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NORTHEAST GEORGIA PHYSICIANS GROUP INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
NORTHEAST GEORGIA PHYSICIANS GROUP INC (EIN 58-2078064)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-14
IRS object ID
201142269349300424
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)
Timestamp2011-08-14T20:32:49-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Pershing Yoakley & Associates P CBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1One Cherokee Mills 2220 SutherlandAddressLine1
CityKnoxvilleCity
StateTNState
ZIP Code379192363ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN582078064EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1NORTHEAST GEORGIA PHYSICIANS GROUP INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNORTNameControl
Phone7702196646Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1743 SPRING STREETAddressLine1
CityGAINESVILLECity
StateGAState
ZIP Code305013899ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameAnthony HerdenerName
TitleVice President/CFOTitle
Phone7702196646Phone
Date Signed2011-08-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone8656730844Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCarol BurrellNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1743 SPRING STREETAddressLine1
CityGAINESVILLECity
StateGAState
ZIP Code305013899ZIPCode
FieldValueIRS element (for citing)
Gross Receipts39316361GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.NGHS.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1993YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionNORTHEAST GEORGIA PHYSICIANS GROUP (NGPG) IS COMMITTED TO IMPROVING THE HEALTH (SEE SCHEDULE O) of OUR COMMUNITY IN ALL WE DO THROUGH THE PROVISION OF PHYSICIAN PRIMARY CARE, SPECIALTY AND URGENT CARE SERVICES.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members4NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI14159TotalGrossUBI
Net Unrelated Business Txbl Income-180NetUnrelatedBusinessTxblIncome
Contributions Grants Current Year1445ContributionsGrantsCurrentYear
Program Service Revenue Prior Year26785876ProgramServiceRevenuePriorYear
Program Service Revenue CY38355979ProgramServiceRevenueCY
Investment Income Prior Year1011InvestmentIncomePriorYear
Investment Income Current Year-207InvestmentIncomeCurrentYear
Other Revenue Prior Year736176OtherRevenuePriorYear
Other Revenue Current Year784999OtherRevenueCurrentYear
Total Revenue Prior Year27523063TotalRevenuePriorYear
Total Revenue Current Year39142216TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year500GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year29004849SalariesEtcPriorYear
Salaries Etc Current Year40090055SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year14847577OtherExpensePriorYear
Other Expenses Current Year19089169OtherExpensesCurrentYear
Total Expenses Prior Year43852926TotalExpensesPriorYear
Total Expenses Current Year59179224TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-16329863RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-20037008RevenuesLessExpensesCY
Total Assets BOY18331717TotalAssetsBOY
Total Assets EOY20153789TotalAssetsEOY
Total Liabilities BOY2192071TotalLiabilitiesBOY
Total Liabilities EOY3953297TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY16139646NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY16200492NetAssetsOrFundBalancesEOY
Mission DescriptionWE ARE COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITY IN ALL WE DO through the PROVIsion of PHYSICIAN PRIMARY CARE, SPECIALTY AND URGENT CARE SERVICES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense56479605Expense
Revenue38355979Revenue
DescriptionNortheast Georgia Physicians Group, Inc. (NGPG) is a tax-exempt affiliate of Northeast Georgia Health System. NGPG is a multi-specialty group of physicians, physician assistants, nurse practitioners and other clinical staff members serving the Northeast Georgia geographic service area at more than 20 locations. Services include primary care and a wide range of specialty services.See Schedule O for Program Service Accomplishments ContinuationDescription
Total Program Service Expense56479605TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
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 Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
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
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members4NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
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

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1LINDA D NICHOLSONCONTROLLERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7702196646TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1743 SPRING STREETAddressLine1
CitygainesvilleCity
StateGAState
ZIP Code305013899ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (32 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
James Jackson
MEMBER, NGPG Physician40.00X030241118998
Jeffery Black
MEMBER, NGPG Physician40.00X026330130733
Paul Vervalin
VP - NGHS & CAO, NGCP President1.00X033241162869X
James Bailey
VP - NGHS1.00X062060217562X
Antonio Rios
Physician Executive & Chairperson40.00X027433035215X
Robert Taylor
Member, NGPG Physician40.00X018706534959
Eric Bohn
Member, NGPG Physician40.00X023658637136
JOhn Alsobrook
Member, NGPG Physician40.00X023400125240
Steven Accarino
Member, NGPG Physician40.00X041000329087
Lorry Schrage
Member1.00X000
Brent Hoffman
member1.00X000
Denise Deal
Member1.00X000
Doug Carter
Member1.00X000
Olivia Erbele Skey
Member1.00X000
ERNST NIEuWOUDT
Member, NGPG Physician40.00X025649428744
Jack Keener
member1.00X000
JAMES GARDNER
President & CEO1.000904800523546X
CAROL BURRELL
VP - NGMC & COO1.000490527233089X
Anthony HErdener
VP - NGHS & CFO1.000464211169906X
Mark Klein
Director - Administrative40.00011992122508X
Dane Henry
VP - NGHS1.00022761933042X
Joseph Fulbright
VP - NGHS1.00023862561463X
Tracy Vardeman
VP - NGHS1.00020066559262X
Tina Walden
Executive Director40.00013094024497X
Sandra Johnson
VP - NGHS1.00000X
Allana Cummings
VP - NGHS & CIO1.00000X
James Walker
VP - NGHS1.00000X
Ahmed Abdussalam
NGPG Physician40.00035310823178X
Joe Clements
NGPG Physician40.00037809628330X
John Gorecki
NGPG Physician40.00047546113744X
Darlene Lobel
NGPG Physician40.00035740312013X
James Varnell
NGPG Physician40.0003154676389X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs7774047TotalReportableCompFrmRltdOrgs
Total Other Compensation1531510TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
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
MD SOLUTIONS INC
ONE WESTINGHOUSE PLAZABOSTONMA02136CONSULTING1519365
GAINESVILLE EMERGENCY DEPT SVC
PO BOX 2938GAINESVILLEGA30503PHYSICIAN FEES/MED DIR FEES1416465
GE HEALTHCARE
PO BOX 640200PITTSBURGHPA15264S/W AND EQUIP MAINTENANCE282521
ALLSCRIPTS LLC
2297 PAYSHERE CIRCLECHICAGOIL60674S/W SUPPORT203311
HALL COUNTY HEALTH DEPT
1290 Athens StreetGAINESVILLEGA30507MIDWIFE SERVICES200400
FieldValueIRS element (for citing)
Number Of Contractors GT100 K6NumberOfContractorsGT100K
Government Grants1445GovernmentGrants
Total Contributions1445TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT REVENUE6214003745202437452024
OTHER OPERATING REVENU900099889796889796
BILLING SERVICES5419001415914159
FieldValueIRS element (for citing)
Total Program Service Revenue38355979TotalProgramServiceRevenue

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real956095Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real171096Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real784999Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column784999TotalRevenueColumn
Exclusion$784,999ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other2842Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other3049Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-207Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-207TotalRevenueColumn
Exclusion-$207ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column39142216TotalRevenueColumn
Related Or Exempt Function Income38341820RelatedOrExemptFunctionIncome
Unrelated Business Revenue14159UnrelatedBusinessRevenue
Exclusion$784,792ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1939053Total
Program Services1845009ProgramServices
Management And General94044ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total32046764Total
Program Services30492496ProgramServices
Management And General1554268ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total736979Total
Program Services701236ProgramServices
Management And General35743ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3422321Total
Program Services3256338ProgramServices
Management And General165983ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1944938Total
Program Services1850609ProgramServices
Management And General94329ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total18602Total
Program Services17700ProgramServices
Management And General902ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5480526Total
Program Services5214720ProgramServices
Management And General265806ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total77170Total
Program Services73427ProgramServices
Management And General3743ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3954014Total
Program Services3762244ProgramServices
Management And General191770ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total118872Total
Program Services113107ProgramServices
Management And General5765ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total148528Total
Program Services141324ProgramServices
Management And General7204ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1376517Total
Program Services1309756ProgramServices
Management And General66761ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total366165Total
Program Services348406ProgramServices
Management And General17759ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE27237542723754
SUPPLIES1360421129444165980
SOFTWARE MAINTENANCE1129943107514154802
Medical Supplies793223793223
RENTAL & MAINTENANCE53797551188326092

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1003459Total
Program Services954791ProgramServices
Management And General48668ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total59179224Total
Program Services56479605ProgramServices
Management And General2699619ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY193724BOY
EOY133985EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2675864BOY
EOY3679047EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY35769BOY
EOY64054EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis30705335LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec14428632LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY15422209BOY
EOY16276703EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4151BOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY18331717BOY
EOY20153789EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2143144BOY
EOY3953297EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY48927BOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2192071BOY
EOY3953297EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY16139646BOY
EOY16200492EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY16139646BOY
EOY16200492EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY18331717BOY
EOY20153789EOY
FieldValueIRS element (for citing)
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)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1Northeast Georgia Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
EIN581694098EIN
Type Of Organization3TypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$0Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$8,352OtherActivitiesAmount
Total Lobbying Expenditures IIB8352TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1i:Identifier
Return ReferenceExplanation of Other Lobbying Activities:ReturnReference
ExplanationNortheast Georgia Physicians Group, INc. pays membership dues to several professional and trade associations such as Medical Association of Georgia and MGMA. A portion of these dues are designated for lobbying activities by these organizations.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2841176OtherCostOrOtherBasis
Book Value2841176BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis14827236OtherCostOrOtherBasis
Depreciation6195352Depreciation
Book Value8631884BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1041680OtherCostOrOtherBasis
Depreciation650888Depreciation
Book Value390792BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis9811531OtherCostOrOtherBasis
Depreciation6720350Depreciation
Book Value3091181BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2183712OtherCostOrOtherBasis
Depreciation862042Depreciation
Book Value1321670BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings16276703TotalOfBookValueLandBuildings

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
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 Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (22 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
James Jackson
0266760025000331510186230375032140900
Jeffery Black
0242047010749010505014216016517029403400
Paul Vervalin
0224937081673025801041077021792039528000
James Bailey
05780230200000225790857508987063816400
Antonio Rios
0234197026052014081016730018485030954500
Robert Taylor
0137420038065011580018685016274022202400
Eric Bohn
0192012027922016652020863016273027372200
JOhn Alsobrook
01983920250003310908314016926025924100
Steven Accarino
03757030003430008575020512043909000
ERNST NIEuWOUDT
0175510064375016609014734014010028523800
JAMES GARDNER
0476216037188005670404888010347450142834600
CAROL BURRELL
029925601403350509360209523023566072361600
Anthony HErdener
027055401261300675270139628030278063411700
Dane Henry
01613670623790387302504807994026066100
Joseph Fulbright
01346400852510187340487720126910300088080393
Tracy Vardeman
0125988047446027231037596021666025992700
Tina Walden
0120816087310139307386017111015543700
Ahmed Abdussalam
03423200001078807119016059037628600
Joe Clements
03449340003316208575019755040642600
John Gorecki
03671370100000083240551708227048920500
Darlene Lobel
02905030457000212000855503458036941600
James Varnell
0305565000990206300089032185600

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 4b:ReturnReference
ExplanationPart I, Line 4b: Employer Contribution to 457(f) executive retirement benefit plan James Gardner $467,821 Anthony Herdener $108,261 Carol Burrell $182,225 Dane Henry $ 22,557 Joseph Fulbright $ 21,950 Tracy Vardeman $ 21,164 Paul VerValin $ 32,502 Payout from 457(f) Plan (including vested earnings on previously reported compensation) Joseph Fulbright $85,251Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Chestnut Mountain Family Medicine LLCBusinessNameLine1
FieldValueIRS element (for citing)
RelationshipEric Bohn, Board Member owns 33% of LLCRelationship
Amount Of Transaction275283AmountOfTransaction
Description Of TransactionNortheast Georgia Physicians Group, Inc. pays fair market rent to Chesnut Mountain Family Medicine, LLC. Eric Bohn, Board Member of the organization owns 33% of Chesnut Mountain Family Medicine.DescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section A, line 6Northeast Georgia Health System, Inc. is the sole member of Northeast Georgia Physicians Group, Inc.
Form 990, Part VI, Section A, line 7aSix members of the Board of Directors of Northeast Georgia Physicians Group, Inc. are appointed by the Board of Northeast Georgia Health System, Inc. - a related 501(c)(3) organization. Four other members serve on the board by virtue of their office at Northeast Georgia Health System, Inc. The remaining board members are elected by physicians employed by the organization.
Form 990, Part VI, Section A, line 7bSix members of the Board of Directors of Northeast Georgia Physicians Group, Inc. are appointed by the Board of Northeast Georgia Health System, Inc. - a related 501(c)(3) organization. Four other members serve on the board by virtue of their office at Northeast Georgia Health System, Inc. The remaining board members are elected by physicians employed by the organization.
Form 990, Part VI, Section B, line 11Information for the Form 990 was provided to an independent certified public accountant for preparation of return. After the return was prepared, it was reviewed by senior financial management. The 990 is made available to members of the board prior to filing.
Form 990, Part VI, Section B, line 12cBoard members are required to complete a conflict of interest questionnaire annually. Employees attest to their understanding and reporting/disclosure requirements at hire and annually. Compliance is monitored continuously throughout the year by the board.
Form 990, Part VI, Section B, line 15The compensation committee of the Northeast Georgia Health System Board (NGHS Board) has developed and installed compensation policies and procedures that seek to further the purpose of NGHS and affiliates and the importance of these policies to attract and retain key employees. The compensation committee is composed entirely of directors who are not employees of NGHS. All decisions of the compensation committee are reviewed and ratified by the NGHS Board. The committee's methodology and approach incorporates both qualitative and quantitative considerations, which are reflected in the committee's determinations concerning key employee compensation and the specific components thereof. The compensation decisions of the committee are described below as to each of the three categories. Base Salary Annual base salaries are set at competitive levels with healthcare institutions of a similar size and complexity from throughout the country. Specifically the committee considers peer group comparisons from survey data for other health systems, recommendations from an independent compensation consultant, and individual performance assessments for each position. In each instance the committee members reach a consensus based on the combination of available information, and the committee sets a base salary level for each key employee. Performance Based Variable Compensation Numerous performance goals are quantitative in nature, resulting in a performance based variable compensation component that is weighted toward attaining NGHS Board-approved goals and objectives. Annual goals and objective are established through a formal planning process involving board and community members. The board approves theses goals and objectives at the beginning of each year. Officers and key employees receive cash awards as a formula driven percentage of base salary levels based on achievement and predetermined individual objectives. Benefits and Retention Programs Benefit categories and amounts are determined by a comparison process similar to determining base salaries with positions and organizations similar to NGHS. Included in benefits are retirement programs to enhance retention and progress toward long-term goals within NGHS' mission.
Form 990, Part VI, Section C, line 19Financial statements and statistics are filed quarterly with Digital Assurance Certification, LLC (DAC Bond). DAC Bond serves as a disclosure dissemination agent for issuers of municipal bonds electronically posting and transmitting information to repositories and investors. All other items are available upon request.
Form 990, Part III. Line 4A, Program Service Accomplishments:Located in the northeastern section of the state in Hall County, Northeast Georgia Medical Center (NGMC) is a 557-bed not-for-profit regional referral facility that provides a comprehensive range of acute care and specialty services. Through its role as a regional safety net hospital, NGMC serves the area's low-income, uninsured, underinsured and other vulnerable populations. Approximately half of NGMC's patients come from outside of Hall County. As a not-for-profit hospital, NGMC reinvests all funds in excess of operating expenses into healthcare services for the community. The Medical Center receives no operating funds from Hall or other counties served, and services are funded by revenue generated from operations. NGMC provided indigent care to Hall County residents at a cost of $16 million in 2010, with another $9 million provided to regional residents outside Hall County. The Medical Center's charity care policy provides financial assistance up to 400 percent of the poverty level - double the amount generally provided by other hospitals across the State. The hospital is a key participant and fiscal sponsor in programs aimed at treating low-income and uninsured patients, including the Good News Clinics, the largest free health care clinic in Georgia, and Health Access Initiative (HAI), a local service that matches financially eligible patients to specialty physicians and provides access to care, among other services. Additionally: - Located in Georgia's fastest growing region , the 59-year-old hospital has expanded considerably in recent years to meet demand and update its aging plant, investing a quarter of a billion dollars in its facilities; - NGMC's quality of care is often awarded, and the hospital ranks among the top in the state for cardiac services; - Since 2000, NGMC has provided nearly three times the amount of indigent and charity care set forth in requirements by the Georgia Department of Community Health for successful passage of a certificate of need for new services, and, unlike many Georgia not-for-for profit hospitals held to the same requirements, NGMC does not receive tax funding from its local county to help fund indigent care to area residents; - NGMC is the primary hospital for low-income patients in Gainesville-Hall County and throughout the region in counties such as Banks, Lumpkin, and White, where many key medical specialties are not available. NORTHEAST GEORGIA MEDICAL CENTER NGMC provided the sixth highest dollar amount of indigent/charity care in the state in 2009. NGMC serves as a financial engine for its local economy. In 2009 (latest numbers available), the hospital generated nearly a billion dollars in revenue for the local economy, according to a report by the Georgia Hospital Association, which applied an economic multiplier to the hospital's direct expenditures to account for the "ripple" effect the hospital's spending has on other sectors of the local economy. Applying an employment multiplier, the report found that the hospital sustained more than 8,000 jobs in 2009 in addition to the more than 4,000 employed directly by Northeast Georgia Health System. Under the Internal Revenue Code, a tax-exempt organization, classified as a 501(c)(3) charity, is required to: have a mission that will benefit its community; reinvest all surplus funds in the organization in a way that benefits the community; compensate executives, contractors and other employees in accordance to fair market value; remain accountable to the community; refrain from participating in political campaigns for or against candidates; refrain from lobbying as a substantial part of its activities; and, remain financially accountable to the community by not allowing any portion of its net earnings to benefit any private shareholder or individual. As a not-for-profit hospital, NGMC carries additional responsibilities, as established by the IRS in 1969: - Operate a full-time emergency room that is available to all people, regardless of their ability to pay; - NGMC operates the 6th busiest ER in Georgia. In 2010, approximately 26% of all NGMC's emergency room visits were made by self-pay patients. - Provide non-emergency services to anyone able to pay; - Northeast Georgia Health System provides high quality, advanced specialty and primary healthcare services to the Northeast Georgia community, serving almost 700,000 people in more than 13 counties. In FY2010, NGMC's payor mix was 55% Medicare/Medicaid, 33% commercial insurance and 12% self-pay. - Participate in Medicaid and Medicare; - 55% of patients served by NGMC in FY10 were Medicaid and Medicare patients. - Create a governing board that is representative of the community it serves; - More than 75 community members are actively involved in governance through Northeast Georgia Health System, NGMC and other subsidiary boards and committees. - Allow medical staff privileges to any professional who is qualified and applies; and, - NGMC extends open medical staff privileges to qualified physicians for most services such as pathology, radiology and anesthesiology. - Reinvest surplus funds in operations. - As not-for-profit organizations, NGMC and its parent organization, Northeast Georgia Health System, reinvest all revenue generated above operating expenses into the community through new facilities, such as the North Patient Tower and Women and Children's Pavilion, and in new advanced technology, such as the region's first 3T MRI, the State's first Stereotaxis Odyssey magnetic catheterization system and Region 2's only hyperbaric oxygen therapy chamber. NGMC participates in the Indigent Care Trust Fund (ICTF), a 20-year-old program that expands Medicaid eligibility and services, supports rural health care facilities that serve the medically indigent and funds primary health care programs for medically indigent Georgians. Georgia's Disproportionate Share Hospital (DSH) program is funded through the ICTF, and assists hospitals and other health providers that care for high proportions of Medicaid, uninsured and/or low-income patients. In 2010, NGMC received $8,308,587 in net funds allocated through the ICTF and DSH program to partially offset a financial loss of $41.5 million in cost the Medical Center incurred treating uninsured and Medicaid patients.
COMMUNITY BENEFITS Situated in a region with an uninsured rate that is higher than the state average, area health consumers can face significant barriers in affording care. NGMC has significantly contributed to local programs that aim to address these issues, primarily through its support of the Good News Clinics and Health Access Initiative (HAI). NGMC provided the sixth highest dollar amount of indigent/charity care in the state in 2009. Good News Clinics Within Hall County, there are several low-cost alternatives to help people avoid choosing the hospital's emergency department for primary care services. Serving as the largest free clinic in Georgia, the Good News Clinics offers primary medical, ophthalmology services and dental care, as well as medications to indigent, homeless and low-income individuals at or below 150 percent of the Federal Poverty Level in Hall County who have no healthcare insurance and cannot afford his or her medical care. All services are provided free of charge, even though the clinic receives no federal, state or local government funding. Patients who need specialty care are referred to Health Access Initiative. Since 1999, NGMC has provided $2,982,307 in support of Good News Clinics I and an average annual support of $307,002 from FY2007-2010. In 2010, NGMC contributed over $350,000 in financial support. Hall County Medical Society's Health Access Initiative Launched in 2003, Hall County's Health Access Initiative (HAI) is a referral service founded by the Hall County Medical Society that matches financially eligible patients to physicians who have volunteered to provide free treatment to patients who qualify for services, provides help with obtaining medications and offers ancillary services such as x-rays and translation services. HAI also provides ancillary services and outreach education for its community, and collaborates with other medical centers, such as NGMC. In 2010, approximately 1,800 people were assisted with needed medical care through HAI. To qualify for its services, a patient's income must be at or below 150 percent Federal Poverty Level and have no medical insurance. The patient must live in Hall County and must be referred by a physician that is in the HAI network. First conceived in 1998, the need for the program was largely determined by a community needs assessment conducted by Healthy Hall, a coalition of community members, including NGMC. Since its launch, the hospital has fiscally contributed to HAI. Specifically, in 2010, over $11 million in donated hospital services was provided to low income, uninsured patients through Health Access. In addition, since 2005, HAI has received more than $988,000 from The Medical Center Foundation. Other HAI partners include the Hall County Health Department and MedLink of Gainesville, a federally qualified health center. In 2006, Healthcare Georgia Foundation named the HAI program "Community Service Collaborative of the Year." NGMC also plays a major role in funding a primary care clinic at the Hall County Health Department to improve access to primary healthcare services for low-income people in our community. In FY10, NGMC contributed over $1.2 million. In 2010, Northeast Georgia Medical Center received a National Charitable Healthcare Award from Jackson Healthcare for collaborative support of Good News Clinics and Health Access Initiative. ADDITIONAL HIGHLIGHTS OF COMMUNITY BENEFIT PROGRAMS NGMC values cooperative efforts with community services and other healthcare providers to improve the health status of area citizens. NGMC demonstrates its value for collaborative efforts within the community through many partnerships ranging from serving as lead agency of the Safe Kids Coalition of Gainesville-Hall County, to partnering with community health organizations, to helping reach at-risk populations in need of healthcare. In FY10, over $4.3 million was provided in community benefit programs/outreach. Community education was provided through free community lectures, various support groups, and the semi-annual health magazine, Communicare. Over 20 presentations were made through the Speaker's Bureau, and NGMC also offered smoking cessation classes, as well as Living Lighter, a weight loss program. In FY10, more than 500 NGMC volunteers contributed more than 61,000 volunteer hours, equivalent to 36 full time employees and a value of over $1.2 million. This is a record in the history of The Medical Center Auxiliary. While these figures are not included in the quantitative portion of the community benefit report, they show the depth of support the community gives NGMC. The Medical Center Foundation Raises Funds to Benefit the Community The Medical Center Foundation is the fundraising arm of Northeast Georgia Medical Center and Health System and raises funds to improve the health of the community. The Foundation's operating expenses are supported by NGMC so that donated funds can be used to support NGMC projects and community health improvement initiatives. Following are items of interest to note: - The 2009 Medical Center Open Golf Tournament, held in FY10, raised over $200,000 to benefit the Outdoor Recreation Complex at the Boys and Girls Clubs of Hall County. - Since 1997, nearly $2 million has been raised for community health improvement projects through The Medical Center Open. Safe Kids Coalition Works to Keep Kids Safe The Gainesville-Hall County Safe Kids Coalition, led by NGMC, is part of the National Safe Kids Campaign, the first and only national organization dedicated solely to the prevention of unintentional childhood injury, which is the nation's number one killer of children ages 14 and under. This program provides affordable safety equipment such as car seats and bike helmets to area children in need. Working with a coalition made up of law enforcement, area schools, community volunteers and others, Safe Kids provides educational materials and programs that teach children and their parents how to avoid accidents and injuries. Safe Kids continued the work of injury prevention for families in the Hall County community in 2010 thanks to the support of The Medical Center Foundation and the Healthy Journey II Campaign. In FY10, members of the Gainesville-Hall County Safe Kids Coalition provided over 400 programs and events that reached an estimated 52,000 children and their family members, teachers and caregivers. Through these programs, over 5,900 safety devices were distributed to families who were in need of them. Senior Partners Provides Health Information Approximately 150 people participated in the Getting Older and Better Workshop in May at First United Methodist Church. This event was sponsored by The Medical Center Auxiliary, provided by Northeast Georgia Medical Center, and featured speakers on heart disease treatment and prevention. Sponsorships and Donations In FY10, NGMC sponsored or made a donation to over 20 community agencies serving health and human service needs, ranging from supporting the Alliance for Literacy Spelling Bee, to the North Georgia AIDS Alliance. Sponsorships/donations totaled over $48,000 in FY10.
Employees of NGHS and it's Affiliates Lead the Way: United Way Pacesetter & More NGMC served as a pacesetter company for the United Way Campaign. Donations from NGMC and affiliate employees totaled over $120,000. NGMC Chief Operating Officer and Interim CEO Carol Burrell serves as Chairperson of the Board of Directors of United Way. NGMC employees are very active in the community, volunteering at the Good News Clinics, in their churches on mission trips and for community agencies such as the Humane Society and Habitat for Humanity. When it comes to supporting The Medical Center Foundation's employee giving club, W.A.T.C.H. (We Are Targeting Community Healthcare), over 2,200 employees donated over $360,000 in FY10. NGMC employees donated over 190 units of blood in FY10, benefitting over 500 individuals. Employees also turned out in full force for community events such as the American Heart Walk, March of Dimes' WalkAmerica and American Cancer Society's Relay for Life, averaging participation of 200-300 per event. Training and Education for Healthcare Professionals and Other Students Northeast Georgia Medical Center supports the training and education of nurses and other healthcare professionals. - NGMC is a training site for handicapped high school students who work in the areas of materials management, nutritional services, pharmacy and linens. Twenty-one students and 2 instructors participated in FY10; - 64 students from area high schools participated in the Youth Apprenticeship Program in FY10; - NGMC partners with Lanier Tech to house a Radiology Tech Program and helps fund faculty; also provides 2 PC labs and classroom space for Lanier Tech's LPN program; - 145 job shadows were placed at NGMC during FY10, allowing high school and postsecondary students from area schools to shadow professional healthcare staff.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsDirect Controlling Entity NADirectControllingEntityNA
Northeast Ga Specialty Group LLC
743 Spring StreetGainesvilleGA30501260556238Healthcare ClinicsGA9439600757026N/A
NGHS Quickcare LLC
743 Spring StreetGainesvilleGA30501205064238Healthcare ClinicsGA110249071250364N/A
The Braselton Clinic LLC
743 Spring StreetGainesvilleGA30501260556190Healthcare ClinicsGA39830221847137N/A
Northeast Georgia Occupational Health LLC
743 Spring StreetgainesvilleGA30501582608332Occupational MedicineGA4605591417N/A
River Place Medical Office Plaza I LLC
743 Spring StreetGainesvilleGA30501581694090RentalGAN/A

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNA
Northeast Georgia Health System Inc
743 Spring StreetGainesvilleGA30501581694090Healthcare - Parent Org.GA501 (c) (3)11N/A
The Medical Center Foundation Inc
743 Spring StreetGainesvilleGA30501581694820FundraisingGA501 (c) (3)7N/A
Northeast Georgia Medical Center
743 Spring StreetGainesvilleGA30501581694098healthcareGA501 (c) (3)3N/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntity
NORTHEAST GEORGIA HEALTH PARTNERS LLC
743 Spring StreetGainesvilleGA30501582131807PPO DEVELOPMENTGAN/AC
STRATEGIC PHYSICIAN SERVICES INC
743 Spring StreetGainesvilleGA30501260342081HEALTHCARE PSSGAN/AC
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 Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
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Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
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Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg