2020-08-14T15:10:50-05:00 2019-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2018-10-01 581519913 HAMILTON HEALTH CARE SYSTEM INC HAMI 7062726115 PO BOX 1168 DALTON GA 307221168 JULIE A SOEKORO VP/CFO/ASSISTANT TREASURER 7062726115 2020-08-14 1 AMY BIBBY P00445891 8282542254 2020-08-14 99.47.28.203 2020-08-14 14:07:21 ED P B6FD9AFAEFFBB4389B3F723AC8EEB9995B3F41FF 48FB394F9AA065459641371F168D9F2AFFFBB473 2018 2020-09-23 17:36:50Z JEFFREY D MYERS PO BOX 1168 DALTON GA 307221168 127813720 0 X WWW.HAMILTONHEALTH.COM X 1983 GA TO PROVIDE SUPPORT FOR AFFILIATED TAX-EXEMPT ORGANIZATIONS. 12 10 697 0 0 0 0 0 18983199 17967609 3690728 4495355 333495 549644 23007422 23012608 0 0 0 0 16413698 15762520 0 0 0 4195692 4478143 20609390 20240663 2398032 2771945 142110759 132703248 6173588 1946366 135937171 130756882 WE PROVIDE LEADERSHIP, PARTNERSHIPS AND SEAMLESS RESOURCE COORDINATION TO MEET HEALTH CARE NEEDS THAT ADVANCE THE QUALITY AND DIGNITY OF LIFE. 0 0 19684745 17967609 PROVIDED SUPPORT FOR AFFILIATED TAX-EXEMPT ORGANIZATIONS LISTED IN SCHEDULE A, PART I. 19684745 1 0 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 26 0 1 697 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 GA X JULIE A SOEKORO 7062782105 1200 MEMORIAL DRIVE DALTON GA 30720 G LAMAR LYLE CHAIRMAN 1.00 X X 0 0 0 ROBERT M CHANDLER VICE CHAIRMAN 1.00 X X 0 0 0 BRYAN E MCALLISTER SECRETARY/TREASURER 1.00 X X 0 0 0 DON W ADCOCK TRUSTEE 1.00 X 0 0 0 CHARLES N DOBBINS JR TRUSTEE 1.00 X 0 0 0 ERIC E JENSEN MD TRUSTEE 1.00 X 0 0 0 W NORRIS LITTLE TRUSTEE 1.00 X 0 0 0 GARY A MIDDLETON TRUSTEE 1.00 X 0 0 0 JOHN P NEAL III TRUSTEE 1.00 X 0 0 0 HENRY C THARPE JR TRUSTEE 1.00 X 0 0 0 LUIS M VIAMONTE MD TRUSTEE 1.00 X 0 0 0 JEFFREY D MYERS PRESIDENT/CEO 40.00 X X 1501927 0 122161 JOSEPH L MCGUIRE VP/CFO/ASSISTANT TREASURER 40.00 X 596639 0 62378 SANDRA D MCKENZIE EVP/COO 40.00 X 297483 299772 56388 RANDALL F FOSTER ASSISTANT TREASURER 40.00 X 0 202041 21488 VALERIE BRANTLEY VP/GENERAL COUNSEL 40.00 X 297244 0 54018 TYLER KENDALL VP-POST ACUTE CARE 40.00 X 216463 0 0 YVETTE LEE DIRECTOR CBO 40.00 X 137459 0 62196 STEVEN BRIDENSTINE DIRECTOR FINANCE 40.00 X 145612 0 17366 KIMBERLY REYNOLDS DIRECTOR MARKETING 40.00 X 108858 0 24646 SAVANNAH MOORE DIRECTOR RISK MANAGEMENT 40.00 X 109540 0 20899 3411225 501813 441540 9 0 1 0 BRASFIELD GORRIE LLC PO BOX 11407 BIRMINGHAM AL 352460351 CONTRACTOR SERVICES 10133498 NEW LIFE LANDSCAPES 2507 OLD ROCKBRIDGE NORCROSS GA 60197 LANDSCAPING ARCHITECTS 385282 CES PARTNERS LTD 1314 KENSINGTON ROAD 5195 OAKBROOK IL 605225195 EXECUTIVE RECRUITING 153784 QUADAX INC 25201 CHARGRINE BLVD SUITE 290 BEECHWOOD OH 44122 EDI SERVICES 136332 ALSTON BIRD PO BOX 933124 ATLANTA GA 31193 LEGAL FEES 123527 10 MANAGEMENT FEES 900099 11107456 11107456 AFFILIATE STAFFING 900099 6860153 6860153 17967609 1814821 1814821 107461646 20000 104801112 0 2660534 20000 2680534 2680534 MISCELLANEOUS REVENUE 900099 549644 549644 549644 23012608 17967609 0 5044999 2909756 2909756 9047130 9047130 257395 257395 2726054 2726054 822185 822185 225000 225000 136335 136335 26713 26713 21652 21652 361403 361403 1652320 1652320 639151 639151 487304 487304 143305 143305 12600 12600 479093 479093 32581 32581 MISCELLANEOUS 260686 312823 -52137 20240663 19684745 555918 0 3983926 439929 2361952 2601083 3582880 4071477 400000 1700000 65553 74773 24868990 1314487 14161081 23554503 104199787 89249745 13355580 11011738 142110759 132703248 5531284 1274491 642304 671875 6173588 1946366 X 134957171 129790043 980000 966839 135937171 130756882 142110759 132703248 X 2771945 -51212 -7901022 X X 0 1 X 1 0 X X 10 HAMILTON AMBULATORY SURGERY CENTER 582654791 3 1 0 0 HAMILTON MEDICAL CENTER INC 581519911 3 1 0 0 HAMILTON EMERGENCY MEDICAL SERVICES INC 581651002 10 1 1675000 0 HLTC INC 582341574 10 1 5300000 0 MURRAY MEDICAL CENTER INC 582341574 3 1 0 0 ROYAL OAK COMMUNITY LTD 582373427 3 1 0 0 WHITFIELD HEALTHCARE FOUNDATION INC 510175056 3 1 0 0 WHITFIELD PLACE INC 582103085 10 1 45000 0 HAMILTON CHILDREN'S INSTITUTE 823312912 10 1 810000 0 DALTON SENIOR HOUSING INC 581518011 10 1 0 0 10 7830000 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 21652 21652 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND THE GEORGIA HOSPITAL ASSOCIATION. EACH YEAR, A PORTION OF DUES PAID TO THESE ORGANIZATONS IS ALLOCATED TO LOBBYING EFFORTS ENGAGED BY THESE ORGANIZATIONS ON BEHALF OF THEIR MEMBERSHIP BODIES. THE AMOUNT ON LINE 1(I) ABOVE IS AN ESTIMATION OF THE LOBBYING PORTION OF DUES PAID FOR THE FISCAL YEAR. 1141372 1141372 21184053 353068 20830985 522624 56721 465903 2020941 904698 1116243 23554503 TIMBERLAND INVESTMENTS 3854194 F REAL ESTATE 7157544 F 11011738 DEFERRED COMPENSATION 435704 ASSETS HELD ON BEHALF OF OTHERS 236171 671875 X PART X, LINE 2: THE ORGANIZATION HAS ADOPTED PROCEDURES FOR DETERMINING THE EXISTENCE OF UNCERTAIN TAX POSITIONS, AND THE RELATED TIMING AND AMOUNT OF THEIR IMPACT ON THE FINANCIAL STATEMENTS, AND DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2019. X X 1 1 X X X 0 1 0 0 0 0 0 0 0 JEFFREY D MYERS PRESIDENT/CEO 943863 0 388206 0 169858 0 53955 0 68206 0 1624088 0 40205 0 JOSEPH L MCGUIRE VP/CFO/ASSISTANT TREASURER 361906 0 114299 0 120434 0 13750 0 48628 0 659017 0 93756 0 SANDRA D MCKENZIE EVP/COO 182912 167511 114571 0 0 132261 0 19934 0 36454 297483 356160 0 6184 RANDALL F FOSTER ASSISTANT TREASURER 0 158572 0 16842 0 26627 0 0 0 21488 0 223529 0 0 VALERIE BRANTLEY VP/GENERAL COUNSEL 177552 0 62617 0 57075 0 8215 0 45803 0 351262 0 0 0 TYLER KENDALL VP-POST ACUTE CARE 150694 0 40797 0 24972 0 0 0 0 0 216463 0 0 0 YVETTE LEE DIRECTOR CBO 118753 0 8775 0 9931 0 7048 0 55148 0 199655 0 0 0 STEVEN BRIDENSTINE DIRECTOR FINANCE 124301 0 13760 0 7551 0 6402 0 10964 0 162978 0 0 0 PART I, LINE 4B THE FOLLOWING PERSONS RECEIVED CURRENT YEAR DEFERRED COMPENSATION ACCRUALS FROM NON-QUALIFIED PLANS: - JEFFREY D. MYERS - $ 40,205 - SANDRA D. MCKENZIE - $6,184 FORM 990, PART VI, SECTION B, LINE 11B FOLLOWING MANAGEMENT PREPARATION AND REVIEW, THE FORM 990 IS REVIEWED BY AN INDEPENDENT CPA FIRM. SUBSEQUENTLY, A DRAFT OF THE UNFILED FORM 990 IS POSTED TO A SECURE PAGE ON THE HAMILTON HEALTH CARE SYSTEM WEBSITE FOR REVIEW AND COMMENT BY ALL MEMBERS OF THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CLEAR AND DETAILED CONFLICT OF INTEREST POLICY WHICH ESTABLISHES A PROCEDURE FOR IDENTIFYING, REVIEWING AND ADDRESSING CONFLICTS OF INTEREST. THIS POLICY ALSO REQUIRED EACH TRUSTEE AND OFFICER OF THE ORGANIZATION TO ANNUALLY SIGN A STATEMENT ACKNOWLEDGING RECEIPT OF THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 UNDER A BOARD RESOLUTION, THE ORGANIZATION'S COMPENSATION COMMITTEE HAS THE AUTHORITY TO TAKE ACTION ON BEHALF OF THE BOARD WITH RESPECT TO THE COMPENSATION OF OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE MAINTAINS MINUTES OF ITS PROCEEDINGS. ON AN ANNUAL BASIS THE COMPENSATION COMMITTEE WILL MEET TO SET THE ANNUAL COMPENSATION OF THE PRESIDENT/CEO. THIS ACTION IS BASED ON CONSULTATION WITH A THIRD PARTY CONSULTING FIRM TO REVIEW THE TOTAL COMPENSATION OF THE CEO AND KEY EMPLOYEES SUCH THAT TOTAL COMPENSATION PACKAGES ARE CONSIDERED FAIR MARKET AND NOT EXCESSIVE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: EQUITY TRANSFER TO HLTC, INC. -5,987,581. EQUITY TRANSFER TO HEMS, INC. -1,900,281. EQUITY TRANSFER TO RO INC. DECREASE IN TEMPORARILY RESTRICTED NET ASSETS -13,160. FORM 990, PART XII, LINE 2: THE FINANCIAL STATEMENTS OF HAMILTON HEALTH CARE SYSTEM, INC. ARE AUDITED ON A CONSOLIDATED BASIS TO INCLUDE ALL AFFILIATES OF THE SYSTEM. DALTON SENIOR HOUSING INC 519 WEST HAWTHORNE STREET DALTON GA 30720 581518011 LOW-INCOME HOUSING GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON AMBULATORY SURGERY CENTER INC PO BOX 1168 DALTON GA 30722 582654791 SURGICAL SERVICES GA 501(C)(3) LINE 3 HAMILTON MEDICAL CENTER INC 1 HAMILTON EMERGENCY MEDICAL SERVICES INC PO BOX 1168 DALTON GA 30722 581651002 EMERGENCY MEDICAL GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON MEDICAL CENTER INC PO BOX 1168 DALTON GA 30722 581519911 HEALTHCARE GA 501(C)(3) LINE 3 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON PHYSICIAN GROUP INC PO BOX 1168 DALTON GA 30722 271198701 PHYSICIAN PRACTICE GA 501(C)(3) LINE 3 HAMILTON MEDICAL CENTER INC 1 HLTC INC PO BOX 1168 DALTON GA 30722 582341574 LONG TERM ELDERLY CARE GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 1 MURRAY MEDICAL CENTER INC PO BOX 1168 DALTON GA 30722 582373427 HOSPITAL CARE / SERVICES GA 501(C)(3) LINE 3 HAMILTON HEALTH CARE SYSTEM INC 1 ROYAL OAK COMMUNITY LTD PO BOX 1900 DALTON GA 30722 581970228 SENIOR LIVING SERVICES GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 1 WHITFIELD PLACE INC PO BOX 1168 DALTON GA 30722 582103085 LOW-INCOME HOUSING GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 1 DALTON-WHITFIELD COUNTY HOSPITAL LIABILITY TRUST PO BOX 1168 DALTON GA 30722 581331514 LIABILITY CLAIMS COVERAGE GA 501(C)(3) LINE 12C, III-FI HAMILTON HEALTH CARE SYSTEM INC 1 WHITFIELD HEALTHCARE FOUNDATION INC PO BOX 1900 DALTON GA 30722 510175056 FUNDS FOR HEALTHCARE GA 501(C)(3) LINE 12B, II HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON CHILDREN'S INSTITUTE PO BOX 1168 DALTON GA 30722 823312912 PEDIARIC DEVELOPMENTAL/BEHAVORIAL TRETMENT GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON HEALTH FIRST INC PO BOX 1168 DALTON GA 30722 581694713 PREFERRED PROVIDER GA HAMILTON HEALTH CARE SYSTEM INC C 1.00000 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 HAMILTON EMERGENCY MEDICAL SERVICES A 0 FMV HLTC INC D 5300000 Y/E BALANCE HAMILTON EMERGENCY MEDICAL SERVICES D 1675000 Y/E BALANCE ROYAL OAK COMMUNITY LTD D 0 Y/E BALANCE HAMILTON EMERGENCY MEDICAL SERVICES E 0 Y/E BALANCE ROYAL OAK COMMUNITY LTD E 0 Y/E BALANCE HLTC INC E 9000000 Y/E BALANCE DALTON SENIOR HOUSING E 35000 Y/E BALANCE WHITFIELD PLACE E 86000 Y/E BALANCE HAMILTON MEDICAL CENTER O 4567300 FMV HAMILTON MEDICAL CENTER P 6780958 FMV HAMILTON EMERGENCY MEDICAL SERVICES P 367962 FMV ROYAL OAK COMMUNITY LTD P 302098 FMV HAMILTON MEDICAL CENTER Q 0 FMV DALTON SENIOR HOUSING K 31027 FMV WHITFIELD PLACE K 37922 FMV HAMILTON MEDICAL CENTER K 9495000 FMV HAMILTON EMERGENCY MEDICAL SERVICES K 115200 FMV HLTC INC K 450000 FMV WHITFIELD HEALTHCARE FOUNDATION K 237409 FMV ROYAL OAK COMMUNITY LTD K 186900 FMV HAMILTON CHILDREN'S INSTITURE K 49998 FMV HAMILTON EMERGENCY MEDICAL SERVICES R 1900281 FMV HLTC INC R 1189575 FMV ROYAL OAK COMMUNITY LTD R 0 FMV