2014-05-14T07:18:27-05:00 2013-06-30 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2012-07-01 630288852 CHATTAHOOCHEE VALLEY HOSPITAL SOCIETY CHAT 3347561050 4800 48TH STREET VALLEY AL 368543666 TOMMY LANE 3347561050 2014-05-15 true JACQUELINE G ATKINS 2298837878 2014-05-13 2012 2015-11-30 17:44:51Z GEORGE H LANIER MEMORIAL HOSPITAL WILLIAM SCOTT PRESIDENT 4800 48TH STREET VALLEY AL 368543666 40548572 false X WWW.LANIERHOSPITAL.COM X 1942 AL TO PROVIDE MEDICAL SERVICES TO RESIDENTS OF CHAMBERS COUNTY, ALABAMA AND WEST POINT, GEORGIA. 19 18 717 75 48734 90245 60552 49479644 38705467 26666 267047 2101568 1507172 51698123 40540238 0 0 23339131 22823512 0 0 29023532 20241676 52362663 43065188 -664540 -2524950 37243295 33655439 20178285 19115379 17065010 14540060 TO PROVIDE MEDICAL SERVICES TO RESIDENTS OF CHAMBERS COUNTY, ALABAMA AND WEST POINT, GEORGIA. false false 39845971 39999906 CHATTAHOOCHEE VALLEY HOSPITAL SOCIETY OPERATES GEORGE H. LANIER MEMORIAL HOSPITAL (HOSPITAL), GEORGE H. LANIER NURSING HOME, AND LANIER HOME HEALTH SERVICE. THE HOSPITAL PROVIDES EMERGENCY SERVICES, AN ENCOSCOPY UNIT, SURGERY UNIT, CATH LAB, CARDIAC REHAB, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, RADIOLOGY LAB AND SLEEP DISORDERS LAB. THE HOSPITAL IS A LICENSED 115-BED NOT-FOR-PROFIT ACUTE CARE FACILITY PRIMARILY SERVING CHAMBER COUNTY, ALABAMA AND WEST POINT, GEORGIA. SERVICES PROVIDED INCLUDE GENERAL SURGERY, CARDIOLOGY, GENERAL MEDICINE, GASTROENTEROLOGY, PULMONARY, EMERGENCY MEDICINE, IMAGING/RADIOLOGY, DIALYSIS, AMBULATORY SURGERY AND SWING BED. THE GEORGE H. LANIER NURSING HOME IS A 103-BED SKILLED NURSING FACILITY. 39845971 true true false false false false false false false false true false false false true true true false false false false false false false true false true true false false true false false false false false false false true false false false false false true true true false false true 111 0 717 true true true false false false false false false false false false X 19 18 false false false false false false false true true false false true true true true false true true true false X DAVID WILKERSON 3347561050 4800 48TH STREET VALLEY AL 368543666 KRIS REDDY MD 3.00 X 8730 0 0 ARVIND KAMATH MD 3.00 0.10 X 8115 0 0 DOT ANDERSON 3.00 X 0 0 0 LUANNE D BERLIN 3.00 0.10 X X 0 0 0 ARTHUR PERKINS MD 3.00 X 0 0 0 KATE PRUITT 3.00 X 0 0 0 KAYE MAXWELL 3.00 X 0 0 0 CY WOOD 3.00 X 0 0 0 JOSH MOON 3.00 X 0 0 0 CURT KOLLAR 3.00 X 0 0 0 JAMES BENDELL MD 3.00 X 0 0 0 OSCAR CRAWLEY 3.00 X 0 0 0 GLORIA HULL 3.00 X 0 0 0 WILLIAM SCOTT III 3.00 1.00 X X 0 0 0 GAINES LANIER 3.00 X 0 0 0 VALERIE GRAY 3.00 X 0 0 0 TERRY VESTER MD 3.00 X 0 0 0 DAVID WILKERSON 3.00 0.10 X X 0 0 0 TERRY BISHOP 3.00 0.10 X 0 0 0 PENNY COLLINS 3.00 X 0 0 0 STEPHEN COLLINS MD 3.00 X 0 0 0 LEONARD RILEY 3.00 X 0 0 0 DOUG DEWBERRY 50.00 1.00 X 272401 0 12424 TOMMY LANE 50.00 X 130863 0 4657 RONALD EVANS MD 50.00 X 346655 0 9688 PHILLIPPE TRANQUI MD 50.00 X 311129 0 12424 DAVID FAGAN MD 50.00 X 310916 0 12287 MAX SHIVER MD 42.00 X 308434 0 12424 SERGE MISTIVAR MD 40.00 X 180482 0 8746 1877725 72650 11 false true false HUMAN PERFORMANCE & REHAB CTRS P O BOX 8068 COLUMBUS GA 319088068 PHYSICAL THERAP 1412923 LANGFORD CONSTRUCTION 314 GREENVILLE ST LAGRANGE GA 30240 CONTRACTOR 1198152 SIEMENS MEDICAL SOLUTIONS DEPT AT 40065 ATLANTA GA 31192 EQUIPMENT MAINT 719784 CPSI P O BOX 850309 MOBILE AL 366850309 IT SYSTEMS 403634 PHILIPS HEALTHCARE P O BOX 100355 ATLANTA GA 303845360 EQUIPMENT MAINT 317729 8 5000 10000 45552 60552 PATIENT SERVICE REVENUES 623000 38656733 38656733 REFERENCE LAB 621500 48734 48734 38705467 266947 266947 100 100 100 100 31500 5000 8334 23166 23166 MEDICAID EHR INCENTIVES 623000 1272995 1272995 CAFETERIA 722513 140833 140833 MISCELLANEOUS 621990 43651 43651 26527 26527 1484006 40540238 39999906 48734 431046 429075 8730 420345 19032805 18123025 909780 1973384 1855910 117474 1388248 1294402 93846 62988 62988 80130 80130 3302062 2974779 327283 41785 41785 2600906 2124128 476778 2056620 1872552 184068 57785 44392 13393 13240 10449 2791 2219358 2020725 198633 306575 197601 108974 MEDICAL SUPPLIES 5806538 5806538 PROVIDER TAX 2457855 2457855 REPAIRS & MAINTENANCE 790862 786011 4851 USE TAX 190664 190664 254308 78210 176098 43065188 39845971 3219217 0 1550 1550 4471526 4555660 7458895 5956840 235146 232425 169853 123055 63917826 44275272 21151155 19642554 1840185 1860385 372620 372620 1542365 910350 37243295 33655439 5535147 5637332 413483 461652 10280000 9585000 3757260 3341403 192395 89992 20178285 19115379 X 17065010 14540060 17065010 14540060 37243295 33655439 -2524950 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 600197 600197 39755318 23820100 15935218 1146755 1039916 106839 22352601 19415256 2937345 62955 62955 19642554 BOND INTEREST PAYABLE 89992 THIRD PARTY SETTLEMENTS 89992 X 40437879 40437879 102359 102359 40540238 43002829 43002829 62359 62359 43065188 LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X TAX STATUS THE SOCIETY IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE SOCIETY 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 SYSTEM 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 OR AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD 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 INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF JUNE 30, 2013 AND 2012 OR FOR THE YEARS THEN ENDED. THE SOCIETY'S OPEN AUDIT PERIODS ARE FOR TAX YEARS ENDED 2010-2012. REVENUE AMOUNTS INCLUDED ON RETURN - OTHER SCHEDULE D, PAGE 4, PART XI, LINE 4B WAIVER EXPENSE 46,670 SCHOLARSHIP/RECRUITING EXPENSE 15,689 CAPITAL CONTRIBUTION 40,000 EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER SCHEDULE D, PAGE 4, PART XII, LINE 4B WAIVER EXPENSE 46,670 SCHOLARSHIP/RECRUITING EXPENSE 15,689 GOLF TOURNAMENT 36500 5000 31500 2847 4710 777 36500 5000 31500 2847 4710 777 8334 23166 true true X true X true X 1.75000 true false true true 67667 67667 0.00160 9029869 8063545 966324 0.02240 162543 114442 48101 0.00110 9260079 8177987 1082092 0.02510 9260079 8177987 1082092 0.02510 105000 105000 0.00240 105000 105000 0.00240 true 7836765 14732568 14207267 525301 X true true 1 1 CHATTAHOOCHEE VALLEY HOSPITAL SOCIE GEORGE H LANIER MEMORIAL HOSPITAL

4800 48TH STREET VALLEY AL 368543666

WWWLANIERHOSPITALCOM X X X SNF; HOME HEALTH CARE; CLINICS CHATTAHOOCHEE VALLEY HOSPITAL SOCIE 1 true X X X X X X X X 13 true false true X X X X X false false true true 100.0 true 175.0 true X X X X true true X X X X true false X X X X true X false false 2 LANIER HOME HEALTH SERVICES

4800 48TH STREET VALLEY AL 368543666

HOME HEALTH AGENCY GEORGE H LANIER NURSING HOME

4800 48TH STREET VALLEY AL 368543666

SKILLED NURSING FACILITY EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE PART I LINE 7 COLUMN F IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN F THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990 PART IX LINE 25 FORM 990 PART IX LINE 25 43065188 ADD EXPENSES REPORTED IN PART VIII 8334 DENOMINATOR FOR COLUMN F 43073522 COSTING METHODOLOGY EXPLANATION PART I LINE 7 COSTS FOR PART I LINE 7A 7B AND 7C WERE CALCULATED USING THE RCC CALCULATED IN WORKSHEET 2 SEE ALSO THE EXPLANATION FOR PART III LINE 4 COMMUNITY BUILDING ACTIVITIES PART II THE ORGANIZATION PROMOTES COMMUNITY HEALTH BY OFFERING HEALTH FAIRS EDUCATION IN THE FORM OF LECTURES SEMINARS AND BROCHURES PARTICIPATION IN COMMUNITY SPONSORED EVENTS BAD DEBT EXPENSE EXPLANATION PART III LINE 4 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 EXCERPT FROM FOOTNOTE TO AUDITED FINANCIAL STATEMENT ALLOWANCE FOR DOUBTFUL ACCOUNTS ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE THE SOCIETY 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 THIRDPARTY COVERAGE THE SOCIETY ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS IF NECESSARY FOR EXAMPLE FOR EXPECTED UNCOLLECTIBLES DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRDPARTY PAYOR HAS NOT YET PAID OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY FOR RECEIVABLES ASSOCIATED WITH SELFPAY PATIENTS WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRDPARTY COVERAGE EXISTS FOR PART OF THE BILL THE SOCIETY RECORDS A SIGNIFICANT 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 IF NEGOTIATED AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS THE SOCIETYS ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELFPAY PATIENTS REMAINED CONSISTENT AT 82 OF SELFPAY ACCOUNTS RECEIVABLE AT JUNE 30 2013 AND 2012 HOWEVER THE SOCIETYS SELFPAY WRITEOFFS DECREASED APPROXIMATELY 1600000 FROM 10400000 FOR FISCAL YEAR 2012 TO 8800000 FOR FISCAL YEAR 2013 THE DECREASE IN WRITEOFFS IS PRIMARILY THE RESULT OF HAVING LESS SELFPAY ACCOUNTS RECEIVABLE OVERALL THE SOCIETY HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING FISCAL YEARS 2012 OR 2013 MEDICARE EXPLANATION 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 COLLECTION PRACTICES EXPLANATION PART III LINE 9B COLLECTION ATTEMPTS ON ALL ACCOUNTS ARE MADE BY THE HOSPITAL WITHIN THE FIRST 90 DAYS AFTER AN ACCOUNT GOES BEYOND 90 DAYS THE ACCOUNT IS SENT TO A COLLECTION AGENCY THE ACCOUNT STAYS WITH THE COLLECTION AGENCY FOR APPROXIMATELY 4 MONTHS AND IF NOT COLLECTED THE ACCOUNT IS SENT BACK TO THE HOSPITAL AND WRITTEN OFF AS A BAD DEBT NEEDS ASSESSMENT PART VI IN FEBRUARY 2013 LANIER HEALTH SERVICES CONDUCTED A COMMUNITYWIDE COMMUNITY HEALTH NEEDS ASSESSMENT CHNA THE ASSESSMENT WAS DESIGNED TO IDENTIFY THE HOSPITALS PRIMARY MARKET AREA BY COUNTY AND CITY USING VALID HEALTH INDICATORS AND COMPARATIVE INFORMATION IT WAS ALSO DESIGNED TO PROVIDE THE COMMUNITYS PUBLIC AND PRIVATE HEALTH PROVIDERS WITH INFORMATION TO ASSESS ESSENTIAL PUBLIC HEALTH PREVENTIVE CARE AND MEDICAL SERVICES ADDITIONALLY THE ASSESSMENT IDENTIFIES KEY SERVICES WHERE BETTER INTEGRATION OF PUBLIC HEALTH AND HEALTH CARE CAN IMPROVE ACCESS QUALITY AND COST EFFECTIVENESS THIS PROJECT REPRESENTS LANIER HEALTH SERVICES COLLABORATIVE EFFORTS TO SHARE INFORMATION THAT CAN LEAD TO IMPROVED HEALTH STATUS AND QUALITY OF CARE AVAILABLE TO THE HOSPITALS PRIMARY MARKET AREA RESIDENTS WHILE BUILDING UPON AND STRENGTHENING ITS EXISTING INFRASTRUCTURE OF SERVICES AND PROVIDERS WE USE THE STATE DEPARTMENT OF PUBLIC HEALTHS ANNUAL STATISTICAL REPORT TO LOOK AT THE HEALTHCARE NEEDS OF CHAMBERS COUNTY AND EVALUATE SERVICES NEEDED OR PROVIDED IN RESPONSE TO THAT REPORT OUR BOARD OF TRUSTEES ALSO REVIEWS AND DISCUSSES SERVICES AS PART OF OUR ANNUAL STRATEGIC PLAN UPDATE PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI A SOCIAL WORKER WORKS WITH PATIENTS AND EXPLAINS TO THEM OPTIONS THEY HAVE AVAILABLE AND TRIES TO HELP THEM QUALIFY FOR ANY OUTSIDE AID THAT MIGHT BE AVAILABLE WE ALSO HAVE AN INDIGENTCHARITY CARE POLICY FOR WHICH QUALIFYING PATIENTS ARE ELIGIBLE COMMUNITY INFORMATION PART VI THE ORGANIZATION SERVES A PREDOMINATELY RURAL AREA THE PRIMARY SERVICE AREA IS CHAMBERS COUNTY IN ALABAMA AND WEST POINT GEORGIA AND SURROUNDING AREA THE POPULATION OF CHAMBERS COUNTY IS APPROXIMATELY 34000 WITH A PER CAPITA INCOME OF 18478 AND A MEDIAN HOUSEHOLD INCOME OF 32181 APPROXIMATELY 233 OF THE POPULATION LIVES BELOW THE POVERTY LINE APPROXIMATELY 11 OF THE POPULATION HAS A BACHELORS DEGREE OR HIGHER EDUCATION APPROXIMATELY 26 OF THE POPULATION DOESNT HAVE A HIGH SCHOOL DIPLOMA THE UNEMPLOYMENT RATE IN THE COUNTY IS APPROXIMATELY 9 THE POPULATION OF WEST POINT GEORGIA IS APPROXIMATELY 3500 WITH A PER CAPITA INCOME OF 16735 AND A MEDIAN HOUSEHOLD INCOME OF 31886 APPROXIMATELY 199 PERCENT OF THE POPULATION LIVES BELOW THE POVERTY LINE THE AREAS CITIZENS EXPERIENCE HIGH LEVELS OF HEART DISEASE DIABETES AND CANCER HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI CVHS HAS BEEN INSTRUMENTAL IN PROVIDING HEALTHCARE AWARENESS TO THE COMMUNITY BY HOSTING NUMEROUS EVENTS INCLUDING AN ANNUAL HEALTH FAIR OPEN TO ALL RESIDENTS OF THE COMMUNITY OFFERING SERVICES FOR THE PEDIATRIC TO THE GERIATRIC RESIDENTS LANIER PROVIDED MINI HEALTH SCREENS AND FLU SHOTS TO VARIOUS BUSINESSES IN THE COMMUNITY OTHER EVENTS INCLUDE BREAST CANCER AWARENESS PRENATAL AND BREAST FEEDING EDUCATION CLASSES HEART HEALTH MONTH SELFMANAGED DIABETES CLASSES DIABETIC EYE DISEASE SEMINAR AND VARIOUS HEALTH RELATED SUPPORT GROUPS CVHS ALSO PARTICIPATES IN LOCAL SCHOOL OUTREACH PROGRAMS PROVIDING EDUCATION IN THE AREAS OF SMOKING CESSATION ALCOHOL HEALTHY EATING HABITS AND THE IMPORTANCE OF EXERCISE AND READING WE ALSO PARTICIPATE IN KID CHECK CAREER DAY EVENTS AND SCHOOL HEALTH FAIRS CVHS PARTICIPATED IN NATIONAL WELLNESS CAMPAIGN SCALEBACK ALABAMA AS WELL AS INVOLVING COMMUNITY PARTICIPATION IN SCALEBACK ALABAMA PHYSICIANS AND MIDLEVEL PRACTITIONERS SPEAK REGULARLY AT LOCAL CIVIC CLUBS TO PROVIDE HEALTHCARE AWARENESS AND PREVENTATIVE MEASURE INFORMATION CVHS PARTNERED WITH LOCAL LIBRARY TO PROVIDE PHYSICIAN DRIVEN EDUCATION SEMINARS CVHS HOLDS QUARTERLY FORUMS FOR LOCAL EMS DEPARTMENTS AFFILIATED HEALTH CARE INFORMATION PART VI CHATTAHOOCHEE VALLEY HOSPITAL SOCIETY OPERATES GEORGE H LANIER MEMORIAL HOSPITAL GEORGE H LANIER NURSING HOME LANIER HOME HEALTH SERVICE AND LANIER HEALTH SERVICES FOUNDATION THE HOSPITAL IS A 115BED NOTFOR PROFIT ACUTE CARE HOSPITAL AND THE NURSING HOME IS A 103BED EXTENDED CARE PROVIDER THE SOCIETY PROVIDES HEALTH CARE SERVICES PRIMARILY TO THE RESIDENTS OF CHAMBERS COUNTY ALABAMA AND WEST POINT GEORGIA THE FOUNDATION RAISES FUNDS THROUGH DONATIONS AND OTHER FUNDRAISING ACTIVITIES FOR THE SUPPORT OF CHATTAHOOCHEE VALLEY HOSPITAL SOCIETY CHATTAHOOCHEE VALLEY HOSPITAL SOCIE LINE NUMBER 1 PART V LINE 3 PART V LINE 3 TO HELP GUIDE THE PROCESS USED FOR THE ASSESSMENT A CHNA STEERING COMMITTEE WITH REPRESENTATIVES FROM LANIER HEALTH SERVICES WAS FORMED THIS COMMITTEES ROLE WAS TO PROVIDE INPUT ON A IDENTIFICATION OF EXISTING DATA SOURCES FOR THE STUDY B CONTENT OF THE COMMUNITY MEMBER SURVEY C INTERPRETATION OF SURVEY FINDINGS D REVIEW OF RECOMMENDATIONS AND E A FOLLOWUP PLAN THE CHNA STEERING COMMITTEE ALSO ENSURED THAT INFORMATION FROM OTHER LOCAL HEALTH ASSESSMENTS WAS INTEGRATED INTO THE CHAMBERS COUNTY ALABAMA CHNA IN ADDITION TO THE CHNA STEERING COMMITTEE AN ADVISORY COMMITTEE WAS CONVENED WITH REPRESENTATION FROM A DIVERSE GROUP OF STAKEHOLDERS TO ENSURE THAT THE DATA COLLECTED WOULD MEET THE NEEDS OF CHAMBERS COUNTYS POPULATION COMMITTEE MEMBERS REPRESENTED PUBLIC HEALTH LOCAL CITY GOVERNMENT BUSINESSES COUNTY SCHOOL HEALTH PHYSICIANS AND COMMUNITY SERVICE ORGANIZATIONS THE ADVISORY COMMITTEE PROVIDED CRITICAL INPUT INTO THE NEEDS ASSESSMENT FROM INITIAL CONCEPT TO HOW THE DATA WOULD BE SHARED WITH COMMUNITIES CHATTAHOOCHEE VALLEY HOSPITAL SOCIE LINE NUMBER 1 PART V LINE 5C PART V LINE 5C ALL THE PARTICIPATING COMMITTEE MEMBERS WERE PROVIDED COPIES OF THE FULL DOCUMENT FOR THEIR RESPECTIVE ORGANIZATIONS THE DOCUMENT IS LOCATED ON THE HOSPITALS WEBSITE AT HTTPWWWLANIERHOSPITALCOMPDFCHNAR041113PDF CHATTAHOOCHEE VALLEY HOSPITAL SOCIE LINE NUMBER 1 PART V LINE 6I PART V LINE 6I IN APRIL 2013 THE BOARD APPROVED THE CHNA REPORT AND STRATEGIES WERE DISCUSSED AT THAT TIME REGARDING THE HEALTH NEEDS OF THE COMMUNITY HOWEVER THROUGH AN OVERSIGHT THIS STRATEGY DISCUSSION WAS NOT FORMALIZED INTO A WRITTEN IMPLEMENTATION PLAN AT THE TIME THE BOARD AND MANAGEMENT WERE IN THE MIDDLE OF NEGOTIATIONS WITH EAST ALABAMA MEDICAL CENTER IN OPELIKA ALABAMA TO FORM AN AFFILIATION WHICH WAS ANNOUNCED AND BEGUN IN DECEMBER AND WHICH REACHED FINAL CLOSING IN JANUARY 2014 A WRITTEN IMPLEMENTATION PLAN HAS SINCE BEEN APPROVED BY THE BOARD AND IS ATTACHED CHATTAHOOCHEE VALLEY HOSPITAL SOCIE LINE NUMBER 1 PART V LINE 7 PART V LINE 7 CERTAIN NEEDS IDENTIFIED IN THE 2013 CHNA ARE NOT ADDRESSED BECAUSE EITHER THE ORGANIZATION ADDRESSES THE NEED BUT CURRENTLY HAS NO PLANS TO EXPAND SERVICES OTHER PROVIDERS ARE ALREADY ADDRESSING THE NEEDS AND THE NEED IDENTIFIED IS BEYOND THE SCOPE OF THE ORGANIZATION CHATTAHOOCHEE VALLEY HOSPITAL SOCIE LINE NUMBER 1 PART V LINE 14G PART V LINE 14G THE HOSPITALS SOCIAL WORKER REVIEWS CRITERIA AND ELIGIBILITY WITH ALL SELF PAY PATIENTS ADMITTED TO THE HOSPITAL CHATTAHOOCHEE VALLEY HOSPITAL SOCIE LINE NUMBER 1 PART V LINE 20D PART V LINE 20D THE ORGANIZATION BILLS SELF PAY PATIENTS BASED ON ESTABLISHED CHARGES AND OFFERS A 50 DISCOUNT IF PAID WITHIN 30 DAYS AFTER 30 DAYS THE DISCOUNT IS CALCULATED AT A SLIDING RATE BASED ON DAYS TO RECEIPT OF PAYMENT ULTIMATELY CHARGES FOR SELF PAY PATIENTS ARE REDUCED TO THE AVERAGE NEGOTIATED CHARGE FOR AN INSURED PATIENT X X X X false false false false false false false false false DOUG DEWBERRY 232401 40000 12424 284825 RONALD EVANS MD 346655 9688 356343 PHILLIPPE TRANQUI MD 311129 12424 323553 DAVID FAGAN MD 310916 12287 323203 MAX SHIVER MD 308434 12424 320858 SERGE MISTIVAR MD 180482 8746 189228 OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III THE CEO IS PAID AN ANNUAL PERFORMANCE INCENTIVE ONE-THIRD OF WHICH IS PAID FOR ATTAINMENT OF FINANCIAL PERFORMANCE TARGETS. CURT KOLLAR BD MBR/BANK CFO 1049508 BANK LOAN BALANCE false CURT KOLLAR BD MBR/BANK CFO 4794431 BANK CASH BALANCES false TOMMY LANE HOSP CFO/BK BD 1049508 BANK LOAN BALANCE false TOMMY LANE HOSP CFO/BK BD 4794431 BANK CASH BALANCES false ADDITIONAL INFORMATION SCHEDULE L PART V CURT KOLLAR CFO OF CHARTER BANK IS A BOARD MEMBER OF THE FILING ORGANIZATION THE ORGANIZATION HAS A LOAN WITH THE BANK IN THE AMOUNT OF 1049508 AS WELL AS VARIOUS CASH DEPOSITS TOTALING 4794431 AT FISCAL YEAR END THE CFO OF THE FILING ORGANIZATION TOMMY LANE SERVES ON THE BOARD AT CHARTER BANK ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS REVIEWED BY MANAGEMENT IN DETAIL FOR ACCURACY OF FINANCIAL AND OTHER DATA. THE FORM IS THEN DISTRIBUTED TO TRUSTEES BY POSTING ON LANIER'S WEBSITE UNDER A SECURE FORMAT/PASSWORD PROTECTED. IMMEDIATE NOTIFICATION OF ITS AVAILABILITY IS SENT TO THE BOARD'S EXECUTIVE COMMITTEE, WHICH HAS THE AUTHORITY TO ACT FOR THE FULL BOARD, VIA EMAIL FOR THEIR REVIEW AND EVALUATION, PRIOR TO FILING WITH THE IRS. REMAINING BOARD MEMBERS HAVE FULL ACCESS TO THE WEBSITE AND PERIODICALLY VISIT THE WEBSITE FOR ESSENTIAL BOARD MEETING MATERIALS. ANY QUESTIONS FROM THE GENERAL BOARD TRUSTEES ARE RESOLVED AT THE NEXT OFFICIAL BOARD MEETING. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C THE ORGANIZATION REQUIRES ALL BOARD MEMBERS AND MANAGEMENT EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY AND MONITORS THE COMPLIANCE WITH THIS POLICY. BOARD MEMBERS RECUSE THEMSELVES DURING DISCUSSIONS AND ANY VOTING IF THEY HAVE A CONFLICT OF INTEREST. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A A COMMITTEE COMPRISED OF INDEPENDENT BOARD MEMBERS REVIEWS THE ANNUAL PERFORMANCE OF THE CEO AND SETS THE COMPENSATION AFTER THE REVIEW. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B PERFORMANCE APPRAISALS ARE PERFORMED ANNUALLY BY THE CEO. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 AS A GENERAL RULE, THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. ANY WRITTEN REQUESTS BY THE PUBLIC WOULD BE REVIEWED AND ACTED UPON BY THE BOARD. LANIER HEALTH SERVICES FOUNDATION 4800 48TH STREET VALLEY AL 368543666 631286859 FOUNDATION AL 501C3 11A CVHS CHATTAHOOCHEE VALLEY HOSPITAL SOCIE true false false true false false false false false false false false false true true true false false false false LANIER HEALTH SERVICES FOUNDATION C 10000 FOUNDATION RECORDS LANIER HEALTH SERVICES FOUNDATION M -702 FOUNDATION NET INCOME LANIER HEALTH SERVICES FOUNDATION N AMOUNT INDETERMINABLE LANIER HEALTH SERVICES FOUNDATION O AMOUNT INDETERMINABLE