2016-05-13T07:39:57-05:00 2015-06-30 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 31708 990 2014-07-01 581973570 FLOYD HEALTHCARE MANAGEMENT INC FLOY 7065096074 304 TURNER MCCALL BLVD ROME GA 301620233 RICHARD T SHEERIN CFO 7065096074 2016-05-16 true JACQUELINE G ATKINS P00861721 2298837878 2016-05-13 2014 2016-08-17 19:52:53Z KURT STUENKEL 304 TURNER MCCALL BLVD ROME GA 301620233 397407500 false X WWW.FLOYD.ORG X 1990 GA OPERATE A NON-PROFIT HOSPITAL SYSTEM AND SUPPORT 501 (C)(3)ORGANIZATIONS 17 13 3843 198 997393 372598 452870 288195 333335915 360754945 5852093 5729074 4874855 330294 344515733 367102508 1508266 1611141 0 181353568 187507563 0 197884 148507526 150688941 331369360 339807645 13146373 27294863 361388788 379641237 215720786 215622681 145668002 164018556 OPERATE A NON-PROFIT HOSPITAL SYSTEM AND SUPPORT 501 (C)(3)ORGANIZATIONS false false 263540267 1611141 359825475 FLOYD HEALTHCARE MANAGEMENT, INC. OPERATES FLOYD MEDICAL CENTER, A GENERAL ACUTE CARE HOSPITAL, AND FLOYD BEHAVIORAL HEALTH CENTER, A PSYCHIATRIC UNIT. SEE ADDITIONAL DISCLOSURES AT SCHEDULE O, "SUPPLEMENTAL INFORMATION TO FORM 990". 263540267 true true false true false false false false false false true false false false true true false true false false false false false false false false true true true true true true false false false false false true true false true true false false false false true true false false false true 117 0 3843 true true true false false false false false false false false false X 17 13 false false false false false true false true true false false true true true true true false true true true true GA X RICHARD T SHEERIN 7065096074 304 TURNER MCCALL BLVD ROME GA 30161 X KURT STUENKEL PRES/SECRE/C 50.00 2.00 X X 1559023 0 49041 ROBERT HOLCOMBE JR MD DIRECTOR 41.00 1.00 X 346644 0 22443 JAMES COLLINS JR MD DIRECTOR 41.00 1.00 X 298018 0 10525 ANNE LULE MD DIRECTOR 1.00 X 166864 0 15531 BRAD WARD MD DIRECTOR 41.00 1.00 X 103793 0 8800 GEORGE BOSWORTH MD CHAIRMAN 1.00 2.00 X X 5225 3250 0 JOHN SAM FREEMAN DIRECTOR 1.00 1.00 X 4375 2750 0 J ROGER SUMNER PAST CHAIRMA 1.00 1.00 X 4000 2750 0 DAVID JOHNSON DIRECTOR 1.00 1.00 X 6600 0 0 KAY CHUMBLER VICE CHAIRMA 1.00 2.00 X X 5250 0 0 LARRY KUGLAR DIRECTOR 1.00 1.00 X 2875 2250 0 FRANK SHELLEY DIRECTOR 1.00 1.00 X 2625 2500 0 TIM MAHANAY DIRECTOR 1.00 1.00 X 4500 0 0 GARRY FRICKS DIRECTOR 1.00 1.00 X 4029 0 0 CARL HERRING MD DIRECTOR 1.00 1.00 X 2625 0 0 MARK MANIS DIRECTOR 1.00 1.00 X 0 0 0 RHONDA WALLACE DIRECTOR 1.00 1.00 X 0 0 0 RICHARD T SHEERIN CFO 50.00 5.00 X 475853 0 37085 JOSEPH BIUSO MD VP & CMO 40.00 X 546647 0 51296 WARREN RIGAS SVP COO 40.00 X 477600 0 37428 C WADE MONK GENERAL COUN 40.00 0.00 X 417249 0 50744 SHEILA HORNER VP & CNO 40.00 0.00 X 343464 0 8818 GREG POLLEY VICE PRESIDE 40.00 0.00 X 325082 0 46645 REBEKAH LOWREY MD SURGICAL DIR 40.00 X 263146 0 6470 BETH BRADFORD CHIEF HR OFF 40.00 X 262792 0 9018 JEFFERY D BUDA CHF INFORMAT 40.00 X 247834 0 19529 ALISON LAND VICE PRESIDE 40.00 0.00 X 243628 0 27522 DAVID EARLY DIRECTOR SUP 40.00 X 225375 0 17947 JULIE ROGERS CORP COMPLIA 40.00 0.00 X 225209 0 22356 ROBERT PURCELL PHARMACY DIR 40.00 0.00 X 209098 0 23646 DAN SWEITZER VP MARKET DE 40.00 0.00 X 172937 0 6150 JOHN HARDWELL MD PHYSICIAN 40.00 X 818243 0 22156 MOLLY VICCHRILLI MD PHYSICIAN 40.00 X 523054 0 21456 LOUIS A SPENCER MD PHYSICIAN 40.00 X 515093 0 20697 NADIA MEYER MD PHYSICIAN 40.00 X 507662 0 25879 MATTHEW T CORNFORTH MD PHYSICIAN 40.00 X 474942 0 9028 9791354 13500 570210 205 false true false BRASFIELD AND GORRIE LLC PO BOX 11407 BIRMINGHAM AL 352461407 GEN CONTRACTOR 9907657 CERNER CORP PO BOX 412702 KANSAS CITY MO 641412702 IT SERVICES 5735243 ARAMARK MANAGEMENT SERVICES PO BOX 233 ROME GA 301610233 LAUNDRY 4701896 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 303682289 DIETARY SVC 4168450 IN COMPASS HEALTH INC 318 MAXWELL ROAD SUITE 500 ALPHARETTA GA 30009 HOSPITALIST 3748282 63 260000 28195 288195 PATIENT SERVICE REVENUE 623000 358232187 358232187 FAMILY PRACTICE CAPITATION 621990 1525365 1525365 REFERENCE LAB 621500 997393 997393 360754945 6021067 6021067 433386 223867 209519 209519 209519 29702843 86289 29959362 121763 -256519 -35474 -291993 -291993 CAFETERIA 722513 52852 52852 PURCHASE DISCOUNTS 621990 26075 26075 FAMILY PRACTICE REVENUE 621110 23386 23386 18462 18462 120775 367102508 359825475 997393 5991445 X 1430231 1430231 180910 180910 7240969 7240969 142858309 119066878 23636214 155217 2999006 2486608 509274 3124 24334354 19633253 4676436 24665 10074925 7509945 2553730 11250 560539 560539 526484 526484 32759 32759 34759833 26735563 8024270 1772999 192543 1580456 7382214 4579314 2799986 2914 7693271 1248001 6445270 13083345 10566486 2516859 3533320 1299120 2233486 714 582775 448900 133875 237615 237615 22256129 19122466 3133663 4131082 987697 3143385 MEDICAL SUPPLIES 43772085 43661335 110750 REPAIRS & MAINTENANCE 4291531 2720075 1571456 LICENSE & TAXES 3843713 126447 3717266 DUES & SUBSCRIPTIONS 1147021 339209 807812 1082226 1172527 -90301 339807645 263540267 76069494 197884 3869580 20495334 44039612 57088179 65869855 52714943 72871 45924 790348 680725 9727134 9320766 2993776 3858931 345459632 189086138 168266309 156373494 61485969 72693088 1583919 2841319 948989 857151 1740426 2671383 361388788 379641237 37272117 35345470 120301042 117727660 32225769 25897882 25921858 36651669 215720786 215622681 X 145668002 164018556 145668002 164018556 361388788 379641237 X 27294863 -175244 -8769065 X false true X true false X SUPPLEMENTAL INFORMATION SCHEDULE A, PART IV - REASON FOR NON-PRIVATE FOUNDATION STATUS ON JANUARY 1, 1998 FLOYD HEALTHCARE MANAGEMENT, INC. ACQUIRED BY LEASE ALL OF THE ASSETS OF THE HOSPITAL AUTHORITY OF FLOYD COUNTY AND THEREBY BECAME THE LICENSED OPERATOR OF FLOYD MEDICAL CENTER, A GENERAL, ACUTE CARE HOSPITAL WITH 300+ BEDS. SINCE THAT TIME, FLOYD HEALTHCARE MANAGEMENT, INC. HAS CONTINUED TO OPERATE FLOYD MEDICAL CENTER AS A NON-PROFIT HOSPITAL, OFFERING A WIDE ARRAY OF SERVICES TO THE COMMUNITY, INCLUDING AN EMERGENCY ROOM WHICH SEES APPROXIMATELY 76,000 PATIENTS PER YEAR AND A BUSY OUTPATIENT INDIGENT CLINIC. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 32759 32759 false SCHEDULE C, PART II-B, LINE 1 THE ORGANIZATION PAYS MEMBERSHIP DUES TO NATIONAL AND STATE ORGANIZATIONS. A PORTION OF THOSE DUES IS ALLOCATED TO LOBBYING ACTIVITIES IN WHICH THOSE ORGANIZATIONS PARTICIPATE. 12929005 12929005 119650864 44936796 74714068 15069935 10252280 4817655 190441088 133897062 56544026 7368740 7368740 156373494 ACCRUED PENSION 23741527 MALPRACTICE CLAIMS 7103448 THIRD PARTY SETTLEMENTS 3129150 ACCRUED INTEREST 2677544 36651669 X SCHEDULE D, PAGE 3, PART X THE CORPORATION IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE CORPORATION APPLIES 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, THE CORPORATION ONLY RECOGNIZES THE 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 RECOGNIZED FOR THE 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 THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF JUNE 30, 2015 AND 2014 OR FOR THE YEARS THEN ENDED. THE CORPORATION'S 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 OF THOSE RETURNS. true true X true X 1.250000000000 true X 3.250000000000 true true false true true 23393583 23393583 0.06880 58592742 52193512 6399230 0.01880 81986325 52193512 29792813 0.08760 186210 186210 0.00050 6658510 3126970 3531540 0.01040 1310307 1310307 0.00390 946626 3360 943266 0.00280 9101653 3130330 5971323 0.01760 91087978 55323842 35764136 0.10520 true 30538511 16185411 81690431 82509608 -819177 X true true 1 1 FLOYD HEALTHCARE MANAGEMENT INC FLOYD MEDICAL CENTER 304 TURNER MCCALL BLVD ROME GA 301620233 WWW.FLOYD.ORG 057-556 X X X X HOSPICE, CLINICS, REHAB, PSYCH FLOYD HEALTHCARE MANAGEMENT INC 1 false false true X X X X X X X 14 true false false true X WWW.FLOYD.ORG X X true 14 false true false true X 125.000000000000 325.000000000000 X X true true X X X X true X X X true X true X X X X true X false false FACILITY 1, FLOYD HEALTHCARE MANAGEMENT INC. - PART V, LINE 5 THE INTERESTS OF THE COMMUNITIES WERE ENLISTED THROUGH A SURVEY PROCESS, COMMUNITY FORUMS, AND DIRECT INPUT FROM REPRESENTATIVES OF THE GEORGIA DEPARTMENT OF PUBLIC HEALTH. THE SURVEY PROCESS WAS COMPLETED ON A CONVENIENCE BASIS AT PUBLIC EVENTS USING AN INSTRUMENT DESIGNED TO CAPTURE THE PUBLIC'S PERCEPTION OF HEALTH AND HEALTHCARE SERVICES IN THE COMMUNITY. THE SURVEY INSTRUMENT AND RESULTS ARE INCLUDED IN THE CHNA. THE INTERESTS OF THE COMMUNITY ARE ALSO REPRESENTED IN THE CHNA THROUGH PRIMARY DATA COLLECTED AT PUBLIC INPUT SESSIONS HELD IN EACH COUNTY. CARE WAS TAKEN TO INVITE A CROSS-SECTION OF THE COMMUNITY WITH REPRESENTATIVES FROM BUSINESS, HEALTHCARE, NON-PROFITS, PUBLIC HEALTH, LOCAL GOVERNMENT, AND EDUCATIONAL INSTITUTIONS. DISTRICT PUBLIC HEALTH REPRESENTATIVES WERE ASKED TO REVIEW RAW DATA AND PROVIDE ASSISTANCE DEVELOPING PRIORITY NEEDS. FACILITY 1, FLOYD HEALTHCARE MANAGEMENT INC. - PART V, LINE 7D THE 2014 CHNA HAS BEEN DISTRIBUTED UPON REQUEST TO OTHER NON-PROFIT AGENCIES IN THE AREA TO ASSIST WITH GRANTS. COPIES HAVE ALSO BEEN MADE AVAILABLE TO ELECTED OFFICIALS, CHAMBERS OF COMMERCE, AND EDUCATIONAL INSTITUTIONS IN THE AREA. A LINK TO THE 2014 CHNA AND IMPLEMENTATION PLAN CAN BE FOUND ON THE ORGANIZATION'S WEBSITE AT HTTP://FLOYDSTRAIGHTFORWARD.ORG/LIBRARY/2011- COMMUNITY-HEALTH-ASSESSMENT-REPORT. FACILITY 1, FLOYD HEALTHCARE MANAGEMENT INC. - PART V, LINE 22D FLOYD USES A SLIDING SCALE BASED ON FEDERAL POVERTY GUIDELINES. 2 FLOYD HEYMAN HOSPICE P O BOX 233 ROME GA 30165 HOME HOSPICE CARE FLOYD EMERGENCY MEDICAL SERVICES P O BOX 233 ROME GA 30165 EMERGENCY SERVICES PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN (F), THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25: FORM 990, PART IX, LINE 25 339,807,647 ADD: EXPENSES REPORTED IN PART VIII 223,867 DENOMINATOR FOR COLUMN (F) 340,031,514 PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATION'S "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS, 2008". SEE ALSO THE DESCRIPTION FOR PART III, LINE 2. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE. THE FIGURE ON PART III LINE 3 REPRESENTS MANAGEMENT'S ESTIMATE (APPROXIMATELY 53%) BASED ON AN ANALYSIS OF SELF PAY PATIENTS' ABILITY TO PAY THEIR OUTSTANDING ACCOUNT. THIS ANALYSIS INCLUDES REVIEWING THE PATIENT'S CREDIT HISTORY, INCOME LEVELS AND OVERALL COLLECTIBILITY OF THE ACCOUNT. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE CORPORATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS, SERVICE DATES, AND SERVICE TYPE AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY, BASED ON THE ANTICIPATED REIMBURSEMENT. MANAGEMENT ALSO REVIEWS SUBSEQUENT COLLECTION ACTIVITY TO ASSESS THE ACCURACY OF THE ALLOWANCE ESTIMATED. THE ALLOWANCE ASSOCIATED WITH THESE ACCOUNTS DECREASED SIGNIFICANTLY IN 2015. DURING 2014, THE CORPORATION CHANGED MANY PROCESSES SURROUNDING THE BILLING AND COLLECTING OF THESE ACCOUNTS. THESE CHANGES CAUSED AN INCREASE IN THE PATIENT RECEIVABLES AT THE END OF 2014 THAT CAUSED AN INCREASE IN THE ALLOWANCES OVERALL. IN 2015 THESE RECEIVABLES DECREASED AS DID THE ALLOWANCE ASSOCIATED WITH THEM. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF PRIOR PAYMENTS, SERVICE DATE, SERVICE TYPE, AND ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITAL AND PMCI'S COMBINED ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF- PAY PATIENTS WAS 95% AND 97% OF SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2015 AND 2014, RESPECTIVELY. IN ADDITION, THE HOSPITAL AND PMCI'S COMBINED SELF-PAY WRITE OFFS, INCLUDING WRITE OFFS FOR CHARITY AND INDIGENT PATIENTS, INCREASED APPROXIMATELY 11,000,000 FROM 119,000,000 FOR FISCAL YEAR 2014 TO 130,000,000 FOR FISCAL YEAR 2015. THE INCREASE IN WRITE OFFS WAS MOSTLY ATTRIBUTED TO THE HOSPITAL PROCESSING MORE SELF-PAY CLAIMS, WHICH RESULTED IN MORE CLAIMS BEING SENT THROUGH THE COLLECTIONS PROCESS AND WRITTEN OFF. THE HOSPITAL DID NOT CHANGE ITS CHARITY CARE AND UNINSURED DISCOUNT POLICIES DURING FISCAL YEARS 2014 OR 2015. PART III, LINE 8 - MEDICARE EXPLANATION 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. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION FOR PATIENTS RECEIVING ONLY A PORTION OF THEIR BILL AS CHARITY, THE REMAINING PORTION OF THE BILL IS TREATED THE SAME AS ALL OTHER PATIENTS IN REGARDS TO COLLECTIONS. PART VI, LINE 2 - NEEDS ASSESSMENT FLOYD HEALTHCARE MANAGEMENT, INC. ("FHMI") COMPLETED A HEALTH CARE NEEDS ASSESSMENT IN CHATTOOGA, FLOYD, AND POLK COUNTIES IN FISCAL YEAR 2014. THIS INCLUDED A RANDOM PAPER SURVEY OF RESIDENTS OF EACH COUNTY AS WELL AS INTERVIEWS WITH COMMUNITY LEADERS AND HEALTH CARE PROFESSIONALS AND FOCUS GROUPS. IN ADDITION, FHMI DEVELOPS A STRATEGIC PLAN THAT IS UPDATED ANNUALLY. THE STRATEGIC PLAN TAKES INTO CONSIDERATION HEALTH NEEDS FOR OUR SERVICE AREA IN ADDITION TO UTILIZATION OF SERVICES, COMMUNITY PARTICIPATION, AND QUALITY OF SERVICES PROVIDED. BOTH THE 2014 CHNA AND IMPLEMENTATION PLAN ARE POSTED ON THE FACILITY'S HOME WEBPAGE. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE FHMI COMMUNICATES THIS INFORMATION THROUGH SIGNAGE IN THE EMERGENCY CARE CENTER, PATIENT REGISTRATION AREAS, IN THE BUSINESS/PATIENT FINANCIAL SERVICES OFFICES, AND IN THE OFFICES OF OUR FINANCIAL COUNSELORS. DURING TIMES OF PREADMISSION AS WELL AS ON-SITE REGISTRATION THE ACCESS/REGISTRATION STAFF DISCUSS POLICIES WITH THE PATIENT/PATIENT'S FAMILY IF APPROPRIATE. AFTER DISCHARGE AND DURING THE "COLLECTION" PERIOD OUR STAFF ONCE AGAIN DISCUSS OUR FINANCIAL ASSISTANCE POLICIES. IN ADDITION THERE IS A DEMONSTRATED WORD-OF-MOUTH COMMUNICATION OF THESE POLICIES THROUGH OUR PATIENT POPULATION. PART VI, LINE 4 - COMMUNITY INFORMATION LOCATED IN NORTHWEST GA, FHMI DBA FLOYD MEDICAL CENTER ("FMC") IS BASED IN ROME, GA, WHICH IS THE COUNTY SEAT FOR FLOYD COUNTY, ABOUT 60 MILES NORTH OF ATLANTA AND 60 MILES SOUTH OF CHATTANOOGA, TN. THE 162,135 (2014 ESTIMATE) RESIDENTS OF THE THREE-COUNTY REGION ARE SERVED BY FMC AND TWO SMALLER HOSPITALS. THE POPULATION BASE IS APPROXIMATELY 76% CAUCASIAN, 13% AFRICAN AMERICAN, 9% HISPANIC OR LATINO AND 2% OTHER ETHNICITIES. NORTHWEST GA IS A MEDICAL AND EDUCATIONAL HUB. THREE OF THE LARGEST EMPLOYERS IN THE THREE-COUNTY AREA ARE HEALTH CARE PROVIDERS. THE AREA IS ALSO HOME TO FOUR POST-SECONDARY EDUCATIONAL INSTITUTIONS. STILL, THE MANUFACTURING SECTOR REMAINS AN ECONOMIC FORCE IN THE AREA. THE UNEMPLOYMENT RATE FOR THE THREE-COUNTY AREA WAS 7% IN 2014, AND ALMOST 23% OF RESIDENTS ARE BELOW THE FEDERAL POVERTY LEVEL. SLIGHTLY MORE THAN ONE-FOURTH OF THE ADULT POPULATION (26.8%) HAS NOT GRADUATED HIGH SCHOOL. THE PRIMARY CAUSES OF DEATH IN THESE COUNTIES ARE: "ISCHEMIC HEART AND VASCULAR DISEASE "MALIGNANT NEOPLASMS OF THE TRACHEA, BRONCHUS AND LUNG "COPD "CEREBROVASCULAR DISEASE "ALZHEIMER'S DISEASE "ACCIDENTAL POISONING AND EXPOSURE TO NOXIOUS SUBSTANCES "SUICIDE "FALLS PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH FHMI IS THE SAFETY-NET HEALTH CARE PROVIDER FOR NORTHWEST GEORGIA. IN ADDITION TO PROVIDING EMERGENCY CARE SERVICES, FMC HAS GONE THE EXTRA STEP OF PROVIDING 24-HOUR COVERAGE FOR SURGERY AND OTHER SERVICES TO MAINTAIN STATUS AS A LEVEL II TRAUMA CENTER. FHMI IS ALSO THE SITE FOR THE REGIONAL POISON CONTROL CENTER, HOUSES THE REGION'S ONLY LEVEL III NEONATAL INTENSIVE CARE UNIT, AND OPERATES A FAMILY MEDICINE RESIDENCY PROGRAM THAT OPERATES THE FLOYD COUNTY CLINIC TO PROVIDE BASIC HEALTH CARE SERVICES FOR THE ECONOMICALLY DISADVANTAGED IN THE COMMUNITY. IN ADDITION TO THESE SERVICES, FHMI ACTIVELY PROMOTES HEALTH AND SAFETY THROUGHOUT THE COMMUNITY THROUGH VARIOUS COMMUNITY BENEFIT ACTIVITIES, PRIMARILY THROUGH THE PROVISION OF INDIGENT AND CHARITY CARE TO UNDER-INSURED AND UNINSURED PATIENTS. IN ADDITION, FLOYD IS ACTIVE IN THE COMMUNITY PROVIDING SCHOOL- BASED CHILD SAFETY PROGRAMS; MOBILE MAMMOGRAPHY; CHILDBIRTH CLASSES; COMMUNITY HEALTH SCREENINGS AND HEALTH FAIRS; HEALTH CARE INTERNSHIPS; EXTERNSHIPS AND SHADOWING OPPORTUNITIES; AND SUPPORT FOR COMMUNITY-WIDE INITIATIVES WITH HEALTH PARTNERS INCLUDING THE NORTHWEST GEORGIA CANCER COALITION, CANCER NAVIGATORS, AND THE FREE CLINIC OF ROME. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM FLOYD HEALTHCARE MANAGEMENT, INC. (FHMI) OPERATES FLOYD MEDICAL CENTER (FMC), A GENERAL ACUTE CARE HOSPITAL, AND FLOYD BEHAVIORAL HEALTH CENTER, A PSYCHIATRIC UNIT. THESE TWO FACILITIES SERVE THE AREAS OF FLOYD COUNTY AND THE NORTHWEST GEORGIA REGION. OTHER AFFILIATED ORGANIZATIONS INCLUDE: - HOSPITAL AUTHORITY OF FLOYD COUNTY - A NONPROFIT ORGANIZATION THAT SUPPORTS FMC AND OPERATES POLK MEDICAL CENTER, A 25-BED, CRITICAL ACCESS HOSPITAL LOCATED IN CEDARTOWN, GA. - FLOYD HEALTHCARE RESOURCES, INC. - A NONPROFIT ORGANIZATION WHICH FACILITATES THE OPERATIONS OF FMC FOR THE BENEFIT OF CITIZENS LOCATED IN FLOYD COUNTY AND THE NORTHWEST GEORGIA REGION. - HOSPITAL AUTHORITY OF FLOYD COUNTY SELF INSURANCE TRUST - A NONPROFIT ORGANIZATION THAT SUPPORTS THE HOSPITAL AUTHORITY OF FLOYD COUNTY. THIS ORGANIZATION PROVIDES FUNDING TO SATISFY MALPRACTICE AND COMPREHENSIVE GENERAL PATIENT CLAIMS AGAINST THE AUTHORITY AND FHMI. - FLOYD HEALTH CARE FOUNDATION, INC. - A NONPROFIT ORGANIZATION THAT PROMOTES HEALTH CARE BY PROVIDING SUPPORT TO TAX-EXEMPT HEALTH CARE ORGANIZATIONS AND PUBLIC CHARITIES IN AND AROUND THE ROME, GEORGIA AREA. - POLK MEDICAL CENTER, INC. - A 25-BED, CRITICAL ACCESS HOSPITAL WHICH PROVIDES INPATIENT AND OUTPATIENT SERVICES. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT GEORGIA true HOSPITAL AUTHORITY OF FLOYD COUNTY 304 TURNER MCCALL BLVD ROME GA 301610233 586001173 501C3 1430231 PENSION PLAN FUNDING 1 COBRA INSURANCE PREMIUM 14 62770 TUITION 29 118140 SCHEDULE I, PAGE 1, PART I, LINE 2 IT IS THE POLICY OF THE ORGANIZATION TO ESTABLISH PROCEDURES TO POTENTIALLY SECURE PAYMENT FOR HEALTHCARE SERVICES VIA EXTENSION OF INSURANCE BENEFITS THROUGH COBRA. THIS EXTENSION OF INSURANCE COVERAGE WILL BE PROVIDED ON A CASE-BY-CASE BASIS. THE HOSPITAL'S ROLE IN COVERAGE PAYMENT WILL BE REVIEWED MONTHLY; THERE IS NO OBLIGATION FOR THE HOSPITAL TO CONTINUE COVERAGE PAYMENT BEYOND THE INITIAL STATED LENGTH. THIS COVERAGE PAYMENT IS NOT TYPICALLY INTENDED FOR LONGER THAN A SPECIFIC SERVICE EVENT. IN GENERAL, ASSIGNED STAFF WILL EXAMINE PATIENTS FOR POTENTIAL QUALIFICATION FOR THIS PROGRAM. UPON QUALIFICATION, PAYMENT OF THE INSURANCE PREMIUM IS MADE TO THE EMPLOYER/INSURANCE COMPANY. PATIENT LIABILITY WILL BE EVALUATED AND DISCUSSED WITH THE PATIENT/GUARANTOR PRIOR TO DISCHARGE. THIS DISCUSSION WILL FOLLOW THE SAME PROTOCOL AS OTHER PATIENTS WITH RESIDUAL LIABILITIES. FINALLY, A 1099 TAX FORM IS ISSUED TO THE PATIENT. TUITION POLICY: THE ORGANIZATION PROVIDES OPPORTUNITIES FOR TRAINING, DEVELOPMENT, AND ADVANCEMENT WHICH ARE CONSISTENT WITH INDIVIDUAL ABILITY AND PERFORMANCE AS WELL AS BUDGETARY LIMITATIONS AND NEEDS OF THE ORGANIZATION. FHMI WILL SHARE IN THE COST OF TUITION AND BOOKS FOR CLASSROOM AND/OR CORRESPONDENCE COURSES FOR ELIGIBLE EMPLOYEES. THE EDUCATION MUST BE DIRECTLY RELATED TO THE EMPLOYEE'S DUTIES OR A POSITION TO WHICH THE EMPLOYEE MIGHT REASONABLY BE EXPECTED TO PROGRESS BY REASON OF PROMOTION. APPROVAL FROM THE EMPLOYEE'S DEPARTMENT HEAD, HUMAN RESOURCES DIRECTOR, AND APPLICABLE VICE PRESIDENT MUST BE GRANTED PRIOR TO ENROLLMENT, AND A GRADE OF B OR HIGHER MUST BE MAINTAINED. ALL EDUCATIONAL ASSISTANCE WILL BE SET UP AS A "FORGIVABLE LOAN" CONTRACT BETWEEN THE EMPLOYEE AND FHMI. THE LOAN WILL BE REPAID BY SERVICE. REIMBURSEMENT IS MADE SUBJECT TO RECEIPTS AND PROOF OF AWARDED GRADES. X X true true X X X X X false true false false false false false false false KURT STUENKEL PRES/SECRE/CEO 646282 294288 618453 19409 29632 1608064 ROBERT HOLCOMBE JR MD DIRECTOR 198622 146276 1746 22443 369087 JAMES COLLINS JR MD DIRECTOR 199058 93915 5045 10525 308543 ANNE LULE MD DIRECTOR 130007 36277 580 15531 182395 RICHARD T SHEERIN CFO 348998 123583 3272 15583 21502 512938 JOSEPH BIUSO MD VP & CMO 380789 162262 3596 19921 31375 597943 WARREN RIGAS SVP COO 347845 126483 3272 16177 21251 515028 C WADE MONK GENERAL COUNSEL 299907 113036 4306 20332 30412 467993 SHEILA HORNER VP & CNO 252950 88228 2286 8818 352282 GREG POLLEY VICE PRESIDENT 220602 101385 3095 15544 31101 371727 REBEKAH LOWREY MD SURGICAL DIRECTOR 227357 32703 3086 6470 269616 BETH BRADFORD CHIEF HR OFFICER 225004 34699 3089 9018 271810 JEFFERY D BUDA CHF INFORMATION OFCR 222262 24551 1021 19529 267363 ALISON LAND VICE PRESIDENT 189483 53551 594 7975 19547 271150 DAVID EARLY DIRECTOR SUPPORT SVC 197646 27220 509 17947 243322 JULIE ROGERS CORP COMPLIANCE OFCR 152273 71547 1389 22356 247565 ROBERT PURCELL PHARMACY DIRECTOR 185413 22823 862 9933 13713 232744 DAN SWEITZER VP MARKET DEVELOP 101135 68900 2902 6150 179087 JOHN HARDWELL MD PHYSICIAN 604624 212880 739 22156 840399 MOLLY VICCHRILLI MD PHYSICIAN 405838 116477 739 21456 544510 LOUIS A SPENCER MD PHYSICIAN 513332 51 1710 20697 535790 NADIA MEYER MD PHYSICIAN 299337 207946 379 25879 533541 MATTHEW T CORNFORTH MD PHYSICIAN 225436 249186 320 9028 483970 SCHEDULE J, PAGE 1, PART I, LINE 1A TRAVEL FOR COMPANIONS SPOUSAL TRAVEL EXPENSES ARE REIMBURSED WHEN ATTENDANCE IS NECESSARY AND APPROPRIATE. THE POLICY RECOGNIZES THAT GOVERNING BOARD MEMBERS AND SENIOR EXECUTIVES ARE OFTEN PLACED IN SOCIAL SITUATIONS AT SUCH MEETINGS AND WOULD REPRESENT THE HOSPITAL OPTIMALLY WITH THE ASSISTANCE OF THEIR SPOUSES. CONSEQUENTLY, THESE BENEFITS ARE NOT INCLUDED IN THEIR TAXABLE WAGES. SPOUSAL TRAVEL EXPENSES REQUIRE PRIOR APPROVAL AND ARE LIMITED TO EVENTS WHERE BOARD MEMBERS AND SENIOR EXECUTIVES ATTEND. REIMBURSEMENT SHALL BE LIMITED TO TRANSPORTATION EXPENSE NOT TO EXCEED THE AIR TRAVEL RATE IN COACH CLASS AND OUT-OF-POCKET EXPENSES WITH RESPECT TO LODGING AND FOOD. REIMBURSEMENT SHALL BE LIMITED TO LODGING BASED ON DOUBLE ACCOMMODATIONS. FLOYD HEALTHCARE MANAGEMENT, INC. (FHMI) PROVIDES THE CEO WITH A MONTHLY AUTO ALLOWANCE. EACH YEAR THE AMOUNT THAT IS NONBUSINESS RELATED IS INCLUDED IN TAXABLE INCOME. FHMI PROVIDES A MEMBERSHIP TO THE LOCAL COUNTRY CLUB FOR THE CEO AND CMO. ANY AMOUNT CONSIDERED NONBUSINESS IS INCLUDED IN THE RECIPIENT'S TAXABLE INCOME. SCHEDULE J, PAGE 1, PART I, LINE 4 KURT STUENKEL 0 608,759 0 SCHEDULE J, PART III THE CEO PARTICIPATES IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WHICH IS FUNDED ANNUALLY IN AN AMOUNT WHICH, WHEN ADDED TO OTHER SOURCES OF RETIREMENT INCOME, WILL AFFORD A RETIREMENT INCOME AT A TARGETED PERCENTAGE OF PRE-RETIREMENT COMPENSATION. THE SERP IS A NON-QUALIFIED RETIREMENT PLAN, AND AS SUCH THE ANNUAL FUNDING PAYMENTS PAID INTO IT ARE TAXABLE TO THE PARTICIPANT IN THE YEAR IN WHICH MADE. EFFECTIVE WITH CALENDAR YEAR 2009, MR. STUENKEL'S SERP IS A CASH-BASED PROGRAM. ADDITIONALLY, OF THE 1,599,022 LISTED AS W-2 COMPENSATION FOR MR. KURT STUENKEL ON PART VII SECTION A COLUMN (D), 608,759 REPRESENTS THE NONQUALIFIED SERP PLAN. ACCORDINGLY, MR. STUENKEL'S SALARY FOR 2014 WOULD HAVE BEEN 950,263 EXCLUDING THE 2014 SERP PLAN AMOUNT. BONUS/INCENTIVE PAY ALL MEMBERS OF THE EXECUTIVE TEAM FOR FHMI PARTICIPATE IN AN INCENTIVE COMPENSATION PLAN UNDER WHICH ANNUAL YEAR-END BONUSES ARE PAID BASED ON INDIVIDUAL AND CORPORATE-WIDE ACHIEVEMENT OF SPECIFIC GOALS AND OBJECTIVES. ONE OF THE GOALS RELATES TO THE RELATED ORGANIZATION'S NET INCOME. THE BONUSES ARE AWARDED ON A CASH-BASED SYSTEM. A HOSPITAL AUTHORITY OF FLOYD COUNTY REVENUE CERTIFICATES 2003 586001973 343575ER3 2003-12-17 40000000 HOSPITAL IMPROVEMENTS false false false B HOSPITAL AUTHORITY OF FLOYD COUNTY 2009 REVENUE ANTICIPATION BONDS 586001973 343575FQ4 2009-06-30 40000000 IMPROVEMENTS/DEFEASE 2005-2006 BONDS false false false C HOSPITAL AUTHORITY OF FLOYD COUNTY REVENUE BOND SERIES 2012 A 586001173 343575GH3 2012-06-27 20000000 CAPITAL IMPROVEMENTS false false false D HOSPITAL AUTHORITY OF FLOYD COUNTY REVENUE BONDS SERIES 2012B 586001173 343575GY6 2012-06-27 31885000 DEFEASE 2003 REVENUE SERIES BONDS false false false A 14010000 40710583 1572553 25989711 576451 12571868 2004 false false true true B 40232146 1332751 18595720 588380 18170340 2010 false false true true C 750000 20074922 279011 243560 19552351 2013 false false true true D 2165000 34970725 444814 36387986 388296 1777 2013 false false true true A false false false false false false true B false false false false false false true C false false false false false false true D false false false false false false true A false false false false false false false false false B false false false false false false false false false C false false false false false false false false false D false false false false false false false false false A false B false C false D false SCHEDULE K - DIFFERENCES IN ISSUE PRICE EXPLANATION HOSPITAL AUTHORITY OF FLOYD COUNTY THE DIFFERENCE IN THE ISSUE PRICE REPORTED IN SCHEDULE K PART I AND TOTAL PROCEEDS OF ISSUE REPORTED IN SCHEDULE K PART II IS A PREMIUM ASSOCIATED WITH THE 2003 ISSUE. HOSPITAL AUTHORITY OF FLOYD COUNTY THE DIFFERENCE IN THE ISSUE PRICE REPORTED IN SCHEDULE K PART I AND TOTAL PROCEEDS OF ISSUE REPORTED IN SCHEDULE K PART II IS A PREMIUM ASSOCIATED WITH THE 2009 ISSUE. HOSPITAL AUTHORITY OF FLOYD COUNTY THE DIFFERENCE IN THE ISSUE PRICE REPORTED IN SCHEDULE K PART I AND TOTAL PROCEEDS OF ISSUE REPORTED IN SCHEDULE K PART II IS A PREMIUM ASSOCIATED WITH THE 2012A ISSUE. HOSPITAL AUTHORITY OF FLOYD COUNTY THE DIFFERENCE IN THE ISSUE PRICE REPORTED IN SCHEDULE K PART I AND TOTAL PROCEEDS OF ISSUE REPORTED IN SCHEDULE K PART II IS A PREMIUM ASSOCIATED WITH THE 2012B ISSUE. SCHEDULE K - ADDITIONAL INFORMATION HOSPITAL AUTHORITY OF FLOYD COUNTY EXPENDITURES INCLUDE 2,252,148 IN FUNDS FROM THE SERIES 2002 DEBT SERVICE RESERVE FUNDS. BRAD WARD MD BOARD MEMBER PROFESSIONAL OFFICE RENTAL X 150285 45924 false true true 45924 SHEILA B HORNER VP OF NURSING 10182 GRANT TUITION JOSHUA POLLEY FAMILY-KEY EMP 67787 EMPLOYEE WAGES false DAVID JOHNSON BOARD MEMBER BANKING SERVICES false JOSEPH D BIUSO FAMILY-KEY EMP 31643 EMPLOYEE WAGES false SCHEDULE L, PART V LISTED ABOVE ARE THE FAMILY MEMBERS OF CORPORATE OFFICERS/KEY EMPLOYEES AND BOARD MEMBERS WHO ARE ACTIVELY EMPLOYED AND COMPENSATED BY FHMI. THE ORGANIZATION MAINTAINS A BANK ACCOUNT FOR MALPRACTICE SELF INSURANCE FUND ACTIVITY AT UNITED COMMUNITY BANK. DIRECTOR DAVID JOHNSON IS AN OFFICER AT UNITED COMMUNITY BANK. FORM 990, PAGE 6, PART VI, LINE 7A THE ORGANIZATION'S BOARD MAKES ALL DECISIONS RELATED TO APPOINTMENT OF MEMBERS OF THE BOARD. THE CEO IS AUTOMATICALLY A MEMBER OF THE BOARD BY VIRTUE OF HIS POSITION IN THE ORGANIZATION. FLOYD HEALTHCARE RESOURCES' BOARD CHAIRMAN IS AUTOMATICALLY A MEMBER OF THE FHMI'S BOARD BY VIRTUE OF HIS POSITION IN THE ORGANIZATION. BY CONTRACT, THE ORGANIZATION AGREES TO HAVE TWO OF THE FLOYD COUNTY BOARD COMMISSIONERS ON THE BOARD. FORM 990, PAGE 6, PART VI, LINE 11B THE ORGANIZATION'S CEO, CFO, CONTROLLER, LEGAL COUNSEL AND EMPLOYEES OF FHMI REVIEW THE FORM 990 FOR FINANCIAL AND DISCLOSURE ACCURACY. PRIOR TO ITS FILING, A COPY OF THE ORGANIZATION'S 990 RETURN IS POSTED ON THE BOARD OF DIRECTOR'S SECURE WEBSITE FOR THEIR REVIEW. MANAGEMENT WILL SEND AN EMAIL NOTIFYING MEMBERS OF ITS POSTING. FORM 990, PAGE 6, PART VI, LINE 12C FLOYD HEALTHCARE MANAGEMENT, INC. ("FHMI") HAS A WRITTEN POLICY RESPECTING CONFLICTS OF INTEREST AND DISCLOSURE OF SAME. GENERALLY SPEAKING, THE POLICY REQUIRES ANY "COVERED PERSON" WHO BELIEVES HE HAS A CONFLICT OF INTEREST TO: -DISCLOSE THE EXISTENCE AND NATURE OF THE CONFLICT OF INTEREST (INCLUDING ALL FACTS KNOWN RESPECTING THE SUBJECT MATTER) TO THE CHAIRMAN OF THE BOARD; -PLAY NO PART, DIRECTLY OR INDIRECTLY, IN THE DELIBERATION OR VOTE OF THE BOARD OF DIRECTORS WITH RESPECT TO THE DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS; AND -ABSENT HIMSELF FROM THAT PORTION OF THE MEETING AT WHICH THE CONFLICT OF INTEREST IS DISCUSSED. THE DEFINITION OF A "COVERED PERSON" INCLUDES ALL BOARD MEMBERS, OFFICERS AND MEMBERS OF SENIOR MANAGEMENT OF FHMI. WHEN A COVERED PERSON DISCLOSES A POTENTIAL CONFLICT OF INTEREST TO THE BOARD CHAIRMAN, THE CHAIRMAN IS OBLIGED TO BRING THE MATTER TO THE ATTENTION OF THE FULL BOARD. THE BOARD DETERMINES WHETHER A CONFLICT OF INTEREST ACTUALLY EXISTS. IF THE BOARD DETERMINES THAT THERE IS A CONFLICT OF INTEREST, THE TRANSACTION OR MATTER GIVING RISE TO THE CONFLICT OF INTEREST MAY NOT PROCEED UNLESS THE BOARD DETERMINES, BY A MAJORITY VOTE, THAT, DESPITE THE CONFLICT OF INTEREST, THE TRANSACTION/MATTER IS NEVERTHELESS IN THE CORPORATION'S BEST INTEREST AND IS FAIR AND REASONABLE TO THE CORPORATION. IN ADDITION TO THE REQUIREMENT THAT A COVERED PERSON DISCLOSE A POTENTIAL CONFLICT OF INTEREST AT THE TIME IT ARISES, EACH COVERED PERSON IS ALSO REQUIRED TO SUBMIT, ON AN ANNUAL BASIS, A `CONFLICT AND DISCLOSURE OF INTEREST QUESTIONNAIRE'. THIS MULTI-QUESTION DOCUMENT SERVES AS A REMINDER AND PROMPTS EACH COVERED PERSON TO PONDER THOSE AREAS AND SITUATIONS WHERE A POTENTIAL CONFLICT MIGHT EXIST. ADDITIONALLY, ANY PROPOSED TRANSACTION AT FHMI WHICH INVOLVES AN "INSIDER" (I.E., A BOARD MEMBER, OFFICER, MANAGER, ETC.) IS SCRUTINIZED, WITH THE ASSISTANCE OF CORPORATE LEGAL COUNSEL, FROM THE STANDPOINT OF WHETHER THE TRANSACTION WILL RESULT IN ANY EXCESS BENEFIT TO THE INSIDER. TYPICALLY THIS INVOLVES OBTAINING APPROPRIATE DATA REGARDING COMPARABILITY WHICH IS PROVIDED TO THE BOARD FOR ITS USE IN DETERMINING THAT THE CONSIDERATION BEING PAID TO THE INSIDER AS A PART OF THE TRANSACTION IS REASONABLE AND DOES NOT EXCEED THE VALUE OF THE BENEFIT RECEIVED BY FHMI. FORM 990, PAGE 6, PART VI, LINE 15A IT IS THE RESPONSIBILITY OF THE COMPENSATION COMMITTEE OF FLOYD HEALTHCARE MANAGEMENT, INC. BOARD TO ACTIVELY MANAGE AND MONITOR EXECUTIVE COMPENSATION. TO DO SO, THE COMMITTEE HAS ESTABLISHED THE FOLLOWING OBJECTIVES FOR THE EXECUTIVE COMPENSATION PROGRAM: -PROVIDE A COMPETITIVE TOTAL COMPENSATION EARNING OPPORTUNITY TO RECRUIT, RETAIN, AND REWARD THE EXECUTIVES NEEDED TO MEET THE COMMUNITY'S HEALTHCARE NEEDS, NOW AND IN THE FUTURE; -PROVIDE PAY OPPORTUNITIES THAT WILL REWARD THE EXECUTIVE TEAM WHEN ORGANIZATIONAL PERFORMANCE IN KEY AREAS IS DEMONSTRATED; -INCENTIVE COMPENSATION UNDER THE EXECUTIVE INCENTIVE COMPENSATION PLAN IS PAYABLE ONLY IN THE EVENT THE ORGANIZATION'S OPERATING MARGIN FROM OPERATING REVENUE EXCEEDS CERTAIN PARAMETERS ESTABLISHED BY THE COMPENSATION COMMITTEE; -ENSURE THAT THE COMPENSATION PROGRAMS ARE EASY FOR ALL INTERESTED PARTIES TO UNDERSTAND. ANNUALLY, THE COMMITTEE REVIEWS THE APPROPRIATENESS OF THE TOTAL COMPENSATION PROVIDED TO EACH EXECUTIVE: -AS RELATED TO THE COMPETITIVE MARKET PAY RATES; -AS RELATED TO THE INDIVIDUAL'S ROLE AND RESPONSIBILITY IN THE ORGANIZATION; -AS IT PERTAINS TO VARIABLE OR INCENTIVE EARNING OPPORTUNITIES RELATING TO THE PERFORMANCE OF THE ORGANIZATION. TO DETERMINE THE MARKET RATES FOR EACH POSITION, THE COMMITTEE UTILIZES AN OUTSIDE CONSULTANT TO SURVEY COMPARABLE ORGANIZATIONS TO DEVELOP AN APPROPRIATE RANGE OF PAY FOR EACH EXECUTIVE POSITION. THIS RANGE GENERALLY REFLECTS THE PAY PRACTICES AND LEVELS OF COMPARABLE ORGANIZATIONS IN GEORGIA, THE SOUTHEAST, AND ACROSS THE COUNTRY. SPECIFICALLY, THE COMMITTEE REVIEWS DATA FOR MARKET RATES OF BASE SALARY AND TOTAL COMPENSATION (THE COMBINATION OF BASE SALARY AND BONUSES). AFTER REVIEWING THIS DATA, THE COMMITTEE ASSESSES THE APPROPRIATENESS OF THE BASE PAY LEVELS FOR EACH EXECUTIVE WITHIN A RANGE THAT GENERALLY REFLECTS INDUSTRY NORMS. IN ADDITION TO MONITORING BASE SALARIES, THE COMMITTEE IS RESPONSIBLE FOR ADMINISTERING THE EXECUTIVE INCENTIVE COMPENSATION PROGRAM. THE PROGRAM IS DESIGNED TO: -FURTHER ALIGN EXECUTIVE PAY WITH THE STRATEGIC AND OPERATIONAL ACHIEVEMENTS OF THE ORGANIZATION; -WHEN THE ORGANIZATION ACHIEVES RESULTS IN KEY AREAS OF PERFORMANCE, TO APPROPRIATELY REWARD EXECUTIVES ACCORDING TO THAT PROGRAM; THE COMMITTEE HAS ALSO ESTABLISHED SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAMS (SERPS). THESE SERPS WERE DESIGNED WITH THE ADVICE AND HELP OF CONSULTANTS AND ARE DESIGNED TO RETAIN AND REWARD EXECUTIVES WITH RETIREMENT OPPORTUNITIES THAT ARE CONSISTENT WITH MARKET PRACTICES IN GEORGIA, THE SOUTHEAST, AND ACROSS THE COUNTRY. IN 2001, THESE PLANS VESTED TWO EXECUTIVES. IT IS THE PHILOSOPHY OF THE FHMI BOARD THAT THE COMBINATION OF THE INCENTIVE EARNING OPPORTUNITY, THE BASE SALARY, AND THE SERPS WILL PROVIDE A COMPETITIVE COMPENSATION LEVEL TO EACH EXECUTIVE THAT REFLECTS THE MARKET FOR EACH POSITION AND ORGANIZATION PERFORMANCE. THE COMMITTEE HAS DEVELOPED THE PROGRAM TO RECRUIT, RETAIN, AND REWARD EXECUTIVES IN ORDER TO MEET THE PRESENT AND FUTURE NEEDS OF THE ORGANIZATION TO PROVIDE A HIGH QUALITY OF PATIENT CARE TO THE COMMUNITY IN A COST EFFECTIVE MANNER. FORM 990, PAGE 6, PART VI, LINE 15B SEE NARRATIVE UNDER PART VI, LINE 15A. FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC WHEN THE REQUEST IS MADE AT THE ADMINISTRATIVE OFFICE OF THE FILING CORPORATION. FORM 990, PAGE 7, PART VII FORM 990, PART VII SECTION A - COMPENSATION FROM RELATED ORGANIZATIONS MEMBERS OF THE BOARD OF DIRECTORS FOR FLOYD HEALTHCARE RESOURCES, INC., A RELATED PARTY OF FLOYD HEALTHCARE MANAGEMENT, INC., RECEIVE A STIPEND FOR EACH BOARD MEETING ATTENDED. FOR THE FISCAL YEAR 2015, DIRECTORS MANIS, BOSWORTH, CHUMBLER, AND SUMNER ALSO SERVED ON THE BOARD OF FLOYD HEALTHCARE RESOURCES, INC. THREE BOARD MEMBERS (COLLINS, HOLCOMBE, AND WARD) ARE PHYSICIANS WHO ARE EMPLOYED AND COMPENSATED BY FHMI. DIRECTOR DAVID JOHNSON IS A SENIOR OFFICER OF UNITED COMMUNITY BANK. FHMI MAINTAINS AN ACCOUNT FOR MALPRACTICE SELF-INSURANCE ACTIVITY AT UNITED COMMUNITY BANK. FORM 990, PART VII SECTION A - COMPENSATION DR. CARL HERRING BOARD MEMBER CARL HERRING, MD, A PRACTICING NEUROSURGEON HAD CLINICAL PRIVILEGES AT FLOYD MEDICAL CENTER (FMC) UNTIL HIS RETIREMENT ON JANUARY 9, 2015. AS SUCH, HE WAS A PARTY TO A CONTRACT UNDER WHICH FMC PAYS THE NEUROSURGEONS ON ITS MEDICAL STAFF A PER DIEM FOR COVERING TRAUMA CALL IN THE EMERGENCY ROOM. UNDER THIS CONTRACT, THE NEUROSURGEON COVERING CALL FOR THE DAY DURING THE CALENDAR YEAR 2014 WAS PAID A PER DIEM OF 2,000. FMC HAS DETERMINED WITH THE ASSISTANCE OF OUTSIDE EXPERT VALUATION CONSULTANTS THAT THIS AMOUNT IS CONSISTENT WITH FAIR MARKET VALUE. ADDITIONALLY, DR. HERRING WAS AN EMPLOYEE AND SHAREHOLDER IN THE HARBIN CLINIC, LLC, A 140+ DOCTOR MULTI-SPECIALTY GROUP MEDICAL PRACTICE. FMC HAS NUMEROUS CONTRACTS WITH HARBIN CLINIC UNDER WHICH HARBIN SUPPLIES ITS PHYSICIANS TO SERVE AS MEDICAL DIRECTORS OF VARIOUS DEPARTMENTS AND SERVICE LINES AT FMC, INCLUDING RESPIRATORY THERAPY, BARIATRICS, NEUROLOGY, VASCULAR LAB, HOSPICE, BREAST CENTER, INPATIENT REHABILITATION, INFECTIOUS DISEASE, ETC. UNDER THESE CONTRACTS HARBIN CLINIC IS PAID FAIR MARKET COMPENSATION BASED ON AN HOURLY RATE FOR THE ACTUAL TIME EXPENDED BY ITS PHYSICIANS IN THE PERFORMANCE OF THE DUTIES CALLED FOR IN THESE CONTRACTS. OTHER COMMENTS AND DISCLOSURES: FLOYD MEDICAL CENTER IS A 300+ BED GENERAL ACUTE-CARE HEALTH INSTITUTION, OFFERING A WIDE RANGE OF SPECIALIZED SERVICES AND PROGRAMS. SUCH SERVICES AND PROGRAMS INCLUDE: ACUTE, MEDICAL/SURGICAL CARE; AMBULANCE SERVICE; BLOOD BANK; CANCER CARE UNIT; CARDIOVASCULAR LABORATORY; CORONARY CARE UNIT; CHAPLAIN SERVICE; CHEMICAL DEPENDENCY UNIT; CRISIS INTERVENTION; CT SCANNER; DIABETES CARE UNIT; LITHOTRIPSY, MEDICAL/SURGICAL INTENSIVE CARE; MAGNETIC RESONANCE IMAGING; NEUROLOGY; LEVEL III NEWBORN NURSERY/NEONATAL INTENSIVE CARE UNIT; OB/GYN; ORTHOPEDIC SURGERY, OUTPATIENT SURGERY CENTER; PATIENT REPRESENTATIVES; PEDIATRIC CARE; PHARMACY; DIAGNOSTIC RADIOLOGY; A 24-HOUR EMERGENCY SERVICE; ENDOSCOPIC LABORATORY; FAMILY PRACTICE RESIDENCY PROGRAM; PRIMARY CARE PHYSICIAN NETWORK; HEALTH EDUCATION AND PROMOTION; HOSPITAL AUXILIARY; INDUSTRIAL MEDICINE PROGRAM; INPATIENT REHABILITATION UNIT; LAPAROSCOPIC CHOLECYSTECTOMY SURGERY; LASER SURGERY; PHYSICAL THERAPY; OCCUPATIONAL THERAPY; SPEECH THERAPY; POISON CONTROL CENTER; POST-OPERATIVE RECOVERY ROOM; PROGRESSIVE INTENSIVE CARE UNIT; RESPIRATORY CARE SERVICES; SOCIAL WORK SERVICES; ULTRASOUND; CONGESTIVE HEART FAILURE CLINIC; WOUND OSTOMY CLINIC; BREAST CENTER, MOBILE MAMMOGRAPHY. DURING FISCAL YEAR 2015, PATIENT DAYS AT FLOYD MEDICAL CENTER TOTALED 86,639 AND DISCHARGES TOTALED 14,191. FLOYD MEDICAL CENTER PROVIDED APPROXIMATELY 93,500,000 IN DIRECT CHARITY AND INDIGENT CARE, AND IT INCURRED UNREIMBURSED MEDICARE AND MEDICAID ADJUSTMENTS OF 382,178,000 AND 199,710,000 RESPECTIVELY. A COPY OF THE REPORT TO THE COMMUNITY FOR FLOYD MEDICAL CENTER CAN BE FOUND AT WWW.FLOYD.ORG/ABOUT/INDEX.HTM. FORM 990, PART IX, LINE 11G CONTRACT SERVICES 10,219,532 2,586,918 0 PURCHASED SERVICES 14,300,908 3,630,825 0 CONSULTING FEES 165,991 1,025,678 0 BILLING AND COLLECTIONS 1,945,634 780,849 0 FPC MANAGEMENT FEES 103,498 0 0 FORM 990, PART XI, LINE 9 AMORTIZATION OF ACTUARIAL LOSS 222,665 CURRENT YEAR ACTUARIAL LOSS -8,991,730 NET DECREASE IN NET ASSETS -8,769,065 FLOYD EMERGENCY PHYSICIANS LLC 304 TURNER MCCALL BLVD ROME GA 301620233 050608795 ER SVC GA 8426457 3055429 FHMI FLOYD PHYSICIANS LLC 304 TURNER MCCALL BLVD ROME GA 301620233 205415285 SPEC PHYS GA 2181796 7954 FHMI ACCOUNTABLE CARE ORGANIZATION OF 304 TURNER MCCALL BLVD ROME GA 301620233 474054900 GA FHMI HOSPITAL AUTHORITY OF FLOYD COUNTY 304 TURNER MCCALL BLVD ROME GA 301620233 586001173 HEALTHCARE GA 501C3 3 NA false FLOYD HEALTHCARE RESOURCES INC 304 TURNER MCCALL BLVD ROME GA 301620233 582010524 HEALTHCARE GA 501C3 9 NA false HOSP AUTH OF FLOYD CO SELF INSUR TR 304 TURNER MCCALL BLVD ROME GA 301620233 586140617 TRUST GA 501C4 FHMI FLOYD HEALTHCARE MANAGEMENT INC true FLOYD HEALTH CARE FOUNDATION INC PO BOX 233 ROME GA 301620233 581375074 FOUNDATION GA 501C3 11A FHMI FLOYD HEALTHCARE MANAGEMENT INC true POLK MEDICAL CENTER INC 420 E SECOND AVENUE STE 102 ROME GA 301613210 453957368 HOSPITAL GA 501C3 3 FHMI FLOYD HEALTHCARE MANAGEMENT INC true false false true true false false false false false false false true true true true true true false false ALL ENTITIES N AMOUNT INDETERMINABLE ALL ENTITIES O AMOUNT INDETERMINABLE ALL ENTITIES Q AMOUNT INDETERMINABLE FLOYD HEALTH CARE FOUNDATION INC C 260000 CASH ALL ENTITIES D 5601628 GENERAL LEDGER BALANCE ALL ENTITIES M AMOUNTS INDETERMINABLE ALL ENTITIES L AMOUNT INDETERMINABLE SCHEDULE R PART I - DISREGARDED ENTITIES IN SEPTEMBER 2004, FLOYD HEALTHCARE MANAGEMENT, INC. (FHMI) SPONSORED THE CREATION OF FLOYD EMERGENCY PHYSICIANS, LLP (FEP), A GEORGIA LIMITED LIABILITY COMPANY. FHMI IS THE SOLE MEMBER/OWNER OF FEP AND HAS THE SOLE AUTHORITY TO APPOINT FEP'S FIVE-PERSON BOARD OF DIRECTORS. FEP WAS FORMED FOR THE PURPOSE OF HIRING OR OTHERWISE ENGAGING EMERGENCY PHYSICIANS TO PROVIDE PROFESSIONAL MEDICAL SERVICES TO PATIENTS PRESENTING TO FLOYD MEDICAL CENTER'S EMERGENCY CARE CENTER. FEP ALSO PROVIDES EMERGENCY PHYSICIAN STAFFING TO POLK MEDICAL CENTER. IN AUGUST 2006, FHMI SPONSORED THE CREATION OF FLOYD PHYSICIANS, LLC (FP), A GEORGIA LIMITED LIABILITY COMPANY. FHMI IS THE SOLE MEMBER/OWNER OF FP AND HAS THE SOLE AUTHORITY TO APPOINT FP'S FIVE-PERSON BOARD OF DIRECTORS. FP WAS FORMED FOR THE PURPOSE OF HIRING OR OTHERWISE ENGAGING PHYSICIANS TO PROVIDE PROFESSIONAL MEDICAL SERVICES TO PATIENTS. PART II - DISCONTINUED ENTITIES THE HOSPITAL AUTHORITY OF FLOYD COUNTY SELF INSURANCE TRUST WAS LEGALLY DISSOLVED AUGUST 4, 2014 AND THE REMAINING ASSETS WERE TRANSFERRED IN FULL TO FHMI IN ACCORDANCE WITH THE ORGANIZATION'S GOVERNING DOCUMENTS' DISSOLUTION CLAUSE.