2020-02-13T10:35:46-06:00 2019-03-31 721396621 CARR RIGGS & INGRAM LLC 4004 SUMMIT BLVD NE SUITE 800 ATLANTA GA 30319 990 2018-04-01 510141601 SHEPHERD CENTER INC SHEP 4043507310 2020 PEACHTREE ROAD NW ATLANTA GA 30309 STEPHEN B HOLLEMAN CFO 4043507310 2020-02-13 1 STANLEY M SMITH II P00319916 7703948000 2020-02-13 23.117.199.162 2020-02-13 07:57:21 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 2AA6FE8C781D4C29AA431BDBF194B8C642DD1A05 2018 2020-09-23 17:36:50Z 2020 PEACHTREE ROAD NW ATLANTA GA 30309 262530954 0 X WWW.SHEPHERD.ORG X 1975 GA SEE SCHEDULE O FOR A COMPLETE DESCRIPTION OF SHEPHERD CENTER'S MISSION STATEMENT.SHEPHERD CENTER'S MISSION IS TO HELP PEOPLE WITH A TEMPORARY OR PERMANENT DISABILITY CAUSED BY INJURY OR DISEASE REBUILD THEIR LIVES WITH HOPE, INDEPENDENCE, AND DIGNITY, ADVOCATING FOR THEIR FULL INCLUSION IN ALL ASPECTS OF COMMUNITY LIFE WHILE PROMOTING SAFETY AND INJURY PREVENTION. 30 24 1991 1000 132614 -9995 16805336 16178224 223185460 237078466 3211990 3866002 5140276 5407254 248343062 262529946 0 0 0 0 118098359 127285894 0 0 0 97613021 110863225 215711380 238149119 32631682 24380827 500514140 539758138 79599040 81316572 420915100 458441566 X SHEPHERD CENTER'S PRIMARY PURPOSE IS TO PROVIDE ACUTE AND REHABILITATIVE HOSPITAL CARE TO PATIENTS WITH SPINAL CORD INJURIES, ACQUIRED BRAIN INJURIES, MULTIPLE SCLEROSIS, AND OTHER NEUROMUSCULAR AND NEUROLOGICAL CONDITIONS. CONTINUED ON SCHEDULE O. WE STRIVE TO BE THE MOST COMPREHENSIVE CATASTROPIC CARE SPECIALTY HOSPITAL IN THE WORLD, COMMITTED TO IMPROVING OUR PATIENTS' LIVES. 0 0 177311426 237078467 IN REFERENCE TO THE PROVISION OF PATIENT CARE SERVICES, SHEPHERD CENTER IS DEDICATED TO HELPING PEOPLE WHO HAVE EXPERIENCED CATASTROPHIC INJURY OR DISEASE REBUILD THEIR LIVES WITH HOPE, DIGNITY, AND INDEPENDENCE, ADVOCATING FOR THEIR FULL INCLUSION IN ALL ASPECTS OF COMMUNITY LIFE. IN THE LAST FISCAL YEAR, SHEPHERD CENTER INCURRED EXPENSES TO PROVIDE SERVICES FOR 935 INPATIENT ADMISSIONS, 47,429 INPATIENT DAYS, 14,295 DAY PATIENT DAYS, AND 55,199 OUTPATIENT VISITS. 15722471 11482431 BECAUSE OF THE GENEROUS FINANCIAL SUPPORT OF THE COMMUNITY, SHEPHERD CENTER IS ABLE TO PROVIDE MANY COMMUNITY FUNDED SERVICES THAT ARE NOT AVAILABLE IN OTHER HOSPITALS. SHEPHERD CENTER OFFERS SERVICES SUCH AS FAMILY HOUSING AND TRAINING, EXPANDED THERAPEUTIC RECREATION SERVICES, ASSISTIVE TECHNOLOGY AND ADAPTIVE EQUIPMENT, AND VOCATIONAL TRAINING, AS WELL AS MEDICAL CARE FOR PATIENTS WITHOUT THE ABILITY TO PAY FOR THESE SERVICES. 3851299 4603471 WITH REGARD TO RESEARCH ACTIVITY, SHEPHERD CENTER IS A SITE FOR LEADING-EDGE RESEARCH AND PROVIDES IMPORTANT OUTCOMES TRACKING THAT HELP SHAPE THE FACE OF REHABILITATION IN THE UNITED STATES. OUR VISION IS TO BE A CENTER OF EXCELLENCE IN PATIENT CARE, PARTICIPATING IN RESEARCH THAT WILL ACHIEVE THE HIGHEST OUTCOMES AND IMPROVE THE LIVES OF OUR PATIENTS AND FAMILIES. 196885196 1 0 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 1 0 0 1 338 0 1 1991 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 30 24 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 GA SC FL NC X X X KIMBERLY L LABOONE 4043507336 2020 PEACHTREE RD NW ATLANTA GA 303091402 ALANA SHEPHERD BOARD RECORDING SECRETARY 30.00 30.00 X X 0 0 0 BRIAN BARNETTE VP CHIEF INFORMATION OFFICER 50.00 0.00 X X 279788 0 20037 BROCK BOWMAN MD ASSOCIATE MEDICAL DIRECTOR 50.00 0.00 X 509652 0 31399 BRYANT G COATS BOARD MEMBER 1.00 0.00 X 0 0 0 CHARLES L DAVIDSON III BOARD MEMBER 1.00 0.00 X 0 0 0 CHETAN BHASIN CHIEF OPERATING OFFICER 50.00 0.00 X X 229709 0 16671 CLARK H DEAN BOARD MEMBER 1.00 0.00 X 0 0 0 CYNDAE ARRENDALE BOARD MEMBER 1.00 0.00 X 0 0 0 DAVID F APPLE JR MD MED DIR EMERITUS 50.00 1.00 X 133987 0 12065 DAVID H FLINT BOARD MEMBER 1.00 0.00 X 0 0 0 DONALD P LESLIE MD FND SPECIAL ADVISOR 50.00 1.00 X 148900 0 24549 DOUGLAS LINDAUER BOARD MEMBER 1.00 0.00 X 0 0 0 FRED V ALIAS BOARD MEMBER 1.00 0.00 X 0 0 0 J HAROLD SHEPHERD BOARD MEMBER - DECEASED 1.00 0.00 X 0 0 0 JAMES D THOMPSON VICE PRESIDENT 1.00 0.00 X X 0 0 0 JAMES E STEPHENSON BOARD MEMBER 1.00 0.00 X 0 0 0 JAMES H SHEPHERD III DIR OF COMMUNITY SVC/RISK MGT 50.00 0.00 X 161745 0 28967 JAMES H SHEPHERD JR CHAIRMAN/CHIEF STRATEGY OFFICER 50.00 1.00 X X 471642 0 19236 JOHN ROOKER BOARD MEMBER 1.00 0.00 X 0 0 0 JOHN S DRYMAN BOARD MEMBER 1.00 0.00 X 0 0 0 JULI OWENS BOARD MEMBER 1.00 0.00 X 0 0 0 K BOYNTON SMITH BOARD MEMBER 1.00 0.00 X 0 0 0 LARRY R ELLIS GENERAL RET BOARD MEMBER 1.00 0.00 X 0 0 0 LORIE HUTCHESON VP HUMAN RESOURCES 50.00 0.00 X 220062 0 16836 MCKEE NUNNALLY BOARD MEMBER 1.00 0.00 X 0 0 0 MICHAEL L JONES PHD VP CLINICAL RESEARCH 50.00 0.00 X 361384 0 31392 MICHAEL YOCHELSON MD CHIEF MEDICAL OFFICER 50.00 1.00 X X 664030 0 12631 MITCH FILLHABER VP MARKETING 50.00 0.00 X 304528 0 25216 MOLLY Y LANIER BOARD MEMBER 1.00 0.00 X 0 0 0 SALLY D NUNNALLY BOARD MEMBER 1.00 0.00 X 0 0 0 SARA S CHAPMAN BOARD MEMBER 1.00 0.00 X 0 0 0 SARAH BATTS VP FOUNDATION 1.00 50.00 X 250055 0 11861 SARAH MORRISON PRESIDENT/CEO 50.00 1.00 X X 757302 0 26480 STEPHEN B HOLLEMAN CFO 50.00 1.00 X X 477935 0 31719 TALBOT NUNNALLY BOARD MEMBER 1.00 0.00 X 0 0 0 TAMARA KING CHIEF NURSE EXECUTIVE 50.00 0.00 X 231812 0 26480 TOBY REGAL BOARD MEMBER 1.00 1.00 X 0 0 0 W CLYDE SHEPHERD III BOARD MEMBER 1.00 0.00 X 0 0 0 WILLIAM C FOWLER BOARD TREASURER 2.00 0.00 X X 0 0 0 WILMA BUNCH VP FACILITIES 50.00 0.00 X 254440 0 19486 BEN THROWER MD PHYSICIAN 40.00 0.00 X 603205 0 28896 ERIK SHAW MD PHYSICIAN 40.00 0.00 X 622360 0 28729 GERALD BILSKY PHYSICIAN 40.00 0.00 X 467392 0 19486 GUY BUCKLE PHYSICIAN 40.00 0.00 X 507500 0 20491 SHERRILL LORING MD PHYSICIAN 40.00 0.00 X 545343 0 10152 GARY ULICNY PHD FORMER PRESIDENT/CEO 0.00 0.00 X 450000 0 0 8652771 0 462779 166 1 1 0 PIEDMONT HEALTHCARE PO BOX 102859 ATLANTA GA 303682859 MEDICAL SERVICES 9342664 CERNER HEALTH SERVICES INC CO US BANK PO BOX 959167 ST LOUIS MO 631959167 COMPUTER MAINTENANCE SERVICES 1208918 MAYO COLLABORATIVE MAYO MEDICAL LABORAT PO BOX 9146 MINNEAPOLIS MN 554809146 MEDICAL SERVICES 695167 HIMFORMATICS 1579 MONROE DR NE STE F BOX 188 ATLANTA GA 30324 COMPUTER CONSULTING SERVICES 598321 CAREFUSION SOLUTIONSPYXIS 25082 NETWORK PLACE CHICAGO IL 606731250 EQUIPMENT RENTAL SERVICES 552447 44 2306688 13871536 120431 16178224 NET INPATIENT SERVICE 900099 159443313 159443313 NET DAYPATIENT SERVICE 900099 71483280 71483280 NET OUTPATIENT SERVICE 900099 6151873 6151873 237078466 3865010 3865010 2000 1008 992 992 992 CAFETERIA REVENUE 900099 1444574 1444574 ADMINISTRATIVE FEES 532000 69898 69898 RENTAL INCOME 532000 62716 62716 3830066 3830066 5407254 262529946 240908532 132614 5310576 X 9115549 5288215 3827334 93609883 77449242 16160641 2895901 2895901 7160530 5924349 1236181 14504031 5734464 8769567 2228854 880877 1347977 295859 19621 276238 115938 115938 19694 19694 18487892 15142831 3345061 741330 18740 722590 3390489 1875267 1515222 4005435 139824 3865611 2202522 435718 1766804 1049415 728653 320762 849303 379218 470085 1162587 2658 1159929 9925290 2425797 7499493 767074 150840 616234 MEDICAL SUPPLIES 60262925 60220991 41934 OTHER DIRECT EXPENSES 2806848 181379 2625469 EQUIPMENT RENTAL & MAIN 2551770 1785364 766406 ALLOCATION OF INDIRECT 0 18101148 -18101148 238149119 196885196 41263923 0 32149649 18353730 27266404 51852536 1503537 1115538 59748594 64610371 65483 132294 3124760 3505385 3071795 3463771 300219607 166434275 116856425 133785332 252754308 247833334 10766786 3973185 4339061 500514140 539758138 22775910 24215356 51503 349766 50920416 50960772 5851211 5790678 79599040 81316572 X 317070015 344581471 59644192 69418217 44200893 44441878 420915100 458441566 500514140 539758138 X 24380827 5184453 7961186 X X 0 1 X 1 1 1 X 65754 74506 140260 196744936 196885196 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 101010 108883 98727 140260 448880 250000 250000 250000 250000 1000000 1500000 67340 67191 54980 65754 255265 PART II-A SUPPLEMENTAL INFORMATION: SHEPHERD CENTER EMPLOYS MARK JOHNSON AS DIRECTOR OF ADVOCACY. DURING FISCAL YEAR OF 2019, HE WAS INVOLVED IN THE FOLLOWING ACTIVITIES: 1. MAINTAINED ADVOCACY LISTSERV, A LISTING OF ADVOCACY OPPORTUNITIES FOR STAFF AND CONSUMERS (GRASSROOTS - LINE 1A) 2. SUPPORTED EFFORTS TO SAVE MEDICAID AND LONG-TERM SERVICES AND SUPPORTS. (GRASSROOTS - LINE 1A) 3. SUPPORTED EFFORTS TO PROMOTE THE DISABILITY INTERGRATION ACT. (GRASSROOTS - LINE 1A) 4. SUPPORTED ADVOCACY DAYS HOSTED BY THE GEORGIA COUNCIL ON DEVELOPMENTAL DISABILITIES DURING THE 2018 LEGISLATIVE SESSION. (GRASSROOTS - LINE 1A AND DIRECT LOBBYING - LINE 1B) 5. ACTED AS THE PRIMARY CONTACT PERSON FOR STRATEGIC HEALTHCARE. (DIRECT LOBBYING - LINE 1B) SHEPHERD CENTER HIRED JOHN SMITH IN DECEMBER 2018 AS THE DIRECTOR OF GOVERNMENT RELATIONS AND ADVOCACY. DURING FISCAL YEAR 2019, HE WAS INVOLVED IN THE FOLLOWING ACTIVITIES: 1. REPRESENTED SHEPHERD CENTER ON HEALTHCARE AND RELATED ISSUES BEFORE THE GEORGIA GENERAL ASSEMBLY. 2. REPRESENTED SHEPHERD CENTER ON HEALTHCARE AND RELATED ISSUES BEFORE CONGRESSIONAL OFFICES. 44200893 240985 44441878 44047086 153808 44200894 43669511 377574 44047085 43604276 65235 43669511 42960755 643521 43604276 0.00000 1.00000 0.00000 0 0 38069819 38069819 116999558 52437424 64562134 142597373 112835938 29761435 2552857 1160913 1391944 133785332 ANNUITIES PAYABLE 5790678 5790678 X PART V, LINE 4: SHEPHERD CENTER HAS ESTABLISHED MULTIPLE PERMANENT ENDOWMENT FUNDS TO SUPPORT A VARIETY OF COMMUNITY FUNDED PROGRAMS SUCH AS RECREATION THERAPY, HOUSING, ASSISTIVE TECHNOLOGY AND MANY OTHER PROGRAMS THAT ARE NOT TRADITIONALLY OFFERED IN OTHER HOSPITALS. THESE PROGRAMS ARE VALUE ADDED SERVICES THAT ARE NOT REIMBURSED BY THIRD PARTY PAYORS AND ENSURE THAT SHEPHERD CENTER PROVIDES A FULL AND EXPANDED CONTINUUM OF CARE THAT HELPS FULFILL OUR MISSION OF HELPING PATIENTS REBUILD THEIR LIVES TO THE FULLEST EXTENT POSSIBLE. PART X, LINE 2: SHEPHERD AND FOUNDATION HAVE BOTH BEEN GRANTED TAX-EXEMPT STATUS UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE (THE CODE) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) WHEREBY ONLY UNRELATED BUSINESS INCOME, AS DEFINED BY SECTION 512(A)(1) OF THE CODE, IS SUBJECT TO FEDERAL INCOME TAX. SHEPHERD AND FOUNDATION HAD NO SIGNIFICANT UNRELATED BUSINESS TAXABLE INCOME DURING 2019 AND 2018; ACCORDINGLY, NO PROVISION OR BENEFIT FOR INCOME TAXES HAS BEEN INCLUDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE PROVISIONS OF ACCOUNTING STANDARDS FOR INCOME TAXES REQUIRE THAT A TAX POSITION BE RECOGNIZED OR DERECOGNIZED BASED ON A 'MORE-LIKELY-THAN-NOT' THRESHOLD. THIS APPLIES TO POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE CENTER DOES NOT BELIEVE ITS CONSOLIDATED FINANCIAL STATEMENTS INCLUDE ANY MATERIAL UNCERTAIN TAX POSITIONS. THE CENTER IS NO LONGER SUBJECT TO FEDERAL OR STATE INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR CALENDAR YEARS BEFORE 2015. 1 1 1 X 250.000000000000 0 1 1 1 0 1 1 1 3912 5393203 597808 4795395 0.02010 1 874 5645490 5645490 0.02370 2 4786 11038693 597808 10440885 0.04380 69 13206 9296955 4742873 4554082 0.01910 2 1007 350217 350217 0.00150 12 3083 612773 548122 64651 0.00030 39 350 4315619 4283278 32341 0.00010 1 1 50000 50000 0.00020 123 17647 14625564 9574273 5051291 0.02120 125 22433 25664257 10172081 15492176 0.06500 1 1580 938766 937609 1157 0.00000 1 21300 175941 29169 146772 0.00060 5 56755 134037 132079 1958 0.00000 7 79635 1248744 1098857 149887 0.00060 0 520465 13921181 18160651 -4239470 X 1 1 1 1 SHEPHERD CENTER INC 2020 PEACHTREE ROAD NW ATLANTA GA 30309 WWW.SHEPHERD.ORG 060-500 X X SHEPHERD CENTER INC 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X SHEPHERD.ORG X 1 18 1 WWW.SHEPHERD.ORG 0 1 X 250.000000000000 X X X X X 1 1 X X X 1 X SHEPHERD.ORG X SHEPHERD.ORG X SHEPHERD.ORG X X X X X X 0 0 0 X 0 0 SHEPHERD CENTER, INC. PART V, SECTION B, LINE 5: SHEPHERD CENTER'S COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION PLAN WAS DEVELOPED BY SHEPHERD STAFF WITH THE ASSISTANCE OF LEGACY CONSULTING GROUP AND GENEROUS INPUT FROM PEOPLE WITH SPECIALIZED KNOWLEDGE AND REPRESENTING THE BRAIN AND SPINAL CORD INJURY COMMUNITIES, AND PERSONS WITH MULTIPLE SCLEROSIS, INCLUDING INDIVIDUALS WHO HAVE SUSTAINED SPINAL CORD INJURIES, CAREGIVERS, CLINICIANS, SERVICE PROVIDERS, ADVOCATES, STATE AGENCY REPRESENTATIVES, AND GEORGIA AND NATIONAL ASSOCIATIONS' MEMBERS. THE INDIVIDUALS LISTED BELOW CONTRIBUTED IMMEASURABLE VALUE IN THE FORMATION OF THIS REPORT, PROVIDING PERSONAL AND CAREGIVER FIRST-HAND EXPERIENCE, EXPERT MEDICAL DIRECTION, AND PUBLIC POLICY INFORMATION AND EFFECTIVE ADVOCACY REPRESENTATION AND INPUT. SHEPHERD CENTER WOULD LIKE TO ACKNOWLEDGE THESE INDIVIDUALS AND THANK THEM FOR THEIR GENEROUS TIME AND CONTRIBUTIONS TO THIS ASSESSMENT.ALEXANDRA BENNEWITH, VICE PRESIDENT, GOVERNMENT RELATIONS, UNITED SPINAL ASSOCIATION; BROCK BOWMAN, M.D., ASSOCIATE MEDICAL DIRECTOR & MEDICAL DIRECTOR, SPINAL CORD INJURY PROGRAM, SHEPHERD CENTER; EMILY CADE, DIRECTOR, OUTPATIENT SERVICES, SHEPHERD CENTER; SUSAN CONNORS, PRESIDENT & CEO, BRAIN INJURY ASSOCIATION OF AMERICA; MITCH FILLHABER, SENIOR VICE PRESIDENT, CORPORATE DEVELOPMENT, SHEPHERD CENTER; JOSEPH FRAZIER, FORMER CHAIR, GEORGIA BRAIN & SPINAL CORD INJURY TRUST FUND COMMISSION, PERSON WITH SCI; MARK JOHNSON, DIRECTOR OF ADVOCACY, SHEPHERD CENTER, PERSON WITH SCI; SUSAN JOHNSON,DIRECTOR, BRAIN INJURY SERVICES, SHEPHERD CENTER, MEMBER GEORGIA BRAIN & SPINAL CORD INJURY TRUST FUND COMMISSION, FAMILY MEMBER OF PERSON WITH SCI; DONALD LESLIE, M.D., MEDICAL DIRECTOR EMERITUS, BOARD OF DIRECTORS, FOUNDATION TRUSTEE, SHEPHERD CENTER; SHARI MC DOWELL, DIRECTOR, SPINAL CORD INJURY SERVICES, SHEPHERD CENTER; SARAH MORRISON, PRESIDENT & CEO, SHEPHERD CENTER; JAMIE SHEPHERD, III, DIRECTOR OF COMMUNITY SERVICES, SHEPHERD CENTER; JAMES SHEPHERD, JR., CHAIRMAN OF THE BOARD OF DIRECTORS, CO-FOUNDER, CHIEF STRATEGY OFFICER, SHEPHERD CENTER, PERSON WITH SCI; MICHAEL YOCHELSON, M.D., CHIEF MEDICAL OFFICER, SHEPHERD CENTER. SHEPHERD CENTER, INC. PART V, SECTION B, LINE 11: THROUGH INTERVIEWS WITH PERSONS WITH EXPERT KNOWLEDGE OF AND A PASSION FOR ADVOCATING FOR MEMBERS OF THE ACQUIRED BRAIN INJURY, SPINAL CORD INJURY AND MULTIPLE SCLEROSIS COMMUNITIES, WE REVIEWED THE STATUS OF COMMUNITY HEALTH NEEDS IDENTIFIED IN SHEPHERD CENTER'S 2015 COMMUNITY HEALTH NEEDS ASSESSMENT. THERE REMAINS STRONG CONSENSUS THAT EACH OF THE PREVIOUSLY IDENTIFIED ISSUES CONTINUE TO AFFECT NEARLY ALL PERSONS WITHIN THE ABI AND SCI COMMUNITIES REGARDLESS OF INCOME, INSURANCE OR MINORITY STATUS. IN ADDITION, MANY OF THESE ISSUES ARE ALSO EXPERIENCED BY PERSONS WITH MULTIPLE SCLEROSIS. THESE HEALTH NEEDS ARE PARTICULARLY EVIDENT AS PERSONS WHO HAVE SUSTAINED CATASTROPHIC INJURIES RETURN TO THEIR LOCAL COMMUNITIES AND MOVE FORWARD WITH REBUILDING THEIR LIVES WITH HOPE, INDEPENDENCE AND DIGNITY.FROM THE LIST OF COMMUNITY-BASED HEALTH NEEDS, EACH PARTICIPANT WAS ASKED TO RANK PRIORITIES ON AN ORDINAL SCALE WITH 1 BEING THE HIGHEST PRIORITY AND 8 BEING THE LOWEST PRIORITY. THE COMMUNITY HEALTH NEED ASSESSMENT WAS COMPLETED FROM JUNE THROUGH JULY 2018. A 93 PERCENT RESPONSE RATE WAS ACHIEVED, RESULTING IN THE FOLLOWING RANKING OF COMMUNITY-BASED HEALTH NEEDS#1 NEED FOR COMMUNITY-BASED PRIMARY CARE PHYSICIANS WILLING TO ACCEPT INDIVIDUALS WITH ABI AND SCI.#2 NEED FOR SPECIALIZED SERVICES TO MEET THE UNIQUE HOME HEALTH NEEDS OF PERSONS WITH ABI AND SCI.#3 NEED FOR COMMUNITY-BASED PROGRAMS TO PROVIDE CAREGIVER EDUCATION, TRAINING AND SUPPORT.#4 NEED FOR COMMUNITY-BASED SPECIALIZED REHABILITATION SERVICES FOR INDIVIDUALS WITH ABI, SCI AND MS.#5 NEED FOR COMMUNITY CARE COORDINATION AND MANAGEMENT PROFESSIONALS WITH AN UNDERSTANDING OF THE UNIQUE PAIN MANAGEMENT, BEHAVIORAL ADJUSTMENT AND SEXUALITY-RELATED ISSUES OF INDIVIDUALS WITH ABI AND SCI.#6 NEED FOR ENHANCED COMMUNITY EDUCATIONAL OUTREACH ON THE PREVENTION OF PRIMARY INJURIES, SECONDARY COMPLICATIONS, APPROPRIATE STANDARDS OF CARE, AND AGING-RELATED ISSUES OF INDIVIDUALS WITH ABI AND SCI.#7 NEED FOR TELEPHONE AND WEB-BASED PEER SUPPORT SYSTEMS FOR INDIVIDUALS WITH ABI, SCI AND MS.#8 NEED FOR COMMUNITY-BASED EXERCISE PROGRAMS AND FACILITIES FOR INDIVIDUALS WITH AB, SCI AND MS.SHEPHERD CENTER'S IMPLEMENTATION STRATEGY WILL PRIMARILY FOCUS ON ADDRESSING THE COMMUNITY HEALTH NEEDS OF PERSONS WITH SPINAL CORD AND BRAIN INJURIES WHO RESIDE WITHIN THE EIGHT COUNTIES AROUND METRO ATLANTA (CHEROKEE, CLAYTON, COBB, DEKALB, DOUGLAS, FULTON, GWINNETT AND HENRY COUNTIES) WHERE IT CAN REALISTICALLY PROVIDE ACCESS TO COMMUNITY HEALTH PROGRAMS, SERVICES, AND RESOURCES. IN ADDITION, IT WILL SEEK TO ADDRESS LOCAL COMMUNITY HEALTH NEEDS OF PERSONS WITH MULTIPLE SCLEROSIS. WHEN PRACTICAL AND FINANCIALLY FEASIBLE, THE CENTER WILL SEEK TO PROVIDE WEB-BASED OR TELEPHONE CONTACT AND SERVE AS A RESOURCE CENTER TO ASSIST IN ADDRESSING COMMUNITY HEALTH NEEDS OF THE BROADER BRAIN INJURY, SPINAL CORD INJURY AND MULTIPLE SCLEROSIS CLIENT POPULATIONS.FOR ADDITIONAL DETAILS AND INFORMATION REGARDING EACH NEED AND SHEPHERD IMPLEMENTATION PLANS AND PROGRESS, PLEASE VISIT WWW.SHEPHERD.ORG FOR OUR COMMUNITY HEALTH NEEDS ASSESSMENT POSTED UNDER ABOUT SHEPHERD CENTER/PUBLICATIONS. SHEPHERD CENTER, INC. PART V, SECTION B, LINE 13H: FAMILY SIZE SHEPHERD CENTER, INC. PART V, SECTION B, LINE 16J: WHEN PATIENTS ARE SCHEDULED OR AN ADMISSION REFERRAL IS MADE, APPROPRIATE FINANCIAL SCREENING IS PROVIDED. 3 1 - SHARE INITIATIVE 80 PEACHTREE PARK DRIVE ATLANTA GA 30309 OUTPATIENT CENTER SERVING INJURED SERVICEMEN AND WOMEN 2 - SHEPHERD PATHWAYS 1942 CLAIRMONT ROAD DECATUR GA 30033 OUTPATIENT CENTER SERVING BRAIN INJURY PATIENTS 3 - PATHWAY RESIDENTIAL 2086 AZELEA CIRCLE DECATUR GA 30033 RESIDENTIAL UNITS SERVING BRAIN INJURY PATIENTS PART I, LINE 3C: IF INCOME EXCEEDS 250% OF THE FEDERAL POVERTY GUIDELINES, ADDITIONAL INFORMATION MAY BE REQUIRED FROM THE PATIENT OR GUARANTOR TO DETERMINE IF ASSISTANCE CAN BE GRANTED BASED ON A 'MEDICALLY NEEDY' SITUATION RESULTING FROM THE CATASTROPHIC EVENT NECESSITATING ADMISSION TO SHEPHERD CENTER. PART II, COMMUNITY BUILDING ACTIVITIES: SHEPHERD CENTER'S COMMUNITY BUILDING ACTIVITIES ARE CONCENTRATED IN THE FOLLOWING AREAS:- ADVOCACYSHEPHERD CENTER'S ADVOCACY PROGRAM IS RESPONSIBLE FOR THE FOLLOWING:1.SERVE AS A PRIMARY LIAISON BETWEEN SHEPHERD CENTER AND THE DISABILITY COMMUNITY.2.PROVIDE DAY-TO-DAY EXPERTISE ON DISABILITY RIGHTS ISSUES.3.PROMOTE DISABILITY RIGHTS.4.SUPPORT THE DEVELOPMENT OF LOCAL AND NATIONAL CAMPAIGNS RELATED TO HOME AND COMMUNITY BASED SERVICES (HCBS), ACCESSIBLE, AFFORDABLE, INTEGRATED HOUSING, REUSE EFFORTS AND INCLUSIVE EMERGENCY MANAGEMENT.5.SERVE ON AMERIGROUP'S AGING AND DISABILITY ADVISORY BOARD IN FY 2018 MARK JOHNSON, DIRECTOR OF ADVOCACY AT SHEPHERD CENTER, PROMOTED EFFORTS TO INCREASE AND IMPROVE HOME AND COMMUNITY BASED SERVICES AND DISABILITY EMPLOYMENT AWARENESS.- HOUSINGHAVING THE FAMILIES AND LOVED ONES INVOLVED IN REHABILITATION AFTER A CATASTROPHIC INJURY IS IMPERATIVE TO THE SUCCESSFUL TRANSITION TO COMMUNITY, HOME, WORK AND/OR SCHOOL. SHEPHERD CENTER PROVIDES HOUSING FOR 30 DAYS FOR FAMILIES WHO TRAVEL MORE THAN 60 MILES FROM ATLANTA TO GET TO OUR FACILITIES. THIS SUPPORT IS CRUCIAL AND APPRECIATED BY FAMILIES AS IT ENABLES THEM TO FOCUS ON THEIR LOVED ONE GETTING BETTER AND NOT THE FINANCIAL BURDENS AND STRESS THAT COMES WITH MOVING FROM HOME FOR CARE. THIS HOUSING IS ALSO OFFERED FOR DAY PROGRAM PATIENTS AS A WAY TO EXPERIENCE WHAT THEY HAVE LEARNED IN THE INPATIENT SETTING AND PUT IT TO WORK IN A SAFE ENVIRONMENT. THE HOUSING PROGRAM HELPS ALLEVIATE STRESS AND UNCERTAINTY AS PATIENTS TRANSITION BACK TO THEIR HOME AND COMMUNITY. IN ORDER TO PROVIDE A PEER SUPPORT COMMUNITY FOR MILITARY PATIENTS, HOUSING IS PROVIDED AT BISCAYNE PLACE, AN APARTMENT COMPLEX WITHIN TWO MILES OF SHEPHERD CENTER. MOST EVERY FAMILY MEMBER THAT STAYS IN THE WOODRUFF FAMILY RESIDENCE CENTER HAS SHARED THAT, BY HAVING HOUSING AVAILABLE TO THEM, SHEPHERD CENTER HAS ALLEVIATED THE STRESS AND WORRY OF TRYING TO FIND AND PAY FOR A PLACE TO STAY. PLUS, THEY ARE SO CLOSE TO THEIR LOVED ONES AT THE HOSPITAL, IT GIVES THEM A SENSE OF SECURITY AND CONVENIENCE THEY WOULDN'T HAVE HAD OTHERWISE.-INJURY PREVENTIONSHEPHERD CENTER BEGAN ITS INJURY PREVENTION EFFORTS IN 1995, FORMALIZING THE PROGRAM IN 2012. IN THIS TIME, SHEPHERD CENTER HAS BECOME A LEADER IN PREVENTION THROUGHOUT GEORGIA, CREATING EVIDENCE-BASED PROGRAMS TO LESSEN THE INCIDENCE OF CATASTROPHIC BRAIN AND SPINAL CORD INJURY.1. SHEPHERD CENTER'S BRAIN AND SPINAL CORD INJURY CURRICULUM - SAFETY EDUCATION RELATED TO PARTICULAR ACTIVITIES INCLUDING: CONTACT SPORTS, WATER SPORTS AND DIVING INJURIES; BICYCLE, MOTORCYCLES, AND ALL-TERRAIN VEHICLE SAFETY; SAFE DRIVING; AND GUN SAFETY. THE CURRICULUM IS CURRENTLY BEING DELIVERED TO 7TH GRADE STUDENTS IN A COBB COUNTY MIDDLE SCHOOL. DURING THE THREE-WEEK COURSE, STUDENTS EXPLORE CASE STUDIES AND HEAR FROM ACTUAL PATIENTS REGARDING THE HEALTH CONSEQUENCES AND DAILY CHALLENGES RESULTING FROM TRAUMATIC SPINAL CORD AND BRAIN INJURY. AS THE CURRICULUM CONTINUES TO PROVE SUCCESSFUL, SHEPHERD CENTER WILL MAINTAIN THIS PARTNERSHIP AND WORK TO ESTABLISH MORE PARTNERSHIPS LOCALLY AND REGIONALLY.2. DIVING INJURY AWARENESS - USING DATA FROM A TEN-YEAR RETROSPECTIVE STUDY ON LOCAL AND NATIONWIDE DIVING INJURIES, SHEPHERD CENTER'S INJURY PREVENTION PROGRAM HAS CREATED SEVERAL DIVING INTERVENTIONS TARGETED TO THE MOST AT-RISK POPULATIONS INCLUDING "FEET FIRST, EVERYTIME" SOCIAL MEDIA PSAS THAT ARE PROMOTED DURING PEAK SWIMMING/WATER SPORTS SEASON AND TV INTERVIEWS AND RADIO SEGMENTS TARGETED TO AT-RISK DEMOGRAPHICS.CURRENTLY, SHEPHERD IS DESIGNING AND IMPLEMENTING A SEARCH ENGINE FLAG THAT WILL DISPLAY A SIMILAR "FEET FIRST EVERYTIME" MESSAGE POP-UP TO GOOGLE, YAHOO, AND BING USERS WHEN SEARCHING FOR METRO ATLANTA LAKES, SWIMMING POOLS, AND OTHER POPULAR SWIMMING LOCATIONS.3. FALL PREVENTION FOR SENIORS - A PARTNERSHIP WITH A MATTER OF BALANCE (AMOB AN EVIDENCE-BASED PROGRAM FOR AGES 65 AND OVER THAT COMBINES EDUCATION AND EXERCISES TO TARGET THE FEARS OF FALLING. AMOB IS CONDUCTED IN CLASS SESSIONS OF TWO HOURS OVER AN 8-WEEK PERIOD. SHEPHERD CENTER IS LEADING THE EFFORTS WITH THE GEORGIA COMMISSION ON TRAUMA EXCELLENCE (GCTE) SUB-COMMITTEE ON INJURY PREVENTION AND THE GEORGIA AREA AGENCIES ON AGING (AAA) TO DISSEMINATE THE PROGRAM STATE-WIDE.4. DISTRACTED DRIVING - END DISTRACTED DRIVING (ENDDD.ORG) IS AN EVIDENCE-BASED PROGRAM, SCIENTIFICALLY DESIGNED BY AN EXPERT TEAM OF TEEN MESSAGING SPECIALISTS AND PSYCHOLOGISTS TO INFLUENCE TEENS' ATTITUDES AND PERCEPTIONS AROUND THE DANGERS OF DISTRACTED DRIVING. THE INTERACTIVE PROGRAM HAS BEEN DESIGNED TO CAPTURE TEENAGERS' ATTENTION AND CAN BE COMPLETED IN LESS THAN AN HOUR AND CAN BE TAILORED TO FIT THE NEEDS OF ANY AUDIENCE.5. ADVOCACY AND POLICY - IN ADDITION TO EDUCATION, SHEPHERD CENTER'S INJURY PREVENTION PROGRAM PARTNERS WITH THE AMERICAN TRAUMA SOCIETY TO PROVIDE CURRICULUM TRAINING TO NEW INJURY PREVENTION COORDINATORS NATIONWIDE. AS WELL, SHEPHERD'S INJURY PREVENTION STAFF MAINTAINS LEADERSHIP ROLES IN THE GOVERNOR'S OFFICE OF HIGHWAY SAFETY TASK TEAMS, THE GEORGIA COMMITTEE ON TRAUMA EXCELLENCE INJURY PREVENTION SUBCOMMITTEE, AND THE GEORGIA FALLS PREVENTION COALITION IN ORDER TO ADVOCATE FOR PUBLIC POLICY THAT WILL IMPROVE STATE-WIDE INJURY PREVENTION EFFORTS.6. AUTO COACH - DEVELOPED IN PARTNERSHIP WITH THE GOVERNOR'S OFFICE OF HIGHWAY SAFETY, AUTOCOACH IS A FIRST-OF-ITS-KIND SMARTPHONE APP RELEASED IN AUGUST 2017 THAT HELPS PARENTS TEACH SAFE DRIVING TO THEIR TEENS. IT USES A CURRICULUM DEVELOPED BY SHEPHERD CENTER'S CERTIFIED DRIVING EXPERTS TO INSTRUCT PARENTS AND OTHER ADULTS HOW TO TEACH SAFE DRIVING BEHAVIORS. BECAUSE MOST STATES REQUIRE A SET NUMBER OF HOURS OF EACH BEFORE ISSUING A LICENSE, AUTOCOACH LOGS SUPERVISED DRIVING HOURS UNDER DAYTIME AND NIGHTTIME CONDITIONS. THE APP IS CUSTOMIZABLE BY STATE BASED ON EACH STATE'S REQUIREMENTS AND COMPLETELY FREE TO USE. SHEPHERD CENTER RECENTLY LAUNCHED AUTOCOACH 2.0 AN UPDATED VERSION ENHANCED WITH SPECIFIC CURRICULUM FOR PARENTS WHO ARE TRAINING THEIR TEEN DRIVERS WHO HAVE CERTAIN PHYSICAL AND/OR COGNITIVE DISABILITIES. AUTOCOACH WAS FUNDED BY A GENEROUS GRANT OVER TWO YEARS FROM THE GEORGIA GOVERNOR'S OFFICE OF HIGHWAY SAFETY (GOHS) AND DEVELOPED BY CAPTECH. PART III, LINE 2: BAD DEBT EXPENSE IS RECORDED AT COST BASED ON ACTUAL BAD DEBT CHARGES WRITTEN OFF DURING THE FISCAL YEAR MULTIPLIED BY THE RATIO OF COST TO CHARGES FOR THE FISCAL YEAR. PART III, LINE 4: THE CENTER GRANTS CREDIT WITHOUT COLLATERAL TO ITS PATIENTS, MOST OF WHOM ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS. PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT THEIR NET REALIZABLE VALUE FROM THIRD-PARTY PAYORS, PATIENTS, RESIDENTS AND OTHERS FOR SERVICES RENDERED. ALLOWANCES ARE PROVIDED FOR THIRD-PARTY PAYORS BASED ON ESTIMATED REIMBURSEMENT RATES. ALLOWANCES ARE ALSO PROVIDED FOR DOUBTFUL ACCOUNTS BASED ON AN ESTIMATE OF UNCOLLECTIBLE ACCOUNTS. WRITE-OFF OF UNCOLLECTIBLE ACCOUNTS IS DETERMINED ON A CASE-BY-CASE BASIS AFTER A REVIEW OF THE CIRCUMSTANCES SURROUNDING THE INDIVIDUAL PATIENT ACCOUNTS.FOR FINAL SETTLEMENTS THAT HAVE NOT BEEN REACHED FOR BAD DEBT EXPENSE WITH MEDICARE FOR ANY FISCAL YEARS, MANAGEMENT EXPECTS THAT THE AMOUNTS PAYABLE OR RECEIVABLE FOR THE UNSETTLED YEARS WILL APPROXIMATE THE AMOUNTS INCLUDED IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF FINANCIAL POSITION. ANY ADJUSTMENTS TO AMOUNTS PREVIOUSLY RECORDED, BASED ON FINAL SETTLEMENTS, ARE RECORDED IN THE PERIOD OF FINAL SETTLEMENT. PART III, LINE 8: SHEPHERD IS NOT TREATING ANY AMOUNT OF LINE 7 AS A COMMUNITY BENEFIT. THE AMOUNT ON LINE 6 IS DETERMINED BY MULTIPLYING GROSS MEDICARE CHARGES X SHEPHERD'S COST TO CHARGE RATIOS FOR INPATIENT AND OUTPATIENT. PART III, LINE 9B: ACCORDING TO SHEPHERD CENTER'S DEBT COLLECTION POLICY, ALL PATIENTS ARE ASKED TO COMPLETE A FINANCIAL SCREENING AT THE TIME OF REGISTRATION. IF A PATIENT IS APPROVED FOR ASSISTANCE BASED ON THE FINANCIAL DATA SUPPLIED, ANY PATIENT BALANCES WILL BE APPLIED TO A CHARITY ALLOWANCE BASED ON THE HOSPITAL'S FINANCIAL ASSISTANCE TO PATIENTS POLICY. PART VI, LINE 2: PURPOSE AND SCOPETHE PURPOSE OF SHEPHERD CENTER'S TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN IS PRIMARILY TO ENHANCE THE HEALTH AND WELLNESS OF INDIVIDUALS LIVING WITH SPINAL CORD INJURIES, BRAIN INJURIES AND MULTIPLE SCLEROSIS WHEN THEY RETURN TO LIVE IN THEIR COMMUNITY.WHILE SHEPHERD CENTER IS A LOCAL, REGIONAL, STATE, NATIONAL AND INTERNATIONAL RESOURCE FOR INDIVIDUALS WHO HAVE SUSTAINED SPINAL CORD AND BRAIN INJURIES, OR WHO HAVE MULTIPLE SCLEROSIS, THE SCOPE OF THIS ASSESSMENT ADDRESSES THE HEALTH NEEDS OF THE TARGET POPULATIONS WHO LIVE WITHIN SHEPHERD'S LOCAL COMMUNITY, THE EIGHT COUNTIES AROUND METRO ATLANTA INCLUDING: CHEROKEE, CLAYTON, COBB, DEKALB, DOUGLAS, FULTON, GWINNETT AND HENRY.APPROACH AND PROCESSSHEPHERD CENTER'S APPROACH TO ADDRESSING THE COMMUNITY HEALTH NEEDS FOR PEOPLE LIVING WITH BRAIN INJURIES, SPINAL CORD INJURIES AND MULTIPLE SCLEROSIS IS DESIGNED TO BE UPDATED EVERY THREE YEARS TO ASSESS PROGRESS IN MEETING THE SPECIALIZED HEALTH NEEDS OF THESE COMMUNITIES.IT BEGINS WITH DEFINING THE TARGET COMMUNITY, AND THEN ASSESSING THE HEALTH NEEDS OF THESE COMMUNITIES USING AVAILABLE HEALTH DATA AND INPUT FROM INDIVIDUALS REPRESENTING THE INTERESTS OF AND WITH SPECIALIZED KNOWLEDGE OF THE UNIQUE HEALTH NEEDS OF PERSONS WITHIN THESE COMMUNITIES.FROM THE LIST OF HEALTH NEEDS IDENTIFIED BY MEMBERS OF COMMUNITY WITH SPECIALIZED KNOWLEDGE, THE LEADERSHIP AT SHEPHERD CENTER DEVELOPED STRATEGIES AND PLANS TO ADDRESS THESE COMMUNITY HEALTH NEEDS.PROGRESS TOWARDS IMPLEMENTING THESE STRATEGIES AND PLANS ARE ONGOING AND REPORTED TO THE PUBLIC VIA THE HOSPITAL'S WEBSITE IN EACH TRIENNIAL REPORT. SHEPHERD CENTER EDUCATES COMMUNITY PROVIDERS THROUGH OUR LEARNING MANAGEMENT SYSTEM, AVAILABLE ONLINE. PART VI, LINE 3: IT IS SHEPHERD CENTER'S POLICY TO EXTEND ITS SERVICES TO AS MANY PATIENTS AS IT CAN WITHIN THE FINANCIAL RESOURCES THAT ARE AVAILABLE. THOSE WHO DO NOT HAVE FINANCIAL RESOURCES TO PAY FOR THEIR CARE WILL BE CONSIDERED FOR FINANCIAL ASSISTANCE. IT IS CRITICAL TO SAFEGUARD FUNDS AVAILABLE FOR THIS PURPOSE BY ASSURING THAT THIS ASSISTANCE PROGRAM IS THE "PAYER OF LAST RESORT AND IS ONLY PROVIDED TO THOSE WHO HAVE PROVEN AN INABILITY TO PAY.WHEN PATIENTS ARE SCHEDULED OR AN ADMISSION REFERRAL IS MADE, APPROPRIATE FINANCIAL SCREENING IS PROVIDED. THE FIRST STEP OF THIS SCREENING WILL INCLUDE DETERMINING WHETHER THIRD PARTY PAYER RESOURCES ARE AVAILABLE TO COVER THE COST OF CARE FOR THE INPATIENT OR DAY PATIENT CHARGES IN FULL. IF THERE ARE NO THIRD PARTY PAYER RESOURCES AVAILABLE, OR THERE IS EXPECTED TO BE PATIENT LIABILITY BALANCES DUE AFTER INSURANCE, THE FINANCIAL COUNSELOR WILL COMPLETE A "PRE-SCREENING" USING THE FINANCIAL ASSISTANCE SCREENING FORM. IF FINANCIAL RESOURCES DO NOT APPEAR TO BE AVAILABLE AND THE PATIENT LIABILITY IS EXPECTED TO EXCEED $5,000, THE PATIENT OR GUARANTOR WILL BE ASKED TO COMPLETE A "PATIENT FINANCIAL EVALUATION" FORM TO OBTAIN ADDITIONAL INFORMATION THAT WILL FURTHER ASSIST IN THE ASSESSMENT OF THEIR ELIGIBILITY FOR CHARITY ASSISTANCE. THE PATIENT OR GUARANTOR WILL BE REQUIRED TO COMPLETE THE APPLICATION IN FULL AND PROVIDE SUPPORTING EVIDENCE TO SUBSTANTIATE INCOME.MINIMUM SUPPORTING EVIDENCE FOR INCOME INCLUDES:- PAY STUBS REPRESENTING CURRENT INCOME OF HOUSEHOLD.- ANYTHING THAT PROVIDES PROOF OF INCOME, I.E., W2S, PRIOR YEAR INCOME TAX FORMS, LETTERS FROM EMPLOYERS ETC.- IF NO INCOME, LETTER FROM PERSON PROVIDING ROOM & BOARD TO PATIENT IS REQUIRED.ONCE THE FINANCIAL ASSISTANCE FORM IS COMPLETE THE FINANCIAL COUNSELOR WILL REVIEW TO ASSURE THAT SUPPORTING DOCUMENTATION IS ATTACHED, PROVIDE ALL THE CALCULATIONS REQUIRED, AND PROVIDE A PRELIMINARY ASSESSMENT OF ELIGIBILITY. ELIGIBILITY WILL BE BASED ON THE CRITERIA ESTABLISHED BY SHEPHERD CENTER AS FOLLOWS:A. CURRENT INCOME MUST NOT EXCEED 250% OF THE FEDERAL POVERTY GUIDELINES FOR THE CURRENT YEAR.B. IF INCOME EXCEEDS 250% OF THE FEDERAL POVERTY GUIDELINES, ADDITIONAL INFORMATION MAY BE REQUIRED FROM THE PATIENT OR GUARANTOR TO DETERMINE IF ASSISTANCE CAN BE GRANTED BASED ON A "MEDICALLY NEEDY" SITUATION RESULTING FROM THE CATASTROPHIC EVENT NECESSITATING ADMISSION TO SHEPHERD CENTER.IF THE PATIENT STILL DOES NOT MEET CRITERIA, THE FINANCIAL COUNSELOR WILL ESTABLISH DEPOSIT REQUIREMENTS BASED ON THE EXPECTED LENGTH OF STAY AND WILL OFFER THE PATIENT PAYMENT OPTIONS INCLUDING, BUT NOT LIMITED TO: (SEE ALSO FINANCIAL ARRANGEMENTS POLICY FOR SELF PAY PATIENTS)- BANK LOAN- VISA/MASTERCARD/DISCOVER/AMERICAN EXPRESS- NINETY(90) DAY PAYMENT PLAN, AS DETAILED IN THE CREDIT & COLLECTIONS POLICYIF THE PRELIMINARY ASSESSMENT APPROVES THE PATIENT FOR FINANCIAL ASSISTANCE, THE FINANCIAL COUNSELOR WILL PRESENT THE PACKET TO THE MANAGER OF PATIENT FINANCIAL SERVICES FOR REVIEW AND QUALIFICATION APPROVAL. IN ADDITION, THE PROGRAM DIRECTOR WILL SIGN TO APPROVE THAT THE USE OF FUNDS MEETS CLINICAL APPROPRIATENESS FOR THEIR AREA.FOR INPATIENTS AND DAY PATIENTS, THE PATIENT WILL NEED TO MEET ASSET REQUIREMENTS. EXPECTATION WOULD BE THAT ASSETS OTHER THAN THOSE LISTED BELOW AND DISPOSABLE INCOME AFTER REASONABLE LIVING EXPENSES WOULD BE USED TO SATISFY A PORTION OR ALL OF THE FINANCIAL REQUIREMENTS OF THE PATIENT'S CARE. ASSETS THAT MAY BE EXCLUDED FROM CONSIDERATION ARE:- PATIENT'S HOME WITH NO MORE THAN 25% OR $25,000 EQUITY, WHICHEVER IS LESS. THE REQUIREMENTS TO USE HOME EQUITY CAN BE WAIVED IF THE PATIENT IS UNABLE TO MAKE PAYMENTS ON ADDITIONAL DEBT.- IF THE PATIENT HAS APPLIED FOR GEORGIA MEDICAID, THE FINANCIAL ASSISTANCE PROGRAM FORM SHOULD BE COMPLETED AND IF SUCH CHARGES ARE ULTIMATELY NOT COVERED OR UNCOLLECTIBLE THE PATIENT IS DEEMED ELIGIBLE FOR FINANCIAL ASSISTANCE.ALL FINANCIAL AND OTHER MITIGATING CIRCUMSTANCES ARE REVIEWED BY THE MANAGER OF PATIENT FINANCIAL SERVICES WHO THEN MAKES THE FINAL DECISION REGARDING ELIGIBILITY. IF ASSISTANCE IS NOT APPROVED THE FINANCIAL COUNSELOR WILL COORDINATE THE NOTIFICATION TO THE PATIENT. PAYMENT ARRANGEMENTS WILL BE COMPLETED AS LISTED ABOVE AND BASED ON THE FINANCIAL ARRANGEMENTS POLICY.IF APPROVED FOR FULL ASSISTANCE OR ASSISTANCE FOR PATIENT LIABILITY OVER INSURANCE AMOUNTS, THE FINANCIAL COUNSELOR WILL NOTIFY THE PATIENT. THE COVERED AMOUNT WILL BE WRITTEN-OFF PURSUANT TO ESTABLISHED POLICY AFTER DISCHARGE OR INSURANCE IS FINALIZED. PART VI, LINE 4: IN 2017, 50 PERCENT OF SHEPHERD CENTER'S TOTAL ADMISSIONS CAME FROM GEORGIA WITH 25 PERCENT COMING FROM EIGHT ATLANTA AREA COUNTIES. THE 23 COUNTIES OF THE GREATER ATLANTA REGION ACCOUNTED FOR 32 PERCENT OF TOTAL ADMISSIONS AND 50 PERCENT OF ADMISSIONS COMING FROM GEORGIA. OVER THE SAME PERIOD, SHEPHERD CENTER HAD OVER 46,000 OUTPATIENT VISITS, INCLUDING A SUBSTANTIAL OUTPATIENT POPULATION OF PATIENTS WITH MULTIPLE SCLEROSIS.BASED ON THE RESIDENCE OF BRAIN INJURY, SPINAL CORD INJURY AND MULTIPLE SCLEROSIS PATIENTS TREATED, SHEPHERD CENTER DEFINES ITS LOCAL COMMUNITY AS THE EIGHT COUNTIES AROUND METRO ATLANTA INCLUDING: CHEROKEE, CLAYTON, COBB, DEKALB, DOUGLAS, FULTON, GWINNETT AND HENRY COUNTIES. SHEPHERD'S REGIONAL COMMUNITY INCLUDES 23 COUNTIES IN THE GREATER ATLANTA REGION.IN 2017, SHEPHERD CENTER ADMITTED 872 PERSONS WITH 70 PERCENT OF INPATIENT ADMISSIONS FAIRLY EVENLY SPLIT BETWEEN ACQUIRED BRAIN INJURIES AND SPINAL CORD INJURIES. THE MAJORITY OF PATIENTS WITH MULTIPLE SCLEROSIS WERE TREATED ON AN OUTPATIENT BASIS.SHEPHERD CENTER'S DAY PROGRAMS ENABLE PATIENTS WHO NO LONGER NEED 24-HOUR NURSING CARE TO CONTINUE THEIR RECOVERY AND REHABILITATION WHILE LIVING IN NEARBY APARTMENTS PROVIDED BY THE CENTER. SERVICES ARE FOCUSED ON FUNCTIONAL RETURN OF SKILLS NECESSARY FOR COMMUNITY REINTEGRATION. DAY PROGRAM HOUSING IS ALSO AVAILABLE FOR UP TO EIGHT WEEKS FOR PATIENTS AND FAMILIES IN SHEPHERD CENTER'S SPINAL CORD INJURY DAY PROGRAM IF BOTH FAMILY AND PATIENT LIVE MORE THAN 60 MILES FROM THE HOSPITAL. COMPLIMENTARY HOUSING FOR SHEPHERD PATHWAYS PATIENTS AND FAMILIES IS AVAILABLE FOR A LIMITED TIME TO FAMILIES AND DAY PROGRAM PATIENTS REFERRED DIRECTLY FROM SHEPHERD CENTER'S INPATIENT REHABILITATION PROGRAM IF BOTH THE PATIENT AND FAMILY LIVE MORE THAN 60 MILES FROM THE HOSPITAL'S MAIN CAMPUS IN ATLANTA. PART VI, LINE 5: SHEPHERD CENTER PROMOTES HEALTH OF THE COMMUNITY THROUGH A PLANNED, ORGANIZED, AND MEASURED APPROACH TO SERVICES AND ACTIVITIES THAT SPECIFICALLY ADDRESS THE HEALTHCARE NEEDS OF PEOPLE WITH SPINAL CORD AND BRAIN INJURY, MULTIPLE SCLEROSIS, CHRONIC PAIN, OTHER NEUROMUSCULAR DISEASES, AS WELL AS THE FAMILY OR LOVED ONES IMPACTED. PATIENTS AT SHEPHERD CENTER GET MORE THAN MEDICAL CARE, BUT RECEIVE THE FULL CONTINUUM OF CARE -- FROM EVALUATION AND MEDICAL TREATMENT TO REHABILITATION AND LIFELONG SUPPORT PROGRAMS -- THAT EXTENDS BACK TO THEIR COMMUNITIES. OUR PATIENT POPULATION HAS UNIQUE NEEDS THAT ARE TYPICALLY UNDERSERVED, WHICH MAKES SHEPHERD AN IMPORTANT LIFELINE AND RESOURCE FOR OUR PATIENTS THROUGHOUT THEIR LIFE. SHEPHERD CENTER'S COMMUNITY INCLUDES CURRENT PATIENTS AND THEIR FAMILY, AS WELL AS FORMER PATIENTS AND THEIR FAMILY. SHEPHERD CENTER TAKES A LEADERSHIP ROLE IN EDUCATING HEALTHCARE PROFESSIONALS (PHYSICIANS, NURSES AND THERAPISTS) WHO SPECIALIZE IN SPINAL CORD AND BRAIN INJURY REHABILITATION. WE ALSO SERVE AS A STRONG COMMUNITY ADVOCATE, MONITORING LEGISLATION AND RELATED ISSUES THAT IMPACT THE DISABILITY COMMUNITY. SHEPHERD CENTER'S REACH EXTENDS BEYOND METRO ATLANTA TO ALL OF GEORGIA, THE UNITED STATES AND THE WORLD, AS THE LEADING SPECIALTY HOSPITAL FOR THIS PATIENT POPULATION. AS A RECOGNIZED ADVOCATE FOR PEOPLE LIVING WITH DISABILITIES, SHEPHERD CENTER HAS CHANGED THE LANDSCAPE IN ATLANTA AND BEYOND TO BE MORE RECEPTIVE OF PEOPLE WITH DISABILITIES LIVING IN OUR COMMUNITY. SHEPHERD CENTER HAS TREATED PATIENTS FROM ALL 50 STATES AND NEARLY 50 FOREIGN COUNTRIES. PART VI, LINE 6: SHEPHERD IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. X X X X X 0 0 0 0 0 1 0 0 0 BRIAN BARNETTE VP CHIEF INFORMATION OFFICER 259788 0 20000 0 0 0 6125 0 13912 0 299825 0 0 0 BROCK BOWMAN MD ASSOCIATE MEDICAL DIRECTOR 496152 0 13500 0 0 0 12250 0 19149 0 541051 0 0 0 CHETAN BHASIN CHIEF OPERATING OFFICER 212709 0 17000 0 0 0 3691 0 12980 0 246380 0 0 0 DONALD P LESLIE MD FND SPECIAL ADVISOR 144700 0 4200 0 0 0 12250 0 12299 0 173449 0 0 0 JAMES H SHEPHERD III DIR OF COMMUNITY SVC/RISK MGT 144045 0 17700 0 0 0 4238 0 24729 0 190712 0 0 0 JAMES H SHEPHERD JR CHAIRMAN/CHIEF STRATEGY OFFICER 316842 0 154800 0 0 0 12000 0 7236 0 490878 0 0 0 LORIE HUTCHESON VP HUMAN RESOURCES 197895 0 22167 0 0 0 6125 0 10711 0 236898 0 0 0 MICHAEL L JONES PHD VP CLINICAL RESEARCH 346384 0 15000 0 0 0 12243 0 19149 0 392776 0 0 0 MICHAEL YOCHELSON MD CHIEF MEDICAL OFFICER 494926 0 169104 0 0 0 1601 0 11030 0 676661 0 0 0 MITCH FILLHABER VP MARKETING 287528 0 17000 0 0 0 12250 0 12966 0 329744 0 0 0 SARAH BATTS VP FOUNDATION 230055 0 20000 0 0 0 4625 0 7236 0 261916 0 0 0 SARAH MORRISON PRESIDENT/CEO 546052 0 211250 0 0 0 12250 0 14230 0 783782 0 0 0 STEPHEN B HOLLEMAN CFO 354526 0 123409 0 0 0 12240 0 19479 0 509654 0 0 0 TAMARA KING CHIEF NURSE EXECUTIVE 216812 0 15000 0 0 0 12250 0 14230 0 258292 0 0 0 WILMA BUNCH VP FACILITIES 237440 0 17000 0 0 0 12250 0 7236 0 273926 0 0 0 BEN THROWER MD PHYSICIAN 590005 0 13200 0 0 0 12250 0 16646 0 632101 0 0 0 ERIK SHAW MD PHYSICIAN 609160 0 13200 0 0 0 9250 0 19479 0 651089 0 0 0 GERALD BILSKY PHYSICIAN 453892 0 13500 0 0 0 12250 0 7236 0 486878 0 0 0 GUY BUCKLE PHYSICIAN 496700 0 10800 0 0 0 6125 0 14366 0 527991 0 0 0 SHERRILL LORING MD PHYSICIAN 532843 0 12500 0 0 0 10110 0 42 0 555495 0 0 0 GARY ULICNY PHD FORMER PRESIDENT/CEO 0 0 450000 0 0 0 0 0 0 0 450000 0 0 0 PART I, LINE 6 THE SHEPHERD CENTER'S EXECUTIVE LEADERSHIP TEAM APPROVED A "SHEPHERD SHARE" BONUS TO QUALIFIED EMPLOYEES FOR FY 2019, THAT WAS PAID IN FY 2020. THIS YEAR'S BONUS WAS BASED ON VARIOUS FACTORS INCLUDING PATIENT OUTCOMES, CUSTOMER SERVICE (INTERNAL AND EXTERNAL), AND FISCAL PERFORMANCE. SCHEDULE J, PART II GARY ULICNY, FORMER PRESIDENT & CEO OF SHEPHERD CENTER, OFFICIALLY RETIRED ON 3/31/17. THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS APPROVED A TAX-DEFERRED CASH COMPENSATION AMOUNT OF $450,000, WHICH WAS PAID IN JANUARY 2018. THIS AMOUNT IS REPORTED ON FY 2019 TAX RETURN. A DEVELOPMENT AUTHORITY OF FULTON COUNTY 581506878 359900ZT7 2009-11-04 56000000 PROVIDE FUNDS TO REFUND 4/20/05 ISSUE FOR HOSPITAL EXPANSION 0 0 0 A 4800000 56000000 56000000 2007 1 0 1 1 A 0 1 1 0 0 0.00000 0.01400 0.01400 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 JULIE SHEPHERD FAMILY MEMBER 86183 EMPLOYEE 0 CLARE HARTIGAN FAMILY MEMBER 149508 EMPLOYEE 0 SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: (D) DESCRIPTION OF TRANSACTION: EMPLOYEE COMPENSATION X 38 448685 FAIR MARKET VALUE X VARIOUS GIFTS 5 120431 FAIR MARKET VALUE 0 1 0 PART I, LINE 33: SHEPHERD CENTER USES THE ACCRUAL METHOD OF ACCOUNTING. SECURITY DONATIONS ARE RECEIVED BY SHEPHERD CENTER FOUNDATION AND PASSED THROUGH TO SHEPHERD CENTER. THESE SECURITIES ARE LIQUIDATED IMMEDIATELY AND THE PROCEEDS ARE RECORDED DIRECTLY TO THE TEMPORARILY AND PERMANENTLY RESTRICTED NET ASSETS PORTION OF THE BALANCE SHEET. AS EXPENSES ARE INCURRED, THESE FUNDS ARE RELEASED FROM RESTRICTION AND ONLY THEN BECOME AN ELEMENT OF REVENUE. WE REPORT THE ENTIRE AMOUNT OF THESE DONATIONS ON SCHEDULE M FOR TRANSPARENCY SINCE THE AMOUNT ON THE STATEMENT OF REVENUE, LINE 1G DOES NOT FULLY REPRESENT THE NON-CASH DONATIONS RECEIVED. FORM 990, PART VI, SECTION A, LINE 2 FAMILY RELATIONSHIP: JAMES H. SHEPHERD, JR.(CHAIRMAN OF THE BOARD), ALANA SHEPHERD(RECORDING SECRETARY), J. HAROLD SHEPHERD (BOARD MEMBER - DECEASED), W. CLYDE SHEPHERD, III (BOARD MEMBER) AND JAMES H. SHEPHERD, III (BOARD MEMBER). FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY CARR, RIGGS & INGRAM, LLC WITH THE ASSISTANCE OF THE ACCOUNTING STAFF AT THE SHEPHERD CENTER. THE RETURN IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER WITH FURTHER CONSULTATION WITH CRI FOR ALL QUESTIONS THAT ARE UNCLEAR AS TO MEANING AND INTENT. THE CHIEF FINANCIAL OFFICER THEN REVIEWS THE FORM 990 WITH THE CHAIRMAN OF THE BOARD, THE CHIEF EXECUTIVE OFFICER, AND THE EXECUTIVE DIRECTOR OF THE SHEPHERD CENTER FOUNDATION FOR THEIR INPUT AND APPROVAL. THE SHEPHERD CENTER PROVIDES EACH MEMBER OF THE BOARD WITH A FINAL COPY OF THE FILED 990 UPON COMPLETION OF THE PROCESS. FORM 990, PART VI, SECTION B, LINE 12C THE SHEPHERD CENTER'S BOARD OF DIRECTORS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ON AN ANNUAL BASIS. ALL PAPERWORK IS KEPT ON FILE IN THE EXECUTIVE ADMINISTRATION OFFICE. THE EXECUTIVE ASSISTANT ALSO CROSS REFERENCES WITH THE DEVELOPMENT OFFICE FOR ANY ADDITIONAL INFORMATION REGARDING BOARD MEMBER AFFILIATIONS WITH OTHER ENTITIES WITH WHICH SHEPHERD CENTER DOES BUSINESS. ADDITIONALLY, FOR THE PURPOSE OF PROTECTING INTEGRITY AND OBJECTIVITY OF ITS STAFF IN THE PERFORMANCE OF THEIR HOSPITAL OBLIGATIONS, IT IS THE POLICY OF THE SHEPHERD CENTER THAT CONFLICTS OF INTERESTS SHOULD BE AVOIDED WHERE POSSIBLE, OR DISCLOSED AND MANAGED SO AS TO AVOID VIOLATION OF STATE AND FEDERAL LAWS AND THE HOSPITAL CODE OF CONDUCT POLICY. SINCE THE EXISTENCE OF A CONFLICT OF INTEREST IS NOT ALWAYS EASILY DETERMINED, STAFF IS REQUIRED TO DISCLOSE THOSE RELATIONSHIPS OR KNOWLEDGE OF A POTENTIAL CONFLICT, SO THAT A REASONABLE DETERMINATION CAN BE MADE REGARDING THE CONFLICT AND, IF NEEDED, THE APPROPRIATE MANAGEMENT OF SUCH CONFLICT. ALL SHEPHERD CENTER EMPLOYED HEALTH CARE PROVIDERS, SENIOR LEADERS AND OTHER IDENTIFIED INDIVIDUALS WHO HAVE SUBSTANTIAL PURCHASING AUTHORITY ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTERESTS QUESTIONNAIRE AND PROVIDE DOCUMENTATION OF OUTSIDE ACTIVITIES. ALL PAPERWORK IS KEPT ON FILE IN THE COMPLIANCE OFFICE. PROVIDERS ARE SCREENED VIA THE OPEN PAYMENTS DATABASE ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE SHEPHERD CENTER UTILIZES A BOARD COMPENSATION COMMITTEE TO DETERMINE COMPENSATION FOR THE CEO AND OTHER EXECUTIVE MANAGEMENT. THIS COMMITTEE UTILIZES OUTSIDE CONSULTANTS (FOR EXAMPLE, SULLIVAN COTTER), INDUSTRY COMPENSATION SURVEYS, AND REVIEWS OF SIMILAR ORGANIZATIONS' FORM 990 TO DETERMINE APPROPRIATENESS OF COMPENSATION. SHEPHERD CENTER UTILIZES HEALTHCARE SOURCE PAYDATA'S COMPENSATION SURVEYS TO DETERMINE WHETHER OR NOT A COMPENSATION PACKAGE IS IN LINE WITH OUR REGION AND RELATIVE BED SIZE. THE HUMAN RESOURCES VICE PRESIDENT ANALYZES THE DATA AND GETS APPROVAL FROM THE CHIEF EXECUTIVE OFFICER. SALARY INCREASES FOR THE BOARD CHAIRMAN/CHIEF STRATEGY OFFICER, CEO, MEDICAL DIRECTOR, AND CFO ARE RECOMMENDED BY THE BOARD COMPENSATION COMMITTEE, WHICH IS DOCUMENTED IN THE COMMITTEE MINUTES. THE COMMITTEE MUST APPROVE RAISES AND THEY USE AN INDEPENDENT COMPENSATION CONSULTING FIRM TO MAKE THEIR FINAL DECISION. THE FINAL RESULTS ARE SENT TO THE HUMAN RESOURCES VICE PRESIDENT FOR PROCESSING AND INSERTION INTO THEIR EMPLOYEE FILES. FORM 990, PART VI, SECTION C, LINE 18 SHEPHERD CENTER'S COMPLETED 990 RETURN IS AVAILABLE FOR INSPECTION ON THE CENTER'S WEBSITE: WWW.SHEPHERD.ORG. THE RETURN IS ALSO AVAILABLE UPON REQUEST AND IS LISTED FOR PUBLIC USE ON GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST. FORM 990, PART IX: SHEPHERD CENTER HAS ALLOCATED A PORTION OF THE EXPENSES OF THESE INDIRECT COST CENTERS TO PROGRAM SERVICE EXPENSE: DEPRECIATION EXPENSE, COMMUNICATIONS, FOOD SERVICES, INFORMATION SYSTEMS, ENGINEERING, SECURITY, RENOVATIONS AND LANDSCAPING, AND RISK MANAGEMENT. FORM 990, PART XI, LINE 9: CHANGES IN TEMPORARILY RESTRICTED NET ASSETS 9,774,026. CHANGES IN INTERCOMPANY ACCOUNTS -2,073,481. CHANGES IN PERMANENTLY RESTRICTED NET ASSETS 240,985. CY INCOME FROM PASS-THROUGH ENTITY -3,864. PY INCOME FROM PASS-THROUGH ENTITY 23,520. FORM 990, PART XII, LINE 2C NO CHANGE HAS OCCURRED FROM PRIOR YEAR. FORM 990,SCHEDULE M SUPPLEMENTAL INFORMATION: SHEPHERD CENTER USES THE ACCRUAL METHOD OF ACCOUNTING. SECURITY DONATIONS ARE RECEIVED BY SHEPHERD CENTER FOUNDATION AND SHEPHERD CENTER. THESE SECURITIES ARE LIQUIDATED IMMEDIATELY AND THE PROCEEDS ARE RECORDED DIRECTLY TO THE TEMPORARILY AND PERMANENTLY RESTRICTED NET ASSETS PORTION OF THE BALANCE SHEET. AS EXPENSES ARE INCURRED, THESE FUNDS ARE RELEASED FROM RESTRICTION AND ONLY THEN BECOME AN ELEMENT OF REVENUE. WE REPORT THE ENTIRE AMOUNT OF THESE DONATIONS ON SCHEDULE M FOR TRANSPARENCY SINCE THE AMOUNT ON THE STATEMENT OF REVENUE, LINE 1G DOES NOT FULLY REPRESENT THE NON-CASH DONATIONS RECEIVED. 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