2024-05-08T07:55:03-05:00 2023-06-30 440160260 FORVIS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2022-07-01 842738089 MAGNOLIA MANOR OF LIBERTY COUNTY INC MAGN 2299249352 2001 SOUTH LEE STREET AMERICUS GA 31709 MARK TODD PRESIDENT 2299249352 2024-05-07 1 MARK TODD XXX-XX-XXXX 0 AMY BIBBY P00445891 8282542254 2024-05-07 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MAGNOLIA MANOR OF MIDWAY MARK TODD 2001 SOUTH LEE STREET AMERICUS GA 31709 6795815 0 X WWW.MAGNOLIAMANOR.COM X 2020 GA THE CORPORATION IS ORGANIZED TO PROVIDE LONG-TERM CARE TO THE SICK AND ELDERLY IN A SPIRITUAL SETTING THROUGH THE OPERATION OF A 169-BED SKILLED NURSING FACILITY LOCATED IN MIDWAY, GEORGIA. 14 14 142 40 0 0 0 0 5027257 6653717 58935 70891 212415 71207 5298607 6795815 0 0 0 0 3830743 4234193 0 0 0 3721253 4858948 7551996 9093141 -2253389 -2297326 12845049 13016789 11785137 12325496 1059912 691293 THE CORPORATION IS ORGANIZED TO PROVIDE LONG-TERM CARE TO THE SICK AND ELDERLY IN A SPIRITUAL SETTING THROUGH THE OPERATION OF A 169-BED SKILLED NURSING FACILITY LOCATED IN MIDWAY, GEORGIA. 0 0 7833660 6664005 PROVIDED LONG-TERM CARE FOR THE SICK AND ELDERLY IN A SPIRITUAL SETTING IN A 169-BED SKILLED NURSING FACILITY. THE ORGANIZATION PROVIDED 25,878 PATIENT DAYS OF SERVICE DURING THE YEAR. 7833660 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 9 0 1 142 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 GA X DAVID F CHARTER 2299315907 2001 SOUTH LEE STREET AMERICUS GA 31709 MARK JOHNSON BOARD OF TRUSTEE CHAIRMAN 1.00 6.00 X X 0 0 0 CHUCK REEVES BOARD OF TRUSTEE VICE CHAIRMAN 1.00 6.00 X X 0 0 0 JEAN WHEELER BOARD OF TRUSTEE SECRETARY 1.00 6.00 X X 0 0 0 HAL WEATHERS BOARD TRUSTEE 1.00 6.00 X 0 0 0 EDIE VINSON BOARD TRUSTEE 1.00 6.00 X 0 0 0 WILL PETERSON BOARD TRUSTEE 1.00 6.00 X 0 0 0 ANN HARRIS BOARD TRUSTEE 1.00 6.00 X 0 0 0 CHARLES PRYOR BOARD TRUSTEE 1.00 6.00 X 0 0 0 GEORGE YOUMANS JR BOARD TRUSTEE 1.00 6.00 X 0 0 0 CHARLES SHEFFIELD BOARD TRUSTEE 1.00 6.00 X 0 0 0 ED COLLIER BOARD TRUSTEE 1.00 6.00 X 0 0 0 TY TURNER BOARD TRUSTEE 1.00 6.00 X 0 0 0 PETE CATES BOARD TRUSTEE 1.00 6.00 X 0 0 0 RICK WHALEY BOARD TRUSTEE 1.00 6.00 X 0 0 0 MARK TODD CEO 10.00 50.00 X 0 340665 9957 DAVID CHARTER CFO 10.00 50.00 X 0 130915 6461 JENICE BAKER FACILITY ADMINISTRATOR 40.00 X 110485 0 2869 110485 471580 19287 1 0 1 0 LEADERSTAT 1322 B MANNING PKWY POWELL OH 430659179 CONTRACT NURSING AGENCY 1041122 1 MEDICARE/MEDICAID PAYM 623000 5530329 5530329 ROUTINE ROOM/BOARD 623000 1123388 1123388 6653717 29 29 70862 0 70862 70862 70862 MISCELLANEOUS INCOME 623000 60919 60919 CAFETERIA SALES 623000 6217 6217 REBATES AND REFUNDS 623000 4071 4071 71207 6795815 6664005 0 131810 X 3656719 3401995 254724 8138 2123 6015 308638 282307 26331 260698 241327 19371 455816 455816 33875 33875 1545121 1456748 88373 4257 4257 204447 121612 82835 8528 8528 187313 187313 9538 3005 6533 505225 505225 415985 415985 374337 106101 268236 MEDICAID PROVIDER FEE 416112 416112 RAW FOOD 350280 350280 SUPPLIES 187723 174608 13115 DRUGS 84757 84757 75634 75634 9093141 7833660 1259481 0 202065 208078 347949 783514 4522 5390 504 506 7764028 1195221 6984178 6568807 -27420 -2614 5140569 5140569 192682 312539 12845049 13016789 1764692 2316998 10020445 10008498 11785137 12325496 X 1059912 691293 1059912 691293 12845049 13016789 X -2297326 1928707 X X 0 1 X 1 0 X 4915936 5076492 5031504 6664005 21687937 4915936 5076492 5031504 6664005 21687937 0 0 0 21687937 50 36 26 29 141 50 36 26 29 141 3931 4170 208168 60919 277188 4919917 5080698 5239698 6724953 21965266 X 186240 186240 7380126 1095440 6284686 19129 5471 13658 178533 94310 84223 6568807 X PART X, LINE 2: THE CORPORATION AND CERTAIN OF ITS AFFILIATES ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SEC. 501(C) (3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, A PROVISION FOR INCOME TAXES HAS NOT BEEN MADE ON THE FINANCIAL STATEMENTS. GEORGIA PHARMACY VENTURES, LLC FILES AS A PARTNERSHIP. THE CORPORATION FILES ITS FORM 990, RETURN OF ORGANIZATIONS EXEMPT FROM INCOME TAX, IN THE U.S. FEDERAL JURISDICTION AND WITH THE STATE OF GEORGIA. THIS FORM IS OPEN FOR PUBLIC INSPECTION. THE CORPORATION BELIEVES IT HAS APPROPRIATE SUPPORT FOR ALL TAX POSITIONS TAKEN, AND THE CORPORATION HAS EVALUATED ITS TAX POSITIONS AND HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF JUNE 30, 2023 AND 2022. X 0 0 X 0 0 0 0 0 0 0 0 0 MARK TODD CEO 0 340665 0 0 0 0 0 0 0 9957 0 350622 0 0 PART I, LINE 1A ONE KEY EMPLOYEE IS ALSO A MEMBER OF THE CLERGY. AS PART OF THEIR COMPENSATION AGREED UPON THROUGH THE SOUTH GA CONFERENCE, HOUSING ALLOWANCE IS INCLUDED. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS ELECTRONICALLY PROVIDED TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING THE RETURN WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C REVIEWED AT QUARTERLY COMPLIANCE COMMITTEE MEETINGS AND ANNUALLY AT BOARD OF DIRECTORS MEETING. FORM 990, PART VI, SECTION B, LINE 15A THE CEO IS PAID ENTIRELY FROM A RELATED SECTION 501(C)(3) ORGANIZATION. THE BOARD OF TRUSTEES ESTABLISHES THE CEO'S SALARY BASED ON INDUSTRY NORMS AND COMPENSATION STUDIES FOR SIMILAR TYPE ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ORGANIZATION'S CORPORATE OFFICE IN AMERICUS, GEORGIA. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ORGANIZATION'S CORPORATE OFFICE IN AMERICUS, GEORGIA. THE ORGANIZATION DOES NOT RECEIVE SEPARATE AUDITED FINANCIAL STATEMENTS. FORM 990, PART IX, LINE 11G CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,424,799. MANAGEMENT AND GENERAL EXPENSES 24,992. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,449,791. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 16,751. MANAGEMENT AND GENERAL EXPENSES 63,381. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 80,132. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 15,198. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,198. FORM 990, PART XI, LINE 9: CHANGE IN DUE TO/FROM INTERCOMPANY ACCOUNTS 1,928,707. FORM 990. PART XII, LINE 2C THIS IS THE INITIAL RETURN FILED FOR MAGNOLIA MANOR OF LIBERTY COUNTY, INC. MAGNOLIA MANOR INC 2001 SOUTH LEE STREET AMERICUS GA 31709 580911706 MANAGEMENT AND OPERATION OF LONG-TERM CARE AND RETIREMENT FACILITIES GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF MACON SUPPORTIVE HOUSING INC 190 PIERCE AVE MACON GA 31204 311651955 HUD SUPPORTIVE HOUSING FACILITY GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF MARION COUNTY INC 349 GENEVA RD BUENA VISTA GA 31803 201220860 LEASE AND OPERATION OF A LONG-TERM CARE FACILITY GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF ST SIMMONS INC 2255 FREDENCA RD ST SIMONS GA 31522 201364957 LEASE AND OPERATION OF A LONG-TERM CARE FACILITY AND A RETIREMENT COMMUNITY GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF MACON INC 190 PIERCE AVE MACON GA 31204 261311379 OPERATION OF A RETIREMENT FACILITY GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF COLUMBUS INC 2010 WARM SPRINGS RD COLUMBUS GA 31904 208034409 OPERATION OF 2 LONG-TERM CARE FACILITIES AND A RETIREMENT FACILITY GA 501(C)(3) LINE 10 0 GEORGIA PHARMACY VENTURES 440 INDUSTRIAL BOULEVARD HAWKINSVILLE GA 31036 261918757 PROVIDES PHARMACY RELATED PRODUCTS AND SERVICES TO MAGNOLIA MANOR RESIDENTS GA N/A 0 0 MMI ASSURANCE LTD 2001 SOUTH LEE STREET AMERICUS GA 31709 981082342 CAPTIVE INSURANCE COMPANY CJ N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1