2024-05-08T07:55:04-05:00 2023-06-30 440160260 FORVIS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2022-07-01 580911706 MAGNOLIA MANOR INC MAGN 2299249352 2001 SOUTH LEE STREET AMERICUS GA 31709 MARK TODD CEO, 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 MARK TODD 2001 SOUTH LEE STREET AMERICUS GA 31709 32120595 0 X WWW.MAGNOLIAMANOR.COM X 1962 GA THE CORPORATION IS ORGANIZED TO PROVIDE AFFORDABLE HOUSING AND LONG-TERM CARE AND ASSISTED LIVING TO THE ELDERLY IN A SPIRITUAL SETTING. THE CORPORATION OPERATES A LONG-TERM CARE FACILITY, FIVE RETIREMENT COMMUNITIES AND SEVERAL MORE INDEPENDENT LIVING APARTMENT COMPLEXES THROUGHOUT SOUTH AND MIDDLE GEORGIA. 14 14 550 24 0 0 995748 538563 23189205 24264173 3865754 1117289 5222283 6146766 33272990 32066791 0 0 0 0 15604327 16898153 0 0 598549 17008277 23464539 32612604 40362692 660386 -8295901 101720114 92280050 53133859 52383061 48586255 39896989 X THE CORPORATION IS ORGANIZED TO PROVIDE AFFORDABLE HOUSING AND LONG-TERM CARE AND ASSISTED LIVING TO THE ELDERLY IN A SPIRITUAL SETTING. THE CORPORATION OPERATES A LONG-TERM CARE FACILITY, FIVE RETIREMENT COMMUNITIES AND SEVERAL MORE INDEPENDENT LIVING APARTMENT COMPLEXES THROUGHOUT SOUTH AND MIDDLE GEORGIA. 0 0 30261595 29545757 THE ORGANIZATION PROVIDES RESIDENTIAL SERVICES TO THE SICK AND AGED IN A SPIRITUAL SETTING. THE ORGANIZATION PROVIDES THESE SERVICES THROUGH THE OPERATION AND LONG-TERM CARE AND ASSISTED AND INDEPENDENT LIVING FACILITIES. THE ORGANIZATION OPERATES 268 LONG-TERM SKILLED NURSING BEDS AND APPROXIMATELY 600 ASSISTED LIVING AND INDEPENDENT LIVING BEDS IN SEVERAL FACILITIES THROUGHOUT THE STATE OF GEORGIA. 30261595 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 1 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 78 0 1 550 1 0 1 CJ 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 THE ORGANIZATION 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 40.00 20.00 X 340665 0 9957 HILLERY FORT COO 40.00 20.00 X 254324 0 28948 DAVID CHARTER CFO 40.00 X 130915 0 6461 DIANE HARRISON VP OF HUMAN RESOURCES 40.00 X 191259 0 20519 LORI PORTFLEET VP OF OPERATIONS 40.00 X 168677 0 14562 MELVIN KINSLOW VP OF COMMUNICATIONS 40.00 X 166814 0 28948 SUSAN FUSSELL VP OF RESIDENT SAFETY & ER 40.00 X 126856 0 9030 BARBARA MITCHELL VP FOR CLINICAL 40.00 X 125526 0 9444 DAVID PRINCE VP FOR INFORMATION SYSTEMS 40.00 X 109695 0 9030 JOY ROBERTS VP FOR CLINICAL REIMBURSEMENT 40.00 X 105360 0 16111 ANDREA EVANS VP FOR CORPORATE SALES 40.00 X 102868 0 24097 1822959 0 177107 11 0 1 0 ACCOUNTABLE HEALTHCARE STAFFING PO BOX 732800 DALLAS IL 606756773 CONTRACT NURSING AGENCY 1140675 LEADERSTAT L-4234 COLUMBUS OH 432604234 CONTRACT NURSING AGENCY 957525 PIEDMONT CONSTRUCTION 107 GATEWAY DR SUITE B MACON GA 31210 MAINTENANCE/CONSTRUCTION 522832 SALTERS PAINTING & ROOFING 504 VALLEY DR AMERICUS GA 31709 MAINTENANCE/CONSTRUCTION 260491 SOLUTION ADVISORS 12425 28TH STREET N SUITE 100 ST PETERSBURG FL 33716 PLANNING/DESIGNING/CONSULTING 231296 9 5470 533093 61250 538563 ROUTINE ROOM/BOARD 623000 17088031 17088031 MEDICARE/MEDICAID PAYMENT 623000 7176142 7176142 24264173 773389 773389 10208 0 10208 10208 10208 343485 415 0 0 343485 415 343900 343900 202150 5470 53291 148859 148859 513 -513 -513 MANAGEMENT FEE REVENUE 541610 4825032 4825032 MISCELLANEOUS INCOME 900099 503435 503435 CAFETERIA SALES 623000 257316 257316 402429 189541 212888 5988212 32066791 29545757 0 1982471 X 1530873 1530873 12251386 9707324 2221765 322297 251014 138927 99501 12586 1889828 1393681 446320 49827 975052 690166 262398 22488 2179455 767095 1412360 515284 515284 112428 112428 48000 48000 8089058 7564658 522407 1993 392172 44952 347220 989477 123601 736667 129209 68332 3014 49773 15545 1848783 1848783 368344 105932 233349 29063 5000 5000 1862230 1862230 2484616 2418754 65862 1286104 653378 632726 RAW FOOD 1332595 1332595 SUPPLIES 1204071 927915 260615 15541 BAD DEBT EXPENSE 300488 300488 DRUGS 197452 197452 180650 180650 40362692 30261595 9502548 598549 2389445 2542595 15844494 6594954 372020 783582 1576426 1547697 50922 47766 139633 219718 88832927 53705120 37842910 35127807 30280327 32451804 441346 454719 12782591 12509408 101720114 92280050 4193480 5092028 6351036 7401620 1103868 561875 19322111 17990301 22163364 21337237 53133859 52383061 X 44929311 36178220 3656944 3718769 48586255 39896989 101720114 92280050 X -8295901 3512493 -3905858 X X 0 1 X 1 0 X 465143 936146 787932 995748 740713 3925682 31066514 27426561 30249049 27995850 29545757 146283731 85116 85116 31616773 28362707 31036981 28991598 30286470 150294529 5104 5100 5600 17050 10200 43054 0 5104 5100 5600 17050 10200 43054 150251475 724244 986923 1557028 1401976 783597 5453768 724244 986923 1557028 1401976 783597 5453768 439718 534051 601276 281341 716323 2572709 32780735 29883681 33195285 30674915 31786390 158321006 0.94900 0.94800 0.03440 0.03360 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 48000 48000 0 PART II-B, LINE 1: THE ORGANIZATION ENTERED INTO A CONTRACT WITH A LAW FIRM TO PERFORM LOBBYING ON THEIR BEHALF. NO DIRECT LOBBYING PAYMENTS WERE MADE TO ANY SPECIFIC CANDIDATE. 5018252 384324 174516 5228060 5931164 359133 1272045 5018252 4739719 1372072 180627 5931164 4661573 261746 183600 4739719 4464076 361358 163861 4661573 1.00000 0 0 2189068 2189068 65169680 39256117 25913563 14158291 12513092 1645199 7315888 1935911 5379977 35127807 ESTIMATED 3RD PARTY PAYOR SETTLEMENTS 23332 OTHER RECEIVABLES 12486076 12509408 DUE TO RELATED ORGANIZATIONS 21337237 21337237 X PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS ARE HELD TO PROVIDE SUPPORT OF OPERATIONS AND PATIENT SUPPORT. 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. CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, INVESTMENTS INVESTMENT IN CAPTIVE INSURANCE.LIST 74 _ 2JOHN.MODLIN@DHG.COM - 11/30/21 09:19 AM WORKSHEET SCHEDULE F - STATEMENT OF ACTIVITIES OUTSIDE THE U.S. AFS - TOTAL ASSETS MMI ASSURAN _ 4998000.LIST 74 _ 2JOHN.MODLIN@DHG.COM - 01/27/23 11:42 AM WORKSHEET SCHEDULE F - STATEMENT OF ACTIVITIES OUTSIDE THE U.S. AFS - TOTAL ASSETS MMI ASSURAN _ 5076000 6117687 0 0 0 0 0 0 6117687 0 6117687 1 0 1 0 0 0 PART III ACCOUNTING METHOD: JOHN BATTS MEMORIAL GOLF CLASSIC 65157 65157 988 8370 5913 3881 JOHN GILL MEMORIAL QUAIL HUNT 63700 63700 3495 17417 2145 2 78763 5470 73293 500 7789 700 2093 207620 5470 202150 4483 26287 15847 700 5974 53291 148859 X 0 0 0 0 0 0 0 0 0 MARK TODD CEO 340665 0 0 0 0 0 0 0 9957 0 350622 0 0 0 HILLERY FORT COO 254324 0 0 0 0 0 0 0 28948 0 283272 0 0 0 DIANE HARRISON VP OF HUMAN RESOURCES 190657 0 0 0 602 0 0 0 20519 0 211778 0 0 0 MELVIN KINSLOW VP OF COMMUNICATIONS 166814 0 0 0 0 0 0 0 28948 0 195762 0 0 0 LORI PORTFLEET VP OF OPERATIONS 168677 0 0 0 0 0 0 0 14562 0 183239 0 0 0 A AMERICUS AND SUMTER COUNTY HOSPITAL AUTHORITY 586000058 2020-08-25 37114739 REFINANCE EXISTING DEBT AND LAND 0 0 0 A 1802243 37114739 12662227 24451512 2043 1 0 0 0 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 0 A 0 X 4 61250 FMV 0 0 0 FORM 990, PART V, LINE 13A GA 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 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 UPON REQUEST AT THE ORGANIZATION'S OFFICE LOCATED IN AMERICUS, GEORGIA. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE UPON REQUEST AT THE ORGANIZATION'S OFFICE LOCATED IN AMERICUS, GEORGIA. FORM 990, PART IX, LINE 11G CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 7,470,266. MANAGEMENT AND GENERAL EXPENSES 324,207. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,794,473. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 52,617. MANAGEMENT AND GENERAL EXPENSES 198,200. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 250,817. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 41,775. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 1,993. TOTAL EXPENSES 43,768. FORM 990, PART XI, LINE 9: CHANGE IN DUE TO/FROM INTERCOMPANY ACCOUNTS -3,905,858. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MAGNOLIA MANOR OF COLUMBUS INC 2001 SOUTH LEE STREET AMERICUS GA 31709 208034409 OPERATION OF (2) NURSING FACILITIES AND A RETIREMENT FACILITY GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF MACON SUPPORTIVE HOUSING INC 2001 SOUTH LEE STREET AMERICUS GA 31709 311651955 HUD SUPPORTIVE HOUSING FACILITY GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF MARION COUNTY INC 2001 SOUTH LEE STREET AMERICUS GA 31709 201220860 LEASE AND OPERATION OF A LONG-TERM CARE FACILITY GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF ST SIMONS INC 2001 SOUTH LEE STREET AMERICUS GA 31709 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 2001 SOUTH LEE STREET AMERICUS GA 31709 261311379 OPERATION OF AN ASSISTED LIVING FACILITY GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF LIBERTY COUNTY INC 2001 SOUTH LEE STREET AMERICUS GA 31709 842738089 OPERATION OF A NURSING FACILITY GA 501(C)(3) LINE 10 0 GEORGIA PHARMACY VENTURES LLC 440 INDUSTRIAL BOULEVARD HAWKINSVILLE GA 31036 261918757 PROVIDES PHARMACY RELATED PRODUCTS AND SERVICES TO MAGNOLIA MANOR RESIDENTS GA MAGNOLIA MANOR INC RELATED 598643 311777 0 0 0.25960 MMI ASSURANCE LTD 2001 SOUTH LEE STREET AMERICUS GA 31709 981082342 CAPTIVE INSURANCE COMPANY CJ MAGNOLIA MANOR INC C 1873850 5075764 1.00000 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 1 0 1 1 0