2014-11-13T13:24:45-06:00 2013-12-31 454084437 WARREN AVERETT LLC 2500 ACTON ROAD BIRMINGHAM AL 35243 990 2013-01-01 630385130 RUSSELL HOSPITAL CORPORATION RUSS 2053297100 PO BOX 939 ALEXANDER CITY AL 35011 TIMOTHY J THORNTON CFO 2053297100 2014-11-12 1 JC ROUSE P00081132 2059794100 2013 2015-11-30 17:44:51Z JIM PEACE PO BOX 939 ALEXANDER CITY AL 35011 86059579 0 X WWW.RUSSELLMEDCENTER.COM X 1923 AL RUSSELL HOSPITAL CORPORATION D/B/A RUSSELL MEDICAL CENTER OPERATES AN ACUTE CARE GENERAL HOSPITAL IN ALEXANDER CITY, AL INCLUDING AN URGENT CARE CENTER (MPFC) IN DADEVILLE, AL. OUR MISSION IS TO BE THE REGIONAL HEALTHCARE PROVIDER OF CHOICE. WE ARE COMMITTED TO QUALITY, TEAMWORK, PROFESSIONALISM AND PERSONALIZED CARE. 11 10 669 100 0 0 39420 23800 68544794 67058464 607596 3154222 3112981 2632697 72304791 72869183 0 0 0 0 30047972 30265127 0 0 0 42740185 41548947 72788157 71814074 -483366 1055109 86678886 91080715 58857648 54962009 27821238 36118706 RUSSELL MEDICAL CENTER AND ITS PHYSICIANS ARE COMMITTED TO PROVIDING THE HIGHEST STANDARDS OF PATIENT CARE AND CUSTOMER SERVICE. OUR MISSION IS SIMPLE...BEING THE BEST BECAUSE WE CARE. 0 0 4758860 0 6071763 THE CANCER CENTER AT RUSSELL MEDICAL CENTER OFFERS A MULTI-DISCIPLINARY CARE TEAM THAT INCLUDES A MEDICAL ONCOLOGIST, RADIATION ONCOLOGISTS, DOSIMETRIST PYSICIST AND A SKILLED TEAM OF SUPPORT STAFF. OUR CONTINUUM OF CARE PROCESS ENCOMPASSES THE ENTIRE CANCER EXPERIENCE INCLUDING TWO CANCER SUPPORT GROUPS ON SITE AND FOR REFERRAL. ON SITE SUPPORT GROUPS INCLUDE "LOOK GOOD...FEEL BETTER", WHICH IS DESIGNED FOR WOMEN PATIENTS AND THE "T.O.U.C.H." (TODAY OUR UNDERSTANDING OF CANCER IS HOPE), WHICH IS FOR PATIENTS IN ACTIVE TREATMENT AND REMISSION. THEY MEET TO TALK, LISTEN AND LEARN FROM OTHERS WHO HAVE BEEN THROUGH THE SAME EXPERIENCE. THE CANCER CENTER SERVED ABOUT 6,408 PATIENTS IN 2013. 2138076 9772269 RUSSELL MEDICAL CENTER PROVIDES TWENTY-FOUR HOUR/SEVEN DAYS A WEEK EMERGENCY SERVICES TO THE COMMUNITY WITH 24,121 VISITS IN 2013. IN 2008, THE ORGANIZATION COMPLETED A TWO MILLION DOLLAR RENOVATION PROJECT TO THE EMERGENCY DEPARTMENT WHICH EXPANDED EXAM ROOM CAPACITY AND IMPROVED OVERALL SERVICE TO OUR PATIENT POPULATION. 1354343 0 3445604 RUSSELL MEDICAL CENTER PARTICIPATES IN THE GIFT OF LIFE MATERNITY CARE PROGRAM ADMINISTERED THROUGH THE ALABAMA MEDICAID AGENCY. THE PROGRAM PROVIDES SERVICES TO WOMEN AND INFANTS WHO QUALIFY FOR SERVICES PURSUANT TO TITLE XIX OF THE SOCIAL SECURITY ACT. TOTAL PATIENT DAYS FOR ALL PAYORS IN 2013 WERE 2,353. 63562795 0 50224634 63562795 50224634 71814074 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 113 0 1 669 1 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X PAUL OSWALD 2563297170 3316 HIGHWAY 280 ALEXANDER CITY AL 35010 JAMES D NABORS CHAIRMAN 5.00 X 0 0 0 HUGH NEIGHBORS III VICE CHAIRMAN 5.00 X 0 0 0 SCOTT HOWELL SECRETARY/TREASURER 5.00 X 0 0 0 JIM PEACE CEO 40.00 X X 363880 0 11067 RALPH FROSHIN DIRECTOR 5.00 X 0 0 0 BEN RUSSELL DIRECTOR 5.00 X 0 0 0 JAMES W BROWN JR DIRECTOR 5.00 X 0 0 0 THOMAS RADNEY DIRECTOR 5.00 X 0 0 0 EDWARD HILL MD DIRECTOR 5.00 X 0 0 0 TONY MCLEOD MD DIRECTOR 5.00 X 0 0 0 MICHELE GOLDHAGEN MD DIRECTOR 5.00 X 0 0 0 SARAH BETH GETTYS VP PATIENT SERVICES 40.00 X 251011 0 6415 TIM THORNTON CFO 40.00 X 244427 0 8476 KERI K BROWN MD PULMONOLOGIST 40.00 X 361485 0 3357 JOHN ELGIN MD DIRECTOR - PATHOLOGY 40.00 X 411018 0 0 WILLIAM MOORE MD GYN PHYSICIAN 40.00 X 314481 0 2356 MARY EMILY SHEFFIELD MD MEDICAL ONCOLOGIST 40.00 X 403280 0 8771 ZHOU ZHENHONG PHYSICIAN 40.00 X 326800 0 8771 2676382 0 49213 38 0 1 0 COMPHEALTH PO BOX 972651 DALLAS TX 75397 PHYSICIAN SERVICES 776887 PARAGON CONTRACTING SERVICES PO BOX 634850 CINCINNATI OH 45263 ER PHYSICIAN COVERAGE 751422 DIVERSIFIED CLINICAL SERVICES INC PO BOX 636981 CINCINNATI OH 45263 WOUND CARE SERVICES 732151 LAB CORP OF AMERICA PO BOX 12140 BURLINGTON NC 27216 LAB SERVICES 331436 ANESTHESIA SERVICES OF BIRMINGHAM PC 2151 OLD ROCKY RIDGE ROAD STE 106 BIRMINGHAM AL 35216 ANESTHESIA SERVICES 170000 11 23800 23800 PATIENT REVENUE 900099 67058464 67058464 67058464 879396 879396 706704 529813 176891 176891 176891 14893096 42313 12609879 50704 2283217 -8391 2274826 2274826 MISCELLANEOUS INCOME 900099 1651613 1651613 CAFETERIA INCOME 900099 495120 495120 DRUG SALES 900099 206610 206610 102463 102463 2455806 72869183 69514270 0 3331113 759318 759318 22909633 22909633 1507802 1507802 3415690 3415690 1672684 1672684 104542 104542 132994 132994 58244 58244 2488782 2488782 190752 190752 66615 66615 2072666 2072666 4271654 4271654 726593 726593 SUPPLIES 14194817 14194817 PROVISION FOR BAD DEBTS 9220887 9220887 PURCHASED SERVICES 3237820 3237820 MAINTENANCE AND REPAIRS 1890588 1890588 2891993 2891993 71814074 71814074 0 0 7947587 7593258 4018010 2376615 10684226 11970029 2552347 2595080 465174 517017 101786110 60746005 42322336 41040105 16091967 22227818 2597239 2760793 86678886 91080715 15524251 12376306 38832750 37215019 4500647 5370684 58857648 54962009 X 27821238 36118706 27821238 36118706 86678886 91080715 X 1055109 1495917 5746442 X X 0 1 X 1 0 X 1811667 1811667 56961349 27094871 29866478 81565 81565 0 41675988 33569569 8106419 1255541 1255541 41040105 ASSETS HELD BY TRUSTEE 4022645 F INVESTMENT IN COASTAL INSURANCE 360930 C COMMON STOCK 16344243 F UNSECURED DEBENTURES 1500000 F 22227818 UNAMORTIZED BOND PREMIUM 297724 MISCELLANEOUS LIABILITIES 2802314 DUE TO CONTRACTUAL AGENCIES 2151032 OTHER LIABILITIES 119614 5370684 X 70103620 1495917 -3603056 -2107139 72210759 658424 658424 72869183 62464576 -8691074 -8691074 71155650 658424 658424 71814074 PART X, LINE 2: THE HOSPITAL IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3). THE HOSPITAL HAS EVALUATED ITS TAX POSITIONS AS REQUIRED UNDER THE RELEVANT ACCOUNTING STANDARDS AND HAS DETERMINED THAT IT DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT IT WOULD BE UNABLE TO SUBSTANTIATE UPON EXAMINATION. RETURNS HAVE BEEN FILED FOR ALL YEARS THROUGH DECEMBER 31, 2012. TAX RETURNS FOR 2010 THROUGH 2012 ARE SUBJECT TO AUDIT BY TAXING AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: MINIMUM PENSION LIABILITY 5,088,018. RENTAL EXPENSES SHOWN AS AN OFFSET TO REVENUE 529,813. PROVISION FOR BAD DEBT EXPENSE SHOWN AS AN OFFSET TO REVENUE ON FINANCIALS -9,220,887. PART XI, LINE 4B - OTHER ADJUSTMENTS: MINORITY INTEREST SHOWN AS AN OFFSET TO EXPENSES 658,424. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES SHOWN AS AN OFFSET TO REVENUE 529,813. PROVISION FOR BAD DEBT EXPENSE SHOWN AS AN OFFSET TO REVENUE ON FINANCIALS -9,220,887. PART XII, LINE 4B - OTHER ADJUSTMENTS: MINORITY INTEREST SHOWN AS AN OFFSET TO EXPENSES 658,424. 1 1 1 X 300.000000000000 1 X 1 1 0 1 1 559932 559932 0.00890 10587327 9776327 811000 0.01300 11147259 9776327 1370932 0.02190 216241 216241 0.00350 216241 216241 0.00350 11363500 9776327 1587173 0.02540 1 3208869 1604434 28980917 28244881 736036 X 1 1 1 1 RUSSELL MEDICAL CENTER PO BOX 939 ALEXANDER CITY AL 35011 X X X RUSSELL MEDICAL CENTER 1 1 X X X X X X X X X 13 1 0 1 X WWW.RUSSELLMEDCENTER.COM X X X X X X X X 1 0 1 1 300.000000000000 1 350.000000000000 1 X X X X 1 1 X X X X X X 1 X X 0 X X X X 1 X 0 0 RUSSELL MEDICAL CENTER PART V, SECTION B, LINE 3: IN CONDUCTING THE CHNA, THE HOSPITAL CONSULTED WITH A BROAD RANGE OF PEOPLE REPRESENTING THE HEALTH INTERESTS OF RESIDENTS OF ALEXANDER CITY AND TALLAPOOSA COUNTY INCLUDING: EXECUTIVE DIRECTOR, LOCAL UNITED WAY; ADMINISTRATOR, LOCAL NURSING HOME; NURSE SUPERVISOR - TALLAPOOSA COUNTY HEALTH DEPARTMENT. THE CONTRIBUTORS ALSO INCLUDED LEADERSHIP AND CLINICAL EMPLOYEES OF RUSSELL MEDICAL CENTER AND MEMBERS OF THE MEDICAL STAFF OF THE HOSPITAL. RUSSELL MEDICAL CENTER PART V, SECTION B, LINE 20D: HOSPITAL CHARGES ARE DISCOUNTED 65%. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 9,220,887. PART III, LINE 4: ALLOWANCES FOR DOUBTFUL ACCOUNTS ARE ESTIMATED BASED ON HISTORICAL WRITE-OFF PERCENTAGES AND REVIEW OF LARGE BALANCE SELF PAY ACCOUNTS, AND CONTRACTUAL ALLOWANCES ARE ESTIMATED BASED ON THE TERMS OF THIRD-PARTY INSURED CONTRACTS. DOUBTFUL ACCOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE AFTER ADEQUATE COLLECTION EFFORT IS EXHAUSTED AND RECORDED AS RECOVERIES OF BAD DEBTS IF SUBSEQUENTLY COLLECTED. COST DETERMINED BY USING OVERALL COST TO CHARGE RATIO. PART III, LINE 9B: RUSSELL MEDICAL CENTER INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR THE ORGANZIATION'S CHARITY CARE POLICY IN SEVERAL DIFFERENT WAYS. EACH PATIENT BILL HAS A PRINTED STATEMENT ABOUT OUR FINANCIAL ASSISTANCE PROGRAM AND WHO THE PATIENT SHOULD CONTACT. THIS SAME PRINTED STATEMENT IS DISPLAYED IN ALL REGISTRATION AND ADMISSION AREAS THROUGHOUT RUSSELL MEDICAL CENTER, THE PROFESSIONAL OFFICE BUILDING AND THE CANCER CENTER. PATIENTS WHO PRESENT TO AN ADMISSIONS CLERK AS SELF PAY OR UNDER-INSURED ARE DIRECTED TO THE BUSINESS OFFICE FOR FINANCIAL COUNSELING. PATIENTS ARE OFFERED A CHARITY APPLICATION PACKET WHICH INSTRUCTS THEM ON THE REQUIREMENTS FOR COMPLETING THE APPLICATION PROCESS. IT IS ULTIMATELY THE PATIENT'S RESPONSIBILITY TO RETURN THE DOCUMENTATION TO THE BUSINESS OFFICE FOR ELIGIBILITY DETERMINATION. WHEN THE APPLICATION IS RETURNED, THE FINANCIAL COUNSELOR CHECKS FOR COMPLETENESS AND FORWARDS THIS TO THE SOCIAL WORKER. THE APPLICANT IS THEN SCREENED FOR ANY ADDITIONAL ASSISTANCE. IF IT IS DETERMINED THE PATIENT MAY BE ELIGIBLE FOR MEDICAID, THE SOCIAL WORKER CONTACTS THE PATIENT TO ASSIST IN THIS PROCESS. IF DETERMINATION IS MADE THAT NO OTHER ASSISTANCE IS AVAILABLE, THE APPLICATION IS RETURNED TO THE PATIENT ACCOUNTS SUPERVISOR. THE CURRENT FEDERAL POVERTY GUIDELINES ARE FOLLOWED TO DETERMINE THE AMOUNT OF CHARITY, IF ANY, THE PATIENT IS ELIGIBLE FOR. ACCOUNTS THAT TOTAL $5,000.00 AND LESS ARE SENT TO THE BUSINESS OFFICE DIRECTOR FOR APPROVAL AND ACCOUNTS GREATER THAN $5,000.00 ARE SENT TO THE CFO FOR APPROVAL. AFTER 3 MONTHS OF THE INTITIAL APPLICATION, PATIENTS MUST PROVIDE ADDITIONAL DOCUMENTATION FOR ANY NEW ACCOUNTS. PART VI, LINE 2: HEALTH FAIRS, COMMUNITY EDUCATION PROGRAMS AND A VARIETY OF HEALTH SCREENINGS ARE PROVIDED THROUGHOUT THE YEAR, AND SHORT HEALTH QUESTIONNAIRES AND INTERVIEWS ARE SECURED THROUGH THESE EVENTS. IN ADDITION, A MARKET ANALYSIS TEAM WAS DEVELOPED AS PART OF THE HOSPITAL'S STRATEGIC PLAN TO RESEARCH, ANALYZE AND TREND THE DEMOGRAPHICS AND HEALTH STATUS OF OUR PRIMARY AND SECONDARY SERVICE AREA THROUGH VARIOUS DATA BASES INCLUDING REAL TIME MEDICAL DATA. THE HOSPITAL ALSO CONSIDERS INFORMATION PROVIDED BY LOCAL PEDIATRICIANS, PRIMARY CARE PHYSICIANS, INDUSTRY HR DIRECTORS AND THE TALLAPOOSA COUNTY PUBLIC HEALTH DEPARTMENT. PART VI, LINE 3: RUSSELL MEDICAL CENTER INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR THE ORGANZIATION'S CHARITY CARE POLICY IN SEVERAL DIFFERENT WAYS. EACH PATIENT BILL HAS A PRINTED STATEMENT ABOUT OUR FINANCIAL ASSISTANCE PROGRAM AND WHO THE PATIENT SHOULD CONTACT. THIS SAME PRINTED STATEMENT IS DISPLAYED IN ALL REGISTRATION AND ADMISSION AREAS THROUGHOUT RUSSELL MEDICAL CENTER, THE PROFESSIONAL OFFICE BUILDING AND THE CANCER CENTER. PATIENTS WHO PRESENT TO AN ADMISSIONS CLERK AS SELF PAY OR UNDER-INSURED ARE DIRECTED TO THE BUSINESS OFFICE FOR FINANCIAL COUNSELING. PATIENTS ARE OFFERED A CHARITY APPLICATION PACKET WHICH INSTRUCTS THEM ON THE REQUIREMENTS FOR COMPLETING THE APPLICATION PROCESS. IT IS ULTIMATELY THE PATIENT'S RESPONSIBILITY TO RETURN THE DOCUMENTATION TO THE BUSINESS OFFICE FOR ELIGIBILITY DETERMINATION. WHEN THE APPLICATION IS RETURNED, THE FINANCIAL COUNSELOR CHECKS FOR COMPLETENESS AND FORWARDS THIS TO THE SOCIAL WORKER. THE APPLICANT IS THEN SCREENED FOR ANY ADDITIONAL ASSISTANCE. IF IT IS DETERMINED THE PATIENT MAY BE ELIGIBLE FOR MEDICAID, THE SOCIAL WORKER CONTACTS THE PATIENT TO ASSIST IN THIS PROCESS. IF DETERMINATION IS MADE THAT NO OTHER ASSISTANCE IS AVAILABLE, THE APPLICATION IS RETURNED TO THE PATIENT ACCOUNTS SUPERVISOR. THE CURRENT FEDERAL POVERTY GUIDELINES ARE FOLLOWED TO DETERMINE THE AMOUNT OF CHARITY, IF ANY, THE PATIENT IS ELIGIBLE FOR. ACCOUNTS THAT TOTAL $5,000.00 AND LESS ARE SENT TO THE BUSINESS OFFICE DIRECTOR FOR APPROVAL AND ACCOUNTS GREATER THAN $5,000.00 ARE SENT TO THE CFO FOR APPROVAL. AFTER 3 MONTHS OF THE INTITIAL APPLICATION, PATIENTS MUST PROVIDE ADDITIONAL DOCUMENTATION FOR ANY NEW ACCOUNTS. PART VI, LINE 4: RUSSELL MEDICAL CENTER'S SERVICE AREAS ARE DETERMINED BY PATIENT ORIGIN PATTERNS. THE PRIMARY SERVICE AREA IS DEFINED BY THE NATURAL GEOGRAPHIC BOUNDARY POSTED BY LAKE MARTIN, WHICH DIVIDES TALLAPOSSA COUNTY INTO A NORTHWEST SECTOR (INCLUDING ALEXANDER CITY) AND A SOUTHEAST SECTOR (INCLUDING DADEVILLE). THE PRIMARY SERVICE AREA CONSISTS OF ALEXANDER CITY, DADEVILLE, GOODWATER, KELLYTON AND JACKSON'S GAP. THE SECONDARY SERVICE AREA CONSISTS OF DAVISTON, EQUALITY, ROCKFORD AND CAMP HILL. OTHER AREAS NOT CONSIDERED PRIMARY OR SECONDARY BUT SUPPLYING RUSSELL MEDICAL CENTER WITH A FAIRLY SIGNIFICANT NUMBER OF PATIENTS (IN TOTAL) INCLUDE ASHLAND, LINEVILLE, ECLECTIC, WADLEY, TALLASSEE AND SYLACAUGA.DEMOGRAPHIC DATA INCLUDING RACE, GENDER AND AGE IS CAPTURED THROUGH THE REGISTRATION PROCESS. FOR 2013, CAUCASIAN, AFRICAN AMERICAN, HISPANIC AND OTHER RACES ACCOUNTED FOR 69%, 30%, LESS THAN 1% AND LESS THAN 1% RESPECTIVELY, OF THE PATIENTS SERVED WHILE 6%, 59% AND 35% WERE AGES 0-13, 14-65 AND 66+ YEARS, RESPECTIVELY. ECONOMIC DEMOGRAPHIC DATA IS NOT SPECIFICALLY CAPTURED; HOWEVER BASED ON THE LATEST MARKET SHARE DATA THE MEDICAL CENTER PROVIDED SERVICES TO 49% OF MEDICAID AND 29% OF UNINSURED/CHARITY PATIENTS IN TALLAPOOSA COUNTY AND 46% OF MEDICAID AND 23% OF UNINSURED/CHARITY PATIENTS IN COOSA COUNTY. PART VI, LINE 5: RUSSELL MEDICAL CENTER IS THE PRIMARY SOURCE OF ACUTE CARE IN OUR SERVICE AREA. THE HOSPITAL OPERATES AN OPEN MEDICAL STAFF AND ACTIVELY RECRUITS PHYSICIAN SPECIALTIES BASED ON NEED IN OUR COMMUNITY. THE HOSPITAL HAS A BOARD OF DIRECTORS COMPRISED OF COMMUNITY MEMBERS AND MEDICAL STAFF TO ENSURE WE ARE CONNECTED TO COMMUNITY NEEDS WITH THE HIGHEST QUALITY OF SERVICE. RUSSELL MEDICAL CENTER ANNUALLY PREPARES A COMMUNITY BENEFIT REPORT OUTLINING OUR NUMEROUS ACTIVITES AS WELL AS DOCUMENTS OUR FINANCIAL BENEFITS TO OUR LOCAL AREA. PART VI, LINE 6: ALL ORGANIZATIONS AFFILIATED WITH RUSSELL HOSPITAL CORPORATION ARE ORGANIZED FOR THE PURPOSE OF ENSURING THE HIGHEST QUALITY OF HEALTHCARE IN OUR SERVICE AREA. X X 1 1 X X X X 0 0 0 0 0 0 0 0 0 JIM PEACE CEO 277156 0 86724 0 0 0 6120 0 14727 0 384727 0 0 0 SARAH BETH GETTYS VP PATIENT SERVICES 190939 0 60072 0 0 0 4059 0 2356 0 257426 0 0 0 TIM THORNTON CFO 183839 0 60588 0 0 0 6120 0 5116 0 255663 0 0 0 KERI K BROWN MD PULMONOLOGIST 361485 0 0 0 0 0 2400 0 957 0 364842 0 0 0 JOHN ELGIN MD DIRECTOR - PATHOLOGY 411018 0 0 0 0 0 0 0 0 0 411018 0 0 0 WILLIAM MOORE MD GYN PHYSICIAN 314481 0 0 0 0 0 0 0 2356 0 316837 0 0 0 MARY EMILY SHEFFIELD MD MEDICAL ONCOLOGIST 362415 0 40865 0 0 0 6120 0 2651 0 412051 0 0 0 ZHOU ZHENHONG PHYSICIAN 278189 0 48611 0 0 0 6120 0 2651 0 335571 0 0 0 A THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF ALEX CITY 631165091 014545CE5 2006-05-10 38792980 REFINANCE OUTSTANDING BONDS & CAPITAL LEASE OBLIGATIONS & PAY COST OF ISSUE 1 1 0 B THE SPECIAL CARE FACILITIES FINANCING AUTHORITY OF THE CITY OF ALEX CITY 631165091 2011-10-27 5000000 EQUIPMENT PURCHASE 0 1 0 A 38792980 2939850 579882 9603669 2008 0 1 1 1 B 5000000 5000000 2013 0 0 0 0 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 1 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 A 0 B 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PROVIDED TO THE BOARD FOR REVIEW AND IS AN AGENDA ITEM AT A REGULARLY SCHEDULED BOARD MEETING OPEN FOR ANY DISCUSSION BEFORE THE RETURN IS FILED. FORM 990, PART VI, SECTION B, LINE 12C ALL QUESTIONNAIRES COMPLETED DURING EMPLOYEE ORIENTATION ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER. IF CONCERNS ARE IDENTIFIED, HOSPITAL ADMINISTRATION IS CONSULTED. EMPLOYEES ARE ALSO REQUIRED TO COMPLETE AN ANNUAL DISCLOSURE STATEMENT WITH THE ORGANIZATION. HOSPITAL BOARD MEMBERS ARE REQUIRED TO COMPLETE A DISCLOSURE FORM ANNUALLY. THEY ARE ASKED TO RECUSE THEMSELVES FROM ALL VOTES WHERE A CONFLICT MAY EXIST. THE BOARD, ALONG WITH HOSPITAL ADMINISTRATION, IS RESPONSIBLE FOR THE MONITORING OF EVENTS WHICH MAY GIVE RISE TO POTENTIAL CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 RUSSELL MEDICAL CENTER DETERMINES APPROPRIATE COMPENSATION FOR OFFICERS AND OTHER KEY EMPLOYEES THROUGH THE USE OF AN INDEPENDENT CONSULTING GROUP WITH RESULTS AND RECOMMENDATIONS FORWARDED TO GOVERNING BOARD. FORM 990, PART VI, SECTION C, 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. FORM 990, PART XI, LINE 9: MINIMUM PENSION LIABILITY 5,088,018. NONCONTROLLING INTEREST IN CENTRAL ALABAMA CANCER CARE, LLC 658,424. FORM 990, PART XI, LINE 2C: THE ORGANIZATION MADE NO CHANGES TO ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR. MEDICAL PARK HEALTHCARE CENTER INC PO BOX 939 ALEXANDER CITY AL 35011 630987400 MANAGEMENT OF HEALTHCARE FACILITIES AL 501(C)(3) 11A RUSSELL HOSPITAL CORPORATION 1 RUSSELL HOSPITAL FOUNDATION PO BOX 939 ALEXANDER CITY AL 35011 630987401 FUNDRAISING ACTIVITIES AL 501(C)(3) 11C MEDICAL PARK HEALTHCARE CENTER INC 0 CENTRAL ALABAMA CANCER CARE LLC PO BOX 939 ALEXANDER CITY AL 35011 453656764 CANCER TREATMENT AL RUSSELL HOSPITAL CORPORATION RELATED 3213768 2258985 0 1 0.51000 MEDICAL PARK DEVELOPMENT INC PO BOX 939 ALEXANDER CITY AL 35011 630987345 RENTAL REAL ESTATE AL MEDICAL PARK HEALTHCARE CENTER INC C 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 RUSSELL HOSPITAL FOUNDATION INC D 23366 FMV MEDICAL PARK DEVELOPMENT INC D 14124 FMV