JOHN D ARCHBOLD MEMORIAL HOSPITAL INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: JOHN D ARCHBOLD MEMORIAL HOSPITAL INC (EIN 58-0566121)
Tax period: 2020-10-01 to 2021-09-30
Filed: 2023-09-25
IRS object ID: 202322689349300937
Schema version: 2020v4.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-09-25T13:17:29-04:00	ReturnTs
Tax Period End	2021-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	580914992	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	DRAFFIN & TUCKER LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 71309	AddressLine1Txt
City	ALBANY	CityNm
State Abbreviation	GA	StateAbbreviationCd
ZIP	317081309	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2020-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	580566121	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JOHN D ARCHBOLD MEMORIAL	BusinessNameLine1Txt
Business Name Line2	HOSPITAL INC	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	JOHN	BusinessNameControlTxt
Phone	2292282853	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	P O BOX 1018	AddressLine1Txt
City	THOMASVILLE	CityNm
State Abbreviation	GA	StateAbbreviationCd
ZIP	317991018	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DARCY M CRAVEN	PersonNm
Person Title	PRESIDENT/CEO	PersonTitleTxt
Phone	2292282737	PhoneNum
Signature	2023-09-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	DARCY	PersonFirstNm
Person Last	CRAVEN	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	WILLIAM EDWARD PHILLIPS	PreparerPersonNm
PTIN	P00451499	PTIN
Phone	2298837878	PhoneNum
Preparation	2023-09-25	PreparationDt

Field	Value	IRS element (for citing)
Tax	2020	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Amended Return	Yes (X)	AmendedReturnInd
Principal Officer	DARCY M CRAVEN	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	P O BOX 1018	AddressLine1Txt
City	THOMASVILLE	CityNm
State Abbreviation	GA	StateAbbreviationCd
ZIP	317991018	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$439,203,918	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.ARCHBOLD.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1923	FormationYr
Legal Domicile State	GA	LegalDomicileStateCd
Activity Or Mission	HEALTHCARE SERVICES	ActivityOrMissionDesc
Voting Members Governing Body	16	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	48	TotalVolunteersCnt
Total Gross UBI	$1,181,212	TotalGrossUBIAmt
PY Contributions Grants	$5,274,021	PYContributionsGrantsAmt
CY Contributions Grants	$51,872,256	CYContributionsGrantsAmt
PY Program Service Revenue	$327,140,092	PYProgramServiceRevenueAmt
CY Program Service Revenue	$353,338,607	CYProgramServiceRevenueAmt
PY Investment Income	$12,067,665	PYInvestmentIncomeAmt
CY Investment Income	$30,593,277	CYInvestmentIncomeAmt
PY Other Revenue	$2,191,950	PYOtherRevenueAmt
CY Other Revenue	$2,398,727	CYOtherRevenueAmt
PY Total Revenue	$346,673,728	PYTotalRevenueAmt
CY Total Revenue	$438,202,867	CYTotalRevenueAmt
PY Grants And Similar Paid	$551,636	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$438,050	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$147,610,361	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$152,916,057	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$175,974,703	PYOtherExpensesAmt
CY Other Expenses	$192,952,770	CYOtherExpensesAmt
PY Total Expenses	$324,136,700	PYTotalExpensesAmt
CY Total Expenses	$346,306,877	CYTotalExpensesAmt
PY Revenues Less Expenses	$22,537,028	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$91,895,990	CYRevenuesLessExpensesAmt
Total Assets BOY	$893,092,785	TotalAssetsBOYAmt
Total Assets EOY	$974,216,793	TotalAssetsEOYAmt
Total Liabilities BOY	$223,103,329	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$185,777,374	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$669,989,456	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$788,439,419	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	HEALTHCARE SERVICES	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$244,980,446	ExpenseAmt
Grant	$438,050	GrantAmt
Revenue	$283,196,414	RevenueAmt
Desc	JOHN D. ARCHBOLD MEMORIAL HOSPITAL (JDAMH) IN THOMASVILLE GEORGIA OPERATES WITH 264 LICENSED BEDS; OF WHICH 226 ARE MED/SURG, 18 BEDS ARE DESIGNATED TO A PSYCH UNIT, 20 BEDS ARE REHAB. IN ADDITION, THEY OPERATE A 64 BED SKILLED NURSING FACILITY. JDAMH IS A RURAL REFERRAL CENTER COVERING THOMAS COUNTY AND SURROUNDING COUNTIES IN SOUTHERN GEORGIA AND NORTHERN FLORIDA. 69% OF PATIENTS WERE COVERED BY MEDICARE AND MEDICAID, AND 4.0% OF PATIENT REVENUE WAS PROVIDED AS INDIGENT CARE. IN 2021, JDAMH PROVIDED AN ESTIMATED 33.1 MILLION IN INDIGENT CARE CHARGES. JDAMH TREATS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN ADDITION JDAMH PROVIDED APPROXIMATELY 51.2 MILLION IN ADDITIONAL UNCOMPENSATED CARE. THROUGHOUT THE YEAR, JDAMH PRODUCES OR SPONSORS MANY SPECIAL PROGRAMS FOR THE COMMUNITY TO EDUCATE THEM ON IMPORTANT HEALTH NEEDS. JDAMH, INC. ALSO MAINTAINS HOSPITALS IN GRADY COUNTY, BROOKS COUNTY, AND MITCHELL COUNTY, FILING UNDER EIN 58-0566121.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$27,130,858	ExpenseAmt
Revenue	$30,758,559	RevenueAmt
Desc	MITCHELL COUNTY HOSPITAL AND NURSING HOMES OPERATE IN CAMILLA, GEORGIA AS A CRITICAL ACCESS HOSPITAL WITH 25 ACUTE CARE BEDS AND 156 NURSING HOME BEDS. IT SERVES MITCHELL COUNTY AND 58% OF ITS PATIENTS WERE MEDICARE/MEDICAID. IN 2021, APPROXIMATELY 2.8 MILLION OF INDIGENT CARE WAS PROVIDED TO THE COMMUNITY. IN ADDITION, MITCHELL COUNTY HOSPITAL PROVIDED AN ESTIMATED 6.3 MILLION IN ADDITIONAL UNCOMPENSATED CARE. EIN 58-6001307 FILED UNDER EIN 58-0566121.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$21,380,890	ExpenseAmt
Revenue	$29,921,358	RevenueAmt
Desc	GRADY GENERAL HOSPITAL (GGH) IN CAIRO, GEORGIA OPERATES A 60 LICENSED BED ACUTE CARE FACILITY. TEN BEDS CAN BE USED AS SWING BEDS. IT SERVES GRADY COUNTY AND 57% OF ITS PATIENTS WERE MEDICARE/MEDICAID. IN 2021, GGH PROVIDED APPROXIMATELY 4.3 MILLION IN INDIGENT CARE. IN ADDITION, GRADY GENERAL HOSPITAL PROVIDED AN ESTIMATED 7.4 MILLION IN ADDITIONAL UNCOMPENSATED CARE. EIN 58-1646537 FILED UNDER EIN 58-0566121.	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Expense	$9,379,324	ExpenseAmt
Revenue	$8,857,584	RevenueAmt
Desc	BROOKS COUNTY HOSPITAL OPERATES IN QUITMAN, GEORGIA AS A CRITICAL ACCESS HOSPITAL WITH 25 ACUTE CARE BEDS. IT SERVES BROOKS COUNTY AND 57% OF ITS PATIENTS WERE MEDICARE/MEDICAID. IN 2021, AN ESTIMATED 2.1 MILLION OF INDIGENT CARE WAS PROVIDED TO THE COMMUNITY. IN ADDITION, BROOKS COUNTY HOSPITAL PROVIDED APPROXIMATELY 3.4 MILLION IN ADDITIONAL UNCOMPENSATED CARE. EIN 58-6002830 FILED UNDER EIN 58-0566121.	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$9,379,324	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue	$8,857,584	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$302,871,518	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (true)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	false	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	Yes (true)	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	Yes (true)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	Yes (true)	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	206	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	16	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	GA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	GREG HEMBREE	PersonNm
Phone	2292282853	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 1018	AddressLine1Txt
City	THOMASVILLE	CityNm
State Abbreviation	GA	StateAbbreviationCd
ZIP	317991018	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd
J PERRY MUSTIAN
PAST PRES/CE	0.00	40.00	Yes (X)	$0	$895,220	$810,070
GREG HEMBREE
ASST SEC/SR	1.00	51.00	Yes (X)	$0	$473,627	$73,420
COY IRVIN MD
VP MEDICAL A	40.00			$431,026	$0	$57,661	Yes (X)
JIM CARTER
COO	40.00	1.00	Yes (X)	$410,004	$0	$63,260
DINESH B PATEL MD
PHYSICIAN	40.00			$387,927	$0	$24,207		Yes (X)
EUGENE SUN MD
PHYSICIAN	40.00			$361,948	$0	$21,208		Yes (X)
AMY GRIFFIN
VP PATIENT C	40.00			$330,546	$0	$47,634	Yes (X)
JASON NESMITH MD
TRUSTEE	1.00			$0	$337,367	$16,370			Yes (X)
KEN BROOKER
VP CLINICAL	20.00	20.00		$267,723	$0	$38,668	Yes (X)
RAMESAN NAIR MD
PHYSICIAN	40.00			$271,679	$0	$25,418		Yes (X)
SHANE HERRIN MD
PHYSICIAN	40.00			$263,230	$0	$23,042		Yes (X)
LISSA MURPHY MD
PHYSICIAN	40.00			$268,248	$0	$16,343		Yes (X)
DARCY M CRAVEN
PRESIDENT/CE	1.00	51.00	Yes (X)	$269,113	$0	$12,285			Yes (X)
JAMIE WOMACK
VP CRITICAL	20.00	20.00		$227,004	$0	$32,456	Yes (X)
CHRIS NEWMAN
VP ANCILLARY	40.00			$233,587	$0	$24,337	Yes (X)
JIM BUE
VP FACILITY	40.00			$230,931	$0	$25,582	Yes (X)
MARK LOWE
VP MARKETING	40.00			$163,294	$0	$22,915	Yes (X)
JOE BROWN
TRUSTEE	1.00			$0	$0	$0			Yes (X)
DAVID I MEDEROS DO
TRUSTEE	1.00	1.00		$0	$0	$0			Yes (X)
CRAIG R WENTWORTH EDD
CHAIRMAN	1.00	1.00	Yes (X)	$0	$0	$0			Yes (X)
DEBORAH GASKINS
TRUSTEE	1.00			$0	$0	$0			Yes (X)
SINA GRIFFITH
VICE CHAIRMA	1.00		Yes (X)	$0	$0	$0			Yes (X)
W GREGORY HAMIL
TRUSTEE	1.00	1.00		$0	$0	$0			Yes (X)
HENRY A STONE III
TRUSTEE	1.00	1.00		$0	$0	$0			Yes (X)
NATHANIEL H ABRAMS JR
TREASURER	1.00	1.00	Yes (X)	$0	$0	$0			Yes (X)
BRIAN SZWARC MD
TRUSTEE	1.00			$0	$0	$0			Yes (X)
CHARLES R SANDERS JR MD
TRUSTEE	1.00			$0	$0	$0			Yes (X)
DARYL CRENSHAW MD
TRUSTEE	1.00	1.00		$0	$0	$0			Yes (X)
JAMES TREY W FALCONER III MD
TRUSTEE	1.00			$0	$0	$0			Yes (X)
HAILE MCCOLLUM
SECRETARY	1.00		Yes (X)	$0	$0	$0			Yes (X)
SUE STEPHENSON
TRUSTEE	1.00	1.00		$0	$0	$0			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$4,116,260	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,706,214	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,334,876	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	104	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
MORRISON MANAGEMENT SPECIALISTS
5801 PEACHTREE DUNWOODY RD	ATLANTA	GA	303421503	DIETARY SVCS	$6,519,301
RED HILLS RADIOLOGY
714 N DAWSON STREET	THOMASVILLE	GA	317924451	RADIOLOGY SVC	$5,900,484
SOUTHLAND HOSPITALIST GROUP
PO BOX 1276	THOMASVILLE	GA	317991276	HOSPITALIST SVC	$4,366,680
QUALIVIS LLC
5930 CONERSTONE CT W300	SAN DIEGO	CA	92121	NURSING	$3,777,966
CHILDERS CONSTRUCTION
3472 WEEMS ROAD	TALLAHASSEE	FL	32317	CONSTRUCTION	$3,141,991

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	81	CntrctRcvdGreaterThan100KCnt
Related Organizations	$5,458,878	RelatedOrganizationsAmt
Government Grants	$44,263,750	GovernmentGrantsAmt
All Other Contributions	$2,149,628	AllOtherContributionsAmt
Total Contributions	$51,872,256	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICE REVENUE	623000	$352,157,395	$352,157,395
LAB SERVICES	621500	$1,181,212		$1,181,212

Field	Value	IRS element (for citing)
Total Program Service Revenue	$353,338,607	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$30,604,349	TotalRevenueColumnAmt
Exclusion	$30,604,349	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$2,060,326	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$422,508	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$1,637,818	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,637,818	TotalRevenueColumnAmt
Exclusion	$1,637,818	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$376,528	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$387,600	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$11,072	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$11,072	TotalRevenueColumnAmt
Exclusion	-$11,072	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$245,253	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$190,943	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$54,310	TotalRevenueColumnAmt
Exclusion	$54,310	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
MEDICAL RECORD TRANSCRIPT FEE	621990	$264,051	$264,051
MISCELLANOUS REVENUE	621990	$229,422	$229,422
DRUG SALES	623000	$130,079		$130,079

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$83,047	TotalRevenueColumnAmt
Related Or Exempt Func Income	$83,047	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$706,599	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$438,202,867	TotalRevenueColumnAmt
Related Or Exempt Func Income	$352,733,915	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,181,212	UnrelatedBusinessRevenueAmt
Exclusion	$32,415,484	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$96,000	TotalAmt
Program Services	$96,000	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$342,050	TotalAmt
Program Services	$342,050	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$2,431,709	TotalAmt
Program Services	$353,737	ProgramServicesAmt
Management And General	$2,077,972	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$118,918,153	TotalAmt
Program Services	$100,740,167	ProgramServicesAmt
Management And General	$18,177,986	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$2,260,883	TotalAmt
Program Services	$1,889,008	ProgramServicesAmt
Management And General	$371,875	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$17,780,352	TotalAmt
Program Services	$14,820,982	ProgramServicesAmt
Management And General	$2,959,370	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$11,524,960	TotalAmt
Program Services	$9,601,444	ProgramServicesAmt
Management And General	$1,923,516	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$257,932	TotalAmt
Management And General	$257,932	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$27,597	TotalAmt
Management And General	$27,597	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$93,044	TotalAmt
Management And General	$93,044	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$69,126,842	TotalAmt
Program Services	$64,455,690	ProgramServicesAmt
Management And General	$4,671,152	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$215,217	TotalAmt
Program Services	$39,144	ProgramServicesAmt
Management And General	$176,073	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$9,480,666	TotalAmt
Program Services	$7,402,989	ProgramServicesAmt
Management And General	$2,077,677	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,272,661	TotalAmt
Program Services	$1,153,613	ProgramServicesAmt
Management And General	$119,048	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$6,539,394	TotalAmt
Program Services	$5,661,105	ProgramServicesAmt
Management And General	$878,289	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$745,665	TotalAmt
Program Services	$498,727	ProgramServicesAmt
Management And General	$246,938	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$36,627	TotalAmt
Program Services	$36,627	ProgramServicesAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$27,234	TotalAmt
Management And General	$27,234	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$25,270,016	TotalAmt
Program Services	$21,921,739	ProgramServicesAmt
Management And General	$3,348,277	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$2,872,657	TotalAmt
Program Services	$2,872,657	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES JDAMH	$60,633,473	$60,633,126	$347
PROVIDER FEES	$4,945,705		$4,945,705
REPAIRS & MAINTENANCE JDA	$3,623,045	$3,089,164	$533,881
MEDICAL SUPPLIES GRADY	$2,934,331	$2,934,331

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,850,664	TotalAmt
Program Services	$4,329,218	ProgramServicesAmt
Management And General	$521,446	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$346,306,877	TotalAmt
Program Services	$302,871,518	ProgramServicesAmt
Management And General	$43,435,359	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$144,307,432	BOYAmt
EOY	$55,058,932	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$102,755	BOYAmt
EOY	$102,856	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$8,722,067	BOYAmt
EOY	$52,008,632	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$3,627,452	BOYAmt
EOY	$3,738,150	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$4,720,587	BOYAmt
EOY	$5,069,254	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$575,235,016	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$366,871,629	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$208,261,317	BOYAmt
EOY	$208,363,387	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$311,794,304	BOYAmt
EOY	$447,989,506	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$1,229,669	BOYAmt
EOY	$1,229,669	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$210,327,202	BOYAmt
EOY	$200,656,407	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$893,092,785	BOYAmt
EOY	$974,216,793	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$81,442,881	BOYAmt
EOY	$37,130,400	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$39,175,448	BOYAmt
EOY	$2,151,974	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$102,485,000	BOYAmt
EOY	$96,495,000	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
EOY	$50,000,000	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$223,103,329	BOYAmt
EOY	$185,777,374	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$667,798,932	BOYAmt
EOY	$785,768,285	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,190,524	BOYAmt
EOY	$2,671,134	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$669,989,456	BOYAmt
EOY	$788,439,419	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$893,092,785	BOYAmt
EOY	$974,216,793	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$91,895,990	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$26,553,973	NetUnrlzdGainsLossesInvstAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	Yes (true)	AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Total Direct Lobbying TotalDirectLobbyingGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$13,029	FilingOrganizationsTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$13,029	FilingOrganizationsTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$303,208,645	FilingOrganizationsTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$303,221,674	FilingOrganizationsTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$1,000,000	FilingOrganizationsTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$250,000	FilingOrganizationsTotalAmt

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$1,000,000	CurrentYearMinus3Amt
Current Year Minus2	$1,000,000	CurrentYearMinus2Amt
Current Year Minus1	$1,000,000	CurrentYearMinus1Amt
Current Year	$1,000,000	CurrentYearAmt
Total	$4,000,000	TotalAmt

Field	Value	IRS element (for citing)
Lobbying Ceiling	$6,000,000	LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$11,616	CurrentYearMinus3Amt
Current Year Minus2	$12,512	CurrentYearMinus2Amt
Current Year Minus1	$12,686	CurrentYearMinus1Amt
Current Year	$13,029	CurrentYearAmt
Total	$49,843	TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$250,000	CurrentYearMinus3Amt
Current Year Minus2	$250,000	CurrentYearMinus2Amt
Current Year Minus1	$250,000	CurrentYearMinus1Amt
Current Year	$250,000	CurrentYearAmt
Total	$1,000,000	TotalAmt

Field	Value	IRS element (for citing)
Grassroots Ceiling	$1,500,000	GrassrootsCeilingAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,190,524	BeginningYearBalanceAmt
Investment Earnings Or Losses	$480,610	InvestmentEarningsOrLossesAmt
End Year Balance	$2,671,134	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,997,550	BeginningYearBalanceAmt
Investment Earnings Or Losses	$192,974	InvestmentEarningsOrLossesAmt
End Year Balance	$2,190,524	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,973,758	BeginningYearBalanceAmt
Investment Earnings Or Losses	$23,792	InvestmentEarningsOrLossesAmt
End Year Balance	$1,997,550	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,335,125	BeginningYearBalanceAmt
Investment Earnings Or Losses	$251,064	InvestmentEarningsOrLossesAmt
Other Expenditures	$2,612,431	OtherExpendituresAmt
End Year Balance	$1,973,758	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,798,338	BeginningYearBalanceAmt
Investment Earnings Or Losses	$536,787	InvestmentEarningsOrLossesAmt
End Year Balance	$4,335,125	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	1.00000	PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$9,647,084	OtherCostOrOtherBasisAmt
Book Value	$9,647,084	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$162,458,971	OtherCostOrOtherBasisAmt
Depreciation	$76,404,837	DepreciationAmt
Book Value	$86,054,134	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$29,141,549	OtherCostOrOtherBasisAmt
Depreciation	$18,987,521	DepreciationAmt
Book Value	$10,154,028	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$364,467,912	OtherCostOrOtherBasisAmt
Depreciation	$271,479,271	DepreciationAmt
Book Value	$92,988,641	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$9,519,500	OtherCostOrOtherBasisAmt
Book Value	$9,519,500	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$208,363,387	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (8 entries)

DescDesc	Book ValueBookValueAmt
DUE FROM RELATED PARTIES	$175,664,831
OTHER RECEIVABLES	$16,454,170
DUE FROM MEDICARE/MEDICAID	$2,649,895
DUE FROM SELF INSURANCE TRUST	$2,238,241
PHYSICIAN RECEIVABLES	$1,754,962
SCHOLARSHIP/TUITION RECEIVABLE	$1,428,056
INTEREST RECEIVABLE	$429,571
DEFERRED BOND ISSUE COST - 2003	$36,681

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$200,656,407	TotalBookValueOtherAssetsAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE D, PAGE 2, PART V, LINE 4

ENDOWMENT FUNDS RESTRICTED BY DONORS ARE HELD IN A PERMANENT HEALTHCARE ENDOWMENT FUND WHICH WAS ESTABLISHED TO SUPPORT HEALTH CARE SERVICES.

SCHEDULE D, PAGE 3, PART X

THE MEDICAL CENTER, WITH THE EXCEPTION OF ARCHBOLD MEDICAL ENTERPRISES, INC., IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX- EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEDICAL CENTER APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE CONSOLIDATED FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE MEDICAL CENTER ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF SEPTEMBER 30, 2021 AND 2020 OR FOR THE YEARS THEN ENDED. THE MEDICAL CENTER'S TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAXING AUTHORITIES. FOR FEDERAL INCOME TAX PURPOSES, THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. NOTE, "THE MEDICAL CENTER" REFERS TO ARCHBOLD MEDICAL CENTER, INC. THE PARENT ORGANIZATION OF THE MULTI-ENTITY HEALTHCARE SYSTEM.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
Most Hospitals Policy	Yes (X)	MostHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	3.250000000000	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	false	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$9,637,452	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$9,637,452	NetCommunityBenefitExpnsAmt
Total Expense	0.02780	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$45,917,382	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$43,394,202	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,523,180	NetCommunityBenefitExpnsAmt
Total Expense	0.00730	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$550,474	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$459,260	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$91,214	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$56,105,308	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$43,853,462	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,251,846	NetCommunityBenefitExpnsAmt
Total Expense	0.03540	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Persons Served	24869	PersonsServedCnt
Total Community Benefit Expns	$154,610	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$154,610	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Persons Served	506	PersonsServedCnt
Total Community Benefit Expns	$1,375,579	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,375,579	NetCommunityBenefitExpnsAmt
Total Expense	0.00400	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$27,962,472	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$27,962,472	NetCommunityBenefitExpnsAmt
Total Expense	0.08070	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$96,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$96,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Persons Served	25375	PersonsServedCnt
Total Community Benefit Expns	$29,588,661	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$29,588,661	NetCommunityBenefitExpnsAmt
Total Expense	0.08540	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Persons Served	25375	PersonsServedCnt
Total Community Benefit Expns	$85,693,969	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$43,853,462	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$41,840,507	NetCommunityBenefitExpnsAmt
Total Expense	0.12080	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$80,611,211	BadDebtExpenseAmt
Reimbursed By Medicare	$74,318,699	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$76,828,964	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$2,510,265	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	4	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (4 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	OtherOtherDesc	Facility Reporting GroupFacilityReportingGroupCd	Critical Access HospitalCriticalAccessHospitalInd
JOHN D ARCHBOLD MEM HOSP
1	P O BOX 1018	THOMASVILLE	GA	317991018	WWW.ARCHBOLD.ORG	136-91	Yes (X)	Yes (X)	Yes (X)	PSYCH, REHAB, NURSING HOME	A
GRADY GENERAL HOSPITAL
2	1155 FIFTH STREET SE	CAIRO	GA	31728	WWW.ARCHBOLD.ORG	065-413	Yes (X)	Yes (X)	Yes (X)	SWING BED SNF	A
BROOKS COUNTY HOSPITAL
3	903 N COURT ST	QUITMAN	GA	31643	WWW.ARCHBOLD.ORG	014-028	Yes (X)		Yes (X)	RHC; SWING BED SNF	A	Yes (X)
MITCHELL COUNTY HOSPITAL
4	90 STEPHENS ST	CAMILLA	GA	31730	WWW.ARCHBOLD.ORG	101-120	Yes (X)		Yes (X)	NURSING HOME, RHC, SWING BED	A	Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	A	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1234	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
Other	Yes (X)	OtherInd
CHNA Conducted	19	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.ARCHBOLD.ORG	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	19	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	WWW.ARCHBOLD.ORG	StrategyWebsiteURLTxt
Strategy Attached	false	StrategyAttachedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	325.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	WWW.ARCHBOLD.ORG	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	WWW.ARCHBOLD.ORG	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	WWW.ARCHBOLD.ORG	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 3E	THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IS IDENTIFIED AND THE METHODOLOGY FOR PRIORITIZING EACH NEED IS DESCRIBED ON PAGES 13-14 OF THE 2019 CHNAS.
GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 5	INPUT FROM COMMUNITY MEMBERS REPRESENTING THE BROADER INTERESTS OF THE COUNTY WAS GATHERED THROUGH A COMBINATION OF WRITTEN SURVEYS, TELEPHONE INTERVIEWS AND IN-PERSON MEETINGS. WE EXPANDED OUR WRITTEN SURVEYS FOR THIS CHNA THAN IN THE 2016-2017 CHNA TO FURTHER UNDERSTAND FACTORS AFFECTING THOSE IN THE COMMUNITY WE SERVE. SURVEY QUESTIONS INCLUDED MULTIPLE CHOICE AND OPEN-ENDED ANSWERS. INPUT WAS GATHERED FROM THE FOLLOWING SOURCES FROM FEBRUARY 28-JUNE 6, 2019: . MAGNOLIA HIGH SCHOOL ALUMNI ASSOCIATIONGROUP MEETING AND WRITTEN SURVEYS . BOSTON COMMUNITY SCREENWRITTEN SURVEYS . ARCHBOLD HOSPITAL HEALTH TALKWRITTEN SURVEYS . THOMAS COUNTY FAMILY CONNECTION WRITTEN SURVEYS . THOMAS COUNTY HEALTH DEPARTMENT(TYPICALLY REPRESENTING LOW- INCOME/MINORITY/MEDICALLY UNDERSERVED POPULATION)WRITTEN SURVEYS AND TELEPHONE INTERVIEW
GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 6A	THE NEEDS ASSESSMENT WAS CONDUCTED FOR JOHN D. ARCHBOLD MEMORIAL HOSPITAL ALONG WITH GRADY GENERAL HOSPITAL, BROOKS COUNTY HOSPITAL AND MITCHELL COUNTY HOSPITAL.
GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 7D	DISTRIBUTED COPIES TO THE COMMUNITY; AVAILABLE ONLINE
GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 11	QUALITATIVELY, THE GREATEST MEDICAL NEEDS ACCORDING TO COMMUNITY PERCEPTION INCLUDED: 1. HIGH BLOOD PRESSURE 2. DIABETES 3. HEART DISEASE 4. OBESITY 5. CANCER 6. BACK/JOINT PAIN 7. MENTAL HEALTH ISSUES 8. DRUG ADDICTION 9. LUNG DISEASE/ALCOHOL ABUSE/STROKE NEEDS NOT ADDRESSED A QUANTITATIVE ANALYSIS OF SOME OF THE HEALTH ISSUES WE FACE EVERY DAY IS INCLUDED IN THE KEY HEALTH NEEDS SECTION OF ACCESS TO CARE WITHIN THE CHNA. EVALUATING BOTH QUALITATIVE AND QUANTITATIVE INFORMATION, WE CHOSE AREAS TO FOCUS OUR EFFORTS ON WHERE WE WERE BEST SUITED TO HAVE IMPACT.

Field	Value	IRS element (for citing)
Facility	8	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
GLENN-MOR NURSING HOME
10629 U S HIGHWAY 19 S	THOMASVILLE	GA	31792	SKILLED NURSING HOME
JDA PSYCHIATRIC UNIT
P O BOX 1018	THOMASVILLE	GA	31792	PSYCHIATRIC UNIT
JDA REHABILITATION UNIT
P O BOX 1018	THOMASVILLE	GA	31792	REHABILITATION UNIT
MITCHELL CO CONVALESCENT CENTER
90 STEPHENS STREET	CAMILLA	GA	31728	SKILLED NURSING HOME
CAMILLA PEDIATRICS CENTER
P O BOX 360	CAMILLA	GA	31728	RURAL HEALTH CLINIC
MEDICAL GROUP OF MITCHELL COUNTY
P O BOX 360	CAMILLA	GA	31728	RURAL HEALTH CLINIC
ARCHBOLD PELHAM PRIMARY CARE CLINIC
P O BOX 360	CAMILLA	GA	31728	RURAL HEALTH CLINIC
PELHAM PARKWAY NURSING HOME
608 DOGWOOD DRIVE NE	PELHAM	GA	31797	SKILLED NURSING HOME

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7	THE ORGANIZATION USES THE COST TO CHARGE RATIO USING THE IRS' RECOMMENDED FORMAT IN WORKSHEET 2. OTHER COSTS IN PART I LINES 7E THROUGH 7I WERE OBTAINED FROM THE ORGANIZATION'S ACCOUNTING RECORDS.
SCHEDULE H, PART III, LINE 2	AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AND INCLUDES IMPLICIT PRICE CONCESSIONS . SEE THE DISCUSSION OF IMPLICIT PRICE CONCESSIONS IN FOOTNOTE 2 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, LINE 4	SEE THE DISCUSSION OF PRICE CONCESSIONS AND NET PATIENT SERVICE REVENUE IN FOOTNOTE 2 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, LINE 8	MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS.
SCHEDULE H, PART III, LINE 9B	PATIENTS THAT ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE ARE APPROVED FOR A PERIOD OF 6 MONTHS. THE PATIENTS ARE REQUIRED TO CONTACT THE FINANCIAL ASSISTANCE OFFICE DURING THIS POINT IF THEY INCUR ADDITIONAL CHARGES THAT QUALIFY FOR FINANCIAL ASSISTANCE DURING THIS TIME PERIOD. THE SAME PROCESS IS IN EFFECT FOR THE PATIENTS WHO QUALIFY FOR THE SLIDING FEE DISCOUNT. THIS DISCOUNT WILL LIMIT THE PATIENTS TO AN OUT OF POCKET MAXIMUM AMOUNT IN THE GIVEN TIME PERIOD. WE DO NOT HAVE ANY AUTOMATIC ADJUSTMENTS OR AN AUTOMATED SYSTEM TO TRACK THE PREVIOUSLY APPROVED PATIENTS.
SCHEDULE H, PART VI, LINE 2	REVIEW OF ASSESSMENTS OF OTHER ORGANIZATIONS THAT IDENTIFY NEEDS AND HAVE ON-GOING PARTICIPATION WITH THOSE ORGANIZATIONS. COLLECT, REVIEW AND USE PRIMARY,SECONDARY AND QUALITATIVE DATA IN DETERMINING NEEDS. UPDATE COMMUNITY HEALTH STATUS AS LOCAL, STATE AND FEDERAL DATA IS REPORTED. REVIEW INTERNAL DATA SUCH AS SCREENING OUTCOMES AND PATIENT VOLUMES FOR SERVICES. RESPONSE TO REQUESTS FROM COMMUNITY, INPUT FROM A GROUP MEETING OF THE DOUGLASS HIGH SCHOOL ALUMNI ASSOCIATION, SEVERAL WRITTEN SURVEYS AND A TELEPHONE INTERVIEW. THE ORGANIZATION ANALYZES QUANTITATIVE FEDERAL, STATE AND LOCAL DATA AS WELL AS SEEKS QUALITATIVE INPUT FROM MEMBERS OF THE COMMUNITY, ESPECIALLY THE UNDERSERVED. THE ORGANIZATION ALSO ASSESSES THE NEEDS OF THE COMMUNITY THROUGH UTILIZING ASSESSMENTS CONDUCTED BY OTHER COMMUNITY ORGANIZATIONS, REVIEWING INTERNAL DATA ON PATIENT VOLUMES AND SCREENING OUTCOMES, PARTICIPATING IN COMMUNITY ORGANIZATIONS THAT IDENTIFY NEEDS, SPONSORING COMMUNITY EDUCATION TASK FORCES THAT PROVIDE INPUT AND RESPONDING TO SPECIFIC REQUESTS FROM COMMUNITY MEMBERS. COPIES OF THE 2019-2020 CHNA'S AND THE RELATED IMPLEMENTATION PLAN CAN BE FOUND AT THE FOLLOWING WEB ADDRESSES: HTTPS://ARCHBOLD.ORG/ABOUT/PUBLIC-RELATIONS/PUBLICATIONS
SCHEDULE H, PART VI, LINE 3	ANNUAL NOTICES ARE PLACED IN THE NEWSPAPERS FOR THE COUNTIES WE SERVE WITH HEALTHCARE. NOTICE OF THE FAP PROGRAM IS CONTAINED IN THE PATIENT HANDBOOK, SIGNS AND BROCHURES OUTLINING THE AVAILABILITY OF THE FAP PROGRAM ARE AVAILABLE AT POINTS OF ACCESS FOR PATIENTS, PAPER APPLICATIONS ARE AVAILABLE AT ALL ADMISSION AREAS AND BUSINESS OFFICES, ELECTRONIC VERSION OF THE APPLICATION CAN BE DOWNLOADED FREE OF CHARGE VIA WEBSITE AND THE ASSISTANCE PROGRAM IS DISCUSSED IN DETAIL DURING COLLECTION CALLS WITH PATIENTS.
SCHEDULE H, PART VI, LINE 4	COUNTIES SERVED IN GEORGIA INCLUDE BROOKS, GRADY, MITCHELL, THOMAS. DISPROPORTIONATE HEALTHCARE NEEDS, FEDERALLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS(MUA) OR HEALTH PROFESSIONAL SHORTAGE AREAS(HSPA), LOW- INCOME, PUBLIC HOUSING RESIDENTS, SENIORS, MIGRANT WORKERS, UNINSURED, UNDERINSURED, MIXTURE OF ETHNICITIES, ALL AGES, MIXTURE OF EDUCATIONAL LEVELS. BROOKS COUNTY: ESTIMATED POPULATION 15,457; 61.4% WHITE/35.2% BLACK, MEDIAN HOUSEHOLD INCOME 38,285; 21.9% LIVING IN POVERTY; 20% UNDER 65 UNINSURED. GRADY COUNTY: ESTIMATED POPULATION 24,748; MEDIAN HOUSEHOLD INCOME 43,531; 21.7% LIVING IN POVERTY, 20.8% UNDER 65 UNINSURED. MITCHELL COUNTY: ESTIMATED POPULATION 21,863; 49.3% WHITE/48.0% BLACK; MEDIAN HOUSEHOLD INCOME 38,116; 30.7% LIVING IN POVERTY, 17.7% UNDER 65 UNINSURED. THOMAS COUNTY: ESTIMATED POPULATION 44,451; 60.6% WHITE/36.2% BLACK; MEDIAN HOUSEHOLD INCOME 43,740; 18% LIVING IN POVERTY, 17% UNDER 65 UNINSURED. INFORMATION OBTAINED FROM WWW.CENSUS.GOV 2019 ESTIMATES
SCHEDULE H, PART VI, LINE 5	LIVE BETTER IS THE NAME THAT REPRESENTS AN ARCHBOLD-LED EFFORT OF KEY COMMUNITY LEADERS AND COMMUNITY FOCUSED ON IMPROVING THE HEALTH OF THE CITIZENS OF THOMAS COUNTY. LIVE BETTER IS STEERED BY LEADERS OF MAJOR SECTORS OF THE COMMUNITY (GOVERNMENT, EDUCATION, MEDIA, BUSINESS) THAT ARE WORKING TOGETHER WITH ARCHBOLD TO LEVERAGE THE STRENGTHS OF THEIR ORGANIZATIONS TO ACHIEVE MEASURED HEALTH GOALS. THE GROUP HAS MEASURABLE GOALS TO REDUCE THE OBESITY RATE IN THOMAS COUNTY, THE BIGGEST COMMON DENOMINATOR OF POOR HEALTH. OBESITY IS A PREVENTABLE CONDITION, YET THE COMMON RISK FACTOR WITH THE MOST PROMINENT HEALTH ISSUES IN THOMAS COUNTY: HEART DISEASE, HYPERTENSION, STROKE, COPD, VASCULAR DISEASE, DIABETES AND CANCER. THE GOVERNING BODIES OF ALL JDAMH'S HOSPITAL FACILITIES ARE PRIMARILY COMPRISED OF PERSONS WHO ARE NOT EMPLOYEES OR CONTRACTORS (NOR FAMILY MEMBERS THEREOF) AND WHO REPRESENT A BROAD SPECTRUM OF THE COMMUNITY. THE HOSPITALS' MEDICAL STAFFS ARE OPEN TO ALL QUALIFIED PHYSICIANS IN THE REGION. SURPLUS FUNDS ARE REINVESTED IN THE FACILITIES AND OPERATIONS.
SCHEDULE H, PART VI, LINE 6	ARCHBOLD MEDICAL CENTER, INC. (MEDICAL CENTER) AS THE PARENT CORPORATION HAS SOLE CONTROL OVER ITS NONPROFIT SUBSIDIARIES, JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC., ARCHBOLD HEALTH SERVICES, INC., ARCHBOLD FOUNDATION, INC., ARCHBOLD MEDICAL GROUP, INC. AND SOLE OWNERSHIP OF ITS FOR-PROFIT SUBSIDIARY, ARCHBOLD MEDICAL ENTERPRISES, INC. JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. OPERATES JOHN D. ARCHBOLD MEMORIAL HOSPITAL, GRADY GENERAL HOSPITAL, BROOKS COUNTY HOSPITAL, AND MITCHELL COUNTY HOSPITAL AND NURSING HOMES. ARCHBOLD HEALTH SERVICES, INC. PROVIDES FACILITIES AND SUPPORT FOR HOME HEALTH CARE AND AMBULATORY HEALTH CARE SERVICES. ARCHBOLD FOUNDATION, INC. SOLICITS CONTRIBUTIONS AND MANAGES FUNDS FOR THE BENEFIT OF JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. AND ARCHBOLD HEALTH SERVICES, INC. ARCHBOLD MEDICAL GROUP, INC. EMPLOYS PHYSICIANS AND OTHER SUPPORT PERSONNEL TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES ESSENTIAL TO THE PREVENTION AND TREATMENT OF DISEASE FOR THE BENEFIT OF ALL INDIVIDUALS IN THE SERVICE AREA. ARCHBOLD MEDICAL GROUP, INC. ALSO SERVES AS THE SOLE MEMBER OF CCSG, INC. AND AMGIR, INC., BOTH 501(C)(3) ORGANIZATIONS WHICH OPERATE MEDICAL CLINICS.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
THOMAS UNIVERSITY
1501 MILLPOND ROAD	THOMASVILLE	GA	31792	580644897	501C3	$11,000	MEDICAL LAB PROG
THOMAS UNIVERSITY
1501 MILLPOND ROAD	THOMASVILLE	GA	31792	580644897	501C3	$85,000	NURSG PROGRAM

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxt	Cash GrantCashGrantAmt	RecipientRecipientCnt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
SCHOLARSHP/TUITION PROG	$252,851
MED STUDENT HOUSING		46	$89,199	FMV	HOUSING/UTIL.

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PAGE 1, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION OFFERS A TUITION/SCHOLARSHIP REIMBURSEMENT PROGRAM FOR QUALIFIED EMPLOYEES ON SATISFACTORY COMPLETION OF APPROVED COURSES. THE PURPOSE IS TO ENCOURAGE AND ENABLE EMPLOYEES TO ACQUIRE ADDITIONAL EDUCATION IN A HEALTH CARE OR JOB RELATED FIELD WHICH WILL PROMOTE CAREER ADVANCEMENT AND/OR PROVIDE ADVANCED CREDENTIALING OF EMPLOYEES IN AREAS OF NEED. CONDITIONS OF ELIGIBILITY: FULL-TIME EMPLOYMENT OF AT LEAST SIX MONTHS WITH SATISFACTORY WORK RECORD AND PERFORMANCE EVALUATION. COMPLETION OF THE RELEVANT EDUCATION PROGRAM REQUIRES THE APPLICANT TO COMMIT TO OBTAIN STATUS AS A FULL-TIME EMPLOYEE EQUAL TO THE AMOUNT OF TIME SPENT IN EDUCATION. FAILURE TO COMPLY WITH THE REQUIREMENTS OF ELIGIBILITY WOULD SUBJECT THE EMPLOYEE TO FULL OR PARTIAL REIMBURSEMENT OF THE FUNDS RECEIVED TO THE ORGANIZATION. FOR REIMBURSEMENT THE EMPLOYEE MUST PROVIDE A COPY OF A RECEIPT SHOWING ACTUAL PAYMENT OF TUITION FEES. APPLICANT MUST MAINTAIN A C OR HIGHER GRADE AND AN OFFICIAL RECORD OF GRADES AND HOURS CREDIT MAILED DIRECTLY TO THE ORGANIZATION. THE ORGANIZATION SUPPORTS CERTAIN MEDICAL EDUCATION PROGRAMS WITH GRANTS TO THOMAS UNIVERSITY. THIS SUPPORT IS REVIEWED ANNUALLY.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	Yes (X)	TravelForCompanionsInd
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt
J PERRY MUSTIAN
PAST PRES/CEO (8/20)	$711,714	$167,063	$16,443	$797,100	$12,970	$1,705,290
GREG HEMBREE
ASST SEC/SR VP/CFO	$372,834	$96,251	$4,542	$60,450	$12,970	$547,047
COY IRVIN MD
VP MEDICAL AFFAIRS							$334,489	$68,979	$27,558	$44,691	$12,970	$488,687
JIM CARTER
COO							$319,058	$81,250	$9,696	$53,250	$10,010	$473,264
DINESH B PATEL MD
PHYSICIAN							$233,620	$153,779	$528	$14,399	$9,808	$412,134
EUGENE SUN MD
PHYSICIAN							$285,827	$50,824	$25,297	$11,400	$9,808	$383,156
AMY GRIFFIN
VP PATIENT CARE							$274,104	$55,200	$1,242	$41,489	$6,145	$378,180
JASON NESMITH MD
TRUSTEE	$211,400	$116,165	$9,802	$6,562	$9,808	$353,737
KEN BROOKER
VP CLINICAL SERVICES							$203,745	$40,800	$23,178	$31,691	$6,977	$306,391
RAMESAN NAIR MD
PHYSICIAN							$269,973		$1,706	$18,620	$6,798	$297,097
SHANE HERRIN MD
PHYSICIAN							$257,346		$5,884	$13,234	$9,808	$286,272
LISSA MURPHY MD
PHYSICIAN							$261,090		$7,158	$15,665	$678	$284,591
DARCY M CRAVEN
PRESIDENT/CEO							$244,064		$25,049	$3,155	$9,130	$281,398
JAMIE WOMACK
VP CRITICAL ACCESS							$179,674	$42,550	$4,780	$22,684	$9,772	$259,460
CHRIS NEWMAN
VP ANCILLARY SVCS							$188,928	$39,119	$5,540	$23,508	$829	$257,924
JIM BUE
VP FACILITY SERVICES							$177,719	$35,463	$17,749	$24,873	$709	$256,513
MARK LOWE
VP MARKETING							$134,484	$28,000	$810	$18,232	$4,683	$186,209

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE J, PAGE 1, PART I, LINE 4

J. PERRY MUSTIAN 0 780,000 0 GREG HEMBREE 0 46,200 0 COY IRVIN, M.D. 0 27,591 0 JIM CARTER 0 39,000 0 AMY GRIFFIN 0 22,080 0 KEN BROOKER 0 16,320 0 JAMIE WOMACK 0 15,096 0 CHRIS NEWMAN 0 15,648 0 JIM BUE 0 14,185 0 MARK LOWE 0 11,200 0

SCHEDULE J, PART III

THE IRS RULES & REGULATIONS REQUIRE THAT CERTAIN NON-CURRENT, NON-CASH ITEMS ARE REPORTED IN PART VII, COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, HIGHEST COMPENSATED EMPLOYEES, AND INDEPENDENT CONTRACTORS, OF THE CORE FORM 990 REGARDLESS OF THE CURRENT BENEFIT TO THE EMPLOYEE. THESE SAME RULES, IN SOME CASES, REQUIRE THE COMPENSATION AND BENEFITS TO BE REPORTED TWICE IN PART VII, ONCE WHEN THE ENTITY ACCRUES FOR A FUTURE PAYMENT AND ONCE WHEN THE PAYMENT IS ACTUALLY MADE TO THE EMPLOYEE. THEREFORE, AN EMPLOYEE'S STATED TOTAL COMPENSATION AND BENEFITS REPORTED ON PART VII ARE SUBSTANTIALLY HIGHER THAN THE ACTUAL CASH COMPENSATION RECEIVED IN THE CURRENT YEAR. AMOUNTS REPORTED AS BENEFITS INCLUDE AMOUNTS FOR LIFE INSURANCE, HEALTH INSURANCE, THRIFT PLAN CONTRIBUTIONS, AND PENSION CONTRIBUTIONS. BENEFITS RELATED TO PENSION AND RETIREMENT PLANS REFLECT AMOUNTS ACCUMULATED, BUT NOT PAID, TO THE INDIVIDUAL IN RECOGNITION OF TOTAL YEARS OF EMPLOYMENT, NOT JUST THE CURRENT YEAR. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ONE EXECUTIVE PARTICIPATES IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WHICH IS ACCRUED BUT UNFUNDED IN AN AMOUNT WHICH, WHEN ADDED TO OTHER SOURCES OF RETIREMENT INCOME, WILL AFFORD A RETIREMENT INCOME AT A TARGETED PERCENTAGE OF PRE-RETIREMENT COMPENSATION. THE SERP IS A NON- QUALIFIED RETIREMENT PLAN. AMC 457(F) RETIREMENT PLAN CERTAIN EXECUTIVES WHO ARE NOT ELIGIBLE FOR THE SERP MAY BE ELIGIBLE TO PARTICIPATE IN A 457(F) PLAN TO HELP THEM ACCUMULATE FUNDS FOR THEIR LONG TERM FINANCIAL NEEDS. THE ORGANIZATION MAY CONTRIBUTE A PERCENTAGE OF BASE SALARY INTO AN INDIVIDUAL EXECUTIVES ACCOUNT IF THE ORGANIZATION MEETS CERTAIN FINANCIAL TARGETS. THE ORGANIZATION OWNS ANY PLAN ASSETS UNTIL THEY ARE PAID TO THE EMPLOYEE AND ALL FUNDS ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. VESTING BEGINS AT AGE 55 WITH FIVE YEARS OF SERVICE AT A RATE OF 90% AND THEN INCREASES TO 100% AT AGE 60. PAYMENTS ARE MADE ANNUALLY UPON VESTING. BONUS AWARDS: OFFICERS AND PHYSICIANS ARE AWARDED BONUSES/INCENTIVES CONTINGENT IN PART ON MEETING MANAGEMENT-BY-OBJECTIVE INCENTIVE PLAN GOALS AND EXCESS OF REVENUE OVER EXPENSES.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCd	Business Name Line2IssuerName/BusinessNameLine2Txt	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
HOSP AUTH OF THE CITY OF THOMASVILL
A	2017C REVENUE BONDS	581719301	NONENONEN	2017-07-12	$82,750,000	CONSTRUCTION BLDG AND EQUIPMENT	false	Yes (true)	false
HOSP AUTH OF THE CITY OF THOMASVILL
B	2017A REVENUE BONDS	581719301	NONENONEN	2017-07-12	$17,985,000	CONSTRUCTION PROJECT DEPOSIT	false	Yes (true)	false
HOSP AUTH OF THE CITY OF THOMASVILL
C	2017B REVENUE BONDS	581719301	NONENONEN	2017-07-12	$15,435,000	CONSTRUCTION PROJECT DEPOSIT	false	Yes (true)	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr
A	$11,365,000	$82,850,000	$82,522,324	$327,676	false	Yes (true)	false	Yes (true)
B		$17,985,000			false	false	Yes (true)	Yes (true)	$17,985,000	2017
C	$8,310,000	$15,435,000			false	false	Yes (true)	Yes (true)	$15,435,000	2017

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	false	false	false	false	false	Yes (true)
B	false	false	false	false	false	false	Yes (true)
C	false	false	false	false	false	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	false	Yes (true)	false	false	false	false	false	false	Yes (true)
B	false	Yes (true)	false	false	Yes (true)	false	false	false	Yes (true)
C	false	Yes (true)	false	false	Yes (true)	false	false	false	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)
C	Yes (true)

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
DIFFERENCES IN ISSUE PRICE EXPLANATION	HOSP AUTH OF THE CITY OF THOMASVILLE ORIGINAL ISSUE PRICE INCLUDES A PREMIUM OF 100,000.
PURPOSE OF ISSUE DESCRIPTION	HOSP AUTH OF THE CITY OF THOMASVILLE CONSTRUCTION BLDG AND EQUIPMENT
PURPOSE OF ISSUE DESCRIPTION	HOSP AUTH OF THE CITY OF THOMASVILLE CONSTRUCTION PROJECT DEPOSIT
PURPOSE OF ISSUE DESCRIPTION	HOSP AUTH OF THE CITY OF THOMASVILLE CONSTRUCTION PROJECT DEPOSIT

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
JAMES W FALCONER III MD
BOARD TRUSTEE	$612,404	RENTAL, PATIENT SVCS	false
JAMI STEPHENSON
FAMILY MEMBER	$129,676	COMPENSATION	false
DAVID MEDEROS DO
BOARD TRUSTEE	$4,084,623	PROFESSIONAL MED SVC	false
HAILE P MCCOLLUM
BOARD TRUSTEE	$28,500	SERVICE AGREEMENT	false

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE L, PART V	FormAndLineReferenceDesc
Explanation	JAMES W. FALCONER, III, MD - RENT OF PROPERTY; MEDICAL SERVICES TO PRACTICE; PAYMENTS TO TREAT UNINSURED EMERGENCY PATIENTS. JAMI STEPHENSON IS THE SON OF SUE STEPHENSON, BOARD TRUSTEE, AND IS EMPLOYED AND COMPENSATED BY JDAMH. DAVID MEDEROS, D.O., BOARD TRUSTEE, PROVIDES HOSPITALIST COVERAGE FOR HOSPITAL, INPATIENT REHAB AND IS A MEMBER OF THE MEDICAL STAFF LEADERSHIP COMMITTEE. HAILE P. MCCOLLUM PROVIDES PROFESSIONAL BRANDING AND MARKETING SERVICES.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PAGE 1, ITEM B	FORM 990 IS AMENDED TO REFLECT CHANGES TO SCHEDULE H AS A RESULT OF: - BAD DEBT EXPENSES ERRONEOUSLY CLASSIFIED AS FINANCIAL ASSISTANCE, AND - AMENDING COST REPORT DATA USED IN CALCULATING COMMUNITY BENEFIT EXPENSE.
FORM 990, PAGE 2, PART III, LINE 4A	JOHN D. ARCHBOLD MEMORIAL HOSPITAL (JDAMH) IN THOMASVILLE GEORGIA OPERATES WITH 264 LICENSED BEDS; OF WHICH 226 ARE MED/SURG, 18 BEDS ARE DESIGNATED TO A PSYCH UNIT, 20 BEDS ARE REHAB. IN ADDITION, THEY OPERATE A 64 BED SKILLED NURSING FACILITY. JDAMH IS A RURAL REFERRAL CENTER COVERING THOMAS COUNTY AND SURROUNDING COUNTIES IN SOUTHERN GEORGIA AND NORTHERN FLORIDA. 69% OF PATIENTS WERE COVERED BY MEDICARE AND MEDICAID, AND 4.0% OF PATIENT REVENUE WAS PROVIDED AS INDIGENT CARE. IN 2021, JDAMH PROVIDED AN ESTIMATED 33.1 MILLION IN INDIGENT CARE CHARGES. JDAMH TREATS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN ADDITION JDAMH PROVIDED APPROXIMATELY 51.2 MILLION IN ADDITIONAL UNCOMPENSATED CARE. THROUGHOUT THE YEAR, JDAMH PRODUCES OR SPONSORS MANY SPECIAL PROGRAMS FOR THE COMMUNITY TO EDUCATE THEM ON IMPORTANT HEALTH NEEDS. JDAMH, INC. ALSO MAINTAINS HOSPITALS IN GRADY COUNTY, BROOKS COUNTY, AND MITCHELL COUNTY, FILING UNDER EIN 58-0566121.
FORM 990, PAGE 2, PART III, LINE 4D	BROOKS COUNTY HOSPITAL OPERATES IN QUITMAN, GEORGIA AS A CRITICAL ACCESS HOSPITAL WITH 25 ACUTE CARE BEDS. IT SERVES BROOKS COUNTY AND 57% OF ITS PATIENTS WERE MEDICARE/MEDICAID. IN 2021, AN ESTIMATED 2.1 MILLION OF INDIGENT CARE WAS PROVIDED TO THE COMMUNITY. IN ADDITION, BROOKS COUNTY HOSPITAL PROVIDED APPROXIMATELY 3.4 MILLION IN ADDITIONAL UNCOMPENSATED CARE. EIN 58-6002830 FILED UNDER EIN 58-0566121.
FORM 990, PAGE 6, PART VI, LINE 2	NATHANIEL ABRAMS, JR HAILE MCCOLLUM TRUSTEE TRUSTEE BUSINESS RELATIONSHIP NATHANIEL ABRAMS, JR HENRY STONE III TRUSTEE TRUSTEE BUSINESS RELATIONSHIP HAILE MCCOLLUM HENRY STONE III TRUSTEE TRUSTEE BUSINESS RELATIONSHIP
FORM 990, PAGE 6, PART VI, LINE 6	THE ORGANIZATION HAS A SOLE MEMBER, ARCHBOLD MEDICAL CENTER, INC. (AMC) WITH THE POWER TO ELECT OR REPLACE AND TO REMOVE THE TRUSTEES OF THE GOVERNING BODY, AS WELL AS THE AUTHORITY TO APPROVE THE DECISIONS OF THE GOVERNING BODY.
FORM 990, PAGE 6, PART VI, LINE 7A	THE BOARD OF TRUSTEES OF THE FILING ENTITY ARE ELECTED ANNUALLY BY THE SOLE MEMBER, AMC. IN ADDITION, AMC HAS THE POWER TO ELECT OR REPLACE AND TO REMOVE THE TRUSTEES OF THE GOVERNING BODY. THE CEO OF AMC SHALL BE A MEMBER OF THE BOARD WITH THE POWER TO VOTE.
FORM 990, PAGE 6, PART VI, LINE 7B	THE SOLE MEMBER, AMC HAS THE AUTHORITY TO APPROVE THE DECISIONS OF THE GOVERNING BODY, INCLUDING BUT NOT LIMITED TO, CAPITAL AND OPERATING BUDGETS, MERGERS OR ACQUISITIONS, CONTRACTS AND TRANSACTIONS OVER A CERTAIN AMOUNT, DISSOLUTION, ETC.
FORM 990, PAGE 6, PART VI, LINE 11B	MANAGEMENT REVIEWS THE FORM 990 AS PREPARED BY ITS EXTERNAL AUDITOR, AND THEN MAKES A COMPLETE COPY AVAILABLE ELECTRONICALLY TO TRUSTEES PRIOR TO FILING THE RETURN. IF TRUSTEES HAVE QUESTIONS ABOUT THE RETURN, MANAGEMENT IS AVAILABLE AND ACCESSIBLE TO PROVIDE APPLICABLE EXPLANATIONS TO TRUSTEES.
FORM 990, PAGE 6, PART VI, LINE 12C	ON AN ANNUAL BASIS, THE ORGANIZATION DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE AND DISCLOSURE STATEMENT TO EACH TRUSTEE. THIS QUESTIONNAIRE INCLUDES QUESTIONS RELATED TO FINANCIAL INTERESTS, OUTSIDE INTERESTS OR ACTIVITIES, AND GIFTS, MEALS, AND ENTERTAINMENT. IN ADDITION TO DISCLOSING ANY APPLICABLE INFORMATION ON THE QUESTIONNAIRE, THE TRUSTEE ACKNOWLEDGES THAT (S)HE HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ, UNDERSTANDS, AND AGREES TO COMPLY WITH IT, AND UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. RESPONSES ARE SUMMARIZED AND COLLECTIVELY REVIEWED BY THE AUDIT & COMPLIANCE COMMITTEE OF AMC, THE SOLE MEMBER. DURING EACH BOARD MEETING, THE CHAIRMAN INQUIRES IF ANY TRUSTEE HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST RELATED TO ANY AGENDA ITEM. IF THE TRUSTEE DISCLOSES ANY SUCH INTEREST, THE TRUSTEE IS EXCUSED FROM THE MEETING WHILE THE DETERMINATION AS TO WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS IS DISCUSSED AND VOTED UPON BY DISINTERESTED MEMBERS OF THE BOARD AND COMMITTEE. IF INVITED TO DO SO, THE TRUSTEE WITH A POTENTIAL CONFLICT MAY RESPOND TO QUESTIONS PUT FORTH BY FELLOW DISINTERESTED TRUSTEES REGARDING ANY PROPOSED TRANSACTION OR ARRANGEMENT. THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS DOCUMENTS THE NAME OF ANY INTERESTED PERSON/TRUSTEE WHO DISCLOSED OR WAS FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH A TRANSACTION OR ARRANGEMENT RESULTING IN AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; AND THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATED TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSIONS, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH.
FORM 990, PAGE 6, PART VI, LINE 15A	ARCHBOLD MEDICAL CENTER'S (AMC) COMPENSATION COMMITTEE (COMMITTEE) OF THE AMC BOARD OF TRUSTEES MAKES RECOMMENDATIONS TO THE FULL AMC BOARD ON THE FOLLOWING POSITIONS: THE PRESIDENT OF AMC AND THE PRESIDENT OF THE ARCHBOLD FOUNDATION. AMC'S PRESIDENT PRESENTS RECOMMENDATIONS FOR ALL SENIOR VICE PRESIDENTS, VICE PRESIDENTS, AND OTHER KEY EMPLOYEES OF AMC AND ALL RELATED ARCHBOLD ENTITIES TO THE COMMITTEE. SINCE AMC HAS RESERVE POWERS FOR ARCHBOLD RELATED ENTITIES, THE COMMITTEE SERVES AS THE COMPENSATION COMMITTEE FOR EACH APPLICABLE ARCHBOLD ENTITY. THE COMMITTEE CONSIDERS THE AMC PRESIDENT'S RECOMMENDATIONS, BUT IT ALSO CONSIDERS RECOMMENDATIONS AND INDEPENDENT MARKET DATA ANALYSIS FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE AMC BOARD UTILIZES AN INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE EXECUTIVE COMPENSATION PROGRAM AND MAKE RECOMMENDATIONS REGARDING PLAN DESIGN AND ACTUAL COMPENSATION INCLUDING BENEFITS.
FORM 990, PAGE 6, PART VI, LINE 15B	SEE 15A ABOVE.
FORM 990, PAGE 6, PART VI, LINE 19	NO DOCUMENTS ARE OR WILL BE MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11G	CONSULTANT FEES JDAMH 0 402,830 0 CONTRACT SERVICES JDAMH 32,931,243 1,851,689 0 CONTRACT SERVICES BROOKS 1,002,584 0 0 CONTRACT SERVICES GRADY 4,073,789 0 0 CONTRACT SERVICES MITCHELL 4,848,900 0 0 OUTSIDE LAB REFERRAL FEES JDA 1,103,878 0 0 OUTSIDE LAB REFERRAL GRADY 14,033 0 0 OUTSIDE LAB REFERRAL BROOKS 2,508 0 0 PROFESSIONAL FEES JDAMH 15,142,366 2,416,633 0 PROFESSIONAL FEES GRADY 2,261,328 0 0 PROFESSIONAL FEES BROOKS 1,169,705 0 0 PROFESSIONAL FEES MITCHELL 1,905,356 0 0 TOTAL 64,455,690 4,671,152 0

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Business Name Line2DirectControllingEntityName/BusinessNameLine2Txt	Controlled OrganizationControlledOrganizationInd
ARCHBOLD FOUNDATION INC
PO BOX 620	THOMASVILLE	GA	317990620	581559677	FOUNDATION	GA	501C3	12B	AMC	ARCHBOLD MEDICAL CENTER INC	false
ARCHBOLD HEALTH SERVICES INC
PO BOX 620	THOMASVILLE	GA	317990620	581376434	HEALTHCARE	GA	501C3	10	AMC	ARCHBOLD MEDICAL CENTER INC	false
ARCHBOLD MEDICAL CENTER INC
PO BOX 1018	THOMASVILLE	GA	317991018	581552650	H/C MGMT	GA	501C3	12C	NA		false
ARCHBOLD MEDICAL GROUP INC
P O BOX 620	THOMASVILLE	GA	317990620	262988454	PHYSICIANS	GA	501C3	3	AMC	ARCHBOLD MEDICAL CENTER INC	false
CCSG INC
915 GORDON AVENUE	THOMASVILLE	GA	317926614	473501366	MED CLINIC	GA	501C3	3	AMG		false
AMGIR INC
915 GORDON AVENUE	THOMASVILLE	GA	317926614	821188691	MED CLINIC	GA	501C3	3	AMG		false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct
ARCHBOLD MEDICAL ENTERPRISES
400 OLD ALBANY ROAD	THOMASVILLE	GA	317924013	581494513	HEALTHCARE	GA	N/A	false
GEORGIA-FLORIDA PREFERRED INC
915 GORDON AVE	THOMASVILLE	GA	31792	581744334	HEALTHCARE	GA		Yes (true)	JDAMH	C CORP	$13,485	$173,750	1.00000

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd