GEORGIA MOUNTAINS HOSPICE INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- GEORGIA MOUNTAINS HOSPICE INC (EIN 58-2051326)
- Tax period
- 2014-10-01 to 2015-09-30
- Filed
- 2016-04-25
- IRS object ID
- 201611169349301016
- 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 | 2016-04-25T11:46:10-05:00 | ReturnTs |
| Tax Period End | 2015-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 454084437 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Warren Averett LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Six Concourse Parkway Suite 600 | AddressLine1Txt |
| City | Atlanta | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30328 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 582051326 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Georgia Mountains Hospice Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GEOR | BusinessNameControlTxt |
| Phone | 8006927199 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 70 Caring Way | AddressLine1Txt |
| City | Jasper | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30143 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mary Anne Bramlett | PersonNm |
| Person Title | Chief Financial Officer | PersonTitleTxt |
| Phone | 7062534100 | PhoneNum |
| Signature | 2016-04-25 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Susan Hill | PreparerPersonNm |
| PTIN | P00846200 | PTIN |
| Phone | 7703961100 | PhoneNum |
| Preparation | 2016-04-25 | 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) |
|---|---|---|
| Principal Officer | Gina Pendley | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 70 Caring Way | AddressLine1Txt |
| City | Jasper | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30143 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,125,484 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.georgiamountainhospice.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1993 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | Georgia Mountains Hospice's mission is to provide excellent hospice care utilizing the interdisciplinary team model. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 40 | TotalEmployeeCnt |
| Total Volunteers | 40 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $103,094 | PYContributionsGrantsAmt |
| CY Contributions Grants | $130,928 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,885,614 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,893,616 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,713 | PYInvestmentIncomeAmt |
| CY Investment Income | $6,306 | CYInvestmentIncomeAmt |
| PY Other Revenue | $5,491 | PYOtherRevenueAmt |
| CY Other Revenue | -$5,076 | CYOtherRevenueAmt |
| PY Total Revenue | $1,998,912 | PYTotalRevenueAmt |
| CY Total Revenue | $2,025,774 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,450,649 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,338,881 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $33,661 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $712,226 | PYOtherExpensesAmt |
| CY Other Expenses | $776,784 | CYOtherExpensesAmt |
| PY Total Expenses | $2,162,875 | PYTotalExpensesAmt |
| CY Total Expenses | $2,115,665 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$163,963 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$89,891 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,770,372 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,584,118 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $431,188 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $339,367 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,339,184 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,244,751 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | To offer hope to a patient for whom all hope for cure has been exhausted; hope for maximum alertness, hope for independence and control over one's life. To offer support to families by allowing terminal patients to live at home pain free and with dignity. To offer the opportunity to tie up loose ends, make reconciliations, to know "good" goodbyes. To offer spiritual guidance and answers to one's search for meaning in one's life and death. To offer relief from financial strain. To offer care and support to family members and significant others through the bereavment period. To offer support to the community through education on death and dying. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,476,880 | ExpenseAmt |
| Revenue | $1,893,796 | RevenueAmt |
| Desc | Hospice Program: See schedule OWe provide access to the highest quality hospice program for the people of North Georgia we care for through comprehensive approaches to palliative care, pain management, and compassionate customer services while developing exceptional professional skills regarding hospice care for a rural community.Our goals are 1: To provide service excellence in nursing care, emotional support, spiritual guidance, and bereavement services to terminally ill patients and their families. 2: To provide a spirit of acceptance and mutual respect, quality and compassionate care to all patients requesting services. 3: To promote independence, comfort, and dignity surrounding death in one's chosen environment. 4: To serve as a facilitator of education and community resources for patients with limited life expectancy, their families, and community physicians. | Desc |
| Total Program Service Expenses | $1,476,880 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 40 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Organization | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8006927199 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 70 Caring Way | AddressLine1Txt |
| City | Jasper | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30143 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| Mark Atkins | ||||||
| Chairman | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Jerry Tyson | ||||||
| Vice Chairman | 0.50 | Yes (X) | $0 | $0 | $0 | |
| Betty Francis | ||||||
| Secretary | 0.50 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Paul Nealey | ||||||
| Treasurer | 0.50 | Yes (X) | $0 | $0 | $0 | |
| Steve Purvis | ||||||
| Director | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Marie Lindsey | ||||||
| Director | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Caroline Carder | ||||||
| Director | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Patricia Roberts | ||||||
| Director | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Honorable Brenda Weaver | ||||||
| Director | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Jim Jackson | ||||||
| Director | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Jack Short | ||||||
| Director | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Gina Pendley | ||||||
| Executive Director | 36.00 | $71,994 | $0 | $0 | Yes (X) | |
| Mary Anne Bramlett | ||||||
| CFO | 40.00 | $53,180 | $0 | $9,224 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $125,174 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $9,224 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Wildwood Healthcare Inc | |||||
| 184 Pin Hook Road | Talking Rock | GA | 30175 | Patient care | $210,382 |
| Blue Cross Blue Shield | |||||
| PO Box 100376 | Atlanta | GA | 303840376 | Health insurance | $190,792 |
| HospiScript Services LLC | |||||
| PO Box 933273 | Atlanta | GA | 311933273 | Medications | $163,276 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $64,655 | FundraisingAmt |
| All Other Contributions | $66,273 | AllOtherContributionsAmt |
| Total Contributions | $130,928 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Medicare revenue | 621610 | $1,687,169 | $1,687,169 |
| Commercial benefits re | 621610 | $129,613 | $129,613 |
| Medicaid revenue | 621610 | $76,834 | $76,834 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,893,616 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,182 | TotalRevenueColumnAmt |
| Exclusion | $5,182 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $32,633 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $31,509 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,124 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,124 | TotalRevenueColumnAmt |
| Exclusion | $1,124 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $62,945 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $64,655 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $68,201 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$5,256 | TotalRevenueColumnAmt |
| Exclusion | -$5,256 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Other revenue | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $180 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $180 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $180 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,025,774 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,893,796 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,050 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $128,793 | TotalAmt |
| Management And General | $111,554 | ManagementAndGeneralAmt |
| Fundraising | $17,239 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,008,868 | TotalAmt |
| Program Services | $688,648 | ProgramServicesAmt |
| Management And General | $308,516 | ManagementAndGeneralAmt |
| Fundraising | $11,704 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,275 | TotalAmt |
| Program Services | $117,639 | ProgramServicesAmt |
| Management And General | $2,636 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,945 | TotalAmt |
| Program Services | $63,900 | ProgramServicesAmt |
| Management And General | $17,045 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,000 | TotalAmt |
| Management And General | $15,000 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,784 | TotalAmt |
| Management And General | $23,784 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,684 | TotalAmt |
| Program Services | $1,841 | ProgramServicesAmt |
| Management And General | $26,536 | ManagementAndGeneralAmt |
| Fundraising | $307 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,732 | TotalAmt |
| Program Services | $11,886 | ProgramServicesAmt |
| Management And General | $15,091 | ManagementAndGeneralAmt |
| Fundraising | $755 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,534 | TotalAmt |
| Program Services | $8,506 | ProgramServicesAmt |
| Management And General | $20,316 | ManagementAndGeneralAmt |
| Fundraising | $712 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,095 | TotalAmt |
| Program Services | $12,028 | ProgramServicesAmt |
| Management And General | $26,062 | ManagementAndGeneralAmt |
| Fundraising | $2,005 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,276 | TotalAmt |
| Program Services | $7,785 | ProgramServicesAmt |
| Management And General | $6,898 | ManagementAndGeneralAmt |
| Fundraising | $593 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Direct medical expense | $421,954 | $421,954 | ||
| Mileage reimbursements | $133,473 | $130,559 | $2,731 | $183 |
| Communication | $8,361 | $8,361 | ||
| Community Education | $6,108 | $6,108 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,783 | TotalAmt |
| Program Services | $12,134 | ProgramServicesAmt |
| Management And General | $14,486 | ManagementAndGeneralAmt |
| Fundraising | $163 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,115,665 | TotalAmt |
| Program Services | $1,476,880 | ProgramServicesAmt |
| Management And General | $605,124 | ManagementAndGeneralAmt |
| Fundraising | $33,661 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,071,958 | BOYAmt |
| EOY | $449,731 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,706 | BOYAmt |
| EOY | $541,492 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $180,213 | BOYAmt |
| EOY | $158,733 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,114 | BOYAmt |
| EOY | $22,874 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $820,938 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $459,787 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $392,020 | BOYAmt |
| EOY | $361,151 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,361 | BOYAmt |
| EOY | $50,137 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,770,372 | BOYAmt |
| EOY | $1,584,118 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $203,494 | BOYAmt |
| EOY | $111,673 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $227,694 | BOYAmt |
| EOY | $227,694 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $431,188 | BOYAmt |
| EOY | $339,367 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,305,843 | BOYAmt |
| EOY | $1,217,716 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,341 | BOYAmt |
| EOY | $27,035 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,339,184 | BOYAmt |
| EOY | $1,244,751 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,770,372 | BOYAmt |
| EOY | $1,584,118 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$89,891 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$4,542 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $51,244 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $80,057 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $98,656 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $103,094 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $130,928 | CurrentTaxYearAmt |
| Total | $463,979 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,890,593 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,967,200 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,211,763 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,890,931 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,888,360 | CurrentTaxYearAmt |
| Total | $9,848,847 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,941,837 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,047,257 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,310,419 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,994,025 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,019,288 | CurrentTaxYearAmt |
| Total | $10,312,826 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $10,312,826 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,357 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,461 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,618 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,713 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,182 | CurrentTaxYearAmt |
| Total | $26,331 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,357 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,461 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,618 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,713 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,182 | CurrentTaxYearAmt |
| Total | $26,331 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,275 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $17,347 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $406 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $174 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $180 | CurrentTaxYearAmt |
| Total | $19,382 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,949,469 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,071,065 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,314,443 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,998,912 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,024,650 | CurrentTaxYearAmt |
| Total | $10,358,539 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99560 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99520 | PublicSupportPY509Pct |
| Investment Income CY | 0.00250 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00280 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $125,233 | OtherCostOrOtherBasisAmt |
| Book Value | $125,233 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $436,425 | OtherCostOrOtherBasisAmt |
| Depreciation | $229,377 | DepreciationAmt |
| Book Value | $207,048 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,271 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,832 | DepreciationAmt |
| Book Value | $439 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $239,009 | OtherCostOrOtherBasisAmt |
| Depreciation | $210,578 | DepreciationAmt |
| Book Value | $28,431 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $361,151 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Medicaid overpayment liability | Desc |
| Amt | $227,694 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $227,694 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $2,027,538 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$4,542 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$4,542 | RevenueNotReportedAmt |
| Revenue Subtotal | $2,032,080 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$6,306 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$6,306 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $2,025,774 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,115,665 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $2,115,665 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $2,115,665 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | The Organization's policy is to record a liability for any tax position taken that is beneficial to the Organization, including any related interest and penalties, when it is more likely than not the position taken by management with respect to a transaction or class of transactions will be overturned by a taxing authority upon examination. Management believes there are no such positions as of September 30, 2015 and 2014, and, accordingly, no liability has been accrued. Accordingly, the Organization is not required to pay federal taxes on income. Generally, the taxing authorities may examine a return for three years from the date it is filed. At September 30, 2015, tax years ended September 30, 2012, 2013, and 2014 remain open for possible examination by taxing authorities. |
| Part XI, Line 4b - Other Adjustments: | Contributions to temporarily restricted net assets 22,736. Temporarily restricted net assets released from restriction -29,042. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Golf Tournament | Event1Nm |
| Gross Receipts Event1 | $42,584 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $19,044 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $23,540 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $9,456 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $981 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $1,061 | OtherDirectExpensesEvent1Amt |
| Event2 | Mardi Gras Gala | Event2Nm |
| Gross Receipts Event2 | $73,598 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $44,988 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $28,610 | GrossRevenueEvent2Amt |
| Rent Facility Costs Event2 | $1,900 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $8,423 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $3,500 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $37,133 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $6,672 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $623 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $6,049 | GrossRevenueOtherEventsAmt |
| Rent Fclty Costs Other Events | $250 | RentFcltyCostsOtherEventsAmt |
| Food And Beverage Other Events | $1,784 | FoodAndBeverageOtherEventsAmt |
| Entertainment Other Events | $850 | EntertainmentOtherEventsAmt |
| Oth Direct Expnss Other Events | $2,863 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $122,854 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $64,655 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $58,199 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $11,606 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $11,188 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $4,350 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $41,057 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $68,201 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$10,002 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 8b | During the year, minutes of the Executive Committee Meetings were not maintained due to the fact that any decisions arrived at during the Executive Committe Meetings were still subject to full board approval. As such, these motions were documented in the minutes of the full Board meetings. |
| Form 990, Part VI, Section B, line 11 | Prior to the filing of the Form 990 the Organization's management performed a formal review of a draft copy of the Form 990 as provided by the CPA firm that prepared the return. Management directed any questions and concerns that arose during their review to the CPA firm for further understanding and/or corrections. Once Management was comfortable with the contents of the Form 990, an updated draft of the Form 990 was presented to the Executive Committee of the Board of Directors for their review and approval and then to the full Board. Once the draft was approved by the Board, a final copy of Form 990 was filed with the IRS. |
| Form 990, Part VI, Section B, line 12c | All members of the Board of Directors, contractors, and agency employees must disclose actual and potential conflicts of interest to the Organization via a "Potential Conflict of Interest Declaration." This declaration must be completed prior to the individual serving the Organization and and must be updated when changes occur. The Executive Director reviews all declarations and reports a summary of declarations to the Board of Directors as requested. |
| Form 990, Part VI, Section B, line 15 | The Board of Directors conducts an annual review of performance for the Executive Director utilizing the position's job description as a guide for evaluating performance. Additionally, the Board uses historical compensation data of the Organization's Executive Director in order to determine an appropriate compensation for this position. The Executive Director conducts performance reviews for other members of management on an annual basis. |
| Form 990, Part VI, Section C, line 18 | Any information related to the tax exempt status is available upon request from the Organization. |
| Form 990, Part VI, Section C, line 19 | Governing documents are available via the Georgia Secretary of State website at https://sos.georgia.gov. All other governing documents, the Organization's conflict of interest policy and latest financial statements are available upon request during business hours. |
| Part VI, Section A Line 1a | The Organization is governed by a Board of Directors, which is elected in a manner consistent with the state corporate law. The Board of Directors has chosen to delegate certain authority to an Executive Committee consisting of a chairperson, vice chair, treasurer, and secretary. Authority delegated to the Executive Committee includes but is not limited to oversight and involvement in the design and implementation of the Organization's internal control procedures, monitoring of mangement's activity, financial oversight, and committee appointment. However, powers of the Executive Committee are not such as to materially impact the Board's governance responsibilites. |
| Schedule D, Part X Other Liabilities | The Organization has received overpayments over a period of time from Medicaid on the patient liability portion of room and board claims for patients residing in nursing homes. The Organization has made many attempts to resolve this problem with Medicaid to no avail. Therfore, the Organization maintains these overpayments in a separate board designated non-interest bearing bank account. The corresponding liability is recorded as Medicaid payable and the balance as of September 30, 2015 was $227,694. |