2016-11-28T15:00:38-06:00 2016-06-30 580692043 Mauldin & Jenkins LLC P O Box 1877 Macon GA 312021877 990 2015-07-01 201220860 Magnolia Manor of Marion County Inc MAGN 2299249352 2001 South Lee Street Americus GA 31709 Mark Todd President 2299249352 2016-11-22 1 Linda Corty P00221297 4784648000 2016-11-22 X 2015 2017-02-10 21:41:12Z Mark Todd 2001 South Lee Street Americus GA 31709 4827355 0 X www.magnoliamanor.com X 2004 GA The Corporation is organized to provide long-term care to the sick and elderly in a spiritual setting through operation of a 70-bed skilled nursing facility located in Buena Vista, Georgia. 12 12 85 28 0 0 0 0 4908711 4794123 1106 1265 28117 31967 4937934 4827355 0 0 0 0 1932958 2079686 0 0 0 1773339 1725231 3706297 3804917 1231637 1022438 1658051 1787038 298691 343276 1359360 1443762 The Corporation is organized to provide long-term care to the sick and elderly in a spiritual setting through the operation of a 70-bed skilled nursing facility located in Buena Vista, Georgia. 0 0 3402156 4799903 Provided long-term care for the sick and elderly in a spiritual setting in a 70-bed skilled nursing facility. The Organization provided 21,477 patient days of service during the year. 3402156 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 6 0 1 85 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 GA X The Organization 2299249352 2001 South Lee Street Americus GA 31709 James R Buchanan Jr Trustee 0.00 X 0 0 0 Ann Harris Trustee 0.00 X 0 0 0 Mark Johnson Chairman 0.00 X X 0 0 0 Edie Vinson Trustee 0.00 X 0 0 0 Hal Weathers Trustee 0.00 X 0 0 0 Jean Wheeler Secretary 0.00 X X 0 0 0 Chuck Reeves Vice Chairman 0.00 X X 0 0 0 Schley Gatewood Jr Trustee 0.00 X 0 0 0 Robert Beckum Trustee 0.00 X 0 0 0 Will Peterson Trustee 0.00 X 0 0 0 Cindy Higdon Trustee 0.00 X 0 0 0 Russ Carreker Trustee 0.00 X 0 0 0 Mark Todd President/CEO 4.00 36.00 X 0 220531 7970 Scott Adkins SVP Finance 4.00 36.00 X 0 137919 8205 Hillery Fort SVP Operations 4.00 36.00 X 0 166053 8467 Diane Harrison SVP of Human Resources 0.00 40.00 X 0 145513 5600 0 670016 30242 0 0 1 0 0 Medicare/Medicaid Paym 623000 4530185 4530185 Routine Room/Board 623000 263938 263938 4794123 1265 1265 Share of LLC investmen 900099 26187 26187 Food Sale Revenue 623000 3970 3970 Miscellaneous 623000 1810 1810 31967 4827355 4799903 0 27452 1628440 1517735 110705 20511 18195 2316 305302 291086 14216 125433 116812 8621 9636 9636 312747 301229 11518 4097 4097 25113 25113 234584 234584 12115 6525 5590 52486 52486 63914 63914 Medicaid Provider Fee 383706 383706 Supplies 280044 273273 6771 Management Fees 181296 181296 Raw Food 141321 141321 24172 1290 22882 3804917 3402156 402761 0 116057 68707 113199 230518 5439 6421 12820 1877 639841 196695 428262 443146 39835 39022 942439 997347 1658051 1787038 298691 343276 298691 343276 X 1359360 1443762 1359360 1443762 1658051 1787038 X 1022438 -938036 X X 0 1 X 1 0 X 4354128 4806252 4631778 4897392 4794123 23483673 4354128 4806252 4631778 4897392 4794123 23483673 0 0 0 23483673 57113 62163 5958 1106 1265 127605 57113 62163 5958 1106 1265 127605 22111 34995 43718 28183 31967 160974 4433352 4903410 4681454 4926681 4827355 23772252 0.98790 0.98470 0.00540 0.00830 X 218601 39599 179002 421240 157096 264144 443146 Related party accounts receivable 997347 997347 X Part X, Line 2: The Corporation and certain of its affiliates are not-for-profit corporations and have been recognized as tax-exempt persuant to Sec. 501(c)(3) of the Internal Revenue Code. Georgia Pharmacy Ventures, LLC files as a Partnership. The Corporation files its Forms 990, Return of Organizations Exempt from Income Tax, in the U.S. federal jurisdiction and with the State of Georgia. This form is open for public inspection. The Organization believes that it has appropriate support for all tax positions taken and, as such, does not have any uncertain tax positions that are material to the financial statements. Management believes that all positions taken in those returns would be sustained if examined by taxing authorities. X 0 0 0 0 0 0 0 0 0 Mark Todd President/CEO 0 220531 0 0 0 0 0 3434 0 4536 0 228501 0 0 Hillery Fort SVP Operations 0 166053 0 0 0 0 0 2723 0 5744 0 174520 0 0 Diane Harrison SVP of Human Resources 0 145513 0 0 0 0 0 0 0 5600 0 151113 0 0 Form 990, Part VI, Section B, line 11 The Form 990 was reviewed by the Organization's President and Senior Vice President for Finance prior to filing. A copy of Form 990 was also provided to all members of the Executive of the Board of Trustees for their review and approval. Form 990, Part VI, Section B, line 12c Board members in general and Finance Committee members in particular are aware of potential conflicts and consider these potential conflicts in making decisions. Form 990, Part VI, Section B, line 15a The CEO is paid entirely from a related tax-exempt organization. The Board of Trustees establishes the CEO's salary based on industry norms and compensation studies for similar type organizations. Form 990, Part VI, Section C, line 18 The Organization makes its Form 990 available to the public upon request at the Magnolia Manor, Inc. Corporate office in Americus, Georgia. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request at the Magnolia Manor, Inc. Corporate office in Americus, Georgia. Form 990, Part XI, line 9: Transfers from related parties - forgiveness of debt -938,036. Form 990, Part XII, Line 2c Review of financial statements - The process for the review and oversight of the audit process and audited financial statements has not changed from the prior year. Magnolia Manor Inc 2001 S Lee Street Americus GA 31709 580911706 Elderly affordable long-term care and assisted living GA 501(c)(3) Line 9 0 Magnolia Manor of St Simons Inc 2255 Frederica Rd St Simons Island GA 31522 201364957 Elderly affordable long-term care and assisted living GA 501(c)(3) Line 9 0 Magnolia Manor of Macon Supportive Housing Inc 190 Pierce Ave Macon GA 31204 311651955 Assisted Living GA 501(c)(3) Line 9 0 Magnolia Manor of Columbus Inc 2010 Warm Springs Rd Columbus GA 31904 208034409 Elderly affordable long-term care and assisted living GA 501(c)(3) Line 9 0 Magnolia Manor of Macon Inc 190 Pierce Ave Macon GA 31204 261311379 Assisted Living GA 501(c)(3) Line 9 0 MMI Assurance Ltd 2001 S Lee Street Americus GA 31709 981082342 Captive Insurance company CJ Magnolia Manor Inc 1 Georgia Pharmacy Ventures LLC 440 Industrial Boulevard Hawkinsville GA 31036 261918757 Provision of pharmacy-related products and services GA Magnolia Manor Inc Related 26187 67079 0 0 0.07500 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 Magnolia Manor Inc M 181296 Amounts charged