2014-01-21T15:32:54-06:00 2013-06-30 560747981 DIXON HUGHES GOODMAN LLP 111 FRANKLIN RD SE SUITE 501 ROANOKE VA 240112114 990 2012-07-01 540895648 BUCHANAN GENERAL HOSPITAL BUCH 2769351111 1535 SLATE CREEK RD GRUNDY VA 24614 KIM BOYD 2769351111 2014-01-06 1 MICHAEL P NORTON P00430694 5409896144 2014-01-03 2012 2015-11-30 17:44:51Z KIM BOYD 1535 SLATE CREEK RD GRUNDY VA 24614 26218758 0 X WWW.BGH.ORG X 1979 VA THE HOSPITAL'S MISSION IS TO PROVIDE COMPREHENSIVE HEALTHCARE SERVICES WITH A CARING, COMPETENT STAFF, DEDICATED TO MEETING THE COMMUNITY'S NEEDS FOR SAFE AND EFFICIENT QUALITY HEALTHCARE AT A REASONABLE COST. 9 9 282 12 523 0 0 4500 25090393 25573276 677665 635224 552 523 25768610 26213523 0 0 0 0 12923549 11777578 0 0 0 13689687 14277601 26613236 26055179 -844626 158344 43914079 44683390 2939081 3550048 40974998 41133342 THE HOSPITAL'S PRIMARY MISSION IS TO PROVIDE COMPREHENSIVE SERVICES WITH A CARING, COMPETENT STAFF DEDICATED TO MEETING THE COMMUNITY'S NEEDS FOR SAFE AND EFFICIENT QUALITY HEALTHCARE AT A REASONABLE COST. 0 0 15269628 25573681 GENERAL PATIENT SERVICE CARE - 1,307 INPATIENTS REPRESENTING 5,188 PATIENT DAYS, 10,773 EMERGENCY ROOM VISITS, 31,028 OUTPATIENT VISITS, 510 MEDICARE DISCHARGES WHICH REPRESENTS 39% OF TOTAL DISCHARGES 1040000 CHARITY CARE PROVIDED AMOUNTED TO $1,040,000; THE HOSPITAL IS THE SOLE PROVIDER OF ACUTE MEDICAL AND SURGICAL SERVICES IN BUCHANAN COUNTY, VIRGINIA, A MEDICALLY UNDERSERVED AREA. 16309628 1 0 0 1 0 0 0 0 0 0 1 0 0 0 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 1 0 0 0 0 1 30 0 1 282 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X ROBERT RUCHTI CEO 2769351111 1535 SLATE CREEK ROAD GRUNDY VA 24614 ROGER COLEMAN 1.00 X 0 0 0 DAVID TOLLIVER 1.00 X 0 0 0 BETTY LOONEY 1.00 X 0 0 0 WILLIS SMITH 1.00 X 0 0 0 ANGELA JOHNSON 1.00 X 0 0 0 DANNY ELSWICK 1.00 X X 0 0 0 JANIE OWENS 1.00 X X 0 0 0 MARY RUTH SPENCER 1.00 X X 0 0 0 JAMES W CHILDRESS 1.00 X X 0 0 0 JOAN JAMISON 40.00 X 205180 0 6147 KIMETHA BOYD 40.00 X 118420 0 686 BEVERLY ANDERSON 40.00 X 93487 0 530 PATRICIA DORTON 40.00 X 92308 0 514 ROBERT RUCHTI 40.00 X 196299 0 838 NAGARAJA VISHAKAANTAIAH 40.00 X 168891 0 659 PAUL PETROZZO 40.00 X 351877 0 790 RICARDO MARTINEZ 40.00 X 156491 0 650 1382953 0 10814 6 0 1 0 UNITED EMERGENCY SERVICES PO BOX 730551 DALLAS TX 753730551 EMERGENCY ROOM PHYSICIANS 563251 PAMELA ENJETTI MD 14316 BRISTOW ROAD MANASSAS VA 20112 ANESTHESIA 390000 CARILION MEDICAL CENTER PO BOX 40032 ROANOKE VA 24022 MOBILE MRI 256440 MOUNTAIN THERAPY GROUP PO BOX 152 VANSANT VA 24656 PHYSICAL THERAPY SERVICES 151755 LABCORP PO BOX 12140 BURLINGTON NC 272162140 REFERENCE LAB 128593 6 4500 4500 PROG.SERV.REVENUE-RELATED-990 621990 24423839 24423839 1149437 1149437 25573276 634819 634819 405 0 405 405 405 5758 5235 523 523 26213523 25573681 523 634819 1382953 940408 442545 7890956 5365850 2525106 2503669 1702495 801174 44114 22057 22057 55278 22111 33167 815274 326110 489164 228731 157824 70907 56560 22624 33936 12520 8639 3881 1890138 1304195 585943 83333 58333 25000 PROVISION FOR BAD DEBTS 3986458 1474989 2511469 CONTRACT AND OTHER FEES 3276234 1965740 1310494 PATIENT CHARGEABLES AND 1337401 1337401 SUPPLIES 1281124 1093405 187719 1210436 507447 702989 26055179 16309628 9745551 0 2597803 3132127 1241519 1997471 2401295 807888 963316 942376 959773 240268 238999 52782686 40540903 13178861 12241783 22839120 24673072 68773 73025 43914079 44683390 2839081 2974302 100000 100000 0 475746 2939081 3550048 X 40974998 41133342 40974998 41133342 43914079 44683390 158344 0 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 5633 5633 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: A PORTION OF AHA AND VHHA DUES ARE ATTRIBUTABLE TO LOBBYING AHA $15,317 X 23.98% VHHA $12,495 X 15.69% 1489393 1489393 17670454 12228721 5441733 30788594 26303267 4485327 2834245 2008915 825330 12241783 LEASE PAYABLE 475746 475746 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE HOSPITAL AND ITS SUBSIDIARY, BUCHANAN HEALTH CARE LLC, ARE EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE HOSPITAL AND BHC HAVE DETERMINED THEY DO NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF JUNE 30, 2013. FISCAL YEARS ENDING ON OR AFTER JUNE 30, 2010 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. 1 1 1 X 1 X 150.000000000000 1 1 0 0 324404 324404 0.01250 2455372 1350107 1105265 0.04240 2779776 1350107 1429669 0.05490 2779776 1350107 1429669 0.05490 1 3563443 178000 7943608 8423428 -479820 X 1 1 1 1 BUCHANAN GENERAL HOSPITAL

1535 SLATE CREEK ROAD GRUNDY VA 24614

X BUCHANAN GENERAL HOSPITAL 1 1 X X X X X X X X X 12 1 0 1 X X X X X X X X X X 0 0 1 1 100.000000000000 1 150.000000000000 1 X 1 1 X X X X 1 X X X 1 X X X X X X 1 X 0 1 PART I, L7 COL(F): DURING FISCAL YEAR 2013, THE HOSPITAL ADOPTED FASB ACCOUNTING STANDARDS UPDATE (ASU) 2011-07, "PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION FOR BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTH CARE ENTITIES." IN CONJUNCTION WITH THE ADOPTION, THE HOSPITAL RECLASSIFIED THE PROVISION FOR BAD DEBTS ASSOCIATED WITH PATIENT SERVICE REVENUE FROM AN OPERATING EXPENSE TO A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS). THE 2012 PROVISION FOR BAD DEBTS HAS BEEN RECLASSIFIED TO CONFORM WITH THE 2013 PRESENTATION. ACCORDINGLY, THE PROVISION FOR BAD DEBT IS INCLUDED AS A COMPONENT OF NET PATIENT SERVICE REVENUE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS FOR 2013 AND 2012. PART III, LINE 4: AN ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS IS RECORDED BASED ON HISTORICAL BAD DEBT EXPERIENCE AND MANAGEMENT'S EVALUATION OF THE ACCOUNTS RECEIVABLE. BALANCES ARE WRITTEN OFF AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN MADE. FOR PURPOSES OF THE COMMUNITY BENEFIT CALCULATION, BAD DEBT EXPENSE PER THE FINANCIAL STATEMENTS WAS GROSSED UP USING A NET REALIZED REVENUE PERCENTAGE AND THEN APPLIED AGAINST A COST TO CHARGE RATIO. PART III, LINE 9B: THE HOSPITAL ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT BY REFERENCE TO CERTAIN ESTABLISHED POLICIES OF THE HOSPITAL. THESE POLICIES DEFINE CHARITY SERVICES AS THOSE SERVICES FOR WHICH NO PAYMENT IS ANTICIPATED. IN ASSESSING A PATIENT'S INABILITY TO PAY, THE HOSPITAL UTILIZES THE GENERALLY RECOGNIZED POVERTY INCOME LEVELS, BUT ALSO INCLUDES CERTAIN CASES WHERE INCURRED CHARGES ARE SIGNIFICANT WHEN COMPARED TO INCOME. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE; HOWEVER, EXPENSES INCURRED IN PROVIDING THESE SERVICES ARE INCLUDED IN THE HOSPITAL'S OPERATING EXPENSES. BUCHANAN GENERAL HOSPITAL PART V, SECTION B, LINE 3: THE COMMUNITY NEEDS ASSESSMENT TEAM SURVEYED KEY COMMUNITY PARTNERS, INCLUDING REPRESENTATIVES OF THE LOCAL CITY/COUNTY HEALTH DEPARTMENT, COMMUNITY OUTREACH GROUPS, AND OTHER FOCUS GROUPS TO SUPPLEMENT THE FINDINGS OF THE ASSESSMENT. THERE WAS ONE IN-PERSON INTERVIEW WITH THE LOCAL HEALTH DEPARTMENT AND THE REST OF THOSE CONTACTED WERE GIVEN THE OPTION OF AN ONLINE OR PAPER SURVEY TO COMPLETE. BUCHANAN GENERAL HOSPITAL PART V, SECTION B, LINE 7: IN INITIAL DISCUSSION AND SUBSEQUENT PRIORITIZATION, THE COMMUNITY NEEDS ASSESSMENT TEAM CONSIDERED THE LEVELS TO WHICH SOME NEEDS WERE ALREADY BEING ADDRESSED IN THE SERVICE AREA. ADDITIONALLY, SOME COMMUNITY NEEDS FALL OUT OF THE SCOPE OF EXPERTISE AND RESOURCES OF THE HOSPITAL. THESE NEEDS ARE ACCESS TO PCP, MENTAL HEALTH AND SUICIDE RATES, ORAL HEALTH, DRUG AND TOBACCO USE, TEEN PREGNANCY, AND MOTOR VEHICLE DEATHS. BUCHANAN GENERAL HOSPITAL PART V, SECTION B, LINE 20D: NO SPECIFIC POLICY ON HOW PATIENTS WERE CHARGED, BUT A PROMPT PAY DISCOUNT OF 40% IS OFFERED. BUCHANAN GENERAL HOSPITAL PART V, SECTION B, LINE 22: CHARGED GROSS CHARGES TO PATIENTS THAT DID NOT MEET THE INDIGENT GUIDELINES OR THE PROMPT PAY TIME FRAME. X X X X X 1 0 0 0 0 0 0 0 0 JOAN JAMISON 205180 0 0 0 0 0 5500 0 647 0 211327 0 0 0 ROBERT RUCHTI 196299 0 0 0 0 0 0 0 838 0 197137 0 0 0 NAGARAJA VISHAKAANTAIAH 168891 0 0 0 0 0 0 0 659 0 169550 0 0 0 PAUL PETROZZO 351877 0 0 0 0 0 0 0 790 0 352667 0 0 0 RICARDO MARTINEZ 156491 0 0 0 0 0 0 0 650 0 157141 0 0 0 PART I, LINE 4A JOAN JAMISON - SEVERANCE - $58,386 FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED BY THE CFO AND THE FINANCE COMMITTEE PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C TO ENSURE THAT BUCHANAN GENERAL HOSPITAL OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGAINZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS ARE CONDUCTED. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAS AN EXECUTIVE COMPENSATION COMMITTEE WHO REVIEWS EXECUTIVE SALARIES ON AN ANNUAL BASIS. COMPENSATION LEVELS ARE BASED ON DATA REGARDING COMPARABLE POSITIONS IN PEER INSTITUTIONS FOR EXPERIENCED PROFESSIONALS AND PRIOR PERFORMANCE, AMONG OTHER FACTORS. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST FORM 990, PART XII, LINE 2C THE PROCESS OF FINANCIAL STATEMENT REVIEW AND OVERSIGHT HAS NOT CHANGED FROM THE PRIOR YEAR. BUCHANAN HEALTH CARE LLC RT 5 BOX 20 GRUNDY VA 24614 311671512 OPERATES PHYSICIAN PRACTICES AND PROVIDES OTHER HEALTH CARE SERVICES VA -383893 43500 BUCHANAN GENERAL HOSPITAL INC