2012-05-11T16:49:13-05:00 2011-06-30 DRAFFIN & TUCKER LLP PO BOX 6 ALBANY GA 317020006 990 2010-07-01 581955423 SOUTHERN REGIONAL HEALTH SYSTEMINC SOUT 7709918010 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 302742600 S LEE BOLES JR 7709918010 2012-05-15 true JACQUELINE G ATKINS 2298837878 2012-05-11 2010 2016-02-24 21:20:13Z JAMES CRISSEY INTERIM CEO 11 UPPER RIVERDALE RD SW RIVERDALE GA 302742600 272650469 false X WWW.SOUTHERNREGIONAL.ORG X 1991 GA SOUTHERN REGIONAL HEALTH SYSTEM, INC. EXISTS TO SERVE THE COMMUNITIES OF THE SOUTHERN CRESCENT OF THE METRO ATLANTA AREA BY IMPROVING THE HEALTH STATUS AND QUALITY OF LIFE OF ITS CITIZENS. 23 21 2291 90 346247 921992 64039 259468386 262758081 1827403 100005 2435160 1707993 264652941 264630118 3995791 2425034 0 114036024 108530402 0 0 153016302 156817249 271048117 267772685 -6395176 -3142567 167420168 162108520 122617628 106870197 44802540 55238323 SOUTHERN REGIONAL HEALTH SYSTEM, INC. EXISTS TO SERVE THE COMMUNITIES OF THE SOUTHERN CRESCENT OF THE METRO ATLANTA AREA BY IMPROVING THE HEALTH STATUS AND QUALITY OF LIFE OF ITS CITIZENS. false false 212202069 2425034 262667616 SOUTHERN REGIONAL HEALTH SYSTEM, INC. PROVIDED 72,273 DAYS OF ACUTE AND INTENSIVE CARE, TREATED MORE THAN 140,000 OUTPATIENTS, AND PROVIDED EMERGENCY CARE TO MORE THAN 79,000 PATIENTS IN ITS EMERGENCY ROOM. SRHS ALSO PROVIDED 4,980 DAYS OF CARE TO THE MORE THAN 3,116 BABIES BORN AT SRHS. 212202069 true false false true false false false false false false true false false false true true false true false false false false false false false false true true true true true true false false false false false false false false false false false false false false false true true false false false true 72 0 2291 true true true false false false false false false false false false false false false false false X 23 21 false true false false false false false true true false false true true true true true true true true false GA X LEE BOLES CFO 7709918010 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 302742600 X BENNY WHITMORE 5.00 X X 10800 0 0 RONALD M DODSON 4.00 X X 10800 0 0 JAMES G ADAMS 4.00 X 10200 0 0 RICHARD PROKESCH MD 4.00 X X 10200 0 0 JAY R PRAKASH MD 3.00 X X 9300 0 0 WILLIAM C MCBERRY 4.00 X 8900 0 0 RAJU M VANAPALLI 4.00 X 7400 0 49412 ANDREA CALLAWAY 3.00 X 7020 0 0 REV ED J BEST JR 4.00 X 6850 0 0 DANIEL T MCDEVITT 3.00 X 6800 0 6125 RONALD SHIPMAN 3.00 X 6000 0 0 SHERRY HANCOCK 3.00 X 5150 0 0 JAMES O WATKINS 2.00 X 4400 0 0 GLYNDA B KING 3.00 X 3800 0 0 GARY J LAGGIS 3.00 X 3400 0 0 HOMAYOUN AMIN MD 2.00 X 3400 0 0 PRAVEEN RASTOGI MD 1.00 X 2496 0 0 ANGELA JACKSON 1.00 X 2100 0 0 RALPH WOLE 1.00 X 800 0 0 REV CHARLES GRANT 1.00 X 400 0 0 ALAN VIGIL 1.00 X 0 0 0 RAMESH REDDY MD 2.00 X 0 0 15000 STARR S HELMS 1.00 X 0 0 0 STEVE MAHAN 40.00 X 249291 0 11649 STEVEN LEE BOLES 40.00 X 129219 0 4267 JOHN R MCLAIN 40.00 X 128721 0 3585 JANIS M DARNABY 40.00 X 70804 0 2121 JOHN SCHIBLER 40.00 X 0 0 0 WILLIE COCHRAN 40.00 X 256184 0 7754 JAMES CRISSEY 40.00 X 215155 0 10833 NORMA ADAMS 40.00 X 163341 0 8099 ROY GILLELAND 40.00 X 409872 0 16834 WILLIAM APPLEGATE 40.00 X 195629 0 5360 MELODY MENA 40.00 X 152177 0 4639 NICHOLAS MAIDA 67.00 X 150008 0 5780 KIRSTEN GLAVOSEK 60.00 X 137239 0 4141 EDWARD BONN 0.00 X 442038 0 0 MARY KAY GARDENIER 0.00 X 147883 0 0 2967777 155599 61 true true true COMPLETERX 3100 S GESSNER SUITE 640 HOUSTON TX 77063 PHARMACY MGMT 9507759 MORRISONS MANAGEMENT SERVICES PO BOX 102289 ATLANTA GA 30368 CAFETERIA MGMT 4025600 EAGLE HOSPITAL PHYSICIANS 5901 PEACHTREE DUNWOODY RD ATLANTA GA 30328 PHYSICIAN MGMT 4010151 MCKESSON INFORMATION SOLUTIONS PO BOX 98347 CHICAGO IL 60693 IT SUPPORT 1754254 GREENBERG TRAURIG LLP 3290 NORTHSIDE PARKWAY ATLANTA GA 30327 LEGAL SERVICES 1602940 105 64039 64039 PATIENT REVENUE 623000 262411834 262411834 LAB OUTREACH 621500 346247 346247 262758081 809386 95301 714085 583266 583266 583266 583266 7310970 6662370 1357981 648600 -1357981 -709381 -709381 PAID PARKING REVENUE 621990 522064 522064 CAFETERIA 624200 401010 401010 DIETICIAN INTERNSHIP REVENUE 621990 69594 69594 132059 90887 41172 1124727 264630118 262667616 346247 1552216 2342647 2342647 82387 82387 1381235 1381235 589921 589921 87316260 72540902 14775358 4681320 3885496 795824 8001574 6641306 1360268 6560092 5444876 1115216 1091443 1091443 225908 225908 10000 10000 23506417 10496780 13009637 985866 17734 968132 47203506 46116475 1087031 2929705 2929705 4765506 4222238 543268 235220 23732 211488 31316 18899 12417 2120430 2120430 9353659 8287342 1066317 4820059 4820059 BAD DEBT 51096957 51096957 REPAIRS AND MAINTENANCE 4651596 599976 4051620 PROVIDER TAX 3284124 3284124 MISCELLANEOUS 388513 382360 6153 RECRUITMENT 116962 1900 115062 62 62 267772685 212202069 55570616 0 8750 7550 12215007 5854841 30623132 40144537 264990 338279 3588340 3354346 1361331 1768653 267901611 203381062 70121283 64520549 42653220 41865649 2775571 2556972 271129 255710 3537415 1441434 167420168 162108520 28593098 28897164 50172147 42778995 871278 928423 42981105 34265615 122617628 106870197 X 44613698 55012183 188842 226140 44802540 55238323 167420168 162108520 X -3142567 13578350 X false true true X false X false false false false false false false false false true 10000 false false false 10000 false false false false false SCHEDULE C, PART II-B, LINE 1I ADDITIONALLY A DONATION WAS MADE TO "YES 2 SAVE LIVES, INC.", A GRASSROOTS MOVEMENT TO INFLUENCE PUBLIC VOTE ON FUNDING TRAUMA CARE FOR THE STATE OF GEORGIA. false false false false false false false false false false 7394613 7394613 126286615 87346668 38939947 133262063 116034394 17227669 958320 958320 64520549 SELF INSURANCE RESERVE 16651756 UNFUNDED PENSION LIABILITY 16461907 ACCRUED BOND INTEREST PAYABLE 819007 PHYSICIAN DINNING ROOM 313894 PROFESSIONAL FEES PAYABLE 19051 MORRISION'S DEBT FORGIVENESS 34265615 LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X THE SOUTHERN REGIONAL HEALTH SYSTEM, INC., SOUTHERN CRESCENT PHYSICIANS GROUP, SOUTHERN CRESCENT REAL ESTATE, INC., SOUTHERN REGIONAL AMBULATORY SURGERY, AND SOUTHERN REGIONAL MEDICAL CENTER FOUNDATION (ALL RELATED/SUPPORTING ORGANIZATIONS) HAVE BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501 (A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3), AND THEREFORE, RELATED INCOME IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. INCOME TAX FROM THE SYSTEM'S TAXABLE AFFILIATES NETWORK AND MEDICAL SERVICES IS NOT SIGNIFICANT. THE SYSTEM'S COMBINED AFFILIATES, SCRE AND SSASC, ARE ORGANIZED AS A LIMITED LIABILITY COMPANY AND LIMITED PARTNERSHIP, RESPECTIVELY, AND THEREFORE, THE SYSTEM'S PROPORTIONATE SHARE OF EARNINGS AND LOSSES FROM THESE AFFILIATES IS REFLECTED IN THE SYSTEM'S TAX REPORTING. INCOME TAXES ASSOCIATED WITH THESE AFFILIATES ARE IMMATERIAL TO THE SYSTEM'S COMBINED FINANCIAL STATEMENTS. THE SYSTEM ACCOUNTS FOR ITS INCOME TAXES IN ACCORDANCE WITH FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES. ASC 740 ADDRESSES ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS AND GUIDANCE ON WHEN TAX POSITIONS, ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. THERE IS CURRENTLY NO IMPACT ON THE SYSTEM'S COMBINED FINANCIAL STATEMENTS AS A RESULT OF ASC 740. true true true X 1.25000 true X true true false true true 7470684 7470684 0.03480 50927388 47159866 3767522 0.01760 58398072 47159866 11238206 0.05240 22959553 14954170 8005383 0.03730 22959553 14954170 8005383 0.03730 81357625 62114036 19243589 0.08970 true 13981507 49998690 51709564 -1710874 X true true SPIVEY STATION ASC REAL ESTATE MGMT 0.45000 0.48000 1 1 SOUTHERN REGIONAL HEALTH SYSTEM INC

11 UPPER RIVERDALE ROAD SW RIVERDALE GA 30274

X X X SOUTHERN REGIONAL HEALTH SYSTEM INC 1 RELATED ORGANIZATION INFORMATION PART I LINE 6A THE ORGANIZATION PREPARED A REPORT TO THE COMMUNITY FOR FY 2011 AND IT IS POSTED ON THE SOUTHERN REGIONAL MEDICAL CENTER WEB SITE IN AN ADOBE PDF FORMAT SUBSIDIZED HEALTH SERVICES EXPLANATION PART I LINE 7G THE SUBSIDIZED HEALTH SERVICES LISTED ON LINE 7G ARE RELATED TO EMERGENCY ROOM SERVICES AND WOMENS COMMUNITY CARE SERVICES PROVIDED TO THE RESIDENTS OF THE SOUTHERN CRESCENT 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 LESS BAD DEBTS IN PART IX 51096957 DENOMINATOR FOR COLUMN F XXX-XX-XXXX COSTING METHODOLOGY EXPLANATION PART I LINE 7 UTILIZED THE RATIO OF COST TO CHARGE INFORMATION FROM WORKSHEET 2 OF SCHEDULE H FORM 990 BAD DEBT EXPENSE EXPLANATION PART III LINE 4 THE ORGANIZATION FOLLOWS THE METHOD DESCRIBED IN HFMA STATEMENT 15 THE COSTING METHODOLOGY WAS BASED ON THE WORKSHEET C FROM THE FY 2010 COST REPORT AND THE COST TO CHARGE RATIO WAS APPLIED TO BAD DEBT EXPENSE TO CALCULATE BAD DEBT EXPENSE AT COST MEDICARE EXPLANATION PART III LINE 8 THE METHODOLOGY USED FOR THIS SECTION WAS WORKSHEET 2 SCHEDULE H OF THE FORM 990 COLLECTION PRACTICES EXPLANATION PART III LINE 9B PATIENTS ARE SCREENED BASED ON COUNTY OF RESIDENCE INCOME LEVELS AND IF THE MEDICAL CARE IS CONSIDERED CATASTROPHIC IN NATURE DEPENDING ON THE CRITERIA PATIENTS BILLS ARE REDUCED BY ADJUSTMENTS TO CHARITY OR INDIGENT CARE USING THE SPECIFIC GUIDELINES IN THE POLICY INCOME CRITERIA ARE BASED ON VARIOUS PERCENTAGES OF FEDERAL POVERTY GUIDELINES FPG THE ORGANIZATION WRITES OFF PATIENT ACCOUNTS RECEIVABLE BALANCES WHEN THEY QUALIFY FOR INDIGENT CHARITY CARE AND DOES NOT MAKE FURTHER COLLECTION EFFORTS NEEDS ASSESSMENT PART VI HEALTH NEEDS ARE GENERALLY ASSESSED THROUGH A STRATEGIC PLANNING PROCESS THAT LOOKS AT THE PRIMARY AND SECONDARY SERVICE AREAS FOR TRENDS IN AGE INCOME AND USE RATES FOR VARIOUS SERVICES OR ILLNESSES COMMUNITY NEEDS ARE ALSO BASED ON A NEEDS ASSESSMENT RELATED TO VARIOUS PHYSICIAN SPECIALTIES FOR EXAMPLE THE SERVICE AREA HAS NEEDS FOR PRIMARY CARE PHYSICIANS THE ORGANIZATION WORKS WITH LOCAL PHYSICIAN PRACTICES TO SHARE THIS INFORMATION AND ENCOURAGE VARIOUS PHYSICIAN RECRUITMENT ACTIVITIES HEALTH NEEDS ARE ALSO INDIRECTLY ASSESSED BY ANALYZING TRENDS FOR SERVICES OFFERED AT THE ORGANIZATION AND THE HEALTH STATUS OF THOSE PATIENTS PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI THE ORGANIZATION INFORMS AND EDUCATES PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE BY POSTED SIGNS FORMS AND EMAILS COMMUNITY INFORMATION PART VI THE ORGANIZATION SERVES THE PATIENTS IN THE SOUTHERN CRESCENT OF THE METRO ATLANTA AREA OUR PRIMARY SERVICE AREA INCLUDES CLAYTON COUNTY FAYETTE COUNTY HENRY COUNTY AND PORTIONS OF SOUTH FULTON COUNTY THE SOUTHERN CRESCENT IS A LARGE DIVERSE COMMUNITY AND THE ORGANIZATION OFFERS SERVICES TO MEET THESE VARIED NEEDS THE MAJOR SERVICES THE ORGANIZATION OFFERS IN THE SOUTHERN CRESCENT ARE OB SERVICES NEONATOLOGY GYNECOLOGICAL ONCOLOGY HEMATOLOGY NEUROLOGY NEUROSURGERY ORTHOPEDICS VASCULAR CARE CARDIOLOGY AND INTERVENTIONAL CARDIOLOGY ACUTE REHABILITATION OP IMAGING OP SURGERY GASTROENTEROLOGY EMERGENCY CARE AND WOMENS COMMUNITY CARE HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI THE ORGANIZATION PROMOTES HEALTH IN THE COMMUNITY THROUGH 90 SECOND HEALTH BREAK COMMERCIALS SPRING INTO HEALTHY LIVING CONFERENCE HEALTH SCREENINGS AND SPONSORSHIPS THE ORGANIZATION HAS A COMMUNITY BASED BOARD OF DIRECTORS AND IS ALSO LINKED TO THE COMMUNITY THROUGH THE CLAYTON COUNTY HOSPITAL AUTHORITY CCHA WHICH IS A GOVERNMENTAL ENTITY EXCESS FUNDS FROM THE OPERATION OF THE ORGANIZATION ARE REDIRECTED BACK TO THE MISSION OF THE ORGANIZATION THROUGH THE PURCHASE OF EQUIPMENT MAINTAINING UPGRADING THE FACILITIES DEVELOPING NEW SERVICES TO BENEFIT THE COMMUNITY OR FUNDING OPERATIONS LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED PART VI GEORGIA ADDITIONAL INFORMATION PART VI PART IV MANAGEMENT COMPANIES AND JOINT VENTURES SURGERY CENTER REAL ESTATE INVESTORS SCREI OWNS A 4959 OF SPIVEY STATION ASC BUILDING LLP PHYSICIANS WHO ARE EITHER EMPLOYEES OF SOUTHERN CRESCENT PHYSICIANS GROUP A RELATED ORGANIZATION OR HAVE ADMITTING PRIVILEGES TO THE FILING ORGANIZATION OWN APPROXIMATELY 4848 OF SCREI true UNITED WAY 107 WESTRIDGE INDUSTRIAL BLVD MCDONOUGH GA 30253 580566194 3 5200 DONATION SOUTHERN CRESCENT PHYSCIAN GROUP 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 30274 581955425 3 975590 OPERATIONS SOUTHERN CRESCENT REAL ESTATE INC 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 30274 581955424 3 1321867 OPERATIONS GOOD SHEPHERD CLINIC 6392 MURPHY DRIVE MORROW GA 30260 582578581 3 10100 DONATION GEORGIA CHAMBER OF COMMERCE 233 PEACHTREE STREET SUITE 200 ATLANTA GA 30303 581537370 3 10000 DONATION 5 TUITION ASSISTANCE 47 82387 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES SCHEDULE I, PAGE 1, PART I, LINE 2 THE FILING ORGANIZATION MONITORS TAX EXEMPT PURPOSE COMPLIANCE FOR THE USE OF FUNDS GRANTED TO ITS SUPPORTED ORGANIZATION THROUGH A SHARED MANAGEMENT TEAM. ADDITIONAL INFORMATION SCHEDULE I, PAGE 4, PART IV SOUTHERN REGIONAL HEALTH SYSTEM, INC. OFFERS ITS EMPLOYEES A TUITION REIMBURSEMENT AND STUDENT SCHOLARSHIP PROGRAM. THE PROGRAM PROVIDES TUITION ASSISTANCE TO EMPLOYEES SEEKING CERTIFICATION OR DEGREES AT ACCREDITED, APPROVED SCHOOLS AND SCHOLARSHIP ASSISTANCE TO STUDENTS IN APPROVED EDUCATION PROGRAMS DURING PERIODS OF SIGNIFICANT LABOR SHORTAGES. TO BE CONSIDERED FOR TUITION REIMBURSEMENT, EMPLOYEES MUST APPLY PRIOR TO THE START OF THE COURSE. WITHIN 30 DAYS OF SUCCESSFUL COMPLETION OF THE COURSE, (PASSING GRADE OF "C" OR BETTER FOR UNDERGRADUATE PROGRAMS; "B" OR BETTER FOR GRADUATE PROGRAMS) THE EMPLOYEE MUST SUBMIT A COPY OF THEIR GRADE AND THE ORIGINAL TUITION RECEIPT FROM THE INSTITUTION TO THE HUMAN RESOURCES DEPARTMENT FOR PROCESSING. EMPLOYEES MUST COMPLETE THE COURSE WHILE EMPLOYED AT THE FACILITY IN ORDER TO RECEIVE REIMBURSEMENT. FAILURE TO ABIDE BY THE POLICY MAY REQUIRE FULL OR PARTIAL RECOVERY OF AMOUNTS PAID TO THE EMPLOYEE UNDER THE PROGRAM. X X true true X X X X true false false false false false false false false STEVE MAHAN 246628 2663 11649 260940 JOHN SCHIBLER WILLIE COCHRAN 251498 4686 7754 263938 JAMES CRISSEY 212031 3124 10833 225988 NORMA ADAMS 161666 1675 8099 171440 ROY GILLELAND 291175 117001 1696 16834 426706 WILLIAM APPLEGATE 114265 80885 479 5360 200989 MELODY MENA 149521 2656 4639 156816 NICHOLAS MAIDA 143663 6345 5780 155788 EDWARD BONN 442038 442038 MARY KAY GARDENIER 147883 147883 FRINGE OR EXPENSE EXPLANATION SCHEDULE J, PAGE 1, PART I, LINE 1A SPOUSAL TRAVEL EXPENSES ARE REIMBURSED WHEN HIS/HER ATTENDANCE IS NECESSARY AND ESSENTIAL. SPOUSAL TRAVEL EXPENSES REQUIRE PRIOR APPROVAL. 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 ACCOMMODATION. THE POLICY RECOGNIZES THAT GOVERNING BOARD MEMBERS ARE OFTEN PLACED IN SOCIAL SITUATIONS AT SUCH MEETINGS AND WOULD REPRESENT THE HOSPITAL OPTIMALLY WITH THE ASSISTANCE OF THEIR SPOUSES. ADDITIONALLY, SOUTHERN REGIONAL HEALTH SYSTEM, INC. HAS A CORPORATE MEMBERSHIP TO A LOCAL COUNTRY CLUB FOR WHICH SELECTED OFFICERS AND KEY EMPLOYEES PARTICIPATE IN SOCIAL CLUB MEMBERSHIP. THE ORGANIZATION INTENDS FOR THESE PRIVILEGES TO BE BUSINESS USE ONLY AND CONSEQUENTLY, THESE BENEFITS ARE NOT INCLUDED IN THEIR TAXABLE WAGES. A FORMAL POLICY EXISTS, AND RECEIPTS AND APPROVAL ARE REQUIRED BEFORE REIMBURSEMENT FORMS ARE PROCESSED THROUGH THE ACCOUNTING DEPARTMENT FOR PAYMENT. SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 EDWARD BONN 442,038 0 0 MARY KAY GARDENIER 147,883 0 0 OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III FTI CONSULTING, INC., AN UNRELATED ORGANIZATION, IS A CONSULTING FIRM PROVIDING RESTRUCTURING AND OPERATIONAL IMPROVEMENT SERVICES TO SOUTHERN REGIONAL HEALTH SYSTEM, INC. ("SRHS"), A RELATED ORGANIZATION. THE AMOUNT PAID TO FTI CONSULTING, INC. BY SRHS DURING THE FISCAL YEAR ENDING JUNE 30, 2011 INCLUDES COMPENSATION FOR SERVICES PROVIDED BY JOHN SCHIBLER, CFO. JOHN SCHIBLER LEFT THE ORGANIZATION ON JULY 7, 2010. PART I LINE 4 - SEVERANCE SEVERANCE COMPENSATION IS IN ACCORDANCE WITH EACH INDIVIDUAL'S EMPLOYMENT AGREEMENT. CLAYTON CO HOSPITAL AUTHORITY SERIES 2010A 582016041 184153EE0 2010-12-15 35205000 REFINANCE 2009 BONDS. false true false CLAYTON CO HOSPITAL AUTHORITY SERIES 2010B 582016041 184153EQ3 2010-12-15 7500000 REFINANCE 1998A BONDS false true false 35280659 34693200 587459 2010 true false true true 7500000 7374841 125159 2010 true false true true false false false false true true false false false false true true false false false false false false false false false false false false MANAGEMENT DELEGATED FORM 990, PAGE 6, PART VI, LINE 3 EFFECTIVE 10/07/08, SOUTHERN REGIONAL HEALTH SYSTEM, INC. ("SRHS") ENTERED INTO AN AGREEMENT WITH FTI CONSULTING, INC. ("FTI"), AN UNRELATED ORGANIZATION, FOR INTERIM MANAGEMENT AND SUPPORT SERVICES. UNDER THIS AGREEMENT, FTI ASSIGNED THREE EMPLOYEES TO PROVIDE FULL-TIME, ON-SITE SERVICES FOR THE FOLLOWING POSITIONS: CHIEF RESTRUCTURING OFFICER (CRO), VICE PRESIDENT OPERATIONS (VPO), AND CHIEF NURSING OFFICER (CNO). AS PART OF THE SUPPORT SERVICES COMPONENT OF THIS AGREEMENT, A FINANCIAL ADVISOR (FA) WAS ALSO PROVIDED TWO DAYS PER WEEK. AS OF 12/19/08, THE CRO ASSUMED THE ROLE OF CHIEF EXECUTIVE OFFICER (CEO). UNDER THE GUIDANCE AND DIRECTION OF THE BOARD, THE CEO, AS AN INDEPENDENT CONTRACTOR OF SRHS AND AN EMPLOYEE OF FTI, ASSUMED THE RESPONSIBILITY OF OVERSEEING THE DUTIES OF PREVIOUS CHIEF EXECUTIVE OFFICERS OF SRHS. AN AGREEMENT DATED 1/15/09 TRANSITIONED THE VPO TO THE ROLE OF CHIEF OPERATING OFFICER (COO), AND ALSO CHANGED THE FA TO THE ROLE OF CHIEF FINANCIAL OFFICER (CFO). THE COO, UNDER THE DIRECTION OF THE CEO, IS RESPONSIBLE FOR DAY-TO-DAY FUNCTIONING OF SRHS DEPARTMENTS. THE CFO, ALSO UNDER THE DIRECTION OF THE CEO, IS RESPONSIBLE FOR THE FINANCIAL FUNCTIONS OF SRHS, CONSISTENT WITH THE DUTIES GIVEN TO PRIOR CHIEF FINANCIAL OFFICERS OF SRHS. DURING THE LAST HALF OF FY 2010, SRHS BEGAN HIRING PERMANENT EXECUTIVE MANAGEMENT AND WAS ABLE TO HIRE THE CEO ON APRIL 26, 2010. THE FTI ASSIGNED COO AND CNO LEFT THE ORGANIZATION ON APRIL 23, 2010. THE FTI ASSIGNED CFO AND CONTROLLER LEFT THE ORGANIZATION ON JULY 7, 2010. THE PERMANENT CFO, COO, AND CNO WERE HIRED IN FY 2011. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS DRAFTED BY INTERNAL ACCOUNTING STAFF, REVIEWED BY MANAGEMENT AND SUBMITTED TO AN OUTSIDE ACCOUNTING FIRM FOR TECHNICAL REVIEW AND PROCESSING. A DRAFT IS SUBMITTED TO CONTROLLER AND MANAGEMENT FOR A FINAL REVIEW. ONCE APPROVED AND PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE, THE COMPLETED IRS FORM 990 TAX RETURN, ALONG WITH ALL SUPPORTING SCHEDULES, ARE POSTED TO THE SRHS EXTRANET FOR BOARD MEMBER ACCESS AND REVIEW. NOTIFICATION OF THE POSTING IS SENT VIA EMAIL. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS ALL BOARD MEMBERS AND SENIOR MANAGEMENT. ANY POTENTIAL CONFLICT IS DISCUSSED WITH THE BOARD OF DIRECTORS (ABSENT THE MEMBER WITH THE POTENTIAL CONFLICT). IF IT IS DETERMINED THAT CONFLICT EXISTS, THEN THE BOARD MAY HAVE THE MEMBER EITHER RESIGN, REMOVE THE CONFLICT, OR THEY MOVE FORWARD WITH THE TRANSACTION IF SPECIFIC FACTS ARE PRESENT. IF THE LATTER SITUATION TAKES PLACE, THEN THE MEMBER IS EXCLUDED FROM DISCUSSIONS AND THE VOTE FOR THAT TRANSACTION. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AUTHORIZES THE COMPENSATION PACKAGE OF EXECUTIVES UTILIZING THE VHA GEORGIA SURVEY OF EXECUTIVE COMPENSATION AND OTHER APPROPRIATE SURVEYS. THE SURVEY IS REVIEWED TO ENSURE COMPETITIVE WAGES AND BENEFITS FOR THE CEO. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AUTHORIZES THE COMPENSATION PACKAGE OF EXECUTIVES UTILIZING THE VHA GEORGIA SURVEY OF EXECUTIVE COMPENSATION AND OTHER APPROPRIATE SURVEYS. THE SURVEY IS REVIEWED TO ENSURE COMPETITIVE WAGES AND BENEFITS FOR THE CFO AND OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 THE SOUTHERN REGIONAL HEALTH SYSTEM, INC.'S BOARD OF DIRECTORS COMPLIES WITH THE OPEN RECORDS LAW. UPON WRITTEN REQUEST, GOVERNING DOCUMENTS DEEMED ACCESSIBLE TO THE PUBLIC UNDER THE LAW CAN BE VIEWED IN THE OFFICE OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER. RELATED ORGANIZATIONS FORM 990, PAGE 7, PART VII RAJU VANAPALLI - 4 HOURS WILLIAM MCBERRY - 1 HOUR REV. CHARLES GRANT - 3 HOURS BENNY WHITMORE - 5 HOURS RONALD DODSON - 5 HOURS GLYNDA KING - 2 HOURS JAMES WATKINS - 2 HOURS JAMES ADAMS - 4 HOURS STEVE MAHAN - 8 HOURS LEE BOLES - 7 HOURS OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 5 PENSION PLAN ADJUSTMENT 8,486,676 UNREALIZED GAIN/LOSS ON INVESTMENTS 4,459,146 ASSETS RELEASED FROM RESTRICTION 595,229 CHANGE IN TEMPORARILY RESTRICTED NET ASSETS 37,299 SOUTHERN REGIONAL MED CTR AUXILIARY 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 302742600 582027384 VOLUNTEER GA 501C3 11B NA false SOUTHERN REG MED CNT FOUNDATION INC 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 302742600 581983516 FUNDRSG GA 501C3 11B NA false SOUTHERN CRESCENT REAL ESTATE INC 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 302742600 581955424 REAL EST GA 501C3 11B SRHS SOUTHERN REGIONAL HEALTH SYSTEM true SOUTHERN REG AMBULATORY SURGERY 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 302742600 582541044 SURGICAL GA 501C3 11B SRHS SOUTHERN REGIONAL HEALTH SYSTEM true CLAYTON CO HOSP AUTH TRUST CO LIAB 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 302742600 582016041 LIAB CLAIM GA 501C3 11B NA false SOUTHERN CRESCENT PHYSICIANS GROUP 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 302742600 581955425 PHYS PRACT GA 501C3 3 SRHS SOUTHERN REGIONAL HEALTH SYSTEM true PROMINA HEALTH SYSTEM INC P O BOX 500428 ATLANTA GA 31550 582135501 PURCHASING GA 501C3 11A NA false SPIVEY STATION ASC BUILDING LP TWO SUN COURT SUITE 350 NORCROSS GA 30092 263323060 RENTAL GA SRHS SOUTHERN REGIONAL HEALTH SYSTEM INC RELATED 95301 1669883 false false 0.45410 SOUTHLAKE AMBULATORY SURGERY CENTER 4000 CORPORATE CENTER DR MORROW GA 30260 582272588 SURGICAL GA N/A false false SOUTHERN REGIONAL MEDICAL SVCS INC 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 30274 208774854 EQP LEASE GA SRHS SOUTHERN REGIONAL HEALTH SYSTEM IN C CORP 108648 436246 1.00000 SOUTHERN CRESCENT HEALTH NETWORK IN 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 30274 582220817 PHYS NTWRK GA SRHS SOUTHERN REGIONAL HEALTH SYSTEM IN C CORP 3772 82153 1.00000 SPIVEY STATION MGMT ASSN INC 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 30274 260629861 HEALTHCARE GA SRHS SOUTHERN REGIONAL HEALTH SYSTEM IN C CORP 1.00000 false true true false false false false false false false false true true true false false true true