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COMMUNITY ANCILLARY SERVICES INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY ANCILLARY SERVICES INC (EIN 43-2007496)
Tax period
2018-07-01 to 2019-06-30
Filed
2020-05-13
IRS object ID
202031349349301433
Schema version
2018v3.2
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)
Return2020-05-13T10:14:21-05:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

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 Begin2018-07-01TaxPeriodBeginDt

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 Line1213 THIRD STREETAddressLine1Txt
CityMACONCityNm
State AbbreviationGAStateAbbreviationCd
ZIP31201ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTERESA MOODYPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone4786212100PhoneNum
Signature2020-05-08SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWILLIAM R ROUNTREEPreparerPersonNm
PTINP01231836PTIN
Phone4787466277PhoneNum
Preparation2020-05-13PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address98.175.202.218IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-05-13IPDt
IP Tm10:14:21IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdA3B94424D657E207F786669336710D9C6E8823F7AtSubmissionCreationDeviceId
At Submission Filing Device IdA3B94424D657E207F786669336710D9C6E8823F7AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTERESA MOODYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1440 INDUSTRIAL BOULEVARDAddressLine1Txt
CityHAWKINSVILLECityNm
State AbbreviationGAStateAbbreviationCd
ZIP31036ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$98,955,246GrossReceiptsAmt
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 Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee681TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$97,862,513PYProgramServiceRevenueAmt
CY Program Service Revenue$97,508,544CYProgramServiceRevenueAmt
PY Investment Income$233,597PYInvestmentIncomeAmt
CY Investment Income$473,010CYInvestmentIncomeAmt
PY Other Revenue$438,803PYOtherRevenueAmt
CY Other Revenue$973,692CYOtherRevenueAmt
PY Total Revenue$98,534,913PYTotalRevenueAmt
CY Total Revenue$98,955,246CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$27,688,670PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$27,748,567CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$60,761,182PYOtherExpensesAmt
CY Other Expenses$62,750,308CYOtherExpensesAmt
PY Total Expenses$88,449,852PYTotalExpensesAmt
CY Total Expenses$90,498,875CYTotalExpensesAmt
PY Revenues Less Expenses$10,085,061PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$8,456,371CYRevenuesLessExpensesAmt
Total Assets BOY$38,870,866TotalAssetsBOYAmt
Total Assets EOY$38,406,482TotalAssetsEOYAmt
Total Liabilities BOY$11,758,292TotalLiabilitiesBOYAmt
Total Liabilities EOY$15,446,862TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$27,112,574NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$22,959,620NetAssetsOrFundBalancesEOYAmt
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$90,498,875ExpenseAmt
Revenue$97,508,544RevenueAmt
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$90,498,875TotalProgramServiceExpensesAmt
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
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 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 With Officer EntfalseBusinessRlnWithOfficerEntInd
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 Document517IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee681EmployeeCnt
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 Members5GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
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 (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
JOSEPH A WALL
CHAIRMAN4.0040.00Yes (X)$0$24,000$0
PAUL A CABLE
DIRECTOR4.0040.00Yes (X)$0$24,000$0
JAMES B PATTON
DIRECTOR4.0040.00Yes (X)$0$24,000$0
HERBERT M PONDER JR
DIRECTOR4.0040.00Yes (X)$0$24,000$0
KATHRYN DENNIS
DIRECTOR4.0040.00Yes (X)$0$24,000$0
JAMES R LEE JR
VICE PRESIDE40.000.00$0$307,056$12,228Yes (X)
CALVIN D FRANKLIN
VICE PRESIDE40.000.00$254,616$0$16,929Yes (X)
ANGELA HAMMACK
CORPORATE SE4.0040.00$0$207,575$15,002Yes (X)
TERESA MOODY
PRESIDENT4.0040.00$0$203,294$16,776Yes (X)
ANDY HILL
VP PROJECT M40.000.00$198,538$0$10,728Yes (X)
AMANDA ROBERSON
VP OPERATION40.000.00$193,055$0$9,522Yes (X)
MELISSA PRICE
VP COMPLIANC40.000.00$176,654$0$16,418Yes (X)
SARAH THOMPSON
VICE PRESIDE40.000.00$152,028$0$16,100Yes (X)
TRACIE P CLARK
VICE PRESIDE40.000.00$131,806$0$9,488Yes (X)
STEPHANIE KIRKLAND
SENIOR DIR P40.000.00$169,675$0$12,601Yes (X)
GINGER LANCASTER
DIR PHARMACY40.000.00$150,242$0$16,757Yes (X)
LESLIE MAY
SR. DIR. OF40.000.00$146,972$0$9,737Yes (X)
JACLYN HOWARD
DIR PHARMACY40.000.00$146,520$0$9,991Yes (X)
RONALD HOGLAND
DIR PHARMACY40.000.00$142,958$0$15,949Yes (X)
LORRAINE T TAYLOR
FORMER SECRE0.0040.00$0$737,116$21,988Yes (X)
MICHELLE MOORE-ANDREWS
FORMER PRESI0.0040.00$0$291,912$18,725Yes (X)
GENEEN RANSAW
FORMER VP0.0040.00$0$155,876$10,109Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,863,064TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,022,829TotReportableCompRltdOrgAmt
Total Other Compensation$239,048TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K39IndivRcvdGreaterThan100KCnt
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
INTEGRA REHABILITATION
1013 RIVERBURCH PARKWAYDALTONGA30721REHAB SERVICES$2,256,155
STRATEGIC DELIVERY SOLUTIONS
PO BOX 239FARMINGDALENY11735COURIER SERVICE$1,157,155
HARTWELL HEALTH AND REHABILITATION
94 CADE STREETHARTWELLGA306431814HEATLH CARE$680,549
BROWN HEALTH AND REHABILITATION
545 COOK STREETROYSTONGA30662HEALTH CARE$514,456
SOUTHLAND HEALTH AND REHABILITATION
PO BOX 2747PEACHTREE CITYGA30269HEALTH CARE$447,981
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K23CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
GOVERNMENTAL PROGRAMS REV$64,304,447$64,304,447
PROGRAM SERVICES$33,204,097$33,204,097
FieldValueIRS element (for citing)
Total Program Service Revenue$97,508,544TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$473,010TotalRevenueColumnAmt
Exclusion$473,010ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
OTHER$744,992$744,992
MANAGEMENT FEE$228,700$228,700
FieldValueIRS element (for citing)
Other Revenue Total$973,692OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$98,955,246TotalRevenueColumnAmt
Related Or Exempt Func Income$98,482,236RelatedOrExemptFuncIncomeAmt
Exclusion$473,010ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,185,882TotalAmt
Program Services$1,185,882ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$22,247,021TotalAmt
Program Services$22,247,021ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$572,613TotalAmt
Program Services$572,613ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,014,351TotalAmt
Program Services$2,014,351ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,728,700TotalAmt
Program Services$1,728,700ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$62,514TotalAmt
Program Services$62,514ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,686,150TotalAmt
Program Services$2,686,150ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$377,003TotalAmt
Program Services$377,003ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$880,860TotalAmt
Program Services$880,860ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$336,623TotalAmt
Program Services$336,623ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MEDICAL SUPPLY EXPENSE$36,602,542$36,602,542
CONTRACTED SERVICES$7,628,514$7,628,514
OTHER ADMINISTRATIVE$6,438,642$6,438,642
SUPPORT ORGANIZATION FEES$5,771,697$5,771,697

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,965,763TotalAmt
Program Services$1,965,763ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$90,498,875TotalAmt
Program Services$90,498,875ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$6,204,583BOYAmt
EOY$5,825,988EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$8,959,795BOYAmt
EOY$9,309,714EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$3,355,736BOYAmt
EOY$3,205,239EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$408,177BOYAmt
EOY$444,152EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$10,537,423LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,384,159LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$6,510,375BOYAmt
EOY$6,153,264EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$6,519,687BOYAmt
EOY$9,049,920EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$6,912,513BOYAmt
EOY$4,418,205EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$38,870,866BOYAmt
EOY$38,406,482EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$5,995,625BOYAmt
EOY$11,917,117EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,997,581BOYAmt
EOY$2,339,524EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,302,586BOYAmt
EOY$877,721EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$462,500BOYAmt
EOY$312,500EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$11,758,292BOYAmt
EOY$15,446,862EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$21,812,407BOYAmt
EOY$17,887,688EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,300,167BOYAmt
EOY$5,071,932EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$27,112,574BOYAmt
EOY$22,959,620EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$38,870,866BOYAmt
EOY$38,406,482EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$8,456,371ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$12,609,325OtherChangesInNetAssetsAmt
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 RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$65,855,499CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$67,803,264CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$81,029,683CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$98,301,316CurrentTaxYearMinus1YearAmt
Current Tax Year$98,482,236CurrentTaxYearAmt
Total$411,471,998TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$65,855,499CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$67,803,264CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$81,029,683CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$98,301,316CurrentTaxYearMinus1YearAmt
Current Tax Year$98,482,236CurrentTaxYearAmt
Total$411,471,998TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$411,471,998PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$146,668CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$157,587CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$46,028CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$233,597CurrentTaxYearMinus1YearAmt
Current Tax Year$473,010CurrentTaxYearAmt
Total$1,056,890TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$146,668CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$157,587CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$46,028CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$233,597CurrentTaxYearMinus1YearAmt
Current Tax Year$473,010CurrentTaxYearAmt
Total$1,056,890TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$66,002,167CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$67,960,851CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$81,075,711CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$98,534,913CurrentTaxYearMinus1YearAmt
Current Tax Year$98,955,246CurrentTaxYearAmt
Total$412,528,888TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99740PublicSupportCY509Pct
Public Support PY5090.99680PublicSupportPY509Pct
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$4,666,669OtherCostOrOtherBasisAmt
Depreciation$1,078,539DepreciationAmt
Book Value$3,588,130BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,029,538OtherCostOrOtherBasisAmt
Depreciation$391,836DepreciationAmt
Book Value$637,702BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,711,575OtherCostOrOtherBasisAmt
Depreciation$2,913,784DepreciationAmt
Book Value$1,797,791BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$6,153,264TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
RESTRICTED FUNDS$3,217,245
OTHER ASSETS$1,200,960
FieldValueIRS element (for citing)
Total Book Value Other Assets$4,418,205TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescCONTRACT LIABILITYDesc
Amt$312,500Amt
FieldValueIRS element (for citing)
Total Liability$312,500TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$98,955,246TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$98,955,246RevenueSubtotalAmt
Total Revenue Per Form990$98,955,246TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$90,498,875TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$90,498,875ExpensesSubtotalAmt
Total Expenses Per Form990$90,498,875TotalExpensesPerForm990Amt

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 (16 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
JAMES R LEE JR
VICE PRESIDENT$294,282$12,774$12,228$319,284
CALVIN D FRANKLIN
VICE PRESIDENT$244,304$10,312$16,929$271,545
ANGELA HAMMACK
CORPORATE SECRETARY$199,544$8,031$15,002$222,577
TERESA MOODY
PRESIDENT$192,424$10,870$16,776$220,070
ANDY HILL
VP PROJECT MANAGER$190,855$7,683$10,728$209,266
AMANDA ROBERSON
VP OPERATIONS$189,580$3,475$9,522$202,577
MELISSA PRICE
VP COMPLIANCE & QA$169,420$7,234$16,418$193,072
SARAH THOMPSON
VICE PRESIDENT$145,773$6,255$16,100$168,128
STEPHANIE KIRKLAND
SENIOR DIR PHARMACY$164,075$5,600$12,601$182,276
GINGER LANCASTER
DIR PHARMACY$144,248$5,994$16,757$166,999
LESLIE MAY
SR. DIR. OF PHARMACY$143,032$3,940$9,737$156,709
JACLYN HOWARD
DIR PHARMACY$142,332$4,188$9,991$156,511
RONALD HOGLAND
DIR PHARMACY$137,054$5,904$15,949$158,907
LORRAINE T TAYLOR
FORMER SECRETARY$722,655$14,461$21,988$759,104
MICHELLE MOORE-ANDREWS
FORMER PRESIDENT$278,226$13,686$18,725$310,637
GENEEN RANSAW
FORMER VP$148,126$7,750$10,109$165,985

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

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 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 11BTHIS PROCESS INVOLVES THE ELECTRONIC POSTING OF THE DRAFT FORM 990 WITH ALL ITS SCHEDULES FOR THE ORGANIZATION'S BOARD OF DIRECTORS TO REVIEW FOLLOWED, AFTER A SUFFICIENT REVIEW PERIOD, BY A MEETING OF THE BOARD AT WHICH BOARD MEMBERS WILL HAVE THE OPPORTUNITY TO ASK QUESTIONS OF MANAGEMENT AND THE OUTSIDE TAX ADVISORS INVOLVED IN THE PREPARATION OF THE FORM 990.
FORM 990, PAGE 6, PART VI, LINE 12CTHE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICTS OF INTEREST POLICY. SUCH COMPLIANCE IS EFFECTUATED THROUGH THE ORGANIZATION'S BOARD OF DIRECTORS' REVIEW OF ANNUAL CONFLICT DISCLOSURE STATEMENTS FROM THE DIRECTORS AS WELL AS RECEIPT AND REVIEW OF CONFLICT DISCLOSURE STATEMENTS WITH RESPECT TO CERTAIN PROPOSED TRANSACTIONS OR ARRANGEMENTS THE ORGANIZATION IS CONSIDERING PRIOR TO ANY BOARD ACTION WITH RESPECT TO SUCH MATTERS. THE CONFLICTS POLICY OUTLINES THE SPECIFIC PROCEDURE TO BE FOLLOWED TO DETERMIN WHETHER INTERESTED PERSONS HAVE ACTUAL CONFLICTS OF INTEREST. IF IT IS DETERMINED THAT A BOARD MEMBER HAS AN ACTUAL CONFLICT OF INTEREST, THEN SUCH BOARD MEMBER IS NOT ALLOWED TO PARTICIPATE IN THE BOARD DELIBERATIONS ON THE SPECIFIC MATTER AND IS EXCUSED FROM, AND IT 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 WHICH IS PART OF ITS CONFLICT OF INTEREST POLICY. EVERY TWO TO THREE YEARS, ON AVERAGE, THE ORGANIZATION PARTICIPATES IN A COMPREHENSIVE PROCESS CONDUCTED ON ITS BEHALF BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF COMMUNITY HEALTH SYSTEMS, INC., ITS SOLE MEMBER AND PARENT OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM IN WHICH THE ORGAINZATION IS A MEMBER. THIS PROCESS INVOLVES REVIEW OF THE COMPARABILITY DATA COMPILED BY AN INDEPENDENT THIRD-PARTY COMPENSATION CONSULTANT. COMPARABILITY DATA IS GATHERED FOR THE ORGANIZATION'S SENIOR MANAGEMENT, AND ON OCCASION, KEY OR HIGHLY COMPENSATED EMPLOYEES, AND, BASED ON THE SAME, THE CONSULTANT ISSUES A WRITTEN REPORT REFLECTING THE CONSULTANT'S OPINION CONCERNING WHETHER THE PROPOSED COMPENSATION ARRANGEMENTS CONSTITUTE RESONABLE COMPENSATION UNDER SECTION 4958 OF THE CODE. THIS PROCESS IS CONDUCTED BY THE COMPENSATION COMMITTEE, WHICH THEN MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS IS ALSO PROVIDED WITH MATERIALS REGARDING TEH COMPENSATION REIVEW, INCLUDING COPIES OF THE CONSULTANT'S REPORT. THE BOARD THEN VOTES AS TO THE RESONABLENESS OF EACH OF THE INDIVIDUAL COMPENSATION ARRANGEMENTS (IF ANY DISQUALIFIED OR OTHERWISE CONFLICTED INDIVIDUALS ARE PRESENT AT THE MEETING, THEY DO NOT PARTICIPATE IN THE DELIBERATIONS AND ARE EXCUSED FROM THE ROOM DURING THE VOTE). THE PROCESS IS DESIGNED AND CARRIED OUT BY THE 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 ARRANGMENTS FOR DISQUALIFIED PERSON UNDER SECTION 53.4958-6 OF THE REGULATIONS. AS PART OF THIS PROCESS, OUTSIDE COUNSEL IS RETAINED TO FURTHER ADVISE THE BOARD ON THE REBUTTABLE PRESUMPTION PROCESS AND TO PROVIDE THE BOARD WITH A LEGAL OPINION REGARDING THE SAME. AS A FINAL STEP, EACH PART OF THE PROCESS REQUIRED TO ESTABLISH THE REBUTTABLE PRESUMPTION IS DOCUMENTED USING THE REBUTTABLE PRESUMPTION CHECKLIST RELEASED BY THE IRS.
FORM 990, PAGE 6, PART VI, LINE 15BTHE ORGANIZATION REGULARLY AND CONSISTENTLY COMPLIES WITH THE COMPENSATION APPROVAL PROCESS WHICH IS PART OF ITS CONFLICTS OF INTEREST POLICY. EVERY TWO TO THREE YEARS, ON AVERAGE, THE ORGANIZATION PARTICIPATES IN A COMPREHENSIVE PROCESS CONDUCTED ON ITS BEHALF BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF COMMUNITY HEALTH SYSTEMS, INC., ITS SOLE MEMBER AND PARENT OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM IN WHICH THE ORGANIZATION IS A MEMBER. THIS PROCESS INVOLVES REVIEW OF COMPARABILITY DATA COMPILED BY AN INDEPENDENT THIRD-PARTY COMPENSATION CONSULTANT. COMPARABILITY DATA IS GATHERED FOR THE ORGANIZATION'S SENIOR MANAGEMENT, AND ON OCCASION, KEY OR HIGHLY COMPENSATED EMPLOYEES, AND, BASED ON THE SAME, THE CONSULTANT ISSUES A WRITTEN REPORT REFLECTING THE CONSULTANT'S OPINION CONCERNING WHETHER THE PROPOSED COMPENSATION ARRANGEMENTS CONSTITUTE REASONABLE COMPENSATION UNDER SECTION 4958 OF THE CODE. THIS PROCESS IS CONDUCTED BY THE COMPENSATION COMMITTEE, WHICH MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS IS ALSO PROVIDED WITH MATERIALS REGARDING THE COMPENSATION REVIEW, INCLUDING COPIES OF THE CONSULTANT'S REPORT. THE BOARD THEN VOTES AS TO THE REASONABLENESS OF EACH OF THE INDIVIDUAL COMPENSATION ARRANGEMENTS (IF ANY DISQUALIFIED OR OTHERWISE CONFLICTED INDIVIDUALS ARE PRESENT AT THE MEETING, THEY DO NOT PARTICIPATE IN THE DELIBERATIONS AND ARE EXCUSED FROM THE ROOM DURING THE VOTE). THE PROCESS IS DESIGNED AND CARRIED OUT BY THE 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 REGULATIONS. AS PART OF THIS PROCESS, OUTSIDE COUNSEL IS RETAINED TO FURTHER ADVISE THE BOARD ON THE REBUTTABLE PRESUMPTION PROCESS AND TO PROVIDE THE BOARD WITH A LEGAL OPINION REGARDING THE SAME. AS A FINAL STEP, EACH PART OF THE PROCESS REQUIRED TO ESTABLISH THE REBUTTABLE PRESUMPTION IS DOCUMENTED USING THE REBUTTABLE PRESUMPTION CHECKLIST RELEASED BY THE IRS.
FORM 990, PAGE 6, PART VI, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST IN ACCORDANCE WITH THE SECTION 6104(D) DISCLOSURE REQUIREMENTS.
FORM 990, PART XI, LINE 9DISTRIBUTION OF NET ASSETS -12,609,325

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$50,836,627$8,494,086NA
HDI LLC
440 INDUSTRIAL BOULEVARDHAWKINSVILLEGA31036432007496SUPPLY DISGA$22,008,050$5,462,901NA
SOURCE CARE MANAGEMENT LLC
PO BOX 1803MACONGA31202582651175CASE MANAGGA$11,493,982$1,951,152NA
HELPLINK LLC
PO BOX 1803MACONGA31202141904766EMERGENCYGA$912,193$255,626NA
AFFINIS HOSPICE LLC
213 THIRD STREETMACONGA31201271452535HOSPICEGA$20,942,363$3,669,590NA
AMICITA HOME HEALTH LLC
213 THIRD STREETMACONGA31201271563270HOMEHEALTHGA$3,882,860$2,702,601NA

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
PO BOX 1833MACONGA31202571157153FINANCIALGA501C10CHSIfalse
COMMUNITY HEALTH SYSTEMS INC
PO BOX 1037MACONGA31202743083593SUPPORT SEGA501C12ANAfalse
COMMUNITY REHABILITATION SERVICES
PO BOX 1804MACONGA31202203253779REHABILITAGA501C10CHSIfalse
HEALTH SCHOLARSHIPS INC
1005 BOULDER DRIVEGRAYGA31032581805305OPERATIONGA501C10CHSIfalse
HEALTH SYSTEMS FACILITIES INC
1005 BOULDER DRIVEGRAYGA31032743083594OPERATIONGA501C10CHSIfalse
HEALTH SYSTEMS REAL ESTATE INC
1005 BOULDER DRIVEGRAYGA31032432007488REGA501C10CHSIfalse
HOME & COMMUNITY SERVICES INC
PO BOX 1803MACONGA31202432007492TRANSGA501C10CHSIfalse
PIEDMONT REGIONAL HEALTH INC
1005 BOULDER DRIVEGRAYGA31032432007498OPERATIONGA501C10CHSIfalse
STEWARD HEALTH SERVICES INC
213 THIRD STREETMACONGA31201432007486HOSPICEGA501C10CHSIfalse

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
213 THIRD STREETMACONGA31201201392241RISK MGMTGACHSIC CORPfalse
GEORGIA PHARMACY SERVICES INC
213 THIRD STREETMACONGA31201200248574PHARMACYGAfalseN/A
HEALTH DISTRIBUTION SERVICES INC
213 THIRD STREETMACONGA31201200248557SUPPLY 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 (7 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
COMMUNITY HEALTH SYSTEMS INC
M$6,102,252
COMMUNITY HEALTH FOUNDATION INC
R$15,868
HEALTH SCHOLARSHIPS INC
L$17,833,175
HEALTH SYSTEMS FACILITIES INC
L$6,636,400
PIEDMONT REGIONAL HEALTH INC
L$1,985,959
HOME & COMMUNITY SERVICES INC
L$473,453
COMMUNITY HEALTLH SYSTEMS INC
K$159,000