2012-11-13T04:46:04-08:00 2011-12-31 990 2011-01-01 581581103 UNIVERSITY HEALTH SERVICES INC UNIV 7068282406 1350 WALTON WAY AUGUSTA GA 30901 David Belkoski 2012-11-13 2011 2016-02-24 21:20:13Z James R Davis 1350 Walton Way Augusta GA 30901 489168155 false false X www.universityhealth.org X 1984 GA The mission of University Health Care Services is to operate an acute and subacute care hospital providing health care services which help the citizens of our communities achieve and maintain optimal health. 15 14 3448 343 3988944 835066 2340067 482697 362721760 366575614 -3844762 11370512 5183238 8549487 366400303 386978310 1308770 1491840 0 174256345 164000475 0 0 183792894 207315173 359358009 372807488 7042294 14170822 690079783 680520097 292827610 321768380 397252173 358751717 The mission of University Health Care Services is to operate an acute and subacute care hospital providing health care services which help the citizens of our communities achieve and maintain optimal health. false false 339861853 366575614 Operation of a general acute care and subacute care hospital with 551 licensed beds total (551 acute and 0 subacute). Patient days for adults and pediatrics for 2011 were 109,065, newborn days were 12,583 (for both term & ICU nursery), and outpatient visits were 261,821. Emergency room registrations were 72,807, observation stays were 5,390, Cardiovascular interventional procedures were 15,217, and Radiology procedures were 140,922, Occupational Medicine visits were 21,918 and Home Health visits for 2011 were 53,600. Within all these indicators are the efforts of University Health Services to service the needs of the community, which include the indigent. In 2011 the cost of indigent and charity care provided, with no local funding, was $28,813,764, however the Hospital did receive Disproportionate Share (DSH) payments to help with this service of $4,663,022 and Upper Payment Limit (UPL) funds of $1,630,337. The $28,813,764 includes the cost for providing inpatient and outpatient services for indigent and charity patients of $19,322,359. Also $1,794,505 to help support community based clinics, $7,488,260 for uncompensated physician services for indigent and charity patients, and $208,640 for disease management. Also provided are programs for congestive heart failure and asthma/COPD, which helped indigent patients manage their condition and improve the quality of their lives. Other community outreach services for 2011 included diabetes testing and education, Prostate Specific Antigen (PSA) testing, Skin Cancer Screenings, free counseling and education for women and their family members through all stages of breast cancer, free mammograms, heart health education, and support groups for cancer, heart attack, and stroke. In 2011, University Hospital reached more than 200,000 people and invested more than $2 million in free screenings, community education, publications, and more. Additionally, in 2011, over $750,000 was provided for health professional education for cardiovascular and radiology schools, and dietetic internships, in support of tomorrow's care givers. 339861853 true true false true false false false false false false true false false false true true false true false true true false false false false false true true true false true true false false false false false false false false false false false false false false true true false false false false true 221 0 true 3448 true true true true CJ false false false false false false false false 0 false false false false false false false false false false false X 15 14 false false false false false false false true true false true true true true true true true true true true true true GA X X David Belkoski 7068282406 1350 Walton Way Augusta GA 30901 John P Rhodes 2.00 X 0 0 0 Richard K Fairey 2.00 X 0 0 0 Thomas A Parfenchuck MD 2.00 X 0 0 0 Thomas E Sizemore 2.00 X 0 0 0 Wyck A Knox Jr 2.00 X 0 0 0 Hugh L Hamilton 2.00 X 0 0 0 Jerry W Howington MD 2.00 X 0 0 0 Terry D Elam 2.00 X 0 0 0 Natalie D Schweers 2.00 X 0 0 0 Eugene F McManus 2.00 X 0 0 0 Reverend Clyde Hill Sr 2.00 X 0 0 0 Steven B Vaughn MD 50.00 X 131515 0 0 Gerald E Matheis 2.00 X 0 0 0 Brian J Marks 2.00 X X 0 0 0 R Lee Smith Jr 2.00 X X 0 0 0 William L Farr Jr 50.00 X 457288 0 37652 Marilyn A Bowcutt 50.00 X 342970 0 62521 Dave A Belkoski 50.00 X 528031 0 42471 James R Davis 50.00 X 607722 0 239093 Stephen M Gooden 45.00 X 259342 0 9463 Shannon M Stinson MD 45.00 X 305360 0 16327 Leslie A Clonch 45.00 X 189493 0 8866 Kyle E Howell 45.00 X 423768 0 34757 Brent J Mallek 40.00 X 293570 0 28759 Joan F Wessman 45.00 X 294610 0 21690 Edward L Burr 50.00 X 291997 0 80567 Teresa Waters 45.00 X 164890 0 25217 Richard W Severson 45.00 X 154915 0 31463 Lynda Jones Watts 45.00 X 148048 0 21510 Christine A Martin 45.00 X 137172 0 20346 Tara A Kattine 40.00 X 212536 0 14759 4943227 695461 17 false true false Morrisons Management Specialists PO Box 102289 Atlanta GA 30368 Food Services 5429837 IN COMPASS HEALTH 318 Maxwell Road Suite 500 Alpharetta GA 30004 Physician Services 1562362 EPIC Systems Corporation PO BOX 88314 Milwaukee WI 53288 EPIC Support 1319095 Crothall Laundry Services 901 RA Dent Blvd Augusta GA 30901 Linen Services 2488599 Crothall Healthcare 955 Chesterbrooks Blvd Wayne PA 19087 Plant & Houskeeping 7814195 56 293537 53070 136090 482697 Physician Answering SVC 541900 407151 407151 Patient Service Revenue 900099 356799001 356799001 Other Program Services 900099 336083 336083 Home Health Services 621610 7043382 7043382 Admin Support Services 900099 1653155 1653155 336842 336842 366575614 9742768 9742768 0 0 3095447 35746 2084260 1011187 35746 1046933 72129 974804 101703093 30236 99916737 188848 1786356 -158612 1627744 1627744 0 0 0 Outreach Lab 3916815 3916815 Miscellaneous 900099 273003 273003 Employee Pharmacy 446110 2654002 2654002 658734 359401 299333 7502554 386978310 376950786 3988944 5555883 1491840 1491840 0 0 0 4707833 1134307 3573526 0 112888352 106679493 6208859 7686022 7263291 422731 28852226 27265354 1586872 9866042 9323410 542632 14644576 13839124 805452 282866 282866 216613 216613 228234 228234 0 1227540 1227540 19154193 18100712 1053481 1612432 1523748 88684 1394389 1317698 76691 6668208 6301457 366751 0 15387910 14541575 846335 862868 812845 50023 0 0 8305339 8305339 0 26612332 25148654 1463678 2993752 2829096 164656 Med Surg supplies 74613453 74613453 General Supplies 3933048 3716730 216318 GA DCH Hospital Tax 5059666 5059666 Dues,Memberships, Misc Fees 1456427 1376324 80103 Bad Debt Expense 22582742 22582742 78585 78585 372807488 339861853 32945635 0 39893732 31019669 21337929 22152854 0 63422064 55796887 0 0 11853506 9643330 6734447 6700122 8780030 7019777 476853776 256865146 217398855 219988630 305534935 294373453 0 0 0 15124285 33825375 690079783 680520097 15667534 17176913 150965982 148650743 4540194 4738710 121653900 151202014 292827610 321768380 X 397217173 358716717 35000 35000 397252173 358751717 690079783 680520097 X 14170822 -52671278 X false true true X false false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 228234 228234 false false Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description A part of the various association dues include a percentage allocation for expenditures on Lobbying activities. Dues paid to the Georgia Hospital Association, The American Hospital Association, the Georgia Alliance of Community Hospitals and The Georgia Initiative, all have a lobby component. For 2011 these fees amounted to $140,234. Additionally, Oglethorpe Consulting Group was contracted during 2011 to review and advise the Hospital on legislative issues. During 2011 $88,000 was paid to Oglethorpe Consulting Group. 14518882 14518882 245154270 105246695 139907575 213046714 151618451 61428263 4133910 4133910 219988630 Reserve for Self Insured Losses 22451472 Other Current Liabilities 2903969 Est Third Party Payor Settlements 15504238 Asset Retirement Obligation 2699600 Accrued postretirement benefit cost 32323673 Accrued Pension Cost 56430647 Accrued Compensation, Benefits, & PR Tax 18888415 151202014 386978310 372807488 14170822 -18700252 -33971026 -52671278 -38500456 370931926 -18700252 3881408 -14818844 385750770 1227540 1227540 386978310 376030515 4017981 4017981 372012534 794954 794954 372807488 Part X Part X : FIN48 Footnote Accounting for Income Taxes - University Health Services is exempt from federal income tax under Section 501(a) as organizations described in Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. Accordingly, the accompanying financial statements do not reflect a provision or liability for federal and state income taxes. University Health Services has evaluated their tax positions and determined that they do not have any material unrecognized tax benefits or obligations as of December 31, 2011. Fiscal years ended no or after December 31, 2008 remain subject to examination by federal and state authorities.There is presently no taxation imposed by the government of the Cayman Islands on income or premiums of WWI. As a result, no tax liability or expense has been recorded. Part XIII, Line 4b Part XIII, Line 4b: Other revenue amounts included on 990 but not included in F/S Bad Debt Expense $0 Investment manager fees $1227540 Steam/Elect reimb, netted to exp $-432586 Part XIII, Line 2d Part XIII, Line 2d: Other expenses and losses per audited F/S Expenses netted to rental income $2084260 UHCF Exp on Consolidated AFS $2040473 UHCF Elimination entries on AFS $-106752 Part XII, Line 4b Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S Bad Debt expense, in revenue on Audit $0 Investment mgr fees, in revenue on audit $1227540 Part XII, Line 2d Part XII, Line 2d: Other revenue amounts included in F/S but not included on form 990 Steam/Electric Reimb-netted against exp $432586 Rental Expenses shown net on 990 $2084260 UHCF Unrest Revenue on Consolidated AFS $1471314 UHCF Revenue eliminations on AFS $-106752 Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances Other Cumulative effect on Assets Retirement Obligation $157323 Tranfer to affiliate $ -710949 Cumulative effects on assets retirement obligations $ -0 Changes in Unfunded Pension/Postretirement Loses $ -32624618 Loss on Discontinued Operations $ -792782 Caribbean 1 2 Insurance Captive 2422916 1 2 1 2 2422916 2422916 X false false false false false false Additional Supplemental Information Please see form 5471 filing for details related to Offshore Captive Insurance true true true X true X true true true false true true 18022757 2479023 15543734 0.04170 38853223 34072068 4781155 0.01280 56875980 36551091 20324889 0.05450 10441489 582233 9859256 0.02640 817764 137824 679940 0.00180 1510149 1510149 0.00410 12769402 720057 12049345 0.03230 69645382 37271148 32374234 0.08680 183324 183324 0.00050 183324 183324 0.00050 true 22582741 3161584 107776647 130677996 -22901349 X true true 1 0 UHS University Hospital

1350 Walton Way Augusta GA 30901

X X X X 3 Hospital Based Home Health Agencies UHS University Hospital 1 false true true 200.0000 true 400.0000 true X X X X X true true X X X X X true X X X false true X false false Part VI - Additional Information Part III, Section C-Collection Practices-Question 9aThe Catastrophic Policy allows for the Collection Department to apply the Indigent criteria and write-off the account. And at any point during the collection process if patient is believed that he/she can not afford to pay then an indigent/Charity Care application is begun by the Collection Department. Part V - Explanation of Number of Facility Type UH owns and operates three (3) Home Health Agencies as hospital-based agencies. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose UH governing Board members are comprised of citizens who reside in the UH's primary service area and are not employees of UH. UH Board members are active in the community and are eager to improve the health and welfare of the community. Several of UH Board Members worked with the local State Medical School to get interns & residents at the hospital since UH is among several counties that have been deemed as a Health Professional Shortage Area (HPSA). UH extends medical staff privileges to all qualified physicians in our community for all of the UH Departments.UH works with the Greater Augusta Healthcare Network (GAHN) which is made up of area hospitals and the local Medical Colleges School of Nursing and area primary care clinics. This group addresses the primary and specialty care needs in the community. Also UH supports the Project Access Program in Richmond and Columbia County. UH provides all of the Inpatient hospitalization for the Indigent population that is approved for Project Access. UH is the only hospital in the area that is responsive to the needs of these organizations who also support the needs of the Indigent. UH provides many screenings in the community. One such screening is the PSA screening that is performed at Lowes Home Building stores. Many received the screening, some with positive results, indicating cancer. However these were caught at an early stage, thanks to these free screenings. UH's Mobile Mammography unit travels to area plants and is available for screenings at the job site during lunch. These are only a few examples of the Screenings UH provides in the community but they have tremendous impact when just one screening identifies problems that can be treated at an early stage 1 cancer verses at the later stages of cancer. Part VI - Community Building Activities The Community Building Activities reported are support for the various Chambers of Commerces for the communities that we serve. In supporting these organizations we can support the development of our community by bringing in new industries and jobs, increasing the average household income, improving living conditions, and impacting overall general health. Part VI - Community Information UH resides in Richmond County, Georgia. In 2008 The Department of Community Health (state Medicaid division) issued a Georgia Health Disparities Report which listed Richmond County as having 53% Black, 44% White & the remaining 3% mostly Hispanic with some Asian, American Indian and other. 19.6% of the population is below the Federal Poverty Guidelines (FPG). 7.5% of the Adult population completing less than the 9th Grade. 9.2% of the Adult population is unemployed and 18.1 are uninsured.Surrounding Counties include : Burke County with 51% African American and 2% Latino; 28% below FPG; 21.3% with no insurance coverage and 9% unemployed. Jefferson County with 56% African American and 2% Latino; 32% below FPG; 21% with no insurance coverage and 12% unemployed. Lincoln County with 33% African American and 1% Latino; 15% below FPG; 16% with no insurance coverage and 6 % unemployed. McDuffy County with 60% African American and 4% Latino; 18% below FPG; 21% with no insurance coverage and 8% unemployed. Part VI - Patient Education of Eligibility for Assistance UH has the following information available to patients and visitors on the eligibility for assistance. Information is available on the University Hospital web site, patient/visitor information booklet, and UH has signage at registration and billing areas that ask "... help with your Hospital bill?" In addition, when a registering patient indicates that he/she can not afford to pay, UH will offer the Indigent and Charity Care Application (ICCP) and set up patient to speak with the Financial Assistance Office (FAO). FAO will direct patients to a Department of Family and Children (DFCS) case manager located at the hospital to see if patient qualifies for state Medicaid or the UH ICCP program. The patient may be deemed to qualify for other State/Federal assistance in which the FAO staff will help direct the patient to another group operated out of of the hospital, Resource Corporation of America (RCA), to assist with getting the patient qualified for SSI, etc. Part VI - Needs Assessment UH continues to use the Health needs Assessment that was completed historically which showed a need for primary health care homes for patients in the the 30901, 30906 and 30904 zip code areas (Richmond County). University established three clinics in these areas after the assessment and continues to fund and expand the support of the Primary Care Health clinics in this area. UH works with the Greater Augusta Health Care Network (GAHN) which is made up of area hospitals and primary care clinics along with the Medical College of Georgia's School of Nursing. GAHN has been collecting data showing the continued need for Primary Health Care homes for the uninsured and under insured even with the support that UH has provided. In addition to this data UH continues to rely on the national data for other opportunities to support the community; such as, Cancer screening, Mammograms, diabetes, cardiovascular clinics, obesity, etc. In addition UH works with ER personnel to identify needs based on patients seeking help through the Emergency Room. This process still shows that patients need a medical home, asthma, diabetes assistance. The programs that UH has initiated and continue to support. The Health Resources and Services Administration has designated Richmond County as a Health Professional Shortage Area (HPSA). In 2008, the State of Georgia issued a Georgia Health Disparities Report. In this report Richmond County showed above -average outcomes but some racial inequality for Access to primary care providers; even though, UH has sponsored 4 to 5 area clinics with one being designated as a Federally-Qualified Community Health Center (FQHC). Counties surrounding UH show Lincoln County, McDuffy County, Burke County, and Jefferson county as a HPSA with no FQHC having poor outcomes made worse by extremely severe racial inequalities. Number of Hospital Faciltiy - 0 Part V, Line 13g - Other Means Hospital Facility Publicized the Policy Financial Counselors & Access Coordinators explain to Patient and offer Financial Assistance form to patient. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients As outstanding balances age, statement messages, collection letters and/or telephone calls may be used at appropriate intervals determined by the Patient Accounting/Collection Department. The Patient Accounting /Collection Department recognizes that there are occasions when a patient is not financially able to pay their medical bill in full and/or the patient is experiencing financial hardship. The Hospital has established a Catastrophic Policy which allows for the Collection Department to apply the Indigent criteria and write-off as Medically Indigent. And at any point during the collection process if patient states or Patient Accounting/Collections believes that the patient can not afford to pay then an indigent/Charity Care application is begun by the Collection Department where discounts may be given. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The services provided to the Medicare Beneficiaries are to promote the well-being of the community which is part of the Hospital charitable tax-exempt purpose. The Medicare difference between cost and Medicare reimbursment should be allowed as CB since providers can not negotiate rates with Centers for Medicare/Medicaid Services (CMS). CMS regulates that the reimbursement be federal budget neutral thus placing the cost of the caring for medicare beneficiaries as a cost to the Hospitals. Part III, Line 4 - Bad Debt Expense Page 8 of Audited Financial Statement: Accounts Receivable--Current Operations are charged with provisions for uncollectible accounts based upon experience and any unusual circumstances which affect the collectability of receivables. Amounts deemed uncollectible are charged against this allowance. In the opinion of managment, adequate provision has been made for uncollectible accounts.Bad Debt should be included as a Community Benefit since the services that incur bad debt are provided by the hospital to promote the well-being of the community. These services are rendered in conjunction with the Hospital's charitable tax-exempt purposes. There is no local support for uninsured patients; therefore, the services provided by the hospital relief the health care burdens of the local governments. Part I, Line 7 - Explanation of Costing Methodology Used Cost to Charge Ratio calculated using Worksheet 2 --the optional worksheets provided to assist in preparation of Schedule H. Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) Also uses Asset Test, regardless of income, to determine eligibility for free and discounted care. In addition the hospital takes into consideration Bankruptcy and financial standing when offering discounts on patient liability. true United Way of Greater Augusta PO Box 1166 Fishersville VA 22939 540955100 501(c)(3) 15240 0 Support Programs Rape Crisis 806 13th Street Augusta GA 30901 581581102 501(c)(3) 0 81264 Medicare Cost Report Donated Facilities Support Programs Neighborhood Improvement Project 2467 Golden Camp Road Augusta GA 30906 311491242 501(c)(3) 300000 0 Clinic Financial Support Miracle Making Ministries 1127 Druid Park Ave Augusta GA 30904 582358627 501(c)(3) 40000 0 Clinic Financial Support Harrisburg Family Heal 423 Crawford Ave Augusta GA 30904 264366421 501(c)(3) 120000 0 Clinic Financial Support Coordinated Health Services Inc 2110 Broad Street Augusta GA 30904 582060572 501(c)(3) 160000 11716 Cost of Tests Lab Testing Clinic Financial Support Christ Community Health Services 519 Scotts Way Augusta GA 30909 205404353 501(c)(3) 480000 174442 Medicare Cost Report Donated Facilities Clinic Financial Support Beulah Grove Community Resource 1446 Lee Beard Way Augusta GA 30901 582159621 501(c)(3) 60000 31878 Cost of Tests & Drugs Lab Testing Clinic Finanical Support American Cancer Society 250 Williams Street NW Atlanta GA 30303 131788491 501(c)(3) 13000 0 Support Research 9 0 Grantmaker's Description of How Grants are Used University Health Care System does not provide "grants" to assist other organizations, but does donate funds based on the following policy and procedures: POLICY:University Health Care System is committed to the overall health and well-being of the communities it serves and recognizes the need to support other non-profit organizations who share this commitment. Corporate contributions and sponsorships are sometimes an appropriate vehicle for building partnerships with these non-profit organizations and maximizing our overall positive impact on the community.PROCEDURE1.All contribution/sponsorship requests should be submitted in writing to the Corporate Communications Department for consideration. Every effort should be made to process these requests and notify the requester within two weeks of receiving the written information required to evaluate the opportunity.2.In consultation with the CEO, the Director of Corporate Communications will prepare the annual budget for Corporate Contributions/Sponsorships and process/manage actual disbursements throughout the year.3.Requests will be evaluated based on the following criteria:a.Does the organization, event or publication promote the overall health and well-being of the communities we serve? Special consideration will be given to requests that directly impact health and wellness even though support may be available for organizations, events and/or publications that have a positive impact on the CSRA by:"assisting in attracting and retaining a viable work-force"assisting in attracting and retaining viable businesses and employers in the CSRA"promoting the continued growth and economic well-being of the community"enhancing the quality of life in the CSRAb.Does the proposed contribution/sponsorship primarily assist people locally rather than a national effort/initiative?c.Does the requesting organization have an approved tax-exempt status?d.Will the proposed contribution/sponsorship enhance the overall image/reputation of University Health Care System?e.Will the proposed contribution/sponsorship heighten awareness of a significant health issue or disease that has a negative impact on the citizens in the communities we serve?4.Under no circumstances will contributions be made to political campaigns.5.Because of the large number of public and private schools in the CSRA, University will limit financial support/contributions to the various Boards of Education rather than individual schools (elementary, middle and high schools).6.Because of the large number of churches in the CSRA, University will limit financial support/contributions to programs that include health-related services for underserved residents such as community clinics.7.Exception: Financial support and partnerships with area colleges and technical schools do not fall under this policy. X true true X X X X X true true false false false true false false false false William L Farr Jr 312007 65763 79518 20825 16827 494940 Teresa Waters 148572 15448 870 16122 9095 190107 Tara A Kattine 212174 362 6854 7905 227295 Stephen M Gooden 256779 2563 2450 7013 268805 Shannon M Stinson MD 269540 35820 10224 6103 321687 Richard W Severson 132396 2900 19619 15795 15668 186378 Marilyn A Bowcutt 234880 52920 55170 53549 8972 405491 Lynda Jones Watts 127381 18159 2508 14145 7365 169558 Leslie A Clonch 99738 31836 57919 1010 7856 198359 Kyle E Howell 164504 37075 222189 22380 12377 458525 Joan F Wessman 169184 125426 7068 14622 316300 James R Davis 520195 84252 3275 223697 15396 846815 Edward L Burr 239614 50492 1891 59925 20642 372564 Dave A Belkoski 373170 83500 71361 20825 21646 570502 Christine A Martin 127676 5044 4452 11529 8817 157518 Brent J Mallek 150362 46315 96893 6832 21927 322329 Sch J, Part III, Additional Information Part III, Additional Information Social Club Dues- The organization pays membership fees for the CEO (James Davis) and CFO (David Belkoski) to the Augusta Country Club and the West Lake Country Club. These membership fees are paid so the organization can have access to the meeting facilities and catering services these organizations provide for meetings that are held off campus. Any personal use related to these memberships are included in the wages of the CEO and CFO. Sch J, Part I, Line 1a Part I, Line 1a: Relevant information in regards to selections on 1a. The Richmond County Hospital Authority 586001901 764603AV8 2009-12-03 150901243 Refund Bond Certificates (Bond Series 99,03,08) false false 2375000 150901243 1243 150901243 2008 true false true true false true false false true 0.03000 0.00200 0.03200 false false false false false false false X Rhonda U Belkoski Spouse of CFO 19092 Employee Compensation RN false Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available All governing documents, policies, financial statements, and informational returns are available upon request at the Administrative offices.The 990 is also available on www.Guidestar.org Form 990, Part VI, Line 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The Organization follows the process described in Treasury Regulation 4958(6)(c) for establishing the rebuttable presumption of reasonableness in the review, approval, and documentation of officer, key management, and director compensation. Annually a compensation committee of the University Health Services Board, comprised of three independent board members, reviews the compensation of the CEO and other senior management members. The review is conducted in the context of a Board approved executive compensation philosophy. Both the development of the compensation philosophy and the review involve the advice and assistance of an independent compensation consulting firm. Minutes of the compensation committee are recorded. The compensation committee reports to the University Health Services Board Executive Committee. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts The steps in the conflict of interest policy are outlined below:1.Senior management (vice presidents and above) shall complete a Potential Conflict of Interest Questionnaire periodically. Each System organization's CEO, COO, CFO and within their divisions' vice presidents may require any employee to complete a Potential Conflict of Interest Questionnaire.2.Each employee is expected to report a potential conflict of interest when it arises.3.A. An employee will report a potential conflict by initiating a Potential Conflict of Interest Disclosure Form and delivering it to his/her vice president. All employee potential conflicts will be screened by two levels of senior management to identify conflict or duality of interest situations. (A duality of interest exists when an individual has personal or outside interests that can be affected by decisions of the System. Such a duality or even multiplicity of interest can be beneficial to and consistent with the primary goals of the institutions. Duality of interest can raise the potential for conflict of interest when the personal interests of individuals come into conflict with the interests of the System.) B.When a division vice president is notified of a potential conflict/duality of interest, the vice president shall investigate the situation and make a report of his or her findings along with a recommendation to the Executive Vice President (COO) or CEO of the involved System organization.C.The Executive Vice President or CEO who received the 3.B report shall make a decision concerning a potential conflict of interest and any resolution measures to be taken. In the event the potential conflict involves a vice president, the President of University Health shall investigate the situation and make a decision concerning a potential conflict of interest and any resolution measures to be taken. This information shall be communicated directly to the concerned employee.D.The employee may appeal the conflict of interest determination to the President of University Health. The President's decision about a potential conflict of interest and any resolution measures is final and not cognizable under the Employee Grievance Policy A-30.E.In the event the potential conflict involves the CEO of any System organization, the matter shall be reported to the Chairman of the involved System organization board, who shall determine if a conflict exists and what, if any, resolution measures are necessary in accordance with that corporation's conflict of interest policy. 4.Filing of FormsA.Conflict of Interest Questionnaires of those who are required by this policy to complete one periodically shall be filed in the applicable corporation's CEO's office and retained for no less than seven years. Optional Conflict of Interest Questionnaires shall be filed in the office of the vice president who requested completion of the form.B.Completed Potential Conflict of Interest Disclosure Forms shall be filed in the applicable corporation's CEO's office for the CEO, COO, and vice presidents and for all others in the appropriate vice president's office. The forms should be retained for no less than seven years.5.The Vice President for Legal Affairs will be available to advise on potential conflict of interest matters.BOARD MEMBERS:Board Members are also required to complete a Potential Conflict of Interest Questionnaire annually. This questionnaire asks for disclosures related to any family relationships or business relationships with other board members, or business relationships with the Organization. Form 990, Part VI, Line 11 Form 990, Part VI, Line 11: Form 990 Review Process A copy of the 990 form and all related schedules was provided to the governing board before filing. Walton Way Indemnity SPC 2nd Fl Governors Sq 23 Lime Tree Grand Cayman CJ Insurance Captive CJ 2996567 33997497 University Health Services Inc University Hospice Inc 1350 Walton Way Augusta GA 30901 275008428 End of Life Support GA 501(c)(3) 9 University Health Inc false University Health Inc 1350 Walton Way Augusta GA 30901 581581102 Consolidating Parent GA 501(c)(3) 9 N/A false University Health Care Foundation Inc 2100 Central Avenue Suite D-1 Augusta GA 30904 581343550 Philantrophy GA 501(c)(3) 7 University Health Inc false Augusta Resource Center on Aging Inc 4275 Owens Road Evans GA 30809 581728812 Non Profit Life Care Community GA 501(c)(3) 9 University Health Inc false University Extended Care Inc 1350 Walton Way Augusta GA 30901 581581105 Skilled Nursing Homes GA 501(c)(3) 3 University Health Inc false Richmond County Hospital Authority 1350 Walton Way Augusta GA 30901 586001901 Leased facilities GA 501(c)(3) 3 N/A false University Health Resources Inc 1350 Walton Way Augusta GA 30901 581601372 Services to Physicians GA University Health In C Corp false false false true false false false false false true false true false true false false false false