2012-08-15T13:00:08-05:00 2011-09-30 MCNAIR MCLEMORE MIDDLEBROOKS & CO LLC POST OFFICE BOX ONE MACON GA 312020001 990 2010-10-01 237363555 MEDCEN COMMUNITY HEALTH FOUNDATION INC MEDC 4786337388 691 Cherry Street Macon GA 31201 RHONDA S PERRY 2012-08-14 true JERRY A WOLFE 4787466277 2010 2016-02-24 21:20:13Z ETHEL A CULLINAN 691 Cherry Street Suite 400 Macon GA 31201 93672537 false X MEDCENFOUNDATION.ORG X 1973 GA THE MEDCEN COMMUNITY HEALTH FOUNDATION'S MISSION IS TO MAXIMIZE DONOR RESOURCES TO IMPROVE THE HEALTH OF OUR REGION THROUGH COMMUNITY AND HOSPITAL PARTNERSHIPS. SEE PART III, LINE 1. 40 36 8 1087 0 0 4208998 3821736 0 0 2674777 4049396 -255415 -268046 6628360 7603086 1044244 1723702 0 0 1088542 691391 0 0 37750 560063 660444 2692849 3075537 3935511 4527549 59669923 60934658 157424 158510 59512499 60776148 THE MEDCEN COMMUNITY HEALTH FOUNDATION'S MISSION IS TO MAXIMIZE DONOR RESOURCES TO IMPROVE THE HEALTH OF OUR REGION THROUGH COMMUNITY AND HOSPITAL PARTNERSHIPS. THE FOUNDATION PRIMARILY SUPPORTS THE MEDICAL CENTER OF CENTRAL GEORGIA, INC. (MCCG), IN WHICH CONTRIBUTIONS ARE USED FOR CHARITABLE, MEDICAL, EDUCATIONAL AND SCIENTIFIC PURPOSES. false false 1723702 1723702 2829700 PROGRAM GRANTS WERE PRINCIPALLY TO SUPPORT THE MEDICAL CENTER OF CENTRAL GEORGIA, INC. (MCCG), IN WHICH FUNDS ARE USED FOR CHARITABLE, MEDICAL, EDUCATIONAL AND SCIENTIFIC PURPOSES. 1723702 true true false false false false false false false true false false false false false true 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 1 0 true 8 true false true CJ false false false false false false false false X 40 36 false false false false false false false true true false false true true true true true true true true false GA X MEDCEN COMMUNITY HEALTH FOUNDATION INC 4786337388 691 CHERRY STREET SUITE 400 MACON GA 31201 X ETHEL A CULLINAN 40 X X 914237 0 47149 DANNY GIBSON 1 X X 0 0 0 SCOTT SEIGEL 1 X X 0 0 0 KENNETH BANKS 1 X X 0 404251 411427 RHONDA PERRY 1 X X 0 552478 1681095 TIMOTHY E ANDREWS 1 X 0 0 0 KENT BALDSCHUN 1 X 0 0 0 GENE BATTLES MD 1 X 0 0 0 HARRIETTE CARTER 1 X 0 0 0 KENNETH CLARK 1 X 0 0 0 LINDA CLAY 1 X 0 0 0 JOHN DRAUGHON 1 X 0 0 0 J DOUG DUNWODY 1 X 0 0 0 A DONALD FAULK JR 1 X 0 7940312 61400 FREDDY GATON MD 1 X 0 0 0 BENT GAY RPH 1 X 0 0 0 DUKE GROOVER 1 X 0 0 0 CAL HAYS 1 X 0 0 0 ANGELA HICKS 1 X 0 0 0 DOTTIE HOUSER 1 X 0 0 0 JAMES MANLEY 1 X 0 0 0 DAVID ROZIER 1 X 0 0 0 C WARREN SELBY JR 1 X 0 0 0 R EARL SMITH 1 X 0 0 0 JEFF THOMPSON 1 X 0 0 0 BETTY TREADWELL 1 X 0 0 0 MATILDA WALKER 1 X 0 0 0 PAM WHITE-COLBERT 1 X 0 0 0 THOMAS J WICKER 1 X 0 0 0 WILLIAM W BAXLEY III 1 X 0 0 0 RICK BONFIM 1 X 0 0 0 CYNTHIA C BUSBEE 1 X 0 0 0 WITT GAITHER 1 X 0 0 0 THOMAS E GIBBONS 1 X 0 0 0 CHRISTOPHER R GREENE 1 X 0 0 0 EMORY JOHNSON MD 1 X 0 0 0 JEFF RUTLEDGE 1 X 0 0 0 LAMAR SIZEMORE 1 X 0 0 0 KAREN SMITH 1 X 0 0 0 DAN SPEIGHT 1 X 0 0 0 914237 8897041 2201071 1 false true false 0 439382 992036 2390318 3821736 0 0 0 0 0 1109625 1109625 0 0 0 0 0 88741176 85801405 2939771 0 2939771 2939771 439382 268046 -268046 -268046 0 0 0 0 0 0 0 7603086 0 0 3781350 1723702 1723702 0 0 0 324846 324846 0 245203 245203 20865 20865 56719 56719 43758 43758 0 0 22000 22000 0 0 299881 299881 0 0 58141 58141 0 0 79971 79971 0 0 22871 21201 1670 0 0 0 0 PRINTING AND PUBLICATIONS 45860 45144 716 POSTAGE AND SHIPPING 12486 12486 MISCELLANEOUS ADMINISTRATIVE 119234 83870 35364 0 0 0 0 3075537 1723702 1314085 37750 0 363148 283352 864074 1254344 117695 125165 233500 0 233500 233500 58010126 58945120 0 0 0 0 81380 93177 59669923 60934658 90544 106510 66880 52000 0 0 157424 158510 X 6309701 6375758 53202798 54400390 59512499 60776148 59669923 60934658 X 4527549 -3263900 X false true true X false X 3903511 2917826 2069091 3170103 2439430 14499961 0 0 3903511 2917826 2069091 3170103 2439430 14499961 14499961 1269631 1130069 962066 1140423 1109625 5611814 0 0 20111775 0.72100 0.71670 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 233500 233500 0 0 0 0 233500 0 0 7603086 3075537 4527549 -3263900 0 -3263900 1263649 4307351 -3263900 0 -3263900 7571251 299881 -268046 31835 7603086 3043702 268046 268046 2775656 299881 0 299881 3075537 CMN BROADCAST 174532 174532 0 125824 CELEBRITY CLASSIC 222665 222665 0 130408 1 42185 42185 0 11814 439382 439382 0 0 0 0 0 0 268046 268046 -268046 true MEDICAL CENTER OF CENTRAL GEORGIA INC 777 HEMLOCK ST MACON GA 31201 582149128 501(C)(3) 1632156 SUPPORT MCCG UNITED WAY OF CENTRAL GEORGIA INC 277 MARTIN LUTHER KING JR BLVD W SUITE 301 MACON GA 312010513 580639811 501(C)(3) 15000 SUPPORT UNITED WAY PROGRAMS 2 0 Procedures for monitoring use of grant funds Schedule I, Part I, Line 2 PROGRAM GRANTS WERE PRINCIPALLY TO SUPPORT THE MEDICAL CENTER OF CENTRAL GEORGIA, INC. (MCCG), IN WHICH FUNDS ARE USED FOR CHARITABLE, MEDICAL, EDUCATIONAL AND SCIENTIFIC PURPOSES. THE USE OF GRANT FUNDS IS APPROVED AND MONITORED BY THE BOARD OF TRUSTEES. false true false false false false false false false ETHEL A CULLINAN 249919 0 40038 0 624280 0 38787 0 8362 0 961386 0 0 0 KENNETH BANKS 0 300047 0 62041 0 42163 0 397030 0 14397 0 815678 0 0 RHONDA PERRY 0 413105 0 111218 0 28155 0 1676164 0 4931 0 2233573 0 0 A DONALD FAULK JR 0 705046 0 210066 0 7025200 0 50716 0 10684 0 8001712 0 0 Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b EMPLOYER 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. ORGANIZATION EMPLOYEES FORM 990, PART I, LINE 5 COMPENSATION FOR FOUNDATION EMPLOYEES WAS PAID BY THE MEDICAL CENTER OF CENTRAL GEORGIA, INC. (MCCG; EIN: 58-2149128), AND W-2S WERE ISSUED BY MCCG AS AGENT FOR THE FOUNDATION. Review of form 990 by governing body Form 990, Part VI, Section B, Line 11a THE FORM 990 IS REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES PRIOR TO FILING. Conflict of interest policy Form 990, Part VI, Section B, Line 12c THE CORPORATE DEPARTMENT OF AUDIT AND COMPLIANCE ISSUES CONFLICT OF INTEREST DISCLOSURE FORMS ANNUALLY TO OUR BOARD MEMBERS, ADMINISTRATION AND DIRECTORS. THE DEPARTMENT OF AUDIT AND COMPLIANCE RECEIVES, REVIEWS AND DOCUMENTS ALL POTENTIAL CONFLICTS (PERCEIVED AND REAL). THE RESULTS ARE TAKEN TO THE COMPLIANCE COMMITTEE WHERE THE REAL DISCLOSURES ARE DISCUSSED FOR CORRECTIVE ACTION. THE CORRECTIVE ACTION SUGGESTIONS 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 CONFLICT OF INTEREST DISCLOSURE FORM. Process used to establish compensation of top management official Form 990, Part VI, Section B, Line 15a THE COMPENSATION COMMITTEE OF THE CORPORATE BOARD OF DIRECTORS ENGAGES AN EXECUTIVE CONSULTING FIRM EVERY 2 TO 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 HUMAN RESOURCES, THE CHIEF OPERATING OFFICER, AND THE CHIEF EXECUTIVE OFFICER 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 IS NATIONAL HOSPITALS AND HEALTH SYSTEMS OF SIMILAR SIZE AND SCOPE. KEY EMPLOYEES AND OTHERS OUTSIDE OF THE EXECUTIVE LEADERSHIP TEAM HAVE COMPENSATION SET BY HR GUIDELINES AND/OR MARKET COMPENSATION STUDIES. (ALSO IN RESPONSE TO SCHEDULE J, PART I, LINE 3) Process used to establish compensation of other officers/key employees Form 990, Part VI, Section B, Line 15b THE COMPENSATION COMMITTEE OF THE CORPORATE BOARD OF DIRECTORS ENGAGES AN EXECUTIVE CONSULTING FIRM EVERY 2 TO 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 HUMAN RESOURCES, THE CHIEF OPERATING OFFICER, AND THE CHIEF EXECUTIVE OFFICER 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 IS NATIONAL HOSPITALS AND HEALTH SYSTEMS OF SIMILAR SIZE AND SCOPE. KEY EMPLOYEES AND OTHERS OUTSIDE OF THE EXECUTIVE LEADERSHIP TEAM HAVE COMPENSATION SET BY HR GUIDELINES AND/OR MARKET COMPENSATION STUDIES. Public Disclosure Form 990, Part VI, Section C, Line 19 INFORMATION WILL BE MADE AVAILABLE UPON REQUEST TO THE BOARD OF TRUSTEES. Average hours worked per week for related organization Form 990, Part VII, Section A, Column B KENNETH BANKS - AT LEAST 40 HOURS PER WEEK RHONDA PERRY - AT LEAST 40 HOURS PER WEEK A. DONALD FAULK JR. - AT LEAST 40 HOURS PER WEEK MANAGEMENT AND GENERAL EXPENSES FORM 990, PART IX, COLUMN (C) MANAGEMENT AND GENERAL EXPENSES IN THE AMOUNT OF $992,036 WERE PAID BY A RELATED ORGANIZATION (SEE FORM 990, PART VIII, LINE 1D). Other changes in net assets or fund balances Form 990, Part XI, Line 5 NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - -3263900; CENTRAL GEORGIA HEALTH SYSTEMS INC 691 CHERRY STREET SUITE 400 MACON GA 31201 582149127 PARENT COMPANY - MCCG GA 501(C)(3) 11 NA false CENTRAL GEORGIA SENIOR HEALTH INC 691 CHERRY STREET SUITE 400 MACON GA 31201 582345439 RETIREMENT COMMUNITY GA 501(C)(3) 11 CENTRAL GEORIGA HEALTH SYSTEMS INC false HEALTH SERVICES OF CENTRAL GEORGIA INC 691 CHERRY STREET SUITE 400 MACON GA 31201 582307485 HEALTH CARE PROVIDER GA 501(C)(3) 3 CENTRAL GEORIGA HEALTH SYSTEMS INC false MEDICAL CENTER OF GEORGIA INC 691 CHERRY STREET SUITE 400 MACON GA 31201 582149128 HOSPITAL GA 501(C)(3) 3 NA false SECURE HEALTH PLANS OF GEORGIA LLC 577 MULBERRY STREET SUITE 1000 MACON GA 31201 582306549 MANAGED CARE GA NA N/A false CENTRAL GEORGIA PET LLC 1650 HARDEMAN AVENUE MACON GA 31201 371464470 MEDICAL IMAGING CENTER GA NA N/A false CENTRAL GEORGIA HEALTH VENTURES INC 691 CHERRY STREET SUITE 400 MACON GA 31201 582164989 MANAGEMENT GA NA C CORPORATION CENTRAL GEORGIA HOME CARE SERVICES INC 691 CHERRY STREET SUITE 400 MACON GA 31201 582457422 MEDICAL EQUIPMENT SALES GA NA C CORPORATION AMERICAN EAGLE INSURANCE CO RRG 40 MAIN STREET SUITE 500 BURLINGTON VT 05401 161645557 RISK MANAGEMENT VT NA C CORPORATION CENTRA PROFESSIONAL INDEMNITY LTD PO BOX 1363 GRAND CAYMAN CJ INSURANCE - FOREIGN CORP. 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