2015-12-18T13:29:57-06:00 2014-12-31 621517792 PERSHING YOAKLEY & ASSOCIATES P C ONE CHEROKEE MILLS 2220 SUTHERLAND AVE KNOXVILLE TN 37919 990 2014-01-01 580641240 ST FRANCIS HOSPITAL INC STFR 7065964000 2122 MANCHESTER PKWY PO BOX 7000 COLUMBUS GA 319087000 GREG HEMBREE CFO 7065964000 2015-12-18 1 DEBORAH O ERNSBERGER P00364912 8656730844 2014 2016-03-07 17:11:31Z GREG HEMBREE 2122 MANCHESTER PARKWAY COLUMBUS GA 319046878 331287330 0 X WWW.WECAREFORLIFE.COM X 1950 GA ST. FRANCIS, A COMMUNITY-OWNED HEALING MINISTRY, EXISTS TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES, IN PARTNERSHIP WITH PHYSICIANS, FOR ALL THOSE IN NEED. 22 20 3179 550 23969 17198 7100000 7925502 255964696 313596023 5708627 889733 4978347 4040916 273751670 326452174 20638 18200 0 0 134629563 183607710 0 0 0 133261528 166277320 267911729 349903230 5839941 -23451056 380462018 337630922 226353658 253328004 154108360 84302918 X ST. FRANCIS, A COMMUNITY-OWNED HEALING MINISTRY, EXISTS TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES, IN PARTNERSHIP WITH PHYSICIANS, FOR ALL THOSE IN NEED. 0 0 289036742 18200 316786844 THE HOSPITAL IS A 292-LICENSED BED GENERAL ACUTE CARE HOSPITAL WITH A HOSPITAL-BASED 84-LICENSED BED BEHAVIORAL HEALTH CENTER SERVING SOUTHWEST GEORGIA AND EAST CENTRAL ALABAMA. ADDITIONALLY, THE HOSPITAL PROVIDES ASSISTED LIVING FOR 60 LICENSED RESIDENTIAL UNITS. ST. FRANCIS IS HOME TO 300 PHYSICIANS OFFERING A FULL RANGE OF INPATIENT, OUTPATIENT AND EMERGENCY ROOM SERVICES, INCLUDING THE AREA'S ONLY OPEN HEART SURGERY PROGRAM. ST. FRANCIS CONTINUES TO REACH FOR THE HIGHEST STANDARDS OF QUALITY AND SAFETY TO OFFER ITS PATIENTS THE BEST POSSIBLE CARE. ST. FRANCIS HAS MANY AREAS OF EXPERTISE:-ST. FRANCIS HEART HOSPITAL, THE AREA'S ONLY OPEN HEART SURGERY PROGRAM, PROVIDES HIGH QUALITY CARDIAC CARE-ST. FRANCIS ORTHOPEDIC INSTITUTE OFFERS OUTSTANDING ORTHOPEDIC CARE-TOP-NOTCH SURGICAL SERVICES ARE PERFORMED AT ST. FRANCIS CENTER FOR SURGICAL CARE-ST. FRANCIS SPINE CENTER HOUSES PAIN MANAGEMENT AND RELIEF FROM BACK AND NECK PAIN-WOMEN'S HEALTH SERVICES ARE PROVIDED AT ST. FRANCIS WOMEN'S HOSPITAL-THE BRADLEY CENTER IS ST. FRANCIS'S MENTAL HEALTH CARE FACILITY-SENIOR LIVING IS OFFERED AT FRANCISCAN WOODSTHE HOSPITAL'S PROGRAM SERVICE REVENUES ARE GENERATED PREDOMINANTLY FROM THE PROVISION OF INPATIENT AND OUTPATIENT SERVICES FOR THE YEAR ENDING DECEMBER 31, 2014. 289036742 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 230 0 1 3179 1 1 1 0 0 0 0 0 0 0 0 0 X 22 20 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 GA X GREG HEMBREE CHIEF FINANCIAL OFFICER 7065964000 2122 MANCHESTER EXPRESSWAY COLUMBUS GA 319046878 ROBERT P GRANGER PRESIDENT/CHIEF EXECUTIVE OFFICER 50.00 1.00 X X 747958 0 97675 WILLIAM TAYLOR MD TRUSTEE/FORMER CHIEF OF STAFF 50.00 X 704191 0 45000 EDWIN PAGE MD TRUSTEE/CHIEF OF STAFF-ELECT 50.00 X 468088 0 30000 BIPIN PATEL MD TRUSTEE/CHIEF OF STAFF 40.00 X 0 0 0 THOMAS B BUCK III TRUSTEE/FORMER CHAIRMAN 1.00 X 0 0 0 MARK G HOLLADAY TREASURER 1.00 X X 0 0 0 MARTHA S BICKERSTAFF PAST CHAIR 1.00 X 0 0 0 AUDREY D HOLLINGSWORTH SECRETARY/CHAIR-ELECT 1.00 X X 0 0 0 J DANIEL PARKER JR TRUSTEE 1.00 X 0 0 0 MICHAEL SIMS MD TRUSTEE 1.00 X 0 0 0 OTIS J SCARBOROUGH TRUSTEE 1.00 X 0 0 0 R LARRY CARDIN TRUSTEE 10.00 X 0 0 0 RICHARD Y BRADLEY CHAIRMAN 10.00 X X 0 0 0 STEPHEN T BUTLER TRUSTEE 1.00 X 0 0 0 CAROLYNN OBLETON TRUSTEE 1.00 X 0 0 0 PHILIP THAYER TRUSTEE 10.00 X 0 0 0 MARIO DAVIS TRUSTEE 1.00 X 0 0 0 PAUL TODD TRUSTEE 1.00 X 0 0 0 SARA DISMUKE TRUSTEE 1.00 X 0 0 0 JOHN MARTIN TRUSTEE 1.00 X 0 0 0 ROBERT M GILSON JR TRUSTEE 1.00 X 0 0 0 LUTHER WOLFF JR MD TRUSTEE 1.00 X 0 0 0 GREG HEMBREE CHIEF FINANCIAL OFFICER 50.00 0.00 X 147333 0 24996 DEBBIE BOSTIC SENIOR VICE PRESIDENT 50.00 X 189641 0 23110 MCDONALD PLUMMER FOUNDATION VICE PRESIDENT 50.00 X 212297 0 34186 DEBORAH L SAYLOR SENIOR VP/CNO/ASSISTANT SECRETARY 50.00 X 384291 0 23232 BOBBIE FARBER MD SENIOR VICE PRESIDENT/CHIEF MEDICAL OFFICER 50.00 X 431130 0 48935 EWINS R LOWE SENIOR VICE PRESIDENT/CAO 50.00 X 318429 0 54559 GEORGE M MCCLUSKEY III MD SURGEON 50.00 X 1166258 0 9559 THOMAS WALSH MD SPINE/NEUROSURGEON 50.00 X 1073057 0 52142 GEORGE ZIMMERMAN MD SURGEON 50.00 X 955039 0 84028 ROBERT LEWIS MD SURGEON 50.00 X 941052 0 34969 LE WESTERLUND MD ORTHOPEDIC SURGEON 50.00 X 1041560 0 29969 MATTHEW MOORE FORMER CHIEF FINANCIAL OFFICER 50.00 1.00 X 323592 0 42202 9103916 0 634562 199 1 1 0 HUMAN PERFORMANCE AND RESOURCE CENTERS 6298 VETERANS PARKWAY SUITE 5-A COLUMBUS GA 31908 PT/OT PATIENT MONITORING 5453674 SKANSKA 55 IVAN ALLEN JR BOULEVARD ATLANTA GA 30308 CONSTRUCTION CONTRACTOR 3920054 SODEXO INC & AFFILIATES PO BOX 536922 ATLANTA GA 303536922 DIETARY & ENVIRONMENTAL 3789049 TRIMEDXLLC PO BOX 636129 CINCINNATI OH 452636129 HEALTHCARE EQUIPMENT MAINTENANCE 2385769 HATCHER STUBBS LAND HOLLIS & ROTHSCHI PO BOX 2707 COLUMBUS GA 319022707 LEGAL SERVICES 1739696 89 7840663 84839 7925502 NET PATIENT SERVICE REVENUES 621990 308058676 308058676 MILITARY REHAB PT SERVICE REVENUE 621990 5501340 5501340 OTHER PATIENT RELATED INCOME 621990 36007 36007 313596023 130826 130826 307944 0 307944 307944 307944 5594063 4835156 758907 758907 758907 EHR REVENUES 621990 1552933 1552933 MISCELLANEOUS 621990 1305975 1305975 CAFETERIA 722514 850095 850095 23969 23969 3732972 326452174 316762875 23969 1739828 18200 18200 4350843 2347616 2003227 157130187 142988470 14141717 1048726 760105 288621 12707960 10179987 2527973 8369994 6663352 1706642 1871727 1121697 750030 846009 846009 146923 146923 113382 113382 25995096 15852261 10142835 935463 93646 841817 4884288 1372252 3512036 2883802 230704 2653098 8966255 8074112 892143 449276 105470 343806 9020904 9020904 22187476 19979822 2207654 3672462 3672462 MEDICAL SUPPLIES 70067368 70067368 MISCELLANEOUS 9762145 6328117 3434028 COLLECTION FEES 2892088 2805182 86906 LICENSES & TAXES 1582656 48381 1534275 349903230 289036742 60866488 0 601391 8931190 55499982 45221605 9671569 10654356 6409348 3352554 460936402 236598401 222754450 224338001 5811916 11715129 7840663 79713362 25577424 380462018 337630922 45275799 67666893 180972139 185661101 105720 10 226353658 253328004 X 154108360 84302918 154108360 84302918 380462018 337630922 X -23451056 -56734 -38044100 -8253552 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 113382 113382 0 PART II-B, LINE 1: A SMALL PERCENTAGE OF THE DUES PAID TO THE GEORGIA HOSPITAL ASSOCIATION IS DESIGNATED LOBBYING COSTS. 6723315 6723315 244344854 114431719 129913135 205133282 120756505 84376777 4734951 1410177 3324774 224338001 OTHER CURRENT ASSETS 2557164 DUE FROM RELATED ORGANIZATIONS 8288537 DEFERRED DEBT COSTS 5453288 MORTGAGE RESERVE FUND 2501804 OTHER ASSETS 6776631 25577424 X PART X, LINE 2: THE HOSPITAL AND THE FOUNDATION ARE TAX EXEMPT UNDER SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. AFFILIATED SERVICES IS A FOR-PROFIT ENTITY WHICH ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC)740, INCOME TAXES. WITH RESPECT TO ITS FOR-PROFIT ENTITY AS WELL AS ANY UNRELATED BUSINESS INCOME GENERATED THROUGH THE TAX EXEMPT ENTITIES, ST. FRANCIS RECORDS INCOME TAXES USING THE LIABILITY METHOD UNDER WHICH DEFERRED TAX ASSETS AND LIABILITY ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASIS 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 CORPORATION APPLIES ASC 740-10-50-15, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE STANDARD PRESCRIBES A MINIMUM RECOGNITION THRESHOLD AND MEASUREMENT METHODOLOGY THAT A TAX POSITION, TAKEN OR EXPECTED TO BE TAKEN, IN A TAX RETURN IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION HAD NO UNRECOGNIZED TAX BENEFITS OR ACCRUED INTEREST OR PENALTIES RELATED TO UNCERTAIN TAX POSITIONS FOR 2014 AND 2013. THE CORPORATION'S TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAX 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 FOR THOSE RETURNS. 1 1 X 1 X 250.000000000000 1 X 1 1 0 1 1 5052480 5052480 0.01440 18238559 16097481 2141078 0.00610 23291039 16097481 7193558 0.02050 1812208 1812208 0.00520 1812208 1812208 0.00520 25103247 16097481 9005766 0.02570 1 27759104 93032287 94757672 -1725385 X 1 1 1 ST FRANCIS CARDIAC PHYSICIAN PRACTICE MGMT 0.38620 0.61380 1 1 ST FRANCIS HOSPITAL INC 2122 MANCHESTER EXPRESSWAY COLUMBUS GA 319046878 WWW.WECAREFORLIFE.COM 099-287 X X X PSYCH & ASSISTED LIVING ST FRANCIS HOSPITAL INC 0 0 1 X X X X X X X X X 12 1 1 0 1 X HTTP://WWW.COLUMBUSREGIONAL.COM/MEDIA/FILE/COMMUNITYHEALTHRESPONSEPLAN/2013 X 1 12 1 HTTP://WWW.COLUMBUSREGIONAL.COM/MEDIA/FILE/COMMUNITYHEALTHRESPONSEPLAN/2013 0 0 1 X 250.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X X X X X X X X 1 0 X X X X 1 X 0 0 ST FRANCIS HOSPITAL, INC. PART V, SECTION B, LINE 3J: THE STUDY AREA FOR THE SURVEY EFFORT IS DEFINED AS EACH OF THE RESIDENTIAL ZIP CODES PRIMARILY ASSOCIATED WITH MUSCOGEE COUNTY IN WEST GEORGIA, INCLUDING 31820, 31829, 31901, 31903, 31904, 31906, 31907 AND 31909. TO ENSURE THE BEST REPRESENTATION OF THE POPULATION SURVEYED, A TELEPHONE INTERVIEW METHODOLOGY - ONE THAT INCORPORATES BOTH LANDLINE AND CELL PHONE INTERVIEWS - WAS EMPLOYED. THE PRIMARY ADVANTAGES OF TELEPHONE INTERVIEWING ARE TIMELINESS, EFFICIENCY AND RANDOM-SELECTION CAPABILITIES.THE SAMPLE DESIGN USED FOR THIS EFFORT CONSISTED OF A RANDOM SAMPLING OF 900 INDIVIDUALS AGE 18 AND OLDER IN MUSCOGEE COUNTY. ALL ADMINISTRATION OF THE SURVEYS, DATA COLLECTION AND DATA ANALYSTS WAS CONDUCTED BY PROFESSIONAL RESEARCH CONSULTANTS, INC. (PRC), A NATIONALLY RECOGNIZED HEALTHCARE CONSULTING FIRM.AS PART OF THE COMMUNITY HEALTH ASSESSMENT, TWO FOCUS GROUPS WERE HELD ON AUGUST 16, 2012. THE FOCUS GROUP PARTICIPANTS INCLUDED REPRESENTATIVES FROM PUBLIC HEALTH, PHYSICIANS, OTHER HEALTH PROFESIONALS, SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY LEADERS. A LIST OF RECOMMENDED PARTICIPANTS FOR THE FOCUS GROUPS WAS PROVIDED BY ST. FRANCIS HOSPITAL AND COLUMBUS REGIONAL HEALTHCARE SYSTEM. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. PARTICIPANTS INCLUDED A REPRESENTATIVE OF PUBLIC HEALTH, AS WELL AS SEVERAL INDIVIDUALS WHO WORK WITH LOW-INCOME, MINORITY OR OTHER MEDICALLY UNDERSERVED POPULATIONS, AND THOSE WHO WORK WITH PERSONS WITH CHRONIC DISEASE CONDITIONS. ST FRANCIS HOSPITAL, INC. PART V, SECTION B, LINE 6A: THE HOSPITAL ORGANIZATION CONDUCTED ITS CHNA IN PARTNERSHIP WITH COLUMBUS REGIONAL HEALTHCARE SYSTEM: THE MEDICAL CENTER, DOCTORS HOSPITAL AND HUGHSTON HOSPITAL. ST FRANCIS HOSPITAL, INC. PART V, SECTION B, LINE 7D: ST. FRANCIS HOSPITAL PROVIDES MANY COMMUNITY BENEFIT PROGRAMS THAT ADDRESS THE HEALTH AND SOCIAL DETERMINANTS OF HEALTH THROUGHOUT MUSCOGEE COUNTY AND THE SURROUNDING COMMUNITIES. MUSCOGEE COUNTY IS FORTUNATE TO HAVE A LARGE NUMBER OF HEALTH AND SOCIAL SERVICE AGENCIES WHO WORK INDIVIDUALLY AND COLLECTIVELY TO PROVIDE SERVICE PROGRAMS AND SUPPORT FOR THE COUNTY RESIDENTS. ST FRANCIS HOSPITAL, INC. PART V, SECTION B, LINE 11: IN 2012, ST. FRANCIS HOSPITAL REVIEWED THE HEALTHCARE NEEDS PREPARED IN PARTNERSHIP WITH COLUMBUS REGIONAL HEALTHCARE SYSTEM AND IDENTIFIED A NUMBER OF INITIATIVES FOR FOCUS. ACTION PLANS ARE IN PLACE TO ADDRESS THESE NEEDS. OTHER BEHAVIORAL, AT-RISK BEHAVIOR IDENTIFIED IN THE CHNA HAS BEEN COMMUNICATED TO OUTSIDE SOCIAL SERVICE ORGANIZATIONS IN ORDER FOR THEM TO ASSIST IN ADDRESSING THESE NEEDS. ST FRANCIS HOSPITAL, INC. PART V, SECTION B, LINE 16I: THE POLICY WAS ATTACHED TO BILLING INVOICES, AND THE POLICY WAS PROVIDED, IN WRITING, TO PATIENTS ON ADMISSION TO THE HOSPITAL FACILITY. ST FRANCIS HOSPITAL, INC. PART V, SECTION B, LINE 20E: ALL UNINSURED PATIENTS ARE GIVEN A 45% DISCOUNT OFF GROSS CHARGES REGARDLESS OF THEIR ABILITY TO PAY. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY ST FRANCIS HOSPITAL, INC. PART V, SECTION B, LINE 16A WEBSITE: WWW.WECAREFORLIFE.COM ST FRANCIS HOSPITAL, INC. PART V, SECTION B, LINE 16C WEBSITE: WWW.WECAREFORLIFE.COM 2 THE BRADLEY CENTER 2000 16TH AVENUE COLUMBUS GA 31904 PSYCHIATRIC UNIT FRANCISCAN WOODS 2425 WILLIAMS ROAD COLUMBUS GA 31909 ASSISTED LIVING FACILITY PART I, LINE 6A: THE HOSPITAL'S COMMUNITY BENEFIT REPORT IS REPORTED AS PART OF THE COMBINED ANNUAL REPORT PREPARED BY ST. FRANCIS HOSPITAL. THIS REPORT IS DISTRIBUTED TO THE COMMUNITY IN PRINT AND IS AVAILABLE ON THE HOSPITAL'S WEBSITE. PART I, LINE 7: THE COST OF FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFITS IS REPORTED BASED ON THE RATIO OF COST-TO-CHARGES. THIS RATIO WAS DERIVED FROM THE "RATIO OF PATIENT CARE COST-TO-CHARGES" WORKSHEETS PROVIDED BY THE IRS. PART III, LINE 2: 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. PART III, LINE 4: 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 ALLOWANCES 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 ESTIMATED UNCOLLECTIBLE 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 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 DEBT 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 AGREED UPON RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 8: MEDICARE COSTS ON LINE 5 ARE FROM THE MEDICARE COST REPORT AND INCLUDE BOTH DIRECT AND INDIRECT COSTS ALLOCATED USING THE APPROPRIATE STATISTICAL BASIS. AMOUNTS ON LINE 6 REPRESENT THE PAYMENTS RECEIVED FOR THE RELATED MEDICARE COSTS. PART III, LINE 9B: PATIENT ACCOUNTS RECEIVABLE BALANCES ARE WRITTEN OFF FOR PATIENTS WHO QUALIFY FOR FULL FINANCIAL ASSISTANCE AND NO FURTHER COLLECTION EFFORTS ARE MADE. FOR PATIENTS WHO QUALIFY FOR PARTIAL FINANCIAL ASSISTANCE, COLLECTION PROCEDURES FOLLOW THE SAME PROCESS AS OTHER PATIENTS WHO ARE RESPONSIBLE FOR UNPAID BALANCES. ALL UNINSURED PATIENTS ARE OFFERED A SELF-PAY DISCOUNT OF 45% OF CHARGES REGARDLESS OF THEIR ABILITY TO PAY. PART VI, LINE 2: TO DETERMINE HOW TO BEST SERVE THE COMMUNITY, WE CONDUCT REGULAR NEEDS ASSESSMENTS BY SEEKING INPUTS FROM MEMBERS OF THE COMMUNITY AND THROUGH OUR ALLIANCES WITH OTHER LOCAL AGENCIES. OUR STRATEGY IS TO DEVELOP AND ENHANCE PROGRAMS AND SERVICES THAT MEET THE CHANGING NEEDS OF THE COMMUNITY WE SERVE.A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED LATE IN 2012. THIS ASSESSMENT CONSISTED OF A SYSTEMATIC, DATA-DRIVEN APPROACH TO DETERMINING THE HEALTH STATUS, BEHAVIORS AND NEEDS OF THE RESIDENTS OF MUSCOGEE COUNTY, GEORGIA. THE GOAL OF THE COMMUNITY HEALTH ASSESSMENT WAS THREEFOLD: TO IDENTIFY NEEDS THAT IF ADDRESSED COULD LEAD TO IMPROVED HEALTH STATUS, INCREASED LIFE SPANS, AND ELEVATED OVERALL QUALITY OF LIFE; TO REDUCE HEALTH DISPARITIES; AND TO INCREASE ACCESSIBILITY TO PREVENTATIVE SERVICES FOR ALL RESIDENTS OF MUSCOGEE COUNTY, GEORGIA. PART VI, LINE 3: PATIENTS WHO HAVE NO INSURANCE, LIMITED COVERAGE AND MEDICAID PATIENTS WITHOUT SUPPLEMENTAL INSURANCE HAVE THE OPPORTUNITY TO MEET WITH FINANCIAL COUNSELORS WHO PROVIDE APPLICATIONS FOR FINANCIAL ASSISTANCE FOR FULL OR PARTIAL DISCOUNTING OF THEIR BILLS AND WHO AID PATIENTS IN OBTAINING MEDICAID OR OTHER COVERAGE. WE INFORM PATIENTS ABOUT OUR FINANCIAL ASSISTANCE PROGRAM AND ASSIST THEM IN MAKING AN APPLICATION. ALL UNINSURED PATIENTS ARE OFFERED A SELF-PAY DISCOUNT OF 45% OF CHARGES REGARDLESS OF THEIR ABILITY TO PAY. PATIENT EDUCATION ON THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM IS CONDUCTED DURING PRE-REGISTRATION AND THROUGH FLOOR VISITS BY BUSINESS OFFICE REPRESENTATIVES FOR THOSE PATIENTS WHO HAVE BEEN IDENTIFIED AS POSSIBLY QUALIFYING FOR FINANCIAL ASSISTANCE OR OTHER PROGRAMS. THE "PATIENT GUIDE" BOOKLET DISTRIBUTED TO ALL INPATIENTS GIVES ADDITIONAL INFORMATION ABOUT HOW WE CAN ASSIST UNINSURED PATIENTS IN QUALIFYING FOR PUBLIC ASSISTANCE OR OUR FINANCIAL ASSISTANCE PROGRAM. PATIENT STATEMENTS ENCOURAGE PATIENTS TO CALL FOR INFORMATION ON FINANCIAL ASSISTANCE. PART VI, LINE 4: WE ARE LOCATED IN COLUMBUS, GEORGIA AND SERVE A METROPOLITAN POPULATION BASE OF APPROXIMATELY 300,000 PEOPLE. THE LOCAL MUSCOGEE COUNTY SERVICE AREA REPORTS A 2010 POPULATION OF 189,885 RESIDENTS CONSISTING OF A RACIAL MIX MADE UP MAINLY BY: 46.3% WHITE, 45.5% AFRICAN AMERICAN AND 6.9% HISPANIC RESIDENTS. OUR SERVICE AREA IS NOTED TO HAVE A SIGNIFICANTLY HIGHER PERCENTAGE OF CHRONIC DISEASE CONDITIONS RELATED TO DIABETES, HEART DISEASE, STROKE, AND CANCER WHEN COMPARED WITH BOTH STATE AND NATIONAL LEVELS. THESE CONDITIONS HAVE NECESSITATED THE DEVELOPMENT, OPERATION AND MAINTENANCE OF COMMUNITY-FOCUSED SERVICES. PART VI, LINE 5: ST. FRANCIS' LEADERSHIP AND ITS VOLUNTEER BOARDS ARE COMPRISED OF BUSINESS AND COMMUNITY LEADERS AS WELL AS LOCAL PHYSICIANS WHO BRING VARIED PROFESSIONAL AND COMMUNITY SERVICE EXPERIENCE TO THESE POSITIONS. OUR EMERGENCY DEPARTMENT OPERATES 24 HOURS A DAY, 7 DAYS A WEEK AND IS OPEN TO ALL, REGARDLESS OF THEIR ABILITY TO PAY. WE SEEK TO MAXIMIZE BENEFIT TO THE COMMUNITY BY UTILIZING DELIVERY OF CARE MODELS THAT CAN MOST EFFECTIVELY MEET THE NEEDS OF THE COMMUNITY (E.G. THE TRINITY CENTER FOR WOMEN OFFERS ACCESS TO QUALITY PRENATAL CARE AND COUNSELING TO LOW INCOME WOMEN IN A NEWLY RENOVATED OUTPATIENT CLINIC). THE HOSPITAL'S MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS IN THE REGION. FOR PHYSICIANS IN THE REGION WHO DO NOT HAVE PRIVILEGES, A PROCESS IS AVAILABLE TO ADMIT PATIENTS THROUGHOUT HOSPITALITIES OR OTHER PHYSICIANS.ST. FRANCIS' FACILITIES INCLUDE THE HOSPITAL, THE BRADLEY CENTER, FRANCISCAN WOODS AND PHYSICIAN OFFICES FURTHER THEIR EXEMPT PURPOSE BY PROMOTING COMMUNITY HEALTH IN A VARIETY OF WAYS. WE TAKE A MULTI-FACETED APPROACH TO IMPROVING THE HEALTH OF OUR SERVICE AREA: BETTER ACCESS, GREATER CAPACITY, BUILDING PHYSICIAN AND COMMUNITY PARTNERSHIPS AND DEVELOPING LEADERSHIP. WE REINVEST OUR FUNDS IN THE COMMUNITY TO IMPROVE HEALTH CARE SERVICES. AN EXAMPLE IS ST. FRANCIS' SENIORS' PROGRAM, PRIMETIME SENIORS, WHICH IS OFFERED FREE TO THE PUBLIC. MEMBERS RECEIVE ACCESS TO FREE HEALTH SCREENINGS, AND FREE SEMINARS PRESENTED BY PHYSICIANS AND OTHER HEALTH CARE PROFESSIONALS. FUNDS ARE USED TO SUPPORT OUTREACH EFFORTS, PROVIDE MEDICAL EDUCATION TO THE COMMUNITY, ENHANCE SAFETY, INCREASE CAPACITY AND IMPLEMENT NEW TECHNOLOGY TO PROVIDE THE HIGHEST QUALITY TREATMENT. PART VI, LINE 7, REPORTS FILED WITH STATES GA 1 0 0 CHILDCARE SPONSORSHIP 15 18200 PART I, LINE 2: THE ORGANIZATION SPONSORS ST. LUKE EARLY LEARNING CENTER, AN ORGANIZATION THAT IS DEDICATED TO PROVIDING HIGH QUALITY, DEVELOPMENTALLY APPROPRIATE CARE AND EDUCATION TO CHILDREN. HUMAN RESOURCES REVIEWS AND APPROVES MONTHLY BILLING AND SUBMITS FOR PAYMENT. X 1 1 X X X X 0 1 0 0 0 0 0 0 0 ROBERT P GRANGER PRESIDENT/CHIEF EXECUTIVE OFFICER 605000 0 0 0 142958 0 84590 0 13085 0 845633 0 0 0 WILLIAM TAYLOR MD TRUSTEE/FORMER CHIEF OF STAFF 410000 0 94851 0 199340 0 45000 0 0 0 749191 0 0 0 EDWIN PAGE MD TRUSTEE/CHIEF OF STAFF-ELECT 270000 0 197281 0 807 0 30000 0 0 0 498088 0 0 0 GREG HEMBREE CHIEF FINANCIAL OFFICER 125005 0 20000 0 2328 0 23340 0 1656 0 172329 0 0 0 DEBBIE BOSTIC SENIOR VICE PRESIDENT 163736 0 20000 0 5905 0 22500 0 610 0 212751 0 0 0 MCDONALD PLUMMER FOUNDATION VICE PRESIDENT 165006 0 0 0 47291 0 32723 0 1463 0 246483 0 0 0 DEBORAH L SAYLOR SENIOR VP/CNO/ASSISTANT SECRETARY 146843 0 0 0 237448 0 22500 0 732 0 407523 0 0 0 BOBBIE FARBER MD SENIOR VICE PRESIDENT/CHIEF MEDICAL 357199 0 26778 0 47153 0 44000 0 4935 0 480065 0 0 0 EWINS R LOWE SENIOR VICE PRESIDENT/CAO 257501 0 0 0 60928 0 49590 0 4969 0 372988 0 0 0 GEORGE M MCCLUSKEY III MD SURGEON 1000000 0 118150 0 48108 0 4590 0 4969 0 1175817 0 0 0 THOMAS WALSH MD SPINE/NEUROSURGEON 750029 0 144236 0 178792 0 52142 0 0 0 1125199 0 0 0 GEORGE ZIMMERMAN MD SURGEON 700000 0 179625 0 75414 0 79059 0 4969 0 1039067 0 0 0 ROBERT LEWIS MD SURGEON 525000 0 389685 0 26367 0 30000 0 4969 0 976021 0 0 0 LE WESTERLUND MD ORTHOPEDIC SURGEON 600000 0 415459 0 26101 0 25000 0 4969 0 1071529 0 0 0 MATTHEW MOORE FORMER CHIEF FINANCIAL OFFICER 316056 0 0 0 7536 0 38340 0 3862 0 365794 0 0 0 PART I, LINE 1A THE ORGANIZATION REIMBURSES CERTAIN EXECUTIVES FOR THEIR SOCIAL CLUB DUES. AMOUNTS ARE NOT INCLUDED IN TAXABLE INCOME AS THE ORGANIZATION RECOGNIZES THAT MEMBERSHIP TO THE LOCAL CLUB IS A DESIRABLE MARKETING TOOL FOR THE BENEFIT OF THE HOSPITAL ORGANIZATION ITSELF. ADDITIONALLY, CERTAIN EXECUTIVE STAFF ARE ENTITLED TO RECEIVE AN AUTOMOBILE ALLOWANCE, WHICH IS INCLUDED IN THEIR TAXABLE INCOME AT YEAR END. PART I, LINE 4B SEVERANCE NONQUALIFIED EQUITY-BASED ROBERT P. GRANGER 0 80,000 0 MATTHEW MOORE 0 33,750 0 DEBORAH L. SAYLOR 0 22,500 0 BOBBI FARBER, MD 0 39,410 0 EWINS R. LOWE 0 45,000 0 THOMAS WALSH, MD 0 47,552 0 GEORGE ZIMMERMAN, MD 0 74,469 0 ROBERT LEWIS, MD 0 30,000 0 L.E. WESTERLUND, MD 0 20,410 0 GREG HEMBREE 0 18,750 0 MCDONALD PLUMMER 0 30,000 0 DEBBIE BOSTIC 0 22,500 0 PART III - OTHER ADDITIONAL INFORMATION THE ORGANIZATION HAS ESTABLISHED AN UNFUNDED 457(F) DEFERRED COMPENSATION PLAN. THIS IS A DEFINED CONTRIBUTION PLAN WHERE BENEFITS ARE PAYABLE TO ELIGIBLE PARTICIPANTS IN ACCORDANCE WITH CONTRACTUAL AGREEMENTS UPON A PARTICIPANT'S SERVICE COMPLETION DATE. PHYSICIAN PRODUCTIVITY INCENTIVE: EACH OF THE ORGANIZATION'S PHYSICIAN CONTRACTS PROVIDES THE PHYSICIAN WITH THE ABILITY TO EARN ADDITIONAL COMPENSATION BASED ON HIS/HER OWN PRODUCTIVITY AS MEASURED BY WORK RVU'S. THE FORMULA FOR DETERMINING THIS ADDITIONAL COMPENSATION IS PRE-DETERMINED BASED ON THE TERMS OF THE CONTRACT. MANAGEMENT INCENTIVE: THE MANAGEMENT INCENTIVE PLAN CONSISTS OF SEVERAL INDICATORS EACH HAVING A POINT VALUE BASED ON A MINIMUM, TARGET, AND MAXIMUM VALUE. ONE OF THOSE INDICATORS IS INCOME FROM OPERATIONS. THE POINTS ASSIGNED FOR THIS INDICATOR ARE PURELY BASED ON WHETHER THE ORGANIZATION REACHES ONE OF THESE LEVELS. BEYOND THE MAXIMUM VALUE, THERE IS NO ADDITIONAL CREDIT AWARDED FOR A GREATER LEVEL OF OPERATING INCOME. OTIS J SCARBOROUGH TRUSTEE 40731 REAL ESTATE MANAGEMENT 0 BIPIN PATEL MD TRUSTEE 126002 PHYSICIAN SERVICES 0 SCHEDULE L, PART V: BOARD MEMBER, OTIS J. SCARBOROUGH, IS THE PRESIDENT OF THE WOODRUFF COMPANY. THE HOSPITAL ENGAGES THE COMPANY FOR REAL ESTATE MANAGEMENT SERVICES.BOARD MEMBER, BIPIN PATEL, MD, IS CONTRACTED BY ST. FRANCIS HOSPITAL TO PROVIDE PHYSICIAN SERVICES IN HIS ROLE AS CHIEF OF STAFF. FORM 990, PART VI, SECTION A, LINE 7A THE MEDICAL STAFF HAVE THE AUTHORITY TO ELECT TWO MEMBERS OF THE GOVERNING BODY - THE MEDICAL STAFF PRESIDENT AND PRESIDENT ELECT. FORM 990, PART VI, SECTION B, LINE 11 THE ENTIRE BOARD REVIEWS FORM 990 WITH PARTICIPATION BY EXECUTIVE MANAGEMENT. EXECUTIVE MANAGEMENT REVIEWS FORM 990 FOR APPROPRIATE DISCLOSURE OF FINANCIAL DATA. ALL REVIEWS ARE CONDUCTED PRIOR TO THE FILING OF THE RETURN WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C I. COVERED INDIVIDUALS (A) ALL TRUSTEES AND OFFICERS OF THE HOSPITAL (B) ALL MEMBERS OF COMMITTEES AUTHORIZED TO ACT ON BEHALF OF THE BOARD OF TRUSTEES OF THE HOSPITAL (C) THE CHIEF OF STAFF OF THE HOSPITAL (D) ANY OTHER OFFICERS OF THE MEDICAL STAFF OF THE HOSPITAL (E) ANY OTHER PERSON EXERCISING MATERIAL AND SUBSTANTIAL INFLUENCE OVER THE OPERATIONS OF THE HOSPITAL, AND (F) ANY RELATED PERSON TO ANY OF THE FOREGOING PERSONS II. LEVEL AT WHICH THE CONFLICT IS ADDRESSED AND III RESTRICTIONS IMPOSED. A. ALL COVERED INDIVIDUALS SHALL FILE ANNUALLY AT THE BEGINNING OF EACH FISCAL YEAR OF THE HOSPITAL WITH THE SECRETARY OF THE HOSPITAL A DISCLOSURE STATEMENT SETTING FORTH ANY CONFLICT OF INTEREST THAT SUCH COVERED INDIVIDUAL MAY HAVE WITH THE HOSPITAL. B. THE SECRETARY OF THE HOSPITAL SHALL REVIEW ALL DISCLOSURE STATEMENTS WITH THE CHAIR OF THE BOARD TO ENSURE COMPLIANCE WITH THE POLICIES REGARDING CONFLICT OF INTEREST. C. THE BOARD OF TRUSTEES MAKES A DETERMINATION AS TO WHETHER A CONFLICT EXISTS. D. THE BOARD OF TRUSTEES REVIEWS THE POTENTIAL CONFLICT. E. UPON DETERMINATION OF THE EXISTENCE OF A CONFLICT, THE BOARD OF TRUSTEES MAKES A DETERMINATION OF HOW THE CONFLICT WILL BE RESOLVED AS FOLLOWS: A. IF DEEMED APPROPRIATE BY THE BOARD OF TRUSTEES, A COMMITTEE APPOINTED BY THE BOARD OF TRUSTEES AND CONSISTING SOLELY OF MEMBERS WITH NO CONFLICT OF INTEREST WITH RESPECT TO SAID TRANSACTION, CONTRACTUAL RELATIONSHIP OR ARRANGEMENT SHALL BE AUTHORIZED TO REVIEW AND INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION, CONTRACTUAL RELATIONSHIP OR ARRANGEMENT AND SUCH COMMITTEE SHALL REPORT ITS FINDINGS TO THE FULL BOARD OF TRUSTEES. B. THE COVERED INDIVIDUAL WITH THE CONFLICT OF INTEREST SHALL NOT PARTICIPATE IN ANY DISCUSSION, VOTE OR ACTION TAKEN WITH REGARD TO THE TRANSACTION, CONTRACTUAL RELATIONSHIP OR ARRANGEMENT, BUT SHALL BE ENTITLED TO FURNISH ANY INFORMATION REQUESTED BY THE BOARD OR COMMITTEE OR BELIEVED BY THE COVERED INDIVIDUAL TO BE RELEVANT TO THE DISCUSSION. C. ANY TRANSACTION, CONTRACTUAL RELATIONSHIP OR ARRANGEMENT IN WHICH A COVERED INDIVIDUAL SHALL BE DEEMED TO HAVE A CONFLICT OF INTEREST MUST BE CONSIDERED AND APPROVED BY A MAJORITY VOTE OF TRUSTEES WHO HAVE NO CONFLICT OF INTEREST WITH RESPECT TO THE PROPOSED TRANSACTION, CONTRACTUAL RELATIONSHIP OR ARRANGEMENT, AND THEN ONLY AFTER DETERMINING THAT SUCH TRANSACTION, CONTRACTUAL RELATIONSHIP OR ARRANGEMENT IS IN THE BEST INTEREST OF AND PRIMARILY FOR THE BENEFIT OF THE HOSPITAL AND IS FAIR AND REASONABLE TO THE HOSPITAL. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR REVIEWING AND EVALUATING SENIOR LEADERSHIP COMPENSATION IS OVERSEEN BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE FOLLOWING HIGHLIGHTS THE KEY ITEMS RELATED TO THIS PROCESS: 1) EACH DECEMBER, EACH MEMBER OF THE BOARD IS ASKED TO COMPLETE AN EVALUATION FORM FOR THE CEO BASED ON THE ANNUAL GOALS PREVIOUSLY APPROVED BY THE BOARD. 2) IN JANUARY, MANAGEMENT WILL PROVIDE THE COMPENSATION COMMITTEE WITH THE FOLLOWING: A. INFORMATION RELATED TO ACHIEVEMENT OF ANNUAL GOALS AND THE PROPOSED INCENTIVE AWARD TO SENIOR LEADERSHIP AND ASSOCIATES B. MARKET COMPARATIVE COMPENSATION INFORMATION FOR EACH KEY POSITION C. CEO'S RECOMMENDATION AS IT RELATES TO SENIOR LEADERSHIP COMPENSATION 3) THE COMPENSATION COMMITTEE WILL REVIEW THE INFORMATION AND PROVIDE A WRITTEN REPORT TO BE DISTRIBUTED TO THE BOARD FOR THE JANUARY BOARD MEETING THAT INCLUDES THE FOLLOWING ITEMS: A. REVIEW OF SELF-ASSESSMENT BY SENIOR LEADERSHIP ON ACCOMPLISHMENT OF GOALS B. GOALS FOR THE UPCOMING YEAR FOR SENIOR LEADERSHIP AND ASSOCIATES C. CEO RECOMMENDATIONS FOR SENIOR LEADERSHIP COMPENSATION D. CEO RECOMMENDATIONS FOR CURRENT YEAR INCENTIVE COMPENSATION AWARDS FOR SENIOR LEADERSHIP AND ASSOCIATES E. EVALUATION OF CEO PERFORMANCE F. ASSESSMENT OF CEO COMPENSATION, INCLUDING MARKET COMPARATIVE COMPENSATION INFORMATION G. ASSESSMENT OF SENIOR LEADERSHIP COMPENSATION ADJUSTMENTS H. ASSESSMENT OF ASSOCIATE RECOGNITION RECOMMENDATIONS THIS REPORT WILL BE REVIEWED DURING AN EXECUTIVE SESSION OF THE BOARD EACH JANUARY. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTION -7,333,601. NONCONTROLLING DIVIDENDS PAID -493,234. OTHER ADJUSTMENTS -426,717. 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