2011-08-15T16:05:11-05:00 2010-09-30 DIXON HUGHES GOODMAN LLP 500 Ridgefield Court Asheville NC 28806 990 2009-10-01 582176794 HUTCHESON MEDICAL CENTER INC HUTC 7068582000 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742 DENISE BAKER 7068582000 2011-08-15 1 Amy Bibby 8282542254 2009 2016-02-24 21:20:13Z DENISE BAKER 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742 91580584 0 X WWW.HUTCHESON.ORG X 1995 GA TO PROVIDE ACCESS TO QUALITY, COST-EFFECTIVE, COMMUNITY-BASED HEALTH CARE SERVICES. 12 12 1388 125 9699 7236 593420 186652 96435900 89602041 51285 437819 1492978 1354072 98573583 91580584 0 0 54968188 48393136 0 0 50218241 50085441 105186429 98478577 -6612846 -6897993 74358237 70009689 51121843 54711828 23236394 15297861 THE PRIMARY MISSION OF HUTCHESON MEDICAL CENTER, INC. (HMC) IS TO PROVIDE ACCESS TO QUALITY, COST-EFFECTIVE, COMMUNITY-BASED HEALTH CARE SERVICES TO RESIDENTS OF WALKER, DADE, AND CATOOSA COUNTIES IN NORTHWEST GEORGIA. 0 1 87883782 90428164 HMC INCLUDES AN ACUTE CARE HOSPITAL, A SKILLED NURSING SUB ACUTE CARE UNIT, AND A NURSING HOME. ADDITIONALLY, HMC OFFERS HOSPICE RELATED SERVICES. HMC PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF HMC, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. FURTHER, HMC'S MISSION IS TO SERVE THE COMMUNITY WITH RESPECT, PROVIDING HEALTH CARE SERVICES AND HEALTH CARE EDUCATION. THEREFORE, IN KEEPING WITH THE HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY: FREE CARE AND/OR SUBSIDIZED IS CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST; AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND AN INDIVIDUAL'S INABILITY TO PAY COEXIST. THESE ACTIVITIES INCLUDE HEALTH EVALUATION, SCREENING PROGRAMS AND SPECIFIC SERVICES FOR THE ELDERLY AND HOMEBOUND AS WELL AS A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.HMC PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. CHARITY CARE IS ALSO PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES WHICH HMC BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. 87883782 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 96 0 1 1388 1 1 1 0 0 0 0 0 0 0 0 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 1 1 GA X X DENISE BAKER 7068582385 100 GROSS CRESCENT CIRLCE FORT OGLETHORPE GA 30742 MARTHA ATTAWAY 1.00 X X 0 0 0 PAUL R CHAMBERS 1.00 X X 0 0 0 WILLIAM CRAIG 1.00 X X 0 0 0 RICHARD CLARK 1.00 X X 0 0 0 CHARLES BERRY 1.00 X X 0 0 0 TIKU BHUTWALA 1.00 X 0 0 0 JIM EMBERSON 1.00 X 0 0 0 ED HOLMES 1.00 X 0 0 0 GRANT HUNTZINGER 1.00 X 0 0 0 CHARLES MCCALLIE 1.00 X 0 0 0 STAN PORTER 1.00 X 0 0 0 RANDALL STREET 1.00 X 0 0 0 CHARLES STEWART 40.00 X 368500 0 12243 DOUGLAS VOLINSKI 40.00 X 150800 0 12881 MICHAEL ERIC GARRARD 40.00 X 125968 0 12588 THOMAS GERALD FAIRCLOTH 40.00 X 152412 0 12588 DEBBIE REEVES 40.00 X 157052 0 12881 RADIAN FLOREA MD 40.00 X 397895 0 0 CARLOS BALEERIO MD 40.00 X 361680 0 12588 NATHAN H MULL 40.00 X 397160 0 12588 SHAHID IQBAL 40.00 X 244080 0 12588 ETHAN HIX 40.00 X 214150 0 12588 2569697 0 113533 36 0 1 0 SPECIALTY NETWORKS LLC 1949 GUNBARREL RD SUITE 170 CHATTANOOGA TN 37421 CONSULTING/NETWORKS 382922 BRIAMAH SAAKA MD 100 GROSS CRESCENT CIRCLE FT OGLETHORPE GA 30742 PHYSICIAN 175832 HARBIN CLINIC LLC 1825 MARTHA BERRY BLVD ROME GA 30165 CANCER CENTER CONSULTING 166525 CUSTOM HEALTHCARE SERVICES LLC 3700 BRAINERD ROAD SUITE C CHATTANOOGA TN 37411 HOME HEALTH CONSULTING 158927 DIXON HUGHES GOODMAN LLP 225 PEACHTREE ST NE 600 ATLANTA GA 30303 ACCOUNTING/CONSULTING 145632 8 186652 186652 paTIENT SERVICES REVEN 621110 85374312 85374312 ANCILLARY REVENUE 900099 3421999 3421999 IMAGING SERVICES 621110 781217 781217 MEDICAL RECORD FEES 900099 24513 24513 89602041 165962 165962 484378 33836 484378 33836 518214 518214 271857 271857 271857 271857 CHILD CARE REVENUE 900099 401694 401694 PURCHASE REBATES 900099 216740 216740 CAFETERIA SALES 900099 193084 193084 24340 9699 14641 835858 91580584 89602041 9699 1782192 2683231 1824610 858621 34575455 32455307 2120148 196800 181066 15734 8009396 7369058 640338 2928254 2694145 234109 278704 278704 163798 163798 4050897 3082304 968593 181421 10100 171321 17128929 15142149 1986780 954321 954321 2262194 2153696 108498 204286 178884 25402 2059123 2059123 2870758 2870758 635544 635544 BAD DEBT EXPENSE 19126577 19126577 INCOME GUARANTEES 126897 126897 MISCELLANEOUS 41992 32687 9305 98478577 87883782 10594795 0 2428921 3622217 1025310 175008 14603490 12055831 1869263 1548330 942638 862163 149154153 122310329 29129318 26843824 18173346 19115306 105596 96328 4152622 4782123 1927733 908559 74358237 70009689 13156101 12914146 35500000 34410000 2465742 7387682 51121843 54711828 X 22990859 15024451 245535 273410 23236394 15297861 74358237 70009689 X 0 0 0 X 5140038 5140038 69430692 59062505 10368187 74350727 63247824 11102903 232696 232696 26843824 INVESTMENT IN BATTLEFIELD IMAGING, LLC 470613 C FOUNDATION RELATED INVESTMENT 1193007 C DUE FROM AFFILIATES 3118503 C 4782123 DUE TO AFFILIATE 11730 UNREALIZED INTEREST RATE SWAP LIABILITY (SERIES 2008 CERTIFICATES) 3305220 THIRD PARTY PAYABLES 4070732 7387682 91580584 98478577 -6897993 -6897993 1 1 1 X 1 X 1 1 1 0 0 3170133 3390046 -219913 0.00000 14965521 12777329 2188192 0.02760 18135654 16167375 1968279 0.02760 25484 14637 10847 0.00010 24000 24000 0.00030 3215 3215 0.00000 52699 14637 38062 0.00040 18188353 16182012 2006341 0.02800 6313683 2084147 21259948 27258136 -5998188 X 1 1 HUTCHESON MEDICAL CENTER INC

100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742

X X X SUBACUTE CARE AT HUTCHESON

100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742

SUBACUTE UNIT PARKSIDE AT HUTCHESON MEDICAL CENTER

110 PARK CITY ROAD ROSSVILLE GA 30741

NURSING HOME HUTCHESON HOME HEALTH

100 MITCHELL ROAD FORT OGLETHORPE GA 30742

HOME HEALTH HUTCHESON HOSPICE

100 MITCHELL ROAD FORT OGLETHORPE GA 30742

HOSPICE Part III, Line 4: APPROXIMATELY 15% OF THE POPULATION IN THE SERVICE AREA ARE UNDER THE POVERTY LEVEL. CHARITY GUIDELINES ARE AT 200% FOR FREE CARE AND 400% FOR SLIDING SCALE. APPROXIMATELY 30% OF THE BAD DEBT WOULD QUALIFY FOR CHARITY CARE UNDER THIS POLICY. Part III, Line 9b: ONCE A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THEIR ACCOUNT IS WRITTEN OFF ACCORDING TO THE PERCENTAGE ALLOWED IN THE POLICY (E.G. IF THEY ARE BELOW THE 200% POVERTY LEVEL, 100% OF THEIR PORTION OF THE BILL IS WRITTEN OFF). Part VI, Line 2: THE HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY THROUGH PHYSICIAN, HOSPITAL BOARD, AND COMMUNITY LEADER GUIDANCE. ADDITIONALLY, THE HOSPITAL HOSTS COMMUNITY FORUMS TO GARNER FEEDBACK FROM THE PUBLIC ABOUT COMMUNITY HEALTH CARE NEEDS. Part VI, Line 3: FINANCIAL ASSISTANCE POLICIES ARE POSTED IN ALL OF THE HOSPITAL REGISTRATION AREAS AND PATIENT ACCOUNT AREAS. A SUMMARY OF THE PROGRAM IS PART OF THE WRITTEN INFORMATION PROVIDED TO THE PATIENT UPON REGISTRATION. Part VI, Line 4: HUTCHESON MEDICAL CENTER SERVES THE PRINCIPAL AREA OF CATOOSA, DADE, AND WALKER COUNTIES IN NORTH GEORGIA. PER THE 2010 CENSUS, THE POPULATION OF CATOOSA COUNTY IS 63,942, PRIMARILY CAUCASIAN, WITH A MEDIAN INCOME OF $43,814. 13.1% OF THE POPULATION IS BELOW THE POVERTY LEVEL. THE POPULATION OF WALKER COUNTY IS 68,756, PRIMARILY CAUCASIAN, WITH A MEDIAN INCOME OF $38,497. 17.4% OF THE POPULATION IS BELOW THE POVERTY LEVEL. THE POPULATION OF DADE COUNTY IS 16,633, PRIMARILY CAUCASIAN, WITH A MEDIAN INCOME OF $38,797. 18.3% OF THE POPULATION IS BELOW THE POVERTY LEVEL. Part VI, Line 6: IN ORDER TO PROMOTE COMMUNITY HEALTH, THE HOSPITAL PROVIDES CARE TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL FURTHERS ITS EXEMPT PURPOSE THROUGH A LOCAL, INDEPENDENT BOARD OF DIRECTORS. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO QUALIFIED COMMUNITY PHYSICIANS WHEN APPROPRIATE. SURPLUS FUNDS ARE REINVESTED IN THE HOSPITAL TO PURCHASE MEDICAL EQUIPMENT. X X X X 0 0 0 0 0 0 0 0 0 CHARLES STEWART 325000 0 32500 0 11000 0 0 0 12243 0 380743 0 0 0 DOUGLAS VOLINSKI 150800 0 0 0 0 0 0 0 12881 0 163681 0 0 0 THOMAS GERALD FAIRCLOTH 152412 0 0 0 0 0 0 0 12588 0 165000 0 0 0 DEBBIE REEVES 157052 0 0 0 0 0 0 0 12881 0 169933 0 0 0 RADIAN FLOREA MD 397895 0 0 0 0 0 0 0 0 0 397895 0 0 0 CARLOS BALEERIO MD 361680 0 0 0 0 0 0 0 12588 0 374268 0 0 0 NATHAN H MULL 397160 0 0 0 0 0 0 0 12588 0 409748 0 0 0 SHAHID IQBAL 244080 0 0 0 0 0 0 0 12588 0 256668 0 0 0 ETHAN HIX 214150 0 0 0 0 0 0 0 12588 0 226738 0 0 0 THE HOSPITAL AUTHORITY OF WALKER DADE AND CATOOSA COUNTIES 586004464 931635GEO 2008-05-28 35500000 ACQUISITION, RENOVATION, AND EQUIPMENT, CURRENT REFUNING 0 0 35500000 3723861 10937851 611829 12350253 2011 1 0 0 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 1 0 Form 990, Part III, line 3 Changes in Program Services DURING THE FISCAL YEAR THE ORGANIZATION DISCONTINUED ITS HOME HEALTH SERVICES. Form 990, Part VI, Section B, line 11 A COPY OF THE FORM 990 WAS PROVIDED TO EACH VOTING BOARD MEMBER THROUGH SECURE WEBSITE ACCESS. Form 990, Part VI, Section B, line 12c OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST PER THE POLICY ANNUALLY. THEY ARE ALSO REQUIRED TO NOTIFY THE ORGANIZATION OF ANY CHANGES THAT MAY AFFECT THEIR DISCLOSURE. CORPORATE COMPLIANCE INVESTIGATES ALL POTENTIAL CONFLICTS OF INTEREST THAT HAVE BEEN REPORTED. Form 990, Part VI, Section B, line 15a CEO COMPENSATION PACKAGES ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. CEO, OTHER TOP MANAGEMENT OFFICIALS, OFFICERS AND KEY EMPLOYEES' COMPENSATION PACKAGES ARE DETERMINED THROUGH USE OF WYATT SALARY SURVEY, INTEGRATED HEALTHCARE STRATEGIES SURVEY AND VARIOUS MARKET SURVEYS. Form 990, Part VI, Section C, line 18 THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE UPON REQUEST. ADDITIONALLY, RECENT FILINGS OF THE FORM ARE AVAILABLE AT GUIDESTAR.ORG. Form 990, Part VI, Section C, line 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. SCHEDULE K, PART II, LINE 5: AMOUNTS REPORTED ON LINE 5 INCLUDE: PROCEEDS USED FOR BOND ISSUANCE COSTS - $ 415,000 PROCEEDS USED FOR CREDIT ENHANCEMENT - 196,829 TOTAL REPORTED ON LINE 5 - 611,829 HMC PHYSICIAN'S BILLING LLC 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742 061803009 PHYSICIAN BILLING GA 2828767 N/A HUTCHESON HEALTH FOUNDATION INC 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742 581984748 SUPPORT HUTCHESON MEDICAL CENTER, INC. GA 501(C)(3) 7 N/A HUTCHESON HEALTH ENTERPRISES INC 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742 582176793 SUPPORT THE PROVISION OF HOSPITAL CARE GA 501(C)(3) 11, TYPE III N/A BATTLEFIELD IMAGING LLC 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742 113661778 PROVIDE IMAGING AND RADIOLOGICAL SERVICES GA N/A RELATED 781217 941185 0 0 HUTCHESON MEDICAL DIVISION INC 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE GA 30742 582605147 PHYSICIAN PRACTICES GA N/A C 0 0 0 1 0 0 0 0 1 0 0 0 1 1 1 0 0 0 HUTCHESON MEDICAL DIVISION D 882467