2015-05-13T13:01:32-05:00 2014-06-30 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2013-07-01 582175978 CRISP REGIONAL HOSPITAL INC CRIS 2292763130 902 7TH STREET NORTH CORDELE GA 310153234 STEVEN GAUTNEY CEO 2292763130 2015-05-15 true JACQUELINE G ATKINS P00861721 2298837878 2015-05-12 2013 2016-02-25 16:41:14Z STEVEN GAUTNEY 902 7TH STREET NORTH CORDELE GA 310153234 74088918 false X WWW.CRISPREGIONAL.ORG X 1995 GA TO PROVIDE APPROPRIATE, QUALITY CARE AND ASSISTANCE IN MAINTAINING GOOD HEALTH IN AN EFFICIENT AND CARING MANNER TO ALL WHO NEED OUR SERVICES AND AS NEAR THEIR HOME AS POSSIBLE. 8 6 972 48 -11706 -11706 3573 37843 63609347 71602981 356582 293215 1739189 2067773 65708691 74001812 216370 208781 0 30323098 32699457 0 0 34340487 37331571 64879955 70239809 828736 3762003 99541315 101650774 37934172 35901711 61607143 65749063 TO PROVIDE APPROPRIATE, QUALITY CARE AND ASSISTANCE IN MAINTAINING GOOD HEALTH IN AN EFFICIENT AND CARING MANNER TO ALL WHO NEED OUR SERVICES AND AS NEAR THEIR HOME AS POSSIBLE. false false 48997559 208781 72711881 HOSPITAL, SNF & HHA; SHORT-TERM ACUTE CARE FOR IP & OP SERVICES FOR CRISP COUNTY AND SURROUNDING COUNTIES. TOTAL PATIENT DAYS FOR FYE 6/30/14 WERE 12,488; HHA VISITS FOR WERE 10,128; AND SNF PATIENT DAYS WERE 26,189; CORDELE HEALTH AND REHABILITATION (A FREE-STANDING SNF) PATIENT DAYS TOTAL 23,398. 48997559 true false 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 false true true true false false false false false false false false false false false false false false false true true true false false true 187 0 972 true true true false false false false false false false false false X 8 6 false false false false false false false true true false false true true true true true true true true true true GA X JESSICA CARTER 2292763130 902 7TH STREET CORDELE GA 310153234 STEVE GAUTNEY PRES/CEO 40.00 3.00 X X 255184 0 31059 WILLIAM PANNELL MD BOARD MEMBER 1.00 1.00 X 225255 0 0 SULE SALAMI MD ASST SEC/TRE 1.00 1.00 X X 2700 0 0 ROE J DAVIS CHAIRMAN 1.00 3.00 X X 0 0 0 BETTYE ROBERSON FORMER BOARD 1.00 1.00 X 0 0 0 RONNEY LEDFORD FRMR SECRETA 1.00 X X 0 0 0 WAYNE MARTIN BOARD MEMBER 1.00 2.00 X 0 0 0 MIKE MILLER RPH BOARD MEMBER 1.00 X 0 0 0 PHIL BERRYMAN FORMER BOARD 1.00 X 0 0 0 NOEL WILLIAMS JR BOARD MEMBER 1.00 1.00 X 0 0 0 RANN FOLSOM SECRETARY/TR 1.00 X X 0 0 0 JESSICA CARTER CFO 40.00 3.00 X 151974 0 30132 SRILATHA NADIPINENI MD PHYSICIAN 40.00 X 257880 0 22632 VISHAL BURRA MD PHYSICIAN 40.00 X 183281 0 14983 MARILYN CARTER MD PHYSICIAN 40.00 X 166857 0 0 MILTON JONES MD PHYSICIAN 40.00 X 158873 0 22783 MARY ELLEN HANCOCK PHARMACIST 40.00 X 123759 0 13604 1525763 135193 16 false true false ROBINS & MORTON P O BOX 59289 BIRMINGHAM AL 35259 CONSTRUCTION 5534314 INNOVATIVE THERAPY CONCEPTS LLC 2 MASHBURN ST SUITE 102 HAWKINSVILLE GA 31036 THERAPY 1309981 SONOCARE INC 155 OVERLOOK ROAD AMERICUS GA 31709 ULTRASOUND SVC 434215 GT YOUNG LLC 79 ABERDEEN CIRCLE CORDELE GA 31015 ANESTHESIA 402400 BOLD PERFORMANCE STRATEGIES LLC P O BOX 27697 PANAMA CITY BEACH FL 32411 CONSULTING SVC 366601 28 7255 30588 37843 PROGRAM SERVICE REVENUE 623000 68975227 68975227 MEDICAID EHR INCENTIVES 621990 2037554 2037554 EMS OPERATIONS CONTRACT 621910 590200 590200 71602981 347341 347341 186113 32073 154040 154040 165746 -11706 907 55033 -54126 -54126 -54126 29145 29145 29145 OTHER REVENUES 621990 798218 798218 DIETARY/VENDING 722513 527136 527136 DIETARY CATERING 722513 303130 303130 256104 144936 111168 1884588 74001812 72711881 -11706 1263794 X 208781 208781 696304 222700 473604 25242852 18628648 6614204 575199 507935 67264 3734995 2111750 1623245 2450107 1636230 813877 486734 45000 441734 407284 407284 158776 158776 9801 9801 13592536 10894024 2698512 182927 77299 105628 4339601 3476899 862702 2247857 192612 2055245 589273 381162 208111 63017 34630 28387 4158646 1827123 2331523 1032729 537687 495042 MEDICAL SUPPLIES 7739461 7739461 LICENSES AND TAXES 1323669 26177 1297492 REPAIRS & MAINTENANCE 253731 118157 135574 HOSPITAL/NURSING HOME 247208 247208 498321 84076 414245 70239809 48997559 21242250 0 173273 293249 5907926 8733146 9383619 11845857 1470066 1419945 1181283 1024559 84968602 47424395 39916645 37544207 35965560 34602074 402000 415865 1787041 3505730 3353902 2266142 99541315 101650774 5964172 5015456 31970000 30615000 271255 37934172 35901711 X 61607143 65749063 61607143 65749063 99541315 101650774 3762003 379917 X false true X true false X false false false false false false false false true 9801 9801 false SCHEDULE C, PART II-B, LINE 1 THE HOSPITAL PAYS MEMBERSHIP DUES TO NATIONAL AND STATE ORGANIZATIONS. A PORTION OF THOSE DUES IS ALLOCATED TO LOBBYING ACTIVITIES IN WHICH THOSE ORGANIZATIONS PARTICIPATE. 2102410 2102410 44729592 18571880 26157712 1070174 981189 88985 37013379 27871326 9142053 53047 53047 37544207 THIRD PARTY SETTLEMENTS 271255 271255 X SCHEDULE D, PAGE 3, PART X CRISP REGIONAL HEALTH SERVICES, INC., CRISP REGIONAL HOSPITAL, INC. AND CRISP REGIONAL DEVELOPMENT FOUNDATION, INC. ARE NOT-FOR-PROFIT CORPORATIONS THAT HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE CORPORATIONS APPLY ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THEY ONLY RECOGNIZE 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 OR 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, 2014 AND 2013 OR FOR THE YEARS THEN ENDED. 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 true false false 208381 208381 0.00300 15844026 16312821 -468795 16052407 16312821 -260414 0.00300 9508278 5427977 4080301 0.05810 9508278 5427977 4080301 0.05810 25560685 21740798 3819887 0.06110 false 18490599 16124301 15256349 867952 X true true CRISP HC ALLIANCE HEALTH SERVICES 0.80000 0.20000 1 1 CRISP REGIONAL HOSPITAL INC 902 7TH STREET NORTH CORDELE GA 310105007 WWW.CRISPREGIONAL.ORG X X X SNF, NF, HHA, HOSPICE, RHC, RD CRISP REGIONAL HOSPITAL INC 1 true X X X X X X X X X X 13 true false true X WWW.CRISPREGIONAL.ORG X X X X X true false true true 125.000000000000 true 200.000000000000 true X X X X X true true X X X true false X X X X true X false false FACILITY 1, CRISP REGIONAL HOSPITAL INC - PART V, LINE 3 THE HOSPITALS CHIEF EXECUTIVE OFFICER APPOINTED INDIVIDUALS TO SERVE ON THE CHNA HOSPITAL STEERING COMMITTEE (CHSC). THE CHSC IDENTIFIED COMMUNITY LEADERS, PARTNERS, AND REPRESENTATIVES TO INCLUDE IN THE CHNA PROCESS. INDIVIDUALS, AGENCIES, PARTNERS, POTENTIAL PARTNERS, AND OTHERS WERE REQUESTED TO WORK WITH THE HOSPITAL TO 1) ASSESS THE NEEDS OF THE COMMUNITY, 2) REVIEW AVAILABLE COMMUNITY RESOURCES AND 3) PRIORITIZE THE HEALTH NEEDS OF THE COMMUNITY. GROUPS OR INDIVIDUALS, WHO REPRESENT MEDICALLY-UNDERSERVED POPULATIONS, LOW INCOME POPULATIONS, MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASES, WERE INCLUDED. THE HOSPITAL IDENTIFIED OVER 120 COMMUNITY MEMBERS TO PARTICIPATE IN THE CHNA PROCESS. TWO-HOUR COMMUNITY HEALTH INPUT MEETINGS (COMMUNITY MEETINGS) AND ONE-HOUR COMMUNITY STAKEHOLDER INTERVIEWS (INTERVIEWS) WERE ESSENTIAL PARTS OF THE CHNA PROCESS. THREE COMMUNITY MEETINGS AND 10 STAKEHOLDER INTERVIEWS WERE CONDUCTED IN ORDER TO OBTAIN THE COMMUNITYS INPUT INTO THE HEALTH NEEDS OF CRISP COUNTY. EACH COMMUNITY MEETING WAS DRIVEN BY AN AGENDA PLANNED IN ADVANCE. SIGN-IN SHEETS AND EVALUATIONS WERE ALSO USED. THE COMMUNITY HEALTH PROFILE WAS SHARED WITH THE PARTICIPANTS AT EACH MEETING. PARTICIPANTS WERE ASKED ABOUT THEIR OBSERVATIONS ON THE HEALTH DATA PRESENTED IN THE PROFILE. IN ADDITION, PARTICIPANTS WERE REQUESTED TO PROVIDE INPUT AS TO NEEDS THAT MAY NOT HAVE BEEN IDENTIFIED IN THE PROFILE. QUESTIONS AND DISCUSSION WERE ENCOURAGED, WITH THE OBJECTIVE THAT PARTICIPANTS WOULD INCREASE THEIR UNDERSTANDING OF WHAT THE DATA MEANT IN TERMS OF THE BURDEN OF CHRONIC DISEASES, THE IMPACT OF THE DEMOGRAPHICS OF THE POPULATION ON HEALTH SERVICES, HEALTH STATUS, HEALTH BEHAVIORS, AND, ACCESS TO HEALTH CARE. AS THE GROUP DISCUSSED THE HEALTH PROBLEMS OR HEALTH ISSUES, THE FACILITATOR MADE A LIST OF THE HEALTH PROBLEMS THE COMMUNITY PARTICIPANTS INDICATED WERE IMPORTANT. PRIORITY ISSUES WERE IDENTIFIED AT THE END OF THE DISCUSSION. THESE PRIORITIES DID NOT REFLECT PROGRAMS, SERVICES OR APPROACHES TO RESOLVING PROBLEMS, BUT RATHER HEALTH ISSUES TO BE ADDRESSED. COMMUNITY PARTICIPANTS INCLUDED PHYSICIANS AND OTHER MEDICAL PROFESSIONALS; EDUCATORS; ENTREPRENEURS AND OTHER BUSINESSMEN AND WOMEN; PROFESSIONALS; REPRESENTATIVES FROM THE DEPARTMENT OF LABOR, HOUSING AUTHORITY, LAW ENFORCEMENT, UNITED WAY, AND CHAMBER OF COMMERCE; RELIGIOUS LEADERS AS WELL AS JOURNALISTS. FACILITY 1, CRISP REGIONAL HOSPITAL INC - PART V, LINE 20D WHETHER OR NOT THE BALANCE IS WRITTEN OFF 100% OR LESS IS BASED ON INFORMATION RECEIVED FROM THE PATIENT VIA THE INDIGENT CARE APPLICATION AND WHAT TIERED LEVEL OF ELIGIBILITY WITHIN THE FEDERAL POVERTY GUIDELINES AND ASSOCIATED LEVEL OF DISCOUNTS UNDER WHICH THEY MAY QUALIFY. 9 CRISP REGIONAL NURSING HOME & REHAB 902 BLACKSHEAR ROAD CORDELE GA 31015 NURSING FACILITY CARESOUTH OF CRISP REGIONAL 906 5TH STREET NORTH CORDELE GA 31015 HOME HEALTH CRISP REGIONAL HOSPICE 910 5TH STREET NORTH CORDELE GA 31015 HOSPICE ARABI HEALTHCARE CENTER 4110 BEDGOOD AVENUE ARABI GA 31712 RHC WARWICK HEALTHCARE CENTER 135 DOGWOOD STREET WARWICK GA 31796 RHC CRISP REGIONAL DIALYSIS UNIT 1302 5TH STREET NORTH CORDELE GA 31015 DIALYSIS CORDELE HEALTH & REHAB 1106 NORTH 4TH STREET CORDELE GA 31015 NURSING FACILITY CRISP REGIONAL CONVENIENT CARE 902 NORTH 7TH STREET CORDELE GA 31015 RHC BLACKSHEAR RETIREMENT VILLAS 1110 BLACKSHEAR ROAD CORDELE GA 31015 ASSISTED LIVING PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION THIS SECTION INCLUDES NET ACTUAL COSTS FOR SUBSIDIZED PHYSICIAN AND RURAL HEALTH CLINICS OF 2,838,700. 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 70,239,806 ADD: EXPENSES ON PART VIII 32,073 DENOMINATOR FOR COLUMN (F) 70,271,879 PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION COSTS FOR PART I, LINE 7A AND 7B AND PART III, SECTION A, LINE 2 WERE CALCULATED USING THE RCC CALCULATED IN WORKSHEET 2. OTHER COSTS WERE OBTAINED FROM THE ORGANIZATION'S ACCOUNTING RECORDS. SEE ALSO THE DESCRIPTION FOR PART III, LINE 2 AND FOR PART III, LINE 4. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY AMOUNTS ON PART III, LINE 2 REPRESENT THE AMOUNT OF NET CHARGES WRITTEN OFF AS UNCOLLECTIBLE AND RECORDED AS BAD DEBT EXPENSE ON THE AUDITED FINANCIAL STATEMENTS. 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 AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). 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 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 (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE CORPORATION'S SELF-PAY WRITE-OFFS INCREASED APPROXIMATELY 1,181,000 FROM APPROXIMATELY 14,334,000 IN 2013 AND 15,515,000 IN 2014 AS A RESULT OF NEGATIVE TRENDS EXPERIENCED IN THE COLLECTION OF AMOUNTS FROM SELF-PAY PATIENTS IN FISCAL YEAR 2014. THE CORPORATION HAS NOT CHANGED ITS INDIGENT CARE POLICIES DURING FISCAL YEARS 2013 OR 2014. THE CORPORATION DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITE-OFFS FROM THIRD-PARTY PAYORS. 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 PATIENTS, WHO MEET ALL THE REQUIREMENTS TO BE CLASSIFIED AS MEDICALLY INDIGENT UNDER THE ORGANIZATION'S ICTF POLICY, WILL HAVE THEIR ACCOUNTS WRITTEN OFF ON A SLIDING SCALE FEE (100% OF ACCOUNTS AT 125% OF THE FEDERAL POVERTY SCALE, 7% OF ACCOUNTS WHEN INCOME IS AT 200% OF THE SCALE, UP TO THE MAXIMUM ALLOWED PER PATIENT PER YEAR). ANY AMOUNT NOT ADJUSTED OFF PER POLICY, WOULD FOLLOW THE COLLECTION PRACTICE AS ANY OTHER ACCOUNT. PART VI, LINE 2 - NEEDS ASSESSMENT CRISP REGIONAL ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY BY EVALUATING DISEASE INCIDENCES IN THE POPULATION AS WELL AS ECONOMIC AND DEMOGRAPHIC CHARACTERISTICS OF THE POPULATION IN COMPARISON TO THE UTILIZATION AND AVAILABILITY OF APPLICABLE SERVICES. PRIMARY SOURCE FOR ASSESSMENT INFORMATION IS THE COMMUNITY HEALTH STATUS INDICATORS PUBLISHED BY THE U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES AND INTERNAL INFORMATION PRODUCED BY HOSPITAL RECORDS. CRISP REGIONAL IS CLASSIFIED AS A HEALTH MANPOWER SHORTAGE AREA DUE TO THE DISPROPORTIONALLY LARGE LOW INCOME POPULATION. IN ADDITION, CRISP'S SERVICE HAS A SIGNIFICANT NUMBER OF MIGRANT AND UNDOCUMENTED FARM WORKS THAT PRESENT EPISODIC COMMUNITY HEALTH NEEDS. THE ORGANIZATION COMPLETED ITS FIRST COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY PLAN. BOTH DOCUMENTS CAN BE FOUND ON ITS WEBSITE AT HTTP://CRISPREGIONAL.ORG ON THE HOME PAGE UNDER 2013 COMMUNITY HEALTH NEEDS ASSESSMENT. PROGRESS ON CHNA IMPLEMENTATION STRATEGIES 2013-2014: SENIOR HEALTH -CRISP REGIONAL OFFERS MANY HEALTH FAIRS THROUGHOUT THE COMMUNITY. WE OFFER DISCOUNTED BLOOD TESTS WHICH INCLUDES LIPID PROFILE, BLOOD SUGAR, COMPLETE BLOOD COUNT, PULMONARY FUNCTION, PROSTATE SPECIFIC ANTIGEN, AND MAMMOGRAMS TESTING. EACH HEALTH FAIR INCLUDES FREE EDUCATION ON NUTRITION, DIABETES, EXERCISE PROGRAMS, VISION SCREENINGS, CHIROPRACTIC SCREENINGS AND MUCH MORE. CRH OFFERS THESE ON A QUARTERLY BASIS AND ALSO OFFERS A DISCOUNTED TEST OF THE MONTH EACH MONTH OF THE YEAR. -MONTHLY SOLAS (SENIORS OUT LEARNING AND SOCIALIZING) PROGRAMS LED BY A PHYSICIAN OR MEDICAL EXPERT TO EDUCATE SENIORS ON VARIOUS HEALTH TOPICS. THESE EDUCATIONAL TOPICS INCLUDE HEART DISEASE, ORTHOPEDICS, GERIATRICS, RADIOLOGY, NEPHROLOGY, UROLOGY, VEIN SCREENING AND WOUND CARE. -CRH OFFERS TRIPS FOR SENIORS TO VARIOUS SHOWS TO HELP MOTIVATE, ENTERTAIN AND KEEP THEM ACTIVE. ACCESS TO CARE -COMBINED MANY OF OUR DOCTOR OFFICES INTO CARE CENTERS SO THAT THEY HAVE ACCESS TO MORE THAN ONE DOCTOR. -IMPLEMENTED A DOCTOR'S TABLE TO INCLUDE A MINIMUM OF ONE DOCTOR OR PHYSICIAN ASSISTANT DURING TWO OF OUR LARGEST COMMUNITY HEALTH FAIRS. THIS PROVIDES AN OPPORTUNITY FOR PEOPLE TO ASK QUESTIONS TO DOCTORS OR PHYSICIAN ASSISTANTS WITHOUT HAVING TO HAVE AN APPOINTMENT. CANCER AND DIABETES -CRISP REGIONAL OFFERS AN ANNUAL LADIES CONFERENCE DAY EACH OCTOBER TO EDUCATE THE WOMEN OF THE COMMUNITY ON THE IMPORTANCE OF GOOD HEALTH. WE HAVE MANY SPEAKERS, WHICH INCLUDE DOCTORS, INSPIRATIONAL SPEAKERS AND COMMUNITY LEADERS. -CRH OFFERS TEST OF THE MONTH FOR DIABETES TO HELP KEEP A WATCH ON BLOOD SUGAR LEVELS. THIS IS AT A REDUCED COST TO THE PATIENTS. -CRH CONDUCTED A DIABETIC HEALTH FAIR IN THE MONTH OF NOVEMBER DURING DIABETIC MONTH TO MAKE PEOPLE MORE AWARE OF THE DIFFERENT WAYS TO CONTROL, MANAGE, AND HELP ELIMINATE THIS DISEASE THAT HAS TAKEN OVER OUR COMMUNITY. OBESITY -WE OFFER SEVERAL WELLNESS WALKS AT THE PERRY BUSBEE WALKING TRACK LOCATED ON THE HOSPITAL CAMPUS, FREE OF COST. THIS ENCOURAGES WEIGHT LOSS AT A SLOWER PACE. -CRH SPONSORS SEVERAL 5K RUNS THROUGHOUT THE YEAR TO HELP ACTIVE PEOPLE STAY ACTIVE. A FEW OF THOSE RUNS ARE RUN FOR YOUR LUNGS, CANCER COALITION WALK/RUN, WATERMELON RUN AND CAMP SUNSHINE RUN. -CRH HAS PLACED AN ATHLETIC TRAINER AT CRISP COUNTY HIGH SCHOOL TO HELP IN GUIDING THE STUDENTS AND ATHLETES IN A HEALTHIER WAY OF LIFE, MENTORING THE STUDENTS ON EATING HABITS AND MAINTAINING AN IDEAL WEIGHT AS WELL AS PROTECTING THEM FROM INJURY DUE TO SPORTS. -CRH RAISED FUNDS TO PLACE AN AED DEVICE IN EVERY SCHOOL IN CRISP COUNTY. THESE DEVICES HELP PROTECT THE STUDENTS AT PE AND SPORTING EVENTS. HEART DISEASE -AT SEVERAL COMMUNITY HEALTH FAIRS WE OFFER A DISCOUNTED SCREENING FOR CAROTID ARTERIES. -WE EDUCATE OUR SENIORS ON THE IMPORTANCE OF A HEALTHY HEART AS WELL AS THE SIGNS AND SYMPTOMS OF HEART DISEASE. TEEN PREGNANCY -CRH SPONSORS A TEEN MAZE EVENT IN OUR LOCAL HIGH SCHOOL EVERY OTHER YEAR. THE TEEN MAZE IS A LARGE, INTERACTIVE LIFE SIMULATION WHERE STUDENTS ARE SHOWN THE POSITIVE AND NEGATIVE CONSEQUENCES OF THEIR BEHAVIOR AND LIFE CHOICES. EACH PARTICIPANT DRAWS RANDOM CHOICES ABOUT LIFE DECISIONS THEY MAKE REGARDING RISKY BEHAVIORS. CARDS ARE DRAWN, DICE ARE ROLLED, OR A WHEEL IS SPUN TO LEARN THE CONSEQUENCES OF THESE ACTIONS, BOTH GOOD AND BAD. THOSE WHO DRAW CARDS AVOIDING RISKY BEHAVIORS ARE REWARDED BY MOVING ON TO GRADUATION. OTHERS LEARN THE POTENTIAL CONSEQUENCES OF RISKY BEHAVIOR, LOSS OF FREEDOM, MEDICAL PROBLEMS, PREGNANCY, STD'S, DROPPING OUT OF SCHOOL, PRISON, UNEMPLOYMENT AND POSSIBLE DEATH. PATHS ARE RANDOMLY ASSIGNED, SO NO TWO PARTICIPANTS HAVE THE SAME EXPERIENCE SUCH AS IN REAL LIFE. ADOLESCENT -CAMP SUNSHINE IS HELD IN JULY. THIS IS A GRIEF COUNSELING CAMP FOR KIDS WHO HAVE LOST A LOVED ONE AND ARE GRIEVING THE LOSS OF THAT PERSON. REFLECTIONS HOSPICE GOALS IS TO LET THE KIDS KNOW THAT THEY ARE NOT ALONE IN THEIR GRIEF. CAMP SUNSHINE GIVES THEM TOOLS TO LEARN HOW TO SHARE AND MOVE THROUGH THEIR GRIEF. ALL ACTIVITIES FOCUSED ON EXPRESSING FEELINGS AND SHARING EXPERIENCES. RESPIRATORY -PULMONARY FUNCTION SCREENING IS OFFERED AT SEVERAL HEALTH FAIRS ANNUALLY. THIS IS DISCOUNTED FOR EVERYONE WHO PARTICIPATES IN THE HEALTH FAIR. ACCESS TO CARE - TRANSPORTATION -CRISP REGIONAL HOSPITAL PARTNERS WITH PHOEBE PUTNEY, ALBANY, GA, TO HELP TRANSPORT PATIENTS TO AND FROM ALBANY TO RECEIVE THEIR RADIATION. OUR CRH AUXILIARY ALSO DONATES MONEY TO OUR ONCOLOGY DEPARTMENT TO HELP PATIENTS WHO ARE RECEIVING CHEMO TAKE TAXIS TO AND FROM THEIR HOMES. WE ARE IN THE PROCESS OF OFFERING A TRANSPORTATION SYSTEM THROUGH OUR HOSPITAL. MENTAL HEALTH -THIS IS A GREAT NEED IN OUR COMMUNITY. AT PRESENT, WE EXPLORE EVERY OPPORTUNITY TO ASSIST OUR PATIENTS TO FIND A SUITABLE ALTERNATIVE TO THEIR NEED AT HAND. A FEW EXAMPLES ARE THE PHOENIX HOUSE IN WARNER ROBINS, GA, GREENLEAF IN VALDOSTA, GA AND PINE WOODS IN BARNESVILLE, GA. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE CRISP REGIONAL HOSPITAL HAS A CLEARLY DEFINED PROCESS FOR ADDRESSING INDIGENT AND/OR SELF-PAY PATIENTS. PATIENTS THAT PRESENT AT THE REGISTRATION DESK AS SELF PAY PATIENTS RECEIVING OUTPATIENT SERVICES ARE DIRECTED TO OUR PATIENT FINANCIAL COUNSELOR FOR ADVISEMENT. AT THIS POINT, A FINANCIAL COUNSELOR REVIEWS THE APPLICATION FOR THE INDIGENT CARE TRUST FUND ASSISTANCE. IF THIS ASSISTANCE APPLIES, THE COUNSELOR WILL ASSIST IN THE APPLICATION PROCESS AND ASSURE COMPLETION OF THE APPLICATION FOR REVIEW. IF THIS ASSISTANCE DOES NOT APPLY, WE REFER TO A LIST OF SERVICES THAT REQUIRE A CERTAIN AMOUNT TO BE PAID BEFORE THE SERVICE IS RENDERED. WE ALSO ASSIST IN SETTING UP A CONTRACT TO INITIATE A MONTHLY PAYMENT PLAN. FOR A PATIENT THAT PRESENTS IN CRISP REGIONAL HOSPITAL AS AN INPATIENT AND IS SELF PAY, THE PATIENT FINANCIAL COUNSELOR GOES TO THE PATIENT'S ROOM TO ASSURE THAT THEY ARE CORRECTLY CLASSIFIED AS A SELF PAY PATIENT. SELF PAY PATIENTS ARE THEN REFERRED TO CHAMBERLIN AND EDMONDS TO ASSESS ELIGIBILITY FOR MEDICAID ASSISTANCE. IF NOT ELIGIBLE FOR MEDICAID, WE ASSIST THEM WITH AN APPLICATION FOR INDIGENT CARE TRUST FUND ASSISTANCE. IF NOT ELIGIBLE FOR THE INDIGENT PROGRAM, THEN WE ASSIST WITH A CONTRACT TO START MONTHLY PAYMENTS. POLICY: INDIGENT CARE TRUST FUND POLICY PURPOSE: TO PROVIDE GUIDELINES AND CRITERIA FOR USE IN DETERMINING A PATIENT'S FINANCIAL STATUS, WITH A DISTINCTION MADE BETWEEN A PATIENT'S UNWILLINGNESS TO PAY (BAD DEBT) AND A PATIENT'S INABILITY TO PAY (INDIGENT CARE). INDIGENT CARE IS DEFINED AS A TOTAL OR PARTIAL WRITE-OFF OF A PATIENT'S ACCOUNT BALANCES FOR A PATIENT WHO IS DETERMINED TO BE MEDICALLY INDIGENT. POLICY STATEMENT: CLASSIFY AS MEDICALLY INDIGENT, THOSE PATIENTS WITH AN INCOME NO GREATER THAN 200% OF THE FEDERAL POVERTY LEVEL GUIDELINES AS PUBLISHED BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES. PATIENTS WHO ARE CLASSIFIED AS MEDICALLY INDIGENT, WHO HAVE MET ALL REQUIREMENTS SET FORTH, WILL HAVE THEIR ACCOUNTS WRITTEN OFF ON A SLIDING SCALE FEE (100% OF THE ACCOUNTS AT 125% OF THE FEDERAL POVERTY SCALE, TO 7% OF ACCOUNTS WHEN INCOME IS AT 200% OF THE SCALE, UP TO THE MAXIMUM ALLOWED AMOUNT PER PATIENT, PER YEAR. 1. GUIDELINES FOR THE INDIGENT CARE TRUST FUND FINANCIAL ASSISTANCE PROGRAM. THE INTENT OF THESE GUIDELINES IS TO PROVIDE ALL AFFECTED PARTIES WITH DEFINITIONS, INTERPRETATIONS AND STANDARDS FOR THE UNIFORM ADMINISTRATION OF CRISP REGIONAL HOSPITAL'S INDIGENT CARE TRUST FUND (ICTF). DEFINITIONS: A.INDIGENT/CHARITY PATIENT: A PATIENT WHO IS A RESIDENT OF GEORGIA, WHOSE FAMILY INCOME DOES NOT EXCEED 200% OF THE FEDERAL POVERTY LEVELS AS ESTABLISHED BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR THE CURRENT YEAR. B.RESIDENCY REQUIREMENTS: A PATIENT MUST BE A RESIDENT OF THE STATE OF GEORGIA FOR SIX MONTHS TO MEET RESIDENCY REQUIREMENTS. EVIDENCE OF RESIDENCY, SUCH AS A LIGHT BILL, MUST BE PROVIDED (PHYSICAL ADDRESSES, NO POST OFFICE BOXES ALLOWED). C.GROSS INCOME: THE INDIVIDUAL AND FAMILY FEDERAL ADJUSTED GROSS INCOME AS SHOWN ON THE MOST RECENT FEDERAL OR STATE INCOME TAX RETURN AND THE PATIENTS LAST 3 MONTHS PAY STUBS. INCOME INCLUDES SALARIES. TIPS, WAGES, ETC; INTEREST AND DIVIDEND INCOME; UNEMPLOYMENT COMPENSATION, RETIREMENT PAY AND ANY OTHER TAXABLE INCOME. D.HOUSEHOLD: THE NUMBER OF PERSONS CLAIMED ON INCOME TAX FILING, OR THE PERSONS THE APPLICANT IS LEGALLY RESPONSIBLE FOR. 2. LEVELS OF ASSISTANCE: TWO LEVELS OF ASSISTANCE ARE OFFERED AND ARE DEFINED BELOW: A.INDIGENT FINANCIAL ASSISTANCE: PATIENTS WHOSE INCOME IS BELOW 125% OF THE FEDERAL POVERTY LEVELS ARE CLASSIFIED AS MEDICALLY INDIGENT. B.CHARITABLE FINANCIAL ASSISTANCE: PATIENTS WHOSE INCOME LEVEL IS BETWEEN 126%-200% OF THE FEDERAL POVERTY LEVELS WILL BE CLASSIFIED AS CHARITABLE CASES. THESE PATIENTS WILL BE RESPONSIBLE FOR A PERCENTAGE OF HOSPITAL CHARGES AND ARE REQUIRED TO SIGN (AND MAINTAIN CURRENT PAYMENTS ON) A REPAYMENT CONTRACT WITH THE BUSINESS OFFICE. C.ALL PATIENTS MUST COMPLETE A DETERMINATION OF INDIGENT CARE WORKSHEET PRIOR TO BEING CONSIDERED FOR FINANCIAL ASSISTANCE. DISCLOSURE OF ALL CIRCUMSTANCES CONCERNING INSURANCE, THIRD PARTY LIABILITY, ASSETS, LIABILITIES, AND ANY OTHER FACTORS ARE REQUIRED. REFUSAL TO DISCLOSE ALL REQUIRED INFORMATION WILL RESULT IN AUTOMATIC INELIGIBILITY. D.ALL PATIENTS ARE REQUIRED TO APPLY FOR STATE AND FEDERAL PROGRAMS (E.G. MEDICAID) IN CONJUNCTION WITH THE APPLICATION FOR FINANCIAL ASSISTANCE. REFUSAL TO APPLY WILL RENDER A PATIENT INELIGIBLE. PROOF OF APPROVAL OR DENIAL FROM STATE AND/OR FEDERAL PROGRAMS MUST BE PROVIDED TO DETERMINE FINAL ELIGIBILITY FOR FINANCIAL ASSISTANCE. 3. CATEGORY OF PATIENTS: INDIGENT CARE TRUST FUNDS HAVE SEEN A SIGNIFICANT DECREASE IN THE RECENT PAST. IN AN EFFORT TO PROVIDE AS MUCH ASSISTANCE TO AS MANY PATIENTS AS POSSIBLE, TWO CATEGORIES OF ASSISTANCE HAVE BEEN DEVELOPED. EACH CATEGORY HAS MONETARY LIMITATIONS. A.CATEGORY 1: PATIENTS WHO ARE CHRONICALLY ILL OR WHOSE CONDITION IS LIFE THREATENING. B.CATEGORY 2: PATIENT WHO HAVE SHORT TERM ILLNESSES OR WHOSE CONDITIONS ARE NOT LIFE THREATENING. 4. INELIGIBLE PATIENTS/NON-COVERED CHARGES: CERTAIN TYPES OF CHARGES AND/OR CONDITIONS ARE NOT COVERED. THOSE ARE OUTLINED BELOW: A.PREGNANT WOMEN ARE NOT ELIGIBLE FOR INDIGENT TRUST CARE FINANCIAL ASSISTANCE. B.ACCOUNTS COVERED UNDER LIABILITY OR WORKER'S COMPENSATION. C.VICTIMS OF CRIME, UNLESS THE PATIENT HAS PURSUED ASSISTANCE FROM THE STATE AND/OR FEDERAL VICTIMS ASSISTANCE PROGRAM AND BEEN DENIED. D.PATIENTS WHO HAVE INSURANCE COVERAGE INCLUDING COBRA. E.UNDOCUMENTED IMMIGRANTS ARE NOT ELIGIBLE. F.CHARGES NOT COVERED ARE AS FOLLOWS: PRIVATE ROOM DIFFERENCES; ELECTIVE SURGERY, PLASTIC SURGERY, FEES CHARGED BY YOUR PHYSICIAN, RADIOLOGY, ANESTHESIOLOGIST AND PATHOLOGIST. AMBULANCE, PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY AND WOUND CARE ARE ALSO NOT COVERED. 5. CAPS ON ASSISTANCE: LIMITATIONS OF ASSISTANCE ARE FOR ONE CONSECUTIVE YEAR. ONCE A PATIENT REACHES THEIR CATEGORY CAP, NO FURTHER ASSISTANCE WILL BE PROVIDED UNTIL THE NEW CALENDAR YEAR BEGINS. A.CATEGORY 1 PATIENTS' ASSISTANCE IS CAPPED AT 15,000 FOR 12 MONTHS. B.CATEGORY 2 PATIENTS' ASSISTANCE IS CAPPED AT 7,000 FOR 12 MONTHS. PART VI, LINE 4 - COMMUNITY INFORMATION CRISP REGIONAL HOSPITAL SERVES CRISP, DOOLY AND WILCOX COUNTIES AS OUR PRIMARY SERVICE AREAS. THESE AREAS ACCOUNT FOR 91% OF PATIENT ACTIVITY. THE OTHER FOUR CONTIGUOUS COUNTIES, SUMTER, WORTH, TURNER AND LEE, ARE SECONDARY GEOGRAPHIC MARKET AREAS. CORDELE IS THE ECONOMIC AND MEDICAL HUB OF THIS AREA AND DRAWS ON A POPULATION APPROACHING 136,000. THE TOTAL SCHOOL ENROLLMENT IN CRISP COUNTY WAS 6,233. NURSERY SCHOOL AND KINDERGARTEN ENROLLMENT WAS 862 AND ELEMENTARY OR HIGH SCHOOL ENROLLMENT WAS 4,029 CHILDREN. COLLEGE OR GRADUATE SCHOOL ENROLLMENT WAS 1,342. INDUSTRIES: IN 2012, FOR THE EMPLOYED POPULATION 16 YEARS AND OLDER, THE LEADING INDUSTRIES IN CRISP COUNTY WERE HEALTHCARE, SOCIAL ASSISTANCE, EDUCATIONAL SERVICES, MANUFACTURING, AND RETAIL TRADE. INCOME: THE MEDIAN INCOME OF HOUSEHOLDS IN CRISP COUNTY WAS 32,320. 69% OF THE HOUSEHOLDS RECEIVED EARNINGS AND 15% RECEIVED RETIREMENT INCOME OTHER THAN SOCIAL SECURITY. 35% OF THE HOUSEHOLDS RECEIVED SOCIAL SECURITY. THE AVERAGE INCOME FROM SOCIAL SECURITY WAS 15,297. THESE INCOME SOURCES ARE NOT MUTUALLY EXCLUSIVE; THAT IS, SOME HOUSEHOLDS RECEIVED INCOME FROM MORE THAN ONE SOURCE. POVERTY AND PARTICIPATION IN GOVERNMENT PROGRAMS: IN 2012, 31% OF PEOPLE WERE IN POVERTY. 53% OF RELATED CHILDREN UNDER 18 WERE BELOW THE POVERTY LEVEL, COMPARED WITH 14% OF PEOPLE 65 YEARS OLD AND OVER. RESIDENTS WITH INCOME BELOW 50% OF THE POVERTY LEVEL IN 2012 WERE 12%. 23% OF ALL FAMILIES AND 51% OF FAMILIES WITH A FEMALE HOUSEHOLDER AND NO HUSBAND PRESENT HAD INCOMES BELOW THE POVERTY LEVEL. FOR PEOPLE REPORTING ONE RACE ALONE, 51% WAS WHITE; 44% WAS BLACK OR AFRICAN AMERICAN; 3% WAS HISPANIC OR LATINO; 1% WAS ASIAN; AND 1% WAS CLASSIFIED AS OTHER RACE. 1% REPORTED TWO OR MORE RACES. HOUSING COSTS: THE MEDIAN MONTHLY HOUSING COSTS FOR MORTGAGED OWNERS WAS 1,023, NON-MORTGAGED OWNERS 325, AND RENTERS 576. 29% OF OWNERS WITH MORTGAGES, 8% OF OWNERS WITHOUT MORTGAGES, AND 47% OF RENTERS IN CRISP COUNTY SPENT 35% OR MORE OF HOUSEHOLD INCOME ON HOUSING. NATIVITY AND LANGUAGE: LESS THAN 1.2% OF THE PEOPLE LIVING IN CRISP COUNTY IN 2008-2012 WERE FOREIGN BORN. 99% WAS NATIVE, INCLUDING 85% WHO WERE BORN IN GEORGIA. AMONG PEOPLE AT LEAST 5 YEARS OLD LIVING IN CRISP COUNTY IN 2008-2012, 4.2% SPOKE A LANGUAGE OTHER THAN ENGLISH AT HOME. OF THOSE SPEAKING A LANGUAGE OTHER THAN ENGLISH AT HOME, 63% SPOKE SPANISH. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH CRISP REGIONAL IS SERVED BY A VOLUNTEER GOVERNING BOARD COMPOSED OF COMMUNITY MEMBERS FROM CRISP AND DOOLY COUNTIES. TWO BOARD MEMBERS ARE MEMBERS OF THE ACTIVE MEDICAL STAFF. A PRIMARY FOCUS OF THE BOARD IS TO ADDRESS THE ACCESSIBILITY OF HEALTHCARE SERVICES AND ACCESS TO QUALIFIED HEALTHCARE PROFESSIONALS. THE ORGANIZATION OPERATES A 24HR/7DAY A WEEK EMERGENCY DEPARTMENT THAT SERVES OVER 20,000 PATIENTS ANNUALLY. AS A MEANS TO ALLEVIATE ED OVERCROWDING AND CREATE A MORE APPROPRIATE TREATMENT ENVIRONMENT, THE BOARD ALSO FUNDS FINANCIALLY OPERATING DEFICITS AT THE CRISP CONVENIENT CARE CLINIC. THE ED PATIENT POPULATION INCLUDES 26% THAT ARE CLASSIFIED AS INDIGENT OR NON-INSURED. THE CONVENIENT CARE CLINIC EXPERIENCES NEARLY 17% INDIGENT OR SELF-PAY POPULATION AND REQUIRES 333,000 IN NON- COMPENSATED FUNDING FROM THE ORGANIZATION'S GENERAL FUNDS. CRISP REGIONAL PROMOTES HEALTH AND ADDRESSES HEALTH PROFESSIONAL ACCESS IN SEVERAL COMMUNITY SERVICES. THE HOSPITAL PROVIDES HOUSING WITHOUT COST TO MEDICAL RESIDENTS AND STUDENTS ENGAGED IN CLINICAL EXPERIENCE AT CRISP REGIONAL. THE BOARD FURNISHES THREE APARTMENTS AS A MEANS TO ASSURE MEDICAL STUDENTS AND MEDICAL RESIDENTS ARE EXPOSED TO THE SPECIAL NEEDS OF RURAL POPULATIONS AND AGRICULTURE ECONOMY. IN ADDITION TO THESE SERVICES, CRISP REGIONAL PARTNERS WITH COLLEGES TO OFFER PRACTICAL EXPERIENCE IN A VARIETY OF AREAS THROUGHOUT THE HOSPITAL - FROM PROVIDING BEDSIDE CARE ON PATIENT FLOORS TO THE INTENSIVE CARE UNIT (ICU) AND EMERGENCY DEPARTMENT (ED). DURING THEIR CLINICAL ROTATIONS, STUDENTS CAN DIRECTLY APPLY WHAT THEY ARE LEARNING ABOUT THE CAUSES OF CERTAIN HEALTH CONDITIONS AND HOW TO DIAGNOSE AND TREAT THEM. CRISP REGIONAL HOSPITAL OFFERS THE OPPORTUNITY FOR AN ADDITIONAL FELLOWSHIP FOR ONE YEAR IN THE SPECIALTY OF THE PHYSICIAN. THIS IS A VALUABLE TRANSITION YEAR TO GAIN NEEDED EXPERIENCE UNDER AN EXPERIENCED GENERAL SURGEON WHO SERVES AS MENTOR DURING THE FELLOWSHIP YEAR. THROUGH ITS RURAL HEALTH CLINIC PROGRAM, CRISP REGIONAL HEALTH SERVICES OFFERS MEDICAL CARE TO SURROUNDING RURAL COMMUNITIES. TWO RURAL HEALTH CARE CLINICS PROVIDE COVERAGE FOR PRIMARY HEALTH CARE, CHRONIC AND ACUTE ILLNESS, MINOR SUTURING, OB-GYN SERVICES, VARIOUS VACCINATIONS, LAB DRAWINGS AND PHYSICALS. THE PROGRAM ALLOWS RURAL RESIDENTS TO RECEIVE EXCELLENT HEALTH CARE PROVIDED BY HIGH-QUALITY HEALTH CARE PROFESSIONALS CLOSE TO HOME. IT ALSO OFFERS AFFORDABLE HEALTH CARE COVERAGE TO THESE RESIDENTS. LAST YEAR, BOTH CLINICS TREATED A TOTAL OF 2,677 PATIENTS. CRISP REGIONAL HEALTH SERVICES HOSTS FOUR ANNUAL COMMUNITY HEALTH FAIRS, OFFERING INFORMATION, EDUCATION AND BASIC TESTS FOR FREE OR AT DEEPLY- REDUCED COSTS. TESTS INCLUDE BODY MASS INDEX, BLOOD PRESSURE SCREENING, HEIGHT AND WEIGHT CHECKS, BLOOD GLUCOSE, AND PULMONARY LUNG FUNCTION. ALSO INCLUDED IS DIAGNOSTIC LAB WORK, CONSISTING OF LIPID PROFILE, THYROID, PROSTATE AND IRON PANEL SCREENINGS. WE PROVIDE THIS TO OUR COMMUNITY BECAUSE THE IMPORTANCE OF PRE-SCREENING, INCREASED AWARENESS AND EDUCATING THE COMMUNITY CONTRIBUTES TO RESIDENTS' BETTER OVERALL HEALTH. CRISP REGIONAL HOSPITAL SPONSORED "LET'S HEAR IT FOR THE GIRLS" WITH THE ALBANY CANCER COALITION TO PROMOTE CANCER AWARENESS TO THE LADIES OF THE COMMUNITY. ADDITIONAL INFORMATION PART III LINE 6A COMMUNITY BENEFIT REPORT THE ORGANIZATION DOES NOT HAVE A FORMALIZED WRITTEN COMMUNITY BENEFIT REPORTING PROCESS, BUT DOES PUBLICIZE A COMMUNITY BENEFIT REPORT. true EMPLOYEE EDUCATION LOANS 29 44577 PHYSICIAN EDUCATION LOANS 10 164204 SCHEDULE I, PAGE 1, PART I, LINE 2 THE ORGANIZATION OFFERS TO PROMOTE HEALTH CARE CAREERS FOR PEOPLE IN CRISP AND SURROUNDING COUNTIES BY PROVIDING SCHOLARSHIPS WITHIN CERTAIN GUIDELINES. EACH APPLICANT MUST PROVIDE A COMPLETED APPLICATION, SCHOOL TRANSCRIPTS, LETTER OF RECOMMENDATION, COMPLETION OF PREREQUISITES AND LETTER OF ACCEPTANCE TO A SPECIFIC PROGRAM, INTENT TO BECOME EMPLOYED BY THE ORGANIZATION, INTERVIEW BY APPROPRIATE VICE PRESIDENT, AND OBTAIN APPROVAL BY THE EDUCATIONAL LOAN REVIEW BOARD. REIMBURSEMENT FOR THE COST OF TUITION, BOOKS, AND REQUIRED COURSE MATERIALS PER SEMESTER WILL BE GIVEN FOR A CURRENT GPA OF 2.0 OR BETTER. A REIMBURSEMENT REQUEST INCLUDING EVIDENCE OF ACTUAL EXPENSES MUST BE SUBMITTED FOR APPROVAL. DEFAULT OF THE TERMS REQUIRES FULL OR PARTIAL PAYBACK OF THE SCHOLARSHIP FUNDS. AMOUNTS REPORTED REFLECT ASSISTANCE FORGIVEN BASED ON YEARS OF EMPLOYMENT PROVIDED. X X false false false false false false false false false STEVE GAUTNEY PRES/CEO 250219 4965 8427 22632 286243 WILLIAM PANNELL MD BOARD MEMBER 225255 225255 JESSICA CARTER CFO 151749 225 7500 22632 182106 SRILATHA NADIPINENI MD PHYSICIAN 257880 22632 280512 VISHAL BURRA MD PHYSICIAN 183281 14983 198264 MARILYN CARTER MD PHYSICIAN 166857 166857 MILTON JONES MD PHYSICIAN 158873 7800 14983 181656 A HOSPITAL AUTH OF CRISP COUNTYGA CRH REV CERTIFICATES PAYABLE 2008A 586003098 226688BY4 2008-05-29 10000000 REFUND/CONSTRUCTION false true false B HOSPITAL AUTH OF CRISP COUNTY GA CRH REV CERTIFICATES PAYABLE 2008B 586003098 226688CE7 2008-05-29 3000000 CONSTRUCTION false true false C HOSPITAL AUTH OF CRISP COUNTY GA CRH REV CERTIFICATES PAYABLE 2013 586003098 226688CS6 2013-06-18 16500000 CONSTRUCTION false true false A 935000 7743975 9830000 525885 1772086 2008 true false true true B 3000000 157765 2735973 2009 false false true true C 16500000 847137 16170000 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 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 FORM 990, PAGE 6, PART VI, LINE 11B ALL BOARD MEMBERS RECEIVE A COPY OF THE FORM 990 BEFORE IT IS FILED. IF ANY MEMBER HAS ANY CONCERNS, THEY MUST INFORM ADMINISTRATION. AN EXTENSIVE REVIEW IS PERFORMED BY MANAGEMENT. THE BOARD MEMBERS PERFORM ONLY A BASIC REVIEW OF THE RETURN PRIOR TO ITS FILING WITH THE IRS. FORM 990, PAGE 6, PART VI, LINE 12C THE CONFLICT OF INTEREST POLICY IS DIRECTED NOT ONLY TO DIRECTORS AND OFFICERS, BUT TO ALL EMPLOYEES WHO CAN INFLUENCE THE ACTIONS OF CRISP REGIONAL HOSPITAL, INC. A CONFLICTING INTEREST MAY BE DEFINED AS AN INTEREST, DIRECT OR INDIRECT, WITH ANY PERSONS OR FIRMS. IT IS THE POLICY OF THE BOARD THAT THE EXISTENCE OF ANY OF THE INTERESTS SHALL BE DISCLOSED BEFORE ANY TRANSACTION IS CONSUMMATED. IT SHALL BE THE CONTINUING RESPONSIBILITY OF THE BOARD, OFFICERS, AND MANAGEMENT EMPLOYEES TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES. DISCLOSURES OF CONFLICTS SHOULD BE MADE TO THE BOARD OR A COMMITTEE THEREOF, WHO WILL DETERMINE WHETHER A CONFLICT EXISTS, AND IN THE CASE OF AN EXISTING CONFLICT, DETERMINE APPROPRIATE ACTION. THE INDIVIDUAL WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTIONS. FORM 990, PAGE 6, PART VI, LINE 15A THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE COMPENSATION FOR THE CEO. THE BOARD USES COMPARABLE COMPENSATION DATA FOR SIMILARLY QUALIFIED PERSONS AT SIMILARLY SIZED ORGANIZATIONS. THE GHA ANNUAL SALARY SURVEY AND OTHER DATA IS USED TO DETERMINE COMPENSATION FOR MANAGEMENT. THE DECISION IS DOCUMENTED BY THE BOARD. THIS PROCESS IS PERFORMED ANNUALLY. FORM 990, PAGE 6, PART VI, LINE 15B THE CEO REVIEWS AND APPROVES THE COMPENSATION FOR THE CFO AND OTHER TOP OFFICERS. THE CEO USES COMPARABLE COMPENSATION DATA FOR SIMILARLY QUALIFIED PERSONS AT SIMILARLY SIZED ORGANIZATIONS. THE GHA ANNUAL SALARY SURVEY AND OTHER DATA IS ALSO UTILIZED. THIS PROCESS IS PERFORMED ANNUALLY. CRISP REGIONAL'S COMPENSATION PHILOSOPHY IS THE SAME FOR ALL OFFICERS AND EMPLOYEES - TO PROVIDE APPROPRIATE COMPENSATION TO EMPLOYEES BASED ON MARKET DRIVEN DATA AS WELL AS DEMAND WITHIN THE ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION WILL MAKE AVAILABLE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS TO ANY MEMBER OF THE PUBLIC WHO MAKES THEIR REQUEST AT THE ADMINISTRATIVE OFFICE OF THE FILING ENTITY. FORM 990, PART IX, LINE 11G COLLECTION AGENCIES 0 277,834 0 SERVICE CONTRACTS 1,041,756 889,681 0 LAUNDRY/LINEN SERVICES 68,164 194,458 0 OTHER PURCHASED SERVICES 3,870,671 1,336,539 0 PHYSICIAN FEES 5,649,403 0 0 THERAPY CONTRACT FEES 264,030 0 0 CRISP REGIONAL HEALTH SERVICE INC 902 7TH STREET NORTH CORDELE GA 310153234 582175975 HOLDING CO GA 501C3 11A NA false CRISP REGIONAL HOSP DEV FNDN INC 902 7TH STREET NORTH CORDELE GA 310153234 582175978 FOUNDATION GA 501C3 11A CRH CRISP REGIONAL HOSPITAL true HOSPITAL AUTHORITY OF CRISP COUNTY 902 7TH STREET NORTH CORDELE GA 310153234 586003098 AUTHORITY GA 501C3 6 NA false CRISP HEALTHCARE ALLIANCE LLC PO BOX 5007 CORDELE GA 310105007 582307830 PURCHASING GA CRH CRISP REGIONAL HOSPITAL INC RELATED 40003 611704 false false 0.80000 CRISP MEDICAL SERVICES INC 902 7TH STREET NORTH CORDELE GA 310153234 582175987 DORMANT GA N/A false false false false false false false false false false false false false true true true false true false false CRISP REGIONAL HOSPITAL DEVELOPMENT M 56424 NET FUNDS RAISED