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HAMILTON MEDICAL CENTER INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
HAMILTON MEDICAL CENTER INC (EIN 58-1519911)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-11-14
IRS object ID
201233199349302308
Schema version
2010v3.4
Note
A later return for the same period supersedes this one.
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)
Timestamp2012-11-14T09:51:13-06:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DIXON HUGHES GOODMAN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1500 RIDGEFIELD COURTAddressLine1
CityASHEVILLECity
StateNCState
ZIP Code28806ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN581519911EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HAMILTON MEDICAL CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHAMINameControl
Phone7062782105Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1168AddressLine1
CityDALTONCity
StateGAState
ZIP Code307221168ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOSEPH MCGUIREName
TitleVP/CONTROLLER/ASST TREASURERTitle
Phone7062782105Phone
Date Signed2012-11-14DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameAMY BIBBYName
Phone8282542254Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Amended ReturnXAmendedReturn
Name Of Principal Officer PersonJOSEPH MCGUIRENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1168AddressLine1
CityDALTONCity
StateGAState
ZIP Code307221168ZIPCode
FieldValueIRS element (for citing)
Gross Receipts278628223GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteHAMILTONHEALTH.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1983YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionHAMILTON MEDICAL CENTER, INC. OPERATES A 282-BED, ACUTE CARE HOSPITAL, INCLUDING A 24-HOUR EMERGENCY ROOM IN DALTON, GA. DURING THE FISCAL YEAR ENDED 09/30/2010, HAMILTON HAD 46,649 PATIENT DAYS AND 219,377 OUTPATIENT VISITS. HAMILTON'S VISION IS TO SERVE THE NEEDS OF AREA RESIDENTS WITHOUT DISCRIMINATION AND REGARDLESS OF ABILITY TO PAY.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees1413TotalNbrEmployees
Total Nbr Volunteers232TotalNbrVolunteers
Total Gross UBI62100TotalGrossUBI
Net Unrelated Business Txbl Income-68114NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year5242969ContributionsGrantsPriorYear
Contributions Grants Current Year2549849ContributionsGrantsCurrentYear
Program Service Revenue Prior Year209976010ProgramServiceRevenuePriorYear
Program Service Revenue CY207121057ProgramServiceRevenueCY
Investment Income Prior Year10301464InvestmentIncomePriorYear
Investment Income Current Year9275930InvestmentIncomeCurrentYear
Other Revenue Prior Year4294616OtherRevenuePriorYear
Other Revenue Current Year3492459OtherRevenueCurrentYear
Total Revenue Prior Year229815059TotalRevenuePriorYear
Total Revenue Current Year222439295TotalRevenueCurrentYear
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 Year87119602SalariesEtcPriorYear
Salaries Etc Current Year82825518SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year120602339OtherExpensePriorYear
Other Expenses Current Year118478988OtherExpensesCurrentYear
Total Expenses Prior Year207721941TotalExpensesPriorYear
Total Expenses Current Year201304506TotalExpensesCurrentYear
Revenues Less Expenses Prior Year22093118RevenuesLessExpensesPriorYear
Revenues Less Expenses CY21134789RevenuesLessExpensesCY
Total Assets BOY298585609TotalAssetsBOY
Total Assets EOY306739010TotalAssetsEOY
Total Liabilities BOY131460852TotalLiabilitiesBOY
Total Liabilities EOY127018132TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY167124757NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY179720878NetAssetsOrFundBalancesEOY
Mission DescriptionWE EXIST TO SERVE PEOPLE THROUGH THE MINISTRY OF HEALTHCAREMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense172646477Expense
Revenue208002920Revenue
DescriptionHAMILTON MEDICAL CENTER OPERATES A 282 BED ACUTE CARE HOSPITAL INCLUDING A 24-HOUR EMERGENCY ROOM, IN DALTON, GA WHICH SERVES THE NEEDS OF RESIDENTS OF THE CITY OF DALTON, WHITFIELD COUNTY AND SURROUNDING AREAS OF NORTHWEST GEORGIA. DURING THE YEAR ENDED SEPTEMBER 30,2011 THE MEDICAL CENTER HAD 44,191 PATIENT DAYS AND 227,237 OUTPATIENT VISITS. HAMILTON SERVES THE NEEDS OF AREA RESIDENTS WITHOUT DISCRIMINATION AND REGARDLESS OF ABILTIY TO PAY. ACCORDINGLY, THE HOSPITAL PROVIDED $42,784,864 IN CHARITY CARE AT ESTABLISHED RATES TO PATIENTS UNABLE TO PAY FOR THEIR HEALTH CARE SERVICES. IN ADDITION, CAHRGES OF $224,051,490 WERE NOT COLLECTED DUE TO SHORTFALLS FROM MEDICARE AND MEDICAID.Description
Total Program Service Expense172646477TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096193NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1413NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJOSEPH L MCGUIRENamePerson
Telephone Number7062782105TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11200 MEMORIAL DRIVEAddressLine1
CityDALTONCity
StateGAState
ZIP Code30720ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
ROBERT M CHANDLER
CHAIRMAN1.00XX000
ROBERT H BROOKER
VICE CHAIRMAN1.00XX000
ROBERT B HUBBS
SECRETARY/TREASURER1.00XX000
ANGELA M GORDY
TRUSTEE1.00X000
STEVEN W PAYNTER MD
TRUSTEE1.00X000
STEPHEN H RYALS MD
TRUSTEE1.00X000
W SCOTT SELLERS
TRUSTEE1.00X000
MATHEW D SMITH MD
TRUSTEE1.00X000
JEFFREY D MYERS
PRESIDENT/CEO1.00XX0378247110947
EZAD N AHMAD MD
TRUSTEE1.00X000
CAROLYN K TURNER
TRUSTEE1.00X000
GARY L HOWARD
VP/CFO1.00X0382983120327
KAREN J WISDOM
VP40.00X403110054241
JOSEPH MCGUIRE
VP/CONTROLLER/ASST TREASURER1.00X017299965820
RANDALL F FOSTER
VP/ASSISTANT TREASURER40.00X189948051260
JANICE C KEYS
VICE PRESIDENT40.00205210023774X
SANDRA D MCKENZIE
VICE PRESIDENT40.00175609046031X
T STEVEN POUND
VICE PRESIDENT40.00197975042747X
SHAWN MOLSBERGER
VICE PRESIDENT40.00200441043651X
CARLTON LANCASTER
PHYSICIAN/ MED STAFF CONSULTANT40.00337397087769X
TIMOTHY R BUNKER
PHYSICIAN40.00268864037895X
MICHAEL HARTLEY
PHYSICIAN40.0018125302363X
DC CLARK JR
PHARMACIST40.00169847024529X
JAMES PIRKLE JR
PHYSICIAN40.00156317022103X
JOHN S BOWLING
PRESIDENT/CEO1.000270838185612X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2485971TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1205067TotalReportableCompFrmRltdOrgs
Total Other Compensation919069TotalOtherCompensation
Number Individuals GT100 K45NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SODEXO OPERATIONS LLC
86 HOPEMEADOW STREETSIMSBURGCT06089FACILITY MANAGEMENT5416880
SIEMENS MEDICAL SOLUTIONS
PO BOX 40065ATLANTAGA31192I.S. CONSULTING AND SUPPORT3984643
ANESTHESIA ASSSOCIATES PC
PO BOX 2563DALTONGA30720ANESTHISIA SERVICES2301649
SOUTHEASTERN PHYSICIANS ASSOCIATION
PO BOX 634850CINCINNATIOH45263ER PHYSICIANS1157159
GASTROINTESTINAL SPECIALITSTS
302 POINT NORTH PLACEDALTONGA30720GASTROINTESTINAL SERVICES797009
FieldValueIRS element (for citing)
Number Of Contractors GT100 K53NumberOfContractorsGT100K
Related Organizations2549849RelatedOrganizations
Total Contributions2549849TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICE REVENU900099204213138204213138
WELLNESS CENTER71394018725441872544
MANAGEMENT FEES561000973275973275
ANSWERING SERVICE5170006210062100
FieldValueIRS element (for citing)
Total Program Service Revenue207121057TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5194639TotalRevenueColumn
Exclusion$5,194,639ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real2050954Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real2050954Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column2050954TotalRevenueColumn
Exclusion$2,050,954ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities60091666Securities
Other178553Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities56170125Securities
Other18803Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities3921541Securities
Other159750Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column4081291TotalRevenueColumn
Exclusion$4,081,291ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
WENDOR REBATES900099943963943963
GIFT SHOP453220244960$244,960
EDUCATION61171030425$30,425

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column222157TotalRevenueColumn
Exclusion$222,157ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1441505TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column222439295TotalRevenueColumn
Related Or Exempt Function Income208002920RelatedOrExemptFunctionIncome
Unrelated Business Revenue62100UnrelatedBusinessRevenue
Exclusion$11,824,426ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1633997Total
Management And General1633997ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total63387875Total
Program Services61966876ProgramServices
Management And General1420999ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2041559Total
Program Services2041559ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total11433126Total
Program Services11433126ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4328961Total
Program Services4328961ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total35655Total
Management And General35655ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total376154Total
Management And General376154ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total83939Total
Management And General83939ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total469282Total
Management And General469282ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total19742849Total
Program Services19032845ProgramServices
Management And General710004ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total131926Total
Program Services131926ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total30141493Total
Program Services18350253ProgramServices
Management And General11791240ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3789938Total
Program Services3789938ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total6182018Total
Management And General6182018ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total280572Total
Program Services280572ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total142355Total
Management And General142355ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total3852389Total
Management And General3852389ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total14263825Total
Program Services14263825ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total864997Total
Management And General864997ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT3144413731444137
PROVIDER TAX23296722329672
MISCELLANEOUS22712632271263
MANAGEMENT FEE TO HHCS10950001095000
CONSULTING FEES981524981524

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total201304506Total
Program Services172646477ProgramServices
Management And General28658029ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3709458BOY
EOY3825866EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2335685BOY
EOY3289907EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY22203734BOY
EOY26218202EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1235933BOY
EOY2621556EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3411759BOY
EOY2819204EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY7521327BOY
EOY6302842EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis244588697LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec129356093LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY118350281BOY
EOY115232604EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY98569329BOY
EOY102720094EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY29554384BOY
EOY31392182EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY9896958BOY
EOY10672319EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1796761BOY
EOY1644234EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY298585609BOY
EOY306739010EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY19253156BOY
EOY17273748EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY111020000BOY
EOY108410000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1187696BOY
EOY1334384EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY131460852BOY
EOY127018132EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY167124757BOY
EOY179720878EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY167124757BOY
EOY179720878EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY298585609BOY
EOY306739010EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses21134789ReconcilationRevenueExpenses
Reconcilation Other Changes-8538668ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis5937617OtherCostOrOtherBasis
Book Value5937617BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis114792650OtherCostOrOtherBasis
Depreciation44150701Depreciation
Book Value70641949BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2808735OtherCostOrOtherBasis
Depreciation2023778Depreciation
Book Value784957BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis119445785OtherCostOrOtherBasis
Depreciation83181614Depreciation
Book Value36264171BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1603910OtherCostOrOtherBasis
Book Value1603910BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings115232604TotalOfBookValueLandBuildings

Other Securities OtherSecurities (4 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
US TREASURY20143725F
INTEREST RECEIVABLE751467F
TIMBERLAND INVESTMENTS4308615F
REAL ESTATE6188375F
FieldValueIRS element (for citing)
Total Of Book Value Securities31392182TotalOfBookValueSecurities

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionASSET RETIREMENT OBLIGATIONDescription
Amount$1,334,384Amount
FieldValueIRS element (for citing)
Total Of Amounts1334384TotalOfAmounts
Total Revenue222439295TotalRevenue
Total Expenses201304506TotalExpenses
Excess Or Deficit For Year21134789ExcessOrDeficitForYear
Net Unrealized GL On Investments-8726720NetUnrealizedGLOnInvestments
Other$188,052OtherAmount
Total Adjustments-8538668TotalAdjustments
Excess Or Deficit Per FS12596121ExcessOrDeficitPerFS

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE ORGANIZATION HAS ADOPTED PROCEDURES FOR DETERMINING THE EXISTENCE OF UNCERTAIN TAX POSITIONS, AND THE RELATED TIMING AND AMOUNT OF THEIR IMPACT ON THE FINANCIAL STATEMENTS, AND DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2011.
PART XI, LINE 8 - OTHER ADJUSTMENTS:CHANGE IN LIABILITY CLAIMS ACCRUAL 188,052.
FORM 990 PART XI LINE 5 UNREALIZED LOSS ON TRADING SECURITIES ($8,726,720) OFFSET BY CHANGE IN LIABILITY CLAIMS ACCRUAL ($79,203), GAIN ON INVESTMENT IN HEALTH ONE ALLIANCE ($95,361) AND OTHER ADJUSTMENT ($13,488).

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage125.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense14878147TotalCommunityBenefitExpense
Direct Offsetting Revenue2249849DirectOffsettingRevenue
Net Community Benefit Expense12628298NetCommunityBenefitExpense
Percent Of Total Expense0.07430PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense31725038TotalCommunityBenefitExpense
Direct Offsetting Revenue27149191DirectOffsettingRevenue
Net Community Benefit Expense4575847NetCommunityBenefitExpense
Percent Of Total Expense0.02690PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense46603185TotalCommunityBenefitExpense
Direct Offsetting Revenue29399040DirectOffsettingRevenue
Net Community Benefit Expense17204145NetCommunityBenefitExpense
Percent Of Total Expense0.10120PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1002416TotalCommunityBenefitExpense
Direct Offsetting Revenue21124DirectOffsettingRevenue
Net Community Benefit Expense981292NetCommunityBenefitExpense
Percent Of Total Expense0.00580PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense24284819TotalCommunityBenefitExpense
Direct Offsetting Revenue18826759DirectOffsettingRevenue
Net Community Benefit Expense5458060NetCommunityBenefitExpense
Percent Of Total Expense0.03210PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense111000TotalCommunityBenefitExpense
Net Community Benefit Expense111000NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense25398235TotalCommunityBenefitExpense
Direct Offsetting Revenue18847883DirectOffsettingRevenue
Net Community Benefit Expense6550352NetCommunityBenefitExpense
Percent Of Total Expense0.03860PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense72001420TotalCommunityBenefitExpense
Direct Offsetting Revenue48246923DirectOffsettingRevenue
Net Community Benefit Expense23754497NetCommunityBenefitExpense
Percent Of Total Expense0.13980PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$10,965,832BadDebtExpenseAmount
Amount Attributable To2741458AmountAttributableTo
Amount Reimbursed By Medicare52201254AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare55454336CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-3253082MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost Accounting SystemXCostAccountingSystem
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1HAMILTON MEDICAL CENTER INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11200 MEMORIAL DRIVEAddressLine1
CityDALTONCity
StateGAState
ZIP Code30720ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NOT REQUIREDBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities9NumberOfOtherFacilities

Other Facilities OtherFacilities (9 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
HAMILTON DIAGNOSTIC CENTER
1407 NORTH THORNTON AVENUEDALTONGA30720DIAGNOSTIC IMAGING, SLEEP DISORDERS
HAMILTON SPECIALTY IMAGING
1436 BROADRICK DRIVEDALTONGA30720DIAGNOSTIC IMAGING
HAMILTON WOUND CARE
1109 BURLEYSON ROADDALTONGA30720WOUND CARE
ENDOVASCULAR SURGERY PRACTICE
1109 BURLEYSON ROADDALTONGA30720ENDOVASCULAR SERVICES
HAMILTON CONVENIENT CARE
1012 BURLEYSON ROADDALTONGA30720URGENT CARE CLINIC, FAMILY PRACTICE
HAMILTON SPINE CENTER
1107 MEMORIAL DRIVEDALTONGA30720SPINE CARE CLINIC
BRADLEY WELLNESS CENTER
1250 BROADRICK DRIVEDALTONGA30720FITNESS, CARIAC REHAB, PHYS./OCC. THERAPY
NEPHROLOGY PRACTICE
1506 BROADRICKDALTONGA30720NEPHROLOGY SERVICES
DIABETES TREATMENT CENTER
1109 BURLEYSON ROADDALTONGA30720DIABETES TREATMENT CENTER

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

ExplanationExplanationReturn ReferenceReturnReference
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 31444137.
HAMILTON MEDICAL CENTER ANNUAL COMMUNITY BENEFIT INFORMATION IS INCLUDED IN A SPECIAL SECTION OF HAMILTONHEALTH, A MAGAZINE PUBLISHED QUARTERLY BY HAMILTON HEALTH CARE SYSTEM (HHCS). HAMILTONHEALTH IS MADE AVAILABLE BY DIRECT MAIL TO HOUSEHOLDS IN THE PRIMARY SERVICE AREA; WAITING AREAS AROUND THE CAMPUS; IN WAITING AREAS OF PHYSICIAN OFFICES IN THE PRIMARY SERVICE AREA; AND ON THE HHCS WEBSITE, WWW.HAMILTONHEALTH.COM.PART I LINE 6A
THE AMOUNTS REPORTED IN THE TABLE OF CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS WERE DERIVED FROM COST TO CHARGE RATIO. THE TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN A WAS $201,304,506. THE BAD DEBT INCLUDED IN THIS AMOUNT WAS $31,444,137. AFTER BAD DEBT WAS DEDUCTED FROM THE TOTAL EXPENSES THE AMOUNT OF TOTAL EXPENSES USED TO CALCULATE THE PERCENT IN LINE 7, COLUMN F WAS $169,860,369.PART I LINE 7
IN FURTHERANCE OF ITS MISSION, HAMILTON MEDICAL CENTER PROVIDES CERTAIN SERVICES TO THE COMMUNITY AT A LOSS. THESE SERVICES INCLUDE OBSTETRICS, BEHAVIORAL HEALTH, HOME HEALTH, AND HOSPICE.PART I LINE 7G
HAMILTON MEDICAL CENTER PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THIRD-PARTY PAYORS ARE BILLED DIRECTLY AND THE PATIENT'S PORTION IS DETERMINED AND BILLED SUBSEQUENTLY. ACCOUNTS NOT MEETING CHARITY ASSISTANCE GUIDELINES AND UNPAID AFTER CERTAIN COLLECTION EFFORTS ARE CONSIDERED DELINQUENT AND WRITTEN OFF AS BAD DEBTS. THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED ON LINES 2 AND 3 IS COST TO CHARGE RATIO. THE AUDITED FINANCIAL STATEMENT FOR HAMILTON HEALTH CARE SYSTEM, INC, WHICH INCLUDES HAMILTON MEDICAL CENTER, REPORTS THE PROVISION FOR DOUBTFUL ACCOUNTS AT ESTABLISHED RATES AND CONTAINS THE FOLLOWING FOOTNOTE: "THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE AND OTHER COLLECTION TRENDS. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES." SINCE HAMILTON MEDICAL CENTER PROVIDES CARE REGARDLESS OF ABILITY TO PAY, A PORTION OF THE PROVISION FOR DOUBTFUL ACCOUNTS SHOULD BE INCLUDED IN COMMUNITY BENEFIT.PART III LINE 4
HAMILTON MEDICAL CENTER BELIEVES THAT THE ENTIRE AMOUNT OF MEDICARE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT. IT IS LIKELY THAT MANY OF THE INDIVIDUALS WOULD QUALIFY FOR CHARITY CARE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS AND THE BURDENS OF GOVERNMENT ARE RELIEVED UPON ACCEPTANCE OF PAYMENT LESS THAN COST. THE AMOUNT REPORTED WAS DERIVED FROM A COST ACCOUNTING SYSTEM THAT INCLUDES ALL SERVICE LINES AND PAYORS.PART III LINE 8
HAMILTON MEDICAL CENTER'S COLLECTIONS POLICY CONTAINS PROVISIONS RELATED TO THE MEDICALLY INDIGENT. PATIENTS WHO STATE THAT THEY HAVE LIMITED RESOURCES OR AN INABILITY TO PAY ARE SCREENED FOR ELIGIBILITY FOR CHARITY ASSISTANCE UNDER THE MEDICAL CENTER'S POLICY. QUALIFYING PATIENTS' ACCOUNTS ARE PARTIALLY OR FULLY WRITTEN-OFF UNDER POLICY PROVISIONS. UPON DETERMINATION OF PATIENT RESPONSIBILITY, BALANCES NOT QUALIFYING FOR ASSISTANCE ARE SUBJECTED TO A COLLECTION CYCLE WITH REGULAR NOTICES AND STATEMENTS. IF PAYMENT ARRANGEMENTS HAVE NOT BEEN MADE UPON COMPLETION OF THE COLLECTION CYCLE, THE ACCOUNT IS WRITTEN-OFF AND REFERRED FOR EXTERNAL COLLECTION FOLLOW-UP.PART III LINE 9B
HAMILTON MEDICAL CENTER, IN CONJUNCTION WITH HAMILTON HEALTH CARE SYSTEM AND OTHER AFFILIATES, WORKS CLOSELY WITH LOCAL GOVERNMENT AND NOT-FOR-PROFIT AGENCIES TO ASSESS AND MEET COMMUNITY NEEDS. IN ORDER TO ASSESS UNMET PHYSICIAN NEEDS OF WHITFIELD AND MURRAY COUNTIES, PHYSICIAN NEEDS ASSESSMENTS ARE PERIODICALLY CONDUCTED, MOST RECENTLY IN MAY, 2010.PART VI LINE 2
HAMILTON MEDICAL CENTER (HMC) PROVIDES CARE REGARDLESS OF ABILITY TO PAY. HMC EMPLOYS TWO FULL TIME FINANCIAL COUNSELORS WHO ARE RESPONSIBLE FOR EDUCATING PATIENTS AND RESPONSIBLE PARTIES OF POTENTIAL PAYMENT OPTIONS AS WELL AS THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM. THE FINANCIAL COUNSELORS ASSIST PATIENTS WITH THE COMPLETION OF THE FINANCIAL ASSISTANCE APPLICATION AND PROCESS THE APPLICATION FOR APPROVAL. HMC ALSO EMPLOYS THE SERVICES OF A MEDICAID ELIGIBILITY SERVICE TO ASSIST ELIGIBLE PATIENTS WITH OBTAINING MEDICAID COVERAGE.PART VI LINE 3
HAMILTON MEDICAL CENTER'S PRIMARY SERVICE AREA CONSISTS OF WHITFIELD AND MURRAY COUNTIES IN NORTHWEST GEORGIA AND REPRESENTS 94% OF THE FACILITY'S VOLUME. THE SERVICE AREA HAS A POPULATION OF 142,227 CONSISTING OF 102,599 AND 39,628 IN WHITFIELD AND MURRAY COUNTIES, RESPECTIVELY. MINORITY POPULATIONS IN WHITFIELD COUNTY CONSIST OF HISPANIC (32%) AND AFRICAN AMERICAN (4%). APPROXIMATELY 23% OF THE POPULATION LIVE BELOW THE POVERTY LEVEL. MINORITY POPULATIONS IN MURRAY COUNTY CONSIST OF HISPANIC (13%) AND AFRICAN AMERICAN (1%). APPROXIMATELY 21% OF THE POPULATION LIVE BELOW THE POVERTY LEVEL.PART VI LINE 4
HAMILTON MEDICAL CENTER (HMC), INCLUDING ITS RELATED AFFILIATES, IS ORGANIZED AND OPERATED FOR CHARITABLE PURPOSES WITH THE GOAL OF PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES. HMC SUPPORTS THIS MISSION WITH A COMMUNITY BOARD, OPEN MEDICAL STAFF AND AN EMERGENCY ROOM AVAILABLE TO PATIENTS REGARDLESS OF ABILITY TO PAY. THE BOARD IS COMPOSED OF CIVIC LEADERS AND PHYSICIANS WHO RESIDE IN THE HOSPITAL'S SERVICE AREA. THE BOARD SETS POLICY AND STRATEGIC DIRECTION AND DETERMINES THE USE OF SURPLUS FUNDS IN FURTHERANCE OF THE HOSPITAL'S CHARITABLE PURPOSE.PART VI LINE 6
HAMILTON MEDICAL CENTER, INC. (HMC) IS A CONTROLLED AFFILIATE OF HAMILTON HEALTH CARE SYSTEM, INC. (SYSTEM), WHEREBY THE TRUSTEES AND OFFICERS ARE ELECTED AND APPOINTED BY THE BOARD OF TRUSTEES OF SYSTEM. OTHER CONTROLLED AFFILIATES INCLUDE: DALTON SENIOR HOUSING, INC. AND WHITFIELD PLACE, INC., PROVIDERS OF HOUSING TO LOW INCOME SENIORS AND HANDICAPPED INDIVIDUALS; HAMILTON EMERGENCY MEDICAL SERVICES, INC., WHICH OPERATES WHITFIELD EMERGENCY MEDICAL SERVICES; HLTC, INC., A LONG-TERM CARE SERVICES PROVIDER; MURRAY MEDICAL CENTER, INC.; ROYAL OAK COMMUNITY, LTD., A RETIREMENT COMMUNITY; AND WHITFIELD HEALTHCARE FOUNDATION, INC., A PHILANTHROPIC ORGANIZATION. HAMILTON AMBULATORY SURGERY CENTER, INC., A MULTI-SPECIALTY SURGERY CENTER, AND HAMILTON PHYSICIAN GROUP, INC., A CARDIOLOGY PRACTICE EMPLOYING FOUR CARDIOLOGISTS, ARE CONTROLLED AFFILIATES OF HMC.PART VI LINE 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs1CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (15 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
JEFFREY D MYERS
033922500039022018825092122048919400
GARY L HOWARD
027152200011146101970501006220503310067350
KAREN J WISDOM
29919800010391201599203824904573510581380
JOSEPH MCGUIRE
014573300027266077870580330238819017977
RANDALL F FOSTER
130976000589720750604375402412080416040
JANICE C KEYS
163024000421860120302257102289840401310
SANDRA D MCKENZIE
139476000361330800403802702216400188770
T STEVEN POUND
151600000463750775803498902407220292920
SHAWN MOLSBERGER
147656000527850668703696402440920459830
CARLTON LANCASTER
23373500010366201720907056004251660616630
TIMOTHY R BUNKER
251122000177420136140242810306759000
MICHAEL HARTLEY
176474000477900023630183616000
DC CLARK JR
15059100019256075930169360194376000
JAMES PIRKLE JR
13998200016335000221030178420000
JOHN S BOWLING
024905500021783011146307414904564500104878

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 4BJOHN S. BOWLING - $110,520; GARY L. HOWARD - $4,038; JEFFREY D. MYERS - $3,741; CARLTON LANCASTER, M.D. - $3,617
PART I, LINE 6THE ORGANIZATION HAS A MANAGEMENT PERFORMANCE INCENTIVE PLAN FOR ELIGIBLE PARTICIPANTS TO FOCUS ON SPECIFIC STRATEGIC, ORGANIZATIONAL AND FINANCIAL GOALS. THE TOTAL AWARDS UNDER THE PLAN CANNOT EXCEED TEN PERCENT OF THE HAMILTON HEALTH CARE SYSTEM COMBINED EXCESS OF REVENUES OVER EXPENSES EXCLUDING INVESTMENT INCOME. INDIVIDUAL INCENTIVES ARE BASED UPON ACHIEVING CERTAIN ORGANIZATIONAL AND INDIVIDUAL SERVICE QUALITY, FINANCIAL RESULTS AND CUSTOMER SATISFACTION GOALS.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancingCUSIP NumberCUSIPNumber
DEVELOPMENT AUTHORITY OF THE CITY OF DALTON
8106148762003-06-021000000REFUND BONDS ISSUED 12/18/96000
DEVELOPMENT AUTHORITY OF THE CITY OF DALTON
8106148762003-09-0455000000EXPANSION AND IMPROVEMENTS TO HEALTH CARE FACILITY000235550EQ9

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpenditures
100000020031011
585990862008001142045058178636

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrsPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUse
000011
0100110.008500.00850

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
010001
110000

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
IdentifierFORM 990, SCHEDULE K, PART III, LINE 5, COLUMN A AND BIdentifier
Return ReferenceREASON FOR AMENDED FORM 990:ReturnReference
ExplanationTHE ORGANIZATION IS FILING AN AMENDED FORM 990 TO CORRECT AN ERROR MADE ON SCHEDULE K PART III LINE 5 COLUMN A AND B FOR THE PRIVATE BUSINESS USE PERCENTAGE.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990 PART IV LINE 12FINANCIAL STATEMENTS OF HAMILTON MEDICAL CENTER, INC ARE AUDITED ON A CONSOLIDATED BASIS TO INCLUDE HAMILTON AMBULATORY SURGERY CENTER, INC. AND HAMILTON PHYSICIAN GROUP, INC, BOTH OF WHICH ARE WHOLLY-OWNED SUBSIDIARIES
CERTAIN CAPITAL EXPENDITURE AND CONTRACTUAL COMMITMENT DECISIONS MUST BE SUBSEQUENTLY APPROVED BY THE HAMILTON HEALTH CARE SYSTEM BOARD OF TRUSTEES.FORM 990, PART VI, SECTION A, LINE 7B
FOLLOWING MANAGEMENT PREPARATION AND REVIEW, THE FORM 990 IS REVIEWED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. SUBSEQUENTLY, A DRAFT OF THE UNFILED FORM 990 IS POSTED TO A SECURE PAGE ON THE HAMILTON HEALTH CARE SYSTEM WEBSITE FOR REVIEW AND COMMENT BY ALL MEMBERS OF THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.FORM 990, PART VI, SECTION B, LINE 11
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION HAS A CLEAR AND DETAILED CONFLICT OF INTEREST POLICY WHICH ESTABLISHES A PROCEDURE FOR IDENTIFYING, REVIEWING AND ADDRESSING CONFLICTS OF INTEREST. THIS POLICY ALSO REQUIRED EACH TRUSTEE AND OFFICER OF THE ORGANIZATION TO ANNUALLY SIGN A STATEMENT ACKNOWLEDGING RECEIPT OF THE CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15UNDER A BOARD RESOLUTION, THE ORGANIZATIONS COMPENSATION COMMITTEE HAS THE AUTHORITY TO TAKE ACTION ON BEHALF OF THE BOARD WITH RESPECT TO THE COMPENSATION OF OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE MAINTAINS MINUTES OF ITS PROCEDURES. ON AN ANNUAL BASIS THE COMPENSATION COMMITTEE WILL MEET TO SET THE ANNUAL COMPENSATION OF THE PRESIDENT/CEO. THIS ACTION IS BASED ON CONSULTATION WITH A THRID PARTY CONSULTING FIRM TO REVIEW THE TOTAL COMPENSATION OF THE CEO AND KEY EMPLOYEES SUCH THAT TOTAL COMPENSATION PACKAGES ARE CONSIDERED FAIR MARKET AND NOT EXCESSIVE.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -8,726,720. CHANGE IN LIABILITY CLAIMS ACCRUAL 188,052. TOTAL TO FORM 990, PART XI, LINE 5: -8,538,668.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, SCHEDULE K, PART III, LINE 5, COLUMN A AND BTHE ORGANIZATION IS FILING AN AMENDED FORM 990 TO CORRECT AN ERROR MADE ON SCHEDULE K PART III LINE 5 COLUMN A AND B FOR THE PRIVATE BUSINESS USE PERCENTAGE.REASON FOR FILING AN AMENDED FORM 990:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (13 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
DALTON SENIOR HOUSING INC
519 WEST HAWTHORNE STREETDALTONGA30720581518011LOW-INCOME HOUSINGGA501(C)(3)LINE 9HAMILTON HEALTH CARE SYSTEM INC0
DALTON-WHITFIELD COUNTY HOSPITAL LIABILITY TRUST
PO BOX 1168DALTONGA30722581331514LIABILITY CLAIMS COVERAGEGA501(C)(3)LINE 11D, III-OHAMILTON HEALTH CARE SYSTEM INC0
DALTON-WHITFIELD ADDITIONAL TRUST
PO BOX 1168DALTONGA30722586345013FUNDS FOR INDIGENT CAREGA501(C)(3)LINE 11A, IHAMILTON HEALTH CARE SYSTEM INC0
DALTON-WHITFIELD INDIGENT CARE TRUST
PO BOX 1168DALTONGA30722586345011FUNDS FOR INDIGENT CAREGA501(C)(3)LINE 11A, IHAMILTON HEALTH CARE SYSTEM INC0
HAMILTON AMBULATORY SURGERY CENTER INC
PO BOX 1168DALTONGA30722582654791SURGICAL SERVICESGA501(C)(3)LINE 3HAMILTON MEDICAL CENTER INC1
HAMILTON EMERGENCY MEDICAL SERVICES INC
PO BOX 1168DALTONGA30722581651002EMERGENCY MEDICALGA501(C)(3)LINE 9HAMILTON HEALTH CARE SYSTEM INC0
HAMILTON HEALTH CARE SYSTEM INC
PO BOX 1900DALTONGA30722581519913SUPPORT RELATED ENTITIESGA501(C)(3)LINE 11D, III-O0N/A
HAMILTON PHYSICIAN GROUP INC
PO BOX 1168DALTONGA30722271198701PHYSICIAN PRACTICEGA501(C)(3)LINE 3HAMILTON MEDICAL CENTER INC1
HLTC INC
PO BOX 1168DALTONGA30722582341574LONG TERM ELDERLY CAREGA501(C)(3)LINE 9HAMILTON HEALTH CARE SYSTEM INC0
MURRAY MEDICAL CENTER INC
PO BOX 1406CHATSWORTHGA30705582373427HOSPITAL CARE / SERVICESGA501(C)(3)LINE 3HAMILTON HEALTH CARE SYSTEM INC0
ROYAL OAK COMMUNITY LTD
PO BOX 1900DALTONGA30722581970228SENIOR LIVING SERVICESGA501(C)(3)LINE 9HAMILTON HEALTH CARE SYSTEM INC0
WHITFIELD HEALTHCARE FOUNDATION INC
PO BOX 1900DALTONGA30722510175056FUNDS FOR HEALTHCAREGA501(C)(3)LINE 11A, IHAMILTON HEALTH CARE SYSTEM INC0
WHITFIELD PLACE INC
PO BOX 1168DALTONGA30722582103085LOW-INCOME HOUSINGGA501(C)(3)LINE 9HAMILTON HEALTH CARE SYSTEM INC0

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1HAMILTON HEALTH FIRST INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1168AddressLine1
CityDALTONCity
StateGAState
ZIP Code30722ZIPCode
FieldValueIRS element (for citing)
EIN581694713EIN
Primary ActivityPREFERRED PROVIDERPrimaryActivity
Legal Domicile StateGALegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
HAMILTON AMBULATORY SURGERY CENTER INC
A686500FMV
HAMILTON AMBULATORY SURGERY CENTER INC
N1425228FMV
HAMILTON AMBULATORY SURGERY CENTER INC
P909058FMV
HAMILTON PHYSICIANS GROUP INC
D2140000FMV