OKEFENOKEE HEALTH INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- OKEFENOKEE HEALTH INC (EIN 58-1667166)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-15
- IRS object ID
- 201843199349310754
- Schema version
- 2017v2.3
- 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 I
- Schedule J
- Schedule L
- Schedule N
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-15T13:44:17-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 12237 | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 543072237 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581667166 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OKEFENOKEE HEALTH INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | OKEF | BusinessNameControlTxt |
| Phone | 9123375821 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3163 ORION DRIVE | AddressLine1Txt |
| City | WAYCROSS | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 315038908 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | P OWEN HERRIN JR | PersonNm |
| Person Title | VICE PRESIDENT | PersonTitleTxt |
| Phone | 9123375821 | PhoneNum |
| Signature | 2018-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TERRI REXRODE CPA MST | PreparerPersonNm |
| PTIN | P00096513 | PTIN |
| Phone | 9206620016 | PhoneNum |
| Preparation | 2018-11-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 74.87.127.216 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-15 | IPDt |
| IP Tm | 13:21:57 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | A43ECD1EE6AF4781A69F6BFA161A98BDE8FA2C07 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B2BBC66CE798CC4B98B5BAE532B86AFD0426F743 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3163 ORION DRIVE | AddressLine1Txt |
| City | WAYCROSS | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 315038908 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $224,076,775 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1985 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | FROM JANUARY THROUGH APRIL OF 2017, THE ORGANIZATION OPERATED A HOSPITAL TO PROMOTE HEALTH AND WELLNESS IN THE COMMUNITY. FOLLOWING THE SALE OF ALL THE HOSPITAL ASSETS AND THE ASSIGNMENT OF ALL THE NURSING HOME OPERATIONS EFFECTIVE MAY 1, 2017, OKEFENOKEE HEALTH, INC. CONTINUED IN AN ADMINISTRATIVE FUNCTION TO COMPLETE ITS OBLIGATIONS CONNECTED WITH ITS PRIOR BUSINESS OPERATIONS AS THE OWNER AND OPERATOR OF A HOSPITAL AND NURSING HOMES INCLUDING COLLECTING RELATED REVENUES AND SATISFYING ITS EXPENSES. IN ADDITION, OKEFENOKEE HEALTH, INC. CONTINUED TO MONITOR THE ACTIVITIES OF THE HOSPITAL BUYER TO ENSURE THAT THE HOSPITAL BUYER (I) CONTINUES TO OPERATE THE HOSPITAL AS AN ACUTE CARE HOSPITAL; (II) REMAINS ENROLLED IN THE MEDICARE AND MEDICAID PROGRAMS; (III) CONTINUES THE PROVISION OF INDIGENT CARE SERVICES AT A MINIMUM CONSISTENT WITH OHI'S PREVIOUS POLICIES; (IV) MAINTAINS IDENTIFIED CORE SERVICES FOR THE BENEFIT OF THE COMMUNITY; AND (V) MAKES CAPITAL EXPENDITURES AS AGREED UPON. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 4 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 1178 | TotalEmployeeCnt |
| Total Volunteers | 71 | TotalVolunteersCnt |
| Total Gross UBI | $8,050 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $944,717 | PYContributionsGrantsAmt |
| CY Contributions Grants | $90,706,204 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $175,189,949 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $56,442,914 | CYProgramServiceRevenueAmt |
| PY Investment Income | $484,648 | PYInvestmentIncomeAmt |
| CY Investment Income | -$20,945,391 | CYInvestmentIncomeAmt |
| PY Other Revenue | $684,679 | PYOtherRevenueAmt |
| CY Other Revenue | $307,959 | CYOtherRevenueAmt |
| PY Total Revenue | $177,303,993 | PYTotalRevenueAmt |
| CY Total Revenue | $126,511,686 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $18,648 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $76,457,208 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $90,793,426 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $24,760,448 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $111,828,623 | PYOtherExpensesAmt |
| CY Other Expenses | $39,616,752 | CYOtherExpensesAmt |
| PY Total Expenses | $202,640,697 | PYTotalExpensesAmt |
| CY Total Expenses | $140,834,408 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$25,336,704 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$14,322,722 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $156,090,990 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,707,828 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $139,921,832 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $940,714 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $16,169,158 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,767,114 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | NONE | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $117,496,329 | ExpenseAmt |
| Grant | $76,417,625 | GrantAmt |
| Revenue | $595,931 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $14,522,018 | ExpenseAmt |
| Grant | $39,583 | GrantAmt |
| Revenue | $55,975,987 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $132,018,347 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | Yes (1) | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 101 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1178 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 4 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | Yes (1) | OfficerMailingAddressInd |
| Local Chapters | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | P OWEN HERRIN JR | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9123375821 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3163 ORION DRIVE | AddressLine1Txt |
| City | WAYCROSS | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 315038908 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| BYRON C MAY MD | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $563,769 | $83,277 | |||
| DANIEL L TOMLINSON | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $245,431 | $67,344 | |||
| ROBERT M WALTERS | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $334,892 | $86,237 | |||
| DONALD WATERS MD | |||||||||
| PRESIDENT | 10.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| P OWEN HERRIN JR | |||||||||
| VICE PRESIDENT | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JAMES W DYE MD | |||||||||
| SECRETARY | 5.00 | 0.00 | Yes (X) | $17,500 | $0 | $0 | Yes (X) | ||
| ZIBIA A MUSIC | |||||||||
| TREASURER | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| RICHARD J PRESUTTI DO | |||||||||
| CHAIR | 1.00 | 40.00 | Yes (X) | $0 | $487,916 | $70,920 | Yes (X) | ||
| MICHAEL C DEITSCHMANN | |||||||||
| SECRETARY/TREASURER | 1.00 | 40.00 | Yes (X) | $0 | $178,988 | $67,611 | Yes (X) | ||
| HOLLI H SWEAT | |||||||||
| ASSISTANT SECRETARY | 40.00 | 0.00 | $102,685 | $0 | $7,983 | Yes (X) | |||
| ROGER FORGEY | |||||||||
| CEO | 40.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| GE HOFFMAN JR | |||||||||
| CFO | 40.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| TIMOTHY T CATCHINGS MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $389,034 | $0 | $14,347 | Yes (X) | |||
| HOWARD GRIFFIN MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $242,523 | $0 | $4,657 | Yes (X) | |||
| ASIT K JHA MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $287,392 | $0 | $17,553 | Yes (X) | |||
| BRIAN A SINGLETON MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $291,653 | $0 | $12,984 | Yes (X) | |||
| SRIDHAR SRINIVASAN MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $257,392 | $0 | $12,703 | Yes (X) | |||
| TERESA B BEARD | |||||||||
| FORMER OFFICER | 1.00 | 40.00 | $0 | $119,628 | $33,191 | Yes (X) | |||
| KENNETH T CALAMIA MD | |||||||||
| FORMER OFFICER | 1.00 | 40.00 | $0 | $215,798 | $56,224 | Yes (X) | |||
| CHERYL R CROFT | |||||||||
| FORMER OFFICER | 1.00 | 40.00 | $0 | $227,461 | $69,593 | Yes (X) | |||
| NANCY L DAWSON MD | |||||||||
| FORMER OFFICER | 1.00 | 40.00 | $0 | $313,936 | $80,540 | Yes (X) | |||
| STEPHEN M LANGE MD | |||||||||
| FORMER OFFICER | 1.00 | 40.00 | $0 | $508,189 | $39,402 | Yes (X) | |||
| KEVIN M LOCKETT | |||||||||
| FORMER OFFICER | 1.00 | 40.00 | $0 | $260,407 | $64,985 | Yes (X) | |||
| MCGREGOR N LOTT MD | |||||||||
| FORMER KEY EMPLOYEE | 40.00 | 0.00 | $229,121 | $0 | $14,952 | Yes (X) | |||
| WINDELL R SMITH JR | |||||||||
| FORMER KEY EMPLOYEE | 1.00 | 40.00 | $0 | $192,961 | $62,618 | Yes (X) | |||
| DAVID J WYKSTRA MD | |||||||||
| FORMER KEY EMPLOYEE | 40.00 | 0.00 | $218,701 | $0 | $14,106 | Yes (X) | |||
| MICHAEL P BAKER MD | |||||||||
| FORMER KEY EMPLOYEE | 1.00 | 40.00 | $0 | $142,744 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,036,001 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,792,120 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $881,227 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| NELSON MULLINS RILEY & SCARBROUG | |||||
| PO DRAWER 11009 | COLUMBIA | SC | 29211 | LEGAL SERVICES | $921,080 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972634 | DALLAS | TX | 75398 | PHYSICIAN SERVICES | $484,430 |
| DIAGNOSTIC PET LLC | |||||
| 1256 SHILOH ROAD | WILLAVILLE | GA | 31806 | DIAGNOSTIC SERVICES | $355,500 |
| BENCURA INC | |||||
| 125 TOWN PARK DR SUITE 300 | KENNESAW | GA | 30144 | REHABILIATION SERVICES | $313,604 |
| EMCARE INC | |||||
| 7032 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | PHYSICIAN SERVICES | $300,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 17 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $90,494,660 | RelatedOrganizationsAmt |
| Government Grants | $204,630 | GovernmentGrantsAmt |
| All Other Contributions | $6,914 | AllOtherContributionsAmt |
| Total Contributions | $90,706,204 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT REVENUE | 620000 | $56,373,142 | $56,365,092 | $8,050 |
| EDUCATION REVENUE | 611600 | $69,772 | $69,772 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $56,442,914 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $165,859 | TotalRevenueColumnAmt |
| Exclusion | $165,859 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $57,179 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $57,179 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $57,179 | TotalRevenueColumnAmt |
| Exclusion | $57,179 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $73,136,720 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $94,247,970 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$21,111,250 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$21,111,250 | TotalRevenueColumnAmt |
| Exclusion | -$21,111,250 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $3,280,905 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $3,317,119 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$36,214 | TotalRevenueColumnAmt |
| Exclusion | -$36,214 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CAFETERIA/VENDING | 722514 | $128,893 | $128,893 |
| MEDICAL RECORD/TRANSCRIPTION FEE | 900099 | $197 | $197 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $157,904 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,964 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $149,940 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $286,994 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $126,511,686 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $56,571,918 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $8,050 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$20,774,486 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,457,208 | TotalAmt |
| Program Services | $76,457,208 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,632,360 | TotalAmt |
| Program Services | $2,632,360 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $545,640 | TotalAmt |
| Program Services | $545,640 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,972,834 | TotalAmt |
| Program Services | $15,096,443 | ProgramServicesAmt |
| Management And General | $1,876,391 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,184 | TotalAmt |
| Program Services | $127,184 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,261,872 | TotalAmt |
| Program Services | $3,172,698 | ProgramServicesAmt |
| Management And General | $89,174 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,220,558 | TotalAmt |
| Program Services | $1,220,558 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,854,754 | TotalAmt |
| Management And General | $1,854,754 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,660 | TotalAmt |
| Management And General | $2,660 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168 | TotalAmt |
| Management And General | $168 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,024,809 | TotalAmt |
| Program Services | $9,908,347 | ProgramServicesAmt |
| Management And General | $4,116,462 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,034 | TotalAmt |
| Program Services | $227 | ProgramServicesAmt |
| Management And General | $35,807 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,980,321 | TotalAmt |
| Program Services | $1,552,170 | ProgramServicesAmt |
| Management And General | $428,151 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,221 | TotalAmt |
| Management And General | $30,221 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $589,618 | TotalAmt |
| Program Services | $536,463 | ProgramServicesAmt |
| Management And General | $53,155 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,707 | TotalAmt |
| Program Services | $4,588 | ProgramServicesAmt |
| Management And General | $47,119 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,563 | TotalAmt |
| Management And General | $5,563 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,955 | TotalAmt |
| Program Services | $60,854 | ProgramServicesAmt |
| Management And General | $21,101 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $10,671,968 | $10,671,968 | |
| BAD DEBT EXPENSE | $9,359,741 | $9,359,741 | |
| MEDICAL SURCHARGE | $574,598 | $574,598 | |
| EMPLOYEE RELATED EXPENS | $107,383 | $97,181 | $10,202 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,252 | TotalAmt |
| Program Services | $119 | ProgramServicesAmt |
| Management And General | $245,133 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $140,834,408 | TotalAmt |
| Program Services | $132,018,347 | ProgramServicesAmt |
| Management And General | $8,816,061 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,707,965 | BOYAmt |
| EOY | $2,407,828 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,784,639 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,794 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,656,743 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $641,544 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,263,618 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,497,976 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,199,464 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,333,247 | BOYAmt |
| EOY | $300,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $156,090,990 | BOYAmt |
| EOY | $2,707,828 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,569,434 | BOYAmt |
| EOY | $199,029 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,281 | BOYAmt |
| EOY | $741,685 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,351,117 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $139,921,832 | BOYAmt |
| EOY | $940,714 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,124,595 | BOYAmt |
| EOY | $1,762,134 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,563 | BOYAmt |
| EOY | $4,980 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,169,158 | BOYAmt |
| EOY | $1,767,114 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $156,090,990 | BOYAmt |
| EOY | $2,707,828 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$14,322,722 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$79,322 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $1,525 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,525 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | PRIOR TO MAY 1, 2017 THE ORGANIZATION HAD ONE EMPLOYEE WHO DEVOTED APPROXIMATELY 5% OF HIS TIME TO LOBBYING. LOBBYING ACTIVITIES CONSISTED OF CONTACT WITH STATE GOVERNMENT OFFICIALS AND/OR THEIR STAFF TO DISCUSS VARIOUS HEALTH CARE RELATED ISSUES. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SUNTRUST ESCROW ACCOUNT | Desc |
| Book Value | $300,000 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $300,000 | TotalBookValueOtherAssetsAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,199,937 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,199,937 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02040 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,365,721 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,042,022 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,323,699 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09030 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,565,658 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,042,022 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,523,636 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11070 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $89,025 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $89,025 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $256,381 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $125,350 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $131,031 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,543,808 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,094,667 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,449,141 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04150 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,889,214 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,220,017 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,669,197 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04520 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,454,872 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,262,039 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,192,833 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15590 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $9,359,740 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $9,681,734 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,707,559 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$25,825 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | 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 | MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 TEBEAU STREET | AddressLine1Txt |
| City | WAYCROSS | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31501 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 148-416 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | MAYOCLINICHEALTHSYSTEM.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| 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 |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | MAYOCLINIC.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | MAYOCLINIC.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | MAYOCLINIC.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | PART V, SECTION B, LINE 5: PRIMARY DATA COLLECTION METHODS INCLUDED INTERVIEWS AND A FOCUS GROUP WITH KEY COMMUNITY REPRESENTATIVES. TO GATHER INPUT FROM AN EXTENSIVE RANGE OF PEOPLE WHO REPRESENT THE BROAD INTERESTS OF WARE AND PIERCE COUNTIES, A FOCUS GROUP AND ONE-ON-ONE INTERVIEWS WERE CONDUCTED IN MARCH 2016. IN TOTAL, INTERVIEWS WERE CONDUCTED WITH 18 INDIVIDUALS AND 6 FOCUS GROUP PARTICIPANTS WHO WERE KEY COMMUNITY REPRESENTATIVES. THE PURPOSE OF THE INTERVIEWS AND FOCUS GROUP WAS TO GAIN DIRECT INPUT FROM THESE INDIVIDUALS REGARDING HEALTH NEEDS, COMMUNITY ASSETS, AND OTHER RELATED TOPICS, INCLUDING PRIMARY AND CHRONIC DISEASE NEEDS AND OTHER HEALTH ISSUES ASSOCIATED WITH UNINSURED PERSONS, LOW-INCOME PERSONS, AND MINORITY GROUPS. FOCUS GROUP AND INTERVIEW PARTICIPANTS INCLUDED COMMUNITY STAKEHOLDERS REPRESENTING HEALTH CARE AND SOCIAL SERVICES PROVIDERS, SCHOOL SYSTEMS, RELIGIOUS ORGANIZATIONS, ECONOMIC ORGANIZATIONS, POLITICAL AND OTHER COMMUNITY OFFICIALS AND THE ELDERLY/SENIOR POPULATION. MANY OF THE FOCUS GROUP AND INTERVIEW PARTICIPANTS REPRESENTED, AND WERE VERY FAMILIAR WITH, THE HEALTH NEEDS ASSOCIATED WITH THE MEDICALLY UNDERSERVED, LOW INCOME, MINORITY, AND POPULATIONS WITH CHRONIC AND ACUTE DISEASES IN WARE AND PIERCE COUNTIES. |
| MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | PART V, SECTION B, LINE 11: ADDRESSING OBESITY IN OUR COMMUNITY: WITH OBESITY AS ONE OF THE MOST SIGNIFICANT RISK FACTORS FOR SEVERAL DISEASES AFFECTING RESIDENTS OF WARE AND PIERCE COUNTIES, IT INCLUDES CARDIOVASCULAR DISEASE, DIABETES, AND HYPERTENSION. A MAJOR FACTOR CAUSING THE SUBSTANTIAL CARDIOVASCULAR DISEASE MORTALITY RATES IN THE REGION IS THE LEVEL OF OBESITY, WITH ONE-THIRD OF THE ADULT POPULATION IN WARE AND PIERCE COUNTIES CONSIDERED OBESE. MCHS IN WAYCROSS CONTINUES TO WORK WITH THE YMCA IN SUPPORT OF CAMP REVEILLE, A CAMP FOR UNDERSERVED CHILDREN, TO PROMOTE HEALTHY EATING AND EXERCISE. TO ADDRESS THE ADULT POPULATION, MCHS IN WAYCROSS HAS REACHED OUT TO COMMUNITY MEMBERS AND COMMUNITY ORGANIZATIONS THROUGH EDUCATIONAL TALKS, LECTURES AND PRESENTATIONS ON HEALTH ISSUES CONDUCTED BY PHYSICIANS AND CLINICAL STAFF, RAISING THE AWARENESS OF HEALTHY EATING CHOICES AMONG COMMUNITY MEMBERS. AT ALL MCHS IN WAYCROSS COMMUNITY EVENTS, A HEALTHY SNACK AND EDUCATIONAL LITERATURE ARE OFFERED TO REINFORCE OUR MISSION.ADDRESSING SMOKING/TOBACCO USAGE: TO ENCOURAGE THE DEVELOPMENT OF HEALTHY EATING HABITS AND LIFESTYLES, MCHS IN WAYCROSS WORKS WITH MEMORIAL DRIVE ELEMENTARY AND BLACKSHEAR ELEMENTARY SCHOOLS TO ENGAGE STUDENTS IN EDUCATION PROGRAMS ABOUT THE DANGERS OF OBESITY AND TOBACCO USE. AN ADDITIONAL GOAL OF THESE EFFORTS IS TO ENCOURAGE STUDENTS TO STRESS THE IMPORTANCE OF HEALTHY LIFESTYLES TO THEIR PARENTS.MCHS IN WAYCROSS' RESPIRATORY DEPARTMENT COLLABORATES WITH WARE AND PIERCE COUNTY SCHOOL SYSTEMS TO OFFER EDUCATION ON SMOKING AND GENERAL TOBACCO USE AS AN ONGOING PUBLIC EDUCATION PROGRAM THAT IS OFFERED TO ALL RESPIRATORY PATIENTS AND THEIR FAMILIES REGARDLESS OF A REPORTED INCIDENCE OF SMOKING. ALL PATIENTS ARE PRESENTED WITH A DISCHARGE PACKET REGARDING THE USE OF TOBACCO AND SMOKING, WHICH FURTHER ASSISTS COMMUNITY MEMBERS IN QUITTING AND/OR NEVER STARTING TO USE TOBACCO.MCHS IN WAYCROSS IS A SMOKE FREE CAMPUS.ADDRESSING HEALTH CARE ACCESS AND COST: INCREASING ACCESS TO HEALTH CARE IS A CHALLENGING GOAL GIVEN LIMITED RESOURCES AND STRONG DEMAND. IN RESPONSE, MCHS IN WAYCROSS HAS RECRUITED NEW PHYSICIANS AND PHYSICIAN ASSISTANTS TO EXPAND SERVICES OFFERED AT OUR FACILITY, AND COMMUNICATED THE AVAILABILITY OF MCHS IN WAYCROSS SERVICES TO COMMUNITY LEADERS AND CITIZENS. MCHS IN WAYCROSS PHYSICIANS AND CLINICAL STAFF HAVE ALSO MADE MANY HEALTH EDUCATION PRESENTATIONS TO THE COMMUNITY. NEEDS THAT ARE NOT BEING ADDRESSED: SUBSTANCE ABUSE AND MENTAL HEALTH WERE MENTIONED BY MANY FOCUS GROUP AND INTERVIEW PARTICIPANTS AS A SIGNIFICANT HEALTH ISSUE IN WARE AND PIERCE COUNTIES. ALTHOUGH THERE IS LITTLE SECONDARY DATA TO SUPPORT THESE CONCERNS, IT IS APPARENT THAT TREATMENT OPTIONS TO ADDRESS THIS HEALTH ISSUE ARE LIMITED. DUE TO SEVERAL FACTORS, INCLUDING A LIMITED OPPORTUNITY TO INTERVENE AT THE PREVENTION LEVEL, RELATIVELY LOW EXPECTED EFFECTIVENESS OF POSSIBLE INTERVENTIONS, AND LACK OF COMPETENCY TO ADDRESS THESE NEEDS BEYOND THE SERVICES PROVIDED THROUGH ITS SENIOR BEHAVIORAL UNIT, MAYO CLINIC HEALTH SYSTEM IN WAYCROSS BELIEVES IT IS MOST APPROPRIATE TO FOCUS ITS EFFORTS ON OBESITY, SMOKING/TOBACCO CESSATION AND ACCESS TO HEALTH CARE. |
| MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | PART V, SECTION B, LINE 13B: MEDICAL INDIGENCY MAY BE USED TO DETERMINE ELIGIBILITY. IF A PATIENT BALANCE EXCEEDS 25% OF THE ANNUAL HOUSEHOLD INCOME, BUT THE PATIENT DOES NOT QUALIFY BASED ON FPG, CHARITY WILL BE ADJUSTED TO A MINIMUM OF THE AMOUNT GENERALLY BILLED (AGB). THE AGB IS DETERMINED USING THE LOOK-BACK METHOD AND CALCULATED USING ALL CLAIMS ALLOWED BY PRIVATE PAY INSURERS (INCLUDING MEDICARE ADVANTAGE) AND MEDICARE (TRADITIONAL) FOR INPATIENT AND OUTPATIENT SERVICES. |
| MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | PART V, SECTION B, LINE 13H: THE REGIONAL PROXIMITY OF A PATIENT'S RESIDENCY IS A FACTOR FOR PRESCHEDULED SERVICES ONLY AND SECONDARY TO MEDICAL NEED. REGIONAL PROXIMITY IS NOT A FACTOR FOR EMERGENCY CARE PROVIDED. |
| MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | PART V, SECTION B, LINE 15E: REFER PATIENT TO APPLY FOR MEDICAL ASSISTANCE PROGRAMS. |
| MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | PART V, SECTION B, LINE 16J: UPON ADMISSION, IF THE PATIENT DOES NOT HAVE INSURANCE OR EXPRESSES AN INABILITY TO PAY, ALL AVAILABLE OPTIONS INCLUDING STATE AND FEDERAL FUNDING AS WELL AS CHARITY CARE ARE DISCUSSED WITH THE PATIENT. |
| MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | PART V, SECTION B, LINE 20E: FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE TO EVERY PATIENT VIA MAYO'S PUBLIC WEBSITE, FROM CUSTOMER SERVICE AND PATIENT ACCESS LOCATIONS, AND IS REFERENCED ON MAYO'S AUTHORIZATION FORMS, STATEMENTS, AND LETTERS. IN ADDITION, BROCHURES ARE AVAILABLE IN THE ADMISSIONS AREA AND THE PROCESS OF HOW TO APPLY IS AVAILABLE ON THE MAYO CLINIC WEBSITE.UPON ADMISSION, IF THE PATIENT DOES NOT HAVE INSURANCE OR EXPRESSES AN INABILITY TO PAY, MAYO DISCUSSES ALL AVAILABLE OPTIONS INCLUDING STATE AND FEDERAL FUNDING AS WELL AS CHARITY CARE.MONTHLY STATEMENTS ARE SENT TO PATIENTS THAT OUTLINE CURRENT CHARGES AND ACTIONS WITH INSURANCE AND INCLUDES INFORMATION ABOUT MAYO'S CHARITY CARE POLICY. SOME MAYO SITES UTILIZE ADVOCATES TO CONTACT THE PATIENT UPON DISCHARGE TO HELP THEM SECURE GOVERNMENTAL ASSISTANCE OR FINANCIAL ASSISTANCE.EACH CHARITY CARE REVIEW IS DOCUMENTED IN MAYO'S BILLING SYSTEM AND COMMUNICATED TO THE PATIENT. COMPLETED CHARITY CARE FORMS ARE MAINTAINED EITHER IN PAPER OR ELECTRONIC FORMAT. THE PATIENT IS INFORMED REGARDING THE OUTCOME OF THE REVIEW.MAYO OFTEN IDENTIFIES CHARITY CARE OPPORTUNITIES AFTER THE PATIENT HAS BEEN DISMISSED. IN MANY CASES, THIS IS DUE TO LIMITED INSURANCE COVERAGE OR INSURANCE DENIALS AFTER THE SERVICE WAS PERFORMED. IN THESE CASES, WHEN A PATIENT EXPRESSES AN INABILITY TO PAY FOR THEIR SERVICES, STAFF WILL INITIATE A CHARITY REVIEW AS INDICATED BY THE FINANCIAL ASSISTANCE POLICY, WHICH IS AVAILABLE FOR EVERY PATIENT AT MAYOCLINIC.ORG. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 22 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (22 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - SATILLA CARE CENTER | ||||
| 1600 RIVERSIDE AVENUE | WAYCROSS | GA | 31501 | SKILLED NURSING FACILITY |
| 2 - PIERCE COUNTY NURSING HOME | ||||
| 221 EAST CARTER AVENUE | BLACKSHEAR | GA | 31516 | SKILLED NURSING FACILITY |
| 3 - SATILLA REGIONAL REHAB INSTITUTE | ||||
| 2500 SATILLA PARKWAY | WAYCROSS | GA | 31501 | REHAB UNIT |
| 4 - MCHSW - FAMILY PSYCHIATRY | ||||
| 1707 CITY BOULEVARD SQUARE | WAYCROSS | GA | 31501 | PSYCHIATRY CLINIC |
| 5 - MCHSW - NEUROLOGY | ||||
| 2101 TEBEAU STREET | WAYCROSS | GA | 31501 | NEUROLOGY CLINIC |
| 6 - MCHSW - PULMONOLOGY | ||||
| 2005 PIONEER STREET | WAYCROSS | GA | 31501 | PULMONOLOGY CLINIC |
| 7 - MCHSW - SURGICAL ASSOCIATES | ||||
| 1908 ALICE STREET | WAYCROSS | GA | 31501 | SURGICAL OFFICE |
| 8 - MCHSW - ORTHOPEDICS | ||||
| 305 PINEVIEW DRIVE | WAYCROSS | GA | 31501 | ORTHOPEDICS CLINIC |
| 9 - MCHSW - OPHTHALMOLOGY | ||||
| 413 LISTER STREET | WAYCROSS | GA | 31501 | OPTHALMOLOGY CLINIC |
| 10 - MCHSW - CARDIOLOGY | ||||
| 2004 PIONEER STREET | WAYCROSS | GA | 31501 | CARDIOLOGY CLINIC |
| 11 - MCHSW - INFECTIOUS DISEASES | ||||
| 411 LISTER STREET | WAYCROSS | GA | 31501 | INFECTIOUS DISEASES CLINIC |
| 12 - MCHSW - OBGYN | ||||
| 505 CITY BLVD | WAYCROSS | GA | 31501 | OB/GYN CLINIC |
| 13 - MCHSW - FAMILY MEDICINE | ||||
| 1921 ALICE STREET | WAYCROSS | GA | 31501 | FAMILY MEDICINE CLINIC |
| 14 - MCHSW - CONVENIENT CARE | ||||
| 1921 ALICE STREET | WAYCROSS | GA | 31501 | CONVENIENT CARE CLINIC |
| 15 - MCHSW - HEMATOLOGYONCOLOGY | ||||
| 1706 ALICE STREET | WAYCROSS | GA | 31501 | HEMATOLOGY/ONCOLOGY CLINIC |
| 16 - MCHSW - RADIATION ONCOLOGY | ||||
| 1451 CHURCH STREET | WAYCROSS | GA | 31501 | RADIATION ONCOLOGY CLINIC |
| 17 - MCHSW - HEMATOLOGYONCOLOGY - DOUGLAS | ||||
| SHIRLEY AVENUE SUITES XXX-XX-XXXX | DOUGLAS | GA | 31535 | HEMATOLOGY/ONCOLOGY CLINIC |
| 18 - MCHSW - OUTREACH CLINIC | ||||
| 396 KINGSLAND DRIVE | FOLKSTON | GA | 31537 | OUTREACH CLINIC |
| 19 - MCSHW - FAMILY MEDICINE | ||||
| 808 BEACON STREET | WAYCROSS | GA | 31501 | PRIMARY CARE CLINIC |
| 20 - MCSHW - HEMATOLOGYONCOLOGY | ||||
| 1206 ALICE STREET | WAYCROSS | GA | 31501 | HEMATOLOGY/ONCOLOGY CLINIC |
| 21 - MCHSW - HEMATOLOGYONCOLOGY | ||||
| 101 SEYMOUR ST | DOUGLAS | GA | 31533 | HEMATOLOGY/ONCOLOGY CLINIC |
| 22 - MCHSW - OUTPATIENT IMAGING CENTER | ||||
| 410 ZACHARY STREET | WAYCROSS | GA | 31501 | RADIOLOGY/IMAGING |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | MEDICAL INDIGENCY MAY BE USED TO DETERMINE ELIGIBILITY. IF A PATIENT BALANCE EXCEEDS 25% OF THE ANNUAL HOUSEHOLD INCOME, BUT THE PATIENT DOES NOT QUALIFY BASED ON FPG, CHARITY WILL BE ADJUSTED TO A MINIMUM OF THE AMOUNT GENERALLY BILLED (AGB). THE AGB IS DETERMINED USING THE LOOK-BACK METHOD AND CALCULATED USING ALL CLAIMS ALLOWED BY PRIVATE PAY INSURERS (INCLUDING MEDICARE ADVANTAGE) AND MEDICARE (TRADITIONAL) FOR INPATIENT AND OUTPATIENT SERVICES |
| PART I, LINE 7: | A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A-7C (FINANCIAL ASSISTANCE, MEDICAID SHORTFALL, AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS).THE AMOUNTS FOR LINES 7E-7I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND WOULD NOT BE BASED ON A COST-TO-CHARGE RATIO. |
| PART I, LINE 7G: | THE FOLLOWING NET COMMUNITY BENEFIT COST ATTRIBUTED TO A PHYSICIAN CLINIC WAS INCLUDED AS SUBSIDIZED HEALTH SERVICES: $211,318. |
| PART I, LINE 7, COLUMN (F) | THE ORGANIZATION IS USING THE TOTAL EXPENSES FOR JANUARY THROUGH APRIL WHEN CALCULATING THE PERCENT OF TOTAL EXPENSES. THIS AMOUNT REFLECTS THE EXPENSES OF THE ORGANIZATION WHILE OPERATING THE HOSPITAL. |
| PART III, LINE 2: | BAD DEBT EXPENSE IS DETERMINED BASED ON GAAP AND IS EXPLAINED IN THE ACCOUNTS RECEIVABLE FOOTNOTE OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 4: | PLEASE SEE NOTE 2 ON PAGE 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE MEDICARE SHORTFALL REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT (USING A MEDICARE COST REPORT STEP-DOWN METHODOLOGY). |
| PART III, LINE 9B: | MAYO CLINIC AND ITS AFFILIATES STRIVE TO ASSIST ALL PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION AND CONSIDERING FINANCIAL ASSISTANCE PRIOR TO ENLISTING THE ASSISTANCE OF A COLLECTION AGENCY. MAYO CLINIC AND AFFILIATES ALSO MAKE REASONABLE ATTEMPTS TO COLLECT FROM INSURANCE COMPANIES AND OTHER THIRD-PARTY PAYORS BEFORE REQUESTING PAYMENT FROM A PATIENT. IN ADDITION, MAYO CLINIC AND ITS AFFILIATES ACCEPT REASONABLE PAYMENT PLANS FROM PATIENTS WHEN AN ACCOUNT IS THE PATIENT'S RESPONSIBILITY AND TRY TO IDENTIFY THOSE PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE IS OFFERED TO ANY PATIENT IF THE FACTS AND CIRCUMSTANCES SUGGEST THAT THE PATIENT DOES NOT HAVE THE ABILITY TO PAY THEIR BILL IN WHOLE OR IN PART. IN THE EVENT THAT AN ACCOUNT IS REFERRED TO A COLLECTION AGENCY, GUIDELINES ARE FOLLOWED; INCLUDING SUSPENDING ALL COLLECTION ACTIVITY IF A FINANCIAL ASSISTANCE APPLICATION HAS BEEN SUBMITTED AFTER THE ACCOUNT HAS BEEN REFERRED FOR COLLECTION. IF A COLLECTION AGENCY IDENTIFIES A PATIENT AS POTENTIALLY MEETING MAYO CLINIC'S FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA OR THE PATIENT ASKS TO APPLY FOR FINANCIAL ASSISTANCE, COLLECTION ACTIVITY IS SUSPENDED UNTIL MAYO REVIEWS THE ACCOUNT FOR FINANCIAL ASSISTANCE ELIGIBILITY BASED ON SUBMISSION OF REQUESTED INFORMATION. COLLECTION ACTIVITY WOULD ONLY RESUME IF THE PATIENT IS DETERMINED TO BE INELIGIBLE FOR FINANCIAL ASSISTANCE OR IS ELIGIBLE FOR ONLY PARTIAL FINANCIAL ASSISTANCE AND DOES NOT AGREE TO PAY THE REMAINING BALANCE. |
| PART VI, LINE 2: | MAYO CLINIC HEALTH SYSTEM IN WAYCROSS' EFFORTS TO ASSESS THE HEALTH CARE NEEDS OF ITS LOCAL COMMUNITY RESTS ON FOUR GUIDING PRINCIPLES DEVELOPED IN CONJUNCTION WITH COMMUNITY PARTNERS AND AFFIRMED BY MAYO CLINIC LEADERSHIP:1. HEALTH IS VALUED BY BOTH THE COMMUNITY AND MAYO CLINIC.2. "HEALTH" IS DETERMINED BY BOTH MEDICAL AND NON-MEDICAL (E.G., SOCIAL AND BEHAVIORAL) FACTORS AND BOTH CATEGORIES OF FACTORS MUST BE ADDRESSED.3. MAYO CLINIC IS COMMITTED TO PRODUCING MEASURABLE IMPROVEMENTS IN THE HEALTH OF LOCAL COUNTY RESIDENTS AND BEYOND.4. STRATEGIES TO IMPROVE COMMUNITY HEALTH ARE BEST DETERMINED AND IMPLEMENTED THROUGH PARTNERSHIPS BETWEEN HEALTH CARE PROVIDERS AND COMMUNITY MEMBERS.WITH THESE PRINCIPLES AS THE BASIS OF ITS DECISION MAKING, AND CONSISTENT WITH ITS PRIMARY VALUE OF "THE NEEDS OF THE PATIENT COME FIRST", MAYO CLINIC HEALTH SYSTEM IN WAYCROSS' APPROACH TO ASSESS THE NEEDS OF THE COMMUNITY IS ORGANIZED INTO TWO MAIN FUNCTIONS: 1) MECHANISMS TO ENGAGE AND UTILIZE INPUT FROM THE COMMUNITY AND 2) MECHANISMS TO SUPPORT AND COORDINATE INITIATIVES WITHIN MAYO CLINIC HEALTH SYSTEM IN WAYCROSS. |
| PART VI, LINE 3: | MAYO CLINIC IS COMMITTED TO OFFERING FINANCIAL ASSISTANCE TO ELIGIBLE PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY FOR THEIR MEDICAL SERVICES IN WHOLE OR IN PART. IN ORDER TO ACCOMPLISH THIS CHARITABLE GOAL, MAYO CLINIC AND MAYO CLINIC HEALTH SYSTEM SITES WIDELY PUBLICIZE THE FINANCIAL ASSISTANCE POLICY IN THE COMMUNITIES THAT THE INDIVIDUAL MAYO CLINIC AFFILIATED SITES SERVE. MAYO CLINIC AFFILIATED SITES MAKE COPIES OF THIS POLICY AND APPLICATIONS AVAILABLE ON THEIR WEBPAGES, INCLUDING THE ABILITY TO DOWNLOAD A COPY OF THE POLICY AND APPLICATION FREE OF CHARGE. INDIVIDUALS IN THE COMMUNITY SERVED WILL BE ABLE TO OBTAIN A COPY OF THE POLICY IN LOCATIONS THROUGHOUT EACH MAYO CLINIC AFFILIATED SITE OR UPON REQUEST IN PERSON OR BY PHONE. THE FINANCIAL ASSISTANCE POLICY (FAP) AND THE PLAIN LANGUAGE SUMMARY (PLS) EXPLAIN THE FINANCIAL ASSISTANCE PROGRAM AND OUTLINES ELIGIBILITY CRITERIA AND PROVIDES INSTRUCTIONS TO SUBMIT AN APPLICATION. WITHIN EACH HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED. ADDITIONALLY, CHARITABLE CARE AND FINANCIAL ASSISTANCE IS REFERENCED ON PATIENT CORRESPONDENCE INCLUDING: THE MONTHLY STATEMENT OF ACCOUNT, ACCOUNT BALANCE LETTERS, AND LATE PAYMENT NOTIFICATIONS. ALL PATIENT CORRESPONDENCE REFERENCING CHARITABLE CARE AND FINANCIAL ASSISTANCE INCLUDE INTERNET, PHONE, AND MAILING ADDRESS CONTACT INFORMATION. PATIENTS MAY ALSO BE MADE AWARE OF THE FAP VIA THEIR PROVIDER AND/OR OTHER MAYO CLINIC EMPLOYEES, WHO CAN PUT A PATIENT IN CONTACT WITH RESOURCES AVAILABLE TO ASSIST WITH THE APPLICATION PROCESS. |
| PART VI, LINE 4: | MCHS IN WAYCROSS SERVES A NINE-COUNTY REGION IN SOUTHEAST GEORGIA WITH THE MAJORITY OF PATIENTS COMING FROM WARE COUNTY.DEMOGRAPHICS: BASED ON U.S. CENSUS BUREAU QUICK FACTS AS OF JULY 1, 2016, WARE COUNTY HAD AN ESTIMATED POPULATION OF 35,738, OF WHICH AN ESTIMATED 23.9% OF THE POPULATION WAS UNDER THE AGE OF 18 AND AN ESTIMATED 16.7% WAS 65 YEARS OF AGE OR OLDER. THE ESTIMATED MEDIAN HOUSEHOLD INCOME FOR 2011 TO 2015 WAS $34,747 WITH APPROXIMATELY 28.4% OF THE POPULATION BELOW THE POVERTY LEVEL. |
| PART VI, LINE 5: | MAYO CLINIC AND ITS AFFILIATES ARE LARGE, MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICES AND HEALTH SYSTEMS. AT MAYO CLINIC, DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF "THE NEEDS OF THE PATIENT COME FIRST." THE ORGANIZATIONS (INCLUDING HOSPITAL AND NON-HOSPITAL ENTITIES) WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, NATIONAL, AND GLOBAL LEVELS. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION, AND RESEARCH. SPECIFICALLY, THE TAX-EXEMPT PURPOSE OF MAYO CLINIC AND ITS AFFILIATES IS THREE-FOLD:PRACTICE - PRACTICE MEDICINE AS AN INTEGRATED TEAM OF COMPASSIONATE, MULTI-DISCIPLINARY PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS WHO ARE FOCUSED ON THE NEEDS OF PATIENTS FROM OUR COMMUNITIES, REGIONS, THE NATION AND THE WORLD.EDUCATION - EDUCATE PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS AND BE A DEPENDABLE SOURCE OF HEALTH INFORMATION FOR OUR PATIENTS AND THE PUBLIC.RESEARCH - CONDUCT BASIC AND CLINICAL RESEARCH PROGRAMS TO IMPROVE PATIENT CARE AND TO BENEFIT SOCIETY, INCLUDING PARTNERING WITH MAYO CLINIC HEALTH SYSTEM PRACTICES TO PERFORM PRACTICE-BASED RESEARCH DESIGNED TO IMPROVE PATIENT CARE.THROUGH ITS MISSION, MAYO CLINIC AND ITS AFFILIATES ENRICH THE COMMUNITIES IN WHICH THEY OPERATE AS WELL AS THE BROADER COMMUNITY IMPROVING MEDICINE THROUGH RESEARCH, EDUCATING PHYSICIANS AND OTHER HEALTH CARE PROVIDERS, AND PROVIDING CARE AND SUPPORT TO PEOPLE IN NEED.PLEASE REFER TO THE PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, FOR FURTHER DESCRIPTION OF THE FILING ORGANIZATION'S ACTIVITIES.SURPLUS FUNDS - MAYO CLINIC AND ITS AFFILIATES REINVEST THEIR NET OPERATING INCOME TO ADVANCE MEDICAL RESEARCH AND TEACH THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS, AS WELL AS TO ALLOW THE INDIVIDUAL ENTITY TO SUSTAIN ITS MISSION AND PREPARE FOR THE FUTURE.COMMUNITY REPRESENTATION ON GOVERNING BODY - THE BOARD OF TRUSTEES IS THE GOVERNING BODY OF MAYO CLINIC. A MAJORITY OF ITS MEMBERS ARE EXTERNAL, INDEPENDENT TRUSTEES. IT HAS OVERALL RESPONSIBILITY FOR THE CHARITABLE, CLINICAL PRACTICE, SCIENTIFIC AND EDUCATIONAL MISSION AND PURPOSES OF MAYO CLINIC AND ITS AFFILIATES AS SET FORTH IN ITS ARTICLES OF INCORPORATION AND BYLAWS. BECAUSE OF MAYO CLINIC'S NATIONAL PRESENCE, THESE TRUSTEES ARE SELECTED BASED ON THEIR AREAS OF EXPERTISE, EXPERIENCE, AND OTHER CRITERIA ESTABLISHED BY THE INDEPENDENT NOMINATING COMMITTEE OF THE BOARD OF TRUSTEES. AREAS OF EXPERTISE AND EXPERIENCE INCLUDE SUCH AREAS AS HEALTH CARE POLICY, RESEARCH, EDUCATION, BUSINESS, AND GOVERNMENT. MAYO CLINIC HEALTH SYSTEM IN WAYCROSS, WHICH IS CONTROLLED BY MAYO CLINIC, RELIES ON THE COMMUNITY REPRESENTATION OF THE MAYO CLINIC BOARD OF TRUSTEES TO FULFILL THIS REQUIREMENT. OPEN V. CLOSED STAFF MODEL - SEVERAL OF MAYO CLINIC'S HOSPITAL ENTITIES HAVE OBTAINED LETTER RULINGS APPROVING A STAFF MODEL IN WHICH ONLY MAYO CLINIC EMPLOYED PHYSICIANS ARE GIVEN STAFF PRIVILEGES IN ORDER TO MAINTAIN STANDARD METHODS OF PRACTICE AND PROTOCOLS. FOR THOSE ENTITIES, THE PHYSICIANS ARE SALARIED EMPLOYEES AND THUS THE ISSUE OF PRIVATE INUREMENT AND PRIVATE BENEFIT ADDRESSED BY THE OPEN STAFF REQUIREMENT ARE OTHERWISE ADDRESSED. EMERGENCY ROOM MAYO CLINIC HEALTH SYSTEM IN WAYCROSS MAINTAINS AN EMERGENCY ROOM WITHIN THE HOSPITAL FACILITY 24 HOURS A DAY, 7 DAYS A WEEK, WHICH IS OPEN TO ALL WITHOUT REGARD TO THE ABILITY TO PAY. |
| PART VI, LINE 6: | MAYO CLINIC IS THE FIRST AND LARGEST INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICE IN THE WORLD. DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF "THE NEEDS OF THE PATIENT COME FIRST." MORE THAN 4,500 STAFF PHYSICIANS AND SCIENTISTS AND OVER 58,000 ADMINISTRATIVE AND ALLIED HEALTH STAFF WORK AT MAYO CLINIC, WHICH HAS SITES IN ROCHESTER, MINNESOTA, JACKSONVILLE, FLORIDA, AND SCOTTSDALE/PHOENIX, ARIZONA, AS WELL AS A REGIONAL NETWORK OF HOSPITALS AND CLINICS IN MINNESOTA, WISCONSIN, IOWA, AND GEORGIA. COLLECTIVELY, MORE THAN 1.3 MILLION PEOPLE ARE TREATED EACH YEAR. MAYO CLINIC AND ITS AFFILIATES PROVIDE ONE OR MORE OF THE FOLLOWING SERVICES AT THEIR RESPECTIVE LOCATIONS: MEDICAL EDUCATION, RESEARCH, HOSPITAL AND CLINIC SERVICES. |
| PART VI, LINE 7 | NEITHER THE FILING ORGANIZATION, NOR ANY RELATED ORGANIZATION, FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS SUCH AS INFORMATION PROVIDED TO A STATE HOSPITAL ASSOCIATION. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| SATILLA HEALTH FOUNDATION INC | |||||||
| 1900 TEBEAU STREET | WAYCROSS | GA | 31501 | 582008998 | 501(C)(3) | $39,583 | GENERAL SUPPORT |
| SATILLA HEALTH PARTNERS INC | |||||||
| 3163 ORION DRIVE | WAYCROSS | GA | 31503 | 814882114 | 501(C)(4) | $76,417,625 | ENSURE PROVISION OF ESSENTIAL HEALTH CARE SERVICES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 2: | THE FILING ORGANIZATION CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY WITH PROGRAMS THAT ENHANCE THE MISSION OF THE FILING ORGANIZATION. THE FILING ORGANIZATION ONLY CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY THAT ADDRESS UNMET OR UNDER-FUNDED COMMUNITY NEEDS IN THE AREAS OF HEALTHCARE, EDUCATION, RESEARCH, DIVERSITY AND EQUALITY OF OPPORTUNITY. |
| FORM 990, SCH I, PART II, LINE 1 | PURSUANT TO A GRANT AGREEMENT BETWEEN OKEFENOKEE HEALTH, INC. AND SATILLA HEALTH PARTNERS, INC., A NON-PROFIT, TAX-EXEMPT 501(C)(4) ORGANIZATION ("SHP"), OHI GRANTED APPROXIMATELY $76,417,625 TO SHP WHICH OHI HAD RECEIVED IN CONNECTION WITH THE SALE OF THE HOSPITAL-RELATED ASSETS AND NURSING HOME RELATED ASSETS. TWO FUNDS WERE ESTABLISHED, THE COMMUNITY RESERVES FUND ("CRF") AND THE COMMUNITY HEALTH FUND ("CHF"). WITH THE CRF, SHP IS CHARGED WITH USING THE FUNDS TO ENSURE THE CONTINUED PROVISION OF ESSENTIAL HEALTH SERVICES IN THE COMMUNITY IN A MANNER THAT IS EXCLUSIVELY FOR THE PROMOTION OF SOCIAL WELFARE WITHIN THE MEANING OF IRC SECTION 501(C)(4) AND CONSISTENT WITH CHARITABLE PURPOSES WITHIN THE MEANING OF IRC SECTION 501(C)(3). WITH THE CHF, SHP IS CHARGED WITH USING THE FUNDS TO ACCOMPLISH THE FOLLOWING PURPOSES OF: (W) IMPROVING ACCESS TO HEALTHCARE FOR INDIVIDUALS IN THE COMMUNITY; (X) PROMOTING HEALTH AND WELLNESS IN THE COMMUNITY; (Y) PROVIDING HEALTH AND SAFETY EDUCATION TO THE PEOPLE OF THE COMMUNITY; AND (Z) ENSURING THE CONTINUED PROVISION OF ESSENTIAL HEALTH SERVICES IN THE COMMUNITY IN A MANNER THAT IS EXCLUSIVELY FOR THE PROMOTION OF SOCIAL WELFARE WITHIN THE MEANING OF IRC SECTION 501(C)(4) AND CONSISTENT WITH CHARITABLE PURPOSES WITHIN THE MEANING OF IRC SECTION 501(C)(3). |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (20 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BYRON C MAY MD | ||||||||||||||
| DIRECTOR | $0 | $559,330 | $0 | $0 | $0 | $4,439 | $0 | $55,089 | $0 | $28,188 | $0 | $647,046 | $0 | $0 |
| DANIEL L TOMLINSON | ||||||||||||||
| DIRECTOR | $0 | $227,693 | $0 | $0 | $0 | $17,738 | $0 | $41,403 | $0 | $25,941 | $0 | $312,775 | $0 | $0 |
| ROBERT M WALTERS | ||||||||||||||
| DIRECTOR | $0 | $316,720 | $0 | $0 | $0 | $18,172 | $0 | $66,570 | $0 | $19,667 | $0 | $421,129 | $0 | $0 |
| RICHARD J PRESUTTI DO | ||||||||||||||
| CHAIR | $0 | $434,394 | $0 | $0 | $0 | $53,522 | $0 | $43,893 | $0 | $27,027 | $0 | $558,836 | $0 | $0 |
| MICHAEL C DEITSCHMANN | ||||||||||||||
| SECRETARY/TREASURER | $0 | $178,288 | $0 | $0 | $0 | $700 | $0 | $31,335 | $0 | $36,276 | $0 | $246,599 | $0 | $0 |
| TIMOTHY T CATCHINGS MD | ||||||||||||||
| PHYSICIAN | $358,333 | $0 | $0 | $0 | $30,701 | $0 | $7,177 | $0 | $7,170 | $0 | $403,381 | $0 | $0 | $0 |
| HOWARD GRIFFIN MD | ||||||||||||||
| PHYSICIAN | $223,424 | $0 | $0 | $0 | $19,099 | $0 | $4,472 | $0 | $185 | $0 | $247,180 | $0 | $0 | $0 |
| ASIT K JHA MD | ||||||||||||||
| PHYSICIAN | $268,542 | $0 | $0 | $0 | $18,850 | $0 | $8,109 | $0 | $9,444 | $0 | $304,945 | $0 | $0 | $0 |
| BRIAN A SINGLETON MD | ||||||||||||||
| PHYSICIAN | $272,554 | $0 | $0 | $0 | $19,099 | $0 | $5,475 | $0 | $7,509 | $0 | $304,637 | $0 | $0 | $0 |
| SRIDHAR SRINIVASAN MD | ||||||||||||||
| PHYSICIAN | $240,626 | $0 | $0 | $0 | $16,766 | $0 | $3,654 | $0 | $9,049 | $0 | $270,095 | $0 | $0 | $0 |
| TERESA B BEARD | ||||||||||||||
| FORMER OFFICER | $0 | $118,754 | $0 | $0 | $0 | $874 | $0 | $18,379 | $0 | $14,812 | $0 | $152,819 | $0 | $0 |
| KENNETH T CALAMIA MD | ||||||||||||||
| FORMER OFFICER | $0 | $159,162 | $0 | $0 | $0 | $56,636 | $0 | $34,844 | $0 | $21,380 | $0 | $272,022 | $0 | $0 |
| CHERYL R CROFT | ||||||||||||||
| FORMER OFFICER | $0 | $211,094 | $0 | $0 | $0 | $16,367 | $0 | $48,731 | $0 | $20,862 | $0 | $297,054 | $0 | $0 |
| NANCY L DAWSON MD | ||||||||||||||
| FORMER OFFICER | $0 | $293,388 | $0 | $0 | $0 | $20,548 | $0 | $61,409 | $0 | $19,131 | $0 | $394,476 | $0 | $0 |
| STEPHEN M LANGE MD | ||||||||||||||
| FORMER OFFICER | $0 | $417,711 | $0 | $0 | $0 | $90,478 | $0 | $10,800 | $0 | $28,602 | $0 | $547,591 | $0 | $0 |
| KEVIN M LOCKETT | ||||||||||||||
| FORMER OFFICER | $0 | $257,900 | $0 | $0 | $0 | $2,507 | $0 | $39,496 | $0 | $25,489 | $0 | $325,392 | $0 | $0 |
| MCGREGOR N LOTT MD | ||||||||||||||
| FORMER KEY EMPLOYEE | $212,132 | $0 | $0 | $0 | $16,989 | $0 | $4,330 | $0 | $10,622 | $0 | $244,073 | $0 | $0 | $0 |
| WINDELL R SMITH JR | ||||||||||||||
| FORMER KEY EMPLOYEE | $0 | $192,205 | $0 | $0 | $0 | $756 | $0 | $34,503 | $0 | $28,115 | $0 | $255,579 | $0 | $0 |
| DAVID J WYKSTRA MD | ||||||||||||||
| FORMER KEY EMPLOYEE | $204,756 | $0 | $0 | $0 | $13,945 | $0 | $2,647 | $0 | $11,459 | $0 | $232,807 | $0 | $0 | $0 |
| MICHAEL P BAKER MD | ||||||||||||||
| FORMER KEY EMPLOYEE | $0 | $0 | $0 | $0 | $0 | $142,744 | $0 | $0 | $0 | $0 | $0 | $142,744 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | HOLLI SWEAT RECEIVED A BONUS OF $10,000 THAT WAS GROSSED UP. THIS WAS INCLUDED IN TAXABLE WAGES. ROGER FORGEY WAS REIMBURSED FOR $15,743 FOR HOUSING ALLOWANCES. THIS WAS INCLUDED IN TAXABLE WAGES. ROGER FORGEY WAS REIMBURSED $150 FOR CLUB DUES. THIS WAS INCLUDED IN TAXABLE WAGES. |
| PART I, LINE 4B | THE FOLLOWING RECEIVED NQDC PAYMENTS IN 2017: BYRON C. MAY M.D. $21,035 ROBERT M. WALTERS $12,021 RICHARD J. PRESUTTI D.O. $31,319 MCGREGOR N. LOTT M.D. $16,863 DAVID J. WYKSTRA M.D. $13,819 KENNETH T. CALAMIA M.D. $30,444 NANCY L. DAWSON M.D. $7,022 STEPHEN M. LANGE M.D. $74,965 TIMOTHY T CATCHINGS M.D. $30,575 HOWARD GRIFFIN M.D. $18,973 ASIT K. JHA M.D. $18,724 BRIAN A. SINGLETON M.D. $18,973 SRIDHAR SRINIVASAN M.D. $16,640 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| MEDICAL CONSULTING RESOURCES LLC | |||
| ENTITY OWNED BY ROGER FORGEY | $153,659 | MANAGEMENT SERVICES PROVIDED TO OHI. | 0 |
| JH ENTERPRISES OF INDIANA LLC | |||
| ENTITY OWNED BY G.E. HOFFMAN JR | $164,148 | MANAGEMENT SERVICES PROVIDED TO OHI. | 0 |
Schedule N IRS990ScheduleN
Disposition Of Assets Detail DispositionOfAssetsDetail (4 entries)
| Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDesc | DistributionDistributionDt | Fair Market Value Of AssetFairMarketValueOfAssetAmt | Method Of FMV DeterminationMethodOfFMVDeterminationTxt | EINEIN | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | IRC SectionIRCSectionTxt |
|---|---|---|---|---|---|---|---|---|---|
| WAYCROSS REALTY HOLDINGS LLC | |||||||||
| ALL ASSETS ASSOCIATED WITH THE OWNERSHIP AND OPERATION OF TWO NURSING HOMES | 2017-09-01 | $14,000,000 | APPRAISAL | 611816654 | 3163 ORION DRIVE | WAYCROSS | GA | 31503 | LIMITED LIABILITY COMPANY |
| SOUTHEAST GEORGIA HEALTH SERVICES LLC | |||||||||
| ALL ASSETS ASSOCIATED WITH THE OWNERSHIP AND OPERATION OF A HOSPITAL | 2017-05-01 | $62,417,625 | APPRAISAL | 814223395 | PO BOX 570 | NASHVILLE | TN | 37202 | 501(C)(3) |
| SATILLA HEALTH PARTNERS INC | |||||||||
| CASH - SEE SCH I, PART IV (FOR SCH I, PART II, LINE 1) FOR DETAIL EXPLANATION OF TRANSACTION | 2017-05-01 | $62,417,625 | CASH | 814882114 | 3163 ORION DRIVE | WAYCROSS | GA | 31503 | 501(C)(4) |
| SATILLA HEALTH PARTNERS INC | |||||||||
| CASH - SEE SCH I, PART IV (FOR SCH I, PART II, LINE 1) FOR DETAIL EXPLANATION OF TRANSACTION | 2017-09-01 | $14,000,000 | CASH | 814882114 | 3163 ORION DRIVE | WAYCROSS | GA | 31503 | 501(C)(4) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | Yes (1) | DirectorOfSuccessor2Ind |
| Employee Of Successor2 | Yes (1) | EmployeeOfSuccessor2Ind |
| Owner Of Successor2 | 0 | OwnerOfSuccessor2Ind |
| Receive Compensation2 | Yes (1) | ReceiveCompensation2Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART II, LINE 2E: | PERSON(S) INVOLVED: P. OWEN HERRIN, JR.SATILLA HEALTH PARTNERS, INC.JAMES W. DYE, M.D. ZIBIA A. MUSICDONALD WATERS M.D. |
| PART II, LINE 2E: | EXPLANATION OF INVOLVEMENT: SATILLA HEALTH PARTNERS, INC.P. OWEN HERRIN, JR. BECAME AN OFFICER OF THE SUCCESSOR CORPORATION AND RECEIVED COMPENSATION AS AN INDEPENDENT CONTRACTOR FOR OTHER SERVICES PROVIDED. JAMES W. DYE, M.D. BECAME AN OFFICER OF THE SUCCESSOR CORPORATION AND RECEIVED COMPENSATION.ZIBIA A. MUSIC BECAME AN OFFICER OF THE SUCCESSOR CORPORATION AND RECEIVED COMPENSATION.DONALD WATERS M.D. BECAME AN OFFICER OF THE SUCCESSOR CORPORATION AND RECEIVED COMPENSATION. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 3 | IN THE FIRST FOUR MONTHS OF THE YEAR, OKEFENOKEE HEALTH, INC. (FKA MAYO CLINIC HEALTH SYSTEM IN WAYCROSS) SERVED A NINE-COUNTY REGION IN SOUTHEAST GEORGIA. OKEFENOKEE HEALTH, INC. OPERATED A 231-BED HOSPITAL, A 96-BED SKILLED NURSING FACILITY, A REHAB UNIT AND A PSYCHIATRIC UNIT IN WAYCROSS, GEORGIA ALONG WITH AN ADDITIONAL 78-BED SKILLED NURSING FACILITY IN BLACKSHEAR, GEORGIA. DURING THE YEAR, THE ORGANIZATION SOLD ALL THE ASSETS ASSOCIATED WITH THESE OPERATIONS. OKEFENOKEE HEALTH, INC. IS NOW A PUBLIC CHARITY WHOSE PURPOSE IS TO PROMOTE COMMUNITY HEALTH THROUGH ACTIVITIES DESIGNED TO ENSURE AND IMPROVE ACCESS TO HEALTHCARE FOR ALL INDIVIDUALS IN THE COMMUNITY AND TO PROMOTE HEALTHCARE AND WELLNESS IN THE COMMUNITIES. |
| FORM 990, PART III, LINE 4A | IN THE FIRST FOUR MONTHS OF THE YEAR, OKEFENOKEE HEALTH, INC. (FKA MAYO CLINIC HEALTH SYSTEM IN WAYCROSS) SERVED A NINE-COUNTY REGION IN SOUTHEAST GEORGIA. OKEFENOKEE HEALTH, INC. OPERATED A 231-BED HOSPITAL, A 96-BED SKILLED NURSING FACILITY, A REHAB UNIT AND A PSYCHIATRIC UNIT IN WAYCROSS, GEORGIA ALONG WITH AN ADDITIONAL 78-BED SKILLED NURSING FACILITY IN BLACKSHEAR, GEORGIA. OKEFENOKEE HEALTH, INC. PROVIDED CARE TO PATIENTS WHO MET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. SERVICES ARE ALSO PROVIDED TO MEDICAID AND MEDICARE PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. SATILLA ADVOCACY SERVICES, A RAPE CRISIS AND CHILD ADVOCACY CENTER, OPERATES UNDER THE UMBRELLA OF OKEFENOKEE HEALTH, INC. AND SERVED VICTIMS OF SEXUAL ASSAULT AND OTHER VIOLENT CRIMES IN THE SIX COUNTIES THAT MAKE UP THE WARE JUDICIAL CIRCUIT. A FULL RANGE OF SERVICES WERE OFFERED FROM THE TIME A VICTIM REPORTS AN INCIDENT, INCLUDING EMERGENCY DEPARTMENT SERVICES, FOLLOW UP AT THE RAPE CRISIS/CHILD ADVOCACY. |
| FORM 990, PART III, LINE 4B | FOLLOWING THE SALE OF ALL THE HOSPITAL ASSETS AND THE ASSIGNMENT OF ALL THE NURSING HOME OPERATIONS EFFECTIVE MAY 1, 2017, OKEFENOKEE HEALTH, INC. CONTINUED IN AN ADMINISTRATIVE FUNCTION TO COMPLETE ITS OBLIGATIONS CONNECTED WITH ITS PRIOR BUSINESS OPERATIONS AS THE OWNER AND OPERATOR OF A HOSPITAL AND NURSING HOMES INCLUDING COLLECTING RELATED REVENUES AND SATISFYING ITS EXPENSES. IN ADDITION, OKEFENOKEE HEALTH, INC. CONTINUED TO MONITOR THE ACTIVITIES OF THE HOSPITAL BUYER TO ENSURE THAT THE HOSPITAL BUYER (I) CONTINUES TO OPERATE THE HOSPITAL AS AN ACUTE CARE HOSPITAL; (II) REMAINS ENROLLED IN THE MEDICARE AND MEDICAID PROGRAMS; (III) CONTINUES THE PROVISION OF INDIGENT CARE SERVICES AT A MINIMUM CONSISTENT WITH OHI'S PREVIOUS POLICIES; (IV) MAINTAINS IDENTIFIED CORE SERVICES FOR THE BENEFIT OF THE COMMUNITY; AND (V) MAKES CAPITAL EXPENDITURES TO IMPROVE THE HOSPITAL IN A MINIMUM AMOUNT OF $21.6 MILLION. OHI IS REQUIRED TO PERFORM THESE SERVICES UNDER THE TRANSACTION DOCUMENTS RELATING TO THE SALE OF THE HOSPITAL ASSETS, AND IN A SIMILAR MANNER IS CHARGED WITH MONITORING THE OBLIGATIONS OF THE NURSING HOME BUYER. |
| FORM 990, PART VI, SECTION A, LINE 2 | THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: BYRON C. MAY M.D. RICHARD J. PRESUTTI D.O. THE FOLLOWING INDIVIDUALS HAVE A BUSINESS RELATIONSHIP WITH A RELATED ORGANIZATION AS AN OFFICER, DIRECTOR OR TRUSTEE: MICHAEL C. DEITSCHMANN DANIEL L. TOMLINSON ROBERT M. WALTERS BYRON C. MAY M.D. RICHARD J. PRESUTTI D.O. |
| FORM 990, PART VI, SECTION A, LINE 3 | FOR THE FIRST FOUR MONTHS OF THE YEAR, MAYO CLINIC, MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH, MAYO CLINIC JACKSONVILLE AND OTHER RELATED ENTITIES PROVIDE MANAGEMENT SERVICES FOR MCHS-WAYCROSS. SINCE THE ENTITIES ARE RELATED ORGANIZATIONS, COMPENSATION FOR THE OFFICERS, DIRECTORS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES HAS BEEN DISCLOSED IN PART VII AND SCHEDULE J. |
| FORM 990, PART VI, SECTION A, LINE 4 | AS OF MAY 1, 2017, THE ORGANIZATION ADOPTED NEW BYLAWS TO REFLECT ITS CHANGE IN ACTIVITIES AS REPORTED TO THE IRS WITH FORM 1023. THE CHANGES INCLUDED (1) AN EXEMPT PURPOSE OF ENHANCING COMMUNITY HEALTHCARE AND ACCESS TO HEALTHCARE, ESPECIALLY FOR POOR AND INDIGENT INDIVIDUALS; (2) THE NAME OF THE ORGANIZATION WAS CHANGED TO OKEFENOKEE HEALTH, INC.; (3) THE NUMBER OF INITIAL BOARD OF DIRECTORS WILL BE FOUR. ONCE THE NUMBER OF BOARD MEMBERS REACHES SEVEN, THE COMPOSITION OF THE BOARD MEMBERS SHALL BE THAT AT LEAST TWO ARE RESIDENTS OF PIERCE COUNTY, GA, AT LEAST TWO ARE RESIDENTS OF WARE COUNTY, GA, AT LEAST TWO ARE PHYSICIANS AND AT LEAST ONE MEMBER OF THE PIERCE COUNTY HOSPITAL AUTHORITY OR ITS SUCCESSOR, AT LEAST ONE MEMBER OF THE WARE COUNTY HOSPITAL AUTHORITY OR ITS SUCCESSOR AND AT LEAST ONE INDIVIDUAL THAT SERVES AS A DIRECTOR ON THE BOARD OF SATILLA HEALTH PARTNERS, INC. OR ITS SUCCESSOR. BOARD MEMBERS MUST HAVE EXPERTISE IN CRITICAL AREAS INVOLVING ACCOUNTING, FINANCE, COMPENSATION AND ETHICS. THE OFFICERS OF THE ORGANIZATION SHALL BE THE PRESIDENT, VICE PRESIDENT, A SECRETARY, A TREASURER AND ANY OTHER OFFICERS DEEMED APPROPRIATE BY THE BOARD. THE OFFICERS SHALL BE VESTED WITH THE AUTHORITY TO ADMINISTER AND IMPLEMENT DUTIES, RESPONSIBILITIES AND DIRECTIVES IN CONFORMITY WITH RESPECTIVE OFFICES IN FURTHERANCE OF THE PURPOSES SET FORTH IN THE BYLAWS AND ARTICLES. UPON LIQUIDATION, ALL PROPERTY AND ASSETS SHALL BE DISTRIBUTED TO AN ENTITY EXEMPT UNDER 501(C)(3) THAT WILL FULFILL A HEALTH CARE MISSION IN THE COMMUNITY CURRENTLY SERVED BY THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF MCHS-WAYCROSS (DURING THE FIRST FOUR MONTHS OF THE YEAR) WAS MAYO CLINIC JACKSONVILLE. OKEFENOKEE HEALTH, INC. HAS NO MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7A | WHILE MCHS-WAYCROSS (DURING THE FIRST 4 MONTHS OF THE REPORTING YEAR), THE SOLE CORPORATE MEMBER APPOINTED MEMBERS TO THE BOARD OF DIRECTORS THROUGH MULTIPLE PROCESSES AS SPECIFIED IN THE BYLAWS. THERE ARE NO MEMBERS OF OKEFENOKEE HEALTH INC. |
| FORM 990, PART VI, SECTION A, LINE 7B | WHILE MCHS-WAYCROSS (DURING THE FIRST 4 MONTHS OF THE REPORTING YEAR), THE ARTICLES AND BYLAWS PROVIDED THE SOLE CORPORATE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS CAPITAL, DEBT, AMENDMENT OF ARTICLES AND BYLAWS AND GENERAL OPERATIONAL DECISIONS. IN ADDITION DURING THAT TIME, THE COMMUNITY DIRECTORS HAVE THE AUTHORITY TO ENFORCE CERTAIN PROVISIONS OF THE INTEGRATION AGREEMENT. THERE WERE NO MEMBERS AS OKEFENOKEE HEALTH, INC. |
| FORM 990, PART VI, SECTION A, LINE 8B | OKEFENOKEE HEALTH, INC. HAS NO COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION'S MANAGEMENT WILL RECEIVE A COPY OF THE 990 PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | AS OF MAY 1, 2017, ANY DIRECTOR, PRINCIPAL OFFICER, MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS OR A PERSON WITH FINANCIAL INTEREST DIRECTLY OR INDIRECTLY, THROUGH BUSINESS, INVESTMENT, OR FAMILY IS COVERED BY THE CONFLICT OF INTEREST POLICY. ANY PERSON COVERED UNDER THE CONFLICT OF INTEREST POLICY IS REQUIRED TO DISCLOSE A CONFLICT OF INTEREST TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH POWERS DELEGATED BY THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS OR COMMITTEE SET BY THE BOARD OF DIRECTORS IS RESPONSIBLE FOR REVIEWING AND DISCUSSING THE MATERIAL FACTS OF THE CONFLICT OF INTEREST PRESENTED BY THE INTERESTED PERSON. AFTER EXERCISING DUE DILIGENCE, THE BOARD OF DIRECTORS OR APPOINTED COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE THE BOARD OF DIRECTORS OR APPOINTED COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE WHETHER OR NOT THE TRANSACTION OR ARRANGEMENT WITH THE INTERESTED PERSON SHALL BE ENTERED INTO. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION REVIEW AND APPROVAL PROCESS FOR EMPLOYEES OF THE ORGANIZATION WAS CONDUCTED BY MAYO CLINIC'S BOARD OF TRUSTEES GOVERNANCE AND NOMINATING COMMITTEE, NOT BY ANY COMMITTEE OF MCHS-WAYCROSS OR OKEFENOKEE HEALTH, INC. |
| FORM 990, PART VI, SECTION C, LINE 19 | FOR THE FIRST FOUR MONTHS OF THE TAX YEAR THE FILING ORGANIZATION WAS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC'S CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST AND ALSO ON THE MAYOCLINIC.ORG WEBSITE. |
| FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC | BYRON C. MAY M.D. - 4500 SAN PABLO ROAD, JACKSONVILLE, FL 32224. DANIEL L. TOMLINSON - 200 FIRST STREET SW, ROCHESTER, MN 55905. ROBERT M. WALTERS - 4500 SAN PABLO ROAD, JACKSONVILLE, FL 32224. DONALD WATERS M.D. - 3366 TWIN LAKE ROAD, BLACKSHEAR, GA 31516. JAMES W. DYE, M.D. - 6215 TALL PINES DRIVE, BLACKSHEAR, GA 31516. ZIBIA A. MUSIC - 5963 DOUGLAS HIGHWAY, MILLWOOD, GA 31552. RICHARD J. PRESUTTI D.O. - 4500 SAN PABLO ROAD, JACKSONVILLE, FL 32224. MICHAEL C. DEITSCHMANN - 4500 SAN PABLO ROAD, JACKSONVILLE, FL 32224. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SATILLA RELIANT PSYCHIATRIC SERVICES LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6 OFFICE PARK CIRCLE SUITE 100 | AddressLine1Txt |
| City | BIRMINGHAM | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 35223 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 205721155 | EIN |
| Primary Activities | PSYCHIATRIC SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | AL | LegalDomicileStateCd |
| Total Income | $0 | TotalIncomeAmt |
| End Of Year Assets | $0 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OKEFENOKEE HEALTH INC | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (38 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BLOOMER LAKEVIEW INC | |||||||||||||||
| 2110 DUNCAN ROAD | BLOOMER | WI | 54724 | 391450617 | LOW INCOME HOUSING | WI | 501(C)(3) | LINE 7 | MCHS CHIPPEWA VALLEY INC | Yes (1) | |||||
| CHARTERHOUSE INC | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411405254 | RETIREMENT LIVING CENTER | MN | 501(C)(3) | LINE 10 | MAYO CLINIC | Yes (1) | |||||
| DESTINATION MEDICAL CENTER EDA | |||||||||||||||
| 50 SOUTH SIXTH STREET SUITE 1500 | MINNEAPOLIS | MN | 55402 | 464893585 | ECONOMIC DEVELOPMENT | MN | 501(C)(3) | LINE 12A, I | MAYO CLINIC | Yes (1) | |||||
| GOLD CROSS AMBULANCE SERVICE | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411917516 | AMBULANCE SERVICE | MN | 501(C)(3) | LINE 10 | MFMER | Yes (1) | |||||
| MCHS SPRINGFIELD | |||||||||||||||
| 625 NORTH JACKSON AVENUE | SPRINGFIELD | MN | 56087 | 411893827 | HOSPITAL AND CLINIC | MN | 501(C)(3) | LINE 3 | MCHS MANKATO | Yes (1) | |||||
| MCHS ST JAMES | |||||||||||||||
| 1101 MOULTON PARSONS DR PO BOX 46 | ST JAMES | MN | 56081 | 410797368 | HOSPITAL AND CLINIC | MN | 501(C)(3) | LINE 3 | MCHS MANKATO | Yes (1) | |||||
| MCHS WASECA | |||||||||||||||
| 501 NORTH STATE STREET | WASECA | MN | 56093 | 363606405 | HOSPITAL AND CLINIC | MN | 501(C)(3) | LINE 3 | MCHS MANKATO | Yes (1) | |||||
| LUTHER LAKESIDE APARTMENTS INC | |||||||||||||||
| PO BOX 1510 | EAU CLAIRE | WI | 54702 | 391409024 | LOW INCOME HOUSING FOR ELDERLY | WI | 501(C)(3) | LINE 10 | MCHS NORTHWEST WISCONSIN REGION INC | Yes (1) | |||||
| MAYO CLINIC | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 416011702 | PATIENT CARE - CLINIC | MN | 501(C)(3) | LINE 10 | Yes (1) | N/A | |||||
| MAYO CLINIC ARIZONA | |||||||||||||||
| 13400 EAST SHEA BOULEVARD | SCOTTSDALE | AZ | 85259 | 860800150 | HOSPITAL AND CLINIC | AZ | 501(C)(3) | LINE 3 | MAYO CLINIC | Yes (1) | |||||
| MAYO CLINIC FLORIDA (A NONPROFIT CORPORATION) | |||||||||||||||
| 4500 SAN PABLO ROAD | JACKSONVILLE | FL | 32224 | 590714831 | HOSPITAL | FL | 501(C)(3) | LINE 3 | MAYO CLINIC JACKSONVILLE | Yes (1) | |||||
| MAYO CLINIC HOSPITAL - ROCHESTER | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 410944601 | HOSPITAL | MN | 501(C)(3) | LINE 3 | MAYO CLINIC | Yes (1) | |||||
| MAYO CLINIC STIFTUNG | |||||||||||||||
| FUNDRAISING FOUNDATION | MFMER | Yes (1) | 60486 FRANKFURT AM MAIN | FRANKFURT | GM | GM | |||||||||
| MAYO CLINIC JACKSONVILLE | |||||||||||||||
| 4500 SAN PABLO ROAD | JACKSONVILLE | FL | 32224 | 593337028 | PATIENT CARE - CLINIC | FL | 501(C)(3) | LINE 7 | MAYO CLINIC | Yes (1) | |||||
| MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411506440 | CHARITABLE, EDUCATIONAL & SCIENTIFIC ACTIVITIES | MN | 501(C)(3) | LINE 10 | MAYO CLINIC | Yes (1) | |||||
| MCHS NORTHWEST WISCONSIN REGION INC | |||||||||||||||
| 1221 WHIPPLE STREET | EAU CLAIRE | WI | 54703 | 390813418 | HOSPITAL | WI | 501(C)(3) | LINE 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS NEW PRAGUE | |||||||||||||||
| 301 SECOND STREET NE | NEW PRAGUE | MN | 56071 | 410723639 | HOSPITAL AND CLINIC | MN | 501(C)(3) | LINE 3 | MCHS MANKATO | Yes (1) | |||||
| MCHS FAIRMONT | |||||||||||||||
| 800 MEDICAL CENTER DRIVE PO BOX 80 | FAIRMONT | MN | 56031 | 410760836 | HOSPITAL AND CLINIC | MN | 501(C)(3) | LINE 3 | MCHS MANKATO | Yes (1) | |||||
| MCHS ALBERT LEA AND AUSTIN | |||||||||||||||
| 1000 FIRST DRIVE NN | AUSTIN | MN | 55912 | 411404075 | HOSPITAL AND CLINIC | MN | 501(C)(3) | LINE 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS AUSTIN FOUNDATION | |||||||||||||||
| 1000 FIRST DRIVE NM | AUSTIN | MN | 55912 | 300107471 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | LINE 7 | MCHS ALBERT LEA AND AUSTIN | Yes (1) | |||||
| MCHS CHIPPEWA VALLEY INC | |||||||||||||||
| 1501 THOMPSON STREET | BLOOMER | WI | 54724 | 390980343 | HOSPITAL AND CLINIC | WI | 501(C)(3) | LINE 3 | MCHS NORTHWEST WISCONSIN REGION INC | Yes (1) | |||||
| MCHS FRANCISCAN HEALTHCARE INC | |||||||||||||||
| 700 WEST AVE SOUTH | LA CROSSE | WI | 54601 | 391411999 | HEALTHCARE SYSTEM PARENT | WI | 501(C)(3) | LINE 12A, I | MAYO CLINIC | Yes (1) | |||||
| MCHS FRANCISCAN MEDICAL CENTER INC | |||||||||||||||
| 700 WEST AVE SOUTH | LA CROSSE | WI | 54601 | 390806374 | HOSPITAL AND CLINIC | WI | 501(C)(3) | LINE 3 | MCHS FRANCISCAN HEALTHCARE INC | Yes (1) | |||||
| MCHS LAKE CITY | |||||||||||||||
| 500 WEST GRANT STREET | LAKE CITY | MN | 55011 | 411906820 | HOSPITAL | MN | 501(C)(3) | LINE 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS MANKATO | |||||||||||||||
| 1025 MARSH STREET | MANKATO | MN | 56002 | 411236756 | HOSPITAL AND CLINIC | MN | 501(C)(3) | LINE 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS MANKATO HEALTH CARE FOUNDATION | |||||||||||||||
| 1025 MARSH STREET | MANKATO | MN | 56002 | 411663357 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | LINE 7 | MCHS MANKATO | Yes (1) | |||||
| MCHS OAKRIDGE INC | |||||||||||||||
| 13025 EIGHTH STREET PO BOX 70 | OSSEO | WI | 54758 | 391029430 | HOSPITAL AND CLINIC | WI | 501(C)(3) | LINE 3 | MCHS NORTHWEST WISCONSIN REGION INC | Yes (1) | |||||
| MCHS OWATONNA | |||||||||||||||
| 2200 26TH STREET NW | OWATONNA | MN | 55060 | 411862132 | PATIENT CARE - CLINIC | MN | 501(C)(3) | LINE 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS RED WING | |||||||||||||||
| 701 HEWIT BOULEVARD | RED WING | MN | 55066 | 411713783 | PATIENT CARE SERVICES | MN | 501(C)(3) | LINE 3 | MAYO CLINIC | Yes (1) | |||||
| MILES AND SHIRLEY FITERMAN ENDOWMENT FUND FOR DIGESTIVE DISEASES | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 412020392 | SUPPORT RESEARCH, PRACTICE & EDUCATION | MN | 501(C)(3) | LINE 12A, I | MAYO CLINIC | Yes (1) | |||||
| MCHS CANNON FALLS | |||||||||||||||
| 32021 COUNTY ROAD 24 BLVD | CANNON FALLS | MN | 55009 | 204156428 | HOSPITAL AND CLINIC | MN | 501(C)(3) | LINE 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS RED CEDAR INC | |||||||||||||||
| 2321 STOUT ROAD | MENOMONIE | WI | 54751 | 510190875 | HOSPITAL AND CLINIC | WI | 501(C)(3) | LINE 3 | MCHS NORTHWEST WISCONSIN REGION INC | Yes (1) | |||||
| MCHS FRANCISCAN HEALTHCARE FOUNDATION INC | |||||||||||||||
| 700 WEST AVE SOUTH | LA CROSSE | WI | 54601 | 391186647 | FUNDRAISING FOUNDATION | WI | 501(C)(3) | LINE 7 | MCHS FRANCISCAN HEALTHCARE INC | Yes (1) | |||||
| POVERELLO FOUNDATION | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411494881 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | LINE 7 | MAYO CLINIC HOSPITAL ROCHESTER | Yes (1) | |||||
| SATILLA HEALTH FOUNDATION INC | |||||||||||||||
| 1900 TEBEAU STREET | WAYCROSS | GA | 31501 | 582008998 | FUNDRAISING FOUNDATION | GA | 501(C)(3) | LINE 12C, III-FI | 0 | N/A | |||||
| SATILLA REGIONAL MEDICAL CENTER AUXILIARY | |||||||||||||||
| 410 DARLING AVENUE | WAYCROSS | GA | 31501 | 586066381 | PROMOTE AND COMPLEMENT HEALTH CARE | GA | 501(C)(3) | LINE 12A, I | 0 | N/A | |||||
| MCHS NORTHLAND INC | |||||||||||||||
| 1222 EAST WOODLAND AVENUE | BARRON | WI | 54812 | 390920634 | HOSPITAL AND CLINIC | WI | 501(C)(3) | LINE 3 | MCHS NORTHWEST WISCONSIN REGION INC | Yes (1) | |||||
| SATILLA HEALTH PARTNERS INC | |||||||||||||||
| 3163 ORION DRIVE | WAYCROSS | GA | 31503 | 814882114 | PROMOTE HEALTH AND WELLNESS IN THE COMMUNITY | GA | 501(C)(4) | Yes (1) | N/A | ||||||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| FRANKLIN HEATING STATION | |||||||||
| 119 THIRD ST SW | ROCHESTER | MN | 55902 | 410264830 | UTILITY | MN | N/A | 0 | 0 |
| LATIGO PETROLEUM LLC | |||||||||
| PO BOX 14230 | ODESSA | TX | 79768 | 364767494 | OIL & GAS EXPLORATION | TX | N/A | 0 | 0 |
| WATERSHED CAP INSTITUTIONAL PARTNERS III LP | |||||||||
| ONE MARITIME PLAZA SUITE 1525 | SAN FRANCISCO | CA | 94111 | 462982848 | INVESTMENT ACTIVITIES | CA | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (36 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AMBIENT CLINICAL ANALYTICS INC | |||||||||||||
| 221 1ST AVE SW SUITE 202 | ROCHESTER | MN | 55902 | 800928405 | SOFTWARE | MN | N/A | C | Yes (1) | ||||
| BWL HOLDINGS INC | |||||||||||||
| 1209 ORANGE STREET | WILMINGTON | DE | 19801 | 472413749 | OIL & GAS | DE | N/A | C | Yes (1) | ||||
| CAVALRY CLO III LTD | |||||||||||||
| INVESTMENT ACTIVITIES | N/A | C | Yes (1) | PO BOX 1093 GT QUEENSGATE HOUSE S | GEORGETOWN | CJ | CJ | ||||||
| CAVALRY CLO IV LTD | |||||||||||||
| INVESTMENT ACTIVITIES | N/A | C | Yes (1) | PO BOX 1093 GT QUEENSGATE HOUSE S | GEORGETOWN | CJ | CJ | ||||||
| CHARITABLE LEAD TRUST | |||||||||||||
| CHARITABLE TRUST | CA | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | AZ | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | CO | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | LA | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | MA | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | IL | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | MI | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | WI | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | TX | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | CO | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST (56) | |||||||||||||
| CHARITABLE TRUST | MN | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST (7) | |||||||||||||
| CHARITABLE TRUST | MN | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST (3) | |||||||||||||
| CHARITABLE TRUST | NC | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST (78) | |||||||||||||
| CHARITABLE TRUST | MN | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST (8) | |||||||||||||
| CHARITABLE TRUST | FL | N/A | T | Yes (1) | |||||||||
| GMO GLOBAL BOND INVESTMENT FUND | |||||||||||||
| OTHER FINANCIAL INVESTMENT | N/A | C | Yes (1) | 78 SIR JOHN ROGERSONS QUAY DUBLIN | EI | EI | |||||||
| HEALTH TRADITION HEALTH PLAN | |||||||||||||
| 1808 EAST MAIN STREET | ONALASKA | WI | 54650 | 391545987 | MEDICAL SERVICES COMPANY | WI | N/A | C | Yes (1) | ||||
| LOBSS NETWORK SUPPORT 2002 INC | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 481276150 | ADMINISTRATIVE SERVICES | MN | N/A | C | Yes (1) | ||||
| MAYO CLINIC SUPPORT SERVICES TEXAS | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 471751102 | HEALTH SERVICES | MN | N/A | C | Yes (1) | ||||
| MAYO HOLDING COMPANY | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411578020 | HOLDING COMPANY | MN | N/A | C | Yes (1) | ||||
| MAYO INSURANCE COMPANY LTD | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | SELF INSURANCE POOL | MN | N/A | C | Yes (1) | |||||
| MCHS--DECORAH CLINIC PHYSICIANS | |||||||||||||
| 907 MONTGOMERY STREET | DECORAH | IA | 52101 | 411711329 | PATIENT CARE - CLINIC | IA | N/A | C | Yes (1) | ||||
| MCHS--PHARMACY & HOME MEDICAL INC | |||||||||||||
| 1221 WHIPPLE STREET | EAU CLAIRE | WI | 54703 | 391528920 | PHARMACY SERVICES | WI | N/A | C | Yes (1) | ||||
| MMSI INC | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411547003 | THIRD PARTY | MN | N/A | C | Yes (1) | ||||
| PERPETUAL TRUST | |||||||||||||
| CHARITABLE TRUST | LA | N/A | T | Yes (1) | |||||||||
| PERPETUAL TRUST | |||||||||||||
| CHARITABLE TRUST | MO | N/A | T | Yes (1) | |||||||||
| PERPETUAL TRUST | |||||||||||||
| CHARITABLE TRUST | ND | N/A | T | Yes (1) | |||||||||
| PERPETUAL TRUST (2) | |||||||||||||
| CHARITABLE TRUST | MA | N/A | T | Yes (1) | |||||||||
| RESOUNDANT INC | |||||||||||||
| 221 1ST AVE SW SUITE 202 | ROCHESTER | MN | 55902 | 461661978 | MANUFACTURING | MN | N/A | C | Yes (1) | ||||
| ROCHESTER AIRPORT COMPANY | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 410506870 | AIRPORT MANAGEMENT | MN | N/A | C | Yes (1) | ||||
| SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION | |||||||||||||
| 13400 E SHEA BLVD | SCOTTSDALE | AZ | 85259 | 860870505 | COMMERCIAL PROPERTY OWNERS ASSOCIATION | AZ | N/A | C | Yes (1) | ||||
| THE STABILE BUILDING OWNERS' ASSOCIATION | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 208994499 | COMMERCIAL PROPERTY OWNERS ASSOCIATION | MN | N/A | C | Yes (1) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | Yes (1) | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MMSI INC | ||
| S | $286,088 | GAAP |
| MMSI INC | ||
| M | $163,730 | GAAP |