2024-05-13T12:08:11-04:00 2023-06-30 581094351 MCNAIR MCLEMORE MIDDLEBROOKS & CO LLC POST OFFICE BOX ONE MACON GA 312020001 990 2022-07-01 432007496 COMMUNITY ANCILLARY SERVICES INC COMM 4786212100 110 STONE BROOKE DRIVE GRAY GA 31032 TERESA MOODY SECRETARY 4786212100 2024-05-10 true TERESA MOODY 999009999 false WILLIAM R ROUNTREE P01231836 4787466277 2024-05-13 2022 2023-04-26 12:10:37Z TERESA MOODY 110 STONE BROOKE DRIVE GRAY GA 31032 52274147 false X WWW.ELDERCAREPHARMACY.ORG X 2003 GA THE PROVISION OF PHARMACEUTICAL, MEDICAL SUPPLIES AND EQUIPMENT, HOME HEALTH AND RELATED SERVICES AS PART OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. 3 3 163 0 802237 0 52426881 51411880 -696426 13677 993215 848590 53525907 52274147 0 0 9509707 9059322 0 0 37299894 36763060 46809601 45822382 6716306 6451765 13636765 14558962 3481741 4206986 10155024 10351976 X THE PROVISION OF PHARMACEUTICAL, MEDICAL EQUIPMENT, HEALTHCARE SUPPLIES, HOME CARE AND RELATED SERVICES, HOSPICE SERVICES, AND HOME HEALTH SERVICES AS PART OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. false false 45822382 PROVIDED A FULL SERVICE PHARMACY THROUGH A REGIONAL NETWORK OF PERSONAL CARE AND NURSING FACILITIES TO PATIENTS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED MEDICAL, HEALTH CARE AND RELATED SUPPLIES TO PERSONAL CARE AND NURSING FACILITIES FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED MEDICAL EQUIPMENT, GOODS, LINENS, UNIFORMS AND COMMODITIES TO PERSONAL CARE AND NURSING FACILITIES FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED HOME-HEALTH CARE FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED HOSPICE SERVICES AND HOME HEALTH SERVICES FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. CONSISTENT WITH THE POLICIES AND PROCEDURES PREVIOUSLY ADOPTED BY THE BOARD OF DIRECTORS OF COMMUNITY HEALTH SYSTEMS, INC., THE SECTION 509(A)(3) SUPPORTING ORGANIZATION AND PARENT ENTITY OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM OF WHICH THE ORGANIZATION IS A MEMBER, THE ORGANIZATION PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITIES IT SERVES PURSUANT TO BOTH COMMUNITY BENEFIT GUIDELINES AND A CHARITY CARE POLICY. 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DIR. OF PHARMACY 142497 6322 18788 167607 GINGER LANCASTER DIR OF PHARMACY 137913 5768 19106 162787 HERBERT M PONDER JR DIRECTOR 12000 12000 LUCY ROGERS DIRECTOR 12000 12000 FORM 990, PAGE 2, PART III, LINE 4A PROVIDED A FULL SERVICE PHARMACY THROUGH A REGIONAL NETWORK OF PERSONAL CARE AND NURSING FACILITIES TO PATIENTS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED MEDICAL, HEALTH CARE AND RELATED SUPPLIES TO PERSONAL CARE AND NURSING FACILITIES FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED MEDICAL EQUIPMENT, GOODS, LINENS, UNIFORMS AND COMMODITIES TO PERSONAL CARE AND NURSING FACILITIES FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED HOME-HEALTH CARE FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED HOSPICE SERVICES AND HOME HEALTH SERVICES FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. CONSISTENT WITH THE POLICIES AND PROCEDURES PREVIOUSLY ADOPTED BY THE BOARD OF DIRECTORS OF COMMUNITY HEALTH SYSTEMS, INC., THE SECTION 509(A)(3) SUPPORTING ORGANIZATION AND PARENT ENTITY OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM OF WHICH THE ORGANIZATION IS A MEMBER, THE ORGANIZATION PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITIES IT SERVES PURSUANT TO BOTH COMMUNITY BENEFIT GUIDELINES AND A CHARITY CARE POLICY. THE ORGANIZATION CONTINUES TO ASSESS AND DEVELOP PROGRAMS TO BENEFIT THE COMMUNITY. FORM 990, PAGE 6, PART VI, LINE 6 THE ORGANIZATION HAS A SOLE MEMBER, COMMUNITY HEALTH SYSTEMS, INC., A NONPROFIT GEORGIA CORPORATION. FORM 990, PAGE 6, PART VI, LINE 7A UNDER THE ORGANIZATION'S BYLAWS, WHILE IT IS THE SOLE MEMBER OF THE ORGANIZATION, COMMUNITY HEALTH SYSTEMS, INC., AS A TYPE I SECTION 509(A)(3) AND SECTION 501(C)(3) SUPPORTING ORGANIZATION, HAS THE SOLE RIGHT TO ELECT, REPLACE AND TO REMOVE THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS AND SHALL ENSURE THAT AT ALL TIMES, A MAJORITY OF THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS SHALL BE COMPOSED OF PERSONS WHO ARE CONCURRENTLY SERVING AS MEMBERS OF THE BOARD OF DIRECTORS OF COMMUNITY HEALTH SYSTEMS, INC. FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 FOR COMMUNITY ANCILLARY SERVICES, INC. IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. UPON COMPLETION, THE INDEPENDENT ACCOUNTING FIRM PROVIDES A DRAFT OF THE FORM 990 TO THE AUDIT COMMITTEE OF THE ORGANIZATION FOR ITS REVIEW. ALLOWING ADEQUATE TIME FOR REVIEW, THE INDEPENDENT ACCOUNTING FIRM SUBSEQUENTLY MEETS WITH THE AUDIT COMMITTEE OF THE ORGANIZATION TO REVIEW AND DISCUSS THE DRAFT FORM 990. FOLLOWING THE AUDIT COMMITTEE'S REVIEW, DISCUSSION AND APPROVAL OF THE DRAFT FORM 990, THE AUDIT COMMITTEE THEN PROVIDES THE DRAFT FORM 990 TO THE ORGANIZATION'S BOARD OF DIRECTORS WITH A RECOMMENDATION TO REVIEW AND APPROVE THE FORM 990. SUBSEQUENT TO RECEIPT OF THE DRAFT FORM 990, A MEETING OF THE ORGANIZATION'S BOARD OF DIRECTORS IS HELD TO DISCUSS THE RECOMMENDATION FROM ITS AUDIT COMMITTEE AND TO ASK QUESTIONS OF THE INDEPENDENT ACCOUNTING FIRM AND THE ORGANIZATION'S MANAGEMENT. FOLLOWING REVIEW AND DISCUSSION, THE BOARD THEN APPROVES THE FORM 990 TO BE FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PAGE 6, PART VI, LINE 12C COMPLIANCE WITH THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY IS EFFECTUATED BY, AT A MINIMUM, THE BOARD OF DIRECTOR'S ANNUAL REVIEW OF CONFLICT DISCLOSURE STATEMENTS PROVIDED BY THE ORGANIZATION'S DIRECTORS AND OFFICERS. ALSO, THE ORGANIZATION'S BOARD OF DIRECTORS REVIEW CONFLICT DISCLOSURE STATEMENTS PRIOR TO TAKING ACTION ON PROPOSED TRANSACTIONS AND CONTRACTUAL ARRANGEMENTS. THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY PROVIDES THE PROCEDURE FOR WHICH INTERESTED PERSONS ARE EVALUATED TO DETERMINE IF A CONFLICT EXISTS. IF IT IS DETERMINED THAT A BOARD MEMBER HAS A CONFLICT OF INTEREST, THEN SUCH BOARD MEMBERS ARE NOT ALLOWED TO PARTICIPATE IN DELIBERATIONS ON THE SPECIFIC MATTER AND IS EXCUSED FROM, AND NOT ALLOWED TO PARTICIPATE IN, ANY BOARD VOTE ON THE MATTER. FORM 990, PAGE 6, PART VI, LINE 15A THE ORGANIZATION REGULARLY AND CONSISTENTLY COMPLIES WITH THE COMPENSATION APPROVAL PROCESS, AS DEFINED BY ITS CONFLICTS OF INTEREST POLICY, THROUGH A COMPREHENSIVE ENGAGEMENT CONDUCTED BY ITS COMPENSATION COMMITTEE. A THIRD-PARTY COMPENSATION CONSULTANT IS ENGAGED TO GATHER COMPARABILITY DATA FOR THE ORGANIZATION'S SENIOR MANAGEMENT AND ITS KEY OR HIGHLY COMPENSATED EMPLOYEES. FOLLOWING COMPLETION OF THE ENGAGEMENT, THE THIRD-PARTY CONSULTANT ISSUES A WRITTEN REPORT REFLECTING ITS OPINION CONCERNING WHETHER THE ORGANIZATION'S PROPOSED COMPENSATION ARRANGEMENTS CONSTITUTE REASONABLE COMPENSATION UNDER SECTION 4958 OF THE INTERNAL REVENUE CODE. UPON RECEIPT AND REVIEW OF THE CONSULTANT'S WRITTEN REPORT AND SUPPORTING MATERIALS, THE ORGANIZATION'S COMPENSATION COMMITTEE THEN PROVIDES ALL SUCH MATERIALS ALONG WITH RECOMMENDATIONS TO ITS BOARD OF DIRECTORS FOR CONSIDERATION. SUBSEQUENTLY, THE BOARD OF DIRECTORS HOLDS A MEETING TO REVIEW THE MATERIALS AND RECOMMENDATIONS FROM ITS COMPENSATION COMMITTEE AT WHICH TIME THE BOARD WILL VOTE ON THE REASONABLENESS OF COMPENSATION FOR EACH INDIVIDUAL INCLUDED IN THE COMPENSATION ENGAGEMENT. IF ANY DISQUALIFIED OR OTHERWISE CONFLICTED BOARD MEMBERS ARE PRESENT AT THE MEETING, THEY DO NOT PARTICIPATE IN THE DELIBERATIONS AND ARE EXCUSED FROM VOTING ON SUCH MATTERS. THE COMPENSATION APPROVAL PROCESS IS CARRIED OUT BY THE ORGANIZATION'S BOARD OF DIRECTORS IN A MANNER DESIGNED TO SATISFY ALL THREE OF THE REQUIREMENTS NECESSARY TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS WITH RESPECT TO COMPENSATION ARRANGEMENTS FOR DISQUALIFIED PERSONS UNDER SECTION 53.4958-6 OF THE INTERNAL REVENUE CODE. AS PART OF THE PROCESS, THE ORGANIZATION'S BOARD OF DIRECTORS RETAINS THIRD-PARTY LEGAL COUNSEL TO FURTHER ADVISE THE BOARD ON THE REBUTTABLE PRESUMPTION PROCESS AND TO PROVIDE THE BOARD WITH A LEGAL OPINION REGARDING THE SAME. THE FINAL STEP IN THE PROCESS IS PREPARATION OF DOCUMENTATION REQUIRED TO ESTABLISH THE REBUTTABLE PRESUMPTION UTILIZING THE REBUTTABLE PRESUMPTION CHECKLIST ISSUED BY THE INTERNAL REVENUE SERVICE. FORM 990, PAGE 6, PART VI, LINE 15B THE ORGANIZATION REGULARLY AND CONSISTENTLY COMPLIES WITH THE COMPENSATION APPROVAL PROCESS, AS DEFINED BY ITS CONFLICTS OF INTEREST POLICY, THROUGH A COMPREHENSIVE ENGAGEMENT CONDUCTED BY ITS COMPENSATION COMMITTEE. A THIRD-PARTY COMPENSATION CONSULTANT IS ENGAGED TO GATHER COMPARABILITY DATA FOR THE ORGANIZATION'S SENIOR MANAGEMENT AND ITS KEY OR HIGHLY COMPENSATED EMPLOYEES. FOLLOWING COMPLETION OF THE ENGAGEMENT, THE THIRD-PARTY CONSULTANT ISSUES A WRITTEN REPORT REFLECTING ITS OPINION CONCERNING WHETHER THE ORGANIZATION'S PROPOSED COMPENSATION ARRANGEMENTS CONSTITUTE REASONABLE COMPENSATION UNDER SECTION 4958 OF THE INTERNAL REVENUE CODE. UPON RECEIPT AND REVIEW OF THE CONSULTANT'S WRITTEN REPORT AND SUPPORTING MATERIALS, THE ORGANIZATION'S COMPENSATION COMMITTEE THEN PROVIDES ALL SUCH MATERIALS ALONG WITH RECOMMENDATIONS TO ITS BOARD OF DIRECTORS FOR CONSIDERATION. SUBSEQUENTLY, THE BOARD OF DIRECTORS HOLDS A MEETING TO REVIEW THE MATERIALS AND RECOMMENDATIONS FROM ITS COMPENSATION COMMITTEE AT WHICH TIME THE BOARD WILL VOTE ON THE REASONABLENESS OF COMPENSATION FOR EACH INDIVIDUAL INCLUDED IN THE COMPENSATION ENGAGEMENT. IF ANY DISQUALIFIED OR OTHERWISE CONFLICTED BOARD MEMBERS ARE PRESENT AT THE MEETING, THEY DO NOT PARTICIPATE IN THE DELIBERATIONS AND ARE EXCUSED FROM VOTING ON SUCH MATTERS. THE COMPENSATION APPROVAL PROCESS IS CARRIED OUT BY THE ORGANIZATION'S BOARD OF DIRECTORS IN A MANNER DESIGNED TO SATISFY ALL THREE OF THE REQUIREMENTS NECESSARY TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS WITH RESPECT TO COMPENSATION ARRANGEMENTS FOR DISQUALIFIED PERSONS UNDER SECTION 53.4958-6 OF THE INTERNAL REVENUE CODE. AS PART OF THE PROCESS, THE ORGANIZATION'S BOARD OF DIRECTORS RETAINS THIRD-PARTY LEGAL COUNSEL TO FURTHER ADVISE THE BOARD ON THE REBUTTABLE PRESUMPTION PROCESS AND TO PROVIDE THE BOARD WITH A LEGAL OPINION REGARDING THE SAME. THE FINAL STEP IN THE PROCESS IS PREPARATION OF DOCUMENTATION REQUIRED TO ESTABLISH THE REBUTTABLE PRESUMPTION UTILIZING THE REBUTTABLE PRESUMPTION CHECKLIST ISSUED BY THE INTERNAL REVENUE SERVICE. FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST IN ACCORDANCE WITH THE SECTION 6104(D) DISCLOSURE REQUIREMENTS. FORM 990, PART VIII PART VIII, LINE 1E -- THE PROVIDER RELIEF FUND WAS ESTABLISHED THROUGH THE CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY ACT (CARES ACT)AND THE PAYCHECK PROTECTION PROGRAM AND HEALTHCARE ENHANCEMENT ACT (PPCHE). THIS LEGISLATION AUTHORIZED THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES TO MAKE GENERAL AND TARGETED DISTRIBUTIONS TO QUALIFYING HEALTHCARE PROVIDERS BASED ON THE VARIOUS FORMULAS AND CRITERIA DESIGNATED IN THE LEGISLATION. THE CORPORATION RECEIVED 1,162,533 UNDER THESE PROGRAMS FOR THE YEAR ENDED JUNE 30, 2021. OF THIS AMOUNT, THE CORPORATION UTILIZED FUNDS TOTALING 1,162,533 DURING THE YEAR ENDED JUNE 30, 2021. THIS AMOUNT IS INCLUDED ON LINE 1E ON THE FORM 990 STATEMENT OF REVENUE. FORM 990, PART XI, LINE 9 DISTRIBUTION OF NET ASSETS -6,254,813 PSI LLC 440 INDUSTRIAL BOULEVARD HAWKINSVILLE GA 31036 432007496 PHARMACY GA 40031403 6284448 NA HDI LLC 440 INDUSTRIAL BOULEVARD HAWKINSVILLE GA 31036 432007496 SUPPLY DIS GA 20481725 5998480 NA HELPLINK LLC PO BOX 1803 MACON GA 31202 141904766 EMERGENCY GA 904067 101814 NA CLINICAL SERVICES INC 1005 BOULDER DRIVE GRAY GA 31032 571157115 CLINICAL & GA 501C 10 CHSI false COMMUNITY HEALTH FOUNDATION INC 110 STONE BROOKE DRIVE GRAY GA 31032 571157153 FINANCIAL GA 501C 10 CHSI false COMMUNITY HEALTH SYSTEMS INC PO BOX 1037 MACON GA 31202 743083593 SUPPORT SE GA 501C 12A NA false COMMUNITY REHABILITATION SERVICES 110 STONE BROOKE DRIVE GRAY GA 31032 203253779 REHABILITA GA 501C 10 CHSI false HEALTH SCHOLARSHIPS INC 1005 BOULDER DRIVE GRAY GA 31032 581805305 OPERATION GA 501C 10 CHSI false HEALTH SYSTEMS FACILITIES INC 1005 BOULDER DRIVE GRAY GA 31032 743083594 OPERATION GA 501C 10 CHSI false HEALTH SYSTEMS REAL ESTATE INC 110 STONE BROOKE DRIVE GRAY GA 31032 432007488 RE GA 501C 10 CHSI false HOME & COMMUNITY SERVICES INC 110 STONE BROOKE DRIVE GRAY GA 31032 432007492 TRANS GA 501C 10 CHSI false PIEDMONT REGIONAL HEALTH INC 1005 BOULDER DRIVE GRAY GA 31032 432007498 OPERATION GA 501C 10 CHSI false STEWARD HEALTH SERVICES INC 110 STONE BROOKE DRIVE GRAY GA 31032 432007486 HOSPICE GA 501C 10 CHSI false COMMUNITY HEALTH VENTURES INC 4875 RIVERSIDE DRIVE SUITE 105 MACON GA 31210 201392241 RISK MGMT GA CHSI C CORP false GEORGIA PHARMACY SERVICES INC 110 STONE BROOKE DRIVE GRAY GA 31032 200248574 PHARMACY GA N/A false HEALTH DISTRIBUTION SERVICES INC 110 STONE BROOKE DRIVE GRAY GA 31032 200248557 SUPPLY DIS GA N/A false COMMUNITY CARE PHAR - HAWKINSVILLE 150 COMMERCE STREET HAWKINSVILLE GA 31036 320395216 PHARMACY GA N/A false COMMUNITY CARE PHARMACY-ROYSTON 635 COOK STREET ROYSTON GA 30662 383931420 PHARMACY GA N/A false false false false false false false false false false false true true true false false false false true false COMMUNITY HEALTH SYSTEMS INC M 3310490 COMMUNITY HEALTH FOUNDATION INC R 2060 HEALTH SCHOLARSHIPS INC L 13981106 HEALTH SYSTEMS FACILITIES INC L 5081479 PIEDMONT REGIONAL HEALTH INC L 1513839 HOME & COMMUNITY SERVICES INC L 726801 COMMUNITY HEALTLH SYSTEMS INC K 159000 HEATLH SCHOLARSHIPS INC K HEALTH SYSTEMS FACILITIES INC K PIEDMONT REGIONAL HEALTH INC K