2011-05-16T14:38:26-05:00 2010-06-30 DRAFFIN & TUCKER LLP PO BOX 6 ALBANY GA 317020006 990 2009-07-01 581955423 SOUTHERN REGIONAL HEALTH SYSTEMINC SOUT 7709918010 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 302742600 S LEE BOLES JR 7709918010 2011-05-16 true JACQUELINE G ATKINS 2298837878 2011-05-16 2009 2016-02-24 21:20:13Z STEPHEN MAHAN CEO 11 UPPER RIVERDALE RD SW RIVERDALE GA 302742600 281534165 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 23 2445 90 326680 2120744 921992 257088896 259468386 5371237 1827403 3413074 2435160 267993951 264652941 1978140 3995791 0 116243051 114036024 0 0 153466599 153016302 271687790 271048117 -3693839 -6395176 176872790 167420168 122530461 122617628 54342329 44802540 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 220050028 3995791 259458383 SOUTHERN REGIONAL HEALTH SYSTEM, INC. PROVIDED 74,475 DAYS OF ACUTE AND INTENSIVE CARE, TREATED MORE THAN 145,000 OUTPATIENTS, AND PROVIDED EMERGENCY CARE TO MORE THAN 78,000 PATIENTS IN ITS EMERGENCY ROOM. SRHS ALSO PROVIDED 5,913 DAYS OF CARE TO THE MORE THAN 3,853 BABIES BORN AT SRHS. 220050028 true true false false false false false false false true false true false false false false false false false false true true true true true false false false false false false false false false false false false false false false true true true false true 93 0 true 2445 true true true false false false false false false false false false false false false false 23 23 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 BENNY WHITMORE 4.00 X X 11440 0 0 RONALD M DODSON 3.00 X X 11300 0 0 DANIEL T MCDEVITT 3.00 X 11050 0 0 REV ED J BEST JR 3.00 X 9500 0 0 ANDREA CALLAWAY 2.00 X 8730 0 0 JAY R PRAKASH MD 2.00 X 8000 0 0 WILLIAM C MCBERRY 2.00 X 7900 0 0 RAMESH REDDY MD 1.00 X 7600 0 0 HOMAYOUN AMIN MD 1.00 X 6800 0 0 JAMES G ADAMS 3.00 X X 6300 0 0 RAJU M VANAPALLI 2.00 X 6100 0 0 SHERRY HANCOCK 3.00 X 5600 0 0 GARY J LAGGIS 2.00 X 4000 0 0 JAMES O WATKINS 1.00 X 3800 0 0 PRAVEEN RASTOGI 1.00 X 2800 0 0 GLYNDA B KING 2.00 X 2000 0 0 RONALD SHIPMAN 1.00 X 2000 0 0 ALLAN VIGIL 1.00 X 1800 0 0 ANGELA JACKSON 2.00 X 800 0 0 RALPH WOLFE 1.00 X 800 0 0 REV CHARLES GRANT 1.00 X 0 0 0 RICHARD PROKESCH MD 3.00 X X 0 0 0 STARR S HELMS 1.00 X 0 0 0 CLINT MATTHEWS 40.00 X 0 0 0 JOHN SCHIBLER 40.00 X 0 0 0 CATHY KENNEY 40.00 X 0 0 0 STEVE MAHAN 40.00 X 0 0 0 THERESE SUCHER 40.00 X 0 0 0 MARY KAY GARDENIER 40.00 X 299106 0 14507 WILLIE COCHRAN 40.00 X 250432 0 3412 JAMES CRISSEY 40.00 X 199920 0 15800 KAREN MOORE 40.00 X 165778 0 2245 NORMA ADAMS 40.00 X 161665 0 2912 ROY GILLELAND 40.00 X 370050 0 14267 NICHOLAS MAIDA 66.00 X 162621 0 7729 MELODY MENA 40.00 X 153438 0 3326 WILLIAM APPLEGATE 40.00 X 153289 0 9285 DANIEL HOODIN 40.00 X 149893 0 7638 EDWARD BONN 40.00 X 486164 0 13609 RICHARD G STOVALL 40.00 X 194688 0 11292 2865364 106022 83 true true true COMPLETERX 3100 S GESSNER SUITE 640 HOUSTON TX 77063 PHARMACY MGMT 12236199 FTI HEALTHCARE PO BOX 630391 BALTIMORE MD 21263 MANAGEMENT 5122579 MCKESSON INFORMATION SOLUTIONS PO BOX 98347 CHICAGO IL 60693 IT SUPPORT 1735886 AGFA FINANCE CORPORATION PO BOX 223531 PITTSBURGH PA 15251 EQUIPMENT FINAN 1351730 GE HEALTHCARE PO BOX 402076 ATLANTA GA 30384 IMAGING SERVICE 1302578 84 921992 921992 PATIENT REVENUE 259141706 259141706 LAB OUTREACH 621500 326680 326680 259468386 1553283 134596 1418687 566277 566277 566277 566277 17155344 16881224 274120 274120 274120 CAFETERIA 1126479 1126479 PAID PARKING REVENUE 521983 521983 MISCELLANEOUS 98137 98137 122284 83944 38340 1868883 264652941 259458383 326680 3945886 3875728 3875728 120063 120063 1336968 1336968 705753 705753 92408247 77238482 15169765 3297564 2765327 532237 9269091 7874538 1394553 7018401 5769593 1248808 5122579 5122579 1357501 1357501 496464 496464 19540369 10769257 8771112 720333 20898 699435 48107057 46931915 1175142 3202673 3202673 5122156 4538107 584049 130152 58500 71652 19973 13075 6898 2121450 2121450 10687004 9468686 1218318 822080 822080 BAD DEBT 48953145 48953145 REPAIRS AND MAINTENANCE 4808441 778495 4029946 MISCELLANEOUS 1161846 752677 409169 DUES AND SUBSCRIPTIONS 222194 69210 152984 TAXES AND LICENSES 216538 10617 205921 204347 41715 162632 271048117 220050028 50998089 0 8750 8750 4930730 12215007 33335544 30623132 418227 264990 3505047 3588340 2414127 1361331 264422961 194301678 75064160 70121283 51726881 42653220 2909716 2775571 286549 271129 2273059 3537415 176872790 167420168 28099662 28593098 53607863 50172147 871278 40822936 42981105 122530461 122617628 X 54177675 44613698 164654 188842 54342329 44802540 176872790 167420168 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false 7215082 7215082 124932251 83063670 41868581 131930891 111238008 20692883 344737 344737 70121283 UNFUNDED PENSION LIABILITY 26956871 SELF INSURANCE RESERVE 15629847 ACCRUED BOND INTEREST PAYABLE 222985 MORRISION'S DEBT FORGIVENESS 150019 PROFESSIONAL FEES PAYABLE 21383 42981105 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 FOLLOWS 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 7176692 7176692 0.03230 49155185 44666791 4488394 0.02020 56331877 44666791 11665086 0.05250 5 1027 7445 7445 1 423 108723 51900 56823 0.00030 20665843 16961601 3704242 0.01670 1 17400 17400 0.00010 7 1450 20799411 17013501 3785910 0.01710 7 1450 77131288 61680292 15450996 0.06960 true 13441897 54214244 51694888 2519356 X true true SPIVEY STATION ASC REAL ESTATE MGMT 0.45000 SOUTHERN REGIONAL HEALTH SYSTEM INC

11 UPPER RIVERDALE ROAD SW RIVERDALE GA 30274

X THE ORGANIZATION PREPARED A COMMUNITY BENEFITS REPORT AND IT WAS PROVIDED TO THE CLAYTON COUNTY HOSPITAL AUTHORITY AND FILED WITH THE CLERK OF THE SUPERIOR COURT. THE COMMUNITY BENEFIT REPORT IS AVAILABLE TO THE PUBLIC THROUGH THESE PUBLIC ENTITIES. UTILIZED THE RATIO OF COST TO CHARGE INFORMATION FROM WORKSHEET C OF THE FY 2010 COST REPORT. 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 25 271,048,117 LESS: BAD DEBTS IN PART IX ( 48,953,145) DENOMINATOR FOR COLUMN (F) 222,094,972 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. THE METHODOLOGY USED FOR THIS SECTION WAS THE MEDICARE COST REPORT RATIO OF COST TO CHARGE APPROACH. PATIENTS ARE SCREENED BASED ON COUNTY OF RESIDENCE, INCOME LEVELS, AND IF THE MEDICAL CARE IS CONSIDERED CATASTROPHIC IN NATURE. DEPENDING ON THE CRITERIA, PATIENT'S 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. PART IV - MANAGEMENT COMPANIES AND JOINT VENTURES SURGERY CENTER REAL ESTATE INVESTORS ("SCREI") OWNS A 49.59% 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 48% OF SCREI. 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. THE ORGANIZATION INFORMS AND EDUCATES PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE BY POSTED SIGNS, FORMS, AND EMAILS. 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 WOMEN'S COMMUNITY CARE. 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. GA true UNITED WAY 107 WESTRIDGE INDUSTRIAL BLVD MCDONOUGH GA 30253 580566194 3 5200 DONATION PROPS DESIGN GROUP 11392 AZALEA TRAIL HAMPTON GA 30228 17712 DONATION SOUTHERN REGIONAL AMBULATORY SURGERY INC 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 30274 582541044 3 62286 OPERATIONS SOUTHERN CRESCENT PHYSCIAN GROUP 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 30274 581955425 3 1384802 OPERATIONS SOUTHERN CRESCENT REAL ESTATE INC 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 30274 581955424 3 2396487 OPERATIONS 4 1 TUITION ASSISTANCE 73 120063 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 CLINT MATTHEWS JOHN SCHIBLER CATHY KENNEY THERESE SUCHER MARY KAY GARDENIER 299106 14507 313613 WILLIE COCHRAN 245718 4714 3412 253844 JAMES CRISSEY 196768 3152 15800 215720 KAREN MOORE 164899 879 2245 168023 NORMA ADAMS 159980 1685 2912 164577 ROY GILLELAND 275638 92416 1996 14267 384317 NICHOLAS MAIDA 156403 6218 7729 170350 MELODY MENA 150782 2656 3326 156764 WILLIAM APPLEGATE 152642 647 9285 162574 DANIEL HOODIN 149893 7638 157531 EDWARD BONN 486164 13609 499773 RICHARD G STOVALL 194688 11292 205980 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 MARY KAY GARDENIER 299,106 0 0 DANIEL HOODIN 149,893 0 0 EDWARD BONN 486,164 0 0 RICHARD G. STOVALL 194,688 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"). ADDITIONALLY DURING THE FISCAL YEAR, FTI PROVIDED MANAGEMENT SERVICES INCLUDING THE FOLLOWING EXECUTIVE POSITIONS: CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, CHIEF OPERATING OFFICER, AND CHIEF NURSING OFFICER. THE AMOUNT PAID TO FTI CONSULTING, INC. BY SRHS DURING THE FISCAL YEAR ENDING JUNE 30, 2010 INCLUDES COMPENSATION FOR SERVICES PROVIDED BY CLINT MATTHEWS, PAST CEO; CATHY KENNEY, CNO; THERESE SUCHER, COO; AND JOHN SCHIBLER, CFO. CLINT MATTHEWS, PAST CEO, LEFT SRHS 4/26/10 WITH THE TERMINATION OF THE FTI MANAGEMENT CONTRACT. AS PART OF THE PERMANENT EXECUTIVE MANAGEMENT TEAM, SRHS HIRED STEVE MAHAN AS THE CEO ON APRIL 26, 2010. SINCE COMPENSATION IN PART VII, SECTION A IS REPORTED ON A CALENDAR YEAR BASIS, NO COMPENSATION IS REPORTED FOR HIM THIS YEAR. PART I LINE 4 - SEVERANCE SEVERANCE COMPENSATION IS IN ACCORDANCE WITH EACH INDIVIDUAL'S EMPLOYMENT AGREEMENT. CLAYTON COUNTY HOSPITAL AUTHORITY 2009 SERIES BONDS 582016041 184153ED2 2009-04-01 40200000 REFINANCE 1998B BOND false true 39675000 2009 true false true true false false false false true true false true 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 11 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 THIS POSTING WAS 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. THE 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. ADDITIONAL INFORMATION SCHEDULE O FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS IN ADDITION, SOUTHERN REGIONAL PARTICIPATED IN COMMUNITY WELLNESS SERVICES FREE OR AT REDUCED COSTS TO THE COMMUNITY, INCLUDING: DIET CONSULTATIONS AND WEIGHT LOSS CLASSES, PAIN MANAGEMENT PROGRAMS, OCCUPATIONAL HEALTH, INFLUENZA VIRUS VACCINATION DRIVE, MAMMOGRAPHY SCREENINGS, DIABETES EDUCATION AND CONSULTATION, CHILDBIRTH PREPARATION CLASSES, CPR AND FIRST AID COURSES, AND MEDICAL LIBRARY SERVICES. CORE 990, PART VII, SECTION A LINE 5 - UNRELATED ORGANIZATION COMPENSATION STEVE MAHAN, CURRENT CFO, WAS HIRED APRIL 26, 2010; THE DATE THE PREVIOUS CFO CLINT MATTHEWS TERMINATED. THE ORGANIZATION'S CEO AND CFO, AS WELL AS VARIOUS OTHER HIGH-LEVEL INDIVIDUALS, WERE PROVIDED UNDER A MANAGEMENT CONTRACT WITH FTI CONSULTING, INC. THIS UNRELATED ENTITY PROVIDED ADDITIONAL SERVICES TO THE ORGANIZATION AND AN OVERHEAD FEE IS INCLUDED IN AMOUNTS CHARGED TO THE ENTITY FOR MANAGEMENT TEAM COMPENSATION. AFTER MULTIPLE ATTEMPTS BY THE ORGANIZATION ITSELF TO OBTAIN THIS INFORMATION, FTI IS STILL UNWILLING TO PROVIDE THE INDIVIDUAL'S COMPENSATION OR COPIES OF THE W-2 FOR FORM 990 PURPOSES. THEREFORE, SUCH DATA IS NOT AVAILABLE. SOUTHERN REGIONAL MED CTR AUXILIARY 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 302742600 582027384 VOLUNTEER GA 501 11B NA SOUTHERN REG MED CNT FOUNDATION INC 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 302742600 581983516 FUNDRSG GA 501 11B NA SOUTHERN CRESCENT REAL ESTATE INC 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 302742600 581955424 REAL EST GA 501 11B NA SOUTHERN REG AMBULATORY SURGERY 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 302742600 582541044 SURGICAL GA 501 11B NA CLAYTON CO HOSP AUTH TRUST CO LIAB 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 302742600 582016041 LIAB CLAIM GA 501 11B NA SOUTHERN CRESCENT PHYSICIANS GROUP 11 UPPER RIVERDALE ROAD SW RIVERDALE GA 302742600 581955425 PHYS PRACT GA 501 3 NA PROMINA HEALTH SYSTEM INC P O BOX 500428 ATLANTA GA 31550 582135501 PURCHASING GA 501 11A NA SPIVEY STATION ASC BUILDING LP TWO SUN COURT SUITE 350 NORCROSS GA 30092 263323060 RENTAL GA NA RELATED 134596 5814858 false false SOUTHLAKE AMBULATORY SURGERY CENTER 4000 CORPORATE CENTER DR MORROW GA 30260 582272588 SURGICAL GA SRAS RELATED -1461626 1553607 false true false true true false false false false false false false false true true true false false true true