2026-05-11T08:36:22-04:00 2025-06-30 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2024-07-01 580973772 DONALSONVILLE HOSPITAL INC DONA 2295245217 102 HOSPITAL CIRCLE DONALSONVILLE GA 398451100 HERMAN BROOKINS CHAIRMAN/CEO 2295245217 2026-05-07 true false WILLIAM EDWARD PHILLIPS P00451499 2298837878 2026-05-08 2024 2025-03-06 01:10:19Z HERMAN BROOKINS 102 HOSPITAL CIRCLE DONALSONVILLE GA 398451100 35134892 false X WWW.DONALSONVILLEHOSPITAL.ORG X 1977 GA DONALSONVILLE HOSPITAL OPERATES A 65-BED GENERAL ACUTE CARE HOSPITAL FOR THE COMMUNITY OF DONALSONVILLE, GEORGIA AND SURROUNDING AREAS REGARDLESS OF THEIR ABILITY TO PAY. 7 5 495 0 417240 315000 29810346 32022130 220251 95240 5758089 2572441 36205926 35004811 98991 95551 0 20035526 20773132 0 0 18806421 16369234 38940938 37237917 -2735012 -2233106 29131323 27836193 9352151 10156860 19779172 17679333 DONALSONVILLE HOSPITAL OPERATES A 65-BED GENERAL ACUTE CARE HOSPITAL FOR THE COMMUNITY OF DONALSONVILLE, GEORGIA AND SURROUNDING AREAS REGARDLESS OF THEIR ABILITY TO PAY. false false 30535098 95551 33794994 DONALSONVILLE HOSPITAL PROVIDES PRIMARY HEALTHCARE TO RESIDENTS OF SEMINOLE COUNTY AND SURROUNDING AREAS REGARDLESS OF THEIR ABILITY TO PAY. DURING THE FISCAL YEAR 2025, INPATIENT DAYS TOTALED 2,190 WITH 488 DISCHARGES; PSYCHIATRIC DAYS NUMBERED 6,643 WITH 940 DISCHARGES, AND THE SKILLED NURSING FACILITY HAD 23,252 RESIDENT DAYS. 30535098 true true false true false false false false false true true false false false true true true false false false false false false false false false true true false true true false false false false false false true false false false false false false false false false false true 27 0 495 true false false false false false false false false false false false false X 7 5 false false false false false false false true true false false true true true true false true true true false GA X X KAY LIVINGSTON 2295245217 102 HOSPITAL CIRCLE DONALSONVILLE GA 398451100 HERMAN BROOKINS CHAIRMAN/CEO 40.00 X X 536622 0 0 JOSEPH WALKER SR MD PHYSICIAN 40.00 X 509249 0 21635 JAMES MOODY ADMINISTRATO 40.00 X X 281582 0 34417 JACOB HOLLEY III MD PHYSICIAN 40.00 X 269413 0 5500 BRIAN BROOKINS PHARMACIST 40.00 X 236309 0 0 VINCENT KELLY CRNA 40.00 X 155601 0 22247 ROYCE CANNINGTON JR CRNA 40.00 X 163606 0 0 ASHLEY MASSEY ASST. HOSPIT 40.00 X 144570 0 0 KATIE HATCHER CFO(TERM 1/2 X 126361 0 3967 VIRGINIA WHITTAKER BOARD MEMBER 1.00 X 23890 0 0 TERRY SHAMBLIN DIRECTOR/SEC 1.00 X X 21253 0 0 WILLIAM BURKE CPA DIRECTOR 1.00 X 20680 0 0 CHARLES H ORRICK TRUSTEE 1.00 X X 17870 0 0 MITCH BLANKS DIRECTOR 1.00 X 10666 0 0 KAY LIVINGSTON CFO X 0 0 0 2517672 87766 19 false true false HEALTHCARE SERVICES GROUP PO BOX 829677 PHILADELPHIA PA 191829677 DIETARY CONSULT 1083346 MCKESSON CORPORATION PO BOX 848442 DALLAS TX 752048442 PHARMACEUTICALS 791343 VIRTUAL RADIOLOGIC CORP 11995 SINGLETREE LANE SUITE 500 MINNEAPOLIS MN 55344 TELERADIOLOGY 497231 LABCORP P O BOX 2240 BURLINGTON NC 272162240 OUTSIDE LAB 435476 BECKMAN COULTER INC DEPT CH 10164 PALATINE IL 600550164 MARKETING 331336 20 10000 305000 315000 PATIENT REVENUE 621990 31950725 31950725 UPL REVENUE 621990 71405 71405 32022130 59073 59073 117626 124081 -6455 -6455 -6455 42167 6000 36167 36167 36167 SOUTHWEST GA HEALTHCARE REIMB 621990 1726422 1726422 CAFETERIA 722513 806032 806032 MISCELLANEOUS REVENUE 621990 38582 38582 7860 7860 2578896 35004811 33794994 894817 X 95551 95551 1070218 1070218 15620759 14110558 1510201 600000 528000 72000 2522452 2219758 302694 959703 844539 115164 48831 48831 205897 205897 3989674 3636903 352771 123223 123223 3370385 1872600 1497785 612721 539194 73527 161188 148374 12814 68830 57720 11110 414570 364822 49748 1264471 1112734 151737 190213 50712 139501 MEDICAL SUPPLIES 3941214 3941214 REPAIR AND MAINTENANCE 983613 353718 629895 MISCELLANEOUS EXPENSE 374499 374499 DUES & SUBSCRIPTIONS 343398 7695 335703 276507 276507 37237917 30535098 6702819 0 4350694 4538362 103956 107389 7461306 6054053 1165129 1211390 1044521 1002577 579172 453386 38781757 28858121 10631944 9923636 3070535 3460748 724066 1084652 29131323 27836193 3842822 4532641 5250000 5250000 259329 374219 9352151 10156860 X 19222172 17104333 557000 575000 19779172 17679333 29131323 27836193 -2233106 133267 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 3381 3381 false SCHEDULE C, PART II-B, LINE 1 THE ORGANIZATION BELONGS TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS. A PORTION OF THE MEMBERSHIP DUES PAID TO THE ASSOCIATIONS ARE DEDICATED TO LOBBYING ACTIVITIES. 2526344 18000 289014 13157 2820201 2170278 29000 338489 11423 2526344 2326342 50000 282939 -465913 23090 2170278 2839667 100000 -595198 18127 2326342 2075937 100000 680517 16787 2839667 0.79620 0.20380 false false 696053 696053 3596655 15951700 14246084 5302271 382206 365953 16253 18042685 14246084 3796601 112458 112458 9923636 MEDICARE ADVANCE PAYMENTS 374219 374219 X 32834350 133267 124801 258068 32576282 2428529 2428529 35004811 34934189 124801 124801 34809388 2428529 2428529 37237917 SCHEDULE D, PAGE 2, PART V, LINE 4 ENDOWMENT FUNDS CONSIST OF INVESTMENTS FOR THE DEFERRED COMPENSATION PLAN AND MALPRACTICE INSURANCE. THE ORGANIZATION HAS ESTABLISHED A FUNDED DEFERRED COMPENSATION PLAN FOR CERTAIN KEY EMPLOYEES. MALPRACTICE INSURANCE IS A TRUST SET UP TO FUND POTENTIAL LIABILITIES UNDER THE HOSPITAL'S SELF INSURANCE PROGRAM. THE TRUSTEE IS SYNOVUS TRUST COMPANY, N.A. WALTER SCOTT FOUNDATION ENDOWMENT IS ESTABLISHED TO GENERATE INVESTMENT INCOME WHICH CAN BE SPENT ON GENERAL HOSPITAL OPERATIONS. SCHEDULE D, PAGE 3, PART X THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE ORGANIZATION ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEETS FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF JUNE 30, 2025 AND 2024 OR FOR THE YEARS THEN ENDED. THE ORGANIZATION'S TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAXING AUTHORITIES. FOR FEDERAL INCOME TAX PURPOSES, THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THESE RETURNS. SCHEDULE D, PAGE 4, PART XI, LINE 2D RENTAL EXPENSE OFFSET TO REVENUE 124,801 SCHEDULE D, PAGE 4, PART XI, LINE 4B MEALS EXPENSE FOR SNF PATIENTS 688,427 RENTAL EXPENSES OFFSET TO REVENUE 13,680 SGHC MANAGEMENT FEE REVENUE IN EXP 1,726,422 SCHEDULE D, PAGE 4, PART XII, LINE 2D RENTAL EXPENSE OFFSET TO REVENUE 124,801 SCHEDULE D, PAGE 4, PART XII, LINE 4B MEALS EXPENSE FOR SNF PATIENTS 688,427 RENTAL EXPENSES OFFSET TO REVENUE 13,680 SGHC MANAGEMENT FEE REVENUE IN EXP 1,726,422 true true X true X 1.250000000000 true X true true false true true 1354224 1354224 0.03640 4229074 8148738 78842 31880 46962 0.00130 5662140 8180618 1401186 0.03760 5662140 8180618 1401186 0.03760 false 4502042 225102 3901605 4414015 -512410 X true true 1 1 DONALSONVILLE HOSPITAL INC 102 HOSPITAL CIRCLE DONALSONVILLE GA 398451100 WWW.DONALSONVILLEHOSPITAL.ORG 125-318 X X X SNF, REHAB DONALSONVILLE HOSPITAL INC 1 false false true X X X X X X X X X X 23 true false false true X WWW.DONALSONVILLEHOSPITAL.ORG X true 23 true WWW.DONALSONVILLEHOSPITAL.ORG false false true X 125.000000000000 200.000000000000 X true true X X X X true X WWW.DONALSONVILLEHOSPITAL.ORG X WWW.DONALSONVILLEHOSPITAL.ORG X WWW.DONALSONVILLEHOSPITAL.ORG X X X X X X true X false X X X X true X false false FACILITY 1, DONALSONVILLE HOSPITAL, INC. - PART V, LINE 3E THE SERVICE PRIORITIES OF THE HOSPITAL IN 2023 AND FORWARD WILL BE: 1. EMERGENCY CENTER 2. DIAGNOSTIC 3. INPATIENT SURGERY, OUTPATIENT SURGERY, AND ENDOSCOPY 4. INPATIENT ACUTE AND CHRONIC CARE 5. INPATIENT MENTAL HEALTH CARE 6. HEALTH EDUCATION AND ILLNESS PREVENTION FACILITY 1, DONALSONVILLE HOSPITAL, INC. - PART V, LINE 5 THE CHNA PANEL WAS SELECTED, STARTING WITH EIGHT HOSPITAL BOARD MEMBERS. THE BOARD MEMBERS HAVE A BROAD RANGE OF COMMUNITY INVOLVEMENT AND LEADERSHIP ROLES, INCLUDING ONE WHO IS A FORMER DIRECTOR OF NURSING; ONE WHO IS INVOLVED WITH LOCAL COUNTY AND CITY GOVERNMENTS; THREE WHO ARE ACTIVE WITH OTHER NONPROFIT ORGANIZATIONS AND ARE COMMUNITY LEADERS; AND ONE WITH A VAST KNOWLEDGE AND EXPERIENCE IN THE AGRICULTURAL AREA, A MAJOR INDUSTRY OF SEMINOLE COUNTY. THE CHNA PANEL INCLUDED ALL EIGHT MEMBERS OF THE BOARD PLUS TWO ADDITIONAL MEMBERS - A LOCAL COUNTY COMMISSIONER WHO ALSO SERVES AS CO-PASTOR IN A LOCAL MINISTRY, AND THE LOCAL HEALTH DEPARTMENT DIRECTOR. THE DONALSONVILLE HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT PANEL REVIEWED AND DISCUSSED DATA GATHERED FROM OUTSIDE SOURCES, INPUT FROM LOCAL MEDICAL STAFF, EMPLOYEE MEETINGS, INPUT FROM LOCAL GOVERNMENT, INPUT FROM LOCAL BUSINESSES AS WELL AS INTERNAL DATA. IN UTILIZING THESE SOURCES, THE PANEL ESTABLISHED THE SPECIFIC NEEDS OF THE COMMUNITY BASED ON THE FOLLOWING CRITERIA: SEVERITY, OF CASES, IMPACT ON COMMUNITY AND THE ORGANIZATION'S ABILITY TO IMPLEMENT A SOLUTION TO IMPROVE THE NEED. FACILITY 1, DONALSONVILLE HOSPITAL, INC. - PART V, LINE 11 AFTER LOOKING AT ALL OF THE DATA GATHERED AND CONSISTENT WITH THE PREVIOUS CHNA, THE 2023 CHNA PANEL DETERMINED THAT THE HEALTH NEEDS THAT COULD BE IMPROVED BY THE HOSPITAL INPUT WERE AS FOLLOWS: 1. DIABETES/HYPERTENSION DISEASE 2. OBESITY IN ADULTS 3. CANCER 4. MENTAL HEALTH BOTH 2023 COMMUNITY HEALTH NEEDS ASSESSMENT AND THE 2022 CHNA IMPLEMENTATION PLAN ARE WIDELY PUBLICIZED ON THE ORGANIZATION'S WEBSITE AND CAN BE FOUND AT HTTPS://DONALSONVILLEHOSPITAL.ORG/ABOUT/FINANCIAL-AND-ORGANIZATIONAL- INFORMATION/ FACILITY 1, DONALSONVILLE HOSPITAL, INC. - PART V, LINE 13H ALL PATIENTS ARE CHARGED EQUALLY REGARDLESS OF ANY OF THE ABOVE. THOSE INDIVIDUALS WITHOUT THIRD PARTY COVERAGE ARE GIVEN A 15% DISCOUNT IF THEY DO NOT QUALIFY FOR FREE CARE. THEY ARE ALSO GIVEN THE OPPORTUNITY TO RECEIVE A 50% DISCOUNT IF BILL IS PAID WITHIN 1 YEAR OF DISCHARGE. ALSO, FREE CARE IS OFFERED FOR PATIENTS MEETING CHARITY GUIDELINES - RANGING FROM 125% TO 200% OF FEDERAL POVERTY GUIDELINES. 2 SEMINOLE MANOR NURSING HOME 102 HOSPITAL CIRCLE DONALSONVILLE GA 317451100 SNF DONALSONVILLE HOSP BEHAV HLTH UNIT 102 HOSPITAL CIRCLE DONALSONVILLE GA 317451100 BEHAVIORAL HLTH UNIT SCHEDULE H, PART I, LINE 7 COSTS FOR PART I, LINE 7A, 7B AND 7C WERE COMPUTED USING THE RATIO OF PATIENT CARE COST TO CHARGES CALCULATED ON WORKSHEET 2. OTHER COSTS WERE OBTAINED FROM THE ORGANIZATION'S ACCOUNTING RECORDS. SCHEDULE H, PART III, LINE 2 AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. SEE FOOTNOTES 2 AND 3 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR A COMPLETE DISCUSSION OF PRICE CONCESSIONS, DISCOUNTS AND UNCOMPENSATED CARE PROVIDED BY THE ORGANIZATION. SCHEDULE H, PART III, LINE 3 THE FIGURE ON PART III LINE 3 REPRESENTS MANAGEMENT'S ESTIMATE (APPROXIMATELY 5%) BASED ON AN ANALYSIS OF SELF PAY PATIENTS' ABILITY TO PAY THEIR OUTSTANDING ACCOUNT. THIS ANALYSIS INCLUDES REVIEWING THE PATIENT'S CREDIT HISTORY, INCOME LEVELS AND OVERALL COLLECTIBILITY OF THE ACCOUNT. SCHEDULE H, PART III, LINE 4 SEE PAGE 14-20 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR A DISCUSSION ON UNINSURED PATIENTS, PRICE CONCESSIONS, AND UNCOMPENSATED CARE. SCHEDULE H, PART III, LINE 8 MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. SCHEDULE H, PART III, LINE 9B OUR PATIENT FINANCIAL SERVICES DEPARTMENT VISITS PATIENTS WHO HAVE NO INSURANCE TO DISCUSS ASSISTANCE AND REFER THOSE PATIENTS TO OUR LOCAL DFCS OFFICE TO OBTAIN ASSISTANCE WITH APPLYING FOR MEDICAID OR OTHER FINANCIAL ASSISTANCE. OUR PATIENT FINANCIAL SERVICES DEPARTMENT, WHICH DOES SELF-PAY BILLING AND COLLECTION, INFORMS PATIENTS ABOUT OUR FINANCIAL ASSISTANCE PROGRAM AND ASSISTS THEM IN COMPLETING AN APPLICATION. BILLING STATEMENTS PROVIDE A MESSAGE AND TELEPHONE NUMBER TO CALL IF THE PATIENT IS HAVING DIFFICULTIES MAKING PAYMENTS. FOR PATIENTS WHO QUALIFY AS INDIGENT OR CHARITY PATIENTS, THERE IS NO FINANCIAL OBLIGATION. THOSE PATIENTS WHO DO NOT QUALIFY AS INDIGENT OR CHARITY ARE SENT MULTIPLE STATEMENTS FOR 30, 60, AND 90 DAYS PAST DUE. THOSE PATIENTS WILL ALSO BE SENT TWO LETTERS REGARDING PAST DUE ACCOUNTS. ONCE AN ACCOUNT HAS NO ACTIVITY FOR 180 DAYS, IT WILL BE SENT TO AN OUTSIDE COLLECTION AGENCY. SCHEDULE H, PART VI, LINE 2 A COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN FISCAL YEAR 2023. INFORMATION WAS SOLICITED FROM VARIOUS INDIVIDUALS REPRESENTING THE INTERESTS OF THE COMMUNITY BY MEANS OF FOCUS GROUPS, EXTERNAL STATISTICS, AND INTERNAL DATA. THE ORGANIZATION CONDUCTS VARIOUS TYPES OF ASSESSMENTS TO DETERMINE THE COMMUNITY'S NEEDS FOR HEALTH SERVICES AND COLLABORATES WITH THE CITIZENS OF SEMINOLE AND SURROUNDING COUNTIES TO IDENTIFY THE NEEDS OF THE COMMUNITY. COMMUNITY RESEARCH HAS SHOWN THAT THE SERVICES FOR WHICH THE CITIZENS OF SEMINOLE AND SURROUNDING COUNTIES TURN TO THE ORGANIZATION ARE EMERGENCY SERVICES, DIAGNOSTIC TESTS AND X-RAYS, AND ALSO GENERAL MEDICAL CARE. OTHER SERVICES FOR WHICH THEY TURN TO US AS A MAJOR PROVIDER ARE MINOR SURGERY, PEDIATRIC CARE, AND GENERAL SURGERY. THIS INFORMATION, COMBINED WITH OUR EXTENSIVE COLLABORATIONS AND OUR ROLE AS A LEADER IN THE COMMUNITY, PROVIDES US THE MEANS TO UNDERSTAND AND ADDRESS THE COMMUNITY'S NEEDS AND ENSURES OUR OUTREACH PROGRAMS ARE FOCUSED ON THE POPULATIONS WHO NEED OUR SERVICES THE MOST. OUR BOARD OF DIRECTORS WORKS CLOSELY WITH THE LOCAL CIVIC ORGANIZATIONS, ELECTED OFFICIALS AND COMMUNITY LEADERS TO DETERMINE WHAT THE HEALTHCARE NEEDS ARE OF OUR COMMUNITY. SCHEDULE H, PART VI, LINE 3 THE BOARD HAS CLEARLY WRITTEN INDIGENT AND FINANCIAL AID POLICIES THAT ARE AVAILABLE THROUGH THE BUSINESS OFFICE. SIGNS ARE PROMINENTLY POSTED ON THE AVAILABILITY OF FREE AND FINANCIAL AID. PATIENT EDUCATION ON THE ORGANIZATIONS INDIGENT/CHARITY AND FINANCIAL AID PROGRAMS ARE CONDUCTED DURING PRE-REGISTRATION, THROUGH OUR PATIENT FINANCIAL SERVICES DEPARTMENT FOR PATIENTS THAT DO NOT HAVE ANY 3RD PARTY COVERAGE. BROCHURES ARE PROMINENTLY DISPLAYED AT EACH REGISTRATION BOOTH. THE BUSINESS OFFICE CONTINUOUSLY PROVIDES INFORMATION TO THE BUSINESS OFFICE MANAGERS OF OUR LOCAL PHYSICIAN'S PRACTICES. PHONE CALLS AND LETTERS ARE SENT TO ALL PATIENTS THAT ARE NOT INTERVIEWED AT THE TIME OF ADMISSION EXPLAINING OUR FINANCIAL ASSISTANCE PROGRAMS. OUR EMERGENCY DEPARTMENT IS OPERATED 24/7 AND OPEN TO ALL PERSONS, REGARDLESS OF ABILITY TO PAY. SCHEDULE H, PART VI, LINE 4 THE ORGANIZATION SERVES A PREDOMINATELY RURAL AREA IN SEMINOLE COUNTY, IN ITS BROADEST BOUNDARIES. DONALSONVILLE IS THE ECONOMIC AND MEDICAL HUB FOR THE REGION, AND THE ORGANIZATION DRAWS FROM A POPULATION OF APPROXIMATELY 9,000 RESIDENTS FOR MAJOR HEALTH CARE SERVICES. THE REGION IS MARKED BY VAST DICHOTOMIES OF WEALTH, EDUCATION, AND HEALTH STATUS. THE ORGANIZATION SERVES A POPULATION THAT HAS A HIGH PROPORTION OF LOW-INCOME INDIVIDUALS. ABOUT 25.2% OF FAMILIES AND 25.49% OF THE POPULATION WERE BELOW THE POVERTY LINE. SCHEDULE H, PART VI, LINE 5 OUR BOARD OF DIRECTORS WORKS CLOSELY WITH THE LOCAL CIVIC ORGANIZATIONS, ELECTED OFFICIALS AND COMMUNITY LEADERS TO DETERMINE WHAT THE HEALTHCARE NEEDS ARE OF OUR COMMUNITY. WE HAVE PARTICIPATED IN VARIOUS LOCAL HEALTH FAIRS TO PROMOTE GOOD HEALTH AND PROVIDE SCREENING MECHANISMS FOR DETECTING HIGH BLOOD PRESSURE, ABNORMAL BLOOD SUGAR LEVELS AND HIGH CHOLESTEROL. THESE ARE THE MOST PRESSING AND PREVENTABLE DISEASES IN OUR COMMUNITY. WE WORK CLOSELY WITH THE LOCAL HEALTH DEPARTMENT TO ASSIST THEM WITH THE PROGRAMS THAT THEY FACILITATE THROUGHOUT THE YEAR. OUR BOARD HAS HAD IN PLACE FOR MORE THAN 20 YEARS, A SCHOLARSHIP PROGRAM FOR PHYSICIANS AND OTHER HEALTHCARE PROFESSIONALS. WE HAVE BEEN FORTUNATE TO HAVE MANY OF OUR LOCAL RESIDENTS FINISH MEDICAL SCHOOL, NURSING SCHOOL AND OTHER PROFESSIONAL CERTIFICATIONS, AND COME BACK TO DONALSONVILLE TO PRACTICE AND WORK IN OUR LOCAL HEALTHCARE COMMUNITY. THIS TYPE OF PROGRAM HAS HELPED KEEP HEALTHCARE AVAILABLE AND ACCESSIBLE TO OUR RURAL COMMUNITY. IT HAS ENABLED US TO START NEW SERVICES THAT WOULD NOT HAVE EXISTED OTHERWISE. OUR BOARD IS DEDICATED TO PLANNING AND PREPARING FOR THIS RURAL COMMUNITY TO HAVE EASILY ACCESSIBLE HEALTHCARE FOR YEARS TO COME. SCHEDULE H, PART VI, LINE 7 GEORGIA true 1 MAMMOGRAPHY-INDIGENT 130 95551 SCHEDULE I, PAGE 1, PART I, LINE 2 INDIGENT MAMMOGRAM PROGRAM THE RADIOLOGY DEPARTMENT AT DONALSONVILLE HOSPITAL MAKES SCREENING PATIENTS FOR BREAST CANCER DURING THE MONTH OF OCTOBER A SPECIAL EVENT. TO SCHEDULE A FREE MAMMOGRAM SCREENING, PATIENTS NEED TO CALL THEIR PRIMARY CARE PHYSICIAN OR OB/GYN AND HAVE THE OFFICE SCHEDULE THEIR APPOINTMENT WITH DHI RADIOLOGY. X X false false false false false false false false false HERMAN BROOKINS CHAIRMAN/CEO 510956 15000 10666 536622 JOSEPH WALKER SR MD PHYSICIAN 429998 79251 21635 530884 JAMES MOODY ADMINISTRATOR 255326 15590 10666 28827 5590 315999 JACOB HOLLEY III MD PHYSICIAN 269413 5500 274913 BRIAN BROOKINS PHARMACIST 207739 15590 12980 236309 VINCENT KELLY CRNA 155601 20800 1447 177848 ROYCE CANNINGTON JR CRNA 152206 11400 163606 SCHEDULE J, PART III PART I, LINE 4 - DEFERRED COMPENSATION PLAN 457(B) THE ORGANIZATION HAS ESTABLISHED A DEFERRED COMPENSATION PLAN FOR CERTAIN KEY EMPLOYEES. THE 457(B) PLAN IS A NON-QUALIFIED RETIREMENT PLAN THAT ALLOWS A MAXIMUM SALARY DEFERRAL OF THE LESSER OF THE APPLICABLE DOLLAR AMOUNT AS SPECIFIED UNDER CODE SECTION 457(E)(15), OR SUCH OTHER AMOUNT AS THE COMMISSIONER OF THE IRS MAY PRESCRIBE, OR 100% OF THE PARTICIPANT'S INCLUDIBLE COMPENSATION FOR THE TAX YEAR. BRIAN BROOKINS FAMILY BD MMBR 246421 COMPENSATION false SCHEDULE L, PART V BRIAN BROOKINS, AN EMPLOYEE OF THE ORGANIZATION, IS THE SON OF HERMAN BROOKINS, THE BOARD CHAIRMAN AND CEO. FORM 990, PAGE 6, PART VI, LINE 11B THE INDEPENDENT ACCOUNTING FIRM THAT PREPARES THE FORM 990 (BASED UPON INFORMATION PROVIDED BY THE ORGANIZATION) PROVIDES A COPY OF THE RETURN TO BE REVIEWED BY MANAGEMENT. MANAGEMENT PERFORMS A DETAILED REVIEW WHICH CONSISTS OF REVIEWING THE FINANCIAL DATA, THE NARRATIVES DISCLOSED, AND OTHER FACTS PRESENTED ON THE RETURN. UPON REVIEW, THE FORM 990 AND RELATED SCHEDULES ARE PROVIDED TO ALL BOARD MEMBERS FOR REVIEW AND FEEDBACK. ONCE THE FORM 990 IS REVIEWED BY ALL APPLICABLE PARTIES, A COPY OF THE FINAL VERSION IS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO FILING. FORM 990, PAGE 6, PART VI, LINE 12C THE ORGANIZATION HAS A WRITTEN POLICY RESPECTING CONFLICTS OF INTEREST AND DISCLOSURE OF SAME. GENERALLY SPEAKING, THE POLICY REQUIRES ANY "COVERED PERSON" WHO BELIEVES HE HAS A CONFLICT OF INTEREST TO: -DISCLOSE THE EXISTENCE AND NATURE OF THE CONFLICT OF INTEREST (INCLUDING ALL FACTS KNOWN RESPECTING THE SUBJECT MATTER) TO THE CHAIRMAN OF THE BOARD; -PLAY NO PART, DIRECTLY OR INDIRECTLY, IN THE DELIBERATION OR VOTE OF THE BOARD OF DIRECTORS WITH RESPECT TO THE DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS; AND -RECUSE HIMSELF FROM THAT PORTION OF THE MEETING AT WHICH THE CONFLICT OF INTEREST IS DISCUSSED. THE DEFINITION OF A "COVERED PERSON" INCLUDES ALL BOARD MEMBERS, OFFICERS AND MEMBERS OF SENIOR MANAGEMENT OF THE ORGANIZATION. WHEN A COVERED PERSON DISCLOSES A POTENTIAL CONFLICT OF INTEREST TO THE BOARD CHAIRMAN, THE CHAIRMAN IS OBLIGED TO BRING THE MATTER TO THE ATTENTION OF THE FULL BOARD WHO DETERMINES WHETHER A CONFLICT OF INTEREST ACTUALLY EXISTS. IF A CONFLICT OF INTEREST EXISTS, THE TRANSACTION OR MATTER GIVING RISE TO THE CONFLICT OF INTEREST MAY NOT PROCEED UNLESS THE BOARD DETERMINES, BY A MAJORITY VOTE, THAT, DESPITE THE CONFLICT OF INTEREST, THE TRANSACTION/MATTER IS NEVERTHELESS IN THE ORGANIZATION'S BEST INTEREST AND IS FAIR AND REASONABLE TO THE ORGANIZATION. IN ADDITION TO THE REQUIREMENT TO DISCLOSE A POTENTIAL CONFLICT OF INTEREST AT THE TIME IT ARISES, EACH MUST SUBMIT ANNUALLY A `CONFLICT AND DISCLOSURE OF INTEREST QUESTIONNAIRE'. FORM 990, PAGE 6, PART VI, LINE 15A THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE COMPENSATION FOR THE CEO. THE BOARD USES COMPARABLE COMPENSATION DATA FOR SIMILARLY QUALIFIED PERSONS AT SIMILARLY SIZED ORGANIZATIONS AND SALARY SURVEYS TO DETERMINE THE COMPENSATION FOR THE CEO. THE CEO, A VOTING MEMBER OF THE BOARD, IS DISMISSED FROM THE MEETING DURING THE REVIEW OF HIS COMPENSATION. THE LAST DETERMINATION USING COMPARABLE COMPENSATION DATA AND SALARY SURVEYS WAS IN 2023. HOWEVER, COST OF LIVING ADJUSTMENTS ARE GIVEN ANNUALLY AND ARE APPROVED BY THE BOARD. FORM 990, PAGE 6, PART VI, LINE 15B THE BOARD OF DIRECTORS MEETS ON A MONTHLY BASIS, AND THE SALARY DECISIONS ARE REVIEWED BY THE BOARD. FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION WILL MAKE AVAILABLE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS TO ANY MEMBER OF THE PUBLIC WHO MAKES THEIR REQUEST AT THE ADMINISTRATIVE OFFICE OF THE FILING ENTITY. FORM 990, PART IX, LINE 11G CONTRACT FEES 1,166,119 117,382 0 PROFESSIONAL FEES 2,192,554 0 0 PURCHASED SERVICES 179,655 235,389 0 CONSULTING FEES 98,575 0 0 TOTAL 3,636,903 352,771 0