2011-08-15T13:10:13-05:00 2010-09-30 Deloitte Tax LLP 191 Peachtree Street Suite 2000 Atlanta GA 30303 990 2009-10-01 202935692 McLeod Physician Associates II MCLE 8437772256 555 E Cheves Street Florence SC 295020551 S Fulton ErvinIII 8437772911 2011-08-15 1 John W Sadoff Jr 4042201500 2009 2016-02-24 21:20:13Z McLeod Physician Associates Robert Colones 555 E Cheves Street Florence SC 29502 56941350 0 X www.mcleodhealth.org X 2005 SC Physician Services 3 0 537 0 0 0 32200 37564 54758295 57100376 -102737 -1115 384387 -196590 55072145 56940235 0 0 42835757 45078430 0 0 16433618 15904384 59269375 60982814 -4197230 -4042579 9230166 8709821 20489377 24011611 -11259211 -15301790 To provide physician services to the residents of the Pee Dee Region of South Carolina. 0 0 58542921 57100376 McLeod Physician Associates II's primary goal is to provide physician services to the residents of the Pee Dee Region of South Carolina. 58542921 1 1 0 0 0 0 0 0 0 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 1 58 0 1 537 1 0 0 0 0 0 0 0 0 0 1 1 3 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Mark Cameron 8437775304 555 East Cheves Street Florence SC 29505 X Robert L Colones 40.00 X 0 714862 71143 S Fulton Ervin III 40.00 X 0 367217 55968 Michael E Payne 40.00 X 0 207329 46696 Dane P Ficco 40.00 X 0 296992 35597 Christopher Cunningham MD 40.00 X 851956 0 49124 Albert T Gilpin MD 40.00 X 678436 0 65245 Charles R Tatum MD 40.00 X 666040 0 65124 Kyle Watford MD 40.00 X 606876 0 29491 Fred Holland MD 40.00 X 588916 0 23748 3392224 1586400 442136 78 0 1 0 Medical University Hospital PO Box 931854 Atlanta GA 31193 Medical Services 466667 Medical Doctor Associates Inc PO Box 277185 Atlanta GA 303847185 Medical Services 308355 Dr Gerald Atwood 2150 Lake Adeger Parkway Mill Spring NC 28756 Medical Services 134187 Staff Care Inc PO Box 281923 Atlanta GA 303841923 Medical Services 122278 Lab Corp PO Box 12140 Burlington NC 272162140 Medical Services 101014 5 37564 37564 Physician Services 621110 47032792 47032792 Subsidy Fees 621110 10067584 10067584 57100376 1115 -1115 -1115 -1115 Other Revenue 900099 -196590 -196590 -196590 56940235 57100376 0 -197705 395169 355652 39517 39170977 38513152 657825 216137 202796 13341 3512880 3420962 91918 1783267 1731987 51280 1171830 1171830 71484 1100 70384 2426599 2348928 77671 66337 37123 29214 4076937 4022722 54215 260096 257672 2424 2796350 2668907 127443 121438 116009 5429 13157 8008 5149 599619 570754 28865 624833 622071 2762 Bad Debt 3467038 3471838 -4800 0 Contract Labor 48067 48067 0 0 Dues and Subscriptions 38784 34199 4585 0 Other Direct Expenses 26951 20222 6729 0 Licenses and Taxes 13278 12351 927 0 81586 78401 3185 60982814 58542921 2439893 0 -175225 -626703 5012032 4408418 330351 326062 581332 579827 10150860 7054941 2405713 3095919 1075963 926298 9230166 8709821 5009025 4355388 15480352 19656223 20489377 24011611 X -11259211 -15301790 -11259211 -15301790 9230166 8709821 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 180930 80613 100317 9969930 6974328 2995602 3095919 Due from Foundation 66400 Other Miscellaneous 22991 Due from Caresouth (Current) 48446 CSV-Life Insurance 607138 Other Assets Due From 181323 926298 Retirement Liabilities/Split Dollar Plan 919501 Intercompany 18736722 19656223 X X X X X X 0 0 0 0 0 1 1 0 0 Robert L Colones 0 583044 0 98184 0 33634 0 31200 0 39943 0 786005 0 0 S Fulton Ervin III 0 295520 0 53506 0 18191 0 22000 0 33968 0 423185 0 0 Michael E Payne 0 172462 0 23647 0 11220 0 17027 0 29669 0 254025 0 0 Dane P Ficco 0 242550 0 45332 0 9110 0 14700 0 20897 0 332589 0 0 Christopher Cunningham MD 829769 0 0 0 22187 0 22000 0 27124 0 901080 0 0 0 Albert T Gilpin MD 672316 0 0 0 6120 0 38500 0 26745 0 743681 0 0 0 Charles R Tatum MD 661032 0 0 0 5008 0 38500 0 26624 0 731164 0 0 0 Kyle Watford MD 603536 0 0 0 3340 0 4900 0 24591 0 636367 0 0 0 Fred Holland MD 584251 0 0 0 4665 0 0 0 23748 0 612664 0 0 0 Part I, Line 6 Part I, Line 6a: Incentives are available to employees in leadership positions based on a combination of criteria including financial goals as well as quality initiatives. Part I, Line 6b: Incentives are available to employees in leadership positions of this and related organizations based on a combination of criteria including financial goals as well as quality initiatives. Form 990, Part VI, Section A, line 6 McLeod Physician Associates II has a sole member which is McLeod Health. Form 990, Part VI, Section A, line 7a The Board of McLeod Health (sole member) has final authority as needed on the makeup and decision-making of McLeod Physician Associate II's Board. Form 990, Part VI, Section A, line 7b The Board of McLeod Health (sole member) has final authority as needed on the makeup and decision-making of McLeod Physician Associate II's Board. Form 990, Part VI, Section B, line 11 The process the organization uses to review the Form 990 consists of providing copies of the Form 990 to the Board of Trustees of McLeod Health (Sole Member of McLeod Physician Associates II) at the May 2011 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, 2011. 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 Physician Associates II's top management official, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The compensation committee reviewed and approved the compensation. In the review of compensation, the top management official was compared to other similarly situated organizations and positions. He was not present when his compensation was determined. Form 990, Part VI, Section C, line 19 Governing documents, conflict of interest policy, and financial statements are available to the public upon request. Form 990, Part VII: Avg hours devoted to related org(s) when related comp is reported: 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. Form 990, Part III, Line 4a: Community Benefit Report: The McLeod Health system (of which McLeod Physician Associates II is a part of) conducts or participates in many community programs that help further McLeod Physician Associates II's exempt purpose by promoting the health of the community. This narrative highlights just some of these programs: The Mission of McLeod Health is to improve the overall health and well being of people living within South Carolina and eastern North Carolina by providing excellence in healthcare. The medical center has championed this mission for more than a century -- celebrating 105 years of exceptional medical service to the region. McLeod Health is driven by a spirit of willing and compassionate service to others that is evident in the day-to-day hospital operations, long-range planning, and the people who are chosen to be a part of the McLeod team of professionals. This team of physicians, nurses, staff members, board members and volunteers are dedicated to providing the community with much more than medical care. Their commitment extends past the medical center's walls and into the region in an effort to build a stronger and healthier place for patients, co-workers, children and neighbors to live and work. McLeod Support to Area Organizations: McLeod Health supports more than 50 not-for-profit and local organizations by participating in events and fundraisers for these groups, providing financial contributions, and by offering the talents of McLeod staff members who serve as board members on planning committees for these organizations as well. McLeod Health annually partners with the American Heart Association for the Pee Dee Heart Walk each October. Hundreds of employees from the McLeod Cardiac and Stroke Units, Cardiac Rehabilitation Centers, Cardiac Catheterization Lab, McLeod Health & Fitness Center and other areas of McLeod Health passionately raise funds and walk in this event to reduce the prevalence of coronary heart disease and stroke in the region. For many McLeod participants, they are committed to the Heart Walk because they have been personally affected by heart disease, while others rise to the challenge in support of their patients and prevention efforts. Employees from many different areas of McLeod Health touched by cancer also join forces to take part in area American Cancer Society Relay for Life events in an effort to celebrate survivorship, prevent cancer, save lives, and diminish suffering from this disease. Each spring, walkers from the McLeod Neonatal Intensive Care Unit, McLeod Children's Hospital, Labor & Delivery and Newborn Nursery Units at McLeod Regional Medical Center and McLeod Medical Center Dillon also participate with their families in area March of Dimes' March for Babies events in hopes that someday every mom and baby will experience a healthy, full-term pregnancy. These McLeod physicians, nurses, support staff and volunteers form teams to support causes that have touched their lives in some way - - both personally and professionally-- in honor of the patients they serve and the families they have provided care. McLeod Health also works to uphold the services of the American Red Cross with financial support as well as through resources and blood donations made by employees during regular McLeod blood drives. According to the Red Cross, there is a critical need at national and state levels for blood, which is used in emergency situations as well as for people with cancer, blood disorders and other illnesses. Last year, McLeod Health collected 714 units of blood. This number is significant as one unit of blood can save up to three lives - - indicating that McLeod Health employees and community members who donated at McLeod facilities and events could potentially have saved more than 2,000 lives from one year's worth of donations. In addition, McLeod staff members dedicate invaluable time to serve on community boards including the Florence County Board of Health, Mercy Medicine, Science South, the Florence Public School District One Board and United Way, amongst others. McLeod Community Health Education Outreach Programs: McLeod Community Health Education outreach programs have provided numerous industries, school groups, churches, community festivals and countless organizations with tools to improve the health of these individuals and their loved ones. In fiscal year 2010, more than 10,000 community members were provided with information on cancer, diabetes, heart disease, diet and exercise, and safety for children, in addition to free or reduced-cost health screenings including blood pressure, blood sugar, bone density, and cholesterol screenings. Often this information can be the key to recognizing the signs and symptoms of a potentially serious health problem, allowing for more timely attention and follow up with one's physician. McLeod Resource Center: The McLeod Resource Center is a hub of information for the community with an emphasis on pregnancy, childbirth and family health. The Resource Center houses an Internet research area, which provides patients and their families with computer stations and a resource guide they can use to find reliable health information online. Patients in need of additional information about their diagnosis can visit the Resource Center to research their condition, ask questions of the clinically trained staff, or enjoy the quiet atmosphere and read educational materials provided by the American Heart Association, McLeod Diabetes Center, and the American Cancer Society as well as many others. Free childbirth and parenting magazines, baby care booklets, samples and informational literature are also available for expectant mothers who visit the Resource Center. In addition, the McLeod Resource Center offers an extensive series of free maternity education classes including Childbirth Preparation, Breastfeeding, Baby Care Postpartum, Maternity Tour, Big Sibling, and Family & Friends CPR. In addition, the Center hosts a free informal class for pregnant women called the Night for Expectant Women, or NEW. In the last year, there were more than 1,500 participants who attended the five to ten courses that are offered each month for expectant families. McLeod Safe Kids Florence: Safe Kids Florence, led by McLeod Health, works to reduce the number of unintentional childhood injuries through a multi-faceted approach combining community action, public awareness, education, technology and public policy initiatives. In the past 12 months, McLeod Safe Kids has checked more than 500 child safety seats for proper installation and trained an additional 155 caregivers on correct car seat installation techniques; attended nearly 20 area health fairs; provided more than 150 child photo ID cards; trained more than 20 teens in babysitting safety with the Safe Sitter program, and donated more than 50 helmets, and 100 smoke detectors to local children and their families. McLeod Safe Kids continues to grow and expand with the support of the McLeod Health Foundation and a grant from their community partner, Kohl's Cares for Kids. Form 990, Part III, Line 4a: Community Benefit Report (Continued): A number of McLeod Safe Kids programs have touched many families locally helping to ensure safety for them and their community. Two ongoing examples are the Third Thursday with Kohl's Safe Seats Child Safety Seat Check program and the Photo Identification project. - The Third Thursday with Kohl's Safe Seats Child Safety Seat Check program has made a tremendous impact in the community by helping educate parents of young children that they are required by law to have their children secured in child safety seats. The Kohl's program, which originated in November of 2008, is also extremely valuable as four out of five child safety seats are installed incorrectly. Safe Kids holds a child safety seat check the third Thursday of each month from 4:00 p.m. until 6:00 p.m. in the Florence Kohl's parking lot. McLeod Safe Kids certified child safety seat technicians check for proper installation of child safety seats, correct those in need, and educate parents on proper installation and use of car seats. If the technician determines a new child safety seat is needed, the car seats are available on site. - The Photo Identification project allows parents to maintain an ID card featuring their child's up-to-date picture and accurate identification information. Safe Kids Florence recommends that children have a new photo identification card made each year. These cards provide valuable information for law enforcement such as digital fingerprint scans to assist in a missing child case. The photo identification cards are an invaluable tool for parents should anything happen to their child. Retention of Nurses and Support of Nursing Programs in the Region: As mentioned in #5, McLeod Health continues to support Florence-Darlington Technical College and Francis Marion University to help maintain and expand their nursing programs. These nursing programs are vital to the community as the medical center continues to grow and expand to meet the needs of the region's patients as well as offer enhanced services which will require need additional staffing and nurses. McLeod also serves as a learning site for more than 100 nurses a year who are students in local nursing programs. In addition, McLeod offers scholarships to eligible students to assist those who need financial aid with nursing school. McLeod scholarships are available to college students who have been accepted in an accredited allied healthcare program such as nursing. Other Notable Contributions Made by McLeod Health during Fiscal Year 2010 included: - McLeod Medical Center Darlington provided a free breast health screening for the community in October during National Breast Cancer Awareness month. The screening was held on October 6, 2009. - Free Saturday morning Injury Clinics are hosted each fall athletic season for high school athletes. The clinics are staffed by the Certified Athletic Trainers of McLeod Sports Medicine along with the physicians of McLeod Orthopedics and Pee Dee Orthopedic Associates. These healthcare professionals provide a complimentary medical assessment to evaluate the athlete's injury and make sure the injury is properly treated. They also determine if the injury requires an x-ray, if a referral is needed for physical therapy or if the athlete needs to see an orthopedic surgeon or other specialist. - For children with chronic illnesses including Asthma, Sickle Cell, and Type I Diabetes, McLeod Children's Hospital annually hosts Camp Health each summer. A free, three-day camp for children ages five to 12, Camp Health allows medical professionals to educate the pediatric participants and their caregivers on their conditions while offering fun and exciting activities such as trips to the Myrtle Beach Aquarium, Science South and the McLeod Health and Fitness Center. In Fiscal Year 2010, McLeod Health provided the region with $96.0 million dollars worth of charity care to benefit community families. McLeod Health not only provides community benefit through the services offered but also by stimulating the local economy. Last year, we contributed more than $296 million dollars in salaries and benefits, approximately $10 million dollars in sales tax, approximately $818,000 in property taxes, and more than $13.3 million dollars in hospital provider taxes to benefit the communities where its employees and patients live and work. These efforts demonstrate the spirit of willing and compassionate service that is at the heart, 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 hospital SC 501(c)(3) Line 3 McLeod Health Foundation 555 East Cheves Street Florence SC 295020551 570818672 To raise money for Mcleod Entites SC 501(c)(3) Line 11 Type I McLeod Medical Center-Dillon 555 East Cheves Street Florence SC 295020551 510473471 To operate a hospital SC 501(c)(3) Line 3 McLeod Health 555 East Cheves Street Florence SC 295020551 510473500 To operate a hospital SC 501(c)(3) Line 3 McLeod Medical Partners LLC 4401 Barclay Down Dr Ste 300 Charlotte NC 282094670 570812002 Rental SC McLeod Regional Medical Center Of The Pee Dee Inc N/A 0 0 McLeod Physicians Associates Inc 555 East Cheves Street Florence SC 29501 582279897 Physician Services SC McLeod Regional Medical Center Of The Pee Dee Inc C 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 McLeod Health L 1171830