HEALTHMONT, INC. COMPANY DISCLOSURE SCHEDULE
EXHIBIT 10.50
HEALTHMONT, INC.
COMPANY DISCLOSURE SCHEDULE
This Company Disclosure Schedule has been prepared and delivered in accordance with that certain Agreement and Plan of Merger, dated as of October 15, 2002 (the “Agreement”), by and among SunLink Health Systems, Inc., an Ohio corporation (“SunLink” or “Parent”), HM Acquisition Corp., a Delaware corporation (“Merger Sub”), on the one hand, and HealthMont, Inc., a Tennessee corporation (the “Company”), on the other hand. Unless the context otherwise requires, terms that are not defined in this Company Disclosure Schedule shall have the meanings set forth in the Agreement.
The Company Disclosure Schedule is qualified in its entirety by reference to specific provisions of the Agreement. Inclusion of the information herein shall not be construed as an admission that such information is material to the business, financial condition or results of operations of the Company except to the extent that the Agreement requires that such information for a particular Section is material.
Matters reflected in these schedules are not necessarily limited to matters required by the Agreement to be reflected herein. Such additional matters are set forth for informational purposes only and do not necessarily include other matters of a similar nature.
Headings have been inserted for each schedule for convenience of reference only and shall to no extent have the effect of amending or changing the express description of such schedules as set forth in the Purchase Agreement. A disclosure made in one schedule need not be made in another schedule if such disclosure on its face would reasonably put the party to whom such disclosure is made on notice of the applicability of such disclosure to other schedules, and would not make the disclosure in the other schedule materially misleading, and would not result in the omission of any material fact necessary in light of the circumstances to make the disclosure in such other schedule or schedules (or the absence of any such disclosure) not misleading. The disclosure of an item by a party in one schedule shall not result in any duty on the part of the party to whom such disclosure is made to inquire as to the application of such matter to any other section of the Company Disclosure Schedule.
1
Section 1.6
Director Consulting Agreements
The Company has entered into a Consulting Agreement with each of the following directors of the Company (collectively, the “Director Consulting Agreements”):
Xxxxxxx X. Xxxxxxxx
X. Xxxxxx Xxxxxx
Xxxx X. Xxxxxx
Xxxx X. Xxxxxxxx
Xxx X. Xxxxx
Xxx X. Xxxx
Xxxxx X. Xxxxxxxx
2
Section 3.2
Subsidiaries and Affiliates
Section 3.2(a)
A. |
Name of Company Subsidiaries Jurisdiction | Qualification | ||
1. HealthMont of Georgia, Inc. Tennessee | Tennessee, Georgia | |||
2. HealthMont of Texas, Inc. Tennessee | Tennessee, Texas | |||
3. HealthMont of Texas I, LLC Tennessee | Tennessee, Texas | |||
4. HealthMont of Missouri, Inc. Tennessee | Tennessee, Missouri | |||
5. HealthMont of West Virginia, Inc. Tennessee | Tennessee | |||
B. |
Other Securities Owned by Company | |||
None |
Section 3.2(b)
Liens held on Capital Stock of Company Subsidiaries
The Company and each of the Company Subsidiaries is a party to (i) that certain Mortgage Loan Agreement (the “Mortgage Loan Agreement”), dated as of August 31, 2000, with Xxxxxx Healthcare Finance, Inc. (“Xxxxxx”), and (ii) that certain Revolving Loan and Security Agreement (the “Revolving Loan Agreement” and together with the Mortgage Loan Agreement, the “Xxxxxx Loan Documents”)), dated as of August 31, 2000, with Xxxxxx.
The collateral for the loan evidenced by the Revolving Loan Agreement includes those items listed in Section 3.1 of the Revolving Loan Agreement. The Company and the Parent acknowledge that the collateral for such loan does not include the capital stock of the Company Subsidiaries because the stock certificates evidencing the capital stock of the Company Subsidiaries are currently held by and are under the control of the Company and have not been pledged to Xxxxxx or a bailee or affiliate of Xxxxxx. In the event that the definition of “general intangibles” in Section 3.1(f) of the Revolving Loan Agreement is
3
held to include the capital stock of the Company Subsidiaries as collateral under the Revolving Loan Agreement, the Company and the Parent acknowledge that such interpretation will not be considered a breach of the Company’s representations and warranties under this Agreement.
4
Section 3.3
Capitalization
Section 3.3(b)
Under the Shareholders’ Agreement, dated as of August , 2000, among the Company and the shareholders of the Company (the “Shareholders’ Agreement”):
1. | The shareholders are obligated to vote such that five (5) directors consist of persons nominated by the Sovereign Shareholders (as defined in the Shareholders’ Agreement”) and three (3) directors consist of persons nominated by the Founders (as defined in the Shareholders’ Agreement). |
2. | Certain types of significant transactions (including the Merger) must be approved by a majority of the directors, plus at least one director nominated by the Founders. |
Section 3.3(d)
In addition to the Xxxxxx Warrants, the Company has outstanding the following Company Derivative Securities:
NAME OF STOCKHOLDER |
Options @ 1.82 |
Options @ 2.75 |
Total Options |
Options to be Forgiven |
Remaining Options |
Warrants @ 1.25 | |||||||
Xxxxx X. Xxxxxxxx |
10,000 | 5,000 | 15,000 | 0 | 15,000 | ||||||||
Xxx X. Xxxxx |
10,000 | 5,000 | 15,000 | 0 | 15,000 | ||||||||
Xxxx X. Xxxxxx |
10,000 | 5,000 | 15,000 | 0 | 15,000 | 200,000 | |||||||
Xxxx X. Xxxxxxxx & X. Xxx Xxxxxxxx |
10,000 | 5,000 | 15,000 | 0 | 15,000 | 80,000 | |||||||
Xxx Xxxx and Xxxxxx Xxxx |
10,000 | 5,000 | 15,000 | 0 | 15,000 | ||||||||
Xxxxxxx X. Xxxxxxxx |
10,000 | 5,000 | 15,000 | 0 | 15,000 | 200,000 | |||||||
Xxxxxx Family Partnership LTD |
10,000 | 5,000 | 15,000 | 0 | 15,000 | 160,000 | |||||||
Xxxxxxx X. Xxxx |
40,000 | 40,000 | (40,000 | ) | 0 | 20,000 | |||||||
Xxxx Xxxxxxxx |
14,000 | 4,000 | 18,000 | (18,000 | ) | 0 | |||||||
Xxxx Xxxxxx |
7,000 | 3,000 | 10,000 | (10,000 | ) | 0 | |||||||
Xxxxx Xxxxxx |
7,000 | 3,000 | 10,000 | (10,000 | ) | 0 |
5
Xxxxxx Xxxxxx |
5,000 | 3,000 | 8,000 | (8,000 | ) | 0 | |||||
Xxxxxx Xxxxxxx |
14,000 | 8,000 | 22,000 | (22,000 | ) | 0 | |||||
Xxxxx Xxxxx |
- | 10,000 | 10,000 | (10,000 | ) | 0 | |||||
Xxxxxxx Xxxxxx |
- | 4,000 | 4,000 | (4,000 | ) | 0 | |||||
Xxx Xxxxxx |
- | 60,000 | 60,000 | (60,000 | ) | 0 | |||||
Xxx Xxxxx |
8,000 | 5,000 | 13,000 | (13,000 | ) | 0 | |||||
Xxxxx Xxxx |
4,000 | 2,000 | 6,000 | (6,000 | ) | 0 |
6
Section 3.6
Vote Required
The Shareholder Approval requirement is now seventy-five percent (75%).
7
Section 3.7
Consents and Approvals
Section 3.7(a)
Pursuant to the Xxxxxx Loan Documents, the consent of Xxxxxx is necessary for the Company to complete the transactions contemplated by this Agreement.
Section 3.7(b)
None.
8
Section 3.8
Financial Statements
Section 3.8(b)
None.
Section 3.8(d)
None.
9
Section 3.9
Undisclosed Liabilities
A. | The Company is a party to a certain Master Lease Agreement, dated as of January 15, 2001, with Comdisco Healthcare Group, Inc. (“Comdisco”) related to the lease of certain equipment described in the schedules attached thereto (the “Comdisco Lease Agreement”). Certain equipment leased pursuant to the Comdisco Lease Agreement is used at the Eastmoreland Hospital, which hospital is no longer owned by the Company. GKPS, Inc. (“GKPS”), the current owner of the hospital, assumed the Company’s obligations under Comdisco Lease Agreement when it purchased the hospital from the Company, but the Company remains liable to Comdisco under the agreement. |
The equipment leased pursuant to the Comdisco Lease Agreement that is used at Eastmoreland Hospital consists of the following:
1. | Acuson X-10 ART Ultrasound (60-month lease; $1,548/month) |
2. | Siemens Mobile 1.0 Impact Expert MRI (60-month lease; $12,248/month) |
3. | GE High Speed Advantage RP CT (60-month lease; $6,686/month) |
Attached is a schedule showing the total amount for which HealthMont may be liable under each of the above as of the date of the Agreement.
B. | Symphony Healthcare V, LLC (f/k/a HealthMont of Oregon V, LLC) leases certain real property located in Multnomah County, Oregon (the lease agreement, as amended. being referred to herein as the “Woodland Park Lease Agreement”). The Company is guarantor under the Woodland Park Lease Agreement in an amount up to $500,000. GKPS, current owner of the Woodland Park Hospital, assumed the Company’s obligations as guarantor when it purchased the hospital from the Company, but the Company remains liable to the lessor under the lease agreement to the extent of its guaranty. |
C. | The Company is a party to certain capital leases (the “LinvaTec Leases”) with LinvaTec Financial Services (“LinvaTec”) related to equipment located at Woodland Park Hospital, which is no longer owned by the Company. GKPS, the current owner of the hospital, assumed the Company’s obligations under the LinvaTec Leases, but the Company remains liable to LinvaTec under the lease agreements. |
The equipment leased pursuant to the LinvaTec leases consists of the following:
1. | 2 Apex 3 chip camera controller |
2. | 2 Sony Medical Monitor 20” |
3. | 2 Sony UP5/MD printer |
10
4. | 3 Autoclav 300D Eyecap camera head |
5. | 2 Xenon light source |
6. | 1 Laparoflator console 252 |
Attached is a schedule showing the total amount for which HealthMont may be liable under each of the above as of the date of the Agreement.
D. | The agreements described in subparagraphs A.9., 14., and 15. of Section 3.20 of this Company Disclosure Schedule may relate in part to equipment used at Eastmoreland Hospital and/or Woodland Park Hospital. GKPS, the current owner of the hospitals, assumed the Company’s obligations under these agreements, but the Company remains liable to the lessors under the agreements. |
Attached is a schedule showing the total amount for which HealthMont may be liable under each of the above as of the date of the Agreement.
E. | When the Company sold the subsidiaries that own Eastmoreland Hospital and Woodland Park Hospital to GKPS, it retained the following liabilities: |
1. | Xxxxxxx Xxxxx |
i. | Incident Occurrence Date: 5/99-10/00 |
ii. | Incident Report Date: 6/1/01 |
iii. | Description: Former employee requesting severance pay from New American Healthcare |
iv. | Plaintiff Atty: Xxxxx X. Xxxxxxxx, 0 Xxxxxx Xxxx, Xxxxx X, Xxxx Xxxxxx, XX 00000 |
v. | Status: Demand made on HealthMont through summons (jury trial requested) |
vi. | Claim: $38,423.07 plus legal fees |
vii. | HealthMont Attorney: Xxxxxxxx X. Xxxxx, Xxxxx, Xxxxxx Xxxxxxxx, 0000 XX Xxxxx Xxx., Xxxxxxxx, XX 00000 |
2. | Xxx Xxxx |
i. | Incident Occurrence Date: 8/3/01 |
ii. | Incident Report Date: 8/31/01 |
iii. | Description: Employee (night shift charge nurse) defied physician orders for a patient admitted and when reprimanded became very upset. Employee was diagnosed with manic, paranoid behavior by staff psychiatrist. Employee was subsequently terminated. |
iv. | Plaintiff Atty: Oregon Bureau Labor & Ind., 000 XX Xxxxxx Xxxxxx #00, Xxxxxxxx, XX 00000 |
v. | Status: Precautionary file established |
vi. | Claim: None to date |
11
Sep-02 |
Oct-02 |
Nov-02 |
Dec-02 |
Jan-03 |
Feb-03 |
Mar-03 |
Apr-03 |
May-03 |
Jun-03 |
Jul-03 |
Aug-03 |
Sep-03 |
Oct-03 | |||||||||||||||
HealthMont Payment Guarantees: |
||||||||||||||||||||||||||||
Dolly |
||||||||||||||||||||||||||||
XX Xxxxx (copiers) |
1,447 | 1,447 | 1,447 | 1,447 | 1,447 | 1,447 | 1,447 | 1,447 | 1,447 | 1,447 | 1,447 | 1,447 | 1,447 | 1,447 | ||||||||||||||
Comdisco |
||||||||||||||||||||||||||||
CT |
7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | ||||||||||||||
R&F |
3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | ||||||||||||||
IBM AS400 lease |
1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | ||||||||||||||
Woodland Park Hospital (Portland) |
||||||||||||||||||||||||||||
XX Xxxxx (copiers) |
3,348 | 3,348 | 3,348 | 3,348 | 3,348 | 3,348 | 3,348 | 3,348 | 3,348 | 3,348 | 3,348 | 3,348 | 3,348 | 3,348 | ||||||||||||||
IBM AS400 lease |
3,032 | 3,032 | 3,032 | 3,032 | 3,032 | 3,032 | 3,032 | 3,032 | 3,032 | 3,032 | 3,032 | 3,032 | 3,032 | 3,032 | ||||||||||||||
Linvatec |
2,411 | 2,411 | 2,411 | 2,411 | 2,411 | 2,411 | 2,411 | 2,411 | 2,411 | 2,411 | 2,411 | 2,411 | 2,411 | 2,411 | ||||||||||||||
Eastmoreland Hospital (Portland) |
||||||||||||||||||||||||||||
XX Xxxxx (copiers) |
1,767 | 1,767 | 1,767 | 1,767 | 1,767 | 1,767 | 1,767 | 1,767 | 1,767 | 1,767 | 1,767 | 1,767 | 1,767 | 1,767 | ||||||||||||||
Comdisco |
||||||||||||||||||||||||||||
Ultrasound |
1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | ||||||||||||||
MRI |
12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | ||||||||||||||
CT |
20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | ||||||||||||||
Monthly Total |
59,210 | 59,210 | 59,210 | 59,210 | 59,210 | 59,210 | 59,210 | 59,210 | 59,210 | 59,210 | 59,210 | 59,210 | 59,210 | 59,210 | ||||||||||||||
Cumulative Total |
2,549,813 | 2,490,603 | 2,431,393 | 2,372,183 | 2,312,973 | 2,253,763 | 2,194,553 | 2,135,343 | 2,076,133 | 2,016,923 | 1,957,712 | 1,898,502 | 1,839,292 | 1,780,082 | ||||||||||||||
Woodland Park Hospital (Portland) |
||||||||||||||||||||||||||||
Hospital Lease (flat $500,000 guarantee for lease default on 20 plus year lease) | ||||||||||||||||||||||||||||
500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | |||||||||||||||
Total |
3,049,813 | 2,990,603 | 2,931,393 | 2,872,183 | 2,812,973 | 2,753,763 | 2,694,553 | 2,635,343 | 2,576,133 | 2,516,923 | 2,457,712 | 2,398,502 | 2,339,292 | 2,280,082 |
12
Nov-03 |
Dec-03 |
Jan-04 |
Feb-04 |
Mar-04 |
Apr-04 |
May-04 |
Jun-04 |
Jul-04 |
Aug-04 |
Sep-04 |
Oct-04 |
Nov-04 |
Dec-04 |
Jan-05 |
Feb-05 |
Mar-05 |
Apr-05 | |||||||||||||||||||
HealthMont Payment Guarantees: |
||||||||||||||||||||||||||||||||||||
Dolly |
||||||||||||||||||||||||||||||||||||
XX Xxxxx (copiers) |
1,447 | 1,447 | 1,447 | 1,447 | 1,447 | 1,447 | 1,447 | 1,447 | 1,447 | 1,447 | ||||||||||||||||||||||||||
Comdisco |
||||||||||||||||||||||||||||||||||||
CT |
7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | ||||||||||||||||||
R&F |
3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | ||||||||||||||||||
IBM AS400 lease |
1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | 1,693 | ||||||||||||||||||
Woodland Park Hospital (Portland) |
||||||||||||||||||||||||||||||||||||
XX Xxxxx (copiers) |
3,348 | 3,348 | 3,348 | 3,348 | 3,348 | 3,348 | 3,348 | 3,348 | 3,348 | 3,348 | ||||||||||||||||||||||||||
IBM AS400 lease |
||||||||||||||||||||||||||||||||||||
Linvatec |
2,411 | |||||||||||||||||||||||||||||||||||
Eastmoreland Hospital (Portland) |
||||||||||||||||||||||||||||||||||||
XX Xxxxx (copiers) |
1,767 | 1,767 | 1,767 | 1,767 | 1,767 | 1,767 | 1,767 | 1,767 | 1,767 | 1,767 | ||||||||||||||||||||||||||
Comdisco |
||||||||||||||||||||||||||||||||||||
Ultrasound |
1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | ||||||||||||||||||
MRI |
12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | ||||||||||||||||||
CT |
20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | ||||||||||||||||||
Monthly Total |
56,178 | 53,767 | 53,767 | 53,767 | 53,767 | 53,767 | 53,767 | 53,767 | 53,767 | 53,767 | 47,205 | 47,205 | 47,205 | 47,205 | 47,205 | 47,205 | 47,205 | 47,205 | ||||||||||||||||||
Cumulative Total |
1,720,872 | 1,664,694 | 1,610,927 | 1,557,160 | 1,503,393 | 1,449,626 | 1,395,859 | 1,342,092 | 1,288,325 | 1,234,558 | 1,180,791 | 1,133,586 | 1,086,381 | 1,039,176 | 991,971 | 944,766 | 897,560 | 850,355 | ||||||||||||||||||
Woodland Park Hospital (Portland) |
||||||||||||||||||||||||||||||||||||
Hospital Lease (flat $500,000 guarantee for lease default on 20 plus year lease) |
||||||||||||||||||||||||||||||||||||
500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | |||||||||||||||||||
Total |
2,220,872 | 2,164,694 | 2,110,927 | 2,057,160 | 2,003,393 | 1,949,626 | 1,895,859 | 1,842,092 | 1,788,325 | 1,734,558 | 1,680,791 | 1,633,586 | 1,586,381 | 1,539,176 | 1,491,971 | 1,444,766 | 1,397,560 | 1,350,355 |
13
May-05 |
Jun-05 |
Jul-05 |
Aug-05 |
Sep-05 |
Oct-05 |
Nov-05 |
Dec-05 |
Jan-06 |
Feb-06 |
Mar-06 |
Apr-06 |
May-06 |
Jun-06 |
Jul-06 |
Aug-06 |
Sep-06 |
Oct-06 | |||||||||||||||||||
HealthMont Payment Guarantees: |
||||||||||||||||||||||||||||||||||||
Dolly |
||||||||||||||||||||||||||||||||||||
XX Xxxxx (copiers) |
||||||||||||||||||||||||||||||||||||
Comdisco |
||||||||||||||||||||||||||||||||||||
CT |
7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | 7,446 | ||||||||||||||||||||||
R&F |
3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | 3,788 | ||||||||||||||||||||||
IBM AS400 lease |
1,693 | 1,693 | 1,693 | 1,693 | ||||||||||||||||||||||||||||||||
Woodland Park Hospital (Portland) |
||||||||||||||||||||||||||||||||||||
XX Xxxxx (copiers) |
||||||||||||||||||||||||||||||||||||
IBM AS400 lease |
||||||||||||||||||||||||||||||||||||
Linvatec |
||||||||||||||||||||||||||||||||||||
Eastmoreland Hospital (Portland) |
||||||||||||||||||||||||||||||||||||
XX Xxxxx (copiers) |
||||||||||||||||||||||||||||||||||||
Comdisco |
||||||||||||||||||||||||||||||||||||
Ultrasound |
1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | 1,548 | |||||||||||||||||||||||||
MRI |
12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | 12,248 | ||||||||||||||||||||||
CT |
20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | 20,482 | ||||||||||||||||||
Monthly Total |
47,205 | 47,205 | 47,205 | 47,205 | 45,512 | 45,512 | 45,512 | 45,512 | 45,512 | 45,512 | 45,512 | 43,964 | 43,964 | 43,964 | 20,482 | 20,482 | 20,482 | 20,482 | ||||||||||||||||||
Cumulative Total |
803,150 | 755,945 | 708,740 | 661,535 | 614,330 | 568,818 | 523,306 | 477,794 | 432,282 | 386,770 | 341,258 | 295,746 | 251,782 | 207,819 | 163,855 | 143,373 | 122,891 | 102,409 | ||||||||||||||||||
Woodland Park Hospital (Portland) |
||||||||||||||||||||||||||||||||||||
Hospital Lease (flat $500,000 guarantee for lease default on 20 plus year lease) |
||||||||||||||||||||||||||||||||||||
500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | 500,000 | |||||||||||||||||||
Total |
1,303,150 | 1,255,945 | 1,208,740 | 1,161,535 | 1,114,330 | 1,068,818 | 1,023,306 | 977,794 | 932,282 | 886,770 | 841,258 | 795,746 | 751,782 | 707,819 | 663,855 | 643,373 | 622,891 | 602,409 |
14
Nov-06 |
Dec-06 |
Jan-07 |
Feb-07 |
Total |
Will Remain |
Working To |
||||||||||
HealthMont Payment |
||||||||||||||||
Dolly |
0 | |||||||||||||||
XX Xxxxx (copiers) |
34,728 | 34,728 | ||||||||||||||
Comdisco |
0 | 0 | ||||||||||||||
CT |
342,522 | 342,522 | ||||||||||||||
R&F |
174,248 | 174,248 | ||||||||||||||
IBM AS400 lease |
60,948 | 60,948 | ||||||||||||||
Woodland Park |
||||||||||||||||
XX Xxxxx (copiers) |
80,352 | 80,352 | Credit app being completed | |||||||||||||
IBM AS400 lease |
42,448 | 42,448 | ||||||||||||||
Linvatec |
36,166 | |||||||||||||||
Eastmoreland |
||||||||||||||||
XX Xxxxx (copiers) |
42,408 | 42,408 | Credit app being completed | |||||||||||||
Comdisco |
0 | |||||||||||||||
Ultrasound |
66,582 | 66,582 | Working with GE-should hear back next week | |||||||||||||
MRI |
563,390 | 563,390 | ||||||||||||||
CT |
20,482 | 20,482 | 20,482 | 20,482 | 1,106,022 | 1,106,022 | ||||||||||
Monthly Total |
20,482 |
20,482 | 20,482 | 20,482 | ||||||||||||
Cumulative Total |
81,928 |
61,446 | 40,964 | 20,482 | 2,549,813 | 654,894 | 1,858,754 | |||||||||
Woodland Park |
||||||||||||||||
Hospital Lease (flat $500,000 guarantee for lease default on 20 plus year lease) |
||||||||||||||||
500,000 | 500,000 | 500,000 | 500,000 | 110,000 To get removed. Six weeks to get finalized. | ||||||||||||
Total |
581,928 |
561,446 | 540,964 | 520,482 |
15
Section 3.10
Absence of Certain Changes
A. | Arrangements relating to the Divestco Disposition. (Sections 3.10(b)(i) and (ii)) |
B. | Draws under the Revolving Loan Agreement. (Section 3.10(b)(iv)) |
C. | The Company intends to take the actions disclosed in Section 5.1 of the Company Disclosure Schedule. |
D. | The Company has entered into a Settlement Agreement with GKPS, dated as of August 20, 2002, and certain related agreements (the “GKPS Settlement Agreements”) settling certain disputes related to the acquisition by GKPS of the stock of certain of the Company’s subsidiaries. As part of that settlement, the Company released certain claims against GKPS, relinquished its rights to certain property tax refunds and cancelled a promissory note from GKPS in the original principal amount of $600,000, all as described more particularly in the GKPS Settlement Agreements. (Sections 3.10(b)(iv) and (vii)) |
E. | The Company has entered into a Lease Termination Agreement (the “Lease Termination Agreement”) with The Dover Centre LLC (the “Lessor”), dated as of August 27, 2002, terminating the lease of the Company’s corporate offices located at 110 Xxxxxxxx Xxxx, Xxxxxxxx, Xxxxxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxx X-000 in Building C of Phase I of the Dover Centre. Pursuant to the Lease Termination Agreement, the Company must pay Lessor $275,000. In connection with the Lease Termination Agreement, the Company has closed its corporate offices and sold certain office furniture and other equipment. (Section 3.10(b)(x)) |
F. | The Company has entered into Separation and Settlement Agreements (the “Separation and Settlement Agreements”) with the former employees listed below, which agreements require the payment of severance in the amounts set forth opposite their names (Section 3.10(b)(iii)): |
Name |
Title |
Severance | |||
Corporate Severance |
|||||
Xxxxxx, Xxxxx |
VP | $ | 28,739 | ||
Xxxxx, Xxx |
X | $ | 14,312 | ||
Xxxx, Xxxxxxxx |
AA | $ | 1,594 | ||
XxXxxxxx, Xxxx |
AA | $ | 2,160 | ||
Xxxx, Xxxxx |
AA | $ | 9,000 |
16
G. | The Company entered into a letter agreement (the “NAHC Settlement Agreement”) with New American Healthcare Corporation (“NAHC”) settling certain claims of the Company against NAHC stemming from the Company’s acquisition of certain hospitals from NAHC in August 2000. (Section 3.10(b)(xv)) |
H. | The Company amended that certain letter agreement (the “Overline Loan Agreement”), dated as of January 17, 2002, between the Company and certain subsidiaries, on the one hand, and Xxxxxx, on the other hand, generally extending the maturity date of the overline loan referenced therein (the “Overline Loan”) from August 31, 2002 to August 31, 2003. Any reference in this Company Disclosure Schedule to the Xxxxxx Loan Documents shall be deemed to include the Overline Loan Agreement. (Section 3.10(b)(x)) |
I. | The Company has entered into a Letter of Credit Reimbursement Agreement (the “Letter of Credit Reimbursement Agreement”), dated as of August , 2002, with Xxxxxxx X. Xxxx, X. Xxxxxx Xxxxxx, Chicago Private Investments, Inc., Xxxx X. Xxxxxxxx and Xxxxxxx X. Xxxxxxxx (collectively, the “Lending Directors”), on the other hand, relating to the reimbursement of the Lending Directors in the event the letters of credit maintained by the Lending Directors that secure the Overline Loan are drawn upon. Such reimbursement is to be in the form of Shares, as more fully described in the agreement. (Section 3.10(b)(xiii)) |
J. | The Company has entered into a Separation Agreement and General Release, dated as of , 2001, with Xxxx Xxxxxx (the “Xxxxxx Separation Agreement”) pursuant to which the Company redeemed from Xx. Xxxxxx a total of 450,670 Shares in consideration for, among other things, the forgiveness of certain loans from the Company. (Sections 3.10(b)(vii) and (xiii)) |
K. | The Company has entered into a Separation Agreement and General Release, dated as of June 24, 2002, with Xxxx Xxxxxx (the “Xxxxxx Separation Agreement”) pursuant to which the Company redeemed from Xx. Xxxxxx a total of 42,016 Shares. (Sections 3.10(b)(vii) and (xiii)) |
L. | The Company has entered into a Separation Agreement and General Release, dated as of July 15, 2002, with Xxxxx Xxxxxxxxx (the “Xxxxxxxxx Xxxxxxxxxx Agreement”). (Sections 3.10(b)(vii) and (xiii)) |
M. | The Company entered into that certain Amendment No. 4 to Mortgage Loan Agreement (the “Mortgage Loan Agreement”), dated as of March 31, 2002, between the Company and certain subsidiaries, on the one hand, and Xxxxxx, on the other hand, generally making certain modifications to certain financial covenant provisions in the Mortgage Loan Agreement. Any reference herein to the Xxxxxx Loan Documents is deemed to include this amendment. (Section 3.10(b)(x)) |
17
N. | The Company has entered into that certain Founders Stock Redemption Agreement (the “Founders Stock Redemption Agreement”), dated as of , 2002, between the Company, on the one hand, and certain founding shareholders of the Company, on the other hand, pursuant to which the Company will redeem certain shares held by such shareholders prior to the Closing. (Sections 3.10(b)(i) and (ii)) |
O. | The Company intends to make an election under Section 338(h)(10) of the Internal Revenue Code of 1986, as amended, with respect to the transactions effected pursuant to the GKPS Agreements. (Sections 3.10(b)(xvii)) |
18
Section 3.11
Litigation
X. | Xxxx |
1. | The Georgia Department of Community Health has alleged Medicaid overpayments of approximately $106,000 relating to periods during which the hospital was owned by New American Healthcare Corporation. The Company is no longer challenging this claim and has been reimbursed the amount of the overpayments pursuant to the NAHC Settlement Agreement. |
2. | See attached. |
X. | Xxxxxxxx |
See attached.
C. | Xxxxx Xxxxxxx |
See attached.
D. | Other |
See Section 3.9.E. of this Company Disclosure Schedule.
19
HEALTHMONT, INC.
Month End: 10/08/2002
ACTIVE/THREATENED/POTENTIAL LIGITATION-MASTER LIST
Hospital |
Case |
Incident Occurred |
Incident Reported |
Description |
Legal Action By Potential Plaintiff |
HealthMont Attorney |
Potential Plaintiff Request |
Current Status | ||||||||
Dolly |
3/14/01 | 5/21/01 | 25 y/o female admitted for chronic cholecystitis. Patient subsequently underwent laparascopic surgery & open choledochoduodenostmy with anastomosis. Patient had transsection of common bile duct. | Xxxx Xxxxxxxxxx Xxxxxxxxxx Law Firm 1700 Xxxx Xxxx Xxxxxx Xxxxxxx, XX 00000 015-570-1919 |
St. Xxxx notified | None to date | Precautionary file established | |||||||||
Adel |
03/26/01 | 06/07.01 | Patient admitted to ER due to auto accident. Patient received a chest Tube before being life-flighted to another facility. He complained that His wallet was missing with $4,300. Xxxxxxx’s office said the wife had The wallet. Later the family said there was the money missing along with A necklace and two rings. Two months later hospital received letter From atty stating the patient’s chest tube was installed incorrectly. | Xxxx Xxxxxxxxx Xxxxxxxx & Xxxxxxxxx, LLC 125 W. Columbus Street Dadeville, AL 36853 |
St. Xxxx notified | $4,300 and jewelry | Precautionary file established | |||||||||
09/29/01 | 02/05/02 | Patient born in hospital 9/29/01 then transferred to Xxxxxx? Patient was seen again on 10/31/01 and again on 11/22/01. Xx. Xxxxx Stated that patient is deceased but does not have any information. Patient was not brought to Adel. Hospital has received a request For medical records. | Xxxxxxxx, Xxxxxxxxx, Xxxxxxx & Wetherington 1000 X. Xxxxxxxxx Xx. Xxxxxxxx, XX 00000-0571 |
St. Xxxx notified | No request to date | Precautionary file established | ||||||||||
03/17/02 | 03/19/02 | Two year old treated in ER on morning of 3/17/02 for fever, Nausea, vomiting & loss of appetite and discharged home. Evening 3/17/02 ambulance brought child in code with Diagnosis of cardiorespiratory arrest, etiology unclear, child Deceased. Child also seen in ER 4 days prior with diagnosis Of influenza. Autopsy being performed. Medical records requested. | Xxxx &Holt 200 X. Xxxxxx Xxxxxx X.O. Box 1571 Valdosta, GA 31603-1571 |
St. Xxxx notified | No request to date | Precautionary file established | ||||||||||
01/30/01 | 08/28/02 | Patient brought to ER via EMS with diagnosis of Retroperitoneal hematoma, acute blood loss anemia. Patient transferred to South GA Med Ctr then expired. | Xxxxxxx, Xxxxxxx & Xxxxxxxx 700 00xx Xxx X Xxxxxxxx, XX 00000 029-273-7150 |
St. Xxxx notified | Copy of Medical Records | Precautionary file established | ||||||||||
11/07/00 | 08/03/02 | Patient to emergency room via EMS in full arrest. Entire record sent to Potential Plaintiff. | Xxxxxx, Xxxxxx, Xxxxxx & Xxxxxx, L.L.P. One Atlanta Plaza 950 Xxxx Xxxxx Xxxxx Xxxx N.E. Atlanta, GA |
St. Xxxx notified 08/30/2002 |
Copy of Medical Records | Precautionary file established | ||||||||||
02/07/02 | 10/04/02 | Patient seen in ER on 2/07/02 and claims she stumbled on steps in MRI unit Three days ago complaining of swollen right foot with redness to big toe. | X. Xxxx Xxxxxx PO Drawer 1188 Tifton, GA 31793 |
St. Xxxx notified 10/04/02 |
Copy of Medical Records | Precautionary file established | ||||||||||
Callaway |
03/29/01 | 04/04/01 | Patient reesented to ER with abdominal pain and subsequently died as a Result of a ruptured ectopic pregnancy. | Padberg Law Firm 1000 Xxxxxx Xxxxxx Xxxxx 000 Xx. Xxxxx, XX 00000 014-621-2900 |
St. Xxxx notified | Husband of deceased stated that he would be suing the hospital regarding the hospital care. | Notification of suit served on 4/3/02 | |||||||||
06/05/01 | 07/11/02 | Patient admitted for a bowel obstruction, experienced complications Following surgery and was transferred to another hospital. On 6/27/01 she expired. | Xxxxxx X. Xxxxxx Xxxxxx X. Xxxx & Assoc. Inc. 1000 Xxxxxx Xxxxxx, Xxxxx 000 Xx. Xxxxx, XX 00000-0322 314-621-3833 |
St. Xxxx notified | No request to date | Precautionary file established. |
20
Section 3.12
Employee Benefit Plans
A. | Employees at Adel, Georgia may purchase certain types of supplemental medical policies, and upon separation from service have the right to retain those policies. (Section 3.12(f)) |
B. | Each of the hospitals provides medical and dental coverage to its employees through welfare plans that are self-funded. The plans are administered by Employee Benefits Services. They maintain reinsurance generally for claims in excess of $50,000 through American National Insurance Company/CCH. (Section 3.12(g)) |
Section 3.12(l)
None
21
Section 3.14
Environmental Laws
None, other than as stated in the following Phase I and Phase II reports previously furnished to Parent:
A. | Phase I Environmental Site Assessment for Xxxxx Xxxxxxx Memorial Hospital dated June 26, 2000. |
B. | Phase I Environmental Site Assessment for Memorial Hospital of Adel dated June 26, 2000. |
C. | Report of Phase I Environmental Site Assessment for Callaway Community Hospital dated December 5, 2000. |
D. | Report of Limited Phase II Environmental Site Assessment for Callaway Community Hospital dated December 5, 2000. |
22
Section 3.17
Employees
23
GENERAL LIST
24
HealthMont, Inc. Corporate Office Employees as of 04/01/02
“Confidential portion of material has been omitted and filed separately with the SEC”
25
HealthMont, Inc.
Board of Directors
Annual Consulting Compensation Amounts
Board Member |
Annual Compensation | ||
Xxx X. Xxxxx |
$ | 15,000.00 | |
Xxxx X. Xxxxxxxx |
$ | 15,000.00 | |
X. Xxxxxx Xxxxxx |
$ | 49,000.00 | |
Xxx X. Xxxx |
$ | 15,000.00 | |
Xxxx X. Xxxxxx |
$ | 15,000.00 | |
Xxxxxxx X. Xxxxxxxx |
$ | 44,000.00 | |
Xxxxx X. Xxxxxxxx |
$ | 15,000.00 | |
Total |
$ | 168,000.00 | |
26
“Confidential portion of material has been omitted and filed separately with the SEC”
27
Section 3.19
Interested Party Transactions
Section 3.19(a)
A. | On August 31, 2000, the Company made a loan to Xxx Xxxx in the original principal amount of $ 89,000. Loan will be repaid at or prior to Closing, in the form of the Company shares as set forth in that certain Non-Competition Agreement and General Release, dated October , 2002, between Xxx Xxxx and the Company. |
B. | The Company has entered into the Director Consulting Agreements. |
C. | The Company intends to effect the Divestco Disposition. |
D. | The Company has entered into the Letter of Credit Reimbursement Agreement. |
Section 3.19(b)
None
Section 3.19(c)
None
28
Section 3.20
Contracts
Section 3.20(a)
A. | General Agreements |
1. | Amended and Restated Employment Agreement, dated as of February 1, 2002, between the Company and Xxxxxxx X. Xxxx. |
2. | Xxxxxx Separation Agreement. |
3. | Xxxxxx Separation Agreement. |
4. | Shareholders’ Agreement. |
5. | Xxxxxx Loan Documents. |
6. | Asset Purchase Agreement, dated as of August 31, 2000, among the Company, on the one hand, and NAHC and certain of its subsidiaries, on the other hand, and certain agreements related thereto (the “NAHC Agreements”). |
7. | Stock Purchase Agreement, dated as of February 28, 2002, between the Company and GKPS, and certain agreements related thereto (the “GKPS Agreements”). |
8. | Agreement between the Company and Healthcare Management Systems, Inc. (software license) |
9. | End of Lease Supplement, dated September 6, 2001, between the Company and IBM Credit Corporation, amending that certain Term Lease Master Agreement, dated April 27, 1998, and Quicklease Agreement, dated October 20, 1998, between New American Healthcare Corporation (computer hardware lease) |
• | Recurring Amounts Due: See End of Lease Supplement for schedule of monthly payments. |
29
10. | Agreement between the Company and Hospital Resource Management, L.C. (chargemaster maintenance) |
• | Dated: November 7, 2001 |
• | Amended: May 3, 2002 |
• | Recurring Amounts Due: $4,500 per month |
11. | Agreement between the Company and LBMC Healthcare Group (reimbursement services) |
12. | Agreement between the Company and MSLI, GP (license for Microsoft software) |
13. | Lease Agreement between the Company and The Dover Centre, LLC (office lease). This Lease Agreement was terminated, generally effective as of September 15, 2002, pursuant to the Lease Termination Agreement. |
14. | Agreement between the Company and Minnesota Mining and Manufacturing Company (coding software license) |
15. | Agreement between the Company and X.X. Xxxxx Leasing (copiers at the Company facilities, including the Hospitals) |
16. | Agreement between the Company and SSI Group Inc. (software license) |
17. | Property Tax Consulting Agreement with the Company: |
• | Dated: October 26, 2001 |
• | Name: Xxxxxx, XxXxxxx & Associates, Inc. |
• | Services: Property Tax Consultants |
• | Rate of Compensation: $1,250 flat fee per hospital/$10 per bed |
18. | Comdisco Lease Agreement |
19. | Agreement between the Company and MCI WorldCom Communications, Inc. (telecommunications/internet services) |
20. | Agreement between the Company and Broadline (group purchasing agreement) |
21. | LinvaTec Leases |
22. | GKPS Settlement Agreements |
23. | Lease Termination Agreement |
30
24. | Separation and Settlement Agreements |
25. | NAHC Settlement Agreement |
26. | Letter of Credit Reimbursement Agreement |
27. | Xxxxxxxxx Xxxxxxxxxx Agreement |
28. | Service Agreement between the Company and Cambridge Integrated Services Group, Incorporated (claims management) |
• | Dated: October 1, 2002 |
• | Termination Date: September 30, 2003 |
29. | Services Agreement between the Company and Xxxxx X. Xxxxxx (information services) |
• | Dated: September 23, 2002 |
• | Termination Date: December 31, 2002 |
30. | Founders Stock Redemption Agreement. |
B. | Agreements Related to Adel |
1. | Lease Agreement between the Company and Xxxx Xxxxx (lease of annex on North Xxxxxxxxxx) |
• | Commencement Date: October 30, 1998 |
• | Termination Date: October 31, 2005 |
• | Recurring Amounts Due: $1,800 per month as of November 1, 2000 (subject to annual increases) |
2. | Following month-to-month lease agreements related to leases of the real property described in subparagraphs 3 through 7 of Section 3.24A of the Company Disclosure Schedule: |
(a) | Home Health Building located at 1905 South Xxxxxxxxxx, Xxxx, Georgia |
• | Commencement Date: November 1, 1998 |
• | Recurring Amount Due: $1,250 per month |
(b) | Medical Record Storage Building located at 100 Xxxxxxxx Xxxxx |
• | Commencement Date: June 7, 1999 |
• | Recurring Amount Due: $600 per month |
(c) | Surgeon’s Office located at 900 X. Xxxxxxx, Xxxx Xxxxxxx |
31
• | Commencement Date: July 1, 2000 |
• | Recurring Amount Due: $500 per month |
(d) | Memorial Hospital Annex located at 8000 X. Xxxxxxxxxx, Xxxx, Xxxxxxx |
• | Commencement Date: June 15, 2000 |
• | Recurring Amount Due: $500 per month |
3. | Equipment Lease between HealthMont of Georgia, Inc. and Acuson Corporation |
• | Signing Date: October 17, 2000, by Company; May 16, 2001, by Acuson |
• | Termination Date: 60 months commencing on Term Commencement Date (undefined) |
• | Recurring Amounts Due: $4,266.97 per month |
4. | Magnetic Resonance Imaging Shared Service Agreement between HealthMont of Georgia, Inc. and Diversified Imaging Services, Inc. (MRI Services) |
• | Commencement Date: November 1, 2000 |
• | Termination Date: November 1, 2002, renewable for one successive one-year period |
• | Recurring Amounts Due: See Fee Schedule, Section 15 |
5. | Agreement between HealthMont of Georgia, Inc. and Xxxxxxx Enterprises (preventive maintenance for hospital systems) |
• | Commencement Date: October 1, 2000 |
• | Termination Date: September 30, 2001 |
• | Recurring Amounts Due: $900 per month |
• | Addendum I: October 19, 2000 |
• | Addendum II: October 19, 2000 |
6. | Agreement between HealthMont of Georgia, Inc. and Xxxxxxxx Management Specialists, Inc. (food services) |
• | Commencement Date: September 1, 2000 |
• | Termination Date: Renewable for one-year periods |
• | Recurring Amounts Due: Regular Monthly Billing, including management fee, pursuant to Article 2 |
• | Amendment: August 1, 2002 |
32
7. | Master Rental and License Agreement between HealthMont of Georgia, Inc. and Pyxis Corporation |
• | Dated: May 1, 2001 |
• | Termination Date: 60 months from April 1, 2001 |
• | Recurring Amounts Due: $2,844 per month |
8. | Physician Recruitment Agreement |
• | Dated: July 26, 2001 |
• | Name: Xxxx Xxxxxxx, DPM |
• | Position: Podiatrist |
• | Rate of Compensation: Income guarantee based on gross receipts of [****] per year, which amount is split with hospital in Nashville, Georgia |
• | Termination Date: September 30, 2004 |
• | Addendum: July 26, 2001 |
9. | Managed Care Contract between Memorial Hospital of Adel, Inc. and Blue Cross and Blue Shield of Georgia, Inc. |
• | Dated: May 15, 1997 |
• | Termination Date: Renewable one-year terms |
• | Amendment: April 5, 2002 |
10. | Professional Services Agreement |
• | Dated: March 19, 1997 |
• | Name: Xxxxxx Xxxxxxx, M.D. |
• | Position: Family Practice |
• | Rate of Compensation: Provides for payments based on physician’s net revenue |
• | Termination Date: June 30, 2001 (loan forgiveness period extends for as long as physician working at hospital) |
11. | Physician Assistance Agreement |
• | Dated: October 11, 1999 |
• | Name: Xxxx X. Xxxxxxxxx, Xx., M.D. |
• | Position: Family Practice |
• | Rate of Compensation: Income guarantee based on net receipts of [****] per year |
• | Termination Date: August 1, 2003 (by letter dated 12/13/01, it looks like he may have wanted to repudiate the contract) |
[****] Confidential portion of material has been omitted and filed separately with the SEC.
33
12. | Lease Agreement between the Company and GE Capital Healthcare Financial Services (lease of GEGS Millennium MPS) |
• | Commencement Date: March 19, 2002 |
• | Termination Date: 60 months from Commencement Date |
• | Recurring Amount Due: $3,713.50 per month plus tax |
13. | Lease Agreement between the Company and GE Healthcare Financial Services (lease of GE Sanographic 800T) |
• | Commencement Date: March 19, 2002 |
• | Termination Date: 60 months from Commencement Date |
• | Recurring Amount Due: $1,216.08 per month plus tax |
14. | Exclusive Professional Services Agreement |
• | Dated: October 1, 2001 |
• | Name: General Anesthesia Services, LLC |
• | Services: Anesthesia Services |
• | Rate of Compensation: [****] per year |
• | Termination Date: September 30, 2004 |
15. | Physician Recruitment Agreement |
• | Dated: July 25, 2001 |
• | Name: Xxxx X. Xxxxxx, M.D. |
• | Position: Obstetrician and Gynecologist |
• | Rate of Compensation: Income guarantee based on gross receipts of [****] per year to be split with hospital in Nashville, Georgia (60% to be paid by Xxxx) |
• | Termination Date: September 30, 2002 (provides for two-year forgiveness of loan period up to September 30, 2004) |
16. | Mobile MRI Services Agreement |
• | Dated: August 14, 2002 |
• | Name: Shared Imaging |
• | Commencement Date: November 2002 |
• | Termination Date: 12 months following Commencement Date |
• | Recurring Amounts Due: See Exhibit A, page 1 |
17. | Cooperating Provider Network Hospital Cooperating Provider Agreement between Memorial Hospital of Adel and America’s Health Plan, Inc., dated July 1, 1997. |
[****] Confidential portion of material has been omitted and filed separately with the SEC.
34
18. | Health Care Provider Network Agreement Hospital – National between BCE Emergis Corporation and Memorial Hospital of Adel, dated August 1, 2002. |
19. | Master Preferred Provider Network Hospital Agreement between Beech Street Corporation and Memorial Hospital of Adel, Inc., dated January 27, 1997. |
20. | Facility Contract between Community Care Network, Inc. and Memorial Hospital of Adel, Inc., dated December 10, 1997. |
21. | Hospital Participation Agreement between the State of Georgia, Department of Community Health, Division of Public Employee Health Benefits and Memorial Hospital of Adel, dated January 1, 2000. |
22. | Agreement between CompFirst, Inc. and Memorial Hospital of Adel, Inc., dated August 21, 1997. |
23. | Hospital Contract between First Health Group Corp., acting in its capacity as owner and operator of The First Health® Network and Memorial Hospital of Adel, dated March 2, 1999, and amended on March 2, 1999, March 10, 1999, and June 12, 2000. |
24. | Hospital Participation Agreement, State of Georgia, between FOCUS Healthcare Management, Inc. and Memorial Hospital of Adel, Inc., dated January 16, 1998. |
25. | Hospital Participation Agreement for the State of Georgia Department of Community Health (DCH) between Memorial Hospital of Adel, Inc. and Georgia 1st, Inc., dated April 4, 2000. |
26. | Hospital Agreement between Memorial Hospital of Adel and Humana Military Healthcare Services, Inc., dated September 29, 1998. |
27. | PPO Participating Facility Agreement between MultiPlan, Inc. and Memorial Hospital of Adel, dated May 2, 1995. |
28. | Network Facility Agreement between National Provider Network, Incorporated and Memorial Hospital, dated July 13, 1999. |
29. | PPO Hospital Participation Agreement between Principal Health Care of Georgia, Inc. and Memorial Hospital of Adel, dated March 1, 1998. |
30. | Provider Agreement between Memorial Hospital of Adel and Provider Networks of America, Inc., dated April 4, 1997. |
35
31. | Affiliate Hospital Participation Agreement between South Georgia Health Partners, L.L.C. and Memorial Hospital of Adel, dated September 17, 2001. |
32. | Hospital Agreement between SpecialNet, Inc. and Memorial Hospital of Adel, dated March 1, 1998. |
33. | Participating Hospital Agreement between UNICARE Life & Health Insurance Company and Memorial Hospital of Adel, dated September 25, 1998. |
34. | Health Care Service Facility Agreement between Memorial Hospital of Adel and USA Managed Care Organization, Inc., dated August 26, 1997. |
C. | Agreements Related to Callaway |
1. | Managed Care Contract between HealthMont of Missouri, Inc. and Xxxx Corporation d/b/a American Health Group, dated October 1, 2001. |
2. | Managed Care Contract between Callaway Community Hospital and Right Choice Managed Care, Inc. (Blue Cross/Blue Shield), dated February 10, 2000. |
3. | Managed Care Contract between HealthMont of Missouri, Inc. and Beech Street Corporation, dated February 1, 2001. |
4. | Agreement between HealthMont of Missouri, Inc. and Chem/Aqua (water quality assurance program) |
• | Commencement Date: January 4, 2002 |
• | Termination Date: January 3, 2003 |
• | Recurring Amount Due: $716.45 per month plus taxes and freight |
5. | Managed Care Agreement between HealthMont of Missouri, Inc. and Health Value Management, Inc. |
6. | Managed Care Contract between HealthMont of Missouri, Inc. and Cigna HealthCare of St. Louis, Inc., dated October 1, 2001. |
7. | Managed Care Contract between HealthMont of Missouri, Inc. and CorVel Corporation, dated May 31, 2001. |
36
8. | Physical Therapy Agreement |
• | Dated: March 1, 2002 |
• | Termination Date: March 1, 2005 |
• | Name: Xxxxxxxxxxx Physical Therapy, P.C. |
• | Services: Physical Therapy |
• | Rate of Compensation: [****] per outpatient and [****] per inpatient |
9. | Agreement between HealthMont of Missouri, Inc. and Specialized Imaging Services, Inc. (nuclear medicine equipment rental) |
• | Dated: February 1, 2002 |
• | Termination Date: February 1, 2005 |
• | Recurring Amount Due: $2,700 per month |
10. | Emergency Services Agreement |
• | Dated: September 26, 2001 |
• | Termination Date: One-year renewable terms |
• | Name: ECS of Missouri, Inc. |
• | Services: Emergency Services |
• | Rate of Compensation: Approximately [****] annually |
11. | Physician Employment Agreement |
• | Dated: January 24, 2002 |
• | Name: Xxxxxxx X. Xxxxxx, M.D. |
• | Position: Internal Medicine Physician |
• | Rate of Compensation: Base rate of [****], plus bonus award |
• | Termination Date: (three years from commencement date which was based on the approval of, or entry into U.S. in, H-1B status and receipt of J-1 visa waiver) |
12. | Agreement between HealthMont of Missouri, Inc. and Xxxxxx X. Xxxxx, M.D. and Xxxx X. Xxxxx (lease for hospital space) |
• | Commencement Date: January 1, 2001 |
• | Termination Date: January 1, 2002 |
• | Recurring Amount Due: [****] per month |
[****] Confidential portion of material has been omitted and filed separately with the SEC.
37
13. | Managed Care Agreement between HealthMont of Missouri, Inc. and HealthCare and USA of Missouri, LLC |
• | Dated: April 1, 1996 |
• | Amendment Number 1: March 5, 1996 |
• | Amendment Number 2: December 1, 2001 |
14. | Managed Care Agreement between HealthMont of Missouri, Inc. and HealthLink HMO, Inc., dated August 1, 2001. |
15. | Managed Care Contract between HealthMont of Missouri, Inc. and HealthLink, Inc., dated August 1, 2001. |
16. | Managed Care Contract between HealthMont of Missouri, Inc. and Humana Kansas City, Inc. and Humana Insurance Company, dated September 12, 2001. |
17. | Childbirth Instruction Agreement |
• | Dated: March 20, 2002 |
• | Name: Xxxx Xxxxxxx |
• | Services: Pre-Natal Classes |
• | Rate of Compensation: [****] per 6-week session |
• | Termination Date: Term is for six 6-week sessions |
18. | Physical Therapy Agreement |
• | Dated: January 1, 2001 |
• | Name: Xxxxxx X. Xxxxxxx |
• | Services: Home Health Physical Therapy |
• | Rate of Compensation: [****] per visit and $0.30 per mile |
• | Termination Date: Originally January 1, 2002 with renewable one-year terms |
19. | Agreement for Biological Specimen Collection |
• | Dated: February 26, 2002 |
• | Termination Date: None; can be terminated by either party with 30 days’ notice |
• | Name: LabOne |
• | Services: Biological specimen Collection |
[****] Confidential portion of material has been omitted and filed separately with the SEC.
38
20. | Professional Services Agreement |
• | Dated: January 1, 2001 |
• | Name: Professional Associates, LLC |
• | Services: Home Health Medical Social Services |
• | Rate of Compensation: [****] per visit and $0.31 per mile |
• | Expiration Date: Originally January 1, 2002 with one-year renewable terms |
21. | Consulting Agreement |
• | Dated: April 9, 2001 |
• | Name: Midwest Radiation Safety Consultants |
• | Services: Nuclear Medicine Consulting |
• | Rate of Compensation: [****] per quarter |
• | Termination Date: April 9, 2002 with renewable one-year terms |
22. | Managed Care Contract between HealthMont of Missouri, Inc. and Missouri Care Health Plan, dated April 1, 2002. |
23. | Managed Care Agreement between HealthMont of Missouri, Inc. and Multiplan, Inc. |
24. | Managed Care Agreement between HealthMont of Missouri, Inc. and One Health Plan of Kansas Missouri, Inc., dated December 5, 2001. |
25. | Pharmacy Services Agreement |
• | Dated: May 16, 2002 |
• | Name: PharmaSource Healthcare, Inc. |
• | Services: Operation and Management of Hospital Pharmacy Department |
• | Rate of Compensation: [****] per month and 127% of actual salary costs |
• | Termination Date: May 7, 2004 with renewable two-year terms |
26. | Managed Care Contract between HealthMont of Missouri, Inc. and ppoNEXT, Inc., dated December 1, 2001. |
27. | Managed Care Contract between HealthMont of Missouri, Inc. and Private Healthcare Systems, Inc., dated April 26, 2001. |
28. | Rapid Response Testing and Specimen Collection Agreement |
• | Dated: May 30, 2001 |
2. | Managed Care agreement between HealthMont of Texas I, LLC and AmCare Health Plans of Texas, Inc., dated April 1, 2002. |
3. | Agreement between HealthMont of Texas I, LLC and AES NewEnergy, Inc. (retail electric services) |
• | Dated: January 3, 2002 |
• | Termination Date: February 2003 |
• | Recurring Amounts Due: Based on monthly utility usage |
4. | Professional Services Agreement |
• | Dated: April 17, 2001 |
• | Name: A.S.A.P. Nursing Agency, LLC |
• | Services: Nursing Services |
[****] Confidential portion of material has been omitted and filed separately with the SEC.
39
• | Name: Quest Diagnostics Inc. |
• | Services: Rapid response testing and specimen collection |
• | Rate of Compensation: Attachment 1 lists payment terms for various testing |
• | Termination Date: May 30, 2002 |
29. | Sleep Disorder Testing Agreement |
• | Dated: April 1, 2002 |
• | Name: WH Somnography Sleep Disorder Labs |
• | Services: Provide in-hospital sleep disorder testing |
• | Rate of Compensation: Dependent on healthcare plan of patient |
• | Termination Date: April 30, 2004 |
30. | Managed Care Contract between HealthMont of Missouri, Inc. and UnitedHealthcare of the Midwest, Inc., dated September 15, 2001. |
31. | Managed Care Contract between HealthMont of Missouri, Inc. and USA Managed Care Organization, Inc. |
• | Dated: September 2, 1997 |
• | Termination Date: Renewable one-year terms |
32. | Agreement for Medical and Related Services between HealthMont of Missouri, Inc. doing business as Callaway Community Hospital and Xxxxxx State Hospital, dated March 27, 2001. |
33. | Hospital Participation Agreement between Group Health Plan, Inc. and Callaway Community Hospital, dated June 19, 1997, and amended April 8, 1998. |
34. | Hospital Contract between Affordable Health Care Concepts and Callaway Community Hospital, dated July 22, 1993. |
35. | Nurse Practitioner Recruitment Agreement, dated September 16, 2002, between HealthMont of Missouri, Inc. and Xxxxxxx Xxxxx Xxxxxxx. |
D. | Agreements Related to Xxxxx Xxxxxxx |
1. | Agreement between HealthMont of Texas I, LLC and Alcon Laboratories (equipment lease for Phaco Machine) |
• | Commencement Date: February 2002 |
• | Termination Date: February 2005 |
• | Recurring Amounts Due: $394.06 per month |
40
• | Rate of Compensation: Rate solicited under Section 3 of Agreement |
• | Termination Date: April 17, 2003 |
5. | Agreement between HealthMont of Texas I, LLC and Xxxxxxx Xxxxxxx (lease of laboratory equipment) |
• | Dated: February 28, 2002 |
• | Termination Date: February 28, 2007 |
• | Recurring Amounts Due: Approximately $10,800 per month |
6. | Physician Recruitment Agreement |
• | Date: January 14, 2002 |
• | Name: Xxxxxxxxx Xxxxxxxx |
• | Position: Internal Medicine Physician |
• | Rate of Compensation: Income guarantee based on gross receipts of [****] per month |
• | Termination Date: December 2, 2003 but loan forgiveness period continues until December 2, 2005 |
7. | Managed Care Agreement between NAHC II of Texas, Inc. and USA Managed Care Organization, Inc. (children’s health insurance program—“CHIP”) |
8. | Emergency Services Agreement |
• | Commencement Date: November 1, 1998 |
• | Name: Emergency Care Specialists of Texas, P.A. |
• | Services: Emergency medical services |
• | Rate of Compensation: [****] per month |
• | Termination Date: Original termination date October 31, 2001 |
[****] Confidential portion of material has been omitted and filed separately with the SEC.
41
• | Amended: September 1, 2000 |
9. | Managed Care Agreement between HealthMont of Texas I, LLC and Health Value Management, Inc. |
10. | Nursing Services Agreement |
• | Dated: February 15, 2001 |
• | Name: Intensivo Nursing Service, Inc. |
• | Services: Nursing staff coverage |
• | Rate of Compensation: Rate schedule on Exhibit A of Agreement |
• | Termination Date: Originally February 15, 2002 |
11. | Physician Recruitment Agreement |
• | Dated: June 6, 2001 |
• | Name: Xxxxxxx Xxxxxxxxx, D.O. |
• | Position: Family Medicine Practitioner |
• | Rate of Compensation: Income guarantee based on gross receipts of [****] per month |
• | Termination Date: Original term ends August 12, 2002 and forgiveness of loan period ends August 12, 2005 |
12. | Medical Staffing Agreement |
• | Commencement Date: May 17, 2001 |
• | Name: Medical Staffing Network, Inc. |
• | Services: Nurse staffing services |
• | Rate of Compensation: Rates on last page of agreement |
• | Termination Date: Original term ends May 16, 2002 unless renewed |
13. | Managed Care Agreement between HealthMont of Texas I, LLC and Private Healthcare Systems, Inc., dated November 5, 2001. |
14. | Administrative Services Agreement |
• | Dated: November 17, 1999 |
• | Name: Special Care Hospital Management Corporation |
• | Services: Inpatient emergency medical/surgical detoxification services and chemical dependency education |
• | Rate of Compensation: [****] per month |
• | Termination Date: Original termination date September 1, 2002 with renewable one-year terms |
[****] Confidential portion of material has been omitted and filed separately with the SEC.
42
15. | Managed Care Contract between HealthMont of Texas I, LLC and Texas Department of Health |
16. | Managed Care Contract between HealthMont of Texas I, LLC and Texas Rehabilitation Commission, dated October 20, 1996. |
17. | Managed Care Contract between HealthMont of Texas I, LLC and Texas True Choice, Inc./Ethix Southwest, Inc., dated August 7, 2001. |
18. | Managed Care Contract between HealthMont of Texas I, LLC and UnitedHealthcare of Texas, Inc., UnitedHealthcare Insurance Company, United Healthcare Services, Inc. and United Health Networks, Inc. |
19. | Managed Care Contract between HealthMont of Texas I, LLC and UP & UP Health Services, dated May 1, 1996. |
20. | Agreement between HealthMont of Texas I, LLC and The Scope Exchange, Inc. (lease of GI equipment) |
• | Commencement Date: January 24, 2002 |
• | Termination Date: January 24, 2005 |
• | Recurring Amount Due: $2,400 per month |
21. | Agreement between HealthMont of Texas I, LLC and Regions Financial Corporation (master equipment lease for telephone system) |
22. | Purchase/Service Agreement between HealthMont of Texas I, LLC and AVAYA Communication (purchase of telephone system) |
23. | Term promissory note from Petros Chapanos, M.D. in the original principal amount of $55,000, maturity date: January 1, 2007 |
24. | Term promissory note from Xxxxxx Xxxxx, M.D. in the original principal amount of $25,000, maturity date: February 1, 2005 |
25. | Term promissory note from Xxxx X. Xxxxxxxx, D.O. in the original principal amount of $50,000; maturity date: March 1, 2005 |
26. | Managed Care Agreement with South Texas Veterans Health Care System. |
27. | Managed Care Agreement with USC Health Services, dated May 1, 1998. |
28. | Managed Care Agreement with Unicare Life and Health Insurance Company, dated July 28, 1998. |
43
29. | Managed Care Agreement with Texas Municipal League Group Benefits Risk Pool/TML Intergovernmental Employee Benefits Pool, dated July 28, 1998. |
30. | Managed Care Agreement with ProAmerica Managed Care Inc., dated July 1, 1994 and amended July 17, 1999. |
31. | Managed Care Agreement with Preferred Health Network Inc., dated June 1, 1993 and amended April 12, 1993. |
32. | Managed Care Agreement with PHP Healthcare corporation dated October 15, 1997. |
33. | Managed Care Agreement with Xxxxxx Healthcare Network LLC. |
34. | Managed Care Agreement with MultiPlan Inc., dated March 1, 1993. |
35. | Managed Care Agreement with National Healthcare Alliance Inc., dated June 1, 1994. |
36. | Managed Care Agreement with MedicalControl Network Solutions, Inc., dated June 1, 1999. |
37. | Managed Care Agreement with MedCorp. Southwest, Inc., dated May 1, 1993. |
38. | Managed Care Agreement with Med-Care Advantage Corp., dated December 15, 1995. |
39. | Managed Care Agreement with HealthSmart Preferred Care, Inc., dated April 10, 2000. |
40. | Managed Care Agreement with Health Strategies, Inc., dated January 1, 1994. |
41. | Managed Care Agreement with Guardian Resources, Inc., dated August 1, 1998. |
42. | Managed Care Agreement with BCBSTX, dated July 15, 1996 and amended April 3, 2000. |
43. | Managed Care Agreement with Teachers Retirement System of Texas, Inc. |
44
Section 3.20(a)(i)
None
Section 3.2(a)(vii)
None
Section 3.20(b)
None
Section 3.20(c)
None
45
Section 3.21
Licenses and Accreditations
X. | Xxxx Licenses and Accreditations |
1. | Hospital Permit granted November 1, 1998 by the Georgia Department of Human Resources, Effective Date 9/1/2000, #037-597 |
2. | Nursing Home or Intermediate Care Home Permit issued November 1, 1998 by the Georgia Department of Human Resources, 0-000-0000 |
3. | Home Health Agency License granted to Memorial Hospital of Adel to operate Memorial Home Health, license granted by the Georgia Department of Human Resources, effective 10/1/01 – 9/30/02, #037-101 |
4. | Occupation Tax Certification No. 375 issued by the City of Adel, Georgia, expiration date December 31, 2002. Boiler and Pressure Vessel Operating Permit, expiration date April 30, 1992. Certificate of Inspection of Boiler Room issued April 8, 1999 by Georgia Department of Labor, expiration date April 1, 2000 (inspection has been delayed; new certificate cannot be issued until inspection is performed); Certificate of Inspection of new wing and fire tube issued May 6, 1999 by Georgia Department of Labor, expiration date May 1, 2002 (new inspection to be scheduled by Zurich, the company that insures the boilers, as soon as possible). |
5. | Control Substance Registration Certificate, DEA registration no. XX0000000 and DEA registration no. XX0000000, issued by the United States Department of Justice Drug Enforcement Administration, expiration date January 31, 2002, #XX0000000, expires 1/31/05 and #XX0000000, expires 10/31/03. |
6. | Georgia State Board of Pharmacy, Pharmacy and License No. 005557 issued by the State of Georgia, expiration date June 30, 2001, #005557, expires 6/30/03. |
7. | CLIA Laboratory Certificate of Accreditation issued by the Department of Health and Human Services Healthcare Financing Administration, CLI ID No. 11D0265621, expiration date November 17, 2001, expires 11/17/03. |
8. | Certified Mammography Facility, as certified by the U.S. Department of Health and Human Services Public Health Service Food and Drug Administration, expiration date February 28, 2003. |
9. | Georgia Radioactive Materials License issued by the Georgia Department of Natural Resources, license no. GA.571-1, expiration date 8/31/05. |
10. | Accreditation by the Joint Commission on Accreditation of Healthcare Organizations, 2000-2003. |
B. | Xxxxx Xxxxxxx Licenses and Accreditations |
46
1. | Hospital License No. 000245 from the Texas Department of Health, expiration August 31, 2002. |
2. | Texas Sales and Use Tax Permit for Tax Payer No. 3-00029-3302-3, effective October 21, 1976. |
3. | Pharmacy License issued by the Texas Board of Pharmacy to Xxxxx Xxxxxxx Memorial Hospital, #20672, expiration 11/02. |
4. | Controlled Substance Registration Certificate issued by the United States Department of Justice Drug Enforcement Administration, DEA registration no. XX0000000, expiration October 31, 2000, #XX0000000, expiration 6/30/03. |
5. | CLIA Laboratory Certificate of Accreditation issued by the Department of Health and Human Services Health Care Financing Administration, #45D0660557, expiration 11/30/03. |
6. | Radioactive Material License No. L04567, issued by the Texas Department of Health Bureau of Radiation Control, expiration date April 30, 2002. |
7. | Accreditation issued by the Joint Commission on Accreditation of Health Care Organizations dated July 1, 1998 effective for three years from April 18, 1998. |
8. | Petroleum Storage Tank registered to New American Healthcare Corp. by the Texas Natural Resource Conservation Commission (“TNRCC”), Facility ID No. 69803, Owner Account ID No. 53650, registration does not expire but TNRCC requires notification of transfer of ownership. |
9. | Boiler Certificate of Operation, #C-99L07993, expiration date 10/27/03. |
X. | Xxxxxxxx Licenses and Accreditations |
1. | Missouri Department of Health & Senior Services – CCH License, Expiration Date: 12/31/2002, License #463-1 |
2. | Missouri Department of Health Home Health License, Expiration Date: 11/30/2002, License #709 |
3. | City of Xxxxxx Business License, Expiration Date: 02/28/2003, License #20010600 |
47
4. | DEA, Expiration Date: 08/31/2003, License #XX0000000 |
5. | BNDD, Expiration Date: 12/31/2004, License #19605 |
6. | Missouri Board of Pharmacy, Expiration Date: 10/31/2003, License #2001000394 |
7. | HCFA, CLIA Certificate, Expiration Date: 11/30/2002, CLIA ID: 26D0446483 |
8. | Missouri Department of Health Certified Mammography Facility, Expiration Date: 12/31/2002 |
9. | JCAHO, 2003 |
48
Section 3.22
Insurance
HEALTHMONT, INC.
Full List of Lines of Coverage
Covered Hospitals
Xxxxx Xxxxxxx Memorial Hospital—Retro Date: September 1, 2000
Memorial Hospital of Adel, Inc.—Retro Date: September 1, 2000
Xxxxxxxx Community Hospital—Retro Date: January 1, 2001
Coverage Line |
Carrier |
Policy # |
Limits | ||||||
Property |
Zurich | [****] 8/31/00—8/31/02 |
$ | 147,508,654 | Blanket | ||||
$ | 53,496,414 | Business Interruption | |||||||
$ | 15,000 | Deductible | |||||||
$ | 50,000 | Flood Limit | |||||||
$ | 50,000 | Earth Movement Limit | |||||||
$ | 15,000 | Deductible except for Woodland Park & Eastmoreland | |||||||
5% of PD and BI value or $100,000 whichever is greater | |||||||||
$ | 25,000 | Windstorm deductible applies to Dolly Memorial Hospital | |||||||
Hospital Professional Liability Hospital General Liability (GL & HPL)l |
St. Xxxx Fire & Marine | [****] 8/31/01—8/31/02 |
$ $ |
1,000,000 300,000 |
Each Occurrence Fire Damage—Each Event Pollution Liability Hazard—Ea. | ||||
Event | |||||||||
Pollution Liability Hazard | |||||||||
$ | 2,000,000 | Aggregate—All Events | |||||||
$ | 50 | Damage Deductible/Per claim | |||||||
$ | 250,000 | Deductible/Annual/Aggregate | |||||||
Umbrella Liability |
St. Xxxx Insurance Co. | [****] 8/31/01—8/31/02 |
$ $ |
10,000,000 10,000,000 |
Occurrence Limit Aggregate Limit | ||||
Automobile Liability |
St. Xxxx Mercury Insurance Co. | [****] 8/31/01—8/31/02 |
$ $ |
1,000,000 1,000,000 |
Limit of Liability Uninsured Motorists | ||||
$ | 2,000 | Medical Payments | |||||||
$ | 2,500 | Personal Injury Protection | |||||||
$ | 500 | Collision Deductible | |||||||
$ | 250 | Comprehensive Deductible | |||||||
Texas Automobiles |
St. Xxxx Mercury Insurance Co. | [****] 8/31/01—8/31/02 |
$ $ |
1,000,000 1,000,000 |
Limit of Liability Uninsured Motorists | ||||
$ | 2,500 | Medical payments | |||||||
$ | 2,500 | Personal Injury Protection | |||||||
$ | 500 | Collision Deductible | |||||||
$ | 250 | Comprehensive Deductible | |||||||
Workers Compensation |
American Home Assurance | [****] 8/31/01—8/31/02 |
State Statutory Limits | ||||||
Workers Compensation—Georgia |
[****] 8/31/01—8/31/02 |
||||||||
Employers Liability |
$ | 1,000,000 | Each Accident | ||||||
$ | 1,000,000 | Policy Limit | |||||||
$ | 1,000,000 | Each Employee | |||||||
Xxxxxxxx Community Hospital (Covered by Separate State policy) |
Missouri Hospital Association | [****] 1/01/02—1/01/03 |
|||||||
Heliport (Coverage for Xxxxxxxx Community Hospital) |
National Union | [****] 1/1/02—1/1/03 |
$ $ |
3,000,000 1,000 |
Per Occurrence Medical Payments Per Person | ||||
Sensitive Risk |
Gulf Insurance Company | [****] 8/31/01—8/31/02 |
$ $ |
3,000,000 250,000 |
Limit of Liability—Each Loss Maximum Benefit applicable to any one | ||||
person | |||||||||
$ | 1,250,000 | Aggregate Limit for any one accident | |||||||
Crime |
National Union Fire Insurance co. | [****] | $ | 1,000,000 | Fiduciary Limit | ||||
8/31/01—8/31/02 | $ | 25,000 | Deductible | ||||||
Fiduciary |
National Union Fire Insurance Co. | [****] | $ | 3,000,000 | Fiduciary Limit | ||||
4/31/00—4/31/01 | $ | 0 | Deductible | ||||||
Directors and Officers |
National Union Fire Insurance Co. | [****] | $ | 5,000,000 | Limit of Liability | ||||
Executive Directors & Officers |
8/31/01—8/31/02 | $ | 100,000 | Retention Limit | |||||
$ | 100,000 | Employment Practices |
[****] Confidential portion of material has been omitted and filed separately with the SEC.
49
SCHEDULE OF YOUR CURRENT INSURANCE
As of September 30, 2002
Prepared for: HealthMont, Inc.
Type of Coverage |
Policy Limits |
Policy Period |
Company & Policy Number |
Annual Premium | ||||||
Property |
Limit | 08/31/02 to 08/31/03 |
Zurich [****] |
$115,233 | ||||||
$36,062,431 | Blanket Occurrence Limit as follows: | |||||||||
Included | Building | |||||||||
Included | Contents | |||||||||
Included | Improvements and Betterments | |||||||||
Included | EDP | |||||||||
Included | Business Interruption | |||||||||
Sublimits | ||||||||||
$36,062,431 | Flood per occurrence at Premises Outside a 500 Year Flood Plain | |||||||||
$10,000,000 | Flood per occurrence at Premises Outside a 100 Year Flood Plain but Within a 500 Year Flood Plain | |||||||||
$ 5,000,000 | Flood per occurrence at Locations Within a 100 Year Flood Plain | |||||||||
Excluded | Earthquake (Zone 1) | |||||||||
$25,000,000 | Earthquake (Zone 2) | |||||||||
$36,062,431 | Earthquake Annual Aggregate (Zone 3 & 4) | |||||||||
$ 1,000 | Per Patient Property with $500,000 Annual Aggregate | |||||||||
$ 250,000 | Transit (Aggregate Liability in any single occurrence) | |||||||||
$ 5,000,000 | Valuable Paper | |||||||||
$ 2,500,000 | Accounts Receivable | |||||||||
$ 250,000 | Exhibition Floater | |||||||||
$ 1,000,000 | Service Interruption | |||||||||
$ 2,000,000 | Building Ordinance/Demolition/Increased Cost of Construction | |||||||||
$ 5,000,000 | Extra Expense—Schedule Premises |
[****] Confidential portion of material has been omitted and filed separately with the SEC.
Note: This Policy Schedule is only an outline of coverage that has been prepared for your convenience. Actual Policy Language must be consulted for any definitive evaluation of coverage terms and conditions.
50
SCHEDULE OF YOUR CURRENT INSURANCE
As of September 30, 2002
Prepared for: HealthMont, Inc.
Type of Coverage |
Policy Limits |
Policy Period |
Company & Policy Number |
Annual Premium | ||||||
Deductibles |
$ 25,000 | Except | ||||||||
1X Daily Average Value for Business Income | ||||||||||
$ 100,000 | Flood at Premises Outside a 500 Year Flood Plain | |||||||||
$ 250,000 | Flood at Premises Outside a 100 Year Flood Plain but Within a 500 Year Flood Plain | |||||||||
$ 500,000 | Flood each Building Within a 100 Year Flood Plain | |||||||||
$ 500,000 | Flood each Building Contents Within a 100 Year Flood Plain | |||||||||
$ 500,000 | Flood Business Income at Premises Within a 100 Year Flood Plain | |||||||||
$ 100,000 | Earthquake (Zone 3, 4 and 5) (Zone 1 excluded) | |||||||||
$ 100,000 | Wind except | |||||||||
$ 250,000 | For Xxxxx Xxxxxxx Memorial Hospital, San Benito, TX | |||||||||
$ 25,000 | Service Interruption Property Damage with 24 hour waiting period followed by a $25,000 deductible except 72 hour Waiting Period followed by a $25,000 deductible for Xxxxx Xxxxxxx Memorial Hospital | |||||||||
Boiler and Machinery Sublimits | $36,062,431 | Combined Property Damage/Business Interruption | 08/31/02 to 08/31/03 |
Zurich [****] |
Included | |||||
$ 1,000,000 | Spoilage | |||||||||
$ 25,000 | Hazardous Substance | |||||||||
$ 25,000 | Ammonia Contamination | |||||||||
$ 25,000 | Water Damage | |||||||||
Deductible: | $25,000 Property Damage | |||||||||
1 Times Average Daily Value for Business Interruption |
[****] Confidential portion of material has been omitted and filed separately with the SEC.
Note: This Policy Schedule is only an outline of coverage that has been prepared for your convenience. Actual Policy Language must be consulted for any definitive evaluation of coverage terms and conditions.
51
SCHEDULE OF YOUR CURRENT INSURANCE
As of September 30, 2002
Prepared for: HealthMont, Inc.
Type of Coverage |
Policy Limits |
Policy Period |
Company & Policy Number |
Annual Premium | ||||||||
General Liability/ |
$ | 3,000,000 | General Aggregate | 08/31/02 to | Lexington Insurance | $ | 1,350,000 + | |||||
(occurrence form) Health Care |
$ | 3,000,000 | Products and Completed Operations Aggregate | 08/31/03 | Company [****] |
|
Taxes and Surcharges | |||||
Professional (claims made) |
$ $ $ $ $ |
1,000,000 1,000,000 50,000 5,000 500,000 |
Personal and Advertising Injury Each Occurrence Limit Fire Damage Limit (any one fire) Medical Expenses Limit (any one person) Deductible |
|||||||||
Employee Benefits |
$ $ |
1,000,000 1,000 |
Aggregate Limit (claims made) Deductible |
Lexington Insurance Co. | Included | |||||||
Crime |
$ $ |
1,000,000 25,000 |
Limit of Liability Deductible |
08/31/02 to 08/31/03 |
National Union Fire Ins. Company [****] |
$ | 6,984 | |||||
Automobile |
$ $ $ $ $ $ |
1,000,000 1,000,000 2,000 35,000 250 500 |
Combined Single Limit Uninsured Motorist (Owned Autos) Medical Payments Hired Car Physical Damage Deductible—Comprehensive Deductible—Collision |
08/31/02 to 08/31/03 |
St. Xxxx Fire & Marine [****] |
$ | 9,379 | |||||
Automobile (Texas) |
$ $ $ $ $ $ |
1,000,000 1,000,000 2,500 35,000 250 500 |
Combined Single Limit Uninsured Motorist (Owned Autos) Medical Payments Hired Car Physical Damage Deductible—Comprehensive Deductible—Collision |
08/31/02 to 08/31/03 |
St. Xxxx Fire & Marine [****] |
$ | 1,146 | |||||
Aviation |
$ $ |
5,000,000 1,000 |
Each Occurrence Medical Expenses |
01/01/01 to 01/01/02 |
National Union [****] |
$ | 3,545 | |||||
[****] Confidential portion of material has been omitted and filed separately with the SEC.
* | This policy is on a “Claims Made” basis, which means that the policy in force at the time of the loss is the responding party. Late reporting could result in declination of coverage by the carrier. |
Note: This Policy Schedule is only an outline of coverage that has been prepared for your convenience. Actual Policy Language must be consulted for any definitive evaluation of coverage terms and conditions.
52
SCHEDULE OF YOUR CURRENT INSURANCE
As of September 30, 2002
Prepared for: HealthMont, Inc.
Type of Coverage |
Policy Limits |
Policy Period |
Company & Policy Number |
Annual Premium | ||||||
Workers Compensation |
Statutory | |||||||||
Employers Liability |
$1,000,000 $1,000,000 $1,000,000 |
Each Accident Policy Limit Each Employee |
08/31/02 to 08/31/03 |
American Home Assurance [****] |
$348,650 | |||||
Special Coverage |
$3,000,000 | Limit of Liability | 08/31/02 to 08/31/03 |
Gulf Insurance Company [****] |
$ 2,800 | |||||
Directors & Officers Liability | $5,000,000 $100,000 |
Limit of Liability Retention |
08/31/02 to 08/31/03 |
National Union Fire Ins. Co. [****] |
$ 97,500 | |||||
Fiduciary |
$3,000,000 $3,000,000 |
Each Loss Aggregate |
08/31/02 to 08/31/03 |
National Union Fire Ins. Co. [****] |
$ 7,300 |
[****] Confidential portion of material has been omitted and filed separately with the SEC.
Note: This Policy Schedule is only an outline of coverage that has been prepared for your convenience. Actual Policy Language must be consulted for any definitive evaluation of coverage terms and conditions.
53
Section 3.23
Books and Records
None.
54
Section 3.24
Real Property
Section 3.24(a)
A. | Adel Real Property |
1. | Memorial Hospital/Convalescent Center (owned) |
2. | OB/GYN Clinic located at 000 X. Xxxxxxx, Xxxx, Xxxxxxx (owned) |
3. | Home Health Building located at 1905 South Xxxxxxxxxx, Xxxx, Georgia (leased) |
4. | Medical Record Storage Building located at 000 X. Xxxxxxxx Xx., Xxxx, Xxxxxxx (leased) |
6. | Surgeon’s Office located at 000 X. Xxxxxxx, Xxxx, Xxxxxxx (leased) |
7. | Memorial Hospital Annex located at 000 X. Xxxxxxxxxx, Xxxx, Xxxxxxx (leased) |
B. | Xxxxx Xxxxxxx |
1. | Real property consists of 7.498 acres of land on the southeast quarter of block #81 of San Xxxxxx Land and Water Company Subdivision, City of San Benito, Texas, and the structures (hospital and maintenance building) that lie on the property. |
2. | Leases for the purpose of medical office practice are active for three parcels of the hospital building totaling approximately 4000 square feet. The Company is the lessor. |
X. | Xxxxxxxx |
See | attached description of owned real property. |
Under | the Xxxxxx Loan Documents, Xxxxxx possesses a Lien with respect to real property of the Company and the Subsidiaries. |
Section 3.24(c)
None.
55
Section 3.24(e)
None.
Section 3.24(f)
None.
56
Exhibit “A”
Legal Description
Part of Section 18, Township 47 North, Range 9 West, Callaway County, Missouri, described as follows:
Commencing at an Aluminum State Monument at the Southeast corner of said Section 18; thence N 81° 44’ 27” W, 1041.05 feet to a ½” iron pin at the Southwest corner of Lot 1, of the Corrected Plat of Westminster College Subdivision, Recorded in Plat Book 8, page 12, said point being the True Point of Beginning, thence N 89° 18’ 24” E along the north right of way line of South Hospital Drive, 165.00’ to a ½” iron pin at a point of curve; thence continuing along said North right of way line on a curve to the left having a central angle of 25° 05’ 08”, a radius of 795.00’, an arc distance of 348.07’, and a chord bearing and distance of N 76° 45’ 50” E, 345.30’ to a point of compound curve; thence continuing along said right of way line in a Northeasterly to Northwesterly direction, on a curve to the left having a central angle of 88° 50’ 00”, a radius of 625.00’, an arc distance of 969.02’, and a chord bearing and distance of N 19° 48’ 19” E, 874.84’ to a point of reverse curve; thence continue along the Westerly right of way line of said South Hospital Drive in a Northwesterly direction on a curve to the right having a central angle of 16° 15’ 00”, a radius of 1065.00’, an arc distance of 302.05’, and a chord bearing and distance of N 16° 29’ 13” W, 301.04’ to a concrete monument on the South right of way line of Missouri State Route “F”; thence S 81° 38’ 16” W along said right of way line, 135.00’ to a ½” iron pin at a point of curve; thence continue along said right of way line on a curve to the right having a central angle of 17° 07’ 09”, a radius of 1562.69’, an arc distance of 466.91’, and a chord bearing and distance of N 81° 18’ 24” W, 465.17’ to a ½” iron pin; thence leaving said right of way line S 20° 28’ 53” W, 152.75’ to a ½” iron pin; thence N 89° 58’ 07” W, 57.31’ to a ½” iron pin at the Northwest corner of said Lot 1; thence S 0° 15’ 35” W, along the West line of said Lot 1, 1076.28’ to the True Point of Beginning,
EXCEPT THEREFROM, a tract of land being a part of Lot 1 of the corrected Plat of Westminster College Subdivision #1, a subdivision filed for public record in Plat Book 8, Page 12, of Callaway County Land Records, located in Section 18, Township 47 North, Range 9 West, Callaway County, Missouri, described as follows: Commencing at a point on the Northern right of way line of South Hospital Drive, 50’ wide, said point being on the South boundary line of said Lot 1, said point bears N 89° 18’ 24” E, 39.17’ from the Southwest corner of said Lot 1; thence leaving said right of way line along the projection of the Southeast wall of the existing Hospital N 49° 45’ 02” E, 582.58’ to the corner of the existing wall; thence S 12° 32’ 32” E, 32.76’ to the True Point of Beginning, thence S 40° 14’ 58” E, 32.87’ to a point; thence S 49°45’ 02” W, 39.33’ to a point; thence N 40° 14’ 58” W, 32.87 feet to a point; thence N 49° 45’ 02” E, 39.33’ to the True Point of Beginning.
G230788.1
57
Section 3.25
Tangible Personal Property; Investment Assets
Section 3.25(a)
A. | Each lessor of equipment leased to the Company or any of its Subsidiaries possesses a Lien with respect to the equipment so leased. Such leases include those listed in Section 3.20(a)A.9, A.15, A.18, A.21, B.3, D.1, D.5, D.20, D.21. |
B. | Under the Xxxxxx Loan Documents, Xxxxxx possesses a Lien with respect to personal property of the Company and the Subsidiaries, including machinery, equipment, furniture and fixtures. |
Section 3.25(b)
None.
58
Section 3.26
Bank and Brokerage Accounts
HealthMont, Inc.
Bank Account Numbers
Account Number |
Intended Use |
Signatory | ||||
HealthMont, Inc. — Corporate |
||||||
Regions Bank 000 Xxxxxxxxx Xxxxxx Xxxxx |
[****] | CONCENTRATION | Xxxxxxx X. Xxxx, Xxxxxx X. Xxxxxxxxx | |||
Xxxxxxxx, TN 37067 |
[****] | Co-wide A/P | Xxxxxxx X. Xxxx, Xxxxxx X. Xxxxxxxxx | |||
[****] | Corp. Manual A/P | Xxxxxxx X. Xxxx, Xxxxxx X. Xxxxxxxxx | ||||
[****] | Co-wide Payroll | Xxxxxxx X. Xxxx, Xxxxxx X. Xxxxxxxxx | ||||
[****] | Management Payroll | Xxxxxxx X. Xxxx, Xxxxxx X. Xxxxxxxxx | ||||
[****] | Employee Benefits Medical Claims |
Xxxxxxx X. Xxxx, Xxxxxx X. Xxxxxxxxx, Xxxxxxx X. Xxx, Xxxxx X. Xxxx | ||||
[****] | Customer Debit Account | Xxxxxxx X. Xxxx, Xxxxxx X. Xxxxxxxxx | ||||
BankOne, Texas 0000 Xxxx Xxxxxx Xxxxxx, XX 00000 |
[****] | Lockbox Account | Xxxxxxx X. Xxxx | |||
Xxxxx Xxxxxxx Memorial Hospital |
||||||
BankOne, TX 0000 Xxxx Xxxxxx Xxxxxx, XX 00000 |
[****] P.O. Box 972400 |
Lockbox Account Number Lockbox P.O. Number |
Xxxxxxx X. Xxxx | |||
Coastal Bank 000 Xxxxx Xxx Xxxxxxx Xxx Xxxxxx, XX 00000 |
[****] [****] |
Depository Tax Deposit & Impress Account |
Xxxxxxx X. Xxxx, Xxx X. Xxxxx Xxxxxx Xxxxxxx, Xxxxxx Xxxxxx, Xxxxxxx X. Xxxx, Xxx X. Xxxxx | |||
Memorial Hospital of Adel BankOne, TX 0000 Xxxx Xxxxxx Xxxxxx, XX 00000 |
[****] P.O. Box 972398
|
Lockbox Account Number Lockbox P.O. Number |
Xxxxxxx X. Xxxx | |||
Xxxx Banking Company 000 X. Xxxxxxxxxx Xxx. P.O. Box 191 Adel, GA 31620 |
[****] | Depository | Xxxxxxx X. Xxxx, Xxx X. Xxxxx | |||
First State Bank & Trust Company of Valdosta 000 X. Xxxxxxxxx Xxxxxx Xxxxxxxx, XX 00000 |
[****] | MasterCard/Visa | Xxxxxxx X. Xxxx, Xxxxxx X. Xxxxxxxxx | |||
Farmers & Merchants Bank 000 Xxxx Xxxxxx Xxxxxx P.O. Box 560 Adel, GA 31620 |
[****] [****] [****] |
Tax Deposit Impress Resident Trust Account |
Xxxxxxx X. Xxxx, Xxxx Xxxxxxxx, Xxxx Xxxxxxx X. Xxxx, Xxxx Xxxxxxxx, Xxxx Xxxxxxx X. Xxxx, Xxxx Xxxxxxxx, Xxxx | |||
Xxxxxxxx Community Hospital BankOne, TX 0000 Xxxx Xxxxxx Xxxxxx, XX 00000 |
P.O. Box 972508 |
Lockbox P.O. Number |
Xxxxxxx X. Xxxx | |||
Central Bank P.O. Box 779 Jefferson City, MO 65102 |
[****] [****] [****] |
Depository Payroll Tax & Impress Account Checking Account |
Xxxxxxx X. Xxxx, Xxx X. Xxxxx Xxxxxxx X. Xxxx, Xxxxxx X. Xxxxx, Xxxxxxx X. Xxxxx Xxxxxxx X. Xxxx, Xxx X. Xxxxx | |||
07/10/2002 |
[****] Confidential portion of material has been omitted and filed separately with the SEC.
59
Section 3.27
Powers of Attorney
Xxxxxx, XxXxxxx & Associates, Inc. has a power of attorney related to the Property Tax Consulting Agreement listed in Section 3.20(a)A.17.
60
Section 3.28
Accounts Receivable
None.
61
Section 3.30
Healthcare Licenses
A. | See Section 3.21 of this Company Disclosure Schedule. |
B. | The Company owns rights to the servicemark “HealthMont, Inc.,” which is currently pending approval from the United States Patent and Trademark Office. |
C. | HealthMont of Georgia, Inc. owns the right to the names: (i) Memorial Hospital of Adel; (ii) Memorial Home Health; and (iii) Memorial Convalescent Center. |
D. | HealthMont of Texas, Inc. owns the right to use the names: (i) Xxxxx Xxxxxxx Memorial Hospital; (ii) The Dolly V L.C.; (iii) The Dolly, Inc.; (iv) The Dolly Home Healthcare; (v) Dolly Home Oxygen Service; and (vi) San Xxxxxx Medical Associates After Hours Clinic. |
62
Section 3.31
Medicare Participation/Accreditation
None.
63
Section 3.33
Medical Staff Matters
None.
64
Section 3.34
Sensitive Payments
None.
65
Section 3.35
Healthcare Reports and Documents
The only extension the Company has requested outside of the normal guidelines for filing a healthcare report was for the Callaway Medicaid Cost Report for period ending 3/31/01.
66
Section 5.1
Conduct of the Business of the Company
Section 5.1(b)(vi)
A. | In consideration of a general release in form reasonably acceptable to Parent and in consideration of all rights to receive shares of the Company or any successor thereto, whether under any Company Benefit Plan, Company Derivative Security, employment agreement, consulting agreement or otherwise, the Company may pay the following amounts as severance (which amounts shall be in lieu of, and not in addition to, any severance benefits otherwise payable) to the persons set forth below prior to the Effective Date. |
Name |
Title |
Severance | ||
Corporate Severance |
||||
Xxxx, Xxx |
CEO | $175,000 | ||
Xxxxxx, Xxx |
AVP | 50,000 | ||
Xxxxx, Xxx |
AVP | 50,000 | ||
Xxxx, Xxxxx |
X | 20,000 |
B. | The Company will acquire a tail for its directors and officers insurance. |
C. | The Company may take such other actions as agreed upon from time to time by the Company and the Parent. |
Section 5.1(b)(x)
None
Section 5.1(b)(xi)
None
Section 5.1(b)(xiv)
None
Section 5.1(b)(xvi)
None
Section 5.1(c)
67
None.
Section 5.1(e)
None
68
Section 5.7
Company Stock Options
Options granted to the following directors/entities will be outstanding as of the Effective Time:
Xxxxx X. Xxxxxxxx |
15,000 | |
Xxx X. Xxxxx |
15,000 | |
Xxxx X. Xxxxxx |
15,000 | |
Xxxx X. and X. Xxx Xxxxxxxx |
15,000 | |
Xxx and Xxxxxx Xxxx |
15,000 | |
Xxxxxxx X. Xxxxxxxx |
15,000 | |
Xxxxxx Family Partnership |
15,000 |
69
Section 5.8
Company Warrants
All Company Warrants other than the Xxxxxx Warrants will be cancelled on or before the Effective Time.
70
Section 5.14(a)
Healthcare Approvals
The Company may be required: (i) to file notice with the State of Georgia at least thirty (30) days prior to consummation of the Merger; (ii) to file notice with the State of Missouri within fifteen (15) days after consummation of the Merger; and (iii) to file notice with the State of Texas within fifteen (15) days after consummation of the Divestco Disposition.
71
Section 5.24(a)
Closing Net Working Capital
HealthMont, Inc.
Working Capital Computation
March 31, 2002 |
August 31, 2002 |
||||||||||||
Total |
Dolly |
Total W/O Dolly |
Total |
Dolly |
Total W/O Dolly |
||||||||
Current Assets: |
|||||||||||||
Cash |
$567 | $205 | $362 | $235 | $147 | $88 | |||||||
Total accounts receivable |
4,397 | 945 | 3,452 | 4,834 | 1,546 | 3,288 | |||||||
Investory |
714 | 209 | 505 | 804 | 214 | 590 | |||||||
Prepaid expense |
567 | 58 | 509 | 160 | 29 | 131 | |||||||
Total current assets |
$6,245 | $1,417 | $4,828 | $6,033 | $1,936 | $4,097 | |||||||
Current liabilities: |
|||||||||||||
Accounts payable |
$2,870 | $496 | $2,374 | $3,332 | $833 | $2,499 | |||||||
Accrued expenses |
1,915 | 163 | 1,752 | 1,787 | 219 | 1,568 | |||||||
Current portion capital leases |
368 | 161 | 207 | 388 | 166 | 222 | |||||||
Change in Revolver |
0 | 0 | 190 | 190 | |||||||||
Total current liabilities |
$5,153 | $820 | $4,333 | $5,697 | $1,218 | $4,479 | |||||||
Net working capital |
$495 | ($382 | ) | ||||||||||
Net working capital at testing date cannot be less than ($150,000) |
Fail |
||||||||||||
Computation of change in revolver: |
|||||||||||||
Current portion LTD (revolver) |
|||||||||||||
Base |
$3,889 | $3,889 | $3,889 | $3,889 | |||||||||
Current balance |
3,889 | 3,889 | 4,079 | 4,079 | |||||||||
Change |
$0 | $0 | $190 | $190 | |||||||||
72
Section 5.24(b)
Closing Hospital-Level EBITDA
HealthMont, Inc.
EBITDA Test
August-02 |
||||||||
Prior twelve month EBITDA: |
||||||||
Adel |
$ | 1,368,935 | ||||||
Callaway |
1,683,483 | |||||||
Subtotal |
$ | 3,052,418 | ||||||
Less Prior year contractuals: |
||||||||
Xxxx |
$ | (231,597 | ) | |||||
Medicare PY |
92,452 | |||||||
Medicaid XX |
||||||||
Xxxxxxxx |
||||||||
Medicare PY |
(128,071 | ) | ||||||
Medicaid PY |
(28,243 | ) | ||||||
Total prior year amounts |
$ | (295,459 | ) | |||||
Add back cost related to Surgeon: |
||||||||
Jun-02 |
23,414 | |||||||
Jul-02 |
23,458 | |||||||
Aug-02 |
23,778 | |||||||
Sep-02 |
23,872 | |||||||
Total cost add back |
94,522 | |||||||
$ | 2,851,481 | |||||||
EBITDA test: |
||||||||
Base EBITDA |
$ | 3,000,000 | ||||||
Collar % |
90.83 | % | ||||||
Collar amount |
2,725,000 | |||||||
Test | Pass |
73
Section 6.1(p)
Indebtedness Described in Section 6.1(p)(iv)
A. | Any Indebtedness identified in Section 3.9 of this Company Disclosure Schedule. |
B. | Liabilities incurred pursuant to any action permitted under Section 5.1 of this Company Disclosure Schedule. |
C. | Contingent liabilities associated with HealthMont of Texas, Inc. (“HealthMont of Texas”) as to which HealthMont of Texas has agreed to indemnify the Company pursuant to the Indemnification Agreement. |
74
Section 8.1
Divestco Liabilities
A. | Pursuant to the Divestco Disposition Agreement, the Company, as part of the Company Debt Restructuring, will cause Divestco to be released from any further liability to Xxxxxx and will cause any liens held by Xxxxxx on the stock and assets of Divestco to be released. |
B. | After completion of the Divestment, the Company will retain liability under the Comdisco Lease Agreement, the LinvaTec Leases and the agreements listed in subparagraphs A.9., 14., and 15. of Section 3.20. See also the attachment to Section 3.9. Divestco has agreed to indemnify the Company for these contingent liabilities. |
75
Executed as of this 15th day of October, 2002.
HEALTHMONT, INC. | ||
By: |
/s/ XXXXXXX X. XXXX | |
Its: | President |
76