2016-03-14T08:38:26-05:00 2015-04-30 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 31708 990 2014-05-01 582513901 CHATUGE REGIONAL HOSPITAL INC CHAT 7068962222 110 SOUTH MAIN STREET HIAWASSEE GA 305460509 TIMOTHY N HENRY CFO 7068962222 2016-03-11 true WILLIAM EDWARD PHILLIPS P00451499 2298837878 2016-03-14 2014 2016-08-17 19:52:53Z TIMOTHY N HENRY 110 SOUTH MAIN STREET HIAWASSEE GA 30546 19900423 false X WWW.UNIONGENERALHOSPITAL.COM X 1955 GA TO PROVIDE HIGH QUALITY, COST EFFECTIVE HEALTH CARE AND TO PROMOTE WELLNESS THROUGHOUT OUR COMMUNITY. 7 5 383 0 25879 31538 18261870 19514467 9390 60334 240695 294084 18537834 19900423 0 0 9987061 10552683 0 0 7043846 8430867 17030907 18983550 1506927 916873 12426046 17085150 2812816 6555047 9613230 10530103 X TO PROVIDE HIGH QUALITY, COST EFFECTIVE HEALTH CARE AND TO PROMOTE WELLNESS THROUGHOUT OUR COMMUNITY. false false 16542523 19690599 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. 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A PERCENTAGE OF THE DUES PAID TO THESE ORGANIZATIONS IS ALLOCATED TO LOBBYING ACTIVITIES CONDUCTED BY THOSE ASSOCIATIONS. 727121 727121 7049506 1921918 5127588 149323 129525 19798 6306136 5253235 1052901 1586206 1586206 8513614 DUE TO UNION GENERAL 3086397 THIRD PARTY SETTLEMENTS 59476 PHYSICIAN RECRUTING 46851 LEASE OBLIGATION 3192724 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 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 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 TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF APRIL 30, 2015 AND 2014 OR FOR THE YEARS THEN ENDED. FOR FEDERAL INCOME TAX PURPOSES, THE TAX RETURNS 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 102738 102738 0.00540 1879695 1549320 330375 0.01740 1982433 1549320 433113 0.02280 874801 551880 322921 0.01700 874801 551880 322921 0.01700 2857234 2101200 756034 0.03980 true 1711082 265218 5631117 57709174 -52078057 X true true 1 1 CHATUGE REGIONAL HOSPITAL INC 110 SOUTH MAIN STREET HIAWASSEE GA 305460509 WWW.CHATUGEREGIONALHOSPITAL.ORG 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.CHATUGEREGIONALHOSPITAL.ORG true 15 false true false true X 125.000000000000 400.000000000000 X X X X X true true X X X X true X WWWUNIONGENERALHOSPITALCOMPATIENTB X WWWUNIONGENERALHOSPTIALCOMPATIENTB X WWWUNIONGENERALHOSPITALCOMPATIENTB 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 ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIABLE, THE CORPORATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENURE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVSISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOICATED WITH SELF-PAY PATIENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-APRTY COVERAGES EXISTS FOR PART OF THE BILL, THE CORPORATION RECORDS A SIGNFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR SHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE AGREED UPON RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE CORPORATION'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS 84% AND 89% OF SELF-PAY ACCOUNTS RECEIVABLE AT APRIL 30, 2015 AND 2014, RESPECTIVELY. IN ADDITION, THE CORPORATION'S SELF-PAY WRITE-OFFS DECREASED FROM 8,565,000 FOR FISCAL YEAR 2014 TO 7,818,000 FOR FISCAL YEAR 2015. THE DECREASE IN SELF-PAY WRITE-OFFS IS DUE TO THE CORPORATION CONDUCTING A THOROUGH REVIEWS OF OLD PATIENT ACCOUNTS DURING 2014. THE CORPORATION DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOT DID IT HAVE SIGNIFICANT WRITE-OFFS FROM THIRD-PARTY PAYORS. 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 PRIMARILY SOLICITS FEEDBACK FROM THE MEDICAL STAFF AND THE CITY AND COUNTY OFFICIALS. IN 2013, THE ORGANIZATION, WITH THE ASSISTANCE OF GEORGIA SOUTHERN UNIVERSITY AND STATE FUNDING, CONDUCTED ITS FIRST FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT. THIS DOCUMENT CAN BE FOUND AT WWW.UNIONGENERALHOSPITAL.COM ON THE HOME PAGE. 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. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT GEORGIA false false false false false false false false false J MICHAEL GOWDER CEO 201511 5445 7217 1855 216028 RICHARD L KELLEY COO 57600 94329 5000 325 6338 488 683 63088 101675 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. 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 BOTH UNION GENERAL HOSPITAL AND CHATUGE REGIONAL HOSPITAL. THEREFORE A BUSINESS RELATIONSHIP EXISTS BETWEEN ALL OF THESE INDIVIDUALS. ADDITIONALLY, OFFICERS GOWDER AND HENRY SERVE ON THE GOVERNING BODY FOR UNION GENERAL AMBULANCE SERVICE, INC., A RELATED 501C3 ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 2 G. DAVID GOWDER, MD J. MICHAEL GOWDER BOARD MBR CEO FAMILY 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 PERFORMED AS ER DIRECTOR OF THAT ORGANIZATION. NO PART OF HIS COMPENSATION IS PAID FOR HIS SERVICES AS BOARD MEMBER. FORM 990, PART IX, LINE 11G CONTRACT LABOR - PATIENT CARE 1,530,680 0 0 PURCHASED SERVICES 675,424 0 0 CONSULTING 3,750 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 11B 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 false true false false false