2012-08-15T07:31:22-05:00 2011-09-30 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2010-10-01 561936354 FIRSTHEALTH OF THE CAROLINAS INC FIRS 9107151000 155 MEMORIAL DRIVE PINEHURST NC 28374 LYNN DEJACO 9107151000 2012-08-15 1 AMY BIBBY 8282542254 2010 2016-02-24 21:20:13Z CHARLES T FROCK 155 MEMORIAL DRIVE PINEHURST NC 28374 494731389 0 X WWW.FIRSTHEALTH.ORG X 1995 NC TO SERVICE THE COMMUNITY'S TOTAL HEALTH CARE NEEDS. 20 19 4538 883 878338 -89019 3247673 5100727 461163936 466091070 -4549326 10454938 6641791 11307103 466504074 492953838 223109 211225 0 0 201947848 213539178 0 0 70997 248212943 248760158 450383900 462510561 16120174 30443277 808656420 807891417 358418002 336984262 450238418 470907155 X FIRSTHEALTH OF THE CAROLINAS, INC. (FIRSTHEALTH) IS A COMPREHENSIVE HEALTH CARE CENTER ORGANIZED AND OPERATED TO SERVICE THE COMMUNITY'S TOTAL HEALTH CARE NEEDS. FIRSTHEALTH PROVIDES NEEDED MEDICAL CARE TO THE COMMUNITY REGARDLESS OF A PERSON'S ABILITY TO PAY. A VARIETY OF HEALTH CARE SERVICES ARE OFFERED IN SUPPORT OF THE ORGANIZATION'S CHARITABLE MISSION AS A COMMUNITY-BASED HEALTH CARE SYSTEM. 0 0 335024525 211225 465251616 SEE SCHEDULE O 335024525 1 1 0 1 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 736 0 1 4538 1 1 1 0 0 0 0 0 0 0 0 0 X 20 19 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NC X X LYNN DEJACO CFO 9107151568 155 MEMORIAL DRIVE PINEHURST NC 28374 ALEX BOWNESS 2.00 X X 0 0 0 JULIAN KING 2.00 X X 0 0 0 JOHN MAY 2.00 X X 0 0 0 EDWARD BARNES 2.00 X X 0 0 0 ROBERT BAHNER MD 1.00 X 0 0 0 DAVID BRUTON MD 1.00 X 0 0 0 JAMES BULTHUIS 1.00 X 0 0 0 DAVID COWHERD MD 1.00 X 0 0 0 JOHN ELLIS MD 1.00 X 0 0 0 WALTER FASOLAK MD 1.00 X 0 0 0 ANNA HOLLERS 1.00 X 0 0 0 KENNETH C MITCHELL MD 1.00 X 0 0 0 DR SUSAN PURSER 1.00 X 0 0 0 BRUCE SOLOMON DO 1.00 X 0 0 0 JOHN STEVENSON MD 1.00 X 0 0 0 WILLIAM STEWART MD 1.00 X 0 0 0 ROBERT TWEED 1.00 X 0 0 0 DAVID WORONOFF 1.00 X 0 0 0 CHARLES T FROCK 50.00 X X 6444466 0 11856 DAVID BURNS 1.00 X 0 0 0 LYNN DEJACO 50.00 X 485472 0 23977 DANIEL BIEDIGER 50.00 X 275761 0 24227 GEORGE BUSSEY MD 50.00 X 454857 0 639 JEFFREY CASEY 50.00 X 318226 0 22498 DAVID DILLEHUNT 50.00 X 321028 0 18408 VIVIAN HARRINGTON 50.00 X 195956 0 21678 KERRY HENSLEY 50.00 X 209976 0 5366 JOHN JACKSON 50.00 X 313709 0 22353 STUART VOELPEL 50.00 X 495456 0 5687 LINDA WALLACE 50.00 X 278954 0 3299 CYNTHIA MCDONALD 50.00 X 225825 0 11332 JOHN KRAHNERT MD 50.00 X 563376 0 20794 ANDY KISER 50.00 X 644403 0 0 DANIEL BARNES MD 50.00 X 355660 0 20794 PETER ELLMAN MD 50.00 X 415839 0 17194 BOHDAN KOPYNEC MD 50.00 X 332821 0 22123 STEPHEN SZABO MD 1.00 X 0 0 0 CAROLYN HELMS 1.00 X 0 0 0 DAVID THORNTON MD 1.00 X 0 0 0 ROBERT BOONE 50.00 X 27729 0 0 JOHN STREITMAN MD 50.00 X 297183 0 0 12628968 0 252225 202 1 1 0 GMK OF NORTH CAROLINA PC 4340 SWINNEA ROAD MEMPHIS TN 38118 ARCHITECT AND CONSTRUCTION MANAGEMENT SE 5235223 BRASFIELD AND GORRIE 3700 GLENWOOD AVE STE 300 RALIGH NC 27612 CONSTRUCTION MANAGEMENT SERVICES 4733468 MCKESSON 5995 WINDWARD PARKWAY ALPHARETTA GA 30005 MAINTENANCE FEES, MEDICAL SUPPLIES 4203711 PINEHURST MEDICAL CLINIC 205 PAGE ROAD PINEHURST NC 28374 MEDICAL ONCOLOGY PHYSICIAN SERVICES 3674284 TEXICAN HORIZON ENERGY PO BOX 2392 HOUSTON TX 77252 NATURAL GAS SUPPLIER 1026826 49 681891 2199669 2219167 5100727 NET PATIENT SERVICE RE 621110 432257997 432257997 OTHER OPERATING REVENU 621110 23086937 22427870 659067 HEALTH AND FITNESS 713940 5496861 5133446 363415 EMS REVENUE 621110 5249275 5249275 466091070 7926414 7926414 30070 30070 2191277 1379717 811560 811560 -153269 964829 2259486 238968 2259486 238968 2498454 2498454 580862 397834 183028 183028 MISCELLANEOUS 621110 7615193 7615193 FOOD SERVICE 722210 2697322 9125 2688197 10312515 492953838 465251616 878338 21723157 183225 183225 28000 28000 10218831 10218831 146596940 124100199 22496741 43282526 34252742 9029784 13440881 10636788 2804093 361758 361758 746211 746211 235714 13170 222544 39287 39287 702784 702784 50744786 26305543 24439083 160 1923446 505279 1418167 96926964 89921094 7005870 92619 86251 6368 11033204 2504497 8516750 11957 1779999 1335520 444479 946314 56147 890167 6416747 6416747 29498748 2126028 27319679 53041 4589782 204967 4384815 BAD DEBT 41894395 41894395 MISCELLANEOUS 827400 508922 312639 5839 462510561 335024525 127415039 70997 29555070 22227988 15117010 6142392 61312708 60107457 41603 32907 7586483 7257348 4353275 4438676 683699022 371351221 284286815 312347801 360915301 361522582 4884511 99000 3342321 8771478 37261323 24943788 808656420 807891417 63733810 57578016 276998 244008041 239730453 1239923 1160186 49159230 38515607 358418002 336984262 X 448089418 468758155 2149000 2149000 450238418 470907155 808656420 807891417 X 30443277 -9774540 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1000000 1000000 1000000 1000000 4000000 6000000 56583 41734 38367 39287 175971 250000 250000 250000 250000 1000000 1500000 42583 10500 70000 67100 190183 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: LOBBYING EXPENSES - PORTION OF AHA (24.60) AND NCHA (23.46%) ASSOCIATION DUES ALLOCATED FOR LOBBYING PURPOSES. GRASSROOTS LOBBYING - FIRSTHEALTH OF THE CAROLINA, INC ("FIRSTHEATH") WORKS WITH THE NATIONAL AND STATE ASSOCIATION TO MAINTAIN AND STRENGTHEN RELATIONSHIPS WITH LEGISLATORS AND POLICYMAKERS AT THE NATIONAL, STATE, AND LOCAL LEVELS. THE OBJECTIVE IS TO ENSURE THAT FIRSTHEALTH'S EXPERIENCE AND EXPERTISE IS CONSISTENTLY AND CONTINUALLY HEARD SO THAT HEALTH LEGISLATION, REGULATION, AND POLICIES SUPPORT THE ORGANIZATION'S ABILITY TO FULFILL ITS MISSION - "TO CARE FOR PEOPLE." 7613452 7613452 373972884 210925262 163047622 13578784 7578112 6000672 271000968 152847847 118153121 17532934 17532934 312347801 THIRD PARTY PAYABLES 13552740 DUE TO AFFILIATES 4131276 PROFESSIONAL LIABILITY RESERVE 7635326 SWAP TRANSACTION 13196265 38515607 492953838 462510561 30443277 -10209891 435351 -9774540 20668737 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: FIRSTHEALTH OF THE CAROLINA, INC. IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3). RELATED INCOME IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE TAXES. FIRSTHEALTH ADOPTED THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS AND PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THIS STANDARD HAS HAD NO SIGNIFICANT IMPACT ON THE CONSOLIDATED FINANCIAL STATEMENTS. PART XI, LINE 8 - OTHER ADJUSTMENTS: LOSS ON SWAP MARKET ADJUSTMENT 984,746. LOSS ON ADVANCED REFUDNING -549,395. 1 1 X 1 X 1 X 360.000000000000 1 1 1 0 1 1 12779011 4440156 8338855 0.01980 13210966 13210966 0.03140 25989977 4440156 21549821 0.05120 2679034 2679034 0.00640 855304 855304 0.00200 253777 253777 0.00060 519434 519434 0.00120 4307549 4307549 0.01020 30297526 4440156 25857370 0.06140 209 209 0.00000 9591 9591 0.00000 834 834 0.00000 2055 2055 0.00000 59109 59109 0.00010 71798 71798 0.00010 0 11387828 151643467 160056443 -8412976 X 1 1 1 FIRST IMAGING OF THE CAROLINAS LLC MOBILE IMAGING SERVICES 0.50000 0.50000 2 SURGERY CENTER OF PINEHURST LLC AMBULATORY SURGERY CENTER 0.40000 0.52000 3 1 FIRSTHEALTH MOORE REGIONAL HOSPITAL

155 MEMORIAL DRIVE PO BOX 3000 PINEHURST NC 28374

X X X 2 FIRSTHEALTH MONTGOMERY MEMORIAL HOSPITAL

520 ALLEN STREET PO BOX 486 TROY NC 37371

X X X X 3 FIRSTHEALTH RICHMOND MEMORIAL HOSPITAL

925 LONG DRIVE ROCKINGHAM NC 28379

X X X NA FOR 2010 1 PART I, LINE 7: THE ORGANIZATION USED WORKSHEET 2 OF THE 2010 SCHEDULE H INSTRUCTIONS TO COMPUTE A COST-TO-CHARGES RATIO USED TO CALCULATE CHARITY CARE AND UNREIMBURSED MEDICAID AT COST. PART I, L7 COL(F): TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25 CONTAINS A BAD DEBT EXPENSE OF $41,894,395 THAT HAS BEEN REMOVED FOR PURPOSES OF COMPUTING PERCENTAGE OF TOTAL EXPENSE ON COLUMN (F). PART II: FIRSTHEALTH OF THE CAROLINAS WORKS WITH THE COMMUNITIES WE SERVE TO CREATE OPPORTUNITIES TO IMPROVE THE PHYSICAL ENVIRONMENT FOR BETTER HEALTH. FIRSTHEALTH PERSONNEL WORK IN COLLABORATION WITH VARIOUS COMMUNITY GROUPS AND CIVIC ORGANIZATIONS TO PROMOTE THE HEALTH AND WELLNESS OF OUR REGION AND THE LOCAL COMMUNITIES WE SERVE. FIRSTHEALTH ACCOMPLISHES THESE GOALS BY OBTAINING PUBLIC AND PRIVATE GRANTS TO INCREASE ACCESS TO WALKING TRAILS AND SIDEWALKS, BUILDING COMMUNITY GARDENS, PROMOTING HEALTH AND WELLNESS THROUGH LOCAL BUSINESSES, SCHOOLS, AND THE CHAMBER OF COMMERCE, AND FACILITATING OF AND PARTICIPATING ON COMMUNITY-BASED COMMITTEES CONSISTING OF KEY LEADERS IN THE HEALTH FIELD TO HELP CREATE A HEALTHIER COMMUNITY AND REGION. PART III, LINE 4: THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE FOOTNOTE ON BAD DEBT EXPENSE.WORKSHEET 2 OF THE 2010 SCHEDULE H INSTRUCTIONS WAS USED TO COMPUTE A COST-TO-CHARGES RATIO USED TO CALCULATE BAD DEBT EXPENSE AT COST FOR PURPOSES OF LINE PART III, LINE 2 PART III, LINE 8: THE MEDICARE COST REPORT WAS USED TO CALCULATE THE OVERALL SHORTFALL. THE ORGANIZATION BELIEVES THE ENTIRE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT. PART VI, LINE 2: FIRSTHEALTH OF THE CAROLINAS CONDUCTS A PERIODIC COMMUNITY TELEPHONE SURVEY (EVERY 3 -4 YEARS) TO ASSESS THE HEALTH CONDITION OF THE POPULATION OF OUR PRIMARY SERVICE AREA (MOORE, MONTGOMERY, RICHMOND, AND HOKE COUNTIES) AS WELL AS SCOTLAND AND ROBESON COUNTIES, AND TRACKS THIS INFORMATION OVER TIME. THE FIRST SURVEY WAS CONDUCTED IN 1999. THE SURVEY AND ANALYSIS OF DATA IS CONDUCTED BY PRC ASSOCIATES. ADDITIONALLY, FIRSTHEALH OF THE CAROLINAS CONVENES 2010 VISION GROUPS THROUGHOUT OUR PRIMARY SERVICE AREA TO OBTAIN AN "ON THE GROUND PERSPECTIVE" OF THE POPULATION'S HEALTH STATUS AND DEVELOP ACTION PLAN TO ADDRESS IDENTIFIED HEALTH ISSUES. THE GROUPS CONSIST OF KEY COMMUNITY HEALTH LEADERS IN EACH COUNTY. PART VI, LINE 3: ANYONE WHO VISITS A FIRSTHEALTH HOSPITAL FOR MEDICAL CARE IS TREATED REGARDLESS OF HIS/HER ABILITY TO PAY. ALTHOUGH AN EFFORT IS MADE TO COLLECT A PORTION OF THE BILL ON ADMISSION OR AT DISCHARGE, THE FIRSTHEALTH STAFF IS TRAINED TO IDENTIFY THOSE WHO MAY NEED FINANCIAL ASSISTANCE. FOR SOME, THIS COULD SIMPLY INVOLVE ESTABLISHING A PAYMENT PLAN THAT FITS WITH THE FAMILY BUDGET. FOR OTHERS, THE HELP IS MORE COMPLEX. WHEN PATIENTS ARE UNABLE TO HELP WITH MEDICAL EXPENSES, FINANCIAL COUNSELORS MEET WITH THEM ONE ON ONE TO IDENTIFY ANY PROGRAM FOR WHICH THEY MIGHT QUALIFY. THESE INCLUDE MEDICAID, VOCATIONAL REHABILITATION AND NORTH CAROLINA PURCHASE OF CASE SERVICES. WHEN NECESSARY, THE HOSPITAL ITSELF ABSORBS SOME OR ALL OF THE COST OF CASE FOR THOSE THAT MEET DESIGNATED CRITERIA. THE AMOUNT OF ASSISTANCE DEPENDS ON FAMILY INCOME. PATIENTS AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES QUALIFY FOR 100% FINANCIAL ASSISTANCE FOR THE FIRSTHEALTH FINANCIAL ASSISTANCE PROGRAM. PATIENTS WHOSE INCOME EXCEEDS 200% MAY STILL QUALIFY FOR ASSISTANCE DEPENDING ON THEIR INDIVIDUAL FINANCIAL CIRCUMSTANCES. INFORMATION ABOUT FEDERAL, STATE, AND LOCAL PROGRAMS, AS WELL AS FIRSTHEALTH'S FINANCIAL AID PROGRAM IS OFFERED TO ALL PATIENTS IN THE FIRSTHEALTH OF THE CAROLINAS PATIENT HANDBOOK AND CAN BE FOUND ON OUR CORPORATE WEBSITE, WWW.FIRSTHEALTH.ORG. PART VI, LINE 4: FIRSTHEALTH OF THE CAROLINAS OWNS AND OPERATES A HEALTH CARE DELIVERY SYSTEM THAT PROVIDES HEALTH CARE SERVICES TO PATIENTS THROUGHOUT A 15-COUNTY SERVICE AREA IN SOUTH-CENTRAL NORTH CAROLINA AND NORTHWEST SOUTH CAROLINA. FIRSTHEALTH OF THE CAROLINAS OPERATES THREE ACUTE CARE HOSPITALS IN THIS SERVICE AREA. FIRSTHEALTH DRAWS APPROXIMATELY 67.0% OF ITS PATIENTS FROM MOORE, MONTGOMERY, AND RICHMOND COUNTIES, NORTH CAROLINA AND APPROXIMATELY 11.0% OF ITS PATIENTS FROM THE TWO SURROUNDING COUNTIES OF HOKE AND SCOTLAND. THESE FIVE COUNTIES COLLECTIVELY COMPRISE OF FIRSTHEALTH'S PRIMARY SERVICE AREA. FIRSTHEALTH'S PRIMARY SERVICE AREA REPRESENTS A POPULATION BASE OF APPROXIMATELY 247,168. THE POPULATION BASE OF FIRSTHEALTH'S TOTAL SERVICE AREA IS APPROXIMATELY 1,250,824. PART VI, LINE 6: FIRSTHEALTH OF THE CAROLINAS ALSO FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY BY EXTENDING MEDICAL STAFF PRIVILEGES TO QUALIFIED PHYSICIANS OF THE COMMUNITY. IN ADDITION, A MAJORITY OF FIRSTHEALTH'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN FIRSTHEALTH'S PRIMARY SERVICE AREA WHO ARE INDEPENDENT MEMBERS OF THE COMMUNITY. REPORTS FILED WITH STATES PART VI, LINE 7 NC 1 COUNTY OF MOORE PO BOX 905 CARTHAGE NC 28374 566000322 501(C)(3) 45635 FMV SUPPORT HEALTH & WELLNESS PROGRAMS SANDHILLS COMMUNITY COLLEGE FOUNDATION 2200 AIRPORT ORAD PINEHURST NC 28374 560946799 501(C)(3) 50000 FMV SUPPORT HEALTH EDUCATION PROGRAMS MOORE COUNTY FREE CLINIC 211 TRIMBLE PLANT RD SOUTHERN PINES NC 28387 010781234 501(C)(3) 45000 FMV GENERAL SUPPORT VILLAGE OF PINEHURST 395 MAGNOLIA RD PINEHURST NC 28374 561211319 501(C)(3) 27480 FMV SUPPORT HEALTH & WELLNESS PROGRAMS 4 SCHOLARSHIP PAYMENTS TO HEALTH CHOICE ELIGABLE CHILDREN FOR PROGRAM ENROLLMENT FEES 618 28000 FMV PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: FIRSTHEALTH OF THE CAROLINAS, INC..("FIRSTHEALTH") SUPPORTS VARIOUS COMMUNITY-BASED TAX-EXEMPT ORGANIZATIONS AND LOCAL GOVERNMENTAL UNITS THROUGH CASH DONATIONS. FIRSTHEALTH DOES NOT RESTRICT THE USE OF THESE DONATIONS AND SUPPORT PAYMENTS. THE RECEIVING EXEMPT ORGANIZATIONS OR GOVERNMENTAL UNITS MAY USE THE DONATION/SUPPORT PAYMENT AT WILL TO FURTHER THEIR EXEMPT PURPOSES. 1 X X X X X 0 1 0 1 0 0 0 0 0 CHARLES T FROCK 471266 0 343672 0 5629528 0 0 0 11856 0 6456322 0 5389394 0 LYNN DEJACO 347201 0 82864 0 55407 0 12740 0 11237 0 509449 0 0 0 DANIEL BIEDIGER 188596 0 50208 0 36957 0 13720 0 10507 0 299988 0 0 0 GEORGE BUSSEY MD 347849 0 86589 0 20419 0 0 0 639 0 455496 0 0 0 JEFFREY CASEY 224080 0 58136 0 36010 0 11760 0 10738 0 340724 0 0 0 DAVID DILLEHUNT 228103 0 57980 0 34945 0 11760 0 6648 0 339436 0 0 0 VIVIAN HARRINGTON 145714 0 35397 0 14845 0 11495 0 10183 0 217634 0 0 0 KERRY HENSLEY 145399 0 38276 0 26301 0 0 0 5366 0 215342 0 0 0 JOHN JACKSON 208634 0 96244 0 8831 0 11760 0 10593 0 336062 0 0 0 STUART VOELPEL 340833 0 87958 0 66665 0 0 0 5687 0 501143 0 0 0 LINDA WALLACE 214530 0 50936 0 13488 0 0 0 3299 0 282253 0 0 0 CYNTHIA MCDONALD 170502 0 40876 0 14447 0 10528 0 804 0 237157 0 0 0 JOHN KRAHNERT MD 482941 0 61919 0 18516 0 9800 0 10994 0 584170 0 0 0 ANDY KISER 529113 0 100297 0 14993 0 0 0 0 0 644403 0 0 0 DANIEL BARNES MD 217791 0 130016 0 7853 0 9800 0 10994 0 376454 0 0 0 PETER ELLMAN MD 380945 0 34497 0 397 0 6200 0 10994 0 433033 0 0 0 BOHDAN KOPYNEC MD 214050 0 117718 0 1053 0 11760 0 10363 0 354944 0 0 0 JOHN STREITMAN MD 240249 0 50298 0 6636 0 0 0 0 0 297183 0 0 0 PART I, LINE 4B THE ORGANIZATION'S CEO PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE AMOUNT OF THE PAYOUT WAS $5.55 MILLION TO THE CORPORATE CEO UNDER THE BOARD-APPROVED CEO SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) ESTABLISHED IN 1998. OF THIS TOTAL, $5.389 MILLION HAD BEEN REPORTED IN THE ANNUAL EXECUTIVE COMPENSATION IN THE PRIOR TAX YEARS THAT THE ACTUARIALLY-CALCULATED FUNDING LIABILITY WAS DETERMINED. $167,250 OF THE PAYOUT WAS BOOKED BY FIRSTHEALTH DURING FISCAL 2011 AND IS REPORTED ON THIS TAX RETURN. PART I, LINE 5 PHYSICIANS ARE PAID UNDER A PRODUCTIVITY-BASED COMPENSATION MODEL, WHICH TIES TOTAL COMPENSATION TO A RELATIVE VALUE UNIT (RVU). AN RVU IS A DOLLAR AMOUNT ASSIGNED TO EACH PATIENT ENCOUNTER OR MEDICAL TEST/PROCEDURE PERFORMED. NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2010-01-06 29535000 SERIES 2010 - REFUND ISSUE DATED 12/9/08 0 0 0 NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2009-12-09 40830000 SERIES 2009D - REFUND ISSUE DATED 4/15/109; NEW HEART INSTITUTE 0 0 0 NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DDT5 2009-12-09 54734475 SERIES 2009C - REFUND ISSUES DATED 4/15/19, 12/9/08, 5/1/02 0 0 0 NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DCT6 2009-04-15 45505000 SERIES 2009A - CONSTRUCTION OF NEW HEART INSTITUTE 0 0 0 29535000 135000 1 0 1 1 40938198 190000 25244123 8401072 1 0 0 1 3270000 54747321 784475 3021876 1018286 1 0 0 1 45726447 910100 32271489 8726052 0 0 0 1 0 1 1 0 1 0.01800 0.00100 0.01900 1 0 0 0 0 1 1 0 1 1 0 1 0.10000 0.00100 0.10100 1 0 0 0 0 1 1 0 1 1 CITIGROUP FINANCIAL 18.000000000000 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE K SUPPLENTAL INFORMATION PART I, BOND B, COLUMN F: REISSUANCE OF 29,400,000 OF BOND PROCEEDS ORIGINALLY ISSUED ON 2/27/2002; AND ISSUANCE OF 20,600,000 OF NEW MONEY FOR VARIOUS CAPITAL PROJECTS, PART II, LINE 14, COLUMN B: THE REISSUANCE OF THE 2/27/2002 ISSUE WAS DEEMED A CURRENT REFUNDING FOR TAX PURPOSES. PART II, LINE 1, COLUMN A: 28,900,000 OF THE 2008 B ORIGINAL PRINCIPAL AMOUNT WAS REFUNDED BY ISSUE DATED 12/9/2009; THIS REPRESENTED THE ENTIRE OUTSTANDING AMOUNT OF THE 2008 B AS OF THE DATE OF REFUNDING; 29,400,000 OF THE 2008A ORIGINAL PRINCIPAL AMOUNT WAS REFUNDED BY ISSUE DATED 1/6/2010. ONLY THE A PORTION OF THE ISSUE REMAINS OUTSTANDING AS OF 9/30/2011. NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DBZ3 2008-12-09 106845000 SERIES 2008A & 2008B - REFUND ISSUES DATED 4/9/03 AND 2/20/98 0 0 0 930000 106845000 1037629 1 0 1 1 0 1 1 0 1 0.01800 0.00100 0.01900 1 0 1 1 CITIGROUP FINANCIAL 14.000000000000 0 0 0 0 0 JOHN STREITMAN MD ADVANCE X 103580 32907 0 0 1 32907 FORM 990, PART VI, SECTION B, LINE 11 FIRSTHEALTH'S FORM 990 WAS INITIALLY REVIEWED BY QUALIFIED MEMBERS OF ADMINISTRATION, INCLUDING THE CORPORATE CEO AND CFO, AND COMPLIANCE DEPARTMENTS. THE ENTIRE RETURN WAS REVIEWED BY THE COMPENSATION AND CORPORATE FINANCE/AUDIT/COMPLIANCE COMMITTEES OF THE FIRSTHEALTH BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FIRSTHEALTH'S INDEPENDENT TAX PREPARER, DIXON HUGHES GOODMAN, LLP, ALSO CONDUCTED A REVIEW OF THE RETURN DURING THEIR PREPARATION PROCESS. ONCE THE RETURN IS SUCCESSFULLY E-FILED WITH THE IRS, A COPY OF THE RETURN IS MADE AVAILABLE TO ALL MEMBERS OF THE FIRSTHEALTH BOARD OF DIRECTORS. IN ADDITION TO THE POSTING OF THE FIRSTHEALTH RETURN ON GUIDESTAR, A PUBLIC INSPECTION COPY OF THE FORM 990 IS MADE AVAILABLE FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C FIRSTHEALTH STRIVES TO MAINTAIN THE HIGHEST ETHICAL STANDARDS AND HAS ADOPTED A CONFLICT OF INTEREST/DUALITY OF INTEREST POLICY THAT APPLIES TO ANY DIRECTOR, TRUSTEE, OFFICER OR MEMBER OF A BOARD COMMITTEE, OR ANY EMPLOYEE WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST OR DUALITY OF INTEREST WITH ANY ORGANIZATION SEEKING TO DO BUSINESS WITH OR IS IN AN ACTUAL OR POTENTIAL ADVERSARIAL RELATIONSHIP WITH FIRSTHEALTH. ANY COVERED INDIVIDUAL WITH AN ACTUAL OR POSSIBLE CONFLICT MUST DISCLOSE THE EXISTENCE OF THE CONFLICT TO THE DIRECTORS, TRUSTEES AND MEMBERS OF BOARD COMMITTEES WITH BOARD-DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION, ARRANGEMENT OR ISSUE. EACH TRUSTEE, OFFICER OR MEMBER OF A BOARD COMMITTEE WITH BOARD-DELEGATED POWERS COMPLETES AN ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT, AND ALL REPORTED CONFLICTS ARE REPORTED TO AND REVIEWED BY THE FIRSTHEALTH BOARD OF DIRECTORS. ALL MANAGEMENT EMPLOYEES ALSO COMPLETE ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENTS, WHICH ARE SUMMARIZED AND REVIEWED WITH SENIOR MANAGEMENT. FORM 990, PART VI, SECTION B, LINE 15 FIRSTHEALTH'S BOARD OF DIRECTORS DETERMINES COMPENSATION FOR THE CEO THROUGH ITS COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE IS COMPOSED OF BOARD MEMBERS WHO ARE INDEPENDENT OF FIRSTHEALTH MANAGEMENT, HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS, ARE NOT RELATED TO OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED, HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH FIRSTHEALTH, AND ARE NOT PAID FOR THEIR SERVICES AS A BOARD MEMBER. THE COMMITTEE RETAINS AN INDEPENDENT CONSULTANT TO CONDUCT PERIODIC COMPENSATION ANALYSES TO HELP ENSURE FIRSTHEALTH'S COMPENSATION PRACTICES AND COMPENSATION LEVELS ARE REASONABLE. THIS CONSULTANT PROVIDES ONLY ADVISORY SERVICES RELATED TO COMPENSATION MATTERS TO FIRSTHEALTH. TO ATTRACT AND RETAIN THE HIGHEST CALIBER OF HEALTHCARE PROFESSIONALS NEEDED TO SUSTAIN THE QUALITY OF THE HEALTHCARE FIRSTHEALTH PROVIDES TO THE COMMUNITIES THAT IT SERVES, COMPENSATION MUST BE COMPETITIVE WITH THAT PROVIDED BY OTHER COMPETING ORGANIZATIONS IN THE AREA JOB MARKET. WHEN EXECUTIVE POSITIONS ARE FILLED, FIRSTHEALTH TYPICALLY CONDUCTS NATIONAL SEARCHES. FIRSTHEALTH BENCHMARKS AGAINST ORGANIZATIONS OF COMPARABLE SIZE AND MISSION, ACROSS THE REGION AND THE NATION. MARKET DATA IS ASSEMBLED FOR ALL ELEMENTS OF EXECUTIVE COMPENSATION (I.E. CASH COMPENSATION, BENEFITS AND PERQUISITES). COMPENSATION LEVELS REFLECT THE SCOPE OF THE CEO'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE AND INDUSTRY STANDING, AS WELL AS INDIVIDUAL AND ORGANIZATION PERFORMANCE. THE MOST RECENT REVIEW WAS PERFORMED DURING FISCAL YEAR 2011. A SIMILAR PROCESS TO THAT FOR THE CEO IS AFFECTED FOR DETERMINING THE COMPENSATION OF THE OTHER CORPORATE OFFICERS OR KEY EMPLOYEES OF FIRSTHEALTH (I.E. USE OF INDEPENDENT CONSULTANT, COMPARABLE INDUSTRY DATA, ETC.). THE COMMITTEE REVIEWS AND APPROVES THE CEO'S PERFORMANCE ASSESSMENTS AND COMPENSATION RECOMMENDATIONS FOR OTHER CORPORATE OFFICERS AND KEY EMPLOYEES. ALL COMPENSATION DECISIONS ARE MADE IN A MANNER THAT IS CONSISTENT WITH FIRSTHEALTH'S BOARD-APPROVED COMPENSATION PHILOSOPHY. THE MOST RECENT YEAR REVIEW WAS PERFORMED DURING FISCAL YEAR 2011. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST AND ON WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. IN ADDITION, QUARTERLY AND ANNUAL FINANCIAL STATEMENTS ARE POSTED TO THE DIGITAL ASSURANCE CERTIFICATION (DAC) WEBSITE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -10,209,891. LOSS ON SWAP MARKET ADJUSTMENT 984,746. LOSS ON ADVANCED REFUDNING -549,395. TOTAL TO FORM 990, PART XI, LINE 5: -9,774,540. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PAGE 2, PART III FIRSTHEALTH OF THE CAROLINAS, INC. ("FIRSTHEALTH") PROVIDES A COMPREHENSIVE COMMUNITY BENEFITS PROGRAM IN ITS PRIMARY AND SECONDARY SERVICE AREAS. FIRSTHEALTH PLAYS A PIVOTAL ROLE IN DELIVERING HEALTH CARE IN THE MID-CAROLINAS AND IS BOTH THE INFRASTRUCTURE AND SAFETY NET FOR HEALTH CARE IN ITS COMMUNITIES. HOSPITAL CARE IS THE CORNERSTONE OF HEALTH CARE IN MOST COMMUNITIES, BUT FIRSTHEALTH GOES BEYOND THE WALLS OF ITS THREE HOSPITALS (FIRSTHEALTH MOORE REGIONAL HOSPITAL, FIRSTHEALTH MONTGOMERY MEMORIAL HOSPITAL AND FIRSTHEALTH RICHMOND MEMORIAL HOSPITAL) TO ENHANCE THE HEALTH AND WELLNESS OF THE RESIDENTS OF ITS SERVICE AREAS. FIRSTHEALTH PROVIDES LOW-COST AND, IN MANY CASES, FREE PROGRAMS TO OUR MOST VULNERABLE PATIENT POPULATIONS. ONE OF FIRSTHEALTH'S MOST IMPORTANT FINANCIAL CONTRIBUTIONS IS BRIDGING THE GAP CREATED BY UNDERPAYMENTS FROM MEDICARE AND MEDICAID AND OTHER GOVERNMENT PROGRAMS, WHILE CONTINUING TO PROVIDE ACCESS TO FREE OR LOW COST HEALTH SCREENINGS AND DIAGNOSTIC SERVICES, AS WELL AS HEALTH/WELLNESS EDUCATIONAL PROGRAMS IN THE COMMUNITIES FIRSTHEALTH SERVES. FREE AND DISCOUNTED CHARITY CARE TO ELIGIBLE PATIENTS SERVED ANYONE WHO VISITS A FIRSTHEALTH HOSPITAL FOR MEDICAL CARE IS TREATED REGARDLESS OF HIS OR HER ABILITY TO PAY FOR THE TREATMENT PROVIDED. WHEN PATIENTS ARE UNABLE TO HELP WITH THEIR MEDICAL EXPENSES, FIRSTHEALTH ABSORBS SOME OR ALL OF THE COST OF CARE FOR THOSE THAT MEET DESIGNATED FINANCIAL CRITERIA, DEPENDING ON FAMILY INCOME. PATIENTS WITH FAMILY INCOMES AT OR BELOW 200 PERCENT OF THE FEDERAL POVERTY GUIDELINE QUALIFY FOR 100 PERCENT FINANCIAL ASSISTANCE UNDER FIRSTHEALTH'S FINANCIAL ASSISTANCE PROGRAM. FIRSTHEALTH'S NET COSTS OF FREE CARE (TREATING PATIENTS THAT QUALIFIED FOR 100% FINANCIAL ASSISTANCE) WERE $8,338,855 IN FISCAL 2011. THROUGH ITS FINANCIAL ASSISTANCE PROGRAM, FIRSTHEALTH ALSO OFFERS VARYING LEVELS OF DISCOUNTED CARE TO PATIENTS WHO ARE POOR AND/OR MEET CERTAIN INCOME GUIDELINES. PATIENTS WITH FAMILY INCOMES BETWEEN 201 AND 360 PERCENT OF THE FEDERAL POVERTY GUIDELINE QUALIFY FOR DISCOUNTS AGAINST FIRSTHEALTH'S LIST PRICE FOR SERVICES RENDERED. FIRSTHEALTH HAS ALSO EXPERIENCED AN UPWARD TRENDING IN BAD DEBT EXPENSE, AS THE NUMBER OF PATIENTS WHO HAVE BEEN DETERMINED TO HAVE THE FINANCIAL CAPACITY TO PAY FOR HEALTHCARE SERVICES PROVIDED BUT ARE UNWILLING/FINANCIALLY UNABLE TO SETTLE THE CLAIM CONTINUES TO INCREASE. FIRSTHEALTH CONTINUES TO PROVIDE ALL NECESSARY HEALTHCARE SERVICES TO THIS PATIENT POPULATION. IN FISCAL 2011, THE COST TO FIRSTHEALTH FOR THESE SERVICES WAS $11,387,828. FIRSTHEALTH'S FINANCIAL COUNSELORS WORK CLOSELY WITH PATIENTS AND FAMILIES TO HELP DETERMINE ELIGIBILITY FOR ASSISTANCE OR QUALIFICATION FOR PUBLIC PROGRAMS. FIRSTHEALTH REQUESTS THAT PATIENTS PROVIDE APPROPRIATE DOCUMENTATION, SUCH AS TAX RETURNS, CURRENT PAY STUBS, OR OTHER RELEVANT INFORMATION, THAT IS USED TO DEMONSTRATE FINANCIAL NEED. FIRSTHEALTH ALSO OFFERS EXTENDED PAYMENT PLANS THAT WILL VARY IN LENGTH, DEPENDING ON THE BALANCE OF THE PATIENT'S ACCOUNT. FIRSTHEALTH ASSISTS PATIENTS WITH FINDING AVAILABLE GOVERNMENTAL PROGRAMS THAT MATCH PATIENTS' NEEDS, SUCH AS MEDICAID, VOCATIONAL REHABILITATION, CRIME VICTIM ASSISTANCE, ETC. FIRSTHEALTH ALSO POSTS DETAILED INFORMATION ABOUT ITS FINANCIAL ASSISTANCE PROGRAM ON ITS WEBSITE (WWW.FIRSTHEALTH.ORG) SO THE PUBLIC CAN BE AWARE OF ITS AVAILABILITY. MEDICAID SHORTFALL FIRSTHEALTH PROVIDES MEDICAID SERVICES IN ITS THREE HOSPITALS, AS WELL AS THROUGH ITS HOME CARE, HOSPICE, AND DENTAL CARE PROGRAMS IN ITS PRIMARY AND SECONDARY SERVICE AREAS. THE MEDICAID PROGRAM, WHICH PROVIDES HEALTH CARE COVERAGE FOR LOW-INCOME FAMILIES AND INDIVIDUALS, IS FUNDED BY THE STATE AND FEDERAL GOVERNMENTS. IN NORTH CAROLINA, AS IN MANY STATES, MEDICAID PAYMENTS ARE WELL BELOW THE PROVIDER'S ACTUAL COST OF TREATING MEDICAID PATIENTS AND THE REIMBURSEMENT LEVEL IS PREDICTED TO DECLINE AS FINANCIAL PRESSURES ON THE FEDERAL AND STATE GOVERNMENT OPERATING BUDGETS MOUNT. IN FISCAL 2011, FIRSTHEALTH'S UNPAID COSTS FROM MEDICAID TOTALED $13,210,966. MEDICARE SHORTFALL FIRSTHEALTH PROVIDES SERVICES TO MEDICARE BENEFICIARIES IN ITS THREE HOSPITALS. IN ADDITION, MEDICARE BENEFICIARIES ARE SERVED BY FIRSTHEALTH'S HOME CARE AND HOSPICE AND PALLIATIVE CARE PROGRAMS. THE MEDICARE SHORTFALL REPRESENTS THE DIFFERENCE BETWEEN THE ACTUAL COST OF CARE RENDERED AND THE REIMBURSEMENT RECEIVED FOR DELIVERING THAT CARE TO PATIENTS. THE COST OF DELIVERING CARE INCLUDES, BUT IS NOT LIMITED TO, PERSONNEL COSTS, TECHNOLOGY, SUPPLIES, PHARMACEUTICALS, MEDICAL DEVICES, FACILITY OPERATING COSTS, ETC. FIRSTHEALTH'S FINANCIAL SHORTFALL FROM PROVIDING THESE MEDICARE SERVICES IN FISCAL 2011 WAS $8,412,976. SUBSIDIZED MEDICALLY ESSENTIAL SERVICES AS A RURAL HEALTH CARE PROVIDER, FIRSTHEALTH IS MANY TIMES THE PROVIDER OF LAST RESORT FOR OUR PATIENTS. IN ORDER TO OFFER A FULL-SPECTRUM OF HEALTH CARE SERVICES, FIRSTHEALTH PROVIDES SERVICES AND PROGRAMS THAT YIELD NEGATIVE OPERATING MARGINS. HOWEVER, BECAUSE THESE SERVICES ARE ESSENTIAL TO THE OVERALL HEALTH OF THE COMMUNITIES SERVED, FIRSTHEALTH CONTINUES TO PROVIDE THEM. SUBSIDIZED MEDICALLY NECESSARY HOSPITAL SERVICES PROVIDED BY FIRSTHEALTH INCLUDE, BUT ARE NOT LIMITED TO: INPATIENT PSYCHIATRY UNIT AND OUTPATIENT MENTAL HEALTH SERVICES; INPATIENT PHYSICAL REHABILITATION UNIT; NEONATAL INTENSIVE CARE UNIT; EMERGENCY DEPARTMENTS (APPROXIMATELY 104,340 PATIENT ENCOUNTERS); WOMEN'S AND CHILDREN'S SERVICES; INPATIENT MEDICAL AND RADIATION ONCOLOGY SERVICES; RENAL DIALYSIS SERVICES; DIABETES CARE; AND A NUMBER OF OTHER OUTPATIENT SERVICES. IN ADDITION, FIRSTHEALTH OF THE CAROLINAS, INC., THROUGH ITS REGIONAL EMERGENCY MEDICAL SERVICES BUSINESS LINE, PROVIDED 18,653 EMERGENCY TRANSPORTS TO RESIDENTS OF THREE NORTH CAROLINA AND ONE SOUTH CAROLINA COUNTIES. IN FISCAL 2011, FIRSTHEALTH RECEIVED $5,249,275 OF OPERATING SUBSIDIES FROM THESE COUNTIES TO OFFSET THE UNREIMBURSED OPERATING COSTS OF PROVIDING THESE ESSENTIAL TRANSPORT SERVICES. FIRSTHEALTH COMMUNITY HEALTH SERVICES MOBILE HEALTH SERVICES FIRSTHEALTH MOBILE HEALTH SERVICES PROVIDES THE FIRSTHEALTH-SERVED COMMUNITIES WITH CONVENIENT ACCESS TO PREVENTIVE HEALTH SCREENINGS AND HEALTH/WELLNESS EDUCATION PROGRAMS/EVENTS AT NO OR LOW COST. SCREENINGS OFFERED INCLUDE: OSTEOPOROSIS, CHOLESTEROL, BLOOD PRESSURE, BLOOD SUGAR, PROSTATE CANCER (PSA) BLOOD DRAW, VASCULAR SCREENINGS FOR ABDOMINAL AORTIC ANEURYSM, CORONARY ARTERY DISEASE, AND PERIPHERAL VASCULAR DISEASE. NINETY-ONE PERCENT OF THOSE WITH ABNORMAL RESULTS WERE REFERRED FOR FURTHER LIFE-SAVING TESTING. IN ADDITION, MOBILE HEALTH SERVICES STAFF PROVIDED 24 EDUCATION EVENTS TO THE RESIDENTS OF THE COMMUNITIES SERVED. ALL MOBILE HEALTH SCREENINGS ARE PROVIDED AT A REDUCED RATE, AND FINANCIAL ASSISTANCE FOR SCREENINGS IS AVAILABLE WHEN APPROPRIATE, BASED ON INCOME. IN FISCAL 2011 FIRSTHEALTH MOBILE HEALTH SERVICES PROVIDED SERVICES TO 2,047 PEOPLE. FIRSTHEALTH PROVIDED $105,168 OF FINANCIAL SUBSIDIES TO OFFSET THE UNFUNDED OPERATING COSTS OF THE MOBILE HEALTH SERVICES PROGRAM IN FISCAL 2011. TOBACCO CESSATION FIRSTHEALTH OFFERED TOBACCO CESSATION PROGRAMS THROUGHOUT ITS SERVICE AREA. A TOBACCO USE PREVENTION AND CESSATION INITIATIVE PROVIDED PREVENTIVE SERVICES THROUGH SCHOOL SYSTEMS AND CESSATION SERVICES THROUGH PROVIDER OFFICES AND OCCUPATIONAL SITES. FIRSTHEALTH SPONSORED THE TOBACCO REALITY UNFILTERED (TRU) PROGRAM THROUGH SUPPORT OF SCHOOL TEENS AGAINST TOBACCO USE (TATU) GROUPS. TATU RECRUITED TEENAGERS TO TEACH YOUNGER CHILDREN ABOUT THE HAZARDS OF TOBACCO USE. FIRSTHEALTH OF THE CAROLINAS WAS AWARDED FUNDING FROM THE NORTH CAROLINA HEALTH AND WELLNESS TRUST FUND (HWTF) TO DEVELOP THE SANDHILLS REGION COMMUNITY COLLEGE TOBACCO-FREE TASK FORCE. THE OVERALL SIX MONTH CUMULATIVE PROGRAM QUIT RATE AS FOR FISCAL 2011 WAS 36%. TATU RECRUITED TEENAGERS TO TEACH YOUNGER CHILDREN ABOUT THE HAZARDS OF TOBACCO. IN FISCAL 2011, 55 TEENS WERE TRAINED AND 156 ADVOCACY ACTIVITIES WERE CONDUCTED TO PROMOTE PREVENTION OF TOBACCO USE. THIS GROUP WAS DESIGNED TO COORDINATE TOBACCO USE PREVENTION AWARENESS ACTIVITIES, PROMOTE CESSATION SERVICES AND CONDUCT GRASSROOTS POLICY ADVOCACY FOR TOBACCO-FREE CAMPUS ENVIRONMENTS. FIRSTHEALTH CONTRIBUTED $20,750 OF FINANCIAL SUBSIDIES TO OFFSET THE UNFUNDED OPERATING COSTS OF THE TOBACCO CESSATION PROGRAMS IN FISCAL 2011. SCHOOL HEALTH PROGRAM THROUGH A PARTNERSHIP WITH MOORE COUNTY SCHOOLS AND THE NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES, THE FIRSTHEALTH SCHOOL HEALTH PROGRAM PROVIDES SCHOOL-BASED NURSES TO 24 SCHOOLS IN MOORE COUNTY. THE PROGRAM HAS RECEIVED BOTH STATE AND NATIONAL RECOGNITION AS A BEST PRACTICE STANDARD AS IT CONTRIBUTES TO THE ACADEMIC SUCCESS AND ADVANCEMENT OF THE WELL BEING AND THE LIFELONG ACHIEVEMENT OF THE SCHOOL-AGED CHILD. SPECIALLY TRAINED NURSES HELP OVER 12,330 SCHOOL CHILDREN EACH YEAR. NURSES PROMOTE HEALTH AND SAFETY, INTERVENE WITH ACTUAL AND POTENTIAL HEALTH PROBLEMS AND PROVIDE CASE MANAGEMENT AND OTHER SERVICES. IN ADDITION TO THE NURSES IN THE SCHOOLS, FIRSTHEALTH ALSO OFFERS ON-SITE MEDICAL CARE AT TWO LOCATIONS IN MONTGOMERY COUNTY. HUNDREDS OF SCHOOL CHILDREN IN MONTGOMERY COUNTY HAVE ACCESS TO MEDICAL CARE ON THE SCHOOL CAMPUS OR JUST STEPS AWAY FROM THE CLASSROOM DOOR. THE TWO SCHOOL HEALTH CENTERS PROVIDE ON-SITE MEDICAL CARE THAT IS SENSIBLE, CONVENIENT, VALUABLE AND OPEN TO ANY CHILD IN THE MONTGOMERY COUNTY SCHOOL SYSTEM. THE CENTERS PROVIDE PHYSICAL, MENTAL, NUTRITIONAL, AND HEALTH AND WELLNESS INTERVENTIONS THAT ARE AVAILABLE TO ALL CHILDREN EVEN IN THE MOST RURAL SECTIONS OF THE COUNTY. A PATIENT SERVICE REPRESENTATIVE, ON-SITE REGISTERED NURSE AND A FAMILY NURSE PRACTITIONER PROVIDE CARE FOR THOUSANDS OF CHILDREN EACH YEAR. MEDICAL PROFESSIONALS STAFFING THESE CENTERS PROVIDE HEALTH, WELLNESS, LEARNING AND EASY ACCESS TO CARE FOR CHILDREN WORKING TOGETHER TO MEET FIRSTHEALTH'S CORE PURPOSE- TO CARE FOR PEOPLE-AS A HOSPITAL WITHOUT WALLS. FIRSTHEALTH PROVIDED $343,387 OF FINANCIAL SUBSIDIES TO OFFSET THE UNFUNDED OPERATING COSTS OF THE SCHOOL HEALTH NURSE PROGRAM AND THE SCHOOL BASED CENTERS IN FISCAL 2011. FIRSTHEALTH MEDICATION ASSISTANCE PROGRAM FIRSTHEALTH CARES HELPS LOW-INCOME INDIVIDUALS OBTAIN FREE OR LOW-COST PRESCRIPTION MEDICATIONS. PATIENTS ARE ELIGIBLE BASED ON MEDICATION NEEDS, LACK OF INSURANCE OR INELIGIBILITY FOR PRESCRIPTION DRUG COVERAGE AND INDIVIDUAL PHARMACEUTICAL COMPANY PROGRAM GUIDELINES. THESE MEDICATIONS ARE FOR CHRONIC DISEASE CONDITIONS SUCH AS ASTHMA, BRONCHITIS, CONGESTIVE HEART FAILURE, COPD, DIABETES, EMPHYSEMA, HYPERTENSION AND HIGH CHOLESTEROL. AN ON-STAFF PHARMACIST MAKES SURE EACH PATIENT'S MEDICATIONS CAN SAFELY BE TAKEN TOGETHER, ARE RIGHT FOR THE PATIENT'S CONDITION, THAT MEDICATIONS ARE NOT UNNECESSARY OR DUPLICATIONS, AND ADVISES IF LESS EXPENSIVE OPTIONS ARE AVAILABLE. THE MEDICATION ASSISTANCE SERVICE IS FREE OF CHARGE. FOR FISCAL 2011, 1,204 PATIENTS WERE SERVED, WITH 7,171 MEDICATIONS RECEIVED, AT AN AVERAGE WHOLESALE PRICE OF $4,178,691 IF THE PATIENTS HAD TO PURCHASE THESE MEDICATIONS. FIRSTHEALTH PROVIDED $4,834 OF FINANCIAL SUBSIDIES TO OFFSET THE UNFUNDED OPERATING COSTS OF FIRSTHEALTH CARES IN FISCAL 2011. DENTAL CARE CENTERS FIRSTHEALTH OPERATES THREE DENTAL CARE CENTERS IN SOUTHERN PINES (MOORE COUNTY), TROY (MONTGOMERY COUNTY) AND RAEFORD (HOKE COUNTY), NORTH CAROLINAS. EACH DENTAL CARE CENTER PROVIDES COMPREHENSIVE DENTAL CARE SERVICES TO MEDICAID AND HEALTHCHOICE-ELIGIBLE CHILDREN UP TO AGE 18. SINCE FEW DENTISTS IN THESE COUNTIES PARTICIPATE IN MEDICAID'S DENTAL PROGRAM, THE FIRSTHEALTH DENTAL CARE CENTERS PROVIDES A TREMENDOUS UNMET NEED IN THE REGION. WHEN THE DENTAL CARE CENTERS OPENED IN 1997, NEARLY HALF OF THE CHILDREN OF LOW-INCOME FAMILIES IN FIRSTHEALTH'S SERVICE AREA WERE GETTING LITTLE TO NO DENTAL CARE SERVICES. IN FISCAL 2011, FIRSTHEALTH'S DENTAL CARE SERVICES PROVIDED 14,804 DENTAL CARE VISITS FOR 4,792 ELIGIBLE CHILDREN RESIDING IN THE THREE COUNTIES SERVED. SECURING AFFORDABLE HEALTH COVERAGE SERVICES TECHNICAL, FINANCIAL AND OTHER ASSISTANCE IS PROVIDED TO UNINSURED PATIENTS TOWARD SECURING HEALTH CARE COVERAGE THROUGH MEDICAID, HEALTH CHOICE AND OTHER COVERAGE PROGRAMS. DURING FISCAL 2011, FIRSTHEALTH ASSISTED 618 CHILDREN WITH SCHOLARSHIPS TO PAY HEALTH CHOICE ENROLLMENT FEES. FIRSTHEALTH CONTINUES TO SPONSOR FIRSTPLAN, A SUBSIDIZED HEALTH INSURANCE PRODUCT FOR SMALL BUSINESSES OFFERING COVERAGE FOR PREVIOUSLY UNINSURED EMPLOYEES. FIRSTHEALTH PROVIDED $201,290 IN FINANCIAL SUBSIDIES TO COVER PREMIUMS PAID BY THE SMALL BUSINESSES PARTICIPATING IN THE FIRSTPLAN PROGRAM IN FISCAL 2011. DIABETES SELF-MANAGEMENT PROGRAM THE FIRSTHEALTH DIABETES SELF-MANAGEMENT PROGRAM, AN AMERICAN DIABETES ASSOCIATION ACCREDITED PROGRAM, ASSISTED PEOPLE WITH OR AT RISK FOR DIABETES AND HELPED THEM GAIN THE KNOWLEDGE AND SKILLS NEEDED TO SELF-MANAGE THE DISEASE AND RELATED CONDITIONS. THIS ASSISTANCE INCLUDED DIABETES SELF-MANAGEMENT EDUCATION (INDIVIDUAL AND GROUP SETTING), MEDICAL NUTRITION THERAPY, HEALTH CARE PROFESSIONAL EDUCATION, DISEASE MANAGEMENT, TELEPHONE CARE MANAGEMENT, COMMUNITY OUTREACH AND CASE MANAGEMENT SERVICES. APPROXIMATELY 1,400 DIABETICS RECEIVED ASSISTANCE THROUGH THIS PROGRAM IN FISCAL 2011. FIRSTHEALTH PROVIDED $4,380 IN FINANCIAL SUBSIDIES TO OFFSET THE UNFUNDED OPERATING COSTS OF THE DIABETES & NUTRITION COUNSELING CENTER IN FISCAL 2011. HEALTHY LIVING IN THE MID-CAROLINAS PROGRAM UNDER A SEVEN-YEAR GRANT FROM THE KATE B. REYNOLDS CHARITABLE TRUST, FIRSTHEALTH PROVIDED EVIDENCE-BASED LIFESTYLE BEHAVIOR CHANGE CLASSES THROUGH THE PEOPLE LIVING ACTIVE YEAR-ROUND (PLAY) AND THE HAPPY KITCHEN (THK) PROGRAMS. 175 LOW-INCOME INDIVIDUALS (FAMILY INCOMES AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL) ENROLLED IN THE PLAY PROGRAM AND 336 ENROLLED IN THE THK PROGRAM IN FISCAL 2011. FIRSTHEALTH PROVIDED $32,921 OF FINANCIAL SUBSIDIES TO OFFSET THE UNFUNDED OPERATING COSTS OF THE HEALTH LIVING INITIATIVES IN FISCAL 2011. SUPPORT IN THE COMMUNITY FIRSTHEALTH EMPLOYEES IDENTIFY LOCAL NEEDS AND RECOMMEND IN-KIND AND FINANCIAL SUPPORT TO ORGANIZATIONS IN NEED. DURING FISCAL 2011, FIRSTHEALTH SUPPORTED HEALTH EDUCATION EVENTS, DISTRIBUTED EQUIPMENT AND PROMOTED COMMUNITY-BASED HEALTH INITIATIVES. FIRSTHEALTH ALSO PROVIDED MEALS FOR OVER 50 COMMUNITY MEETINGS AND EVENTS. THOUGH THESE INITIATIVES, FIRSTHEALTH SERVED 44,234 PEOPLE AT A COST OF $252,081 FOR FISCAL 2011. VOLUNTEER EFFORTS BY FIRSTHEALTH EMPLOYEES FIRSTHEALTH PROVIDED ALMOST 1,100 HOURS OF ASSISTANCE TO THE COMMUNITY IN THE AREAS OF LEADERSHIP, PLANNING, RESOURCE IDENTIFICATION, TIME MANAGEMENT AND INFORMATION SYSTEMS ON A LOW OR NO-COST BASIS. FIRSTHEALTH PARTICIPATED IN AND PROVIDED ADMINISTRATIVE SUPPORT TO COUNTY-BASED MULTI-AGENCY GROUPS INCLUDING MOOREHEALTH, MONTGOMERY COMMUNITY RESOURCE TEAM, RICHMOND HEALTHY CAROLINIANS, AND HEALTHY HOKE. LOCAL SAFE KIDS COALITIONS WERE ALSO SUPPORTED IN MONTGOMERY, MOORE AND RICHMOND COUNTIES AS PART OF THE STATEWIDE INITIATIVE TO REDUCE CHILDHOOD INJURIES. THESE GROUPS HOSTED EVENTS SUCH AS BIKE RODEOS AND CAR SEAT SAFETY CHECKS. FAMILY ASSISTANCE FIRSTHEALTH'S PASTORAL CARE SERVICES PROVIDED FREE MEALS FOR MORE THAN 758 FAMILY MEMBERS STAYING WITH LOVED ONES IN THE HOSPITAL WHO COULD NOT AFFORD MEALS AND HOUSING. THE COST TO FIRSTHEALTH FOR FREE MEALS PROVIDED IN FISCAL 2011 TOTALED $9,068, WITH AN ADDITIONAL $8,097 PAID TO AREA HOTELS FOR TEMPORARY HOUSING PROVIDED TO 126 FAMILY MEMBERS. MOORE AND MONTGOMERY COUNTIES - FREE CARE CLINIC THE MOORE FREE CARE CLINIC (MFCC) IS A PRIVATE, VOLUNTEER-BASED, NON-PROFIT ORGANIZATION THAT PROVIDES PRIMARY HEALTH CARE SERVICES AT NO COST TO THE LIMITED-INCOME RESIDENTS OF MOORE COUNTY THAT LACK HEALTH CARE INSURANCE COVERAGE. FIRSTHEALTH PROVIDED DIRECT FINANCIAL SUPPORT TOTALING $45,000 IN FISCAL 2011 TO MFCC IN SUPPORT OF ITS MISSION. PATIENTS OF MFCC THAT REQUIRED INPATIENT/OUTPATIENT ACUTE CARE SERVICES WERE REFERRED TO FIRSTHEALTH MOORE REGIONAL HOSPITAL FOR CARE, GENERATING A TOTAL OF 1,689 PATIENT ENCOUNTERS IN FISCAL 2011. THE $724,148 COST OF PROVIDING THESE SERVICES IN FISCAL 2011 WAS ABSORBED BY FIRSTHEALTH. FIRSTHEALTH ALSO PROVIDED PHYSICIANS, NURSES AND PHYSICAL THERAPISTS TO MFCC, AND FIRSTHEALTH ABSORBED ANY ADDED COSTS ASSOCIATED WITH PROVIDING THIS COVERAGE. THE MONTGOMERY COUNTY FREE CLINIC (MCFC), INCORPORATED IN NOVEMBER 2009, PROVIDES PRIMARY HEALTH CARE SERVICES AT NO COST TO THE LIMITED-INCOME RESIDENTS OF MONTGOMERY COUNTY THAT LACK HEALTH CARE INSURANCE COVERAGE. PATIENTS OF MCFC THAT REQUIRED INPATIENT/OUTPATIENT ACUTE CARE SERVICES WERE REFERRED TO FIRSTHEALTH MONTGOMERY MEMORIAL HOSPITAL FOR CARE, GENERATING A TOTAL OF 340 PATIENT ENCOUNTERS IN FISCAL 2011. THE $89,600 COST OF PROVIDING THESE SERVICES IN FISCAL 2011 WAS ABSORBED BY FIRSTHEALTH. IN ADDITION, FIRSTHEALTH PROVIDED OFFICE SPACE TO MCFC AT 104 PROFESSIONAL DRIVE, BISCOE, NC. MCFC PAID $1 PER YEAR IN RENT FOR THE SPACE. FIRSTHEALTH ABSORBED A TOTAL OF $9,793 IN OPERATING COSTS ON THE MCFC BUILDING IN FISCAL 2011. MEDICAL STAFF DEVELOPMENT / PHYSICIAN RECRUITMENT ASSISTANCE FIRSTHEALTH PROVIDES FINANCIAL ASSISTANCE TO AREA PHYSICIAN PRACTICES AND INDIVIDUAL PHYSICIANS FOR THE RECRUITMENT OF PHYSICIANS TO PRACTICE IN THE GEOGRAPHIC AREAS SERVED BY THE THREE FIRSTHEALTH HOSPITALS. UNDER FIRSTHEALTH'S MEDICAL STAFF DEVELOPMENT PLAN, RECRUITMENT ASSISTANCE IS APPROPRIATE TO: (1) ADD PHYSICIANS IN AN UNDER-SERVED GEOGRAPHIC LOCATION; (2) ADD OR ENHANCE A SERVICE OF THE HOSPITAL OR COMMUNITY; OR (3) INCREASE PHYSICIAN COVERAGE WHERE THERE IS AN EXISTING SHORTAGE. DURING FISCAL 2011, FIRSTHEALTH PARTICIPATED IN A SEARCH FOR AN OB/GYN IN MOORE COUNTY. FIRSTHEALTH ALSO FORGAVE APPROXIMATELY $91,208 IN PAYMENTS MADE IN PRIOR YEARS TOWARD THE RECRUITMENT OF A PEDIATRICIAN AND PSYCHIATRIST IN MOORE COUNTY. IN ADDITION TO RECRUITMENT ASSISTANCE PROVIDED TO THE AREA PHYSICIAN PRACTICES, FIRSTHEALTH ALSO RECRUITED A TOTAL OF TEN PHYSICIANS AND MID-LEVEL PRACTITIONERS TO ITS HOSPITALIST PROGRAMS AT THE THREE FIRSTHEALTH HOSPITALS IN FISCAL 2011. 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