COMMUNITY ANCILLARY SERVICES INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY ANCILLARY SERVICES INC (EIN 43-2007496)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-04
- IRS object ID
- 201801249349301100
- Schema version
- 2016v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-04T11:36:06-04:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 581094351 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCNAIR MCLEMORE MIDDLEBROOKS & CO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | POST OFFICE BOX ONE | AddressLine1Txt |
| City | MACON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 312020001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 432007496 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY ANCILLARY SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 4786212100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 THIRD STREET | AddressLine1Txt |
| City | MACON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31201 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TERESA MOODY | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 4786212100 | PhoneNum |
| Signature | 2018-05-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | J RANDOLPH NICHOLS | PreparerPersonNm |
| PTIN | P00347246 | PTIN |
| Phone | 4787466277 | PhoneNum |
| Preparation | 2018-05-04 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TERESA MOODY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 440 INDUSTRIAL BOULEVARD | AddressLine1Txt |
| City | HAWKINSVILLE | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31036 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $81,075,711 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ELDERCAREPHARMACY.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2003 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | THE PROVISION OF PHARMACEUTICAL, MEDICAL SUPPLIES AND EQUIPMENT, HOME HEALTH AND RELATED SERVICES AS PART OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 651 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $67,231,414 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $77,603,446 | CYProgramServiceRevenueAmt |
| PY Investment Income | $157,587 | PYInvestmentIncomeAmt |
| CY Investment Income | $46,028 | CYInvestmentIncomeAmt |
| PY Other Revenue | $571,850 | PYOtherRevenueAmt |
| CY Other Revenue | $3,426,237 | CYOtherRevenueAmt |
| PY Total Revenue | $67,960,851 | PYTotalRevenueAmt |
| CY Total Revenue | $81,075,711 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,311,065 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $20,301,001 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $43,699,483 | PYOtherExpensesAmt |
| CY Other Expenses | $51,139,454 | CYOtherExpensesAmt |
| PY Total Expenses | $62,010,548 | PYTotalExpensesAmt |
| CY Total Expenses | $71,440,455 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,950,303 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $9,635,256 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $29,400,351 | TotalAssetsBOYAmt |
| Total Assets EOY | $37,942,947 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,947,249 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $13,341,108 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,453,102 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $24,601,839 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE PROVISION OF PHARMACEUTICAL, MEDICAL SUPPLIES AND EQUIPMENT, HOME HEALTH AND RELATED SERVICES AS PART OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $71,440,455 | ExpenseAmt |
| Desc | PROVIDED A FULL SERVICE PHARMACY THROUGH A REGIONAL NETWORK OF PERSONAL CARE AND NURSING FACILITIES TO PATIENTS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED MEDICAL, HEALTH CARE AND RELATED SUPPLIES TO PERSONAL CARE AND NURSING FACILITIES FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED MEDICAL EQUIPMENT, GOODS, LINENS, UNIFORMS AND COMMODITIES TO PERSONAL CARE AND NURSING FACILITIES FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED HOME-HEALTH CARE FOR MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. CONSISTENT WITH THE POLICIES AND PROCEDURES PREVIOUSLY ADOPTED BY THE BOARD OF DIRECTORS OF COMMUNITY HEALTH SYSTEMS, INC., THE SECTION 509(A)(3) SUPPORTING ORGANIZATION AND PARENT ENTITY OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM OF WHICH THE ORGANIZATION IS A MEMBER, THE ORGANIZATION PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITIES IT SERVES PURSUANT TO BOTH COMMUNITY BENEFIT GUIDELINES AND A CHARITY CARE POLICY. THE ORGANIZATION CONTINUES TO ASSESS AND DEVELOP PROGRAMS TO BENEFIT THE COMMUNITY. | Desc |
| Total Program Service Expenses | $71,440,455 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 81 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 651 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | COMMUNITY ANCILLARY SERVICES INC | PersonNm |
| Phone | 4786212100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 213 THIRD STREET | AddressLine1Txt |
| City | MACON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31201 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 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 |
|---|---|---|---|---|---|---|---|---|---|
| JOSEPH A WALL | |||||||||
| CHAIRMAN | 4.00 | 40.00 | Yes (X) | $0 | $24,000 | $0 | |||
| PAUL A CABLE | |||||||||
| DIRECTOR | 4.00 | 40.00 | Yes (X) | $0 | $24,000 | $0 | |||
| JAMES B PATTON | |||||||||
| DIRECTOR | 4.00 | 40.00 | Yes (X) | $0 | $24,000 | $0 | |||
| BUDDY PONDER | |||||||||
| DIRECTOR | 4.00 | 40.00 | Yes (X) | $0 | $24,000 | $0 | |||
| KATHRYN DENNIS | |||||||||
| DIRECTOR | 4.00 | 40.00 | Yes (X) | $0 | $24,000 | $0 | |||
| CALVIN D FRANKLIN | |||||||||
| VICE PRESIDE | 40.00 | $227,290 | $0 | $20,405 | Yes (X) | ||||
| JAMES R LEE JR | |||||||||
| VICE PRESIDE | 40.00 | $211,554 | $0 | $19,028 | Yes (X) | ||||
| ANDY HILL | |||||||||
| VP PROJECT M | 40.00 | $179,138 | $0 | $17,332 | Yes (X) | ||||
| AMANDA ROBERSON | |||||||||
| VP OPERATION | 40.00 | $171,518 | $0 | $17,104 | Yes (X) | ||||
| TERESA MOODY | |||||||||
| PRESIDENT | 4.00 | 40.00 | $0 | $159,010 | $25,157 | Yes (X) | |||
| MELISSA PRICE | |||||||||
| VP COMPLIANC | 40.00 | $149,466 | $0 | $16,162 | Yes (X) | ||||
| ANGELA HAMMACK | |||||||||
| CORPORATE SE | 4.00 | 40.00 | $0 | $148,282 | $20,521 | Yes (X) | |||
| LORAY CHILDS | |||||||||
| VICE PRESIDE | 40.00 | $109,360 | $0 | $15,290 | Yes (X) | ||||
| TRACIE P CLARK | |||||||||
| VICE PRESIDE | 40.00 | $108,074 | $0 | $14,902 | Yes (X) | ||||
| CLAUDETTE SLADE | |||||||||
| VICE PRESIDE | 40.00 | $93,561 | $0 | $7,895 | Yes (X) | ||||
| GENEEN RANSAW | |||||||||
| VICE PRESIDE | 40.00 | 4.00 | $46,770 | $38,298 | $13,752 | Yes (X) | |||
| STEPHANIE KIRKLAND | |||||||||
| SENIOR DIR P | 40.00 | $161,030 | $0 | $16,262 | Yes (X) | ||||
| JACLYN SCOTT | |||||||||
| DIR PHARMACY | 40.00 | $152,488 | $0 | $15,783 | Yes (X) | ||||
| LESLIE MAY | |||||||||
| SR. DIR. OF | 40.00 | $144,533 | $0 | $15,385 | Yes (X) | ||||
| WILLIE LATCH | |||||||||
| DIR PHARMACY | 40.00 | $136,685 | $0 | $15,149 | Yes (X) | ||||
| RONALD HOGLAND | |||||||||
| ASSIST DIR P | 40.00 | $127,176 | $0 | $14,851 | Yes (X) | ||||
| LORRAINE T TAYLOR | |||||||||
| FORMER SECRE | 0.00 | 40.00 | $0 | $687,209 | $30,764 | Yes (X) | |||
| MICHELLE MOORE-ANDREWS | |||||||||
| FORMER PRESI | 0.00 | 40.00 | $0 | $286,167 | $22,180 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,018,643 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,438,966 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $317,922 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 37 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| INTEGRA REHABILITIATION | |||||
| 1013 RIVERBURCH PARKWAY | DALTON | GA | 30721 | REHAB SERVICES | $6,274,719 |
| STRATEGIC DELIVERY SOLUTIONS | |||||
| PO BOX 239 | FARMINGDALE | NY | 11735 | COURIER SERVICE | $2,880,527 |
| JOYCE D BARLOW | |||||
| 1020 TALLAHASSEE RD | ALBANY | GA | 31721 | HEALTHCARE | $2,657,256 |
| AVALON HEALTH REHABILITATION | |||||
| 120 SPRING STREET | NEWNAN | GA | 302632824 | HEALTHCARE | $1,507,057 |
| NEWNAN NURSING AND REHABILITATION | |||||
| 244 EAST BROAD STREET | NEWNAN | GA | 302631818 | HEALTHCARE | $1,412,100 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 22 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| GOVERNMENTAL PROGRAMS REV | $54,227,191 | $54,227,191 |
| PROGRAM SERVICES | $23,376,255 | $23,376,255 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $77,603,446 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,028 | TotalRevenueColumnAmt |
| Exclusion | $46,028 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| OTHER | $2,445,183 | $2,445,183 |
| UNREALIZED GAIN ON INVEST | $761,451 | $761,451 |
| MANAGEMENT FEE | $219,603 | $219,603 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,426,237 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $81,075,711 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $81,029,683 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $46,028 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,431,447 | TotalAmt |
| Program Services | $1,431,447 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,793,376 | TotalAmt |
| Program Services | $16,793,376 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $428,987 | TotalAmt |
| Program Services | $428,987 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $320,519 | TotalAmt |
| Program Services | $320,519 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,326,672 | TotalAmt |
| Program Services | $1,326,672 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,196 | TotalAmt |
| Program Services | $48,196 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $587,610 | TotalAmt |
| Program Services | $587,610 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $535,962 | TotalAmt |
| Program Services | $535,962 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,494,547 | TotalAmt |
| Program Services | $1,494,547 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SUPPLY EXPENSE | $38,517,814 | $38,517,814 |
| SUPPORT ORGANIZATION FEES | $2,596,470 | $2,596,470 |
| LEASING AND RENTS | $2,388,931 | $2,388,931 |
| SUPPLIES | $2,094,269 | $2,094,269 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,875,655 | TotalAmt |
| Program Services | $2,875,655 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,440,455 | TotalAmt |
| Program Services | $71,440,455 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,265,090 | BOYAmt |
| EOY | $5,879,366 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,217,487 | BOYAmt |
| EOY | $10,015,651 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,286,143 | BOYAmt |
| EOY | $3,177,472 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $222,113 | BOYAmt |
| EOY | $409,678 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $10,157,665 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,294,678 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,546,574 | BOYAmt |
| EOY | $6,862,987 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,659,039 | BOYAmt |
| EOY | $3,804,953 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,203,905 | BOYAmt |
| EOY | $7,792,840 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,400,351 | BOYAmt |
| EOY | $37,942,947 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,924,419 | BOYAmt |
| EOY | $5,604,569 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,022,734 | BOYAmt |
| EOY | $5,554,859 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,000,096 | BOYAmt |
| EOY | $1,569,180 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $612,500 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,947,249 | BOYAmt |
| EOY | $13,341,108 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,430,272 | BOYAmt |
| EOY | $17,477,800 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,022,830 | BOYAmt |
| EOY | $7,124,039 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,453,102 | BOYAmt |
| EOY | $24,601,839 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,400,351 | BOYAmt |
| EOY | $37,942,947 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $9,635,256 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$4,486,519 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $58,442,630 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $65,338,716 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $65,855,499 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $67,803,264 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $81,029,683 | CurrentTaxYearAmt |
| Total | $338,469,792 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $58,442,630 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $65,338,716 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $65,855,499 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $67,803,264 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $81,029,683 | CurrentTaxYearAmt |
| Total | $338,469,792 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $338,469,792 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $445,664 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $625,779 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $146,668 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $157,587 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $46,028 | CurrentTaxYearAmt |
| Total | $1,421,726 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $445,664 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $625,779 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $146,668 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $157,587 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $46,028 | CurrentTaxYearAmt |
| Total | $1,421,726 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $58,888,294 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $65,964,495 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $66,002,167 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $67,960,851 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $81,075,711 | CurrentTaxYearAmt |
| Total | $339,891,518 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99580 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99420 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.01000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $129,641 | OtherCostOrOtherBasisAmt |
| Book Value | $129,641 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,666,669 | OtherCostOrOtherBasisAmt |
| Depreciation | $832,578 | DepreciationAmt |
| Book Value | $3,834,091 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $885,927 | OtherCostOrOtherBasisAmt |
| Depreciation | $237,704 | DepreciationAmt |
| Book Value | $648,223 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,475,428 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,224,396 | DepreciationAmt |
| Book Value | $2,251,032 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,862,987 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| RESTRICTED FUNDS | $7,124,039 |
| OTHER ASSETS | $668,801 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $7,792,840 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CONTRACT LIABILITY | Desc |
| Amt | $612,500 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $612,500 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $81,075,711 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $81,075,711 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $81,075,711 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $71,440,455 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $71,440,455 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $71,440,455 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|
| CALVIN D FRANKLIN | ||||||||
| VICE PRESIDENT | $227,290 | $9,706 | $10,699 | $247,695 | ||||
| JAMES R LEE JR | ||||||||
| VICE PRESIDENT | $211,554 | $8,557 | $10,471 | $230,582 | ||||
| ANDY HILL | ||||||||
| VP PROJECT MANAGER | $179,138 | $7,331 | $10,001 | $196,470 | ||||
| AMANDA ROBERSON | ||||||||
| VP OPERATIONS | $171,518 | $7,214 | $9,890 | $188,622 | ||||
| TERESA MOODY | ||||||||
| PRESIDENT | $159,010 | $10,274 | $14,883 | $184,167 | ||||
| MELISSA PRICE | ||||||||
| VP COMPLIANCE & QA | $149,466 | $6,592 | $9,570 | $165,628 | ||||
| ANGELA HAMMACK | ||||||||
| CORPORATE SECRETARY | $148,282 | $9,010 | $11,511 | $168,803 | ||||
| STEPHANIE KIRKLAND | ||||||||
| SENIOR DIR PHARMACY | $161,030 | $6,524 | $9,738 | $177,292 | ||||
| JACLYN SCOTT | ||||||||
| DIR PHARMACY | $152,488 | $6,169 | $9,614 | $168,271 | ||||
| LESLIE MAY | ||||||||
| SR. DIR. OF PHARMACY | $144,533 | $5,886 | $9,499 | $159,918 | ||||
| WILLIE LATCH | ||||||||
| DIR PHARMACY | $136,685 | $5,764 | $9,385 | $151,834 | ||||
| LORRAINE T TAYLOR | ||||||||
| FORMER SECRETARY | $687,209 | $10,600 | $20,164 | $717,973 | ||||
| MICHELLE MOORE-ANDREWS | ||||||||
| FORMER PRESIDENT | $286,167 | $10,600 | $11,580 | $308,347 | ||||
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BONDS PAYABLE | BusinessNameLine1Txt |
| Business Name Line2 | PULASKI COUNTY - HAWKINSVILLE | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 586000877 | BondIssuerEIN |
| Bond Issued | 2003-09-30 | BondIssuedDt |
| Issue Price | $17,200,000 | IssuePriceAmt |
| Purpose | ACQUISITION OF REAL ESTATE | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Current Refunding | false | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | false | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | false | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | false | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4A | DELIVERY SYSTEM OF WHICH THE ORGANIZATION IS A MEMBER, THE ORGANIZATION PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITIES IT SERVES PURSUANT TO BOTH COMMUNITY BENEFIT GUIDELINES AND A CHARITY CARE POLICY. THE ORGANIZATION CONTINUES TO ASSESS AND DEVELOP PROGRAMS TO BENEFIT THE COMMUNITY. |
| FORM 990, PAGE 6, PART VI, LINE 6 | THE ORGANIZATION HAS A SOLE MEMBER, COMMUNITY HEALTH SYSTEMS, INC., A NONPROFIT GEORGIA CORPORATION. |
| FORM 990, PAGE 6, PART VI, LINE 7A | UNDER THE ORGANIZATION'S BYLAWS, WHILE IT IS THE SOLE MEMBER OF THE ORGANIZATION, COMMUNITY HEALTH SYSTEMS, INC., AS A TYPE I SECTION 509(A)(3) AND SECTION 501(C)(3) SUPPORTING ORGANIZATION, HAS THE SOLE RIGHT TO ELECT, REPLACE AND TO REMOVE THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS AND SHALL ENSURE THAT AT ALL TIMES, A MAJORITY OF THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS SHALL BE COMPOSED OF PERSONS WHO ARE CONCURRENTLY SERVING AS MEMBERS OF THE BOARD OF DIRECTORS OF COMMUNITY HEALTH SYSTEMS, INC. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THIS PROCESS INVOLVES THE ELECTRONIC POSTING OF THE DRAFT FORM 990 WITH ALL ITS SCHEDULES FOR THE ORGANIZATION'S BOARD OF DIRECTORS TO REVIEW FOLLOWED, AFTER A SUFFICIENT REVIEW PERIOD, BY A MEETING OF THE BOARD AT WHICH BOARD MEMBERS WILL HAVE THE OPPORTUNITY TO ASK QUESTIONS OF MANAGEMENT AND THE OUTSIDE TAX ADVISORS INVOLVED IN THE PREPARATION OF THE FORM 990. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICTS OF INTEREST POLICY. SUCH COMPLIANCE IS EFFECTUATED THROUGH THE ORGANIZATION'S BOARD OF DIRECTORS' REVIEW OF ANNUAL CONFLICT DISCLOSURE STATEMENTS FROM THE DIRECTORS AS WELL AS RECEIPT AND REVIEW OF CONFLICT DISCLOSURE STATEMENTS WITH RESPECT TO CERTAIN PROPOSED TRANSACTIONS OR ARRANGEMENTS THE ORGANIZATION IS CONSIDERING PRIOR TO ANY BOARD ACTION WITH RESPECT TO SUCH MATTERS. THE CONFLICTS POLICY OUTLINES THE SPECIFIC PROCEDURE TO BE FOLLOWED TO DETERMIN WHETHER INTERESTED PERSONS HAVE ACTUAL CONFLICTS OF INTEREST. IF IT IS DETERMINED THAT A BOARD MEMBER HAS AN ACTUAL CONFLICT OF INTEREST, THEN SUCH BOARD MEMBER IS NOT ALLOWED TO PARTICIPATE IN THE BOARD DELIBERATIONS ON THE SPECIFIC MATTER AND IS EXCUSED FROM, AND IT NOT ALLOWED TO PARTICIPATE IN ANY BOARD VOTE ON THE MATTER. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE ORGANIZATION REGULARLY AND CONSISTENTLY COMPLIES WITH THE COMPENSATION APPROVAL PROCESS WHICH IS PART OF ITS CONFLICT OF INTEREST POLICY. EVERY TWO TO THREE YEARS, ON AVERAGE, THE ORGANIZATION PARTICIPATES IN A COMPREHENSIVE PROCESS CONDUCTED ON ITS BEHALF BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF COMMUNITY HEALTH SYSTEMS, INC., ITS SOLE MEMBER AND PARENT OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM IN WHICH THE ORGAINZATION IS A MEMBER. THIS PROCESS INVOLVES REVIEW OF THE COMPARABILITY DATA COMPILED BY AN INDEPENDENT THIRD-PARTY COMPENSATION CONSULTANT. COMPARABILITY DATA IS GATHERED FOR THE ORGANIZATION'S SENIOR MANAGEMENT, AND ON OCCASION, KEY OR HIGHLY COMPENSATED EMPLOYEES, AND, BASED ON THE SAME, THE CONSULTANT ISSUES A WRITTEN REPORT REFLECTING THE CONSULTANT'S OPINION CONCERNING WHETHER THE PROPOSED COMPENSATION ARRANGEMENTS CONSTITUTE RESONABLE COMPENSATION UNDER SECTION 4958 OF THE CODE. THIS PROCESS IS CONDUCTED BY THE COMPENSATION COMMITTEE, WHICH THEN MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS IS ALSO PROVIDED WITH MATERIALS REGARDING TEH COMPENSATION REIVEW, INCLUDING COPIES OF THE CONSULTANT'S REPORT. THE BOARD THEN VOTES AS TO THE RESONABLENESS OF EACH OF THE INDIVIDUAL COMPENSATION ARRANGEMENTS (IF ANY DISQUALIFIED OR OTHERWISE CONFLICTED INDIVIDUALS ARE PRESENT AT THE MEETING, THEY DO NOT PARTICIPATE IN THE DELIBERATIONS AND ARE EXCUSED FROM THE ROOM DURING THE VOTE). THE PROCESS IS DESIGNED AND CARRIED OUT BY THE BOARD OF DIRECTORS IN A MANNER DESIGNED TO SATISFY ALL THREE OS THE REQUIREMENTS NECESSARY TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS WITH RESPECT TO COMPENSATION ARRANGMENTS FOR DISQUALIFIED PERSON UNDER SECTION 53.4958-6 OF THE REGULATIONS. AS PART OF THIS PROCESS, OUTSIDE COUNSEL IS RETAINED TO FURTHER ADVISE THE BOARD ON THE REBUTTABLE PRESUMPTION PROCESS AND TO PROVIDE THE BOARD WITH A LEGAL OPINION REGARDING THE SAME. AS A FINAL STEP, EACH PART OF THE PROCESS REQUIRED TO ESTABLISH THE REBUTTABLE PRESUMPTION IS DOCUMENTED USING THE REBUTTABLE PRESUMPTION CHECKLIST RELEASED BY THE IRS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE ORGANIZATION REGULARLY AND CONSISTENTLY COMPLIES WITH THE COMPENSATION APPROVAL PROCESS WHICH IS PART OF ITS CONFLICTS OF INTEREST POLICY. EVERY TWO TO THREE YEARS, ON AVERAGE, THE ORGANIZATION PARTICIPATES IN A COMPREHENSIVE PROCESS CONDUCTED ON ITS BEHALF BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF COMMUNITY HEALTH SYSTEMS, INC., ITS SOLE MEMBER AND PARENT OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM IN WHICH THE ORGANIZATION IS A MEMBER. THIS PROCESS INVOLVES REVIEW OF COMPARABILITY DATA COMPILED BY AN INDEPENDENT THIRD-PARTY COMPENSATION CONSULTANT. COMPARABILITY DATA IS GATHERED FOR THE ORGANIZATION'S SENIOR MANAGEMENT, AND ON OCCASION, KEY OR HIGHLY COMPENSATED EMPLOYEES, AND, BASED ON THE SAME, THE CONSULTANT ISSUES A WRITTEN REPORT REFLECTING THE CONSULTANT'S OPINION CONCERNING WHETHER THE PROPOSED COMPENSATION ARRANGEMENTS CONSTITUTE REASONABLE COMPENSATION UNDER SECTION 4958 OF THE CODE. THIS PROCESS IS CONDUCTED BY THE COMPENSATION COMMITTEE, WHICH MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS IS ALSO PROVIDED WITH MATERIALS REGARDING THE COMPENSATION REVIEW, INCLUDING COPIES OF THE CONSULTANT'S REPORT. THE BOARD THEN VOTES AS TO THE REASONABLENESS OF EACH OF TEH INDIVIDUAL COMPENSATION ARRANGEMENTS (IF ANY DISQUALIFIED OR OTHERWISE CONFLICTED INDIVIDUALS ARE PRESENT AT THE MEETING, THEY DO NOT PARTICIPATE IN THE DELIBERATIONS AND ARE EXCUSED FROM THE ROOM DURING THE VOTE). THE PROCESS IS DESIGNED AND CARRIED OUT BY THE BOARD OF DIRECTORS IN A MANNER DESIGNED TO SATISFY ALL THREE OF THE REQUIREMENTS NECESSARY TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS WITH RESPECT TO COMPENSATION ARRANGEMENTS FOR DISQUALIFIED PERSONS UNDER SECTION 53.4958-6 OF THE REGULATIONS. AS PART OF THIS PROCESS, OUTSIDE COUNSEL IS RETAINED TO FURTHER ADVISE THE BOARD ON THE REBUTTABLE PRESUMPTION PROCESS AND TO PROVIDE THE BOARD WITH A LEGAL OPINION REGARDING THE SAME. AS A FINAL STEP, EACH PART OF THE PROCESS REQUIRED TO ESTABLISH THE REBUTTABLE PRESUMPTION IS DOCUMENTED USING THE REBUTTABLE PRESUMPTION CHECKLIST RELEASED BY THE IRS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST IN ACCORDANCE WITH THE SECTION 6104(D) DISCLOSURE REQUIREMENTS. |
| FORM 990, PART XI, LINE 9 | DISTRIBUTION OF NET ASSETS -4,486,519 |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| PSI LLC | |||||||||
| 440 INDUSTRIAL BOULEVARD | HAWKINSVILLE | GA | 31036 | 432007496 | PHARMACY | GA | $49,821,618 | $9,338,963 | NA |
| HDI LLC | |||||||||
| 440 INDUSTRIAL BOULEVARD | HAWKINSVILLE | GA | 31036 | 432007496 | SUPPLY DIS | GA | $19,301,925 | $4,786,817 | NA |
| SOURCE CARE MANAGEMENT LLC | |||||||||
| PO BOX 1803 | MACON | GA | 31202 | 582651175 | CASE MANAG | GA | $11,028,090 | $1,841,405 | NA |
| HELPLINK LLC | |||||||||
| PO BOX 1803 | MACON | GA | 31202 | 141904766 | EMERGENCY | GA | $893,876 | $242,970 | NA |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| CLINICAL SERVICES INC | ||||||||||
| 1005 BOULDER DRIVE | GRAY | GA | 31032 | 571157115 | CLINICAL & | GA | 501C | 10 | CHSI | false |
| COMMUNITY HEALTH FOUNDATION INC | ||||||||||
| PO BOX 1833 | MACON | GA | 31202 | 571157153 | FINANCIAL | GA | 501C | 10 | CHSI | false |
| COMMUNITY HEALTH SYSTEMS INC | ||||||||||
| PO BOX 1037 | MACON | GA | 31202 | 743083593 | SUPPORT SE | GA | 501C | 12A | NA | false |
| COMMUNITY REHABILITATION SERVICES | ||||||||||
| PO BOX 1804 | MACON | GA | 31202 | 203253779 | REHABILITA | GA | 501C | 10 | CHSI | false |
| HEALTH SCHOLARSHIPS INC | ||||||||||
| 1005 BOULDER DRIVE | GRAY | GA | 31032 | 581805305 | OPERATION | GA | 501C | 10 | CHSI | false |
| HEALTH SYSTEMS FACILITIES INC | ||||||||||
| 1005 BOULDER DRIVE | GRAY | GA | 31032 | 743083594 | OPERATION | GA | 501C | 10 | CHSI | false |
| HEALTH SYSTEMS REAL ESTATE INC | ||||||||||
| 1005 BOULDER DRIVE | GRAY | GA | 31032 | 432007488 | RE | GA | 501C | 10 | CHSI | false |
| HOME & COMMUNITY SERVICES INC | ||||||||||
| PO BOX 1803 | MACON | GA | 31202 | 432007492 | TRANS | GA | 501C | 10 | CHSI | false |
| PIEDMONT REGIONAL HEALTH INC | ||||||||||
| 1005 BOULDER DRIVE | GRAY | GA | 31032 | 432007498 | OPERATION | GA | 501C | 10 | CHSI | false |
| STEWARD HEALTH SERVICES INC | ||||||||||
| 213 THIRD STREET | MACON | GA | 31201 | 432007486 | HOSPICE | GA | 501C | 10 | CHSI | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY HEALTH VENTURES INC | ||||||||||
| 213 THIRD STREET | MACON | GA | 31201 | 201392241 | RISK MGMT | GA | CHSI | C CORP | false | |
| GEORGIA PHARMACY SERVICES INC | ||||||||||
| 213 THIRD STREET | MACON | GA | 31201 | 200248574 | PHARMACY | GA | false | N/A | ||
| HEALTH DISTRIBUTION SERVICES INC | ||||||||||
| 213 THIRD STREET | MACON | GA | 31201 | 200248557 | SUPPLY DIS | GA | false | N/A | ||
| COMMUNITY CARE PHAR - HAWKINSVILLE | ||||||||||
| 150 COMMERCE STREET | HAWKINSVILLE | GA | 31036 | 320395216 | PHARMACY | GA | false | N/A | ||
| COMMUNITY CARE PHARMACY-ROYSTON | ||||||||||
| 635 COOK STREET | ROYSTON | GA | 30662 | 383931420 | PHARMACY | GA | false | N/A | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt |
|---|---|
| COMMUNITY HEALTH SYSTEMS INC | |
| M | $2,691,738 |
| COMMUNITY HEALTH FOUNDATION INC | |
| R | $9,661 |
| HEALTH SCHOLARSHIPS INC | |
| L | $15,946,294 |
| HEALTH SYSTEMS FACILITIES INC | |
| L | $6,196,516 |
| PIEDMONT REGIONAL HEALTH INC | |
| L | $1,666,661 |