SOUTHEAST GEORGIA HEALTH SYSTEM INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- SOUTHEAST GEORGIA HEALTH SYSTEM INC (EIN 58-1911751)
- Tax period
- 2011-05-01 to 2012-04-30
- Filed
- 2012-12-14
- IRS object ID
- 201213499349300126
- Schema version
- 2011v1.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-12-14T08:54:19-08:00 | Timestamp |
| Tax Period End Date | 2012-04-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-05-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581911751 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KINGS BAY COMM HOSPITALINC | BusinessNameLine1 |
| Business Name Line2 | dba S E GA HEALTH SYSTEM-CAMDEN | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | KING | NameControl |
| Phone | 9124663395 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2000 Dan Proctor Dr | AddressLine1 |
| City | St Marys | City |
| State | GA | State |
| ZIP Code | 31558 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Michael D Scherneck | Name |
| Title | Exec Vice Pres, CFO | Title |
| Date Signed | 2012-12-14 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Gary R Colberg FACHE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5030 Riverside Dr | AddressLine1 |
| City | Brunswick | City |
| State | GA | State |
| ZIP Code | 31520 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 42564407 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | sghs.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1990 | YearFormation |
| State Legal Domicile | GA | StateLegalDomicile |
| Activity Or Mission Description | Southeast Georgia Health System will provide safe, quality, accessible, and cost-effective care to meet the health needs of the people and communities it serves. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 342 | TotalNbrEmployees |
| Total Nbr Volunteers | 176 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 33200 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 37755 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 38129831 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 41985968 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 155540 | InvestmentIncomePriorYear |
| Investment Income Current Year | 162143 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 256457 | OtherRevenuePriorYear |
| Other Revenue Current Year | 378541 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 38575028 | TotalRevenuePriorYear |
| Total Revenue Current Year | 42564407 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 17437362 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 18575063 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 16371998 | OtherExpensePriorYear |
| Other Expenses Current Year | 18920713 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 33809360 | TotalExpensesPriorYear |
| Total Expenses Current Year | 37495776 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4765668 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 5068631 | RevenuesLessExpensesCY |
| Total Assets BOY | 66959339 | TotalAssetsBOY |
| Total Assets EOY | 72546646 | TotalAssetsEOY |
| Total Liabilities BOY | 35050273 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 35568949 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 31909066 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 36977697 | NetAssetsOrFundBalancesEOY |
| Mission Description | Southeast Georgia Health System will provide safe, quality, accessible, and cost-effective care to meet the health needs of the people and communities it serves. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 36041476 | Expense |
| Revenue | 41985968 | Revenue |
| Description | King's Bay Hospital, D/B/A Southeast Georgia Health System - Camden Campus, is a 40 bed hospital located in southeast Georgia in the city of St. Marys. For the 12 month fiscal period beginning 05/01/2011 and ended 04/30/2012, the medical center had 6,261 inpatient patient days and 716 births. We served 46,356 patients on an outpatient basis and an additional 30,723 patients were seen in the emergency room. Our financial statements include over $13.7 million in free care (includes indigent care, charity care and bad debts). | Description |
| Total Program Service Expense | 36041476 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | true | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 44 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 342 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Form990-T Filed | false | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Form720 Filed | false | Form720Filed |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | GA | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Michael DScherneckExecVPCFO | NamePerson |
| Telephone Number | 9124667049 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2415 Parkwood Dr | AddressLine1 |
| City | Brunswick | City |
| State | GA | State |
| ZIP Code | 31520 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| Carla L Yarbrough | |||||||||
| Boardmember | 2.00 | X | 0 | 0 | 0 | ||||
| Walter C McNeely | |||||||||
| Boardmember | 2.00 | X | 0 | 0 | 0 | ||||
| Mark Bedner | |||||||||
| Boardmember | 2.00 | X | 0 | 0 | 0 | ||||
| Vance Hughes | |||||||||
| Boardmember | 2.00 | X | 0 | 0 | 0 | ||||
| MHWoodyWoodside | |||||||||
| Secretary | 2.00 | X | 0 | 0 | 0 | X | |||
| Laura Cross-McKinley | |||||||||
| Treasurer | 2.00 | X | 0 | 0 | 0 | X | |||
| Mitchell Jones MD | |||||||||
| Boardmember | 2.00 | X | 0 | 0 | 0 | ||||
| Carl Alexander | |||||||||
| Vice Chair | 2.00 | X | 0 | 0 | 0 | X | |||
| Michael Hodges | |||||||||
| Chairman | 5.00 | X | 0 | 0 | 0 | X | |||
| Michael D Scherneck | |||||||||
| Exec VP/CFO | 40.00 | 0 | 340222 | 50897 | X | ||||
| Gary R Colberg FACHE | |||||||||
| President & CEO | 40.00 | 0 | 710031 | 106567 | X | ||||
| Howard Sepp | |||||||||
| Assistant Administrator | 40.00 | 0 | 239321 | 62772 | X | ||||
| Patrick D Ebri | |||||||||
| VP, Human Resources | 40.00 | 0 | 188180 | 52468 | X | ||||
| Elizabeth Gunn | |||||||||
| VP, Patient Care Services | 40.00 | 0 | 168003 | 35647 | X | ||||
| Kevin Smiley | |||||||||
| Pharmacy Manager | 40.00 | 133504 | 0 | 39822 | X | ||||
| Christie Foddrell | |||||||||
| Nurse Manager | 40.00 | 95626 | 0 | 19656 | X | ||||
| Robert D Moore | |||||||||
| Pharmicist | 40.00 | 101845 | 0 | 53142 | X | ||||
| Jeffrey Zawislak | |||||||||
| MGR, Rehab Svcs | 40.00 | 94502 | 0 | 40828 | X | ||||
| John Cox | |||||||||
| Nuclear Med Tech | 40.00 | 77893 | 0 | 45141 | X | ||||
| Ellen Hamilton | |||||||||
| Nurse Exec in Residence | 40.00 | 0 | 190813 | 44927 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 503370 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1836570 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 551867 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cross Country Staffing | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 404674 | AddressLine1 |
| City | Atlanta | City |
| State | GA | State |
| ZIP Code | 303844674 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | Contract Nursing | DescriptionOfServices |
| Compensation | 130509 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| All Other Contributions | 37755 | AllOtherContributions |
| Total Contributions | 37755 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Net Patient Svc Revenue | Description |
| Business Code | 621400 | BusinessCode |
| Total Revenue Column | 41985968 | TotalRevenueColumn |
| Related Or Exempt Function Income | 41985968 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 41985968 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 162143 | TotalRevenueColumn |
| Exclusion | $162,143 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 237811 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 237811 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 237811 | TotalRevenueColumn |
| Exclusion | $237,811 | ExclusionAmount |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| Other Revenue | 900099 | 17889 | $17,889 |
| Cafeteria Sales | 722210 | 122841 | $122,841 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 140730 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 42564407 | TotalRevenueColumn |
| Related Or Exempt Function Income | 41985968 | RelatedOrExemptFunctionIncome |
| Exclusion | $540,684 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14266349 | Total |
| Program Services | 13564546 | ProgramServices |
| Management And General | 701803 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 440296 | Total |
| Program Services | 418633 | ProgramServices |
| Management And General | 21663 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2946152 | Total |
| Program Services | 2801201 | ProgramServices |
| Management And General | 144951 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 922266 | Total |
| Program Services | 876891 | ProgramServices |
| Management And General | 45375 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25543 | Total |
| Management And General | 25543 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13406 | Total |
| Management And General | 13406 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5076325 | Total |
| Program Services | 5085436 | ProgramServices |
| Management And General | -9111 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 421512 | Total |
| Management And General | 421512 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6514505 | Total |
| Program Services | 6449504 | ProgramServices |
| Management And General | 65001 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 992182 | Total |
| Program Services | 992182 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 81716 | Total |
| Program Services | 57568 | ProgramServices |
| Management And General | 24148 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1747856 | Total |
| Program Services | 1747856 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3008426 | Total |
| Program Services | 3008426 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 530762 | Total |
| Program Services | 530762 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| Provider Taxes | 450004 | 450004 |
| Other Taxes | 4320 | 4320 |
| Licenses/Permits | 17210 | 17210 |
| Employee Recruiting | 1732 | 1732 |
| Ambulance | 35122 | 35122 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 92 | Total |
| Program Services | 83 | ProgramServices |
| Management And General | 9 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37495776 | Total |
| Program Services | 36041476 | ProgramServices |
| Management And General | 1454300 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3262019 | BOY |
| EOY | 426417 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6164022 | BOY |
| EOY | 6956155 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 856135 | BOY |
| EOY | 803133 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 242970 | BOY |
| EOY | 242042 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 66134757 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 19833692 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45918112 | BOY |
| EOY | 46301065 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6857484 | BOY |
| EOY | 3956400 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3503397 | BOY |
| EOY | 13425662 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 155200 | BOY |
| EOY | 435772 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66959339 | BOY |
| EOY | 72546646 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4080358 | BOY |
| EOY | 5053212 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 266400 | BOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30524256 | BOY |
| EOY | 30382675 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 179259 | BOY |
| EOY | 133062 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35050273 | BOY |
| EOY | 35568949 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31909066 | BOY |
| EOY | 36977697 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31909066 | BOY |
| EOY | 36977697 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66959339 | BOY |
| EOY | 72546646 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 5068631 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1156762 | OtherCostOrOtherBasis |
| Book Value | 1156762 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 43479477 | OtherCostOrOtherBasis |
| Depreciation | 5813858 | Depreciation |
| Book Value | 37665619 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 21098197 | OtherCostOrOtherBasis |
| Depreciation | 13892812 | Depreciation |
| Book Value | 7205385 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 400321 | OtherCostOrOtherBasis |
| Depreciation | 127022 | Depreciation |
| Book Value | 273299 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 46301065 | TotalOfBookValueLandBuildings |
| Total Of Book Value Program Related | 13425662 | TotalOfBookValueProgramRelated |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Rounding | $1 |
| 2000-3500 Lease Obligation L/T | $133,061 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 133062 | TotalOfAmounts |
| Total Revenue | 42564407 | TotalRevenue |
| Total Expenses | 37495776 | TotalExpenses |
| Excess Or Deficit For Year | 5068631 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 5068631 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 42564407 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 42564407 | RevenueSubtotal |
| Total Revenue Per Form990 | 42564407 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 37495776 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 37495776 | ExpensesSubtotal |
| Total Expenses Per Form990 | 37495776 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part X | Identifier |
| Return Reference | Part X : FIN48 Footnote | ReturnReference |
| Explanation | On May 1, 2009, Southeast Georgia Health System adopted the uncertain tax positions provisions of FASB ASC Topic 740 ("ASC 740"), Income Taxes, which addresses the determination of whether tax benefits claimed or expected to be claimed on a tax return should be recorded in the combined financial statements. Under ASC 740-10-25, Southeast Georgia Health System may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by taxing authorities based on the technical merits of the position. The tax benefits recognized in the combined financial statements from such a position are measured based on the largest benefit that has a greater than fifty percent likelihood of being realized upon ultimate settlement. ASC 740 also provides guidance on de-recognition, classification, interest and penalties on income taxes, and accounting in interim periods. The System has determined that it does not have any material unrecognized tax benefits or obligations as of April 30, 2012 and 2011, respectively. Fiscal years ending on and after April 30, 2009 remain subject to examination by federal and state tax authorities. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 125.000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2608042 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1297301 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1310741 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03500 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4989895 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3752109 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1237786 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03300 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 119248 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 86972 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 32276 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7717185 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5136382 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2580803 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06890 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 25200 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 25200 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 25200 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 25200 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7742385 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5136382 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2606003 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06960 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $3,611,193 | BadDebtExpenseAmount |
| Amount Attributable To | 552513 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 7608281 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 6720265 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 888016 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | false | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 0 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kings Bay Comm HspInc dba | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | SE GA Health Sys Camden MD Ctr | AddressLine1 |
| City | St Marys | City |
| State | GA | State |
| ZIP Code | 31558 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kings Bay Comm HspInc dba | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | false | CHNAConducted |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 125.0000 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 200.0000 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Other Factors | X | OtherFactors |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Other Actions | X | PermitOtherActions |
| Collection Activities | true | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Other Actions | X | OtherActions |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Other Actions Taken | X | OtherActionsTaken |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | true | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part VI - States Where Community Benefit Report Filed | GA | |
| Part VI - Community Building Activities | Our community efforts resulted in patients being served by our Wellness on Wheels (WOW) mobile health vehicle which provides free screening (mammography, dexascan, blood pressure and blood sugar, hearing, vaccinations), and Community Care Center, a pediatric center that is dedicated to the health care needs of our Medicaid population. These programs and many others form the foundation of our commitment to community health improvement.Wellness on Wheels (WOW) mobile health vehicle is our mobile "health care on wheels" that travels and delivers care throughout the nine county region. The WOW operates mostly Monday through Saturday and some Sunday's, as requested and serves a different location each week.. Staffed by our expert providers; the WOW provides a broad range of free services: mammography, dexascan, blood pressure and blood sugar, hearing, cholesterol screenings to basic health care check-ups, medical exams, and vaccinations. In addition to providing medical care, our financial counselor assist patients in applying for a variety of community assistance programs. Our financial counselors work with individuals to understand their unique needs and assist them in applying for federal, state, and local programs they may qualify for, including Medicaid and pharmaceutical assistance, food stamps, and the Women, Infants and Children (WIC) program. Our community partners are critical to helping us improve the health and well-being of the greater coastal Georgia region. Together, we can combine resources and strengths, positively impacting the greatest number of people. By working closely with community leaders, we also build a greater sense of community and a shared commitment toward our common goal of improving the community's health. We're proud of our partners.Community partners include:Coastal Medical Access ProgramCoastal Health DistrictCoastal Coalition of ChildrenGolden Isles Child Advocacy CenterOur vice president responsible for ancillary services and our administrative resident coordinates with area high schools to offer an Explorer Post program that brings awareness to high school students of the job opportunities in the health care field. Our director of volunteer services also coordinates and works with area high school students on a shadowing program and promote health careers at their annual information fairs at the local high schools. Employees in the CommunityEvery year, Southeast Georgia Health System unites around corporate-wide efforts: Ringing bells for the Salvation Army; fundraising for the American Cancer Society, participating in our local United Way Campaign and so much more.At Southeast Georgia Health System, it's important to us to give back to our community. In addition to team member United Way donations and volunteer time at Relay For Life and other sponsored events, our team members participate in a variety of community service initiatives, from Habitat for Humanity to the Boys and Girls Club of Southeast Georgia to local student mentoring programs. | |
| Part VI - Community Information | King's Bay Community Hospital, Inc., is located in St.Marys, Georgia. The primary service area for the King's Bay Community Hospital, Inc., is Camden County which had an approximate population of 50,513 according to the U.S. Census Bureau estimates for 2010. King's Bay Community Hospital, Inc., derived approximately 87 % of its admissions from Camden County. The King's Bay Community Hospital, Inc., secondary service area includes Charlton and Brantley Counties in Georgia and Nassau County in Northeast Florida, with a combined population of 103,896 according to the U.S. Census Bureau estimates for 2010. King's Bay Community Hospital, Inc., is the only hospital in Camden County. Other hospitals in the secondary service area are Charlton Memorial Hospital, a 25 bed critical access hospital located in Folkston(Charlton County), Georgia, and Baptist Medical Center, Nassau, a 54 bed primary care hospital located in Fernandina Beach, Florida. | |
| Part VI - Patient Education of Eligibility for Assistance | *Southeast Georgia Health System's Financial Assistance Program (Indigent/Charity Policy) is advertised by signage in Admissions, the Emergency Care Center and the Business Office. Program information is also contained periodically in Southeast Georgia Health System's healthcare magazine which is distributed throughout the community.*The standard registration packet for all patients contains a printed form describing the Financial Assistance Program and the application process. The Financial Assistance process is further explained to the patients by the Registrars during the registration process. Additionally, patients being admitted as an inpatient are provided an information booklet which further details the Financial Assistance Program relating to the inability to pay for medical costs.*Financial Counselors in Admissions engage patients/financially responsible persons and investigate repayment options for medical costs incurred by patients being admitted to an inpatient status who display no identifiable means of paying for medical services through a third party insurer or other source. Contract staff are available to assist patients with United States Social Security Disability and/or Supplemental Income programs. Financial Counselors will assist patients in the application process for other federal and state public assistance programs and if ineligible, will promote Southeast Georgia Health System's internal financial assistance program as an additional option.*All billing statements address the patient's potential inability to pay for medical services by advertising Southeast Georgia Health System's Financial Assistance Program on the front and back of each statement mailer.*Business Office reception and telephone inquiry staff educate and promote Southeast Georgia Health System's Financial Assistance Program and distribute applications when a patient has indicated financial hardship, unemployment or the need for a low monthly repayment plan.*Financial Assistance Program information is contained on Southeast Georgia Health System's website with the ability for the patient to print an application for their use.*Financial Assistance Program information and applications are also provided by collection staff and collection subcontractors upon indication of a patient's financial need or inability to pay for medical services. Federal and state public assistance programs are suggested as well. | |
| Part VI - Needs Assessment | At King's Bay Community Hospital,Inc., our goal is to strengthen the health and well-being of our patients and neighbors, as well as the broader community. King's Bay Community Hospital,Inc., D/B/A Southeast Georgia Health System-Camden Campus, provided over $2.6 million in community benefits, which is more important to building the vitality of our community than ever. The services we provide are essential to not only the community's overall health, but also to the quality of life of every resident. This belief is ingrained in our culture, from our volunteer King's Bay Community Hospital,Inc., board to our physicians and nurses, staff, auxiliary volunteers, and our Southeast Georgia Health System Foundation.We participate in informal community needs assessments regularly, collaborating with local agencies, schools, and community groups. The results help us determine our short- and long-term priorities as well as strategies for improving community health. Our leadership team is involved with several community activities and on boards. These range from the Rotaries to the International Seafarers program to the Coastal Medical Access Program which serves the under-and uninsured in our community and beyond. | |
| Part V, Line 21 - Charge Patients Amount Equal Gross Charge for Services | See attachment for line 19D | Number of Hospital Faciltiy - 0 |
| Part V, Line 19d - Other Billing Determination of Individuals Without Insurance | Southeast Georgia Health System medical charges are the same for all patients and are not tiered by payer source. Patients incurring financial liabilities whether insured or uninsured are provided discount incentives for resolving outstanding balances. A substantial prompt pay discount which is the equivalent of our average managed care insurance contracted discount rate is offered for patient balances. Also, patients demonstrating a diminished ability to pay through full financial disclosure and repayment analysis are considered for settlement discounts which may exceed or be equivalent to Medicare rates. | Number of Hospital Faciltiy - 0 |
| Part V, Line 17e - Other Actions Took Before Any Collection Actions | Collection agencies are required to promote Southeast Georgia Health System's Financial Assistance Program when the debtor has demonstrated an inability to pay in response to collection activity. Repayment plans are allowed and monthly payments can be modified to align with the debtor's resources. At the end of ninety days of collection activity from the date of debt referral, collection agencies are required to assess the debtor's ability to pay based upon their response or lack of response in meeting their financial obligation. Debt identified as having no collection potential or an identifiable source for repayment will be closed and returned to Southeast Georgia Health System as "uncollectible" and all collection activity ceases. | Number of Hospital Faciltiy - 0 |
| Part V, Line 16e - Other Collection Actions by Facility or Third Party Engaged | Third party collection services are required to abide by a "Conduct Protocol For Collection Personnel" which deals with customer service standards Southeast Georgia Health System maintains and debt collection activity allowed by the protocol. Normal debt collection through statement mailers, telephone calls, credit reporting and legal suits for the purpose of wage garnishment are allowed. Rude or abusive collection behavior is not allowed nor is the filing of property liens. | Number of Hospital Faciltiy - 0 |
| Part V, Line 15e - Other Collection Actions Against a Patient | The credit and collection policy defines the process which Southeast Georgia Health System uses to collect debt and is applied consistently to all patients regardless of being insured or uninsured. It is designed in accordance with the debtor's ability to pay and promotes the use of State and Government assistance programs and Southeast Georgia Health System's internal Financial Assistance Program. | Number of Hospital Faciltiy - 0 |
| Part V, Line 13g - Other Means Hospital Facility Publicized the Policy | For patients seeking medical care, Southeast Georgia Health System does process applications and issue approvals prior to the rendering of services upon completion of a financial assistance application and provision of supporting documentation. In situations where medical care is emergent and the patient is receiving or has just received services, the application process can be initiated at the time of service but processing and adjudication cannot occur until supporting documentation such as the most current tax return, paycheck stubs, social security payments and financial assets such as savings, investments, rental income or income producing property are investigated. Household income and dependents supported are factored into the eligibility criteria. The patient's residence is not considered in the determination of eligibility. | Number of Hospital Faciltiy - 0 |
| Part V, Line 11h - Other Factors Used in Determing Amounts Charged Patients | Southeast Georgia Health System medical charges are the same for all patients and are not tiered by payer source. Patients incurring financial liabilities whether insured or uninsured are provided discount incentives for resolving outstanding balances. | Number of Hospital Faciltiy - 0 |
| Part III, Line 8 - Explanation Of Shortfall As Community Benefit | To the extent that Medicare revenue is not sufficient to pay for the cost of providing that care, Southeast Georgia Health System believes that the full amount of that shortfall should be considered in the determination of community benefits. | |
| Part III, Line 4 - Bad Debt Expense | Net patient service revenue is reported at the estimated net realizable amounts from patients, third-party payors, and others as services are rendered, including estimated retroactive adjustments under reimbursement agreements with third-party payors, and provision for bad debts. Retroactive third-party payor settlements and bad debt adjustments are accrued on an estimated basis in the period the related services are rendered and adjusted in future periods as final settlements are determined. The cost value of Bad Debts was determined by multiplying Bad Debt measured on a gross charge basis by the overall cost to charge ratio developed on the Medicare Cost Report. The amount estimated to have been elibible for financial assistance was determined by multiplying Bad Debt Expense,(at cost), by the poverty rate for Camden County, Georgia. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | true | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | true | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
| Rebuttable Presumption Procedure | false | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs | Bonus Filing OrgBonusFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Robert D Moore | ||||||||||||
| 97214 | 4631 | 22611 | 30531 | 154987 | ||||||||
| Patrick D Ebri | ||||||||||||
| 156589 | 18685 | 12906 | 18978 | 33490 | 240648 | |||||||
| Michael D Scherneck | ||||||||||||
| 286148 | 39748 | 14326 | 26981 | 23916 | 391119 | 5000 | ||||||
| Kevin Smiley | ||||||||||||
| 122138 | 4958 | 8010 | 31812 | 173326 | 6408 | |||||||
| Howard Sepp | ||||||||||||
| 208289 | 22555 | 8477 | 32056 | 30716 | 302093 | |||||||
| Gary R Colberg FACHE | ||||||||||||
| 398450 | 128294 | 183287 | 57096 | 49471 | 816598 | |||||||
| Ellen Hamilton | ||||||||||||
| 176032 | 14781 | 15700 | 29227 | 235740 | 108482 | |||||||
| Elizabeth Gunn | ||||||||||||
| 147072 | 17614 | 3317 | 17018 | 18629 | 203650 | |||||||
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Sch J, Part I, Line 6b | Identifier |
| Return Reference | Part I, Line 6b: Explanation of organization compensation contingent on net earnings from related or | ReturnReference |
| Explanation | Compensation contingent on Net Earnings of the organization: Certain members of Management participate in a Management Incentive Plan which is based on a variety of managerial, quality and financial performance indicators. However, compensation is provided under that plan only if a certain net earnings threshold is met. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part VI, Line 19 | Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Except through the normal I.R.S/ Form 990 inspection process, King's Bay Community Hospital D/B/A Southeast Georgia Helath System Camden has not established a standard process for making its governing documents, conflict of interest policy and financial statements available to the public. |
| Form 990, Part VI, Line 15b | Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | As employees of Southeast Georgia Health System, the compensation amounts paid to the individual serving in the capacity as Chief Executive Officer, Executive Director and/or other top management officials and officers are determined based on comparative survey/market data compiled by an independent consulting firm specializing in executive and employee compensation matters. The findings and recommendation of the consultant are reviewed with the Compensation Committee and/or the Executive Compensation Committee of Southeast Georgia Health System which in turn makes recommendations to the full Authority (i.e., Board) of Southeast Georgia Health System which ultimately approves those compensation amounts. In addition, the compensation amounts for those key employees included on Schedule J who receive compensation directly from the organization are determined based on comparative survey/market data compiled by an independent consulting firm specializing in executive and employee compensation matters. The findings and recommendation of the consultant are reviewed with the Human Resource Committee of Southeast Georgia Health System which in turn makes recommendations to the full Authority (i.e., Board) of Southeast Georgia Health System which ultimately approves those compensation amounts. |
| Form 990, Part VI, Line 12c | Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | King's Bay Community Hospital,Inc d/b/a Southeast Georgia Health System Camden has adopted the conflict-of-interest, whistleblower, and document retention and destruction policies of The Glynn-Brunswick Memorial Hospital Authority d/b/a Southeast Georgia Health System, the sole corporate member of King's Bay Community Hospital, Inc. Services,Inc. Under the conflict-of-interest policy, the Compliance Department requires all members of the Board of Directors, officers and key employees to report any potential conflicts on an annual basis. |
| Form 990, Part VI, Line 11 | Form 990, Part VI, Line 11: Form 990 Review Process | A draft electronic copy of Form 990 was provided to the members of the Board of Directors prior to being filed with the Internal Revenue Service. Management reviewed Form 990 with the Hospital Authority at a subsequent meeting and addressed all questions and recommendations that the Hospital Authority raised. |
| Form 990, Part VI, Line 6 | Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | Glynn-Brunswick Memorial Hospital Authority, EIN (58-6000498), is the sole corporate member of King's Bay Community Hospital, Inc. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SE Georgia Health System Foundation Inc | |||||||||||
| 2415 Parkwood Dr | Brunswick | GA | 31520 | 582125644 | Charitable Foundation | GA | 501(c)(3) | 11 | Glynn-Brunswick Memorial Hosp Authority | true | |
| Cooperative Healthcare Svcs Inc | |||||||||||
| 2415 Parkwood Dr | Brunswick | GA | 31520 | 010594994 | Physician and Immediate Care Facilities | GA | 501(c)(3) | 11 | Glynn-Brunswick Memorial Hosp Authority | true | |
| Glynn-Bwk Mem Hosp DBA | |||||||||||
| SE GA Health System-Brunswick | Brunswick | GA | 31520 | 586000498 | Inpatient and Outpatient Healthcare Services | GA | 501(c)(3) | 3 | false | N/A | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |