CHATUGE REGIONAL HOSPITAL INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- CHATUGE REGIONAL HOSPITAL INC (EIN 58-2513901)
- Tax period
- 2021-05-01 to 2022-04-30
- Filed
- 2023-03-15
- IRS object ID
- 202320749349302067
- Schema version
- 2021v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-03-15T10:04:34-04:00 | ReturnTs |
| Tax Period End | 2022-04-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 580914992 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRAFFIN & TUCKER LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71309 | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317081309 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-05-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 582513901 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHATUGE REGIONAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHAT | BusinessNameControlTxt |
| Phone | 7068962222 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 SOUTH MAIN STREET | AddressLine1Txt |
| City | HIAWASSEE | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 305460509 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NICHOLAS TOWNSEND | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7068962222 | PhoneNum |
| Signature | 2023-03-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | NICHOLAS | PersonFirstNm |
| Person Last | TOWNSEND | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WILLIAM EDWARD PHILLIPS | PreparerPersonNm |
| PTIN | P00451499 | PTIN |
| Phone | 2298837878 | PhoneNum |
| Preparation | 2023-03-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KEVIN L BIERSCHENK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 35 HOSPITAL ROAD | AddressLine1Txt |
| City | BLAIRSVILLE | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30512 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $37,180,775 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.UNIONGENERALHEALTHSYSTEM.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1955 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH QUALITY, COST EFFECTIVE HEALTH CARE AND TO PROMOTE WELLNESS THROUGHOUT OUR COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 419 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,673,176 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,350,794 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $26,950,618 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $32,207,028 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,277 | PYInvestmentIncomeAmt |
| CY Investment Income | $95 | CYInvestmentIncomeAmt |
| PY Other Revenue | $605,278 | PYOtherRevenueAmt |
| CY Other Revenue | $622,858 | CYOtherRevenueAmt |
| PY Total Revenue | $29,232,349 | PYTotalRevenueAmt |
| CY Total Revenue | $37,180,775 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $1,000 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,142,827 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,397,508 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,186,712 | PYOtherExpensesAmt |
| CY Other Expenses | $13,132,387 | CYOtherExpensesAmt |
| PY Total Expenses | $28,329,539 | PYTotalExpensesAmt |
| CY Total Expenses | $30,530,895 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $902,810 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,649,880 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $14,558,257 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,176,211 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,699,366 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,667,440 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,858,891 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,508,771 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE HIGH QUALITY, COST EFFECTIVE HEALTH CARE AND TO PROMOTE WELLNESS THROUGHOUT OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $26,552,180 | ExpenseAmt |
| Grant | $1,000 | GrantAmt |
| Revenue | $32,207,028 | RevenueAmt |
| Desc | CHATUGE REGIONAL HOSPITAL (CRH), A 501(C)(3) HEALTHCARE ORGANIZATION, TAKES A PROACTIVE APPROACH TO MEET COMMUNITY HEALTH NEEDS, THE ORGANIZATION'S TAX-EXEMPTION REQUIREMENTS AND OFFERS COMMUNITY BENEFIT PROGRAMS AND SERVICES WHICH RESULT IN A POSITIVE IMPACT ON COMMUNITY HEALTH. CRH AND CHATUGE REGIONAL NURSING HOME (CRNH) HAVE A VISION TO BE THE "FIRST CHOICE" PROVIDER OF COMPREHENSIVE MEDICAL SERVICES IN OUR AREA. WE VALUE OUR PATIENTS AND RESIDENTS AND BELIEVE THEY ARE OUR MOST IMPORTANT RESPONSIBILITY. WE SHALL ALWAYS SEEK TO MEET THE PHYSICAL, EMOTIONAL, EDUCATIONAL, AND SPIRITUAL NEEDS OF OUR PATIENTS AND THEIR FAMILIES. WE VALUE OUR MEDICAL STAFF AND WILL SEEK WAYS TO HELP THEM IMPROVE PROFESSIONALLY AND FACILITATE THE PRACTICE OF MEDICINE. WE VALUE OUR EMPLOYEES AND SHALL TREAT EACH OTHER WITH COURTESY, FAIRNESS, RESPECT, AND INTEGRITY. WE SHALL WORK AS A TEAM TO DO OUR BEST TO PROMOTE OUR MISSION AND FULFILL OUR VISION. WE VALUE OUR COMMUNITY. WE ARE COMMITTED TO THE TREATMENT AND CARE OF OUR PATIENTS AND PROMOTION OF HEALTH AND WELLNESS IN OUR COMMUNITY. WE WILL CONFRONT ALL ETHICAL AND MORAL HEALTH-RELATED ISSUES NECESSARY TO ENHANCE THE QUALITY OF LIFE IN OUR COMMUNITY. WE VALUE QUALITY CARE AND WILL SEEK TO DELIVER CUSTOMER-FOCUSED, COST EFFICIENT SERVICES WITH COMPASSION AND CARING. EFFECTIVE MAY 1, 2002, CRH WAS DEEMED TO BE A CRITICAL ACCESS HOSPITAL BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) AND BY THE GEORGIA DEPARTMENT OF COMMUNITY HEALTH (DCH). CRH IS THE ONLY ACUTE CARE HOSPITAL IN TOWNS COUNTY, GEORGIA. CRH IS LIMITED TO 25 ACUTE AND INTENSIVE CARE MEDICAL/SURGICAL BEDS. THESE BEDS ARE ALSO USED FOR SHORT-TERM SKILLED NURSING CARE. OUTPATIENT SERVICES INCLUDE RADIOLOGY, LABORATORY AND OTHER DIAGNOSTIC SERVICES, REHABILITATION SERVICES, AND 24/7 EMERGENCY MEDICAL SERVICES. CRNH IS THE ONLY NURSING FACILITY IN THE COUNTY PROVIDING SKILLED AND INTERMEDIATE LEVELS OF LONG-TERM CARE. CRNH IS LICENSED FOR 112 BEDS AND CONSISTENTLY HAS A WAITING LIST FOR ADMISSIONS. A MAJORITY OF THE RESIDENTS OF CRNH ARE MEDICARE AND MEDICAID BENEFICIARIES. IT IS A LONG-ESTABLISHED POLICY OF CRH TO PROVIDE QUALITY CARE FOR ITS PATIENTS REGARDLESS OF THEIR FINANCIAL CIRCUMSTANCES. QUALIFICATION FOR HOSPITAL INDIGENT CARE IS SET AT 125% OF THE CURRENT FEDERAL POVERTY GUIDELINES AND IS BASED ON SIZE OF THE FAMILY UNIT. CRH AND CRNH ALSO PROVIDE FREE OR REDUCED COST CARE TO ALL ELIGIBLE PERSONS REQUESTING CHARITY CARE ASSISTANCE. FOR EMERGENCY MEDICAL SERVICES, INCLUDING ACTIVE LABOR, NO PERSON WILL BE DENIED CARE DUE TO AN INABILITY TO PAY FOR SERVICES. CRH AND CRNH PARTICIPATE IN MEDICARE, MEDICAID, PEACHCARE, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. CRH, IN CONJUNCTION WITH ITS SISTER HOSPITAL, UNION GENERAL HOSPITAL, ARE THE ONLY TAX-EXEMPT, NON-PROFIT HOSPITALS WITHIN THE IMMEDIATE EIGHT-COUNTY AREA OF THE NORTH CENTRAL AND NORTHEAST GEORGIA MOUNTAINS. DUE TO THE MOUNTAINOUS TERRAIN AND BEING BOUNDED BY THE CHATTAHOOCHEE NATIONAL FOREST AND LAKE CHATUGE, TOWNS COUNTY AND ITS NEIGHBORING CLAY COUNTY, NC, HAVE SEVERAL VERY REMOTE COMMUNITIES FROM WHICH ACCESS TO MEDICAL CARE CAN LITERALLY BE MORE THAN AN HOUR AWAY IN SOME CASES. TOWNS COUNTY ATTRACTS MANY VISITORS FOR CAMPING, HIKING, FISHING AND HUNTING. THE TWISTING MOUNTAIN ROADS ATTRACT BICYCLISTS AND MOTORCYCLISTS THROUGHOUT THE SPRING, SUMMER AND FALL SEASONS. THESE ACTIVITIES MANY TIMES RESULT IN MEDICAL EMERGENCIES, SOME VERY SERIOUS, FOR WHICH THE EMERGENCY DEPARTMENT OF CRH MUST BE PREPARED. CRH ESTABLISHED A FAMILY MEDICAL PRACTICE IN HAYESVILLE, NC (CLAY COUNTY) TO HELP MEET THE MEDICALLY UNDERSERVED IN THE COMMUNITY. THE MEDICAL OFFICE IS STAFFED WITH FAMILY NURSE PRACTITIONERS AND SUPPORTED BY PHYSICIANS FROM CRH'S EMERGENCY DEPARTMENT. | Desc |
| Total Program Service Expenses | $26,552,180 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 29 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 419 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NICK TOWNSEND | PersonNm |
| Phone | 7064396498 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 35 HOSPITAL ROAD | AddressLine1Txt |
| City | BLAIRSVILLE | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30512 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| SUZANNE TURNER MD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $620,443 | $0 | $14,804 | |||
| KEVIN L BIERSCHENK | ||||||||
| CEO | 6.00 | $0 | $398,374 | $14,825 | 4.00 | Yes (X) | ||
| JULIA BARNETT | ||||||||
| CNO | 5.00 | $0 | $254,433 | $18,995 | 35.00 | Yes (X) | ||
| MICHAEL GAY | ||||||||
| COO | 6.00 | $0 | $236,638 | $19,561 | 34.00 | Yes (X) | ||
| NICHOLAS TOWNSEND | ||||||||
| CFO | 6.00 | $0 | $238,816 | $15,861 | 34.00 | Yes (X) | ||
| RYAN SNOW | ||||||||
| ADMINISTRATO | 40.00 | Yes (X) | $197,511 | $0 | $6,200 | |||
| KRYSTAL YOUNG | ||||||||
| REGISTERED N | 40.00 | Yes (X) | $125,719 | $0 | $11,057 | |||
| EDWARD DELONG | ||||||||
| REGISTERED N | 40.00 | Yes (X) | $111,969 | $0 | $13,943 | |||
| JUDY GAINER | ||||||||
| NURSE PRACTI | 40.00 | Yes (X) | $110,147 | $0 | $10,143 | |||
| RICK DAVENPORT | ||||||||
| SECRETARY | 1.00 | $0 | $0 | $0 | 1.50 | Yes (X) | ||
| THOMAS GARY MD | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | 1.50 | Yes (X) | ||
| SONNY MAHAN | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | 1.50 | Yes (X) | ||
| GREG OWENBY | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | 1.50 | Yes (X) | ||
| DINAH PARIS | ||||||||
| VICE CHAIR | 1.00 | $0 | $0 | $0 | 1.50 | Yes (X) | Yes (X) | |
| STEVEN ROWE | ||||||||
| CHAIRMAN | 1.00 | $0 | $0 | $0 | 1.50 | Yes (X) | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,165,789 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,128,261 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $125,389 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| FUNCTIONAL PATHWAYS OF TENNESSEE LLC | |||||
| 10133 SHERRILL BLVD SUITE 200 | KNOXVILLE | TN | 379323347 | THERAPY | $426,938 |
| HEALTHCARE SERVICES GROUP | |||||
| 3220 TILLMAN DR SUITE 300 | BENSALEM | PA | 19020 | DIETARY SERVICE | $335,764 |
| CAPESIDE TELE LLC | |||||
| 311 JUDGES ROAD 4E | WILMINGTON | NC | 28405 | BEHAVIORAL STAF | $207,130 |
| MILLER EDX LLC | |||||
| PO BOX 2696 | BLUE RIDGE | GA | 30513 | MEDICAL SERVICE | $141,015 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,486,008 | GovernmentGrantsAmt |
| All Other Contributions | $864,786 | AllOtherContributionsAmt |
| Total Contributions | $4,350,794 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $32,207,028 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $32,207,028 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $32,207,028 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $95 | TotalRevenueColumnAmt |
| Exclusion | $95 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $69,936 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $69,936 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $69,936 | TotalRevenueColumnAmt |
| Exclusion | $69,936 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| PHARMACY - NURSING HOME | 623000 | $435,120 | $435,120 | |
| MISCELLANEOUS | 623000 | $44,400 | $44,400 | |
| CAFETERIA & VENDING | 722514 | $27,356 | $27,356 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,046 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $28,898 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $17,148 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $552,922 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,180,775 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $32,715,446 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $114,535 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,000 | TotalAmt |
| Program Services | $1,000 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,118,120 | TotalAmt |
| Program Services | $11,671,450 | ProgramServicesAmt |
| Management And General | $2,446,670 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $157,112 | TotalAmt |
| Program Services | $129,884 | ProgramServicesAmt |
| Management And General | $27,228 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,122,434 | TotalAmt |
| Program Services | $1,754,616 | ProgramServicesAmt |
| Management And General | $367,818 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $999,842 | TotalAmt |
| Program Services | $826,569 | ProgramServicesAmt |
| Management And General | $173,273 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,046 | TotalAmt |
| Management And General | $69,046 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,528,243 | TotalAmt |
| Program Services | $3,272,331 | ProgramServicesAmt |
| Management And General | $255,912 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,007 | TotalAmt |
| Management And General | $20,007 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,166 | TotalAmt |
| Program Services | $98,514 | ProgramServicesAmt |
| Management And General | $20,652 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,197 | TotalAmt |
| Program Services | $25,248 | ProgramServicesAmt |
| Management And General | $2,949 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $771,997 | TotalAmt |
| Program Services | $691,245 | ProgramServicesAmt |
| Management And General | $80,752 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,145 | TotalAmt |
| Program Services | $17,481 | ProgramServicesAmt |
| Management And General | $3,664 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,334 | TotalAmt |
| Program Services | $8,838 | ProgramServicesAmt |
| Management And General | $1,496 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $322 | TotalAmt |
| Program Services | $322 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,791,979 | TotalAmt |
| Program Services | $1,604,538 | ProgramServicesAmt |
| Management And General | $187,441 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $572,900 | TotalAmt |
| Program Services | $556,867 | ProgramServicesAmt |
| Management And General | $16,033 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $3,776,370 | $3,776,370 | |
| REPAIRS & MAINTENANCE | $1,278,633 | $1,144,888 | $133,745 |
| DUES & SUBSCRIPTIONS | $575,484 | $475,753 | $99,731 |
| PROVIDER FEE | $476,884 | $476,884 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,680 | TotalAmt |
| Program Services | $19,382 | ProgramServicesAmt |
| Management And General | $72,298 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,530,895 | TotalAmt |
| Program Services | $26,552,180 | ProgramServicesAmt |
| Management And General | $3,978,715 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $433,534 | BOYAmt |
| EOY | $148,541 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,931,880 | BOYAmt |
| EOY | $3,344,838 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $608,705 | BOYAmt |
| EOY | $632,283 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,427 | BOYAmt |
| EOY | $32,135 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $25,709,775 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $18,024,850 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,126,801 | BOYAmt |
| EOY | $7,684,925 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,420,910 | BOYAmt |
| EOY | $6,333,489 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,558,257 | BOYAmt |
| EOY | $18,176,211 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,134,023 | BOYAmt |
| EOY | $1,298,376 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,540,262 | BOYAmt |
| EOY | $2,164,480 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,025,081 | BOYAmt |
| EOY | $6,204,584 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,699,366 | BOYAmt |
| EOY | $9,667,440 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,858,891 | BOYAmt |
| EOY | $8,508,771 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,858,891 | BOYAmt |
| EOY | $8,508,771 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,558,257 | BOYAmt |
| EOY | $18,176,211 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $6,649,880 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $877,121 | OtherCostOrOtherBasisAmt |
| Book Value | $877,121 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,869,171 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,313,858 | DepreciationAmt |
| Book Value | $4,555,313 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $321,267 | OtherCostOrOtherBasisAmt |
| Depreciation | $239,357 | DepreciationAmt |
| Book Value | $81,910 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,455,006 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,471,635 | DepreciationAmt |
| Book Value | $1,983,371 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $187,210 | OtherCostOrOtherBasisAmt |
| Book Value | $187,210 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,684,925 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM RELATED PARTIES | $4,549,570 |
| THIRD PARTY RECEIVABLE | $1,783,919 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $6,333,489 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| MEDICARE ADVANCE PAYMENTS | $2,448,314 |
| THIRD PARTY SETTLEMENTS | $1,839,637 |
| REFUNDABLE CARES LIABILITY | $1,790,997 |
| PATIENT REFUNDS PAYABLE | $125,636 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,204,584 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | UNION, CHATUGE, THE AMBULANCE SERVICE, THE UNION GENERAL AFFILIATED SERVICES, AND THE NORTH CAROLINA AFFILIATED SERVICES ARE TAX EXEMPT UNDER SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. THE DIALYSIS CLINIC IS ORGANIZED UNDER GEORGIA LAW AND THE INTERNAL REVENUE CODE (IRC) AS A LIMITED LIABILITY COMPANY (LLC). THE DIALYSIS CLINIC IS TAXED AS A PARTNERSHIP UNDER FEDERAL AND STATE LAW AND IS THEREFORE NOT SUBJECT TO CORPORATE INCOME TAXATION. THE CORPORATION IS THE SOLE OWNER OF THE LLC. THE CORPORATION'S INCOME FROM DIALYSIS CLINIC'S OPERATIONS IS CONSIDERED RELATED BUSINESS INCOME AND THEREFORE IS NOT SUBJECT TO TAX. UNION GENERAL HEALTH SYSTEM SEGREGATED PORTFOLIO IS EXEMPTED FROM ALL LOCAL INCOME, PROFIT, OR CAPITAL GAINS TAXES UNTIL MAY 1, 2040, UNDER THE CAYMAN ISLANDS CONCESSIONS LAW. THE CORPORATION 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 CORPORATION 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 SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF APRIL 30, 2022 OR 2021 OR FOR THE YEARS THEN ENDED. THE CORPORATION'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 THOSE RETURNS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 1.250000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $68,932 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $68,932 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00230 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,503,737 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,573,422 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,572,669 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,573,422 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $68,932 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00230 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $669 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $669 | NetCommunityBenefitExpnsAmt |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $669 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $669 | NetCommunityBenefitExpnsAmt |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,573,338 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,573,422 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $69,601 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00230 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,202,487 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $341,385 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $9,899,149 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,704,387 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $194,762 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHATUGE REGIONAL HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 SOUTH MAIN STREET | AddressLine1Txt |
| City | HIAWASSEE | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 305460509 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.UNIONGENERALHEALTHSYSTEM.COM | WebsiteAddressTxt |
| State License | 139-583 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | SNF, CLINICS | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHATUGE REGIONAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.UNIONGENERALHEALTHSYSTEM.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.UNIONGENERALHEALTHSYSTEM.COM/COMMU | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 125.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.UNIONGENERALHEALTHSYSTEM.COM/PATIE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.UNIONGENERALHEALTHSYSTEM.COM/PATIE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.UNIONGENERALHEALTHSYSTEM.COM/PATIE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, CHATUGE REGIONAL HOSPITAL, INC - PART V, LINE 3E | THE COMMUNITY ADVISORY PARTICIPATION COMMITTEE PRIORITIZED THE FOLLOWING COMMUNITY HEALTH NEEDS: 1) HEART/VASCULAR DISEASE 2) OVERWEIGHT/OBESITY 3) DRUG/SUBSTANCE ABUSE 4) CHILD NUTRITION 5) MENTAL HEALTH |
| FACILITY 1, CHATUGE REGIONAL HOSPITAL, INC - PART V, LINE 5 | THE HOSPITAL COLLABORATED WITH GEORGIA SOUTHERN UNIVERSITY TO ENLIST COMMUNITY REPRESENTATIVES TO SERVE ON THE COMMUNITY ADVISORY COMMITTEE (CAC) TO ASSIST WITH DESIGN AND DISTRIBUTION OF A HEALTH NEEDS SURVEY. TWO COMMUNITY MEETINGS WERE SCHEDULED AND HELD REMOTELY USING ZOOM TECHNOLOGY WITH THE CAC DUE TO COVID-19. APPROXIMATELY 250 SURVEYS WERE DISTRIBUTED THROUGHOUT THE COMMUNITY AND 4 KEY STAKEHOLDER INTERVIEWS WERE CONDUCTED. |
| FACILITY 1, CHATUGE REGIONAL HOSPITAL, INC - PART V, LINE 11 | THE FOLLOWING COMMUNITY HEALTH NEEDS WERE IDENTIFIED BY THE CHATUGE REGIONAL HOSPITAL'S COMMUNITY ADVISORY COMMITTEE AS SIGNFICANT HEALTH NEEDS: 1. HEART/VASCULAR DISEASE 2. OVERWEIGHT/OBESITY 3. DRUG/SUBSTANCE ABUSE 4. CHILD NUTRITION 5. MENTAL HEALTH THE HOSPITAL ADDRESSES THE IDENTIFIED NEEDS IN SOME MANNER FROM COLLABORATION WITH OTHER PROVIDERS TO CLINICAL OUTREACH TO COMMUNITY EDUCATION. THE CURRENT CHNA AND IMPLEMENTATION STRATEGIES, AS WELL AS THE PREVIOUS CHNA (WHICH WAS CONDUCTED IN 2018) ARE AVAILABLE ON THE HOSPITAL'S WEBSITE AT: HTTP://WWW.UNIONGENERALHEALTHSYSTEM.COM/COMMUNITY-HEALTH/. |
| FACILITY 1, CHATUGE REGIONAL HOSPITAL, INC - PART V, LINE 16J | A NOTICE IS RUN ANNUALLY IN THE LOCAL NEWSPAPER REGARDING THE AVAILABILITY OF FREE AND DISCOUNTED CARE FOR PATIENTS THAT QUALIFY UNDER THE HOPSITAL'S FINANCIAL ASSISTANCE POLICY. COMPLETE URL FOR COMMUNITY HEALTH NEEDS ASSESSMENTS AND ACTION PLANS (IMPLEMENTATION STRATEGY REPORTS) - HTTP://WWW.UNIONGENERALHEALTHSYSTEM.COM/COMMUNITY-HEALTH/ COMPLETE URL - FAP, FAP SUMMARY AND APPLICATION HTTP://WWW.UNIONGENERALHEALTHSYSTEM.COM/PATIENTS/BUSINESS-DEPARTMENT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|
| CHATUGE REGIONAL NURSING HOME | |||||
| 386 BELAIRE DRIVE | HIAWASSEE | GA | 30546 | SKILLED NURSING | |
| HAYESVILLE FAMILY PRACTICE | |||||
| 450 HIGHWAY 64 BUSINESS | HAYESVILLE | NC | 28904 | FAMILY CLINIC | SUITE 4 |
| UNION GENERAL AT SUCHES | |||||
| 56 FIREWATER LANE | SUCHES | GA | 30572 | PHYSICIAN CLINIC | |
| UNION GENERAL AT YOUNG HARRIS | |||||
| 1155 MAIN STREET | YOUNG HARRIS | GA | 30582 | PHYSICIAN CLINIC | |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7 | THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATION'S "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS, 2008". THE COSTS FOR PART I, LINE 7A AND 7B WERE CALCULATED USING THE RATIO OF COSTS TO CHARGES USING WORKSHEET 2 IN THE INSTUCTIONS TO FORM 990 SCHEDULE H. |
| SCHEDULE H, PART III, LINE 2 | AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE. PURSUANT TO ASU NO. 2014-09 (TOPIC 606) DISCUSSED IN MORE DETAIL BELOW, THE AMOUNT IDENTIFIED AS BAD DEBT ON SCHEDULE H, PART II, LINE 2 PRIMARILY REPRESENTS AMOUNTS ESTIMATED AT THE TRANSACTION DATE THAT ARE CONSIDERED A PRICE CONCESSION. |
| SCHEDULE H, PART III, LINE 3 | BASED ON PAST EXPERIENCE, THE ORGANIZATION HAS FOUND THAT THERE IS A PORTION OF BAD DEBT THAT IS GENERALLY ATTRIBUTABLE TO CHARITY CARE. BASED ON ECONOMIC CENSUS RECORDS, 15.5% OF PERSONS ARE BELOW THE POVERTY LEVEL, WE ESTIMATE THAT 15.5% IF THE BAD DEBT AMOUNT ON LINE 2 WOULD BE ATTRIBUTABLE TO THOSE PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY HAD THEY COMPLETED AN APPLICATION. |
| SCHEDULE H, PART III, LINE 4 | IN MAY 2014, THE FASB ISSUED ASU NO. 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606), WHICH IS A NEW COMPREHENSIVE REVENUE RECOGNITION STANDARD. THE CORE PRINCIPLE OF THE REVENUE MODEL IS THAT AN ENTITY RECOGNIZES REVENUE TO DEPICT THE TRANSFER OF PROMISED GOODS OR SERVICES TO CUSTOMERS IN AN AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE ENTITY EXPECTS TO BE ENTITLED IN EXCHANGE FOR THOSE GOODS OR SERVICES. THE CORPORATION ADOPTED ASU NO. 2014-09 ON MAY 1, 2020 USING THE FULL RETROSPECTIVE METHOD OF TRANSITION WITH PRACTICAL EXPEDIENTS IN FASB ASC 606-10-65-1(F) WITH NO SIGNIFICANT IMPACT. THE CORPORATION PERFORMED AN ANALYSIS OF REVENUE STREAMS AND TRANSACTIONS UNDER ASU NO. 2014-09. IN PARTICULAR, FOR NET PATIENT SERVICE REVENUE, THE CORPORATION PERFORMED AN ANALYSIS INTO THE APPLICATION OF THE PORTFOLIO APPROACH AS A PRACTICAL EXPEDIENT TO GROUP PATIENT CONTRACTS WITH SIMILAR CHARACTERISTICS, SUCH THAT REVENUE FOR A GIVEN PORTFOLIO WOULD NOT BE MATERIALLY DIFFERENT THAN IF IT WERE EVALUATED ON A CONTRACT-BY-CONTRACT BASIS. UPON ADOPTION, THE MAJORITY OF WHAT WAS PREVIOUSLY CLASSIFIED AS PROVISION FOR BAD DEBTS (REPRESENTING APPROXIMATELY 4 MILLION FOR THE YEAR ENDED APRIL 30, 2020) AND PRESENTED AS A REDUCTION TO NET PATIENT SERVICE REVENUE ON THE STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS IS NOW TREATED AS A PRICE CONCESSION THAT REDUCES THE TRANSACTION PRICE, WHICH IS REPORTED AS NET PATIENT SERVICE REVENUE. CHANGES IN CREDIT ISSUES NOT ASSESSED AT THE DATE OF SERVICE, ARE RECOGNIZED AS BAD DEBT EXPENSE AND INCLUDED AS A COMPONENT OF OPERATING EXPENSES ON THE STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS. THE NEW STANDARD ALSO REQUIRES ENHANCED DISCLOSURES RELATED TO THE DISAGGREGATION OF REVENUE AND SIGNIFICANT JUDGMENTS MADE IN MEASUREMENT AND RECOGNITION. THE ADOPTION OF THIS GUIDANCE DID NOT MATERIALLY IMPACT TOTAL OPERATING REVENUES, EXCESS REVENUES (EXPENSES), OR NET ASSETS. SEE FOOTNOTES 2 AND 3 IN THE ATTACHED AUDITED STATEMENTS FOR A DISCUSSION OF NET PATIENT SERVICE REVENUE WHICH INCLUDES A DISCUSSION OF CHARITY CARE AND UNINSURED DISCOUNTS. |
| 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 | ONCE A PATIENT IS APPROVED FOR INDIGENT CARE (100% WRITE OFF) THE ACCOUNT(S) IS (ARE) RECLASSIFIED TO INDIGENT CARE AND NO FURTHER COLLECTION ACTIVITY IS CONDUCTED. FOR PATIENTS APPROVED FOR CHARITY CARE (REDUCED CHARGE), THE ACCOUNT GUARANTOR WILL RECEIVE STATEMENTS AND PHONE CALLS TO COLLECT ANY REMAINING BALANCE DUE. PATIENTS WILL RECEIVE THREE (3) STATEMENTS, ONE (1) NOTICE LETTER AND MULTIPLE PHONE CALLS REQUESTING PAYMENT IN FULL OR PAYMENT ARRANGEMENTS BE MADE. STATEMENTS 1. INITIAL A. PATIENTS WILL NORMALLY RECEIVE A STATEMENT FOR SERVICES RENDERED WITHIN THIRTY (30) DAYS OF DISCHARGE AS AN INPATIENT OR TREATMENT AS AN OUTPATIENT (EXCLUDING RECURRING VISITS). B. RECURRING VISIT PATIENTS WILL NORMALLY RECEIVE A BILL FOR SERVICES RENDERED FOR THE PRIOR MONTH WITHIN ONE MONTH. 2. SUBSEQUENT STATEMENTS A. THE SECOND STATEMENT WILL BE ISSUED THIRTY (30) DAYS AFTER THE INITIAL STATEMENT. B. THE THIRD STATEMENT WILL BE ISSUED SIXTY (60) DAYS AFTER THE INITIAL STATEMENT. C. THE NOTICE LETTER WILL BE ISSUED NINETY (90) DAYS AFTER THE INITIAL STATEMENT REQUESTING PAYMENT IN FULL UPON RECEIPT. THIS LETTER WILL NOTIFY THE PATIENT THEIR ACCOUNT WILL BE REFLECTED AS A BAD DEBT AND REFERRED TO AN OUTSIDE COLLECTION AGENCY IF PAYMENT IN FULL IS NOT RECEIVED WITHIN THIRTY (30) CALENDAR DAYS OF THE STATEMENT DATE. THE NOTIFICATION WILL SPECIFY ANY EXTRAORDINARY COLLECTION ACTIONS THAT MAY BE UNDERTAKEN IF THE PATIENT DOES NOT MAKE FULL PAYMENT OR COMPLETE A FINANCIAL ASSISTANCE APPLICATION. D. ONE HUNDRED TWENTY (120) DAYS AFTER THE INITIAL STATEMENT THESE ACCOUNTS WILL BE WRITTEN OFF AS A BAD DEBT ADJUSTMENT AND SENT TO AN OUTSIDE COLLECTION AGENCY. 3. ALL STATEMENTS WILL INCLUDE LANGUAGE THAT INFORMS THE RECIPIENT ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE AND INCLUDES A TELEPHONE NUMBER AND THE WEBSITE ADDRESS TO OBTAIN ADDITIONAL INFORMATION. PHONE CALLS THIRTY (30) DAYS AFTER THE INITIAL STATEMENT, THE PATIENT MAY BEGIN TO RECEIVE MULTIPLE PHONE CALLS REQUESTING PAYMENT IN FULL OR PAYMENT ARRANGEMENTS BE MADE. THE PATIENT WILL BE INFORMED THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE AND OFFERED A COPY OF THE PLAIN LANGUAGE SUMMARY OF THE FAP. USE OF OUTSIDE COLLECTION AGENCY WHEN A PATIENT AND/OR GUARANTOR FAIL TO PAY THE PATIENT LIABILITY, THE ACCOUNT WILL BE REFERRED TO AN OUTSIDE COLLECTION AGENCY. REASONABLE EFFORTS - THE BUSINESS OFFICE MANAGER WILL BE RESPONSIBLE FOR ENSURING THAT THE FACILITY HAS MADE REASONABLE EFFORTS TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE PRIOR TO ENGAGING IN ANY EXTRAORDINARY COLLECTION ACTION (ECA). EXTRAORDINARY COLLECTION ACTIONS (ECAS) - THE PATIENT AND/OR GUARANTOR SHALL BE PROVIDED AT LEAST THIRTY (30) DAYS WRITTEN NOTICE PRIOR TO ANY ECAS BEING TAKEN. THE WRITTEN NOTICE WILL INCLUDE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY, NOTIFICATION OF ANY ECAS THAT MAYBE INITIATED AGAINST THE PATIENT AND /OR GUARANTOR, AND THE DATE AFTER WHICH ANY ECAS WILL BE INITIATED. ORAL NOTIFICATION TO THE PATIENT AND/OR GUARANTOR WILL BE ATTEMPTED VIA A PHONE CALL PRIOR TO ANY ECAS BEING INITIATED. THE ORAL NOTIFICATION WILL INFORM THE PATIENT AND/OR GUARANTOR ABOUT THE FINANCIAL ASSISTANCE POLICY AND HOW TO OBTAIN HELP WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS. ECAS MAY NOT COMMENCE PRIOR DURING THE NOTIFICATION PERIOD. THE NOTIFICATION PERIOD ENDS ON THE 120TH DAY AFTER THE FACILITY ISSUES THE FIRST POST-DISCHARGE BILLING STATEMENT TO THE PATIENT. IF, BY THE END OF THIS 120 DAY PERIOD THE PATIENT HAS NOT SUBMITTED A FINANCIAL ASSISTANCE APPLICATION, THE FACILITY MAY BEGIN COLLECTION ACTIONS AGAINST THE PATIENT. THE APPLICATION PERIOD DURING WHICH FACILITY WILL ACCEPT AND PROCESS A FINANCIAL ASSISTANCE APPLICATION ENDS ON THE 240TH DAY AFTER THE FACILITY ISSUES THE FIRST POST-DISCHARGE BILLING STATEMENT TO THE PATIENT. LEGAL ACTIONS LEGAL ACTIONS MAY BE INITIATED AGAINST THE PATIENT AND/OR GUARANTOR WHO DEFAULT ON PAYMENT TO THE FACILITY. THESE LEGAL ACTIONS MAY INCLUDE: - PLACING A LIEN ON AN INDIVIDUALS PROPERTY EXCEPT FOR ANY LIEN THE FACILITY IS ENTITLED TO ASSERT UNDER STATE LAW ON THE PROCEEDS OF A JUDGMENT, SETTLEMENT, ORE COMPROMISE OWED TO AN INDIVIDUAL AS A RESULT OF PERSONAL INJURIES FOR WHICH CARE WAS PROVIDED; - FORECLOSING ON AN INDIVIDUALS REAL PROPERTY; - ATTACHING OR SEIZING AN INDIVIDUALS BANK ACCOUNT OR ANY OTHER PERSONAL PROPERTY; - COMMENCING A CIVIL ACTION AGAINST AN INDIVIDUAL; AND - GARNISHING AN INDIVIDUALS WAGES. ALL LEGAL ACTIONS TAKEN BY ANY COLLECTION AGENCY ON BEHALF OF THE FACILITY SHALL HAVE HAD PRIOR REVIEW AND APPROVAL FROM THE FACILITY. THE FACILITY OR ANY COLLECTIONS AGENCY WORKING ON BEHALF OF THE FACILITY SHALL NOT PURSUE ENFORCEMENT OF A JUDGMENT LIEN, WHETHER BY SHERIFFS LEVY AND SALE OR OTHERWISE, ON A PRIMARY RESIDENCE, PURSUE AN INVOLUNTARY BANKRUPTCY PROCEEDING AGAINST A PATIENT AND /OR GUARANTOR, OR TAKE ANY ACTION THAT WOULD CAUSE A BENCH WARRANT (AN ORDER ISSUED BY A JUDGE OR COURT FOR THE ARREST OF A PERSON) TO BE ISSUED. HOWEVER, THE FACILITY MAY PURSUE APPROPRIATE COURT ORDERS, INCLUDING CONTEMPT OF COURT, FOR A PATIENT/JUDGMENT DEBTOR FAILING TO RESPOND TO POST-JUDGMENT DISCOVERY AS REQUIRED BY LAW. |
| SCHEDULE H, PART VI, LINE 2 | THE ORGANIZATION PERIODICALLY SOLICITS FEEDBACK FROM THE MEDICAL STAFF AND FROM CITY AND COUNTY OFFICIALS, IN ADDITION TO THE INPUT RECEIVED DURING THE CHNA PROCESS. |
| SCHEDULE H, PART VI, LINE 3 | THE ORGANIZATION PUBLISHES A NOTICE IN THE LOCAL COMMUNITY NEWSPAPER. AT THE TIME OF REGISTRATION, AN AGENT INFORMS THE ACCOUNT GUARANTOR OF THE AVAILABILITY OF INDIGENT AND CHARITY CARE. ACCOUNT COLLECTORS ALSO INFORM THE GUARANTOR OF THE AVAILABILITY OF THE POLICIES. THE FAP, THE PLAIN LANGUAGE SUMMARY AND THE APPLICATION FOR FINANCIAL ASSISTANCE ARE ON THE ORGANIZATION'S WEBSITE. A PLAIN LANGUAGE SUMMARY OF THE POLICY IS OFFERED TO ALL PATIENTS PRIOR TO DISCHARGE. SIGNAGE IN KEY AREAS OF THE HOSPITAL NOTIFY PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. |
| SCHEDULE H, PART VI, LINE 4 | CHATUGE REGIONAL HOSPITAL ("CRH") SERVES A GENERALLY RURAL, MOUNTAINOUS AREA AND IS THE SOLE HOSPITAL IN TOWNS COUNTY. DUE TO THE MOUNTAINOUS TERRAIN AND BEING BOUNDED BY THE CHATTAHOOCHEE NATIONAL FOREST AND LAKE CHATUGE, TOWNS COUNTY AND ITS NEIGHBORING CLAY COUNTY, NC HAVE VERY REMOTE COMMUNITIES FROM WHICH ACCESS TO MEDICAL CARE CAN LITERALLY BE MORE THAN AN HOUR AWAY IN SOME CASES. TOWNS COUNTY ATTRACTS MANY VISITORS FOR CAMPING, BOATING, HIKING, FISHING AND HUNTING, AS WELL AS BICYCLISTS AND MOTORCYCLISTS, WHICH OFTEN LEAD TO SERIOUS INJURY THAT THE EMERGENCY DEPARTMENT MUST BE PREPARED TO MEET. FURTHERMORE, CRH IS A CRITICAL ACCESS HOSPITAL FOR THE RESIDENTS OF TOWNS COUNTY, GA, AND CLAY COUNTY, NC. SIGNIFICANT PORTIONS OF THE RESIDENT POPULATION ARE MEDICARE AND MEDICAID BENEFICIARIES. TOWNS COUNTY IS DEEMED TO HAVE A MEDICALLY UNDERSERVED POPULATION (MUP) BY THE GEORGIA DEPARTMENT OF COMMUNITY HEALTH. |
| SCHEDULE H, PART VI, LINE 5 | THE ORGANIZATION PROMOTES/CONDUCTS HEALTH FAIRS OPEN TO THE COMMUNITY WHEREIN FREE HEALTH SCREENINGS AND LOW-COST BASIC LAB TESTS ARE DONE. OTHER HEALTH INFORMATION IS PROVIDED INCLUDING INFORMATION ON SMOKING CESSATION AND DIABETES. THE ORGANIZATION IS ENTIRELY TOBACCO-FREE, THUS PROMOTING A HEALTHY LIFESTYLE. SURPLUS FUNDS ARE USED TO PROVIDE FOR THE ADDITION, IMPROVEMENT, OR REPLACEMENT OF CAPITAL AND EQUIPMENT NEEDS. THE BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY VOLUNTEERS. THE HOSPITAL PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS, OFFERS FINANCIAL ASSISTANCE FOR MEDICAL CARE TO ELIGIBLE INDIVIDUALS AND IT HAS AN OPEN MEDICAL STAFF. |
| SCHEDULE H, PART VI, LINE 7 | GEORGIA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|
| SUZANNE TURNER MD | ||||||||||
| PHYSICIAN | $385,277 | $235,166 | $8,700 | $6,104 | $635,247 | |||||
| KEVIN L BIERSCHENK | ||||||||||
| CEO | $358,624 | $39,750 | $8,700 | $6,125 | $413,199 | |||||
| JULIA BARNETT | ||||||||||
| CNO | $215,408 | $39,025 | $10,039 | $8,956 | $273,428 | |||||
| MICHAEL GAY | ||||||||||
| COO | $215,113 | $21,525 | $9,777 | $9,784 | $256,199 | |||||
| NICHOLAS TOWNSEND | ||||||||||
| CFO | $217,291 | $21,525 | $9,736 | $6,125 | $254,677 | |||||
| RYAN SNOW | ||||||||||
| ADMINISTRATOR | $179,186 | $18,325 | $6,200 | $203,711 | ||||||
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PAGE 1, PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE OFFICERS OF THE ORGANIZATION ARE EMPLOYED BY UNION COUNTY HOSPITAL AUTHORITY (DBA UNION GENERAL HOSPITAL), A RELATED TAX-EXEMPT ORGANIZATION. THE BOARD OF DIRECTORS OF THE AUTHORITY REVIEW THE FORM 990 OF SIMILAR ORGANIZATIONS AND REVIEW INDEPENDENT COMPENSATION SURVEY DATA WHEN APPROVING THE COMPENSATION OF THE CEO. THE CEO IS RESPONSIBLE FOR SETTING THE COMPENSATION OF THE OTHER OFFICERS OF THE AUTHORITY. CURRENTLY, THE BOARD OF DIRECTORS OF THE AUTHORITY AND CHATUGE REGIONAL HOSPITAL, INC. ARE IDENTICAL. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4A | CHATUGE REGIONAL HOSPITAL (CRH), A 501(C)(3) HEALTHCARE ORGANIZATION, TAKES A PROACTIVE APPROACH TO MEET COMMUNITY HEALTH NEEDS, THE ORGANIZATION'S TAX-EXEMPTION REQUIREMENTS AND OFFERS COMMUNITY BENEFIT PROGRAMS AND SERVICES WHICH RESULT IN A POSITIVE IMPACT ON COMMUNITY HEALTH. CRH AND CHATUGE REGIONAL NURSING HOME (CRNH) HAVE A VISION TO BE THE "FIRST CHOICE" PROVIDER OF COMPREHENSIVE MEDICAL SERVICES IN OUR AREA. WE VALUE OUR PATIENTS AND RESIDENTS AND BELIEVE THEY ARE OUR MOST IMPORTANT RESPONSIBILITY. WE SHALL ALWAYS SEEK TO MEET THE PHYSICAL, EMOTIONAL, EDUCATIONAL, AND SPIRITUAL NEEDS OF OUR PATIENTS AND THEIR FAMILIES. WE VALUE OUR MEDICAL STAFF AND WILL SEEK WAYS TO HELP THEM IMPROVE PROFESSIONALLY AND FACILITATE THE PRACTICE OF MEDICINE. WE VALUE OUR EMPLOYEES AND SHALL TREAT EACH OTHER WITH COURTESY, FAIRNESS, RESPECT, AND INTEGRITY. WE SHALL WORK AS A TEAM TO DO OUR BEST TO PROMOTE OUR MISSION AND FULFILL OUR VISION. WE VALUE OUR COMMUNITY. WE ARE COMMITTED TO THE TREATMENT AND CARE OF OUR PATIENTS AND PROMOTION OF HEALTH AND WELLNESS IN OUR COMMUNITY. WE WILL CONFRONT ALL ETHICAL AND MORAL HEALTH-RELATED ISSUES NECESSARY TO ENHANCE THE QUALITY OF LIFE IN OUR COMMUNITY. WE VALUE QUALITY CARE AND WILL SEEK TO DELIVER CUSTOMER-FOCUSED, COST EFFICIENT SERVICES WITH COMPASSION AND CARING. EFFECTIVE MAY 1, 2002, CRH WAS DEEMED TO BE A CRITICAL ACCESS HOSPITAL BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) AND BY THE GEORGIA DEPARTMENT OF COMMUNITY HEALTH (DCH). CRH IS THE ONLY ACUTE CARE HOSPITAL IN TOWNS COUNTY, GEORGIA. CRH IS LIMITED TO 25 ACUTE AND INTENSIVE CARE MEDICAL/SURGICAL BEDS. THESE BEDS ARE ALSO USED FOR SHORT-TERM SKILLED NURSING CARE. OUTPATIENT SERVICES INCLUDE RADIOLOGY, LABORATORY AND OTHER DIAGNOSTIC SERVICES, REHABILITATION SERVICES, AND 24/7 EMERGENCY MEDICAL SERVICES. CRNH IS THE ONLY NURSING FACILITY IN THE COUNTY PROVIDING SKILLED AND INTERMEDIATE LEVELS OF LONG-TERM CARE. CRNH IS LICENSED FOR 112 BEDS AND CONSISTENTLY HAS A WAITING LIST FOR ADMISSIONS. A MAJORITY OF THE RESIDENTS OF CRNH ARE MEDICARE AND MEDICAID BENEFICIARIES. IT IS A LONG-ESTABLISHED POLICY OF CRH TO PROVIDE QUALITY CARE FOR ITS PATIENTS REGARDLESS OF THEIR FINANCIAL CIRCUMSTANCES. QUALIFICATION FOR HOSPITAL INDIGENT CARE IS SET AT 125% OF THE CURRENT FEDERAL POVERTY GUIDELINES AND IS BASED ON SIZE OF THE FAMILY UNIT. CRH AND CRNH ALSO PROVIDE FREE OR REDUCED COST CARE TO ALL ELIGIBLE PERSONS REQUESTING CHARITY CARE ASSISTANCE. FOR EMERGENCY MEDICAL SERVICES, INCLUDING ACTIVE LABOR, NO PERSON WILL BE DENIED CARE DUE TO AN INABILITY TO PAY FOR SERVICES. CRH AND CRNH PARTICIPATE IN MEDICARE, MEDICAID, PEACHCARE, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. CRH, IN CONJUNCTION WITH ITS SISTER HOSPITAL, UNION GENERAL HOSPITAL, ARE THE ONLY TAX-EXEMPT, NON-PROFIT HOSPITALS WITHIN THE IMMEDIATE EIGHT-COUNTY AREA OF THE NORTH CENTRAL AND NORTHEAST GEORGIA MOUNTAINS. DUE TO THE MOUNTAINOUS TERRAIN AND BEING BOUNDED BY THE CHATTAHOOCHEE NATIONAL FOREST AND LAKE CHATUGE, TOWNS COUNTY AND ITS NEIGHBORING CLAY COUNTY, NC, HAVE SEVERAL VERY REMOTE COMMUNITIES FROM WHICH ACCESS TO MEDICAL CARE CAN LITERALLY BE MORE THAN AN HOUR AWAY IN SOME CASES. TOWNS COUNTY ATTRACTS MANY VISITORS FOR CAMPING, HIKING, FISHING AND HUNTING. THE TWISTING MOUNTAIN ROADS ATTRACT BICYCLISTS AND MOTORCYCLISTS THROUGHOUT THE SPRING, SUMMER AND FALL SEASONS. THESE ACTIVITIES MANY TIMES RESULT IN MEDICAL EMERGENCIES, SOME VERY SERIOUS, FOR WHICH THE EMERGENCY DEPARTMENT OF CRH MUST BE PREPARED. CRH ESTABLISHED A FAMILY MEDICAL PRACTICE IN HAYESVILLE, NC (CLAY COUNTY) TO HELP MEET THE MEDICALLY UNDERSERVED IN THE COMMUNITY. THE MEDICAL OFFICE IS STAFFED WITH FAMILY NURSE PRACTITIONERS AND SUPPORTED BY PHYSICIANS FROM CRH'S EMERGENCY DEPARTMENT. |
| FORM 990, PART VI | THE BOARD OF DIRECTORS, CEO, AND CFO SERVE IN A SIMILAR CAPACITY FOR UNION GENERAL HOSPITAL, CHATUGE REGIONAL HOSPITAL AND UNION GENERAL AMBULANCE SERVICE. |
| FORM 990, PAGE 6, PART VI, LINE 6 | UNION GENERAL HOSPITAL, INC., A GEORGIA 501(C)(3) NON-PROFIT HEALTHCARE ORGANIZATION, IS THE SOLE MEMBER OF THE ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 7A | EACH MEMBER OF THE BOARD OF DIRECTORS IS APPOINTED BY RESOLUTION OF THE BOARD OF DIRECTORS OF THE SOLE MEMBER, UNION GENERAL HOSPITAL. CURRENTLY, THE BOARD OF DIRECTORS OF UNION GENERAL HOSPITAL AND OF CHATUGE REGIONAL HOSPITAL ARE IDENTICAL. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. THE CFO REVIEWED THE RETURN IN DETAIL AND PROVIDED A COPY OF THE COMPLETED FORM 990 TO EACH BOARD MEMBER PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | OFFICERS AND DIRECTORS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY THAT REQUIRES DISCLOSURE OF ANY POTENTIAL RELATIONSHIP CONFLICTS. ANY CONFLICTS ARE REPORTED TO THE CHAIRMAN OF THE BOARD AND/OR DISINTERESTED PERSON OR COMMITTEE. THE INDIVIDUAL MEMBER WITH THE CONFLICT RECUSES HIMSELF FROM THE DISCUSSIONS AND VOTES ON THE ISSUE. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE CEO IS PAID BY UNION GENERAL HOSPITAL. CURRENTLY, UNION GENERAL HOSPITAL AND CHATUGE REGIONAL HOSPITAL SHARE A COMMON BOARD OF DIRECTORS. THE BOARD PROVIDES ALL OVERSIGHT FOR THE PROCESS OF COMPENSATING THE CEO. THE CEO IS RESPONSIBLE FOR THE COMPENSATION OF THE OTHER OFFICERS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SEE THE RESPONSE TO QUESTION 15A ABOVE. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONTRACT LABOR - PATIENT CARE 1,218,315 142,323 0 PURCHASED SERVICES 699,064 81,664 0 CONSULTING 59,917 6,999 0 MEDICAL - PROFESSIONAL FEES 1,081,660 0 0 OTHER 213,375 24,926 0 TOTAL 3,272,331 255,912 0 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Business Name Line2DirectControllingEntityName/BusinessNameLine2Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| UNION GENERAL HOSPITAL INC | ||||||||||||
| 35 HOSPITAL ROAD | BLAIRSVILLE | GA | 30512 | 586025393 | HOSPITAL | GA | 501C3 | 3 | N/A | false | ||
| MOUNTAIN COMMUNITY HEALTHCARE FOUND | ||||||||||||
| P O BOX 509 | HIAWASSEE | GA | 30546 | 201376498 | FUNDRAISIN | GA | 501C3 | 12C | false | UGH | UNION GENERAL HOSPITAL INC | |
| UNION GENERAL AMBULANCE SERVICE INC | ||||||||||||
| 35 HOSPITAL ROAD | BLAIRSVILLE | GA | 30512 | 452735005 | AMBULANCE | GA | 501C3 | 10 | false | UGH | UNION GENERAL HOSPITAL INC | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNION GENERAL HEALTH SYSTEM SEGR P | BusinessNameLine1Txt |
| Business Name Line2 | PORTFOLIO | BusinessNameLine2Txt |
Foreign Address ForeignAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1159 878 WEST BAY RD | AddressLine1Txt |
| Address Line2 | CARIBBEAN PLAZA 2ND FL N BLDG | AddressLine2Txt |
| City | GRAND CAYMAN | CityNm |
| Province Or State | CAYMAN ISLANDS | ProvinceOrStateNm |
| Country | CJ | CountryCd |
| Foreign Postal | KY1-1102 | ForeignPostalCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | SELF INSUR | PrimaryActivitiesTxt |
| Legal Domicile Foreign Country | CJ | LegalDomicileForeignCountryCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |