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WE HELP PEOPLE LIVE BETTER LIVES THROUGH BETTER HEALTH. WE WILL BE OUR REGION’S FIRST CHOICE FOR HEALTH AND WELLNESS. BETTER HEALTH BEGINS HERE.

This is our mission.

This is our vision.

This is our purpose.

OURS IS A TEAM OF PEOPLE HELPING PEOPLE. PEOPLE IN ALL WE DO, WE SERVE OUR PATIENTS AND COMMUNITY. SERVICE OUR COMMITMENT TO EXCELLENCE IS UNRELENTING. QUALITY WE STRIVE TO PREVENT HARM, KEEPING OUR PATIENTS AND EACH OTHER SAFE. SAFETY WHERE THERE IS A NEED, WE GROW TO MEET IT. GROWTH WE OPERATE EFFICIENTLY AND INTELLIGENTLY TO REMAIN STRONG. FINANCE

THESE ARE THE PILLARS UPON WHICH OUR ORGANIZATION IS BUILT. TIDELANDS HEALTH l 2020 ANNUAL REPORT l

A MESSAGE FROM OUR BOARD CHAIRMAN AND CEO

TIDELANDS HEALTH BOARD OF TRUSTEES J. Edward Norris III, Chairman Daniel Scheffing, Vice Chairman

For Tidelands Health, our region, state, nation and the world, the first year of the new decade brought unprecedented and historic challenge.

Julian Reynolds Jr., Secretary The Honorable James A. Battle Jr.

In March 2020, the first COVID-19 case was diagnosed at Tidelands Health as the global COVID-19 pandemic reached our doorstep. The impact on our organization was swift and unrelenting. Battling a highly contagious virus with no cure, our team responded with courage, resilience, compassion and grace. As in other parts of the country and globe, surges of COVID-19 hospitalizations at times pushed our organization to its limits — and beyond. There was tremendous loss but also the strength to bear it.

our state’s academic medical center, we are bringing new physicians,

Patrick Cawley, MD, MBA, FACHE

new technologies and new clinical services to the Tidelands region.

Thomas Chandler, MD

We also announced plans to construct our fifth hospital, Tidelands Health Carolina Bays Hospital, in south Horry County. The 36-bed

Paul T. Davis, DMD

hospital, to be located at the interchange of Highways 31 and 707 in

Francis Ford Jr.

the Socastee community, will offer a wide range of services to support

Eugene Hong, MD

the health care needs of our fast-growing community. Plus, plans are underway to build a state-of-the-art medical park in

Christine Gerber, MD

Through it all, we helped each other, and our community helped us.

Carolina Forest. The 34,000-square-foot facility, to be located at the

Already our region’s largest health care provider, we became its leader

corner of Carolina Forest Boulevard and Revolutionary War Way, will

William Greer, MD

in COVID-19 response.

be home to physician offices and outpatient services.

Judith Ingle

Everyone at Tidelands Health played an essential role. From the

As we look back at 2020, we must acknowledge the tremendous

bedside to the business office, from the laboratory to the loading dock

challenges we faced — and also the many organizations and

— our team shone brightly amid the darkness of the pandemic.

individuals who helped us overcome them.

The community took notice, offering an outpouring of support. We were humbled by the countless calls and emails we received offering kindness and support, as well as many generous donations of

Robert Jones Tony Jordan

So many people at Tidelands Health and beyond made sacrifices to

Dr. Marthena Morant

support the COVID-19 fight. They are the #helpers, and it’s to them we

Mark Nash

dedicate this annual report.

food, supplies and more that nourished our bodies and spirits. Even as we battled the pandemic, however, we continued to look

Michael Ratz, MD Sincerely,

Matthew Severance, MBA, MHA, FACHE

ahead — to relentlessly pursue initiatives to help Tidelands Health remain vibrant and strong for our community long into the future.

Willie Shelley

In 2020, we expanded our longtime affiliation and collaboration with MUSC Health to improve health and wellness in Georgetown and J. Edward Norris III

Horry counties. Through our enhanced relationship with MUSC Health,

Daniel Stacy Jr. J. Edward Norris III Chairman of the Board

Bruce Bailey President and CEO

Bruce Bailey

Michael Stavrinakis TIDELANDS HEALTH l 2020 ANNUAL REPORT l

STEPPING FORWARD

A TIMELINE OF OUR COVID-19 RESPONSE

• Even before the first case of COVID-19 was diagnosed at Tidelands Health, measures such as enhanced visitor screening and restrictions are put in place to help protect health system team members, patients and families. • As part of comprehensive efforts to help keep team members and area residents safe and informed about the virus, Tidelands Health develops an online coronavirus information center, takes part in a televised phone bank about the virus, launches a dedicated COVID-19 Nurse Line to answer community questions about the disease and offers expert advice through the news media, among other outreach and education efforts.

M A RC H 16, 20 2 0

APRIL 30, 2020

The first case of COVID-19 at Tidelands Health is diagnosed. A patient treated in the emergency department at Tidelands Waccamaw Community Hospital tests positive for COVID-19 and is sent home to recover safely.

Building upon the enhanced safety

In the face of a national shortage of N95 respirators, more than 2,000 community members step forward to help Tidelands Health by volunteering their time to sew new elastic straps on thousands of new, never-used N95 respirators that had been stored in a Tidelands Health warehouse since a previous public health emergency.

protocols already in place amid Click here to show your appreciation to all those fighting the COVID-19 coronavirus.

the pandemic, Tidelands Health

MARC H 23, 2020

launches “Safe in Our Care,” a

Tidelands Health launches “Thank you to

series of enhanced measures

the helpers,” which gives area residents

designed to help protect and

the opportunity to offer thanks to those

reassure patients it’s safe to receive

professionals — everyone from grocery

the care they need.

store workers and truck drivers to first responders and health care workers — for their sacrifices to support the COVID-19 coronavirus fight. The #helpers website was viewed more than 400,000 times in 2020.

MARCH 2020

APRIL 2020

SEW MUCH SUPPORT On March 16, 2020, the first case of COVID-19 at Tidelands Health was

system and community to provide accurate and reliable information about

diagnosed.

the disease and ways to help limit its spread.

For the health system, state, nation and world, it was an uncertain and

One of the most significant challenges during the early days of the

troubling time. Scientists and public health officials were still learning about

pandemic was a persistent, worldwide shortage of N95 respirators, a

the virus, who was most at risk and the most effective ways of treating it.

critical piece of protective gear used by health care workers to protect

As would be the case throughout the pandemic, Tidelands Health

themselves from the disease.

took a proactive approach to the disease. Before the first case was ever

Thousands of N95 respirators purchased for a previous health

diagnosed at the health system, new policies and procedures, including

emergency were located in a Tidelands Health warehouse, but their

enhanced visitation requirements and screening, were already in place to

elastic bands had become brittle over time while in storage.

help protect Tidelands Health team members, patients and their families.

So, Tidelands Health turned to the community for help. In a heartwarming

Meanwhile, extensive outreach was underway both within the health

display of support, more than 2,000 helpers from the community donated

their time and sewing skills to replace elastic straps on the respirators. One of the biggest contributors was Tara Grinna Swim & Resort Wear, which stepped up to offer material and manpower to sew new elastic bands on 35,000 N95 respirators as part of the effort. TIDELANDS HEALTH l 2020 ANNUAL REPORT l

Charles Costello came home to a hero’s welcome.

A HERO’S WELCOME HOME

On Thursday, April 9, 2020, the Murrells Inlet resident was released from Tidelands Waccamaw Community Hospital after overcoming a nearly fatal COVID-19 infection. As he and his wife, Diane, reached their neighborhood, they were greeted by a heartwarming sight. A parade of socially distanced neighbors marched before them holding signs and balloons to celebrate Charles’ recovery. Kool & The Gang’s hit song “Celebration” accompanied their cheers and claps. “It was really unexpected,” Charles says, “and a wonderful welcome back.” At times during his battle with COVID-19, it was unclear if Charles would ever return home or live to be with Diane for their 40th wedding anniversary on May 17. Charles was taken by ambulance to Tidelands Waccamaw on March 26 after experiencing weakness, fever and increasing shortness of breath. By the following day, his condition had deteriorated so rapidly that his care team placed him in a medically induced coma and put him on a mechanical ventilator to breathe. Charles and Diane Costello both became ill with the COVID-19 coronavirus, although Diane was able to safely recover at home. “He was fighting for his life,” says Dr. Desmond Young,

“HIS RECOVERY IS REMARKABLE. CHARLES IS A FIGHTER; I’M REALLY PROUD OF HIM AND EVERYONE WHO WAS INVOLVED IN HIS CARE.” DR. DESMOND YOUNG

TIDELANDS HEALTH CRITICAL CARE AND PULMONARY SPECIALIST

a Tidelands Health critical care and pulmonary specialist and one of several physicians who led his care. “It was very much touch and go.” For a week, Charles remained in a coma in the hospital’s critical care unit. Over time, after receiving advanced care from a team that included Dr. Young and several other physicians, respiratory therapists, nurses, pharmacists and more, his condition began to improve. “His recovery is remarkable,” Dr. Young says. “Charles is a fighter; I’m really proud of him and everyone who was involved in his care.” By Saturday, April 4, Charles was breathing on his own, and his condition began to consistently improve. Charles was extremely happy to be discharged, calling it the “happiest day since my wedding.” Diane, too, recovered after being infected with COVID-19. She began experiencing symptoms a few days after her husband, a major concern because she is at high risk of complications from the illness due to an immune system disorder called common variable immune deficiency. When she learned her husband would be released from the hospital, she was ecstatic. “It was one of the happiest days of my life picking him up,” she says. Charles and Diane are grateful for the care and support they received. One of their thoughtful neighbors even anonymously dropped off a roll of in-demand toilet paper. “I just want to thank everyone for all their support and prayers,” Charles says. “COVID-19 is very serious, so make sure to practice social distancing and the other recommendations out there right now. “Just be safe.”

TIDELANDS HEALTH l 2020 ANNUAL REPORT l

MAY 4, 2020

JU NE 26, 2020

JULY 31, 2020

Non-emergency appointments and

Tidelands Health hosts the region’s largest free COVID-19 testing event at Coastal Carolina University. In just one day, 2,500 area residents are tested for the illness. As the region’s leader in COVID-19 testing, Tidelands Health went on to provide more than more than 45,000 COVID-19 tests in the year after the pandemic began in our region.

The region’s four health systems stand together

procedures, which were halted in mid-March at the request of Gov. Henry McMaster, resume.

to issue a united plea asking for the community to take safety precautions amid a continuing surge of COVID-19 cases and hospitalizations. Throughout the fall of 2020, Tidelands Health implements a major flu shot campaign to help protect

JULY 10, 2020

area residents from the illness and prevent the

The South Carolina National Guard, which provided crucial support to

region’s health systems from becoming overburdened

Tidelands Health throughout the pandemic, arrives in the region for the first

Horry County is named a COVID-19 hot spot as cases begin to surge within the region.

time to help support large-scale COVID-19 testing. The Guard would also provide significant support in the health system’s emergency departments as COVID-19 cases and hospitalizations surge and would later assist the

by flu and COVID-19 cases. As part of the campaign, the health system offers walk-in flu shot clinics and partners with South Carolina DHEC to offer free flu shots at drive-through events within the region.

health system administer COVID-19 vaccinations.

MAY 2020

JUNE 2020

A LEADER IN TESTING, RESPONSE

JULY 2020 to their questions.

As our nation and the world continued to learn more about

Still, with no cure for the highly contagious disease,

COVID-19, testing people for the illness became critically

COVID-19 continued to spread. In July, more than 5,000 new

important — both to help people already ill with the virus and

cases of the illness were diagnosed in Horry and Georgetown

dedicated COVID-19 Nurse Line established by the

help prevent others from contracting it.

counties, a surge that pushed area hospitals to their limits

health system. A similar number of calls was also

At tent sites outside Tidelands Health physician practices

and prompted a request from the region’s health systems

placed to 1-866-TIDELANDS —

and at testing events held in partnership with South Carolina

for help from the South Carolina National Guard, which sent

more than double the number

DHEC, Tidelands Health became the region’s leader in

about 40 medics to assist.

of calls from the year before

COVID-19 testing.

At Tidelands Health, our team — facing tremendous

In 2020, nearly 13,000 calls were placed to the

— as community members

Major drive-through testing events at Myrtle Beach

physical, emotional and spiritual strain — responded to the

sought information about

Pelicans Stadium, Coastal Carolina University and other

surge in cases with heroic strength and compassion, buoyed

COVID-19 testing

venues drew thousands of people. In total, Tidelands Health

by a continued outpouring of community support in the form

and resources.

provided more than 45,000 COVID-19 tests in the year after

of meal donations, cards and much more.

the pandemic began — testing as many as 2,500 people in a single day.

Meanwhile, the health system continued its concerted push to educate people about the illness and provide answers TIDELANDS HEALTH l 2020 ANNUAL REPORT l

‘I LOVE THE CARE THERE’ Maurice Meadows never imagined a COVID-19 infection would nearly cost him his life and leave his three young children without their father.

MAURICE MEADOWS CREDITS THE CARE HE RECEIVED FROM THE DEDICATED TEAM AT TIDELANDS HEALTH WITH HELPING HIM RECOVER FROM A NEAR-FATAL CASE OF COVID-19.

The Andrews resident successfully recovered from COVID-19, but not before spending about a month in critical care in an unpredictable battle with the illness. At one point, his heart suddenly stopped, and his care team wasn’t sure if he’d pull through. “I don’t remember any of it — only what my doctors and nurses told me I’d been through,” says the forklift operator. “They had me sedated through most of it. When I woke up three weeks later in the ICU, I had no idea where I was. It was pretty scary.” Meadows was diagnosed with COVID-19 in mid-June 2020 after a positive test for the illness. In only a few hours, he went from bad to worse, prompting his wife, Chrisetta, to drive him to the emergency department at Tidelands Georgetown Memorial Hospital, where he was admitted for treatment. “I really don’t have any underlying health conditions,” he says. “I was in good shape before I got sick. I very rarely get sick. It really took a toll on me.” None of his children were infected, but Chrisetta, who has diabetes, high blood pressure and requires weekly dialysis, contracted the disease. She, too, spent about a week battling COVID-19 in the critical care unit at Tidelands Georgetown — just a few doors down from where her husband was fighting for his life.

During the course of his battle with COVID-19, Maurice Meadows suffered with pneumonia in both lungs and was twice placed on a mechanical ventilator. At one point, after being taken off the ventilator the first time, he went into sudden cardiac arrest. Eventually, after a second stint on a ventilator, Meadows turned the corner, though his battle with COVID-19 left him weak and unable to walk. He was released from Tidelands Georgetown in late July and headed to Tidelands Health Rehabilitation Hospital at Little River, an affiliate of Encompass Health, where he spent about a week working to regain the strength in his legs. “The only effect I had when I got out was that I felt a little fatigued,” he says. “I had to build my stamina back up. All I wanted to do was lay around.” After his release from the rehabilitation hospital, Maurice continued to work rebuilding his strength and mobility at home. After about a month, he was able to return to work. He credits the medical care he received at both Tidelands Georgetown and Tidelands Health Rehabilitation Hospital with helping him recover. “I love the care there,” he says about both hospitals. “The care was awesome, and the staff treated me like I was their child.” TIDELANDS HEALTH l 2020 ANNUAL REPORT l

M A RC H 16 , 2 0 21

N OVEMBER 2020

DEC. 22, 2020

JAN . 19, 2021

Tidelands Health

The number of COVID-19

In alignment with the state’s vaccination

becomes one of the

hospitalizations at Tidelands

guidelines, Tidelands Health begins

first health systems in

Health exceed peaks

administering COVID-19 vaccines to individuals

South Carolina to offer

experienced over the summer

70 and older. More than 30,000 people 70 and

monoclonal antibody

as another surge of COVID-19

older sign up to request a COVID-19 vaccination

therapy, a groundbreaking

infections washes over the

appointment with the health system, although

region. The health system’s

the speed of the vaccination effort is slowed by

hospitals and critical care units

the nation’s extremely limited vaccine supply.

treatment that can lessen a patient’s risk of becoming hospitalized with COVID-19.

DEC. 16, 2020

The first dose of COVID-19 vaccine is administered in Georgetown County to a Tidelands Health

To date, the health system

critical care unit nurse, the beginning of the health

has administered more

system’s comprehensive program to vaccinate its

than 1,500 doses of the

workforce — and the community — as more doses

innovative treatment.

of the new vaccine become available.

NOVEMBER 2020

exceed their capacities — more

By the one-year anniversary of its first COVID-19 case, the health system has administered more than 37,000 doses of the vaccine, a figure that would grow rapidly in the coming weeks as more vaccine became available across the nation. To date, the health system has administered more than 76,000 vaccine doses.

than one-third of all patients hospitalized at Tidelands Health’s acute-care hospitals are COVID-19 positive.

DECEMBER 2020

The health system marks the anniversary of the start of the pandemic at Tidelands Health with “Lights to Remember, Hope for Tomorrow.” The observance is an opportunity to honor those who have lost their lives to the virus, offer thanks for recovery, recognize the sacrifice and commitment of our region’s health care heroes and celebrate the promise of the COVID-19 vaccine. More than 700 luminaries — each representing a life lost to COVID-19 in our region — shine bright against the night sky outside four Tidelands Health campuses.

JANUARY 2021

MARCH 2021

THE VACCINE, AND HOPE By late December, COVID-19 hospitalizations reached —

Treatment for COVID-19 had markedly improved. In

then exceeded — peaks experienced over the summer,

November, Tidelands Health became one of the first health

putting unprecedented strain on Tidelands Health

care providers in South Carolina to offer the monoclonal

As with COVID-19 testing, Tidelands Health quickly

To support community vaccination, the health system

resources and team members.

antibody therapy Bamlanivimab, adding to the advanced

became the region’s leader in COVID-19 vaccination,

established regional vaccination sites and hired additional

With the health system’s acute-care hospitals

treatment options — including convalescent plasma

education and outreach. The health system’s commitment

staff to help operate them.

exceeding their capacities, the organization temporarily

therapy and medications such as Remdesvir — already

to its mission — “We help people live better lives through

By March 16, 2021, the anniversary of the first case

reassigned 33 nurses in non-clinical roles back to the

available to COVID-19 patients through the health system.

better health” — remained as relentless and unwavering

of COVID-19 at Tidelands Health, the health system had

as ever before.

administered more than 37,000 doses of the vaccine,

bedside to help respond to the surge.

But undoubtedly the biggest development in the fight

to other populations in alignment with state vaccination

residents with accurate and useful information about the

guidelines.

vaccine and encourage them to receive it.

The challenge facing the organization and its

against the disease was the arrival of the COVID-19

Recognizing the inherent challenges associated with

a number that would increase by tens of thousands in

caregivers, however, was juxtaposed against a backdrop

vaccine, which Tidelands Health began administering to

the introduction of a new vaccine, Tidelands Health began

subsequent weeks. More than 4,500 people had received

of growing hope.

its own workforce in mid-December before expanding

a comprehensive and wide-ranging effort to provide area

care for the disease at the health system. TIDELANDS HEALTH l 2020 ANNUAL REPORT l

‘ANOTHER CHANCE TO LOVE’ At first, Leonard Nelson’s symptoms were mild. It was early August 2020, and he assumed the meal he’d eaten at a local restaurant just wasn’t sitting well with him. Still, to be safe, he and his wife, Linda, decided to get COVID-19 tests. A few days later, a phone call alerted the Pawleys Island couple they both were positive for the virus. Although his wife never developed symptoms, Leonard Nelson’s condition deteriorated rapidly. “He was sluggish and sleepy. He just had no energy,” Linda Nelson says of her husband, who serves as a deacon at Mt. Zion Missionary Baptist Church in Pawleys Island. When she noticed Leonard’s tongue had turned purple on Aug. 10, Linda Nelson took him to the emergency department at Tidelands Waccamaw Community Hospital, where he would spend the next 17 days fighting for his life.

“By the grace of God, he got through this,” says Linda Nelson, who didn’t see her husband again until Aug. 27. “The staff at Waccamaw took good care of him. They really treated him like a king.” After arriving at Tidelands Waccamaw, Leonard Nelson was admitted to the hospital’s critical care unit, where he received intensive care and support, says Nathan Mattox, the unit’s director. For two weeks, he remained sedated and reliant on a ventilator while his body battled COVID-19. As part of his treatment, Nelson received a transfusion of convalescent plasma — a blood product rich in COVID-19 antibodies because it

was donated by someone who had recovered from the virus. And he was placed on Remdesivir, a medication that has shown promise in treating COVID-19. In late August, with his condition slowly improving, Leonard Nelson was taken off the ventilator and underwent a tracheostomy, which provides long-term breathing support without the need for sedation. He also received a PEG tube, a way for medical staff to provide nourishment directly to his stomach instead of through an IV. By Aug. 27, he had recovered enough to be discharged to a rehabilitation facility where he received physical, speech and occupational

“I WOULD LIKE TO SAY TO THE DOCTORS, THE NURSES AND THE STAFF AND ALL WHO TOOK A PART IN CARING FOR ME, I THANK YOU FOR A JOB WELL DONE. YOU WENT BEYOND THE CALL OF DUTY.”

therapy to continue his recovery. He also had the tracheostomy and PEG tube removed. Leonard and Linda Nelson say they will be forever grateful for the care Leonard received at Tidelands Waccamaw. In fact, they surprised the critical care staff with a tray of cookies to express their gratitude. “I’ve come a long ways in a relatively short period of time, but I’ve still got ways to go,” Leonard Nelson says. “By the help of the Good Master, I’ll get back to where I was once. I’ve learned now that it’s time to take care of self and family. “I would like to say to the doctors, the nurses and the staff and all who took a part in caring for me, I thank you for a job well done. You went beyond the call of duty.” Linda Nelson says the experience has brought the couple closer. “I thank God for giving us another chance, another chance to love.” TIDELANDS HEALTH l 2020 ANNUAL REPORT l

MOVING FORWARD At Tidelands Health, our not-for-profit organization does not have stockholders – we exist to improve the health and lives of those we serve. It’s our mission: “We help people live better lives through better health.” Even amid the pandemic, we remained focused on achieving that mission and continued to build upon our six foundational pillars — people, service, quality, safety, finance and growth. These pillars provide a lens through which we evaluate our decisions to ensure we are doing the right thing, always, for the patients we serve.

TIDELANDS HEALTH l 2020 ANNUAL REPORT l

OURS IS A TEAM OF PEOPLE HELPING PEOPLE.

To support ongoing leadership training and development, Tidelands Health partners with Coastal Carolina University to offer the Tidelands Health Leadership Academy. Promising employee and physician leaders receive instruction in important disciplines such as strategic planning and project management. Since its inception, eight cohorts of leaders have completed the academy’s 101 level offering. A 201 curriculum is set to launch in 2021. In response to the COVID-19 pandemic, Tidelands Health Rehabilitation Services developed a “virtual visit” option for patients to receive their treatments through a realtime telehealth visit with a licensed therapist. Patient participation was simple — the only equipment needed was a laptop, desktop, tablet or smartphone equipped with a camera and microphone.

Through the McRoy and Jo Skipper Initiative for Learning and Teaching and using donations from the Tidelands Health Foundation’s annual Lights of Love campaign, Tidelands Health in 2020 provided five $5,000 scholarships to qualified employee partners who are furthering their health care education. In 2020, Tidelands Health served as a partner in Helping Hands of Georgetown County’s Youth Empowerment Program. The goal of the effort is to help high school students identify a career path and/or prepare them for the workforce after graduation. As a participant in virtual sessions with the students, Tidelands Health offered information about opportunities in health care, guidance on interviewing and participated in engaging discussions with the students. In 2020, three Tidelands Health nurses earned statewide recognition for excellence in their profession by receiving prestigious Palmetto Gold awards. Mindy Foster, Kristi Jones and Sharon Parrott each earned Palmetto Gold awards, which are conferred by

A telehealth program developed in 2020 by Tidelands Health allowed patients to receive physical, occupational and speech therapy without leaving their home.

the South Carolina Nurses Foundation to nurses who exemplify excellence in nursing practice and commitment to the nursing profession. Only about 100 nurses in South Carolina receive the awards each year. Tidelands Waccamaw Community Hospital has earned re-designation as a Pathway to Excellence hospital by the American Nurses Credentialing Center, a division of the American Nurses Association. Tidelands Waccamaw first received the Pathway to Excellence designation in 2014 and was redesignated in 2017 and again in 2020. The coveted designation signals that a hospital has created an environment where nurses feel valued and are motivated to go above and beyond in caring for their patients. Tidelands Georgetown Memorial Hospital is also a Pathway to Excellence hospital. Gayle Resetar, chief operating officer at Tidelands Health, was appointed to the South Carolina Hospital Association board of trustees in 2020. Resetar, who joined Tidelands Health in 1990 and is responsible for the health system’s day-to-day operations, is also representing the SCHA board at a national level as a member of the American Hospital Association’s Regional Policy Board 4. Supported by the McRoy and Jo Skipper Initiative for Learning and Teaching, Tidelands Health provided $1,000 scholarships to eight area high school graduates pursuing careers in health care in 2020.

TIDELANDS HEALTH l 2020 ANNUAL REPORT l

IN ALL WE DO, WE SERVE OUR PATIENTS AND COMMUNITY.

In 2020, Tidelands Health received a $500,000 grant from The Duke Endowment as part of a longstanding partnership between the two organizations to improve health and wellness in the region. The funding will be used to support the Tidelands Community Care Network, a public-private partnership that helps break down barriers to provide access to medical care for uninsured and underinsured adults. The program was established in 2011 with the support of a $500,000 grant from The Duke Endowment and has now received more than $2.5 million from the organization.

Innovative efforts underway at Tidelands Health to address the behavioral health needs of patients and community members were highlighted nationally in 2020 as a model for other health systems. As part of Mental Health Awareness Month, the American Hospital Association recognized the health system’s creative approaches to behavioral health needs by featuring the efforts in a series of podcasts and through a blog by Bruce Bailey, president and CEO of Tidelands Health.

Tidelands Health offers 1-866-TIDELANDS, a no-cost health information and referral line for area residents. Available 24 hours a day, seven days a week, the information line received nearly 13,000 calls in 2020 — more than double the year before. Community members reached out for help with questions about COVID-19 testing, assistance facilitating medical appointments and more. A 24/7 online chat option is also available through tidelandshealth.org.

Tidelands HealthPoint Center for Health and Fitness, our region’s only medical fitness center, made it easier than ever for area residents to stay active in 2021 by expanding the center’s offerings to include a new virtual membership.

In fiscal 2020, Tidelands Community Care Network served 1,376 individuals, providing access to 587 primary care visits, 486 specialty care visits, 257 behavioral health visits and 3,996 medications. Tidelands Community Care Network partners include more than two dozen not-forprofit, government and faith-based organizations.

Virtual-only members can participate in some of Tidelands HealthPoint’s most popular classes such as Zumba, Pilates and yoga through a livestreamed format. Members also have access to an app featuring thousands of workout videos and a search function that helps users easily find the best workout to meet their needs.

TIDELANDS HEALTH l 2020 ANNUAL REPORT l

OUR COMMITMENT TO EXCELLENCE IS UNRELENTING.

In 2020, Tidelands Health and MUSC Health expanded our longtime affiliation and collaboration to improve health and wellness in Georgetown and Horry counties. In a first-of-its-kind relationship for both organizations, Tidelands Health and MUSC Health joined forces to meet the health care needs of Georgetown and Horry counties, giving patients enhanced access to leading medical treatment and technologies close to home. The enhanced relationship, which builds on a more than 10-year collaboration between the two organizations, is bringing new physicians, new technologies and new clinical services to the Tidelands region, which has been repeatedly recognized as one of the fastest-growing areas in the United States. As it has for more than 70 years, Tidelands Health remains an independent, community-led health system, with the same name, leadership team and singular mission — “We help people live better lives through better health.” The deeper relationship between Tidelands Health and MUSC Health presents opportunities to improve access and enhance patient care, increase access to a broader range of educational opportunities for MUSC students and position the organizations to take advantage of future strategic initiatives. Tidelands Georgetown Memorial Hospital and Tidelands Waccamaw Community Hospital earned national recognition as high-performing hospitals for 2020-21 by U.S. News & World Report. The hospitals earned the “High Performing” rating in recognition of care that was significantly better than

alignment with the institute’s evidence-based framework for caring for seniors.

the national average, as measured by factors such as patient outcomes. For its 2020-21 ratings, U.S. News evaluated more than 4,500 medical centers nationwide in 10 procedures and conditions. Fewer than a third of all hospitals received any high-performing rating. Tidelands Waccamaw Community Hospital has been designated an “Age-Friendly Health System – Committed to Care Excellence” by the Institute for Healthcare Improvement. The recognition is granted to hospitals and medical practices that have demonstrated exemplary

Tidelands Georgetown Memorial Hospital and Tidelands Waccamaw Community Hospital both earned recognition for dedication to high-quality stroke care in 2020. The hospitals received Gold Plus Quality Achievement awards through the American Heart Association/ American Stroke Association’s Get With The GuidelinesStroke program. The awards recognize the hospitals’ commitment to providing stroke treatment that meets nationally accepted, evidence-based guidelines. In addition, both hospitals earned the Target: Stroke Elite Honor Roll award for meeting standards meant to reduce the time between a stroke patient’s arrival at the hospital and treatment with the clot-busting medication known as t-PA.

Walking is just what the doctor ordered — literally. In 2020, Tidelands Health launched “A Walk in the Garden,” a new and unique collaboration with Brookgreen Gardens. Just as they write prescriptions for medication, participating Tidelands Health physicians can now offer qualifying patients a walking program prescription — redeemable for a free, 30-day pass to Brookgreen Gardens.

TIDELANDS HEALTH l 2020 ANNUAL REPORT l

WE STRIVE TO PREVENT HARM, KEEPING OUR PATIENTS AND EACH OTHER SAFE.

In 2020, Tidelands Health continued an organization-wide high reliability initiative that has enhanced a culture of safety by engaging its board of trustees on the issue and creating a robust reporting system for quality and patient safety incidents. In 2020, we emerged stronger and more resilient following a malware incident that targeted our computer network in late 2019 — one of a series of similar occurrences across the country. Although portions of our network had to be taken offline as the incident was investigated and resolved, our team successfully implemented downtime procedures and patients continued to receive the high-quality care they expect from Tidelands Health. Tidelands Health hospitals were again recognized by the South Carolina Hospital Association for outstanding performance in patient safety. In 2020, Tidelands Georgetown Memorial Hospital and Tidelands Waccamaw Community Hospital earned more than a dozen Certified Zero Harm Awards, which are given to hospitals that experience no preventable hospital-acquired infections of a specific nature over an extended period. Tidelands Georgetown earned awards for having no infections at surgical sites for knee replacements for two

Amid the COVID-19 pandemic, Tidelands Health offered virtual prenatal classes to help improve the labor and post-delivery experience and set up baby for the best possible start to life. In fiscal 2020, more than 240 people participated in the classes, which included virtual classroom instruction as well as fun, interactive components, including games and videos. years, hip replacements over 18 months, colon surgeries over 24 months and abdominal hysterectomies over 24 months. The hospital also received awards for having no central line-associated bloodstream infections in the critical care unit for five years and no hospital onset MRSA for 18 months. Tidelands Waccamaw earned awards for having no central line-associated bloodstream infections in the critical care unit for 88 months and having no infections at surgical sites for hip replacements and abdominal hysterectomies over the past year. Tidelands Health is continuing to partner with two local organizations in the fight against the opioid epidemic. The health system is collaborating on a program with Shoreline Behavioral Health Services and the local chapter of Faces and Voices of Recovery, a community group that works to eliminate barriers to recovery from substance-use disorders. Participants are identified when they come into the emergency department or are admitted at Tidelands Georgetown Memorial

Hospital or Tidelands Waccamaw Community Hospital. Patients are asked a series of simple questions to help identify those who may have a substance-use disorder. Individuals determined to be dependent on opioids are connected with a hospital-based peer navigator. The peer navigators encourage the patient to consider recovery and help identify obstacles that may impede the process. Within 24 hours of discharge, opioid-dependent patients see a provider in the community for medication-assisted treatment. Meanwhile, a Shoreline Behavioral Health case manager connects the patient with counseling and other resources. For many patients, a hospital stay is just one part of their care journey, which is why Tidelands Health partners with area assisted living centers, skilled nursing facilities, home health and hospice agencies and an array of other organizations and individuals to manage a patient’s journey through the care continuum. Through careful care coordination, patients are seamlessly transitioned from home to acute care to the post-acute-care setting.

TIDELANDS HEALTH l 2020 ANNUAL REPORT l

WHERE THERE IS A NEED, WE GROW TO MEET IT.

Tidelands Health is planning a state-of-the-art medical park in fast-growing Carolina Forest to better meet the health care needs of Horry County residents. The planned 34,000-square-foot facility, to be located at the corner of Carolina Forest Boulevard and Revolutionary War Way, will be home to physician offices and outpatient services. As part of continued efforts to support the increasing need for convenient, accessible health care within our rapidly growing region, Tidelands Health began the process to construct a new hospital in south Horry County in 2020. Pending state approval, Tidelands Health Carolina Bays Hospital will be conveniently located at the interchange of Highways 31 and 707 in the rapidly growing Socastee community. The 36-bed hospital will offer an emergency department, medical, surgical and critical care, four operating suites, diagnostic imaging, laboratory services and more.

Once constructed, Tidelands Health Carolina Bays will become the fifth Tidelands Health hospital serving the region.

Tidelands Health Medical Park at The Market Common, which opened in the fall of 2019, celebrated its first anniversary in 2020. In its initial year of operation, more than 50,000 care appointments were provided at the medical park, reflecting the tremendous impact the facility has had on the availability and accessibility of care within the Myrtle Beach area. The medical park brings together numerous practices and specialties — including primary care, cardiology, gastroenterology, orthopedics and more — to provide highly coordinated care all under one roof close to home.

Since its opening, Tidelands Health has added several new services to the location at The Market Common, including endocrinology, ear, nose and throat care, pediatric orthopedics and an outpatient surgery center.

The Tidelands Health MUSC Family Medicine Residency Program welcomed its fourth class of eight residents in 2020. The residency program offers newly graduated physicians broad-based training in family medicine with an emphasis on leadership and work-life balance. Several physicians who have graduated the residency program have subsequently decided to stay in our area to continue practicing medicine — achieving one of the core goals of the program.

Despite the challenges brought by the pandemic, Tidelands Health continued to successfully recruit new care providers to help support the region’s growing health care needs. In 2020, Tidelands Health welcomed 21 new physicians and advanced practice providers to the team.

TIDELANDS HEALTH l 2020 ANNUAL REPORT l

WE OPERATE EFFICIENTLY AND INTELLIGENTLY TO REMAIN STRONG

As we stepped forward to care for patients and our community amid the COVID-19 pandemic, we also took important steps to protect and strengthen the financial health of our organization. As a not-for-profit health system, we do not have shareholders, and our focus is not on generating an investment return. Rather, we must be good financial stewards so we have the resources to support our growing community’s health and wellness needs. In fiscal 2020, our organization posted total revenue of $378.7 million. Our income on operations was $3.5 million. We recorded a loss of $9 million in non-operating income, translating into an overall loss of $5.5 million in total revenue in excess of expenses for the year. As a vital component of our region’s safety net, we absorbed the cost of $18.2 million in charity care and bad debt and $38 million in unpaid costs when Medicare

Revenues

Gain from operations:..............................................................................................................................................$3,468,000 Non-operating gains:.................................................................................................................................................($9,017,000) Total excess revenue over expenses:....................................................................................($5,549,000) and Medicaid reimbursement fell short of the actual cost of care (for a complete accounting of our community benefit, please see Page 17). The start of the COVID-19 pandemic midway through the fiscal year brought a wave of financial uncertainty to health care providers across our state and nation. In March 2020, as the disease continued spread across South Carolina, Tidelands Health and other health care providers temporarily halted non-emergency procedures at the request of Gov. Henry McMaster. Coupled with government requirements limiting

Net patient service revenue

Expenses

361,877,000

Non-operating revenues

($9,017,000)

Other operating revenues

25,814,000

community movement early in the pandemic, Tidelands Health experienced volume declines of 50 percent or more at the health system’s care locations, putting unsustainable financial pressure on the organization. In response, the health system took forward-looking, comprehensive action — making difficult operational adjustments that helped Tidelands Health weather the immediate decline in patient volumes while also positioning the organization to continue supporting the community for the remainder of the pandemic and beyond.

Interest

Fees, supplies and other

180,415,000

4,156,000

Depreciation and amortization

27,344,000

Salaries and benefits

172,308,000

Total revenues

378,674,000

TIDELANDS HEALTH l 2020 ANNUAL REPORT l

Outpatient visits........................... 519,666 ER visits..............................................................50,477 Surgeries................................................................7,451 Licensed beds......................................................330 • 255 acute hospital • 75 rehab hospital

Inpatient stays...................................... 14,679 • 13,303 acute hospital • 1,376 rehab hospital

Uncompensated care.................................................... $56,200,000 Discounted and free care for those who fall within certain income guidelines

Community health education and outreach........................ $3,100,000 Programs and events to help community residents live healthier lives

Training and education for health care professionals........................ $4,200,000 Continuing medical education, clinical education and other training

Donations to community organizations....................... $1,200,000 Partnerships and support for community and philanthropic organizations

Full-time equivalent employee partners.............................2,061 • 168 rehab hospital

As an anchor of health and wellness, we believe we have a responsibility to support our community in good times and in bad. Much like we have during hurricanes and other disasters, Tidelands Health stood firm in the face of the tremendous challenges brought by COVID-19 pandemic to our region. Rather than walk away, we chose to step forward. From the earliest days of the pandemic when little was known about the mysterious virus to large-scale COVID-19 testing events and vaccination, the role of our health system expanded substantially in 2020 to support our community’s needs amid the pandemic. As our dedicated care providers perservered through a worldwide PPE shortage and took on extra shifts to help save lives during surges of COVID-19 hospitalizations, other members of our team were educating residents about ways to help protect themselves and their loved ones from the deadly illness. We partnered with South Carolina DHEC to bring large-scale community testing to the Grand Strand and stepped up to offer emerging COVID-19 treatments such as convalescent plasma and monoclonal antibody therapy. And when the COVID-19 vaccine became available, we quickly became the region’s vaccination leader.

Through it all, we proudly worked with a broad range of community partners including churches, health and human service agencies, elected leaders and others to support our community’s response and reach underserved populations. It was a team effort, and everyone at Tidelands Health played an essential part in our health system’s COVID-19 response. Even as we battled the pandemic, however, we continued with many other efforts to improve health and wellness within our region. Through Tidelands Community Care Network, a regional collaborative of more than two dozen not-for-profit, government and faith-based organizations, we helped individuals in need connect with medical care and services such as food, transportation and housing to sustain their health and wellness. In fiscal 2020, Tidelands Community Care Network served 1,376 individuals, providing access to 587 primary care visits, 486 specialty care visits, 257 behavioral health visits and 3,996 medications. Our community health resources department also played an important role by leading initiatives such as LiveWell Georgetown County, which has brought together more than 40 community partners to advance health and wellness through the use

of evidence-based practices. Funded by The Duke Endowment as part of the agency’s Healthy People, Healthy Carolinas initiative, LiveWell Georgetown County focuses on nutrition and obesity prevention, improved physical activity and reducing the severity and rate of chronic diseases. By the end of its second year of operation, LiveWell Georgetown County had funded 20 health initiatives in Georgetown County and positively impacted nearly 21,000 residents. Our community health resources department is also involved in a variety of other efforts including the Positive Parenting Program, an evidence-based program that has helped hundreds of area families by offering practical strategies to help parents build strong, healthy relationships, confidently manage their children’s behavior and promote positive childhood development.

COMMUNITY BENEFIT TIDELANDS HEALTH l 2020 ANNUAL REPORT l

As care providers at Tidelands Health selflessly battled the COVID-19 pandemic, the Tidelands Health Foundation proudly assumed an expanded role within the community as a conduit for individuals and organizations to show their support and appreciation. Founded in 1990, the foundation works in partnership with Tidelands Health to provide new technologies, convenient facilities and increased access to health care services across the region. Amid the pandemic, the health system’s team was nourished by an outpouring of support from residents, businesses and other organizations. Donations of food, inspiring cards, personal protective gear and other medical equipment, comfort insoles from Scholl’s Wellness Co., candy bars from Hershey and more helped lift the spirits of health care workers battling a pandemic the likes of which most never imagined they’d see.

TIDELANDS HEALTH FOUNDATION Through The Helpers Fund, the foundation accepted donations from as little as $5 to as much as $25,000 from people seeking to support Tidelands Health. A community church even donated massage chairs to comfort the health system’s team and provide respite. In total, the foundation raised more than $60,000 for the health system through The Helpers Fund. In addition to its pandemic-related efforts in 2020, the foundation also continued its work raising funds to advance health and wellness within the region. The foundation is focused on a campaign to raise $5

million to enhance neuroscience, pediatric rehabilitation and cancer services within the region, as well as support the McRoy and Jo Skipper Initiative for Learning and Teaching. The foundation’s “In the Pink” Breast Cancer Awareness Walk went virtual in 2020, a change that was well received. The popular event raised nearly $33,000 for the Tidelands Health Breast Care Fund, which helps uninsured and underinsured patients receive mammograms. Meanwhile, the foundation continued its “Lights of Love” holiday campaign, which raised more than $7,300 to fund scholarships through the Skipper Initiative for Tidelands Health employee partners to advance their education. And the foundation also continued to take a leadership role raising funds among Tidelands Health employee partners through the Care2Share Employee Partner Giving Campaign, which supports the Skipper Initiative and the Tidelands Health Employee Partner Relief Fund.

Tidelands Health Foundation board of directors Collin Jewell, chairman Sharon Abee Bruce Bailey Ashley DesMarteau Tom Marchant Dr. Caroline Millan J. Edward Norris III Blayne Perry Brit Rodgers Kathryn Schwartz Anita Williams

TIDELANDS HEALTH l 2020 ANNUAL REPORT l

Our mission: We help people live better lives through better health. Our vision: We will be our region’s first choice for health and wellness. Our purpose: Better health begins here. P.O. Box 421718 • Georgetown, SC 29442 tidelandshealth.org 1-866-TIDELANDS physician referral • health information • class registration