2011-08-15T10:23:50-05:00 2010-09-30 DIXON HUGHES GOODMAN LLP 500 Ridgefield Court Asheville NC 28806 990 2009-10-01 561936354 FIRSTHEALTH OF THE CAROLINAS INC FIRS 9107151000 155 MEMORIAL DRIVE PINEHURST NC 28374 LYNN DEJACO 9107151000 2011-08-15 1 Amy Bibby 8282542254 2009 2016-02-24 21:20:13Z CHARLES T FROCK 155 MEMORIAL DRIVE PINEHURST NC 28374 479706256 0 X WWW.FIRSTHEALTH.ORG X 1995 NC TO SERVICE THE COMMUNITY'S TOTAL HEALTH CARE NEEDS. 22 21 4440 955 1222137 0 2573702 3247673 409791322 461163936 1857278 -4549326 19683822 6641791 433906124 466504074 210615 223109 0 200831260 201947848 0 0 219170457 248212943 420212332 450383900 13693792 16120174 756688991 808656420 344920825 358418002 411768166 450238418 FIRSTHEALTH OF THE CAROLINAS, INC. ("FIRSTHEALTH") IS A COMPREHENSIVE HEALTH CARE CENTER ORGANIZED AND OPERATED TO SERVICE THE COMMUNITY'S TOTAL HEALTH CARE NEEDS. FIRSTHEALTH PROVIDES NEEDED MEDICAL CARE TO THE COMMUNITY REGARDLESS OF A PERSON'S ABILITY TO PAY. A VARIETY OF HEALTH CARE SERVICES ARE OFFERED IN SUPPORT OF THE ORGANIZATION'S CHARITABLE MISSION AS A COMMUNITY-BASED HEALTH CARE SYSTEM. 0 0 339129552 223109 459767721 SEE SCHEDULE O 339129552 1 1 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 609 0 1 4440 1 1 1 0 0 0 0 0 0 0 0 22 21 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 NC X X LYNN DEJACO CFO 9107151568 155 MEMORIAL DRIVE PINEHURST NC 28374 ALEX BOWNESS 2.00 X 0 0 0 JULIAN KING 2.00 X 0 0 0 JOHN MAY 2.00 X 0 0 0 EDWARD BARNES 2.00 X 0 0 0 ROBERT BAHNER MD 1.00 X 0 0 0 DAVID BRUTON MD 1.00 X 0 0 0 JAMES BULTHUIS 1.00 X 0 0 0 DAVID COWHERD MD 1.00 X 0 0 0 JOHN ELLIS MD 1.00 X 0 0 0 WALTER FASOLAK MD 1.00 X 0 0 0 ANNA HOLLERS 1.00 X 0 0 0 KENNETH C MITCHELL MD 1.00 X 0 0 0 DR SUSAN PURSER 1.00 X 0 0 0 FRANCES REEVES 1.00 X 0 0 0 STEVEN SMITH 1.00 X 0 0 0 BRUCE SOLOMON DO 1.00 X 0 0 0 JOHN STEVENSON MD 1.00 X 0 0 0 WILLIAM STEWART MD 1.00 X 0 0 0 ROBERT TWEED 1.00 X 0 0 0 DAVID WORONOFF 1.00 X 0 0 0 CHARLES T FROCK 50.00 X X 842542 0 888785 DAVID BURNS 1.00 X 0 0 0 JAMES RICE MD 1.00 X 0 0 0 CAROLYN HELMS 1.00 X 0 0 0 DAVID THORNTON MD 1.00 X 0 0 0 LYNN DEJACO 50.00 X 398862 0 24004 DANIEL BEIDIGER 50.00 X 267059 0 22479 ROBERT BOONE 50.00 X 163837 0 0 GEORGE BUSSEY MD 50.00 X 411386 0 18219 JEFFREY CASEY 50.00 X 275133 0 22529 DAVID DILLEHUNT 50.00 X 282630 0 17606 VIVIAN HARRINGTON 50.00 X 217367 0 21638 KERRY HENSLEY 50.00 X 199432 0 19146 JOHN JACKSON 50.00 X 215092 0 22479 STUART VOELPEL 50.00 X 489157 0 22240 LINDA WALLACE 50.00 X 267980 0 21457 CYNTHIA MCDONALD 50.00 X 196797 0 11010 JOHN STREITMAN MD 50.00 X 1087425 0 0 ANDY KISER MD 50.00 X 883184 0 0 JOHN KRAHNERT MD 50.00 X 751544 0 21893 JEFFREY MOORE MD 50.00 X 425250 0 0 DANIEL BARNES MD 50.00 X 327549 0 20545 7702226 0 1154030 168 0 1 0 MCKESSON 5995 WINDWARD PARKWAY ALPHARETTA GA 30005 MAINTENANCE FEES, MEDICAL SUPPLIES 6061275 PINEHURST MEDICAL CLINIC 205 PAGE ROAD PINEHURST NC 28374 MEDICAL ONCOLOGY PHYSICIAN SERVICES 3281630 BRASFIELD AND GORRIE 3700 GLENWOOD AVE STE 300 RALIGH NC 27612 CONSTRUCTION MANAGEMENT SERVICES 1942391 TEXICAN HORIZON ENERGY PO BOX 2392 HOUSTON TX 77252 NATURAL GAS SUPPLIER 1066245 SPINALGRAFT TECHNOLOGIES 4340 SWINNEA ROAD MEMPHIS TN 38118 BIOLOGICS AND SUPPLIES 920979 42 1644796 902637 700240 3247673 NET PATIENT SERVICE RE 621110 427416808 427416808 OTHER OPERATING REVENU 621110 22615943 21610119 1005824 EMS REVENUE 621110 5781230 5781230 HEALTH AND FITNESS 713940 5349955 4986165 363790 461163936 6225890 6225890 289356 289356 2257199 1459751 797448 797448 -156747 954195 82437 11147009 -11147009 82437 -11064572 -11064572 568821 595422 -26601 -26601 MISCELLANEOUS 621110 3284153 9270 3274883 FOOD SERVICE 722210 2586791 2586791 5870944 466504074 459767721 1222137 2266543 190109 190109 33000 33000 5338865 5338865 156858474 117895718 38962756 6402967 5428182 974785 20941150 15398032 5543118 12406392 9080012 3326380 301031 301031 681778 681778 281349 7765 273584 38367 38367 519691 5738 513953 44069637 20887020 23182617 1610071 541795 1068276 107627972 98183639 9444333 423354 83580 339774 7572989 1209962 6363027 1969238 1041472 927766 6509 5942 567 5616797 149956 5466841 27855103 27855103 8419270 228366 8190904 BAD DEBT 40507916 40507916 MISCELLANEOUS 711871 396245 315626 450383900 339129552 111254348 0 32494283 29555070 15117010 61972531 61312708 41603 3601072 7586483 6736107 4353275 629365089 345078274 245323919 284286815 365874733 360915301 4884511 3342321 40686346 37261323 756688991 808656420 50537141 63733810 276998 247223241 244008041 1239923 47160443 49159230 344920825 358418002 X 409571143 448089418 2197023 2149000 411768166 450238418 756688991 808656420 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1000000 1000000 1000000 1000000 4000000 6000000 58684 56583 41734 38367 195368 250000 250000 250000 250000 1000000 1500000 50184 42583 10500 70000 173267 Part II-B, Line 1i: Explanation of Other Lobbying Activities: LOBBYING EXPENSES - PORTION OF AHA (24.425) AND NCHA (23.25%) ASSOCIATION DUES ALLOCATED FOR LOBBYING PURPOSES. GRASSROOTS LOBBYING - FIRSTHEALTH OF THE CAROLINA, INC ("FIRSTHEATH") WORKS WITH THE NATIONAL AND STATE ASSOCIATION TO MAINTAIN AND STRENGTHEN RELATIONSHIPS WITH LEGISLATORS AND POLICYMAKERS AT THE NATIONAL, STATE, AND LOCAL LEVELS. THE OBJECTIVE IS TO ENSURE THAT FIRSTHEALTH'S EXPERIENCE AND EXPERTISE IS CONSISTENTLY AND CONTINUALLY HEARD SO THAT HEALTH LEGISLATION, REGULATION, AND POLICIES SUPPORT THE ORGANIZATION'S ABILITY TO FULFILL ITS MISSION - "TO CARE FOR PEOPLE." 7354709 7354709 304263193 141497469 162765724 340801 340801 238001440 196336317 41665123 79404946 7244488 72160458 284286815 INVESTMENTS IN SUBSIDIARIES 4884511 C 4884511 DUE FROM AFFILIATES 29985824 OTHER RECEIVABLES 6774433 ACCRUED SWAP MARKET ADJUSTMENT 501066 37261323 THIRD PARTY PAYABLES 13401808 DUE TO AFFILIATES 14752819 PROFESSIONAL LIABILITY RESERVE 6925399 SWAP TRANSACTION 14079204 49159230 1 1 X 1 X 1 X 360.000000000000 1 1 1 0 1 1 10907057 6659766 4247291 0.01040 10928296 10928296 0.02670 21835353 6659766 15175587 0.03710 2476724 2476724 0.00600 946410 946410 0.00230 227017 227017 0.00060 647119 647119 0.00160 4297270 4297270 0.01050 26132623 6659766 19472857 0.04760 1066 1066 0.00000 313 313 0.00000 21383 20 21363 0.00010 2444 90 2354 0.00000 1209 1209 0.00000 128980 128980 0.00030 155395 110 155285 0.00040 0 13914469 2089600 147653567 152127800 -4474233 X 1 1 FIRST IMAGING OF THE CAROLINAS LLC MOBILE IMAGING SERVICES 0.50000 0.50000 SURGERY CENTER OF PINEHURST LLC AMBULATORY SURGERY CENTER 0.40000 0.52000 FIRSTHEALTH MOORE REGIONAL HOSPITAL

155 MEMORIAL DRIVE PO BOX 3000 PINEHURST NC 28374

X X X FIRSTHEALTH MONTGOMERY MEMORIAL HOSPITAL

520 ALLEN STREET PO BOX 486 TROY NC 37371

X X X X FIRSTHEALTH RICHMOND MEMORIAL HOSPITAL

925 LONG DRIVE ROCKINGHAM NC 28379

X X X Part I, Line 7: THE ORGANIZATION USED WORKSHEET 2 OF THE 2009 SCHEDULE H INSTRUCTIONS TO COMPUTE A COST-TO-CHARGES RATIO USED TO CALCULATE CHARITY CARE AND UNREIMBURSED MEDICAID AT COST. Part I, Line 7f: TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25 CONTAINS A BAD DEBT EXPENSE OF $40,507,916 THAT HAS BEEN REMOVED FOR PURPOSES OF COMPUTING PERCENTAGE OF TOTAL EXPENSE ON COLUMN (F). Part III, Line 4: THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE FOOTNOTE ON BAD DEBT EXPENSE.WORKSHEET 2 OF THE 2009 SCHEDULE H INSTRUCTIONS WAS USED TO COMPUTE A COST-TO-CHARGES RATIO USED TO CALCULATE BAD DEBT EXPENSE AT COST FOR PURPOSES OF LINE PART III, LINE 2 Part III, Line 8: THE MEDICARE COST REPORT WAS USED TO CALCULATE THE OVERALL SHORTFALL. THE ORGANIZATION BELIEVES THE ENTIRE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT. Part VI, Line 2: FIRSTHEALTH OF THE CAROLINAS CONDUCTS A PERIODIC COMMUNITY TELEPHONE SURVEY (EVERY 3 -4 YEARS) TO ASSESS THE HEALTH CONDITION OF THE POPULATION OF OUR PRIMARY SERVICE AREA (MOORE, MONTGOMERY, RICHMOND, AND HOKE COUNTIES) AS WELL AS SCOTLAND AND ROBESON COUNTIES, AND TRACKS THIS INFORMATION OVER TIME. THE FIRST SURVEY WAS CONDUCTED IN 1999. THE SURVEY AND ANALYSIS OF DATA IS CONDUCTED BY PRC ASSOCIATES. ADDITIONALLY, FIRSTHEALH OF THE CAROLINAS CONVENES 2010 VISION GROUPS THROUGHOUT OUR PRIMARY SERVICE AREA TO OBTAIN AN "ON THE GROUND PERSPECTIVE" OF THE POPULATION'S HEALTH STATUS AND DEVELOP ACTION PLAN TO ADDRESS IDENTIFIED HEALTH ISSUES. THE GROUPS CONSIST OF KEY COMMUNITY HEALTH LEADERS IN EACH COUNTY. Part VI, Line 3: ANYONE WHO VISITS A FIRSTHEALTH HOSPITAL FOR MEDICAL CARE IS TREATED REGARDLESS OF HIS/HER ABILITY TO PAY. ALTHOUGH AN EFFORT IS MADE TO COLLECT A PORTION OF THE BILL ON ADMISSION OR AT DISCHARGE, THE FIRSTHEALTH STAFF IS TRAINED TO IDENTIFY THOSE WHO MAY NEED FINANCIAL ASSISTANCE. FOR SOME, THIS COULD SIMPLY INVOLVE ESTABLISHING A PAYMENT PLAN THAT FITS WITH THE FAMILY BUDGET. FOR OTHERS, THE HELP IS MORE COMPLEX. WHEN PATIENTS ARE UNABLE TO HELP WITH MEDICAL EXPENSES, FINANCIAL COUNSELORS MEET WITH THEM ONE ON ONE TO IDENTIFY ANY PROGRAM FOR WHICH THEY MIGHT QUALIFY. THESE INCLUDE MEDICAID, VOCATIONAL REHABILITATION AND NORTH CAROLINA PURCHASE OF CASE SERVICES. WHEN NECESSARY, THE HOSPITAL ITSELF ABSORBS SOME OR ALL OF THE COST OF CASE FOR THOSE THAT MEET DESIGNATED CRITERIA. THE AMOUNT OF ASSISTANCE DEPENDS ON FAMILY INCOME. PATIENTS AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES QUALIFY FOR 100% FINANCIAL ASSISTANCE FOR THE FIRSTHEALTH FINANCIAL ASSISTANCE PROGRAM. PATIENTS WHOSE INCOME EXCEEDS 200% MAY STILL QUALIFY FOR ASSISTANCE DEPENDING ON THEIR INDIVIDUAL FINANCIAL CIRCUMSTANCES. INFORMATION ABOUT FEDERAL, STATE, AND LOCAL PROGRAMS, AS WELL AS FIRSTHEALTH'S FINANCIAL AID PROGRAM IS OFFERED TO ALL PATIENTS IN THE FIRSTHEALTH OF THE CAROLINAS PATIENT HANDBOOK AND CAN BE FOUND ON OUR CORPORATE WEBSITE, WWW.FIRSTHEALTH.ORG. Part VI, Line 4: FIRSTHEALTH OF THE CAROLINAS OWNS AND OPERATES A HEALTH CARE DELIVERY SYSTEM THAT PROVIDES HEALTH CARE SERVICES TO PATIENTS THROUGHOUT A 15-COUNTY SERVICE AREA IN SOUTH-CENTRAL NORTH CAROLINA AND NORTHWEST SOUTH CAROLINA. FIRSTHEALTH OF THE CAROLINAS OPERATES THREE ACUTE CARE HOSPITALS IN THIS SERVICE AREA. FIRSTHEALTH DRAWS APPROXIMATELY 66.2% OF ITS PATIENTS FROM MOORE, MONTGOMERY, AND RICHMOND COUNTIES, NORTH CAROLINA AND APPROXIMATELY 10.5% OF ITS PATIENTS FROM THE TWO SURROUNDING COUNTIES OF HOKE AND SCOTLAND. THESE FIVE COUNTIES COLLECTIVELY COMPRISE OF FIRSTHEALTH'S PRIMARY SERVICE AREA. FIRSTHEALTH'S PRIMARY SERVICE AREA REPRESENTS A POPULATION BASE OF APPROXIMATELY 296,242. THE POPULATION BASE OF FIRSTHEALTH'S TOTAL SERVICE AREA IS APPROXIMATELY 1,204,826. Part VI, Line 5: FIRSTHEALTH OF THE CAROLINAS WORKS WITH THE COMMUNITIES WE SERVE TO CREATE OPPORTUNITIES TO IMPROVE THE PHYSICAL ENVIRONMENT FOR BETTER HEALTH. FIRSTHEALTH PERSONNEL WORK IN COLLABORATION WITH VARIOUS COMMUNITY GROUPS AND CIVIC ORGANIZATIONS TO PROMOTE THE HEALTH AND WELLNESS OF OUR REGION AND THE LOCAL COMMUNITIES WE SERVE. FIRSTHEALTH ACCOMPLISHES THESE GOALS BY OBTAINING PUBLIC AND PRIVATE GRANTS TO INCREASE ACCESS TO WALKING TRAILS AND SIDEWALKS, BUILDING COMMUNITY GARDENS, PROMOTING HEALTH AND WELLNESS THROUGH LOCAL BUSINESSES, SCHOOLS, AND THE CHAMBER OF COMMERCE, AND FACILITATING OF AND PARTICIPATING ON COMMUNITY-BASED COMMITTEES CONSISTING OF KEY LEADERS IN THE HEALTH FIELD TO HELP CREATE A HEALTHIER COMMUNITY AND REGION. Part VI, Line 6: FIRSTHEALTH OF THE CAROLINAS ALSO FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY BY EXTENDING MEDICAL STAFF PRIVILEGES TO QUALIFIED PHYSICIANS OF THE COMMUNITY. IN ADDITION, A MAJORITY OF FIRSTHEALTH'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN FIRSTHEALTH'S PRIMARY SERVICE AREA WHO ARE INDEPENDENT MEMBERS OF THE COMMUNITY. NC 1 COUNTY OF MOORE PO BOX 905 CARTHAGE NC 28374 566000322 501(C)(3) 45635 FMV SUPPORT HEALTH & WELLNESS PROGRAMS SANDHILLS COMMUNITY COLLEGE FOUNDATION 2200 AIRPORT ORAD PINEHURST NC 28374 560946799 501(C)(3) 50000 FMV SUPPORT HEALTH EDUCATION PROGRAMS MOORE COUNTY FREE CLINIC 211 TRIMBLE PLANT RD SOUTHERN PINES NC 28387 010781234 501(C)(3) 45000 FMV GENERAL SUPPORT VILLAGE OF PINEHURST 395 MAGNOLIA RD PINEHURST NC 28374 561211319 501(C)(3) 27480 FMV SUPPORT HEALTH & WELLNESS PROGRAMS MONTGOMERY COUNTY COMMUNITY COLLEGE 1011 PAGE ST TROY NC 27371 561834221 501(C)(3) 5000 FMV SUPPORT HEALTH EDUCATION PROGRAMS 5 SCHOLARSHIP PAYMENTS TO HEALTH CHOICE ELIGABLE CHILDREN FOR PROGRAM ENROLLMENT FEES 673 33000 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: FIRSTHEALTH OF THE CAROLINAS, INC..("FIRSTHEALTH") SUPPORTS VARIOUS COMMUNITY-BASED TAX-EXEMPT ORGANIZATIONS AND LOCAL GOVERNMENTAL UNITS THROUGH CASH DONATIONS. FIRSTHEALTH DOES NOT RESTRICT THE USE OF THESE DONATIONS AND SUPPORT PAYMENTS. THE RECEIVING EXEMPT ORGANIZATIONS OR GOVERNMENTAL UNITS MAY USE THE DONATION/SUPPORT PAYMENT AT WILL TO FURTHER THEIR EXEMPT PURPOSES. X 1 1 X X X X X 0 1 0 1 0 0 0 0 0 CHARLES T FROCK 465830 0 316039 0 60673 0 878090 0 10695 0 1731327 0 0 0 LYNN DEJACO 317921 0 70500 0 10441 0 13090 0 10914 0 422866 0 0 0 DANIEL BEIDIGER 182941 0 45008 0 39110 0 13090 0 9389 0 289538 0 0 0 ROBERT BOONE 160194 0 300 0 3343 0 0 0 0 0 163837 0 0 0 GEORGE BUSSEY MD 318967 0 73660 0 18759 0 11130 0 7089 0 429605 0 0 0 JEFFREY CASEY 204247 0 47906 0 22980 0 12110 0 10419 0 297662 0 0 0 DAVID DILLEHUNT 207215 0 48818 0 26597 0 11130 0 6476 0 300236 0 0 0 VIVIAN HARRINGTON 143852 0 59080 0 14435 0 12541 0 9097 0 239005 0 0 0 KERRY HENSLEY 136547 0 33255 0 29630 0 13011 0 6135 0 218578 0 0 0 JOHN JACKSON 160825 0 45637 0 8630 0 12110 0 10369 0 237571 0 0 0 STUART VOELPEL 330891 0 78861 0 79405 0 12110 0 10130 0 511397 0 0 0 LINDA WALLACE 209030 0 45664 0 13286 0 15050 0 6407 0 289437 0 0 0 CYNTHIA MCDONALD 147389 0 36844 0 12564 0 10318 0 692 0 207807 0 0 0 JOHN STREITMAN MD 594889 0 475574 0 16962 0 0 0 0 0 1087425 0 0 0 ANDY KISER MD 596749 0 269221 0 17214 0 0 0 0 0 883184 0 0 0 JOHN KRAHNERT MD 487490 0 245538 0 18516 0 10150 0 11743 0 773437 0 0 0 JEFFREY MOORE MD 219930 0 193600 0 11720 0 0 0 0 0 425250 0 0 0 DANIEL BARNES MD 218975 0 94250 0 14324 0 10104 0 10441 0 348094 0 0 0 Part I, Line 1a THE CEO WAS ALLOWED TRAVEL FOR COMPANIONS. AMOUNTS IN 2009 DID NOT EXCEED $5,000 AND WERE INCLUDED IN THE CEO'S 2009 W-2 ACCORDINGLY. Part I, Line 4b: THE ORGANIZATION'S CEO PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE AMOUNT OF DEFERRED COMPENSATION ACCRUED IN 2009 FOR THIS PLAN WAS $865,000. Part I, Line 5 PHYSICIANS ARE PAID UNDER A PRODUCTIVITY-BASED COMPENSATION MODEL, WHICH TIES TOTAL COMPENSATION TO A RELATIVE VALUE UNIT (RVU). AN RVU IS A DOLLAR AMOUNT ASSIGNED TO EACH PATIENT ENCOUNTER OR MEDICAL TEST/PROCEDURE PERFORMED. NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2010-01-06 29535000 SERIES 2010 - REFUND ISSUE DATED 12/9/08 0 0 NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 2009-12-09 40830000 SERIES 2009D - REFUND ISSUE DATED 4/15/109; NEW HEART INSTITUTE 0 0 NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DDT5 2009-12-09 54734475 SERIES 2009C - REFUND ISSUES DATED 4/15/19, 12/9/08, 5/1/02 0 0 NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DCT6 2009-04-15 45505000 SERIES 2009A - CONSTRUCTION OF NEW HEART INSTITUTE 0 0 NORTH CAROLINA MEDICAL CARE COMMISSION 521309402 65821DBZ3 2008-12-09 106845000 SERIES 2008A & 2008B - REFUND ISSUES DATED 4/9/03 AND 2/20/98 0 0 29535000 135000 1 0 1 1 40924278 19215780 190000 14802540 1 0 1 1 54745686 2312903 784475 1896400 1 0 1 1 45711989 19984764 910100 25565969 0 0 0 1 106845000 1037629 1 0 1 1 0 1 1 0 1 0.01800 0.00100 0.01900 1 0 0 0 0 1 1 0 1 1 0 1 0.01000 0.00100 0.01100 1 0 0 0 0 1 1 0 1 1 0 1 0.01800 0.00100 0.01900 1 0 1 1 CITIGROUP FINANCIAL 18.000000000000 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 CITIGROUP FINANCIAL 14.000000000000 0 0 0 JOHN STREITMAN MD ADVANCE X 103580 41603 0 0 1 41603 Form 990, Part VI, Section B, line 11 FIRSTHEALTH'S FORM 990 IS INITIALLY REVIEWED BY QUALIFIED MEMBERS OF ADMINISTRATION, INCLUDING THE CORPORATE CEO AND CFO, AND COMPLIANCE DEPARTMENTS. THE ENTIRE RETURN IS REVIEWED BY THE COMPENSATION AND CORPORATE FINANCE/AUDIT/COMPLIANCE COMMITTEES OF THE FIRSTHEALTH BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FIRSTHEALTH'S INDEPENDENT TAX PREPARER, DIXON HUGHES GOODMAN, LLP, ALSO CONDUCTS A REVIEW OF THE RETURN DURING THEIR PREPARATION PROCESS. ONCE THE RETURN IS SUCCESSFULLY E-FILED WITH THE IRS, A COPY OF THE RETURN IS MADE AVAILABLE TO ALL MEMBERS OF THE FIRSTHEALTH BOARD OF DIRECTORS. IN ADDITION TO THE POSTING OF THE FIRSTHEALTH RETURN ON GUIDESTAR, A PUBLIC INSPECTION COPY OF THE FORM 990 IS MADE AVAILABLE FOR REVIEW. Form 990, Part VI, Section B, line 12c FIRSTHEALTH STRIVES TO MAINTAIN THE HIGHEST ETHICAL STANDARDS AND HAS ADOPTED A CONFLICT OF INTEREST/DUALITY OF INTEREST POLICY THAT APPLIES TO ANY DIRECTOR, TRUSTEE, OFFICER OR MEMBER OF A BOARD COMMITTEE, OR ANY EMPLOYEE WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST OR DUALITY OF INTEREST WITH ANY ORGANIZATION SEEKING TO DO BUSINESS WITH OR IS IN AN ACTUAL OR POTENTIAL ADVERSARIAL RELATIONSHIP WITH FIRSTHEALTH. ANY COVERED INDIVIDUAL WITH AN ACTUAL OR POSSIBLE CONFLICT MUST DISCLOSE THE EXISTENCE OF THE CONFLICT TO THE DIRECTORS, TRUSTEES AND MEMBERS OF BOARD COMMITTEES WITH BOARD-DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION, ARRANGEMENT OR ISSUE. EACH TRUSTEE, OFFICER OR MEMBER OF A BOARD COMMITTEE WITH BOARD-DELEGATED POWERS COMPLETES AN ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT, AND ALL REPORTED CONFLICTS ARE REPORTED TO AND REVIEWED BY THE FIRSTHEALTH BOARD OF DIRECTORS. ALL MANAGEMENT EMPLOYEES ALSO COMPLETE ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENTS, WHICH ARE SUMMARIZED AND REVIEWED WITH SENIOR MANAGEMENT. Form 990, Part VI, Section B, line 15 FIRSTHEALTH'S BOARD OF DIRECTORS DETERMINES COMPENSATION FOR THE CEO THROUGH ITS COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE IS COMPOSED OF BOARD MEMBERS WHO ARE INDEPENDENT OF FIRSTHEALTH MANAGEMENT, HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS, ARE NOT RELATED TO OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED, HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH FIRSTHEALTH, AND ARE NOT PAID FOR THEIR SERVICES AS A BOARD MEMBER. THE COMMITTEE RETAINS AN INDEPENDENT CONSULTANT TO CONDUCT PERIODIC COMPENSATION ANALYSES TO HELP ENSURE FIRSTHEALTH'S COMPENSATION PRACTICES AND COMPENSATION LEVELS ARE REASONABLE. THIS CONSULTANT PROVIDES ONLY ADVISORY SERVICES RELATED TO COMPENSATION MATTERS TO FIRSTHEALTH. TO ATTRACT AND RETAIN THE HIGHEST CALIBER OF HEALTHCARE PROFESSIONALS NEEDED TO SUSTAIN THE QUALITY OF THE HEALTHCARE FIRSTHEALTH PROVIDES TO THE COMMUNITIES THAT IT SERVES, COMPENSATION MUST BE COMPETITIVE WITH THAT PROVIDED BY OTHER COMPETING ORGANIZATIONS IN THE AREA JOB MARKET. WHEN EXECUTIVE POSITIONS ARE FILLED, FIRSTHEALTH TYPICALLY CONDUCTS NATIONAL SEARCHES. FIRSTHEALTH BENCHMARKS AGAINST ORGANIZATIONS OF COMPARABLE SIZE AND MISSION, ACROSS THE REGION AND THE NATION. MARKET DATA IS ASSEMBLED FOR ALL ELEMENTS OF EXECUTIVE COMPENSATION (I.E. CASH COMPENSATION, BENEFITS AND PERQUISITES). COMPENSATION LEVELS REFLECT THE SCOPE OF THE CEO'S RESPONSIBILITIES, EDUCATIONAL BACKGROUND, EXPERIENCE AND INDUSTRY STANDING, AS WELL AS INDIVIDUAL AND ORGANIZATION PERFORMANCE. THE MOST RECENT REVIEW WAS PERFORMED DURING FISCAL YEAR 2010. A SIMILAR PROCESS TO THAT FOR THE CEO IS AFFECTED FOR DETERMINING THE COMPENSATION OF THE OTHER CORPORATE OFFICERS OR KEY EMPLOYEES OF FIRSTHEALTH (I.E. USE OF INDEPENDENT CONSULTANT, COMPARABLE INDUSTRY DATA, ETC.). THE COMMITTEE REVIEWS AND APPROVES THE CEO'S PERFORMANCE ASSESSMENTS AND COMPENSATION RECOMMENDATIONS FOR OTHER CORPORATE OFFICERS AND KEY EMPLOYEES. ALL COMPENSATION DECISIONS ARE MADE IN A MANNER THAT IS CONSISTENT WITH FIRSTHEALTH'S BOARD-APPROVED COMPENSATION PHILOSOPHY. THE MOST RECENT YEAR REVIEW WAS PERFORMED DURING FISCAL YEAR 2010. Form 990, Part VI, Section C, line 18 THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST AND ON WWW.GUIDESTAR.ORG. Form 990, Part VI, Section C, line 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. IN ADDITION, QUARTERLY AND ANNUAL FINANCIAL STATEMENTS ARE POSTED TO THE DIGITAL ASSURANCE CERTIFICATION (DAC) WEBSITE. Schedule K Supplental Information Part I, Bond B, Column f: Reissuance of 29,400,000 of bond proceeds originally issued on 2/27/2002; and issuance of 20,600,000 of new money for various capital projects, Part II, Line 14, Column B: The reissuance of the 2/27/2002 issue was deemed a current refunding for tax purposes. Part II, Line 1, Column A: 28,900,000 of the 2008 B original principal amount was refunded by issue dated 12/9/2009; this represented the entire outstanding amount of the 2008 B as of the date of refunding; 29,400,000 of the 2008A original principal amount was refunded by issue dated 1/6/2010. Only the A portion of the issue remains outstanding as of 9/30/2010. FORM 990, PAGE 2, PART III STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS FIRSTHEALTH OF THE CAROLINAS, INC. ("FIRSTHEALTH") PROVIDES A COMPREHENSIVE COMMUNITY BENEFITS PROGRAM IN ITS PRIMARY AND SECONDARY SERVICE AREAS. FIRSTHEALTH PLAYS A PIVOTAL ROLE IN DELIVERING HEALTH CARE IN THE MID-CAROLINAS AND IS BOTH THE INFRASTRUCTURE AND SAFETY NET FOR HEALTH CARE IN ITS COMMUNITIES. HOSPITAL CARE IS THE CORNERSTONE OF HEALTH CARE IN MOST COMMUNITIES, BUT FIRSTHEALTH GOES BEYOND THE WALLS OF ITS THREE HOSPITALS (FIRSTHEALTH MOORE REGIONAL HOSPITAL, FIRSTHEALTH MONTGOMERY MEMORIAL HOSPITAL AND FIRSTHEALTH RICHMOND MEMORIAL HOSPITAL) TO ENHANCE THE HEALTH AND WELLNESS OF THE RESIDENTS OF ITS SERVICE AREAS. FIRSTHEALTH PROVIDES LOW-COST AND, IN MANY CASES, FREE PROGRAMS TO OUR MOST VULNERABLE PATIENT POPULATIONS. ONE OF FIRSTHEALTH'S MOST IMPORTANT FINANCIAL CONTRIBUTIONS IS BRIDGING THE GAP CREATED BY UNDERPAYMENTS FROM MEDICARE AND MEDICAID AND OTHER GOVERNMENT PROGRAMS, WHILE CONTINUING TO PROVIDE ACCESS TO FREE OR LOW COST HEALTH SCREENINGS AND DIAGNOSTIC SERVICES, AS WELL AS HEALTH/WELLNESS EDUCATIONAL PROGRAMS IN THE COMMUNITIES FIRSTHEALTH SERVES. FREE AND DISCOUNTED CHARITY CARE TO ELIGIBLE PATIENTS SERVED ANYONE WHO VISITS A FIRSTHEALTH HOSPITAL FOR MEDICAL CARE IS TREATED REGARDLESS OF HIS OR HER ABILITY TO PAY FOR THE TREATMENT PROVIDED. WHEN PATIENTS ARE UNABLE TO HELP WITH THEIR MEDICAL EXPENSES, FIRSTHEALTH ABSORBS SOME OR ALL OF THE COST OF CARE FOR THOSE THAT MEET DESIGNATED FINANCIAL CRITERIA, DEPENDING ON FAMILY INCOME. PATIENTS WITH FAMILY INCOMES AT OR BELOW 200 PERCENT OF THE FEDERAL POVERTY GUIDELINE QUALIFY FOR 100 PERCENT FINANCIAL ASSISTANCE UNDER FIRSTHEALTH'S FINANCIAL ASSISTANCE PROGRAM. FIRSTHEALTH'S COSTS OF FREE CARE (TREATING PATIENTS THAT QUALIFIED FOR 100% FINANCIAL ASSISTANCE) WERE $10,907,057 IN FISCAL 2010. THROUGH ITS FINANCIAL ASSISTANCE PROGRAM, FIRSTHEALTH ALSO OFFERS VARYING LEVELS OF DISCOUNTED CARE TO PATIENTS WHO ARE POOR AND/OR MEET CERTAIN INCOME CRITERIA. PATIENTS WITH FAMILY INCOMES BETWEEN 201 AND 360 PERCENT OF THE FEDERAL POVERTY GUIDELINE QUALIFY FOR DISCOUNTS AGAINST FIRSTHEALTH'S LIST PRICE FOR SERVICES RENDERED. FIRSTHEALTH HAS ALSO EXPERIENCED AN UPWARD TRENDING IN BAD DEBT EXPENSE, AS THE NUMBER OF PATIENTS WHO HAVE BEEN DETERMINED TO HAVE THE FINANCIAL CAPACITY TO PAY FOR HEALTHCARE SERVICES PROVIDED BUT ARE UNWILLING/FINANCIALLY ABLE TO SETTLE THE CLAIM CONTINUES TO INCREASE. FIRSTHEALTH CONTINUES TO PROVIDE ALL NECESSARY HEALTHCARE SERVICES TO THIS PATIENT POPULATION. IN FISCAL YEAR 2010, THE COST TO FIRSTHEALTH FOR THOSE SERVICES WAS $13,930,961. FIRSTHEALTH'S FINANCIAL COUNSELORS WORK CLOSELY WITH PATIENTS AND FAMILIES TO HELP DETERMINE ELIGIBILITY FOR ASSISTANCE OR QUALIFICATION FOR PUBLIC PROGRAMS. FIRSTHEALTH REQUESTS THAT PATIENTS PROVIDE APPROPRIATE DOCUMENTATION, SUCH AS TAX RETURNS, CURRENT PAY STUBS, OR OTHER RELEVANT INFORMATION, THAT IS USED TO DEMONSTRATE FINANCIAL NEED. FIRSTHEALTH ALSO OFFERS EXTENDED PAYMENT PLANS THAT WILL VARY IN LENGTH, DEPENDING ON THE BALANCE OF THE PATIENT'S ACCOUNT. FIRSTHEALTH ASSISTS PATIENTS WITH FINDING AVAILABLE GOVERNMENTAL PROGRAMS THAT MATCH PATIENTS' NEEDS, SUCH AS MEDICAID, VOCATIONAL REHABILITATION, CRIME VICTIM ASSISTANCE, ETC. FIRSTHEALTH ALSO POSTS DETAILED INFORMATION ABOUT ITS FINANCIAL ASSISTANCE PROGRAM ON ITS WEBSITE (WWW.FIRSTHEALTH.ORG) SO THE PUBLIC CAN BE AWARE OF ITS AVAILABILITY. MEDICAID SHORTFALL FIRSTHEALTH PROVIDES MEDICAID SERVICES IN ITS THREE HOSPITALS, AS WELL AS THROUGH ITS HOME CARE, HOSPICE, AND DENTAL CARE PROGRAMS IN ITS PRIMARY AND SECONDARY SERVICE AREAS. THE MEDICAID PROGRAM, WHICH PROVIDES HEALTH CARE COVERAGE FOR LOW-INCOME FAMILIES AND INDIVIDUALS, IS FUNDED BY THE STATE AND FEDERAL GOVERNMENTS. IN NORTH CAROLINA, AS IN MANY STATES, MEDICAID PAYMENTS ARE WELL BELOW THE PROVIDER'S ACTUAL COST OF TREATING MEDICAID PATIENTS AND THE REIMBURSEMENT LEVEL IS PREDICTED TO DECLINE AS FINANCIAL PRESSURES ON THE FEDERAL AND STATE GOVERNMENT OPERATING BUDGETS MOUNT. IN FISCAL 2010, FIRSTHEALTH'S UNPAID COSTS FROM MEDICAID TOTALED $10,928,296. MEDICARE SHORTFALL FIRSTHEALTH PROVIDES SERVICES TO MEDICARE BENEFICIARIES IN ITS THREE HOSPITALS. IN ADDITION, MEDICARE BENEFICIARIES ARE SERVED BY FIRSTHEALTH'S HOME CARE AND HOSPICE AND PALLIATIVE CARE PROGRAMS. THE MEDICARE SHORTFALL REPRESENTS THE DIFFERENCE BETWEEN THE ACTUAL COST OF CARE RENDERED AND THE REIMBURSEMENT RECEIVED FOR DELIVERING THAT CARE TO PATIENTS. THE COST OF DELIVERING CARE INCLUDES, BUT IS NOT LIMITED TO, PERSONNEL COSTS, TECHNOLOGY, SUPPLIES, PHARMACEUTICALS, MEDICAL DEVICES, FACILITY OPERATING COSTS, ETC. FIRSTHEALTH'S FINANCIAL SHORTFALL FROM PROVIDING THESE MEDICARE SERVICES IN FISCAL 2010 WAS $2,643,831. SUBSIDIZED MEDICALLY ESSENTIAL SERVICES AS A RURAL HEALTH CARE PROVIDER, FIRSTHEALTH IS MANY TIMES THE PROVIDER OF LAST RESORT FOR OUR PATIENTS. IN ORDER TO OFFER A FULL-SPECTRUM OF HEALTH CARE SERVICES, FIRSTHEALTH PROVIDES SERVICES AND PROGRAMS THAT YIELD NEGATIVE OPERATING MARGINS. HOWEVER, BECAUSE THESE SERVICES ARE ESSENTIAL TO THE OVERALL HEALTH OF THE COMMUNITIES SERVED, FIRSTHEALTH CONTINUES TO PROVIDE THEM. SUBSIDIZED MEDICALLY NECESSARY HOSPITAL SERVICES PROVIDED BY FIRSTHEALTH INCLUDE, BUT ARE NOT LIMITED TO: INPATIENT PSYCHIATRY UNIT AND OUTPATIENT MENTAL HEALTH SERVICES; INPATIENT PHYSICAL REHABILITATION UNIT; NEONATAL INTENSIVE CARE UNIT; EMERGENCY DEPARTMENTS (APPROXIMATELY 105,700 PATIENT ENCOUNTERS); WOMEN'S AND CHILDREN'S SERVICES; INPATIENT MEDICAL AND RADIATION ONCOLOGY SERVICES; RENAL DIALYSIS SERVICES; DIABETES CARE; AND A NUMBER OF OTHER OUTPATIENT SERVICES. IN ADDITION, FIRSTHEALTH OF THE CAROLINAS, INC., THROUGH ITS REGIONAL EMERGENCY MEDICAL SERVICES BUSINESS LINE, PROVIDED 18,130 EMERGENCY TRANSPORTS TO RESIDENTS OF THREE NORTH CAROLINA AND ONE SOUTH CAROLINA COUNTIES. IN FISCAL 2010, FIRSTHEALTH RECEIVED $5,781,230 OF OPERATING SUBSIDIES FROM THESE COUNTIES TO OFFSET THE UNREIMBURSED OPERATING COSTS OF PROVIDING THESE ESSENTIAL TRANSPORT SERVICES. FIRSTHEALTH COMMUNITY HEALTH SERVICES MOBILE HEALTH SERVICES FIRSTHEALTH MOBILE HEALTH SERVICES PROVIDES THE FIRSTHEALTH-SERVED COMMUNITIES WITH CONVENIENT ACCESS TO PREVENTIVE HEALTH SCREENINGS AND HEALTH/WELLNESS EDUCATION PROGRAMS/EVENTS AT NO OR LOW COST. SCREENINGS OFFERED INCLUDE: OSTEOPOROSIS, CHOLESTEROL, BLOOD PRESSURE, BLOOD SUGAR, PROSTATE CANCER (PSA) BLOOD DRAW, VASCULAR SCREENINGS FOR ABDOMINAL AORTIC ANEURYSM, CORONARY ARTERY DISEASE, AND PERIPHERAL VASCULAR DISEASE. NINETY-ONE PERCENT OF THOSE WITH ABNORMAL RESULTS WERE REFERRED FOR FURTHER LIFE-SAVING TESTING. IN ADDITION, MOBILE HEALTH SERVICES STAFF PROVIDED 24 EDUCATION EVENTS TO THE RESIDENTS OF THE COMMUNITIES SERVED. ALL MOBILE HEALTH SCREENINGS ARE PROVIDED AT A REDUCED RATE, AND FINANCIAL ASSISTANCE FOR FREE SCREENINGS IS AVAILABLE WHEN APPROPRIATE, BASED ON INCOME. IN FISCAL 2010 FIRSTHEALTH MOBILE HEALTH SERVICES PROVIDED SERVICES TO 2,939 PEOPLE. FIRSTHEALTH PROVIDED $113,629 OF FINANCIAL SUBSIDIES TO OFFSET THE UNFUNDED OPERATING COSTS OF THE MOBILE HEALTH SERVICES PROGRAM IN FISCAL 2010. TOBACCO CESSATION FIRSTHEALTH OFFERED TOBACCO CESSATION PROGRAMS THROUGHOUT ITS SERVICE AREA. A TOBACCO USE PREVENTION AND CESSATION INITIATIVE PROVIDED PREVENTIVE SERVICES THROUGH SCHOOL SYSTEMS AND CESSATION SERVICES THROUGH PROVIDER OFFICES AND OCCUPATIONAL SITES. FIRSTHEALTH SPONSORED THE TOBACCO REALITY UNFILTERED (TRU) PROGRAM THROUGH SUPPORT OF SCHOOL TEENS AGAINST TOBACCO USE (TATU) GROUPS. TATU RECRUITED TEENAGERS TO TEACH YOUNGER CHILDREN ABOUT THE HAZARDS OF TOBACCO USE. FIRSTHEALTH OF THE CAROLINAS WAS AWARDED FUNDING FROM THE NORTH CAROLINA HEALTH AND WELLNESS TRUST FUND (HWTF) TO DEVELOP THE SANDHILLS REGION COMMUNITY COLLEGE TOBACCO-FREE TASK FORCE. THE OVERALL SIX MONTH CUMULATIVE PROGRAM QUIT RATE AS FOR FISCAL 2010 WAS 33.1%. TATU RECRUITED TEENAGERS TO TEACH YOUNGER CHILDREN ABOUT THE HAZARDS OF TOBACCO. IN FISCAL 2010, 54 TEENS WERE TRAINED AND 235 PRESENTATIONS/ADVOCACY ACTIVITIES WERE CONDUCTED TO PROMOTE PREVENTION OF TOBACCO USE. THIS GROUP WAS DESIGNED TO COORDINATE TOBACCO USE PREVENTION AWARENESS ACTIVITIES, PROMOTE CESSATION SERVICES AND CONDUCT GRASSROOTS POLICY ADVOCACY FOR TOBACCO-FREE CAMPUS ENVIRONMENTS. USING CAMPUS-BASED PARTNERSHIPS TO EMPOWER FACULTY, STAFF AND STUDENTS, FIRSTHEALTH TARGETED 18 TO 24 YEAR-OLD STUDENTS ATTENDING MONTGOMERY COMMUNITY COLLEGE, RICHMOND COMMUNITY COLLEGE AND SANDHILLS COMMUNITY COLLEGE IN HOKE, RICHMOND, MOORE, MONTGOMERY AND SCOTLAND COUNTIES. FIRSTHEALTH CONTRIBUTED $11,402 OF FINANCIAL SUBSIDIES TO OFFSET THE UNFUNDED OPERATING COSTS OF THE TOBACCO CESSATION PROGRAMS IN FISCAL 2010. FIRSTHEALTH RESOURCE ASSISTANCE FIRSTHEALTH PROVIDES A BILINGUAL RESOURCE COORDINATOR TO ASSIST MOORE COUNTY RESIDENTS IN NEED WITH FINDING INFORMATION ON NUMEROUS RESOURCE ASSISTANCE PROGRAMS SUCH AS MEDICAID ELIGIBILITY, HEALTH CHOICE AND THE FEDERAL FOOD STAMP PROGRAM. THE RESOURCE COORDINATOR ALSO LINKS INDIVIDUALS TO COMMUNITY RESOURCES INCLUDING TRANSPORTATION, HOUSING ASSISTANCE AND FOOD SUPPORT THOUGH COMMUNITY ASSISTANCE PROGRAMS SUCH AS THE MOORE FREE CARE CLINIC, MOORE COUNTY DEPARTMENT OF SOCIAL SERVICES AND THE FIRSTHEALTH MOBILE HEALTH SERVICES. A KEY SERVICE PROVIDED IS INTERPRETATION AND TRANSLATION SERVICES FOR SPANISH-SPEAKING RESIDENTS OF MOORE COUNTY. DURING FISCAL 2010, 292 PEOPLE WERE ASSISTED WITH INTERPRETATION AND TRANSLATION SERVICES AND 100% OF THESE INDIVIDUALS WERE SCREENED FOR AVAILABLE SERVICES AND REFERRED TO APPROPRIATE SERVICES AVAILABLE WITHIN THE COUNTY. SCHOOL HEALTH PROGRAM THROUGH A PARTNERSHIP WITH MOORE COUNTY SCHOOLS AND THE NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES, THE FIRSTHEALTH SCHOOL HEALTH PROGRAM PROVIDES SCHOOL-BASED NURSES TO 24 SCHOOLS IN MOORE COUNTY. THE PROGRAM HAS RECEIVED BOTH STATE AND NATIONAL RECOGNITION AS A BEST PRACTICE STANDARD AS IT CONTRIBUTES TO THE ACADEMIC SUCCESS AND ADVANCEMENT OF THE WELL BEING AND THE LIFELONG ACHIEVEMENT OF THE SCHOOL-AGED CHILD. SPECIALLY TRAINED NURSES HELP OVER 12,330 SCHOOL CHILDREN EACH YEAR. NURSES PROMOTE HEALTH AND SAFETY, INTERVENE WITH ACTUAL AND POTENTIAL HEALTH PROBLEMS AND PROVIDE CASE MANAGEMENT AND OTHER SERVICES. IN ADDITION TO THE NURSES IN THE SCHOOLS, FIRSTHEALTH ALSO OFFERS ON-SITE MEDICAL CARE AT TWO LOCATIONS IN MONTGOMERY COUNTY. HUNDREDS OF SCHOOL CHILDREN IN MONTGOMERY COUNTY HAVE ACCESS TO MEDICAL CARE ON THE SCHOOL CAMPUS OR JUST STEPS AWAY FROM THE CLASSROOM DOOR. THE TWO SCHOOL HEALTH CENTERS PROVIDE ON-SITE MEDICAL CARE THAT IS SENSIBLE, CONVENIENT, VALUABLE AND OPEN TO ANY CHILD IN THE MONTGOMERY COUNTY SCHOOL SYSTEM. THE CENTERS PROVIDE PHYSICAL, MENTAL, NUTRITIONAL, AND HEALTH AND WELLNESS INTERVENTIONS THAT ARE AVAILABLE TO ALL CHILDREN EVEN IN THE MOST RURAL SECTIONS OF THE COUNTY. A PATIENT SERVICE REPRESENTATIVE, ON-SITE REGISTERED NURSE AND A FAMILY NURSE PRACTITIONER PROVIDE CARE FOR THOUSANDS OF CHILDREN EACH YEAR. MEDICAL PROFESSIONALS STAFFING THESE CENTERS PROVIDE HEALTH, WELLNESS, LEARNING AND EASY ACCESS TO CARE FOR CHILDREN WORKING TOGETHER TO MEET FIRSTHEALTH'S CORE PURPOSE - TO CARE FOR PEOPLE - AS A HOSPITAL WITHOUT WALLS. FIRSTHEALTH PROVIDED $307,662 OF FINANCIAL SUBSIDIES TO OFFSET THE UNFUNDED OPERATING COSTS OF THE SCHOOL HEALTH NURSE PROGRAM AND THE SCHOOL BASED CENTERS IN FISCAL 2010. FIRSTHEALTH MEDICATION ASSISTANCE PROGRAM FIRSTHEALTH CARES HELPS LOW-INCOME INDIVIDUALS OBTAIN FREE OR LOW-COST PRESCRIPTION MEDICATIONS. PATIENTS ARE ELIGIBLE BASED ON MEDICATION NEEDS, LACK OF INSURANCE OR INELIGIBILITY FOR PRESCRIPTION DRUG COVERAGE AND INDIVIDUAL PHARMACEUTICAL COMPANY PROGRAM GUIDELINES. THESE MEDICATIONS ARE FOR CHRONIC DISEASE CONDITIONS SUCH AS ASTHMA, BRONCHITIS, CONGESTIVE HEART FAILURE, COPD, DIABETES, EMPHYSEMA, HYPERTENSION AND HIGH CHOLESTEROL. AN ON-STAFF PHARMACIST MAKES SURE EACH PATIENT'S MEDICATIONS CAN SAFELY BE TAKEN TOGETHER, ARE RIGHT FOR THE PATIENT'S CONDITION, THAT MEDICATIONS ARE NOT UNNECESSARY OR DUPLICATIONS, AND ADVISES IF LESS EXPENSIVE OPTIONS ARE AVAILABLE. THE MEDICATION ASSISTANCE SERVICE IS FREE OF CHARGE. FOR FISCAL 2010, 177 PATIENTS WERE SERVED, WITH 4,428 MEDICATIONS RECEIVED, AT AN AVERAGE WHOLESALE PRICE OF $2,201,451 IF THE PATIENTS HAD TO PURCHASE THESE MEDICATIONS. DENTAL CARE CENTERS FIRSTHEALTH OPERATES THREE DENTAL CARE CENTERS IN SOUTHERN PINES (MOORE COUNTY), TROY (MONTGOMERY COUNTY) AND RAEFORD (HOKE COUNTY), NORTH CAROLINAS. EACH DENTAL CARE CENTER PROVIDES COMPREHENSIVE DENTAL CARE SERVICES TO MEDICAID AND HEALTHCHOICE-ELIGIBLE CHILDREN UP TO AGE 18. SINCE FEW DENTISTS IN THESE COUNTIES PARTICIPATE IN MEDICAID'S DENTAL PROGRAM, THE FIRSTHEALTH DENTAL CARE CENTERS PROVIDES A TREMENDOUS UNMET NEED IN THE REGION. WHEN THE DENTAL CARE CENTERS OPENED IN 1997, NEARLY HALF OF THE CHILDREN OF LOW-INCOME FAMILIES IN FIRSTHEALTH'S SERVICE AREA WERE GETTING LITTLE TO NO DENTAL CARE SERVICES. FOR FISCAL 2010 THE FIRSTHEALTH DENTAL CARE CENTERS PROVIDED DENTAL CARE TO NEARLY 21% OF MEDICAID-ENROLLED CHILDREN IN HOKE, MONTGOMERY AND MOORE COUNTIES. IN FISCAL 2010, FIRSTHEALTH'S DENTAL CARE SERVICES LOGGED 13,476 DENTAL CARE VISITS TO ELIGIBLE CHILDREN RESIDING IN THE THREE COUNTIES SERVED. SECURING AFFORDABLE HEALTH COVERAGE SERVICES TECHNICAL, FINANCIAL AND OTHER ASSISTANCE IS PROVIDED TO UNINSURED PATIENTS TOWARD SECURING HEALTH CARE COVERAGE THROUGH MEDICAID, HEALTH CHOICE AND OTHER COVERAGE PROGRAMS. DURING FISCAL 2010, FIRSTHEALTH ASSISTED 673 CHILDREN WITH SCHOLARSHIPS TO PAY HEALTH CHOICE ENROLLMENT FEES. FIRSTPLAN, A HEALTH INSURANCE PRODUCT SPONSORED BY FIRSTHEALTH FOR SMALL BUSINESSES, SUBMITTED 66 PROPOSALS TO BUSINESSES AND 12.6% OF MEMBERS SUBSEQUENTLY ENROLLED WERE PREVIOUSLY UNINSURED. A TOTAL OF 2,302 PEOPLE WERE SERVED THROUGH THESE PROGRAMS AT A COST OF $311,880 IN FISCAL 2010. DIABETES SELF-MANAGEMENT PROGRAM THE FIRSTHEALTH DIABETES SELF-MANAGEMENT PROGRAM, AN AMERICAN DIABETES ASSOCIATION ACCREDITED PROGRAM, ASSISTED PEOPLE WITH OR AT RISK FOR DIABETES AND HELPED THEM GAIN THE KNOWLEDGE AND SKILLS NEEDED TO SELF-MANAGE THE DISEASE AND RELATED CONDITIONS. THIS ASSISTANCE INCLUDED DIABETES SELF-MANAGEMENT EDUCATION (INDIVIDUAL AND GROUP SETTING), MEDICAL NUTRITION THERAPY, HEALTH CARE PROFESSIONAL EDUCATION, DISEASE MANAGEMENT, TELEPHONE CARE MANAGEMENT, COMMUNITY OUTREACH AND CASE MANAGEMENT SERVICES. APPROXIMATELY 1,390 DIABETICS RECEIVED ASSISTANCE THROUGH THIS PROGRAM IN FISCAL 2010. HEALTHY LIVING IN THE MID-CAROLINAS PROGRAM UNDER A SEVEN-YEAR GRANT FROM THE KATE B. REYNOLDS CHARITABLE TRUST, FIRSTHEALTH PROVIDED EVIDENCE-BASED LIFESTYLE BEHAVIOR CHANGE CLASSES THROUGH THREE SPECIFIC PROGRAMS: THE ACTIVE LIVING EVERY DAY (ALED) AND THE HEALTH EATING EVERY DAY (HEED) AND THE HAPPY KITCHEN (THK) PROGRAMS. APPROXIMATELY 70% OF THE PARTICIPANTS IN THESE PROGRAMS WERE FINANCIALLY NEEDY, WITH FAMILY INCOMES AT OR BELOW 200% THE FEDERAL POVERTY LEVEL. 113 LOW-INCOME INDIVIDUALS ENROLLED IN THE ALED PROGRAM AND 433 ENROLLED IN THE HEED/THK PROGRAMS IN FISCAL 2010. FIRSTHEALTH PROVIDED $15,090 OF FINANCIAL SUBSIDIES TO OFFSET THE UNFUNDED OPERATING COSTS OF THE HEALTH LIVING INITIATIVES IN FISCAL 2010. SUPPORT IN THE COMMUNITY FIRSTHEALTH EMPLOYEES IDENTIFY LOCAL NEEDS AND RECOMMEND IN-KIND AND FINANCIAL SUPPORT TO ORGANIZATIONS IN NEED. DURING FISCAL 2010, FIRSTHEALTH SUPPORTED HEALTH EDUCATION EVENTS, DISTRIBUTED EQUIPMENT AND PROMOTED COMMUNITY-BASED HEALTH INITIATIVES. FIRSTHEALTH ALSO PROVIDED MEALS FOR 50 COMMUNITY MEETINGS AND EVENTS. THOUGH THESE INITIATIVES, FIRSTHEALTH SERVED 23,180 PEOPLE AT A COST OF $329,553 FOR FISCAL 2010. VOLUNTEER EFFORTS BY FIRSTHEALTH EMPLOYEES FIRSTHEALTH PROVIDED ALMOST 1,100 HOURS OF ASSISTANCE TO THE COMMUNITY IN THE AREAS OF LEADERSHIP, PLANNING, RESOURCE IDENTIFICATION, TIME MANAGEMENT AND INFORMATION SYSTEMS ON A LOW OR NO-COST BASIS. FIRSTHEALTH PARTICIPATED IN AND PROVIDED ADMINISTRATIVE SUPPORT TO COUNTY-BASED MULTI-AGENCY GROUPS INCLUDING MOOREHEALTH, MONTGOMERY COMMUNITY RESOURCE TEAM, RICHMOND HEALTHY CAROLINIANS, AND HEALTHY HOKE. LOCAL SAFE KIDS COALITIONS WERE ALSO SUPPORTED IN MONTGOMERY, MOORE AND RICHMOND COUNTIES AS PART OF THE STATEWIDE INITIATIVE TO REDUCE CHILDHOOD INJURIES. THESE GROUPS HOSTED EVENTS SUCH AS BIKE RODEOS AND CAR SEAT SAFETY CHECKS. OVER 3,000 PEOPLE WERE SERVED AT A COST OF $26,404 IN FISCAL 2010. FAMILY ASSISTANCE FIRSTHEALTH'S PASTORAL CARE SERVICES PROVIDED FREE MEALS FOR MORE THAN 650 FAMILY MEMBERS STAYING WITH LOVED ONES IN THE HOSPITAL WHO COULD NOT AFFORD MEALS AND HOUSING. THE COST TO FIRSTHEALTH FOR FREE MEALS PROVIDED IN FISCAL 2009 TOTALED $7,992, WITH AN ADDITIONAL $12,991 PAID TO AREA HOTELS FOR TEMPORARY HOUSING PROVIDED TO FAMILY MEMBERS. MOORE FREE CARE CLINIC THE MOORE FREE CARE CLINIC (MFCC) IS A PRIVATE, VOLUNTEER-BASED, NON-PROFIT ORGANIZATION THAT PROVIDES PRIMARY HEALTH CARE SERVICES AT NO COST TO THE LIMITED-INCOME RESIDENTS OF MOORE COUNTY THAT LACK HEALTH CARE INSURANCE COVERAGE. FIRSTHEALTH PROVIDED DIRECT FINANCIAL SUPPORT TOTALING $45,000 IN FISCAL 2010 TO MFCC IN SUPPORT OF ITS MISSION. PATIENTS OF MFCC THAT REQUIRED INPATIENT/OUTPATIENT ACUTE CARE SERVICES WERE REFERRED TO FIRSTHEALTH MOORE REGIONAL HOSPITAL FOR CARE. THE $321,779 COST OF PROVIDING THESE SERVICES IN FISCAL 2010 WAS ABSORBED BY FIRSTHEALTH. FIRSTHEALTH ALSO PROVIDED PHYSICIANS, NURSES AND PHYSICAL THERAPISTS TO MFCC, AND FIRSTHEALTH ABSORBED ANY ADDED COSTS ASSOCIATED WITH PROVIDING THIS COVERAGE. MEDICAL STAFF DEVELOPMENT / PHYSICIAN RECRUITMENT ASSISTANCE FIRSTHEALTH PROVIDES FINANCIAL ASSISTANCE TO AREA PHYSICIAN PRACTICES AND INDIVIDUAL PHYSICIANS FOR THE RECRUITMENT OF PHYSICIANS TO PRACTICE IN THE GEOGRAPHIC AREAS SERVED BY THE THREE FIRSTHEALTH HOSPITALS. UNDER FIRSTHEALTH'S MEDICAL STAFF DEVELOPMENT PLAN, RECRUITMENT ASSISTANCE IS APPROPRIATE TO: (1) ADD PHYSICIANS IN AN UNDER-SERVED GEOGRAPHIC LOCATION; (2) ADD OR ENHANCE A SERVICE OF THE HOSPITAL OR COMMUNITY; OR (3) INCREASE PHYSICIAN COVERAGE WHERE THERE IS AN EXISTING SHORTAGE. DURING FISCAL 2010, FIRSTHEALTH PARTICIPATED IN SEARCHES FOR TWO PSYCHIATRISTS AND A PEDIATRICIAN IN MOORE COUNTY AND TWO CARDIOLOGISTS AND AN INTERNAL MEDICINE PHYSICIAN IN RICHMOND COUNTY, AT A COST TO FIRSTHEALTH OF $36,888. 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