SCOTLAND REGIONAL HEALTH NETWORK: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
SCOTLAND REGIONAL HEALTH NETWORK (EIN 27-2187756)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-13
IRS object ID
201412259349301981
Schema version
2012v2.1
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-13T14:01:12-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN560747981EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DIXON HUGHES GOODMAN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1500 RIDGEFIELD COURTAddressLine1
CityASHEVILLECity
StateNCState
ZIP Code28806ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN272187756EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SCOTLAND REGIONAL HEALTH NETWORKBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSCOTNameControl
Phone9102917920Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 LAUCHWOOD DRIVEAddressLine1
CityLAURINBURGCity
StateNCState
ZIP Code28352ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMATTHEW PRACHTName
TitleCFO/TREASURERTitle
Phone9102917920Phone
Date Signed2014-08-12DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJEREMY NAESSName
Phone8282542254Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMATTHEW PRACHTNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1500 LAUCHWOOD DRIVEAddressLine1
CityLAURINBURGCity
StateNCState
ZIP Code28352ZIPCode
FieldValueIRS element (for citing)
Gross Receipts7313865GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2010YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionTO OPERATE FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, AND TO CARRY OUT THE PURPOSES OF SCOTLAND MEMORIAL HOSPITAL, INC.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members1NbrIndependentVotingMembers
Total Nbr Employees56TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6354983ProgramServiceRevenuePriorYear
Program Service Revenue CY7040697ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year42972OtherRevenuePriorYear
Other Revenue Current Year273168OtherRevenueCurrentYear
Total Revenue Prior Year6397955TotalRevenuePriorYear
Total Revenue Current Year7313865TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year7603509SalariesEtcPriorYear
Salaries Etc Current Year8222268SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year3375397OtherExpensePriorYear
Other Expenses Current Year3450452OtherExpensesCurrentYear
Total Expenses Prior Year10978906TotalExpensesPriorYear
Total Expenses Current Year11672720TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-4580951RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-4358855RevenuesLessExpensesCY
Total Assets BOY974375TotalAssetsBOY
Total Assets EOY789343TotalAssetsEOY
Total Liabilities BOY275483TotalLiabilitiesBOY
Total Liabilities EOY725632TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY698892NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY63711NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PROMOTE AND FURTHER THE HEALTH AND WELFARE OF COMMUNITIES WITHIN THIS STATE THROUGH SUPPORT OF AND INVOLVEMENT IN HEATH CARE AND HEALTH CARE RELATED ORGANIZATIONS, AND TO SUPPORT AND TO OPERATE FOR THE BENEFIT OF ANDRECEIVE AND PROVIDE FUNDS, PROPERTY, OR OTHER BENEFITS TO (I) HOSPITALS, (II) OUTPATIENT CLINICS, (III) REHABILITATION INSTITUTIONS, (IV) ALCOHOL OR DRUG TREATMENT CENTERS, (V) ANY ORGANIZATION PROVIDING HOSPITAL OR MEDICAL CARE, OR (VI) ANY OTHER HEALTH CARE ORGANIZATION OR ORGANIZATION ENGAGED IN HEALTH CARE RELATED ACTIVITIES, PROVIDED ALL SUCH SUPPORTED ORGANIZATIONS MUST QUALIFY AS EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE CODE OR THE CORRESPONDING PROVISIONS OF ANY FUTURE UNITED STATES FEDERAL INCOME TAX LAWS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense10434963Expense
Grants0Grants
Revenue7040697Revenue
DescriptionTHE MISSION AND PURPOSE OF SCOTLAND REGIONAL HEALTH NETWORK IS TO PROVIDE HEALTH CARE SERVICES TO THE COMMUNITIES SERVED.UTILIZING THE SERVICES OF 20 PHYSICIANS AND MID-LEVEL PROVIDERS, THE NETWORK RECORDED OVER 41,000 VISITS IN ITS' FAMILY PRACTICE, SURGICAL, GASTROINTESTINAL, WOMENS' CARE, AND HOSPITALIST.DURING THE YEAR, THE NETWORK OPERATED A FAMILY PHYSICIAN, SURGICAL PRACTICE, A GASTROENTEROLOGY PRACTICE, AN OB/GYN PRACTICE, AND PROVIDED HOSPITALIST SERVICES TO SCOTLAND MEMORIAL HOSPITAL INPATIENTS.Description
Total Program Service Expense10434963TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees56NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members1NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLARRY BROOKSNamePerson
Telephone Number9102917000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1500 LAUCHWOOD DRIVEAddressLine1
CityLAURINBURGCity
StateNCState
ZIP Code28352ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (6 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
MIKE VINSON
CHAIRMAN (BEGINNING 12/12)2.00XX000
NANCY L WALKER
CHAIRMAN (THROUGH 12/12)2.00XX000
GREGORY C WOOD
CEO/PRESIDENT2.00XX033781659177
MATTHEW D PRACHT
CFO/TREASURER2.00XX021046647439
PAMELA J ASHLEY
SECRETARY1.00X03899810708
PAUL G BROOKS
EXECUTIVE DIRECTOR1.00X010153929995
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs688819TotalReportableCompFrmRltdOrgs
Total Other Compensation147319TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT REVENUEDescription
Business Code624100BusinessCode
Total Revenue Column7040697TotalRevenueColumn
Related Or Exempt Function Income7040697RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue7040697TotalProgramServiceRevenue

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUS REVENUEDescription
Business Code900099BusinessCode
Total Revenue Column273168TotalRevenueColumn
Exclusion$273,168ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue273168TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column7313865TotalRevenueColumn
Related Or Exempt Function Income7040697RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$273,168ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7765858Total
Program Services6602994ProgramServices
Management And General1162864ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total9122Total
Program Services7756ProgramServices
Management And General1366ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total431635Total
Program Services367002ProgramServices
Management And General64633ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total15653Total
Program Services13309ProgramServices
Management And General2344ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total6550Total
Management And General6550ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total970433Total
Program Services970433ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total10826Total
Program Services10826ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total147512Total
Program Services147512ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1618Total
Program Services1618ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total460099Total
Program Services460099ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total25346Total
Program Services25346ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total258Total
Program Services258ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total7839Total
Program Services7839ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total393915Total
Program Services393915ProgramServices

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
BAD DEBT12441561244156
MEDICAL SUPPLIES170300170300
MISCELLANEOUS EXPENSE1160011600

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total11672720Total
Program Services10434963ProgramServices
Management And General1237757ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY109347BOY
EOY68650EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY547161BOY
EOY522979EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY262968BOY
EOY150654EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis59413LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec12353LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY54899BOY
EOY47060EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY974375BOY
EOY789343EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6956BOY
EOY54257EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY268527BOY
EOY671375EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY275483BOY
EOY725632EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY698892BOY
EOY63711EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY698892BOY
EOY63711EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY974375BOY
EOY789343EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-4358855ReconcilationRevenueExpenses
Reconcilation Other Changes3723674ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1SCOTLAND MEMORIAL HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
EIN560583151EIN
Type Of Organization3TypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Amount$0Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

Schedule D IRS990ScheduleD

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis59413OtherCostOrOtherBasis
Depreciation12353Depreciation
Book Value47060BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings47060TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO AFFILIATESDescription
Amount$671,375Amount
FieldValueIRS element (for citing)
Total Of Amounts671375TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt9793383TotRevenueEtcAuditedFinclStmt
Other Revenues3723674OtherRevenues
Revenue Not Rptd F9903723674RevenueNotRptdF990
Revenue Subtotal6069709RevenueSubtotal
Other Revenues Not Included1244156OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1244156RevenueNotRptdOnFinStmt
Total Revenue Per Form9907313865TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt10428564TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal10428564ExpensesSubtotal
Other Expenses Not Included1244156OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt1244156ExpensesNotRptdOnFinStmt
Total Expenses Per Form99011672720TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:THE CORPORATION AND ITS NONPROFIT AFFILIATES ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE LLC IS TREATED AS A PARTNERSHIP AND AS SUCH, THE INCOME FLOWS THROUGH TO THE OWNERS OF THE LLC. THE CORPORATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2013. THE CORPORATION BELIEVES THEY ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2010.
PART XI, LINE 2D - OTHER ADJUSTMENTS:EQUITY TRANSFER TO AFFILIATE 3,723,674.
PART XI, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT NET WITH REVENUE 1,244,156.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT NET WITH REVENUE 1,244,156.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
GREGORY C WOOD
CEO/PRESIDENT0238474074258025084027427031750039699300
MATTHEW D PRACHT
CFO/TREASURER017101203765101803023658023781025790500

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 6ReturnReference
ExplanationGREGORY WOOD (CEO) AND MATTHEW PRACHT (CFO) WERE ON A MANAGEMENT INCENTIVE PROGRAM THAT REQUIRED THE COMPLETION OF SPECIFIC ORGANIZATION PERFORMANCE MEASURES, WHICH INCLUDED FINANCIAL PERFORMANCE, QUALITY OUTCOMES, CUSTOMER SATISFACTION, AND EMPLOYEE RETENTION.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 3SCOTLAND HEALTH CARE SYSTEM IS ENGAGED IN A TEN-YEAR MANAGEMENT AGREEMENT WITH THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY D/B/A CAROLINAS HEALTHCARE SYSTEM TO MANAGE THE SYSTEM ON A DAY-TO-DAY BASIS.
FORM 990, PART VI, SECTION B, LINE 11PRIOR TO THE FILING DATE, THE FORM 990 WAS PRESENTED TO THE BOARD OF TRUSTEES FOR REVIEW. AFTER A DISCUSSION PERIOD AND QUESTION & ANSWER PERIOD, THE BOARD OF TRUSTEES VOTED TO APPROVE THE FORM 990 AS PRESENTED.
FORM 990, PART VI, SECTION B, LINE 12CTHE HOSPITAL REQUIRES ALL OFFICERS, DIRECTORS, TRUSTEES TO REVIEW AND SIGN THE CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY.
FORM 990, PART VI, SECTION B, LINE 15THE PROCESS FOR DETERMINING COMPENSATION FOR CEO AND CFO ENTAILS A REVIEW OF PERFORMANCE BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES. A COMPENSATION BENCHMARK STUDY IS CONDUCTED BY AN INDEPENDENT RECOGNIZED THIRD PARTY, AND REVIEW OF COMPENSATION BY CAROLINAS HEALTHCARE SYSTEM COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. FINAL APPROVAL IS THEN MADE AND DOCUMENTED BY THE SCOTLAND HEALTH CARE SYSTEM BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION C, LINE 18PHOTOCOPIES 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 19THE HOSPITAL MAKES IT GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST AT THE SCOTLAND MEMORIAL HOSPITAL EXECUTIVE ASSISTANT TO THE PRESIDENT'S OFFICE. THE HOSPITAL MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE VP, FINANCE OFFICE OR GENERAL ACCOUNTING DEPARTMENT.
FORM 990, PART VII & SCHEDULE JTHE ORGANIZATION IS UTILIZING PART VII AND SCHEDULE J OF THE FORM 990 TO REPORT THE COMPENSATION PAID TO THE CEO AND CFO BY A MANAGEMENT COMPANY FOR SERVICES PROVIDED TO A RELATED ORGANIZATION. THE COMPENSATION HAS BEEN REPORTED IN THE RELATED ORGANIZATION'S COMPENSATION COLUMNS OF THESE SECTIONS.
FORM 990, PART XI, LINE 9:EQUITY TRANSFER TO AFFILIATE 3,723,674.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
SCOTLAND MEMORIAL HOSPITAL INC
500 LAUCHWOOD DRIVELAURINBURGNC28352560583151OFFER HEALTH CARE TO RESIDENTS OF SCOTLAND COUNTY, NC AND SURROUNDING AREASNC501(C)(3)LINE 11A, ISCOTLAND HEALTH CARE SYSTEM INC0
SCOTLAND HEALTH CARE SYSTEM INC
500 LAUCHWOOD DRIVELAURINBURGNC28352581847657OPERATE FOR THE BENEFIT OF, PERFORM FUNCTIONS, AND CARRY OUT PURPOSES OF SMHNC501(C)(3)LINE 11A, I0N/A
SCOTLAND MEMORIAL FOUNDATION INC
500 LAUCHWOOD DRIVELAURINBURGNC28352581828201CONDUCT FUNDRAISING ACTIVITIES FOR SCOTLAND HEALTH CARE SYSTEMNC501(C)(3)LINE 7SCOTLAND HEALTH CARE SYSTEM INC0
EDWIN MORGAN CENTER INC
500 LAUCHWOOD DRIVELAURINBURGNC28352589178020SKILLED NURSING FACILITYNC501(C)(3)LINE 9SCOTLAND HEALTH CARE SYSTEM INC0
HOSPICE OF SCOTLAND COUNTY INC
610 E LAUCHWOOD DRIVELAURINBURGNC28352561468269HEALTHCARE FOR TERMINALLY ILL PATIENTSNC501(C)(3)LINE 7SCOTLAND HEALTH CARE SYSTEM INC0
SMH TITLE HOLDING COMPANY
500 LAUCHWOOD DRIVELAURINBURGNC28352581849143TITLE HOLDING COMPANYNC501(C)(2)SCOTLAND HEALTH CARE SYSTEM INC0

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1SCOTLAND MOB LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1500 LAUCHWOOD DRIVEAddressLine1
CityLAURINBURGCity
StateNCState
ZIP Code28352ZIPCode
FieldValueIRS element (for citing)
EIN205900149EIN
Primary ActivityRENTAL ESTATEPrimaryActivity
Legal Domicile StateNCLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1SCOTLAND ENTERPRISES INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1500 LAUCHWOOD DRIVEAddressLine1
CityLAURINBURGCity
StateNCState
ZIP Code28352ZIPCode
FieldValueIRS element (for citing)
EIN561651832EIN
Primary ActivityHEALTH CAREPrimaryActivity
Legal Domicile StateNCLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

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