2019-05-15T07:37:48-05:00 2018-06-30 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2017-07-01 581973570 FLOYD HEALTHCARE MANAGEMENT INC FLOY 7065096074 304 TURNER MCCALL BLVD ROME GA 301620233 RICHARD T SHEERIN CFO 7065095774 2019-05-14 true JACQUELINE G ATKINS P00861721 2298837878 2019-05-13 208.73.87.26 2019-05-15 07:37:48 CD P 3DB754BF4A86932C7270BAD44D636E9B352C5FAB 3DB754BF4A86932C7270BAD44D636E9B352C5FAB 2017 2019-02-21 02:37:17Z KURT STUENKEL 304 TURNER MCCALL BLVD ROME GA 301620233 423641549 false X WWW.FLOYD.ORG X 1990 GA OPERATE A NON-PROFIT HOSPITAL SYSTEM AND SUPPORT 501 (C)(3)ORGANIZATIONS 18 14 3905 204 795740 297232 382377 1052354 386478272 398725012 3006941 3241797 232727 486081 390100317 403505244 1442695 310566 0 217609413 228164243 0 247195 164296919 176783633 383349027 405258442 6751290 -1753198 426257845 431732086 248861991 244535295 177395854 187196791 X OPERATE A NON-PROFIT HOSPITAL SYSTEM AND SUPPORT 501 (C)(3)ORGANIZATIONS true false 305747464 310566 397961783 FLOYD HEALTHCARE MANAGEMENT, INC. OPERATES FLOYD MEDICAL CENTER, A GENERAL ACUTE CARE HOSPITAL, AND FLOYD BEHAVIORAL HEALTH CENTER, A PSYCHIATRIC UNIT. SEE ADDITIONAL DISCLOSURES AT SCHEDULE O, "SUPPLEMENTAL INFORMATION TO FORM 990". 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 2018, PATIENT DAYS (INCLUDING PSYCH AND REHAB) AT FLOYD MEDICAL CENTER TOTALED 86,067 AND DISCHARGES TOTALED 15,854. FLOYD MEDICAL CENTER PROVIDED APPROXIMATELY 64,000,000 IN DIRECT CHARITY AND INDIGENT CARE, AND IT INCURRED UNREIMBURSED MEDICARE AND MEDICAID ADJUSTMENTS OF 523,627,000 AND 240,307,000 RESPECTIVELY. A COPY OF THE REPORT TO THE COMMUNITY FOR FLOYD MEDICAL CENTER CAN BE FOUND AT WWW.FLOYD.ORG. 305747464 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 true true true true false false false false true true false false false true 219 0 3905 true true true false false false false false false false false false X 18 14 false false false false false true false true true false false true true true true true false true true true true GA X RICHARD T SHEERIN 7065096074 304 TURNER MCCALL BLVD ROME GA 30161 KURT STUENKEL PRES/SECRE/C 50.00 4.00 X X 2860734 0 23258 ROBERT HOLCOMBE JR MD DIRECTOR 41.00 X 261785 0 25209 JAMES COLLINS JR MD DIRECTOR 41.00 X 209261 0 4004 ANNE LULE MD PAST DIRECTO 41.00 X 124162 0 17958 GEORGE BOSWORTH MD CHAIRMAN 1.00 2.00 X X 7000 5750 0 LARRY KUGLAR DIRECTOR 1.00 1.00 X 4500 2500 0 DAVID JOHNSON DIRECTOR 1.00 1.00 X 6725 0 0 FRANK SHELLEY DIRECTOR 1.00 1.00 X 3500 2750 0 KAY CHUMBLER VICE CHAIRMA 1.00 1.00 X X 5625 0 0 BRAD WARD MD DIRECTOR 1.00 1.00 X 3000 2500 0 TIM MAHANAY DIRECTOR 1.00 X 4375 0 0 W DAVID NEWBY DIRECTOR 1.00 1.00 X 3575 0 0 CARL HERRING MD DIRECTOR 1.00 X 2750 0 0 GARRY FRICKS DIRECTOR 1.00 X 2125 0 0 RHONDA WALLACE DIRECTOR 1.00 1.00 X 1550 0 0 J ROGER SUMNER DIRECTOR 1.00 X 0 0 0 MARK MANIS DIRECTOR 1.00 1.00 X 0 0 0 SHANNON JOE VAUGHN MD DIRECTOR 1.00 X 0 0 0 WRIGHT BAGBY JR DIRECTOR 1.00 X 0 0 0 RICHARD T SHEERIN CFO 50.00 5.00 X 515595 0 19536 JOSEPH BIUSO MD VP & CMO 40.00 X 562039 0 24318 WARREN RIGAS SVP COO 40.00 X 471766 0 27836 BETH BRADFORD CHIEF HR OFF 40.00 X 394406 0 12746 TOMMY MANNING CORPORATE CO 40.00 X 387876 0 26083 SHEILA HORNER VP & CNO 40.00 X 374919 0 10146 GREG POLLEY VICE PRESIDE 40.00 X 345548 0 28083 JEFFERY D BUDA CHF INFORMAT 40.00 X 344284 0 25883 RICHARD CHILDS VP REVENUE C 40.00 X 312720 0 24318 REBEKAH LOWREY MD SURGICAL DIR 40.00 X 289300 0 26785 DAVID EARLY DIRECTOR SUP 40.00 X 256804 0 18078 JULIE ROGERS CORP COMPLIA 40.00 X 232099 0 26930 ROBERT PURCELL PHARMACY DIR 40.00 X 219916 0 13730 TAUYNA FAULKNER VP 40.00 X 216721 0 35322 EDWIN MONTAGUE MD PHYSICIAN 40.00 X 485209 0 26083 MATTHEW CORNFORTH MD PHYSICIAN 40.00 X 481539 0 10204 BRIDGETTE DINGLE NEONATOLOGIS 40.00 X 424666 0 22675 JOEL JAGER MD PHYSICIAN 40.00 X 376674 0 23618 ALAN BARNES MD PHYSICIAN 40.00 X 363896 0 20678 10556644 13500 493481 236 false true false IN COMPASS HEALTH INC 318 MAXWELL ROAD SUITE 500 ALPHARETTA GA 30009 HOSPITALIST 5273923 CERNER CORP PO BOX 412702 KANSAS CITY MO 641412702 IT SERVICES 5235217 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 303682289 DIETARY SVC 4885590 ARAMARK MANAGEMENT SERVICES PO BOX 233 ROME GA 301610233 HOUSEKEEPING 4724261 BRASFIELD AND GORRIE LLC PO BOX 11407 BIRMINGHAM AL 352461407 GEN CONTRACTOR 3627054 60 1000000 52354 1052354 PATIENT SERVICE REVENUE 623000 396261766 396261766 FAMILY PRACTICE CAPITATION 621990 1667506 1667506 REFERENCE LAB 621500 795740 795740 398725012 2817571 2817571 588014 237178 350836 350836 350836 20288824 34529 19890378 8749 398446 25780 424226 424226 CAFETERIA 722513 102734 102734 PURCHASE DISCOUNTS 621990 21574 21574 FAMILY PRACTICE REVENUE 621990 9310 9310 1627 1627 135245 403505244 397961783 795740 3695367 X 310566 310566 8814885 8814885 163729059 135729892 27817867 181300 7212022 5687401 1516688 7933 36234835 28882519 7312028 40288 12173442 8943812 3216563 13067 2287376 2287376 442089 442089 46037019 32824087 13212932 2302117 473964 1828153 7879578 5009927 2868507 1144 14235294 1463682 12770647 965 12711739 10878706 1833033 3698783 1257465 2438820 2498 654698 379644 275054 604589 604589 21719524 18587569 3131955 2391389 516431 1874958 MEDICAL SUPPLIES 48765728 48667797 97931 LICENSE & TAXES 6239551 1686659 4552892 REPAIRS & MAINTENANCE 4429078 2709292 1719786 DUES & SUBSCRIPTIONS 1016007 371350 644657 1369074 1366701 2373 405258442 305747464 99263783 247195 16836834 19079431 36145097 30391027 55598249 62688211 289491 263162 8760289 9506858 4721425 6202607 384569798 224566959 168999429 160002839 115783787 121123254 13013752 15082171 6109492 7392526 426257845 431732086 34620309 38863930 140722535 136966324 26244320 25532349 47274827 43172692 248861991 244535295 X 177395854 187196791 177395854 187196791 426257845 431732086 X -1753198 3299835 8254300 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 74,000 PATIENTS PER YEAR AND A BUSY OUTPATIENT INDIGENT CLINIC. false false false false false false false false true 36767 36767 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. 14176098 14176098 145799253 54653236 91146017 15804816 11639941 4164875 205505779 158273782 47231997 3283852 3283852 160002839 ACCRUED PENSION 25874197 DUE TO RELATED PARTIES 7854385 MALPRACTICE CLAIMS 5365772 ACCRUED INTEREST 2756697 THIRD PARTY SETTLEMENTS 1321641 43172692 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, 2018 AND 2017 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 3.250000000000 true true false true true 14753768 14753768 0.03640 73023922 50601591 22422331 0.05530 87777690 50601591 37176099 0.09170 1431680 1431680 0.00350 6661627 4035524 2626103 0.00650 1786346 1786346 0.00440 64403 64403 0.00020 9944056 4035524 5908532 0.01460 97721746 54637115 43084631 0.10630 true 107377921 56910298 84297191 93928829 -9631638 X true true 1 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 FLOYD HEALTHCARE MANAGEMENT INC FLOYD MEDICAL CENTER 1 false false true X X X X X X X X 16 true false false true X WWW.FLOYD.ORG X WWW.FLOYDSTRAIGHTFORWARD.ORG X X true 16 true WWW.FLOYD.ORG false false true X 125.000000000000 325.000000000000 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 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 17-18 OF THE 2016 CHNA. 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 AND CHATTOOGA COUNTIES INDIVIDUAL COMMUNITY SURVEYS FOCUS GROUPS WITH A RANGE OF DIVERSE INDIVIDUALS INCLUDING PROVIDERS, ELECTED OFFICIALS, COMMUNITY-BASED ORGANIZATIONAL STAFF AND COMMUNITY RESIDENTS FACILITY 1, FLOYD HEALTHCARE MANAGEMENT INC. - PART V, LINE 7D THE 2016 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 2016 CHNA AND IMPLEMENTATION PLAN CAN BE FOUND ON THE ORGANIZATION'S WEBSITE AT HTTPS://FLOYDSTRAIGHTFORWARD.ORG/WP- CONTENT/UPLOADS/2016/06/CHNA-2016-FLOYD.PDF. 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 AND CHATTOOGA 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 PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE 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 25 405,258,442 ADD: EXPENSES REPORTED IN PART VIII 237,178 DENOMINATOR FOR COLUMN (F) 405,495,620 PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION 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. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY 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. THE FIGURE ON PART III LINE 3 REPRESENTS MANAGEMENT'S ESTIMATE (APPROXIMATELY 53%) 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. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS SEE PAGE 11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE. PART III, LINE 8 - MEDICARE EXPLANATION 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. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION 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. PART VI, LINE 2 - NEEDS ASSESSMENT FLOYD HEALTHCARE MANAGEMENT, INC. ("FHMI") COMPLETED A HEALTH CARE NEEDS ASSESSMENT IN CHATTOOGA, FLOYD, AND POLK COUNTIES IN FISCAL YEAR 2016. 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 2016 CHNA AND IMPLEMENTATION PLAN ARE POSTED ON THE FACILITY'S HOME WEBPAGE. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE 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. PART VI, LINE 4 - COMMUNITY INFORMATION 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 164,468 (2017) RESIDENTS OF THE THREE-COUNTY REGION ARE SERVED BY FMC AND TWO SMALLER HOSPITALS. THE POPULATION BASE IS APPROXIMATELY 76% CAUCASIAN, 13% AFRICAN AMERICAN, 9% HISPANIC OR LATINO AND 2% OTHER ETHNICITIES. NORTHWEST GA IS A MEDICAL AND EDUCATIONAL HUB. THREE OF THE LARGEST EMPLOYERS IN THE THREE-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 UNEMPLOYMENT RATE FOR THE THREE-COUNTY AREA WAS 5% IN 2017, AND 18.6% OF RESIDENTS ARE BELOW THE FEDERAL POVERTY LEVEL. SLIGHTLY LESS THAN ONE-FOURTH OF THE ADULT POPULATION (24.1%) HAS NOT GRADUATED HIGH SCHOOL. 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 PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH 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. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM FLOYD HEALTHCARE MANAGEMENT, INC. (FHMI) OPERATES FLOYD MEDICAL CENTER (FMC), A GENERAL ACUTE CARE HOSPITAL, FLOYD CHEROKEE MEDICAL CENTER, LLC (FCMC), CURRENTLY OPERATING A 45-BED ACUTE CARE HOSPITAL, AND FLOYD BEHAVIORAL HEALTH CENTER, A PSYCHIATRIC UNIT. TWO OF THE FACILITIES SERVE THE AREAS OF FLOYD COUNTY AND THE NORTHWEST GEORGIA REGION. 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. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT GEORGIA true COBRA INSURANCE PREMIUM 50 189280 TUITION 32 121286 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, 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 677895 1162596 1020243 23258 2883992 ROBERT HOLCOMBE JR MD DIRECTOR 257798 51 3936 25209 286994 JAMES COLLINS JR MD DIRECTOR 203573 51 5637 4004 213265 RICHARD T SHEERIN CFO 410980 95851 8764 19536 535131 JOSEPH BIUSO MD VP & CMO 441183 111351 9505 24318 586357 WARREN RIGAS SVP COO 369086 94751 7929 27836 499602 BETH BRADFORD CHIEF HR OFFICER 298929 90351 5126 12746 407152 TOMMY MANNING CORPORATE COUNSEL 312218 72051 3607 26083 413959 SHEILA HORNER VP & CNO 297540 71151 6228 10146 385065 GREG POLLEY VICE PRESIDENT 273139 66951 5458 28083 373631 JEFFERY D BUDA CHF INFORMATION OFCR 279530 60151 4603 25883 370167 RICHARD CHILDS VP REVENUE CYCLE MGT 250452 58251 4017 24318 337038 REBEKAH LOWREY MD SURGICAL DIRECTOR 264624 18840 5836 26785 316085 DAVID EARLY DIRECTOR SUPPORT SVC 205491 48151 3162 18078 274882 JULIE ROGERS CORP COMPLIANCE OFCR 180518 47551 4030 26930 259029 ROBERT PURCELL PHARMACY DIRECTOR 202501 16437 978 13730 233646 TAUYNA FAULKNER VP 202201 13756 764 35322 252043 EDWIN MONTAGUE MD PHYSICIAN 484595 51 563 26083 511292 MATTHEW CORNFORTH MD PHYSICIAN 481133 51 355 10204 491743 BRIDGETTE DINGLE NEONATOLOGIST 423967 51 648 22675 447341 JOEL JAGER MD PHYSICIAN 375806 51 817 23618 400292 ALAN BARNES MD PHYSICIAN 363513 51 332 20678 384574 SCHEDULE J, PAGE 1, PART I, LINE 4 KURT STUENKEL 0 1,004,542 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. ADDITIONALLY, OF THE 2,860,734 LISTED AS COMPENSATION FOR MR. KURT STUENKEL IN FORM 990 PART VII SECTION A, 180,879 REPRESENTS A PERFORMANCE BASED PAYMENT ARISING FROM THE 2017 PERFORMANCE PERIOD, 981,717 REPRESENTS A RETENTION BONUS, AND 1,004,542 REPRESENTS THE NONQUALIFIED SERP PLAN. ACCORDINGLY, MR. STUENKEL'S SALARY FOR 2017 WOULD HAVE BEEN 693,596 EXCLUDING THE 2017 PORTION OF THE INCENTIVE BASED PAYMENT AND THE SERP PLAN AMOUNT. 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 1985000 20074922 279011 243560 19552351 2013 false false true true B 5610000 34970725 444814 36387986 388296 1777 2013 false false true true C 3435000 101960422 71108289 845684 30006449 2016 false true false 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 false false false false false false B false false false false false false false false false C false false false false false false false false false A false B false C false SCHEDULE K - 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. 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. 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. BEN RIGAS EMPLOYEE 4670 TUITION EDUCATION JEFF BUDA KEY EMPLOYEE 45329 TUITION EDUCATION TAUYNA FAULKNER KEY EMPLOYEE 25896 TUITION EDUCATION JOSHUA POLLEY FAMILY-KEY EMP 80029 EMPLOYEE WAGES false BENJAMIN RIGAS FAMILY-KEY EMP 71395 EMPLOYEE WAGES false DAVID JOHNSON BOARD MEMBER BANKING SERVICES false JOSEPH D BIUSO FAMILY-KEY EMP 26675 EMPLOYEE WAGES false BETHANY POLLEY FAMILY-KEY EMP 21354 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 2 FLOYD HEALTHCARE MANAGEMENT, INC. (FHMI) CREATED FLOYD CHEROKEE MEDICAL CENTER, LLC (FCMC) APRIL 10, 2018 AND IS THE SOLE MEMBER OF FCMC. FCMC IS AN ALABAMA LIMITED LIABILITY CORPORATION. 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. FORM 990, PAGE 2, PART III, LINE 4A 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 2018, PATIENT DAYS (INCLUDING PSYCH AND REHAB) AT FLOYD MEDICAL CENTER TOTALED 86,067 AND DISCHARGES TOTALED 15,854. FLOYD MEDICAL CENTER PROVIDED APPROXIMATELY 64,000,000 IN DIRECT CHARITY AND INDIGENT CARE, AND IT INCURRED UNREIMBURSED MEDICARE AND MEDICAID ADJUSTMENTS OF 523,627,000 AND 240,307,000 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 16,033,380 1,744,655 0 PURCHASED SERVICES 15,558,013 6,214,403 0 CONSULTING FEES 111,398 1,664,759 0 BILLING AND COLLECTIONS 975,884 3,589,115 0 FPC MANAGEMENT FEES 145,412 0 0 TOTAL 32,824,087 13,212,932 0 FORM 990, PART XI, LINE 9 CURRENT YEAR ACTUARIAL LOSS 6,575,712 AMORTIZATION OF ACTUARIAL LOSS 685,410 EQUITY TRANSFER 230,040 PAST SERVICE COST - PENSION PLAN 763,138 TOTAL 8,254,300 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 143000 138169 FHMI FLOYD PHYSICIANS LLC 304 TURNER MCCALL BLVD ROME GA 301620233 205415285 SPEC PHYS GA 2118220 2402495 FHMI ACCOUNTABLE CARE ORGANIZATION OF 304 TURNER MCCALL BLVD ROME GA 301620233 474054900 HEALTHCARE GA 719868 FHMI FLOYD CHEROKEE MEDICAL CENTER LLC 400 NORTHWOOD DRIVE CENTRE AL 359601023 825207287 HOSPITAL AL 1943072 2667086 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 7854385 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. 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. 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.