2022-11-15T09:33:56-05:00 2021-12-31 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2021-01-01 581734026 UPSON COUNTY HOSPITAL INC UPSO 7066478111 801 WEST GORDON STREET THOMASTON GA 302860027 JOHN WILLIAMS CFO/COO 7066478111 2022-11-13 true JOHN WILLIAMS 999009999 WILLIAM EDWARD PHILLIPS P00451499 2298837878 2022-11-15 2021 2022-09-23 18:48:47Z UPSON REGIONAL MEDICAL CENTER JEFF TARRANT 801 WEST GORDON ST THOMASTON GA 30286 140063366 false X WWW.URMC.ORG X 1951 GA UPSON REGIONAL MEDICAL CENTER'S MISSION IS TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE SURROUNDING AREA, REGARDLESS OF THE ABILITY TO PAY. 8 7 1006 39 379197 11511509 4430082 87466522 112666274 9699344 14150185 1759661 690236 110437036 131936777 17260 19613 0 50825438 54646990 0 0 47078205 55521975 97920903 110188578 12516133 21748199 231951132 251563523 16727453 16371225 215223679 235192298 UPSON REGIONAL MEDICAL CENTER'S MISSION IS TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE SURROUNDING AREA, REGARDLESS OF THE ABILITY TO PAY. false false 91862494 19613 UPSON REGIONAL MEDICAL CENTER OFFERS A COMPLETE LINE OF MEDICAL SERVICES INCLUDING 24-HOUR EMERGENCY CENTER, MEDICAL-SURGICAL CARE, OBSTETRICS, PEDIATRICS, WOMEN'S HEALTH SERVICES, AND MORE. PATIENT DAYS FOR THE YEAR TOTALED 18,226 IN 2021. THE PSYCH UNIT HAD 5,156 VISITS WHILE THE RURAL HEALTH CLINIC EXPERIENCED 4,358 VISITS IN 2021. 78053 78053 91940547 true true false true false false false false false false true false false false true true false true false false true false false false false false true true false true true true false false false false false false false false false false false false false false true true false false false true 164 0 1006 true true true true CJ false false false false false false false false false false X 8 7 false true false false false false false true true false false true true true true true true true true false GA X X JOHN WILLIAMS 7066478111 801 WEST GORDON STREET THOMASTON GA 302860227 BRANDON M BOYCE MD ORTHOPEDIC S 40.00 X 1048086 0 27895 KEVIN A GINGRICH MD ORTHOPEDIC S 40.00 X 643618 0 17376 DARRYL KNIGHT MD SURGEON 40.00 X 609473 0 40977 DANIEL A BRIDGES MD UROLOGY SURG 40.00 X 608128 0 20493 ROBERT SOLYOMVARI MD SURGEON 40.00 X 563574 0 40977 JEFF TARRANT HOSPITAL CEO 40.00 1.00 X 483075 0 0 BENJAMIN WILLIAMS MD BOARD MEMBER 40.00 0.25 X 412925 0 14274 JOHN WILLIAMS CFO/COO 40.00 1.00 X 297123 0 20457 MARK ANDREWS BOARD MEMBER 0.75 0.20 X 0 0 0 SCOTT BLACKSTOCK BOARD MEMBER 0.75 0.20 X 0 0 0 JIM EDWARDS VICE CHAIRMA 0.75 0.20 X X 0 0 0 WILLIAM HIGHTOWER IV CHAIRMAN 0.75 0.20 X X 0 0 0 STEVE KEADLE ASSISTANT SE 0.75 0.20 X X 0 0 0 RALPH WARNOCK MD SECRETARY 0.75 0.20 X X 0 0 0 KAY SEARCY BOARD MEMBER 0.75 0.20 X 0 0 0 4666002 182449 80 false true false CARDIOSOLUTION PHYSICIANS 125 S PARK DR SUITE F BROWNWOOD TX 76801 2790543 GUARDIAN MEDICAL SERVICES LLC 1001 JENKINS RD FORSYTH GA 31029 ANESTHESIA 2183472 INNOVATIVE THERAPY CONCEPTS LLC 2 MASHBURN ST SUITE 102 HAWKINSVILLE GA 31036 PHYSICAL THER 1405037 SODEXO INC & AFFILIATES P O BOX 360170 PITTSBURGH PA 15251 FOOD SERVICE 1208074 HORIZON MENTAL HEALTH MANAGEMENT 350 N GRANDVIEW AVE DUBUQUE IA 520016388 1100000 25 4225957 204125 4430082 NET PATIENT SERVICE REVENUE 621990 112287077 112287077 713940 361557 361557 CATERING SALES 722320 17640 17640 112666274 10976043 10976043 11300731 8126589 3174142 3174142 3174142 DISCOUNTS AND REBATES 621990 259283 259283 COMPUTER FEE 621990 205407 205407 MEANINGFUL USE & INCENTIVE 561499 90455 90455 135091 135091 690236 131936777 115946048 379197 11181450 X 19613 19613 1227856 1227856 44320178 38626191 5693987 589043 494678 94365 5327797 4474284 853513 3182116 2672341 509775 534193 220383 313810 80671 80671 177443 177443 71915 71915 16876430 13641899 3234531 318225 318225 2364590 1596498 768092 2883127 636795 2246332 2221782 1996049 225733 155790 130064 25726 4544 4544 7614366 6848677 765689 573973 482907 91066 MEDICAL SUPPLIES 17300005 17300005 REPAIRS & MAINTENANCE 2213218 1423516 789702 PROVIDER FEES 1128321 1128321 RECRUITMENT 552624 552624 450758 248326 202432 110188578 91940547 18248031 0 6202 8058 9941427 13517896 13229989 16873676 236655 579727 2916339 2936209 1723375 1868023 150816271 101017757 52035897 49798514 147902512 160296792 1639203 1639203 2319533 4045425 231951132 251563523 9456843 9731068 2171979 2327204 4300000 3290000 798631 1022953 16727453 16371225 X 215223679 235192298 215223679 235192298 231951132 251563523 21748199 -1779580 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 11646 11646 false SCHEDULE C, PART II-B, LINE 1 THE ORGANIZATION PAYS ANNUAL DUES TO NATIONAL AND STATE INDUSTRY ORGANIZATIONS. A PORTION OF THOSE DUES ARE ATTRIBUTABLE TO THE LOBBYING ACTIVITIES OF THESE ORGANIZATIONS FOR THE BENEFIT OF THEIR MEMBERS. 1856656 1856656 72337911 44876129 27461782 903685 821454 82231 72981286 55320174 17661112 2736733 2736733 49798514 ESTIMATED THIRD PARTY SETTLEMENTS 1259895 DUE TO RELATED PARTIES -236942 1022953 X SCHEDULE D, PAGE 3, PART X THE HOSPITAL AND FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AND ARE TAX- EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE SEGREGATED PORTFOLIO INTENDS TO CONDUCT ITS AFFAIRS IN A MANNER IN WHICH IT WILL NOT BE SUBJECT TO U.S. FEDERAL INCOME TAX OR GEORGIA INCOME TAX. THE REMAINING WHOLLY OWNED SUBSIDIARIES ARE CONSIDERED DISREGARDED ENTITIES AND ARE INCLUDED IN THE HOSPITAL'S TAX FILINGS. THEREFORE, NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPITAL AND FOUNDATION 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, THE HOSPITAL AND FOUNDATION ONLY RECOGNIZE 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 SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF DECEMBER 31, 2021 AND 2020 OR FOR THE YEARS THEN ENDED. THE HOSPITAL AND FOUNDATION'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. false CENTRAL AMERICA & THE CARIBBEAN 1 INVESTMENTS 4217626 1 1 4217626 4217626 true false true false false false SCHEDULE F, PAGE 1, PART I, LINE 3 CENTRAL AMERICA & THE CARIBBEAN 4,217,626 0 true true X true X 1.250000000000 true X true true false false 3614623 3614623 0.03280 12720273 11178310 1541963 0.01400 115319 56256 59063 0.00050 16450215 11234566 5215649 0.04730 8867 8867 0.00010 240448 240448 0.00220 19577506 11168655 8408851 0.07630 19826821 11168655 8658166 0.07860 36277036 22403221 13873815 0.12590 3000 3000 363555 363555 0.00330 366555 366555 0.00330 false 20266416 10133209 18476167 16682307 1793860 X true true 1 1 UPSON COUNTY HOSPITAL 801 WEST GORDON STREET THOMASTON GA 30286 WWW.URMC.ORG 145-415 X X X WELLNESS CTR, PHYS OFC, PSYCH UPSON COUNTY HOSPITAL 1 false false true X X X X X X X X X X 21 true false false true X WWW.URMC.ORG X true 22 true WWW.URMC.ORG false false true X 125.000000000000 300.000000000000 true true X X X X X true X WWW.URMC.ORG X WWW.URMC.ORG X WWW.URMC.ORG X X X X X true X false X X X X X true X false false FACILITY 1, UPSON COUNTY HOSPITAL - PART V, LINE 3E THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IS IDENTIFIED AND THE METHODOLOGY FOR PRIORITIZING EACH NEED IS DESCRIBED ON PAGE 39 OF THE 2021 CHNA. FACILITY 1, UPSON COUNTY HOSPITAL - PART V, LINE 5 UPSON SELECTED A GEOGRAPHIC SERVICE AREA DEFINITION. THIS DEFINITION WAS BASED UPON THE HOSPITALS PRIMARY SERVICE AREA IN A MANNER THAT INCLUDED THE BROAD INTERESTS OF THE COMMUNITY SERVED AND INCLUDED MEDICALLY UNDERSERVED POPULATIONS, LOW-INCOME PERSONS, MINORITY GROUPS, OR THOSE WITH CHRONIC DISEASE NEEDS. UPSON COUNTY WAS SELECTED AS THE COMMUNITY FOR INCLUSION IN THE CHNA. UPSON IDENTIFIED COMMUNITY LEADERS, PARTNERS, AND REPRESENTATIVES TO INCLUDE IN THE CHNA PROCESS. INDIVIDUALS, AGENCIES, PARTNERS, POTENTIAL PARTNERS, AND OTHERS WERE REQUESTED TO WORK WITH THE HOSPITAL TO 1) ASSESS THE NEEDS OF THE COMMUNITY, 2) REVIEW AVAILABLE COMMUNITY RESOURCES AND 3) PRIORITIZE THE HEALTH NEEDS OF THE COMMUNITY. GROUPS OR INDIVIDUALS, WHO REPRESENT MEDICALLY-UNDERSERVED POPULATIONS, LOW INCOME POPULATIONS, MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASES WERE INCLUDED. COMMUNITY STAKEHOLDERS (ALSO CALLED KEY INFORMANTS) ARE PEOPLE INVESTED OR INTERESTED IN THE WORK OF THE HOSPITAL, PEOPLE WHO HAVE SPECIAL KNOWLEDGE OF HEALTH ISSUES, PEOPLE IMPORTANT TO THE SUCCESS OF ANY HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT OR HEALTH PROJECT, OR ARE FORMAL OR INFORMAL COMMUNITY LEADERS. THE HOSPITAL IDENTIFIED 24 COMMUNITY MEMBERS TO PARTICIPATE IN THE STAKEHOLDER INTERVIEWS. FACILITY 1, UPSON COUNTY HOSPITAL - PART V, LINE 11 INFORMATION GATHERED FROM COMMUNITY-WIDE SURVEYS, STAKEHOLDER INTERVIEWS, DISCUSSIONS WITH THE HOSPITAL LEADERSHIP TEAM, REVIEW OF DEMOGRAPHIC AND HEALTH STATUS DATA, AND HOSPITAL UTILIZATION DATA WAS USED TO DETERMINE THE PRIORITY HEALTH NEEDS OF THE POPULATION. URMC PROVIDED A WRITTEN REPORT OF THE OBSERVATIONS, COMMENTS, AND PRIORITIES RESULTING FROM THE STAKEHOLDER INTERVIEWS. THE LEADERSHIP TEAM REVIEWED THIS INFORMATION, FOCUSING ON THE IDENTIFIED NEEDS, PRIORITIES, AND CURRENT COMMUNITY RESOURCES AVAILABLE. LEADERSHIP DEBATED THE MERITS AND VALUES OF THESE PRIORITIES, AND CONSIDERED THE RESOURCES AVAILABLE TO MEET THESE NEEDS. FROM THIS INFORMATION AND DISCUSSIONS, THE HOSPITAL DEVELOPED THE PRIORITY NEEDS OF THE COMMUNITY, EACH OF WHICH ARE ADDRESSED SEPARATELY IN THE HOSPITALS IMPLEMENTATION STRATEGY DOCUMENT. BOTH THE 2021 CHNA AND 2022 IMPLMENTATION STRATEGY DOCUMENTS ARE LOCATED AT THE FOLLOWING WEB ADDRESS: HTTPS://URMC.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT FACILITY 1, UPSON COUNTY HOSPITAL - PART V, LINE 15E INFORMATION IS MAILED TO ALL PATIENTS ON EACH STATEMENT AS LONG AS A BALANCE IS OUTSTANDING. IT IS AVAILABLE ON THE HOSPITAL WEBSITE AND AT ANY ENTRANCE POINT OF THE HOSPITAL. FACILITY 1, UPSON COUNTY HOSPITAL - PART V, LINE 20E ECA WILL NOT BEGIN UNTIL AFTER 240 DAYS. 8 UPSON MEDICAL ASSOCIATES LLC 801 W GORDON ST THOMASTON GA 30286 PHYSICIANS OFFICE UPSON REGIONAL WELLNESS CENTER LLC 801 W GORDON ST THOMASTON GA 30286 WELLNESS CENTER ORTHOPEDICS SPORTS MEDICINE & SURG 801 W GORDON ST THOMASTON GA 30286 PHYSICIANS OFFICE UPSON WOMEN'S SERVICES LLC 801 W GORDON ST THOMASTON GA 30286 PHYSICIANS OFFICE UPSON FAMILY PHYSICIANS LLC 801 W GORDON ST THOMASTON GA 30286 PHYSICIANS OFFICE UPSON SURGICAL ASSOCIATES LLC 801 W GORDON ST THOMASTON GA 30286 PHYSICIANS OFFICE UPSON FAMILY MEDICAL CENTER 801 W GORDON ST THOMASTON GA 30286 FAMILY MEDICAL CENTER URMC PSYCH UNIT 801 W GORDON ST THOMASTON GA 30286 PSYCHIATRIC UNIT SCHEDULE H, PART I, LINE 7G SUBSIDIZED HEALTH SERVICE COSTS INCLUDE THOSE ATTRIBUTABLE TO UPSON MEDICAL ASSOCIATES, UPSON WOMEN'S SERVICES, UPSON SURGICAL ASSOCIATES, ORTHOPEDIC SPORTS MEDICINE, AND UPSON FAMILY PHYSICIANS TOTALING 21,740,975. THESE CLINICS PROMOTE HEALTH CARE FOR UNDERSERVED POPULATIONS IN THE AREA. SCHEDULE H, PART I, LINE 7 THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATION'S "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS, 2008". FOR LINE 7A, COSTS WERE CALCULATED USING THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 AS PROVIDED IN THE IRS INSTRUCTIONS. SUBSIDIZED HEALTH SERVICES PRESENTED ON LINE 7G WERE BASED ON ACTUAL COSTS PER THE MEDICARE COST REPORT NET OF ASSOCIATED BAD DEBT, CHARITY AND MEDICAID EXPENSE. ALL OTHER COSTS PRESENTED IN THE TABLE WERE ACCUMULATED THROUGH THE COMMUNITY BENEFITS SOFTWARE CBISA. SCHEDULE H, PART II HEALTH PROFESSIONALS RECRUITMENT AND LOCAL CHAMBER/CIVIC SPONSORSHIPS. SCHEDULE H, PART III, LINE 2 BAD DEBT EXPENSE AMOUNT REPRESENTS THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT AND WRITTEN OFF TO BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 3 THE FIGURE ON PART III LINE 3 REPRESENTS MANAGEMENT'S ESTIMATE (APPROXIMATELY 50%) BASED ON AN ANALYSIS OF SELF PAY PATIENTS' ABILITY TO PAY THEIR OUTSTANDING ACCOUNT. THIS ANALYSIS INCLUDES REVIEWING THE PATIENT'S CREDIT HISTORY, INCOME LEVELS AND OVERALL COLLECTIBILITY OF THE ACCOUNT. SCHEDULE H, PART III, LINE 4 THE FOOTNOTE DISCUSSING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND BAD DEBTS (IMPLICIT PRICE CONCESSIONS) CAN BE FOUND ON PAGES 12-14 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, LINE 8 MEDICARE COSTS REFLECT ALLOWABLE COSTS PER THE MEDICARE COST REPORT USING ACCEPTABLE ALLOCATIONS OF INDIRECT COSTS BASED ON APPROPRIATE STATISTICS. SCHEDULE H, PART III, LINE 9B ACCOUNTS KNOWN TO HAVE QUALIFIED FOR FINANCIAL ASSISTANCE ARE WRITTEN OFF TO INDIGENT/CHARITY CARE. SCHEDULE H, PART VI, LINE 2 UPSON REGIONAL MEDICAL CENTER (URMC) IS A 115-BED NOT-FOR-PROFIT COMMUNITY HOSPITAL LOCATED IN THOMASTON. GEORGIA. UPSON COMPLETES A TRIENNIAL NEEDS ASSESSMENT. INFORMATION GATHERED FROM STAKEHOLDER INTERVIEWS, COMMUNITY-WIDE SURVEYS, DISCUSSIONS WITH THE HOSPITAL LEADERSHIP TEAM, REVIEW OF DEMOGRAPHIC AND HEALTH STATUS, AND HOSPITAL UTILIZATION DATA IS USED TO DETERMINE THE PRIORITY HEALTH NEEDS OF THE POPULATION. THE FOLLOWING PRIORITIES WERE IDENTIFIED: 1. MENTAL HEALTH 2. ACCESS TO CARE/OBESITY/EDUCATION 3. SUBSTANCE ABUSE 4. OBESITY AND CHRONIC DISEASES 5. POVERTY 6. TEEN PREGNANCY SCHEDULE H, PART VI, LINE 3 URMC INFORMS AND EDUCATES THE PATIENTS USING THE FOLLOWING PROCESSES: THE FINANCIAL ASSISTANCE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IS POSTED IN THE ADMISSION AREAS, EMERGENCY DEPARTMENTS AND OTHER AREAS OF THE FACILITY IN WHICH ELIGIBLE PATIENTS ARE PRESENT. A COPY OF THE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IS PROVIDED TO THE PATIENTS AS PART OF THE ADMISSION PROCESS. ADDITIONALLY, THE POLICY IS AVAILABLE ON THE HOSPITAL WEBSITE AS IS THE PRINTABLE APPLICATION. A SUMMARY OF THE POLICY IS ALSO INCLUDED IN THE PATIENT BILLING. WE DISCUSS WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS QUALIFYING FOR MEDICAID OR STATE PROGRAMS AND ASSIST THE PATIENT WITH QUALIFYING FOR SUCH PROGRAMS, WHERE APPLICABLE. WE PROVIDE TRAINING TO THE STAFF ON FINANCIAL ASSISTANCE AND CONTRACT WITH CHAMBERLON & EDMONDS FOR SCREENING OUR PATIENTS FOR MEDICAID ELIGIBILITY AND/OR OTHER SOURCES OF ASSISTANCE. WE ALSO PROVIDE INFORMATION ON THE ADMISSIONS PACKAGE EXPLAINING THE AVAILABILITY, CRITERIA, AND THE PROCESS FOR APPLYING FOR FINANCIAL ASSISTANCE. OUR EFFORTS TO INFORM NON-ENGLISH SPEAKING PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY IS PROVIDED BY AN INTERPRETER THROUGH THE USE OF LANGUAGE LINE, A TELEPHONE INTERPRETATION SERVICE. SCHEDULE H, PART VI, LINE 4 UPSON COUNTY IS LOCATED IN WEST CENTRAL GEORGIA AND HAS A POPULATION OF 26,320. THE RACIAL AND ETHNIC MAKEUP OF UPSON COUNTY IS 68% WHITE, 28% BLACK, 1% MIXED RACE, 2% OTHER, AND 2% HISPANIC ORIGIN. THE PERCENTAGE OF RESIDENTS AGED 55 AND OLDER IS SET TO INCREASE 0.6% BY 2022; THIS IDENTIFIED AN INCREASED NEED FOR DELIVERY OF HEALTHCARE THAT SERVES INDIVIDUALS WITH CHRONIC CONDITIONS. URMC, A REGIONAL HEALTHCARE PROVIDER WITH 115 ACUTE CARE BEDS, SERVES THIS AREA OF GEORGIA. THE HOSPITAL IS LOCATED IN THE COUNTY SEAT OF THOMASTON. SCHEDULE H, PART VI, LINE 5 SINCE 2015, URMC HAS RECRUITED FAMILY PHYSICIANS, A CARDIOLOGIST, UROLOGIST, OBSTETRICIAN, AUDIOLOGIST, ENT, FAMILY PRACTICE, ORTHOPEDIC SURGEON, AND ADVANCED PRACTICE PROFESSIONALS. URMC'S AWARD-WINNING DIETICIANS IMPLEMENT THE QUARTERLY SODEXO COMMUNITY EDUCATION PROGRAMMING AND ACTIVELY PARTICIPATE IN COMMUNITY EVENTS, HEALTH FAIRS, AND IN THE WELLNESS CENTER TO INCREASE AWARENESS OF GOOD EATING HABITS AND THEIR IMPACTS ON HEALTH. URMC ALSO PROVIDES MONTHLY DIABETES EDUCATION ON DISEASE MANAGEMENT AND NUTRITION. IN 2017, URMC WAS DESIGNATED AS A REMOTE STROKE TREATMENT CENTER, PROVIDING TIMELY CONSULTS WITH NEUROLOGISTS. URMC CONSISTENTLY OFFERS BLOOD PRESSURE CHECKS AND EDUCATION AT COMMUNITY EVENTS AND HEALTH FAIRS. IN 2017, URMC OPENED SILVERCARE, AN 18-BED INPATIENT GERIATRIC BEHAVIORAL HEALTH UNIT. IN 2018, URMC OPENED A RURAL HEALTH CLINIC AS WELL AS PURCHASING AN URGENT CARE FACILITY TO IMPROVE ACCESS TO CARE. IN EARLY 2019, URMC RECRUITED A NEW CARDIOLOGIST AS WELL AS A NEW FAMILY MEDICINE PROVIDER. IN LATE 2019, URMC ADDED TWO NEW FAMILY MEDICINE PHYSICIANS, A NEW OB/GYN, A NEW OTHROPEDIC SURGEON, AND A NEW ENT. WE ALSO ADDED SATURDAY HOURS AT ONE OF OUR WALK-IN PRIMARY CARE CLINICS. IN 2020, URMC ESTABLISHED AN INTERVENTIONAL CARDIOLOGY PROGRAM, GIVING URMC THE ABILITY TO PERFORM PROCEDURES (SUCH AS STENTING AND ANGIOPLASTY) TO TREAT COMPLEX HEART CONDITIONS, INCLUDING EMERGENCY TREATMENT OF HEART ATTACKS. URMC RECRUITED A CARDIOLOGIST, FAMILY PRACTICE PHYSICIAN, AND OB/GYN IN 2021. THE GOVERNING BODY IS PRIMARILY COMPRISED OF PERSONS WHO ARE NOT EMPLOYEES, CONTRACTORS (NOR FAMILY MEMBERS THEREOF), AND GENERALLY REPRESENT THE INTERESTS OF THE POPULATION SERVED. THE MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS IN THE REGION. THE EMERGENCY ROOM IS OPEN 24/7, SERVING PATIENTS REGARDLESS OF ABILITY TO PAY. AS A NONPROFIT ORGANIZATION DEDICATED TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES, URMC REINVESTS ALL OF ITS SURPLUS FUNDS FROM ITS OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE ACCESS TO CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS AND ADVANCE MEDICAL TRAINING, EDUCATION AND RESEARCH. SCHEDULE H, PART VI, LINE 7 GEORGIA true EDUCATION SCHOLARSHIP 1 2078 TUITION REIMBURSEMENT 5 17535 SCHEDULE I, PAGE 1, PART I, LINE 2 SCHOLARSHIP ASSISTANCE IS OFFERED TO UPSON COUNTY RESIDENTS AND FULL TIME, PART TIME AND PRN EMPLOYEES PURSUING A HEALTHCARE CAREER. EACH APPLICANT MUST COMPLETE AN APPLICATION; BE ACCEPTED BY AN ACCREDITED SCHOOL IN A HEALTHCARE PROGRAM OF THEIR CHOICE; SUBMIT TWO LETTERS OF RECOMMENDATION, A CERTIFIED COPY OF PREVIOUS EDUCATIONAL TRANSCRIPTS, AND A LETTER OF ACCEPTANCE IN THE HEALTHCARE CAREER PROGRAM, OBTAIN APPROVAL FROM THE DEPARTMENT DIRECTOR OR SENIOR MANAGEMENT, BE INTERVIEWED BY CHIEF NURSING OFFICER, MAINTAIN A 3.0 CUMULATIVE AVERAGE, SUBMIT TRANSCRIPTS OF GRADES EVERY SCHOOL TERM, AND SERVE AS AN EMPLOYEE A MINIMUM OF ONE YEAR FOR EACH SCHOOL YEAR FOR WHICH SCHOLARSHIP MONIES WERE GRANTED. TRANSCRIPTS OF GRADES MUST BE RECEIVED BEFORE REIMBURSEMENT. SHOULD THE STUDENT NOT SEEK AND MAINTAIN EMPLOYMENT WITH URMC AFTER GRADUATION, FUNDS WILL BECOME DUE AND PAYABLE IN A PRORATA FASHION BASED ON EMPLOYMENT TERM. TUITION REIMBURSEMENT IS AWARDED FULLTIME AND REGULARLY SCHEDULED PART TIME EMPLOYEES. MONIES ARE GRANTED TO COVER TUITION, BOOKS AND LABORATORY FEES. EACH APPLICANT MUST BE ENROLLED IN AN ACCREDITED COLLEGE/UNIVERSITY WITHIN A PROGRAM DIRECTLY RELATED TO THE EMPLOYEE'S PRESENT POSITION OR A FIELD THAT WILL BE OF BENEFIT TO THE MEDICAL CENTER, SEEK APPROVAL FROM MANAGEMENT, FURNISH A TRANSCRIPT OF GRADES, MAINTAIN A "C- OR HIGHER GRADE AVERAGE. TO BE REIMBURSED, AN EMPLOYEE MUST PRESENT A CERTIFIED COPY OF THE GRADE REPORT WITH AN AVERAGE OF "C- OR HIGHER. X X false false false false false false false false false BRANDON M BOYCE MD ORTHOPEDIC SURGEON 766266 161764 120056 6500 21395 1075981 KEVIN A GINGRICH MD ORTHOPEDIC SURGEON 598368 1250 44000 6500 10876 660994 DARRYL KNIGHT MD SURGEON 339952 216623 52898 6500 34477 650450 DANIEL A BRIDGES MD UROLOGY SURGEON 568728 1000 38400 20493 628621 ROBERT SOLYOMVARI MD SURGEON 396517 69848 97209 6500 34477 604551 JEFF TARRANT HOSPITAL CEO/PRES 483075 483075 BENJAMIN WILLIAMS MD BOARD MEMBER 273923 96058 42944 4398 9876 427199 JOHN WILLIAMS CFO/COO 295123 2000 6031 14426 317580 SCHEDULE J, PART III MANAGEMENT SERVICES: THE FOUNDATION'S CEO IS CONTRACTUALLY PROVIDED BY HEALTHTECH MANAGEMENT, A FIRM HIRED BY THE SUPPORTED ORGANIZATION, URMC, TO PROVIDE CEO AND OTHER MANAGEMENT SERVICES. HEALTHTECH WAS PAID A TOTAL OF 993,088 IN 2021 FOR THESE SERVICES, INCLUDING AMOUNTS PAID TO JEFF TARRANT SERVING AS CEO TO BOTH THE FOUNDATION AND URMC. BONUSES/AWARDS PHYSICIAN BONUSES ARE PAID BASED ON RELATIVE VALUE UNITS (RVUS) ACHIEVED DURING A SPECIFIED TIME PERIOD. EACH PHYSICIAN'S EMPLOYMENT CONTRACT INCLUDES A RVU GOAL. THE PHYSICIAN IS PAID BONUSES BASED ON MEETING OR EXCEEDING THE GOAL AS DETERMINED BY THEIR CONTRACT. A HOSPITAL AUTHORITY OF UPSON COUNTY 586002427 2004-12-31 10000000 RENOVATION AND EXPANSION OF HOSPITAL false true false B HOSPITAL AUTHORITY OF UPSON COUNTY 586002427 2005-01-20 6000000 RENOVATION & EXPANSION OF HOSPITAL false true false A 7945000 10000000 124175 9875825 2007 false false true true B 4765000 6000000 79846 5920154 2007 false false true 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 false B false false false true false false false false false A false B false PURPOSE OF ISSUE DESCRIPTION HOSPITAL AUTHORITY OF UPSON COUNTY RENOVATION AND EXPANSION OF HOSPITAL PURPOSE OF ISSUE DESCRIPTION HOSPITAL AUTHORITY OF UPSON COUNTY RENOVATION & EXPANSION OF HOSPITAL DATE REBATE COMPUTATION PERFORMED HOSPITAL AUTHORITY OF UPSON COUNTY 12/30/09 DATE REBATE COMPUTATION PERFORMED HOSPITAL AUTHORITY OF UPSON COUNTY 01/20/10 FORM 990, PART V, LINE 4B CAYMAN ISLANDS FORM 990, PAGE 6, PART VI, LINE 3 THE ORGANIZATION ENGAGED HEALTHTECH MANAGEMENT TO PROVIDE THE SERVICES OF THE CEO. HEALTHTECH WAS COMPENSATED 993,088 FOR THESE SERVICES. SEE SCHEDULE J PART III FOR ADDITIONAL DETAILS. FORM 990, PAGE 6, PART VI, LINE 11B THE ORGANIZATION POSTS THE FORM 990 ON A SECURE WEBSITE FOR BOARD MEMBERS ONLY AND EACH CURRENT VOTING BOARD MEMBER IS ALERTED BY EMAIL AS TO ITS AVAILABILITY. THE CFO/COO PERFORMS A DETAILED REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PAGE 6, PART VI, LINE 12C THE POLICY COVERS ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. SHOULD A MATTER COME BEFORE THE BOARD OF DIRECTORS WHICH CONSTITUTES A CONFLICT OF INTEREST, THE INDIVIDUAL INVOLVED WILL MAKE KNOWN THE POTENTIAL CONFLICT AND WITHDRAW FROM THE MEETING SO LONG AS THE MATTER SHALL CONTINUE UNDER DISCUSSION AND SHALL NOT EITHER VOTE ON THE MATTER UNDER DISCUSSION OR ATTEMPT TO INFLUENCE A DECISION OF THE GOVERNING AUTHORITY WITH RESPECT TO SUCH MATTERS, UPON WHICH THERE COULD POSSIBLY BE A CONFLICT OF INTEREST. FORM 990, PAGE 6, PART VI, LINE 15A HEALTHTECH PRESENTS SALARY INFORMATION FOR THE CEO TO THE BOARD OF DIRECTORS FOR THEIR REVIEW. IN DETERMINING COMPENSATION FOR THE CFO/COO, OTHER OFFICERS OR KEY EMPLOYEES, THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT OBTAINS COMPARABLE SALARY DATA AND PRESENTS IT TO THE CEO WHO MAKES THE FINAL DECISION. THE INDIVIDUAL IN THE CONSIDERATION PROCESS IS NOT PRESENT DURING THE DISCUSSION AND DECISION-MAKING PROCESS. ANNUAL MERIT ADJUSTMENT: SALARY ADJUSTMENT IS DETERMINED BY ORGANIZATIONAL PERFORMANCE AS REFLECTED IN THE SCORE OF THE ESTABLISHED PERFORMANCE MEASUREMENT INSTRUMENT. (PAYSCALE) - PERIODIC MARKET ADJUSTMENT: SALARY OF EACH OFFICER IS REVIEWED PERIODICALLY BY HUMAN RESOURCES AND APPROPRIATE OFFICER AND COMPARED TO SALARIES OF COMPARABLE ORGANIZATIONS TO ENSURE THAT THE CURRENT RATE IS COMPETITIVE. FORM 990, PAGE 6, PART VI, LINE 15B SEE RESPONSE AT 15A. FORM 990, PAGE 6, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE FOR INSPECTION, WITH NOTICE, IN THE OFFICE OF THE ORGANIZATION. IN ADDITION, THE FINANCIAL STATEMENTS ARE AVAILABLE ON THE ORGANIZATION'S WEBSITE. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES 5,351,993 1,028,754 0 PROFESSIONAL FEES 349,392 100,240 0 PHYSICIAN FEES 5,413,503 0 0 PURCHASED SERVICES 1,854,235 696,520 0 THERAPY FEES 57,151 0 0 CONSULTING FEES 14,428 494,515 0 OTHER FEES 562,764 277,037 0 COLLECTION FEES 38,433 637,465 0 TOTAL 13,641,899 3,234,531 0 UPSON MEDICAL ASSOCIATES LLC 801 WEST GORDON STREET THOMASTON GA 30286 550840991 PHYS OFC GA -12522 279367 UCH UPSON REGIONAL WELLNESS CTR LLC 801 WEST GORDON STREET THOMASTON GA 30286 205095610 WELLNESS GA -255985 123021 UCH UPSON WOMEN'S SVCS LLC 801 WEST GORDON STREET THOMASTON GA 30286 263227893 PHYS OFC GA -985602 1188250 UCH UPSON FAMILY PHYSICIANS LLC 801 WEST GORDON STREET THOMASTON GA 30286 270192553 PHYS OFC GA -624505 -1312201 UCH UPSON SURGICAL ASSOCIATES LLC 801 WEST GORDON STREET THOMASTON GA 30286 275252545 PHYS OFC GA -3684035 1312201 UCH ORTHOPEDICS SPORTS MEDICINE & SURG 801 WEST GORDON STREET THOMASTON GA 30286 272123255 PHYS OFC GA 1375166 755578 UCH URMC MEDICAL OFFICE BLDG LLC 801 WEST GORDON STREET THOMASTON GA 30286 474279645 MED OFC BL GA -241947 4552986 UCH UPSON FAMILY MEDICAL CENTER LLC 801 WEST GORDON STREET THOMASTON GA 30286 824385128 PHYS OFC GA -154593 2348829 UCH URMC HEALTH FOUNDATION P O BOX 1089 THOMASTON GA 30286 830411781 FOUNDATION GA 501C3 12A UCH true HOSPITAL AUTHORITY OF UPSON COUNTY 801 WEST GORDON STREET THOMASTON GA 302860027 586002427 MGMT GA GOVT 6 N/A false false false false false false false false false false false false true true true true false false false false URMC HEALTH FOUNDATION L INDETERMINABLE VALUE URMC HEALTH FOUNDATION M INDETERMINABLE VALUE URMC HEALTH FOUNDATION N INDETERMINABLE VALUE URMC HEALTH FOUNDATION O INDETERMINABLE VALUE