2024-05-08T07:55:03-05:00 2023-06-30 440160260 FORVIS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2022-07-01 201220860 MAGNOLIA MANOR OF MARION 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 MARK TODD 2001 SOUTH LEE STREET AMERICUS GA 31709 6563224 0 X WWW.MAGNOLIAMANOR.COM X 2004 GA THE CORPORATION IS ORGANIZED TO PROVIDE LONG-TERM CARE TO THE SICK AND ELDERLY IN A SPIRITUAL SETTING THROUGH THE OPERATION OF A 70-BED SKILLED NURSING FACILITY LOCATED IN BUENA VISTA, GEORGIA. 14 14 119 0 0 0 0 0 6722856 6389221 1992 27571 150060 146432 6874908 6563224 0 0 0 0 2908352 3096270 0 0 0 2689392 4040318 5597744 7136588 1277164 -573364 8489949 7624974 2834820 4064805 5655129 3560169 THE CORPORATION IS ORGANIZED TO PROVIDE LONG-TERM CARE TO THE SICK AND ELDERLY IN A SPIRITUAL SETTING THROUGH THE OPERATION OF A 70-BED SKILLED NURSING FACILITY LOCATED IN BUENA VISTA, GEORGIA. 0 0 6329482 6390821 PROVIDED LONG-TERM CARE FOR THE SICK AND ELDERLY IN A SPIRITUAL SETTING IN A 70-BED SKILLED NURSING FACILITY. THE ORGANIZATION PROVIDED 22,786 PATIENT DAYS OF SERVICE DURING THE YEAR. 6329482 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 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 8 0 1 119 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 0 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 10.00 50.00 X 0 340665 9957 DAVID CHARTER CFO 10.00 50.00 X 0 130915 6461 ANGELA WATKINS FACILITY ADMINISTRATOR 40.00 X 105977 0 9030 JACKIE SAMPSON-LOCKHART LPN SUPERVISOR 40.00 X 100241 0 9030 206218 471580 34478 2 0 1 0 LEADERSTAT L-4234 COLUMBUS OH 432604234 CONTRACT NURSING AGENCY 533143 JACKSON NURSE PROFESSIONALS PO BOX 404118 ATLANTA GA 303844118 CONTRACT NURSING AGENCY 233570 2 MEDICARE/MEDICAID PAYM 623000 5396978 5396978 ROUTINE ROOM/BOARD 623000 992243 992243 6389221 27571 27571 MISCELLANEOUS INCOME 623000 108351 108351 SHARE OF AFFILATE INVE 900099 36481 36481 CAFETERIA SALES 623000 1600 1600 146432 6563224 6390821 0 172403 X 2573981 2411281 162700 34502 29868 4634 300509 276296 24213 187278 175065 12213 358443 358443 30865 30865 1937629 1864810 72819 3599 3599 133003 88562 44441 4862 4862 257065 257065 7823 3375 4448 175221 175221 183833 183833 124542 49652 74890 MEDICAID PROVIDER FEE 373140 373140 RAW FOOD 188502 188502 MEDICAL SUPPLIES 97441 97441 DRUGS 83585 83585 80765 71786 8979 7136588 6329482 807106 0 193742 129885 2037183 58636 351024 637154 8692 11161 445 447 4905774 1223098 3624951 3682676 125040 133721 2148872 2971294 8489949 7624974 428891 503654 2405929 2406929 0 1154222 2834820 4064805 X 5655129 3560169 5655129 3560169 8489949 7624974 X -573364 -1521596 X X 0 1 X 1 0 X 6526047 6895773 6533989 6724996 6390821 33071626 6526047 6895773 6533989 6724996 6390821 33071626 0 0 0 33071626 16306 9294 674 1992 27571 55837 16306 9294 674 1992 27571 55837 86814 87112 60596 149912 144832 529266 6629167 6992179 6595259 6876900 6563224 33656729 0.98260 0.98450 0.00170 0.00110 X 3852948 683431 3169517 665503 409459 256044 387323 130208 257115 3682676 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 11258 DUE FROM RELATED ORGANIZATIONS 1803564 OTHER RECEIVABLES 2250 ROU LEASES 1154222 2971294 ROU LEASE LIABILITY 1154222 1154222 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 0 0 0 0 0 0 0 MARK TODD CEO 0 340665 0 0 0 0 0 0 0 9957 0 350622 0 0 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 TAX-EXEMPT 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 IT FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST AT THE MAGNOLIA MANOR, INC. CORPORATE OFFICE IN AMERICUS, GEORGIA. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE MAGNOLIA MANOR, INC. CORPORATE OFFICE IN AMERICUS, GEORGIA. FORM 990, PART IX, LINE 11G CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,851,272. MANAGEMENT AND GENERAL EXPENSES 23,311. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,874,583. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 3,720. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,720. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 9,818. MANAGEMENT AND GENERAL EXPENSES 49,508. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 59,326. FORM 990, PART XI, LINE 9: CHANGE IN DUE TO/FROM INTERCOMPANY ACCOUNTS -1,521,596. FORM 990. PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MAGNOLIA MANOR INC 2001 S LEE STREET AMERICUS GA 31709 580911706 ELDERLY AFFORDABLE LONG-TERM CARE AND ASSISTED LIVING GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF ST SIMONS INC 2255 FREDENCA RD ST SIMMONS ISLAND GA 31522 201364957 ELDERLY AFFORDABLE LONG-TERM CARE AND ASSISTED LIVING GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF MACON SUPPORTIVE HOUSING INC 190 PIERCE AVE MACON GA 31204 311651955 ASSISTED LIVING GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF COLUMBUS INC 2010 WARM SPRINGS RD COLUMBUS GA 31904 208034409 ELDERLY AFFORDABLE LONG-TERM CARE AND ASSISTED LIVING GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF MACON INC 190 PIERCE AVE MACON GA 31204 261311379 ASSISTED LIVING 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 PROVISION OF PHARMACY-RELATED PRODUCTS AND SERVICES GA N/A 0 0 MMI ASSURANCE LTD 2001 S LEE STREET AMERICUS GA 31709 981082342 CAPTIVE INSURANCE COMPANY CJ N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0