2016-05-13T17:43:47-05:00 2015-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2014-10-01 581519913 HAMILTON HEALTH CARE SYSTEM INC HAMI 7062726115 PO BOX 1168 DALTON GA 307221168 GARY L HOWARD SENIOR VICE PRESIDENT & CFO 7062726115 2016-05-13 1 AMY BIBBY P00445891 8282542254 2014 2016-08-17 19:52:53Z GARY L HOWARD PO BOX 1168 DALTON GA 307221168 82209093 0 X WWW.HAMILTONHEALTH.COM X 1983 GA TO PROVIDE SUPPORT FOR AFFILIATED TAX-EXEMPT ORGANIZATIONS. 12 11 591 0 0 0 0 0 14961200 15141457 7349359 5263568 29511 66900 22340070 20471925 0 0 0 0 12947234 12611288 0 0 0 3277445 3285488 16224679 15896776 6115391 4575149 148792074 143427685 3608328 4153341 145183746 139274344 X THE SYSTEM PROVIDES LEADERSHIP TO MEET THE HEALTH CARE NEEDS OF THE AREA WITH SERVICES THAT ADVANCE THE QUALITY AND DIGNITY OF LIFE. THE ORGANIZATION SERVES AS THE PARENT CORPORATION FOR HAMILTON MEDICAL CENTER AND OTHER HEALTH-RELATED ENTITIES. THE ORGANIZATION MANAGES RESOURCES IN A MANNER THAT PROMOTES COMMUNITY TRUST AND ASSURES CONTINUED FINANCIAL VIABILITY. 0 0 15266833 15141457 PROVIDED SUPPORT FOR AFFILIATED TAX-EXEMPT ORGANIZATIONS LISTED IN SCHEDULE A, PART I. 15266833 1 0 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 23 0 1 591 1 0 0 0 0 0 0 0 0 0 0 X 12 11 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 GA X JOSEPH L MCGUIRE 7062782105 1200 MEMORIAL DRIVE DALTON GA 30720 G LAMAR LYLE CHAIRMAN 1.00 2.00 X X 0 0 0 ROBERT M CHANDLER VICE CHAIRMAN 1.00 2.00 X X 0 0 0 DON W ADCOCK TRUSTEE 1.00 1.00 X 0 0 0 MURRAY W BANDY TRUSTEE 1.00 1.00 X 0 0 0 BRYAN E MCALLISTER SECRETARY/TREASURER 1.00 3.00 X X 0 0 0 WILLIAM H PULLEN MD TRUSTEE 1.00 1.00 X 0 0 0 W NORRIS LITTLE TRUSTEE 1.00 X 0 0 0 STEVEN W PAYNTER MD TRUSTEE 1.00 X 0 0 0 HENRY C THARPE JR TRUSTEE 1.00 3.00 X 0 0 0 LUIS M VIAMONTE MD TRUSTEE 1.00 X 0 0 0 GARY A MIDDLETON TRUSTEE 1.00 X 0 0 0 JEFFREY D MYERS PRESIDENT/CEO 1.00 49.00 X X 863095 0 131744 GARY L HOWARD VP/CFO/ASST SECRETARY/TREA 1.00 49.00 X 665788 0 78280 JOSEPH L MCGUIRE ASSISTANT TREASURER 1.00 49.00 X 257163 0 36891 PATRICE FERKO DIRECTOR CBO 1.00 49.00 X 120141 0 19200 STEVEN BRIDENSTINE DIRECTOR FINANCE 1.00 49.00 X 104553 0 6765 VALERIE BRANTLEY GENERAL COUNSEL 1.00 49.00 X 123630 0 31065 2134370 0 303945 6 0 1 0 PHOTOBOOKS INC 755 COMMERCE DRIVE 600 DECATUR GA 30030 PURCHASED SERVICES 131646 FIDUCIARY VEST 115 PERIMETER CTR PL STE 920 ATLANTA GA 30346 CONSULTING FEES 111279 CERNER HEALTH SERVICES INC 51 VALLEY STREAM PARKWAY MALVERN PA 19355 PURCHASED SERVICES 108902 3 MANAGEMENT FEES 900099 7978397 7978397 AFFILIATE STAFFING 900099 7163060 7163060 15141457 2395224 2395224 64605512 61737168 2868344 2868344 2868344 MISCELLANEOUS REVENUE 900099 66900 66900 66900 20471925 15141457 0 5330468 2032961 2032961 7996819 7996819 173133 173133 1689626 1689626 718749 718749 225000 225000 97142 97142 21890 21890 21782 21782 396647 396647 1161527 1161527 524814 524814 493114 493114 73966 73966 24126 24126 146177 146177 31876 31876 67427 80913 -13486 15896776 15266833 629943 0 5777201 1162523 5413091 4309895 10202133 10888802 250000 1000002 127328 170275 2197199 737190 1573149 1460009 102552110 112524388 22897062 11911791 148792074 143427685 1085940 1752164 2522388 2401177 3608328 4153341 X 145183746 139274344 145183746 139274344 148792074 143427685 X 4575149 -7984551 -2500000 X X 0 1 X 1 0 X X 9 HAMILTON AMBULATORY SURGERY CENTER 582654791 3 1 0 0 HAMILTON MEDICAL CENTER INC 581519911 3 1 0 0 HAMILTON EMERGENCY MEDICAL SERVICES INC 581651002 9 1 400000 0 HLTC INC 582341574 9 1 1500000 0 MURRAY MEDICAL CENTER INC 582341574 3 1 0 0 ROYAL OAK COMMUNITY LTD 582373427 3 1 280000 0 WHITFIELD HEALTHCARE FOUNDATION INC 510175056 3 1 0 0 WHITFIELD PLACE INC 582103085 9 1 0 0 DALTON SENIOR HOUSING INC 581518011 9 1 0 0 9 2180000 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 21782 21782 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND THE GEORGIA HOSPITAL ASSOCIATION. EACH YEAR, A PORTION OF DUES PAID TO THESE ORGANIZATONS IS ALLOCATED TO LOBBYING EFFORTS ENGAGED BY THESE ORGANIZATIONS ON BEHALF OF THEIR MEMBERSHIP BODIES. THE AMOUNT ON LINE 1(I) ABOVE IS AN ESTIMATION OF THE LOBBYING PORTION OF DUES PAID FOR THE FISCAL YEAR. 1141372 1141372 37723 32476 5247 1018104 704714 313390 1460009 TIMBERLAND INVESTMENTS 3817707 F REAL ESTATE 8094084 F 11911791 DEFERRED COMPENSATION 1192837 ACCRUED PENSION COST 1208340 2401177 X PART X, LINE 2: THE ORGANIZATION HAS ADOPTED PROCEDURES FOR DETERMINING THE EXISTENCE OF UNCERTAIN TAX POSITIONS, AND THE RELATED TIMING AND AMOUNT OF THEIR IMPACT ON THE FINANCIAL STATEMENTS, AND DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2015. X X 1 1 X X X 0 1 0 0 0 0 0 0 0 JEFFREY D MYERS PRESIDENT/CEO 573606 0 149706 0 139783 0 34894 0 96850 0 994839 0 109992 0 GARY L HOWARD VP/CFO/ASST SECRETARY/TREA 379784 0 91700 0 194304 0 23444 0 54836 0 744068 0 47919 0 JOSEPH L MCGUIRE ASSISTANT TREASURER 181439 0 37529 0 38195 0 11540 0 25351 0 294054 0 16997 0 VALERIE BRANTLEY GENERAL COUNSEL 112084 0 6809 0 4737 0 4469 0 26596 0 154695 0 0 0 PART I, LINE 1A SOCIAL CLUB DUES ARE PAID FOR EXECUTIVES ANY PERSONAL USE PORTION IS EITHER REIMBURSED BY THE EXECUTIVE OR INCLUDED IN TAXABLE WAGES. PART I, LINE 4B THE FOLLOWING PERSONS RECEIVED CURRENT YEAR DEFERRED COMPENSATION ACCRUALS FROM NON-QUALIFIED PLANS: - JEFFREY D. MYERS - $ 21,894 - GARY L. HOWARD - $ 10,444 FORM 990, PART VI, SECTION A, LINE 2 CHAIRMAN OF THE BOARD G. LAMAR LYLE HAS A BUSINESS RELATIONSHIP WITH BOARD MEMBER JACKSON P. TURNER. FORM 990, PART VI, SECTION B, LINE 11 FOLLOWING MANAGEMENT PREPARATION AND REVIEW, THE FORM 990 IS REVIEWED BY AN INDEPENDENT CPA FIRM. SUBSEQUENTLY, A DRAFT OF THE UNFILED FORM 990 IS POSTED TO A SECURE PAGE ON THE HAMILTON HEALTH CARE SYSTEM WEBSITE FOR REVIEW AND COMMENT BY ALL MEMBERS OF THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CLEAR AND DETAILED CONFLICT OF INTEREST POLICY WHICH ESTABLISHES A PROCEDURE FOR IDENTIFYING, REVIEWING AND ADDRESSING CONFLICTS OF INTEREST. THIS POLICY ALSO REQUIRED EACH TRUSTEE AND OFFICER OF THE ORGANIZATION TO ANNUALLY SIGN A STATEMENT ACKNOWLEDGING RECEIPT OF THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 UNDER A BOARD RESOLUTION, THE ORGANIZATION'S COMPENSATION COMMITTEE HAS THE AUTHORITY TO TAKE ACTION ON BEHALF OF THE BOARD WITH RESPECT TO THE COMPENSATION OF OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE MAINTAINS MINUTES OF ITS PROCEEDINGS. ON AN ANNUAL BASIS THE COMPENSATION COMMITTEE WILL MEET TO SET THE ANNUAL COMPENSATION OF THE PRESIDENT/CEO. THIS ACTION IS BASED ON CONSULTATION WITH A THIRD PARTY CONSULTING FIRM TO REVIEW THE TOTAL COMPENSATION OF THE CEO AND KEY EMPLOYEES SUCH THAT TOTAL COMPENSATION PACKAGES ARE CONSIDERED FAIR MARKET AND NOT EXCESSIVE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: EQUITY TRANSFER TO HLTC, INC. -2,500,000. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART XII, LINE 2: THE FINANCIAL STATEMENTS OF HAMILTON HEALTH CARE SYSTEM, INC. ARE AUDITED ON A CONSOLIDATED BASIS TO INCLUDE ALL AFFILIATES OF THE SYSTEM. DALTON SENIOR HOUSING INC 519 WEST HAWTHORNE STREET DALTON GA 30720 581518011 LOW-INCOME HOUSING GA 501(C)(3) LINE 9 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON AMBULATORY SURGERY CENTER INC PO BOX 1168 DALTON GA 30722 582654791 SURGICAL SERVICES GA 501(C)(3) LINE 3 HAMILTON MEDICAL CENTER INC 0 HAMILTON EMERGENCY MEDICAL SERVICES INC PO BOX 1168 DALTON GA 30722 581651002 EMERGENCY MEDICAL GA 501(C)(3) LINE 9 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON MEDICAL CENTER INC PO BOX 1168 DALTON GA 30722 581519911 HEALTHCARE GA 501(C)(3) LINE 3 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON PHYSICIAN GROUP INC PO BOX 1168 DALTON GA 30722 271198701 PHYSICIAN PRACTICE GA 501(C)(3) LINE 3 HAMILTON MEDICAL CENTER INC 0 HLTC INC PO BOX 1168 DALTON GA 30722 582341574 LONG TERM ELDERLY CARE GA 501(C)(3) LINE 9 HAMILTON HEALTH CARE SYSTEM INC 1 MURRAY MEDICAL CENTER INC PO BOX 1168 DALTON GA 30722 582373427 HOSPITAL CARE / SERVICES GA 501(C)(3) LINE 3 HAMILTON HEALTH CARE SYSTEM INC 1 ROYAL OAK COMMUNITY LTD PO BOX 1900 DALTON GA 30722 581970228 SENIOR LIVING SERVICES GA 501(C)(3) LINE 9 HAMILTON HEALTH CARE SYSTEM INC 1 WHITFIELD PLACE INC PO BOX 1168 DALTON GA 30722 582103085 LOW-INCOME HOUSING GA 501(C)(3) LINE 9 HAMILTON HEALTH CARE SYSTEM INC 1 DALTON-WHITFIELD COUNTY HOSPITAL LIABILITY TRUST PO BOX 1168 DALTON GA 30722 581331514 LIABILITY CLAIMS COVERAGE GA 501(C)(3) LINE 11C, III-FI HAMILTON HEALTH CARE SYSTEM INC 1 WHITFIELD HEALTHCARE FOUNDATION INC PO BOX 1900 DALTON GA 30722 510175056 FUNDS FOR HEALTHCARE GA 501(C)(3) LINE 11A, I HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON HEALTH FIRST INC PO BOX 1168 DALTON GA 30722 581694713 PREFERRED PROVIDER GA HAMILTON HEALTH CARE SYSTEM INC C 1.00000 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 HAMILTON EMERGENCY MEDICAL SERVICES A 209190 FMV HLTC INC D 1500000 Y/E BALANCE HAMILTON EMERGENCY MEDICAL SERVICES D 400000 Y/E BALANCE ROYAL OAK COMMUNITY LTD D 280000 Y/E BALANCE HAMILTON EMERGENCY MEDICAL SERVICES E 515000 Y/E BALANCE ROYAL OAK COMMUNITY LTD E 1080000 Y/E BALANCE HLTC INC E 750715 Y/E BALANCE DALTON SENIOR HOUSING E 0 Y/E BALANCE WHITFIELD PLACE E 78000 Y/E BALANCE HAMILTON MEDICAL CENTER O 3350051 FMV HAMILTON MEDICAL CENTER P 9268746 FMV HAMILTON EMERGENCY MEDICAL SERVICES P 429942 FMV ROYAL OAK COMMUNITY LTD P 222990 FMV HAMILTON MEDICAL CENTER Q 1016724 FMV DALTON SENIOR HOUSING K 70880 FMV WHITFIELD PLACE K 86631 FMV HAMILTON MEDICAL CENTER K 7299996 FMV HAMILTON EMERGENCY MEDICAL SERVICES K 75000 FMV HLTC INC K 160000 FMV WHITFIELD HEALTHCARE FOUNDATION K 210890 FMV ROYAL OAK COMMUNITY LTD K 75000 FMV