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JOHN D ARCHBOLD MEMORIAL HOSPITAL INC: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
JOHN D ARCHBOLD MEMORIAL HOSPITAL INC (EIN 58-0566121)
Tax period
2023-10-01 to 2024-09-30
Filed
2025-08-07
IRS object ID
202522199349301402
Schema version
2023v6.0
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)
Return2025-08-07T10:20:07-04:00ReturnTs
Tax Period End2024-09-30TaxPeriodEndDt

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 Begin2023-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN580566121EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOHN D ARCHBOLD MEMORIALBusinessNameLine1Txt
Business Name Line2HOSPITAL INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlJOHNBusinessNameControlTxt
Phone2292282853PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O BOX 1018AddressLine1Txt
CityTHOMASVILLECityNm
State AbbreviationGAStateAbbreviationCd
ZIP317991018ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDARCY M CRAVENPersonNm
Person TitlePRESIDENT/CEOPersonTitleTxt
Phone2292282737PhoneNum
Signature2025-07-24SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrfalseIRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWILLIAM EDWARD PHILLIPSPreparerPersonNm
PTINP00451499PTIN
Phone2298837878PhoneNum
Preparation2025-07-24PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDARCY M CRAVENPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O BOX 1018AddressLine1Txt
CityTHOMASVILLECityNm
State AbbreviationGAStateAbbreviationCd
ZIP317991018ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$514,153,247GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ARCHBOLD.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1923FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionHEALTHCARE SERVICESActivityOrMissionDesc
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Gross UBI$209,078TotalGrossUBIAmt
PY Contributions Grants$6,577,639PYContributionsGrantsAmt
CY Contributions Grants$6,937,846CYContributionsGrantsAmt
PY Program Service Revenue$415,821,829PYProgramServiceRevenueAmt
CY Program Service Revenue$480,597,443CYProgramServiceRevenueAmt
PY Investment Income$37,257,967PYInvestmentIncomeAmt
CY Investment Income$19,787,653CYInvestmentIncomeAmt
PY Other Revenue$3,247,615PYOtherRevenueAmt
CY Other Revenue$4,213,727CYOtherRevenueAmt
PY Total Revenue$462,905,050PYTotalRevenueAmt
CY Total Revenue$511,536,669CYTotalRevenueAmt
PY Grants And Similar Paid$375,843PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$255,767CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$167,565,305PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$188,700,578CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$232,457,095PYOtherExpensesAmt
CY Other Expenses$267,276,699CYOtherExpensesAmt
PY Total Expenses$400,398,243PYTotalExpensesAmt
CY Total Expenses$456,233,044CYTotalExpensesAmt
PY Revenues Less Expenses$62,506,807PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$55,303,625CYRevenuesLessExpensesAmt
Total Assets BOY$1,005,536,729TotalAssetsBOYAmt
Total Assets EOY$1,122,703,892TotalAssetsEOYAmt
Total Liabilities BOY$173,069,940TotalLiabilitiesBOYAmt
Total Liabilities EOY$169,869,495TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$832,466,789NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$952,834,397NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionHEALTHCARE SERVICESMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$338,241,682ExpenseAmt
Grant$255,767GrantAmt
Revenue$391,093,631RevenueAmt
DescARCHBOLD MEMORIAL IN THOMASVILLE GEORGIA OPERATES WITH 264 LICENSED BEDS; OF WHICH 226 ARE MED/SURG, 18 BEDS ARE DESIGNATED TO A PSYCH UNIT, 20 BEDS ARE REHAB. IN ADDITION, IT OPERATES A 64 BED SKILLED NURSING FACILITY, ARCHBOLD LIVING THOMASVILLE. ARCHBOLD MEMORIAL IS A RURAL REFERRAL CENTER COVERING THOMAS COUNTY AND SURROUNDING COUNTIES IN SOUTHERN GEORGIA AND NORTHERN FLORIDA. 65% OF PATIENTS WERE COVERED BY MEDICARE AND MEDICAID, AND 3.0% OF PATIENT REVENUE WAS PROVIDED AS INDIGENT CARE. IN FY 2024, ARCHBOLD MEMORIAL PROVIDED AN ESTIMATED 32.8 MILLION IN INDIGENT CARE CHARGES. ARCHBOLD MEMORIAL TREATS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. ARCHBOLD MEMORIAL PROVIDED APPROXIMATELY 32.8 MILLION IN ADDITIONAL UNCOMPENSATED CARE. THROUGHOUT THE YEAR, ARCHBOLD MEMORIAL PRODUCES OR SPONSORS MANY SPECIAL PROGRAMS FOR THE COMMUNITY TO EDUCATE THEM ON IMPORTANT HEALTH NEEDS. JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. ALSO OPERATES HOSPITALS IN GRADY, BROOKS, AND MITCHELL COUNTIES OF GEORGIA FILING UNDER EIN 58- 0566121.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$31,266,584ExpenseAmt
Revenue$38,945,992RevenueAmt
DescARCHBOLD MITCHELL OPERATES IN CAMILLA, GEORGIA AS A CRITICAL ACCESS HOSPITAL WITH 25 ACUTE CARE BEDS. ARCHBOLD LIVING CAMILLA, AND ARCHBOLD LIVING PELHAM (LOCATED IN CAMILLA, GEORGIA AND PELHAM, GEORGIA, RESPECTIVELY) OPERATE AS LONG-TERM CARE FACILITIES WITH COMBINED 156 NURSING HOME BEDS. THESE FACILITIES SERVE MITCHELL COUNTY, AND 57% OF THE PATIENTS WERE MEDICARE/MEDICAID. IN FY 2024, APPROXIMATELY 4.9 MILLION OF INDIGENT CARE WAS PROVIDED TO THE COMMUNITY. IN ADDITION, ARCHBOLD'S MITCHELL COUNTY FACILITIES PROVIDED AN ESTIMATED 5.6 MILLION IN ADDITIONAL UNCOMPENSATED CARE. THE HOSPITAL AUTHORITY OF MITCHELL COUNTY (EIN 58-6001307) IS FILED UNDER EIN 58-0566121 FOR FORM 990 PURPOSES.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$10,948,639ExpenseAmt
Revenue$38,245,627RevenueAmt
DescARCHBOLD GRADY IN CAIRO, GEORGIA OPERATES A 60 LICENSED BED ACUTE CARE FACILITY. TEN BEDS CAN BE USED AS SWING BEDS. IN ADDITION, IT OPERATES A 75 BED SKILLED NURSING FACILITY, ARCHBOLD LIVING CAIRO. THESE FACILITIES SERVE GRADY COUNTY, AND 55% OF THE PATIENTS WERE MEDICARE/MEDICAID. IN FY 2024, ARCHBOLD GRADY PROVIDED APPROXIMATELY 6.2 MILLION IN INDIGENT CARE. ARCHBOLD GRADY PROVIDED AN ESTIMATED 5.9 MILLION IN ADDITIONAL UNCOMPENSATED CARE. EIN 58-1646537 IS FILED UNDER EIN 58-0566121 FOR FORM 990 PURPOSES.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$32,243,971ExpenseAmt
Revenue$14,965,486RevenueAmt
DescARCHBOLD BROOKS OPERATES IN QUITMAN, GEORGIA AS A CRITICAL ACCESS HOSPITAL WITH 25 ACUTE CARE BEDS. IT SERVES BROOKS COUNTY AND 56% OF ITS PATIENTS WERE MEDICARE/MEDICAID. IN FY 2024, AN ESTIMATED 3.1 MILLION OF INDIGENT CARE WAS PROVIDED TO THE COMMUNITY. IN ADDITION, ARCHBOLD BROOKS PROVIDED APPROXIMATELY 1.4 MILLION IN ADDITIONAL UNCOMPENSATED CARE. EIN 58- 6002830 IS FILED UNDER EIN 58-0566121 FOR FORM 990 PURPOSES.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$32,243,971TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$14,965,486TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$412,700,876TotalProgramServiceExpensesAmt
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 EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
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 ActivitiesfalseForeignActivitiesInd
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 MemYes (true)BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (true)BusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document185IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
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 Members19GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
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
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonGREG HEMBREEPersonNm
Phone2292282853PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1018AddressLine1Txt
CityTHOMASVILLECityNm
State AbbreviationGAStateAbbreviationCd
ZIP317991018ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndKey EmployeeKeyEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
DARCY M CRAVEN
PRESIDENT/CE1.0051.00Yes (X)Yes (X)$0$1,074,520$173,293
JOSH D SIMMONS MD
TRUSTEE1.00Yes (X)$0$691,683$23,602
GREG HEMBREE
ASST SEC/SR1.0051.00Yes (X)$0$596,644$82,864
DINESH B PATEL MD
PHYSICIAN40.00$546,356$0$27,201Yes (X)
JIM CARTER
COO40.00Yes (X)$454,659$0$74,761
AMY GRIFFIN
VP PATIENT C40.00$432,868$0$68,286Yes (X)
STEPHEN RUBENDALL MD
PHYSICIAN40.00$456,429$0$23,946Yes (X)
KRISTOPHER PALMER DO
VP MEDICAL A40.00$419,623$0$54,360Yes (X)
JASON NESMITH MD
TRUSTEE1.00Yes (X)$450,876$0$19,570
EUGENE SUN MD
PHYSICIAN40.00$344,940$0$25,195Yes (X)
MARK L CATTERSON
PHYSICIAN40.00$318,153$0$23,715Yes (X)
CHRIS NEWMAN
VP ANCILLARY40.00$282,235$0$31,739Yes (X)
SHANE HERRIN MD
PHYSICIAN40.00$284,578$0$23,528Yes (X)
JAMIE WOMACK
VP CRITICAL40.00$262,764$0$38,154Yes (X)
JAMES BUE
VP FACILITY40.00$247,191$0$13,941Yes (X)
COY IRVIN MD
VP MEDICAL A$246,667$0$0Yes (X)
JULIE DUMAS
VP QUALITY40.00$189,097$0$32,860Yes (X)
DARYL CRENSHAW MD
VICE CHAIR1.00Yes (X)Yes (X)$0$1,600$0
LISA K BILLUPS
TRUSTEE(TERMYes (X)$0$0$0
JOE BROWN
TRUSTEE1.00Yes (X)$0$0$0
SAMUEL J CARNLINE
TRUSTEE1.00Yes (X)$0$0$0
ASHLEY CASON
TREASURER1.00Yes (X)Yes (X)$0$0$0
JESSE R WARREN DO
TRUSTEE1.00Yes (X)$0$0$0
MARVIN E DAWSON
TRUSTEE1.00Yes (X)$0$0$0
CRAIG R WENTWORTH EDD
SECRETARY1.00Yes (X)Yes (X)$0$0$0
DEBORAH GASKINS
TRUSTEE1.00Yes (X)$0$0$0
SINA GRIFFITH
CHAIR1.00Yes (X)Yes (X)$0$0$0
W GREGORY HAMIL
TRUSTEE1.00Yes (X)$0$0$0
HENRY A STONE III
TRUSTEE1.00Yes (X)$0$0$0
CHRISTOPHER L DANIELS MD
TRUSTEE1.00Yes (X)$0$0$0
KAREN L BRAMBLETT MD
TRUSTEE1.00Yes (X)$0$0$0
JAMI PORTER
TRUSTEE1.00Yes (X)$0$0$0
JACQUELYN V SANTORO
TRUSTEE1.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,936,436TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,364,447TotReportableCompRltdOrgAmt
Total Other Compensation$737,015TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K142IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
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/ZIPCdServicesServicesDescCompensationCompensationAmt
QUALIVIS LLC
5930 CONERSTONE CT W300SAN DIEGOCA92121NURSING$10,593,770
SOUTH GEORGIA ANESTHESIA ASSOCIATES
PO BOX 1506THOMASVILLEGA31799ANESTHESIA SERV$8,049,033
RED HILLS RADIOLOGY
714 N DAWSON STREETTHOMASVILLEGA317924451RADIOLOGY SVC$7,744,813
SOUTHLAND HOSPITALIST GROUP
PO BOX 1276THOMASVILLEGA317991276HOSPITALIST SVC$4,877,820
THOMASVILLE PHYSICAL THERAPY
P O BOX 2476THOMASVILLEGA317992476REHAB SVCS$2,810,576
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K55CntrctRcvdGreaterThan100KCnt
Related Organizations$4,218,450RelatedOrganizationsAmt
Government Grants$324,929GovernmentGrantsAmt
All Other Contributions$2,394,467AllOtherContributionsAmt
Total Contributions$6,937,846TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtBusinessBusinessCdUnrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICE REVENUE$471,837,582$471,837,582
DSH MEDICAID$8,550,783$8,550,783623000
LAB SERVICES$209,078621500$209,078
FieldValueIRS element (for citing)
Total Program Service Revenue$480,597,443TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$19,876,702TotalRevenueColumnAmt
Exclusion$19,876,702ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,576,065RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$430,410RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$1,145,655RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,145,655TotalRevenueColumnAmt
Exclusion$1,145,655ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$1,534,817OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$1,623,866OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$89,049OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$89,049TotalRevenueColumnAmt
Exclusion-$89,049ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$679,175GrossSalesOfInventoryAmt
Cost Of Goods Sold$562,302CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$116,873TotalRevenueColumnAmt
Exclusion$116,873ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CAFETERIA SALES621990$1,401,022$1,401,022
GIFT SHOP621990$534,779$534,779
RESIDENCY623000$479,154$479,154

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$536,244TotalRevenueColumnAmt
Related Or Exempt Func Income$447,416RelatedOrExemptFuncIncomeAmt
Exclusion$88,828ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,951,199OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$511,536,669TotalRevenueColumnAmt
Related Or Exempt Func Income$483,250,736RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$209,078UnrelatedBusinessRevenueAmt
Exclusion$21,139,009ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$255,767TotalAmt
Program Services$255,767ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,413,540TotalAmt
Management And General$2,413,540ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$149,573,260TotalAmt
Program Services$128,909,666ProgramServicesAmt
Management And General$20,663,594ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,458,260TotalAmt
Program Services$2,084,850ProgramServicesAmt
Management And General$373,410ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$20,591,335TotalAmt
Program Services$17,463,511ProgramServicesAmt
Management And General$3,127,824ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$13,664,183TotalAmt
Program Services$11,588,595ProgramServicesAmt
Management And General$2,075,588ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$572,375TotalAmt
Management And General$572,375ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$19,738TotalAmt
Management And General$19,738ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$113,235TotalAmt
Management And General$113,235ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$86,883,868TotalAmt
Program Services$82,678,848ProgramServicesAmt
Management And General$4,205,020ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$262,427TotalAmt
Program Services$46,254ProgramServicesAmt
Management And General$216,173ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$15,117,651TotalAmt
Program Services$13,190,699ProgramServicesAmt
Management And General$1,926,952ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,410,026TotalAmt
Program Services$1,167,123ProgramServicesAmt
Management And General$242,903ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$7,654,846TotalAmt
Program Services$6,640,579ProgramServicesAmt
Management And General$1,014,267ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$889,164TotalAmt
Program Services$732,770ProgramServicesAmt
Management And General$156,394ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$70,282TotalAmt
Program Services$70,282ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$742,514TotalAmt
Program Services$54,923ProgramServicesAmt
Management And General$687,591ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$27,557,223TotalAmt
Program Services$23,905,891ProgramServicesAmt
Management And General$3,651,332ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$3,632,757TotalAmt
Program Services$3,632,757ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES JDAMH$102,953,280$102,953,377-$97
PROVIDER FEES$5,469,749$5,469,749
R&M JDAM$4,234,841$3,916,429$318,412
MEDICAL SUPPLIES GRADY$2,539,238$2,539,238

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$7,153,485TotalAmt
Program Services$5,399,568ProgramServicesAmt
Management And General$1,753,917ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$456,233,044TotalAmt
Program Services$412,700,876ProgramServicesAmt
Management And General$43,532,168ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$38,585,952BOYAmt
EOY$49,799,650EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$58,762,350BOYAmt
EOY$66,572,840EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$4,829,286BOYAmt
EOY$6,195,402EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$7,114,758BOYAmt
EOY$9,674,189EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$681,638,599LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$445,372,082LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$220,964,378BOYAmt
EOY$236,266,517EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$399,602,566BOYAmt
EOY$455,580,440EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$2,106,572BOYAmt
EOY$2,174,653EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$273,570,867BOYAmt
EOY$296,440,201EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,005,536,729BOYAmt
EOY$1,122,703,892EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$43,050,698BOYAmt
EOY$48,341,355EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$1,426,018BOYAmt
EOY$1,146,244EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$84,185,000BOYAmt
EOY$77,870,000EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$43,100,000BOYAmt
EOY$39,600,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,308,224BOYAmt
EOY$2,911,896EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$173,069,940BOYAmt
EOY$169,869,495EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$829,809,288BOYAmt
EOY$949,551,089EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,657,501BOYAmt
EOY$3,283,308EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$832,466,789BOYAmt
EOY$952,834,397EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,005,536,729BOYAmt
EOY$1,122,703,892EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$55,303,625ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$64,889,621NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$174,362OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewYes (true)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
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

Total Direct Lobbying TotalDirectLobbyingGrp

FieldValueIRS element (for citing)
Filing Organizations Total$12,312FilingOrganizationsTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$12,312FilingOrganizationsTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$406,385,422FilingOrganizationsTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$406,397,734FilingOrganizationsTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Filing Organizations Total$1,000,000FilingOrganizationsTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Filing Organizations Total$250,000FilingOrganizationsTotalAmt

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Current Year Minus3$1,000,000CurrentYearMinus3Amt
Current Year Minus2$1,000,000CurrentYearMinus2Amt
Current Year Minus1$1,000,000CurrentYearMinus1Amt
Current Year$1,000,000CurrentYearAmt
Total$4,000,000TotalAmt
FieldValueIRS element (for citing)
Lobbying Ceiling$6,000,000LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Current Year Minus3$13,029CurrentYearMinus3Amt
Current Year Minus2$10,821CurrentYearMinus2Amt
Current Year Minus1$11,602CurrentYearMinus1Amt
Current Year$12,312CurrentYearAmt
Total$47,764TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Current Year Minus3$250,000CurrentYearMinus3Amt
Current Year Minus2$250,000CurrentYearMinus2Amt
Current Year Minus1$250,000CurrentYearMinus1Amt
Current Year$250,000CurrentYearAmt
Total$1,000,000TotalAmt
FieldValueIRS element (for citing)
Grassroots Ceiling$1,500,000GrassrootsCeilingAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,657,501BeginningYearBalanceAmt
Investment Earnings Or Losses$625,807InvestmentEarningsOrLossesAmt
End Year Balance$3,283,308EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,322,848BeginningYearBalanceAmt
Investment Earnings Or Losses$334,653InvestmentEarningsOrLossesAmt
End Year Balance$2,657,501EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,671,134BeginningYearBalanceAmt
Investment Earnings Or Losses-$348,286InvestmentEarningsOrLossesAmt
End Year Balance$2,322,848EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,997,550BeginningYearBalanceAmt
Investment Earnings Or Losses$192,974InvestmentEarningsOrLossesAmt
End Year Balance$2,190,524EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,179,636OtherCostOrOtherBasisAmt
Book Value$10,179,636BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$173,010,339OtherCostOrOtherBasisAmt
Depreciation$90,868,076DepreciationAmt
Book Value$82,142,263BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$57,428,628OtherCostOrOtherBasisAmt
Depreciation$22,852,262DepreciationAmt
Book Value$34,576,366BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$432,379,543OtherCostOrOtherBasisAmt
Depreciation$331,651,744DepreciationAmt
Book Value$100,727,799BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,640,453OtherCostOrOtherBasisAmt
Book Value$8,640,453BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$236,266,517TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (8 entries)

DescDescBook ValueBookValueAmt
DUE FROM RELATED PARTIES$264,921,345
OTHER RECEIVABLES$18,108,042
DUE FROM SELF INSURANCE TRUST$6,086,428
RIGHT-OF-USE ASSET$2,873,709
PHYSICIAN RECEIVABLES$2,080,671
SCHOLARSHIP/TUITION RECEIVABLE$1,635,694
INTEREST RECEIVABLE$481,422
THIRD PARTY SETTLEMENTS$252,890
FieldValueIRS element (for citing)
Total Book Value Other Assets$296,440,201TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
RIGHT-OF- USE OPERATING$2,036,648
RIGHT-OF-USE-FINANCING$875,248
FieldValueIRS element (for citing)
Total Liability$2,911,896TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 2, PART V, LINE 4ENDOWMENT FUNDS RESTRICTED BY DONORS ARE HELD IN A PERMANENT HEALTHCARE ENDOWMENT FUND WHICH WAS ESTABLISHED TO SUPPORT HEALTH CARE SERVICES.
SCHEDULE D, PAGE 3, PART XTHE MEDICAL CENTER, WITH THE EXCEPTION OF ARCHBOLD MEDICAL ENTERPRISES, INC., IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX- EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ARCHBOLD MEDICAL ENTERPRISES, INC. WAS DISSOLVED EFFECTIVE JANUARY 1, 2023. THE MEDICAL CENTER APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE CONSOLIDATED FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE MEDICAL CENTER ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF SEPTEMBER 30, 2024 AND 2023 OR FOR THE YEARS THEN ENDED. THE MEDICAL CENTER'S TAX RETURNS ARE SUBJECT TO RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. NOTE, "THE MEDICAL CENTER" REFERS TO ARCHBOLD MEDICAL CENTER, INC., THE PARENT ORGANIZATION OF THE MULTI-ENTITY HEALTHCARE SYSTEM.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
Most Hospitals PolicyYes (X)MostHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other3.250000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
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$13,853,495TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$13,853,495NetCommunityBenefitExpnsAmt
Total Expense0.03030TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$35,567,629TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$40,976,348DirectOffsettingRevenueAmt

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$723,322TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$625,599DirectOffsettingRevenueAmt
Net Community Benefit Expns$97,723NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$50,144,446TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$41,601,947DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,951,218NetCommunityBenefitExpnsAmt
Total Expense0.03050TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$305,621TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$305,621NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,844,164TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,844,164NetCommunityBenefitExpnsAmt
Total Expense0.00400TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$41,497,137TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$41,497,137NetCommunityBenefitExpnsAmt
Total Expense0.09080TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$43,646,922TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$43,646,922NetCommunityBenefitExpnsAmt
Total Expense0.09550TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$93,791,368TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$41,601,947DirectOffsettingRevenueAmt
Net Community Benefit Expns$57,598,140NetCommunityBenefitExpnsAmt
Total Expense0.12600TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$45,667,105BadDebtExpenseAmt
Reimbursed By Medicare$58,846,935ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$60,096,739CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,249,804MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities4HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (4 entries)

FacilityFacilityNumBusiness Name Line2BusinessName/BusinessNameLine2TxtAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdWebsite AddressWebsiteAddressTxtState LicenseStateLicenseNumLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndEmergency Room24 HrsEmergencyRoom24HrsIndOtherOtherDescFacility Reporting GroupFacilityReportingGroupCdCritical Access HospitalCriticalAccessHospitalInd
JOHN D ARCHBOLD MEM HOSP
1DBA ARCHBOLD MEMORIALP O BOX 1018THOMASVILLEGA317991018WWW.ARCHBOLD.ORG136-91Yes (X)Yes (X)Yes (X)PSYCH, REHAB, NURSING HOMEA
GRADY GENERAL HOSPITAL
2DBA ARCHBOLD GRADY1155 FIFTH STREET SECAIROGA31728WWW.ARCHBOLD.ORG065-413Yes (X)Yes (X)Yes (X)SWING BED SNF, NURSING HOMEA
BROOKS COUNTY HOSPITAL
3DBA ARCHBOLD BROOKS903 N COURT STQUITMANGA31643WWW.ARCHBOLD.ORG014-028Yes (X)Yes (X)RHC, SWING BED SNFAYes (X)
MITCHELL COUNTY HOSPITAL
4DBA ARCHBOLD MITCHELL90 STEPHENS STCAMILLAGA31730WWW.ARCHBOLD.ORG101-120Yes (X)Yes (X)NURSING HOME, RHC, SWING BEDAYes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ABusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1234FacilityNum
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 Conducted22CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.ARCHBOLD.ORGOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLWWW.ARCHBOLD.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 Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care325.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.ARCHBOLD.ORGFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.ARCHBOLD.ORGFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.ARCHBOLD.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 TranslatedYes (X)FAPTranslatedInd
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
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
GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 3ETHE COMMUNITY HEALTH NEEDS ASSESSMENT IS CONDUCTED EVERY THREE YEARS. THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN 2022- 2023 FOR EACH COUNTY IN THE SERVICE AREA. THE TOP 3 SIGNIFICANT HEALTH NEEDS FOR BROOKS, GRADY, MITCHELL AND THOMAS COUNTIES WERE - DIABETES, OBESITY AND HIGH BLOOD PRESSURE. OTHER SIGNIFICANT HEALTH NEEDS IDENTIFIED BY THE COMMUNITY INCLUDE HEART DISEASE, MENTAL HEALTH, CANCER, DRUG ADDICTION, BACK OR JOINT PAIN, COVID-19, ALCOHOL ABUSE, AND ACCESS TO VACCINES. A COMPLETE DISCUSSION OF THE HEALTH NEEDS FOR EACH COUNTY MAY BE FOUND AT - HTTPS://WWW.ARCHBOLD.ORG/ABOUT/COMMUNITY-HEALTH-NEEDSASSESSMENTS/. THE NEXT COMMUNITY HEALTH NEEDS ASSESSMENT WILL BE COMPLETED IN 2025.
GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 5INPUT FROM COMMUNITY MEMBERS REPRESENTING THE BROADER INTERESTS OF THE COUNTY WAS GATHERED THROUGH A COMBINATION OF ONLINE AND WRITTEN SURVEYS. THESE EFFORTS YIELDED INFORMATION THAT WILL BE USED IN ADDRESSING BARRIERS, ALLOCATING RESOURCES AND ASSETS AND DETERMINING OPPORTUNITIES TO SUPPORT. INPUT WAS CONSIDERED IN DETERMINING GAPS IN SERVICES AND TO IDENTIFY WHETHER DEVELOPING NEW RELATIONSHIPS AND PARTNERSHIPS WAS NECESSARY TO MEET THE NEEDS OF THE COMMUNITY. THIS YEAR WE ENHANCED OUR APPROACH TO OBTAINING THIS INFORMATION FROM OUR COMMUNITIES. AN ONLINE SURVEY WAS ACCESSIBLE THROUGH OUR WEBSITE (ARCHBOLD.ORG), ARCHBOLD SOCIAL MEDIA CHANNELS INCLUDING FACEBOOK, INSTAGRAM AND TWITTER. A PRESS RELEASE WAS SENT TO THE THOMASVILLE TIMES-ENTERPRISE ASKING FOR THE COMMUNITY'S PARTICIPATION. A WEBSITE LINK AND/OR PAPER COPIES OF THE SURVEY WERE SENT TO THE FOLLOWING ENTITIES: O DOUGLASS HIGH SCHOOL ALUMNI ASSOCIATION- SURVEY LINK O MAGNOLIA HIGH SCHOOL ALUMNI-SURVEY LINK O SOUTHWEST GEORGIA TECHNICAL COLLEGE-SURVEY LINK O THOMAS COUNTY FAMILY CONNECTION-SURVEY LINK O THOMAS/GRADY UGA EXTENSION-SURVEY LINK O THOMAS COUNTY HEALTH DEPARTMENT-PAPER COPIES AND SURVEY LINK O PRIMARY CARE OF SOUTHWEST GEORGIA-PAPER COPIES AND SURVEY LINK O ARCHBOLD EMPLOYEES-SURVEY LINK O THOMAS COUNTY EMPLOYEES-SURVEY LINK O CITY OF THOMASVILLE EMPLOYEES-SURVEY LINK O THOMASVILLE-THOMAS COUNTY CHAMBER OF COMMERCE-SURVEY LINK O COMMUNITY OUTREACH TRAINING CENTER-SURVEY LINK O JACK HADLEY BLACK HISTORY MUSEUM-SURVEY LINK
GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 6ATHE NEEDS ASSESSMENT WAS CONDUCTED FOR ARCHBOLD MEMORIAL, ALONG WITH ARCHBOLD GRADY, ARCHBOLD BROOKS, AND ARCHBOLD MITCHELL.
GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 7DDISTRIBUTED COPIES TO THE COMMUNITY; AVAILABLE ONLINE
GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 11QUALITATIVELY, THE GREATEST MEDICAL NEEDS ACCORDING TO COMMUNITY PERCEPTION INCLUDED: 1. DIABETES 2. OBESITY 3. HIGH BLOOD PRESSURE 4. HEART DISEASE 5. MENTAL HEALTH ISSUES 6. CANCER 7. DRUG ADDICTION 8. BACK/JOINT PAIN 9. COVID-19 10. ALCOHOL ABUSE 11. LUNG DISEASE 12. ACCESS TO VACCINES NEEDS NOT ADDRESSED NOT ALL HEALTH NEEDS ARE EASILY ADDRESSED BY ARCHBOLD. FURTHER, KEEPING TOO BROAD OF A FOCUS WILL DILUTE THE IMPACT WE CAN HAVE ON EACH HEALTH NEED. THESE ARE SOME OF THE PRIMARY REASONS WE AREN'T ADDRESSING SOME HEALTH NEEDS IN OUR IMPLEMENTATION PLAN. OUR BIGGEST OPPORTUNITY IS TO HELP WITH IMPROVING DISEASE STATES BY ADDRESSING OBESITY AND REMAINING AVAILABLE FOR ASSISTANCE WITH OTHER HEALTH NEEDS AS REQUESTED AND AS TIME AND FINANCES PERMIT.
FieldValueIRS element (for citing)
Facility9FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxtAddress Line2USAddress/AddressLine2Txt
ARCHBOLD LIVING
10629 US HIGHWAY 19STHOMASVILLEGA31792SKILLED NURSING HOME
JDA PSYCHIATRIC UNIT
DBA ARCHBOLD NORTHSIDETHOMASVILLEGA31792PSYCHIATRIC UNITP O BOX 1018
JDA REHABILITATION UNIT
DBA ARCHBOLD MEMORIAL REHABTHOMASVILLEGA31792REHABILITATION UNITP O BOX 1018
ARCHBOLD LIVING CAMILLA
90 STEPHENS STREETCAMILLAGA31728SKILLED NURSING HOME
CAMILLA PEDIATRICS CENTER
DBA ARCHBOLD PEDIATRICS CAMILLACAMILLAGA31728RURAL HEALTH CLINICP O BOX 360
MEDICAL GROUP OF MITCHELL COUNTY
DBA ARCHBOLD PRIMARY CARE CAMILLACAMILLAGA31728RURAL HEALTH CLINICP O BOX 360
ARCHBOLD PELHAM PRIMARY CARE CLINIC
DBA ARCHBOLD PRIMARY CARE PELHAMCAMILLAGA31728RURAL HEALTH CLINICP O BOX 360
ARCHBOLD LIVING PELHAM
608 DOGWOOD DRIVE NEPELHAMGA31797SKILLED NURSING HOME
ARCHBOLD LIVING CAIRO
1155 FIFTH STREET SECAIROGA31728SKILLED NURSING HOME

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7THE ORGANIZATION USES THE COST TO CHARGE RATIO USING THE IRS' RECOMMENDED FORMAT IN WORKSHEET 2. OTHER COSTS IN PART I LINES 7E THROUGH 7I WERE OBTAINED FROM THE ORGANIZATION'S ACCOUNTING RECORDS.
SCHEDULE H, PART III, LINE 2AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AND INCLUDES IMPLICIT PRICE CONCESSIONS. SEE THE DISCUSSION OF IMPLICIT PRICE CONCESSIONS IN FOOTNOTE 2 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, LINE 4SEE THE DISCUSSION OF PRICE CONCESSIONS AND NET PATIENT SERVICE REVENUE IN FOOTNOTE 2 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, LINE 8MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS.
SCHEDULE H, PART III, LINE 9BPATIENTS THAT ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE ARE APPROVED FOR A PERIOD OF 6 MONTHS. THE PATIENTS ARE REQUIRED TO CONTACT THE FINANCIAL ASSISTANCE OFFICE DURING THIS POINT IF THEY INCUR ADDITIONAL CHARGES THAT QUALIFY FOR FINANCIAL ASSISTANCE DURING THIS TIME PERIOD. THE SAME PROCESS IS IN EFFECT FOR THE PATIENTS WHO QUALIFY FOR THE SLIDING FEE DISCOUNT. THIS DISCOUNT WILL LIMIT THE PATIENTS TO AN OUT OF POCKET MAXIMUM AMOUNT IN THE GIVEN TIME PERIOD. WE DO NOT HAVE ANY AUTOMATIC ADJUSTMENTS OR AN AUTOMATED SYSTEM TO TRACK THE PREVIOUSLY APPROVED PATIENTS.
SCHEDULE H, PART VI, LINE 2REVIEW OF ASSESSMENTS OF OTHER ORGANIZATIONS THAT IDENTIFY NEEDS AND HAVE ON-GOING PARTICIPATION WITH THOSE ORGANIZATIONS. COLLECT, REVIEW AND USE PRIMARY, SECONDARY AND QUALITATIVE DATA IN DETERMINING NEEDS. UPDATE COMMUNITY HEALTH STATUS AS LOCAL, STATE AND FEDERAL DATA IS REPORTED. REVIEW INTERNAL DATA SUCH AS SCREENING OUTCOMES AND PATIENT VOLUMES FOR SERVICES. RESPONSE TO REQUESTS FROM COMMUNITY, INPUT FROM A GROUP MEETING OF THE DOUGLASS HIGH SCHOOL ALUMNI ASSOCIATION, SEVERAL WRITTEN SURVEYS AND A TELEPHONE INTERVIEW. THE ORGANIZATION ANALYZES QUANTITATIVE FEDERAL, STATE AND LOCAL DATA AS WELL AS SEEKS QUALITATIVE INPUT FROM MEMBERS OF THE COMMUNITY, ESPECIALLY THE UNDERSERVED. THE ORGANIZATION ALSO ASSESSES THE NEEDS OF THE COMMUNITY THROUGH UTILIZING ASSESSMENTS CONDUCTED BY OTHER COMMUNITY ORGANIZATIONS, REVIEWING INTERNAL DATA ON PATIENT VOLUMES AND SCREENING OUTCOMES, PARTICIPATING IN COMMUNITY ORGANIZATIONS THAT IDENTIFY NEEDS, AND RESPONDING TO SPECIFIC REQUESTS FROM COMMUNITY MEMBERS. COPIES OF THE 2022-2023 CHNA'S AND THE RELATED IMPLEMENTATION PLAN CAN BE FOUND AT THE FOLLOWING WEB ADDRESSES: HTTPS://WWW.ARCHBOLD.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/
SCHEDULE H, PART VI, LINE 3ANNUAL NOTICES ARE PLACED IN THE NEWSPAPERS FOR THE COUNTIES WE SERVE WITH HEALTHCARE. NOTICE OF THE FAP PROGRAM IS CONTAINED IN THE PATIENT HANDBOOK, SIGNS AND BROCHURES OUTLINING THE AVAILABILITY OF THE FAP PROGRAM ARE AVAILABLE AT POINTS OF ACCESS FOR PATIENTS, PAPER APPLICATIONS ARE AVAILABLE AT ALL ADMISSION AREAS AND BUSINESS OFFICES, ELECTRONIC VERSION OF THE APPLICATION CAN BE DOWNLOADED FREE OF CHARGE VIA WEBSITE AND THE ASSISTANCE PROGRAM IS DISCUSSED IN DETAIL DURING COLLECTION CALLS WITH PATIENTS.
SCHEDULE H, PART VI, LINE 4COUNTIES SERVED IN GEORGIA INCLUDE BROOKS, GRADY, MITCHELL, THOMAS. DISPROPORTIONATE HEALTHCARE NEEDS, FEDERALLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS(MUA) OR HEALTH PROFESSIONAL SHORTAGE AREAS(HSPA), LOW INCOME, PUBLIC HOUSING RESIDENTS, SENIORS, MIGRANT WORKERS, UNINSURED, UNDERINSURED, MIXTURE OF ETHNICITIES, ALL AGES, MIXTURE OF EDUCATIONAL LEVELS. BROOKS COUNTY: ESTIMATED POPULATION 16,245, 60.8% WHITE/35.2% BLACK, MEDIAN HH INCOME 47,656, 22.8% LIVING IN POVERTY, 15.1% UNDER 65 UNINSURED GRADY COUNTY: ESTIMATED POPULATION 26,066, 66.0% WHITE/29.5% BLACK, MEDIAN HH INCOME 54,312, 19.7% LIVING IN POVERTY, 17.7% UNDER 65 UNINSURED MITCHELL COUNTY: ESTIMATED POPULATION 21,114, 50.1% WHITE/46.5% BLACK, MEDIAN HH INCOME 51,908, 23.8% LIVING IN POVERTY, 14.1% UNDER 65 UNINSURED THOMAS COUNTY: ESTIMATED POPULATION 45,649, 60.3% WHITE/36.3% BLACK, MEDIAN HH INCOME 60,140, 18.4% LIVING IN POVERTY, 13.4% UNDER 65 UNINSURED INFORMATION OBTAINED FROM WWW.CENSUS.GOV - QUICK FACTS UPDATED 01/20/25
SCHEDULE H, PART VI, LINE 5LIVE BETTER IS THE ARCHBOLD-LED INITIATIVE FOCUSED ON IMPROVING THE HEALTH OF THE CITIZENS OF THOMAS COUNTY. LIVE BETTER WORKS PRIMARILY WITH LOCAL SCHOOL SYSTEMS IN PROVIDING MONTHLY HEALTH EDUCATION MATERIAL TO ALL K-5 STUDENTS IN THOMAS COUNTY. LIVE BETTER ALSO PROVIDES OPPORTUNITIES FOR BOTH KIDS AND ADULTS TO STAY ACTIVE THROUGH ANNUAL 5K AND ONE-MILE FUN RUNS. OUTSIDE OF THE LIVE BETTER INITIATIVE, ARCHBOLD PROVIDES FREE HEALTH SCREENS AND EDUCATIONAL HEALTH TALKS TO THE COMMUNITY THROUGHOUT THE YEAR. OBESITY IS A PREVENTABLE CONDITION, YET THE COMMON RISK FACTOR WITH THE MOST PROMINENT HEALTH ISSUES IN THOMAS COUNTY: HEART DISEASE, HYPERTENSION, STROKE, COPD, VASCULAR DISEASE, DIABETES AND CANCER.
SCHEDULE H, PART VI, LINE 6ARCHBOLD MEDICAL CENTER, INC. AS THE PARENT CORPORATION, HAS SOLE CONTROL OVER ITS NONPROFIT SUBSIDIARIES: JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC., ARCHBOLD FOUNDATION, INC., AND ARCHBOLD MEDICAL GROUP, INC. JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. OPERATES HOSPITALS (ARCHBOLD MEMORIAL, ARCHBOLD GRADY, ARCHBOLD BROOKS, AND ARCHBOLD MITCHELL), AND LONG-TERM CARE FACILITIES ARCHBOLD LIVING THOMASVILLE, ARCHBOLD LIVING CAMILLA, ARCHBOLD LIVING PELHAM, AND ARCHBOLD LIVING CAIRO. ARCHBOLD FOUNDATION, INC. IS A SUPPORT FOUNDATION WITH THE SOLE PURPOSE OF BUILDING AND SUSTAINING A FINANCIAL LEGACY THAT SUPPORTS JOHN D. ARCHBOLD MEMORIAL HOSPITAL AND ITS AFFILIATED ENTITIES. ARCHBOLD MEDICAL GROUP, INC. EMPLOYS PHYSICIANS AND OTHER SUPPORT PERSONNEL TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES ESSENTIAL TO THE PREVENTION AND TREATMENT OF DISEASE FOR THE BENEFIT OF ALL INDIVIDUALS IN THE SERVICE AREA. ARCHBOLD MEDICAL GROUP, INC. ALSO SERVES AS THE SOLE MEMBER OF CCSG, INC. AND AMGIR, INC., BOTH OF WHICH ARE 501(C)(3) ORGANIZATIONS THAT OPERATE MEDICAL CLINICS.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd
Total501c3 Org1Total501c3OrgCnt

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

Grant TypeGrantTypeTxtCash GrantCashGrantAmtRecipientRecipientCntNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDesc
SCHOLARSHP/TUITION PROG$136,934
MED STUDENT HOUSING268$118,833FMVHOUSING/UTIL.

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PAGE 1, PART I, LINE 2FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION OFFERS A TUITION REIMBURSEMENT PROGRAM AND A SCHOLARSHIP PROGRAM FOR QUALIFIED INDIVIDUALS BASED ON SATISFACTORY COMPLETION OF APPROVED COURSES. THE PURPOSE IS TO ENCOURAGE AND ENABLE EMPLOYEES TO ACQUIRE ADDITIONAL EDUCATION IN A HEALTH CARE OR JOB-RELATED FIELD WHICH WILL PROMOTE CAREER ADVANCEMENT AND/OR PROVIDE ADVANCED CREDENTIALING OF EMPLOYEES IN AREAS OF NEED. THE ORGANIZATION EVALUATES CERTAIN MEDICAL EDUCATION PROGRAMS AT AREA EDUCATIONAL INSTITUTIONS (SOUTHERN REGIONAL TECHNICAL COLLEGE AND THOMAS UNIVERSITY) AND PROVIDES FINANCIAL SUPPORT DIRECTLY TO THE EDUCATIONAL INSTITUTIONS AS APPROVED BY MANAGEMENT. CONDITIONS OF ELIGIBILITY: FOR THE TUITION REIMBURSEMENT PROGRAM, INDIVIDUALS MUST BE A FULL-TIME EMPLOYEE FOR AT LEAST SIX MONTHS WITH SATISFACTORY WORK RECORD AND PERFORMANCE EVALUATION. SCHOLARSHIP PROGRAM RECIPIENTS DO NOT HAVE TO BE EMPLOYEES; HOWEVER, THEY MUST AGREE TO A WORK-COMMITMENT UPON COMPLETION OF THE SCHOLARSHIP PROGRAM. COMPLETION OF THE RELEVANT EDUCATION PROGRAM REQUIRES THE APPLICANT TO COMMIT TO: -ONE YEAR, FULL-TIME WORK REQUIREMENT FOR EVERY 5,000 RECEIVED FROM THE TUITION REIMBURSEMENT PROGRAM. -FULL-TIME WORK COMMITMENT DEPENDENT ON THE AMOUNT OF SCHOLARSHIP RECEIVED. (RECIPIENTS OF A 10,000 SCHOLARSHIP HAVE A 3 YEAR WORK COMMITMENT; A 5,000 SCHOLARSHIP HAS A 1.5 YEAR WORK COMMITMENT). FAILURE TO COMPLY WITH THE REQUIREMENTS OF ELIGIBILITY SUBJECTS THE EMPLOYEE TO FULL OR PARTIAL REIMBURSEMENT OF THE FUNDS RECEIVED FROM THE ORGANIZATION. FAILURE TO FULFILL WORK COMMITMENT REQUIRES PAYBACK FOR BOTH PROGRAMS. TO BE REIMBURSED THROUGH THE TUITION REIMBURSEMENT PROGRAM, THE EMPLOYEE MUST PROVIDE A COPY OF A RECEIPT SHOWING ACTUAL PAYMENT OF TUITION FEES. APPLICANTS MUST MAINTAIN A C OR HIGHER GRADE AND SUBMIT A RECORD OF GRADES AND HOURS CREDIT (TRANSCRIPT) TO THE ORGANIZATION.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
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 (17 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtBase Compensation Filing OrgBaseCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountOther Compensation Filing OrgOtherCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
DARCY M CRAVEN
PRESIDENT/CEO$807,430$263,088$4,002$163,745$9,548$1,247,813
JOSH D SIMMONS MD
TRUSTEE$519,277$171,866$540$13,200$10,402$715,285
GREG HEMBREE
ASST SEC/SR VP/CFO$425,607$115,943$55,094$69,576$13,288$679,508
DINESH B PATEL MD
PHYSICIAN$232,840$312,536$980$16,799$10,402$573,557
JIM CARTER
COO$356,201$97,216$1,242$64,303$10,458$529,420
AMY GRIFFIN
VP PATIENT CARE$312,565$84,272$36,031$60,578$7,708$501,154
STEPHEN RUBENDALL MD
PHYSICIAN$261,765$194,286$378$13,544$10,402$480,375
KRISTOPHER PALMER DO
VP MEDICAL AFFAIRS$130,673$122,310$166,640$54,360$473,983
JASON NESMITH MD
TRUSTEE$221,089$227,571$2,216$9,168$10,402$470,446
EUGENE SUN MD
PHYSICIAN$287,747$56,750$443$14,793$10,402$370,135
MARK L CATTERSON
PHYSICIAN$287,739$28,466$1,948$13,313$10,402$341,868
CHRIS NEWMAN
VP ANCILLARY SVCS$232,558$49,137$540$31,061$678$313,974
SHANE HERRIN MD
PHYSICIAN$279,232$4,700$646$13,126$10,402$308,106
JAMIE WOMACK
VP CRITICAL ACCESS$216,168$46,056$540$27,696$10,458$300,918
JAMES BUE
VP FACILITY SERVICES$189,057$39,516$18,618$13,263$678$261,132
COY IRVIN MD
VP MEDICAL AFFAIRS$246,667$246,667
JULIE DUMAS
VP QUALITY$156,237$32,320$540$21,362$11,498$221,957

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PAGE 1, PART I, LINE 4DARCY M. CRAVEN 0 150,545 0 GREG HEMBREE 0 53,076 0 JIM CARTER 0 44,503 0 AMY GRIFFIN 0 38,578 0 KRISTOPHER PALMER, D.O. 0 54,360 0 CHRIS NEWMAN 0 19,281 0 JAMIE WOMACK 0 18,603 0 COY IRVIN, M.D. 246,667 0 0 JULIE DUMAS 0 13,184 0
SCHEDULE J, PART IIITHE IRS RULES & REGULATIONS REQUIRE THAT CERTAIN NON-CURRENT, NON-CASH ITEMS ARE REPORTED IN PART VII, COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, HIGHEST COMPENSATED EMPLOYEES, AND INDEPENDENT CONTRACTORS, OF THE CORE FORM 990 REGARDLESS OF THE CURRENT BENEFIT TO THE EMPLOYEE. THESE SAME RULES, IN SOME CASES, REQUIRE THE COMPENSATION AND BENEFITS TO BE REPORTED TWICE IN PART VII, ONCE WHEN THE ENTITY ACCRUES FOR A FUTURE PAYMENT AND ONCE WHEN THE PAYMENT IS ACTUALLY MADE TO THE EMPLOYEE. THEREFORE, AN EMPLOYEE'S STATED TOTAL COMPENSATION AND BENEFITS REPORTED ON PART VII ARE SUBSTANTIALLY HIGHER THAN THE ACTUAL CASH COMPENSATION RECEIVED IN THE CURRENT YEAR. AMOUNTS REPORTED AS BENEFITS INCLUDE AMOUNTS FOR LIFE INSURANCE, HEALTH INSURANCE, THRIFT PLAN CONTRIBUTIONS, AND PENSION CONTRIBUTIONS. BENEFITS RELATED TO PENSION AND RETIREMENT PLANS REFLECT AMOUNTS ACCUMULATED, BUT NOT PAID, TO THE INDIVIDUAL IN RECOGNITION OF TOTAL YEARS OF EMPLOYMENT, NOT JUST THE CURRENT YEAR. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ONE EXECUTIVE PARTICIPATES IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WHICH IS ACCRUED BUT UNFUNDED IN AN AMOUNT WHICH, WHEN ADDED TO OTHER SOURCES OF RETIREMENT INCOME, WILL AFFORD A RETIREMENT INCOME AT A TARGETED PERCENTAGE OF PRE-RETIREMENT COMPENSATION. THE SERP IS A NONQUALIFIED RETIREMENT PLAN. AMC 457(F) RETIREMENT PLAN CERTAIN EXECUTIVES WHO ARE NOT ELIGIBLE FOR THE SERP MAY BE ELIGIBLE TO PARTICIPATE IN A 457(F) PLAN TO HELP THEM ACCUMULATE FUNDS FOR THEIR LONG- TERM FINANCIAL NEEDS. THE ORGANIZATION MAY CONTRIBUTE A PERCENTAGE OF ITS BASE SALARY INTO AN INDIVIDUAL EXECUTIVE'S ACCOUNT IF THE ORGANIZATION MEETS CERTAIN FINANCIAL TARGETS. THE ORGANIZATION OWNS ANY PLAN ASSETS UNTIL THEY ARE PAID TO THE EMPLOYEE AND ALL FUNDS ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. VESTING BEGINS AT AGE 55 WITH FIVE YEARS OF SERVICE AT A RATE OF 90% AND THEN INCREASES TO 100% AT AGE 60. PAYMENTS ARE MADE ANNUALLY UPON VESTING. BONUS AWARDS: OFFICERS AND PHYSICIANS ARE AWARDED BONUSES/INCENTIVES CONTINGENT IN PART ON MEETING MANAGEMENT-BY-OBJECTIVE INCENTIVE PLAN GOALS AND EXCESS OF REVENUE OVER EXPENSES.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBusiness Name Line2IssuerName/BusinessNameLine2TxtBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
HOSP AUTH OF THE CITY OF THOMASVILL
A2017C REVENUE BONDS581719301NONENONEN2017-07-12$82,750,000CONSTRUCTION BLDG AND EQUIPMENTfalseYes (true)false
HOSP AUTH OF THE CITY OF THOMASVILL
B2017A REVENUE BONDS581719301NONENONEN2017-07-12$17,985,000CONSTRUCTION PROJECT DEPOSITfalseYes (true)false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtRefunding EscrowRefundingEscrowAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndOther Spent ProceedsOtherSpentProceedsAmt
A$22,865,000$82,850,000$82,522,324$327,6762017falseYes (true)falseYes (true)
B$17,985,0002017falsefalseYes (true)Yes (true)$17,985,000

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
AfalsefalseYes (true)falsefalsefalsefalsefalseYes (true)
BfalsefalseYes (true)falseYes (true)falsefalsefalseYes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
Afalse
Bfalse

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
DIFFERENCES IN ISSUE PRICE EXPLANATIONHOSP AUTH OF THE CITY OF THOMASVILLE THE PROCEEDS OF THE ORIGINAL ISSUE INCLUDE A 100,000 PREMIUM.
PURPOSE OF ISSUE DESCRIPTIONHOSP AUTH OF THE CITY OF THOMASVILLE CONSTRUCTION BLDG AND EQUIPMENT
PURPOSE OF ISSUE DESCRIPTIONHOSP AUTH OF THE CITY OF THOMASVILLE CONSTRUCTION PROJECT DEPOSIT

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (7 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
JAMES W FALCONER III MD
BOARD TRUSTEE$317,695RENTAL, PATIENT SVCSfalse
JAMI STEPHENSON
FAMILY MEMBER$138,560COMPENSATIONfalse
DAVID MEDEROS DO
BOARD TRUSTEE$5,563,510PROFESSIONAL MED SVCfalse
TIMOTHY B DANIEL MD
BOARD TRUSTEE$5,314,031SERVICE AGREEMENTfalse
JESSE R WARREN DO
BOARD TRUSTEE$8,436,211PROFESSIONAL MED SVCfalse
KAREN M BRAMBLETT MD
BOARD TRUSTEE$8,436,211PROFESSIONAL MED SVCfalse
CHRISTOPHER L DANIELS MD
BOARD TRUSTEE$17,240,852PROFESSIONAL MED SVCfalse

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE L, PART VFormAndLineReferenceDesc
ExplanationJAMES W. FALCONER, III, MD - RENT OF PROPERTY; MEDICAL SERVICES TO PRACTICE; PAYMENTS TO TREAT UNINSURED EMERGENCY PATIENTS. JAMI STEPHENSON IS THE SON OF SUE STEPHENSON, FORMER BOARD TRUSTEE, AND IS EMPLOYED AND COMPENSATED BY JDAMH. DAVID MEDEROS, D.O., FORMER BOARD TRUSTEE, PROVIDES HOSPITALIST COVERAGE FOR HOSPITAL, INPATIENT REHAB AND IS A MEMBER OF THE MEDICAL STAFF LEADERSHIP COMMITTEE. TIMOTHY B. DANIEL, M.D. SERVED ON THE BOARD AS A TRUSTEE DURING FY 2022, AND HE WAS A PRACTICE PARTNER IN AN INTERVENTIONAL RADIOLOGY PRACTICE WHICH HAS A PROFESSIONAL SERVICES AGREEMENT WITH THE HOSPITAL. AMOUNT REFLECTS PAYMENTS ASSOCIATED WITH INTERVENTIONAL RADIOLOGY SERVICES PERFORMED UNDER THE PROFESSIONAL SERVICES AGREEMENT AND A MEDICAL SERVICES AGREEMENT, ALLOCATED PAYMENTS FROM STATE OF GEORGIA TRAUMA FUNDING, AND PHYSICIAN RECRUITMENT INCOME GUARANTEE FOR AN INTERVENTIONAL PRACTICE PARTNER. KAREN L. BRAMBLETT, MD, SERVED ON THE BOARD AS A TRUSTEE DURING FY 2024 AND SHE WAS A PRACTICE PARTNER IN AN ANESTHESIA SERVICES AND MEDICAL DIRECTORSHIP WHICH HAS A PROFESSIONAL SERVICES AGREEMENT WITH THE HOSPITAL. JESSE R. WARREN, DO, SERVED ON THE BOARD AS A TRUSTEE DURING FY 2024 AND SHE WAS A PRACTICE PARTNER IN AN ANESTHESIA SERVICES AND MEDICAL DIRECTORSHIP WHICH HAS A PROFESSIONAL SERVICES AGREEMENT WITH THE HOSPITAL. CHRISTOPHER L. DANIELS, MD, SERVED ON THE BOARD AS A TRUSTEE DURING FY 2024 AND HE WAS A PRACTICE PARTNER IN AN CARDIOVASCULAR SERVICES AND MEDICAL DIRECTORSHIP WHICH HAS A PROFESSIONAL SERVICES AGREEMENT WITH THE HOSPITALExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 2, PART III, LINE 4AARCHBOLD MEMORIAL IN THOMASVILLE GEORGIA OPERATES WITH 264 LICENSED BEDS; OF WHICH 226 ARE MED/SURG, 18 BEDS ARE DESIGNATED TO A PSYCH UNIT, 20 BEDS ARE REHAB. IN ADDITION, IT OPERATES A 64 BED SKILLED NURSING FACILITY, ARCHBOLD LIVING THOMASVILLE. ARCHBOLD MEMORIAL IS A RURAL REFERRAL CENTER COVERING THOMAS COUNTY AND SURROUNDING COUNTIES IN SOUTHERN GEORGIA AND NORTHERN FLORIDA. 65% OF PATIENTS WERE COVERED BY MEDICARE AND MEDICAID, AND 3.0% OF PATIENT REVENUE WAS PROVIDED AS INDIGENT CARE. IN FY 2024, ARCHBOLD MEMORIAL PROVIDED AN ESTIMATED 32.8 MILLION IN INDIGENT CARE CHARGES. ARCHBOLD MEMORIAL TREATS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. ARCHBOLD MEMORIAL PROVIDED APPROXIMATELY 32.8 MILLION IN ADDITIONAL UNCOMPENSATED CARE. THROUGHOUT THE YEAR, ARCHBOLD MEMORIAL PRODUCES OR SPONSORS MANY SPECIAL PROGRAMS FOR THE COMMUNITY TO EDUCATE THEM ON IMPORTANT HEALTH NEEDS. JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. ALSO OPERATES HOSPITALS IN GRADY, BROOKS, AND MITCHELL COUNTIES OF GEORGIA FILING UNDER EIN 58- 0566121.
FORM 990, PAGE 2, PART III, LINE 4DARCHBOLD BROOKS OPERATES IN QUITMAN, GEORGIA AS A CRITICAL ACCESS HOSPITAL WITH 25 ACUTE CARE BEDS. IT SERVES BROOKS COUNTY AND 56% OF ITS PATIENTS WERE MEDICARE/MEDICAID. IN FY 2024, AN ESTIMATED 3.1 MILLION OF INDIGENT CARE WAS PROVIDED TO THE COMMUNITY. IN ADDITION, ARCHBOLD BROOKS PROVIDED APPROXIMATELY 1.4 MILLION IN ADDITIONAL UNCOMPENSATED CARE. EIN 58- 6002830 IS FILED UNDER EIN 58-0566121 FOR FORM 990 PURPOSES.
FORM 990, PAGE 6, PART VI, LINE 2KAREN L. BRAMBLETT, MD JESSE R. WARREN, DO TRUSTEE BUSINESS
FORM 990, PAGE 6, PART VI, LINE 6THE ORGANIZATION HAS A SOLE MEMBER, ARCHBOLD MEDICAL CENTER, INC. (AMC), WITH THE POWER TO ELECT OR REPLACE AND TO REMOVE THE TRUSTEES OF THE GOVERNING BODY, AS WELL AS THE AUTHORITY TO APPROVE THE DECISIONS OF THE GOVERNING BODY.
FORM 990, PAGE 6, PART VI, LINE 7ATHE BOARD OF TRUSTEES OF THE FILING ENTITY ARE ELECTED ANNUALLY BY THE SOLE MEMBER, AMC. IN ADDITION, AMC HAS THE POWER TO ELECT OR REPLACE AND TO REMOVE THE TRUSTEES OF THE GOVERNING BODY. THE CEO OF AMC SHALL BE A MEMBER OF THE BOARD WITH THE POWER TO VOTE.
FORM 990, PAGE 6, PART VI, LINE 7BTHE SOLE MEMBER, AMC, HAS THE AUTHORITY TO APPROVE THE DECISIONS OF THE GOVERNING BODY, INCLUDING BUT NOT LIMITED TO, CAPITAL AND OPERATING BUDGETS, MERGERS OR ACQUISITIONS, CONTRACTS AND TRANSACTIONS OVER A CERTAIN AMOUNT, DISSOLUTION, ETC
FORM 990, PAGE 6, PART VI, LINE 11BMANAGEMENT REVIEWS THE FORM 990 AS PREPARED BY ITS EXTERNAL AUDITOR, AND THEN MAKES A COMPLETE COPY AVAILABLE ELECTRONICALLY TO TRUSTEES PRIOR TO FILING THE RETURN. IF TRUSTEES HAVE QUESTIONS ABOUT THE RETURN, MANAGEMENT IS AVAILABLE AND ACCESSIBLE TO PROVIDE APPLICABLE EXPLANATIONS TO TRUSTEES.
FORM 990, PAGE 6, PART VI, LINE 12CON AN ANNUAL BASIS, THE ORGANIZATION DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE AND DISCLOSURE STATEMENT TO EACH TRUSTEE. THIS QUESTIONNAIRE INCLUDES QUESTIONS RELATED TO FINANCIAL INTERESTS, OUTSIDE INTERESTS OR ACTIVITIES, AND GIFTS, MEALS, AND ENTERTAINMENT. IN ADDITION TO DISCLOSING ANY APPLICABLE INFORMATION ON THE QUESTIONNAIRE, THE TRUSTEE ACKNOWLEDGES THAT (S)HE HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ, UNDERSTANDS, AND AGREES TO COMPLY WITH IT, AND UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. RESPONSES ARE SUMMARIZED AND COLLECTIVELY REVIEWED BY THE BOARD OF TRUSTEES OF ARCHBOLD MEDICAL CENTER, INC., THE SOLE MEMBER. DURING EACH BOARD MEETING, THE CHAIRMAN INQUIRES IF ANY TRUSTEE HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST RELATED TO ANY AGENDA ITEM. IF THE TRUSTEE DISCLOSES ANY SUCH INTEREST, THE TRUSTEE IS EXCUSED FROM THE MEETING WHILE THE DETERMINATION AS TO WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS IS DISCUSSED AND VOTED UPON BY DISINTERESTED MEMBERS OF THE BOARD AND COMMITTEE. IF INVITED TO DO SO, THE TRUSTEE WITH A POTENTIAL CONFLICT MAY RESPOND TO QUESTIONS PUT FORTH BY FELLOW DISINTERESTED TRUSTEES REGARDING ANY PROPOSED TRANSACTION OR ARRANGEMENT. THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS DOCUMENTS THE NAME OF ANY INTERESTED PERSON/TRUSTEE WHO DISCLOSED OR WAS FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH A TRANSACTION OR ARRANGEMENT RESULTING IN AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; AND THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATED TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSIONS, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH.
FORM 990, PAGE 6, PART VI, LINE 15AARCHBOLD MEDICAL CENTER'S (AMC) COMPENSATION COMMITTEE (COMMITTEE) OF THE AMC BOARD OF TRUSTEES MAKES RECOMMENDATIONS TO THE FULL AMC BOARD ON THE FOLLOWING POSITIONS: THE PRESIDENT OF AMC AND THE PRESIDENT OF THE ARCHBOLD FOUNDATION. AMC'S PRESIDENT PRESENTS RECOMMENDATIONS FOR ALL SENIOR VICE PRESIDENTS, VICE PRESIDENTS, AND OTHER KEY EMPLOYEES OF AMC AND ALL RELATED ARCHBOLD ENTITIES TO THE COMMITTEE. SINCE AMC HAS RESERVE POWERS FOR ARCHBOLD RELATED ENTITIES, THE COMMITTEE SERVES AS THE COMPENSATION COMMITTEE FOR EACH APPLICABLE ARCHBOLD ENTITY. THE COMMITTEE CONSIDERS THE AMC PRESIDENT'S RECOMMENDATIONS, BUT IT ALSO CONSIDERS RECOMMENDATIONS AND INDEPENDENT MARKET DATA ANALYSIS FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE AMC BOARD UTILIZES AN INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE EXECUTIVE COMPENSATION PROGRAM AND MAKE RECOMMENDATIONS REGARDING PLAN DESIGN AND ACTUAL COMPENSATION INCLUDING BENEFITS.
FORM 990, PAGE 6, PART VI, LINE 15BSEE 15A ABOVE.
FORM 990, PAGE 6, PART VI, LINE 19NO DOCUMENTS ARE OR WILL BE MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11GCONSULTANT FEES JDAMH 0 126,523 0 CONTRACT SERVICES JDAMH 41,843,482 1,774,404 0 CONTRACT SERVICES BROOKS 1,510,293 0 0 CONTRACT SERVICES GRADY 6,577,558 201,532 0 CONTRACT SERVICES MITCHELL 4,888,352 74,121 0 OUTSIDE LAB REFERRAL FEES JDA 1,554,361 0 0 OUTSIDE LAB REFERRAL GRADY 22,694 0 0 OUTSIDE LAB REFERRAL BROOKS 1,405 0 0 PROFESSIONAL FEES JDAMH 19,636,412 1,640,338 0 PROFESSIONAL FEES GRADY 3,427,037 181,686 0 PROFESSIONAL FEES BROOKS 1,206,917 57,661 0 PROFESSIONAL FEES MITCHELL 2,010,337 148,755 0 TOTAL 82,678,848 4,205,020 0
FORM 990, PART XI, LINE 9RELATED PARTY TRANSFER 199,707 TRANSFER TO FOUNDATION -25,345 TOTAL 174,362

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtBusiness Name Line2DirectControllingEntityName/BusinessNameLine2TxtControlled OrganizationControlledOrganizationInd
ARCHBOLD FOUNDATION INC
PO BOX 620THOMASVILLEGA317990620581559677FOUNDATIONGA501C312BAMCARCHBOLD MEDICAL CENTER INCfalse
ARCHBOLD MEDICAL CENTER INC
PO BOX 1018THOMASVILLEGA317991018581552650H/C MGMTGA501C312CNAfalse
ARCHBOLD MEDICAL GROUP INC
P O BOX 620THOMASVILLEGA317990620262988454PHYSICIANSGA501C33AMCARCHBOLD MEDICAL CENTER INCfalse
CCSG INC
915 GORDON AVENUETHOMASVILLEGA317926614473501366MED CLINICGA501C33AMGfalse
AMGIR INC
915 GORDON AVENUETHOMASVILLEGA317926614821188691MED CLINICGA501C33AMGfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1GEORGIA-FLORIDA PREFERRED INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1915 GORDON AVEAddressLine1Txt
CityTHOMASVILLECityNm
State AbbreviationGAStateAbbreviationCd
ZIP31792ZIPCd
FieldValueIRS element (for citing)
EIN581744334EIN
Primary ActivitiesHEALTHCAREPrimaryActivitiesTxt
Legal Domicile StateGALegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1JDAMHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeC CORPEntityTypeTxt
Share Of Total Income$6,006ShareOfTotalIncomeAmt
Share Of EOY Assets$188,932ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (true)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
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 OrgYes (true)RentalOfFacilitiesToOthOrgInd
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 OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd