2013-05-15T15:59:44-05:00 2012-09-30 271532035 BARMORE HAMMOND LLP 132 RAILROAD STREET THIRD FLOOR THOMSON GA 30824 990 2011-10-01 586002701 MCDUFFIE COUNTY HOSPITAL AUTHORITY MCDU 7065951411 521 WEST HILL STREET THOMSON GA 30824 JOHN SEAY 7065951411 2013-05-15 1 BENJAMIN B BARMORE P01048656 7065957764 2013-05-15 2011 2016-02-24 21:20:13Z MCDUFFIE REGIONAL MEDICAL CENTER JOHN SEAY 521 WEST HILL STREET THOMSON GA 30824 14796343 0 X WWW.MRMC.ORG X 1948 GA HEALTHCARE 10 10 242 30 0 0 44073 6800 16530118 11930359 117620 -8380317 544003 2775779 17235814 6332621 1000 2000 0 0 9532518 6764659 0 0 89 9785430 7895545 19318948 14662204 -2083134 -8329583 14031000 4007085 2183616 489284 11847384 3517801 X THE MISSION OF MCDUFFIE REGIONAL MEDICAL CENTER IS TO PROVIDE QUALITY HEALTH CARE TO ALL PATIENTS WITH THE ASSISTANCE OF OUR ASSOCIATES AND PHYSICIANS. THE VISION OF MCDUFFIE REGIONAL MEDICAL CENTER IS TO BE UTILIZED AS OUR COMMUNITIES' HEALTHCARE PARTNER OF CHOICE. THE VALUES STATEMENT REFLECTS OUR COMMITMENT AND PRIORITIES TO PEOPLE FIRST, PATIENT CARE THAT EMBODIES COMPASSION, RESPECT, AND PRIVACY, EXCEEDING THE NEED AND EXPECTATIONS OF OUR CUSTOMERS, OPPORTUNITIES TO SERVE OUR COMMUNITIES AND LISTEN TO THEIR NEEDS PHYSICIANS WHO ARE HIGHLY QUALIFIED AND PROVIDE SELECTED MEDICAL SERVICES LEADERSHIP DEDICATED TO PRESERVING THE FUTURE OF HEALTHCARE EXCELLENCE IN HEALTHCARE DELIVERY AND CUSTOMER SERVICE FISCAL STABILITY THAT ENABLES EXPANDED, ADVANCED SERVICES INITIATIVE DEMONSTRATING OUR DEDICATION TO CONTINUOUS QUALITY IMPROVEMENT RELATIONSHIPS THAT FOSTER CONTINUED GROWTH AS PROVIDER OF CHOICE SERVICE AVAILABLE AND ACCESSIBLE TO ALL. 0 0 11531263 6083435 THE HOSPITAL CARRIED OUT MEDICAL RELATED SERVICES TO THE COMMUNITY AND CONDUCTED HEALTH EDUCATION COURSES AND HEALTH FAIRS, PROVIDED EDUCATIONAL LITERATURE AND SPONSORED ILLNESS SUPPORT GROUPS. A STAFF MEMBER SERVES THE EAST GEORGIA CANCER COALITION BOARD WHO PROMOTES CANCER AWARENESS AND SCREENINGS. OTHER STAFF MEMBERS SERVE ON A VARIETY OF BOARDS AND ARE INVOLVED IN CIVIC ENDEAVORS THAT PROMOTE HEALTH AND WELLNESS. THE HOSPITAL PROVIDED DRUGS AND TRANSPORTATION FROM THE HOSPITAL TO THOSE UNABLE TO PAY. UNCOMPENSATED CARE WAS PROVIDED AS WELL AS INDIGENT AND CHARITY CARE. A HOSPITAL BASED PROGRAM ASSISTANCE COUNSELOR IS PROVIDED AT THE HOSPITAL'S EXPENSE IN ORDER TO ASSIST PATIENTS WITH QUALIFYING FOR MEDICARE DISABILITY, MEDICAID, SSI OR OTHER GOVERNMENTAL FINANCIAL ASSISTANCE PROGRAMS. THE HOSPITAL TREATS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND SERVES AS A HEALTHCARE SAFETY NET FOR THOSE WHO ARE NOT ABLE TO RECEIVE SERVICE ELSEWHERE BECAUSE OF THEIR FINANCIAL INABILITY TO PAY. 11531263 1 1 0 0 0 0 0 0 0 1 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 242 1 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 GA X BARMORE HAMMOND LLP 7065957764 132 RAILROAD STREET 3RD FLOOR THOMSON GA 30824 JERRY HARRISON 1.00 X 0 0 0 ANITA CUMMINGS 1.00 X 0 0 0 ROBIN DUDLEY 1.00 X 0 0 0 BILL DOUPE 1.00 X 0 0 0 JOE WILLS MD 1.00 X 0 0 0 JOHN SEAY 1.00 X 0 0 0 MICHELLE COLLINS 1.00 X 0 0 0 JACKIE DUPREE 1.00 X 0 0 0 DARYL WILEY 1.00 X 0 0 0 RUSTY LOVELACE 1.00 X 0 0 0 NED HARBESON 1.00 X 0 0 0 DOUGLAS C KEIR 40.00 X 145166 0 0 PATRICIA W PARRIS 40.00 X 79322 0 0 BELINDA CAMPBELL 40.00 X 56087 0 0 LISA TUCKER 40.00 X 58350 0 0 APRIL KEENE 40.00 X 46020 0 0 DAWN SWAN 1.00 X 44410 0 0 PEGGY BARMORE 40.00 X 75897 0 0 JESSIE LYNN RYAN 40.00 X 126557 0 0 631809 0 0 2 0 0 0 ALSTON AND BIRD PO BOX 933124 ATLANTA GA 311933124 LEGAL FEES 281960 CROTHALL CLINICAL EQU 13028 COLLECTIONS CENTER DRIVE CHICAGO IL 60675 BIO-MED SERVICE 248472 EMCARE 7032 COLLECTION CENTER DRIVE CHARLOTTE IL 60693 ER PHYSICIANS 177464 MEDITECH PO BOX 74569 CHICAGO IL 60696 SOFTWARE SVC 165080 CARDINAL PO BOX 905867 CHARLOTTE NC 28290 DRUGS & MEDICAL SUPPLIES 159264 8 6800 6800 PATIENT SERVICE REVENU 621990 11930359 11930359 11930359 83405 83405 2852 0 2852 2852 2852 8463722 -8463722 -8463722 -8463722 EHR GOVT REIMBURSEMENT 621990 1597236 1597236 SPLOST FUNDS 621990 500000 500000 EMS MANAGEMENT 621990 452595 452595 223096 64115 158981 2772927 6332621 6083435 0 242386 2000 2000 782628 453016 329612 4399856 3924072 475784 36688 29601 7076 11 1108246 979636 128610 437241 322751 114412 78 649001 267169 381832 504666 504666 48500 48500 723657 377725 345932 6060 6060 2184651 2115110 69541 144181 128321 15860 775836 545986 229850 8501 2313 6188 6630 5503 1127 627329 264795 362534 249499 177280 72219 BAD DEBT EXPENSE 1757483 1757483 REPAIRS AND MAINTENANCE 209551 172442 37109 14662204 11531263 3130852 89 72009 1196620 1787355 503441 0 201611 299169 0 0 7587349 0 3519701 2037431 359534 473865 14031000 4007085 1907526 144098 65737 67737 210353 277449 2183616 489284 X 11722397 2893951 500000 124987 123850 11847384 3517801 14031000 4007085 -8329583 0 X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 124988 0 863 2000 0 0 123851 125239 0 749 1000 0 0 124988 124733 0 506 0 0 0 125239 121781 1962 990 0 0 0 124733 1.00000 0 0 0 OTHER SECURITIES 2037431 F 2037431 USRY SCHOLARSHIP RESTRICTED CASH 123850 USRY SCHOLARSHIP LOAN RECCEIVABLES 67737 CMS ELECTRONIC HEALTH RECORD - MEDICAD RECEIVABLE 233836 WORKMANS COMP PREM RECEIVABLE 48442 473865 DUE TO UNIVERSITY HOSPITAL 155075 ALLOWANCE MEDICARE RAC 55542 SETTLEMENT PAYABLE 66832 277449 6332621 14662204 -8329583 -8329583 1 1 1 X 125.000000000000 1 X 1 1 1 0 0 705701 0 705701 0.05470 2426971 783237 1643734 0.12740 0 0 0.00000 3132672 783237 2349435 0.18210 0 0 0.00000 0 0 0.00000 89528 0 89528 0.00690 0 0 0.00000 8447 375 8072 0.00060 97975 375 97600 0.00750 3230647 783612 2447035 0.18960 1 1757483 164884 2503464 2938700 -435236 X 1 1 1 1 MCDUFFIE CTY HOSPITAL AUTHORITY DBA MRMC

521 HILL STREET THOMSON GA 30824

X X X MCDUFFIE REGIONAL MEDICAL CENTER 1 1 1 200.000000000000 1 250.000000000000 1 X 1 1 X 1 0 1 X 0 0 3 MCDUFFIE BONE & JOINT

510 MT PLEASANT ROAD THOMSON GA 30824

OP ORTHOPEDIC PHYSICIAN'S OFFICE MRMC HOSPITALISTS

521 WEST HILL ST THOMSON GA 30824

IP PHYSICIANS' HOSPITALISTS PRACTICE MRMC PHYSICAL & OCCURPATIONAL THERAPY CL

WARE STREET THOMSON GA 30824

OP PHYSICAL & OCCUPATIONAL THERAPY CLINIC PART I, LINE 7G: SUBSIDIES FOR PHYSICIAN CLINICS; SUBSIDIZED SERVICES FOR COLPOSCOPIES PERFORMED AT MCDUFFIE COUNT HEALTH DEPARTMENT; SUBSIDIZED PRESCRIPTION MEDICATIONS AND TRANSPORTATION; WELLNESS WORKS PROGRAM FOR COMMUNITY THAT PROVIDES HEALTH FAIRS, PHYSICALS AND SCHEDULING FOR HEALTH CARE ACCESS. PART I, L7 COL(F): INCOME STATEMENT IS CHARGED WITH ACTUAL BAD DEBT EXPENSE BASED UPON EXHAUSTED COLLECTION EFFORTS PER HOSPITAL POLICY. A PROVISION FOR CURRENT AR UNCOLLECTIBLE ACCOUNTS IS CHARGED BASED UPON EXPERIENCE AND CIRCUMSTANCE WHICH AFFECT THE COLLECTABILITY OF RECEIVABLES. AMOUNTS DEEMED UNCOLLECTIBLE ARE CHARGED AGAINST THE ALLOWANCE. IN THE OPINION OF MANAGEMENT, ADEQUATE PROVISIONS HAVE BEEN MADE FOR UNCOLLECTIBLE ACCOUNTS. PART III, LINE 8: HOSPITALS HAVE NO CHOICE BUT TO TREAT PATIENTS THAT PRESENT FOR EMERGENCY SERVICES AND MUST TREAT WITHOUT REGARD TO ABILITY TO PAY EVEN THOUGH THE PATIENT MAY HAVE NUMEROUS BAD DEBTS. NO OTHER INDUSTRY WOULD CONTINUE TO PROVIDE SERVICES IF THE BILLS REMAINED UNPAID. THEREFORE BAD DEBT SHOULD BE ALLOWED AS COMMUNITY BENEFIT SINCE THERE IS NO BENEFIT TO THE HOSPITAL. BAD DEBT COMPROMISES A HOSPITAL'S OPERATIONS SO THE BENEFIT ARE PROVIDED TO THE COMMUNITY. PART III, LINE 9B: THE HOSPITAL DOES NOT PURSUE COLLECTIONS ON PATIENTS IDENTIFIED AND QUALIFIED FOR INDIGENT CARE. MCDUFFIE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 19D: THERE IS NO MAX CAP ON AMOUNTS TO BE CHARGED TO TO FAP ELIGIBLE INDIVIDUALS. PART VI, LINE 3: PATIENTS ARE INFORMED AT THE TIME OF REGISTRATION THAT AN INDIGENT/CHARITY PROGRAM IS AVAILABLE. SIGNS ARE POSTED IN EACH REGISTRATION AREA, THE EMERGENCY DEPARTMENT, LOBBY AND MAIN CORRIDOR TO INPATIENT WING. EACH PATIENT ACCOUNT REPRESENTATIVE INFORMS THEIR PATIENTS OF THE INDIGENT/CHARITY PROGRAM AND ASSISTS THE PATIENT WITH COMPLETION OF THE APPLICATION. WE EMPLOY RESOURCE CORP. OF AMERICA REPRESENTATIVES THAT NOT ONLY TAKE INDIGENT APPLICATIONS, BUT ASSIST PATIENTS IN APPLYING FOR OTHER GOVERNMENTAL PROGRAMS SUCH AS SSI, MEDICAID, MEDICARE DISABILITY, ETC. PART VI, LINE 4: MCDUFFIE REGIONAL RESIDES IN MCDUFFIE COUNTY. MCDUFFIE COUNTY IS 40% AFRICAN AMERICAN, 2% LATINO, 58% CAUCASIAN, 19% BELOW FPG, 20% WITH NO INSURANCE, AND 9.5% UNEMPLOYED. MRMC SERVES LINCOLN, WARREN AND GLASCOCK COUNTIES IN ITS SERVICE AREA. PART VI, LINE 5: MRMC PROVIDES CLINICAL EDUCATION, TRAINING, AND MENTORSHIP FOR STUDENTS OF AUGUSTA TECH, VIRGINIA COLLEGE, MEDICAL COLLEGE OF GEORGIA, AUGUSTA STATE UNIVERSITY, AND THOMSON HIGH SCHOOL. STUDENTS MEET THEIR CLINICAL AND ON JOB EDUCATIONAL CRITERIA THROUGH SERVICE AT MRMC. PART VI, LINE 6: MRMC'S BOARD IS MADE UP OF A CROSS SECTION OF NONEMPLOYEE COMMUNITY LEADERS AND ETHNIC GROUPS. OUR MEDICAL STAFF IS OPEN. SURPLUS FUNDS ARE USED TO PROVIDE FOR NEW SERVICES, FUTURE GROWTH, AND DEVELOPMENT OF THE FACILITY IN ORDER TO CONTINUE TO PROVIDE SERVICES TO THE COMMUNITIES WE SERVE. FORM 990, PART VI, SECTION B, LINE 11 AN ELECTRONIC COPY OF THE FORM 990 IS PROVIDED TO THE GOVERNING BODY PRIOR TO FILING FOR THEIR APPROVAL FORM 990, PART VI, SECTION B, LINE 12C POLICY AND PROCEDURE WERE EXPLAINED DURING HOSPITAL WIDE ORIENTATION. CODE OF BUSINESS PRACTICE PROVIDED TO EACH ASSOCIATE. FORM 990, PART VI, SECTION B, LINE 15 CEO'S SALARY IS PROVIDED BY HOSPITAL AUTHORITY AS A PORTION OF THE MANAGEMENT CONTRACT THROUGH QUORUM. FORM 990, PART VI, SECTION C, LINE 19 MCDUFFIE COUNTY HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.