CHATUGE REGIONAL HOSPITAL INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- CHATUGE REGIONAL HOSPITAL INC (EIN 58-2513901)
- Tax period
- 2009-05-01 to 2010-04-30
- Filed
- 2011-03-15
- IRS object ID
- 201100749349300600
- Schema version
- 2009v1.7
- 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 | 2011-03-15T05:59:56-05:00 | Timestamp |
| Tax Period End Date | 2010-04-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 Ridgefield Court | AddressLine1 |
| City | Asheville | City |
| State | NC | State |
| ZIP Code | 28806 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-05-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 582513901 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHATUGE REGIONAL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHAT | NameControl |
| Phone | 7068962222 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 SOUTH MAIN ST | AddressLine1 |
| City | HIAWASSEE | City |
| State | GA | State |
| ZIP Code | 30546 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Tim Henry | Name |
| Title | CFO | Title |
| Phone | 7064396493 | Phone |
| Date Signed | 2011-03-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Amy Bibby | Name |
| Phone | 8282542254 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Tim Henry | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 South Main St | AddressLine1 |
| City | Hiawassee | City |
| State | GA | State |
| ZIP Code | 30546 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 17947217 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1955 | YearFormation |
| State Legal Domicile | GA | StateLegalDomicile |
| Activity Or Mission Description | To provide high quality, cost effective health care and to promote wellness in our community. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 6 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 4 | NbrIndependentVotingMembers |
| Total Nbr Employees | 345 | TotalNbrEmployees |
| Total Nbr Volunteers | 42 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 10570 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 95081 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 18391436 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 17589144 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 61196 | InvestmentIncomePriorYear |
| Investment Income Current Year | 19607 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 201484 | OtherRevenuePriorYear |
| Other Revenue Current Year | 243385 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 18664686 | TotalRevenuePriorYear |
| Total Revenue Current Year | 17947217 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9219072 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 9232292 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 9223240 | OtherExpensePriorYear |
| Other Expenses Current Year | 8194739 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 18442312 | TotalExpensesPriorYear |
| Total Expenses Current Year | 17427031 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 222374 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 520186 | RevenuesLessExpensesCY |
| Total Assets BOY | 8843402 | TotalAssetsBOY |
| Total Assets EOY | 9374160 | TotalAssetsEOY |
| Total Liabilities BOY | 1997870 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2008442 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6845532 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 7365718 | NetAssetsOrFundBalancesEOY |
| Mission Description | To provide high quality, cost effective health care and to promote wellness throughout our community. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 16431084 | Expense |
| Revenue | 17660290 | Revenue |
| Description | THE COMMUNITY BENEFIT CONTRIBUTION OF CHATUGE REGIONAL HOSPITAL AND NURSING HOME IS PRIMARILY ATTRIBUTABLE TO THE PROVISION OF GENERAL HOSPITAL AND SKILLED NURSING CARE SUPPORTING THE COMMUNITY'S GENERAL PRACTICE, AND FAMILY PRACTICE PHYSICIANS. THESE SERVICES PROVIDE PRIMARY ACCESS TO HEALTH CARE SERVICES AND IMPROVE HEALTH IN OUR RURAL COMMUNITY.IN ORDER TO PORTRAY THE FULL BREADTH OF OUR CONTRIBUTION, OUR COMMUNITY BENEFIT INFORMATION IS DESCRIBED BELOW: SECTION 1: QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT - DESCRIBES THE HOSPITAL'S COMMUNITY BENEFIT MISSION, HOW THE MISSION IS TRANSLATED INTO A PROACTIVE APPROACH DESIGNED TO MEET COMMUNITY HEALTH NEEDS, HOW THE HOSPITAL MEETS TAX-EXEMPT REQUIREMENTS, AND A DESCRIPTION OF COMMUNITY BENEFIT PROGRAMS AND SERVICES THAT HIGHLIGHT THE HOSPITAL'S IMPACT ON COMMUNITY HEALTH. SECTION 2: QUANTITATIVE DESCRIPTION OF COMMUNITY BENEFIT - DESCRIBES THE HOSPITAL'S COMMUNITY BENEFIT CONTRIBUTION IN FINANCIAL TERMS PRESENTING THE AMOUNT OF CHARITY CARE AND BAD DEBTS, AND THE NET EXPENSE OF COMMUNITY BENEFIT SERVICES. SECTION 1 - QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT ORGANIZATIONAL COMMITMENT TO PROVIDING COMMUNITY BENEFIT:A. THE MISSION OF CHATUGE REGIONAL HOSPITAL AND NURSING HOME IS TO PROVIDE HIGH QUALITY, COST EFFECTIVE HEALTH CARE AND TO PROMOTE WELLNESS THROUGHOUT OUR COMMUNITY. OUR VISION IS TO BE THE "FIRST CHOICE" PROVIDER OF COMPREHENSIVE MEDICAL SERVICES IN OUR AREA. WE VALUE OUR PATIENTS AND RESIDENTS AND BELIEVE THEY ARE OUR MOST IMPORTANT RESPONSIBILITY. WE SHALL ALWAYS SEEK TO MEET THE PHYSICAL, EMOTIONAL, EDUCATIONAL AND SPIRITUAL NEEDS OF OUR PATIENTS AND THEIR FAMILIES. WE VALUE OUR MEDICAL STAFF AND WILL SEEK WAYS TO HELP THEM IMPROVE PROFESSIONALLY AND FACILITATE THE PRACTICE OF MEDICINE. WE VALUE OUR EMPLOYEES AND SHALL TREAT EACH OTHER WITH COURTESY, FAIRNESS, RESPECT AND INTEGRITY. WE SHALL WORK AS A TEAM TO DO OUR BEST TO PROMOTE OUR MISSION AND FULFILL OUR VISION. WE VALUE OUR COMMUNITY. WE ARE COMMITTED TO THE TREATMENT AND CARE OF OUR PATIENTS AND THE PROMOTION OF HEALTH AND WELLNESS IN OUR COMMUNITY. WE WILL CONFRONT ALL ETHICAL AND MORAL HEALTH-RELATED ISSUES NECESSARY TO ENHANCE THE QUALITY OF LIFE IN OUR COMMUNITY. WE VALUE QUALITY CARE AND WILL SEEK TO DELIVER CUSTOMER-FOCUSED, COST EFFICIENT SERVICES WITH COMPASSION AND CARING.CHATUGE REGIONAL HOSPITAL WAS DEEMED TO BE A CRITICAL ACCESS HOSPITAL IN EFFECTIVE MAY 1, 2002, BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) AND THE GEORGIA DEPARTMENT OF COMMUNITY HEALTH (DCH).B. CHATUGE REGIONAL HOSPITAL (CRH) IS THE ONLY ACUTE CARE HOSPITAL IN TOWNS COUNTY, GEORGIA. CRH IS LIMITED TO 25 ACUTE AND INTENSIVE CARE MEDICAL/SURGICAL BEDS FOR SHORT-TERM INPATIENT CARE. THE BEDS ALSO QUALIFY FOR "SWING BED" STATUS FOR SHORT-TERM SKILLED NURSING CARE. OUTPATIENT SERVICES INCLUDE RADIOLOGY, LABORATORY AND OTHER DIAGNOSTIC SERVICES, REHABILITATION SERVICES, AND 24/7 EMERGENCY MEDICAL SERVICES. THE CHATUGE REGIONAL NURSING HOME (CRNH) IS THE ONLY NURSING FACILITY IN THE COUNTY PROVIDING SKILLED AND INTERMEDIATE LEVELS OF LONG-TERM CARE. UCNH IS LICENSED FOR 112 BEDS AND CONSISTENTLY HAS A WAITING LIST FOR ADMISSIONS. A MAJORITY OF THE RESIDENTS OF CRNH ARE MEDICARE AND MEDICAID BENEFICIARIES. C. IT IS A LONG ESTABLISHED POLICY OF CRH TO PROVIDE QUALITY CARE FOR ITS PATIENTS REGARDLESS OF FINANCIAL CIRCUMSTANCES. QUALIFICATION FOR HOSPITAL INDIGENT CARE IS SET AT 125% OF THE CURRENT FEDERAL POVERTY GUIDELINES AND IS BASED ON SIZE OF THE FAMILY UNIT. CRH AND CRNH ALSO PROVIDE FREE OR REDUCED COST CARE TO ALL ELIGIBLE PERSONS REQUESTING CHARITY CARE ASSISTANCE. CRH AND CRNH BUDGETS AVAILABLE INDIGENT AND CHARITY CARE AT 3% OF OPERATING EXPENSES. PATIENTS REQUESTING INDIGENT OR CHARITY CARE ASSISTANCE MUST PROVIDE REASONABLE DOCUMENTATION INCLUDING PLACE OF EMPLOYMENT, GROSS INCOME, LIVING EXPENSE AND FAMILY SIZE. FOR EMERGENCY MEDICAL SERVICES, INCLUDING ACTIVE LABOR, NO PERSON WILL BE DENIED CARE DUE TO AN INABILITY TO PAY FOR SERVICES.SECTION 2 - ORGANIZATIONAL DESCRIPTION FOR TAX EXEMPTIONA. CRH OPERATES AN EMERGENCY DEPARTMENT 24 HOURS/DAY, 7 DAYS/WEEK THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY.B. CRH HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. C. CRH AND CRNH IS OWNED BY THE HOSPITAL AUTHORITY OF UNION COUNTY, ITS GOVERNING BODY COMPRISED OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY AND ARE APPOINTED BY UNION COUNTY SOLE COMMISSIONER.D. CRNH CONDUCTS CERTIFIED NURSING ASSISTANT (CNA) TRAINING COURSES TWICE ANNUALLY.E. CRH AND CRNH PARTICIPATES IN MEDICARE, MEDICAID, PEACHCARE, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS.SECTION 3 - DESCRIPTION OF COMMUNITY BENEFIT PROGRAMSA. CRH IN CONJUNCTION WITH ITS SISTER HOSPITAL, UNION GENERAL HOSPITAL, ARE THE ONLY TAX-EXEMPT, NON-PROFIT HOSPITALS WITHIN THE IMMEDIATE EIGHT COUNTY AREA OF THE NORTH CENTRAL AND NORTHEAST GEORGIA MOUNTAINS. DUE TO THE MOUNTAINOUS TERRAIN AND BEING BOUNDED BY THE CHATTAHOOCHEE NATIONAL FOREST AND LAKE CHATUGE, TOWNS COUNTY AND ITS NEIGHBORING CLAY COUNTY, NC HAS SOME VERY REMOTE COMMUNITIES FROM WHICH ACCESS TO MEDICAL CARE CAN LITERALLY BE MORE THAN HOUR AWAY IN SOME CASES. B. CRH IS A CRITICAL ACCESS HOSPITAL FOR THE RESIDENTS OF TOWNS COUNTY, GA. IN ADDITION, CRH SERVES THE MEDICAL NEEDS FOR CLAY COUNTY, NC, WHICH DOES NOT HAVE A COMMUNITY HOSPITAL.C. DUE TO THE MOUNTAINS ENCOMPASSING THE NATIONAL FOREST AND LAKE CHATUGE, TOWNS COUNTY ATTRACTS MANY VISITORS FOR CAMPING, HIKING, FISHING, AND HUNTING. THE TWISTING MOUNTAIN ROADS ATTRACT BICYCLISTS AND MOTORCYCLISTS THROUGHOUT THE SPRING, SUMMER AND FALL SEASONS. THESE ACTIVITIES MANY TIMES RESULT IN MEDICAL EMERGENCIES, SOME VERY SERIOUS, TO WHICH THE EMERGENCY DEPARTMENT OF CRH MUST BE PREPARED TO MEET.D. IN SEPTEMBER 2005, CRH ESTABLISHED A FAMILY MEDICAL PRACTICE IN HAYESVILLE, NC (CLAY COUNTY) TO HELP MEET THE MEDICALLY UNDERSERVED IN THE COMMUNITY. THE MEDICAL OFFICE IS STAFF WITH FAMILY NURSE PRACTITIONERS (FNPS) WITH PHYSICIAN SUPPORT FROM CRH'S EMERGENCY DEPARTMENT. | Description |
| Total Program Service Expense | 16431084 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 34 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 345 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 6 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 4 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | GA | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RICHARD L KELLEY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7068962222 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 SOUTH MAIN STREET | AddressLine1 |
| City | Hiawasee | City |
| State | GA | State |
| ZIP Code | 30546 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (10 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| JOE GRAY | ||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |
| DAVID BREEDLOVE MD | ||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |
| ERNIE PRUITT | ||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |
| JEFF PATTERSON | ||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |
| MAX COCHRAN | ||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |
| PATSY EFIRD | ||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |
| REBECCA T DYER | ||||||
| CEO | 40.00 | 0 | 123018 | 53327 | X | |
| J MICHAEL GOWDER DDS | ||||||
| COO | 40.00 | 0 | 121585 | 19457 | X | |
| TIMOTHY N HENRY | ||||||
| CFO | 40.00 | 0 | 119135 | 10677 | X | |
| R LEWIS KELLEY | ||||||
| ADMINISTRATOR | 40.00 | 125940 | 0 | 102 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 125940 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 363738 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 83563 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| STERLING EMERGENCY SERVICES | |||||
| PO BOX 758746 | BALTIMORE | MD | 21275 | ER DOCTORS | 986201 |
| MEDICAL ARTS HEALTH CARE | |||||
| PO BOX 102213 | ATLANTA | GA | 30368 | PHARMACY SERVICES | 170413 |
| QUEST DIAGNOSTICS | |||||
| PO BOX 740736 | ATLANTA | GA | 30374 | LABS | 156685 |
| ATLANTIC IMAGING | |||||
| PO BOX 54803 | ATLANTA | GA | 30308 | X-RAY IMAGING | 149825 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Related Organizations | 93000 | RelatedOrganizations |
| All Other Contributions | 2081 | AllOtherContributions |
| Total Contributions | 95081 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE RE | Description |
| Business Code | 623000 | BusinessCode |
| Total Revenue Column | 17589144 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17589144 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 17589144 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 19607 | TotalRevenueColumn |
| Exclusion | $19,607 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 172239 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 172239 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 172239 | TotalRevenueColumn |
| Exclusion | $172,239 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| CAFETERIA & VENDING | 722210 | 42763 | 42763 |
| SALE OF SUPPLIES/DRUGS | 446110 | 13934 | 13934 |
| MISCELLANEOUS | 900099 | 12431 | 12431 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2018 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2018 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 71146 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17947217 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17660290 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $191,846 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 126042 | Total |
| Program Services | 63021 | ProgramServices |
| Management And General | 63021 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7579143 | Total |
| Program Services | 7223371 | ProgramServices |
| Management And General | 355772 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28445 | Total |
| Program Services | 27110 | ProgramServices |
| Management And General | 1335 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 913172 | Total |
| Program Services | 870307 | ProgramServices |
| Management And General | 42865 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 585490 | Total |
| Program Services | 558007 | ProgramServices |
| Management And General | 27483 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66487 | Total |
| Management And General | 66487 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2220409 | Total |
| Program Services | 2210471 | ProgramServices |
| Management And General | 9938 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19947 | Total |
| Program Services | 19947 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2622003 | Total |
| Program Services | 2343797 | ProgramServices |
| Management And General | 278206 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 843489 | Total |
| Program Services | 703089 | ProgramServices |
| Management And General | 140400 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40412 | Total |
| Program Services | 30930 | ProgramServices |
| Management And General | 9482 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14437 | Total |
| Program Services | 14437 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 521837 | Total |
| Program Services | 521837 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 196941 | Total |
| Program Services | 196941 | ProgramServices |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT | 1617056 | 1617056 | |
| MISCELLANEOUS | 31721 | 30763 | 958 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17427031 | Total |
| Program Services | 16431084 | ProgramServices |
| Management And General | 995947 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1479438 | BOY |
| EOY | 2519601 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 264133 | BOY |
| EOY | 234133 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3196181 | BOY |
| EOY | 2316666 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 315316 | BOY |
| EOY | 316780 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 336592 | BOY |
| EOY | 331598 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 8121086 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4670469 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3251742 | BOY |
| EOY | 3450617 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 204765 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8843402 | BOY |
| EOY | 9374160 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1086643 | BOY |
| EOY | 1120418 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 91725 | BOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 225232 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 819502 | BOY |
| EOY | 662792 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1997870 | BOY |
| EOY | 2008442 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6845532 | BOY |
| EOY | 7365718 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6845532 | BOY |
| EOY | 7365718 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8843402 | BOY |
| EOY | 9374160 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
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 | 415739 | OtherCostOrOtherBasis |
| Book Value | 415739 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3547254 | OtherCostOrOtherBasis |
| Depreciation | 1505684 | Depreciation |
| Book Value | 2041570 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 109814 | OtherCostOrOtherBasis |
| Depreciation | 66985 | Depreciation |
| Book Value | 42829 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3971226 | OtherCostOrOtherBasis |
| Depreciation | 3097800 | Depreciation |
| Book Value | 873426 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 77053 | OtherCostOrOtherBasis |
| Book Value | 77053 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 3450617 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| CAPITAL LEASE OBLIGATIONS | $69,680 |
| ESTIMATED 3RD PARTY PAYOR SETTLEMENTS | $170,200 |
| INTERCOMPANY PAYABLES | $245,305 |
| PHYSICIANS RECRUITMENT | $177,607 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 662792 | TotalOfAmounts |
| Total Revenue | 17947217 | TotalRevenue |
| Total Expenses | 17427031 | TotalExpenses |
| Excess Or Deficit For Year | 520186 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | 520186 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 17947217 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 17947217 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 17947217 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 17427031 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 17427031 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 17427031 | TotalExpensesPerForm990 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 125.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 0 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 0 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 26511 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2467 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 24044 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3700516 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5501430 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -1800914 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3727027 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5503897 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -1776870 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10000 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6117 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3883 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5000 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 5000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15000 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6117 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8883 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3742027 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5510014 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -1767987 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00200 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $1,424,489 | BadDebtExpenseAmount |
| Amount Attributable To | 387525 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 4758776 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5196659 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -437883 | 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 | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | Critical Access HospitalCriticalAccessHospital | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|
| CHATUGE REGIONAL HOSPITAL INC | |||||||
| 110 SOUTH MAIN ST | HIAWASSEE | GA | 30546 | X | X | X | |
| CHATUGE REGIONAL NURSING HOME | |||||||
| 110 SOUTH MAIN ST | HIAWASSEE | GA | 30546 | NURSING HOME | |||
| HAYESVILLE FAMILY PRACTICE | |||||||
| 450 HWY 64 BUSINESS SUITE 4 | HAYESVILLE | NC | 28904 | FAMILY CLINIC | |||
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Footnote | Part III, Line 4: THERE IS NO FOOTNOTE ADDRESSING BAD DEBT IN THE ORGANIZATION'S FINANCIAL STATEMENTS.BASED ON EXPERIENCE, WE HAVE FOUND THAT THERE IS A POTION OF BAD DEBT THAT IS GENERALLY ATTRIBUTABLE TO CHARITY CARE. THE ORGANIZATION MULTIPLIED THE PORTION OF BAD DEBT ATTRIBUTABLE TO CHARITY BY THE COST TO CHARGE RATIO CALCULATED USING THE IRS SCHEDULE H WORKSHEETS. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: THIS SHORTFALL IS GENERATED PRIMARILY FROM PROVIDING EMERGENCY PHYSICIAN SERVICES AND SHOULD COUNT 100% TOWARD COMMUNITY BENEFIT EXPENSE. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: ONCE THE PATIENT IS APPROVED FOR INDIGENT CARE (100% WRITE OFF) THE ACCOUNT(S) IS (ARE) RECLASSED TO INDIGENT CARE AND NO FURTHER COLLECTION ACIVITY IS CONDUCTED. FOR PATIENTS APPROVED FOR CHARITY CARE (REDUCED CHARGE), THE ACCOUNT GUARANTOR WILL RECEIVE STATEMENTS AND PHONE CALLS TO COLLECT THE REMAINING BALANCE DUE. | DebtCollectionPolicy |
| Needs Assessment | Part VI, Line 2: THE ORGANIZATION PRIMARILY SOLICITS FEEDBACK FROM THE MEDICAL STAFF AND CITY AND COUNTY OFFICIALS | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: NOTICES ARE PUBLISHED IN THE LOCAL COMMUNITY NEWSPAPER. ACCOUNT COLLECTORS INFORM THE ACCOUNT GUARANTOR OF THE AVAILABILITY OF INDIGENT AND CHARITY CARE. THE ORGANIZATION MAILS OUT APPLICATIONS FOR FINANCIAL AIDE BUT RECEIVES A LIMITED NUMBER RETURNED. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: THE ORGANIZATION SERVES A GENERALLY RURAL MOUNTAINOUS AREA AND IS THE SOLE HOSPITAL IN THE COUNTY. TOWNS COUNTY IS DEEMED TO HAVE A MEDICALLY UNDERSERVED POPULATION (MUP) BY THE GEORGIA DEPARTMENT OF COMMUNITY HEALTH. | CommunityInformation |
| Other Information | Part VI, Line 6: THE ORGANIZATION CONDUCTS HEALTH FAIRS OPEN TO THE COMMUNITY WHEREIN FREE HEALTH SCREENINGS AND LOW-COST BASIC LAB TESTS ARE DONE. OTHER HEALTH INFORMATION IS PROVIDED INCLUDING INFORMATION ON SMOKING CESSATION AND DIABETES. THE ORGANZATION IS ENTIRELY TOBACCO-FREE, THUS PROMOTING A HEALTHY LIFESTYLE.SURPLUS FUNDS ARE USED TO PROVIDE FOR THE ADDITION, IMPROVEMENT, OR REPLACEMENT OF CAPITAL AND EQUIPMENT NEEDS. | OtherInformation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REBECCA T DYER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Base Compensation Filing Org | 0 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 123018 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 0 | BonusFilingOrg |
| Bonus Related Orgs | 0 | BonusRelatedOrgs |
| Other Compensation Filing Org | 0 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 0 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 0 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 49000 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 0 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 4327 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 0 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 176345 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
| Comp Report Prior990 Related Orgs | 0 | CompReportPrior990RelatedOrgs |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section B, line 11 | The CFO provided a copy of the 990 to each board member and reviewed it in detail at a Board meeting prior to filing the return. |
| Form 990, Part VI, Section B, line 12c | OFFICERS, DIRECTORS, AND TRUSTEES ARE REQUIRED TO SIGN A STATEMENT REGARDING CONFLICT OF INTEREST ANNUALLY. |
| Form 990, Part VI, Section B, line 15a | The organization uses The Georgia Association compensation study as a benchmark for all executive compensation. The Board approves the CEO's compensation. All other executive compensation is managed by the CEO. |
| Form 990, Part VI, Section C, line 19 | The organization's governing documents, conflict of interest policy, and financial statements are made available by request. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|
| UNION GENERAL HOSPITAL INC | |||||||||
| 214 HOSPITAL CIRCLE | BLAIRSVILLE | GA | 30512 | 586025393 | HOSPITAL | GA | 501(C)(3) | Line 3 | N/A |
| MOUNTAIN COMMUNITY HEALTHCARE FOUNDATION | |||||||||
| PO BOX 509 | HIAWASSEE | GA | 30546 | 201376498 | SUPPORT | GA | 501(C)(3) | Line 11b, II | N/A |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |