2013-05-15T08:12:01-05:00 2012-06-30 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2011-07-01 581973570 FLOYD HEALTHCARE MANAGEMENT INC FLOY 7065096074 304 TURNER MCCALL BLVD ROME GA 301620233 RICHARD T SHEERIN 7065096074 2013-05-15 true JACQUELINE G ATKINS 2298837878 2013-05-15 2011 2016-02-24 21:20:13Z X KURT STUENKEL 304 TURNER MCCALL BLVD ROME GA 301620233 380411767 false X WWW.FLOYD.ORG X 1990 GA OPERATE A NON-PROFIT HOSPITAL SYSTEM AND SUPPORT 501 (C)(3) ORGANIZATIONS 12 12 2811 263 1591683 216739 2526479 451500 323912023 313013978 2565486 2064697 3810831 4600337 332814819 320130512 141685 3516540 0 156964007 165867051 0 218094 164237033 143580224 321342725 312963815 11472094 7166697 305664058 321675722 186201842 213447564 119462216 108228158 OPERATE A NON-PROFIT HOSPITAL SYSTEM AND SUPPORT 501 (C)(3) ORGANIZATIONS false false 250062367 3516540 311689575 FLOYD HEALTHCARE MANAGEMENT, INC. OPERATES FLOYD MEDICAL CENTER, A GENERAL ACUTE CARE HOSPITAL, AND FLOYD BEHAVIORAL HEALTH CENTER, A PSYCHIATRIC HOSPITAL. SEE ADDITIONAL DISCLOSURES AT SCHEDULE O, "SUPPLEMENTAL INFORMATION TO FORM 990". 250062367 true true false true false false false false false false true false false false true true true false false false false false false false false false true true true true true true false false false false false false true false true false false false false false true true false false false false true 283 0 2811 true true true false false false false false false false false false X 12 12 false false false false false false false true true false false true true true true true false true true true true GA X RICHARD T SHEERIN 7065096074 304 TURNER MCCALL BLVD ROME GA 30161 X J ROGER SUMNER 1.00 X X 6000 3000 0 JERRY NORMAN 1.00 X 7575 0 0 TIM MAHANAY 1.00 X 5475 750 0 JOHN MAYES 1.00 X 6200 0 0 WESLEY F JOHNSON 1.00 X 5875 0 0 WILLIAM V WIGLEY 1.00 X 5875 0 0 GARRY FRICKS 1.00 X 4500 0 0 JOHN S FREEMAN 1.00 X 3000 1000 0 GEORGE BOSWORTH MD 1.00 X 3875 0 0 CARL HERRING MD 1.00 X 2750 0 0 MARK MANIS 1.00 X 0 0 0 LARRY KUGLAR 1.00 X 0 0 0 FRANK SHELLEY 1.00 X 0 0 0 KURT STUENKEL 40.00 X 1086769 0 43096 RICHARD T SHEERIN 40.00 X 379272 0 32508 DEE RUSSELL MD 40.00 X 392897 0 8066 WARREN RIGAS 40.00 X 373841 0 29857 C WADE MONK 40.00 X 369157 0 40989 JOSEPH BIUSO MD 40.00 X 324555 0 35574 GREG POLLEY 40.00 X 277168 0 41836 SHEILA HORNER 40.00 X 263587 0 4992 MARY MAIRE 40.00 X 229827 0 55059 REBEKAH LOWREY MD 40.00 X 228157 0 0 DAN SWEITZER 40.00 X 227766 0 47171 ALISON LAND 40.00 X 208919 0 15309 ROBERT PURCELL 40.00 X 190253 0 21001 DAVID EARLY 40.00 X 160794 0 858 BRIAN BARNETTE 40.00 X 156906 0 18356 JOHN HARDWELL MD 50.00 X 647809 0 2548 LOUIS A SPENCER MD 40.00 X 611310 0 4680 GARRETT H BARNESMD 52.00 X 502670 0 17098 CLINE T JACKSON MD 40.00 X 446196 0 3822 MOLLY VICCHRILLI MD 40.00 X 437408 0 3900 CHARLOTTE DOUGHERTY 0.00 X 19582 0 0 DON TATE 0.00 X 19309 0 0 BG WATERS 0.00 X 6744 0 0 7612021 4750 426720 164 true true false BRASFIELD AND GORRIE LLC PO BOX 11407 BIRMINGHAM AL 35246 GENL CONTRACTOR 7511183 CERNER CORP PO BOX 412702 KANSAS CITY MO 64141 IT SERVICES 6711712 ARAMARK MANAGEMENT SERVICES PO BOX 233 ROME GA 30161 ENVIRON SVCS 3459122 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 DIETARY SVC 2550472 IN COMPASS HEATLH INC 318 MAXWELL ROAD SUITE 500 ALPHARETTA GA 30009 HOSPITALIST 2092034 62 451500 451500 PATIENT SERVICE REVENUE 623000 310194980 310194980 FAMILY PRACTICE CAPITATION 621990 1227732 1227732 REFERENCE LAB 621500 1031685 1031685 SUBWAY/STARBUCKS 722210 559581 559581 313013978 1542823 1542823 3275610 340933 2934677 2934677 2934677 60107230 354134 59646315 293175 460915 60959 521874 521874 1249 832 417 417 CAFETERIA 624200 1398380 1398380 MISCELLANEOUS INCOME 621990 210550 210550 FAMILY PRACTICE REVENUE 621110 30907 30907 25406 25406 1665243 320130512 311689575 1591683 6397754 3271448 3271448 245092 245092 5315665 5315665 125378561 106227090 18982997 168474 5991353 5150667 832476 8210 20237939 16563837 3647701 26401 8943533 6694604 2236846 12083 364607 364607 504400 504400 81404 81404 30903893 22074745 8829148 1471200 173798 1297402 11202856 8424063 2777992 801 4019083 676792 3342291 14618054 12745481 1872573 2704647 1146293 1556229 2125 641362 422787 218575 144941 144941 22204478 19360084 2844394 1671426 926068 745358 MEDICAL SUPPLIES 43033285 42969940 63345 R&M 4364487 2185946 2178541 LICENSE & TAXES 3139517 117265 3022252 DUES & SUBSCRIPTIONS 940456 320997 619459 1570128 365370 1204758 312963815 250062367 62683354 218094 -187421 -82982 10297588 21299969 47957467 49651972 370261 617200 9641637 10156932 3415204 3516658 343998339 172182300 168246690 171816039 59298918 56491768 1453170 1491848 1224502 1132664 3946042 5583654 305664058 321675722 28900554 33108358 105916554 123849124 16551555 16080247 34833179 40409835 186201842 213447564 X 119462216 108228158 119462216 108228158 305664058 321675722 X 7166697 -18400755 X false true true X false X SCHEDULE A, PART IV - REASON FOR NON-PRIVATE FOUNDATION STATUS ON JANUARY 1, 1998 FLOYD HEALTHCARE MANAGEMENT, INC. ACQUIRED BY LEASE ALL OF THE ASSETS OF THE HOSPITAL AUTHORITY OF FLOYD COUNTY AND THEREBY BECAME THE LICENSED OPERATOR OF FLOYD MEDICAL CENTER, A GENERAL, ACUTE CARE HOSPITAL WITH 300+ BEDS. SINCE THAT TIME, FLOYD HEALTHCARE MANAGEMENT, INC. HAS CONTINUED TO OPERATE FLOYD MEDICAL CENTER AS A NON-PROFIT HOSPITAL, OFFERING A WIDE ARRAY OF SERVICES TO THE COMMUNITY, INCLUDING AN EMERGENCY ROOM WHICH SEES APPROXIMATELY 76,000 PATIENTS PER YEAR AND A BUSY OUTPATIENT INDIGENT CLINIC. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false true 50000 true 2338 false true 29066 81404 false false false false false SCHEDULE C, PART II-B, LINE 1 NATIONAL AND STATE ORGANIZATION DUES ARE PAID, A PERCENTAGE OF WHICH ARE DEVOTED TO LOBBYING EXPENDITURES. ADDITIONALLY, A DONATION WAS MADE TO "COALITION TO PROTECT AMERICA'S HEALTH CARE", AN ORGANIZATION WHOSE MISSION IS TO PROTECT HIGH QUALITY PATIENT CARE BY CREATING MEDIA STRATEGIES TO PRESERVE THE FINANCIAL VIABILITY OF AMERICA'S HOSPITALS. THE FILING ORGANIZATION ALSO PAID LOBBYING FEES TO THE RUSS REID COMPANY AND REIMBURSED DIRECTOR FOR THEIR LOBBYING TRIP TO WASHINGTON DC RELATED TO HEALTHCARE ISSUES. false false false false false false false false false false 12803932 12803932 114170801 48198176 65972625 15096900 7155120 7941780 186580191 116829004 69751187 15346515 15346515 171816039 ACCRUED PENSION 32398591 MALPRACTICE CLAIMS 6339271 ACCRUED INTEREST 1671973 40409835 320130512 312963815 7166697 -226729 2819948 2593219 9759916 319699995 -226729 341765 115036 319584959 545553 545553 320130512 309940079 341765 341765 309598314 3365501 3365501 312963815 LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X THE CORPORATION 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 CORPORATION 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 CORPORATION 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, 2012 AND 2011 OR FOR THE YEARS THEN ENDED. THE CORPORATION'S OPEN AUDIT PERIODS ARE FOR TAX YEARS ENDED 2009-2011. RECONCILIATION OF CHANGES - OTHER SCHEDULE D, PAGE 4, PART XI, LINE 8 RENTAL EXPENSES 340,933 COST OF GOODS SOLD 832 GAIN ON SALE/LEASEBACK MOB -94,053 CAPITAL CONTRIBUTIONS -451,500 RENTAL EXPENSES -340,933 COST OF GOODS SOLD -832 GAIN ON SALE/LEASEBACK MOB 94,053 EQUITY TRANSFER 3,271,448 REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER SCHEDULE D, PAGE 4, PART XII, LINE 2D RENTAL EXPENSES 340,933 COST OF GOODS SOLD 832 REVENUE AMOUNTS INCLUDED ON RETURN - OTHER SCHEDULE D, PAGE 4, PART XII, LINE 4B GAIN ON SALE/LEASEBACK MOB 94,053 CAPITAL CONTRIBUTIONS 451,500 EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHER SCHEDULE D, PAGE 4, PART XIII, LINE 2D RENTAL EXPENSES 340,933 COST OF GOODS SOLD 832 EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER SCHEDULE D, PAGE 4, PART XIII, LINE 4B GAIN ON SALE/LEASEBACK MOB 94,053 EQUITY TRANSFER 3,271,448 true true X true X 1.25000 true X 3.25000 true true true false true true 20353457 20353457 0.06500 52840624 41263910 11576714 0.03700 73194081 41263910 31930171 0.10200 9133524 5843139 3290385 0.01050 1188997 4925 1184072 0.00380 10322521 5848064 4474457 0.01430 83516602 47111974 36404628 0.11630 true 33715038 17868970 68287878 72094107 -3806229 X true true 1 1 FLOYD HEALTHCARE MANAGEMENT INC FLOYD MEDICAL CENTER

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P O BOX 233 ROME GA 30165

EMERGENCY SERVICES EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE PART I LINE 7 COLUMN F IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN F THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990 PART IX LINE 25 FORM 990 PART IX LINE 25 XXX-XX-XXXX ADD EXPENSES REPORTED IN PART VIII 341765 DENOMINATOR FOR COLUMN F XXX-XX-XXXX 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 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 THE FIGURE ON PART III LINE 3 REPRESENTS MANAGEMENTS ESTIMATE APPROXIMATELY 53 BASED ON PAST EXPERIENCE FROM INCOMPLETE FINANCIAL APPLICATIONS EXCERPT FROM AUDITED FINANCIAL STATEMENTS ALLOWANCE FOR DOUBTFUL ACCOUNTS THE CORPORATION 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 MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS COLLECTION PRACTICES EXPLANATION PART III LINE 9B FOR PATIENTS RECEIVING ONLY A PORTION OF THEIR BILL AS CHARITY THE REMAINING PORTIN OF THE BILL IS TREATED THE SAME AS ALL OTHER PATIENTS IN REGARDS TO COLLECTIONS NEEDS ASSESSMENT PART VI FLOYD HEALTHCARE MANAGEMENT INC FHMI HAS COMPLETED A HEALTH CARE NEEDS ASSESSMENT IN CHATTOOGA FLOYD AND POLK COUNTIES THIS INCLUDED A RANDOM PAPER SURVEY OF RESIDENTS OF EACH COUNTY AS WELL AS INTERVIEWS WITH COMMUNITY LEADERS AND HEALTH CARE PROFESSIONALS AND FOCUS GROUPS IN ADDITION FHMI DEVELOPES A STRATEGIC PLAN THAT IS UPDATED ANNUALLY THE STRATEGIC PLAN TAKES INTO CONSIDERATION HEALTH NEEDS FOR OUR SERVICE AREA IN ADDITION TO UTILIZATION OF SERVICES COMMUNITY PARTICIPATION AND QUALITY OF SERVICES PROVIDED PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI FHMI COMMUNICATES THIS INFORMATION THROUGH SIGNAGE IN THE EMERGENCY CARE CENTER PATIENT REGISTRATION AREAS IN THE BUSINESSPATIENT FINANCIAL SERVICES OFFICES AND IN THE OFFICES OF OUR FINANCIAL COUNSELORS DURING TIMES OF PREADMISSION AS WELL AS ONSITE REGISTRATION THE ACCESSREGISTRATION STAFF DISCUSS POLICIES WITH THE PATIENTPATIENTS FAMILY IF APPROPRIATE AFTER DISCHARGE AND DURING THE COLLECTION PERIOD OUR STAFF ONCE AGAIN DISCUSS OUR FINANCIAL ASSISTANCE POLICIES IN ADDITION THERE IS A DEMONSTRATED WORDOFMOUTH COMMUNICATION OF THESE POLICIES THROUGH OUR PATIENT POPULATION COMMUNITY INFORMATION PART VI LOCATED IN NORTHWEST GA FHMI DBA FLOYD MEDICAL CENTER FMC IS BASED IN ROME GA WHICH IS THE COUNTY SEAT FOR FLOYD COUNTY ABOUT 60 MILES NORTH OF ATLANTA AND 60 MILES SOUTH OF CHATTANOOGA TN THE 163000 2011 ESTIMATE RESIDENTS OF THE THREECOUNTY REGION ARE SERVED BY FMC AND TWO SMALLER HOSPITALS THE POPULATION BASE IS APPROXIMATELY 81 CAUCASIAN 15 AFRICAN AMERICAN AND 4 OTHER ETHNICITIES NORTHWEST GA IS A MEDICAL AND EDUCATIONAL HUB THREE OF THE LARGEST EMPLOYERS IN THE THREECOUNTY AREA ARE HEALTH CARE PROVIDERS THE AREA IS ALSO HOME TO FOUR POSTSECONDARY EDUCATIONAL INSTITUTIONS STILL THE MANUFACTURING SECTOR REMAINS AN ECONOMIC FORCE IN THE AREA AS IN OTHER PARTS OF THE COUNTRY THE UNEMPLOYMENT RATE REMAINED IN DOUBLE DIGITS IN 2011 AND ALMOST 19 OF RESIDENTS ARE BELOW THE FEDERAL POVERTY LEVEL JUST UNDER ONETHIRD OF THE ADULT POPULATION HAS NOT GRADUATED HIGH SCHOOL MALIGNANT CANCER PRIMARILY LUNG CANCER AND CARDIOVASCULAR DISEASE ARE THE PRIMARY CAUSES OF DEATH IN THESE COUNTIES HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI FHMI IS THE SAFETYNET HEALTH CARE PROVIDER FOR NORTHWEST GEORGIA IN ADDITION TO PROVIDING EMERGENCY CARE SERVICES FMC HAS GONE THE EXTRA STEP OF PROVIDING 24HOUR COVERAGE FOR SURGERY AND OTHER SERVICES TO MAINTAIN STATUS AS A LEVEL II TRAUMA CENTER FHMI IS ALSO THE SITE FOR THE REGIONAL POISON CONTROL CENTER HOUSES THE REGIONS ONLY LEVEL III NEONATAL INTENSIVE CARE UNIT AND OPERATES A FAMILY MEDICINE RESIDENCY PROGRAM THAT OPERATES THE FLOYD COUNTY CLINIC TO PROVIDE BASIC HEALTH CARE SERVICES FOR THE ECONOMICALLY DISADVANTAGED IN THE COMMUNITY IN ADDITION TO THESE SERVICES FHMI ACTIVELY PROMOTES HEALTH AND SAFETY THROUGHOUT THE COMMUNITY THROUGH VARIOUS COMMUNITY BENEFIT ACTIVITIES INCLUDING BUT NOT LIMITED TO BICYCLE SAFETY HELMET GIVEAWAYS AND CLINICS SCHOOLBASED CHILD SAFETY PROGRAMS MOBILE MAMMOGRAPHY AND ACTIVE SPEAKERS BUREAU CHILDBIRTH CLASSES COMMUNITY HEALTH SCREENINGS AND HEALTH FAIRS AN ANNUAL CAMP FOR CHILDREN WITH DIABETES HEALTH CARE INTERNSHIPS EXTERNSHIPS AND SHADOWING OPPORTUNITIES AND SUPPORT FOR COMMUNITYWIDE INITIATIVES WITH HEALTH PARTNERS INCLUDING THE NORTHWEST GEORGIA CANCER COALITION CANCER NAVIGATORS AND THE FREE CLINIC OF ROME LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED PART VI GEORGIA FLOYD HEALTHCARE MANAGEMENT INC LINE NUMBER 1 PART V LINE 3 PART V LINE 3 THE INTERESTS OF THE COMMUNITIES WERE ENLISTED THROUGH A SURVEY PROCESS COMMUNITY FORUMS AND DIRECT INPUT FROM REPRESENTATIVES OF THE GEORGIA DEPARTMENT OF PUBLIC HEALTH THE SURVEY PROCESS WAS COMPLETED ON A CONVENIENCE BASIS AT PUBLIC EVENTS USING AN INSTRUMENT DESIGNED TO CAPTURE THE PUBLICS PERCEPTION OF HEALTH AND HEALTHCARE SERVICES IN THE COMMUNITY THE SURVEY INSTRUMENT AND RESULTS ARE INCLUDED IN THE CHNA THE INTERESTS OF THE COMMUNITY ARE ALSO REPRESENTED IN THE CHNA THROUGH PRIMARY DATA COLLECTED AT PUBLIC INPUT SESSIONS HELD IN EACH COUNTY CARE WAS TAKEN TO INVITE A CROSSSECTION OF THE COMMUNITY WITH REPRESENTATIVES FROM BUSINESS HEALTHCARE NONPROFITS PUBLIC HEALTH LOCAL GOVERNMENT AND EDUCATIONAL INSTITUTIONS DISTRICT PUBLIC HEALTH REPRESENTATIVES WERE ASKED TO REVIEW RAW DATA AND PROVIDE ASSISTANCE DEVELOPING PRIORITY NEEDS FLOYD HEALTHCARE MANAGEMENT INC LINE NUMBER 1 PART V LINE 5C PART V LINE 5C THE 2011 CHNA HAS BEEN DISTRIBUTED UPON REQUEST TO OTHER NONPROFIT AGENCIES IN THE AREA TO ASSIST WITH GRANTS COPIES HAVE ALSO BEEN MADE AVAILABLE TO ELECTED OFFICIALS CHAMBERS OF COMMERCE AND EDUCATIONAL INSTITUTIONS IN THE AREA FLOYD HEALTHCARE MANAGEMENT INC LINE NUMBER 1 PART V LINE 19D PART V LINE 19D FLOYD USES A SLIDING SCALE BASED ON FEDERAL POVERTY GUIDELINES true HOSPITAL AUTHORITY OF FLOYD COUNTY 304 TURNER MCCALL BLVD ROME GA 301610233 586001173 501 1453571 CAPITAL CONTRIBUTION HOSPITAL AUTHORITY OF FLOYD COUNTY 304 TURNER MCCALL BLVD ROME GA 301610233 586001173 501 1817877 PENSION PLAN FUNDING 2 COBRA INSURANCE PREMIUM 42 167872 TUITION 32 77220 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES SCHEDULE I, PAGE 1, PART I, LINE 2 IT IS THE POLICY OF THE ORGANIZATION TO ESTABLISH PROCEDURES TO POTENTIALLY SECURE PAYMENT FOR HEALTHCARE SERVICES VIA EXTENSION OF INSURANCE BENEFITS THROUGH COBRA. THIS EXTENSION OF INSURANCE COVERAGE WILL BE PROVIDED ON A CASE-BY-CASE BASIS. THE HOSPITAL'S ROLE IN COVERAGE PAYMENT WILL BE REVIEWED MONTHLY; THERE IS NO OBLIGATION FOR THE HOSPITAL TO CONTINUE COVERAGE PAYMENT BEYOND THE INITIAL STATED LENGTH. THIS COVERAGE PAYMENT IS NOT TYPICALLY INTENDED FOR LONGER THAN A SPECIFIC SERVICE EVENT. IN GENERAL, ASSIGNED STAFF WILL EXAMINE PATIENTS FOR POTENTIAL QUALIFICATION FOR THIS PROGRAM. UPON QUALIFICATION, PAYMENT OF THE INSURANCE PREMIUM IS MADE TO THE EMPLOYER/INSURANCE COMPANY. PATIENT LIABILITY WILL BE EVALUATED AND DISCUSSED WITH THE PATIENT/GUARANTOR PRIOR TO DISCHARGE. THIS DISCUSSION WILL FOLLOW THE SAME PROTOCOL AS OTHER PATIENTS WITH RESIDUAL LIABILITIES. FINALLY, A 1099 TAX FORM IS ISSUED TO THE PATIENT. TUITION POLICY: THE ORGANIZATION PROVIDES OPPORTUNITIES FOR TRAINING, DEVELOPMENT, AND ADVANCEMENT WHICH ARE CONSISTENT WITH INDIVIDUAL ABILITY AND PERFORMANCE AS WELL AS BUDGETARY LIMITATIONS AND NEEDS OF THE ORGANIZATION. FHMI WILL SHARE IN THE COST OF TUITION AND BOOKS FOR CLASSROOM AND/OR CORRESPONDENCE COURSES FOR ELIGIBLE EMPLOYEES. THE EDUCATION MUST BE DIRECTLY RELATED TO THE EMPLOYEE'S DUTIES OR A POSITION TO WHICH THE EMPLOYEE MIGHT REASONABLY BE EXPECTED TO PROGRESS BY REASON OF PROMOTION. APPROVAL FROM THE EMPLOYEE'S DEPARTMENT HEAD, HUMAN RESOURCES DIRECTOR, AND APPLICABLE VICE PRESIDENT MUST BE GRANTED PRIOR TO ENROLLMENT, AND A GRADE OF B OR HIGHER MUST BE MAINTAINED. ALL EDUCATIONAL ASSISTANCE WILL BE SET UP AS A "FORGIVABLE LOAN" CONTRACT BETWEEN THE EMPLOYEE AND FHMI. THE LOAN WILL BE REPAID BY SERVICE. REIMBURSEMENT IS MADE SUBJECT TO RECEIPTS AND PROOF OF AWARDED GRADES. 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THE POLICY RECOGNIZES THAT GOVERNING BOARD MEMBERS AND SENIOR EXECUTIVES ARE OFTEN PLACED IN SOCIAL SITUATIONS AT SUCH MEETINGS AND WOULD REPRESENT THE HOSPITAL OPTIMALLY WITH THE ASSISTANCE OF THEIR SPOUSES. CONSEQUENTLY, THESE BENEFITS ARE NOT INCLUDED IN THEIR TAXABLE WAGES. SPOUSAL TRAVEL EXPENSES REQUIRE PRIOR APPROVAL AND ARE LIMITED TO EVENTS WHERE BOARD MEMBERS AND SENIOR EXECUTIVES ATTEND. REIMBURSEMENT SHALL BE LIMITED TO TRANSPORTATION EXPENSE NOT TO EXCEED THE AIR TRAVEL RATE IN COACH CLASS AND OUT-OF-POCKET EXPENSES WITH RESPECT TO LODGING AND FOOD. REIMBURSEMENT SHALL BE LIMITED TO LODGING BASED ON DOUBLE ACCOMMODATIONS. FLOYD HEALTHCARE MANAGEMENT, INC. ("FHMI") PROVIDES THE CEO WITH A MONTHLY AUTO ALLOWANCE. EACH YEAR THE AMOUNT THAT IS NONBUSINESS RELATED IS INCLUDED IN TAXABLE INCOME. FHMI PROVIDES A MEMBERSHIP TO THE LOCAL COUNTRY CLUB FOR THE CEO AND CMO. ANY AMOUNT CONSIDERED NONBUSINESS IS INCLUDED IN THE RECIPIENT'S TAXABLE INCOME. SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 KURT STUENKEL 0 351,447 0 COMPENSATION CONTINGENT UPON NET EARNINGS OF ORGANIZATION SCHEDULE J, PAGE 1, PART I, LINE 6A ALL MEMBERS OF THE EXECUTIVE TEAM FOR FHMI PARTICIPATE IN AN INCENTIVE COMPENSATION PLAN UNDER WHICH ANNUAL YEAR-END BONUSES ARE PAID BASED ON INDIVIDUAL AND CORPORATE-WIDE ACHIEVEMENT OF SPECIFIC GOALS AND OBJECTIVES. ONE OF THE GOALS RELATES TO THE ORGANIZATION'S NET INCOME. THESE BONUSES ARE A CASH-BASED SYSTEM. OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III THE CEO PARTICIPATES IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WHICH IS FUNDED ANNUALLY IN AN AMOUNT WHICH, WHEN ADDED TO OTHER SOURCES OF RETIREMENT INCOME, WILL AFFORD A RETIREMENT INCOME AT A TARGETED PERCENTAGE OF PRE-RETIREMENT COMPENSATION. THE SERP IS A NON-QUALIFIED RETIREMENT PLAN, AND AS SUCH THE ANNUAL FUNDING PAYMENTS PAID INTO IT ARE TAXABLE TO THE PARTICIPANT IN THE YEAR IN WHICH MADE. EFFECTIVE WITH CALENDAR YEAR 2009, MR. STUENKEL'S SERP IS A CASH-BASED PROGRAM. ADDITIONALLY, OF THE 1,086,769 LISTED AS COMPENSATION FOR MR. STUENKEL, 187,371 REPRESENTS A PERFORMANCE BASED PAYMENT ARISING FROM THE 2011 PERFORMANCE PERIOD AND 351,447 REPRESENTS THE NONQUALIFIED SERP PLAN. ACORDINGLY, MR. STUENKEL'S SALARY FOR 2011 WOULD HAVE BEEN 547,951 EXCLUDING THE 2011 PORTION OF THE INCENTIVE BASED PAYMENT AND THE SERP PLAN AMOUNT. TOTAL DIRECT CASH COMPENSATION (SALARY AND BONUS) IS 726,452 WHICH DOES NOT INCLUDE A PAYMENT FOR RETIREMENT OF 351,447, NOR OTHER FRINGE BENEFITS WHICH TOTAL 43,096. HOSPITAL AUTHORITY OF FLOYD COUNTY REVENUE CERTIFICATES 2003 586001973 343575ER3 2003-12-17 40000000 HOSPITAL IMPROVEMENTS false false false HOSPITAL AUTHORITY OF FLOYD COUNTY 2009 REVENUE ANTICIPATION BONDS 586001973 343575FQ4 2009-06-30 40000000 IMPROVEMENTS/DEFEASE 2005-2006 BONDS false false false HOSPITAL AUTHORITY OF FLOYD COUNTY REVENUE BOND SERIES 2012 A 586001173 343575GH3 2012-06-27 20000000 CAPITAL IMPROVEMENTS false false false HOSPITAL AUTHORITY OF FLOYD COUNTY REVENUE BONDS SERIES 2012B 586001173 343575GY6 2012-06-27 31885000 DEFEASE 2003 REVENUE SERIES BONDS false false false 11182808 40710583 1572553 25989711 576451 12571868 2004 false false true true 40240151 1332751 18595720 588380 1552974 18170340 2010 false false true true 20074922 279011 243560 19552351 false false true true 34970725 444814 36387986 388296 1777 false false false false false false false false false true true false false false false false true true false false false false false false true false false false false false false false false false false false false false false false false false false false false false false false false false false false false false false false DIFFERENCES IN ISSUE PRICE EXPLANATION SCHEDULE K HOSPITAL AUTHORITY OF FLOYD COUNTY THE DIFFERENCE IN THE ISSUE PRICE REPORTED IN SCHEDULE K PART I AND TOTAL PROCEEDS OF ISSUE REPORTED IN SCHEDULE K PART II IS A PREMIUM ASSOCIATED WITH THE 2003 ISSUE HOSPITAL AUTHORITY OF FLOYD COUNTY THE DIFFERENCE IN THE ISSUE PRICE REPORTED IN SCHEDULE K PART I AND TOTAL PROCEEDS OF ISSUE REPORTED IN SCHEDULE K PART II IS A PREMIUM ASSOCIATED WITH THE 2009 ISSUE HOSPITAL AUTHORITY OF FLOYD COUNTY EXPENDITURES INCLUDE 2252148 IN FUNDS FROM THE SERIES 2002 DEBT SERVICE RESERVE FUNDS SHEILA B HORNER VP OF NURSING 2714 TUITION PAYMENT JOSHUA POLLEY FAMILY-OFFICER 43242 EMPLOYEE WAGES false ROXANNE NORMAN FAMILY-BD MBR 41625 EMPLOYEE WAGES false MISTY RIGAS FAMILY-OFFICER 25038 EMPLOYEE WAGES false JOY HOWARD FAMILY-BD MBR 14022 EMPLOYEE WAGES false ELIZABETH BROOKS FAMILY-BD MBR 20311 EMPLOYEE WAGES false JOAN BIUSO FAMILY-OFFICER 22840 EMPLOYEE WAGES false ADDITIONAL INFORMATION SCHEDULE L PART V VARIOUS FAMILY MEMBERS OF BOARD OFFICERS AND BOARD MEMBERS ARE ACTIVELY EMPLOYED AND COMPENSATED BY FHMI ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE ORGANIZATION'S CEO, CFO, CONTROLLER, LEGAL COUNSEL AND EMPLOYEES OF FHMI REVIEW THE FORM 990 FOR FINANCIAL AND DISCLOSURE ACCURACY. PRIOR TO ITS FILING, A COPY OF THE ORGANIZATION'S 990 RETURN IS POSTED ON THE BOARD OF DIRECTOR'S SECURE WEBSITE FOR THEIR REVIEW. MANAGEMENT WILL SEND AN EMAIL NOTIFYING MEMBERS OF ITS POSTING. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C FLOYD HEALTHCARE MANAGEMENT, INC. ("FHMI") HAS A WRITTEN POLICY RESPECTING CONFLICTS OF INTEREST AND DISCLOSURE OF SAME. GENERALLY SPEAKING, THE POLICY REQUIRES ANY "COVERED PERSON" WHO BELIEVES HE HAS A CONFLICT OF INTEREST TO: -DISCLOSE THE EXISTENCE AND NATURE OF THE CONFLICT OF INTEREST (INCLUDING ALL FACTS KNOWN RESPECTING THE SUBJECT MATTER) TO THE CHAIRMAN OF THE BOARD; -PLAY NO PART, DIRECTLY OR INDIRECTLY, IN THE DELIBERATION OR VOTE OF THE BOARD OF DIRECTORS WITH RESPECT TO THE DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS; AND -ABSENT HIMSELF FROM THAT PORTION OF THE MEETING AT WHICH THE CONFLICT OF INTEREST IS DISCUSSED. THE DEFINITION OF A "COVERED PERSON" INCLUDES ALL BOARD MEMBERS, OFFICERS AND MEMBERS OF SENIOR MANAGEMENT OF FHMI. WHEN A COVERED PERSON DISCLOSES A POTENTIAL CONFLICT OF INTEREST TO THE BOARD CHAIRMAN, THE CHAIRMAN IS OBLIGED TO BRING THE MATTER TO THE ATTENTION OF THE FULL BOARD. THE BOARD DETERMINES WHETHER A CONFLICT OF INTEREST ACTUALLY EXISTS. IF THE BOARD DETERMINES THAT THERE IS A CONFLICT OF INTEREST, THE TRANSACTION OR MATTER GIVING RISE TO THE CONFLICT OF INTEREST MAY NOT PROCEED UNLESS THE BOARD DETERMINES, BY A MAJORITY VOTE, THAT, DESPITE THE CONFLICT OF INTEREST, THE TRANSACTION/MATTER IS NEVERTHELESS IN THE CORPORATION'S BEST INTEREST AND IS FAIR AND REASONABLE TO THE CORPORATION. IN ADDITION TO THE REQUIREMENT THAT A COVERED PERSON DISCLOSE A POTENTIAL CONFLICT OF INTEREST AT THE TIME IT ARISES, EACH COVERED PERSON IS ALSO REQUIRED TO SUBMIT, ON AN ANNUAL BASIS, A `CONFLICT AND DISCLOSURE OF INTEREST QUESTIONNAIRE'. THIS MULTI-QUESTION DOCUMENT SERVES AS A REMINDER AND PROMPTS EACH COVERED PERSON TO PONDER THOSE AREAS AND SITUATIONS WHERE A POTENTIAL CONFLICT MIGHT EXIST. ADDITIONALLY, ANY PROPOSED TRANSACTION AT FHMI WHICH INVOLVES AN "INSIDER" (I.E., A BOARD MEMBER, OFFICER, MANAGER, ETC.) IS SCRUTINIZED, WITH THE ASSISTANCE OF CORPORATE LEGAL COUNSEL, FROM THE STANDPOINT OF WHETHER THE TRANSACTION WILL RESULT IN ANY EXCESS BENEFIT TO THE INSIDER. TYPICALLY THIS INVOLVES OBTAINING APPROPRIATE DATA REGARDING COMPARABILITY WHICH IS PROVIDED TO THE BOARD FOR ITS USE IN DETERMINING THAT THE CONSIDERATION BEING PAID TO THE INSIDER AS A PART OF THE TRANSACTION IS REASONABLE AND DOES NOT EXCEED THE VALUE OF THE BENEFIT RECEIVED BY FHMI. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A IT IS THE RESPONSIBILITY OF THE COMPENSATION COMMITTEE OF FLOYD HEALTHCARE MANAGEMENT, INC. BOARD TO ACTIVELY MANAGE AND MONITOR EXECUTIVE COMPENSATION. TO DO SO, THE COMMITTEE HAS ESTABLISHED THE FOLLOWING OBJECTIVES FOR THE EXECUTIVE COMPENSATION PROGRAM: -PROVIDE A COMPETITIVE TOTAL COMPENSATION EARNING OPPORTUNITY TO RECRUIT, RETAIN, AND REWARD THE EXECUTIVES NEEDED TO MEET THE COMMUNITY'S HEALTHCARE NEEDS, NOW AND IN THE FUTURE; -PROVIDE PAY OPPORTUNITIES THAT WILL REWARD THE EXECUTIVE TEAM WHEN ORGANIZATIONAL PERFORMANCE IN KEY AREAS IS DEMONSTRATED; -INCENTIVE COMPENSATION UNDER THE EXECUTIVE INCENTIVE COMPENSATION PLAN IS PAYABLE ONLY IN THE EVENT THE ORGANIZATION'S OPERATING MARGIN FROM OPERATING REVENUE EXCEEDS CERTAIN PARAMETERS ESTABLISHED BY THE COMPENSATION COMMITTEE; -ENSURE THAT THE COMPENSATION PROGRAMS ARE EASY FOR ALL INTERESTED PARTIES TO UNDERSTAND. ANNUALLY, THE COMMITTEE REVIEWS THE APPROPRIATENESS OF THE TOTAL COMPENSATION PROVIDED TO EACH EXECUTIVE: -AS RELATED TO THE COMPETITIVE MARKET PAY RATES; -AS RELATED TO THE INDIVIDUAL'S ROLE AND RESPONSIBILITY IN THE ORGANIZATION; -AS IT PERTAINS TO VARIABLE OR INCENTIVE EARNING OPPORTUNITIES RELATING TO THE PERFORMANCE OF THE ORGANIZATION. TO DETERMINE THE MARKET RATES FOR EACH POSITION, THE COMMITTEE UTILIZES AN OUTSIDE CONSULTANT TO SURVEY COMPARABLE ORGANIZATIONS TO DEVELOP AN APPROPRIATE RANGE OF PAY FOR EACH EXECUTIVE POSITION. THIS RANGE GENERALLY REFLECTS THE PAY PRACTICES AND LEVELS OF COMPARABLE ORGANIZATIONS IN GEORGIA, THE SOUTHEAST, AND ACROSS THE COUNTRY. SPECIFICALLY, THE COMMITTEE REVIEWS DATA FOR MARKET RATES OF BASE SALARY AND TOTAL COMPENSATION (THE COMBINATION OF BASE SALARY AND BONUSES). AFTER REVIEWING THIS DATA, THE COMMITTEE ASSESSES THE APPROPRIATENESS OF THE BASE PAY LEVELS FOR EACH EXECUTIVE WITHIN A RANGE THAT GENERALLY REFLECTS INDUSTRY NORMS. IN ADDITION TO MONITORING BASE SALARIES, THE COMMITTEE IS RESPONSIBLE FOR ADMINISTERING THE EXECUTIVE INCENTIVE COMPENSATION PROGRAM. THE PROGRAM IS DESIGNED TO: -FURTHER ALIGN EXECUTIVE PAY WITH THE STRATEGIC AND OPERATIONAL ACHIEVEMENTS OF THE ORGANIZATION; -WHEN THE ORGANIZATION ACHIEVES RESULTS IN KEY AREAS OF PERFORMANCE, TO APPROPRIATELY REWARD EXECUTIVES ACCORDING TO THAT PROGRAM; THE COMMITTEE HAS ALSO ESTABLISHED SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAMS (SERPS). THESE SERPS WERE DESIGNED WITH THE ADVICE AND HELP OF CONSULTANTS AND ARE DESIGNED TO RETAIN AND REWARD EXECUTIVES WITH RETIREMENT OPPORTUNITIES THAT ARE CONSISTENT WITH MARKET PRACTICES IN GEORGIA, THE SOUTHEAST, AND ACROSS THE COUNTRY. IN 2001, THESE PLANS VESTED TWO EXECUTIVES. IT IS THE PHILOSOPHY OF THE FHMI BOARD THAT THE COMBINATION OF THE INCENTIVE EARNING OPPORTUNITY, THE BASE SALARY, AND THE SERPS WILL PROVIDE A COMPETITIVE COMPENSATION LEVEL TO EACH EXECUTIVE THAT REFLECTS THE MARKET FOR EACH POSITION AND ORGANIZATION PERFORMANCE. THE COMMITTEE HAS DEVELOPED THE PROGRAM TO RECRUIT, RETAIN, AND REWARD EXECUTIVES IN ORDER TO MEET THE PRESENT AND FUTURE NEEDS OF THE ORGANIZATION TO PROVIDE A HIGH QUALITY OF PATIENT CARE TO THE COMMUNITY IN A COST EFFECTIVE MANNER. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B SEE NARRATIVE UNDER PART VI, LINE 15A. 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 THE PUBLIC WHEN THE REQUEST IS MADE AT THE ADMINISTRATIVE OFFICE OF THE FILING CORPORATION. RELATED ORGANIZATIONS FORM 990, PAGE 7, PART VII AVERAGE HOURS DEVOTED TO RELATED ORGANIZATIONS BILL WIGLEY 1 HOUR CARL HERRING 1 HOUR GARRY FRICKS 1 HOUR GEORGE BOSWORTH, MD 1 HOUR JERRY NORMAN 2 HOURS JOHN MAYES 2 HOURS MARK MANIS 2 HOURS ROGER SUMNER 2 HOURS SAM FREEMAN 2 HOURS TIM MAHANAY 2 HOURS WESLEY JOHNSON 1 HOUR LARRY KUGLAR 1 HOUR FRANK SHELLEY 1 HOUR KURT STUENKEL 4 HOURS RICHARD T. SHEERIN 4 HOURS FORM 990, PART VII SECTION A - COMPENSATION FROM RELATED ORGANIZATIONS MEMBERS OF THE BOARD OF DIRECTORS FOR FLOYD HEALTHCARE RESOURCES, INC., AND FOR THE HOSPITAL AUTHORITY OF FLOYD COUNTY, RELATED PARTIES OF FLOYD HEALTHCARE MANAGEMENT, INC., RECEIVE A STIPEND FOR EACH BOARD MEETING ATTENDED. FOR THE 2011 TAXABLE YEAR, DIRECTORS SUMNER AND MANIS ALSO SERVED ON THE BOARD OF FLOYD HEALTHCARE RESOURCES, INC. WHILE DIRECTORS NORMAN, MAYES, AND MAHANAY SERVED ON THE BOARD OF THE HOSPITAL AUTHORITY OF FLOYD COUNTY. FORM 990, PART VII SECTION A - COMPENSATION DR. CARL HERRING BOARD MEMBER CARL HERRING, MD IS A PRACTICING NEUROSURGEON WHO HAS CLINICAL PRIVILEGES AT FLOYD MEDICAL CENTER (FMC). AS SUCH, HE IS A PARTY TO A CONTRACT UNDER WHICH FMC PAYS THE NEUROSURGEONS ON ITS MEDICAL STAFF A PER DIEM FOR COVERING TRAUMA CALL IN THE EMERGENCY ROOM. UNDER THIS CONTRACT, THE NEUROSURGEON COVERING CALL FOR THE DAY DURING CALENDAR YEAR 2011 WAS PAID A PER DIEM OF 2,000. FMC HAS DETERMINED WITH THE ASSISTANCE OF OUTSIDE EXPERT VALUATION CONSULTANTS THAT THIS AMOUNT IS CONSISTENT WITH FAIR MARKET VALUE. ADDITIONALLY, DR. HERRING IS AN EMPLOYEE AND SHAREHOLDER IN THE HARBIN CLINIC, LLC, A 140+ DOCTOR MULTI-SPECIALTY GROUP MEDICAL PRACTICE. FMC HAS NUMEROUS CONTRACTS WITH HARBIN CLINIC UNDER WHICH HARBIN SUPPLIES ITS PHYSICIANS TO SERVE AS MEDICAL DIRECTORS OF VARIOUS DEPARTMENTS AND SERVICE LINES AT FMC, INCLUDING RESPIRATORY THERAPY, BARIATRICS, NEUROLOGY, VASCULAR LAB, HOSPICE, BREAST CENTER, INPATIENT REHAB, INFECTIOUS DISEASE, ETC. UNDER THESE CONTRACTS HARBIN CLINIC IS PAID FAIR MARKET COMPENSATION BASED ON AN HOURLY RATE FOR THE ACTUAL TIME EXPENDED BY ITS PHYSICIANS IN THE PERFORMANCE OF THE DUTIES CALLED FOR IN THESE CONTRACTS. OTHER COMMENTS & DISCLOSURES: FLOYD MEDICAL CENTER IS A 300+ BED GENERAL, ACUTE-CARE HEALTH INSTITUTION, OFFERING A WIDE RANGE OF SPECIALIZED SERVICES AND PROGRAMS. SUCH SERVICES AND PROGRAMS INCLUDE: ACUTE, MEDICAL/SURGICAL CARE; AMBULANCE SERVICE; BLOOD BANK; CANCER CARE UNIT; CARDIOVASCULAR LABORATORY; CORONARY CARE UNIT; CHAPLAIN SERVICE; CHEMICAL DEPENDENCY UNIT; CRISIS INTERVENTION; CT SCANNER; DIABETES CARE UNIT; LITHOTRIPSY, MEDICAL/SURGICAL INTENSIVE CARE; MAGNETIC RESONANCE IMAGING; NEUROLOGY; LEVEL III NEWBORN NURSERY/NEONATAL INTENSIVE CARE UNIT; OB/GYN; ORTHOPEDIC SURGERY, OUTPATIENT SURGERY CENTER; PATIENT REPRESENTATIVES; PEDIATRIC CARE; PHARMACY; DIAGNOSTIC RADIOLOGY; A 24-HOUR EMERGENCY SERVICE; ENDOSCOPIC LABORATORY; FAMILY PRACTICE RESIDENCY PROGRAM; PRIMARY CARE PHYSICIAN NETWORK; HEALTH EDUCATION AND PROMOTION; HOSPITAL AUXILIARY; INDUSTRIAL MEDICINE PROGRAM; INPATIENT REHABILITATION UNIT; LAPAROSCOPIC CHOLECYSTECTOMY SURGERY; LASER SURGERY; PHYSICAL THERAPY; OCCUPATIONAL THERAPY; SPEECH THERAPY; POISON CONTROL CENTER; POST-OPERATIVE RECOVERY ROOM; PROGRESSIVE INTENSIVE CARE UNIT; RESPIRATORY CARE SERVICES; SOCIAL WORK SERVICES; ULTRASOUND; CONGESTIVE HEART FAILURE CLINIC; WOUND OSTOMY CLINIC; BREAST CENTER, MOBILE MAMMOGRAPHY. DURING FISCAL YEAR 2012, PATIENT DAYS AT FLOYD MEDICAL CENTER TOTALED 73,189 AND DISCHARGES TOTALED 13,878. FLOYD MEDICAL CENTER PROVIDED APPROXIMATELY 68,204,000 IN DIRECT CHARITY AND INDIGENT CARE, AND IT INCURRED UNREIMBURSED MEDICARE AND MEDICAID ADJUSTMENTS OF 256,414,000 AND 134,850,000 RESPECTIVELY. A COPY OF THE REPORT TO THE COMMUNITY FOR FLOYD MEDICAL CENTER CAN BE FOUND AT WWW.FLOYD.ORG/ABOUT/INDEX.HTM. OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 5 INCREASES IN NET ASSETS AMORTIZATION OF ACTUARIAL LOSS 1,297,067 AMORTIZATION OF PRIOR SERVICE CREDIT 29,062 DECREASES IN NET ASSETS CURRENT YEAR ACTUARIAL LOSS 19,500,155 UNREALIZED LOSS ON INVESTMENTS 226,729 TOTAL CHANGES IN NET ASSETS 18,400,755 FLOYD EMERGENCY PHYSICIANS LLC 304 TURNER MCCALL BLVD ROME GA 30161 050608795 ER SVC GA 5730078 2485514 FHMI FLOYD PHYSICIANS LLC 304 TURNER MCCALL BLVD ROME GA 30161 205415285 SPEC PHYS GA 2232032 885337 FHMI HOSPITAL AUTHORITY OF FLOYD COUNTY 304 TURNER MCCALL BLVD ROME GA 301610233 586001173 HEALTHCARE GA 501C3 3 NA false FLOYD HEALTHCARE RESOURCES INC 304 TURNER MCCALL BLVD ROME GA 301610233 582010524 HEALTHCARE GA 501C3 9 NA false HOSPITAL AUTHORITY OF FLOYD COUNTY SELF INSURANCE TRUST 304 TURNER MCCALL BLVD ROME GA 301610233 586140617 TRUST GA 501C3 11D FHMI false NORTHWEST GA COMMUNITY CARE NETWORK 402 EAST 2ND AVENUE ROME GA 30161 582076826 MNGD CARE GA N/A FLOYD HEALTH VENTURES INC 304 TURNER MCCALL BLVD ROME GA 30162 581925982 MED SVCS GA N/A false false false false false false false false false false false false true true false true false false FLOYD EMERGENCY PHYSICIANS N 4901578 GENERAL LEDGER FLOYD EMERGENCY PHYSICIANS P 4800872 GENERAL LEDGER FLOYD PHYSICIANS LLC N 1711010 GENERAL LEDGER FLOYD PHYSICIANS LLC P 2050000 GENERAL LEDGER ADDITIONAL INFORMATION SCHEDULE R PART I DISREGARDED ENTITIES IN SEPTEMBER 2004 FLOYD HEALTHCARE MANAGEMENT INC FHMI SPONSORED THE CREATION OF FLOYD EMERGENCY PHYSICIANS LLP FEP A GEORGIA LIMITED LIABILITY COMPANY FHMI IS THE SOLE MEMBEROWNER OF FEP AND HAS THE SOLE AUTHORITY TO APPOINT FEPS FIVEPERSON BOARD OF DIRECTORS FEP WAS FORMED FOR THE PURPOSE OF HIRING OR OTHERWISE ENGAGING EMERGENCY PHYSICIANS TO PROVIDE PROFESSIONAL MEDICAL SERVICES TO PATIENTS PRESENTING TO FLOYD MEDICAL CENTERS EMERGENCY CARE CENTER IN AUGUST 2006 FHMI SPONSORED THE CREATION OF FLOYD PHYSICIANS LLC FP A GEORGIA LIMITED LIABILITY COMPANY FHMI IS THE SOLE MEMBEROWNER OF FP AND HAS THE SOLE AUTHORITY TO APPOINT FPS FIVEPERSON BOARD OF DIRECTORS FP WAS FORMED FOR THE PURPOSE OF HIRING OR OTHERWISE ENGAGING PHYSICIANS TO PROVIDE PROFESSIONAL MEDICAL SERVICES TO PATIENTS PART IV TAXABLE SUBSIDIARIES IN DECEMBER OF 1990 THE HOSPITAL AUTHORITY OF FLOYD COUNTY GEORGIA AUTHORITY SPONSORED THE CREATION OF FLOYD HEALTH VENTURES I INC VENTURES A GEORGIA NONPROFIT TAXABLE CORPORATION VENTURES I HAS A FOURPERSON BOARD OF DIRECTORS THE MEMBERS OF WHICH ARE APPOINTED BY THE AUTHORITY BECAUSE VENTURES I IS A NONPROFIT NONSTOCK CORPORATION THE AUTHORITY DOES NOT HAVE AN OWNERSHIP INTEREST VENTURES HAS BEEN INACTIVE FOR A NUMBER OF YEARS NORTHWEST GEORGIA COMMUNITY CARE NETWORK INC DBA GEORGIA HEALTH PLUS INC CEASED OPERATION IN SEPTEMBER 2002 THE FINAL DISTRIBUTION HAS NOT BEEN MADE AT THIS TIME THERE WERE NO TRANSFERS BETWEEN FHMI AND TAXABLE SUBSIDIARIES