2023-08-14T07:45:46-04:00 2022-09-30 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2021-10-01 586001667 STEPHENS COUNTY HOSPITAL AUTHORITY STEP 7062824200 163 HOSPITAL DRIVE TOCCOA GA 305776820 VAN LOSKOSKI CEO 7062824200 2023-08-10 true VAN LOSKOSKI 999009999 WILLIAM EDWARD PHILLIPS P00451499 2298837878 2023-08-11 2021 2023-04-26 12:10:37Z VAN LOSKOSKI 163 HOSPITAL DRIVE TOCCOA GA 305776820 40211127 false X WWW.STEPHENSCOUNTYHOSPITAL.COM X 1945 GA THE MISSION OF STEPHENS COUNTY HOSPITAL AUTHORITY IS TO PROVIDE HEALTH CARE AND RELATED SERVICES TO ENHANCE INDIVIDUAL HEALTH AND WELL BEING IN A MANNER THAT MEETS THE EXPECTATIONS OF PATIENTS AND OTHER CUSTOMERS; PRESERVE THE RIGHTS OF PATIENTS, EMPLOYEES AND OTHERS TO BE TREATED WITH DIGNITY, RESPECT AND CONCERN; PROVIDE PROFESSIONALLY AND TECHNICALLY PROFICIENT PERSONNEL IN AN EFFECTIVE AND RESOURCE EFFICIENT MANNER; AND UTLILIZE RESOURCES APPROPRIATELY TO CONTAIN COSTS AND TO PROVIDE FOR ADDITIONAL SERVICE OPPORTUNITIES. ALL PHASES OF OPERATION MUST BE CARRIED OUT IN AN ETHICAL MANNER DEDICATED TO EXCELLENCE IN HEALTHCARE FOR EVERY LIFE WE TOUCH. 7 6 610 0 11123091 3223631 38847335 36748922 26618 8198 292587 230376 50289631 40211127 0 0 22945331 20011263 0 0 25688371 27089434 48633702 47100697 1655929 -6889570 31750136 27647484 24266528 27050849 7483608 596635 X THE MISSION OF STEPHENS COUNTY HOSPITAL AUTHORITY IS TO PROVIDE HEALTH CARE AND RELATED SERVICES TO ENHANCE INDIVIDUAL HEALTH AND WELL BEING IN A MANNER THAT MEETS THE EXPECTATIONS OF PATIENTS AND OTHER CUSTOMERS; PRESERVE THE RIGHTS OF PATIENTS, EMPLOYEES AND OTHERS TO BE TREATED WITH DIGNITY, RESPECT AND CONCERN; PROVIDE PROFESSIONALLY AND TECHNICALLY PROFICIENT PERSONNEL IN AN EFFECTIVE AND RESOURCE EFFICIENT MANNER; AND UTLILIZE RESOURCES APPROPRIATELY TO CONTAIN COSTS AND TO PROVIDE FOR ADDITIONAL SERVICE OPPORTUNITIES. ALL PHASES OF OPERATION MUST BE CARRIED OUT IN AN ETHICAL MANNER DEDICATED TO EXCELLENCE IN HEALTHCARE FOR EVERY LIFE WE TOUCH. false false 41472227 36887494 STEPHENS COUNTY HOSPITAL AUTHORITY IS LICENSED TO OPERATE 96 INPATIENT BEDS AND PROVIDES OUTPATIENT SERVICES TO A SERVICE AREA THAT EXTENDS BEYOND STEPHENS COUNTY INTO THE SURROUNDING COUNTIES OF FRANKLIN, HART, HABERSHAM, RABUN AND BANKS IN GEORGIA, AND INTO NEIGHBORING OCONEE COUNTY IN SOUTH CAROLINA. STEPHENS COUNTY HOSPITAL AUTHORITY ALSO OPERATES A 92-BED PERSONAL CARE HOME. THE HOSPITAL PARTICIPATES IN SEVERAL EMPLOYER SPONSORED HEALTH FAIRS AND SUPPORTS THE LOCAL EMPLOYERS IN THE "DRUGS DON'T WORK" PROGRAM. THE HOSPITAL PROVIDES FREE DIAGNOSTIC TESTING TO THE OPEN ARMS CLINIC (A FREE CLINIC OPERATING IN STEPHENS COUNTY). THE HOSPITAL DOES NOT TURN DOWN ANYONE FOR EMERGENCY AND/OR MEDICALLY NECESSARY SERVICES BASED ON THE ABILITY TO PAY FOR SUCH SERVICES. 41472227 true true false true false false false false false false true true false false true true false true false false false false false false false false true true false false true true false false false false false false false false true false false false false false true true true true false false true 72 0 610 true false false false false false false false false false false false false X 7 6 false false false false false true false true true false false true true true true true true true true false GA X VAN LOSKOSKI 7062824250 163 HOSPITAL DRIVE TOCCOA GA 30577 X KATHRYN A MCKINNEY MD PHYSICIAN 40.00 X 684946 0 8350 CHRISTOPHER M VAUGHN MD PHYSICIAN 40.00 X 552309 0 0 JAMES R WADE MD PHYSICIAN 40.00 X 462782 0 21669 KALPESH V MISTRY MD PHYSICIAN 40.00 X 262077 0 9951 RAY LEADBETTER CFO, INTERIM X 180463 0 14130 CHARLOTTE GRIFFITH NURSE PRACTI 40.00 X 189004 0 0 VAN LOSKOSKI CEO 40.00 2.00 X 162333 0 10855 MICHAEL S HESTER CEO X 115696 0 9116 TONYA B CHITWOOD CNO 40.00 X 73039 0 0 RICHARD STOKES CFO 40.00 2.00 X 5093 0 785 PAUL DEFOOR DIRECTOR 1.00 2.00 X 0 0 0 BO DOTSON DIRECTOR 1.00 2.00 X X 0 0 0 CLAY FISHER DIRECTOR 1.00 2.00 X 0 0 0 BILL MCDOUGAL MD DIRECTOR 1.00 2.00 X 0 0 0 MAK MCALLISTER DIRECTOR 1.00 2.00 X 0 0 0 STAN ROBERTS TREASURER 1.00 2.00 X X 0 0 0 MARK WILKINSON CHAIRMAN 1.00 2.00 X X 0 0 0 2687742 74856 14 true true false HEALTHCARE WORKFORCE LOGISTICS 2655 NORTHWINDS PKWY ALPHARETTA GA 30009 STAFFING 3061615 CORE ADMINISTRATIVE SERVICES 515 MULBERY STREET SUITE 300 MACON GA 31201 BENEFITS MGM/TP 2058540 MCKESSON DRUG COMPANY 6555 STATE HWY 161 IRVING TX 75039 PHARMACY SERV. 1225164 PARAGON CONTRACTING PO BOX 634850 CINCINNATI OH 452634850 ER PHYSICIAN 1084389 PHARMD ON DEMAND 630 HAWTHORNE AVENUE ATHENS GA 30606 PHARMACY MGMT. 924203 5 2313770 909861 3223631 NET PATIENT SERVICE REVENUE 623000 36748922 36748922 36748922 8198 8198 PHARMACY -EMPLOYEES 722514 91804 91804 MISCELLANEOUS 623000 70494 70494 CAFETERIA 623000 63845 63845 4233 4233 230376 40211127 36887494 100002 X 246227 246227 124812 124812 16234755 14215709 2019046 61480 52695 8785 2218489 1918584 299905 1125500 964666 160834 38313 38313 79873 79873 14092283 12711782 1380501 1179851 940910 238941 407896 348751 59145 1352136 1156076 196060 29899 25626 4273 516669 516669 2013898 1711813 302085 1499589 1274651 224938 MEDICAL SUPPLIES 3693291 3693291 REPAIRS & MAINTENANCE 1631548 1386816 244732 PROVIDER TAX 429492 429492 TAXES & LICENSES 51842 51842 72854 72854 47100697 41472227 5628470 0 1120030 1202922 403690 131344 6697202 4480233 1381410 1369320 156600 58131 75299620 57610973 17576423 17688647 4181678 2008228 233103 708659 31750136 27647484 9431335 12552017 1886900 7775000 7165000 4923031 5231258 2137162 215674 24266528 27050849 X 5950047 -2179 1533561 598814 7483608 596635 31750136 27647484 X -6889570 2597 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 5819 5819 false SCHEDULE C, PART II-B, LINE 1 MEMBERSHIP DUES PAID TO THE GEORGIA HOSPITAL ASSOCIATION AND TO HOME TOWN HEALTH ARE ALLOCATED IN PART TO LOBBYING ACTIVITIES. 350787 350787 36534857 22533444 14001413 38410601 35077529 3333072 3375 3375 17688647 RESTRICTED AND TRUSTEE INVESTMENTS 2008228 F 2008228 ESTIMATED 3RD PARTY SETTLEMENT 215674 215674 X 40107386 40107386 103741 103741 40211127 46996956 46996956 103741 103741 47100697 SCHEDULE D, PAGE 3, PART X THE AUTHORITY IS A GOVERNMENTAL ENTITY AND HAS BEEN RECOGNIZED AS TAX- EXEMPT UNDER THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED. SCHPG AND SCEP ARE NOT-FOR-PROFIT ORGANIZATIONS THAT HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. SCHPG AND SCEP APPLY ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, SCHPG AND SCEP ONLY RECOGNIZE THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY TO BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF SEPTEMBER 30, 2022 AND 2021 OR FOR THE YEARS THEN ENDED. SCHPG AND SCEP'S TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAXING AUTHORITIES. FOR FEDERAL INCOME TAX PURPOSES THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. SCHEDULE D, PAGE 4, PART XI, LINE 4B RECLASSIFIED EXPENSES 103,741 SCHEDULE D, PAGE 4, PART XII, LINE 4B RECLASSIFIED EXPENSES 103,741 true true X true X true X true true false false 687957 433674 254283 0.00540 3912591 5763712 37192 23259 13933 0.00030 4637740 6220645 268216 0.00570 4637740 6220645 268216 0.00570 false 14332719 9316267 5787700 8980520 -3192820 X true true 1 1 STEPHENS COUNTY HOSPITAL 163 HOSPITAL DRIVE TOCCOA GA 30577 WWW.STEPHENSCOUNTYHOSPITAL.COM 127-169 X X X DISPROPORTIONATE SHARE HOSP. STEPHENS COUNTY HOSPITAL 1 false false true X X X X X X X X X X 22 true true true true X WWW.STEPHENSCOUNTYHOSPITAL.COM X true 22 true HTTPS://STEPHENSCOUNTYHOSPITAL.COM/FUL false false true X 150.000000000000 300.000000000000 X X X X X true true X X X true X HTTPS://STEPHENSCOUNTYHOSPITAL.COM/FUL X HTTPS://STEPHENSCOUNTYHOSPITAL.COM/FUL X HTTP://STEPHENSCOUNTYHOSPITAL.COM/FULL X X X X X X true X false X X X X true X false false FACILITY 1, STEPHENS COUNTY HOSPITAL - PART V, LINE 3E THE 2022 CHNA IDENTIFIED THE FOLLOWING PRIORITIZED SIGNIFICANT HEALTH NEEDS FOR THE STEPHENS COUNTY SERVICE AREA - MENTAL HEALTH - MIDDLE AND HIGH SCHOOL STUDENTS MENTAL HEALTH - YOUNG ADULTS, ESPECIALLY SINGLE PARENT HOUSEHOLDS MENTAL HEALTH FACILITIES EMERGENCY ROOM - EDUCATION FOR PROPER USE OBESITY FACILITY 1, STEPHENS COUNTY HOSPITAL - PART V, LINE 5 TO IDENTIFY THE HEALTH NEEDS OF THE COMMUNITY, THE CHNA PARTNERS ESTABLISHED A COMPREHENSIVE METHOD OF ACCOUNTING FOR ALL AVAILABLE RELEVANT DATA, INCLUDING COMMUNITY INPUT. THE BASIS OF IDENTIFICATION OF COMMUNITY HEALTH NEEDS WAS THE WEIGHT OF QUALITATIVE AND QUANTITATIVE DATA OBTAINED WHEN ASSESSING THE COMMUNITY. SURVEYORS CONDUCTED INTERVIEWS AND FOCUS GROUPS WITH INDIVIDUALS REPRESENTING PUBLIC HEALTH, COMMUNITY LEADERS/GROUPS, PUBLIC ORGANIZATIONS, AND OTHER PROVIDERS. IN SOME COMMUNITIES, SUPPLEMENTARY QUALITATIVE DATA WAS INCLUDED. IN ADDITION, QUANTITATIVE DATA COLLECTED FROM SEVERAL PUBLIC SOURCES WAS BENCHMARKED AGAINST A STATE VALUE TO INDICATE THE LEVEL OF NEED. PUBLIC HEALTH INDICATORS WERE USED TO ASSESS COMMUNITY HEALTH NEEDS FROM A QUANTITATIVE DATA PERSPECTIVE. THIS INCLUDED COLLECTION OF 129 DATA ELEMENTS GROUPED INTO 11 CATEGORIES AND EVALUATED FOR THE COUNTIES WHERE DATA WAS AVAILABLE. A BENCHMARK ANALYSIS WAS CONDUCTED TO DETERMINE THE PUBLIC HEALTH INDICATORS THAT DEMONSTRATED A COMMUNITY HEALTH NEED FROM A QUANTITATIVE PERSPECTIVE. BENCHMARK HEALTH INDICATORS INCLUDED (WHEN AVAILABLE): OVERALL U.S. VALUES AND STATE OF GEORGIA VALUES. ONCE THE COMMUNITY BENCHMARK WAS SET TO THE STATE VALUE, IT WAS DETERMINED WHICH INDICATORS FOR THE COMMUNITY DID NOT MEET THE STATE BENCHMARKS. THIS CREATED A SUBSET OF INDICATORS FOR FURTHER ANALYSIS. A NEED DIFFERENTIAL ANALYSIS WAS CONDUCTED TO UNDERSTAND THE RELATIVE SEVERITY OF NEED FOR THESE INDICATORS. THE NEED DIFFERENTIAL ESTABLISHED A STANDARDIZED WAY TO EVALUATE THE DEGREE EACH INDICATOR DIFFERED FROM ITS BENCHMARK. HEALTH COMMUNITY INDICATORS WITH NEED DIFFERENTIALS ABOVE THE 50TH PERCENTILE WERE ORDERED BY SEVERITY; THE HIGHEST RANKED INDICATORS WERE THE TOP HEALTH NEEDS FROM A QUANTITATIVE PERSPECTIVE. THE OUTCOMES OF THE QUANTITATIVE DATA ANALYSIS WERE COMPARED TO THE QUALITATIVE DATA FINDINGS. IN ADDITION TO ANALYZING QUANTITATIVE DATA, THE FACILITATOR COLLECTED QUALITATIVE DATA VIA A VARIETY OF SOURCES TO GATHER THE INPUT OF PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITIES SERVED THROUGHOUT THE REGION. INPUT FROM OVER 500 PEOPLE WAS INCLUDED IN THE ASSESSMENT VIA SEVERAL DIFFERENT APPROACHES. FOR THE COMMUNITY SERVED BY STEPHENS COUNTY HOSPITAL, ONE (1) FOCUS GROUP SESSION WITH NINE (9) PARTICIPANTS AND FOUR (4) INTERVIEWS WERE CONDUCTED MARCH THROUGH APRIL 2019. A LIST OF THE ORGANIZATIONS PROVIDING INPUT CAN BE FOUND IN APPENDIX B OF THE CHNA. SUMMARY FINDINGS FROM THE FOCUS GROUPS AND INTERVIEWS CAN BE FOUND IN APPENDIX C OF THE DOCUMENT. THE CHNA PROCESS WAS FACILITATED BY IBM WATSON HEALTH. FACILITY 1, STEPHENS COUNTY HOSPITAL - PART V, LINE 6A THE JOINT CHNA WAS CONDUCTED BY THESE JOINT CHNA PARTNERS: HABERSHAM MEDICAL CENTER NORTHEAST GEORGIA MEDICAL CENTER GAINESVILLE/BRASELTON NORTHEAST GEORGIA MEDICAL CENTER BARROW NORTHEAST GEORGIA MEDICAL CENTER LUMPKIN GOOD NEWS CLINICS FACILITY 1, STEPHENS COUNTY HOSPITAL - PART V, LINE 6B GEORGIA DEPARTMENT OF PUBLIC HEALTH - DISTRICT 2 PUBLIC HEALTH FACILITY 1, STEPHENS COUNTY HOSPITAL - PART V, LINE 11 STEPHENS COUNTY HOSPITAL HAS ADDRESSED EACH OF THE SIGNFICANT HEALTH NEEDS AS PRIORITIZED IN THE CHNA BY ITS WORK GROUP AND DEVELOPED IMPLEMENTATION STRATEGIES TO ADDRESS EACH OF THE HEALTH ISSUES IDENTIFIED OVER THE NEXT THREE YEARS. 2 THE CLARY CARE CENTER 249 HOSPITAL DRIVE TOCCOA GA 30577 ADVANCED PERSONAL CARE THE WILKINSON CENTER 269 HOSPITAL DRIVE TOCCOA GA 30577 PERSONAL CARE SCHEDULE H, PART I, LINE 7 THE ORGANIZATION USES A COST-TO-CHARGE RATIO AS CALCULATED USING FORM 990, SCHEDULE H, WORKSHEET 2 TO CALCULATE THE DISCLOSURES IN SCHEDULE H, PART I, LINE 7 A - C. SCHEDULE H, PART III, LINE 2 THE AUTHORITY PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON THE EVALUATION OF OVERALL COLLECTABILITY OF THE ACCOUNTS RECEIVABLE. AS ACCOUNTS ARE KNOW TO BE UNCOLLECTIBLE, THEY ARE CHARGED AGAINST THE ALLOWANCE. SCHEDULE H, PART III, LINE 3 THE BAD DEBT EXPENSE ATTRIBUTABLE TO CARE THAT WOULD QUALIFY FOR FINANCIAL ASSISTANCE (65%) IS BASED ON MANAGEMENT'S EVALUATION OF THE MEDIAN INCOME AND POVERTY LEVELS IN THE SERVICE AREA. SCHEDULE H, PART III, LINE 4 FOOTNOTES 2 AND 3 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS ADDRESS UNCOMPENSATED CARE INCLUDING UNINSURED PATIENTS AND THE PROVISION FOR BAD DEBTS. PLEASE SEE PAGES 21 - 24. SCHEDULE H, PART III, LINE 8 MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. THE FULL AMOUNT OF THE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT. MEDICARE IS A FEDERAL PROGRAM WHICH DICTATES PAYMENT RATES AND CONDITIONS OF PARTICIPATION FOR SERVING CERTAIN ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. SERVING THE NEEDS OF OUR CITIZENS AT BELOW MEDICARE'S COMPUTATION OF COST PROVIDES NECESSARY LOCAL CARE FOR A SEGMENT OF THE POPULATION THAT CONSTITUTES A CHARITABLE CLASS. SCHEDULE H, PART III, LINE 9B PATIENTS KNOWN TO HAVE QUALIFIED FOR FINANCIAL ASSISTANCE ARE CONTACTED TO ASCERTAIN THEIR ABILITY TO PAY ANY BALANCE DUE AFTER THE FAP DISCOUNT AND/OR THEIR PLACEMENT ON THE INDIGENT/CHARITY CARE POLICY GUIDELINES OR TO CONFIRM WHETHER OR NOT THERE HAS BEEN A CHANGE IN THEIR FINANCIAL SITUATION. IF PREVIOUS QUALIFICATION OCCURRED WITHIN THE PRIOR 3 MONTHS OR THERE IS A HISTORIC LONG-TERM QUALIFICATION PATTERN, A PATIENT MAY BE PRESUMED INDIGENT OR IN NEED OF CHARITY. SCHEDULE H, PART VI, LINE 2 IN ADDITION TO CONDUCTING A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT, THE HOSPITAL RECEIVES INPUT AND ADVICE FROM MEMBERS OF THE MEDICAL STAFF, NURSING STAFF AND COMMUNITY MEMBERS THROUGHOUT THE YEAR. SCHEDULE H, PART VI, LINE 3 ALL PATIENTS AND VISITORS RECEIVE NOTIFICATION AT REGISTRATION THAT THERE ARE ASSISTANCE PROGRAMS AVAILABLE AND THAT THE HOSPITAL STAFF WILL ASSIST THEM IN EXPLORING ELIGIBILITY. ALL UNINSURED PATIENTS ARE CHECKED AGAINST THE MEDICAID DATABASE FOR ELIGIBILITY AND ENCOURAGED TO COMPLETE THE PROCESS IF ELIGIBILITY IS INDICATED. PATIENTS ARE OFFERED A COPY OF THE PLAIN LANGUAGE SUMMARY OF THE FAP UPON ADMISSION AND SIGNAGE THROUGHOUT THE FACILITY ALERTS PATIENTS OF THE AVAILABILITY OF THE FINANCIAL ASSISTANCE POLICY UPON REQUEST. THE FAP, PLAIN LANGUAGE SUMMARY AND FINANCIAL ASSISTANCE APPLICATION ARE AVAILABLE ON THE ORGANIZATION'S WEBSITE. SCHEDULE H, PART VI, LINE 4 STEPHENS COUNTY HOSPITAL AUTHORITY IS LOCATED IN TOCCOA, GEORGIA AND SERVES BOTH STEPHENS AND FRANKLIN COUNTIES. THE AREA IS GROWING SLOWLY WITH A PROJECT GROWTH RATE OF LESS THAN HALF THE RATE OF THE STATE OF GEORGIA. THE MEDIAN AGE OF THE AREA IS MUCH OLDER THAN THE STATE AVERAGE; MEDIAN HOUSEHOLD INCOME IS SIGNFICANTLY LOWER THAN STATE AND NATIONAL BENCHMARKS; AND THE ESTIMATED UNINSURED RATE IS GREATER THAN STATE AND FEDERAL LEVELS. THE 2018 MEDIAN INCOME WITHIN THE ZIP CODES IN THE HOSPITAL'S SEVICE AREA RANGE FROM 34,369 TO 45,362 (THE MEDIAN FOR GEORGIA WAS 55,559 WITH THE NATIONAL MEDIAN WAS 62,175). APPROXIMATELY 21% OF THE COMMUNITY HAS NO HEALTH INSURANCE AND 14% OF THE COMMUNITY IS ON MEDICAID. THE COMMUNITY INCLUDES 5 HEALTH PROFESSIONAL SHORTAGE AREAS AND 1 MEDICALLY UNDERSERVED AREA. SCHEDULE H, PART VI, LINE 5 STEPHENS COUNTY HOSPITAL AUTHORITY APPLIES ANY EXCESS REVENUES OVER EXPENSES TO THE PROVISION OF PATIENT CARE, PATIENT AND COMMUNITY HEALTH EDUCATION, RETIREMENT OF DEBT RELATED TO THE PURCHASE OF FIXED ASSETS UTILIZED IN THE PROVISION OF PATIENT CARE AND THE PURCHASE OF EQUIPMENT FOR THE PROVISION OF HEALTHCARE OR EXPANSION OF HEALTHCARE SERVICES TO THE COMMUNITY. THE STEPHENS COUNTY HOSPITAL AUTHORITY'S GOVERNING BOARD INCLUDES INDIVIDUALS RESIDING IN THE HOSPITAL'S PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION NOR FAMILY MEMBERS THEREOF. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. THE HOSPITAL'S EMERGENCY ROOM IS OPEN 24 HOURS A DAY, 365 DAYS PER YEAR TO EVERYONE WITHOUT REGARD TO THEIR ABILITY TO PAY. THE HOSPITAL PARTICIPATES IN THE MEDICARE, MEDICAID AND OTHER GOVERNMENT PROGRAMS. THE HOSPITAL PROVIDES EMERGENCY AND OTHER MEDICALLY NECESSARY CARE TO THE COMMUNITY ON A NONDISCRIMINATORY BASIS WITHOUT REGARD TO AN INDIVIDUAL'S ABILITY TO PAY FOR SUCH CARE. SCHEDULE H, PART VI, LINE 6 STEPHENS COUNTY HOSPITAL FOUNDATION, INC. IS A FUNDRAISING AFFILATE THAT SUPPORTS THE HOSPITAL. STEPHENS COUNTY EMERGENCY PHYSICIANS, INC. IS A DORMANT TAX-EXEMPT ENTITY. PRIOR TO CEASING OPERATIONS, IT PROVIDED EMERGENCY ROOM PHYSICIANS TO THE HOSPITAL (THE HOSPITAL NOW CONTRACTS DIRECTLY WITH A THIRD PARTY PROVIDER FOR THESE SERVICES). SCHEDULE H, PART VI, LINE 7 GEORGIA SCHEDULE H, PART VI THE COMPLETE URL FOR THE FAP, FAP PLAIN LANGUAGE SUMMARY, THE FINANCIAL ASSISTANCE APPLICATION, THE CHNA AND THE IMPLEMENTATION STRATEGY REPORTS ARE AS FOLLOWS _ FAP - HTTPS://STEPHENSCOUNTYHOSPITAL.COM/FULLPANEL/UPLOADS/FILES/SCH- FINANCIAL-ASSISTANCE-POLICY-PATIENT.PDF. PLS - HTTP://STEPHENSCOUNTYHOSPITAL.COM/FULLPANEL/UPLOADS/FILES/FINANCIAL- ASSISTANCE-PROGRAM---PLAIN-LANGUAGE-00003.PDF. APPLICATION - HTTPS://STEPHENSCOUNTYHOSPITAL.COM/FULLPANEL/UPLOADS/FILES/4 -ITF-APPLICATION.PDF. CHNA - HTTPS://STEPHENSCOUNTYHOSPITAL.COM/FULLPANEL/UPLOADS/FILES/NEGA- CHNA-FOR-EXTERNAL-USE.PDF. IMPLEMENTATION STRATEGY REPORT - HTTPS://STEPHENSCOUNTYHOSPITAL.COM/FULLPANEL/UPLOADS/FILES/2019-SCH- IMPLEMENTATION-STRATEGY.PDF. false false false false false false false false false KATHRYN A MCKINNEY MD PHYSICIAN 684946 8350 693296 CHRISTOPHER M VAUGHN MD PHYSICIAN 549232 3077 552309 JAMES R WADE MD PHYSICIAN 437796 24986 21669 484451 KALPESH V MISTRY MD PHYSICIAN 262077 9951 272028 RAY LEADBETTER CFO, INTERIM CEO 180463 14130 194593 CHARLOTTE GRIFFITH NURSE PRACTITIONER 189004 189004 VAN LOSKOSKI CEO 162333 10855 173188 MICHAEL S HESTER CEO 115696 9116 124812 A STEPHENS COUNTY HOSPITAL AUTHORITY 586001667 NONENONEN 2017-06-07 9500000 CURRENT REFUNDING, IMPROVEMENTS, EQUIPMENT false false false A 2335000 9500000 180500 3340371 4445568 1533561 2017 true false false true A false false false false false false true A false false false false false false false false true A false PURPOSE OF ISSUE DESCRIPTION STEPHENS COUNTY HOSPITAL AUTHORITY CURRENT REFUNDING, IMPROVEMENTS, EQUIPMENT MICHELLE CHITWOOD FAMILY 116912 COMPENSATION false KAREN WRIGHT FAMILY 65513 COMPENSATION false SCHEDULE L, PART V MICHELLE CHITWOOD IS EMPLOYED AS THE DIRECTOR OF RADIOLOGY FOR STEPHENS COUNTY HOSPITAL AUTHORITY. SHE IS THE SISTER IN-LAW OF TONYA CHITWOOD WHO SERVES AS THE CHIEF NURSING OFFICER OF THE HOSPITAL AUTHORITY. KAREN WRIGHT IS EMPLOYED BY THE HOSPITAL. SHE IS THE SISTER IN-LAW OF BOARD MEMBER MARK WILIKINSON. FORM 990 - ORGANIZATION'S MISSION THE MISSION OF STEPHENS COUNTY HOSPITAL AUTHORITY IS TO PROVIDE HEALTH CARE AND RELATED SERVICES TO ENHANCE INDIVIDUAL HEALTH AND WELL BEING IN A MANNER THAT MEETS THE EXPECTATIONS OF PATIENTS AND OTHER CUSTOMERS; PRESERVE THE RIGHTS OF PATIENTS, EMPLOYEES AND OTHERS TO BE TREATED WITH DIGNITY, RESPECT AND CONCERN; PROVIDE PROFESSIONALLY AND TECHNICALLY PROFICIENT PERSONNEL IN AN EFFECTIVE AND RESOURCE EFFICIENT MANNER; AND UTLILIZE RESOURCES APPROPRIATELY TO CONTAIN COSTS AND TO PROVIDE FOR ADDITIONAL SERVICE OPPORTUNITIES. ALL PHASES OF OPERATION MUST BE CARRIED OUT IN AN ETHICAL MANNER DEDICATED TO EXCELLENCE IN HEALTHCARE FOR EVERY LIFE WE TOUCH. FORM 990, PAGE 6, PART VI, LINE 7A MEMBERS OF THE BOARD OF TRUSTEES ARE NOT COMPENSATED. THEY ARE ELECTED TO A SIX YEAR TERM. ANY OPENING OR VACANCY IS FILLED BY THE REMAINING MEMBERS OF THE BOARD SELECTED FROM A SLATE OF THREE NOMINEES MADE BY THE COUNTY COMMISSION. FORM 990, PAGE 6, PART VI, LINE 11B THE RETURN IS PREPARED BY AN INDEPENDENT CPA , REVIEWED BY MANAGEMENT AND PROVIDED TO EACH MEMBER OF THE BOARD FOR REVIEW PRIOR TO FILING. FORM 990, PAGE 6, PART VI, LINE 12C THE ORGANIZATION CONDUCTS PERIODIC REVIEWS OF EXISTING BUSINESS RELATIONSHIPS AND INITIAL REVIEWS OF ANY NEW BUSINESS RELATIONSHIPS. DECISIONS RELATED TO POTENTIAL CONFLICTS ARE MADE BY THE REMAINING NONCONFLICTED BOARD MEMBERS. VIOLATION OF THE COI POLICY IS SUBJECT TO CORRECTIVE ACTION. FORM 990, PAGE 6, PART VI, LINE 15A THE AUTHORITY SETS AND REVIEWS THE COMPENSATION PACKAGE OF THE CEO USING COMPARABLE DATA PROVIDED BY THE GEORGIA HOSPITAL ASSOCIATION ON CEO COMPENSATION AT SIMILAR SIZED HOSPITALS LOCATED IN GEORGIA. CONSIDERATION IS GIVEN TO THE LEVEL OF EXPERIENCE AND OVERALL PERFORMANCE OF THE HOSPITAL. THE SAME PROCESS IS USED THROUGHOUT THE ORGANIZATION IN SETTING AND REVIEWING PAY SCALES FOR ALL JOBS, INCLUDING OTHER OFFICERS AND KEY EMPLOYEES. FORM 990, PAGE 6, PART VI, LINE 15B SEE RESPONSE TO 15A ABOVE. FORM 990, PAGE 6, PART VI, LINE 19 THE STEPHENS COUNTY HOSPITAL AUTHORITY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII STEPHEN PINKERTON, MD IS A MEMBER OF THE BOARD OF DIRECTORS. HE IS COMPENSATED FOR PROFESSIONAL SERVICES PROVIDED AS A PHYSICIAN, NOT AS A MEMBER OF THE BOARD. FORM 990, PART IX, LINE 11G HOUSEKEEPING 604,257 0 0 SECURITY 0 155,905 0 DIETARY 313,428 0 0 MEDICAL & PROFESSIONAL 8,859,072 0 0 CONTRACT LABOR & PURCH. SERV. 2,935,025 203,577 0 CONSULTING 0 1,021,019 0 TOTAL 12,711,782 1,380,501 0 FORM 990, PART XI, LINE 9 RECLASSIFIED EXPENSES -103,741 RECLASSIFIED EXPENSES 103,741 GASB NO. 87 IMPLEMENTATION STEPHENS COUNTY HOSPITAL PHYSICAN GROUP LLC 163 HOSPITAL DRIVE TOCCOA GA 30577 PHYSICIANS GA SCHA STEPHENS COUNTY HOSPITAL AUTHORITY STEPHENS COUNTY EMERGENCY PHYSICIAN 163 HOSPITAL DRIVE TOCCOA GA 305776820 020692996 DORMANT GA 501C3 3 SCHA STEPHENS COUNTY HOSPITAL AUTHORITY true STEPHENS COUNTY HOSPITAL FOUNDATION 163 HOSPITAL DRIVE TOCCOA GA 305776820 208089919 FUNDRAISIN GA 501C3 12A SCHA STEPHENS COUNTY HOSPITAL AUTHORITY true false false true false false false false false false false false false true true true false false false false STEPHENS COUNTY HOSPITAL FOUNDATION C 9185 CASH VALUE STEPHENS COUNTY HOSPITAL FOUNDATION M NO VALUE ESTIMATED STEPHENS COUNTY HOSPITAL FOUNDATION N NO VALUE ESTIMATED STEPHENS COUNTY HOSPITAL FOUNDATION O NO VALUE ESTIMATED