2011-05-12T13:47:10-05:00 2010-06-30 WarrenAverettKimbrough & MarinoLLC 2500 Acton Road Birmingham AL 35243 990 2009-07-01 581966795 DEKALB MEDICAL CENTER INC DEKA 4045011000 2701 NORTH DECATUR ROAD DECATUR GA 30033 DIANE HARDEN 4045015213 2011-05-05 1 2059794100 2009 2016-02-24 21:20:13Z ERIC NORWOOD 2701 NORTH DECATUR ROAD DECATUR GA 30033 404801020 0 X www.dekalbmedical.org X 1991 GA At DeKalb Medical, our mission is to improve lives through the delivery of excellent health and wellness services in partnership with our physicians. 7 6 4343 242 110797 33941 1341775 1620773 385636309 397818422 2255578 -3859566 1575273 1553633 390808935 397133262 0 0 189131408 188069534 0 0 210378941 224083058 399510349 412152592 -8701414 -15019330 395520375 397952138 250501123 266531359 145019252 131420779 At DeKalb Medical, our mission is to improve lives through the delivery of excellent health and wellness services in partnership with our physicians. 0 0 247613800 311879861 DeKalb Medical North Decatur - 22,359 patients discharged from the hospital for a total of 118,487 patient days. There were 187,072 outpatient visits to the hospital during the fiscal year. 59700524 72115584 DeKalb Medical at Hillandale - 4,009 patients were discharged from the hospital for a total of 17,666 patient days. There were 84,341 outpatient visits to the hospital during the fiscal year. 19532402 13822977 DeKalb Medical Physician Network - 105,192 patients were treated in the physician offices during the fiscal year. 874108 1442836 874108 1442836 327720834 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 1 0 0 1 439 0 1 4343 1 1 1 0 0 0 0 0 0 0 0 7 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 GA X DIANE HARDEN 4045015025 2701 NORTH DECATUR ROAD DECATUR GA 30033 Eric Norwood 40.00 X X 1403135 0 44940 Oliver Lee 5.00 X 0 0 0 Terry Duis 5.00 X 0 0 0 Robert Wilson 5.00 X 0 0 0 David Jollay 5.00 X 0 0 0 John Kennedy MD 5.00 X 0 0 0 Tyrone Malloy MD 5.00 X 0 0 0 John Shelton 40.00 X 629864 0 82023 Diane Harden 40.00 X 503294 0 76515 Duane Barclay DO 40.00 X 379247 0 61071 Tom Crawford 40.00 X 269082 0 63920 Cathleen Wheatley 40.00 X 431801 0 47995 Clay Fowler 40.00 X 238344 0 66643 RUTH ANDERSON 40.00 X 253391 0 54024 JAN GANNON 40.00 X 221662 0 60638 CHERYL IVERSON 40.00 X 212309 0 71057 David Holladay MD 40.00 X 935548 0 25595 Raymond Lawhead MD 40.00 X 535260 0 19158 Shainul Bhatia MD 40.00 X 379796 0 31163 MICHELE HARVEY MD 40.00 X 270276 0 16519 Timothy Milner MD 40.00 X 271465 0 15460 6934474 0 736721 15 0 1 0 SODEXHO INC AND AFFILIATES PO BOX 536922 ATLANTA GA 303536922 MANAGEMENT SERVICES 2610929 COGENT HEALTHCARE PO BOX 975075 DALLAS TX 753975075 HOSPITALISTS 2247844 DEKALB ANESTHESIA ASSOCIATES PA 21717 WEST PARK COURT SUITE A STONE MOUNTAIN GA 300870000 ANESTHESIOLOGY SERVICES 2132447 SEGARS GROUP LLC 14355 PROVIDENCE ROAD ALPHARETTA GA 300040000 CONSTRUCTION SERVICES 1946981 CHAMBERLIN EDMONDS PO BOX 536969 ATLANTA GA 303536969 CONSULTING 1512140 51 1390390 230383 1620773 DEKALB MEDICAL AT NORT 900099 311879861 311879861 DEKALB MEDICAL AT HILL 900099 72115584 72115584 PHYSICIAN PRACTICE NET 900099 13822977 13822977 397818422 3795192 3795192 121080 121080 121080 121080 13000 7667126 632 -7667126 12368 -7654758 -7654758 WELLNESS CENTER 900099 797563 797563 LAB OUTREACH REVENUE 900099 110797 110797 CAFETERIA/VENDING 900099 91013 91013 433180 433180 1432553 397133262 399261258 110797 -3859566 5170955 5170955 156682756 131701222 24981534 5825605 4740326 1085279 8385766 5505742 2880024 12004452 9744521 2259931 1292328 1292328 257210 257210 29336938 18121163 11215775 1656149 9055 1647094 71450761 68805517 2645244 6949837 461763 6488074 16879981 8009974 8870007 174927 59181 115746 199880 64536 135344 23807940 19994538 3813402 4822300 458832 4363468 PROVISION FOR UNCOLLECT 51584493 51584493 0 REPAIRS AND MAINTENANCE 9024973 8252949 772024 LOSS ON EXTINGUISHMENT 4432377 0 4432377 OTHER EXPENSES 1214266 6212 1208054 MEMBERSHIPS, DUES & SUB 998698 200810 797888 412152592 327720834 84431758 0 20145291 15942468 7089608 7076737 48702742 50602142 4921712 5439927 2296163 1863143 390982235 247896764 153574989 143085471 151432439 168891348 1168717 1029985 6188714 4020917 395520375 397952138 35759527 39260026 180272680 194411884 34468916 32859449 250501123 266531359 X 143019444 130835289 1999808 585490 145019252 131420779 395520375 397952138 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4941295 4941295 223347699 223347699 158461242 158461242 4231999 247896764 -243664765 143085471 ASSET RETIREMENT OBLIGATION 4385399 INTEREST RATE SWAPS 3075967 RESERVE FOR PENSION EXPENSE 21927526 SELF INSURANCE RESERVES 3470557 32859449 1 1 X 1 X 1 X 1 1 0 1 1 9791651 0 9791651 0.02380 56247259 31722796 24524463 0.05950 66038910 31722796 34316114 0.08330 66038910 31722796 34316114 0.08330 1 21801748 4360350 94235423 87431868 6803555 X 1 0 DEKALB MEDICAL AT NORTH DECATUR

2701 NORTH DECATUR ROAD DECATUR GA 300330000

X X X DEKALB MEDICAL AT HILLANDALE

2801 DEKALB MEDICAL PARKWAY LITHONIA GA 300580000

X X X Part I, Line 3c: The organization uses Federal Poverty Guidelines. Part I, Line 6a: The Community Benefit Report is produced by DeKalb Medical Center, Inc. Part I, Line 7: The costing methodology used was based on a ratio of cost to charges. Costs were calculated by taking total operating expenses and reducing them by bad debt expense and any non-patient care revenue. Charges are equal to total gross patient charges. Part I, Line 7g: N/A Part I, Line 7f: Part III, Line 4: Bad debt expense reported on Form 990, Part IX, Line 25 is recorded at gross patient charges less any payments and discounts, including charity. The bad debt cost on Part III, Line 2 is calculated by multiplying total bad debt expense by the ratio of total operating expense to total gross patient charges. Part III, Line 8: Medicare allowable cost per the as-filed Medicare cost report is used to determine Medicare costs. Revenue received from Medicare including co-pays / deductibles comes from the as-filed Medicare cost report. Part III, Line 9b: N/A Part VI, Line 2: Every five years, we partner with the DeKalb Board of Health to assess local risk factors and measure the success of our healthcare initiatives. The community "health report" includes an evaluation of disease prevalence and comparison against national averages that helps us engineer services to eliminate health disparities based on ethnicity, income, education and other factors. Among the opportunities identified for prevention and community action in DeKalb and surrounding counties were the following:*80% of refugees in Georgia live in DeKalb County and speak more than 64 different languages*72% of all hospitalizations are caused by heart disease *Pregnancy and childbirth complications are the 2nd leading cause of hospitalization*Stroke, heart disease and cancer were the leading causes for death in adults aged 65 and over Part VI, Line 3: Patients provided care by the hospital meet with a Financial Counselor after their care is rendered. Eligibility criteria for various financial assistance programs is reviewed with the patient including charity, Medicaid, or other federal, state, or local government programs. Billing statements received by a patient advises them to contact the Financial Counseling Department about these programs. Part VI, Line 4: DeKalb Regional Health System serves the population of DeKalb County, GA (54% African American, 35% White, 4% Asian) as well as Rockdale and Gwinnett counties. Part VI, Line 5: N/A Part VI, Line 6: Understanding that a healthy community is about more than just the absence of death and disease, we also contribute to the economic vitality and creation of quality jobs right here at home. Named the 2010 Corporation of the Year by the DeKalb County Chamber of Commerce for our role as an active corporate citizen and proponent of diversity, the following programs have helped build the health of our community:*We help reduce teen pregnancy and sexually transmitted disease by providing free prevention education through our Puberty Rocks program for pre-teens.*We support 100 Black Men of DeKalb in the effort to provide higher education to at-risk youth.*We partner with the Physician's Care Clinic to provide nearly 2,000 low or no cost patient visits a year including lab work and prescription medications to area low-income and uninsured residents.*We sponsor a free annual cancer screening day on two of our hospital campuses.*Recent healthy workplace initiatives include smoke-free buildings inside and out, a no-nicotine hiring policy and adoption of healthy food options in hospital cafeterias*We collect and donate surplus medical supplies to MedShare International in support of health initiatives in less fortunate countries.*An open medical staff that attracts unlimited, highly trained medical talent to serve the area.*We are a major sponsor of the Leadership DeKalb initiative to promote community connectivity and action plans for economic development, sustainability and improvement of the quality of life in DeKalb County.*DeKalb Medical provides further enrichment and employment opportunities by championing workplace success for youth and adults with disabilities. Partnering with the nationally recognized Tommy Nobis Center, DeKalb Medical contracts with the Center to provide switchboard operators for the health system. *We partner with DeKalb County high schools to provide mentally and physically challenged students with vocational training and real-life work experience in the healthcare industry. The students, who receive school credit, serve as volunteers in our cafeteria, laundry room and mother-baby units. *We participate in numerous career days, encouraging the science and math education that's needed to provide competent health workers of the future.*We support a DeKalb Workforce Development partnership that provides training programs, education and a clinical site for patient care technician certification.*We maintain a partnership with Georgia Perimeter College and Mercer University to provide clinical rotations, preceptorships, education and instruction to Georgia's future nurses. Part VI, Line 7: DeKalb Regional Health System, Inc. is the parent entity which provides support to DeKalb Medical Center, Inc., Decatur Health Resources, Inc. and DeKalb Medical Center Foundation, Inc. DeKalb Medical Center, Inc. operates two acute care hospitals and a physician practice network to provide healthcare services to the residents of DeKalb County, Georgia and surrounding counties. Decatur Health Resources provides long-term acute care hospital services to patients who need additional time to recover from serious illness. DeKalb Medical Center Foundation's mission is to strengthen the link between DeKalb Regional Health System and the community it services through communication, education, service and philanthropy. GA X 1 1 X X X X X 0 0 0 0 0 0 0 1 0 Eric Norwood 483407 0 864441 0 55287 0 20825 0 31668 0 1455628 0 392679 0 John Shelton 303318 0 303695 0 22851 0 66688 0 17203 0 713755 0 128922 0 Diane Harden 249748 0 213976 0 39570 0 66836 0 11372 0 581502 0 88522 0 Duane Barclay DO 245056 0 96165 0 38026 0 61071 0 1610 0 441928 0 41885 0 Tom Crawford 142063 0 91425 0 35594 0 60676 0 4280 0 334038 0 46332 0 Cathleen Wheatley 210967 0 198001 0 22833 0 43525 0 5829 0 481155 0 129455 0 Clay Fowler 147427 0 75845 0 15072 0 54750 0 12890 0 305984 0 33413 0 RUTH ANDERSON 144935 0 80837 0 27619 0 51885 0 3112 0 308388 0 41751 0 JAN GANNON 150323 0 49036 0 22303 0 49178 0 12029 0 282869 0 0 0 CHERYL IVERSON 125141 0 71913 0 15255 0 54164 0 17773 0 284246 0 38204 0 David Holladay MD 917806 0 0 0 17742 0 13346 0 12249 0 961143 0 0 0 Raymond Lawhead MD 485938 0 25000 0 24322 0 13475 0 5683 0 554418 0 0 0 Shainul Bhatia MD 232911 0 103935 0 42950 0 18375 0 12788 0 410959 0 0 0 MICHELE HARVEY MD 115995 0 137627 0 16654 0 6801 0 9718 0 286795 0 0 0 Timothy Milner MD 271057 0 0 0 408 0 0 0 15460 0 286925 0 0 0 Part I, Line 7 A PORTION OF COMPENSATION FOR PERSONS LISTED IN FORM 990, PART VII IS BASED ON ACHIEVING CERTAIN OPERATIONAL AND FINANCIAL CRITERIA ESTABLISHED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE DEKALB COUNTY HOSPITAL AUTHORITY 586011209 24047CCC0 2003-12-10 28325646 REFUND SERIES 1993 A BONDS 09-21-1993 0 0 THE DEKALB COUNTY HOSPITAL AUTHORITY 586011209 24047CDH8 2010-05-03 180623920 REFUND BONDS DATED 3/29/2000, 12/10/2003, 5/18/2005 0 0 28325646 2691072 233698 1 0 1 1 180623920 14114456 12540951 3421900 7451747 1 0 1 1 0 0 0 0 0 0.00840 0.00000 0.00840 1 0 0 0 0 0 0.00840 0.00000 0.00840 1 1 0 0 0 0 0 0 0 0 0 0 0 DeKalb Anesthesia Associates FORMER BOARD MEMBER HAS DIRECT OWNERSHIP IN EXCESS OF 5% 2132447 Provider of Anesthesia Services 0 Dr John Kennedy Practicing Physician 20833 Medical Director SERVICES 0 Dr Michael Quinones Practicing Physician 68040 Physician Call Coverage 0 Kay Kennedy Spouse of Board Member 142844 Employee OF ORGANIZATION 0 DeKalb Surgical Associates Current Board Member HAS DIRECT OWNERSHIP IN EXCESS OF 5% 188960 Physician Call Coverage 0 Form 990, Part VI, Section A, line 6 DEKALB REGIONAL HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF DEKALB MEDICAL CENTER, INC. Form 990, Part VI, Section A, line 7a THE DEKALB REGIONAL HEALTH SYSTEM, INC. BOARD OF DIRECTORS APPROVE MEMBERS NOMINATED TO THE BOARD OF DIRECTORS FOR DEKALB MEDICAL CENTER, INC. Form 990, Part VI, Section A, line 7b DECISIONS MADE BY THE DEKALB MEDICAL CENTER, INC. BOARD OF DIRECTORS MUST BE APPROVED BY THE BOARD OF DIRECTORS FOR DEKALB REGIONAL HEALTH SYSTEM, INC. Form 990, Part VI, Section B, line 11 A copy of the Form 990 was provided to the Finance Committee of the DeKalb Regional Health System, Inc. Board of Directors for their review and approval prior to filing. Each member of the Dekalb Regional Health System, Inc. Board of Directors was provided a copy of the return. Form 990, Part VI, Section B, line 12c The organization requires all management employees to complete a Conflict of Interest Disclosure Statement annually and monitors the compliance with this policy. Form 990, Part VI, Section B, line 15 Compensation is reviewed and approved by the Compensation Committee of the DeKalb Regional Health System, Inc. Board of Directors. The committee uses an independent consultant to assist in setting compensation levels. Form 990, Part VI, Section C, line 19 AS A GENERAL RULE, THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. ANY WRITTEN REQUEST BY THE PUBLIC WOULD BE REVIEWED AND ACTED UPON BY THE BOARD. FORM 990, PART XI, LINE 2C: THE ORGANIZATION MADE NO CHANGES TO ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR. DEKALB MEDICAL EMERGENCY ASSOCIATES 2701 NORTH DECATUR ROAD DECATUR GA 300330000 582639636 PHYSICIANS SERVICES GA N/A FAMILY CARE CENTER TRUST 2701 NORTH DECATUR ROAD DECATUR GA 300330000 582110792 PHYSICIANS SERVICES GA N/A NETWORK MEDICAL PROVIDERS 2701 NORTH DECATUR ROAD DECATUR GA 300330000 582121470 PHYSICIANS SERVICES GA N/A DEKALB MEDICAL SPECIALTY CARE GROUP LLC 2701 NORTH DECATUR ROAD DECATUR GA 300330000 263454941 PHYSICIANS SERVICES GA N/A DEKALB MEDICAL PRIMARY CARE GROUP LLC 2701 NORTH DECATUR ROAD DECATUR GA 300330000 263454827 PHYSICIANS SERVICES GA N/A DEKALB MEDICAL OCCUPATIONAL MEDICINE GROUP LLC 2701 NORTH DECATUR ROAD DECATUR GA 300330000 263455069 PHYSICIANS SERVICES GA N/A DEKALB REGIONAL HEALTH SYSTEM INC 2701 NORTH DECATUR ROAD DECATUR GA 300330000 582034958 SUPPORT DMC, INC. GA 501(C)(3) TYPE II SUPPORT ORG N/A DECATUR HEALTH RESOURCES INC 450 NORTH CHANDLER STREET DECATUR GA 300300000 582081599 LONG TERM ACUTE CARE GA 501(C)(3) HOSPITAL DEKALB REGIONAL HEALTH SYSTEM INC DEKALB MEDICAL CENTER FOUNDATION INC 2701 NORTH DECATUR ROAD DECATUR GA 300330000 581924605 FUNDRAISING ON BEHALF OF DMC, INC. GA 501(C)(3) TYPE III SUPPORT ORG DEKALB REGIONAL HEALTH SYSTEM INC DRHS VENTURES INC 2701 NORTH DECATUR ROAD DECATUR GA 300330000 201864828 JOINT VENTURES GA DEKALB REGIONAL HEALTH SYSTEM INC C DEKALB PHYSICIAN HEALTH ORGANIZATION INC 250 E PONCE DE LEON AVENUE DECATUR GA 300330000 582110792 PHYSICIANS SERVICES GA N/A C 75562 283117 0.50000 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 DEKALB MEDICAL CENTER FOUNDATION INC C 1390390 DEKALB REGIONAL HEALTH SYSTEM INC J 3142340 DEKALB REGIONAL HEALTH SYSTEM INC R 7561698 DECATUR HEALTH RESOURCES INC Q 808152