UPSON COUNTY HOSPITAL INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- UPSON COUNTY HOSPITAL INC (EIN 58-1734026)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-04
- IRS object ID
- 202003099349300630
- Schema version
- 2019v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-04T09:41:40-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 580914992 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRAFFIN & TUCKER LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71309 | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317081309 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581734026 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UPSON COUNTY HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UPSO | BusinessNameControlTxt |
| Phone | 7066478111 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 WEST GORDON STREET | AddressLine1Txt |
| City | THOMASTON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 302860027 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN WILLIAMS | PersonNm |
| Person Title | HOSPITAL CFO | PersonTitleTxt |
| Phone | 7066478111 | PhoneNum |
| Signature | 2020-11-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JACQUELINE G ATKINS | PreparerPersonNm |
| PTIN | P00861721 | PTIN |
| Phone | 2298837878 | PhoneNum |
| Preparation | 2020-11-04 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 208.73.87.26 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-11-04 | IPDt |
| IP Tm | 09:41:40 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | BCE9FDEBD4CA8CCF95D3BA2F4EBE0DF2FFF03695 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | BCE9FDEBD4CA8CCF95D3BA2F4EBE0DF2FFF03695 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UPSON REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JEFF TARRANT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 WEST GORDON ST | AddressLine1Txt |
| City | THOMASTON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30286 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $105,802,406 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.URMC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1951 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | UPSON REGIONAL MEDICAL CENTER'S MISSION IS TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE SURROUNDING AREA, REGARDLESS OF THE ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 885 | TotalEmployeeCnt |
| Total Volunteers | 64 | TotalVolunteersCnt |
| Total Gross UBI | $647,848 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,001,679 | PYContributionsGrantsAmt |
| CY Contributions Grants | $540,747 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $103,905,611 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $92,810,152 | CYProgramServiceRevenueAmt |
| PY Investment Income | $8,310,600 | PYInvestmentIncomeAmt |
| CY Investment Income | $6,763,370 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,826,293 | PYOtherRevenueAmt |
| CY Other Revenue | $589,809 | CYOtherRevenueAmt |
| PY Total Revenue | $115,044,183 | PYTotalRevenueAmt |
| CY Total Revenue | $100,704,078 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $75,286 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $18,745 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $44,559,918 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $49,536,674 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $65,588,078 | PYOtherExpensesAmt |
| CY Other Expenses | $43,857,688 | CYOtherExpensesAmt |
| PY Total Expenses | $110,223,282 | PYTotalExpensesAmt |
| CY Total Expenses | $93,413,107 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $4,820,901 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $7,290,971 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $174,885,089 | TotalAssetsBOYAmt |
| Total Assets EOY | $193,450,464 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $16,808,342 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $14,243,386 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $158,076,747 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $179,207,078 | NetAssetsOrFundBalancesEOYAmt |
| Mission | UPSON REGIONAL MEDICAL CENTER'S MISSION IS TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE SURROUNDING AREA, REGARDLESS OF THE ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $75,117,335 | ExpenseAmt |
| Grant | $18,745 | GrantAmt |
| Revenue | $92,541,379 | RevenueAmt |
| Desc | UPSON REGIONAL MEDICAL CENTER OFFERS A COMPLETE LINE OF MEDICAL SERVICES INCLUDING 24-HOUR EMERGENCY CENTER, MEDICAL-SURGICAL CARE, OBSTETRICS, PEDIATRICS, WOMEN'S HEALTH SERVICES, AND MORE. PATIENT DAYS FOR THE YEAR TOTALED 13,570 IN 2019. THE PSYCH UNIT SAW 3,998 VISITS WHILE THE RURAL HEALTH CLINIC EXPERIENCED 2,750 VISITS IN 2019. | Desc |
| Total Program Service Expenses | $75,117,335 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | Yes (true) | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 153 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 885 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | Yes (true) | ForeignFinancialAccountInd |
| Foreign Country | CJ | ForeignCountryCd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN WILLIAMS | PersonNm |
| Phone | 7066478111 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 WEST GORDON STREET | AddressLine1Txt |
| City | THOMASTON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 302860227 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|
| BRANDON M BOYCE MD | |||||||||
| ORTHOPEDIC S | 40.00 | Yes (X) | $1,149,402 | $0 | $39,913 | ||||
| ROBERT SOLYOMVARI MD | |||||||||
| SURGEON | 40.00 | Yes (X) | $599,106 | $0 | $39,913 | ||||
| DARRYL KNIGHT MD | |||||||||
| SURGEON | 40.00 | Yes (X) | $535,860 | $0 | $39,913 | ||||
| DANIEL A BRIDGES MD | |||||||||
| UROLOGY SURG | 40.00 | Yes (X) | $525,269 | $0 | $38,951 | ||||
| MARK DOROGY MD | |||||||||
| CARDIOLIGIST | 40.00 | Yes (X) | $441,870 | $0 | $38,951 | ||||
| JEFF TARRANT | |||||||||
| HOSPITAL CEO | 40.00 | $331,296 | $0 | $0 | 1.00 | Yes (X) | |||
| JOHN WILLIAMS | |||||||||
| HOSPITAL CFO | 40.00 | $281,842 | $0 | $15,861 | 1.00 | Yes (X) | |||
| DIANE BRADLEY | |||||||||
| HOSPITAL ICE | 40.00 | $203,954 | $0 | $0 | 1.00 | Yes (X) | |||
| TRIPP PENN | |||||||||
| HOSPITAL CEO | $120,912 | $0 | $0 | Yes (X) | |||||
| JIM EDWARDS | |||||||||
| VICE CHAIRMA | 0.75 | $0 | $0 | $0 | 0.20 | Yes (X) | Yes (X) | ||
| JONATHAN BUSBEE MD | |||||||||
| BOARD MEMBER | 0.75 | $0 | $0 | $0 | 0.20 | Yes (X) | |||
| KAY ROBINSON | |||||||||
| BOARD MEMBER | 0.75 | $0 | $0 | $0 | 0.20 | Yes (X) | |||
| KAY SEARCY | |||||||||
| BOARD MEMBER | 0.75 | $0 | $0 | $0 | 0.20 | Yes (X) | |||
| RALPH WARNOCK MD | |||||||||
| ASST SECRETA | 0.75 | $0 | $0 | $0 | 0.20 | Yes (X) | Yes (X) | ||
| SCOTT BLACKSTOCK | |||||||||
| BOARD MEMBER | 0.75 | $0 | $0 | $0 | 0.20 | Yes (X) | |||
| STEVE KEADLE | |||||||||
| BOARD MEMBER | 0.75 | $0 | $0 | $0 | 0.20 | Yes (X) | |||
| WILLIAM HIGHTOWER IV | |||||||||
| CHAIRMAN | 0.75 | $0 | $0 | $0 | 0.20 | Yes (X) | Yes (X) | ||
| BARNEY HANCOCK | |||||||||
| SECRETARY | 0.75 | $0 | $0 | $0 | 0.20 | Yes (X) | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,189,511 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $213,502 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 62 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (true) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| INNOVATIVE THERAPY CONCEPTS LLC | |||||
| 2 MASHBURN ST SUITE 102 | HAWKINSVILLE | GA | 31036 | PHYSICAL THER | $1,269,486 |
| SODEXO INC & AFFILIATES | |||||
| P O BOX 360170 | PITTSBURGH | PA | 15251 | FOOD SERVICE | $1,188,577 |
| CLOUDWAVE | |||||
| 8401 CHAGRIN RD SUITE 6B | CHAGRIN FALLS | OH | 44023 | REMOTE CLOUD | $984,127 |
| MEDICAL INFORMATION TECHNOLOGY INC | |||||
| MEDITECH CIRCLE | WESTWOOD | MA | 02090 | SOFTWARE & SVC | $753,198 |
| SALVEO INTEGRATIVE HEALTH | |||||
| 311 GWINNETT DRIVE | LAWRENCEVILLE | GA | 30046 | COUNSELING/MH | $733,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 27 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $75,953 | RelatedOrganizationsAmt |
| All Other Contributions | $464,794 | AllOtherContributionsAmt |
| Total Contributions | $540,747 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621990 | $92,162,304 | $92,162,304 | |
| WELLNESS CENTER | 713940 | $618,433 | $618,433 | |
| CATERING SALES | 722320 | $29,415 | $29,415 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $92,810,152 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,537,719 | TotalRevenueColumnAmt |
| Exclusion | $4,537,719 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,447 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,447 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,447 | TotalRevenueColumnAmt |
| Exclusion | $2,447 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,322,284 | SecuritiesAmt |
| Other | $1,695 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,098,328 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,223,956 | SecuritiesAmt |
| Other | $1,695 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,225,651 | TotalRevenueColumnAmt |
| Exclusion | $2,225,651 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| DISCOUNTS AND REBATES | 621990 | $280,170 | $280,170 | |
| COMPUTER FEE | 561499 | $208,287 | $208,287 | |
| MANAGEMENT FEES | 561499 | $59,067 | $59,067 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $39,838 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $39,838 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $587,362 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $100,704,078 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $92,541,379 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $647,848 | UnrelatedBusinessRevenueAmt |
| Exclusion | $6,974,104 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,745 | TotalAmt |
| Program Services | $18,745 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $832,952 | TotalAmt |
| Management And General | $832,952 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,912 | TotalAmt |
| Management And General | $120,912 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,714,274 | TotalAmt |
| Program Services | $32,974,440 | ProgramServicesAmt |
| Management And General | $5,739,834 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $571,613 | TotalAmt |
| Program Services | $475,353 | ProgramServicesAmt |
| Management And General | $96,260 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,590,699 | TotalAmt |
| Program Services | $5,480,825 | ProgramServicesAmt |
| Management And General | $1,109,874 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,706,224 | TotalAmt |
| Program Services | $2,250,496 | ProgramServicesAmt |
| Management And General | $455,728 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $528,493 | TotalAmt |
| Program Services | $71,487 | ProgramServicesAmt |
| Management And General | $457,006 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $402,832 | TotalAmt |
| Management And General | $402,832 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,000 | TotalAmt |
| Management And General | $125,000 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,181 | TotalAmt |
| Management And General | $60,181 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,245,176 | TotalAmt |
| Program Services | $8,207,881 | ProgramServicesAmt |
| Management And General | $3,037,295 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $184,964 | TotalAmt |
| Program Services | $2,186 | ProgramServicesAmt |
| Management And General | $182,778 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,152,850 | TotalAmt |
| Program Services | $1,474,919 | ProgramServicesAmt |
| Management And General | $677,931 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,636,637 | TotalAmt |
| Program Services | $612,057 | ProgramServicesAmt |
| Management And General | $2,024,580 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,332,645 | TotalAmt |
| Program Services | $2,095,182 | ProgramServicesAmt |
| Management And General | $237,463 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $223,338 | TotalAmt |
| Program Services | $118,387 | ProgramServicesAmt |
| Management And General | $104,951 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,557 | TotalAmt |
| Management And General | $6,557 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,599,967 | TotalAmt |
| Program Services | $6,826,290 | ProgramServicesAmt |
| Management And General | $773,677 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $397,415 | TotalAmt |
| Program Services | $365,642 | ProgramServicesAmt |
| Management And General | $31,773 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $11,665,583 | $11,665,583 | |
| REPAIRS & MAINTENANCE | $2,404,827 | $1,398,292 | $1,006,535 |
| PROVIDER FEES | $972,024 | $972,024 | |
| RECRUITMENT | $482,452 | $482,452 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $436,747 | TotalAmt |
| Program Services | $107,546 | ProgramServicesAmt |
| Management And General | $329,201 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,413,107 | TotalAmt |
| Program Services | $75,117,335 | ProgramServicesAmt |
| Management And General | $18,295,772 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $6,339 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,742,967 | BOYAmt |
| EOY | $2,500,870 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,396,982 | BOYAmt |
| EOY | $13,991,608 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $325,083 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,967,656 | BOYAmt |
| EOY | $1,867,441 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,153,329 | BOYAmt |
| EOY | $1,605,777 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $143,019,388 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $86,699,016 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,362,720 | BOYAmt |
| EOY | $56,320,372 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,584,288 | BOYAmt |
| EOY | $114,606,592 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,639,203 | BOYAmt |
| EOY | $1,639,203 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,944 | BOYAmt |
| EOY | $587,179 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $174,885,089 | BOYAmt |
| EOY | $193,450,464 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,581,351 | BOYAmt |
| EOY | $6,572,722 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $29,542 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,205,000 | BOYAmt |
| EOY | $5,270,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,105,815 | BOYAmt |
| EOY | $2,070,959 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $916,176 | BOYAmt |
| EOY | $300,163 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,808,342 | BOYAmt |
| EOY | $14,243,386 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $158,076,747 | BOYAmt |
| EOY | $179,207,078 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $158,076,747 | BOYAmt |
| EOY | $179,207,078 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $174,885,089 | BOYAmt |
| EOY | $193,450,464 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $7,290,971 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $13,839,360 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $23,797 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $23,797 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAYS ANNUAL DUES TO NATIONAL AND STATE INDUSTRY ORGANIZATIONS. A PORTION OF THOSE DUES ARE ATTRIBUTABLE TO THE LOBBYING ACTIVITIES OF THESE ORGANIZATIONS FOR THE BENEFIT OF THEIR MEMBERS. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,922,813 | OtherCostOrOtherBasisAmt |
| Book Value | $1,922,813 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $70,841,530 | OtherCostOrOtherBasisAmt |
| Depreciation | $39,371,207 | DepreciationAmt |
| Book Value | $31,470,323 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $896,431 | OtherCostOrOtherBasisAmt |
| Depreciation | $757,172 | DepreciationAmt |
| Book Value | $139,259 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $68,483,488 | OtherCostOrOtherBasisAmt |
| Depreciation | $46,570,637 | DepreciationAmt |
| Book Value | $21,912,851 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $875,126 | OtherCostOrOtherBasisAmt |
| Book Value | $875,126 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $56,320,372 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED THIRD PARTY SETTLEMENTS | $306,640 |
| DUE TO RELATED PARTIES | -$6,477 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $300,163 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL AND FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AND ARE TAX- EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE SEGREGATED PORTFOLIO INTENDS TO CONDUCT ITS AFFAIRS IN A MANNER IN WHICH IT WILL NOT BE SUBJECT TO U.S. FEDERAL INCOME TAX OR GEORGIA INCOME TAX. THE REMAINING WHOLLY OWNED SUBSIDIARIES ARE CONSIDERED DISREGARDED ENTITIES AND ARE INCLUDED IN THE HOSPITAL'S TAX FILINGS. THEREFORE, NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL AND FOUNDATION APPLY ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE HOSPITAL AND FOUNDATION ONLY RECOGNIZE THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF DECEMBER 31, 2019 AND 2018 OR FOR THE YEARS THEN ENDED. THE HOSPITAL AND FOUNDATION'S TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAXING AUTHORITIES. FOR FEDERAL INCOME TAX PURPOSES, THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. | ExplanationTxt |
Schedule F IRS990ScheduleF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintainedInd |
Account Activities Outside US AccountActivitiesOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | CENTRAL AMERICA & THE CARIBBEAN | RegionTxt |
| Offices | 1 | OfficesCnt |
| Type Of Activities Conducted | INVESTMENTS | TypeOfActivitiesConductedTxt |
| Region Total Expenditures | $3,360,789 | RegionTotalExpendituresAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 1 | SubtotalOfficesCnt |
| Total Office | 1 | TotalOfficeCnt |
| Subtotal Spent | $3,360,789 | SubtotalSpentAmt |
| Total Spent | $3,360,789 | TotalSpentAmt |
| Transfer To Foreign Corp | false | TransferToForeignCorpInd |
| Interest In Foreign Trust | false | InterestInForeignTrustInd |
| Foreign Corp Ownership | Yes (true) | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | false | PassiveForeignInvestmestCoInd |
| Foreign Partnership | false | ForeignPartnershipInd |
| Boycott Countries | false | BoycottCountriesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE F, PAGE 1, PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | CENTRAL AMERICA & THE CARIBBEAN 0 3,360,789 | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 1.250000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,939,334 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,939,334 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06360 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,617,348 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,295,757 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,321,591 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04630 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,556,682 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,295,757 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,260,925 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10980 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,056 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,056 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $138,818 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $138,818 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,895,502 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,358,277 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,537,225 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11280 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,916 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $13,916 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,057,292 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,358,277 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,699,015 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11450 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $42,613,974 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,654,034 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $20,959,940 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.22440 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,000 | NetCommunityBenefitExpnsAmt |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $433,020 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $433,020 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00460 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $436,020 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $436,020 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00470 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $15,859,007 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $7,929,504 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $18,735,552 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $16,754,017 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $1,981,535 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UPSON COUNTY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 WEST GORDON STREET | AddressLine1Txt |
| City | THOMASTON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30286 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.URMC.ORG | WebsiteAddressTxt |
| State License | 145-415 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | WELLNESS CTR, PHYS OFC, PSYCH | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UPSON COUNTY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.URMC.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.URMC.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 125.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.URMC.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.URMC.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.URMC.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, UPSON COUNTY HOSPITAL - PART V, LINE 3E | THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IS IDENTIFIED AND THE METHODOLOGY FOR PRIORITIZING EACH NEED IS DESCRIBED ON PAGE 35 OF THE 2018 CHNA. |
| FACILITY 1, UPSON COUNTY HOSPITAL - PART V, LINE 5 | UPSON SELECTED A GEOGRAPHIC SERVICE AREA DEFINITION. THIS DEFINITION WAS BASED UPON THE HOSPITALS PRIMARY SERVICE AREA IN A MANNER THAT INCLUDED THE BROAD INTERESTS OF THE COMMUNITY SERVED AND INCLUDED MEDICALLY UNDERSERVED POPULATIONS, LOW-INCOME PERSONS, MINORITY GROUPS, OR THOSE WITH CHRONIC DISEASE NEEDS. UPSON COUNTY WAS SELECTED AS THE COMMUNITY FOR INCLUSION IN THE CHNA. UPSON IDENTIFIED COMMUNITY LEADERS, PARTNERS, AND REPRESENTATIVES TO INCLUDE IN THE CHNA PROCESS. INDIVIDUALS, AGENCIES, PARTNERS, POTENTIAL PARTNERS, AND OTHERS WERE REQUESTED TO WORK WITH THE HOSPITAL TO 1) ASSESS THE NEEDS OF THE COMMUNITY, 2) REVIEW AVAILABLE COMMUNITY RESOURCES AND 3) PRIORITIZE THE HEALTH NEEDS OF THE COMMUNITY. GROUPS OR INDIVIDUALS, WHO REPRESENT MEDICALLY-UNDERSERVED POPULATIONS, LOW INCOME POPULATIONS, MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASES WERE INCLUDED. COMMUNITY STAKEHOLDERS (ALSO CALLED KEY INFORMANTS) ARE PEOPLE INVESTED OR INTERESTED IN THE WORK OF THE HOSPITAL, PEOPLE WHO HAVE SPECIAL KNOWLEDGE OF HEALTH ISSUES, PEOPLE IMPORTANT TO THE SUCCESS OF ANY HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT OR HEALTH PROJECT, OR ARE FORMAL OR INFORMAL COMMUNITY LEADERS. THE HOSPITAL IDENTIFIED 19 COMMUNITY MEMBERS TO PARTICIPATE IN THE STAKEHOLDER INTERVIEWS. |
| FACILITY 1, UPSON COUNTY HOSPITAL - PART V, LINE 7D | A COPY IS AVAILABLE THROUGH THE ORGANIZATION'S FACEBOOK PAGE. |
| FACILITY 1, UPSON COUNTY HOSPITAL - PART V, LINE 11 | INFORMATION GATHERED FROM COMMUNITY-WIDE SURVEYS, STAKEHOLDER INTERVIEWS, DISCUSSIONS WITH THE HOSPITAL LEADERSHIP TEAM, REVIEW OF DEMOGRAPHIC AND HEALTH STATUS DATA, AND HOSPITAL UTILIZATION DATA WAS USED TO DETERMINE THE PRIORITY HEALTH NEEDS OF THE POPULATION. URMC PROVIDED A WRITTEN REPORT OF THE OBSERVATIONS, COMMENTS, AND PRIORITIES RESULTING FROM THE STAKEHOLDER INTERVIEWS. THE LEADERSHIP TEAM REVIEWED THIS INFORMATION, FOCUSING ON THE IDENTIFIED NEEDS, PRIORITIES, AND CURRENT COMMUNITY RESOURCES AVAILABLE. LEADERSHIP DEBATED THE MERITS AND VALUES OF THESE PRIORITIES, AND CONSIDERED THE RESOURCES AVAILABLE TO MEET THESE NEEDS. FROM THIS INFORMATION AND DISCUSSIONS, THE HOSPITAL DEVELOPED THE PRIORITY NEEDS OF THE COMMUNITY, EACH OF WHICH ARE ADDRESSED SEPARATELY IN THE HOSPITALS IMPLEMENTATION STRATEGY DOCUMENT. BOTH THE 2018 CHNA AND 2019 IMPLMENTATION STRATEGY DOCUMENTS ARE LOCATED AT THE FOLLOWING WEB ADDRESS: HTTPS://URMC.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT |
| FACILITY 1, UPSON COUNTY HOSPITAL - PART V, LINE 15E | INFORMATION IS MAILED TO ALL PATIENTS ON EACH STATEMENT AS LONG AS A BALANCE IS OUTSTANDING. IT IS AVAILABLE ON THE HOSPITAL WEBSITE AND AT ANY ENTRANCE POINT OF THE HOSPITAL. |
| FACILITY 1, UPSON COUNTY HOSPITAL - PART V, LINE 20E | ECA WILL NOT BEGIN UNTIL AFTER 240 DAYS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 8 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| UPSON MEDICAL ASSOCIATES LLC | ||||
| 801 W GORDON ST | THOMASTON | GA | 30286 | PHYSICIANS OFFICE |
| UPSON REGIONAL WELLNESS CENTER LLC | ||||
| 801 W GORDON ST | THOMASTON | GA | 30286 | WELLNESS CENTER |
| ORTHOPEDICS SPORTS MEDICINE & SURG | ||||
| 801 W GORDON ST | THOMASTON | GA | 30286 | PHYSICIANS OFFICE |
| UPSON WOMEN'S SERVICES LLC | ||||
| 801 W GORDON ST | THOMASTON | GA | 30286 | PHYSICIANS OFFICE |
| UPSON FAMILY PHYSICIANS LLC | ||||
| 801 W GORDON ST | THOMASTON | GA | 30286 | PHYSICIANS OFFICE |
| UPSON SURGICAL ASSOCIATES LLC | ||||
| 801 W GORDON ST | THOMASTON | GA | 30286 | PHYSICIANS OFFICE |
| UPSON FAMILY MEDICAL CENTER | ||||
| 801 W GORDON ST | THOMASTON | GA | 30286 | FAMILY MEDICAL CENTER |
| URMC PSYCH UNIT | ||||
| 801 W GORDON ST | THOMASTON | GA | 30286 | PSYCHIATRIC UNIT |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7G | SUBSIDIZED HEALTH SERVICE COSTS INCLUDE THOSE ATTRIBUTABLE TO UPSON MEDICAL ASSOCIATES, UPSON WOMEN'S SERVICES, UPSON SURGICAL ASSOCIATES, ORTHOPEDIC SPORTS MEDICINE, AND UPSON FAMILY PHYSICIANS TOTALING 19,895,502. THESE CLINICS PROMOTE HEALTH CARE FOR UNDERSERVED POPULATIONS IN THE AREA. |
| SCHEDULE H, PART I, LINE 7 | THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATION'S "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS, 2008". FOR LINE 7A, COSTS WERE CALCULATED USING THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 AS PROVIDED IN THE IRS INSTRUCTIONS. SUBSIDIZED HEALTH SERVICES PRESENTED ON LINE 7G WERE BASED ON ACTUAL COSTS PER THE MEDICARE COST REPORT NET OF ASSOCIATED BAD DEBT, CHARITY AND MEDICAID EXPENSE. ALL OTHER COSTS PRESENTED IN THE TABLE WERE ACCUMULATED THROUGH THE COMMUNITY BENEFITS SOFTWARE CBISA. |
| SCHEDULE H, PART II | HEALTH PROFESSIONALS RECRUITMENT AND STAFF MEMBER APPOINTED BY CITY MAYOR TO REPRESENT THOMASTON AND HEALTHCARE WORKFORCE NEEDS ON THE THREE RIVERS WORKFORCE INVESTMENT BOARD FOR REGION 4. |
| SCHEDULE H, PART III, LINE 2 | BAD DEBT EXPENSE AMOUNT REPRESENTS THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT AND WRITTEN OFF TO BAD DEBT EXPENSE. |
| SCHEDULE H, PART III, LINE 3 | THE FIGURE ON PART III LINE 3 REPRESENTS MANAGEMENT'S ESTIMATE (APPROXIMATELY 50%) BASED ON AN ANALYSIS OF SELF PAY PATIENTS' ABILITY TO PAY THEIR OUTSTANDING ACCOUNT. THIS ANALYSIS INCLUDES REVIEWING THE PATIENT'S CREDIT HISTORY, INCOME LEVELS AND OVERALL COLLECTIBILITY OF THE ACCOUNT. |
| SCHEDULE H, PART III, LINE 4 | THE FOOTNOTE DISCUSSING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND BAD DEBTS (IMPLICIT PRICE CONCESSIONS) CAN BE FOUND ON PAGES 12-14 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. |
| SCHEDULE H, PART III, LINE 8 | MEDICARE COSTS REFLECT ALLOWABLE COSTS PER THE MEDICARE COST REPORT USING ACCEPTABLE ALLOCATIONS OF INDIRECT COSTS BASED ON APPROPRIATE STATISTICS. |
| SCHEDULE H, PART III, LINE 9B | ACCOUNTS KNOWN TO HAVE QUALIFIED FOR FINANCIAL ASSISTANCE ARE WRITTEN OFF TO INDIGENT/CHARITY CARE. |
| SCHEDULE H, PART VI, LINE 2 | UPSON REGIONAL MEDICAL CENTER (URMC) IS A 115-BED NOT-FOR-PROFIT COMMUNITY HOSPITAL LOCATED IN THOMASTON. GEORGIA. URMC CONDUCTS TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) TO IDENTIFY THE HEALTH NEEDS OF UPSON COUNTY. THE IMPLEMENTATION STRATEGY FOR URMC WAS DEVELOPED BASED ON FINDINGS AND PRIORITIES ESTABLISHED IN THE CHNA AND A REVIEW OF THE HOSPITAL'S EXISTING COMMUNITY BENEFIT ACTIVITIES. URMC SUSTAINS AND DEVELOPS COMMUNITY BENEFIT PROGRAMS THAT L)ADDRESS PRIORITIZED NEEDS FROM THE URMC CHNA AND 2)RESPOND TO OTHER IDENTIFIED COMMUNITY HEALTH NEEDS. THE FOLLOWING PRIORITIZED NEEDS WERE IDENTIFIED BY THE COMMUNITY AND THE CHNA STEERING COMMITTEE. PARTICULAR FOCUS WAS PLACED UPON THESE NEEDS IN DEVELOPING THE IMPLEMENTATION STRATEGY. 1. POVERTY/JOBS 2. ACCESS TO CARE/OBESITY/EDUCATION 3. CHILD HEALTH 4. MENTAL HEALTH 5. CHRONIC DISEASES 6. SUBSTANCE ABUSE |
| SCHEDULE H, PART VI, LINE 3 | URMC INFORMS AND EDUCATES THE PATIENTS USING THE FOLLOWING PROCESSES: THE FINANCIAL ASSISTANCE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IS POSTED IN THE ADMISSION AREAS, EMERGENCY DEPARTMENTS AND OTHER AREAS OF THE FACILITY IN WHICH ELIGIBLE PATIENTS ARE PRESENT. A COPY OF THE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IS PROVIDED TO THE PATIENTS AS PART OF THE ADMISSION PROCESS. ADDITIONALLY, THE POLICY IS AVAILABLE ON THE HOSPITAL WEBSITE AS IS THE PRINTABLE APPLICATION. A SUMMARY OF THE POLICY IS ALSO INCLUDED IN THE PATIENT BILLING. WE DISCUSS WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS QUALIFYING FOR MEDICAID OR STATE PROGRAMS AND ASSIST THE PATIENT WITH QUALIFYING FOR SUCH PROGRAMS, WHERE APPLICABLE. WE PROVIDE TRAINING TO THE STAFF ON FINANCIAL ASSISTANCE AND CONTRACT WITH CHAMBERLON & EDMONDS FOR SCREENING OUR PATIENTS FOR MEDICAID ELIGIBILITY AND/OR OTHER SOURCES OF ASSISTANCE. WE ALSO PROVIDE INFORMATION ON THE ADMISSIONS PACKAGE EXPLAINING THE AVAILABILITY, CRITERIA, AND THE PROCESS FOR APPLYING FOR FINANCIAL ASSISTANCE. OUR EFFORTS TO INFORM NON-ENGLISH SPEAKING PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY IS PROVIDED BY AN INTERPRETER THROUGH THE USE OF LANGUAGE LINE, A TELEPHONE INTERPRETATION SERVICE. |
| SCHEDULE H, PART VI, LINE 4 | UPSON COUNTY IS LOCATED IN WEST CENTRAL GEORGIA AND HAS A POPULATION OF 26,197 AS OF 2019. THE POPULATION OF UPSON COUNTY IS EXPECTED TO DECREASE 0.32% FROM 2017 TO 2022. THE RACIAL AND ETHNIC MAKEUP OF UPSON COUNTY IS 68% CAUCASION, 28% BLACK, 1% MIXED RACE, 2% OTHER, AND 2% HISPANIC ORIGIN. THE PERCENTAGE OF RESIDENTS AGED 55 AND OLDER IS SET TO INCREASE 0.6% BY 2022; THIS IDENTIFIED AN INCREASED NEED FOR DELIVERY OF HEALTHCARE THAT SERVES INDIVIDUALS WITH CHRONIC CONDITIONS. URMC, A REGIONAL HEALTHCARE PROVIDER WITH 115 ACUTE CARE BEDS, SERVES THIS AREA OF GEORGIA. THE HOSPITAL IS LOCATED IN THE COUNTY SEAT OF THOMASTON. |
| SCHEDULE H, PART VI, LINE 5 | SINCE 2015, URMC HAS RECRUITED FAMILY PHYSICIANS, A CARDIOLOGIST, UROLOGIST, OBSTETRICIAN, AUDIOLOGIST, ENT, FAMILY PRACTICE, ORTHOPEDIC SURGEON, AND ADVANCED PRACTICE PROFESSIONALS. URMC'S AWARD-WINNING DIETICIANS IMPLEMENT THE QUARTERLY SODEXO COMMUNITY EDUCATION PROGRAMMING AND ACTIVELY PARTICIPATE IN COMMUNITY EVENTS, HEALTH FAIRS, AND AT THE WELLNESS CENTER TO INCREASE AWARENESS OF GOOD EATING HABITS AND THEIR IMPACT ON HEALTH. URMC ALSO PROVIDES MONTHLY DIABETES EDUCATION ON DISEASE MANAGEMENT AND NUTRITION. IN 2017, URMC WAS DESIGNATED AS A REMOTE STROKE TREATMENT CENTER, PROVIDING TIMELY CONSULTS WITH NEUROLOGISTS. URMC CONSISTENTLY OFFERS BLOOD PRESSURE CHECKS AND EDUCATION AT COMMUNITY EVENTS AND HEALTH FAIRS. IN 2017, URMC OPENED SILVERCARE, AN 18-BED INPATIENT GERIATRIC BEHAVIORAL HEALTH UNIT. IN 2018, URMC OPENED A RURAL HEALTH CLINIC AS WELL AS PURCHASING AN URGENT CARE FACILITY TO IMPROVE ACCESS TO CARE. IN EARLY 2019, URMC RECRUITED A NEW CARDIOLOGIST AS WELL AS A NEW FAMILY MEDICINE PROVIDER. IN LATE 2019, URMC ADDED TWO NEW FAMILY MEDICINE PHYSICIANS, A NEW OB/GYN, A NEW OTHROPEDIC SURGEON, AND A NEW ENT. WE ALSO ADDED SATURDAY HOURS AT ONE OF OUR WALK-IN PRIMARY CARE CLINICS. THE GOVERNING BODY IS PRIMARILY COMPRISED OF PERSONS WHO ARE NOT EMPLOYEES, CONTRACTORS (NOR FAMILY MEMBERS THEREOF), AND GENERALLY REPRESENT THE INTERESTS OF THE POPULATION SERVED. THE MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS IN THE REGION. THE EMERGENCY ROOM IS OPEN 24/7, SERVING PATIENTS REGARDLESS OF ABILITY TO PAY. AS A NONPROFIT ORGANIZATION DEDICATED TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES, URMC REINVESTS ALL OF ITS SURPLUS FUNDS FROM ITS OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE ACCESS TO CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS AND ADVANCE MEDICAL TRAINING, EDUCATION AND RESEARCH. |
| SCHEDULE H, PART VI, LINE 7 | GEORGIA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| EDUCATION SCHOLARSHIP | 2 | $6,565 |
| TUITION REIMBURSEMENT | 5 | $12,180 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | SCHOLARSHIP ASSISTANCE IS OFFERED TO UPSON COUNTY RESIDENTS AND FULL TIME, PART TIME AND PRN EMPLOYEES PURSUING A HEALTHCARE CAREER. EACH APPLICANT MUST COMPLETE AN APPLICATION; BE ACCEPTED BY AN ACCREDITED SCHOOL IN A HEALTHCARE PROGRAM OF THEIR CHOICE; SUBMIT TWO LETTERS OF RECOMMENDATION, A CERTIFIED COPY OF PREVIOUS EDUCATIONAL TRANSCRIPTS, AND A LETTER OF ACCEPTANCE IN THE HEALTHCARE CAREER PROGRAM, OBTAIN APPROVAL FROM THE DEPARTMENT DIRECTOR OR SENIOR MANAGEMENT, BE INTERVIEWED BY CHIEF NURSING OFFICER, MAINTAIN A 3.0 CUMULATIVE AVERAGE, SUBMIT TRANSCRIPTS OF GRADES EVERY SCHOOL TERM, AND SERVE AS AN EMPLOYEE A MINIMUM OF ONE YEAR FOR EACH SCHOOL YEAR FOR WHICH SCHOLARSHIP MONIES WERE GRANTED. TRANSCRIPTS OF GRADES MUST BE RECEIVED BEFORE REIMBURSEMENT. SHOULD THE STUDENT NOT SEEK AND MAINTAIN EMPLOYMENT WITH URMC AFTER GRADUATION, FUNDS WILL BECOME DUE AND PAYABLE IN A PRORATA FASHION BASED ON EMPLOYMENT TERM. TUITION REIMBURSEMENT IS AWARDED FULLTIME AND REGULARLY SCHEDULED PART TIME EMPLOYEES. MONIES ARE GRANTED TO COVER TUITION, BOOKS AND LABORATORY FEES. EACH APPLICANT MUST BE ENROLLED IN AN ACCREDITED COLLEGE/UNIVERSITY WITHIN A PROGRAM DIRECTLY RELATED TO THE EMPLOYEE'S PRESENT POSITION OR A FIELD THAT WILL BE OF BENEFIT TO THE MEDICAL CENTER, SEEK APPROVAL FROM MANAGEMENT, FURNISH A TRANSCRIPT OF GRADES, MAINTAIN A "C- OR HIGHER GRADE AVERAGE. TO BE REIMBURSED, AN EMPLOYEE MUST PRESENT A CERTIFIED COPY OF THE GRADE REPORT WITH AN AVERAGE OF "C- OR HIGHER. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|
| BRANDON M BOYCE MD | ||||||
| ORTHOPEDIC SURGEON | $637,862 | $464,790 | $46,750 | $5,500 | $34,413 | $1,189,315 |
| ROBERT SOLYOMVARI MD | ||||||
| SURGEON | $365,243 | $146,749 | $87,114 | $5,500 | $34,413 | $639,019 |
| DARRYL KNIGHT MD | ||||||
| SURGEON | $339,919 | $164,591 | $31,350 | $5,500 | $34,413 | $575,773 |
| DANIEL A BRIDGES MD | ||||||
| UROLOGY SURGEON | $488,766 | $21,303 | $15,200 | $5,500 | $33,451 | $564,220 |
| MARK DOROGY MD | ||||||
| CARDIOLIGIST | $314,450 | $115,328 | $12,092 | $5,500 | $33,451 | $480,821 |
| JEFF TARRANT | ||||||
| HOSPITAL CEO/PRES | $331,296 | $331,296 | ||||
| JOHN WILLIAMS | ||||||
| HOSPITAL CFO | $281,842 | $5,500 | $10,361 | $297,703 | ||
| DIANE BRADLEY | ||||||
| HOSPITAL ICEO/PRES | $203,954 | $203,954 | ||||
| TRIPP PENN | ||||||
| HOSPITAL CEO/PRES | $120,912 | $120,912 | ||||
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 1A | THE INTERIM CHIEF EXECUTIVE OFFICER WAS PROVIDED TEMPORARY HOUSING AS PART OF THE CONTRACT TERMS OF EMPLOYMENT. |
| SCHEDULE J, PAGE 1, PART I, LINE 4 | TRIPP PENN 120,912 0 0 |
| SCHEDULE J, PART III | MANAGEMENT SERVICES: THE ORGANIZATION'S CEO IS CONTRACTUALLY PROVIDED BY HEALTHTECH MANAGEMENT, AN UNRELATED FIRM HIRED TO PROVIDE CEO SERVICES. HEALTHTECH WAS PAID A TOTAL OF 295,000 IN 2019 FOR THESE SERVICES. DURING THE YEAR, JEFF TARRANT AND DIANE BRADLEY WERE COMPENSATED 321,296 AND 203,954, RESPECTIVELY FOR THEIR CEO SERVICES PROVIDED TO THE FOUNDATION AND URMC. BONUSES/AWARDS PHYSICIAN BONUSES ARE PAID BASED ON RELATIVE VALUE UNITS (RVUS) ACHIEVED DURING A SPECIFIED TIME PERIOD. EACH PHYSICIAN'S EMPLOYMENT CONTRACT INCLUDES A RVU GOAL. THE PHYSICIAN IS PAID BONUSES BASED ON MEETING OR EXCEEDING THE GOAL AS DETERMINED BY THEIR CONTRACT. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| HOSPITAL AUTHORITY OF UPSON COUNTY | |||||||
| A | 586002427 | 2004-12-31 | $10,000,000 | RENOVATION AND EXPANSION OF HOSPITAL | false | Yes (true) | false |
| HOSPITAL AUTHORITY OF UPSON COUNTY | |||||||
| B | 586002427 | 2005-01-20 | $6,000,000 | RENOVATION & EXPANSION OF HOSPITAL | false | Yes (true) | false |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|
| A | $6,710,000 | $10,000,000 | $124,175 | $9,875,825 | 2007 | false | false | Yes (true) | Yes (true) |
| B | $4,020,000 | $6,000,000 | $79,846 | $5,920,154 | 2007 | false | false | Yes (true) | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | false | false | false | false | false | false | Yes (true) |
| B | false | false | false | false | false | false | Yes (true) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | false | false | false | Yes (true) | false | false | false | false | false |
| B | false | false | false | Yes (true) | false | false | false | false | false |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | false |
| B | false |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PURPOSE OF ISSUE DESCRIPTION | HOSPITAL AUTHORITY OF UPSON COUNTY RENOVATION AND EXPANSION OF HOSPITAL |
| PURPOSE OF ISSUE DESCRIPTION | HOSPITAL AUTHORITY OF UPSON COUNTY RENOVATION & EXPANSION OF HOSPITAL |
| DATE REBATE COMPUTATION PERFORMED | HOSPITAL AUTHORITY OF UPSON COUNTY 12/30/09 |
| DATE REBATE COMPUTATION PERFORMED | HOSPITAL AUTHORITY OF UPSON COUNTY 01/20/10 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHANIE DAVIS | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FAMILY-BD MBR | RelationshipDescriptionTxt |
| Transaction | $67,332 | TransactionAmt |
| Transaction | EMPLOYEE WAGES | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V | FormAndLineReferenceDesc |
| Explanation | STEPHANIE DAVIS IS A FAMILY MEMBER OF AN ACTIVE MEMBER OF THE HOSPITAL BOARD. MS. DAVIS IS EMPLOYED AND COMPENSATED BY THE HOSPITAL. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 4B | CAYMAN ISLANDS |
| FORM 990, PAGE 6, PART VI, LINE 3 | THE ORGANIZATION ENGAGED HEALTHTECH MANAGEMENT TO PROVIDE THE SERVICES OF AN INTERIM CEO. HEALTHTECH WAS COMPENSATED 295,000 FOR THESE SERVICES. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE ORGANIZATION POSTS THE FORM 990 ON A SECURE WEBSITE FOR BOARD MEMBERS ONLY AND EACH CURRENT VOTING BOARD MEMBER IS ALERTED BY EMAIL AS TO ITS AVAILABILITY. THE CFO PERFORMS A DETAILED REVIEW PRIOR TO FILING WITH THE IRS. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE POLICY COVERS ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. SHOULD A MATTER COME BEFORE THE BOARD OF DIRECTORS WHICH CONSTITUTES A CONFLICT OF INTEREST, THE INDIVIDUAL INVOLVED WILL MAKE KNOWN THE POTENTIAL CONFLICT AND WITHDRAW FROM THE MEETING SO LONG AS THE MATTER SHALL CONTINUE UNDER DISCUSSION AND SHALL NOT EITHER VOTE ON THE MATTER UNDER DISCUSSION OR ATTEMPT TO INFLUENCE A DECISION OF THE GOVERNING AUTHORITY WITH RESPECT TO SUCH MATTERS, UPON WHICH THERE COULD POSSIBLY BE A CONFLICT OF INTEREST. |
| FORM 990, PAGE 6, PART VI, LINE 15A | IN DETERMINING COMPENSATION FOR TOP OFFICIALS, HUMAN RESOURCES OBTAINS THE COMPARABLE SALARY SURVEY AND PRESENTS IT TO THE BOARD OF DIRECTORS WHO MAKE A FINAL DECISION. THE CEO IS NOT PRESENT DURING THE DISCUSSION AND DECISION-MAKING PROCESS. DELIBERATIONS AND DECISIONS ARE DOCUMENTED IN THE MINUTES OF THE MEETING. IN DETERMINING COMPENSATION FOR THE CFO, OTHER OFFICERS OR KEY EMPLOYEES, THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT OBTAINS COMPARABLE SALARY DATA AND PRESENTS IT TO THE CEO WHO MAKES THE FINAL DECISION. THE INDIVIDUAL IN THE CONSIDERATION PROCESS IS NOT PRESENT DURING THE DISCUSSION AND DECISION-MAKING PROCESS. ANNUAL MERIT ADJUSTMENT: SALARY ADJUSTMENT IS DETERMINED BY ORGANIZATIONAL PERFORMANCE AS REFLECTED IN THE SCORE OF THE ESTABLISHED PERFORMANCE MEASUREMENT INSTRUMENT. (PAYSCALE) - PERIODIC MARKET ADJUSTMENT: SALARY OF EACH OFFICER IS REVIEWED PERIODICALLY BY HUMAN RESOURCES AND APPROPRIATE OFFICER AND COMPARED TO SALARIES OF COMPARABLE ORGANIZATIONS TO ENSURE THAT THE CURRENT RATE IS COMPETITIVE. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SEE RESPONSE AT 15A. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE FOR INSPECTION, WITH NOTICE, IN THE OFFICE OF THE ORGANIZATION. IN ADDITION, THE FINANCIAL STATEMENTS ARE AVAILABLE ON THE ORGANIZATION'S WEBSITE. |
| FORM 990, PART IX, LINE 11G | PHYSICIAN FEES 3,429,724 0 0 CONTRACTED SERVICES 2,353,477 938,488 0 PURCHASED SERVICES 1,675,061 942,991 0 PROFESSIONAL FEES 310,736 100,240 0 THERAPY FEES 54,790 0 0 CONSULTING FEES 2,846 410,994 0 OTHER FEES 352,484 109,601 0 COLLECTION FEES 28,763 534,981 0 TOTAL 8,207,881 3,037,295 0 |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| UPSON MEDICAL ASSOCIATES LLC | |||||||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | 550840991 | PHYS OFC | GA | -$153,076 | $173,103 | UCH |
| UPSON REGIONAL WELLNESS CTR LLC | |||||||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | 205095610 | WELLNESS | GA | -$93,896 | $152,233 | UCH |
| UPSON WOMEN'S SVCS LLC | |||||||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | 263227893 | PHYS OFC | GA | -$691,057 | $873,106 | UCH |
| UPSON FAMILY PHYSICIANS LLC | |||||||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | 270192553 | PHYS OFC | GA | -$800,335 | $570,564 | UCH |
| UPSON SURGICAL ASSOCIATES LLC | |||||||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | 275252545 | PHYS OFC | GA | -$2,058,273 | $1,260,412 | UCH |
| ORTHOPEDICS SPORTS MEDICINE & SURG | |||||||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | 272123255 | PHYS OFC | GA | -$996,073 | $456,391 | UCH |
| URMC MEDICAL OFFICE BLDG LLC | |||||||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | 474279645 | MED OFC BL | GA | -$253,183 | $4,996,874 | UCH |
| UPSON FAMILY MEDICAL CENTER LLC | |||||||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | 824385128 | PHYS OFC | GA | -$442,949 | $1,950,210 | UCH |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| URMC HEALTH FOUNDATION | |||||||||||
| P O BOX 1089 | THOMASTON | GA | 30286 | 830411781 | FOUNDATION | GA | 501C3 | 12A | UCH | Yes (true) | |
| HOSPITAL AUTHORITY OF UPSON COUNTY | |||||||||||
| 801 WEST GORDON STREET | THOMASTON | GA | 302860027 | 586002427 | MGMT | GA | GOVT | 6 | false | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| URMC HEALTH FOUNDATION | ||
| C | $45,160 | CASH VALUE |
| URMC HEALTH FOUNDATION | ||
| L | INDETERMINABLE VALUE | |
| URMC HEALTH FOUNDATION | ||
| M | INDETERMINABLE VALUE | |
| URMC HEALTH FOUNDATION | ||
| N | INDETERMINABLE VALUE | |
| URMC HEALTH FOUNDATION | ||
| O | INDETERMINABLE VALUE | |