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LIBERTY REGIONAL MEDICAL CENTER INC: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
LIBERTY REGIONAL MEDICAL CENTER INC (EIN 58-2413173)
Tax period
2023-12-01 to 2024-11-30
Filed
2025-10-14
IRS object ID
202522879349301957
Schema version
2023v6.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2025-10-14T16:16:23-04:00ReturnTs
Tax Period End2024-11-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN580914992PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DRAFFIN & TUCKER LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 71309AddressLine1Txt
CityALBANYCityNm
State AbbreviationGAStateAbbreviationCd
ZIP317081309ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-12-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN582413173EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LIBERTY REGIONAL MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlLIBEBusinessNameControlTxt
Phone9123699438PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 919AddressLine1Txt
CityHINESVILLECityNm
State AbbreviationGAStateAbbreviationCd
ZIP313100919ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDEREK ROZIERPersonNm
Person TitleCFO/CEOPersonTitleTxt
Phone9123699426PhoneNum
Signature2025-10-06SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrfalseIRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWILLIAM EDWARD PHILLIPSPreparerPersonNm
PTINP00451499PTIN
Phone2298837878PhoneNum
Preparation2025-10-06PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDEREK ROZIERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O BOX 919AddressLine1Txt
CityHINESVILLECityNm
State AbbreviationGAStateAbbreviationCd
ZIP313100919ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$594,675GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressHTTPS://WWW.LIBERTYREGIONAL.ORG/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1998FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionFINANCIAL SUPPORT OF AN ACUTE-CARE AUTHORITY HOSPITAL (THE HOSPITAL AUTHORITY OF LIBERTY COUNTY, GEORGIA), PRIMARILY THROUGH FUNDRAISING ACTIVITIES AND INVESTMENTS.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers3TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$1,224PYContributionsGrantsAmt
CY Contributions Grants$581CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$225,012PYOtherRevenueAmt
CY Other Revenue$594,094CYOtherRevenueAmt
PY Total Revenue$226,236PYTotalRevenueAmt
CY Total Revenue$594,675CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$22,870PYOtherExpensesAmt
CY Other Expenses$12,717CYOtherExpensesAmt
PY Total Expenses$22,870PYTotalExpensesAmt
CY Total Expenses$12,717CYTotalExpensesAmt
PY Revenues Less Expenses$203,366PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$581,958CYRevenuesLessExpensesAmt
Total Assets BOY$650,173TotalAssetsBOYAmt
Total Assets EOY$1,076,339TotalAssetsEOYAmt
Total Liabilities BOY$156,359TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$493,814NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,076,339NetAssetsOrFundBalancesEOYAmt
MissionFINANCIAL SUPPORT OF AN ACUTE-CARE AUTHORITY HOSPITAL (THE HOSPITAL AUTHORITY OF LIBERTY COUNTY, GEORGIA), PRIMARILY THROUGH FUNDRAISING ACTIVITIES AND INVESTMENTS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$12,641ExpenseAmt
Revenue$594,094RevenueAmt
DescLIBERTY REGIONAL MEDICAL CENTER, INC. SUPPORTS THE HOSPITAL AUTHORITY OF LIBERTY COUNTY DBA LIBERTY REGIONAL MEDICAL CENTER, AN AUTHORITY HOSPITAL, IN ITS PURSUIT TO PROVIDE HEALTHCARE TO THE RESIDENTS OF LIBERTY COUNTY, REGARDLESS OF ABILITY TO PAY FOR SERVICES. DISBURSEMENTS MADE TO OR ON BEHALF OF LIBERTY REGIONAL MEDICAL CENTER, INC. ARE GENERALLY FOR FACILITY IMPROVEMENTS, AND EQUIPMENT, OR ARE OTHER INVESTMENTS INTENDED TO CARRY OUT THE HOSPITAL'S EXEMPT PURPOSE.Desc
Total Program Service Expenses$12,641TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstYes (true)ReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Own WebsiteYes (X)OwnWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDEREK ROZIERPersonNm
Phone9123699427PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 919AddressLine1Txt
CityHINESVILLECityNm
State AbbreviationGAStateAbbreviationCd
ZIP313100919ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
TAMERA MIMS
CEO1.0040.00Yes (X)$0$426,190$6,638
DEREK ROZIER
CFO/CEO1.0040.00Yes (X)$0$257,399$5,983
HENRY TAYLOR II DPM
TRUSTEE1.001.00$0$0$0Yes (X)
STEPHANIE B OSTEEN
TRUSTEE1.001.00$0$0$0Yes (X)
DAISY PRAY
TRUSTEE1.001.00$0$0$0Yes (X)
JAMES E ROGERS
CHAIRMAN1.001.00Yes (X)$0$0$0Yes (X)
KIM RYON
TRUSTEE1.001.00$0$0$0Yes (X)
REGINALD L PIERCE SR
VICE-CHAIRMA1.001.00Yes (X)$0$0$0Yes (X)
STEVE WELBORN
SECRETARY/TR1.001.00Yes (X)$0$0$0Yes (X)
HEATHER DYER
CFOYes (X)$0$0$0
FieldValueIRS element (for citing)
Tot Reportable Comp Rltd Org$683,589TotReportableCompRltdOrgAmt
Total Other Compensation$12,621TotalOtherCompensationAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$581AllOtherContributionsAmt
Total Contributions$581TotalContributionsAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescONCOLOGY JOINT VEN-BOOK EQUITDesc
Business621990BusinessCd
Total Revenue Column$594,094TotalRevenueColumnAmt
Related Or Exempt Func Income$594,094RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$594,094OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$594,675TotalRevenueColumnAmt
Related Or Exempt Func Income$594,094RelatedOrExemptFuncIncomeAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$76TotalAmt
Management And General$76ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$12,641TotalAmt
Program Services$12,641ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$12,717TotalAmt
Program Services$12,641ProgramServicesAmt
Management And General$76ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$149,661BOYAmt
EOY$188,212EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$500,512BOYAmt
EOY$878,898EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
EOY$9,229EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$650,173BOYAmt
EOY$1,076,339EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$156,359BOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$156,359BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$493,814BOYAmt
EOY$1,076,339EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$493,814BOYAmt
EOY$1,076,339EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$650,173BOYAmt
EOY$1,076,339EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$581,958ReconcilationRevenueExpnssAmt
Prior Period Adjustments$567PriorPeriodAdjustmentsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1HOSP AUTH OF LIBERTY CO DBA LIBERTY REGIONAL MED CTRBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN586025016EIN
Organization Type6OrganizationTypeCd
Governing Document ListedYes (true)GoverningDocumentListedInd
Support$0SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (true)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd
FieldValueIRS element (for citing)
Majority Dir Trst Supported OrgYes (true)MajorityDirTrstSupportedOrgInd

Schedule D IRS990ScheduleD

Invst Program Related Org InvstProgramRelatedOrgGrp

FieldValueIRS element (for citing)
DescINVESTMENT IN SJC ONCOLOGYDesc
Book Value$878,898BookValueAmt
Method ValuationCMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Program Rltd$878,898TotalBookValueProgramRltdAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PAGE 3, PART XFormAndLineReferenceDesc
ExplanationTHE AUTHORITY IS A GOVERNMENTAL ENTITY AND IS EXEMPT FROM INCOME TAXES. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN CONSIDERED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE FOUNDATION IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE. THE FOUNDATION APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE FOUNDATION ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF NOVEMBER 30, 2024 AND 2023. THE FOUNDATION'S TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAXING AUTHORITIES. FOR FEDERAL INCOME TAX PURPOSES, THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmt
TAMERA MIMS
CEO$394,655$30,000$1,535$6,638$432,828
DEREK ROZIER
CFO/CEO$239,369$17,835$195$5,983$263,382

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PAGE 1, PART I, LINE 3FormAndLineReferenceDesc
ExplanationNONE OF THE INDIVIDUAL BOARD MEMBERS OR OFFICERS ARE COMPENSATED BY THE FILING ORGANIZATION. THE FILING ORGANIZATION, INSTEAD, RELIES ON THE METHODS USED BY THE SUPPORTED OGANIZATION, THE HOSPITAL AUTHORITY OF LIBERTY COUNTY DBA LIBERY REGIONAL MEDICAL CENTER, (AUTHORITY), TO ESTABLISH COMPENSATION OF THE CEO AND EXECUTIVE OFFICERS. COMPENSATION DETERMINATION BY THE AUTHORITY INCLUDES INDEPENDENT COMPENSATION SURVEYS,WRITTEN EMPLOYMENT CONTRACTS, AND BOARD APPROVAL.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VITHE AUTHORITY BOARD MEMBERS ALSO SERVE AS THE GOVERNING BOARD FOR THE FILING ORGANIZATION.
FORM 990, PAGE 6, PART VI, LINE 7BANY AMENDMENTS OR REVISIONS TO THE ARTICLES OF INCORPORATION OR BYLAWS ARE SUBJECT TO THE WRITTEN APPROVAL OF THE HOSPITAL AUTHORITY OF LIBERTY COUNTY, THE SUPPORTED ORGANIZATION.
FORM 990, PAGE 6, PART VI, LINE 11BFINAL FORM 990 IS PROVIDED TO BOARD DURING ITS REGULARLY SCHEDULED MEETING PRIOR TO FILING TO ALLOW THE BOARD AN OPPORTUNITY FOR REVIEW BEFORE SUBMISSION TO THE INTERNAL REVENUE SERVICE. MANAGEMENT REVIEWS THE RETURN FOR ACCURACY AND COMPLETENESS IN THE FINANCIAL AND NARRATIVE DETAILS.
FORM 990, PAGE 6, PART VI, LINE 12CCONFLICT OF INTEREST FORMS ARE SIGNED ANNUALLY BY ALL AUTHORITY BOARD MEMBERS. THE AUTHORITY AND FILING ORGANIZATION HAVE THE SAME GOVERNING BODY. ANY DETERMINATION AS TO WHETHER A CONFLICT EXISTS IS THE RESPONSIBIITY OF THE REMAINING BOARD MEMBERS AND THE CONFLICTED INDIVIDUAL IS DISMISSED FROM THE DISCUSSIONS AND VOTES ON THE MATTER.
FORM 990, PAGE 6, PART VI, LINE 19THE FILING ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO ANY MEMBER OF THE PUBLIC WHO MAKES THEIR REQUEST AT THE ADMINISTRATIVE OFFICE.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1HOSP AUTH LIBERTY REGIONAL MED CTRBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 919AddressLine1Txt
CityHINESVILLECityNm
State AbbreviationGAStateAbbreviationCd
ZIP313100919ZIPCd
FieldValueIRS element (for citing)
EIN586025016EIN
Primary ActivitiesHEALTHCAREPrimaryActivitiesTxt
Legal Domicile StateGALegalDomicileStateCd
Exempt Code Section115ExemptCodeSectionTxt
Public Charity Status3PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd