2019-08-05T12:32:09-05:00 2018-09-30 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2017-10-01 262988454 ARCHBOLD MEDICAL GROUP INC ARCH 2292282880 P O BOX 620 THOMASVILLE GA 317990620 J PERRY MUSTIAN PRESIDENT/CEO 2292282880 2019-08-02 true JACQUELINE G ATKINS P00861721 2298837878 2019-08-01 208.73.87.26 2019-08-05 12:32:09 CD P 3DB754BF4A86932C7270BAD44D636E9B352C5FAB 3DB754BF4A86932C7270BAD44D636E9B352C5FAB 2017 2019-02-21 02:37:17Z J PERRY MUSTIAN P O BOX 1018 THOMASVILLE GA 317990620 19083651 false X N/A X 2008 GA TO PROVIDE QUALIFIED HEALTH CARE PROFESSIONALS TO PERFORM HEALTH CARE SERVICES ESSENTIAL TO THE PREVENTION AND TREATMENT OF DISEASE FOR THE BENEFIT OF ALL INDIVIDUALS IN ITS SERVICE AREA. 7 2 0 0 0 17553748 16935308 29191 2567853 2099133 20121601 19063632 0 0 29514982 28900255 0 0 11594034 8967920 41109016 37868175 -20987415 -18804543 6591747 5694296 100109699 118016791 -93517952 -112322495 TO PROVIDE QUALIFIED HEALTH CARE PROFESSIONALS TO PERFORM HEALTH CARE SERVICES ESSENTIAL TO THE PREVENTION AND TREATMENT OF DISEASE FOR THE BENEFIT OF ALL INDIVIDUALS IN ITS SERVICE AREA. false false 31999372 19034441 HEALTH CARE SERVICES ESSENTIAL TO THE PREVENTION AND TREATMENT OF DISEASE FOR THE BENEFIT OF ALL INDIVIDUALS IN ITS SERVICE AREA, ESTABLISH AND PROMOTE HEALTH EDUCATION PROGRAMS FOR PATIENTS AND THE PUBLIC. 31999372 true false false false false false false false false false true false false false true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 0 0 0 false false false false false false false false false false X 7 2 false false false false true true true true true false false true true true true true true true true false GA X GREG HEMBREE 2292282853 915 GORDON AVENUE THOMASVILLE GA 31792 GERALD N KADIS MD VICE CHAIRMA 40.00 X X 1046008 0 25530 J PERRY MUSTIAN PRESIDENT/CE 6.00 45.00 X X 0 862602 -145985 GREG HEMBREE SEC/TREAS; C 6.00 45.00 X X 0 437891 64580 LORRAINE WILLIAMS MD TRUSTEE 40.00 X 432063 0 26092 JOHNNY BELENCHIA MD TRUSTEE 40.00 X 397622 0 33322 MARTA JONES TURNER CHAIRMAN 1.00 2.00 X X 0 0 0 MARK PARKER TRUSTEE 1.00 1.00 X 0 0 0 GRADY RAMSEY VICE PRESIDE 40.00 2.00 X 194194 0 34128 BRIAN RUSSELL MD PHYSICIAN 40.00 X 921162 0 26470 CHRISTOPHER DANIELS MD PHYSICIAN 40.00 X 843170 0 8980 CRAIG A FREDERICKS MD PHYSICIAN 40.00 X 841362 0 29365 BYRON SIZEMORE MD PHYSICIAN 40.00 X 805121 0 21265 TIMOTHY GRAYSON MD PHYSICIAN 40.00 X 698944 0 26665 6179646 1300493 150412 52 false true false WEATHERBY LOCUMS INC P O BOX 972633 DALLAS TX 75397 LOCUM TENENS 1303326 CARDIOLOGY CONSULTANTS OF SOUTH GA 100 MIMOSA DRIVE SUITE 2L THOMASVILLE GA 317926678 PROF FEES 788084 CERNER HEALTH SERVICES INC P O BOX 959167 ST LOUIS MO 63195 SOFTWARE MAINT 455776 DELTA LOCUM TENENS LLC P O BOX 202940 DALLAS TX 75320 LOCUM TENENS 177200 NEXTGEN HEALTHCARE 18111 VON KARMAN AVE IRVINE CA 92612 SOFTWARE MAINT 159730 9 PATIENT SERVICE REVENUE 623000 16935308 16935308 16935308 49210 20019 29191 29191 29191 MANAGEMENT FEES 623990 1849314 1849314 MISCELLANEOUS INCOME 623990 208482 208482 DIRECTOR FEES 623990 41337 41337 2099133 19063632 19034441 29191 2174765 1960636 214129 23477860 21748480 1729380 147857 139293 8564 3099773 2875829 223944 1573260 1573260 7262 7262 15000 15000 2945132 2448566 496566 33944 33944 579093 283389 295704 378233 378233 701837 305089 396748 49919 21352 28567 277978 277978 773257 336135 437122 717241 661355 55886 MEDICAL SUPPLIES 422645 422645 RECRUITMENT 342848 342848 REPAIRS & MAINTENANCE 104334 101523 2811 LICENSES & TAXES 22098 16496 5602 23839 23814 25 37868175 31999372 5868803 0 614923 188185 1752928 2072999 701311 526293 50888 26645 7130601 4250427 3471697 2880174 6591747 5694296 2925964 3163245 97183735 114853546 100109699 118016791 X -93517952 -112322495 -93517952 -112322495 6591747 5694296 -18804543 X true X true X true false X 140680 140680 373661 100352 273309 1700909 740602 960307 4915351 3409473 1505878 2880174 DUE TO RELATED PARTIES 114853546 114853546 X SCHEDULE D, PAGE 3, PART X EXCERPT FROM CONSOLIDATED PARENT ORGANIZATION AUDITED FINANCIAL STATEMENTS. THE MEDICAL CENTER, WITH THE EXCEPTION OF ARCHBOLD MEDICAL ENTERPRISES, INC., IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX- EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEDICAL CENTER APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE CONSOLIDATED FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE MEDICAL CENTER ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENTS EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF SEPTEMBER 30, 2018 AND 2017 OR FOR THE YEARS THEN ENDED. THE MEDICAL CENTERS TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAXING AUTHORITIES. FOR FEDERAL INCOME TAX PURPOSES, THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. (THE MEDICAL CENTER REFERS TO ARCHBOLD MEDICAL CENTER, INC., THE PARENT CORPORATION.) X X true false X X X X X false true false false false false false false false GERALD N KADIS MD VICE CHAIRMAN 1023651 6286 16071 18900 6630 1071538 J PERRY MUSTIAN PRESIDENT/CEO 642611 200027 19964 -159800 13815 716617 GREG HEMBREE SEC/TREAS; CFO 337542 99188 1161 52200 12380 502471 LORRAINE WILLIAMS MD TRUSTEE 424485 604 6974 10800 15292 458155 JOHNNY BELENCHIA MD TRUSTEE 318557 6895 72170 13500 19822 430944 GRADY RAMSEY VICE PRESIDENT 165632 27320 1242 20489 13639 228322 BRIAN RUSSELL MD PHYSICIAN 899359 6036 15767 12728 13742 947632 CHRISTOPHER DANIELS MD PHYSICIAN 584836 26250 232084 8100 880 852150 CRAIG A FREDERICKS MD PHYSICIAN 831762 6036 3564 18900 10465 870727 BYRON SIZEMORE MD PHYSICIAN 605623 29400 170098 10800 10465 826386 TIMOTHY GRAYSON MD PHYSICIAN 292669 406275 16200 10465 725609 SCHEDULE J, PAGE 1, PART I, LINE 1A SOCIAL CLUB DUES ARE PAID BY THE ORGANIZATION ON BEHALF OF OFFICERS AND EXECUTIVES OF THE FILING ORGANIZATION. THESE AMOUNTS ARE INCLUDED IN THE INDIVIDUAL'S TAXABLE INCOME AND REPORTED ON THEIR W-2. THE ORGANIZATION'S POLICY FOR COMPANION TRAVEL INCLUDES THE REIMBURSEMENT OF REGISTRATION, TRAVEL, AND ENTERTAINMENT EXPENSES FOR GUESTS WHO ACCOMPANY BOARD TRUSTEES TO EITHER OF TWO ANNUAL TRUSTEE CONFERENCES. RECEIPTS MUST BE SUBMITTED PRIOR TO REIMBURSEMENT AND THE AMOUNTS ARE NOT INCLUDED IN THE INDIVIDUAL'S TAXABLE INCOME. SCHEDULE J, PAGE 1, PART I, LINE 4 J. PERRY MUSTIAN 0 -176,000 0 GREG HEMBREE 0 41,400 0 GRADY RAMSEY 0 14,192 0 SCHEDULE J, PART III THE IRS RULES & REGULATIONS REQUIRE THAT CERTAIN NON-CURRENT, NON-CASH ITEMS ARE REPORTED IN PART II OF FORM 990 REGARDLESS OF THE CURRENT BENEFIT TO THE EMPLOYEE. THESE SAME RULES, IN SOME CASES, REQUIRE THE COMPENSATION AND BENEFITS TO BE REPORTED TWICE IN PART II, ONCE WHEN THE ENTITY ACCRUES FOR A FUTURE PAYMENT AND ONCE WHEN THE PAYMENT IS ACTUALLY MADE TO THE EMPLOYEE. THEREFORE, AN EMPLOYEE'S STATED TOTAL COMPENSATION AND BENEFITS REPORTED ON PART II ARE SUBSTANTIALLY HIGHER THAN THE ACTUAL CASH COMPENSATION RECEIVED IN THE CURRENT YEAR. AMOUNTS REPORTED AS BENEFITS INCLUDE AMOUNTS FOR LIFE INSURANCE, HEALTH INSURANCE, THRIFT PLAN CONTRIBUTIONS, AND PENSION CONTRIBUTIONS. BENEFITS RELATED TO PENSION AND RETIREMENT PLANS REFLECT AMOUNTS ACCUMULATED, BUT NOT PAID, TO THE INDIVIDUAL IN RECOGNITION OF TOTAL YEARS OF EMPLOYMENT, NOT JUST THE CURRENT YEAR. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN A FEW OF AMC'S TOP EXECUTIVES PARTICIPATE IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WHICH IS ACCRUED BUT UNFUNDED IN AN AMOUNT WHICH, WHEN ADDED TO OTHER SOURCES OF RETIREMENT INCOME, WILL AFFORD A RETIREMENT INCOME AT A TARGETED PERCENTAGE OF PRE-RETIREMENT COMPENSATION. THE SERP IS A NON-QUALIFIED RETIREMENT PLAN. AMC 457(F) RETIREMENT PLAN CERTAIN EXECUTIVES WHO ARE NOT ELIGIBLE FOR THE SERP MAY BE ELIGIBLE TO PARTICIPATE IN A 457(F) PLAN TO HELP THEM ACCUMULATE FUNDS FOR THEIR LONG TERM FINANCIAL NEEDS. THE ORGANIZATION MAY CONTRIBUTE A PERCENTAGE OF BASE SALARY INTO AN INDIVIDUAL EXECUTIVES ACCOUNT IF THE ORGANIZATION MEETS CERTAIN FINANCIAL TARGETS. THE ORGANIZATION OWNS ANY PLAN ASSETS UNTIL THEY ARE PAID TO THE EMPLOYEE AND ALL FUNDS ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. VESTING BEGINS AT AGE 55 WITH FIVE YEARS OF SERVICE AT A RATE OF 90% AND THEN INCREASES TO 100% AT AGE 60. PAYMENTS ARE MADE ANNUALLY UPON VESTING. BONUS AWARDS: OFFICERS AND PHYSICIANS ARE AWARDED BONUSES/INCENTIVES CONTINGENT IN PART ON MEETING MANAGEMENT-BY-OBJECTIVE INCENTIVE PLAN GOALS AND EXCESS OF REVENUE OVER EXPENSES. FORM 990, PAGE 6, PART VI, LINE 6 ARCHBOLD MEDICAL CENTER, INC. (AMC) IS THE SOLE MEMBER OF THE ORGANIZATION WITH RIGHTS TO ELECT MEMBERS OF THE GOVERNING BODY, APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BODY AND RECEIVE A SHARE OF THE ORGANIZATION'S NET ASSETS UPON THE ORGANIZATION'S DISSOLUTION. FORM 990, PAGE 6, PART VI, LINE 7A AMC, THE SOLE MEMBER OF ARCHBOLD MEDICAL GROUP, HAS POWER TO APPOINT, ELECT, REPLACE OR REMOVE THE TRUSTEES OF THE GOVERNING BODY. ADDITIONALLY THE CEO AND CFO OF JOHN D. ARCHBOLD MEMORIAL HOSPITAL, A RELATED ORGANIZATION, SHALL SERVE AS EX-OFFICIO MEMBERS OF THE BOARD WITH THE POWER TO VOTE. FORM 990, PAGE 6, PART VI, LINE 7B THE FILING ORGANIZATION'S GOVERNING BODY MUST SEEK APPROVAL IN WRITING FROM THE SOLE MEMBER, AMC, FOR OPERATING AND CAPITAL BUDGETS, EXPENDITURES OR COMMITMENTS THAT EXCEED 10,000, ASSET SALES AND DISPOSITIONS, PLAN OF DISSOLUTION OF THE ORGANIZATION, ETC. FORM 990, PAGE 6, PART VI, LINE 11B A COPY OF THE FORM 990 IS PROVIDED TO TRUSTEES ELECTRONICALLY THROUGH A SECURE WEBSITE PRIOR TO FILING THE RETURN WITH THE IRS. ADDITIONALLY, AN OVERVIEW OF THE RETURN IS PROVIDED TO TRUSTEES IN ATTENDANCE AT A BOARD MEETING GIVING EACH AN OPPORTUNITY TO ASK QUESTIONS AND MAKE COMMENTS. FORM 990, PAGE 6, PART VI, LINE 12C ON AN ANNUAL BASIS, THE ORGANIZATION DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE AND DISCLOSURE STATEMENT TO EACH TRUSTEE. THIS QUESTIONNAIRE INCLUDES QUESTIONS RELATED TO FINANCIAL INTERESTS, OUTSIDE INTERESTS OR ACTIVITIES, AND GIFTS, MEALS, AND ENTERTAINMENT. IN ADDITION TO DISCLOSING ANY APPLICABLE INFORMATION ON THE QUESTIONNAIRE, THE TRUSTEE ACKNOWLEDGES THAT (S)HE HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ, UNDERSTANDS, AND AGREES TO COMPLY WITH IT, AND UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. RESPONSES ARE SUMMARIZED AND COLLECTIVELY REVIEWED BY THE AUDIT & COMPLIANCE COMMITTEE OF AMC, THE SOLE MEMBER. DURING EACH BOARD MEETING, THE CHAIRMAN INQUIRES IF ANY TRUSTEE HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST RELATED TO ANY AGENDA ITEM. IF THE TRUSTEE DISCLOSES ANY SUCH INTEREST, THE TRUSTEE IS EXCUSED FROM THE MEETING WHILE THE DETERMINATION AS TO WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS IS DISCUSSED AND VOTED UPON BY DISINTERESTED MEMBERS OF THE BOARD OR COMMITTEE. IF INVITED TO DO SO, THE TRUSTEE WITH A POTENTIAL CONFLICT MAY RESPOND TO QUESTIONS PUT FORTH BY FELLOW DISINTERESTED TRUSTEES REGARDING ANY PROPOSED TRANSACTION OR ARRANGEMENT. THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS WILL RECORD THE NAME OF ANY INTERESTED PERSON/TRUSTEE WHO DISCLOSED OR WAS FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH A TRANSACTION OR ARRANGEMENT RESULTING IN AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; AND THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATED TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSIONS, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH. FORM 990, PAGE 6, PART VI, LINE 15A ARCHBOLD MEDICAL CENTER'S (AMC) COMPENSATION COMMITTEE (COMMITTEE) OF THE AMC BOARD OF TRUSTEES MAKES RECOMMENDATIONS TO THE FULL AMC BOARD ON THE FOLLOWING POSITIONS: THE PRESIDENT OF AMC AND THE PRESIDENT OF THE ARCHBOLD FOUNDATION. AMC'S PRESIDENT PRESENTS RECOMMENDATIONS FOR ALL SENIOR VICE PRESIDENTS, VICE PRESIDENTS, AND OTHER KEY EMPLOYEES OF AMC AND ALL RELATED ARCHBOLD ENTITIES TO THE COMMITTEE. SINCE AMC HAS RESERVE POWERS FOR ARCHBOLD RELATED ENTITIES, THE COMMITTEE SERVES AS THE COMPENSATION COMMITTEE FOR EACH APPLICABLE ARCHBOLD ENTITY. THE COMMITTEE CONSIDERS THE AMC PRESIDENT'S RECOMMENDATIONS, BUT IT ALSO CONSIDERS RECOMMENDATIONS AND INDEPENDENT MARKET DATA ANALYSIS FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE AMC BOARD UTILIZES AN INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE EXECUTIVE COMPENSATION PROGRAM AND MAKE RECOMMENDATIONS REGARDING PLAN DESIGN AND ACTUAL COMPENSATION INCLUDING BENEFITS. FORM 990, PAGE 6, PART VI, LINE 15B SEE 15A ABOVE. FORM 990, PAGE 6, PART VI, LINE 19 NO DOCUMENTS ARE OR WILL BE MADE AVAILABLE TO THE PUBLIC. 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