2012-08-14T06:34:27-05:00 2011-09-30 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2010-10-01 272187756 SCOTLAND REGIONAL HEALTH NETWORK SCOT 9102917920 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 MATTHEW PRACHT 9102917920 2012-08-14 1 AMY BIBBY 8282542254 2010 2016-02-24 21:20:13Z MATTHEW PRACHT 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 4475286 0 X N/A X 2010 NC TO OPERATE FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, AND TO CARRY OUT THE PURPOSES OF SCOTLAND MEMORIAL HOSPITAL, INC. 4 1 47 0 0 0 0 0 667344 4468219 0 0 0 7067 667344 4475286 0 0 0 0 1086028 4532712 0 0 0 469723 2224448 1555751 6757160 -888407 -2281874 524442 662747 99705 326270 424737 336477 X TO PROMOTE AND FURTHER THE HEALTH AND WELFARE OF COMMUNITIES WITHIN THIS STATE THROUGH SUPPORT OF AND INVOLVEMENT IN HEATH CARE AND HEALTH CARE RELATED ORGANIZATIONS, AND TO SUPPORT AND TO OPERATE FOR THE BENEFIT OF ANDRECEIVE AND PROVIDE FUNDS, PROPERTY, OR OTHER BENEFITS TO (I) HOSPITALS, (II) OUTPATIENT CLINICS, (III) REHABILITATION INSTITUTIONS, (IV) ALCOHOL OR DRUG TREATMENT CENTERS, (V) ANY ORGANIZATION PROVIDING HOSPITAL OR MEDICAL CARE, OR (VI) ANY OTHER HEALTH CARE ORGANIZATION OR ORGANIZATION ENGAGED IN HEALTH CARE RELATED ACTIVITIES, PROVIDED ALL SUCH SUPPORTED ORGANIZATIONS MUST QUALIFY AS EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE CODE OR THE CORRESPONDING PROVISIONS OF ANY FUTURE UNITED STATES FEDERAL INCOME TAX LAWS. 0 0 6230204 4468219 IN MAY OF 2010, SCOTLAND REGIONAL HEALTH NETWORK ASSUMED THE OPERATIONS OF THE HOSPITALIST PROGRAM. HOSPITALIST ARE PHYSICIANS WHO MANAGE THE MEDICAL CARE OF HOSPITAL INPATIENTS FROM SCOTLAND MEMORIAL HOSPITAL. FOR FISCAL YEAR 2011, HOSPITALISTS LOGGED OVER 12,300 PATIENT ENCOUNTERS. IN JUNE OF 2010, SCOTLAND REGIONAL HEALTH NETWORK PURCHASED THE MEDICAL PRACTICE OF GLEEN HARRIS, MD FOR THE PURPOSE OF ENSURING AND EXPANDING PRIMARY CARE MEDICAL SERVICES TO THE RESIDENTS OF THE COMMUNITY. THIS PRACTICE UTILIZES THE SERVICES OF 2 PHYSICIANS AND 2 MID-LEVEL PROVIDERS AND RECORDED OVER 11,300 PATIENT VISITS THROUGH SEPTEMBER 2011.DURING THE YEAR, THE NETWORK OPERATED A SURGICAL PRACTICE UTILIZING 2 PHYSICIANS AND 1 MID-LEVEL PROVIDER AND PROVIDED OVER 4,100 PATIENT ENCOUNTERS. IN ADDITION, A FAMILY PRACTICE PHYSICIAN OPERATED A PRACTICE IN WAGRAM, PROVIDING OVER 2,700 VISITS DURING THE YEAR. 6230204 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 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 0 1 0 0 1 47 1 0 0 0 0 0 0 0 0 0 0 X 4 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X LARRY BROOKS 9102917000 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 NANCY L WALKER 2.00 X X 0 0 0 GREGORY C WOOD 2.00 X X 0 318252 66355 MATTHEW D PRACHT 2.00 X X 0 183574 46887 PAMELA J ASHLEY 1.00 X 0 37293 12671 PAUL G BROOKS 1.00 X 50039 0 26597 50039 539119 152510 0 0 1 0 0 NET PATIENT REVENUE 624100 4468219 4468219 4468219 MISCELLANEOUS 624100 7067 7067 7067 4475286 4468219 0 7067 4313397 3816870 496527 192383 169297 23086 26932 23700 3232 4111 4111 673709 673709 42407 42407 96607 96607 18944 18944 163236 163236 BAD DEBT 1042208 1042208 MEDICAL SUPPLIES 128370 128370 MISCELLANEOUS 54856 54856 6757160 6230204 526956 0 107627 10617 306294 482071 38566 168574 1782 297 71955 1485 524442 662747 99705 284505 0 41765 99705 326270 X 424737 336477 424737 336477 524442 662747 X -2281874 2193614 X 0 1 1 X 0 X X 0 0 0 SCOTLAND MEMORIAL HOSPITAL INC 560583151 3 1 1 6230204 1 6230204 1782 297 1485 1485 DUE TO AFFILIATES 41765 41765 4475286 6757160 -2281874 2193614 2193614 -88260 4475286 0 4475286 0 4475286 8950774 2193614 2193614 6757160 0 6757160 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CORPORATION AND ITS NONPROFIT AFFILIATES ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE LLC IS TREATED AS A PARTNERSHIP AND AS SUCH, THE INCOME FLOWS THROUGH TO THE OWNERS OF THE LLC. THE CORPORATION HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2011. THE CORPORATION BELIEVES THEY ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2008. PART XI, LINE 8 - OTHER ADJUSTMENTS: EQUITY TRANSFER TO AFFILIATE 2,193,614. PART XIII, LINE 2D - OTHER ADJUSTMENTS: EQUITY TRANSFER TO AFFILIATE 2,193,614. X 0 0 0 0 0 1 0 0 0 GREGORY C WOOD 0 212274 0 82201 0 23777 0 30292 0 36063 0 384607 0 0 MATTHEW D PRACHT 0 146345 0 36996 0 233 0 18622 0 28265 0 230461 0 0 PART I, LINE 6 GREGORY WOOD (CEO) AND MATTHEW PRACHT (CFO) WERE ON A MANAGEMENT INCENTIVE PROGRAM THAT REQUIRED THE COMPLETION OF SPECIFIC ORGANIZATION PERFORMANCE MEASURES, WHICH INCLUDED FINANCIAL PERFORMANCE, QUALITY OUTCOMES, CUSTOMER SATISFACTION, AND EMPLOYEE RETENTION. FORM 990, PART VI, SECTION A, LINE 3 SCOTLAND HEALTH CARE SYSTEM IS ENGAGED IN A TEN-YEAR MANAGEMENT AGREEMENT WITH THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY D/B/A CAROLINAS HEALTHCARE SYSTEM TO MANAGE THE SYSTEM ON A DAY-TO-DAY BASIS. FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO THE FILING DATE, THE FORM 990 WAS PRESENTED TO THE BOARD OF TRUSTEES FOR REVIEW. AFTER A DISCUSSION PERIOD AND QUESTION & ANSWER PERIOD, THE BOARD OF TRUSTEES VOTED TO APPROVE THE FORM 990 AS PRESENTED. FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL REQUIRES ALL OFFICERS, DIRECTORS, TRUSTEES TO REVIEW AND SIGN THE CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF TRUSTEES REVIEWS AND APPROVES THE COMPENSATION OF THE CEO BY THE FOLLOWING PROCEDURE: THE OPERATING COMMITTEE, WHICH IS THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES, ESTABLISHED A FORMAL COMPENSATION PHILOSOPHY WITH RESPONSIBILITIES IN 1996 USING AN OUTSIDE FIRM SPECIALIZING IN EXECUTIVE COMPENSATION. THIS PHILOSOPHY INCLUDES AN ANNUAL PROCESS WHICH BENCHMARKS INCUMBENT CEO AND CFO COMPENSATION AGAINST COMPARATIVE PEERS, OBTAINED FROM EXTERNAL INFORMATION. ANNUAL INCENTIVE PLANS ARE ESTABLISHED USING OBJECTIVE CRITERIA FOR BOTH THESE INDIVIDUALS AND OTHER MEMBERS OF THE EXECUTIVE TEAM. THE ENTIRE BOARD ALSO COMPLETES AN EVALUATION OF THE CEO WHICH IS ADDED TO THE ANNUAL INCENTIVE PLAN OBJECTIVES ESTABLISHED TO DETERMINE THE CEO'S ANNUAL COMPENSATION AND INCENTIVE PLAN PERFORMANCE. THE OPERATING COMMITTEE ALSO APPROVES THE CFO'S ANNUAL COMPENSATION INCLUDING HIS/HER INCENTIVE PLAN. THE OPERATING COMMITTEE CONTRACTS WITH THE CAROLINAS HEALTHCARE SYSTEM FOR THE CEO. THE OPERATING COMMITTEE ALSO REVIEWS AND APPROVES COMPENSATION FOR OTHER MEMBERS OF SHCS EXECUTIVE STAFF ON AN ANNUAL BASIS. FOR THE OTHER THREE VICE PRESIDENT'S, THEIR COMPENSATION IS APPROVED BY THE OPERATING COMMITTEE. 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 THE HOSPITAL MAKES IT GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST AT THE SCOTLAND MEMORIAL HOSPITAL EXECUTIVE ASSISTANT TO THE PRESIDENT'S OFFICE. THE HOSPITAL MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE VP, FINANCE OFFICE OR GENERAL ACCOUNTING DEPARTMENT. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: EQUITY TRANSFER TO AFFILIATE 2,193,614. TOTAL TO FORM 990, PART XI, LINE 5: 2,193,614. SCOTLAND MEMORIAL HOSPITAL INC 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 560583151 OFFER HEALTH CARE TO RESIDENTS OF SCOTLAND COUNTY, NC AND SURROUNDING AREAS NC 501(C)(3) LINE 11A, I N/A 0 SCOTLAND HEALTHCARE SYSTEMS INC 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 581847657 OPERATE FOR THE BENEFIT OF, PERFORM FUNCTIONS, AND CARRY OUT PURPOSES OF SMH NC 501(C)(3) LINE 11A, I N/A 0 SCOTLAND MEMORIAL FOUNDATION INC 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 581828201 CONDUCT FUNDRAISING ACTIVITIES FOR SCOTLAND HEALTH CARE SYSTEM NC 501(C)(3) LINE 7 SCOTLAND HEALTH GROUP INC 0 EDWIN MORGAN CENTER INC 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 589178020 SKILLED NURSING FACILITY NC 501(C)(3) LINE 9 SCOTLAND HEALTH GROUP INC 0 HOSPICE OF SCOTLAND COUNTY INC 610 E LAUCHWOOD DRIVE LAURINBURG NC 28352 561468269 HEALTHCARE FOR TERMINALLY ILL PATIENTS NC 501(C)(3) LINE 7 SCOTLAND HEALTH GROUP INC 0 SMH TITLE HOLDING COMPANY 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 581849143 TITLE HOLDING COMPANY NC 501(C)(2) SCOTLAND HEALTH GROUP INC 0 SCOTLAND MOB LLC 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 205900149 RENTAL ESTATE NC N/A SCOTLAND ENTERPRISES INC 500 LAUCHWOOD DRIVE LAURINBURG NC 28352 561651832 HEALTH CARE NC N/A C 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0