2011-05-16T09:19:46-05:00 2010-06-30 DRAFFIN & TUCKER LLP PO BOX 6 ALBANY GA 317020006 990 2009-07-01 581973570 FLOYD HEALTHCARE MANAGEMENT INC FLOY 7065096074 304 TURNER MCCALL BLVD ROME GA 301620233 RICHARD T SHEERIN 7065096074 2011-05-16 true JACQUELINE G ATKINS 2298837878 2011-05-10 2009 2016-02-24 21:20:13Z KURT STUENKEL 304 TURNER MCCALL BLVD ROME GA 30161 344898609 false X WWW.FLOYD.ORG X 1990 GA OPERATE A NON-PROFIT HOSPITAL SYSTEM AND SUPPORT 501 (C)(3) ORGANIZATIONS 11 11 2608 285 980455 207249 7957683 4934800 260119813 282448984 -3795012 1278791 3086642 3487697 267369126 292150272 40446 102386 0 123176901 134386054 0 188257 130966289 144450049 254183636 278938489 13185490 13211783 270623290 283273344 176749865 180776253 93873425 102497091 OPERATE A NON-PROFIT HOSPITAL SYSTEM AND SUPPORT 501 (C)(3) ORGANIZATIONS false false 232456521 102386 281554157 FLOYD HEALTHCARE MANAGEMENT, INC. OPERATES FLOYD MEDICAL CENTER, A GENERAL ACUTE CARE HOSPITAL, AND FLOYD BEHAVIORAL HEALTH CENTER, A PSYCHIATRIC HOSPITAL. SEE ADDITIONAL DISCLOSURES AT SCHEDULE O, "SUPPLEMENTAL INFORMATION TO FORM 990". 232456521 true true false true false false false false false true true false false false false false false false false false true false true true true false false false false false false true false true false true false false false true true false false false true 285 0 true 2608 true true true false false false false false false false false false false 11 11 false false false false false false false true true false false true true true true true true true true true false GA X RICHARD T SHEERIN 7065096074 304 TURNER MCCALL BLVD ROME GA 30161 J ROGER SUMNER 1.00 X X 5750 1500 0 TIM MAHANAY 1.00 X 4925 1250 0 JERRY NORMAN 1.00 X 6175 0 0 WESLEY F JOHNSON 1.00 X 5375 0 0 WILLIAM V WIGLEY 1.00 X 5125 0 0 JOHN S FREEMAN 1.00 X 3000 1250 0 JOHN MAYES 1.00 X 4200 0 0 GEORGE BOSWORTH MD 1.00 X 3250 0 0 GARRY FRICKS 1.00 X 3125 0 0 CARL HERRING MD 1.00 X 2000 0 0 MARK MANIS 1.00 X 0 0 0 KURT STUENKEL 40.00 X 1316819 0 35533 DEE RUSSELL MD 40.00 X 554897 0 32798 RICHARD T SHEERIN 40.00 X 359723 0 24920 WARREN RIGAS 40.00 X 351665 0 22288 C WADE MONK 40.00 X 351546 0 34894 GREG POLLEY 40.00 X 273712 0 37424 SHEILA BENNETT HORNER 40.00 X 241163 0 2514 DAN SWEITZER 40.00 X 232134 0 36355 MARY MAIRE 40.00 X 220974 0 44912 REBEKAH LOWREY 40.00 X 193896 0 0 BOBBY PURCELL 40.00 X 178968 0 14940 JOHN HARDWELL MD 50.00 X 477760 0 18061 GARRETT H BARNESMD 52.00 X 458251 0 4212 SMITA VARSHNEY 40.00 X 383640 0 20108 MOLLY REES MD 40.00 X 343109 0 9490 JEFFREY BLACKMON 40.00 X 334017 0 755 BG WATERS X 20232 0 88544 CHARLOTTE DOUGHERTY X 19582 0 36531 DON TATE X 19309 0 18188 6374322 4000 482467 108 true true false CERNER CORP PO BOX 412702 KANSAS CITY MO 64141 IT SERVICES 6583908 BRASFIELD AND GORRIE LLC PO BOX 11407 BIRMINGHAM AL 35246 GENL CONTRACTOR 4756120 ARAMARK MANAGEMENT SERVICES PO BOX 233 ROME GA 30161 ENVIRON SVCS 4083464 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 DIETARY SVC 2298447 NELSON AND NELSON CONTRACTORS INC 527 WEST 12TH STREET ROME GA 30165 GENL CONTRACTOR 1646193 69 1904260 3030540 468461 4934800 PATIENT SERVICE REVENUE 281468529 281468529 REFERENCE LAB 621500 525026 525026 SUBWAY/STARBUCKS 722210 455429 455429 282448984 1092832 1092832 2977941 757001 2220940 2220940 2220940 52058236 119059 51755452 235884 302784 -116825 185959 185959 CAFETERIA 1181129 1181129 PURCHASE DISCOUNTS 53334 53334 FAMILY PRACTICE REVENUE 26257 26257 6037 6037 1266757 292150272 281554157 980455 4680860 102386 102386 4605000 4605000 110975267 94481784 16338354 155129 7053883 5629395 1414913 9575 3698803 3476984 215905 5914 8053101 6277650 1764654 10797 445240 445240 429068 429068 123733 123733 23615984 18335865 5277317 2802 2286986 398682 1888304 44329914 42080349 2247306 2259 1051614 1051614 15952356 14345954 1606402 1172424 798493 372150 1781 549363 334990 214373 149225 149225 15225504 13692296 1533208 3061732 1141581 1920151 BAD DEBTS 26696921 26696921 R&M 6751524 3015160 3736364 DUES & SUBSCRIPTIONS 1046612 1046612 EMPLOYEE RECOGNITION 783331 504948 278383 RECRUITING 427382 427382 351136 96471 254665 278938489 232456521 46293711 188257 1582266 2579831 23691109 12369478 38015466 40899343 249715 309314 8546173 9109654 2606818 3228350 310321021 158957987 134052428 151363034 55761234 55888410 1716864 1834372 1408177 1316339 2993040 4375219 270623290 283273344 19477700 25516076 108732506 107132584 9257330 10989246 39282329 37138347 176749865 180776253 X 93873425 102497091 93873425 102497091 270623290 283273344 X false true true X false X SCHEDULE A, PART IV - REASON FOR NON-PRIVATE FOUNDATION STATUS ON JANUARY 1, 1998 FLOYD HEALTHCARE MANAGEMENT, INC. ACQUIRED BY LEASE ALL OF THE ASSETS OF THE HOSPITAL AUTHORITY OF FLOYD COUNTY AND THEREBY BECAME THE LICENSED OPERATOR OF FLOYD MEDICAL CENTER, A GENERAL, ACUTE CARE HOSPITAL WITH 300+ BEDS. SINCE THAT TIME, FLOYD HEALTHCARE MANAGEMENT, INC. HAS CONTINUED TO OPERATE FLOYD MEDICAL CENTER AS A NON-PROFIT HOSPITAL, OFFERING A WIDE ARRAY OF SERVICES TO THE COMMUNITY, INCLUDING AN EMERGENCY ROOM WHICH SEES APPROXIMATELY 70,000 PATIENTS PER YEAR AND A BUSY OUTPATIENT INDIGENT CLINIC. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 123733 false false 123733 false false false false false SCHEDULE C, PART II-B, LINE 1I COSTS INCURRED IN TRAVEL AND LODGING FOR CFO & CEO MEETING WITH LEGISLATORS AND MEETING WITH CHAMBER OF COMMERCE IN WASHINGTON DC PLUS 121,829 IN GENERAL LOBBYING FEES PAID TO PROFESSIONAL LOBBYIST. false false false false false false false false false false 9362290 9362290 10269845 5080302 5189543 174645725 108621923 66023802 17313258 17313258 97888893 ACCRUED PENSION 16473583 DUE RELATED PARTIES 8621884 MALPRACTICE CLAIMS 7301745 ACCRUED INTEREST 2636742 THIRD PARTY SETTLEMENTS 2104393 PAYROLL AND WITHHOLDINGS 37138347 292150272 278938489 13211783 -526589 -526589 12685194 292286629 757001 757001 291529628 620644 620644 292150272 279601435 757001 757001 278844434 94055 94055 278938489 LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X EXCERPT FROM AUDITED FINANCIAL STATEMENTS - INCOME TAXES EFFECTIVE DECEMBER 15, 2009 THE CORPORATION ADOPTED ASC 740-10-50-15, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE STANDARD PRESCRIBES A MINIMUM RECOGNITION THRESHOLD AND MEASUREMENT METHODOLOGY THAT A TAX POSITION, TAKEN OR EXPECTED TO BE TAKEN, IN A TAX RETURN IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. THE CUMULATIVE EFFECT OF THIS CHANGE IN ACCOUNTING PRINCIPLE WAS IMMATERIAL. AS OF JUNE 30, 2010, THE CORPORATION HAS NO UNRECOGNIZED TAX BENEFITS OR ACCRUED INTEREST OR PENALTIES RELATED TO UNCERTAIN TAX POSITIONS. THE CORPORATION'S OPEN AUDIT PERIODS ARE 2007-2009. RECONCILIATION OF CHANGES - OTHER SCHEDULE D, PAGE 4, PART XI, LINE 8 RENTAL EXPENSES 757,001 GAIN ON SALE/LEASEBACK MOB -94,055 CAPITAL CONTRIBUTIONS -526,589 RENTAL EXPENSES -757,001 GAIN ON SALE/LEASEBACK MOB 94,055 REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER SCHEDULE D, PAGE 4, PART XII, LINE 2D RENTAL EXPENSES 757,001 REVENUE AMOUNTS INCLUDED ON RETURN - OTHER SCHEDULE D, PAGE 4, PART XII, LINE 4B GAIN ON SALE/LEASEBACK MOB 94,055 CAPITAL CONTRIBUTIONS 526,589 EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHER SCHEDULE D, PAGE 4, PART XIII, LINE 2D RENTAL EXPENSES 757,001 EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER SCHEDULE D, PAGE 4, PART XIII, LINE 4B GAIN ON SALE/LEASEBACK MOB 94,055 true true true X 1.25000 true X 3.25000 true false true true 13174078 13174078 0.05220 44719808 37682416 7037392 0.02790 57893886 37682416 20211470 0.08010 1198401 1198401 0.00480 2339172 2339172 0.00930 2616675 2616675 0.01040 6154248 6154248 0.02450 64048134 37682416 26365718 0.10460 true 4743673 3800000 62451254 60418663 2032591 X true true FLOYD HEALTHCARE MANAGEMENT INC DBA FLOYD MEDICAL CENTER

304 TURNER MCCALL BLVD ROME GA 30161

X X IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN (F), THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25: FORM 990, PART IX, LINE 25 278,938,489 LESS: BAD DEBTS IN PART IX ( 26,696,921) DENOMINATOR FOR COLUMN (F) 252,241,568 EXCERPT FROM AUDITED FINANCIAL STATEMENTS - ALLOWANCE FOR DOUBTFUL ACCOUNTS THE CORPORATION PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON EVALUATION OF THE OVERALL COLLECTIBILITY OF THE ACCOUNTS RECEIVABLE. AS ACCOUNTS ARE KNOWN TO BE UNCOLLECTIBLE, THE ACCOUNT IS CHARGED AGAINST THE ALLOWANCE. MEDICARE COSTS AND REVENUES WERE EXTRACTED FROM THE MEDICARE COST REPORT FILED FOR THE SAME FISCAL TIME FRAME. FOR PATIENTS RECEIVING ONLY A PORTION OF THEIR BILL AS CHARITY, THE REMAINING PORTION OF THE BILL IS TREATED THE SAME AS ALL OTHER PATIENTS IN REGARDS TO COLLECTIONS. FLOYD HEALTHCARE MANAGEMENT, INC. ("FHMI") IS CURRENTLY IN THE PROCESS OF COMPLETING A HEALTH CARE NEEDS ASSESSMENT IN CHATTOOGA, FLOYD AND POLK COUNTIES. THIS INCLUDES A RANDOM PAPER SURVEY OF RESIDENTS OF EACH COUNTY AS WELL AS INTERVIEWS WITH COMMUNITY LEADERS AND HEALTH CARE PROFESSIONALS AND FOCUS GROUPS. IN ADDITION, FHMI DEVELOPS A STRATEGIC PLAN PERIODICALLY THAT IS UPDATED ANNUALLY. THE STRATEGIC PLAN TAKES INTO CONSIDERATION HEALTH NEEDS FOR OUR SERVICE AREA IN ADDITION TO UTILIZATION OF SERVICES, COMMUNITY PARTICIPATION AND QUALITY OF SERVICES PROVIDED. FHMI COMMUNICATES THIS INFORMATION THROUGH SIGNAGE IN THE EMERGENCY CARE CENTER, PATIENT REGISTRATION AREAS, IN THE BUSINESS/PATIENT FINANCIAL SERVICES OFFICES AND IN THE OFFICES OF OUR FINANCIAL COUNSELORS. DURING TIMES OF PREADMISSION AS WELL AS ON SITE REGISTRATION THE ACCESS/REGISTRATION STAFF DISCUSS POLICIES WITH THE PATIENT/PATIENTS FAMILY IF APPROPRIATE. AFTER DISCHARGE AND DURING THE COLLECTION PERIOD OUR STAFF ONCE AGAIN DISCUSS OUR FINANCIAL ASSISTANCE POLICES. IN ADDITION, THERE IS A DEMONSTRATED WORD-OF-MOUTH COMMUNICATION OF THESE POLICIES THROUGH OUR PATIENT POPULATION. LOCATED IN NORTHWEST GEORGIA, FHMI DBA FLOYD MEDICAL CENTER ("FMC") IS BASED IN ROME, GEORGIA, WHICH IS THE COUNTY SEAT FOR FLOYD COUNTY, ABOUT 60 MILES NORTH OF ATLANTA AND 60 MILES SOUTH OF CHATTANOOGA, TENN. THE 165,000 (2009 ESTIMATE) RESIDENTS OF THE THREE-COUNTY REGION ARE SERVED BY FMC AND TWO SMALLER HOSPITALS. THIS POPULATION BASE IS 78-PERCENT CAUCASIAN, 12 PERCENT AFRICAN AMERICAN, 8 PERCENT HISPANIC, 2 PERCENT OTHER ETHNICITIES. NORTHWEST GEORGIA IS A MEDICAL AND EDUCATIONAL HUB. THREE OF THE LARGEST EMPLOYERS IN THE THREE- COUNTY AREA ARE HEALTH CARE PROVIDERS. THE AREA IS ALSO HOME TO FOUR POST- SECONDARY EDUCATIONAL INSTITUTIONS. STILL, THE MANUFACTURING SECTOR REMAINS AN ECONOMIC FORCE IN THE AREA. AS IN OTHER PARTS OF THE COUNTRY, THE UNEMPLOYMENT RATE CLIMBED INTO DOUBLE DIGITS IN EARLY 2009, AND APPROXIMATELY 15 PERCENT OF RESIDENTS ARE BELOW THE FEDERAL POVERTY LEVEL. OVER ONE-THIRD OF THE ADULT POPULATION HAS NOT GRADUATED HIGH SCHOOL. MALIGNANT CANCERPRIMARILY LUNG CANCER AND CARDIOVASCULAR DISEASE ARE THE PRIMARY CAUSES OF DEATH IN THESE COUNTIES. OF THOSE PATIENTS SEEKING HEALTH CARE IN THE PRIMARY SERVICE AREA, 47.1 PERCENT DEPEND ON MEDICARE FOR THEIR PRIMARY HEALTHCARE COVERAGE; 24.1 PERCENT ARE COVERED BY COMMERCIAL INSURANCE AND 17.3 PERCENT ARE COVERED BY THE STATE MEDICAID PROGRAM. FHMI IS THE SAFETY-NET HEALTH CARE PROVIDER FOR NORTHWEST GEORGIA. IN ADDITION TO PROVIDING EMERGENCY CARE SERVICES, FMC HAS GONE THE EXTRA STEP OF PROVIDING 24-HOUR COVERAGE FOR SURGERY AND OTHER SERVICES TO MAINTAIN STATUS AS A LEVEL II TRAUMA CENTER. FHMI IS ALSO THE SITE FOR THE REGIONAL POISON CONTROL CENTER, HOUSES THE REGIONS ONLY LEVEL II NEONATAL INTENSIVE CARE UNIT, AND OPERATES A FAMILY MEDICINE RESIDENCY PROGRAM THAT OPERATES THE FLOYD COUNTY CLINIC TO PROVIDE BASIC HEALTH CARE SERVICES FOR THE ECONOMICALLY DISADVANTAGED IN OUR COMMUNITY. IN ADDITION TO THESE SERVICES, FHMI ACTIVELY PROMOTES HEALTH AND SAFETY THROUGHOUT THE COMMUNITY THROUGH VARIOUS COMMUNITY BENEFIT ACTIVITIES INCLUDING, BUT NOT LIMITED TO, BICYCLE SAFETY HELMET GIVEAWAYS AND CLINICS; SCHOOL-BASED CHILD SAFETY PROGRAMS; MOBILE MAMMOGRAPHY; AN ACTIVE SPEAKERS BUREAU; CHILDBIRTH CLASSES; COMMUNITY HEALTH SCREENINGS AND HEALTH FAIRS; AN ANNUAL CAMP FOR CHILDREN WITH DIABETES; HEALTH CARE INTERNSHIPS, EXTERNSHIPS AND SHADOWING OPPORTUNITIES; AND SUPPORT FOR COMMUNITY-WIDE INITIATIVES WITH HEALTH PARTNERS INCLUDING THE NORTHWEST GEORGIA CANCER COALITION, CANCER NAVIGATORS AND THE FREE CLINIC OF ROME. GA true COBRA INSURANCE PREMIUM 41 93286 TUITION 1 9100 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES SCHEDULE I, PAGE 1, PART I, LINE 2 IT IS THE POLICY OF THE ORGANIZATION TO ESTABLISH PROCEDURES TO POTENTIALLY SECURE PAYMENT FOR HEALTHCARE SERVICES VIA EXTENSION OF INSURANCE BENEFITS THROUGH COBRA. THIS EXTENSION OF INSURANCE COVERAGE WILL BE PROVIDED ON A CASE-BY-CASE BASIS. THE HOSPITAL'S ROLE IN COVERAGE PAYMENT WILL BE REVIEWED MONTHLY; THERE IS NO OBLIGATION FOR THE HOSPITAL TO CONTINUE COVERAGE PAYMENT BEYOND THE INITIAL STATED LENGTH. THIS COVERAGE PAYMENT IS NOT TYPICALLY INTENDED FOR LONGER THAN A SPECIFIC SERVICE EVENT. IN GENERAL, ASSIGNED STAFF WILL EXAMINE PATIENTS FOR POTENTIAL QUALIFICATION FOR THIS PROGRAM. UPON QUALIFICATION, PAYMENT OF THE INSURANCE PREMIUM IS MADE TO THE EMPLOYER/INSURANCE COMPANY. PATIENT LIABILITY WILL BE EVALUATED AND DISCUSSED WITH THE PATIENT/GUARANTOR PRIOR TO DISCHARGE. THIS DISCUSSION WILL FOLLOW THE SAME PROTOCOL AS OTHER PATIENTS WITH RESIDUAL LIABILITIES. FINALLY, A 1099 TAX FORM IS ISSUED TO THE PATIENT. X X X true true X X X X X false true false false false true false false false KURT STUENKEL 527018 342951 446850 27551 7982 1352352 DEE RUSSELL MD 348546 201082 5269 24420 8378 587695 RICHARD T SHEERIN 264298 94072 1353 19239 5681 384643 WARREN RIGAS 255816 94555 1294 18700 3588 373953 C WADE MONK 259805 89259 2482 29001 5893 386440 GREG POLLEY 196080 75743 1889 25587 11837 311136 SHEILA BENNETT HORNER 192485 47739 939 2514 243677 DAN SWEITZER 167833 61980 2321 32524 3831 268489 MARY MAIRE 168851 50632 1491 38256 6656 265886 REBEKAH LOWREY 168687 23785 1424 193896 BOBBY PURCELL 158696 19804 468 11628 3312 193908 JOHN HARDWELL MD 477274 486 16500 1561 495821 GARRETT H BARNESMD 457580 671 4212 462463 SMITA VARSHNEY 383149 491 16500 3608 403748 MOLLY REES MD 342721 388 7211 2279 352599 JEFFREY BLACKMON 333725 292 755 334772 BG WATERS 20232 88544 108776 CHARLOTTE DOUGHERTY 19582 36531 56113 DON TATE 19309 18188 37497 FRINGE OR EXPENSE EXPLANATION SCHEDULE J, PAGE 1, PART I, LINE 1A TRAVEL FOR COMPANIONS SPOUSAL TRAVEL EXPENSES ARE REIMBURSED WHEN ATTENDANCE IS NECESSARY AND APPROPRIATE. THE POLICY RECOGNIZES THAT GOVERNING BOARD MEMBERS AND SENIOR EXECUTIVES ARE OFTEN PLACED IN SOCIAL SITUATIONS AT SUCH MEETINGS AND WOULD REPRESENT THE HOSPITAL OPTIMALLY WITH THE ASSISTANCE OF THEIR SPOUSES. CONSEQUENTLY, THESE BENEFITS ARE NOT INCLUDED IN THEIR TAXABLE WAGES. SPOUSAL TRAVEL EXPENSES REQUIRE PRIOR APPROVAL AND ARE LIMITED TO EVENTS WHERE BOARD MEMBERS AND SENIOR EXECUTIVES ATTEND. REIMBURSEMENT SHALL BE LIMITED TO TRANSPORTATION EXPENSE NOT TO EXCEED THE AIR TRAVEL RATE IN COACH CLASS AND OUT-OF-POCKET EXPENSES WITH RESPECT TO LODGING AND FOOD. REIMBURSEMENT SHALL BE LIMITED TO LODGING BASED ON DOUBLE ACCOMMODATIONS. FLOYD HEALTHCARE MANAGEMENT, INC. ("FHMI") PROVIDES THE CEO WITH A MONTHLY AUTO ALLOWANCE. EACH YEAR THE AMOUNT THAT IS NONBUSINESS RELATED IS INCLUDED IN TAXABLE INCOME. FHMI PROVIDES A MEMBERSHIP TO THE LOCAL COUNTRY CLUB FOR THE CEO AND CMO. ANY AMOUNT CONSIDERED NONBUSINESS IS INCLUDED IN THE RECIPIENT'S TAXABLE INCOME. SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 KURT STUENKEL 0 441,528 0 COMPENSATION CONTINGENT UPON NET EARNINGS OF ORGANIZATION SCHEDULE J, PAGE 1, PART I, LINE 6A ALL MEMBERS OF THE EXECUTIVE TEAM FOR FHMI PARTICIPATE IN AN INCENTIVE COMPENSATION PLAN UNDER WHICH ANNUAL YEAR-END BONUSES ARE PAID BASED ON INDIVIDUAL AND CORPORATE-WIDE ACHIEVEMENT OF SPECIFIC GOALS AND OBJECTIVES. ONE OF THESE GOALS RELATES TO THE ORGANIZATION'S NET INCOME. THESE BONUSES ARE A CASH-BASED SYSTEM. OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III ADDITIONALLY, OF THE 1,352,352 LISTED AS COMPENSATION FOR MR. KURT STUENKEL, 342,951 REPRESENTS A PERFORMANCE BASED PAYMENT ARISING FROM THE 2009 PERFORMANCE PERIOD, AND 441,528 REPRESENTS THE NONQUALIFIED SERP PLAN. ACCORDINGLY, MR. STUENKEL'S SALARY FOR 2009 WOULD HAVE BEEN 567,873 EXCLUDING THE 2009 PORTION OF THE INCENTIVE BASED PAYMENT AND THE SERP PLAN AMOUNT. TOTAL DIRECT CASH COMPENSATION (SALARY AND BONUS) IS 869,969, WHICH DOES NOT INCLUDE A PAYMENT FOR RETIREMENT OF 441,528, NOR OTHER FRINGE BENEFITS WHICH TOTAL 40,855. THE CEO PARTICIPATES IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WHICH IS FUNDED ANNUALLY IN AN AMOUNT WHICH, WHEN ADDED TO OTHER SOURCES OF RETIREMENT INCOME, WILL AFFORD A RETIREMENT INCOME AT A TARGETED PERCENTAGE OF PRE-RETIREMENT COMPENSATION. THE SERP IS A NON-QUALIFIED RETIREMENT PLAN, AND AS SUCH THE ANNUAL FUNDING PAYMENTS PAID INTO IT ARE TAXABLE TO THE PARTICIPANT IN THE YEAR IN WHICH MADE. EFFECTIVE WITH CALENDAR YEAR 2009, MR. STUENKEL'S SERP IS A CASH-BASED PROGRAM. HOSPITAL AUTHORITY OF FLOYD COUNTY REVENUE CERTIFICATES 2003 586001973 343575ER3 2003-12-17 40000000 HOSPITAL IMPROVEMENT false false HOSPITAL AUTHORITY OF FLOYD COUNTY 2009 REVENUE ANTICIPATION BONDS 586001173 343575GG5 2009-06-30 40240151 IMPROVEMENTS/DEFEASE false false 31725000 1572848 710583 12571868 2004 false false true true 40232146 1332738 18595720 588380 19723314 2010 false false true true false false false false false true false false false false false true false false false false false false false false false false false false SHEILA B HORNER EMPLOYEE/TUITION PYM 9100 JOSHUA POLLEY FAMILY-KEY EMPL 39059 EMPLOYEE false ROXANNE NORMAN FAMILY-BD MEMBR 30792 EMPLOYEE false MISTY DRAKE FAMILY-BD MEMBR 66122 EMPLOYEE false JOY HOWARD FAMILY-BD MEMBR 28557 EMPLOYEE false X 1 468461 BOOK VALUE APPROX FMV false false false ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11 THE ORGANIZATION'S CEO, CFO, CONTROLLER AND INHOUSE COUNSEL REVIEW THE FORM 990 FOR FINANCIAL AND DISCLOSURE ACCCURACY. PRIOR TO ITS FILING, AN ELECTRONIC COPY OF THE ORGANIZATION'S 990 RETURN IS PROVIDED TO EACH MEMBER OF THE ORGANIZATION'S GOVERNING BOARD FOR REVIEW AND COMMENT. THIS IS ACCOMPLISHED BY E-MAILING IT TO THE BOARD MEMBER'S PERSONAL E-MAIL ADDRESS. AT THE REGULAR BOARD MEETING IMMEDIATELY PRIOR TO THE FILING DATE, THE BOARD MEMBERS ARE INFORMED THAT THE 990 RETURN WILL SOON BE FILED WITH THE IRS AND THAT A COPY HAS BEEN (OR WILL SHORTLY BE) E-MAILED TO THEM. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C FLOYD HEALTHCARE MANAGEMENT, INC. ("FHMI") HAS A WRITTEN POLICY RESPECTING CONFLICTS OF INTEREST AND DISCLOSURE OF SAME. GENERALLY SPEAKING, THE POLICY REQUIRES ANY "COVERED PERSON" WHO BELIEVES HE/SHE HAS A CONFLICT OF INTEREST TO: -DISCLOSE THE EXISTENCE AND NATURE OF THE CONFLICT OF INTEREST (INCLUDING ALL FACTS KNOWN RESPECTING THE SUBJECT MATTER) TO THE CHAIRMAN OF THE BOARD; -PLAY NO PART, DIRECTLY OR INDIRECTLY, IN THE DELIBERATION OR VOTE OF THE BOARD OF DIRECTORS WITH RESPECT TO THE DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS; AND -ABSENT HIMSELF/HERSELF FROM THAT PORTION OF THE MEETING AT WHICH THE CONFLICT OF INTEREST IS DISCUSSED. THE DEFINITION OF A "COVERED PERSON" INCLUDES ALL BOARD MEMBERS, OFFICERS AND MEMBERS OF SENIOR MANAGEMENT OF FHMI. WHEN A COVERED PERSON DISCLOSES A POTENTIAL CONFLICT OF INTEREST TO THE BOARD CHAIRMAN, THE CHAIRMAN IS OBLIGED TO BRING THE MATTER TO THE ATTENTION OF THE FULL BOARD. THE BOARD DETERMINES WHETHER A CONFLICT OF INTEREST ACTUALLY EXISTS. IF THE BOARD DETERMINES THAT THERE IS A CONFLICT OF INTEREST, THE TRANSACTION OR MATTER GIVING RISE TO THE CONFLICT OF INTEREST MAY NOT PROCEED UNLESS THE BOARD DETERMINES, BY A MAJORITY VOTE, THAT, DESPITE THE CONFLICT OF INTEREST, THE TRANSACTION/MATTER IS NEVERTHELESS IN THE CORPORATION'S BEST INTEREST AND IS FAIR AND REASONABLE TO THE CORPORATION. IN ADDITION TO THE REQUIREMENT THAT A COVERED PERSON DISCLOSE A POTENTIAL CONFLICT OF INTEREST AT THE TIME IT ARISES, EACH COVERED PERSON IS ALSO REQUIRED TO SUBMIT, ON AN ANNUAL BASIS, A `CONFLICT AND DISCLOSURE OF INTEREST QUESTIONNAIRE'. THIS MULTI-QUESTION DOCUMENT SERVES AS A REMINDER AND PROMPTS EACH COVERED PERSON TO PONDER THOSE AREAS AND SITUATIONS WHERE A POTENTIAL CONFLICT MIGHT EXIST. ADDITIONALLY, ANY PROPOSED TRANSACTION AT FHMI WHICH INVOLVES AN "INSIDER" (I.E., A BOARD MEMBER, OFFICER, MANAGER, ETC.) IS SCRUTINIZED, WITH THE ASSISTANCE OF CORPORATE LEGAL COUNSEL, FROM THE STANDPOINT OF WHETHER THE TRANSACTION WILL RESULT IN ANY EXCESS BENEFIT TO THE INSIDER. TYPICALLY THIS INVOLVES OBTAINING APPROPRIATE DATA REGARDING COMPARABILITY WHICH IS PROVIDED TO THE BOARD FOR ITS USE IN DETERMINING THAT THE CONSIDERATION BEING PAID TO THE INSIDER AS A PART OF THE TRANSACTION IS REASONABLE AND DOES NOT EXCEED THE VALUE OF THE BENEFIT RECEIVED BY FHMI. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A IT IS THE RESPONSIBILITY OF THE COMPENSATION COMMITTEE OF FLOYD HEALTHCARE MANAGEMENT, INC. BOARD TO ACTIVELY MANAGE AND MONITOR EXECUTIVE COMPENSATION. TO DO SO, THE COMMITTEE HAS ESTABLISHED THE FOLLOWING OBJECTIVES FOR THE EXECUTIVE COMPENSATION PROGRAM: -PROVIDE A COMPETITIVE TOTAL COMPENSATION EARNING OPPORTUNITY TO RECRUIT, RETAIN, AND REWARD THE EXECUTIVES NEEDED TO MEET THE COMMUNITY'S HEALTHCARE NEEDS, NOW AND IN THE FUTURE; -PROVIDE PAY OPPORTUNITIES THAT WILL REWARD THE EXECUTIVE TEAM WHEN ORGANIZATIONAL PERFORMANCE IN KEY AREAS IS DEMONSTRATED; -INCENTIVE COMPENSATION UNDER THE EXECUTIVE INCENTIVE COMPENSATION PLAN IS PAYABLE ONLY IN THE EVENT THE ORGANIZATION'S OPERATING MARGIN FROM OPERATING REVENUE EXCEEDS CERTAIN PARAMETERS ESTABLISHED BY THE COMPENSATION COMMITTEE; -ENSURE THAT THE COMPENSATION PROGRAMS ARE EASY FOR ALL INTERESTED PARTIES TO UNDERSTAND. ANNUALLY, THE COMMITTEE REVIEWS THE APPROPRIATENESS OF THE TOTAL COMPENSATION PROVIDED TO EACH EXECUTIVE: -AS RELATED TO THE COMPETITIVE MARKET PAY RATES; -AS RELATED TO THE INDIVIDUAL'S ROLE AND RESPONSIBILITY IN THE ORGANIZATION; -AS IT PERTAINS TO VARIABLE OR INCENTIVE EARNING OPPORTUNITIES RELATING TO THE PERFORMANCE OF THE ORGANIZATION. TO DETERMINE THE MARKET RATES FOR EACH POSITION, THE COMMITTEE UTILIZES AN OUTSIDE CONSULTANT TO SURVEY COMPARABLE ORGANIZATIONS TO DEVELOP AN APPROPRIATE RANGE OF PAY FOR EACH EXECUTIVE POSITION. THIS RANGE GENERALLY REFLECTS THE PAY PRACTICES AND LEVELS OF COMPARABLE ORGANIZATIONS IN GEORGIA, THE SOUTHEAST, AND ACROSS THE COUNTRY. SPECIFICALLY, THE COMMITTEE REVIEWS DATA FOR MARKET RATES OF BASE SALARY AND TOTAL COMPENSATION (THE COMBINATION OF BASE SALARY AND BONUSES). AFTER REVIEWING THIS DATA, THE COMMITTEE ASSESSES THE APPROPRIATENESS OF THE BASE PAY LEVELS FOR EACH EXECUTIVE WITHIN A RANGE THAT GENERALLY REFLECTS INDUSTRY NORMS. IN ADDITION TO MONITORING BASE SALARIES, THE COMMITTEE IS RESPONSIBLE FOR ADMINISTERING THE EXECUTIVE INCENTIVE COMPENSATION PROGRAM. THE PROGRAM IS DESIGNED TO: -FURTHER ALIGN EXECUTIVE PAY WITH THE STRATEGIC AND OPERATIONAL ACHIEVEMENTS OF THE ORGANIZATION; -WHEN THE ORGANIZATION ACHIEVES RESULTS IN KEY AREAS OF PERFORMANCE, TO APPROPRIATELY REWARD EXECUTIVES ACCORDING TO THAT PROGRAM; THE COMMITTEE HAS ALSO ESTABLISHED SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAMS (SERPS). THESE SERPS WERE DESIGNED WITH THE ADVICE AND HELP OF CONSULTANTS AND ARE DESIGNED TO RETAIN AND REWARD EXECUTIVES WITH RETIREMENT OPPORTUNITIES THAT ARE CONSISTENT WITH MARKET PRACTICES IN GEORGIA, THE SOUTHEAST, AND ACROSS THE COUNTRY. IN 2001, THESE PLANS VESTED TWO EXECUTIVES. IT IS THE PHILOSOPHY OF THE FHMI BOARD THAT THE COMBINATION OF THE INCENTIVE EARNING OPPORTUNITY, THE BASE SALARY, AND THE SERPS WILL PROVIDE A COMPETITIVE COMPENSATION LEVEL TO EACH EXECUTIVE THAT REFLECTS THE MARKET FOR EACH POSITION AND ORGANIZATION PERFORMANCE. THE COMMITTEE HAS DEVELOPED THE PROGRAM TO RECRUIT, RETAIN, AND REWARD EXECUTIVES IN ORDER TO MEET THE PRESENT AND FUTURE NEEDS OF THE ORGANIZATION TO PROVIDE A HIGH QUALITY OF PATIENT CARE TO THE COMMUNITY IN A COST EFFECTIVE MANNER. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B SEE NARRATIVE UNDER PART VI, LINE 15A. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 UPON REQUEST, THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE AT THE ADMINISTRATIVE OFFICE. ADDITIONAL INFORMATION SCHEDULE O FORM 990, PART VII SECTION A - COMPENSATION FROM RELATED ORGANIZATIONS MEMBERS OF THE BOARD OF DIRECTORS FOR FLOYD HEALTHCARE RESOURCES, INC., AND FOR THE HOSPITAL AUTHORITY OF FLOYD COUNTY, RELATED PARTIES OF FLOYD HEALTHCARE MANAGEMENT, INC., RECEIVE A STIPEND FOR EACH BOARD MEETING ATTENDED. FOR THE 2009 TAXABLE YEAR, DIRECTORS SUMNER AND MANIS ALSO SERVED ON THE BOARD OF FLOYD HEALTHCARE RESOURCES, INC. WHILE DIRECTORS NORMAN, MAYES, AND MAHANAY SERVED ON THE BOARD OF THE HOSPITAL AUTHORITY OF FLOYD COUNTY. FORM 990, PART VII SECTION A - COMPENSATION DR. CARL HERRING BOARD MEMBER CARL HERRING, MD IS A PRACTICING NEUROSURGEON WHO HAS CLINICAL PRIVILEGES AT FLOYD MEDICAL CENTER (FMC). AS SUCH, HE IS A PARTY TO A CONTRACT UNDER WHICH FMC PAYS THE NEUROSURGEONS ON ITS MEDICAL STAFF A PER DIEM FOR COVERING TRAUMA CALL IN THE EMERGENCY ROOM. UNDER THIS CONTRACT, THE NEUROSURGEON COVERING CALL FOR THE DAY DURING CALENDAR YEAR 2009 WAS PAID A PER DIEM OF 1,000. FMC HAS DETERMINED WITH THE ASSISTANCE OF OUTSIDE EXPERT VALUATION CONSULTANTS THAT THIS AMOUNT IS CONSISTENT WITH FAIR MARKET VALUE. ADDITIONALLY, DR. HERRING IS AN EMPLOYEE AND SHAREHOLDER IN THE HARBIN CLINIC, LLC, A 140+ DOCTOR MULTI-SPECIALTY GROUP MEDICAL PRACTICE. FMC HAS NUMEROUS CONTRACTS WITH HARBIN CLINIC UNDER WHICH HARBIN SUPPLIES ITS PHYSICIANS TO SERVE AS MEDICAL DIRECTORS OF VARIOUS DEPARTMENTS AND SERVICE LINES AT FMC, INCLUDING RESPIRATORY THERAPY, BARIATRICS, NEUROLOGY, VASCULAR LAB, HOSPICE, BREAST CENTER, INPATIENT REHAB, INFECTIOUS DISEASE, ETC. UNDER THESE CONTRACTS HARBIN CLINIC IS PAID FAIR MARKET COMPENSATION BASED ON AN HOURLY RATE FOR THE ACTUAL TIME EXPENDED BY ITS PHYSICIANS IN THE PERFORMANCE OF THE DUTIES CALLED FOR IN THESE CONTRACTS. SCHEDULE R, PART IV - INFORMATION REGARDING TAXABLE SUBSIDIARIES IN DECEMBER OF 1990, THE HOSPITAL AUTHORITY OF FLOYD COUNTY, GEORGIA SPONSORED THE CREATION OF FLOYD HEALTH VENTURES I, INC. ("VENTURES"), A GEORGIA NONPROFIT, TAXABLE CORPORATION. VENTURES I HAS A FOUR-PERSON BOARD OF DIRECTORS, THE MEMBERS OF WHICH ARE APPOINTED BY THE AUTHORITY. BECAUSE VENTURES I IS A NONPROFIT, NONSTOCK CORPORATION, THE AUTHORITY DOES NOT HAVE AN OWNERSHIP INTEREST. VENTURES HAS BEEN INACTIVE FOR A NUMBER OF YEARS. NORTHWEST GEORGIA COMMUNITY CARE NETWORK, INC. DBA GEORGIA HEALTH PLUS, INC. CEASED OPERATION IN SEPTEMBER 2002. THE FINAL DISTRIBUTION HAS NOT BEEN MADE AT THIS TIME. THERE WERE NO TRANSFERS BETWEEN FHM AND TAXABLE SUBSIDIARIES SCHEDULE R, PART I - DISREGARDED ENTITIES IN SEPTEMBER 2004, FLOYD HEALTHCARE MANAGEMENT, INC. ("FHMI") SPONSORED THE CREATION OF FLOYD EMERGENCY PHYSICIANS, LLP ("FEP"), A GEORGIA LIMITED LIABILITY COMPANY. FHMI IS THE SOLE MEMBER/OWNER OF FEP AND HAS THE SOLE AUTHORITY TO APPOINT FEP'S FIVE PERSON BOARD OF DIRECTORS. FEP WAS FORMED FOR THE PURPOSE OF HIRING OR OTHERWISE ENGAGING EMERGENCY PHYSICIANS TO PROVIDE PROFESSIONAL MEDICAL SEVICES TO PATIENTS PRESENTING TO FLOYD MEDICAL CENTER'S EMERGENCY CARE CENTER. IN AUGUST 2006, FLOYD HEALTHCARE MANAGEMENT, INC. (FHMI) SPONSORED THE CREATION OF FLOYD PHYSICIANS, LLC (FP), A GEORGIA LIMITED LIABILITY COMPANY. FHMI IS THE SOLE MEMBER/OWNER OF FP AND HAS THE SOLE AUTHORITY TO APPOINT FP'S FIVE PERSON BOARD OF DIRECTORS. FP WAS FORMED FOR THE PURPOSE OF HIRING OR OTHERWISE ENGAGING PHYSICIANS TO PROVIDE PROFESSIONAL MEDICAL SERVICES TO PATIENTS. OTHER COMMENTS & DISCLOSURES: FLOYD MEDICAL CENTER IS A 300+ BED GENERAL, ACUTE-CARE HEALTH INSTITUTION, OFFERING A WIDE RANGE OF SPECIALIZED SERVICES AND PROGRAMS. SUCH SERVICES AND PROGRAMS INCLUDE: ACUTE, MEDICAL/SURGICAL CARE; AMBULANCE SERVICE; BLOOD BANK; CANCER CARE UNIT; CARDIOVASCULAR LABORATORY; CHILD CARE CENTER; CORONARY CARE UNIT; CHAPLAIN SERVICE; CHEMICAL DEPENDENCY UNIT; CRISIS INTERVENTION; CT RESONANCE IMAGING; NEUROLOGY; LEVEL II, NEWBORN NURSERY/NEONATAL INTENSIVE CARE UNIT; OB/GYN; ORTHOPEDIC SURGERY,OUTPATIENT SURGERY CENTER; PATIENT REPRESENTATIVES; PEDIATRIC CARE; PHARMACY; DIAGNOSTIC RADIOLOGY; A 24-HOUR EMERGENCY SERVICE; ENDOSCOPIC LABORATORY; FAMILY PRACTICE RESIDENCY PROGRAM; PRIMARY CARE PHYSICIAN NETWORK; HEALTH EDUCATION AND PROMOTION; HOSPITAL AUXILIARY; INDUSTRIAL MEDICINE PROGRAM; INPATIENT REHABILITATION UNIT; LAPAROSCOPIC CHOLECYSTECTOMY SURGERY; LASER SURGERY; PHYSICAL THERAPY; OCCUPATIONAL THERAPY; SPEECH THERAPY; POISON CONTROL CENTER; POST-OPERATIVE RECOVERY ROOM; PROGRESSIVE INTENSIVE CARE UNIT; RESPIRATORY CARE SERVICES; SOCIAL WORK SERVICES; ULTRASOUND; CONGESTIVE HEART FAILURE CLINIC; WOUND OSTOMY CLINIC; BREAST CENTER, MOBILE MAMMOGRAPHY. DURING FISCAL YEAR 2010, PATIENT DAYS AT FLOYD MEDICAL CENTER TOTALED 73,128 AND DISCHARGES TOTALED 16,088. FLOYD MEDICAL CENTER PROVIDED APPROXIMATELY 59,025,000 IN DIRECT CHARITY AND INDIGENT CARE. ADDITIONALLY, FLOYD MEDICAL CENTER INCURRED UNREIMBURSED MEDICARE AND MEDICAID ADJUSTMENTS OF 202,345,000 AND 121,122,000 RESPECTIVELY. A COPY OF THE REPORT TO THE COMMUNITY FOR FLOYD MEDICAL CENTER CAN BE FOUND AT WWW.FLOYD.ORG/ABOUT/INDEX.HTM. 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