TY 2017 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)
(1) TED ALMON...................................................................... TRUSTEE	1.0 ................. 2.0	X	0	0	0
(2) ROBERT BEAGLE...................................................................... TRUSTEE	1.0 ................. 2.0	X	0	0	0
(3) STEPHANIE CHAFEE RN MBA...................................................................... TRUSTEE	1.0 ................. 2.0	X	0	0	0
(4) ELEANOR C FERGUSON...................................................................... TRUSTEE	1.0 ................. 2.0	X	0	0	0
(5) JOHN H HOWLAND...................................................................... TRUSTEE	1.0 ................. 2.0	X	0	0	0
(6) JASON MARSHALL...................................................................... TRUSTEE	1.0 ................. 2.0	X	0	0	0
(7) ROBERT PANOFF...................................................................... TRUSTEE	1.0 ................. 2.0	X	0	0	0
(8) DAVID ROWE MD...................................................................... TRUSTEE	1.0 ................. 2.0	X	0	0	0
(9) RICHARD DEL SESTO MD...................................................................... TRUSTEE	1.0 ................. 2.0	X	4,800	0	0
(10) AUSTIN C SMITH...................................................................... TRUSTEE	1.0 ................. 2.0	X	0	0	0
(11) DONNA D VANDERBECK...................................................................... TRUSTEE	1.0 ................. 2.0	X	0	0	0
(12) AARON WEISBORD MD...................................................................... PRESIDENT OF THE MEDICAL STAFF	40.0 ................. 2.0	X	419,607	0	29,103
(13) EVE KEENAN RN EDD...................................................................... CHAIRPERSON UNTIL 5/2018	1.0 ................. 2.0	X	0	0	0
(14) M BEVERLY SWAN PHD...................................................................... VICE CHAIRPERSON UNTIL 5/2018	1.0 ................. 2.0	X	0	0	0
(15) JAMES FARRELL...................................................................... VICE CHAIRMAN AS OF 5/2018	1.0 ................. 2.0	X	0	0	0
(16) DENNIS LYNCH...................................................................... CHAIRMAN AS OF 5/2018	1.0 ................. 2.0	X	0	0	0
(17) SALVATORE ABBRUZZESE JR DO...................................................................... VP OF THE MEDICAL STAFF	40.0 ................. 2.0	X	248,483	2,875	27,487

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) BETTY RAMBUR PHD........................................................................ SECRETARY AS OF 5/2018	1.0 .......................2.0	X					0	0
(19) VICTORIA A WICKS........................................................................ TREASURER AS OF 5/2018	1.0 .......................2.0	X					0	0
(20) ROBERT DYER........................................................................ TRUSTEE AS OF 7/2018	1.0 .......................2.0	X					0	0
(21) LOUIS R GIANCOLA........................................................................ PRESIDENT AND CEO	40.0 .......................2.0		X				392,300	26,348
(22) THOMAS J BREEN........................................................................ CHIEF FINANCIAL OFFICER	40.0 .......................3.0		X				393,731	26,218
(23) JAMES CORCORAN........................................................................ VP OF MED AFFAIRS UNTIL 5/2018	40.0 .......................0.0			X			275,349	29,271
(24) ANNE SCHMIDT........................................................................ VP OF PATIENT CARE SERVICES	40.0 .......................0.0			X			229,442	9,674
(25) KIMBERLY O'CONNELL........................................................................ VP, CHIEF STRATEGY OFFICER	40.0 .......................0.0			X			282,130	20,686
(26) LISA RAMEAKA........................................................................ CMO & VPMA BEGIN 6/2018	40.0 .......................0.0			X			331,187	28,913
(27) DAVID BADER........................................................................ PHYSICIAN	40.0 .......................0.0				X		448,498	29,409
(28) NEIL BRANDON........................................................................ PHYSICIAN	40.0 .......................0.0				X		452,503	29,425
(29) DAVID BROZA........................................................................ PHYSICIAN	40.0 .......................0.0				X		415,153	18,263
(30) STEVEN FERA........................................................................ PHYSICIAN	40.0 .......................0.0				X		367,659	25,577
(31) GERALD COLVIN........................................................................ PHYSICIAN	40.0 .......................0.0				X		548,519	28,992
(32) KATHLEEN CASSIN MD........................................................................ FORMER TRUSTEE/PHYSICIAN	40.0 .......................0.0					X	196,455	15,369
(33) WILLIAM SABINA MD FACEP........................................................................ FORMER PRES OF MED STAFF 10/16	10.0 .......................2.0					X	35,000	0

(A) Name and business address	(B) Description of services	(C) Compensation
SOUTHERN RI PULMONARY CRITICAL CA, 25 BURNS WAY EAST GREENWICH,RI02818	PULMONARY SERVICES	694,971
ORTHOPEDICS RHODE ISLAND, 10 DORRANCE STREET PROVIDENCE,RI02903	ORTHOPEDICS & PT	623,890
INTEGRA COMMUNTIY CARE NETWORK, 45 WILLARD AVENUE PROVIDENCE,RI02905	ACCOUNTABLE CARE ORG	334,617
BENTLEY BUILDERS LLC, 250 SCRABBLETOWN ROAD NORTH KINGSTOWN,RI02852	CONSTRUCTION	175,046
SOUTH COUNTY PULMONARY MEDICINE INC, 360 KINGSTOWN ROAD SUITE 207 NARRAGANSETT,RI02882	PULMONARY EVALUATION	145,970
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 14

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM

Employer identification number

05-0445136

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2019 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM

Employer identification number

05-0445136

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM		Employer identification number 05-0445136

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM			Employer identification number 05-0445136
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM

Employer identification number

05-0445136

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2019

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2019

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

54,345

Total. Add lines 1c through 1i ....................................................................................................

54,345

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1, LOBBYING ACTIVITIES	THE ORGANIZATION PAID BRADFORD GROUP FOR LOBBYING ACTIVITY. IN ADDITION, A PORTION OF THE DUES PAID TO THE HOSPITAL ASSOCIATION OF RHODE ISLAND WERE USED FOR LOBBYING.

Schedule C (Form 990 or 990EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM

Employer identification number

05-0445136

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	40,867,856	36,410,321	33,592,284	35,559,384	33,440,630
b	Contributions ...	1,285,852
c	Net investment earnings, gains, and losses	1,680,199	5,013,956	3,144,062	-1,355,121	2,269,181
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	150,000	556,421	326,025	611,979	150,427
f	Administrative expenses ....
g	End of year balance ......	43,683,907	40,867,856	36,410,321	33,592,284	35,559,384

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

99.900 %

Permanent endowment SchDMd Bullet

0.100 %

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

Yes

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	473,121		473,121
b	Buildings ....	53,399,170	36,411,713	16,987,457
c	Leasehold improvements	3,347,711	1,713,025	1,634,686
d	Equipment ....	119,179,835	76,074,390	43,105,445
e	Other .....	5,578,268	2,674,403	2,903,865
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				65,104,574

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3) Other (A) ENDOWMENT ASSETS	7,386,021	F
(B) ASSETS HELD IN TRUST	9,652,443	F
(C) DONOR RESTRICTED FUNDS	1,745,091	F
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	18,783,555

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	32,654,905
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	191,148,221
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	159,299
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	10,446,057
e	Add lines 2a through 2d .....................			2e	10,605,356
3	Subtract line 2e from line 1..................			3	180,542,865
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a	67,983
b	Other (Describe in Part XIII.) ...........	4b	4,204,953
c	Add lines 4a and 4b....................			4c	4,272,936
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	184,815,801

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	179,303,984
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d	2,058,431
e	Add lines 2a through 2d....................			2e	2,058,431
3	Subtract line 2e from line 1...................			3	177,245,553
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a	67,983
b	Other (Describe in Part XIII.) ............	4b	4,204,953
c	Add lines 4a and 4b.....................			4c	4,272,936
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	181,518,489

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART V, LINE 4	THE HOSPITAL'S ENDOWMENT FUNDS ARE USED PRIMARILY TO SUPPORT OPERATIONS AND FUND CAPITAL EXPENDITURES. THE AMOUNT OF $(135,852) ON LINE 1E REPRESENTS A TRANSFER FROM OPERATIONS. THERE WERE NO CONTRIBUTIONS RECEIVED FOR THE YEAR ENDED SEPTEMBER 30, 2018.
PART X, LINE 2	THE FOOTNOTE BELOW IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF THE SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM ENDOWMENT: THE NOT-FOR-PROFIT ENTITIES (SOUTH COUNTY HEALTHCARE SYSTEM ENDOWMENT, SOUTH COUNTY HOSPITAL AND VNS HOMECARE, INC.) OPERATE AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE TAX PROVISIONS AND RELATED LIABILITIES FOR SILVER SPRING HEALTH CARE MANAGEMENT WHICH IS A TAXABLE ENTITY CONTROLLED BY THE HOSPITAL ARE NOT SIGNIFICANT. THE HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY TO BE REALIZED UPON SETTLEMENT. CHANGES IN RECOGNITION IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. THE HOSPITAL DID NOT RECOGNIZE THE EFFECT OF ANY INCOME TAX POSITIONS IN EITHER 2018 OR 2017. ON DECEMBER 22, 2017, THE PRESIDENT SIGNED INTO LAW H.R. 1, ORIGINAL KNOWN AS THE TAX CUTS AND JOBS ACT. THE NEW LAW INCLUDES SEVERAL PROVISIONS THAT RESULT IN SUBSTANTIAL CHANGES TO THE TAX TREATMENT OF TAX-EXEMPT ORGANIZATIONS AND THEIR DONORS. THE HOSPITAL HAS REVIEWED THESE PROVISIONS AND THE POTENTIAL IMPACT AND CONCLUDED THE ENACTMENT OF HR. 1 WILL NOT HAVE A MATERIAL EFFECT ON THE OPERATIONS OF THE ORGANIZATION.
PART XI, LINE 2D - OTHER ADJUSTMENTS	CHANGE IN FUND STATUS OF EMPLOYEE BENEFIT PLAN 4,406,803 UNREALIZED GAIN ON INTEREST RATE SWAP 2,532,625 RENTAL EXPENSES 2,058,431 NET ASSETS RELEASED FOR CAPITAL EXPENDITURES 1,237,352 UNREALIZED CHANGE IN EQUITY INTERESTS IN LP 210,846 ------------ TOTAL TO SCHEDULE D, PART XI, LINE 2D 10,446,057
PART XI, LINE 4B - OTHER ADJUSTMENTS	PROVISION FOR BAD DEBTS 4,204,953 PART XII, LINE 2D - OTHER ADJUSTMENTS RENTAL EXPENSES 2,058,431 PART XII, LINE 4B - OTHER ADJUSTMENTS PROVISION FOR BAD DEBTS 4,204,953

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM

Employer identification number

05-0445136

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	4,935,880	3,405,314	1,530,566	0.860 %
b	Medicaid (from Worksheet 3, column a) . . . . .	1,832,344	1,537,194	295,150	0.170 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	12,905,507	10,487,194	2,418,313	1.360 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	19,673,731	15,429,702	4,244,029	2.390 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	760,831	306,205	454,626	0.260 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .	229,680	51,734	177,946	0.100 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	77,797		77,797	0.040 %
j	Total. Other Benefits . .	1,068,308	357,939	710,369	0.400 %
k	Total. Add lines 7d and 7j .	20,742,039	15,787,641	4,954,398	2.790 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

7,008,255

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

41,102,954

Enter Medicare allowable costs of care relating to payments on line 5.....

47,748,549

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-6,645,595

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %
1SOUTH COUNTY
2RADIATION THERAPY
3LLC	RADIATION ONCOLOGY	35 %
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2019

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	SOUTH COUNTY HOSPITAL 100 KENYON AVENUE WAKEFIELD,RI02879 WWW.SOUTHCOUNTYHEALTH.ORG H0S00114	X

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	SOUTH COUNTY HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): WWW.SOUTHCOUNTYHEALTH.ORG

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): WWW.SOUTHCOUNTYHEALTH.ORG

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	SOUTH COUNTY HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.%
and FPG family income limit for eligibility for discounted care of 0.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW.SOUTHCOUNTYHEALTH.ORG

The FAP application form was widely available on a website (list url):

WWW.SOUTHCOUNTYHEALTH.ORG

A plain language summary of the FAP was widely available on a website (list url):
WWW.SOUTHCOUNTYHEALTH.ORG

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	SOUTH COUNTY HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	SOUTH COUNTY HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
PART V, SECTION B, LINE 5	TO ENSURE THE CHNA REFLECTED THE NEEDS OF THE COMMUNITY SERVED BY SOUTH COUNTY HOSPITAL (THE HOSPITAL), IN ADDITION TO PARTICIPATION IN THE STATEWIDE HARI CHNA; THE HOSPITAL AND L&M WESTERLY HOSPITAL, ANOTHER HOSPITAL SERVING THE COUNTY, HELD A COUNTY-WIDE PARTNER FORUM ON OCTOBER 2015. THE FORUM INCLUDED 21 PARTNERS FROM THE COMMUNITY. THE OBJECTIVE OF THE FORUM WAS TO SOLICIT FEEDBACK FOR REPRESENTATIVES OF KEY STAKEHOLDER GROUPS, FACILITATE COLLABORATION TO ADDRESS COMMUNITY HEALTH NEEDS, AND ALIGN COMMUNITY HEALTH IMPROVEMENT EFFORTS BETWEEN THE HARI CHNA, THE RI DOH, AND THE LOCAL HEALTH EQUITY ZONES (HEZ). THE PARTICIPANTS OF THE FORUM ARE IDENTIFIED IN THE HOSPITALS CHNA APPROVED IN AUGUST 2016 BY THE HOSPITALS BOARD AND IMPLEMENTATION PLAN DATED JANUARY 30, 2017.
PART V, SECTION B, LINE 6A	THE OTHER HOSPITAL FACILITIES THAT SOUTH COUNTY HOSPITAL PARTNERED WITH FOR THE COMPLETION OF THE CHNA WERE: CARE NEW ENGLAND HEALTH SYSTEMS, CHARTERCARE, LANDMARK MEDICAL CENTER, AND THE L&M WESTERLY HOSPITAL.
PART V, SECTION B, LINE 6B	THE OTHER ORGANIZATIONS THAT SOUTH COUNTY HOSPITAL PARTNERED WITH FOR THE COMPLETION OF THE CHNA WERE: THE HOSPITAL ASSOCIATION OF RHODE ISLAND, AND THE RHODE ISLAND DEPARTMENT OF HEALTH.
PART V, SECTION B, LINE 7D	THE HOSPITAL ALSO PARTICIPATED IN A STATEWIDE COMPREHENSIVE CHNA LED BY THE HOSPITAL ASSOCIATION OF RHODE ISLAND (HARI) AND ITS MEMBER HOSPITALS AND ENGAGED BAKER TILLY AND CREATED A WEBSITE (WWW.RHODEISLANDHEALTHCAREMATTERS.ORG). THE SITE PROVIDED ACCESS TO HEALTH STATISTICS AND INDICATORS FROM SECONDARY DATA SOURCES THAT ARE SPECIFIC TO LOCAL GEOGRAPHIES IN RI AND ALSO IS A COMMUNICATION VENUE FOR SHARING BEST PRACTICES AND RELEVANT HEALTH INFORMATION.
PART V, SECTION B, LINE 11	The 2016 community needs identified for Washington County were behavioral health (including mental health and substance abuse), incidence of cancer, chronic diseases (high cholesterol, diabetes). For Washington County, incidence of suicide, audit binge drinking, DUI related driving deaths, drug poisoning deaths were all above the state average. South County Hospital and The L&M Westerly Hospital held a county-wide Partner Forum on October 27, 2015 to solicit feedback from representative of key state holder groups, facilitate collaboration to address community health needs, and align community health improvement efforts among the HARI CHNA, the RI DOH , and the local Health Equity Zones. Based upon the CHNA and the feedback from the Washington County community South County Hospitals Board of Trustees has set behavioral health as the key focus and priority. By aligning community health activities with local and statewide priorities, in conjunction with the fact that twenty-five (25%) of South County Health inpatients with a chronic condition also have a behavioral health diagnosis, South County Hospital will take a comprehensive approach to addressing the most urgent needs in the community. As with all programs and services, the hospital system will continue to monitor community needs and adjust programming and services accordingly. Other organizations in the community are focusing on the remainder of the health needs.
PART V, SECTION B, LINE 22D	SOUTH COUNTY HOSPITAL PROVIDES FREE CARE TO ALL INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE.

Schedule H (Form 990) 2019

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2019

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
SOUTH COUNTY HOSPITAL	PART I, LINE 6A THE ORGANIZATION PREPARES AN ANNUAL REPORT DETAILING MAJOR ACCOMPLISHMENTS AND COMMUNITY BENEFITS. IN ADDITION, THE ORGANIZATION MAINTAINS A COMPREHENSIVE WEBSITE INCLUDING INFORMATION ON AVAILABLE SERVICES, RESULTS OF VARIOUS QUALITY SURVEYS, AND GENERAL HEALTH EDUCATIONAL INFORMATION FOR THE COMMUNITY. THE HOSPITAL COMPLETED A CHNA WHICH IS AVAILABLE ON THE HOSPITAL WEB SITE.
PART I, LINE 7, COLUMN (F)	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $4,204,953.
PART II, COMMUNITY BUILDING ACTIVITIES	SOUTH COUNTY HOSPITAL PROVIDES VARIOUS PROGRAMS FREE OF CHARGE OR FOR A NOMINAL FEE TO PROMOTE THE HEALTH OF THE COMMUNITY IT SERVES. THESE PROGRAMS INCLUDE FREQUENT SUPPORT GROUPS, WELLNESS SCREENINGS, LECTURES, SEMINARS AND PRESENTATIONS ON VARIOUS HEALTH TOPICS. A NUMBER OF THE PROGRAMS FOCUS ON CHRONIC DISEASE MANAGEMENT. THE HOSPITAL HAS CREATED A PATIENT CENTERED MEDICAL COMMUNITY.
PART III, LINE 2 & 3	SOUTH COUNTY HOSPITAL RECORDS BAD DEBT EXPENSE IN ACCORDANCE WITH U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPALS (GAAP). A COST TO CHARGE RATIO WAS USED AS A COSTING METHOD FOR THE AMOUNTS REPORTED IN LINES 2 AND 3. THE HOSPITAL PROVIDES AN AUTOMATIC 40% SELF PAY DISCOUNT. THE AMOUNT REPORTED ON THE HOSPITAL'S AUDITED STATEMENTS WAS UNDERSTATED BY THIS DISCOUNT OF THE GROSS CHARGES AND THE APPLICATION OF A COST TO CHARGE RATIO BASED ON GROSS CHARGES NOT NET CHARGES. PART III, LINE 4 THE FOOTNOTE REFERENCES TO BAD DEBT EXPENSE ARE ON THE FOLLOWING PAGES IN THE ATTACHED AUDITED FINANCIAL STATEMENTS: PAGE 9 FN #2(E) AND PAGE 22 & 23 FN #8.
PART III, LINE 8	SOUTH COUNTY HOSPITAL SERVES THE MEDICARE POPULATION IN THE COMMUNITY AS PART OF ITS MISSION WITH THE KNOWLEDGE OF THE SIGNIFICANT DIFFERENTIAL BETWEEN PAYMENT AND COST. THIS SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT AS IS THE HOSPITALS CHARITY CARE AND BAD DEBT. THE HOSPITAL UTILIZED THE COST TO CHARGES RATIO AS REPORTED IN THE FY2017 MEDICARE COST REPORT FOR INPATIENT AND OUTPATIENT CHARGES.
PART III, LINE 9B	After our patients have received services, it is the policy of South County Hospital to bill patients and their applicable payers on a timely and accurate basis. During this billing and collection process, staff will be committed to providing quality customer service and timely follow-up on all outstanding accounts. It is the goal of this policy to provide clear and consistent guidelines for conducting billing and collections functions in a manner that promotes compliance, patient satisfaction, and efficiency. Though the use of billing statements, written correspondence, and phone calls, South County Hospital; will make diligent efforts to inform patients of their financial responsibilities and available financial assistance options, as well as follow up with patients regarding outstanding accounts. Additionally, this policy requires South County Hospital to make reasonable efforts to determine a patients eligibility for financial assistance under South County Hospitals financial assistance policy before engaging in extraordinary collections actions to obtain payment.
PART VI, LINE 2	SOUTH COUNTY HOSPITAL IDENTIFIES ITS COMMUNITIES HEALTH NEEDS BY PARTICIPATION IN COMMUNITY AND STATE COALITIONS, BOARDS, COMMITTEES, COMMISSIONS, PANELS AND ADVISORY GROUPS INCLUDING INPUT FROM COMMUNITY MEMBERS AND PROVIDERS. QUARTERLY (OR AS AVAILABLE) INTERNAL PATIENT SURVEYS AND PUBLICLY AVAILABLE DATA ON THE COMMUNITY INCLUDING DEMOGRAPHICS AND UTILIZATION ARE ANALYZED. THE HOSPITAL PARTICIPATES WITH OTHER HEALTH CARE PROVIDERS AND ORGANIZATIONS IN THE STATE FOR THE COMPLETION OF A CHNA. THE RHODE ISLAND DEPARTMENT OF HEALTH SERVES AS AN IMPORTANT SOURCE OF INFORMATION AND POPULATION BASED DISEASE OCCURENCE AND HEALTHCARE NEEDS FOR THE STATE AND THE HOSPITALS COMMUNITY.
PART VI, LINE 3	SOUTH COUNTY HOSPITAL COMMUNICATES WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS BY PROVIDING FINANCIAL COUNSELING TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL ASSISTANCE POLICIES AND EXTERNAL PROGRAMS (INCLUDING MEDICAID, ETC) THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION PROCESSES. IN RESPONSE TO PATIENTS SEEKING FINANCIAL ASSISTANCE, THE SAME INFORMATION REGARDING THE FINANCIAL ASSISTANCE PROGRAMS IS PROVIDED BY ONSITE PATIENT FINANCIAL SERVICES STAFF IN BOTH INPATIENT AND OUTPATIENT DEPARTMENTS INCLUDING THE EMERGENCY DEPARTMENT. THE HOSPITALS FINANCIAL ASSISTANCE POLICY IS PROVIDED ON THE HOSPITAL WEB SITE AND POSTED IN VARIOUS DEPARTMENTS. THE SELF PAY BILLING STATEMENTS ADVISE PATIENTS TO CONTACT THE HOSPITAL REGARDING FINANCIAL ASSISTANCE ELIGIBILITY.
PART VI, LINE 4	THE PRIMARY SERVICE AREA INCLUDES ALL OF WASHINGTON COUNTY, RI COMMONLY KNOWN AS SOUTH COUNTY. THE TOWNS THAT COMPRISE THE SECONDARY SERVICE ARE INCLUDE THE TOWNS OF BLOCK ISLAND, HOPKINTON, RICHMOND, WESTERLY AS WELL AS, THE POPULATION FROM ADJOINING COMMUNITIES IN KENT COUNTY (EAST GREENWICH AND WEST GREENWICH). BASED ON THE DEMOGRAPHIC INFORMATION ANALYZED FOR THE CHNA OBTAINED FROM 2015 THE NIELSON COMPNAY AND 2009-2013 UNITED STATES CENSUS THE SOUTH COUNTY HOSPITAL SERVICE ARE ENCOMPASSES 77,947 HOUSING UNITS, 74.5% ARE OWNER-OCCUPIED AND 25.5% ARE RENTER-OCCUPIED. THE MEDIAN HOUSEHOLD INCOME IS $71,495: HOWEVER, INCOME VARIES BY RACE. THE MEDIAN INCOME FOR BLACKS/AFRICAN AMERICANS IS $33,333. APPROXIMATELY 67% OF RESIDENT'S AGE 16 YEARS OR OVER ARE IN THE WORKFORCE AND 5.2% ARE UNEMPLOYED, WHICH IS LOWER THAN THE STATE AND NATIONAL AVERAGES. THE MAJORITY OF RESIDENTS IN THE WORKFORCE ARE FOR-PROFIT PRIVATE WORKERS (62%) AND HOLD WHITE COLLAR POSITIONS (65.7%). THE PERCENTAGE OF RESIDENTS LIVING IN POVERTY WITH IN SOUTH COUNTY HOSPITAL'S SERVICE ARE IS 8.3%; 9.7% OF WHICH ARE CHILDREN LIVING IN POVERTY. THEIR PERCENTAGES ARE LOWER THAN THE STATE (13.6% AND 19.5%, REPECTIVELY). THE CHNA ASSESSMENT COMPLETED IN 2016 PROVIDES ADDITIONAL INFORMATION ON THE COMMUNITY SERVED BY THE HOSPITAL AND IS AVAILABLE ON THE HOSPITAL WEBSITE AT THE FOLLOWING LINK: WWW.SOUTHCOUNTYHEALTH.ORG.
PART VI, LINE 5	SOUTH COUNTY HOSPITAL IS COMMITTED TO SERVING THE COMMUNITYS HEALTH NEEDS BY CONTINUED INVESTMENT OF FUNDS INTO THE FACILITIES, EQUIPMENT, AND SERVICES PROVIDED. THE HOSPITAL IS COMMITTED TO PROVIDING FUNDS TO RECRUIT AND MAINTAIN PHYSICIANS IN THE COMMUNITY TO MEET THE POPULATIONS NEEDS. THE HOSPITAL AND ITS PHYSICIAN AND COMMUNITY PARTNERS HAVE EMBARKED ON THE CREATION OF A "PATIENT CENTERED MEDICAL COMMUNITY." THE PATIENT CENTERED MEDICAL COMMUNITY (PCMC) WILL OFFER AN INTEGRATED SYSTEM OF CARE THAT IMPROVES THE HEALTH STATUS OF THE POPULATION WE SERVE, PARTICULARLY THOSE WITH AND AT RISK FOR CHRONIC CONDITIONS. TO ACHIEVE THIS VISION, THE PCMC WILL: 1. BE BUILT UPON A FOUNDATION OF STRONG PRIMARY CARE PRACTICES WITH ENHANCED LINKAGES TO THE HOSPITAL, SPECIALISTS AND COMMUNITY-BASED RESOURCES. 2. ADOPT AND IMPLEMENT THE PATIENT CENTERED MEDICAL HOME (PCMH) MODEL BASED ON THE NCQA RECOGNITION STANDARDS AND GUIDELINES, SUPPORTED BY LOCAL MULTIDISCIPLINARY TEAMS AND CHRONIC CARE SERVICES. 3. FACILITATE ADOPTION OF HEALTH INFORMATION TECHNOLOGY TO ENSURE ELECTRONIC INFORMATION SHARING EIGHTEEN (18) PRIMARY CARE PHYSICIANS IN SEVEN (7) SOUTH COUNTY BASED PRACTICES HAVE ADOPTED AND IMPLEMENTED THE PATIENT CENTERED MEDICAL HOME (PCMH) MODEL. THE SOUTH COUNTY "MEDICAL COMMUNITY" INITIATIVE (PCMC) WILL ADVANCE THAT CONCEPT INTO A BROADER SYSTEM OF COMMUNITY-BASED HEALTHCARE THAT LINKS PRIMARY CARE PHYSICIANS AND THEIR PATIENTS TO DISEASE MANAGEMENT SERVICES, SPECIALISTS, EMERGENCY SERVICES AND INPATIENT HOSPITAL SERVICES, SO THAT CARE IS OPTIMALLY COORDINATED AND INFORMATION FLOWS TO SUPPORT THE BEST OUTCOMES FOR PATIENTS AND SYSTEM EFFICIENCY. THE SOUTH COUNTY CONTINGENT IS A PARTICIPANT IN THE RI CHRONIC CARE SUSTAINABILITY INITIATIVE (CSI) WHICH IS A DEMONSTRATION PILOT OF THE PCMH MODEL. THIS PROVIDES A FOUNDATION BASED ON AN INTEGRATED COLLABORATIVE APPROACH THAT WILL ASSIST PHYSICIAN PRACTICES AND THE HOSPITAL TOWARD ENHANCING THE MANAGEMENT OF PATIENTS WITH CHRONIC DISEASES. THE CHNA IMPLEMENTATION PLAN, INCLUDED WITH THIS RETURN, PROVIDES ADDITIONAL DETAILS OF THE HOSPITALS CONTINUED COMMITTMENT TO ADDRESS THE HEALTH NEEDS OF THE COMMUNITY.
PART VI, LINE 6	THE HOSPITAL IS PART OF AN AFFILIATED HEALTHCARE SYSTEM KNOWN AS SOUTH COUNTY HEALTH OFFERING A COMPREHENSIVE RANGE OF ADVANCED INPATIENT, OUTPATIENT, AND HOME HEALTH SERVICES. ACCREDITED BY THE JOINT COMMISSION, THE HEALTHCARE SYSTEM IS MADE UP OF THE HOSPITAL, VNS HOME HEALTH SERVCES, SOUTH COUNTY QUALITY CARE, AND SOUTH COUNTY SURGICAL SUPPLY. THE HOSPITAL IS DEDICATED TO ENRICHING THE QUALITY OF LIFE OF SOUTHERN RHODE ISLAND COMMUNITY MEMBERS AND VISITORS THROUGH THE DELIVERY OF QUALITY HEALTHCARE SERVICES, THE DEVELOPMENT OF COOPERATIVE RELATIONSHIPS WITH OTHER HEALTHCARE PROVIDERS AND THE PROMOTION OF WELLNESS THROUGH HEALTH EDUCATION AND AWARENESS.
PART VI, LINE 7	LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: RI

Schedule H (Form 990) 2019

Additional Data

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM

Employer identification number

05-0445136

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2019

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1AARON WEISBORD MD PRESIDENT OF THE MEDICAL STAFF	(i) (ii)	215,114 ------------- 0	204,242 ------------- 0	251 ------------- 0	9,450 ------------- 0	19,653 ------------- 0	448,710 ------------- 0	0 ------------- 0
2SALVATORE ABBRUZZESE JR DO VP OF THE MEDICAL STAFF	(i) (ii)	234,769 ------------- 2,875	13,375 ------------- 0	339 ------------- 0	8,737 ------------- 0	18,750 ------------- 0	275,970 ------------- 2,875	0 ------------- 0
3LOUIS R GIANCOLA PRESIDENT AND CEO	(i) (ii)	367,088 ------------- 0	0 ------------- 0	25,212 ------------- 0	9,450 ------------- 0	16,898 ------------- 0	418,648 ------------- 0	0 ------------- 0
4THOMAS J BREEN CHIEF FINANCIAL OFFICER	(i) (ii)	390,814 ------------- 0	0 ------------- 0	2,917 ------------- 0	9,450 ------------- 0	16,768 ------------- 0	419,949 ------------- 0	0 ------------- 0
5JAMES CORCORAN VP OF MED AFFAIRS UNTIL 5/2018	(i) (ii)	275,349 ------------- 0	0 ------------- 0	0 ------------- 0	9,450 ------------- 0	19,821 ------------- 0	304,620 ------------- 0	0 ------------- 0
6ANNE SCHMIDT VP OF PATIENT CARE SERVICES	(i) (ii)	229,442 ------------- 0	0 ------------- 0	0 ------------- 0	7,985 ------------- 0	1,689 ------------- 0	239,116 ------------- 0	0 ------------- 0
7KIMBERLY O'CONNELL VP, CHIEF STRATEGY OFFICER	(i) (ii)	282,130 ------------- 0	0 ------------- 0	0 ------------- 0	4,220 ------------- 0	16,466 ------------- 0	302,816 ------------- 0	0 ------------- 0
8LISA RAMEAKA CMO & VPMA BEGIN 6/2018	(i) (ii)	330,666 ------------- 0	0 ------------- 0	521 ------------- 0	9,450 ------------- 0	19,463 ------------- 0	360,100 ------------- 0	0 ------------- 0
9DAVID BADER PHYSICIAN	(i) (ii)	190,046 ------------- 0	258,452 ------------- 0	0 ------------- 0	9,474 ------------- 0	19,935 ------------- 0	477,907 ------------- 0	0 ------------- 0
10NEIL BRANDON PHYSICIAN	(i) (ii)	203,098 ------------- 0	249,405 ------------- 0	0 ------------- 0	9,490 ------------- 0	19,935 ------------- 0	481,928 ------------- 0	0 ------------- 0
11DAVID BROZA PHYSICIAN	(i) (ii)	189,877 ------------- 0	225,276 ------------- 0	0 ------------- 0	9,470 ------------- 0	8,793 ------------- 0	433,416 ------------- 0	0 ------------- 0
12STEVEN FERA PHYSICIAN	(i) (ii)	194,722 ------------- 0	172,937 ------------- 0	0 ------------- 0	9,477 ------------- 0	16,100 ------------- 0	393,236 ------------- 0	0 ------------- 0
13GERALD COLVIN PHYSICIAN	(i) (ii)	385,373 ------------- 0	163,146 ------------- 0	0 ------------- 0	9,450 ------------- 0	19,542 ------------- 0	577,511 ------------- 0	0 ------------- 0
14KATHLEEN CASSIN MD FORMER TRUSTEE/PHYSICIAN	(i) (ii)	160,760 ------------- 0	35,695 ------------- 0	0 ------------- 0	6,879 ------------- 0	8,490 ------------- 0	211,824 ------------- 0	0 ------------- 0
15WILLIAM SABINA MD FACEP FORMER PRES OF MED STAFF 10/16	(i) (ii)	35,000 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	35,000 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
SEVERANCE PAYMENTS	PART I, LINE 4A JAMES CORCORAN RECEIVED SEVERANCE IN THE AMOUNT OF 104,293 DURING THE FISCAL YEAR 2018. UNDER THE TERMS OF HIS AGREEMENT SEVERANCE WAS PAID FOR ONE YEAR FOLLOWING HIS TERMINATION IN MAY 2018.

Schedule J (Form 990) 2019

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM

Employer identification number
05-0445136

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	RI HEALTH & EDUCATION BLDG CORP SERIES 2015	52-1300173		08-12-2015	45,545,000	REFINANCE 2012 BOND ISSUE		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	8,315,000
2 Amount of bonds legally defeased ..............	0
3 Total proceeds of issue ..................	45,545,000
4 Gross proceeds in reserve funds .............	0
5 Capitalized interest from proceeds .............	0
6 Proceeds in refunding escrows ...............	0
7 Issuance costs from proceeds ...............	0
8 Credit enhancement from proceeds .............	0
9 Working capital expenditures from proceeds .............	0
10 Capital expenditures from proceeds .............	0
11 Other spent proceeds .............	45,545,000
12 Other unspent proceeds .............	0
13 Year of substantial completion .............	2015
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2018, a current refunding issue)? ........
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2018, an advance refunding issue)? ........
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2019

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X
b Exception to rebate? ........		X
c No rebate due? .........		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X
b Name of provider ..........	MERRILL LYNCH CAPITA
c Term of hedge .........	30 %
d Was the hedge superintegrated? ......		X
e Was the hedge terminated? ........		X

Schedule K (Form 990) 2019

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X
b Name of provider ..........	0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
SCHEDULE K, PART II, LINE 11	BOND FUNDS WERE USED TO REFUND THE 10/1/2012 BOND ISSUE.
SCHEDULE K, PART III, LINE 3A	MANAGEMENT OR SERVICE CONTRACTS THAT MAY RESULT IN PRIVATE BUSINESS USE: ANY MANAGEMENT OR SERVICE CONTRACTS THAT MAY RESULT IN PRIVATE BUSINESS USE OF BOND-FINANCED PROPERTY ARE INCIDENTAL AND FALL UNDER THE SAFE HARBOR PROVIDED.
SCHEDULE K, PART III, LINE 9	SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM MONITORS THEIR BOND FOR POST ISSUANCE BOND COMPLIANCE, BUT DOES NOT HAVE A SET OF WRITTEN PROCEDURES. THEY ARE IN THE PROCESS OF DEVELOPING WRITTEN PROCEDURES.

Schedule K (Form 990) 2019

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Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM

Employer identification number

05-0445136

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2019

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) WILLIAM SABINA	FORMER TRUSTEE & PRESIDENT OF THE MEDICAL STAFF	35,000	ADMIN CLINICAL SUPPORT		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM

Employer identification number

05-0445136

Return Reference	Explanation
ORGANIZATION'S MISSION	FORM 990, PART III, LINE 1 SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM IS DEDICATED TO ENRICHING THE QUALITY OF LIFE OF SOUTHERN RHODE ISLAND COMMUNITY MEMBERS AND VISITORS THROUGH THE DELIVERY OF QUALITY HEALTHCARE SERVICES, THE DEVELOPMENT OF COOPERATIVE RELATIONSHIPS WITH OTHER HEALTHCARE PROVIDERS AND THE PROMOTION OF WELLNESS THROUGH HEALTH EDUCATION AND AWARENESS.
PROGRAM SERVICE ACCOMPLISHMENTS	FORM 990, PART III, LINE 4A SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM (THE HOSPITAL) IS AN INDEPENDENT, NON-PROFIT, ACUTE-CARE HOSPITAL, SERVING THE COMMUNITIES OF SOUTHERN RHODE ISLAND OFFERING THE LATEST ADVANCES IN TECHNOLOGY AND A COMPREHENSIVE RANGE OF MEDICAL AND SURGICAL SERVICES DELIVERED BY EXPERT PHYSICIANS AND HIGHLY TRAINED STAFF. THE SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM IS COMMITTED TO ITS COMMUNITY AND GUIDED BY THE VALUES OF CARING, RESPECT, INTEGRITY, COLLABORATION AND EXCELLENCE. DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2018, THE HOSPITAL REPORTED 5,817 DISCHARGES AND 18,427 INPATIENT DAYS. THE DISCHARGES INCLUDED 678 DELIVERIES AND 2,359 INPATIENT SURGERIES. THE HOSPITAL PROVIDED 219,634 OUTPATIENT VISITS; INCLUDING 23,554 OUTPATIENT EMERGENCY ROOM VISITS AND 24,811 URGENT CARE VISITS. THE PROVIDERS IN THE HOSPITAL MEDICAL GROUP PROVIDED 106,154 VISITS.
FORM 990, PART VI, SECTION B, LINE 11	SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM AND ITS AFFILIATED ENTITIES ARE KNOWN AS SOUTH COUNTY HEALTH ("SCH") WHICH HAS POLICIES AND PROCEDURES ADOPTED BY ALL ENTITIES IN THE SYSTEM. ALL ENTITIES HAVE MIRROR BOARDS. THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S AUDIT COMMITTEE APPROXIMATELY 30 DAYS PRIOR TO THE FILING DEADLINE. THE AUDIT COMMITTEE THEN REVIEWS THE FORM 990 AND PROVIDES QUESTIONS AND COMMENTS TO THE ORGANIZATION'S ACCOUNTING DEPARTMENT. BEFORE IT IS FILED, A COPY OF THE FINAL FORM 990, INCLUDING REQUIRED SCHEDULES, IS PROVIDED TO THE MEMBERS OF THE BOARD OF TRUSTEES FOR REVIEW AND DISCUSSION WITH THE CHAIRMAN OF THE AUDIT COMMITTEE AT A BOARD MEETING PRIOR TO THE FILING DEADLINE. SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM AND ITS AFFILIATED ENTITIES ARE KNOWN AS SOUTH COUNTY HEALTH ("SCH") WHICH HAS POLICIES AND PROCEDURES ADOPTED BY ALL ENTITIES IN THE SYSTEM. ALL ENTITIES HAVE MIRROR BOARDS. THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S AUDIT COMMITTEE APPROXIMATELY 30 DAYS PRIOR TO THE FILING DEADLINE. THE AUDIT COMMITTEE THEN REVIEWS THE FORM 990 AND PROVIDES QUESTIONS AND COMMENTS TO THE ORGANIZATION'S ACCOUNTING DEPARTMENT. BEFORE IT IS FILED, A COPY OF THE FINAL FORM 990, INCLUDING REQUIRED SCHEDULES, IS PROVIDED TO THE MEMBERS OF THE BOARD OF TRUSTEES FOR REVIEW AND DISCUSSION WITH THE CHAIRMAN OF THE AUDIT COMMITTEE AT A BOARD MEETING PRIOR TO THE FILING DEADLINE.
FORM 990, PART VI, SECTION B, LINE 12C	SCH HAS POLICIES AND PROCEDURES ADOPTED BY ALL ENTITIES IN THE SYSTEM. MEMBERS OF THE GOVERNING BODY, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. IT IS PERIODICALLY REVIEWED AND DISCUSSED AT BOARD MEETINGS. IF A POTENTIAL CONFLICT IS IDENTIFIED, THE BOARD WOULD DISCUSS THE ITEM TO DETERMINE IF A CONFLICT EXISTS. IF A CONFLICT EXISTS, THE INDIVIDUAL WOULD RECUSE THEMSELVES FROM THE DISCUSSIONS. ALL DISCUSSIONS ARE CONTEMPORANEOUSLY DOCUMENTED.
FORM 990, PART VI, SECTION B, LINE 15A	THE ORGANIZATION'S CEO'S COMPENSATION IS DETERMINED BY THE GOVERNING BODY. THE CEO' SALARY IS COMPARED TO OTHER CEO'S SALARIES OF SIMILAR ORGANIZATIONS. IN DETERMINING COMPENSATION THE ORGANIZATION USES FORM 990 OF OTHER ORGANIZATIONS, A COMPENSATION SURVEY. THE REVIEW IS DONE BY INDEPENDENT INDIVIDUALS OF THE GOVERNING BODY AND ALL DISCUSSIONS ARE CONTEMPORANEOUSLY DOCUMENTED.
FORM 990, PART VI, SECTION B, LINE 16B	THE HOSPITAL DOES NOT HAVE A FORMAL POLICY BUT IN PRACTICE ALL JOINT VENTURE AGREEMENTS ARE FULLY REVIEWED BY HOSPITAL LEGAL COUNSEL TO ASSURE THE JOINT VENTURE DOES NOT JEOPARDIZE THE TAX STATUS OF THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9, CHANGES IN NET ASSETS	CHANGE IN FUNDED STATUS OF EMPLOYEE BENEFIT PLANS 4,406,803 UNREALIZED GAIN ON INTEREST RATE SWAP 2,532,625 NET ASSETS RELEASED FOR CAPITAL EXPENDITURES 1,237,352 UNREALIZED CHANGE IN EQUITY INTERESTS IN L.P. 210,846 ---------- TOTAL TO FORM 990, PART XI, LINE 9 8,387,626
FORM 990, PART XII, LINE 2C	FINANCIAL STATEMENTS AND REPORTING THE ORGANIZATIONS AUDIT COMMITTEE IS RESPONSIBLE FOR SELECTING AN INDEPENDENT ACCOUNTANT TO AUDIT THE ORGANIZATIONS FINANCIAL STATEMENTS AND FOR OVERSEEING THE AUDIT OF THE ORGANIZATIONS FINANCIAL STATEMENTS.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM

Employer identification number

05-0445136

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM ENDOWMENT 100 KENYON AVE WAKEFIELD,RI02879 05-0259093	HEALTHCARE	RI	501(C)(3)	7	NA		No
(2)SOUTH COUNTY HOME HEALTH 14 WOODRUFF AVENUE NARRAGANSETT,RI02882 05-6033975	HEALTHCARE	RI	501(C)(3)	10	SC HOSPITAL	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2019

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) SILVER SPRING HEALTHCARE MANAGEMENT 100 KENYON AVENUE WAKEFIELD,RI02879 05-0459095	HOLDING COMPANY	RI	SCH HEALTHCARE	C Corp	-1,350	317,568	100.000 %	Yes
(2) SOUTH COUNTY QUALITY CARE 100 KENYON AVENUE WAKEFIELD,RI02879 05-0491313	PERSONAL CARE	RI	SCH HEALTHCARE	C Corp	0	43,859	100.000 %	Yes
(3) SSHM SURGICAL SUPPLY INC 100 KENYON AVENUE WAKEFILED,RI02879 05-0478937	RETAIL OF MED EQP	RI	SCH HEALTHCARE	C Corp	-383,989	729,460	100.000 %	Yes

Schedule R (Form 990) 2019

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved
(1) SSHM SURGICAL SUPPLY INC	o	899,844
(2) SOUTH COUNTY HOME HEALTH	o	618,472

Schedule R (Form 990) 2019

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO OPERATE AN INDEPENDENT, NON-PROFIT, ACUTE CARE HOSPITAL COMMITTED TO ITS COMMUNITY AND GUIDED BY THE VALUES OF CARING, RESPECT, INTEGRITY, COLLABORATION AND EXCELLENCE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	18
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	16
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	1,474
6	Total number of volunteers (estimate if necessary) .............	6	296
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	10,235
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	760,324	915,510
9	Program service revenue (Part VIII, line 2g) .........	173,390,569	181,944,370
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	431,540	988,153
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,062,560	967,768
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	175,644,993	184,815,801
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	90,024,237	92,761,749
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	84,152,257	88,756,740
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	174,176,494	181,518,489
19	Revenue less expenses. Subtract line 18 from line 12.......	1,468,499	3,297,312
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	133,960,075	144,244,334
21	Total liabilities (Part X, line 26).............	96,135,152	94,575,174
22	Net assets or fund balances. Subtract line 21 from line 20.....	37,824,923	49,669,160

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 151,637,785 including grants of $ ) (Revenue $ 182,497,907 )
	SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM (THE HOSPITAL) IS AN INDEPENDENT, NON-PROFIT, ACUTE-CARE HOSPITAL, SERVING THE COMMUNITIES OF SOUTHERN RHODE ISLAND OFFERING THE LATEST ADVANCES IN TECHNOLOGY AND A COMPREHENSIVE RANGE OF MEDICAL AND SURGICAL SERVICES DELIVERED BY EXPERT PHYSICIANS AND HIGHLY TRAINED STAFF. THE SOUTH COUNTY HOSPITAL HEALTHCARE SYSTEM IS COMMITTED TO ITS COMMUNITY AND GUIDED BY THE VALUES OF CARING, RESPECT, INTEGRITY, COLLABORATION AND EXCELLENCE. FOR MORE INFORMATION, SEE SCHEDULE O.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses151,637,785

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	5,040,816	2,875	344,735

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	256,333

f	All other contributions, gifts, grants, and similar amounts not included above		1f	659,177

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		915,510

		Business Code
2a	PATIENT SERVICE REVENUE	622110	180,951,311	180,951,311
b	OTHER PROGRAM REVENUE	900099	993,059	993,059
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		181,944,370

3 Investment income (including dividends, interest, and othersimilar amounts) ......			651,897			651,897
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		880,249	6a
b	Less: rental expenses		2,058,431	6b
c	Rental income or (loss)	0	-1,178,182	6c
d	Net rental income or (loss).......			-1,178,182	-1,178,182
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	9,575	644,146	7a
b	Less: cost or other basis and sales expenses		317,465	7b
c	Gain or (loss)	9,575	326,681	7c
d	Net gain or (loss).........			336,256			336,256
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a	0
b	Less: direct expenses ...		8b	0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	0
b	Less: cost of goods sold ..		10b	0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	REVENUE FROM JOINT VENTURES		621512	969,875	959,640	10,235
b	SELF INSURED TRUST		900099	372,730	372,730
c	CAFETERIA		722212	403,996			403,996
d	All other revenue ....			399,349	399,349
e	Total. Add lines 11a–11d ......			2,145,950
12	Total revenue. See instructions.....			184,815,801	182,497,907	10,235	1,392,149

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	0
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0
4	Benefits paid to or for members .......	0
5	Compensation of current officers, directors, trustees, and key employees ...........	2,902,247	770,916	2,131,331	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	0
7	Other salaries and wages........	71,750,331	60,057,431	11,692,900	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	2,094,489	1,706,630	387,859	0
9	Other employee benefits .......	11,179,118	9,108,958	2,070,160	0
10	Payroll taxes ...........	4,835,564	3,940,110	895,454	0
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	576,714		576,714	0
c	Accounting ...........	104,802		104,802	0
d	Lobbying ...........	54,345		54,345	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	67,983		67,983	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	9,340,577	6,762,234	2,578,343
12	Advertising and promotion ....	864,704	624,587	240,117	0
13	Office expenses .......	5,266,996	3,804,418	1,462,578	0
14	Information technology ......	2,390,183	1,726,459	663,724	0
15	Royalties ..	0
16	Occupancy ...........	2,749,591	1,986,064	763,527	0
17	Travel ............	71,314	51,511	19,803	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	209,049	151,000	58,049	0
20	Interest ...........	1,959,010		1,959,010	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	9,605,621	6,938,261	2,667,360	0
23	Insurance ...	3,162,971	2,284,654	878,317	0
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES & DRUG	40,665,123	40,665,123		0
b	STATE LICENSE FEE	5,272,110	5,272,110		0
c	BAD DEBT EXPENSE	4,204,953	4,204,953		0
d	MAINTENANCE & REPAIRS	532,649	384,739	147,910	0
e	All other expenses	1,658,045	1,197,627	460,418
25	Total functional expenses. Add lines 1 through 24e	181,518,489	151,637,785	29,880,704	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			7,580	1	8,100
2	Savings and temporary cash investments .........			5,234,330	2	11,371,059
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			13,542,506	4	14,925,266
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			0	7	0
8	Inventories for sale or use ............			3,319,268	8	3,238,290
9	Prepaid expenses and deferred charges ......			2,555,782	9	3,415,373
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	181,978,105
b	Less: accumulated depreciation	10b	116,873,531	66,495,704	10c	65,104,574
11	Investments—publicly traded securities .			23,752,058	11	24,900,352
12	Investments—other securities. See Part IV, line 11 .....			17,115,798	12	18,783,555
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			1,116,503	14	1,184,730
15	Other assets. See Part IV, line 11 ...........			820,546	15	1,313,035
16	Total assets. Add lines 1 through 15 (must equal line 33)...			133,960,075	16	144,244,334

17	Accounts payable and accrued expenses .....	20,377,431	17	22,652,295
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	38,960,954	20	36,814,627
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	2,453,347
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	36,796,767	25	32,654,905
26	Total liabilities. Add lines 17 through 25..	96,135,152	26	94,575,174

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	37,824,923	32	49,669,160
33	Total liabilities and net assets/fund balances ........	133,960,075	33	144,244,334