2024-08-14T12:40:00-05:00 2023-09-30 621517792 PYA P C 2220 SUTHERLAND AVE KNOXVILLE TN 37919 990 2022-10-01 823312912 HAMILTON CHILDREN'S INSTITUTE INC HAMI 7062268900 PO BOX 1168 DALTON GA 307221168 JULIE A SOEKORO VP/CFO 7062268900 2024-08-14 1 0 DEBORAH O ERNSBERGER P00364912 8656730844 2022 2024-08-08 14:25:15Z ANNA SHAW CHILDREN'S INSTITUTE JEFFREY D MYERS PO BOX 1168 DALTON GA 307221168 3918409 0 X HAMILTONHEALTH.COM/SERVICES/ANNA-SHAW-CHILDRENS-I X 2017 GA CHAMPION CARE TO CHILDREN AND FAMILIES FOR HAPPY, HEALTHY LIVES. 7 4 46 0 0 0 2640580 2547480 1158034 1357646 0 0 20724 13283 3819338 3918409 0 0 0 0 2815873 2939861 0 0 0 1680706 1710310 4496579 4650171 -677241 -731762 885129 598262 1537090 1976132 -651961 -1377870 CHAMPION CARE TO CHILDREN AND FAMILIES FOR HAPPY, HEALTHY LIVES. 0 0 4550171 1370929 SERVICES OFFERED IN THE FACILITY INCLUDE AUTISM EVALUATION AND ASSESSMENT AND REHABILITATION SERVICES WHICH INCLUDE PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY. TOTAL PATIENT VISITS IN 2023 WERE 12,823. 4550171 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 4 0 1 46 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 4 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 GA X JULIE A SOEKORO 7062726000 PO BOX 1168 DALTON GA 307221168 ROBERT M CHANDLER CHAIRMAN 1.00 X X 0 0 0 SANDRA D MCKENZIE VP/PRESIDENT OF OPERATIONS 1.00 40.00 X X 0 636061 52898 GARY A MIDDLETON TRUSTEE 1.00 X 0 0 0 JEFFREY D MEYERS PRESIDENT/CEO 1.00 40.00 X X 0 1609084 135112 JOHN P NEAL III TRUSTEE 1.00 X 0 0 0 JULIE A SOEKORO CFO/TREASURER 1.00 40.00 X X 0 721943 112436 SUSAN S YOUNG TRUSTEE 1.00 X 0 0 0 STEVEN P BRIDENSTINE ASSISTANT TREASURER 1.00 40.00 X 0 190514 2534 NANCY CARNEVALE MD MEDICAL DIRECTOR 40.00 X 241232 0 12809 EMILY BRANDT MD PHYSICIAN 40.00 X 161879 0 8613 MARY T WOODRUFF EXECUTIVE DIRECTOR 40.00 X 152345 0 8411 555456 3157602 332813 3 0 1 0 0 2547480 2547480 NET PATIENT SERVICE RE 621300 1357646 1357646 1357646 MISCELLANEOUS INCOME 621300 13283 13283 13283 3918409 1370929 0 0 2311144 2311144 89580 89580 368666 368666 170471 170471 100000 100000 220 220 284204 284204 41070 41070 40511 40511 1139403 1139403 20485 20485 7455 7455 52396 52396 PROFESSIONAL FEES 24566 24566 4650171 4550171 100000 0 363667 93386 71532 73222 45462 22808 431124 22278 404468 408846 885129 598262 1537090 1976132 1537090 1976132 X -651961 -1377870 -651961 -1377870 885129 598262 X -731762 5853 X 0 1 X 1 0 X 1863161 3631238 3122492 2640580 2547480 13804951 278205 577250 1025828 1158034 1357646 4396963 2141366 4208488 4148320 3798614 3905126 18201914 0 0 0 18201914 7997 20724 13283 42004 2141366 4208488 4156317 3819338 3918409 18243918 0.99770 0.99800 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 360000 360000 71124 22278 48846 408846 X PART X, LINE 2: THE SYSTEM HAS ADOPTED PROCEDURES FOR DETERMINING THE EXISTENCE OF UNCERTAIN TAX POSITIONS, AND THE RELATED TIMING AND AMOUNT OF THEIR IMPACT ON THE CONSOLIDATED FINANCIAL STATEMENTS, AND DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2023 AND 2022. 0 1 0 0 0 0 0 0 0 JEFFREY D MEYERS PRESIDENT/CEO 0 955987 0 479272 0 173825 0 59300 0 75812 0 1744196 0 44050 JULIE A SOEKORO CFO/TREASURER 0 391721 0 188023 0 142199 0 31097 0 81339 0 834379 0 15593 SANDRA D MCKENZIE VP/PRESIDENT OF OPERATIONS 0 400619 0 174381 0 61061 0 27158 0 25740 0 688959 0 11908 NANCY CARNEVALE MD MEDICAL DIRECTOR 182966 0 28500 0 29766 0 9098 0 3711 0 254041 0 0 0 STEVEN P BRIDENSTINE ASSISTANT TREASURER 0 168585 0 21040 0 889 0 123 0 2411 0 193048 0 0 EMILY BRANDT MD PHYSICIAN 142798 0 10800 0 8281 0 7875 0 738 0 170492 0 0 0 MARY T WOODRUFF EXECUTIVE DIRECTOR 123417 0 13899 0 15029 0 7543 0 868 0 160756 0 0 0 PART I, LINE 4B THE FOLLOWING PERSONS RECEIVED CURRENT YEAR DEFERREED COMPENSATION ACCRUALS FROM NON-QUALIFIED PLANS: - JEFFREY D. MYERS - $ 44,050 - SANDRA D. MCKENZIE - $ 11,908 - JULIE A. SOEKORO - $ 15,593 THE FOLLOWING PERSONS RECEIVED CURRENT YEAR DEFERRED COMPENSATION ACCRUALS FROM NON-QUALIFIED SERP PLANS: - JEFFREY D. MYERS - $ 405,000 - SANDRA D. MCKENZIE - $ 75,000 FORM 990, PART VI, SECTION A, LINE 7A THE REGULAR TRUSTEES OF THE ORGANIZATION ARE APPOINTED BY THE BOARD OF TRUSTEES OF HAMILTON HEALTH CARE SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN CAPITAL EXPENDITURE AND CONTRACTUAL COMMITMENT DECISIONS MUST BE SUBSEQUENTLY APPROVED BY THE HAMILTON HEALTH CARE SYSTEM BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT CPA FIRM AND REVIEWED BY EXECUTIVE MANAGEMENT. SUBSEQUENTLY, A DRAFT COPY OF THE UNFILED FORM 990 IS POSTED TO A SECURE PAGE ON THE HAMILTON HEALTH CARE SYSTEM WEBSITE FOR REVIEW AND COMMENT BY ALL MEMBERS OF THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CLEAR AND DETAILED CONFLICT OF INTEREST POLICY WHICH ESTABLISHES A PROCEDURE FOR IDENTIFYING, REVIEWING AND ADDRESSING CONFLICTS OF INTEREST. THE POLICY ALSO REQUIRES EACH TRUSTEE AND OFFICER OF THE ORGANIZATION TO ANNUALLY SIGN A STATEMENT ACKNOWLEDGING RECEIPT FOR THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 UNDER A BOARD RESOLUTION, THE FINANCE & AUDIT COMMITTEE OF HAMILTON HEALTH CARE SYSTEM HAS THE AUTHORITY TO TAKE ACTION ON BEHALF OF THE BOARD WITH RESPECT TO THE COMPENSATION OF OFFICERS AND KEY EMPLOYEES. THE FINANCE & AUDIT COMMITTEE OF HAMILTON HEALTH CARE SYSTEM MAINTAINS MINUTES OF ITS PROCEDURES. ON AN ANNUAL BASIS THE FINANCE & AUDIT COMMITTEE OF HAMILTON HEALTH CARE SYSTEM WILL MEET TO SET THE ANNUAL COMPENSATION OF THE PRESIDENT/CEO. THIS ACTION IS BASED ON CONSULTATION WITH A THIRD PARTY CONSULTING FIRM TO REVIEW THE TOTAL COMPENSATION OF THE CEO AND KEY EMPLOYEES SUCH THAT TOTAL COMPENSATION PACKAGES ARE CONSIDERED FAIR MARKET AND NOT EXCESSIVE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: LIABILITY CLAIMS NOT RECOGNIZED 5,121. OTHER ADJUSTMENT 732. HAMILTON HEALTH CARE SYSTEM INC PO BOX 1168 DALTON GA 30722 581519913 SUPPORT RELATED ENTITIES GA 501(C)(3) LINE 12B, II N/A 0 DALTON SENIOR HOUSING INC 519 WEST HAWTHORNE STREET DALTON GA 30720 581518011 LOW-INCOME HOUSING GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 0 HAMILTON AMBULATORY SURGERY CENTER INC PO BOX 1168 DALTON GA 30722 582654791 SURGICAL SERVICES GA 501(C)(3) LINE 3 HAMILTON MEDICAL CENTER INC 0 HAMILTON EMERGENCY MEDICAL SERVICES INC PO BOX 1168 DALTON GA 30722 581651002 EMERGENCY MEDICAL GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 0 HAMILTON MEDICAL CENTER INC PO BOX 1168 DALTON GA 30722 581519911 HEALTHCARE GA 501(C)(3) LINE 3 HAMILTON HEALTH CARE SYSTEM INC 0 HAMILTON PHYSICIAN GROUP INC PO BOX 1168 DALTON GA 30722 271198701 PHYSICIAN PRACTICE GA 501(C)(3) LINE 3 HAMILTON MEDICAL CENTER INC 0 ROYAL OAK COMMUNITY LTD PO BOX 1168 DALTON GA 30722 581970228 SENIOR LIVING SERVICES GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 0 WHITEFIELD PLACE INC PO BOX 1168 DALTON GA 30722 582103085 LOW-INCOME HOUSING GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 0 DALTON-WHITFIELD COUNTY HOSPITAL LIABILITY TRUST PO BOX 1168 DALTON GA 30722 581331514 LIABILITY CLAIMS COVERAGE GA 501(C)(3) LINE 12C, III-FI HAMILTON HEALTH CARE SYSTEM INC 0 WHITFIELD HEALTHCARE FOUNDATION INC PO BOX 1168 DALTON GA 30722 510175056 FUNDS FOR HEALTHCARE GA 501(C)(3) LINE 12B, II HAMILTON HEALTH CARE SYSTEM INC 0 HLTC INC PO BOX 1168 DALTON GA 30722 582341574 LONG TERM CARE GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 0 HAMILTON ORTHOPEDIC SURGERY CENTER 1104 PROFESSIONAL BLVD DALTON GA 30720 873430438 ORTHOPEDIC SURGERY CENTER GA 501(C)(3) LINE 3 HAMILTON HEALTH CARE SYSTEM INC 0 HAMILTON ORTHOPEDIC SURGERY CENTER PO BOX 1168 DALTON GA 30722 873430438 ORTHOPEDIC SURGERY CENTER GA N/A 0 0 HAMILTON HEALTH FIRST INC PO BOX 1168 DALTON GA 30722 581694713 PREFERRED PROVIDER ORGANIZATION GA N/A C 0 HMC HOLDINGS INC PO BOX 1168 DALTON GA 30722 TITLE HOLDINGS GA N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0