2012-05-14T08:19:35-05:00 2011-06-30 PERSHING YOAKLEY & ASSOCIATES P C ONE CHEROKEE MILLS 2220 SUTHERLAND KNOXVILLE TN 379192363 990 2010-07-01 331216751 HUGHSTON HOSPITAL INC HUGH 7066606303 707 CENTER STREET COLUMBUS GA 31901 ROLAND L THACKER 7065711927 2012-05-14 1 SUSAN CLARK 8656730844 2010 2016-02-24 21:20:13Z LARRY S SANDERS 707 CENTER STREET COLUMBUS GA 31901 69715509 0 X COLUMBUSREGIONAL.COM X 2008 GA THE MISSION OF HUGHSTON HOSPITAL, INC. IS TO PROMOTE THE HEALTH AND HEALING OF OUR PATIENTS. 13 10 450 2 0 0 0 0 64730769 69695333 6686 12579 0 0 64737455 69707912 0 145263 0 0 18103426 18579176 0 0 0 42422688 43606064 60526114 62330503 4211341 7377409 72372490 78233824 70425525 68895922 1946965 9337902 X HUGHSTON HOSPITAL PROVIDES OUR COMMUNITY EXCELLENCE IN ORTHOPEDIC AND REHABILITATIVE CARE. BECAUSE THIS IS A SPECIALTY HOSPITAL, SERVICES ARE FOCUSED EXCLUSIVELY ON ORTHOPEDIC RELATED NEEDS.HUGHSTON HOSPITAL WAS THE NATION'S FIRST HOSPITAL DESIGNED SPECIFICALLY TO TREAT PATIENTS WITH MUSCULOSKELETAL INJURIES OR DISORDERS. TODAY, THE 100-BED, PRIVATE ROOM, SPECIALTY HOSPITAL IS NATIONALLY RECOGNIZED FOR DELIVERING OUTSTANDING CLINICAL QUALITY AND THE HIGHEST LEVELS OF CUSTOMER SERVICE. SERVICES ARE DELIVERED THROUGH A HIGHLY SPECIALIZED TEAM OF PROFESSIONALS USING THE LATEST TECHNOLOGY AND RESEARCH TO CARE FOR PEOPLE OF EVERY AGE AND ABILITY AND EVERY LEVEL OF MUSCULOSKELETAL INJURY OR DISORDER. 0 0 3454569 2704326 REHABILITATIONTHE REHABILITATION CENTER AT HUGHSTON HOSPITAL OFFERS THE BEST POSSIBLE REHABILITATIVE CARE DESIGNED TO SERVE INDIVIDUALS WHO HAVE A NEED FOR ACUTE INPATIENT REHABILITATION. HUGHSTON'S REHABILITATION CENTER OFFERS A VARIETY OF THERAPEUTIC TREATMENTS DESIGNED TO GET EMPLOYEES BACK TO WORK, GET PHYSICALLY ACTIVE INDIVIDUALS PLAYING AGAIN AND GET EACH PATIENT TO ENJOYING LIFE. THE THERAPY IS ADMINISTERED IN A HOME-LIKE AREA AIMED AT RESTORING A PATIENT'S FUNCTIONS RELATED TO DAILY LIVING ACTIVITIES. THE PROGRAM INCLUDES FAMILY-CENTERED CARE, AROUND THE CLOCK VISITATION AND ROOMING IN.THE GOAL OF THE PROGRAM IS TO ASSIST INDIVIDUALS IN REGAINING THEIR INDEPENDENCE. THE PROGRAM FEATURES A HIGHLY STRUCTURED ENVIRONMENT AND INDIVIDUAL ASSISTANCE BY A MULTI-DISCIPLINARY TEAM OF PROFESSIONALS, ALL IN A THERAPEUTIC, RESIDENTIALLY FOCUSED SETTING. THE REHABILITATION IS RESIDENTIALLY FOCUSED WHERE FAMILY MEMBERS ARE ENCOURAGED TO JOIN THEM. 4625328 14394696 RECONSTRUCTIVE TRAUMAHUGHSTON HOSPITAL OFFERS THE ONLY ORTHOPEDIST SPECIALIZING IN TRAUMATOLOGY IN THE REGION. HUGHSTON'S ADVANCED RECONSTRUCTIVE TRAUMA SERVICES OFFERS PATIENTS MORE TREATMENT OPTIONS FOR MULTIPLES BROKEN BONES IN MULTIPLE LIMBS, BROKEN BONES THAT DON'T HEAL CORRECTLY OR A SEVERE INJURY.OFTEN, TRAUMATOLOGISTS ARE CONSULTED ABOUT A SEVERELY INJURED PATIENT WHO IS EN ROUTE TO THE HOSPITAL SO THEY CAN BE IN THE EMERGENCY ROOM WHEN THE PATIENT ARRIVES. THIS ALLOWS THE TRAUMATOLOGIST TO BE INVOLVED IN WHAT HAS BECOME KNOWN AS THE "GOLDEN HOUR" OF TRAUMA CARE. DURING THIS PERIOD, DECISIONS HAVE TO BE MADE RAPIDLY WITH VERY LITTLE TIME FOR REFLECTION. ALTHOUGH ALL ORTHOPEDISTS TREAT COMMON INJURIES, THE HUGHSTON TRAUMATOLOGIST IS SOUGHT OUT FOR THE DEFINITIVE CARE OF THE MOST COMPLEX PROBLEMS. 144000 144000 SPORTS MEDICINEHUGHSTON HOSPITAL'S DEDICATION TO KEEPING THE ATHLETIC COMMUNITY HEALTHY AND ACTIVE IS EVIDENCED BY THE COMPREHENSIVE NATURE OF THE PROGRAMMING. IN ADDITION TO PROVIDING SPECIALIZED ASSESSMENT OF SPORTS-RELATED INJURIES, HUGHSTON'S ATHLETIC TRAINERS ARE ALSO ACTIVELY INVOLVED IN EDUCATING THE AREA'S ATHLETES, COACHES, AND PARENTS ABOUT INJURY PREVENTION AND RECOGNITION. THIS EDUCATIONAL PROGRAMMING IS AN INTEGRAL FACTOR IN HUGHSTON HOSPITAL'S SUCCESS. PROVIDING PROGRAMS TO THE COMMUNITY THAT TEACH PROPER STRENGTH BUILDING, FLEXIBILITY, CONDITIONING, ENDURANCE AND TRAINING TECHNIQUES HELPS MINIMIZE THE RISK OF INJURY OCCURRENCE. BY INTEGRATING TRAINING PROGRAMS WITH LOCAL SCHOOL DISTRICTS AND COMMUNITY VENUES, HUGHSTON'S ATHLETIC TRAINERS HAVE HELPED THOUSANDS OF INDIVIDUALS BETTER UNDERSTAND HOW TO CARE FOR THEIR BODIES BEFORE, DURING AND AFTER PARTICIPATING IN ATHLETICS.OTHER ORTHOPEDIC AND REHABILITATIVE SERVICES PROVIDED TO PATIENTS IN THE OPERATION OF THE HOSPITAL IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT MISSION. 43495708 1263 52596311 43495708 1263 52596311 51719605 1 0 0 1 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 77 0 1 450 1 0 0 0 0 0 0 0 0 0 0 X 13 10 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 GA X ROLAND L THACKER TREASURER 7066606303 710 CENTER STREET COLUMBUS GA 31901 LARRY S SANDERS 40.00 X X 0 783770 651273 MAX BRABSON JR 2.00 X 0 0 0 KATHRYN CHEEK MD 2.00 X 0 0 0 CECIL CHEVES ESQ 2.00 X 0 0 0 EUGENE DEMONET 2.00 X 0 0 0 WILLIAM ROUNDTREE MD 2.00 X 0 0 0 MICHAEL GORUM MD 2.00 X 0 0 0 JULIUS HUNTER ESQ 2.00 X 0 0 0 GEORGE JETER 2.00 X 0 0 0 DAVID B MCMICKEN MD 2.00 X 0 0 0 CAROLE RUTLAND PHD 2.00 X 0 0 0 WARREN STEELE 2.00 X 0 0 0 HENRY SWIFT JR 2.00 X 0 0 0 LANCE DUKE 40.00 X 0 434366 85936 ROLAND L THACKER 40.00 X 0 347892 60143 KAREN SMITH 40.00 X 0 65423 20377 JAMES WHEELER 40.00 X 242988 0 96264 DONALD ELDER 40.00 X 0 229889 83922 MICHELLE BREITFELDER 40.00 X 165783 0 19696 MARLENE CHIN 40.00 X 125618 0 8195 JOHN LESH 40.00 X 112761 0 16902 HUGH TAYLOR 40.00 X 131810 0 14902 JOHNNY DOLES 40.00 X 126711 0 27540 JANET PETERS 40.00 X 101302 0 8351 1006973 1861340 1093501 8 0 1 0 AMSOL ANESTHETISTS P O BOX 6633 HIGH POINT NC 27262 ANESTHESIA SERVICES 532632 RADIOLOGY ASSOCIATES 717 20TH STREET COLUMBUS GA 31904 RADIOLOGY SERVICES 381622 HUMAN PERFOMANCE REHAB CENTER PO BOX 8068 COLUMBUS GA 31908 INTRA-OP MONITORING 375900 AMSOL PHYSICIANS P O BOX 6633 HIGH POINT NC 27262 PHYSICIAN SERVICES 200457 HEARTLAND INFORMATION SYSTEMS DEPT CH 16462 PALATINE IL 60055 TRANSCRIPTIONISTS 152485 7 PATIENT REVENUE 621400 69236356 69236356 CAFETERIA 621400 314986 314986 HOSPITAL GIFT SHOP 453220 87674 87674 MEDICAL RECORDS 621400 33161 33161 OTHER PROGRAM SERVICE 621400 23156 23156 69695333 20176 20176 7597 -7597 -7597 -7597 69707912 69236356 0 471556 145263 145263 15597393 14535591 1061802 1932680 1816599 116081 1049103 1057188 -8085 2754435 2754435 10215 10215 5840532 5147723 692809 163469 140529 22940 874152 696020 178132 1273240 1247091 26149 27285 19457 7828 15955 10595 5360 2761340 2761340 2407684 2407684 163280 163280 SUPPLIES 25248487 25175184 73303 PROVIDER TAX 909096 909096 NON-CAPITALIZED EQUIPME 325168 259378 65790 LEASE EXPENSE 200698 200698 BAD DEBT 131595 131595 499433 227598 271835 62330503 51719605 10610898 0 1620443 3703018 9509540 11302678 5893961 5876359 174356 205321 60698159 7484722 55027138 53213437 147052 3933011 72372490 78233824 5489615 6296504 60539350 62323012 4396560 276406 70425525 68895922 X 1946965 9337902 1946965 9337902 72372490 78233824 X 7377409 13528 X 0 1 1 X 0 X X 27379 27379 518735973 518763352 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 24849 21646 31169 27379 105043 250000 250000 250000 250000 1000000 1500000 4190000 4190000 48124170 3609429 44514741 8383989 3875293 4508696 53213437 BOND ISSUE COSTS 2096916 ASSETS LIMITED AS TO USE 1775240 THIRD PARTY SETTLEMENTS 60855 3933011 DUE TO AFFILIATES 276406 276406 69707912 62330503 7377409 13528 13528 7390937 69695333 0 69695333 12579 12579 69707912 62330503 0 62330503 0 62330503 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE HOSPITAL IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. AT JUNE 30, 2011, MANAGEMENT DOES NOT BELIEVE THE HOSPITAL HOLDS ANY UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENTS RECOGNITION OR DISCLOSURE UNDER FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES (ASC 740). PART XII, LINE 4B - OTHER ADJUSTMENTS: NON-OPERATING REVENUE, NET 12,579. 1 1 X 1 X 1 X 1 1 1 0 1 1 173860 173860 0.00280 690337 518827 171510 0.00280 864197 518827 345370 0.00560 147210 235 146975 0.00240 147210 235 146975 0.00240 1011407 519062 492345 0.00800 1 40900 17418338 23075831 -5657493 X 1 1 1 1 HUGHSTON HOSPITAL INC

707 CENTER STREET COLUMBUS GA 31901

X X NA 1 PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT FOR THE HUGHSTON HOSPITAL, INC. WAS PREPARED BY 501(C)(3) AFFILIATE, COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. DATA PRESENTED IN THE REPORT ALSO INCLUDES OTHER 501(C)(3) AFFILIATES DOCTOR'S HOSPITAL, INC. (#26-1739383) AND THE MEDICAL CENTER, INC. (#58-1685139) PART I, LINE 7: THE AMOUNTS ON LINE 7, COLUMN C WERE CALCULATED USING THE COST TO CHARGE RATIO FROM THE ORGANIZATION'S FY 2011 FILED MEDICARE COST REPORT AND IS A COMPOSITE OF TRADITIONAL AND MANAGED CARE MEDICARE AND TRICARE COST TO CHARGE RATIOS EXCLUDING INPATIENT REHAB UNIT. PART I, L7 COL(F): BAD DEBT EXPENSE IN THE AMOUNT OF $131,596 WAS SUBTRACTED FROM FORM 990, PART IX, LINE 25 FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN. PART II: N/A PART III, LINE 4: THE AMOUNTS OF BAD DEBT EXPENSE AT COST WAS CALCULATED USING THE COST TO CHARGE RATIO FROM THE ORGANIZATION'S FY 2011 FILED MEDICARE COST REPORT AND IS A COMPOSITE OF TRADITIONAL AND MANAGED CARE MEDICARE AND TRICARE COST TO CHARGE RATIOS EXCLUDING INPATIENT REHAB UNIT.THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE DESCRIBING BAD DEBT EXPENSE. BAD DEBT EXPENSE REPORTED ON THE INCOME STATEMENT IS CALCULATED ON HISTORICAL WRITE OFFS AND THE PERCENTAGE OF GROSS CHARGES. ONCE GROSS CHARGES FOR SELF-PAY PATIENTS ARE CALCULATED FOR THE MONTH THEN THE HISTORICAL PERCENTAGE IS APPLIED TO THE CHARGES AND REPORTED ON THE FINANCIAL STATEMENT. PART III, LINE 8: HUGHSTON HOSPITAL, INC. FEELS THAT ALL OF THE MEDICARE SHORTFALL REPORTED ON LINE 7 SHOULD BE TREATED AS COMMUNITY BENEFIT. MEMBERS OF THE MEDICARE COMMUNITY ARE PROVIDED THE SAME CARE AND TREATMENT AS ALL OTHER PATIENTS OF THIS FACILITY. BECAUSE OF LOW PAYMENT RATES OF THE MEDICARE PROGRAM, LOSSES RELATED TO SERVING THIS IMPORTANT POPULATION OF OUR COMMUNITY INDICATE THAT THE HUGHSTON HOSPITAL, INC. IS DEDICATED TO PROVIDING QUALITY HEALTHCARE TO ALL PATIENTS. THE SOURCE USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 WAS THE MEDICARE COST REPORT. PART III, LINE 9B: IT IS THE POLICY OF THE HUGHSTON HOSPITAL, INC. TO PROVIDE QUALITY MEDICAL CARE TO ALL PATIENTS. THOSE PATIENTS REQUIRING FINANCIAL ASSISTANCE ARE TREATED IN THIS FACILITY AND ARE TREATED EQUALLY REGARDLESS OF THEIR ABILITY TO PAY. PATIENTS THAT HAVE QUALIFIED FOR FINANCIAL ASSISTANCE ARE CATEGORIZED INTO GROUPS IN ORDER TO CAPTURE THEIR DISPOSITION FOR THE STATE OF GEORGIA INDIGENCY GUIDELINES.UNINSURED PATIENTS AUTOMATICALLY QUALIFY FOR FINANCIAL ASSISTANCE IF INCOME LEVELS ARE AT OR BELOW 200% OF LATEST PUBLISHED FEDERAL POLICY GUIDELINES. PATIENT CHARGES ARE DISCOUNTED 100% IF PATIENT AND/OR GUARANTOR'S ANNUAL INCOME IS AT OR BELOW 200% OF LATEST PUBLISHED FEDERAL POLICY GUIDELINES. ONCE CLASSIFIED IN ONE OF THESE GROUPS, THE ORGANIZATION DOES NOT SEEK TO COLLECT ANY AMOUNTS WRITTEN OFF UNDER THIS POLICY FROM SUCH PATIENTS.ALL PATIENTS REQUIRING FINANCIAL ASSISTANCE ARE ASKED TO COMPLETE AN APPLICATION PROVIDING DEMOGRAPHIC INFORMATION, UNINSURED STATUS AND INCOME. UNINSURED PATIENTS NOT MEETING FINANCIAL ASSISTANCE CRITERIA AUTOMATICALLY RECEIVE A PERCENTAGE DISCOUNT FROM GROSS CHARGES EQUIVALENT TO A CALCULATED AVERAGE CONTRACTED INSURED DISCOUNT. PART VI, LINE 2: HUGHSTON HOSPITAL, INC. NEEDS ASSESSMENT WAS DEVELOPED USING AN EXISTING COMMUNITY-BASED ASSESSMENT PROCESS SPONSORED BY SEVERAL HEALTH ORGANIZATIONS SUCH AS: GEORGIA HEALTH FACTS 2008; GEORGIA HEALTH EQUITY INITIATIVE; CRITICAL NEEDS ASSESSMENT OF MUSCOGEE COUNTY; HEALTHY PEOPLE 2010; AND CDC BEHAVIORAL RISK FACTORS STUDY.THE NEEDS ASSESSMENT CONSISTED OF:A)SURVEY OF EXISTING STATE AND LOCAL HEALTH DATA RELATED TO MORTALITY AND MORBIDITYB)COMPARISON OF OUR COMMUNITY HEALTH PICTURE TO THE STATE AND NATION BY REVIEWING AVAILABLE HOSPITAL DRG'SC)INTERVIEWS WITH HOSPITAL DEPARTMENTS WITH QUESTIONS SUCH AS: 1)WHAT ARE YOU SEEING AS AN UNMET NEED, A GAP IN SERVICE, OR AS A CAUSE TO A MEDICAL CONDITION OR SITUATION? 2)ARE THERE REPEAT QUESTIONS, CONCERNS, OR SITUATIONS WITH WHICH YOU ARE FACED? IS THERE A FIX? IF SO, WHAT IS IT? 3)DO YOU HAVE A LIST OF COMMUNITY RESOURCES/REFERRALS APPROPRIATE TO YOUR DEPARTMENT OR SERVICE? 4)WHAT DO YOU SEE YOUR DEPARTMENT CONTRIBUTING IN THE WAY OF COMMUNITY BENEFIT? PART VI, LINE 3: THE ORGANIZATION HAS POSTED SIGNS IN ALL PATIENT ACCESS AREAS INFORMING THE PATIENTS OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAMS. WRITTEN INFORMATION IS ALSO PROVIDED TO ALL PATIENTS AT THE POINT OF REGISTRATION.ON ALL STATEMENTS SENT TO PATIENTS THERE IS A MESSAGE ABOUT WHO TO CALL IF FINANCIAL ASSISTANCE IS NEEDED. PART VI, LINE 4: HUGHSTON HOSPITAL, INC., LOCATED IN COLUMBUS, GEORGIA, IS A NOT-FOR-PROFIT 100 BED, PRIVATE ROOM, SPECIALTY HOSPITAL THAT IS NATIONALLY RECOGNIZED FOR DELIVERING OUTSTANDING CLINICAL QUALITY AND THE HIGHEST LEVELS OF CUSTOMER SERVICE. COLUMBUS IS LOCATED APPROXIMATELY 100 MILES SOUTHWEST OF ATLANTA AND IS THE THIRD LARGEST CITY IN THE STATE OF GEORGIA AND THE 123RD LARGEST CITY IN THE UNITED STATES. THE CITY COVERS A TOTAL OF 220.8 SQUARE MILES WHICH INCLUDES 4.7 MILES OR WATER AND 216.1 MILES OF LAND. COLUMBUS IS LOCATED APPROXIMATELY ONE MILE FROM THE ALABAMA/GEORGIA BOUNDARY AND SERVES 2 COUNTIES IN ALABAMA. IN 2010, THE COLUMBUS, GEORGIA METROPOLITAN AREA HAD AN ESTIMATED POPULATION OF 189,885. THE WEST GEORGIA HEALTH DISTRICT IS LOCATED IN COLUMBUS AND SERVES A 15 COUNTY AREA IN GEORGIA WHICH INCLUDES TWO OF GEORGIA'S POOREST COUNTIES.THE POPULATION OF MUSCOGEE COUNTY IS COMPRISED OF 48.7% MALE AND 51.3% FEMALE. THE ETHNIC MIX OF THE POPULATION IS 50.42% WHITE, 43.74% BLACK, 4.4% HISPANIC AND 1.44% OTHER. APPROXIMATELY 2.2% ARE PERSONS OF MIXED RACE. PERSONS UNDER THE AGE OF 5 ACCOUNT FOR 7.34% OF THE POPULATION WHILE PERSONS UNDER AGE 18 ACCOUNT FOR 26.8% AND PERSONS OVER THE AGE OF 65 ACCOUNT FOR 11.7%.THERE ARE APPROXIMATELY 2.54 PERSONS PER HOUSEHOLD. MEDIAN INCOME FOR THIS AREA IS $34,276. A TOTAL OF 15.7% OF THE POPULATION IN THIS AREA IS BELOW THE POVERTY LEVEL. HOSPITALS SERVING MUSCOGEE COUNTY AND SURROUNDING AREAS INCLUDE THE MEDICAL CENTER, INC., DOCTOR'S HOSPITAL, INC., ST. FRANCIS HOSPITAL, AND EAST ALABAMA MEDICAL CENTER. THE AREA IS ALSO SERVED BY SPECIALTY HOSPITALS INCLUDING HUGHSTON HOSPITAL, INC., REGIONAL REHABILITATION HOSPITAL, AND JACK HUGHSTON MEMORIAL HOSPITAL. PART VI, LINE 6: SINCE 1984, HUGHSTON HOSPITAL HAS PROVIDED OUR COMMUNITY EXCELLENCE IN ORTHOPEDIC AND REHABILITATIVE CARE. BECAUSE THIS IS A SPECIALTY HOSPITAL, SERVICES ARE FOCUSED EXCLUSIVELY ON ORTHOPEDIC AND REHABILATIVE CARE.SERVICES ARE DELIVERED THROUGH A HIGHLY SPECIALIZED TEAM OF PROFESSIONALS USING THE LATEST TECHNOLOGY AND RESEARCH TO CARE FOR PEOPLE OF EVERY AGE AND ABILITY AND EVERY LEVEL OF MUSCULOSKELETAL INJURY OR DISORDER. HUGHSTON HOSPITAL WAS THE NATION'S FIRST HOSPITAL DESIGNED SPECIFICALLY TO TREAT PATIENTS WITH MUSCULOSKELETAL INJURIES OR DISORDERS. TODAY, THE 100-BED, PRIVATE ROOM, SPECIALTY HOSPITAL IS NATIONALLY RECOGNIZED FOR DELIVERING OUTSTANDING CLINICAL QUALITY AND THE HIGHEST LEVELS OF CUSTOMER SERVICE. HUGHSTON HOSPITAL, INC. BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY LEADERS DEDICATED TO PROVIDING QUALITY HEALTHCARE FOR OUR COMMUNITY. IN GENERAL, OUR VOLUNTEER BOARD MEMBERS ARE PERSONS WHO RESIDE IN OUR PRIMARY SERVICE AREA AND NEITHER THEY (NOR THEIR FAMILY MEMBERS) ARE EMPLOYEES OR CONTRACTORS OF THE ORGANIZATION.MEDICAL STAFF PRIVILEGES IN THE HOSPITAL IS AVAILABLE TO ALL QUALIFIED PHYSICIANS AS DETERMINED THROUGH A DETAILED CREDENTIALING PROCESS. HUGHSTON HOSPITAL, INC. HAS OVER 200 AFFILIATED PHYSICIANS WITH 100 PHYSICIANS IN THE ACTIVE OR ACTIVE PROVISIONAL CATEGORIES PROVIDING HEALTHCARE SERVICE AT HUGHSTON HOSPITAL, INC.THE ORGANIZATION REINVESTS ALL PROFITS BACK INTO PHYSICIAN AND STAFF TRAINING, AND FACILITIES AND EQUIPMENT TO CONTINUALLY IMPROVE PATIENT CARE. IN CONTRAST TO INVESTOR-OWNED HOSPITALS, NO PART OF NET EARNINGS DIRECTLY OR INDIRECTLY BENEFITS ANY PRIVATE SHAREHOLDERS OR INDIVIDUALS.ALL FACILITIES PARTICIPATE IN MEDICARE, MEDICAID, CHAMPUS AND PEACHCARE AS APPROPRIATE FOR SERVICES PROVIDED. PART VI, LINE 7: HUGHSTON HOSPITAL, INC. IS PART OF THE COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. THIS SYSTEM WAS ORGANIZED TO PLAN, DEVELOP AND COORDINATE THE ACTIVITIES OF AN INTEGRATED HEALTH NETWORK SERVING WEST GEORGIA AND EAST ALABAMA. ITS RESPONSIBILITIES INCLUDE STRATEGIC PLANNING, PROJECT DEVELOPMENT, RESOURCE ALLOCATION, PROPERTY MANAGEMENT, DEVELOPMENT OF PHYSICIAN PRACTICES, MARKETING AND COMMUNICATION AND COMMUNITY HEALTH EDUCATION. AS A PART OF THIS SYSTEM, HUGHSTON HOSPITAL, INC. MAKES QUALITY HEALTH CARE SERVICES AVAILABLE TO EVERYONE IN ITS SERVICE AREA, REGARDLESS OF A PATIENT'S ABILITY TO PAY. THE SERVICES PROVIDED INCLUDE ACUTE, PRIMARY AND PREVENTIVE CARE, MEDICAL EDUCATION, CLINICAL TRAINING AND COMMUNITY EDUCATION. AFFILIATES OF HUGHSTON HOSPITAL, INC. IN THE COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. INCLUDE:1)THE MEDICAL CENTER, INC. - A NOT-FOR-PROFIT 413-LICENSED BED, ACUTE-CARE HOSPITAL, 128-BED LONG-TERM CARE FACILITY AND 19-BED TRANSITIONAL CARE UNIT LOCATED IN COLUMBUS, GEORGIA. IN KEEPING WITH ITS TAX EXEMPT MISSION, THE MEDICAL CENTER MAKES QUALITY HEALTH CARE SERVICES AVAILABLE TO EVERYONE IN ITS SERVICE AREA, REGARDLESS OF A PATIENT'S ABILITY TO PAY. THE SERVICES PROVIDED INCLUDE ACUTE, PRIMARY AND PREVENTIVE CARE, MEDICAL EDUCATION, CLINICAL TRAINING AND COMMUNITY EDUCATION.2)CRHS LONG TERM AND HOME CARE, INC. - A NOT-FOR-PROFIT ORGANIZATION PROVIDING SKILLED NURSING FACILITIES FOR RESIDENTS OF MUSCOGEE COUNTY. CRHS LONG TERM AND HOME CARE, INC. OPERATES AZALEA TRACE NURSING CENTER IN COLUMBUS, GEORGIA. AZALEA TRACE IS A 110-BED SKILLED NURSING FACILITY ADJACENT TO THE COLUMBUS REGIONAL HEALTHCARE SYSTEM MEDICAL CAMPUS. AZALEA TRACE NURSING CENTER IS 85% MEDICAID.3)COLUMBUS AMBULATORY HEALTHCARE SERVICES, INC. - A NOT-FOR PROFIT COMPANY SERVING COLUMBUS AND SURROUNDING COUNTIES. COLUMBUS AMBULATORY HEALTHCARE SERVICES PROVIDES A WIDE VARIETY OF PRIMARY AND SPECIALTY PHYSICIAN SERVICES TO ALL PATIENTS REQUESTING SUCH SERVICES REGARDLESS OF ABILITY TO PAY. MANY OF THESE PATIENTS ARE CLASSIFIED AS INDIGENT RESIDENTS OF MUSCOGEE COUNTY, AND AS SUCH ARE COVERED THROUGH A CONTRACTUAL AGREEMENT WITH THE COLUMBUS CONSOLIDATED GOVERNMENT.4)COLUMBUS REGIONAL MEDICAL FOUNDATION, INC. - A NOT-FOR-PROFIT FOUNDATION ESTABLISHED IN 1983 TO ENDOW AND PROMOTE THE MEDICAL, CHARITABLE AND EDUCATIONAL SERVICES OF THE MEDICAL CENTER. PRIMARY FUNCTIONS OF THE FOUNDATION INCLUDE FUND-RAISING TO SUPPORT THE JOHN B. AMOS CANCER CENTER AT THE MEDICAL CENTER AND THE CHILDREN'S MIRACLE NETWORK, TO SUPPORT CLINICAL EDUCATION THROUGH STUDENT SCHOLARSHIPS AND FELLOWSHIPS, AND TO PROVIDE FUNDING FOR THE MEDICAL CENTER TO PURCHASE HEALTH, MEDICAL AND RELATED EQUIPMENT TO BENEFIT PATIENTS AND ENHANCE SERVICES TO THE COMMUNITY.5)DOCTOR'S HOSPITAL, INC. - A NOT-FOR-PROFIT 219-BED FACILITY OFFERING A FULL LINE OF MEDICAL AND SURGICAL SERVICES. DOCTOR'S HOSPITAL ALSO OFFERS BUSINESS HEALTH, CARDIO CATHETERIZATION, EMERGENCY SERVICES, OBSTETRICS SERVICES, OUTPATIENT SURGERY, RADIOLOGY, REHABILITATION SERVICES, SLEEP DISORDERS CENTER AND TELEMETRY SERVICES. THIS COMPREHENSIVE NETWORK OF SERVICES TOUCHES THE LIVES OF MOST OF THE CHILDREN AND ADULTS IN THIS REGION. DOCTOR'S HOSPITAL PLACES A PRIORITY ON EACH PATIENT ENCOUNTER AND LISTENS TO THE NEEDS OF THE COMMUNITY AND PROVIDES A HIGH QUALITY SERVICE TO CONTINUALLY MEET THOSE NEEDS.6)COLUMBUS REGIONAL SENIOR LIVING, INC. - A NOT-FOR-PROFIT CONTINUING CARE RETIREMENT COMMUNITY NAMED SPRING HARBOR AT GREEN ISLAND. SPRING HARBOR PROVIDES CONTINUING CARE LIVING FOR INDEPENDENT OLDER ADULTS WITH COMPREHENSIVE HEALTH AND MEDICAL SERVICES AVAILABLE, INCLUDING ASSISTED LIVING, ALZHEIMER'S DISEASE CARE AND LONG-TERM NURSING CARE. THIS COMMUNITY IS DESIGNED FOR PEOPLE 62 OR OLDER. INDEPENDENT LIVING UNITS INCLUDE TWO AND THREE-BEDROOM APARTMENTS AND GARDEN HOMES. ALL UNITS ARE EQUIPPED WITH CALL SYSTEMS TO SUMMON HELP IF A HEALTH OR MEDICAL PROBLEM ARISES. 7)THE MEDICAL CENTER AUXILIARY - A NOT-FOR-PROFIT ORGANIZATION PROVIDING A WIDE VARIETY OF VALUABLE SERVICES TO THE MEDICAL CENTER. THE AUXILIARY WAS ESTABLISHED IN 1963. MEMBERS VOLUNTEER IN DIFFERENT DEPARTMENT THROUGHOUT THE ORGANIZATION TO PROVIDE ASSISTANCE TO PATIENTS, THEIR FAMILIES AND EMPLOYEES. MEMBERS ALSO ASSIST WITH VARIOUS COMMUNITY ACTIVITIES ON BEHALF OF THE MEDICAL CENTER, INC.8)DOCTOR'S HOSPITAL AUXILIARY - A NOT-FOR-PROFIT ORGANIZATION ESTABLISHED IN 1976 FOR THE PURPOSE OF RENDERING SERVICES TO DOCTOR'S HOSPITAL AND ITS PATIENTS. MEMBERS VOLUNTEER IN DIFFERENT DEPARTMENTS THROUGHOUT THE ORGANIZATION AND ASSIST WITH VARIOUS COMMUNITY ACTIVITIES ON BEHALF OF DOCTOR'S HOSPITAL, INC. REPORTS FILED WITH STATES PART VI, LINE 7 GA 1 COLUMBUS STATE UNIVERSITY 4225 UNIVERSITY AVE COLUMBUS GA 31907 586043198 501 (C)(3) 144000 SUPPORT COLUMBUS STATE UNIVERSITY PROGRAMS 1 OTHER INFORMATION: PART IV: COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. AND ITS AFFILIATES ACKNOWLEDGE THEIR RESPONSIBILITY AS GOOD CORPORATE CITIZENS TO SUPPORT WORTHWHILE ACTIVITIES, SERVICES AND EFFORTS IN THE COMMUNITY, STATE AND NATION. TO EFFECTIVELY CARRY OUT THAT RESPONSIBILITY AND ENSURE ITS RESOURCES FOR THIS PURPOSE ARE USED IN WAYS WHICH ARE OF LASTING VALUE AND IMPORTANCE, CERTAIN PROCEDURES HAVE BEEN ESTABLISHED TO APPROPRIATELY ALLOCATE CORPORATE RESOURCES TO OUTSIDE AGENCIES, ORGANIZATIONS AND EFFORTS. ALL GIFTS OR DONATIONS OF MONEY OR OTHER RESOURCES OF THE SYSTEM MUST BE APPROVED BY COLUMBUS REGIONAL. THE TOTAL AMOUNTS OF FUNDS SET ASIDE FOR PURPOSES OR DONATION OR CONTRIBUTION TO OUTSIDE ORGANIZATIONS IS ESTABLISHED ANNUALLY DURING THE CORPORATE BUDGET PROCESS AND THE AMOUNT MAY VARY FROM YEAR TO YEAR. THE MANAGEMENT OF COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. IS REQUIRED TO ESTABLISH CRITERIA AND STANDARDS TO ASSIST IN ALLOCATING RESOURCES. A COMMUNITY SERVICE COMMITTEE SHALL BE ESTABLISHED TO REVIEW CERTAIN REQUESTS AND MAKE RECOMMENDATIONS ON THE APPROPRIATENESS AND LEVEL OF SUPPORT TO BE CONSIDERED. THE COMMITTEE SHALL BE CHAIRED BY THE SENIOR VICE PRESIDENT OF MARKETING AND SHALL BE COMPRISED OF THE FOLLOWING INDIVIDUALS: MANAGER OR MARKETING AND COMMUNICATIONS, COLUMBUS REGIONAL DIRECTOR OF PASTORAL CARE, COLUMBUS REGIONAL PRESIDENT OF THE MEDICAL CENTER, AND THE SENIOR VICE PRESIDENT OF PHYSICIAN SERVICES. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 LARRY S SANDERS 0 524176 0 218263 0 41331 0 636675 0 14598 0 1435043 0 0 LANCE DUKE 0 346490 0 58196 0 29680 0 72875 0 13061 0 520302 0 0 ROLAND L THACKER 0 290803 0 44501 0 12588 0 46775 0 13368 0 408035 0 0 JAMES WHEELER 183679 0 46000 0 13309 0 86175 0 10089 0 339252 0 0 0 DONALD ELDER 0 195214 0 32683 0 1992 0 70748 0 13174 0 313811 0 0 MICHELLE BREITFELDER 132130 0 25500 0 8153 0 9485 0 10211 0 185479 0 0 0 JOHNNY DOLES 122648 0 0 0 4063 0 20334 0 7206 0 154251 0 0 0 PART I, LINE 4B EMPLOYER CONTRIBUTION TO 457(F) EXECUTIVE RETIREMENT BENEFIT PLAN LARRY SANDERS $587,000 LANCE DUKE $ 44,400 DONALD ELDER $ 25,500 JAMES WHEELER $ 22,800 ROLAND THACKER $ 22,000 FORM 990, PART VI, SECTION A, LINE 6 THE BOARD OF DIRECTORS OF HUGHSTON HOSPITAL, INC. IS APPOINTED BY THE BOARD OF COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. - A RELATED 501(C)(3) ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS OF HUGHSTON HOSPITAL, INC. IS APPOINTED BY THE BOARD OF COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. - A RELATED 501(C)(3) ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF DIRECTORS OF HUGHSTON HOSPITAL, INC. IS APPOINTED BY THE BOARD OF COLUMBUS REGIONAL HEALTHCARE SYSTEM, INC. - A RELATED 501(C)(3) ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 INFORMATION FOR FORM 990 WAS PROVIDED TO AN INDEPENDENT CPA FIRM FOR PREPARATION OF RETURN. AFTER RETURN WAS PREPARED IT WAS REVIEWED BY THE TREASURER OF THE ORGANIZATION. CURRENTLY, A COPY OF THE FORM 990 IS NOT PROVIDED TO THE GOVERNING BODY PRIOR TO FILING. THE ORGANIZATION IS CURRENTLY REVIEWING THIS PROCESS. FORM 990, PART VI, SECTION B, LINE 12C IT IS THE POLICY OF COLUMBUS REGIONAL THAT EMPLOYEES AND AGENTS CANNOT PARTICIPATE IN ANY ACTIVITIES THAT CONFLICT WITH, OR APPEAR TO CONFLICT WITH, THEIR PROFESSIONAL RESPONSIBILITIES TO THE ORGANIZATION. IT IS THE POLICY OF COLUMBUS REGIONAL TO PROVIDE MECHANISMS BY WHICH EMPLOYEES, MEDICAL STAFF,AND OTHER ASSOCIATES OF THE ORGANIZATION MAY REPORT SUSPECTED VIOLATIONS OF GOVERNMENT LAWS OR CORPORATE POLICIES WITHOUT FEAR OF RETALIATION OR TERMINATION OF EMPLOYMENT. EMPLOYEES AND AGENTS HAVE A RESPONSIBILITY TO REPORT SUSPECTED VIOLATIONS, PROVIDED THEY ARE REPORTING IN GOOD FAITH AND HAVE EVIDENCE TO SUPPORT THEIR SUSPICION. COLUMBUS REGIONAL ENCOURAGES THE DEVELOPMENT OF AN "OPEN DOOR" POLICY BY MANAGERS TO WELCOME COMMENTS, CONCERNS AND QUESTIONS FROM THEIR EMPLOYEES AND AGENTS. SUSPECTED CONFLICT OF INTEREST VIOLATIONS MAY BE REPORTED TO MANAGERS OR SUPERVISORS. VIOLATIONS MAY ALSO BE REPORTED TO THE CORPORATE COMPLIANCE OFFICER (BY PHONE, E-MAIL OR IN PERSON), BY COMPLETING A FORM, OR BY CONTACTING THE COMPLIANCE HELPLINE. IF AN INDIVIDUAL IS HESITANT ABOUT USING ANY OF THESE REPORTING MECHANISMS, HE/SHE MAY CONTACT COLUMBUS REGIONAL'S CHAIRMAN AND CHIEF EXECUTIVE OFFICER. ALL REPORTS OF SUSPECTED VIOLATIONS ARE INVESTIGATED IN A PROMPT AND REASONABLE MANNER BY THE CORPORATE COMPLIANCE OFFICER OR, AS APPROPRIATE, BY A MEMBER OF THE CORPORATE COMPLIANCE COMMITTEE. AN INHERENT AND IMPORTANT PART OF COLUMBUS REGIONAL'S CORPORATE COMPLIANCE PROGRAM INVOLVES MEASURING THE EFFECTIVENESS OF THE PROGRAM IN ADHERING TO SPECIFIC GOVERNMENTAL REGULATIONS, CORPORATE POLICIES AND BUSINESS ETHICAL STANDARDS. AT THE DESIGNATION OF MANAGEMENT, COMPLIANCE ACTIVITIES ARE REVIEWED. THE CORPORATE COMPLIANCE OFFICER ENSURES THAT THE RESULTS OF COMPLIANCE-RELATED AUDITS, HELPLINE ACTIVITY, EMPLOYEE COMPLIANCE ACTIVITIES AND OTHER COMPLIANCE ISSUES DEEMED RELEVANT ARE REPORTED ON A PERIODIC BASIS TO COLUMBUS REGIONAL'S CEO AND FINANCE AND PLANNING COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 COLUMBUS REGIONAL TAKES VERY SERIOUSLY THE RESPONSIBILITY TO APPROPRIATELY AND EFFECTIVELY MANAGE THE EXECUTIVE COMPENSATION AND BENEFITS PROGRAM FOR ITS KEY EXECUTIVES. SETTING THE COMPENSATION OF THE CHAIRMAN AND CHIEF EXECUTIVE OFFICER, APPROVING THE COMPENSATION OF OTHER SENIOR EXECUTIVES, AND OVERSEEING THE EXECUTIVE COMPENSATION PROGRAM AS A WHOLE, ARE THE RESPONSIBILITIES OF THE COMPENSATION COMMITTEE OF THE BOARD. COLUMBUS REGIONAL HAS HAD A COMPENSATION COMMITTEE FOR MANY YEARS. THE COMMITTEE IS CURRENTLY CHAIRED BY A 20+ YEAR BOARD MEMBER. TO ASSIST THE COMMITTEE, THE BOARD HAS ENGAGED THE SERVICES OF A NATIONALLY RECOGNIZED EXECUTIVE COMPENSATION CONSULTING FIRM. COLUMBUS REGIONAL'S EXECUTIVE COMPENSATION PROGRAM IS DESIGNED TO ATTRACT AND RETAIN HIGHLY QUALIFIED EXECUTIVES TO FULFILL COLUMBUS REGIONAL'S MISSION OF PROMOTING THE HEALTH AND HEALING OF PATIENTS. COLUMBUS REGIONAL'S PEER GROUP CONSISTS OF NON-PROFIT HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE AND COMPLEXITY FROM ACROSS THE NATION. BASE SALARIES OF EXECUTIVES ARE POSITIONED AT SPECIFIC PERCENTILE TARGETS OF COLUMBUS REGIONAL'S PEER GROUP. CURRENT STUDIES INDICATE THAT OUR BASE SALARIES ARE AT TARGETED LEVELS. COLUMBUS REGIONAL STRIVES TO PROVIDE ALL EXECUTIVES WITH RETIREMENT BENEFITS THAT ARE EQUIVALENT FOR ALL EMPLOYEES. RETIREMENT CONTRIBUTIONS ARE BASED ON A CLEARLY STATED INCOME REPLACEMENT TARGET AS DETERMINED BY RETIREMENT PLAN CONSULTANTS. THE GOAL OF COLUMBUS REGIONAL IS TO PROVIDE MARKET COMPETITIVE COMPENSATION AND BENEFITS PROGRAMS FOR ALL EMPLOYEES AT ALL LEVELS OF THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE CONFLICT OF INTEREST POLICY, IN ADDITION TO OTHER CORPORATE AND GOVERNING POLICIES,IS NOT MADE AVAILABLE TO THE PUBLIC. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 13,528. 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