ANMED HEALTH CANNON: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- ANMED HEALTH CANNON (EIN 57-0342027)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-08-13
- IRS object ID
- 201512259349303206
- Schema version
- 2013v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-08-13T15:14:15-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 560747981 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES GOODMAN LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 RIDGEFIELD COURT | AddressLine1 |
| City | ASHEVILLE | City |
| State | NC | State |
| ZIP Code | 28806 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 570342027 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CANNON MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CANN | BusinessNameControlTxt |
| Phone | 8648784791 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 123 WG ACKER DRIVE | AddressLine1 |
| City | PICKENS | City |
| State | SC | State |
| ZIP Code | 29671 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WILL GRANT | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8648784791 | PhoneNum |
| Signature | 2015-08-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMY BIBBY | PreparerPersonNm |
| PTIN | P00445891 | PTIN |
| Phone | 8282542254 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | WILL GRANT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 123 WG ACKER DRIVE | AddressLine1 |
| City | PICKENS | City |
| State | SC | State |
| ZIP Code | 29671 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $35,673,700 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CANNONHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1950 | FormationYr |
| Legal Domicile State | SC | LegalDomicileStateCd |
| Activity Or Mission | PROVIDING QUALITY HEALTHCARE IN A SAFE, COMPETENT, AND COMPASSIONATE MANNER | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 345 | TotalEmployeeCnt |
| Total Volunteers | 75 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,265,350 | PYContributionsGrantsAmt |
| CY Contributions Grants | $85,138 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $36,239,282 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $35,389,382 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,080 | PYInvestmentIncomeAmt |
| CY Investment Income | $880 | CYInvestmentIncomeAmt |
| PY Other Revenue | $183,091 | PYOtherRevenueAmt |
| CY Other Revenue | $198,300 | CYOtherRevenueAmt |
| PY Total Revenue | $37,694,803 | PYTotalRevenueAmt |
| CY Total Revenue | $35,673,700 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $13,137,482 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,744,759 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $3,732 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $26,483,858 | PYOtherExpensesAmt |
| CY Other Expenses | $25,838,428 | CYOtherExpensesAmt |
| PY Total Expenses | $39,621,340 | PYTotalExpensesAmt |
| CY Total Expenses | $38,583,187 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,926,537 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,909,487 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,501,617 | TotalAssetsBOYAmt |
| Total Assets EOY | $13,753,804 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,680,238 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,818,072 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,821,379 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,935,732 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF CANNON MEMORIAL HOSPITAL IS TO PROVIDE QUALITY HEALTHCARE IN A SAFE, COMPETENT, AND COMPASSIONATE MANNER. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $34,419,759 | ExpenseAmt |
| Revenue | $35,389,382 | RevenueAmt |
| Desc | CANNON MEMORIAL HOSPITAL OFFERS A FULL RANGE OF STATE-OF-THE-ART MEDICAL TECHNOLOGY, EQUIPMENT, AND SERVICES TO MEET THE HEALTH CARE NEEDS OF THE COMMUNITY. THE EXPANDED SERVICES OF THE HOSPITAL INCLUDE A 24-HOUR EMERGENCY DEPARTMENT, A FULL SERVICE LABORATORY, PHYSICAL AND OCCUPATIONAL THERAPY, CRITICAL CARE UNIT, SLEEP CLINIC, WELLNESS PROGRAMS FOR BOTH CHILDREN AND ADULTS, AND DIAGNOSTIC IMAGING FOR BOTH INPATIENT AND OUTPATIENT TEST INCLUDING CT SCANS. FOR FISCAL YEAR 2014, THE HOSPITAL PROVIDED 2,983 PATIENT DAYS OF CARE, 21,389 ER VISITS, AND 18,952 OP VISITS.WE ALSO SPONSOR HEALTH FAIRS, FLU CLINICS, CPR TRAINING, FITNESS CLASSES, SUPPORT GROUPS, AND MANY OTHER COMMUNITY WELLNESS SERVICES THROUGH OUR WELLNESS CENTER LOCATED AT THE HOSPITAL. | Desc |
| Total Program Service Expenses | $34,419,759 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 34 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 345 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | SC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WILL GRANT | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8648981136 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 123 WG ACKER DRIVE | AddressLine1 |
| City | PICKENS | City |
| State | SC | State |
| ZIP Code | 29671 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| WILLIAM MANSON | |||||||
| CHAIRMAN | 2.00 | Yes (X) | Yes (X) | $0 | $545,698 | $320,458 | |
| JAMES R MAHANES MD | |||||||
| VICE CHAIR (THROUGH DECEMBER 2013) | 1.00 | Yes (X) | Yes (X) | $94,269 | $0 | $0 | |
| JERRY PARRISH | |||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $465,191 | $225,438 | |
| KENNETH D ACKER | |||||||
| TREASURER (THROUGH DECEMBER) | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| J FLETCHER PERRY | |||||||
| BOARD MEMBER (THROUGH DECEMBER 2013) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN E SPARKS | |||||||
| BOARD MEMBER (THROUGH DECEMBER 2013) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GEORGE N ACKER | |||||||
| BOARD MEMBER (THROUGH DECEMBER 2013) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| FRANCES C STOKES | |||||||
| BOARD MEMBER (THROUGH DECEMBER 2013) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RANDALL P GRIFFIN | |||||||
| BOARD MEMBER (THROUGH DECEMBER 2013) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| R JANINE PETERSEN | |||||||
| BOARD MEMBER (THROUGH DECEMBER 2013) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DONALD L MARLER | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LINDA S CASSELL | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TIMOTHY E MORGAN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GARRICK CHIDESTER | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $340,045 | $80,107 | ||
| MIKE TILLERSON DO | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $432,488 | $98,707 | ||
| NORMAN RENTZ | |||||||
| CEO | 40.00 | Yes (X) | $167,241 | $0 | $36,416 | ||
| GREG SCARBOROUGH | |||||||
| CFO (THROUGH DECEMBER 2013) | 40.00 | Yes (X) | $50,654 | $0 | $5,631 | ||
| WILL GRANT | |||||||
| CFO (BEGINNING APRIL 2014) | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| DONNA ANDERSON | |||||||
| CNO | 40.00 | Yes (X) | $92,099 | $0 | $16,380 | ||
| MARIAN B CLINCH | |||||||
| PHYSICIAN | 40.00 | $160,056 | $0 | $12,794 | Yes (X) | ||
| DANIEL J DAHLHAUSEN | |||||||
| PHYSICIAN | 40.00 | $179,503 | $0 | $28,785 | Yes (X) | ||
| TRAVIS W DAVIS | |||||||
| PHYSICIAN | 40.00 | $153,101 | $0 | $25,795 | Yes (X) | ||
| BYRON P MARSH | |||||||
| PHYSICIAN | 40.00 | $224,318 | $0 | $0 | Yes (X) | ||
| PETER C SCHRIVER | |||||||
| PHYSICIAN | 40.00 | $232,346 | $0 | $38,785 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,353,587 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,783,422 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $889,296 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ANMED HEALTH | |||||
| 800 N FANT STREET | ANDERSON | SC | 29621 | MANAGEMENT SERVICES | $599,244 |
| DR MICHAEL DILLARD | |||||
| PO BOX 186 | PICKENS | SC | 29671 | ER PHYSICIAN | $373,333 |
| DR JAMES CLIFTON CALDWELL | |||||
| 220 GLEN LAUREL DRIVE | EASLEY | SC | 29642 | ER PHYSICIAN | $366,680 |
| MATRIX REHABILITATION | |||||
| PO BOX 11407 | BIRMINGHAM | AL | 35246 | REHABILITATION SERVICES | $340,605 |
| DR MICHAEL E DONALD | |||||
| 350 NORTH SUMMIT DRIVE | SENECA | SC | 29672 | ER PHYSICIAN | $294,270 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $78,699 | RelatedOrganizationsAmt |
| All Other Contributions | $6,439 | AllOtherContributionsAmt |
| Total Contributions | $85,138 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $35,389,382 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $35,389,382 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $35,389,382 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $880 | TotalRevenueColumnAmt |
| Exclusion | $880 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $10,941 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $10,941 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,941 | TotalRevenueColumnAmt |
| Exclusion | $10,941 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA & FOOD SERVICE | 722210 | $63,671 | $63,671 |
| SALES TO EMPLOYEES | 446110 | $40,405 | $40,405 |
| MEDICAL TRANSCRIPTION | 900099 | $16,358 | $16,358 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $66,925 | TotalRevenueColumnAmt |
| Exclusion | $66,925 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $187,359 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,673,700 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $35,389,382 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $199,180 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $368,421 | TotalAmt |
| Management And General | $368,421 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,970,698 | TotalAmt |
| Program Services | $8,183,514 | ProgramServicesAmt |
| Management And General | $787,184 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,666 | TotalAmt |
| Program Services | $43,520 | ProgramServicesAmt |
| Management And General | $6,146 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,646,526 | TotalAmt |
| Program Services | $2,319,050 | ProgramServicesAmt |
| Management And General | $327,476 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $709,448 | TotalAmt |
| Program Services | $621,662 | ProgramServicesAmt |
| Management And General | $87,786 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $366,854 | TotalAmt |
| Management And General | $366,854 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,000 | TotalAmt |
| Management And General | $90,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,562,350 | TotalAmt |
| Program Services | $2,567,663 | ProgramServicesAmt |
| Management And General | $991,237 | ManagementAndGeneralAmt |
| Fundraising | $3,450 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,977 | TotalAmt |
| Management And General | $69,977 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,900,100 | TotalAmt |
| Program Services | $1,158,892 | ProgramServicesAmt |
| Management And General | $740,926 | ManagementAndGeneralAmt |
| Fundraising | $282 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,465 | TotalAmt |
| Management And General | $28,465 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $326,240 | TotalAmt |
| Program Services | $326,240 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,734 | TotalAmt |
| Program Services | $20,946 | ProgramServicesAmt |
| Management And General | $43,788 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $316,426 | TotalAmt |
| Program Services | $316,426 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,275,784 | TotalAmt |
| Program Services | $1,275,784 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $377,711 | TotalAmt |
| Program Services | $126,275 | ProgramServicesAmt |
| Management And General | $251,436 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| BAD DEBT EXPENSE | $15,406,871 | $15,406,871 |
| MEDICAL SUPPLIES | $2,052,916 | $2,052,916 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,583,187 | TotalAmt |
| Program Services | $34,419,759 | ProgramServicesAmt |
| Management And General | $4,159,696 | ManagementAndGeneralAmt |
| Fundraising | $3,732 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $660,160 | BOYAmt |
| EOY | $376,893 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $831,769 | BOYAmt |
| EOY | $5,070 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,998,838 | BOYAmt |
| EOY | $3,745,699 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $645,682 | BOYAmt |
| EOY | $347,859 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $174,832 | BOYAmt |
| EOY | $160,276 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $27,087,232 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $19,745,349 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,216,760 | BOYAmt |
| EOY | $7,341,883 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $566,487 | BOYAmt |
| EOY | $590,327 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,407,089 | BOYAmt |
| EOY | $1,185,797 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,501,617 | BOYAmt |
| EOY | $13,753,804 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,665,412 | BOYAmt |
| EOY | $2,454,982 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,497,512 | BOYAmt |
| EOY | $8,043,395 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,517,314 | BOYAmt |
| EOY | $319,695 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,680,238 | BOYAmt |
| EOY | $10,818,072 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,420,255 | BOYAmt |
| EOY | $2,510,768 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $401,124 | BOYAmt |
| EOY | $424,964 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,821,379 | BOYAmt |
| EOY | $2,935,732 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,501,617 | BOYAmt |
| EOY | $13,753,804 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,909,487 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $23,840 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $642 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $642 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS A MEMBER OF THE SOUTH CAROLINA HOSPITAL ASSOCIATION (SCHA). THIS ORGANIZATION ROUTINELY ENGAGES IN LOBBYING EFFORTS ON BEHALF OF ITS MEMBERSHIP BODIES, AND A PORTION OF THE DUES PAID TO THIS ORGANIZATIONS IS ALLOCATED TO THOSE EFFORTS EACH YEAR. FOR 2013, DUES PAID TO THIS ORGANIZATION ALLOCATED TO LOBBYING EFFORTS WERE APPROXIMATELY $642. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $758,191 | OtherCostOrOtherBasisAmt |
| Book Value | $758,191 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,163,486 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,999,660 | DepreciationAmt |
| Book Value | $3,163,826 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $384,370 | OtherCostOrOtherBasisAmt |
| Depreciation | $247,587 | DepreciationAmt |
| Book Value | $136,783 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,510,081 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,498,102 | DepreciationAmt |
| Book Value | $3,011,979 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $271,104 | OtherCostOrOtherBasisAmt |
| Book Value | $271,104 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,341,883 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ESTIMATED THIRD PARTY PAYOR SETTLEMENTS | $278,470 |
| DEFERRED FINANCE COSTS | $36,707 |
| NON-PATIENT RECEIVABLES | $860,620 |
| OTHER ASSET | $10,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,185,797 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | Desc |
| Amt | $319,695 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $319,695 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $20,290,033 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $20,290,033 | RevenueSubtotalAmt |
| Other Revenues Not Included | $15,383,667 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $15,383,667 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $35,673,700 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $23,175,680 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $23,175,680 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $15,407,507 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $15,407,507 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $38,583,187 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HOSPITAL IS A TAX-EXEMPT ORGANIZATION UNDER INTERNAL REVENUE CODE SECTION 501 (C)(3) AND, ACCORDINGLY, NO PROVISION FOR INCOME TAX IS RECORDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2014. FISCAL YEARS ENDING ON OR AFTER SEPTEMBER 30, 2011 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | CHANGE IN VALUE OF EQUITY IN FOUNDATION NET ASSETS -23,840. BAD DEBT EXPENSE 15,406,871. EMPLOYEE SALES EXPENSE 636. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 15,406,871. EMPLOYEE SALES EXPENSE 636. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $668,726 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $668,726 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02890 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,461,412 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,617,679 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,843,733 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07960 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,130,138 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,617,679 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,512,459 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10850 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $91,529 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $62,940 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $28,589 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $128,759 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $128,759 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00560 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $220,288 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $62,940 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $157,348 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00680 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,350,426 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,680,619 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,669,807 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11530 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,869,275 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,934,638 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $3,456,061 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $16,562,109 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$13,106,048 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CANNON MEMORIAL HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 123 WG ACKER DRIVE | AddressLine1 |
| City | PICKENS | City |
| State | SC | State |
| ZIP Code | 29671 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CANNON MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SECTION C, SUPPLEMENTAL INFORMATION | OwnWebsiteURLTxt |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CANNON MEMORIAL HOSPITAL | PART V, SECTION B, LINE 3: A COMMUNITY BASED APPROACH WAS TAKEN WITH INPUT FROM LOCAL AND REGIONAL PUBLIC HEALTH PROFESSIONALS, COMMUNITY LEADERS, AND COMMUNITY BOARDS. |
| CANNON MEMORIAL HOSPITAL | PART V, SECTION B, LINE 14G: THE ORGANIZATION INCLUDES SUMMARY LANGUAGE ON BILLING INVOICES DIRECTING PATIENTS ON WHERE THEY CAN OBTAIN ADDITIONAL INFORMATION RELATING TO FINANCIAL ASSISTANCE. |
| CANNON MEMORIAL HOSPITAL | PART V, SECTION B, LINE 20D: IF A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THEIR ACCOUNT IS REDUCED ON A SLIDING SCALE, BASED ON THE FEDERAL POVERTY LEVEL. THE SCALE INCLUDES CHARGES LESS THAN AMOUNTS GENERAL BILLED. |
| PART V, SECTION B, LINE 5A | HTTP://WWW.CANNONHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| CANNON ORTHOPEDIC | ||||
| 123 WG ACKER DRIVE | PICKENS | SC | 29671 | ORTHOPEDIC PRACTICE |
| CANNON SURGICAL | ||||
| 123 WG ACKER DRIVE | PICKENS | SC | 29671 | GENERAL SURGERY PRACTICE |
| CANNON FAMILY PRACTICE - EASTSIDE | ||||
| 111 WEST ROPER ROAD | PICKENS | SC | 29640 | RURAL HEALTH CLINIC |
| CANNON FAMILY PRACTICE - PICKENS | ||||
| 123 WG ACKER DRIVE | PICKENS | SC | 29671 | FAMILY PRACTICE |
| CANNON FAMILY PRACTICE - LIBERTY | ||||
| 105 LIBERTY BOULEVARD | PICKENS | SC | 29657 | FAMILY PRACTICE |
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 $ 15,406,871. |
| PART III, LINE 4: | THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE ON BAD DEBT.WORKSHEET TWO OF THE 2013 SCHEDULE H INSTRUCTIONS WAS USED TO CALCULATE A COST-TO-CHARGES RATIO USED TO COMPUTE BAD DEBT AT COST. |
| PART III, LINE 8: | 100% OF THE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT. |
| PART III, LINE 9B: | CANNON UTILIZES AN EXTENDED BUSINESS OFFICE SERVICE THROUGH A THIRD PARTY VENDOR TO MANAGE ALL OF ITS ACTIVE SELF-PAY ACCOUNTS. CANNON RECOGNIZES THREE ASSISTANCE/CHARITY PROGRAMS FOR ITS PATIENTS. THOSE PROGRAMS ARE: 1) MEDICALLY INDIGENT ASSISTANCE PROGRAM (MIAP), 2) CANNON MEMORIAL'S UNCOMPENSATED ASSISTANCE PROGRAM AND 3) PATIENTS REFERRED BY THE SAMARITAN HEALTH CLINIC OF PICKENS COUNTY. AT THE TIME OF DETERMINATION OF ELIGIBILITY, BILLING & COLLECTION EFFORTS ARE DISCONTINUED FOR THE ELIGIBLE ACCOUNTS. CANNON PROVIDES HELP TO ALL PATIENTS WHO NEED ASSISTANCE COMPLETING THE FINANCIAL AIDE APPLICATION. |
| PART VI, LINE 2: | WE CURRENTLY USE DATA PROVIDED BY THE STATE TO ASSESS OUR COMMUNITY. THAT DATA INCLUDES INFORMATION ABOUT PATIENTS WHO USE OUR HOSPITAL, AS WELL AS PATIENTS FROM OUR SERVICE AREA WHO ACCESS HEALTHCARE AT OTHER HOSPITALS AND WHAT CHARGE CODE THAT CARE IS UNDER. THIS GIVES US AN IDEA OF THE HEALTH PROBLEMS IN OUR SERVICE AREA. |
| PART VI, LINE 3: | THE ASSISTANCE/CHARITY PROGRAM POLICIES ARE POSTED ON CANNON'S WEBSITE AND THE PATIENT IS VERBALLY INFORMED DURING THE REGISTRATION PROCESS. |
| PART VI, LINE 4: | CANNON MEMORIAL HOSPITAL SERVES GREATER PICKENS COUNTY, WITH THE PRIMARY COMMUNITY SERVED BY THE HOSPITAL CLASSIFIED AS RURAL. POPULATION ESTIMATES AS OF 2014 ARE APPROXIMATELY 120,000. THE PER CAPITA INCOME IS $21,182. A SIGNIFICANT PERCENTAGE OF THE POPULATION LIVES BELOW THE FEDERAL POVERTY LEVEL. PICKENS HAS A 6.5% UNEMPLOYMENT RATE AND APRROXIMATELY 24,000 RESIDENTS (OR 20%) ARE UNINSURED. |
| PART VI, LINE 5: | CMH FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY IN SEVERAL WAYS. THE MAJORITY OF OUR BOARD IS COMPRISED OF INDIVIDUALS WHO RESIDE IN PICKENS WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF CMH. CMH EXTENDS MEDICIAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE AREA FOR ALL OF OUR DEPARTMENTS. ANY SURPLUS IS USED TO FUND IMPROVEMENTS IN PATIENT CARE. A DIGITAL MAMMOGRPAHY MACHINE BECAME AVAILABLE TO THE PUBLIC STARTING IN 2011. THE HOSPITAL ALSO PROMOTES HEALTH WITHIN PICKENS COUNTY BY PROVIDING EMERGENCY ROOM CARE TO ALL INDIVIDUALS, REGARDLESS OF THEIR ABILITY TO PAY. CMH ALSO PARTICIPATES IN TRAINING OF STUDENTS FROM MULTIPLE CAREER CENTERS, TECHNICAL SCHOOLS AND UNIVERISTIES IN THE AREA. IN ADDITION, THE HOSPITAL PROVIDES VOLUNTEER OPPPORTUNITIES THROUGH THE AUXILIARY. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM MANSON | ||||||||||||||
| CHAIRMAN | $0 | $393,546 | $0 | $109,916 | $0 | $42,236 | $0 | $293,168 | $0 | $27,290 | $0 | $866,156 | $0 | $0 |
| JERRY PARRISH | ||||||||||||||
| SECRETARY | $0 | $343,306 | $0 | $96,336 | $0 | $25,549 | $0 | $194,558 | $0 | $30,880 | $0 | $690,629 | $0 | $0 |
| GARRICK CHIDESTER | ||||||||||||||
| BOARD MEMBER | $0 | $244,619 | $0 | $69,565 | $0 | $25,861 | $0 | $51,766 | $0 | $28,341 | $0 | $420,152 | $0 | $0 |
| MIKE TILLERSON DO | ||||||||||||||
| BOARD MEMBER | $0 | $331,286 | $0 | $87,826 | $0 | $13,376 | $0 | $61,150 | $0 | $37,557 | $0 | $531,195 | $0 | $0 |
| NORMAN RENTZ | ||||||||||||||
| CEO | $144,608 | $0 | $10,557 | $0 | $12,076 | $0 | $22,280 | $0 | $14,136 | $0 | $203,657 | $0 | $0 | $0 |
| MARIAN B CLINCH | ||||||||||||||
| PHYSICIAN | $129,590 | $0 | $30,466 | $0 | $0 | $0 | $3,500 | $0 | $9,294 | $0 | $172,850 | $0 | $0 | $0 |
| DANIEL J DAHLHAUSEN | ||||||||||||||
| PHYSICIAN | $149,218 | $0 | $30,285 | $0 | $0 | $0 | $13,000 | $0 | $15,785 | $0 | $208,288 | $0 | $0 | $0 |
| TRAVIS W DAVIS | ||||||||||||||
| PHYSICIAN | $126,219 | $0 | $26,882 | $0 | $0 | $0 | $10,010 | $0 | $15,785 | $0 | $178,896 | $0 | $0 | $0 |
| BYRON P MARSH | ||||||||||||||
| PHYSICIAN | $224,318 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $224,318 | $0 | $0 | $0 |
| PETER C SCHRIVER | ||||||||||||||
| PHYSICIAN | $232,346 | $0 | $0 | $0 | $0 | $0 | $23,000 | $0 | $15,785 | $0 | $271,131 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | THE FILING ORGANIZATION PROVIDES THESE BENEFITS THE CEO. NO PART OF THE BENEFIT WAS TREATED AS TAXABLE COMPENSATION DURING FY2014. ALL PERSONAL USE AMOUNTS ARE REQUIRED TO BE PAID BACK TO THE ORGANIZATION. |
| PART I, LINE 4B | THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN (457(F)) AND/OR DEFINED BENEFIT PLAN FOR 2012, AS FOLLOWS. THE AMOUNTS ARE REPRESENTED IN PART II, COLUMN (C): DONNA ANDERSON $1,960 DR. BYRON MARSH 4,500 DR. PETER SCHRIVER 4,741 DR. DANIEL DALHAUSEN 3,572 DR. MARION CLINCH 3,167 DR. TRAVIS DAVIS 2,971 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE OFFICERS OF THE BOARD AND THE CHAIRMEN OF THE STANDING COMMITTEES. THE PRESIDENT/CHIEF EXECUTIVE OFFICER SHALL BE AN EX-OFFICIO MEMBER. THE EXECUTIVE COMMITTEE SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL BETWEEN THE MEETINGS OF THE BOARD OF TRUSTEES, PROVIDED THAT ANY ACTION WHICH IT MAY TAKE SHALL NOT CONFLICT WITH THE POLICIES AND EXPRESSED WISHES OF THE BOARD OF TRUSTEES OR THE CHARTER AND THAT IT SHALL REFER ALL MATTERS OF MAJOR IMPORTANCE OF THE BOARD OF TRUSTEES. THIS COMMITTEE SHALL MEET UPON THE CALL OF THE CHAIRPERSON OF THE BOARD. |
| FORM 990, PART VI, SECTION A, LINE 3 | EFFECTIVE JANUARY 1, 2014, ANMED HEALTH, A SOUTH CAROLINA NON-PROFIT, BECAME THE SOLE MEMBER OF CANNON MEMORIAL HOSPITAL. ANMED HEALTH PROVIDES MANAGEMENT RESPONSOBILITIES AND EMPLOYS ON A FULL-TIME BASIS A PRESIDENT AND CEO, CFO AND OTHER EXECUTIVES AS ARE DESIGNATED AND AGREED UPON BY CANNON AND ANMED HEALTH. ANMED HEALTH IS GRANTED THE AUTHORITY AND RESPONSIBILITY FOR MANAGEMENT OF THE HOSPITAL, SUBJECT TO GENERAL APPROVAL OF THE BOARD OF DIRECTORS OF CANNON MEMORIAL HOSPITAL. THE BOARD SHALL REVIEW AND ACT PROMPTLY ON REQUESTS FOR APPROVAL SUBMITTED TO THE BOARD BY ANMED HEALTH FOR CERTAIN MATTERS OUTLINED IN THE MANAGEMENT AGREEMENT, INCLUDING LARGE CAPITAL EXPENDITURES, SALE OR OTHER DISPOSAL OF HOSPITAL ASSETS, AND BORROWING OTHER THAN IN THE ORDINARY COURSE OF CONDUCT OF HOSPITAL AFFAIRS. |
| FORM 990, PART VI, SECTION A, LINE 4 | ANMED HEALTH IS NOW THE SOLE MEMBER OF CANNON MEMORIAL HOSPITAL. THE ARTICLES OF INCORPORATION WERE AMENDED TO REFLECT THIS CHANGE. THE BYLAWS WERE ALSO AMENDED TO SHOW THAT ANMED HEALTH HAS APPOINTMENT AND ELECTORIAL POWER OVER THE BOARD OF DIRECTORS FOR CANNON MEMORIAL HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 6 | EFFECTIVE JANUARY 1, 2014, ANMED HEALTH, A SOUTH CAROLINA NON-PROFIT, BECAME THE SOLE MEMBER OF CANNON MEMORIAL HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7A | EFFECTIVE JANUARY 1, 2014, ANMED HEALTH, A SOUTH CAROLINA NON-PROFIT, BECAME THE SOLE MEMBER OF CANNON MEMORIAL HOSPITAL. ANMED HEALTH PROVIDES MANAGEMENT RESPONSOBILITIES AND EMPLOYS ON A FULL-TIME BASIS A PRESIDENT AND CEO, CFO AND OTHER EXECUTIVES AS ARE DESIGNATED AND AGREED UPON BY CANNON AND ANMED HEALTH. ANMED HEALTH IS GRANTED THE AUTHORITY AND RESPONSIBILITY FOR MANAGEMENT OF THE HOSPITAL, SUBJECT TO GENERAL APPROVAL OF THE BOARD OF DIRECTORS OF CANNON MEMORIAL HOSPITAL. THE BOARD SHALL REVIEW AND ACT PROMPTLY ON REQUESTS FOR APPROVAL SUBMITTED TO THE BOARD BY ANMED HEALTH FOR CERTAIN MATTERS OUTLINED IN THE MANAGEMENT AGREEMENT, INCLUDING LARGE CAPITAL EXPENDITURES, SALE OR OTHER DISPOSAL OF HOSPITAL ASSETS, AND BORROWING OTHER THAN IN THE ORDINARY COURSE OF CONDUCT OF HOSPITAL AFFAIRS. ANMED HEALTH AS THE SOLE MEMBER APPROVES APPOINTED BOARD MEMBERS OF THE FILING ORGANIZATIONS. |
| FORM 990, PART VI, SECTION A, LINE 7B | ANMED HEALTH IS GRANTED THE AUTHORITY AND RESPONSIBILITY FOR MANAGEMENT OF THE HOSPITAL, SUBJECT TO GENERAL APPROVAL OF THE BOARD OF DIRECTORS OF CANNON MEMORIAL HOSPITAL. THE BOARD SHALL REVIEW AND ACT PROMPTLY ON REQUESTS FOR APPROVAL SUBMITTED TO THE BOARD BY ANMED HEALTH FOR CERTAIN MATTERS OUTLINED IN THE MANAGEMENT AGREEMENT, INCLUDING LARGE CAPITAL EXPENDITURES, SALE OR OTHER DISPOSAL OF HOSPITAL ASSETS, AND BORROWING OTHER THAN IN THE ORDINARY COURSE OF CONDUCT OF HOSPITAL AFFAIRS. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. UPON COMPLETION, THE RETURN WAS REVIEWED BY MANAGEMENT AND PROVIDED TO ALL VOTING MEMBERS OF THE BOARD OF DIRECTORS VIA E-MAIL. A PERIOD OF TIME WAS ALLOWED FOR QUESTIONS AND COMMENTS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ADMINISTRATION REQUIRES ALL MANAGEMENT, KEY OFFICIALS, AND BOARD MEMBERS TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ON AN ANNUAL BASIS. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY GOVERNING BOARD MEMBER SHALL BE DISCLOSED TO THE OTHER MEMBERS OF THE BOARD AND MADE A MATTER OF RECORD THROUGH AN ANNUAL PROCEDURE AND ALSO WHEN THE INTEREST BECOMES A MATTER OF BOARD ACTION. ANY GOVERNING BOARD MEMBER HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHALL NOT VOTE OR USE PERSONAL INFLUENCE ON THE MATTER, EVEN WHERE PERMITTED BY LAW. THE MINUTES OF THE MEETING SHALL REFLECT THAT A DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING, AND THE QUORUM SITUATION. THE FOREGOING REQUIREMENTS SHALL NOT BE CONSTRUED AS PREVENTING THE GOVERNING BOARD MEMBER FROM BRIEFLY STATING A POSITION IN THE MATTER, NOR FROM ANSWERING PERTINENT QUESTIONS OF OTHER BOARD MEMBERS SINCE THE BOARD MEMBER'S KNOWLEDGE MAY BE OF GREAT ASSISTANCE. ANY NEW MEMBER OF THE BOARD WILL BE ADVISED OF THIS POLICY UPON ENTERING INTO THE DUTIES OF BOARD MEMBERSHIP. |
| FORM 990, PART VI, SECTION B, LINE 15 | A COMMITTEE OF FOUR CANNON BOARD MEMBERS KNOWN AS THE "CEO REVIEW COMMITTEE" MEETS ANNUALLY TO REVIEW THE PROGRESS OF THE CEO AGAINST GOALS DETERMINED THE PREVIOUS YEAR. THE COMMITTEE MAKES A RECOMMENDATION TO THE BOARD FOR A SALARY INCREASE AND/OR BONUS FOR THE CEO BASED UPON THAT PROGRESS. THE RECOMMENDATION IS VOTED ON BY THE FULL BOARD. THE BOARD APPROVES THE GOALS FOR THE CEO FOR THE UPCOMING YEAR IN ACCORDANCE WITH THE ORGANIZATION'S STRATEGIC GOALS. SALARY AND BONUS ARE REVIEWED AND COMPARED PERIODICALLY TO APPLICABLE COMPENSATION SURVEYS. THE CEO REVIEWS THE PROGRESS OF THE OTHER OFFICERS/KEY EMPLOYEES AGAINST THE ESTABLISHED GOALS FOR THE PRIOR YEAR AND DETERMINES THE ANNUAL SALARY INCREASE AND/OR BONUS BASED UPON THAT PROGRESS. SALARIES ARE REVIEWED AND COMPARED PERIODICALLY TO APPLICABLE COMPENSATION SURVEYS. THE CEO DETERMINES THE GOALS FOR THE UPCOMING YEAR IN ACCORDANCE WITH THE ORGANIZATION'S STRATEGIC GOALS. THE BOARD APPROVES THE ORGANIZATIONAL BUDGET WHICH INCLUDES THESE SALARY INCREASES. |
| FORM 990, PART VI, SECTION C, LINE 18 | PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. |
| FORM 990, PART VI, SECTION C, LINE 19 | PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. |
| FORM 990, PART XI, LINE 9: | CHANGE IN VALUE OF EQUITY IN FOUNDATION NET ASSETS 23,840. |
| FORM 990, PART XII, LINE 2C | THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CANNON MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| PO BOX 188 | PICKENS | SC | 29671 | 570943822 | SUPPORT/FUNDRAISING | SC | 501(C)(3) | 7 | CANNON MEMORIAL HOSPITAL INC | Yes (1) | |
| ANMED HEALTH | |||||||||||
| 800 N FANT STREET | ANDERSON | SC | 29621 | 570359174 | HEALTHCARE | SC | 501(C)(3) | 3 | ANMED HEALTH SYSTEM | 0 | |
| ANMED HEALTH SYSTEM | |||||||||||
| 800 N FANT STREET | ANDERSON | SC | 29621 | 570817544 | FUNDRAISING/SUPPORT | SC | 501(C)(3) | 3 | 0 | N/A | |
| THE ANMED HEALTH FOUNDATION | |||||||||||
| 800 N FANT STREET | ANDERSON | SC | 29621 | 383886017 | FUNDRAISING/SUPPORT | SC | 501(C)(3) | 3 | ANMED HEALTH SYSTEM | 0 | |
| CLEMSON HEALTH CENTER INC | |||||||||||
| 895 TIGER BLVD | CLEMSON | SC | 29631 | 570988736 | HEALTHCARE | SC | 501(C)(3) | 3 | 0 | N/A | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| 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 | |||||||||
| 800 N FANT STREET | ANDERSON | SC | 29621 | 570741536 | HEALTHCARE | SC | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CANNON MEMORIAL HOSPITAL FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $78,699 | InvolvedAmt |
Comments