2013-10-14T10:24:40-05:00 2012-11-30 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2011-12-01 582413173 LIBERTY REGIONAL FOUNDATION INC LIBE 9123699438 PO BOX 919 HINESVILLE GA 313100919 SCOTT KROELL 9123699438 2013-10-15 true JACQUELINE G ATKINS 2298837878 2013-10-07 2011 2016-02-25 16:41:14Z SCOTT KROELL PO BOX 919 HINESVILLE GA 313100919 2074303 false X N/A X 1998 GA SUPPORT OF AN ACUTE-CARE AUTHORITY HOSPITAL BY PROVIDING FUNDRAISING AND AMBULANCE SERVICES FOR RESIDENTS OF THE COUNTY AND SURROUNDING AREAS REGARDLESS OF ABILITY TO PAY. 7 7 0 3 0 122904 125583 1649942 1920683 165 25 18112 24104 1791123 2070395 27733 24010 0 1540976 1686294 0 696 255156 388037 1823865 2098341 -32742 -27946 940249 1376113 1139618 1603428 -199369 -227315 SUPPORT OF AN ACUTE-CARE AUTHORITY HOSPITAL BY PROVIDING FUNDRAISING AND AMBULANCE SERVICES FOR RESIDENTS OF THE COUNTY AND SURROUNDING AREAS REGARDLESS OF ABILITY TO PAY. false false 2003043 1922813 LIBERTY REGIONAL EMS, INC. SUPPORTS LIBERTY REGIONAL MEDICAL CENTER, AN AUTHORITY HOSPITAL, IN ITS PURSUIT TO PROVIDE HEALTHCARE TO THE RESIDENTS OF LIBERTY COUNTY, REGARDLESS OF ABILITY TO PAY FOR SERVICES. THE CURRENT YEAR DISBURSEMENTS FOR LIBERTY REGIONAL EMS, INC. WERE FOR AMBULANCE SERVICES PROVIDED TO THE COMMUNITY AND SURROUNDING AREAS. 37226 24010 LIBERTY REGIONAL FOUNDATION, INC. SUPPORTS LIBERTY REGIONAL MEDICAL CENTER, AN AUTHORITY HOSPITAL, IN ITS PURSUIT TO PROVIDE HEALTHCARE TO THE RESIDENTS OF LIBERTY COUNTY, REGARDLESS OF ABILITY TO PAY FOR SERVICES. THE CURRENT YEAR DISBURSEMENTS FOR LIBERTY REGIONAL FOUNDATION, INC. WERE FOR FACILITY IMPROVEMENTS AND EQUIPMENT USED TO CARRY OUT THE HOSPITAL'S EXEMPT PURPOSE. 2040269 true true false false false false false false false false true false false false false true false true false false false false false false true false false true false true false false false false false false false false false false false false false true false false false false true 0 0 0 false false false false false false false false false false X 7 7 false false false false false false false true true false false true true true true true true true true false GA X SAM JOHNSON CFO 9123699426 PO BOX 919 HINESVILLE GA 313100919 X JON P LONG 1.00 X X 0 0 0 JAMES E ROGERS 1.00 X X 0 0 0 WILLIAM D DARSEY 1.00 X X 0 0 0 ALAN N BAROODY 1.00 X 0 0 0 REGINALD L PIERCE SR 1.00 X 0 0 0 BOBBY HERRINGTON MD 1.00 X 0 0 0 JAMES THOMAS JR 1.00 X 0 0 0 SCOTT KROELL 1.00 X 0 221323 40926 SAM JOHNSON 1.00 X 0 181621 6310 402944 47236 false true false 124613 970 125583 NET PATIENT REVENUE 621910 1920683 1920683 1920683 25 25 25095 3908 21187 21187 OTHER INCOME 621990 2130 2130 MEDICAL RECORD SALES 621990 787 787 2917 2070395 1922813 21999 24010 24010 1679094 1623402 55692 7200 7200 39156 39156 504 504 151014 148634 1684 696 112702 112702 MISCELLANEOUS 47537 47537 LICENSES & TAXES 15100 15100 REPAIRS & MAINTENANCE 11423 11423 MEDICAL SUPPLIES 8810 8810 1791 1791 2098341 2040269 57376 696 240 240 78813 109693 811316 1263978 30000 30000 49880 2202 940249 1376113 1139618 1603428 1139618 1603428 X -199369 -227315 -199369 -227315 940249 1376113 -27946 X false true true X false X X X false false false HOSP AUTH OF LIBERTY CO DBA LIBERTY REGIONAL MED CTR 586025016 6 true true true 24010 1 24010 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false 30000 30000 LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X THE AUTHORITY IS A GOVERNMENTAL ENTITY AND IS EXEMPT FROM INCOME TAXES. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN CONSIDERED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE FOUNDATION IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE. THE FOUNDATION APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE FOUNDATION ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF NOVEMBER 30, 2012 AND 2011 OR FOR THE YEARS THEN ENDED. THE FOUNDATION'S OPEN AUDIT PERIODS ARE FOR TAX YEARS ENDED 2009-2011. MUSIC ON THE MA 25095 25095 1508 2400 25095 25095 1508 2400 3908 21187 true HOSPITAL AUTHORITY OF LIBERTY COUNT P O BOX 919 HINESVILLE GA 31313 586025016 GOV 24010 CAPITAL CONTRIBUTION 1 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES SCHEDULE I, PAGE 1, PART I, LINE 2 THE ORGANIZATION MONITORS THE USE OF CAPITAL CONTRIBUTIONS TO LIBERTY MEDICAL CENTER THROUGH A COMMON MANAGEMENT TEAM. false false false false false false false false false SCOTT KROELL 191381 25000 4942 22480 18446 262249 SAM JOHNSON 170178 10000 1443 6310 187931 RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION SCHEDULE J, PAGE 1, PART I, LINE 3 NONE OF THE INDIVIDUAL BOARD MEMBERS OR OFFICERS ARE COMPENSATED BY THE FILING ORGANIZATION. THE FILING ORGANIZATION, INSTEAD, RELIES ON THE METHODS USED BY THE SUPPORTED ORGANIZATION, HOSPITAL AUTHORITY OF LIBERTY COUNTY DBA LIBERTY REGIONAL MEDICAL CENTER ("HA"), TO ESTABLISH COMPENSATION OF THE CEO AND EXECUTIVE OFFICERS. COMPENSATION DETERMINATION BY THE HA INCLUDES INDEPENDENT COMPENSATION SURVEYS, WRITTEN EMPLOYMENT CONTRACTS, AND BOARD APPROVAL. THESE METHODS ARE WELL DOCUMENTED. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B FINAL FORM 990 IS PROVIDED TO BOARD DURING ITS REGULARLY SCHEDULED MEETING PRIOR TO FILING TO ALLOW THE BOARD AN OPPORTUNITY FOR REVIEW BEFORE SUBMISSION TO THE INTERNAL REVENUE SERVICE. MANAGEMENT REVIEWS THE RETURN FOR ACCURACY AND COMPLETENESS IN THE FINANCIAL AND NARRATIVE DETAILS. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C CONFLICT OF INTEREST FORMS ARE SIGNED ANNUALLY BY ALL HOSPITAL AUTHORITY BOARD MEMBERS. ANY DETERMINATION AS TO WHETHER A CONFLICT EXISTS IS THE RESPONSIBIITY OF THE REMAINING BOARD MEMBERS AND THE CONFLICTED INDIVIDUAL IS DISMISSED FROM THE DISCUSSIONS AND VOTES ON THE MATTER. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A THE CEO IS COMPENSATED BY THE HOSPITAL AUTHORITY OF LIBERTY COUNTY DBA LIBERTY REGIONAL MEDICAL CENTER ("HA"), THE SUPPORTED ORGANIZATION. HA'S HUMAN RESOURCES DEPARTMENT PROVIDES SALARY RECOMMENDATIONS FOR ALL LIBERTY REGIONAL MEDICAL CENTER'S EMPLOYEES BASED UPON SALARY SURVEY DATA PROVIDED BY THE GEORGIA HOSPITAL ASSOCIATION. THE CEO'S COMPENSATION IS SET BY HIS EMPLOYMENT CONTRACT AND ANY PAY INCREASE IS SUBJECT TO THE APPROVAL OF HA'S BOARD. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B THE CFO IS COMPENSATED BY THE SUPPORTED ORGANIZATION. HA'S HUMAN RESOURCES DEPARTMENT PROVIDE SALARY RECOMMENDATIONS FOR ALL LIBERTY REGIONAL MEDICAL CENTER EMPLOYEES BASED UPON SALARY SURVEY DATA PROVIDED BY THE GEORGIA HOSPITAL ASSOCIATION. THE CFO'S COMPENSATION AND ANY PAY INCREASE IS SUBJECT TO THE APPROVAL OF HA'S BOARD. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 THE FILING ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO ANY MEMBER OF THE PUBLIC WHO MAKES THEIR REQUEST AT THE ADMINISTRATIVE OFFICE. RELATED ORGANIZATIONS FORM 990, PAGE 7, PART VII AVERAGE WEEKLY HOURS DEVOTED TO RELATED ORGANIZATIONS: JOHN LONG 1 HOUR JAMES ROGERS 1 HOUR WILLIAM DARSEY 1 HOUR ALAN BAROODY 1 HOUR REGINALD PIERCE SR 1 HOUR BOBBY HERRINGTON MD 1 HOUR JAMES THOMAS JR 1 HOUR SCOTT KROELL 40 HOURS SAM JOHNSON 40 HOURS HOSP AUTH LIBERTY REGIONAL MED CTR PO BOX 919 HINESVILLE GA 31310 586025016 HEALTHCARE GA 509A1 6 NA false false true false false false false false false false false true false true true true false false false