2023-11-07T06:46:21-06:00 2022-12-31 440160260 FORVIS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2022-01-01 541453954 AUGUSTA HEALTH CARE INC D/B/A AUGUSTA HEALTH AUGU 5409324685 PO BOX 1000 FISHERSVILLE VA 22939 JOE MEADOR VP FINANCE & CFO 5409324685 2023-10-30 1 JOE MEADOR XXX-XX-XXXX 1 AMY BIBBY P00445891 8282542254 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z AUGUSTA HEALTH MARY N MANNIX FACHE PO BOX 1000 FISHERSVILLE VA 22939 449331164 0 X WWW.AUGUSTAHEALTH.COM X 1988 VA PROMOTE THE HEALTH AND WELL-BEING OF OUR COMMUNITY THROUGH ACCESS TO EXCELLENT CARE. 16 14 2429 115 6235919 0 3296519 650298 394451332 429553092 18828860 12467355 2147629 6001876 418724340 448672621 407727 774166 0 0 169778512 193123561 0 0 0 187020403 203376864 357206642 397274591 61517698 51398030 1079243476 1000629746 86984243 60187053 992259233 940442693 X THE MISSION OF AUGUSTA HEALTH IS TO PROMOTE THE HEALTH AND WELL-BEING OF OUR COMMUNITY THROUGH ACCESS TO EXCELLENT CARE. 0 0 345374866 774166 423317173 AUGUSTA HEALTH CARE, INC. IS A 501(C)(3) ORGANIZATION DOING BUSINESS AS AUGUSTA HEALTH. THE ORGANIZATION INCLUDES A MEDICAL CENTER WITH 255 LICENSED INPATIENT BEDS; AN EMERGENCY DEPARTMENT TREATING APPROXIMATELY 55,000 COMMUNITY MEMBERS PER YEAR; FOUR URGENT CARE CENTERS TREATING APPROXIMATELY 57,000 PATIENTS; A STATE OF THE ART CANCER CENTER PROVIDING TAILOR-MADE COMPREHENSIVE CARE INCLUDING MEDICAL ONCOLOGY AND RADIATION ONCOLOGY; A HOME HEALTH AND HOSPICE PROGRAM SERVING PATIENTS WHO WISH TO REMAIN AT HOME DURING THEIR TREATMENT OR FINAL DAYS; A WOUND HEALING CLINIC PROVIDING A COMPREHENSIVE TREATMENT REGIMEN FOR CHRONIC NON-HEALING WOUNDS; AND A SKILLED NURSING UNIT PROVIDING COMPREHENSIVE REHABILITATION FOR PATIENTS RECOVERING FROM ORTHOPEDIC SURGERY.THE CAMPUS OF AUGUSTA HEALTH IS DESIGNED TO PROVIDE NOT ONLY HOSPITAL SERVICES BUT COMMUNITY ORIENTED SERVICES. THE CAMPUS INCLUDES THE HOSPITAL PROPER; A MAJOR FITNESS CENTER; AN EDUCATIONAL BUILDING THAT HOUSES AUGUSTA HEALTH EDUCATIONAL SERVICES; A COMMUNITY BUILDING WITH LARGE CONFERENCE ROOMS AVAILABLE TO OTHER COMMUNITY ORGANIZATIONS; AND A BEHAVIORAL HEALTH BUILDING FOR THE PROVISION OF OUTPATIENT PSYCHIATRIC AND SUBSTANCE ABUSE SERVICES. THIS WIDE RANGE OF FACILITIES HELPS TO SUPPORT AUGUSTA HEALTH'S VISION OF PROVIDING THE COMMUNITY WITH A FULL CONTINUUM OF HEALTH AND COMMUNITY SERVICES. AUGUSTA HEALTH IS SUPPORTED BY AUGUSTA MEDICAL GROUP, A 240 EMPLOYED PROVIDER NETWORK TREATING APPROXIMATELY 600,000 PEOPLE PER YEAR. THE MEDICAL GROUP WAS ESTABLISHED TO SUPPORT THE CHARITABLE PURPOSES OF AUGUSTA HEALTH CARE INC. THIS GROUP ENABLES THE GREATER AUGUSTA COUNTY, VIRGINIA TO BENEFIT FROM A STABLE BASE OF PHYSICIANS IN A BROAD ARRAY OF SPECIALTIES.THE HOSPITAL SERVES AS THE SOLE CORPORATE MEMBER OF AUGUSTA CARE PARTNERS, LLC (THE "LLC"). THE LLC WAS ORGANIZED TO PROVIDE A NETWORK OF INDIVIDUAL PRACTICES OF ACCOUNTABLE CARE ORGANIZATION PROFESSIONALS, WITH 342 PROVIDERS AND FLOW OF $83 MILLION IN MEDICARE CLAIMS COVERING 8,168 BENEFICIARIES IN 2022.IN 2022, AUGUSTA HEALTH RECEIVED THE FOLLOWING HONORS, AWARDS, AND ACCREDITATIONS: 2022 LEAPFROG HOSPITAL SAFETY GRADE A, AMERICAN HEART ASSOCIATION & AMERICAN STROKE ASSOCIATION, 2021-22 BEST HOSPITAL IN THE SHENANDOAH VALLEYAUGUSTA HEALTH'S NET COMMUNITY BENEFIT FOR 2022 IS ESTIMATED TO BE $19,150,005. THIS BENEFIT CAN BE CATEGORIZED AS FOLLOWS: $2,371,810 CHARITY $12,185,746 MEDICAID $1,580,904 COMMUNITY HEALTH SERVICES $375,802 HEALTH PROFESSIONAL EDUCATION $2,148,016 SUBSIDIZED HEALTH SERVICES $487,727 CASH & IN-KIND CONTRIBUTIONS 345374866 1 1 0 1 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 1 1 0 0 0 0 0 1 1 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 478 0 1 2429 1 1 1 1 CJ 0 0 0 0 0 0 0 0 0 0 X 16 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 VA X X SARAH HASH-RODGERS 5403324685 78 MEDICAL CENTER CIRCLE FISHERSVILLE VA 22939 LAUREL L LANDES BOARD CHAIR 1.00 1.00 X X 0 0 0 VICTOR M SANTOS VICE-CHAIRMAN 1.00 X X 0 0 0 BURNIE POWERS SECRETARY/TREASURER 1.00 1.00 X X 0 0 0 JOHN P BOWERS BOARD MEMBER 1.00 X 0 0 0 DEBRA S CALLISON BOARD MEMBER 1.00 X 0 0 0 ROBIN G CROWDER BOARD MEMBER 1.00 X 0 0 0 RONALD W DENNY BOARD MEMBER 1.00 X 0 0 0 RICHARD EVANS MD BOARD MEMBER 1.00 1.00 X 0 0 0 DAVID FOSNOCHT MD BOARD MEMBER 1.00 X 0 0 0 CHRISTOPHER HECK MD BOARD MEMBER 1.00 X 0 235162 2765 HOMER HITE BOARD MEMBER 1.00 1.00 X 0 0 0 A WHIT MORRISS MD BOARD MEMBER 40.00 1.00 X 0 0 0 JACK OTTENI MD BOARD MEMBER 1.00 X 0 0 0 REV JOHN C PETERSON BOARD MEMBER 1.00 X 0 0 0 KERI B RANKIN BOARD MEMBER 1.00 X 0 0 0 MARY N MANNIX PRESIDENT & CEO 39.00 1.00 X X 1381119 0 166778 JOHN KATSIANIS VP AND CFO 40.00 X 584602 0 68653 KAREN CLARK VP OPERATIONS 40.00 X 307637 0 27761 DAN O'CONNOR VP OF POPULATION HEALTH 40.00 X 415668 0 10642 MIKE CANFIELD VP AND CIO 40.00 X 326734 0 51939 MARK LAROSA VP OF BUSINESS DEVELOPMENT 40.00 X 373502 0 43595 SCOTT JUST MD PRESIDENT, AMG 40.00 X 625300 0 69670 JEAN VEILLEUX VP OF LEGAL AFFAIRS AND GE 40.00 X 451247 0 58035 CRYSTAL FARMER VP AND CNO 40.00 X 419568 0 42630 SCOTT CRABTREE ASSISTANT VP 40.00 X 329596 0 35563 SHIRLEY CARTER KEY EMPLOYEE 40.00 X 250313 0 42690 MAHFUZ HOQ MD CHIEF MEDICAL OFFICER 40.00 X 555827 0 70319 SCOTT JONES VP OF COMPLIANCE & PRIVACY 40.00 X 296634 0 36562 JOHN BOSWELL VP OF HUMAN RESOURCES 40.00 X 363288 0 46439 VICKIE TAYLOR ASSISTANT CHIEF NURSING OF 40.00 X 250223 0 12348 ANDREW WEST CMIO 40.00 X 407187 0 15379 BRIAN CROGHAN ADMINISTRATIVE DIRECTOR 40.00 X 242006 0 14461 ANTHONY LONG ADMINISTRATIVE DIRECTOR 40.00 X 226369 0 8892 SARAH E HASH-RODGERS ADMINISTRATIVE DIRECTOR 40.00 X 225575 0 16740 8032395 235162 841861 165 0 1 0 QUALIVIS PO BOX 123847 DALLAS TX 75312 TRAVELING NURSES 25990669 BARTON MALOW BUILDERS 100 10TTH STREET NE 100 CHARLOTTESVILLE VA 22902 CONTRACTOR 22272096 SODEXO INC & AFFILIATES PO BOX 536922 ATLANTA GA 30353 NUTRITION SERVICES MANAGER 3268960 ARTISAN CONSTRUCTION INC 1513 E HIGH ST CHARLOTTESVILLE VA 22902 CONSTRUCTION 2107667 US SECURITY ASSOCIATES PO BOX 828854 PHILADELPHIA PA 19182 SECURITY 1646976 76 650298 650298 NET PATIENT SERVICE REVENUE 621400 409519357 408796116 723241 OTHER PROGRAM SERVICE REVENUE 900099 13991737 13824029 167708 RETAIL PHARMACY 456110 4504189 4504189 FITNESS CENTER 713940 1364600 697028 667572 DME 621400 173209 173209 429553092 12412455 12412455 1299467 643254 656213 656213 656213 70189 15289 54900 54900 54900 MISCELLANEOUS 900099 3102967 3102967 CAFETERIA/VENDING 900099 1177917 1177917 AFFILIATED REVENUES/LOSSES 900099 1064779 1064779 5345663 448672621 423317173 6235919 18469231 X 774166 774166 6681031 6681031 155020193 133691634 21328559 4994034 4128977 865057 17298455 14302048 2996407 9129848 7548392 1581456 730578 730578 1221540 1221540 329365 329365 191738 191738 42139494 34136018 8003476 1269077 24844 1244233 39218512 34483583 4734929 2973875 2488152 485723 8545147 8545147 634354 633976 378 668214 558295 109919 15224734 15224734 1673517 1673517 MEDICAL SUPPLIES 40082221 40082221 COST OF DRUGS SOLD 29932554 29932554 BAD DEBTS 14512272 14512272 COST OF FOOD 2202453 2202453 1827219 431883 1395336 397274591 345374866 51899725 0 19723245 9446750 45842021 58096321 18647 41092 7606552 8408581 7505968 8719477 504734605 305873458 165979308 198861147 585144728 453316462 6539170 9383624 195763950 225890498 1715938 2783631 43403949 25682163 1079243476 1000629746 42944705 48221317 34301 24639 217810 945778 150000 100000 43637427 10895319 86984243 60187053 X 991689426 940093944 569807 348749 992259233 940442693 1079243476 1000629746 X 51398030 -102678427 -536143 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 31589 31589 0 PART II-B, LINE 1: THE HOSPITAL IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE VIRGINIA HOSPITAL & HEALTHCARE ASSOCIATION (VHHA). THESE ORGANIZATIONS ROUTINELY ENGAGE IN LOBBYING EFFORTS ON BEHALF OF ITS MEMBERSHIP BODY, AND A PORTION OF EACH MEMBER'S DUES ARE ALLOCATED TO THOSE LOBBYING EXPENDITURES. THE PORTION OF THE HOSPITAL'S DUES ALLOCATED TO LOBBYING WAS $ 31,589. 7183472 7183472 156489160 78812384 77676776 1116289 175394 940895 267983892 215840924 52142968 71961792 11044756 60917036 198861147 INVESTMENT IN AMG 225890498 C 225890498 OTHER LIABILITIES 10895319 10895319 X 329374821 -102678427 -102678427 432053248 16619373 16619373 448672621 381191361 0 381191361 16083230 16083230 397274591 PART X, LINE 2: THE COMPANY IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON INCOME DERIVED FROM ITS EXEMPT PURPOSE AS A NOT-FOR-PROFIT ORGANIZATION UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAX. THE COMPANY HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2022. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET WITH REVENUE 14,432,953. GRANTS EXPENSE NET WITH REVENUE 774,166. EQUITY TRANSFERS BETWEEN AFFILIATES 536,143. EXPENSES IN REVENUES 876,111. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET WITH REVENUE 14,432,953. GRANTS EXPENSE NET WITH REVENUE 774,166. EXPENSES IN REVENUES 876,111. CENTRAL AMERICA AND THE CARIBBEAN - 0 0 INVESTMENT 9373153 0 0 0 0 0 0 9373153 0 9373153 1 0 1 1 0 0 PART III ACCOUNTING METHOD: PART IV, QUESTION 4 THE ORGANIZATION IS NOT REQUIRED TO FILE THE FORM 8621. 1 1 1 X 1 X 1 1 0 1 1 2506858 135048 2371810 0.00620 46315566 34129820 12185746 0.03180 48822424 34264868 14557556 0.03800 1580904 1580904 0.00410 428196 52394 375802 0.00100 10323935 8175919 2148016 0.00560 487727 487727 0.00130 12820762 8228313 4592449 0.01200 61643186 42493181 19150005 0.05000 7 15 23211 23211 0.00010 10 347 41489 41489 0.00010 2 0 52011 52011 0.00010 17 425 34611 34611 0.00010 36 787 151322 151322 0.00040 1 14432953 1152251 103313863 109819551 -6505688 X 1 1 1 1 AUGUSTA HEALTH 78 MEDICAL CENTER DR FISHERSVILLE VA 22939 X X X HOME HEALTH; SNF; PSYCH, DME; HOSPICE AUGUSTA HEALTH 1 0 0 1 X X X X X X X X X X 22 1 0 0 1 X SEE DISCLOSURE X 1 22 1 SEE DISCLOSURE 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X HTTPS://WWW.AUGUSTAHEALTH.COM/BUSINESS-OFFICE/FINANCIAL-ASSISTANCE X SEE PART VI X HTTPS://WWW.AUGUSTAHEALTH.COM/BUSINESS-OFFICE/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 AUGUSTA HEALTH PART V, SECTION B, LINE 3J: INFORMATION GAPS THAT LIMIT THE HOSPITAL FACILITY'S ABILITY TO ACCESS THE COMMUNITY'S HEALTH NEEDS. AUGUSTA HEALTH PART V, SECTION B, LINE 5: TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS ALSO IMPLEMENTED AS PART OF THIS PROCESS. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY AUGUSTA HEALTH; THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE; REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. IN ALL, 134 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY. AUGUSTA HEALTH PART V, SECTION B, LINE 11: AUGUSTA HEALTH, THROUGH ITS MISSION TO PROMOTE THE HEALTH AND WELL-BEING OF OUR COMMUNITY THROUGH ACCESS TO EXCELLENT CARE, HAS DEVELOPED GOALS, OBJECTIVES AND STRATEGIES TO ADDRESS SELECTED TOP PRIORITY HEALTH NEEDS IN THE AREAS OF: 1) ACCESS TO HEALTHCARE SERVICES 2) BEHAVIORAL HEALTH, 3) DIABETES, AND 4) NUTRITION AND PHYSICAL ACTIVITY. THE ACTION PLANS WILL BE IMPLEMENTED IN COLLABORATION WITH VARIOUS COMMUNITY PARTNERS OVER THE NEXT THREE YEARS. DURING THE CHNA PROCESS, THE DATA REVEALED A TOTAL OF 14 DISTINCT AREAS OF OPPORTUNITY. AUGUSTA HEALTH'S 2023-2025 IMPLEMENTATION STRATEGIES ARE DESIGNED TO ADDRESS THE TOP FOUR HIGHEST PRIORITY AREAS. AUGUSTA HEALTH HAS SELECTED THESE FOUR PRIORITIES BECAUSE OF ITS ABILITY TO WORK IN PARTNERSHIP WITH OTHER ORGANIZATIONS AND AGENCIES TO MAKE THE GREATEST IMPACT. OTHER NEEDS THAT WERE IDENTIFIED HAVE THE POTENTIAL TO BE ADDRESSED THROUGH COLLABORATIVE PROGRAMMING THAT MAY OR MAY NOT INVOLVE AUGUSTA HEALTH AS A FACILITATOR, PARTNER OR FUNDER. AUGUSTA HEALTH PART V, SECTION B, LINE 13H: INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY SHALL NOT BE CHARGED MORE THAN THE AMOUNTS GENERALLY BILLED (AGB) TO INDIVIDUALS WHO HAVE INSURANCE. THIS VALUE SHALL BE CALCULATED USING THE "LOOK-BACK" METHOD BASED ON ACTUAL PAID CLAIMS FROM MEDICARE FEE-FOR-SERVICE AND PRIVATE HEALTH INSURERS. THE CURRENT AGB IS 30.4% AND IS UPDATED ANNUALLY. AUGUSTA HEALTH PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY IS DISCUSSED AND OFFERED BY OUR SELF PAY EXTENDED BUSINESS OFFICE PARTNER DURING THE COLLECTION PROCESS. AUGUSTA HEALTH PART V, SECTION B, LINE 20E: AUGUSTA HEALTH DOES NOT TAKE ANY ECAS ON OUTSTANDING DEBTS. WE DO OFFER FINANCIAL ASSISTANCE MANY TIMES DURING THE REGISTRATION AND BILLING PROCESS. WE ALSO RUN A PRESUMPTIVE ELIGIBILITY SCRUB 120 DAYS INTO THE BILLING CYCLE TO DETERMINE PRESUMPTIVE ELIGIBILITY. PART V, SECTION B, LINE 7A AND 10A: WEBSITE ADDRESS FOR THE CHNA AND IMPLEMENTATION STRATEGY:HTTPS://WWW.AUGUSTAHEALTH.COM/COMMUNITY-OUTREACH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART I, LINE 7: FOR PURPOSES OF PART I, LINE 7(A) THE ORGANIZATION USED THE METHODS PROVIDED IN THE SCHEDULE H INSTRUCTIONS TO COMPUTE A COST-TO-CHARGES RATIO TO CONVERT CHARITY CARE WRITE-OFFS TO COST. AMOUNTS REPORTED ON LINES 7(B) AND 7(G) WERE DERIVED FROM THE ORGANIZATION'S INTERNAL COST ACCOUNTING SYSTEM. PART I, LINE 7G: HOME HEALTH SERVICES PROVIDED BY THE ORGANIZATION CONTRIBUTED $2,148,016 IN NET COMMUNITY BENEFIT. AUGUSTA HEALTH'S HOME HEALTH PROGRAM OFFERS SKILLED NURSING CARE, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, AND MEDICAL SOCIAL WORKERS. PART I, LN 7 COL(F): TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25 INCLUDES BAD DEBT IN THE AMOUNT OF $14,512,272. THIS AMOUNT FOR BAD DEBT HAS BEEN REMOVED FOR PURPOSES OF COMPUTING PERCENTAGE OF TOTAL EXPENSE ON SCHEDULE H, PART I, LINE 7, COL (F). PART III, LINE 2: ACCOUNTS ARE WRITTEN OFF TO BAD DEBT WHEN MANAGEMENT DETERMINES THAT RECOVERY IS UNLIKELY AND THE COMPANY CEASES COLLECTION EFFORTS. PART III, LINE 4: EXCERPT FROM 2022 FINANCIAL AUDIT, PATIENT ACCOUNTS RECEIVABLE:"THE COMPANY GRANTS CREDIT WITHOUT COLLATERAL TO ITS PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS, PRIMARILY WITH MEDICARE, MEDICAID, AND VARIOUS COMMERCIAL INSURANCE COMPANIES. PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. FOR ACCOUNTS RECEIVABLE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE COMPANY ESTIMATES NET REALIZABLE VALUE BASED ON THE ESTIMATED CONTRACTUAL REIMBURSEMENT PERCENTAGE, WHICH IS PREDICATED ON CURRENT CONTRACT PROVISIONS AND HISTORICAL PAID CLAIMS BY PAYORS. FOR SELF-PAY ACCOUNTS RECEIVABLE, INCLUDING UNINSURED AND PATIENT RESPONSIBILITY ACCOUNTS, THE NET REALIZABLE VALUE IS DETERMINED USING HISTORICAL COLLECTION EXPERIENCE, ADJUSTED FOR ESTIMATED CONVERSIONS OF PATIENT RESPONSIBILITY PORTIONS, EXPECTED RECOVERIES AND CHANGE IN TRENDS TO ESTIMATE IMPLICIT PRICE CONCESSIONS. MANAGEMENT CONTINUALLY REVIEWS THE ESTIMATED NET REALIZABLE VALUE OF ACCOUNTS RECEIVABLE BY MONITORING CASH COLLECTIONS, ECONOMIC CONDITIONS AND TRENDS, CHANGES IN PAYOR MIX, CHANGES IN FEDERAL OR STATE HEALTHCARE COVERAGE AND OTHER MATTERS. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN EXHAUSTED IN ACCORDANCE WITH THE COMPANY'S POLICIES." THE BAD DEBT AMOUNT LISTED IN PART III SECTION A, NUMBER 2 WAS CALCULATED USING WORKSHEET A ON PAGE 4 OF THE 2022 SCHEDULE H INSTRUCTIONS.THE PORTION OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE IS BASED ON DISCHARGES IN 2022. PATIENTS THAT WERE CLASSIFIED AS "SELF PAY" WERE UN-INSURED AND THEREFORE CONSIDERED WITHOUT RESOURCES. THEIR ACCOUNT STATUS WAS "BD" MEANING THAT THE ACCOUNT WAS CONSIDERED UNCOLLECTABLE AT THE TIME OF THE REPORT. PART III, LINE 8: THE HOSPITAL CONSIDERS THE FULL AMOUNT OF $6,505,688 TO BE RECOGNIZED AS COMMUNITY BENEFIT. PART III, LINE 9B: ONCE A PATIENT HAS BEEN DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ALL COLLECTION EFFORTS CEASE FOR CURRENT AND PAST DUE BALANCES AND THE NECESSARY ADJUSTMENTS ARE TAKEN TO THE ACCOUNTS RECEIVABLE. SHOULD THE PATIENT ONLY BE ELIGIBLE FOR A PORTION OF FINANCIAL ASSISTANCE (THROUGH OUR SLIDING SCALE), NO-INTEREST, LOW-PAYMENT, AND LONG TERM PAYMENT PLANS ARE AVAILABLE. PART V, LINE 16B HTTPS://WWW.AUGUSTAHEALTH.COM/SITES/DEFAULT/FILES/DOCUMENTS/BUSINESS-OFFICE/FINANCIAL_ASSISTANCE_APPLICATION_06-22-2020.PDF PART VI, LINE 2: AUGUSTA HEALTH COMPLETED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2022 TO DETERMINE THE PRIORITY HEALTH NEEDS OF STAUNTON, AUGUSTA COUNTY AND WAYNESBORO VIRGINIA. AUGUSTA HEALTH'S CHNA IS A SYSTEMATIC, DATA-DRIVEN APPROACH TO DETERMINING THE HEALTH STATUS, BEHAVIORS AND NEEDS OF RESIDENTS IN THE SERVICE AREA OF AUGUSTA HEALTH AND THE INFORMATION GATHERED IS USED TO INFORM DECISIONS AND GUIDE EFFORTS TO IMPROVE COMMUNITY HEALTH AND WELLNESS. THE CHNA SERVES AS TOOL TO REACH THREE BASIC GOALS:TO IMPROVE RESIDENT'S HEALTH STATUS, INCREASE THEIR LIFE SPANS, AND ELEVATE THEIR OVERALL QUALITY OF LIFE. A HEALTHY COMMUNITY IS NOT ONLY ONE WHERE ITS RESIDENTS SUFFER LITTLE FROM PHYSICAL AND MENTAL ILLNESS, BUT ALSO ONE WHERE ITS RESIDENTS ENJOY A HIGH QUALITY OF LIFE. TO REDUCE THE HEALTH DISPARITIES AMOUNT RESIDENTS. BY GATHERING DEMOGRAPHIC INFORMATION ALONG WITH HEALTH STATUS AND BEHAVIOR DATA, IT IS POSSIBLE TO IDENTIFY POPULATION SEGMENTS THAT ARE MOST AT-RISK FOR VARIOUS DISEASES AND INJURIES. INTERVENTION PLANS AIMED AT TARGETING THESE INDIVIDUALS MAY THEN BE DEVELOPED TO COMBAT SOME OF THE SOCIO-ECONOMIC FACTORS WHICH HAVE HISTORICALLY HAD A NEGATIVE IMPACT ON RESIDENTS' HEALTH.TO INCREASE ACCESSIBILITY TO PREVENTATIVE SERVICES FOR ALL COMMUNITY RESIDENTS. MORE ACCESSIBLE PREVENTIVE SERVICES ARE BENEFICIAL IMPROVING HEALTH STATUS, AS WELL AS LOWERING THE COSTS ASSOCIATED WITH CARING FOR LATE-STAGE DISEASE RESULTING FROM A LACK OF PREVENTIVE CARE. THE CHNA INCORPORATES DATA FROM BOTH QUANTITATIVE AND QUALITATIVE SOURCES. QUANTITATIVE DATA INCLUDES PRIMARY RESEARCH (COMMUNITY HEALTH PHONE SURVEYS AND ONLINE SURVEYS OF COMMUNITY RESIDENTS) AND SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA); THESE QUANTITATIVE COMPONENTS ALLOW FOR COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS (VIRGINIA RISK FACTOR DATA AND NATIONWIDE RISK FACTOR DATA, RESPECTIVELY). QUALITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH GATHERED THROUGH AN ONLINE KEY INFORMANT SURVEY OF REPRESENTATIVES FROM VARIOUS COMMUNITY SECTORS. THE SURVEY INSTRUMENT USED FOR THE STUDY IS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, AS WELL AS VARIOUS PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES.THE STUDY AREA FOR THE SURVEY EFFORT IS DEFINED AS EACH OF THE RESIDENTIAL ZIP CODES COMPRISING STAUNTON CITY, WAYNESBORO CITY AND AUGUSTA COUNTY IN VIRGINIA. THIS COMMUNITY DEFINITION WAS DETERMINED BASED ON ZIP CODES OF RESIDENCE OF AUGUSTA HEALTH PATIENTS (APPROXIMATELY 80% OF ADMISSIONS GENERATE FROM THESE AREAS). A PRECISE AND CAREFULLY EXECUTED METHODOLOGY IS CRITICAL IN ASSERTING THE VALIDITY OF RESULTS GATHERED IN THE COMMUNITY HEALTH SURVEY. THUS, TO ENSURE THE BEST REPRESENTATION OF THE POPULATION SURVEYED, A TELEPHONE INTERVIEW METHODOLOGY, ONE THAT INCORPORATES BOTH LANDLINE AND CELL PHONE INTERVIEWS, WAS EMPLOYED. AN ONLINE COMMUNITY HEALTH SURVEY WAS ALSO AVAILABLE COMMUNITY-WIDE AND THE LINK WAS DISTRIBUTED THROUGH COMMUNITY PARTNERS. THE SAMPLE DESIGN FOR THIS EFFORT CONSISTED OF A STRATIFIED RANDOM SAMPLE OF 756 INDIVIDUALS AGE 18 AND OLDER IN THE TOTAL AREA (INCLUDING 185 IN STAUNTON CITY, 170 IN WAYNESBORO CITY AND 401 IN AUGUSTA COUNTY). ONCE THE INTERVIEWS WERE COMPLETED, THESE WERE WEIGHTED IN PROPORTION TO THE ACTUAL POPULATION DISTRIBUTION SO AS TO APPROPRIATELY REPRESENT THE AREA AS A WHOLE. TO SOLICIT INPUT FROM KEY INFORMANTS (INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY), AN ONLINE KEY INFORMANT SURVEY WAS ALSO IMPLEMENTED AS PART OF THIS PROCESS. THE LIST INCLUDED BUSINESS LEADERS, COMMUNITY LEADERS, EDUCATORS, GOVERNMENT REPRESENTATIVES, MEDIA HEALTH REPRESENTATIVES, HEALTH PROVIDERS AND PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES AND SOCIAL SERVICES PROVIDERS. PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE. REMINDER CALLS WERE SENT AS NEEDED. IN ALL, 175 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY. FOURTEEN AREAS OF SIGNIFICANT HEALTH AREAS OF OPPORTUNITY WERE IDENTIFIED INCLUDING ACCESS TO HEALTHCARE SERVICES, CANCER, DIABETES, HEART DISEASE AND STROKE, HOUSING, INFANT HEALTH AND FAMILY PLANNING, INJURY AND VIOLENCE, MENTAL HEALTH, NUTRITION, PHYSICAL ACTIVITY AND WEIGHT, ORAL HEALTH, POTENTIALLY DISABLING CONDITIONS, RESPIRATORY DISEASES, SUBSTANCE ABUSE, AND TOBACCO USE. THESE AREAS OF OPPORTUNITY WERE DETERMINED AFTER CONSIDERATION OF VARIOUS CRITERIA, INCLUDING COMPARISON TO BENCHMARK DATA, IDENTIFIED TRENDS, THE PREPONDERANCE OF SIGNIFICANT FINDINGS WITHIN TOPIC AREAS, THE MAGNITUDE OF THE ISSUE IN TERMS OF THE NUMBER OF PERSONS AFFECTED, AND THE POTENTIAL HEALTH IMPACT OF THE GIVEN ISSUE. A GROUP OF COMMUNITY STAKEHOLDERS, REPRESENTING A CROSS-SECTION OF COMMUNITY-BASED ORGANIZATIONS, WAS CONVENED TO EVALUATE, DISCUSS AND PRIORITIZE THE FOURTEEN AREAS OF OPPORTUNITY IDENTIFIED IN THE CHNA. IN ORDER TO ASSIGN PRIORITY TO THE IDENTIFIED HEALTH NEEDS, A WIRELESS AUDIENCE RESPONSE SYSTEM WAS USED IN WHICH EACH PARTICIPANT WAS ABLE TO REGISTER HIS/HER RATINGS BASED ON TWO CRITERIA: SCOPE AND SEVERITY AND THE ABILITY TO IMPACT. COMPOSITE SCORES WERE USED TO PRIORITIZE THE NEEDS. THE TOP FOUR AREAS OF FOCUS SELECTED BASED ON THIS CRITERIA INCLUDE: 1)ACCESS TO HEALTHCARE SERVICES; 2)MENTAL HEALTH AND SUBSTANCE USE; AND 3)NUTRITION AND PHYSICAL ACTIVITY. AUGUSTA HEALTH, THROUGH ITS MISSION STRENGTHEN THE HEALTH AND WELL-BEING OF ALL PEOPLE IN OUR COMMUNITIES, HAS CREATED INTERNAL, CROSS-DISCIPLINARY WORKGROUPS AROUND EACH OF THE THREE PRIORITY AREAS. EACH WORKGROUP HAS DEVELOPED GOALS, OBJECTIVES AND STRATEGIES TO ADDRESS SELECTED TOP PRIORITY HEALTH NEEDS IN THE AREAS OF: 1) ACCESS TO HEALTHCARE SERVICES, 2) MENTAL HEALTH AND SUBSTANCE USE, AND 4) NUTRITION AND PHYSICAL ACTIVITY. THE ACTION PLANS ARE BEING IMPLEMENTED WITH THE COLLABORATIVE FROM COMMUNITY PARTNERS. AUGUSTA HEALTH'S 2023-2025 IMPLEMENTATION STRATEGIES ARE DESIGNED TO ADDRESS THE TOP THREE HIGHEST PRIORITY AREAS. AUGUSTA HEALTH HAS SELECTED THESE THREE PRIORITIES BECAUSE OF ITS ABILITY TO WORK IN PARTNERSHIP WITH OTHER ORGANIZATIONS AND AGENCIES TO MAKE THE GREATEST IMPACT. OTHER NEEDS THAT WERE IDENTIFIED HAVE BEEN SHARED WITH COMMUNITY PARTNERS SO HAVE THE MOST APPROPRIATE RESOURCES TO ADDRESS. PART VI, LINE 3: AUGUSTA HEALTH HAS A MEDICAID ELIGIBILITY TEAM ONSITE TO SCREEN ITS PATIENTS FOR MEDICAID ELIGIBILITY, INCLUDING MEDICAID DISABILITY. AS FOR THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM, AUGUSTA HEALTH INFORMS ITS PATIENTS ABOUT IT IN THE FOLLOWING WAYS:1. DETAILED INFORMATION ABOUT FINANCIAL ASSISTANCE IS SENT ALONG WITH THE STATEMENTS.2. FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE AVAILABLE ON THE HOSPITAL'S WEBSITE WWW.AUGUSTAHEALTH.COM. 3. COPIES OF THE FINANCIAL ASSISTANCE GUIDELINES AND APPLICATION FORM ARE AVAILABLE AT THE POINTS OF SERVICE (EMERGENCY ROOM, OUTPATIENT AND INPATIENT AREAS, DOCTOR'S OFFICES, ETC). PART VI, LINE 4: OUR PRIMARY SERVICE AREA, THE COMBINED AREA OF STAUNTON, WAYNESBORO AND AUGUSTA COUNTY , ENCOMPASSES 1001.96 SQUARE MILES AND HOUSES A TOTAL POPULATION OF 121,651 RESIDENTS, ACCORDING TO LATEST CENSUS ESTIMATES. BETWEEN THE 2010 AND 2020 US CENSUSES, THE TOTAL AREA POPULATION INCREASED BY 6,932 PERSONS, OR 5.9%. WHILE AUGUSTA COUNTY IS PREDOMINANTLY RURAL, THE CITIES OF STAUNTON AND WAYNESBORO ARE NEARLY ENTIRELY URBAN. IN THE TOTAL AREA, 19.9% OF THE POPULATION ARE INFANTS, CHILDREN OR ADOLESCENTS AGE 17 AND UNDER, ANOTHER 60.1% ARE AGE 18 TO 64, WHILE 20.1% ARE AGE 65 OR OLDER. THE PERCENTAGE OF OLDER ADULTS IS MUCH HIGHER THAN THE STATE AND US FIGURES. IN LOOKING AT RACE INDEPENDENT OF ETHNICITY, 88.7% OF RESIDENTS OF THE TOTAL ARE WHITE AND 7.5% ARE BLACK. THE CITIES OF STAUNTON AND WAYNESBORO ARE MORE RACIALLY DIVERSE THAN AUGUSTA COUNTY. A TOTAL OF 3.8% OF TOTAL AREA RESIDENTS ARE HISPANIC OR LATINO, WITH THE PROPORTION THE LARGEST IN WAYNESBORO. BETWEEN 2010 AND 2020, THE HISPANIC POPULATION IN THE TOTAL AREA INCREASED BY 2,385 PEOPLE, OR 70.7%. PART VI, LINE 5: AS A COMMUNITY OWNED HOSPITAL, 100% OF THE SURPLUS GOES BACK INTO THE COMMUNITY THROUGH INVESTMENT IN A NETWORK OF CLINICAL PROVIDERS TO SERVE THE COMMUNITY, FACILITY UPGRADES, STATE OF THE ART EQUIPMENT PURCHASES, INCREASED PATIENT CARE SERVICES, AND ACCESS POINTS THROUGHOUT THE SERVICE AREA, AS WELL AS PROVIDING SUPPORT TO OTHER LOCAL NON-PROFIT AGENCIES THAT COMPLIMENT AND/OR SUPPORT THE MISSION OF AUGUSTA HEALTH. AUGUSTA HEALTH IS IN A LEADERSHIP POSITION FOR COMMUNITY BENEFIT AS A RESULT OF THE AUGUSTA HEALTH COMMUNITY PARTNERSHIP COMMITTEE. THE COMMUNITY PARTNERSHIP COMMITTEE IS APPOINTED BY THE AUGUSTA HEALTH BOARD OF DIRECTORS. THE COMMITTEE IMPROVES THE HEALTH OF THE COMMUNITY BY PROVIDING INPUT AND OVERSIGHT ON AUGUSTA HEALTH'S COMMUNITY BENEFIT INITIATIVES, COLLABORATIVE PARTNERSHIPS AND STRATEGIC FUNDING AND ENSURES ALIGNMENT WITH THE PRIORITY AREAS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE COMMITTEE IS RESPONSIBLE FOR OVERSEEING THE ADMINSTRATION OF THE CHNA EVERY THREE YEARS AS WELL AS OVERSIGHT OF THE CHNA IMPLENTATION PLAN. PART VI, LINE 6: THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. 1 CENTRAL SHENANDOAH PLANNING 112 MACTANLEY PLACE STAUNTON VA 24401 540857625 501(C)(3) 37083 0 OPERATIONAL SUPPORT VALLEY HOPE COUNSELING CENTER 20 STONERIDGE DR SUITE 202 WAYNESBORO VA 22980 541956722 501(C)(3) 25000 0 OPERATIONAL SUPPORT VALLEY MISSION 1513 WEST BEVERLY STREET STAUNTON VA 24401 540930419 501(C)(3) 20000 0 OPERATIONAL SUPPORT BLUE RIDGE COURT SERVICES 125 SOUTH NEW ST STAUNTON VA 24401 546001631 501(C)(3) 15000 0 OPERATIONAL SUPPORT PROJECT GROWS PO BOX 781 STAUNTON VA 24401 461070735 501(C)(3) 20000 0 OPERATIONAL SUPPORT VALLEY CHILDREN'S CENTER 1105 GREENVILLE AVE STAUNTON VA 24401 200831874 501(C)(3) 15000 0 OPERATIONAL SUPPORT VALLEY PROGRAM FOR THE AGING PO BOX 817 WAYNESBORO VA 22980 540958526 501(C)(3) 10000 0 OPERATIONAL SUPPORT BLUE RIDGE CASA FOR CHILDREN INC 119 WEST FREDRICK ST STAUNTON VA 24401 541721227 501(C)(3) 25000 0 OPERATIONAL SUPPORT SHENANDOAH LGBTQ CENTER 123 W FREDERICK ST STAUNTON VA 24401 464265280 501(C)(3) 62500 0 OPERATIONAL SUPPORT BRAIN INJURY OF THE SHENANDOAH 755 MARTIN KING JR WAY HARRISONBURG VA 22801 204795567 501(C)(3) 14500 0 OPERATIONAL SUPPORT ELK HILL FARM 1975 ELK HILL RD GOOCHLAND VA 23063 237071154 501(C)(3) 12000 0 OPERATIONAL SUPPORT ARROW PROJECT 1011 SPRINGHILL RD STAUNTON VA 24401 873496978 501(C)(3) 20000 0 OPERATIONAL SUPPORT SIN BARRERAS WITHOUT BARRIERS 941 GLENWOOD STATION CHARLOTTESVILLE VA 22901 461040727 501(C)(3) 10000 0 OPERATIONAL SUPPO RENEWING HOMES OF GREATER AUGUSTA PO BOX 3152 STAUNTON VA 24402 541738514 501(C)(3) 10000 0 OPERATIONAL SUPPORT AHC COMMUNITY HEALTH FOUNDATION PO BOX 1000 FISHERVILLE VA 22939 542042365 501(C)(3) 282240 0 OPERATIONAL SUPPORT 18 PART I, LINE 2: AUGUSTA HEALTH MADE GRANTS THROUGHOUT THE YEAR TO NON-PROFIT AND GOVERNMENTAL COMMUNITY PARTNERS WHO DEVELOPED PROJECTS OR PROVIDED SERVICES TO ADDRESS THE COMMUNITY'S HEALTH PRIORITIES IDENTIFIED IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. X X X X X 1 1 0 0 0 1 0 0 0 MARY N MANNIX PRESIDENT & CEO 792707 0 240409 0 348003 0 151936 0 14842 0 1547897 0 257161 0 SCOTT JUST MD PRESIDENT, AMG 457341 0 89203 0 78756 0 56066 0 13604 0 694970 0 102762 0 JOHN KATSIANIS VP AND CFO 457625 0 85397 0 41580 0 55924 0 12729 0 653255 0 102566 0 MAHFUZ HOQ MD CHIEF MEDICAL OFFICER 504447 0 51380 0 0 0 58590 0 11729 0 626146 0 51380 0 JEAN VEILLEUX VP OF LEGAL AFFAIRS AND GE 359327 0 71420 0 20500 0 45081 0 12954 0 509282 0 91920 0 CRYSTAL FARMER VP AND CNO 320024 0 58731 0 40813 0 40301 0 2329 0 462198 0 76692 0 DAN O'CONNOR VP OF POPULATION HEALTH 146504 0 64136 0 205028 0 0 0 10642 0 426310 0 68951 0 ANDREW WEST CMIO 367232 0 39955 0 0 0 9150 0 6229 0 422566 0 39955 0 MARK LAROSA VP OF BUSINESS DEVELOPMENT 288819 0 61828 0 22855 0 37529 0 6066 0 417097 0 79353 0 JOHN BOSWELL VP OF HUMAN RESOURCES 292794 0 52832 0 17662 0 37089 0 9350 0 409727 0 70493 0 MIKE CANFIELD VP AND CIO 296595 0 0 0 30139 0 40383 0 11556 0 378673 0 17430 0 SCOTT CRABTREE ASSISTANT VP 260027 0 51629 0 17940 0 29897 0 5666 0 365159 0 69569 0 KAREN CLARK VP OPERATIONS 209344 0 80930 0 17363 0 26895 0 866 0 335398 0 98292 0 SCOTT JONES VP OF COMPLIANCE & PRIVACY 229124 0 49212 0 18298 0 30433 0 6129 0 333196 0 67509 0 SHIRLEY CARTER KEY EMPLOYEE 250313 0 0 0 0 0 29636 0 13054 0 293003 0 0 0 VICKIE TAYLOR ASSISTANT CHIEF NURSING OF 225863 0 24360 0 0 0 4768 0 7580 0 262571 0 24360 0 BRIAN CROGHAN ADMINISTRATIVE DIRECTOR 217839 0 24167 0 0 0 6665 0 7796 0 256467 0 24167 0 SARAH E HASH-RODGERS ADMINISTRATIVE DIRECTOR 202984 0 22591 0 0 0 3708 0 13032 0 242315 0 22591 0 CHRISTOPHER HECK MD BOARD MEMBER 0 235162 0 0 0 0 0 2765 0 0 0 237927 0 0 ANTHONY LONG ADMINISTRATIVE DIRECTOR 125098 0 21667 0 79604 0 4213 0 4679 0 235261 0 21667 0 PART I, LINES 4A-B A SEVERANCE PAYMENT WAS MADE TO DAN O'CONNOR, VP OF POPULATION HEALTH, IN THE AMOUNT OF $187,149. THE FOLLOWING INDIVIDUALS HAD EMPLOYER CONTRIBUTIONS FROM A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS ARE REPRESENTED IN PART II, COLUMN (C): $122,286 - MARY MANNIX 10,079 - MIKE CANFIELD 8,885 - MARK LAROSA 26,274 - JOHN KATSIANIS 26,416 - SCOTT JUST, MD 6,130 - SCOTT CRABTREE 3,051 - SCOTT JONES 9,635 - JOHN BOSWELL 11,642 - CRYSTAL FARMER 15,431 - JEAN VEILLEUX 2,850 - SHIRLEY CARTER 28,940 - MAHFUZ HOQ, MD PART I, LINE 6 THE TOP EXECUTIVES OF AUGUSTA HEALTH WERE REQUIRED TO SET ANNUAL PERFORMANCE GOALS THAT ALIGNED WITH THE ORGANIZATION'S COMMITMENT TO PERFORMANCE EXCELLENCE. THE GOALS WERE ESTABLISHED WITH FOCUS ON THE FOLLOWING SIX AREAS: QUALITY, SERVICE, PEOPLE, COMMUNITY, GROWTH, AND FINANCE. EACH GOAL WAS REQUIRED TO HAVE MEASURABLE OUTCOMES AND WAS REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD TO ENSURE THAT IT SUPPORTED THE ORGANIZATION'S QUEST FOR SERVICE AND OPERATIONAL EXCELLENCE. WHILE NET EARNINGS WERE A CONSIDERATION IN THE AREA OF FINANCE, THE GOALS WERE ALSO CENTERED AROUND QUALITY, SERVICE, PEOPLE, COMMUNITY, AND GROWTH. EACH EXECUTIVE'S GOALS WERE WEIGHTED ACROSS THE PILLAR GOALS BASED ON THEIR AREA OF RESPONBILITY. WHEN AWARDING VARIABLE COMPENSATION, THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD REVIEWED THE YEAR-END ACCOMPLISHMENTS OF THE TOP EXECUTIVES AND AWARDED INCENTIVE COMPENSATION BASED ON THEIR ACTUAL PERFORMANCE AS COMPARED TO THE ESTABLISHED PERFORMANCE BENCHMARKS. CRYSTAL FARMER OFFICER UNIVERSITY DEGREE X 39000 41092 0 1 1 41092 FORM 990, PART VI, SECTION A, LINE 1A EXECUTIVE COMPENSATION PROGRAM IS ADMINISTERED BY THE EXECUTIVE COMMITTEE OF THE BOARD, BASED ON A COMPENSATION PHILOSOPHY APPROVED BY THE BOARD AT LARGE. QUALIFIED THIRD PARTY CONSULTANTS ARE ENGAGED TO PROVIDE APPROPRIATE MARKET COMPARABILITY, SURVEY DATA, AND TO ASSIST THE COMMITTEE WITH REVIEWS. THE BASE SALARY BENCHMARKS ARE TARGETED AT THE 50TH PERCENTILE WITH FLEXIBILITY TO PAY ABOVE OR BELOW THE 50TH PERCENTILE USING SALARY RANGES WITH A 50% RANGE SPREAD TO RECOGNIZE AN INCUMBENT'S INDIVIDUAL EXPERIENCE, SKILL, PERFORMANCE, OR OTHER RELEVANT RECRUITMENT OR RETENTION FACTORS. INCENTIVE OPPORTUNITIES ARE ESTABLISHED AT LEVELS THAT WHEN COMBINED WITH SALARIES POSITIONED AT THE 50TH PERCENTILE, ARE SUFFICIENT TO PROVIDE TOTAL CASH COMPENSATION THAT TARGETS UP TO THE APPROXIMATELY MARKET 75TH PERCENTILE OF TOTAL CASH COMPENSATION LEVELS. TOTAL COMPENSATION SHALL NOT EXCEED THE 90TH PERCENTILE FOR ANY INDIVIDUAL WITHOUT FULL BOARD APPROVAL AND DOCUMENTATION OF THE BOARD'S REASONS FOR SUCH COMPENSATION. THE BOARD OF DIRECTORS RECEIVES AN ANNUAL REPORT FROM THE EXECUTIVE COMMITTEE ON THE COMPENSATION PROGRAM AT AUGUSTA HEALTH IN AN EXECUTIVE SESSION OF THE BOARD. CONFLICTED MEMBERS ARE EXCUSED FROM THE MEETING. THE CHAIR REVIEWS THE DESIGN OF THE COMPENSATION PROGRAM TO INCLUDE BASE SALARIES RANGES, MARKET INCREASES RANGES, AND PROPOSED PERCENTAGES LEVELS FOR INCENTIVE COMPENSATION OPPORTUNITY. ADDITIONALLY, PREREQUISITES SUCH AS THE SENIOR EXECUTIVE RETIREMENT PLAN (SERP) PROGRAM AND OTHER RELATED BENEFITS ARE PERIODICALLY REVIEWED WITH THE BOARD. FOR THOSE MEMBERS WHO ARE NOT PRESENT FOR THIS MEETING AND REMAIN FREE OF CONFLICT OF INTEREST, THE CHAIRMAN OF THE BOARD MAY PRESENT THE SAME MATERIAL IN A SEPARATE SESSION. FORM 990, PART VI, SECTION B, LINE 11B THE ACCOUNTING DEPARTMENT WILL MAKE COPIES OF THE FORM 990 AVAILABLE TO THE CFO AND CEO FOR REVIEW. ALL QUESTIONS WILL BE RESOLVED AND ANSWERED BEFORE PRESENTATION TO THE EXECUTIVE COMMITTEE OF THE BOARD. THE FINAL DRAFT OF THE RETURN WILL BE POSTED ON THE ORGANIZATION'S INTERNAL WEBSITE WITH ACCESS RESTRICTED TO THE BOARD AND KEY ADMINISTRATIVE PERSONNEL FOR REVIEW. ALL QUESTIONS WILL BE RESOLVED AND ANSWERED BY THE CEO, CFO OR CORPORATE CONTROLLER. ANY REVISIONS AS A RESULT OF THE BOARD REVIEW WILL BE SENT TO THE TAX PREPARER AND SUBSEQUENT REVIEW BY THE BOARD WILL BE SCHEDULED ACCORDINGLY. FORM 990, PART VI, SECTION B, LINE 12C THE GOVERNANCE COMMITTEE IS CHARGED WITH REVIEWING THE CONFLICT OF INTEREST STATEMENTS EACH YEAR. THE REVIEW IS CONDUCTED AFTER THE ANNUAL BOARD MEETING IN APRIL. CONFLICT OF INTEREST REVIEWS OCCUR AT THE BEGINNING OF EACH BOARD AND COMMITTEE MEETING. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THOSE FOUND TO BE IN A CONFLICT OF INTEREST MAY BE ASKED TO ABSTAIN FROM VOTING AND MAY BE ASKED TO LEAVE THE MEETING DEPENDING ON THE TOPIC AND THEIR DEGREE OF CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 AUGUSTA HEALTH UTILIZES THE SERVICES OF GALLAGHER PO BOX 71696, CHICAGO, IL 60694-1696 TO DETERMINE COMPETITIVE WAGE RANGES, VARIABLE COMPENSATION AND PERQUISITES FOR EXECUTIVE POSITIONS. IT IS THE GOAL OF THE AUGUSTA HEALTH BOARD TO SATISFY THE FOLLOWING OBJECTIVES: 1.) COMPETITIVENESS: THE PROCESS MUST PRODUCE COMPENSATION AND BENEFIT LEVELS THAT ENABLE THE BOARD TO ATTRACT AND RETAIN THE MANAGEMENT LEADERSHIP ESSENTIAL TO CARRYING OUT ITS MISSION. 2.) STRATEGIC ALIGNMENT: THE PROCESS MUST ALIGN EXECUTIVE COMPENSATION WITH THE INSTITUTION'S STRATEGIC GOALS. IT MUST REWARD MANAGEMENT FOR ACCOMPLISHING THESE GOALS. 3.) REGULATORY COMPLIANCE: THE PROCESS MUST ASSURE THAT THE INSTITUTION MEETS ITS CHARITABLE PURPOSE OBLIGATIONS TO REMAIN TAX-EXEMPT AND THEREFORE WILL REVIEW AND APPROVE ALL FORMS OF EXECUTIVE COMPENSATION AND BENEFITS IN A MANNER NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE INTERMEDIATE SANCTIONS RULES OF SECTION 4958 OF THE IRC SO AS TO AVOID THE IMPOSITION OF INTERMEDIATE SANCTIONS IN THE FORM OF EXCISE TAXES PENALTIES ON ITS TRUSTEES AND EXECUTIVES. 4.) PUBLIC TRUST: BOARD MEMBERS ARE INVESTED WITH A PUBLIC TRUST TO SHEPHERD INSTITUTIONAL ASSETS AS RESPONSIBLE FIDUCIARIES AND REPRESENTATIVES. THEREFORE, THE PROCESS MUST ASSURE THAT COMPENSATION AND BENEFIT LEVELS ARE REASONABLE, NOT EXCESSIVE, AND DEFENSIBLE IF AND WHEN SUBJECTED TO PUBLIC SCRUTINY. BASE SALARIES TARGETED AT THE 50TH PERCENTILE, WITH FLEXIBILITY TO PAY ABOVE OR BELOW THE 50TH PERCENTILE USING SALARY RANGES WITH A 50% RANGE SPREAD TO RECOGNIZE AN INCUMBENT'S INDIVIDUAL EXPERIENCE, SKILL, PERFORMANCE OR OTHER RELEVANT RECRUITMENT OR RETENTION FACTORS. VARIABLE COMPENSATION LEVELS THAT, WHEN COMBINED WITH SALARIES POSITIONED AT THE 50TH PERCENTILE, ARE SUFFICIENT TO PROVIDE TOTAL CASH COMPENSATION THAT TARGETS UP TO THE APPROXIMATE MARKET 75TH PERCENTILE OF TOTAL CASH COMPENSATION LEVELS. TOTAL COMPENSATION SHALL NOT EXCEED THE 90TH PERCENTILE FOR ANY INDIVIDUAL WITHOUT FULL BOARD APPROVAL AND DOCUMENTATION OF THE BOARD'S REASONS FOR SUCH COMPENSATION. COMPENSATION, INDIVIDUAL PERFORMANCE AND COMPETITIVE DATA ARE REVIEWED ANNUALLY FOR ALL EXECUTIVE POSITIONS AS FOLLOWS: CEO CFO CNO CMO CIO PRESIDENT, MEDICAL GROUP VP OF LEGAL AFFAIRS VP OF HUMAN RESOURCES VP OF BUSINESS DEVELOPMENT AND CSO VP OF POPULATION HEALTH VP OF COMPLIANCE & PRIVACY VP OF PROFESSIONAL SERVICES THE BOARD OF DIRECTORS RECEIVED A SUMMARY FROM THE EXECUTIVE COMMITTEE ON THE COMPENSATION PROGRAM AT AUGUSTA HEALTH IN AN EXECUTIVE SESSION OF THE BOARD. CONFLICTED MEMBERS WERE EXCUSED FROM THE MEETING. THE CHAIR REVIEWS THE DESIGN OF THE COMPENSATION PROGRAM TO INCLUDE BASE SALARIES RANGES, MARKET INCREASES RANGES, AND PROPOSED PERCENTAGES LEVELS FOR INCENTIVE COMPENSATION OPPORTUNITY. ADDITIONALLY, PERQUISITE SUCH AS THE SERP PROGRAM AND OTHER RELATED BENEFITS WERE REVIEWED WITH THE BOARD. FOR THOSE MEMBERS WHO WERE NOT PRESENT FOR THIS MEETING AND REMAINED FREE OF CONFLICT OF INTEREST, THE CHAIRMAN OF THE BOARD OFFERS TO PRESENT THE SAME MATERIAL IN A SEPARATE SESSION. FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ACCOUNTING OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ACCOUNTING OFFICE. PLEASE DIRECT ALL REQUESTS TO: AUGUSTA HEALTH CARE, INC. ATTN: CORPORATE CONTROLLER P.O. BOX 1000 FISHERSVILLE, VA 22939-1000 FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 19,593,362. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,593,362. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 8,158,954. MANAGEMENT AND GENERAL EXPENSES 2,733. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,161,687. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 4,378,593. MANAGEMENT AND GENERAL EXPENSES 4,569,217. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,947,810. CONSULTANTS: PROGRAM SERVICE EXPENSES 2,005,109. MANAGEMENT AND GENERAL EXPENSES 1,149,821. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,154,930. OTHER FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,281,705. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,281,705. FORM 990, PART XI, LINE 9: EQUITY TRANSFERS BETWEEN AFFILIATES -536,143. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART VII BOARD MEMBER CHRISTOPHER HECK IS PAID AS AN EMPLOYEE OF AUGUSTA MEDICAL GROUP, A RELATED ORGANIZATION AND HE IS NOT COMPENSATED FOR HIS BOARD MEMBER SERVICE. AUGUSTA CARE PARTNERS LLC 78 MEDICAL CENTER DR FISHERSVILLE VA 22939 462840076 HEALTHCARE VA 0 0 LIFECORE COMMUNITY INC SPC PO BOX 10233 GRAND CAYMAN CJ CAPTIVE INSURANCE CJ 7586416 10572319 AHC COMMUNITY HEALTH FOUNDATION PO BOX 1000 FISHERSVILLE VA 22939 542042365 SUPPORTING ORGANIZATION VA 501(C)(3) LINE 12A, I AUGUSTA HEALTH CARE INC 1 AUGUSTA MEDICAL GROUP PO BOX 1000 FISHERSVILLE VA 22939 262559916 HEALTHCARE VA 501(C)(3) LINE 10 AUGUSTA HEALTH CARE INC 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 1 1 AUGUSTA MEDICAL GROUP A 1175436 AUGUSTA MEDICAL GROUP Q 54841080 AUGUSTA HEALTH FOUNDATION R 536143 AUGUSTA HEALTH FOUNDATION C 561016