2022-08-15T13:10:30-05:00 2021-09-30 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2020-10-01 453072990 TIFT REGIONAL HEALTH SYSTEM INC TIFT 2293536310 PO BOX 2650 TIFTON GA 317932650 TROY BROOKS CFO 2293536310 2022-08-09 true TROY BROOKS 999009999 WILLIAM EDWARD PHILLIPS P00451499 2298837878 2022-08-13 2020 2022-09-23 18:48:47Z CHRISTOPHER DORMAN PO BOX 2650 TIFTON GA 317932650 471235169 false X HTTPS://WWW.MYSOUTHWELL.COM X 2011 GA OUR MISSION IS TO DELIVER A LIFETIME OF QUALITY AND COMPASSIONATE CARE FOR EACH PATIENT WE SERVE. 8 5 3139 0 41392381 6101509 389938453 412100267 29732972 44973661 7893287 8059732 468957093 471235169 51296 0 229785505 243083256 0 0 204409329 201585207 434194834 444719759 34762259 26515410 948245014 962633657 356282503 337439358 591962511 625194299 X OUR MISSION IS TO DELIVER A LIFETIME OF QUALITY AND COMPASSIONATE CARE FOR EACH PATIENT WE SERVE. false false 322070322 51296 415712920 TIFT REGIONAL HEALTH SYSTEM (TRHS) IS A GROWING, NOT-FOR-PROFIT HOSPITAL SYSTEM. ITS MAIN CAMPUS SERVES 12 COUNTIES IN SOUTH CENTRAL GEORGIA. TRHS OFFERS MORE THAN 135 PHYSICIANS WITH EXPERTISE IN OVER 30 SPECIALTIES. TRHS PROVIDES A WIDE RANGE OF CARE, INCLUDING SIGNATURE SERVICES IN SURGERY, ONCOLOGY, CARDIOVASCULAR CARE, WOMEN'S HEALTH, NEURODIAGNOSTICS, GERIATRIC PSYCHIATRIC CARE, RADIOLOGY AND MORE. THE MAIN CAMPUS IS TIFT REGIONAL MEDICAL CENTER (TRMC), A 181-BED REGIONAL REFERRAL HOSPITAL LOCATED IN TIFTON AT 901 EAST 18TH STREET. TRMC'S WEST CAMPUS, LOCATED IN TIFTON AT 2225 HIGHWAY 41 NORTH, IS AN OUTPATIENT FACILITY WHICH HOUSES VARIOUS DIAGNOSTIC SERVICES AND THE REGION'S LARGEST MULTI-SPECIALTY PRACTICE. A 3RD CAMPUS OF TRMC IS IN ADEL, GA. SOUTHWELL MEDICAL IS A 60-BED HOSPITAL (THAT IS NOT SEPARATELY LICENSED) INCLUDING A 12-BED GERIATRIC PSYCHIATRIC UNIT. A 95-BED SKILLED NURSING FACILITY, SOUTHWELL HEALTH & REHABILITATION, ALSO IS LOCATED ON THE SOUTHWELL MEDICAL CAMPUS. 322070322 true true false true false false false false false false true false false false true true false true false false false false false false false false true true true false true true false false false false false false false false true false false false false false true true false false false true 242 0 3139 true false false false false false false false false false false false false X 8 5 false false false false true true true true true true false true true true true true true true true false GA X TROY BROOKS 2293533397 PO BOX 2650 TIFTON GA 31793 ANTHONY BURKE MD PHYSICIAN 40.00 X 1520192 0 26250 EDWARD HELLMAN MD PHYSICIAN 40.00 X 1424621 0 26250 WILLIAM KAISER MD PHYSICIAN 40.00 X 1126296 0 26250 DAVID BANKS MD PHYSICIAN 40.00 X 1090190 0 26250 GEORGE YARED MD PHYSICIAN 40.00 X 1058869 0 26250 FORTE MCEACHIN MD EXEC. MEDICA 40.00 X 965535 0 26250 CHRISTOPHER DORMAN CEO & PRESID 40.00 2.00 X 873469 0 33002 JESSICA BEIER MD TRUSTEE/PHYS 41.00 1.00 X 748225 0 26250 RUBAL PATEL MD TRUSTEE/PHYS 41.00 X 687563 0 26250 KAREN D SUMMERLIN SVP GENERAL 40.00 2.00 X 604629 0 28021 CAMERON NIXON MD CHIEF TRANSF 40.00 X 560530 0 25969 KIM WILLS SVP CFO 40.00 2.00 X 496308 0 26250 CAROL SMITH SVP CNO 40.00 X 379402 0 24372 CLAIRE BYRNES SVP AMBULATO 40.00 X 287849 0 22579 LINDA WILSON VP REVENUE C 40.00 X 238494 0 22189 JAMES SCOTT MD TRUSTEE/PHYS 41.00 X 240795 0 18986 JUSTIN BECK CHIEF STRATE 40.00 X 227625 0 22350 MARIE ROOF VP CIP 40.00 X 221718 0 21361 VYVYAN DEROUEN VP PHYSICIAN 40.00 X 212522 0 21257 TONIA GARRETT AVP SURGICAL 40.00 X 213436 0 17071 ALEX LE COO 40.00 X 207382 0 21061 TAMARA BRANCH VP LEGAL COU 40.00 X 206523 0 21011 JANE MCKEE VP REVENUE C 40.00 X 180740 0 19096 JOHN BROWNLEE CHAIRMAN X X 0 0 0 SCOTT FULP DMD TRUSTEE 1.00 X 0 0 0 CHASE DAUGHTREY TRUSTEE 1.00 X 0 0 0 GEORGE M D HUNT IV CHAIRMAN 1.00 2.00 X X 0 0 0 WILLIAM BOWEN JR VICE CHAIRMA 1.00 2.00 X 0 0 0 JOYCE MIMS SECRETARY 1.00 1.00 X X 0 0 0 TROY BROOKS CFO 40.00 2.00 X 0 0 0 13772913 554575 23 false true false CHARTIS GROUP LLC DEPARTMENT 5925 CAROL STREAM IL 601225925 CONSULTING 3057566 ASPIRION HEALTH RESOURCES LLC 1506 6TH AVENUE SUITE 3 COLUMBUS GA 31902 BILLING 1226879 JACKSON & COKER LOCUM TENENS PO BOX 277638 ATLANTA GA 303847638 LOCUM TENENS 611785 GOLDFISH LOCUMS LLC 6865 WINDCREST DRIVE SUITE 300 PLANO TX 75024 LOCUM TENENS 594594 TRIAGE LLC PO BOX 773328 CHICAGO IL 606773328 CONTRACT STAFF 458350 42 497995 1013839 4589675 6101509 NET PATIENT SERVICE REVENUE 623000 411971206 411971206 MOB & DATA CENTER 623000 129061 129061 412100267 7800588 7800588 37125949 47124 37125949 47124 37173073 37173073 EMPLOYEE PHARMACY 623000 4447079 4447079 REBATES AND DISCOUNTS 623000 1407928 1407928 CAFETERIA & VENDING 722514 1109049 1109049 1095676 1095676 8059732 471235169 415712920 49420740 51296 51296 6899358 2042340 4857018 180342831 146580453 33762378 7759719 5920666 1839053 33742956 25744731 7998225 14338392 10940193 3398199 88851 88851 515513 515513 40453714 28931954 11521760 470260 36185 434075 9701864 6212650 3489214 12554706 958462 11596244 3878415 3878415 848561 268213 580348 520681 439966 80715 4190362 4190362 36037666 36037666 3678052 3673488 4564 MEDICAL & SURGICAL SUPP. 76359599 74355548 2004051 PROVIDER TAXES 5497520 5497520 REPAIR & MAINTENANCE 3691356 1388704 2302652 DUES & SUBCRIPTIONS 977693 395404 582289 2120394 563772 1556622 444719759 322070322 122649437 0 93759446 92750075 5320712 5391986 56770135 56062883 3371364 4110334 3447728 3715846 8446368 8631856 761206397 407381924 321719990 353824473 445593759 421150231 1047186 1047186 2305376 783371 6462950 15165416 948245014 962633657 65231402 56336175 5400000 3000000 104709229 25316977 150786764 224388465 30155108 28397741 356282503 337439358 X 591962511 625194299 591962511 625194299 948245014 962633657 X 26515410 15419223 -8702845 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 84951 84951 false SCHEDULE C, PART II-B, LINE 1 TIFT REGIONAL HEALTH SYSTEM IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION, THE GEORGIA HOSPITAL ASSOCIATION AND OTHER MEMBERSHIP ORGANIZATIONS. THE LOBBYING EXPENSE REFLECTED REPRESENTS THE ESTIMATED PORTION OF DUES PAID TO THESE ORGANIZATIONS SPENT ON LOBBYING ACTIVITIES AT FEDERAL, STATE OR LOCAL LEVELS OF GOVERNMENT. 10669460 10669460 388341571 107651820 280689751 362195366 299730104 62465262 353824473 MEDICARE ACCELERATED PAYMENTS 19463481 ACCRUED PROFESSIONAL LIABILITY 6757277 ESTIMATED THIRD PARTY SETTLEMENTS 1241745 DEFERRED COMPENSATION 935238 28397741 X SCHEDULE D, PAGE 3, PART X SOUTHWELL, SYSTEM, AND AMBULATORY ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACO IS CONSIDERED A DISREGARDED ENTITY OF THE SYSTEM. ENTERPRISES IS A FOR-PROFIT CORPORATION. SOUTHWELL APPLIES 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, SOUTHWELL ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF 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 SHEETS FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF SEPTEMBER 30, 2021 AND 2020 OR FOR THE YEARS THEN ENDED. SOUTHWELL'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. true true X true X 2.250000000000 false true true false true true 24045345 24045345 0.05410 32823405 26862436 5960969 0.01340 180032 114093 65939 0.00010 57048782 26976529 30072253 0.06760 2852846 112468 2740378 0.00620 2852846 112468 2740378 0.00620 59901628 27088997 32812631 0.07380 false 62694882 60901071 72270402 -11369331 X true true 1 1 TIFT REGIONAL MEDICAL CENTER 901 E 18TH STREET TIFTON GA 31793 137-180 X X X TIFT REGIONAL MEDICAL CENTER 1 false false true X X X X X X X X X X 21 true false false true X HTTPS://WWW.MYSOUTHWELL.COM X HTTPS://MYSOUTHWELL.COM/WP-CONTENT/UPL true 21 true HTTPS://MYSOUTHWELL.COM/WP-CONTENT/UPL false false true X 225.000000000000 X true true X X X true X HTTPS://MYSOUTHWELL.COM/TIFT-REGIONAL- X HTTPS://MYSOUTHWELL.COM/TIFT-REGIONAL- X HTTPS://MYSOUTHWELL.COM/TIFT-REGIONAL- X X X X X X true X false X X X X true X false false FACILITY 1, TIFT REGIONAL MEDICAL CENTER - PART V, LINE 3E THE ADVISORY COMMITTEE REVIEWED THE PRIORITIZED LIST OF COMMUNITY NEEDS, WHICH WAS UPDATED FROM THE PREVIOUS CHNA BASED ON THE FOCUS GROUP DISCUSSIONS, COMMUNITY SURVEY, AND ONE-ON- ONE INTERVIEWS. DURING A THREE- STAGE PROCESS, PARTICIPANTS PRIORITIZED THE NEEDS BASED ON THE DEGREE OF NEED WITHIN THE COMMUNITY, RESOURCE REQUIREMENTS, AND LONG-TERM VERSUS SHORT-TERM OBJECTIVES. THE 2020 NEEDS FALL INTO THREE CATEGORIES: ACCESS TO CARE, CARE COORDINATION SERVICES, AND SYSTEM CAPACITY. ALTHOUGH 53 NEEDS WERE IDENTIFIED AND PRIORITIZED, THE TOP 10 NEEDS ARE SHOWN BELOW. PRIORITIZED 2020 COMMUNITY NEEDS DOMAIN AND RANK HEALTH NEED ACCESS TO CARE: 1 TRANSPORTATION SERVICES FOR PEOPLE NEEDING TO GO TO DOCTORS APPOINTMENTS OR THE HOSPITAL 2 ACCESS TO HEALTHFUL FOOD 3 AFFORDABLE PRESCRIPTION MEDICATIONS 9 WELLNESS INITIATIVES FOR ADULTS EXERCISE AND NUTRITION 10 OBESITY EDUCATION AND PREVENTION CARE COORDINATION SERVICES: 4 SENIORS HEALTH SERVICES CARE COORDINATION 5 SUBSTANCE ABUSE SCREENING, INTERVENTION, TREATMENT, CARE COORDINATION SYSTEM CAPACITY: 6 SENIORS HEALTH SERVICES DIAGNOSTIC AND TREATMENT 7 SENIORS HEALTH SERVICES DEMENTIA SPECTRUM SERVICES FOR ALZHEIMERS, ETC. 8 BEHAVIORAL HEALTH SERVICES FOR ADULTS FOR DEPRESSION, ANXIETY, OR OTHER MENTAL HEALTH CONDITIONS OTHER THAN SUBSTANCE ABUSE ULTIMATELY, THE HOSPITAL FOCUSED ON ADOPTING IMPLEMENTATION STRATEGIES FOR THE TOP 5 COMMUNITY HEALTH NEEDS. FACILITY 1, TIFT REGIONAL MEDICAL CENTER - PART V, LINE 5 TIFT REGIONAL HEALTH SYSTEM INCLUDED AN EXPANSIVE AND HIGHLY DIVERSE GROUP OF INDIVIDUALS TO PARTICIPATE IN ITS CHNA ADVISORY COMMITTEE AND TO CONTRIBUTE INSIGHT FROM COMMUNITY SERVICE ORGANIZATIONS. EACH MEMBER WAS INVITED TO PROVIDE PROJECT INSIGHT, FEEDBACK REGARDING PERCEPTIONS OF AREA HEALTH NEEDS, DATA EVALUATION, AND OTHER GUIDANCE THROUGHOUT THE CHNA PROCESS. THESE INDIVIDUALS HAD A BREADTH OF COMMUNITY HEALTH VISION, KNOWLEDGE, AND POWER TO IMPACT THE WELL-BEING OF THE SERVICE AREA. THE CHNA ADVISIORY COMMITTEE HEALTH SYSTEM AND COMMUNITY PARTICIPANTS ARE IDENTIFIED ON PAGES 7 AND 8 OF THE CHNA. TRHS CONTACTED PHYSICIANS FROM ACROSS MEDICAL SPECIALTIES TO PARTICIPATE IN ITS RESEARCH FOR THE MEDICAL STAFF DEVELOPMENT PLAN AND TO CONTRIBUTE INSIGHT FOR THE CHNA. EACH MEMBER WAS INVITED TO PROVIDE FEEDBACK REGARDING PERCEPTIONS OF PATIENT ACUITY CHANGES, QUANTITY OF PROVIDERS OF VARIOUS SPECIALTIES, RETIREMENT PLANS, AND AREA HEALTH NEEDS. THESE INDIVIDUALS HAD A BREADTH OF COMMUNITY HEALTH VISION, KNOWLEDGE, AND POWER TO IMPACT THE WELL-BEING OF THE SERVICE AREA. THE MEDICAL STAFF DEVELOPMENT PLAN PARTICIPANTS ARE IDENTIFIED ON PAGE 10 OF THE CHNA. THE CHNA METHODOLOGY UTILIZED BOTH QUANTITATIVE AND QUALITATIVE RESEARCH METHODS IN ORDER TO EVALUATE PERSPECTIVES AND OPINIONS OF AREA STAKEHOLDERS AND HEALTHCARE CONSUMERS, ESPECIALLY THOSE REPRESENTING UNDERSERVED POPULATIONS. THIS METHODOLOGY HELPED TO PRIORITIZE THE NEEDS AND ESTABLISH A BASIS FOR CONTINUED COMMUNITY ENGAGEMENT, IN ADDITION TO SIMPLY DEVELOPING A BROAD, COMMUNITY-BASED LIST OF NEEDS. THE MAJOR SECTIONS OF THE METHODOLOGY INCLUDE THE FOLLOWING: STRATEGIC SECONDARY RESEARCH AND DATA ANALYSIS QUALITATIVE DISCUSSION GROUPS WITH SOUTHWELL/ TRHS LEADERS, ADVISORY COMMITTEE MEMBERS, OTHER COMMUNITY LEADERS AND SERVICE PROVIDERS, MEMBERS OF UNDERSERVED POPULATIONS, AND OTHER HEALTHCARE CONSUMERS IN THE PRIMARY SERVICE AREA (PSA) AND SECONDARY SERVICE AREA (SSA) ONE-ON-ONE INTERVIEWS WITH SOUTHWELL/ TRHS LEADERS, ADVISORY COMMITTEE MEMBERS, OTHER COMMUNITY LEADERS AND SERVICE PROVIDERS, AND HEALTHCARE CONSUMERS IN THE PRIMARY SERVICE AREA (PSA) AND SECONDARY SERVICE AREA (SSA) COMMUNITY SURVEYS - TO RECEIVE INPUT FROM LOCAL RESIDENTS, SOUTHWELL/ TRHS CONDUCTED A COMMUNITY HEALTH NEEDS SURVEY BETWEEN APPROXIMATELY OCTOBER 26, 2020 AND NOVEMBER 23, 2020, AMONG ADULTS (AGE 18+) IN THE PRIMARY SERVICE AREA. THE HEALTH SYSTEM CREATED A SUCCESSFUL MARKETING CAMPAIGN TO ENCOURAGE THE COMMUNITY TO PARTICIPATE IN THE ONLINE SURVEY, INCLUDING A PRINT AD IN THREE PUBLICATIONS (TIFTON GAZETTE, ADEL NEWS TRIBUNE, AND WIREGRASS FARMER), PRINTED FLYERS, AN EMAIL BLAST, WEB COMMUNICATIONS, AND SOCIAL MEDIA. RESIDENTS WITHOUT INTERNET ACCESS HAD THE OPTION OF HAVING A PAPER SURVEY MAILED TO THEM ALONG WITH A SELF- ADDRESSED AND SELF- STAMPED RETURN ENVELOPE. AS AN INCENTIVE FOR PARTICIPATION, ALL THOSE SURVEYED WERE ENTERED INTO A DRAWING FOR EITHER A 200 VISA GIFT CARD, A 100 WALMART GIFT CARD, OR A 50 DARDEN RESTAURANT GIFT CARD. THERE WERE 998 TOTAL PARTICIPANTS IN THE SURVEY. IN ADDITION, THE SURVEY WAS TRANSLATED INTO SPANISH AND 8 INDIVIDUALS PARTICIPATED. THE SURVEY INCLUDED REPRESENTATION ACROSS THE PSA COUNTIES AND A DIVERSE MIX OF ECONOMIC STRATA AND EDUCATIONAL ATTAINMENT LEVELS. IN ADDITION, A THREE-PART PRIORITIZATION SURVEY WAS CONDUCTED WITH THE ADVISORY COMMITTEE IN ORDER TO NARROW DOWN THE LARGE LIST OF NEEDS AND GAPS IDENTIFIED DURING THE QUALITATIVE AND QUANTITATIVE RESEARCH PROCESS. THE ADVISORY COMMITTEE FIRST RECEIVED A LIST OF THE 53 IDENTIFIED NEEDS AND WERE ASKED TO RATE THEM ON A SEVEN-POINT SCALE AND PROVIDE A SHORT COMMENT REGARDING THE RATIONALE FOR THE RATING. DURING THE SECOND ROUND, THE ADVISORY COMMITTEE RECEIVED THE SAME LIST OF 53 PRIORITIZED NEEDS, AS WELL AS THE RATINGS AND COMMENTS FROM THE FIRST ROUND. THEY WERE THEN ASKED TO RE-RATE THE LIST BASED ON THE NEW INFORMATION. THE FINAL ROUND INCLUDED A VIRTUAL MEETING WHERE THE RESULTS WERE PRESENTED AND PARTICIPANTS HAD THE OPPORTUNITY TO DISCUSS THE RESULTS, MAKE COMMENTS, AND DETERMINE IF ANY CHANGES TO THE PRIORITIZED LIST WERE NEEDED. FACILITY 1, TIFT REGIONAL MEDICAL CENTER - PART V, LINE 11 FIVE PRIORITIZED NEEDS WERE IDENTIFIED IN THE IMPLEMENTATION STRATEGY REPORT: 1) TRANSPORTATION SERVICES (ACCESS TO CARE) 2) AFFORDABLE PRESCRIPTION MEDICATIONS (ACCESS TO CARE) 3) SENIOR HEALTH SERVICES (CARE COORDINATION AND SYSTEM CAPACITY) 4) BEHAVIORAL HEALTH SERVICES (CARE COORDINATION AND SYSTEM CAPACITY) 5) HEALTH AND WELLNESS ENHANCEMENT (ACCESS TO CARE). THE SPECIFIC IMPLEMENTATION STRATEGIES ARE DISCUSSED BEGINNING ON PAGE 5 OF THE REPORT. NEEDS NOT ADDRESSED IN THE IMPLEMENTATION STRATGY REPORT WERE NOT CONSIDERED TO BE AS HIGH A PRIORITY. RESOURCE LIMITATIONS, ABILITY TO IMPACT AND OTHER CONSIDERATIONS WERE INFLUENCED THIS DECISION. 33 TIFT REGIONAL DIALYSIS CENTER 1010 EDGEFIELD DRIVE TIFTON GA 31794 END STAGE RENAL DIALYSIS AFFINITY CLINIC 2225 US HIGHWAY 41N TIFTON GA 31794 MULTI-SPEICALTY CLINIC GEORGIA SPORTS MEDICINE 2227 US HIGHWAY 41N TIFTON GA 31794 ORTHOPAEDIC SURGERY TIFT REGIONAL ANESTHESIA 2227 US HIGHWAY 41N TIFTON GA 31794 ANESTHESIOLOGY SOUTHWELL HEALTH & REHABLITATION 260 MJ TAYLOR ROAD ADEL GA 31620 SKILLED NURSING SOUTH GEORGIA SURGICAL 1007 GREENFIELD DRIVE TIFTON GA 31794 GENERAL SURGERY TIFT REGIONAL UROLOGY 1815 OLD OCILLA ROAD TIFTON GA 31794 UROLOGY AFFINITY PEDIATRICS 39 KENT ROAD SUITE 5 TIFTON GA 31794 PEDIATRICS HOSPICE OF TIFT AREA 618 N CENTRAL AVENUE TIFTON GA 31794 HOSPICE TIFT REGIONAL WOUND CARE 907 E 18TH STREET SUITE 140 TIFTON GA 31794 OUTPATIENT WOUND CARE TIFT REGIONAL OUTPATIENT THERAPY 2227 US HIGHWAY 41N TIFTON GA 31794 OUTPATIENT THERAPY PT/OT/SPEECH AFFINITY PHYSICIANS FOR WOMEN 1493 KENNEDY ROAD SUITE C TIFTON GA 31794 OBSTETRICS & GYNECOLOGY SOUTHWELL MEDICAL ADEL PRIMARY CARE 172 MJ TAYLOR ROAD ADEL GA 31620 FAMILY MEDICINE ALLURE PLASTIC & RECONSTRUCTIVE 907 E 18TH STREET SUITE 340 TIFTON GA 31794 PLASTIC SURGERY TIFT REGIONAL VASCULAR 1641 MADISON AVENUE TIFTON GA 31794 VASCULAR SURGERY SOUTHWELL NEPHROLOGY 39 KENT ROAD SUITE 1 TIFTON GA 31794 NEPHROLOGY TIFT REGIONAL OPTHALMOLOGY 1803 OLD OCILLA ROAD TIFTON GA 31794 OPTHALMOLOGY/OPTICAL TIFT FAMILY MEDICINE 907 E 18TH STREET SUITE 130 TIFTON GA 31794 FAMILY MEDICINE ARTHRITIS & OSTEOPOROSIS CENTER 2227 US HIGHWAY 41N TIFTON GA 31794 RHEUMATOLOGY AFFINNITY CLINICNEUROLOGY 2227 US HIGHWAY 41N TIFTON GA 31794 NEUROLOGY OCILLA PEDIATRICS 813 IRWIN AVENUE TIFTON GA 31794 PEDIATRICS AFFINTIY PEDIATRICS 3007 2ND STREET NE MOULTRIE GA 31768 PEDIATRICS NASHVILLE PRIMARY CARE 416A E MCPHERSON AVENUE NASHVILLE GA 31639 FAMILY MEDICINE ASHBURN PRIMARY CARE 611 E WASHINGTON AVENUE ASHBURN GA 31714 FAMILY MEDICINE TRMC ONCOLOGY PROFESSIONALS 1623 MADISON AVENUE TIFTON GA 31794 ONCOLOGY AFFINITY CLINIC MOULTRIE 2 HOSPITAL PARK MOULTRIE GA 31768 MULTI-SPECIALTY CLINIC AFFINITY PHYSICIANS FOR WOMEN MOUTL 2 HOSPTIAL PARK MOULTRIE GA 31768 OBSTETRICS & GYNECOLOGY SOUTHWELL CENTER FOR HEARING & WELL 39 KENT ROAD SUITE 2 TIFTON GA 31794 FAMILY MEDICINE SOUTHWELL SCHOOL CLINIC 1464 CARPENTER ROAD S TIFTON GA 31794 SCHOOL BASED CLINIC SOUTHWELL SCHOOL CLINIC 700 8TH STREET W TIFTON GA 31794 SCHOOL BASED CLINIC SYLVESTER FAMILY PRACTICE 1010 W FRANKLIN STREET SYLVESTER GA 31791 FAMILY MEDICINE TIFT COMMUNITY HEALTH CENTER 2735 S CENTRAL AVENUE TIFTON GA 31794 FAMILY MEDICINE WORKSMART OCCUPATION HEALTH 4468 UNION ROAD TIFTON GA 31794 OCCUPATIONAL HEALTH SCHEDULE H, PART I, LINE 7 A COST-TO-CHARGE RATIO IS CALCULATED USING WORKSHEET 2 INCLUDED IN THE FORM 990, SCHEDULE H INSTRUCTIONS. SCHEDULE H, PART III, LINE 2 CHANGES IN CREDIT ISSUES THAT ARE NOT ADDRESSED AT THE DATE OF SERVICE ARE RECOGNIZED AS BAD DEBT EXPENSE AND ARE INCLUDED AS A COMPONENT OF OPERATING EXPENSES. CREDIT ISSUES THAT ARE ADDRESSED AT THE DATE OF SERVICE ARE TREATED AS PRICE CONCESSIONS THAT REDUCE THE TRANSACTION PRICE, WHICH ARE REPORTED AS A REDUCTION OF NET PATIENT SERVICE REVENUE. THERE WERE NO BAD DEBTS RECORDED IN OPERATING EXPENSES DURING THE FISCAL YEAR. BASED ON MANAGEMENT'S JUDGEMENT AND EXPERIENCE, 100% OF SELF-PAY ACCOUNT BALANCES ARE RECORDED AS PRICE CONCESSIONS. SCHEDULE H, PART III, LINE 4 SOUTHWELL HAS ARRANGEMENTS WITH THIRD-PARTY PAYORS THAT PROVIDE FOR PAYMENTS TO SOUTHWELL AT AMOUNTS DIFFERENT FROM ESTABLISHED RATES. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, SOUTHWELL RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES, SUBJECT TO CERTAIN DISCOUNTS AND IMPLICIT PRICE CONCESSIONS AS DETERMINED BY SOUTHWELL. SOUTHWELL DETERMINES THE TRANSACTION PRICE BASED ON STANDARD CHARGES FOR SERVICES PROVIDED, REDUCED BY CONTRACTUAL ADJUSTMENTS PROVIDED TO THIRD- PARTY PAYORS, DISCOUNTS PROVIDED TO UNINSURED PATIENTS IN ACCORDANCE WITH SOUTHWELL'S POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED TO UNINSURED PATIENTS. IMPLICIT PRICE CONCESSIONS REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED AND THE ESTIMATED CONSIDERATION SOUTHWELL EXPECTS TO RECEIVE FROM PATIENTS, WHICH ARE DETERMINED BASED ON HISTORICAL COLLECTION EXPERIENCE, CURRENT MARKET CONDITIONS, AND OTHER FACTORS. SOUTHWELL DETERMINES ITS ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS BASED ON CONTRACTUAL AGREEMENTS, DISCOUNT POLICIES, AND HISTORICAL EXPERIENCE. SEE FOOTNOTES 2 AND 3 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR ADDITIONAL INFORMATION REGARDING UNCOMPENSATED CARE. 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 RESIDENTS AT BELOW MEDICARE'S COMPUTATION OF COSTS PROVIDES NECESSARY LOCAL CARE FOR A SEGMENT OF THE POPULATION THAT CONSTITUTES A CHARITABLE CLASS. SCHEDULE H, PART III, LINE 9B PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY ("FAP") RECIEVE A 100% DISCOUNT. THERE ARE NO COLLECTION ACTIVITIES FOR QUALIFYING FAP-ELIGIBLE PATIENTS. SCHEDULE H, PART VI, LINE 2 AS A GOVERNMENTAL ORGANIZATION OPERATED PURSUANT TO GEORGIA HOSPITAL AUTHORITIES LAW PRIOR TO MARCH 1, 2019, THE HOSPITAL WAS NOT SUBJECT TO THE PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(R). NEVERTHELESS, THE HOSPITAL AUTHORITY CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2014 AN 2017 FOR ITS TIFTON CAMPUS. IN ADDITION, AS PART OF THE STRATEGIC PLANNING PROCESS FOR EACH CAMPUS, COMMUNITY INPUT RELATED TO HEALTH NEEDS IS RECEIVED FROM A VARIETY OF SOURCES, INCLUDING PHYSICIANS, NURING STAFF AND COMMUNITY MEMBERS. SCHEDULE H, PART VI, LINE 3 THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY ("FAP"), PLAIN LANGUAGE SUMMARY AND FINANCIAL ASSISTANCE APPLICATION ARE AVAILABLE ONLINE AND UPON REQUEST AT THE 2 HOSPITAL CAMPUSES (TRMC AND SOUTHWELL MEDICAL). A PLAIN LANGUAGE SUMMARY OF THE FAP IS OFFERED TO EACH PATIENT UPON ADMISSION AND SIGNAGE IS POSTED THROUGHOUT BOTH CAMPUSES REGARDING THE FAP. SCHEDULE H, PART VI, LINE 4 TIFT REGIONAL HEALTH SYSTEM, INC. SERVES A 12-COUNTY AREA OF SOUTHWEST GEORGIA WHICH HAS A TOAL POPULATION IN EXCESS OF A QUARTER OF A MILLION RESIDENTS. THE POPULATION FOR THE COUNTIES IN THE PRIMARY SERVICE AREA ACCORDING TO THE 2020 CENSUS ARE - TIFT COUNTY (41,344), TURNER COUNTY (9,006) AND COOK COUNTY (17,229). THE 9 COUNTIES IN THE SECONDARY SERVICE AREA INCLUDE ATKINSON, BENHILL, BERRIEN, COFFEE, COLQUITT, CRISP, IRWIN, WILCOX, AND WORTH COUNTIES WHICH HAVE A TOTAL POPULATION OF 191,974. THIS AREA OF GEORGIA HAS MEDIAN AGE SIMILAR TO THE STATE AVERAGE, BUT LOWER MEDIAN HOUSEHOLD INCOMES, LOWER EDUCATIONAL ATTAINEMENT LEVELS AND HIGHER DISABILITY RATES. SCHEDULE H, PART VI, LINE 5 TIFT REGIONAL HEALTH SYSTEM, INC. IS GOVERNED BY AN INDEPENDENT BOARD OF DIRECTORS COMPRISED OF COMMUNITY REPRESENTATIVES. THE ORGANIZATION IS A NOT-FOR-PROFIT ORGANIZATION UNDER GEORGIA LAW AND A TAX-EXEMPT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ANY EXCESS REVENUES OVER EXPENSES ARE REINVESTED INTO SERVING THE HEALTHCARE NEEDS OF THE COMMUNITY. TIFT REGIONAL MEDICAL CENTER ("TRMC") IS 181-BED REGIONAL REFERRAL HOSPITAL THAT OPERATES AN EMERGENCY ROOM 24/7/365. SOUTHWELL MEDICAL IS A NON-SEPARATELY LICENSED 60-BED HOSPITAL CAMPUS OF TRMC. THIS FACILITY INCLUDES 12 GERIATRIC PSYCHIATRIC BEDS. A 95-BED SKILLED NURSING FACILITY (SOUTHWELL HEALTH & REHABILITATION) IS ALSO LOCATED ON THIS CAMPUS. TRMC, SOUTHWELL MEDICAL AND SOUTHWELL HEALTH & REHABILITATION PARTICIPATE IN THE MEDICARE AND MEDICAID PROGRAMS. TIFT REGIONAL HEALTH SYSTEM TREATS ALL PATIENTS IN A NONDISCRIMINATORY MANNER WITHOUT REGARD TO THEIR ABILITY TO PAY FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THE MEDICAL STAFF OF THE HOSPITAL IS OPEN TO ALL PROPERLY CREDENTIALED QUALIFIED PHYSICIANS. SCHEDULE H, PART VI, LINE 6 TIFT REGIONAL HEALTH SYSTEM, INC. OPERATES TIFT REGIONAL MEDICAL CENTER, A 181-BED REGIONAL REFERRAL HOSPITAL LOCATED IN TIFTON, GEORGIA, AND SOUTHWELL MEDICAL (FORMERLY COOK MEDICAL CENTER), A 60-BED NONSEPARATELY LICENSED HOSPITAL CAMPUS OF TRMC (INCLUDING 12 GERIATRIC PSYCHIATRIC BEDS) AND A 95-BED SKILLED NURSING FACILITY. TIFT REGIONAL MEDICAL CENTER FOUNDATION, INC. IS A TAX-EXEMPT ORGANIZATION RESPONSIBLE FOR FUNDRAISING EFFORTS BENEFITTING TIFT REGIONAL HEALTH SYSTEM, INC. SOUTHWELL AMBULATORY, INC. IS A NONPROFIT ORGANIZATION THAT PROVIDES SPECIALTY PHYSICIAN AND OTHER MEDICAL SERVICES. ITS EXEMPTION APPLICATION IS PENDING IRS APPROVAL. SOUTHWELL, INC. SERVES AS THE PARENT ORGANIZATION. IT IS A TAX-EXEMPT ORGANIZATION RESPONSIBLE FOR STRATEGIC AND FINANCIAL PLANNING FOR THE VARIOUS MEMBERS OF THE MULTI-ENTITY HEALTHCARE PROVIDER SYSTEM. TIFT ENTERPRISES, INC. IS A FOR-PROFIT SUBSIDIARY OF SOUTHWELL, INC. IT SERVES AS A HOLDING COMPANY FOR CERTAIN INVESTMENTS AND PROVIDES LIMITED MANAGEMENT SERVICES. SCHEDULE H, PART VI, LINE 7 GEORGIA true ABAC FOUNDATION 2802 MOORE HIGHWAY BOX 13 TIFTON GA 31793 586073263 501C3 18680 EDUCATION AMERICAN KIDNEY FUND 11921 ROCKVILLE PIKE SUITE 300 ROCKVILLE MD 20852 237124261 501C3 32616 FINANICAL SUPPORT 2 SCHEDULE I, PAGE 1, PART I, LINE 2 GRANTS ARE MADE TO CHARITABLE, TAX-EXEMPT ORGANIZATIONS. X X X X X false false false false false false false false false ANTHONY BURKE MD PHYSICIAN 811577 708090 525 14250 12000 1546442 EDWARD HELLMAN MD PHYSICIAN 1112651 311004 966 14250 12000 1450871 WILLIAM KAISER MD PHYSICIAN 1104357 20133 1806 14250 12000 1152546 DAVID BANKS MD PHYSICIAN 903592 184792 1806 14250 12000 1116440 GEORGE YARED MD PHYSICIAN 898283 158780 1806 14250 12000 1085119 FORTE MCEACHIN MD EXEC. MEDICAL DIR. 911644 52925 966 14250 12000 991785 CHRISTOPHER DORMAN CEO & PRESIDENT 636488 210147 26834 19875 13127 906471 JESSICA BEIER MD TRUSTEE/PHYSICIAN 685903 61692 630 14250 12000 774475 RUBAL PATEL MD TRUSTEE/PHYSICIAN 636933 50000 630 14250 12000 713813 KAREN D SUMMERLIN SVP GENERAL COUNSEL 466003 112617 26009 14250 13771 632650 CAMERON NIXON MD CHIEF TRANSFORMATION 479386 52925 28219 13969 12000 586499 KIM WILLS SVP CFO 355800 84540 55968 14250 12000 522558 CAROL SMITH SVP CNO 292076 70114 17212 12372 12000 403774 CLAIRE BYRNES SVP AMBULATORY SERV. 219969 52692 15188 10579 12000 310428 LINDA WILSON VP REVENUE CYCLE 203778 29382 5334 10189 12000 260683 JAMES SCOTT MD TRUSTEE/PHYSICIAN 228474 4390 7931 6986 12000 259781 JUSTIN BECK CHIEF STRATEGY & INN 206995 20000 630 10350 12000 249975 MARIE ROOF VP CIP 192225 27687 1806 9361 12000 243079 VYVYAN DEROUEN VP PHYSICIAN SERVICE 185139 26641 742 9257 12000 233779 TONIA GARRETT AVP SURGICAL SERVICE 176477 23643 13316 5071 12000 230507 ALEX LE COO 181212 25834 336 9061 12000 228443 TAMARA BRANCH VP LEGAL COUNSEL 180229 25958 336 9011 12000 227534 JANE MCKEE VP REVENUE CYCLE 149811 29725 1204 7096 12000 199836 SCHEDULE J, PART III TIFT REGIONAL HEALTH SYSTEM, INC. OFFERS A DEFERRED COMPENSATION PLAN TO CERTAIN EXECUTIVES. THE PLAN IS A NONQUALIFIED DEFERRED COMPENSATION ARRANGEMENT ESTABLISHED UNDER INTERNAL REVENUE CODE SECTION 457(F). DURING THE YEAR, NO CONTRIBUTIONS WERE MADE TO OR FOR THE BENEFIT OF ANY OF THE PARTICIPANTS. A 2013 BONDS 586001719 886640HS3 2019-03-01 81326130 FINANCE/REFINANCE ADDITIONS AND IMPROVEMENTS TO HOSPITAL FACILITY; REFUND OUTSTANDING 2002 BONDS; RE false false false B BANK OF AMERICA 586001719 NONENONEN 2019-03-01 31862844 ACQUISITION, INSTALLATION AND IMPLEMENTATION OF EMR SYSTEM. false false false A 8872703 68380000 4073427 2017 true false false true B 10619294 21243550 2017 true false false true A false false false false false false true B false false false false false false true A false false false true false false false false true B false false true false false false false false true A false B false PURPOSE OF ISSUE DESCRIPTION 2013 BONDS FINANCE/REFINANCE ADDITIONS AND IMPROVEMENTS TO HOSPITAL FACILITY; REFUND OUTSTANDING 2002 BONDS; REPAY A BANK LOAN; AND PAY ISSUANCE COST OF 2013 BONDS. PURPOSE OF ISSUE DESCRIPTION BANK OF AMERICA ACQUISITION, INSTALLATION AND IMPLEMENTATION OF EMR SYSTEM. DATE REBATE COMPUTATION PERFORMED 2013 BONDS 01/17/18 JAMES HUNTER GARRETT FAMILY MEMBER 61404 COMPENSATION false RYAN BYRNES MD FAMILY MEMBER 168872 COMPENSATION false MARGARET RICHARDSON-NIXON MD FAMILY MEMBER 388606 COMPENSATION false SCHEDULE L, PART V THE 3 INDIVIDUALS IDENTIFIED ABOVE ARE RELATIVES OF KEY EMPLOYEES OF TIFT REGIONAL HEALTH SYSTEM. ALL ARE COMPENSATED AT FAIR MARKET VALUE FOR SERVICES PERFORMED. FORM 990, PAGE 2, PART III, LINE 4A TIFT REGIONAL HEALTH SYSTEM (TRHS) IS A GROWING, NOT-FOR-PROFIT HOSPITAL SYSTEM. ITS MAIN CAMPUS SERVES 12 COUNTIES IN SOUTH CENTRAL GEORGIA. TRHS OFFERS MORE THAN 135 PHYSICIANS WITH EXPERTISE IN OVER 30 SPECIALTIES. TRHS PROVIDES A WIDE RANGE OF CARE, INCLUDING SIGNATURE SERVICES IN SURGERY, ONCOLOGY, CARDIOVASCULAR CARE, WOMEN'S HEALTH, NEURODIAGNOSTICS, GERIATRIC PSYCHIATRIC CARE, RADIOLOGY AND MORE. THE MAIN CAMPUS IS TIFT REGIONAL MEDICAL CENTER (TRMC), A 181-BED REGIONAL REFERRAL HOSPITAL LOCATED IN TIFTON AT 901 EAST 18TH STREET. TRMC'S WEST CAMPUS, LOCATED IN TIFTON AT 2225 HIGHWAY 41 NORTH, IS AN OUTPATIENT FACILITY WHICH HOUSES VARIOUS DIAGNOSTIC SERVICES AND THE REGION'S LARGEST MULTI-SPECIALTY PRACTICE. A 3RD CAMPUS OF TRMC IS IN ADEL, GA. SOUTHWELL MEDICAL IS A 60-BED HOSPITAL (THAT IS NOT SEPARATELY LICENSED) INCLUDING A 12-BED GERIATRIC PSYCHIATRIC UNIT. A 95-BED SKILLED NURSING FACILITY, SOUTHWELL HEALTH & REHABILITATION, ALSO IS LOCATED ON THE SOUTHWELL MEDICAL CAMPUS. FORM 990, PAGE 6, PART VI, LINE 6 SOUTHWELL, INC. IS THE SOLE MEMBER OF TIFT REGIONAL HEALTH SYSTEM, INC. SOUTHWELL IS A TAX-EXEMPT ORGANIZATION AS DESCRIBED IN INTERNAL REVENUE CODE SECTION 501(C)(3). FORM 990, PAGE 6, PART VI, LINE 7A ALL APPOINTMENTS TO THE BOARD OF DIRECTORS ARE FILLED BY THE REMAINING MEMBERS OF THE BOARD SUBJECT TO THE APPROVAL OF SOUTHWELL, INC. IN ADDITION, A DIRECTOR MAY BE REMOVED AT ANY TIME, WITH OR WITHOUT CAUSE, SUBJECT TO THE APPROVAL OF SOUTHWELL, INC. FORM 990, PAGE 6, PART VI, LINE 7B SOUTHWELL, INC. IS THE SOLE MEMBER OF TIFT REGIONAL HEALTH SYSTEM, INC. ("TRHS"). THE FOLLOWING ACTIONS CANNOT BE TAKEN WITHOUT THE APPROVAL OF THE MEMBER: 1) FILL VACANCIES IN, NOMINATE AND APPROVE THE ELECTION OF AND APPROVE OR DIRECT THE REMOVAL OF DIRECTORS OF TRHS; 2) APPROVE ALL AMENDMENTS, MODIFICATIONS, RESTATEMENTS AND ALTERATIONS OF TRHS'S ARTICLES OF INCORPORATION OR BYLAWS; 3) APPROVE MERGERS, CONSOLIDATIONS, ACQUISITIONS, JOINT VENTURES, AFFILIATIONS OR ANY OTHER REORGANIZATION OF TRHS; 4) APPROVE THE SALE, TRANSFER, LONG-TERM LEASE, LONG-TERM ENCUMBRANCE, MORTGAGE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL ASSETS OF TRHS AND OF ANY REAL PROPERTY OWNED BY TRHS; 5) APPROVE ANY PLAN OF DISSOLUTION; 6) APPROVE AND DETERMINE THE DISTRIBUTION OF ASSETS OF THE CORPORATION UPON DISSOLUTION OF TRHS SUBJECT TO ARTICLE V OF THE TRHS'S ARTICLES OF INCORPORATION; 7) ADD OR REMOVE MEMBERS OF TRHS; 8) APPROVE ANY MATERIAL INCURRENCE OF DEBT THAT REQUIRES AN ADDENDUM TO THE MASTER TRUST INDENTURE, EXCLUDING CAPITAL LEASES OF LESS THAN 1,000,001; 9) APPOINT OR REMOVE THE CHAIR OF THE BOARD OF DIRECTORS OF TRHS; 10) APPROVE THE ANNUAL BUDGET OF TRHS; 11) SELECT THE AUDITOR FIRM FOR TRHS AND APPROVE THE ANNUAL AUDIT PERFORMED BY SUCH FIRM; 12) APPROVE CAPITAL EXPENDITURES BY TRHS OF 1,000,001 OR GREATER; 13) APPROVE SCOPE OF SERVICES PROVIDED BY TRHS; 14) APPOINT OR REMOVE THE PRESIDENT/CEO OF TRHS; AND 15) APPROVE ANY AMENDMENT TO THE LEASE BETWEEN THE HOSPITAL AUTHORITY OF TIFT COUNTY AND TRHS. FORM 990, PAGE 6, PART VI, LINE 9 RUBAL PATEL, MD FORM 990, PAGE 6, PART VI, LINE 11B FORM 990 IS PREPARED BY AN INDEPENDENT CERTIFIED PUBLIC ACCOUNTANT FROM INFORMATION PROVIDED BY MANAGEMENT AND FROM AUDITED FINANCIAL STATEMENTS. AFTER THE RETURN IS PREPARED AND PRIOR TO FILING WITH THE IRS, THE RETURN IS REVIEWED IN DETAIL BY SENIOR FINANCIAL MANAGEMENT. A COPY OF THE RETURN IS THEN MADE AVAILABLE TO ALL BOARD MEMBERS PRIOR TO FILING. FORM 990, PAGE 6, PART VI, LINE 12C TRHS ANNUALLY DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE TO EACH MEMBER OF THE BOARD OF DIRECTORS. BOARD MEMBERS MUST DISCLOSE ANY POTENTIAL CONFLICTS. ANY BOARD MEMBER WITH A POTENTIAL CONFLICT MUST RECUSE THEMSELVES FROM THE MEETING AT WHICH THE POTENTIAL CONFLICT IS DISCUSSED. ONLY NON-CONFLICTED MEMBERS MAY DECIDE TO PURSUE A TRANSACTION INVOLVING A CONFLICT IF A MAJORITY OF THE REMAINING MEMBERS DETERMINE THE TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST. VIOLATION OF THE COI POLICY IS SUBJECT TO CORRECTIVE ACTION. FORM 990, PAGE 6, PART VI, LINE 15A THE TIFT REGIONAL HEALTH SYSTEM, INC.("TRHS") BOARD OF DIRECTORS HAS APPOINTED A COMMITTEE OF INDEPENDENT, CONFLICT-FREE BOARD MEMBERS TO DEVOTE THEIR TIME AND ATTENTION TO THE OVERSIGHT OF TRHS'S EXECUTIVE COMPENSATION PROGRAMS. THE COMMITTEE ANNUALLY RETAINS INDEPENDENT ADVISORS (INCLUDING HEALTH CARE COMPENSATION CONSULTANTS) TO PROVIDE THIRD-PARTY INFORMATION AND ADVICE, TO ENSURE EXECUTIVE COMPENSATION IS REASONABLE WHEN COMPARED TO THE PRACTICES OF OTHER SIMILARLY SITUATED ORGANIZATIONS, AND THAT THE PROGRAM HAS SIGNIFICANT AND APPROPRIATE COMPENSATION THAT IS SUBJECT TO MEETING ORGANIZATIONAL AND INDIVIDUAL GOALS (TO ENSURE THE ALIGNMENT OF PAY AND PERFORMANCE). COMPENSATION IS APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD, WHO ARE INDEPENDENT WITH NO FINANCIAL INTEREST IN THE COMPENSATION THEY REVIEW AND APPROVE. INCENTIVE BASED COMPENSATION IS CALCULATED BASED ON ACHIEVEMENTS AGAINST GOALS AND METRICS THAT WERE PRE-APPROVED BY THE BOARD. THE GOALS AND METRICS SPAN TRHS'S FIVE PILLARS OF SERVICE: QUALITY, FINANCE, PEOPLE, GROWTH AND COMMUNITY. THE PERFORMANCE PAY PLAN IS INTENDED TO REWARD EXECUTIVES FOR EXEMPLARY PERFORMANCE AND TO BE PART OF A COMPETITIVE TOTAL COMPENSATION PACKAGE. TOTAL COMPENSATION (INCLUDING THE PERFORMANCE PAY PLAN) IS DETERMINED TO BE REASONABLE AND STRICTLY COMPLIANT WITH ALL RULES AND REGULATIONS THAT GOVERN EXECUTIVE PAY AT A TAX-EXEMPT ORGANIZATION LIKE TRHS. FORM 990, PAGE 6, PART VI, LINE 15B SEE THE RESPONSE TO QUESTION 15A ABOVE. FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS ARE FILED WITH AND AVAILABLE ON THE GEORGIA SECRETARY OF STATE WEBSITE OR THROUGH THAT OFFICE. GOVERNING DOCUMENTS CAN ALSO BE OBTAINED BY CONTACTING TRHS. TRHS IS UNDER OBLIGATION TO DISCLOSE TO BOND HOLDERS PERTINENT FINANCIAL INFORMATION. A PUBLIC INSPECTION COPY OF FORM 990 IS AVAILABLE UPON REQUEST AND UPON THE TRHS WEBSITE. FORM 990, PART XI, LINE 9 GAIN ON DEBT DISTINGUISHMENT 298,857 EQUITY TRANSFER TO SOUTHWELL, INC. -8,970,541 BOOK TAX DIFFERENCE IN INCOME FROM SUBSIDIARY -31,161 TOTAL -8,702,845 CARE ALLIANCE PO BOX 2650 TIFTON GA 31793 474357229 ACO GA 10000 TRHS SOUTHWELL INC PO BOX 2650 TIFTON GA 31793 581772605 PARENT GA 501C3 12C NA false SOUTHWELL AMBULATORY INC PO BOX 2650 TIFTON GA 31793 843430446 MED. SVCS. GA 501C3 3 SOUTHWELL false TIFT REGIONAL MEDICAL CENTER FND PO BOX 747 TIFTON GA 31793 581705285 FUNDRAISIN GA 501C3 12D NA false TIFT ENTERPRISES INC PO BOX 747 TIFTON GA 31793 581986064 HOLDING CO GA N/A false false true true false false false false false false false false false false true true false false false false