2013-08-13T13:57:25-05:00 2012-09-30 861065772 Deloitte Tax LLP 191 Peachtree Street Suite 2000 Atlanta GA 30303 990 2011-10-01 202935692 McLeod Physician Associates II MCLE 8437772256 555 E Cheves Street Florence SC 295020551 S FULTON ERVIN III 8437772911 2013-08-13 John W Sadoff Jr P00540589 4042201500 2011 2016-02-24 21:20:13Z McLeod Physician Associates Robert Colones 555 E Cheves Street Florence SC 295020551 81364903 0 X www.mcleodhealth.org X 2005 SC Physician Services 4 0 646 0 0 0 58330 0 64582300 80813396 -21374 10630 -72906 540746 64546350 81364772 0 0 0 0 53564058 69033520 0 0 0 19659433 25042292 73223491 94075812 -8677141 -12711040 12065445 15513948 36044376 56383624 -23978931 -40869676 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 90221137 80813396 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. 90221137 1 0 0 0 0 0 0 0 0 0 1 0 0 1 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 1 0 1 60 0 1 646 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 X Robert L Colones 40.00 X X 0 641516 96351 S Fulton Ervin III 40.00 X X 0 394573 116174 Michael E Payne 40.00 X X 0 190458 69431 Dane P Ficco 40.00 X X 0 325707 91676 Ronald L Boring 40.00 X X 0 361601 125001 J Dale Cannon Jr MD 40.00 X 831211 0 82472 Charles R Tatum MD 40.00 X 761897 0 82556 Fred W Holland MD 40.00 X 760412 0 46096 Christopher G Cunningham MD 40.00 X 701077 0 86565 Kyle E Watford MD 40.00 X 705398 0 50962 3759995 1913855 847284 102 0 1 0 University Medical Associates PO Box 250619 Charleston SC 29435 Medical Services 641667 Carolina Health Care PA of Florence PO Box 1905 Florence SC 29503 Medical Services 226497 Dr Nandkishore Raghuram 4501 Chesapeake Place Amarillo TX 791196471 Medical Services 185590 Moore & Van Allen PLLC PO Box 22828 Charleston SC 294132828 Legal Services 173575 Tuomey Healthcare System PO Box 7963 Columbia SC 292027963 Building Rent 106867 5 Physician Services 621110 63449688 63449688 Subsidy Fees 621110 17363708 17363708 80813396 10761 131 10630 10630 10630 Other Revenue 900099 540746 540746 540746 81364772 80813396 0 551376 60529964 59694651 835313 333317 315351 17966 6025266 5902953 122313 2144973 2085343 59630 2038535 2038535 239381 12089 227292 778048 756729 21319 313641 142895 170746 7871979 7758394 113585 378504 376195 2309 4649272 4467485 181787 216417 190772 25645 24453 23604 849 1651685 1620303 31382 1625105 1621367 3738 Bad Debt 5214069 5214069 Licenses and Taxes 21440 19174 2266 Contract Labor 13577 13577 6186 6186 94075812 90221137 3854675 0 -357976 -384222 5743973 5411679 409885 343866 902630 1302061 17328694 9491182 4329537 7837512 1037396 1003052 12065445 15513948 5439093 6866326 30605283 49517298 36044376 56383624 X -23978931 -40869676 -23978931 -40869676 12065445 15513948 X -12711040 -4179705 X 0 1 1 X 0 X 638892 132555 506337 16689802 9358627 7331175 7837512 Other Receivables 305086 CSV-Life Insurance 697966 1003052 Retirement Liabilities/Split Dollar Plan 2120116 Intercompany 47397182 49517298 X X X X X X 0 0 0 0 0 0 0 0 0 Robert L Colones 0 583155 0 50000 0 8361 0 31200 0 65151 0 737867 0 0 S Fulton Ervin III 0 321613 0 65820 0 7140 0 22000 0 94174 0 510747 0 0 Michael E Payne 0 174069 0 12649 0 3740 0 16831 0 52600 0 259889 0 0 Dane P Ficco 0 268384 0 51407 0 5916 0 14700 0 76976 0 417383 0 0 Ronald L Boring 0 305100 0 48840 0 7661 0 38500 0 86501 0 486602 0 0 J Dale Cannon Jr MD 828835 0 0 0 2376 0 34612 0 47860 0 913683 0 0 0 Charles R Tatum MD 755147 0 0 0 6750 0 38500 0 44056 0 844453 0 0 0 Fred W Holland MD 757172 0 0 0 3240 0 0 0 46096 0 806508 0 0 0 Christopher G Cunningham MD 693871 0 0 0 7206 0 38500 0 48065 0 787642 0 0 0 Kyle E Watford MD 702001 0 0 0 3397 0 4900 0 46062 0 756360 0 0 0 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 Associates 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 June 2013 Board meeting, along with a presentation covering the Form 990 by the preparing firm, Deloitte Tax, to allow for a thorough review by the Sole Member's Board before the filing date of August 15, 2013. 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 conflict 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. Avg hours devoted to related org(s) when related comp is reported: Form 990, Part VII: Robert L. Colones' compensation is paid by McLeod Health, a related organization of McLeod Physician Associates II. The compensation he receives is for his role as CEO of McLeod Health and not for his role as a Board Member, an uncompensated role, of McLeod Physician Associates II. Hours worked are not tracked on an entity by entity basis. Therefore, all hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week. S. Fulton Ervin, III's compensation is paid by McLeod Health, a related organization of McLeod Physician Associates II. The compensation he receives is for his role as CFO at McLeod Health and not for his role as a Board Member, an uncompensated role, of McLeod Physician Associates II. Hours worked are not tracked on an entity by entity basis. Therefore, all hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week. Michael Payne's compensation is paid by McLeod Health, a related organization of McLeod Physician Associates II. The compensation he receives is for his role as a Vice President at McLeod Health and not for his role as a Board Member, an uncompensated role, of McLeod Physician Associates II. Hours worked are not tracked on an entity by entity basis. Therefore, all hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week. Dane P. Ficco's compensation is paid by McLeod Health, a related organization of McLeod Physician Associates II. The compensation he receives is for his role as a Vice President at McLeod Health and not for his role as a Board Member, an uncompensated role, of McLeod Physician Associates II. Hours worked are not tracked on an entity by entity basis. Therefore, all hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week. Ronald L. Boring's compensation is paid by McLeod Health, a related organization of McLeod Physician Associates II. The compensation he receives is for his role as COO of McLeod Health, and not for his role as a Board Member, an uncompensated role, of McLeod Physician Associates II. Hours worked are not tracked on an entity by entity basis. Therefore, all hours reported on Form 990, Part VII, Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors represent aggregate hours worked per week. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized losses on investments: -4179705. 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 health of the community it serves. The service area covers a 15 county area encompassing nearly 11,500 square miles and a population of more than one million. Since 1906, McLeod Health has been the choice for medical excellence for the communities it has impacted. The hospitals within McLeod include McLeod Regional Medical Center in Florence, McLeod Darlington, McLeod Behavioral Health Center, McLeod Dillon, and, as of January 2012, 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, and the Center for Advanced Surgery. Additionally, McLeod provides Home Health Services, Hospice, Diabetes Services, state of the art radiology, Health and Fitness, Physical and Cardiac Rehab programs and more. Most recently, McLeod has invested in the community by building a Center for Intensive Care and a new Cancer Center building. The McLeod Foundation also helps financially support specific programs, growth and projects, through philanthropy and grants. McLeod Health strives to recruit and retain employees that have proven their dedication and loyalty to serving others. Recruitment and retention of dedicated employees demonstrates a loyalty to the healthcare environment. Sustaining critical services and adding an additional personal touch to each patient is accomplished every day by 750 physicians and 6,300 employees. Currently, McLeod Regional Medical center in Florence has nearly 500 beds, and in total, McLeod Health includes 883 licensed beds for patient care. These, coupled with the diverse number of services provided, allow McLeod to meet the unique and vast array of health care needs in our 12 county service area. As one of the region's largest service organizations, including physicians, nurses, and pharmacists, as well as computer technicians, environmental workers, therapists, and other medical professionals, McLeod employees' direct wage impact to the region last year was $299 Million. This money flows to groceries stores, car dealers, restaurants, churches, local vendors and suppliers and other organizations to help stimulate the region's economy each year. The challenge in today's medical climate is to improve the quality of care and the ability of healthcare providers to reduce cost while maintaining quality. This is due to the fact of the shrinking reimbursements and healthcare reform. McLeod has continued to provide and grow essential services to care for patients in the region with the core values of Caring, Person, Quality and Integrity as a guide to quality and operational efficiency. McLeod has been recognized numerous times for its outstanding work in quality care, best practices, and clinically proven outcomes. Guests from across the globe seek out McLeod teams 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 numerous initiatives in place to provide community benefits that promote prevention, healing, and treatment. Some of these initiatives include health education, support groups, city sponsored and industry 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. McLeod is proactively affiliating with academic institutions to address our community's healthcare needs. McLeod facilitates a Family Medicine Residency Program and sponsors the Medical University of South Carolina bachelor's degree nursing 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 offered to students from educational programs throughout the state, and the South East Cancer Control Consortium collaborates with McLeod in the field of cancer treatment. Through these structured programs, the complex world of healthcare unfolds for participants for further study. Dedicated to stewardship and service for more than 107 years, McLeod has prudently built and developed reserves in order to continue to grow as a mission minded hospital committed to improving the health of our 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 Moody's Investors Service 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 our 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, these hospitals serve 150,000 patients in their emergency rooms, regardless of a person's ability to pay. McLeod Health hospitals 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, 365 days a year. In Fiscal Year 2012, McLeod Health provided the region with significant amounts 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 $13 Million was contributed in sales tax, approximately $479,000 in Property Taxes, and more than $14.1 Million in hospital provider taxes to benefit the communities where its employees and patients live and work. Healthy lifestyle promotion is a fundamental principle of McLeod. Health screenings are offered to the community to check for problems in blood pressure, cholesterol, diabetes, breast, skin and prostate cancer, osteoporosis, peripheral vascular disease, and stroke. Nearly 100 support groups, classes, health fairs, seminars, screenings and programs free or at a reduced cost are provided to attendees seeking to learn about and deal with many medical issues. Childbirth preparation classes, Infant/Child CPR, Child Safety Passenger Checks from McLeod SafeKids, and SafeSitters sessions are offered. In addition, a computer located in the McLeod Resource Center is available to the public for Internet access to the most current health information. These benefits to the community demonstrate the heart of serving and compassionate care that is the core, and the legacy, of McLeod Health. McLeod Regional Medical Center of Pee Dee Inc 555 East Cheves Street Florence SC 295020551 570370242 To operate a healthcare system SC 501(c)(3) Line 3 N/A 0 McLeod Health Foundation 555 East Cheves Street Florence SC 295020551 570818672 To raise money for McLeod Entities SC 501(c)(3) Line 11a N/A 0 McLeod Medical Center - Dillon 555 East Cheves Street Florence SC 295020551 510473471 To operate a healthcare system SC 501(c)(3) Line 3 N/A 0 McLeod Health 555 East Cheves Street Florence SC 295020551 510473500 To operate a healthcare system SC 501(c)(3) Line 3 N/A 0 LorisSeacoast Healthcare Foundation - 2812-93012 555 East Cheves Street Florence SC 295020551 421704953 To Raise money for McLeod Entities SC 501(c)(3) Line 11a N/A 0 McLeod Loris Seacoast Hospital 555 East Cheves Street Florence SC 295020551 453576100 To operate a community hospital SC 501(c)(3) Line 3 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 LorisSeacoast Healthcare Foundation - 100111-2712 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 1 1 0 0 0 0 0 0 McLeod Health L 2038535 Actual Cost of Services Provided McLeod Regional Medical Center of the Pee Dee Inc K 10711342 Actual Cost of Services Provided McLeod Medical Center - Dillon K 1154338 Actual Cost of Services Provided McLoed Loris Seacoast Hospital K 4126055 Actual Cost of Services Provided