2014-11-07T14:11:24-06:00 2013-12-31 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2013-01-01 581734026 UPSON COUNTY HOSPITAL INC UPSO 7066478111 801 WEST GORDON STREET THOMASTON GA 302860027 JOHN WILLIAMS CFO 7066478111 2014-11-17 true JACQUELINE G ATKINS P00861721 2298837878 2014-11-07 2013 2015-11-30 17:44:51Z UPSON REGIONAL MEDICAL CENTER DAVID CASTLEBERRY CEO 801 WEST GORDON STREET THOMASTON GA 302860027 87575640 false X WWW.URMC.ORG X 1951 GA UPSON REGIONAL MEDICAL CENTER'S MISSION IS TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE SURROUNDING AREA, REGARDLESS OF THE ABILITY TO PAY. 7 7 731 95 642289 -374259 674701 774603 68626046 73698620 2270564 3253489 1694519 2051361 73265830 79778073 29751 30846 0 37327409 37839156 0 0 33162904 34913681 70520064 72783683 2745766 6994390 143577199 155255863 19356200 16518803 124220999 138737060 X UPSON REGIONAL MEDICAL CENTER'S MISSION IS TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE SURROUNDING AREA, REGARDLESS OF THE ABILITY TO PAY. false true 57775476 30846 73698620 UPSON REGIONAL MEDICAL CENTER OFFERS A COMPLETE LINE OF MEDICAL SERVICES INCLUDING 24-HOUR EMERGENCY CENTER, MEDICAL-SURGICAL CARE, OBSTETRICS, PEDIATRICS, WOMEN'S HEALTH SERVICES, AND MORE. PATIENT DAYS FOR THE YEAR TOTALED 12,961 IN 2013. 57775476 true true false true false false false false false false true false false false true true false true false false true false false false false false true true false true true true false false false false false false false false false false false false false false true true false false false true 114 0 731 true true true true CJ false false false false false false false false X 7 7 false true false false false false false true true false false true true true true true true true true false GA X JOHN WILLIAMS CFO 7066478111 801 WEST GORDON ST THOMASTON GA 302860027 JAMES J EDWARDS JR VICE CHAIRMA 0.75 0.15 X X 0 0 0 BARNEY HANCOCK SECRETARY/TR 0.75 0.15 X X 0 0 0 WILLIAM H HIGHTOWER IV CHAIRMAN 0.75 0.15 X X 0 0 0 KAY ROBINSON MEMBER 0.75 0.15 X 0 0 0 STEVE KEADLE MEMBER 0.75 0.15 X 0 0 0 RALPH P WARNOCK MD ASST SECTRET 0.75 0.15 X 0 0 0 KAY SEARCY MEMBER 0.75 X 0 0 0 DAVID CASTLEBERRY CEO 40.00 1.00 X 201540 0 26275 JOHN WILLIAMS CFO 40.00 1.00 X 196943 0 23065 ROBERT SOLYOMVARI MD SURGEON 40.00 X 623002 0 37127 BRANDON BOYCE MD SURGEON 40.00 X 612665 0 24118 DAVID PETERSON MD ANESTHESIOLO 40.00 X 562564 0 37127 STEVEN YANG MD ANESTHESIOLO 40.00 X 557984 0 18921 LOUIS MAMELI MD PHYSICIAN 40.00 X 269577 0 39718 3024275 206351 28 false true true WEST CENTRAL GA RADIOLOGY ASSOCIATES 115 COTTAGE COURTS THOMASTON GA 30286 RADIOLOGY CONTR 1462893 INNOVATIVE THERAPY CONCEPTS LLC 2 MASHBURN STREET SUITE 102 HAWKINSVILLE GA 31036 PHYSICAL THER 1193805 SODEXO INC & AFFILIATES PO BOX 536922 ATLANTA GA 303536922 CAFETERIA MGMT 1039430 DELL MARKETING LP 120 ROYAL STREET CANTON MA 02021 CONSULTANTS 1034456 FACILITY CONTROL GROUP INC 532 BROOKSHYRE COURT WOODSTOCK GA 30188 FACILITY MAINT 542926 22 100000 618409 56194 774603 PATIENT SERVICE REVENUE 621990 71683564 71683564 EHR INCENTIVES 621990 2015056 2015056 73698620 2875453 2875453 455421 317160 138261 138261 138261 7034988 823455 6790276 690131 244712 133324 378036 378036 WELLNESS CENTER 713940 618711 618711 PHYSICIAN BILLING SVC. FEE 722514 443175 443175 MISCELLANEOUS 561499 371164 371164 480050 23578 456472 1913100 79778073 73698620 642289 4662561 X 30846 30846 447823 447823 29545817 24820910 4724907 423884 358113 65771 5369912 4451134 918778 2051720 1700676 351044 493622 117894 375728 638720 638720 118983 118983 11181 11181 29521 29521 9014572 5981531 3033041 134073 1637 132436 3278553 2278838 999715 969353 489687 479666 2046887 1889481 157406 302319 218311 84008 21715 21715 5553350 5124628 428722 540492 513568 26924 MEDICAL SUPPLIES 7617533 7617533 REPAIRS & MAINTENANCE 2199181 978844 1220337 PROVIDER TAXES 989680 989680 MISCELLANEOUS 468005 69976 398029 485941 142189 343752 72783683 57775476 15008207 0 4182 1428 14524741 12894963 10110508 11271254 319378 379056 1782923 1909023 813011 873058 105140605 54475767 51461374 50664838 64228401 76960256 332681 301987 143577199 155255863 6241567 5897905 11085000 10350000 2029633 270898 19356200 16518803 X 124220999 138737060 124220999 138737060 143577199 155255863 6994390 7521671 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 11181 11181 false SCHEDULE C, PART II-B, LINE 1 THE ORGANIZATION PAYS ANNUAL DUES TO NATIONAL AND STATE INDUSTRY ORGANIZATIONS. A PORTION OF THOSE DUES ARE ATTRIBUTABLE TO THE LOBBYING ACTIVITIES OF THESE ORGANIZATIONS FOR THE BENEFIT OF THEIR MEMBERS. 1458199 1458199 57920984 23707058 34213926 880281 499660 380621 44838879 30269049 14569830 42262 42262 50664838 EST. THIRD PARTY PAYOR SETTLEMENTS 271083 RELATED PARTY -185 270898 X SCHEDULE D, PAGE 3, PART X THE HOSPITAL AND FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AND ARE TAX- EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE REMAINING WHOLLY OWNED SUBSIDIARIES ARE CONSIDERED DISREGARDED ENTITIES AND ARE INCLUDED IN THE HOSPITAL'S TAX FILINGS. THEREFORE, NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL AND FOUNDATION APPLY 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 HOSPITAL AND FOUNDATION ONLY RECOGNIZE THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT 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 DECEMBER 31, 2013 AND 2012 OR FOR THE YEARS THEN ENDED. THE HOSPITAL AND FOUNDATION'S TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAXING AUTHORITIES. FOR FEDERAL INCOME TAX PURPOSES, THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. false CENTRAL AMERICA & THE CARIBBEAN 1 1 INVESTMENTS 1858000 1 1 1 1 1858000 1858000 false false true false false false SCHEDULE F, PAGE 1, PART I, LINE 3 CENTRAL AMERICA & THE CARIBBEAN 0 1,858,000 true true X true X 1.250000000000 true X true true true false true true 6522 3429320 3429320 0.04690 14215 11387643 9799339 1588304 0.02170 20737 14816963 9799339 5017624 0.06860 9208 66629 66629 0.00090 376 9536 9536 0.00010 12428816 4172341 8256475 0.11290 8588 8588 0.00010 9584 12513569 4172341 8341228 0.11400 30321 27330532 13971680 13358852 0.18260 1 2 2644 2644 1 500 500 1 56 123910 123910 0.00170 3 58 127054 127054 0.00170 true 20361069 20812427 22349803 -1537376 X true true 1 1 UPSON COUNTY HOSPITAL INC DBA UPSON REGIONAL MEDICAL CENTER 801 WEST GORDON STREET THOMASTON GA 30286 WWW.URMC.ORG X X X O/P PHYS OFC; WELLNS CTR; AMB UPSON COUNTY HOSPITAL INC 1 true X X X X X X X X 12 true false true X WWW.URMC.ORG X X X X X X X X false false true true 125.000000000000 true 300.000000000000 true X true true X X X X X X X true false X X X X true X false false FACILITY 1, UPSON COUNTY HOSPITAL, INC. - PART V, LINE 3 THE CHNA HOSPITAL STEERING COMMITTEE ("CHSC") IDENTIFIED COMMUNITY LEADERS, PARTNERS, AND REPRESENTATIVES TO INCLUDE IN THE CHNA PROCESS. INDIVIDUALS, AGENCIES, PARTNERS, POTENTIAL PARTNERS, AND OTHERS WERE REQUESTED TO WORK WITH THE HOSPITAL TO 1) ASSESS THE NEEDS OF THE COMMUNITY, 2) REVIEW AVAILABLE COMMUNITY RESOURCES AND 3) TO PRIORITIZE THE HEALTH NEEDS OF THE COMMUNITY. REPRESENTATIVES OF GROUPS, OR INDIVIDUALS, WHO REPRESENT MEDICALLY-UNDERSERVED POPULATIONS, LOW INCOME POPULATIONS, MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASES WERE INCLUDED. COMMUNITY STAKEHOLDERS (ALSO CALLED KEY INFORMANTS) ARE PEOPLE INVESTED IN OR INTERESTED IN THE WORK OF THE HOSPITAL, PEOPLE WHO HAVE SPECIAL KNOWLEDGE OF HEALTH ISSUES, OR ARE PEOPLE IMPORTANT TO THE SUCCESS OF ANY HOSPITAL OR HEALTH PROJECT, OR ARE FORMAL OR INFORMAL COMMUNITY LEADERS. THE HOSPITAL IDENTIFIED OVER 120 COMMUNITY MEMBERS TO PARTICIPATE IN THE CHNA PROCESS. TWO-HOUR COMMUNITY HEALTH INPUT MEETINGS (COMMUNITY MEETINGS) AND ONE-HOUR COMMUNITY STAKEHOLDER INTERVIEWS (INTERVIEWS) WERE ESSENTIAL PARTS OF THE CHNA PROCESS. THREE COMMUNITY MEETINGS AND 10 STAKEHOLDER INTERVIEWS WERE CONDUCTED IN ORDER TO OBTAIN THE COMMUNITY'S INPUT INTO THE HEALTH NEEDS OF UPSON COUNTY. EACH COMMUNITY MEETING WAS DRIVEN BY AN AGENDA PLANNED IN ADVANCE. SIGN-IN SHEETS AND EVALUATIONS WERE ALSO USED. THE COMMUNITY HEALTH PROFILE WAS SHARED WITH THE PARTICIPANTS AT EACH MEETING. INFORMATION GATHERED FROM COMMUNITY MEETINGS, STAKEHOLDER INTERVIEWS, DISCUSSIONS WITH THE HOSPITAL LEADERSHIP TEAM, AS WELL AS A REVIEW OF DEMOGRAPHIC AND HEALTH STATUS, AND HOSPITAL UTILIZATION DATA WAS USED TO DETERMINE THE PRIORITY HEALTH NEEDS OF THE POPULATION. DRAFFIN & TUCKER, LLP PROVIDED THE CHSC WITH A WRITTEN REPORT OF THE OBSERVATIONS, COMMENTS, AND PRIORITIES RESULTING FROM THE COMMUNITY MEETINGS AND STAKEHOLDER INTERVIEWS. THE CHSC REVIEWED THIS INFORMATION, FOCUSING ON THE IDENTIFIED NEEDS, PRIORITIES, AND CURRENT COMMUNITY RESOURCES AVAILABLE. THE CHSC DEBATED THE MERITS OR VALUES OF THESE PRIORITIES, CONSIDERING THE RESOURCES AVAILABLE TO MEET THESE NEEDS. FROM THIS INFORMATION AND DISCUSSION, THE HOSPITAL DEVELOPED THE PRIORITY NEEDS OF THE COMMUNITY, EACH OF WHICH WILL BE ADDRESSED SEPARATELY IN THE HOSPITAL'S IMPLEMENTATION STRATEGY DOCUMENT. FACILITY 1, UPSON COUNTY HOSPITAL, INC. - PART V, LINE 5C THE FACILITY'S COMMUNITY HEALTH NEEDS ASSESSMENT FULL REPORT CAN BE FOUND AT HTTP://URMC.ORG/SYSTEM/MEDIA_FILES/ATTACHMENTS/39/ORIGINAL/URMC_REPORT_FINA LB.PDF?1355327495 FACILITY 1, UPSON COUNTY HOSPITAL, INC. - PART V, LINE 7 HEALTH NEEDS WITHOUT SPECIFIC IMPLEMENTATION STRATEGIES 1. MENTAL HEALTH THE COMMUNITY PREVALENCE OF MENTAL HEALTH ISSUES IS RELATIVELY SMALL IN NUMBER OF PERSONS AFFECTED. URMC IS AN ACUTE CARE HOSPITAL THAT PROVIDES EMERGENCY CARE FOR MENTAL HEALTH CONDITIONS, OFTEN ON A CHARITY CARE BASIS. URMC DOES NOT HAVE THE SPECIALIZED STAFF AND PHYSICIAN RESOURCES NEEDED TO ADDRESS MENTAL HEALTH ISSUES. MCINTOSH TRAIL AND PATHWAYS (BARNESVILLE) CURRENTLY PROVIDE FOCUSED MENTAL HEALTH SERVICES TO THE COMMUNITY. THE HOSPITAL WILL DEVELOP A RESOURCE DIRECTORY FOR THE COMMUNITY TO HELP INDIVIDUALS NAVIGATE THE HEALTHCARE SYSTEM AS IT RELATES TO MENTAL HEALTH. THE HOSPITAL WILL CONTINUE TO MEET THE ACUTE CARE AND EMERGENCY CARE NEEDS OF MENTALLY ILL PATIENTS IN THE COMMUNITY, WITH REFERRALS TO SPECIALIZED MENTAL HEALTH PROVIDERS WHEN APPROPRIATE. 2. TEEN PREGNANCY THERE IS A LACK OF COMMUNITY CONSENSUS ON THE RECOMMENDED CURRICULUM FOR SEX EDUCATION. THIS LACK OF CONSENSUS CREATES A BARRIER TO THE HOSPITAL DIRECTLY ADDRESSING THE NEED. A PARTNERSHIP BETWEEN THE SCHOOL SYSTEM AND PUBLIC HEALTH WOULD BETTER SERVE THIS IDENTIFIED NEED. AS STATED ABOVE, URMC WILL DEVELOP IMPLEMENTATION STRATEGIES TO ADDRESS TEEN LIFESTYLE ISSUES. THROUGH THESE STRATEGIES, THE HOSPITAL WILL ADDRESS LIFESTYLE CHOICES WHICH MAY CONTRIBUTE TO TEEN PREGNANCY. THE HOSPITAL WILL ALSO PROVIDE A RESOURCE DIRECTORY TO THE COMMUNITY TO IDENTIFY HEALTH RESOURCES FOR PREGNANT TEENS. FACILITY 1, UPSON COUNTY HOSPITAL, INC. - PART V, LINE 14G NOTICE EXPLAINING POLICY POSTED IN THE LOCAL NEWSPAPER QUARTERLY. FACILITY 1, UPSON COUNTY HOSPITAL, INC. - PART V, LINE 18E AVAILABILITY OF THE POLICY ON THE HOSPITAL WEBSITE. FACILITY 1, UPSON COUNTY HOSPITAL, INC. - PART V, LINE 20D THE FACILITY USES AN ESTIMATE OF THE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES IN DETERMINING WHAT TO BILL INDIVIDUALS WITH NO INSURANCE FOR PROVIDED SERVICES. 7 UPSON MEDICAL ASSOCIATES LLC 801 WEST GORDON STREET THOMASTON GA 30286 PHYSICIANS OFFICE UPSON REGIONAL WELLNESS CENTER LLC 801 WEST GORDON STREET THOMASTON GA 30286 WELLNESS CENTER UPSON AMBULANCE CO LLC 801 WEST GORDON STREET THOMASTON GA 30286 AMBULANCE SERVICE UPSON WOMEN'S SERVICES LLC 801 WEST GORDON STREET THOMASTON GA 30286 PHYSICIANS OFFICE UPSON FAMILY PHYSICIANS LLC 801 WEST GORDON STREET THOMASTON GA 30286 PHYSICIANS OFFICE UPSON SURGICAL ASSOCIATES LLC 801 WEST GORDON STREET THOMASTON GA 30286 PHYSICIANS OFFICE ORTHOPEDICS SPORTS MEDICINE & SURGE 801 WEST GORDON STREET THOMASTON GA 30286 PHYSICIANS OFFICE PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION SUBSIDIZED HEALTH SERVICES COSTS INCLUDE THOSE ATTRIBUTABLE TO UPSON MEDICAL ASSOCIATES, UPSON WOMEN'S SERVICES, UPSON SURGICAL ASSOCIATES, ORTHOPEDIC SPORTS MEDICINE, AND UPSON FAMILY PHYSICIANS TOTALING 9,839,136. THESE CLINICS PROMOTE HEALTH CARE FOR UNDERSERVED POPULATIONS IN THE AREA. PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE 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 72,783,683 ADD: EXPENSES ON PART VIII 317,160 DENOMINATOR FOR COLUMN (F) 73,100,843 PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATION'S "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS, 2008". FOR LINE 7A, COSTS WERE CALCULATED USING THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 AS PROVIDED IN THE IRS INSTRUCTIONS. SUBSIDIZED HEALTH SERVICES PRESENTED ON LINE 7G WERE BASED ON ACTUAL COSTS PER THE MEDICARE COST REPORT NET OF ASSOCIATED BAD DEBT, CHARITY AND MEDICAID EXPENSE. ALL OTHER COSTS PRESENTED IN THE TABLE WERE ACCUMULATED THROUGH THE COST ACCOUNTING SOFTWARE CBISA. PART II - COMMUNITY BUILDING ACTIVITIES AS ONE OF THE REGIONS LARGEST EMPLOYERS, UPSON REGIONAL MEDICAL CENTER INVESTS IN ITS SERVICE AREA TO DEVELOP WORKFORCE AND LEADERSHIP CAPACITY NEEDED TO STRENGTHEN THE REGION. THESE ACTIVITIES PROVIDE OPPORTUNITIES TO ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS. THESE ACTIVITIES SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF HEALTHCARE ORGANIZATIONS. THESE INCLUDE INVOLVEMENT WITH THE LOCAL AND STATE CHAMBERS OF COMMERCE PROVIDING LEADERSHIP TRAINING AND PARTICIPATION IN YOUTH LEADERSHIP PROGRAMS. PART OF THE COMMUNITY HEALTH IMPROVEMENT ADVOCACY INCLUDES OUR PHYSICIAN RECRUITMENT ACTIVITIES TO MEET THE HEALTH NEEDS OF THE UNDERSERVED, AND PHYSICIAN STUDENT LOAN REPAYMENT FOR 5 PRIMARY CARE PHYSICIANS WHO HAVE COME TO SERVE OUR COMMUNITIES. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE 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 ESTIMATED UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD- PARTY 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 SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLES AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL 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 ESTIMATED UNCOLLECTIBLE ACCOUNTS. PART III, LINE 8 - MEDICARE EXPLANATION MEDICARE COSTS REFLECT ALLOWABLE COSTS PER THE MEDICARE COST REPORT USING ACCEPTABLE ALLOCATIONS OF INDIRECT COSTS BASED ON STATISTICAL BASIS. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION ACCOUNTS KNOWN TO HAVE QUALIFIED FOR FINANCIAL ASSISTANCE ARE WRITTEN OFF WITH AN ADJUSTMENT INDICATING INDIGENT WRITEOFF. PART VI, LINE 2 - NEEDS ASSESSMENT UPSON REGIONAL MEDICAL CENTER (URMC) IS AN 115-BED NOT-FOR-PROFIT COMMUNITY HOSPITAL LOCATED IN THOMASTON. GEORGIA. IN 2012, THE HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO IDENTIFY THE HEALTH NEEDS OF UPSON COUNTY. THE IMPLEMENTATION STRATEGY FOR URMC WAS DEVELOPED BASED ON FINDINGS AND PRIORITIES ESTABLISHED IN THE CHNA AND A REVIEW OF THE HOSPITAL'S EXISTING COMMUNITY BENEFIT ACTIVITIES. UPSON REGIONAL MEDICAL CENTER SUSTAINS AND DEVELOPS COMMUNITY BENEFIT PROGRAMS THAT 1)ADDRESS PRIORITIZED NEEDS FROM THE 2012 URMC CHNA AND 2) RESPOND TO OTHER IDENTIFIED COMMUNITY HEALTH NEEDS. THE FOLLOWING PRIORITIZED NEEDS WERE IDENTIFIED BY THE COMMUNITY AND THE CHNA STEERING COMMITTEE. PARTICULAR FOCUS WAS PLACED UPON THESE NEEDS IN DEVELOPING THE IMPLEMENTATION STRATEGY. 1. ACCESS TO CARE 2. HEART DISEASE AND STROKE 3. CANCER 4. DIABETES 5. OBESITY 6. TEEN LIFESTYLE 7. RESPIRATORY 8 MENTAL HEALTH 9. TEEN PREGNANCY 10 ALCOHOL AND DRUG ABUSE 11. TRANSPORTATION 12. SEXUALLY TRANSMITTED DISEASES UPSON REGIONAL MEDICAL CENTER HAS ADDRESSED EACH OF THE HEALTH NEEDS IDENTIFIED IN THE CHNA. URMC DEVELOPED IMPLEMENTATION STRATEGIES TO ADDRESS EACH OF THE HEALTH ISSUES IDENTIFIED, WITH THE EXCEPTION OF MENTAL HEALTH, TEEN PREGNANCY, ALCOHOL AND DRUG ABUSE, TRANSPORTATION AND SEXUALLY TRANSMITTED DISEASES. IMPLEMENTATION PROGRESS SUMMARY IS AS FOLLOWS, WITH EACH ASTERISKED ("") AREA HAVING BEEN ACCOMPLISHED IN 2013. 1. ACCESS TO CARE (APPENDIX 1) A. RECRUIT PRIMARY CARE PHYSICIANS, TARGETED SPECIALISTS AND MID-LEVEL PRACTITIONERS B. PROVIDE CHARITY CARE C. DEVELOP A PRINT AND ONLINE CENTRALIZED RESOURCE DIRECTORY FOR UPSON COUNTY D. ALLOCATE FINANCIAL CONTRIBUTION TO THE PUBLIC HEALTH DEPARTMENT FORTH PROVISION OF PRIMARY CARE SERVICES 2. HEART DISEASE AND STROKE (APPENDIX 2) A. PROVIDE TOBACCO CESSATION CLASSES B. PROVIDE HEART DISEASE AWARENESS COMMUNITY EDUCATION AT LOCAL CHURCHES, REPRESENTATIVE OF THE UNDERSERVED COMMUNITY, AND CIVIC CLUBS C CONDUCT ANNUAL HEART SCREENINGS D CONDUCT BLOOD PRESSURE CHECKS AT COMMUNITY HEALTH FAIRS E PROVIDE DISCOUNTED EKGS AT COMMUNITY HEALTH FAIRS F PROVIDE COMMUNITY EDUCATION ON HEALTHY EATING AND WEIGHT CONTROL 3. CANCER (APPENDIX 3) A PROVIDE TOBACCO CESSATION CLASSES B OFFER CANCER SUPPORT GROUPS C PROVIDE CANCER AWARENESS COMMUNITY EDUCATION AT LOCAL CHURCHES REPRESENTATIVE OF THE UNDERSERVED COMMUNITY AND CIVIC CLUBS D. CONDUCT FREE MEN'S PROSTATE AND COLORECTAL CANCER SCREENING E OFFER DISCOUNTED SCREENING TESTS (PSA AND HEMOCCULT) AT COMMUNITY HEALTH FAIRS 4. DIABETES (APPENDIX 4) A PROVIDE MONTHLY DIABETES EDUCATION ON DISEASE MANAGEMENT AND NUTRITION B PROVIDE BLOOD GLUCOSE SCREENINGS AT COMMUNITY HEALTH FAIRS C OFFER A DIABETES EXERCISE CRASS TAILORED TO HIGH-RISK INDIVIDUALS D PROVIDE INSULIN TO UNINSURED/UNDERSERVED PATIENTS E PROVIDE, UPON MD REFERRAL, ONE-ON-ONE CONSULTS ABOUT DIABETES DISEASE MANAGEMENT F. PROVIDE LINKS TO ONLINE HEALTH EDUCATION RESOURCES VIA WWW.URMC.ORG 5. OBESITY (APPENDIX 5) A. COLLABORATE WITH THE WELLNESS CENTER AND FYCA TO HELP IMPLEMENT GEORGIA SHAPE AT THE LOCAL ELEMENTARY SCHOOL B. PROVIDE HEALTHY EATING/ACTIVE LIVING COMMUNITY EDUCATION C. CONDUCT BODY MASS INDEX SCREENINGS AT COMMUNITY HEALTH FAIRS D. PARTNER WITH CHILDREN'S HEALTHCARE OF ATLANTA TO OFFER STRONG4LIFE TRAINING AND CONTINUING EDUCATION OPPORTUNITIES FOR HEALTHCARE PROVIDERS AND EARLY CHILDCARE EDUCATORS (WWW.STRONG41IFE.COM). 6. TEEN LIFESTYLE (APPENDIX 6) A COLLABORATE WITH SCHOOL SYSTEM AND LOCAL SCHOOL OF DANCE TO ESTABLISH A "GIRL TALK" CHAPTER (WWW.DESIRETOINSPIRE.ORG) B COLLABORATE WITH SCHOOL SYSTEM AND FYCA ON 612 EMPLOYMENT EDUCATION C COLLABORATE WITH SCHOOL SYSTEM AND EMS ON AN ANTI-DRINKING AND DRIVING DEMONSTRATION D PARTNER WITH THE RECREATION DEPARTMENT TO PROVIDE HEALTHY EATING/ACTIVE LIVING EDUCATION TO LEAGUE PARTICIPANTS 7 RESPIRATORY (APPENDIX 7) A PROVIDE TOBACCO CESSATION CLASSES B CONDUCT PULMONARY FUNCTION TESTS AT COMMUNITY HEALTH FAIRS C COLLABORATE WITH SCHOOLS TO PROVIDE ASTHMA EDUCATION TO SCHOOL NURSES AND COACHES. D PROVIDE LINKS TO ONLINE HEALTH EDUCATION RESOURCES VIA WWW.URMC.ORG PRAISE IN THE PARK - ERMA MILLER FELLOWSHIP CHURCH - SAN SHORT DAWN MCCOY- SCHOOL PRESENTATION AND STRONG 4 LIFE UPSON HEALTH DEPT. - SALLIE B. TOOLKITS - SUE MANGUM UPSON HEALTH FAIR IN OCTOBER- DIFFERENT, BASIC - CARLISHA (HARRIS) LIVING WELL - MICHELE BARBER- AAA REGION 4 PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE UPSON REGIONAL MEDICAL CENTER INFORMS AND EDUCATES THE PATIENTS USING THE FOLLOWING PROCESSES: THE CHARITY CARE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IS POSTED IN THE ADMISSION AREAS, EMERGENCY DEPARTMENTS AND OTHER AREAS OF THE FACILITY IN WHICH ELIGIBLE PATIENTS ARE PRESENT. WE PROVIDE A COPY OF THE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION TO THE PATIENTS AS PART OF THE ADMISSION PROCESS. ADDITIONALLY, THE POLICY IS AVAILABLE ON THE HOSPITAL WEBSITE - WITH APPLICATION. A SUMMARY OF THE POLICY IS ALSO INCLUDED IN THE PATIENT BILLING. WE DISCUSS WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS QUALIFYING FOR MEDICAID OR STATE PROGRAMS AND ASSIST THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE. WE PROVIDE TRAINING TO THE STAFF ON FINANCIAL ASSISTANCE AND HOW TO QUALIFY PATIENTS FOR MEDICAID, SCHIP AND OTHER GOVERNMENT PROGRAMS. WE ALSO PROVIDE BROCHURES IN THE ADMISSIONS PACKAGE EXPLAINING THE AVAILABILITY, CRITERIA, AND THE PROCESS FOR APPLYING FOR FINANCIAL ASSISTANCE. OUR EFFORTS TO INFORM NON-ENGLISH SPEAKING PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY IS PROVIDED BY AN INTERPRETER THROUGH THE USE OF LANGUAGE LINE, A TELEPHONE INTERPRETATION SERVICE. PART VI, LINE 4 - COMMUNITY INFORMATION UPSON SERVES A SEVEN-COUNTY AREA IN MIDDLE GEORGIA, INCLUDING PIKE, LAMAR, UPSON, CRAWFORD, MONROE, MERIWETHER AND TALBOT COUNTIES. AS A WHOLE, THE SERVICE AREA, WHICH USED TO BE A BOOMING TEXTILE AREA, HAS RATES OF UNEMPLOYMENT, UNINSURED AND POVERTY THAT ARE HIGHER THAN THE STATE AVERAGE. THE POPULATION AGE MIMICS A BOWTIE, WITH LARGE NUMBERS OF ELDERLY AND LARGE NUMBERS OF CHILDREN UNDER THE AGE OF 18 AND A SHRINKING NUMBER OF MIDDLE-AGED CITIZENS. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH UPSON MADE APPROXIMATELY 9,000 CONTACTS WITH COMMUNITY HEALTH EDUCATION PROGRAMS, HEALTH SCREENINGS, HEALTH CARE SUPPORT VALUED AT 48,000 TO SUPPORT BETTER HEALTH. THROUGH SPONSORSHIPS AND DONATIONS, UPSON CONTRIBUTED MORE THAN 8,588 TO LOCAL CHARITIES, LIKE THE AMERICAN CANCER SOCIETY. UPSON REGIONAL MEDICAL CENTER CONTINUES TO WORK COLLABORATIVELY WITH THE LOCAL HEALTH DEPARTMENTS, COUNTY EXTENSION SERVICES, CIVIC CLUBS, AND CHURCHES TO PROVIDE ANNUAL HEALTH FAIRS, SCREENINGS AND EDUCATIONAL PROGRAMS. DUE TO THE CONTINUAL DECLINE OF INDUSTRY IN THIS AREA BEGINNING WITH THE TEXTILE INDUSTRY SHUT-DOWN, MANY PEOPLE DEPEND ON THESE ANNUAL HEALTH FAIRS FOR THEIR PREVENTATIVE HEALTH CARE. THE NUMBER OF UNDERINSURED AND UNINSURED PEOPLE INCREASES EACH YEAR. UPSON REGIONAL OFFERS MANY FREE AND DISCOUNTED DIAGNOSTIC SCREENINGS AND TESTS. THIS HAS PROVIDED EARLY DETECTION FOR MANY DISEASES AS WELL AS PROMOTED HEALTH AND WELLNESS THROUGH ANNUAL CHECKUPS SINCE THAT TIME. THESE ANNUAL HEALTH FAIRS ARE A COOPERATIVE EFFORT AMONG MANY GROUPS IN OUR COMMUNITY. IN 2013, WE PROVIDED FREE OR DISCOUNTED TESTS AT HEALTH FAIRS, CANCER SCREENINGS, DIABETES SCREENINGS, CARDIAC SCREENINGS, AND EDUCATIONAL OFFERINGS. WE PROVIDED FREE FLU IMMUNIZATIONS. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT GEORGIA true TUITION REIMBURSEMENT 13 23749 SCHOLARSHIP PROGRAM 3 7097 SCHEDULE I, PAGE 4, PART IV SCHEDULE I, PART III - GRANTS AND OTHER ASSISTANCE TO INDIVIDUALS IN THE UNITED STATES SCHOLARSHIP ASSISTANCE IS OFFERED TO UPSON COUNTY RESIDENTS AND FULL TIME, PART TIME AND PRN EMPLOYEES PURSUING A HEALTHCARE CAREER. EACH APPLICANT MUST COMPLETE AN APPLICATION; BE ACCEPTED BY AN ACCREDITED SCHOOL IN A HEALTHCARE PROGRAM OF THEIR CHOICE; SUBMIT TWO LETTERS OF RECOMMENDATION, A CERTIFIED COPY OF PREVIOUS EDUCATIONAL TRANSCRIPTS, AND A LETTER OF ACCEPTANCE IN THE HEALTHCARE CAREER PROGRAM; OBTAIN APPROVAL FROM THE DEPARTMENT DIRECTOR OR SENIOR MANAGEMENT; BE INTERVIEWED BY CHIEF NURSING OFFICER; MAINTAIN A 3.0 CUMULATIVE AVERAGE; SUBMIT TRANSCRIPTS OF GRADES EVERY SCHOOL TERM; AND SERVE AS AN EMPLOYEE A MINIMUM OF ONE YEAR FOR EACH SCHOOL YEAR FOR WHICH SCHOLARSHIP MONIES WERE GRANTED. TRANSCRIPTS OF GRADES MUST BE RECEIVES BEFORE REIMBURSEMENT. SHOULD THE STUDENT NOT SEEK AND MAINTAIN EMPLOYMENT WITH URMC AFTER GRADUATION, FUNDS WILL BECOME DUE AND PAYABLE IN A PRORATA FASHION BASED ON EMPLOYMENT TERM. TUITION REIMBURSEMENT IS AWARDED FULL TIME AND REGULARLY SCHEDULED PART TIME EMPLOYEES. MONIES ARE GRANTED TO COVER TUITION, BOOKS AND LABORATORY FEES. EACH APPLICANT MUST BE ENROLLED IN AN ACCREDITED COLLEGE/UNIVERSITY WITHIN A PROGRAM DIRECTLY RELATED TO THE EMPLOYEE'S PRESENT POSITION OR A FIELD THAT WILL BE OF BENEFIT TO THE MEDICAL CENTER; SEEK APPROVAL FROM MANAGEMENT; FURNISH A TRANSCRIPT OF GRADES; MAINTAIN A "C" OR HIGHER GRADE AVERAGE. TO BE REIMBURSED, AN EMPLOYEE MUST PRESENT A CERTIFIED COPY OF THE GRADE REPORT WITH AN AVERAGE OF "C" OR HIGHER. X X false false false false false false false false false DAVID CASTLEBERRY CEO 201540 4102 22173 227815 JOHN WILLIAMS CFO 196943 4047 19018 220008 ROBERT SOLYOMVARI MD SURGEON 374196 248806 5100 32027 660129 BRANDON BOYCE MD SURGEON 481820 130845 5100 19018 636783 DAVID PETERSON MD ANESTHESIOLOGIST 562564 5100 32027 599691 STEVEN YANG MD ANESTHESIOLOGIST 557984 5100 13821 576905 LOUIS MAMELI MD PHYSICIAN 269577 5100 34618 309295 SCHEDULE J, PART III CEO AND MANAGEMENT COMPANY AN UNRELATED ORGANIZATION, HEALTHTECH MANAGEMENT SERVICES, PROVIDED THE CEO FOR THE FILING ORGANIZATION. THE FILING ORGANIZATION COMPENSATED THE MANAGEMENT COMPANY APPROXIMATELY 144,000 FOR THE SERVICES OF CEO, DAVID CASTLEBERRY. EARLY IN FISCAL YEAR 2013, THE ORGANIZATION AMENDED THE CONTRACT WITH HEALTHTECH AND HIRED THE CEO. HEALTHTECH CONTINUES TO PROVIDE OTHER SERVICES UNDER A CONTRACTUAL ARRANGEMENT INCLUDING CONSULTING,REVENUE CYCLE, LICENSURE, INFORMATION SYSTEMS, AND PRODUCTIVITY REPORTING. A HOSPITAL AUTHORITY OF UPSON COUNTY 586002427 NONENONEN 2004-12-30 10000000 RENOVATION & EXPANSION OF HOSPITAL false false false B HOSPITAL AUTHORITY OF UPSON COUNTY 586002427 NONENONEN 2005-01-20 6000000 RENOVATION & EXPANSION OF HOSPITAL false false false A 3535000 10000000 124175 9875825 2007 false false true true B 2115000 6000000 79846 5920154 2007 false false true true A false false false false false false true B false false false false false false true A false false false false false false false false false B false false false false false false false false false FORM 990, PAGE 2, PART III, LINE 3 THE ORGANIZATION SOLD THEIR AMBULANCE COMPANY TO AN UNRELATED ORGANIZATION AND CEASED ALL AMBULANCE SERVICES AS OF DECEMBER 31, 2013. FORM 990, PART V, LINE 4B CAYMAN ISLANDS FORM 990, PAGE 6, PART VI, LINE 3 THE ORGANIZATION ENGAGED THE MANAGEMENT SERVICES OF HEALTHTECH MANAGEMENT SERVICES TO PROVIDE THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION. SUCH CEO BEARS THE FULL DUTIES AND RESPONSIBILITIES OF THE SAME POSITION THROUGHOUT THE HOSPITAL INDUSTRY. EARLY IN 2013, THE ORGANIZATION AMENDED THEIR CONTRACT WITH HEALTHTECH AND HIRED THE CEO. FORM 990, PAGE 6, PART VI, LINE 11B FORM 990 WAS EMAILED TO EACH BOARD OF TRUSTEE MEMBER PRIOR TO THE IRS FILING DUE DATE FOR THEIR REVIEW. FORM 990 REVIEW WAS PLACED ON THE BOARD AGENDA FOR DISCUSSION SHOULD ANY QUESTIONS OCCUR. THE 990 IS REVIEWED BY THE CFO IN DETAIL PRIOR TO FILING WITH THE IRS. FORM 990, PAGE 6, PART VI, LINE 12C THE POLICY COVERS ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. SHOULD A MATTER COME BEFORE THE BOARD OF DIRECTORS WHICH CONSTITUTES A CONFLICT OF INTEREST, THE INDIVIDUAL INVOLVED WILL MAKE KNOWN THE POTENTIAL CONFLICT AND WITHDRAW FROM THE MEETING SO LONG AS THE MATTER SHALL CONTINUE UNDER DISCUSSION AND SHALL NOT EITHER VOTE ON THE MATTER UNDER DISCUSSION OR ATTEMPT TO INFLUENCE A DECISION OF THE GOVERNING AUTHORITY WITH RESPECT TO SUCH MATTERS, UPON WHICH THERE COULD POSSIBLY BE A CONFLICT OF INTEREST. FORM 990, PAGE 6, PART VI, LINE 15A HEALTHTECH MANAGEMENT SERVICES, THE MANAGEMENT COMPANY OBTAINS THE COMPARABLE SALARY SURVEY AND PRESENTS IT TO THE BOARD OF DIRECTORS WHO MAKE A FINAL DECISION. THE CEO IS NOT PRESENT DURING THE DISCUSSION AND DECISION-MAKING PROCESS. DELIBERATIONS AND DECISIONS ARE DOCUMENTED IN THE MINUTES OF THE MEETING. FORM 990, PAGE 6, PART VI, LINE 15B IN DETERMINING COMPENSATION FOR THE CFO, OTHER OFFICERS OR KEY EMPLOYEES, THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT OBTAINS COMPARABLE SALARY DATA AND PRESENTS IT TO THE GOVERNING BODY WHO MAKES THE FINAL DECISION. THE INDIVIDUAL IN THE CONSIDERATION PROCESS IS NOT PRESENT DURING THE DISCUSSION AND DECISION-MAKING PROCESS. DELIBERATIONS AND DECISIONS ARE DOCUMENTED IN THE MINUTES OF THE MEETING. FORM 990, PAGE 6, PART VI, LINE 19 ALL DOCUMENTS ARE AVAILABLE FOR INSPECTION, WITH NOTICE, IN THE OFFICE OF THE ORGANIZATION. FORM 990, PART IX, LINE 11G CONTRACT LABOR 1,660,660 421,158 0 PROFESSIONAL SERVICES 496,565 38,866 0 PHYSICIAN FEES 906,415 0 0 PURCHASED SERVICES 1,880,563 332,490 0 THERAPISTS 16,550 0 0 ALL OTHER FEES 1,020,778 2,240,527 0 UPSON MEDICAL ASSOCIATES LLC 801 WEST GORDON STREET THOMASTON GA 30286 550840991 PHYS OFC GA -1740613 808467 UCH UPSON COUNTY HOSPITAL INC UPSON REGIONAL WELLNESS CENTER LLC 801 WEST GORDON STREET THOMASTON GA 30286 205095610 WELLNESS C GA -22297 561561 UCH UPSON COUNTY HOSPITAL INC UPSON AMBULANCE COMPANY LLC 801 WEST GORDON STREET THOMASTON GA 30286 205095675 AMBULANCE GA -937455 1165113 UCH UPSON COUNTY HOSPITAL INC UPSON WOMEN'S SERVICES LLC 801 WEST GORDON STREET THOMASTON GA 30286 263227893 PHYS OFC GA -922912 813922 UCH UPSON COUNTY HOSPITAL INC UPSON FAMILY PHYSICIANS LLC 801 WEST GORDON STREET THOMASTON GA 30286 270192553 PHYS OFC GA -436596 360008 UCH UPSON COUNTY HOSPITAL INC UPSON SURGICAL ASSOCIATES LLC 801 WEST GORDON STREET THOMASTON GA 30286 275252545 PHYS OFC GA -465259 348609 UCH UPSON COUNTY HOSPITAL INC ORTHOPEDICS SPORTS MEDICINE & SURGE 801 WEST GORDON STREET THOMASTON GA 30286 272123255 PHYS OFC GA -355507 384051 UCH UPSON COUNTY HOSPITAL INC URMC HEALTH FOUNDATION P O BOX 1089 THOMASTON GA 30286 830411781 FOUNDATION GA 501C3 11A UCH UPSON COUNTY HOSPITAL true false false true false false false false false false false false false true true true false false false false URMC HEALTH FOUNDATION M 81999 NET REVENUES FORM 990