2011-11-15T15:02:35-06:00 2010-12-31 PERSHING YOAKLEY & ASSOCIATES P C ONE CHEROKEE MILLS 2220 SUTHERLAND KNOXVILLE TN 379192363 990 2010-01-01 611428443 COLUMBUS SPECIALTY HOSPITAL COLU 7063216708 710 CENTER STREET 9TH FLOOR COLUMBUS GA 31901 GREG THOMSEN 7063216712 2011-11-15 1 8656730844 2010 2016-03-07 17:11:31Z GREG THOMSEN 710 CENTER STREET 9TH FLOOR COLUMBUS GA 31901 12280315 0 X WWW.COLUMBUSSPECIALTYHOSPITAL.COM X 2003 GA COLUMBUS SPECIALTY HOSPITAL, INC. IS A 30 BED LONG-TERM ACUTE CARE HOSPITAL. 5 5 149 6 0 0 0 0 11274150 12273092 2584 4938 5825 2285 11282559 12280315 0 0 0 0 5268237 5986527 0 0 0 5144501 5474331 10412738 11460858 869821 819457 4409436 6507770 660731 1939608 3748705 4568162 X COLUMBUS SPECIALTY HOSPITAL, INC. IS A 30 BED LONG-TERM ACUTE CARE HOSPITAL, WHICH PROVIDES SPECIALIZED EXTENDED ACUTE CARE SERVICES TO PATIENTS NEEDING 25 OR MORE DAYS OF HOSPITALIZATION. 0 0 8520704 12275377 COLUMBUS SPECIALTY HOSPITAL PROVIDES ACUTE CARE TO LONG-TERM PATIENTS THAT REQUIRE SPECIAL NEEDS. SERVICES ARE PROVIDED BY A DIVERSE TEAM OF HEALTH CARE PROFESSIONALS, AS DISCUSSED IN DETAIL BELOW. FOR 2010, IT PROVIDED $212,134 OF FREE CHARITY CARE AND BAD DEBT, $66,589 OF CONTRIBUTIONS TO GEORGIA MEDICAID AND $3,600 OF SUPPORT FOR CANCER SOCIETY. IT ALSO PROVIDED A TOTAL OF 8,583 DAYS OF CARE. COLUMBUS SPECIALTY HOSPITAL CLINICAL PROGRAMS ARE SERVED BY AN INTERDISCIPLINARY TEAM OF HIGHLY TRAINED STAFF AND PHYSICIANS. THE TEAM CONTINUOUSLY MONITORS GOALS, TRACKS CLINICAL OUTCOMES AND REMAINS CURRENT ON THE BEST CLINICAL PRACTICES TO INCORPORATE INTO EACH PROGRAM. THE INTERDISCIPLINARY TEAM MEETS WEEKLY TO RE-EVALUATE CARE AND SET NEW GOALS INTENDED TO CHALLENGE EACH PATIENT FOR A HIGHER LEVEL OF RECOVERY. FAMILIES AND PATIENTS ARE AN INTEGRAL PART OF THE TEAM AND ARE ENCOURAGED TO REMAIN ACTIVELY INVOLVED IN THE PATIENT'S TREATMENT PLAN. OUR GOAL IS TO RETURN EACH PATIENT TO HIS OR HER OPTIMAL LEVEL OF FUNCTIONING AND HEALTH. COLUMBUS SPECIALTY HOSPITAL OFFERS THE FOLLOWING SERVICES:PHYSICAL THERAPY OCCUPATIONAL THERAPY CASE MANAGEMENT SPEECH THERAPY VENTILATOR WEANING CENTRAL LINE MANAGEMENT - PICC LINES ANTIBIOTIC THERAPY TELEMETRY ACLS TRAINED RN'S/RESPIRATORY THERAPY STAFF NUTRITIONAL ASSESSMENT AND SUPPORT MEDICALLY COMPLEX AND WOUND CARE PROGRAMS:THE MEDICALLY COMPLEX AND WOUND CARE PROGRAMS ARE DESIGNED TO PROVIDE A COMPREHENSIVE AND INTERDISCIPLINARY APPROACH OF CARE FOR PATIENTS WHO HAVE SUSTAINED A RECENT ONSET OF ILLNESS OR INJURY THAT REQUIRES AN EXTENDED PERIOD OF LONG-TERM ACUTE CARE SERVICES. WE WANT TO HELP EACH PATIENT REACH HIS OR HER OPTIMAL LEVEL OF HEALTH AND INDEPENDENCE BY THE MOST EFFICIENT CARE POSSIBLE. MEDICALLY COMPLEX CONDITIONS INCLUDE MULTI-SYSTEM ORGAN FAILURE, NEUROVASCULAR DISEASE, CARDIAC RELATED DISORDERS, CARDIAC MONITORING, NEUROMUSCULAR CARE, CHEST TRAUMA, MRSA/VRE, POST OP COMPLICATIONS, PRE AND POST OP TRANSPLANT CARE, CVA, CERTAIN CANCER-RELATED CARE, BRAIN AND SPINAL CORD INJURY, IV THERAPIES/TPN, CENTRAL LINE MANAGEMENT, PHARMACOLOGICAL MANAGEMENT, AND LOW TOLERANCE REHABILITATION. WOUND CARE SERVICES INCLUDE COMPLEX WOUND CARE, WOUND CARE MANAGEMENT, PAIN MANAGEMENT, PATIENT AND FAMILY TRAINING AND EDUCATION, AND OXYGENATION MONITORING.RESPIRATORY PROGRAM:THE GOAL OF THE RESPIRATORY PROGRAM IS TO HELP EACH PATIENT PROGRESS TO HIS OR HER OPTIMAL LEVEL OF HEALTH AND INDEPENDENCE BY THE MOST EFFICIENT CARE POSSIBLE. THIS PROGRAM INCLUDES THE LATEST CARE IN TRACHEOTOMY, DECANNULATION, VENTILATOR WEANING AND MANAGEMENT AS WELL AS GENERAL RESPIRATORY CARE. WE TREAT THE FOLLOWING:RESPIRATORY FAILURE COPD PNEUMONIA/ARDS CHEST TRAUMA TRACHEOSTOMY AND RESPIRATORY NEEDS MULTIPLE SYSTEM ORGAN FAILURE NEUROMUSCULAR DISEASE INTERSTITIAL PULMONARY FIBROSIS KYPHOSCOLIOSIS CANCER SARCOIDOSIS CYSTIC FIBROSIS OCCUPATIONAL/ENVIRONMENTAL LUNG PRE & POST-OP LUNG REDUCTION/TRANSPLANT PATIENTS IN THIS PROGRAM ARE FOLLOWED BY A TEAM OF CONSULTING PHYSICIANS AND THE MEDICAL DIRECTOR IS A BOARD CERTIFIED PULMONOLOGIST. RN'S ARE ACLS CERTIFIED AND A CLINICAL SPECIALIST IS ALSO AVAILABLE FOR CONSULTATION. IN ADDITION THE TREATMENT TEAM INCLUDES PHYSICAL THERAPISTS, OCCUPATIONAL THERAPISTS AND SPEECH THERAPISTS, CASE MANAGERS, PHARMACISTS AND A DIETICIAN.OUR GOAL IS TO HELP EACH PATIENT PROGRESS TO HIS OR HER OPTIMAL LEVEL OF INDEPENDENCE BY THE MOST EFFICIENT MEANS POSSIBLE. 8520704 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 149 1 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 GA X X GREG THOMSEN 7063216712 710 CENTER STREET 9TH FLOOR COLUMBUS GA 31901 ROBERT JONES 1.00 X 0 0 0 JEAN HARTIN 1.00 X 0 0 0 JAMES WHEELER 1.00 X 0 0 0 JACKSON CROWDER MD 1.00 X 0 0 0 JOHN SIMS 1.00 X 0 0 0 GREG THOMSEN 40.00 X 152259 0 43022 WILLIAM ECKSTEIN 40.00 X 136599 0 31533 VIVIAN LEE 40.00 X 145367 0 31421 MARY SMITH 61.00 X 113548 0 0 547773 0 105976 4 0 1 0 COLUMBUS REGIONAL HEALTHCARE 707 CENTER STREET COLUMBUS GA 31908 FACILITY RENTAL 3475365 COLUMBUS BANK AND TRUST PO BOX 120 COLUMBUS GA 31902 LOANS 217068 MORRISON'S HEALTH CARE INC PO BOX 102289 ATLANTA GA 30368 DIETARY SERVICES 186808 HUMAN PERFORMANCEREHAB PO BOX 8068 COLUMBUS GA 31908 PHYSICAL THERAPY SERVICES 132968 FIRST INSURANCE FUNDING 450 SKOKIE BOULEVARD SUITE 1000 NORTHBROOK IL 60062 INSURANCE SERVICES 100047 8 PROGRAM SERVICE REVENU 623990 12273092 12273092 12273092 4938 4938 MEDICAL RECORDS 621300 2285 2285 2285 12280315 12275377 0 4938 540201 367337 172864 4145964 2823343 1322621 127523 86827 40696 836238 568642 267596 336601 228888 107713 266 266 42635 42635 11728 11728 41113 41113 88495 88495 27263 1748 25515 8437 2888 5549 21332 21332 71772 71772 114717 114717 PURCHASED SERVICES 3643761 3643761 BUILDING LEASE 499743 499743 OTHER EXPENSES 330622 224823 105799 PATIENT SUPPLIES 326157 326157 EQUIPMENT RENTAL 246290 246290 11460858 8520704 2940154 0 1378967 1573489 2623229 3850346 25844 46695 74682 79421 1188287 242892 283807 945395 22907 12424 4409436 6507770 559294 973419 101437 966189 660731 1939608 X 3748705 4568162 3748705 4568162 4409436 6507770 819457 0 X X 0 1 1 X 0 X 1188287 242892 945395 945395 12280315 11460858 819457 0 819457 12280315 0 12280315 0 12280315 11460858 0 11460858 0 11460858 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE HOSPITAL IS AN NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3)OF THE INTERNAL REVENUE CODE AND APPLICABLE PROVISIONS OF GEORGIA STATUTES. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2010. 1 1 1 X 1 X 1 1 0 0 6348 6348 0.00060 22870 22870 0.00200 29218 29218 0.00260 29218 29218 0.00260 0 82486 6740094 6488129 251965 X 0 1 1 COLUMBUS SPECIALTY HOSPITAL

710 CENTER STREET 9TH FLOOR COLUMBUS GA 31901

X LTACH COLUMBUS SPECIALTY HOSPITAL 1 1 1 100.000000000000 1 200.000000000000 1 X 1 1 X 1 X 1 X X X X 0 X X 0 0 PART I, LINE 7: COST IS DERIVED FROM THE ACTUAL EXPENSE DATA ACCUMULATED WITHIN THE COLUMBUS SPECIALTY HOSPITAL GENERAL LEDGER WHICH ADDRESSES ALL PATIENT SEGMENTS (PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, AND SELF-PAY). COLUMBUS SPECIALTY HOSPITAL ALLOCATES THOSE EXPENSES BASED ON A COST TO CHARGE RATIO. PART I, L7 COL(F): BAD DEBT EXPENSE INCLUDES PATIENTS WHO DO NOT PAY AND DO NOT APPLY FOR CHARITY CARE. BAD DEBT EXPENSE INCLUDED IN FORM 990, PART IX, LINE 25, COLUMN (A) IS $82,486. THE FULL AMOUNT OF $82,486 IS EXCLUDED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN COLUMN (F), ON PART I, LINE 7. PART II: THE HOSPITAL IS ABLE TO PROVIDE LONG-TERM CARE FOR THE RESIDENTS OF THE COMMUNITY REQUIRING HOSPITAL STAYS EXCEEDING 25 DAYS. WITHOUT SUCH CARE, MEMBERS OF THE COMMUNITY MAY NOT RECEIVE THE SPECIALIZED LONG-TERM CARE REQUIRED. PART III, LINE 4: NET PATIENT SERVICE REVENUE IS REPORTED ON THE ACCRUAL BASIS IN THE PERIOD IN WHICH SERVICES ARE PROVIDED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS AND OTHERS, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEWS, AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED IN THE FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, AND INVESTIGATIONS. PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF BOTH AN ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS. THE HOSPITAL RECORDS AN ESTIMATED RESERVE FOR UNCOLLECTIBLE PATIENT ACCOUNTS RECEIVABLE BASED UPON PRIOR COLLECTION HISTORY FOR GROUPS OF RECEIVABLES, KNOWN COLLECTION RISKS AND OTHER ENVIRONMENTAL FACTORS, INCLUDING THE AGE OF THE RECEIVABLES. THE HOSPITAL'S POLICY DOES NOT REQUIRE COLLATERAL OR OTHER SECURITY FOR PATIENT ACCOUNTS RECEIVABLE.COLUMBUS SPECIALTY HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, SUCH AMOUNTS ARE NOT REPORTED AS PATIENT SERVICE REVENUE. PART III, LINE 8: THE MEDICARE ALLOWABLE COST REPORTED IN THE MEDICARE COST REPORT, AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6, IS DERIVED FROM THE ACTUAL EXPENSES DATA FROM THE GENERAL LEDGER. COLUMBUS SPECIALTY HOSPITAL ALLOCATES THOSE EXPENSES TO PATIENTS BASED ON A COST TO CHARGE RATIO. PART III, LINE 9B: THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. COLUMBUS SPECIALTY HOSPITAL PART V, SECTION B, LINE 19D: COLUMBUS SPECIALTY HOSPITAL PROVIDES ACUTE CARE TO LONG-TERM PATIENTS THAT REQUIRE SPECIAL NEEDS. IT DOES NOT PROVIDE EMERGENCY CARE SERVICES. PART VI, LINE 2: COLUMBUS SPECIALTY HOSPITAL PROVIDES ACUTE CARE TREATMENT TO LONG-TERM PATIENTS REQUIRING SPECIAL NEEDS. BECAUSE ITS SERVICES ARE SPECIFIC TO LONG-TERM CARE AND ITS FACILITY CONTAINS ONLY 30 BEDS, IT DOES NOT FORMALLY ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES AS THE ORGANIZATION'S SOLE MISSION IS TO PROVIDE SPECIALIZED EXTENDED ACUTE CARE SERVICES TO PATIENTS NEEDING 25 OR MORE DAYS OF HOSPITALIZATION. PART VI, LINE 3: TO COMMUNICATE THE ORGANIZATION'S FINANCIAL POLICY TO THE PATIENT, INFORMATION IS MADE AVAILABLE AT ALL POINTS OF REGISTRATION (INTAKE AND DISCHARGE) AND FINANCIAL COUNSELORS ARE AVAILABLE TO DISCUSS SPECIFIC CASES. THE ORGANIZATION ALSO OFFERS A SCREENING FORM TO DETERMINE PROGRAM ELIGIBILITY. ONCE ELIGIBILITY IS DETERMINED, A FINANCIAL COUNSELOR WILL REQUEST VERIFICATIONS NECESSARY TO APPROVE THE PATIENT FOR SPECIFIED PROGRAMS AND/OR TO DETERMINE IF SERVICES QUALIFY UNDER THE WRITTEN CHARITY CARE POLICY. PART VI, LINE 4: COLUMBUS SPECIALTY HOSPITAL SERVES THE COMMUNITY OF COLUMBUS, GEORGIA AND SURROUNDING AREAS IN SOUTHWEST GEORGIA AND SOUTHEAST ALABAMA. THE HOSPITAL PROVIDES VERY SPECIALIZED ACUTE CARE FOR PATIENTS NEEDING 25 OR MORE DAYS OF HOSPITALIZATION THAT MAY NOT BE OFFERED AT OTHER FACILITIES WITHIN THE AREA. PART VI, LINE 6: PLEASE REFER TO THE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS AS PROVIDED IN SCHEDULE O FOR FURTHER DOCUMENTATION HOW COLUMBUS SPECIALTY HOSPITAL IS SERVING ITS PATIENTS. REPORTS FILED WITH STATES PART VI, LINE 7 GA X X 0 0 0 0 0 0 0 0 0 GREG THOMSEN 152259 0 0 0 0 0 22000 0 21022 0 195281 0 0 0 WILLIAM ECKSTEIN 136599 0 0 0 0 0 0 0 31533 0 168132 0 0 0 VIVIAN LEE 145367 0 0 0 0 0 10400 0 21021 0 176788 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FINAL FORM 990, AS ULTIMATELY FILED WITH THE IRS, WAS NOT PROVIDED TO EACH VOTING MEMBER OF THE GOVERNING BODY OF THE ORGANIZATION, IN PAPER OR ELECTRONIC FORM, PRIOR TO ITS FILING WITH THE IRS. NO POLICY REQUIRING THIS ACTION HAS BEEN IMPLEMENTED AT THIS TIME. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY, IN ADDITION TO OTHER GOVERNING POLICIES, IS AVAILABLE ON THE ORGANIZATION WEBSITE. ALL CORPORATE FINANCIAL STATEMENTS ARE ALSO AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15 AN INDEPENDENT MARKET SURVEY IS COMPLETED TO ASSIST IN DETERMINING APPROPRIATE COMPENSATION FOR THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES. A RECOMMENDATION BASED UPON THE SURVEY IS SUBMITTED TO THE BOARD OF DIRECTORS FOR APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY REQUIRING EMPLOYEES TO SIGN A CODE OF CONDUCT AGREEMENT WHEN HIRED AND UPON POLICY REVIEW. THE ORGANIZATION'S COMPLIANCE HOTLINE IS POSTED ON THE ORGANIZATION WEBSITE AND WITHIN ADMITTING PACKETS FOR HOSPITAL PATIENTS AND THEIR FAMILIES. FORM 990, PART XI, LINE 2C: OVERSIGHT OF AUDIT COLUMBUS SPECIALTY HOSPITAL HAS A FINANCE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANTS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.