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EMORY UNIVERSITY: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
EMORY UNIVERSITY (EIN 58-1966795)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-14
IRS object ID
201441349349304519
Schema version
2012v2.1
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-14T13:38:15-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN621517792EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PERSHING YOAKLEY & ASSOCIATES P CBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1ONE CHEROKEE MILLS 2220 SUTHERLANDAddressLine1
Address Line2AVEAddressLine2
CityKNOXVILLECity
StateTNState
ZIP Code37919ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN581966795EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1DEKALB MEDICAL CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlDEKANameControl
Phone4045011000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12701 NORTH DECATUR ROADAddressLine1
CityDECATURCity
StateGAState
ZIP Code30033ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN KATSIANISName
TitleSVP & CFOTitle
Phone4045011000Phone
Date Signed2014-05-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSUSAN P CLARKCPAFHFMAName
PTINP00017549PTIN
Phone8656730844Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOHN SHELTONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12701 NORTH DECATUR ROADAddressLine1
CityDECATURCity
StateGAState
ZIP Code30033ZIPCode
FieldValueIRS element (for citing)
Gross Receipts520443080GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.DEKALBMEDICAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1991YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionTO IMPROVE PATIENTS' LIVES THROUGH THE DELIVERY OF EXCELLENT HEALTH AND WELLNESS SERVICES.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees4402TotalNbrEmployees
Total Nbr Volunteers240TotalNbrVolunteers
Total Gross UBI100270TotalGrossUBI
Net Unrelated Business Txbl Income-151885NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year3340510ContributionsGrantsPriorYear
Contributions Grants Current Year18234939ContributionsGrantsCurrentYear
Program Service Revenue Prior Year443625483ProgramServiceRevenuePriorYear
Program Service Revenue CY494259365ProgramServiceRevenueCY
Investment Income Prior Year5960679InvestmentIncomePriorYear
Investment Income Current Year7942626InvestmentIncomeCurrentYear
Other Revenue Prior Year8941OtherRevenuePriorYear
Other Revenue Current Year6150OtherRevenueCurrentYear
Total Revenue Prior Year452935613TotalRevenuePriorYear
Total Revenue Current Year520443080TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1777045GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY418960GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year204971666SalariesEtcPriorYear
Salaries Etc Current Year223950366SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year253340341OtherExpensePriorYear
Other Expenses Current Year299736908OtherExpensesCurrentYear
Total Expenses Prior Year460089052TotalExpensesPriorYear
Total Expenses Current Year524106234TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-7153439RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-3663154RevenuesLessExpensesCY
Total Assets BOY379429709TotalAssetsBOY
Total Assets EOY382261284TotalAssetsEOY
Total Liabilities BOY256486577TotalLiabilitiesBOY
Total Liabilities EOY244167202TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY122943132NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY138094082NetAssetsOrFundBalancesEOY
Mission DescriptionAT DEKALB MEDICAL CENTER, INC. ("DMC"), OUR MISSION IS TO IMPROVE LIVES THROUGH THE DELIVERY OF EXCELLENT HEALTH AND WELLNESS SERVICES IN PARTNERSHIP WITH OUR PHYSICIANS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense326619396Expense
Grants418960Grants
Revenue351671487Revenue
DescriptionDEKALB MEDICAL AT NORTH DECATUR - 21,242 PATIENTS DISCHARGED (INCLUDES NICU AND EXCLUDES BABIES) FROM THE HOSPITAL FOR A TOTAL OF 104,510 DISCHARGED DAYS. THERE WERE 179,449 VISITS TO THE HOSPITAL DURING THE YEAR.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense48134232Expense
Revenue111827667Revenue
DescriptionDEKALB MEDICAL AT HILLANDALE - 5,486 PATIENTS DISCHARGED FROM THE HOSPITAL FOR A TOTAL OF 25,519 DISCHARGED DAYS. THERE WERE 99,051 VISITS TO THE HOSPITAL DURING THE YEAR.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense39776877Expense
Revenue30760211Revenue
DescriptionDEKALB MEDICAL PHYSICIAN NETWORK - 131,377 PATIENTS WERE TREATED IN THE PHYSICIANS OFFICES DURING THE FISCAL YEAR.Description
FieldValueIRS element (for citing)
Total Program Service Expense414530505TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096510NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees4402NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JOHN KATSIANISBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4045015025TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12701 NORTH DECATUR ROADAddressLine1
CityDECATURCity
StateGAState
ZIP Code30033ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
OLIVER LEE
CHAIR0.50X000
DAVID JOLLAY
VICE CHAIR0.50X000
ROBERT E WILSON
SECRETARY0.50X000
CHARLES CLIFTON MD
TREASURER0.50X000
KENNETH HARPER MD
DIR., CHIEF OF STAFF - HILLANDALE0.50X0005.00
RAOUL MAYER MD
DIR., CHIEF OF STAFF - NORTH DECATUR0.50X11667005.00
JOHN A SHELTON JR
DIRECTOR, PRESIDENT/CEO40.00X786231036134X
JOHN KATSIANIS
CFO (START 2/2013)40.00000X
MAL UNDERWOOD
INTERIM CFO40.0017589400X
DANE HENRY
CHIEF OPERATING OFFICER40.00340712023720X
ROY GILBREATH
CHIEF MEDICAL OFFICER40.0070200246X
CHARLES BARCLAY
CHIEF MEDICAL OFFICER40.00386829027711X
CHERYL IVERSON
VP MARKETING & BUSINESS DEV.40.00197549036600X
JAMES FORSTNER
VP & CHIEF STRATEGY OFFICER40.00205796025591X
JOEL SCHUESSLER
VP & CHIEF COMPLIANCE OFFICER40.00180026011276X
MARK TROCINO
CHIEF INFORMATION OFFICER40.00324382018716X
STEPHEN THOMAS MD
VP DEKALB MEDICAL PHYSICIANS GROUP40.00339987024520X
SUSAN HARRIS
VP DEKALB MEDICAL PHYSICIANS GROUP40.00191584028110X
AUGUSTINE CONDUAH MD
ORTHOPEDIC PHYSICIAN40.00798384030653X
DAVID HOLLADAY MD
RADIATION ONCOLOGIST40.00841974027688X
RAYMOND LAWHEAD MD
OBSTETRICIAN GYNECOLOGIST40.00544651020267X
SHAINUL BHATIA MD
OCCUPATIONAL MEDICINE PHYSICIAN40.00504232048674X
KALAI PARTHIBAN MD
PHYSICIAN40.00401657031635X
DIANE P HARDEN
FORMER CFO0.00174547019057X
THOMAS CRAWFORD
FORMER VP HUMAN RESOURCES0.0014086100X
CATHLEEN WHEATLEY
FORMER SVP & CHIEF OF QUALITY0.0033861305177X
ERIC NORWOOD
FORMER CEO0.00572325023862X
FieldValueIRS element (for citing)
Total Reportable Comp From Org7464921TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation439637TotalOtherCompensation
Number Individuals GT100 K198NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
DEKALB ANESTHESIA ASSOCIATES PA
21717 W PARK CT STE ASTONE MTNGA30087ANESTHESIOLOGY SRVCS3343863
MORRISON MANAGEMENT
PO BOX 102289ATLANTAGA30368MANAGEMENT SERVICES2204129
SEGAR GROUP
14355 PROVIDENCE ROADALPHARETTAGA30004CONSTRUCTION SRVCS1362617
METRO VASCULAR PC
2675 N DECATUR ROAD SUITE 210DECATURGA30033SURGICAL SERVICES1210459
SODEXO INC & AFFILIATES
PO BOX 536922ATLANTAGA30353MANAGEMENT SERVICES828592
FieldValueIRS element (for citing)
Number Of Contractors GT100 K51NumberOfContractorsGT100K
Related Organizations17950582RelatedOrganizations
Government Grants118591GovernmentGrants
All Other Contributions165766AllOtherContributions
Total Contributions18234939TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT REV N DECATUR621990343544424343544424
NET PATIENT REV HILLANDALE621990111827667111827667
NET PATIENT REV PRIMARY CARE6211103076021130760211
MEANINGFUL USE90009925531462553146
WELLNESS CENTER713940738530738530

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column4835387TotalRevenueColumn
Related Or Exempt Function Income4703744RelatedOrExemptFunctionIncome
Unrelated Business Revenue100270UnrelatedBusinessRevenue
Exclusion$31,373ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue494259365TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4521640TotalRevenueColumn
Exclusion$4,521,640ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real6150Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real6150Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column6150TotalRevenueColumn
Exclusion$6,150ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities3390486Securities
Other30500Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities3390486Securities
Other30500Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column3420986TotalRevenueColumn
Exclusion$3,420,986ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column520443080TotalRevenueColumn
Related Or Exempt Function Income494127722RelatedOrExemptFunctionIncome
Unrelated Business Revenue100270UnrelatedBusinessRevenue
Exclusion$7,980,149ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total418960Total
Program Services418960ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total190792631Total
Program Services156201537ProgramServices
Management And General34591094ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total6462410Total
Program Services5290762ProgramServices
Management And General1171648ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total13057272Total
Program Services11253296ProgramServices
Management And General1803976ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total13638053Total
Program Services11155696ProgramServices
Management And General2482357ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total942966Total
Management And General942966ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total491125Total
Management And General491125ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total409585Total
Management And General409585ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total30072154Total
Program Services18424163ProgramServices
Management And General11647991ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total3016329Total
Program Services2570ProgramServices
Management And General3013759ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total82614322Total
Program Services79018638ProgramServices
Management And General3595684ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total9004897Total
Program Services1227520ProgramServices
Management And General7777377ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total21822404Total
Program Services9347715ProgramServices
Management And General12474689ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total325134Total
Program Services81288ProgramServices
Management And General243846ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total411969Total
Program Services127818ProgramServices
Management And General284151ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total105540Total
Management And General105540ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total21533361Total
Program Services606141ProgramServices
Management And General20927220ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total5597652Total
Program Services1145956ProgramServices
Management And General4451696ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT105146313105146313
REPAIRS AND MAINTENANCE105989199778337820582
MEDICARE PROVIDER TAX47267524726752
MEMBERSHIP, DUES & SUBS1181124263667917457

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1736362Total
Program Services313376ProgramServices
Management And General1422986ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total524106234Total
Program Services414530505ProgramServices
Management And General109575729ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY12249518BOY
EOY2157643EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY7165490BOY
EOY7286276EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY58112119BOY
EOY62084350EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5921091BOY
EOY6458559EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1743794BOY
EOY1055388EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis415601304LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec294945232LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY128925596BOY
EOY120656072EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY160126020BOY
EOY167588235EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY1413807BOY
EOY1687182EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3772274BOY
EOY13287579EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY379429709BOY
EOY382261284EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY38057988BOY
EOY43429244EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY189316202BOY
EOY186537230EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY29112387BOY
EOY14200728EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY256486577BOY
EOY244167202EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY122404058BOY
EOY137519927EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY539074BOY
EOY574155EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY122943132BOY
EOY138094082EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY379429709BOY
EOY382261284EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-3663154ReconcilationRevenueExpenses
Reconciliation Unrealized Invest2553019ReconciliationUnrealizedInvest
Reconcilation Other Changes16261085ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$37,179OtherActivitiesAmount
Total Lobbying Expenditures IIB37179TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationDUES PAID TO GEORGIA HOSPITAL ASSOCIATION WERE $101,038; OF THIS AMOUNT, $25,260 OR APPROXIMATELY 25%, WENT FOR LOBBYING. DUES PAID TO AMERICAN HOSPITAL ASSOCIATION WERE $50,396; OF THIS AMOUNT, $11,919 OR APPROXIMATELY 23.65%, WENT FOR LOBBYING.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance539074BeginningOfYearBalance
Contributions873035Contributions
Other Expenditures837954OtherExpenditures
End Of Year Balance574155EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance549831BeginningOfYearBalance
Contributions826617Contributions
Other Expenditures837374OtherExpenditures
End Of Year Balance539074EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance585490BeginningOfYearBalance
Contributions672897Contributions
Other Expenditures708556OtherExpenditures
End Of Year Balance549831EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1999808BeginningOfYearBalance
Contributions7300Contributions
Investment Earnings Or Losses-1277654InvestmentEarningsOrLosses
Other Expenditures143964OtherExpenditures
End Of Year Balance585490EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2836621BeginningOfYearBalance
Contributions261659Contributions
Investment Earnings Or Losses-1045126InvestmentEarningsOrLosses
Other Expenditures53346OtherExpenditures
End Of Year Balance1999808EndOfYearBalance
FieldValueIRS element (for citing)
Term Endowment EOY Balance1.00000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis403305OtherCostOrOtherBasis
Book Value403305BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis234614252OtherCostOrOtherBasis
Depreciation141187732Depreciation
Book Value93426520BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis175560961OtherCostOrOtherBasis
Depreciation147964407Depreciation
Book Value27596554BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5022786OtherCostOrOtherBasis
Depreciation5793093Depreciation
Book Value-770307BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings120656072TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
SELF INSURANCE RESERVES$3,560,007
ASSET RETIREMENT OBLIGATION$5,207,503
FAIR VALUE OF INTEREST RATE SWAPS$2,069,288
DUE FROM RELATED PARTY$157,167
ESTIMATED THIRD PARTY LIABILITIES$3,206,763
FieldValueIRS element (for citing)
Total Of Amounts14200728TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:TO PURCHASE EQUIPMENT, GRANT FUNDS FOR THE CANCER CENTER, PURCHASE SAFETY EQUIPMENT FOR THE EMERGENCY RESPONSE UNIT, AND FUND THE WELLNESS ON WHEELS PROGRAM.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:PER THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR DEKALB REGIONAL HEALTH SYSTEM, INC. AND SUBSIDIARIES: THE SYSTEM, DEKALB MEDICAL CENTER, INC., DEKALB MEDICAL CENTER FOUNDATION, INC., AND DECATUR HEALTH RESOURCES, INC. ARE EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, AS WELL AS STATE INCOME TAX. VENTURES IS A TAXABLE ENTITY AND ANNUALLY FILES A CORPORATE TAX RETURN. WITH RESPECT TO ITS FOR-PROFIT ENTITY, AS WELL AS ANY UNRELATED BUSINESS INCOME GENERATED AT THE TAX-EXEMPT ENTITIES, THE SYSTEM RECORDS INCOME TAXES USING THE ASSET AND LIABILITY METHOD UNDER WHICH DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASES OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIOD THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR TO BE SETTLED. ALL SUCH INCOME TAX ACCOUNTING IS IMMATERIAL TO THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR THE YEARS ENDED JUNE 30, 2013 AND 2012. THE SYSTEM APPLIES ASC 740, INCOME TAXES, WHICH PROVIDES GUIDANCE ON WHEN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. THERE IS CURRENTLY NO IMPACT ON THE SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS AS A RESULT OF THE APPLICATION OF ASC 740.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense8941027TotalCommunityBenefitExpense
Net Community Benefit Expense8941027NetCommunityBenefitExpense
Percent Of Total Expense0.02130PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense72205912TotalCommunityBenefitExpense
Direct Offsetting Revenue63044868DirectOffsettingRevenue
Net Community Benefit Expense9161044NetCommunityBenefitExpense
Percent Of Total Expense0.02190PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense81146939TotalCommunityBenefitExpense
Direct Offsetting Revenue63044868DirectOffsettingRevenue
Net Community Benefit Expense18102071NetCommunityBenefitExpense
Percent Of Total Expense0.04320PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Persons Served10110PersonsServed
Total Community Benefit Expense1135213TotalCommunityBenefitExpense
Net Community Benefit Expense1135213NetCommunityBenefitExpense
Percent Of Total Expense0.00270PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Persons Served3595PersonsServed
Total Community Benefit Expense3871918TotalCommunityBenefitExpense
Net Community Benefit Expense3871918NetCommunityBenefitExpense
Percent Of Total Expense0.00920PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Persons Served1742PersonsServed
Total Community Benefit Expense196550TotalCommunityBenefitExpense
Net Community Benefit Expense196550NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Persons Served15447PersonsServed
Total Community Benefit Expense5203681TotalCommunityBenefitExpense
Net Community Benefit Expense5203681NetCommunityBenefitExpense
Percent Of Total Expense0.01240PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Persons Served15447PersonsServed
Total Community Benefit Expense86350620TotalCommunityBenefitExpense
Direct Offsetting Revenue63044868DirectOffsettingRevenue
Net Community Benefit Expense23305752NetCommunityBenefitExpense
Percent Of Total Expense0.05560PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$35,345,677BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare96257031AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare90864224CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall5392807MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursFacility Reporting GroupFacilityReportingGroup
DEKALB MEDICAL AT NORTH DECATUR
12701 NORTH DECATUR ROADDECATURGA30033XXXA
DEKALB MEDICAL AT HILLANDALE
22801 DEKALB MEDICAL PARKWAYLITHONIAGA30058XXXA

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1FACILITY REPORTING GROUP ABusinessNameLine1
FieldValueIRS element (for citing)
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent250.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges1GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities3NumberOfOtherFacilities

Other Facilities OtherFacilities (3 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
DEKALB MEDICAL PRIMARY CARE
2701 NORTH DECATUR ROADDECATURGA30033PRIMARY CARE
DEKALB MEDICAL SPECIALTY CARE
2701 NORTH DECATUR ROADDECATURGA30033SPECIALIST CARE
DEKALB MEDICAL OCCUPATIONAL MEDICINE GRO
2701 NORTH DECATUR ROADDECATURGA30033OCCUPATIONAL MEDICINE

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 3C: THE ORGANIZATION USES FEDERAL POVERTY GUIDELINES.
PART I, LINE 7: A COST-TO-CHARGE RATIO, DERIVED FROM THE SCHEDULE H APPLICABLE WORKSHEETS, INCLUDING WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES, WAS USED TO DETERMINE CHARITY CARE. ACTUAL EXPENSE DATA IS ACCUMULATED WITHIN THE GENERAL LEDGER WHICH ADDRESSES ALL PATIENT SEGMENTS INCLUDING INPATIENT, OUTPATIENT, EMERGENCY ROOM, COMMERCIAL INSURANCE, GOVERNMENT INSURANCE, UNINSURED AND SELF-PAY. THE TOTAL OPERATING EXPENSE WAS DIVIDED BY PATIENT REVENUES TO CALCULATE AN OVERALL RATIO THAT WAS THEN APPLIED TO INDIGENT AND CHARITY CARE CHARGES TO ARRIVE AT COST.
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ XXX-XX-XXXX.
PART III, LINE 4: PER THE DEKALB REGIONAL HEALTH SYSTEM, INC. AND SUBSIDIARIES CONSOLIDATED FINANCIAL STATEMENTS: "THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT ROUTINELY ASSESSES, IN THE NORMAL COURSE OF BUSINESS, THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON ITS ASSESSMENT OF THESE AND OTHER FACTORS BY PAYOR CATEGORY, AND ADJUSTS THE ALLOWANCE AND RELATED PROVISION ACCORDINGLY. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, MANAGEMENT ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A RELATED PROVISION, IF NECESSARY, FOR PAYORS WITH KNOWN FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDES PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL (PATIENT APPORTIONMENT), MANAGEMENT RECORDS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICES ON THE BASIS OF 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 AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.THE SYSTEM'S WRITE-OFFS INCREASED $49,776,000 DURING 2013 FROM $62,196,000 IN FISCAL YEAR 2012 TO $111,972,000 IN FISCAL YEAR 2013. THIS INCREASE WAS DUE TO MULTIPLE FACTORS. DURING FISCAL YEAR 2012, THE SYSTEM IMPLEMENTED A NEW PATIENT ACCOUNTING SYSTEM, WHICH NEGATIVELY IMPACTED THE PRIORITIZATION OF COLLECTIONS ON SELF-PAY ACCOUNTS, LEADING TO AN INCREASE IN THE RELATED ACCOUNTS RECEIVABLES AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS THROUGHOUT FISCAL YEAR 2012. DURING FISCAL YEAR 2013, THE SYSTEM IMPLEMENTED STRATEGIC PROCESS CHANGES TO ADDRESS THIS ISSUE; HOWEVER, THE RESOLUTION OF THESE AGED ACCOUNTS CONTRIBUTED TO THE INCREASE IN SELF-PAY WRITE-OFFS. FURTHER, AS A RESULT OF ONGOING POOR ECONOMIC CONDITIONS, THE SYSTEM HAS SEEN AN INCREASE IN SELF-PAY PATIENT VOLUMES (AS EVIDENCED BY THE GROWTH IN SELF-PAY PATIENT SERVICE CHARGES SHOWN IN THE TABLES BELOW). AS NOTED ABOVE, HISTORICAL EXPERIENCE HAS DEMONSTRATED THAT A SIGNIFICANT PORTION OF THE SYSTEM'S UNINSURED OR UNDER-INSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE, ARE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THEREFORE, THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS RELATED TO THESE PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. THE SYSTEM DOES NOT MAINTAIN A SIGNIFICANT ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, NOR DOES IT INCUR SIGNIFICANT WRITE-OFFS, RELATED TO THIRD PARTY PAYORS."
PART III, LINE 9B: THE CURRENT BILLING AND COLLECTION POLICY DOES NOT CONTAIN PROVISIONS FOR COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE BUT THE FAP OR "CHARITY POLICY" DOES AS IT OUTLINES THE COMPLETE WRITE OFF OR SLIDING SCALE AMOUNTS FOR WHICH THE INDIVIDUAL WILL BE RESPONSIBLE.
PART VI, LINE 2: IN COMPLIANCE WITH 501(R)(C) OF THE INTERNAL REVENUE CODE, BOTH DEKALB MEDICAL CENTER HOSPITAL FACILITIES CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION PLAN. THE IMPLEMENTATION PLANS WERE APPROVED BY THE BOARD OF DIRECTORS ON JUNE 10, 2013. THE NEXT FULL CHNAS AND IMPLEMENTATION PLAN ARE DUE IN 2016. SINCE THIS IS THE FIRST YEAR OF THE IMPLEMENTATION PLAN, SOME STRATEGIES HAVE BEEN STARTED, BUT NOT LONG ENOUGH TO ASSESS RESULTS.THE DEKALB COUNTY BOARD OF HEALTH (BOH) HAS A LONG HISTORY OF CONDUCTING COMMUNITY NEEDS HEALTH ASSESSMENTS AND THE DEKALB MEDICAL SYSTEM HAS PARTICIPATED IN AND SUPPORTED THOSE EFFORTS. THE DEKALB COUNTY BOH AGREED TO TAKE THE LEAD IN CONDUCTING COMMUNITY HEALTH ASSESSMENTS ON BEHALF OF DEKALB MEDICAL CENTER AND DEKALB MEDICAL AT HILLANDALE. IN ADDITION TO DEKALB SYSTEM HOSPITALS USING THE CHNAS AND IMPLEMENTATION PLANS, THEY ARE ALSO BEING USED AS THE COMMUNITY HEALTH ASSESSMENT. AFTER REVIEWING THE INFORMATION FROM THE CHNA, A STAKEHOLDER'S MEETING WAS CONVENED WITH OVER 30 REPRESENTATIVES OF COMMUNITY GROUPS, LOCAL GOVERNMENT AND OTHER PROVIDERS WHO REVIEWED THE RECENTLY COMPLETED CHNA, VALIDATED THE FINDINGS, PROVIDED INPUT FOR FUTURE CHNAS AND DEVELOPED A LIST OF COMMUNITY HEALTH PRIORITIES. USING THIS LIST OF PRIORITIES, THE HOSPITALS DEVELOPED IMPLEMENTATION PLANS WITH STRATEGIES IDENTIFIED FOR SELECTED PRIORITIES WHICH THE HOSPITALS DETERMINED THEY COULD MOST EFFECTIVELY ADDRESS. STRATEGIES FOR OTHER IDENTIFIED PRIORITIES WERE NOT DEVELOPED BECAUSE THERE ARE OTHER ORGANIZATIONS WITH MORE EXPERTISE DEALING WITH THOSE HEALTH ISSUES OR A LACK OF RESOURCES, AT THE HOSPITAL-LEVEL, TO ADDRESS THE PARTICULAR HEALTH ISSUE. PRIORITIES SUCH AS COLORECTAL CANCER, FALL PREVENTION, MATERNAL AND INFANTS HEALTH, AND PNEUMOCOCCAL AND PERTUSSIS VACCINATIONS, AMONG OTHERS, WERE IDENTIFIED AS PRIORITIES TO BE ADDRESSED BY HOSPITALS IN THE DEKALB SYSTEM.THE IMPLEMENTATION PLANS WILL HELP GUIDE THE DEKALB SYSTEM HOSPITALS' EFFORTS TOWARDS COMMUNITY HEALTH NEEDS THAT HAVE BEEN IDENTIFIED THROUGH THE CHNAS. ALL THE STRATEGIES IDENTIFIED ARE TO ENHANCE AND IMPROVE THE HEALTH OF THE COMMUNITY AND THE PEOPLE THE HOSPITALS SERVE.
PART VI, LINE 3: PATIENTS PROVIDED CARE BY THE HOSPITAL MEET WITH A FINANCIAL COUNSELOR AFTER THEIR CARE IS RENDERED. ELEGIBILITY CRITERIA FOR VARIOUS FINANCIAL ASSISTANCE PROGRAMS IS REVIEWED WITH THE PATIENT INCLUDING CHARITY, MEDICAID, OR OTHER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS. BILLING STATEMENTS RECEIVED BY A PATIENT ADVISE THEM TO CONTACT THE FINANCIAL COUNSELING DEPARTMENT ABOUT THESE PROGRAMS.
PART VI, LINE 4: DEKALB REGIONAL HEALTH SYSTEM SERVES THE POPULATION OF DEKALB COUNTY, GA (54% AFRICAN AMERICAN, 35% WHITE, 4% ASIAN) AS WELL AS ROCKDALE AND GWINNETT COUNTIES. THE MEDIAN INCOME OF DEKALB COUNTY IS APPROXIMATELY $51,700 AND ABOUT 17% OF THE COUNTY RESIDENTS LIVE BELOW THE POVERTY LEVEL. APPROXIMATELY 9% OF THE POPULATION IS OVER AGE 65 AND 24% OF THE POPULATION IS UNDER AGE 18.
PART VI, LINE 5: UNDERSTANDING THAT A HEALTHY COMMUNITY IS ABOUT MORE THAN JUST THE ABSENCE OF DEATH AND DISEASE, WE ALSO CONTRIBUTE TO THE ECONOMIC VITALITY AND CREATION OF QUALITY JOBS RIGHT HERE AT HOME. NAMED THE 2010 CORPORATION OF THE YEAR BY THE DEKALB COUNTY CHAMBER OF COMMERCE FOR OUR ROLE AS AN ACTIVE CORPORATE CITIZEN AND PROPONENT OF DIVERSITY, THE FOLLOWING PROGRAMS HAVE HELPED BUILD THE HEALTH OF OUR COMMUNITY: 1) WE HELP REDUCE TEEN PREGNANCY AND SEXUALLY TRANSMITTED DISEASE BY PROVIDING FREE PREVENTION EDUCATION THROUGH OUR PUBERTY ROCKS PROGRAM FOR PRE-TEENS; 2) WE SUPPORT 100 BLACK MEN OF DEKALB IN THE EFFORT TO PROVIDE HIGHER EDUCATION TO AT-RISK YOUTH; 3) WE PARTNER WITH THE PHYSICIANS'S CARE CLINIC TO PROVIDE NEARLY 2,000 LOW OR NO COST PATIENT VISITS A YEAR INCLUDING LAB WORK AND PRESCRIPTION MEDICATIONS TO AREA LOW-INCOME AND UNINSURED RESIDENTS; 4) WE SPONSOR A FREE ANNUAL CANCER SCREENING DAY ON TWO OF OUR HOSPITAL CAMPUSES; 5) WE HAVE RECENT HEALTHY WORKPLACE INIATIVES INCLUDE SMOKE-FREE BUILDINGS INSIDE AND OUT, A NO-NICOTINE HIRING POLICY AND ADOPTION OF HEALTHY FOOD OPTIONS IN HOSPITAL CAFETERIAS; 6) WE COLLECT AND DONATE SURPLUS MEDICAL SUPPLIES TO MEDSHARE INTERNATIONAL IN SUPPORT OF HEALTH INITIATIVES IN LESS FORTUNATE COUNTRIES; 7) WE HAVE AN OPEN MEDICAL STAFF THAT ATTRACTS UNLIMITED, HIGHLY TRAINED MEDICAL TALENT TO SERVE THE AREA; 8) WE ARE A MAJOR SPONSOR OF THE LEADERSHIP DEKALB INITIATIVE TO PROMOTE COMMUNITY CONNECTIVITY AND ACTION PLANS FOR ECONOMIC DEVELOPMENT, SUSTAINABILITY AND IMPROVEMENT OF THE QUALITY OF LIFE IN DEKALB COUNTY; 9) DEKALB MEDICAL PROVIDES FURTHER ENRICHMENT AND EMPLOYMENT OPPORTUNITIES BY CHAMPIONING WORKPLACE SUCCESS FOR YOUTH AND ADULTS WITH DISABILITIES. PARTNERING WITH THE NATIONALLY RECOGNIZED TOMMY NOBIS CENTER, DEKALB MEDICAL CONTRACTS WITH THE CENTER TO PROVIDE SWITCHBOARD OPERATORS FOR THE HEALTH SYSTEM; 10) WE PARTNER WITH DEKALB COUNTY HIGH SCHOOLS TO PROVIDE MENTALLY AND PHYSICALLY CHALLENGED STUDENTS WITH VOCATIONAL TRAINING AND REAL-LIFE WORK EXPERIENCE IN THE HEALTHCARE INDUSTRY. THE STUDENTS, WHO RECEIVE SCHOOL CREDIT, SERVE AS VOLUNTEERS IN OUR CAFETERIA, LAUNDRY ROOM AND MOTHER-BABY UNITS; 11) WE PARTICIPATE IN NUMEROUS CAREER DAYS, ENCOURAGING THE SCIENCE AND MATH EDUCATION THAT'S NEEDED TO PROVIDE COMPETENT HEALTH WORKERS OF THE FUTURE; 12) WE SUPPORT A DEKALB WORKFORCE DEVELOPMENT PARTNERSHIP THAT PROVIDES TRAINING PROGRAMS, EDUCATION AND A CLINICAL SITE FOR PATIENT CARE TECHNICIAN CERTIFICATION; AND 13) WE MAINTAIN A PARTNERSHIP WITH GEORGIA PERIMETER COLLEGE AND MERCER UNIVERSITY TO PROVIDE CLINICAL ROTATIONS, PRECEPTORSHIPS, EDUCATION AND INSTRUCTION TO GEORGIA'S FUTURE NURSES.
PART VI, LINE 6: DEKALB REGIONAL HEALTH SYSTEM, INC. IS THE PARENT ENTITY WHICH PROVIDES SUPPORT TO DEKALB MEDICAL CENTER, INC., DECATUR HEALTH RESOURCES, INC. AND DEKALB MEDICAL CENTER FOUNDATION, INC. DEKALB MEDICAL CENTER, INC. OPERATES TWO ACUTE CARE HOSPITALS AND A PHYSICIAN PRACTICE NETWORK TO PROVIDE HEALTHCARE SERVICES TO THE RESIDENTS OF DEKALB COUNTY, GEORGIA AND SURROUNDING COUNTIES. DECATUR HEALTH RESOURCES PROVIDES LONG-TERM ACUTE CARE HOSPITAL SERVICES TO PATIENTS WHO NEED ADDITIONAL TIME TO RECOVER FROM SERIOUS ILLNESS. DEKALB MEDICAL CENTER FOUNDATIONS'S MISSION IS TO STRENGTHEN THE LINK BETWEEN DEKALB REGIONAL HEALTH SYSTEM AND THE COMMUNITY IT SERVICES THROUGH COMMUNICATION, EDUCATION, SERVICE AND PHILANTHROPY.
GAREPORTS FILED WITH STATESPART VI, LINE 7
SEE BELOWPART V, LINE 8 FACILITY REPORTING GROUP A
AFTER REVIEWING THE INFORMATION FROM THE CHNA, A STAKEHOLDER'S MEETING WAS CONVENED WITH OVER 30 REPRESENTATIVES OF COMMUNITY GROUPS, LOCAL GOVERNMENT AND OTHER PROVIDERS WHO REVIEWED THE RECENTLY COMPLETED CHNA, VALIDATED THE FINDINGS, PROVIDED INPUT FOR FUTURE CHNAS AND DEVELOPED A LIST OF COMMUNITY HEALTH PRIORITIES.FACILITY 1 -- NORTH DECATUR & HILLANDALEPART V, SECTION B, LINE 3:
AFTER REVIEWING THE INFORMATION FROM THE CHNA, A STAKEHOLDER'S MEETING WAS CONVENED WITH OVER 30 REPRESENTATIVES OF COMMUNITY GROUPS, LOCAL GOVERNMENT AND OTHER PROVIDERS WHO REVIEWED THE RECENTLY COMPLETED CHNA, VALIDATED THE FINDINGS, PROVIDED INPUT FOR FUTURE CHNAS AND DEVELOPED A LIST OF COMMUNITY HEALTH PRIORITIES. USING THIS LIST OF PRIORITIES, THE HOSPITALS DEVELOPED IMPLEMENTATION PLANS WITH STRATEGIES IDENTIFIED FOR SELECTED PRIORITIES WHICH THE HOSPITALS DETERMINED THEY COULD MOST EFFECTIVELY ADDRESS. STRATEGIES FOR OTHER IDENTIFIED PRIORITIES WERE NOT DEVELOPED BECAUSE THERE ARE OTHER ORGANIZATIONS WITH MORE EXPERTISE DEALING WITH THOSE HEALTH ISSUES OR A LACK OF RESOURCES, AT THE HOSPITAL-LEVEL, TO ADDRESS THE PARTICULAR HEALTH ISSUE. PRIORITIES SUCH AS COLORECTAL CANCER, FALL PREVENTION, MATERNAL AND INFANTS HEALTH, AND PNEUMOCOCCAL AND PERTUSSIS VACCINATIONS, AMONG OTHERS, WERE IDENTIFIED AS PRIORITIES TO BE ADDRESSED BY HOSPITALS IN THE DEKALB SYSTEM.FACILITY 1 -- NORTH DECATUR & HILLANDALEPART V, SECTION B, LINE 7:
AVAILABILITY OF FAP APPLICATION DISCUSSED DURING THE FINANCIAL COUNSELING PROCESSFACILITY 1 -- NORTH DECATUR & HILLANDALEPART V, SECTION B, LINE 14G:
DEKALB'S FAP REQUIRES A COMPLETE WRITE OFF OR ADJUSTMENT OF TOTAL CHARGES OR A PORTION OF CHARGES IF PATIENT IS FAP ELIGIBLE AND IS BASED ON FEDERAL POVERTY GUIDELINES (FPG).FACILITY 1 -- NORTH DECATUR & HILLANDALEPART V, SECTION B, LINE 20D:
THE HOSPITAL CURRENTLY UTILIZES AN AUTOMATIC BILL PROCEDURE WHICH PREPARES THE FIRST BILL AT GROSS CHARGES. DISCOUNTS AND WRITE-OFFS ARE APPLIED AFTER THE FIRST BILL. IN TAX YEAR ENDING 06/30/2013, THE FACILITY BILLED ALL FAP ELIGIBLE PATIENTS AT GROSS BUT COLLECTED LESS THAN GROSS BASED ON FAP AND FPG.FACILITY 1 -- NORTH DECATUR & HILLANDALEPART V, SECTION B, LINE 22:

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1DEKALB REGIONAL HEALTH SYSTEM INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12701 NORTH DECATUR ROADAddressLine1
CityDECATURCity
StateGAState
ZIP Code30033ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient582034958EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant418960AmountOfCashGrant
Purpose Of GrantSUPPORT FOR PATIENT CAREPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: THE ORGANIZATION HAS GUIDELINES IN PLACE THAT ARE USED IN REVIEWING THE ELIGIBILITY OF GRANTEES. SCHOLARSHIP FUNDS ARE REMITTED TO THE EDUCATIONAL INSTITUTIONS DIRECTLY. FOR OTHER GRANTS, VARIOUS PROCEDURES ARE IN PLACE DEPENDING ON GRANT TYPE, INCLUDING REQUIREMENTS TO SUBMIT APPLICATIONS FOR REVIEW AND APPROVAL. ALL GRANTS REQUIRE WRITTEN DOCUMENTATION AND APPROPRIATE LEVELS OF APPROVAL.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (19 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JOHN A SHELTON JR
DIRECTOR, PRESIDENT/CEO61029101352940406460162500198840822365000
MAL UNDERWOOD
INTERIM CFO175894000000000175894000
DANE HENRY
CHIEF OPERATING OFFICER300375017435022902086360150840364432000
CHARLES BARCLAY
CHIEF MEDICAL OFFICER349472013151024206021250064610414540000
CHERYL IVERSON
VP MARKETING & BUSINESS DEV.1635100110240230150142130223870234149000
JAMES FORSTNER
VP & CHIEF STRATEGY OFFICER17602101263901713602465009410231387000
JOEL SCHUESSLER
VP & CHIEF COMPLIANCE OFFICER1595970117560867308568027080191302000
MARK TROCINO
CHIEF INFORMATION OFFICER211324090111022947013437052790343098000
STEPHEN THOMAS MD
VP DEKALB MEDICAL PHYSICIANS GROUP300466022050017471087500157700364507000
SUSAN HARRIS
VP DEKALB MEDICAL PHYSICIANS GROUP172214080630113070149610131490219694000
AUGUSTINE CONDUAH MD
ORTHOPEDIC PHYSICIAN78089800017486087500219030829037000
DAVID HOLLADAY MD
RADIATION ONCOLOGIST818232000237420137500139380869662000
RAYMOND LAWHEAD MD
OBSTETRICIAN GYNECOLOGIST52000900024642013750065170564918000
SHAINUL BHATIA MD
OCCUPATIONAL MEDICINE PHYSICIAN480261000239710382500104240552906000
KALAI PARTHIBAN MD
PHYSICIAN38419600017461057120259230433292000
DIANE P HARDEN
FORMER CFO16390600010641010654084030193604000
THOMAS CRAWFORD
FORMER VP HUMAN RESOURCES000014086100000140861000
CATHLEEN WHEATLEY
FORMER SVP & CHIEF OF QUALITY536601395003192970463605410343790000
ERIC NORWOOD
FORMER CEO0000572325000238620596187000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 4ATHE INDIVIDUALS BELOW RECEIVED SEVERANCE PAYMENTS TOTALING THE FOLLOWING: ERIC NORWOOD $570,003 THOMAS BARCLAY $140,861
PART IIIMAL UNDERWOOD'S COMPENSATION WAS PAID TO HIMFORMATICS, LLC FOR HIS SERVICE AS INTERIM CHIEF FINANCIAL OFFICER OF DEKALB REGIONAL HEALTH SYSTEM, INC. FROM JUNE 2012 THROUGH JANUARY 2013. NO BENEFITS WERE PROVIDED.SUPPLEMENTAL INFORMATION

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
THE DEKALB COUNTY HOSPITAL AUTHORITY
A58601120924047CCC02003-12-1028325646REFUND 2003A SERIES000
THE DEKALB COUNTY HOSPITAL AUTHORITY
B58601120924047CDH82010-05-03180623920REFUND SERIES 2010000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindCapital ExpendituresCapitalExpenditures
A28325646269107217716020031011
B1806239201411445631682802011101119992698

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A00000.008400.000000.00840000
B00000.008400.000000.00840000

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqsRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDue
A100001
B000001100

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A1
B1

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DEKALB ANESTHESIA ASSOCIATESBusinessNameLine1
FieldValueIRS element (for citing)
RelationshipPROVIDER OF MEDICAL SERVICES TO DMCRelationship
Amount Of Transaction3343864AmountOfTransaction
Description Of TransactionCHARLES CLIFTON, M.D., MEMBER OF THE DMC BOARD OF DIRECTORS, IS AN OWNER OF DEKALB ANESTHESIA ASSOCIATES.DescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6DEKALB REGIONAL HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF DEKALB MEDICAL CENTER, INC.
FORM 990, PART VI, SECTION A, LINE 7AEACH BOARD OF DIRECTORS MEMBER NOMINATED TO THE DEKALB MEDICAL CENTER, INC. BOARD IS SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS OF DEKALB REGIONAL HEALTH SYSTEM, INC. IN ACCORDANCE WITH THE DEKALB MEDICAL CENTER BYLAWS.
FORM 990, PART VI, SECTION A, LINE 7BDEKALB REGIONAL HEALTH SYSTEM, INC. MUST APPROVE CAPITAL EXPENDITURES IN EXCESS OF $2,000,000, ACQUISITIONS, REORGANIZATIONS, MERGERS AND/OR CONSOLIDATIONS, BUDGETS AND ANY REVISIONS AND REVISIONS OF THE ARTICLES OF INCORPORATION FOR DEKALB MEDICAL CENTER, INC.
FORM 990, PART VI, SECTION B, LINE 11FORM 990 IS PREPARED BY AN UNRELATED, INDEPENDENT ACCOUNTING FIRM AND SUBMITTED TO THE FINANCE COMMITTEE OF THE DEKALB REGIONAL HEALTH SYSTEM, INC. BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING. A COPY OF FORM 990 IS ALSO PROVIDED TO THE DEKALB MEDICAL CENTER, INC. BOARD OF DIRECTORS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION REQUIRES ALL OFFICERS, DIRECTORS, AND INDIVIDUALS IN MANAGEMENT LEVEL POSITIONS TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THESE CONFLICT OF INTEREST DISCLOSURES ARE REVIEWED TO ASSURE COMPLIANCE WITH THE POLICY. ADDITIONALLY, BOARD MEMBERS ARE ASKED TO RECUSE THEMSELVES ON ANY MATTERS OF INTEREST BEFORE THE BOARD IN WHICH A CONFLICT OF INTEREST MAY EXIST. ANY RECUSAL IS DOCUMENTED WITHIN THE MINUTES OF THE BOARD OR COMMITTEE.
FORM 990, PART VI, SECTION B, LINE 15ALL OFFICERS ARE COMPENSATED BY DEKALB MEDICAL CENTER, INC., A RELATED ENTITY. COMPENSATION IS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE DEKALB REGIONAL HEALTH SYSTEM, INC. BOARD OF DIRECTORS. THE COMMITTEE UTILIZES AN INDEPENDENT CONSULTANT TO ASSIST IN SETTING COMPENSATION LEVELS.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. ANY WRITTEN REQUEST FROM THE PUBLIC TO VIEW THESE DOCUMENTS WOULD BE REVIEWED AND ACTED UPON BY THE ORGANIZATION'S BOARD OF DIRECTORS.
FORM 990, PART XI, LINE 9:MINIMUM PENSION LIABILITY 16,617,154. FMC CHANGE - INTEREST RATE SWAPS -356,069.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
NETWORK MEDICAL PROVIDERS
2701 NORTH DECATUR ROADDECATURGA30033582121470PHYSICIAN SERVICESGA00DEKALB MEDICAL CENTER INC
DEKALB MEDICAL SPECIALTY CARE GROUP LLC
2701 NORTH DECATUR ROADDECATURGA30033263454941PHYSICIAN SERVICESGA00DEKALB MEDICAL CENTER INC
DEKALB MEDICAL PRIMARY CARE GROUP LLC
2701 NORTH DECATUR ROADDECATURGA30033263454827PHYSICIAN SERVICESGA00DEKALB MEDICAL CENTER INC
DEKALB MEDICAL OCCUPATIONAL MEDICINE GROUP LLC
2701 NORTH DECATUR ROADDECATURGA30033263455069PHYSICIAN SERVICESGA00DEKALB MEDICAL CENTER INC
DEKALB MEDICAL HOSPITALISTS
2701 NORTH DECATUR ROADDECATURGA30033582639633PHYSICIAN SERVICESGA00DEKALB MEDICAL CENTER INC
DECATUR NETWORK MEDICAL PROVIDER
2701 NORTH DECATUR ROADDECATURGA30033586300825PHYSICIAN SERVICESGA00DEKALB MEDICAL CENTER INC

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
DEKALB MEDICAL CENTER FOUNDATION INC
2701 NORTH DECATUR ROADDECATURGA30033581924605FUNDRAISING ON BEHALF OF DMCGA501(C)(3)LINE 11B, IIDEKALB REGIONAL HEALTH SYSTEM INC0
DEKALB REGIONAL HEALTH SYSTEM
2701 NORTH DECATUR ROADDECATURGA30033582034958SUPPORT DMC, INC.GA501(C)(3)LINE 30N/A
DECATUR HEALTH RESOURCES INC
450 NORTH CANDLER STREETDECATURGA30030582081599LONG TERM ACUTE CAREGA501(C)(3)LINE 11C, III-FIDEKALB REGIONAL HEALTH SYSTEM INC0

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Share Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
DRHS VENTURES INC
2701 NORTH DECATUR ROADDECATURGA30033201864828JOINT VENTUREGAN/AC0
DEKALB PHYSICIAN HOSPITAL ORGANIZATION INC
250 E PONCE LEON AVENUE STE 434DECATURGA30030582110792PHYSICIANS SERVICESGAC0DEKALB MEDICAL CENTER INC7094744061680.50000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg