2024-08-14T12:48:29-05:00 2023-09-30 440160260 FORVIS MAZARS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2022-10-01 830893719 SELF REGIONAL HEALTHCARE PARTNERS SELF 8778295500 1325 SPRING STREET GREENWOOD SC 29646 MARK WILLIAMS INTERIM CFO - SRHC 8778295500 2024-08-14 1 1 AMY BIBBY P00445891 8282542254 2024-08-14 2022 2024-08-08 14:25:15Z EDGEFIELD COUNTY HEALTHCARE MATTHEW LOGAN 1325 SPRING STREET GREENWOOD SC 29646 21207249 0 X WWW.SELFREGIONAL.ORG X 2018 SC PROVIDING HOSPITAL SERVICES IN EDGEFIELD COUNTY, SC 12 10 111 0 0 0 14026 0 18262490 21203429 407 3820 0 0 18276923 21207249 0 0 0 0 11338344 12558349 0 0 0 8064366 8494114 19402710 21052463 -1125787 154786 5493532 5939016 4286706 4577404 1206826 1361612 THE MISSION OF SELF REGIONAL HEALTH PARTNERS IS TO PROVIDE HOSPITAL SERVICES IN EDGEFIELD COUNTY, SC 0 0 21039028 21203429 SERVICES INCLUDED INPATIENT, OUTPATIENT, AMBULATORY PRIMARY CARE CLINIC, RURAL HEALTH CLINIC, AND EMERGENCY ROOM SERVICES TO THE COMMUNITY 21039028 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 14 0 1 111 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 10 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 SC X MATTHEW LOGAN 8647254253 1325 SPRING STREET GREENWOOD SC 29646 MATTHEW LOGAN CHAIR 1.00 50.00 X X 0 799421 31677 FG MAPPIN SECRETARY 1.00 X X 0 0 0 DAVID HASTINGS TREASURER 1.00 X X 0 0 0 ALVA LEWIS BOARD MEMBER 1.00 X 0 0 0 RON MILLENDER BOARD MEMBER 1.00 X 0 0 0 TOM DORN BOARD MEMBER 1.00 X 0 0 0 KATHLEEN WATES BOARD MEMBER 1.00 X 0 0 0 SANDRA COLLIER BOARD MEMBER 1.00 X 0 0 0 JOYCE OLIVER BOARD MEMBER 1.00 X 0 0 0 SUSAN KECK BOARD MEMBER 1.00 X 0 0 0 TIM EVANS BOARD MEMBER 1.00 50.00 X 0 470264 10916 ALTEE GOODWIN BOARD MEMBER 1.00 X 0 0 0 0 1269685 42593 0 0 1 0 ALLIED UNIVERSAL SECURITY SERVICE PO BOX 828854 PHILADEPHIA PA 19182 SECURITY SERVICES 522740 VIRTUAL RADIOLOGICAL CORP 25983 NETWORK ROAD CHICAGO IL 60673 RADIOLOGY 237510 WILLIAM BRUKER-EDGEFIELD COUNTY HEA 325 COLLETON AVE AIKEN SC 29801 RADIOLOGY 216076 3 PATIENT SERVICE REVENU 621400 19360464 19360464 ANCILLARY REVENUE 900099 1842965 1842965 21203429 3820 3820 21207249 21203429 0 3820 10697681 10697681 246095 246095 854376 854376 760197 760197 13435 13435 1722494 1722494 1199878 1199878 236581 236581 901185 901185 22634 22634 368347 368347 BAD DEBT EXPENSE 2442552 2442552 SUPPLIES EXPENSE 1587008 1587008 21052463 21039028 13435 0 499589 814780 1757203 1885247 410636 503731 16707644 13972386 2826104 2735258 5493532 5939016 4292964 4109960 -6258 467444 4286706 4577404 X 1206826 1361612 1206826 1361612 5493532 5939016 154786 0 X X 0 1 X 1 0 X 126243 126243 6038368 4975355 1063013 189953 187955 1998 8276440 6737357 1539083 2076640 2071719 4921 2735258 DUE TO MEDICARE 498548 DUE FROM MEDICAID -31104 467444 X PART X, LINE 2: SRH, SMRHS, SRHP, THE FOUNDATION, AUXILIARY, AND SMG HAVE BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS NOT-FOR-PROFIT ORGANIZATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC") AND ARE EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE IRC. SRPS, AS A WHOLLY-OWNED LIMITED LIABILITY PARTNERSHIP OF SRH, IS NOT SUBJECT TO FEDERAL INCOME TAXES. THE SURGERY CENTER IS A LIMITED LIABILITY COMPANY AND, THEREFORE, IS NOT SUBJECT TO INCOME TAXES. GREENWOOD MEDICAL COMPANY, INC., AS A WHOLLY-OWNED SUBSIDIARY OF THE FOUNDATION, IS A FOR-PROFIT ENTITY, AND AS SUCH, IS SUBJECT TO FEDERAL AND STATE INCOME TAXES. THE HOSPITAL HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2023. 1 1 1 X 1 X 1 1 1 1 0 171038 171038 0.00920 2212383 950655 1261728 0.06780 2383421 950655 1432766 0.07700 2383421 950655 1432766 0.07700 1 2442552 1691222 5437692 3765055 1672637 X 1 1 1 1 EDGEFIELD COUNTY HOSPITAL 300 RIDGE MEDICAL PLAZA EDGEFIELD SC 29824 WWW.MYECH.ORG X X X X EDGEFIELD COUNTY HOSPITAL 1 0 0 1 X X X X X X X X X 21 1 1 0 1 X HTTPS://WWW.SELFREGIONAL.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ X 1 21 1 HTTPS://WWW.SELFREGIONAL.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X 1 X HTTPS://WWW.SELFREGIONAL.ORG/HEALTHCARE-INFORMATION/FINANCIAL-AID-POLICY/ X HTTPS://WWW.SELFREGIONAL.ORG/HEALTHCARE-INFORMATION/FINANCIAL-AID-POLICY/ X HTTPS://WWW.SELFREGIONAL.ORG/HEALTHCARE-INFORMATION/FINANCIAL-AID-POLICY/ X X X X X 1 X 0 X X X 1 X 0 0 EDGEFIELD COUNTY HOSPITAL PART V, SECTION B, LINE 5: THE TEAM USED SEVERAL SOURCES OF QUANTITATIVE HEALTH, SOCIAL AND DEMOGRAPHIC DATA SPECIFIC TOTHE LAKELANDS PROVIDED BY LOCAL PUBLIC HEALTH AGENCIES, HEALTH CARE ASSOCIATIONS AND OTHER DATA SOURCES. IN ADDITION, THE CHNA TOOK INTO CONSIDERATION VARIOUS COMMUNITY SURVEYS AND INTERVIEWS. EDGEFIELD COUNTY HOSPITAL PART V, SECTION B, LINE 6A: THE ORGANIZATION CHNA IS CONDUCTED WITH SELF REGIONAL HEALTHCARE, A RELATED ORGANIZATION EDGEFIELD COUNTY HOSPITAL PART V, SECTION B, LINE 11: THE ORGANIZATION DEVELOPS AN IMPLENTATION STRATEGY TO OUTLINE HOW THE ORGANIZATION IS ADDRESSING COMMUNITY NEEDS. SEE IMPLEMENTATION DATA FOR PRIORITIES AT: HTTP://WWW.MYECH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,442,552. PART II, COMMUNITY BUILDING ACTIVITIES: EDGEFIELD COUNTY HEALTHCARE IS AFFILIATED WITH SELF REGIONAL HEALTHCARE AND THE COMMUNITY HAS BENEFITED FROM MOBILE HEALTH CARE SCREENINGS AS WELL AS MAMMOGRAPHY SERVICES. IN ADDITION, THE HOSPITAL HAS ACCESS TO SPECIALISTS SUCH AS ORTHOPEDICS AND CARDIOLOGY WHO ROTATE THROUGH THE HOSPITAL'S MEDICAL OFFICE BUILDING ON CAMPUS. PART III, LINE 2: ACCOUNTS WITH NO PAYMENT ACTIVITY FOR 120 DAYS OR 3 STATEMENTS ARE SENT TO A COLLECTION AGENCY. PART III, LINE 3: TOTAL BAD DEBT EXPENSE MULTIPLIED BY THE COST TO CHARGE RATIO. THE RESULT IS THEN ASSUMED THAT 80% OF THE TOTAL WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE. PART III, LINE 8: THE TOTAL AMOUNT SHOULD BE A COMMUNITY BENEFIT. WE ARE A SMALL CAH WITH NO OTHER PROVIDERS IN CLOSE PROXIMITY. WE ARE TRULY A COMMUNITY HOSPITAL. PART III, LINE 9B: THE ORGANIZATION'S POLICY REQUIRES THAT PATIENTS BE NOTIFIED OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. IN ADDITION, THE ORGANIZATION MAKES PRESUMPTION ELIGILIBITY BASED UPON PRIOR ELIGIBILITY DETERMINATIONS. PART VI, LINE 2: EDGEFIELD COUNTY HEALTHCARE ASSESSES THE HEALTH CARE NEEDS OF OUR COMMUNITY THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT. THIS IS DONE EVERY THREE YEARS IN COMPLIANCE WITH THE AFFORDABLE CARE ACT. THE CHNA IS POSTED ON THE HOSPITAL'S WEBSITE AT MYECH.ORG. PART VI, LINE 3: THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AS WELL AS DISCUSSION REGARDING A PATIENT'S POTENTIAL ELIGIBILITY IS MANAGED BY THE HOSPITAL'S BUSINESS OFFICE THROUGH DIRECT COMMUNICATION WITH THE PATIENT. THE FINANCIAL ASSISTANCE POLICY AND THE ELIGIBILITY REQUIREMENTS ARE POSTED ON THE HOSPITAL'S WEBSITE AT MYECH.ORG. PART VI, LINE 4: EDGEFIELD COUNTY HEALTHCARE SERVES THE COUNTY OF EDGEFIELD WITH 26,200 RESIDENTS (2021 DATA). THE POPULATION IS COMPRISED OF 63% WHITE, 34% AFRICAN-AMERICAN WITH THE MEDIAN AGE OF 43. PART VI, LINE 6: ECH IS LEASED BY SELF REGIONAL HELATHCARE PARTNERS AN AFFILIATE OF SELF REGIONAL HEALTHCARE. ECH WAS LEASED TO MAINTAIN CRITICAL HEALTH SERVICES TO THE CITIZENS OF EDGEFIELD COUNTY. 0 0 0 0 0 0 0 0 0 MATTHEW LOGAN CHAIR 0 516701 0 272646 0 10074 0 20500 0 11177 0 831098 0 0 TIM EVANS BOARD MEMBER 0 385632 0 83007 0 1625 0 0 0 10916 0 481180 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE GREENWOOD COUNTY HOSPITAL BOARD D/B/A/ SELF REGIONAL HEALTHCARE IS THE SOLE MEMBER OF SELF REGIONAL HEALTH PARTNERS. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH THE SUPERVISION AND ASSISTANCE OF MANAGEMENT. UPON COMPLETION, THE RETURN WAS PROVIDED TO ALL VOTING BOARD MEMBERS BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD OF DIRECTORS ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY ADMINISTERED BY THE ORGANIZATION'S CORPORATE PARENT. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DID NOT COMPENSATE ANY OFFICERS, TRUSTEES, OR KEY EMPLOYEES; HOWEVER, THE SECRETARY OF THE BOARD IS COMPENSATED BY A RELATED ORGANIZATION. THE BOARD OF DIRECTORS OF SELF REGIONAL HEALTHCARE SECURES AN OUTSIDE, INDEPENDENT FIRM TO EVALUATE COMPENSATION LEVELS FOR THIS INDIVIDUAL IN HIS CAPACITY AS AN EMPLOYEE OF THE RELATED ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS ARE CONSOLIDATED WITH THOSE OF SELF REGIONAL HEALTHCARE. PLEASE CONTACT THE ADMINISTRATIVE OFFICE AT 1325 SPRING STREET, GREENWOOD, SC 29646 FOR DETAILS ON FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND POLICIES. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. SELF REGIONAL HEALTHCARE 1325 SPRING STREET GREENWOOD SC 29646 570331865 HEALTHCARE SC 501(C)(3) LINE 3 N/A 0 SELF MEMORIAL HOSPITAL EMPLOYEE BENEFIT TRUST PLAN 1325 SPRING STREET GREENWOOD SC 29646 570774083 EMPLOYEE BENEFIT PLAN SC 501(C)(9) N/A SELF REGIONAL HEALTHCARE 0 SELF REGIONAL HEALTHCARE FOUNDATION 1325 SPRING STREET GREENWOOD SC 29646 570792372 FUNDRAISING/SUPPORT SC 501(C)(3) LINE 12B, II SELF REGIONAL HEALTHCARE 0 SELF REGIONAL HEALTHCARE AUXILIARY 1325 SPRING STREET GREENWOOD SC 29646 237094889 FUNDRAISING/SUPPORT SC 501(C)(3) LINE 10 SELF REGIONAL HEALTHCARE 0 SELF MEDICAL GROUP 1325 SPRING STREET GREENWOOD SC 29646 270623555 HEALTHCARE SC 501(C)(3) LINE 10 SELF REGIONAL HEALTHCARE 0 SELF MEMORIAL REGIONAL HEALTH SERVICES INC 1325 SPRING STREET GREENWOOD SC 29646 570873845 HEALTHCARE SC 501(C)(3) LINE 3 SELF REGIONAL HEALTHCARE 0 HEALTH PARTNERS OF THE LAKELANDS 1325 SPRING STREET GREENWOOD SC 29646 851863647 SUPPORTING ORGANIZATION SC 501(C)(3) LINE 12A, I SELF REGIONAL HEALTHCARE 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1