2011-02-14T08:02:00-06:00 2010-06-30 DIXON HUGHES PLLC 500 Ridgefield Court Asheville NC 28806 990 2009-07-01 636000090 REGIONAL MEDICAL CENTER BOARD REGI 2562355255 PO BOX 2208 ANNISTON AL 36202 J DAVID MCCORMACK 2562355255 2011-02-10 1 Amy Bibby 8282542254 2009 2016-02-24 21:20:13Z NORTHEAST ALABAMA REGIONAL MEDICAL C J DAVID MCCORMACK PO BOX 2208 ANNISTON AL 36202 182063143 0 X WWW.RMCCARES.ORG X 1974 AL TO PROVIDE PERSONALIZED HEALTHCARE TO CITIZENS OF NORTHEAST ALABAMA 15 15 1717 225 0 0 41671 21676 175110898 173657696 5221697 5785856 537025 267581 180911291 179732809 38805 101670 0 69605917 69063966 0 0 109643299 110138252 179288021 179303888 1623270 428921 184310545 185902414 52515882 53678649 131794663 132223765 THE BOARD'S PRIMARY MISSION IS TO PROVIDE ADVANCED HEALTH CARE OF THE HIGHEST QUALITY, WITH COMPASSION AND INTEGRITY, TO EVERY PATIENT. 0 0 168549203 173836553 DURING THE YEAR ENDED JUNE 30, 2010, NORTHEAST ALABAMA REGIONAL MEDICAL CENTER HAD 13,653 ADULT AND PEDIATRIC INPATIENT ADMISSIONS, 1,373 BABIES DELIVERED, AND SERVED PATIENTS THROUGH AMBULATORY CARE INCLUDING: 3,637 INPATIENT SURGERIES PERFORMED, 217 OPEN HEART SURGERIES PERFORMED, 11,991 OUTPATIENT SURGERIES PERFORMED 49,949 EMERGENCY DEPARTMENT PATIENTS, 50,879 REFERRED OUTPATIENTS, AND 8,317 CARDIOVASCULAR PROCEDURES. THE MEDICAL CENTER IS ALSO INVOLVED IN EDUCATION, RESEARCH, AND COMMUNITY BENEFIT ACTIVITIES DESIGNED TO PROVIDE HEALTH AND WELLNESS.REGIONAL MEDICAL CENTER'S CANCER PROGRAM ACHIEVED ACCREDITATION WITH COMMENDATION IN 2010 FROM THE COMMISSION ON CANCER (COC) OF THE AMERICAN COLLEGE OF SURGEONS (ACOS). THIS ACCREDITATION IS AWARDED EVERY THREE YEARS FOLLOWING AN INTENSIVE ONSITE EVALUATION BY A PHYSICIAN SURVEYOR, AND IS BASED ON A COMMENDATION LEVEL OF COMPLIANCE WITH ONE OR MORE STANDARDS THAT REPRESENT THE FULL SCOPE OF THE CANCER PROGRAM (CANCER COMMITTEE LEADERSHIP, CANCER DATA MANAGEMENT, CLINICAL SERVICES, RESEARCH, COMMUNITY OUTREACH, AND QUALITY IMPROVEMENT). REGIONAL MEDICAL CENTER HOLDS DESIGNATIONS FOR THE FOLLOWING: BLUE CROSS CENTER OF DISTINCTION FOR CARDIAC CARE; MEDICARE CENTER OF EXCELLENCE FOR BARIATRICS; ASCR GOLD STANDARD AWARD (ALABAMA STATEWIDE CANCER REGISTRY).REGIONAL MEDICAL CENTER IS PROUD TO BE CATEGORIZED AS A TIER 1 HOSPITAL BY BLUE CROSS AND BLUE SHIELD OF ALABAMA. HOSPITALS DESIGNATED AS TIER 1 ARE RECOGNIZED AS HAVING ATTAINED THE HIGHEST LEVEL OF COMPLIANCE ACROSS THE FOLLOWING AREAS: QUALITY AWARENESS, PATIENT SAFETY AWARENESS, FINANCIAL AWARENESS, AND PATIENT SATISFACTION. 168549203 1 1 0 1 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 0 0 1 303 0 1 1717 1 0 0 0 0 0 0 0 0 0 15 15 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 0 1 1 X X SUSAN MARNEY DIRECTOR- ACCOUNTING SERVICES 2562355678 PO BOX 2208 ANNISTON AL 36202 JOHN E BLUE II 1.00 X X 87 0 0 TRUDY D HARDEGREE 1.00 X X 171 0 0 THOMAS ANTHONY HUMPHRIES 1.00 X X 0 0 0 ELLEN JOHNSON BASS 1.00 X 0 0 0 EDDYER L BROWN 1.00 X 194 0 0 KOVEN L BROWN 1.00 X 0 0 0 GORDON T HARDY MD 1.00 X 800 0 0 JAMES S HIXON MD 1.00 X 0 0 0 LARRY K DEASON 1.00 X 74 0 0 GREGORY KERNION 1.00 X 0 0 0 STEVEN PAUL LYNCH DMD 1.00 X 74 0 0 SAMUEL H MONK II 1.00 X 0 0 0 VAUGHN M STEWART II 1.00 X 0 0 0 SANDRA FOX SUDDUTH 1.00 X 0 0 0 FRED WILSON 1.00 X 64 0 0 MICHAEL W KIMBERLY PHD 1.00 X 0 0 0 DAVID WESLEY SMITH MD 1.00 X 0 0 0 J DAVID MCCORMACK 40.00 X 295044 0 17987 LOUIS BASS 40.00 X 158018 0 35553 JUDITH GOULD 40.00 X 170937 0 90932 RONALD J VARCAK DO 40.00 X 200833 0 3904 THOMAS C MCGOWAN III 40.00 X 138734 0 9966 KATHERINE D SUNDAY 40.00 X 131708 0 8964 JOHNNIE H EAST 40.00 X 125801 0 1160 AYMAN ABDUL-GHANI 40.00 X 173828 0 8707 ALLEN FLETCHER 1.00 X 560690 0 0 WJ TUTWILER JR 1.00 X 119017 0 0 2076074 0 177173 25 1 1 0 ANESTHESIA SOLUTIONS OF ANNISTON 2901 2ND AVENUE SUITE 270 BIRMINGHAM AL 35233 CRNA SERVICES 3207859 COASTAL EXTRACORPOREAL TECHNOLOGY INC 612 EAST BALDWIN ROAD PANAMA CITY FL 32405 PERFUSION SERVICES 647829 TRANSCRIPTIONS SOLUTIONS INC PO BOX 62391 HOUSTON TX 77205 MEDICAL TRANSCRIPTION SERVICES 506042 EMERGENCY ROOM SERVICES OF ANNISTON LLC PO BOX 3477 OXFORD AL 36203 ER PHYSICIAN SERVICES 505038 AMERICAN ENDOSCOPY SERVICES INC 8 CADILLAC DRIVE STE 200 BRENTWOOD TN 37027 REPROCESSING SURGICAL INSTRUMENTS 444220 29 21676 21676 NET PATIENT SERVICE RE 621400 169473380 169473380 MEDICAID DISP SHARE 900099 3975519 3975519 OTHER OPERATING REVENU 900099 84468 84468 AFTERCARE REHAB SERVIC 624100 76745 76745 DISCOUNTS 900099 37734 37734 9850 9850 173657696 5544005 5544005 1657507 2304800 -647293 -647293 -647293 267385 25534 241851 241851 241851 FOOD SERVICE & VENDING 722210 765760 139976 625784 GIFT SHOP REVENUE 453220 50738 50738 LAUNDRY SERVICES 900099 48731 48731 49645 49645 914874 179732809 173836553 0 5874580 73952 73952 27718 27718 1305170 430706 874464 164205 149427 14778 51476170 47538052 3938118 4195312 3817734 377578 7915538 7203140 712398 4007571 3646890 360681 351651 351651 13300844 11601968 1698876 39889749 39441957 447792 1665316 614163 1051153 3225445 3225445 8987 5739 3248 141952 106705 35247 2072476 2072476 11574071 11574071 2901458 2901458 BAD DEBTS 34049266 34049266 RECRUITMENT 668766 668766 OTHER EXPENSES 288271 68336 219935 179303888 168549203 10754685 0 6880998 6103166 11575339 13694212 1270341 1005035 4438625 4985652 2140803 1399498 241099680 157204992 84230928 83894688 69441075 71474480 4332436 3345683 184310545 185902414 12203197 12755043 39320000 38060000 992685 2863606 52515882 53678649 X 131794663 132213565 10200 131794663 132223765 184310545 185902414 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 15990 15990 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: A PORTION OF MEMBERSHIP DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE ALABAMA HOSPITAL ASSOCIATION (ALHA) IS ALLOCATED TO LOBBYING ACTIVITIES PERFORMED FOR THE BENEFIT OF THOSE ORGANIZATIONS' MEMBER BODY. IN 2009, 23.76% OF DUES TO THE AHA ($7,143) AND 24.07% OF DUES PAID TO THE ALHA ($8,847) WAS ALLOCATED TO LOBBYING EFFORTS. 10212 -12 10200 10000 212 10212 1.00000 0 0 4015957 4015957 83696234 51802123 31894111 4160303 2640995 1519308 149043445 102761874 46281571 183741 183741 83894688 PROFESSIONAL LIABILITY SELF INSURANCE 2751606 WORKER'S COMPENSATION LIABILITY 112000 2863606 179732809 179303888 428921 181 181 429102 148835066 3151523 3151523 145683543 34049266 34049266 179732809 148052452 2797830 2797830 145254622 34049266 34049266 179303888 Part V, Line 4: Description of Intended Use of Endowment Funds: THE KNOX ENDOWMENT WAS ESTABLISHED IN THE 1940'S BY THE KNOX FAMILY TO PROVIDE MATERNITY CARE FOR INDIGENT HOSPITAL PATIENTS. INVESTMENT EARNINGS ON THE FUND ARE PUT TOWARDS INDIGENT MATERNITY PATIENTS ANNUALLY. THE HOSPITAL HAS DISCRETION TO USE THE FUNDS FOR MEDICAL EXPENSES BESIDES MATERNITY CARE IF NECESSARY. Part XII, Line 2d - Other Adjustments: REVENUES OF CONSOLIDATED ENTITIES: 846723. RENTAL EXPENSES NET W/ REVENUES: 2304800. Part XII, Line 4b - Other Adjustments: BAD DEBTS NET W/ REVENUES: 34049266. Part XIII, Line 2d - Other Adjustments: EXPENSES OF CONSOLIDATED ENTITIES: 493030. RENTAL EXPENSES NET W/ REVENUES: 2304800. Part XIII, Line 4b - Other Adjustments: BAD DEBTS NET W/ REVENUES: 34049266. 1 1 1 X 1 X 1 1 1 0 1 1 6489950 6489950 0.04470 15765791 12229827 3535964 0.02430 22255741 12229827 10025914 0.06900 59626 59626 0.00040 6387072 5961486 425586 0.00290 88027 88027 0.00060 6534725 5961486 573239 0.00390 28790466 18191313 10599153 0.07290 48 3730 3730 0.00000 1285 17453 2061 15392 0.00010 1333 21183 2061 19122 0.00010 7327922 55622408 56759244 -1136836 X 1 0 NORTHEAST ALABAMA REGIONAL MEDICAL CENTE

400 EAST 10TH STREET ANNISTON AL 36207

X X X Part III, Line 4: Bad Debt Expense at cost was calculated by multiplying Total Bad Debt Expense by the hospital's cost to charge ratio. The cost to charge ratio was calculated by dividing Total Operating Costs into Total Charges. Part III, Line 9b: There are no specific provisions regarding collection of charity accounts as these accounts are adjusted to a zero balance. Therefore, no collection efforts take place once the individual has qualified. Part VI, Line 2: Our organization assesses the health care needs of our community in several ways. During the past year we conducted an in-depth community needs assessment to provide us with valuable information as we prepared to open the Federally Qualified "Community" Health Center on our campus. We also update our medical staff development plan annually. There are several components to this plan, including the overall population within our service area, the age of our current medical staff, and projected physician needs using calculations provided by the American Medical Association's Physician Characteristics and Distribution in the US. We also assess the needs of our community whenever we consider providing a new service, or when we evaluate expanding existing services that we currently provide. We develop a plan based on calculations of the impact that the new or expanded service may have on our community. Part VI, Line 3: All patient bills have a statement explaining that charity care is available to qualifying individuals. Contact information is listed also. Signs are posted in all registration areas as well as the facility's website regarding charity care. Part VI, Line 4: Our service area is comprised of approximately 200,000 people residing in the counties of Calhoun, Cleburne, Clay, Randolph and Talladega. All age groups are served from newborns to the elderly. Services include medical/surgical, intensive care, obstetrics, pediatrics, psychiatric, cardiology and oncology. All citizens are served regardless of payer or ability to pay. While RMC is the only full service hospital in the service area, smaller hospitals in Calhoun County include Stringfellow Hospital and Jacksonville Hospital. Other hospitals in our 5 county service area include Wedowee Hospital and Randolph Medical Center in Randolph County, Clay County Hospital in Clay County, and Citizens Hospital and Coosa Valley Medical Center in Talladega County. Cleburne and Randolph Counties are considered federally designated medically underserved for primary care, and all counties are considered underserved for specialty physicians. The area also qualifies as underserved for psychiatric services by the National Health ServiceCorps. Part VI, Line 6: Regional Medical Center promotes health within the community we serve in a variety of ways. As a nonprofit, we provide services for all patients regardless of their ability to pay, and we see a very high number of uninsured, underinsured and indigent patients in our Emergency Department. We have recently formed a partnership with a local Federally Qualified Health Clinic (FQHC) to locate a satellite clinic on the RMC campus to serve the uninsured, underinsured and indigent population, ensuring they receive ongoing medical care in the most appropriate setting. We assist the members of our medical staff in recruiting new physicians to the area. As part of our assistance program, recruited physicians must agree to see all patients, regardless of income level or ability to pay. RMC provides many community services in the form of health education, screenings and support groups. Our Cancer Resource Center, Parish Nursing Program, and Congregational Health Outreach are but a few of our services to our community that provide highly skilled staff to perform health screenings and education free of charge. 1 CALHOUN COUNTY CHAMBER OF COMMERCE PO BOX 1087 ANNISTON AL 36202 630039375 501(C)(6) 12000 CASH GENERAL ACTIVITY SPONSORSHIP EAST ALABAMA EMERGENCY MEDICAL SERVICES PO BOX 700 LINCOLN AL 35096 630707345 501(C)(3) 15000 CASH GENERAL ACTIVITY SPONSORSHIP 1 1 MEDICATION/MEDICAL SUPPLIES 141 20029 TRANSPORTATION 292 4954 FOOD 94 511 INFANT CAR SEATS 3 105 BURIAL 1 355 PAYMENTS TO MEDICAL PROVIDERS 3 1042 MISCELLANEOUS 11 722 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: THE ORGANIZATION ADOPTED WRITTEN GUIDELINES FOR ORGANIZATIONS TO APPLY FOR COMMUNITY CONTRIBUTIONS (GRANTS). A DETAILED APPLICATION MUST BE COMPLETED AND APPROVED BY THE REVIEW COMMITTEE OF THE BOARD. A COPY OF THE APPLICATION IS AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINSITRATIVE OFFICE. X X X 1 1 X X X X X 1 0 0 0 0 0 0 0 0 J DAVID MCCORMACK 203101 0 86003 0 5940 0 8061 0 9926 0 313031 0 0 0 LOUIS BASS 150372 0 0 0 7646 0 19979 0 15574 0 193571 0 0 0 JUDITH GOULD 129697 0 0 0 41240 0 76004 0 14928 0 261869 0 0 0 RONALD J VARCAK DO 155398 0 0 0 45435 0 0 0 3904 0 204737 0 0 0 AYMAN ABDUL-GHANI 173828 0 0 0 0 0 0 5215 0 3492 173828 8707 0 0 ALLEN FLETCHER 0 0 0 0 560690 0 0 0 0 0 560690 0 0 0 WJ TUTWILER JR 0 0 0 0 119017 0 0 0 0 0 119017 0 0 0 Part I, Line 1a ALL TRAVEL EXPENSES FOR SPOUSES AND COMPANIONS, AS WELL AS TEMPORARY HOUSING ALLOWANCES PER EMPLOYMENT AGREEMENTS ARE ADDED AS WAGES ON THE RECIPIENTS' FORM W-2 OR 1099-MISC. Part I, Line 4a ALLEN FLETCHER AND WILLIAM J. TUTWILER, JR RECEIVED SEVERANCE PAYMENTS DURING THE YEAR OF $560,690 AND $119,017 RESPECTIVELY. RACHEL CALDWELL FAMILY MEMBER OF CORPORATE OFFICER 48599 COMPENSATION AS EMPLOYEE OF HOSPITAL 0 ANNISTON ORTHOPAEDIC ASSOCIATES PA OWNERSHIP SHARE BY BOARD MEMBER GORDON HARDY, MD 195740 RENT PAID TO HOSPITAL FOR USE OF OFFICE SPACE 0 BRIAN JENKINS FAMILY MEMBER OF FORMER KEY EMPLOYEE 115606 COMPENSATION AS EMPLOYEE OF HOSPITAL 0 Form 990, Part VI, Section A, line 7a THE MEMBERS OF THE BOARD OF DIRECTORS SHALL BE THOSE DULY APPOINTED UNDER THE PROVISIONS OF ORDINANCE NO. 74-0-13 ADOPTED BY THE COUNCIL OF THE CITY OF ANNISTON, AL, ON MAY 7, 1974. Form 990, Part VI, Section A, line 7b THE BOARD IS RESTRICTED FROM THE SALE OR DISPOSAL OF ANY PART OF THE REAL ESTATE USED IN CONNECTION WITH THE OPERATION OF THE MEDICAL CENTER OR THE TRANSFER OF THE OPERATION AND MANAGEMENT OF THE MEDICAL CENTER WITHOUT THE CONSENT OF THE GOVERNING BODY OF THE CITY OF ANNISTON, AL. Form 990, Part VI, Section B, line 11 THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH ASSISTANCE AND INFORMATION PROVIDED BY MANAGEMENT. UPON COMPLETION, THE RETURN WAS REVIEWED INTERNALLY BY MANAGEMENT, AND FORWARDED TO THE MEMBERS OF THE BOARD OF DIRECTORS. AFTER THE RETURN WAS REVIEWED BY THE BOARD MEMBERS, IT WAS FILED WITH THE IRS. Form 990, Part VI, Section B, line 12c BOARD MEMBERS ARE REQUIRED TO DISCLOSE ON AN ANNUAL BASIS ANY POTENTIAL CONFLICTS OF INTEREST PER THE ORGANIZATION'S OFFICIAL WRITTEN POLICY. A DISINTERESTED PARTY IS ASSIGNED TO INVESTIGATE ANY CONFLICTS THAT ARISE, AND AFFECTED BOARD MEMBERS ARE ADVISED OF THE PARTY'S DECISION. Form 990, Part VI, Section B, line 15a THE CEO COMPENSATION PACKAGES ARE DETERMINED BY CONDUCTING SALARY SURVEYS FROM INDIVIDUAL HOSPITALS AS WELL AS UTILIZING SALARY INFORMATION AVAILABLE FROM INDEPENDENT SOURCES SUCH AS STATE HOSPITAL ASSOCIATIONS, INDEPENDENT COMPENSATION CONSULTANTS, AND PERIODICALS. THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OVERSEES THE PROCESS AND DETERMINES THE COMPENSATION FOR THE CEO AFTER REVIEW AND CONSIDERATION OF ALL RELEVANT INFORMATION. THE CEO APPROVES COMPENSATION PACKAGES FOR ALL OTHER APPLICABLE EMPLOYEES. Form 990, Part VI, Section C, line 18 PHOTOCOPIES OF THE FORM 1023 AND RECENT FILINGS OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. Form 990, Part VI, Section C, line 19 PHOTOCOPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. MEDICAL CENTER MEMORIAL FOUNDATION INC PO BOX 2208 ANNISTON AL 36202 630981593 EXEMPT ORG SUPPORT AL 501(c)(3) Line 7 N/A REGIONAL HEALTH SERVICES INC PO BOX 2208 ANNISTON AL 36202 630721572 EXEMPT ORG SUPPORT AL 501(c)(3) Line 11a, I N/A REGIONAL HEALTH MANAGEMENT CORPORATION PO BOX 2345 ANNISTON AL 36202 630819576 MANAGEMENT AL REGIONAL HEALTH SERVICES INC C 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 MEDICAL CENTER MEMORIAL FOUNDATION INC A 1200 REGIONAL HEALTH MANAGMENT CORPORATION D 653142