2026-08-14T09:32:04+00:00 2025-09-30 440160260 FORVIS MAZARS LLP ONE OAK ST SUITE 300 ASHEVILLE NC 28801 990 2024-10-01 814193950 APELLA HEALTH MANAGEMENT INC APEL 8645605010 700 N PINE STREET SPARTANBURG SC 29303 BRUCE DAVIS EVP, CHIEF FINANCIAL OFFICER 8645604376 2026-08-14 true true AMY BIBBY P00445891 8282542254 2026-08-13 2024 2025-03-06 01:10:19Z BRUCE HOLSTIEN 700 N PINE STREET SPARTANBURG SC 29303 524676090 false X WWW.APELLAHEALTH.COM X 2016 SC APELLA HEALTH MANAGEMENT WAS FORMED TO PROVIDE CERTAIN CHARITABLE AND HEALTH CARE SERVICES TO THE BENEFIT OF SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC., A PUBLIC HOSPITAL CORPORATION AND POLITICAL SUBDIVISION OF THE STATE OF SOUTH CAROLINA, IN FURTHERANCE OF SERVING THE HEALTH CARE NEEDS OF SPARTANBURG COUNTY COMMUNITIES IN SOUTH CAROLINA AND OTHER SURROUNDING COMMUNITIES. 10 7 8982 0 -170541 0 0 0 471855286 522344471 1904278 2331619 0 0 473759564 524676090 0 0 0 0 455459682 500298779 0 0 0 7762889 11255753 463222571 511554532 10536993 13121558 78430719 101396949 37862007 47706679 40568712 53690270 APELLA HEALTH MANAGEMENT WAS FORMED TO PROVIDE CERTAIN CHARITABLE AND HEALTH CARE SERVICES TO THE BENEFIT OF SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC., A PUBLIC HOSPITAL CORPORATION AND POLITICAL SUBDIVISION OF THE STATE OF SOUTH CAROLINA, IN FURTHERANCE OF SERVING THE HEALTH CARE NEEDS OF SPARTANBURG COUNTY COMMUNITIES IN SOUTH CAROLINA AND OTHER SURROUNDING COMMUNITIES. false false 496802951 0 522515012 THE ORGANIZATION WAS FORMED TO PROMOTE HEALTH FOR THE BENEFIT OF THE COMMUNITY AND LESSEN THE BURDENS OF GOVERNMENT BOTH WITHIN THE MEANING OF SECTION 501(C) (3) OF THE CODE BY PROVIDING CERTAIN ESSENTIAL CHARITABLE AND HEALTH CARE SERVICES, INCLUDING MANAGEMENT SERVICES TO THE SPARTANBURG RETIONAL HEALTH SERVICES DISTRICT, A STATE INSTRUMENTALITY OF SOUTH CAROLINA (THE "DISTRICT"). SUCH SERVICES ARE ESSENTIAL IN FURTHERANCE OF SERVING THE HEALTH CARE NEEDS OF THE COMMUNITIES IN AND SURROUNDING SPARTANBURG. THE DISTRICT'S HEALTH CARE FACILITIES, INCLUDE FIVE (5) ACUTE-CARE HOSPITALS; A LONG TERM ACUTE CARE HOSPITAL; TWO LONG-TERM CARE FACILITIES; A HOSPICE HOME AND IN-HOME HOSPICE SERVICES; A PHYSICIAN GROUP CONSISTING OF OVER 481 PHYSICIANS LOCATED THROUGHOUT THE DISTRICT'S SERVICE AREA; AND OTHER RELATED ENTITIES. PROVING THESE SERVICES, THE ORGANIZATION'S ACTIVITIES ALLOW THE DISTRICT TO BETTER ACHIEVE ITS CHARITABLE AND GOVERNMENTAL PURPOSES. 496802951 true false false false false false false false false false true false false true false true true false false false false false false false false false false false false true true false false false false false false false false false false false false false false true true false false false false true 7 0 true 8982 true false false false false false false false false false false true false X 10 7 false false false false false false false true true false false false true true true true true true true true true true X THE ORGANIZATION 8645604376 700 N PINE STREET SPARTANBURG SC 29303 D BYRD MILLER III PAST CHAIR 1.0 X 0 0 0 JON JENSEN BOARD MEMBER 1.0 X 0 0 0 KATHERINE O'NEILL CHAIR 1.0 X 0 0 0 MICHAEL ORSECK MD BOARD MEMBER 1.0 40.0 X 0 1407781 9004 NATASHIA JETER MD BOARD MEMBER 1.0 40.0 X 0 331797 24584 ROBERT BARRETT VICE CHAIR 1.0 X 0 0 0 SCOTT MONTGOMERY BOARD MEMBER 1.0 X 0 0 0 TERRY CASH BOARD MEMBER 1.0 X 0 0 0 VIC BAILEY III SECRETARY 1.0 X 0 0 0 WELLESLEY ALEXANDER MD TREASURER 1.0 40.0 X 0 509278 24837 BRUCE DAVIS EVP/CFO 40.0 X 921082 0 189667 ELMER HOLSTIEN PRESIDENT/CEO 40.0 X 2072543 0 661502 BRETT ENGLISH VP FINANCE 40.0 X 507092 0 41224 CODY BUTTS PRESIDENT - RURAL DIVISION HOSPITALS 40.0 X 384285 0 36467 MARIA WILLIAMSON VP-MARKETING 40.0 X 593391 0 13009 MARY JANE JENNINGS CHIEF NURSING OFFICER-SMC 40.0 X 509525 0 31671 PARKES COGGINS VICE PRESIDENT HEART/VASCULAR AND ONCOLOGY SERVICES 40.0 X 454207 0 36909 MARK AYCOCK VP-OPERATIONS 40.0 X 981075 0 32542 6423200 2248856 1101416 654 true true false 0 0 LEASED STAFFING REVENUE 541900 494183554 494183554 MANAGEMENT FEE REVENUE 541900 17344973 17344973 ADMINISTRATIVE FEE REVENUE 541900 9118482 9118482 JOINT VENTURE REVENUE 901101 393702 564243 -170541 NET EARNED PREMIUM 541900 1303760 1303760 0 0 0 0 522344471 2331619 2331619 0 0 0 0 0 0 0 0 0 524676090 522515012 -170541 2331619 4484956 4484956 408867432 408867432 12879818 11689333 1190485 43376201 42880678 495523 30690372 30548432 141940 133900 133900 7973034 229239 7743795 0 193981 59837 134144 12600 12600 10738 10738 2779306 2528000 251306 OTHER EXPENSES 152194 152194 0 0 0 0 511554532 496802951 14751581 0 7880479 15662200 35255442 24342401 2925579 1733423 0 0 0 0 92951 26844 76845 66107 25161934 0 1375993 599732 30916381 33831152 78430719 101396949 37862007 47706679 0 0 0 0 37862007 47706679 X 40568712 53690270 40568712 53690270 78430719 101396949 13121558 0 X false true true false X X 1 SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT 571075649 6 true 0 496802951 1 0 496802951 true false false false false false false false false false false false false false false true false true X SCHEDULE A, PART IV, SECTION D, LINE 2 OFFICERS APPOINTED OR SERVING SUPPORTED ORG. OFFICERS OF APELLA, WHO ARE ALSO OFFICERS OF THE SUPPORTING ORGANIZATION, ATTEND ALL BOARD AND COMMITTEE MEETINGS OF THE SUPPORTED ORGANIZATION. OFFICERS PRESENT FINANCIAL AND OPERATIONAL DATA OF BOTH APELLA AND THE DISTRICT TO THE APELLA BOARD AND ARE AVAILABLE FOR DISCUSSION AND QUESTIONS. SCHEDULE A, PART IV, SECTION D, LINE 3 SUPP. ORG. HAVE SIGNIFICANT VOICE IN INVESTMENT POLICIES THE OFFICERS PERFORM THE SAME FUNCTIONS FOR BOTH THE FILING ORGANIZATION AND SUPPORTED ORGANIZATION, AS A RESULT THE SUPPORTED ORGANIZATION HAD A DIRECT SIGNIFICANT VOICE IN THE USE OF THE INCOME AND THE ASSETS OF THE ORGANIZATION. IN ADDITION, ONE OF THE SUPPORTING ORGANIZATION'S BOARD MEMBERS IS INVITED TO ATTEND THE APELLA BOARD MEETING FOR INFORMATIONAL PURPOSES. SCHEDULE A, PART IV, SECTION E, LINE 1C THE ORGANIZATION SUPPORTED A GOVERNMENT ENTITY EXPLANATION THE ORGANIZATION SUPPORTS SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT WHICH IS A GOVERNMENTAL ENTITY. THE ORGANIZATION LESSENS THE BURDENS OF THE GOVERNMENTAL ENTITY BY PROVIDING CERTAIN ESSENTIAL CHARITABLE AND HEALTH CARE SERVICES. 92951 26844 66107 66107 DUE FROM RELATED ORGANIZATION 33831152 33831152 0 X 521950769 0 0 521950769 2725321 2725321 524676090 511554532 0 0 511554532 0 0 511554532 SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE THE COMPANY HAS BEEN GRANTED EXEMPTION FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND, ACCORDINGLY, NO PROVISION FOR INCOME TAX IS RECORDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE COMPANY HAS DETERMINED THAT IT DOES NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2025. SCHEDULE D, PART XI, LINE 4(B) OTHER REVENUES IN FORM 990 NOT IN AUDITED FINANCIAL STATEMENTS TOTAL NON-OPERATING GAINS - 2725321 X X X X false true false false false false false false false WELLESLEY ALEXANDER MD TREASURER 0 496898 0 0 0 12380 0 0 0 24837 0 534115 0 0 NATASHIA JETER MD BOARD MEMBER 0 326608 0 0 0 5189 0 10200 0 14384 0 356381 0 0 MICHAEL ORSECK MD BOARD MEMBER 0 1392741 0 0 0 15040 0 0 0 9004 0 1416785 0 0 MARK AYCOCK VP-OPERATIONS 595520 0 336370 0 49185 0 12075 0 20467 0 1013617 0 152596 0 ELMER HOLSTIEN PRESIDENT/CEO 1373455 0 655651 0 43437 0 653273 0 8229 0 2734045 0 0 0 BRUCE DAVIS EVP/CFO 687066 0 141652 0 92364 0 164833 0 24834 0 1110749 0 0 0 MARIA WILLIAMSON VP-MARKETING 372853 0 175800 0 44738 0 0 0 13009 0 606400 0 0 0 MARY JANE JENNINGS CHIEF NURSING OFFICER-SMC 350997 0 129600 0 28928 0 11267 0 20404 0 541196 0 0 0 BRETT ENGLISH VP FINANCE 355032 0 149900 0 2160 0 12075 0 29149 0 548316 0 0 0 PARKES COGGINS VICE PRESIDENT HEART/VASCULAR AND ONCOLOGY SERVICES 320667 0 132100 0 1440 0 12075 0 24834 0 491116 0 0 0 CODY BUTTS PRESIDENT - RURAL DIVISION HOSPITALS 263979 0 119200 0 1106 0 7318 0 29149 0 420752 0 0 0 SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN EXECUTIVES OF THE ORGANIZATION PARTICIPATE IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. DURING THE YEAR THE EXECUTIVES ACCRUED THE FOLLOWING AMOUNTS UNDER THE TERMS OF THE PLAN. ELMER HOLSTIEN - $641,198 BRUCE DAVIS - $152,758 THE FOLLOWING AMOUNTS WERE RECEIVED AS COMPENSATION INCLUDED ON FORM W-2 AS A RESULT OF AMOUNTS VESTED IN THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. MARK AYCOCK - $152,597 A SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC 576000934 847113EA1 2022-01-19 125980226 SEE PART VI. false false false B SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC 576000934 847113DH7 2020-07-09 77557006 SEE PART VI. false false false C SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC 571075649 847113CJ4 2017-12-21 201824247 SEE PART VI. false false false A 8190000 125991361 813503 125177858 true false false true B 6060000 77557590 781789 1770223 15916110 59089468 2021 false true true true C 0 202629995 1867799 160668524 40093672 2019 false true true true A false false true true true true 0.0 0.0 0.0 false false 0 false true B false true true true true true 0.0 0.0 0.0 false false 0 false true C false true true true true true 0.0 0.0 0.0 false false 0 false true A false true true false false false 0 false false false 0 false false true B false false true true false false 0 false false false 0 false false true C false false false true false false 0 false false false 0 false false true A true B true C true SCHEDULE K, PART II, LINE 3 COLUMN A: THE TOTAL PROCEEDS SHOWN IN PART II, LINE 3 DIFFERS FROM THE ISSUE PRICE SHOWN IN PART I, (E) DUE TO INTEREST EARNINGS ON INVESTED PROCEEDS. SCHEDULE K, PART II, LINE 13 COLUMN A: SINCE PROCEEDS OF THE BONDS WERE ISSUED FOR REFUNDING PURPOSES, THE YEAR OF SUBSTANTIAL COMPLETION IS NOT APPLICABLE. SCHEDULE K, PART III, LINE 7 COLUMN A: AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE SECURITY OR PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY OR PAYMENT TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE REPORTED IN PART III, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. SCHEDULE K, PART IV, LINE 2B COLUMN A: BOND PROCEEDS HAVE MET AN EXCEPTION TO THE REBATE REQUIREMENT. SCHEDULE K, PART II, LINE 3 COLUMN B: THE TOTAL PROCEEDS SHOWN IN PART II, LINE 3 DIFFERS FROM THE ISSUE PRICE SHOWN IN PART I, (E) DUE TO INTEREST EARNINGS ON INVESTED PROCEEDS. SCHEDULE K, PART III, LINE 7 COLUMN B: AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE SECURITY OR PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY OR PAYMENT TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE REPORTED IN PART III, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. SCHEDULE K, PART IV, LINE 2B COLUMN B: BOND PROCEEDS HAVE MET AN EXCEPTION TO THE REBATE REQUIREMENT. SCHEDULE K, PART II, LINE 3 COLUMN C: THE TOTAL PROCEEDS SHOWN IN PART II, LINE 3 DIFFERS FROM THE ISSUE PRICE SHOWN IN PART I, (E) DUE TO INTEREST EARNINGS ON INVESTED PROCEEDS. SCHEDULE K, PART III, LINE 7 COLUMN C: AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE SECURITY OR PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY OR PAYMENT TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE REPORTED IN PART III, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. SCHEDULE K, PART IV, LINE 2C COLUMN C: THE MOST RECENT 5TH YEAR REBATE REPORT WAS PREPARED ON MAY 11, 2022. SCHEDULE K, PART I, COLUMN (F) COLUMN A: THE BONDS WERE ISSUED TO CURRENT REFUND THE 2012AB REISSUED BONDS (ISSUED ON DECEMBER 19, 2017). SCHEDULE K, PART I, COLUMN (F) COLUMN B: BOND PROCEEDS WERE USED TO FINANCE CAPITAL PROJECTS, PAY OFF TWO TAXABLE LOANS, PAY A BOND INSURANCE PREMIUM, AND PAY COSTS OF ISSUANCE. SCHEDULE K, PART I, COLUMN (F) COLUMN C: BOND PROCEEDS WERE USED TO FINANCE CAPITAL PROJECTS, ADVANCE REFUND A PORTION OF SERIES 2008A BONDS (ISSUED ON JUNE 25, 2008), ADVANCE REFUND SERIES 2008D BONDS (ISSUED ON JULY 30, 2008), AND PAY COSTS OF ISSUANCE. SCHEDULE K, PART IV, LINE 2C THE MOST RECENT 5TH YEAR REBATE REPORT WAS PREPARED ON APRIL 24, 2025. SCHEDULE K, PART IV, LINE 2C COLUMN C ISSUER NAME: SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC. THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 05/11/2022 FORM 990, PART VI, LINE 11B REVIEW OF FORM 990 BY GOVERNING BODY THE RETURN WAS REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE. RETURN WAS THEN PROVIDED TO THE BOARD MEMBERS FOR THEIR REVIEW PRIOR TO ISSUANCE. ALL QUESTIONS AND COMMENTS WERE APPROPRIATELY ADDRESSED. FORM 990, PART VI, LINE 12C CONFLICT OF INTEREST POLICY BOARD MEMBERS MUST DISCLOSE TO THE BOARD ALL APPLICABLE FINANCIAL INTERESTS, BOARD MEMBERSHIPS, AND OTHER INTERESTS, AND ALL MATERIAL FACTS RELATING TO ANY ORGANIZATION ENTERING INTO A TRANSACTION OR ARRANGEMENT WITH THE CORPORATION THAT MAY RESULT IN A CONFLICT OF INTEREST. BOARD MEMBERS ARE RESPONSIBLE FOR IDENTIFYING POTENTIAL CONFLICTS AS ITEMS ARE DISCUSSED. FORM 990, PART VI, LINE 15A PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL THE ORGANIZATION UTILIZES SEVERAL SOURCES OF COMPARIBILITY DATA DURING ITS COMPENSATION REVIEW PROCESS INCLUDING: WILLIS TOWERS WATSON CONDUCTS AN ANNUAL EXECUTIVE MARKET COMPENSATION ASSESSMENT. THE DATA IS PROVIDED FROM NATIONAL SURVEYS: TOWER DATA SERVICES, MERCER, INC., INTEGRATED HEALTHCARE STRATEGIES, AND SULLIVAN COTTER AND ASSOCIATES. FORM 990, PART VI, LINE 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A COMPENSATION REPORTED IN PART VII OF THE RETURN IS REPORTED ON A CALENDAR YEAR BASIS AS REQUIRED BY THE FORM 990 INSTRUCTIONS. COMPENSATION REPORTED IN PART IX LN 5 OF THE RETURN IS REPORTED ON THE FISCAL YEAR BASIS. THIS DIFFERENCE RESULTS IN A DISCREPANCY BETWEEN THE AMOUNTS ILLUSTRATED IN EACH SECTION. PALMETTO SHIELD INSURANCE COMPANY 1444 EYE ST NW STE 950 WASHINGTON DC 20005 995013985 CAPTIVE DC 1349424 3835844 APELLA HEALTH MANAGEMENT INC SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT 101 EAST WOOD STREET SPARTANBURG SC 29303 571075649 HEALTHCARE SERVICES SC 501(C)(1) NA false false false false false false false false false false false false false false true false false false false false