UPSON COUNTY HOSPITAL INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- UPSON COUNTY HOSPITAL INC (EIN 58-1734026)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-07
- IRS object ID
- 201423119349301622
- Schema version
- 2013v3.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-07T14:11:24-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 580914992 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRAFFIN & TUCKER LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71309 | AddressLine1 |
| City | ALBANY | City |
| State | GA | State |
| ZIP Code | 317081309 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581734026 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UPSON COUNTY HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UPSO | BusinessNameControlTxt |
| Phone | 7066478111 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 WEST GORDON STREET | AddressLine1 |
| City | THOMASTON | City |
| State | GA | State |
| ZIP Code | 302860027 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN WILLIAMS | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7066478111 | PhoneNum |
| Signature | 2014-11-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JACQUELINE G ATKINS | PreparerPersonNm |
| PTIN | P00861721 | PTIN |
| Phone | 2298837878 | PhoneNum |
| Preparation | 2014-11-07 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UPSON REGIONAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID CASTLEBERRY CEO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 WEST GORDON STREET | AddressLine1 |
| City | THOMASTON | City |
| State | GA | State |
| ZIP Code | 302860027 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $87,575,640 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.URMC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1951 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | UPSON REGIONAL MEDICAL CENTER'S MISSION IS TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE SURROUNDING AREA, REGARDLESS OF THE ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 731 | TotalEmployeeCnt |
| Total Volunteers | 95 | TotalVolunteersCnt |
| Total Gross UBI | $642,289 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$374,259 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $674,701 | PYContributionsGrantsAmt |
| CY Contributions Grants | $774,603 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $68,626,046 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $73,698,620 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,270,564 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,253,489 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,694,519 | PYOtherRevenueAmt |
| CY Other Revenue | $2,051,361 | CYOtherRevenueAmt |
| PY Total Revenue | $73,265,830 | PYTotalRevenueAmt |
| CY Total Revenue | $79,778,073 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $29,751 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $30,846 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $37,327,409 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $37,839,156 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $33,162,904 | PYOtherExpensesAmt |
| CY Other Expenses | $34,913,681 | CYOtherExpensesAmt |
| PY Total Expenses | $70,520,064 | PYTotalExpensesAmt |
| CY Total Expenses | $72,783,683 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,745,766 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,994,390 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $143,577,199 | TotalAssetsBOYAmt |
| Total Assets EOY | $155,255,863 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $19,356,200 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $16,518,803 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $124,220,999 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $138,737,060 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | UPSON REGIONAL MEDICAL CENTER'S MISSION IS TO PROVIDE QUALITY HEALTH CARE SERVICES TO THE SURROUNDING AREA, REGARDLESS OF THE ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | Yes (true) | SignificantChangeInd |
| Expense | $57,775,476 | ExpenseAmt |
| Grant | $30,846 | GrantAmt |
| Revenue | $73,698,620 | RevenueAmt |
| Desc | UPSON REGIONAL MEDICAL CENTER OFFERS A COMPLETE LINE OF MEDICAL SERVICES INCLUDING 24-HOUR EMERGENCY CENTER, MEDICAL-SURGICAL CARE, OBSTETRICS, PEDIATRICS, WOMEN'S HEALTH SERVICES, AND MORE. PATIENT DAYS FOR THE YEAR TOTALED 12,961 IN 2013. | Desc |
| Total Program Service Expenses | $57,775,476 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | 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 | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | Yes (true) | 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 | Yes (true) | 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 | 114 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 731 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | Yes (true) | ForeignFinancialAccountInd |
| Foreign Country | CJ | ForeignCountryCd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | 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 | JOHN WILLIAMS CFO | PersonNm |
| Phone | 7066478111 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 WEST GORDON ST | AddressLine1 |
| City | THOMASTON | City |
| State | GA | State |
| ZIP Code | 302860027 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JAMES J EDWARDS JR | ||||||||
| VICE CHAIRMA | 0.75 | 0.15 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BARNEY HANCOCK | ||||||||
| SECRETARY/TR | 0.75 | 0.15 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| WILLIAM H HIGHTOWER IV | ||||||||
| CHAIRMAN | 0.75 | 0.15 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KAY ROBINSON | ||||||||
| MEMBER | 0.75 | 0.15 | Yes (X) | $0 | $0 | $0 | ||
| STEVE KEADLE | ||||||||
| MEMBER | 0.75 | 0.15 | Yes (X) | $0 | $0 | $0 | ||
| RALPH P WARNOCK MD | ||||||||
| ASST SECTRET | 0.75 | 0.15 | Yes (X) | $0 | $0 | $0 | ||
| KAY SEARCY | ||||||||
| MEMBER | 0.75 | Yes (X) | $0 | $0 | $0 | |||
| DAVID CASTLEBERRY | ||||||||
| CEO | 40.00 | 1.00 | Yes (X) | $201,540 | $0 | $26,275 | ||
| JOHN WILLIAMS | ||||||||
| CFO | 40.00 | 1.00 | Yes (X) | $196,943 | $0 | $23,065 | ||
| ROBERT SOLYOMVARI MD | ||||||||
| SURGEON | 40.00 | $623,002 | $0 | $37,127 | Yes (X) | |||
| BRANDON BOYCE MD | ||||||||
| SURGEON | 40.00 | $612,665 | $0 | $24,118 | Yes (X) | |||
| DAVID PETERSON MD | ||||||||
| ANESTHESIOLO | 40.00 | $562,564 | $0 | $37,127 | Yes (X) | |||
| STEVEN YANG MD | ||||||||
| ANESTHESIOLO | 40.00 | $557,984 | $0 | $18,921 | Yes (X) | |||
| LOUIS MAMELI MD | ||||||||
| PHYSICIAN | 40.00 | $269,577 | $0 | $39,718 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,024,275 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $206,351 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 28 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (true) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WEST CENTRAL GA RADIOLOGY ASSOCIATES | |||||
| 115 COTTAGE COURTS | THOMASTON | GA | 30286 | RADIOLOGY CONTR | $1,462,893 |
| INNOVATIVE THERAPY CONCEPTS LLC | |||||
| 2 MASHBURN STREET SUITE 102 | HAWKINSVILLE | GA | 31036 | PHYSICAL THER | $1,193,805 |
| SODEXO INC & AFFILIATES | |||||
| PO BOX 536922 | ATLANTA | GA | 303536922 | CAFETERIA MGMT | $1,039,430 |
| DELL MARKETING LP | |||||
| 120 ROYAL STREET | CANTON | MA | 02021 | CONSULTANTS | $1,034,456 |
| FACILITY CONTROL GROUP INC | |||||
| 532 BROOKSHYRE COURT | WOODSTOCK | GA | 30188 | FACILITY MAINT | $542,926 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 22 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $100,000 | RelatedOrganizationsAmt |
| Government Grants | $618,409 | GovernmentGrantsAmt |
| All Other Contributions | $56,194 | AllOtherContributionsAmt |
| Total Contributions | $774,603 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621990 | $71,683,564 | $71,683,564 |
| EHR INCENTIVES | 621990 | $2,015,056 | $2,015,056 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $73,698,620 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,875,453 | TotalRevenueColumnAmt |
| Exclusion | $2,875,453 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $455,421 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $317,160 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $138,261 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $138,261 | TotalRevenueColumnAmt |
| Exclusion | $138,261 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,034,988 | SecuritiesAmt |
| Other | $823,455 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,790,276 | SecuritiesAmt |
| Other | $690,131 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $244,712 | SecuritiesAmt |
| Other | $133,324 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $378,036 | TotalRevenueColumnAmt |
| Exclusion | $378,036 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| WELLNESS CENTER | 713940 | $618,711 | $618,711 | |
| PHYSICIAN BILLING SVC. FEE | 722514 | $443,175 | $443,175 | |
| MISCELLANEOUS | 561499 | $371,164 | $371,164 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $480,050 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $23,578 | UnrelatedBusinessRevenueAmt |
| Exclusion | $456,472 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,913,100 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $79,778,073 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $73,698,620 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $642,289 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,662,561 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,846 | TotalAmt |
| Program Services | $30,846 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $447,823 | TotalAmt |
| Management And General | $447,823 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,545,817 | TotalAmt |
| Program Services | $24,820,910 | ProgramServicesAmt |
| Management And General | $4,724,907 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $423,884 | TotalAmt |
| Program Services | $358,113 | ProgramServicesAmt |
| Management And General | $65,771 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,369,912 | TotalAmt |
| Program Services | $4,451,134 | ProgramServicesAmt |
| Management And General | $918,778 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,051,720 | TotalAmt |
| Program Services | $1,700,676 | ProgramServicesAmt |
| Management And General | $351,044 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $493,622 | TotalAmt |
| Program Services | $117,894 | ProgramServicesAmt |
| Management And General | $375,728 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $638,720 | TotalAmt |
| Management And General | $638,720 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,983 | TotalAmt |
| Management And General | $118,983 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,181 | TotalAmt |
| Management And General | $11,181 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,521 | TotalAmt |
| Management And General | $29,521 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,014,572 | TotalAmt |
| Program Services | $5,981,531 | ProgramServicesAmt |
| Management And General | $3,033,041 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,073 | TotalAmt |
| Program Services | $1,637 | ProgramServicesAmt |
| Management And General | $132,436 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,278,553 | TotalAmt |
| Program Services | $2,278,838 | ProgramServicesAmt |
| Management And General | $999,715 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $969,353 | TotalAmt |
| Program Services | $489,687 | ProgramServicesAmt |
| Management And General | $479,666 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,046,887 | TotalAmt |
| Program Services | $1,889,481 | ProgramServicesAmt |
| Management And General | $157,406 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $302,319 | TotalAmt |
| Program Services | $218,311 | ProgramServicesAmt |
| Management And General | $84,008 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,715 | TotalAmt |
| Management And General | $21,715 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,553,350 | TotalAmt |
| Program Services | $5,124,628 | ProgramServicesAmt |
| Management And General | $428,722 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $540,492 | TotalAmt |
| Program Services | $513,568 | ProgramServicesAmt |
| Management And General | $26,924 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $7,617,533 | $7,617,533 | |
| REPAIRS & MAINTENANCE | $2,199,181 | $978,844 | $1,220,337 |
| PROVIDER TAXES | $989,680 | $989,680 | |
| MISCELLANEOUS | $468,005 | $69,976 | $398,029 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $485,941 | TotalAmt |
| Program Services | $142,189 | ProgramServicesAmt |
| Management And General | $343,752 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,783,683 | TotalAmt |
| Program Services | $57,775,476 | ProgramServicesAmt |
| Management And General | $15,008,207 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,182 | BOYAmt |
| EOY | $1,428 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,524,741 | BOYAmt |
| EOY | $12,894,963 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,110,508 | BOYAmt |
| EOY | $11,271,254 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $319,378 | BOYAmt |
| EOY | $379,056 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,782,923 | BOYAmt |
| EOY | $1,909,023 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $813,011 | BOYAmt |
| EOY | $873,058 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $105,140,605 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $54,475,767 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,461,374 | BOYAmt |
| EOY | $50,664,838 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,228,401 | BOYAmt |
| EOY | $76,960,256 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $332,681 | BOYAmt |
| EOY | $301,987 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $143,577,199 | BOYAmt |
| EOY | $155,255,863 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,241,567 | BOYAmt |
| EOY | $5,897,905 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,085,000 | BOYAmt |
| EOY | $10,350,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,029,633 | BOYAmt |
| EOY | $270,898 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,356,200 | BOYAmt |
| EOY | $16,518,803 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $124,220,999 | BOYAmt |
| EOY | $138,737,060 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $124,220,999 | BOYAmt |
| EOY | $138,737,060 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $143,577,199 | BOYAmt |
| EOY | $155,255,863 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $6,994,390 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $7,521,671 | NetUnrlzdGainsLossesInvstAmt |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $11,181 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $11,181 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAYS ANNUAL DUES TO NATIONAL AND STATE INDUSTRY ORGANIZATIONS. A PORTION OF THOSE DUES ARE ATTRIBUTABLE TO THE LOBBYING ACTIVITIES OF THESE ORGANIZATIONS FOR THE BENEFIT OF THEIR MEMBERS. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,458,199 | OtherCostOrOtherBasisAmt |
| Book Value | $1,458,199 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $57,920,984 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,707,058 | DepreciationAmt |
| Book Value | $34,213,926 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $880,281 | OtherCostOrOtherBasisAmt |
| Depreciation | $499,660 | DepreciationAmt |
| Book Value | $380,621 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $44,838,879 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,269,049 | DepreciationAmt |
| Book Value | $14,569,830 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $42,262 | OtherCostOrOtherBasisAmt |
| Book Value | $42,262 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $50,664,838 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| EST. THIRD PARTY PAYOR SETTLEMENTS | $271,083 |
| RELATED PARTY | -$185 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $270,898 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL AND FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AND ARE TAX- EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE REMAINING WHOLLY OWNED SUBSIDIARIES ARE CONSIDERED DISREGARDED ENTITIES AND ARE INCLUDED IN THE HOSPITAL'S TAX FILINGS. THEREFORE, NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL AND FOUNDATION APPLY 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 HOSPITAL AND FOUNDATION ONLY RECOGNIZE 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 DECEMBER 31, 2013 AND 2012 OR FOR THE YEARS THEN ENDED. THE HOSPITAL AND 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 F IRS990ScheduleF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintainedInd |
Account Activities Outside US AccountActivitiesOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | CENTRAL AMERICA & THE CARIBBEAN | RegionTxt |
| Offices | 1 | OfficesCnt |
| Employee | 1 | EmployeeCnt |
| Type Of Activities Conducted | INVESTMENTS | TypeOfActivitiesConductedTxt |
| Region Total Expenditures | $1,858,000 | RegionTotalExpendituresAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 1 | SubtotalOfficesCnt |
| Subtotal Employees | 1 | SubtotalEmployeesCnt |
| Total Office | 1 | TotalOfficeCnt |
| Total Employee | 1 | TotalEmployeeCnt |
| Subtotal Spent | $1,858,000 | SubtotalSpentAmt |
| Total Spent | $1,858,000 | TotalSpentAmt |
| Transfer To Foreign Corp | false | TransferToForeignCorpInd |
| Interest In Foreign Trust | false | InterestInForeignTrustInd |
| Foreign Corp Ownership | Yes (true) | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | false | PassiveForeignInvestmestCoInd |
| Foreign Partnership | false | ForeignPartnershipInd |
| Boycott Countries | false | BoycottCountriesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE F, PAGE 1, PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | CENTRAL AMERICA & THE CARIBBEAN 0 1,858,000 | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 1.250000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| 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) |
|---|---|---|
| Persons Served | 6522 | PersonsServedCnt |
| Total Community Benefit Expns | $3,429,320 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,429,320 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04690 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 14215 | PersonsServedCnt |
| Total Community Benefit Expns | $11,387,643 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,799,339 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,588,304 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02170 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 20737 | PersonsServedCnt |
| Total Community Benefit Expns | $14,816,963 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,799,339 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,017,624 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06860 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 9208 | PersonsServedCnt |
| Total Community Benefit Expns | $66,629 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $66,629 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 376 | PersonsServedCnt |
| Total Community Benefit Expns | $9,536 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,536 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,428,816 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,172,341 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,256,475 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11290 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,588 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,588 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 9584 | PersonsServedCnt |
| Total Community Benefit Expns | $12,513,569 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,172,341 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,341,228 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11400 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 30321 | PersonsServedCnt |
| Total Community Benefit Expns | $27,330,532 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,971,680 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,358,852 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.18260 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 2 | PersonsServedCnt |
| Total Community Benefit Expns | $2,644 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,644 | NetCommunityBenefitExpnsAmt |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $500 | NetCommunityBenefitExpnsAmt |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 56 | PersonsServedCnt |
| Total Community Benefit Expns | $123,910 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $123,910 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 58 | PersonsServedCnt |
| Total Community Benefit Expns | $127,054 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $127,054 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $20,361,069 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $20,812,427 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $22,349,803 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,537,376 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| 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 | UPSON COUNTY HOSPITAL INC | BusinessNameLine1 |
| Business Name Line2 | DBA UPSON REGIONAL MEDICAL CENTER | BusinessNameLine2 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 WEST GORDON STREET | AddressLine1 |
| City | THOMASTON | City |
| State | GA | State |
| ZIP Code | 30286 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.URMC.ORG | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | O/P PHYS OFC; WELLNS CTR; AMB | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UPSON COUNTY HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.URMC.ORG | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | false | AllNeedsAddressedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (true) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 125.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (true) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, UPSON COUNTY HOSPITAL, INC. - PART V, LINE 3 | THE CHNA HOSPITAL STEERING COMMITTEE ("CHSC") IDENTIFIED COMMUNITY LEADERS, PARTNERS, AND REPRESENTATIVES TO INCLUDE IN THE CHNA PROCESS. INDIVIDUALS, AGENCIES, PARTNERS, POTENTIAL PARTNERS, AND OTHERS WERE REQUESTED TO WORK WITH THE HOSPITAL TO 1) ASSESS THE NEEDS OF THE COMMUNITY, 2) REVIEW AVAILABLE COMMUNITY RESOURCES AND 3) TO PRIORITIZE THE HEALTH NEEDS OF THE COMMUNITY. REPRESENTATIVES OF GROUPS, OR INDIVIDUALS, WHO REPRESENT MEDICALLY-UNDERSERVED POPULATIONS, LOW INCOME POPULATIONS, MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASES WERE INCLUDED. COMMUNITY STAKEHOLDERS (ALSO CALLED KEY INFORMANTS) ARE PEOPLE INVESTED IN OR INTERESTED IN THE WORK OF THE HOSPITAL, PEOPLE WHO HAVE SPECIAL KNOWLEDGE OF HEALTH ISSUES, OR ARE PEOPLE IMPORTANT TO THE SUCCESS OF ANY HOSPITAL OR HEALTH PROJECT, OR ARE FORMAL OR INFORMAL COMMUNITY LEADERS. THE HOSPITAL IDENTIFIED OVER 120 COMMUNITY MEMBERS TO PARTICIPATE IN THE CHNA PROCESS. TWO-HOUR COMMUNITY HEALTH INPUT MEETINGS (COMMUNITY MEETINGS) AND ONE-HOUR COMMUNITY STAKEHOLDER INTERVIEWS (INTERVIEWS) WERE ESSENTIAL PARTS OF THE CHNA PROCESS. THREE COMMUNITY MEETINGS AND 10 STAKEHOLDER INTERVIEWS WERE CONDUCTED IN ORDER TO OBTAIN THE COMMUNITY'S INPUT INTO THE HEALTH NEEDS OF UPSON COUNTY. EACH COMMUNITY MEETING WAS DRIVEN BY AN AGENDA PLANNED IN ADVANCE. SIGN-IN SHEETS AND EVALUATIONS WERE ALSO USED. THE COMMUNITY HEALTH PROFILE WAS SHARED WITH THE PARTICIPANTS AT EACH MEETING. INFORMATION GATHERED FROM COMMUNITY MEETINGS, STAKEHOLDER INTERVIEWS, DISCUSSIONS WITH THE HOSPITAL LEADERSHIP TEAM, AS WELL AS A REVIEW OF DEMOGRAPHIC AND HEALTH STATUS, AND HOSPITAL UTILIZATION DATA WAS USED TO DETERMINE THE PRIORITY HEALTH NEEDS OF THE POPULATION. DRAFFIN & TUCKER, LLP PROVIDED THE CHSC WITH A WRITTEN REPORT OF THE OBSERVATIONS, COMMENTS, AND PRIORITIES RESULTING FROM THE COMMUNITY MEETINGS AND STAKEHOLDER INTERVIEWS. THE CHSC REVIEWED THIS INFORMATION, FOCUSING ON THE IDENTIFIED NEEDS, PRIORITIES, AND CURRENT COMMUNITY RESOURCES AVAILABLE. THE CHSC DEBATED THE MERITS OR VALUES OF THESE PRIORITIES, CONSIDERING THE RESOURCES AVAILABLE TO MEET THESE NEEDS. FROM THIS INFORMATION AND DISCUSSION, THE HOSPITAL DEVELOPED THE PRIORITY NEEDS OF THE COMMUNITY, EACH OF WHICH WILL BE ADDRESSED SEPARATELY IN THE HOSPITAL'S IMPLEMENTATION STRATEGY DOCUMENT. |
| FACILITY 1, UPSON COUNTY HOSPITAL, INC. - PART V, LINE 5C | THE FACILITY'S COMMUNITY HEALTH NEEDS ASSESSMENT FULL REPORT CAN BE FOUND AT HTTP://URMC.ORG/SYSTEM/MEDIA_FILES/ATTACHMENTS/39/ORIGINAL/URMC_REPORT_FINA LB.PDF?1355327495 |
| FACILITY 1, UPSON COUNTY HOSPITAL, INC. - PART V, LINE 7 | HEALTH NEEDS WITHOUT SPECIFIC IMPLEMENTATION STRATEGIES 1. MENTAL HEALTH THE COMMUNITY PREVALENCE OF MENTAL HEALTH ISSUES IS RELATIVELY SMALL IN NUMBER OF PERSONS AFFECTED. URMC IS AN ACUTE CARE HOSPITAL THAT PROVIDES EMERGENCY CARE FOR MENTAL HEALTH CONDITIONS, OFTEN ON A CHARITY CARE BASIS. URMC DOES NOT HAVE THE SPECIALIZED STAFF AND PHYSICIAN RESOURCES NEEDED TO ADDRESS MENTAL HEALTH ISSUES. MCINTOSH TRAIL AND PATHWAYS (BARNESVILLE) CURRENTLY PROVIDE FOCUSED MENTAL HEALTH SERVICES TO THE COMMUNITY. THE HOSPITAL WILL DEVELOP A RESOURCE DIRECTORY FOR THE COMMUNITY TO HELP INDIVIDUALS NAVIGATE THE HEALTHCARE SYSTEM AS IT RELATES TO MENTAL HEALTH. THE HOSPITAL WILL CONTINUE TO MEET THE ACUTE CARE AND EMERGENCY CARE NEEDS OF MENTALLY ILL PATIENTS IN THE COMMUNITY, WITH REFERRALS TO SPECIALIZED MENTAL HEALTH PROVIDERS WHEN APPROPRIATE. 2. TEEN PREGNANCY THERE IS A LACK OF COMMUNITY CONSENSUS ON THE RECOMMENDED CURRICULUM FOR SEX EDUCATION. THIS LACK OF CONSENSUS CREATES A BARRIER TO THE HOSPITAL DIRECTLY ADDRESSING THE NEED. A PARTNERSHIP BETWEEN THE SCHOOL SYSTEM AND PUBLIC HEALTH WOULD BETTER SERVE THIS IDENTIFIED NEED. AS STATED ABOVE, URMC WILL DEVELOP IMPLEMENTATION STRATEGIES TO ADDRESS TEEN LIFESTYLE ISSUES. THROUGH THESE STRATEGIES, THE HOSPITAL WILL ADDRESS LIFESTYLE CHOICES WHICH MAY CONTRIBUTE TO TEEN PREGNANCY. THE HOSPITAL WILL ALSO PROVIDE A RESOURCE DIRECTORY TO THE COMMUNITY TO IDENTIFY HEALTH RESOURCES FOR PREGNANT TEENS. |
| FACILITY 1, UPSON COUNTY HOSPITAL, INC. - PART V, LINE 14G | NOTICE EXPLAINING POLICY POSTED IN THE LOCAL NEWSPAPER QUARTERLY. |
| FACILITY 1, UPSON COUNTY HOSPITAL, INC. - PART V, LINE 18E | AVAILABILITY OF THE POLICY ON THE HOSPITAL WEBSITE. |
| FACILITY 1, UPSON COUNTY HOSPITAL, INC. - PART V, LINE 20D | THE FACILITY USES AN ESTIMATE OF THE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES IN DETERMINING WHAT TO BILL INDIVIDUALS WITH NO INSURANCE FOR PROVIDED SERVICES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 7 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| UPSON MEDICAL ASSOCIATES LLC | ||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | PHYSICIANS OFFICE |
| UPSON REGIONAL WELLNESS CENTER LLC | ||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | WELLNESS CENTER |
| UPSON AMBULANCE CO LLC | ||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | AMBULANCE SERVICE |
| UPSON WOMEN'S SERVICES LLC | ||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | PHYSICIANS OFFICE |
| UPSON FAMILY PHYSICIANS LLC | ||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | PHYSICIANS OFFICE |
| UPSON SURGICAL ASSOCIATES LLC | ||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | PHYSICIANS OFFICE |
| ORTHOPEDICS SPORTS MEDICINE & SURGE | ||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | PHYSICIANS OFFICE |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION | SUBSIDIZED HEALTH SERVICES COSTS INCLUDE THOSE ATTRIBUTABLE TO UPSON MEDICAL ASSOCIATES, UPSON WOMEN'S SERVICES, UPSON SURGICAL ASSOCIATES, ORTHOPEDIC SPORTS MEDICINE, AND UPSON FAMILY PHYSICIANS TOTALING 9,839,136. THESE CLINICS PROMOTE HEALTH CARE FOR UNDERSERVED POPULATIONS IN THE AREA. |
| PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE | IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN (F), THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25: FORM 990, PART IX, LINE 25 72,783,683 ADD: EXPENSES ON PART VIII 317,160 DENOMINATOR FOR COLUMN (F) 73,100,843 |
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATION'S "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS, 2008". FOR LINE 7A, COSTS WERE CALCULATED USING THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 AS PROVIDED IN THE IRS INSTRUCTIONS. SUBSIDIZED HEALTH SERVICES PRESENTED ON LINE 7G WERE BASED ON ACTUAL COSTS PER THE MEDICARE COST REPORT NET OF ASSOCIATED BAD DEBT, CHARITY AND MEDICAID EXPENSE. ALL OTHER COSTS PRESENTED IN THE TABLE WERE ACCUMULATED THROUGH THE COST ACCOUNTING SOFTWARE CBISA. |
| PART II - COMMUNITY BUILDING ACTIVITIES | AS ONE OF THE REGIONS LARGEST EMPLOYERS, UPSON REGIONAL MEDICAL CENTER INVESTS IN ITS SERVICE AREA TO DEVELOP WORKFORCE AND LEADERSHIP CAPACITY NEEDED TO STRENGTHEN THE REGION. THESE ACTIVITIES PROVIDE OPPORTUNITIES TO ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS. THESE ACTIVITIES SUPPORT COMMUNITY ASSETS BY OFFERING THE EXPERTISE AND RESOURCES OF HEALTHCARE ORGANIZATIONS. THESE INCLUDE INVOLVEMENT WITH THE LOCAL AND STATE CHAMBERS OF COMMERCE PROVIDING LEADERSHIP TRAINING AND PARTICIPATION IN YOUTH LEADERSHIP PROGRAMS. PART OF THE COMMUNITY HEALTH IMPROVEMENT ADVOCACY INCLUDES OUR PHYSICIAN RECRUITMENT ACTIVITIES TO MEET THE HEALTH NEEDS OF THE UNDERSERVED, AND PHYSICIAN STUDENT LOAN REPAYMENT FOR 5 PRIMARY CARE PHYSICIANS WHO HAVE COME TO SERVE OUR COMMUNITIES. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD- PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLES AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS. |
| PART III, LINE 8 - MEDICARE EXPLANATION | MEDICARE COSTS REFLECT ALLOWABLE COSTS PER THE MEDICARE COST REPORT USING ACCEPTABLE ALLOCATIONS OF INDIRECT COSTS BASED ON STATISTICAL BASIS. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | ACCOUNTS KNOWN TO HAVE QUALIFIED FOR FINANCIAL ASSISTANCE ARE WRITTEN OFF WITH AN ADJUSTMENT INDICATING INDIGENT WRITEOFF. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | UPSON REGIONAL MEDICAL CENTER (URMC) IS AN 115-BED NOT-FOR-PROFIT COMMUNITY HOSPITAL LOCATED IN THOMASTON. GEORGIA. IN 2012, THE HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO IDENTIFY THE HEALTH NEEDS OF UPSON COUNTY. THE IMPLEMENTATION STRATEGY FOR URMC WAS DEVELOPED BASED ON FINDINGS AND PRIORITIES ESTABLISHED IN THE CHNA AND A REVIEW OF THE HOSPITAL'S EXISTING COMMUNITY BENEFIT ACTIVITIES. UPSON REGIONAL MEDICAL CENTER SUSTAINS AND DEVELOPS COMMUNITY BENEFIT PROGRAMS THAT 1)ADDRESS PRIORITIZED NEEDS FROM THE 2012 URMC CHNA AND 2) RESPOND TO OTHER IDENTIFIED COMMUNITY HEALTH NEEDS. THE FOLLOWING PRIORITIZED NEEDS WERE IDENTIFIED BY THE COMMUNITY AND THE CHNA STEERING COMMITTEE. PARTICULAR FOCUS WAS PLACED UPON THESE NEEDS IN DEVELOPING THE IMPLEMENTATION STRATEGY. 1. ACCESS TO CARE 2. HEART DISEASE AND STROKE 3. CANCER 4. DIABETES 5. OBESITY 6. TEEN LIFESTYLE 7. RESPIRATORY 8 MENTAL HEALTH 9. TEEN PREGNANCY 10 ALCOHOL AND DRUG ABUSE 11. TRANSPORTATION 12. SEXUALLY TRANSMITTED DISEASES UPSON REGIONAL MEDICAL CENTER HAS ADDRESSED EACH OF THE HEALTH NEEDS IDENTIFIED IN THE CHNA. URMC DEVELOPED IMPLEMENTATION STRATEGIES TO ADDRESS EACH OF THE HEALTH ISSUES IDENTIFIED, WITH THE EXCEPTION OF MENTAL HEALTH, TEEN PREGNANCY, ALCOHOL AND DRUG ABUSE, TRANSPORTATION AND SEXUALLY TRANSMITTED DISEASES. IMPLEMENTATION PROGRESS SUMMARY IS AS FOLLOWS, WITH EACH ASTERISKED ("") AREA HAVING BEEN ACCOMPLISHED IN 2013. 1. ACCESS TO CARE (APPENDIX 1) A. RECRUIT PRIMARY CARE PHYSICIANS, TARGETED SPECIALISTS AND MID-LEVEL PRACTITIONERS B. PROVIDE CHARITY CARE C. DEVELOP A PRINT AND ONLINE CENTRALIZED RESOURCE DIRECTORY FOR UPSON COUNTY D. ALLOCATE FINANCIAL CONTRIBUTION TO THE PUBLIC HEALTH DEPARTMENT FORTH PROVISION OF PRIMARY CARE SERVICES 2. HEART DISEASE AND STROKE (APPENDIX 2) A. PROVIDE TOBACCO CESSATION CLASSES B. PROVIDE HEART DISEASE AWARENESS COMMUNITY EDUCATION AT LOCAL CHURCHES, REPRESENTATIVE OF THE UNDERSERVED COMMUNITY, AND CIVIC CLUBS C CONDUCT ANNUAL HEART SCREENINGS D CONDUCT BLOOD PRESSURE CHECKS AT COMMUNITY HEALTH FAIRS E PROVIDE DISCOUNTED EKGS AT COMMUNITY HEALTH FAIRS F PROVIDE COMMUNITY EDUCATION ON HEALTHY EATING AND WEIGHT CONTROL 3. CANCER (APPENDIX 3) A PROVIDE TOBACCO CESSATION CLASSES B OFFER CANCER SUPPORT GROUPS C PROVIDE CANCER AWARENESS COMMUNITY EDUCATION AT LOCAL CHURCHES REPRESENTATIVE OF THE UNDERSERVED COMMUNITY AND CIVIC CLUBS D. CONDUCT FREE MEN'S PROSTATE AND COLORECTAL CANCER SCREENING E OFFER DISCOUNTED SCREENING TESTS (PSA AND HEMOCCULT) AT COMMUNITY HEALTH FAIRS 4. DIABETES (APPENDIX 4) A PROVIDE MONTHLY DIABETES EDUCATION ON DISEASE MANAGEMENT AND NUTRITION B PROVIDE BLOOD GLUCOSE SCREENINGS AT COMMUNITY HEALTH FAIRS C OFFER A DIABETES EXERCISE CRASS TAILORED TO HIGH-RISK INDIVIDUALS D PROVIDE INSULIN TO UNINSURED/UNDERSERVED PATIENTS E PROVIDE, UPON MD REFERRAL, ONE-ON-ONE CONSULTS ABOUT DIABETES DISEASE MANAGEMENT F. PROVIDE LINKS TO ONLINE HEALTH EDUCATION RESOURCES VIA WWW.URMC.ORG 5. OBESITY (APPENDIX 5) A. COLLABORATE WITH THE WELLNESS CENTER AND FYCA TO HELP IMPLEMENT GEORGIA SHAPE AT THE LOCAL ELEMENTARY SCHOOL B. PROVIDE HEALTHY EATING/ACTIVE LIVING COMMUNITY EDUCATION C. CONDUCT BODY MASS INDEX SCREENINGS AT COMMUNITY HEALTH FAIRS D. PARTNER WITH CHILDREN'S HEALTHCARE OF ATLANTA TO OFFER STRONG4LIFE TRAINING AND CONTINUING EDUCATION OPPORTUNITIES FOR HEALTHCARE PROVIDERS AND EARLY CHILDCARE EDUCATORS (WWW.STRONG41IFE.COM). 6. TEEN LIFESTYLE (APPENDIX 6) A COLLABORATE WITH SCHOOL SYSTEM AND LOCAL SCHOOL OF DANCE TO ESTABLISH A "GIRL TALK" CHAPTER (WWW.DESIRETOINSPIRE.ORG) B COLLABORATE WITH SCHOOL SYSTEM AND FYCA ON 612 EMPLOYMENT EDUCATION C COLLABORATE WITH SCHOOL SYSTEM AND EMS ON AN ANTI-DRINKING AND DRIVING DEMONSTRATION D PARTNER WITH THE RECREATION DEPARTMENT TO PROVIDE HEALTHY EATING/ACTIVE LIVING EDUCATION TO LEAGUE PARTICIPANTS 7 RESPIRATORY (APPENDIX 7) A PROVIDE TOBACCO CESSATION CLASSES B CONDUCT PULMONARY FUNCTION TESTS AT COMMUNITY HEALTH FAIRS C COLLABORATE WITH SCHOOLS TO PROVIDE ASTHMA EDUCATION TO SCHOOL NURSES AND COACHES. D PROVIDE LINKS TO ONLINE HEALTH EDUCATION RESOURCES VIA WWW.URMC.ORG PRAISE IN THE PARK - ERMA MILLER FELLOWSHIP CHURCH - SAN SHORT DAWN MCCOY- SCHOOL PRESENTATION AND STRONG 4 LIFE UPSON HEALTH DEPT. - SALLIE B. TOOLKITS - SUE MANGUM UPSON HEALTH FAIR IN OCTOBER- DIFFERENT, BASIC - CARLISHA (HARRIS) LIVING WELL - MICHELE BARBER- AAA REGION 4 |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | UPSON REGIONAL MEDICAL CENTER INFORMS AND EDUCATES THE PATIENTS USING THE FOLLOWING PROCESSES: THE CHARITY CARE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IS POSTED IN THE ADMISSION AREAS, EMERGENCY DEPARTMENTS AND OTHER AREAS OF THE FACILITY IN WHICH ELIGIBLE PATIENTS ARE PRESENT. WE PROVIDE A COPY OF THE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION TO THE PATIENTS AS PART OF THE ADMISSION PROCESS. ADDITIONALLY, THE POLICY IS AVAILABLE ON THE HOSPITAL WEBSITE - WITH APPLICATION. A SUMMARY OF THE POLICY IS ALSO INCLUDED IN THE PATIENT BILLING. WE DISCUSS WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS QUALIFYING FOR MEDICAID OR STATE PROGRAMS AND ASSIST THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE. WE PROVIDE TRAINING TO THE STAFF ON FINANCIAL ASSISTANCE AND HOW TO QUALIFY PATIENTS FOR MEDICAID, SCHIP AND OTHER GOVERNMENT PROGRAMS. WE ALSO PROVIDE BROCHURES IN THE ADMISSIONS PACKAGE EXPLAINING THE AVAILABILITY, CRITERIA, AND THE PROCESS FOR APPLYING FOR FINANCIAL ASSISTANCE. OUR EFFORTS TO INFORM NON-ENGLISH SPEAKING PATIENTS ABOUT THE FINANCIAL ASSISTANCE POLICY IS PROVIDED BY AN INTERPRETER THROUGH THE USE OF LANGUAGE LINE, A TELEPHONE INTERPRETATION SERVICE. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | UPSON SERVES A SEVEN-COUNTY AREA IN MIDDLE GEORGIA, INCLUDING PIKE, LAMAR, UPSON, CRAWFORD, MONROE, MERIWETHER AND TALBOT COUNTIES. AS A WHOLE, THE SERVICE AREA, WHICH USED TO BE A BOOMING TEXTILE AREA, HAS RATES OF UNEMPLOYMENT, UNINSURED AND POVERTY THAT ARE HIGHER THAN THE STATE AVERAGE. THE POPULATION AGE MIMICS A BOWTIE, WITH LARGE NUMBERS OF ELDERLY AND LARGE NUMBERS OF CHILDREN UNDER THE AGE OF 18 AND A SHRINKING NUMBER OF MIDDLE-AGED CITIZENS. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | UPSON MADE APPROXIMATELY 9,000 CONTACTS WITH COMMUNITY HEALTH EDUCATION PROGRAMS, HEALTH SCREENINGS, HEALTH CARE SUPPORT VALUED AT 48,000 TO SUPPORT BETTER HEALTH. THROUGH SPONSORSHIPS AND DONATIONS, UPSON CONTRIBUTED MORE THAN 8,588 TO LOCAL CHARITIES, LIKE THE AMERICAN CANCER SOCIETY. UPSON REGIONAL MEDICAL CENTER CONTINUES TO WORK COLLABORATIVELY WITH THE LOCAL HEALTH DEPARTMENTS, COUNTY EXTENSION SERVICES, CIVIC CLUBS, AND CHURCHES TO PROVIDE ANNUAL HEALTH FAIRS, SCREENINGS AND EDUCATIONAL PROGRAMS. DUE TO THE CONTINUAL DECLINE OF INDUSTRY IN THIS AREA BEGINNING WITH THE TEXTILE INDUSTRY SHUT-DOWN, MANY PEOPLE DEPEND ON THESE ANNUAL HEALTH FAIRS FOR THEIR PREVENTATIVE HEALTH CARE. THE NUMBER OF UNDERINSURED AND UNINSURED PEOPLE INCREASES EACH YEAR. UPSON REGIONAL OFFERS MANY FREE AND DISCOUNTED DIAGNOSTIC SCREENINGS AND TESTS. THIS HAS PROVIDED EARLY DETECTION FOR MANY DISEASES AS WELL AS PROMOTED HEALTH AND WELLNESS THROUGH ANNUAL CHECKUPS SINCE THAT TIME. THESE ANNUAL HEALTH FAIRS ARE A COOPERATIVE EFFORT AMONG MANY GROUPS IN OUR COMMUNITY. IN 2013, WE PROVIDED FREE OR DISCOUNTED TESTS AT HEALTH FAIRS, CANCER SCREENINGS, DIABETES SCREENINGS, CARDIAC SCREENINGS, AND EDUCATIONAL OFFERINGS. WE PROVIDED FREE FLU IMMUNIZATIONS. |
| PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT | GEORGIA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| TUITION REIMBURSEMENT | 13 | $23,749 |
| SCHOLARSHIP PROGRAM | 3 | $7,097 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PAGE 4, PART IV | FormAndLineReferenceDesc |
| Explanation | SCHEDULE I, PART III - GRANTS AND OTHER ASSISTANCE TO INDIVIDUALS IN THE UNITED STATES SCHOLARSHIP ASSISTANCE IS OFFERED TO UPSON COUNTY RESIDENTS AND FULL TIME, PART TIME AND PRN EMPLOYEES PURSUING A HEALTHCARE CAREER. EACH APPLICANT MUST COMPLETE AN APPLICATION; BE ACCEPTED BY AN ACCREDITED SCHOOL IN A HEALTHCARE PROGRAM OF THEIR CHOICE; SUBMIT TWO LETTERS OF RECOMMENDATION, A CERTIFIED COPY OF PREVIOUS EDUCATIONAL TRANSCRIPTS, AND A LETTER OF ACCEPTANCE IN THE HEALTHCARE CAREER PROGRAM; OBTAIN APPROVAL FROM THE DEPARTMENT DIRECTOR OR SENIOR MANAGEMENT; BE INTERVIEWED BY CHIEF NURSING OFFICER; MAINTAIN A 3.0 CUMULATIVE AVERAGE; SUBMIT TRANSCRIPTS OF GRADES EVERY SCHOOL TERM; AND SERVE AS AN EMPLOYEE A MINIMUM OF ONE YEAR FOR EACH SCHOOL YEAR FOR WHICH SCHOLARSHIP MONIES WERE GRANTED. TRANSCRIPTS OF GRADES MUST BE RECEIVES BEFORE REIMBURSEMENT. SHOULD THE STUDENT NOT SEEK AND MAINTAIN EMPLOYMENT WITH URMC AFTER GRADUATION, FUNDS WILL BECOME DUE AND PAYABLE IN A PRORATA FASHION BASED ON EMPLOYMENT TERM. TUITION REIMBURSEMENT IS AWARDED FULL TIME AND REGULARLY SCHEDULED PART TIME EMPLOYEES. MONIES ARE GRANTED TO COVER TUITION, BOOKS AND LABORATORY FEES. EACH APPLICANT MUST BE ENROLLED IN AN ACCREDITED COLLEGE/UNIVERSITY WITHIN A PROGRAM DIRECTLY RELATED TO THE EMPLOYEE'S PRESENT POSITION OR A FIELD THAT WILL BE OF BENEFIT TO THE MEDICAL CENTER; SEEK APPROVAL FROM MANAGEMENT; FURNISH A TRANSCRIPT OF GRADES; MAINTAIN A "C" OR HIGHER GRADE AVERAGE. TO BE REIMBURSED, AN EMPLOYEE MUST PRESENT A CERTIFIED COPY OF THE GRADE REPORT WITH AN AVERAGE OF "C" OR HIGHER. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount |
|---|---|---|---|---|---|
| DAVID CASTLEBERRY | |||||
| CEO | $201,540 | $4,102 | $22,173 | $227,815 | |
| JOHN WILLIAMS | |||||
| CFO | $196,943 | $4,047 | $19,018 | $220,008 | |
| ROBERT SOLYOMVARI MD | |||||
| SURGEON | $374,196 | $5,100 | $32,027 | $660,129 | $248,806 |
| BRANDON BOYCE MD | |||||
| SURGEON | $481,820 | $5,100 | $19,018 | $636,783 | $130,845 |
| DAVID PETERSON MD | |||||
| ANESTHESIOLOGIST | $562,564 | $5,100 | $32,027 | $599,691 | |
| STEVEN YANG MD | |||||
| ANESTHESIOLOGIST | $557,984 | $5,100 | $13,821 | $576,905 | |
| LOUIS MAMELI MD | |||||
| PHYSICIAN | $269,577 | $5,100 | $34,618 | $309,295 | |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART III | FormAndLineReferenceDesc |
| Explanation | CEO AND MANAGEMENT COMPANY AN UNRELATED ORGANIZATION, HEALTHTECH MANAGEMENT SERVICES, PROVIDED THE CEO FOR THE FILING ORGANIZATION. THE FILING ORGANIZATION COMPENSATED THE MANAGEMENT COMPANY APPROXIMATELY 144,000 FOR THE SERVICES OF CEO, DAVID CASTLEBERRY. EARLY IN FISCAL YEAR 2013, THE ORGANIZATION AMENDED THE CONTRACT WITH HEALTHTECH AND HIRED THE CEO. HEALTHTECH CONTINUES TO PROVIDE OTHER SERVICES UNDER A CONTRACTUAL ARRANGEMENT INCLUDING CONSULTING,REVENUE CYCLE, LICENSURE, INFORMATION SYSTEMS, AND PRODUCTIVITY REPORTING. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| HOSPITAL AUTHORITY OF UPSON COUNTY | ||||||||
| A | 586002427 | NONENONEN | 2004-12-30 | $10,000,000 | RENOVATION & EXPANSION OF HOSPITAL | false | false | false |
| HOSPITAL AUTHORITY OF UPSON COUNTY | ||||||||
| B | 586002427 | NONENONEN | 2005-01-20 | $6,000,000 | RENOVATION & EXPANSION OF HOSPITAL | false | false | false |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|
| A | $3,535,000 | $10,000,000 | $124,175 | $9,875,825 | 2007 | false | false | Yes (true) | Yes (true) |
| B | $2,115,000 | $6,000,000 | $79,846 | $5,920,154 | 2007 | false | false | Yes (true) | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | false | false | false | false | false | false | Yes (true) |
| B | false | false | false | false | false | false | Yes (true) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | false | false | false | false | false | false | false | false | false |
| B | false | false | false | false | false | false | false | false | false |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 3 | THE ORGANIZATION SOLD THEIR AMBULANCE COMPANY TO AN UNRELATED ORGANIZATION AND CEASED ALL AMBULANCE SERVICES AS OF DECEMBER 31, 2013. |
| FORM 990, PART V, LINE 4B | CAYMAN ISLANDS |
| FORM 990, PAGE 6, PART VI, LINE 3 | THE ORGANIZATION ENGAGED THE MANAGEMENT SERVICES OF HEALTHTECH MANAGEMENT SERVICES TO PROVIDE THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION. SUCH CEO BEARS THE FULL DUTIES AND RESPONSIBILITIES OF THE SAME POSITION THROUGHOUT THE HOSPITAL INDUSTRY. EARLY IN 2013, THE ORGANIZATION AMENDED THEIR CONTRACT WITH HEALTHTECH AND HIRED THE CEO. |
| FORM 990, PAGE 6, PART VI, LINE 11B | FORM 990 WAS EMAILED TO EACH BOARD OF TRUSTEE MEMBER PRIOR TO THE IRS FILING DUE DATE FOR THEIR REVIEW. FORM 990 REVIEW WAS PLACED ON THE BOARD AGENDA FOR DISCUSSION SHOULD ANY QUESTIONS OCCUR. THE 990 IS REVIEWED BY THE CFO IN DETAIL PRIOR TO FILING WITH THE IRS. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE POLICY COVERS ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. SHOULD A MATTER COME BEFORE THE BOARD OF DIRECTORS WHICH CONSTITUTES A CONFLICT OF INTEREST, THE INDIVIDUAL INVOLVED WILL MAKE KNOWN THE POTENTIAL CONFLICT AND WITHDRAW FROM THE MEETING SO LONG AS THE MATTER SHALL CONTINUE UNDER DISCUSSION AND SHALL NOT EITHER VOTE ON THE MATTER UNDER DISCUSSION OR ATTEMPT TO INFLUENCE A DECISION OF THE GOVERNING AUTHORITY WITH RESPECT TO SUCH MATTERS, UPON WHICH THERE COULD POSSIBLY BE A CONFLICT OF INTEREST. |
| FORM 990, PAGE 6, PART VI, LINE 15A | HEALTHTECH MANAGEMENT SERVICES, THE MANAGEMENT COMPANY OBTAINS THE COMPARABLE SALARY SURVEY AND PRESENTS IT TO THE BOARD OF DIRECTORS WHO MAKE A FINAL DECISION. THE CEO IS NOT PRESENT DURING THE DISCUSSION AND DECISION-MAKING PROCESS. DELIBERATIONS AND DECISIONS ARE DOCUMENTED IN THE MINUTES OF THE MEETING. |
| FORM 990, PAGE 6, PART VI, LINE 15B | IN DETERMINING COMPENSATION FOR THE CFO, OTHER OFFICERS OR KEY EMPLOYEES, THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT OBTAINS COMPARABLE SALARY DATA AND PRESENTS IT TO THE GOVERNING BODY WHO MAKES THE FINAL DECISION. THE INDIVIDUAL IN THE CONSIDERATION PROCESS IS NOT PRESENT DURING THE DISCUSSION AND DECISION-MAKING PROCESS. DELIBERATIONS AND DECISIONS ARE DOCUMENTED IN THE MINUTES OF THE MEETING. |
| FORM 990, PAGE 6, PART VI, LINE 19 | ALL DOCUMENTS ARE AVAILABLE FOR INSPECTION, WITH NOTICE, IN THE OFFICE OF THE ORGANIZATION. |
| FORM 990, PART IX, LINE 11G | CONTRACT LABOR 1,660,660 421,158 0 PROFESSIONAL SERVICES 496,565 38,866 0 PHYSICIAN FEES 906,415 0 0 PURCHASED SERVICES 1,880,563 332,490 0 THERAPISTS 16,550 0 0 ALL OTHER FEES 1,020,778 2,240,527 0 |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (7 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Business Name Line2DirectControllingEntityName/BusinessNameLine2 |
|---|---|---|---|---|---|---|---|---|---|---|
| UPSON MEDICAL ASSOCIATES LLC | ||||||||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | 550840991 | PHYS OFC | GA | -$1,740,613 | $808,467 | UCH | UPSON COUNTY HOSPITAL INC |
| UPSON REGIONAL WELLNESS CENTER LLC | ||||||||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | 205095610 | WELLNESS C | GA | -$22,297 | $561,561 | UCH | UPSON COUNTY HOSPITAL INC |
| UPSON AMBULANCE COMPANY LLC | ||||||||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | 205095675 | AMBULANCE | GA | -$937,455 | $1,165,113 | UCH | UPSON COUNTY HOSPITAL INC |
| UPSON WOMEN'S SERVICES LLC | ||||||||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | 263227893 | PHYS OFC | GA | -$922,912 | $813,922 | UCH | UPSON COUNTY HOSPITAL INC |
| UPSON FAMILY PHYSICIANS LLC | ||||||||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | 270192553 | PHYS OFC | GA | -$436,596 | $360,008 | UCH | UPSON COUNTY HOSPITAL INC |
| UPSON SURGICAL ASSOCIATES LLC | ||||||||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | 275252545 | PHYS OFC | GA | -$465,259 | $348,609 | UCH | UPSON COUNTY HOSPITAL INC |
| ORTHOPEDICS SPORTS MEDICINE & SURGE | ||||||||||
| 801 WEST GORDON STREET | THOMASTON | GA | 30286 | 272123255 | PHYS OFC | GA | -$355,507 | $384,051 | UCH | UPSON COUNTY HOSPITAL INC |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | URMC HEALTH FOUNDATION | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 1089 | AddressLine1 |
| City | THOMASTON | City |
| State | GA | State |
| ZIP Code | 30286 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 830411781 | EIN |
| Primary Activities | FOUNDATION | PrimaryActivitiesTxt |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Exempt Code Section | 501C3 | ExemptCodeSectionTxt |
| Public Charity Status | 11A | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UCH | BusinessNameLine1 |
| Business Name Line2 | UPSON COUNTY HOSPITAL | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (true) | 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 | Yes (true) | 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 | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | URMC HEALTH FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | M | TransactionTypeTxt |
| Involved | $81,999 | InvolvedAmt |
| Method Of Amount Determination | NET REVENUES FORM 990 | MethodOfAmountDeterminationTxt |