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This Settlement Agreement (Agreement) is entered into among the United States of
America, acting through the United States Department of Justice and on behalf of the Office of
Inspector General (OIG-HHS) of the Department of Health and Human Services (HHS)
(collectively the "United States"); Defendants Mercy Health Springfield Communities f/k/a St.
John's Health System, Inc. and Mercy Clinic Springfield Communities f/k/a St. John's Clinic,
Inc.; and Relator Jean N. Moore, M.D. (hereafter collectively referred to as "the Parties"),
through their authorized representatives.
RECITALS
A.
Defendant Mercy Health Springfield Communities f/k/a St. John's Health System,
Inc. (Mercy Health) owns and operates a hospital located at 1235 E. Cherokee in Springfield,
Missouri. Defendant Mercy Clinic Springfield Communities f/k/a St. John's Clinic, Inc. (Clinic)
owns and operates medical office facilities in southwest Missouri. Both Mercy Health and the
Clinic are hereafter referred to collectively as Defendants.
B.
On or about January 15, 2013, Relator Jean N. Moore, M.D. filed a qui tam action
in the United States District Court for the Western District of Missouri captioned United States
ex rel. Jean N Moore, MD. v. Mercy Health Springfield Communities .flkla St. John's Health
System, Inc., No. 13-3019-CV-S-RED, pursuant to the qui tam provisions of the False Claims
Act, 31 U.S.C. 3730(b) (the Civil Action). On or about August 9, 2013, Relator filed her First
Amended Complaint in the Civil Action captioned United States ex rel. Jean N Moore. MD. v.
Mercy Health Springfield Communities, flkla St. John's Health System, Inc. and Mercy Clinic
Springfield Communitiesflk/a St. John's Clinic, Inc. In her complaints, the Relator alleged that
the Defendants' financial relationships with certain of their employed physicians violated the
Stark Law, 42 U.S.C. 1395nn, and the Anti-Kickback Statute. 42 U.S.C. 1320a-7b(b)(2).
C.
The United States contends that between March 1, 2011 and June 30,2014, the
Defendants' financial relationships with certain physicians employed by the Clinic violated the
Stark Law. Specifically, the United States contends that the Clinic improperly paid bonuses to
certain physicians that improperly took into account the value of the physicians' referrals of
patients to the Clinic for certain ancillary services. The physicians and time periods at issue are
identified in Attachment A to this Agreement. The United States further contends, because of the
Stark violations that the Defendants violated the False Claims Act by submitting, or causing to
be submitted, false claims to Medicare for certain services rendered to patients that had been
referred to the Clinic by these physicians. The United States contends that it has certain civil
claims against the Defendants arising from this conduct, which is referred to below as the
Covered Conduct.
D.
a concession by the United States that its claims are not well founded. Mercy expressly denies
the allegations of the United States and the Relator set fm1h herein and in the Civil Action.
E.
this Settlement Agreement and to Relator's reasonable expenses, attorneys' fees and costs.
To avoid the delay, uncertainty, inconvenience, and expense of protracted litigation of the
above claims, and in consideration of the mutual promises and obligations of this Settlement
Agreement. the Parties agree and covenant as follows:
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Defendants shall pay to the United States Five Million Five Hundred Thousand
Dollars ($5,500,000.00) (Settlement Amount) no later than ten days after the Effective Date of
this Agreement by electronic funds transfer pursuant to written instructions to be provided by the
Office of the United States Attorney for the Western District ofMissouri.
2.
Conditioned upon the United States receiving the Settlement Amount from
Defendants and as soon as feasible after receipt, the United States shall pay $825,000 to Relator
by electronic funds transfer.
3.
Defendants shall pay Thirteen Thousand Eight Hundred Thirteen and 93/100
Dollars ($13 ,813 .93) to Relator for her reasonable attorney's fees and costs, pursuant to 31
U.S.C . 3730(d)(l), no later than ten days after the Effective Date of this agreement.
4.
conditioned upon Defendants' full payment of the Settlement Amount, the United States releases
Defendants together with their current and former parent corporations; subsidiaries; affiliates;
brother and sister corporations; and their respective officers, directors and employees; and the
successors and assignees of any of them ("Defendant Releasees") from any civil or administrative
monetary claim the United States has for the Covered Conduct under the False Claims Act, 31
U.S.C. 3729-3733 ; the Civil Monetary Penalties Law, 42 U.S.C. 1320a-7a; the Program
Fraud Civil Remedies Act, 31 U.S.C. 3801-3812; the civil monetary provisions ofthe Stark
Law at 42 U .S.C. 1395nn(g)(3) and (4); or the common law theories of payment by mistake,
unjust enrichment, and fraud.
5.
conditioned upon Defendants' full payment ofthe Settlement Amount, Relator, for herself and
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for her heirs, successors, attorneys, agents, and assigns, releases Defendants and the Defendant
Releasees from any civil monetary claim the Relator has on behalf of the United States for the
Covered Conduct under the False Claims Act, 31 U.S.C. 3729-3733 .
6.
any other term of this Agreement, the following claims of the United States are specifically
reserved and are not released:
a.
Any liability arising under Title 26, U.S. Code (Internal Revenue Code);
b.
c.
d.
Any liability to the United States (or its agencies) for any conduct other
than the Covered Conduct;
e.
f.
Any liability for express or implied warranty claims or other claims for
defective or deficient products or services, including quality of goods and
services;
g.
h.
1.
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7.
Relator and her heirs, successors, attorneys, agents, and assigns shall not object to
this Agreement but agree and confirm that this Agreement is fair, adequate, and reasonable under
aU the circumstances, pursuant to 31 U.S .C. 3730(c)(2)(B). Conditioned upon Relator's receipt
of the payment described in Paragraph 2, Relator and her heirs, successors, attorneys, agents, and
assigns fully and finally release, waive, and forever discharge the United States, its agencies,
officers, agents, employees, and servants, from any claims arising from the filing of the Civil
Action or under 31 U.S.C. 3730, and from any claims to a share of the proceeds of this
Agreement and/or the Civil Action.
8.
Relator, for herself, and for her heirs, successors, attorneys, agents, and assigns,
releases Defendants and the Defendant Releasees, from any liability to Relator arising from the
filing of the Civil Action, or under 31 U.S.C. 3730(d) for expenses or attorney's fees and costs.
9.
Defendants waive and shall not assert any defenses they may have to any criminal
prosecution or administrative action relating to the Covered Conduct that may be based in whole
or in part on a contention that, under the Double Jeopardy Clause in the Fifth Amendment of the
Constitution, or under the Excessive Fines Clause in the Eighth Amendment of the Constitution,
tllis Agreement bars a remedy sought in such criminal prosecution or administrative action.
Nothing in this paragraph or any other provision of this Agreement constitutes an agreement by
the United States concerning the characterization of the Settlement Amount for purposes of the
Internal Revenue laws, Title 26 of the United States Code.
10.
Defendants fully and finally release the United States, its agencies, officers,
agents, employees, and servants, from any claims (including attorney's fees , costs, and expenses
of every kind and however denominated) that Defendants have asserted, could have asserted, or
may assert in the future against the United States, its agencies, officers, agents, employees, and
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servants, related to the Covered Conduct and the United States' investigation and prosecution
thereof.
11.
The Settlement Amount shall not be decreased as a result of the denial of claims
for payment now being withheld from payment by any Medicare contractor (e.g. , Medicare
Administrative Contractor, fiscal intermediary, carrier) or any state payer, related to the Covered
Conduct; and Defendants agree not to resubmit to any Medicare contractor or any state payer any
previously denied claims related to the Covered Conduct, and agrees not to appeal any such
denials of claims.
12.
Acquisition Regulation, 48 C.F.R. 31.205-47; and in Titles XVIII and XIX of the Social
Security Act, 42 U.S.C. 1395-1395kkk-1 and 1396-1396w-5; and the regulations and official
program directives promulgated thereunder) incurred by or on behalf of Defendants, their present
or former officers, directors, employees, shareholders, and agents in connection with:
(1)
(2)
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(5)
separately determined and accotmted for in nonreimbursable cost centers by Defendants, and
Defendants shall not charge such Unallowable Costs directly or indirectly to any contracts with
the United States or any State Medicaid program, or seek payment for such Unallowable Costs
through any cost report, cost statement, information statement, or payment request submitted by
Defendants or any of their subsidiaries or affiliates to the Medicare, Medicaid, TRICARE, or
FEHBP Programs.
c.
Defendants further agree that within 90 days of the Effective Date of this Agreement, they shall
identify to applicable Medicare and TRICARE fiscal intermediaries, carriers, and/or contractors,
and Medicaid and FEHBP fiscal agents, any Unallowable Costs (as defined in this Paragraph)
included in payments previously sought from the United States, or any State Medicaid program,
including, but not limited to, payments sought in any cost reports, cost statements, information
reports, or payment requests already submitted by Defendants or any of their subsidiaries or
affiliates, and shall request, and agree, that such cost reports, cost statements, information
reports, or payment requests, even if already settled, be adjusted to account for the effect of the
inclusion of the Unallowable Costs. Defendants agree that the United States, at a minimum, shall
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be entitled to recoup from Defendants any overpayment plus applicable interest and penalties as
a result of the inclusion of such Unallowable Costs on previously-submitted cost reports,
information reports, cost statements, or requests for payment.
Any payments due after the adjustments have been made shall be paid to the United States
pursuant to the direction of the Department of Justice and/or the affected agencies. The United
States reserves its rights to disagree with any calculations submitted by Defendants or any of
their subsidiaries or affiliates on the effect of inclusion of Unallowable Costs (as defined in this
Paragraph) on Defendants or any of their subsidiaries or affiliates' cost reports, cost statements,
or information reports.
d.
United States to audit, examine, or re-examine Defendants' books and records to determine that
no Unallowable Costs have been claimed in accordance with the provisions of this Paragraph.
13.
This Agreement is intended to be for the benefit of the Parties only. The Parties
do not release any claims against any other person or entity, except to the extent provided for in
Paragraphs 4, 5 and 14 (waiver for beneficiaries paragraph).
14.
Defendants agree that they waive and shall not seek payment for any of the health
care billings covered by this Agreement from any health care beneficiaries or their parents,
sponsors, legally responsible individuals, or third party payors based upon the claims defined as
Covered Conduct.
15.
Upon receipt of the payment described in Paragraph 1, above, Relator and the
United States shall promptly sign and file in the Civil Action a Joint Stipulation of Dismissal of
the Civil Action pursuant to Rule 41 (a)(l ).
-8-
16.
Except as provided in Paragraph 3 above, each Party shall bear its own legal and
other costs incurred in connection with this matter, including the preparation and performance of
this Agreement.
17.
Each party and signatory to this Agreement represents that it freely and
This Agreement is governed by the laws ofthe United States. The exclusive
jurisdiction and venue for any dispute relating to this Agreement is the United States District
Court for the Western District of Missouri. For purposes of construing this Agreement, this
Agreement shall be deemed to have been drafted by all Parties to this Agreement and shall not,
therefore, be construed against any Party for that reason in any subsequent dispute.
19.
This Agreement constitutes the complete agreement between the Parties. This
The undersigned counsel represent and warrant that they are fully authorized to
execute this Agreement on behalf of the persons and entities indicated below.
21.
original and all of which constitute one and the same Agreement.
22.
assigns.
23.
24.
All parties consent to the United States' disclosure of this Agreement, and
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25.
This Agreement is effective on the date of signature oft he last signatory to the
Dated:
Dated :
7/17/tf
1 /11
/15
I+
B y: _ _ :.../1.)=--.!0.
IQ':_,_,
.IJL,___ A_;_...
~.....'th
.......
t.,_
L _ - - - -David T. Cohen
Senior Trial Co unse l
Commercial Lit igation Branch
Civil Division
United Stales Depa1tment of Just ice
By:
~~. (,J~
Lucinda S. Woo lery
Assistant United States Attorney
Western District of Missouri
By:
Ro bert K. DeComi
Assistant Inspecto r General for Legal Affairs
Office of Counsel to the Inspector General
Office of Inspector General
United States Department of Healt h and Human Services
DEFENDANTS
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Dated:
J"v.\'1.''~0\5
f!v .,
~~
Dated:
Jean N. Moore, M.D.
Dated
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Dated:
RELATOR
Dated:
Dated
Co }~q
bo 15
(9) 30/.90)6
B~
Je er M. Placzek, Esq.
Placzek Winget & Placzek
Counsel for Jean N. Moore, M.D.
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Ph sician
ADKISON, BRIAN W
AL-ASSAFEEN, OSSAMA
ALUM NO, MARTIN R A
AMYX, TITAN lA L
ATKINSON, C SCOTT
BAKER, CYNTH IA A
BARBE, DAVID 0
BARTLE, JUDY ANN
BAURICHTER, JOHN D
BEAUMONT, GRACES
BEBEN, KATHERINE E
BECKNER, KATHY G
BELK, MELISSA A
BENEDICT, HOLLY J
BENOIST, PATRICIA A
BERG, SUSAN L
BHAKTA, SONAL T
BOSSO, DANIEL G
BRAND, JOHN C
BROTHERS, MICAH F
BROWN, JOHN H
BROWN, MATTHEW A
BRUNO, RAYMOND E
BUCKNER, JAMES R
BUM BERRY, BARBARA A
BUTLER, CONNIE L
BUTLER, CYLINDA L
CARD, SHANNON R
CAREY, LARRY J
CARLSON, JAY W
CARON, TROY HENRY
CASEY, RICKY D
CATHCART, DAVID L
CHAPPELL, JOHN RODGERS
CHAVEZ, ERIC M
CHISM, WILLIAM R
CLEVELAND, TRACY L
Beginning
Date
End Date
3/1/11
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8/19/13
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COLVILLE, MARTHA J
COPLING, PATSY
CRIM, AMANDA M
CRISOSTOMO, ABIGAIL
CRITES, JONATHAN PETER
CROW II, SAMUEL A
CUNNINGHAM, KARRIE A
CURRIER, DONNA
DAUS, GREGORY P
DAVIS, JESSICA L
DEAN, TODD C
DEFFER, TIMOTHY A
DEL VECCHIO, JEFFREYS
DEMPSEY, SANDRA KAY
DENT, AARON
DENTON, BEVERLY J
DICUS, CYNTHIA G
DIEHL, POLLY A
DOERING, THOMAS M
DONHAM, RODNEY P
EARNEST, DANIELJ
EFIRD, CHAD D
ELAM, JIM R
ELLIS, SCOTT A
ESSMAN, THOMAS F
FAIR PARSONS, TRACY L
FELTS, JAMES A
FEU GATE, JO ELLEN
FORD JR, ROBERT MARVIN
FRASER II, ROBERT F
FRESCOLN, HILARY A
GADDY, MICHAEL K
GARNER, BRADFORD P
GARRISON, JOSH
GEIGER, PAULL.
GESSLER, JAMES A
GETER, RODNEY K
GODDARD, AMANDA R
GOOD, MICHAEL W
GOODMAN Ill, WILLIAM W
GORDIN, AUDREY L
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GRAHAM, MARCIA K
3/ 1/ 11
GREEN, BRYAN R
3/ 1/ 11
6/30/ 14
3/ 1/ 11
6/30/ 14
GRILLOT, MICHAEL B
9/1/ 12
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HADDOW, ALASTAIR D
3/ 1/ 11
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HAMMONS, MATHEW H
3/18/13
6/30/ 14
HARBACH, TODD J
3/ 1/11
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HARDEN, WESLEY C
8/ 6/ 12
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HARR, PATRICK B
7/ 16/ 12
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3/1/ 11
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HARTIGAN, CARRIE L
7/ 16/ 13
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HASSON , JEFFREY
3/ 1/11
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HAUSCHILDT, SHANNON M
3/1/ 11
3/14/14
HAVERSTICK, DALE E
3/ 1/ 11
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HAYES, STANLEY P
3/ 1/11
6/ 30/ 14
9/ 1/11
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HENSON, AUTUMN
HERFKENS AMPLEMAN ,
KATHRYN
3/ 1/ 11
6/ 30/ 14
3/ 1/ 11
6/ 30/ 14
HERRING, AMBER D
9/ 4/ 12
6/30/ 14
HEVEL, ROBERT W
1/ 16/12
6/30/ 14
6/ 30/ 14
HIMES, JOE E
3/ 1/ 11
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HOERNING, ELTON W
3/1/11
6/30/ 14
HOLMAN, CHELSIE N
3/ 1/ 11
6/30/ 14
HOLMES, BEVERLY A
3/1/11
6/ 30/14
HOLTORF, KRAIG M
6/ 3/ 13
6/30/ 14
HONDERICK, RICHARDT
3/ 1/ 11
6/30/ 14
3/1/ 11
6/3 0/ 14
HOPKINS, KAREN B
3/1/11
6/ 30/14
HORNING, ERIC P
3/ 1/ 11
6/ 30/ 14
HORTON, CHARLES R
3/ 1/ 11
6/30/ 14
7/ 16/ 12
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3/ 1/ 11
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HULL, DARLA K
3/ 1/ 11
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7/ 27/ 12
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HURT, CHRISTIE J
3/ 1/ 11
6/ 30/ 14
HUSS, RANDALL D
3/ 1/ 11
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JABEEN, SAIMA
3/1/ 11
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MEYER, KEITH A
MEYSTRIK, JOSEPH M
MEYSTRIK, ROSELLEN S
MICHAELS, ROBERT H
MIDDLETON, RACHELENE
MILAM, CRAIG
MILLER, GUY F
MILLER, NATHANIELJOHN
MISTEROVICH, HOPE E
MOOSE, SCOTI R
MORGAN, HEATH A
MORGAN, LINDA J.
MORIARTY, DONNA
MOSTROM, DAN R
MUTCHLER, JEFFREY J
NACHTIGAL, MICHAEL P
NGUYEN, ROSA P
OHLY, JOHANN
OWSIAK, RACHEL
PARK, DAN D
PENNELLA, RAFFAELE
PETERSON, CRAIG A
PETIEY, GEORGE G
PHIPPEN-GESUALDI, SHERRY L
PURDY, NAOMI C
PYRON, LUKE DOUGLAS
RADHAMMA, RANI K
RANDALL ARELL, JAMIE L
RATCHFORD, NATHAN K
REINERTSEN, KIMBERLY
REPLOGLE, NURSE
REPLOGLE, SHAWN IE S
RIEDEL, ALI CE R
ROBERTS, JON W
ROBINSON, RANDALL M
RUDD ICK, GUY H J
SALINAS, MANUEL
SCHMIDT, SABRINA J
SCHMITZ, RALPH A
SCHOONMAKER, GENE
SCHRUN K, KEVIN F
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SCOTI, WENDELL J
SEAGRAVE, RICHARD A
SEMEYN, JEFFREY
SHAH,BHARAT
SHAW, LUKE PHILIP REINE
SHERWOOD, DANIEL J
SHOEMAKER, MICHAEL D
SHOUP, DAVID L
SIMON, NORMAN J
SIMPSON, MARGARET M
SLINKER, R DEREK
SMITH, KATHLEEN D
SMITH, KYLE P
SMITH, MELANIE R
SPARKS, JAY L
SPURGIN, RANDAL T
STCLAIR, TRACI NICOLE
STRINGER, KENT
SUMMERFORD, PATRICIA A
SUN, X KATHRYN
SWANGO, JOHN SCOTI
TALBERT, DAWN L
TALLEY, DARIN L
TARSNEY, SEAN P
TAUBER, SHACHAR
TAYLOR, MARGARETE
THEOBALD, TODD
THOMAS, THOMAS
THORAT, SACHIN B
THORAT, SA VITA
THORNSBERRY, JONATHAN L
TYLER, OAKLEY B
UNGER, ELOISE J
VERHEYEN, VICTORIA J.
WALKER JR, MELVIN 0
WALZ, BRADLEY H
WARD, MARK R
WAITS, SAMUEL M
WELCH, MARY B
WHITE, RODERICK H
WHITESELL, ANGIE J
6/30/14
6/30/14
6/30/14
6/30/14
6/30/14
6/30/14
11/30/12
6/30/14
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11/30/13
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3/1/11
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8/1/11
3/1/11
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3/1/11
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9/1/12
12/10/12
3/1/11
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3/1/11
3/1/11
3/1/11
3/1/11
8/20/12
10/18/12
3/1/11
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WILLIAMS, DEE E
WILLIAMS, RICK W
WILLIAMS, SONJA GAYLE
WILSON, VICTOR WARREN
WILSON, W TIMOTHY
WINFREY, AMANDA K
WOODALL JR, CHARLES E
WYRSCH, ROBERT BRADLEY
YANTIS, VOLARE A
YERRA, SHANT! S
ZENGOTITA, JAIME
6/30/14
6/30/14
6/30/14
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1/8/13
6/30/14
3/1/11
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