMMUNITY BENEFIT-RELATED PROGRAMS, AND PARTICIPATING WITH CURRENT COMMUNITY EFFORTS THAT ARE TAKING A POLICY, SYSTEMS, AND ENVIRONMENTAL APPROACH. THE OTHER RISK FACTORS THAT WERE IDENTIFIED INCLUDE: DIABETES AND HEART DISEASE. THESE OTHER RISK FACTORS ARE BEING ADDRESSED BY OTHER AGENCIES IN THE AREA. ALSO, ADDRESSING THIS TOP PRIORITY OF HYPERTENSION WILL ALSO HELP WITH THE OTHER FACTORS IDENTIFIED. PART V, SECTION B, LINE 16B: HTTPS://WWW.SCOTLANDHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE-AND-STANDARD-CHARGES PART V, SECTION B, LINE 16A: HTTPS://WWW.SCOTLANDHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE-AND-STANDARD-CHARGES PART V, SECTION B, LINE 16C: HTTPS://WWW.SCOTLANDHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE-AND-STANDARD-CHARGES PART V, SECTION B, LINE 7A: HTTPS://WWW.SCOTLANDHEALTH.ORG/-/MEDIA/SCOTLANDHEALTH/DOCUMENTS/CHNA/CHNA-2016_REVISED.PDF?LA=EN&HASH=72A515CEF6008B13407E10DA373722122EBBB112 9 1 - MARLBORO FAMILY PRACTICE AND URGENT CARE 957 CHERAW STREET BENNETTSVILLE SC 29512 PHYSICIAN PRACTICE-FAMILY PRACTICE 2 - MAXTON FAMILY PRACTICE CENTER 1001 W DR MARTIN LUTHER KING JR DRIVE MAXTON NC 28364 PHYSICIAN PRACTICE-FAMILY PRACTICE 3 - PEMBROKE FAMILY PRACTICE CENTER 410-D SOUTH JONES STREET PEMBROKE NC 28372 PHYSICIAN PRACTICE-FAMILY PRACTICE 4 - WAGRAM FAMILY PRACTICE CENTER 24420 MARLBORO STREET WAGRAM NC 28396 PHYSICIAN PRACTICE-FAMILY PRACTICE 5 - WOLONICK FAMILY PRACTICE 106 MCALPINE LANE LAURINBURG NC 28352 PHYSICIAN PRACTICE-FAMILY PRACTICE 6 - MARLBORO SURGICAL ASSOCIATES 957 CHERAW STREET BENNETTSVILLE SC 29512 PHYSICIAN PRACTICE-GENERAL SURGERY 7 - MARLBORO OBGYN 1007 CHERAW HIGHWAY BENNETTSVILLE SC 29512 PHYSICIAN PRACTICE-OB/GYN 8 - WOMENS HEALTH OF THE CAROLINAS 105 MCALPINE LANE LAURINBURG NC 28352 PHYSICIAN PRACTICE-OB/GYN 9 - HARRIS FAMILY PRACTICE 700-A PROGRESS PLACE LAURINBURG NC 28352 PHYSICIAN PRACTICE-FAMILY PRACTICE PART I, LINE 7G: CARDIAC REHABILITATION AND PULMONARY REHABILITATION SERVICES ARE PROVIDED BY THE HOSPITAL TO ALLOW PATIENTS TO ACCESS MAINTENANCE SESSIONS WITHOUT TRAVELING LONG DISTANCES. PATIENTS ARE CHARGED NOMINAL AMOUNTS AS INSURANCES DO NOT ROUTINELY COVER THE CARE. THEREFORE, THE COSTS THAT EXCEED PATIENT PAYMENTS ARE PROVIDED BY THE HOSPITAL AS A COMMUNITY BENEFIT. PART II, COMMUNITY BUILDING ACTIVITIES: SCOTLAND MEMORIAL HOSPITAL PLAYS A VERY ACTIVE ROLE IN RECRUITING PHYSICIANS AND MID-LEVEL PROVIDERS TO SERVE THE PATIENTS IN OUR SERVICE AREA. SCOTLAND AND ROBESON COUNTY, NC AND MARLBORO COUNTY, SC ROUTINELY HAVE SHORTAGES IN HEALTHCARE PROVIDERS. BY ITS EFFORTS, THE HOSPITAL ENSURES A NETWORK OF PROVIDERS IS AVAILABLE FOR THE CARE OF THOSE IN NEED OUR RURAL SETTING. PART III, LINE 4: THE ANDI METHODOLOGY, WHICH USES A FACILITY-WIDE RATIO OF COST TO CHARGES AS DESCRIBED IN NCHA COMMUNITY BENEFITS GUIDELINES WAS USED.SCOTLAND COUNTY HAS A CURRENT UNEMPLOYMENT RATE OF 6.2%, WELL OVER THE STATE-WIDE AVERAGE OF 3.8%. THE PAYOR MIX DATA FOR FISCAL YEAR 2018 SHOWED MEDICARE AT 45% AND MEDICAID AT 20%. IT IS BELIEVED THAT 6% OF UNEMPLOYED AND 9% OF MEDICARE AND MEDICAID WOULD QUALIFY FOR CHARITY SHOULD PATIENTS COMPLETE THE APPLICATION PROCESS PART III, LINE 8: PARTICIPATING IN THE MEDICARE PROGRAM QUALIFIES THE HOSPITAL FOR REIMBURSEMENT AT PREDETERMINED RATES FOR INPATIENT AND OUTPATIENT SERVICES. AS A CONDITION OF PARTICIPATION, THE HOSPITAL ACCEPTS PAYMENT FROM CMS (CENTERS FOR MEDICARE AND MEDICAID SERVICES), AND WRITES OFF THE DIFFERENCE BETWEEN THE AMOUNT PATIENT BILLED CHARGES AND MEDICARE PAYMENT. MEDICARE ALSO PAYS FOR CERTAIN "PASS-THROUGH" ITEMS, SUCH AS BAD DEBTS. TOTAL MEDICARE PAYMENTS DO NOT FULLY COVER THE COST OF PROVIDING SERVICES TO BENEFICIARIES. PART III, LINE 9B: THE ORGANIZATION HAS A BILLING AND COLLECTION POLICY WITH PROVISIONS FOR COLLECTING AMOUNTS DUE FROM THOSE PATIENTS WHO HAVE OUTSTANDING BALANCES. A DETERMINATION HAS ALREADY BEEN MADE REGARDING FINANCIAL ASSISTANCE PRIOR TO THE COLLECTION PROCESS. ONLY PATIENTS THAT ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE ARE PURSUED. PART VI, LINE 2: SCOTLAND MEMORIAL IS A MEMBER OF CAROLINAS COASTAL HEALTH ALLIANCE, WHICH HAS PREPARED COMMUNITY HEALTH ASSESSMENTS FOR ITS MEMBER HOSPITALS AND THE COMMUNITIES SERVED.HEALTH CARE NEEDS ARE ASSESSED ALSO BY INTERACTION WITH PATIENTS, PHYSICIANS, OTHER HEALTH CARE PROVIDERS, AND RESIDENTS ON AN ON-GOING BASIS. ADDITIONALLY, COMMUNITY NEEDS ARE DETERMINED BASED ON TYPES OF PATIENTS SERVED AND FINANCIAL LEVEL OF FINANCIAL ASSISTANCE PROVIDED IN PRIOR YEARS. PART VI, LINE 3: PATIENTS AND THOSE BILLED FOR CARE MAY BE INFORMED ABOUT ASSISTANCE ELIGIBILITY AT TIME OF REGISTRATION, AT DISCHARGE, AT TIME OF BILLING, AND/OR IN DISCUSSION WITH HOSPITAL BILLING STAFF. SCOTLAND MEMORIAL HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS AVAILABLE FOR ACCESS BY PATIENTS AND THE PUBLIC ON THE WEBSITE AT WWW.SCOTLANDHEALTH.ORG. PART VI, LINE 4: ALTHOUGH SCOTLAND MEMORIAL HOSPITAL SERVES THE NORTH CAROLINA COUNTIES OF SCOTLAND AND ROBESON, AND THE SOUTH CAROLINA COUNTY OF MARLBORO, THE PRIMARY FOCUS OF THE COMMUNITY-BASED SURVEY WAS ON SCOTLAND COUNTY, NORTH CAROLINA. 2015 CENSUS DATA REPORTS THAT SCOTLAND COUNTY IS THE POOREST COUNTY IN NORTH CAROLINA, WITH A MEDIAN HOUSEHOLD INCOME OF $30,958 AND WITH 29% OF PEOPLE LIVING IN POVERTY, SUBSTANTIALLY LOWER THAN THE STATE AND NATIONAL MEDIAN HOUSEHOLD INCOMES. THE COUNTY'S JOB MARKET WAS 6.2% FOR SEPTEMBER 2018, CONSIDERABLY HIGHER THAN THE STATE-WIDE AVERAGE OF 3.8%. WHILE OVER 33% OF AMERICANS HAD AT LEAST A BACHELOR'S DEGREE IN 2015, ONLY 15.8% OF SCOTLAND COUNTY RESIDENTS HAD SUCH A DEGREE. ETHNICALLY, THE COUNTY IS COMPRISED OF 45.7% WHITE, 39.1% BLACK, 11.8% AMERICAN INDIAN, AND 2.9% HISPANIC. PART VI, LINE 5: SCOTLAND MEMORIAL HOSPITAL FULFILLS ITS TAX EXEMPT PURPOSE BY THE PROVISION OF HEALTH CARE SERVICES WITHIN ITS SERVICE AREA TO PATIENTS WITH LITTLE OR NO RESOURCES TO PAY FOR CARE, AND BY THE ACCEPTANCE OF PAYMENTS FROM MEDICARE AND MEDICAID AT SUBSTANTIALLY REDUCED RATES.THE HOSPITAL'S BOARD IS COMPRISED OF UNRELATED, LOCAL MEMBERS OF THE COMMUNITY AND LOCAL PHYSICIANS HAVE PRIVILEDGES IN A MAJORITY OF THE HOSPITAL'S DEPARTMENTS.ALL EXCESS FUNDS ARE APPLIED TO PATIENT CARE THROUGH THE ANNUAL BUDGET PROCESS, WHEREBY ALL AVAILABLE FUNDS ARE ALLOCATED BASED ON NEEDS HIERARCHY. PART VI, LINE 6: AS THE LARGEST EMPLOYER IN SCOTLAND COUNTY, SCOTLAND MEMORIAL HOSPITAL TAKES A LEADERSHIP ROLE IN ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES, AND IN THE COORDINATION OF STRATEGIES TO MEET THE IDENTIFIED NEEDS. PART VI, LINE 7, REPORTS FILED WITH STATES NC,SC 0 SHOLARSHIPS X X X X 0 1 0 0 0 0 0 0 0 GREGORY C WOOD CEO/PRESIDENT 296929 0 124253 0 29011 0 36323 0 33586 0 520102 0 0 0 STEPHEN LANUTI MD TRUSTEE/PHYSICIAN 553000 0 27635 0 29114 0 52200 0 33560 0 695509 0 0 0 GLENN HARRIS MD TRUSTEE/PHYSICIAN 204769 0 33731 0 0 0 49393 0 22904 0 310797 0 0 0 JOHN NOBLES MD TRUSTEE/PHYSICIAN 272022 0 15717 0 0 0 15185 0 0 0 302924 0 0 0 MATTHEW D PRACHT CFO/VP FINANCE/ASST. TREAS 190387 0 50129 0 3836 0 36379 0 27626 0 308357 0 0 0 PAULA MCKINNEY VP CNO 147184 0 24975 0 0 0 0 0 5500 0 177659 0 0 0 PAT PHILLIPS SVP OPERATIONS 213079 0 44814 0 0 0 13102 0 12194 0 283189 0 0 0 GRAY MILLS VP STRATEGIC DEVELOPMENT 160586 0 33897 0 0 0 11581 0 16458 0 222522 0 0 0 CHERYL DAVIS MD VP MEDIAL AFFAIRS 219827 0 41301 0 598 0 19415 0 25248 0 306389 0 0 0 ANN LOCKLEAR VP STRATEGIC DEVELOPMENT 153512 0 32411 0 0 0 1418 0 10973 0 198314 0 0 0 LINDA MITCHELL-FRYE MD PHYSICIAN 377998 0 152358 0 0 0 15132 0 12194 0 557682 0 0 0 CHI-DAI CHEN MD PHYSICIAN 322831 0 22852 0 0 0 15141 0 8805 0 369629 0 0 0 PATRICIA MIDDLETON MD PHYSICIAN 297711 0 0 0 0 0 15192 0 5500 0 318403 0 0 0 JONATHAN ROWSON MD PHYSICIAN 162299 0 60665 0 0 0 8795 0 11645 0 243404 0 0 0 PART I, LINE 4B THE ORGANIZATION HAD OFFICERS WHO PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE APPROXIMATE AMOUNT OF DEFERRED COMPENSATION ACCRUED DURING THE FISCAL YEAR FOR THE PLAN WAS: WOOD $44,556 PRACHT 26,172 FORM 990, PART VI, SECTION A, LINE 3 EFFECTIVE APRIL 1, 2009, SCOTLAND HEALTH CARE SYSTEM IS ENGAGED IN A TEN-YEAR MANAGEMENT AGREEMENT WITH THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY D/B/A CAROLINAS HEALTHCARE SYSTEM TO MANAGE THE SYSTEM ON A DAY-TO-DAY BASIS. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING DATE, THE FORM 990 WAS PRESENTED TO THE BOARD OF TRUSTEES FOR REVIEW. AN OPPORTUNITY WAS PROVIDED FOR QUESTIONS AND ANSWERS. FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL REQUIRES ALL OFFICERS, DIRECTORS, TRUSTEES TO REVIEW AND SIGN THE CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION FOR CEO AND CFO ENTAILS A REVIEW OF PERFORMANCE BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES, CONDUCTING COMPENSATION BENCHMARK STUDY BY INDEPENDENT RECOGNIZED THIRD PARTY, AND REVIEW OF COMPENSATION BY CAROLINAS HEALTHCARE SYSTEM COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. FINAL APPROVAL IS THEN MADE AND DOCUMENTED BY THE SCOTLAND HEALTH CARE SYSTEM BOARD OF TRUSTEES. COMPENSATION FOR OTHER HOSPITAL VICE PRESIDENTS IS DETERMINED BY PERFORMANCE EVALUATION BY CEO, COMPENSATION BENCHMARK STUDY BY INDEPENDENT RECOGNIZED THIRD PARTY, AND FINAL APPROVAL AND DOCUMENTATION BY THE SCOTLAND HEALTH CARE SYSTEM BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. ADDITIONALLY, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST AT THE SCOTLAND MEMORIAL HOSPITAL EXECUTIVE ASSISTANT TO THE PRESIDENT'S OFFICE. THE HOSPITAL MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE VP, FINANCE OFFICE OR GENERAL ACCOUNTING DEPARTMENT. FORM 990, PART VII & SCHEDULE J THE ORGANIZATION IS UTILIZING PART VII AND SCHEDULE J OF THE FORM 990 TO REPORT THE COMPENSATION PAID TO THE CEO AND CFO BY A MANAGEMENT COMPANY FOR SERVICES PROVIDED TO THE FILING ORGANIZATION. THE COMPENSATION HAS BEEN REPORTED IN THE FILING ORGANIZATION'S COMPENSATION COLUMNS OF THESE SECTIONS. FORM 990, PART IX, LINE 11G EQUIP MAINT CONTRACT FEES: PROGRAM SERVICE EXPENSES 2,288,882. MANAGEMENT AND GENERAL EXPENSES 2,027,526. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,316,408. CONSULTANT FEES: PROGRAM SERVICE EXPENSES 112,762. MANAGEMENT AND GENERAL EXPENSES 381,080. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 493,842. CONTRACT FEES: PROGRAM SERVICE EXPENSES 7,474,378. MANAGEMENT AND GENERAL EXPENSES 1,584,727. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,059,105. MEDICAL SPEC FEES: PROGRAM SERVICE EXPENSES 5,352,048. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,352,048. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 407,907. MANAGEMENT AND GENERAL EXPENSES 87,202. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 495,109. FORM 990, PART XI, LINE 9: PENSION PLAN ADJUSTMENT 852,279. TRANSFER TO AFFILIATES -3,690,747. DISSOLUTION OF NONCONTROLLING INTEREST -246,201. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART III SCOTLAND MEMORIAL HOSPITAL, INC., LOCATED IN THE CITY OF LAURINBURG, SCOTLAND COUNTY, NORTH CAROLINA IS A NOT-FOR-PROFIT, 501(C)(3), COMMUNITY OWNED HOSPITAL GOVERNED BY A LOCAL BOARD OF TRUSTEES. THE HOSPITAL IS A SUBSIDIARY OF SCOTLAND HEALTH CARE SYSTEM, A NOT-FOR-PROFIT, 501(C)(3) CORPORATION, WHICH ALSO INCLUDES SCOTLAND MEMORIAL FOUNDATION, AND HOSPICE OF SCOTLAND COUNTY. THE MISSION OF SCOTLAND HEALTH CARE SYSTEM "IS TO WORK WITH OUR HEALTH CARE PARTNERS TO CREATE AND OPERATE A PATIENT CENTERED, INTEGRATED SYSTEM TO PROVIDE SAFE, HIGH QUALITY, COMPASSIONATE, AND SUSTAINABLE HEALTH CARE TO THE PEOPLE WE SERVE." THE VISION IS THAT "SCOTLAND HEALTH CARE SYSTEM WILL BE RECOGNIZED AND CHOSEN BY PATIENTS AND THEIR FAMILIES THROUGHOUT OUR REGION FOR THE QUALITY AND VALUE OF THE SERVICES WE PROVIDE. THIS VALUE WILL BE DEMONSTRATED THROUGH THE HIGHEST LEVEL OF QUALITY AND SERVICE, ALONG WITH THE SAFEST ENVIRONMENT. WE WILL LEAD EFFORTS TO IMPROVE THE HEALTH AND WELL-BEING OF THE CITIZENS IN OUR REGION." THE HOSPITAL OFFERS A FULL RANGE OF INPATIENT, SERVICES, INCLUDING INTENSIVE CARE AND INPATIENT REHABILITATION, AND OUTPATIENT ACUTE CARE SERVICES. DURING THE FISCAL YEAR ENDING SEPTEMBER 30, 2018, THE HOSPITAL RECORDED 18,574 ADULT AND PEDIATRIC PATIENT DAYS AND 1,142 INPATIENT REHABILITATION DAYS, WITH AN AVERAGE DAILY CENSUS OF 51 . THE HOSPITAL PERFORMED OVER 4800 INPATIENT AND OUTPATIENT SURGERIES. OVER 55,000 EMERGENCY ROOM VISITS WERE LOGGED AND 754 BABIES WERE DELIVERED. WITH A STAFF OF APPROXIMATELY 900 EMPLOYEES, THE HOSPITAL RANKS AS THE AREA'S LARGEST EMPLOYER. 71 PHYSICIANS PROVIDE A COMPREHENSIVE RANGE OF SPECIALTIES INCLUDING: ANESTHESIOLOGY, CARDIOLOGY, DERMATALOGY, EMERGENCY MEDICINE, FAMILY MEDICINE, GASTROENTEROLOGY, GENERAL SURGERY, GYNECOLOGY AND OBSTETRICS, HOSPITALIST SERVICES, INTERNAL MEDICINE, MEDICAL AND RADIATION ONCOLOGY, NEPHROLOGY, NEUROLOGY, OCCUPATIONAL MEDICINE, OPHTHALMOLOGY, ORTHOPEDICS, OTOLARYNGOLOGY, PAIN MANAGEMENT, PATHOLOGY, PEDIATRICS, PEDICATRIC CARDIOLOGY, PULMONARY MEDICINE, RADIOLOGY, UROLOGY, VASCULAR SURGERY, AND WOUND CARE, WHICH INCLUDES HYPERBARIC OXYGEN THERAPY. AVAILABLE TECHNOLOGIES INCLUDE NUCLEAR MEDICINE, 64-SLICE COMPUTERIZED TOMOGRAPHY (CT) SCANNING, POSITRON EMISSION TOMOGRAPHY (PET), LASER TECHNOLOGY, MAGNETIC RESONANCE IMAGING (MRI), LAPAROSCOPIC CHOLYCYSTECTOMY, ROBOTIC PARTIAL KNEE SURGERY, INTENSITY-MODULATED RADIATION THERAPY, AND LITHOTRIPSY. THE HOSPITAL OPERATES SIX RURAL HEALTH CLINICS, FOUR FREE-STANDING PHYSICIAN PRACTICES, AN URGENT CARE CENTER, AND AN OCCUPATIONAL HEALTH CLINIC. ALL LOCATED WITHIN A 30-MILE RADIUS OF THE HOSPITAL. TOTAL VISITS AT THESE PRACTICES WERE APPROXIMATELY 94,000 IN 2018 . THE HOSPITAL'S PRIMARY SERVICE AREA IS SCOTLAND COUNTY AND WESTERN ROBESON COUNTY, WHILE THE SECONDARY SERVICE AREA INLCUDES ROBESON COUNTY AND RICHMOND COUNTY, NORTH CAROLINA, AND MARLBORO COUNTY, SOUTH CAROLINA. SEE SCHEDULE H FOR DETAIL OF ORGANIZATIONS CHARITY CARE AND COMMUNITY BENEFITS POLICIES AND REPORTING. FORM 990, PART III COMMUNITY SPONSORED EVENTS AND ACTIVITIES: THE HOSPITAL IS HEAVILY INVOLVED IN COMMUNITY EVENTS AND SPONSORS NUMEROUS CHARITABLE EVENTS, SUCH AS FUND DRIVES FOR UNITED WAY, AMERICAN CANCER SOCIETY RELAY FOR LIFE, MARCH OF DIMES WALK AMERICA (AWAREMESS FOR HEALTHIER BABIES), AND NORTH CAROLINA SMART START ( PROVIDING RESOURCES FOR CHILDREN TO ACHIEVE SUCCESS), WITH MANY HOSPITAL EMPLOYEES PARTICIPATING IN THE INITIATIVE. MIDDLE AND HIGH SCHOOL STUDENTS CAN ACCESS FREE ANNUAL PHYSICIALS, AND, FOR THOSE INTERESTED IN A MEDICAL CAREER, JOB-SHADOWING PURSUITS WITH HOSPITAL EMPLOYEES. SPEAKING AT LOCAL JOB FAIRS AND HIGH SCHOOL CAREER DAY EVENTS IS YET ANOTHER AVENUE FOR HOSPITAL STAFF TO SPREAD KNOWLEDGE ON TOPICS OF HEALTH. A VARIETY OF PREVENTIVE HEALTH EDUCATION PROGRAMS ARE AVAILABLE TO THE COMMUNITY AND TO LOCAL INDUSTRY, MANY OF WHICH ARE OFFERED AT NO CHARGE. AMONG THESE ARE SCREENINGS FOR BLOOD PRESSURE, BODY FAT, CHOLESTEROL, DIABETES, BONE DENSITY, AND PROSTATE CANCER. HEALTH EVENTS FOR WOMEN AND MEN ARE OFFERED EACH YEAR WITH LOCAL PHYSICIANS AS KEYNOTE SPEAKERS AND EDUCATORS. "SCOTTY AND "MISSY", 2 MOBILE HEALTHCARE UNITS, VISIT LOCAL SCHOOLS, BUSINESSES, AND INDUSTRY PROVIDING FREE BLOOD PRESSURE AND CHOLESTEROL SCREENINGS AND PHYSICALS. EXAMPLES OF HEALTH EVENTS OFFERED IN THE COMMUNITY ARE: - PHYSICAL EXAMINATIONS PROVIDED TO SPECIAL OLYMPICS ATHLETES, AND SPORTS PHYSICALS TO MIDDLE/HIGH SCHOOL STUDENTS. - HEALTH & FITNESS DAY, PROVIDING FOCUS ON PHYSICAL ACTIVITY, WHERE THE COMMUNITY AND HOSPITAL EMPLOYEES PARTICIPATE IN HEALTHY ACTIVITIES. - "LOOK GOOD FEEL BETTER" PROGRAM IS DESIGNED FOR WOMEN UNDERGOING CANCER TREATMENT, TEACHES FEMALE CANCER PATIENTS BEAUTY TECHNIQUES THAT HELP RESTORE SELF-IMAGE WHILE UNDERGOING CHEMOTHERAPY AND RADIATION TREATMENTS. VOLUNTEER BEAUTY PROFESSIONALS LEAD SMALL GROUPS OF WOMEN THROUGH PRACTICAL, HANDS-ON EXERCIZES USING COSMETICS, CARING FOR SKIN AND NAILS, AND USING WIGS, HATS, TURBANS, AND SCARVES TO DEAL WITH HAIR LOSS. PARTICIPANTS RECEIVE FREE COSMETICS AND CAN CHOOSE FROM A VARIETY OF WIGS AND HATS FROM WHICH TO CHOOSE. - CANCER SURVIVORS DAY IS SPONSORED FOR PATIENTS AND GUESTS, INVITING PARTICIPATATION IN AN ANNUAL NATIONAL CELEBRATION OF LIFE. - HEALTH-RELATED MONTHLY MEETINGS ARE HELD IN HOSPITAL FACILITIES FOR THESE SUPPORT GROUPS: ALZHEIMER'S BREASTFEEDING DIABETES MULTIPLE SCLEROSIS PARKINSON'S STROKE WOMENS CANCER SCOTLAND HEALTH CARE SYSTEM INC 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 581847657 OPERATE FOR THE BENEFIT OF, PERFORM FUNCTIONS, AND CARRY OUT PURPOSES OF SMH NC 501(C)(3) LINE 12B, II N/A 0 SCOTLAND MEMORIAL FOUNDATION INC 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 581828201 CONDUCT FUNDRAISING ACTIVITIES FOR SCOTLAND HEALTH CARE SYSTEM NC 501(C)(3) LINE 7 SCOTLAND HEALTH CARE SYSTEM INC 0 EDWIN MORGAN CENTER INC 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 589178020 SKILLED NURSING FACILITY NC 501(C)(3) LINE 11 SCOTLAND HEALTH CARE SYSTEM INC 0 HOSPICE OF SCOTLAND COUNTY INC 610 E LAUCHWOOD DRIVE LAURINBURG NC 28352 561468269 HEALTHCARE FOR TERMINALLY ILL PATIENTS NC 501(C)(3) LINE 7 SCOTLAND HEALTH CARE SYSTEM INC 0 SCOTLAND REGIONAL HEALTH NETWORK 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 272187756 OPERATES PHYSICIAN PRACTICES NC 501(C)(3) LINE 7 SCOTLAND HEALTH CARE SYSTEM INC 0 SCOTLAND ENTERPRISES INC 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 561651832 HEALTH CARE NC N/A C 0 1 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 SCOTLAND REGIONAL HEALTH NETWORK R 3641830 FMV