2022-11-15T11:32:52-05:00 2021-12-31 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2021-07-01 581973570 FLOYD HEALTHCARE MANAGEMENT INC FLOY 7065096074 304 TURNER MCCALL BLVD ROME GA 301620233 PHILIP WHEELER CFO 7065095774 2022-10-28 true PHILIPS WHEELER 999009999 WILLIAM EDWARD PHILLIPS P00451499 2298837878 2022-11-15 2021 2022-09-23 18:48:47Z KURT STUENKEL 304 TURNER MCCALL BLVD ROME GA 301620233 262179124 false X WWW.FLOYD.ORG X 1990 GA OPERATE A NON-PROFIT HOSPITAL SYSTEM AND SUPPORT 501 (C)(3)ORGANIZATIONS 24 18 4185 161 0 23851786 2111303 468914670 256264412 6850449 1357213 1685128 1278133 501302033 261011061 197534 60672 0 258532166 147991709 0 181449 202929087 188220544 461658787 336272925 39643246 -75261864 548593704 745543952 313638226 329818958 234955478 415724994 X OPERATE A NON-PROFIT HOSPITAL SYSTEM AND SUPPORT 501 (C)(3)ORGANIZATIONS false false 189433037 60672 237805529 FLOYD HEALTHCARE MANAGEMENT, INC. OPERATES FLOYD MEDICAL CENTER, A GENERAL ACUTE CARE HOSPITAL, AND FLOYD BEHAVIORAL HEALTH, A PSYCHIATRIC UNIT. FLOYD MEDICAL CENTER IS A 300+ BED GENERAL ACUTE-CARE HEALTH INSTITUTION, OFFERING A WIDE RANGE OF SPECIALIZED SERVICES AND PROGRAMS. SUCH SERVICES AND PROGRAMS INCLUDE: ACUTE, MEDICAL/SURGICAL CARE; AMBULANCE SERVICE; BLOOD BANK; CANCER CARE UNIT; CARDIOVASCULAR LABORATORY; CORONARY CARE UNIT; CHAPLAIN SERVICE; CHEMICAL DEPENDENCY UNIT; CRISIS INTERVENTION; CT SCANNER; DIABETES CARE UNIT; LITHOTRIPSY, MEDICAL/SURGICAL INTENSIVE CARE; MAGNETIC RESONANCE IMAGING; NEUROLOGY; LEVEL III NEWBORN NURSERY/NEONATAL INTENSIVE CARE UNIT; OB/GYN; ORTHOPEDIC SURGERY, OUTPATIENT SURGERY CENTER; PATIENT REPRESENTATIVES; PEDIATRIC CARE; PHARMACY; DIAGNOSTIC RADIOLOGY; A 24-HOUR EMERGENCY SERVICE; ENDOSCOPIC LABORATORY; FAMILY PRACTICE RESIDENCY PROGRAM; PRIMARY CARE PHYSICIAN NETWORK; HEALTH EDUCATION AND PROMOTION; HOSPITAL AUXILIARY; INDUSTRIAL MEDICINE PROGRAM; INPATIENT REHABILITATION UNIT; LAPAROSCOPIC CHOLECYSTECTOMY SURGERY; LASER SURGERY; PHYSICAL THERAPY; OCCUPATIONAL THERAPY; SPEECH THERAPY; POISON CONTROL CENTER; POST-OPERATIVE RECOVERY ROOM; PROGRESSIVE INTENSIVE CARE UNIT; RESPIRATORY CARE SERVICES; SOCIAL WORK SERVICES; ULTRASOUND; CONGESTIVE HEART FAILURE CLINIC; WOUND OSTOMY CLINIC; BREAST CENTER, MOBILE MAMMOGRAPHY. DURING THE SHORT PERIOD ENDED DECEMBER 31, 2021, PATIENT DAYS (INCLUDING PSYCH AND REHAB) AT FLOYD MEDICAL CENTER TOTALED 47,384 AND DISCHARGES TOTALED 7,068. FLOYD MEDICAL CENTER PROVIDED APPROXIMATELY 23,255,000 IN DIRECT CHARITY AND INDIGENT CARE, AND IT INCURRED UNREIMBURSED MEDICARE AND MEDICAID ADJUSTMENTS OF 359,266,000 AND 139,644,000 RESPECTIVELY. A COPY OF THE REPORT TO THE COMMUNITY FOR FLOYD MEDICAL CENTER CAN BE FOUND AT WWW.FLOYD.ORG. 8644851 8606671 CHEROKEE MEDICAL CENTER (CMC) IS A 60-BED ACUTE CARE HOSPITAL LOCATED IN CENTRE, ALABAMA. CMC ALSO OPERATES THREE RURAL HEALTH CLINICS LOCATED IN CENTRE AND PIEDMONT, AL. CMC IS OPERATED BY FLOYD CHEROKEE MEDICAL CENTER, LLC (FCMC), AN ALABAMA LIMITED LIABILITY CORPORATION WHOSE SOLE MEMBER IS FHMI. DURING THE SHORT PERIOD ENDED DECEMBER 31, 2021, CMC PROVIDED 2,356 PATIENT DAYS AND DISCHARGES TOTALED 568; THE RURAL HEALTH CLINICS HAD 17,554 VISITS. CMC PROVIDED APPROXIMATELY 217,000 IN DIRECT CHARITY AND INDIGENT CARE, AND IT INCURRED UNREIMBURSED MEDICARE AND MEDICAID ADJUSTMENTS OF 7,520,000 AND 7,494,000 RESPECTIVELY. 198077888 true true false true false false false false false false true false false true true false false true false false false false false false false false true true false true true false false false false false true true true false false false false true true false false false true 200 0 4185 true false false false false false false false false false false true false X 24 18 false false true false false true false true true false false true true true true true true true true true true GA X X CLARICE CABLE 7065096074 304 TURNER MCCALL BLVD ROME GA 30161 KURT STUENKEL PRES/SECRE/C 50.00 4.00 X X 2971233 0 24408 TOMMY MANNING CORPORATE CO 50.00 X 758789 0 71441 KENNETH JONES JR MD VP & CMO 50.00 X 775398 0 37029 WARREN SONNY RIGAS SVP COO 50.00 X 673362 0 73944 CHAD J BECK MD PHYSICIAN 50.00 X 676829 0 24884 SHEILA BENNETT VP & CNO 50.00 X 596905 0 46467 MATTHEW GORMAN VP CORP. & N 50.00 X 531294 0 59726 JEFFERY D BUDA CHF INFORMAT 50.00 X 509226 0 65168 MATTHEW CORNFORTH MD PHYSICIAN 50.00 X 526061 0 12549 BETH BRADFORD CHIEF HR OFF 50.00 X 461144 0 37467 DAVID EARLY DIRECTOR SUP 50.00 X 439267 0 41420 CLARICE CABLE INTERIM CFO 50.00 5.00 X 432294 0 48127 RICHARD CHILDS VP REVENUE C 50.00 X 416011 0 55832 BRIDGETTE DINGLE MD NEONATOLOGIS 50.00 X 434914 0 34417 JULIE ROGERS CORP COMPLIA 50.00 X 371008 0 96720 WILLIAM G ASBURY MD PHYSICIAN 50.00 X 409553 0 35079 TAUNYA FAULKNER VP 50.00 X 409852 0 32514 KEERTHY KRISHNAMANI EXEC. 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D 50.00 X 404135 0 30231 EDWIN MONTAGUE MD PHYSICIAN 50.00 X 382951 0 35279 GREG POLLEY VICE PRESIDE 50.00 X 351750 0 0 ROBERT PURCELL PHARMACY DIR 50.00 X 259007 0 29380 ROBERT HOLCOMBE JR MD DIRECTOR/PHY 41.00 X 235144 0 21966 JAMES COLLINS JR MD DIRCTOR/PHYS 41.00 X 124618 0 14879 GEORGE BOSWORTH MD DIRECTOR 1.00 1.00 X 7250 3750 0 KAY CHUMBLER VICE CHAIRMA 1.00 2.00 X X 7750 2750 0 FRANK SHELLEY DIRECTOR 1.00 2.00 X 3875 2750 0 DANIEL HANKS JR DIRECTOR 1.00 X 3850 2750 0 DAVID JOHNSON DIRECTOR 1.00 1.00 X 6450 0 0 CARL HERRING MD CHAIRMAN 1.00 X X 3875 1250 0 TERRYAL DENISE DOWNER-MCKINNEY DIRECTOR 1.00 1.00 X 2075 3000 0 W DAVID NEWBY DIRECTOR 1.00 X 5000 0 0 TODD BUSSEY DIRECTOR 1.00 1.00 X 2000 2750 0 DEE RUSSELL DIRECTOR 1.00 X 1200 3000 0 KATE DEMPSEY DIRECTOR 1.00 X 1000 3000 0 JOHN W BENNETT DIRECTOR 1.00 X 1650 2250 0 GARRY FRICKS DIRECTOR 1.00 X 3750 0 0 SHANNON JOE VAUGHN MD DIRECTOR 1.00 X 3000 0 0 JOEL SNIDER DIRECTOR 1.00 X X 375 1250 0 JOHN GROUT DIRECTOR 1.00 X 625 0 0 KEN HANES DIRECTOR 1.00 X 0 0 0 KEN HAYNES DIRECTOR 1.00 X 0 0 0 WRIGHT BAGBY JR DIRECTOR 1.00 1.00 X 0 0 0 MARK MANIS DIRECTOR 1.00 1.00 X 0 0 0 KRIS SHEPARD DIRECTOR 1.00 X 0 0 0 KRIS SHEPARD DIRECTOR 1.00 X 0 0 0 RHONDA WALLACE DIRECTOR 1.00 X 0 0 0 PHILIP WHEELER CFO X 0 0 0 13204470 28500 928927 416 false true false BRASFIELD AND GORRIE LLC PO BOX 11407 BIRMINGHAM AL 352461407 GEN CONTRACTOR 4301992 IN COMPASS HEALTH INC 318 MAXWELL ROAD SUITE 500 ALPHARETTA GA 30009 HOSPITALIST 3885052 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 303682289 DIETARY SVC 2937688 CERNER CORP PO BOX 412702 KANSAS CITY MO 641412702 IT SERVICES 2466225 ARAMARK MANAGEMENT SERVICES PO BOX 233 ROME GA 301610233 HOUSEKEEPING 2356525 52 2074303 37000 2111303 PATIENT SERVICE REVENUE 623000 255474114 255474114 FAMILY PRACTICE CAPITATION 621990 790298 790298 256264412 2130134 2130134 219039 146409 72630 72630 72630 52908 825829 -825829 52908 -772921 -772921 289651 195825 93826 93826 CAFETERIA 722210 891611 891611 EMS OPERATING GRANTS 621990 125000 125000 RELATED PARTY BILLING 621990 67878 67878 27188 27188 1111677 261011061 256484478 2415280 60672 60672 10616501 391357 10225144 97537925 87459319 9948393 130213 2106526 1667316 436472 2738 29589164 23419823 6130875 38466 8141593 6268060 1863937 9596 929346 929346 276675 276675 28886360 22883566 6002794 87102206 72369 87029837 4743419 3123308 1620055 56 6245475 336350 5908745 380 3833111 3304908 528203 1866438 1399835 466603 327572 174862 152710 15760466 13588674 2171792 1385440 291475 1093965 MEDICAL SUPPLIES 31396917 31266430 130487 REPAIRS & MAINTENANCE 2429408 1916159 513249 PROVIDER FEES 1553513 1553513 LICENSE & TAXES 676154 129396 546758 808044 324009 484035 336272925 198077888 138013588 181449 34701765 211738450 30978684 15875416 72995180 83655343 157097 227278 12898213 16535085 6528593 7254446 369067873 235895529 129257851 133172344 195772412 109588085 281207 809629 65022702 166687876 548593704 745543952 41544554 42092678 300000 6778326 125024237 63097317 222093277 83672118 58854677 313638226 329818958 X 234955478 415724994 234955478 415724994 548593704 745543952 X -75261864 256031380 X false true X true true true X SUPPLEMENTAL INFORMATION SCHEDULE A, PART IV - REASON FOR NON-PRIVATE FOUNDATION STATUS ON JANUARY 1, 1998 FLOYD HEALTHCARE MANAGEMENT, INC. ACQUIRED BY LEASE ALL OF THE ASSETS OF THE HOSPITAL AUTHORITY OF FLOYD COUNTY AND THEREBY BECAME THE LICENSED OPERATOR OF FLOYD MEDICAL CENTER, A GENERAL, ACUTE CARE HOSPITAL WITH 300+ BEDS. SINCE THAT TIME, FLOYD HEALTHCARE MANAGEMENT, INC. HAS CONTINUED TO OPERATE FLOYD MEDICAL CENTER AS A NON-PROFIT HOSPITAL, OFFERING A WIDE ARRAY OF SERVICES TO THE COMMUNITY, INCLUDING AN EMERGENCY ROOM WHICH SAW 36,299 PATIENTS IN THE 6-MONTH PERIOD ENDING DECEMBER 31, 2021, AND A BUSY OUTPATIENT INDIGENT CLINIC. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false SCHEDULE C, PART II-B, LINE 1 THE ORGANIZATION PAYS MEMBERSHIP DUES TO NATIONAL AND STATE ORGANIZATIONS. A PORTION OF THOSE DUES IS ALLOCATED TO LOBBYING ACTIVITIES IN WHICH THOSE ORGANIZATIONS PARTICIPATE. IN FY 2021, THE ORGANIZATION PAID 60,000 TO TERMINUS SOUTH/GEORGIA PUBLIC AFFAIRS FOR A LOBBYING LIAISON WITH THE GEORGIA STATE GOVERNMENT. 14885041 14885041 139851705 69870598 69981107 16158916 13052135 3106781 180983175 152972796 28010379 17189036 17189036 133172344 APPRAISED ASSETS 117507107 LEASED ASSETS 41133994 OTHER RECEIVABLES 16865372 THIRD PARTY SETTLEMENTS -2311554 DUE FROM RELATED PARTIES -6507043 166687876 MEDICARE ADVANCE PAYMENTS 27910451 ACCRUED PENSION 23217329 MALPRACTICE CLAIMS 7726897 58854677 true true X true X 1.250000000000 true X 4.000000000000 true true false true true 10698494 10698494 0.03180 36139618 25714982 10424636 0.03100 46838112 25714982 21123130 0.06280 3914958 3042593 872365 0.00260 3914958 3042593 872365 0.00260 50753070 28757575 21995495 0.06540 true 12612595 6306298 61085212 91411813 -30326601 X true true 2 1 FLOYD HEALTHCARE MANAGEMENT INC FLOYD MEDICAL CENTER 304 TURNER MCCALL BLVD ROME GA 301620233 WWW.FLOYD.ORG 057-556 X X X X HOSPICE, CLINICS, REHAB, PSYCH A 2 FLOYD CHEROKEE MEDICAL CENTER LLC CHEROKEE MEDICAL CENTER 400 NORTHWOOD DRIVE CENTRE AL 35960 WWW.FLOYD.ORG 010-033 X X X SWING BED SNF; RHCS A A 12 false false true X X X X X X X X X X 19 true true false true X WWW.FLOYD.ORG X X true 19 true HTTPS://WWW.FLOYD.ORG/ABOUT-FLOYD/DOCU false false true X 125.000000000000 400.000000000000 X X X true true X X X X true X WWW.FLOYD.ORG X WWW.FLOYD.ORG X WWW.FLOYD.ORG X X X X X X true X false X X X X true X false false GROUP A, FACILITY 1, FLOYD HEALTHCARE MANAGEMENT INC. - PART V, LINE 3E ATRIUM HEALTH FLOYD CONDUCTED A COMMUNITY SURVEY TO VALIDATE DATA, GIVE MEMBERS OF THE COMMUNITY AN OPPORTUNITY TO COMMENT ON THE PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT AND TO PROVIDE COMMUNITY-LEVEL INSIGHT INTO THE HEALTH NEEDS FOR EACH OF THE COUNTIES IN OUR PRIMARY SERVICE AREA. RESPONDENTS IDENTIFIED ACCESS TO CARE, CARDIOVASCULAR HEALTH, MENTAL HEALTH ISSUES AND OBESITY AS THE MOST IMPORTANT ISSUES FACING THE FOUR-COUNTY PRIMARY SERVICE AREA. OTHER RESPONSES INCLUDE: 1) ALCOHOL ABUSE 2) ALZHEIMER'S DISEASE 3) CANCER 4) COMMUNITY SAFETY 5) COVID-19 6) DRUG ABUSE 7) ELDER CARE 8) EMERGENCY CARE FOR FISHING AND LAKE COMMUNITIES 9) HEALTH EDUCATION 10)NUTRITION 11)PARENTAL SUPPORT FOR CHILDREN AND TEENS 12)PRESCRIPTION PRICES AN ANALYSIS OF THE HEALTH DATA STATISTICS AND SURVEY RESULTS PROVIDES CLEAR GUIDANCE IN ESTABLISHING THE HEALTH NEEDS OF THE FOUR PRIMARY COUNTIES SERVED BY ATRIUM HEALTH FLOYD: ACCESS TO CARE CARDIOVASCULAR DISEASE MENTAL AND BEHAVIORAL HEALTH NUTRITION AND WELLNESS THE SIGNFICANT HEALTH NEEDS ARE SUMMARIZED ON PAGES 19 - 21 OF THE CHNA WHICH IS AVAILABLE AT - HTTPS://WWW.FLOYD.ORG/ABOUT-FLOYD/DOCUMENTS/2021-CHNA-POLK-FINAL.PDF. GROUP A, FACILITY 1, FLOYD HEALTHCARE MANAGEMENT INC. - PART V, LINE 5 THE CHNA UTILIZED A PARTICIPATORY, COLLABORATIVE APPROACH AND EXAMINED HEALTH IN ITS BROADEST CONTEXT. THE ASSESSMENT PROCESS INCLUDED THE FOLLOWING: REVIEW OF PREVIOUS CHNA SYNTHESIZING EXISTING DATA ON SOCIAL, ECONOMIC, AND HEALTH INDICATORS IN FLOYD, POLK, CHATTOOGA AND CHEROKEE COUNTIES INDIVIDUAL COMMUNITY SURVEYS FOCUS GROUPS WITH A RANGE OF DIVERSE INDIVIDUALS INCLUDING PROVIDERS, ELECTED OFFICIALS, COMMUNITY-BASED ORGANIZATIONAL STAFF AND COMMUNITY RESIDENTS GROUP A, FACILITY 1, FLOYD HEALTHCARE MANAGEMENT INC. - PART V, LINE 6A THE 2021 CHNA WAS CONDUCTED WITH POLK MEDICAL CENTER, INC., A 25-BED CRITICAL-ACCESS HOSPITAL IN CEDARTOWN, GA. GROUP A, FACILITY 1, FLOYD HEALTHCARE MANAGEMENT INC. - PART V, LINE 7D THE 2021 CHNA HAS BEEN DISTRIBUTED UPON REQUEST TO OTHER NON-PROFIT AGENCIES IN THE AREA TO ASSIST WITH GRANTS. COPIES HAVE ALSO BEEN MADE AVAILABLE TO ELECTED OFFICIALS, CHAMBERS OF COMMERCE, AND EDUCATIONAL INSTITUTIONS IN THE AREA. A LINK TO THE 2021 CHNA AND IMPLEMENTATION PLAN CAN BE FOUND ON THE ORGANIZATION'S WEBSITE AT HTTPS://WWW.FLOYD.ORG/ABOUT- FLOYD/PAGES/REPORTS.ASPX. GROUP A, FACILITY 1, FLOYD HEALTHCARE MANAGEMENT INC. - PART V, LINE 11 ACCESS TO CARE, CARDIOVASCULAR DISEASE, MENTAL HEALTH SERVICES AND NUTRITION WERE SEEN AS SIGNIFICANT CONCERNS THAT AFFECT MANY RESIDENTS. THE DISTRIBUTION OF BEHAVIORS AND HEALTH OUTCOMES CONSISTENTLY FOLLOW SOCIAL AND ECONOMIC PATTERNS. FURTHERMORE, SOME BARRIERS TO ACCESSING CARE CONTINUE TO PREVENT CURRENT PROGRAMS AND INITIATIVES FROM REACHING THE POPULATIONS IN NEED. THESE CHALLENGES PRESENT IMPORTANT OPPORTUNITIES FOR THE FUTURE. AS WE MOVE FORWARD AS AN INTEGRATED COMMUNITY OF HEALTH CARE, SOCIAL SERVICES AND COMMUNITY LEADERSHIP, WE CAN LEVERAGE COMMUNITY ASSETS TO IMPROVE THE HEALTH OF RESIDENTS IN FLOYD, POLK, CHATTOOGA AND CHEROKEE COUNTIES. 5 FLOYD HEYMAN HOSPICE P O BOX 233 ROME GA 30165 HOME HOSPICE CARE FLOYD EMERGENCY MEDICAL SERVICES P O BOX 233 ROME GA 30165 EMERGENCY SERVICES FLOYD CHEROKEE MEDICAL CENTER RHC 395 NORTHWOOD DRIVE CENTRE AL 35960 RURAL HEALTH CLINIC FLOYD CHEROKEE MEDICAL CENTER RHC 32 ROUNDTREE DRIVE PIEDMONT AL 36272 RURAL HEALTH CLINIC FLOYD CHEROKEE MEDICAL CENTER RHC 391 NORTHWOOD DRIVE CENTRE AL 35960 RURAL HEALTH CLINIC SCHEDULE H, PART I, LINE 7G FHMI OPERATES THE FLOYD COUNTY CLINIC FOR THE COUNTYS UNINSURED AND UNDEREMPLOYED POPULATION. THE CLINIC PROVIDES ASSISTANCE TO FINANCIALLY AND MEDICALLY INDIGENT PATIENTS IN AN EFFORT TO REDUCE THEIR NEED FOR EMERGENCY AND INPATIENT HOSPITAL CARE. SCHEDULE H, PART I, LINE 7, COLUMN (F) IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN (F), THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25: FORM 990, PART IX, LINE 25 336,272,922 ADD: EXPENSES REPORTED IN PART VIII 342,234 DENOMINATOR FOR COLUMN (F) 336,615,156 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". SEE ALSO THE DESCRIPTION FOR PART III, LINE 2. SCHEDULE H, PART III, LINE 2 AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT 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 SEE THE DISCUSSION OF UNINSURED PATIENTS AND BAD DEBT EXPENSE ON PAGES 15- 24 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. 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. SCHEDULE H, PART III, LINE 9B FOR PATIENTS RECEIVING ONLY A PORTION OF THEIR BILL AS CHARITY, THE REMAINING PORTION OF THE BILL IS TREATED THE SAME AS ALL OTHER PATIENTS IN REGARDS TO COLLECTIONS. SCHEDULE H, PART VI, LINE 2 FLOYD HEALTHCARE MANAGEMENT, INC. ("FHMI") COMPLETED A HEALTH CARE NEEDS ASSESSMENT IN CHATTOOGA, FLOYD, CHEROKEE, AND POLK COUNTIES IN FISCAL YEAR 2021. THIS INCLUDED INTERVIEWS WITH COMMUNITY LEADERS AND HEALTH CARE PROFESSIONALS AND FOCUS GROUPS. IN ADDITION, FHMI DEVELOPS A STRATEGIC PLAN THAT IS UPDATED ANNUALLY. THE STRATEGIC PLAN TAKES INTO CONSIDERATION HEALTH NEEDS FOR OUR SERVICE AREA IN ADDITION TO UTILIZATION OF SERVICES, COMMUNITY PARTICIPATION, AND QUALITY OF SERVICES PROVIDED. BOTH THE 2021 CHNA AND IMPLEMENTATION PLAN ARE POSTED ON THE FACILITY'S HOME WEBPAGE. SCHEDULE H, PART VI, LINE 3 FHMI COMMUNICATES THIS INFORMATION THROUGH SIGNAGE IN THE EMERGENCY CARE CENTER, PATIENT REGISTRATION AREAS, IN THE BUSINESS/PATIENT FINANCIAL SERVICES OFFICES, AND IN THE OFFICES OF OUR FINANCIAL COUNSELORS. DURING TIMES OF PREADMISSION AS WELL AS ON-SITE REGISTRATION THE ACCESS/REGISTRATION STAFF DISCUSS POLICIES WITH THE PATIENT/PATIENT'S FAMILY IF APPROPRIATE. AFTER DISCHARGE AND DURING THE "COLLECTION" PERIOD OUR STAFF ONCE AGAIN DISCUSS OUR FINANCIAL ASSISTANCE POLICIES. IN ADDITION THERE IS A DEMONSTRATED WORD-OF-MOUTH COMMUNICATION OF THESE POLICIES THROUGH OUR PATIENT POPULATION. SCHEDULE H, PART VI, LINE 4 LOCATED IN NORTHWEST GA, FHMI DBA FLOYD MEDICAL CENTER ("FMC") IS BASED IN ROME, GA, WHICH IS THE COUNTY SEAT FOR FLOYD COUNTY, ABOUT 60 MILES NORTH OF ATLANTA AND 60 MILES SOUTH OF CHATTANOOGA, TN. THE 192,096 (2021) RESIDENTS OF THE FOUR-COUNTY REGION ARE SERVED BY FMC AND TWO SMALLER HOSPITALS. NORTHWEST GA IS A MEDICAL AND EDUCATIONAL HUB. THREE OF THE LARGEST EMPLOYERS IN THE FOUR-COUNTY AREA ARE HEALTH CARE PROVIDERS. THE AREA IS ALSO HOME TO FOUR POST-SECONDARY EDUCATIONAL INSTITUTIONS. STILL, THE MANUFACTURING SECTOR REMAINS AN ECONOMIC FORCE IN THE AREA. THE PERCENTAGE OF RESIDENTS IN THE FOUR-COUNTY AREA WHO LIVE BELOW THE FEDERAL POVERTY LEVEL RANGES FROM 14% TO 19%. THE PERCENTAGE OF RESIDENTS WHO HAVE EITHER GRADUATED HIGH SCHOOL OR HAVE A GENERAL EDUCATIONAL DEVELOPMENT CERTIFICATE RANGES FROM 80% TO 94% IN THE REGION. THE PRIMARY CAUSES OF DEATH IN THESE COUNTIES ARE: -ISCHEMIC HEART AND VASCULAR DISEASE -MALIGNANT NEOPLASMS OF THE TRACHEA, BRONCHUS AND LUNG -COPD -CEREBROVASCULAR DISEASE -ALZHEIMER'S DISEASE -ACCIDENTAL POISONING AND EXPOSURE TO NOXIOUS SUBSTANCES -SUICIDE -FALLS SCHEDULE H, PART VI, LINE 5 FHMI IS THE SAFETY-NET HEALTH CARE PROVIDER FOR NORTHWEST GEORGIA. IN ADDITION TO PROVIDING EMERGENCY CARE SERVICES, FMC HAS GONE THE EXTRA STEP OF PROVIDING 24-HOUR COVERAGE FOR SURGERY AND OTHER SERVICES TO MAINTAIN STATUS AS A LEVEL II TRAUMA CENTER. FHMI IS ALSO THE SITE FOR THE REGIONAL POISON CONTROL CENTER, HOUSES THE REGION'S ONLY LEVEL III NEONATAL INTENSIVE CARE UNIT, AND OPERATES A FAMILY MEDICINE RESIDENCY PROGRAM THAT OPERATES THE FLOYD COUNTY CLINIC TO PROVIDE BASIC HEALTH CARE SERVICES FOR THE ECONOMICALLY DISADVANTAGED IN THE COMMUNITY. IN ADDITION TO THESE SERVICES, FHMI ACTIVELY PROMOTES HEALTH AND SAFETY THROUGHOUT THE COMMUNITY THROUGH VARIOUS COMMUNITY BENEFIT ACTIVITIES, PRIMARILY THROUGH THE PROVISION OF INDIGENT AND CHARITY CARE TO UNDER-INSURED AND UNINSURED PATIENTS. IN ADDITION, FLOYD IS ACTIVE IN THE COMMUNITY PROVIDING SCHOOL- BASED CHILD SAFETY PROGRAMS; MOBILE MAMMOGRAPHY; CHILDBIRTH CLASSES; COMMUNITY HEALTH SCREENINGS AND HEALTH FAIRS; HEALTH CARE INTERNSHIPS; EXTERNSHIPS AND SHADOWING OPPORTUNITIES; AND SUPPORT FOR COMMUNITY-WIDE INITIATIVES WITH HEALTH PARTNERS INCLUDING THE NORTHWEST GEORGIA CANCER COALITION, CANCER NAVIGATORS, AND THE FREE CLINIC OF ROME. FHMI'S GOVERNING BODY IS PRIMARILY COMPRISED OF PERSONS WHO ARE NOT EMPLOYEES, CONTRACTORS (NOR FAMILY MEMBERS THEREOF), AND RESIDE IN THE PRIMARY SERVICE AREA. THE HOSPITAL'S MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS IN THE REGION. FUNDS RECEIVED FROM OPERATIONS, AFTER OPERATING EXPENSES, ARE USED TO SUPPORT VARIOUS OUTREACH EFFORTS DESCRIBED IN SCHEDULE H AND THE COMMUNITY BENEFIT REPORT, AND TO FURTHER IMPROVEMENT IN PATIENT CARE. SCHEDULE H, PART VI, LINE 6 FLOYD HEALTHCARE MANAGEMENT, INC. (FHMI) OPERATES FLOYD MEDICAL CENTER (FMC) (ONE OF THREE LICENSED GENERAL ACUTE CARE HOSPITALS), WHICH INCLUDES FLOYD BEHAVIORAL HEALTH, A PSYCHIATRIC UNIT, AND FLOYD PHYSICIANS, LLC, A SINGLE MEMBER DISREGARDED ENTITY. POLK MEDICAL CENTER, INC., OPERATES POLK MEDICAL CENTER, A 25-BED LICENSED CRITICAL CARE HOSPITAL AND FLOYD CHEROKEE MEDICAL CENTER, LLC (FCMC) OPERATES FLOYD CHEROKEE MEDICAL CENTER, A 60-BED LICENSED ALABAMA HOSPITAL. THE FACILITIES SERVE THE AREAS OF FLOYD COUNTY, THE NORTHWEST GEORGIA REGION, AND ALABAMA. FCMC IS AN ALABAMA LIMITED LIABILITY CORPORATION THAT WAS CREATED ON APRIL 10, 2018. FHMI IS THE SOLE MEMBER OF FCMC. FCMC ENTERED INTO A LEASE WITH AN EFFECTIVE DATE OF JUNE 1, 2018 WITH THE CHEROKEE COUNTY HEALTH CARE AUTHORITY, AN ALABAMA PUBLIC CORPORATION ORGANIZED UNDER THE LAWS OF THE STATE OF ALABAMA, TO TRANSFER CONTROL OF CHEROKEE MEDICAL CENTER TO FCMC. CHEROKEE MEDICAL CENTER IS A 60-BED ACUTE CARE HOSPITAL, CURRENTLY OPERATING 45 BEDS, LOCATED IN CENTRE, ALABAMA. OTHER AFFILIATED ORGANIZATIONS INCLUDE: - HOSPITAL AUTHORITY OF FLOYD COUNTY - A NONPROFIT ORGANIZATION THAT SUPPORTS FMC. - FLOYD HEALTHCARE RESOURCES, INC. - A NONPROFIT INVESTMENT INSTITUTE THAT AIDS IN FUNDING FMC IN ORDER TO BENEFIT CITIZENS LOCATED IN FLOYD COUNTY AND NORTHWEST GEORGIA REGION. - FLOYD HEALTH CARE FOUNDATION, INC. - A NONPROFIT ORGANIZATION THAT PROMOTES HEALTH CARE BY PROVIDING SUPPORT TO TAX-EXEMPT HEALTH CARE ORGANIZATIONS AND PUBLIC CHARITIES IN AND AROUND THE ROME, GEORGIA AREA. - POLK MEDICAL CENTER, INC. - A 25-BED, CRITICAL ACCESS HOSPITAL WHICH PROVIDES INPATIENT AND OUTPATIENT SERVICES. - CANCER NAVIGATORS, INC. - A NOT-FOR-PROFIT CORPORATION WHOSE MISSION IS TO HELP PATIENTS DIAGNOSED WITH CANCER NAVIGATE THE HEALTH CARE SYSTEM TO OBTAIN THE PROPER TREATMENT. SCHEDULE H, PART VI, LINE 7 GEORGIA true COBRA INSURANCE PREMIUM 9 36942 TUITION 8 23730 SCHEDULE I, PAGE 1, PART I, LINE 2 IT IS THE POLICY OF THE ORGANIZATION TO ESTABLISH PROCEDURES TO POTENTIALLY SECURE PAYMENT FOR HEALTHCARE SERVICES VIA EXTENSION OF INSURANCE BENEFITS THROUGH COBRA. THIS EXTENSION OF INSURANCE COVERAGE WILL BE PROVIDED ON A CASE-BY-CASE BASIS. THE HOSPITAL'S ROLE IN COVERAGE PAYMENT WILL BE REVIEWED MONTHLY; THERE IS NO OBLIGATION FOR THE HOSPITAL TO CONTINUE COVERAGE PAYMENT BEYOND THE INITIAL STATED LENGTH. THIS COVERAGE PAYMENT IS NOT TYPICALLY INTENDED FOR LONGER THAN A SPECIFIC SERVICE EVENT. IN GENERAL, AS FHMI IS APPROACHED BY INDIVIDUALS OF THE COMMUNITY FOR SERVICES, ASSIGNED STAFF WILL EXAMINE PATIENTS FOR POTENTIAL QUALIFICATION FOR THIS PROGRAM. UPON QUALIFICATION, PAYMENT OF THE INSURANCE PREMIUM IS MADE TO THE EMPLOYER/INSURANCE COMPANY. PATIENT LIABILITY WILL BE EVALUATED AND DISCUSSED WITH THE PATIENT/GUARANTOR PRIOR TO DISCHARGE. THIS DISCUSSION WILL FOLLOW THE SAME PROTOCOL AS OTHER PATIENTS WITH RESIDUAL LIABILITIES. FINALLY, A 1099 TAX FORM IS ISSUED TO THE PATIENT. TUITION POLICY: THE ORGANIZATION PROVIDES OPPORTUNITIES FOR TRAINING, DEVELOPMENT, AND ADVANCEMENT WHICH ARE CONSISTENT WITH INDIVIDUAL ABILITY AND PERFORMANCE AS WELL AS BUDGETARY LIMITATIONS AND NEEDS OF THE ORGANIZATION. FHMI WILL SHARE IN THE COST OF TUITION AND BOOKS FOR CLASSROOM AND/OR CORRESPONDENCE COURSES FOR ELIGIBLE EMPLOYEES. THE EDUCATION MUST BE DIRECTLY RELATED TO THE EMPLOYEE'S DUTIES OR A POSITION TO WHICH THE EMPLOYEE MIGHT REASONABLY BE EXPECTED TO PROGRESS BY REASON OF PROMOTION. APPROVAL FROM THE EMPLOYEE'S DEPARTMENT HEAD, HUMAN RESOURCES DIRECTOR, AND APPLICABLE VICE PRESIDENT MUST BE GRANTED PRIOR TO ENROLLMENT, AND A GRADE OF B OR HIGHER MUST BE MAINTAINED. ALL EDUCATIONAL ASSISTANCE WILL BE SET UP AS A "FORGIVABLE LOAN" CONTRACT BETWEEN THE EMPLOYEE AND FHMI. THE LOAN WILL BE REPAID BY SERVICE. REIMBURSEMENT IS MADE SUBJECT TO RECEIPTS AND PROOF OF AWARDED GRADES. X X true true X X X X X false true false false false false false false false KURT STUENKEL PRES/SECRE/CEO 440188 2006600 524445 14500 9908 2995641 TOMMY MANNING CORPORATE COUNSEL 557185 163300 38304 34162 37279 830230 KENNETH JONES JR MD VP & CMO 564496 206000 4902 37029 812427 WARREN SONNY RIGAS SVP COO 464823 164600 43939 36915 37029 747306 CHAD J BECK MD PHYSICIAN 675579 500 750 24884 701713 SHEILA BENNETT VP & CNO 393249 166500 37156 31350 15117 643372 MATTHEW GORMAN VP CORP. & NETWORK S 356151 149800 25343 24546 35180 591020 JEFFERY D BUDA CHF INFORMATION OFCR 344179 133800 31247 27889 37279 574394 MATTHEW CORNFORTH MD PHYSICIAN 524427 500 1134 12549 538610 BETH BRADFORD CHIEF HR OFFICER 315231 118200 27713 22350 15117 498611 DAVID EARLY DIRECTOR SUPPORT SVC 299393 123000 16874 15420 26000 480687 CLARICE CABLE INTERIM CFO 302684 115100 14510 13048 35079 480421 RICHARD CHILDS VP REVENUE CYCLE MGT 276920 110300 28791 24617 31215 471843 BRIDGETTE DINGLE MD NEONATOLOGIST 433489 500 925 34417 469331 JULIE ROGERS CORP COMPLIANCE OFCR 216908 85400 68700 65505 31215 467728 WILLIAM G ASBURY MD PHYSICIAN 408186 500 867 35079 444632 TAUNYA FAULKNER VP 275432 123400 11020 9885 22629 442366 KEERTHY KRISHNAMANI EXEC. MED. DIRECTOR 334209 69400 526 30231 434366 EDWIN MONTAGUE MD PHYSICIAN 381685 500 766 35279 418230 GREG POLLEY VICE PRESIDENT 351750 351750 ROBERT PURCELL PHARMACY DIRECTOR 217440 27839 13728 11799 17581 288387 ROBERT HOLCOMBE JR MD DIRECTOR/PHYSICIAN 231666 500 2978 21966 257110 SCHEDULE J, PAGE 1, PART I, LINE 4 TOMMY MANNING 0 34,162 0 WARREN "SONNY" RIGAS 0 36,915 0 SHEILA BENNETT 0 31,350 0 MATTHEW GORMAN 0 24,546 0 JEFFERY D BUDA 0 27,889 0 BETH BRADFORD 0 22,350 0 DAVID EARLY 0 15,420 0 CLARICE CABLE 0 13,048 0 RICHARD CHILDS 0 24,617 0 JULIE ROGERS 0 65,505 0 TAUNYA FAULKNER 0 9,885 0 ROBERT PURCELL 0 11,799 0 SCHEDULE J, PART III THE CEO PARTICIPATES IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WHICH IS FUNDED ANNUALLY IN AN AMOUNT WHICH, WHEN ADDED TO OTHER SOURCES OF RETIREMENT INCOME, WILL AFFORD A RETIREMENT INCOME AT A TARGETED PERCENTAGE OF PRE-RETIREMENT COMPENSATION. THE SERP IS A NON-QUALIFIED RETIREMENT PLAN, AND AS SUCH THE ANNUAL FUNDING PAYMENTS PAID INTO IT ARE TAXABLE TO THE PARTICIPANT IN THE YEAR IN WHICH MADE. EFFECTIVE WITH CALENDAR YEAR 2009, MR. STUENKEL'S SERP IS A CASH-BASED PROGRAM. BONUS/INCENTIVE PAY ALL MEMBERS OF THE EXECUTIVE TEAM FOR FHMI PARTICIPATE IN AN INCENTIVE COMPENSATION PLAN UNDER WHICH ANNUAL YEAR-END BONUSES ARE PAID BASED ON INDIVIDUAL AND CORPORATE-WIDE ACHIEVEMENT OF SPECIFIC GOALS AND OBJECTIVES. ONE OF THE GOALS RELATES TO THE RELATED ORGANIZATION'S NET INCOME. THE BONUSES ARE AWARDED ON A CASH-BASED SYSTEM. JOSHUA POLLEY FAMILY-KEY EMP 79616 EMPLOYEE WAGES false BENJAMIN RIGAS FAMILY-KEY EMP 119014 EMPLOYEE WAGES false GREGORY ROGERS FAMILY-KEY EMP 247842 EMPLOYEE WAGES false RUSSELL BISHOP FAMILY-KEY EMP 90010 EMPLOYEE WAGES false DEBORAH BISHOP FAMILY-KEY EMP 86558 EMPLOYEE WAGES false DAVID JOHNSON BOARD MEMBER 4445850 BANKING SERVICES false ZELMA CABLE FAMILY-KEY EMP 41171 EMPLOYEE WAGES false SCHEDULE L, PART V LISTED ABOVE ARE THE FAMILY MEMBERS OF CORPORATE OFFICERS/KEY EMPLOYEES WHO ARE ACTIVELY EMPLOYED AND COMPENSATED BY FHMI. THE ORGANIZATION MAINTAINS A BANK ACCOUNT FOR MALPRACTICE SELF INSURANCE FUND ACTIVITY AT UNITED COMMUNITY BANK. DIRECTOR DAVID JOHNSON IS AN OFFICER AT UNITED COMMUNITY BANK. FORM 990, PAGE 2, PART III, LINE 4A FLOYD HEALTHCARE MANAGEMENT, INC. OPERATES FLOYD MEDICAL CENTER, A GENERAL ACUTE CARE HOSPITAL, AND FLOYD BEHAVIORAL HEALTH, A PSYCHIATRIC UNIT. FLOYD MEDICAL CENTER IS A 300+ BED GENERAL ACUTE-CARE HEALTH INSTITUTION, OFFERING A WIDE RANGE OF SPECIALIZED SERVICES AND PROGRAMS. SUCH SERVICES AND PROGRAMS INCLUDE: ACUTE, MEDICAL/SURGICAL CARE; AMBULANCE SERVICE; BLOOD BANK; CANCER CARE UNIT; CARDIOVASCULAR LABORATORY; CORONARY CARE UNIT; CHAPLAIN SERVICE; CHEMICAL DEPENDENCY UNIT; CRISIS INTERVENTION; CT SCANNER; DIABETES CARE UNIT; LITHOTRIPSY, MEDICAL/SURGICAL INTENSIVE CARE; MAGNETIC RESONANCE IMAGING; NEUROLOGY; LEVEL III NEWBORN NURSERY/NEONATAL INTENSIVE CARE UNIT; OB/GYN; ORTHOPEDIC SURGERY, OUTPATIENT SURGERY CENTER; PATIENT REPRESENTATIVES; PEDIATRIC CARE; PHARMACY; DIAGNOSTIC RADIOLOGY; A 24-HOUR EMERGENCY SERVICE; ENDOSCOPIC LABORATORY; FAMILY PRACTICE RESIDENCY PROGRAM; PRIMARY CARE PHYSICIAN NETWORK; HEALTH EDUCATION AND PROMOTION; HOSPITAL AUXILIARY; INDUSTRIAL MEDICINE PROGRAM; INPATIENT REHABILITATION UNIT; LAPAROSCOPIC CHOLECYSTECTOMY SURGERY; LASER SURGERY; PHYSICAL THERAPY; OCCUPATIONAL THERAPY; SPEECH THERAPY; POISON CONTROL CENTER; POST-OPERATIVE RECOVERY ROOM; PROGRESSIVE INTENSIVE CARE UNIT; RESPIRATORY CARE SERVICES; SOCIAL WORK SERVICES; ULTRASOUND; CONGESTIVE HEART FAILURE CLINIC; WOUND OSTOMY CLINIC; BREAST CENTER, MOBILE MAMMOGRAPHY. DURING THE SHORT PERIOD ENDED DECEMBER 31, 2021, PATIENT DAYS (INCLUDING PSYCH AND REHAB) AT FLOYD MEDICAL CENTER TOTALED 47,384 AND DISCHARGES TOTALED 7,068. FLOYD MEDICAL CENTER PROVIDED APPROXIMATELY 23,255,000 IN DIRECT CHARITY AND INDIGENT CARE, AND IT INCURRED UNREIMBURSED MEDICARE AND MEDICAID ADJUSTMENTS OF 359,266,000 AND 139,644,000 RESPECTIVELY. A COPY OF THE REPORT TO THE COMMUNITY FOR FLOYD MEDICAL CENTER CAN BE FOUND AT WWW.FLOYD.ORG. FORM 990, PAGE 6, PART VI, LINE 4 FLOYD HEALTHCARE MANAGEMENT, INC. ("FHMI") MADE CHANGES TO ITS GOVERNING DOCUMENTS SINCE ITS LAST 990 FILING. ON JULY 14, 2022, FLOYD HEALTHCARE MANAGEMENT, INC. ENTERED INTO A MEMBER SUBSTITUTION AGREEMENT WITH THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY ("CMHA") AND AH GEORGIA, INC., A NORTH CAROLINA NONPROFIT CORPORATION AND WHOLLY-OWNED SUBSIDIARY OF CMHA WHEREBY AH GEORGIA, INC. BECAME THE SOLE MEMBER OF FHMI. PRIOR TO THAT DATE FHMI WAS A MEMBERLESS GEORGIA NONPROFIT CORPORATION. CMHA AND FHMI DETERMINED THAT THE MEMBERSHIP SUBSTITUTION AGREEMENT WOULD ALLOW TWO LEADING AND COMPLEMENTARY HEALTH SYSTEMS TO BRING VALUE TO THE COMMUNITIES THEY SERVE BEYOND WHAT EITHER CMHA OR THE FLOYD HEALTH CARE SYSTEM COULD DO ON ITS OWN. THE OBJECTIVES OF THE TRANSACTION WERE TO: A.ENHANCE THE MISSION OF THE FLOYD HEALTH CARE SYSTEM TO BE RESPONSIVE TO THE COMMUNITIES IT SERVES WITH A COMPREHENSIVE AND TECHNOLOGICALLY ADVANCED HEALTHCARE SYSTEM COMMITTED TO THE DELIVERY OF CARE THAT IS CHARACTERIZED BY CONTINUALLY IMPROVING QUALITY, ACCESSIBILITY, AFFORDABILITY AND PERSONAL DIGNITY, AND ITS VISION OF BEING THE REGIONAL HEALTH CARE PROVIDER OF CHOICE AND THE EMPLOYER OF CHOICE BY STRIVING TO DELIVER PATIENT AND FAMILY CENTERED CARE THAT IS COMPASSIONATE, SENSITIVE AND RESPECTFUL OF EACH INDIVIDUAL'S NEEDS; B.PROVIDE QUALITY, COST-EFFICIENT AND INNOVATIVE HEALTH CARE SERVICES TO RESIDENTS OF NORTHWEST GEORGIA (AND OTHER LOCATIONS IN GEORGIA AND ALABAMA WHERE THE FLOYD HEALTH CARE SYSTEM CURRENTLY PROVIDES HEALTH CARE SERVICES) WHILE MAINTAINING THE ACCESSIBILITY AND AFFORDABILITY OF A LOCAL HEALTH CARE PROVIDER; C.MAINTAIN AND ENHANCE THE HISTORICAL LEVELS OF INDIGENT AND CHARITY CARE PROVIDED BY THE FLOYD HEALTH CARE SYSTEM ON A GOING FORWARD BASIS; D.STRENGTHEN THE FLOYD HEALTH CARE SYSTEM PHYSICIAN ENTERPRISE BY (A) SUPPORTING AND ENHANCING THE FLOYD HEALTH CARE SYSTEM'S PRIMARY AND URGENT CARE PROVIDERS AND FACILITIES, (B) PROVIDING THE FLOYD HEALTH CARE SYSTEM WITH ACCESS TO REGIONAL SPECIALISTS AND SPECIALTY CLINICAL SERVICES, (C) DEPLOYING CMHA'S DEMONSTRATED ABILITY TO ATTRACT, RECRUIT AND RETAIN QUALIFIED PHYSICIANS, (D) PROVIDING ACCESS TO CMHA'S PHYSICIAN PRACTICE MANAGEMENT CAPABILITIES, INTELLECTUAL CAPITAL AND CLINICAL BEST PRACTICES, AND (E) OPTIMIZING THE FLOYD HEALTH CARE SYSTEM'S EXISTING PHYSICIAN INFRASTRUCTURE AND RELATED CAPABILITIES; E.ENSURE THAT FHMI MAINTAINS SIGNIFICANT AND MEANINGFUL ROLES IN ONGOING LOCAL GOVERNANCE AND MANAGEMENT AT THE APPROPRIATE LEVELS OF REPRESENTATION AMONG AND BETWEEN FHMI AND CMHA, AS PROVIDED HEREIN; F.SUPPORT FLOYD WITH THE CAPITAL COMMITMENTS NECESSARY TO FUND STRATEGIC INVESTMENTS AND ROUTINE ANNUAL MAINTENANCE CAPITAL EXPENDITURES, AS PROVIDED IN THE MEMBER SUBSTITUTION AGREEMENT; G. PROVIDE MEANINGFUL OPPORTUNITIES TO OPTIMIZE ECONOMIES OF SCALE AND CREATE OPERATIONAL EFFICIENCIES IN CORPORATE MANAGEMENT AND BACK-OFFICE FUNCTIONS, YET SEEK TO HELP THE DELIVERY AND ONGOING IMPROVEMENT OF HEALTHCARE AT THE LOCAL LEVEL; H.PROVIDE THE NECESSARY FINANCIAL, CLINICAL, AND CORPORATE SUPPORT TO EXPAND FHMI'S, POLK MEDICAL CENTER INC.'S (A SUBSIDIARY OF FHMI) AND FLOYD CHEROKEE MEDICAL CENTER'S (A SUBSIDIARY OF FHMI) FACILITIES, SERVICES, OPERATIONS, AND WORKFORCE, AS PROVIDED IN THE MEMBER SUBSTITUTION AGREEMENT, WITH THE OBJECTIVE OF ENHANCING THE FLOYD HEALTH CARE SYSTEM'S ABILITY TO SERVE ITS COMMUNITY; AND I.EXPAND THE CMHA HEALTH SYSTEM AND PROVIDE A FOUNDATION FOR FURTHER REGIONAL GROWTH, BY ADDING A HIGH-QUALITY HEALTH SYSTEM COMPONENT THAT IS SUCCESSFULLY INTEGRATED INTO CMHA'S QUALITY CARE DELIVERY AND ADMINISTRATIVE SERVICES. AS PART OF THE TRANSACTION FHMI AMENDED AND RESTATED ITS ARTICLES OF INCORPORATION AND ITS CORPORATE BYLAWS IN THE FORM ATTACHED HERETO. FORM 990, PAGE 6, PART VI, LINE 7A THE ORGANIZATION'S BOARD MAKES ALL DECISIONS RELATED TO APPOINTMENT OF MEMBERS OF THE BOARD. THE CEO IS AUTOMATICALLY A MEMBER OF THE BOARD BY VIRTUE OF HIS POSITION IN THE ORGANIZATION. FLOYD HEALTHCARE RESOURCES' BOARD CHAIRMAN IS AUTOMATICALLY A MEMBER OF THE FHMI'S BOARD BY VIRTUE OF HIS POSITION IN THE ORGANIZATION. BY CONTRACT, THE ORGANIZATION AGREES TO HAVE TWO OF THE FLOYD COUNTY BOARD COMMISSIONERS ON THE BOARD. FORM 990, PAGE 6, PART VI, LINE 11B THE ORGANIZATION'S CEO, CFO, CONTROLLER, LEGAL COUNSEL AND EMPLOYEES OF FHMI REVIEW THE FORM 990 FOR FINANCIAL AND DISCLOSURE ACCURACY. PRIOR TO ITS FILING, A COPY OF THE ORGANIZATION'S 990 RETURN IS POSTED ON THE BOARD OF DIRECTOR'S SECURE WEBSITE FOR THEIR REVIEW. MANAGEMENT WILL SEND AN EMAIL NOTIFYING MEMBERS OF ITS POSTING. FORM 990, PAGE 6, PART VI, LINE 12C FLOYD HEALTHCARE MANAGEMENT, INC. ("FHMI") HAS A WRITTEN POLICY RESPECTING CONFLICTS OF INTEREST AND DISCLOSURE OF SAME. GENERALLY SPEAKING, THE POLICY REQUIRES ANY "COVERED PERSON" WHO BELIEVES HE HAS A CONFLICT OF INTEREST TO: -DISCLOSE THE EXISTENCE AND NATURE OF THE CONFLICT OF INTEREST (INCLUDING ALL FACTS KNOWN RESPECTING THE SUBJECT MATTER) TO THE CHAIRMAN OF THE BOARD; -PLAY NO PART, DIRECTLY OR INDIRECTLY, IN THE DELIBERATION OR VOTE OF THE BOARD OF DIRECTORS WITH RESPECT TO THE DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS; AND -ABSENT HIMSELF FROM THAT PORTION OF THE MEETING AT WHICH THE CONFLICT OF INTEREST IS DISCUSSED. THE DEFINITION OF A "COVERED PERSON" INCLUDES ALL BOARD MEMBERS, OFFICERS AND MEMBERS OF SENIOR MANAGEMENT OF FHMI. WHEN A COVERED PERSON DISCLOSES A POTENTIAL CONFLICT OF INTEREST TO THE BOARD CHAIRMAN, THE CHAIRMAN IS OBLIGED TO BRING THE MATTER TO THE ATTENTION OF THE FULL BOARD. THE BOARD DETERMINES WHETHER A CONFLICT OF INTEREST ACTUALLY EXISTS. IF THE BOARD DETERMINES THAT THERE IS A CONFLICT OF INTEREST, THE TRANSACTION OR MATTER GIVING RISE TO THE CONFLICT OF INTEREST MAY NOT PROCEED UNLESS THE BOARD DETERMINES, BY A MAJORITY VOTE, THAT, DESPITE THE CONFLICT OF INTEREST, THE TRANSACTION/MATTER IS NEVERTHELESS IN THE CORPORATION'S BEST INTEREST AND IS FAIR AND REASONABLE TO THE CORPORATION. IN ADDITION TO THE REQUIREMENT THAT A COVERED PERSON DISCLOSE A POTENTIAL CONFLICT OF INTEREST AT THE TIME IT ARISES, EACH COVERED PERSON IS ALSO REQUIRED TO SUBMIT, ON AN ANNUAL BASIS, A `CONFLICT AND DISCLOSURE OF INTEREST QUESTIONNAIRE'. THIS MULTI-QUESTION DOCUMENT SERVES AS A REMINDER AND PROMPTS EACH COVERED PERSON TO PONDER THOSE AREAS AND SITUATIONS WHERE A POTENTIAL CONFLICT MIGHT EXIST. ADDITIONALLY, ANY PROPOSED TRANSACTION AT FHMI WHICH INVOLVES AN "INSIDER" (I.E., A BOARD MEMBER, OFFICER, MANAGER, ETC.) IS SCRUTINIZED, WITH THE ASSISTANCE OF CORPORATE LEGAL COUNSEL, FROM THE STANDPOINT OF WHETHER THE TRANSACTION WILL RESULT IN ANY EXCESS BENEFIT TO THE INSIDER. TYPICALLY THIS INVOLVES OBTAINING APPROPRIATE DATA REGARDING COMPARABILITY WHICH IS PROVIDED TO THE BOARD FOR ITS USE IN DETERMINING THAT THE CONSIDERATION BEING PAID TO THE INSIDER AS A PART OF THE TRANSACTION IS REASONABLE AND DOES NOT EXCEED THE VALUE OF THE BENEFIT RECEIVED BY FHMI. FORM 990, PAGE 6, PART VI, LINE 15A IT IS THE RESPONSIBILITY OF THE COMPENSATION COMMITTEE OF FLOYD HEALTHCARE MANAGEMENT, INC. BOARD TO ACTIVELY MANAGE AND MONITOR EXECUTIVE COMPENSATION. TO DO SO, THE COMMITTEE HAS ESTABLISHED THE FOLLOWING OBJECTIVES FOR THE EXECUTIVE COMPENSATION PROGRAM: -PROVIDE A COMPETITIVE TOTAL COMPENSATION EARNING OPPORTUNITY TO RECRUIT, RETAIN, AND REWARD THE EXECUTIVES NEEDED TO MEET THE COMMUNITY'S HEALTHCARE NEEDS, NOW AND IN THE FUTURE; -PROVIDE PAY OPPORTUNITIES THAT WILL REWARD THE EXECUTIVE TEAM WHEN ORGANIZATIONAL PERFORMANCE IN KEY AREAS IS DEMONSTRATED; -INCENTIVE COMPENSATION UNDER THE EXECUTIVE INCENTIVE COMPENSATION PLAN IS PAYABLE ONLY IN THE EVENT THE ORGANIZATION'S OPERATING MARGIN FROM OPERATING REVENUE EXCEEDS CERTAIN PARAMETERS ESTABLISHED BY THE COMPENSATION COMMITTEE; -ENSURE THAT THE COMPENSATION PROGRAMS ARE EASY FOR ALL INTERESTED PARTIES TO UNDERSTAND. ANNUALLY, THE COMMITTEE REVIEWS THE APPROPRIATENESS OF THE TOTAL COMPENSATION PROVIDED TO EACH EXECUTIVE: -AS RELATED TO THE COMPETITIVE MARKET PAY RATES; -AS RELATED TO THE INDIVIDUAL'S ROLE AND RESPONSIBILITY IN THE ORGANIZATION; -AS IT PERTAINS TO VARIABLE OR INCENTIVE EARNING OPPORTUNITIES RELATING TO THE PERFORMANCE OF THE ORGANIZATION. TO DETERMINE THE MARKET RATES FOR EACH POSITION, THE COMMITTEE UTILIZES AN OUTSIDE CONSULTANT TO SURVEY COMPARABLE ORGANIZATIONS TO DEVELOP AN APPROPRIATE RANGE OF PAY FOR EACH EXECUTIVE POSITION. THIS RANGE GENERALLY REFLECTS THE PAY PRACTICES AND LEVELS OF COMPARABLE ORGANIZATIONS IN GEORGIA, THE SOUTHEAST, AND ACROSS THE COUNTRY. SPECIFICALLY, THE COMMITTEE REVIEWS DATA FOR MARKET RATES OF BASE SALARY AND TOTAL COMPENSATION (THE COMBINATION OF BASE SALARY AND BONUSES). AFTER REVIEWING THIS DATA, THE COMMITTEE ASSESSES THE APPROPRIATENESS OF THE BASE PAY LEVELS FOR EACH EXECUTIVE WITHIN A RANGE THAT GENERALLY REFLECTS INDUSTRY NORMS. IN ADDITION TO MONITORING BASE SALARIES, THE COMMITTEE IS RESPONSIBLE FOR ADMINISTERING THE EXECUTIVE INCENTIVE COMPENSATION PROGRAM. THE PROGRAM IS DESIGNED TO: -FURTHER ALIGN EXECUTIVE PAY WITH THE STRATEGIC AND OPERATIONAL ACHIEVEMENTS OF THE ORGANIZATION; -WHEN THE ORGANIZATION ACHIEVES RESULTS IN KEY AREAS OF PERFORMANCE, TO APPROPRIATELY REWARD EXECUTIVES ACCORDING TO THAT PROGRAM; THE COMMITTEE HAS ALSO ESTABLISHED SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAMS (SERPS). THESE SERPS WERE DESIGNED WITH THE ADVICE AND HELP OF CONSULTANTS AND ARE DESIGNED TO RETAIN AND REWARD EXECUTIVES WITH RETIREMENT OPPORTUNITIES THAT ARE CONSISTENT WITH MARKET PRACTICES IN GEORGIA, THE SOUTHEAST, AND ACROSS THE COUNTRY. IN 2001, THESE PLANS VESTED TWO EXECUTIVES. IT IS THE PHILOSOPHY OF THE FHMI BOARD THAT THE COMBINATION OF THE INCENTIVE EARNING OPPORTUNITY, THE BASE SALARY, AND THE SERPS WILL PROVIDE A COMPETITIVE COMPENSATION LEVEL TO EACH EXECUTIVE THAT REFLECTS THE MARKET FOR EACH POSITION AND ORGANIZATION PERFORMANCE. THE COMMITTEE HAS DEVELOPED THE PROGRAM TO RECRUIT, RETAIN, AND REWARD EXECUTIVES IN ORDER TO MEET THE PRESENT AND FUTURE NEEDS OF THE ORGANIZATION TO PROVIDE A HIGH QUALITY OF PATIENT CARE TO THE COMMUNITY IN A COST EFFECTIVE MANNER. FORM 990, PAGE 6, PART VI, LINE 15B SEE NARRATIVE UNDER PART VI, LINE 15A. FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC WHEN THE REQUEST IS MADE AT THE ADMINISTRATIVE OFFICE OF THE FILING CORPORATION. FORM 990, PART XI, LINE 9 ATRIUM VALUATION 117,507,107 TRANSFER FROM ATRIUM 147,681,427 BOND DEFEASEMENT -9,157,154 TOTAL 256,031,380 FLOYD PHYSICIANS LLC 304 TURNER MCCALL BLVD ROME GA 301620233 205415285 SPEC PHYS GA 1544592 727882 FHMI FLOYD CHEROKEE MEDICAL CENTER LLC 400 NORTHWOOD DRIVE CENTRE AL 359601023 825207287 HOSPITAL AL 46743443 13215823 FHMI ACCOUNTABLE CARE ORGANIZATION OF FMC 304 TURNER MCCALL BLVD ROME GA 301620233 474054900 DORMANT FHMI FLOYD EMERGENCY PHYSICIANS 304 TURNER MCCALL BLVD ROME GA 301620233 050608795 DORMANT GA FHMI HOSPITAL AUTHORITY OF FLOYD COUNTY 304 TURNER MCCALL BLVD ROME GA 301620233 586001173 HEALTHCARE GA 501C3 3 NA false FLOYD HEALTHCARE RESOURCES INC 304 TURNER MCCALL BLVD ROME GA 301620233 582010524 HEALTHCARE GA 501C3 10 NA false FLOYD HEALTH CARE FOUNDATION INC PO BOX 233 ROME GA 301620233 581375074 FOUNDATION GA 501C3 12A FHMI FLOYD HEALTHCARE MANAGEMENT INC true POLK MEDICAL CENTER INC 420 E SECOND AVENUE STE 102 ROME GA 301613210 453957368 HOSPITAL GA 501C3 3 FHMI FLOYD HEALTHCARE MANAGEMENT INC true CANCER NAVIGATORS INC 255 W 5TH STREET SUITE 300 ROME GA 301652817 030397867 EDUCATION GA 501C3 7 FHMI true FLOYD-POLK HEALTHCARE FOUNDATION 304 TURNER MCCALL BLVD ROME GA 30165 872546864 SUPPORT GA 501C3 12A NA false AH GEORGIA INC PO BOX 32862 CHARLOTTE NC 282322861 831707383 SOLE MEMBE NC 501C3 7 CMHA false THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY 1000 BLYTHE BLVD CHARLOTTE NC 28203 560529945 HEALTHCARE NC NA false false false false false true false false false false false false true true true true true true false false ALL ENTITIES N AMOUNT INDETERMINABLE ALL ENTITIES O AMOUNT INDETERMINABLE ALL ENTITIES Q AMOUNT INDETERMINABLE ALL ENTITIES E 9248746 GENERAL LEDGER BALANCE ALL ENTITIES M AMOUNTS INDETERMINABLE ALL ENTITIES L AMOUNT INDETERMINABLE SCHEDULE R PART I - DISREGARDED ENTITIES IN AUGUST 2006, FHMI SPONSORED THE CREATION OF FLOYD PHYSICIANS, LLC (FP), A GEORGIA LIMITED LIABILITY COMPANY. FHMI IS THE SOLE MEMBER/OWNER OF FP AND HAS THE SOLE AUTHORITY TO APPOINT FP'S FIVE-PERSON BOARD OF DIRECTORS. FP WAS FORMED FOR THE PURPOSE OF HIRING OR OTHERWISE ENGAGING PHYSICIANS TO PROVIDE PROFESSIONAL MEDICAL SERVICES TO PATIENTS. FLOYD CHEROKEE MEDICAL CENTER, LLC IS A SINGLE MEMBER LIMITED LIABILITY CORPORATION OPERATING CHEROKEE MEDICAL CENTER, A 60-BED ACUTE CARE HOSPITAL, CURRENTLY OPERATING 45 BEDS, LOCATED IN CENTRE, ALABAMA.