2012-12-20T09:03:08-06:00 2012-06-30 580692043 Mauldin & Jenkins LLC P O Box 1877 Macon GA 312021877 990 2011-07-01 201220860 Magnolia Manor of Marion County Inc MAGN 2299249352 2001 South Lee Street Americus GA 31709 Mark Todd 2299249352 2012-12-17 1 Rick Alibozek P00108158 4784648000 2012-12-17 X 2011 2016-02-24 21:20:13Z Mark Todd 2001 South Lee Street Americus GA 31709 4433352 0 X www.magnoliamanor.com X 2004 GA The Corporation is organized to provide long-term care to the sick and elderly in a spiritual setting through a 70-bed skilled nursing facility located in Buena Vista, Georgia. 11 11 86 28 0 0 0 0 4191696 4354128 772 870 102026 78354 4294494 4433352 0 0 0 0 1748267 1801890 0 0 0 1416690 1392968 3164957 3194858 1129537 1238494 5192603 6429227 255647 253777 4936956 6175450 The Corporation is organized to provide long-term care to the sick and elderly in a spiritual setting through a 70-bed skilled nursing facility located in Buena Vista, Georgia. 0 0 2536457 4416650 Provided long-term care for the sick and elderly in a spiritual setting in a 70-bed skilled nursing facility. The Organization provided 21,445 patient days of service during the year. 2536457 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 7 0 86 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 1 1 GA X The Organization 2299249352 2001 South Lee Street Americus GA 31709 James R Buchanan Jr 0.00 X 0 0 0 Eloise Paschal 0.00 X X 0 0 0 Ann Harris 0.00 X 0 0 0 Mark Johnson 0.00 X X 0 0 0 Hon J Taylor Phillips 0.00 X 0 0 0 Edie Vinson 0.00 X 0 0 0 Dr Connie Blanchard 0.00 X 0 0 0 John Stephens 0.00 X 0 0 0 Jean Wheeler 0.00 X 0 0 0 Chuck Reeves 0.00 X 0 0 0 Kip Smith 0.00 X 0 0 0 Mark Todd 40.00 X 0 223846 9976 Jerry Vick 40.00 X 0 164769 8771 Hill Fort 40.00 X 0 176784 9025 Diane Wade 40.00 X 0 107789 7288 0 673188 35060 0 0 1 0 Integra Rehabilitation Co Inc 1013 Riverburch Parkway Ste 2 Dalton GA 30721 Rehabilitation Services 104128 1 Medicare/Medicaid Paym 623000 4115828 4115828 Routine Room/Board 623000 238300 238300 4354128 870 870 56243 0 56243 56243 56243 Share of LLC investmen 900099 15832 15832 Food Sale Revenue 623000 5008 5008 Miscellaneous 623000 1271 1271 22111 4433352 4416650 0 16702 1438395 1302584 135811 33703 31493 2210 216960 207360 9600 112832 102366 10466 9144 9144 2155 2155 18974 18974 1440 1440 310501 310501 5796 3189 2607 17828 17828 53596 53596 Georgia Provider Fee 271911 271911 Contracted Services 198206 198206 Supplies 192555 192555 Raw Food 132888 132888 177974 37487 140487 3194858 2536457 658401 0 67515 42013 221220 181076 4290 4981 9810 8678 270564 45513 155601 225051 44386 33218 4689781 5934210 5192603 6429227 255647 253777 255647 253777 X 4936956 6175450 4936956 6175450 5192603 6429227 1238494 0 X X 0 1 1 X 0 X 3791163 3633828 3813848 4191696 4354128 19784663 3791163 3633828 3813848 4191696 4354128 19784663 0 0 0 19784663 63218 57012 61821 67241 57113 306405 63218 57012 61821 67241 57113 306405 4888 5227 30524 32934 22111 95684 3859269 3696067 3906193 4291871 4433352 20186752 0.98010 0.97850 0.01520 0.01650 X 5500 1650 3850 265064 43863 221201 225051 Related party accounts receivable 5934210 5934210 Description of Uncertain Tax Positions Under FIN 48: Part X: It is the Organization's policy to account for any uncertainties in income tax law in accordance with FASB ASC 740-10 'Accounting for Uncertainty in Income Taxes.' ASC 740-10 clarifies the accounting for uncertain income tax positions and requires that the Organization recognize the impact of such a tax position in its financial statements if, upon ultimate settlement, that position is more likely than not to be sustained. Management has evaluated the Organization's tax positions and concluded that the Organization has maintained its tax-exempt status and has taken no uncertain tax positions that require adjustment of the financial statements. X 0 0 0 0 0 0 0 0 0 Mark Todd 0 223846 0 0 0 0 0 4477 0 5499 0 233822 0 0 Jerry Vick 0 164769 0 0 0 0 0 3295 0 5476 0 173540 0 0 Hill Fort 0 176784 0 0 0 0 0 3536 0 5489 0 185809 0 0 Form 990, Part VI, Section A, line 3 Magnolia Manor, Inc., a related Section 501(c)(3) organization, provided certain management services to the Organization. Form 990, Part VI, Section B, line 11 The Form 990 was reviewed by the Organization's President and Senior Vice President for Finance prior to filing. A copy of the Form 990 was also provided to all members of the Executive Committee of the Board of Trustees for their review and approval. Form 990, Part VI, Section B, line 12c Board members in general and Finance Committee members in particular are aware of potential conflicts and consider these potential conflicts in making decisions. Form 990, Part VI, Section B, line 15a The CEO is paid entirely from a related tax-exempt organization. The Board of Trustees establishes the CEO's salary based on industry norms and compensation studies for other similar type organizations. Form 990, Part VI, Section C, line 18 The Organization will make its Form 1023 and Form 990 available to the public upon request at the Magnolia Manor, Inc. Corporate office in Americus, Georgia. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request at the Magnolia Manor, Inc. Corporate office in Americus, Georgia. Form 990, Part XII, Line 2c The process for the review and oversight of the audit process and audited financial statements has not changed from the prior year. Magnolia Manor Inc 2001 S Lee Street Americus GA 31709 580911706 Elderly affordable long-term care and assisted living GA 501(c)(3) Line 9 None 0 Magnolia Manor of St Simons Inc 2255 Frederica Rd St Simons Island GA 31522 201364957 Elderly affordable long-term care and assisted living GA 501(c)(3) Line 9 Magnolia Manor Inc 0 Magnolia Manor of Macon Supportive Housing Inc 190 Pierce Ave Macon GA 31204 311651955 HUD supportive housing GA 501(c)(3) Line 9 Magnolia Manor Inc 0 Magnolia Manor of Columbus Inc 2010 Warm Springs Rd Columbus GA 31904 208034409 Elderly affordable long-term care and assisted living GA 501(c)(3) Line 9 Magnolia Manor Inc 0 Magnolia Manor of Macon Inc 190 Pierce Ave Macon GA 31204 261311379 Elderly assisted living GA 501(c)(3) Line 9 Magnolia Manor Inc 0 Georgia Pharmacy Ventures LLC 440 Industrial Boulevard Hawkinsville GA 31036 261918757 Provision of pharmacy-related products and services GA Magnolia Manor Inc Related 15832 49358 0 0 0.07500 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1