2014-08-11T06:15:06-05:00 2013-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2012-10-01 570341194 GEORGETOWN MEMORIAL HOSPITAL GEOR 8435277100 PO DRAWER 1718 GEORGETOWN SC 294421718 BRUCE P BAILEY 8435277100 2014-08-11 1 AMY BIBBY P00445891 8282542254 2012 2015-11-30 17:44:51Z BRUCE P BAILEY PO DRAWER 1718 GEORGETOWN SC 294421718 142312123 0 X WWW.GEORGETOWNHOSPITALSYSTEM.ORG X 1946 SC TO PROVIDE HIGH QUALITY HEALTHCARE TO THE CITIZENS OF GEORGETOWN CO. AND SURROUNDING AREAS 7 5 0 106 0 0 584053 618228 129369249 137497805 4280302 2927998 1232254 1142051 135465858 142186082 118083 141150 0 0 59272409 57188357 0 72000 399991 70821991 75871615 130212483 133273122 5253375 8912960 305120886 321489492 80705840 69065114 224415046 252424378 X GEORGETOWN HOSPITAL SYSTEM IS COMMITTED TO PROVIDING HIGH QUALITY HEALTHCARE TO THE CITIZENS OF GEORGETOWN COUNTY AND SURROUNDING AREAS. OUR MISSION IS TO CONTINUOUSLY IMPROVE THE CARE WE ARE ABLE TO RENDER TO EXCEED THE EXPECTATIONS OF OUR PATIENTS AND CUSTOMERS. 0 0 114639942 141150 137479514 GEORGETOWN MEMORIAL HOSPITAL PROVIDES QUALITY HEALTH CARE AND PROMOTES HEALTH AND WELLNESS TO GEORGETOWN COUNTY AND SURROUNDING AREAS. GEORGETOWN MEMORIAL HOSPITAL IS A 131 BED ACUTE FACILITY LOCATED IN THE CITY OF GEORGETOWN, SOUTH CAROLINA. THE HOSPITAL WAS ORGANIZED UNDER THE LAWS OF THE STATE OF SOUTH CAROLINA IN 1946 FOR THE PURPOSE OF OPERATING A COMMUNITY HOSPITAL IN GEORGETOWN COUNTY. THE HOSPITAL WAS CREATED FOR THE PURPOSE OF PROMOTING HEALTH FOR ALL RESIDENTS OF GEORGETOWN COUNTY AND ITS OUTLYING AREAS. THE PROMOTION OF HEALTH HAS BEEN ESTABLISHED AS A CHARITABLE PURPOSE UNDER INTERNAL REVENUE CODE (IRC) SECTION 501 (C)(3). REVENUE RULING 69-545, 1969-2 C.B. 117, AS MODIFIED BY REV. RUL. 83-157, 1983-2 C.B. 94, SETS FORTH THE FACTORS THE INTERNAL REVENUE SERVICES WILL CONSIDER IN DETERMINING WHETHER A NONPROFIT HOSPITAL QUALIFIED FOR TAX EXEMPT STATUS.THE HOSPITAL OPERATES ITS FACILITIES IN A MANNER DESCRIBED IN REV. RUL. 69-545, SUPRA. THE HOSPITAL HAS A BOARD OF TRUSTEES COMPOSED OF INDEPENDENT CIVIC LEADERS AND PHYSICIANS. AN OPEN MEDICAL STAFF IS MAINTAINED BY THE HOSPITAL, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS. ALSO, THE HOSPITAL PROVIDES EMERGENCY AND NON-EMERGENCY CARE TO ANYONE REGARDLESS OF THEIR ABILITY TO PAY, EITHER DIRECTLY OR THROUGH THIRD PARTY REIMBURSEMENT, INCLUDING MEDICARE AND MEDICAID.DURING THE YEAR ENDED SEPTEMBER 30, 2013, THE HOSPITAL FURNISHED CHARITY CARE IN THE AMOUNT OF $13,435,675. IN ADDITION TO PROVIDING PATIENT CHARITY CARE, AND IN FURTHERANCE OF ITS EXEMPT PURPOSE TO BENEFIT THE COMMUNITY, THE HOSPITAL PROVIDES CAR SEATS TO FAMILIES AND NEWBORN INFANTS WHO DO NOT PRESENTLY HAVE OR CANNOT AFFORD TO PURCHASE ONE. IN ADDITION, THE HOSPITAL PROVIDES FREE TAXI SERVICE THROUGH AN AUXILIARY ORGANIZATION FOR INDIVIDUALS THAT CANNOT AFFORD OR ARRANGE FOR TRANSPORTION TO THEIR RESIDENCE. THE HOSPITAL ALSO PARTICIPATES IN STATE PROGRAMS SUCH AS THE BEST CHANCE NETWORK, WHICH TARGETS LOW-INCOME WOMEN FOR PREVENTATIVE HEALTHCARE TESTING.THE HOSPITAL IS PART OF THE GEORGETOWN HOSPITAL SYSTEM WHICH PERIODICALLY CONDUCTS VARIOUS COMMUNITY OUTREACH, SCREENING, AND EDUCATIONAL PROGRAMS. AMONG THESE ARE CHOLESTEROL AND BLOOD PRESSURE SCREENINGS, PERIODIC HEALTH FAIRS HELD THROUGHOUT THE SERVICE AREA WHICH OFFER A VARIETY OF HEALTH-RELATED INFORMATION AND SCREENINGS, SUCH AS GLUCOSE, CHOLESTEROL, BLOOD PRESSURE, BODY FAT ANALYSIS, AND A LABORATORY BLOOD PROFILE. THE HOSPITAL SYSTEM'S COMMUNITY EDUCATION PROGRAM CONDUCTS A VARIETY OF CLASSES AND LECTURE OPEN TO THE PUBLIC, INCLUDING CPR, WEIGHT CONTROL, SMOKING CESSATION, CHILDBIRTH EDUCATION, PRE-NATAL AND INFANT NUTRITION, AND OTHERS. 114639942 1 1 0 1 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 0 0 0 1 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 X 112 0 1 0 0 0 0 0 0 1 1 0 0 0 0 X 7 5 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 SC X X TERRY KISER 8435277100 606 BLACK RIVER RD GEORGETOWN SC 29440 H MCROY SKIPPER 1.00 2.00 X X 450 0 0 ALAN S ALTMAN 1.00 2.00 X X 0 0 0 JULIAN A REYNOLDS JR 1.00 2.00 X X 600 0 0 WALTER F JOHNSON III 1.00 2.00 X 100 0 0 FRANCIS B FORD JR 1.00 2.00 X 150 0 0 MARTHENA MORANT 1.00 2.00 X 450 0 0 MARK NASH 1.00 2.00 X 0 0 0 VICTOR DIAZ-GONZALEZ 1.00 2.00 X 10763 0 0 BRUCE BAILEY 19.00 21.00 X 265418 307838 63044 TERRY KISER 19.00 21.00 X 186162 215915 35609 GAYLE RESETAR 19.00 21.00 X 179691 208412 36694 RICK KAYLOR 19.00 21.00 X 130944 151872 19461 ROY E GILBREATH III 19.00 21.00 X 190976 221499 27974 ANN L WATERS 34.00 6.00 X 202751 35779 20873 JAMES F HARPER 22.00 18.00 X 129262 103349 37643 FRANK SCAFIDI 19.00 21.00 X 100213 116229 32681 SUZANNE C DOSCHER 20.00 20.00 X 102121 102121 22136 1500051 1463014 296115 46 0 1 1 COASTAL STRUCTURES CORPORATION PO BOX 937 GEORGETOWN SC 29442 CONSTRUCTION 3111018 PALMETTO EMERGENCY PHYSICIANS 86 SHOREBIRD LOOP PAWLEYS ISLAND SC 29585 ER PHYSICIANS 2964482 SODEXHO PO BOX 536922 ATLANTA GA 30353 FOOD SERVICE 2682260 EAGLE HOSPITAL PHYSICIANS 16000 N DALLAS PKWY STE 450 DALLAS TX 75248 HOSPITALISTS 2444612 ARAMARK HEALTHCARE (SERVICE MASTER) 22506 NETWORK PLACE CHICAGO IL 60673 HOUSEKEEPING 2308609 40 127833 490395 618228 NET PATIENT SERVICE REVENUE 621400 131808749 131808749 EHR INCENTIVE PAYMENT 900099 1754116 1754116 FITNESS CENTER 900099 1730880 1730880 PHARMACY 446110 1116202 1116202 OTHER RELATED SERVICES 900099 620059 620059 467799 467799 137497805 2446628 2446628 1119753 0 1119753 1119753 1119753 441979 39391 0 0 441979 39391 481370 481370 30178 127833 68450 -38272 -38272 78703 57591 21112 21112 DISCOUNTS/REBATES 900099 39458 39458 39458 142186082 137497805 0 4070049 141150 141150 844654 10763 833891 50648 50648 43053794 34748854 8088259 216681 1217011 979349 231564 6098 8915562 7174505 1696385 44672 3106688 2500005 591117 15566 510187 510187 1644559 1644559 57678 57678 72000 72000 3177915 2668042 480688 29185 520189 15536 504653 6625459 5090547 1522605 12307 2031009 2004917 26092 529232 251282 274468 3482 1226786 1226786 9812025 9812025 515572 515572 MEDICAL SUPPLIES 24861643 24861643 BAD DEBT EXPENSE 22967293 22967293 RECRUITMENT 818670 818670 MISCELLANEOUS EXPENSE 573398 136597 436801 133273122 114639942 18233189 399991 3990 3590 43098435 39693814 15780544 16071701 4885164 4786449 2509292 3475186 223946963 124821460 93345858 99125503 104646377 117205718 36636283 35864762 583838 533838 3631105 4728931 305120886 321489492 17396990 17753385 44964785 43790928 18344065 7520801 80705840 69065114 X 223443605 251377746 971441 1046632 224415046 252424378 305120886 321489492 X 8912960 10230999 8865373 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 1 50 0 0 0 0 1 4153 4203 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE HOSPITAL IS A MEMBER OF BOTH THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE SOUTH CAROLINA HOSPITAL ASSOCIATION (SCHA). THESE ORGANIZATIONS ENGAGE IN LOBBYING FOR THE BENEFIT OF THEIR MEMBERSHIP BODIES, AND A PORTION OF THE MEMBERSHIP DUES PAID TO THE ORGANIZATIONS IS ATTRIBUTABLE TO LOBBYING EXPENDITURES. FOR THE YEAR, THE PORTION OF DUES ATTRIBUTABLE TO LOBBYING EXPENDITURES WAS $1,273 FOR AHA AND $2,880 FOR SCHA. 2010666 17223678 19234344 93870511 42112060 51758451 2985936 2332614 653322 100363019 80376786 19986233 7493153 7493153 99125503 DUE FROM AFFILIATE 35864762 C 35864762 ACCRUED PENSION LIABILITY 7520801 7520801 X 129518238 10230999 -22967293 -12736294 142254532 -68450 -68450 142186082 110374279 68450 68450 110305829 22967293 22967293 133273122 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: GEORGETOWN MEMORIAL HOSPITAL HAS BEEN GRANTED EXEMPTION FROM INCOME TAXES AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. ACCORDINGLY, THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A PROVISION FOR INCOME TAXES. THE HOSPITAL HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2013. FISCAL YEARS ENDING ON OR AFTER SEPTEMBER 30, 2010 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT NET WITH REVENUE -22,967,293. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES NET WITH REVENUE -68,450. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES NET WITH REVENUE 68,450. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET WITH REVENUE 22,967,293. X X X X 1 PRIDE PHILANTHROPY 885 WOODSTOCK RD STE 430 ROSWELL GA 300752374 CAPITAL CAMPAIGN 0 500678 72000 428678 500678 72000 428678 BREAST CANCER AWARENESS WALK & DUCK 58471 58471 302 14660 CIRCUS UNDER THE STARS GALA 56650 39037 17613 14930 1600 9068 2 42890 30325 12565 1336 12062 2495 11997 158011 127833 30178 1336 12062 17425 1902 35725 68450 -38272 1 1 X 1 X 1 X 1 1 0 1 1 4301942 833759 3468183 0.03140 15385501 12631550 2753951 0.02500 19687443 13465309 6222134 0.05640 552767 552767 0.00500 124516 124516 0.00110 182439 39355 143084 0.00130 859722 39355 820367 0.00740 20547165 13504664 7042501 0.06380 782489 782489 0.00710 782489 782489 0.00710 0 6444875 4177023 38790609 41339817 -2549208 X 1 1 1 1 GEORGETOWN MEMORIAL HOSPITAL

606 BLACK RIVER ROAD GEORGETOWN SC 29440

X X X DISPROPORTIONATE SHARE HOSPITAL GEORGETOWN MEMORIAL HOSPITAL 1 1 X X X X X X X X X 12 1 1 1 X X X X X X X X X X 1 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X 1 1 X X X X X 1 X 0 1 X 0 0 12 NEXTSTEP REHABILITATION & PAIN MANAGEMEN

219 CHURCH STREET GEORGETOWN SC 29440

ADULT REHAB/PAIN MGMT HEALTHPOINT CENTER FOR HEALTH & FITNESS

12965 OCEAN HIGHWAY PAWLEYS ISLAND SC 29585

FITNESS CLUB/ADULT REHAB NEXTSTEP REHABILITATION SERVICES

3515 CADUCEUS DRIVE MYRTLE BEACH SC 29588

ADULT & PEDIATRIC REHAB NEXTSTEP REHABILITATION SERVICES

4040 HWY 17 SUITE 201 MURRELLS INLET SC 29576

ADULT REHABILITATION NEXTSTEP REHABILITATION SERVICES

4033 HWY 17 SUITE 102 MURRELLS INLET SC 29576

NEUROLOGICAL REHABILITATION NEXTSTEP REHABILITATION SERVICES

701 S MORGAN AVE ANDREWS SC 29510

ADULT REHABILITATION NEXTSTEP REHABILITATION SERVICES

407 CHURCH ST SUITE E GEORGETOWN SC 29440

PEDIATRIC REHABILITATION GEORGETOWN INFUSION SERVICES MURRELS

4181 HIGHWAY 17 BYPASS MURRELLS INLET SC 29576

INFUSION SERVICES GEORGETOWN INFUSION SERVICES GEORGETOWN

2405 NORTH FRASER ST GEORGETOWN SC 29440

INFUSION SERVICES GEORGETOWN ENDOSCOPY CENTER

2361 NORTH FRASER ST GEORGETOWN SC 29440

ENDOSCOPY CENTER NEXTSTEP REHABILITATION SERVICES

106 WACCAMAW MEDICAL PARK COURT CONWAY SC 29526

ADULT REHABILITATION NEXTSTEP REHABILITATION SERVICES

3650 COALITION DRIVE MYRTLE BEACH SC 29588

ADULT REHABILITATION PART I, LINE 6A: THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT AND DISTRIBUTES TO RESIDENTS OF THE SURROUNDING COUNTIES. THE REPORT OFFERS STATISTICAL, FINANCIAL AND INFORMATIONAL DATA, TARGETED TO PORTRAY THE VITAL COMMITMENT THE ORGANIZATION HAS TO THE COMMUNITY. THE REPORT IS MAILED TO HOMES THROUGHOUT THE COMMUNITY AND CAN BE ACCESSED BY VISITING OUR WEBSITE AT WWW.GEORGETOWNHOSPITALSYSTEM.ORG. PART I, LINE 7: THE ORGANIZATION USED WORKSHEET 2 OF THE 2012 SCHEDULE H INSTRUCTIONS TO COMPUTE A COST-TO-CHARGES RATIO USED TO CALCULATE CHARITY CARE AND UNREIMBURSED MEDICAID AT COST. PART I, L7 COL(F): TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25 CONTAINS A BAD DEBT EXPENSE OF $22,967,293 THAT HAS BEEN REMOVED FOR PURPOSES OF COMPUTING PERCENTAGE OF TOTAL EXPENSE ON COLUMN (F). PART II: IN ADDITION, $782,000 WAS SPENT TO RECRUIT PHYSICIANS WITH THE SKILLS AND TRAINING NECESSARY TO BEST SERVE THE NEEDS OF THE COMMUNITY IN AREAS SUCH AS ORTHOPEDICS, FAMILY AND INTERNAL MEDICINE, PEDIATRICS, NEUROLOGY, AND SURGERY. PART III, LINE 4: THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE ON BAD DEBT EXPENSE.WORKSHEET 2 OF THE 2012 SCHEDULE H INSTRUCTIONS WAS USED TO COMPUTE A COST-TO-CHARGES RATIO USED TO CALCULATE BAD DEBT EXPENSE AT COST FOR PURPOSES OF LINE PART III, LINES 2 AND 3.THE PERCENTAGE OF FAMILIES BELOW THE POVERTY LEVEL IN THE AREA SERVED IS USED TO ESTIMATE THE PERCENTAGE OF NET REVENUE EXPECTED TO BE AWARDED CHARITY CARE. THE VARIANCE WITH ACTUAL CHARITY CARE ADJUSTMENTS IS THE AMOUNT OF THE ORGANIZATION'S BAD DEBT ATTRIBUTED TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. PART III, LINE 8: THE MEDICARE COST REPORT WAS USED TO CALCULATE THE OVERALL SHORTFALL. THE ORGANIZATION BELIEVES THE ENTIRE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT. APPROXIMATELY 50% OF THE ORGANIZATION'S PAYER MIX IS DEVOTED TO MEDICARE. PART III, LINE 9B: GEORGETOWN HOSPITAL SYSTEM HAS A PROCESS IN PLACE TO ASSIST PATIENTS IN UNDERSTANDING THEIR FINANCIAL RESPONSIBILITY, BEGINNING WITH SCHEDULING AND REGISTRATION. SIGNAGE AND FINANCIAL RESPONSIBILITY BROCHURES ARE CLEARLY DISPLAYED THROUGHOUT THE REGISTRATION AREAS OF THE SYSTEM. THIS INFORMATION DETAILS THE POTENTIAL PATIENT RESPONSIBILITY AND ALSO PROVIDES INFORMATION ON THE AVAILABLE PROGRAMS IN THE EVENT THE PATIENT CAN NOT PAY THE BILL. IF THE PATIENT COMMUNICATES THEIR INABILITY TO PAY, THE FINANCIAL ASSISTANCE PROGRAM IS REVIEWED AND THE PATIENT IS DIRECTED TO THE FINANCIAL ASSISTANCE DEPARTMENT. COLLECTION PRACTICES WILL CONTINUE AS NORMAL UNTIL THE PATIENT PROVIDES ALL NECESSARY PAPERWORK TO BE OFFICIALLY CONSIDERED FOR FINANCIAL ASSISTANCE. ONCE FINANCIAL ASSISTANCE IS GRANTED, COLLECTION PRACTICES WILL EITHER CEASE, OR CONTINUE AT A REDUCED PATIENT RESPONSIBILITY. GEORGETOWN MEMORIAL HOSPITAL PART V, SECTION B, LINE 3: GEORGETOWN MEMORIAL HOSPITAL FACILITY TOOK INTO ACCOUNT THE REPRESENTATION OF GEORGETOWN COMMUNITY CARE NETWORK AND THE ASSOCIATED COMMUNITY CARE NETWORKS: ST. JAMES-SANTEE FQHCTHE SMITH MEDICAL CLINICAREA PRIMARY CARE PHYSICIANSHORRY-GEORGETOWN TECHNICAL COLLEGE DENTAL CLINICHELPING HANDSFRIENDSHIP PLACESALVATION ARMYHABITAT FOR HUMANITYGEORGETOWN HOUSING AUTHORITYDIABETES CORE GROUPHEALTHY LEARNERSWACCAMAW CENTER FOR MENTAL HEALTHTHE S.C. DEPARTMENT OF SOCIAL SERVICES GEORGETOWN AND HORRY COUNTY HEALTH DEPARTMENTSTHE BUNNELLE FOUNDATIONTHE WACCAMAW COMMUNITY FOUNDATIONGEORGETOWN COUNTY UNITED WAYWELLVISTANEIGHBOR TO NEIGHBORIN ADDITION THE FACILITY USED AN INTERNET-BASED SURVEY TO IDENTIFY POTENTIAL COMMUNITY NEEDS FROM LOCAL EXPERTS WITH AN ASSOCIATED RANKING OF THOSE POTENTIAL NEEDS. GEORGETOWN MEMORIAL HOSPITAL PART V, SECTION B, LINE 4: WACCAMAW COMMUNITY HOSPITAL PART VI, LINE 2: THE ORGANIZATION ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY WITH THE ASSISTANCE OF STATE AND INTERNAL REPORTING INFORMATION. THE INFORMATION IS INTERPRETED, REVIEWED AND ANALYZED. IF A NEED IS PRESENT, A STRATEGIC PLAN IS DEVELOPED, WITH THE GOAL OF PROVIDING AS MANY LOCAL SERVICES AS POSSIBLE. THE PLAN IS THEN PRESENTED TO THE BOARD FOR APPROVAL. ONCE BOARD APPROVAL IS RECEIVED, THE IMPLEMENTATION PROCESS BEGINS. THE ORGANIZATION'S COMMUNITY HEALTH PROGRAM'S OBJECTIVE IS TO ENHANCE THE HEALTH CARE STATUS OF THE COMMUNITY, PROVIDING EDUCATION, SCREENINGS, AND REGULAR FOLLOW UP TO ENSURE READY ACCESS TO QUALITY HEALTHCARE. PART VI, LINE 3: THE ORGANIZATION REGULARLY ADVERTISES THE AVAILABLE STATE, FEDERAL, AND LOCAL FINANCIAL ASSISTANCE PROGRAMS. ALL PATIENTS ARE EDUCATED AT THE TIME OF REGISTRATION ON FINANCIAL ASSISTANCE PROGRAMS AVAILABLE. IN ADDITION, ALL PATIENTS WITHOUT INSURANCE ARE SCREENED FOR AVAILABLE STATE AND FEDERAL PROGRAMS. PATIENTS NOT MEETING STATE AND FEDERAL PROGRAM GUIDELINES ARE PROVIDED A ONE-ON-ONE CONSULTATION FOR LOCAL FINANCIAL ASSISTANCE, IF DESIRED. THE HOSPITAL FEATURES SIGNAGE AND BROCHURES THROUGHOUT THE REGISTRATION AREAS THAT OUTLINE RESPONSIBILITIES AND OPTIONS. PART VI, LINE 4: THE ORGANIZATION SERVES THE SOUTH CAROLINA COUNTIES OF HORRY AND GEORGETOWN, AS WELL AS OUTLYING AREAS. HORRY COUNTY (1,100 SQ. MILES) HAS AN ESTIMATED 2013 POPULATION OF 290,000. 19% OF THE POPULATION IS OVER THE AGE OF 65 AND THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $42,000. IN ADDITION, AN ESTIMATED 18% OF THE POPULATION IS BELOW THE POVERTY LEVEL. GEORGETOWN COUNTY (815 SQ. MILES) HAS A POPULATION OF APPROXIMATELY 60,000 PEOPLE AND AN ESTIMATED 22% OF THE POPULATION IS OVER THE AGE OF 65. THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $42,000 AND AN ESTIMATED 20% OF THE POPULATION IS BELOW THE POVERTY LEVEL. COMPETING HOSPITALS ARE LOCATED APPROXIMATELY 40-45 NORTH AND NORTHWEST AND 60 MILES SOUTH. MAJOR SURROUNDING CITIES INCLUDE: CHARLESTON, SC (60 MILES), COLUMBIA, SC (150 MILES) AND CHARLOTTE, NC (215 MILES). PART VI, LINE 5: A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR MANY OF ITS DEPARTMENTS.USAGE OF THE ORGANIZATION'S SURPLUS OF FUNDS IS DESCRIBED ON FORM 990, PART III; HOWEVER IN GENERAL, A SURPLUS OF FUNDS IS USED TO REINVEST IN PROPERTY AND EQUIPMENT IN ORDER TO CONTINUE PROVIDING TO THE PUBLIC THE BEST IN PATIENT CARE AND TECHNOLOGY. PART VI, LINE 6: GEORGETOWN MEMORIAL HOSPITAL IS PART OF GEORGETOWN HOSPITAL SYSTEM. GEORGETOWN HOSPITAL SYSTEM IS A RELATED 501(C)(3) HEALTHCARE ORGANIZATION. REPORTS FILED WITH STATES PART VI, LINE 7 SC 1 AMERICAN CANCER SOCIETY 950 48TH AVE N SUITE 101 MYRTLE BEACH SC 29577 131788491 501(C)(3) 5000 OPERATIONAL SUPPORT AMERICAN HEART ASSOCIATION (MID-ATLANTIC AFFILIATE) 4217 PARK PLACE COURT GLEN ALLEN VA 23060 135613797 501(C)(3) 11000 OPERATIONAL SUPPORT CARVERS BAY SCHOOL ALL SPORTS BOOSTER CLUB 13002 CHOPEE ROAD HEMINGWAY SC 29554 GOVT 5000 OPERATIONAL SUPPORT GEORGETOWN COUNTY UNITED WAY PO BOX 1065 GEORGETOWN SC 29442 570526145 501(C)(3) 5000 OPERATIONAL SUPPORT HEALTHY LEARNERS PROGRAM 2749 LAUREL STREET COLUMBIA SC 29204 571127197 501(C)(3) 50000 OPERATIONAL SUPPORT MARCH OF DIMES FOUNDATION 608 16TH AVE NORTH STE F MYRTLE BEACH SC 29577 131846366 501(C)(3) 5000 OPERATIONAL SUPPORT SMITH MEDICAL CLINIC PO BOX 1740 PAWLEYS ISLAND SC 29585 570786699 501(C)(3) 39000 OPERATIONAL SUPPORT WACCAMAW HIGH SCHOOL ATHLETICS 2412 KINGS RIVER RD PAWLEYS ISLAND SC 29585 GOVT 6150 OPERATIONAL SUPPORT THE ASHLEY G CHARITABLE FOUNDATION PO BOX 14 PAWLEYS ISLAND SC 29585 262115367 501(C)(3) 5000 OPERATIONAL SUPPORT COASTAL EDUCATIONAL FOUNDATION PO BOX 261954 CONWAY SC 29528 570354696 501(C)(3) 5000 OPERATIONAL SUPPORT GEORGETOWN HIGH SCHOOL ATHLETICS 25000 ANTHUAN MAYBANK DR GEORGETOWN SC 29440 GOVT 5000 OPERATIONAL SUPPORT 11 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION SELECTS GRANT RECIPIENTS BASED ON COMMUNITY NEEDS AND INDIVIDUAL PROJECT MERIT. FOLLOW-UP ON GRANTS AND ASSISTANCE VARIES DEPENDING ON THE TYPE OF ASSISTANCE AND TYPE OF PROJECT. MANY SMALLER GRANTS ARE PROVIDED FOR LOCAL SCHOOLS AND PUBLIC CHARITIES BASED ON A DEMONSTRATED NEED FOR OPERATIONAL FUNDS AND REQUIRE NO MONITORING. LARGER GRANTS, REQUIRE PRE-ESTABLISHED PROJECT MILESTONES TO BE REACHED BEFORE EACH DISBURSEMENT OF THE GRANT IS PAID OUT. 0 0 0 1 1 1 1 0 0 BRUCE BAILEY 175863 203971 55971 64916 33584 38951 4051 4699 25138 29156 294607 341693 0 0 TERRY KISER 132122 153238 40095 46503 13945 16174 4051 4699 12436 14423 202649 235037 0 0 GAYLE RESETAR 132752 153970 38777 44975 8162 9467 4051 4699 12938 15006 196680 228117 0 0 RICK KAYLOR 88782 102971 27518 31916 14644 16985 4584 5316 4427 5134 139955 162322 0 0 ROY E GILBREATH III 143200 166088 29028 33667 18748 21744 4584 5316 8368 9706 203928 236521 0 0 ANN L WATERS 136466 24082 31648 5585 34637 6112 7924 1398 9818 1733 220493 38910 0 0 JAMES F HARPER 86124 68859 20746 16587 22392 17903 5094 4073 15824 12652 150180 120074 0 0 FRANK SCAFIDI 72379 83947 11973 13886 15861 18396 3908 4533 11223 13017 115344 133779 0 0 SUZANNE C DOSCHER 79577 79577 15227 15227 7317 7317 3577 3577 7491 7491 113189 113189 0 0 PART I, LINE 5 INCENTIVE COMPENSATION PAID TO THE OFFICERS AND OTHER ADMINISTRATORS OF THE ORGANIZATION IS CONTINGENT UPON QUALITY INDICATORS, NET REVENUES, AND THE OVERALL PROFITABILITY OF THE ORGANIZATION. IF PREDETERMINED GOALS ARE MET, INCENTIVE COMPENSATION IS PAID TO THE OFFICER OR ADMINISTRATOR IN ACCORDANCE WITH AN INCENTIVE COMPENSATION PROGRAM. SEE PART II, COLUMN (B)(II). PART I, LINE 6 SEE THE RESPONSE TO LINE 5A AND 5B. SUPPLEMENTAL INFORMATION PART III PART I, LINE 3: THE ORGANIZATION RELIES ON THE BOARD OF ITS SOLE MEMBER ORGANIZATION TO NEGOTIATE AND ESTABLISH THE COMPENSATION AGREEMENTS FOR ITS CEO AND OTHER OFFICERS. THE BOARD OF GEORGETOWN HOSPITAL SYSTEM USES THE FOLLOWING METHODS TO DETERMINE COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANTS - COMPENSATION STUDY/SURVEY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE BOARD OF GEORGETOWN HOSPITAL SYSTEM IS A MAJORITY INDEPENDENT. PART II, COMPENSATION FROM UNRELATED ORGANIZATION: COMPENSATION PAID TO BRUCE BAILEY, TERRY KISER, SUZANNE DOSCHER, AND GAYLE RESETAR WAS PAID THROUGH QUORUM HEALTH RESOURCES (QHR), AN UNRELATED MANAGEMENT COMPANY. SEE THE RESPONSE TO PART VI, LINE 3 ON SCHEDULE O FOR DETAILS ON THE ARRANGEMENT. ALL AMOUNTS LISTED ON SCHEDULE J, PART II, LINE (I AND II) FOR EACH INDIVIDUAL ARE FROM QHR, EXCEPT FOR SMALL AUTOMOTIVE STIPENDS PAID DIRECTLY BY THE ORGANIZATION. IN ADDITION, BRUCE BAILEY, TERRY KISER, GAYLE RESETAR, RICK KAYLOR, ROY GILBREATH, JAMES HARPER, FRANK SCAFIDI, ANN WATERS, AND SUZANNE DOSCHER ARE COMPENSATED BY A COMMON PAYING AGENT FOR SERVICES PERFORMED FOR BOTH GEORGETOWN MEMORIAL HOSPITAL AND A RELATED ORGANIZATION. COMPENSATION FOR THESE INDIVIDUALS IS PRESENTED TO REFLECT AN ALLOCATION OF SERVICES PERFORMED FOR THESE ORGANIZATIONS. A SC JOBS - ECONOMIC DEVELOPMENT AUTHORITY 570960018 2010-12-22 30000000 CAPITAL ACQUISITION 0 0 0 B SC JOBS - ECONOMIC DEVELOPMENT AUTHORITY 570960018 2011-09-22 25565000 CURRENT REFUNDING 0 0 0 C SC JOBS - ECONOMIC DEVELOPMENT AUTHORITY 570960018 2011-12-22 12165620 CURRENT REFUNDING 0 0 0 D SC JOBS - ECONOMIC DEVELOPMENT AUTHORITY 570960018 2012-05-30 34099717 CURRENT REFUNDING 0 0 0 A 361305 10000000 82807 9917193 2012 0 0 1 1 B 1652964 9350748 94698 46050 9210000 2001 1 0 1 1 C 12190000 123522 12066478 1999 1 0 1 1 D 14664291 163692 345599 14155000 2001 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 1 0 1 0 0 0 0 B 0 0 1 0 0 0 0 0 0 C 0 0 1 0 1 0 0 0 0 D 0 0 1 0 0 0 0 0 0 A 0 B 0 C 0 D 0 FORM 990, SCH K, PART II, LINE 11 THE AMOUNTS ON THIS LINE WERE USED TO REFUND PRIOR ISSUE BONDS. THE AMOUNTS IN COLUMN B WERE USED TO REFUND BONDS THAT WERE ISSUED ON 8/15/1999 AND 8/1/2001. THE AMOUNTS IN COLUMN C WERE USED TO REFUND BONDS THAT WERE ISSUED ON 3/15/1998 AND 8/15/1999. THE AMOUNTS IN COLUMN D WERE USED TO REFUND BONDS THAT WERE ISSUED ON 3/15/1998 AND 8/23/2001. BEVERLY SUE SKIPPER FAMILY MEMBER OF BOARD TRUSTEE H. MCROY SKIPPER 28390 COMPENSATION AS EMPLOYEE OF ORGANIZATION. AMOUNT SHOWN ON SCHEDULE L REPRESENTS GMH'S ALLOCATED PORTION OF TOTAL SALARY PAID FROM A RELATED ORGANIZATION. THE INDIVIDUAL RECEIVED $61,317 IN TOTAL FOR SERVICES RENDERED TO ALL RELATED ORGANIZATIONS. 0 BECCA KAYLOR FAMILY MEMBER OF OFFICER RICK KAYLOR 22258 COMPENSATION AS EMPLOYEE OF ORGANIZATION. AMOUNT SHOWN ON SCHEDULE L REPRESENTS GMH'S ALLOCATED PORTION OF TOTAL SALARY PAID FROM A RELATED ORGANIZATION. THE INDIVIDUAL RECEIVED $48,074 IN TOTAL FOR SERVICES RENDERED TO ALL RELATED ORGANIZATIONS. 0 EMPLOYEES REPORTED ON FORM W-3: FORM 990, PART V, LINE 2A: THE ORGANIZATION HAS NO DIRECT EMPLOYEES. GEORGETOWN HOSPITAL SYSTEM, A RELATED ORGANIZATION, FILES PAYROLL FOR THE ORGANIZATION. THE NUMBER OF EMPLOYEES REPORTED BY GEORGETOWN HOSPITAL SYSTEM THAT ARE RELATED TO THE ORGANIZATION IS 995. FORM 990, PART VI, SECTION A, LINE 1 THE ORGANIZATION HAS AN EXECUTIVE COMMITTEE, FINANCE COMMITTEE, AND COMPENSATION COMMITTEE THAT HAVE LIMITED POWERS DELEGATED FROM THE FULL VOTING BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE IS COMPRISED OF FIVE OR MORE MEMBERS, INCLUDING FOUR WHO ARE ALSO MEMBERS OF THE MEMBER ORGANIZATION'S BOARD OF DIRECTORS. THE FINANCE COMMITTEE CONTAINS FOUR OR MORE MEMBERS INCLUDING THE TREASURER OF THE MEMBER ORGANIZATION. THE COMPENSATION COMMITTEE IS AS APPOINTED BY THE CHAIRMAN OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 3 THE BOARD OF DIRECTORS HAS ENTERED A MANAGEMENT AGREEMENT WITH QUORUM HEALTH RESOURCES TO PROVIDE KEY MANAGEMENT EMPLOYEES FOR THE ORGANIZATION. THE CEO, CFO, AND COO ARE EMPLOYEES OF QUORUM AND ARE COMPENSATED DIRECTLY BY THAT ORGANIZATION. THE QUORUM EMPLOYEES ARE ACCOUNTABLE TO THE BOARD OF DIRECTORS OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A MEMBER ORGANIZATION WITHIN THE MEANING OF THE SOUTH CAROLINA NONPROFIT CORPORATION ACT OF 1994. THE SOLE MEMBER OF THE CORPORATION IS GEORGETOWN HOSPITAL SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS THE SOLE AUTHORITY TO APPOINT OR REMOVE A TRUSTEE OR THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS THE SOLE AUTHORITY TO (1) DIRECT HEALTHCARE SERVICES UNDERTAKEN BY THE ORGANIZATION, INCLUDING THE ADDITION OR DELETION OF CLINICAL SERVICE LINES, AND AUDIT COMPLIANCE WITH SUCH DIRECTIVES, (2) VETO POLICIES AND PROCEDURES, (3) REQUIRE DISTRIBUTION OF INCOME, ASSETS, OR OTHER PROPERTY FROM, OR MAKE CONTRIBUTIONS TO THE ORGANIZATION TO ACHIEVE THE MUTUAL OBJECTIVES OF THE ORGANIZATION AND THE SOLE MEMBER, (4) APPROVE BUDGETS, (5) AUTHORIZE CAPITAL TRANSACTIONS, (6) ADOPT A PLAN OF DISSOLUTION, (7) ADMIT NEW MEMBERS TO THE ORGANIZATION, (8) AMEND THE ARTICLES OF THE ORGANIZATION, AND (9) NEGOTIATE AND AUTHORIZE MANAGEMENT AGREEMENTS WITH THIRD PARTIES. FORM 990, PART VI, SECTION B, LINE 11 THE RETURN WAS PREPARED BY AN OUTSIDE ACCOUNTING FIRM WITH THE ASSISTANCE AND OVERSIGHT OF MANAGEMENT. A REPRESENTATIVE OF THE ACCOUNTING FIRM PRESENTED THE RETURN TO THE FINANCE COMMITTEE WITH MANAGEMENT AND ANSWERED QUESTIONS FROM BOARD MEMBERS. THE CEO AND CFO THEN REVIEWED THE FORM WITH ALL BOARD MEMBERS, AS EVIDENCED IN THE BOARD MINUTES. A COPY OF THE RETURN WAS PROVIDED TO EACH VOTING BOARD MEMBER. AFTER A DISCUSSION PERIOD, THE BOARD VOTED TO APPROVE THE FILING OF THE FORM 990 WITH THE IRS AS PRESENTED. THE CFO/CEO MET IN PERSON WITH ANY MEMBERS ABSENT FROM THE MEETING TO DISCUSS THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY WHICH IS REVIEWED, ACCEPTED, AND SIGNED BY EACH OFFICER AND VOTING BOARD MEMBER ON AN ANNUAL BASIS. PURSUANT TO THIS POLICY, EACH OFFICER AND BOARD MEMBER WILL RECUSE HIMSELF OR HERSELF FROM ANY DISCUSSIONS AND VOTES FOR WHICH A CONFLICT EXISTS. DETERMINATION OF WHETHER A CONFLICT EXISTS IS MADE AT A MANAGEMENT, BOARD MEMBER, OFFICER, AND INDIVIDUAL LEVEL. ACTUAL CONFLICTS ARE REVIEWED BY MANAGEMENT AND THE BOARD WITHOUT THE PRESENSE OF THE INTERESTED PARTY. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USES OUTSIDE AGENCIES TO ESTABLISH, ASSESS THE REASONABLENESS OF, REVIEW, AND APPROVE THE COMPENSATION OF DIRECTORS AND KEY MANAGEMENT. THE INDIVIDUAL COMPENSATION PACKAGE OF EACH PERSON IS BASED ON COMPARABILITY FACTORS INCLUDING, BUT NOT LIMITED TO, THE SIZE OF THE ORGANIZATION, THE GEOGRAPHICAL LOCATION OF THE ORGANIZATION, AND THE EMPLOYEE'S LENGTH OF SERVICE. COMPENSATION IS THEN REVIEWED AND APPROVED BY OFFICERS OF THE ORGANIZATION. OFFICER COMPENSATION IS APPROVED BY THE BOARD OR CEO THROUGH CONTRACT NEGOTIATION WITH THE OUTSIDE MANAGMENT CORPORATION. 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN ADDITIONAL PENSION LIABILITY 8,865,373. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORMER CHIEFS OF STAFF: FORM 990, PART VII, LINE 1A: FORMER CHIEFS OF STAFF MAY CONTINUE TO BE COMPENSATED FOR EMERGENCY ROOM CALL PAY, COMMITTEE PAY, ETC. GEORGETOWN HOSPITAL SYSTEM PO DRAWER 1718 GEORGETOWN SC 29442 020598440 HEALTHCARE SC 501(C)(3) LINE 11A, I 0 WACCAMAW COMMUNITY HOSPITAL PO BOX 3350 MURRELLS INLET SC 29576 043633263 HEALTHCARE SC 501(C)(3) LINE 3 GEORGETOWN HOSPITAL SYSTEM 0 GEORGETOWN RADIATION THERAPY CENTER 2405 N FRASER STREET GEORGETOWN SC 29440 200131459 HEALTHCARE SC N/A 0 0 0 1 0 0 0 0 1 1 1 1 0 1 1 1 1 0 0