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HAMILTON PHYSICIAN GROUP INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
HAMILTON PHYSICIAN GROUP INC (EIN 27-1198701)
Tax period
2016-10-01 to 2017-09-30
Filed
2018-05-14
IRS object ID
201811349349306086
Schema version
2016v3.0
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

FieldValueIRS element (for citing)
Return2018-05-14T14:14:55-05:00ReturnTs
Tax Period End2017-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN560747981PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DIXON HUGHES GOODMAN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 RIDGEFIELD COURTAddressLine1Txt
CityASHEVILLECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28806ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN271198701EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HAMILTON PHYSICIAN GROUP INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHAMIBusinessNameControlTxt
Phone7068765000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1168AddressLine1Txt
CityDALTONCityNm
State AbbreviationGAStateAbbreviationCd
ZIP307221168ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOSEPH L MCGUIREPersonNm
Person TitleASSISTANT TREASURERPersonTitleTxt
Phone7068765000PhoneNum
Signature2018-05-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAmy BibbyPreparerPersonNm
PTINP00445891PTIN
Phone8282542254PhoneNum
Preparation2018-05-11PreparationDt
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJEFFREY D MYERSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1168AddressLine1Txt
CityDALTONCityNm
State AbbreviationGAStateAbbreviationCd
ZIP307221168ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$13,030,317GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2009FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionHAMILTON PHYSICIAN GROUP (HPG) PROVIDES VARIOUS PHYSICIAN SPECIALTY SERVICES TO THE CITY OF DALTON AND WHITFIELD COUNTY. DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2017, HPG HAD 87,764 OUTPATIENT VISITS. HPG'S VISION IS TO SERVE THE NEEDS OF AREA RESIDENTS WITHOUT DISCRIMINATION AND REGARDLESS OF ABILITY TO PAY.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent2VotingMembersIndependentCnt
Total Employee136TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$9,418,537PYProgramServiceRevenueAmt
CY Program Service Revenue$12,906,041CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$156,683PYOtherRevenueAmt
CY Other Revenue$124,276CYOtherRevenueAmt
PY Total Revenue$9,575,220PYTotalRevenueAmt
CY Total Revenue$13,030,317CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$12,561,650PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$16,471,411CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$5,999,867PYOtherExpensesAmt
CY Other Expenses$5,006,675CYOtherExpensesAmt
PY Total Expenses$18,561,517PYTotalExpensesAmt
CY Total Expenses$21,478,086CYTotalExpensesAmt
PY Revenues Less Expenses-$8,986,297PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$8,447,769CYRevenuesLessExpensesAmt
Total Assets BOY$1,985,213TotalAssetsBOYAmt
Total Assets EOY$4,319,082TotalAssetsEOYAmt
Total Liabilities BOY$5,180,767TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,274,841TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$3,195,554NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$1,955,759NetAssetsOrFundBalancesEOYAmt
MissionNoneMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$21,145,167ExpenseAmt
Revenue$13,030,317RevenueAmt
DescHAMILTON PHYSICIAN GROUP, INC. (HPG) PROVIDES SPECIALTY PHYSICIAN SERVICES TO THE CITY OF DALTON, WHITFIELD COUNTY, AND SURROUNDING AREAS OF NORTHWEST GEORGIA. DURING FISCAL YEAR 2017, HPG HAD 87,764 OUTPATIENT VISITS. HPG'S MISSION IS TO SERVE THE NEEDS OF AREA RESIDENTS WITHOUT DISCRIMINATION AND REGARDLESS OF ABILITY TO PAY. THUS, HPG PROVIDED $237,956 IN CHARITY CARE AT ESTABLISHED RATES FOR PATIENTS UNABLE TO PAY FOR THEIR HEALTH CARE SERVICES DURING THE YEAR. IN ADDITION, CHARGES OF $8,999,158 WERE NOT COLLECTED DUE TO SHORTFALLS FROM MEDICARE AND MEDICAID.Desc
Total Program Service Expenses$21,145,167TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document20IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee136EmployeeCnt
Employment Tax Returns Filed0EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member2IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Joseph L McGuIreBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7062782105PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11200 Memorial DriveAddressLine1Txt
CityDaltonCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30720ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
BRYAN D CHEEVER MD
CHAIRMAN40.00Yes (X)Yes (X)$260,758$0$28,495
ROBERT M CHANDLER
VICE CHAIRMAN1.00Yes (X)Yes (X)$0$0$0
JOSHUA L HARE DO
TRUSTEE40.00Yes (X)$1,273,515$0$22,785
JEFFREY D MYERS
PRESIDENT/CEO/TREASURER1.00Yes (X)Yes (X)$0$1,132,953$104,11140.00
SANDRA D MCKENZIE
SECRETARY / VP1.00Yes (X)Yes (X)$0$473,171$54,68340.00
JOSEPH L MCGUIRE
ASSISTANT TREASURER1.00Yes (X)$0$377,484$62,74440.00
RANDALL F FOSTER
ASSISTANT SECRETARY1.00Yes (X)$0$188,454$50,88740.00
TOMMY BLEDSOE JR
PHYSICIAN40.00$406,300$0$31,749Yes (X)
ERIC GUERRA
PHYSICIAN40.00$955,676$0$41,546Yes (X)
GARY OLSON
PHYSICIAN40.00$579,323$0$63,227Yes (X)
Michel Pare
PHYSICIAN40.00$1,020,670$0$54,148Yes (X)
STEVEN ROHN
PHYSICIAN40.00$464,186$526,198$121,535Yes (X)
GARY L HOWARD
SVP/CFO FOR HHCS (FORMER)0.00$0$726,738$103,341Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,960,428TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,424,998TotReportableCompRltdOrgAmt
Total Other Compensation$739,251TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K22IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
WEATHERBY LOCUMS INC
PO BOX 972633DALLASTX753972633PHYSICIAN LOCUM TENENS$219,311
THE MINOR FIRM
745-B COLLEGE DRIVEDALTONGA30720LEGAL FEES$122,962
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT SERVICE REDesc
Business621990BusinessCd
Total Revenue Column$12,906,041TotalRevenueColumnAmt
Related Or Exempt Func Income$12,906,041RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$12,906,041TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS INCOMEDesc
Business900099BusinessCd
Total Revenue Column$124,276TotalRevenueColumnAmt
Related Or Exempt Func Income$124,276RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$124,276OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,030,317TotalRevenueColumnAmt
Related Or Exempt Func Income$13,030,317RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$13,567,194TotalAmt
Program Services$13,567,194ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$502,761TotalAmt
Program Services$502,761ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,693,294TotalAmt
Program Services$1,693,294ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$708,162TotalAmt
Program Services$708,162ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$175,000TotalAmt
Management And General$175,000ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$157,919TotalAmt
Management And General$157,919ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,697,923TotalAmt
Program Services$1,697,923ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$23,452TotalAmt
Program Services$23,452ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,072,391TotalAmt
Program Services$1,072,391ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$901,140TotalAmt
Program Services$901,140ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$97,518TotalAmt
Program Services$97,518ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$171,505TotalAmt
Program Services$171,505ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$706,727TotalAmt
Program Services$706,727ProgramServicesAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS EXPENSEDesc
Total$3,100TotalAmt
Program Services$3,100ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$21,478,086TotalAmt
Program Services$21,145,167ProgramServicesAmt
Management And General$332,919ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$146,104BOYAmt
EOY$1,263,479EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$718,983BOYAmt
EOY$1,351,385EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$156,073BOYAmt
EOY$482,068EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,007,327LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$785,177LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$964,053BOYAmt
EOY$1,222,150EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,985,213BOYAmt
EOY$4,319,082EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,011,770BOYAmt
EOY$3,017,077EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,168,997BOYAmt
EOY$3,257,764EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,180,767BOYAmt
EOY$6,274,841EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$3,195,554BOYAmt
EOY-$1,955,759EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$3,195,554BOYAmt
EOY-$1,955,759EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,985,213BOYAmt
EOY$4,319,082EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$8,447,769ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$9,687,564OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$85,000InvestmentCostOrOtherBasisAmt
Book Value$85,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$291,182InvestmentCostOrOtherBasisAmt
Depreciation$7,921DepreciationAmt
Book Value$283,261BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$1,631,145InvestmentCostOrOtherBasisAmt
Depreciation$777,256DepreciationAmt
Book Value$853,889BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,222,150TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescNOTE TO HAMILTON MEDICAL CENTERDesc
Amt$3,257,764Amt
FieldValueIRS element (for citing)
Total Liability$3,257,764TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationTHE SYSTEM HAS ADOPTED PROCEDURES FOR DETERMINING THE EXISTENCE OF UNCERTAIN TAX POSITIONS, AND THE RELATED TIMING AND AMOUNT OF THEIR IMPACT ON THE FINANCIAL STATEMENTS, AND DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2017.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
BRYAN D CHEEVER MD
CHAIRMAN$176,988$0$39,775$0$43,995$0$12,072$0$16,423$0$289,253$0$0$0
JOSHUA L HARE DO
TRUSTEE$731,856$0$482,933$0$58,726$0$9,667$0$13,118$0$1,296,300$0$0$0
JEFFREY D MYERS
PRESIDENT/CEO/TREASURER$0$613,620$0$257,057$0$262,276$0$35,256$0$68,855$0$1,237,064$0$31,612
SANDRA D MCKENZIE
SECRETARY / VP$0$251,191$0$86,587$0$135,393$0$13,768$0$40,915$0$527,854$0$3,282
JOSEPH L MCGUIRE
ASSISTANT TREASURER$0$209,366$0$78,636$0$89,482$0$13,250$0$49,494$0$440,228$0$64,100
RANDALL F FOSTER
ASSISTANT SECRETARY$0$152,789$0$13,179$0$22,486$0$9,210$0$41,677$0$239,341$0$0
TOMMY BLEDSOE JR
PHYSICIAN$280,671$0$30,228$0$95,401$0$13,250$0$18,499$0$438,049$0$0$0
ERIC GUERRA
PHYSICIAN$683,968$0$228,241$0$43,467$0$13,250$0$28,296$0$997,222$0$0$0
GARY OLSON
PHYSICIAN$421,445$0$110,252$0$47,626$0$21,543$0$41,684$0$642,550$0$8,293$0
Michel Pare
PHYSICIAN$833,971$0$141,052$0$45,647$0$40,049$0$14,099$0$1,074,818$0$26,799$0
STEVEN ROHN
PHYSICIAN$307,385$336,800$138,757$78,324$18,044$111,074$9,412$25,726$0$86,397$473,598$638,321$9,412$14,489
GARY L HOWARD
SVP/CFO FOR HHCS (FORMER)$0$294,614$0$0$0$432,124$0$11,088$0$92,253$0$830,079$0$64,226

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 4bFormAndLineReferenceDesc
ExplanationTHE FOLLOWING PERSONS RECEIVED CURRENT YEAR DEFERRED COMPENSATION ACCRUALS FROM NON-QUALIFIED PLANS: - JEFFREY D. MYERS - $ 22,006 - SANDRA D. MCKENZIE - $ 922 - GARY W. OLSON - $ 8,293 - MICHEL PARE - $ 26,799 - STEVEN ROHN - $ 21,888ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 7aTHE REGULAR TRUSTEES OF THE ORGANIZATION ARE APPOINTED BY THE BOARD OF TRUSTEES OF HAMILTON MEDICAL CENTER, INC.
Form 990, Part VI, Section A, line 7bCERTAIN CAPITAL EXPENDITURE AND CONTRACTUAL COMMITMENT DECISIONS MUST BE SUBSEQUENTLY APPROVED BY THE HAMILTON HEALTH CARE SYSTEM BOARD OF TRUSTEES.
Form 990, Part VI, Section B, line 11bFOLLOWING MANAGEMENT PREPARATION AND REVIEW, THE FORM 990 IS REVIEWED BY AN INDEPENDENT CPA FIRM. SUBSEQUENTLY, A DRAFT COPY OF THE UNFILED FORM 990 IS POSTED TO A SECURE PAGE ON THE HAMILTON HEALTH CARE SYSTEM WEBSITE FOR REVIEW AND COMMENT BY ALL MEMBERS OF THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
Form 990, Part VI, Section B, line 12cTHE ORGANIZATION HAS A CLEAR AND DETAILED CONFLICT OF INTEREST POLICY WHICH ESTABLISHES A PROCEDURE FOR IDENTIFYING, REVIEWING AND ADDRESSING CONFLICTS OF INTEREST. THIS POLICY ALSO REQUIRES EACH TRUSTEE AND OFFICER OF THE ORGANIZATION TO ANNUALLY SIGN A STATEMENT ACKNOWLEDGING RECEIPT OF THE CONFLICT OF INTEREST POLICY.
Form 990, Part VI, Section B, line 15UNDER A BOARD RESOLUTION, THE ORGANIZATION'S COMPENSATION COMMITTEE HAS THE AUTHORITY TO TAKE ACTION ON BEHALF OF THE BOARD WITH RESPECT TO THE COMPENSATION OF OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE MAINTAINS MINUTES OF ITS PROCEEDINGS. ON AN ANNUAL BASIS THE COMPENSATION COMMITTEE WILL MEET TO SET THE ANNUAL COMPENSATION OF THE PRESIDENT/CEO. THIS ACTION IS BASED ON CONSULTATION WITH A THIRD PARTY CONSULTING FIRM TO REVIEW THE TOTAL COMPENSATION OF THE CEO AND KEY EMPLOYEES SUCH THAT TOTAL COMPENSATION PACKAGES ARE CONSIDERED FAIR MARKET AND NOT EXCESSIVE.
Form 990, Part VI, Section C, line 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
Form 990, Part XI, line 9:CHANGE IN ACCRUED LIABILITY CLAIMS 626,219. DISTRIBUTION FROM RELATED ENTITY 660,000. EQUITY TRANSFER 8,401,345.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
HAMILTON HEALTH CARE SYSTEM INC
PO BOX 1168DALTONGA30722581519913SUPPORT RELATED ENTITIESGA501(c)(3)Line 12b, IIN/A0
DALTON SENIOR HOUSING INC
519 WEST HAWTHORNE STREETDALTONGA30720581518011LOW-INCOME HOUSINGGA501(c)(3)Line 100HAMILTON HEALTH CARE SYSTEM INC
HAMILTON AMBULATORY SURGERY CENTER INC
PO BOX 1168DALTONGA30722582654791SURGICAL SERVICESGA501(c)(3)Line 30HAMILTON MEDICAL CENTER INC
HAMILTON EMERGENCY MEDICAL SERVICES INC
PO BOX 1168DALTONGA30722581651002EMERGENCY MEDICALGA501(c)(3)Line 100HAMILTON HEALTH CARE SYSTEM INC
HAMILTON MEDICAL CENTER INC
PO BOX 1168DALTONGA30722581519911HEALTHCAREGA501(c)(3)Line 30HAMILTON HEALTH CARE SYSTEM INC
HLTC INC
PO BOX 1168DALTONGA30722582341574LONG TERM ELDERLY CAREGA501(c)(3)Line 100HAMILTON HEALTH CARE SYSTEM INC
MURRAY MEDICAL CENTER INC
PO BOX 1168DALTONGA30722582373427HOSPITAL CARE / SERVICESGA501(c)(3)Line 30HAMILTON HEALTH CARE SYSTEM INC
ROYAL OAK COMMUNITY LTD
PO BOX 1900DALTONGA30722581970228SENIOR LIVING SERVICESGA501(c)(3)Line 100HAMILTON HEALTH CARE SYSTEM INC
WHITFIELD PLACE INC
PO BOX 1168DALTONGA30722582103085LOW-INCOME HOUSINGGA501(c)(3)Line 100HAMILTON HEALTH CARE SYSTEM INC
DALTON-WHITFIELD COUNTY HOSPITAL LIABILITY TRUST
PO BOX 1168DALTONGA30722581331514LIABILITY CLAIMS COVERAGEGA501(c)(3)Line 12d, III-O0HAMILTON HEALTH CARE SYSTEM INC
WHITFIELD HEALTHCARE FOUNDATION INC
PO BOX 1900DALTONGA30722510175056FUNDS FOR HEALTHCAREGA501(c)(3)Line 12b, II0HAMILTON HEALTH CARE SYSTEM INC

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1HAMILTON HEALTH FIRST INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1168AddressLine1Txt
CityDALTONCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30722ZIPCd
FieldValueIRS element (for citing)
EIN581694713EIN
Primary ActivitiesPREFERRED PROVIDERPrimaryActivitiesTxt
Legal Domicile StateGALegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd