2018-11-15T07:02:47-06:00 2017-12-31 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2017-01-01 541453954 AUGUSTA HEALTH CARE INC D/B/A AUGUSTA HEALTH AUGU 5409324685 PO BOX 1000 FISHERSVILLE VA 22939 JOHN KATSIANIS CFO 5409324685 2018-11-13 1 AMY BIBBY P00445891 8282542254 12.25.12.224 2018-11-13 10:20:48 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 083993E8E059FCB3C563BE1594239D73DD9572BD 2017 2018-06-14 16:35:46Z AUGUSTA HEALTH MARY N MANNIX FACHE PO BOX 1000 FISHERSVILLE VA 22939 326420195 0 X WWW.AUGUSTAHEALTH.COM X 1988 VA PROMOTE THE HEALTH AND WELL-BEING OF OUR COMMUNITY THROUGH ACCESS TO EXCELLENT CARE. 15 13 2127 291 3979053 -748491 239415 938645 296376664 305293592 10750924 18054193 3591514 590058 310958517 324876488 455931 563401 0 0 114740842 124026785 0 0 0 154145051 150043261 269341824 274633447 41616693 50243041 614368744 695970228 46444319 49927921 567924425 646042307 X THE MISSION OF AUGUSTA HEALTH IS TO PROMOTE THE HEALTH AND WELL-BEING OF OUR COMMUNITY THROUGH ACCESS TO EXCELLENT CARE. 0 0 234756976 563401 301379261 AUGUSTA HEALTH CARE, INC. IS A 501(C)(3) ORGANIZATION DOING BUSINESS AS AUGUSTA HEALTH. THE ORGANIZATION INCLUDES A MEDICAL CENTER WITH 255 LICENSED INPATIENT BEDS; AN EMERGENCY DEPARTMENT TREATING APPROXIMATELY 57,000 COMMUNITY MEMBERS PER YEAR; FOUR URGENT CARE CENTERS TREATING APPROXIMATELY 61,000 PATIENTS; A STATE OF THE ART CANCER CENTER PROVIDING TAILOR-MADE COMPREHENSIVE CARE INCLUDING MEDICAL ONCOLOGY AND RADIATION ONCOLOGY; A HOME HEALTH AND HOSPICE PROGRAM SERVING PATIENTS WHO WISH TO REMAIN AT HOME DURING THEIR TREATMENT OR FINAL DAYS; A WOUND HEALING CLINIC PROVIDING A COMPREHENSIVE TREATMENT REGIMEN FOR CHRONIC NON-HEALING WOUNDS; AND A SKILLED NURSING UNIT PROVIDING COMPREHENSIVE REHABILITATION FOR PATIENTS RECOVERING FROM ORTHOPEDIC SURGERY.THE CAMPUS OF AUGUSTA HEALTH IS DESIGNED TO PROVIDE NOT ONLY HOSPITAL SERVICES BUT COMMUNITY ORIENTED SERVICES. THE CAMPUS INCLUDES THE HOSPITAL PROPER; A MAJOR FITNESS CENTER; AN EDUCATIONAL BUILDING THAT HOUSES AUGUSTA HEALTH EDUCATIONAL SERVICES, A BRANCH OF A LOCAL COMMUNITY COLLEGE; A COMMUNITY BUILDING WITH LARGE CONFERENCE ROOMS AVAILABLE TO OTHER COMMUNITY ORGANIZATIONS; AND A BEHAVIORAL HEALTH BUILDING FOR THE PROVISION OF OUTPATIENT PSYCHIATRIC AND SUBSTANCE ABUSE SERVICES. THIS WIDE RANGE OF FACILITIES HELPS TO SUPPORT AUGUSTA HEALTH'S VISION OF PROVIDING THE COMMUNITY WITH A FULL CONTINUUM OF HEALTH AND COMMUNITY SERVICES. AUGUSTA HEALTH IS SUPPORTED BY AUGUSTA MEDICAL GROUP WHICH WAS ESTABLISHED TO SUPPORT THE CHARITABLE PURPOSES OF AUGUSTA HEALTH CARE INC. THROUGH THE OWNERSHIP AND OPERATION OF A COMMUNITY PHYSICIAN DEVELOPMENT SERVICE. THIS GROUP ENABLES THE GREATER AUGUSTA COUNTY, VIRGINIA TO BENEFIT FROM A STABLE BASE OF PHYSICIANS IN A BROAD ARRAY OF SPECIALTIES.IN 2017 AUGUSTA HEALTH RECEIVED THE FOLLOWING HONORS, AWARDS, AND ACCREDITATIONS: 2017 HEALTHGRADES AMERICA'S 50 BEST HOSPITALS, 2017 HEALTHGRADES JOINT REPLACEMENT EXCELLENCE AWARD, 2017 HEALTHGRADES PULMONARY CARE EXCELLENCE AWARD, 2017 HEALTHGRADES ORTHOPEDIC SURGERY EXCELLENCE AWARD, 2017- GET WITH THE GUIDELINES- STROKE GOLD PLUS AWARD WITH TARGET STROKE HONOR ROLL, BECKER'S HOSPITAL REVIEW 100 GREAT COMMUNITY HOSPITALS, AND ACCREDITATION BY THE THE AMERICAN COLLEGE OF RADIOLOGY FOR LUNG CANCER SCREENING.AUGUSTA HEALTH'S NET COMMUNITY BENEFIT FOR 2017 IS ESTIMATED TO BE $20,325,024. THIS BENEFIT CAN BE CATEGORIZED AS FOLLOWS: $9,212,360 CHARITY$6,747,836 MEDICAID $967,306 COMMUNITY HEALTH SERVICES $84,523 HEALTH PROFESSIONAL EDUCATION$2,782,024 SUBSIDIZED HEALTH SERVICES $530,975 CASH & IN-KIND CONTRIBUTIONS 234756976 1 1 0 1 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 2127 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 15 13 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 VA X X SARAH HASH-RODGERS 5403324685 78 MEDICAL CENTER CIRCLE FISHERSVILLE VA 22939 REV JOHN C PETERSON CHAIRMAN 1.00 1.00 X X 0 0 0 VICTOR M SANTOS VICE CHAIRMAN 1.00 X X 0 0 0 BURNIE POWERS SECRETARY/TREASURER 1.00 1.00 X 0 0 0 CHARLES ANDERSEN MD BOARD MEMBER 1.00 1.00 X 0 0 0 JOHN P BOWERS BOARD MEMBER 1.00 X 0 0 0 DEBRA S CALLISON BOARD MEMBER 1.00 X 0 0 0 ROBIN G CROWDER BOARD MEMBER 1.00 1.00 X 0 0 0 JOHN B DAVIS BOARD MEMBER 1.00 X 0 0 0 RONALD W DENNEY BOARD MEMBER 1.00 X 0 0 0 DAVID W FOSNOCHT MD BOARD MEMBER 1.00 X 0 0 0 BEVERLY CHERI S MORAN BOARD MEMBER 1.00 1.00 X 0 0 0 A WHIT MORRISS MD BOARD MEMBER 1.00 1.00 X 0 0 0 JOSEPH L RANZINI MD BOARD MEMBER 40.00 X 424795 0 15288 WILLIAM L VAUHGN BOARD MEMBER 1.00 X 0 0 0 MARY N MANNIX PRESIDENT & CEO 38.00 2.00 X X 938608 0 123441 JOHN KATSIANIS CFO (BEGAN SEP) 39.00 1.00 X 132220 0 20955 JIM GRAVELL INTERIM CFO (THRU SEP) 39.00 1.00 X 0 0 0 RICH EMBREY MD CMO & VP POPULATION HEALTH 40.00 X 463401 0 56404 MARVELLA REA CNO 40.00 X 275592 0 23899 KAREN CLARK PRESIDENT, AMG 40.00 X 381938 0 37866 DAN O'CONNOR VP OF HUMAN RESOURCES 40.00 X 335635 0 44962 LISA CLINE COO 40.00 X 449367 0 53053 MIKE CANFIELD CIO 40.00 X 316160 0 39864 GEORGE SEMKO ADMIN DIRECTOR REVENUE CYC 40.00 X 233734 0 14059 ALEXANDER BROWN VP OF LEGAL AFFAIRS 40.00 X 246428 0 21967 MARK LAROSA CHIEF STRATEGY OFFICER 40.00 X 202416 0 25647 SCOTT JUST MD VP/CMO, AMG 40.00 X 438613 0 52166 ANDREW WEST CMIO 40.00 X 348553 0 12098 FRANCIS CARRUCIO ADMIN DIRECTOR FACILITIES, 40.00 X 248879 0 11203 SCOTT CRABTREE ADMIN DIRECTOR OF PROFESSI 40.00 X 220696 0 8308 VICKIE TAYLOR SURGICAL DIRECTOR 40.00 X 180892 0 10355 SARAH HASH-RODGERS CORPORATE CONTROLLER 40.00 X 162370 0 14280 ROBERT W RILEY FORMER CFO 40.00 X 221037 0 0 6221334 0 585815 87 1 1 0 SODEXO INC & AFFILIATES PO BOX 536922 ATLANTA GA 303536922 NUTRITION SERVICES MANAGEMENT 2914817 DPR CONSTRUCTION 5500 COX RD GLEN ALLEN VA 23060 CONSTRUCTION 2701195 BARTON MARLOW COMPANY 26500 AMERICAN DR SOUTHFIELD MI 48034 CONSTRUCTION 2500604 ARTISAN CONSTRUCTION INC 1132 E MARKET ST CHARLOTTESVILLE VA 22902 CONSTRUCTION 1744718 KJELLSTROM & LEE INC 1607 OWNBY LANE RICHMOND VA 23220 CONSTRUCTION 1635527 51 938645 938645 NET PATIENT SERVICE REVENUE 621400 291919576 291470551 449025 RETAIL PHARMACY 446110 5826523 3782293 2044230 DME 621400 4910683 4684726 225957 FITNESS CENTER 713940 2012176 928299 1083877 OTHER PROGRAM SERVICE REVENUE 900099 624634 513392 111242 305293592 19123385 19123385 1267175 474515 792660 792660 792660 1069192 -1069192 -1069192 -1069192 CAFETERIA/VENDING 722210 1319453 1319453 TELEPHONE ANSWERING 900099 64722 64722 AFFILIATED REVENUES/LOSSES 900099 -1586777 -1586777 -202602 324876488 301379261 3979053 18579529 X 563401 563401 5100084 5100084 90583657 79660563 10923094 4082592 3398922 683670 17444054 14522877 2921177 6816398 5674926 1141472 795968 795968 243668 243668 133019 133019 27884 27884 35112780 24446260 10666520 1221418 749679 471739 11519715 6144151 5375564 2421449 2146931 274518 5299531 5299531 411668 392347 19321 281010 128776 152234 605605 605605 16295084 16295084 966325 966325 MEDICAL SUPPLIES 30190620 30190620 COST OF DRUGS SOLD 23117200 23117200 BAD DEBTS 18474431 18474431 COST OF FOOD 1891348 1891348 1034538 87999 946539 274633447 234756976 39876471 0 20848886 21678777 44308491 37565595 27204 0 6235053 5886575 2347918 2490624 370389526 231207405 136977910 139182121 295073981 360753693 6679968 5511059 90159686 108361376 280577 1036384 11429070 13504024 614368744 695970228 22888479 23608065 104779 71786 17867406 14635966 271554 126917 5312101 11485187 46444319 49927921 X 566391326 644464928 1533099 1577379 567924425 646042307 614368744 695970228 X 50243041 28468660 -593819 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 27884 27884 0 PART II-B, LINE 1: THE HOSPITAL IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE VIRGINIA HOSPITAL & HEALTHCARE ASSOCIATION (VHHA). THESE ORGANIZATIONS ROUTINELY ENGAGE IN LOBBYING EFFORTS ON BEHALF OF ITS MEMBERSHIP BODY, AND A PORTION OF EACH MEMBER'S DUES ARE ALLOCATED TO THOSE LOBBYING EXPENDITURES. THE PORTION OF THE HOSPITAL'S DUES ALLOCATED TO LOBBYING WAS $ 27,884. 1511837 4573200 6085037 119660734 52809163 66851571 10858465 9524692 1333773 218499882 168873550 49626332 15285408 15285408 139182121 INVESTMENT IN AMG 108361376 C 108361376 OTHER LIABILITIES 11450865 UNAMORTIZED BOND DISCOUNTS 34322 11485187 X 333620240 28468660 28468660 305151580 19724908 19724908 324876488 255595615 0 255595615 19037832 19037832 274633447 PART X, LINE 2: THE COMPANY IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON INCOME DERIVED FROM ITS EXEMPT PURPOSE AS A NOT-FOR-PROFIT ORGANIZATION UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAX. THE COMPANY HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2017. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET WITH REVENUE 18,474,431. GRANTS EXPENSE NET WITH REVENUE 563,401. EQUITY TRANSFERS BETWEEN AFFILIATES 687,076. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET WITH REVENUE 18,474,431. GRANTS EXPENSE NET WITH REVENUE 563,401. CENTRAL AMERICA AND THE CARIBBEAN - 0 0 INVESTMENT 635922 0 0 0 0 0 0 635922 0 635922 1 0 1 0 0 0 1 1 1 X 1 X 1 1 1 0 1 0 9212360 9212360 0.03600 20406113 13658277 6747836 0.02630 29618473 13658277 15960196 0.06230 967306 967306 0.00380 84523 84523 0.00030 9536275 6754251 2782024 0.01090 530975 530975 0.00210 11119079 6754251 4364828 0.01710 40737552 20412528 20325024 0.07940 1 18474431 2234768 99995366 95405571 4589795 X 1 1 1 1 AUGUSTA HEALTH 78 MEDICAL CENTER DR FISHERSVILLE VA 22939 X X X HOME HEALTH; SNF; PSYCH, DME; HOSPICE AUGUSTA HEALTH 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X SEE DISCLOSURE X 1 17 1 SEE DISCLOSURE 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X WWW.AUGUSTAHEALTH.COM X SEE PART VI X WWW.AUGUSTAHEALTH.COM/BILLING-INSURANCE/ASSISTANCE-PROGRAMS X X X X X 1 X 0 X X X X 1 X 0 0 AUGUSTA HEALTH PART V, SECTION B, LINE 3J: INFORMATION GAPS THAT LIMIT THE HOSPITAL FACILITY'S ABILITY TO ACCESS THE COMMUNITY'S HEALTH NEEDS. AUGUSTA HEALTH PART V, SECTION B, LINE 5: TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS ALSO IMPLEMENTED AS PART OF THIS PROCESS. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY AUGUSTA HEALTH; THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE; REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. IN ALL, 206 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY. AUGUSTA HEALTH PART V, SECTION B, LINE 11: AUGUSTA HEALTH, THROUGH ITS MISSION TO PROMOTE THE HEALTH AND WELL-BEING OF OUR COMMUNITY THROUGH ACCESS TO EXCELLENT CARE, HAS DEVELOPED GOALS, OBJECTIVES AND STRATEGIES TO ADDRESS SELECTED TOP PRIORITY HEALTH NEEDS IN THE AREAS OF: 1) NUTRITION, PHYSICAL ACTIVITY AND WEIGHT, 2) DIABETES AND 3) MENTAL HEALTH. THE ACTION PLANS WILL BE IMPLEMENTED IN COLLABORATION WITH VARIOUS COMMUNITY PARTNERS OVER THE NEXT THREE YEARS. DURING THE CHNA PROCESS, THE DATA REVEALED A TOTAL OF 13 DISTINCT AREAS OF OPPORTUNITY. AUGUSTA HEALTH'S 2017-2019 IMPLEMENTATION STRATEGIES ARE DESIGNED TO ADDRESS THE TOP THREE HIGHEST PRIORITY AREAS. AUGUSTA HEALTH HAS SELECTED THESE THREE PRIORITIES BECAUSE OF ITS ABILITY TO WORK IN PARTNERSHIP WITH OTHER ORGANIZATIONS AND AGENCIES TO MAKE THE GREATEST IMPACT. OTHER NEEDS THAT WERE IDENTIFIED HAVE THE POTENTIAL TO BE ADDRESSED THROUGH COLLABORATIVE PROGRAMMING THAT MAY OR MAY NOT INVOLVE AUGUSTA HEALTH AS A FACILITATOR, PARTNER OR FUNDER. AUGUSTA HEALTH PART V, SECTION B, LINE 13H: INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY SHALL NOT BE CHARGED MORE THAN THE AMOUNTS GENERALLY BILLED (AGB) TO INDIVIDUALS WHO HAVE INSURANCE. THIS VALUE SHALL BE CALCULATED USING THE "LOOK-BACK" METHOD BASED ON ACTUAL PAID CLAIMS FROM MEDICARE FEE-FOR-SERVICE AND PRIVATE HEALTH INSURERS. THE CURRENT AGB IS 35% AND IS UPDATED ANNUALLY. AUGUSTA HEALTH PART V, SECTION B, LINE 16J: THE FAP IS DISCUSSED AND OFFERED BY OUR SP EXTENDED BUSINESS OFFICE PARTNER DURING THE COLLECTION PROCESS. PART V, SECTION B, LINE 7A AND 10A: WEBSITE ADDRESS FOR THE CHNA AND IMPLEMENTATION STRATEGY:HTTPS://WWW.AUGUSTAHEALTH.COM/COMMUNITY-OUTREACH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART I, LINE 7: FOR PURPOSES OF PART I, LINE 7(A) THE ORGANIZATION USED THE METHODS PROVIDED IN THE SCHEDULE H INSTRUCTIONS TO COMPUTE A COST-TO-CHARGES RATIO TO CONVERT CHARITY CARE WRITE-OFFS TO COST. AMOUNTS REPORTED ON LINES 7(B) AND 7(G) WERE DERIVED FROM THE ORGANIZATION'S INTERNAL COST ACCOUNTING SYSTEM. PART I, LINE 7G: INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES ACCOUNT FOR $1,894,322 OF THE NET COMMUNITY BENEFIT OF SUBSIDIZED SERVICES. THESE SERVICES PROVIDE SHORT-TERM PSYCHIATRIC CARE FOR ADULTS AND GERIATRIC PATIENTS IN A SUPPORTIVE ENVIRONMENT WITH 24-HOUR NURSING CARE. HOME HEALTH SERVICES PROVIDED BY THE ORGANIZATION CONTRIBUTED $887,702 IN NET COMMUNITY BENEFIT. AUGUSTA HEALTH'S HOME HEALTH PROGRAM OFFERS SKILLED NURSING CARE, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, AND MEDICAL SOCIAL WORKERS. PART I, LN 7 COL(F): TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25 INCLUDES BAD DEBT IN THE AMOUNT OF $18,474,431. THIS AMOUNT FOR BAD DEBT HAS BEEN REMOVED FOR PURPOSES OF COMPUTING PERCENTAGE OF TOTAL EXPENSE ON SCHEDULE H, PART I, LINE 7, COL (F). PART III, LINE 2: ACCOUNTS ARE WRITTEN OFF TO BAD DEBT WHEN MANAGEMENT DETERMINES THAT RECOVERY IS UNLIKELY AND THE COMPANY CEASES COLLECTION EFFORTS. PART III, LINE 4: EXCERPT FROM 2017 FINANCIAL AUDIT, PATIENT ACCOUNTS RECEIVABLE:"PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT ESTABLISHED BILLING RATES WHEN PATIENT SERVICES ARE RENDERED. ALLOWANCE FOR DOUBTFUL ACCOUNTS AND CONTRACTUAL ADJUSTMENTS ARE RECORDED AS DEDUCTIONS FROM PATIENT ACCOUNTS RECEIVABLE TO REDUCE RECORDED AMOUNTS TO THEIR NET REALIZABLE VALUE. CONTRACTUAL ADJUSTMENTS REPRESENT THE DIFFERENCE BETWEEN ESTABLISHED BILLING RATES AND AMOUNTS REIMBURSED. THE COMPANY PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR ESTIMATED LOSSES RESULTING FROM THE UNWILLINGNESS OR INABILITY OF PATIENTS TO MAKE PAYMENTS FOR SERVICES. THE ALLOWANCE IS DETERMINED BY ANALYZING HISTORICAL DATA AND TRENDS. PATIENT ACCOUNTS RECEIVABLE ARE CHARGED AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WHEN MANAGEMENT DETERMINES THAT RECOVERY IS UNLIKELY AND THE COMPANY CEASES COLLECTION EFFORTS."THE BAD DEBT AMOUNT LISTED IN PART III SECTION A, NUMBER 2 WAS CALCULATED USING WORKSHEET A ON PAGE 4 OF THE 2017 SCHEDULE H INSTRUCTIONS.THE PORTION OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE IS BASED ON DISCHARGES IN 2017. PATIENTS THAT WERE CLASSIFIED AS "SP" WERE UN-INSURED AND THEREFORE CONSIDERED WITHOUT RESOURCES. THEIR ACCOUNT STATUS WAS "BD" MEANING THAT THE ACCOUNT WAS CONSIDERED UNCOLLECTABLE AT THE TIME OF THE REPORT. PART III, LINE 9B: ONCE A PATIENT HAS BEEN DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ALL COLLECTION EFFORTS CEASE FOR CURRENT AND PAST DUE BALANCES AND THE NECESSARY ADJUSTMENTS ARE TAKEN TO THE ACCOUNTS RECEIVABLE. SHOULD THE PATIENT ONLY BE ELIGIBLE FOR A PORTION OF FINANCIAL ASSISTANCE (THROUGH OUR SLIDING SCALE), NO-INTEREST, LOW-PAYMENT, AND LONG TERM PAYMENT PLANS ARE AVAILABLE. PART V, LINE 16B HTTPS://WWW.AUGUSTAHEALTH.COM/SITES/DEFAULT/FILES/DOCUMENTS/BUSINESS-OFFICE/FINANCIAL_ASSISTANCE_APPLICATION_2015-FORMS.PDF PART VI, LINE 2: AUGUSTA HEALTH COMPLETED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2016 TO DETERMINE THE PRIORITY HEALTH NEEDS OF STAUNTON, AUGUSTA COUNTY AND WAYNESBORO VIRGINIA. AUGUSTA HEALTH'S CHNA IS A SYSTEMATIC, DATA-DRIVEN APPROACH TO DETERMINING THE HEALTH STATUS, BEHAVIORS AND NEEDS OF RESIDENTS IN THE SERVICE AREA OF AUGUSTA HEALTH AND THE INFORMATION GATHERED IS USED TO INFORM DECISIONS AND GUIDE EFFORTS TO IMPROVE COMMUNITY HEALTH AND WELLNESS. THE CHNA SERVES AS TOOL TO REACH THREE BASIC GOALS:TO IMPROVE RESIDENT'S HEALTH STATUS, INCREASE THEIR LIFE SPANS, AND ELEVATE THEIR OVERALL QUALITY OF LIFE. A HEALTHY COMMUNITY IS NOT ONLY ONE WHERE ITS RESIDENTS SUFFER LITTLE FROM PHYSICAL AND MENTAL ILLNESS, BUT ALSO ONE WHERE ITS RESIDENTS ENJOY A HIGH QUALITY OF LIFE. TO REDUCE THE HEALTH DISPARITIES AMONG RESIDENTS. BY GATHERING DEMOGRAPHIC INFORMATION ALONG WITH HEALTH STATUS AND BEHAVIOR DATA, IT IS POSSIBLE TO IDENTIFY POPULATION SEGMENTS THAT ARE MOST AT-RISK FOR VARIOUS DISEASES AND INJURIES. INTERVENTION PLANS AIMED AT TARGETING THESE INDIVIDUALS MAY THEN BE DEVELOPED TO COMBAT SOME OF THE SOCIO-ECONOMIC AND SOCIAL DETERMIANTS WHICH HAVE HISTORICALLY HAD A NEGATIVE IMPACT ON RESIDENTS' HEALTH.TO INCREASE ACCESSIBILITY TO PREVENTATIVE SERVICES FOR ALL COMMUNITY RESIDENTS. MORE ACCESSIBLE PREVENTIVE SERVICES ARE BENEFICIAL TO IMPROVING HEALTH STATUS, AS WELL AS LOWERING THE COSTS ASSOCIATED WITH CARING FOR LATE-STAGE DISEASE RESULTING FROM A LACK OF PREVENTIVE CARE. THE CHNA INCORPORATES DATA FROM BOTH QUANTITATIVE AND QUALITATIVE SOURCES. QUANTITATIVE DATA INCLUDES PRIMARY RESEARCH (COMMUNITY HEALTH PHONE SURVEY OF COMMUNITY RESIDENTS) AND SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA); THESE QUANTITATIVE COMPONENTS ALLOW FOR COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS (VIRGINIA RISK FACTOR DATA AND NATIONWIDE RISK FACTOR DATA, RESPECTIVELY). QUALITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH GATHERED THROUGH AN ONLINE KEY INFORMANT SURVEY OF REPRESENTATIVES FROM VARIOUS COMMUNITY SECTORS. THE SURVEY INSTRUMENT USED FOR THE STUDY IS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, AS WELL AS VARIOUS PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES.THE STUDY AREA FOR THE SURVEY EFFORT IS DEFINED AS EACH OF THE RESIDENTIAL ZIP CODES COMPRISING STAUNTON CITY, WAYNESBORO CITY AND AUGUSTA COUNTY IN VIRGINIA. THIS COMMUNITY DEFINITION WAS DETERMINED BASED ON ZIP CODES OF RESIDENCE OF AUGUSTA HEALTH PATIENTS (APPROXIMATELY 80% OF ADMISSIONS GENERATE FROM THESE AREAS). A PRECISE AND CAREFULLY EXECUTED METHODOLOGY IS CRITICAL IN ASSERTING THE VALIDITY OF RESULTS GATHERED IN THE COMMUNITY HEALTH SURVEY. THUS, TO ENSURE THE BEST REPRESENTATION OF THE POPULATION SURVEYED, A TELEPHONE INTERVIEW METHODOLOGY, ONE THAT INCORPORATES BOTH LANDLINE AND CELL PHONE INTERVIEWS, WAS EMPLOYED. THE SAMPLE DESIGN FOR THIS EFFORT CONSISTED OF A STRATIFIED RANDOM SAMPLE OF 400 INDIVIDUALS AGE 18 AND OLDER IN THE TOTAL AREA (INCLUDING 100 IN STAUNTON CITY, 100 IN WAYNESBORO CITY AND 200 IN AUGUSTA COUNTY). ONCE THE INTERVIEWS WERE COMPLETED, THESE WERE WEIGHTED IN PROPORTION TO THE ACTUAL POPULATION DISTRIBUTION SO AS TO APPROPRIATELY REPRESENT THE AREA AS A WHOLE. TO SOLICIT INPUT FROM KEY INFORMANTS (INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY), AN ONLINE KEY INFORMANT SURVEY WAS ALSO IMPLEMENTED AS PART OF THIS PROCESS. THE LIST INCLUDED BUSINESS LEADERS, COMMUNITY LEADERS, EDUCATORS, GOVERNMENT REPRESENTATIVES, MEDIA HEALTH REPRESENTATIVES, HEALTH PROVIDERS AND PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES AND SOCIAL SERVICES PROVIDERS. PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE. REMINDER CALLS WERE SENT AS NEEDED. IN ALL, 206 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY. THIRTEEN SIGNIFICANT HEALTH AREAS OF OPPORTUNITY WERE IDENTIFIED INCLUDING ACCESS TO HEALTHCARE SERVICES, CANCER, CHRONIC KIDNEY DISEASE, DEMENTIA, DIABETES, HEART DISEASE AND STROKE, INJURY AND VIOLENCE, MENTAL HEALTH, NUTRITION, PHYSICAL ACTIVITY AND WEIGHT, ORAL HEALTH AND RESPIRATORY DISEASES. THESE AREAS OF OPPORTUNITY WERE DETERMINED AFTER CONSIDERATION OF VARIOUS CRITERIA, INCLUDING COMPARISON TO BENCHMARK DATA, IDENTIFIED TRENDS, THE PREPONDERANCE OF SIGNIFICANT FINDINGS WITHIN TOPIC AREAS, THE MAGNITUDE OF THE ISSUE IN TERMS OF THE NUMBER OF PERSONS AFFECTED, AND THE POTENTIAL HEALTH IMPACT OF THE GIVEN ISSUE. A GROUP OF COMMUNITY STAKEHOLDERS, REPRESENTING A CROSS-SECTION OF COMMUNITY-BASED ORGANIZATIONS, WAS CONVENED TO EVALUATE, DISCUSS AND PRIORITIZE THE THIRTEEN AREAS OF OPPORTUNITY IDENTIFIED IN THE CHNA. IN ORDER TO ASSIGN PRIORITY TO THE IDENTIFIED HEALTH NEEDS, A WIRELESS AUDIENCE RESPONSE SYSTEM WAS USED IN WHICH EACH PARTICIPANT WAS ABLE TO REGISTER HIS/HER RATINGS BASED ON TWO CRITERIA: SCOPE AND SEVERITY AND THE ABILITY TO IMPACT. COMPOSITE SCORES WERE USED TO PRIORITIZE THE NEEDS. THE TOP THREE AREAS OF FOCUS SELECTED BASED ON THIS CRITERIA INCLUDE: 1)NUTRITION, PHYSICAL ACTIVITY AND WEIGHT; 2)DIABETES; AND 3)MENTAL HEALTH.AUGUSTA HEALTH, THROUGH ITS MISSION TO PROMOTE THE HEALTH AND WELL-BEING OF OUR COMMUNITY THROUGH ACCESS TO EXCELLENT CARE, HAS CREATED INTERNAL, CROSS-DISCIPLINARY WORKGROUPS AROUND EACH OF THE THREE PRIORITY AREAS. EACH WORKGROUP HAS DEVELOPED GOALS, OBJECTIVES AND STRATEGIES TO ADDRESS SELECTED TOP PRIORITY HEALTH NEEDS IN THE AREAS OF: 1) NUTRITION, PHYSICAL ACTIVITY AND WEIGHT, 2) DIABETES AND 3) MENTAL HEALTH. THE ACTION PLANS ARE BEING IMPLEMENTED WITH THE COLLABORATIVE FROM COMMUNITY PARTNERS. AUGUSTA HEALTH'S 2017-2019 IMPLEMENTATION STRATEGIES ARE DESIGNED TO ADDRESS THE TOP THREE HIGHEST PRIORITY AREAS. AUGUSTA HEALTH HAS SELECTED THESE THREE PRIORITIES BECAUSE OF ITS ABILITY TO WORK IN PARTNERSHIP WITH OTHER ORGANIZATIONS AND AGENCIES TO MAKE THE GREATEST IMPACT. OTHER NEEDS THAT WERE IDENTIFIED HAVE THE POTENTIAL TO BE ADDRESSED THROUGH COLLABORATIVE PROGRAMMING THAT MAY OR MAY NOT INVOLVE AUGUSTA HEALTH AS A FACILITATOR, PARTNER OR FUNDER. PART VI, LINE 3: AUGUSTA HEALTH HAS A MEDICAID ELIGIBILITY TEAM ONSITE TO SCREEN ITS PATIENTS FOR MEDICAID ELIGIBILITY, INCLUDING DISABILITY. AS FOR THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM, AUGUSTA HEALTH INFORMS ITS PATIENTS ABOUT IT IN THE FOLLOWING WAYS:1. DETAILED INFORMATION ABOUT FINANCIAL ASSISTANCE IS SENT ALONG WITH THE STATEMENTS.2. FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE AVAILABLE ON THE HOSPITAL'S WEBSITE WWW.AUGUSTAHEALTH.COM. 3. COPIES OF THE FINANCIAL ASSISTANCE GUIDELINES AND APPLICATION FORM ARE AVAILABLE AT THE POINTS OF SERVICE (EMERGENCY ROOM, OUTPATIENT AND INPATIENT AREAS, DOCTOR'S OFFICES, ETC.). PART VI, LINE 4: OUR PRIMARY SERVICE AREA, THE COMBINED AREA OF STAUNTON, WAYNESBORO AND AUGUSTA COUNTY , ENCOMPASSES 1002.02 SQUARE MILES AND HOUSES A TOTAL POPULATION OF 119,016 RESIDENTS, ACCORDING TO LATEST CENSUS ESTIMATES. BETWEEN THE 2000 AND 2010 US CENSUSES, THE TOTAL AREA POPULATION INCREASED BY 9,514 PERSONS, OR 8.7%. WHILE AUGUSTA COUNTY IS PREDOMINANTLY RURAL, THE CITIES OF STAUNTON AND WAYNESBORO ARE NEARLY ENTIRELY URBAN. IN THE TOTAL AREA, 20.7% OF THE POPULATION ARE INFANTS, CHILDREN OR ADOLESCENTS AGE 17 AND UNDER, ANOTHER 61.3% ARE AGE 18 TO 64, WHILE 18% ARE AGE 65 OR OLDER. THE PERCENTAGE OF OLDER ADULTS IS MUCH HIGHER THAN THE STATE AND US FIGURES. IN LOOKING AT RACE INDEPENDENT OF ETHNICITY, 88.9% OF RESIDENTS OF THE TOTAL ARE WHITE AND 7.1% ARE BLACK. THE CITIES OF STAUNTON AND WAYNESBORO ARE MORE RACIALLY DIVERSE THAN AUGUSTA COUNTY. A TOTAL OF 3.1% OF TOTAL AREA RESIDENTS ARE HISPANIC OR LATINO, WITH THE PROPORTION THE LARGEST IN WAYNESBORO. BETWEEN 2000 AND 2010, THE HISPANIC POPULATION IN THE TOTAL AREA INCREASED BY 1,846 PEOPLE, OR 120.7% LESS THAN ONE PERCENT OF THE TOTAL AREA POPULATION AND 5 AND OLDER LIVE IN A HOME IN WHICH NO PERSONS AGE 14 OR OLDER IS PROFICIENT IN ENGLISH. PART VI, LINE 5: AS A COMMUNITY OWNED HOSPITAL, 100% OF THE SURPLUS GOES BACK INTO THE COMMUNITY THROUGH FACILITY UPGRADES, STATE OF THE ART EQUIPMENT PURCHASES, INCREASED PATIENT CARE SERVICES, AND PATIENT CARE ACCESS POINTS THROUGHOUT THE SERVICE AREA, AS WELL AS PROVIDING SUPPORT TO OTHER LOCAL NON-PROFIT AGENCIES THAT COMPLIMENT AND/OR SUPPORT THE MISSION OF AUGUSTA HEALTH. AUGUSTA HEALTH IS IN A LEADERSHIP POSITION FOR COMMUNITY BENEFIT AS A RESULT OF THE AUGUSTA HEALTH COMMUNITY PARTNERSHIP COMMITTEE. THE COMMUNITY PARTNERSHIP COMMITTEE IS APPOINTED BY THE AUGUSTA HEALTH BOARD OF DIRECTORS. THE COMMITTEE IMPROVES THE HEALTH OF THE COMMUNITY BY PROVIDING INPUT AND OVERSIGHT ON AUGUSTA HEALTH'S COMMUNITY BENEFIT INITIATIVES, COLLABORATIVE PARTNERSHIPS AND STRATEGIC FUNDING AND ENSURES ALIGNMENT WITH THE PRIORITY AREAS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. PART VI, LINE 6: THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. 1 CENTRAL SHENANDOAH PLANNING 112 MACTANLEY PLACE STAUNTON VA 24401 540857625 501(C)(3) 52416 OPERATIONAL SUPPORT MARY BALDWIN COLLEGE 101 E FREDRICK ST STAUNTON VA 24401 540506319 501(C)(3) 60000 OPERATIONAL SUPPORT AUGUSTA REGIONAL FREE CLINIC 342 MULE ACADEMY RD FISHERSVILLE VA 22939 541651896 501(C)(3) 40000 OPERATIONAL SUPPORT AUGUSTA REGIONAL DENTAL CLINIC 342 MULE ACADEMY RD FISHERSVILLE VA 22939 202922988 501(C)(3) 20000 OPERATIONAL SUPPORT BLUE RIDGE COURT SERVICES 125 SOUTH NEW ST STAUNTON VA 24401 546001631 501(C)(3) 16750 OPERATIONAL SUPPORT ALLEGHENY MOUNTAIN INSTITUE PO BOX 542 STAUNTON VA 24402 465717620 501(C)(3) 90000 OPERATIONAL SUPPORT CENTRAL SHENANDOAH EMS COUNCIL PO BOX 256 FISHERSVILLE VA 22939 541906904 501(C)(3) 10000 OPERATIONAL SUPPORT CROSSROADS TO BRAIN INJURY BLUE RIDGE HALL MSC 9020 601 UNIVERSITY BLVD HARRISONBURG VA 22807 204795567 501(C)(3) 11000 OPERATIONAL SUPPORT PROJECT GROWS PO BOX 781 STAUNTON VA 24401 461070735 501(C)(3) 15000 OPERATIONAL SUPPORT VALLEY AREA COMMUNITY SUPPORT PO BOX 1907 STAUNTON VA 24401 270132429 501(C)(3) 20000 OPERATIONAL SUPPORT VALLEY HOPE COUNSELING CENTER 20 STONERIDGE DR SUITE 202 WAYNESBORO VA 22980 541956722 501(C)(3) 30000 OPERATIONAL SUPPORT NEW DIRECTIONS CENTER PO BOX 3069 STAUNTON VA 24401 541186253 501(C)(3) 12500 OPERATIONAL SUPPORT VALLEY CHILDRENS CENTER 1234 MIDDLEBROOK AVE STAUNTON VA 24401 200831874 501(C)(3) 7000 OPERATIONAL SUPPORT VALLEY MISSION 1513 WEST BEVERLY STREET STAUNTON VA 24401 540930419 501(C)(3) 27500 OPERATIONAL SUPPORT BLUE RIDGE COMMUNITY COLLEGE PO BOX 80 WEYERS CAVE VA 24486 541268283 501(C)(3) 15000 OPERATIONAL SUPPORT WAYNESBORO AREA REFUGE MINISTRY INC 1035 FAIRFAX AVENUE WAYNESBORO VA 22980 471937790 501(C)(3) 12500 OPERATIONAL SUPPORT 16 PART I, LINE 2: AUGUSTA HEALTH MADE GRANTS THROUGHOUT THE YEAR TO NON-PROFIT AND GOVERNMENTAL COMMUNITY PARTNERS WHO DEVELOPED PROJECTS OR PROVIDED SERVICES TO ADDRESS THE COMMUNITY'S HEALTH PRIORITIES IDENTIFIED IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. X 0 0 X X X X X 1 1 0 0 0 1 0 0 0 JOSEPH L RANZINI MD BOARD MEMBER 424795 0 0 0 0 0 4516 0 10772 0 440083 0 0 0 MARY N MANNIX PRESIDENT & CEO 596741 0 170957 0 170910 0 114686 0 8755 0 1062049 0 189457 0 JOHN KATSIANIS CFO (BEGAN SEP) 123367 0 0 0 8853 0 14289 0 6666 0 153175 0 0 0 RICH EMBREY MD CMO & VP POPULATION HEALTH 359928 0 61950 0 41523 0 44490 0 11914 0 519805 0 72888 0 MARVELLA REA CNO 174401 0 34960 0 66231 0 15273 0 8626 0 299491 0 52960 0 KAREN CLARK PRESIDENT, AMG 278522 0 53524 0 49892 0 35316 0 2550 0 419804 0 73794 0 DAN O'CONNOR VP OF HUMAN RESOURCES 257186 0 49798 0 28651 0 34115 0 10847 0 380597 0 69451 0 LISA CLINE COO 349587 0 64230 0 35550 0 42598 0 10455 0 502420 0 82230 0 MIKE CANFIELD CIO 248862 0 55375 0 11923 0 33450 0 6414 0 356024 0 67298 0 GEORGE SEMKO ADMIN DIRECTOR REVENUE CYC 186679 0 19333 0 27722 0 7202 0 6857 0 247793 0 19333 0 ALEXANDER BROWN VP OF LEGAL AFFAIRS 187489 0 36894 0 22045 0 21967 0 0 0 268395 0 46751 0 MARK LAROSA CHIEF STRATEGY OFFICER 197654 0 0 0 4762 0 21194 0 4453 0 228063 0 0 0 SCOTT JUST MD VP/CMO, AMG 320325 0 61701 0 56587 0 41391 0 10775 0 490779 0 76751 0 ANDREW WEST CMIO 336378 0 0 0 12175 0 7950 0 4148 0 360651 0 0 0 FRANCIS CARRUCIO ADMIN DIRECTOR FACILITIES, 205317 0 21245 0 22317 0 7398 0 3805 0 260082 0 21245 0 SCOTT CRABTREE ADMIN DIRECTOR OF PROFESSI 180854 0 14208 0 25634 0 2576 0 5732 0 229004 0 14208 0 VICKIE TAYLOR SURGICAL DIRECTOR 142188 0 12931 0 25773 0 4150 0 6205 0 191247 0 12931 0 SARAH HASH-RODGERS CORPORATE CONTROLLER 138382 0 11996 0 11992 0 4586 0 9694 0 176650 0 11996 0 ROBERT W RILEY FORMER CFO 0 0 0 0 221037 0 0 0 0 0 221037 0 0 0 PART I, LINE 1A BOARD MEMBER JOHN DAVIS, WAS ACCOMPANIED BY HIS WIFE TO A DINNER WITH LEGISLATORS, HER PORTION WAS $61.31 AND SHE ALSO ATTENDED THE VHHA SPRING CONFERENCE, REGISTRATION AND MEAL TOTALED $244.21. FINANCE COMMITTEE MEMBER THOMAS ROBERTS TOOK HIS WIFE TO THE DINNER WITH LEGISLATORS , HER PORTION WAS ALSO $61.31. PART I, LINES 4A-B ROBERT RILEY RECEIVED A SEVERANCE PAYMENT OF $221,037, AND MARVELLA REA RECEIVED A SEVERANCE PAYMENT OF $48,231. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENT FROM A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS ARE REPRESENTED IN PART II, COLUMN (C): $152,410 MARY MANNIX $390 DAN O'CONNOR $17,550 LISA CLINE PART I, LINE 6 THE TOP EXECUTIVES OF AUGUSTA HEALTH WERE REQUIRED TO SET ANNUAL PERFORMANCE GOALS THAT ALIGNED WITH THE ORGANIZATION'S COMMITMENT TO PERFORMANCE EXCELLENCE. THE GOALS WERE ESTABLISHED WITH FOCUS ON THE FOLLOWING SIX AREAS: QUALITY, SERVICE, PEOPLE, COMMUNITY, GROWTH, AND FINANCE. EACH GOAL WAS REQUIRED TO HAVE MEASURABLE OUTCOMES AND WAS REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD TO ENSURE THAT IT SUPPORTED THE ORGANIZATION'S QUEST FOR SERVICE AND OPERATIONAL EXCELLENCE. WHILE NET EARNINGS WERE A CONSIDERATION IN THE AREA OF FINANCE, THE GOALS WERE ALSO CENTERED AROUND QUALITY, SERVICE, PEOPLE, COMMUNITY, AND GROWTH. EACH EXECUTIVE'S GOALS WERE WEIGHTED ACROSS THE PILLAR GOALS BASED ON THEIR AREA OF RESPONBILITY. WHEN AWARDING INCENTIVE COMPENSATION, THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD REVIEWED THE YEAR-END ACCOMPLISHMENTS OF THE TOP EXECUTIVES AND AWARDED INCENTIVE COMPENSATION BASED ON THEIR ACTUAL PERFORMANCE AS COMPARED TO THE ESTABLISHED PERFORMANCE BENCHMARKS. A INDUSTRIAL DEVELOPMENT AUTHORITY OF THE COUNTY OF AUGUSTA VA 541311681 05112MCP8 2003-12-17 33510000 CURRENT REFUNDING 0 0 0 A 18580000 38637362 5267469 374087 33483180 1994 1 0 1 1 A 0 0 0 1 0 0 0 0 1 A 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: INDUSTRIAL DEVELOPMENT AUTHORITY OF THE COUNTY OF AUGUSTA, VA DATE THE REBATE COMPUTATION WAS PERFORMED: 08/31/2010 SCHEDULE K, PART I, DESCRIPTION OF PURPOSE: THE SERIES 2003 BONDS WERE ISSUED FOR THE PURPOSE OF: 1) REFUNDING THE ISSUER'S PRIOR SERIES 1993 BONDS, 2) FUNDING A DEBT SERVICE RESERVE FUND FOR THE SERIES 2003 BONDS, AND 3) PAYING COST OF ISSUANCE EXPENSES. SCHEDULE K, PART II, LINE 11, OTHER SPENT PROCEEDS: THE AMOUNTS PRESENT ON PART II, LINE 11 REPRESENT AMOUNTS USED TO CURRENTLY REFUND BONDS ISSUED IN 1993. SCHEDULE K, PART III: THE SERIES 2003 BONDS WERE ISSUED ENTIRELY TO REFUND A PRIOR ISSUE DATED BEFORE JANUARY 1, 2003 AND WERE NOT USED TO ACQUIRE NEW PROPERTY; THEREFORE, SCHEDULE K, PART III IS NOT REQUIRED TO BE COMPLETED FOR THIS ISSUE. FORM 990, PART VI, SECTION A, LINE 1 EXECUTIVE COMPENSATION PROGRAM IS ADMINISTERED BY THE EXECUTIVE COMMITTEE OF THE BOARD, BASED ON A COMPENSATION PHILOSOPHY APPROVED BY THE BOARD AT LARGE. QUALIFIED THIRD PARTY CONSULTANTS ARE ENGAGED TO PROVIDE APPROPRIATE MARKET COMPARABILITY, SURVEY DATA, AND TO ASSIST THE COMMITTEE WITH REVIEWS. THE BASE SALARY BENCHMARKS ARE TARGETED AT THE 50TH PERCENTILE WITH FLEXIBILITY TO PAY ABOVE OR BELOW THE 50TH PERCENTILE USING SALARY RANGES WITH A 50% RANGE SPREAD TO RECOGNIZE AN INCUMBENT'S INDIVIDUAL EXPERIENCE, SKILL, PERFORMANCE, OR OTHER RELEVANT RECRUITMENT OR RETENTION FACTORS. INCENTIVE OPPORTUNITIES ARE ESTABLISHED AT LEVELS THAT WHEN COMBINED WITH SALARIES POSITIONED AT THE 50TH PERCENTILE, ARE SUFFICIENT TO PROVIDE TOTAL CASH COMPENSATION THAT TARGETS UP TO THE APPROXIMATELY MARKET 75TH PERCENTILE OF TOTAL CASH COMPENSATION LEVELS. TOTAL COMPENSATION SHALL NOT EXCEED THE 90TH PERCENTILE FOR ANY INDIVIDUAL WITHOUT FULL BOARD APPROVAL AND DOCUMENTATION OF THE BOARD'S REASONS FOR SUCH COMPENSATION. THE BOARD OF DIRECTORS RECEIVES A FULL REPORT FROM THE EXECUTIVE COMMITTEE ON THE FULL COMPENSATION PROGRAM AT AUGUSTA HEALTH IN AN EXECUTIVE SESSION OF THE BOARD. CONFLICTED MEMBERS ARE EXCUSED FROM THE MEETING. MATERIAL COVERED INCLUDES THE DESIGN OF THE COMPENSATION PROGRAM, AS WELL AS A DISCLOSURE ON RANGE OF BASE SALARIES, MARKET BENCHMARK DATA, AND EARNED INCENTIVE COMPENSATION LEVELS. ADDITIONALLY, PREREQUISITES SUCH AS THE SENIOR EXECUTIVE RETIREMENT PLAN (SERP) PROGRAM AND OTHER RELATED BENEFITS ARE PERIODICALLY REVIEWED WITH THE BOARD. FOR THOSE MEMBERS WHO ARE NOT PRESENT FOR THIS ANNUAL REPORT AND REMAIN FREE OF CONFLICT OF INTEREST, THE CHAIRMAN OF THE BOARD PRESENTS THE SAME MATERIAL IN A SEPARATE SESSION. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES CFO DUTIES TO WARBIRD. THE MANAGEMENT COMPANY PROVIDES JIM GRAVELL AS AN INTERIM CFO. THE ORGANIZATION PAID WARBIRD $711,229 FOR SERVICES. THE CONTRACT FOR THE MANAGEMENT SERVICES TERMINATED IN SEPTEMBER 2017. FORM 990, PART VI, SECTION B, LINE 11B THE ACCOUNTING DEPARTMENT WILL MAKE COPIES OF THE FORM 990 AVAILABLE TO THE CFO AND CEO FOR REVIEW. ALL QUESTIONS WILL BE RESOLVED AND ANSWERED BEFORE PRESENTATION TO THE EXECUTIVE COMMITTEE OF THE BOARD. THE FINAL DRAFT OF THE RETURN WILL BE POSTED ON THE ORGANIZATION'S INTERNAL WEBSITE WITH ACCESS RESTRICTED TO THE BOARD AND KEY ADMINISTRATIVE PERSONNEL FOR REVIEW. ALL QUESTIONS WILL BE RESOLVED AND ANSWERED BY THE CEO, CFO OR CORPORATE CONTROLLER. ANY REVISIONS AS A RESULT OF THE BOARD REVIEW WILL BE SENT TO THE TAX PREPARER AND SUBSEQUENT REVIEW BY THE BOARD WILL BE SCHEDULED ACCORDINGLY. FORM 990, PART VI, SECTION B, LINE 12C THE GOVERNANCE COMMITTEE IS CHARGED WITH REVIEWING THE CONFLICT OF INTEREST STATEMENTS EACH YEAR. THE REVIEW IS CONDUCTED AFTER THE ANNUAL BOARD MEETING IN APRIL. CONFLICT OF INTEREST REVIEWS OCCUR AT THE BEGINNING OF EACH BOARD AND COMMITTEE MEETING. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THOSE FOUND TO BE IN A CONFLICT OF INTEREST MUST ABSTAIN FROM VOTING AND MAY BE ASKED TO LEAVE THE MEETING DEPENDING ON THE TOPIC AND THEIR DEGREE OF CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 AUGUSTA HEALTH UTILIZES THE SERVICES OF INTEGRATED HEALTHCARE STRATEGIES, 901 MARQUETTE AVENUE SOUTH SUITE 2100 MINNEAPOLIS, MINNESOTA TO DETERMINE COMPETITIVE WAGE RANGES, VARIABLE COMPENSATION AND PREQUISITES FOR EXECUTIVE POSITIONS. IT IS THE GOAL OF THE AUGUSTA HEALTH BOARD TO SATISFY THE FOLLOWING OBJECTIVES: 1.) COMPETITIVENESS: THE PROCESS MUST PRODUCE COMPENSATION AND BENEFIT LEVELS THAT ENABLE THE BOARD TO ATTRACT AND RETAIN THE MANAGEMENT LEADERSHIP ESSENTIAL TO CARRYING OUT ITS MISSION. 2.) STRATEGIC ALIGNMENT: THE PROCESS MUST ALIGN EXECUTIVE COMPENSATION WITH THE INSTITUTION'S STRATEGIC GOALS. IT MUST REWARD MANAGEMENT FOR ACCOMPLISHING THESE GOALS. 3.) REGULATORY COMPLIANCE: THE PROCESS MUST ASSURE THAT THE INSTITUTION MEETS ITS CHARITABLE PURPOSE OBLIGATIONS TO REMAIN TAX-EXEMPT AND THEREFORE WILL REVIEW AND APPROVE ALL FORMS OF EXECUTIVE COMPENSATION AND BENEFITS IN A MANNER NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE INTERMEDIATE SANCTIONS RULES OF SECTION 4958 OF THE IRC SO AS TO AVOID THE IMPOSITION OF INTERMEDIATE SANCTIONS IN THE FORM OF EXCISE TAXES PENALTIES ON ITS TRUSTEES AND EXECUTIVES. 4.) PUBLIC TRUST: BOARD MEMBERS ARE INVESTED WITH A PUBLIC TRUST TO SHEPHERD INSTITUTIONAL ASSETS AS RESPONSIBLE FIDUCIARIES AND REPRESENTATIVES. THEREFORE, THE PROCESS MUST ASSURE THAT COMPENSATION AND BENEFIT LEVELS ARE REASONABLE, NOT EXCESSIVE, AND DEFENSIBLE IF AND WHEN SUBJECTED TO PUBLIC SCRUTINY. BASE SALARIES TARGETED AT THE 50TH PERCENTILE, WITH FLEXIBILITY TO PAY ABOVE OR BELOW THE 50TH PERCENTILE USING SALARY RANGES WITH A 50% RANGE SPREAD TO RECOGNIZE AN INCUMBENT'S INDIVIDUAL EXPERIENCE, SKILL, PERFORMANCE OR OTHER RELEVANT RECRUITMENT OR RETENTION FACTORS. INCENTIVE OPPORTUNITY LEVELS THAT, WHEN COMBINED WITH SALARIES POSITIONED AT THE 50TH PERCENTILE, ARE SUFFICIENT TO PROVIDE TOTAL CASH COMPENSATION THAT TARGETS UP TO THE APPROXIMATE MARKET 75TH PERCENTILE OF TOTAL CASH COMPENSATION LEVELS. TOTAL COMPENSATION SHALL NOT EXCEED THE 90TH PERCENTILE FOR ANY INDIVIDUAL WITHOUT FULL BOARD APPROVAL AND DOCUMENTATION OF THE BOARD'S REASONS FOR SUCH COMPENSATION. COMPENSATION, INDIVIDUAL PERFORMANCE AND COMPETITIVE DATA ARE REVIEWED ANNUALLY FOR ALL EXECUTIVE POSITIONS AS FOLLOWS: CEO CFO COO CNO CMO CIO PRESIDENT MEDICAL GROUP VICE PRESIDENT LEGAL AFFAIRS VP OF HUMAN RESOURCES VP OF PLANNING AND DEVELOPMENT THE BOARD OF DIRECTORS RECEIVED A FULL REPORT FROM THE EXECUTIVE COMMITTEE ON THE FULL COMPENSATION PROGRAM AT AUGUSTA HEALTH IN AN EXECUTIVE SESSION OF THE BOARD. CONFLICTED MEMBERS WERE EXCUSED FROM THE MEETING. MATERIAL COVERED INCLUDED THE DESIGN OF THE COMPENSATION PROGRAM, AS WELL AS ACTUAL BASE SALARIES, MARKET BENCHMARK DATA, AND INCENTIVE COMPENSATION EARNED BY EACH EXECUTIVE. ADDITIONALLY, PREREQUISITES SUCH AS THE SERP PROGRAM AND OTHER RELATED BENEFITS WERE REVIEWED WITH THE BOARD. FOR THOSE MEMBERS WHO WERE NOT PRESENT FOR THIS MEETING AND REMAINED FREE OF CONFLICT OF INTEREST, THE CHAIRMAN OF THE BOARD PRESENTED THE SAME MATERIAL IN A SEPARATE SESSION. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ACCOUNTING OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ACCOUNTING OFFICE. PLEASE DIRECT ALL REQUESTS TO: AUGUSTA HEALTH CARE, INC. ATTN: CORPORATE CONTROLLER P.O. BOX 1000 FISHERSVILLE, VA 22939-1000 FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 10,373,354. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,373,354. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 7,754,649. MANAGEMENT AND GENERAL EXPENSES 4,270,491. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,025,140. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 4,352,675. MANAGEMENT AND GENERAL EXPENSES 2,512,917. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,865,592. CONSULTANTS: PROGRAM SERVICE EXPENSES 1,965,582. MANAGEMENT AND GENERAL EXPENSES 872,420. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,838,002. OTHER FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 3,010,692. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,010,692. FORM 990, PART XI, LINE 9: EQUITY TRANSFERS BETWEEN AFFILIATES -687,076. CHANGE IN NET ASSETS OF SHENANDOAH HOUSE 93,257. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART VII BOARD MEMBER JOSEPH RANZINI IS PAID AS AN EMPLOYEE OF AUGUSTA MEDICAL GROUP, A RELATED ORGANIZATION AND NOT COMPENSATED FOR HIS BOARD MEMBER SERVICE. AUGUSTA CARE PARTNERS LLC 78 MEDICAL CENTER DR FISHERSVILLE VA 22939 462840076 HEALTHCARE VA 0 0 AHC COMMUNITY HEALTH FOUNDATION PO BOX 1000 FISHERSVILLE VA 22939 542042365 SUPPORTING ORGANIZATION VA 501(C)(3) LINE 12A, I AUGUSTA HEALTH CARE INC 1 AUGUSTA MEDICAL GROUP PO BOX 1000 FISHERSVILLE VA 22939 262559916 HEALTHCARE VA 501(C)(3) LINE 10 AUGUSTA HEALTH CARE INC 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 1 1 AUGUSTA MEDICAL GROUP A 726811 AUGUSTA MEDICAL GROUP Q 13400000 AUGUSTA HEALTH FOUNDATION C 938645 AUGUSTA HEALTH FOUNDATION R 687076 AUGUSTA MEDICAL GROUP O 541906