2021-03-02T11:03:17-06:00 2020-06-30 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2019-07-01 581973570 FLOYD HEALTHCARE MANAGEMENT INC FLOY 7065096074 304 TURNER MCCALL BLVD ROME GA 301620233 CLARICE CABLE INTERIM CFO 7065095774 2021-03-01 true JACQUELINE G ATKINS P00861721 2298837878 2021-03-01 2019 2022-09-23 18:48:47Z KURT STUENKEL 304 TURNER MCCALL BLVD ROME GA 301620233 514870198 false X WWW.FLOYD.ORG X 1990 GA OPERATE A NON-PROFIT HOSPITAL SYSTEM AND SUPPORT 501 (C)(3)ORGANIZATIONS 16 12 3895 130 479129 197205 2203820 10330798 440157562 418974444 3045656 11873640 746113 1022224 446153151 442201106 264289 261313 0 243426237 245968299 0 371986 189315613 190156640 433006139 436386252 13147012 5814854 441873119 474932938 244877073 288172283 196996046 186760655 X OPERATE A NON-PROFIT HOSPITAL SYSTEM AND SUPPORT 501 (C)(3)ORGANIZATIONS false false 321333447 261313 409270783 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 FISCAL YEAR 2020, PATIENT DAYS (INCLUDING PSYCH AND REHAB) AT FLOYD MEDICAL CENTER TOTALED 74,402 AND DISCHARGES TOTALED 13,721. FLOYD MEDICAL CENTER PROVIDED APPROXIMATELY 58,345,000 IN DIRECT CHARITY AND INDIGENT CARE, AND IT INCURRED UNREIMBURSED MEDICARE AND MEDICAID ADJUSTMENTS OF 581,934,000 AND 227,618,000 RESPECTIVELY. A COPY OF THE REPORT TO THE COMMUNITY FOR FLOYD MEDICAL CENTER CAN BE FOUND AT WWW.FLOYD.ORG. 9394656 9719245 CHEROKEE MEDICAL CENTER (CMC) IS A 60-BED ACUTE CARE HOSPITAL LOCATED IN CENTRE, ALABAMA. CMC IS OPERATED BY FLOYD CHEROKEE MEDICAL CENTER, LLC (FCMC), AN ALABAMA LIMITED LIABILITY CORPORATION WHOSE SOLE MEMBER IS FHMI. DURING FISCAL YEAR 2020, CHEROKEE MEDICAL CENTER PROVIDED 3,366 PATIENT DAYS AND DISCHARGES TOTALED 723. CHEROKEE MEDICAL CENTER PROVIDED APPROXIMATELY 374,000 IN DIRECT CHARITY AND INDIGENT CARE, AND IT INCURRED UNREIMBURSED MEDICARE AND MEDICAID ADJUSTMENTS OF 17,419,000 AND 12,571,000 RESPECTIVELY. 330728103 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 false true true true false false false false false false false true true true false false false false true true false false false true 237 0 3895 true true true false false false false false false false false false true false X 16 12 false false false 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 3.00 X X 1264689 0 27591 RICHARD T SHEERIN CFO (RETIRED 50.00 5.00 X 725452 0 19727 WARREN RIGAS SVP COO 50.00 X 690056 0 33821 SHEILA HORNER VP & CNO 50.00 X 598951 0 14761 TOMMY MANNING CORPORATE CO 50.00 X 537227 0 34071 BRIDGETTE DINGLE MD NEONATOLOGIS 50.00 X 485884 0 32071 MATTHEW CORNFORTH MD PHYSICIAN 50.00 X 503740 0 12292 JEFFERY D BUDA CHF INFORMAT 50.00 X 447566 0 26071 EDWIN MONTAGUE MD PHYSICIAN 50.00 X 420958 0 32071 RICHARD CHILDS VP REVENUE C 50.00 X 397727 0 28678 BETH BRADFORD CHIEF HR OFF 50.00 X 410199 0 14761 GREG POLLEY VICE PRESIDE 50.00 X 382992 0 34071 RYAN D RAINER MD PHYSICIAN 50.00 X 387141 0 26071 DAVID EARLY DIRECTOR SUP 50.00 X 375503 0 25000 DURIEL D GRAY MD PHYSICIAN 50.00 X 365561 0 21286 ROBERT HOLCOMBE JR MD DIRECTOR 51.00 X 344091 0 25271 JULIE ROGERS CORP COMPLIA 50.00 X 296111 0 28527 REBEKAH LOWREY MD SURG DIR -LE 50.00 X 316121 0 5793 TAUYNA FAULKNER VP 50.00 X 282273 0 12587 CLARICE CABLE INTERIM CFO 50.00 5.00 X 239604 0 27980 ROBERT PURCELL PHARMACY DIR 50.00 X 245845 0 10243 JAMES COLLINS JR MD DIRECTOR 51.00 X 171488 0 25774 GEORGE BOSWORTH MD CHAIRMAN 1.00 2.00 X X 8000 5750 0 KAY CHUMBLER VICE CHAIRMA 1.00 X X 8000 0 0 LARRY KUGLAR DIRECTOR 1.00 1.00 X 4500 2250 0 DAVID JOHNSON DIRECTOR 1.00 1.00 X 5850 0 0 FRANK SHELLEY DIRECTOR 1.00 1.00 X 3500 2000 0 W DAVID NEWBY DIRECTOR 1.00 1.00 X 4400 0 0 SHANNON JOE VAUGHN MD DIRECTOR 1.00 X 3500 0 0 BRAD WARD MD DIRECTOR (LE 1.00 1.00 X 2250 1000 0 GARRY FRICKS DIRECTOR 1.00 X 3000 0 0 CARL HERRING MD DIRECTOR 1.00 X 2875 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 RHONDA WALLACE DIRECTOR 1.00 X 0 0 0 9935054 11000 518518 293 false true false IN COMPASS HEALTH INC 318 MAXWELL ROAD SUITE 500 ALPHARETTA GA 30009 HOSPITALIST 6540197 CERNER CORP PO BOX 412702 KANSAS CITY MO 641412702 IT SERVICES 5180109 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 303682289 DIETARY SVC 4776656 ARAMARK MANAGEMENT SERVICES PO BOX 233 ROME GA 301610233 HOUSEKEEPING 3919822 GEORGIA GROUP SERVICES LLC P O BOX 740666 ATLANTA GA 306740666 ANESTHESIA 2990587 73 350000 9927660 53138 10330798 PATIENT SERVICE REVENUE 623000 416720505 416720505 FAMILY PRACTICE CAPITATION 621990 1774810 1774810 REFERENCE LAB 621500 479129 479129 418974444 3302041 3302041 450236 231926 218310 218310 218310 80651743 78600 71103471 1055273 9548272 -976673 8571599 8571599 479424 278422 201002 201002 EMS OPERATING GRANTS 621990 250000 250000 RELATED PARTY BILLING 621990 137313 137313 CAFETERIA 621990 108199 108199 107400 107400 602912 442201106 418990028 479129 12401151 X 261313 261313 8166485 560874 7605611 177324496 147504931 29544873 274692 5292615 4233563 1051113 7939 42338543 33866600 8408435 63508 12846160 9591138 3235245 19777 4101241 4101241 542498 542498 51696615 39105000 12591615 2157329 173548 1983781 8396500 4986055 3410084 361 15700079 794220 14902351 3508 13302660 11469553 1833107 4679299 1369034 3308064 2201 576004 311948 264056 61432 61432 18893307 16289809 2603498 2416380 343350 2073030 MEDICAL SUPPLIES 56277952 55993556 284396 PROVIDER FEES 5172475 5172475 REPAIRS & MAINTENANCE 3813498 2888056 925442 DUES & SUBSCRIPTIONS 934207 315834 618373 1435164 669721 765443 436386252 330728103 105286163 371986 50172126 25751481 30648925 30907409 68987419 65942192 206860 189832 11456656 11887443 5681555 5002476 355270095 219444959 145612028 135825136 106184578 185671534 15092605 5687999 7830367 8067436 441873119 474932938 41940903 38373431 8419649 133100377 129122655 24148074 22485207 45687719 89771341 244877073 288172283 X 196996046 186760655 196996046 186760655 441873119 474932938 X 5814854 -5332900 -10717345 X false true X true false 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 SEES APPROXIMATELY 64,400 PATIENTS PER YEAR AND A BUSY OUTPATIENT INDIGENT CLINIC. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 50000 false false true 38025 88025 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 2020, THE ORGANIZATION PAID 50,000 TO TERMINUS SOUTH/GEORGIA PUBLIC AFFAIRS FOR A LOBBYING LIAISON WITH THE GEORGIA STATE GOVERNMENT. 14774479 14774479 147183013 66110065 81072948 16992485 13138977 3853508 175891579 140195917 35695662 428539 428539 135825136 MEDICARE ADVANCE PAYMENTS 39149252 ACCRUED PENSION 37945913 MALPRACTICE CLAIMS 7396868 DUE TO RELATED PARTIES 2666673 ACCRUED INTEREST 2612635 89771341 X SCHEDULE D, PAGE 3, PART X THE CORPORATION IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE CORPORATION 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, THE CORPORATION 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 MANAGEMENTS 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 JUNE 30, 2020 AND 2019 OR FOR THE YEARS THEN ENDED. THE CORPORATIONS 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 1.250000000000 true X 4.000000000000 true true false true true 13465087 13465087 0.03080 73746265 57033124 16713141 0.03830 87211352 57033124 30178228 0.06910 1682942 1682942 0.00390 7634822 5974750 1660072 0.00380 1151627 1151627 0.00260 81801 81801 0.00020 10551192 5974750 4576442 0.01050 97762544 63007874 34754670 0.07960 true 131509049 65754524 80469165 91750158 -11280993 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 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 WWW.FLOYDSTRAIGHTFORWARD.ORG X X true 19 true WWW.FLOYD.ORG 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 true X false false GROUP A, FACILITY 1, FLOYD HEALTHCARE MANAGEMENT INC. - 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 PAGES 14-18 OF THE 2019 CHNA. 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 2019 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 2019 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 2019 CHNA AND IMPLEMENTATION PLAN CAN BE FOUND ON THE ORGANIZATION'S WEBSITE AT HTTPS://WWW.FLOYD.ORG/ABOUT-FLOYD/PAGES/REPORTS- AND-AUDITS.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. 2 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 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 25 436,386,252 ADD: EXPENSES REPORTED IN PART VIII 510,348 DENOMINATOR FOR COLUMN (F) 436,896,600 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 18- 23 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 2019. 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 2019 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 (2019) 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 16.3% TO 21.8%. THE PERCENTAGE OF RESIDENTS WHO HAVE EITHER GRADUATED HIGH SCHOOL OR HAVE A GENERAL EDUCATIONAL DEVELOPMENT CERTIFICATE RANGES FROM 73.1% TO 81.0% 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. 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 33 169876 TUITION 36 91437 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 false false false false false false false false KURT STUENKEL PRES/SECRE/CEO 928017 324072 12600 27591 1292280 RICHARD T SHEERIN CFO (RETIRED 2019) 569368 149772 6312 19727 745179 WARREN RIGAS SVP COO 554868 128772 6416 33821 723877 SHEILA HORNER VP & CNO 477282 116172 5497 14761 613712 TOMMY MANNING CORPORATE COUNSEL 404673 128972 3582 34071 571298 BRIDGETTE DINGLE MD NEONATOLOGIST 485236 648 32071 517955 MATTHEW CORNFORTH MD PHYSICIAN 502984 756 12292 516032 JEFFERY D BUDA CHF INFORMATION OFCR 337100 107472 2994 26071 473637 EDWIN MONTAGUE MD PHYSICIAN 420395 563 32071 453029 RICHARD CHILDS VP REVENUE CYCLE MGT 298555 95272 3900 28678 426405 BETH BRADFORD CHIEF HR OFFICER 309073 93872 7254 14761 424960 GREG POLLEY VICE PRESIDENT 284997 93272 4723 34071 417063 RYAN D RAINER MD PHYSICIAN 385937 1204 26071 413212 DAVID EARLY DIRECTOR SUPPORT SVC 286616 87572 1315 25000 400503 DURIEL D GRAY MD PHYSICIAN 365043 518 21286 386847 ROBERT HOLCOMBE JR MD DIRECTOR 338428 72 5591 25271 369362 JULIE ROGERS CORP COMPLIANCE OFCR 218776 74372 2963 28527 324638 REBEKAH LOWREY MD SURG DIR -LEFT 10/20 280231 31501 4389 5793 321914 TAUYNA FAULKNER VP 218007 63272 994 12587 294860 CLARICE CABLE INTERIM CFO 219316 19699 589 27980 267584 ROBERT PURCELL PHARMACY DIRECTOR 218771 25154 1920 10243 256088 JAMES COLLINS JR MD DIRECTOR 166096 51 5341 25774 197262 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. ADDITIONALLY, OF THE 1,264,689 LISTED AS COMPENSATION FOR MR. KURT STUENKEL IN FORM 990 PART VII SECTION A, 324,000 REPRESENTS A PERFORMANCE-BASED PAYMENT RISING FROM THE 2019 PERFORMANCE PERIOD. ACCORDINGLY, MR. STUENKEL'S SALARY FOR 2019 WOULD HAVE BEEN 940,689 EXCLUDING THE 2019 PORTION OF THE INCENTIVE-BASED PAYMENT. 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. A HOSPITAL AUTHORITY OF FLOYD COUNTY REVENUE BOND SERIES 2012 A 586001173 343575GH3 2012-06-27 20000000 CAPITAL IMPROVEMENTS false false false B HOSPITAL AUTHORITY OF FLOYD COUNTY REVENUE BONDS SERIES 2012B 586001173 343575GY6 2012-06-27 31885000 DEFEASE 2003 REVENUE SERIES BONDS false false false C HOSPITAL AUTHORITY OF FLOYD COUNTY 2016 SERIES FHMI AND POLK 586001173 343575HQ2 2016-04-12 85435000 DEFEASE 2003 & 2009 REVENUE SERIES BONDS false false false A 2900000 20074922 279011 243560 19552351 2013 false false true true B 8105000 34970725 444814 36387986 388296 1777 2013 false false true true C 6310000 101960422 71108289 845684 30006449 2016 false true true true A false false false false false false true B false false false false false false true C 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 C false false false true false false false false false A false B false C false DIFFERENCES IN ISSUE PRICE EXPLANATION HOSPITAL AUTHORITY OF FLOYD COUNTY THE DIFFERENCE IN THE ISSUE PRICE REPORTED IN SCHEDULE K PART I AND TOTAL PROCEEDS OF ISSUE REPORTED IN SCHEDULE K PART II IS A PREMIUM ASSOCIATED WITH THE 2012A ISSUE. DIFFERENCES IN ISSUE PRICE EXPLANATION HOSPITAL AUTHORITY OF FLOYD COUNTY THE DIFFERENCE IN THE ISSUE PRICE REPORTED IN SCHEDULE K PART I AND TOTAL PROCEEDS OF ISSUE REPORTED IN SCHEDULE K PART II IS A PREMIUM ASSOCIATED WITH THE 2012B ISSUE. DIFFERENCES IN ISSUE PRICE EXPLANATION HOSPITAL AUTHORITY OF FLOYD COUNTY THE PART I, COLUMN (E), ROW (C) ISSUE PRICE DOES NOT AGREE WITH THE PART II, COLUMN (C) LINE 3 TOTAL PROCEEDS OF ISSUE DUE TO NET PREMIUM OF 10,689,619; AND 5,835,803 OF THE DEBT SERVICE RESERVE FUND FOR THE SERIES 2003 AND 2009 CERTIFICATES WAS DEPOSITED WITH THE TRUSTEE ON THE DATE OF ISSUANCE OF THE SERIES 2016 BONDS. PURPOSE OF ISSUE DESCRIPTION HOSPITAL AUTHORITY OF FLOYD COUNTY CAPITAL IMPROVEMENTS PURPOSE OF ISSUE DESCRIPTION HOSPITAL AUTHORITY OF FLOYD COUNTY DEFEASE 2003 REVENUE SERIES BONDS PURPOSE OF ISSUE DESCRIPTION HOSPITAL AUTHORITY OF FLOYD COUNTY DEFEASE 2003 & 2009 REVENUE SERIES BONDS DATE REBATE COMPUTATION PERFORMED HOSPITAL AUTHORITY OF FLOYD COUNTY 04/26/17 DATE REBATE COMPUTATION PERFORMED HOSPITAL AUTHORITY OF FLOYD COUNTY 04/26/17 DATE REBATE COMPUTATION PERFORMED HOSPITAL AUTHORITY OF FLOYD COUNTY 04/26/17 JOSHUA POLLEY FAMILY-KEY EMP 76301 EMPLOYEE WAGES false BENJAMIN RIGAS FAMILY-KEY EMP 84247 EMPLOYEE WAGES false BETHANY POLLEY FAMILY-KEY EMP 5846 EMPLOYEE WAGES false GREGORY ROGERS FAMILY-KEY EMP 263357 EMPLOYEE WAGES false RUSSELL BISHOP FAMILY-KEY EMP 73955 EMPLOYEE WAGES false DEBORAH BISHOP FAMILY-KEY EMP 93415 EMPLOYEE WAGES false DAVID JOHNSON BOARD MEMBER 4077390 BANKING SERVICES 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 FISCAL YEAR 2020, PATIENT DAYS (INCLUDING PSYCH AND REHAB) AT FLOYD MEDICAL CENTER TOTALED 74,402 AND DISCHARGES TOTALED 13,721. FLOYD MEDICAL CENTER PROVIDED APPROXIMATELY 58,345,000 IN DIRECT CHARITY AND INDIGENT CARE, AND IT INCURRED UNREIMBURSED MEDICARE AND MEDICAID ADJUSTMENTS OF 581,934,000 AND 227,618,000 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 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 IX, LINE 11G CONTRACT SERVICES 20,173,256 1,709,097 0 PURCHASED SERVICES 18,448,900 7,402,972 0 CONSULTING FEES 247,585 1,453,702 0 BILLING AND COLLECTIONS 223,200 2,025,844 0 FPC MANAGEMENT FEES 12,059 0 0 TOTAL 39,105,000 12,591,615 0 FORM 990, PART XI, LINE 9 AMORTIZATION OF ACTUARIAL LOSS 782,681 REDUCTION IN PENSION LIABILITY 546,312 CURRENT YEAR ACTUARIAL LOSS -12,046,338 TOTAL -10,717,345 NET INCREASE REPRESENTS NONCASH ACTIVITY EFFECTING NET ASSETS. SEE DETAILS ABOVE. FLOYD EMERGENCY PHYSICIANS LLC 304 TURNER MCCALL BLVD ROME GA 301620233 050608795 ER SVC GA FHMI FLOYD PHYSICIANS LLC 304 TURNER MCCALL BLVD ROME GA 301620233 205415285 SPEC PHYS GA 2013232 279221 FHMI ACCOUNTABLE CARE ORGANIZATION OF 304 TURNER MCCALL BLVD ROME GA 301620233 474054900 HEALTHCARE GA FHMI FLOYD CHEROKEE MEDICAL CENTER LLC 400 NORTHWOOD DRIVE CENTRE AL 359601023 825207287 HOSPITAL AL 75036852 11558411 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 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 9144534 GENERAL LEDGER BALANCE ALL ENTITIES M AMOUNTS INDETERMINABLE ALL ENTITIES L AMOUNT INDETERMINABLE SCHEDULE R PART I - DISREGARDED ENTITIES IN SEPTEMBER 2004, FLOYD HEALTHCARE MANAGEMENT, INC. (FHMI) SPONSORED THE CREATION OF FLOYD EMERGENCY PHYSICIANS, LLP (FEP), A GEORGIA LIMITED LIABILITY COMPANY. FHMI IS THE SOLE MEMBER/OWNER OF FEP AND HAS THE SOLE AUTHORITY TO APPOINT FEP'S FIVE-PERSON BOARD OF DIRECTORS. FEP WAS FORMED FOR THE PURPOSE OF HIRING OR OTHERWISE ENGAGING EMERGENCY PHYSICIANS TO PROVIDE PROFESSIONAL MEDICAL SERVICES TO PATIENTS PRESENTING TO FLOYD MEDICAL CENTER'S EMERGENCY CARE CENTER. FEP ALSO PROVIDES EMERGENCY PHYSICIAN STAFFING TO POLK MEDICAL CENTER. FEP BECAME INACTIVE AS OF JANUARY 31, 2017 AND WAS CLOSED AS OF JUNE 30, 2020. 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. IN THE SUMMER OF 2015, FLOYD MEDICAL CENTER MADE THE DECISION TO APPLY FOR PARTICIPATION IN THE CMS MEDICARE SHARE SAVINGS PROGRAM (MSSP), AN INCENTIVE-BASED PROGRAM THAT SHARES SAVINGS WITH PROVIDERS WHO MAKE QUALITY AND COST IMPROVEMENTS. FLOYD ESTABLISHED AN ACCOUNTABLE CARE ORGANIZATION (ACO), WHICH IS A REQUIREMENT TO BECOME A PARTICIPANT IN THE MSSP. FLOYDS ACO APPLICATION WAS APPROVED IN DECEMBER OF 2015 WITH AN EFFECTIVE DATE OF JANUARY 1, 2016. ACO WAS CLOSED AND NO LONGER OPERATING AS OF JUNE 30, 2020. 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.