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CENTRAL GEORGIA SENIOR HEALTH INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
CENTRAL GEORGIA SENIOR HEALTH INC (EIN 58-2345439)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-08-15
IRS object ID
201202289349302655
Schema version
2010v3.2
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)
Timestamp2012-08-15T13:00:22-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DRAFFIN & TUCKER LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1FIVE CONCOURSE PARKWAY SUITE 1250AddressLine1
CityATLANTACity
StateGAState
ZIP Code30328ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN582345439EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CENTRAL GEORGIA SENIOR HEALTH INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCENTNameControl
Phone4786331407Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1691 CHERRY STREETAddressLine1
CityMACONCity
StateGAState
ZIP Code31201ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRHONDA S PERRYName
TitleCFOTitle
Date Signed2012-08-14DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameW Edward PhillipsName
Phone4042208494Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1CARLYLE PLACEBusinessNameLine1

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

FieldValueIRS element (for citing)
Business Name Line1ETHEL CULLINANBusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1691 CHERRY STREET SUITE 400AddressLine1
CityMACONCity
StateGAState
ZIP Code31201ZIPCode
FieldValueIRS element (for citing)
Gross Receipts33012708GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.CARLYLEPLACE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1997YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionCONTINUING CARE RETIREMENT COMMUNITY OFFERING A FULFILLING INDEPENDENT LIFESTYLE EXPERIENCE IN A RESIDENTIAL SETTING WHILE PROVIDING COMPREHENSIVE HEALTH CARE SERVICES AND AMMENITIES TO INCLUDE ASSISTED LIVING, MEMORY CARE, AND SKILLED NURSING, ALL HOUSED ON THE SAME CAMPUS.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees284TotalNbrEmployees
Total Nbr Volunteers168TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14339947ProgramServiceRevenuePriorYear
Program Service Revenue CY14353247ProgramServiceRevenueCY
Investment Income Prior Year2066962InvestmentIncomePriorYear
Investment Income Current Year2287081InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year16406909TotalRevenuePriorYear
Total Revenue Current Year16640328TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year6134918SalariesEtcPriorYear
Salaries Etc Current Year6263278SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year8908204OtherExpensePriorYear
Other Expenses Current Year9022800OtherExpensesCurrentYear
Total Expenses Prior Year15043122TotalExpensesPriorYear
Total Expenses Current Year15286078TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1363787RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1354250RevenuesLessExpensesCY
Total Assets BOY89065183TotalAssetsBOY
Total Assets EOY87191398TotalAssetsEOY
Total Liabilities BOY85880645TotalLiabilitiesBOY
Total Liabilities EOY84971129TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY3184538NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2220269NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionCENTRAL GEORGIA SENIOR HEALTH, INC., INCORPORATED ON MAY 2, 1997, IS A NONPROFIT CORPORATION WHOSE PRIMARY PURPOSE IS TO CONSTRUCT, OWN AND OPERATE A CONTINUING CARE RETIREMENT COMMUNITY IN MACON, GEORGIA. IT WAS ORGANIZED FOR THE WELL-BEING OF OUR RESIDENTS, AND SHARING OUR KNOWLEDGE BEYOND OUR COMMUNITY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense11596000Expense
Revenue14353247Revenue
DescriptionCARLYLE PLACE (CP) IS A CONTINUING CARE RETIREMENT COMMUNITY (CCRC) OFFERING A FULFILLING LIFESTYLE EXPERIENCE IN A RESIDENTIAL SETTING, EMPHASIZING HEALTHY, ACTIVE LIFESTYLES FROM RETIREMENT UNTIL THE END OF LIFE. THERE ARE FOUR LIFESTYLE OPTIONS OFFERED BY CP: INDEPENDENT LIVING, ASSISTED LIVING, MEMORY SUPPORT AND SKILLED NURSING. RESIDENTS ARE ASSURED OF HAVING THEIR NEEDS MET - FROM RETIREMENT THROUGH THEIR END-OF-LIFE EXPERIENCE, ALL ON ONE CAMPUS AND WITH NO NEED TO RELOCATE OUTSIDE THE COMMUNITY. COUPLES WHO HAVE VARYING DEGREES OF HEALTH NEEDS MAY RECEIVE AS LITTLE OR AS MUCH ASSISTANCE AS NEEDED AND REMAIN IN CLOSE PROXIMITY TO EACH OTHER. CARLYLE PLACE IS COMMITTED TO PROVIDING A QUALITY LIFE EXPERIENCE IN THE BEST ENVIRONMENT POSSIBLE, DEPENDING UPON NEED. ON SITE SECURITY AND A TWENTY-FOUR HOUR EMERGENCY CALL SYSTEM PROVIDE RESIDENTS PEACE OF MIND AS HELP IS MERELY A PULL-CORD AWAY.Description
Total Program Service Expense11596000TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109626NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees284NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Excess Business HoldingsfalseExcessBusinessHoldings
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
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 Line1CONNIE W JONES CPABusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4784054500TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15300 ZEBULON ROADAddressLine1
CityMACONCity
StateGAState
ZIP Code31210ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (10 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
JAMES ADAMS JR
DIRECTOR1X000
MARJORIE CARTER
DIRECTOR1X000
JIM MCLENDON
DIRECTOR/CHAIRMAN1X000
ALFRED SAMS
DIRECTOR/VICE CHAIR1X000
JAMES WANSLEY
DIRECTOR1X000
PATRICIA ROBINSON
DIRECTOR1X000
RHONDA S PERRY
TREASURER105524781681095X
KENNETH B BANKS
SECRETARY10404251411427X
ETHEL A CULLINAN
PRESIDENT/CEO0091423747149X
A DONALD FAULK JR
CEO CGHS10794031261400X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs9811278TotalReportableCompFrmRltdOrgs
Total Other Compensation2201071TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SODEXO INC AND AFFILIATES
PO BOX 536922ATLANTAGA30353FOOD SERVICES1321987
SUNTRUST BANK
17TH FLOOR 245 PEACHTREE CTR AVEATLANTAGA30303BANKING SERVICES294771
FUNCTIONAL PATHWAYS OF TENNESSEE LLC
P O BOX 102426ATLANTAGA303682426REHAB SERVICES288942
LANDSCAPE SOUTH INC
PO BOX 26998MACONGA31008LANDSCAPING205285
BURGESS CARPET CENTER
PO BOX 4464MACONGA31208FLOORING SERVICES191742
FieldValueIRS element (for citing)
Number Of Contractors GT100 K7NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
RESIDENCY REVENUE6230001365697613656976
MEDICARE/MEDICAID PAYMENT524297599818599818
GUEST MEALS72232057077$57,077
RESIDENT TRANSPORTATION48000024746$24,746
GUEST ROOM REVENUE7210009312$9,312

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column5318TotalRevenueColumn
Related Or Exempt Function Income5318RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue14353247TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1430133TotalRevenueColumn
Exclusion$1,430,133ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities17229328Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities16372380Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities856948Securities
Other0Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column856948TotalRevenueColumn
Exclusion$856,948ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column16640328TotalRevenueColumn
Related Or Exempt Function Income14262112RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,378,216ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total5270872Total
Program Services4201018ProgramServices
Management And General1069854ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total20240Total
Management And General20240ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total570706Total
Program Services432296ProgramServices
Management And General138410ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total401460Total
Program Services309298ProgramServices
Management And General92162ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total352441Total
Management And General352441ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total69783Total
Management And General69783ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total62894Total
Management And General62894ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total378781Total
Program Services63390ProgramServices
Management And General315391ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total189017Total
Management And General189017ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total46995Total
Program Services889ProgramServices
Management And General46106ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total53531Total
Management And General53531ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total811567Total
Program Services746462ProgramServices
Management And General65105ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total67046Total
Program Services38818ProgramServices
Management And General28228ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total20553Total
Program Services10277ProgramServices
Management And General10276ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1233251Total
Program Services1109926ProgramServices
Management And General123325ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2939391Total
Program Services2645452ProgramServices
Management And General293939ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total238206Total
Program Services12016ProgramServices
Management And General226190ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES17613031612588148715
SODEXO DINING MANAGEMENT FEES346762346762
EQUIPMENT RENTAL AND MAINTENANCE16647624325142151
REFURBISHMENT EXPENSES8064180641
ENTERTAINERS/ENTERTAINMENT2828728287

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total175875Total
Program Services14196ProgramServices
Management And General161679ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total15286078Total
Program Services11596000ProgramServices
Management And General3690078ManagementAndGeneral
Fundraising0Fundraising

Total Joint Costs TotalJointCosts

FieldValueIRS element (for citing)
Total0Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2106996BOY
EOY1489504EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1477238BOY
EOY760951EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY17955BOY
EOY17955EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY56709BOY
EOY62106EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis62526630LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec26111354LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY38367450BOY
EOY36415276EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY46089665BOY
EOY47316340EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY235113EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY896354BOY
EOY789526EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY52816BOY
EOY104627EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY89065183BOY
EOY87191398EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY771526BOY
EOY824513EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY37327680BOY
EOY37525944EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY44500000BOY
EOY43350000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3281439BOY
EOY3270672EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY85880645BOY
EOY84971129EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY3184538BOY
EOY2220269EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3184538BOY
EOY2220269EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY89065183BOY
EOY87191398EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1354250ReconcilationRevenueExpenses
Reconcilation Other Changes-2318519ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1MEDICAL CENTER OF CENTRAL GEORGIABusinessNameLine1
FieldValueIRS element (for citing)
EIN582149127EIN
Type Of Organization3TypeOfOrganization
Listed In Governing DoctrueListedInGoverningDoc
Supported Organization NotifiedtrueSupportedOrganizationNotified
Organized In UStrueOrganizedInUS
Amount$0Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1732834OtherCostOrOtherBasis
Book Value1732834BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis51561927OtherCostOrOtherBasis
Depreciation19724591Depreciation
Book Value31837336BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis5280676OtherCostOrOtherBasis
Depreciation3847522Depreciation
Book Value1433154BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3747157OtherCostOrOtherBasis
Depreciation2539241Depreciation
Book Value1207916BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis204036OtherCostOrOtherBasis
Book Value204036BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings36415276TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
DUE TO AFFILIATES$155,330
INTEREST RATE SWAP$3,115,342
$0
FieldValueIRS element (for citing)
Total Of Amounts3270672TotalOfAmounts
Total Revenue16640328TotalRevenue
Total Expenses15286078TotalExpenses
Excess Or Deficit For Year1354250ExcessOrDeficitForYear
Net Unrealized GL On Investments-2313086NetUnrealizedGLOnInvestments
Other-$5,436OtherAmount
Total Adjustments-2318522TotalAdjustments
Excess Or Deficit Per FS-964272ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt16640328TotRevenueEtcAuditedFinclStmt
Other Revenues0OtherRevenues
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal16640328RevenueSubtotal
Other Revenues Not Included0OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99016640328TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt15286078TotExpensesEtcAuditedFinclStmt
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal15286078ExpensesSubtotal
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99015286078TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierFIN 48 (ASC 740) footnoteIdentifier
Return ReferenceSchedule D, Part X, Line 2ReturnReference
ExplanationCARLYLE PLACE IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. CARLYLE PLACE HAS EVALUATED ITS TAX POSITIONS AND DETERMINED THAT THEY DO NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2011. FISCAL YEARS ENDING ON OR AFTER SEPTEMBER 30, 2008 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

Base 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
RHONDA S PERRY
0413105011121802815501676164049310223357300
KENNETH B BANKS
03000470620410421630397030014397081567800
ETHEL A CULLINAN
0249919040038062428003878708362096138600
A DONALD FAULK JR
07050460210066070252000507160106840800171200

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSupplemental nonqualified retirement planIdentifier
Return ReferenceSchedule J, Part I, Line 4bReturnReference
ExplanationEMPLOYER PAYMENT FROM 457(F) EXECUTIVE SUPPLEMENTAL RETIREMENT PLAN DON FAULK $6,945,614 MCCG HAD A SUPPLEMENTAL EXECUTIVE BENEFIT PROGRAM ("SEBP") FOR CERTAIN EXECUTIVES THAT WAS DESIGNED AS A LOAN REGIME SPLIT DOLLAR LIFE INSURANCE PROGRAM. THIS PROGRAM WAS EXPECTED TO PROVIDE DEATH AND OTHER BENEFITS TO EXECUTIVES AND TO PROVIDE REPAYMENT OF LIFE INSURANCE PREMIUMS TO THE ORGANIZATION. AS A RESULT OF ECONOMIC CONDITIONS, THE LIFE INSURANCE POLICIES HAVE NOT PERFORMED AS ANTICIPATED. DURING 2009 MCCG DETERMINED THAT IT WOULD SUSPEND ALL PREMIUM PAYMENTS AND REEVALUATE THE EFFECTIVENESS OF THE PROGRAM FOR ALL CURRENT PARTICIPANTS. DURING CALENDAR YEAR 2009 THE MCCG BOARD OF DIRECTORS, AFTER CONSULTATION WITH COMPENSATION AND LEGAL ADVISERS, ADOPTED A RESOLUTION TO MAKE PAYMENTS TO THE RETIRED PARTICIPANTS IN THE SEBP. IN CONSIDERATION FOR THE RECEIPT OF SUCH PAYMENT, THE RETIRED EXECUTIVES SURRENDERED SUBSTANTIALLY ALL RIGHTS AND BENEFITS (OTHER THAN A SMALL DEATH BENEFIT) UNDER THE SEBP TO THE ORGANIZATION. SUBSEQUENTLY, A SIMILAR DECISION WAS MADE FOR THE CURRENT (EMPLOYED) PARTICIPANTS WITH ANY PAYMENTS TO BE MADE DEPENDENT ON THE INDIVIDUAL CONTINUING TO PROVIDE SUBSTANTIAL SERVICES TO A SPECIFIED FUTURE DATE. IN ADDITION, MCCG AND ITS AFFILIATED ORGANIZATIONS ADOPTED A SERP PROGRAM FOR CERTAIN EXECUTIVES EFFECTIVE FOR SERVICES RENDERED ON OR AFTER JANUARY 1, 2010. THIS PROGRAM PROVIDES FOR ANNUAL ACCOUNT VESTING IF THE PARTICIPANT IS EMPLOYED ON DECEMBER 31 OF THE THIRD YEAR AFTER THE ACCOUNT IS CREATED. THE BENEFIT EQUALS THE ANNUAL INCREASE IN THE PRESENT VALUE OF A LIFETIME ANNUITY PAYABLE COMMENCING AT A SPECIFIED TARGETED FUTURE DATE. THE ANNUTIY IS EQUAL TO 60% OF FINAL AVERAGE EARNINGS LESS (1) THE EXPECTED ANNUAL SEBP PAYMENT USED IN CALCULATING THE SEBP LUMP SUM PAYMENT, (2) THE ANNUAL BENEFIT PROVIDED UNDER THE DEFINED BENEFIT PLAN, AND (3) 100% OF THE PARTICIPANT'S SOCIAL SECURITY BENEFIT. AN ACTUARIAL CACULATION HAS NOT YET BEEN MADE FOR THESE BENEFITS.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1MACON-BIBB COUNTY HOSPITAL AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN581034851IssuerEIN
CUSIP Number55553RCC7CUSIPNumber
Date Issued2009-09-01DateIssued
Issue Price45900000IssuePrice
Description Of PurposeREFUNDING OF BONDS ISSUED IN 2000 TO CONSTRUCT THE FACILITYDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds45900000TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow45900000RefundingEscrow
Issuance Costs From Proceeds0IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures0CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent0AmountUnspent
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementstrueAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Bond Counsel Routinely EngagedtrueBondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others0.0034PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.0000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.0034TotalPrivateBusinessUse
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuetrueVariableRateIssue
Hedge Identified In Books And RecdstrueHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line1SUNTRUST BANKBusinessNameLine1
FieldValueIRS element (for citing)
Term Of Hedge20.0TermOfHedge
Superintegrated HedgefalseSuperintegratedHedge
Hedge TerminatedfalseHedgeTerminated
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
CONTINUED FROM STATEMENT TO PROGRAM SERVICES ACCOMPLISHMENTSFORM 990 PART III LINE 4A CONTINUEDINDEPENDENT LIVING - A RESIDENT OF CP MUST BE AT LEAST SIXTY-TWO YEARS OF AGE AT THE TIME OF RESIDENCY (IN THE CASE OF A COUPLE AT LEAST ONE RESIDENT MUST BE SIXTY-TWO AND THE OTHER MUST BE AT LEAST FIFTY-FIVE). INDEPENDENT LIVING CHOICES INCLUDE GARDEN HOMES OR VARIOUS SIZE APARTMENTS, WITH ACCESS TO ALL AMENITIES INCLUDING, BUT NOT LIMITED TO, NUTRITIONAL MEAL PLANS, SCHEDULED TRANSPORTATION, FITNESS PROGRAMS AND THE WELLNESS CLINIC, WHERE AN R.N. SEES RESIDENTS FOR ASSESSMENT AS NEEDED THROUGHOUT THE WEEK. CP'S RESIDENT CENTERED APPROACH ENSURES THAT RESIDENTS HAVE A HUGE VARIETY OF ACTIVITY AND ENTERTAINMENT OPTIONS, WITH EMPHASIS ON AN ACTIVE, EDUCATIONAL AND ENJOYABLE LIFESTYLE. NUMBER OF UNITS: 226 ASSISTED LIVING - ASSISTED LIVING IN STAFFORD SUITES IS AVAILABLE. A VARIETY OF OPTIONS FOR SERVICES ARE AVAILABLE DEPENDING UPON NEED - CNAS AND LPNS WILL HELP RESIDENTS WITH MAINTAINING A QUALITY OF LIFE AS CLOSE TO INDEPENDENT LIVING AS POSSIBLE, MONITORING MEDICATIONS, ASSISTING WITH PHYSICAL NEEDS TO INCLUDE BATHING AND DRESSING, AND PROVIDING HEALTH MONITORING. REHABILITATION SERVICES TO INCLUDE PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES ARE AVAILABLE AS NEEDED. OUR RESIDENT CENTERED APPROACH ENSURES THAT RESIDENTS HAVE A DIVERSITY OF ACTIVITY AND ENTERTAINMENT OPTIONS, ADAPTED AS NEEDED TO RESIDENT'S LIMITATIONS. NUMBER OF UNITS: 29 SKILLED NURSING - HARRINGTON HOUSE IS CP'S SKILLED NURSING FACILITY WHERE RESIDENTS MAY GO TO RECUPERATE FROM SURGERY, A LIFE THREATENING EVENT OR ILLNESS, OR AS THEIR HEALTH DETERIORATES, TO RECEIVE TOP QUALITY CARE AS THEY NEAR THE END OF THEIR LIVES. REHABILITATION SERVICES TO INCLUDE PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES ARE AVAILABLE AS NEEDED. OUR RESIDENT CENTERED APPROACH ENSURES THAT RESIDENTS HAVE CHOICES OF ACTIVITY AND ENTERTAINMENT OPTIONS, TAILORED AS NEEDED TO RESIDENT'S LIMITATIONS. NUMBER OF UNITS: 40 MEMORY CARE - THE MEMORY CARE UNIT OF CARLYLE PLACE ASSISTS RESIDENTS WHO ARE EXPERIENCING AGE-RELATED DEMENTIA, ALZHEIMER'S, OR OTHER HEALTH ISSUES THAT IMPACT THEIR MEMORIES AND ABILITIES, ENSURING THEIR HEALTH AND SAFETY. REHABILITATION SERVICES TO INCLUDE PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES ARE AVAILABLE AS NEEDED. OUR RESIDENT CENTERED APPROACH ENSURES THAT RESIDENTS HAVE CHOICES OF ACTIVITY AND ENTERTAINMENT OPTIONS, MODIFIED AS NEEDED TO RESIDENT'S ABILITIES. NUMBER OF UNITS: 26 CARLYLE PLACE IS COMMITTED TO AN ONGOING RELATIONSHIP WITH THE MIDDLE GEORGIA COMMUNITY AND SERVING SENIORS BOTH WITHIN AND BEYOND OUR WALLS. THE BOARD, MANAGEMENT AND STAFF ARE COMMITTED TO SHARING THEIR PROFESSIONAL KNOWLEDGE AND EXPERTISE REGARDING SENIORS AS WELL AS MATERIALLY SUPPORTING GERIATRIC SERVICES. SUPPORT OF THE ALZHEIMER'S ASSOCIATION IS A SALIENT EXAMPLE. EACH YEAR STAFF IS SUPPORTED IN THEIR EFFORTS TO RAISE FUNDS DURING WORKING HOURS TO SUPPORT THIS CAUSE. ADDITIONALLY, THE ORGANIZATION CORPORATELY SUPPORTS THE UNITED WAY. ON STAFF TIME, VOLUNTEER HOURS AND CIVIC MEMBERSHIPS ARE SUPPORTED AND ENCOURAGED. OUR RESIDENTS AND STAFF CONTINUALLY FIND TIME TO ASSURE THAT WE CONTRIBUTE OUTSIDE OUR CARLYLE COMMUNITY. WE ARE IN OUR NINTH YEAR OF PROVIDING LUNCHES FOR THE HOMELESS IN MIDDLE GEORGIA. PERSONAL GIFT BAGS ARE PROVIDED TO THE HOMELESS AT CHRISTMAS THROUGH THE SALVATION ARMY AND THE MACON RESCUE MISSION AND INCLUDE USEFUL ITEMS SUCH AS PERSONAL HYGIENE PRODUCTS, GLOVES, HATS, SOCKS, FLASHLIGHTS, SNACKS, ETC. SUPPLIES AND VOLUNTEER SUPPORT HAVE BEEN PROVIDED TO THE METHODIST HOME FOR CHILDREN, BIBB COUNTY PUBLIC SCHOOLS, THE GEORGIA VETERANS' HOME, FAMILY ADVANCEMENT MINISTRIES AND TWO LOCAL COLLEGES/UNIVERSITIES. EACH YEAR STAFF CONDUCTS A CANNED FOOD DRIVE WITH COMPETITION BETWEEN DEPARTMENTS TO BENEFIT OUR LOCAL FOOD BANK. THE VALUE OF VOLUNTEER ACTIVITIES PROVIDED BY RESIDENTS AND STAFF FOR THE FISCAL YEAR IS AS FOLLOWS: ALZHEIMER'S ASSOCIATION - DIRECT CORPORATE, RESIDENT AND STAFF CONTRIBUTIONS FROM VARIOUS FUNDRAISERS; SUPPORT GROUP SUPPORT; VOLUNTEER HOURS: $23,923 VALUE OF NON-CASH CONTRIBUTIONS TO LOCAL FOOD BANK, LOAVES & FISHES MINISTRIES, HABITAT FOR HUMANITY: $1,675 UNITED WAY OF CENTRAL GEORGIA - $1,000 LOCAL COLLEGES/UNIVERSITIES (WESLEYAN COLLEGE/MERCER UNIVERSITY), INCLUDING SPONSORSHIP OF UNIVERSITY OF LIFE LONG LEARNING/WESLEYAN COLLEGE: $5,200 SUPPORT FOR THE HOMELESS, CHILDREN, FAMILY AND VETERANS MINISTRIES: $3804 MEMORIAL GIFTS TO VARIOUS NON-PROFITS: $1050
Classes of members or stockholdersForm 990, Part VI, Section A, Line 6CENTRAL GEORGIA HEALTH SYSTEMS, INC., A RELATED 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF THE ORGANIZATION.
Members or stockholders electing members of governing bodyForm 990, Part VI, Section A, Line 7aCENTRAL GEORGIA HEALTH SYSTEMS, INC., A RELATED 501(C)(3) ORGANIZATION, HAS CERTAIN RESERVE POWERS AS WELL AS THE POWER TO APPOINT, APPROVE AND REMOVE BOARD MEMBERS OF CENTRAL GEORGIA SENIOR HEALTH, INC.
Decisions requiring approval by members or stockholdersForm 990, Part VI, Section A, Line 7bCENTRAL GEORGIA HEALTH SYSTEMS, INC., A RELATED 501(C)(3) ORGANIZATION, HAS CERTAIN RESERVE POWERS AS WELL AS THE POWER TO APPOINT, APPROVE AND REMOVE BOARD MEMBERS OF CENTRAL GEORGIA SENIOR HEALTH, INC.
Review of form 990 by governing bodyForm 990, Part VI, Section B, Line 11aTHE FORM 990 WAS PREPARED BY CENTRAL GEORGIA SENIOR HEALTH PERSONNEL FROM INFORMATION PROVIDED BY MANAGEMENT AND FROM AUDITED FINANCIAL STATEMENTS (AUDITED BY AN INDEPENDENT CPA). IT WAS REVIEWED BY OUR OUTSIDE TAX ADVISOR (ANOTHER INDEPENDENT CPA) AND BY FINANCIAL MANAGEMENT. A COPY OF THE FORM 990 WAS PROVIDED TO EACH BOARD MEMBER PRIOR TO FILING THE RETURN WITH THE INTERNAL REVENUE SERVICE.
Conflict of interest policyForm 990, Part VI, Section B, Line 12cTHE DEPARTMENT OF AUDIT AND COMPLIANCE ISSUES COI DISCLOSURE FORMS ANNUALLY TO OUR BOARD MEMBER, ADMINISTRATION AND DIRECTORS. AUDIT AND COMPLIANCE RECEIVES, REVIEWS AND DOCUMENTS ALL POTENTIAL CONFLICTS (PERCEIVED AND REAL). THE RESULTS ARE TAKEN TO THE COMPLIANCE COMMITTEE WHERE THE REAL CONFLICTS OF INTEREST ARE DISCUSSED AND A PLAN FOR CORRECTIVE ACTION IS DEVELOPED. THE CORRECTIVE ACTION RECOMMENDATIONS ARE TAKEN TO THE VARIOUS BOARDS AND ADMINISTRATION FOR IMPLEMENTATION. ANY TIME A CHANGE IN A RELATIONSHIP OR NEW POTENTIAL CONFLICT EVOLVES, THE INDIVIDUAL MUST AMEND THEIR COI DISCLOSURE FORM.
Process used to establish compensation of top management officialForm 990, Part VI, Section B, Line 15aTHE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS ENGAGES AN EXECUTIVE CONSULTING FIRM EVERY 2-3 YEARS TO REVIEW AND PROVIDE RECOMMENDATIONS REGARDING TOTAL COMPENSATION AND BENEFITS FOR THE EXECUTIVE LEADERSHIP TEAM. BASE COMPENSATION, INCENTIVE COMPENSATION, AND BENEFITS ARE INCLUDED IN THE REVIEW. THE EXECUTIVE CONSULTANTS REVIEW ORGANIZATION STRUCTURE, INDIVIDUAL JOB DESCRIPTIONS, AND DISCUSS SCOPE OF LEADERSHIP AND SPAN OF CONTROL WITH HR, THE COO, AND THE CEO AS A PART OF THE PROCESS TO DETERMINE PROPER PLACEMENT OF THE PAY GRADE AND LEVEL OF PARTICIPATION IN INCENTIVE AND BENEFITS PROGRAMS. THE COMPENSATION COMMITTEE PERIODICALLY REAFFIRMS THE TOTAL COMPENSATION PHILOSOPHY WHICH TARGETS THE 75TH PERCENTILE OF TOTAL COMPENSATION FOR OUR LEADERSHIP TEAM. THE PEER GROUP USED ITS NATIONAL HOSPITALS AND HEALTH SYSTEMS OF SIMILAR SIZE AND SCOPE. IT SHOULD BE NOTED THAT DR. CULLINAN'S TOTAL COMPENSATION INCLUDES AMOUNTS FOR SERVICES TO OTHER AFFILIATED ORGANIZATIONS. OUR HUMAN RESOURCES DEPARTMENT SURVEYS THOSE EMPLOYED OUTSIDE OF THE EXECUTIVE LEADERSHIP TEAM USING TOOLS THAT PROVIDE COMPARABLE DATA IN OUR MARKET AREA TO ENSURE THE COMPENSATION IS IN LINE WITH OTHER HEALTH CARE ORGANIZATIONS.
Process used to establish compensation of other officers/key employeesForm 990, Part VI, Section B, Line 15bTHE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS ENGAGES AN EXECUTIVE CONSULTING FIRM EVERY 2-3 YEARS TO REVIEW AND PROVIDE RECOMMENDATIONS REGARDING TOTAL COMPENSATION AND BENEFITS FOR THE EXECUTIVE LEADERSHIP TEAM. BASE COMPENSATION, INCENTIVE COMPENSATION, AND BENEFITS ARE INCLUDED IN THE REVIEW. THE EXECUTIVE CONSULTANTS REVIEW ORGANIZATION STRUCTURE, INDIVIDUAL JOB DESCRIPTIONS, AND DISCUSS SCOPE OF LEADERSHIP AND SPAN OF CONTROL WITH HR, THE COO, AND THE CEO AS A PART OF THE PROCESS TO DETERMINE PROPER PLACEMENT OF THE PAY GRADE AND LEVEL OF PARTICIPATION IN INCENTIVE AND BENEFITS PROGRAMS. THE COMPENSATION COMMITTEE PERIODICALLY REAFFIRMS THE TOTAL COMPENSATION PHILOSOPHY WHICH TARGETS THE 75TH PERCENTILE OF TOTAL COMPENSATION FOR OUR LEADERSHIP TEAM. THE PEER GROUP USED ITS NATIONAL HOSPITALS AND HEALTH SYSTEMS OF SIMILAR SIZE AND SCOPE. IT SHOULD BE NOTED THAT DR. CULLINAN'S TOTAL COMPENSATION INCLUDES AMOUNTS FOR SERVICES TO OTHER AFFILIATED ORGANIZATIONS. OUR HUMAN RESOURCES DEPARTMENT SURVEYS THOSE EMPLOYED OUTSIDE OF THE EXECUTIVE LEADERSHIP TEAM USING TOOLS THAT PROVIDE COMPARABLE DATA IN OUR MARKET AREA TO ENSURE THE COMPENSATION IS IN LINE WITH OTHER HEALTH CARE ORGANIZATIONS.
Public DisclosureForm 990, Part VI, Section C, Line 19THE ORGANIZATION PROVIDES COPIES OF ITS GOVERNING DOCUMENTS UPON REQUEST.
Other changes in net assets or fund balancesForm 990, Part XI, Line 5NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - -2313086; CHANGE IN INTEREST RATE SWAP - -5436; ROUNDING - 3;

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
CENTRAL GEORGIA HEALTH SYSTEMS INC
691 CHERRY STREET SUITE 400MACONGA31201582149127PARENT/STRATEIC PLANNING AND FINANCIAL MANAGEMENTGA501(C)(3)11 - Type III - FINAfalse
HEALTH SERVICES OF CENTRAL GEORGIA INC
691 CHERRY STREET SUITE 400MACONGA31201582307485HEALTHCARE SERVICESGA501(C)(3)3CENTRAL GEORGIA HEALTH SYSTEMSfalse
MEDCEN COMMUNITY HEALTH FOUNDATION INC
858 HIGH STREETMACONGA31201237363555FUNDRAISINGGA501(C)(3)7NAfalse
MEDICAL CENTER OF GEORGIA INC
691 CHERRY STREET SUITE 400MACONGA31201582149128HOSPITALGA501(C)(3)3CENTRAL GEORGIA HEALTH SYSTEMSfalse

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeType
SECURE HEALTH PLANS OF GEORGIA LLC
577 MULBERRY STREET SUITE 1000MACONGA31201582306549MANAGED CAREGANAN/A
CENTRAL GEORGIA PET LLC
1650 HARDEMAN AVENUEMACONGA31201371464470MEDICAL IMAGING CENTERGANAN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityAddress Line1AddressForeign/AddressLine1Province Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
CENTRAL GEORGIA HEALTH VENTURES INC
691 CHERRY STREET SUITE 400MACONGA31201582164989MANAGEMENTGANAC CORPORATION
CENTRAL GEORGIA HOME CARE SERVICES INC
691 CHERRY STREET SUITE 400MACONGA31201582457422MED. EQUP. SALEGANAC CORPORATION
AMERICAN EAGLE INSURANCE CO RRG
40 MAIN STREET SUITE 500BURLINGTONVT05401161645557RISK MGMT.VTNAC CORPORATION
CENTRA PROFESSIONAL INDEMNITY LTD
INSURANCENAC CORPORATIONPO BOX 1363GRAND CAYMANCJCJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg