2015-04-21T15:24:25-05:00 2014-06-30 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2013-07-01 631058174 CULLMAN REGIONAL MEDICAL CENTER INC CULL 2567372598 1912 ALABAMA HIGHWAY 157 CULLMAN AL 350580609 NESHA DONALDSON CFO 2567372598 2015-05-15 true JACQUELINE G ATKINS P00861721 2298837878 2015-04-21 2013 2016-02-25 16:41:14Z JAMES CLEMENTS CEO 1912 ALABAMA HIGHWAY 157 CULLMAN AL 350580609 100221785 false X CRMCHOSPITAL.COM X 1939 AL CULLMAN REGIONAL MEDICAL CENTER, LICENSED FOR 145 BEDS, OPERATES A 115-BED GENERAL ACUTE CARE HOSPITAL FOR THE COMMUNITY OF CULLMAN, ALABAMA AND SURROUNDING AREAS REGARDLESS OF A PATIENT'S ABILITY TO PAY. 14 13 1075 32 1206211 73886 714318 970661 88112173 91596673 347428 2332099 5063637 5295109 94237556 100194542 74177 76297 0 45592056 46967312 0 370 47868267 49081377 93534500 96124986 703056 4069556 100396208 104627424 86250051 85951042 14146157 18676382 X CULLMAN REGIONAL MEDICAL CENTER, LICENSED FOR 145 BEDS, OPERATES A 115-BED GENERAL ACUTE CARE HOSPITAL FOR THE COMMUNITY OF CULLMAN, ALABAMA AND SURROUNDING AREAS REGARDLESS OF A PATIENT'S ABILITY TO PAY. false false 82763795 76297 94771800 CRMC PROVIDES ACUTE CARE PATIENT SERVICES WHICH ARE RENDERED TO ALL MEMBERS OF THE COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY. CRMC USES CHARITY APPLICATIONS BASED UPON FEDERAL POVERTY GUIDELINES AND FAMILY SIZE TO DETERMINE ELIGIBILITY FOLLOWING SERVICES PROVIDED. CRMC PROVIDES CARE 24 HOURS PER DAY, SEVEN DAYS A WEEK AND HAS PROVIDED 23,448 INPATIENT DAYS CARE, 7% WERE NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PLAN; 43,569 EMERGENCY ROOM VISITS, 21% WERE NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PLAN; AND 91,767 OUTPATIENT VISITS, 10% NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PLAN. THE TOTAL UNREIMBURSED COST OF MEDICAL SERVICES PROVIDED TO THOSE NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PLAN IS REPORTED ON SCHEDULE H. CRMC ALSO PROVIDES COMMUNITY EDUCATION AND WELLNESS ACTIVITIES TO THE COMMUNITY AND IS A MAJOR CONTRIBUTOR TO A LOCAL INDIGENT CLINIC SERVICING CULLMAN COUNTY. 82763795 true true false false false false false false false false true false false false true true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true false false false true 213 0 1075 true true true false false false false false false false false false X 14 13 false false false false true true true true true false false true true true true true true true false true false X NESHA DONALDSON 2567372598 1912 ALABAMA HWY 157 CULLMAN AL 350580609 JIM WEIDNER PAST CEO 40.00 2.00 X X 310030 0 22510 CHERYL BAILEY CNO/INTERIM 40.00 2.00 X X 132160 0 5477 DAVID MCKOY PAST CHAIRMA 2.00 X 0 0 0 TODD MCLEROY CHAIRMAN 2.00 2.00 X X 0 0 0 ALAN WOOD SECRETARY 2.00 X X 0 0 0 CLINT FREY MEMBER 2.00 2.00 X 0 0 0 DEL BROCK MEMBER 2.00 X 0 0 0 ROBIN HALL MD MEMBER 2.00 X 0 0 0 ROGER HUMPHREY MEMBER 2.00 X 0 0 0 VINCE BERGQUIST MD FORMER MEMBE 2.00 X 0 0 0 GREG BARKSDALE TREASURER 2.00 X X 0 0 0 JUDY BUTLER PATTERSON VICE CHAIRMA 2.00 X X 0 0 0 MARK BUSSMAN MEMBER 2.00 X 0 0 0 LIONEL POWELL MEMBER 2.00 X 0 0 0 BETH ANDERSON MEMBER 2.00 X 0 0 0 BILL SMITH MD MEMBER 2.00 X 0 0 0 NESHA DONALDSON CFO 40.00 1.00 X 119071 0 4881 JOEL JOHNS MD HOSPITALIST 40.00 X 172312 0 6854 JOHN MORRIS MD HOSPITALIST 40.00 X 161585 0 6854 SUSAN COPELAND VP AMBULATOR 40.00 X 117217 0 8923 STACEY HILL PHARMACY DIR 40.00 X 115823 0 12719 TERESA AARON PHARMACIST 40.00 X 114096 0 12631 1242294 80849 15 false true false CULLMAN ANESTHESIOLOGY & PAIN CONSUL PO BOX 1005 CULLMAN AL 350561005 CRNA SVCS 1825697 MEDASSETS P O BOX 405652 ATLANTA GA 303845652 BUS OFC SVCS 1420333 CROTHALL HEALTHCARE INC 13028 COLLECTION CENTER DRIVE CHICAGO IL 606930130 ENVIRONMENTAL S 838586 HUNTSVILLE HOSPITAL 109 GOVERNORS DRIVE SW HUNTSVILLE AL 358014326 BUS OFC SVCS 470509 DIVERSIFIED CLINICAL SERVICES P O BOX 636981 CINCINNATI OH 452636981 WOUND CARE SVC 448655 23 860396 56190 54075 970661 PATIENT SERVICE REVENUES 623000 90390462 90390462 OUTREACH LAB SERVICES 621500 639691 639691 CPAP MEDICAL EQUIPMENT 621990 474319 474319 CONFERENCE CENTER 532000 60538 60538 SPORTS FIRST 713940 31663 31663 91596673 2336279 2336279 320943 170043 320943 170043 490986 170043 320943 23063 27243 -4180 -4180 -4180 EMS MANAGEMENT FEES 621910 2713623 2713623 EHR REVENUES 621990 723645 723645 CAFETERIA/CATERING 561000 527569 527569 839286 774027 65259 4804123 100194542 94771800 1206211 3245870 X 76297 76297 594129 594129 36120826 32594510 3526316 1856733 1695693 161040 5795483 5239327 556156 2600141 2346367 253774 3591198 3045886 545312 495441 26290 469151 164974 164974 120795 120795 9957208 7811543 2145295 370 185399 610 184789 10306943 8799978 1506965 16054 16054 6457349 6111881 345468 449798 433825 15973 70580 27390 43190 6931 6931 4635101 4387123 247978 863564 863564 MEDICAL SUPPLIES 8886492 8886492 REPAIRS AND MAINT 2391765 374381 2017384 STRATEGIC PLANNING 202938 202938 DUES AND SUBSCRIPTIONS 133275 133275 145572 42638 102934 96124986 82763795 13360821 370 7504453 8340308 10581800 10741334 390565 385856 1059085 1074826 618992 910117 98523217 60678138 36465168 37845079 37526323 41913473 3060521 2580926 3189301 835505 100396208 104627424 11222854 11417640 36128 33988 66479971 65045756 255754 385712 8255344 9067946 86250051 85951042 X 14146157 18676382 14146157 18676382 100396208 104627424 X 4069556 1990602 -1529933 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1875736 1875736 44894007 21819858 23074149 7029225 6193357 835868 43190420 32664923 10525497 1533829 1533829 37845079 MINIMUM PENSION LIABILITY 4982354 ACCRUED INTEREST 1759826 COST REPORT SETTLEMENTS 1412677 INTERCOMPANY LIABILITY 913089 9067946 X SCHEDULE D, PAGE 3, PART X THE AUTHORITY IS A GOVERNMENTAL ENTITY AND IS EXEMPT FROM INCOME TAXES. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN CONSIDERED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)3 OF THE INTERNAL REVENUE CODE. THE HOSPITAL IS REQUIRED TO FILE A FORM 990 WITH THE INTERNAL REVENUE SERVICE. ANY INCOME EARNED FROM NON-RELATED BUSINESS SERVICES IS SUBJECT TO TAXATION. THE HOSPITAL APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE HOSPITAL ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF JUNE 30, 2014 AND 2013 OR FOR THE YEARS THEN ENDED. THE HOSPITAL'S TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAXING AUTHORITIES. FOR FEDERAL INCOME TAX PURPOSES, THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. true true X true X true X true true false true true 1848 1842561 1842561 0.01920 15276 8869343 4281352 4587991 0.04770 17124 10711904 4281352 6430552 0.06690 24 1688 404685 3020 401665 0.00420 2 3477 3477 2 12550 12550 0.00010 28 1688 420712 3020 417692 0.00430 28 18812 11132616 4284372 6848244 0.07120 14 25764 29496 2710 26786 0.00030 1 103 8358 5150 3208 15 25867 37854 7860 29994 0.00030 true 22443390 40202982 32760388 7442594 X true true HERITAGE DIAGNOSTICS IMAGING SERVICES 0.21000 0.79000 1 1 CULLMAN REGIONAL MEDICAL CENTER 1912 ALABAMA HIGHWAY 157 CULLMAN AL 350580609 CRMCHOSPITAL.COM H2201 X X X HOSPICE, CLINICS & HOME HEALTH CULLMAN REGIONAL MEDICAL CENTER 1 true X X X X X X X X 13 true false true X CRMCHOSPITAL.COM X X X X X X true false true true 200.000000000000 true 300.000000000000 true X X X X X true true X X X X X true false X X X X true X false false FACILITY 1, CULLMAN REGIONAL MEDICAL CENTER - PART V, LINE 3 THE CULLMAN COUNTY COMMUNITY HEALTH COALITION CREATED A TARGETED LIST OF AREAS OF EXPERTISE IN THE COMMUNITY THAT WOULD PROVIDE VALUABLE INPUT. EACH MEMBER OF THE COALITION WAS RESPONSIBLE FOR SUPPLYING AND COLLECTING SURVEYS TO THESE DIFFERENT AREAS IN THE COMMUNITY. THESE AREAS WOULD HELP GENERATE INPUT FROM A VARIETY OF SOURCES THAT WOULD HELP GENERATE AN OVERALL VIEW OF THE HEALTH OF THE COMMUNITY. THE GROUP ALSO CREATED BOTH A PRINTED SURVEY AND AN ONLINE ELECTRONIC SURVEY IN ORDER TO REACH MULTIPLE DEMOGRAPHICS THROUGHOUT THE COMMUNITY. AFTER BOTH THE SURVEY DATA AND SECONDARY DATA WERE COMPILED, DISCUSSION WAS CONDUCTED BY THE MEMBERS OF THE CULLMAN COUNTY COMMUNITY HEALTH COALITION IN ORDER TO COLLECT PRIMARY DATA ABOUT OUR COMMUNITY. THE COMMUNITY HEALTH COALITION MEMBERS REPRESENT BOTH THE HEALTHCARE COMMUNITY AND THE COMMUNITY AT LARGE; THEREFORE, THIS GROUP SERVED AS THE FOCUS GROUP PORTION OF THE NEEDS ASSESSMENT PROCESS. ONCE DATA COLLECTION WAS COMPLETE, A DISCUSSION MEETING WAS HELD WITH SEVERAL KEY COALITION AND COMMUNITY MEMBERS TO DISCUSS THE FINDINGS AND OBTAIN THEIR ASSISTANCE IN SETTING PRIORITIES TO RESPOND TO NEEDS IN THE COMMUNITY. FINALLY, A LEADERSHIP COMMITTEE WITHIN CULLMAN REGIONAL MEDICAL CENTER MET TO PRIORITIZE THESE NEEDS EVEN FURTHER AND DETERMINE HOW CULLMAN REGIONAL CAN BEST PARTICIPATE IN HELPING TO MEET THE NEEDS OF THE COMMUNITY. FACILITY 1, CULLMAN REGIONAL MEDICAL CENTER - PART V, LINE 12I THE HOSPITAL HAS CLEARLY WRITTEN FINANCIAL AID POLICIES THAT ARE AVAILABLE ON THE ORGANIZATION WEB SITE AND THROUGH THE BUSINESS OFFICE. SIGNS ARE PROMINENTLY POSTED IN THE ER ABOUT THE AVAILABILITY OF FINANCIAL AID. A REPRESENTATIVE IS ALSO AVAILABLE TO DISCUSS ELIGIBILITY TO GOVERNMENT PROGRAMS. 1 HOSPICE OF CULLMAN COUNTY 1912 ALABAMA HIGHWAY 157 CULLMAN AL 350580609 HOSPICE PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE FEDERAL POVERTY GUIDELINES (200%) ARE USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. DISCOUNTED CARE WILL BE BASED ON MEDICARE REIMBURSEMENT. PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATION'S "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS, 2008". SEE ALSO THE DESCRIPTION FOR PART III, LINE 4. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY LINE 2 IS TAKEN DIRECTLY FROM THE INCOME STATEMENT AND REPRESENTS THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE EVALUATION OF THE OVERALL COLLECTIBILITY OF THE ACCOUNTS RECEIVABLE. AS ACCOUNTS ARE KNOWN TO BE UNCOLLECTIBLE, THE ACCOUNT IS CHARGED AGAINST THE ALLOWANCE. PART III, LINE 8 - MEDICARE EXPLANATION THE HOSPITAL UTILIZES EPSI SOFTWARE FOR COST ACCOUNTING PURPOSES. THE MEDICARE COST REPORT WAS USED TO GATHER INFORMATION RELATED TO MEDICARE CHARGES AND REIMBURSEMENT. MEDICARE COST WAS CALCULATED BY ADDING DIRECT COSTS TO INDIRECT COSTS WHICH ARE ALLOCATIONS OF OVERHEAD DEPARTMENTS USING A REASONABLE STATISTICAL BASIS. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL AID POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS FINANCIAL AID, THEY ARE NOT REPORTED AS REVENUE. PART VI, LINE 2 - NEEDS ASSESSMENT THE HOSPITAL PARTICIPATES IN THE CULLMAN COUNTY HEALTH COALITION. THIS ORGANIZATION, COMPRISED OF VARIOUS HEALTH CARE PROVIDERS AND COMMUNITY LEADERS, ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY AND STRIVES TO PROVIDE RESOURCES THAT BEST MEET THOSE NEEDS. CRMC FILED A COMMUNITY HEALTH NEEDS ASSESSMENT AND IT IS AVAILABLE ON THE ORGANIZATION WEBSITE. PROGRESS ON CHNA IMPLEMENTATION STRATEGIES 2013-2014: PRIORITY: TREAT, EDUCATE AND PREVENT CHRONIC CONDITIONS SUCH AS OBESITY, HEART DISEASE, COPD, DIABETES, HYPERTENSION THE HOSPITAL, ALONG WITH LOCAL BUSINESSES AND PHYSICIAN GROUPS HELPED SUPPORT A FREE, ONLINE INTERACTIVE BUSINESS TOOL THAT PROVIDES RESOURCES TO HELP MAKE HEALTHIER CHOICES IN THE COMMUNITY. PRIORITY: WORKING WITH VARIOUS AGENCIES TO PROVIDE RESOURCES TO ASSIST IN IMPROVING OVERALL WELLNESS FOR THE COMMUNITY THE HOSPITAL NOW PARTICIPATES IN THE SILVERSNEAKERS FITNESS PROGRAM. THE SILVERSNEAKERS FITNESS PROGRAM IS A FUN, ENERGIZING PROGRAM THAT HELPS OLDER ADULTS TAKE GREATER CONTROL OF THEIR HEALTH BY ENCOURAGING PHYSICAL ACTIVITY AND OFFERING SOCIAL EVENTS. PRIORITY: IMPROVE ACCESS TO CARE THE HOSPITAL WORKED WITH LOCAL AGENCIES TO PROVIDE AFFORDABLE TRANSPORTATION ACCESS TO INDIVIDUALS IN THE COMMUNITY. PRIORITY: STEER PATIENTS TO LOCAL RESOURCES FOR AN APPROPRIATE LEVEL OF CARE CALLS RECEIVED BY CRMC NURSE NAVIGATION/CASE MANAGEMENT DEPARTMENT WERE DIRECTED TO GOOD SAMARITAN CLINIC AND STIDHAM MEDICAID CLINIC. CALLS DIRECTED TO GOOD SAMARITAN CLINIC AVERAGED 50-80 PER MONTH AND THE AVERAGE REFERRALS TO STIDHAM MEDICAID CLINIC AVERAGED 15 PATIENTS PER MONTH. PRIORITY: USE NURSE NAVIGATORS TO HELP NAVIGATE PATIENTS THROUGH THEIR HEALTHCARE ISSUES AFTER MEETING IMMEDIATE NEEDS NURSE NAVIGATION PROVIDES SUPPORT AND DISTRIBUTION OF FOUNDATION FUNDS OF THREE SEPARATE FOUNDATIONS. NURSE NAVIGATION HELPS POTENTIAL PATIENTS COMPLETE APPLICATIONS AND OBTAIN FREE OR REDUCED COST MEDICATION AND TREATMENTS. THESE 3 FUNDS ARE ALL CANCER-RELATED PROGRAMS. CULLMAN COUNTY BOSOM BUDDIES - 19 PATIENTS ASSISTED BOSOM BUDDIES FOUNDATION - 26 PATIENTS ASSISTED SCOTT LOCHRIDGE FOUNDATION - 18 PATIENTS ASSISTED PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE HOSPITAL HAS CLEARLY WRITTEN FINANCIAL AID POLICIES THAT ARE AVAILABLE ON THE ORGANIZATION WEB SITE AND THROUGHOUT THE BUSINESS OFFICE. SIGNS ARE PROMINENTLY POSTED IN THE ER ABOUT THE AVAILABILITY OF FINANCIAL AID. A REPRESENTATIVE IS ALSO AVAILABLE TO DISCUSS ELIGIBILITY TO GOVERNMENT PROGRAMS. PART VI, LINE 4 - COMMUNITY INFORMATION THE HOSPITAL DRAWS PATIENTS PRINCIPALLY FROM CULLMAN COUNTY AND THE NEIGHBORING COUNTIES OF WALKER, WINSTON, MARSHALL, MORGAN, AND BLOUNT. CRMC IS THE ONLY HOSPITAL IN ITS PRIMARY SERVICE AREA. THE PRIMARY SERVICE AREA INCLUDES THE CITY OF CULLMAN, POPULATION 15,000, AND CULLMAN COUNTY, POPULATION 81,000. PER CAPITA INCOME FOR THIS AREA IS SLIGHTLY BELOW THE PER CAPITA INCOME FOR THE STATE OF ALABAMA. CULLMAN IS SERVED BY I-65, AND IS LOCATED BETWEEN HUNTSVILLE AND BIRMINGHAM. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH THE ORGANIZATION AND ITS VOLUNTEER BOARDS ARE COMPOSED OF COMMUNITY MEMBERS WITH DIVERSE PROFESSIONAL AND COMMUNITY SERVICE BACKGROUNDS, AS WELL AS PHYSICIAN MEMBERS. THE EMERGENCY DEPARTMENT IS OPEN 24 HOURS PER DAY, 7 DAYS PER WEEK, AND IS OPEN TO ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY. HOSPITAL EMPLOYEES, IN CONJUNCTION WITH OUR LOCAL JUDGES, HAVE DEVELOPED A TRAUMA PREVENTION PROGRAM. THIS PROGRAM IS PROVIDED BY CRMC EMPLOYEES ON A VOLUNTARY BASIS. OUR LOCAL JUDGES REFER TEENAGE DRIVING OFFENDERS TO THE PROGRAM TO TEACH THEM THE IMPORTANCE OF VEHICLE SAFETY. WHILE THEY ARE HERE, THEY ACTUALLY GET TO WITNESS THE VARIOUS STAGES OF A TRAUMA ACCIDENT, FROM THE TIME THEY ARRIVE AT THE ER, UNTIL THEY LEAVE THE HOSPITAL. COMMUNITY BUILDING ACTIVITIES ALSO INCLUDE PROVIDING AMBULANCE SUPPORT FOR VARIOUS COMMUNITY ACTIVITIES AND PROVIDING COMMUNITY SUPPORT GROUPS. THESE SUPPORT GROUPS (ALZHEIMER'S, BREAST CANCER, ETC) PROMOTE THE PHYSICAL AND MENTAL HEALTH OF THE COMMUNITY THAT WE SERVE. CRMC PROVIDES WOMEN'S FIRST AND SENIOR CHOICE PROGRAMS. THE WOMEN'S FIRST PROGRAM OFFERS SEMINARS AND EDUCATION ON HEALTH AND LIFESTYLE ISSUES SUCH AS STRESS MANAGEMENT, PMS, MENOPAUSE, AND HEART DISEASE. IT ALSO GIVES DISCOUNT ADMISSION TO WORKSHOPS AND HEALTH SCREENINGS. SENIOR CHOICE PROVIDES SERVICES TO PROMOTE EMOTIONAL, SOCIAL, AND PHYSICAL WELL BEING FOR COMMUNITY MEMBERS WHO ARE 50 AND OVER. THESE PROGRAMS CURRENTLY HAVE 6,903 MEMBERS. CRMC ALSO PROVIDES A COMMUNITY EDUCATION CENTER WHICH OFFERS MEETING ROOMS AND CATERING SERVICES FOR LOCAL BUSINESSES, CHURCHES, CIVIC ORGANIZATIONS AND EDUCATIONAL GROUPS. ALL OF OUR AMBULANCES ARE EQUIPPED WITH 12 LEAD EKG TECHNOLOGY, WHICH TRANSMITS THE INFORMATION DIRECTLY TO THE EMERGENCY ROOM PHYSICIAN, ALLOWING THEM TO GET THE INFORMATION WHILE THE PATIENT IS IN TRANSIT. THIS PROGRAM HAS REDUCED THE TIME FROM DOOR TO ANGIOPLASTY, BY GETTING THE CARDIOLOGY TEAM IN PLACE BEFORE THE PATIENT ARRIVES. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT ALABAMA true GOOD SAMARITAN CLINIC 401 ARNOLD ST NE CULLMAN AL 350551919 200149215 3 76297 CURRENT OPERATIONS 1 SCHEDULE I, PAGE 1, PART I, LINE 2 THE HOSPITAL CONTINUOUSLY EVALUATES COMMUNITY ORGANIZATIONS (AS IDENTIFIED IN PART II ABOVE) PROVIDING HEALTHCARE NEEDS TO THE MEDICALLY UNDERSERVED WHO ALSO ARE MOST LIKELY UNABLE TO PAY. THE HOSPITAL EVALUATES THE NEEDS ON AN INDIVIDUAL BASIS BASED ON DOCUMENTED REQUESTS FOR SERVICES PROVIDED. X true true X X X X X false false false false false false false false false JIM WEIDNER PAST CEO 294313 15000 717 12514 9996 332540 JOEL JOHNS MD HOSPITALIST 129135 43050 127 6854 179166 JOHN MORRIS MD HOSPITALIST 128884 32500 201 6854 168439 SCHEDULE J, PAGE 1, PART I, LINE 1A THE ORGANIZATION PROVIDES A MEMBERSHIP TO THE LOCAL COUNTRY CLUB FOR THE CEO. ANY AMOUNTS CONSIDERED NONBUSINESS RELATED ARE INCLUDED IN THE RECIPIENT'S TAXABLE INCOME AND REPORTED ON THE FORM W-2. SCHEDULE J, PART III CERTAIN EXECUTIVE OFFICERS ARE ELIGIBLE FOR BONUS/INCENTIVE PAYMENTS. THESE PAYMENTS ARE RELIANT ON VARIOUS ORGANIZATIONAL AND PERSONAL GOALS ESTABLISHED BY THE GOVERNING BODY. WHETHER A BONUS/INCENTIVE PAYMENT IS AWARDED IS DEPENDENT UPON THE NET PROFIT OF THE ORGANIZATION. A HEALTH CARE AUTHORITY OF CULLMAN CT 631149220 230186AMO 2009-12-03 68624416 DEFEASE 1993/2007 BONDS. false false false A 4652392 68624416 61819381 1352854 5452182 2009 true false true true A false false false false false true 0.01100 true false A false true false false false true MERRILL LYNCH 26.000000000000 false false false false false SCHEDULE K - ADDITIONAL INFORMATION HEALTH CARE AUTHORITY OF CULLMAN CTY THE ONLY BONDS ISSUED BY THE AUTHORITY FOR THE BENEFIT OF CRMC ARE THE BONDS, WHICH WERE ISSUED DECEMBER 3, 2009. A PORTION OF THE BONDS IS ALLOCABLE TO CAPITAL EQUIPMENT (THE "BOND- FINANCED EQUIPMENT") FINANCED BY CRMC AND THE AUTHORITY FOR USE AT A FREE- STANDING RADIATION ONCOLOGY CENTER OPERATED BY CRMC. THE BOND-FINANCED EQUIPMENT WAS SOLD ON DECEMBER 31, 2010 FOR CASH IN THE AMOUNT OF 800,000 TO A NONGOVERNMENTAL PERSON. THE SALE CONSTITUTES A DISPOSITION OF THE BOND-FINANCED EQUIPMENT FOR PURPOSES OF THE CHANGE IN USE RULES. WITHIN 2 YEARS OF THE SALE DATE, THE AUTHORITY USED THE DISPOSITION PROCEEDS FOR ALTERNATE USES COMPLYING WITH THE REQUIREMENTS OF TREAS. REG 1.141-12(E). FORM 990, PAGE 2, PART III, LINE 4A COMMUNITY EDUCATION AND WELLNESS ACTIVITIES TO THE COMMUNITY AND IS A MAJOR CONTRIBUTOR TO A LOCAL INDIGENT CLINIC SERVICING CULLMAN COUNTY. FORM 990, PAGE 6, PART VI, LINE 6 THE HEALTH CARE AUTHORITY OF CULLMAN COUNTY IS THE SOLE MEMBER OF CULLMAN REGIONAL MEDICAL CENTER INC. FORM 990, PAGE 6, PART VI, LINE 7A THE HEALTH CARE AUTHORITY OF CULLMAN COUNTY APPOINTS THE VOTING MAJORITY OF THE ORGANIZATION'S BOARD AND CONTROLS THE OPERATIONS AS WELL. FORM 990, PAGE 6, PART VI, LINE 7B THE HEALTH CARE AUTHORITY OF CULLMAN COUNTY APPOINTS THE VOTING MAJORITY OF THE ORGANIZATION'S BOARD AND CONTROLS THE OPERATIONS OF THE ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 11B MANAGEMENT ASSISTS IN PREPARING SCHEDULES, REVIEWS THE ENTIRE DRAFT OF THE FORM 990 FOR CONTENT, AND RECOMMENDS CHANGES, IF ANY. PRIOR TO FILING, THE FINANCE COMMITTEE, CFO, AND ACCOUNTING DEPARTMENT REVIEW THE FORM. THE FINAL FORM, AS IT IS ULTIMATELY FILED WITH ALL SCHEDULES AND ATTACHMENTS, IS SENT TO EACH VOTING MEMBER, PRIOR TO FILING WITH THE IRS. FORM 990, PAGE 6, PART VI, LINE 12C ANNUALLY, BOARD MEMBERS, OFFICERS, AND DEPARTMENTAL DIRECTORS MUST IDENTIFY ANY CONFLICT, MANAGEMENT MONITORS AND MAY SUGGEST ANY AREAS OF CONFLICT. THE BOARD CHAIRMAN OR ADMINISTRATION REVIEWS ACTUAL AND PERCEIVED CONFLICTS OF INTEREST. IN THE EVENT OF A CONFLICT, THE MEMBER OR OFFICER WITH THE CONFLICT WILL DISMISS THEMSELVES FROM THE DISCUSSION AND ANY VOTES ON THE ISSUE. FORM 990, PAGE 6, PART VI, LINE 15A ANNUALLY THE BOARD (OR A COMMITTEE CHARGED WITH THE RESPONSIBILITY AND AUTHORITY TO DO SO ON BEHALF OF THE BOARD) REVIEWS THE COMPENSATION PACKAGE AND PROPOSED CONTRACT OF THE CEO. THE REVIEW IS CONDUCTED BY INDEPENDENT BOARD MEMBERS, IS BASED UPON REVIEW OF COMPARABILITY DATA PROVIDED BY OUTSIDE CONSULTANTS, AND IS DOCUMENTED IN THE RECORDS OF THE BOARD REFLECTING THE BASIS OF THE DETERMINATION BY THE BOARD (OR AUTHORIZED COMMITTEE). FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO ANY MEMBER OF THE PUBLIC WHO MAKES THEIR REQUEST AT THE ADMINISTRATIVE OFFICES OF THE ORGANIZATION. FORM 990, PART IX, LINE 11G CONTRACT LABOR 332,742 70,633 0 MEDICAL PROFESSIONAL FEE 1,021,327 187,321 0 OUTSIDE SERVICE FEES 5,850,380 1,887,341 370 COLLECTION FEES 427,099 0 0 RECRUITING FEES 179,995 0 0 FORM 990, PART XI, LINE 9 CHANGE IN VALUE OF INTEREST RATE SWAP 105,775 CHANGE IN TEMP REST NET ASSETS OF AFFILIATE -445,897 CHANGE IN UNRESTRICTED ASSETS OF AFFILIATE -33,698 GASB 65 IMPLEMENTATION IMPACT -1,156,113 NET DECREASE IN NET ASSETS -1,529,933 CULLMAN REGIONAL MEDICAL CTR FNDN 1912 ALABAMA HIGHWAY 157 CULLMAN AL 350580609 630727880 FOUNDATION AL 501C3 7 NA false HEALTH CARE AUTHORITY OF CULLMAN CO 1912 ALABAMA HIGHWAY 157 CULLMAN AL 350580609 631149220 AUTHORITY AL 501C1 6 NA false false false true false false false false false false false false false true true true false false false false