2015-05-14T14:13:13-05:00 2014-06-30 621517792 PERSHING YOAKLEY & ASSOCIATES P C ONE CHEROKEE MILLS 2220 SUTHERLAND AVE KNOXVILLE TN 37919 990 2013-07-01 582081599 DECATUR HEALTH RESOURCES INC DECA 4045011000 450 NORTH CHANDLER STREET DECATUR GA 30030 JOHN KATSIANIS EVP & CFO 4045011000 2015-05-14 1 SUSAN P CLARKCPAFHFMA P00017549 8656730844 2013 2016-03-07 17:11:31Z JOHN SHELTON 450 NORTH CHANDLER STREET DECATUR GA 30030 18952726 0 X WWW.DEKALBMEDICAL.ORG X 1994 GA TO PROVIDE LONG-TERM ACUTE CARE TO PATIENTS WHO REQUIRE SPECIALIZED, EXPERT CARE AND REHABILITATION. 8 4 0 3 0 0 2761753 2621127 15983280 16331308 59351 291 0 0 18804384 18952726 3403620 1583274 0 0 0 0 0 0 0 17673335 17719665 21076955 19302939 -2272571 -350213 7408666 7185743 979028 1106318 6429638 6079425 X DECATUR HEALTH RESOURCES, INC. ("DHR") SPECIALIZES IN THE TREATMENT OF MEDICALLY COMPLEX, CATASTROPHICALLY INJURED OR CRITICALLY ILL PATIENTS WHO REQUIRE A LONGER HOSPITAL STAY THAN AT A TRADITIONAL ACUTE CARE FACILITY, AND WHO REQUIRE SPECIALIZED, EXPERT CARE AND REHABILITATION. 0 0 13103794 1583274 16331308 DHR BEGAN PROVIDING LONG-TERM ACUTE CARE IN 1996 WITH 19 BEDS AND SINCE THEN HAS GROWN TO 44 BEDS, INCLUDING A SIX-BED SPECIAL CARE UNIT. ALL ROOMS ARE PRIVATE, ENSURING THAT PATIENTS EXPERIENCE MAXIMUM COMFORT DURING THEIR STAY.DHR IS GEORGIA'S FIRST HOSPITAL TO EARN A CENTER OF EXCELLENCE DESIGNATION AND GOLD SEAL DISEASE-SPECIFIC CERTIFICATION FOR WOUND CARE TREATMENT FROM THE JOINT COMMISSION (2010) - ALSO THE NATION'S FIRST AND ONLY HOSPITAL TO EARN THE JOINT COMMISSION'S GOLD SEAL DISEASE - SPECIFIC CERTIFICATION FOR THE TREATMENT OF PATIENTS ON VENTILATORS WHO ARE DIAGNOSED WITH RESPIRATORY FAILURE.DHR'S PHYSICIAN-LED TEAM OF NURSES, RESPIRATORY AND PHYSICAL THERAPISTS, OCCUPATIONAL AND SPEECH THERAPISTS, CASE MANAGERS AND DIETITIANS COLLABORATIVELY APPLY THEIR EXPERTISE TO EACH PATIENT FOR THE BEST POSSIBLE OUTCOME. DHR'S GOAL IS TO RETURN PATIENTS TO THEIR HIGHEST-FUNCTIONING LEVEL. DHR'S UNIQUE EXPERTISE ALLOWS PATIENTS TO RECOVER WITHOUT STRICT TIME LIMITS - TYPICALLY 20 TO 30 DAYS.FOR THE YEAR ENDED JUNE 30, 2014, THERE WERE 391 PATIENTS DISCHARGED FROM DHR FOR A TOTAL OF 10,288 PATIENT DAYS. 13103794 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 GA X JOHN KATSIANIS 4045015025 2701 NORTH DECATUR ROAD DECATUR GA 30033 DAVID JOLLAY CHAIRMAN 5.00 X X 0 0 0 ROBERT E WILSON VICE CHAIRMAN 5.00 X X 0 0 0 CHARLES CLIFTON MD TREASURER 5.00 X X 0 362 0 JOHN A SHELTON JR DMC PRESIDENT/CEO 5.00 40.00 X X 0 822689 35998 THOMAS DEMARINI MD DIR., CHIEF OF STAFF- DWNT 5.00 5.00 X 0 5059 0 RAUOL MAYER MD DIR., CHIEF OF STAFF - NOR 40.00 5.00 X 0 18333 0 DANIEL THOMPSON SECRETARY 5.00 X 0 0 0 GREGORY LEVETT MEMBER-AT-LARGE 5.00 X 0 0 0 JOHN KATSIANIS EVP & CFO 5.00 40.00 X 0 362184 27680 DANE HENRY DMC COO 5.00 40.00 X 0 391526 30340 ERIC NORWOOD DMC FORMER CEO 0.00 X 0 572325 24824 0 2172478 118842 0 1 1 0 MICHAEL WALDMAN 125 CARL SANDER DRIVE ACWORTH GA 30101 PULMONARY SPECIALIST 297500 MORRISON MANAGEMENT PO BOX 102289 ATLANTA GA 303682289 MANAGEMENT SERVICES 141275 GEORGIA NEURODIAGNOSTICS TEST 7426 LAZY HAMMOCK WAY FLOWERY BRANCH GA 30542 MEDICAL SERVICES 130277 G4S SECURE SOLUTIONS LLC PO BOX 277469 ATLANTA GA 30384 SECURITY SERVICES (OFFICERS) 122441 SOUTHEASTERN LUNG CARE 2665 NORTH DECATUR RD DECATUR GA 30033 PULMONARY SPECIALIST 109600 6 2621127 2621127 NET PATIENT REVENUE 623000 16331017 16331017 CAFETERIA 722210 254 254 DISCOUNTS 900099 37 37 16331308 291 291 18952726 16331017 0 582 X 1583274 1583274 339095 247598 91497 34319 34319 12487 12487 6610 6610 10508775 6964004 3544771 88366 382 87984 273840 140860 132980 317004 2649 314355 551936 477652 74284 28324 20150 8174 17300 1425 15875 1631690 38 1631652 12050 12050 MEDICAL SUPPLIES 2275380 2273177 2203 REPAIRS & MAINTENANCE 464618 426683 37935 MEDICAID PROVIDER TAX 233632 233632 BAD DEBT 218173 218173 706066 514097 191969 19302939 13103794 6199145 0 1648 870 2721030 3787352 275927 226756 47099 500 24034148 21022712 4115360 3011436 247602 158829 7408666 7185743 489713 592627 489315 513691 979028 1106318 X 6429638 6079425 6429638 6079425 7408666 7185743 -350213 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 14479293 12395692 2083601 8789661 8300850 488811 765194 326170 439024 3011436 ASSET RETIREMENT OBLIGATION 513691 513691 X PART X, LINE 2: PER THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR DEKALB REGIONAL HEALTH SYSTEM, INC. AND SUBSIDIARIES: THE SYSTEM, DEKALB MEDICAL CENTER, INC., DEKALB MEDICAL CENTER FOUNDATION, INC., AND DECATUR HEALTH RESOURCES, INC. ARE EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, AS WELL AS STATE INCOME TAX. VENTURES IS A TAXABLE ENTITY AND FILES A CORPORATE TAX RETURN. WITH RESPECT TO ITS FOR-PROFIT ENTITY, AS WELL AS ANY UNRELATED BUSINESS INCOME GENERATED AT THE TAX-EXEMPT ENTITIES, THE SYSTEM RECORDS INCOME TAXES USING THE ASSET AND LIABILITY METHOD UNDER WITH DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASES OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIOD THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR TO BE SETTLED. ALL SUCH INCOME TAX ACCOUNTING IS IMMATERIAL TO THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR THE YEARS ENDED JUNE 30, 2014 AND 2013. THE SYSTEM APPLIES ASC 740, INCOME TAXES, WHICH PROVIDES GUIDANCE ON WHEN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. THERE IS CURRENTLY NO IMPACT ON THE SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS AS A RESULT OF THE APPLICATION OF ASC 740. 1 1 X 1 X 1 X 1 0 1 1 -6728 -6728 0.00000 1122155 330911 791244 0.04150 1115427 330911 784516 0.04150 2000 2000 0.00010 54 31955 31955 0.00170 54 33955 33955 0.00180 54 1149382 330911 818471 0.04330 1 89085 0 6835349 6920179 -84830 X 1 0 1 1 DEKALB MEDICAL AT DOWNTOWN DECATUR 450 NORTH CANDLER STREET DECATUR GA 30030 X LONG-TERM ACUTE CARE DEKALB MEDICAL AT DOWNTOWN DECATUR 1 1 X X X X X X X X X 12 1 0 1 X X X X X X X X 1 0 1 1 200.000000000000 1 250.000000000000 1 X X X X X X X 1 1 X X 1 0 0 X X 0 1 DEKALB MEDICAL AT DOWNTOWN DECATUR PART V, SECTION B, LINE 3: PUBLIC HEALTH PROFESSIONALS FROM THE ROLLINS SCHOOL OF PUBLIC HEALTH AT EMORY UNIVERSITY AGREED TO TAKE THE LEAD IN CONDUCTING A CHNA ON BEHALF OF DEKALB MEDICAL AT DOWNTOWN DECATUR ("DECATUR HOSPITAL"). IN ORDER TO OBTAIN THE COMMUNITY PRIORITIES, IN-DEPTH INTERVIEWS WERE CONDUCTED WITH VARIOUS STAKEHOLDERS. STAKEHOLDERS WERE DEFINED AS INDIVIDUALS, OR GROUPS OF INDIVIDUALS, WHO WERE ACTIVE PARTICIPANTS IN THE TRANSITION OF THE PATIENT TO THE LTAC. THESE INCLUDED THE DISCHARGE PLANNERS, CURRENT PATIENTS, AND PATIENTS' FAMILIES. DISCHARGE PLANNERS FROM TWO OF LTAC'S MAJOR REFERRAL SOURCES - DEKALB MEDICAL CENTER AND EMORY HEALTHCARE WERE INTERVIEWED. DEKALB MEDICAL AT DOWNTOWN DECATUR PART V, SECTION B, LINE 14G: AVAILABILITY OF FAP APPLICATION DISCUSSED DURING THE FINANCIAL COUNSELING PROCESS. DEKALB MEDICAL AT DOWNTOWN DECATUR PART V, SECTION B, LINE 19C: THE FACILITY DOES NOT PROVIDE ANY EMERGENCY MEDICAL CARE. DEKALB MEDICAL AT DOWNTOWN DECATUR PART V, SECTION B, LINE 20D: THE FAP REQUIRES A COMPLETE WRITE OFF OR ADJUSTMENT OF TOTAL CHARGES OR A PORTION OF CHARGES IF PATIENT IS FAP ELIGIBLE AND IS BASED ON FEDERAL POVERTY GUIDELINES (FPG). DEKALB MEDICAL AT DOWNTOWN DECATUR PART V, SECTION B, LINE 22: THE HOSPITAL CURRENTLY UTILIZES AN AUTOMATIC BILL PROCEDURE WHICH PREPARES THE FIRST BILL AT GROSS CHARGES. DISCOUNTS AND WRITE-OFFS ARE APPLIED AFTER THE FIRST BILL. IN TAX YEAR ENDING JUNE 30, 2014, THE FACILITY BILLED ALL FAP ELIGIBLE PATIENTS AT GROSS BUT COLLECTED LESS THAN GROSS BASED ON FAP AND FPG. PART I, LINE 3C: THE ORGANIZATION USES FEDERAL POVERTY GUIDELINES. PART I, LINE 6A: DECATUR HEALTH RESOURCES, INC. IS INCLUDED IN THE COMMUNITY BENEFIT REPORT PRODUCED BY DEKALB MEDICAL CENTER, INC,. A RELATED ENTITY. PART I, LINE 7: A COST-TO-CHARGE RATIO, DERIVED FROM THE SCHEDULE H APPLICABLE WORKSHEETS, INCLUDING WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES, WAS USED TO DETERMINE CHARITY CARE. ACTUAL EXPENSE DATA IS ACCUMULATED WITHIN THE GENERAL LEDGER WHICH ADDRESSES ALL PATIENT SEGMENTS INCLUDING INPATIENT, OUTPATIENT, EMERGENCY ROOM, COMMERCIAL INSURANCE, GOVERNMENT INSURANCE, UNINSURED AND SELF-PAY. THE TOTAL OPERATING EXPENSE WAS DIVIDED BY PATIENT REVENUES TO CALCULATE AN OVERALL RATIO THAT WAS THEN APPLIED TO INDIGENT AND CHARITY CARE CHARGES TO ARRIVE AT COST. PART I, LN 7 COL(F): THE BAD DEBT COST ON PART III, LINE 2 IS CALCULATED BY MULTIPLYING TOTAL BAD DEBT EXPENSE BY THE RATIO OF TOTAL OPERATING EXPENSE TO TOTAL GROSS PATIENT CHARGES. PART III, LINE 4: PER THE DEKALB REGIONAL HEALTH SYSTEM, INC. AND SUBSIDIARIES CONSOLIDATED FINANCIAL STATEMENTS: "THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT ROUTINELY ASSESSES, IN THE NORMAL COURSE OF BUSINESS, THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ITS ASSESSMENT OF THESE AND OTHER FACTORS BY PAYOR CATEGORY, AND ADJUSTS THE ALLOWANCE AND RELATED PROVISION ACCORDINGLY. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, MANAGEMENT ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A RELATED PROVISION, IF NECESSARY, FOR PAYORS WITH KNOWN FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDES PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL (PATIENT APPORTIONMENT), MANAGEMENT RECORDS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.THE SYSTEM'S WRITE-OFFS DECREASED $18,506,000 DURING 2014 FROM $111,972,000 IN FISCAL YEAR 2013 TO $93,466,000 IN FISCAL YEAR 2014. THIS DECREASE WAS DUE TO MULTIPLE FACTORS. DURING FISCAL YEAR 2012, THE SYSTEM IMPLEMENTED A NEW PATIENT ACCOUNTING SYSTEM, WHICH NEGATIVELY IMPACTED THE PRIORITIZATION OF COLLECTIONS ON SELF-PAY ACCOUNTS, LEADING TO AN INCREASE IN THE RELATED ACCOUNTS RECEIVABLES AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS THROUGHOUT FISCAL YEAR 2012. DURING FISCAL YEAR 2013, THE SYSTEM IMPLEMENTED STRATEGIC PROCESS CHANGES TO ADDRESS THIS ISSUE; HOWEVER, THE RESOLUTION OF THESE AGED ACCOUNTS CONTRIBUTED TO THE INCREASE IN SELF-PAY WRITE-OFFS. FURTHER, AS A RESULT OF ONGOING POOR ECONOMIC CONDITIONS, THE SYSTEM HAS SEEN AN INCREASE IN SELF-PAY PATIENT VOLUMES. AS NOTED ABOVE, HISTORICAL EXPERIENCE HAS DEMONSTRATED THAT A SIGNIFICANT PORTION OF THE SYSTEM'S UNINSURED OR UNDER-INSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE, ARE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THEREFORE, THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS RELATED TO THESE PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. THE SYSTEM DOES NOT MAINTAIN A SIGNIFICANT ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, NOR DOES IT INCUR SIGNIFICANT WRITE-OFFS, RELATED TO THIRD PARTY PAYORS." PART III, LINE 8: MEDICARE ALLOWABLE COST PER THE AS-FILED MEDICARE COST REPORT IS USED TO DETERMINE MEDICARE COSTS. REVENUE RECEIVED FROM MEDICARE INCLUDING CO-PAYS / DEDUCTIBLES FROM THE AS-FILED MEDICARE COST REPORT. PART III, LINE 9B: THE CURRENT BILLING AND COLLECTION POLICY DOES NOT CONTAIN PROVISIONS FOR COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE BUT THE FAP OR "CHARITY POLICY" DOES AS IT OUTLINES THE COMPLETE WRITE OFF OR SLIDING SCALE AMOUNTS FOR WHICH THE INDIVIDUAL WILL BE RESPONSIBLE. PART VI, LINE 2: IN COMPLIANCE WITH 501(R)(C) OF THE INTERNAL REVENUE CODE, ALL THREE HOSPITALS OF THE DEKALB MEDICAL SYSTEM CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION PLAN. THE IMPLEMENTATION PLANS WERE APPROVED BY THE BOARD OF DIRECTORS ON JUNE 10, 2013. THE NEXT FULL CHNAS AND IMPLEMENTATION PLAN ARE DUE IN 2016. SINCE THIS IS THE FIRST YEAR OF THE IMPLEMENTATION PLAN, SOME STRATEGIES HAVE BEEN STARTED, BUT HAVE NOT BEEN IMPLEMENTED LONG ENOUGH TO ASSESS RESULTS.PUBLIC HEALTH PROFESSIONALS FROM THE ROLLINS SCHOOL OF PUBLIC HEALTH AT EMORY UNIVERSITY AGREED TO TAKE THE LEAD IN CONDUCTING A CHNA ON BEHALF OF DEKALB MEDICAL AT DOWNTOWN DECATUR ("DECATUR HOSPITAL"). IN ORDER TO OBTAIN THE COMMUNITY PRIORITIES, IN-DEPTH INTERVIEWS WERE CONDUCTED WITH VARIOUS STAKEHOLDERS. STAKEHOLDERS WERE DEFINED AS INDIVIDUALS, OR GROUPS OF INDIVIDUALS, WHO WERE ACTIVE PARTICIPANTS IN THE TRANSITION OF THE PATIENT TO THE LTAC. THESE INCLUDED THE DISCHARGE PLANNERS, CURRENT PATIENTS, AND PATIENTS' FAMILIES. DISCHARGE PLANNERS FROM TWO OF LTAC'S MAJOR REFERRAL SOURCES - DEKALB MEDICAL CENTER AND EMORY HEALTHCARE WERE INTERVIEWED.BASED ON THE PATIENT AND DISCHARGE PLANNER INTERVIEWS, PRIORITIES WERE IDENTIFIED. THOSE PRIORITIES WERE ANALYZED AND AN IMPLEMENTATION PLAN WITH STRATEGIES IDENTIFIED FOR SELECTED PRIORITIES WAS DEVELOPED. THIS WAS APPROVED BY THE DECATUR HEALTH RESOURCES BOARD OF DIRECTORS IN JUNE 2013.THE IMPLEMENTATION PLAN WAS ACCOMPLISHED BY A TEAM OF DEKALB REGIONAL HEALTH SYSTEM STAFF (INCLUDING STAFF FROM DEKALB MEDICAL AT DOWNTOWN DECATUR) AND PUBLIC HEALTH PROFESSIONALS WHO SPEARHEADED THE DEVELOPMENT OF THE CHNA. THE IMPLEMENTATION PLAN IDENTIFIED AS PRIORITIES (1) THE NEED FOR EDUCATION TOOLS FOR PATIENT TRANSITION FROM LTAC TO HOME CARE, AND USE OF AVAILABLE HEALTH CARE RESOURCES IN THE COMMUNITY INCLUDING LTAC AND (2) THE NEED FOR PROFESSIONAL EDUCATION AND COMMUNICATION TO IMPROVE QUALITY OF CARE AND PATIENT AWARENESS.THE IMPLEMENTATION PLANS WILL HELP GUIDE THE DEKALB SYSTEM HOSPITALS' EFFORTS TOWARDS COMMUNITY HEALTH NEEDS THAT HAVE BEEN IDENTIFIED THROUGH THE CHNAS. ALL THE STRATEGIES IDENTIFIED ARE TO ENHANCE AND IMPROVE THE HEALTH OF THE COMMUNITY AND THE PEOPLE THE HOSPITALS SERVE. PART VI, LINE 3: PATIENTS PROVIDED CARE BY THE HOSPITAL MEET WITH A FINANCIAL COUNSELOR AFTER THEIR CARE IS RENDERED. ELEGIBILITY CRITERIA FOR VARIOUS FINANCIAL ASSISTANCE PROGRAMS IS REVIEWED WITH THE PATIENT INCLUDING CHARITY, MEDICAID, OR OTHER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS. BILLING STATEMENTS RECEIVED BY A PATIENT ADVISE THEM TO CONTACT THE FINANCIAL COUNSELING DEPARTMENT ABOUT THESE PROGRAMS. PART VI, LINE 4: DEKALB REGIONAL HEALTH SYSTEM SERVES THE POPULATION OF DEKALB COUNTY, GA (54% AFRICAN AMERICAN, 35% WHITE, 4% ASIAN) AS WELL AS ROCKDALE AND GWINNETT COUNTIES. THE MEDIAN INCOME OF DEKALB COUNTY IS APPROXIMATELY $51,700 AND ABOUT 17% OF THE COUNTY RESIDENTS LIVE BELOW THE POVERTY LEVEL. APPROXIMATELY 9% OF THE POPULATION IS OVER AGE 65 AND 24% OF THE POPULATION IS UNDER AGE 18. PART VI, LINE 5: UNDERSTANDING THAT A HEALTH COMMUNITY IS ABOUT MORE THAN JUST THE ABSENCE OF DEATH AND DISEASE, WE ALSO CONTRIBUTE TO THE ECONOMIC VITALITY AND CREATION OF QUALITY JOBS RIGHT HERE AT HOME. NAMED THE 2010 CORPORATION OF THE YEAR BY THE DEKALB COUNTY CHAMBER OF COMMERCE FOR OUR ROLE AS AN ACTIVE CORPORATE CITIZEN AND PROPONENT OF DIVERSTITY, THE FOLLOWING PROGRAMS HAVE HELPED BUILD THE HEALTH OF OUR COMMUNITY: 1) WE HELP REDUCE TEEN PREGNANCY AND SEXUALLY TRANSMITTED DISEASE BY PROVIDING FREE PREVENTION EDUCATION THROUGH OUR PUBERTY ROCKS PROGRAM FOR PRE-TEENS; 2) WE SUPPORT 100 BLACK MEN OF DEKALB IN THE EFFORT TO PROVIDE HIGHER EDUCATION TO AT-RISK YOUTH; 3) WE PARTNER WITH THE PHYSICIANS'S CARE CLINIC TO PROVIDE NEARLY 2,000 LOW OR NO COST PATIENT VISITS A YEAR INCLUDING LAB WORK AND PRESCRIPTION MEDICATIONS TO AREA LOW-INCOME AND UNINSURED RESIDENTS; 4) WE SPONSOR A FREE ANNUAL CANCER SCREENING DAY ON TWO OF OUR HOSPITAL CAMPUSES; 5) WE HAVE RECENT HEALTHY WORKPLACE INIATIVES INCLUDE SMOKE-FREE BUILDINGS INSIDE AND OUT, A NO-NICOTINE HIRING POLICY AND ADOPTION OF HEALTHY FOOD OPTIONS IN HOSPITAL CAFETERIAS; 6) WE COLLECT AND DONATE SURPLUS MEDICAL SUPPLIES TO MEDSHARE INTERNATIONAL IN SUPPORT OF HEALTH INITIATIVES IN LESS FORTUNATE COUNTRIES; 7) WE HAVE AN OPEN MEDICAL STAFF THAT ATTRACTS UNLIMITED, HIGHLY TRAINED MEDICAL TALENT TO SERVE THE AREA; 8) WE ARE A MAJOR SPONSOR OF THE LEADERSHIP DEKALB INITIATIVE TO PROMOTE COMMUNITY CONNECTIVITY AND ACTION PLANS FOR ECONOMIC DEVELOPMENT, SUSTAINABILITY AND IMPROVEMENT OF THE QUALITY OF LIFE IN DEKALB COUNTY; 9) DEKALB MEDICAL PROVIDES FURTHER ENRICHMENT AND EMPLOYMENT OPPORTUNITIES BY CHAMPIONING WORKPLACE SUCCESS FOR YOUTH AND ADULTS WITH DISABILITIES. PARTNERING WITH THE NATIONALLY RECOGNIZED TOMMY NOBIS CENTER, DEKALB MEDICAL CONTRACTS WITH THE CENTER, DEKALB MEDICAL CONTRACTS WITH THE CENTER TO PROVIDE SWITCHBOARD OPERATORS FOR THE HEALTH SYSTEM; 10) WE PARTNER WITH DEKALB COUNTY HIGH SCHOOLS TO PROVIDE MENTALLY AND PHYSICALLY CHALLENGED STUDENTS WITH VOCATIONAL TRAINING AND REAL-LIFE WORK EXPERIENCE IN THE HEALTHCARE INDUSTRY. THE STUDENTS, WHO RECEIVE SCHOOL CREDIT, SERVE AS VOLUNTEERS IN OUR CAFETERIA, LAUNDRY ROOM AND MOTHER-BABY UNITS; 11) WE PARTICIPATE IN NUMEROUS CAREER DAYS, ENCOURAGING THE SCIENCE AND MATH EDUCATION THAT'S NEEDED TO PROVIDE COMPETENT HEALTH WORKERS OF THE FUTURE; 12) WE SUPPORT A DEKALB WORKFORCE DEVELOPMENT PARTNERSHIP THAT PROVIDES TRAINING PROGRAMS, EDUCATION AND A CLINICAL SITE FOR PATIENT CARE TECHNICIAN CERTIFICATION; AND 13) WE MAINTAIN A PARTNERSHIP WITH GEORGIA PERIMETER COLLEGE AND MERCER UNIVERSITY TO PROVIDE CLINICAL ROTATIONS, PRECEPTORSHIPS, EDUCATION AND INSTRUCTION TO GEORGIA'S FUTURE NURSES. PART VI, LINE 6: DEKALB REGIONAL HEALTH SYSTEM, INC. IS THE PARENT ENTITY WHICH PROVIDES SUPPORT TO DEKALB MEDICAL CENTER, INC., DECATUR HEALTH RESOURCES, INC. AND DEKALB MEDICAL CENTER FOUNDATION, INC. DEKALB MEDICAL CENTER, INC. OPERATES TWO ACUTE CARE HOSPITALS AND A PHYSICIAN PRACTICE NETWORK TO PROVIDE HEALTHCARE SERVICES TO THE RESIDENTS OF DEKALB COUNTY, GEORGIA AND SURROUNDING COUNTIES. DECATUR HEALTH RESOURCES PROVIDES LONG-TERM ACUTE CARE HOSPITAL SERVICES TO PATIENTS WHO NEED ADDITIONAL TIME TO RECOVER FROM SERIOUS ILLNESS. DEKALB MEDICAL CENTER FOUNDATIONS'S MISSION IS TO STRENGTHEN THE LINK BETWEEN DEKALB REGIONAL HEALTH SYSTEM AND THE COMMUNITY IT SERVICES THROUGH COMMUNICATION, EDUCATION, SERVICE AND PHILANTHROPY. PART VI, LINE 7, REPORTS FILED WITH STATES GA 1 DEKALB MEDICAL CENTER INC 2701 NORTH DECATUR ROAD DECATUR GA 30033 581966795 501(C)(3) 1583274 SUPPORT FOR PATIENT CARE 1 PART I, LINE 2: THE ORGANIZATION HAS GUIDELINES IN PLACE THAT ARE USED IN REVIEWING THE ELIGIBILITY OF GRANTEES. SCHOLARSHIP FUNDS ARE REMITTED TO THE EDUCATIONAL INSTITUTIONS DIRECTLY. FOR OTHER GRANTS, VARIOUS PROCEDURES ARE IN PLACE DEPENDING ON GRANT TYPE, INCLUDING REQUIREMENTS TO SUBMIT APPLICATIONS FOR REVIEW AND APPROVAL. ALL GRANTS REQUIRE WRITTEN DOCUMENTATION AND APPROPRIATE LEVELS OF APPROVAL. 1 0 0 0 0 0 0 0 0 JOHN A SHELTON JR DMC PRESIDENT/CEO 0 615202 0 171245 0 36242 0 16102 0 19896 0 858687 0 0 JOHN KATSIANIS EVP & CFO 0 309617 0 29567 0 23000 0 8925 0 18755 0 389864 0 0 DANE HENRY DMC COO 0 334756 0 30728 0 26042 0 8925 0 21415 0 421866 0 0 ERIC NORWOOD DMC FORMER CEO 0 0 0 0 0 572325 0 0 0 24824 0 597149 0 0 PART I, LINE 4A ERIC NORWOOD RECEIVED SEVERANCE PAYMENTS OF $570,003. FORM 990, PART VI, SECTION A, LINE 6 DEKALB REGIONAL HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF DECATUR HEALTH RESOURCES, INC. FORM 990, PART VI, SECTION A, LINE 7A EACH BOARD OF DIRECTORS MEMBER NOMINATED TO THE DECATUR HEALTH RESOURCES, INC. BOARD IS SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS OF DEKALB REGIONAL HEALTH SYSTEM, INC. IN ACCORDANCE WITH THE DECATUR HEALTH RESOURCES BYLAWS. FORM 990, PART VI, SECTION A, LINE 7B DEKALB REGIONAL HEALTH SYSTEM, INC. MUST APPROVE CAPITAL EXPENDITURES IN EXCESS OF $2,000,000, ACQUISITIONS, REORGANIZATIONS, MERGERS AND/OR CONSOLIDATIONS, BUDGETS AND ANY REVISIONS AND REVISIONS OF THE ARTICLES OF INCORPORATION FOR DECATUR HEALTH RESOURCES, INC. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS PREPARED BY AN UNRELATED, INDEPENDENT ACCOUNTING FIRM AND SUBMITTED TO THE AUDIT COMMITTEE OF THE DEKALB REGIONAL HEALTH SYSTEM, INC. BOARD OF DIRECTORS FOR THEIR REVIEW AND APPROVAL PRIOR TO FILING. A COPY OF FORM 990 IS ALSO PROVIDED TO THE DECATUR HEALTH RESOURCES, INC. BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES ALL OFFICERS, DIRECTORS, AND INDIVIDUALS IN MANAGEMENT LEVEL POSITIONS TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THESE CONFLICT OF INTEREST DISCLOSURES ARE REVIEWED BY THE ORGANIZATION'S GENERAL COUNSEL TO ASSURE COMPLIANCE WITH THE POLICY. ADDITIONALLY, BOARD MEMBERS ARE ASKED TO RECUSE THEMSELVES ON ANY MATTERS OF INTEREST BEFORE THE BOARD IN WHICH A CONFLICT OF INTEREST MAY EXIST. ANY RECUSAL IS DOCUMENTED WITHIN THE MINUTES OF THE BOARD OR COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 ALL OFFICERS ARE COMPENSATED BY DEKALB MEDICAL CENTER, INC., A RELATED ENTITY. COMPENSATION IS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE DEKALB REGIONAL HEALTH SYSTEM, INC. BOARD OF DIRECTORS. THE COMMITTEE UTILIZES AN INDEPENDENT CONSULTANT TO ASSIST IN SETTING COMPENSATION LEVELS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. ANY WRITTEN REQUEST FROM THE PUBLIC TO VIEW THESE DOCUMENTS WOULD BE REVIEWED AND ACTED UPON BY THE ORGANIZATION'S BOARD OF DIRECTORS. FORM 990, PART IX, LINE 11G NONEMPLOYEE WAGES: PROGRAM SERVICE EXPENSES 6,892,181. MANAGEMENT AND GENERAL EXPENSES 1,477,240. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,369,421. NONEMPLOYEE BENEFITS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,498,940. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,498,940. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 164,889. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 164,889. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 71,823. MANAGEMENT AND GENERAL EXPENSES 403,702. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 475,525. DEKALB MEDICAL CENTER INC 2701 NORTH DECATUR ROAD DECATUR GA 30033 581966795 ACUTE CARE HOSPITAL GA 501(C)(3) LINE 3 DEKALB REGIONAL HEALTH SYSTEM INC 0 DEKALB REGIONAL HEALTH SYSTEM INC 2701 NORTH DECATUR ROAD DECATUR GA 30033 582034958 SUPPORT OF DMC, INC. & DHR, INC. GA 501(C)(3) LINE 11B, II N/A 0 DEKALB MEDICAL CENTER FOUNDATION INC 2701 NORTH DECATUR ROAD DECATUR GA 30033 581924605 FUNDRAISING ON BEHALF OF DMC, INC. GA 501(C)(3) LINE 11C, III-FI DEKALB REGIONAL HEALTH SYSTEM INC 0 DRHS VENTURES INC 2701 NORTH DECATUR ROAD DECATUR GA 30033 201864828 JOINT VENTURE GA N/A C 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0