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UPSON COUNTY HOSPITAL INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
UPSON COUNTY HOSPITAL INC (EIN 58-1734026)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-15
IRS object ID
202213199349304001
Schema version
2021v4.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2022-11-15T09:33:56-05:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN580914992PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DRAFFIN & TUCKER LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 71309AddressLine1Txt
CityALBANYCityNm
State AbbreviationGAStateAbbreviationCd
ZIP317081309ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN581734026EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UPSON COUNTY HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlUPSOBusinessNameControlTxt
Phone7066478111PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1801 WEST GORDON STREETAddressLine1Txt
CityTHOMASTONCityNm
State AbbreviationGAStateAbbreviationCd
ZIP302860027ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN WILLIAMSPersonNm
Person TitleCFO/COOPersonTitleTxt
Phone7066478111PhoneNum
Signature2022-11-13SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJOHNPersonFirstNm
Person LastWILLIAMSPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWILLIAM EDWARD PHILLIPSPreparerPersonNm
PTINP00451499PTIN
Phone2298837878PhoneNum
Preparation2022-11-15PreparationDt
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1UPSON REGIONAL MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerJEFF TARRANTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1801 WEST GORDON STAddressLine1Txt
CityTHOMASTONCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30286ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$140,063,366GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.URMC.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1951FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionUPSON REGIONAL MEDICAL CENTER'S MISSION IS TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE SURROUNDING AREA, REGARDLESS OF THE ABILITY TO PAY.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee1006TotalEmployeeCnt
Total Volunteers39TotalVolunteersCnt
Total Gross UBI$379,197TotalGrossUBIAmt
PY Contributions Grants$11,511,509PYContributionsGrantsAmt
CY Contributions Grants$4,430,082CYContributionsGrantsAmt
PY Program Service Revenue$87,466,522PYProgramServiceRevenueAmt
CY Program Service Revenue$112,666,274CYProgramServiceRevenueAmt
PY Investment Income$9,699,344PYInvestmentIncomeAmt
CY Investment Income$14,150,185CYInvestmentIncomeAmt
PY Other Revenue$1,759,661PYOtherRevenueAmt
CY Other Revenue$690,236CYOtherRevenueAmt
PY Total Revenue$110,437,036PYTotalRevenueAmt
CY Total Revenue$131,936,777CYTotalRevenueAmt
PY Grants And Similar Paid$17,260PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$19,613CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$50,825,438PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$54,646,990CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$47,078,205PYOtherExpensesAmt
CY Other Expenses$55,521,975CYOtherExpensesAmt
PY Total Expenses$97,920,903PYTotalExpensesAmt
CY Total Expenses$110,188,578CYTotalExpensesAmt
PY Revenues Less Expenses$12,516,133PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$21,748,199CYRevenuesLessExpensesAmt
Total Assets BOY$231,951,132TotalAssetsBOYAmt
Total Assets EOY$251,563,523TotalAssetsEOYAmt
Total Liabilities BOY$16,727,453TotalLiabilitiesBOYAmt
Total Liabilities EOY$16,371,225TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$215,223,679NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$235,192,298NetAssetsOrFundBalancesEOYAmt
MissionUPSON REGIONAL MEDICAL CENTER'S MISSION IS TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE SURROUNDING AREA, REGARDLESS OF THE ABILITY TO PAY.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$91,862,494ExpenseAmt
Grant$19,613GrantAmt
DescUPSON REGIONAL MEDICAL CENTER OFFERS A COMPLETE LINE OF MEDICAL SERVICES INCLUDING 24-HOUR EMERGENCY CENTER, MEDICAL-SURGICAL CARE, OBSTETRICS, PEDIATRICS, WOMEN'S HEALTH SERVICES, AND MORE. PATIENT DAYS FOR THE YEAR TOTALED 18,226 IN 2021. THE PSYCH UNIT HAD 5,156 VISITS WHILE THE RURAL HEALTH CLINIC EXPERIENCED 4,358 VISITS IN 2021.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$78,053ExpenseAmt
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$78,053TotalOtherProgSrvcExpenseAmt
Total Program Service Expenses$91,940,547TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesYes (true)ForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document164IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee1006EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountYes (true)ForeignFinancialAccountInd
Foreign CountryCJForeignCountryCd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Own WebsiteYes (X)OwnWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJOHN WILLIAMSPersonNm
Phone7066478111PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1801 WEST GORDON STREETAddressLine1Txt
CityTHOMASTONCityNm
State AbbreviationGAStateAbbreviationCd
ZIP302860227ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
BRANDON M BOYCE MD
ORTHOPEDIC S40.00Yes (X)$1,048,086$0$27,895
KEVIN A GINGRICH MD
ORTHOPEDIC S40.00Yes (X)$643,618$0$17,376
DARRYL KNIGHT MD
SURGEON40.00Yes (X)$609,473$0$40,977
DANIEL A BRIDGES MD
UROLOGY SURG40.00Yes (X)$608,128$0$20,493
ROBERT SOLYOMVARI MD
SURGEON40.00Yes (X)$563,574$0$40,977
JEFF TARRANT
HOSPITAL CEO40.00$483,075$0$01.00Yes (X)
BENJAMIN WILLIAMS MD
BOARD MEMBER40.00$412,925$0$14,2740.25Yes (X)
JOHN WILLIAMS
CFO/COO40.00$297,123$0$20,4571.00Yes (X)
MARK ANDREWS
BOARD MEMBER0.75$0$0$00.20Yes (X)
SCOTT BLACKSTOCK
BOARD MEMBER0.75$0$0$00.20Yes (X)
JIM EDWARDS
VICE CHAIRMA0.75$0$0$00.20Yes (X)Yes (X)
WILLIAM HIGHTOWER IV
CHAIRMAN0.75$0$0$00.20Yes (X)Yes (X)
STEVE KEADLE
ASSISTANT SE0.75$0$0$00.20Yes (X)Yes (X)
RALPH WARNOCK MD
SECRETARY0.75$0$0$00.20Yes (X)Yes (X)
KAY SEARCY
BOARD MEMBER0.75$0$0$00.20Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,666,002TotalReportableCompFromOrgAmt
Total Other Compensation$182,449TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K80IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdCompensationCompensationAmtServicesServicesDesc
CARDIOSOLUTION PHYSICIANS
125 S PARK DR SUITE FBROWNWOODTX76801$2,790,543
GUARDIAN MEDICAL SERVICES LLC
1001 JENKINS RDFORSYTHGA31029$2,183,472ANESTHESIA
INNOVATIVE THERAPY CONCEPTS LLC
2 MASHBURN ST SUITE 102HAWKINSVILLEGA31036$1,405,037PHYSICAL THER
SODEXO INC & AFFILIATES
P O BOX 360170PITTSBURGHPA15251$1,208,074FOOD SERVICE
HORIZON MENTAL HEALTH MANAGEMENT
350 N GRANDVIEW AVEDUBUQUEIA520016388$1,100,000
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K25CntrctRcvdGreaterThan100KCnt
Government Grants$4,225,957GovernmentGrantsAmt
All Other Contributions$204,125AllOtherContributionsAmt
Total Contributions$4,430,082TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE621990$112,287,077$112,287,077
713940$361,557$361,557
CATERING SALES722320$17,640$17,640
FieldValueIRS element (for citing)
Total Program Service Revenue$112,666,274TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,976,043TotalRevenueColumnAmt
Exclusion$10,976,043ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$11,300,731SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$8,126,589SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$3,174,142SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,174,142TotalRevenueColumnAmt
Related Or Exempt Func Income$3,174,142RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
DISCOUNTS AND REBATES621990$259,283$259,283
COMPUTER FEE621990$205,407$205,407
MEANINGFUL USE & INCENTIVE561499$90,455$90,455

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$135,091TotalRevenueColumnAmt
Related Or Exempt Func Income$135,091RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$690,236OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$131,936,777TotalRevenueColumnAmt
Related Or Exempt Func Income$115,946,048RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$379,197UnrelatedBusinessRevenueAmt
Exclusion$11,181,450ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$19,613TotalAmt
Program Services$19,613ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,227,856TotalAmt
Management And General$1,227,856ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$44,320,178TotalAmt
Program Services$38,626,191ProgramServicesAmt
Management And General$5,693,987ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$589,043TotalAmt
Program Services$494,678ProgramServicesAmt
Management And General$94,365ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,327,797TotalAmt
Program Services$4,474,284ProgramServicesAmt
Management And General$853,513ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,182,116TotalAmt
Program Services$2,672,341ProgramServicesAmt
Management And General$509,775ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$534,193TotalAmt
Program Services$220,383ProgramServicesAmt
Management And General$313,810ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$80,671TotalAmt
Management And General$80,671ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$177,443TotalAmt
Management And General$177,443ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$71,915TotalAmt
Management And General$71,915ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$16,876,430TotalAmt
Program Services$13,641,899ProgramServicesAmt
Management And General$3,234,531ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$318,225TotalAmt
Management And General$318,225ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,364,590TotalAmt
Program Services$1,596,498ProgramServicesAmt
Management And General$768,092ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$2,883,127TotalAmt
Program Services$636,795ProgramServicesAmt
Management And General$2,246,332ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,221,782TotalAmt
Program Services$1,996,049ProgramServicesAmt
Management And General$225,733ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$155,790TotalAmt
Program Services$130,064ProgramServicesAmt
Management And General$25,726ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$4,544TotalAmt
Management And General$4,544ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$7,614,366TotalAmt
Program Services$6,848,677ProgramServicesAmt
Management And General$765,689ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$573,973TotalAmt
Program Services$482,907ProgramServicesAmt
Management And General$91,066ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$17,300,005$17,300,005
REPAIRS & MAINTENANCE$2,213,218$1,423,516$789,702
PROVIDER FEES$1,128,321$1,128,321
RECRUITMENT$552,624$552,624

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$450,758TotalAmt
Program Services$248,326ProgramServicesAmt
Management And General$202,432ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$110,188,578TotalAmt
Program Services$91,940,547ProgramServicesAmt
Management And General$18,248,031ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$6,202BOYAmt
EOY$8,058EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$9,941,427BOYAmt
EOY$13,517,896EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$13,229,989BOYAmt
EOY$16,873,676EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$236,655BOYAmt
EOY$579,727EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,916,339BOYAmt
EOY$2,936,209EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,723,375BOYAmt
EOY$1,868,023EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$150,816,271LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$101,017,757LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$52,035,897BOYAmt
EOY$49,798,514EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$147,902,512BOYAmt
EOY$160,296,792EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$1,639,203BOYAmt
EOY$1,639,203EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,319,533BOYAmt
EOY$4,045,425EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$231,951,132BOYAmt
EOY$251,563,523EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,456,843BOYAmt
EOY$9,731,068EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$2,171,979BOYAmt
EOY$2,327,204EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,300,000BOYAmt
EOY$3,290,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$798,631BOYAmt
EOY$1,022,953EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,727,453BOYAmt
EOY$16,371,225EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$215,223,679BOYAmt
EOY$235,192,298EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$215,223,679BOYAmt
EOY$235,192,298EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$231,951,132BOYAmt
EOY$251,563,523EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$21,748,199ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,779,580NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$11,646OtherActivitiesAmt
Total Lobbying Expenditures$11,646TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION PAYS ANNUAL DUES TO NATIONAL AND STATE INDUSTRY ORGANIZATIONS. A PORTION OF THOSE DUES ARE ATTRIBUTABLE TO THE LOBBYING ACTIVITIES OF THESE ORGANIZATIONS FOR THE BENEFIT OF THEIR MEMBERS.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,856,656OtherCostOrOtherBasisAmt
Book Value$1,856,656BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$72,337,911OtherCostOrOtherBasisAmt
Depreciation$44,876,129DepreciationAmt
Book Value$27,461,782BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$903,685OtherCostOrOtherBasisAmt
Depreciation$821,454DepreciationAmt
Book Value$82,231BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$72,981,286OtherCostOrOtherBasisAmt
Depreciation$55,320,174DepreciationAmt
Book Value$17,661,112BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,736,733OtherCostOrOtherBasisAmt
Book Value$2,736,733BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$49,798,514TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
ESTIMATED THIRD PARTY SETTLEMENTS$1,259,895
DUE TO RELATED PARTIES-$236,942
FieldValueIRS element (for citing)
Total Liability$1,022,953TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PAGE 3, PART XFormAndLineReferenceDesc
ExplanationTHE HOSPITAL AND FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AND ARE TAX- EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE SEGREGATED PORTFOLIO INTENDS TO CONDUCT ITS AFFAIRS IN A MANNER IN WHICH IT WILL NOT BE SUBJECT TO U.S. FEDERAL INCOME TAX OR GEORGIA INCOME TAX. THE REMAINING WHOLLY OWNED SUBSIDIARIES ARE CONSIDERED DISREGARDED ENTITIES AND ARE INCLUDED IN THE HOSPITAL'S TAX FILINGS. THEREFORE, NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPITAL AND FOUNDATION APPLY ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE 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 HOSPITAL AND FOUNDATION ONLY RECOGNIZE 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 BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF DECEMBER 31, 2021 AND 2020 OR FOR THE YEARS THEN ENDED. THE HOSPITAL AND FOUNDATION'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.ExplanationTxt

Schedule F IRS990ScheduleF

FieldValueIRS element (for citing)
Grant Records MaintainedfalseGrantRecordsMaintainedInd

Account Activities Outside US AccountActivitiesOutsideUSGrp

FieldValueIRS element (for citing)
RegionCENTRAL AMERICA & THE CARIBBEANRegionTxt
Offices1OfficesCnt
Type Of Activities ConductedINVESTMENTSTypeOfActivitiesConductedTxt
Region Total Expenditures$4,217,626RegionTotalExpendituresAmt
FieldValueIRS element (for citing)
Subtotal Offices1SubtotalOfficesCnt
Total Office1TotalOfficeCnt
Subtotal Spent$4,217,626SubtotalSpentAmt
Total Spent$4,217,626TotalSpentAmt
Transfer To Foreign CorpYes (true)TransferToForeignCorpInd
Interest In Foreign TrustfalseInterestInForeignTrustInd
Foreign Corp OwnershipYes (true)ForeignCorpOwnershipInd
Passive Foreign Investmest CofalsePassiveForeignInvestmestCoInd
Foreign PartnershipfalseForeignPartnershipInd
Boycott CountriesfalseBoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE F, PAGE 1, PART I, LINE 3FormAndLineReferenceDesc
ExplanationCENTRAL AMERICA & THE CARIBBEAN 4,217,626 0ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other1.250000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportfalseAnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,614,623TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,614,623NetCommunityBenefitExpnsAmt
Total Expense0.03280TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,720,273TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,178,310DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,541,963NetCommunityBenefitExpnsAmt
Total Expense0.01400TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$115,319TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$56,256DirectOffsettingRevenueAmt
Net Community Benefit Expns$59,063NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,450,215TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,234,566DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,215,649NetCommunityBenefitExpnsAmt
Total Expense0.04730TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,867TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,867NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$240,448TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$240,448NetCommunityBenefitExpnsAmt
Total Expense0.00220TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,577,506TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,168,655DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,408,851NetCommunityBenefitExpnsAmt
Total Expense0.07630TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,826,821TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,168,655DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,658,166NetCommunityBenefitExpnsAmt
Total Expense0.07860TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$36,277,036TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$22,403,221DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,873,815NetCommunityBenefitExpnsAmt
Total Expense0.12590TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,000NetCommunityBenefitExpnsAmt

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$363,555TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$363,555NetCommunityBenefitExpnsAmt
Total Expense0.00330TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$366,555TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$366,555NetCommunityBenefitExpnsAmt
Total Expense0.00330TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$20,266,416BadDebtExpenseAmt
Bad Debt Expense Attributable$10,133,209BadDebtExpenseAttributableAmt
Reimbursed By Medicare$18,476,167ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$16,682,307CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$1,793,860MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UPSON COUNTY HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1801 WEST GORDON STREETAddressLine1Txt
CityTHOMASTONCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30286ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.URMC.ORGWebsiteAddressTxt
State License145-415StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherWELLNESS CTR, PHYS OFC, PSYCHOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1UPSON COUNTY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
OtherYes (X)OtherInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.URMC.ORGOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLWWW.URMC.ORGStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care125.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Other MethodYes (X)OtherMethodInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.URMC.ORGFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.URMC.ORGFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.URMC.ORGFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FACILITY 1, UPSON COUNTY HOSPITAL - PART V, LINE 3ETHE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IS IDENTIFIED AND THE METHODOLOGY FOR PRIORITIZING EACH NEED IS DESCRIBED ON PAGE 39 OF THE 2021 CHNA.
FACILITY 1, UPSON COUNTY HOSPITAL - PART V, LINE 5UPSON SELECTED A GEOGRAPHIC SERVICE AREA DEFINITION. THIS DEFINITION WAS BASED UPON THE HOSPITALS PRIMARY SERVICE AREA IN A MANNER THAT INCLUDED THE BROAD INTERESTS OF THE COMMUNITY SERVED AND INCLUDED MEDICALLY UNDERSERVED POPULATIONS, LOW-INCOME PERSONS, MINORITY GROUPS, OR THOSE WITH CHRONIC DISEASE NEEDS. UPSON COUNTY WAS SELECTED AS THE COMMUNITY FOR INCLUSION IN THE CHNA. UPSON IDENTIFIED COMMUNITY LEADERS, PARTNERS, AND REPRESENTATIVES TO INCLUDE IN THE CHNA PROCESS. INDIVIDUALS, AGENCIES, PARTNERS, POTENTIAL PARTNERS, AND OTHERS WERE REQUESTED TO WORK WITH THE HOSPITAL TO 1) ASSESS THE NEEDS OF THE COMMUNITY, 2) REVIEW AVAILABLE COMMUNITY RESOURCES AND 3) PRIORITIZE THE HEALTH NEEDS OF THE COMMUNITY. GROUPS OR INDIVIDUALS, WHO REPRESENT MEDICALLY-UNDERSERVED POPULATIONS, LOW INCOME POPULATIONS, MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASES WERE INCLUDED. COMMUNITY STAKEHOLDERS (ALSO CALLED KEY INFORMANTS) ARE PEOPLE INVESTED OR INTERESTED IN THE WORK OF THE HOSPITAL, PEOPLE WHO HAVE SPECIAL KNOWLEDGE OF HEALTH ISSUES, PEOPLE IMPORTANT TO THE SUCCESS OF ANY HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT OR HEALTH PROJECT, OR ARE FORMAL OR INFORMAL COMMUNITY LEADERS. THE HOSPITAL IDENTIFIED 24 COMMUNITY MEMBERS TO PARTICIPATE IN THE STAKEHOLDER INTERVIEWS.
FACILITY 1, UPSON COUNTY HOSPITAL - PART V, LINE 11INFORMATION GATHERED FROM COMMUNITY-WIDE SURVEYS, STAKEHOLDER INTERVIEWS, DISCUSSIONS WITH THE HOSPITAL LEADERSHIP TEAM, REVIEW OF DEMOGRAPHIC AND HEALTH STATUS DATA, AND HOSPITAL UTILIZATION DATA WAS USED TO DETERMINE THE PRIORITY HEALTH NEEDS OF THE POPULATION. URMC PROVIDED A WRITTEN REPORT OF THE OBSERVATIONS, COMMENTS, AND PRIORITIES RESULTING FROM THE STAKEHOLDER INTERVIEWS. THE LEADERSHIP TEAM REVIEWED THIS INFORMATION, FOCUSING ON THE IDENTIFIED NEEDS, PRIORITIES, AND CURRENT COMMUNITY RESOURCES AVAILABLE. LEADERSHIP DEBATED THE MERITS AND VALUES OF THESE PRIORITIES, AND CONSIDERED THE RESOURCES AVAILABLE TO MEET THESE NEEDS. FROM THIS INFORMATION AND DISCUSSIONS, THE HOSPITAL DEVELOPED THE PRIORITY NEEDS OF THE COMMUNITY, EACH OF WHICH ARE ADDRESSED SEPARATELY IN THE HOSPITALS IMPLEMENTATION STRATEGY DOCUMENT. BOTH THE 2021 CHNA AND 2022 IMPLMENTATION STRATEGY DOCUMENTS ARE LOCATED AT THE FOLLOWING WEB ADDRESS: HTTPS://URMC.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
FACILITY 1, UPSON COUNTY HOSPITAL - PART V, LINE 15EINFORMATION IS MAILED TO ALL PATIENTS ON EACH STATEMENT AS LONG AS A BALANCE IS OUTSTANDING. IT IS AVAILABLE ON THE HOSPITAL WEBSITE AND AT ANY ENTRANCE POINT OF THE HOSPITAL.
FACILITY 1, UPSON COUNTY HOSPITAL - PART V, LINE 20EECA WILL NOT BEGIN UNTIL AFTER 240 DAYS.
FieldValueIRS element (for citing)
Facility8FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
UPSON MEDICAL ASSOCIATES LLC
801 W GORDON STTHOMASTONGA30286PHYSICIANS OFFICE
UPSON REGIONAL WELLNESS CENTER LLC
801 W GORDON STTHOMASTONGA30286WELLNESS CENTER
ORTHOPEDICS SPORTS MEDICINE & SURG
801 W GORDON STTHOMASTONGA30286PHYSICIANS OFFICE
UPSON WOMEN'S SERVICES LLC
801 W GORDON STTHOMASTONGA30286PHYSICIANS OFFICE
UPSON FAMILY PHYSICIANS LLC
801 W GORDON STTHOMASTONGA30286PHYSICIANS OFFICE
UPSON SURGICAL ASSOCIATES LLC
801 W GORDON STTHOMASTONGA30286PHYSICIANS OFFICE
UPSON FAMILY MEDICAL CENTER
801 W GORDON STTHOMASTONGA30286FAMILY MEDICAL CENTER
URMC PSYCH UNIT
801 W GORDON STTHOMASTONGA30286PSYCHIATRIC UNIT

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7GSUBSIDIZED HEALTH SERVICE COSTS INCLUDE THOSE ATTRIBUTABLE TO UPSON MEDICAL ASSOCIATES, UPSON WOMEN'S SERVICES, UPSON SURGICAL ASSOCIATES, ORTHOPEDIC SPORTS MEDICINE, AND UPSON FAMILY PHYSICIANS TOTALING 21,740,975. THESE CLINICS PROMOTE HEALTH CARE FOR UNDERSERVED POPULATIONS IN THE AREA.
SCHEDULE H, PART I, LINE 7THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATION'S "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS, 2008". FOR LINE 7A, COSTS WERE CALCULATED USING THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 AS PROVIDED IN THE IRS INSTRUCTIONS. SUBSIDIZED HEALTH SERVICES PRESENTED ON LINE 7G WERE BASED ON ACTUAL COSTS PER THE MEDICARE COST REPORT NET OF ASSOCIATED BAD DEBT, CHARITY AND MEDICAID EXPENSE. ALL OTHER COSTS PRESENTED IN THE TABLE WERE ACCUMULATED THROUGH THE COMMUNITY BENEFITS SOFTWARE CBISA.
SCHEDULE H, PART IIHEALTH PROFESSIONALS RECRUITMENT AND LOCAL CHAMBER/CIVIC SPONSORSHIPS.
SCHEDULE H, PART III, LINE 2BAD DEBT EXPENSE AMOUNT REPRESENTS THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT AND WRITTEN OFF TO BAD DEBT EXPENSE.
SCHEDULE H, PART III, LINE 3THE FIGURE ON PART III LINE 3 REPRESENTS MANAGEMENT'S ESTIMATE (APPROXIMATELY 50%) BASED ON AN ANALYSIS OF SELF PAY PATIENTS' ABILITY TO PAY THEIR OUTSTANDING ACCOUNT. THIS ANALYSIS INCLUDES REVIEWING THE PATIENT'S CREDIT HISTORY, INCOME LEVELS AND OVERALL COLLECTIBILITY OF THE ACCOUNT.
SCHEDULE H, PART III, LINE 4THE FOOTNOTE DISCUSSING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND BAD DEBTS (IMPLICIT PRICE CONCESSIONS) CAN BE FOUND ON PAGES 12-14 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, LINE 8MEDICARE COSTS REFLECT ALLOWABLE COSTS PER THE MEDICARE COST REPORT USING ACCEPTABLE ALLOCATIONS OF INDIRECT COSTS BASED ON APPROPRIATE STATISTICS.
SCHEDULE H, PART III, LINE 9BACCOUNTS KNOWN TO HAVE QUALIFIED FOR FINANCIAL ASSISTANCE ARE WRITTEN OFF TO INDIGENT/CHARITY CARE.
SCHEDULE H, PART VI, LINE 2UPSON REGIONAL MEDICAL CENTER (URMC) IS A 115-BED NOT-FOR-PROFIT COMMUNITY HOSPITAL LOCATED IN THOMASTON. GEORGIA. UPSON COMPLETES A TRIENNIAL NEEDS ASSESSMENT. INFORMATION GATHERED FROM STAKEHOLDER INTERVIEWS, COMMUNITY-WIDE SURVEYS, DISCUSSIONS WITH THE HOSPITAL LEADERSHIP TEAM, REVIEW OF DEMOGRAPHIC AND HEALTH STATUS, AND HOSPITAL UTILIZATION DATA IS USED TO DETERMINE THE PRIORITY HEALTH NEEDS OF THE POPULATION. THE FOLLOWING PRIORITIES WERE IDENTIFIED: 1. MENTAL HEALTH 2. ACCESS TO CARE/OBESITY/EDUCATION 3. SUBSTANCE ABUSE 4. OBESITY AND CHRONIC DISEASES 5. POVERTY 6. TEEN PREGNANCY
SCHEDULE H, PART VI, LINE 3URMC INFORMS AND EDUCATES THE PATIENTS USING THE FOLLOWING PROCESSES: THE FINANCIAL ASSISTANCE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IS POSTED IN THE ADMISSION AREAS, EMERGENCY DEPARTMENTS AND OTHER AREAS OF THE FACILITY IN WHICH ELIGIBLE PATIENTS ARE PRESENT. A COPY OF THE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IS PROVIDED TO THE PATIENTS AS PART OF THE ADMISSION PROCESS. ADDITIONALLY, THE POLICY IS AVAILABLE ON THE HOSPITAL WEBSITE AS IS THE PRINTABLE APPLICATION. A SUMMARY OF THE POLICY IS ALSO INCLUDED IN THE PATIENT BILLING. WE DISCUSS WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS QUALIFYING FOR MEDICAID OR STATE PROGRAMS AND ASSIST THE PATIENT WITH QUALIFYING FOR SUCH PROGRAMS, WHERE APPLICABLE. WE PROVIDE TRAINING TO THE STAFF ON FINANCIAL ASSISTANCE AND CONTRACT WITH CHAMBERLON & EDMONDS FOR SCREENING OUR PATIENTS FOR MEDICAID ELIGIBILITY AND/OR OTHER SOURCES OF ASSISTANCE. WE ALSO PROVIDE INFORMATION ON THE ADMISSIONS PACKAGE EXPLAINING THE AVAILABILITY, CRITERIA, AND THE PROCESS FOR APPLYING FOR FINANCIAL ASSISTANCE. OUR EFFORTS TO INFORM NON-ENGLISH SPEAKING PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY IS PROVIDED BY AN INTERPRETER THROUGH THE USE OF LANGUAGE LINE, A TELEPHONE INTERPRETATION SERVICE.
SCHEDULE H, PART VI, LINE 4UPSON COUNTY IS LOCATED IN WEST CENTRAL GEORGIA AND HAS A POPULATION OF 26,320. THE RACIAL AND ETHNIC MAKEUP OF UPSON COUNTY IS 68% WHITE, 28% BLACK, 1% MIXED RACE, 2% OTHER, AND 2% HISPANIC ORIGIN. THE PERCENTAGE OF RESIDENTS AGED 55 AND OLDER IS SET TO INCREASE 0.6% BY 2022; THIS IDENTIFIED AN INCREASED NEED FOR DELIVERY OF HEALTHCARE THAT SERVES INDIVIDUALS WITH CHRONIC CONDITIONS. URMC, A REGIONAL HEALTHCARE PROVIDER WITH 115 ACUTE CARE BEDS, SERVES THIS AREA OF GEORGIA. THE HOSPITAL IS LOCATED IN THE COUNTY SEAT OF THOMASTON.
SCHEDULE H, PART VI, LINE 5SINCE 2015, URMC HAS RECRUITED FAMILY PHYSICIANS, A CARDIOLOGIST, UROLOGIST, OBSTETRICIAN, AUDIOLOGIST, ENT, FAMILY PRACTICE, ORTHOPEDIC SURGEON, AND ADVANCED PRACTICE PROFESSIONALS. URMC'S AWARD-WINNING DIETICIANS IMPLEMENT THE QUARTERLY SODEXO COMMUNITY EDUCATION PROGRAMMING AND ACTIVELY PARTICIPATE IN COMMUNITY EVENTS, HEALTH FAIRS, AND IN THE WELLNESS CENTER TO INCREASE AWARENESS OF GOOD EATING HABITS AND THEIR IMPACTS ON HEALTH. URMC ALSO PROVIDES MONTHLY DIABETES EDUCATION ON DISEASE MANAGEMENT AND NUTRITION. IN 2017, URMC WAS DESIGNATED AS A REMOTE STROKE TREATMENT CENTER, PROVIDING TIMELY CONSULTS WITH NEUROLOGISTS. URMC CONSISTENTLY OFFERS BLOOD PRESSURE CHECKS AND EDUCATION AT COMMUNITY EVENTS AND HEALTH FAIRS. IN 2017, URMC OPENED SILVERCARE, AN 18-BED INPATIENT GERIATRIC BEHAVIORAL HEALTH UNIT. IN 2018, URMC OPENED A RURAL HEALTH CLINIC AS WELL AS PURCHASING AN URGENT CARE FACILITY TO IMPROVE ACCESS TO CARE. IN EARLY 2019, URMC RECRUITED A NEW CARDIOLOGIST AS WELL AS A NEW FAMILY MEDICINE PROVIDER. IN LATE 2019, URMC ADDED TWO NEW FAMILY MEDICINE PHYSICIANS, A NEW OB/GYN, A NEW OTHROPEDIC SURGEON, AND A NEW ENT. WE ALSO ADDED SATURDAY HOURS AT ONE OF OUR WALK-IN PRIMARY CARE CLINICS. IN 2020, URMC ESTABLISHED AN INTERVENTIONAL CARDIOLOGY PROGRAM, GIVING URMC THE ABILITY TO PERFORM PROCEDURES (SUCH AS STENTING AND ANGIOPLASTY) TO TREAT COMPLEX HEART CONDITIONS, INCLUDING EMERGENCY TREATMENT OF HEART ATTACKS. URMC RECRUITED A CARDIOLOGIST, FAMILY PRACTICE PHYSICIAN, AND OB/GYN IN 2021. THE GOVERNING BODY IS PRIMARILY COMPRISED OF PERSONS WHO ARE NOT EMPLOYEES, CONTRACTORS (NOR FAMILY MEMBERS THEREOF), AND GENERALLY REPRESENT THE INTERESTS OF THE POPULATION SERVED. THE MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS IN THE REGION. THE EMERGENCY ROOM IS OPEN 24/7, SERVING PATIENTS REGARDLESS OF ABILITY TO PAY. AS A NONPROFIT ORGANIZATION DEDICATED TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES, URMC REINVESTS ALL OF ITS SURPLUS FUNDS FROM ITS OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE ACCESS TO CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS AND ADVANCE MEDICAL TRAINING, EDUCATION AND RESEARCH.
SCHEDULE H, PART VI, LINE 7GEORGIA

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

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

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmt
EDUCATION SCHOLARSHIP1$2,078
TUITION REIMBURSEMENT5$17,535

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PAGE 1, PART I, LINE 2FormAndLineReferenceDesc
ExplanationSCHOLARSHIP ASSISTANCE IS OFFERED TO UPSON COUNTY RESIDENTS AND FULL TIME, PART TIME AND PRN EMPLOYEES PURSUING A HEALTHCARE CAREER. EACH APPLICANT MUST COMPLETE AN APPLICATION; BE ACCEPTED BY AN ACCREDITED SCHOOL IN A HEALTHCARE PROGRAM OF THEIR CHOICE; SUBMIT TWO LETTERS OF RECOMMENDATION, A CERTIFIED COPY OF PREVIOUS EDUCATIONAL TRANSCRIPTS, AND A LETTER OF ACCEPTANCE IN THE HEALTHCARE CAREER PROGRAM, OBTAIN APPROVAL FROM THE DEPARTMENT DIRECTOR OR SENIOR MANAGEMENT, BE INTERVIEWED BY CHIEF NURSING OFFICER, MAINTAIN A 3.0 CUMULATIVE AVERAGE, SUBMIT TRANSCRIPTS OF GRADES EVERY SCHOOL TERM, AND SERVE AS AN EMPLOYEE A MINIMUM OF ONE YEAR FOR EACH SCHOOL YEAR FOR WHICH SCHOLARSHIP MONIES WERE GRANTED. TRANSCRIPTS OF GRADES MUST BE RECEIVED BEFORE REIMBURSEMENT. SHOULD THE STUDENT NOT SEEK AND MAINTAIN EMPLOYMENT WITH URMC AFTER GRADUATION, FUNDS WILL BECOME DUE AND PAYABLE IN A PRORATA FASHION BASED ON EMPLOYMENT TERM. TUITION REIMBURSEMENT IS AWARDED FULLTIME AND REGULARLY SCHEDULED PART TIME EMPLOYEES. MONIES ARE GRANTED TO COVER TUITION, BOOKS AND LABORATORY FEES. EACH APPLICANT MUST BE ENROLLED IN AN ACCREDITED COLLEGE/UNIVERSITY WITHIN A PROGRAM DIRECTLY RELATED TO THE EMPLOYEE'S PRESENT POSITION OR A FIELD THAT WILL BE OF BENEFIT TO THE MEDICAL CENTER, SEEK APPROVAL FROM MANAGEMENT, FURNISH A TRANSCRIPT OF GRADES, MAINTAIN A "C- OR HIGHER GRADE AVERAGE. TO BE REIMBURSED, AN EMPLOYEE MUST PRESENT A CERTIFIED COPY OF THE GRADE REPORT WITH AN AVERAGE OF "C- OR HIGHER.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountOther Compensation Filing OrgOtherCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
BRANDON M BOYCE MD
ORTHOPEDIC SURGEON$766,266$161,764$120,056$6,500$21,395$1,075,981
KEVIN A GINGRICH MD
ORTHOPEDIC SURGEON$598,368$1,250$44,000$6,500$10,876$660,994
DARRYL KNIGHT MD
SURGEON$339,952$216,623$52,898$6,500$34,477$650,450
DANIEL A BRIDGES MD
UROLOGY SURGEON$568,728$1,000$38,400$20,493$628,621
ROBERT SOLYOMVARI MD
SURGEON$396,517$69,848$97,209$6,500$34,477$604,551
JEFF TARRANT
HOSPITAL CEO/PRES$483,075$483,075
BENJAMIN WILLIAMS MD
BOARD MEMBER$273,923$96,058$42,944$4,398$9,876$427,199
JOHN WILLIAMS
CFO/COO$295,123$2,000$6,031$14,426$317,580

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART IIIFormAndLineReferenceDesc
ExplanationMANAGEMENT SERVICES: THE FOUNDATION'S CEO IS CONTRACTUALLY PROVIDED BY HEALTHTECH MANAGEMENT, A FIRM HIRED BY THE SUPPORTED ORGANIZATION, URMC, TO PROVIDE CEO AND OTHER MANAGEMENT SERVICES. HEALTHTECH WAS PAID A TOTAL OF 993,088 IN 2021 FOR THESE SERVICES, INCLUDING AMOUNTS PAID TO JEFF TARRANT SERVING AS CEO TO BOTH THE FOUNDATION AND URMC. BONUSES/AWARDS PHYSICIAN BONUSES ARE PAID BASED ON RELATIVE VALUE UNITS (RVUS) ACHIEVED DURING A SPECIFIED TIME PERIOD. EACH PHYSICIAN'S EMPLOYMENT CONTRACT INCLUDES A RVU GOAL. THE PHYSICIAN IS PAID BONUSES BASED ON MEETING OR EXCEEDING THE GOAL AS DETERMINED BY THEIR CONTRACT.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
HOSPITAL AUTHORITY OF UPSON COUNTY
A5860024272004-12-31$10,000,000RENOVATION AND EXPANSION OF HOSPITALfalseYes (true)false
HOSPITAL AUTHORITY OF UPSON COUNTY
B5860024272005-01-20$6,000,000RENOVATION & EXPANSION OF HOSPITALfalseYes (true)false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$7,945,000$10,000,000$124,175$9,875,8252007falsefalseYes (true)Yes (true)
B$4,765,000$6,000,000$79,846$5,920,1542007falsefalseYes (true)Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
AfalsefalsefalsefalsefalsefalseYes (true)
BfalsefalsefalsefalsefalsefalseYes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
AfalsefalsefalseYes (true)falsefalsefalsefalsefalse
BfalsefalsefalseYes (true)falsefalsefalsefalsefalse

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
Afalse
Bfalse

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PURPOSE OF ISSUE DESCRIPTIONHOSPITAL AUTHORITY OF UPSON COUNTY RENOVATION AND EXPANSION OF HOSPITAL
PURPOSE OF ISSUE DESCRIPTIONHOSPITAL AUTHORITY OF UPSON COUNTY RENOVATION & EXPANSION OF HOSPITAL
DATE REBATE COMPUTATION PERFORMEDHOSPITAL AUTHORITY OF UPSON COUNTY 12/30/09
DATE REBATE COMPUTATION PERFORMEDHOSPITAL AUTHORITY OF UPSON COUNTY 01/20/10

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINE 4BCAYMAN ISLANDS
FORM 990, PAGE 6, PART VI, LINE 3THE ORGANIZATION ENGAGED HEALTHTECH MANAGEMENT TO PROVIDE THE SERVICES OF THE CEO. HEALTHTECH WAS COMPENSATED 993,088 FOR THESE SERVICES. SEE SCHEDULE J PART III FOR ADDITIONAL DETAILS.
FORM 990, PAGE 6, PART VI, LINE 11BTHE ORGANIZATION POSTS THE FORM 990 ON A SECURE WEBSITE FOR BOARD MEMBERS ONLY AND EACH CURRENT VOTING BOARD MEMBER IS ALERTED BY EMAIL AS TO ITS AVAILABILITY. THE CFO/COO PERFORMS A DETAILED REVIEW PRIOR TO FILING WITH THE IRS.
FORM 990, PAGE 6, PART VI, LINE 12CTHE POLICY COVERS ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. SHOULD A MATTER COME BEFORE THE BOARD OF DIRECTORS WHICH CONSTITUTES A CONFLICT OF INTEREST, THE INDIVIDUAL INVOLVED WILL MAKE KNOWN THE POTENTIAL CONFLICT AND WITHDRAW FROM THE MEETING SO LONG AS THE MATTER SHALL CONTINUE UNDER DISCUSSION AND SHALL NOT EITHER VOTE ON THE MATTER UNDER DISCUSSION OR ATTEMPT TO INFLUENCE A DECISION OF THE GOVERNING AUTHORITY WITH RESPECT TO SUCH MATTERS, UPON WHICH THERE COULD POSSIBLY BE A CONFLICT OF INTEREST.
FORM 990, PAGE 6, PART VI, LINE 15AHEALTHTECH PRESENTS SALARY INFORMATION FOR THE CEO TO THE BOARD OF DIRECTORS FOR THEIR REVIEW. IN DETERMINING COMPENSATION FOR THE CFO/COO, OTHER OFFICERS OR KEY EMPLOYEES, THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT OBTAINS COMPARABLE SALARY DATA AND PRESENTS IT TO THE CEO WHO MAKES THE FINAL DECISION. THE INDIVIDUAL IN THE CONSIDERATION PROCESS IS NOT PRESENT DURING THE DISCUSSION AND DECISION-MAKING PROCESS. ANNUAL MERIT ADJUSTMENT: SALARY ADJUSTMENT IS DETERMINED BY ORGANIZATIONAL PERFORMANCE AS REFLECTED IN THE SCORE OF THE ESTABLISHED PERFORMANCE MEASUREMENT INSTRUMENT. (PAYSCALE) - PERIODIC MARKET ADJUSTMENT: SALARY OF EACH OFFICER IS REVIEWED PERIODICALLY BY HUMAN RESOURCES AND APPROPRIATE OFFICER AND COMPARED TO SALARIES OF COMPARABLE ORGANIZATIONS TO ENSURE THAT THE CURRENT RATE IS COMPETITIVE.
FORM 990, PAGE 6, PART VI, LINE 15BSEE RESPONSE AT 15A.
FORM 990, PAGE 6, PART VI, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE FOR INSPECTION, WITH NOTICE, IN THE OFFICE OF THE ORGANIZATION. IN ADDITION, THE FINANCIAL STATEMENTS ARE AVAILABLE ON THE ORGANIZATION'S WEBSITE.
FORM 990, PART IX, LINE 11GCONTRACTED SERVICES 5,351,993 1,028,754 0 PROFESSIONAL FEES 349,392 100,240 0 PHYSICIAN FEES 5,413,503 0 0 PURCHASED SERVICES 1,854,235 696,520 0 THERAPY FEES 57,151 0 0 CONSULTING FEES 14,428 494,515 0 OTHER FEES 562,764 277,037 0 COLLECTION FEES 38,433 637,465 0 TOTAL 13,641,899 3,234,531 0

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
UPSON MEDICAL ASSOCIATES LLC
801 WEST GORDON STREETTHOMASTONGA30286550840991PHYS OFCGA-$12,522$279,367UCH
UPSON REGIONAL WELLNESS CTR LLC
801 WEST GORDON STREETTHOMASTONGA30286205095610WELLNESSGA-$255,985$123,021UCH
UPSON WOMEN'S SVCS LLC
801 WEST GORDON STREETTHOMASTONGA30286263227893PHYS OFCGA-$985,602$1,188,250UCH
UPSON FAMILY PHYSICIANS LLC
801 WEST GORDON STREETTHOMASTONGA30286270192553PHYS OFCGA-$624,505-$1,312,201UCH
UPSON SURGICAL ASSOCIATES LLC
801 WEST GORDON STREETTHOMASTONGA30286275252545PHYS OFCGA-$3,684,035$1,312,201UCH
ORTHOPEDICS SPORTS MEDICINE & SURG
801 WEST GORDON STREETTHOMASTONGA30286272123255PHYS OFCGA$1,375,166$755,578UCH
URMC MEDICAL OFFICE BLDG LLC
801 WEST GORDON STREETTHOMASTONGA30286474279645MED OFC BLGA-$241,947$4,552,986UCH
UPSON FAMILY MEDICAL CENTER LLC
801 WEST GORDON STREETTHOMASTONGA30286824385128PHYS OFCGA-$154,593$2,348,829UCH

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
URMC HEALTH FOUNDATION
P O BOX 1089THOMASTONGA30286830411781FOUNDATIONGA501C312AUCHYes (true)
HOSPITAL AUTHORITY OF UPSON COUNTY
801 WEST GORDON STREETTHOMASTONGA302860027586002427MGMTGAGOVT6falseN/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
URMC HEALTH FOUNDATION
LINDETERMINABLE VALUE
URMC HEALTH FOUNDATION
MINDETERMINABLE VALUE
URMC HEALTH FOUNDATION
NINDETERMINABLE VALUE
URMC HEALTH FOUNDATION
OINDETERMINABLE VALUE