2013-03-07T13:19:57-06:00 2012-06-30 560747981 DIXON HUGHES GOODMAN LLP 111 FRANKLIN RD SE SUITE 501 ROANOKE VA 240112114 990 2011-07-01 540895648 BUCHANAN GENERAL HOSPITAL BUCH 2769351111 1535 SLATE CREEK RD GRUNDY VA 24614 KIM BOYD 2769351111 2013-02-27 1 MELISSA C STANLEY P00720497 5409896144 2013-02-27 2011 2016-02-25 16:41:14Z KIM BOYD 1535 SLATE CREEK RD GRUNDY VA 24614 25774133 0 X WWW.BGH.ORG X 1979 VA TO PROVIDE GENERAL ACUTE HOSPITAL CARE FOR THE SOUTHWESTERN AREA OF VIRGINIA. 9 9 292 10 552 0 0 0 25299271 25090393 421828 677665 3173 552 25724272 25768610 0 0 0 0 12626572 12923549 0 0 0 13399083 13689687 26025655 26613236 -301383 -844626 43973620 43914079 2153996 2939081 41819624 40974998 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 16118639 25098403 GENERAL PATIENT SERVICE CARE - 1,480 INPATIENTS REPRESENTING 6,002 PATIENT DAYS, 10,181 EMERGENCY ROOM VISITS, 30,859 OUTPATIENT VISITS, 679 MEDICARE DISCHARGES WHICH REPRESENTS 45% OF TOTAL DISCHARGES 533421 CHARITY CARE PROVIDED AMOUNTED TO $533,421; THE HOSPITAL IS THE SOLE PROVIDER OF ACUTE MEDICAL AND SURGICAL SERVICES IN BUCHANAN COUNTY, VIRGINIA, A MEDICALLY UNDERSERVED AREA. 16652060 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 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 0 1 39 0 1 292 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 KIM BOYD 2769351111 1535 SLATE CREEK ROAD GRUNDY VA 24614 HAROLD MUSICK 1.00 X 0 0 0 WARREN BLANKENSHIP 1.00 X 0 0 0 MARY RUTH SPENCER 1.00 X 0 0 0 ROGER COLEMAN 1.00 X 0 0 0 DAVID TOLLIVER 1.00 X 0 0 0 BETTY LOONEY 1.00 X 0 0 0 DANNY ELSWICK 1.00 X X 0 0 0 JANIE OWENS 1.00 X X 0 0 0 JAMES W CHILDRESS 1.00 X X 0 0 0 JOAN JAMISON 40.00 X 254713 0 17553 KIMETHA BOYD 40.00 X 118771 0 585 BEVERLY ANDERSON 40.00 X 95361 0 482 PATRICIA DORTON 40.00 X 89066 0 467 KEMPER BAUSELL 40.00 X 72918 0 387 ROBERT RUCHTI 40.00 X 51525 0 208 NAGARAJA VISHAKAANTAIAH 40.00 X 168634 0 595 PAUL PETROZZO 40.00 X 348136 0 709 RICARDO MARTINEZ 40.00 X 141326 0 541 CHARLES SCOTT JUSTUS 40.00 X 134754 0 560 1475204 0 22087 6 0 1 0 UNITED EMERGENCY SERVICES PO BOX 730551 DALLAS TX 753730551 EMERGENCY ROOM PHYSICIANS 566399 PAMELA ENJETTI MD 14316 BRISTOW ROAD MANASSAS VA 20112 ANESTHESIA 390000 CARILION MEDICAL CENTER PO BOX 40032 ROANOKE VA 24022 MOBILE MRI 266702 LABCORP PO BOX 12140 BURLINGTON NC 272162140 REFERENCE LAB 136510 UVA HEALTH SERVICES PO BOX 9007 CHARLOTTESVILLE VA 229069007 TELERADIOLOGY 106091 5 PROG.SERV.REVENUE-RELA 621990 23310429 23310429 1779964 1779964 25090393 669655 669655 8010 0 8010 8010 8010 6075 5523 552 552 25768610 25098403 552 669655 1497292 1018159 479133 8737480 5941486 2795994 2688777 1828368 860409 45906 27544 18362 59294 29647 29647 36877 13644 23233 791666 316666 475000 144764 99887 44877 57028 22811 34217 7000 4830 2170 1869531 1289976 579555 253909 177736 76173 PROVISION FOR BAD DEBTS 3844663 1422525 2422138 CONTRACT AND OTHER FEES 2982685 1789611 1193074 PATIENT CHARGEABLES AND 1270063 1270063 SUPPLIES 1111833 949753 162080 1214468 449354 765114 26613236 16652060 9961176 0 2880821 2597803 2241809 1241519 2127295 1997471 687789 807888 844319 942376 298953 240268 51834693 38655832 13599265 13178861 21210209 22839120 83160 68773 43973620 43914079 2053996 2839081 100000 100000 2153996 2939081 X 41819624 40974998 41819624 40974998 43973620 43914079 -844626 0 X X 0 1 1 X 0 X 0 0 0 0 0 0 0 0 1 6998 6998 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: A PORTION OF AHA AND VHHA DUES ARE ATTRIBUTABLE TO LOBBYING AHA $15,717*24.60% VHHA $12850*24.37% 1489393 1489393 17667494 11615595 6051899 29899116 25368727 4530389 2778690 1671510 1107180 13178861 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: 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, 2012. FISCAL YEARS ENDING ON OR AFTER JUNE 30, 2009 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES. 1 1 1 X 1 X 150.000000000000 1 1 0 0 198749 198749 0.00750 2641427 1409971 1231456 0.04630 2840176 1409971 1430205 0.05380 2840176 1409971 1430205 0.05380 1 3743488 187000 9664748 9830080 -165332 X 1 1 1 1 BUCHANAN GENERAL HOSPITAL

1535 SLATE CREEK ROAD GRUNDY VA 24614

X BUCHANAN GENERAL HOSPITAL 1 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 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: CHARITY 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. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION FOR AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE; HOWEVER, EXPENSES INCURRED IN PROVIDING THESE SERVICES ARE INCLUDED IN THE HOSPITAL'S OPERATING EXPENSES. BUCHANAN GENERAL HOSPITAL PART V, SECTION B, LINE 19D: 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 21: CHARGED GROSS CHARGES TO PATIENTS THAT DID NOT MEET THE INDIGENT GUIDELINES OR THE PROMPT PAY TIME FRAME. X X X X X 0 0 0 0 0 1 0 0 0 JOAN JAMISON 254713 0 0 0 0 0 16500 0 1053 0 272266 0 0 0 NAGARAJA VISHAKAANTAIAH 168634 0 0 0 0 0 0 0 595 0 169229 0 0 0 PAUL PETROZZO 348136 0 0 0 0 0 0 0 709 0 348845 0 0 0 PART I, LINE 6 IN ADDITION TO THE BASE SALARY, EXECUTIVES SHALL BE ELIGIBLE FOR AN INCENTIVE BONUS, SUBJECT TO THE FOLLOWING TERMS AND CONDITIONS. IN THE EVENT THAT THE AUDITED CONSOLIDATED NET INCOME STATEMENT SHOWS A PROFIT IN ANY AMOUNT AT THE END OF THE FISCAL YEAR, THE EXECUTIVES WOULD QUALIFY TO RECEIVE 3% OF THE PROFIT GAINED DURING THIS PERIOD. THE INCENTIVE BONUS, IF ANY, SHALL BE PAID WITHIN A REASONABLE TIME (NOT TO EXCEED 90 DAYS) AFTER THE ANNUAL FINANCIAL AUDIT REPORT IS RECEIVED BY THE HOSPITAL. THE CFO IS ELIGIBLE FOR A 1% BONUS BASED ON THE SAME CRITERIA. 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 AUDIT COMMITTEE OVERSIGHT PROCESS HAS NOT CHANGED FROM LAST YEAR. BUCHANAN HEALTH CARE LLC RT 5 BOX 20 GRUNDY VA 24614 311671512 OPERATES PHYSICIAN PRACTICES AND PROVIDES OTHER HEALTH CARE SERVICES VA 1193329 73696 BUCHANAN GENERAL HOSPITAL INC