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MAGNOLIA MANOR OF ST SIMONS INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
MAGNOLIA MANOR OF ST SIMONS INC (EIN 20-1364957)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-02-10
IRS object ID
201140419349300119
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

FieldValueIRS element (for citing)
Timestamp2011-02-10T15:34:17-06:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Mauldin & Jenkins LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1P O Box 1877AddressLine1
CityMaconCity
StateGAState
ZIP Code312021877ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN201364957EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Magnolia Manor of St Simons IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMAGNNameControl
Phone2299249352Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12001 South Lee StreetAddressLine1
CityAmericusCity
StateGAState
ZIP Code31709ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMark ToddName
TitlePresidentTitle
Phone2299249352Phone
Date Signed2011-02-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRick AlibozekName
Phone4784648000Phone
Date Prepared2011-02-08DatePrepared
Self EmployedXSelfEmployed
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMark ToddNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12001 South Lee StreetAddressLine1
CityAmericusCity
StateGAState
ZIP Code31709ZIPCode
FieldValueIRS element (for citing)
Gross Receipts8821255GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.magnoliamanor.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2004YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionThe Corporation is organized to provide residential and long-term care services to the sick and elderly in a spirtual setting. The mission is accomplished through the operation of a 125-bed long term care facility and a 94-unit retirement community located on St. Simon's Island, Georgia.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees205TotalNbrEmployees
Total Nbr Volunteers32TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year9479609ProgramServiceRevenuePriorYear
Program Service Revenue CY8742718ProgramServiceRevenueCY
Investment Income Prior Year677InvestmentIncomePriorYear
Investment Income Current Year204InvestmentIncomeCurrentYear
Other Revenue Prior Year80671OtherRevenuePriorYear
Other Revenue Current Year78333OtherRevenueCurrentYear
Total Revenue Prior Year9560957TotalRevenuePriorYear
Total Revenue Current Year8821255TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4370293SalariesEtcPriorYear
Salaries Etc Current Year4069860SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year5544253OtherExpensePriorYear
Other Expenses Current Year5757035OtherExpensesCurrentYear
Total Expenses Prior Year9914546TotalExpensesPriorYear
Total Expenses Current Year9826895TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-353589RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1005640RevenuesLessExpensesCY
Total Assets BOY1564762TotalAssetsBOY
Total Assets EOY1888915TotalAssetsEOY
Total Liabilities BOY1852980TotalLiabilitiesBOY
Total Liabilities EOY3182773TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-288218NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-1293858NetAssetsOrFundBalancesEOY
Mission DescriptionThe Corporation is organized to provide long-term care to the sick and elderly in a spiritual setting through the operation of a 125-bed long-term care facility and a 94-bed retirement community.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense8386624Expense
Revenue8821051Revenue
DescriptionThe Corporation provided residential services to the sick and aged through the operation of a 125-bed long term care facililty and a 94-bed retirement community located in St. Simons, Georgia.Description
Total Program Service Expense8386624TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
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
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
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 Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109625NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees205NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
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
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
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 Approval0DecisionsSubjectToApproval
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 Other0CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Magnolia Manor IncBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2299249352TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12001 South Lee StreetAddressLine1
CityAmericusCity
StateGAState
ZIP Code31709ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
Cecil Abarr
Director1.00X000
Dr Hal Brady
Director1.00X000
James R Buchanan Jr
Chairman1.00X000X
John Gill
Vice Chairman1.00X000
Ann Harris
Director1.00X000
Mark Johnson
Director1.00X000
Eloise Paschal
Secretary1.00X000X
Hon J Taylor Phillips
Director1.00X000
Bob Reinhardt
Director1.00X000
Edie Vinson
Director1.00X000
George Youmans Sr
Director1.00X000
Dr Connie Blanchard
Director1.00X000
Wayne Johnson
Director1.00X000
Mark Todd
President/CEO3.0001843135323X
Jerry Vick
Senior Vice President Fi3.0001361087946X
Hill Fort
Senior Vice President Op3.0001460328450X
Diane Wade
Senior Vice President Ma3.000954236832X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs561876TotalReportableCompFrmRltdOrgs
Total Other Compensation28551TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Aegis Therapies Inc
One Thousand Beverly WayFort SmithAR72919Therapy services659215
Sterigen LLC
1769 Plains HighwayDawsonGA39842Laundry358434
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Medicare/Medicaid Paym62300048349484834948
Routine Room/Board62300039077703907770
FieldValueIRS element (for citing)
Total Program Service Revenue8742718TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column204TotalRevenueColumn
Exclusion$204ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Share of earning in Ph9000994925749257
Miscellaneous9000992169621696
Beauty Shop Revenue62300058125812

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column1568TotalRevenueColumn
Related Or Exempt Function Income1568RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue78333TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column8821255TotalRevenueColumn
Related Or Exempt Function Income8821051RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$204ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3368983Total
Program Services3037840ProgramServices
Management And General331143ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total25975Total
Program Services20718ProgramServices
Management And General5257ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total415188Total
Program Services392853ProgramServices
Management And General22335ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total259714Total
Program Services234061ProgramServices
Management And General25653ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total19586Total
Management And General19586ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total27436Total
Management And General27436ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total68500Total
Management And General68500ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1915Total
Management And General1915ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1980642Total
Program Services1980642ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total13194Total
Program Services5097ProgramServices
Management And General8097ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total3020Total
Management And General3020ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total67300Total
Program Services67300ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total125123Total
Management And General125123ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Contracted Services141124514036597586
Supplies63758960780029789
Raw Food402106402106
Georgia Provider fee379926379926
Management Fees352141352141

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total267312Total
Program Services234548ProgramServices
Management And General32764ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total9826895Total
Program Services8386624ProgramServices
Management And General1440271ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY27100BOY
EOY83084EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY5753EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY848998BOY
EOY1173377EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY18110BOY
EOY21203EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY190316BOY
EOY136451EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis635169LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec245114LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY415426BOY
EOY390055EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY64812BOY
EOY78992EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1564762BOY
EOY1888915EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY932441BOY
EOY884337EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY858300BOY
EOY548600EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY62239BOY
EOY1749836EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1852980BOY
EOY3182773EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-288218BOY
EOY-1293858EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-288218BOY
EOY-1293858EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1564762BOY
EOY1888915EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited0FSAudited
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8178751CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8612118CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years9962768CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9479609CurrentTaxYearMinus1Year
Current Tax Year8742718CurrentTaxYear
Total44975964Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8178751CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8612118CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years9962768CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9479609CurrentTaxYearMinus1Year
Current Tax Year8742718CurrentTaxYear
Total44975964Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50944975964PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5130CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7145CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3850CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year677CurrentTaxYearMinus1Year
Current Tax Year204CurrentTaxYear
Total17006Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5130CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7145CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3850CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year677CurrentTaxYearMinus1Year
Current Tax Year204CurrentTaxYear
Total17006Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years99129CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years154622CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years95350CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year80671CurrentTaxYearMinus1Year
Current Tax Year78333CurrentTaxYear
Total508105Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8283010CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years8773885CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10061968CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9560957CurrentTaxYearMinus1Year
Current Tax Year8821255CurrentTaxYear
Total45501075Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98850PublicSupportPercentage509
Prior Year Support Percentage0.98500PriorYearSupportPercentage
Investment Income Percentage0.00040InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00060PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis401719OtherCostOrOtherBasis
Depreciation142422Depreciation
Book Value259297BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis233450OtherCostOrOtherBasis
Depreciation102692Depreciation
Book Value130758BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings390055TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDue to Sponsoring organization and related entitiesDescription
Amount$1,749,836Amount
FieldValueIRS element (for citing)
Total Of Amounts1749836TotalOfAmounts

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 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
Mark Todd
018431300000005323018963600
Hill Fort
014603200000008450015448200

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section B, line 11The Form 990 was reviewed by the Organization's President and Senior Vice President for Finance prior to filing. The contents of the Form 990 were presented and explained to the members of the Executive Committee for their review and approval.
Form 990, Part VI, Section B, line 12cBoard members in general and the Finance Committee in particular are aware of potential conflicts of interest and consider these potential conflicts in making decisions.
Form 990, Part VI, Section B, line 15aThe Board of Directors establishes the CEO's salary based on industry norms and compensation studies for other similar type organizations. The CEO establishes compensation levels for other members of management.
Form 990, Part VI, Section C, line 19The Organization makes its governing documents, conflict of interest policy and Form 990 available to the public upon request.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNABusiness Name Line1DirectControllingEntityName/BusinessNameLine1Legal Domicile Foreign CountryLegalDomicileForeignCountry
Magnolia Manor Inc
2001 South Lee StreetAmericusGA31709580911706Management and operation of long-term care and retirement facilitiesGA501(c)(3)Line 9N/A
Magnolia Manor of Columbus Inc
2001 South Lee StreetAmericusGA31709208034409Lease and operation of 2 long-term care facilities and assisted living fac.GA501(c)(3)Line 9Magnolia Manor Inc
Magnolia Manor of Macon Supportive Housing Inc
2001 South Lee StreetAmericusGA31709311651955HUD Supportive Housing facilityGA501(c)(3)Line 9Magnolia Manor Inc
Magnolia Manor of Marion County Inc
2001 South Lee StreetAmericusGA31709201220860Lease and operation of a long-term care facilityGA501(c)(3)Line 9Magnolia Manor Inc
Magnolia Manor of Macon Inc
2001 South Lee StreetAmericusGA31709261311379Operation of an assisted living facilityGA501(c)(3)Line 9Magnolia Manor Inc
MMI Assurance Ltd
2001 South Lee StreetAmericusGA31709Captive insurance companyMagnolia Manor IncCJ

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Georgia Pharmacy Ventures LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1440 Industrial BoulevardAddressLine1
CityHawkinsvilleCity
StateGAState
ZIP Code31036ZIPCode
FieldValueIRS element (for citing)
EIN261918757EIN
Primary ActivityProvides pharmacy related products and services to Magnolia Manor residentsPrimaryActivity
Legal Domicile StateGALegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Magnolia Manor IncBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeRelatedPredominantIncomeType
Share Of Total Income49257ShareOfTotalIncome
Share Of EOY Assets127535ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
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 Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Georgia Pharmacy Ventures LLC
L240501
Magnolia Manor Inc
R1490340
Magnolia Manor of Marion County Inc
R80500
Magnolia Manor of Columbus Inc
R110956