2016-11-11T11:49:16-06:00 2015-12-31 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2015-01-01 383886017 THE ANMED HEALTH FOUNDATION ANME 8645121000 800 NORTH FANT STREET ANDERSON SC 29621 CHRISTINE PEARSON CFO 8645121000 2016-11-10 1 AMY BIBBY P00445891 8282542254 2015 2017-02-10 21:41:12Z WILLIAM T MANSON III 800 NORTH FANT STREET ANDERSON SC 29621 1013416 0 X WWW.ANMEDHEALTH.ORG X 2012 SC EDUCATE TO INSPIRE PHILANTHROPIC GIVING TO FINANCIALLY SUPPORT PROGRAMS AND SERVICES OF ANMED HEALTH 18 15 0 99 0 0 838950 848639 0 0 0 39 18520 89248 857470 937926 68479 642652 0 0 0 0 0 0 0 4242 17518 72721 660170 784749 277756 1144632 1422388 0 0 1144632 1422388 X THE MISSION OF THE ANMED HEALTH FOUNDATION IS TO INSPIRE GENEROUS CHARITABLE GIVING THAT STRENGTHENS AND SUSTAINS EXCELLENT HEALTHCARE THROUGH THE ANMED HEALTH SYSTEM WITH THE VISION TO ENDOW THE FUTURE OF THE ANMED HEALTH SYSTEM. 0 0 660170 642652 THE ANMED HEALTH FOUNDATION WAS ORGANIZED TO PROVIDE FINANCIAL SUPPORT FOR THE PROGRAMS AND SERVICES OF ANMED HEALTH SYSTEM. THE ORGANIZATION PROVIDED APPROXIMATELY $6,550 DURING 2015 TO FUND FREE LIFELINE MONITORING SERVICE TO THOSE IN NEED.PLEASE SEE SCHEDULE O FOR A CONTINUATION OF THE PROGRAM SERVICE ACCOMPLISHMENTS. THE ORGANIZATION DIRECTS CONTRIBUTIONS RECEIVED TO VITAL PROGRAMS THAT ASSIST OUR COMMUNITY IN THE FOLLOWING WAYS: (1) OFFER FINANCIAL ASSISTANCE TO PATIENTS DISCHARGED FROM THE HOSPITAL WITHOUT ABILITY TO PAY FOR NEEDED MEDICATIONS (2) BRING MEDICAL SCREENINGS AND INFORMATION TO COMMUNITIES THROUGHOUT OUR REGION (3) PROVIDE PREVENTIVE AND WELLNESS CARE TO PROMOTE THE OVERALL WELL-BEING OF THE WESTSIDE AREA (4) DELIVER SPECIALIZED THERAPY TO IMPROVE THE LIVES OF CHILDREN DEVELOPMENTAL DELAYS AND DISORDERS (5) PROVIDE A PERSONAL EMERGENCY RESPONSE SERVICE FOR ELDERLY AND DISABLED INDIVIDUALS THAT CANNOT AFFORD THE SERVICE ON THEIR OWN (6) PROVIDE SCREENING MAMMOGRAMS TO UNINSURED WOMEN. 660170 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 18 15 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 SC X CHRISTINE PEARSON 8645121000 800 NORTH FANT STREET ANDERSON SC 29621 X ANN HERBERT CHAIRMAN 1.00 2.00 X X 0 0 0 DR JOHN R HUNT VICE CHAIRMAN 1.00 2.00 X X 0 22000 0 ROBERT RAINEY SECRETARY/TREASURER 1.00 2.00 X X 0 0 0 PHILIP ASHLEY DIRECTOR 1.00 X 0 0 0 HUGH BURGESS DIRECTOR 1.00 X 0 0 0 PEGGY DEANE DIRECTOR 1.00 X 0 0 0 BARBARA HODGES DIRECTOR 1.00 X 0 0 0 BUTCH HUGHES DIRECTOR 1.00 X 0 0 0 SHELIA KING DIRECTOR 1.00 X 0 0 0 MARY ANNE LAKE DIRECTOR 1.00 2.00 X 0 0 0 TOM MCDONALD DIRECTOR 1.00 X 0 0 0 SHAWN MCGEE DIRECTOR 1.00 X 0 0 0 HAMID MOHSSENI DIRECTOR 1.00 X 0 0 0 JANE MUDD DIRECTOR 1.00 2.00 X 0 0 0 MARSHALL PICKENS DIRECTOR 1.00 X 0 0 0 ALEXANDRIA STATHAKIS DIRECTOR 1.00 X 0 0 0 SCOTT WEBBER DIRECTOR 1.00 X 0 0 0 WILLIAM MANSON CEO 1.00 49.00 X 0 867267 184143 JOHN A MILLER JR EXEC. DIRECTOR (THROUGH AUGUST '15) 5.00 X 0 2666691 4718 TIM SELF EXEC. DIRECTOR (BEGAN SEPTEMBER '15) 50.00 X 0 32789 791 JERRY A PARRISH CFO (THROUGH JULY '15) 1.00 49.00 X 0 748269 56414 CHRISTINE PEARSON CFO (BEGAN AUGUST '15) 1.00 49.00 X 0 103031 23365 0 4440047 269431 0 0 1 1 0 109824 738815 848639 39 39 164738 109824 75490 89248 89248 937926 0 0 89287 573410 573410 69242 69242 17518 17518 660170 660170 0 0 528795 1198648 375679 115472 240158 108268 1144632 1422388 0 0 X 283089 49082 861543 1373306 1144632 1422388 1144632 1422388 X 277756 0 X X 0 1 X 1 0 X X 1 ANMED HEALTH 570359174 3 1 573410 0 1 573410 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE FROM AFFILIATES 108268 108268 X 699427 -238499 -238499 937926 0 937926 421671 75490 75490 346181 313989 313989 660170 PART X, LINE 2: THE FOUNDATION IS EXEMPT FROM INCOME TAX UNDER SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE CONSOLIDATED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL OR STATE INCOME TAXES. THE FOUNDATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2015. FISCAL YEARS ENDING ON OR AFTER SEPTEMBER 30, 2012 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES 75,490. GRANT EXPENSE IN EQUITY TRANSFER TO ANMED HEALTH -313,989. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES 75,490. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANT EXPENSE IN EQUITY TRANSFER TO ANMED HEALTH 313,989. CAMELLIA BALL 186765 74706 112059 53046 KIDS CLASSIC GOLF TOURNAMENT 74556 29822 44734 19167 1 13241 5296 7945 3277 274562 109824 164738 75490 75490 89248 1 ANMED HEALTH 800 NORTH FANT STREET ANDERSON SC 29621 570359174 501(C)(3) 573410 AH MEDICAL EDUCATION OPERATIONS AND CAPITAL EXPENSES OPERATIONAL SUPPORT 1 RADIOLOGIC TECHNOLOGY PROGRAM 1 2500 CHAPLAIN'S ASSISTANCE FOR INDIGENT PATIENTS 445 22868 FREEDOM LINK SUBSCRIPTIONS 78 6551 MAMMOGRAMS 86 9013 CANCER CARE SERVICE ASSISTANCE 29 5560 EMPLOYEE ASSISTANCE 24 22750 PART I, LINE 2: THE ORGANIZATION IS AFFILIATED WITH ANMED HEALTH. ALL ASSISTANCE PROVIDED BY THE ORGANIZATION TO OUTSIDE PARTIES IS DIRECTED EXCLUSIVELY TO ANMED HEALTH TO ASSIST THAT ORGANIZATION IN FULFILLING ITS TAX EXEMPT PURPOSE. 1 1 0 0 0 0 0 0 0 WILLIAM MANSON CEO 0 557218 0 192295 0 117754 0 160236 0 23907 0 1051410 0 132947 JOHN A MILLER JR EXEC. DIRECTOR (THROUGH AUGUST '15) 0 38629 0 2378998 0 249064 0 3818 0 900 0 2671409 0 1783110 JERRY A PARRISH CFO (THROUGH JULY '15) 0 249067 0 288135 0 211067 0 39090 0 17324 0 804683 0 153588 PART I, LINE 3 COMPENSATION PAID TO OFFICERS THE ANMED HEALTH FOUNDATION WAS PAID BY ANMED HEALTH, A RELATED ORGANIZATION. ANMED HEALTH UTILIZED THE FOLLOWING METHODS TO DETERMINE APPROPRIATE COMPENSATION FOR THE TOP EXECUTIVE OFFICER AND CERTAIN OTHER OFFICERS THAT HAD INFLUENCE OVER THE FOUNDATION'S ACTIVITIES: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACTS - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINES 4A-B THE FOLLOWING OFFICERS RECEIVED DEFERRED COMPENSATION ALLOCATIONS BY THE FILING ORGANIZATION FROM A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP): WILLIAM T. MANSON - $ 262,320 TINA JURY - 14,690 THE FOLLOWING OFFICERS RECEIVED DEFERRED COMPENSATION ALLOCATIONS BY CAROLINAS HEALTHCARE SYSTEM, AN UNRELATED ORGANIZATION FROM A NON-QUALIFIED PLAN: WILLIAM T. MANSON - $144,336 JERRY A. PARRISH - 23,190 CHRISTINE PEARSON - 14,280 DR. MICHAEL L. TILLIRSON - 101,412 THE PURPOSE OF THE SERP FOR WILLIAM T. MANSON IS TO PROVIDE SUPPLEMENTAL RETIREMENT BENEFITS TO THE PARTICIPANT TO ENCOURAGE HIS CONTINUED INTEREST IN THE SUCCESS OF THE COMPANY, AND TO PROVIDE REASONABLE RETIREMENT BENEFITS. THE PLAN COMMENCED ON MARCH 1, 2005. THE COMPANY SHALL CREDIT TO THE PARTICIPANT'S SERP ACCOUNT AN AMOUNT PROJECTED TO PROVIDE ANNUAL RETIREMENT BENEFITS EQUAL TO 50% OF THE PARTICIPANT'S FINAL FIVE-YEAR AVERAGE CASH COMPENSATION AT AGE 65. THE PROJECTION TAKES INTO ACCOUNT THAT THE TOTAL TARGETED RETIREMENT BENEFIT CONSISTS OF THE QUALIFIED DEFINED BENEFIT PENSION PLAN, 403(B) PLAN MATCHING CONTRIBUTIONS EARNED THEREON, 50% OF THE PROJECTED SOCIAL SECURITY PRIMARY RETIREMENT BENEFITS, AND BENEFITS UNDER THIS PLAN. THE COMPANY DOES NOT GUARANTEE THAT THE CREDITS WILL ACTUALLY PROVIDE THE TARGETED BENEFIT; RATHER, THE PARTICIPANT'S BENEFIT IS LIMITED TO THE AMOUNT ACCRUED IN HIS ACCOUNT. THE PARTICIPANT'S ENTITLEMENT TO THE BENEFITS DEPENDS ON THE PARTICIPANT'S FUTURE PERFORMANCE OF SUBSTANTIAL SERVICES. PART II: COMPENSATION FROM AN UNRELATED ORGANIZATION: THE FOLLOWING OFFICERS OF THE FILING ORGANIZATION RECEIVED COMPENSATION FOR SERVICES PROVIDED TO ANMED HEALTH, ANMED HEALTH SYSTEM, AND THE ANMED HEALTH FOUNDATION UNDER THE TERMS OF THE MANAGEMNT AGREEMENT WITH CAROLINAS HEALTHCARE SYSTEM DISCLOSED IN CONNECTION WITH FORM 990, PART VI, LINE 3. JOHN A. MILLER JR. - $1,057,622 TAXABLE, 3,818 DEFRD, 900 N/T WILLIAM T. MANSON, III - 856,170 TAXABLE, 160,236 DEFRD, 23,907 N/T JERRY A. PARRISH - 611,421 TAXABLE, 39,090 DEFRD, 117,324 N/T CHRISTINE PEARSON 103,032 TAXABLE, 16,305 DEFRD, 7,060 N/T THE ABOVE AMOUNTS ARE REPRESENTED IN THE TOTALS SHOWN IN PART II. THE REMAINDER OF THE AMOUNTS SHOWN IN PART II WERE PAID DIRECTLY BY A RELATED ORGANIZATION. PART II, COLUMN (B)(III): THE FOLLOWING OFFICER RECEIVED A ONE TIME CASH PAYOUT FROM A DEFERRED COMPENSATION PLAN BY ANMED HEALTH, A RELATED ORGANIZATION, THAT IS TAXABLE IN THE CURRENT PERIOD. THIS PAYMENT COINCIDED WITH HIS RETIREMENT. THESE AMOUNTS WERE REPORTED ON PRIOR 990'S AS INDICATED ON SCHEDULE J, PART II, COLUMN F. JOHN A. MILLER - $ 1,684,927 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE FOUNDATION BOARD CHAIR, VICE-CHAIR, AND SECRETARY AND/OR TREASURER, AND ITS THREE EX-OFFICIO TRUSTEES. BETWEEN REGULAR MEETINGS, THE EXECUTIVE COMMITTEE MAY MEET AT THE CALL OF THE CHAIR, AND ACT ON BEHALF OF THE FOUNDATION BOARD AND TAKE ANY ACTION THE FOUNDATION BOARD MIGHT OTHERWISE HAVE TAKEN. A QUORUM OF THE EXECUTIVE COMMITTEE SHALL CONSIST OF FOUR MEMBERS, INCLUDING AT LEAST ONE EX-OFFICIO MEMBER. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION SHARES ITS MANAGEMENT OVERSIGHT WITH ANMED HEALTH, A RELATED ORGANIZATION. ON OCTOBER 1, 2009, THE HOSPITAL SYSTEM ENTERED INTO A SERVICES AND AFFILIATION AGREEMENT WITH THE CHARLOTTE MECKLENBURG HOSPITAL AUTHORITY D/B/A CAROLINAS HEALTHCARE SYSTEM (CHS). THE AGREEMENT APPOINTS CAROLINAS HEALTHCARE SYSTEM AS THE MANAGER OF THE HOSPITAL SYSTEM. THE BOARD OF ANMED HEALTH CONTINUES TO OVERSEE THE OPERATIONS OF THE HEALTHCARE FACILITY AND RELATED TAX EXEMPT ACTIVITIES. AS PART OF THE AGREEMENT, ANMED HEALTH GRANTS CHS THE RESPONSIBILITY FOR MANAGEMENT OF THE HEALTH SYSTEM, SUBJECT TO THE GENERAL APPROVAL OF THE BOARD OF DIRECTORS OF ANMED HEALTH. BOARD APPROVAL IS REQUIRED FOR LARGE CAPITAL EXPENDITURES, SALE OR DISPOSAL OF SYSTEM ASSETS, AND BORROWING IN EXCESS OF IMMATERIAL AMOUNTS. CHS IS REQUIRED TO PROVIDE KEY MANAGEMENT PERSONNEL FOR ANDMED HEALTH SYSTEM AND ITS RELATED ORGANIZATIONS. UNDER THE TERMS OF THE ARRANGEMENT THE KEY MANAGEMENT PERSONNEL RECEIVE A PORTION OF THEIR COMPENSATION FROM CHS AS WELL AS A PORTION FROM ANMED HEALTH. THE ORGANIZATION IS UTILIZING FORM 990 PARTS VII AND SCHEDULE J TO REPORT COMPENSATION RECEIVED BY THESE INDIVIDUALS FOR SERVICES PROVIDED TO ANMED HEALTH SYSTEM AND ITS RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 6 THE ANMED HEALTH FOUNDATION IS A SUBSIDIARY OF THE ANMED HEALTH SYSTEM(SYSTEM), A SOUTH CAROLINA 501(C)(3) ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE INITIAL BOARD OF TRUSTEES OF THE ANMED HEALTH FOUNDATION AS PROVIDED FOR IN ITS BYLAWS IS ELECTED BY THE SYSTEM BOARD. THE SYSTEM BOARD IS ALSO ELIGIBLE TO ELECT SUCCESSOR TRUSTEES AND INTERIM TRUSTEES OF THE FILING ORGANZATION. FORM 990, PART VI, SECTION B, LINE 11 THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. UPON COMPLETION AND REVIEW BY MANAGEMENT, THE RETURN WAS REVIEWED BY THE BOARD AT THE NOVEMBER 8, 2016 BOARD MEETING. DURING THE MEETING, BOARD MEMBERS HAD AN OPPORTUNITY TO DISCUSS THE RETURN AND ASK QUESTIONS OF MANAGEMENT, AND A REPRESENTATIVE OF THE ACCOUNTING FIRM. FORM 990, PART VI, SECTION B, LINE 12C A COPY OF THE DISCLOSURE OF THE CONFLICT OF INTEREST POLICY, ALONG WITH AN EXPLANATION AND QUESTIONNIARE IS SENT TO ALL TRUSTEES, DIRECTORS, EXECUTIVE STAFF, MEDICAL STAFF WITH ADMINISTRATIVE RESPONSIBILITY, SELECTED OTHER EMPLOYEES, AND VOLUNTEERS ANNUALLY. THE QUESTIONNAIRE MUST BE COMPLETED AND RETURNED TO THE CHAIR OF THE BOARD. A REPORT IS SUBMITTED TO THE BOARD CONCERNING ANY POTENTIAL CONFLICTS THAT ARE DISCLOSED. IN SITUATIONS WHERE A POTENTIAL CONFLICT IS FOUND, THE BOARD REVIEWS THE CIRCUMSTANCES BEFORE A VOTE OR DISCUSSION OF MATTERS INVOLVING INTERESTED PARTIES. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S EXECUTIVE OFFICES. FORM 990, PART VI, SECTION C, LINE 19 PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S EXECUTIVE OFFICES. FORM 990, PART VII, LINE 1: BOARD MEMBER COMPENSATION: DR. JOHN R. HUNT IS COMPENSATED BY A RELATED ORGANIZATION FOR SERVICES RENDERED TO THE HOSPITAL SYSTEM. ALL PAYMENTS TO HIM ON PART VII OF THE FORM 990 ARE FOR MEDICAL SERVICES. FORM 990, PART XI, LINE 2: CONSOLIDATED FINANCIAL STATEMENTS: THE ORGANIZATION RECEIVED AUDITED FINANCIAL STATEMENTS ON A CONSOLIDATED BASIS WITH ANMED HEALTH SYSTEM, ANMED HEALTH ENTERPRISES, INC., ANMED HEALTH, AND THEIR CONTROLLED AND MAJORITY OWNED AFFILIATES. ALL SIGNIFICANT INTERCOMPANY ACCOUNTS AND TRANSACTIONS HAVE BEEN ELIMINATED. ANMED HEALTH 800 N FANT STREET ANDERSON SC 29621 570359174 HEALTHCARE SC 501(C)(3) LINE 3 ANMED HEALTH SYSTEM 0 ANMED HEALTH SYSTEM 800 N FANT STREET ANDERSON SC 29621 570817544 SUPPORT SC 501(C)(3) LINE 7 N/A 0 CANNON MEMORIAL HOSPITAL 123 WG ACKER DRIVE PICKENS SC 29671 570342027 HEALTHCARE SC 501(C)(3) LINE 3 ANMED HEALTH SYSTEM 0 CANNON MEMORIAL HOSPITAL FOUNDATION PO BOX 188 PICKENS SC 29671 570943822 FUNDRAISING/SUPPORT SC 501(C)(3) LINE 7 CANNON MEMORIAL HOSPITAL 0 CLEMSON HEALTH CENTER 885 TIGER BLVD CLEMSON SC 29631 570988736 HEALTHCARE SC 501(C)(3) LINE 11A, I ANMED HEALTH 0 ANMED HEALTH ENTERPRISES INC 800 N FANT STREET ANDERSON SC 29621 570815011 HOLDING CORPORATION SC N/A C 0 ANMED HEALTH PLAN INC 800 N FANT STREET ANDERSON SC 29621 570811053 MANAGEMENT SERVICES ORGANIZATION SC N/A C 0 ANMED HEALTH SERVICES INC 800 N FANT STREET ANDERSON SC 29621 570741536 HEALTHCARE SC N/A C 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1