Hospital Authority of Floyd County

“One member of the organization's governing body is selected by the board of commissioners of floyd county, georgia from its membership. The remaining board members are selected by the floyd county grand jury from nominees selected by the filing organization's governing board.”

“Nominated board members for vacancies are selected by the filing organization's board, but final approval is the responsibility of the floyd county grand jury.”

“The organization's ceo, cfo, controller, legal counsel and employees of fhmi review the form 990 for financial and disclosure accuracy. Prior to its filing, a copy of the organization's 990 return is posted on the board of director's secure website for their review. Management will send an email notifying members of its posting.”

“Hospital authority of floyd county ("hafc") 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 hafc. 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 hafc 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 hafc.”

“The organization makes its governing documents, conflict of interest policy and financial statements available to the public when the request is made at the administrative office of the filing corporation.”

“Form 990 part vii, section a - compensation of officers board members are paid a stipend for each board meeting attended. This amount is paid by floyd medical center and is included in the due to/from floyd medical center account. Form 990, part vii section a - board member business relationship floyd healthcare management, inc., a related party, maintains a self- insurance trust fund, the trustee of which is united community bank/reliance trust company. Director david johnson is an officer of united community bank/reliance trust company.”

“Related organization the authority owns floyd medical center, 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; coronary care unit; chaplain service; chemical dependency unit; crisis intervention; ct scanner; diabetes care unit; lithotripsy, medical/surgical intensive care; magnetic resonance imaging; neurology; level iii 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. Since january 1, 1998, the authority has leased all of its operations, including floyd medical center to floyd healthcare management, inc., a nonprofit corporation created under the sponsorship of the authority.”

“Line 25 - other liabilities this amount is due to fhmi to fund the frozen pension plan of the authority as per the lease agreement.”