2013-11-11T15:47:32-06:00 2012-12-31 201941244 HORNE LLP 1020 HIGHLAND COLONY PKWY STE 400 RIDGELAND MS 39157 990 2012-01-01 640345119 RUSH MEDICAL FOUNDATION RUSH 6017039992 1314 19TH AVENUE MERIDIAN MS 39301 DARRELL WILDMAN 6017039992 2013-11-05 1 MARSHA H DIECKMAN CPA P00246741 6013261000 2013-11-05 2012 2016-02-24 21:20:13Z DARRELL WILDMAN 1314 19TH AVENUE MERIDIAN MS 39301 203819557 0 X RUSHHEALTHSYSTEMS.ORG X 1947 MS PROVIDE HEALTH CARE 9 7 1436 0 4787 0 3150242 689816 167387005 181573910 625965 1065448 14774053 20473376 185937265 203802550 21592407 19599567 0 0 54325311 58806078 0 0 0 109984062 108891833 185901780 187297478 35485 16505072 230191658 259846541 186130077 201169041 44061581 58677500 X TO PROVIDE ACUTE, EMERGENCY AND OUTPATIENT HEALTH CARE TO PERSONS IN LAUDERDALE COUNTY, MISSISSIPPI AND THE SURROUNDING AREA. 0 0 168504440 19599567 188718042 RUSH FOUNDATION HOSPITAL IS A 215-BED TERTIARY CARE FACILITY LOCATED IN MERIDIAN, MS IN LAUDERDALE COUNTY AND IS THE FLAGSHIP HOSPITAL OF RUSH HEALTH SYSTEMS WHICH ALSO INCLUDES THE SPECIALTY HOSPITAL OF MERIDIAN, MEDICAL FOUNDATION, INC., RUSH MEDICAL GROUP, LAIRD HOSPITAL, UNION, MISSISSIPPI, H.C. WATKINS HOSPITAL IN QUITMAN, MISSISSIPPI, SCOTT REGIONAL HOSPITAL IN MORTON, MISSISSIPPI, JOHN C. STENNIS MEMORIAL HOSPITAL, DEKALB, MS AND CHOCTAW GENERAL HOSPITAL, BUTLER, AL.WHILE THE CITY OF MERIDIAN'S POPULATION IS APPROXIMATELY 38,000 PEOPLE, RUSH FOUNDATION HOSPITAL AND ITS SISTER FACILITIES IN RUSH HEALTH SYSTEMS SERVE A POPULATION OF 232,900 PEOPLE IN A 45-MILE RADIUS AND 526,500 RESIDENTS IN A 65-MILE RADIUS. NINE COUNTIES IN EAST MISSISSIPPI AND THREE COUNTIES IN WEST ALABAMA, MOST OF WHICH ARE PRIMARILY RURAL COUNTIES, MAKE UP THE MAJORITY OF THE SERVICE REGION. IN 2012, RUSH FOUNDATION HOSPITAL SERVED 7,738 INPATIENTS, 82,815 OUTPATIENTS AND 24,690 EMERGENCY ROOM PATIENTS. RUSH FOUNDATION HOSPITAL PROVIDES THE MAJOR SERVICES OF CARDIOVASCULAR SURGERY, CARDIOLOGY, VASCULAR AND THORACIC SURGERY, ORTHOPEDICS AND ORTHOPEDIC SURGERY, NEUROLOGY, NEUROSURGERY, GENERAL SURGERY, OBSTETRICS AND GYNECOLOGY, A GASTROENTEROLOGY LABORATORY, PAIN TREATMENT CENTER, AND CRITICAL CARE IN ADDITION TO A FULL COMPLEMENT DIAGNOSTICS AND TREATMENT SERVICES AND ACCESS TO MORE THAN 100 PHYSICIAN SPECIALISTS AND PRIMARY CARE PHYSICIANS. ADDITIONALLY, THE HEALTH SYSTEM HAS MORE THAN THIRTY NURSE PRACTITIONERS AND NURSE MIDWIVES WHO EXTEND CARE TO THE PATIENT POPULATION.SPECIALIZED SERVICES PROVIDED THROUGH RUSH FOUNDATION HOSPITAL INCLUDE: A LEVEL III TRAUMA CENTER IN THE 24-HOUR A DAY PHYSICIAN-STAFFED EMERGENCY DEPARTMENT; THE NEWBORN INTENSIVE CARE UNIT, A 12-BED UNIT THAT OFFERS A SPECIAL QUALITY OF CARE FOR PREMATURE AND HIGH-RISK INFANTS; RUSH REHABILITATION SERVICES, HOUSED IN A 17,632-SQUARE-FOOT FACILITY, WHICH EARNED RECOGNITION FROM THE NATIONAL STUDIED ENTITLED FOCUS ON THERAPEUTIC OUTCOMES (FOTO) AND OFFERS SERVICES INCLUDING PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, AQUATIC THERAPY AND A READING CLINIC; AND THE RUSH HEART INSTITUTE, LOCATED IN THE HOSPITAL, PROVIDES CARDIAC CARE INCLUDING PREVENTION, DETECTION AND TREATMENT, CARDIOVASCULAR AND VASCULAR SURGERY AND AN ARRAY OF NON-INVASIVE TESTING INCLUDING: TREADMILLS, NUCLEAR MEDICINE, ECHOCARDIOGRAPHY, ARRHYTHMIA DETECTION AND PACEMAKER EVALUATION. INTERVENTIONAL CARDIOLOGY INCLUDES BALLOON ANGIOPLASTY AND STENTS, AS WELL AS ROBOTIC CARDIAC PROCEDURES. IN 2012, RUSH FOUNDATION HOSPITAL OPENED THE REGION'S COMPREHENSIVE VEIN CENTER FOR THE DETECTION AND TREATMENT OF PERIPHERAL VASCULAR DISEASE.IN 2012, RUSH FOUNDATION HOSPITAL EARNED NATIONAL RECOGNITION FOR QUALITY CARE FROM THE CMS-SPONSORED HOSPITAL QUALITY INCENTIVE DEMONSTRATION. RUSH FOUNDATION HOSPITAL RECEIVED AWARDS IN THE CATEGORIES OF TREATMENT OF PATIENTS WITH HEART ATTACKS, TREATMENT OF PATIENTS WITH HEART FAILURE, THE SURGICAL CARE PROGRAM AND TREATMENT OF PATIENTS WITH PNEUMONIA.IN 2012, RUSH FOUNDATION HOSPITAL WAS DUALLY ACCREDITED BY THE DNV. RUSH FOUNDATION HOSPITAL PROVIDES QUALITY MEDICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP OR AGE.AS PRESENTED IN THE ATTACHED SCHEDULE H, RUSH FOUNDATION HOSPITAL PROVIDED FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS DURING 2012 AT A COST OF $7,679,337. ALTHOUGH EQUITABLE PAYMENT FOR SERVICES IS ESSENTIAL TO THE ORGANIZATION'S FINANCIAL VIABILITY, RUSH FOUNDATION HOSPITAL RECOGNIZES THAT NOT ALL INDIVIDUALS POSSESS THE RESOURCES REQUIRED TO REIMBURSE THE HOSPITAL FOR ALL SERVICES PROVIDED. KEEPING ITS COMMITMENT TO THE COMMUNITY, RUSH FOUNDATION HOSPITAL PROVIDES FREE CARE AND SUBSIDIZED CARE WITHIN EXISTING RESOURCES WHERE THE NEED FOR SUCH CARE EXISTS. ALONG WITH BEING THE REGION'S SECOND LARGEST EMPLOYER AND A MAJOR ECONOMIC STIMULUS BY VIRTUE OF ITS PAYROLL, RUSH FOUNDATION HOSPITAL AND ITS SISTER FACILITIES PROVIDE MANY BENEFITS TO THE BROADER COMMUNITY IN THE AREAS OF CIVIC INVOLVEMENT AND GIVING; MENTORING AND PROGRAM SUPPORT TO NURSING AND ALLIED HEALTH PROGRAMS AT MERIDIAN COMMUNITY COLLEGE, EAST MISSISSIPPI COMMUNITY COLLEGE, MISSISSIPPI STATE UNIVERSITY/MERIDIAN BRANCH AND THE UNIVERSITY OF WEST ALABAMA; A STRONG AND GENEROUS PROGRAM OF COMMUNITY HEALTH EDUCATION, CHARITABLE DONATIONS, SCHOOL AND SPORTS PHYSICALS, INDUSTRIAL HEALTH SCREENINGS AND WELLNESS EVENTS, VOLUNTEER HOURS AND PASTORAL CARE. SEVERAL OF THE LARGER-SCALE EXAMPLES OF THESE PROGRAMS WHICH OCCURRED DURING 2012 INCLUDE THE SPONSORSHIP OF CARDIAC AND GASTROINTESTINAL HEALTH EDUCATION SEMINARS ESPECIALLY FOR WOMEN, VEIN SCREENINGS, AND MEDIA PLACEMENTS OF HEALTH INFORMATION PROVIDED BY RUSH-AFFILIATED PHYSICIANS. ADDITIONALLY, RUSH FOUNDATION HOSPITAL PROVIDES ONGOING PRENATAL AND BREASTFEEDING CLASSES AS WELL AS PROVIDING SPECIALIZED COMMUNITY EDUCATION PROGRAMS FOR SMOKING CESSATION, WOMEN'S HEALTH, GASTROENTEROLOGICAL HEALTH, SLEEP DISORDERS, GENERAL HEALTH FAIRS, AND PROSTATE SCREENINGS. RUSH IS ALSO A FOUNDING SPONSOR OF THE STATE GAMES OF MISSISSIPPI, WHICH IN 2011 BROUGHT MORE THAN 5,000 AMATEUR ATHLETES FROM AROUND THE STATE TO MERIDIAN EACH YEAR FOR COMPETITION IN TWENTY-NINE SPORTING EVENTS. THE HOSPITAL EMPLOYS CERTIFIED ATHLETIC TRAINERS TO PROVIDE THE AREA HIGH SCHOOLS WITH BASIC HEALTHCARE AND INSTRUCTIONAL SERVICES AT NO COST ON A DAILY BASIS DURING PRACTICE AND TRAINING AS WELL AS AT IN-SEASON COMPETITIONS AND DURING SATURDAY MORNING CLINICS. 168504440 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 117 0 1 1436 1 1 1 0 0 0 0 0 0 0 0 0 X 9 7 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X DARRELL WILDMAN 6017039992 1314 19TH AVENUE MERIDIAN MS 39301 ANN ALEXANDER 1.00 0.00 X 0 0 0 CHARLES SHEPHERD 1.00 0.00 X 0 0 0 HARRY G CAUSEY MD 1.00 0.00 X 0 0 0 H LOWRY RUSH III 5.00 35.00 X 0 129697 54374 BILLY PIERCE 1.00 0.00 X 0 0 0 L VAUGHAN RUSH JR MD 1.00 31.00 X 0 199108 10664 JAMES K PURVIS 1.00 0.00 X 0 0 0 ABDUL LALA 1.00 0.00 X 0 0 0 ALAN GERTRELL 1.00 0.00 X 0 0 0 RICK BARRY 1.00 13.00 X 0 0 0 CHRIS RUSH 40.00 11.00 X 0 183986 51706 CHUCK REECE 5.00 55.00 X 0 282563 163755 DARRELL WILDMAN 5.00 55.00 X 0 217440 83474 CATHY ROBINSON 5.00 45.00 X 0 147105 42300 FRED ROGERS 5.00 45.00 X 0 134417 56064 DONNIE SMITH 5.00 47.00 X 0 173956 58028 DALE ARMOUR 1.00 49.00 X 0 199620 39112 G CLINTON EAVES 40.00 0.00 X 0 123085 18560 LARKIN KENNEDY 10.00 43.00 X 0 168256 45319 IVAN V ZAMORA 40.00 0.00 X 176135 0 15819 HERBERT B FLOYD 40.00 0.00 X 284357 0 811 LYNN M HOLIFIED 40.00 0.00 X 119208 0 17628 CADE CARSON 40.00 0.00 X 122647 0 18752 SAMUEL M ALLEN 20.00 20.00 X 197400 174416 1376 899747 2133649 677742 12 0 1 0 BRASFIELD & GORRIE LLC 3021 7TH AVENUE SOUTH BIRMINGHAM AL 35234 CONSTRUCTION CONTRACTOR 4558687 PHILIPS MEDICAL SYSTEMS PO BOX 100355 ATLANTA GA 30384 BIO MED SERVICES 2600061 HHS LTD PO BOX 826 SAN ANTONIO TX 78293 HOUSEKEEPING SERVICES 1833021 HEALTHCARE SECURITY SERVICES 1395 S PLATTE RIVER DRIVE DENVER CO 80223 SECURITY SERVICES 577665 EMCARE INC PO BOX 905223 CHARLOTTE NC 282905816 ER PHYSICIAN COVERAGE 297646 16 689816 689816 PATIENT CARE SERVICES 621990 179138191 179138191 MANAGEMENT FEES 561000 2435719 2435719 181573910 1047914 1047914 13324457 0 13324457 13324457 13324457 34541 17007 0 -17007 34541 17534 17534 OTHER REVENUE 900099 4177611 4177611 OTHER INVESTMENT INCOME 900099 2971308 2966521 4787 7148919 203802550 188718042 4787 14389905 19599567 19599567 48158927 47665913 493014 7409712 7355464 54248 3237439 3216021 21418 17007581 17007581 35882 35882 25303 24437 866 3157776 3157776 96371 92992 3379 285223 52704 232519 6416161 6416161 11477198 11477198 920468 920468 SUPPLIES 29671406 29624494 46912 PURCHASED SERVICES 23255866 22652637 603229 PROVISION FOR BAD DEBTS 8065964 8065964 TAXES & LICENSES 4251224 4240854 10370 4225410 3941790 283620 187297478 168504440 18793038 0 165326 387507 29733731 36078238 10063105 7514519 4459836 4276136 231562838 125094696 106460309 106468142 7147013 8184794 72162338 96937205 230191658 259846541 26640045 20839571 129300150 133061458 30189882 47268012 186130077 201169041 X 44061581 58677500 44061581 58677500 230191658 259846541 X 16505072 18420 -1907573 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7390631 7390631 94692211 35253037 59439174 124951994 89841659 35110335 4528002 4528002 106468142 OTHER CURRENT ASSETS 1863135 OTHER NONCURRENT ASSETS 1653839 NOTES RECEIVABLE - AFFILIATE 91538827 OTHER ACCOUNTS RECEIVABLE 1440542 DEFERRED FINANCING COSTS 440862 96937205 FAIR VALUE OF INTEREST RATE SWAP AGREEMENT 22110065 DUE TO AFFILIATE 20158285 LINE OF CREDIT 4999662 47268012 X 199209876 0 199209876 4592674 4592674 203802550 182704804 0 182704804 4592674 4592674 187297478 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE HOSPITAL IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON THEIR INCOME UNDER SECTION 501(A) OF THE CODE. THE HOSPITAL FOLLOWS THE GUIDANCE FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN THE HOSPITAL'S CONSOLIDATED FINANCIAL STATEMENTS THAT PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. THE GUIDANCE ALSO ADDRESSES DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, AND DISCLOSURE. MANAGEMENT HAS DETERMINED THAT THIS GUIDANCE HAD NO MATERIAL EFFECT ON THE CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPITAL'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN GENERAL AND ADMINISTRATIVE EXPENSES. THERE WERE NO INTEREST OR PENALTIES RECOGNIZED ON THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS AS A RESULT OF THIS GUIDANCE. GENERALLY, TAX RETURNS FOR YEARS ENDED DECEMBER 31, 2009, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. PART XI, LINE 4B - OTHER ADJUSTMENTS: REVENUES CLASSIFIED AS EXPENSES ON FINANCIAL STATEMENTS 3,902,858. INCOME FROM AFFILIATE NETTED WITH EXPENSE ON FINANCIAL STATEMENTS 689,816. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES CLASSIFIED AS REVENUES ON FINANCIAL STATEMENTS 3,902,858. INCOME FROM AFFILIATE NETTED WITH EXPENSE ON FINANCIAL STATEMENTS 689,816. 1 1 X 1 X 1 X 1 1 1 0 0 8234466 4158041 4076425 0.02270 16380739 22596333 -6215594 0.00000 588971 727455 -138484 0.00000 25204176 27481829 -2277653 0.02270 1083394 42799 1040595 0.00580 640861 640861 0.00360 15016706 5387616 9629090 0.05370 299770 299770 0.00170 17040731 5430415 11610316 0.06480 42244907 32912244 9332663 0.08750 3708 3708 0.00000 4503 4503 0.00000 8530 8530 0.00000 16741 16741 1 8065964 0 37202139 42534211 -5332072 X 1 1 2 1 RUSH FOUNDATION HOSPITAL

1314 19TH AVENUE MERIDIAN MS 39301

X X X 2 HC WATKINS MEMORIAL HOSPITAL

605 S ARCHUSA AVE QUITMAN MS 39355

X X X RUSH FOUNDATION HOSPITAL 1 1 1 200.000000000000 1 200.000000000000 1 X X X X 1 1 X 1 0 X 1 X 0 0 HC WATKINS MEMORIAL HOSPITAL 2 1 1 200.000000000000 1 200.000000000000 1 X X X X 1 1 X 1 0 X 1 X 0 0 PART I, LINE 7: COSTING METHODOLOGY USED ON LINE 7 IS THE RATIO OF PATIENT CARE COST TO CHARGES DERIVED FROM WORKSHEET 2. PART I, LINE 7G: SUBSIDIES FOR NEUROSURGICAL SERVICES, EMERGENCY ROOM, AND DIABETIC EDUCATION ARE REPORTED AS PART OF THE SUBSIDIZED HEALTH SERVICES. THE GEOGRAPHIC AREA SERVICED BY RUSH FOUNDATION HOSPITAL HAS ONLY 2 NEUROSURGEONS TO HANDLE ALL TRAUMA AND OTHER NEURO ASSOCIATED CONDITIONS. THESE 2 NEUROSURGEONS WOULD NOT BE ABLE TO PROVIDE A PRACTICE AND SERVICES TO OUR COMMUNITY WITHOUT SUBSIDIES. SO IN ORDER TO BETTER THE HEALTH OF OUR SURROUNDING AREA RUSH PROVIDES SUBSIDY TO THEIR PRACTICE. 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 $ 8065964. PART II: ALL ACTIVITIES ENGAGED IN BY RUSH FOUNDATION HOSPITAL ARE GEARED TOWARD PROMOTION AND IMPROVEMENT OF THE WELLBEING OF THE CITIZENS OF OUR PRIMARY SERVICE AREA. RUSH PROMOTES HEALTH EDUCATION THROUGH SUPPORT OF ITS COMMUNITY BASED NURSING AND ALLIED HEALTH PROGRAMS AS WELL AS COMMUNITY HEALTH EDUCATION AND TRAINING SESSIONS. NUMEROUS VOLUNTEER HOURS ARE SPENT WITH ACTIVITIES SUCH AS THE SEXUAL ASSAULT NURSE EXAMINER PROGRAM, PHYSICALS FOR SCHOOL AGE CHILDREN AND HEALTH FAIRS. RUSH ALSO SUPPORTS THE COMMUNITY BY ENSURING THE PROVISION OF NEEDED SPECIALTY CARE SUCH AS NEURO SURGERY AND EMERGENCY MEDICINE. PART III, LINE 4: BAD DEBT EXPENSE IS REFLECTED AS AMOUNT OF CHARGES ACTUALLY WRITTEN OFF. PER NOTE 1 OF THE FINANCIAL STATEMENTS, PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT ESTIMATED NET REALIZABLE VALUE AFTER DEDUCTION OF ALLOWANCES FOR DOUBTFUL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED ON HISTORICAL LOSSES AND AN ANALYSIS OF CURRENTLY OUTSTANDING AMOUNTS. THIS ACCOUNT IS GENERALLY INCREASED BY CHARGES TO A PROVISION FOR BAD DEBTS AND DECREASED BY WRITE OFFS OF ACCOUNTS DETERMINED BY MANAGEMENT TO BE UNCOLLECTIBLE. THE HEALTH SYSTEM ENGAGED A FIRM TO ANALYZE PATIENT ACCOUNTS RECEIVABLE TO DETERMINE WHICH ACCOUNTS QUALIFIED AS CHARITY CARE IN ORDER THAT THEY WERE PROPERLY CLASSIFIED. PART III, LINE 8: THE COST OF PROVIDING SERVICES TO MEDICARE PATIENTS, AS EVIDENCED ON LINE 7, SIGNIFICANTLY EXCEEDS REVENUE. THIS COST PROVIDES A NECESSARY HEALTH BENEFIT TO THE ELDERLY POPULATION IN THE HOSPITAL'S SERVICE AREA AND SHOULD BE CONSIDERED COMMUNITY BENEFIT. PART III, LINE 9B: THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAT ITS ESTABLISHED RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. ADDITIONALLY, THE HOSPITAL MAY UTILIZE OUTSIDE AGENCIES AS APPROPRIATE TO ASSIST IN DETERMINING ACCOUNTS THAT QUALIFY AS CHARITY CARE. ANY ACCOUNTS DETERMINED TO BE CHARITY BASED ON AN AGENCY'S RECOMMENDATION ARE REPORTED AS CHARITY CARE AND REVENUE REDUCED BY THIS AMOUNT AS OPPOSED TO BEING REPORTED AS BAD DEBT EXPENSE. RUSH FOUNDATION HOSPITAL PART V, SECTION B, LINE 22: THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR A 100% DISCOUNT TO ELIGIBLE INDIVIDUALS (THOSE AT 200% OF FEDERAL POVERTY GUIDELINES); THEREFORE, PATIENTS MEETING THIS REQUIREMENT ARE NOT CHARGED FOR SERVICES PROVIDED. H.C. WATKINS MEMORIAL HOSPITAL PART V, SECTION B, LINE 22: THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY PROVIDES FOR A 100% DISCOUNT TO ELIGIBLE INDIVIDUALS (THOSE AT 200% OF FEDERAL POVERTY GUIDELINES); THEREFORE, PATIENTS MEETING THIS REQUIREMENT ARE NOT CHARGED FOR SERVICES PROVIDED. PART VI, LINE 2: OUTSIDE CONSULTANTS ARE HIRED TO CONDUCT A COMMUNITY NEEDS ASSESSMENT PERIODICALLY. PART VI, LINE 3: PATIENTS ARE PROVIDED AN APPLICATION FOR CHARITY CARE AND A CRITERIA FOR CHARITY CARE CHECKLIST AS CLOSE TO POINT OF SERVICE AS POSSIBLE. ADDITIONALLY, THE HOSPITAL UTILIZES AN OUTSIDE ELIGIBILITY COMPANY THAT REVIEWS ALL NO INSURANCE PATIENTS FOR POTENTIAL QUALIFICATION FOR OTHER GOVERNMENTAL PROGRAMS SUCH AS MEDICAID. PART VI, LINE 4: RUSH FOUNDATION HOSPITAL IS A MAJOR COMMUNITY -BASED ACUTE-CARE MEDICAL CENTER THAT SERVES INPATIENTS AND OUTPATIENTS, IN THE EAST MISSISSIPPI AND WEST ALABAMA AREA. RFH'S PRIMARY SERVICE AREA EXTENDS TO COMMUNITES IN OVER A 70-MILE RADIUS OF MERIDIAN, MS. MERIDIAN SERVES AS A HEALTHCARE HUB FOR THE MANY SURROUNDING COUNTIES WITH THREE ACUTE-CARE HOSPITALS BASED IN ITS CITY LIMITS. THESE FACILITES SERVE AS THE PRIMARY HEALTHCARE OF THE VERY NEEDY AREAS OF EAST MISSISSIPPI AND WEST ALABAMA WITH ONLY A FEW SMALL, PRIMARILY CRITICAL ACCESS HOSPITALS IN THE OUTLYING VICINITIES. OF THE COUNTIES SERVED, THE FOLLOWING ARE COUNTIES IDENTIFIED BY HEALTH RESOURCES AND SERVICES ADMINISTRATION OF THE US DEPT OF HEALTH AND HUMAN SERVICES AS HEALTH PROFESSIONAL SHORTAGE AREAS: CHOCTAW AND SUMTER COUNTIES IN ALABAMA; CLARKE, KEMPER, LAUDERDALE, NESHOBA, NEWTON AND SCOTT COUNTIES IN MISSISSIPPI. PART VI, LINE 5: ALL MEMBERS OF RUSH FOUNDATION HOSPITAL'S BOARD RESIDE IN RFH'S PRIMARY SERVICE AREA. THE ORGANIZATION HAS AN OPEN MEDICAL STAFF EXTENDING PRIVILEGES TO ALL QUALIFIED PHYSICIANS AND NON-PHYSICIAN PRACTITIONERS THAT APPLY FOR PRIVILEGES AND MEET ALL REQUIREMENTS OF CREDENTIALING AND THE MEDICAL STAFF RULES AND REGS AND BY-LAWS. THE FACILITY UTILIZES SURPLUS FUNDS FOR ADDITIONAL MEDICAL TECHNOLOGY, RECRUITMENT OF MEDICAL STAFF THAT IS OTHERWISE UNAVAILABLE (I.E. NEUROSURGERY, MIDWIFERY, ETC.), FUNDING OF LOCAL AREA HEALTHCARE WORKFORCE TRAINING AND ECONOMIC DEVELOPMENT. PART VI, LINE 6: RUSH FOUNDATION HOSPITAL IS WHOLLY OWNED BY RUSH HEALTH SYSTEMS, A NON-PROFIT ORGAINIZATION. WITHIN RUSH HEALTH SYSTEMS ARE THE SPECIALTY HOSPITAL OF MERIDIAN (A LONG TERM ACUTE CARE FACILITY), LAIRD HOSPITAL (A CRITICAL ACCESS HOSPITAL, HC WATKINS HOSPITAL (A CRITICAL ACCESS HOSPITAL), SCOTT HOSPITAL (A CRITICAL ACCESS HOSPITAL), MEDICAL FOUNDATION INC. (A CLINIC ORGANIZATION), AND RUSH MEDICAL GROUP (A CLINIC ORGANIZATION). EACH OF THESE ENTITES COORDINATE TO IMPROVE THE HEALTHCARE OF EAST MISSISSIPPI AND WEST ALABAMA. CLINICAL INTEGRATION BETWEEN OUTLYING CRITICAL ACCESS HOSPITALS, SPECIALIST PHYSICIANS AND THE GENERAL ACUTE CARE HOSPITAL PROVIDE FOR IMPROVED ACCESS AND IMPROVED OUTCOMES FOR THE POPULATION WE SERVE. 1 RUSH CARE INC 1314 19TH AVENUE MERIDIAN MS 39301 640833381 501(C)(3) 3333265 AFFILIATE SUPPORT MEDICAL FOUNDATION INC PO BOX 5183 MERIDIAN MS 39302 640834532 501(C)(3) 12125625 AFFILIATE SUPPORT MANAGED HEALTHCARE INC 1314 19TH AVENUE MERIDIAN MS 39301 640862241 54709 AFFILIATE SUPPORT RUSH HOSPITAL - BUTLER INC 1314 19TH AVENUE MERIDIAN MS 39301 640655993 501(C)(3) 1440071 AFFILIATE SUPPORT RUSH HOME CARE 1314 19TH AVENUE MERIDIAN MS 39301 640670314 501(C)(3) 240763 AFFILIATE SUPPORT RUSH MEDICAL GROUP NEWTON 1314 19TH AVENUE MERIDIAN MS 39301 640783323 501(C)(3) 116821 AFFILIATE SUPPORT KEMPER CAH DBA JOHN C STENNIS MEMORIAL HOSPITAL INC 1314 19TH AVENUE MERIDIAN MS 39301 271757642 501(C)(3) 2288313 AFFILIATE SUPPORT 6 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ALL REQUESTS FOR DONATIONS, CONTRIBUTIONS, SPONSORSHIPS ARE FORWARDED TO A SPONSORSHIP COMMITTEE CONSISTING OF SEVERAL HEALTH SYSTEM EXECUTIVES. THE COMMITTEE DETERMINES WHETHER THERE IS A HEALTH NEED, ECONOMIC DEVELOPMENT NEED, ETC. FOR THE REQUEST AND THEN VOTE TO DETERMINE IF THE REQUEST WILL BE GRANTED. X X X X X X 0 1 0 0 0 0 0 0 0 H LOWRY RUSH III 0 123972 0 0 0 5725 0 27117 0 27257 0 184071 0 0 L VAUGHAN RUSH JR MD 0 194308 0 0 0 4800 0 5530 0 5134 0 209772 0 0 CHRIS RUSH 0 178204 0 0 0 5782 0 35100 0 16606 0 235692 0 0 CHUCK REECE 0 276968 0 0 0 5595 0 111100 0 52655 0 446318 0 0 DARRELL WILDMAN 0 211128 0 0 0 6312 0 45949 0 37525 0 300914 0 0 CATHY ROBINSON 0 141520 0 0 0 5585 0 29067 0 13233 0 189405 0 0 FRED ROGERS 0 131877 0 0 0 2540 0 29256 0 26808 0 190481 0 0 DONNIE SMITH 0 168091 0 0 0 5865 0 37666 0 20362 0 231984 0 0 DALE ARMOUR 0 179820 0 15000 0 4800 0 27750 0 11362 0 238732 0 0 LARKIN KENNEDY 0 152219 0 10000 0 6037 0 27750 0 17569 0 213575 0 0 IVAN V ZAMORA 176135 0 0 0 0 0 4809 0 11010 0 191954 0 0 0 HERBERT B FLOYD 284357 0 0 0 0 0 0 0 811 0 285168 0 0 0 SAMUEL M ALLEN 197400 174416 0 0 0 0 0 0 1376 0 198776 174416 0 0 PART I, LINE 4B RUSH HEALTH SYSTEMS (SOLE MEMBER OF THE ORGANIZATION) PROVIDES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN UNDER SECTION 457(F). CONTRIBUTIONS TOTALED $542,380 FOR 2012 AND DISTRIBUTIONS TOTALED $946,210. A MISSISSIPPI BUSINESS FINANCE CORPORATION 640679132 2012-04-16 64665000 REFUNDING/HOSPITAL EQUIPMENT/CONSTRUCTION 0 0 0 A 64665000 64665000 2012 1 1 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 1 1 REGIONS 20.000000000000 0 0 0 0 0 AIMEE MCWILLIAMS DAUGHTER OF CATHY ROBINSON, CORP COMPLIANCE OFFICER 23920 AIMEE MCWILLIAMS IS AN EMPLOYEE OF RUSH MEDICAL FOUNDATION. 0 JILLIAN ANNE RUSH DAUGHTER OF H.L. RUSH, III, BOARD CHAIRMAN 15015 JILLIAN A. RUSH IS AN EMPLOYEE OF RUSH MEDICAL FOUNDATION. 0 FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBERS H. LOWRY RUSH, III AND L. VAUGHAN RUSH JR., MD HAVE A FAMILY RELATIONSHIP; THEY ARE COUSINS. FORM 990, PART VI, SECTION A, LINE 6 RUSH HEALTH SYSTEMS, INC. IS THE PARENT ORGANIZATION AND SOLE MEMBER OF THIS ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF RUSH HEALTH SYSTEMS, INC. (SOLE MEMBER OF ORGANIZATION) APPOINTS BOARD MEMBERS FOR THE ORGANIZATION ANNUALLY FOR A ONE YEAR TERM. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF RUSH HEALTH SYSTEMS, INC. (SOLE MEMBER OF ORGANIZATION) APPROVES AND RATIFIES THE ACTIONS OF THE ORGANIZATION'S BOARD. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF RUSH HEALTH SYSTEMS, INC. (SOLE MEMBER OF THE ORGANIZATION) REVIEWED AND APPROVED THE FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. THE OFFICERS AND DIRECTORS OF THE ORGANIZATION REVIEW THE POLICY ANNUALLY AND SIGN A CONFLICT OF INTEREST STATEMENT STATING THEY HAVE READ AND UNDERSTAND THE POLICY AND ARE IN COMPLIANCE. EDUCATION IS GIVEN TO THE STAFF ON THE CONFLICT OF INTEREST POLICY WHICH INCLUDES DIRECTION TO VOICE ANY QUESTIONS OR CONCERNS THEY HAVE AND TO BRING FORTH ANY POTENTIAL CONFLICT OR CONCERN TO THE ATTENTION OF THE CORPORATE COMPLIANCE OFFICER. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION FOR THE AFFILIATED GROUP OF RUSH HEALTH SYSTEMS (SOLE MEMBER OF THE ORGANIZATION) IS REVIEWED ANNUALLY BY INDEPENDENT CONSULTANTS. CONSULTANTS COMPARE COMPENSATION ORDINARILY PROVIDED BY SIMILAR ORGANIZATIONS, UNDER LIKE CIRCUMSTANCES, AND ADJUSTED TO REFLECT CURRENT MARKET RATES. CONSULTANTS MEET WITH THE COMPENSATION COMMITTEE AND MAKE RECOMMENDATIONS WHICH ARE APPROVED AND RATIFIED BY THE BOARD. THE INDEPENDENT CONSULTANTS REGULARLY CONTRACTED TO PERFORM SUCH REVIEWS ARE HORNE LLP AND SULLIVAN, COTTER & ASSOCIATES, INC. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT -1,907,573. AUDIT COMMITTEE FORM 990, PART XII, LINE 2C THE AUDIT/COMPENSATION COMMITTEE OVERSEES RESPONSIBILITY FOR THE AUDITED FINANCIAL STATEMENTS FOR THE ORGANIZATION. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR. 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