2004 Annual Questionnaire Completion Status Report As of 7/19/2005 Hospital Operational Status as of the Close Date Survey Authorized County Hospital of Report Year Received Signature

2004 Year Summary 179 Surveys Expected 176 Surveys Completed 98.3% Incomplete Baldwin Central State Hospital-Medical/Surgical Closed Med/Surg in 2004

Bibb Macon Behavioral Health System Operational

Fulton Southwest Hospital And Medical Center Operational

Complete Appling Appling Hospital Operational 4/28/2005 Dale Spell

Bacon Bacon County Hospital Operational 4/22/2005 Cindy R. Turner

Baldwin Central State Hospital - Psychiatric Operational 3/30/2005 Frezalia Oliver Services Division Baldwin Oconee Regional Medical Center Operational 5/23/2005 Brian L. Riddle

Barrow Barrow Community Hospital Operational 3/23/2005 James O. Litchford

Bartow Cartersville Medical Center Operational 4/14/2005 Keith Sandlin

Ben Hill Dorminy Medical Center Operational 5/10/2005 Bruce Shepard

Berrien Berrien County Hospital Operational 3/31/2005 Richard Langosch

Bibb Macon Operational 3/22/2005 Bernard A. Costello

Bibb HealthSouth Central Operational 3/23/2005 Elbert McQueen Rehabilitation Hospital Bibb Medical Center of Central Georgia Operational 3/24/2005 A. Donald Faulk, Jr.

Bibb Coliseum Psychiatric Center Operational 3/25/2005 Mark W. Nichols

Bibb Coliseum Medical Centers Operational 3/25/2005 Michael S. Boggs

Bleckley Bleckley Memorial Hospital Operational 3/28/2005 Cary Martin

Brooks Brooks County Hospital Operational 3/25/2005 J William Sellers

Bulloch Operational 3/24/2005 Barbara S. Reid

Bulloch East Georgia Regional Medical Center Operational 4/5/2005 Bradley K. Nurkin

Burke Burke Medical Center Operational 3/25/2005 Jennifer A. Royal

Butts Sylvan Grove Hospital Operational 5/3/2005 Lisa Napier

Calhoun Calhoun Memorial Hospital Operational 5/6/2005 Peggy W. Pierce

Camden Camden Medical Center Operational 3/25/2005 Michael D. Scherneck, VP & CFO Candler Candler County Hospital Operational 4/1/2005 Michael Alexander

Tuesday, July 19, 2005 Page 1 of 7 Hospital Operational Status as of the Close Date Survey Authorized County Hospital of Report Year Received Signature

Carroll Tanner Medical Center/Villa Rica Operational 4/22/2005 Larry N. Steed

Carroll Tanner Medical Center/Carrollton Operational 4/22/2005 Richard McConahy

Catoosa Hutcheson Medical Center Operational 3/25/2005 David M. Snyder

Charlton Charlton Memorial Hospital Operational 3/28/2005 Merita Hinnant

Chatham Candler Hospital Operational 3/25/2005 Paul P. Hinchey

Chatham St. Joseph's Hospital Operational 3/25/2005 Paul P. Hinchey

Chatham Georgia Regional Hospital-Savannah Operational 3/25/2005 Dr. Frank Drummond

Chatham Memorial Health University Medical Operational 4/1/2005 Robert A. Colvin Center Chatham Coastal Harbor Treatment Center Operational 5/20/2005 Ray Heckerman

Cherokee Northside Hospital-Cherokee Operational 5/25/2005 Billy Hayes

Clarke Athens Regional Medical Center Operational 3/28/2005 John A. Drew

Clarke St. Mary's Hospital Operational 4/8/2005 Thomas E. Fitz, Jr

Clayton Anchor Hospital Operational 4/5/2005 Trey Carter

Clayton Southern Regional Medical Center Operational 5/13/2005 Edward J. Bonn

Clinch Clinch Memorial Hospital Operational 5/3/2005 Bill Forbes

Cobb Devereux Georgia Treatment Network Operational 3/25/2005 Mario Bolivar

Cobb Ridgeview Institute Operational 3/25/2005 Monica Tippett

Cobb WellStar Cobb Hospital Operational 3/28/2005 Robert A. Lipson, MD

Cobb WellStar Windy Hill Hospital Operational 3/28/2005 Robert A. Lipson, MD

Cobb WellStar Kennestone Hospital Operational 3/28/2005 Robert A. Lipson, MD

Cobb Emory-Adventist Hospital Operational 4/11/2005 Dennis Kiley

Coffee Coffee Regional Medical Center Operational 3/25/2005 George L. Heck

Colquitt Colquitt Regional Medical Center Operational 3/25/2005 James R. Lowry

Colquitt Turning Point Hospital Operational 4/6/2005 Ben Marion

Cook Memorial Hospital of Adel Operational 6/24/2005 Bill Hawley

Coweta Newnan Hospital West Operational 5/27/2005 Mr. Richard Hubbard

Coweta Newnan Hospital Operational 5/31/2005 Mr. Richard Hubbard

Crisp Crisp Regional Hospital Operational 4/11/2005 Wayne Martin

Dade Wildwood Lifestyle Center & Hospital Operational 3/9/2005 Derrick Hamilton

Decatur Memorial Hospital of Bainbridge Operational 3/23/2005 James G. Peak

DeKalb Laurel Heights Hospital Operational 3/2/2005 Shawn Lemon

Tuesday, July 19, 2005 Page 2 of 7 Hospital Operational Status as of the Close Date Survey Authorized County Hospital of Report Year Received Signature

DeKalb Children's Healthcare of at Operational 3/24/2005 Dr. James Tally Egleston DeKalb Northlake Medical Center, LLC Operational 3/28/2005 Robbin Moore

DeKalb DeKalb Medical Center Operational 3/28/2005 Eric Norwood

DeKalb Emory Dunwoody Medical Center Operational 3/30/2005 Thomas Gilbert

DeKalb Georgia Regional Hospital-Atlanta Operational 4/1/2005 Ronald C. Hogan

DeKalb Decatur Hospital Operational 4/1/2005 Homer Wright

DeKalb Emory University Hospital Operational 4/13/2005 Jimmy Hatcher

DeKalb Wesley Woods Geriatric Hospital Operational 4/13/2005 Peter Basler

DeKalb Peachford Behavioral Health System of Operational 6/10/2005 Matt Crouch Atlanta Dodge Dodge County Hospital Operational 4/26/2005 Ken Stegner

Dougherty Palmyra Medical Centers Operational 3/25/2005 Allen Golson

Dougherty Phoebe Putney Memorial Hospital Operational 4/11/2005 Joel Wernick

Douglas WellStar Douglas Hospital Operational 3/28/2005 Robert A. Lipson, MD

Douglas Inner Harbour Hospital Operational 6/14/2005 Ron J. Scroggy

Early Early Memorial Hospital Operational 3/25/2005 J. William Sellers

Effingham Effingham Hospital Operational 5/6/2005 Don Tomberlin, Sr.

Elbert Elbert Memorial Hospital Operational 3/23/2005 Mark LeNeave

Emanuel Emanuel Medical Center Operational 5/26/2005 H.D.Cannington

Evans Evans Memorial Hospital Operational 5/6/2005 Ronald M. Gilliard

Fannin Fannin Regional Hospital Operational 3/24/2005 Barry Mousa

Fayette Fayette Community Hospital Operational 3/25/2005 John Miles

Floyd Redmond Regional Medical Center Operational 3/25/2005 Brenda Waltz

Floyd Operational 3/25/2005 Kurt Stuenkel

Floyd Northwest Georgia Regional Hospital Operational 4/6/2005 Karl Schwarzkopf, Ph.D.

Forsyth Northside Hospital Forsyth Operational 5/25/2005 Robert A. Putnam

Franklin Cobb Memorial Hospital Operational 3/25/2005 John Herron

Fulton Operational 3/22/2005 Gary R. Ulicny

Fulton Children's Healthcare of Atlanta at Operational 3/24/2005 Dr. James Tally Scottish Rite Fulton South Fulton Medical Center Operational 3/25/2005 Chris Hummer

Fulton Kindred Hospital-Atlanta Operational 3/25/2005 Craig A. Hoover

Tuesday, July 19, 2005 Page 3 of 7 Hospital Operational Status as of the Close Date Survey Authorized County Hospital of Report Year Received Signature

Fulton North Fulton Regional Hospital Operational 3/25/2005 Elizabeth Lamkin

Fulton Operational 3/25/2005 William J. Masterton

Fulton Operational 3/29/2005 Robert Maynard

Fulton Emory Crawford Long Hosptial Operational 4/13/2005 Albert K. Blackwelder, FACHE Fulton Saint Joseph's Hospital of Atlanta Operational 4/19/2005 Bonnie Phipps

Fulton Operational 5/6/2005 Dr. Andrew Agwunobi

Fulton Hughes Spalding Children's Hospital Operational 5/6/2005 Dr. Andrew Agwunobi

Fulton Northside Hospital Operational 5/25/2005 Robert Quattrocchi

Fulton Hillside Hospital Operational 5/25/2005 Teresa Stoker

Gilmer North Georgia Medical Center Operational 4/3/2005 Jeff Dunn

Glynn Southeast Georgia Regional Medical Operational 3/25/2005 Michael D. Scherneck, Center VP & CFO Glynn Focus By the Sea Operational 3/28/2005 Russ Dean

Gordon Gordon Hospital Operational 3/25/2005 Carlene Jamerson

Grady Grady General Hospital Operational 3/25/2005 J William Sellers

Greene Minnie G. Boswell Memorial Hospital Operational 3/25/2005 Floyd D. Bounds 3/25/2005

Gwinnett Emory Eastside Medical Center Operational 4/5/2005 Les Beard

Gwinnett Joan Glancy Memorial Hospital Operational 5/2/2005 Franklin M. Rinker

Gwinnett Operational 5/4/2005 Franklin M. Rinker

Habersham Habersham County Medical Center Operational 3/23/2005 James A. Peterson

Hall Northeast Georgia Medical Center Operational 6/9/2005 James E. Gardner, Jr.

Haralson Higgins General Hospital Operational 4/22/2005 Robbie Smith

Hart Hart County Hospital Operational 3/25/2005 Jerry Wise

Henry Henry Medical Center Operational 3/25/2005 G. Sam Ahern

Houston Perry Hospital Operational 4/6/2005 Frank Aaron

Houston Houston Medical Center Operational 4/6/2005 Frank Aaron

Irwin Irwin County Hospital Operational 3/25/2005 Sue Spivey

Jackson BJC Medical Center Operational 3/24/2005 Jim Yarborough

Jasper Jasper Memorial Hospital Operational 5/23/2005 David Owens

Jeff Davis Jeff Davis Hospital Operational 3/15/2005 RICHARD J MCCLEMENTS

Tuesday, July 19, 2005 Page 4 of 7 Hospital Operational Status as of the Close Date Survey Authorized County Hospital of Report Year Received Signature

Jefferson Jefferson Hospital Operational 5/24/2005 Rita G. Culvern

Jenkins Jenkins County Hospital Operational 3/18/2005 Alvin Burke

Lanier Louis Smith Memorial Hospital Operational 5/25/2005 Neil W. Ginty

Laurens Fairview Park Hospital Operational 4/19/2005 James E. Raynor

Liberty Liberty Regional Medical Center Operational 3/25/2005 Martha F. Traylor

Lowndes Smith Northview Hospital Operational 3/25/2005 Shamb Purohit, CFO

Lowndes South Georgia Medical Center Operational 3/25/2005 Bill Huling

Lumpkin Chestatee Regional Hospital Operational 3/25/2005 Rob A. Followell

Macon Flint River Community Hospital Operational 3/25/2005 Curt L. Roberts

McDuffie McDuffie Regional Medical Center Operational 6/30/2005 Douglas C. Keir

Meriwether Roosevelt Warm Springs Institute for Operational 3/24/2005 Frank C. Ruzycki Rehabilitation Meriwether Warm Springs Medical Center - Operational 3/25/2005 Jon Dixon

Miller Miller County Hospital Operational 3/14/2005 Harley Smith

Mitchell Mitchell County Hospital Operational 3/25/2005 J William Sellers

Monroe Monroe County Hospital Operational 3/30/2005 Oliver J. Booker, III

Morgan Morgan Memorial Hospital Operational 3/23/2005 Christopher W. Bonham

Murray Murray Medical Center Operational 5/24/2005 Jim Hazel

Muscogee West Central Georgia Regional Hospital Operational 3/25/2005 James M. Jackson

Muscogee Hughston Orthopedic Hospital Operational 3/25/2005 Donald R. Avery

Muscogee St. Francis Hospital Operational 3/25/2005 Richard E. Hudson, FACHE Muscogee The Medical Center Operational 3/29/2005 Lance Duke

Muscogee The Bradley Center of St. Francis Operational 4/1/2005 Richard E. Hudson

Muscogee Doctor's Hospital (Columbus) Operational 4/1/2005 Hugh Wilson

Newton Newton Medical Centerl Operational 3/28/2005 James Weadick

Paulding WellStar Paulding Hospital Operational 3/28/2005 Robert A. Lipson, MD

Peach Peach Regional Medical Center Operational 3/15/2005 Nancy H. Peed

Pickens Mountainside Memoral Center Piedmont Operational 3/29/2005 Ed Lovern Mountainside Hospital, Inc. Polk Polk Medical Center Operational 3/28/2005 Tim Prestridge

Pulaski Taylor Regional Hospital Operational 3/25/2005 Dan S. Maddock

Putnam Putnam General Hospital Operational 3/28/2005 Darrell Oglesby

Tuesday, July 19, 2005 Page 5 of 7 Hospital Operational Status as of the Close Date Survey Authorized County Hospital of Report Year Received Signature

Rabun Rabun County Memorial Hospital Operational 6/7/2005 William S. Allen

Randolph Southwest Georgia Regional Medical Operational 4/12/2005 Todd Cox Center Richmond University Hospital Operational 3/29/2005 J. Larry Read

Richmond Doctor's Hospital of Augusta Operational 3/30/2005 Shayne George

Richmond Medical College of Georgia Operational 4/1/2005 Don Snell and Clinics Richmond Saint Joseph Hospital of Augusta Operational 4/12/2005 Andrew A. Lasser, Dr. P.H. Richmond East Central Regional Hospital Operational 4/20/2005 Gail C. Jackson, M.D.

Richmond Walton Rehabilitation Hospital Operational 5/24/2005 Dennis B. Skelley

Rockdale Rockdale Hospital & Health Systems Operational 3/25/2005 Dr. David Huber

Screven Screven County Hospital Operational 3/24/2005 George H. St. George

Seminole Donalsonville Hospital, Inc. Operational 3/25/2005 Charles H. Orrick

Spalding Spalding Regional Medical Center Operational 5/6/2005 Lisa Napier

Stephens Stephens County Hospital Operational 5/25/2005 Edward C. Gambrell, Jr

Stewart Stewart Webster Hospital Operational 3/29/2005 Ransom Stigleman

Sumter Sumter Regional Hospital, Inc. Operational 3/31/2005 David H. Seagraves

Tattnall Tattnall Community Hospital Operational 6/1/2005 Karen H. O'Neal

Taylor Georgia Center for Youth Operational 6/14/2005 Robin Robinson

Telfair Taylor Telfair Regional Hospital Operational 3/18/2005 Joan Hartley

Thomas Southwestern State Hospital Operational 3/23/2005 Beverly Bajerski

Thomas John D. Archbold Memorial Hospital Operational 3/31/2005 James L. Story, Jr., M.D. Tift Tift Regional Medical Center Operational 3/25/2005 William T. Richardson

Toombs Meadows Regional Medical Center Operational 5/31/2005 Alan Kent

Towns Chatuge Regional Hospital Operational 3/25/2005 R. Lewis Kelley

Troup West Georgia Medical Center Operational 3/25/2005 Gerald N. Fulks

Union Operational 4/22/2005 Rebecca T. Dyer

Upson Upson Regional Medical Center Operational 3/25/2005 Thomas D. Plantz

Walton Walton Regoinal Medical Center Operational 3/25/2005 Alan E. George

Ware Satilla Regional Medical Center Operational 3/24/2005 Robert M. Trimm

Washington Washington County Regional Medical Operational 3/25/2005 H. Thomas Brown Center Wayne Wayne Memorial Hospital Operational 3/16/2005 Charles R. Morgan II

Tuesday, July 19, 2005 Page 6 of 7 Hospital Operational Status as of the Close Date Survey Authorized County Hospital of Report Year Received Signature

Wheeler Wheeler County Hospital Operational 3/21/2005 Brenda A. Josey

Whitfield Hamilton Medical Center Operational 3/25/2005 Gary Howard

Wilkes Wills Memorial Hospital Operational 3/25/2005 T. MARVIN GOLDMAN

Worth Phoebe Worth Medical Center Operational 3/25/2005 Keith Petersen

Source: Annual Hospital Questionnaire Prepared By: Department of Community Health Notes:

The report totals and subtotals include only those records specified in selection criteria, if any, shown below. If no criteria are shown, all records are included. ([Year] >= '2004'AND [Year] <='2004' )

Tuesday, July 19, 2005 Page 7 of 7