2014-11-14T05:34:28-08:00 2013-12-31 990 2013-01-01 581581103 UNIVERSITY HEALTH SERVICES INC UNIV 7068282406 1350 WALTON WAY AUGUSTA GA 30901 David Belkoski CFO 2014-11-14 2013 2015-11-30 17:44:51Z James R Davis 1350 Walton Way Augusta GA 30901 556124491 false false X www.universityhealth.org X 1984 GA The mission of University Health Care Services is to operate an acute and subacute care hospital providing health care services which help the citizens of our communities achieve and maintain optimal health. 14 12 3506 385 4274624 962237 359813 834964 385193304 405371876 20423308 27833246 9702021 11650585 415678446 445690671 1525323 1133963 0 175856538 169837230 0 0 200182218 233181101 377564079 404152294 38114367 41538377 752120083 781621660 327297489 319595107 424822594 462026553 The mission of University Health Care Services is to operate an acute and subacute care hospital providing health care services which help the citizens of our communities achieve and maintain optimal health. false false 375666875 1133963 409284381 Operation of a general acute care and subacute care hospital with 551 licensed beds total (551 acute and 0 subacute). Patient days for adults and pediatrics for 2013 were 110,312, newborn days were 12,457 (for both term & ICU nursery), and outpatient visits were 428,897. Emergency room registrations were 76,375, observation stays were 6,222, Cardiovascular interventional procedures were 12,088, and Radiology procedures were 139,084, Occupational Medicine visits were 23,352 and Home Health visits for 2013 were 53,094. Within all these indicators are the efforts of University Health Services to service the needs of the community, which include the indigent. In 2013 the cost of indigent and charity care provided, with no local funding, was $33,191,063, however the Hospital did receive Disproportionate Share (DSH) payments to help with this service of a net $3,624,456 and Upper Payment Limit (UPL) net funds of $1,651,508. The $33,191,063 includes the cost for providing inpatient and outpatient services for indigent and charity patients of $20,986,802. Also $1,376,086 to help support community based clinics, $10,624,611 for uncompensated physician services for indigent and charity patients, and $203,564 for disease management. Also provided are programs for congestive heart failure and asthma/COPD, which helped indigent patients manage their condition and improve the quality of their lives. Other community outreach services for 2013 included diabetes testing and education, Prostate Specific Antigen (PSA) testing, Skin Cancer Screenings, free counseling and education for women and their family members through all stages of breast cancer, free mammograms, heart health education, and support groups for cancer, heart attack, and stroke. In 2013, University Hospital reached more than 550,000 people and invested more than $600,000 in free screenings, community education, publications, and more. Additionally, in 2013,over $639,000 was provided for health professional education for cardiovascular and radiology schools, and dietetic internships, in support of tomorrow's care givers. 375666875 true true false true false false false false false false true false false false true true false true false true true false false false false false true true true false true true false false false false false false false false true false false false false false true true false false false false true 283 0 true 3506 true true true CJ false false false false false 0 false false false false false false false false false false X 14 12 false false false false false false false true true false true true true true true true true true true true true true X X David Belkoski 7068282406 1350 Walton Way Augusta GA 30901 Randolph R Smith MD Board Chairman 2.00 1.00 X X 0 0 0 Brian J Marks Board Secretary 2.00 1.00 X X 0 0 0 Jeffrey L Foreman Board Member 2.00 1.00 X 0 0 0 Dana T Atkins Board Member 2.00 1.00 X 0 0 0 Levi W Hill IV Board Member 2.00 1.00 X 0 0 0 Eugene F McManus Board Member 2.00 1.00 X 0 0 0 Natalie D Schweers Board Member 2.00 1.00 X 0 0 0 Terry D Elam Board Member 2.00 1.00 X 0 0 0 Sanford Loyd Board Member 2.00 1.00 X 0 0 0 Hugh L Hamilton Board Member 2.00 1.00 X 0 0 0 James W Bennett Jr Board Member 2.00 1.00 X 0 0 0 Daniel H Boone MD Board Member 10.00 1.00 X 35000 0 0 William P Doupe Board Member 2.00 1.00 X 0 0 0 Ellen G Shaver MD Board Member 2.00 1.00 X 0 0 0 James R Davis President & CEO 50.00 5.00 X 797503 0 260477 Dave A Belkoski CFO 50.00 5.00 X 568872 0 26548 Marilyn A Bowcutt President 50.00 5.00 X 572849 0 16663 William L Farr Jr CMO 50.00 5.00 X 491194 0 21761 Edward L Burr VP-Legal Affairs-Compliance 50.00 0.00 X 376701 0 60692 Kyle E Howell VP-Support-Ancillary Systems 50.00 0.00 X 270574 0 16632 Leslie A Clonch VP-Chief Information Officer 50.00 0.00 X 326175 0 15850 Stephen M Gooden VP-Clinical Transformation 50.00 0.00 X 370576 0 9967 Sandra McVicker CEO-University Hospital McDuffie 50.00 0.00 X 284314 0 15521 Laurie Ott Smith President-Foundation, VP HR-CommSV 50.00 0.00 X 288581 0 8405 Lynda Jones Watts VP Patient Care Svcs-CNO 50.00 0.00 X 244925 0 17408 Tara A Kattine Physician 40.00 0.00 X 247391 0 14350 John C Pope PA 45.00 0.00 X 182005 0 8112 Timothy L Woodall Adm Dir Phy SVCs 45.00 0.00 X 171085 0 17859 Lisa Ritch Corp Controller 45.00 0.00 X 164815 0 11342 Teresa Waters Director 45.00 0.00 X 165825 0 12091 Shannon M Stinson VP-Chief Medical Informatics 0.00 0.00 X 243535 0 3842 5801920 537520 114 true true false Crothall Healthcare 13028 Collection Center Drive Chicago IL 60693 Plant & Houskeeping 10753420 EPIC Systems Corporation PO BOX 88314 Milwaukee WI 53288 EPIC Support 7663355 McKesson Information Solutions PO Box 98347 Chicago IL 60693 System Support 2792656 Morrisons Management Specialists PO Box 102289 Atlanta GA 30368 Food Services 5133423 ENCORE HEALTH RESOURCES LLC PO Box 4652 Houston TX 77210 System Support 8850166 78 307939 40000 487025 834964 Ask-A-Nurse 541900 211388 211388 Home Health Services 621610 7530595 7530595 Other Program Services 900099 256947 256947 Patient Service Revenue 900099 396876497 396876497 Physician Answering SVC 541900 362149 362149 134300 134300 405371876 14139942 14139942 0 0 3556838 1577 2501600 1055238 1577 1056815 -20982 1077797 121454069 171455 107905299 26921 13548770 144534 13693304 13693304 0 0 0 EHR Incentive Program 900099 3498338 3498338 Employee Pharmacy 446110 2385659 2385659 Outreach Lab 4295606 4295606 414167 414167 10593770 445690671 409284381 4274624 31296702 1133963 1133963 0 0 0 5097188 1061186 4036002 0 120546334 116797343 3748991 6095021 5905466 189555 27289459 26440757 848702 10809228 10473061 336167 14810751 14350137 460614 397308 397308 247478 247478 201806 201806 0 1446813 1446813 21504825 20836025 668800 1110502 1075965 34537 960068 930210 29858 7086329 6865944 220385 0 5906479 5722788 183691 1029595 995334 34261 0 0 8781279 8781279 0 32074647 31077125 997522 5875081 5692366 182715 Med Surg supplies 81843042 81843042 Bad Debt Expense 30510534 30510534 Reparis & Maintenance 6902225 6687566 214659 GA DCH Hospital Tax 4912048 4912048 7580291 7268063 312228 404152294 375666875 28485419 0 15401274 26777647 21337699 17338179 0 64516903 64366859 0 0 9903818 12617422 6884019 8156732 6734130 7569241 536271301 304972931 235627093 231298370 328823397 383590238 0 0 0 62891750 29906972 752120083 781621660 26986254 16879455 146265503 143820264 3528438 63830027 150517294 95065361 327297489 319595107 X 424787594 461991553 35000 35000 424822594 462026553 752120083 781621660 X 41538377 14395558 -18729976 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 201806 201806 false false Part II-B, Line 1i - Other Activities Description A part of the various association dues include a percentage allocation for expenditures on Lobbying activities. Dues paid to the Georgia Hospital Association, The American Hospital Association, the Georgia Alliance of Community Hospitals, The Georgia Initiative. and the Georgia Chamber of Commerce, all have a lobby component. For 2013 these fees amounted to $153,806. Additionally, Oglethorpe Consulting Group was contracted during 2013 to review and advise the Hospital on legislative issues. During 2013 $48,000 was paid to Oglethorpe Consulting Group. 14764946 14764946 255212962 121097315 134115647 258270088 183875616 74394472 8023305 8023305 231298370 Accrued Compensation, Benefits, & PR Tax 16252849 Accrued Pension Cost 593134 Accrued postretirement benefit cost 25406380 Amount due to Affiliate 4572086 Asset Retirement Obligation 1834785 Est Third Party Payor Settlements 26012364 Other Current Liabilities 1609749 Reserve for Self Insured Losses 18784014 95065361 X Part X : FIN48 Footnote Accounting for Income Taxes - University Health Services is exempt from federal income tax under Section 501(a) as organizations described in Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. Accordingly, the accompanying financial statements do not reflect a provision or liability for federal and state income taxes. University Health Services has evaluated their tax positions and determined that they do not have any material unrecognized tax benefits or obligations as of December 31, 2013. Fiscal years ended on or after December 31, 2010 remain subject to examination by federal and state authorities.There is presently no taxation imposed by the government of the Cayman Islands on income or premiums of WWI. As a result, no tax liability or expense has been recorded. Caribbean 1 2 Insurance Captive 0 1 2 1 2 false false true false false false Part I - Additional Supplemental Information Please see form 5471 filing for details related to Offshore Captive Insurance true true true X true X true true true false true true 19587682 2537119 17050563 0.04220 44095662 33437209 10658453 0.02640 63683344 35974328 27709016 0.06860 15614119 1502175 14111944 0.03490 983601 437383 546218 0.00140 1238226 1238226 0.00310 17835946 1939558 15896388 0.03940 81519290 37913886 43605404 0.10800 76304 76304 0.00020 76304 76304 0.00020 true 30510534 8542950 107352727 152569300 -45216573 X true true 1 1 University Health Services Inc 1350 Walton Way Augusta GA 30901 121-375 X X X X Home Health Agencies University Health Services Inc 1 true X X X X X X X X X 13 true true true X www.universityhealth.org X X X X X X false false false true true 200.0000 true 400.0000 true X X X X X true true X X X X X true false true X false false Part V, Line 3 - Account Input from Person Who Represent the Community Many local organization and Hospital staff contributed to the 2013 Community Health Needs Assessment. These individuals and their local organizations represent an inventory of community services already available to address needs of the Augusta area. The following is a summary of those organizations and individuals. Please see page 28 of the 2013 Community Health Needs Assessment for more details.Public Health Departments Key Staff- Dr. Ketty Gonzales, DirectorGeorgia Regents University Augusta School of Nursing Key Staff- Christine O'Meara, Special Projects CoordinatorProject Access Key Staff-Dr. Terence CookGreater Augusta Healthcare Network (GAHN) Key Staff- Lucy Marion, Dean of the School of Nursing, GRUChrist Community Clinic Key Staff- Dr. Robert CampbellUnited Way's 1st Stop 211 Key Staff- Amy RickardUniversity Medical Associates Key Staff- Dr. Daniel BooneUniversity Health Care Foundation Key Staff- Laurie Ott, President of UHCFUniversity Health Care System Departments Key Staff- Lynda Watts, CNO Lynn Beaulieu, Emergency Dept Director, EMS Council GAHN Denise Gibson-Cato, Emergency Dept Nurse Manager Marie Jackson, Pharmacy Director Heidi Nelson, Disease Management Director Ellen Tereshinski, Home Health/ Hospice University Extended Care Director Mary Goolsby, National Nurse Practitioner Debra Whitley, Manager of Diabetes ServicesEmory University Nell Hodgson Woodruff School of Nursing Key Staff- Dr. Bonnie Jennings, ProfessorArea Agency on Aging Key Staff- Jeanette Cummings Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment Georgia Regents University Medical Center of Augusta Part V, Line 7 - Explanation of Needs Not Addressed and Reasons Why Teen Pregnancy- Area schools and the Health Department have programs geared to address this issue.Sexually Transmitted STIs- Area schools and the Health department have programs to address this issue. Part V, Line 14g - Other Means Hospital Facility Publicized the Policy Financial Counselors & Access Coordinators explain to Patient and offer Financial Assistance form to patient. Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) Also uses Asset Test, regardless of income, to determine eligibility for free and discounted care. In addition the hospital takes into consideration Bankruptcy and financial standing when offering discounts on patient liability. Part I, Line 7 - Explanation of Costing Methodology Used Cost to Charge Ratio calculated using Worksheet 2 --the optional worksheets provided to assist in preparation of Schedule H. Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and co-payment balances due for which third-party coverage exists for part of the bill), UHS records provision for bad debts in the period of service on the basis of its 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) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. Recoveries of accounts previously written off are recorded as a reduction to the provision for bad debt expense when received. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit Bad Debt should be included as a Community Benefit since the services that incur bad debt are provided by the hospital to promote the well-being of the community. These services are rendered in conjunction with the Hospital's charitable tax-exempt purposes. There is no local support for uninsured patients; therefore, the services provided by the hospital relieve the health care burdens of the local governments. Part III, Line 4 - Bad Debt Expense Footnote from Page 8 of the Audited Financial Statement:"Patient Accounts Receivable - Patient accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Corporation analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision 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 associated with self-pay patients (which includes both patients without insurance and patients with deductible and co-payment balances due for which third-party coverage exists for part of the bill), the Corporation records a provision for bad debts in the period of service on the basis of its 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) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. Recoveries of accounts previously written off are recorded as a reduction to the provision for bad debt expense when received." Part III, Line 8 - Explanation Of Shortfall As Community Benefit The services provided to the Medicare Beneficiaries are to promote the well-being of the community which is part of the Hospital charitable tax-exempt purpose. The Medicare difference between cost and Medicare reimbursement should be allowed as Community Benefit since providers can not negotiate rates with Centers for Medicare/Medicaid Services (CMS). CMS regulates that the reimbursement be federal budget neutral thus placing the cost of the caring for Medicare beneficiaries as a cost to the Hospitals. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients As outstanding balances age, statement messages, collection letters and/or telephone calls may be used at appropriate intervals determined by the Patient Accounting/Collection Department. The Patient Accounting /Collection Department recognizes that there are occasions when a patient is not financially able to pay their medical bill in full and/or the patient is experiencing financial hardship. The Hospital has established a Catastrophic Policy which allows for the Collection Department to apply the Indigent criteria and write-off as Medically Indigent. And at any point during the collection process if patient states or Patient Accounting/Collections believes that the patient can not afford to pay then an indigent/Charity Care application is begun by the Collection Department where discounts may be given. Part VI - Needs Assessment In addition to the CHNA performed in 2013, UH works with ER personnel to identify needs based on patients seeking help through the Emergency Room. This process still shows that patients need a medical home, asthma, CHF & diabetes assistance. The programs that UH has initiated and continue to support. UH also used the Healthy People 2020 framework to guide data gathering for leading health indicators. Part VI - Patient Education of Eligibility for Assistance UH has the following information available to patients and visitors on the eligibility for assistance. Information is available on the University Hospital web site, patient/visitor information booklet, and UH has signage at registration and billing areas that ask "... help with your Hospital bill?" In addition, when a registering patient indicates that he/she can not afford to pay, UH will offer the Indigent and Charity Care Application (ICCP) and set up patient to speak with the Financial Assistance Office (FAO). FAO will direct patients to a Department of Family and Children (DFCS) case manager located at the hospital to see if patient qualifies for state Medicaid or the UH ICCP program. The patient may be deemed to qualify for other State/Federal assistance in which the FAO staff will help direct the patient to another group operated out of of the hospital, Resource Corporation of America (RCA), to assist with getting the patient qualified for SSI, etc. Part VI - Community Information Richmond County is a county located in the U.S. state of Georgia. As of the 2010 census, the population was 200,549. It is one of the original counties of Georgia, created February 5, 1777.Following an election in 1995, the city of Augusta (the county seat) consolidated governments with Richmond County. The consolidated entity is known as Augusta-Richmond County, or simply Augusta. The cities of Hephzibah and Blythe in southern Richmond County voted to remain separate and not consolidate.Richmond County is included in the Augusta-Richmond County, GA-SC Metropolitan Statistical Area.As of the census of 2000, there were 199,775 people, 73,920 households, and 49,526 families residing in the county. The population density was 616 people per square mile (238/km). There were 82,312 housing units at an average density of 254 per squaremile (98/km). The racial makeup of the county was 49.75% Black or African American, 45.55% White, 0.28% Native American, 1.50% Asian, 0.12% Pacific Islander, 1.01% from other races, and 1.78% from two or more races. 2.78% of the population were Hispanic or Latino of any race.There were 73,920 households out of which 33.60% had children under the age of 18 living with them, 41.80% were married couples living together, 20.80% had a female householder with no husband present, and 33.00% were non-families. 27.70% of all households were made up of individuals and 8.50% had someone living alone who was 65 years of age or older. The average household size was 2.55 and the average family size was 3.13.In the county the population was spread out with 26.80% under the age of 18, 12.00% from 18 to 24, 29.90% from 25 to 44, 20.50% from 45 to 64, and 10.80% who were 65 years of age or older. The median age was 32 years. For every 100 females there were 93.20 males. For every 100 females age 18 and over, there were 89.80 males.The median income for a household in the county was $38,004, and the median income for a family was $52,892. Males had a median income of $30,028 versus $23,512 for females. The per capita income for the county was $18,133. About 16.20% of families and 19.60% of the population were below the poverty line, including 27.20% of those under age 18 and 14.10% of those age 65 or over. Part VI - Community Building Activities The Community Building Activities reported are support for the various Chambers of Commerces for the communities that we serve. In supporting these organizations we can support the development of our community by bringing in new industries and jobs, increasing the average household income, improving living conditions, and impacting overall general health. In 2013 University Health Services, Inc. invested $76,304 in this support (see Part II, Sch H). Also University Health Services also works with the following community organizations to support and promote health in our community:The Public Health DepartmentGeorgia Regents University Augusta School of NursingProject AccessGreater Augusta Healthcare Network (GAHN)Christ Community Health ServicesBeulah Grove Community ResourcesCoordinated Health ServicesHarrisburg Family HealthMiracle Making MinistriesNeighborhood Improvement ProjectUnited Way's 1st Stop 211Area Agency on Aging Part VI - Explanation Of How Organization Furthers Its Exempt Purpose UH governing Board members are comprised of citzens who reside in the UH's primary service area and are neither employees nor contractors of UH. UH Board members are active in the community and are eager to improve the health and welfare of the community. Several of UH Board Members worked with the local State Medical School to get interns & residents at the hospital since UH is among several counties that have been deemed as a Health Professional Shortage Area (HPSA). UH extends medical staff privileges to all qualified physicians in our community for all of the UH Departments.UH works with the Greater Augusta Healthcare Network (GAHN) which is made up of area hospitals and the local Medical Colleges School of Nursing and area primary care clinics. This group addresses the primary and specialty care needs in the community. UH supports the Project Access Program (PJA) in Richmond and Columbia County. PJA is a program whereby the local Medical Society Physicians agree to treat a number of Indigent county residents without payment. UH provides all of the Inpatient hospitalization for the Indigent population that is approved for Project Access. Through both of these groups UH is responsive to support them in their needs.UH provides many screenings in the community. One such screening is the PSA screening that is performed at Lowes Home Building stores. Many have received the screening and received positive results which were caught at an early stage. UH's Mobile Mammography unit travels to area plants and is available for screenings at the job site during lunch. These are only a few screening of the Screenings that UH provides in the community but have tremendous impact when just one screening identifies problems that can be treated at an early stage 1 cancer verses at the later stages of cancer. Part VI - States Where Community Benefit Report Filed GA Part V - Explanation of Number of Facility Type UH owns and operates three (3) Home Health Agencies as hospital-based agencies. true American Cancer Society 250 Williams Street NW Atlanta GA 30303 131788491 501(c)(3) 15000 0 Support Research Beulah Grove Community Resource 1446 Lee Beard Way Augusta GA 30901 582159621 501(c)(3) 40000 16211 Cost EPIC Clinical System, Lab Tests Clinic Finanical Support Christ Community Health Services 519 Scotts Way Augusta GA 30909 205404353 501(c)(3) 360000 211931 Medicare Cost Report Donated Facilities Clinic Financial Support Coordinated Health Services Inc 2110 Broad Street Augusta GA 30904 582060572 501(c)(3) 140000 8821 Cost of Tests Lab Testing Clinic Financial Support Harrisburg Family Health 423 Crawford Ave Augusta GA 30904 264366421 501(c)(3) 100000 0 Clinic Financial Support Miracle Making Ministries 1127 Druid Park Ave Augusta GA 30904 582358627 501(c)(3) 40000 0 Clinic Financial Support Neighborhood Improvement Project 2467 Golden Camp Road Augusta GA 30906 311491242 501(c)(3) 192000 0 Clinic Financial Support 7 0 Grantmaker's Description of How Grants are Used University Health Care System does not provide "grants" to assist other organizations, but does donate funds based on the following policy and procedures: POLICY:University Health Care System is committed to the overall health and well-being of the communities it serves and recognizes the need to support other non-profit organizations who share this commitment. Corporate contributions and sponsorships are sometimes an appropriate vehicle for building partnerships with these non-profit organizations and maximizing our overall positive impact on the community.PROCEDURE1.All contribution/sponsorship requests should be submitted in writing to the Corporate Communications Department for consideration. Every effort should be made to process these requests and notify the requester within two weeks of receiving the written information required to evaluate the opportunity.2.In consultation with the CEO, the Director of Corporate Communications will prepare the annual budget for Corporate Contributions/Sponsorships and process/manage actual disbursements throughout the year.3.Requests will be evaluated based on the following criteria:a.Does the organization, event or publication promote the overall health and well-being of the communities we serve? Special consideration will be given to requests that directly impact health and wellness even though support may be available for organizations, events and/or publications that have a positive impact on the CSRA by:"assisting in attracting and retaining a viable work-force"assisting in attracting and retaining viable businesses and employers in the CSRA"promoting the continued growth and economic well-being of the community"enhancing the quality of life in the CSRAb.Does the proposed contribution/sponsorship primarily assist people locally rather than a national effort/initiative?c.Does the requesting organization have an approved tax-exempt status?d.Will the proposed contribution/sponsorship enhance the overall image/reputation of University Health Care System?e.Will the proposed contribution/sponsorship heighten awareness of a significant health issue or disease that has a negative impact on the citizens in the communities we serve?4.Under no circumstances will contributions be made to political campaigns.5.Because of the large number of public and private schools in the CSRA, University will limit financial support/contributions to the various Boards of Education rather than individual schools (elementary, middle and high schools).6.Because of the large number of churches in the CSRA, University will limit financial support/contributions to programs that include health-related services for underserved residents such as community clinics.7.Exception: Financial support and partnerships with area colleges and technical schools do not fall under this policy. X true true X X X X X true true false false false true false false false false Dave A Belkoski CFO 377770 95254 95848 10351 16197 595420 Edward L Burr VP-Legal Affairs-Compliance 265069 72317 39315 45431 15261 437393 James R Davis President & CEO 623567 152342 21594 246139 14338 1057980 John C Pope PA 148539 150 33316 907 7205 190117 Kyle E Howell VP-Support-Ancillary Systems 176213 51480 42881 6690 9942 287206 Laurie Ott Smith President-Foundation, VP HR-CommSV 216023 35648 36910 6779 1626 296986 Leslie A Clonch VP-Chief Information Officer 231844 60348 33983 1402 14448 342025 Lisa Ritch Corp Controller 153180 10650 985 5219 6123 176157 Lynda Jones Watts VP Patient Care Svcs-CNO 208092 2500 34333 6994 10414 262333 Marilyn A Bowcutt President 392313 112082 68454 9217 7446 589512 Sandra McVicker CEO-University Hospital McDuffie 248351 35963 7452 8069 299835 Shannon M Stinson VP-Chief Medical Informatics 243535 3842 247377 Stephen M Gooden VP-Clinical Transformation 274327 66147 30102 1582 8385 380543 Tara A Kattine Physician 229436 17955 7228 7122 261741 Teresa Waters Director 148983 16300 542 5559 6532 177916 Timothy L Woodall Adm Dir Phy SVCs 166034 5051 6033 11826 188944 William L Farr Jr CMO 353721 91656 45817 9540 12221 512955 Part I, Line 1a: Relevant information in regards to selections on 1a. Social Club Dues- The organization pays membership fees for the CEO (James Davis) CFO (David Belkoski) to the Augusta Country Club and West Lake Country Club. These membership fees are paid so the organization can have access to the meeting facilities and catering services these organizations provide for meetings that are held off campus. Any personal use related to these memberships are included in the wages of the CEOs and CFO. A The Richmond County Hospital Authority 586001901 764603AV8 2009-12-03 150901243 Refund Bond Certificates (Bond Series 99,03,08) false false false A 7080979 150901243 1243 150900000 2008 true false true true A false true false false 0.03000 0.00200 0.03200 false false false A false true false false false false A false Part VI $150,900,000 was used to refund prior bonds issued 1999, 2003, and 2008 Rhonda U Belkoski Spouse of CFO 25543 Employee Comp as RN false Natalie H Thompson Dau-Bd Memb 40028 Employee Comp as RN false Rebecca E Smith Dau Bd Mem 57425 Employee Comp as RN false Form 990, Part VI, Line 1a: Explanation of Delegated Broad Authority to Committee In January 1985, the full Board approved the formation of an Executive Board by passing the following resolution:Be it resolved that an Executive Committee of University Health Services, Inc. be created to meet on a routine basis, such committee being composed of seven members. The size of the committee may be changed from time to time by the Chairman of the Board but must always conform to the bylaws. The tasks of the committee shall consist of planning, capital expenditure review, and financial review of the activities of University Health Services, Inc. The Executive Committee may act on behalf of University Health Services, Inc. and on budgeted capital requests; however, all capital requests in excess of $500,000 must be acted on by the full Board of Trustees. Form 990, Part VI, Line 11b: Form 990 Review Process A copy of the 990 form and all related schedules was provided to the governing board before filing in electronic form. An email was sent to all members of the governing body containing a link to a password-protected web site on which the entire 990 could be viewed. The email explained that the Form 990 was available for review on the web site. Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts The steps in the conflict of interest policy are outlined below:1.Senior management (vice presidents and above) shall complete a Potential Conflict of Interest Questionnaire periodically. Each System organization's CEO, COO, CFO and within their divisions' vice presidents may require any employee to complete a Potential Conflict of Interest Questionnaire.2.Each employee is expected to report a potential conflict of interest when it arises.3.A. An employee will report a potential conflict by initiating a Potential Conflict of Interest Disclosure Form and delivering it to his/her vice president. All employee potential conflicts will be screened by two levels of senior management to identify conflict or duality of interest situations. (A duality of interest exists when an individual has personal or outside interests that can be affected by decisions of the System. Such a duality or even multiplicity of interest can be beneficial to and consistent with the primary goals of the institutions. Duality of interest can raise the potential for conflict of interest when the personal interests of individuals come into conflict with the interests of the System.) B.When a division vice president is notified of a potential conflict/duality of interest, the vice president shall investigate the situation and make a report of his or her findings along with a recommendation to the Executive Vice President (COO) or CEO of the involved System organization.C.The Executive Vice President or CEO who received the 3.B report shall make a decision concerning a potential conflict of interest and any resolution measures to be taken. In the event the potential conflict involves a vice president, the President of University Health shall investigate the situation and make a decision concerning a potential conflict of interest and any resolution measures to be taken. This information shall be communicated directly to the concerned employee.D.The employee may appeal the conflict of interest determination to the President of University Health. The President's decision about a potential conflict of interest and any resolution measures is final and not cognizable under the Employee Grievance Policy A-30.E.In the event the potential conflict involves the CEO of any System organization, the matter shall be reported to the Chairman of the involved System organization board, who shall determine if a conflict exists and what, if any, resolution measures are necessary in accordance with that corporation's conflict of interest policy. 4.Filing of FormsA.Conflict of Interest Questionnaires of those who are required by this policy to complete one periodically shall be filed in the applicable corporation's CEO's office and retained for no less than seven years. Optional Conflict of Interest Questionnaires shall be filed in the office of the vice president who requested completion of the form.B.Completed Potential Conflict of Interest Disclosure Forms shall be filed in the applicable corporation's CEO's office for the CEO, COO, and vice presidents and for all others in the appropriate vice president's office. The forms should be retained for no less than seven years.5.The Vice President for Legal Affairs will be available to advise on potential conflict of interest matters.BOARD MEMBERS:Board Members are also required to complete a Potential Conflict of Interest Questionnaire annually. This questionnaire asks for disclosures related to any family relationships or business relationships with other board members, or business relationships with the Organization. Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The Organization follows the process described in Treasury Regulation 4958(6)(c) for establishing the rebuttable presumption of reasonableness in the review, approval, and documentation of officer, key management, and director compensation. Annually a compensation committee of the University Health Services Board, comprised of three independent board members, reviews the compensation of the CEO and other senior management members. The review is conducted in the context of a Board approved executive compensation philosophy. Both the development of the compensation philosophy and the review involve the advice and assistance of an independent compensation consulting firm. Minutes of the compensation committee are recorded. The compensation committee reports to the University Health Services Board Executive Committee. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available All governing documents, policies, financial statements, and informational returns are available upon request at the Administrative offices.The 990 is also available on www.Guidestar.org Other Changes In Net Assets Or Fund Balances - Other Increases Change in unfunded pension gains = $44196042 Other Changes In Net Assets Or Fund Balances - Other Increases Other Cumulative Effect on Asset Retirement Obliations = $279390 Other Changes In Net Assets Or Fund Balances - Other Decreases Rounding = -$0 Other Changes In Net Assets Or Fund Balances - Other Increases Rounding = $1 Other Changes In Net Assets Or Fund Balances - Other Decreases Transfer to Affiliate = -$63205409 Walton Way Indemnity SPC 2nd Fl Governors Sq 23 Lime Tree Grand Cayman CJ Insurance Captive CJ -634159 35092408 University Health Services Inc Richmond County Hospital Authority 1350 Walton Way Augusta GA 30901 586001901 Leased facilities GA 501(c)(3) 3 N/A false University Extended Care Inc 1350 Walton Way Augusta GA 30901 581581105 Skilled Nursing Homes GA 501(c)(3) 3 University Health Inc false Augusta Resource Center on Aging Inc 4275 Owens Road Evans GA 30809 581728812 Non Profit Life Care Community GA 501(c)(3) 9 University Health Inc false University Health Care Foundation Inc 2100 Central Avenue Suite D-1 Augusta GA 30904 581343550 Philantrophy GA 501(c)(3) 7 University Health Inc false University Health Inc 1350 Walton Way Augusta GA 30901 581581102 Consolidating Parent GA 501(c)(3) 9 N/A false University Hospice Inc 1350 Walton Way Augusta GA 30901 275008428 End of Life Support GA 501(c)(3) 9 University Health Inc false University McDuffie County Regional Medi 1350 Walton Way Augusta GA 30901 454166209 Hospital GA 501(c)(3) 3 University Health Inc false University Health Resources Inc 1350 Walton Way Augusta GA 30901 581601372 Services to Physicians GA University Health In C Corp false false false false true false false false false false true false true false false true false false false false