HOME & COMMUNITY SERVICES INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- HOME & COMMUNITY SERVICES INC (EIN 43-2007492)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-12
- IRS object ID
- 201601339349301710
- Schema version
- 2014v6.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-12T09:14:16-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | 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 | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 432007492 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOME & COMMUNITY SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOME | BusinessNameControlTxt |
| Phone | 4786212070 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1803 | AddressLine1Txt |
| City | MACON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31202 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LORRAINE TAYLOR | PersonNm |
| Person Title | SECRETARY | PersonTitleTxt |
| Phone | 4786212070 | PhoneNum |
| Signature | 2016-05-10 | 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 | 2016-05-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $49,433,128 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SOURCE-GA.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2003 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE A CENTRAL, EFFICIENT, AND COST-EFFECTIVE HEALTH CARE TRANSPORTATION SERVICES AS A MEMBER OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. TO PROVIDE PHYSICIAN'S CARE TO OTHER ENTITIES WHICH ARE A PART OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM. TO PROVIDE ACUTE CARE SERVICES (HOSPITAL), EMERGENCY CARE SERVICES AND SKILLED NURSING SERVICES FOR RESIDENTS IN COMMERCE, GEORGIA AND SURROUNDING AREAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 1140 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $29,775,699 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $48,722,294 | CYProgramServiceRevenueAmt |
| PY Investment Income | $93 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,084 | CYInvestmentIncomeAmt |
| PY Other Revenue | $82,967 | PYOtherRevenueAmt |
| CY Other Revenue | $708,750 | CYOtherRevenueAmt |
| PY Total Revenue | $29,858,759 | PYTotalRevenueAmt |
| CY Total Revenue | $49,433,128 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $19,524,170 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $29,897,484 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $14,320,426 | PYOtherExpensesAmt |
| CY Other Expenses | $24,269,096 | CYOtherExpensesAmt |
| PY Total Expenses | $33,844,596 | PYTotalExpensesAmt |
| CY Total Expenses | $54,166,580 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$3,985,837 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,733,452 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $31,526,259 | TotalAssetsBOYAmt |
| Total Assets EOY | $29,413,278 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,927,084 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,157,720 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,599,175 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $18,255,558 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE A CENTRAL, EFFICIENT, AND COST-EFFECTIVE HEALTH CARE TRANSPORTATION SERVICES AS A MEMBER OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. TO PROVIDE PHYSICIAN'S CARE TO OTHER ENTITIES WHICH ARE A PART OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM. TO PROVIDE ACUTE CARE SERVICES (HOSPITAL), EMERGENCY CARE SERVICES AND SKILLED NURSING SERVICES FOR RESIDENTS IN COMMERCE, GEORGIA AND SURROUNDING AREAS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $54,166,580 | ExpenseAmt |
| Revenue | $48,722,294 | RevenueAmt |
| Desc | PROVIDED A CENTRAL, EFFICIENT, AND COST-EFFECTIVE HEALTH CARE TRANSPORTATION SERVICES AS A MEMBER OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED PHYSICIAN'S CARE TO OTHER ENTITIES WHICH ARE A PART OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS IN COMMERCE, GEORGIA AND SURROUNDING AREAS. 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 | $54,166,580 | 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 | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | 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 | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| 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 | 158 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1140 | 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 | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | 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 | Yes (true) | 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 | HOME COMMUNITY SERVICES INC | PersonNm |
| Phone | 4786212100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1803 | AddressLine1Txt |
| City | MACON | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31202 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 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 |
|---|---|---|---|---|---|---|---|---|
| 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 | ||
| HERBERT M PONDER JR | ||||||||
| DIRECTOR | 4.00 | 40.00 | Yes (X) | $0 | $24,000 | $0 | ||
| KATHRYN DENNIS | ||||||||
| DIRECTOR | 4.00 | 40.00 | Yes (X) | $0 | $14,000 | $0 | ||
| J OLAN JONES | ||||||||
| DIRECTOR | 4.00 | 40.00 | Yes (X) | $0 | $12,000 | $0 | ||
| LORRAINE T TAYLOR | ||||||||
| SECRETARY | 4.00 | 40.00 | $0 | $649,986 | $14,378 | Yes (X) | ||
| ROGER FORGEY | ||||||||
| PRESIDENT-AC | 20.00 | 20.00 | $223,372 | $83,489 | $12,859 | Yes (X) | ||
| RALPH WARNOCK | ||||||||
| VP-CLINICAL | 40.00 | 0.00 | $212,915 | $0 | $23,706 | Yes (X) | ||
| JOE ROBINSON | ||||||||
| COO | 40.00 | 0.00 | $207,861 | $0 | $15,448 | Yes (X) | ||
| LARRY EBERT | ||||||||
| CFO/COO | 40.00 | 0.00 | $187,931 | $0 | $14,997 | Yes (X) | ||
| PERRY KEMP | ||||||||
| VP OPERATION | 40.00 | 0.00 | $160,615 | $0 | $13,886 | Yes (X) | ||
| TERESA MOODY | ||||||||
| PRESIDENT | 4.00 | 40.00 | $0 | $156,142 | $16,216 | Yes (X) | ||
| JOE WATERS | ||||||||
| INTERIM ADMI | 40.00 | 0.00 | $101,612 | $0 | $14 | Yes (X) | ||
| KACY KEENE | ||||||||
| COMPLIANCE/S | 40.00 | 0.00 | $42,838 | $0 | $5,269 | Yes (X) | ||
| KENNETH O'NEAL | ||||||||
| HOSPITALIST | 40.00 | 0.00 | $263,836 | $0 | $17,416 | Yes (X) | ||
| THAD LONG | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $228,168 | $0 | $16,525 | Yes (X) | ||
| WYATT BLAKE | ||||||||
| ATTENDING PH | 40.00 | 0.00 | $193,207 | $0 | $10,349 | Yes (X) | ||
| LING LI | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $177,037 | $0 | $2,918 | Yes (X) | ||
| MIRIAM GWATHNEY | ||||||||
| ADMINISTRATO | 40.00 | 0.00 | $120,532 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,119,924 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,011,617 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $163,981 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 13 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | 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 |
|---|---|---|---|---|---|
| EGERTON MCAFEE ARMISTEAD DAVIS | |||||
| 900 SOUTH GAY STREET SUITE 14 | KNOXVILLE | TN | 37902 | LEGAL | $333,937 |
| ATLANTIC IMAGING CORPORATION | |||||
| 1075 CHESTATEE ROAD | GAINESVILLE | GA | 30501 | IMAGING | $321,440 |
| NE GA ANESTHESIA INC | |||||
| 182 LAKE TEHAMA TRAIL | HOMER | GA | 30547 | ANESTHESTIA | $295,637 |
| RHC REAL ESTATE LLC | |||||
| PO BOX 1037 | MACON | GA | 31201 | LEASE | $276,000 |
| EMCARE PHYSICIAN SERVICES | |||||
| 7032 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | PHYSICIAN SV | $230,214 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| PROGRAM REVENUES | $36,187,727 | $36,187,727 |
| GOVERNMENTAL PROGRAMS REV | $12,534,567 | $12,534,567 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $48,722,294 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,084 | TotalRevenueColumnAmt |
| Exclusion | $2,084 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Total Revenue Column | $708,750 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $708,750 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $708,750 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $49,433,128 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $49,431,044 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $2,084 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,221,577 | TotalAmt |
| Program Services | $1,221,577 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,829,430 | TotalAmt |
| Program Services | $23,829,430 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $529,254 | TotalAmt |
| Program Services | $529,254 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,464,978 | TotalAmt |
| Program Services | $2,464,978 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,852,245 | TotalAmt |
| Program Services | $1,852,245 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $399,413 | TotalAmt |
| Program Services | $399,413 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $521,611 | TotalAmt |
| Program Services | $521,611 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,412,098 | TotalAmt |
| Program Services | $1,412,098 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $432,360 | TotalAmt |
| Program Services | $432,360 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $875,689 | TotalAmt |
| Program Services | $875,689 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| AMBULATORY SERVCIES | $6,355,988 | $6,355,988 |
| DEPRECIATION | $5,000,472 | $5,000,472 |
| CONTRACTED SERVICES | $4,761,033 | $4,761,033 |
| TAXES | $1,440,373 | $1,440,373 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,070,059 | TotalAmt |
| Program Services | $3,070,059 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,166,580 | TotalAmt |
| Program Services | $54,166,580 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,390,593 | BOYAmt |
| EOY | $2,506,227 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,151,532 | BOYAmt |
| EOY | $4,869,902 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $460,757 | BOYAmt |
| EOY | $505,794 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $250,081 | BOYAmt |
| EOY | $355,526 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $19,577,143 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,443,471 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,535,653 | BOYAmt |
| EOY | $14,133,672 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,116,116 | BOYAmt |
| EOY | $6,437,981 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $621,527 | BOYAmt |
| EOY | $604,176 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,526,259 | BOYAmt |
| EOY | $29,413,278 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,591,084 | BOYAmt |
| EOY | $4,205,720 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,336,000 | BOYAmt |
| EOY | $6,952,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,927,084 | BOYAmt |
| EOY | $11,157,720 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,599,175 | BOYAmt |
| EOY | $18,255,558 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,599,175 | BOYAmt |
| EOY | $18,255,558 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,526,259 | BOYAmt |
| EOY | $29,413,278 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$4,733,452 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $3,389,835 | 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 | $14,001,245 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,468,489 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,725,879 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $29,858,666 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $49,431,044 | CurrentTaxYearAmt |
| Total | $116,485,323 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,001,245 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,468,489 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,725,879 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $29,858,666 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $49,431,044 | CurrentTaxYearAmt |
| Total | $116,485,323 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $116,485,323 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $29 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $93 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,084 | CurrentTaxYearAmt |
| Total | $2,206 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $29 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $93 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,084 | CurrentTaxYearAmt |
| Total | $2,206 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,001,245 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,468,489 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,725,908 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $29,858,759 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $49,433,128 | CurrentTaxYearAmt |
| Total | $116,487,529 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 1.00000 | PublicSupportCY509Pct |
| Public Support PY509 | 1.00000 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | 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 | $1,644,091 | OtherCostOrOtherBasisAmt |
| Book Value | $1,644,091 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,822,689 | OtherCostOrOtherBasisAmt |
| Depreciation | $244,072 | DepreciationAmt |
| Book Value | $8,578,617 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,110,363 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,199,399 | DepreciationAmt |
| Book Value | $3,910,964 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $14,133,672 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $49,433,128 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $49,433,128 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $49,433,128 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $54,166,580 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $54,166,580 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $54,166,580 | TotalExpensesPerForm990Amt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 1.750000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $126,634 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $126,634 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00230 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,399,777 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $815,444 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $584,333 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01080 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,526,411 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $815,444 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $710,967 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01310 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,526,411 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $815,444 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $710,967 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01310 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,614,327 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $342,255 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,867,282 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,867,282 | CostOfCareReimbursedByMedcrAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | 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 | NORTHRIDGE MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 70 MEDICAL CENTER DRIVE | AddressLine1Txt |
| City | COMMERCE | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30529 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.NORTHRIDGEMC.COM | WebsiteAddressTxt |
| State License | 078-665 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | SNF | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHRIDGE MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | 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 |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.NORTHRIDGEMC.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | false | ImplementationStrategyAdoptInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 175.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWWNORTHRIDGEMCORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWWNORTHRIDGEMCORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWWNORTHRIDGEMCORG | 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | Yes (true) | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, NORTHRIDGE MEDICAL CENTER - PART V, LINE 5 | SEE SECTION II OF ATTACHED CHNA. |
| FACILITY 1, NORTHRIDGE MEDICAL CENTER - PART V, LINE 11 | THE ORGANIZATION PROVIDES MANY COMMUNITY BENEFIT PROGRAMS THAT WERE IDENTIFIED IN THE HEALTH NEEDS ASSESSMENT. THE ORGANIZATION PROACTIVELY ADDRESSED/ADOPTED THE HEALTH NEEDS IDENTIFIED PRIOR TO THE FINALIZATION OF THE HEALTH NEEDS ASSESSMENT. |
| FACILITY 1, NORTHRIDGE MEDICAL CENTER - PART V, LINE 22D | PATIENTS WITH INCOME AT OR BELOW 100% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR 100% CHARITY CARE WRITE-OFF OF THE CHARGES FOR MEDICALLY NECESSARY SERVICES. PATIENTS WITH INCOME BETWEEN 101% AND 175% OF THE FPG RECEIVE A PERCENTAGE DISCOUNT OFF OF THE HOSPITAL CHARGE FOR MEDICALLY NECESSARY SERVICES, BASED ON A SLIDING SCALE. SEE THE COMPANY'S "FINANCIAL ASSISTANCE POLICIES" ATTACHED TO THIS FORM. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHRIDGE HEALTH & REHAB | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 70 MEDICAL CENTER DRIVE | AddressLine1Txt |
| City | COMMERCE | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30529 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | HOSPITAL BASED SNF | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART II - COMMUNITY BUILDING ACTIVITIES | NORTHRIDGE MEDICAL CENTER CONTINUALLY EVALUATES THE NEEDS OF ITS LOCAL COMMUNITY AND OFFERS NEW AND TAILORED SERVICES TO ENSURE RESIDENTS OF JACKSON AND BANKS COUNTIES HAVE ACCESS TO THE SAME SERVICES AVAILABLE IN A MORE URBAN SETTING. THIS ENSURES HEALTHCARE FOR ALL RESIDENTS IS TIMELY AND CONVENIENT, ENABLING PATIENTS TO SAVE TIME AND MONEY BY ACCESSING CARE CLOSE TO HOME WHENEVER POSSIBLE RATHER THAN TRAVELING TO ATLANTA, ATHENS, OR OTHER METRO CENTERS. INCREASING ACCESS TO SPECIALISTS LIKE MANY RURAL GEORGIANS, RESIDENTS IN THE NORTHRIDGE SERVICE AREA HAD DIFFICULTY ACCESSING SPECIALIST CARE THAT DID NOT REQUIRE NUMEROUS TRIPS TO A MORE URBAN SETTING. NORTHRIDGE STAFF IDENTIFIED A NEED FOR MORE SPECIALISTS IN THREE KEY AREAS: PULMONOLOGY, ORTHOPEDICS, AND SURGERY. SERVICES IN ALL THREE OF THESE AREAS ARE NOW AVAILABLE 24/7. PULMONOLOGY COUNTY PUBLIC HEALTH DATA SHOW THAT COPD (CHRONIC OBSTRUCTIVE PULMONARY DISEASE) IS A TOP CAUSE OF DEATH IN JACKSON COUNTY; IT IS ALSO ONE OF THE MOST FREQUENT CONDITIONS SEEN IN PATIENTS ADMITTED TO THE HOSPITAL. THE HOSPITAL HAS RECENTLY CONTRACTED WITH PULMONARY & SLEEP SPECIALISTS OF NORTHEAST GEORGIA TO PROVIDE 24/7 COVERAGE TO PATIENTS. ORTHOPEDICS FULL-TIME ORTHOPEDIC COVERAGE ENSURES THAT OLDER PATIENTS WITH BROKEN HIPS ARE ABLE TO STAY LOCAL FOR TREATMENT AND SURGERY AS NEEDED. THIS IS CRUCIAL AS CENSUS DATA SHOWS THAT JACKSON AND BANKS COUNTIES HAVE A GREATER THAN AVERAGE NUMBER OF INDIVIDUALS AGED 65 AND OLDER COMPARED TO THE REST OF THE STATE. PROJECTIONS FROM THE GOVERNOR'S OFFICE OF PLANNING AND BUDGET SHOW THIS TREND TO CONTINUE AT LEAST THROUGH 2020, MAKING THE AVAILABILITY OF GERIATRIC AND SENIOR SERVICES CRITICAL FOR THIS COMMUNITY. SURGERY A FULL-TIME GENERAL SURGEON WAS HIRED IN JULY 2014 TO PROVIDE FULL-TIME SURGICAL COVERAGE, ELIMINATING THE NEED FOR PATIENTS TO TRAVEL TO MORE DISTANT HOSPITALS FOR APPENDECTOMIES AND OTHER ROUTINE SURGERIES. AN OUTPATIENT SURGICAL WING ALSO OFFERS COLONOSCOPY, ENDOSCOPY, AND OTHER SAME DAY PROCEDURES. GERIATRIC PSYCHIATRY NORTHRIDGE RESPONDED TO A NEED FOR LOCAL BEHAVIORAL HEALTHCARE DEDICATED TO SENIOR ADULTS BY CREATING WILLOW BROOK SENIOR WELLNESS IN NOVEMBER 2011. THIS 12-BED GERIATRIC PSYCHIATRIC UNIT IS DEDICATED TO TAKING CARE OF SENIOR ADULTS WHO SUFFER FROM DEPRESSION, ANXIETY, UNRESOLVED GRIEF, ALZHEIMER'S DISEASE AND OTHER TYPES OF DEMENTIA. NORTHRIDGE INVESTED 1.2 MILLION IN THIS UNIT AS A NEW SERVICE FOR SENIOR ADULTS IN JACKSON AND BANKS COUNTIES AS WELL AS OUTLYING AREAS. THE UNIT IMPROVES ACCESS TO MENTAL HEALTH SERVICES FOR FAMILIES WHO LACKED THE RESOURCES TO TRAVEL TO ATLANTA, WHICH PREVIOUSLY WAS THE CLOSEST LOCATION WITH A SENIOR MENTAL HEALTH TREATMENT CENTER. WILLOW BROOK PROGRAMMATIC AND CLINIC STAFF MEET WITH THE HOSPITAL'S DIRECTOR OF OUTREACH EACH MONTH TO ASSESS NEEDS IDENTIFIED BY BOTH STAFF AND COMMUNITY PARTNERS. NORTHRIDGE CONTINUES TO SEEK WAYS TO MEET THE NEEDS OF WILLOW BROOK PATIENTS UPON DISCHARGE, AS THEY MAY RETURN TO COMMUNITIES WITH NO LOCAL PSYCHIATRIST, MAKING FOLLOW UP CARE DIFFICULT. THE TWO LOCAL COMMUNITY SERVICE BOARDS (ADVANTAGE BEHAVIORAL HEALTH AND AVITA COMMUNITY PARTNERS) OFFER MENTAL HEALTH SERVICES IN JACKSON AND BANKS COUNTIES; HOWEVER, THIS IS NOT SUFFICIENT TO MEET THE MENTAL HEALTH NEEDS OF RESIDENTS. PREVENTIVE CARE PREVENTIVE CARE IS INCREASINGLY A FOCUS OF HOSPITAL ACTIVITIES DUE TO THE HIGH RATE OF DIABETES, COPD, CARDIOVASCULAR DISEASE, AND OTHER CHRONIC CONDITIONS IN SERVICE AREA. IN ADDITION TO REGULAR PARTICIPATION IN HEALTH FAIRS, NORTHRIDGE RENOVATED ITS WELLNESS CENTER IN JANUARY 2015, MAKING COSMETIC AND AESTHETIC IMPROVEMENTS WHILE INSTALLING A NEW KEY CARD SYSTEM WHICH ENABLES EASY TRACKING OF ATTENDANCE. MEMBERSHIP IS OPEN TO THE PUBLIC AND DISCOUNTS ARE OFFERED TO AREA BUSINESSES AS WELL AS FIRST RESPONDERS. THE WELLNESS CENTER IS ALSO NOW A PARTICIPANT IN THE SILVER SNEAKERS FITNESS PROGRAM WHICH PROVIDES A FREE MEMBERSHIP TO SENIORS VIA MEDICARE AND OTHER INSURANCE PLANS. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | BAD DEBT EXPENSE AND AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS ARE BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS AND TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | PAGE 6 OF ATTACHED AUDITED FINANCIAL STATEMENTS |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | SEE ATTACHED "PATIENT FINANCIAL SERVICES" POLICIES AND PROCEDURES. |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | NORTHRIDGE COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. AT THE TIME OF ADMISSION, NORTHRIDGE MEDICAL CENTER WORKS WITH MEDASSIST TO ENLIST PATIENTS IN QUALIFYING PROGRAMS. MEDASSIST MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY HELP THEM OBTAIN AND PAY FOR HEALTHCARE SERVICES. FINANCIAL COUNSELING IS ALSO PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | NORTHRIDGE MEDICAL CENTER IS A 90 BED ACUTE CARE HOSPITAL LOCATED IN COMMERCE, GEORGIA. IT IS THE ONLY HOSPITAL IN JACKSON COUNTY. IT INCLUDES A 167 BED SKILLED NURSING FACILITY ON SITE AS WELL AS A 12 BED GERIATRIC PSYCHIATRIC UNIT. HOSPITAL SERVICES INCLUDE EMERGENCY MEDICINE, CARDIOLOGY, GASTROENTEROLOGY, GENERAL SURGERY, GYNECOLOGY, MAMMOGRAPHY, OCCUPATIONAL THERAPY, ORTHOPEDIC SURGERY, OUTPATIENT DIAGNOSTIC SERVICES, OUTPATIENT SURGERY, PAIN MANAGEMENT, PHYSICAL THERAPY, PODIATRY, PULMONARY FUNCTION TESTING, RADIOLOGY, REHABILITATION SERVICES, RESPIRATORY THERAPY, SPEECH THERAPY, SWING BED/SHORT TERM REHABILITATION, ULTRASOUND, AND UROLOGICAL SURGERY. THE PRIMARY SERVICE AREA FOR NORTHRIDGE MEDICAL CENTER IS JACKSON AND BANKS COUNTIES. IN 2014, THE TOTAL INPATIENT COUNT FROM JACKSON COUNTY WAS 337 WITH 137 FROM BANKS COUNTY, ACCOUNTING FOR 80% OF ALL INPATIENT ADMISSIONS. IN 2014 THE HOSPITAL HAD 5,165 OUTPATIENTS FROM JACKSON COUNTY AND 2,141 FROM BANKS COUNTY, REPRESENTING 78% OF ALL OUTPATIENTS. BANKS AND JACKSON COUNTIES ARE LOCATED IN THE NORTHEAST PART OF THE STATE, JUST BEYOND THE MAJOR ATLANTA METROPOLITAN AREA TO THE WEST WHICH IS COMPRISED OF OVER TWO DOZEN COUNTIES. THESE TWO COUNTIES HAVE POORER HEALTH THAN THE ADJOINING METRO ATLANTA COUNTIES AND THOSE IMMEDIATELY TO THE SOUTH AS WELL. JACKSON COUNTY JACKSON COUNTY WAS CREATED IN 1796 FROM PART OF FRANKLIN COUNTY. IT IS NAMED FOR REVOLUTIONARY WAR GENERAL, CONGRESSMAN, AND SENATOR JAMES JACKSON. THE COUNTY SEAT AND MOST POPULOUS CITY IS JEFFERSON. INCORPORATED CITIES INCLUDE ARCADE, BRASELTON, COMMERCE, HOSCHTON, JEFFERSON, MAYSVILLE, NICHOLSON, PENDERGRASS AND TALMO. JACKSON COUNTY COMPRISES THE JEFFERSON, GA MICROPOLITAN STATISTICAL AREA, WHICH IS INCLUDED IN THE ATLANTA-ATHENS-CLARKE COUNTY-SANDY SPRINGS, GA COMBINED STATISTICAL AREA. THE COUNTY IS HOME TO TANGER OUTLETS, COMPRISING ALMOST 100 STORES, AS WELL AS THE PEACH STATE MOTORSPEEDWAY. THE COUNTY ENCOMPASSES 342.2 SQUARE MILES. JACKSON COUNTY HAS MOVED TO THE FOREFRONT IN POULTRY FARMING, CONTINUALLY RANKING IN THE TOP FIVE COUNTIES IN BROILER AND EGG PRODUCTION. THE COUNTY ALSO RANKS NEAR THE TOP IN BEEF CATTLE NUMBERS AND LIVESTOCK INCOME IN THE STATE. BANKS COUNTY BANKS COUNTY WAS CREATED IN 1858 FROM PARTS OF FRANKLIN AND HABERSHAM COUNTIES. IT WAS NAMED FOR DR. RICHARD E. BANKS, A CIRCUIT-RIDING PHYSICIAN WHO TREATED THE SETTLERS AND NATIVE AMERICANS OF NORTHERN GEORGIA AND SOUTH CAROLINA. HOMER, THE COUNTY'S ONLY MUNICIPALITY, WAS INCORPORATED IN 1859 AND WAS NAMED AFTER HOMER JACKSON, A PROMINENT SETTLER. THE NORTHERN BOUNDARY OF BANKS COUNTY IS THE CHATTAHOOCHEE NATIONAL FOREST AND MUCH OF THE COUNTY IS WOODLANDS. THE COUNTY ENCOMPASSES 233.7 SQUARE MILES. COMMERCIAL FORESTRY HAS GIVEN WAY TO SMALL POULTRY FARMS IN RECENT DECADES, ALTHOUGH MUCH OF THE WORKFORCE IS EMPLOYED IN THE MANUFACTURING SECTOR, MOSTLY IN TEXTILES AND APPAREL PRODUCTION. DEMOGRAPHICS THE TABLE BELOW SHOWS BASIC DEMOGRAPHIC INFORMATION FOR BOTH COUNTIES AS WELL AS THE COMBINED SERVICE AREA TOTALS. JACKSON COUNTY IS FAR MORE POPULOUS THAN BANKS; ITS POPULATION IS MORE EDUCATED AND MORE LIKELY TO HAVE OWNED A HOME. JACKSON COUNTY ALSO HAS A MUCH HIGHER MEDIAN HOUSEHOLD INCOME (2009 -2013) AT 53,179 COMPARED TO BANKS COUNTY (41,141). THE MEDIAN INCOME IN BANKS COUNTY IS ALSO SIGNIFICANTLY LOWER THAN THE GEORGIA NATIONAL AVERAGE (49,179). DATA FROM THE GOVERNOR'S OFFICE OF PLANNING AND BUDGET SHOW THAT THE POPULATION OF JACKSON AND BANKS COUNTIES WILL CONTINUE TO GROW AT A RATE OUTPACING THE GEORGIA AVERAGE THROUGH 2030. GEORGIA IS ONE OF THE FASTER GROWING STATES IN THE COUNTRY BUT POPULATION GROWTH IS EXPECTED TO BE EVEN MORE PRONOUNCED IN BANKS COUNTY (26.2% INCREASE) AND ESPECIALLY IN JACKSON COUNTY WHOSE POPULATION WILL JUMP 33% IN THE NEXT FIFTEEN YEARS. IN ADDITION, SENIORS WILL MAKE UP AN INCREASING PERCENTAGE OF THE POPULATION. JACKSON AND BANKS COUNTIES HAVE A GREATER THAN AVERAGE NUMBER OF INDIVIDUALS AGED 65 AND OLDER COMPARED TO THE REST OF THE STATE AND THIS TREND IS EXPECTED TO CONTINUE. 13.8% OF GEORGIANS IN 2020 WILL BE AGED 65 AND OLDER; IN JACKSON COUNTY THIS INCREASES TO 14.8% IN JACKSON COUNTY AND 16.4% IN BANKS, FOR A TOTAL OF ALMOST 100,000 RESIDENTS IN THIS AGE RANGE BY 2020. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | SEE SCHEDULE O FOR THE ORGANIZATION'S MISSION AND PROGRAM ACCOMPLISHMENTS WHICH INCLUDES AN EMPHASIS ON COMMUNITY BENEFIT AND COMMUNITY HEALTH. |
| PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM | THE INTEGRATED HEALTH DELIVERY SYSTEM IS DESCRIBED IN SCHEDULE O AND AFFILIATED ORGNANIZATIONS ARE INCLUDED IN SCHEDULE R. |
| PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT | GEORGIA |
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 (11 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt |
|---|---|---|---|---|---|---|---|---|
| LORRAINE T TAYLOR | ||||||||
| SECRETARY | $649,986 | $10,400 | $3,978 | $664,364 | ||||
| ROGER FORGEY | ||||||||
| PRESIDENT-ACUTE CARE | $83,489 | $1,746 | $85,235 | $223,372 | $11,113 | $234,485 | ||
| RALPH WARNOCK | ||||||||
| VP-CLINICAL Q & COMP | $212,915 | $15,464 | $236,621 | $8,242 | ||||
| JOE ROBINSON | ||||||||
| COO | $207,861 | $7,307 | $223,309 | $8,141 | ||||
| LARRY EBERT | ||||||||
| CFO/COO | $187,931 | $7,243 | $202,928 | $7,754 | ||||
| PERRY KEMP | ||||||||
| VP OPERATIONS | $160,615 | $7,357 | $174,501 | $6,529 | ||||
| TERESA MOODY | ||||||||
| PRESIDENT | $156,142 | $6,512 | $9,704 | $172,358 | ||||
| KENNETH O'NEAL | ||||||||
| HOSPITALIST | $263,836 | $7,016 | $281,252 | $10,400 | ||||
| THAD LONG | ||||||||
| PHYSICIAN | $228,168 | $7,319 | $244,693 | $9,206 | ||||
| WYATT BLAKE | ||||||||
| ATTENDING PHYSICIAN | $193,207 | $7,016 | $203,556 | $3,333 | ||||
| LING LI | ||||||||
| PHYSICIAN | $177,037 | $606 | $179,955 | $2,312 | ||||
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 | CENTRAL GEORGIA JOINT DEV AUTHORITY | BusinessNameLine1Txt |
| Business Name Line2 | BANK OF OKLAHOMA | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 611416768 | BondIssuerEIN |
| Bond Issued | 2012-07-01 | BondIssuedDt |
| Issue Price | $8,000,000 | IssuePriceAmt |
| Purpose | ACQUISITION OF RE | 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 (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | TO PROVIDE A CENTRAL, EFFICIENT, AND COST-EFFECTIVE HEALTH CARE TRANSPORTATION SERVICES AS A MEMBER OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. TO PROVIDE PHYSICIAN'S CARE TO OTHER ENTITIES WHICH ARE A PART OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM. TO PROVIDE ACUTE CARE SERVICES (HOSPITAL), EMERGENCY CARE SERVICES AND SKILLED NURSING SERVICES FOR RESIDENTS IN COMMERCE, GEORGIA AND SURROUNDING AREAS. |
| FORM 990, PAGE 2, PART III, LINE 4A | 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. |
| 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 DETERMINE 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 IS 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 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 THEN MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS SI 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 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 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 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 THEN 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 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 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 | RECEIVED FROM SUPPORTING ORGANIZATION OF IHDS 3,389,835 |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|
| H&CS SERVICES LLC | |||||||||
| PO BOX 1803 | MACON | GA | 31202 | 455012031 | HEALTHCARE | GA | $20,192,095 | $15,948,601 | NA |
| COMMUNITY PRIMARY CARE OF GEORGIA | |||||||||
| PO BOX 1803 | MACON | GA | 31202 | 455441372 | COMMUNITY- | GA | $1,857,681 | $273,872 | NA |
| MGAS HOLDINGS LLC | |||||||||
| PO BOX 1803 | MACON | GA | 31202 | 453639743 | HEALTHCARE | GA | NA | ||
| JACKSON COUNTY HC HOLDINGS LLC | |||||||||
| PO BOX 1037 | MACON | GA | 31202 | 464302674 | HEALTHCARE | GA | $6,825,754 | NA | |
| UPSON AMBULANCE COMPANY LLC | |||||||||
| PO BOX 1803 | MACON | GA | 31202 | 205095675 | AMBULANCE | GA | NA | ||
| RESTORATION HEALTHCARE COMMERCELLC | |||||||||
| 70 MEDICAL CENTER DRIVE | COMMERCE | GA | 30529 | 271914362 | HOSPITAL | GA | $27,604,575 | $5,382,671 | NA |
| RHC REAL ESTATE LLC | |||||||||
| PO BOX 1037 | MACON | GA | 31202 | 272146759 | REALESTATE | GA | $552,000 | $3,982,393 | NA |
| COMMERCE PHYSICIAN GROUP LLC | |||||||||
| PO BOX 1037 | MACON | GA | 31202 | 364737947 | HEALTHCARE | GA | NA | ||
| OPTIMUS ULTRASOUND LLC | |||||||||
| PO BOX 1037 | MACON | GA | 31202 | 474303769 | ULTRASOUND | GA | 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 | 9 | CHSI | false |
| COMMUNITY HEALTH FOUNDATION INC | ||||||||||
| PO BOX 1833 | MACON | GA | 31202 | 571157153 | FINANCIAL | GA | 501C | 9 | CHSI | false |
| COMMUNITY HEALTH SYSTEMS INC | ||||||||||
| PO BOX 1037 | MACON | GA | 31202 | 743083593 | SUPPORT SE | GA | 501C | 11A | NA | false |
| COMMUNITY REHABILITATION SERVICES | ||||||||||
| PO BOX 1804 | MACON | GA | 31202 | 203253779 | REHABILITA | GA | 501C | 9 | CHSI | false |
| HEALTH SCHOLARSHIPS INC | ||||||||||
| 1005 BOULDER DRIVE | GRAY | GA | 31032 | 581805305 | OPERATION | GA | 501C | 9 | CHSI | false |
| HEALTH SYSTEMS REAL ESTATE INC | ||||||||||
| 1005 BOULDER DRIVE | GRAY | GA | 31032 | 432007488 | RE | GA | 501C | 9 | CHSI | false |
| HEALTH SYSTEMS FACILITIES INC | ||||||||||
| 1005 BOULDER DRIVE | GRAY | GA | 31032 | 743083594 | OPERATION | GA | 501C | 9 | CHSI | false |
| COMMUNITY ANCILLARY SERVICES INC | ||||||||||
| 213 THIRD STREET | MACON | GA | 31201 | 432007496 | PHAR | GA | 501C | 9 | CHSI | false |
| PIEDMONT REGIONAL HEALTH INC | ||||||||||
| 1005 BOULDER DRIVE | GRAY | GA | 31032 | 432007498 | OPERATION | GA | 501C | 9 | CHSI | false |
| STEWARD HEALTH SERVICES INC | ||||||||||
| 213 THIRD STREET | MACON | GA | 31201 | 432007486 | HOSPICE | GA | 501C | 9 | CHSI | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH VENTURES INC | BusinessNameLine1Txt |
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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201392241 | EIN |
| Primary Activities | RISK MGMT. | PrimaryActivitiesTxt |
| Legal Domicile State | GA | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHSI | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C CORP | EntityTypeTxt |
| Controlled Organization | false | ControlledOrganizationInd |
| 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 FOUNDATION INC | |
| R | $4,072 |
| COMMUNITY HEATH SYSTEMS INC | |
| M | $475,020 |
| CLINICAL SERVICES INC | |
| L | $105,650 |
| COMMUNITY ANCILLARY SERVICES INC | |
| L | $666,703 |
| COMMUNITY REHABILITATION SERVICES | |
| L | $192,609 |