2024-08-14T12:48:29-05:00 2023-09-30 440160260 FORVIS MAZARS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2022-10-01 570873845 SELF MEMORIAL REGIONAL HEALTH SERVICES INC SELF 8642274255 1325 SPRING STREET GREENWOOD SC 29646 MARK WILLIAMS INTERIM CFO - SRHC 8642274255 2024-08-14 1 1 AMY BIBBY P00445891 8282542254 2022 2024-08-08 14:25:15Z MATTHEW LOGAN 1325 SPRING STREET GREENWOOD SC 29646 5213366 0 X WWW.SELFREGIONAL.ORG X 1987 SC TO PROVIDE SUPPORT TO SELF REGIONAL HEALTHCARE. 3 1 0 0 0 0 0 0 4698249 5198247 0 15119 0 0 4698249 5213366 0 0 0 0 1746900 1817501 0 0 0 2467917 3049393 4214817 4866894 483432 346472 9849222 11001642 282302 1088250 9566920 9913392 THE MISSION OF SELF MEMORIAL REGIONAL HEALTH SERVICES IS TO PROVIDE SUPPORT TO SELF REGIONAL HEALTHCARE. 0 0 4866894 294295 SELF MEMORIAL REGIONAL HEALTH SERVICES (SMRHS) IS A 501(C)(3) ORGANIZATION THAT PROVIDES HEALTHCARE RELATED SERVICES TO THE RESIDENTS OF GREENWOOD COUNTY AND THE SURROUNDING AREAS. FURTHER, THE ORGANIZATION IS DEDICATED TO SUPPORTING RELATED ENTITY SELF REGIONAL HEALTHCARE IN ACCOMPLISHING ITS MISSION. 4866894 1 0 0 0 0 0 0 0 0 0 1 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 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 1 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 0 0 0 0 0 SC X MATTHEW LOGAN 8647254253 1325 SPRING STREET GREENWOOD SC 29646 MATTHEW LOGAN MD CHAIR 1.00 50.00 X X 0 799421 31677 ROB TILLER MD BOARD MEMBER 1.00 50.00 X 0 601006 37222 DAVID HASTINGS BOARD MEMBER 1.00 X 0 0 0 0 1400427 68899 0 0 1 0 0 PATIENT SERVICE REVENU 621400 4903941 4903941 OTHER PROGRAM SERVICE 621400 160395 160395 RENTAL INCOME 531120 133911 133911 5198247 15119 15119 5213366 5198247 0 15119 1467817 1467817 31998 31998 235030 235030 82656 82656 104432 104432 3063 3063 146817 146817 10773 10773 432070 432070 3894 3894 460 460 233725 233725 12428 12428 MEDICAL SUPPLIES 2045235 2045235 REPAIRS AND MAINTENANCE 56496 56496 4866894 4866894 0 0 2852727 6640719 381471 951071 292360 301055 16678 103550 8425274 6068027 2048109 2357247 4257877 648000 9849222 11001642 282302 1088250 282302 1088250 X 9566920 9913392 9566920 9913392 9849222 11001642 346472 0 X X 0 1 X 1 0 X 215000 215000 3592577 2086896 1505681 4617697 3981131 636566 2357247 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. 0 0 0 0 0 0 0 0 0 MATTHEW LOGAN MD CHAIR 0 516701 0 272646 0 10074 0 20500 0 11177 0 831098 0 0 ROB TILLER MD BOARD MEMBER 0 421942 0 0 0 179064 0 25975 0 11247 0 638228 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 MEMORIAL REGIONAL HEALTH SERVICES. FORM 990, PART VI, SECTION A, LINE 7A THE GREENWOOD COUNTY HOSPITAL BOARD D/B/A SELF REGIONAL HEALTHCARE HAS THE POWER TO ELECT THE BOARD OF DIRECTORS OF THE FILING ORGANIZATIONS. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH THE SUPERVISION AND ASSISTANCE OF MANAGEMENT. THE FORM WAS PROVIDED TO BOARD MEMBERS FOR THEIR REVIEW PRIOR TO FILING. 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. PART VI LN 1 THE ORGANIZATION IS A SUBSIDIARY OF SELF REGIONAL HEALHTCARE A GOVERNMENTAL HOSPITAL. THE ORGANIZATION'S BOARD OF DIRECTORS IS APPOINTED BY THE SELF REGIONAL HEALTHCARE WHICH IS GOVERNED BY AN INDEPENDENT BOARD OF DIRECTORS. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. THE SURGERY CENTER AT SELF MEMORIAL HOSPITAL LLC 101 ACADEMY STREET GREENWOOD SC 29646 571087792 SURGERY CENTER SC 4903951 5105090 SELF MEMORIAL REGIONAL HEALTH SERVICES INC 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 REGIONAL HEALTHCARE PARTNERS 1325 SPRING STREET GREENWOOD SC 29646 830893719 HOSPITAL 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 THE SURGERY CENTER AT SELF MEMORIAL HOSPITAL LLC A CASH