2016-05-16T14:45:13-05:00 2015-06-30 560747981 DIXON HUGHES GOODMAN LLP PO BOX 1747 CHARLESTON WV 253261747 990 2014-07-01 331216751 HUGHSTON HOSPITAL INC HUGH 7066606103 707 CENTER STREET COLUMBUS GA 31901 ALLEN BUTCHER CFO 7606606303 2016-05-10 1 SUSAN S DULL P00233523 3043430168 2016-05-10 2014 2016-08-17 19:52:53Z M SCOTT HILL 707 CENTER STREET COLUMBUS GA 31901 64100110 0 X COLUMBUSREGIONAL.COM X 2008 GA TO PROMOTE THE HEALTH AND HEALING OF OUR PATIENTS AND DELIVERY OF CLINICAL CARE. 15 14 470 14 0 0 0 0 66922897 63749375 2465981 350735 0 0 69388878 64100110 10607 0 0 0 19399150 20930031 0 0 0 46536795 45386948 65946552 66316979 3442326 -2216869 92190271 87516028 73604912 71099628 18585359 16416400 X HUGHSTON HOSPITAL, INC. PROVIDES OUR COMMUNITY EXCELLENCE IN ORTHOPEDIC AND REHABILITATIVE CARE. SERVICES ARE FOCUSED EXCLUSIVELY ON ORTHOPEDIC RELATED NEEDS. HUGHSTON HOSPITAL WAS THE NATION'S FIRST HOSPITAL DESIGNED SPECIFICALLY TO TREAT PATIENTS WITH MUSCULOSKELETAL INJURIES OR DISORDERS. TODAY, THE 100-BED, PRIVATE ROOM HOSPITAL IS NATIONALLY RECOGNIZED FOR DELIVERING OUTSTANDING CLINICAL QUALITY AND THE HIGHEST LEVELS OF CUSTOMER SERVICE.SERVICES ARE DELIVERED THROUGH A HIGHLY SPECIALIZED TEAM OF PROFESSIONALS USING THE LATEST TECHNOLOGY AND RESEARCH TO CARE FOR PEOPLE OF EVERY AGE AND ABILITY AND EVERY LEVEL OF MUSCULOSKELETAL INJURY OR DISORDER. 0 0 18344974 23628380 HUGHSTON HOSPITAL'S JOINT REPLACEMENT CENTER IS DEDICATED SPECIFICALLY TO THE CARE OF KNEE, HIP AND SHOULDER REPLACEMENT PATIENTS. PATIENTS ARE TREATED LIKE SPECIAL GUESTS WHO ARE TEMPORARILY SIDELINED WITH A JOINT OR ORTHOPEDIC PROBLEM. THE FOCUS IS ON WELLNESS AND GUEST ARE ACTIVE PARTICIPANTS IN A UNIQUE TREATMENT MODEL THAT BEGINS AT DIAGNOSIS IN THE SURGEON'S OFFICE AND CONTINUES AT THE HUGHSTON HOSPITAL JOINT REPLACEMENT CENTER. GUESTS ARE PROVIDED AS MUCH INFORMATION AS POSSIBLE AND KEPT EDUCATED, MOTIVATED AND INVOLVED. HUGHSTON'S JOINT REPLACEMENT SPECIALISTS, VOTED BEST SURGEONS FOR TOTAL JOINT REPLACEMENT, OFFER THE LATEST PROCEDURES AND TECHNOLOGY, INCLUDING COMPUTER ASSISTED SURGICAL NAVIGATION, MINIMALLY INVASIVE SURGERY AND REVERSE TOTAL SHOULDER. THESE INNOVATIVE TECHNIQUES PROVIDE EXTRAORDINARY OUTCOMES AND QUICKER RECOVERIES FOR THEIR PATIENTS. 3092717 12979614 HUGHSTON HOSPITAL OFFERS THE ONLY ORTHOPEDIST SPECIALIZING IN TRAUMATOLOGY IN THE REGION. HUGHSTON'S ADVANCED RECONSTRUCTIVE TRAUMA SERVICES OFFERS PATIENTS MORE TREATMENT OPTIONS FOR MULTIPLE BROKEN BONES IN MULTIPLE LIMBS, BROKEN BONES THAT DON'T HEAL CORRECTLY OR A SEVERE INJURY.OFTEN, TRAUMATOLOGISTS ARE CONSULTED ABOUT A SEVERELY INJURED PATIENT WHO IS EN ROUTE TO THE HOSPITAL SO THEY CAN BE IN THE EMERGENCY ROOM WHEN THE PATIENT ARRIVES. THIS ALLOWS THE TRAUMATOLOGIST TO BE INVOLVED IN WHAT HAS BECOME KNOWN AS THE "GOLDEN HOUR" OF TRAUMA CARE. DURING THIS PERIOD, DECISIONS HAVE TO BE MADE RAPIDLY WITH VERY LITTLE TIME FOR REFLECTION. ALTHOUGH ALL ORTHOPEDISTS TREAT COMMON INJURIES, THE HUGHSTON TRAUMATOLOGIST IS SOUGHT OUT FOR THE DEFINITIVE CARE OF THE MOST COMPLEX PROBLEMS. 3045287 2533421 AWARDED THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL FOR STROKE REHABILITATION, THE REHABILITATION CENTER AT HUGHSTON HOSPITAL OFFERS THE BEST POSSIBLE REHABILITATIVE CARE DESIGNED TO SERVE INDIVIDUALS WHO HAVE A NEED FOR ACUTE INPATIENT REHABILITATION.HUGHSTON'S REHABILITATION CENTER OFFERS A VARIETY OF THERAPEUTIC TREATMENTS DESIGNED TO GET EMPLOYEES BACK TO WORK, GET PHYSICALLY ACTIVE INDIVIDUALS PLAYING AGAIN AND GET EACH PATIENT TO ENJOYING LIFE. THE THERAPY IS ADMINISTERED IN A HOME-LIKE AREA AIMED AT RESTORING A PATIENT'S FUNCTION RELATED TO DAILY LIVING ACTIVITIES. THE PROGRAM INCLUDES FAMILY-CENTERED CARE, AROUND THE CLOCK VISITATION AND ROOMING IN.THE GOAL OF THE PROGRAM IS TO ASSIST INDIVIDUALS IN REGAINING THEIR INDEPENDENCE. THE PROGRAM FEATURES A HIGHLY STRUCTURED ENVIRONMENT AND INDIVIDUAL ASSISTANCE BY A MULTI-DISCIPLINARY TEAM OF PROFESSIONALS, ALL IN A THERAPEUTIC, RESIDENTIALLY FOCUSED SETTING. THE REHABILITATION IS RESIDENTIALLY FOCUSED WHERE FAMILY MEMBERS ARE ENCOURAGED TO JOIN THEM. FOR CONSIDERATION, PATIENTS SHOULD BE MEDICALLY STABLE, HAVE THE POTENTIAL TO IMPROVE, AND BE PHYSICALLY ABLE TO START THE PROGRAM. 28640477 24270746 28640477 24270746 53123455 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 78 0 1 470 1 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 GA X ALLEN BUTCHER CFO 7066606303 707 CENTER STREET COLUMBUS GA 31901 EUGENE DEMONET CHAIRMAN DIRECTOR 2.00 X 0 0 0 MAX BRABSON JR DIRECTOR 2.00 X 0 0 0 KATHRYN CHEEK MD DIRECTOR 2.00 X 0 0 0 CECIL CHEVES DIRECTOR 2.00 X 0 0 0 MICHAEL W GORUM MD DIRECTOR, RSGND 6/30/15 2.00 X 0 0 0 R SCOTT HANNAY MD DIRECTOR, RSGND 3/1/15 2.00 X 0 0 0 JULIUS H HUNTER JR DIRECTOR, RSGND 6/30/15 2.00 X 0 0 0 TODD JARRELL MD DIRECTOR 2.00 X 0 0 0 JOEY LOUDERMILK DIRECTOR 2.00 X 0 0 0 LILIANA MCDANIEL DIRECTOR 2.00 X 0 0 0 WILIAM ROUNDTREE MD DIRECTOR 2.00 X 0 0 0 CAROLE RUTLAND PHD DIRECTOR 2.00 X 0 0 0 WARREN STEELE II DIRECTOR 2.00 X 0 0 0 M SCOTT HILL PRESIDENT & CEO CRHS 2.00 40.00 X X 0 648246 135074 SHANE DARRAH MD DIRECTOR 2.00 X 0 0 0 WILL WHITE DIRECTOR 2.00 X 0 0 0 ALLEN R BUTCHER SR. VP & CFO 2.00 40.00 X 0 327199 69217 KAREN SMITH CORPORATE SECRETARY 2.00 40.00 X 0 74372 15047 TAMARA L JACKSON CEO; TRMD 11/3/14 10.00 40.00 X 192257 0 13017 MICHELLE BREITFELDER VP & CNO 15.00 25.00 X 288775 0 30570 DIANE MORRIS DIRECTOR - SURGICAL SERVIC 40.00 X 129289 0 19572 JOHN LESH PHYSICAL THERAPIST 40.00 X 104154 0 21850 THOMAS PERKINS CLINICAL PHARMACIST 40.00 X 102921 0 19772 LYNN KELLY DIRECTOR - NURSING 40.00 X 102965 0 23311 JUDITH HILL CLINICAL PHARMACIST 40.00 X 101234 0 19705 CHARLES A STARK PRESIDENT & CEO; RSGND 6/12/14 2.00 40.00 X 0 1386600 32703 ROLAND L THACKER SR. VP & CFO; TRMD 10/31/13 2.00 40.00 X 0 315031 32798 1021595 2751448 432636 7 1 1 0 HSS SYSTEMS LLC 6640 CAROTHERS PKWY FRANKLIN TN 37067 REVENUE CYCLE SERVICES 1461011 PARALLON TECHNOLOGY SOLUTIONS PO BOX 41500 NASHVILLE TN 372415000 IT SERVICES 1045229 AMSOL ANESTHETISTS OF GA LLC PO BOX 6633 HIGH POINT NC 27262 CRNA SUBSIDY 855532 CENTRAL SHARED SERVICES LLC PO BOX 741995 ATLANTA GA 37027 AP, PURCHASING, MATERIALS MGMT SALARIES 332113 ANGELICA TEXTILE SERVICES-EAST PO BOX 535122 ATLANTA GA 30353 LINEN SERVICES 217998 8 PATIENT SERVICE REVENUE 621400 63136500 63136500 CAFETERIA 722210 333995 333995 OTHER PROGRAM SERVICE REVENUE 900099 236939 236939 MEDICAL RECORDS 621400 41941 41941 63749375 344907 344907 5828 0 5828 5828 5828 64100110 63136500 0 963610 799015 799015 15220330 14154770 1065560 3769868 3708373 61495 1140818 1083961 56857 4190011 4190011 541819 541819 4579871 4024520 555351 30567 30567 468010 403794 64216 32 32 1705244 1686340 18904 8527 4920 3607 7899 7899 3813459 3813459 2812653 2812653 -61557 -61557 SUPPLIES 24984403 24943853 40550 BAD DEBT EXPENSE 1010635 1010635 PROVIDER FEE 895840 895840 EQUIPMENT RENTAL 399535 399535 66316979 53123455 13193524 0 1051240 11025297 9370372 5311173 5806788 2094976 146524 66894062 17033349 52066533 49860713 7501627 10678406 14190665 10601985 92190271 87516028 6760460 8319606 64000943 62564122 2843509 215900 73604912 71099628 X 18585359 16416400 18585359 16416400 92190271 87516028 X -2216869 -153212 201122 X 0 1 X 1 0 X X 2511 26833 2511 26833 66314468 587499773 66316979 587526606 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 32330 32191 14315 26833 105669 250000 250000 250000 250000 1000000 1500000 4190000 4190000 48124170 8422154 39702016 13379306 8611195 4768111 1200586 1200586 49860713 DUE FROM AFFILIATES 10403743 DUE FROM UNRELATED PARTIES 198242 10601985 PROFESSIONAL LIABILITY 215900 215900 X PART X, LINE 2: THE SYSTEM IS PRIMARILY COMPRISED OF ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAX PURSUANT TO SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. WITH RESPECT TO ANY INCOME GENERATED BY FOR-PROFIT SUBSIDIARIES OR UNRELATED BUSINESS INCOME, THE SYSTEM RECORDS INCOME TAXES USING THE LIABILITY METHOD UNDER WHICH THE DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASES OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIOD THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR TO BE SETTLED. THE SYSTEM HAS EVALUATED ITS TAX POSITIONS AND HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF JUNE 30, 2015 AND 2014. FISCAL YEARS ENDED ON OR AFTER JUNE 30, 2012 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. 1 1 1 X 125.000000000000 1 X 185.000000000000 1 1 1 0 0 561934 1825 560109 0.00840 1538828 492651 1046177 0.01580 561961 1825 560136 0.00840 2662723 496301 2166422 0.03260 2662723 496301 2166422 0.03260 1 1010635 251729 23457104 31036088 -7578984 X 1 1 1 1 HUGHSTON HOSPITAL INC 707 CENTER STREET COLUMBUS GA 31901 WWW.COLUMBUSREGIONAL.COM X X HUGHSTON HOSPITAL INC 1 0 0 1 X X X X X X X X X 12 1 1 0 1 X HTTP://COLUMBUSREGIONAL.COM/ABOUT-US/COMMUNITY-OUTREACH/ X 1 13 1 HTTP://COLUMBUSREGIONAL.COM/ABOUT-US/COMMUNITY-OUTREACH/ 0 0 1 X 125.000000000000 185.000000000000 X X X X X X X 1 1 X X X 1 X HTTP://COLUMBUSREGIONAL.COM/MEDIA/1260/CHARITY-CARE-POLICY.PDF X HTTP://COLUMBUSREGIONAL.COM/MEDIA/1258/FINANCIAL-ASSISTANCE-APPLICATION.PDF X HTTP://COLUMBUSREGIONAL.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE/ X 1 X 0 X X X X 0 X X 0 0 HUGHSTON HOSPITAL, INC. PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH ASSESSMENT NEEDS CONSISTED OF QUANTITATIVE AND QUALITATIVE DATA. QUALITATIVE DATA WAS COLLECTED THROUGH INPUT FROM KEY REPRESENTATIVES IN THE COMMUNITY CONSISTING OF PHYSICIANS, OTHER HEALTH PROFESSIONALS, COMMUNITY LEADERS, BUSINESS LEADERS, FAITH-BASED MEMBERS AND SCHOOL DISTRICT REPRESENTATIVES. FOCUS GROUPS PROVIDED THE FORUM FOR THIS DATA COLLECTION AND WERE ARRANGED IN ADVANCE TO PROMOTE ACTIVE PARTICIPATION. OPPORTUNITIES FOR COLLECTIVE AS WELL AS INDIVIDUAL INPUT WERE PROVIDED AND USED IN THE OVERALL ASSESSMENT REPORT. IN ADDITION TO FOCUS GROUPS, A VARIETY OF EXISTING (SECONDARY) DATA SOURCES WAS CONSULTED TO COMPLEMENT THE RESEARCH QUALITY OF THIS COMMUNITY HEALTH NEEDS ASSESSMENT. DATA FOR MUSCOGEE COUNTY WAS OBTAINED FROM THE FOLLOWING SOURCES: CENTERS FOR DISEASE CONTROL & PREVENTION, GEORGIA DEPARTMENT OF PUBLIC HEALTH, GEORGIA BUREAU OF INVESTIGATION, NATIONAL CENTER FOR HEALTH STATISTICS, U.S. CENSUS BUREAU, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, AND THE U.S. DEPARTMENT OF JUSTICE, FEDERAL BUREAU OF INVESTIGATION. HUGHSTON HOSPITAL, INC. PART V, SECTION B, LINE 6A: THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR HUGHSTON HOSPITAL, INC. WAS CONDUCTED WITH THREE OTHER AREA HOSPITALS. TWO OF THOSE FACILITIES, THE MEDICAL CENTER, INC. AND DOCTOR'S HOSPITAL, INC. ARE AFFILIATES OF HUGHSTON HOSPITAL, INC. ALSO PARTICIPATING IN THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS ST. FRANCIS HOSPITAL WHICH ALSO SERVES MUSCOGEE COUNTY AND THE SURROUNDING AREA. HUGHSTON HOSPITAL, INC. PART V, SECTION B, LINE 11: CRHS HAS SELECTED NINE (9) OF THE IDENTIFIED FOURTEEN (14) PRIORITY AREAS UPON WHICH TO FOCUS ITS EFFORTS AND HAS SPLIT THOSE NINE (9) AMONGST ITS THREE HOSPITALS FOR PRIMARY RESPONSIBILITY TO IMPLEMENT THE ACTION PLANS ACCORDINGLY, RECOGNIZING THAT COORDINATION AMONGST ITS HOSPITALS AND SHARING OF RESOURCES WILL BE REQUIRED TO SUPREMELY EFFECTIVE: HUGHSTON HOSPITAL SHALL PRIMARILY COORDINATE STRATEGIES TO ADDRESS THE CHALLENGES OF CHILDHOOD OBESITY AND SEPARATELY, NUTRITION.THE ENTIRE RESPONSE CAN BE ACCESSED AT:HTTP://WWW.COLUMBUSREGIONAL.COM/MEDIA/FILE/COMMUNITYHEALTHRESPONSE/2013_COMMUNITY_HEALTH_RESPONSE_PLAN-HUGHSTONHOSPITAL.PDF HUGHSTON HOSPITAL, INC. PART V, SECTION B, LINE 13B: HUGHSTON HOSPITAL, INC. ALSO CONSIDERS PATIENTS WITH INCOME LOW ENOUGH THAT THEY ARE NOT REQUIRED TO FILE AN INCOME TAX RETURN. HUGHSTON HOSPITAL, INC. PART V, SECTION B, LINE 13H: IN CALCULATING AMOUNTS CHARGED TO FINANCIAL ASSISTANCE POLICY ELIGIBLE PATIENTS, HUGHSTON HOSPITAL, INC. ALSO CONSIDERS THE RESIDENCY OF APPLICANTS TO DETERMINE FOR WHICH FINANCIAL ASSISTANCE PROGRAM THE PATIENT MAY QUALIFY. HUGHSTON HOSPITAL, INC. PART V, SECTION B, LINE 22D: THE AMOUNTS GENERALLY BILLED (AGB) FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE ARE CALCULATED BASED ON MEDICARE FEE FOR SERVICE. THE FACILITY CALCULATES THE CHARGE FOR SERVICE DIVIDED BY THE SUM OF ASSOCIATED GROSS CHARGES RELATED TO THOSE CLAIMS. IF A PATIENT DOES NOT QUALIFY FOR ANY OF THE EXTENSIVE FINANCIAL ASSISTANCE AVAILABLE AND IS UNINSURED, A DISCOUNT OF 30% BILLED CHARGES IS AVAILABLE. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY HUGHSTON HOSPITAL, INC. PART V, SECTION B, LINE 16A WEBSITE: HTTP://COLUMBUSREGIONAL.COM/MEDIA/1260/CHARITY-CARE-POLICY.PDF HUGHSTON HOSPITAL, INC. PART V, SECTION B, LINE 16B WEBSITE: HTTP://COLUMBUSREGIONAL.COM/MEDIA/1258/FINANCIAL-ASSISTANCE-APPLICATION.PDF HUGHSTON HOSPITAL, INC. PART V, SECTION B, LINE 16C WEBSITE: HTTP://COLUMBUSREGIONAL.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE/ PART I, LINE 7: THE AMOUNTS ON LINE 7, COLUMN C WERE CALCULATED USING THE COST TO CHARGE RATIO FROM THE ORGANIZATION'S FISCAL YEAR 2014 FILED MEDICARE COST REPORT AND IS A COMPOSITE OF TRADITIONAL AND MANAGED CARE MEDICARE AND TRICARE COST TO CHARGE RATIOS EXCLUDING THE INPATIENT REHABILITATION UNIT. PART I, LN 7 COL(F): BAD DEBT EXPENSE IN THE AMOUNT OF $1,010,635 WAS SUBTRACTED FROM FORM 990, PART IX, LINE 25 FOR PURPOSES OF COMPUTING THE PERCENTAGE IN THIS COLUMN. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF BOTH AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND AN ESTIMATED ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS. THE CONTRACTUAL ALLOWANCE REPRESENTS THE DIFFERENCE BETWEEN ESTABLISHED BILLING RATES AND ESTIMATED REIMBURSEMENT FROM MEDICARE, MEDICAID, AND OTHER THIRD-PARTY PAYMENT PROGRAMS. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTIMATED BASED UPON THE AGE OF THE PATIENT ACCOUNT, PRIOR EXPERIENCE AND ANY UNUSUAL CIRCUMSTANCES WHICH MAY AFFECT THE COLLECTABILITY OF RECEIVABLES, INCLUDING MANAGEMENT'S ASSUMPTIONS AND JUDGMENTS ABOUT CONDITIONS IT EXPECTS TO EXIST AND COURSES OF ACTION IT EXPECTS TO TAKE. PART III, LINE 8: HUGHSTON HOSPITAL, INC. BELIEVES THAT ALL OF THE MEDICARE SHORTFALL REPORTED ON LINE 7 SHOULD BE TREATED AS COMMUNITY BENEFIT. MEMBERS OF THE MEDICARE COMMUNITY ARE PROVIDED THE SAME CARE AND TREATMENT AS ALL OTHER PATIENTS OF THIS FACILITY. BECAUSE OF LOW PAYMENT RATES OF THE MEDICARE PROGRAM, LOSSES RELATED TO SERVING THIS IMPORTANT POPULATION OF OUR COMMUNITY INDICATE THAT HUGHSTON HOSPITAL, INC. IS DEDICATED TO PROVIDING QUALITY HEALTHCARE TO ALL PATIENTS REGARDLESS OF REIMBURSEMENT. THE SOURCE USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 WAS THE MEDICARE COST REPORT. PART III, LINE 9B: IT IS THE POLICY OF HUGHSTON HOSPITAL, INC. TO PROVIDE QUALITY MEDICAL CARE TO ALL PATIENTS. THOSE PATIENTS REQUIRING FINANCIAL ASSISTANCE ARE TREATED IN THIS FACILITY AND ARE TREATED EQUALLY REGARDLESS OF THEIR ABILITY TO PAY. PATIENTS THAT HAVE QUALIFIED FOR FINANCIAL ASSISTANCE ARE CATEGORIZED INTO GROUPS IN ORDER TO CAPTURE THEIR DISPOSITION FOR THE STATE OF GEORGIA INDIGENCY GUIDELINES. PART VI, LINE 2: THE FORMAL NEEDS ASSESSMENT WAS CONDUCTED BY THE INDEPENDENT RESEARCH FIRM, PROFESSIONAL RESEARCH CONSULTANTS, INC. THE HEALTH STATUS, BEHAVIORS AND NEEDS OF THE RESIDENTS OF MUSCOGEE COUNTY, GEORGIA WERE DETERMINED USING A SYSTEMATIC, DATA-DRIVEN APPROACH. THE COMMUNITY NEEDS ASSESSMENT PROVIDED INFORMATION TO ALLOW COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. TO: IDENTIFY NEEDS THAT IF ADDRESSED COULD LEAD TO IMPROVED HEALTH STATUS, INCREASE LIFE SPANS AND ELEVATE OVERALL QUALITY OF LIFE; REDUCE HEALTH DISPARITIES; AND INCREASE ACCESSIBILITY TO PREVENTATIVE SERVICES FOR ALL RESIDENTS IN THE SERVICE AREA. THE PRIMARY DATA FROM PROFESSIONAL RESEARCH CONSULTANTS IS REFLECTIVE OF A POPULATION-BASED TELEPHONE SURVEY WITH RANDOM SAMPLING OF RESIDENTS IN THE COMMUNITY SEGMENTED BY VARYING ZIP CODES FOR EASE OF GEOGRAPHICAL IDENTIFICATION. THE TELEPHONE SURVEYS INCLUDED LANDLINE SUPPLEMENTED BY CELL PHONE NUMBERS AND FINDINGS WERE GENERALIZED TO INDIVIDUALS VERSUS HOUSEHOLDS. IN ORDER TO QUANTIFY INDIVIDUAL EXPERIENCES AND BEHAVIORS, PROFESSIONAL RESEARCH CONSULTANTS USED THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM WHICH ALLOWED FOR RANDOMIZED SAMPLING WITHIN THE HOUSEHOLD. BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM IS A NATIONAL TELEPHONE HEALTH SURVEY SYSTEM ESTABLISHED BY THE CENTER FOR DISEASE CONTROL. THE SYSTEM ADDRESSES SUCH ISSUES AS MEDICAL CONDITIONS, ACCESS TO CARE AND INJURY CONTROL. THE INFORMATION FROM THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM WAS COMBINED WITH THE PROFESSIONAL RESEARCH CONSULTANTS CUSTOMIZED COMMUNITY HEALTH SURVEY FINDINGS REFLECTIVE OF GENERAL HEALTH STATUS, PRIMARY CARE, ACCESS TO HEALTHCARE SERVICES, USE OF ALCOHOL AND TOBACCO, DISEASE SCREENING, NUTRITION AND PHYSICAL FITNESS, AMONG OTHERS TO COMPLETE THEIR PRIMARY RESEARCH.THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED FOURTEEN PRIORITY COMMUNITY NEEDS. COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. HAS SELECTED NINE OF THE IDENTIFIED PRIORITY AREAS TO FOCUS ITS EFFORTS. THOSE NINE WILL BE DIVIDED BETWEEN HUGHSTON HOSPITAL, INC., THE MEIDCAL CENTER, INC. AND DOCTOR'S HOSPITAL, INC., THE THREE AFFILIATE HOSPITALS IN THE COLUMBUS REGIONAL HEALTHCARE SYSTEM.THE REMAINING FIVE PRIORITY AREAS WILL HAVE MORE LIMITED FOCUS BY THE COLUMBUS REGIONAL HEALTHCARE SYSTEM BUT WILL BE ADDRESSED BY THE SYSTEM IN MANY MEANINGFUL WAYS. COLUMBUS REGIONAL HEALTHCARE SYSTEM WILL PLAY A LEADERSHIP ROLE IN HELPING TO COORDINATE CARE AND SERVICES SO AS TO CONSERVE THE LIMITED FISCAL RESOURCES OF THE STATE AND FEDERAL GOVERNMENTS, WHILE REDUCING DUPLICATION OF SERVICES AND WHILE ALSO BEING A PRIMARY PROVIDER OF SERVICES AS FEASIBLE.WITH THE COMPLETION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. DEVELOPED A THREE YEAR PLAN TO ADDRESS THE NINE PRIORITY AREAS. THE PLAN RELIES ON SPECIFIC, MEASURABLE, ACHIEVABLE, REALISTIC AND TIME SPECIFIC ACTION STEPS. THIS APPROACH WILL SUPPORT THE PROCESS OF ONGOING EVALUATION THROUGH EASIER IDENTIFICATION OF AREAS THAT NEED MODIFICATION AND CAN REASONABLY BE EXPECTED TO BE IMPACTED BY THE EFFORTS OF COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. PART VI, LINE 3: THE ORGANIZATION HAS POSTED SIGNS IN ALL PATIENT ACCESS AREAS INFORMING THE PATIENTS OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAMS. WRITTEN INFORMATION IS ALSO PROVIDED TO ALL PATIENTS AT THE POINT OF REGISTRATION. IN ADDITION, ALL STATEMENTS SENT TO PATIENTS CONTAIN A MESSAGE ABOUT WHO TO CALL IF FINANCIAL ASSISTANCE IS NEEDED. PART VI, LINE 4: HUGHSTON HOSPITAL, INC., LOCATED IN COLUMBUS, GEORGIA, IS A NOT-FOR-PROFIT 100-BED PRIVATE ROOM HOSPITAL THAT IS NATIONALLY RECOGNIZED FOR DELIVERING OUTSTANDING CLINICAL QUALITY AND THE HIGHEST LEVELS OF CUSTOMER SERVICE. COLUMBUS IS LOCATED APPROXIMATELY 100 MILES SOUTHWEST OF ATLANTA AND IS THE THIRD LARGEST CITY IN THE STATE OF GEORGIA AND THE 116TH LARGEST CITY IN THE UNITED STATES. THE CITY COVERS A TOTAL OF 220.8 SQUARE MILES WHICH INCLUDES 4.7 MILES OF WATER AND 216.1 FILES OF LAND. COLUMBUS, GA IS THE BORDER AND THE SYSTEM IS LOCATED APPROXIMATELY ONE MILE FROM THE ALABAMA/GEORGIA BOUNDARY AND SERVES 2 COUNTIES IN ALABAMA. IN 2012, THE COLUMBUS, GEORGIA METROPOLITAN AREA HAD AN ESTIMATED POPULATION OF 198,413. THE WEST GEORGIA HEALTH DISTRICT IS LOCATED IN COLUMBUS AND SERVES A 15 COUNTY AREA IN GEORGIA WHICH INCLUDES TWO OF GEORGIA'S POOREST COUNTIES.COLUMBUS, GEORGIA IS LOCATED IN MUSCOGEE COUNTY WHICH IS COMPRISED OF 48.7% MALE AND 51.3% FEMALE. THE ETHNIC MIX OF THE POPULATION IS 43.0% WHITE, 46.1% BLACK, 7.3% HISPANIC, AND 3.6% OTHER. APPROXIMATELY 2.6% ARE PERSONS OF MIXED RACE. PERSONS UNDER THE AGE OF 5 ACCOUNT FOR 7.6% OF THE POPULATION WHILE PERSONS UNDER AGE 18 ACCOUNT FOR 25.4% AND PERSONS OVER THE AGE OF 65 ACCOUNT FOR 11.5%. THERE ARE APPROXIMATLEY 2.45 PERSONS PER HOUSEHOLD. MEDIAN INCOME FOR THIS AREA IS $41,088. THE TOTAL OF 18.8% OF THE POPULATION IN THIS AREA IS BELOW THE POVERTY LEVEL. PART VI, LINE 5: SINCE 1984, HUGHSTON HOSPITAL, INC. HAS PROVIDED OUR COMMUNITY EXCELLENCE IN ORTHOPEDIC AND REHABILITATIVE CARE. SERVICES FOCUSED EXCLUSIVELY ORTHOPEDIC AND REHABILITATIVE CARE. SERVICES ARE DELIVERED THROUGH A HIGHLY SPECIALIZED TEAM OF PROFESSIONALS USING THE LATEST TECHNOLOGY AND RESEARCH TO CARE FOR PEOPLE OF EVERY AGE AND ABILITY AND EVERY LEVEL OF MUSCULOSKELETAL INJURY OR DISORDER.HUGHSTON HOSPITAL, INC. WAS THE NATION'S FIRST HOSPITAL DESIGNED SPECIFICALLY TO TREAT PATIENTS WITH MUSCULOSKELETAL INJURIES OR DISORDERS. TODAY, THE 100-BED, PRIVATE ROOM HOSPITAL IS NATIONALLY RECOGNIZED FOR DELIVERING OUTSTANDING CLINICAL QUALITY AND THE HIGHEST LEVELS OF CUSTOMER SERVICE.HUGHSTON HOSPITAL, INC. BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY LEADERS DEDICATED TO PROVIDING QUALITY HEALTHCARE FOR OUR COMMUNITY. IN GENERAL, OUR VOLUNTEER BOARD MEMBERS ARE PERSONS WHO RESIDE IN OUR PRIMARY SERVICE AREA AND NEITHER THEY (NOR THEIR FAMILY MEMBERS) ARE EMPLOYEES ARE CONTRACTORS OF THE ORGANIZATION.MEDICAL STAFF PRIVILEGES IN THE HOSPITAL ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS AS DETERMINED THROUGH A DETAILED CREDENTIALING PROCESS. HUGHSTON HOSPITAL, INC. HAS OVER 200 AFFILIATED PHYSICIANS WITH 100 PHYSICIANS IN THE ACTIVE OR ACTIVE PROVISIONAL CATEGORIES PROVIDING HEALTHCARE SERVICE AT HUGHSTON HOSPITAL, INC. THE ORGANIZATION REINVESTS ALL PROFITS BACK INTO PHYSICIAN AND STAFF TRAINING AND FACILITIES AND EQUIPMENT TO CONTINUALLY IMPROVE PATIENT CARE. IN CONTRACTS TO INVESTOR-OWNED HOSPITALS, NO PART OF NET EARNINGS DIRECTLY OR INDIRECTLY BENEFITS ANY PRIVATE SHAREHOLDERS OR INDIVIDUALS.ALL FACILITIES PARTICIPATE IN MEDICARE, MEDICAID, CHAMPUS AND PEACHCARE AS APPROPRIATE FOR SERVICES PROVIDED. PART VI, LINE 6: HUGHSTON HOSPITAL, INC. IS PART OF THE COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. THIS SYSTEM WAS ORGANIZED TO PLAN, DEVELOP AND COORDINATE THE ACTIVITIES OF AN INTEGRATED HEALTH NETWORK SERVING WEST GEORGIA AND EAST ALABAMA. THE SYSTEM'S RESPONSIBILITIES INCLUDE STRATEGIC PLANNING, PROJECT DEVELOPMENT, RESOURCE ALLOCATION, PROPERTY MANAGEMENT, DEVELOPMENT OF PHYSICIAN PRACTICES, MARKETING AND COMMUNICATION AND COMMUNITY HEALTH EDUCATION. AS A PART OF THIS SYSTEM, DOCTOR'S HOSPITAL, INC. MAKES QUALITY HEALTH CARE SERVICES AVAILABLE TO EVERYONE IN ITS SERVICE AREA, REGARDLESS OF A PATIENT'S ABILITY TO PAY. THE SERVICES PROVIDED INCLUDE ACUTE, PRIMARY AND PREVENTIVE CARE, MEDICAL EDUCATION, CLINICAL TRAINING AND COMMUNITY EDUCATION. ALL AFFILIATES IN THIS SYSTEM PLACE A HIGH PRIORITY ON EXCEEDING THE EXPECTATIONS OF EACH PATIENT, VISITOR AND CUSTOMER.AFFILIATES OF HUGHSTON HOSPITAL, INC. IN THE COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. INCLUDE:1) COLUMBUS AMBULATORY HEALTHCARE SERVICES, INC. - A NOT-FOR-PROFIT COMPANY SERVING COLUMBUS AND SURROUNDING COUNTIES. COLUMBUS AMBULATORY HEALTHCARE SERVICES PROVIDES A WIDE VARIETY OF PRIMARY AND SPECIALTY PHYSICIAN SERVICES TO ALL PATIENTS REQUESTING SUCH SERVICES REGARDLESS OF ABILITY TO PAY. MANY OF THESE PATIENTS ARE CLASSIFIED AS INDIGENT RESIDENTS OF MUSCOGEE COUNTY, AND AS SUCH ARE COVERED THROUGH A CONTRACTUAL AGREEMENT WITH THE COLUMBUS CONSOLIDATED GOVERNMENT.2) COLUMBUS REGIONAL MEDICAL FOUNDATION, INC. - A NOT-FOR-PROFIT FOUNDATION ESTABLISHED IN 1983 TO ENDOW AND PROMOTE THE MEDICAL CHARITABLE AND EDUCATIONAL SERVICES OF THE MEDICAL CENTER, INC. PRIMARY FUNCTIONS OF THE FOUNDATION INCLUDE FUND-RAISING TO SUPPORT THE JOHN B. AMOS CANCER CENTER AT THE MEDICAL CENTER, INC. AND THE CHILDREN'S MIRACLE NETWORK, TO SUPPORT CLINICAL EDUCATION THROUGH STUDENT SCHOLARSHIPS AND FELLOWSHIPS, AND TO PROVIDE FUNDING FOR THE MEDICAL CENTER TO PURCHASE HEALTH, MEDICAL AND RELATED EQUIPMENT TO BENEFIT PATIENTS AND ENHANCE SERVICES TO THE COMMUNITY.3) THE MEDICAL CENTER, INC. - A NOT-FOR-PROFIT 413-BED LICENSED ACUTE CARE HOSPITAL LOCATED IN COLUMBUS, GEORGIA. IN KEEPING WITH ITS TAX-EXEMPT MISSION, THE MEDICAL CENTER MAKES QUALITY HEALTH CARE SERVICES AVAILABLE TO EVERYONE IN ITS SERVICE AREA, REGARDLESS OF A PATIENT'S ABILITY TO PAY. THE SERVICES PROVIDED INCLUDED ACUTE, PRIMARY AND PREVENTIVE CARE, MEDICAL EDUCATION, CLINICAL TRANING AND COMMUNITY EDUCATION.4) DOCTOR'S HOSPITAL, INC. - A NOT-FOR-PROFIT 219-BED GENERAL ACUTE CARE FACILITY THAT HAS SERVED THE REGION SINCE 1975. THE HOSPITAL IS KNOWN THROUGHOUT THE COMMUNITY FOR ITS QUALITY OF CARE AND CUSTOMER SERVICE. SERVICES INCLUDE MEDICAL AND SURGICAL SERVICES, IMAGING, A SLEEP DISORDERS CENTER AND SPECIALTY UNITS FOR GYNECOLOGY, OBSTETRICS, POST-SURGICAL, REHABILITATIVE AND TELEMETRY/CRITICAL CARE UNIT. THIS COMPREHENSIVE NETWORK OF SERVICES TOUCHES THE LIVES OF MOST OF THE CHILDREN AND ADULTS IN THIS REGION. DOCTOR'S HOSPITAL PLACES A PRIORITY ON EACH PATIENT ENCOUNTER AND LISTENS TO THE NEEDS OF THE COMMUNITY AND PROVIDES A HIGH QUALITY SERVICE TO CONTINUALLY MEET THOSE NEEDS.5) COLUMBUS REGIONAL SENIOR LIVING, INC. - A NOT-FOR-PROFIT CONTINUING CARE RETIREMENT COMMUNITY NAMED SPRING HARBOR AT GREEN ISLAND. SPRING HARBOR PROVIDES CONTINUING CARE LIVING FOR INDEPENDENT OLDER ADULTS WITH COMPREHENSIVE HEALTH AND MEDICAL SERVICES AVAILABLE, INCLUDING ASSISTED LIVING, ALZHEIMER'S DISEASE CARE AND LONG-TERM NURSING CARE. THIS COMMUNITY IS DESIGNED FOR PEOPLE 62 OR OLDER. INDEPENDENT LIVING UNITS INCLUDE TWO AND THREE-BEDROOM APARTMENTS AND GARDEN HOMES. ALL UNITS ARE EQUIPPED WITH CALL SYSTEMS TO SUMMON HELP IF A HEALTH OR MEDICAL PROBLEM ARISES. 6) COLUMBUS REGIONAL AUXILIARY - A NOT-FOR-PROFIT ASSOCIATION PROVIDING A WIDE VARIETY OF VALUABLE SERVICES TO THE MEDICAL CENTER, DOCTOR'S HOSPITAL AND HUGHSTON HOSPITAL. THE AUXILIARY WAS ESTABLISHED IN 1963. MEMBERS VOLUNTEER IN DIFFERENT DEPARTMENTS THROUGHOUT THE ORGANIZATION TO PROVIDE ASSISTANCE TO PATIENTS AND THEIR FAMILIES AND EMPLOYEES. MEMBERS ALSO ASSIST WITH VARIOUS COMMUNITY ACTIVITIES ON BEHALF OF THE THREE AFFILIATE HOSPITALS. 7) CRHS LONG TERM AND HOME CARE, INC. - A NOT-FOR-PROFIT ORGANIZATION FORMED TO PROVIDE SKILLED NURSING FACILITIES FOR RESIDENTS OF MUSCOGEE COUNTY. CRHS LONG TERM AND HOME CARE, INC. SOLD ITS FACILITY TO THE HOSPITAL AUTHORITY IN MARCH 2012. PRIORITY ON EACH PATIENT ENCOUNTER AND LISTENS TO THE NEEDS OF THE COMMUNITY AND PROVIDES A HIGH QUALITY SERVICE TO CONTINUALLY MEET THOSE NEEDS. PART VI, LINE 7, REPORTS FILED WITH STATES GA X X X X X 1 1 0 0 0 0 0 0 0 M SCOTT HILL PRESIDENT & CEO CRHS 0 513294 0 0 0 134952 0 113558 0 21516 0 783320 0 128547 ALLEN R BUTCHER SR. VP & CFO 0 282693 0 0 0 44506 0 58344 0 10873 0 396416 0 0 TAMARA L JACKSON CEO; TRMD 11/3/14 190472 0 0 0 1785 0 7488 0 5529 0 205274 0 67800 0 MICHELLE BREITFELDER VP & CNO 187898 0 0 0 100877 0 15689 0 14881 0 319345 0 89631 0 CHARLES A STARK PRESIDENT & CEO; RSGND 6/12/14 0 688509 0 0 0 698091 0 9945 0 22758 0 1419303 0 585755 ROLAND L THACKER SR. VP & CFO; TRMD 10/31/13 0 308649 0 0 0 6382 0 17459 0 15339 0 347829 0 0 PART I, LINES 4A-B THE COLUMBUS REGIONAL HEALTHCARE SYSTEM MAINTAINS A SERP PLAN THAT VESTS EVERY 3 YEARS FOR ITS PARTICIPATING OFFICERS. THE LAST VESTING OCCURRED ON 6/30/2014; THEREFORE, NO PAYMENT WAS MADE IN THE FISCAL YEAR ENDING 6/30/2015. THE NEXT VESTING DATE WILL OCCUR ON 6/30/2017. EMPLOYER CONTRIBUTIONS TO 457(F) EXECUTIVE RETIREMENT BENEFIT PLAN: SCOTT HILL $104,500 ALLEN BUTCHER $ 57,200 PAYOUT FROM 457(F) EXECUTIVE RETIREMENT BENEFIT PLAN (INCLUDED IN REPORTABLE COMPENSATION): CHARLES STARK: $585,755 SCOTT HILL $128,547 MICHELLE BREITFELDER $ 89,631 TAMARA JACKSON $ 67,800 SEVERANCE PAYMENTS: THE 2014 W-2 INCOME RECEIVED BY CHARLES STARK AND ROLAND THACKER REPRESENTS SEVERANCE COMPENSATION FROM RELATED ENTITY, COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. CHARLES STARK RECEIVED SEVERANCE THROUGH 3/15/15. ROLAND THACKER RECEIVED SEVERANCE THROUGH 10/31/14. TAMARA JACKSON WILL RECEIVE SEVERANCE FROM HUGHSTON HOSPITAL THROUGH 11/2/15. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC - A RELATED 501(C)(3) ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS OF HUGHSTON HOSPITAL, INC. IS APPOINTED BY THE BOARD OF COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. - A RELATED 501(C)(3) ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF DIRECTORS OF HUGHSTON HOSPITAL, INC. DETERMINES THE ISSUES THAT ARE BROUGHT UP FOR DISCUSSION AND MOST ITEMS CAN BE APPROVED ALONG WITH THE EXECUTIVE TEAM OF COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. - A RELATED 501(C)(3) ORGANIZATION. CAPITAL EXPENDITURES IN EXCESS OF $500,000 MUST BE APPROVED BY THE COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. FORM 990, PART VI, SECTION B, LINE 11 INFORMATION FOR FORM 990 WAS PROVIDED TO AN INDEPENDENT CPA FIRM FOR PREPARATION OF THE RETURN. AFTER THE RETURN WAS PREPARED IT WAS REVIEWED BY THE CFO OF THE ORGANIZATION. THE BOARD IS PROVIDED A THOROUGH AND CONDENSED OVERVIEW OF INFORMATION ON THE FORM 990 AT A BOARD MEETING BY THE CFO OF THE ORGANIZATION ASSISTED BY THE INDEPENDENT CPA PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C COLUMBUS REGIONAL HEALTHCARE SYSTEM AND ITS AFFILIATES ARE ACCOUNTABLE TO GOVERNMENTAL AUTHORITIES AS WELL AS TO MEMBERS OF THE PUBLIC FOR BOTH THE INTEGRITY OF ITS ACTIONS AS WELL AS PERCEPTIONS AS RELATED TO THOSE ACTIONS. CONSEQUENTLY, THERE EXISTS BETWEEN COLUMBUS REGIONAL AND THE PUBLIC THE FIDUCIARY RESPONSIBILITY WHICH CARRIES WITH IT A BROAD AND UNBENDING DUTY OF LOYALTY AND FIDELITY. COLUMBUS REGIONAL AGENTS (I.E., BOARD MEMBERS, MANAGEMENT, EMPLOYEES, CONTRACTED PARTIES AND CREDENTIALED STAFF) HAVE THE RESPONSIBILITY OF ADMINISTERING THE AFFAIRS OF THE ORGANIZATION HONESTLY AND PRUDENTLY, AND OF EXERCISING THE BEST CARE, SKILL AND JUDGMENT FOR THE SOLE BENEFIT OF COLUMBUS REGIONAL. THOSE AGENTS SHALL EXERCISE THE UTMOST GOOD FAITH IN ALL TRANSACTIONS INVOLVED IN THEIR DUTIES AND SHALL NOT USE THEIR POSITIONS WITH COLUMBUS REGIONAL OR KNOWLEDGE GAINED FOR THEIR PERSONAL BENEFIT IN ANY MANNER. THE INTEREST OF THE ORGANIZATION MUST BE THE FIRST PRIORITY IN ALL RELATED DECISIONS AND ACTIONS. THIS POLICY IS ALSO DIRECTED TOWARD ANYONE WHO HAS PROPRIETARY INFORMATION CONCERNING COLUMBUS REGIONAL. IT IS THE POLICY OF COLUMBUS REGIONAL HEALTHCARE SYSTEM AND ITS AFFILIATES, IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, ASSOCIATED AGENTS MUST ANNUALLY DISCLOSE THE EXISTENCE OF A FINANCIAL OR OTHERWISE BENEFICIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE CHIEF COMPLIANCE OFFICER ASSOCIATED WITH THE PROPOSED CONFLICTING TRANSACTION OR AGREEMENT. A CONFLICT OF INTEREST MAY ARISE IN THE RELATIONSHIPS WITH COLUMBUS REGIONAL AGENTS WITH PERSONS AND FIRMS FROM WHOM THE COMPANY LEASES PROPERTY AND EQUIPMENT; PERSONS AND FIRMS WITH WHOM COLUMBUS REGIONAL IS DEALING OR PLANNING TO DEAL IN CONNECTION WITH THE GIFT, PURCHASE OR SALE OF REAL ESTATE, SECURITIES OR OTHER PROPERTY; COMPETING OR AFFINITY ORGANIZATIONS; DONORS, MEMBERS OR OTHERS SUPPORTING THE ORGANIZATION; AGENCIES, ORGANIZATIONS AND ASSOCIATIONS WHICH AFFECT THE OPERATIONS OF THE COMPANY; AND FAMILY MEMBERS, FRIENDS AND OTHER EMPLOYEES. CONFLICTS OF INTEREST MAY ARISE IN A NUMBER OF DIFFERENT CIRCUMSTANCES AND TRANSACTIONS. IT IS ASSUMED THAT COLUMBUS REGIONAL AGENTS WILL RECOGNIZE SUCH AREAS AND RELATION BY ANALOGY. TRANSACTIONS WITH PARTIES WITH WHOM A CONFLICTING INTEREST EXISTS MAY BE UNDERTAKEN ONLY IF ALL OF THE FOLLOWING ARE OBSERVED: THE CONFLICT OF INTEREST IS FULLY DISCLOSED; THE PERSON WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION; A COMPETITIVE BID OR COMPARABLE VALUATION EXISTS FOR PURCHASING OR RELATED DECISIONS; AND THE CHIEF COMPLIANCE OFFICER IN CONSULTATION WITH OTHERS AS APPROPRIATE, HAS DETERMINED THAT THE TRANSACTION IS IN THE BEST INTEREST OF THE ORGANIZATION. ALL DISCLOSURES MUST BE MADE TO THE CHIEF COMPLIANCE OFFICER (OR IF SHE/HE IS THE ONE WITH THE CONFLICT, THEN THE BOARD CHAIR), WHO WILL BRING THE MATTER TO THE ATTENTION OF THE BOARD AS NECESSARY. THE CHIEF COMPLIANCE OFFICER, IN CONSULTATION WITH OTHERS AS APPROPRIATE, SHALL DETERMINE WHETHER A CONFLICT EXISTS AND IN THE CASE OF AN EXISTING CONFLICT, WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR AND REASONABLE TO THE ORGANIZATION. THE DECISION OF THE CHIEF COMPLIANCE OFFICER AND/OR BOARD ON THESE MATTERS WILL REST IN THEIR SOLE DISCRETION AND THEIR CONCERN MUST BE FOR THE WELFARE OF THE ORGANIZATION IN THE ADVANCEMENT OF ITS PURPOSE. EACH MEMBER OF MANAGEMENT AND EMPLOYEES WITH DELEGATED POWERS WHO CAN INFLUENCE THE ACTIONS OF COLUMBUS REGIONAL SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON: HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY AND COMPLETED THE DISCLOSURE STATEMENT; HAS READ AND UNDERSTANDS THE POLICY; AND HAS AGREED TO COMPLY WITH THE POLICY. IN ADDITION, SHOULD A POTENTIAL CONFLICT OCCUR DURING THE YEAR BUT PRIOR TO THE ANNUAL DISCLOSURE, THE INDIVIDUAL IS OBLIGATED TO CONTACT THE CHIEF COMPLIANCE OFFICER AND UPDATE THEIR DISCLOSURE STATEMENT IN A TIMELY MANNER. IF THE CHIEF COMPLIANCE OFFICER HAS REASONABLE CAUSE TO BELIEVE A COLUMBUS REGIONAL AGENT HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, HE/SHE SHALL INFORM THAT INDIVIDUAL OF THE BASIS OF SUCH BELIEF AND AFFORD HIM/HER THE OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE INDIVIDUAL'S RESPONSE AND AFTER MAKING FURTHER INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, THE CHIEF COMPLIANCE OFFICER DETERMINES THE INDIVIDUAL HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, HE/SHE SHALL FORWARD THE INFORMATION TO THE HUMAN RESOURCES DEPARTMENT AND/OR THE BOARD OF DIRECTORS TO TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. FORM 990, PART VI, SECTION B, LINE 15 COLUMBUS REGIONAL TAKES VERY SERIOUSLY THE RESPONSIBILITY TO APPROPRIATELY AND EFFECTIVELY MANAGE THE EXECUTIVE COMPENSATION AND BENEFITS PROGRAM FOR ITS KEY EXECUTIVES. SETTING THE COMPENSATION OR THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, APPROVING THE COMPENSATION OF OTHER SENIOR EXECUTIVES, AND OVERSEEING THE EXECUTIVE COMPENSATION PROGRAM AS A WHOLE, ARE THE RESPONSIBILITIES OF THE COMPENSATION COMMITTEE OF THE BOARD. TO ASSIST THE COMMITTEE, THE BOARD HAS ENGAGED THE SERVICES OF A NATIONALLY RECOGNIZED EXECUTIVE COMPENSATION CONSULTING FIRM. COLUMBUS REGIONAL'S EXECUTIVE COMPENSATION PROGRAM IS DESIGNED TO ATTRACT AND RETAIN HIGHLY QUALIFIED EXECUTIVES TO FULFILL COLUMBUS REGIONAL'S MISSION OF PROMOTING THE HEALTH AND HEALING OF PATIENTS. COLUMBUS REGIONALS PEER GROUP CONSISTS OF NON-PROFIT HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE AND COMPLEXITY FROM ACROSS THE NATION. BASE SALARIES OF EXECUTIVES ARE POSITIONED AT SPECIFIC PERCENTILE TARGETS OF COLUMBUS REGIONAL'S PEER GROUP. CURRENT STUDIES INDICATE THAT OUR BASE SALARIES ARE AT TARGETED LEVELS. COLUMBUS REGIONAL STRIVES TO PROVIDE ALL EXECUTIVES WITH RETIREMENT BENEFITS THAT ARE EQUIVALENT FOR ALL EMPLOYEES. RETIREMENT CONTRIBUTIONS ARE BASED ON A CLEARLY STATED INCOME REPLACEMENT TARGET AS DETERMINED BY RETIREMENT PLAN CONSULTANTS. THE GOAL OF COLUMBUS REGIONAL IS TO PROVIDE MARKET COMPETITIVE COMPENSATION AND BENEFITS PROGRAMS FOR ALL EMPLOYEES AT ALL LEVELS OF THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE CONFLICT OF INTEREST POLICY, AS WELL AS FINANCIAL STATEMENTS AND OTHER CORPORATE AND GOVERNING DOCUMENTS, IS NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: FUNDS TRANSFER FROM FOUNDATION 201,122. 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