2014-08-15T18:47:56-05:00 2013-09-30 861065772 Deloitte Tax LLP 191 Peachtree Street Suite 2000 Atlanta GA 30303 990 2012-10-01 202935692 McLeod Physician Associates II MCLE 8437772256 555 E Cheves Street Florence SC 295020551 S FULTON ERVIN III 8437772911 2014-08-15 1 John W Sadoff Jr P00540589 4042201500 2012 2015-11-30 17:44:51Z McLeod Physician Associates Robert Colones 555 E Cheves Street Florence SC 295020551 99509694 0 X www.mcleodhealth.org X 2005 SC Physician Services 4 0 935 0 0 0 0 26400 80813396 98019270 10630 -235842 540746 1320798 81364772 99130626 0 0 0 0 69033520 89783684 0 0 0 25042292 23783682 94075812 113567366 -12711040 -14436740 15513948 15880831 56383624 71187247 -40869676 -55306416 McLeod Physician Associates II operates as part of the McLeod Health system. The Mission of McLeod Health is to improve the overall health and well being of people living within South Carolina and eastern North Carolina by providing excellence in health care. 0 0 103019032 98019270 McLeod Physician Associates II's primary goal is to provide physician services to the residents of the Eastern Region of South Carolina and the extreme Southeastern Region of North Carolina. 103019032 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 69 0 1 935 1 0 0 0 0 0 0 0 0 0 0 1 1 0 X 4 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Mark W Cameron 8437775304 555 East Cheves Street Florence SC 29505 Ronald L Boring 1.00 39.00 X 0 480775 147843 S Fulton Ervin III 1.00 39.00 X 0 425843 121656 Dane P Ficco 36.00 4.00 X 0 366169 95165 Michael E Payne 36.00 4.00 X 0 211424 74030 John Browning MD 40.00 0.00 X 868427 0 88439 J Dale Cannon Jr MD 40.00 0.00 X 782197 0 88502 Gary Emerson MD 40.00 0.00 X 936218 0 81797 Trevor W Poole MD 40.00 0.00 X 735952 0 82268 Charles R Tatum MD 40.00 0.00 X 880484 0 89661 4203278 1484211 869361 142 0 1 0 University Medical Associates PO Box 250619 Charleston SC 29435 Medical Services 662083 Moore & Van Allen PLLC PO Box 22828 Charleston SC 294132828 Legal Services 227724 Dr Nandkishore Raghuram 4501 Chesapeake Place Amarillo TX 791196471 Medical Services 204378 Medical Doctor Associates PO Box 277185 Atlanta GA 303847185 Medical Services 176739 Comphealth Associates Inc PO Box 972625 Dallas TX 75397 Medical Services 147661 9 26400 26400 Physician Services 621110 77238468 77238468 Subsidy Fees 621110 20780802 20780802 98019270 143226 379068 -235842 -235842 -235842 Other Revenue 900099 1320798 1320798 1320798 99130626 98019270 0 1084956 78457694 74949898 3507796 11325990 10361761 964229 2274549 2274549 364433 67600 296833 442112 442112 2952682 2094721 857961 329092 199564 129528 6356093 6195612 160481 473942 304875 169067 5763218 5102078 661140 248009 149332 98677 9995 5949 4046 2608878 1218095 1390783 1795683 1791473 4210 Other Direct Expenses 140527 113767 26760 Licenses and Taxes 17110 15450 1660 Contract Labor 7359 6745 614 113567366 103019032 10548334 0 -384222 5411679 6536810 343866 398802 1302061 1564130 19091753 11710664 7837512 7381089 1003052 0 15513948 15880831 6866326 8570543 49517298 62616704 56383624 71187247 X -40869676 -55306416 0 0 -40869676 -55306416 15513948 15880831 -14436740 0 X X 0 1 X 1 0 X 32200 37564 58330 26400 154494 54758295 57100376 64582300 80813396 98019270 355273637 54790495 57137940 64640630 80813396 98045670 355428131 0 0 0 355428131 384387 -196590 -72906 540746 1320798 1976435 55174882 56941350 64567724 81354142 99366468 357404566 0.99450 0.99750 0.00000 X Schedule A, Part II, Line 12, Explanation of Other Income: Other Income - 2008 Amount: $ 384,387. 2009 Amount: $ -196,590. 2010 Amount: $ -72,906. 2011 Amount: $ 540,746. 2012 Amount: $ 1,320,798. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1349049 206352 1142697 17742704 11504312 6238392 7381089 Retirement Liabilities/Split Dollar Plan 1137231 Deferred Income-MPA 1248709 Voluntary Auxilary Fund -74 Inter company Payables 60230838 62616704 X X X X X X 0 0 0 0 0 0 0 0 0 Ronald L Boring 0 367493 0 100980 0 12302 0 39500 0 108343 0 628618 0 0 S Fulton Ervin III 0 350033 0 65625 0 10185 0 22500 0 99156 0 547499 0 0 Dane P Ficco 0 284554 0 75407 0 6208 0 15000 0 80165 0 461334 0 0 Michael E Payne 0 178452 0 29150 0 3822 0 18687 0 55343 0 285454 0 0 John Browning MD 863772 0 0 0 4655 0 39500 0 48939 0 956866 0 0 0 J Dale Cannon Jr MD 779461 0 0 0 2736 0 39500 0 49002 0 870699 0 0 0 Gary Emerson MD 932948 0 0 0 3270 0 34000 0 47797 0 1018015 0 0 0 Trevor W Poole MD 734053 0 0 0 1899 0 34000 0 48268 0 818220 0 0 0 Charles R Tatum MD 873894 0 0 0 6590 0 39500 0 50161 0 970145 0 0 0 Part I, Line 3 CEO of Sole Member (McLeod Health) of McLeod Physician Associates is Robert Colones who has compensation determined by all methods listed in Schedule J, Line 3. Form 990, Part VI, Section A, line 6 McLeod Physician Associates II has a sole member which is McLeod Health. Form 990, Part VI, Section A, line 7a The Board of McLeod Health (sole member) has final authority as needed on the makeup and decision-making of McLeod Physician Associate II's Board. Form 990, Part VI, Section A, line 7b The Board of McLeod Health (sole member) has final authority as needed on the makeup and decision-making of McLeod Physician Associate II's Board. Form 990, Part VI, Section B, line 11 The process the organization uses to review the Form 990 consists of providing copies of the Form 990 to the Board of Trustees of McLeod Health (Sole Member of McLeod Physician Associates II) at the May 2014 Board meeting, along with a presentation covering the Form 990 by the preparing firm, Deloitte Tax LLP, to allow for a thorough review by the Sole Member's Board before the filing date of August 15, 2014. Form 990, Part VI, Section B, line 12c McLeod Physician Associates II regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Section B, line 15 In determining compensation of McLeod Health's (sole member's) CEO and the other officers and key employees, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The governance committee reviewed and approved the CEO's compensation. In the review of compensation, the CEO, other officers, and other key employees were compared to other similarly situated organizations and positions. Individuals were not present when their compensation was determined. Form 990, Part VI, Section C, line 19 Governing documents, conflict of interest policy, and financial statements are available to the public upon request. Form 990, Part XII, Line 2a: The financial statements of McLeod Health (sole member) were audited on a consolidated basis for the fiscal year ended September 30, 2013. Community Benefit Report: Form 990, Part III, Line 4a: Nationally recognized for quality, McLeod Health is a not-for-profit regional medical center that is built on the foundation of premier technology, modern facilities, and an unsurpassed dedication to improving the lives of the patients and families it serves. For more than a century, McLeod Health (McLeod) has been the choice for medical excellence for the region. The health system covers a service area of 15 counties, encompassing nearly 11,500 square miles and a population of more than one million. The Mission of McLeod Health is to improve the overall health and well being of people living within South Carolina and eastern North Carolina by providing excellence in healthcare. McLeod has been recognized numerous times for its outstanding work in quality care, best practices, and clinically proven outcomes. Healthcare visitors from across the globe visit McLeod to share and observe best practices in quality and safety. These extensive efforts have resulted in the 2010 American Hospital Association - McKesson Quest for Quality Prize, in which McLeod was the first hospital in South Carolina to be presented with this honor since its inception. McLeod Health has also recently celebrated national recognition from Healthgrades, the leading online resource for comprehensive information about physicians and hospitals. Healthgrades selected McLeod Regional Medical Center for 23 top honors including the 2014 Distinguished Hospital Award for Clinical Excellence. This distinction places McLeod among the Top 5% of more than 4,500 hospitals nationwide for its clinical performance. Based on quality measurements, McLeod was also listed among Healthgrades' Top 100 hospitals in Cardiac Care and Surgical Care. The hospitals within McLeod include McLeod Regional Medical Center in Florence, McLeod Darlington, McLeod Behavioral Health Center, McLeod Dillon, McLeod Loris, and McLeod Seacoast. The Florence facility is the flagship of McLeod Health. This regional referral center features an accredited Cancer Center and Heart & Vascular Institute, three dedicated open-heart surgery suites as well as Centers of Excellence in Heart, Cancer, Surgery, Neurosurgery, Trauma, Children's and Women's Services as well as its Diabetes Center, Rehabilitation and Sports Medicine Services, and the Center for Advanced Surgery, which all deliver an unmatched level of care and experience to people in the region. McLeod Health also operates a Health and Fitness Center, Sports Medicine and Outpatient Rehabilitation Center, a Behavioral Health Center, Hospice, and Home Health Services. Most recently, McLeod has invested in the community by opening a Center for Intensive Care and a new Center for Cancer Treatment and Research. The McLeod Foundation also helps financially support specific programs, growth, and projects through philanthropy and grants. Sustaining critical services and offering a personal touch to each patient is accomplished every day by over 650 physicians and 6,200 employees. Currently, McLeod Regional Medical center in Florence has 453 licensed beds, and in total, McLeod Health includes 883 licensed beds for patient care. This level of care, coupled with the diverse number of services provided, allows McLeod to meet the unique and vast array of health care needs in its 15-county service area. As one of the region's largest service organizations, including physicians, nurses, and pharmacists, as well as computer technicians, environmental services workers, therapists, and other medical professionals, McLeod is also the region's largest employer. This money flows into numerous local organizations to help stimulate the region's economy each year. McLeod has prudently built and developed reserves in order to continue to grow as a mission-minded hospital committed to improving the health of people in the region. In terms of surpluses, like any business or family, a hospital must earn more than it spends to be viable and fulfill its mission. McLeod has set aside funds for the future growth needed in healthcare services. These funds are professionally managed and are in accordance with guidelines established by Standard & Poor's Financial Services for a service organization appropriate to McLeod's size and scope. Money from the operating margin is reinvested in the local economy and used for expansion or replacement of equipment, technology and facilities to meet the highest standards of care, quality and safety for patients. Improvements translate to services needed in the community, as well as access to medical care for acutely ill patients and those impacted by the state's most prevalent diseases, many of which are the highest in the nation. McLeod's projects and medical developments are consistent with the needs identified by South Carolina DHEC's State Health Plan. Every year, the McLeod Hospitals serve 150,000 patients in their emergency departments, regardless of a person's ability to pay. McLeod Health hospitals also annually diagnose or treat nearly half a million people as outpatients and care for more than 30,000 ill and surgical inpatients. The hospitals and their Emergency Departments are open 24 hours a day, seven days a week, 365 days a year. McLeod is proactively affiliating with academic institutions to address the community's healthcare needs. McLeod facilitates a Family Medicine Residency Program and sponsors Francis Marion University's bachelor of science nursing degree program as well as Florence-Darlington Technical College's associate degree nursing program. Rotations at McLeod Regional Medical Center in clinical and administrative areas are also offered to students from educational programs throughout the state. In addition, in the area of cancer research, McLeod is a member of the Southeast Cancer Control Consortium (SCCC), which is comprised of a group of community hospitals in North Carolina, South Carolina, Georgia, Virginia and Tennessee, who offer research protocols to their patients under this National Cancer Institute Sponsored Community Clinical Oncology Program. McLeod offers national state-of-the-art cancer research trials for the prevention and treatment of cancer to eligible patients in the northeastern region of South Carolina. Currently, the research department has more than 100 patients involved in cancer studies and approximately 20 to 25 protocols open that patients can participate in. As nurses are so vital to health care, the Pee Dee is very fortunate to have two excellent nursing education programs in Florence at Francis Marion University and Florence-Darlington Technical College. These two programs are the cornerstone for recruiting, retention and cultivation of exceptional nurses by McLeod and other health care providers in the region. Annually, McLeod Health donates $75,000 to both the Florence-Darlington Technical College and Francis Marion University Nursing Programs. These contributions recognize each school's nursing program for their commitment to the development of outstanding health care professionals for the Pee Dee Region. The success of the relationships with the two college nursing programs, coupled with strong recruiting efforts, has helped McLeod and other health care providers in the region improve their nursing vacancy rate considerably. In addition to this year's gifts to Francis Marion University and Florence-Darlington Technical College Nursing Programs, McLeod also offers scholarships to eligible students to assist those who need financial aid with nursing school. McLeod scholarships are available to college students who have been accepted in an accredited allied healthcare program such as nursing. McLeod Health has numerous initiatives in place to provide community benefits that promote prevention, healing, and treatment. Some of these initiatives include health education, support groups, health fairs, health screenings and immunizations, free and discounted medical supplies, research, and financial and in-kind contributions. The community outreach budget allocates approximately $250,000 across the healthcare system to sponsorships and donations to serve in civic, academic and corporate partnerships. In Fiscal Year 2013, McLeod Health provided the region with $135 Million dollars worth of Charity Care to benefit community families. McLeod Health not only provides community benefit through the services offered but also by stimulating the local economy. Last year, more than $14 Million was contributed in sales tax, approximately $665,000 in Property Taxes, and just under $15 Million in hospital provider taxes to benefit the communities where its employees and patients live and work. Community Benefit Report (Continued): Form 990, Part III, Line 4a: Healthy lifestyle promotion is also a primary focus of McLeod. Health screenings are offered to the community to check for problems with blood pressure, cholesterol, diabetes, breast cancer, skin cancer, osteoporosis, peripheral vascular disease, and stroke. In addition, nearly 100 support groups, classes, health fairs, seminars, screenings and programs are provided free or at a reduced cost to attendees seeking to learn about and deal with many medical issues. McLeod Health also works to support the services of the American Red Cross with financial support as well as through resources and blood donations made by employees during regular McLeod blood drives. According to the Red Cross, there is a critical need at national and state levels for blood, which is used in emergency situations as well as for patients with cancer, blood disorders and other illnesses. The McLeod Mobile Mammography Unit makes visits across the region to businesses and industries to reach working women where scheduling the time for a mammogram is an issue. For calendar year 2013, there were 2,461 screening mammograms completed on the Mobile Mammography Unit. Of these, 11 cases of breast cancer were diagnosed. Safe Kids Pee Dee/Coastal, led by McLeod Health, works to reduce the number of unintentional childhood injuries through a multi-faceted approach combining community action, safety events, public awareness, education, and public policy initiatives. Events and awareness programs are held regularly throughout the community, including car seat checks, bicycle rodeos, Safe Sleep classes, Injury Prevention talks, Fire Safety education through school districts, and health fairs. Childbirth preparation classes, Infant/Child CPR, Community Car Seat Safety Checks by Certified Child Passenger Safety Technicians, and SafeSitters sessions are also offered to the community. In addition, a computer located in the McLeod Resource Center is available to the public for Internet access to the most current health information. A spirit of willing and compassionate service to others is evident in the hospital's outreach efforts to the community, day-to-day operations, and long-range planning. The McLeod team of physicians, nurses, staff members, board members and volunteers are dedicated to providing the community with much more than medical care. Their commitment extends beyond the medical center's walls and into the region in an effort to build a stronger and healthier place for patients, co-workers, children and neighbors to live and work. McLeod Regional Medical Center of Pee Dee Inc 555 East Cheves Street Florence SC 295020551 570370242 To operate a healthcare system SC section 501(c)(3) Line 3: 170(b)(1)(a) N/A 0 McLeod Health Foundation 555 East Cheves Street Florence SC 295020551 570818672 To raise money for McLeod Entities SC section 501(c)(3) PF (Private Foundati N/A 0 McLeod Medical Center - Dillon 555 East Cheves Street Florence SC 295020551 510473471 To operate a healthcare system SC section 501(c)(3) Line 3: 170(b)(1)(a) N/A 0 LorisSeacoast Healthcare Foundation 555 East Cheves Street Florence SC 295020551 421704953 To raise money for McLeod Entities SC section 501(c)(3) PF (Private Foundati N/A 0 McLeod Health 555 East Cheves Street Florence SC 295020551 510473500 To operate a healthcare system SC section 501(c)(3) Line 3: 170(b)(1)(a) N/A 0 McLeod Loris Seacoast Hospital 555 East Cheves Street Florence SC 295020551 453576100 To operate a community hospital SC section 501(c)(3) Line 3: 170(b)(1)(a) N/A 0 McLeod Medical Partners LLC 4401 Barclay Down Dr STE 300 Charlotte NC 282094670 570812002 Rental SC N/A McLeod Physician Associates Inc 555 East Cheves Street Florence SC 29501 582279897 Physician Services SC N/A C 0 LorisSeacoast Healthcare Foundation 555 East Cheves Street Florence SC 295020551 421704953 To raise money for McLeod Entities SC N/A C 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0