2015-08-13T15:14:15-05:00 2014-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2013-10-01 570342027 CANNON MEMORIAL HOSPITAL CANN 8648784791 123 WG ACKER DRIVE PICKENS SC 29671 WILL GRANT CFO 8648784791 2015-08-13 1 AMY BIBBY P00445891 8282542254 2013 2016-02-25 16:41:14Z WILL GRANT 123 WG ACKER DRIVE PICKENS SC 29671 35673700 0 X WWW.CANNONHOSPITAL.ORG X 1950 SC PROVIDING QUALITY HEALTHCARE IN A SAFE, COMPETENT, AND COMPASSIONATE MANNER 13 8 345 75 0 0 1265350 85138 36239282 35389382 7080 880 183091 198300 37694803 35673700 0 0 0 0 13137482 12744759 0 0 3732 26483858 25838428 39621340 38583187 -1926537 -2909487 16501617 13753804 10680238 10818072 5821379 2935732 X THE MISSION OF CANNON MEMORIAL HOSPITAL IS TO PROVIDE QUALITY HEALTHCARE IN A SAFE, COMPETENT, AND COMPASSIONATE MANNER. 0 0 34419759 35389382 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. 34419759 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 34 0 1 345 1 0 0 0 0 0 0 0 0 0 0 X 13 8 0 1 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 SC X WILL GRANT 8648981136 123 WG ACKER DRIVE PICKENS SC 29671 WILLIAM MANSON CHAIRMAN 2.00 X X 0 545698 320458 JAMES R MAHANES MD VICE CHAIR (THROUGH DECEMBER 2013) 1.00 X X 94269 0 0 JERRY PARRISH SECRETARY 2.00 X X 0 465191 225438 KENNETH D ACKER TREASURER (THROUGH DECEMBER) 1.00 X X 0 0 0 J FLETCHER PERRY BOARD MEMBER (THROUGH DECEMBER 2013) 1.00 X 0 0 0 JOHN E SPARKS BOARD MEMBER (THROUGH DECEMBER 2013) 1.00 X 0 0 0 GEORGE N ACKER BOARD MEMBER (THROUGH DECEMBER 2013) 1.00 X 0 0 0 FRANCES C STOKES BOARD MEMBER (THROUGH DECEMBER 2013) 1.00 X 0 0 0 RANDALL P GRIFFIN BOARD MEMBER (THROUGH DECEMBER 2013) 1.00 X 0 0 0 R JANINE PETERSEN BOARD MEMBER (THROUGH DECEMBER 2013) 1.00 X 0 0 0 DONALD L MARLER BOARD MEMBER 1.00 X 0 0 0 LINDA S CASSELL BOARD MEMBER 1.00 X 0 0 0 TIMOTHY E MORGAN BOARD MEMBER 1.00 X 0 0 0 GARRICK CHIDESTER BOARD MEMBER 1.00 X 0 340045 80107 MIKE TILLERSON DO BOARD MEMBER 1.00 X 0 432488 98707 NORMAN RENTZ CEO 40.00 X 167241 0 36416 GREG SCARBOROUGH CFO (THROUGH DECEMBER 2013) 40.00 X 50654 0 5631 WILL GRANT CFO (BEGINNING APRIL 2014) 40.00 X 0 0 0 DONNA ANDERSON CNO 40.00 X 92099 0 16380 MARIAN B CLINCH PHYSICIAN 40.00 X 160056 0 12794 DANIEL J DAHLHAUSEN PHYSICIAN 40.00 X 179503 0 28785 TRAVIS W DAVIS PHYSICIAN 40.00 X 153101 0 25795 BYRON P MARSH PHYSICIAN 40.00 X 224318 0 0 PETER C SCHRIVER PHYSICIAN 40.00 X 232346 0 38785 1353587 1783422 889296 12 0 1 0 ANMED HEALTH 800 N FANT STREET ANDERSON SC 29621 MANAGEMENT SERVICES 599244 DR MICHAEL DILLARD PO BOX 186 PICKENS SC 29671 ER PHYSICIAN 373333 DR JAMES CLIFTON CALDWELL 220 GLEN LAUREL DRIVE EASLEY SC 29642 ER PHYSICIAN 366680 MATRIX REHABILITATION PO BOX 11407 BIRMINGHAM AL 35246 REHABILITATION SERVICES 340605 DR MICHAEL E DONALD 350 NORTH SUMMIT DRIVE SENECA SC 29672 ER PHYSICIAN 294270 6 78699 6439 85138 NET PATIENT SERVICE 621400 35389382 35389382 35389382 880 880 10941 0 10941 10941 10941 CAFETERIA & FOOD SERVICE 722210 63671 63671 SALES TO EMPLOYEES 446110 40405 40405 MEDICAL TRANSCRIPTION 900099 16358 16358 66925 66925 187359 35673700 35389382 0 199180 368421 368421 8970698 8183514 787184 49666 43520 6146 2646526 2319050 327476 709448 621662 87786 366854 366854 90000 90000 3562350 2567663 991237 3450 69977 69977 1900100 1158892 740926 282 28465 28465 326240 326240 64734 20946 43788 316426 316426 1275784 1275784 377711 126275 251436 BAD DEBT EXPENSE 15406871 15406871 MEDICAL SUPPLIES 2052916 2052916 38583187 34419759 4159696 3732 660160 376893 831769 5070 3998838 3745699 645682 347859 174832 160276 27087232 19745349 8216760 7341883 566487 590327 1407089 1185797 16501617 13753804 1665412 2454982 5497512 8043395 3517314 319695 10680238 10818072 X 5420255 2510768 401124 424964 5821379 2935732 16501617 13753804 X -2909487 23840 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 642 642 0 PART II-B, LINE 1: 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. 758191 758191 11163486 7999660 3163826 384370 247587 136783 14510081 11498102 3011979 271104 271104 7341883 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 278470 DEFERRED FINANCE COSTS 36707 NON-PATIENT RECEIVABLES 860620 OTHER ASSET 10000 1185797 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 319695 319695 X 20290033 0 20290033 15383667 15383667 35673700 23175680 0 23175680 15407507 15407507 38583187 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. 1 1 1 X 1 X 1 1 1 0 1 1 668726 668726 0.02890 4461412 2617679 1843733 0.07960 5130138 2617679 2512459 0.10850 91529 62940 28589 0.00120 128759 128759 0.00560 220288 62940 157348 0.00680 5350426 2680619 2669807 0.11530 1 3869275 1934638 3456061 16562109 -13106048 X 1 1 1 1 CANNON MEMORIAL HOSPITAL 123 WG ACKER DRIVE PICKENS SC 29671 X X X CANNON MEMORIAL HOSPITAL 1 1 X X X X X X X X X 12 1 0 1 X SEE SECTION C, SUPPLEMENTAL INFORMATION X X X X X 1 0 1 1 100.000000000000 1 200.000000000000 1 X X X X 1 1 X X X 1 0 1 X 0 0 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/ 5 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 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. X 1 1 X X X X 0 1 0 0 0 0 0 0 0 WILLIAM MANSON CHAIRMAN 0 393546 0 109916 0 42236 0 293168 0 27290 0 866156 0 0 JERRY PARRISH SECRETARY 0 343306 0 96336 0 25549 0 194558 0 30880 0 690629 0 0 GARRICK CHIDESTER BOARD MEMBER 0 244619 0 69565 0 25861 0 51766 0 28341 0 420152 0 0 MIKE TILLERSON DO BOARD MEMBER 0 331286 0 87826 0 13376 0 61150 0 37557 0 531195 0 0 NORMAN RENTZ CEO 144608 0 10557 0 12076 0 22280 0 14136 0 203657 0 0 0 MARIAN B CLINCH PHYSICIAN 129590 0 30466 0 0 0 3500 0 9294 0 172850 0 0 0 DANIEL J DAHLHAUSEN PHYSICIAN 149218 0 30285 0 0 0 13000 0 15785 0 208288 0 0 0 TRAVIS W DAVIS PHYSICIAN 126219 0 26882 0 0 0 10010 0 15785 0 178896 0 0 0 BYRON P MARSH PHYSICIAN 224318 0 0 0 0 0 0 0 0 0 224318 0 0 0 PETER C SCHRIVER PHYSICIAN 232346 0 0 0 0 0 23000 0 15785 0 271131 0 0 0 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 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. CANNON MEMORIAL HOSPITAL FOUNDATION PO BOX 188 PICKENS SC 29671 570943822 SUPPORT/FUNDRAISING SC 501(C)(3) 7 CANNON MEMORIAL HOSPITAL INC 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 N/A 0 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 N/A 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 800 N FANT STREET ANDERSON SC 29621 570741536 HEALTHCARE SC N/A C 0 0 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 CANNON MEMORIAL HOSPITAL FOUNDATION C 78699