2012-05-07T08:00:56-05:00 2011-06-30 PERSHING YOAKLEY & ASSOCIATES P C ONE CHEROKEE MILLS 220 SUTHERLAND A KNOXVILLE TN 379192363 990 2010-07-01 582002413 GWINNETT HOSPITAL SYSTEM INC GWIN 6783124321 1000 MEDICAL CENTER BOULEVARD LAWRENCEVILLE GA 30046 THOMAS Y MCBRIDE III 6783125603 2012-05-03 1 SUSAN P CLARK CPA 8656730844 2010 2016-02-24 21:20:13Z PHILIP R WOLFE 1000 MEDICAL CENTER BOULEVARD LAWRENCEVILLE GA 30046 618096175 0 X WWW.GWINNETTMEDICALCENTER.ORG X 1992 GA GWINNETT HOSPITAL SYSTEM, INC. (GHSI) IS A NOT-FOR-PROFIT HEALTHCARE NETWORK THAT PROVIDES AWARD-WINNING HEALTHCARE SERVICES TO THE GWINNETT COMMUNITY AND BEYOND. GHSI HAS CAMPUSES IN DULUTH & LAWRENCEVILLE, GEORGIA. GHSI PROVIDES ACUTE CARE, OUTPATIENT SERVICES, ORTHOPEDIC & NEUROSCIENCE SPECIALTY CARE, TWO EMERGENCY ROOMS & SEVERAL CLINICS AS WELL AS A FULL CONTINUUM OF WELLNESS SERVICES. 5 2 4850 300 681418 243272 10977083 12836923 578979592 595270227 7756579 10023121 -344784 -34096 597368470 618096175 3612215 7799033 0 0 270235251 249431783 0 0 0 296380773 330335175 570228239 587565991 27140231 30530184 814489437 828442212 481162720 437216897 333326717 391225315 X GHSI IS A NOT-FOR-PROFIT HEALTHCARE NETWORK THAT PROVIDES AWARD-WINNING HEALTHCARE SERVICES TO THE GWINNETT COMMUNITY AND BEYOND. GHSI HAS CAMPUSES IN DULUTH AND LAWRENCEVILLE, GEORGIA. GHSI PROVIDES ACUTE CARE, OUTPATIENT SERVICES, ORTHOPEDIC AND NEUROSCIENCE SPECIALTY CARE, AS WELL AS A FULL CONTINUUM OF WELLNESS SERVICES TO THE COMMUNITY. THESE FACILITIES EMPLOYEE OVER 4,000 EMPLOYEES AND ARE AFFILIATED WITH OVER 800 PHYSICIANS. GHSI'S GOAL IS TO BE THE LEADING HOSPITAL SYSTEM IN OUR COMMUNITY BY NOT ONLY EFFECTIVELY TREATING DISEASES AND INJURIES, BUT TO PROVIDE EARLY INTERVENTION AND PREVENTION. 0 0 503496496 7799033 594794053 THE HOSPITAL'S PRIMARY PROGRAM ACTIVITY IS THE PROVISION OF PATIENT CARE. THE HOSPITAL PROVIDED NURSING CARE IN THE AREAS OF MEDICAL, POST-SURGICAL, CRITICAL CARE, AND INTERMEDIATE CARE. 4730592 0 THE HOSPITAL PROVIDES HEALTH PROFESSIONAL EDUCATION SERVICES WITH FOCUSES ON NURSING AND OTHER ALLIED HEALTH PROFESSIONS EDUCATION. 3150356 0 281116 THE HOSPITAL ALSO PROVIDES COMMUNITY HEALTH IMPROVEMENT SERVICES. TWO OF THE LARGEST PROGRAMS INCLUDE THE CONGREGATIONAL HEALTH MINISTRY AND THE SPORTS MEDICINE SUPPORT SERVICES. THESE PROGRAMS ARE CONDUCTED IN THE COMMUNITY THROUGH FAITH-BASED ORGANIZATIONS AND SCHOOLS AND GWINNETT COUNTY'S PARKS AND RECREATION DEPARTMENT. 511377444 1 1 0 1 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 1 1 1 1 0 0 0 1 1 1 0 0 0 1 483 0 1 4850 1 1 1 0 0 0 0 0 0 0 0 0 X 5 2 0 0 0 0 1 1 1 1 1 0 0 1 1 0 1 1 1 1 1 1 1 GA X LAVERNE GROVE 6783125603 1000 MEDICAL CENTER BOULEVARD LAWRENCEVILLE GA 30046 MANFRED SANDLER 5.00 X 2776 0 0 DAVID MCCLESKEY 5.00 X 2125 0 0 CHUNG LEE 5.00 X 1625 0 0 MILES MASON III MD 5.00 X 51747 0 759 ED RADFORD 5.00 X 1875 0 0 PHILIP R WOLFE 60.00 X 696711 0 132367 ALAN BIER 60.00 X 381450 0 80574 THOMAS Y MCBRIDE III 60.00 X 717272 0 330513 JEFFREY NOWLIN 60.00 X 351995 0 85716 PETER WHEELER 60.00 X 285800 0 86264 WALLACE BROWN 60.00 X 306962 0 75566 STEPHEN NADEAU 60.00 X 293832 0 72298 CAROL DANIELSON 60.00 X 261640 0 64000 LEA BAY 60.00 X 248699 0 60125 CARLTON KEITH BUCHANAN MD 5.00 X 52000 0 4688 JESSIE T SHEPHERD 60.00 X 222992 0 62613 SCOTT OREM 60.00 X 172022 0 59158 JAMES DENNARD JR 60.00 X 188670 0 44967 DIANA POTTS 60.00 X 171440 0 40681 CATHY DOUGHERTY 60.00 X 162049 0 41776 BONNY RICHARDSON 60.00 X 150963 0 37728 PAMELA KAUFFMAN 60.00 X 144073 0 42178 MICHAEL HEMPHILL 60.00 X 151752 0 41435 JASON CHANDLER 60.00 X 194605 0 48769 JANET SCHWALBE 60.00 X 177453 0 35948 THOMAS LYNCH 60.00 X 188023 0 49466 LAURA TUCKER 60.00 X 150651 0 21857 ROMEO P MASSOUD MD 60.00 X 676715 0 55197 MICHAEL A AMARAL MD 60.00 X 586922 0 67406 MICHAEL T STECHISON MD 60.00 X 589521 0 50391 BARRY RENZ MD 60.00 X 524769 0 55678 HERSCHEL W SMITH III MD 60.00 X 372097 0 50328 8337153 0 1756268 177 0 1 0 MCKESSON TECHNOLOGIES INC PO BOX 98347 CHICAGO IL 606938347 SOFTWARE DEVELOPMENT & MAINTENANCE 5304979 ALLIANCE LAUNDRY 7990 SECOND FLAGS DRIVE SUITE A AUSTELL GA 30168 LAUNDRY & TEXTILE SERVICES 2335796 SYNTHES USA SALES LLC PO BOX 8538-662 PHILADELPHIA PA 191710662 SURGICAL PRODUCTS 2269785 GWINNETT ANESTHESIA SERVICE PC PO BOX 669 LAWRENCEVILLE GA 30046 ANESTHESIA 2254700 CLINTON A HARKINS PC 4901 OLDE TOWNE PARKWAY STE 300 MARIETTA GA 300684354 COLLECTIONS 1387612 242 2348637 10342572 145714 104310 12836923 PATIENT SERVICE REVENU 621500 583834799 583462805 371994 CLINIC REVENUE 900099 3205848 3205848 DISCOUNTS 900099 2773635 2773635 CAFETERIA & PARKING 900099 2674380 2674380 MANAGEMENT FEES 900099 1253106 999444 253662 1528459 1472697 55762 595270227 9401191 9401191 160962 160962 160962 160962 589090 32840 589090 32840 621930 621930 BARING FOCUSED INTERNA 900099 -26 -26 INTECH RISK MGD. LG. C 900099 -2920 -2920 GWINNETT ENDOSCOPY SER 900099 -192112 -192112 -195058 618096175 591719371 681418 12858463 7725498 7725498 73535 73535 8588456 70590 8517866 187339666 166805529 20534137 11954807 10161586 1793221 27469462 23350521 4118941 14079392 11967483 2111909 870523 870523 802796 127929 674867 530570 530570 485821 485821 9591277 4398899 5192378 1912996 38272 1874724 7784048 5346558 2437490 6868667 1133335 5735332 10834400 9456032 1378368 276170 130540 145630 234562 76702 157860 8426611 8426611 35003606 35003606 490698 281832 208866 BAD DEBTS 110732317 110732317 MEDICAL AND SURGICAL SU 76685215 76685215 PURCHASED SERVICES 26762662 14142019 12620643 EQUIPMENT RENTAL & MAIN 11342045 10287082 1054963 UBI TAX 108000 108000 20592191 13491409 7100782 587565991 511377444 76188547 0 137452974 93039042 5000000 90430037 88705978 1698594 0 1001694 580924 4781924 4857955 6337838 6197320 587321042 287263410 292234097 300057632 257935934 314069368 8335360 8185532 3430000 9280985 9318461 814489437 828442212 43934199 38130845 5000000 5126543 214231 322252000 317192910 104849978 81678911 481162720 437216897 X 325569334 381247441 7570288 9690779 187095 287095 333326717 391225315 814489437 828442212 X 30530184 27368414 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 29979 29979 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: DUES PAID TO GEORGIA HOSPITAL ASSOCIATION WERE $119,916. OF THIS AMOUNT, 25%, OR $29,979 WENT FOR LOBBYING. 7757383 1970363 150129 100000 9777875 6154854 4262776 -2658501 1750 7757379 3960633 44549 2149672 6154854 0.97120 0.02880 0 1 1 14184177 14184177 258556972 95671536 162885436 17092263 11741579 5350684 270262686 178696924 91565762 27224944 1153371 26071573 300057632 ACCRUED INTEREST PAYABLE 3853141 ACCRUED PENSION COSTS 27486355 SELF-INSURANCE RESERVES 8191717 THIRD PARTY SETTLEMENTS 13436115 ASSET RETIREMENT OBLIGATION 265362 INTEREST RATE SWAP 25006715 EXECUTIVE BENEFITS LIABILITY 1812275 BOND EXPENSE PAYABLE 606669 MINORITY INT. IN GWINNETT ENDOSCOPY 290000 DUE TO AFFILIATES 730562 81678911 618096175 587565991 30530184 13446994 104310 -618342 14435452 27368414 57898598 629431000 13446994 149710 13596704 615834296 485821 1776058 2261879 618096175 587008000 1365 1365 587006635 485821 73535 559356 587565991 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: TERM ENDOWMENT FUNDS WILL BE USED FOR SPECIFIC PROJECTS OR PROGRAMS OF THE HOSPITAL. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE INTERNAL REVENUE SERVICE HAS DETERMINED THAT THE HOSPITAL IS EXEMPT FROM FEDERAL INCOME TAX ON RELATED INCOME UNDER INTERNAL REVENUE CODE SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3). THE HOSPITAL FOLLOWS FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, WHICH ADDRESSES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS. IT ALSO PROVIDED GUIDANCE ON WHEN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. THERE IS CURRENTLY NO IMPACT ON THE HOSPITAL'S FINANCIAL STATEMENTS AS A RESULT OF APPLYING ASC 740. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN ASSETS OF FOUNDATION 250,129. LOSS ON BOND DEFEASANCE -864,954. GAIN FROM K-1 INVESTMENTS 805,749. CHANGE IN PENSION ACCOUNTING 14,026,533. OTHER CHANGES 217,995. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIFFERENCE IN TRANSFER FROM GMSI 149,710. PART XII, LINE 4B - OTHER ADJUSTMENTS: NONCASH CONTRIBUTIONS 104,310. LOSS ON BOND DEFEASANCE 864,954. GAIN FROM K-1 INVESTMENTS 805,749. ROUNDING 1,045. PART XIII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 1,365. PART XIII, LINE 4B - OTHER ADJUSTMENTS: NONCASH GRANTS 33,535. ONCOLOGY GRANT 40,000. 1 1 X 1 X 125.000000000000 1 X 200.000000000000 1 1 1 0 1 1 32624680 2755254 29869426 0.06260 74076577 51358799 22717778 0.04760 96318 49653 46665 0.00010 106797575 54163706 52633869 0.11030 183 298308 3299041 281116 3017925 0.00630 26 3209 4730592 0 4730592 0.00990 8 14993 26978254 22838663 4139591 0.00870 5 1416 577660 0 577660 0.00120 5 1922 11619 0 11619 0.00000 227 319848 35597166 23119779 12477387 0.02610 227 319848 142394741 77283485 65111256 0.13640 7 915 17426 17426 0.00000 2 0 334133 334133 0.00070 9 915 351559 351559 0.00070 0 31840996 23045 85594643 88473535 -2878892 X 1 1 1 GWINNETT ENDOSCOPY SERVICES LLC ENDOSCOPY SERVICES 0.55520 0.00000 0.44480 2 1 GWINNETT MEDICAL CENTER LAWRENCEVILLE

1000 MEDICAL CENTER BOULEVARD LAWRENCEVILLE GA 30046

X X X 2 GWINNETT MEDICAL CENTER DULUTH

3620 HOWELL FERRY ROAD DULUTH GA 30096

X X X NA 1 10 GLANCY REHABILITATION CENTER

3215 MCCLURE BRIDGE ROAD DULUTH GA 30096

REHABILITATION 575 OUTPATIENT IMAGING CENTER

575 PROFESSIONAL DRIVE FOURTH FLOOR LAWRENCEVILLE GA 30046

IMAGING GWINNETT BREAST CENTER

631 PROFESSIONAL DRIVE SUITE 250 LAWRENCEVILLE GA 30046

IMAGING GWINNETT MEDICAL CENTER IMAGING CENTER

HAMILTON MILL STATION 2078 TERON TRACE DACULA GA 30019

IMAGING JOHNS CREEK ORTHOPEDIC SURGERY CENTER

10670 MEDLOCK BRIDGE RD DULUTH GA 30097

ORTHOPEDIC SURGERY 631 IMAGING CENTER (PETCT & MRI)

GWINNETT PHYS CTR 631 PROFESSIONAL DR LAWRENCEVILLE GA 30046

IMAGING OBGYN CLINIC

100 MEDICAL CENTER BLVD LAWRENCEVILLE GA 30046

PHYSICIAN SERVICES MILES & LIB MASON CHILDREN'S ASSOCIATES

555 OLD NORCROSS ROAD SUITE 210 LAWRENCEVILLE GA 30045

PEDIATRIC SERVICES GWINNETT EXTENDED CARE CENTER

650 PROFESSIONAL DDRIVE LAWRENCEVILLE GA 30046

NURSING HOME GWINNETT DAY SURGERY

1000 MEDICAL CENTER BLVD LAWRENCEVILLE GA 30046

SURGERY PART I, LINE 7: LINE 7A - CHARITY CARE COSTS WERE CALCULATED USING A MEDICAID SPECIFIC COST-TO-CHARGE RATIO (CCR) FROM THE MEDICARE COST REPORT. A MEDICAID CCR WAS USED BECAUSE THE MEDICAID POPULATION BETTER REPRESENTS THE UTILIZATION AND ACUITY OF THE CHARITY POPULATION THAN THE USE OF AN OVERALL CCR AS CALCULATED IN WORKSHEET 2. A CCR WAS USED INSTEAD OF A COST ACCOUNTING SYSTEM BECAUSE CHARITY, AS WELL AS BAD DEBTS, REPRESENT ONLY A PORTION OF A PATIENT ACCOUNT THAT IS BEING WRITTEN OFF.LINE 7B, 7C & 7G - AN RVU BASED COST ACCOUNTING SYSTEM (ADS) WAS USED TO ESTIMATE THE MEDICAID FFS & MEDICAID MANAGED CARE AMOUNTS REPORTED ON LINE 7B, THE PEACH CARE (GA SCHIP PROGRAM) REPORTED ON LINE 7C AND THE SUBSIDIZED HEALTH SERVICES REPORTED ON LINE 7G. ADS DOES INCLUDE INFORMATION FROM ALL PATIENT SEGMENTS REGARDLESS OF PAYOR. THE MEDICAID SHORTFALL REPORTED ON LINE 7B INCLUDES A PRIOR YEAR SETTLEMENT HIT OF $60,352. PART I, LINE 7G: THREE PHYSICIAN PRACTICES/CLINICS WERE INCLUDED IN THE SUBSIDIZED SERVICES CATEGORY, THE OB/GYN CLINIC, MILES AND LIB MASON CHILDREN'S CLINIC AND WOUND CARE CLINIC. EACH CLINIC PROVIDES SERVICES THAT MEET IDENTIFIED COMMUNITY NEEDS. THESE CLINICS OFFER SERVICES THAT THE COMMUNITY DOES NOT CURRENTLY HAVE THE CAPACITY TO PROVIDE. THESE MEDICAL PRACTICES PROVIDE A SIGNIFICANT BENEFIT TO THE COMMUNITY AND DO NOT OPERATE PRIMARILY TO INCREASE REFERRALS OF PATIENTS WITH THIRD PARTY COVERAGE AS A MAJORITY OF THE PATIENTS ARE UNDERINSURED, UNINSURED OR COVERED BY FEDERAL OR STATE INSURANCE PLANS FOR AT-RISK POPULATIONS (CHILDREN AND PREGNANT WOMEN AS AN EXAMPLE). IN ADDITION, THE MEDICAL PRACTICES ARE OPERATED EFFICIENTLY AND PAYMENTS TO PHYSICIANS ARE REASONABLE AND IN-LINE WITH THE GUIDELINES FROM THE MEDICAL GROUP MANAGEMENT ASSOCIATION AS WELL AS PREVAILING COMMUNITY RATES FOR PHYSICIAN REIMBURSEMENT. EXPENSES AT COST FOR SUBSIDIZED SERVICES FOR PHYSICIAN CLINICS HAVE BEEN CALCULATED FROM TOTAL DEPARTMENT EXPENSES AT COST MINUS BAD DEBT, MEDICAID AND CHARITY CARE. - OB/GYN CLINIC COSTS $735,378 WITH A NET COMMUNITY BENEFIT EXPENSE OF $508,444 - MILES AND LIB MASON CHILDREN'S CLINIC COSTS $294,157 WITH A NET COMMUNITY BENEFIT EXPENSE OF $112,805 - WOUND CARE CLINIC COSTS $1,056,827 WITH A NET COMMUNITY BENEFIT EXPENSE OF $578,840 PART I, L7 COL(F): $110,732,317 IN BAD DEBT EXPENSES WERE SUBTRACTED FROM FORM 990, PART IX, LINE 25 FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN. PART II: COMMUNITY BUILDING ACTIVITIES INCLUDE PROGRAMS THAT ADDRESS ROOT CAUSES OF HEALTH PROBLEMS AND ARE CAPTURED IN THE CATEGORIES OF COALITION BUILDING AND WORKFORCE DEVELOPMENT IN AN EFFORT TO ENHANCE PUBLIC HEALTH. OUR ORGANIZATION DID NOT PARTICIPATE IN THESE ACTIVITIES TO INCREASE REFERRALS OR TO FULFILL REGULATORY REQUIREMENTS OR CURRENT STANDARDS-OF-CARE. COALITION BUILDING INCLUDES PARTICIPATION OF THE CHAPLAINCY, COORDINATED CARE, CONGREGATIONAL HEALTH MINISTRY, SPORTS REHABILITATION, WOMEN'S SERVICES, PHYSICIAN SERVICES AND THE COMMUNITY BENEFIT & RESEARCH DEPARTMENTS. THESE DEPARTMENTS PARTICIPATE IN COMMUNITY COALITIONS AND OTHER COLLABORATIVE EFFORTS WITH THE COMMUNITY TO ADDRESS SAFETY AND HEALTH ISSUES TO PROMOTE THE HEALTH OF THE COMMUNITY; FOR EXAMPLES, GWINNETT FIRE SERVICES CRITICAL INCIDENT STRESS MANAGEMENT TEAM, CHILD PROTECTION TASK FORCE AND THE YMCA BOARD OF DIRECTORS. OUR COMMUNITY COLLABORATIONS CONTINUE TO SUPPORT OUR VISION AND MISSION AND FURTHER TIE US TO THE COMMUNITY WE SERVE. GWINNETT HOSPITAL SYSTEM PARTICIPATED ON THE GWINNETT COALITION FOR HEALTH AND HUMAN SERVICES BOARD THAT SERVES THE COMMUNITY THROUGH INITIATIVES DRIVEN BY ITS SUBCOMMITTEES (E.G., EXECUTIVE COMMITTEE, BOARD OF DIRECTORS, GREAT DAYS OF SERVICE, RESEARCH AND ACCOUNTABILITY COMMITTEE AND THE TASK FORCE FOR THE YOUTH SURVEY FACT BOOK). WE COLLABORATE WITH AIDGWINNETT, J. M. TULL - GWINNETT YMCA, GWINNETT UNITED IN DRUG EDUCATION, INC. (GUIDE), GWINNETT FOSTER CHILDREN'S FOUNDATION AND BOY SCOUTS' MEDICAL EXPLORERS PROGRAM. OUR ORGANIZATION WORKS CLOSELY WITH THE GWINNETT CHAMBER OF COMMERCE AND ACTIVELY PARTICIPATES IN PARTNERSHIP GWINNETT, WHICH IS A COMPREHENSIVE PLAN THAT PARTNERS GOVERNMENT, EDUCATION, HEALTHCARE AND BUSINESS IN AN ECONOMIC DEVELOPMENT PLAN. IN ADDITION TO THE CHAMBER, GWINNETT HOSPITAL SYSTEM IS INVOLVED WITH INDIVIDUAL CITIES IN THE COUNTY.GWINNETT HOSPITAL SYSTEM IS INVOLVED WITH STATE AND COUNTY GOVERNMENT AGENCIES INCLUDING GEORGIA DEPARTMENT OF HEALTH AND HUMAN SERVICES, GWINNETT PUBLIC HEALTH DEPARTMENT, GRN COMMUNITY SERVICE BOARD, GEORGIA TRAUMA CARE NETWORK COMMISSION, GEORGIA STATE OFFICE OF EMERGENCY MEDICAL SERVICES AND TRAUMA, PARTNERSHIP AGAINST DOMESTIC VIOLENCE (PADV), GWINNETT COUNTY RAPE CRISIS CENTER, GWINNETT COUNTY JUSTICE SYSTEM, GWINNETT COUNTY POLICE DEPARTMENT, GWINNETT COUNTY PUBLIC LIBRARY, GWINNETT COUNTY PUBLIC SCHOOL SYSTEM, DEPARTMENT OF FAMILY CHILDREN SERVICES (DFCS), DEPARTMENT OF AGING SERVICES (DAS), GWINNETT COUNTY SENIOR SERVICES AND THE GEORGIA MEDICARE FOUNDATION. GWINNETT HOSPITAL SYSTEM WORKS WITH NATIONAL AGENCIES WHICH HAVE LOCAL CHAPTERS INCLUDING THE AMERICAN HEART ASSOCIATION, AMERICAN RED CROSS, MARCH OF DIMES, AMERICAN STROKE ASSOCIATION, AMERICAN CANCER SOCIETY, AMERICAN DIABETES ASSOCIATION AND THE UNITED WAY. OUR EFFORTS IN WORKFORCE DEVELOPMENT INCLUDE RECRUITING PHYSICIANS IN MULTIPLE SPECIALTIES FOR COMMUNITY PRACTICES ACCORDING TO COMMUNITY NEEDS ESTABLISHED IN THE 2010 PHYSICIAN NEEDS ASSESSMENT. THE ORGANIZATION'S PRIMARY PURPOSE IN THESE EFFORTS IS TO ASSIST IN COMMUNITY PHYSICIAN RECRUITMENT TO IMPROVE ACCESS TO CARE IN OUR COMMUNITY. PART III, LINE 4: LINE 2 - THE COST REPORTED ON LINE 2 WERE ARRIVED AT USING AN OVERALL CCR CALCULATED PER WORKSHEET 2 INSTRUCTIONS WITH A COUPLE OF EXCEPTIONS. BAD DEBT COSTS WERE SUBTRACTED WHEN COMING UP WITH SHORTFALL AMOUNTS FOR MEDICARE, MEDICAID, PEACH CARE AND SUBSIDIZED SERVICES SO THAT THOSE COSTS WOULD NOT BE DOUBLE COUNTED IN THE BAD DEBT SHORTFALL CALCULATION. THEREFORE IT IS NOT NECESSARY TO SUBTRACT CHARGES AND COSTS FOR THOSE POPULATIONS WHEN CALCULATING THE OVERALL CCR ON WORKSHEET 2 AS THOSE PAYORS ARE BEING ACCOUNTED FOR IN THE BAD DEBT CHARGES WRITTEN OFF.DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE REFLECTED IN THE PATIENT BALANCE PRIOR TO ACCOUNTS BEING WRITTEN OFF TO BAD DEBT. THE HOSPITAL'S FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE RELATED TO BAD DEBT EXPENSE. BAD DEBTS ARE REFLECTED IN THE FINANCIAL STATEMENTS AS AN OPERATING EXPENSE LINE ITEM LABELED "PROVISION FOR UNCOLLECTIBLE ACCOUNTS" IN THE STATEMENT OF OPERATIONS. LINE 3 - THE HOSPITAL USES A NOTE ON THE PATIENT ACCOUNT TO IDENTIFY PATIENTS UNCOOPERATIVE WITH THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY THAT WOULD HAVE LIKELY QUALIFIED FOR CHARITY IF INFORMATION HAD BEEN AVAILABLE TO DETERMINE ELIGIBILITY. DUE TO THESE ACCOUNTS LIKELY BEING ELIGIBLE FOR FINANCIAL ASSISTANCE, THEY SHOULD BE INCLUDED AS PART OF THE HOSPITAL'S COMMUNITY BENEFIT. PART III, LINE 8: THE COSTS REPORTED ON LINE 6 ARE PER THE MEDICARE COST REPORT AND WERE CALCULATED BASED ON COST-TO-CHARGE RATIOS. SINCE THE AMOUNTS REPORTED ON LINES 5 & 6 ONLY INCLUDE MEDICARE PART A COSTS AND PAYMENTS. THE OTHER MEDICARE SHORTFALL (I.E. FOR MEDICARE PART C, PHYSICIAN SERVICES, FEE SCHEDULE, NON-ALLOWABLE COSTS AND PAYMENTS) IS $12,556,121. THE PORTION OF THE MEDICARE SHORTFALL REPORTED ON LINE 7 THAT SHOULD BE TREATED AS A COMMUNITY BENEFIT IS $209,769 WHICH REPRESENTS THE SHORTFALL RELATED TO THOSE PATIENTS THAT HAD MEDICAID AS A SECONDARY PAYOR AND THEREFORE DEEMED INDIGENT FOR MEDICARE BAD DEBT PURPOSES. THE MEDICARE SHORTFALL REPORTED ON LINE 7 INCLUDES A PRIOR YEAR SETTLEMENT PICK-UP OF $572,084. PART III, LINE 9B: THE CREDIT AND COLLECTION POLICY DESCRIBES HOW UNINSURED PATIENTS CAN RECEIVE A PROMPT PAY DISCOUNT. THE POLICY DESCRIBES THE AVAILABILITY OF THE FINANCIAL ASSISTANCE PROGRAM AND INDICATES THAT AN APPLICATION FOR FINANCIAL ASSISTANCE IS PART OF THE PROCESS FOR FINANCIALLY SECURING ACCOUNTS AND INDICATES THAT SENIOR FINANCIAL COUNSELORS ARE ON STAFF TO PROCESS THE APPLICATIONS. IN ADDITION, THE POLICY DICTATES THAT AN APPROVED FINANCIAL ASSISTANCE APPLICATION QUALIFIES AN ACCOUNT AS FINANCIALLY SECURED. THIS POLICY ALSO INDICATES THAT UNINSURED PATIENTS ARE GIVEN AN AUTOMATIC DISCOUNT FROM GROSS CHARGES NOT RELATED TO THE FINANCIAL ASSISTANCE PROGRAM. PATIENTS APPROVED FOR FREE CARE ARE NOT BILLED OR REQUESTED TO PAY AS THEIR TOTAL ACCOUNT BALANCE IS WRITTEN OFF TO INDIGENT CARE. PATIENTS APPROVED FOR DISCOUNTED CARE THROUGH THE CHARITY CRITERIA ARE ONLY BILLED FOR THE BALANCE LEFT AFTER THE CHARITY ADJUSTMENT IS MADE TO THEIR ACCOUNTS. PATIENTS ARE ALLOWED TO ENTER INTO A PAYMENT PLAN AGREEMENT TO SATISFY THEIR OUT OF POCKET COSTS. PART VI, LINE 2: OVER THE PAST DECADE, OUR HOSPITALS HAVE CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENTS IN COLLABORATION WITH THE GWINNETT COUNTY HEALTH DEPARTMENT TO ASSESS THE HEALTHCARE NEEDS OF RESIDENTS OF GWINNETT COUNTY. THE MAJORITY OF THE PATIENTS WHO UTILIZE OUR HOSPITALS ARE RESIDENTS OF GWINNETT COUNTY; ON AVERAGE, ABOUT 20 PERCENT OF OUR PATIENTS ARE FROM SURROUNDING COUNTIES. THE HEALTH NEEDS ASSESSMENT PROVIDES A SNAPSHOT OF OUR COMMUNITY IN THE AREAS OF DEMOGRAPHICS INCLUDING: POPULATION, ECONOMICS, EDUCATION, HOUSING, LABOR, TRANSPORTATION AND PUBLIC ASSISTANCE AS WELL AS PROVIDING FIVE-YEAR TREND DATA MEASURING MORTALITY AND HOSPITAL MORBIDITY RATES BY DISEASE STATES, SELECT NOTIFIABLE DISEASES AND MATERNAL/INFANT HEALTH. THE LAST HEALTH STATUS REPORT WAS PUBLISHED IN 2007. THIS REPORT WAS MADE AVAILABLE TO THE PUBLIC THROUGH MAILINGS TO CITY, COUNTY, STATE AND FEDERAL GOVERNMENT REPRESENTATIVES; TO COMMUNITY SERVICE ORGANIZATIONS; AND UPON REQUEST. THE REPORT IS ALSO AVAILABLE ON OUR WEBSITE. THE INFORMATION CONTAINED IN THE NEEDS ASSESSMENT IS UPDATED BETWEEN PUBLISHED REPORTS THROUGH SECONDARY VITAL STATISTICS DATA PROVIDED BY THE ONLINE ANALYTICAL STATISTICAL INFORMATION SYSTEM (OASIS), WHICH IS A TOOLSET THAT ALLOWS ACCESS TO THE GEORGIA DIVISION OF PUBLIC HEALTH'S STANDARDIZED HEALTH DATA REPOSITORY. DATA FROM THE U.S. CENSUS BUREAU, CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AND THE COMPARISONS TO THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES' HEALTH PEOPLE 2010 OBJECTIVES ARE ALSO INCLUDED IN THE REPORT.IN ADDITION TO THE PUBLISHED REPORT, OUR PLANNING DEPARTMENT IDENTIFIES HOSPITAL-BASED NEEDS USING ADMISSION/DISCHARGE AND OTHER UTILIZATION DATA. THE COMMUNITY BENEFIT PLAN IS UPDATED ANNUALLY. THIS PLAN DESCRIBES HOW THE HOSPITALS AND SUPPORT FACILITIES ADDRESS IDENTIFIED COMMUNITY HEALTH NEEDS. EACH YEAR PROGRAMS ARE EVALUATED FOR EFFICIENCY, EFFECTIVENESS, OUTCOMES AND COMMUNITY COLLABORATION; THEN, ADMINISTRATION PRIORITIZES HOW THE ORGANIZATION MEETS COMMUNITY NEEDS THROUGH DEPARTMENT BUDGETING FOR EACH COMMUNITY BENEFIT PROGRAM. THE ORGANIZATION'S COMMUNITY HEALTH & WELLNESS COUNCIL IS AN INTERNAL COMMUNITY BENEFIT COMMITTEE WITH REPRESENTATIVES FROM 29 DEPARTMENTS FROM BOTH HOSPITALS. THIS COUNCIL IS TASKED WITH THE ANNUAL PLAN UPDATE THEN THE PLAN IS REVIEWED AND APPROVED BY HOSPITAL ADMINISTRATION AND IS PRESENTED TO THE GWINNETT HOSPITAL SYSTEM BOARD OF DIRECTORS FOR THEIR INPUT, REVIEW AND APPROVAL. COMMUNITY HEALTH NEEDS ARE IDENTIFIED BY OUR ORGANIZATION PRIMARILY THROUGH MORBIDITY AND MORTALITY VITAL STATISTICS. MAJOR HEALTH PROBLEMS IN OUR COMMUNITY ARE IDENTIFIED BY MONITORING MORBIDITY THROUGH STATISTICS ASSOCIATED WITH THE LEADING CAUSES OF HOSPITAL DISCHARGES (NOT INCLUDING EMERGENCY DEPARTMENT VISITS). ACCORDING TO THE MOST RESENT FIVE-YEAR AGGREGATE DATA FROM THE GEORGIA DEPARTMENT OF PUBLIC HEALTH - OFFICE OF HEALTH INDICATORS FOR PLANNING (OHIP) THE TOP CAUSES OF HOSPITALIZATION FOR GWINNETT COUNTY RESIDENTS ARE:1.PREGNANCY AND CHILDBIRTH 2.DISEASE OF THE HEART3.UNINTENTIONAL INJURIES4.CANCER5.INFLUENZA AND PNEUMONIATHE TOP CAUSES OF EMERGENCY ROOM VISITS ARE ANOTHER SET OF INDICATORS. ACCORDING TO THE MOST RESENT FIVE-YEAR AGGREGATE DATA FROM THE GEORGIA DEPARTMENT OF PUBLIC HEALTH - OFFICE OF HEALTH INDICATORS FOR PLANNING (OHIP) THE TOP CAUSES OF EMERGENCY ROOM VISITS FOR GWINNETT COUNTY RESIDENTS ARE:1.UNINTENTIONAL INJURIES2.PREGNANCY AND CHILDBIRTH3.CHRONIC LOWER RESPIRATORY DISEASES4.INFLUENZA AND PNEUMONIA 5.ACUTE BRONCHITIS THE LEADING CAUSES OF PREMATURE DEATH ARE IMPORTANT TO EVALUATE BECAUSE IN MANY SITUATIONS THESE MAY BE PREVENTABLE. GWINNETT COUNTY HAS AN UNUSUAL AGE DISTRIBUTION PATTERN WITH 72 PERCENT OF THE POPULATION UNDER THE AGE OF 45. ACCORDING TO THE MOST RESENT FIVE-YEAR AGGREGATE DATA FROM THE GEORGIA DEPARTMENT OF PUBLIC HEALTH - OFFICE OF HEALTH INDICATORS FOR PLANNING (OHIP) THE TOP CAUSES OF PREMATURE DEATH RATES (WHEN RANKED BY YEARS OF LIFE LOST BEFORE AGE 75) FOR GWINNETT COUNTY RESIDENTS ARE: 1.CANCER2.UNINTENTIONAL INJURIES3.DISEASES OF THE HEART4.PERINATAL CONDITIONS5.SUICIDEMORTALITY IS ANOTHER MEASURE FOR ESTABLISHING COMMUNITY HEALTH NEEDS. AGE-ADJUSTED DEATH RATES PROVIDE COMPARABLE DATA ON DEATH BECAUSE THEY TAKE INTO CONSIDERATION THE AGE DISTRIBUTION OF THE POPULATION. ACCORDING TO THE MOST RESENT FIVE-YEAR AGGREGATE DATA FROM THE GEORGIA DEPARTMENT OF PUBLIC HEALTH - OFFICE OF HEALTH INDICATORS FOR PLANNING (OHIP) THE TOP CAUSES OF AGE-ADJUSTED DEATH RATES FOR GWINNETT COUNTY RESIDENTS ARE: 1.DISEASE OF THE HEARTH2.CANCER3.STROKE4.CHRONIC LOWER RESPIRATORY DISEASES5.UNINTENTIONAL INJURIESIN OUR ORGANIZATION, SOME NEED AREAS HAVE MORE PROGRAMS THAN OTHERS. CARDIOVASCULAR DISEASE (HEART CONDITIONS AND STROKES), CANCER, EMERGENCY AND TRAUMA SERVICES, RESPIRATORY DISEASES (ASTHMA, COPD, FLU AND PNEUMONIA), DIABETES, MATERNAL/ INFANT HEALTH, INJURY PREVENTION AND WELLNESS PROGRAMS ARE AREAS WE PROVIDE MOST OF OUR PROGRAMS TO IMPROVE COMMUNITY HEALTH. THERE ARE IDENTIFIED COMMUNITY HEALTH NEEDS WHICH OUR HOSPITALS CURRENTLY ONLY PROVIDE MINIMAL SUPPORT AS WE DO NOT HAVE DESIGNATED MEDICAL UNITS OR OUTREACH PROGRAMS TO TREAT THESE CONDITIONS. ALTHOUGH WE TRIAGE PATIENTS WITH MENTAL HEALTH AND SUBSTANCE ABUSE PROBLEMS IN OUR EMERGENCY SERVICE AREAS, OUR ORGANIZATION DOES NOT HAVE A FACILITY TO TREAT METAL AND BEHAVIORAL CONDITIONS. THERE IS A PRIVATE FOR-PROFIT MENTAL HEALTH AND SUBSTANCE ABUSE HOSPITAL IN OUR COMMUNITY AND THE STATE OF GEORGIA PROVIDES MENTAL HEALTH SERVICES. OUR GMC-LAWRENCEVILLE CAMPUS HAS A LEVEL III NEONATAL INTENSIVE CARE UNIT AND A 12-BED PEDIATRIC EMERGENCY DEPARTMENT; HOWEVER, THE HOSPITAL DOES NOT HAVE A PRIMARY FOCUS ON INPATIENT PEDIATRICS (AFTER THE NEONATE PERIOD). IN GWINNETT COUNTY, THERE IS A WIDE RANGE OF PEDIATRIC HEALTHCARE SERVICES AVAILABLE THROUGH CHILDREN'S HEALTHCARE OF ATLANTA. PART VI, LINE 3: EVERY PATIENT REGISTERED AT A GHS FACILITY IS PROVIDED A DOCUMENT ALERTING THEM TO THE AVAILABILITY OF THE SYSTEM'S FINANCIAL ASSISTANCE PROGRAM. ADDITIONALLY, PATIENTS ARE PROVIDED A "BILLING AND COLLECTION INFORMATION" DOCUMENT THAT AGAIN ADVISES THE PATIENT HOW TO APPLY FOR FINANCIAL ASSISTANCE. FOR THOSE PATIENTS ADMITTED TO THE HOSPITAL, THE INPATIENT HANDBOOK ALSO INSTRUCTS THEM HOW TO SEEK FINANCIAL ASSISTANCE FROM OUR TEAM OF FINANCIAL COUNSELORS. IN ADDITION, PATIENT BILLS INCLUDE CONTACT INFORMATION FOR SEEKING FINANCIAL ASSISTANCE VIA TELEPHONE OR BY EMAIL AT FINANCIALCOUNSELOR@GWINNETTMEDICALCENTER.ORG. THE HOSPITAL SYSTEM'S WEBSITE ALSO INCLUDES THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND APPLICATIONS IN ENGLISH, SPANISH, KOREAN AND VIETNAMESE. PART VI, LINE 4: GWINNETT COUNTY IS LOCATED IN THE NORTHEAST SUBURBS OF THE METROPOLITAN ATLANTA AREA AND IS 98 PERCENT URBAN. THIS IS THE 50TH LARGEST COUNTY IN THE STATE OF GEORGIA BY LAND MASS (432.73 SQUARE MILES) AND THE SECOND LEADING BY POPULATION (805,321 RESIDENTS IN 2010). THE POPULATION OF GWINNETT COUNTY HAS INCREASED BY 36.9 PERCENT SINCE 2000. ACCORDING TO THE 2010 U.S. CENSUS, GWINNETT COUNTY IS THE 65TH MOST POPULATED COUNTY IN THE NATION.OVERALL, GWINNETT COUNTY HAS A YOUNG POPULATION WITH THE MEDIAN AGE FROM 2005 THROUGH 2009 AT 33.1 YEARS OF AGE. THIRTY-ONE PERCENT OF THE POPULATION WAS UNDER 20 YEARS OF AGE AND 11 PERCENT WAS 60 YEARS OF AGE AND OLDER, ACCORDING TO THE GEORGIA DIVISION OF PUBLIC HEALTH (ONLINE ANALYTICAL STATISTICAL INFORMATION SYSTEM, OASIS, 2011).THE POPULATION HAS BECOME MORE RACIALLY AND ETHNICALLY DIVERSE WITH REPRESENTATION FROM ACROSS THE NATION AND AROUND THE WORLD. IN 2010, THE U.S. CENSUS BUREAU ESTIMATED THE GWINNETT COUNTY POPULATION TO BE 44 PERCENT NON-HISPANIC WHITES, 22.9 PERCENT NON-HISPANIC BLACKS, 10.5 PERCENT NON-HISPANIC ASIANS (2.7 PERCENT KOREAN, 2.6 PERCENT ASIAN INDIAN, 2.0 PERCENT VIETNAMESE, 3.3 OTHER ASIAN) AND 2.2 PERCENT WAS NON-HISPANIC OTHERS (AMERICAN INDIAN OR ALASKA NATIVE, NATIVE HAWAIIAN OR PACIFIC ISLANDER, MULTIRACIAL OR UNKNOWN). 20.1 PERCENT OF THE POPULATION WAS HISPANICS OR LATINO WITH 10.7 PERCENT OF THAT POPULATION BEING MEXICAN.THE GWINNETT COUNTY PUBLIC SCHOOL SYSTEM INCLUDES 133 SCHOOLS AND OTHER EDUCATIONAL FACILITIES AND SERVES NEARLY 162,000 STUDENTS.THE RATIO OF POPULATION TO PRIMARY CARE PHYSICIANS IN GWINNETT COUNTY IS 1,320:1. ACCORDING TO COUNTY HEALTH RANKINGS, THE NATIONAL BENCHMARK IS 631:1 (90TH PERCENTILE).THE DATA ON PRIMARY CARE PHYSICIANS WERE OBTAINED FROM THE HEALTH RESOURCES AND SERVICES ADMINISTRATION'S AREA RESOURCE FILE (ARF) FOR 2009. THE ARF DATA ON PRACTICING PHYSICIANS COMES FROM THE AMA MASTER FILE (2008), AND THE POPULATION ESTIMATES ARE FROM THE U.S. CENSUS BUREAU'S 2008 POPULATION ESTIMATES. ACCORDING TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS), THE AVERAGE NUMBER OF MEDICAID RECIPIENTS IN 2009 WAS 138,561 OR 17.1 PERCENT OF THE TOTAL GWINNETT POPULATION. MEDICARE PAYMENTS FOR GWINNETT COUNTY RESIDENTS IN 2008 WERE $482,648,000. THE LACK OF HEALTH INSURANCE COVERAGE IS A SIGNIFICANT BARRIER TO ACCESSING NEEDED HEALTHCARE. IN 2009, THE U.S. CENSUS BUREAU SMALL AREA HEALTH INSURANCE ESTIMATED 22.9 PERCENT (168,416 RESIDENTS) OF GWINNETT RESIDENTS UNDER THE AGE OF 65 YEARS WERE UNINSURED. ACCORDING TO CENSUS BUREAU REPORT, 232,856 GWINNETT COUNTY RESIDENTS ARE AT OR BELOW 200 PERCENT OF THE POVERTY LEVEL; OF THAT NUMBER 43.1 PERCENT (100,330 RESIDENTS) ARE UNINSURED.THE U.S. CENSUS BUREAU'S AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES FOR 2005-2009 PROVIDES A REPRESENTATION OF AVERAGE CHARACTERISTICS OF THE POPULATION AND IS NOT REPRESENTATIVE OF A SINGLE POINT IN TIME. FROM THESE SURVEYS, THE FOLLOWING INFORMATION HAS BEEN MADE AVAILABLE ABOUT GWINNETT COUNTY RESIDENTS. - THERE WERE 255,000 HOUSEHOLDS IN GWINNETT. THE AVERAGE HOUSEHOLD SIZE WAS THREE. FAMILIES MAKE UP 75 PERCENT OF THE HOUSEHOLDS; 57 PERCENT MARRIED-COUPLE FAMILIES AND 17 PERCENT OTHER FAMILIES. NONFAMILY HOUSEHOLDS MADE UP 25 PERCENT OF ALL HOUSEHOLDS; 20 PERCENT WERE PEOPLE LIVING ALONE AND FIVE PERCENT WERE COMPOSED OF PEOPLE LIVING IN HOUSEHOLDS IN WHICH NO ONE WAS RELATED TO THE HOUSEHOLDER. - EIGHTY-EIGHT PERCENT OF RESIDENTS 25 YEARS OF AGE AND OVER HAD AT LEAST GRADUATED FROM HIGH SCHOOL AND 35 PERCENT HAD A BACHELOR'S DEGREE OR HIGHER. TWELVE PERCENT OF RESIDENTS WERE DROPOUTS, WERE NOT ENROLLED IN SCHOOL AND HAD NOT GRADUATED FROM HIGH SCHOOL. - TWENTY-THREE PERCENT OF THE POPULATION WAS FOREIGN BORN. THIRTY-SIX PERCENT WAS BORN IN GEORGIA. - OF INDIVIDUALS AT LEAST FIVE YEARS OF AGE, 29 PERCENT SPOKE A LANGUAGE OTHER THAN ENGLISH AT HOME; OF THAT 29 PERCENT, 52 PERCENT SPOKE SPANISH AND 48 PERCENT SPOKE SOME OTHER LANGUAGE. IN ADDITION, OF THOSE WHO SPOKE ANOTHER LANGUAGE, 50 PERCENT REPORTED THEY DID NOT SPEAK ENGLISH "VERY WELL". - SEVENTY-FOUR PERCENT OF THE POPULATION 16 YEARS OF AGE AND OLDER ARE IN THE LABOR FORCE. - SEVENTY-NINE PERCENT OF WORKERS DROVE TO WORK ALONE, 11 PERCENT CARPOOLED, ONE PERCENT TOOK PUBLIC TRANSPORTATION AND THREE PERCENT USED OTHER MEANS. THE REMAINING FIVE PERCENT WORKED FROM HOME. FOR THOSE WHO COMMUTED, THE AVERAGE TRAVEL TIME TO WORK WAS 32.4 MINUTES. - THE MEDIAN INCOME OF HOUSEHOLDS WAS $65,136. NINETY-ONE PERCENT OF THE HOUSEHOLDS RECEIVED EARNINGS AND 11 PERCENT RECEIVED RETIREMENT INCOME OTHER THAN SOCIAL SECURITY. FIFTEEN PERCENT OF THE HOUSEHOLDS RECEIVED SOCIAL SECURITY. THE AVERAGE INCOME FROM SOCIAL SECURITY WAS $15,586. THESE INCOME SOURCES ARE NOT MUTUALLY EXCLUSIVE; THAT IS, SOME HOUSEHOLDS RECEIVE INCOME FROM MORE THAN ONE SOURCE. - TEN PERCENT OF RESIDENTS WERE BELOW THE POVERTY LEVEL. THIRTEEN PERCENT OF RELATED CHILDREN UNDER 18 WERE BELOW THE POVERTY LEVEL, COMPARED WITH EIGHT PERCENT OF THE PEOPLE 65 YEARS OF AGE OLD AND OVER. SEVEN PERCENT OF ALL FAMILIES AND 21 PERCENT OF FAMILIES WITH A FEMALE HEAD OF HOUSEHOLD AND NO HUSBAND PRESENT HAD INCOMES BELOW THE POVERTY LEVEL. - THE MEDIAN MONTHLY HOUSING COSTS FOR MORTGAGED OWNERS WAS $1,591, NONMORTGAGED OWNERS $433 AND RENTERS $939. THIRTY-SEVEN PERCENT OF OWNERS WITH MORTGAGES, 12 PERCENT OF OWNERS WITHOUT MORTGAGES AND 49 PERCENT OF RENTERS SPENT 30 PERCENT OR MORE OF HOUSEHOLD INCOME ON HOUSING. - THERE WERE 280,000 HOUSING UNITS IN GWINNETT COUNTY, NINE PERCENT OF WHICH WERE VACANT. OF THE TOTAL NUMBER OF HOUSING UNITS 78 PERCENT WERE IN SINGLE-UNITS STRUCTURES, 20 PERCENT WERE IN MULTI-UNIT STRUCTURES AND TWO PERCENT WERE MOBILE HOMES. THE COUNTY HAD 255,000 OCCUPIED HOUSING UNITS; 74 PERCENT (187,000 UNITS) WERE OWNER OCCUPIED AND 26 PERCENT (67,000 UNITS) WERE RENTER OCCUPIED. - FOUR PERCENT OF THE HOUSEHOLDS DID NOT HAVE TELEPHONES. - THREE PERCENT OF THE HOUSEHOLDS DID NOT HAVE ACCESS TO A CAR, TRUCK OR VAN FOR PRIVATE USE.IN ADDITION TO OUR FACILITIES, GWINNETT COUNTY HAS ONE FOR-PROFIT HOSPITAL, EASTSIDE MEDICAL CENTER IN SNELLVILLE. THERE ARE MANY HOSPITALS IN SURROUNDING COUNTIES OF THE METROPOLITAN ATLANTA AREA. SUMMITRIDGE HOSPITAL IN LAWRENCEVILLE IS A FOR-PROFIT HOSPITAL TO SERVE MENTAL HEALTH AND SUBSTANCE ABUSE. THREE CENSUS TRACTS ARE DESIGNATED MEDICALLY UNDERSERVED AREAS (CT 0503.12, CT 0504.19 AND CT 0504.21) IN GWINNETT COUNTY. THERE IS ONE FEDERALLY QUALIFIED HEALTH CENTER IN GWINNETT COUNTY (NORCROSS) SERVING RESIDENTS FROM THESE CENSUS TRACTS AS WELL AS OTHER GWINNETT COUNTY RESIDENTS. PART VI, LINE 6: OUR VISION IS TO BE THE HEALTH SYSTEM OF CHOICE IN OUR COMMUNITY BY ENHANCING THE HEALTH OF OUR PATIENTS AND OTHER CUSTOMERS. WE LIVE THAT VISION BY JOINING WITH PHYSICIANS, COMMUNITY AND OTHER HEALTHCARE ORGANIZATIONS TO TREAT INJURY AND DISEASE AS WELL AS PROVIDING PREVENTIVE AND EARLY INTERVENTION CARE. THE GWINNETT HOSPITAL SYSTEM BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY LEADERS DEDICATED TO PROVIDING QUALITY HEALTHCARE FOR OUR COMMUNITY. THESE VOLUNTEER BOARD MEMBERS ARE PERSONS WHO RESIDE IN OUR PRIMARY SERVICE AREA AND ARE NOT EMPLOYEES OR CONTRACTORS OF THE ORGANIZATION OR FAMILY MEMBERS. MEDICAL STAFF PRIVILEGES IN THE HOSPITALS ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS AS DETERMINED THROUGH A DETAILED CREDENTIALING PROCESS. GWINNETT HOSPITAL SYSTEM HAS OVER 800 AFFILIATED PHYSICIANS PROVIDING HEALTHCARE SERVICES AT BOTH GWINNETT MEDICAL CENTER-LAWRENCEVILLE AND GWINNETT MEDICAL CENTER-DULUTH CAMPUSES. THE ORGANIZATION REINVESTS ALL PROFITS BACK INTO PHYSICIAN AND STAFF TRAINING, FACILITIES AND EQUIPMENT TO CONTINUALLY IMPROVE PATIENT CARE. IN CONTRAST TO INVESTOR-OWNED HOSPITALS, NO PART OF NET EARNINGS DIRECTLY OR INDIRECTLY BENEFITS ANY PRIVATE SHAREHOLDERS OR INDIVIDUALS.FULL-TIME EMERGENCY DEPARTMENTS ARE OPERATED AT BOTH THE GWINNETT MEDICAL CENTER-LAWRENCEVILLE AND GWINNETT MEDICAL CENTER-DULUTH CAMPUSES. NO ONE REQUIRING EMERGENCY CARE IS DENIED TREATMENT. THE TOTAL NUMBER OF DISCHARGES FROM BOTH EMERGENCY DEPARTMENTS WAS 132,293 FOR FISCAL YEAR 2011. THE 60-BED EMERGENCY DEPARTMENT AT GWINNETT MEDICAL CENTER-LAWRENCEVILLE IS ONE OF THE BUSIEST IN GEORGIA. THIS LOCATION HAS A 12-BED CHILDREN'S EMERGENCY CENTER, AN ACCREDITED CHEST PAIN CENTER AND IS DESIGNATED AS A LEVEL II TRAUMA CENTER PROVIDING 24 HOURS A DAY, SEVEN DAYS A WEEK TRAUMA TEAM COVERAGE SERVING RESIDENTS OF GWINNETT COUNTY AND THE SURROUNDING AREA. ONLY 19 OF THE STATE'S 152 ACUTE-CARE HOSPITALS ARE DESIGNATED TRAUMA CENTERS. BOTH GWINNETT MEDICAL CENTER-LAWRENCEVILLE AND GWINNETT MEDICAL CENTER-DULUTH AND ASSOCIATED FACILITIES PARTICIPATE IN MEDICARE, MEDICAID, CHAMPUS AND PEACHCARE AS APPROPRIATE FOR SERVICES PROVIDED. PART VI, LINE 7: GWINNETT HOSPITAL SYSTEM IS A LICENSED 553 BED HEALTHCARE ORGANIZATION WITH TWO ACUTE-CARE HOSPITALS: GWINNETT MEDICAL CENTER-LAWRENCEVILLE AND GWINNETT MEDICAL CENTER-DULUTH. THESE TWO FACILITIES SERVE AREAS OF BOTH GWINNETT COUNTY AND TO A LESSER EXTENT SEVERAL SURROUNDING COUNTIES. IN ADDITION TO THE MEDICAL-SURGICAL HOSPITALS, THE ORGANIZATION ALSO INCLUDES THE GWINNETT WOMEN'S PAVILION AND THE GWINNETT EXTENDED CARE CENTER ON THE GWINNETT MEDICAL CENTER-LAWRENCEVILLE CAMPUS AS WELL AS THE GLANCY REHABILITATION CENTER IN DULUTH. OTHER AFFILIATED ORGANIZATIONS INCLUDE: - GWINNETT HEALTH SYSTEM, INC. - THE NONPROFIT PARENT ORGANIZATION OF GWINNETT HOSPITAL SYSTEM AND ITS AFFILIATES. - GWINNETT MEDICAL CENTER FOUNDATION - A NONPROFIT PHILANTHROPIC ORGANIZATION THAT SUPPORTS THE GWINNETT HOSPITAL SYSTEM BY RAISING MONEY FOR THE MILES AND LIB MASON CHILDREN'S CLINIC, CAPITAL EQUIPMENT PURCHASES FOR GWINNETT MEDICAL CENTER-DULUTH AND GWINNETT MEDICAL CENTER-LAWRENCEVILLE, NEUROSCIENCE, ORTHOPEDICS AND A VARIETY OF OTHER PROGRAMS. - GWINNETT MEDICAL PROPERTIES - A NONPROFIT ORGANIZATION THAT OWNS MEDICAL PROPERTIES IN AND AROUND GWINNETT COUNTY FOR THE PURPOSE OF AIDING GWINNETT HOSPITAL SYSTEM IN FULFILLING ITS MISSION. - GWINNETT MEDICAL SERVICES - A NONPROFIT ORGANIZATION WHOSE MISSION IS TO OPERATE PHYSICIAN CLINICS IN AND AROUND GWINNETT COUNTY. REPORTS FILED WITH STATES PART VI, LINE 7 GA 1 GWINNETT MEDICAL SERVICES INC 1000 MEDICAL CENTER BLVD LAWRENCEVILLE GA 30046 582143107 501(C)(3) 7408612 TRANSFER OF ASSETS GWINNETT HOSPITAL SYSTEM FOUNDATION INC 1000 MEDICAL CENTER BLVD LAWRENCEVILLE GA 30046 581828486 501(C)(3) 316886 OPERATING EXPENSES 2 EDUCATIONAL SCHOLARSHIPS 16 40000 FMV OF CASH BLOOD GLUCOSE METERS 978 0 24675 MANUFACTURER'S PRICE BLOOD GLUCOSE METERS INSULIN START KITS 443 0 8860 MANUFACTURER'S PRICE INSULIN START KITS PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: GRANTS WERE MADE TO RELATED 501(C)(3) ORGANIZATIONS. X X 1 1 X X X X X X 0 1 0 0 0 0 0 0 0 PHILIP R WOLFE 535117 0 0 0 161594 0 101622 0 30745 0 829078 0 0 0 ALAN BIER 315932 0 0 0 65518 0 51498 0 29076 0 462024 0 0 0 THOMAS Y MCBRIDE III 319705 0 0 0 397567 0 303843 0 26670 0 1047785 0 0 0 JEFFREY NOWLIN 306491 0 0 0 45504 0 49975 0 35741 0 437711 0 0 0 PETER WHEELER 234843 0 0 0 50957 0 48024 0 38240 0 372064 0 0 0 WALLACE BROWN 218710 0 0 0 88252 0 53092 0 22474 0 382528 0 0 0 STEPHEN NADEAU 225391 0 0 0 68441 0 47154 0 25144 0 366130 0 0 0 CAROL DANIELSON 214605 0 0 0 47035 0 29904 0 34096 0 325640 0 0 0 LEA BAY 215864 0 0 0 32835 0 20825 0 39300 0 308824 0 0 0 JESSIE T SHEPHERD 193723 0 0 0 29269 0 30231 0 32382 0 285605 0 0 0 SCOTT OREM 145547 0 0 0 26475 0 27136 0 32022 0 231180 0 0 0 JAMES DENNARD JR 161403 0 0 0 27267 0 11897 0 33070 0 233637 0 0 0 DIANA POTTS 122344 0 0 0 49096 0 18493 0 22188 0 212121 0 0 0 CATHY DOUGHERTY 122126 0 0 0 39923 0 13198 0 28578 0 203825 0 0 0 BONNY RICHARDSON 138932 0 0 0 12031 0 11590 0 26138 0 188691 0 0 0 MICHAEL HEMPHILL 121554 0 0 0 30198 0 12597 0 28838 0 193187 0 0 0 JASON CHANDLER 169785 0 0 0 24820 0 16518 0 32251 0 243374 0 0 0 JANET SCHWALBE 143404 0 0 0 34049 0 21737 0 14211 0 213401 0 0 0 THOMAS LYNCH 150055 0 0 0 37968 0 20141 0 29325 0 237489 0 0 0 LAURA TUCKER 124415 0 0 0 26236 0 12205 0 9652 0 172508 0 0 0 ROMEO P MASSOUD MD 371910 0 81442 0 223363 0 15925 0 39272 0 731912 0 0 0 MICHAEL A AMARAL MD 533990 0 0 0 52932 0 13475 0 53931 0 654328 0 0 0 MICHAEL T STECHISON MD 544845 0 0 0 44676 0 13475 0 36916 0 639912 0 0 0 BARRY RENZ MD 425585 0 4337 0 94847 0 18375 0 37303 0 580447 0 0 0 HERSCHEL W SMITH III MD 251973 0 26010 0 94114 0 18375 0 31953 0 422425 0 0 0 PART I, LINE 4B EMPLOYER CONTRIBUTIONS TO 457(F) EXECUTIVE RETIREMENT BENEFIT PLAN PHILIP WOLFE 88,147 ALAN BIER 38,023 JEFFREY NOWLIN 36,500 WALLACE BROWN 37,167 PETER WHEELER 27,199 STEPHEN NADEAU 12,250 JESSIE T. SHEPHERD 11,147 THOMAS LYNCH 9,944 JAMES DENNARD 5,503 SCOTT OREM 12,320 JANET SCHWALBE 9,061 DIANA POTTS 4,347 CAROL DANIELSON 18,788 SETTLEMENT OF OUTSTANDING LOAN ON SERP THOMAS Y. MCBRIDE III $309,275 EMPLOYER CONTRIBUTION TO SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN THOMAS Y. MCBRIDE III $283,018 HOSPITAL AUTHORITY OF GWINNETT COUNTY GEORGIA 586011878 403732DE7 2009-11-12 32700000 CURRENT REFUNDING OF 7/26/07 ISSUE 0 0 0 HOSPITAL AUTHORITY OF GWINNETT COUNTY GEORGIA 586011878 403732DS6 2009-11-12 36435000 CURRENT REFUNDING OF 7/26/07 ISSUE 0 0 0 HOSPITAL AUTHORITY OF GWINNETT COUNTY GEORGIA 586011878 403732DU1 2009-11-12 19240000 CURRENT REFUNDING OF 7/26/07 ISSUE 0 0 0 HOSPITAL AUTHORITY OF GWINNETT COUNTY GEORGIA 586011878 403732DZ0 2009-11-12 61095000 CURRENT REFUNDING OF 7/26/07 ISSUE 0 0 0 32700000 32700000 1 0 1 1 36435000 36435000 1 0 1 1 19240000 19240000 1 0 1 1 61095000 61095000 2007 1 0 1 1 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 HOSPITAL AUTHORITY OF GWINNETT COUNTY GEORGIA 586011878 403732EQ9 2009-11-24 78635000 RENOVATION & EXPANSION 0 0 0 HOSPITAL AUTHORITY OF GWINNETT COUNTY GEORGIA 586011878 2011-02-17 88425000 REFINANCINS 2008 A & C 0 0 0 78635000 60075000 454320 18105680 2008 1 0 1 1 88425000 88425000 2011 1 0 1 1 0 0 0 0 1 1 0 0 0 0 1 1 0 1 0 0 0 0 0 1 0 0 0 0 TRACY WALDROP DAUGHTER OF BOARD MEMBER ED RADFORD 61207 TRACY IS EMPLOYED BY THE ORGANIZATION. 0 CARDIOVASCULAR GROUP MEDICAL PRACTICE OF BOARD MEMBER MANFRED SANDLER 526324 MEDICAL SERVICES PROVIDED BY GROUP 0 X 5 33310 FMV X FURNITURE 1 21000 FMV X MASON KIDS CLINIC RENOVATION 1 50000 FMV 0 0 1 0 OPTIONAL EXPLANATION FOR PART I, LINE 6: VOLUNTEER SERVICES HAS A DATABASE SYSTEM THAT TRACKS THE NUMBER OF VOUNTEERS AND THEIR HOURS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF GWINNETT HOSPITAL SYSTEM, INC. IS GWINNETT HEALTH SYSTEM,INC., A RELATED 501(C)(3) ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS OF GWINNETT HOSPITAL SYSTEM, INC. IS APPOINTED BY THE GWINNETT HEALTH SYSTEM, INC., A RELATED 501(C)(3) ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN ACTIONS OF THE BOARD OF DIRECTORS OF GWINNETT HOSPITAL SYSTEM, INC. MUST BE APPROVED BY THE BOARD OF DIRECTORS OF GWINNETT HEALTH SYSTEM, INC., A RELATED 501(C)(3) ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 GHSI MAKES A COPY OF THE 990 AVAILABLE TO ALL BOARD MEMBERS THROUGH A SECURE WEBSITE. IT IS ALSO PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD EACH YEAR. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST QUESTIONNAIRE IS DISCUSSED AND DISTRIBUTED ANNUALLY TO EACH BOARD MEMBER. THE LEGAL DEPARTMENT IS RESPONSIBLE FOR INSURING THESE ARE SIGNED AND RETURNED. LEGAL MONITORS ALL TRANSACTIONS INVOLVING CONFLICTS OF INTEREST WITH BOARD MEMBERS. APPROVAL FOR ANY LOANS, PAYMENTS, HONORARIUMS, TRIP OR TRAVEL REIMBURSEMENTS, SERVICES, PRODUCTS, ENTERTAINMENT, PRIZES OR AWARDS PROVIDED TO ANY BOARD MEMBER MUST BE APPROVED BY AN ADMINISTRATIVE OFFICER OR HIS/HER DESIGNEE. THE CEO MUST OBTAIN THE APPROVAL OF THE CHAIRMAN OF THE BOARD (AND PAYMENTS TO THE CEO ARE APPROVED BY ANOTHER ADMINISTRATIVE OFFICER.) IN ADDITION, HUMAN RESOURCES SENDS OUT A CONFLICT OF INTEREST POLICY AND DISCLOSURE FORM TO OFFICERS AND KEY EMPLOYEES EVERY 3-5 YEARS. FORM 990, PART VI, SECTION B, LINE 15 GWINNETT HOSPITAL SYSTEM, INC. (GHSI) BOARD OF DIRECTORS HAS ESTABLISHED A COMPENSATION COMMITTEE MADE UP OF VARIOUS BOARD MEMBERS WHO REVIEW COMPENSATION OF THE CEO, TOP MANAGEMENT AND OTHER KEY EMPLOYEES. THIS COMPENSATION COMMITTEE IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF THE SALARY OF THE CEO. THE CEO IS RESPONSIBLE FOR DETERMINING THE SALARIES OF TOP MANAGEMENT WITH OVERSIGHT BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. AN INDEPENDENT PROFESSIONAL EXECUTIVE COMPENSATION CONSULTING COMPANY HIRED BY THE BOARD PROVIDES SALARY AND BENEFIT SURVEY INFORMATION AND MAKES RECOMMENDATIONS TO THE COMPENSATION COMMITTEE REGARDING COMPENSATION OF THE CEO, TOP MANAGEMENT AND KEY EMPLOYEES. THESE PERIODIC SURVEYS ARE CONDUCTED TO ENSURE THE SALARIES AND BENEFITS FOR GHSI EXECUTIVES AND OTHER DISQUALIFIED PARTIES ARE COMPENSATED APPROPRIATELY AT FAIR MARKET VALUE. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS ARE FILED AND AVAILABLE ON THE GEORGIA SECRETARY OF STATE WEBSITE OR THROUGH THAT OFFICE. THESE CAN ALSO BE OBTAINED BY CONTACTING GHSI. LIMITED FINANCIAL INFORMATION IS AVAILABLE ONLINE THROUGH THE COMMUNITY BENEFIT REPORT AS WELL AS OUR ANNUAL REPORT, BOTH OF WHICH ARE AVAILABLE ON LINE AT WWW.GWINNETTMEDICALCENTER.ORG. GWINNETT HOSPITAL'S CONFLICT OF INTEREST POLICY CAN BE OBTAINED BY CONTACTING GHSI. GHSI IS UNDER OBLIGATION TO DISCLOSE TO BOND HOLDERS PERTINENT FINANCIAL INFORMATION IN THE ANNUAL DISCLOSURE DOCUMENTS. CONTACT INFORMATION FOR GHSI CAN BE OBTAINED AT WWW.GWINNETTMEDICALCENTER.ORG. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 13,446,994. DONATED SERVICES AND USE OF FACILITIES: 104,310. PRIOR PERIOD ADJUSTMENTS: -618,342. CHANGE IN ASSETS OF FOUNDATION 250,129. LOSS ON BOND DEFEASANCE -864,954. GAIN FROM K-1 INVESTMENTS 805,749. CHANGE IN PENSION ACCOUNTING 14,026,533. OTHER CHANGES 217,995. TOTAL TO FORM 990, PART XI, LINE 5: 27,368,414. GWINNETT HOSPITAL SYSTEM PHYSICIAN'S GROUP LLC 1000 MEDICAL CENTER BLVD LAWRENCEVILLE GA 30046 204553410 PHYSICIAN SERVICES GA 0 0 N/A GWINNETT HEALTH SYSTEM INC 1000 MEDICAL CENTER BOULEVARD LAWRENCEVILLE GA 30046 582135755 PARENT OF GWINNETT HOSPITAL GA 501C(3) 11 N/A 0 GWINNETT HOSPITAL SYSTEM FOUNDATION 1755 NORTH BROWN ROAD 100 LAWRENCEVILLE GA 30043 581828486 FUNDRAISING ORGANIZATION FOR GHSI GA 501C(3) 7 N/A 0 GWINNETT MEDICAL SERVICES INC 1000 MEDICAL CENTER BOULEVARD LAWRENCEVILLE GA 30046 582143107 PHYSICIANS PRACTICE OWNER GA 501C(3) 3 GWINNETT HEALTH SYSTEM INC 0 GWINNETT MEDICAL PROPERTIES INC 1000 MEDICAL CENTER BOULEVARD LAWRENCEVILLE GA 30046 582132516 PROPERTY HOLDING GA 501C(3) 11 GWINNETT HEALTH SYSTEM INC 0 GWINNETT ENDOSCOPY SERVICES INC 3855 PLEASANT HILL ROAD SUITE 130 DULUTH GA 30096 262905890 ENDOSCOPY HEALTHCARE GA N/A RELATED -192071 684010 0 1 GWINNETT MANAGED CARE INC 1000 MEDICAL CENTER BOULEVARD LAWRENCEVILLE GA 30046 582135759 PHO GA N/A C 0 1 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 GWINNETT ENDOSCOPY SERVICES LLC D