TIFT REGIONAL HEALTH SYSTEM INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- TIFT REGIONAL HEALTH SYSTEM INC (EIN 45-3072990)
- Tax period
- 2019-10-01 to 2020-09-30
- Filed
- 2021-08-13
- IRS object ID
- 202122259349302367
- Schema version
- 2019v5.0
- 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 J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-08-13T15:18:30-05:00 | ReturnTs |
| Tax Period End | 2020-09-30 | 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 | 2019-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 453072990 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TIFT REGIONAL HEALTH SYSTEM INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | TIFT | BusinessNameControlTxt |
| Phone | 2293536310 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2650 | AddressLine1Txt |
| City | TIFTON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317932650 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KIM WILLS | PersonNm |
| Person Title | SVP CFO | PersonTitleTxt |
| Phone | 2293536310 | PhoneNum |
| Signature | 2021-08-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WILLIAM EDWARD PHILLIPS | PreparerPersonNm |
| PTIN | P00451499 | PTIN |
| Phone | 2298837878 | PhoneNum |
| Preparation | 2021-08-13 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHRISTOPHER DORMAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2650 | AddressLine1Txt |
| City | TIFTON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317932650 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $468,957,093 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://WWW.TIFTREGIONAL.COM/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | OUR MISSION IS TO DELIVER A LIFETIME OF QUALITY AND COMPASSIONATE CARE FOR EACH PATIENT WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 2971 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,118,273 | PYContributionsGrantsAmt |
| CY Contributions Grants | $41,392,381 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $253,173,677 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $389,938,453 | CYProgramServiceRevenueAmt |
| PY Investment Income | $14,764,121 | PYInvestmentIncomeAmt |
| CY Investment Income | $29,732,972 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,344,892 | PYOtherRevenueAmt |
| CY Other Revenue | $7,893,287 | CYOtherRevenueAmt |
| PY Total Revenue | $272,400,963 | PYTotalRevenueAmt |
| CY Total Revenue | $468,957,093 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $152,220,028 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $229,785,505 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $105,228,458 | PYOtherExpensesAmt |
| CY Other Expenses | $204,409,329 | CYOtherExpensesAmt |
| PY Total Expenses | $257,448,486 | PYTotalExpensesAmt |
| CY Total Expenses | $434,194,834 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $14,952,477 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $34,762,259 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $904,950,801 | TotalAssetsBOYAmt |
| Total Assets EOY | $948,245,014 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $338,302,114 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $356,282,503 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $566,648,687 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $591,962,511 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | OUR MISSION IS TO DELIVER A LIFETIME OF QUALITY AND COMPASSIONATE CARE FOR EACH PATIENT WE SERVE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $331,794,105 | ExpenseAmt |
| Revenue | $392,588,410 | RevenueAmt |
| Desc | TIFT REGIONAL HEALTH SYSTEM (TRHS) IS A GROWING, NOT-FOR-PROFIT HOSPITAL SYSTEM. ITS MAIN CAMPUS SERVES 12 COUNTIES IN SOUTH CENTRAL GEORGIA. TRHS OFFERS MORE THAN 135 PHYSICIANS WITH EXPERTISE IN OVER 30 SPECIALTIES. TRHS PROVIDES A WIDE RANGE OF CARE, INCLUDING SIGNATURE SERVICES IN SURGERY, ONCOLOGY, CARDIOVASCULAR CARE, WOMEN'S HEALTH, NEURODIAGNOSTICS, GERIATRIC PSYCHIATRIC CARE, RADIOLOGY AND MORE. THE MAIN CAMPUS IS TIFT REGIONAL MEDICAL CENTER (TRMC), A 181-BED REGIONAL REFERRAL HOSPITAL LOCATED IN TIFTON AT 901 EAST 18TH STREET. TRMC'S WEST CAMPUS, LOCATED IN TIFTON AT 2225 HIGHWAY 41 NORTH, IS AN OUTPATIENT FACILITY WHICH HOUSES VARIOUS DIAGNOSTIC SERVICES AND THE REGION'S LARGEST MULTI-SPECIALTY PRACTICE. A 3RD CAMPUS OF TRMC IS IN ADEL, GA. SOUTHWELL MEDICAL IS A 60-BED HOSPITAL (THAT IS NOT SEPARATELY LICENSED) INCLUDING A 12-BED GERIATRIC PSYCHIATRIC UNIT. A 95-BED SKILLED NURSING FACILITY, SOUTHWELL HEALTH & REHABILITATION, ALSO IS LOCATED ON THE SOUTHWELL MEDICAL CAMPUS. | Desc |
| Total Program Service Expenses | $331,794,105 | 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 | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | 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 | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | 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 | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | 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 | 269 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 2971 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| 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 | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | Yes (true) | 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 | KIM WILLS | PersonNm |
| Phone | 2293533397 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2650 | AddressLine1Txt |
| City | TIFTON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31793 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ANTHONY BURKE MD | ||||||||||
| PHYSICIAN | 40.00 | Yes (X) | $1,336,194 | $0 | $37,000 | |||||
| EDWARD HELLMAN MD | ||||||||||
| PHYSICIAN | 40.00 | Yes (X) | $1,241,834 | $0 | $37,000 | |||||
| WILLIAM KAISER MD | ||||||||||
| PHYSICIAN | 40.00 | Yes (X) | $1,154,574 | $0 | $37,000 | |||||
| JEFFRY PETERS MD | ||||||||||
| PHYSICIAN | 40.00 | Yes (X) | $1,102,072 | $0 | $37,000 | |||||
| GEORGE YARED MD | ||||||||||
| PHYSICIAN | 40.00 | Yes (X) | $1,079,603 | $0 | $37,000 | |||||
| FORTE MCEACHIN MD | ||||||||||
| EXEC. MEDICA | 40.00 | $969,106 | $0 | $37,000 | Yes (X) | |||||
| JESSICA BEIER MD | ||||||||||
| TRUSTEE/PHYS | 41.00 | $806,062 | $0 | $37,000 | 1.00 | Yes (X) | ||||
| CHRISTOPHER DORMAN | ||||||||||
| CEO & PRESID | 40.00 | $711,187 | $0 | $91,028 | 1.00 | Yes (X) | ||||
| JAMES SCOTT MD | ||||||||||
| TRUSTEE/PHYS | 41.00 | $771,628 | $0 | $26,000 | Yes (X) | |||||
| KAREN D SUMMERLIN | ||||||||||
| SVP GENERAL | 40.00 | $537,044 | $0 | $65,275 | Yes (X) | |||||
| WILLIAM RICHARDSON | ||||||||||
| CEO (FORMER) | 40.00 | $540,445 | $0 | $28,041 | Yes (X) | |||||
| CAMERON NIXON MD | ||||||||||
| CHIEF TRANSF | 40.00 | $530,845 | $0 | $37,000 | Yes (X) | |||||
| KIM WILLS | ||||||||||
| SVP CFO | 40.00 | $401,705 | $0 | $50,475 | 2.00 | Yes (X) | ||||
| CAROL SMITH | ||||||||||
| SVP CNO | 40.00 | $337,531 | $0 | $45,476 | Yes (X) | |||||
| CLAIRE BYRNES | ||||||||||
| SVP AMBULATO | 40.00 | $234,670 | $0 | $35,433 | Yes (X) | |||||
| LINDA WILSON | ||||||||||
| VP REVENUE C | 40.00 | $218,973 | $0 | $22,475 | Yes (X) | |||||
| JUSTIN BECK | ||||||||||
| CHIEF STRATE | 40.00 | $213,526 | $0 | $22,645 | Yes (X) | |||||
| MARIE ROOF | ||||||||||
| VP CIP | 40.00 | $201,123 | $0 | $21,538 | Yes (X) | |||||
| MICHAEL PURVIS | ||||||||||
| VP COO (SW M | 40.00 | $200,428 | $0 | $21,300 | Yes (X) | |||||
| TAMARA BRANCH | ||||||||||
| VP LEGAL COU | 40.00 | $188,485 | $0 | $21,393 | Yes (X) | |||||
| TONIA GARRETT | ||||||||||
| AVP SURGICAL | 40.00 | $187,841 | $0 | $16,735 | Yes (X) | |||||
| ALEX LE | ||||||||||
| COO | 40.00 | $173,452 | $0 | $18,490 | Yes (X) | |||||
| INDERA RAMPAL-HARROD | ||||||||||
| VP HR (FORME | 40.00 | $158,289 | $0 | $12,532 | Yes (X) | |||||
| JOHN BROWNLEE | ||||||||||
| CHAIRMAN | 1.00 | $0 | $0 | $0 | 1.00 | Yes (X) | Yes (X) | |||
| SCOTT FULP DMD | ||||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||||
| CHASE DAUGHTREY | ||||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||||
| GEORGE M D HUNT IV | ||||||||||
| VICE CHAIRMA | 1.00 | $0 | $0 | $0 | 2.00 | Yes (X) | Yes (X) | |||
| WILLIAM BOWEN JR | ||||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | 1.00 | Yes (X) | ||||
| JOYCE MIMS | ||||||||||
| SECRETARY | 1.00 | $0 | $0 | $0 | 1.00 | Yes (X) | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $13,296,617 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $794,836 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 262 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | 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 |
|---|---|---|---|---|---|
| ASPIRION HEALTH RESOURCES LLC | |||||
| 1506 6TH AVENUE SUITE 3 | COLUMBUS | GA | 31902 | BILLING | $837,428 |
| DIAGNOSTIC PET LLC | |||||
| 1670 ROSCOE ROAD | NEWNAN | GA | 30263 | MEDICAL | $834,250 |
| GOLDFISH LOCUMS LLC | |||||
| 6865 WINDCREST DRIVE SUITE 300 | PLANO | TX | 75024 | LOCUM TENENS | $704,407 |
| MEADOWS & OHLY | |||||
| 275 SCIENTIFIC DRIVE | PEACHTREE CORNERS | GA | 30092 | PROJECT MANAGER | $566,913 |
| HEALTHFUSE LLC | |||||
| 414 NORTH MAIN STREET | THIENSVILLE | WI | 53092 | CONSULTING | $507,354 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 44 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $41,392,381 | AllOtherContributionsAmt |
| Noncash Contributions | $786,960 | NoncashContributionsAmt |
| Total Contributions | $41,392,381 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 623000 | $388,929,096 | $388,929,096 |
| CLINIC AND OTHER PATIENT REV. | 623000 | $884,137 | $884,137 |
| MOB & DATA CENTER | 531120 | $125,220 | $125,220 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $389,938,453 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,695,854 | TotalRevenueColumnAmt |
| Exclusion | $9,695,854 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $20,017,149 | SecuritiesAmt |
| Other | $19,969 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $20,017,149 | SecuritiesAmt |
| Other | $19,969 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,037,118 | TotalRevenueColumnAmt |
| Exclusion | $20,037,118 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| EMPLOYEE PHARMACY | 623000 | $5,243,330 | $5,243,330 | |
| REBATES AND DISCOUNTS | 623000 | $1,367,151 | $1,367,151 | |
| CAFETERIA & VENDING | 722514 | $1,184,691 | $1,184,691 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $98,115 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $98,115 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $7,893,287 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $468,957,093 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $392,588,410 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $34,976,302 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,505,301 | TotalAmt |
| Program Services | $2,112,306 | ProgramServicesAmt |
| Management And General | $4,392,995 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,841 | TotalAmt |
| Management And General | $14,841 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,874,016 | TotalAmt |
| Program Services | $136,291,437 | ProgramServicesAmt |
| Management And General | $38,582,579 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,246,708 | TotalAmt |
| Program Services | $5,529,238 | ProgramServicesAmt |
| Management And General | $1,717,470 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,249,807 | TotalAmt |
| Program Services | $22,317,603 | ProgramServicesAmt |
| Management And General | $6,932,204 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,894,832 | TotalAmt |
| Program Services | $9,075,757 | ProgramServicesAmt |
| Management And General | $2,819,075 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $212,755 | TotalAmt |
| Management And General | $212,755 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $326,206 | TotalAmt |
| Management And General | $326,206 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,856,502 | TotalAmt |
| Program Services | $27,209,333 | ProgramServicesAmt |
| Management And General | $11,647,169 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $653,457 | TotalAmt |
| Program Services | $180,158 | ProgramServicesAmt |
| Management And General | $473,299 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,697,182 | TotalAmt |
| Program Services | $2,059,243 | ProgramServicesAmt |
| Management And General | $1,637,939 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,490,559 | TotalAmt |
| Program Services | $4,822,147 | ProgramServicesAmt |
| Management And General | $12,668,412 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,959,662 | TotalAmt |
| Program Services | $1,643,079 | ProgramServicesAmt |
| Management And General | $4,316,583 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $267,421 | TotalAmt |
| Program Services | $73,728 | ProgramServicesAmt |
| Management And General | $193,693 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $384,784 | TotalAmt |
| Program Services | $106,085 | ProgramServicesAmt |
| Management And General | $278,699 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,761,710 | TotalAmt |
| Program Services | $4,761,710 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,052,992 | TotalAmt |
| Program Services | $34,824,919 | ProgramServicesAmt |
| Management And General | $3,228,073 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,459,193 | TotalAmt |
| Program Services | $953,700 | ProgramServicesAmt |
| Management And General | $2,505,493 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL & SURGICAL SUPP. | $38,396,496 | $35,520,598 | $2,875,898 |
| PHARMACY & DRUGS | $37,576,196 | $34,761,739 | $2,814,457 |
| PROVIDER TAXES | $5,065,326 | $5,065,326 | |
| FRAUD LOSS | $2,691,296 | $2,691,296 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,557,592 | TotalAmt |
| Program Services | $4,485,999 | ProgramServicesAmt |
| Management And General | $2,071,593 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $434,194,834 | TotalAmt |
| Program Services | $331,794,105 | ProgramServicesAmt |
| Management And General | $102,400,729 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,187,178 | BOYAmt |
| EOY | $93,759,446 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,258,571 | BOYAmt |
| EOY | $5,320,712 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,667,200 | BOYAmt |
| EOY | $56,770,135 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,771,228 | BOYAmt |
| EOY | $3,371,364 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,912,332 | BOYAmt |
| EOY | $3,447,728 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,753,866 | BOYAmt |
| EOY | $8,446,368 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $697,344,077 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $375,624,087 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $269,695,978 | BOYAmt |
| EOY | $321,719,990 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $493,974,158 | BOYAmt |
| EOY | $445,593,759 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,047,186 | BOYAmt |
| EOY | $1,047,186 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,490,886 | BOYAmt |
| EOY | $2,305,376 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,192,218 | BOYAmt |
| EOY | $6,462,950 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $904,950,801 | BOYAmt |
| EOY | $948,245,014 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,375,273 | BOYAmt |
| EOY | $65,231,402 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $5,400,000 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $149,034,015 | BOYAmt |
| EOY | $104,709,229 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $132,063,887 | BOYAmt |
| EOY | $150,786,764 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,828,939 | BOYAmt |
| EOY | $30,155,108 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $338,302,114 | BOYAmt |
| EOY | $356,282,503 | 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 | $566,648,687 | BOYAmt |
| EOY | $591,962,511 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $566,648,687 | BOYAmt |
| EOY | $591,962,511 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $904,950,801 | BOYAmt |
| EOY | $948,245,014 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $34,762,259 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$865,206 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$8,583,229 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| 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 | false | FederalGrantAuditRequiredInd |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $84,951 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $84,951 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | TIFT REGIONAL HEALTH SYSTEM IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION, THE GEORGIA HOSPITAL ASSOCIATION AND OTHER MEMBERSHIP ORGANIZATIONS. THE LOBBYING EXPENSE REFLECTED REPRESENTS THE ESTIMATED PORTION OF DUES PAID TO THESE ORGANIZATIONS SPENT ON LOBBYING ACTIVITIES AT FEDERAL, STATE OR LOCAL LEVELS OF GOVERNMENT. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,015,460 | OtherCostOrOtherBasisAmt |
| Book Value | $11,015,460 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $328,855,756 | OtherCostOrOtherBasisAmt |
| Depreciation | $98,726,700 | DepreciationAmt |
| Book Value | $230,129,056 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $357,472,861 | OtherCostOrOtherBasisAmt |
| Depreciation | $276,897,387 | DepreciationAmt |
| Book Value | $80,575,474 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $321,719,990 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| MEDICARE ACCELERATED PAYMENTS | $25,325,348 |
| ACCRUED PROFESSIONAL LIABILITY | $3,008,926 |
| ESTIMATED THIRD PARTY SETTLEMENTS | $1,018,373 |
| DEFERRED COMPENSATION | $802,461 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $30,155,108 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | SOUTHWELL, SYSTEM, AND AMBULATORY ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACO IS CONSIDERED A DISREGARDED ENTITY OF THE SYSTEM. ENTERPRISES IS A FOR-PROFIT CORPORATION. SOUTHWELL APPLIES 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, SOUTHWELL 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 BALANCE SHEETS FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF SEPTEMBER 30, 2020 AND 2019 OR FOR THE YEARS THEN ENDED. 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 FOR THOSE RETURNS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 2.250000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,008,099 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $23,008,099 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05300 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $35,259,955 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $26,214,753 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,045,202 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02080 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $375,451 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $212,969 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $162,482 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $58,643,505 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $26,427,722 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $32,215,783 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07420 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,650,610 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $112,468 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,538,142 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01740 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,650,610 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $112,468 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,538,142 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01740 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $66,294,115 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $26,540,190 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $39,753,925 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09160 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $54,093,940 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $59,318,322 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $68,979,682 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$9,661,360 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TIFT REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 E 18TH STREET | AddressLine1Txt |
| City | TIFTON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31793 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 137-180 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TIFT REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (true) | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | false | CHNAConductedInd |
| 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 | 225.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| 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.TIFTREGIONAL.COM/FINANCIALASSISTAN | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.TIFTREGIONAL.COM/FINANCIALASSISTAN | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.TIFTREGIONAL.COM/FINANCIALASSISTAN | 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 | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FACILITY 1, TIFT REGIONAL MEDICAL CENTER - PART V, LINE 2 | FormAndLineReferenceDesc |
| Explanation | EFFECTIVE MARCH 1, 2019, THE TIFT COUNTY HOSPITAL AUTHORITY (THE "AUTHORITY") TRANSFERRED VIA A 40-YEAR LEASE SUBSTANTIALLY ALL OF ITS OPERATIONS, ASSETS AND LIABILITIES TO TIFT REGIONAL HEALTH SYSTEM, INC. THE AUTHORITY IS A GOVERNMENTAL HOSPITAL AUTHORITY ORGANIZED PURSUANT TO THE OFFICIAL CODE OF GEORGIA, AND IS CONSIDERED A GOVERNMENTAL INSTRUMENTALITY UNDER THE INTERNAL REVENUE CODE. TIFT REGIONAL HEALTH SYSTEM, INC. IS A TAX-EXEMPT ORGANIZATION PUSUANT TO INTERNAL REVENUE CODE SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN SECTIONS 501(C)(3), 509(A) (1) AND 170(B)(1)(III). | ExplanationTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 33 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (33 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| TIFT REGIONAL DIALYSIS CENTER | ||||
| 1010 EDGEFIELD DRIVE | TIFTON | GA | 31794 | END STAGE RENAL DIALYSIS |
| AFFINITY CLINIC | ||||
| 2225 US HIGHWAY 41N | TIFTON | GA | 31794 | MULTI-SPEICALTY CLINIC |
| GEORGIA SPORTS MEDICINE | ||||
| 2227 US HIGHWAY 41N | TIFTON | GA | 31794 | ORTHOPAEDIC SURGERY |
| TIFT REGIONAL ANESTHESIA | ||||
| 2227 US HIGHWAY 41N | TIFTON | GA | 31794 | ANESTHESIOLOGY |
| SOUTHWELL HEALTH & REHABLITATION | ||||
| 260 MJ TAYLOR ROAD | ADEL | GA | 31620 | SKILLED NURSING |
| SOUTH GEORGIA SURGICAL | ||||
| 1007 GREENFIELD DRIVE | TIFTON | GA | 31794 | GENERAL SURGERY |
| TIFT REGIONAL UROLOGY | ||||
| 1815 OLD OCILLA ROAD | TIFTON | GA | 31794 | UROLOGY |
| AFFINITY PEDIATRICS | ||||
| 39 KENT ROAD SUITE 5 | TIFTON | GA | 31794 | PEDIATRICS |
| HOSPICE OF TIFT AREA | ||||
| 618 N CENTRAL AVENUE | TIFTON | GA | 31794 | HOSPICE |
| TIFT REGIONAL WOUND CARE | ||||
| 907 E 18TH STREET SUITE 140 | TIFTON | GA | 31794 | OUTPATIENT WOUND CARE |
| TIFT REGIONAL OUTPATIENT THERAPY | ||||
| 2227 US HIGHWAY 41N | TIFTON | GA | 31794 | OUTPATIENT THERAPY PT/OT/SPEECH |
| AFFINITY PHYSICIANS FOR WOMEN | ||||
| 1493 KENNEDY ROAD SUITE C | TIFTON | GA | 31794 | OBSTETRICS & GYNECOLOGY |
| SOUTHWELL MEDICAL ADEL PRIMARY CARE | ||||
| 172 MJ TAYLOR ROAD | ADEL | GA | 31620 | FAMILY MEDICINE |
| ALLURE PLASTIC & RECONSTRUCTIVE | ||||
| 907 E 18TH STREET SUITE 340 | TIFTON | GA | 31794 | PLASTIC SURGERY |
| TIFT REGIONAL VASCULAR | ||||
| 1641 MADISON AVENUE | TIFTON | GA | 31794 | VASCULAR SURGERY |
| SOUTHWELL NEPHROLOGY | ||||
| 39 KENT ROAD SUITE 1 | TIFTON | GA | 31794 | NEPHROLOGY |
| TIFT REGIONAL OPTHALMOLOGY | ||||
| 1803 OLD OCILLA ROAD | TIFTON | GA | 31794 | OPTHALMOLOGY/OPTICAL |
| TIFT FAMILY MEDICINE | ||||
| 907 E 18TH STREET SUITE 130 | TIFTON | GA | 31794 | FAMILY MEDICINE |
| ARTHRITIS & OSTEOPOROSIS CENTER | ||||
| 2227 US HIGHWAY 41N | TIFTON | GA | 31794 | RHEUMATOLOGY |
| AFFINNITY CLINICNEUROLOGY | ||||
| 2227 US HIGHWAY 41N | TIFTON | GA | 31794 | NEUROLOGY |
| OCILLA PEDIATRICS | ||||
| 813 IRWIN AVENUE | TIFTON | GA | 31794 | PEDIATRICS |
| AFFINTIY PEDIATRICS | ||||
| 3007 2ND STREET NE | MOULTRIE | GA | 31768 | PEDIATRICS |
| NASHVILLE PRIMARY CARE | ||||
| 416A E MCPHERSON AVENUE | NASHVILLE | GA | 31639 | FAMILY MEDICINE |
| ASHBURN PRIMARY CARE | ||||
| 611 E WASHINGTON AVENUE | ASHBURN | GA | 31714 | FAMILY MEDICINE |
| TRMC ONCOLOGY PROFESSIONALS | ||||
| 1623 MADISON AVENUE | TIFTON | GA | 31794 | ONCOLOGY |
| AFFINITY CLINIC MOULTRIE | ||||
| 2 HOSPITAL PARK | MOULTRIE | GA | 31768 | MULTI-SPECIALTY CLINIC |
| AFFINITY PHYSICIANS FOR WOMEN MOUTL | ||||
| 2 HOSPTIAL PARK | MOULTRIE | GA | 31768 | OBSTETRICS & GYNECOLOGY |
| SOUTHWELL CENTER FOR HEARING & WELL | ||||
| 39 KENT ROAD SUITE 2 | TIFTON | GA | 31794 | FAMILY MEDICINE |
| SOUTHWELL SCHOOL CLINIC | ||||
| 1464 CARPENTER ROAD S | TIFTON | GA | 31794 | SCHOOL BASED CLINIC |
| SOUTHWELL SCHOOL CLINIC | ||||
| 700 8TH STREET W | TIFTON | GA | 31794 | SCHOOL BASED CLINIC |
| SYLVESTER FAMILY PRACTICE | ||||
| 1010 W FRANKLIN STREET | SYLVESTER | GA | 31791 | FAMILY MEDICINE |
| TIFT COMMUNITY HEALTH CENTER | ||||
| 2735 S CENTRAL AVENUE | TIFTON | GA | 31794 | FAMILY MEDICINE |
| WORKSMART OCCUPATION HEALTH | ||||
| 4468 UNION ROAD | TIFTON | GA | 31794 | OCCUPATIONAL HEALTH |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7 | A COST-TO-CHARGE RATIO IS CALCULATED USING WORKSHEET 2 INCLUDED IN THE FORM 990, SCHEDULE H INSTRUCTIONS. |
| SCHEDULE H, PART III, LINE 2 | CHANGES IN CREDIT ISSUES THAT ARE NOT ADDRESSED AT THE DATE OF SERVICE ARE RECOGNIZED AS BAD DEBT EXPENSE AND ARE INCLUDED AS A COMPONENT OF OPERATING EXPENSES. CREDIT ISSUES THAT ARE ADDRESSED AT THE DATE OF SERVICE ARE TREATED AS PRICE CONCESSIONS THAT REDUCE THE TRANSACTION PRICE, WHICH ARE REPORTED AS A REDUCTION OF NET PATIENT SERVICE REVENUE. THERE WERE NO BAD DEBTS RECORDED IN OPERATING EXPENSES DURING THE FISCAL YEAR. BASED ON MANAGEMENT'S JUDGEMENT AND EXPERIENCE, 100% OF SELF-PAY ACCOUNT BALANCES ARE RECORDED AS PRICE CONCESSIONS. |
| SCHEDULE H, PART III, LINE 4 | SOUTHWELL HAS ARRANGEMENTS WITH THIRD-PARTY PAYORS THAT PROVIDE FOR PAYMENTS TO SOUTHWELL AT AMOUNTS DIFFERENT FROM ESTABLISHED RATES. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, SOUTHWELL RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES, SUBJECT TO CERTAIN DISCOUNTS AND IMPLICIT PRICE CONCESSIONS AS DETERMINED BY SOUTHWELL. SOUTHWELL DETERMINES THE TRANSACTION PRICE BASED ON STANDARD CHARGES FOR SERVICES PROVIDED, REDUCED BY CONTRACTUAL ADJUSTMENTS PROVIDED TO THIRD- PARTY PAYORS, DISCOUNTS PROVIDED TO UNINSURED PATIENTS IN ACCORDANCE WITH SOUTHWELL'S POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED TO UNINSURED PATIENTS. IMPLICIT PRICE CONCESSIONS REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED AND THE ESTIMATED CONSIDERATION SOUTHWELL EXPECTS TO RECEIVE FROM PATIENTS, WHICH ARE DETERMINED BASED ON HISTORICAL COLLECTION EXPERIENCE, CURRENT MARKET CONDITIONS, AND OTHER FACTORS. SOUTHWELL DETERMINES ITS ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS BASED ON CONTRACTUAL AGREEMENTS, DISCOUNT POLICIES, AND HISTORICAL EXPERIENCE. SEE FOOTNOTES 2 AND 3 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR ADDITIONAL INFORMATION REGARDING UNCOMPENSATED CARE. |
| 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. THE FULL AMOUNT OF THE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT. MEDICARE IS A FEDERAL PROGRAM WHICH DICTATES PAYMENT RATES AND CONDITIONS OF PARTICIPATION FOR SERVING CERTAIN ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. SERVING THE NEEDS OF OUR RESIDENTS AT BELOW MEDICARE'S COMPUTATION OF COSTS PROVIDES NECESSARY LOCAL CARE FOR A SEGMENT OF THE POPULATION THAT CONSTITUTES A CHARITABLE CLASS. |
| SCHEDULE H, PART III, LINE 9B | PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY ("FAP") RECIEVE A 100% DISCOUNT. THERE ARE NO COLLECTION ACTIVITIES FOR QUALIFYING FAP-ELIGIBLE PATIENTS. |
| SCHEDULE H, PART VI, LINE 2 | AS A GOVERNMENTAL ORGANIZATION OPERATED PURSUANT TO GEORGIA HOSPITAL AUTHORITIES LAW PRIOR TO MARCH 1, 2019, THE HOSPITAL WAS NOT SUBJECT TO THE PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(R). NEVERTHELESS, THE HOSPITAL AUTHORITY CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2014 AN 2017 FOR ITS TIFTON CAMPUS. IN ADDITION, AS PART OF THE STRATEGIC PLANNING PROCESS FOR EACH CAMPUS, COMMUNITY INPUT RELATED TO HEALTH NEEDS IS RECEIVED FROM A VARIETY OF SOURCES, INCLUDING PHYSICIANS, NURING STAFF AND COMMUNITY MEMBERS. |
| SCHEDULE H, PART VI, LINE 3 | THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY ("FAP"), PLAIN LANGUAGE SUMMARY AND FINANCIAL ASSISTANCE APPLICATION ARE AVAILABLE ONLINE AND UPON REQUEST AT THE 2 HOSPITAL CAMPUSES (TRMC AND SOUTHWELL MEDICAL). A PLAIN LANGUAGE SUMMARY OF THE FAP IS OFFERED TO EACH PATIENT UPON ADMISSION AND SIGNAGE IS POSTED THROUGHOUT BOTH CAMPUSES REGARDING THE FAP. |
| SCHEDULE H, PART VI, LINE 4 | TIFT REGIONAL HEALTH SYSTEM, INC. SERVES A 12-COUNTY AREA OF SOUTHWEST GEORGIA WHICH HAS A TOAL POPULATION IN EXCESS OF A QUARTER OF A MILLION RESIDENTS. THE POPULATION FOR THE COUNTIES IN THE PRIMARY SERVICE AREA ACCORDING TO THE 2010 CENSUS ARE - TIFT COUNTY (40,787), TURNER COUNTY (8,338) AND COOK COUNTY (17,033). THE 9 COUNTIES IN THE SECONDARY SERVICE AREA INCLUDE ATKINSON, BENHILL, BERRIEN, COFFEE, COLQUITT, CRISP, IRWIN, WILCOX, AND WORTH COUNTIES WHICH HAVE A TOTAL POPULATION OF 196,667. THIS AREA OF GEORGIA HAS MEDIAN AGE SIMILAR TO THE STATE AVERAGE, BUT LOWER MEDIAN HOUSEHOLD INCOMES, LOWER EDUCATIONAL ATTAINEMENT LEVELS AND HIGHER DISABILITY RATES. IN THE PRIMARY SERVICE AREA, OVER 50% OF THE POPULATION LIVES BELOW 200% OF THE FEDERAL POVERTY LINE. MORE THAN A THIRD OF THE POPULATION OF TIFT COUNTY AND COOK COUNTY ARE OBESE, AND THE OBESITY RATE IN TURNER COUNTY IS 31.1%. HEART DISEASE IS THE LEADING CAUSE OF DEATH IN THE PRIMARY SERVICE AREA AND IS OVER 30% HIGHER THAN THE AVERAGE FOR THE STATE. |
| SCHEDULE H, PART VI, LINE 5 | TIFT REGIONAL HEALTH SYSTEM, INC. IS GOVERNED BY AN INDEPENDENT BOARD OF DIRECTORS COMPRISED OF COMMUNITY REPRESENTATIVES. THE ORGANIZATION IS A NOT-FOR-PROFIT ORGANIZATION UNDER GEORGIA LAW AND A TAX-EXEMPT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ANY EXCESS REVENUES OVER EXPENSES ARE REINVESTED INTO SERVING THE HEALTHCARE NEEDS OF THE COMMUNITY. TIFT REGIONAL MEDICAL CENTER ("TRMC") IS 181-BED REGIONAL REFERRAL HOSPITAL THAT OPERATES AN EMERGENCY ROOM 24/7/365. SOUTHWELL MEDICAL IS A NON-SEPARATELY LICENSED 60-BED HOSPITAL CAMPUS OF TRMC. THIS FACILITY INCLUDES 12 GERIATRIC PSYCHIATRIC BEDS. A 95-BED SKILLED NURSING FACILITY (SOUTHWELL HEALTH & REHABILITATION) IS ALSO LOCATED ON THIS CAMPUS. TRMC, SOUTHWELL MEDICAL AND SOUTHWELL HEALTH & REHABILITATION PARTICIPATE IN THE MEDICARE AND MEDICAID PROGRAMS. TIFT REGIONAL HEALTH SYSTEM TREATS ALL PATIENTS IN A NONDISCRIMINATORY MANNER WITHOUT REGARD TO THEIR ABILITY TO PAY FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THE MEDICAL STAFF OF THE HOSPITAL IS OPEN TO ALL PROPERLY CREDENTIALED QUALIFIED PHYSICIANS. |
| SCHEDULE H, PART VI, LINE 6 | TIFT REGIONAL HEALTH SYSTEM, INC. OPERATES TIFT REGIONAL MEDICAL CENTER, A 181-BED REGIONAL REFERRAL HOSPITAL LOCATED IN TIFTON, GEORGIA, AND SOUTHWELL MEDICAL (FORMERLY COOK MEDICAL CENTER), A 60-BED NONSEPARATELY LICENSED HOSPITAL CAMPUS OF TRMC (INCLUDING 12 GERIATRIC PSYCHIATRIC BEDS) AND A 95-BED SKILLED NURSING FACILITY. TIFT REGIONAL MEDICAL CENTER FOUNDATION, INC. IS A TAX-EXEMPT ORGANIZATION RESPONSIBLE FOR FUNDRAISING EFFORTS BENEFITTING TIFT REGIONAL HEALTH SYSTEM, INC. SOUTHWELL AMBULATORY, INC. IS A NONPROFIT ORGANIZATION THAT PROVIDES SPECIALTY PHYSICIAN AND OTHER MEDICAL SERVICES. ITS EXEMPTION APPLICATION IS PENDING IRS APPROVAL. SOUTHWELL, INC. SERVES AS THE PARENT ORGANIZATION. IT IS A TAX-EXEMPT ORGANIZATION RESPONSIBLE FOR STRATEGIC AND FINANCIAL PLANNING FOR THE VARIOUS MEMBERS OF THE MULTI-ENTITY HEALTHCARE PROVIDER SYSTEM. TIFT ENTERPRISES, INC. IS A FOR-PROFIT SUBSIDIARY OF SOUTHWELL, INC. IT SERVES AS A HOLDING COMPANY FOR CERTAIN INVESTMENTS AND PROVIDES LIMITED MANAGEMENT SERVICES. |
| SCHEDULE H, PART VI, LINE 7 | GEORGIA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Yes (true) | 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 (23 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|
| ANTHONY BURKE MD | ||||||
| PHYSICIAN | $794,727 | $513,797 | $27,670 | $25,000 | $12,000 | $1,373,194 |
| EDWARD HELLMAN MD | ||||||
| PHYSICIAN | $1,039,328 | $201,540 | $966 | $25,000 | $12,000 | $1,278,834 |
| WILLIAM KAISER MD | ||||||
| PHYSICIAN | $1,064,142 | $88,626 | $1,806 | $25,000 | $12,000 | $1,191,574 |
| JEFFRY PETERS MD | ||||||
| PHYSICIAN | $789,071 | $311,195 | $1,806 | $25,000 | $12,000 | $1,139,072 |
| GEORGE YARED MD | ||||||
| PHYSICIAN | $962,601 | $115,336 | $1,666 | $25,000 | $12,000 | $1,116,603 |
| FORTE MCEACHIN MD | ||||||
| EXEC. MEDICAL DIR. | $908,124 | $60,016 | $966 | $25,000 | $12,000 | $1,006,106 |
| JESSICA BEIER MD | ||||||
| TRUSTEE/PHYSICIAN | $695,578 | $92,438 | $18,046 | $25,000 | $12,000 | $843,062 |
| CHRISTOPHER DORMAN | ||||||
| CEO & PRESIDENT | $554,798 | $114,274 | $42,115 | $77,901 | $13,127 | $802,215 |
| JAMES SCOTT MD | ||||||
| TRUSTEE/PHYSICIAN | $755,868 | $7,108 | $8,652 | $14,000 | $12,000 | $797,628 |
| KAREN D SUMMERLIN | ||||||
| SVP GENERAL COUNSEL | $466,003 | $64,075 | $6,966 | $51,504 | $13,771 | $602,319 |
| WILLIAM RICHARDSON | ||||||
| CEO (FORMER) | $44,524 | $90,639 | $405,282 | $16,041 | $12,000 | $568,486 |
| CAMERON NIXON MD | ||||||
| CHIEF TRANSFORMATION | $474,267 | $28,428 | $28,150 | $25,000 | $12,000 | $567,845 |
| KIM WILLS | ||||||
| SVP CFO | $324,002 | $60,750 | $16,953 | $38,475 | $12,000 | $452,180 |
| CAROL SMITH | ||||||
| SVP CNO | $281,715 | $38,736 | $17,080 | $33,476 | $12,000 | $383,007 |
| CLAIRE BYRNES | ||||||
| SVP AMBULATORY SERV. | $208,123 | $26,211 | $336 | $23,433 | $12,000 | $270,103 |
| LINDA WILSON | ||||||
| VP REVENUE CYCLE | $197,704 | $14,828 | $6,441 | $10,475 | $12,000 | $241,448 |
| JUSTIN BECK | ||||||
| CHIEF STRATEGY & INN | $200,845 | $12,051 | $630 | $10,645 | $12,000 | $236,171 |
| MARIE ROOF | ||||||
| VP CIP | $185,411 | $13,906 | $1,806 | $9,538 | $12,000 | $222,661 |
| MICHAEL PURVIS | ||||||
| VP COO (SW MEDICAL) | $159,117 | $41,311 | $9,300 | $12,000 | $221,728 | |
| TAMARA BRANCH | ||||||
| VP LEGAL COUNSEL | $173,810 | $14,339 | $336 | $9,393 | $12,000 | $209,878 |
| TONIA GARRETT | ||||||
| AVP SURGICAL SERVICE | $155,319 | $9,091 | $23,431 | $4,735 | $12,000 | $204,576 |
| ALEX LE | ||||||
| COO | $158,660 | $11,757 | $3,035 | $6,490 | $12,000 | $191,942 |
| INDERA RAMPAL-HARROD | ||||||
| VP HR (FORMER) | $28,929 | $129,360 | $6,532 | $6,000 | $170,821 | |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PAGE 1, PART I, LINE 4 | FormAndLineReferenceDesc |
| Explanation | ANTHONY BURKE, MD 0 11,000 0 EDWARD HELLMAN, MD 0 11,000 0 WILLIAM KAISER, MD 0 11,000 0 JEFFRY PETERS, MD 0 11,000 0 GEORGE YARED, MD 0 11,000 0 FORTE MCEACHIN, MD 0 11,000 0 JESSICA BEIER, MD 0 11,000 0 CHRISTOPHER DORMAN 0 63,901 0 KAREN D. SUMMERLIN 0 37,504 0 CAMERON NIXON, MD 0 11,000 0 KIM WILLS 0 24,475 0 CAROL SMITH 0 21,299 0 CLAIRE BYRNES 0 12,331 0 MICHAEL PURVIS 29,789 0 0 INDERA RAMPAL-HARROD 105,452 0 0 | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| 2013 BONDS | ||||||||
| A | 586001719 | 886640HS3 | 2019-03-01 | $81,326,130 | FINANCE/REFINANCE ADDITIONS AND IMPROVEMENTS TO HOSPITAL FACILITY; REFUND OUTSTANDING 2002 BONDS; RE | false | false | false |
| BANK OF AMERICA | ||||||||
| B | 586001719 | NONENONEN | 2019-03-01 | $31,862,844 | ACQUISITION, INSTALLATION AND IMPLEMENTATION OF EMR SYSTEM. | false | false | false |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Refunding EscrowRefundingEscrowAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|
| A | $2,029,779 | $79,296,351 | 2017 | Yes (true) | false | false | Yes (true) |
| B | $6,449,966 | $25,412,878 | 2017 | Yes (true) | false | false | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 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) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 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 | false | false | false | false | Yes (true) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (true) |
| B | Yes (true) |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PURPOSE OF ISSUE DESCRIPTION | 2013 BONDS FINANCE/REFINANCE ADDITIONS AND IMPROVEMENTS TO HOSPITAL FACILITY; REFUND OUTSTANDING 2002 BONDS; REPAY A BANK LOAN; AND PAY ISSUANCE COST OF 2013 BONDS. |
| PURPOSE OF ISSUE DESCRIPTION | BANK OF AMERICA ACQUISITION, INSTALLATION AND IMPLEMENTATION OF EMR SYSTEM. |
| ADDITIONAL INFORMATION | 2013 BONDS EFFECTIVE MARCH 1, 2019 THE OPERATIONS, ASSETS AND LIABILITIES OF THE TIFT COUNTY HOSPITAL AUTHORITY AN INSTRUMENTALITY OF THE STATE OF GEORGIA, WERE TRANSFERRED TO TIFT REGIONAL HEALTH SYSTEM, INC., AN ORGANIZATION EXEMPT FROM INCOME TAXES PURSUANT TO IRC SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3). AS A RESULT, THE EXISTING TAX-EXEMPT DEBT OF THE HOSPITAL AUTHORITY WAS REISSUED AS QUALIFIED 501(C)(3) DEBT. AS A RESULT OF THE REISSUANCE, THE NEW OBLIGATIONS ARE TREATED AS CURRENTLY REFUNDING THE AUTHORITY'S DEBT AT THE DATE OF THE TRANSFER. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| JAMES HUNTER GARRETT | |||
| FAMILY MEMBER | $47,443 | COMPENSATION | false |
| RYAN BYRNES MD | |||
| FAMILY MEMBER | $146,379 | COMPENSATION | false |
| MARGARET RICHARDSON-NIXON MD | |||
| FAMILY MEMBER | $345,543 | COMPENSATION | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V | FormAndLineReferenceDesc |
| Explanation | THE 3 INDIVIDUALS IDENTIFIED ABOVE ARE RELATIVES OF KEY EMPLOYEES OF TIFT REGIONAL HEALTH SYSTEM. ALL ARE COMPENSATED AT FAIR MARKET VALUE FOR SERVICES PERFORMED. | ExplanationTxt |
Schedule M IRS990ScheduleM
Real Estate Commercial RealEstateCommercialGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $786,960 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4A | TIFT REGIONAL HEALTH SYSTEM (TRHS) IS A GROWING, NOT-FOR-PROFIT HOSPITAL SYSTEM. ITS MAIN CAMPUS SERVES 12 COUNTIES IN SOUTH CENTRAL GEORGIA. TRHS OFFERS MORE THAN 135 PHYSICIANS WITH EXPERTISE IN OVER 30 SPECIALTIES. TRHS PROVIDES A WIDE RANGE OF CARE, INCLUDING SIGNATURE SERVICES IN SURGERY, ONCOLOGY, CARDIOVASCULAR CARE, WOMEN'S HEALTH, NEURODIAGNOSTICS, GERIATRIC PSYCHIATRIC CARE, RADIOLOGY AND MORE. THE MAIN CAMPUS IS TIFT REGIONAL MEDICAL CENTER (TRMC), A 181-BED REGIONAL REFERRAL HOSPITAL LOCATED IN TIFTON AT 901 EAST 18TH STREET. TRMC'S WEST CAMPUS, LOCATED IN TIFTON AT 2225 HIGHWAY 41 NORTH, IS AN OUTPATIENT FACILITY WHICH HOUSES VARIOUS DIAGNOSTIC SERVICES AND THE REGION'S LARGEST MULTI-SPECIALTY PRACTICE. A 3RD CAMPUS OF TRMC IS IN ADEL, GA. SOUTHWELL MEDICAL IS A 60-BED HOSPITAL (THAT IS NOT SEPARATELY LICENSED) INCLUDING A 12-BED GERIATRIC PSYCHIATRIC UNIT. A 95-BED SKILLED NURSING FACILITY, SOUTHWELL HEALTH & REHABILITATION, ALSO IS LOCATED ON THE SOUTHWELL MEDICAL CAMPUS. |
| FORM 990, PAGE 6, PART VI, LINE 5 | THE ORGANIZATION FELL VICTIM TO A SOCIAL ENGINEERING SCHEME THAT RESULTED IN A THEFT OF 2,691,296. TWO WIRE TRANSFERS WERE MADE TO AN ACCOUNT SETUP TO APPEAR AS IF THEY BELONGED TO THE ACTUAL CONTRACTOR ON THE EMERGENCY ROOM/BED TOWER CONSTRUCTION PROJECT. CONTACT WAS MADE VIA EMAIL AND TELEPHONE TO SET UP THE ACH TRANSFERS. AS A RESULT OF THE FRAUD, NEW POLICIES HAVE BEEN IMPLEMENTED TO REDUCE THE LIKLIHOOD OF SIMILAR FUTURE ATTEMPTS AND EMPLOYEES HAVE RECEIVED ADDITIONAL EDUCATION ON THE POLICIES AND ON SECURITY. THE FBI CYBER CRIMES UNIT IS INVESTIGATING THIS CRIME. |
| FORM 990, PAGE 6, PART VI, LINE 6 | SOUTHWELL, INC. IS THE SOLE MEMBER OF TIFT REGIONAL HEALTH SYSTEM, INC. SOUTHWELL IS A TAX-EXEMPT ORGANIZATION AS DESCRIBED IN INTERNAL REVENUE CODE SECTION 501(C)(3). |
| FORM 990, PAGE 6, PART VI, LINE 7A | ALL APPOINTMENTS TO THE BOARD OF DIRECTORS ARE FILLED BY THE REMAINING MEMBERS OF THE BOARD SUBJECT TO THE APPROVAL OF SOUTHWELL, INC. IN ADDITION, A DIRECTOR MAY BE REMOVED AT ANY TIME, WITH OR WITHOUT CAUSE, SUBJECT TO THE APPROVAL OF SOUTHWELL, INC. |
| FORM 990, PAGE 6, PART VI, LINE 7B | SOUTHWELL, INC. IS THE SOLE MEMBER OF TIFT REGIONAL HEALTH SYSTEM, INC. ("TRHS"). THE FOLLOWING ACTIONS CANNOT BE TAKEN WITHOUT THE APPROVAL OF THE MEMBER: 1) FILL VACANCIES IN, NOMINATE AND APPROVE THE ELECTION OF AND APPROVE OR DIRECT THE REMOVAL OF DIRECTORS OF TRHS; 2) APPROVE ALL AMENDMENTS, MODIFICATIONS, RESTATEMENTS AND ALTERATIONS OF TRHS'S ARTICLES OF INCORPORATION OR BYLAWS; 3) APPROVE MERGERS, CONSOLIDATIONS, ACQUISITIONS, JOINT VENTURES, AFFILIATIONS OR ANY OTHER REORGANIZATION OF TRHS; 4) APPROVE THE SALE, TRANSFER, LONG-TERM LEASE, LONG-TERM ENCUMBRANCE, MORTGAGE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL ASSETS OF TRHS AND OF ANY REAL PROPERTY OWNED BY TRHS; 5) APPROVE ANY PLAN OF DISSOLUTION; 6) APPROVE AND DETERMINE THE DISTRIBUTION OF ASSETS OF THE CORPORATION UPON DISSOLUTION OF TRHS SUBJECT TO ARTICLE V OF THE TRHS'S ARTICLES OF INCORPORATION; 7) ADD OR REMOVE MEMBERS OF TRHS; 8) APPROVE ANY MATERIAL INCURRENCE OF DEBT THAT REQUIRES AN ADDENDUM TO THE MASTER TRUST INDENTURE, EXCLUDING CAPITAL LEASES OF LESS THAN 1,000,001; 9) APPOINT OR REMOVE THE CHAIR OF THE BOARD OF DIRECTORS OF TRHS; 10) APPROVE THE ANNUAL BUDGET OF TRHS; 11) SELECT THE AUDITOR FIRM FOR TRHS AND APPROVE THE ANNUAL AUDIT PERFORMED BY SUCH FIRM; 12) APPROVE CAPITAL EXPENDITURES BY TRHS OF 1,000,001 OR GREATER; 13) APPROVE SCOPE OF SERVICES PROVIDED BY TRHS; 14) APPOINT OR REMOVE THE PRESIDENT/CEO OF TRHS; AND 15) APPROVE ANY AMENDMENT TO THE LEASE BETWEEN THE HOSPITAL AUTHORITY OF TIFT COUNTY AND TRHS. |
| FORM 990, PAGE 6, PART VI, LINE 11B | FORM 990 IS PREPARED BY AN INDEPENDENT CERTIFIED PUBLIC ACCOUNTANT FROM INFORMATION PROVIDED BY MANAGEMENT AND FROM AUDITED FINANCIAL STATEMENTS. AFTER THE RETURN IS PREPARED AND PRIOR TO FILING WITH THE IRS, THE RETURN IS REVIEWED IN DETAIL BY SENIOR FINANCIAL MANAGEMENT. A COPY OF THE RETURN IS THEN MADE AVAILABLE TO ALL BOARD MEMBERS PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | TRHS ANNUALLY DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE TO EACH MEMBER OF THE BOARD OF DIRECTORS. BOARD MEMBERS MUST DISCLOSE ANY POTENTIAL CONFLICTS. ANY BOARD MEMBER WITH A POTENTIAL CONFLICT MUST RECUSE THEMSELVES FROM THE MEETING AT WHICH THE POTENTIAL CONFLICT IS DISCUSSED. ONLY NON-CONFLICTED MEMBERS MAY DECIDE TO PURSUE A TRANSACTION INVOLVING A CONFLICT IF A MAJORITY OF THE REMAINING MEMBERS DETERMINE THE TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST. VIOLATION OF THE COI POLICY IS SUBJECT TO CORRECTIVE ACTION. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE TIFT REGIONAL HEALTH SYSTEM, INC.("TRHS") BOARD OF DIRECTORS HAS APPOINTED A COMMITTEE OF INDEPENDENT, CONFLICT-FREE BOARD MEMBERS TO DEVOTE THEIR TIME AND ATTENTION TO THE OVERSIGHT OF TRHS'S EXECUTIVE COMPENSATION PROGRAMS. THE COMMITTEE ANNUALLY RETAINS INDEPENDENT ADVISORS (INCLUDING HEALTH CARE COMPENSATION CONSULTANTS) TO PROVIDE THIRD-PARTY INFORMATION AND ADVICE, TO ENSURE EXECUTIVE COMPENSATION IS REASONABLE WHEN COMPARED TO THE PRACTICES OF OTHER SIMILARLY SITUATED ORGANIZATIONS, AND THAT THE PROGRAM HAS SIGNIFICANT AND APPROPRIATE COMPENSATION THAT IS SUBJECT TO MEETING ORGANIZATIONAL AND INDIVIDUAL GOALS (TO ENSURE THE ALIGNMENT OF PAY AND PERFORMANCE). COMPENSATION IS APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD, WHO ARE INDEPENDENT WITH NO FINANCIAL INTEREST IN THE COMPENSATION THEY REVIEW AND APPROVE. INCENTIVE BASED COMPENSATION IS CALCULATED BASED ON ACHIEVEMENTS AGAINST GOALS AND METRICS THAT WERE PRE-APPROVED BY THE BOARD. THE GOALS AND METRICS SPAN TRHS'S FIVE PILLARS OF SERVICE: QUALITY, FINANCE, PEOPLE, GROWTH AND COMMUNITY. THE PERFORMANCE PAY PLAN IS INTENDED TO REWARD EXECUTIVES FOR EXEMPLARY PERFORMANCE AND TO BE PART OF A COMPETITIVE TOTAL COMPENSATION PACKAGE. TOTAL COMPENSATION (INCLUDING THE PERFORMANCE PAY PLAN) IS DETERMINED TO BE REASONABLE AND STRICTLY COMPLIANT WITH ALL RULES AND REGULATIONS THAT GOVERN EXECUTIVE PAY AT A TAX-EXEMPT ORGANIZATION LIKE TRHS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SEE THE RESPONSE TO QUESTION 15A ABOVE. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS ARE FILED WITH AND AVAILABLE ON THE GEORGIA SECRETARY OF STATE WEBSITE OR THROUGH THAT OFFICE. GOVERNING DOCUMENTS CAN ALSO BE OBTAINED BY CONTACTING TRHS. TRHS IS UNDER OBLIGATION TO DISCLOSE TO BOND HOLDERS PERTINENT FINANCIAL INFORMATION. A PUBLIC INSPECTION COPY OF FORM 990 IS AVAILABLE UPON REQUEST AND UPON THE TRHS WEBSITE. |
| FORM 990, PART XI, LINE 9 | FUND BAL. TRANSFER TO SOUTHWELL AMBUL. -8,633,229 INTERCOMPANY ADJUSTMENT TIFT ENTERPRISES 50,000 TOTAL -8,583,229 OTHER CHANGES IN FUND BALANCE RESULT FROM TRANSFERS WITH AFFILIATED ENTITIES |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARE ALLIANCE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2650 | AddressLine1Txt |
| City | TIFTON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31793 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 474357229 | EIN |
| Primary Activities | ACO | PrimaryActivitiesTxt |
| Legal Domicile State | GA | LegalDomicileStateCd |
| End Of Year Assets | $10,000 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TIFT REG | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 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 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SOUTHWELL INC | ||||||||||
| PO BOX 2650 | TIFTON | GA | 31793 | 581772605 | PARENT | GA | 501C3 | 12C | NA | false |
| SOUTHWELL AMBULATORY INC | ||||||||||
| PO BOX 2650 | TIFTON | GA | 31793 | 843430446 | MED. SVCS. | GA | 501C3 | 3 | SOUTHWELL | false |
| TIFT REGIONAL MEDICAL CENTER FND | ||||||||||
| PO BOX 747 | TIFTON | GA | 31793 | 581705285 | FUNDRAISIN | GA | 501C3 | 12D | NA | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TIFT ENTERPRISES INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 747 | AddressLine1Txt |
| City | TIFTON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31793 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581986064 | EIN |
| Primary Activities | HOLDING CO | PrimaryActivitiesTxt |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | 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 | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | 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 | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |