2023-11-14T10:59:15-06:00 2022-12-31 990 2022-01-01 453765471 THE MEDICAL CENTER OF PEACH COUNTY INC MEDI 4786336968 777 HEMLOCK STREET MSC 111 MACON GA 31201 KIMBERLY SHREWSBURY TREASURER 4786336968 2023-11-14 KIMBERLY SHREWSBURY 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z SEE SCHEDULE O THE MEDICAL CENTER OF PEACH COUNTY NAVICENT HEALTH LAURA GENTRY 777 HEMLOCK STREET MSC 111 MACON GA 31201 29419010 0 X WWW.NAVICENTHEALTH.ORG X 2011 GA TO PROVIDE ACCESS TO INPATIENT, OUTPATIENT, PHYSICIAN CARE, EMERGENCY AND OTHER HEALTH CARE RELATED SERVICES TO PEACH COUNTY AND THE SURROUNDING COUNTIES, WHICH ARE PRIMARILY RURAL. 6 6 249 3 0 0 756009 498289 19496316 28855288 2587 666 16545 47967 20271457 29402210 0 0 0 0 10684544 10348042 0 0 0 9968411 18559217 20652955 28907259 -381498 494951 21159955 20690896 28801783 27837773 -7641828 -7146877 THE MEDICAL CENTER OF PEACH COUNTY (MCPC) PARTNERS WITH NAVICENT HEALTH, INC. TO OPERATE A 25-BED RURAL, CRITICAL ACCESS HOSPITAL AND PROVIDE EMERGENCY, SURGICAL, INPATIENT AND OUTPATIENT CARE FOR RESIDENTS OF PEACH AND SURROUNDING COUNTIES. 0 0 27099784 28858327 MCPC IS A NON-PROFIT CRITICAL ACCESS HOSPITAL AFFILIATED WITH NAVICENT HEALTH, INC. MCPC PROVIDES EXPANDED SERVICES WITH INNOVATIVE TECHNOLOGY TO THE LOCAL COMMUNITY FURTHERING ITS MISSION TO IMPROVE RURAL HEATH CARE ACCESS. MCPC IS LICENSED FOR 25 BEDS. FOR THE YEAR ENDED DECEMBER 31, 2022, MCPC HAD 6,621 PATIENT DAYS AND 23,552 EMERGENCY ROOM VISITS. 27099784 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 249 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 GA X KIMBERLY SHREWSBURY 4786331452 777 HEMLOCK STREET MACON GA 31201 JIM MCLENDON VICE CHAIR (TO 12/31/22) 1.00 0.00 X X 0 0 0 THOMAS M GREEN CHAIR 1.00 0.00 X X 0 0 0 AL WALDREP BOARD MEMBER 1.00 0.00 X 0 0 0 CRYSTAL BROWN MD BOARD MEMBER (TO 12/31/22) 1.00 0.00 X 0 0 0 ISAAC CRUMBLY BOARD MEMBER 1.00 0.00 X 0 0 0 PAUL JONES BOARD MEMBER 1.00 0.00 X 0 0 0 ROBERT C WILDE TREASURER (TO 9/30/22) 1.00 39.00 X 0 1026382 32316 KENNETH B BANKS SECRETARY 1.00 39.00 X 0 724222 68421 LAURA T GENTRY PRESIDENT/CEO 40.00 0.00 X 0 264208 34614 KIMBERLY SHREWSBURY TREASURER (FR 11/17/22) 1.00 39.00 X 0 100605 197 ALBERT JONES JR CERT RESP THERAPIST 40.00 0.00 X 0 129356 16613 JILL HANCOCK CH NURSE OFF 40.00 0.00 X 0 165122 39847 KRISTY ARD NURSE MANAGER 40.00 0.00 X 0 117747 24093 DIANA WILSON-HIRST MEDICAL TECHNOLOGIST 40.00 0.00 X 0 122719 13901 SUSAN PAYNE CLINICAL OPS DIRECTOR 40.00 0.00 X 0 111084 28511 0 2761445 258513 8 0 1 0 ACCOUNTABLE HEALTHCARE STAFFING PO BOX 732800 DALLAS TX 75373 HEALTHCARE SERVICES 1560796 MORRISON MANAGEMENT SPECIALISTS INC PO BOX 102289 ATLANTA GA 30368 FOOD SERVICES 683188 PHARMD ON DEMAND 630 HAWTHORNE AVE ATHENS GA 30606 CONTRACT SERVICES 532471 JACKSON & COKER LOCUMTENENS LLC PO BOX 277638 ATLANTA GA 30384 CONTRACT LABOR 300436 HOUSTON PRIMARY CARE INC 1719 RUSSELL PKWY SUITE 700 WARNER ROBINS GA 31008 CONTRACT SERVICES 280865 12 117383 380906 498289 PATIENT REVENUE 621990 28855288 28855288 28855288 666 666 61728 16800 44928 44928 44928 OTHER REVENUE 900099 3039 3039 3039 29402210 28858327 0 45594 X 821544 776065 45479 7393891 6984583 409308 204048 192655 11393 1350068 1274687 75381 578491 546191 32300 34638 30965 3673 738 738 6937997 6331285 606712 50282 44951 5331 1463105 1307980 155125 22041 19704 2337 19297 17251 2046 687069 472095 214974 946413 705427 240986 4130 3692 438 BAD DEBT 6765916 6765916 MEDICAL SUPPLIES 1608805 1608805 REPAIRS & MAINTENANCE 18786 16794 1992 28907259 27099784 1807475 0 596869 25509 4535977 4891708 198744 235602 46668 46668 28653447 13162038 15745474 15491409 36223 21159955 20690896 735183 706324 28066600 27131449 28801783 27837773 X -7641828 -7146877 -7641828 -7146877 21159955 20690896 494951 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 738 738 0 PART II-B, LINE 1: THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THE MEMBERSHIP DUES PAID ARE ALLOCATED TO LOBBYING EFFORTS BY THE ORGANIZATION ON BEHALF OF THEIR MEMBERSHIP BODY. 930354 930354 20084311 6456150 13628161 7338217 6705888 632329 300565 300565 15491409 INTERCOMPANY PAYABLE 25521244 MEDICARE ADVANCED FUNDING 1231213 RESERVES 378992 27131449 X PART X, LINE 2: THE ORGANIZATION HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS CALENDAR YEARS ENDED DECEMBER 31, 2022 AND DECEMBER 31, 2021, INCLUDING A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF ITS JOINT VENTURES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS FOR THE CALENDAR YEARS ENDED DECEMBER 31, 2022 AND DECEMBER 31, 2021. 1 1 1 X 1 X 1 1 0 1 1 1269663 1633564 0 0.00000 3469190 2596927 872263 0.03940 4738853 4230491 872263 0.03940 4738853 4230491 872263 0.03940 1 1837229 9482794 8676882 805912 X 1 1 1 1 MEDICAL CENTER OF PEACH COUNTY INC 1960 HIGHWAY 247 CONNECTOR BYRON GA 31008 WWW.NAVICENTHEALTH.ORG 111-687 X X X MEDICAL CENTER OF PEACH COUNTY INC 1 0 0 1 X X X X X X X X X 20 1 0 0 1 X HTTPS://NAVICENTHEALTH.ORG/OUR-ANNUAL-REPORTS X 1 21 1 HTTPS://NAVICENTHEALTH.ORG/OUR-ANNUAL-REPORTS 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X 1 X HTTPS://ATRIUMHEALTH.ORG/FOR-PATIENTS-VISITORS/FINANCIAL-ASSISTANCE#HELPFUL X HTTPS://ATRIUMHEALTH.ORG/FOR-PATIENTS-VISITORS/FINANCIAL-ASSISTANCE#HELPFUL X HTTPS://ATRIUMHEALTH.ORG/FOR-PATIENTS-VISITORS/FINANCIAL-ASSISTANCE#HELPFUL X X X X X X 1 X 0 X X X X 1 X 0 0 MEDICAL CENTER OF PEACH COUNTY, INC. PART V, SECTION B, LINE 5: DURING THE CONDUCTION OF ITS MOST RECENT CHNA, THE HOSPITAL FACILITY SOUGHT COMMUNITY INPUT THROUGH THE PROFESSIONAL RESEARCH CONSULTANTS (PRC) COMMUNITY HEALTH SURVEY AND PRC ONLINE KEY INFORMANT SURVEY. THE SURVEY INSTRUMENTS USED ARE BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS); AS WELL AS, VARIOUS OTHER PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES. THE FINAL SURVEY INSTRUMENT WAS DEVELOPED BY THE ORGANIZATION AND PRC AND IS SIMILAR TO THE PREVIOUS SURVEYS USED IN THE REGION, ALLOWING FOR DATA TRENDING. THE STUDY AREA FOR THE SURVEY EFFORT IS DEFINED AS EACH OF THE RESIDENTIAL ZIP CODES IN THE PRIMARY AND SECONDARY SERVICE AREAS. A PRECISE AND CAREFUL EXECUTED METHODOLOGY IS CRITICAL IN ASSERTING THE VALIDITY OF THE RESULTS GATHERED IN THE PRC COMMUNITY HEALTH SURVEY. THUS, TO ENSURE THE BEST REPRESENTATION OF THE POPULATION SURVEYED A MIXED-MODE METHODOLOGY WAS IMPLEMENTED. THIS INCLUDED SURVEYS CONDUCTED VIA TELEPHONE AND ONLINE QUESTIONNAIRES. RESULTS WERE WEIGHTED IN PROPORTION TO THE ACTUAL POPULATION DISTRIBUTION SO AS TO APPROPRIATELY REPRESENT THE TOTAL AREA AS A WHOLE. ADDITIONALLY, THE HOSPITAL FACILITY USED SECONDARY DATA SOURCES INCLUDING NATIONAL AND STATE SOURCES PROVIDING TARGET VIEWS OF THE PROGRAM SERVICE AREA; AS WELL AS, HOSPITAL-SPECIFIC DATA. MEDICAL CENTER OF PEACH COUNTY, INC. PART V, SECTION B, LINE 11: THE HOSPITAL FACILITY'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") IDENTIFIED NUMEROUS COMMUNITY HEALTH NEEDS AND CONCERNS. EACH IDENTIFIED HEALTH NEED WAS REVIEWED AND PRIORITIZED BASED ON THE ALIGNMENT WITH THE HOSPITAL'S MISSION, GOALS, AND STRATEGIC PRIORITIES. THE HOSPITAL FACILITY IMPLEMENTATION STRATEGY OUTLINES THE PROGRAMS AND RESOURCES THE HOSPITAL FACILITY WILL USE TO ADDRESS THE PRIORITIZED HEALTH NEEDS. THE HOSPITAL FACILITY ACKNOWLEDGES THE IMPORTANCE OF ALL COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA; HOWEVER, THE HOSPITAL FACILITY'S RESOURCES AND ASSETS WERE BEST ALIGNED TO FOCUS ON THE PRIORITIZED NEEDS. ALTHOUGH NOT PRIORITIZED, THE HOSPITAL FACILITY WILL CONTINUE TO PARTNER WITH COMMUNITY AND NON-PROFIT ORGANIZATIONS TO HELP ADDRESS THESE NEEDS. 1 1 - VALLEY MEDICAL CENTER 701 BLUEBIRD BLVD FT VALLEY GA 31030 RURAL HEALTH CLINIC PART I, LINE 3C: THE FINANCIAL ASSISTANCE PROGRAMS ARE DESIGNED TO ENSURE ASSISTANCE IS PROVIDED TO PATIENTS DEMONSTRATING A FINANCIAL NEED AND TO ENSURE THE ORGANIZATION COMPLIES WITH ANY REQUIRED FEDERAL OR STATE REGULATIONS RELATED TO FINANCIAL ASSISTANCE. THOSE ELIGIBLE FOR FINANCIAL ASSISTANCE WILL NEVER BE BILLED MORE THAN THE AMOUNTS GENERALLY BILLED (AGB) TO AN INSURED PATIENT. THE ORGANIZATION USES THE LOOK-BACK METHOD TO CALCULATE AGB. PART I, LINE 7: THE ORGANIZATION USED THE WORKSHEETS PROVIDED IN THE INSTRUCTIONS TO FORM 990, SCHEDULE H TO COMPUTE ITS COST TO CHARGE RATIO. PART I, LN 7 COL(F): THE ORGANIZATION'S PATIENT BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS WAS $6,765,916 FOR THE YEAR ENDED DECEMBER 31, 2022. THIS AMOUNT IS NOT INCLUDED IN THE CALCULATION OF CHARITY CARE FOR PART I, LINE 7. PART III, LINE 2: THE ORGANIZATION USED WORKSHEET 2 OF THE FORM 990, SCHEDULE H INSTRUCTIONS TO COMPUTE A COST TO CHARGE RATIO, WHICH IS USED TO CALCULATE BAD DEBT AT COST. BAD DEBT HAS NOT BEEN INCLUDED IN THE COMPUTATION OF COMMUNITY BENEFIT ON PART I, LINE 7. PART III, LINE 4: FOOTNOTE 2.J (PATIENT SERVICE REVENUE) ON PAGE 30 OF THE AUDITED FINANCIAL STATEMENTS DESCRIBES THE TREATMENT OF BAD DEBT. PART III, LINE 8: THE COSTING METHODOLOGY USES THE COSTS INCLUDED IN THE COST REPORT, WHICH ARE CALCULATED USING A DEPARTMENTAL SPECIFIC COST TO CHARGE RATIO AS COMPARED TO ACTUAL MEDICARE PAYMENTS. THE MEDICARE COST REPORT DOES NOT FULLY CAPTURE ALL MEDICARE REVENUE AND COSTS, INCLUDING BUT NOT LIMITED TO PHYSICIAN SERVICES AND MEDICARE PART C. PART III, LINE 9B: THE HOSPITAL MAKES A REASONABLE EFFORT TO DETERMINE AN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE ENGAGING IN ANY COLLECTION ACTIONS. ALL COLLECTION ACTIONS WILL BE SUSPENDED IF THE INDIVIDUAL SUBMITS A COMPLETED FAP APPLICATION DURING THE APPLICATION PERIOD, OR IF THE INDIVIDUAL SUBMITS AN INCOMPLETE APPLICATION DURING THE APPLICATION PERIOD THAT IS SUBSEQUENTLY COMPLETED WITHIN A REASONABLE TIME AFTER THE HOSPITAL REQUESTS FURTHER INFORMATION. IF THE INDIVIDUAL IS DETERMINED NOT TO BE ELIGIBLE FOR A FULL DISCOUNT UNDER THE FAP, ANY COLLECTION ACTIVITIES WILL BE RESUMED AS TO THE OUTSTANDING BALANCE OWED. IF THE INDIVIDUAL IS DETERMINED TO BE ELIGIBLE FOR ASSISTANCE UNDER THE FAP, APPROPRIATE MEASURES ARE TAKEN TO REFUND ANY AMOUNTS OWED TO THE INDIVIDUAL AND REVERSE OR MODIFY COLLECTION ACTIONS CONSISTENT WITH THE NEW BALANCE OWED AFTER APPLYING THE APPLICABLE FAP DISCOUNTS. PART VI, LINE 2: THE HOSPITAL FACILITY'S MOST RECENT CHNA WAS BASED ON A SET OF BEST PRACTICES FOR COMMUNITY HEALTH ASSESSMENTS WITH THE PURPOSE OF IDENTIFYING REGIONAL PRIORITY AREAS TO FOCUS ON FOR CY2021 TO CY2023. THE PROCESS WAS DESIGNED TO RELY ON EXISTING PUBLIC DATA, DIRECTLY ENGAGING COMMUNITY STAKEHOLDERS, AND COLLABORATE WITH LOCAL PUBLIC HEALTH AND OTHER HEALTH CARE PROVIDERS. COMMUNITY FEEDBACK WAS RECEIVED IN THE FORM OF A COMMUNITY HEALTH SURVEY CONDUCTED BY PROFESSIONAL RESEARCH CONSULTANTS ON BEHALF OF THE ORGANIZATION. THE HOSPITAL FACILITY DEVELOPED AN IMPLEMENTATION STRATEGY TO IDENTIFY THE MEANS THROUGH WHICH IT PLANS TO ADDRESS THOSE PRIORITIZED. BEYOND PROGRAMS ADDRESSED IN THE IMPLEMENTATION STRATEGY, THE HOSPITAL FACILITY WILL CONTINUE TO ADDRESS MANY OF THE PRIORITIES BY PROVIDING CARE TO ALL, REGARDLESS OF ABILITY TO PAY. PART VI, LINE 3: THE ORGANIZATION USES A VARIETY OF MEANS TO EDUCATE AND INFORM PATIENTS OF THEIR FINANCIAL ASSISTANCE OPTIONS. INFORMATION REGARDING FINANCIAL ASSISTANCE CAN BE FOUND ON THE HOSPITAL FACILITY'S WEBSITE, CONSPICUOUSLY DISPLAYED SIGNAGE THROUGHOUT THE HOSPITAL FACILITY, PATIENT BILLING STATEMENTS, AND FROM TEAMMATES DURING CONVERSATIONS CONCERNING A PATIENT'S LIABILITY FOR SERVICES DURING PREADMISSION, DISCHARGE, AND THE "COLLECTION" PERIOD. PART VI, LINE 4: THE FILING ORGANIZATION'S PRIMARY SERVICE AREA IS PEACH COUNTY, GEORGIA. PEACH COUNTY, GEORGIA HAS AN ESTIMATED POPULATION OF 26,966 INDIVIDUALS AND ENCOMPASSES APPROXIMATELY 150 SQUARE MILES. THERE ARE NO OTHER HOSPITALS IN THE COUNTY. THE HOSPITAL FACILITY IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL FOR MEDICARE PURPOSES. APPROXIMATELY 21.5% OF PEACH COUNTY, GA'S, POPULATION LIVES BELOW THE POVERTY LEVEL.AGE:21.5% - 0 -1763.4% - 18 - 6415.1% - 65+RACE:48.8% - WHITE44.7% - BLACK6.5% - HISPANIC PART VI, LINE 5: THE ORGANIZATION IS COMMITTED TO BEING RESPONSIVE TO THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES THROUGH A NUMBER OF PROGRAM ACTIVITIES AND COMMUNITY HEALTH IMPROVEMENT INITIATIVES. THE ORGANIZATION HAS ADOPTED AND MAINTAINED A FINANCIAL ASSISTANCE POLICY, PROVIDES SUBSIDIZED HEALTH SERVICES TO PATIENTS IN NEED, AND ACCEPT ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OPERATES AN EMERGENCY ROOM THAT IS OPEN 24/7. THE GOVERNING BOARD IS COMPRISED OF LEADERS WITHIN THE COMMUNITY THE HOSPITAL SERVES. FUNDS ARE REINVESTED IN HEALTH IMPROVEMENT INITIATIVES TO BETTER SERVE THE COMMUNITY HEALTH NEEDS. PART VI, LINE 6: THE FILING ORGANIZATION IS PART OF ADVOCATE HEALTH, WHICH IS HEADQUARTERED IN CHARLOTTE, NORTH CAROLINA, AND IS THE THIRD-LARGEST NONPROFIT HEALTH SYSTEM IN THE UNITED STATES, CREATED FROM THE COMBINATION OF ATRIUM HEALTH AND ADVOCATE AURORA HEALTH. TOGETHER WITH AN INTEGRATED GROUP OF 501(C)(3) HOSPITALS, PHYSICIAN NETWORKS, OTHER HEALTHCARE PROVIDERS, THE ORGANIZATION IS COMMITTED TO PROVIDING SIGNIFICANT BENEFITS TO THE COMMUNITIES IT SERVES ACROSS. EACH HOSPITAL ORGANIZATION IN THE ADVOCATE HEALTH SYSTEM REPORTS ITS OWN COMMUNITY BENEFIT ON FORM 990, SCHEDULE H. THE CONSOLIDATED COMMUNITY BENEFIT TOTAL OF THE HEALTH SYSTEM IS REPORTED AT HTTPS://NAVICENTHEALTH.ORG/OUR-ANNUAL-REPORTS PART VI, LINE 7, REPORTS FILED WITH STATES GA 1 1 0 0 0 0 0 0 0 ROBERT C WILDE TREASURER (TO 9/30/22) 0 371753 0 218593 0 436036 0 12200 0 20116 0 1058698 0 217759 KENNETH B BANKS SECRETARY 0 467410 0 207586 0 49226 0 37570 0 30851 0 792643 0 25341 LAURA T GENTRY PRESIDENT/CEO 0 170690 0 71893 0 21625 0 10677 0 23937 0 298822 0 0 JILL HANCOCK CH NURSE OFF 0 143740 0 21216 0 166 0 6898 0 32949 0 204969 0 0 PART I, LINES 4A-B CERTAIN DIRECTORS, OFFICERS, AND KEY EMPLOYEES OF THE FILING ORGANIZATION PARTICIPATED IN AND/OR RECEIVED PAYMENTS FROM A NON-QUALIFIED DEFERRED COMPENSATION PLAN (RESTORATION OR SERP) AND/OR RECEIVED PAYMENTS FOR SEVERANCE. THE DETERMINATION OF THE PAYMENT AMOUNT FROM NON-QUALIFIED DEFERRED COMPENSATION PLANS FOLLOWED THE EMPLOYMENT ORGANIZATION'S COMPENSATION PROCEDURES. THE FOLLOWING DIRECTORS, OFFICERS, AND KEY EMPLOYEES RECEIVED PAYMENTS FOR SEVERANCE AND/OR PAYMENTS FROM NON-QUALIFIED DEFERRED COMPENSATION PLANS DURING THE CURRENT TAX YEAR: SEVERANCE PAYMENTS: ROBERT C. WILDE 124,807 NON-QUALIFIED DEFERRED COMPENSATION PAYMENTS: ROBERT C. WILDE 290,104 KENNETH B. BANKS 27,538 FORM 990, PART VI, SECTION A, LINE 6 NAVICENT HEALTH, INC., A RELATED SECTION 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A NAVICENT HEALTH, INC., A RELATED SECTION 501(C)(3) ORGANIZATION, HAS THE RIGHT TO APPOINT AND REMOVE MEMBERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATION. HOWEVER, ONE MEMBER OF THE BOARD OF DIRECTORS MUST BE A CURRENTLY SERVING MEMBER OF THE HOSPITAL AUTHORITY OF PEACH COUNTY AND TWO OTHER MEMBERS ARE TO BE NOMINATED BY THE HOSPITAL AUTHORITY OF PEACH COUNTY. FORM 990, PART VI, SECTION A, LINE 7B NAVICENT HEALTH, INC., A RELATED SECTION 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF THE FILING ORGANIZATION. THE MEMBER HAS CERTAIN RESERVE POWERS AS WELL AS THE POWER TO APPOINT, APPROVE AND REMOVE BOARD MEMBERS OF THE MEDICAL CENTER OF PEACH COUNTY, INC. IN ADDITION, THE PRIOR APPROVAL OF THE BOARD OF DIRECTORS OF NAVICENT HEALTH. INC. IS REQUIRED FOR CHANGES IN GOVERNANCE, ORGANIZATIONAL STRUCTURE CHANGES (ORGANIZING A SUBSIDIARY OR ENTERING A JOINT VENTURE, LIQUIDATING OR DISSOLVING, MERGING OF CONSOLIDATING THE ENTITY), ADOPTING OR AMENDING CAPITAL OR OPERATING BUDGETS (OR SPENDING MORE THAN IS AUTHORIZED PURSUANT TO SUCH BUDGETS UNLESS PERMITTED BY A NAVICENT HEALTH APPROVED POLICY), APPOINTING OR REMOVING THE CEO, AND AMENDING OR TERMINATING ANY LEASE AGREEMENT. FORM 990, PART VI, SECTION B, LINE 11B THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVES COPIES OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL DIRECTORS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES ITS OFFICERS, DIRECTORS AND KEY EMPLOYEES TO ANNUALLY REVIEW THE CONFLICT OF INTEREST POLICY AND DETERMINE ANY POTENTIAL CONFLICTS OF INTEREST. ANY POTENTIAL CONFLICTS NOTED IN THE QUESTIONNAIRE ARE REVIEWED BY A STANDING COMMITTEE FOR APPROPRIATE RESOLUTION. ALL MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED TO DETERMINE AND REPORT ANNUALLY, AND AS THEY ARISE, ANY POTENTIAL CONFLICTS OF INTEREST TO THE SECRETARY OF THE BOARD OF DIRECTORS. THE RESOLUTION OF POTENTIAL AND ACTUAL CONFLICTS IS SUBJECT TO THE APPROVAL OF THE CHAIR OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 THE DIVERSITY, INCLUSION, & COMPENSATION COMMITTEE (THE "COMMITTEE") OF THE ATRIUM HEALTH, INC. BOARD OF DIRECTORS HAS AUTHORITY AS THE NAVICENT HEALTH BOARD DELEGATES TO IT, FOR THE REVIEW AND APPROVAL OF SENIOR EXECUTIVE COMPENSATION, INCLUDING SENIOR EXECUTIVE INCENTIVE PLANS. NO MEMBER OF THE COMMITTEE IS AN EMPLOYEE OF NAVICENT HEALTH OR OF THE FILING ORGANIZATION. THE COMMITTEE RELIES UPON AN EXTERNAL, INDEPENDENT COMPENSATION CONSULTANT EXPERIENCED IN HEALTHCARE TO PROVIDE THE COMMITTEE WITH COMPENSATION COMPARABILITY DATA FOR NEW EXECUTIVE POSITION APPOINTMENTS AND FOR COMPENSATION REVIEWS FOR EXISTING EXECUTIVES. THE CONSULTANT, WHICH IS RETAINED DIRECTLY BY THE COMMITTEE, PROVIDES THIRD-PARTY INFORMATION AND EVALUATES THE COMPETITIVENESS AND REASONABLENESS OF EXECUTIVE COMPENSATION AND BENEFITS PROGRAMS IN RELATION TO MARKET PRACTICES FOR SIMILARLY SITUATED HEALTHCARE ORGANIZATIONS. THE COMMITTEE MAKES ITS DECISIONS WITH RESPECT TO EXECUTIVE COMPENSATION IN ACCORDANCE WITH NAVICENT HEALTH AND THE FILING ORGANIZATION'S POLICIES, IRS REGULATIONS, AND STANDARD CORPORATE GOVERNANCE PRACTICES. SUCH POLICIES INCLUDE ADHERENCE TO EXECUTIVE COMPENSATION PHILOSOPHY AND REVIEW PROCESSES; PROCESSES ENSURING COMMITTEE MEMBER AND COMPENSATION CONSULTANT INDEPENDENCE; USE OF VALID MARKET COMPARISONS OF DATA FROM HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE, STRUCTURE, AND COMPLEXITY AND ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS, PER IRS GUIDELINES. MINUTES OF THE DELIBERATIONS OF THE COMMITTEE ARE MAINTAINED IN THE ATRIUM HEALTH, INC. LEGAL DEPARTMENT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON REQUEST. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES AND CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 6,331,285. MANAGEMENT AND GENERAL EXPENSES 606,712. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,937,997. CENTRAL GEORGIA SENIOR HEALTH INC 777 HEMLOCK STREET MSC 111 MACON GA 31201 582345439 CONTINUING CARE RETIREMENT COMMUNITY GA 501(C)(3) LINE 12B, II NAVICENT HEALTH INC 0 HEALTH SERVICES OF CENTRAL GEORGIA INC 777 HEMLOCK STREET MSC 111 MACON GA 31201 582307485 HEALTHCARE GA 501(C)(3) LINE 3 NAVICENT HEALTH INC 0 MEDICAL CENTER OF CENTRAL GEORGIA INC 777 HEMLOCK STREET MSC 111 MACON GA 31201 582149128 HEALTHCARE GA 501(C)(3) LINE 3 NAVICENT HEALTH INC 0 NAVICENT HEALTH INC 777 HEMLOCK STREET MSC 111 MACON GA 31201 582149127 HEALTHCARE GA 501(C)(3) LINE 12C, III-FI AH GEORGIA INC 0 NAVICENT HEALTH BALDWIN INC 777 HEMLOCK STREET MSC 111 MACON GA 31201 823914925 HEALTHCARE GA 501(C)(3) LINE 3 NAVICENT HEALTH INC 0 AH GEORGIA INC PO BOX 32861 CHARLOTTE NC 282322861 831707383 HOLDING COMPANY NC 501(C)(3) LINE 7 THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY 0 THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY 1000 BLYTHE BOULEVARD CHARLOTTE NC 28203 560529945 HEALTHCARE NC NC POLITICAL SUBDIVI N/A 0 FLOYD HEALTHCARE MANAGEMENT INC 304 TURNER MCCALL BOULEVARD ROME GA 301620233 581973570 HEALTHCARE GA 501(C)(3) LINE 3 AH GEORGIA INC 0 ADVOCATE HEALTH INC 1000 BLYTHE BOULEVARD CHARLOTTE NC 28203 884157429 HEALTHCARE NC 501(C)(3) LINE 12B, II 0 COWLES CLINIC REALTY LLC 1000 COWLES CLINIC WAY C100 GREENSBORO GA 30642 810636590 REAL ESTATE GA N/A 0 0 SECURE HEALTH PLANS OF GEORGIA LLC 577 MULBERRY STREET MACON GA 31201 582306549 MANAGED CARE GA N/A 0 0 CENTRAL GEORGIA PET LLC 1650 HARDEMAN AVENUE MACON GA 31201 371464470 HEALTHCARE GA N/A 0 0 MACON OUTPATIENT SURGERY LLC 3708 NORTHSIDE DRIVE MACON GA 31210 203027560 HEALTHCARE GA N/A 0 0 NAVICENT HOLDING LLC 777 HEMLOCK ST MSC 111 MACON GA 31201 844982377 HOLDING CO. GA N/A 0 0 CENTRAL GEORGIA HEALTH VENTURES INC 777 HEMLOCK STREET MSC 111 MACON GA 31201 582164989 HOME CARE MANAGEMENT SERVICE GA N/A C 0 NAVICENT HEALTHPLAN INC 777 HEMLOCK STREET MSC 111 MACON GA 31201 202467391 INSURANCE GA N/A C 0 CENTRA PROFESSIONAL INDEMNITY LTD PO BOX 1363 GRAND CAYMAN CJ SELF-INSURANCE CJ N/A C 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 1 0 0 0