2020-11-10T15:27:51-06:00 2019-12-31 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2019-01-01 541453954 AUGUSTA HEALTH CARE INC D/B/A AUGUSTA HEALTH AUGU 5409324685 PO BOX 1000 FISHERSVILLE VA 22939 JOHN KATSIANIS CFO 5409324685 2020-11-03 1 AMY BIBBY P00445891 8282542254 47.27.82.235 2020-11-03 12:19:47 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 BEC9594289F9DCBB4F655B5045764FC48E5A1487 2019 2021-01-29 14:40:06Z AUGUSTA HEALTH MARY N MANNIX FACHE PO BOX 1000 FISHERSVILLE VA 22939 381382232 0 X WWW.AUGUSTAHEALTH.COM X 1988 VA PROMOTE THE HEALTH AND WELL-BEING OF OUR COMMUNITY THROUGH ACCESS TO EXCELLENT CARE. 14 12 2290 201 4069892 0 433897 956999 307069986 351816484 21347866 23359880 3896764 4754871 332748513 380888234 455333 615890 0 0 127827334 143265053 0 0 0 149859443 166793460 278142110 310674403 54606403 70213831 703002857 826767939 45403520 52233791 657599337 774534148 X THE MISSION OF AUGUSTA HEALTH IS TO PROMOTE THE HEALTH AND WELL-BEING OF OUR COMMUNITY THROUGH ACCESS TO EXCELLENT CARE. 0 0 267172946 615890 347746592 AUGUSTA HEALTH CARE, INC. IS A 501(C)(3) ORGANIZATION DOING BUSINESS AS AUGUSTA HEALTH. THE ORGANIZATION INCLUDES A MEDICAL CENTER WITH 255 LICENSED INPATIENT BEDS; AN EMERGENCY DEPARTMENT TREATING APPROXIMATELY 57,000 COMMUNITY MEMBERS PER YEAR; FOUR URGENT CARE CENTERS TREATING APPROXIMATELY 61,000 PATIENTS; A STATE OF THE ART CANCER CENTER PROVIDING TAILOR-MADE COMPREHENSIVE CARE INCLUDING MEDICAL ONCOLOGY AND RADIATION ONCOLOGY; A HOME HEALTH AND HOSPICE PROGRAM SERVING PATIENTS WHO WISH TO REMAIN AT HOME DURING THEIR TREATMENT OR FINAL DAYS; A WOUND HEALING CLINIC PROVIDING A COMPREHENSIVE TREATMENT REGIMEN FOR CHRONIC NON-HEALING WOUNDS; AND A SKILLED NURSING UNIT PROVIDING COMPREHENSIVE REHABILITATION FOR PATIENTS RECOVERING FROM ORTHOPEDIC SURGERY.THE CAMPUS OF AUGUSTA HEALTH IS DESIGNED TO PROVIDE NOT ONLY HOSPITAL SERVICES BUT COMMUNITY ORIENTED SERVICES. THE CAMPUS INCLUDES THE HOSPITAL PROPER; A MAJOR FITNESS CENTER; AN EDUCATIONAL BUILDING THAT HOUSES AUGUSTA HEALTH EDUCATIONAL SERVICES; A COMMUNITY BUILDING WITH LARGE CONFERENCE ROOMS AVAILABLE TO OTHER COMMUNITY ORGANIZATIONS; AND A BEHAVIORAL HEALTH BUILDING FOR THE PROVISION OF OUTPATIENT PSYCHIATRIC AND SUBSTANCE ABUSE SERVICES. THIS WIDE RANGE OF FACILITIES HELPS TO SUPPORT AUGUSTA HEALTH'S VISION OF PROVIDING THE COMMUNITY WITH A FULL CONTINUUM OF HEALTH AND COMMUNITY SERVICES. AUGUSTA HEALTH IS SUPPORTED BY AUGUSTA MEDICAL GROUP WHICH WAS ESTABLISHED TO SUPPORT THE CHARITABLE PURPOSES OF AUGUSTA HEALTH CARE INC. THROUGH THE OWNERSHIP AND OPERATION OF A COMMUNITY PHYSICIAN DEVELOPMENT SERVICE. THIS GROUP ENABLES THE GREATER AUGUSTA COUNTY, VIRGINIA TO BENEFIT FROM A STABLE BASE OF PHYSICIANS IN A BROAD ARRAY OF SPECIALTIES.IN 2019 AUGUSTA HEALTH RECEIVED THE FOLLOWING HONORS, AWARDS, AND ACCREDITATIONS: 2019 US NEWS & WORLD REPORT BEST HOSPITAL IN THE SHENANDOAH VALLEY, 2019 HEALTH GRADES AMERICA'S 50 BEST HOSPITALS, AND 2019 GET WITH THE GUIDELINES STROKE GOLD PLUS WITH TARGETS STROKE HONOR ROLL.AUGUSTA HEALTH'S NET COMMUNITY BENEFIT FOR 2019 IS ESTIMATED TO BE $21,801,655. THIS BENEFIT CAN BE CATEGORIZED AS FOLLOWS: $4,293,718 CHARITY$14,014,069 MEDICAID $706,136 COMMUNITY HEALTH SERVICES $749,356 HEALTH PROFESSIONAL EDUCATION $1,538,969 SUBSIDIZED HEALTH SERVICES $499,407 CASH & IN-KIND CONTRIBUTIONS 267172946 1 1 0 1 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 480 0 1 2290 1 1 1 1 CJ 0 0 0 0 0 0 0 0 0 0 X 14 12 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 VA X X SARAH HASH-RODGERS 5403324685 78 MEDICAL CENTER CIRCLE FISHERSVILLE VA 22939 VICTOR M SANTOS CHAIRMAN 1.00 X X 0 0 0 LAUREL L LANDES VICE-CHAIRMAN 1.00 1.00 X X 0 0 0 BURNIE POWERS SECRETARY/TREASURER 1.00 1.00 X X 0 0 0 JOHN P BOWERS BOARD MEMBER 1.00 X 0 0 0 DEBRA S CALLISON BOARD MEMBER 1.00 X 0 0 0 ROBIN G CROWDER BOARD MEMBER 1.00 X 0 0 0 RONALD W DENNEY BOARD MEMBER 1.00 X 0 0 0 RICHARD EVANS MD BOARD MEMBER 1.00 1.00 X 0 0 0 DAVID FOSNOCHT MD BOARD MEMBER 1.00 X 0 0 0 HOMER HITE BOARD MEMBER 1.00 1.00 X 0 0 0 A WHIT MORRISS MD BOARD MEMBER 1.00 1.00 X 0 0 0 JOSPEH RANZINI MD BOARD MEMBER 40.00 X 581667 0 37311 CHRISTOPHER HECK BOARD MEMBER 1.00 X 0 0 0 MARY MANNIX PRESIDENT & CEO 39.00 1.00 X X 1183011 0 153814 JOHN KATSIANIS VP AND CFO 39.00 1.00 X 458826 0 75794 KAREN CLARK VP OPERATIONS 40.00 X 395509 0 59173 DAN O'CONNOR VP OF POPULATION HEALTH 40.00 X 366866 0 57463 MIKE CANFIELD VP AND CIO 40.00 X 349434 0 59160 ALEXANDER BROWN VP OF LEGAL AFFAIRS (THRU JULY) 40.00 X 157872 0 6985 MARK LAROSA VP OF BUSINESS DEVELOPMENT 40.00 X 288649 0 45227 SCOTT JUST MD PRESIDENT, AMG 40.00 X 507180 0 70332 SCOTT JONES CHIEF COMPLIANCE AND PRIVACY OFFICER 40.00 X 207341 0 17168 SCOTT CRABTREE ASSISTANT VP AND CMO 40.00 X 215343 0 25711 VICKIE TAYLOR SURGICAL DIRECTOR 40.00 X 220532 0 26099 FRANCIS CARUCCIO KEY EMPLOYEE 40.00 X 247499 0 29791 CRYSTAL FARMER VP AND CNO 40.00 X 259814 0 45842 BILL DOHERTY KEY EMPLOYEE 40.00 X 240881 0 34738 SARAH HASH-RODGERS CORPORATE CONTROLLER 40.00 X 169825 0 21208 JOHN GIRARD ADMINISTRATIVE DIRECTOR 40.00 X 172947 0 38958 ANTHONY LONG ADMINISTRATIVE DIRECTOR 40.00 X 215712 0 27815 ANDREW WEST CMIO 40.00 X 387655 0 30134 ANDREA HALEY ADMINISTRATIVE DIRECTOR OF HUMAN RESOURCES 40.00 X 176185 0 17601 6802748 0 880324 88 0 1 0 DPR CONSTRUCTION 5500 COX RD GLEN ALLEN VA 23060 CONSTRUCTION 3026232 SODEXO INC & AFFILIATES PO BOX 536922 ATLANTA GA 303536922 NUTRITION SERVICES MANAGEMENT 2585207 ARTISAN CONSTRUCTION INC 1132 E MARKET ST CHARLOTTESVILLE VA 22902 CONSTRUCTION 1240552 BLUE RIDGE PATHOLOGISTS SUITE 309 MEDICAL CENTER CR FISHERVILLE VA 22939 PHYSICIAN SERVICES 1176549 STATE COLLECTION SERVICE 2509 S STOUGHTON RD MADISON WI 53716 COLLECTIONS 928230 69 956999 956999 NET PATIENT SERVICE REVENUE 621400 347031402 346647568 383834 RETAIL PHARMACY 446110 2253730 2253730 FITNESS CENTER 713940 2010870 917870 1093000 OTHER PROGRAM SERVICE REVENUE 900099 296510 181154 115356 DME 621400 223972 223972 351816484 23334531 23334531 1248086 486453 761633 761633 761633 32894 7545 25349 25349 25349 AFFILIATED REVENUES/LOSSES 900099 2547232 2547232 CAFETERIA/VENDING 722210 1446006 1446006 3993238 380888234 347746592 4069892 28114751 615890 615890 6138091 6138091 109240176 93275694 15964482 4116723 3328098 788625 16288431 13168119 3120312 7481632 6048404 1433228 705815 705815 396919 396919 131954 131954 178224 178224 30087030 23733608 6353422 1347957 36197 1311760 22973247 18130082 4843165 3083829 2051530 1032299 6187043 6187043 512410 478924 33486 538880 326902 211978 367619 367619 15631340 15631340 1458956 1458956 MEDICAL SUPPLIES 35295317 35295317 COST OF DRUGS SOLD 27671789 27671789 BAD DEBTS 17240294 17240294 COST OF FOOD 2018027 2018027 966810 109113 857697 310674403 267172946 43501457 0 14161952 13313658 40494884 41863977 6395385 6596949 4026975 5247860 409414912 259842674 148057505 149572238 340578921 433939911 4734246 6235402 131291097 151200368 991741 1078460 12270151 17719116 703002857 826767939 22648447 27566829 71275 63534 11259526 7937083 5850 305100 11418422 16361245 45403520 52233791 X 656323375 774287684 1275962 246464 657599337 774534148 703002857 826767939 X 70213831 47334678 -613698 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 30372 30372 0 PART II-B, LINE 1: THE HOSPITAL IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE VIRGINIA HOSPITAL & HEALTHCARE ASSOCIATION (VHHA). THESE ORGANIZATIONS ROUTINELY ENGAGE IN LOBBYING EFFORTS ON BEHALF OF ITS MEMBERSHIP BODY, AND A PORTION OF EACH MEMBER'S DUES ARE ALLOCATED TO THOSE LOBBYING EXPENDITURES. THE PORTION OF THE HOSPITAL'S DUES ALLOCATED TO LOBBYING WAS $ 30,372. 1511837 4864400 6376237 139880863 62519408 77361455 1116289 175394 940895 237073705 187011999 50061706 24967818 10135873 14831945 149572238 INVESTMENT IN AMG 151200368 C 151200368 OTHER LIABILITIES 13473681 SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN 2887564 16361245 X 409753030 47334678 47334678 362418352 18469882 18469882 380888234 292818219 0 292818219 17856184 17856184 310674403 PART X, LINE 2: THE COMPANY IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON INCOME DERIVED FROM ITS EXEMPT PURPOSE AS A NOT-FOR-PROFIT ORGANIZATION UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAX. THE COMPANY HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2019. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET WITH REVENUE 17,240,294. GRANTS EXPENSE NET WITH REVENUE 615,890. EQUITY TRANSFERS BETWEEN AFFILIATES 613,698. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET WITH REVENUE 17,240,294. GRANTS EXPENSE NET WITH REVENUE 615,890. CENTRAL AMERICA AND THE CARIBBEAN - 0 0 INVESTMENT 5732465 0 0 0 0 0 0 5732465 0 5732465 1 0 1 1 0 0 PART III ACCOUNTING METHOD: PART IV, QUESTION 4 THE ORGANIZATION IS NOT REQUIRED TO FILE THE FORM 8621. 1 1 1 X 1 X 1 1 1 0 1 0 4293718 4293718 0.01460 37004400 22990331 14014069 0.04780 41298118 22990331 18307787 0.06240 706136 706136 0.00240 778641 29285 749356 0.00260 9509448 7970479 1538969 0.00520 499407 499407 0.00170 11493632 7999764 3493868 0.01190 52791750 30990095 21801655 0.07430 2 3449 3449 0.00000 4 55884 55884 0.00020 13 734 82302 82302 0.00030 19 734 141635 141635 0.00050 1 17240294 1565370 107646648 106062873 1583775 X 1 1 1 1 AUGUSTA HEALTH 78 MEDICAL CENTER DR FISHERSVILLE VA 22939 X X X HOME HEALTH; SNF; PSYCH, DME; HOSPICE AUGUSTA HEALTH 1 0 0 1 X X X X X X X X X X 19 1 0 0 1 X SEE DISCLOSURE X 1 17 1 SEE DISCLOSURE 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X X 1 X WWW.AUGUSTAHEALTH.COM X SEE PART VI X WWW.AUGUSTAHEALTH.COM/BILLING-INSURANCE/ASSISTANCE-PROGRAMS X X X X X 1 X 0 X X X 1 X 0 0 AUGUSTA HEALTH PART V, SECTION B, LINE 3J: INFORMATION GAPS THAT LIMIT THE HOSPITAL FACILITY'S ABILITY TO ACCESS THE COMMUNITY'S HEALTH NEEDS. AUGUSTA HEALTH PART V, SECTION B, LINE 5: TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS ALSO IMPLEMENTED AS PART OF THIS PROCESS. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY AUGUSTA HEALTH; THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE; REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. IN ALL, 134 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY. AUGUSTA HEALTH PART V, SECTION B, LINE 11: AUGUSTA HEALTH, THROUGH ITS MISSION TO PROMOTE THE HEALTH AND WELL-BEING OF OUR COMMUNITY THROUGH ACCESS TO EXCELLENT CARE, HAS DEVELOPED GOALS, OBJECTIVES AND STRATEGIES TO ADDRESS SELECTED TOP PRIORITY HEALTH NEEDS IN THE AREAS OF: 1) ACCESS TO HEALTHCARE SERVICES 2) BEHAVIORAL HEALTH, 3) DIABETES, AND 4) NUTRITION AND PHYSICAL ACTIVITY. THE ACTION PLANS WILL BE IMPLEMENTED IN COLLABORATION WITH VARIOUS COMMUNITY PARTNERS OVER THE NEXT THREE YEARS. DURING THE CHNA PROCESS, THE DATA REVEALED A TOTAL OF 14 DISTINCT AREAS OF OPPORTUNITY. AUGUSTA HEALTH'S 2020-2022 IMPLEMENTATION STRATEGIES ARE DESIGNED TO ADDRESS THE TOP FOUR HIGHEST PRIORITY AREAS. AUGUSTA HEALTH HAS SELECTED THESE FOUR PRIORITIES BECAUSE OF ITS ABILITY TO WORK IN PARTNERSHIP WITH OTHER ORGANIZATIONS AND AGENCIES TO MAKE THE GREATEST IMPACT. OTHER NEEDS THAT WERE IDENTIFIED HAVE THE POTENTIAL TO BE ADDRESSED THROUGH COLLABORATIVE PROGRAMMING THAT MAY OR MAY NOT INVOLVE AUGUSTA HEALTH AS A FACILITATOR, PARTNER OR FUNDER. AUGUSTA HEALTH PART V, SECTION B, LINE 13H: INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY SHALL NOT BE CHARGED MORE THAN THE AMOUNTS GENERALLY BILLED (AGB) TO INDIVIDUALS WHO HAVE INSURANCE. THIS VALUE SHALL BE CALCULATED USING THE "LOOK-BACK" METHOD BASED ON ACTUAL PAID CLAIMS FROM MEDICARE FEE-FOR-SERVICE AND PRIVATE HEALTH INSURERS. THE CURRENT AGB IS 32% AND IS UPDATED ANNUALLY. AUGUSTA HEALTH PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY IS DISCUSSED AND OFFERED BY OUR SELF PAY EXTENDED BUSINESS OFFICE PARTNER DURING THE COLLECTION PROCESS. PART V, SECTION B, LINE 7A AND 10A: WEBSITE ADDRESS FOR THE CHNA AND IMPLEMENTATION STRATEGY:HTTPS://WWW.AUGUSTAHEALTH.COM/COMMUNITY-OUTREACH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART I, LINE 7: FOR PURPOSES OF PART I, LINE 7(A) THE ORGANIZATION USED THE METHODS PROVIDED IN THE SCHEDULE H INSTRUCTIONS TO COMPUTE A COST-TO-CHARGES RATIO TO CONVERT CHARITY CARE WRITE-OFFS TO COST. AMOUNTS REPORTED ON LINES 7(B) AND 7(G) WERE DERIVED FROM THE ORGANIZATION'S INTERNAL COST ACCOUNTING SYSTEM. PART I, LINE 7G: INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES ACCOUNT FOR $1,072,186 OF THE NET COMMUNITY BENEFIT OF SUBSIDIZED SERVICES. THESE SERVICES PROVIDE SHORT-TERM PSYCHIATRIC CARE FOR ADULTS AND GERIATRIC PATIENTS IN A SUPPORTIVE ENVIRONMENT WITH 24-HOUR NURSING CARE. HOME HEALTH SERVICES PROVIDED BY THE ORGANIZATION CONTRIBUTED $466,783 IN NET COMMUNITY BENEFIT. AUGUSTA HEALTH'S HOME HEALTH PROGRAM OFFERS SKILLED NURSING CARE, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, AND MEDICAL SOCIAL WORKERS. PART I, LN 7 COL(F): TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25 INCLUDES BAD DEBT IN THE AMOUNT OF $17,240,294. THIS AMOUNT FOR BAD DEBT HAS BEEN REMOVED FOR PURPOSES OF COMPUTING PERCENTAGE OF TOTAL EXPENSE ON SCHEDULE H, PART I, LINE 7, COL (F). PART III, LINE 2: ACCOUNTS ARE WRITTEN OFF TO BAD DEBT WHEN MANAGEMENT DETERMINES THAT RECOVERY IS UNLIKELY AND THE COMPANY CEASES COLLECTION EFFORTS. PART III, LINE 4: EXCERPT FROM 2019 FINANCIAL AUDIT, PATIENT ACCOUNTS RECEIVABLE:"THE COMPANY GRANTS CREDIT WITHOUT COLLATERAL TO ITS PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS, PRIMARILY WITH MEDICARE, MEDICAID, AND VARIOUS COMMERCIAL INSURANCE COMPANIES. PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. FOR ACCOUNTS RECEIVABLE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE THE COMPANY ESTIMATES NET REALIZABLE VALUE BASED ON THE ESTIMATED CONTRACTUAL REIMBURSEMENT PERCENTAGE, WHICH IS PREDICATED ON CURRENT CONTRACT PROVISIONS AND HISTORICAL PAID CLAIMS BY PAYOR. FOR SELF-PAY ACCOUNTS RECEIVABLE, INCLUDING UNINSURED AND PATIENT RESPONSIBILITY ACCOUNTS, THE NET REALIZABLE VALUE IS DETERMINED USING HISTORICAL COLLECTION EXPERIENCE, ADJUSTED FOR ESTIMATED CONVERSIONS OF PATIENT RESPONSIBILITY PORTIONS, EXPECTED RECOVERIES AND CHANGE IN TRENDS TO ESTIMATE IMPLICIT PRICE CONCESSIONS. MANAGEMENT CONTINUALLY REVIEWS THE ESTIMATED NET REALIZABLE VALUE OF ACCOUNTS RECEIVABLE BY MONITORING CASH COLLECTIONS, ECONOMIC CONDITIONS AND TRENDS, CHANGES IN PAYOR MIX, CHANGES IN FEDERAL OR STATE HEALTHCARE COVERAGE AND OTHER MATTERS." THE BAD DEBT AMOUNT LISTED IN PART III SECTION A, NUMBER 2 WAS CALCULATED USING WORKSHEET A ON PAGE 4 OF THE 2019 SCHEDULE H INSTRUCTIONS.THE PORTION OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE IS BASED ON DISCHARGES IN 2019. PATIENTS THAT WERE CLASSIFIED AS "SELF PAY" WERE UN-INSURED AND THEREFORE CONSIDERED WITHOUT RESOURCES. THEIR ACCOUNT STATUS WAS "BD" MEANING THAT THE ACCOUNT WAS CONSIDERED UNCOLLECTABLE AT THE TIME OF THE REPORT. PART III, LINE 9B: ONCE A PATIENT HAS BEEN DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ALL COLLECTION EFFORTS CEASE FOR CURRENT AND PAST DUE BALANCES AND THE NECESSARY ADJUSTMENTS ARE TAKEN TO THE ACCOUNTS RECEIVABLE. SHOULD THE PATIENT ONLY BE ELIGIBLE FOR A PORTION OF FINANCIAL ASSISTANCE (THROUGH OUR SLIDING SCALE), NO-INTEREST, LOW-PAYMENT, AND LONG TERM PAYMENT PLANS ARE AVAILABLE. PART V, LINE 16B HTTPS://WWW.AUGUSTAHEALTH.COM/SITES/DEFAULT/FILES/DOCUMENTS/BUSINESS-OFFICE/FINANCIAL_ASSISTANCE_APPLICATION_06-22-2020.PDF PART VI, LINE 2: AUGUSTA HEALTH COMPLETED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2019 TO DETERMINE THE PRIORITY HEALTH NEEDS OF STAUNTON, AUGUSTA COUNTY AND WAYNESBORO VIRGINIA. AUGUSTA HEALTH'S CHNA IS A SYSTEMATIC, DATA-DRIVEN APPROACH TO DETERMINING THE HEALTH STATUS, BEHAVIORS AND NEEDS OF RESIDENTS IN THE SERVICE AREA OF AUGUSTA HEALTH AND THE INFORMATION GATHERED IS USED TO INFORM DECISIONS AND GUIDE EFFORTS TO IMPROVE COMMUNITY HEALTH AND WELLNESS. THE CHNA SERVES AS TOOL TO REACH THREE BASIC GOALS:TO IMPROVE RESIDENT'S HEALTH STATUS, INCREASE THEIR LIFE SPANS, AND ELEVATE THEIR OVERALL QUALITY OF LIFE. A HEALTHY COMMUNITY IS NOT ONLY ONE WHERE ITS RESIDENTS SUFFER LITTLE FROM PHYSICAL AND MENTAL ILLNESS, BUT ALSO ONE WHERE ITS RESIDENTS ENJOY A HIGH QUALITY OF LIFE. TO REDUCE THE HEALTH DISPARITIES AMONG RESIDENTS. BY GATHERING DEMOGRAPHIC INFORMATION ALONG WITH HEALTH STATUS AND BEHAVIOR DATA, IT IS POSSIBLE TO IDENTIFY POPULATION SEGMENTS THAT ARE MOST AT-RISK FOR VARIOUS DISEASES AND INJURIES. INTERVENTION PLANS AIMED AT TARGETING THESE INDIVIDUALS MAY THEN BE DEVELOPED TO COMBAT SOME OF THE SOCIO-ECONOMIC AND SOCIAL DETERMINANTS WHICH HAVE HISTORICALLY HAD A NEGATIVE IMPACT ON RESIDENTS' HEALTH.TO INCREASE ACCESSIBILITY TO PREVENTATIVE SERVICES FOR ALL COMMUNITY RESIDENTS. MORE ACCESSIBLE PREVENTIVE SERVICES ARE BENEFICIAL TO IMPROVING HEALTH STATUS, AS WELL AS LOWERING THE COSTS ASSOCIATED WITH CARING FOR LATE-STAGE DISEASE RESULTING FROM A LACK OF PREVENTIVE CARE. PART VI, LINE 3: AUGUSTA HEALTH HAS A MEDICAID ELIGIBILITY TEAM ONSITE TO SCREEN ITS PATIENTS FOR MEDICAID ELIGIBILITY, INCLUDING DISABILITY. AS FOR THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM, AUGUSTA HEALTH INFORMS ITS PATIENTS ABOUT IT IN THE FOLLOWING WAYS:1. DETAILED INFORMATION ABOUT FINANCIAL ASSISTANCE IS SENT ALONG WITH THE STATEMENTS.2. FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE AVAILABLE ON THE HOSPITAL'S WEBSITE WWW.AUGUSTAHEALTH.COM. 3. COPIES OF THE FINANCIAL ASSISTANCE GUIDELINES AND APPLICATION FORM ARE AVAILABLE AT THE POINTS OF SERVICE (EMERGENCY ROOM, OUTPATIENT AND INPATIENT AREAS, DOCTOR'S OFFICES, ETC.). PART VI, LINE 4: OUR PRIMARY SERVICE AREA, THE COMBINED AREA OF STAUNTON, WAYNESBORO AND AUGUSTA COUNTY , ENCOMPASSES 1002.02 SQUARE MILES AND HOUSES A TOTAL POPULATION OF 119,016 RESIDENTS, ACCORDING TO LATEST CENSUS ESTIMATES. BETWEEN THE 2000 AND 2010 US CENSUSES, THE TOTAL AREA POPULATION INCREASED BY 9,514 PERSONS, OR 8.7%. WHILE AUGUSTA COUNTY IS PREDOMINANTLY RURAL, THE CITIES OF STAUNTON AND WAYNESBORO ARE NEARLY ENTIRELY URBAN. IN THE TOTAL AREA, 20.7% OF THE POPULATION ARE INFANTS, CHILDREN OR ADOLESCENTS AGE 17 AND UNDER, ANOTHER 61.3% ARE AGE 18 TO 64, WHILE 18% ARE AGE 65 OR OLDER. THE PERCENTAGE OF OLDER ADULTS IS MUCH HIGHER THAN THE STATE AND US FIGURES. IN LOOKING AT RACE INDEPENDENT OF ETHNICITY, 88.9% OF RESIDENTS OF THE TOTAL ARE WHITE AND 7.1% ARE BLACK. THE CITIES OF STAUNTON AND WAYNESBORO ARE MORE RACIALLY DIVERSE THAN AUGUSTA COUNTY. A TOTAL OF 3.1% OF TOTAL AREA RESIDENTS ARE HISPANIC OR LATINO, WITH THE LARGEST POPULATION IN WAYNESBORO. BETWEEN 2000 AND 2010, THE HISPANIC POPULATION IN THE TOTAL AREA INCREASED BY 1,846 PEOPLE, OR 120.7% PART VI, LINE 5: AS A COMMUNITY OWNED HOSPITAL, 100% OF THE SURPLUS GOES BACK INTO THE COMMUNITY THROUGH INVESTMENT IN A NETWORK OF CLINICAL PROVIDERS TO SERVE THE COMMUNITY, FACILITY UPGRADES, STATE OF THE ART EQUIPMENT PURCHASES, INCREASED PATIENT CARE SERVICES, AND ACCESS POINTS THROUGHOUT THE SERVICE AREA, AS WELL AS PROVIDING SUPPORT TO OTHER LOCAL NON-PROFIT AGENCIES THAT COMPLIMENT AND/OR SUPPORT THE MISSION OF AUGUSTA HEALTH. AUGUSTA HEALTH IS IN A LEADERSHIP POSITION FOR COMMUNITY BENEFIT AS A RESULT OF THE AUGUSTA HEALTH COMMUNITY PARTNERSHIP COMMITTEE. THE COMMUNITY PARTNERSHIP COMMITTEE IS APPOINTED BY THE AUGUSTA HEALTH BOARD OF DIRECTORS. THE COMMITTEE IMPROVES THE HEALTH OF THE COMMUNITY BY PROVIDING INPUT AND OVERSIGHT ON AUGUSTA HEALTH'S COMMUNITY BENEFIT INITIATIVES, COLLABORATIVE PARTNERSHIPS AND STRATEGIC FUNDING AND ENSURES ALIGNMENT WITH THE PRIORITY AREAS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. PART VI, LINE 6: THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. 1 CENTRAL SHENANDOAH PLANNING 112 MACTANLEY PLACE STAUNTON VA 24401 540857625 501(C)(3) 87360 OPERATIONAL SUPPORT BLUE RIDGE AREA FOOD BANK PO BOX 937 VERONA VA 24482 521202644 501(C)(3) 15000 OPERATIONAL SUPPORT BLUE RIDGE COURT SERVICES 125 SOUTH NEW ST STAUNTON VA 24401 546001631 501(C)(3) 25000 OPERATIONAL SUPPORT BOYS & GIRLS CLUBS 302 E MAIN ST WAYNESBORO VA 22980 130997525 501(C)(3) 12500 OPERATIONAL SUPPORT PROJECT GROWS PO BOX 781 STAUNTON VA 24401 461070735 501(C)(3) 13000 OPERATIONAL SUPPORT VALLEY HOPE COUNSELING CENTER 20 STONERIDGE DR SUITE 202 WAYNESBORO VA 22980 541956722 501(C)(3) 30000 OPERATIONAL SUPPORT VALLEY MISSION 1513 WEST BEVERLY STREET STAUNTON VA 24401 540930419 501(C)(3) 27500 OPERATIONAL SUPPORT ELK HILL FARM 1975 ELK HILL RD GOOCHLAND VA 23063 237071154 501(C)(3) 10000 OPERATIONAL SUPPORT VALLEY CHILDREN'S ADVOCACY CENTER 1105 GREENVILLE AVE STAUNTON VA 24401 200831874 501(C)(3) 10000 OPERATIONAL SUPPORT SHENANDOAH LGBTQ CENTER 123 W FREDERICK ST STAUNTON VA 24401 200831874 501(C)(3) 7000 OPERATIONAL SUPPORT 10 PART I, LINE 2: AUGUSTA HEALTH MADE GRANTS THROUGHOUT THE YEAR TO NON-PROFIT AND GOVERNMENTAL COMMUNITY PARTNERS WHO DEVELOPED PROJECTS OR PROVIDED SERVICES TO ADDRESS THE COMMUNITY'S HEALTH PRIORITIES IDENTIFIED IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. X 1 0 X X X X X 0 1 0 0 0 1 0 0 0 JOSPEH RANZINI MD BOARD MEMBER 581667 0 0 0 0 0 25000 0 12311 0 618978 0 0 0 MARY MANNIX PRESIDENT & CEO 666991 0 188904 0 327116 0 144585 0 9229 0 1336825 0 207404 0 JOHN KATSIANIS VP AND CFO 360269 0 69314 0 29243 0 62312 0 13482 0 534620 0 87814 0 KAREN CLARK VP OPERATIONS 311726 0 54302 0 29481 0 56523 0 2650 0 454682 0 73144 0 DAN O'CONNOR VP OF POPULATION HEALTH 284421 0 54804 0 27641 0 47344 0 10119 0 424329 0 73342 0 MIKE CANFIELD VP AND CIO 269279 0 53813 0 26342 0 52581 0 6579 0 408594 0 72323 0 ALEXANDER BROWN VP OF LEGAL AFFAIRS (THRU JULY) 101774 0 37983 0 18115 0 6985 0 0 0 164857 0 56097 0 MARK LAROSA VP OF BUSINESS DEVELOPMENT 224700 0 43141 0 20808 0 39504 0 5723 0 333876 0 61641 0 SCOTT JUST MD PRESIDENT, AMG 372719 0 65211 0 69250 0 57486 0 12846 0 577512 0 81190 0 SCOTT JONES CHIEF COMPLIANCE AND PRIVACY OFFICER 188231 0 19110 0 0 0 14524 0 2644 0 224509 0 19110 0 SCOTT CRABTREE ASSISTANT VP AND CMO 198709 0 16634 0 0 0 19490 0 6221 0 241054 0 16634 0 VICKIE TAYLOR SURGICAL DIRECTOR 202391 0 18141 0 0 0 19000 0 7099 0 246631 0 18141 0 FRANCIS CARUCCIO KEY EMPLOYEE 224694 0 22805 0 0 0 25000 0 4791 0 277290 0 22805 0 CRYSTAL FARMER VP AND CNO 259814 0 0 0 0 0 39905 0 5937 0 305656 0 0 0 BILL DOHERTY KEY EMPLOYEE 240881 0 0 0 0 0 34633 0 105 0 275619 0 0 0 SARAH HASH-RODGERS CORPORATE CONTROLLER 157547 0 12278 0 0 0 9577 0 11631 0 191033 0 12278 0 JOHN GIRARD ADMINISTRATIVE DIRECTOR 160231 0 12716 0 0 0 24973 0 13985 0 211905 0 12716 0 ANTHONY LONG ADMINISTRATIVE DIRECTOR 197701 0 18011 0 0 0 25000 0 2815 0 243527 0 18011 0 ANDREW WEST CMIO 350172 0 37483 0 0 0 25000 0 5134 0 417789 0 37483 0 ANDREA HALEY ADMINISTRATIVE DIRECTOR OF HUMAN RES 161788 0 14397 0 0 0 17601 0 0 0 193786 0 14397 0 PART I, LINE 1A THE FOLLOWING BOARD MEMBERS HAD TRAVEL FOR COMPANION EXPENSES: - ROBIN CROWDER: VHHA FALL CONFERENCE, COMPANION ROOM CHARGE OF 478.45 - RICHARD EVANS: VHHA ANNUAL MEETING, DINNER CHARGE OF 85.51 - LAUREL LANDES: VHHA FALL CONFERENCE, COMPANION ROOM CHARGE OF 453.14 - BURNE POWERS: VHHA ANNUAL MEETING, DINNER CHARGE OF 85.51 - VICTOR SANTOS: VHHA FALL CONFERENCE, COMPANION ROOM CHARGE AND MEALS OF 453.17 PART I, LINE 4B THE FOLLOWING INDIVIDUALS HAD EMPLOYER CONTRIBUTIONS FROM A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS ARE REPRESENTED IN PART II, COLUMN (C): $100,585 - MARY MANNIX 12,523 - KAREN CLARK 10,335 - DAN O'CONOR 8,581 - MIKE CANFIELD 4,121 - MARK LAROSA 18,312 - JOHN KATSIANIS 19,486 - SCOTT JUST, MD 6,000 - CRYSTAL FARMER 2,750 - BILL DOHERTY PART I, LINE 6 THE TOP EXECUTIVES OF AUGUSTA HEALTH WERE REQUIRED TO SET ANNUAL PERFORMANCE GOALS THAT ALIGNED WITH THE ORGANIZATION'S COMMITMENT TO PERFORMANCE EXCELLENCE. THE GOALS WERE ESTABLISHED WITH FOCUS ON THE FOLLOWING SIX AREAS: QUALITY, SERVICE, PEOPLE, COMMUNITY, GROWTH, AND FINANCE. EACH GOAL WAS REQUIRED TO HAVE MEASURABLE OUTCOMES AND WAS REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD TO ENSURE THAT IT SUPPORTED THE ORGANIZATION'S QUEST FOR SERVICE AND OPERATIONAL EXCELLENCE. WHILE NET EARNINGS WERE A CONSIDERATION IN THE AREA OF FINANCE, THE GOALS WERE ALSO CENTERED AROUND QUALITY, SERVICE, PEOPLE, COMMUNITY, AND GROWTH. EACH EXECUTIVE'S GOALS WERE WEIGHTED ACROSS THE PILLAR GOALS BASED ON THEIR AREA OF RESPONBILITY. WHEN AWARDING VARIABLE COMPENSATION, THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD REVIEWED THE YEAR-END ACCOMPLISHMENTS OF THE TOP EXECUTIVES AND AWARDED INCENTIVE COMPENSATION BASED ON THEIR ACTUAL PERFORMANCE AS COMPARED TO THE ESTABLISHED PERFORMANCE BENCHMARKS. A INDUSTRIAL DEVELOPMENT AUTHORITY OF THE COUNTY OF AUGUSTA VA 541311681 05112MCP8 2003-12-17 33510000 CURRENT REFUNDING 0 0 0 A 25660000 38637362 5267469 374087 33483180 1994 1 0 1 1 A 0 0 0 1 0 0 0 0 1 A 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: INDUSTRIAL DEVELOPMENT AUTHORITY OF THE COUNTY OF AUGUSTA, VA DATE THE REBATE COMPUTATION WAS PERFORMED: 08/31/2010 SCHEDULE K, PART I, DESCRIPTION OF PURPOSE: THE SERIES 2003 BONDS WERE ISSUED FOR THE PURPOSE OF: 1) REFUNDING THE ISSUER'S PRIOR SERIES 1993 BONDS, 2) FUNDING A DEBT SERVICE RESERVE FUND FOR THE SERIES 2003 BONDS, AND 3) PAYING COST OF ISSUANCE EXPENSES. SCHEDULE K, PART II, LINE 11, OTHER SPENT PROCEEDS: THE AMOUNTS PRESENT ON PART II, LINE 11 REPRESENT AMOUNTS USED TO CURRENTLY REFUND BONDS ISSUED IN 1993. SCHEDULE K, PART III: THE SERIES 2003 BONDS WERE ISSUED ENTIRELY TO REFUND A PRIOR ISSUE DATED BEFORE JANUARY 1, 2003 AND WERE NOT USED TO ACQUIRE NEW PROPERTY; THEREFORE, SCHEDULE K, PART III IS NOT REQUIRED TO BE COMPLETED FOR THIS ISSUE. FORM 990, PART VI, SECTION A, LINE 1 EXECUTIVE COMPENSATION PROGRAM IS ADMINISTERED BY THE EXECUTIVE COMMITTEE OF THE BOARD, BASED ON A COMPENSATION PHILOSOPHY APPROVED BY THE BOARD AT LARGE. QUALIFIED THIRD PARTY CONSULTANTS ARE ENGAGED TO PROVIDE APPROPRIATE MARKET COMPARABILITY, SURVEY DATA, AND TO ASSIST THE COMMITTEE WITH REVIEWS. THE BASE SALARY BENCHMARKS ARE TARGETED AT THE 50TH PERCENTILE WITH FLEXIBILITY TO PAY ABOVE OR BELOW THE 50TH PERCENTILE USING SALARY RANGES WITH A 50% RANGE SPREAD TO RECOGNIZE AN INCUMBENT'S INDIVIDUAL EXPERIENCE, SKILL, PERFORMANCE, OR OTHER RELEVANT RECRUITMENT OR RETENTION FACTORS. INCENTIVE OPPORTUNITIES ARE ESTABLISHED AT LEVELS THAT WHEN COMBINED WITH SALARIES POSITIONED AT THE 50TH PERCENTILE, ARE SUFFICIENT TO PROVIDE TOTAL CASH COMPENSATION THAT TARGETS UP TO THE APPROXIMATELY MARKET 75TH PERCENTILE OF TOTAL CASH COMPENSATION LEVELS. TOTAL COMPENSATION SHALL NOT EXCEED THE 90TH PERCENTILE FOR ANY INDIVIDUAL WITHOUT FULL BOARD APPROVAL AND DOCUMENTATION OF THE BOARD'S REASONS FOR SUCH COMPENSATION. THE BOARD OF DIRECTORS RECEIVES A FULL REPORT FROM THE EXECUTIVE COMMITTEE ON THE FULL COMPENSATION PROGRAM AT AUGUSTA HEALTH IN AN EXECUTIVE SESSION OF THE BOARD. CONFLICTED MEMBERS ARE EXCUSED FROM THE MEETING. MATERIAL COVERED INCLUDES THE DESIGN OF THE COMPENSATION PROGRAM, AS WELL AS A DISCLOSURE ON RANGE OF BASE SALARIES, MARKET BENCHMARK DATA, AND EARNED INCENTIVE COMPENSATION LEVELS. ADDITIONALLY, PREREQUISITES SUCH AS THE SENIOR EXECUTIVE RETIREMENT PLAN (SERP) PROGRAM AND OTHER RELATED BENEFITS ARE PERIODICALLY REVIEWED WITH THE BOARD. FOR THOSE MEMBERS WHO ARE NOT PRESENT FOR THIS MEETING AND REMAIN FREE OF CONFLICT OF INTEREST, THE CHAIRMAN OF THE BOARD MAY PRESENT THE SAME MATERIAL IN A SEPARATE SESSION. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES CMO DUTIES TO LEADERS FOR TODAY. THE MANAGEMENT COMPANY PROVIDES WILLIAM DOHERTY AS AN INTERIM CMO. THE ORGANIZATION PAID LEADERS FOR TODAY $229,950 FOR SERVICES. FORM 990, PART VI, SECTION B, LINE 11B THE ACCOUNTING DEPARTMENT WILL MAKE COPIES OF THE FORM 990 AVAILABLE TO THE CFO AND CEO FOR REVIEW. ALL QUESTIONS WILL BE RESOLVED AND ANSWERED BEFORE PRESENTATION TO THE EXECUTIVE COMMITTEE OF THE BOARD. THE FINAL DRAFT OF THE RETURN WILL BE POSTED ON THE ORGANIZATION'S INTERNAL WEBSITE WITH ACCESS RESTRICTED TO THE BOARD AND KEY ADMINISTRATIVE PERSONNEL FOR REVIEW. ALL QUESTIONS WILL BE RESOLVED AND ANSWERED BY THE CEO, CFO OR CORPORATE CONTROLLER. ANY REVISIONS AS A RESULT OF THE BOARD REVIEW WILL BE SENT TO THE TAX PREPARER AND SUBSEQUENT REVIEW BY THE BOARD WILL BE SCHEDULED ACCORDINGLY. FORM 990, PART VI, SECTION B, LINE 12C THE GOVERNANCE COMMITTEE IS CHARGED WITH REVIEWING THE CONFLICT OF INTEREST STATEMENTS EACH YEAR. THE REVIEW IS CONDUCTED AFTER THE ANNUAL BOARD MEETING IN APRIL. CONFLICT OF INTEREST REVIEWS OCCUR AT THE BEGINNING OF EACH BOARD AND COMMITTEE MEETING. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THOSE FOUND TO BE IN A CONFLICT OF INTEREST MUST ABSTAIN FROM VOTING AND MAY BE ASKED TO LEAVE THE MEETING DEPENDING ON THE TOPIC AND THEIR DEGREE OF CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 AUGUSTA HEALTH UTILIZES THE SERVICES OF GALLAGHER PO BOX 71696, CHICAGO, IL 60694-1696 TO DETERMINE COMPETITIVE WAGE RANGES, VARIABLE COMPENSATION AND PERQUISITES FOR EXECUTIVE POSITIONS. IT IS THE GOAL OF THE AUGUSTA HEALTH BOARD TO SATISFY THE FOLLOWING OBJECTIVES: 1.) COMPETITIVENESS: THE PROCESS MUST PRODUCE COMPENSATION AND BENEFIT LEVELS THAT ENABLE THE BOARD TO ATTRACT AND RETAIN THE MANAGEMENT LEADERSHIP ESSENTIAL TO CARRYING OUT ITS MISSION. 2.) STRATEGIC ALIGNMENT: THE PROCESS MUST ALIGN EXECUTIVE COMPENSATION WITH THE INSTITUTION'S STRATEGIC GOALS. IT MUST REWARD MANAGEMENT FOR ACCOMPLISHING THESE GOALS. 3.) REGULATORY COMPLIANCE: THE PROCESS MUST ASSURE THAT THE INSTITUTION MEETS ITS CHARITABLE PURPOSE OBLIGATIONS TO REMAIN TAX-EXEMPT AND THEREFORE WILL REVIEW AND APPROVE ALL FORMS OF EXECUTIVE COMPENSATION AND BENEFITS IN A MANNER NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE INTERMEDIATE SANCTIONS RULES OF SECTION 4958 OF THE IRC SO AS TO AVOID THE IMPOSITION OF INTERMEDIATE SANCTIONS IN THE FORM OF EXCISE TAXES PENALTIES ON ITS TRUSTEES AND EXECUTIVES. 4.) PUBLIC TRUST: BOARD MEMBERS ARE INVESTED WITH A PUBLIC TRUST TO SHEPHERD INSTITUTIONAL ASSETS AS RESPONSIBLE FIDUCIARIES AND REPRESENTATIVES. THEREFORE, THE PROCESS MUST ASSURE THAT COMPENSATION AND BENEFIT LEVELS ARE REASONABLE, NOT EXCESSIVE, AND DEFENSIBLE IF AND WHEN SUBJECTED TO PUBLIC SCRUTINY. BASE SALARIES TARGETED AT THE 50TH PERCENTILE, WITH FLEXIBILITY TO PAY ABOVE OR BELOW THE 50TH PERCENTILE USING SALARY RANGES WITH A 50% RANGE SPREAD TO RECOGNIZE AN INCUMBENT'S INDIVIDUAL EXPERIENCE, SKILL, PERFORMANCE OR OTHER RELEVANT RECRUITMENT OR RETENTION FACTORS. VARIABLE COMPENSATION LEVELS THAT, WHEN COMBINED WITH SALARIES POSITIONED AT THE 50TH PERCENTILE, ARE SUFFICIENT TO PROVIDE TOTAL CASH COMPENSATION THAT TARGETS UP TO THE APPROXIMATE MARKET 75TH PERCENTILE OF TOTAL CASH COMPENSATION LEVELS. TOTAL COMPENSATION SHALL NOT EXCEED THE 90TH PERCENTILE FOR ANY INDIVIDUAL WITHOUT FULL BOARD APPROVAL AND DOCUMENTATION OF THE BOARD'S REASONS FOR SUCH COMPENSATION. COMPENSATION, INDIVIDUAL PERFORMANCE AND COMPETITIVE DATA ARE REVIEWED ANNUALLY FOR ALL EXECUTIVE POSITIONS AS FOLLOWS: CEO CFO VP OF OPERATIONS CNO CMO CIO PRESIDENT, MEDICAL GROUP VICE PRESIDENT LEGAL AFFAIRS VP OF HUMAN RESOURCES VP OF PLANNING AND DEVELOPMENT VP OF POPULATION HEALTH THE BOARD OF DIRECTORS RECEIVED A SUMMARY FROM THE EXECUTIVE COMMITTEE ON THE COMPENSATION PROGRAM AT AUGUSTA HEALTH IN AN EXECUTIVE SESSION OF THE BOARD. CONFLICTED MEMBERS WERE EXCUSED FROM THE MEETING. MATERIAL COVERED INCLUDED THE DESIGN OF THE COMPENSATION PROGRAM, AS WELL AS ACTUAL BASE SALARIES, MARKET BENCHMARK DATA, AND VARIABLE COMPENSATION EARNED BY EACH EXECUTIVE. ADDITIONALLY, PREREQUISITES SUCH AS THE SERP PROGRAM AND OTHER RELATED BENEFITS WERE REVIEWED WITH THE BOARD. FOR THOSE MEMBERS WHO WERE NOT PRESENT FOR THIS MEETING AND REMAINED FREE OF CONFLICT OF INTEREST, THE CHAIRMAN OF THE BOARD PRESENTED THE SAME MATERIAL IN A SEPARATE SESSION. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ACCOUNTING OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ACCOUNTING OFFICE. PLEASE DIRECT ALL REQUESTS TO: AUGUSTA HEALTH CARE, INC. ATTN: CORPORATE CONTROLLER P.O. BOX 1000 FISHERSVILLE, VA 22939-1000 FORM 990, PART XI, LINE 9: EQUITY TRANSFERS BETWEEN AFFILIATES -613,698. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART VII BOARD MEMBER JOSEPH RANZINI IS PAID AS AN EMPLOYEE OF AUGUSTA MEDICAL GROUP, A RELATED ORGANIZATION AND NOT COMPENSATED FOR HIS BOARD MEMBER SERVICE. AUGUSTA CARE PARTNERS LLC 78 MEDICAL CENTER DR FISHERSVILLE VA 22939 462840076 HEALTHCARE VA 0 0 AHC COMMUNITY HEALTH FOUNDATION PO BOX 1000 FISHERSVILLE VA 22939 542042365 SUPPORTING ORGANIZATION VA 501(C)(3) LINE 12A, I AUGUSTA HEALTH CARE INC 1 AUGUSTA MEDICAL GROUP PO BOX 1000 FISHERSVILLE VA 22939 262559916 HEALTHCARE VA 501(C)(3) LINE 10 AUGUSTA HEALTH CARE INC 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 1 1 AUGUSTA MEDICAL GROUP A 825576 AUGUSTA MEDICAL GROUP Q 19150000 AUGUSTA HEALTH FOUNDATION R 613698 AUGUSTA HEALTH FOUNDATION C 956999