STEPHENS COUNTY HOSPITAL AUTHORITY: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- STEPHENS COUNTY HOSPITAL AUTHORITY (EIN 58-6001667)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-08-17
- IRS object ID
- 202032309349302708
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-08-17T13:27:24-05:00 | ReturnTs |
| Tax Period End | 2019-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 580914992 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRAFFIN & TUCKER LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71309 | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317081309 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 586001667 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEPHENS COUNTY HOSPITAL AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STEP | BusinessNameControlTxt |
| Phone | 7062824200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 163 HOSPITAL DRIVE | AddressLine1Txt |
| City | TOCCOA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 305776820 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL HESTER | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7062824200 | PhoneNum |
| Signature | 2020-08-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WILLIAM EDWARD PHILLIPS | PreparerPersonNm |
| PTIN | P00451499 | PTIN |
| Phone | 2298837878 | PhoneNum |
| Preparation | 2020-08-17 | 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 | 2020-08-17 | IPDt |
| IP Tm | 13:27:24 | IPTm |
| IP Timezone | CD | 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 | 2018 | TaxYr |
| Build TS | 2020-09-22 18:59:49Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL HESTER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 163 HOSPITAL DRIVE | AddressLine1Txt |
| City | TOCCOA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30577 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $44,045,153 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.STEPHENSCOUNTYHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1945 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF STEPHENS COUNTY HOSPITAL AUTHORITY IS TO PROVIDE HEALTH CARE AND RELATED SERVICES TO ENHANCE INDIVIDUAL HEALTH AND WELL BEING IN A MANNER THAT MEETS THE EXPECTATIONS OF PATIENTS AND OTHER CUSTOMERS; PRESERVE THE RIGHTS OF PATIENTS, EMPLOYEES AND OTHERS TO BE TREATED WITH DIGNITY, RESPECT AND CONCERN; PROVIDE PROFESSIONALLY AND TECHNICALLY PROFICIENT PERSONNEL IN AN EFFECTIVE AND RESOURCE EFFICIENT MANNER; AND UTLILIZE RESOURCES APPROPRIATELY TO CONTAIN COSTS AND TO PROVIDE FOR ADDITIONAL SERVICE OPPORTUNITIES. ALL PHASES OF OPERATION MUST BE CARRIED OUT IN AN ETHICAL MANNER DEDICATED TO EXCELLENCE IN HEALTHCARE FOR EVERY LIFE WE TOUCH. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 631 | TotalEmployeeCnt |
| Total Volunteers | 24 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $564,528 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,429,629 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $51,330,337 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $41,589,243 | CYProgramServiceRevenueAmt |
| PY Investment Income | $48,259 | PYInvestmentIncomeAmt |
| CY Investment Income | $94,491 | CYInvestmentIncomeAmt |
| PY Other Revenue | $754,307 | PYOtherRevenueAmt |
| CY Other Revenue | $931,790 | CYOtherRevenueAmt |
| PY Total Revenue | $52,697,431 | PYTotalRevenueAmt |
| CY Total Revenue | $44,045,153 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $23,194,551 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $25,721,871 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $30,360,991 | PYOtherExpensesAmt |
| CY Other Expenses | $21,227,903 | CYOtherExpensesAmt |
| PY Total Expenses | $53,555,542 | PYTotalExpensesAmt |
| CY Total Expenses | $46,949,774 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$858,111 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,904,621 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $39,590,385 | TotalAssetsBOYAmt |
| Total Assets EOY | $35,685,279 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $24,295,529 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $23,295,044 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $15,294,856 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $12,390,235 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF STEPHENS COUNTY HOSPITAL AUTHORITY IS TO PROVIDE HEALTH CARE AND RELATED SERVICES TO ENHANCE INDIVIDUAL HEALTH AND WELL BEING IN A MANNER THAT MEETS THE EXPECTATIONS OF PATIENTS AND OTHER CUSTOMERS; PRESERVE THE RIGHTS OF PATIENTS, EMPLOYEES AND OTHERS TO BE TREATED WITH DIGNITY, RESPECT AND CONCERN; PROVIDE PROFESSIONALLY AND TECHNICALLY PROFICIENT PERSONNEL IN AN EFFECTIVE AND RESOURCE EFFICIENT MANNER; AND UTLILIZE RESOURCES APPROPRIATELY TO CONTAIN COSTS AND TO PROVIDE FOR ADDITIONAL SERVICE OPPORTUNITIES. ALL PHASES OF OPERATION MUST BE CARRIED OUT IN AN ETHICAL MANNER DEDICATED TO EXCELLENCE IN HEALTHCARE FOR EVERY LIFE WE TOUCH. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $41,003,049 | ExpenseAmt |
| Revenue | $42,410,215 | RevenueAmt |
| Desc | STEPHENS COUNTY HOSPITAL AUTHORITY IS LICENSED TO OPERATE 96 INPATIENT BEDS AND PROVIDES OUTPATIENT SERVICES TO A SERVICE AREA THAT EXTENDS BEYOND STEPHENS COUNTY INTO THE SURROUNDING COUNTIES OF FRANKLIN, HART, HABERSHAM, RABUN AND BANKS IN GEORGIA, AND INTO NEIGHBORING OCONEE COUNTY IN SOUTH CAROLINA. STEPHENS COUNTY HOSPITAL AUTHORITY ALSO OPERATES A 92-BED PERSONAL CARE HOME. THE HOSPITAL PARTICIPATES IN SEVERAL EMPLOYER SPONSORED HEALTH FAIRS AND SUPPORTS THE LOCAL EMPLOYERS IN THE "DRUGS DON'T WORK" PROGRAM. THE HOSPITAL PROVIDES FREE DIAGNOSTIC TESTING TO THE OPEN ARMS CLINIC (A FREE CLINIC OPERATING IN STEPHENS COUNTY). THE HOSPITAL DOES NOT TURN DOWN ANYONE FOR EMERGENCY AND/OR MEDICALLY NECESSARY SERVICES BASED ON THE ABILITY TO PAY FOR SUCH SERVICES. | Desc |
| Total Program Service Expenses | $41,003,049 | 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 |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| 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 | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 19 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 631 | EmployeeCnt |
| Employment Tax Returns Filed | false | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | 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 |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RAY LEADBETTER | PersonNm |
| Phone | 7062824281 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 163 HOSPITAL DRIVE | AddressLine1Txt |
| City | TOCCOA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30577 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MARK WILKINSON | ||||||||
| CHAIRMAN | 2.00 | 0.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JON WEST | ||||||||
| VICE CHAIRMA | 2.00 | 0.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| STAN ROBERTS | ||||||||
| SECRETARY/TR | 2.00 | 0.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PAULA DICKERSON | ||||||||
| AT LARGE OFF | 2.00 | 0.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GEORGE SANDERS | ||||||||
| DIRECTOR | 2.00 | 0.25 | Yes (X) | $0 | $0 | $0 | ||
| STEPHEN PINKERTON MD | ||||||||
| DIRECTOR | 2.00 | 0.25 | Yes (X) | $0 | $0 | $0 | ||
| BILL MCDOUGAL MD | ||||||||
| DIRECTOR | 2.00 | 0.25 | Yes (X) | $0 | $0 | $0 | ||
| MAX BROCK | ||||||||
| DIRECTOR | 2.00 | 0.25 | Yes (X) | $0 | $0 | $0 | ||
| KATHY F WHITMIRE | ||||||||
| COO | 40.00 | Yes (X) | $144,987 | $0 | $7,005 | |||
| JEFFREY B LAIRD | ||||||||
| CFO | 40.00 | 0.25 | Yes (X) | $104,541 | $0 | $14,638 | ||
| RUTH LYNNE M ANDERSON | ||||||||
| CEO | 0.25 | Yes (X) | $78,500 | $0 | $0 | |||
| MICHAEL HESTER | ||||||||
| CEO | 40.00 | 0.25 | Yes (X) | $0 | $0 | $0 | ||
| CHRISTOPHER M VAUGHN MD | ||||||||
| PHYSICIAN | 40.00 | $555,959 | $0 | $0 | Yes (X) | |||
| JAMES R WADE MD | ||||||||
| PHYSICIAN | 40.00 | $489,911 | $0 | $14,638 | Yes (X) | |||
| DEARL V BIRDSONG MD | ||||||||
| PHYSICIAN | 40.00 | $377,241 | $0 | $16,369 | Yes (X) | |||
| KATHRYN A MCKINNEY MD | ||||||||
| PHYSICIAN | 40.00 | $352,271 | $0 | $7,361 | Yes (X) | |||
| MICHELLE S CHITWOOD | ||||||||
| RADIOLOGY MA | 40.00 | $120,956 | $0 | $11,141 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,224,366 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $71,152 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SOUTHLAND MD | |||||
| PO BOX 1276 | THOMASVILLE | GA | 30799 | PHYSICIAN & ER | $1,783,224 |
| GE PRECISION HEALTHCARE LLC | |||||
| PO BOX 96483 | CHICAGO | IL | 60693 | RADIOLOGY | $698,137 |
| DIVERSIFIED CLINICAL SERVICES | |||||
| 28525 NETWORK PLACE | CHICAGO | IL | 60673 | WOUND CARE | $563,885 |
| JACKSON & COKER | |||||
| PO BOX 277638 | ATLANTA | GA | 30384 | LOCUM TENENS | $525,523 |
| PHARMD ON DEMAND | |||||
| 630 HAWTHORNE AVENUE | ATHENS | GA | 30606 | PHARMACY MGMT. | $522,599 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 27 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $46,939 | RelatedOrganizationsAmt |
| Government Grants | $1,126,914 | GovernmentGrantsAmt |
| All Other Contributions | $255,776 | AllOtherContributionsAmt |
| Total Contributions | $1,429,629 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $41,589,243 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $41,589,243 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $41,589,243 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $86,491 | TotalRevenueColumnAmt |
| Exclusion | $86,491 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $8,000 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $8,000 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,000 | TotalRevenueColumnAmt |
| Exclusion | $8,000 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| CAFETERIA | 722514 | $535,150 | $535,150 | |
| PHARMACY -EMPLOYEES | 623000 | $110,818 | $110,818 | |
| DOT EXAMINATIONS | 621110 | $97,887 | $97,887 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $187,935 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $187,935 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $931,790 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $44,045,153 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $42,410,215 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $205,309 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $336,833 | TotalAmt |
| Management And General | $336,833 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,293,170 | TotalAmt |
| Program Services | $19,112,271 | ProgramServicesAmt |
| Management And General | $2,180,899 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,732,381 | TotalAmt |
| Program Services | $2,414,332 | ProgramServicesAmt |
| Management And General | $318,049 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,359,487 | TotalAmt |
| Program Services | $1,201,243 | ProgramServicesAmt |
| Management And General | $158,244 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,825 | TotalAmt |
| Management And General | $92,825 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,270 | TotalAmt |
| Management And General | $17,270 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,396,623 | TotalAmt |
| Program Services | $6,471,554 | ProgramServicesAmt |
| Management And General | $925,069 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,940 | TotalAmt |
| Management And General | $94,940 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,403,715 | TotalAmt |
| Program Services | $750,180 | ProgramServicesAmt |
| Management And General | $653,535 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $186,221 | TotalAmt |
| Management And General | $186,221 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,191,995 | TotalAmt |
| Program Services | $1,022,613 | ProgramServicesAmt |
| Management And General | $169,382 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,058 | TotalAmt |
| Program Services | $36,279 | ProgramServicesAmt |
| Management And General | $4,779 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $600,817 | TotalAmt |
| Program Services | $599,043 | ProgramServicesAmt |
| Management And General | $1,774 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,631,387 | TotalAmt |
| Program Services | $1,399,567 | ProgramServicesAmt |
| Management And General | $231,820 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $590,571 | TotalAmt |
| Program Services | $506,651 | ProgramServicesAmt |
| Management And General | $83,920 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| OTHER MEDICAL SUPPLIES | $3,003,809 | $3,003,809 | |
| PHARMACY & DRUGS | $1,936,181 | $1,936,181 | |
| REPAIRS & MAINTENANCE | $1,809,742 | $1,552,578 | $257,164 |
| RENTALS & LEASES | $562,920 | $482,929 | $79,991 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $667,829 | TotalAmt |
| Program Services | $513,819 | ProgramServicesAmt |
| Management And General | $154,010 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,949,774 | TotalAmt |
| Program Services | $41,003,049 | ProgramServicesAmt |
| Management And General | $5,946,725 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,506,876 | BOYAmt |
| EOY | $2,020,187 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,056,957 | BOYAmt |
| EOY | $4,975,741 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,527,975 | BOYAmt |
| EOY | $7,549,104 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,460,043 | BOYAmt |
| EOY | $1,498,287 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $336,757 | BOYAmt |
| EOY | $399,278 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $71,043,268 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $52,420,107 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,284,591 | BOYAmt |
| EOY | $18,623,161 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $417,186 | BOYAmt |
| EOY | $619,521 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,590,385 | BOYAmt |
| EOY | $35,685,279 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,610,331 | BOYAmt |
| EOY | $7,573,545 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,290,000 | BOYAmt |
| EOY | $8,940,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,395,198 | BOYAmt |
| EOY | $6,597,319 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $184,180 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,295,529 | BOYAmt |
| EOY | $23,295,044 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,791,706 | BOYAmt |
| EOY | $9,516,648 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,503,150 | BOYAmt |
| EOY | $2,873,587 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,294,856 | BOYAmt |
| EOY | $12,390,235 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,590,385 | BOYAmt |
| EOY | $35,685,279 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$2,904,621 | ReconcilationRevenueExpnssAmt |
| 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 | $5,161 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $5,161 | 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 | MEMBERSHIP DUES PAID TO THE GEORGIA HOSPITAL ASSOCIATION AND TO HOME TOWN HEALTH ARE USED IN PART FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $348,788 | OtherCostOrOtherBasisAmt |
| Book Value | $348,788 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $33,617,773 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,382,748 | DepreciationAmt |
| Book Value | $14,235,025 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,743,884 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,251,641 | DepreciationAmt |
| Book Value | $492,243 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,126,507 | OtherCostOrOtherBasisAmt |
| Depreciation | $31,785,718 | DepreciationAmt |
| Book Value | $3,340,789 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $206,316 | OtherCostOrOtherBasisAmt |
| Book Value | $206,316 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $18,623,161 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED 3RD PARTY SETTLEMENT | Desc |
| Amt | $184,180 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $184,180 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $43,585,491 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$459,662 | OtherRevenueAmt |
| Revenue Not Reported | -$459,662 | RevenueNotReportedAmt |
| Revenue Subtotal | $44,045,153 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $44,045,153 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $46,490,112 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$459,662 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$459,662 | ExpensesNotReportedAmt |
| Expenses Subtotal | $46,949,774 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $46,949,774 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 3, PART X | THE AUTHORITY IS A GOVERNMENTAL ENTITY AND HAS BEEN RECOGNIZED AS TAX- EXEMPT UNDER THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISIONS FOR INCOME TAXES HAS BEEN PROVIDED. SCHPG AND SCEP ARE NOT-FOR-PROFIT ORGANIZATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3). ACCORDINGLY, NO PROVISIONS FOR INCOME TAXES HAS BEEN PROVIDED. NOTE, SCHPG IS A DISREGARDED ENTITY. SCEP HAD NO OPERATIONS DURING FISCAL YEAR ENDED SEPTEMBER 30, 2019. |
| SCHEDULE D, PAGE 4, PART XI, LINE 2D | PROVIDER FEES RECLASSIFIED -459,662 |
| SCHEDULE D, PAGE 4, PART XII, LINE 2D | PROVIDER FEES RECLASSIFIED -459,662 |
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 |
| Percent150 | Yes (X) | Percent150Ind |
| 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 | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,846,804 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $410,057 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,436,747 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03060 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,134,791 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,122,072 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,719 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,350 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,675 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,675 | NetCommunityBenefitExpnsAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,988,945 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,537,804 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,451,141 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03090 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,988,945 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,537,804 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,451,141 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03090 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $6,856,068 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $4,456,444 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $9,228,066 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,683,946 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,455,880 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEPHENS COUNTY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 163 HOSPITAL DRIVE | AddressLine1Txt |
| City | TOCCOA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30577 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.STEPHENSCOUNTYHOSPITAL.COM | WebsiteAddressTxt |
| State License | 127-169 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | DISPROPORTIONATE SHARE HOSP. | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEPHENS 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 |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| 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 | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.STEPHENSCOUNTYHOSPITAL.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://STEPHENSCOUNTYHOSPITAL.COM/FUL | 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 | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://STEPHENSCOUNTYHOSPITAL.COM/FUL | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://STEPHENSCOUNTYHOSPITAL.COM/FUL | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://STEPHENSCOUNTYHOSPITAL.COM/FULL | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, STEPHENS COUNTY HOSPITAL - PART V, LINE 3E | ON JUNE 19, 2019, A SESSION WAS HELD WITH THE JOINT CHNA PARTNERS AND THEIR COMMUNITY ADVISORS TO IDENTIFY AND PRIORITIZE THE SIGNIFICANT HEALTH NEEDS FOR EACH PARTNER'S COMMUNITY. THE PARTNERS AND THEIR ADVISORS UTILIZED A COMPREHENSIVE METHOD OF CONSIDERING ALL AVAILABLE RELEVANT DATA, INCLUDING COMMUNITY INPUT. THE MEETING INCLUDED: AN OVERVIEW OF THE CHNA PROCESS FOR THE NORTHEAST GEORGIA REGION; THE METHODOLOGY FOR DETERMINING THE TOP HEALTH NEEDS; THE SELECTION AND PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS FOR EACH PARTNER COMMUNITY; AND IDENTIFICATION OF COMMON PRIORITIES ACROSS THE COMMUNITIES OF NORTHEAST GEORGIA. PARTICIPANTS INCLUDED THE EXECUTIVE SPONSOR AND PROJECT SPONSOR FROM EACH OF THE CHNA PARTNERS. IN ADDITION, EACH PARTNER INVITED COMMUNITY ADVISORS TO THE PRIORITIZATION SESSION. COMMUNITY ADVISORS WERE INDIVIDUALS WITH A DEEP KNOWLEDGE OF EACH PARTNER'S COMMUNITY AND WERE INVOLVED/INVESTED IN COMMUNITY DEVELOPMENT. PARTICIPANTS WERE ORGANIZED INTO WORKING GROUPS FOR EACH CHNA PARTNER'S COMMUNITY. A LIST OF THE PARTICIPANTS AND THEIR COMMUNITY WORKING GROUPS IS INCLUDED IN APPENDIX E OF THE CHNA. PRIORITIZATION OF THE HEALTH NEEDS TOOK PLACE IN TWO STEPS. IN THE FIRST STEP, PARTICIPANTS REVIEWED THE CHNA FINDINGS AND THE HEALTH NEEDS MATRIX FOR EACH COMMUNITY AND AGREED THAT THE NEEDS IN THE UPPER RIGHT QUADRANT OF THE MATRIX, THOSE IDENTIFIED AS HIGH DATA/HIGH QUALITATIVE, WERE SIGNIFICANT. THE WORK GROUPS THEN REVIEWED THE OTHER QUADRANTS OF THE MATRIX WHERE EITHER THE QUANTITATIVE DATA OR QUALITATIVE INPUT INDICATED A NEED (UPPER LEFT AND LOWER RIGHT QUADRANTS RESPECTIVELY). LEVERAGING THE PROFESSIONAL EXPERIENCE AND COMMUNITY KNOWLEDGE OF THEIR GROUP VIA DISCUSSION, EACH GROUP DETERMINED IF ANY NEEDS FROM THE OTHER QUADRANTS WERE CONSIDERED SIGNIFICANT DUE TO THEIR POTENTIAL OR ACTUAL IMPACT ON THE COMMUNITY. IN THE SECOND STEP, PARTICIPANTS RANKED THE SIGNIFICANT HEALTH NEEDS ON A SET OF PRIORITIZATION CRITERIA CHOSEN BY THE CHNA PARTNERS: 1) MAGNITUDE: THE NUMBER OF PEOPLE AFFECTED ACTUALLY OR POTENTIALLY BY THE NEED AND/OR THE MAGNITUDE OF THE NEED COMPARED TO OTHER NEEDS IN THE COMMUNITY. 2) ALIGNMENT: ALIGNMENT WITH MISSION, VISION, AND VALUES OF EACH ORGANIZATION. 3) CONSEQUENCES: EXTENT OF DISABILITY, PREMATURE DEATH, SOCIAL, ECONOMIC OR OTHER BURDENS TO THE COMMUNITY. 4) ROOT CAUSE: THE ISSUE IS A ROOT CAUSE OF OTHER PROBLEMS, THEREBY POSSIBLY AFFECTING MULTIPLE ISSUES. THE MEMBERS OF THE STEPHENS COUNTY HOSPITAL PRIORITIZATION WORK GROUP RECOMMENDED THE FOLLOWING SIGNIFICANT HEALTH NEEDS BE ADDRESSED IN THE IMPLEMENTATION STRATEGY REPORT - 1) SUBSTANCE ABUSE 2) ACCESS TO CARE - PRIMARY CARE AND PREVENTABLE HOSPITALIZATION 3) MENTAL HEALTH 4) MATERNAL AND CHILD HEALTH |
| FACILITY 1, STEPHENS COUNTY HOSPITAL - PART V, LINE 5 | TO IDENTIFY THE HEALTH NEEDS OF THE COMMUNITY, THE CHNA PARTNERS ESTABLISHED A COMPREHENSIVE METHOD OF ACCOUNTING FOR ALL AVAILABLE RELEVANT DATA, INCLUDING COMMUNITY INPUT. THE BASIS OF IDENTIFICATION OF COMMUNITY HEALTH NEEDS WAS THE WEIGHT OF QUALITATIVE AND QUANTITATIVE DATA OBTAINED WHEN ASSESSING THE COMMUNITY. SURVEYORS CONDUCTED INTERVIEWS AND FOCUS GROUPS WITH INDIVIDUALS REPRESENTING PUBLIC HEALTH, COMMUNITY LEADERS/GROUPS, PUBLIC ORGANIZATIONS, AND OTHER PROVIDERS. IN SOME COMMUNITIES, SUPPLEMENTARY QUALITATIVE DATA WAS INCLUDED. IN ADDITION, QUANTITATIVE DATA COLLECTED FROM SEVERAL PUBLIC SOURCES WAS BENCHMARKED AGAINST A STATE VALUE TO INDICATE THE LEVEL OF NEED. PUBLIC HEALTH INDICATORS WERE USED TO ASSESS COMMUNITY HEALTH NEEDS FROM A QUANTITATIVE DATA PERSPECTIVE. THIS INCLUDED COLLECTION OF 129 DATA ELEMENTS GROUPED INTO 11 CATEGORIES AND EVALUATED FOR THE COUNTIES WHERE DATA WAS AVAILABLE. A BENCHMARK ANALYSIS WAS CONDUCTED TO DETERMINE THE PUBLIC HEALTH INDICATORS THAT DEMONSTRATED A COMMUNITY HEALTH NEED FROM A QUANTITATIVE PERSPECTIVE. BENCHMARK HEALTH INDICATORS INCLUDED (WHEN AVAILABLE): OVERALL U.S. VALUES AND STATE OF GEORGIA VALUES. ONCE THE COMMUNITY BENCHMARK WAS SET TO THE STATE VALUE, IT WAS DETERMINED WHICH INDICATORS FOR THE COMMUNITY DID NOT MEET THE STATE BENCHMARKS. THIS CREATED A SUBSET OF INDICATORS FOR FURTHER ANALYSIS. A NEED DIFFERENTIAL ANALYSIS WAS CONDUCTED TO UNDERSTAND THE RELATIVE SEVERITY OF NEED FOR THESE INDICATORS. THE NEED DIFFERENTIAL ESTABLISHED A STANDARDIZED WAY TO EVALUATE THE DEGREE EACH INDICATOR DIFFERED FROM ITS BENCHMARK. HEALTH COMMUNITY INDICATORS WITH NEED DIFFERENTIALS ABOVE THE 50TH PERCENTILE WERE ORDERED BY SEVERITY; THE HIGHEST RANKED INDICATORS WERE THE TOP HEALTH NEEDS FROM A QUANTITATIVE PERSPECTIVE. THE OUTCOMES OF THE QUANTITATIVE DATA ANALYSIS WERE COMPARED TO THE QUALITATIVE DATA FINDINGS. IN ADDITION TO ANALYZING QUANTITATIVE DATA, THE FACILITATOR COLLECTED QUALITATIVE DATA VIA A VARIETY OF SOURCES TO GATHER THE INPUT OF PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITIES SERVED THROUGHOUT THE REGION. INPUT FROM OVER 500 PEOPLE WAS INCLUDED IN THE ASSESSMENT VIA SEVERAL DIFFERENT APPROACHES. FOR THE COMMUNITY SERVED BY STEPHENS COUNTY HOSPITAL, ONE (1) FOCUS GROUP SESSION WITH NINE (9) PARTICIPANTS AND FOUR (4) INTERVIEWS WERE CONDUCTED MARCH THROUGH APRIL 2019. A LIST OF THE ORGANIZATIONS PROVIDING INPUT CAN BE FOUND IN APPENDIX B OF THE CHNA. SUMMARY FINDINGS FROM THE FOCUS GROUPS AND INTERVIEWS CAN BE FOUND IN APPENDIX C OF THE DOCUMENT. THE CHNA PROCESS WAS FACILITATED BY IBM WATSON HEALTH. |
| FACILITY 1, STEPHENS COUNTY HOSPITAL - PART V, LINE 6A | THE JOINT CHNA WAS CONDUCTED BY THESE JOINT CHNA PARTNERS: HABERSHAM MEDICAL CENTER NORTHEAST GEORGIA MEDICAL CENTER BARROW NORTHEAST GEORGIA MEDICAL CENTER BRASELTON NORTHEAST GEORGIA MEDICAL CENTER GAINESVILLE NORTHEAST GEORGIA MEDICAL CENTER LUMPKIN |
| FACILITY 1, STEPHENS COUNTY HOSPITAL - PART V, LINE 6B | GEORGIA DEPARTMENT OF PUBLIC HEALTH - DISTRICT 2 PUBLIC HEALTH |
| FACILITY 1, STEPHENS COUNTY HOSPITAL - PART V, LINE 11 | 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) SUBSTANCE ABUSE, 2) ACCESS TO CARE, 3) BEHAVIORAL AND MENTAL HEALTH, AND 4) MATERNAL AND CHILD HEALTH. STEPHENS COUNTY HOSPITAL HAS ADDRESSED EACH OF THE SIGNFICANT HEALTH NEEDS AS PRIORITIZED IN THE CHNA BY ITS WORK GROUP AND DEVELOPED IMPLEMENTATION STRATEGIES TO ADDRESS EACH OF THE HEALTH ISSUES IDENTIFIED OVER THE NEXT THREE YEARS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| THE CLARY CARE CENTER | ||||
| 249 HOSPITAL DRIVE | TOCCOA | GA | 30577 | ADVANCED PERSONAL CARE |
| THE WILKINSON CENTER | ||||
| 269 HOSPITAL DRIVE | TOCCOA | GA | 30577 | PERSONAL CARE |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE | BAD DEBTS EXPENSE OF 6,856,068 WAS SUBTRACTED FROM GROSS PATIENT REVENUE IN THE AUDITED FINANCIAL STATEMENTS. NO ADJUSTMENT OF TOTAL EXPENSES ARE NEEDED FOR THIS CALCULATION. |
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | THE ORGANIZATION USES A COST-TO-CHARGE RATIO AS CALCULATED USING FORM 990, SCHEDULE H, WORKSHEET 2 TO CALCULATE THE DISCLOSURES IN SCHEDULE H, PART I, LINE 7 A - C. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | THE AUTHORITY PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON THE EVALUATION OF OVERALL COLLECTABILITY OF THE ACCOUNTS RECEIVABLE. AS ACCOUNTS ARE KNOW TO BE UNCOLLECTIBLE, THEY ARE CHARGED AGAINST THE ALLOWANCE. |
| PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE | THE BAD DEBT EXPENSE ATTRIBUTABLE TO CARE THAT WOULD QUALIFY FOR FINANCIAL ASSISTANCE (65%) IS BASED ON MANAGEMENT'S EVALUATION OF THE MEDIAN INCOME AND POVERTY LEVELS IN THE SERVICE AREA. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | FOOTNOTES 2 AND 3 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS ADDRESS UNCOMPENSATED CARE INCLUDING UNINSURED PATIENTS AND THE PROVISION FOR BAD DEBTS. PLEASE SEE PAGES 18 - 21. |
| PART III, LINE 8 - MEDICARE EXPLANATION | MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. THE FULL AMOUNT OF THE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT. MEDICARE IS A FEDERAL PROGRAM WHICH DICTATES PAYMENT RATES AND CONDITIONS OF PARTICIPATION FOR SERVING CERTAIN ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. SERVING THE NEEDS OF OUR CITIZENS AT BELOW MEDICARE'S COMPUTATION OF COST PROVIDES NECESSARY LOCAL CARE FOR A SEGMENT OF THE POPULATION THAT CONSTITUTES A CHARITABLE CLASS. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | PATIENTS KNOWN TO HAVE QUALIFIED FOR FINANCIAL ASSISTANCE ARE CONTACTED TO ASCERTAIN THEIR ABILITY TO PAY ANY BALANCE DUE AFTER THE FAP DISCOUNT AND/OR THEIR PLACEMENT ON THE INDIGENT/CHARITY CARE POLICY GUIDELINES OR TO CONFIRM WHETHER OR NOT THERE HAS BEEN A CHANGE IN THEIR FINANCIAL SITUATION. IF PREVIOUS QUALIFICATION OCCURRED WITHIN THE PRIOR 3 MONTHS OR THERE IS A HISTORIC LONG-TERM QUALIFICATION PATTERN, A PATIENT MAY BE PRESUMED INDIGENT OR IN NEED OF CHARITY. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | IN ADDITION TO CONDUCTING A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT, THE HOSPITAL RECEIVES INPUT AND ADVICE FROM MEMBERS OF THE MEDICAL STAFF, NURSING STAFF AND COMMUNITY MEMBERS THROUGHOUT THE YEAR. |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | ALL PATIENTS AND VISITORS RECEIVE NOTIFICATION AT REGISTRATION THAT THERE ARE ASSISTANCE PROGRAMS AVAILABLE AND THAT THE HOSPITAL STAFF WILL ASSIST THEM IN EXPLORING ELIGIBILITY. ALL UNINSURED PATIENTS ARE CHECKED AGAINST THE MEDICAID DATABASE FOR ELIGIBILITY AND ENCOURAGED TO COMPLETE THE PROCESS IF ELIGIBILITY IS INDICATED. PATIENTS ARE OFFERED A COPY OF THE PLAIN LANGUAGE SUMMARY OF THE FAP UPON ADMISSION AND SIGNAGE THROUGHOUT THE FACILITY ALERTS PATIENTS OF THE AVAILABILITY OF THE FINANCIAL ASSISTANCE POLICY UPON REQUEST. THE FAP, PLAIN LANGUAGE SUMMARY AND FINANCIAL ASSISTANCE APPLICATION ARE AVAILABLE ON THE ORGANIZATION'S WEBSITE. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | STEPHENS COUNTY HOSPITAL AUTHORITY IS LOCATED IN TOCCOA, GEORGIA AND SERVES BOTH STEPHENS AND FRANKLIN COUNTIES. THE AREA IS GROWING SLOWLY WITH A PROJECT GROWTH RATE OF LESS THAN HALF THE RATE OF THE STATE OF GEORGIA. THE MEDIAN AGE OF THE AREA IS MUCH OLDER THAN THE STATE AVERAGE; MEDIAN HOUSEHOLD INCOME IS SIGNFICANTLY LOWER THAN STATE AND NATIONAL BENCHMARKS; AND THE ESTIMATED UNINSURED RATE IS GREATER THAN STATE AND FEDERAL LEVELS. THE 2018 MEDIAN INCOME WITHIN THE ZIP CODES IN THE HOSPITAL'S SEVICE AREA RANGE FROM 34,369 TO 45,362 (THE MEDIAN FOR GEORGIA WAS 55,559 WITH THE NATIONAL MEDIAN WAS 62,175). APPROXIMATELY 21% OF THE COMMUNITY HAS NO HEALTH INSURANCE AND 14% OF THE COMMUNITY IS ON MEDICAID. THE COMMUNITY INCLUDES 5 HEALTH PROFESSIONAL SHORTAGE AREAS AND 1 MEDICALLY UNDERSERVED AREA. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | STEPHENS COUNTY HOSPITAL AUTHORITY APPLIES ANY EXCESS REVENUES OVER EXPENSES TO THE PROVISION OF PATIENT CARE, PATIENT AND COMMUNITY HEALTH EDUCATION, RETIREMENT OF DEBT RELATED TO THE PURCHASE OF FIXED ASSETS UTILIZED IN THE PROVISION OF PATIENT CARE AND THE PURCHASE OF EQUIPMENT FOR THE PROVISION OF HEALTHCARE OR EXPANSION OF HEALTHCARE SERVICES TO THE COMMUNITY. THE STEPHENS COUNTY HOSPITAL AUTHORITY'S GOVERNING BOARD INCLUDES INDIVIDUALS RESIDING IN THE HOSPITAL'S PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION NOR FAMILY MEMBERS THEREOF. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. THE HOSPITAL'S EMERGENCY ROOM IS OPEN 24 HOURS A DAY, 365 DAYS PER YEAR TO EVERYONE WITHOUT REGARD TO THEIR ABILITY TO PAY. THE HOSPITAL PARTICIPATES IN THE MEDICARE, MEDICAID AND OTHER GOVERNMENT PROGRAMS. THE HOSPITAL PROVIDES EMERGENCY AND OTHER MEDICALLY NECESSARY CARE TO THE COMMUNITY ON A NONDISCRIMINATORY BASIS WITHOUT REGARD TO AN INDIVIDUAL'S ABILITY TO PAY FOR SUCH CARE. |
| PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM | STEPHENS COUNTY HOSPITAL FOUNDATION, INC. IS A FUNDRAISING AFFILATE THAT SUPPORTS THE HOSPITAL. STEPHENS COUNTY EMERGENCY PHYSICIANS, INC. IS A DORMANT TAX-EXEMPT ENTITY. PRIOR TO CEASING OPERATIONS, IT PROVIDED EMERGENCY ROOM PHYSICIANS TO THE HOSPITAL (THE HOSPITAL NOW CONTRACTS DIRECTLY WITH A THIRD PARTY PROVIDER FOR THESE SERVICES). |
| PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT | GEORGIA |
| ADDITIONAL INFORMATION | THE COMPLETE URL FOR THE FAP, FAP PLAIN LANGUAGE SUMMARY, THE FINANCIAL ASSISTANCE APPLICATION, THE CHNA AND THE IMPLEMENTATION STRATEGY REPORTS ARE AS FOLLOWS _ FAP - HTTPS://STEPHENSCOUNTYHOSPITAL.COM/FULLPANEL/UPLOADS/FILES/SCH- FINANCIAL-ASSISTANCE-POLICY-PATIENT.PDF. PLS - HTTP://STEPHENSCOUNTYHOSPITAL.COM/FULLPANEL/UPLOADS/FILES/FINANCIAL- ASSISTANCE-PROGRAM---PLAIN-LANGUAGE-00003.PDF. APPLICATION - HTTPS://STEPHENSCOUNTYHOSPITAL.COM/FULLPANEL/UPLOADS/FILES/4 -ITF-APPLICATION.PDF. CHNA - HTTPS://STEPHENSCOUNTYHOSPITAL.COM/FULLPANEL/UPLOADS/FILES/NEGA- CHNA-FOR-EXTERNAL-USE.PDF. IMPLEMENTATION STRATEGY REPORT - HTTPS://STEPHENSCOUNTYHOSPITAL.COM/FULLPANEL/UPLOADS/FILES/2019-SCH- IMPLEMENTATION-STRATEGY.PDF. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | 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 (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt |
|---|---|---|---|---|---|
| KATHY F WHITMIRE | |||||
| COO | $144,987 | $7,005 | $151,992 | ||
| CHRISTOPHER M VAUGHN MD | |||||
| PHYSICIAN | $500,616 | $555,959 | $55,343 | ||
| JAMES R WADE MD | |||||
| PHYSICIAN | $359,870 | $14,638 | $504,549 | $130,041 | |
| DEARL V BIRDSONG MD | |||||
| PHYSICIAN | $377,241 | $16,369 | $393,610 | ||
| KATHRYN A MCKINNEY MD | |||||
| PHYSICIAN | $302,271 | $7,361 | $359,632 | $50,000 | |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEPHENS COUNTY HOSPITAL AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 586001667 | BondIssuerEIN |
| CUSIP | NONENONEN | CUSIPNum |
| Bond Issued | 2017-06-07 | BondIssuedDt |
| Issue Price | $9,500,000 | IssuePriceAmt |
| Purpose | CURRENT REFUNDING, IMPROVEMENTS, EQUIPMENT | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $560,000 | RetiredAmt |
| Total Proceeds | $9,500,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $180,500 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $2,000,345 | CapitalExpendituresAmt |
| Other Spent Proceeds | $4,445,568 | OtherSpentProceedsAmt |
| Unspent | $2,873,587 | UnspentAmt |
| Substantial Completion | 2017 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (true) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | false | RefundingTaxableBondsInd |
| Final Allocation Made | false | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | false | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | false | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K - ADDITIONAL INFORMATION | FormAndLineReferenceDesc |
| Explanation | STEPHENS COUNTY HOSPITAL AUTHORITY THE AMOUNT LISTED ON PART II, LINE 11 REPRESENT PROCEEDS SPENT TO REFUND THE SERIES 2006 ISSUE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | THE MISSION OF STEPHENS COUNTY HOSPITAL AUTHORITY IS TO PROVIDE HEALTH CARE AND RELATED SERVICES TO ENHANCE INDIVIDUAL HEALTH AND WELL BEING IN A MANNER THAT MEETS THE EXPECTATIONS OF PATIENTS AND OTHER CUSTOMERS; PRESERVE THE RIGHTS OF PATIENTS, EMPLOYEES AND OTHERS TO BE TREATED WITH DIGNITY, RESPECT AND CONCERN; PROVIDE PROFESSIONALLY AND TECHNICALLY PROFICIENT PERSONNEL IN AN EFFECTIVE AND RESOURCE EFFICIENT MANNER; AND UTLILIZE RESOURCES APPROPRIATELY TO CONTAIN COSTS AND TO PROVIDE FOR ADDITIONAL SERVICE OPPORTUNITIES. ALL PHASES OF OPERATION MUST BE CARRIED OUT IN AN ETHICAL MANNER DEDICATED TO EXCELLENCE IN HEALTHCARE FOR EVERY LIFE WE TOUCH. |
| FORM 990, PAGE 6, PART VI, LINE 7A | MEMBERS OF THE BOARD OF TRUSTEES ARE NOT COMPENSATED. THEY ARE ELECTED TO A SIX YEAR TERM. ANY OPENING OR VACANCY IS FILLED BY THE REMAINING MEMBERS OF THE BOARD SELECTED FROM A SLATE OF THREE NOMINEES MADE BY THE COUNTY COMMISSION. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE RETURN IS PREPARED BY AN INDEPENDENT CPA , REVIEWED BY MANAGEMENT AND PROVIDED TO EACH MEMBER OF THE BOARD FOR REVIEW PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE ORGANIZATION CONDUCTS PERIODIC REVIEWS OF EXISTING BUSINESS RELATIONSHIPS AND INITIAL REVIEWS OF ANY NEW BUSINESS RELATIONSHIPS. DECISIONS RELATED TO POTENTIAL CONFLICTS ARE MADE BY THE REMAINING NONCONFLICTED BOARD MEMBERS. VIOLATION OF THE COI POLICY IS SUBJECT TO CORRECTIVE ACTION. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE AUTHORITY SETS AND REVIEWS THE COMPENSATION PACKAGE OF THE CEO USING COMPARABLE DATA PROVIDED BY THE GEORGIA HOSPITAL ASSOCIATION ON CEO COMPENSATION AT SIMILAR SIZED HOSPITALS LOCATED IN GEORGIA. CONSIDERATION IS GIVEN TO THE LEVEL OF EXPERIENCE AND OVERALL PERFORMANCE OF THE HOSPITAL. THE SAME PROCESS IS USED THROUGHOUT THE ORGANIZATION IN SETTING AND REVIEWING PAY SCALES FOR ALL JOBS, INCLUDING OTHER OFFICERS AND KEY EMPLOYEES. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SEE RESPONSE TO 15A ABOVE. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE STEPHENS COUNTY HOSPITAL AUTHORITY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONSULTING & FINANCIAL SERV. 0 467,706 0 COLLECTIONS 0 457,363 0 ER COVERAGE 1,512,302 0 0 PROFESSIONAL FEES 4,959,252 0 0 TOTAL 6,471,554 925,069 0 |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEPHENS COUNTY HOSPITAL PHYSICAN | BusinessNameLine1Txt |
| Business Name Line2 | GROUP LLC | BusinessNameLine2Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 163 HOSPITAL DRIVE | AddressLine1Txt |
| City | TOCCOA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30577 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | PHYSICIANS | PrimaryActivitiesTxt |
| Legal Domicile State | GA | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCHA | BusinessNameLine1Txt |
| Business Name Line2 | STEPHENS COUNTY HOSPITAL AUTHORITY | BusinessNameLine2Txt |
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 | Business Name Line2DirectControllingEntityName/BusinessNameLine2Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| STEPHENS COUNTY EMERGENCY PHYSICIAN | |||||||||||
| 163 HOSPITAL DRIVE | TOCCOA | GA | 305776820 | 020692996 | DORMANT | GA | 501C3 | 3 | SCHA | STEPHENS COUNTY HOSPITAL AUTHORITY | Yes (true) |
| STEPHENS COUNTY HOSPITAL FOUNDATION | |||||||||||
| 163 HOSPITAL DRIVE | TOCCOA | GA | 305776820 | 208089919 | FUNDRAISIN | GA | 501C3 | 12A | SCHA | STEPHENS COUNTY HOSPITAL AUTHORITY | Yes (true) |
| 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 | false | 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 (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| STEPHENS COUNTY HOSPITAL FOUNDATION | ||
| C | $46,939 | CASH VALUE |
| STEPHENS COUNTY HOSPITAL FOUNDATION | ||
| M | NO VALUE ESTIMATED | |
| STEPHENS COUNTY HOSPITAL FOUNDATION | ||
| N | NO VALUE ESTIMATED | |
| STEPHENS COUNTY HOSPITAL FOUNDATION | ||
| O | NO VALUE ESTIMATED | |