SOUTHEASTERN REGIONAL MEDICAL CENTER: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
SOUTHEASTERN REGIONAL MEDICAL CENTER (EIN 56-0530233)
Tax period
2011-10-01 to 2012-09-30
Filed
2014-10-24
IRS object ID
201442979349300704
Schema version
2011v1.5
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)
Timestamp2014-10-24T09:50:18-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1S PRESTON DOUGLAS & ASSOCIATES LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 2339AddressLine1
CityLUMBERTONCity
StateNCState
ZIP Code283592339ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN560530233EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SOUTHEASTERN REGIONAL MEDICALBusinessNameLine1
Business Name Line2CENTERBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlSOUTNameControl
Phone9106715090Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O BOX 1408 300 W 27TH STAddressLine1
CityLUMBERTONCity
StateNCState
ZIP Code283591408ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameC THOMAS JOHNSON IIIName
TitleVICE-PRESIDENT, CFOTitle
Phone9106715090Phone
Date Signed2014-10-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJOHN L GRISSOM JRName
Phone9107397523Phone
Date Prepared2014-10-15DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Amended ReturnXAmendedReturn
Name Of Principal Officer PersonC THOMAS JOHNSON III VP CFONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1408AddressLine1
CityLUMBERTONCity
StateNCState
ZIP Code283591408ZIPCode
FieldValueIRS element (for citing)
Gross Receipts265387899GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.SRMC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1960YearFormation
State Legal DomicileNCStateLegalDomicile
Activity Or Mission DescriptionSOUTHEASTERN REGIONAL MEDICAL CENTER EXISTS TO PROVIDE QUALITY REGIONAL HEALTH CARE IN A SAFE, COMPASSIONATE, AND EFFICIENT ENVIRONMENTActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees2359TotalNbrEmployees
Total Nbr Volunteers52TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year269883287ProgramServiceRevenuePriorYear
Program Service Revenue CY252947384ProgramServiceRevenueCY
Investment Income Prior Year9002128InvestmentIncomePriorYear
Investment Income Current Year7126131InvestmentIncomeCurrentYear
Other Revenue Prior Year3274178OtherRevenuePriorYear
Other Revenue Current Year5314384OtherRevenueCurrentYear
Total Revenue Prior Year282159593TotalRevenuePriorYear
Total Revenue Current Year265387899TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year124426378SalariesEtcPriorYear
Salaries Etc Current Year132339144SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year140217420OtherExpensePriorYear
Other Expenses Current Year107236042OtherExpensesCurrentYear
Total Expenses Prior Year264643798TotalExpensesPriorYear
Total Expenses Current Year239575186TotalExpensesCurrentYear
Revenues Less Expenses Prior Year17515795RevenuesLessExpensesPriorYear
Revenues Less Expenses CY25812713RevenuesLessExpensesCY
Total Assets BOY306796490TotalAssetsBOY
Total Assets EOY349178356TotalAssetsEOY
Total Liabilities BOY139969815TotalLiabilitiesBOY
Total Liabilities EOY151534668TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY166826675NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY197643688NetAssetsOrFundBalancesEOY
Mission DescriptionSOUTHEASTERN REGIONAL MEDICAL CENTER EXISTS TO PROVIDE QUALITY REGIONAL HEALTH CARE IN A SAFE, COMPASSIONATE, AND EFFICIENT ENVIRONMENTMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense174764188Expense
DescriptionSERVICES PROVIDED FOR MORE THAN 15,000 INPATIENTS AND OVER 75,000 EMERGENCY ROOM PATIENTSDescription
Total Program Service Expense174764188TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccounttrueEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096197NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees2359NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonC THOMAS JOHNSON IIINamePerson
Telephone Number9106715000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1408AddressLine1
CityLUMBERTONCity
StateNCState
ZIP Code283591408ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
CHANCELLOR KYLE CARTER
TRUSTEE5.00X000
JOHN C ROZIER JR MD
TRUSTEE5.00X000
MARTIN L BROOKS MD
TRUSTEE5.00X000
FAYE C CATON
VICE CHAIR,5.00X000
DENNIS HEMPSTEAD
TRUSTEE5.00X000
JERRY JOHNSON
TRUSTEE5.00X000
RANDALL S JONES
TRUSTEE5.00X000
AL LEWIS
TRUSTEE5.00X000
ALPHONZO MCRAE JR
TRUSTEE5.00X000
MICHAEL T STONE
TRUSTEE5.00X000
MICHAEL P WALTERS
TRUSTEE5.00X000
W C WASHINGTON
CHAIRMAN5.00X000
JAMES R RUST
TRUSTEE5.00X000
MARY ALICE TEETS
TRUSTEE5.00X000
FRED G WILLIAMS
TRUSTEE5.00X000
JOSEPH R THOMPSON
TRUSTEE5.00X000
JOANN ANDERSON
PRES, CEO40.00692504057739X
C THOMAS JOHNSON III
VP, TREA, AS40.00395128027213X
ANDREW SCHWARTZ
VP MED AFFAI40.00349603042644X
TERESA BARNES
VP, CNO40.00257691010082X
DAVID SUMNER
VP40.0022627107999X
W REID CALDWELL
GOVT AFFAIRS40.0022250000X
MARK JORDAN
PHYSICIAN40.0055052100X
VINOD KUMAR
PHYSICIAN40.0050198700X
ERIC W MILLER
PHYSICIAN40.0048308300X
MICHEAL G KIDD
PHYSICIAN40.0048308000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4162368TotalReportableCompFromOrg
Total Other Compensation145677TotalOtherCompensation
Number Individuals GT100 K100NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
PRIVATE DIAGNOSTIC CLINIC
DUMC BOX 3070DURHAMNC27710PHYS MED2916924
SIMPLIFI MANAGED
1934 SALLY HILL FARMS BLVDFLORENCESC29501STAFFING1656848
YOUNGBLOOD STAFFING
2517 DELANEY AVENUEWILMINGTONNC28403STAFFING AGENCY1336924
SPEECH PATHOLOGY
765 OAKRIDGE BLVDLUMBERTONNC28358SPEECH THERAPY544622
DIRECCARE PHYSICAL THERAPY INC
63 PRIDGEN ROADLUMBERTONNC28358PHYSICAL THERAP437359
FieldValueIRS element (for citing)
Number Of Contractors GT100 K21NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REVENUEDescription
Total Revenue Column252947384TotalRevenueColumn
Related Or Exempt Function Income252947384RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue252947384TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4471496TotalRevenueColumn
Related Or Exempt Function Income4471496RelatedOrExemptFunctionIncome

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real154286Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real154286Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column154286TotalRevenueColumn
Related Or Exempt Function Income154286RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2654635Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities2654635Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2654635TotalRevenueColumn
Related Or Exempt Function Income2654635RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
OTHER REVENUE3939456$3,939,456
SALES OF CAFETERIA MEALS1220642$1,220,642
FieldValueIRS element (for citing)
Total Other Revenue5160098TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column265387899TotalRevenueColumn
Related Or Exempt Function Income260227801RelatedOrExemptFunctionIncome
Exclusion$5,160,098ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2143698Total
Management And General2143698ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total95989361Total
Program Services79018316ProgramServices
Management And General16971045ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4518473Total
Program Services3027377ProgramServices
Management And General1491096ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total21124120Total
Program Services14153160ProgramServices
Management And General6970960ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total8563492Total
Program Services5737540ProgramServices
Management And General2825952ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total211834Total
Management And General211834ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total697301Total
Management And General697301ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total15462900Total
Program Services8970458ProgramServices
Management And General6492442ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1139798Total
Program Services350701ProgramServices
Management And General789097ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3788773Total
Program Services3346010ProgramServices
Management And General442763ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total107248Total
Program Services83556ProgramServices
Management And General23692ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total523954Total
Program Services245081ProgramServices
Management And General278873ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total3194197Total
Management And General3194197ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total12762110Total
Program Services3593810ProgramServices
Management And General9168300ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total2918046Total
Program Services2214323ProgramServices
Management And General703723ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES42631151400072982623853
OUTSIDE SERVICES1156642876246993941729
EQUIPMENT RENTAL1154890660374265511480
OTHER OPERATING EXPENSES668929354433314496

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total14467Total
Management And General14467ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total239575186Total
Program Services174764188ProgramServices
Management And General64810998ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY12525281BOY
EOY9524176EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY35957053BOY
EOY44017844EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3631280BOY
EOY4960285EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1262751BOY
EOY1675783EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis310355905LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec193453742LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY116398899BOY
EOY116902163EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY135803721BOY
EOY170902397EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1217505BOY
EOY1195708EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY306796490BOY
EOY349178356EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY41042079BOY
EOY56943310EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY71060000BOY
EOY68420000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY27867736BOY
EOY26171358EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY139969815BOY
EOY151534668EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY166826675BOY
EOY197643688EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY166826675BOY
EOY197643688EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY306796490BOY
EOY349178356EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses25812713ReconcilationRevenueExpenses
Reconcilation Other Changes5004300ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3339259OtherCostOrOtherBasis
Book Value3339259BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis124494996OtherCostOrOtherBasis
Depreciation51632616Depreciation
Book Value72862380BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis182521650OtherCostOrOtherBasis
Depreciation141821126Depreciation
Book Value40700524BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings116902163TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionLIABILITY FOR PENSION BENEFITSDescription
Amount$26,171,358Amount
FieldValueIRS element (for citing)
Total Of Amounts26171358TotalOfAmounts
Total Revenue265387899TotalRevenue
Total Expenses239575186TotalExpenses
Excess Or Deficit For Year25812713ExcessOrDeficitForYear
Net Unrealized GL On Investments15535323NetUnrealizedGLOnInvestments
Other-$4,107,769OtherAmount
Total Adjustments11427554TotalAdjustments
Excess Or Deficit Per FS37240267ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt309607488TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments15535323NetUnrealizedGainsInvestments
Other Revenues28684266OtherRevenues
Revenue Not Rptd F99044219589RevenueNotRptdF990
Revenue Subtotal265387899RevenueSubtotal
Total Revenue Per Form990265387899TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt272367221TotExpensesEtcAuditedFinclStmt
Other Expenses Included32792035OtherExpensesIncluded
Expenses Not Rptd F99032792035ExpensesNotRptdF990
Expenses Subtotal239575186ExpensesSubtotal
Total Expenses Per Form990239575186TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RECONCILIATION OF CHANGES - OTHERSCHEDULE D, PAGE 4, PART XI, LINE 8REVENUE OF RELATED ORGANIZATIONS REPORTED ON SEPARATE 0 990'S 28,684,266 EXPENSES OF RELATED ORGANIZATIONS REPORTED ON SEPARATE 0 990'S -33,347,678 PENSION RELATED CHANGES IN NET PERIODIC PENSION COST 555,643
REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 2DREVENUE OF RELATED ORGANIZATIONS REPORTED ON SEPARATE 0 990'S 28,684,266
EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XIII, LINE 2DEXPENSES OF RELATED ORGANIZATIONS REPORTED ON SEPARATE 0 990'S 33,347,678 PENSION RELATED CHANGES IN NET PERIODIC PENSION COST -555,643

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense5618972TotalCommunityBenefitExpense
Net Community Benefit Expense5618972NetCommunityBenefitExpense
Percent Of Total Expense0.02350PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense9175113TotalCommunityBenefitExpense
Net Community Benefit Expense9175113NetCommunityBenefitExpense
Percent Of Total Expense0.03830PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense14794085TotalCommunityBenefitExpense
Net Community Benefit Expense14794085NetCommunityBenefitExpense
Percent Of Total Expense0.06180PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense327325TotalCommunityBenefitExpense
Net Community Benefit Expense327325NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense327325TotalCommunityBenefitExpense
Net Community Benefit Expense327325NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense15121410TotalCommunityBenefitExpense
Net Community Benefit Expense15121410NetCommunityBenefitExpense
Percent Of Total Expense0.06310PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$51,705,918BadDebtExpenseAmount
Amount Attributable To37884533AmountAttributableTo
Amount Reimbursed By Medicare82945683AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare84636020CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1690337MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicyfalseWrittenDebtCollectionPolicy
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1SOUTHEASTERN REGIONAL MEDICAL CENTEBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1300 W 27TH STREETAddressLine1
CityLUMBERTONCity
StateNCState
ZIP Code28358ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SOUTHEASTERN REGIONAL MEDICAL CENTEBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.0FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent300.0FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Collection ActivitiestrueCollectionActivities
Report To Credit AgencyXReportToCreditAgency
Notify Upon AdmissionXNotifyUponAdmission
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ADDITIONAL INFORMATIONPART VISCHEDULE H PART VI 2 NEEDS ASSESSMENT SOUTHEASTERN ATTEMPTS TO ADDRESS PUBLIC CONCERN AND COMMUNITY NEEDS BY BEING HIGHLY INVOLVED WITH THE COMMUNITY AND AWARE OF PUBLIC PERCEPTION OF THE ORGANZATION THE CEO AND SENIOR LEADERS ARE AVAILABLE TO THE MEDIA AND HAVE DISCUSSED HEALTH CARE REFORM AND OTHER PUBLIC ISSUES IN MANY EVENTS AND FORUMS THE CEO AND SENIOR LEADERS PARTICIPATE WITH MANY COMMUNITY ORGANIZATIONS PRESENT REGULARLY AND ANSWER QUESTIONS AND CONCERNS TO ENSURE COMMUNITY NEEDS ARE ADDRESSED SOUTHEASTERN COMMISSIONS A CONSUMER TOP OF MIND SURVEY TO IDENTIFY NEEDS BELIEFS AND CONCERNS THIS SURVEY IS USED TO TAILOR NEEDS TO THE COMMUNITY 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SOUTHEASTERN HAS NINE INHOUSE BENEFIT ADVISORS WHO MEET WITH ALL SELF PAY PATIENTS THEY SCREEN FOR MEDICAID SSIDISABILITY AND CHARITY ASSISTANCE THEY HELP PATIENTS APPLY FOR AND QUALIFY FOR ANY NUMBER OF ASSISTANCE PROGRAMS CUSTOMER SERVICE REPRESENTATIVES ADDITIONALLY REFER PATIENTS TO THESE ADVISORS BASED ON TELEPHONE INQUIRIES EMAILS ANDOR LETTERS PATIENT STATEMENTS INCLUDE THE CUSTOMER SERVICE TELEPHONE NUMBER IN THE EVENT A PATIENT FEELS THEY NEED ASSISTANCE WITH THEIR BILLS THE SRMC WEB SITE SRMCORG INCLUDES INFORMATION AND AN ARTICLE PERTAINING TO CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS OFFERED SRMC ALSO USES THE LOCAL NEWSPAPER AND BROCHURES FOR EDUCATING THE PUBLIC REGARDING FINANCIAL ASSISTANCE 4 SOUTHEASTERN REGIONAL MEDICAL CENTER SERVES THE RESIDENTS OF ROBESON AND SURROUNDING COUNTIES THE POPULATION IS COMPRISED OF TRIRACIAL DECENT WHITE AMERICAN INDIAN AND AFRICAN AMERICAN RECENT YEARS HAS SEEN AN INCREASE IN THE HISPANIC POPULATION 6 WORKING IN PARTNERSHIP WITH OTHER LOCAL HEALTH AND HUMAN SERVICE AGENCIES SOUTHEASTERN OFFERS FREE HEALTH SCREENS EDUCATION PROGRAMS AND EVENTS DESIGNED TO PREVENT DETECT ANDOR MANAGE CHRONIC DISEASE IN HIGH RISK UNDERSERVED INDIVIDUALS NEIGHBORHOODS AND COMMUNITIES SOUTHEASTERN MAINTAINS AN OPEN MEDICAL STAFF AND THE LEADERS ARE MEMBERS OF VARIOUS COMMUNITY ORGANIZATION BOARDS ALL SURPLUS FUNDS GENERATED FROM THE OPERATIONS ARE UTILIZED TO PROVIDE ADDITIONAL RESOURCES AND SERVICES TO MAINTAIN AND UPGRADE THE HEALTH SERVICES OFFERED TO THE COMMUNITY
SOUTHEASTERN REGIONAL MEDICAL CENTE LINE NUMBER 1 PART V LINE 1JPART V LINE 1JPART V QUESTION 5C THE CHNA REPORT WAS MADE WIDELY AVAILABLE THROUGH 1 SOUTHEASTERN REGIONAL MEDICAL CENTER AND ROBESON COUNTY HEALTH DEPT UTILIZED THEIR COLUMN SPACES IN THE LOCAL ROBESONIAN NEWSPAPER TO REPORT FINDINGS OF THE CHNA 2 THE ROBESON COUNTY HEALTH DEPARTMENT PLACE THE CHNA DOCUMENT ON ITS WEBSITE 3 PRESENTATIONS WERE MADE TO HEALTHY ROBESON AND THE ROBESON COUNTY BOARD OF HEALTH MEMBERS
SOUTHEASTERN REGIONAL MEDICAL CENTE LINE NUMBER 1 PART V LINE 19DPART V LINE 19DPART V 19D WE DISCOUNT ALL FINANCIAL ASSISTANCE PATIENTS CHARGES A FLAT 25 PER POLICY

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
JOANN ANDERSON
53036216214257739750243
C THOMAS JOHNSON III
3426545247427213422341
ANDREW SCHWARTZ
3097773982642644392247
TERESA BARNES
2252233246810082267773
DAVID SUMNER
194928313437999234270
W REID CALDWELL
18855433946222500
MARK JORDAN
276086274435550521
VINOD KUMAR
273571228416501987
ERIC W MILLER
483083483083
MICHEAL G KIDD
483080483080

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1SERIES 2005 HOSPITAL REVENUE BONDSBusinessNameLine1
FieldValueIRS element (for citing)
Date Issued2005-09-15DateIssued
Issue Price20000000IssuePrice
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Current RefundingfalseCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadefalseFinalAllocationMade
Adequate Books And Recds MaintaindfalseAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Engage Bond Counsel ContractsfalseEngageBondCounselContracts
Any Research AgreementsfalseAnyResearchAgreements
Engage Bond Counsel ResearchfalseEngageBondCounselResearch
Post Issuance Compliance ProcdrsfalsePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
AMENDED RETURN EXPLANATIONFORM 990, PAGE 1, ITEM BRETURN AMENDED TO CORRECTLY REPORT OFFICERS, DIRECTORS, AN KEY EMPLOYEES SALARIES ON PART VII AND VIII OF FORM 990 AND PART II OF SCHEDULE J.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BNO REVIEW WAS OR WILL BE CONDUCTED.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CA COPY OF SOUTHEASTERN REGIONAL MEDICAL CENTER'S (CENTER) CONFLICT OF INTEREST POLICY ALONG WITH A STATEMENT OF CONFLICT OF INTEREST IS GIVEN TO THE CENTER'S OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ANNUALLY TO REVIEW AND SIGN. IF ANY DISCLOSURES ARE MADE, DISCUSSIONS WITH THE INTERESTED PERSON OCCUR AND THEN HE OR SHE LEAVES THE MEETING, AT WHICH TIME THE REMAINING BOARD OR COMMITTEE MEMBERS DECIDE IF A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE BOARD DETERMINES WHETHER THE CENTER CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF THAT IS NOT REASONABLY ATTAINABLE, THE BOARD OR COMMITTEE, BY A MAJORITY VOTE OF DISINTERESTED DIRECTORS, SHALL DETERMINE WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CENTER'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CENTER.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE CEO AND VICE PRESIDENT POSITIONS WERE EVALUATED BY A SEPARATE COMPENSATION COMMITTEE AND AN INDEPENDENT CONSULTING FIRM. THE EXECUTIVE COMPENSATION PHILOSOPHY WAS UPDATED. INFORMATION WAS GATHERED ON COMPETITIVE PRACTICES AND A REASONABLE COMPENSATION PLAN WAS DETERMINED. ACTIONS OF THE COMMITTEE WERE APPROVED IN 2009.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BSAME AS A ABOVE
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19VARIOUS GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE GENERAL PUBLIC USING SRMC'S WEBSITE, OTHER WEBSITE,AND PROVIDING COPIES UPON REQUEST

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