2024-05-13T11:41:16-04:00 2023-06-30 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2022-07-01 582175978 CRISP REGIONAL HOSPITAL INC CRIS 2292763130 902 7TH STREET NORTH CORDELE GA 310153234 STEVE GAUTNEY PRES/CEO 2292763132 2024-05-11 true STEVE GAUTNEY 999009999 false WILLIAM EDWARD PHILLIPS P00451499 2298837878 2024-05-13 2022 2023-04-26 12:10:37Z STEVE GAUTNEY 902 7TH STREET NORTH CORDELE GA 310153234 123957447 false X WWW.CRISPREGIONAL.ORG X 1995 GA TO PROVIDE APPROPRIATE, QUALITY CARE AND ASSISTANCE IN MAINTAINING GOOD HEALTH IN AN EFFICIENT AND CARING MANNER TO ALL WHO NEED OUR SERVICES AND AS NEAR THEIR HOME AS POSSIBLE. 9 8 1075 32 -3505 16439674 3872408 114840810 115592044 3520100 710212 1550467 2356190 136351051 122530854 329133 230066 0 49649694 51670568 0 0 69344208 74210471 119323035 126111105 17028016 -3580251 183252929 179801700 71747604 68962180 111505325 110839520 TO PROVIDE APPROPRIATE, QUALITY CARE AND ASSISTANCE IN MAINTAINING GOOD HEALTH IN AN EFFICIENT AND CARING MANNER TO ALL WHO NEED OUR SERVICES AND AS NEAR THEIR HOME AS POSSIBLE. false false 91847540 230066 115465463 THE ORGANIZATION OPERATES A HOSPITAL, TWO SNFS & A HHA PROVIDING SHORT-TERM ACUTE CARE FOR INPATIENT & OUTPATIENT SERVICES FOR CRISP COUNTY AND SURROUNDING COUNTIES. TOTAL PATIENT DAYS FOR FYE 6/30/21 WERE 16,386; HHA VISITS FOR WERE 13,117; AND SNF PATIENT DAYS WERE 19,654; CORDELE HEALTH AND REHABILITATION (A FREE-STANDING SNF) PATIENT DAYS TOTAL 18,671, AND RURAL HEALTH CLINIC VISITS TOTALED 16,808. 91847540 true true false true false false false false false false true false false false true true false true false false true false false false false false true true false true true true false false false false false false false false false false false false false false false true true true false false true 187 0 1075 true false false false false false false false false false false false false X 9 8 false false false false false false false true true false false true true true true true true true true true true GA X X JESSICA CARTER 2292763130 902 7TH STREET CORDELE GA 310153234 SAMYUKTA CHAVA MD PHYSICIAN 40.00 X 643743 0 2726 LYNN ALAN LYONS MD PHYSICIAN 40.00 X 595473 0 35568 STEVE GAUTNEY PRES/CEO 40.00 2.00 X X 497503 0 57445 VINCENT S CULPEPPER MD PHYSICIAN 40.00 X 494398 0 35568 JAMES FORDYCE MD PHYSICIAN 40.00 X 505880 0 16388 JESSICA CARTER CFO 40.00 2.00 X 271201 0 51991 APRIL DUKES VP PATIENT C 40.00 X 170578 0 27477 DAVID KICKER VP 40.00 X 141470 0 18759 VICKIE TEEMER VP HR 40.00 X 151503 0 7848 MATT COLEY BOARD MEMBER 1.00 1.00 X 0 0 0 HEATH HAMILTON BOARD MEMBER 1.00 1.00 X 0 0 0 CINDY HUGHES BOARD MEMBER 1.00 X 0 0 0 NOEL WILLIAMS JR BOARD MEMBER 1.00 1.00 X 0 0 0 CLAIRE KRAUSE SECRETARY/TR 1.00 X X 0 0 0 SULE SALAMI MD ASST SEC/TRE 1.00 1.00 X X 0 0 0 WILLIAM PANNELL MD CHAIRMAN 1.00 1.00 X X 0 0 0 ARTHUR PARKER BOARD MEMBER 1.00 X 0 0 0 3471749 253770 9 false true false PARRISH CONSTRUCTION GROUP 221 INDUSTRIAL PARK DRIVE PERRY GA 31069 PROFESSIONAL SV 3336554 INNOVATIVE THERAPY CONCEPTS LLC 2 MASHBURN ST SUITE 102 HAWKINSVILLE GA 310364961 THERAPY 2121348 ALLY HEALTHCARE STAFFING PO BOX 393 GRAY GA 31032 STAFFING 1360056 4NGELS HEALTHCARE 4922 BILL GARDNER PARKWAY STE 280 LOCUST GROVE GA 30248 CONTRACT LABOR 1241539 GT YOUNG LLC 79 ABERDEEN CIRCLE CORDELE GA 310155155 ANESTHESIA 997751 35 923684 2948724 3872408 PROGRAM SERVICE REVENUE 623000 115020606 115020606 EMS OPERATIONS CONTRACT 621990 571438 571438 115592044 1146330 1146330 115578 115578 115578 115578 987939 1424057 -436118 -436118 -436118 22309 2536 19773 19773 DIETARY/VENDING 722514 525844 525844 PRISON CLINIC 621990 428481 428481 OTHER REVENUES 621990 374838 374838 891676 406309 -3505 488872 2220839 122530854 116917250 -3505 1744701 X 230066 230066 1213832 1213832 39454267 29765684 9688583 821764 586417 235347 6079981 3144303 2935678 4100724 2865143 1235581 282459 45000 237459 913140 913140 15036 15036 372711 372711 31306611 25115913 6190698 401900 291215 110685 6282713 5106214 1176499 2888675 402428 2486247 581151 278270 302881 85965 44323 41642 6857243 2741483 4115760 3736665 2958067 778598 MEDICAL SUPPLIES 17284274 17284274 LICENSES AND TAXES 1638332 53313 1585019 HOSPITAL/NURSING HOME 429031 429031 OTHER MISCELLANEOUS 407512 71337 336175 727053 435059 291994 126111105 91847540 34263565 0 204100 87035 43597413 28302785 24219913 30150081 2292523 2026946 1946098 2757968 129887926 80223593 44882847 49664333 51613102 54452243 431969 431969 337286 9580012 8735294 4484952 2855760 183252929 179801700 14120816 17087939 4013082 9001 49369470 48534933 3704248 2823490 539988 506817 71747604 68962180 X 111505325 110839520 111505325 110839520 183252929 179801700 X -3580251 2910941 3505 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 15122 15122 false SCHEDULE C, PART II-B, LINE 1 THE HOSPITAL PAYS MEMBERSHIP DUES TO NATIONAL AND STATE ORGANIZATIONS. A PORTION OF THOSE DUES IS ALLOCATED TO LOBBYING ACTIVITIES IN WHICH THOSE ORGANIZATIONS PARTICIPATE. 3939620 3939620 52201566 30039133 22162433 1371751 1172353 199398 67060129 49012107 18048022 5314860 5314860 49664333 THIRD PARTY SETTLEMENTS 506817 506817 X SCHEDULE D, PAGE 3, PART X PART X - FIN 48 FOOTNOTE CRISP REGIONAL HEALTH SERVICES, INC., CRISP REGIONAL HOSPITAL, INC. AND CRIS REGIONAL DEVELOPMENT FOUNDATION, INC. ARE NOT-FOR-PROFIT CORPORATIONS THAT HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CRISP REGIONAL HOSPITAL PORTFOLIO INSURANCE COMPANY IS EXEMPTED FROM ALL LOCAL INCOME, PROFIT, OR CAPITAL GAINS TAXES UNTIL JULY 28, 2042 UNDER THE CAYMAN ISLAND TAX CONCESSIONS LAW. THE CORPORATIONS APPLY ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THEY ONLY RECOGNIZE THAT MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIXED FOR UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING COMBINED BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FUTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF JUNE 30, 2023 OR 2022 OR FOR THE YEARS THEN ENDED. THE CORPORATIONS' TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAXING AUTHORITIES. FOR FEDERAL INCOME TAX PURPOSES, THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OFT THOSE RETURNS. false CENTRAL AMERICA AND THE CARIBBEAN INVESTMENT 5391845 5391845 5391845 true false true false false false SCHEDULE F, PAGE 1, PART I, LINE 3 CENTRAL AMERICA AND THE CARIBBEAN 0 5,391,845 true true X true X 1.250000000000 true X true false false 823168 823168 0.00650 26769554 23735770 3033784 0.02410 27592722 23735770 3856952 0.03060 73147 73147 0.00060 16060372 7273785 8786587 0.06970 3800 3800 16137319 7273785 8863534 0.07030 43730041 31009555 12720486 0.10090 true 26675450 12181687 14532030 -2350343 X true true CRISP HC ALLIANCE HEALTH SERVICES 0.82000 0.18000 1 1 CRISP REGIONAL HOSPITAL INC 902 7TH STREET NORTH CORDELE GA 310105007 WWW.CRISPREGIONAL.ORG 040-495 X X X SNF, NF, HHA, HOSPICE, RHC, RD CRISP REGIONAL HOSPITAL INC 1 false false true X X X X X X X X X X 22 true false false true X WWW.CRISPREGIONAL.ORG X true 22 true HTTP://WWW.CRISPREGIONAL.ORG false false true X 125.000000000000 200.000000000000 X X X X true true X X X X true X WWW.CRISPREGIONAL.ORG X WWW.CRISPREGIONAL.ORG X WWW.CRISPREGIONAL.ORG X X X X X X true X false X X X X true X false false FACILITY 1, CRISP REGIONAL HOSPITAL INC - PART V, LINE 3E AREAS OF NEED THAT WERE HIGHLIGHTED IN MORE THAN ONE DATA SOURCE INCLUDED PHYSICAL ACTIVITY/EXERCISE, MENTAL HEALTH, RISKY TEEN SEXUAL BEHAVIOR, NUTRITION, PRESCRIPTION COMPLIANCE, TRANSPORTATION AND ACCESS TO CARE, SENIOR CARE, AND PULMONARY HEALTH. AFTER REVIEWING THESE DATA AND CONSIDERING THE HOSPITALS PAST CHNA PLANS AND RELATED INITIATIVES, THE HOSPITAL CHNA STEERING COMMITTEE PRIORITIZED FOUR AREAS FOR THE 2022 IMPLEMENTATION PLAN: 1) MATERNAL AND CHILD HEALTH, 2) MENTAL HEALTH, 3) TRANSPORTATION, AND 4) RISKY TEEN BEHAVIORS. EACH PRIORITIZED NEED IS ADDRESSED THROUGH COLLABORATION, EDUCATION OR SERVICE. FACILITY 1, CRISP REGIONAL HOSPITAL INC - PART V, LINE 5 THE CENTER FOR PUBLIC HEALTH PRACTICE AND RESEARCH PROJECT TEAM WORKED WITH THE HOSPITAL CHNA STEERING COMMITTEE THROUGHOUT THE PROJECT. THE STEERING COMMITTEE FACILITATED COMPLETION OF A COMMUNITY SURVEY, RECRUITED KEY STAKEHOLDERS FOR FOCUS GROUP DISCUSSIONS, PROVIDED INFORMATION ABOUT THE HOSPITALS ACTIVITIES TO ADDRESS COMMUNITY HEALTH NEEDS SINCE THE LAST CHNA WAS COMPLETED IN 2019, AND PROVIDED THE HEALTHCARE RESOURCE LISTING AT THE END OF THIS REPORT. THE COMMUNITY SURVEY THAT WAS ADMINISTERED AIMED AT ASSESSING LOCAL HEALTH CARE ACCESS AND NEEDS OF THE PEOPLE RESIDING IN THE PRIMARY SERVICE AREA OF CRISP REGIONAL HOSPITAL CRISP COUNTY. THE COMMUNITY SURVEY WAS DISSEMINATED VIA THE HOSPITALS SOCIAL MEDIA WEBPAGES AND EMAIL LISTSERVS, AS WELL AS THOSE OF LOCAL COMMUNITY PARTNERS. FOCUS GROUP PARTICIPANTS WERE ALL KEY STAKEHOLDERS IN MAINTAINING THE OVERALL HEALTH OF THE COMMUNITY. THEIR PERSPECTIVES PROVIDED A WELL-ROUNDED VIEW OF LIFE IN THE COMMUNITY AND THE HEALTH AND HEALTHCARE NEEDS OF THE RESIDENTS. INFORMATION FROM THESE PRIMARY DATA COLLECTION EFFORTS WAS SUPPLEMENTED BY SECONDARY QUANTITATIVE DATA ON THE COMMUNITYS PROFILE, HEALTH CARE ACCESS, AND UTILIZATION. THESE DATA WERE OBTAINED FROM MULTIPLE PUBLICLY AVAILABLE SOURCES INCLUDING THE US CENSUS BUREAU, THE AREA RESOURCE FILE, CENTERS FOR DISEASE CONTROL (CDC) DISEASE AND MORTALITY DATA, GEORGIA POPULATION PROJECTIONS, COUNTY HEALTH RANKINGS, AND THE GEORGIA DEPARTMENT OF HEALTHS ONLINE ANALYTICAL STATISTICAL INFORMATION SYSTEM (OASIS). THE MOST RECENTLY AVAILABLE DATA WERE OBTAINED FROM ALL DATA SOURCES AT THE TIME OF ANALYSIS. FINDINGS FROM ALL THE ABOVE-DESCRIBED PRIMARY AND SECONDARY DATA COLLECTION EFFORTS INFORMED THE IDENTIFICATION AND PRIORITIZATION OF COMMUNITY HEALTH NEEDS BY THE HOSPITAL STEERING COMMITTEE, AS WELL AS PROVIDED SUGGESTED SOLUTIONS TO ADDRESS THESE NEEDS. FACILITY 1, CRISP REGIONAL HOSPITAL INC - PART V, LINE 11 INFORMATION GATHERED FROM THE COMMUNITY MEETING, INTERVIEW, DISCUSSIONS WITH THE HOSPITAL LEADERSHIP TEAM, REVIEW OF DEMOGRAPHIC AND HEALTH STATUS, AND HOSPITAL UTILIZATION DATA WERE USED TO DETERMINE THE PRIORITY HEALTH NEEDS OF THE POPULATION. A VARIETY OF NEEDS WERE IDENTIFIED THAT ARE NOT POSSIBLE FOR THE HOSPITAL TO ADDRESS BY ITSELF, BUT WILL BE ADDRESSED THROUGH COMMUNITY EDUCATION OR IN COLLABORATION WITH OTHERS WITHIN THE COMMUNITY. THE CHNA AND IMPLEMENTATION STRATEGY CAN BE DOWNLOADED BY VISITING HTTPS://CRISPREGIONAL.ORG 8 CRISP REGIONAL NURSING HOME & REHAB 902 BLACKSHEAR ROAD CORDELE GA 31015 NURSING FACILITY CARESOUTH OF CRISP REGIONAL 906 5TH STREET NORTH CORDELE GA 31015 HOME HEALTH CRISP REGIONAL HOSPICE 910 5TH STREET NORTH CORDELE GA 31015 HOSPICE WARWICK HEALTHCARE CENTER 135 DOGWOOD STREET WARWICK GA 31796 RHC CRISP REGIONAL DIALYSIS UNIT 1302 5TH STREET NORTH CORDELE GA 31015 DIALYSIS CORDELE HEALTH & REHAB 1106 NORTH 4TH STREET CORDELE GA 31015 NURSING FACILITY CRISP REGIONAL CONVENIENT CARE 902 NORTH 7TH STREET CORDELE GA 31015 RHC BLACKSHEAR RETIREMENT VILLAS 1110 BLACKSHEAR ROAD CORDELE GA 31015 ASSISTED LIVING SCHEDULE H, PART I, LINE 7G THIS SECTION INCLUDES NET ACTUAL COSTS FOR SUBSIDIZED PHYSICIAN AND RURAL HEALTH CLINICS OF 16,060,372. SCHEDULE H, PART I, LINE 7 COSTS FOR PART I, LINE 7A WERE CALCULATED USING THE RCC CALCULATED IN WORKSHEET 2. PART I, LINE 7B COSTS WERE CALCULATED FROM THE ORGANIZATION'S ACCOUNTING RECORDS. PART I, LINE 7G COSTS WERE CALCULATED FROM THE ORGANIZATION'S ACCOUNTING RECORDS. SCHEDULE H, PART III, LINE 2 AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE. PURSUANT TO ASU NO. 2014-09 (TOPIC 606), THE AMOUNT IDENTIFIED AS BAD DEBT ON SCHEDULE H, PART II, LINE 2 PRIMARILY REPRESENTS AMOUNTS ESTIMATED AT THE TRANSACTION DATE THAT ARE CONSIDERED A PRICE CONCESSION. THE ORGANIZATION DETERMINES THE TRANSACTION PRICE BASED ON STANDARD CHARGES FOR SERVICES PROVIDED, REDUCED BY CONTRACTUAL ADJUSTMENTS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO UNINSURED PATIENTS IN ACCORDANCE WITH THE SYSTEMS POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED TO UNINSURED PATIENTS. IMPLICIT PRICE CONCESSIONS REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED AND THE ESTIMATED CONSIDERATION THE ORGANIZATION EXPECTS TO RECEIVE FROM PATIENTS, WHICH ARE DETERMINED BASED ON HISTORICAL COLLECTION EXPERIENCE, CURRENT MARKET CONDITIONS, AND OTHER FACTORS. SCHEDULE H, PART III, LINE 4 SEE THE DISCUSSION REGARDING UNINSURED PATIENTS AND BAD DEBT EXPENSE WITH THE NET PATIENT SERVICE REVENUE FOOTNOTE ON PAGES 15-21 ON THE ACCOMPANYING AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, LINE 8 MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. SCHEDULE H, PART III, LINE 9B PATIENTS, WHO MEET ALL THE REQUIREMENTS TO BE CLASSIFIED AS MEDICALLY INDIGENT UNDER THE ORGANIZATION'S ICTF POLICY, WILL HAVE THEIR ACCOUNTS WRITTEN OFF ON A SLIDING SCALE FEE (100% OF ACCOUNTS AT 125% OF THE FEDERAL POVERTY SCALE, 7% OF ACCOUNTS WHEN INCOME IS AT 200% OF THE SCALE, UP TO THE MAXIMUM ALLOWED PER PATIENT PER YEAR). ANY AMOUNT NOT ADJUSTED OFF PER POLICY, WOULD FOLLOW THE COLLECTION PRACTICE AS ANY OTHER ACCOUNT. SCHEDULE H, PART VI, LINE 2 CRISP REGIONAL ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY BY EVALUATING DISEASE INCIDENCES IN THE POPULATION AS WELL AS ECONOMIC AND DEMOGRAPHIC CHARACTERISTICS OF THE POPULATION IN COMPARISON TO THE UTILIZATION AND AVAILABILITY OF APPLICABLE SERVICES. PRIMARY SOURCE FOR ASSESSMENT INFORMATION IS THE COMMUNITY HEALTH STATUS INDICATORS PUBLISHED BY THE U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES AND INTERNAL INFORMATION PRODUCED BY HOSPITAL RECORDS. CRISP REGIONAL IS CLASSIFIED AS A HEALTH MANPOWER SHORTAGE AREA DUE TO THE DISPROPORTIONALLY LARGE LOW INCOME POPULATION. IN ADDITION, CRISP'S SERVICE HAS A SIGNIFICANT NUMBER OF MIGRANT AND UNDOCUMENTED FARM WORKS THAT PRESENT EPISODIC COMMUNITY HEALTH NEEDS. BOTH OF THE ORGANIZATION'S 2022 AND 2019 COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGY PLANS ARE AVAILABLE FOR DOWNLOAD ON ITS WEBSITE AT HTTPS://CRISPREGIONAL.ORG SCHEDULE H, PART VI, LINE 3 CRISP REGIONAL HOSPITAL HAS A CLEARLY DEFINED PROCESS FOR ADDRESSING INDIGENT AND/OR SELF-PAY PATIENTS. PATIENTS THAT PRESENT AT THE REGISTRATION DESK AS SELF PAY PATIENTS RECEIVING OUTPATIENT SERVICES ARE DIRECTED TO OUR PATIENT FINANCIAL COUNSELOR FOR ADVISEMENT. AT THIS POINT, A FINANCIAL COUNSELOR REVIEWS THE APPLICATION FOR THE INDIGENT CARE TRUST FUND ASSISTANCE. IF THIS ASSISTANCE APPLIES, THE COUNSELOR WILL ASSIST IN THE APPLICATION PROCESS AND ASSURE COMPLETION OF THE APPLICATION FOR REVIEW. IF THIS ASSISTANCE DOES NOT APPLY, WE REFER TO A LIST OF SERVICES THAT REQUIRE A CERTAIN AMOUNT TO BE PAID BEFORE THE SERVICE IS RENDERED. WE ALSO ASSIST IN SETTING UP A CONTRACT TO INITIATE A MONTHLY PAYMENT PLAN. FOR A PATIENT THAT PRESENTS IN CRISP REGIONAL HOSPITAL AS AN INPATIENT AND IS SELF PAY, THE PATIENT FINANCIAL COUNSELOR GOES TO THE PATIENT'S ROOM TO ASSURE THAT THEY ARE CORRECTLY CLASSIFIED AS A SELF PAY PATIENT. SELF PAY PATIENTS ARE THEN REFERRED TO CHANGE HEALTHCARE TO ASSESS ELIGIBILITY FOR MEDICAID ASSISTANCE. IF NOT ELIGIBLE FOR MEDICAID, WE ASSIST THEM WITH AN APPLICATION FOR INDIGENT CARE TRUST FUND ASSISTANCE. IF NOT ELIGIBLE FOR THE INDIGENT PROGRAM, THEN WE ASSIST WITH A CONTRACT TO START MONTHLY PAYMENTS. SCHEDULE H, PART VI, LINE 4 CRISP REGIONAL HOSPITAL SERVES CRISP, DOOLY AND WILCOX COUNTIES AS OUR PRIMARY SERVICE AREAS. THESE AREAS ACCOUNT FOR 85.62% OF PATIENT ACTIVITY. THE OTHER FOUR CONTIGUOUS COUNTIES, SUMTER, WORTH, TURNER AND LEE, ARE SECONDARY GEOGRAPHIC MARKET AREAS. CORDELE IS THE ECONOMIC AND MEDICAL HUB OF THIS AREA AND DRAWS ON A POPULATION APPROACHING 135,000. THE MOST RECENTLY AVAILABLE SCHOOL ENROLLMENT IN CRISP COUNTY WAS 6,351. NURSERY SCHOOL AND KINDERGARTEN ENROLLMENT WAS 698 AND ELEMENTARY OR HIGH SCHOOL ENROLLMENT WAS 3,975 CHILDREN. COLLEGE OR GRADUATE SCHOOL ENROLLMENT WAS 1,678. INDUSTRIES: IN 2021, FOR THE EMPLOYED POPULATION 16 YEARS AND OLDER, THE LEADING INDUSTRIES IN CRISP COUNTY WERE HEALTHCARE, SOCIAL ASSISTANCE, EDUCATIONAL SERVICES, MANUFACTURING, AND RETAIL TRADE. INCOME: THE MEDIAN INCOME OF HOUSEHOLDS IN CRISP COUNTY WAS 41,605 IN 2021. 67% OF THE HOUSEHOLDS RECEIVED EARNINGS AND 15% RECEIVED RETIREMENT INCOME OTHER THAN SOCIAL SECURITY. 12% OF THE HOUSEHOLDS RECEIVED SOCIAL SECURITY. THESE INCOME SOURCES ARE NOT MUTUALLY EXCLUSIVE; THAT IS, SOME HOUSEHOLDS RECEIVED INCOME FROM MORE THAN ONE SOURCE. POVERTY AND PARTICIPATION IN GOVERNMENT PROGRAMS: IN 2021, 29.7% OF PEOPLE WERE IN POVERTY. 47.9% OF RELATED CHILDREN UNDER 18 WERE BELOW THE POVERTY LEVEL, COMPARED WITH 16.9% OF PEOPLE 65 YEARS OLD AND OVER. 28% OF ALL FAMILIES AND 68% OF FAMILIES WITH A FEMALE HOUSEHOLDER AND NO HUSBAND PRESENT HAD INCOMES BELOW THE POVERTY LEVEL. FOR PEOPLE REPORTING ONE RACE ALONE, 52% WERE WHITE; 45% WERE BLACK OR AFRICAN AMERICAN; 4% WERE HISPANIC OR LATINO; 1% WAS ASIAN; AND 1% WAS CLASSIFIED AS OTHER RACE. 2% REPORTED TWO OR MORE RACES. HOUSING COSTS: THE MEDIAN MONTHLY HOUSING COSTS FOR MORTGAGED OWNERS WAS 1,099, NON-MORTGAGED OWNERS 420, AND RENTERS 695. 18% OF OWNERS WITH MORTGAGES, 11% OF OWNERS WITHOUT MORTGAGES, AND 27% OF RENTERS IN CRISP COUNTY SPENT 50% OR MORE OF HOUSEHOLD INCOME ON HOUSING. NATIVITY AND LANGUAGE: LESS THAN 1% OF THE PEOPLE LIVING IN CRISP COUNTY IN 2021 WERE FOREIGN BORN. 99% WERE NATIVE, INCLUDING 86% WHO WERE BORN IN GEORGIA. AMONG PEOPLE AT LEAST 5 YEARS OLD LIVING IN CRISP COUNTY IN 2021, 3.4% SPOKE A LANGUAGE OTHER THAN ENGLISH AT HOME. SCHEDULE H, PART VI, LINE 5 CRISP REGIONAL IS SERVED BY A VOLUNTEER GOVERNING BOARD COMPOSED OF COMMUNITY MEMBERS FROM CRISP AND DOOLY COUNTIES. A PRIMARY FOCUS OF THE BOARD IS TO ADDRESS THE ACCESSIBILITY OF HEALTHCARE SERVICES AND ACCESS TO QUALIFIED HEALTHCARE PROFESSIONALS. THE ORGANIZATION OPERATES A 24HR/7DAY A WEEK EMERGENCY DEPARTMENT THAT SERVES APPROXIMATELY 20,000 PATIENTS ANNUALLY. AS A MEANS TO ALLEVIATE ED OVERCROWDING AND CREATE A MORE APPROPRIATE TREATMENT ENVIRONMENT, THE BOARD ALSO FUNDS FINANCIALLY OPERATING DEFICITS AT THE CRISP CONVENIENT CARE CLINIC. THE ED PATIENT POPULATION INCLUDES 23% THAT ARE CLASSIFIED AS INDIGENT OR NON-INSURED. THE CONVENIENT CARE CLINIC EXPERIENCES NEARLY 22% INDIGENT OR SELF-PAY POPULATION AND REQUIRES 332,000 IN NON- COMPENSATED FUNDING FROM THE ORGANIZATION'S GENERAL FUNDS. CRISP REGIONAL PROMOTES HEALTH AND ADDRESSES HEALTH PROFESSIONAL ACCESS IN SEVERAL COMMUNITY SERVICES. THE HOSPITAL PROVIDES HOUSING WITHOUT COST TO MEDICAL RESIDENTS AND STUDENTS ENGAGED IN CLINICAL EXPERIENCE AT CRISP REGIONAL. THE BOARD FURNISHES THREE APARTMENTS AS A MEANS TO ASSURE MEDICAL STUDENTS AND MEDICAL RESIDENTS ARE EXPOSED TO THE SPECIAL NEEDS OF RURAL POPULATIONS AND AGRICULTURE ECONOMY. IN ADDITION TO THESE SERVICES, CRISP REGIONAL PARTNERS WITH COLLEGES TO OFFER PRACTICAL EXPERIENCE IN A VARIETY OF AREAS THROUGHOUT THE HOSPITAL - FROM PROVIDING BEDSIDE CARE ON PATIENT FLOORS TO THE INTENSIVE CARE UNIT (ICU) AND EMERGENCY DEPARTMENT (ED). DURING THEIR CLINICAL ROTATIONS, STUDENTS CAN DIRECTLY APPLY WHAT THEY ARE LEARNING ABOUT THE CAUSES OF CERTAIN HEALTH CONDITIONS AND HOW TO DIAGNOSE AND TREAT THEM. THROUGH ITS RURAL HEALTH CLINIC PROGRAM, CRISP REGIONAL HEALTH SERVICES OFFERS MEDICAL CARE TO SURROUNDING RURAL COMMUNITIES. TWO RURAL HEALTH CARE CLINICS PROVIDE COVERAGE FOR PRIMARY HEALTH CARE, CHRONIC AND ACUTE ILLNESS, MINOR SUTURING, VARIOUS VACCINATIONS, LAB DRAWINGS AND PHYSICALS. THE PROGRAM ALLOWS RURAL RESIDENTS TO RECEIVE EXCELLENT HEALTH CARE PROVIDED BY HIGH-QUALITY HEALTH CARE PROFESSIONALS CLOSE TO HOME. IT ALSO OFFERS AFFORDABLE HEALTH CARE COVERAGE TO THESE RESIDENTS. LAST YEAR, BOTH CLINICS TREATED A TOTAL OF 19,382 PATIENTS. CRISP REGIONAL HEALTH SERVICES HOSTS FIVE ANNUAL COMMUNITY HEALTH FAIRS, OFFERING INFORMATION, EDUCATION AND BASIC TESTS FOR FREE OR AT DEEPLY- REDUCED COSTS. TESTS INCLUDE BODY MASS INDEX, BLOOD PRESSURE SCREENING, HEIGHT AND WEIGHT CHECKS, BLOOD GLUCOSE, AND PULMONARY LUNG FUNCTION. ALSO INCLUDED IS DIAGNOSTIC LAB WORK, CONSISTING OF LIPID PROFILE, THYROID, PROSTATE AND IRON PANEL SCREENINGS. WE PROVIDE THIS TO OUR COMMUNITY BECAUSE THE IMPORTANCE OF PRE-SCREENING, INCREASED AWARENESS AND EDUCATING THE COMMUNITY CONTRIBUTES TO RESIDENTS' BETTER OVERALL HEALTH. CRISP REGIONAL OFFERS THE WELLNESS WORKS PROGRAM TO PARTNER WITH LOCAL BUSINESSES TO MAINTAIN THE HEALTH OF THEIR EMPLOYEES AND PREVENT ILLNESS TO MAINTAIN A HEALTHY WORKPLACE. THIS PROGRAM INCLUDES SCREENINGS, HEALTH FAIRS, AND EDUCATION TO EMPLOYEES. ATHLETIC TRAINER-CRISP COUNTY SCHOOL SYSTEM SERVING AS AN EXTENSION OF ELITE PHYSICAL THERAPY SERVICES AT CRISP REGIONAL AND WITH A PARTNERSHIP WITH CRISP COUNTY SCHOOL SYSTEM, CRISP COUNTY HIGH SCHOOL BENEFITS BY HAVING AN ONSITE CERTIFIED ATHLETIC TRAINER (ATC) AVAILABLE TO ALL STUDENT ATHLETES PROVIDING FIRST AID AND EMERGENCY CARE DURING SPORTING EVENTS ALONG WITH PHYSICAL THERAPY AS PART OF ATHLETIC TRAINING AND MUSCULOSKELETAL THERAPY. THE ATHLETIC TRAINER CARES FOR STUDENT ATHLETES USING THERAPEUTIC MODALITIES SUCH AS ULTRASOUND, ELECTRICAL STIMULATION, CRYOTHERAPY, SEQUENTIAL COMPRESSION, LASER, THERMAL THERAPY, WHIRLPOOL AND OTHER EQUIPMENT. THE ATHLETIC TRAINER WORKS UNDER THE DIRECT SUPERVISION AND PROTOCOLS OF A SUPERVISING ORTHOPEDIC PHYSICIAN AND IN COLLABORATION WITH OUR PHYSICAL THERAPISTS AND STAFF. STOP THE BLEED- CRISP COUNTY EMS AND CRISP REGIONAL NURSING STAFF PARTNERED WITH THE SCHOOL SYSTEMS TO OFFER LIFE SAVING TRAINING WITH STOP THE BLEED. THROUGH OUR STOP THE BLEED COURSE, OUR COMMUNITY PARTNERS GAIN THE ABILITY TO RECOGNIZE LIFE-THREATENING BLEEDING AND INTERVENE EFFECTIVELY. THIS PROGRAM IS DESIGNED TO ENABLE SCHOOL TEACHERS, NURSES, AND STAFF HOW TO RENDER IMMEDIATE, POTENTIALLY LIFE-SAVING MEDICAL AID TO INJURED STUDENTS OR CO- WORKERS WHILE AWAITING THE ARRIVAL OF PROFESSIONAL RESPONDERS. EACH SCHOOL RECEIVED LIFE SAVING STOP THE BLEED KITS TO HAVE AVAILABLE DURING LIFE SAVING EMERGENCIES. TEEN MAZE- PARTNERING WITH THE CRISP COUNTY SCHOOL SYSTEM AND OTHER PARTNERS, THE TEEN MAZE IS A LIFE-SIZED INTERACTIVE GAME THAT STUDENTS ADVANCE THROUGH BY CHANCE. THE TEEN MAZE IS AN EXPERIENTIAL LEARNING EVENT. THE GOAL OF THE EFFORT IS TO HELP STUDENTS REALIZE THE IMPACT OF MAKING GOOD CHOICES. STUDENTS HAVE NO CONTROL OF THEIR CHOICES DURING THE MAZE, AND ARE PRESENTED CONSEQUENCES OF CHOICES RELATED TO SUBSTANCE ABUSE, UNPROTECTED SEX, TEEN PREGNANCY/PARENTING, FINANCIAL OBLIGATIONS, DATE VIOLENCE, DRINKING/TEXTING AND DRIVING, CRIMINAL ACTIVITY, ETC. THE OVERALL MESSAGE IS THAT MAKING GOOD CHOICES WILL SET STUDENTS ON A SUCCESSFUL PATH TO HIGH SCHOOL GRADUATION. STUDENTS WILL BE ENCOURAGED TO LEARN FROM THEIR PEERS EXPERIENCES IN THE MAZE AND TO DISCUSS THEIR OWN EXPERIENCES WITH THEIR PARENTS. MEDICATION ASSISTANCE CRISP REGIONAL IDENTIFIES PATIENTS DURING THEIR HOSPITAL STAY THAT CAN'T AFFORD THEIR MAINTENANCE AND DISCHARGE MEDICATIONS. ONCE THIS NEED IS DETERMINED, THE HOSPITAL OWNED RETAIL PHARMACY FILLS THESE MEDICATIONS AT NO COST TO THE PATIENT PRIOR TO DISCHARGE TO HELP ENSURE THAT ALL PATIENTS HAVE ACCESS TO THEIR REQUIRED MEDICATIONS TO KEEP THEM HEALTHY AND PREVENT A READMISSION. THE APPROXIMATE COST OF PROVIDING THESE MEDICATIONS WAS 10,000 IN THE 2023 FISCAL YEAR. SCHEDULE H, PART VI, LINE 6 THE HOSPITAL AUTHORITY OF CRISP COUNTY (AUTHORITY) REORGANIZED AND ESTABLISHED CRISP REGIONAL HEALTH SERVICES, INC. AS THE CONTROLLING COMPANY OF CRISP REGIONAL HOSPITAL, INC., CRISP REGIONAL DEVELOPMENT FOUNDATION, INC., AND CRISP MEDICAL SERVICES, INC. CRISP REGIONAL HOSPITAL, INC. AND CRISP REGIONAL DEVELOPMENT FOUNDATION, INC. ARE NOT-FOR-PROFIT CORPORATIONS. CRISP REGIONAL HOSPITAL, INC. OPERATES CRISP REGIONAL HOSPITAL (ACUTE CARE HOSPITAL), CRISP REGIONAL NURSING AND REHABILITATION CENTER (SKILLED NURSING FACILITY), CARESOUTH OF CRISP REGIONAL HOSPITAL (HOME HEALTH AGENCY), BLACKSHEAR RETIREMENT VILLA (A RETIREMENT FACILITY), AND CORDELE HEALTH AND REHABILITATION CENTER, INC. (SKILLED NURSING FACILITY). IN ADDITION, CRISP REGIONAL HOSPITAL, INC. OPERATES VARIOUS HEALTH CLINICS AND PHYSICIAN PRACTICES. CRISP MEDICAL SERVICES, INC. IS A DORMANT FOR-PROFIT CORPORATION ORGANIZED TO CONDUCT TAXABLE ACTIVITIES. SCHEDULE H, PART VI PART I LINE 6A COMMUNITY BENEFIT REPORT THE ORGANIZATION DOES NOT HAVE A FORMALIZED WRITTEN COMMUNITY BENEFIT REPORTING PROCESS, BUT DOES PUBLICIZE A COMMUNITY BENEFIT REPORT. true EMPLOYEE EDUCATION LOANS 13 31853 PHYSICIAN EDUCATION LOANS 23 198213 SCHEDULE I, PAGE 1, PART I, LINE 2 THE ORGANIZATION OFFERS TO PROMOTE HEALTH CARE CAREERS FOR PEOPLE IN CRISP AND SURROUNDING COUNTIES BY PROVIDING SCHOLARSHIPS WITHIN CERTAIN GUIDELINES. EACH APPLICANT MUST PROVIDE A COMPLETED APPLICATION, SCHOOL TRANSCRIPTS, LETTER OF RECOMMENDATION, COMPLETION OF PREREQUISITES AND LETTER OF ACCEPTANCE TO A SPECIFIC PROGRAM, INTENT TO BECOME EMPLOYED BY THE ORGANIZATION, INTERVIEW BY APPROPRIATE VICE PRESIDENT, AND OBTAIN APPROVAL BY THE EDUCATIONAL LOAN REVIEW BOARD. REIMBURSEMENT FOR THE COST OF TUITION, BOOKS, AND REQUIRED COURSE MATERIALS PER SEMESTER WILL BE GIVEN FOR A CURRENT GPA OF 2.0 OR BETTER. A REIMBURSEMENT REQUEST INCLUDING EVIDENCE OF ACTUAL EXPENSES MUST BE SUBMITTED FOR APPROVAL. DEFAULT OF THE TERMS REQUIRES FULL OR PARTIAL PAYBACK OF THE SCHOLARSHIP FUNDS. AMOUNTS REPORTED REFLECT ASSISTANCE FORGIVEN BASED ON YEARS OF EMPLOYMENT PROVIDED. X X false true false false false false false false false SAMYUKTA CHAVA MD PHYSICIAN 611347 31965 431 2726 646469 LYNN ALAN LYONS MD PHYSICIAN 593863 1610 35568 631041 STEVE GAUTNEY PRES/CEO 486710 10793 25000 32445 554948 VINCENT S CULPEPPER MD PHYSICIAN 493162 1236 35568 529966 JAMES FORDYCE MD PHYSICIAN 488410 16664 806 16388 522268 JESSICA CARTER CFO 253774 17427 12587 39404 323192 APRIL DUKES VP PATIENT CARE SVC 169872 706 7932 19545 198055 DAVID KICKER VP 139961 1509 18759 160229 VICKIE TEEMER VP HR 151062 441 6236 1612 159351 SCHEDULE J, PAGE 1, PART I, LINE 4 STEVE GAUTNEY 0 25,000 0 JESSICA CARTER 0 12,587 0 APRIL DUKES 0 7,932 0 VICKIE TEEMER 0 6,236 0 A HOSPITAL AUTH OF CRISP COUNTY GA 586003098 226688DP1 2021-09-01 49552495 ISSUED FOR PURPOSES OF (I) FINANCING OR REFUNDING A PORTION OF THE COST OF ACQUISITION, CONSTRUCTION false false false A 834538 49552495 22874970 677524 3770077 22229923 true false false false A false false false false false false false A false true false false false false false false false A false PURPOSE OF ISSUE DESCRIPTION HOSPITAL AUTH OF CRISP COUNTY, GA ISSUED FOR PURPOSES OF (I) FINANCING OR REFUNDING A PORTION OF THE COST OF ACQUISITION, CONSTRUCTION, INSTALLATION AND EQUIPPING OF HOSPITAL AND RELATED FACILITIES OF THE CORPORATION, (II)REFUNDING THE SERIES 2013 AND 2015 CERTIFICATES, AND (III) PAYING ALL OR A PORTION OF THE COSTS OF ISSUANCE OF THE 2021 CERTIFICATES FORM 990, PAGE 6, PART VI, LINE 11B ALL BOARD MEMBERS RECEIVE A COPY OF THE FORM 990 BEFORE IT IS FILED. IF ANY MEMBER HAS ANY CONCERNS, THEY MUST INFORM ADMINISTRATION. AN EXTENSIVE REVIEW IS PERFORMED BY MANAGEMENT. THE BOARD MEMBERS PERFORM ONLY A BASIC REVIEW OF THE RETURN PRIOR TO ITS FILING WITH THE IRS. FORM 990, PAGE 6, PART VI, LINE 12C THE CONFLICT OF INTEREST POLICY IS DIRECTED NOT ONLY TO DIRECTORS AND OFFICERS, BUT TO ALL EMPLOYEES WHO CAN INFLUENCE THE ACTIONS OF CRISP REGIONAL HOSPITAL, INC. A CONFLICTING INTEREST MAY BE DEFINED AS AN INTEREST, DIRECT OR INDIRECT, WITH ANY PERSONS OR FIRMS. IT IS THE POLICY OF THE BOARD THAT THE EXISTENCE OF ANY OF THE INTERESTS SHALL BE DISCLOSED BEFORE ANY TRANSACTION IS CONSUMMATED. IT SHALL BE THE CONTINUING RESPONSIBILITY OF THE BOARD, OFFICERS, AND MANAGEMENT EMPLOYEES TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES. DISCLOSURES OF CONFLICTS SHOULD BE MADE TO THE BOARD OR A COMMITTEE THEREOF, WHO WILL DETERMINE WHETHER A CONFLICT EXISTS, AND IN THE CASE OF AN EXISTING CONFLICT, DETERMINE APPROPRIATE ACTION. THE INDIVIDUAL WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTIONS. FORM 990, PAGE 6, PART VI, LINE 15A THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE COMPENSATION FOR THE CEO. THE BOARD USES COMPARABLE COMPENSATION DATA FOR SIMILARLY QUALIFIED PERSONS AT SIMILARLY SIZED ORGANIZATIONS. THE GHA ANNUAL SALARY SURVEY AND OTHER DATA IS USED TO DETERMINE COMPENSATION FOR MANAGEMENT. THE DECISION IS DOCUMENTED BY THE BOARD. THIS PROCESS IS PERFORMED ANNUALLY. FORM 990, PAGE 6, PART VI, LINE 15B THE CEO REVIEWS AND APPROVES THE COMPENSATION FOR THE CFO AND OTHER TOP OFFICERS. THE CEO USES COMPARABLE COMPENSATION DATA FOR SIMILARLY QUALIFIED PERSONS AT SIMILARLY SIZED ORGANIZATIONS. THE GHA ANNUAL SALARY SURVEY AND OTHER DATA IS ALSO UTILIZED. THIS PROCESS IS PERFORMED ANNUALLY. CRISP REGIONAL'S COMPENSATION PHILOSOPHY IS THE SAME FOR ALL OFFICERS AND EMPLOYEES - TO PROVIDE APPROPRIATE COMPENSATION TO EMPLOYEES BASED ON MARKET DRIVEN DATA AS WELL AS DEMAND WITHIN THE ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION WILL MAKE AVAILABLE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS TO ANY MEMBER OF THE PUBLIC WHO MAKES THEIR REQUEST AT THE ADMINISTRATIVE OFFICE OF THE FILING ENTITY. FORM 990, PART IX, LINE 11G SERVICE CONTRACTS 1,682,999 2,756,495 0 PHYSICIAN FEES 10,532,258 0 0 OTHER PURCHASED SERVICES 10,918,721 2,910,092 0 THERAPY CONTRACT FEES 1,431,563 0 0 LAUNDRY/LINEN SERVICES 549,412 261,602 0 CONSULTING FEES 960 0 0 COLLECTION AGENCIES 0 262,509 0 TOTAL 25,115,913 6,190,698 0 FORM 990, PART XI, LINE 9 UBI LOSSES FROM PASSTHROUGH K1S 3,505 CRISP REGIONAL HEALTH SERVICE INC 902 7TH STREET NORTH CORDELE GA 310153234 582175975 HOLDING CO GA 501C3 12B NA false CRISP REGIONAL HOSP DEV FNDN INC 902 7TH STREET NORTH CORDELE GA 310153234 582175978 FOUNDATION GA 501C3 12A CRH CRISP REGIONAL HOSPITAL true HOSPITAL AUTHORITY OF CRISP COUNTY 902 7TH STREET NORTH CORDELE GA 310153234 586003098 AUTHORITY GA 501C3 6 NA false CRISP HEALTHCARE ALLIANCE LLC PO BOX 5007 CORDELE GA 310105007 582307830 PURCHASING GA CRH CRISP REGIONAL HOSPITAL INC RELATED 13131 806276 false false 0.82000 CRISP MEDICAL SERVICES INC 902 7TH STREET NORTH CORDELE GA 310153234 582175987 DORMANT GA N/A false false false false true false false false false false false false false true true true false true false false CRISP REGIONAL HOSPITAL DEVELOPMENT D BELOW THRESHOLD CRISP REGIONAL HOSPITAL DEVELOPMENT M BELOW THRESHOLD CRISP REGIONAL HOSPITAL DEVELOPMENT N AMOUNT INDETERMINABLE CRISP REGIONAL HOSPITAL DEVELOPMENT O AMOUNT INDETERMINABLE CRISP REGIONAL HOSPITAL DEVELOPMENT Q BELOW THRESHOLD CRISP REGIONAL HOSPITAL DEVELOPMENT S BELOW THRESHOLD