Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
SOUTHCOAST HOSPITALS GROUP INC |
222592333 | 3 | Yes | 0 | 0 | |
|
Total 1
|
0 | 0 | ||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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 | ||||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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.) | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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 on 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.).. | ||||||
| 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 0.015 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 0.035 | 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 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2023 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2024. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | 23018249 |
| Software Version: | v1.00 |
| Return Reference | Explanation |
|---|---|
| Form 990, Part IV, Line 12a | FINANCIAL RESULTS FOR SLTCS ARE INCLUDED IN THE SOUTHCOAST HEALTH SYSTEM, INC. AND AFFILIATES CONSOLIDATED FINANCIAL STATEMENTS AS OF AND FOR THE YEARS ENDED SEPTEMBER 30, 2024, AND 2023 WHICH WERE ISSUED WITH AN INDEPENDENT AUDITOR'S REPORT WITH AN UNQUALIFIED AUDIT OPINION. INCLUDED IN THESE AUDITED FINANCIAL STATEMENTS IS SUPPLEMENTAL CONSOLIDATED INFORMATION FOR THE YEAR ENDED SEPTEMBER 30, 2024. NO STAND ALONE AUDITED FINANCIAL STATEMENTS WERE ISSUED FOR SOUTHCOAST LONG TERM CARE SERVICES, INC. FOR THE YEAR ENDED SEPTEMBER 30, 2024. |
| Form 990, Part VI, Section A, Line 2 | CERTAIN OFFICERS AND TRUSTEES OF SLTCS ARE OFFICERS OR TRUSTEES OF RELATED ORGANIZATIONS. INDIVIDUALS WITH REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS IN PART VII, SECTION A, COLUMN (E), ARE EMPLOYEES OF RELATED ORGANIZATIONS. |
| Form 990, Part VI, Section A, Line 4 | DURING FY2024 SLTCS AMENDED TO THE BYLAWS AS FOLLOWS: (1) THE BOARD OF TRUSTEES SHALL ALSO INCLUDE THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE STOCKHOLDER AND THE PRESIDENT OF THE CORPORATION WHO SHALL SERVE EXOFFICIO WITH VOTE. THE EXOFFICIO TRUSTEES SHALL SERVE SO LONG AS THEY OCCUPY THE POSITION RESULTING IN SERVICE AS A TRUSTEE. (2) DEFINITION OF THE PRESIDENT - THE PRESIDENT OF THE STOCKHOLDER SHALL SERVE AS THE PRESIDENT OF THE CORPORATION. THE PRESIDENT SHALL BE THE CHIEF EXECUTIVE OFFICER WITHIN THE FRAMEWORK OF THESE BYLAWS AND THE PLANS AND POLICIES ADOPTED BY THE STOCKHOLDER AND THE BOARD. |
| Form 990, Part VI, Section A, Line 6 | SLTCS PARENT CORPORATION, SOUTHCOAST HEALTH SYSTEM, INC. (SHS) SERVES AS THE SOLE CORPORATE MEMBER OR SOLE CORPORATE STOCKHOLDER OF EACH OF ITS AFFILIATES. |
| Form 990, Part VI, Section A, Line 7a | SLTCS PARENT CORPORATION SHS ELECTS THE TRUSTEES OR DIRECTORS OF EACH AFFILIATE AND WITH RESPECT TO CERTAIN OF THE AFFILIATES, EXERCISES SPECIFIED RESERVE POWERS AND IS GOVERNED BY A BOARD OF TRUSTEES. |
| Form 990, Part VI, Section A, Line 7b | THE ROLE OF THE SHS BOARD IS TO MAINTAIN A SYSTEM PERSPECTIVE WITH A REGIONAL EMPHHASIS AND A BROAD FOCUS ACROSS ALL ACTIVITIES IN THE ORGANIZATION. PRIMARY FUNCTIONS OF THE SHS BOARD INCLUDE STRATEGIC PLANNING, NETWORK GROWTH AND DEVELOPMENT, AND OVERALL FISCAL RESPONSIBILITIES. EACH AFFILIATE BOARD IS EXPECTED TO FOCUS ON ITS OWN ACTIVITIES ADDRESSING COMMUNITY NEEDS WITH ITS SCOPE OF SERVICES. |
| Form 990, Part VI, Section B, Line 11b | THE GOVERNING BOARD OF SHS REVIEWS FORM 990 AND ALL OF ITS RELATED SCHEDULES PRIOR TO FILING. THE REVIEW IS PERFORMED BY THE GOVERNING BOARD AS IT PROVIDES OVERSIGHT FOR COMPENSATION AND CONFLICT OF INTEREST MATTERS ON ITS OWN BEHALF AND ON BEHALF OF ITS AFFILIATES ON A SYSTEM WIDE BASIS. A COMPLETE COPY OF FORM 990 AND ITS SCHEDULES ARE POSTED TO THE SHS BOARD WEBSITE PORTAL FOR ALL BOARD MEMBERS TO REVIEW, MAKE INQUIRIES AND HAVE ANY ADJUSTMENTS MADE PRIOR TO FILING. |
| Form 990, Part VI, Section B, Line 12c | SHS HAS CONFLICT OF INTEREST, LEGAL COMPLIANCE, AND CODE OF CONDUCT POLICIES THAT APPLY TO ALL TRUSTEES, OFFICERS, DIRECTORS, AND EMPLOYEES (REFERRED TO AS "MEMBERS"), ON AN ANNUAL BASIS, EACH MEMBER WILL COMPLETE THE CONFLICT OF INTEREST QUESTIONNAIRE WHICH AFFIRMS THAT EACH PERSON HAS: (1) RECEIVED A COPY OF THE POLICY, (2) READ AND UNDERSTAND THE POLICY, (3) AGREED TO COMPLY WITH THE POLICY, AND (4) UNDERSTAND THAT THE SYSTEM ENTITIES ARE CHARITABLE ORGANIZATIONS AND THAT TO MAINTAIN THEIR FEDERAL TAX EXEMPTION, SUCH ENTITIES MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. TO ENSURE THE SYSTEM OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES, DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL TAXATION, AND IN CONNECTION WITH ITS COMPLIANCE PROGRAM, SYSTEM'S MANAGEMENT SHALL CONDUCT PERIODIC REVIEWS OF THE CONFLICT OF INTEREST POLICY AND THE OPERATION AND APPLICATION OF IT. MEMBERS SHALL DISCLOSE ANY INTEREST OR ACTIVITIES IN WHICH THEY ARE INVOLVED OR BECOME INVOLVED THAT DO RESULT, OR MAY APPEAR TO RESULT IN A CONFLICT OF INTEREST OR POTENTIAL CONFLICT OF INTEREST AND SHALL COMPLY WITH, AND MAKE ALL REQUIRED DISCLOSURES UNDER THE CONFLICT OF INTEREST POLICY PRIOR TO COMMENCING, CONTINUING, OR CONSUMMATING ANY ACTIVITY OR TRANSACTION WHICH RAISES A CONFLICT OF INTEREST OR POTENTIAL CONFLICT OF INTEREST. EACH MEMBER IS UNDER AN ONGOING DUTY TO UPDATE AND KEEP CURRENT INFORMATION CONTAINED IN THEIR QUESTIONNAIRE AT LEAST ANNUALLY, OR AS NECESSARY BASED ON DISCLOSURES. THE GENERAL COUNSEL WILL SUMMARIZE AND REPORT ALL DISCLOSURES TO THE PRESIDENT AND CEO AND THE CHAIRMAN OF THE BOARD OF TRUSTEES (OR HIS/HER DESIGNEE). UPON DISCLOSURE OF FINANCIAL OR NON-FINANCIAL INTERESTS ("INTERESTS") AND ALL MATERIAL FACTS RELATED THERETO BY MEMBER OR AN INTERESTED PERSON, THE CHAIR OF THE SYSTEM'S GOVERNANCE COMMITTEE SHALL DETERMINE IN CONJUNCTION WITH THE GENERAL COUNSEL WHETHER A CONFLICT OF INTEREST EXISTS. THE GOVERNANCE COMMITTEE CAN CONTINUE TO DISCUSS THE ISSUE WITH THE MEMBER OR INTERESTED PERSON TO CLARIFY OR OBTAIN ADDITIONAL INFORMATION. HOWEVER, BEFORE THE GOVERNANCE COMMITTEE DISCUSSES OR DETERMINES WHETHER THE MEMBER OR OTHER INTERESTED PERSONS INTEREST CONSTITUTE A CONFLICT OF INTEREST, THE MEMBER OR INTERESTED PERSON MUST LEAVE THE MEETING. IN THE EVENT THE INTEREST INVOLVES THE CHAIR OR CEO, THE REMAINING GOVERNANCE COMMITTEE MEMBERS SHALL APPOINT ONE OR MORE DISINTERESTED TRUSTEES TO MAKE SUCH A DETERMINATION. ONCE THE DETERMINATION OF THE CONFLICT OF INTEREST IS MADE BY THE GOVERNANCE COMMITTEE, SUCH DETERMINATION, ALONG WITH APPROPRIATE MITIGATION PLANS, WILL BE SUBMITTED BY THE GOVERNANCE COMMITTEE FOR REVIEW AND APPROVAL. IF ANY BOARD OR BOARD COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE AN ACTUAL CONFLICT OF INTEREST OR A POTENTIAL CONFLICT OF INTEREST, IT SHALL INFORM SUCH PERSON OF THE BASIS FOR SUCH BELIEF AND AFFORD SUCH A MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE IT. IF, AFTER HEARING THE RESPONSE OF SUCH PERSON AND MAKING FURTHER INQUIRY OR INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, THE BOARD OR BOARD COMMITTEE DETERMINES THAT SUCH PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL CONFLICT OF INTEREST OR A POTENTIAL CONFLICT OF INTEREST, THE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION SHALL BE TAKEN. |
| Form 990, Part VI, Section B, Line 15 | SOUTHCOAST LONG TERM CARE SERVICES, INC. DOES NOT HAVE ANY EMPLOYEES. COMPENSATION FOR THE SLTCS PRESIDENT AND CEO WAS ESTABLISHED BY SOUTHCOAST HOSPITALS GROUP, INC. (SHG), A RELATED ENTITY. COMPENSATION FOR ALL VICE PRESIDENTS AND HIGHER LEVEL EXECUTIVES WHO MAY SERVE AS OFFICERS AND DIRECTORS IS ESTABLISHED USING THE FOLLOWING PROCEDURES: (1) REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE OF SHS, WITHOUT THE INVOLVEMENT OF PERSONS WITH A CONFLICT OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT AT ISSUE, (2) USE OF DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONAL COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THE COMPENSATION COMMITTEE ENGAGED THE SERVICES OF AN INDEPENDENT HUMAN RESOURCE CONSULTING FIRM ("CONSULTANT") TO PROVIDE UPDATED COMPENSATION DATA AND ASSESS THE REASONABLENESS OF THE TOTAL COMPENSATION PROVIDED TO SHS' EXECUTIVES. THIS INCLUDED RELEVANT COMPETITIVE MARKET PRACTICE INFORMATION FOR THE NORTHEAST REGION MARKET OBTAINED FROM TWO HEALTHCARE EXECUTIVE COMPENSATION SURVEYS THAT WERE PREPARED BY INDEPENDENT FIRMS. THE CONSULTANT ALSO COMPILED NATIONAL MARKET DATA FROM THREE COMMERCIALLY AVAILABLE HEALTHCARE EXECUTIVE COMPENSATION SURVEYS PREPARED BY INDEPENDENT FIRMS, AND (3) CONTEMPORANEOUS DOCUMENTATION AND RECORD KEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENT. |
| 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 VII, Section A, Line 1a | TRUSTEES AND OFFICERS ARE COMPENSATED FOR THEIR ROLES OUTSIDE OF THEIR CAPACITY AS TRUSTEES AND OFFICERS. |
| Form 990, Part XII, Line 2b | FINANCIAL RESULTS FOR SLTCS ARE INCLUDED IN THE SOUTHCOAST HEALTH SYSTEM, INC. AND AFFILIATES CONSOLIDATED FINANCIAL STATEMENTS AS OF AND FOR THE YEARS ENDED SEPTEMBER 30, 2024, AND 2023 WHICH WERE ISSUED WITH AN INDEPENDENT AUDITOR'S REPORT WITH AN UNQUALIFIED AUDIT OPINION. INCLUDED IN THESE AUDITED FINANCIAL STATEMENTS IS SUPPLEMENTAL CONSOLIDATED INFORMATION FOR THE YEAR ENDED SEPTEMBER 30, 2024. NO STAND ALONE AUDITED FINANCIAL STATEMENTS WERE ISSUED FOR CHARLTON LONG TERM CARE SERVICES, INC. FOR THE YEAR ENDED SEPTEMBER 30, 2024. |
| Software ID: | 23018249 |
| Software Version: | v1.00 |