2025-11-17T05:54:24-06:00 2024-12-31 990 2024-01-01 453957368 POLK MEDICAL CENTER INC POLK 7065096074 420 E SECOND AVENUE SUITE 102 ROME GA 301613210 PHILIP WHEELER CFO 7065096074 2025-11-16 0 2024 2025-03-06 01:10:19Z ATRIUM HEALTH FLOYD POLK MEDICAL CENTER KURT STUENKEL 304 TURNER MCCALL BLVD ROME GA 301620233 61245755 0 X WWW.FLOYD.ORG X 2011 GA TO IMPROVE HEALTH, ELEVATE HOPE, AND ADVANCE HEALING - FOR ALL. 12 11 0 17 28751 24256 507245 1761571 54479348 55135547 949042 4336674 54402 11963 55990037 61245755 0 525248 0 0 14624179 18581276 0 0 0 17734153 22126684 32358332 41233208 23631705 20012547 115877947 134975991 6079403 6870456 109798544 128105535 ATRIUM HEALTH FLOYD POLK MEDICAL CENTER IS A 25-BED CRITICAL ACCESS HOSPITAL WHOSE MISSION IS TO IMPROVE HEALTH, ELEVATE HOPE, AND ADVANCE HEALING TO THE COMMUNITY IT SERVES. 0 0 33496195 525248 55106796 THE FILING ORGANIZATION OPERATES A 25-BED, CRITICAL ACCESS HOSPITAL THAT OFFERS HEALTH CARE SERVICES TO POLK COUNTY AND NORTHERN HARALSON COUNTY WITH SUPPORT FROM ATRIUM HEALTH FLOYD HEALTH SYSTEM'S COMPREHENSIVE NETWORK OF CARE. THE HOSPITAL PROVIDES A LEVEL IV TRAUMACENTER, INPATIENT REHABILITATION, IMAGING, LAB WORK, AND INFUSION THERAPY. DURING 2024, ATRIUM HEALTH FLOYD POLK MEDICAL CENTER HAD APPROXIMATELY 8,000 PATIENT DAYS AND NEARLY 27,000 EMERGENCY ROOM VISITS. 33496195 1 1 0 1 0 0 0 0 0 0 1 0 0 1 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 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 GA X X PHILLIP WHEELER 7065096074 304 TURNER MCCALL BOULEVARD ROME GA 30161 KURT STUENKEL BOARD MEMBER, PRES/SEC 1.00 39.00 X X 0 2012980 57514 TOMMY MANNING SVP, CHF LEGAL OFF & SEC 1.00 39.00 X 0 694580 99938 MATTHEW GORMAN VP CORP/NETWORK SVC 1.00 39.00 X 0 609482 100172 PHILIP WHEELER CFO 20.00 20.00 X 0 524897 45844 E CLARICE CABLE FORMER OFFICER (6/22) 0.00 40.00 X 0 413191 74510 TIFANI KINARD VP RURAL HEALTH 40.00 0.00 X 0 313093 53590 NEIL E GORDON MD BOARD MEMBER (TO 6/30/24) 1.00 0.00 X 2750 310944 34470 WARREN SONNY RIGAS FORMER OFFICER (6/22) 0.00 0.00 X 0 300931 0 ANITA JACKSON AVP ASST ADMINISTRATOR 40.00 0.00 X 0 189890 41645 LOVEJOY LEIGH PHARMACIST 40.00 0.00 X 0 155595 53778 LAURA CORN CLINICAL NURSING SUPERVISOR 40.00 0.00 X 0 158444 53860 VELVET SMITH REGISTERED NURSE - WEEKEND PROGRAM 40.00 0.00 X 0 160270 45188 MARY MCELWEE STAFF EDUCATION COORDINATOR 40.00 0.00 X 0 144719 52648 KAY CHUMBLER BOARD MEMBER (TO 6/30/24) 1.00 2.00 X 2750 7750 0 CARL HERRING MD BOARD MEMBER 1.00 0.00 X 1250 7726 0 TODD BUSSEY CHAIR 1.00 1.00 X X 2500 2750 0 DEANNA WILLIAMS BOARD MEMBER 1.00 0.00 X 4500 0 0 BRITT MADDEN JR BOARD MEMBER 1.00 0.00 X 2750 0 0 SONDI SMITH VEST BOARD MEMBER 1.00 0.00 X 2500 250 0 DARCY MORRIS BOARD MEMBER (TO 6/30/24) 1.00 0.00 X 2500 0 0 DOUGLAS E ELLIOTT BOARD MEMBER 1.00 0.00 X 2500 0 0 GEORGE BOSWORTH MD BOARD MEMBER (TO 6/30/24) 1.00 1.00 X 750 1500 0 DARRIN KINES BOARD MEMBER 1.00 0.00 X 2000 0 0 MARY MILLER BOARD MEMBER 1.00 0.00 X 1750 250 0 FRANK SHELLEY BOARD MEMBER (TO 6/30/24) 1.00 2.00 X 0 0 0 28500 6009242 713157 39 1 1 0 ARAMARK MANAGEMENT SERVICE PO BOX 978839 DALLAS TX 75397 FOOD SERVICES, FACILITIES UNIFORMS 1381541 MORRISON MANAGEMENT SPECIALISTS INC PO BOX 102289 ATLANTA GA 30368 FOOD SERVICES 978808 DELTA HEALTHCARE PROVIDERS PO BOX 202940 DALLAS TX 75320 CONTRACT LABOR 219317 ALLIANCE HEALTHCARE SERVICES INC PO BOX 735714 DALLAS TX 75373 HEALTHCARE SERVICES 160100 4 525248 1236323 1761571 PATIENT SERVICE REVENUE 622110 55029471 55000720 28751 OTHER HEALTHCARE REVENUE 621990 106076 106076 55135547 5531 5531 4331143 0 4331143 4331143 4331143 GIFT SHOP REVENUE 459420 11963 11963 11963 61245755 55106796 28751 4348637 525248 525248 13574370 10113220 3461150 358144 266826 91318 3684267 2744864 939403 964495 718571 245924 1597 1597 4907 16 4891 2204757 1681488 523269 1435 796 639 153760 78185 75575 38034 19340 18694 1842436 936851 905585 40637 20663 19974 3369 1713 1656 92830 301 92529 2108570 955994 1152576 225785 225785 BAD DEBT 12550408 12550408 MEDICAL SUPPLIES 2445562 2445562 OTHER SUPPLIES 379152 192793 186359 MISCELLANEOUS 33445 15974 17471 41233208 33496195 7737013 0 385697 103002 42991406 0 11572639 10134433 217044 230543 616360 75310 58883374 25999513 33318983 32883861 26775551 29404773 267 62144069 115877947 134975991 1526339 1438063 59748 67926 4493316 5364467 6079403 6870456 X 109798544 128105535 109798544 128105535 115877947 134975991 20012547 -1705556 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1597 1597 0 PART II-B, LINE 1: THE ORGANIZATION PAYS MEMBERSHIP DUES TO NATIONAL AND STATE ORGANIZATIONS. A PORTION OF THOSE DUES IS ALLOCATED TO LOBBYING ACTIVITIES IN WHICH THOSE ORGANIZATIONS PARTICIPATE. 1177394 1177394 43422473 17638953 25783520 12692801 8360560 4332241 1590706 1590706 32883861 OP LEASES 267 INTERCOMPANY RECEIVABLE 62143802 62144069 0 THIRD PARTY SETTLEMENTS 3093862 OPERATING LEASE PAYABLE 17 CAPITAL LEASE 2270588 5364467 X PART X, LINE 2: THE ORGANIZATION HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS CALENDAR YEARS ENDED DECEMBER 31, 2024 AND 2023 INCLUDING A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF ITS JOINT VENTURES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS FOR CALENDAR YEARS ENDED DECEMBER 31, 2024 AND 2023. 1 1 1 X 300.000000000000 1 X 1 1 1 0 1 1 2538651 0 2538651 0.08850 6222809 6023019 199790 0.00700 8761460 6023019 2738441 0.09550 157614 0 157614 0.00550 525248 0 525248 0.01830 682862 682862 0.02380 9444322 6023019 3421303 0.11930 1 2330894 0 18563335 12231212 6332123 X 1 1 1 1 ATRIUM HEALTH FLOYD POLK MEDICAL CENTER 2360 ROCKMART HIGHWAY CEDARTOWN GA 30125 HTTPS://WWW.FLOYD.ORG 115-705 X X X X SWING BED SNF ATRIUM HEALTH FLOYD POLK MEDICAL CENTER 1 0 0 1 X X X X X X X X X 23 1 0 0 1 X SEE PART V X 1 23 1 SEE PART V 0 1 X 300.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X SEE PART V X SEE PART V X SEE PART V X X X X X X 1 X 0 X X X X 1 X 0 0 ATRIUM HEALTH FLOYD POLK MEDICAL CENTER PART V, SECTION B, LINE 5: DURING THE CONDUCTION OF ITS MOST RECENT CHNA, THE HOSPITAL FACILITY SOUGHT COMMUNITY INPUT THROUGH THE FOLLOWING PRIMARY SOURCES: -A COMMUNITY HEALTH SURVEY CONDUCTED ON BEHALF OF THE HOSPITAL FACILITY BY PRC, INC., A NATIONALLY RECOGNIZED HEALTH CARE CONSULTING FIRM. SURVEYS WERE CONDUCTED VIA PRC THROUGH TELEPHONE AND ONLINE QUESTIONNAIRES WITH LOCAL RESIDENTS.-INTERVIEWS WITH KEY INFORMANTS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY; INCLUDING PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND VARIOUS COMMUNITY LEADERS. -COMMENTS FROM PRIOR COMMUNITY HEALTH NEED ASSESSMENTS AND IMPLEMENTATION STRATEGIES.ADDITIONALLY, A VARIETY OF SECONDARY DATA SOURCES WERE USED INCLUDING, BUT NOT LIMITED TO: -METOPIO, A ROBUST PLATFORM THAT OFFERS CURATED DATA FROM PUBLIC AND PROPRIETARY SOURCES FOR INFORMATION ON HEALTH BEHAVIORS AND HEALTH RISKS, HEALTH OUTCOMES, HEALTH UTILIIZATION, DEMOGRAPHIC, AND COMMUNITY-LEVEL DRIVERS OF HEALTH LIKE ECONOMIC, HOUSING, EMPLOYMENT, AND ENVIRONMENTAL CONDITIONS. -AMERICAN COMMUNITY SURVEY (ACS), U.S. CENSUS BUREAU-AREA HEALTH RESOURCES FILES, HELATH RESOURCES & SERVICES ADMINISTRATION-FBI CRIME DATA EXPLORER, FEDERAL BUREAU OF INVESTIGATION-FOOD ACCESS RESEARCH ATLAS, US DEPARTMENT OF AGRICULTURE (USDA) - ECONOMIC RESEARCH SERVICES-VARIOUS REPORTS FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION-CENTERS FOR MEDICARE/MEDICAID-HEALTHY PEOPLE 2030ATRIUM HEALTH FLOYD POLK MEDICAL CENTER:PART V, SECTION B, LINE 7A:HTTPS://WWW.FLOYD.ORG/ABOUT-FLOYD/PAGES/REPORTS.ASPXATRIUM HEALTH FLOYD POLK MEDICAL CENTER:PART V, SECTION B, LINE 10A:HTTPS://WWW.FLOYD.ORG/ABOUT-FLOYD/PAGES/REPORTS.ASPX ATRIUM HEALTH FLOYD POLK MEDICAL CENTER PART V, SECTION B, LINE 11: THE HOSPITAL FACILITY'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IDENTIFIED NUMEROUS COMMUNITY HEALTH NEEDS AND CONCERNS. THE TOP HEALTH ISSUES IDENTIFIED WERE PRESENTED TO THE FACILITY'S STEERING COUNCIL WHERE MEMBERS WERE ASKED TO RANK THE ISSUES BASED ON THE FOLLOWING CRITERIA: SIZE/SERIOUSNESS OF THE PROBLEM, EFFECTIVENESS OF AVAILABLE INTERVENTIONS, AVAILABLE RESOURCES TO ADDRESS THE HEALTH ISSUE, HEALTH CARE SYSTEM ADEQUATELY SITUATED TO ADDRESS THE HEALTH ISSUE, MEETS A DEFINED COMMUNITY NEED AS IDENTIFIED THROUGH DATA, POTENTIAL FOR ISSUE TO IMPACT OTHER HEALTH AND SOCIAL ISSUES, AND ABILITY TO EFFECTIVELY ADDRESS OR IMPACT HEALTH ISSUE THROUGH COLLABRATION. THE FOLLOWING HEALTH NEEDS WERE PRIORITIZED BY THE HOSPITAL FACILITY IN ITS MOST RECENT CHNA: 1) ACCESS TO HEALTH CARE SERVICES2) CHRONIC DISEASE: HEART DISEASE AND STROKE3) NUTRITION, PHYSICAL ACTIVITY, AND WEIGHTTHE HOSPITAL FACILITY IMPLEMENTATION STRATEGY OUTLINES THE PROGRAMS AND RESOURCES THE HOSPITAL FACILITY WILL USE TO ADDRESS THE ABOVE MENTIONED PRIORITIZED HEALTH NEEDS. THE IMPLEMENTATION STRATEGY ALSO INCLUDES AN EVALUATION OF IMPACT OF THOSE PROGRAMS ON PRIORITIZED COMMUNITY HEALTH NEEDS IDENTIFIED FROM THE CHNA. ALL EFFORTS IN COMBINATION WITH THE HOSPITAL'S VALUE OF NONDISCRIMINATION AND COMPASSIONATE CARE ARE DESIGNED TO MEET THE SIGNIFICANT HEALTH NEEDS OF THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. THE HOSPITAL FACILITY ACKNOWLEDGES THE IMPORTANCE OF ALL COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA; HOWEVER, THE HOSPITAL FACILITY'S RESOURCES AND ASSETS WERE BEST ALIGNED TO FOCUS ON THE PRIORITIZED NEEDS MENTIONED ABOVE. THE CHNA PROVIDES A COMPREHENSIVE LIST OF AVAILABLE RESOURCES IN THE COMMUNITY FOR THOSE NEEDS THAT WERE NOT PRIORITIZED BY THE HOSPITAL FACILITY. ALTHOUGH NOT PRIORITIZED, THE HOSPITAL FACILITY WILL CONTINUE TO PARTNER WITH COMMUNITY AND NON-PROFIT ORGANIZATIONS TO HELP ADDRESS THESE NEEDS. ATRIUM HEALTH FLOYD POLK MEDICAL CENTER PART V, SECTION B, LINE 13B: THE HOSPITAL USES A PRESUMPTIVE PROCESS TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY FOR (CATEGORY II) SERVICES.ATRIUM HEALTH POLK MEDICAL CENTERPART V, LINE 16A, FAP WEBSITE: WWW.FLOYD.ORG/PATIENTS-VISITORS/BILLING/PAGES/DEFAULT.ASPXATRIUM HEALTH POLK MEDICAL CENTERPART V, LINE 16BM FAP APPLICATION WEBSITE: WWW.FLOYD.ORG/PATIENTS-VISITORS/BILLING/PAGES/DEFAULT.ASPXATRIUM HEALTH POLK MEDICAL CENTERPART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: WWW.FLOYD.ORG/PATIENTS-VISITORS/BILLING/PAGES/DEFAULT.ASPX PART I, LINE 3C: THE FINANCIAL ASSISTANCE PROGRAMS ARE DESIGNED TO ENSURE ASSISTANCE IS PROVIDED TO PATIENTS DEMONSTRATING A FINANCIAL NEED AND TO ENSURE THE ORGANIZATION COMPLIES WITH ANY REQUIRED FEDERAL OR STATE REGULATIONS RELATED TO FINANCIAL ASSISTANCE. THOSE ELIGIBLE FOR FINANCIAL ASSISTANCE WILL NEVER BE BILLED MORE THAN THE AMOUNTS GENERALLY BILLED (AGB) TO AN INSURED PATIENT. THE ORGANIZATION USES THE LOOK-BACK METHOD TO CALCULATE AGB. PART I, LINE 6A: THE ORGANIZATION PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT THAT IS AVAILABLE ON ITS WEBSITE. PART I, LN 7 COL(F): THE ORGANIZATION'S PATIENT BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS WAS $12,550,408 FOR THE YEAR ENDED DECEMBER 31, 2024. THIS AMOUNT IS NOT INCLUDED IN THE CALCULATION OF CHARITY CARE FOR PART I, LINE 7. PART II, COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION PROVIDES RESOURCES AND FINANCIAL SUPPORT TO OTHER LOCAL ORGANIZATIONS WHOSE MISSIONS ARE TO IMPROVE PUBLIC HEALTH BY ADDRESSING THE ROOT CAUSES OF HEALTH ISSUES BY FOCUSING ON THE SOCIAL DETERMINANTS OF HEALTH SUCH AS POVERTY, LACK OF EDUCATION, RACISM, AND OTHER SOCIAL DISPARITIES. ADDITIONALLY, HOSPITAL EMPLOYEES PROVIDE COMMUNITY SUPPORT BY SERVING ON LOCAL BOARDS FOR COMMUNITY BASED ORGANIZATIONS OR PARTICIPATING IN COMMUNITY COALITIONS OR TASKFORCES. PART III, LINE 2: 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. PART III, LINE 4: FOOTNOTE 2 (PATIENT SERVICE REVENUE) ON PAGE 23 OF THE AUDITED FINANCIAL STATEMENTS DESCRIBES THE TREATMENT OF BAD DEBT. PART III, LINE 8: 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: THE HOSPITAL MAKES A REASONABLE EFFORT TO DETERMINE AN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE ENGAGING IN ANY COLLECTION ACTIONS. ALL COLLECTION ACTIONS WILL BE SUSPENDED IF THE INDIVIDUAL SUBMITS A COMPLETED FAP APPLICATION DURING THE APPLICATION PERIOD, OR IF THE INDIVIDUAL SUBMITS AN INCOMPLETE APPLICATION DURING THE APPLICATION PERIOD THAT IS SUBSEQUENTLY COMPLETED WITHIN A REASONABLE TIME AFTER THE HOSPITAL REQUESTS FURTHER INFORMATION. IF THE INDIVIDUAL IS DETERMINED NOT TO BE ELIGIBLE FOR A FULL DISCOUNT UNDER THE FAP, ANY COLLECTION ACTIVITIES WILL BE RESUMED AS TO THE OUTSTANDING BALANCE OWED. IF THE INDIVIDUAL IS DETERMINED TO BE ELIGIBLE FOR ASSISTANCE UNDER THE FAP, APPROPRIATE MEASURES ARE TAKEN TO REFUND ANY AMOUNTS OWED TO THE INDIVIDUAL AND REVERSE OR MODIFY COLLECTION ACTIONS CONSISTENT WITH THE NEW BALANCE OWED AFTER APPLYING THE APPLICABLE FAP DISCOUNTS. PART VI, LINE 2: THE HOSPITAL FACILITY'S MOST RECENT CHNA WAS BASED ON A SET OF BEST PRACTICES FOR COMMUNITY HEALTH ASSESSMENTS WITH THE PURPOSE OF IDENTIFYING REGIONAL PRIORITY AREAS TO FOCUS ON FOR CY2024 TO CY2026. THE PROCESS WAS DESIGNED TO RELY ON EXISTING PUBLIC DATA, DIRECTLY ENGAGING COMMUNITY STAKEHOLDERS, AND COLLABORATE WITH LOCAL PUBLIC HEALTH, OTHER HEALTH CARE PROVIDERS; AS WELL AS, COMMUNITY PARTNERS SUCH AS FAITH NETWORKS RELEVANT TO THE SOCIAL FACTORS UNDERLYING PATTERNS OF ACCESS. THE ASSESSMENT WAS CONDUCTED IN THREE STAGES: 1) DATA REVIEW OF PRIMARY AND SECONDARY SOURCES, 2) SETTING PRIORITIES, AND 3) COMMUNITY ASSET INVENTORY. THE DATA REVIEW AND PRIORITY SETTING PHASES BEGAN WITH THE COMPILATION OF EXISTING HEALTH-RELATED DATA. STAKEHOLDERS REVIEWED MULTIPLE DATA SETS INCLUDING LOCAL PUBLIC HEALTH NEEDS ASSESSMENTS, NORTH CAROLINA INDICATORS FOR COMMUNITY HEALTH ASSESSMENT, INTERNAL DISEASE REGISTRIES, COUNTY HEALTH RANKINGS, AND OTHERS. COMMUNITY FEEDBACK IN THE FORM OF RESIDENT SURVEYS AND INTERVIEWS WITH COMMUNITY LEADERS THAT REPRESENT THE UNDERSERVED AND VULNERABLE POPULATIONS WERE ALSO CONSIDERED. ONCE COMMUNITY HEALTH NEEDS WERE IDENTIFIED, AN INTERNAL STEERING COMMITTEE AND SENIOR LEADERSHIP REVIEWED A SET OF CRITERIA TO DEVELOP THE PRIORITY RANKINGS. EACH IDENTIFIED HEALTH NEED WAS REVIEWED AND ASSIGNED A VALUE WITH THE GREATEST WEIGHT PLACED UPON HEALTH DISPARITIES ASSOCIATED WITH THE NEED, THE BURDEN OF THE HEALTH NEED, THE FEASIBILITY OF INTERVENTIONS, AND THE IMPORTANCE THE COMMUNITY PLACES ON ADDRESSING THE HEALTH NEED. FINALLY, THE HOSPITAL FACILITY DEVELOPED AN IMPLEMENTATION STRATEGY TO IDENTIFY THE MEANS THROUGH WHICH IT PLANS TO ADDRESS THOSE PRIORITIZED NEEDS THAT ARE CONSISTENT WITH THE CHARITABLE MISSION AS PART OF ITS COMMUNITY BENEFIT PROGRAMS FOR THE NEXT THREE CALENDAR YEARS. BEYOND PROGRAMS ADDRESSED IN THE IMPLEMENTATION STRATEGY, THE HOSPITAL FACILITY WILL CONTINUE TO ADDRESS MANY OF THE PRIORITIES BY PROVIDING CARE TO ALL, REGARDLESS OF ABILITY TO PAY. PART VI, LINE 3: THE ORGANIZATION USES A VARIETY OF MEANS TO EDUCATE AND INFORM PATIENTS OF THEIR FINANCIAL ASSISTANCE OPTIONS. INFORMATION REGARDING FINANCIAL ASSISTANCE CAN BE FOUND ON THE HOSPITAL FACILITY'S WEBSITE, CONSPICUOUSLY DISPLAYED SIGNAGE THROUGHOUT THE HOSPITAL FACILITY, PATIENT BILL STATEMENTS, AND FROM TEAMMATES DURING CONVERSATIONS CONCERNING A PATIENT'S LIABILITY FOR SERVICES DURING PREADMISSION, DISCHARGE, AND THE "COLLECTION" PERIOD. PART VI, LINE 4: ATRIUM HEALTH FLOYD POLK MEDICAL CENTER IS LOCATED IN CEDARTOWN, GEORGIA. THE PRIMARY COMMUNITY BENEFIT SERVICE AREA (CBSA) INCLUDES FOUR COUNTIES: CHATTOOGA, FLOYD, POLK, ALL LOCATED IN GEORGIA, AND CHEROKEE COUNTY IN ALABAMA. BELOW IS A DEMOGRAPHIC SNAPSHOT OF THE POPULATION OF THE TOTAL SERVICE AREA: POPULATION BY RACE/ETHNICITY-NON-HISPANIC WHITE: 74.3%-NON-HISPANIC AFRICAN-AMERICAN: 11.6%-DIVERSE RACES*: 11.5%-MULTIPLE RACES: 2.6%*DIVERSE RACES INCLUDES THOSE WHO IDENTIFY AS AMERICAN INDIAN O ALASKA NATIVE, ASIAN, OR NATIVE HAWAIIAN/PACIFIC ISLANDER, WITHOUT HISPANIC ORIGINPOPULATION BY AGE DISTRIBUTION -AGE 0-4 YEARS: 5.6%-AGE 5-19: 20.1%-AGE 20-39: 24.2%-AGE 40-64: 32.0%-AGE 65+: 18.2%POPULATION BY SEX-MALE 48.3%-FEMALE 51.7%POPULATION IN POVERTY-BELOW FEDERAL POVERTY LEVEL: 14.5%-BELOW 200% OF FEDERAL POVERTY LEVEL: 39.3%UNEMPLOYMENT RATE: 3.3%PERCENT OF HIGH SCHOOL GRADUATES: 85.4% PART VI, LINE 5: THE ORGANIZATION IS COMMITTED TO BEING RESPONSIVE TO THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES THROUGH A NUMBER OF PROGRAM ACTIVITIES AND COMMUNITY HEALTH IMPROVEMENT INITIATIVES. THE ORGANIZATION HAS ADOPTED AND MAINTAINED A FINANCIAL ASSISTANCE POLICY, PROVIDES SUBSIDIZED HEALTH SERVICES TO PATIENTS IN NEED, AND ACCEPT ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OPERATES AN EMERGENCY ROOM THAT IS OPEN 24/7. THE GOVERNING BOARD IS COMPRISED OF LEADERS WITHIN THE COMMUNITY THE HOSPITAL SERVES. FUNDS ARE REINVESTED IN HEALTH IMPROVEMENT INITIATIVES TO BETTER SERVE THE COMMUNITY HEALTH NEEDS, INCLUDING PROVIDING SCHOOL-BASED CHILD SAFETY PROGRAMS, ATHLETIC TRAINERS TO POLK COUNTY HIGH SCHOOLS, MOBILE MAMMOGRAPHY, CPR TRAININGS, COMMUNITY HEALTH SCREENINGS AND HEALTH FAIRS, HEALTH CARE INTERNSHIPS, EXTERNSHIPS AND SHADOWING OPPORTUNITIES, AND SUPPORT FOR COMMUNITY-WIDE INITIATIVES WITH HEALTH PARTNERS. PART VI, LINE 6: THE FILING ORGANIZATION IS PART OF ADVOCATE HEALTH, WHICH IS HEADQUARTERED IN CHARLOTTE, NORTH CAROLINA, AND IS THE THIRD-LARGEST NONPROFIT HEALTH SYSTEM IN THE UNITED STATES, CREATED FROM THE COMBINATION OF ATRIUM HEALTH AND ADVOCATE AURORA HEALTH. TOGETHER WITH AN INTEGRATED GROUP OF 501(C)(3) HOSPITALS, PHYSICIAN NETWORKS, OTHER HEALTHCARE PROVIDERS, THE ORGANIZATION IS COMMITTED TO PROVIDING SIGNIFICANT BENEFITS TO THE COMMUNITIES IT SERVES ACROSS NORTHWEST GEORGIA AND NORTHEAST ALABAMA. EACH HOSPITAL ORGANIZATION IN THE ADVOCATE HEALTH SYSTEM REPORTS ITS OWN COMMUNITY BENEFIT ON FORM 990, SCHEDULE H. THE CONSOLIDATED COMMUNITY BENEFIT TOTAL OF THE HEALTH SYSTEM IS REPORTED AT HTTPS://WWW.FLOYD.ORG/ABOUT-FLOYD/PAGES/REPORTS.ASPX. PART VI, LINE 7, REPORTS FILED WITH STATES GA 1 BERRY COLLEGE INC PO BOX 490129 MOUNT BERRY GA 30149 580566133 501(C)(3) 131555 0 GRANT FOR PHYSICIAN ASSOCIATE PROGRAM BOYS & GIRLS CLUBS OF NORTHWEST GEORGIA PO BOX 2939 ROME GA 30161 580632795 501(C)(3) 25000 0 COMMUNITY IMPACT GRANT: PROJECT LEARN POLK CEDARTOWN UNITED FUND INC PO BOX 311 CEDARTOWN GA 30125 580566153 501(C)(3) 10360 0 SUPPORT FOR BASIC NEEDS: FOOD, CLOTHING, AND PRESCRIPTIONS CITY OF CEDARTOWN 201 EAST AVE CEDARTOWN GA 30125 582475857 GOVERNMENT 83333 0 COMMUNITY IMPACT GRANT: PLAY AT PEEK PARK FRIENDS OF THE SARA HIGHTOWER REGIONAL LIBRARY INC 205 RIVERSIDE PARKWAY ROME GA 30161 581719332 501(C)(3) 100000 0 TO SUPPORT THE PUBLIC LIBRARY NORTHWEST GEORGIA HUNGER MINISTRIES 90 EAST CALLAHAN ST ROME GA 30161 874452905 501(C)(3) 20000 0 GRANT TO SUPPORT HUNGER RELIEF POLK COUNTY COUNCIL FOR CHILDREN AND FAMILIES INC 424 N MAIN ST SUITE 1 CEDARTOWN GA 30125 582188725 501(C)(3) 25000 0 OUTREACH FACILITY AND COMMUNITY RESOURCE HUB OF THE CITY OF CEDARTOWN POLK SCHOOL DISTRICT 612 S COLLEGE ST CEDARTOWN GA 30125 596000807 GOVERNMENT 125000 0 COMMUNITY IMPACT GRANT: LEARNING TO GROW FOR TOMORROW 8 PART I, LINE 2: THE HOSPITAL FOLLOWS THE MEDICAL CENTER'S CORPORATE POLICY USED IN REVIEWING THE ELIGIBILITY AND SELECTION OF GRANTEES RECEIVING CERTAIN EXEMPT PURPOSE FUNDS. THE HOSPITAL MAINTAINS DOCUMENTATION OF THE ELIGIBILITY AND SELECTION CRITERIA AND RECORDS OF THE AMOUNTS DISBURSED. 1 1 0 0 0 0 0 0 0 KURT STUENKEL BOARD MEMBER, PRES/SEC 0 881703 0 843176 0 288101 0 24150 0 33364 0 2070494 0 0 TOMMY MANNING SVP, CHF LEGAL OFF & SEC 0 422581 0 205721 0 66278 0 53017 0 46921 0 794518 0 38514 MATTHEW GORMAN VP CORP/NETWORK SVC 0 401649 0 175776 0 32057 0 47763 0 52409 0 709654 0 32135 PHILIP WHEELER CFO 0 356148 0 155365 0 13384 0 36143 0 9701 0 570741 0 5701 E CLARICE CABLE FORMER OFFICER (6/22) 0 283734 0 69275 0 60182 0 35397 0 39113 0 487701 0 18823 TIFANI KINARD VP RURAL HEALTH 0 222725 0 83297 0 7071 0 20009 0 33581 0 366683 0 14190 NEIL E GORDON MD BOARD MEMBER (TO 6/30/24) 0 244449 0 62156 2750 4339 0 0 0 34470 2750 345414 0 0 WARREN SONNY RIGAS FORMER OFFICER (6/22) 0 0 0 0 0 300931 0 0 0 0 0 300931 0 0 ANITA JACKSON AVP ASST ADMINISTRATOR 0 152146 0 26161 0 11583 0 7821 0 33824 0 231535 0 0 LOVEJOY LEIGH PHARMACIST 0 155025 0 77 0 493 0 6599 0 47179 0 209373 0 0 LAURA CORN CLINICAL NURSING SUPERVISOR 0 128998 0 14147 0 15299 0 10116 0 43744 0 212304 0 0 VELVET SMITH REGISTERED NURSE - WEEKEND PROGRAM 0 122629 0 36940 0 701 0 6652 0 38536 0 205458 0 0 MARY MCELWEE STAFF EDUCATION COORDINATOR 0 140718 0 3592 0 409 0 6053 0 46595 0 197367 0 0 PART I, LINES 4A-B CERTAIN DIRECTORS, OFFICERS, AND/OR KEY EMPLOYEES OF THE FILING ORGANIZATION PARTICIPATED IN AND/OR RECEIVED PAYMENTS FROM A NON-QUALIFIED DEFERRED COMPENSATION PLAN (RESTORATION OR SERP) AND/OR RECEIVED PAYMENTS FOR SEVERANCE. THE DETERMINATION OF THE PAYMENT AMOUNT FROM NON-QUALIFIED DEFERRED COMPENSATION PLANS FOLLOWED THE EMPLOYMENT ORGANIZATION'S COMPENSATION PROCEDURES. THE FOLLOWING DIRECTORS, OFFICERS, AND/OR KEY EMPLOYEES RECEIVED PAYMENTS FOR SEVERANCE AND/OR PAYMENTS FROM NON-QUALIFIED DEFERRED COMPENSATION PLANS DURING THE CURRENT TAX YEAR: SEVERANCE PAYMENTS: WARREN "SONNY" RIGAS 300,931 NON-QUALIFIED DEFERRED COMPENSATION PAYMENTS: PHILIP WHEELER 12,078 MATTHEW GORMAN 34,431 E. CLARICE CABLE 25,115 THOMAS MANNING 39,217 TIFANI KINARD 12,497 FORM 990, PART VI, SECTION A, LINE 6 FLOYD HEALTHCARE MANAGEMENT, INC. (FHMI) IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A FLOYD HEALTHCARE MANAGEMENT, INC. (FHMI), A RELATED ORGANIZATION, HAS THE POWER TO APPOINT ELEVEN OF THE TWELVE MEMBER GOVERNING BODY WHILE THE PRESIDENT/CEO OF FHMI IS THE FINAL MEMBER OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B PRIOR APPROVAL OF FHMI IS REQUIRED FOR ANY OF THE FOLLOWING ACTIONS: DISSOLUTION; SALE, MERGER OR DISPOSITION; ADOPTION OF CAPITAL OR OPERATING BUDGETS; SELECT OR REMOVE THE ADMINISTRATOR; INCUR INDEBTEDNESS IN EXCESS OF $1,000,000; TAKE ANY ACTION ON THE LEASE OR CONTRACT BETWEEN THE CORPORATION AND CEDARTOWN-POLK COUNTY HOSPITAL AUTHORITY; AMEND THE CORPORATE ARTICLES OF INCORPORATION OR BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVES COPIES OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL DIRECTORS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES ITS OFFICERS, DIRECTORS, AND KEY EMPLOYEES TO ANNUALLY REVIEW THE CONFLICT OF INTEREST POLICY AND DETERMINE ANY POTENTIAL CONFLICTS OF INTEREST. ANY POTENTIAL CONFLICTS NOTED IN THE QUESTIONNAIRE ARE REVIEWED BY A STANDING COMMITTEE FOR APPROPRIATE RESOLUTION. ALL MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED TO DETERMINE AND REPORT ANNUALLY, AND AS THEY ARISE, ANY POTENTIAL CONFLICTS OF INTEREST TO THE SECRETARY OF THE BOARD OF DIRECTORS. THE RESOLUTION OF POTENTIAL AND ACTUAL CONFLICTS IS SUBJECT TO THE APPROVAL OF THE CHAIR OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S CEO & PRESIDENT AND ONE DIRECTOR ARE COMPENSATED BY CHARLOTTE MECKLENBURG HOSPITAL AUTHORITY (CMHA), A RELATED ORGANIZATION. THE ORGANIZATION'S OTHER OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE COMPENSATED BY THE FILING ORGANIZATION AND THE DETERMINATION OF THE COMPENSATION OF SUCH INDIVIDUALS IS CONDUCTED VIA THE PROCESS UTILIZED BY THE FLOYD HEALTHCARE MANAGEMENT (FHMI) BOARD, AS FOLLOWS: THE ADVOCATE HEALTH COMPENSATION AND BENEFITS COMMITTEE ("THE COMMITTEE") OF THE ADVOCATE HEALTH, INC. BOARD OF DIRECTORS ("THE BOARD") HAS AUTHORITY AS THE BOARD DELEGATES TO IT, FOR THE REVIEW AND APPROVAL OF EXECUTIVE COMPENSATION. THE COMMITTEE RELIES UPON AN EXTERNAL, INDEPENDENT COMPENSATION CONSULTANT RETAINED DIRECTLY BY THE COMMITTEE TO PROVIDE THIRD-PARTY COMPENSATION COMPARABILITY DATA FOR EVALUATING THE COMPETITIVENESS AND REASONABLENESS OF EXECUTIVE COMPENSATION AND BENEFITS PROGRAMS RELATIVE TO MARKET PRACTICES FOR SIMILARLY SITUATED HEALTHCARE ORGANIZATIONS. IN EVALUATING COMPENSATION, THE COMMITTEE FOLLOWS CORPORATE GOVERNANCE BEST PRACTICE SUCH AS ADHERENCE TO THE COMPANY'S EXECUTIVE COMPENSATION PHILOSOPHY AND REVIEW PROCESSES; PROCESSES TO ENSURE COMMITTEE MEMBER AND COMPENSATION CONSULTANT INDEPENDENCE; DATA FROM HEALTHCARE ORGANIZATIONS OF COMPARABLE SIZE, STRUCTURE, AND COMPLEXITY; AND ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS, PER IRS GUIDELINES. MINUTES OF THE DELIBERATIONS OF THE COMMITTEE ARE MAINTAINED IN THE ADVOCATE HEALTH, INC. LEGAL DEPARTMENT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON REQUEST. FLOYD HEALTHCARE MANAGEMENT INC 304 TURNER MCCALL BLVD ROME GA 301620233 581973570 HEALTHCARE GA 501C3 LINE 3 AH GEORGIA 0 FLOYD HEALTH CARE FOUNDATION INC 304 TURNER MCCALL BLVD ROME GA 301620233 581375074 FOUNDATION GA 501C3 LINE 12A, I FHMI 0 CANCER NAVIGATORS INC 255 W 5TH STREET SUITE 300 ROME GA 301652817 030397867 EDUCATION GA 501C3 LINE 7 FHMI 0 AH GEORGIA INC PO BOX 32861 CHARLOTTE NC 282322861 831707383 HOLDING CO. NC 501C3 LINE 7 CMHA 0 THE CHARLOTE-MECKLENBURG HOSPITAL AUTHORITY 1000 BLYTHE BLVD CHARLOTTE NC 28203 560529945 HEALTHCARE NC NC POLITICAL SUBDIVI N/A 0 FLOYD-POLK HEALTHCARE FOUNDATION 304 TURNER MCCALL BLVD ROME GA 301620233 872546864 FOUNDATION GA 501C3 LINE 12A, I N/A 0 ADVOCATE HEALTH INC 1000 BLYTHE BLVD CHARLOTTE NC 28203 884157429 HEALTHCARE NC 501(C)(3) LINE 12B, II 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 1