2023-08-14T12:43:44-05:00 2022-09-30 440160260 FORVIS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2021-10-01 271198701 HAMILTON PHYSICIAN GROUP INC HAMI 7068765000 PO BOX 1168 DALTON GA 307221168 JULIE A SOEKORO VP/CFO/ASST TREASURER 7068765000 2023-08-14 1 JULIE SOEKORO 999009999 AMY BIBBY P00445891 8282542254 2023-08-14 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z JEFFREY D MYERS PO BOX 1168 DALTON GA 307221168 28321481 0 X N/A X 2009 GA HAMILTON PHYSICIAN GROUP (HPG) PROVIDES VARIOUS PHYSICIAN SPECIALTY SERVICES TO THE CITY OF DALTON AND WHITFIELD COUNTY. DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, HPG HAD 153,501 OUTPATIENT VISITS. HPG'S VISION IS TO SERVE THE NEEDS OF AREA RESIDENTS WITHOUT DISCRIMINATION AND REGARDLESS OF ABILITY TO PAY. 7 1 301 0 0 0 1228912 1929342 23413346 26257309 0 0 406654 134830 25048912 28321481 0 0 0 0 33361299 34366474 0 0 0 6654961 9526658 40016260 43893132 -14967348 -15571651 5739755 9753726 12606715 13166816 -6866960 -3413090 AS AN AFFILIATE OF HAMILTON HEALTH CARE SYSTEM, HAMILTON PHYSICIAN GROUP, INC. SUPPORTS THE SYSTEM MISSION OF PROVIDING LEADERSHIP, PARTNERSHIPS AND SEAMLESS RESOURCE COORDINATION TO MEET HEALTH CARE NEEDS THAT ADVANCE THE QUALITY AND DIGNITY OF LIFE. 0 0 43319332 26392139 HAMILTON PHYSICIAN GROUP, INC. (HPG) PROVIDES SPECIALTY PHYSICIAN SERVICES TO THE CITY OF DALTON, WHITFIELD COUNTY, AND SURROUNDING AREAS OF NORTHWEST GEORGIA. DURING FISCAL YEAR 2022, HPG HAD 153,501 OUTPATIENT VISITS. HPG'S MISSION IS TO SERVE THE NEEDS OF AREA RESIDENTS WITHOUT DISCRIMINATION AND REGARDLESS OF ABILITY TO PAY. THUS, HPG PROVIDED $729,108 IN CHARITY CARE AT ESTABLISHED RATES FOR PATIENTS UNABLE TO PAY FOR THEIR HEALTH CARE SERVICES DURING THE YEAR. IN ADDITION, CHARGES OF $10,919,181 WERE NOT COLLECTED DUE TO SHORTFALLS FROM MEDICARE AND MEDICAID. 43319332 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 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 31 0 1 301 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 1 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 GA X JULIE SOEKORO 7062782105 1200 MEMORIAL DRIVE DALTON GA 30720 BRYAN D CHEEVER MD CHAIRMAN 40.00 X X 95279 267613 8948 ROBERT M CHANDLER VICE CHAIRMAN 1.00 X X 0 0 0 JEFFREY D MYERS PRESIDENT/CEO/TREASURER 1.00 40.00 X X 0 1504658 372966 SANDRA D MCKENZIE SECRETARY / VP 1.00 40.00 X X 0 645007 124954 JOSHUA L HARE DO TRUSTEE 1.00 X 1084943 0 75600 LAUREN LITTLE TRUSTEE/PHYSICIAN 40.00 X 262853 0 1535 ASHISH KABIR TRUSTEE/PHYSICIAN 40.00 X 429112 0 16212 RANDALL F FOSTER ASSISTANT SECRETARY 1.00 40.00 X 0 237252 14795 JULIE A SOEKORO ASSISTANT TREASURER 1.00 40.00 X 0 653933 94454 JAMES TURNER MD PHYSICIAN 40.00 X 774997 0 13202 STEVEN PAYNTER MD PHYSICIAN 40.00 X 736007 0 37636 SAMUEL CRITIDES JR MD PHYSICIAN 40.00 X 1622125 0 70649 RICHARD MORRISON MD PHYSICIAN 40.00 X 1146896 0 0 JAMES STEWART MD PHYSICIAN 40.00 X 1049287 0 1306 7201499 3308463 832257 75 0 1 0 ALL STAR RECUITING LOCUMS LLC PO BOX 963725 ATLANTA GA 31193 LOCUM TENENS 750174 HAMILTON MEDICAL CENTER INC PO BOX 1168 DALTON GA 30722 DIAGNOSTICS PURCHASED SERVICES 429478 COMPHEALTH PO BOX 972651 DALLAS TX 75397 LOCUM TENENS 396100 WEATHERBY LOCUMS PO BOX 972633 DALLAS TX 75397 LOCUM TENENS 329599 NORTH GEORGIA RADIOLOGY PA PO BOX 2339 DALTON GA 30722 DIAGNOSTICS PURCHASED SERVICES 103368 5 922826 1006516 1929342 NET PATIENT SERVICE RE 621990 26257309 26257309 26257309 MISCELLANEOUS INCOME 900099 134830 134830 134830 28321481 26392139 0 0 1872187 1872187 27999624 27999624 824177 824177 2009895 2009895 1660591 1660591 355000 355000 185200 185200 2960449 2926849 33600 28789 28789 2821656 2821656 1860960 1860960 121113 121113 289843 289843 867230 867230 MISCELLANEOUS EXPENSE 36418 36418 43893132 43319332 573800 0 -120015 220741 3537100 3267279 780544 1620524 3523453 2100638 1542126 1422815 0 3222367 5739755 9753726 3612412 3476584 8994303 9690232 12606715 13166816 X -6866960 -3413090 -6866960 -3413090 5739755 9753726 X -15571651 19025521 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 420976 106967 314009 3102477 1993671 1108806 1422815 RIGHT OF USE ASSET, NET 3222367 3222367 NOTE TO HAMILTON MEDICAL CENTER 6857882 LONG-TERM LEASE LIABILITY, NET 2832350 9690232 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 FINANCIAL STATEMENTS, AND DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2022. 0 1 0 0 0 0 0 0 0 JEFFREY D MYERS PRESIDENT/CEO/TREASURER 0 973129 0 359454 0 172075 0 298747 0 74219 0 1877624 0 59247 SAMUEL CRITIDES JR MD PHYSICIAN 1592386 0 0 0 29739 0 69343 0 1306 0 1692774 0 54843 0 JOSHUA L HARE DO TRUSTEE 1005364 0 39982 0 39597 0 72489 0 3111 0 1160543 0 57989 0 RICHARD MORRISON MD PHYSICIAN 1097228 0 13000 0 36668 0 0 0 0 0 1146896 0 0 0 JAMES STEWART MD PHYSICIAN 1030484 0 0 0 18803 0 0 0 1306 0 1050593 0 0 0 JAMES TURNER MD PHYSICIAN 746919 0 0 0 28078 0 10896 0 2306 0 788199 0 0 0 STEVEN PAYNTER MD PHYSICIAN 534070 0 150858 0 51079 0 33863 0 3773 0 773643 0 19363 0 SANDRA D MCKENZIE SECRETARY / VP 0 386756 0 118564 0 139687 0 100836 0 24118 0 769961 0 11586 JULIE A SOEKORO ASSISTANT TREASURER 0 365187 0 134241 0 154505 0 14500 0 79954 0 748387 0 0 ASHISH KABIR TRUSTEE/PHYSICIAN 267704 0 114699 0 46709 0 14500 0 1712 0 445324 0 0 0 BRYAN D CHEEVER MD CHAIRMAN 80498 213846 6000 14000 8781 39767 7642 0 0 1306 102921 268919 5420 0 LAUREN LITTLE TRUSTEE/PHYSICIAN 196136 0 9000 0 57717 0 1535 0 0 0 264388 0 0 0 RANDALL F FOSTER ASSISTANT SECRETARY 0 188627 0 18892 0 29733 0 11436 0 3359 0 252047 0 0 PART I, LINE 4B THE FOLLOWING PERSONS RECEIVED CURRENT YEAR DEFERRED COMPENSATION ACCRUALS FROM NON-QUALIFIED PLANS: - JEFFREY D. MYERS - $ 59,247 - SANDRA D. MCKENZIE - $ 11,586 - TOMMY BLEDSOE, JR. - $ 17,273 - JOSHUA L. HARE, DO - $ 57,989 - BRYAN D. CHEEVER, MD - $ 5,420 - SAMUEL CRITIDES, JR, MD - $ 54,843 - STEVEN PAYNTER, MD - $19,363 THE FOLLOWING PERSONS RECEIVED CURRENT YEAR DEFERRED COMPENSATION ACCRUALS FROM NON-QUALIFIED SERP PLANS: - JEFFREY D. MYERS - $ 225,000 - 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 MEDICAL CENTER, 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 FOLLOWING MANAGEMENT PREPARATION AND REVIEW, THE FORM 990 IS REVIEWED BY AN INDEPENDENT CPA FIRM. 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. THIS POLICY ALSO REQUIRES EACH TRUSTEE AND OFFICER OF THE ORGANIZATION TO ANNUALLY SIGN A STATEMENT ACKNOWLEDGING RECEIPT OF 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 THRID 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, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN ACCRUED LIABILITY CLAIMS 352,436. EQUITY TRANSFER 18,673,085. 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 HLTC INC PO BOX 1168 DALTON GA 30722 582341574 LONG TERM ELDERLY CARE GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 0 MURRAY MEDICAL CENTER INC PO BOX 1168 DALTON GA 30722 582373427 HOSPITAL CARE / SERVICES GA 501(C)(3) LINE 3 HAMILTON HEALTH CARE SYSTEM INC 0 ROYAL OAK COMMUNITY LTD PO BOX 1900 DALTON GA 30722 581970228 SENIOR LIVING SERVICES GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 0 WHITFIELD 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 1900 DALTON GA 30722 510175056 FUNDS FOR HEALTHCARE GA 501(C)(3) LINE 12B, II HAMILTON HEALTH CARE SYSTEM INC 0 HAMILTON CHILDREN'S INSTITUTE INC PO BOX 1168 DALTON GA 30722 823312912 PEDIATRIC DEVELOPMENTAL/BEHAVIORAL TREATMENT GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 0 HAMILTON ORTHOPEDIC SURGERY CENTER PO BOX 1168 DALTON GA 30720 ORTHOPEDIC SURGERY CENTER GA N/A 0 0 HAMILTON HEALTH FIRST INC PO BOX 1168 DALTON GA 307221168 581694713 PREFERRED PROVIDER ORGANIZATION GA N/A C 0 HMC HOLDINGS INC PO BOX 1168 DALTON GA 307221168 TITLE HOLDING GA N/A C 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0