2011-08-03T12:32:10-05:00 2010-09-30 DIXON HUGHES GOODMAN LLP 111 FRANKLIN RD SE SUITE 501 ROANOKE VA 240112114 990 2009-10-01 546075662 TWIN COUNTY REGIONAL HEALTHCARE INC TWIN 2762368181 200 HOSPITAL DRIVE GALAX VA 24333 Nelson Montgomery 2762368181 2011-07-25 1 Michael P Norton 5409896144 2011-07-25 2009 2016-02-24 21:20:13Z Nelson Montgomery 200 HOSPITAL DRIVE Galax VA 24333 49163225 0 X www.tcrh.org X 1973 VA To promote, preserve, and restore the health of our community. 13 12 653 0 0 0 1631 56214 52257028 48426007 167126 161300 483295 519704 52909080 49163225 0 0 28661334 27558751 0 0 22955231 23406532 51616565 50965283 1292515 -1802058 27436549 23464311 14527874 14441743 12908675 9022568 To provide health services for residents in the surrounding areas of rural southwest virginia. 0 0 29050210 56214 49107011 PATIENT SERVICES PROVIDED BY A 141 BED HOSPITAL including rural health clinics, operating room, pharmacy services, home health services, CORONARY CARE, OCCUPATIONAL tHERAPY, REPIRATORY THERAPY,pHYSICAL THERAPY AND HEALTH PROMOTION. 29050210 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 1 70 0 1 653 1 0 0 0 0 0 0 0 0 0 13 12 0 0 0 0 0 0 0 1 1 0 1 1 0 1 1 0 1 1 1 0 0 X THE HOSPITAL 5402368181 200 HOSPITAL DRIVE GALAX VA 24333 John W Bolen Jr 1.00 X 0 0 0 James Griffeth 1.00 X 0 0 0 Rebecca W Cardwell 1.00 X 0 0 0 William L Davis 1.00 X 0 0 0 Blake M Edwards 1.00 X 0 0 0 joseph killon 1.00 X 0 0 0 oliver mcbride 1.00 X 0 0 0 Edward A Hanks II 1.00 X 0 0 0 Barry mayberry 1.00 X 0 0 0 Robert E Pryor 1.00 X 0 0 0 William R Roberts 1.00 X 0 0 0 Larry G South 1.00 X 0 0 0 Taylor C Vaughan 1.00 X 0 0 0 Douglas S Vaught 1.00 X 0 0 0 c m mitchell 1.00 X 0 0 0 Jon Applebaum 40.00 X X 181262 0 19608 Sandra Moretz 40.00 X 133757 0 12681 Nelson montgomery 40.00 X 120225 0 20044 Dianne Dill 40.00 X 160932 0 12619 Michael Shanks 40.00 X 169870 0 22809 Mitch Mize 40.00 X 152630 0 22955 JAMES HELMS 40.00 X 157513 0 20412 1076189 0 131128 13 0 1 0 CARDINAL HEALTH PHARMACY MGMT 21377 NETWORK PLACE CHICAGO IL 60673 PHARMACY 885585 EPMG of Virginia PC 2000 Green Road Ann Arbor MI 48105 emergency department services 575135 aramark cts 12483 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 biomedical services 488555 Hospital Revenue Cycle Mgmt 4140 CLEMMONS ROAD SUITE 202 CLEMMONS NC 27012 Patient Accounting Services 435599 Johnston Memorial Hospital 351 Court Street NE Abingdon VA 24210 Blood Bank 329672 8 56214 56214 Ancillary revenue-nET 624100 36360342 36360342 Room and Board 624100 12065665 12065665 48426007 161300 161300 149167 149167 149167 149167 Cafeteria and Vending 900099 213412 213412 Miscellaneous 900099 66149 66149 Gift Shop Sales 900099 57707 57707 33269 33269 370537 49163225 48945711 0 161300 1076189 613428 462761 21451223 12227197 9224026 550478 313772 236706 2842515 1620234 1222281 1638346 933857 704489 192579 109770 82809 46427 26463 19964 106745 60845 45900 2632074 1500282 1131792 39665 22609 17056 134057 76412 57645 1389416 791967 597449 379022 216043 162979 521004 296972 224032 1810296 1031869 778427 339718 193639 146079 Supplies 6619593 3773168 2846425 Bad Debt Expense 4726761 2694254 2032507 Purchased Services 1157502 659776 497726 Contract Labor 1090518 621595 468923 Equipment Rental 871914 496991 374923 1349241 769067 580174 50965283 29050210 21915073 0 6053378 3590527 1395428 1052630 5637888 5536113 1199824 1149963 349921 361013 47621151 37015183 11840096 10605968 960014 1168097 27436549 23464311 4944611 6084582 9254485 7976257 328778 380904 14527874 14441743 X 12908675 9022568 12908675 9022568 27436549 23464311 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 274349 274349 20034846 13676242 6358604 112123 102310 9813 26420986 22504484 3916502 778847 732147 46700 10605968 Est MC/MCaid Settlement 172763 Federal Income Tax Withheld 90325 FICA Taxes Withheld 117816 380904 1 1 1 X 1 X 1 0 0 1 0 1762351 1762351 0.03460 6406187 4294633 2111554 0.04140 8168538 4294633 3873905 0.07600 46 1203 102674 102674 0.00200 12551 12551 0.00020 9 6395 6395 0.00010 55 1203 121620 121620 0.00230 55 1203 8290158 4294633 3995525 0.07830 4 1587 1587 0.00000 4 1587 1587 1 4441761 1538235 22061312 24628442 -2567130 X 1 1 Twin County Regional Hospital

200 Hospital Drive Galax VA 24222

X X Part I, Line 6a: An annual community benefit report is prepared by Twin County Regional Healthcare for inclusion in the Virginia Hospital and Healthcare Association. Part III, Line 4: The amounts in line 2-3 were derived based on the cost to charge ratio. Bad debt should be included in community benefit because we are providing a service to our community population that is either unable or unwilling to pay. Part III, Line 8: Medicare makes up over 50% of our business. Any shortfall that results from the payments received being less than the cost of providing the service should be considered as a community benefit. For small, rural hospitals like us, this can have a huge financial impact. Part III, Line 9b: Twin County Regional Hospital does not pursue collection of amounts determined to qualify as charity care. The expenses incurred in providing these services are included in the hospital's operating expenses. Part VI, Line 2: Twin County Regional Healthcare has four community advisory boards; Galax City Advisory Board, Grayson County Advisory Board, Carroll County Advisory Board and the Hispanic Advisory Board. Each of these groups meets quarterly to discuss the needs of the areas citizens. Groups are made up of TCRH Board Members that live in the respective area, social services, local police departments, local physicians and other community leaders that have been identified. The groups make suggestions of needed services, express concerns regarding healthcare needs and poll the citizens for their opinions. Part VI, Line 3: Twin County Regional Healthcare has an eligibility worker in partnership with the local Department of Social Services, cashiers and collection representatives available to help patients determine their eligibility for Medicaid, charity care or other programs for which they meet the qualifications. Cashiers and collection representatives are also trained to help establish payment plans for patients who do not qualify for other assistance. TCRH also offers a pre-pay program which discounts some of the most popular services offered. Brochures are available at local physician offices and entry points at TCRH. Part VI, Line 4: Grayson and Carroll counties and the City of Galax are the main areas which Twin County Regional Hospital services. These counties are located in southwest Virginia. With populations of 15,793 for Grayson County, 29,034 for Carroll County and 6,880 for Galax City, it is a rural area with several local physician offices meeting the rural health status. Over 20% of Grayson Countys population is over 65 years of age, 64% of the population is a high school graduate and most citizens have a daily commute to work for 30 minutes. Carroll County has 18% of its population over age 65, 64 % of the population is a high school graduate and the average commute is 26 minutes. Galax City has a 20% population of over age 65, 60% of residents have a high school degree and have a 15 minute commute to work. The unemployment rate of the two counties is over 10% and most jobs in the are manufacturing and local government. In these counties, 14.8-19% of the population is below the poverty level. Part VI, Line 5: Twin County Regional Healthcare has representation of the Virginia Asthma Coalition, Roanoke Asthma Coalition and the Twin County Coalition. The Virginia Asthma Coalition and the Roanoke Asthma Coalition target Virginia and Southwest Virginia, respectively, in a project to improve asthma education for the area. Our cardiopulmonary department manager has worked with the Roanoke branch to help establish the project in our counties. The Twin County Coalition was organized to provide opportunities for prevention, recovery and support for various health issues, drug prevention, community education and many early childhood programs. X X 0 0 0 0 0 0 0 0 0 Jon Applebaum 181262 0 0 0 0 0 6000 0 13608 0 200870 0 0 0 Dianne Dill 160932 0 0 0 0 0 0 0 12619 0 173551 0 0 0 Michael Shanks 169870 0 0 0 0 0 0 0 22809 0 192679 0 0 0 Mitch Mize 152630 0 0 0 0 0 0 0 22955 0 175585 0 0 0 JAMES HELMS 157513 0 0 0 0 0 0 0 20412 0 177925 0 0 0 X MEDICAL MONITORS 1 56214 FMV 0 0 0 0 Form 990, Part VI, Section B, line 11 The CFO reviews and signs the return. Form 990, Part VI, Section B, line 15a We have a compensation committee that is part of our board of directors. They are responsible for determining the compensation of the CEO. Form 990, Part VI, Section C, line 18 Copies are provided upon request Form 990, Part VI, Section C, line 19 Copies are provided upon request form 990, part xi, line 2c the review process has not changed during the year. Twin County Family Care Center 200 Hospital Drive Galax VA 24333 621455713 Physican Office VA 501(c)(3) Line 3 Twin County Regional Healthcare Inc Twin County Regional Health Services 200 Hospital Drive galax VA 24333 541397631 Wellness Center VA 501(c)(3) Line 3 Twin County Regional Healthcare Inc Twin County Regional Foundation 200 Hospital Drive galax VA 24333 541593923 Foundation VA 501(c)(3) Line 11a, I twin County Regional Healthcare Inc 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 Twin County Regional Foundation C 56214 Twin County Family Care Centers I 135740