2016-09-29T09:43:44-05:00 2015-12-31 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2015-01-01 541453954 AUGUSTA HEALTH CARE INC D/B/A AUGUSTA HEALTH AUGU 5409324685 PO BOX 1000 FISHERSVILLE VA 22939 ROBERT RILEY CFO 5409324685 2016-09-29 1 AMY BIBBY P00445891 8282542254 2015 2017-02-10 21:41:12Z AUGUSTA HEALTH MARY MANNIX PO BOX 1000 FISHERSVILLE VA 22939 325621448 0 X WWW.AUGUSTAHEALTH.COM X 1988 VA PROVISION OF FULL SERVICE HEALTHCARE. 15 12 2201 300 4287588 -970127 175663 344459 281698281 300740641 17181294 20199185 2187274 3541960 301242512 324826245 893750 532629 0 0 116678417 122038991 0 0 0 135698963 186689447 253271130 309261067 47971382 15565178 566426956 571891380 63245007 52844656 503181949 519046724 X THE MISSION OF AUGUSTA HEALTH IS TO PROMOTE THE HEALTH AND WELL-BEING OF OUR COMMUNITY THROUGH ACCESS TO EXCELLENT CARE. 0 0 269274166 532629 296534601 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 61,000 COMMUNITY MEMBERS PER YEAR; 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 BRANCH OF A LOCAL COMMUNITY COLLEGE; 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'S NET COMMUNITY BENEFIT FOR 2015 IS ESTIMATED TO BE $18,565,126. THIS BENEFIT CAN BE CATEGORIZED AS FOLLOWS: CHARITY - $ 9,359,951 MEDICAID - 3,870,964 COMMUNITY HEALTH SERVICES - 1,895,341 HEALTH PROFESSIONAL EDUCATION - 123,543 SUBSIDIZED HEALTH SERVICES - 2,782,283 CASH & IN-KIND CONTRIBUTIONS - 533,044 269274166 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 1 0 0 0 0 0 0 1 1 1 0 0 1 274 0 2201 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 15 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 189 MEDICAL CENTER DRIVE FISHERSVILLE VA 22939 REV JOHN C PETERSON CHAIRMAN 1.00 1.00 X X 0 0 0 VICTOR M SANTOS VICE CHAIRMAN 1.00 X X 0 0 0 MARY N MANNIX PRESIDENT & CEO 38.00 2.00 X X 738160 0 104093 WILLIAM PFOST MD SECRETARY/TREASURER 1.00 1.00 X X 0 0 0 CHARLES ANDERSEN MD BOARD MEMBER 1.00 1.00 X 0 0 0 E STUART CROW BOARD MEMBER 1.00 X 0 0 0 JOHN B DAVIS BOARD MEMBER 1.00 X 0 0 0 DEBRA S CALLISON BOARD MEMBER 1.00 X 0 0 0 A WHIT MORRISS MD BOARD MEMBER 1.00 1.00 X 0 0 0 LAUREL L LANDES BOARD MEMBER 1.00 X 0 0 0 JOHN ROB O MARSH MD BOARD MEMBER 1.00 X 0 0 0 BEVERLY CHERI S MORAN BOARD MEMBER 1.00 1.00 X 0 0 0 JOSEPH L RANZINI MD BOARD MEMBER 1.00 X 0 0 0 ARONA E RICHARD BOARD MEMBER 1.00 1.00 X 0 0 0 BURNIE POWERS BOARD MEMBER 1.00 X 0 0 0 ROBERT W RILEY CFO 39.00 1.00 X 418881 0 46246 FRED CASTELLO MD CHIEF MEDICAL OFFICER 40.00 X 318947 0 27088 KATHLEEN HEATWOLE VP OF PLANNING AND DEVELOP 40.00 X 269951 0 27882 MARVELLA REA CNO 40.00 X 214006 0 32036 LISA CLINE COO 40.00 X 413044 0 45284 DAN O'CONNOR VP OF HUMAN RESOURCES 40.00 X 278006 0 36143 GEORGE SEMKO ADMIN DIRECTOR REVENUE CYCLE 40.00 X 179940 0 9961 SCOTT CRABTREE ADMIN DIRECTOR OF PROFESSIONAL SERV 40.00 X 170449 0 7660 MATTHEW GARNER PHARMACIST 40.00 X 148567 0 8774 VICKIE TAYLOR SURGICAL DIRECTOR 40.00 X 157095 0 9989 FRANCIS CARRUCIO ADMIN DIRECTOR 40.00 X 210760 0 6257 3517806 0 361413 71 0 1 0 DEARBORN ADVISORS LLC PO BOX 6686 CAROL STREAM IL 60197 IT MANAGEMENT AND STAFF 9579560 SODEXO INC & AFFILIATES PO BOX 536922 ATLANTA GA 303536922 FOOD SERVICES MANAGEMENT 2994693 XTEND HEALTHCARE 500 W MAIN ST STE 14 HENDERSONVILLE TN 37075 BUSINESS OFFICE CONSULTANT 1400446 CREDIT SOULUTIONS LLC PO BOX 24710 LEXINGTON KY 40505 CREDIT AND COLLECTION SERVICES 1206992 QUALITY SYSTEMS INC 18111 VON KARMAN AVE STE 600 IRVINE CA 92612 IT STAFF AND SUPPORT 1118311 34 138864 205595 5595 344459 NET PATIENT SERVICE REVENUE 621400 286437889 286437889 DME 621400 5676503 5436518 239985 RETAIL PHARMACY 446110 5206978 3275554 1931424 FITNESS CENTER 713940 2165304 1006866 1158438 OTHER PROGRAM SERVICE REVENUE 900099 1115342 239149 876193 138625 138625 300740641 19999357 19999357 824681 520812 303869 303869 303869 474219 274391 199828 199828 199828 AFFILIATED REVENUES 900099 1692564 1692564 CAFETERIA/VENDING 722210 1409169 1409169 TELEPHONE ANSWERING 900099 81548 81548 54810 54810 3238091 324826245 296534601 4287588 23659597 X 532629 532629 2303072 2303072 128866 128866 91579645 82027359 9552286 4651592 4065002 586590 16614602 14519413 2095189 6761214 5908589 852625 782718 782718 1043160 1043160 144624 144624 37770 37770 38499062 21625759 16873303 1649998 1087243 562755 15478963 11096068 4382895 1624046 1624046 5319795 5234724 85071 499888 410805 89083 470566 267915 202651 1006619 1006619 14935000 14935000 1387151 1387151 PENSION TERMINATION EXP 38795442 38795442 MEDICAL SUPPLIES 24047231 24047231 BAD DEBTS 19772130 19772130 COST OF DRUGS SOLD 18734426 18734426 2460858 2067749 393109 309261067 269274166 39986901 0 16253830 10138246 34718733 43176162 30435 34704 5896182 6416197 2216329 2049513 338470351 201996869 133595204 136473482 282849774 264121349 22382519 23907502 56056844 73576200 43125 326970 12383981 11671055 566426956 571891380 25127907 22407451 141339 162308 24440000 21400000 564644 418576 12971117 8456321 63245007 52844656 X 502814779 518606781 367170 439943 503181949 519046724 566426956 571891380 X 15565178 -26741437 27041034 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 36605 36605 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 $ 36,605. 1511837 4208600 5720437 112914334 44317316 68597018 10760012 8598710 2161302 203246473 149080843 54165630 5829095 5829095 136473482 INVESTMENT IN AMG 73576200 C 73576200 OTHER LIABILITIES 8363331 UNAMORTIZED BOND DISCOUNTS 92990 8456321 X 265953655 -26741437 -11231383 -37972820 303926475 20899770 20899770 324826245 250160866 0 250160866 59100201 59100201 309261067 PART X, LINE 2: THE HOSPITAL, MEDICAL GROUP, AND FOUNDATION ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON INCOME DERIVED FROM ITS EXEMPT PURPOSE AS A NONPROFIT 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, 2015. FISCAL YEARS ENDING ON OR AFTER DECEMBER 31, 2012, REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FUNDING OF PENSION PLAN 27,266,041. CHANGE IN TEMPORARILY RESTRICTED ASSETS 72,773. NET ASSETS RELEASED FROM RESTRICTIONS 225,245. PENSION TERMINATION EXPENSE -38,795,442. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET WITH REVENUE 19,772,130. CONTRIBUTIONS EXPENSE NET WITH REVENUE 532,629. EQUITY TRANSFERS BETWEEN AFFILIATES 595,011. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET WITH REVENUE 19,772,130. CONTRIBUTIONS EXPENSE NET WITH REVENUE 532,629. PENSION TERMINATION EXPENSE 38,795,442. CENTRAL AMERICA AND THE CARIBBEAN - 0 0 INVESTMENT IN CAPTIVE INSURANCE 3809845 CENTRAL AMERICA AND THE CARIBBEAN - 0 0 SELF INSURANCE PREMIUMS 1203571 0 0 0 0 0 0 5013416 0 5013416 1 0 1 0 0 0 1 1 1 X 1 X 1 1 1 0 1 0 9359951 9359951 0.03230 17791718 13920754 3870964 0.01340 27151669 13920754 13230915 0.04570 1895341 1895341 0.00650 123543 123543 0.00040 8836311 6054028 2782283 0.00960 533044 533044 0.00180 11388239 6054028 5334211 0.01830 38539908 19974782 18565126 0.06400 2100 26173 26173 0.00010 6 285 4220 4220 0.00000 6 2385 30393 30393 0.00010 1 19772130 2962426 85672904 89940450 -4267546 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 13 1 0 0 1 X SEE DISCLOSURE X 1 13 0 0 0 1 X 200.000000000000 400.000000000000 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 X 1 X 0 0 AUGUSTA HEALTH PART V, SECTION B, LINE 5: THE HOSPITAL FACILITY CONDUCTED FOCUS GROUPS AND ALSO HELD A COMMUNITY HEALTH SUMMIT.FOR ADDITIONAL INFORMATION GO TO:WWW.AUGUSTAHEALTH.COM/SITES/DEFAULT/FILES/COMMUNITY_OUTREACH/AH-CHNA-2013.PDF AUGUSTA HEALTH PART V, SECTION B, LINE 11: NO HOSPITAL CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. AUGUSTA HEALTH IS COMMITTED TO SERVING THE COMMUNITY BY ADHERING TO ITS MISSION, USING ITS SKILLS AND CAPABILITIES, AND REMAINING A STRONG ORGANIZATION SO THAT IT CAN CONTINUE TO PROVIDE A WIDE RANGE OF COMMUNITY BENEFITS. THIS IMPLEMENTATION STRATEGY DOES NOT INCLUDE SPECIFIC PLANS TO ADDRESS THE FOLLOWING HEALTH PRIORITIES THAT WERE IDENTIFIED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT: HEALTH BEHAVIORS AND COMMUNITY HEALTH EDUCATION: TAKE PERSONAL RESPONSIBILITY IN REGARD TO HEALTHY LIFESTYLE CHOICES (NUTRITION, PHYSICAL ACTIVITY) AUGUSTA WILL PROVIDE EDUCATIONAL OPPORTUNITIES REGARDING NUTRITION, PHYSICAL ACTIVITY, AND CHRONIC DISEASE MANAGEMENT. HOWEVER, THE HOSPITAL WILL NOT MEET THE NEED FOR INCREASED PERSONAL RESPONSIBILITY DUE TO A LACK OF EVIDENCE-BASED INTERVENTIONS AND INSUFFICIENT RESOURCES TO MAKE A MEANINGFUL CHANGE IN THIS AREA. ACCESS AND AFFORDABILITY: AFFORDABLE HEALTH INSURANCE DIRECTLY OFFERING INSURANCE PRODUCTS IS BEYOND THE PURVIEW OF THE HOSPITAL. OTHER RESOURCES IN THE COMMUNITY, INCLUDING THE HEALTH INSURANCE EXCHANGES IMPLEMENTED BY THE ACA ARE MEETING THIS NEED. AUGUSTA WILL ENGAGE IN PROMOTION OF THE EXCHANGES. AUGUSTA ALSO WILL CONTINUE TO PROVIDE ACCESS TO AFFORDABLE HEALTH CARE THROUGH ITS CHARITY CARE PROGRAM. BEHAVIORAL HEALTH: DEPRESSION, TEEN SUICIDE, SUBSTANCE ABUSE, ACCESS TO MENTAL HEALTH CARE AND SUBSTANCE ABUSE TREATMENT SERVICESSOCIOECONOMIC FACTORS: LOW INCOME/POVERTY IN STAUNTON AND WAYNESBORO THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO EFFECTIVELY IMPACT ECONOMIC DEVELOPMENT ISSUES. 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 35% AND IS UPDATED ANNUALLY. AUGUSTA HEALTH PART V, SECTION B, LINE 22D: 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 35% AND IS UPDATED ANNUALLY. PART V, SECTION B, LINE 7A: HTTP://WWW.AUGUSTAHEALTH.COM/SITES/DEFAULT/FILES/COMMUNITY_OUTREACH/AH- CHNA-2013.PDF PART I, LINE 7: FOR PURPOSES OF PART I, LINE 7(A) THE ORGANIZATION USED THE METHODS PROVIDED IN THE 2015 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 $1,269,041 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 $1,513,242 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 $19,772,130. 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 II, COMMUNITY BUILDING ACTIVITIES: IN PRIOR YEARS, THE PROGRAMS OF AHC COMMUNITY HEALTH FOUNDATION ADDRESSED THE COMMUNITY HEALTH AND WELLNESS NEEDS. BEGINNING IN 2012, THESE PROGRAMS WERE TAKEN OVER BY THE HOSPITAL'S COMMUNITY BENEFIT COMMITTEE. THE HOSPITAL BOARD AND THE COMMUNITY BENEFIT COMMITTEE HAVE TAKEN A LEADERSHIP ROLE IN COORDINATING AND ORGANIZING COMMUNITY PARTNERSHIPS TO ADDRESS SYSTEMS THAT WILL LEAD TO A HEALTHIER COMMUNITY. THE COMMUNITY HEALTH FORUM, THE AUGUSTA REGIONAL DENTAL CLINIC AND AUGUSTA REGIONAL FREE CLINIC, THE WORKING ON WELLNESS PROGRAM (WOW), GO GIRLS AND SPARKABC ARE ALL PROGRAMS THAT THE HOSPITAL HAS SUPPORTED OR INITIATED TO HELP CREATE AND SUSTAIN A HEALTHY COMMUNITY. PART III, LINE 2: THE RECORDED AMOUNT OF $19,772,130 WAS TAKEN FROM THE ORGANIZATION'S INCOME STATEMENT FOR THE YEAR-ENDED, 2015. 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 2015 FINANCIAL AUDIT, NOTE 1 PATIENT ACCOUNTS RECEIVABLE:"PATIENT RECEIVABLES ARE RECORDED AT ESTABLISHED BILLING RATES WHEN PATIENT SERVICES ARE RENDERED. ALLOWANCE FOR DOUBTFUL ACCOUNTS AND CONTRACTUAL ADJUSTMENTS ARE RECORDED AS DEDUCTIONS FROM PATIENT ACCOUNTS RECEIVABLE TO REDUCE RECORDED AMOUNTS TO THEIR NET REALIZABLE VALUE. CONTRACTUAL ADJUSTMENTS REPRESENT THE DIFFERENCE BETWEEN ESTABLISHED BILLING RATES AND AMOUNTS REIMBURSED. THE COMPANY PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR ESTIMATED LOSSES RESULTING FROM THE UNWILLINGNESS OR INABILITY OF PATIENTS TO MAKE PAYMENTS FOR SERVICES. THE ALLOWANCE IS DETERMINED BY ANALYZING HISTORICAL DATA AND TRENDS. PATIENT ACCOUNTS RECEIVABLE ARE CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WHEN MANAGEMENT DETERMINES THAT RECOVERY IS UNLIKELY AND THE COMPANY CEASES COLLECTION EFFORTS."THE BAD DEBT AMOUNT LISTED IN PART III SECTION A, NUMBER 2 WAS CALCULATED USING WORKSHEET A ON PAGE 4 OF THE 2015 SCHEDULE H INSTRUCTIONS.THE PORTION OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE IS BASED ON DISCHARGES IN 2015. PATIENTS THAT WERE CLASSIFIED AS "SP" 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 8: THE HOSPITAL CONSIDERS $4,267,546 TO BE THE AMOUNT RECOGNIZED AS COMMUNITY BENEFIT. 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 HTTP://WWW.AUGUSTAHEALTH.COM/SITES/DEFAULT/FILES/BILLING_AMP_INSURANCE/FINANCIAL_ASSISTANCE_APPLICATION_2015.PDF PART VI, LINE 2: THE AUGUSTA HEALTH BOARD OF DIRECTORS RECOGNIZES THAT THE HEALTH OF THE COMMUNITY IS MULTI-FACETED. AUGUSTA HEALTH PARTICIPATES WITH OVER 110 AGENCIES AND ORGANIZATIONS IN THE COMMUNITY HEALTH FORUM BY DONATING STAFF SUPPORT AND RESOURCES TO COORDINATE MEETINGS. THE GOALS OF THE FORUM ARE TO DETERMINE THE NEEDS OF THE COMMUNITY, IDENTIFY GAPS AND DUPLICATION OF SERVICES AND COORDINATE EFFORTS AS WELL AS TO FACILITATE COMMUNICATION AND EDUCATION AMONG ALL FORUM PARTICIPANTS ABOUT COMMUNITY HEALTH NEEDS. IN 2009, THE AUGUSTA HEALTH FOUNDATION IN CONJUNCTION WITH AUGUSTA HEALTH AND THE COMMUNITY FORUM CONDUCTED A NEEDS ASSESSMENT WHICH IDENTIFIED MENTAL HEALTH AND CHRONIC DISEASE MANAGEMENT AS TWO PRIORITIES FOR THE AREA. SINCE THEN THE MENTAL HEALTH COALITION HAS BEEN ESTABLISHED WITH 4 ACTIVE WORKGROUPS TO ADDRESS STIGMA, ACCESS AND SERVICES, CONSUMER SUPPORT AND FUNDING. CHRONIC DISEASE MANAGEMENT HAS BEEN ADDRESSED THROUGH COMMUNITY SCREENINGS AND EVIDENCED BASED SELF MANAGEMENT COURSES AND PROGRAMS. 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: AUGUSTA HEALTH SERVES A LARGE RURAL 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 FIGURESIN 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 PROPORTION THE LARGEST IN WAYNESBORO. BETWEEN 2000 AND 2010, THE HISPANIC POPULATION IN THE TOTAL AREA INCREASED BY 1,846 PEOPLE, OR 120.7% LESS THAN ONE PERCENT OF THE TOTAL AREA POPULATION AND 5 AND OLDER LIVE IN A HOME IN WHICH NO PERSONS AGE 14 OR OLDER IS PROFICIENT IN ENGLISH. PART VI, LINE 5: AUGUSTA HEALTH RECEIVED THE FOLLOWING AWARDS IN 2015: AMERICA'S 50 BEST HOSPITALS BY HEALTHGRADES AND 100 GREAT COMMUNITY HOSPITALS BY BECKERS. ALSO IN 2015, AUGUSTA HEALTH EARNED OR MAINTAINED THE FOLLOWING ACCREDITATIONS: AMERICAN ACADEMY OF SLEEP MEDICINE ACCREDITED CENTER; AMERICAN COLLEGE OF SURGEONS, COMMISSION ON CANCER FOR AN OUTSTANDING CANCER PROGRAM; THE JOINT COMMISSION PRIMARY STROKE CENTER CERTIFICATION; THE NATIONAL ACCREDITATION FOR BREAST CENTERS; NUCLEAR MEDICINE ACCREDITED FACILITY BY THE AMERICAN COLLEGE OF RADIOLOGY; RADIATION ONCOLOGY ACCREDITED FACILITY BY THE AMERICAN COLLEGE OF RADIOLOGY; SOCIETY OF CHEST PAIN CENTERS; AND THE SOCIETY OF CARDIOVASCULAR PATIENT CARE, CHEST PAIN CENTER ACCREDITATION WITH PCI (CORONARY ANGIOPLASTY). PART VI, LINE 6: THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. 1 AUGUSTA REGIONAL DENTAL CLINIC 342 MULE ACADEMY RD FISHERVILLE VA 22939 202922988 501(C)(3) 20000 OPERATIONAL SUPPORT - MULTI-YEAR GRANT AUGUSTA REGIONAL FREE CLINIC PO BOX 153 FISHERVILLE VA 22939 541651896 501(C)(3) 20000 OPERATIONAL SUPPORT - MULTI-YEAR GRANT BLUE RIDGE COMMUNITY COLLEGE PO BOX 80 WEYERS CAVE VA 24486 541268283 501(C)(3) 80000 FUNDS TO BE ALLOCATED TO THE NURSING PROGRAM MARY BALDWIN COLLEGE PO BOX 1500 STAUNTON VA 24402 540506319 501(C)(3) 65000 OPERATIONAL SUPPORT CENTRAL SHENANDOAH EMS COUNCIL PO BOX 256 FISHERVILLE VA 22939 541906904 501(C)(3) 10000 FUNDING FOR COMMUNITY TRAINING CROSSROADS TO BRAIN INJURY RECOVERY 601 UNVIERSITY BLVD STE 317 HARRISONBURG VA 22807 204795567 501(C)(3) 10000 OPERATIONAL SUPPORT ROCKBRIDGE AREA TRANSPORT PO BOX 1108 LEXINGTON VA 24450 043586915 501(C)(3) 9528 OPERATIONAL SUPPORT VALLEY PROGRAM FOR THE AGING PO BOX 817 WAYNESBORO VA 22980 540958526 501(C)(3) 12000 OPERATIONAL SUPPORT SALVATION ARMY WAYNESBORO E AUGUSTA 246 ARCH AVENUE WAYNESBORO VA 22980 580660607 501(C)(3) 21154 OPERATIONAL SUPPORT VALLEY HOPE COUNSELING CENTER 20 STONERIDGE DR STE 202 WAYNESBORO VA 22980 541956722 501(C)(3) 20000 OPERATIONAL SUPPORT VALLEY MISSION 1513 W BEVERLY ST STAUNTON VA 24401 540930419 501(C)(3) 20000 OPERATIONAL SUPPORT SHENANDOAH VALLEY COMMUNITY FOCUS INC 250 SOUTH WAYNE AVE 101 WAYNESBORO VA 22980 262111079 501(C)(3) 14450 OPERATIONAL SUPPORT 12 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 1 X X X X X 0 1 0 0 0 1 0 0 0 MARY N MANNIX PRESIDENT & CEO 553270 0 167390 0 17500 0 96257 0 7836 0 842253 0 184890 0 ROBERT W RILEY CFO 323675 0 70960 0 24246 0 40910 0 5336 0 465127 0 95206 0 FRED CASTELLO MD CHIEF MEDICAL OFFICER 206663 0 64618 0 47666 0 24007 0 3081 0 346035 0 82522 0 KATHLEEN HEATWOLE VP OF PLANNING AND DEVELOP 204028 0 40767 0 25156 0 26610 0 1272 0 297833 0 58511 0 MARVELLA REA CNO 182940 0 31066 0 0 0 24700 0 7336 0 246042 0 31066 0 LISA CLINE COO 320781 0 60501 0 31762 0 40637 0 4647 0 458328 0 78942 0 DAN O'CONNOR VP OF HUMAN RESOURCES 231164 0 39730 0 7112 0 30807 0 5336 0 314149 0 46842 0 GEORGE SEMKO ADMIN DIRECTOR REVENUE CYCLE 179940 0 0 0 0 0 4625 0 5336 0 189901 0 0 0 SCOTT CRABTREE ADMIN DIRECTOR OF PROFESSIONAL SERV 150075 0 13868 0 6506 0 4143 0 3517 0 178109 0 13868 0 MATTHEW GARNER PHARMACIST 148567 0 0 0 0 0 4580 0 4194 0 157341 0 0 0 VICKIE TAYLOR SURGICAL DIRECTOR 137282 0 14383 0 5430 0 4863 0 5126 0 167084 0 14383 0 FRANCIS CARRUCIO ADMIN DIRECTOR 191404 0 19356 0 0 0 4238 0 2019 0 217017 0 19356 0 PART I, LINE 1A ANNUALLY, AUGUSTA HEALTH HOLDS A LEADERSHIP RETREAT FOR BOARD MEMBERS, MEDICAL STAFF, AND SENIOR MANAGEMENT. SPOUSES ARE INVITED TO ATTEND THE RETREAT AT THE EXPENSE OF THE ORGANIZATION. THE VALUE PLACED ON THE HOTEL/MEALS FOR THE TWO DAY PERIOD IS $243 PER PERSON. THE AMOUNT IS NOT TAXABLE TO EMPLOYEES. PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS ARE REPRESENTED IN PART II, COLUMN (C): MARY MANNIX: $70,307 ROBERT RILEY: 14,960 MARVELLA REA: 1,000 KATHLEEN HEATWOLE: 2,509 DAN O'CONNOR: 5,716 LISA CLINE: 14,687 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 INCENTIVE 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 12110000 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. HEATHER SMITH FAMILY RELATIONSHIP WITH BOARD MEMBER E. STUART CROW 56282 COMPENSATION AS EMPLOYEE OF AUGUSTA HEALTH CARE, INC. 0 BRENDA CASTELLO FAMILY RELATIONSHIP WITH KEY EMPLOYEE FRED CASTELLO, MD 8655 COMPENSATION AS EMPLOYEE OF AUGUSTA HEALTH CARE, INC. 0 PATTI KANNEY FAMILY RELATIONSHIP WITH BOARD MEMBER WILLIAM PFOST 63929 COMPENSATION AS EMPLOYEE OF AUGUSTA HEALTH CARE, INC. 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIR, THE VICE-CHAIR, THE PRESIDENT, THE SECRETARY, AND THE TREASURER AND TWO OTHER MEMBERS OF THE BOARD. THE CHAIR OF THE BOARD SHALL BE THE CHAIR OF THE EXECUTIVE COMMITTEE. IT SHALL BE THE DUTY OF THE EXECUTIVE COMMITTEE TO REVIEW AND ORGANIZE MATTERS TO BE CONSIDERED BY THE BOARD; TO DELIBERATE MATTERS OF A SIGNIFICANT STRATEGIC OR ADMINISTRATIVE NATURE; AND TO ADVISE THE BOARD AND ADMINISTRATION ON SUCH MATTERS. THE EXECUTIVE COMMITTEE MAY ACT ON BEHALF OF THE BOARD BUT ONLY WHEN SPECIFICALLY AUTHORIZED BY THE BOARD TO DO SO. THE EXECUTIVE COMMITTEE SHALL HANDLE ALL MATTERS RELATED TO EXECUTIVE COMPENSATION. WHEN EXECUTIVE COMPENSATION MATTERS ARE BEING DELIBERATED, ANY COMMITTEE MEMBER WHO MAY BE DEEMED TO HAVE A DISQUALIFYING BUSINESS, PERSONAL OR PROFESSIONAL RELATIONSHIP WITH THE CORPORATION WILL BE EXCUSED, INCLUDING BUT NOT LIMITED TO THE PRESIDENT AND PRACTICING PHYSICIANS. THE PRESIDENT MAY PRESENT INFORMATION, MAKE RECOMMENDATIONS AND ANSWER QUESTIONS ON MATTERS OF COMPENSATION BUT MAY NOT BE A VOTING MEMBER ON THESE MATTERS. EXECUTIVE COMPENSATION MATTERS SHALL BE REVIEWED AT LEAST ANNUALLY TO EVALUATE THE PERFORMANCE OF THE PRESIDENT AND TO OVERSEE THE ADMINISTRATION OF THE EXECUTIVE COMPENSATION SYSTEM AND APPROVE COMPENSATION PROVIDED UNDER THAT SYSTEM ON BEHALF OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL ADMINISTER THE CORPORATE CONTRACT POLICY AS APPROVED BY THE BOARD AND, ON BEHALF OF THE BOARD. THE COMMITTEE SHALL PROVIDE FOR REVIEW OF ALL CONTRACTS WITH PHYSICIANS AND CONTRACTS FOR TRANSACTIONS OUTSIDE THE NORMAL COURSE OF BUSINESS. THE CONTRACTS SHALL BE REVIEWED TO ENSURE THE CONTRACTS MEET THE CORPORATION'S MISSION AND VALUES STANDARDS, AS WELL AS, ALL APPLICABLE LAWS AND REGULATIONS. ANY EXECUTIVE COMMITTEE MEMBER WHO MAY HAVE A DISQUALIFYING BUSINESS, PERSONAL OR PROFESSIONAL RELATIONSHIP WITH THE CORPORATION OR ANY ENTITY WHICH HAS OR MAY HAVE A COMPETING INTEREST WITH THE CORPORATION WILL BE EXCUSED FROM DELIBERATING ON ANY MATTERS RELATED TO CORPORATE CONTRACT POLICY AND ADMINISTRATION. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES INFORMATION TECHNOLOGY MANAGEMENT DUTIES TO DEARBORN ADVISORS. DEARBORN PROVIDED A SENIOR EXECUTIVE TO LEAD THE INFORMATION TECHNOLOGY DIVISION AND ADDITIONAL MANPOWER TO OPTIMIZE THE HEALTH SYSTEM'S AMBULATORY ELECTRONIC MEDICAL RECORD. FORM 990, PART VI, SECTION B, LINE 11 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. THE FORM WILL BE PRESENTED, REVIEWED AND DISCUSSED AT THE EXECUTVIE COMMITTEE OF THE BOARD MEETING HELD PRIOR TO FILING. THE REVIEW WILL BE DULY NOTED IN THE MINTUES. 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 INTEGRATED HEALTHCARE STRATEGIES, 901 MARQUETTE AVENUE SOUTH SUITE 2100 MINNEAPOLIS, MINNESOTA TO DETERMINE COMPETITIVE WAGE RANGES, VARIABLE COMPENSATION AND PREQUISITES 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. INCENTIVE OPPORTUNITY 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. BENEFITS AND PERQUISITES AT MARKET COMPETITIVE LEVELS. SEVERANCE AT CONSERVATIVE LEVELS ON AN INDIVIDUAL BASIS. 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 COO CNO CMO VP OF HUMAN RESOURCES VP OF PLANNING AND DEVELOPMENT THE BOARD OF DIRECTORS RECEIVED A FULL REPORT FROM THE EXECUTIVE COMMITTEE ON THE FULL 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 INCENTIVE 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 IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 7,150,631. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,150,631. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 7,973,315. MANAGEMENT AND GENERAL EXPENSES 4,734,581. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,707,896. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 4,244,567. MANAGEMENT AND GENERAL EXPENSES 2,227,884. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,472,451. CONSULTANTS: PROGRAM SERVICE EXPENSES 2,257,246. MANAGEMENT AND GENERAL EXPENSES 7,596,391. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,853,637. OTHER FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,314,447. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,314,447. FORM 990, PART XI, LINE 9: CHANGE IN FUNDED STATUS OF PENSION PLAN 27,266,041. TEMPORARILY RESTRICTED CONTRIBUTIONS 72,773. NET ASSETS RELEASED FROM RESTRICTIONS 225,245. EQUITY TRANSFERS BETWEEN AFFILIATES -595,011. CHANGE IN NET ASSETS OF SHEN HOUSE 71,986. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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 11A, I AUGUSTA HEALTH CARE INC 1 AUGUSTA MEDICAL GROUP PO BOX 1000 FISHERSVILLE VA 22939 262559916 HEALTHCARE VA 501(C)(3) LINE 9 AUGUSTA HEALTH CARE INC 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 AUGUSTA MEDICAL GROUP M 3921628 AUGUSTA MEDICAL GROUP Q 6400000 AUGUSTA MEDICAL GROUP A 442830 AUGUSTA HEALTH FOUNDATION M 369676 AUGUSTA HEALTH FOUNDATION C 138864