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COMMUNITY ANCILLARY SERVICES INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY ANCILLARY SERVICES INC (EIN 43-2007496)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-12
IRS object ID
202141329349302909
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 ReturnHeader

FieldValueIRS element (for citing)
Return2021-05-12T12:23:11-05:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN581094351PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MCNAIR MCLEMORE MIDDLEBROOKS & CO LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1POST OFFICE BOX ONEAddressLine1Txt
CityMACONCityNm
State AbbreviationGAStateAbbreviationCd
ZIP312020001ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN432007496EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY ANCILLARY SERVICES INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone4786212100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1111 STONE BROOKE DRIVEAddressLine1Txt
CityGRAYCityNm
State AbbreviationGAStateAbbreviationCd
ZIP31032ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTERESA MOODYPersonNm
Person TitleSECRETARYPersonTitleTxt
Phone4786212100PhoneNum
Signature2021-05-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWILLIAM R ROUNTREEPreparerPersonNm
PTINP01231836PTIN
Phone4787466277PhoneNum
Preparation2021-05-12PreparationDt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd
Principal OfficerTERESA MOODYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1111 STONE BROOKE DRIVEAddressLine1Txt
CityGRAYCityNm
State AbbreviationGAStateAbbreviationCd
ZIP31032ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$101,206,203GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ELDERCAREPHARMACY.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2003FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTHE PROVISION OF PHARMACEUTICAL, MEDICAL SUPPLIES AND EQUIPMENT, HOME HEALTH AND RELATED SERVICES AS PART OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee716TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
CY Contributions Grants$907,558CYContributionsGrantsAmt
PY Program Service Revenue$97,508,544PYProgramServiceRevenueAmt
CY Program Service Revenue$100,033,642CYProgramServiceRevenueAmt
PY Investment Income$473,010PYInvestmentIncomeAmt
CY Investment Income-$93,808CYInvestmentIncomeAmt
PY Other Revenue$973,692PYOtherRevenueAmt
CY Other Revenue$358,811CYOtherRevenueAmt
PY Total Revenue$98,955,246PYTotalRevenueAmt
CY Total Revenue$101,206,203CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$27,748,567PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$30,188,881CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$62,750,308PYOtherExpensesAmt
CY Other Expenses$61,773,532CYOtherExpensesAmt
PY Total Expenses$90,498,875PYTotalExpensesAmt
CY Total Expenses$91,962,413CYTotalExpensesAmt
PY Revenues Less Expenses$8,456,371PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$9,243,790CYRevenuesLessExpensesAmt
Total Assets BOY$38,406,482TotalAssetsBOYAmt
Total Assets EOY$40,278,752TotalAssetsEOYAmt
Total Liabilities BOY$15,446,862TotalLiabilitiesBOYAmt
Total Liabilities EOY$12,962,279TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$22,959,620NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$27,316,473NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE PROVISION OF PHARMACEUTICAL, MEDICAL EQUIPMENT, HEALTHCARE SUPPLIES, HOME CARE AND RELATED SERVICES, HOSPICE SERVICES, AND HOME HEALTH SERVICES AS PART OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$91,962,413ExpenseAmt
Revenue$100,169,152RevenueAmt
DescPROVIDED A FULL SERVICE PHARMACY THROUGH A REGIONAL NETWORK OF PERSONAL CARE AND NURSING FACILITIES TO PATIENTS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED MEDICAL, HEALTH CARE AND RELATED SUPPLIES TO PERSONAL CARE AND NURSING FACILITIES FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED MEDICAL EQUIPMENT, GOODS, LINENS, UNIFORMS AND COMMODITIES TO PERSONAL CARE AND NURSING FACILITIES FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED HOME-HEALTH CARE FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED HOSPICE SERVICES AND HOME HEALTH SERVICES FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. CONSISTENT WITH THE POLICIES AND PROCEDURES PREVIOUSLY ADOPTED BY THE BOARD OF DIRECTORS OF COMMUNITY HEALTH SYSTEMS, INC., THE SECTION 509(A)(3) SUPPORTING ORGANIZATION AND PARENT ENTITY OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM OF WHICH THE ORGANIZATION IS A MEMBER, THE ORGANIZATION PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITIES IT SERVES PURSUANT TO BOTH COMMUNITY BENEFIT GUIDELINES AND A CHARITY CARE POLICY. THE ORGANIZATION CONTINUES TO ASSESS AND DEVELOP PROGRAMS TO BENEFIT THE COMMUNITY.Desc
Total Program Service Expenses$91,962,413TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document512IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee716EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
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 Members3GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
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 ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCOMMUNITY ANCILLARY SERVICES INCPersonNm
Phone4786212100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1213 THIRD STREETAddressLine1Txt
CityMACONCityNm
State AbbreviationGAStateAbbreviationCd
ZIP31201ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
LORRAINE T TAYLOR
FORMER SECRE0.0040.00Yes (X)$0$755,200$23,966
JAMES R LEE JR
FORMER VP0.000.00Yes (X)$0$325,620$17,093
MICHELLE MOORE-ANDREWS
FORMER PRESI0.0040.00Yes (X)$0$260,344$18,948
CALVIN D FRANKLIN
VICE PRESIDE40.000.00$252,420$0$17,570Yes (X)
ANGELA HAMMACK
CORPORATE SE0.0040.00Yes (X)$0$233,178$15,799
KIMBERLY SHEFFIELD
PRESIDENT4.0040.00$0$213,164$17,709Yes (X)
TERESA MOODY
SECRETARY4.0040.00$0$207,375$17,628Yes (X)
AMANDA ROBERSON
VICE PRESIDE40.000.00$204,888$0$17,729Yes (X)
ANDY HILL
VICE PRESIDE40.000.00$201,456$0$11,048Yes (X)
MELISSA PRICE
VICE PRESIDE40.000.00$182,901$0$16,570Yes (X)
STEPHANIE KIRKLAND
SENIOR DIR P40.000.00$170,784$0$16,458Yes (X)
SARAH THOMPSON
VICE PRESIDE40.000.00$155,863$0$16,914Yes (X)
LESLIE MAY
SR. DIR. OF40.000.00$152,490$0$16,202Yes (X)
GINGER LANCASTER
DIR PHARMACY40.000.00$148,093$0$16,925Yes (X)
JACLYN HOWARD
DIR PHARMACY40.000.00$154,279$0$10,416Yes (X)
LORAY CHILDS
VICE PRESIDE40.000.00$145,450$0$16,282Yes (X)
JAMIE DIAGOSTINO
DIR PHARMACY40.000.00$144,154$0$13,745Yes (X)
TRACIE P CLARK
VICE PRESIDE40.000.00$137,394$0$9,856Yes (X)
LUCY ROGERS
DIRECTOR0.0030.00Yes (X)$0$50,034$3,828
PAUL A CABLE
DIRECTOR4.001.00$0$24,000$0Yes (X)
HERBERT M PONDER JR
DIRECTOR4.001.00$0$24,000$0Yes (X)
JOSEPH A WALL
CHAIRMAN4.001.00$0$24,000$0Yes (X)
KATHRYN DENNIS
DIRECTOR0.004.00Yes (X)$0$24,000$0
JAMES B PATTON
DIRECTOR0.000.00Yes (X)$0$12,000$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,050,172TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,152,915TotReportableCompRltdOrgAmt
Total Other Compensation$294,686TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K47IndivRcvdGreaterThan100KCnt
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
STRATEGIC DELIVERY SOLUTIONS
PO BOX 239FARMINGDALENY11735COURIER SERVICE$1,166,140
INTEGRA REHABILITATION
1007 BOULDER DRIVEGRAYGA31032REHAB$1,071,256
NATIONAL HME INC
7501 ESTERS BLVD SUITE 100IRVINGTX75063HOSPICE$799,139
STEVENS PARK HEALTH REHABILITATION
820 STEVENS CREEK ROADAUGUSTAGA30907HEALTHCARE$257,964
GAHC3 ACWORTH GA MOB LLC
32922 COLLECTION CENTER DRIVECHICAGOIL606930329COLLECTIONS$188,948
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K8CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
Government Grants$907,558GovernmentGrantsAmt
Total Contributions$907,558TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
GOVERNMENTAL PROGRAMS REV$74,972,304$74,972,304
PROGRAM SERVICES$25,061,338$25,061,338
FieldValueIRS element (for citing)
Total Program Service Revenue$100,033,642TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column-$93,808TotalRevenueColumnAmt
Exclusion-$93,808ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MANAGEMENT FEE$327,703$327,703
OTHER$31,108$31,108
FieldValueIRS element (for citing)
Other Revenue Total$358,811OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$101,206,203TotalRevenueColumnAmt
Related Or Exempt Func Income$100,392,453RelatedOrExemptFuncIncomeAmt
Exclusion-$93,808ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,386,523TotalAmt
Program Services$1,386,523ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$24,261,742TotalAmt
Program Services$24,261,742ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$614,824TotalAmt
Program Services$614,824ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,071,770TotalAmt
Program Services$2,071,770ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,854,022TotalAmt
Program Services$1,854,022ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$57,984TotalAmt
Program Services$57,984ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,662,978TotalAmt
Program Services$2,662,978ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$236,148TotalAmt
Program Services$236,148ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$909,292TotalAmt
Program Services$909,292ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$369,250TotalAmt
Program Services$369,250ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MEDICAL SUPPLY EXPENSE$36,858,799$36,858,799
CONTRACTED SERVICES$10,843,352$10,843,352
SUPPORT ORGANIZATION FEES$5,356,592$5,356,592
OTHER ADMINISTRATIVE$2,537,252$2,537,252

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,941,885TotalAmt
Program Services$1,941,885ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$91,962,413TotalAmt
Program Services$91,962,413ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$5,825,988BOYAmt
EOY$6,553,260EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,309,714BOYAmt
EOY$10,324,927EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$3,205,239BOYAmt
EOY$3,656,620EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$444,152BOYAmt
EOY$474,582EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$11,184,326LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,967,245LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$6,153,264BOYAmt
EOY$6,217,081EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$9,049,920BOYAmt
EOY$11,133,306EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$4,418,205BOYAmt
EOY$1,918,976EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$38,406,482BOYAmt
EOY$40,278,752EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$11,917,117BOYAmt
EOY$6,885,317EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,339,524BOYAmt
EOY$978,352EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$877,721BOYAmt
EOY$474,489EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$312,500BOYAmt
EOY$4,624,121EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,446,862BOYAmt
EOY$12,962,279EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$20,620,096BOYAmt
EOY$26,338,121EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,339,524BOYAmt
EOY$978,352EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$22,959,620BOYAmt
EOY$27,316,473EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$38,406,482BOYAmt
EOY$40,278,752EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$9,243,790ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$4,886,937OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
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)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year$907,558CurrentTaxYearAmt
Total$907,558TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$67,803,264CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$81,029,683CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$98,301,316CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$98,482,236CurrentTaxYearMinus1YearAmt
Current Tax Year$100,392,453CurrentTaxYearAmt
Total$446,008,952TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$67,803,264CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$81,029,683CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$98,301,316CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$98,482,236CurrentTaxYearMinus1YearAmt
Current Tax Year$101,300,011CurrentTaxYearAmt
Total$446,916,510TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$446,916,510PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$157,587CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$46,028CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$233,597CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$473,010CurrentTaxYearMinus1YearAmt
Current Tax Year-$93,808CurrentTaxYearAmt
Total$816,414TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$157,587CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$46,028CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$233,597CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$473,010CurrentTaxYearMinus1YearAmt
Current Tax Year-$93,808CurrentTaxYearAmt
Total$816,414TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$67,960,851CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$81,075,711CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$98,534,913CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$98,955,246CurrentTaxYearMinus1YearAmt
Current Tax Year$101,206,203CurrentTaxYearAmt
Total$447,732,924TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99820PublicSupportCY509Pct
Public Support PY5090.99740PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$129,641OtherCostOrOtherBasisAmt
Book Value$129,641BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,666,666OtherCostOrOtherBasisAmt
Depreciation$1,201,521DepreciationAmt
Book Value$3,465,145BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,029,874OtherCostOrOtherBasisAmt
Depreciation$503,150DepreciationAmt
Book Value$526,724BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,358,145OtherCostOrOtherBasisAmt
Depreciation$3,262,574DepreciationAmt
Book Value$2,095,571BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$6,217,081TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
ADVANCE PAYMENTS UNAPPLIED$3,851,998
ACCRUED PAYROLL TAXES$463,823
CONTRACT LIABILITY$162,500
UNEARNED INCOME$145,800
FieldValueIRS element (for citing)
Total Liability$4,624,121TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$101,206,203TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$101,206,203RevenueSubtotalAmt
Total Revenue Per Form990$101,206,203TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$91,962,413TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$91,962,413ExpensesSubtotalAmt
Total Expenses Per Form990$91,962,413TotalExpensesPerForm990Amt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (20 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtBase Compensation Filing OrgBaseCompensationFilingOrgAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
LORRAINE T TAYLOR
FORMER SECRETARY$740,426$14,774$23,966$779,166
JAMES R LEE JR
FORMER VP$313,399$12,221$17,093$342,713
MICHELLE MOORE-ANDREWS
FORMER PRESIDENT$249,865$10,479$18,948$279,292
CALVIN D FRANKLIN
VICE PRESIDENT$242,253$10,167$17,570$269,990
ANGELA HAMMACK
CORPORATE SECRETARY$224,158$9,020$15,799$248,977
KIMBERLY SHEFFIELD
PRESIDENT$204,290$8,874$17,709$230,873
TERESA MOODY
SECRETARY$198,696$8,679$17,628$225,003
AMANDA ROBERSON
VICE PRESIDENT$194,156$10,732$17,729$222,617
ANDY HILL
VICE PRESIDENT$193,650$7,806$11,048$212,504
MELISSA PRICE
VICE PRESIDENT$171,557$11,344$16,570$199,471
STEPHANIE KIRKLAND
SENIOR DIR PHARMACY$163,810$6,974$16,458$187,242
SARAH THOMPSON
VICE PRESIDENT$149,460$6,403$16,914$172,777
LESLIE MAY
SR. DIR. OF PHARMACY$146,117$6,373$16,202$168,692
GINGER LANCASTER
DIR PHARMACY$142,161$5,932$16,925$165,018
JACLYN HOWARD
DIR PHARMACY$148,348$5,931$10,416$164,695
LORAY CHILDS
VICE PRESIDENT$137,020$8,430$16,282$161,732
JAMIE DIAGOSTINO
DIR PHARMACY$138,768$5,386$13,745$157,899
LUCY ROGERS
DIRECTOR$50,034$3,828$53,862
KATHRYN DENNIS
DIRECTOR$24,000$24,000
JAMES B PATTON
DIRECTOR$12,000$12,000

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1BONDS PAYABLEBusinessNameLine1Txt
Business Name Line2PULASKI COUNTY - HAWKINSVILLEBusinessNameLine2Txt
FieldValueIRS element (for citing)
Bond Issuer EIN586000877BondIssuerEIN
Bond Issued2003-09-30BondIssuedDt
Issue Price$17,200,000IssuePriceAmt
PurposeACQUISITION OF REAL ESTATEPurposeDesc
DefeasedfalseDefeasedInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Pool FinancingfalsePoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Refunding Tax Exempt BondsfalseRefundingTaxExemptBondsInd
Refunding Taxable BondsfalseRefundingTaxableBondsInd
Final Allocation MadeYes (true)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsfalseAnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropfalseMgmtContractBondFincdPropInd
Any Research AgreementsfalseAnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt TestfalseBondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed PropfalseChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdfalseProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetfalseRebateNotDueYetInd
Exception To RebatefalseExceptionToRebateInd
No Rebate DuefalseNoRebateDueInd
Variable Rate IssuefalseVariableRateIssueInd
Hedge Identified In Bks And RecfalseHedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (true)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionfalseProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePURPOSE OF ISSUE DESCRIPTIONFormAndLineReferenceDesc
ExplanationBONDS PAYABLE ACQUISITION OF REAL ESTATEExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 2, PART III, LINE 4APROVIDED A FULL SERVICE PHARMACY THROUGH A REGIONAL NETWORK OF PERSONAL CARE AND NURSING FACILITIES TO PATIENTS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED MEDICAL, HEALTH CARE AND RELATED SUPPLIES TO PERSONAL CARE AND NURSING FACILITIES FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED MEDICAL EQUIPMENT, GOODS, LINENS, UNIFORMS AND COMMODITIES TO PERSONAL CARE AND NURSING FACILITIES FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED HOME-HEALTH CARE FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED HOSPICE SERVICES AND HOME HEALTH SERVICES FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. CONSISTENT WITH THE POLICIES AND PROCEDURES PREVIOUSLY ADOPTED BY THE BOARD OF DIRECTORS OF COMMUNITY HEALTH SYSTEMS, INC., THE SECTION 509(A)(3) SUPPORTING ORGANIZATION AND PARENT ENTITY OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM OF WHICH THE ORGANIZATION IS A MEMBER, THE ORGANIZATION PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITIES IT SERVES PURSUANT TO BOTH COMMUNITY BENEFIT GUIDELINES AND A CHARITY CARE POLICY. THE ORGANIZATION CONTINUES TO ASSESS AND DEVELOP PROGRAMS TO BENEFIT THE COMMUNITY.
FORM 990, PAGE 6, PART VI, LINE 6THE ORGANIZATION HAS A SOLE MEMBER, COMMUNITY HEALTH SYSTEMS, INC., A NONPROFIT GEORGIA CORPORATION.
FORM 990, PAGE 6, PART VI, LINE 7AUNDER THE ORGANIZATION'S BYLAWS, WHILE IT IS THE SOLE MEMBER OF THE ORGANIZATION, COMMUNITY HEALTH SYSTEMS, INC., AS A TYPE I SECTION 509(A)(3) AND SECTION 501(C)(3) SUPPORTING ORGANIZATION, HAS THE SOLE RIGHT TO ELECT, REPLACE AND TO REMOVE THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS AND SHALL ENSURE THAT AT ALL TIMES, A MAJORITY OF THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS SHALL BE COMPOSED OF PERSONS WHO ARE CONCURRENTLY SERVING AS MEMBERS OF THE BOARD OF DIRECTORS OF COMMUNITY HEALTH SYSTEMS, INC.
FORM 990, PAGE 6, PART VI, LINE 11BTHE FORM 990 FOR COMMUNITY ANCILLARY SERVICES, INC. IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. UPON COMPLETION, THE INDEPENDENT ACCOUNTING FIRM PROVIDES A DRAFT OF THE FORM 990 TO THE AUDIT COMMITTEE OF THE ORGANIZATION FOR ITS REVIEW. ALLOWING ADEQUATE TIME FOR REVIEW, THE INDEPENDENT ACCOUNTING FIRM SUBSEQUENTLY MEETS WITH THE AUDIT COMMITTEE OF THE ORGANIZATION TO REVIEW AND DISCUSS THE DRAFT FORM 990. FOLLOWING THE AUDIT COMMITTEE'S REVIEW, DISCUSSION AND APPROVAL OF THE DRAFT FORM 990, THE AUDIT COMMITTEE THEN PROVIDES THE DRAFT FORM 990 TO THE ORGANIZATION'S BOARD OF DIRECTORS WITH A RECOMMENDATION TO REVIEW AND APPROVE THE FORM 990. SUBSEQUENT TO RECEIPT OF THE DRAFT FORM 990, A MEETING OF THE ORGANIZATION'S BOARD OF DIRECTORS IS HELD TO DISCUSS THE RECOMMENDATION FROM ITS AUDIT COMMITTEE AND TO ASK QUESTIONS OF THE INDEPENDENT ACCOUNTING FIRM AND THE ORGANIZATION'S MANAGEMENT. FOLLOWING REVIEW AND DISCUSSION, THE BOARD THEN APPROVES THE FORM 990 TO BE FILED WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PAGE 6, PART VI, LINE 12CCOMPLIANCE WITH THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY IS EFFECTUATED BY, AT A MINIMUM, THE BOARD OF DIRECTOR'S ANNUAL REVIEW OF CONFLICT DISCLOSURE STATEMENTS PROVIDED BY THE ORGANIZATION'S DIRECTORS AND OFFICERS. ALSO, THE ORGANIZATION'S BOARD OF DIRECTORS REVIEW CONFLICT DISCLOSURE STATEMENTS PRIOR TO TAKING ACTION ON PROPOSED TRANSACTIONS AND CONTRACTUAL ARRANGEMENTS. THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY PROVIDES THE PROCEDURE FOR WHICH INTERESTED PERSONS ARE EVALUATED TO DETERMINE IF A CONFLICT EXISTS. IF IT IS DETERMINED THAT A BOARD MEMBER HAS A CONFLICT OF INTEREST, THEN SUCH BOARD MEMBERS ARE NOT ALLOWED TO PARTICIPATE IN DELIBERATIONS ON THE SPECIFIC MATTER AND IS EXCUSED FROM, AND NOT ALLOWED TO PARTICIPATE IN, ANY BOARD VOTE ON THE MATTER.
FORM 990, PAGE 6, PART VI, LINE 15ATHE ORGANIZATION REGULARLY AND CONSISTENTLY COMPLIES WITH THE COMPENSATION APPROVAL PROCESS, AS DEFINED BY ITS CONFLICTS OF INTEREST POLICY, THROUGH A COMPREHENSIVE ENGAGEMENT CONDUCTED BY ITS COMPENSATION COMMITTEE. A THIRD-PARTY COMPENSATION CONSULTANT IS ENGAGED TO GATHER COMPARABILITY DATA FOR THE ORGANIZATION'S SENIOR MANAGEMENT AND ITS KEY OR HIGHLY COMPENSATED EMPLOYEES. FOLLOWING COMPLETION OF THE ENGAGEMENT, THE THIRD-PARTY CONSULTANT ISSUES A WRITTEN REPORT REFLECTING ITS OPINION CONCERNING WHETHER THE ORGANIZATION'S PROPOSED COMPENSATION ARRANGEMENTS CONSTITUTE REASONABLE COMPENSATION UNDER SECTION 4958 OF THE INTERNAL REVENUE CODE. UPON RECEIPT AND REVIEW OF THE CONSULTANT'S WRITTEN REPORT AND SUPPORTING MATERIALS, THE ORGANIZATION'S COMPENSATION COMMITTEE THEN PROVIDES ALL SUCH MATERIALS ALONG WITH RECOMMENDATIONS TO ITS BOARD OF DIRECTORS FOR CONSIDERATION. SUBSEQUENTLY, THE BOARD OF DIRECTORS HOLDS A MEETING TO REVIEW THE MATERIALS AND RECOMMENDATIONS FROM ITS COMPENSATION COMMITTEE AT WHICH TIME THE BOARD WILL VOTE ON THE REASONABLENESS OF COMPENSATION FOR EACH INDIVIDUAL INCLUDED IN THE COMPENSATION ENGAGEMENT. IF ANY DISQUALIFIED OR OTHERWISE CONFLICTED BOARD MEMBERS ARE PRESENT AT THE MEETING, THEY DO NOT PARTICIPATE IN THE DELIBERATIONS AND ARE EXCUSED FROM VOTING ON SUCH MATTERS. THE COMPENSATION APPROVAL PROCESS IS CARRIED OUT BY THE ORGANIZATION'S BOARD OF DIRECTORS IN A MANNER DESIGNED TO SATISFY ALL THREE OF THE REQUIREMENTS NECESSARY TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS WITH RESPECT TO COMPENSATION ARRANGEMENTS FOR DISQUALIFIED PERSONS UNDER SECTION 53.4958-6 OF THE INTERNAL REVENUE CODE. AS PART OF THE PROCESS, THE ORGANIZATION'S BOARD OF DIRECTORS RETAINS THIRD-PARTY LEGAL COUNSEL TO FURTHER ADVISE THE BOARD ON THE REBUTTABLE PRESUMPTION PROCESS AND TO PROVIDE THE BOARD WITH A LEGAL OPINION REGARDING THE SAME. THE FINAL STEP IN THE PROCESS IS PREPARATION OF DOCUMENTATION REQUIRED TO ESTABLISH THE REBUTTABLE PRESUMPTION UTILIZING THE REBUTTABLE PRESUMPTION CHECKLIST ISSUED BY THE INTERNAL REVENUE SERVICE.
FORM 990, PAGE 6, PART VI, LINE 15BTHE ORGANIZATION REGULARLY AND CONSISTENTLY COMPLIES WITH THE COMPENSATION APPROVAL PROCESS, AS DEFINED BY ITS CONFLICTS OF INTEREST POLICY, THROUGH A COMPREHENSIVE ENGAGEMENT CONDUCTED BY ITS COMPENSATION COMMITTEE. A THIRD-PARTY COMPENSATION CONSULTANT IS ENGAGED TO GATHER COMPARABILITY DATA FOR THE ORGANIZATION'S SENIOR MANAGEMENT AND ITS KEY OR HIGHLY COMPENSATED EMPLOYEES. FOLLOWING COMPLETION OF THE ENGAGEMENT, THE THIRD-PARTY CONSULTANT ISSUES A WRITTEN REPORT REFLECTING ITS OPINION CONCERNING WHETHER THE ORGANIZATION'S PROPOSED COMPENSATION ARRANGEMENTS CONSTITUTE REASONABLE COMPENSATION UNDER SECTION 4958 OF THE INTERNAL REVENUE CODE. UPON RECEIPT AND REVIEW OF THE CONSULTANT'S WRITTEN REPORT AND SUPPORTING MATERIALS, THE ORGANIZATION'S COMPENSATION COMMITTEE THEN PROVIDES ALL SUCH MATERIALS ALONG WITH RECOMMENDATIONS TO ITS BOARD OF DIRECTORS FOR CONSIDERATION. SUBSEQUENTLY, THE BOARD OF DIRECTORS HOLDS A MEETING TO REVIEW THE MATERIALS AND RECOMMENDATIONS FROM ITS COMPENSATION COMMITTEE AT WHICH TIME THE BOARD WILL VOTE ON THE REASONABLENESS OF COMPENSATION FOR EACH INDIVIDUAL INCLUDED IN THE COMPENSATION ENGAGEMENT. IF ANY DISQUALIFIED OR OTHERWISE CONFLICTED BOARD MEMBERS ARE PRESENT AT THE MEETING, THEY DO NOT PARTICIPATE IN THE DELIBERATIONS AND ARE EXCUSED FROM VOTING ON SUCH MATTERS. THE COMPENSATION APPROVAL PROCESS IS CARRIED OUT BY THE ORGANIZATION'S BOARD OF DIRECTORS IN A MANNER DESIGNED TO SATISFY ALL THREE OF THE REQUIREMENTS NECESSARY TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS WITH RESPECT TO COMPENSATION ARRANGEMENTS FOR DISQUALIFIED PERSONS UNDER SECTION 53.4958-6 OF THE INTERNAL REVENUE CODE. AS PART OF THE PROCESS, THE ORGANIZATION'S BOARD OF DIRECTORS RETAINS THIRD-PARTY LEGAL COUNSEL TO FURTHER ADVISE THE BOARD ON THE REBUTTABLE PRESUMPTION PROCESS AND TO PROVIDE THE BOARD WITH A LEGAL OPINION REGARDING THE SAME. THE FINAL STEP IN THE PROCESS IS PREPARATION OF DOCUMENTATION REQUIRED TO ESTABLISH THE REBUTTABLE PRESUMPTION UTILIZING THE REBUTTABLE PRESUMPTION CHECKLIST ISSUED BY THE INTERNAL REVENUE SERVICE.
FORM 990, PAGE 6, PART VI, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND ITS AUDITED FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC CONSUMPTION UPON REQUEST IN ACCORDANCE WITH THE INTERNAL REVENUE CODE SECTION 6104(D) DISCLOSURE REQUIREMENTS.
FORM 990, PART VIIIPART VIII, LINE 1E -- THE PROVIDER RELIEF FUND WAS ESTABLISHED THROUGH THE CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY ACT (CARES ACT)AND THE PAYCHECK PROTECTION PROGRAM AND HEALTHCARE ENHANCEMENT ACT (PPCHE). THIS LEGISLATION AUTHORIZED THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES TO MAKE GENERAL AND TARGETED DISTRIBUTIONS TO QUALIFYING HEALTHCARE PROVIDERS BASED ON THE VARIOUS FORMULAS AND CRITERIA DESIGNATED IN THE LEGISLATION. THE CORPORATION RECEIVED 1,053,358 UNDER THESE PROGRAMS FOR THE YEAR ENDED JUNE 30, 2020. OF THIS AMOUNT, THE CORPORATION UTILIZED FUNDS TOTALING 907,558 DURING THE YEAR ENDED JUNE 30, 2020. THIS AMOUNT IS INCLUDED ON LINE 1E ON THE FORM 990 STATEMENT OF REVENUE. THE CORPORATION HAS YET TO UTILIZE 145,800 OF THE STIMULUS AS OF JUNE 30, 2020. THIS AMOUNT IS REFLECTED AS UNEARNED INCOME UNDER OTHER LIABILITIES ON THE BALANCE SHEET.
FORM 990, PART XI, LINE 9DISTRIBUTION OF NET ASSETS -4,886,937

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
PSI LLC
440 INDUSTRIAL BOULEVARDHAWKINSVILLEGA31036432007496PHARMACYGA$48,320,414$7,641,452NA
HDI LLC
440 INDUSTRIAL BOULEVARDHAWKINSVILLEGA31036432007496SUPPLY DISGA$22,643,158$6,175,338NA
SOURCE CARE MANAGEMENT LLC
PO BOX 1803MACONGA31202582651175CASE MANAGGA$11,421,318$2,107,606NA
HELPLINK LLC
PO BOX 1803MACONGA31202141904766EMERGENCYGA$924,461$183,247NA
AFFINIS HOSPICE LLC
111 STONE BROOKE DRIVEGRAYGA31032271452535HOSPICEGA$26,590,361$5,275,655NA
AMICITA HOME HEALTH LLC
111 STONE BROOKE DRIVEGRAYGA31032271563270HOMEHEALTHGA$3,378,645$2,244,667NA

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CLINICAL SERVICES INC
1005 BOULDER DRIVEGRAYGA31032571157115CLINICAL &GA501C10CHSIfalse
COMMUNITY HEALTH FOUNDATION INC
111 STONE BROOKE DRIVEGRAYGA31032571157153FINANCIALGA501C10CHSIfalse
COMMUNITY HEALTH SYSTEMS INC
PO BOX 1037MACONGA31202743083593SUPPORT SEGA501C12ANAfalse
COMMUNITY REHABILITATION SERVICES
111 STONE BROOKE DRIVEGRAYGA31032203253779REHABILITAGA501C10CHSIfalse
HEALTH SCHOLARSHIPS INC
1005 BOULDER DRIVEGRAYGA31032581805305OPERATIONGA501C10CHSIfalse
HEALTH SYSTEMS FACILITIES INC
1005 BOULDER DRIVEGRAYGA31032743083594OPERATIONGA501C10CHSIfalse
HEALTH SYSTEMS REAL ESTATE INC
111 STONE BROOKE DRIVEGRAYGA31032432007488REGA501C10CHSIfalse
HOME & COMMUNITY SERVICES INC
111 STONE BROOKE DRIVEGRAYGA31032432007492TRANSGA501C10CHSIfalse
PIEDMONT REGIONAL HEALTH INC
1005 BOULDER DRIVEGRAYGA31032432007498OPERATIONGA501C10CHSIfalse
STEWARD HEALTH SERVICES INC
111 STONE BROOKE DRIVEGRAYGA31032432007486HOSPICEGA501C10CHSIfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
COMMUNITY HEALTH VENTURES INC
4875 RIVERSIDE DRIVE SUITE 105MACONGA31210201392241RISK MGMTGACHSIC CORPfalse
GEORGIA PHARMACY SERVICES INC
111 STONE BROOKE DRIVEGRAYGA31032200248574PHARMACYGAfalseN/A
HEALTH DISTRIBUTION SERVICES INC
111 STONE BROOKE DRIVEGRAYGA31032200248557SUPPLY DISGAfalseN/A
COMMUNITY CARE PHAR - HAWKINSVILLE
150 COMMERCE STREETHAWKINSVILLEGA31036320395216PHARMACYGAfalseN/A
COMMUNITY CARE PHARMACY-ROYSTON
635 COOK STREETROYSTONGA30662383931420PHARMACYGAfalseN/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (10 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
COMMUNITY HEALTH SYSTEMS INC
M$5,433,660
COMMUNITY HEALTH FOUNDATION INC
R$40,356
HEALTH SCHOLARSHIPS INC
L$15,862,675
HEALTH SYSTEMS FACILITIES INC
L$6,503,809
PIEDMONT REGIONAL HEALTH INC
L$1,772,557
HOME & COMMUNITY SERVICES INC
L$380,886
COMMUNITY HEALTLH SYSTEMS INC
K$159,000
HEATLH SCHOLARSHIPS INC
K$7,680,538
HEALTH SYSTEMS FACILITIES INC
M$2,678,000
PIEDMONT REGIONAL HEALTH INC
M$946,000