2004 Annual Hospital 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 Northside Hospital Operational 3/22/2005 Bernard A. Costello
Bibb HealthSouth Central Georgia 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 Willingway Hospital 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 Atlanta 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 Floyd Medical Center 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 Shepherd Center 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 Atlanta Medical Center Operational 3/25/2005 William J. Masterton
Fulton Piedmont Hospital 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 Grady Memorial Hospital 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 Gwinnett Medical Center 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 Hospitals 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 Union General Hospital 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