2017-03-13T16:17:34-04:00 2016-04-30 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2015-05-01 582513901 CHATUGE REGIONAL HOSPITAL INC CHAT 7068962222 110 SOUTH MAIN STREET HIAWASSEE GA 305460509 RICHARD L KELLEY COO/CEO 7068962222 2017-03-05 true WILLIAM EDWARD PHILLIPS P00451499 2298837878 2017-03-13 2015 2021-01-29 14:40:06Z RICHARD L KELLEY 110 SOUTH MAIN STREET HIAWASSEE GA 30546 20815599 false X WWW.UNIONGENERALHOSPITAL.COM X 1955 GA TO PROVIDE HIGH QUALITY, COST EFFECTIVE HEALTH CARE AND TO PROMOTE WELLNESS THROUGHOUT OUR COMMUNITY. 7 6 462 0 31538 11312 19514467 20543569 60334 3508 294084 257210 19900423 20815599 0 0 10552683 12520523 0 0 8430867 9982079 18983550 22502602 916873 -1687003 17085150 14483734 6555047 5640634 10530103 8843100 X TO PROVIDE HIGH QUALITY, COST EFFECTIVE HEALTH CARE AND TO PROMOTE WELLNESS THROUGHOUT OUR COMMUNITY. false false 19918089 20701041 CHATUGE REGIONAL HOSPITAL (CRH), A 501(C)(3) HEALTHCARE ORGANIZATION, TAKES A PROACTIVE APPROACH TO MEET COMMUNITY HEALTH NEEDS, THE ORGANIZATION'S TAX-EXEMPTION REQUIREMENTS AND OFFERS COMMUNITY BENEFIT PROGRAMS AND SERVICES WHICH RESULT IN A POSITIVE IMPACT ON COMMUNITY HEALTH. CRH AND CHATUGE REGIONAL NURSING HOME (CRNH) HAVE A VISION TO BE THE "FIRST CHOICE" PROVIDER OF COMPREHENSIVE MEDICAL SERVICES IN OUR AREA. WE VALUE OUR PATIENTS AND RESIDENTS AND BELIEVE THEY ARE OUR MOST IMPORTANT RESPONSIBILITY. WE SHALL ALWAYS SEEK TO MEET THE PHYSICAL, EMOTIONAL, EDUCATIONAL, AND SPIRITUAL NEEDS OF OUR PATIENTS AND THEIR FAMILIES. WE VALUE OUR MEDICAL STAFF AND WILL SEEK WAYS TO HELP THEM IMPROVE PROFESSIONALLY AND FACILITATE THE PRACTICE OF MEDICINE. WE VALUE OUR EMPLOYEES AND SHALL TREAT EACH OTHER WITH COURTESY, FAIRNESS, RESPECT, AND INTEGRITY. WE SHALL WORK AS A TEAM TO DO OUR BEST TO PROMOTE OUR MISSION AND FULFILL OUR VISION. WE VALUE OUR COMMUNITY. WE ARE COMMITTED TO THE TREATMENT AND CARE OF OUR PATIENTS AND PROMOTION OF HEALTH AND WELLNESS IN OUR COMMUNITY. WE WILL CONFRONT ALL ETHICAL AND MORAL HEALTH-RELATED ISSUES NECESSARY TO ENHANCE THE QUALITY OF LIFE IN OUR COMMUNITY. WE VALUE QUALITY CARE AND WILL SEEK TO DELIVER CUSTOMER-FOCUSED, COST EFFICIENT SERVICES WITH COMPASSION AND CARING. CRH WAS DEEMED TO BE A CRITICAL ACCESS HOSPITAL BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS), EFFECTIVE MAY 1, 2002, AND BY THE GEORGIA DEPARTMENT OF COMMUNITY HEALTH (DCH). CRH IS THE ONLY ACUTE CARE HOSPITAL IN TOWNS COUNTY, GEORGIA. CRH IS LIMITED TO 25 ACUTE AND INTENSIVE CARE MEDICAL/SURGICAL BEDS. THESE BEDS ARE ALSO USED FOR SHORT-TERM SKILLED NURSING CARE. OUTPATIENT SERVICES INCLUDE RADIOLOGY, LABORATORY AND OTHER DIAGNOSTIC SERVICES, REHABILITATION SERVICES, AND 24/7 EMERGENCY MEDICAL SERVICES. CRNH IS THE ONLY NURSING FACILITY IN THE COUNTY PROVIDING SKILLED AND INTERMEDIATE LEVELS OF LONG-TERM CARE. CRNH IS LICENSED FOR 112 BEDS AND CONSISTENTLY HAS A WAITING LIST FOR ADMISSIONS. A MAJORITY OF THE RESIDENTS OF CRNH ARE MEDICARE AND MEDICAID BENEFICIARIES. IT IS A LONG-ESTABLISHED POLICY OF CRH TO PROVIDE QUALITY CARE FOR ITS PATIENTS REGARDLESS OF THEIR FINANCIAL CIRCUMSTANCES. QUALIFICATION FOR HOSPITAL INDIGENT CARE IS SET AT 125% OF THE CURRENT FEDERAL POVERTY GUIDELINES AND IS BASED ON SIZE OF THE FAMILY UNIT. CRH AND CRNH ALSO PROVIDE FREE OR REDUCED COST CARE TO ALL ELIGIBLE PERSONS REQUESTING CHARITY CARE ASSISTANCE. FOR EMERGENCY MEDICAL SERVICES, INCLUDING ACTIVE LABOR, NO PERSON WILL BE DENIED CARE DUE TO AN INABILITY TO PAY FOR SERVICES. CRH AND CRNH PARTICIPATE IN MEDICARE, MEDICAID, PEACHCARE, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. CRH, IN CONJUNCTION WITH ITS SISTER HOSPITAL, UNION GENERAL HOSPITAL, ARE THE ONLY TAX-EXEMPT, NON-PROFIT HOSPITALS WITHIN THE IMMEDIATE EIGHT-COUNTY AREA OF THE NORTH CENTRAL AND NORTHEAST GEORGIA MOUNTAINS. DUE TO THE MOUNTAINOUS TERRAIN AND BEING BOUNDED BY THE CHATTAHOOCHEE NATIONAL FOREST AND LAKE CHATUGE, TOWNS COUNTY AND ITS NEIGHBORING CLAY COUNTY, NC, HAVE SEVERAL VERY REMOTE COMMUNITIES FROM WHICH ACCESS TO MEDICAL CARE CAN LITERALLY BE MORE THAN AN HOUR AWAY IN SOME CASES. TOWNS COUNTY ATTRACTS MANY VISITORS FOR CAMPING, HIKING, FISHING AND HUNTING. THE TWISTING MOUNTAIN ROADS ATTRACT BICYCLISTS AND MOTORCYCLISTS THROUGHOUT THE SPRING, SUMMER AND FALL SEASONS. THESE ACTIVITIES MANY TIMES RESULT IN MEDICAL EMERGENCIES, SOME VERY SERIOUS, FOR WHICH THE EMERGENCY DEPARTMENT OF CRH MUST BE PREPARED. CRH ESTABLISHED A FAMILY MEDICAL PRACTICE IN HAYESVILLE, NC (CLAY COUNTY) TO HELP MEET THE MEDICALLY UNDERSERVED IN THE COMMUNITY. THE MEDICAL OFFICE IS STAFFED WITH FAMILY NURSE PRACTITIONERS AND SUPPORTED BY PHYSICIANS FROM CRH'S EMERGENCY DEPARTMENT. 19918089 true false false false 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 false true false false false false false false false false false false false false false true false false false true 34 0 462 true false false false false false false false false false false X 7 6 true false false false true false false true true false false true true true true false false true false false GA X X NICK TOWNSEND 7064396498 35 HOSPITAL ROAD BLAIRSVILLE GA 30512 X DAVID GOWDER MD DIRECTOR 1.00 1.50 X 0 9920 0 PATSY EFIRD CHAIRPERSON 1.00 1.50 X X 0 0 0 DAVID BREEDLOVE MD DIRECTOR 1.00 1.50 X 0 0 0 MAX COCHRAN DIRECTOR 1.00 1.50 X 0 0 0 DINAH PARIS DIRECTOR 1.00 1.50 X 0 0 0 MYRON TURNER DIRECTOR 1.00 1.50 X 0 0 0 JAMES K WILLIAMS DIRECTOR 1.00 1.50 X 0 0 0 STEVEN ROWE DIRECTOR 1.00 1.50 X 0 0 0 ANDRE SCHOEFFLER MD DIRECTOR 1.00 1.50 X 0 0 0 JAMES HEATON MD DIRECTOR 1.00 1.50 X 0 0 0 J MICHAEL GOWDER CEO 12.00 28.00 X 0 222058 5913 MICHAEL JOHNSTON COO 12.00 28.00 X 0 188165 4801 TIMOTHY N HENRY CFO 12.00 28.00 X 0 155866 8405 RICHARD L KELLEY COO/CEO 30.00 0.00 X 132927 0 0 MATTHEW HUNTER CIO 12.00 28.00 X 0 131219 3957 JULIA BARNETT CNO 12.00 28.00 X 0 126681 6764 SHELLY MCINTYRE MD PSYCHIATRIST 40.00 X 165232 0 5032 EMORY PLOTT NURSE PRACTI 40.00 X 146108 0 0 KAREN KELLEY PHARMACIST 40.00 X 116833 0 5717 PATRICIA LEDFORD REGISTERED N 40.00 0.00 X 111655 0 4809 JOHN GORDON ADMINISTRATO 40.00 X 105021 0 6153 777776 833909 51551 8 false true false QUEST DIAGNOSTICS PO BOX 740736 ATLANTA GA 303740736 LAB SVCS 198080 MILLER EDX LLC PO BOX 2696 BLUE RIDGE GA 30513 MEDICAL SERVICE 130922 2 11312 11312 NET PATIENT REVENUE 623000 20543569 20543569 20543569 3083 3083 99738 99738 99738 99738 425 425 425 425 EHR INCENTIVE 621990 78779 78779 CAFETERIA & VENDING 722514 54999 54999 PURCHASE DISCOUNTS 621990 8038 8038 15656 15656 157472 20815599 20701041 103246 X 96927 96927 10488766 9676218 812548 192776 176217 16559 1742054 1592412 149642 38093 38093 2636915 2490611 146304 75393 47535 27858 2046186 1823283 222903 82471 38156 44315 512454 449781 62673 36997 21767 15230 10948 10948 1526512 1339820 186692 168538 168538 MEDICAL SUPPLIES 1100562 917348 183214 PROVIDER FEE 630613 630613 REPAIRS & MAINTENANCE 539956 539956 DUES & SUBSCRIPTIONS 511617 152578 359039 64824 10846 53978 22502602 19918089 2584513 0 4919925 1641470 247273 247273 2049259 2399910 352636 195909 416579 414158 585864 343066 17419503 8679416 8513614 8740087 501861 17085150 14483734 1690412 1291086 22254 152876 1649657 1479003 3192724 2717669 6555047 5640634 X 10530103 8843100 10530103 8843100 17085150 14483734 -1687003 X false true X true false X 727121 727121 7369643 2658788 4710855 204720 140360 64360 9002789 5880268 3122521 115230 115230 8740087 DUE TO UNION GENERAL 1668107 THIRD PARTY SETTLEMENTS 992711 PHYSICIAN RECRUITING 46851 OTHER LIABILITIES 10000 2717669 X SCHEDULE D, PAGE 3, PART X UNION, CHATUGE AND THE AMBULANCE SERVICE ARE TAX EXEMPT UNDER SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. THE DIALYSIS CLINIC IS ORGANIZED UNDER GEORGIA LAW AND THE CODE AS A LIMITED LIABILITY COMPANY (LLC). THE DIALYSIS CLINIC IS TAXED AS A PARTNERSHIP UNDER FEDERAL AND STATE LAW AND IS THEREFORE NOT SUBJECT TO CORPORATE INCOME TAXATION. THE MEMBERS REPORT THEIR ALLOCATED SHARE OF INCOME FROM THE LLC ON THEIR INCOME TAX RETURNS. UNION'S SHARE OF INCOME FROM DIALYSIS CLINIC'S OPERATIONS IS CONSIDERED RELATED BUSINESS INCOME AND THEREFORE IS NOT SUBJECT TO TAX. 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 MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF APRIL 30, 2016 AND 2015 OR FOR THE YEARS THEN ENDED. THE CORPORATION'S TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAXING AUTHORITIES. FOR FEDERAL INCOME TAX PURPOSES, THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. true true X true X 1.250000000000 true X true false true true 249314 249314 0.01110 2269451 1598176 671275 0.02980 2518765 1598176 920589 0.04090 9344 9344 0.00040 9344 9344 0.00040 2528109 1598176 929933 0.04130 false 2464385 381980 6138979 6698296 -559317 X true true 1 1 CHATUGE REGIONAL HOSPITAL INC 110 SOUTH MAIN STREET HIAWASSEE GA 305460509 WWW.UNIONGENERALHOSPITAL.COM 139-583 X X X SNF, CLINICS CHATUGE REGIONAL HOSPITAL INC 1 false false true X X X X X X X X X X 15 true true false true X WWW.UNIONGENERALHOSPITAL.COM true 15 true WWW.UNIONGENERALHOSPITAL.COM/COMMUNITY false false true X 125.000000000000 400.000000000000 X X X X X true true X X X X true X WWWUNIONGENERALHOSPITALCOM X WWWUNIONGENERALHOSPTIALCOM X WWWUNIONGENERALHOSPITALCOM X X X X X X true X true X X X true X false false FACILITY 1, CHATUGE REGIONAL HOSPITAL, INC - PART V, LINE 5 INITIALLY, THE COMMUNITY ADVISORY COMMITTEE WAS SELECTED, ITS 22 MEMBERS REPRESENTING A CROSS-SECTION OF THE TARGET AREA, INCLUDING LOCAL POLITICIANS, EDUCATORS, BUSINESSMEN, NURSES, AND OTHER COMMUNITY MEMBERS. COMMUNITY-BASED SURVEYS AND FOCUS GROUPS PROVIDED A WIDE ARRAY OF COMMUNITY INPUT. FACILITY 1, CHATUGE REGIONAL HOSPITAL, INC - PART V, LINE 6A THE COLLEGE OF PUBLIC HEALTH, GEORGIA SOUTHERN UNIVERSITY WAS GRANTED FUNDING BY THE DEPARTMENT OF COMMUNITY HEALTH TO PROVIDE TECHNICAL ASSISTANCE TO 18 NONPROFIT HOSPITALS IN COMPLETING THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AS MANDATED BY THE IRS. HOSPITALS INCLUDED IN THE CHNA PROJECT INCLUDED: BACON REGIONAL HOSPITAL CHATUGE REGIONAL HOSPITAL CLINCH COUNTY HOSPITAL EVANS MEMORIAL HOSPITAL JASPER MEMORIAL HOSPITAL JEFF DAVIS HOSPITAL JEFFERSON HOSPITAL MILLER COUNTY HOSPITAL MONROE COUNTY HOSPITAL MORGAN MEMORIAL HOSPITAL PHOEBE WORTH MEDICAL CENTER TAYLOR REGIONAL HOSPITAL UNION GENERAL HOSPITAL WASHINGTON COUNTY MEDICAL CENTER MEMORIAL HOSPITAL & MANOR MEADOWS REGIONAL MEDICAL CENTER STEPHENS COUNTY HOSPITAL LOUIS SMITH MEMORIAL HOSPITAL FACILITY 1, CHATUGE REGIONAL HOSPITAL, INC - PART V, LINE 11 THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN 2015 IDENTIFIED 10 SPECIFIC NEEDS THAT ARE ADDRESSED IN THE ATTACHED IMPLEMENTATION STRATEGIES. THE HOSPITAL ADDRESSES ALL OF THE IDENTIFIED NEEDS IN SOME MANNER FROM CLINICAL OUTREACH TO COMMUNITY EDUCATION. THE CURRENT CHNA AND IMPLEMENTATION STRATEGIES, AS WELL AS THE PREVIOUS CHNA (WHICH WAS CONDUCTED IN 2012) ARE AVAILABLE ON THE HOSPITAL'S WEBSITE AT: WWW.UNIONGENERALHOSPITAL.COM/COMMUNITY-HEALTH/. FACILITY 1, CHATUGE REGIONAL HOSPITAL, INC - PART V, LINE 15E A NOTICE IS RUN ANNUALLY IN THE LOCAL NEWSPAPER REGARDING THE AVAILABILITY OF FREE AND DISCOUNTED CARE FOR PATIENTS THAT QUALIFY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. FACILITY 1, CHATUGE REGIONAL HOSPITAL, INC - PART V, LINE 16I ANNUAL NEWSPAPER NOTICE INDICATING THE AVAILABILITY OF FINANCIAL ASSISTANCE. REGISTRATION AND COLLECTORS PROVIDE INFORMATION AND FINANCIAL ASSISTANCE APPLICATIONS. SIGNAGE POSTED IN REGISTRATION AND EMERGENCY DEPARTMENTS. 2 CHATUGE REGIONAL NURSING HOME 386 BELAIRE DRIVE HIAWASSEE GA 30546 SKILLED NURSING HAYESVILLE FAMILY PRACTICE 450 HIGHWAY 64 BUSINESS SUITE 4 HAYESVILLE NC 28904 FAMILY CLINIC 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". THE ORGANIZATION USES A RATIO OF COST TO CHARGES TO ESTIMATE THE COSTS OF COMMUNITY BENEFITS. 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. LINE 3 - BASED ON EXPERIENCE, THE ORGANIZATION HAS FOUND THAT THERE IS A PORTION OF BAD DEBT THAT IS GENERALLY ATTRIBUTABLE TO CHARITY CARE. BASED ON ECONOMIC CENSUS RECORDS, 15.5% OF PERSONS ARE BELOW POVERTY LEVEL AND SINCE OUR FINANCIAL ASSISTANCE POLICY GOES TO 400% OF THE POVERTY LEVEL, WE ESTIMATED THAT 15.5% OF THE BAD DEBT AMOUNT ON LINE 2 WOULD BE ATTRIBUTABLE TO THOSE PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, BUT FAILED TO COMPLETE THE APPLICATION PROCESS FOR WHATEVER REASON. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS FOOTNOTE 1 ON PAGE 9 OF THE AUDITED FINANCIAL STATEMENTS DESCRIBES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOOTNOTE 3 (ON PAGE 20) SUMMARIZES ALL UNCOMPENSATED CHARGES INCLUDING BAD DEBTS. 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 ONCE THE PATIENT IS APPROVED FOR INDIGENT CARE (100% WRITE OFF) THE ACCOUNT(S) IS (ARE) RECLASSIFIED TO INDIGENT CARE AND NO FURTHER COLLECTION ACTIVITY IS CONDUCTED. FOR PATIENTS APPROVED FOR CHARITY CARE (REDUCED CHARGE), THE ACCOUNT GUARANTOR WILL RECEIVE STATEMENTS AND PHONE CALLS TO COLLECT THE REMAINING BALANCE DUE. PART VI, LINE 2 - NEEDS ASSESSMENT THE ORGANIZATION PERIODICALLY SOLICITS FEEDBACK FROM THE MEDICAL STAFF AND FROM CITY AND COUNTY OFFICIALS, IN ADDITION TO THE INPUT RECEIVED DURING THE CHNA PROCESS. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE NOTICES ARE PUBLISHED IN THE LOCAL COMMUNITY NEWSPAPER REGARDING THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. ACCOUNT COLLECTORS ALSO INFORM THE ACCOUNT GUARANTOR OF THE AVAILABILITY OF INDIGENT AND CHARITY CARE ONCE THE COLLECTION PROCESS IS INITIATED. THE ORGANIZATION MAILS OUT APPLICATIONS FOR FINANCIAL AID, BUT A LIMITED NUMBER ARE EVER RETURNED. PART VI, LINE 4 - COMMUNITY INFORMATION CHATUGE REGIONAL HOSPITAL ("CRH") SERVES A GENERALLY RURAL, MOUNTAINOUS AREA AND IS THE SOLE HOSPITAL IN TOWNS COUNTY. DUE TO THE MOUNTAINOUS TERRAIN AND BEING BOUNDED BY THE CHATTAHOOCHEE NATIONAL FOREST AND LAKE CHATUGE, TOWNS COUNTY AND ITS NEIGHBORING CLAY COUNTY, NC HAVE VERY REMOTE COMMUNITIES FROM WHICH ACCESS TO MEDICAL CARE CAN LITERALLY BE MORE THAN AN HOUR AWAY IN SOME CASES. TOWNS COUNTY ATTRACTS MANY VISITORS FOR CAMPING, BOATING, HIKING, FISHING AND HUNTING, AS WELL AS BICYCLISTS AND MOTORCYCLISTS, WHICH OFTEN LEAD TO SERIOUS INJURY THAT THE EMERGENCY DEPARTMENT MUST BE PREPARED TO MEET. FURTHERMORE, CRH IS A CRITICAL ACCESS HOSPITAL FOR THE RESIDENTS OF TOWNS COUNTY, GA, AND CLAY COUNTY, NC. SIGNIFICANT PORTIONS OF THE RESIDENT POPULATION ARE MEDICARE AND MEDICAID BENEFICIARIES. TOWNS COUNTY IS DEEMED TO HAVE A MEDICALLY UNDERSERVED POPULATION (MUP) BY THE GEORGIA DEPARTMENT OF COMMUNITY HEALTH. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH THE ORGANIZATION PROMOTES CONDUCTS HEALTH FAIRS OPEN TO THE COMMUNITY WHEREIN FREE HEALTH SCREENINGS AND LOW-COST BASIC LAB TESTS ARE DONE. OTHER HEALTH INFORMATION IS PROVIDED INCLUDING INFORMATION ON SMOKING CESSATION AND DIABETES. THE ORGANIZATION IS ENTIRELY TOBACCO-FREE, THUS PROMOTING A HEALTHY LIFESTYLE. SURPLUS FUNDS ARE USED TO PROVIDE FOR THE ADDITION, IMPROVEMENT, OR REPLACEMENT OF CAPITAL AND EQUIPMENT NEEDS. THE BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY VOLUNTEERS. THE HOSPITAL PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS, OFFERS FINANCIAL ASSISTANCE FOR MEDICAL CARE TO ELIGIBLE INDIVIDUALS AND IT HAS AN OPEN MEDICAL STAFF. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT GEORGIA false false false false false false false false false J MICHAEL GOWDER CEO 216423 5635 5913 227971 MICHAEL JOHNSTON COO 182579 5586 4801 192966 TIMOTHY N HENRY CFO 150280 5586 3466 4939 164271 SHELLY MCINTYRE MD PSYCHIATRIST 165232 2700 2332 170264 SCHEDULE J, PAGE 1, PART I, LINE 3 THE COMPENSATION OF THE CEO IS DETERMINED BY A RELATED ORGANIZATION, UNION GENERAL HOSPITAL, A TAX EXEMPT ORGANIZATION DESCRIBED IN IRC SECTION 501 (C)(3). THE BOARD OF DIRECTORS OF UNION GENERAL HOSPITAL APPROVES THE COMPENSATION OF THE CEO AND UTILIZES COMPARISONS TO INDEPENDENTLY GENERATED SURVEYS AND TO THE FORM 990 OF OTHER SIMILAR TAX EXEMPT HOSPITALS. IN THE CURRENT YEAR, THE BOARD OF DIRECTORS OF BOTH ORGANIZATIONS ARE IDENTICAL. FORM 990, PAGE 2, PART III, LINE 4A EMPLOYEES AND SHALL TREAT EACH OTHER WITH COURTESY, FAIRNESS, RESPECT, AND INTEGRITY. WE SHALL WORK AS A TEAM TO DO OUR BEST TO PROMOTE OUR MISSION AND FULFILL OUR VISION. WE VALUE OUR COMMUNITY. WE ARE COMMITTED TO THE TREATMENT AND CARE OF OUR PATIENTS AND PROMOTION OF HEALTH AND WELLNESS IN OUR COMMUNITY. WE WILL CONFRONT ALL ETHICAL AND MORAL HEALTH-RELATED ISSUES NECESSARY TO ENHANCE THE QUALITY OF LIFE IN OUR COMMUNITY. WE VALUE QUALITY CARE AND WILL SEEK TO DELIVER CUSTOMER-FOCUSED, COST EFFICIENT SERVICES WITH COMPASSION AND CARING. CRH WAS DEEMED TO BE A CRITICAL ACCESS HOSPITAL BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS), EFFECTIVE MAY 1, 2002, AND BY THE GEORGIA DEPARTMENT OF COMMUNITY HEALTH (DCH). CRH IS THE ONLY ACUTE CARE HOSPITAL IN TOWNS COUNTY, GEORGIA. CRH IS LIMITED TO 25 ACUTE AND INTENSIVE CARE MEDICAL/SURGICAL BEDS. THESE BEDS ARE ALSO USED FOR SHORT-TERM SKILLED NURSING CARE. OUTPATIENT SERVICES INCLUDE RADIOLOGY, LABORATORY AND OTHER DIAGNOSTIC SERVICES, REHABILITATION SERVICES, AND 24/7 EMERGENCY MEDICAL SERVICES. CRNH IS THE ONLY NURSING FACILITY IN THE COUNTY PROVIDING SKILLED AND INTERMEDIATE LEVELS OF LONG-TERM CARE. CRNH IS LICENSED FOR 112 BEDS AND CONSISTENTLY HAS A WAITING LIST FOR ADMISSIONS. A MAJORITY OF THE RESIDENTS OF CRNH ARE MEDICARE AND MEDICAID BENEFICIARIES. IT IS A LONG-ESTABLISHED POLICY OF CRH TO PROVIDE QUALITY CARE FOR ITS PATIENTS REGARDLESS OF THEIR FINANCIAL CIRCUMSTANCES. QUALIFICATION FOR HOSPITAL INDIGENT CARE IS SET AT 125% OF THE CURRENT FEDERAL POVERTY GUIDELINES AND IS BASED ON SIZE OF THE FAMILY UNIT. CRH AND CRNH ALSO PROVIDE FREE OR REDUCED COST CARE TO ALL ELIGIBLE PERSONS REQUESTING CHARITY CARE ASSISTANCE. FOR EMERGENCY MEDICAL SERVICES, INCLUDING ACTIVE LABOR, NO PERSON WILL BE DENIED CARE DUE TO AN INABILITY TO PAY FOR SERVICES. CRH AND CRNH PARTICIPATE IN MEDICARE, MEDICAID, PEACHCARE, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. CRH, IN CONJUNCTION WITH ITS SISTER HOSPITAL, UNION GENERAL HOSPITAL, ARE THE ONLY TAX-EXEMPT, NON-PROFIT HOSPITALS WITHIN THE IMMEDIATE EIGHT-COUNTY AREA OF THE NORTH CENTRAL AND NORTHEAST GEORGIA MOUNTAINS. DUE TO THE MOUNTAINOUS TERRAIN AND BEING BOUNDED BY THE CHATTAHOOCHEE NATIONAL FOREST AND LAKE CHATUGE, TOWNS COUNTY AND ITS NEIGHBORING CLAY COUNTY, NC, HAVE SEVERAL VERY REMOTE COMMUNITIES FROM WHICH ACCESS TO MEDICAL CARE CAN LITERALLY BE MORE THAN AN HOUR AWAY IN SOME CASES. TOWNS COUNTY ATTRACTS MANY VISITORS FOR CAMPING, HIKING, FISHING AND HUNTING. THE TWISTING MOUNTAIN ROADS ATTRACT BICYCLISTS AND MOTORCYCLISTS THROUGHOUT THE SPRING, SUMMER AND FALL SEASONS. THESE ACTIVITIES MANY TIMES RESULT IN MEDICAL EMERGENCIES, SOME VERY SERIOUS, FOR WHICH THE EMERGENCY DEPARTMENT OF CRH MUST BE PREPARED. CRH ESTABLISHED A FAMILY MEDICAL PRACTICE IN HAYESVILLE, NC (CLAY COUNTY) TO HELP MEET THE MEDICALLY UNDERSERVED IN THE COMMUNITY. THE MEDICAL OFFICE IS STAFFED WITH FAMILY NURSE PRACTITIONERS AND SUPPORTED BY PHYSICIANS FROM CRH'S EMERGENCY DEPARTMENT. FORM 990, PART VI THE BOARD OF DIRECTORS, CEO, AND CFO SERVE IN A SIMILAR CAPACITY FOR UNION GENERAL HOSPITAL, CHATUGE REGIONAL HOSPITAL AND UNION GENERAL AMBULANCE SERVICE. FORM 990, PAGE 6, PART VI, LINE 2 G. DAVID GOWDER, MD J. MICHAEL GOWDER BOARD MBR CEO FAMILY RELATIONSHIP J. MICHAEL GOWDER MICHAEL E. JOHNSTON CEO COO BUSINESS RELATIONSHIP FORM 990, PAGE 6, PART VI, LINE 6 UNION GENERAL HOSPITAL, INC., A GEORGIA 501(C)(3) NON-PROFIT HEALTHCARE ORGANIZATION, IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 11B THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. THE CFO REVIEWED THE RETURN IN DETAIL AND PROVIDED A COPY OF THE COMPLETED FORM 990 TO EACH BOARD MEMBER PRIOR TO FILING. FORM 990, PAGE 6, PART VI, LINE 12C OFFICERS AND DIRECTORS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY THAT REQUIRES DISCLOSURE OF ANY POTENTIAL RELATIONSHIP CONFLICTS. ANY CONFLICTS ARE REPORTED TO THE CHAIRMAN OF THE BOARD AND/OR DISINTERESTED PERSON OR COMMITTEE. THE INDIVIDUAL MEMBER WITH THE CONFLICT RECUSES HIMSELF FROM THE DISCUSSIONS AND VOTES ON THE ISSUE. FORM 990, PAGE 6, PART VI, LINE 15A NO COMPENSATION IS PAID BY THIS ORGANIZATION TO ITS OFFICERS. THE COMPENSATION OF THE OFFICERS FOR WORK PERFORMED FOR THIS ORGANIZATION AND ANY RELATED PARTIES IS DETERMINED IN ACCORDANCE WITH THE COMPENSATION PRACTICES OF UNION GENEREAL HOSPITAL AND INCLUDE COMPARISONS TO AN INDEPENDENT COMPENSATION STUDY, APPROVAL OF THE CEO'S COMPENSATION BY THE BOARD OF DIRECTORS, AND MANAGEMENT AND OVERSIGHT OF OTHER EXECUTIVE COMPENSATION BY THE CEO. FORM 990, PAGE 6, PART VI, LINE 18 PHOTOCOPIES OF THE ORGANIZATION'S FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII G. DAVID GOWDER IS COMPENSATED BY A RELATED ORGANIZATION FOR SERVICES FORM 990, PART IX, LINE 11G CONTRACT LABOR - PATIENT CARE 1,047,915 2,490 0 PURCHASED SERVICES 691,306 140,465 0 CONSULTING 3,550 3,349 0 EMERGENCY ROOM - PROF. FEES 747,840 0 0 UNION GENERAL HOSPITAL INC 35 HOSPITAL ROAD BLAIRSVILLE GA 30512 586025393 HOSPITAL GA 501C3 3 N/A false MOUNTAIN COMMUNITY HEALTHCARE FOUND P O BOX 509 HIAWASSEE GA 30546 201376498 FUNDRAISIN GA 501C3 11C UGH UNION GENERAL HOSPITAL INC false UNION GENERAL AMBULANCE SERVICE INC 35 HOSPITAL ROAD BLAIRSVILLE GA 30512 452735005 AMBULANCE GA 501C3 11A UGH UNION GENERAL HOSPITAL INC false UNION COUNTY DIALYSIS LLC 72 APPALACHIAN AVENUE BLAIRSVILLE GA 30512 582503326 DIALYSIS C GA N/A false false false false false false true false false false false false false false false false true true false false false