2014-02-27T08:50:30-06:00 2013-06-30 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2012-07-01 631058174 CULLMAN REGIONAL MEDICAL CENTER INC CULL 2567372598 1912 ALABAMA HIGHWAY 157 CULLMAN AL 35058 NESHA DONALDSON 2567372598 2014-05-15 true JACQUELINE G ATKINS 2298837878 2014-02-26 2012 2015-11-30 17:44:51Z JIM WEIDNER CEO 1912 ALABAMA HIGHWAY 157 CULLMAN AL 35058 95060045 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 1159 58 1180603 65152 899159 714318 86348609 88112173 1430535 347428 5599750 5063637 94278053 94237556 75004 74177 0 47975187 45592056 0 0 48051373 47868267 96101564 93534500 -1823511 703056 98326482 100396208 97809827 86250051 516655 14146157 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 80978351 74177 90975919 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 23,325 INPATIENT DAYS CARE, 6% WERE NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PLAN; 44,961 EMERGENCY ROOM VISITS, 21% WERE NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PLAN; AND 91,950 OUTPATIENT VISITS, 5% NOT COVERED BY ANY GOVERNMENTAL OR PRIVATE INSURANCE PLAN. THE TOTAL UNREIMBUSED 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. 80978351 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 207 0 1159 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 true true false X NESHA DONALDSON 2567372598 1912 ALABAMA HWY 157 CULLMAN AL 35058 JIM WEIDNER 40.00 1.00 X X 289952 0 18174 DAVID MCKOY 2.00 X 0 0 0 TODD MCLEROY 2.00 X X 0 0 0 HOYT BROWNIE PRICE MD 2.00 X 0 0 0 ALAN WOOD 2.00 X X 0 0 0 R CLYNE ADAMS DMD 2.00 X 0 0 0 CLINT FREY 2.00 X 0 0 0 DEL BROCK 2.00 X 0 0 0 ROBIN HALL MD 2.00 X 0 0 0 STEPHEN DONALDSON 2.00 X 0 0 0 JUDY BUTLER 2.00 X X 0 0 0 ROGER HUMPHREY 2.00 X X 0 0 0 VINCE BERGQUIST MD 2.00 X 0 0 0 GREG BARKSDALE 2.00 X 0 0 0 CHERYL BAILEY 40.00 X 130956 0 3811 NESHA DONALDSON 40.00 1.00 X 109523 0 3202 SUSAN JOHNSON 40.00 X 121875 0 727 SUSAN COPELAND 40.00 X 114180 0 7481 STACEY HILL 40.00 X 113063 0 13498 JERIMAH DAVIS 40.00 X 111526 0 12501 TERESA AARON 40.00 X 110851 0 12413 JETE EDMISSON 0.00 0.00 X 104996 0 5792 1206922 77599 15 true true false CULLMAN ANESTHESIOLOGY & PAIN CONSUL PO BOX 1005 CULLMAN AL 350561005 CRNA SVCS 1824921 MEDASSETS P O BOX 405652 ATLANTA GA 303845652 BUS OFC SVCS 1629114 CROTHALL HEALTHCARE INC 13028 COLLECTION CENTER DRIVE CHICAGO IL 60693 ENVIRONMENTAL S 671554 HUNTSVILLE HOSPITAL 109 GOVERNORS DRIVE SW HUNTSVILLE AL 35801 BUS OFC SVCS 467789 DIVERSIFIED CLINICAL SERVICES P O BOX 636981 CINCINNATI OH 452636981 WOUND CARE SVC 445497 27 377566 248674 88078 714318 PATIENT SERVICE REVENUES 623000 86931570 86931570 OUTREACH LAB SERVICES 621500 670784 670784 CPAP MEDICAL EQUIPMENT 621990 433388 433388 CONFERENCE CENTER 532000 47063 47063 SPORTS FIRST 713940 29368 29368 88112173 1036290 1036290 227445 411356 227445 411356 638801 411356 227445 133627 822489 -688862 -688862 -688862 EMS MANAGEMENT FEES 621910 2752076 2752076 CAFETERIA/CATERING 561000 572473 572473 COMMUNITY SERVICE/EDUCATION 713940 431346 431346 668941 449571 219370 4424836 94237556 90975919 1180603 1366716 X 74177 74177 555618 555618 110788 110788 34709293 31454182 3255111 1658811 1490292 168519 5897496 5261633 635863 2660050 2367178 292872 2659782 2210501 449281 612540 47706 564834 148476 148476 113277 113277 9851166 8145560 1705606 160199 890 159309 10835592 9147365 1688227 68829 68829 6543641 6194211 349430 434575 417352 17223 35880 12665 23215 1876 1876 4602300 4356537 245763 641818 641818 MEDICAL SUPPLIES 8765472 8765472 REPAIRS AND MAINT 2099936 385323 1714613 DUES AND SUBSCRIPTIONS 122343 122343 TAXES AND LICENSE 107077 107077 63488 5489 57999 93534500 80978351 12556149 0 3877620 7504453 13849345 10581800 390565 928471 1059085 626132 618992 103768290 67303122 37488871 36465168 34195337 37526323 2207757 3060521 5152949 3189301 98326482 100396208 10628658 11222854 25950 36128 68167633 66479971 233184 255754 18754402 8255344 97809827 86250051 X 516655 14146157 516655 14146157 98326482 100396208 X 703056 1971570 10954876 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1819363 1819363 44289832 20807062 23482770 7036443 5927306 1109137 49437433 40568754 8868679 1185219 1185219 36465168 MINIMUM PENSION LIABILITY 5642894 ACCRUED INTEREST 1785888 INTERCOMPANY LIABILITY 826562 8255344 X LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X THE AUTHORITY IS A TAX-EXEMPT ENTITY; THEREFORE, NO PROVISION FOR INCOME TAXES IS MADE IN THE 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 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, 2013 AND 2012 OR FOR THE YEARS THEN ENDED. THE HOSPITAL'S OPEN AUDIT PERIODS ARE FOR TAX YEARS ENDED 2010-2012. true true X true X true X true true false true true 1604 1772388 1772388 0.01890 17749 8512884 4375302 4137582 0.04420 19353 10285272 4375302 5909970 0.06320 25 5113 484204 3840 480364 0.00510 2 304 304 2 13560 13560 0.00010 29 5113 498068 3840 494228 0.00530 29 24466 10783340 4379142 6404198 0.06850 1 56 56 15 26160 28132 1610 26522 0.00030 16 26160 28188 1610 26578 0.00030 true 24871805 35566731 35960446 -393715 X true true HERITAGE DIAGNOSTICS IMAGING SERVICES 0.21000 0.79000 1 1 CULLMAN REGIONAL MEDICAL CENTER

1912 ALABAMA HIGHWAY 157 CULLMAN AL 35058

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1912 ALABAMA HIGHWAY 157 CULLMAN AL 35058

HOSPICE OTHER TESTING METHODS FOR FREE OR DISCOUNTED CARE PART I LINE 3C FEDERAL POVERTY GUIDELINES 150 ARE USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE DISCOUNTED CARE WILL BE BASED ON MEDICARE REIMBURSEMENT COSTING METHODOLOGY EXPLANATION PART I LINE 7 THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATIONS A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS 2008 SEE ALSO THE DESCRIPTION FOR PART III LINE 4 BAD DEBT EXPENSE EXPLANATION PART III LINE 4 LINE 2 IS TAKEN DIRECTLY FROM THE INCOME STATEMENT AND REPRESENTS TOTAL BAD DEBT EXPENSED DURING THE FISCAL YEAR THE FOLLOWING IS AN EXCERPT FROM THE AUDITED 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 MEDICARE EXPLANATION PART III LINE 8 THE HOSPITAL UTILIZES LYONS 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 COLLECTION PRACTICES EXPLANATION PART III LINE 9B 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 NEEDS ASSESSMENT PART VI 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 AVAILIABLE ON THE HOSPITAL WEBSITE PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI 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 THERE IS ALSO A MEDICAID KIOSK LOCATED IN THE ER WAITING ROOM COMMUNITY INFORMATION PART VI 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 15000 AND CULLMAN COUNTY POPULATION 81000 PER CAPITA INCOME FOR THIS AREA IS SLIGHTLY BELOW THE PER CAPITA INCOME FOR THE STATE OF ALABAMA CULLMAN IS SERVED BY I65 AND IS LOCATED BETWEEN HUNTSVILLE AND BIRMINGHAM HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI 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 ALZHEIMERS BREAST CANCER ETC PROMOTE THE PHYSICAL AND MENTAL HEALTH OF THE COMMUNITY THAT WE SERVE CRMC PROVIDES WOMENS FIRST AND SENIOR CHOICE PROGRAMS THE WOMENS 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 6974 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 LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED PART VI ALABAMA CULLMAN REGIONAL MEDICAL CENTER LINE NUMBER 1 PART V LINE 3 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 CULLMAN REGIONAL MEDICAL CENTER LINE NUMBER 1 PART V LINE 12H PART V LINE 12H 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 true GOOD SAMARITAN CLINIC 401 ARNOLD ST NE CULLMAN AL 35055 200149215 3 74177 CURRENT OPERATIONS 1 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES 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 REQEUSTS FOR SERVICES PROVIDED. X true true X X X X X true false false false false false false false false JIM WEIDNER 289281 671 8337 9837 308126 JETE EDMISSON 104785 211 5792 110788 SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 SUSAN JOHNSON 40,830 0 0 JETE EDMISSON 104,785 0 0 OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III JETE EDMISSION RECEIVED A SEVERANCE PACKAGE UPON TERMINATION IN ACCORDANCE WITH HIS CONTRACTUAL AGREEMENT. A HEALTH CARE AUTHORITY OF CULLMAN CT 631149220 230186AMO 2009-12-03 68624416 DEFEASE 1993/2007 BONDS. false false false A 3323953 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 26.0 false false false false false A false ADDITIONAL INFORMATION SCHEDULE K HEALTH CARE AUTHORITY OF CULLMAN CT THE ONLY BONDS ISSUED BY THE AUTHORITY FOR THE BENEFIT OF CRMC ARE THE 2009 BONDS WHICH WERE ISSUED DECEMBER 3 2009 A PORTION OF THE BONDS IS ALLOCABLE TO CAPITAL EQUIPMENT THE BOND FINANCED EQUIPMENTFINANCED BY CRMC AND THE AUTHORITY FOR USE AT A FREE STANDING RADIATION ONCOLOGY CENTER OPERATED BY CRMC THE BONDFINANCED EQUIPMENT WAS SOLD ON DECEMBER 31 2010 FOR CASH IN THE AMOUNT OF 800000 TO A NONGOVERNMENTAL PERSON THE SALE CONSTITUTES A DISPOSITION OF THE BONDFINANCED EQUIPMENT FOR PURPOSES OF THE CHANGE IN USE RULES WITHIN 2 YEARS OF THE SALE DATE THE AUTHORITY COMPLIED WITH THE REQUIREMENTS OF TREASURY REGULATION 114112E AND USED THE DISPOSITION PROCEEDS FOR ALTERNATE USES FIRST ACCOMPLISHMENT DESCRIPTION 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. CLASSES OF MEMBERS OR STOCKHOLDERS 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. ELECTION OF MEMBERS AND THEIR RIGHTS 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. DECISIONS SUBJECT TO APPROVAL OF MEMBERS 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. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 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, ATTORNEY AND ACCOUNTING DEPARTMENT REVIEW THE FORM. THE FINAL FORM, AS IT IS ULTIMATELY FILED WITH ALL SCHEDULES AND ATTACHMENTS, IS POSTED TO THE BOARD WEBSITE PRIOR TO FILING AND AN E-MAIL ALERTS EACH VOTING MEMBER OF ITS AVAILABILITY. ENFORCEMENT OF CONFLICTS POLICY 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. COMPENSATION PROCESS FOR TOP OFFICIAL 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 THE BOARD (OR AUTHORIZED COMMITTEE). COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B ANNUALLY THE CEO REVIEWS THE COMPENSATION PACKAGE OF THE CFO AND OTHER OFFICERS. THE REVIEW UTILIZES A SALARY SCALE AND MATRIX ESTABLISHED BY CRMC'S HUMAN RESOURCE DEPARTMENT AND CONSIDERS THE ACCOMPLISHMENT OF KEY PERSONAL AND ORGANIZATIONAL GOALS. COMPENSATION IS BASED ON YEARS OF EXPERIENCE IN THAT POSITION AND USES GUIDELINES FOR INHOUSE PROMOTIONS. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION 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. OTHER FEES FOR SERVICES FORM 990, PART IX, LINE 11G CONTRACT LABOR 11,806 44,660 0 MEDICAL PROFESSIONAL FEE 1,197,951 160,207 0 OUTSIDE SERVICE FEES 6,439,699 1,500,739 0 COLLECTION FEES 406,868 0 0 RECRUITING FEES 89,236 0 0 OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 9 CHANGE IN VALUE OF INTEREST RATE SWAP 439,224 CHANGE IN PLAN ASSETS & PBO 9,662,888 CHANGE IN TEMP REST NET ASSETS OF AFFILIATE 941,212 CHANGE IN UNRESTRICTED ASSETS OF AFFILIATE -88,448 NET INCREASE IN NET ASSETS 10,954,876 CULLMAN REGIONAL MEDICAL CTR FNDN 1912 ALABAMA HIGHWAY 157 CULLMAN AL 35056 630727880 FOUNDATION AL 501C3 11C NA false HEALTH CARE AUTHORITY OF CULLMAN CO 1912 ALABAMA HIGHWAY 157 CULLMAN AL 35058 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