GEORGIA REGIONAL ACADEMIC COMMUNITY HEALTH INFORMATION EXCHANGE INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
GEORGIA REGIONAL ACADEMIC COMMUNITY HEALTH INFORMATION EXCHANGE INC (EIN 45-4091895)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-17
IRS object ID
202141379349301554
Schema version
2019v5.0
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

FieldValueIRS element (for citing)
Return2021-05-17T06:57:40-07:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN581645669PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1JONES JONES DAVIS CPA PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13602 WHEELER RDAddressLine1Txt
CityAUGUSTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP30909ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN454091895EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GEORGIA REGIONAL ACADEMIC COMMUNITYBusinessNameLine1Txt
Business Name Line2HEALTH INFORMATION EXCHANGE INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlGEORBusinessNameControlTxt
Phone4785532498PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11726 KAOLIN ROADAddressLine1Txt
CitySANDERSVILLECityNm
State AbbreviationGAStateAbbreviationCd
ZIP31082ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTARA B CRAMERPersonNm
Person TitleExecutive DirectorPersonTitleTxt
Signature2021-05-14SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWALTER R JONES CPAPreparerPersonNm
PTINP00534335PTIN
Phone4786257775PhoneNum
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTARA B CRAMERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11726 KAOLIN RDAddressLine1Txt
CitySANDERSVILLECityNm
State AbbreviationGAStateAbbreviationCd
ZIP31082ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$778,632GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.GRACHIE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2011FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTO OPERATE AN INTEGRATED HEALTH INFORMATION EXCHANGE FOR THE BENEFIT OF THE MEDICAL PATIENTS IN THE STATE OF GEORGIA.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers7TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$74,830PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$646,077PYProgramServiceRevenueAmt
CY Program Service Revenue$773,232CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$5,400PYOtherRevenueAmt
CY Other Revenue$5,400CYOtherRevenueAmt
PY Total Revenue$726,307PYTotalRevenueAmt
CY Total Revenue$778,632CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$809,158PYOtherExpensesAmt
CY Other Expenses$854,253CYOtherExpensesAmt
PY Total Expenses$809,158PYTotalExpensesAmt
CY Total Expenses$854,253CYTotalExpensesAmt
PY Revenues Less Expenses-$82,851PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$75,621CYRevenuesLessExpensesAmt
Total Assets BOY$632,252TotalAssetsBOYAmt
Total Assets EOY$557,748TotalAssetsEOYAmt
Total Liabilities BOY$256,274TotalLiabilitiesBOYAmt
Total Liabilities EOY$257,391TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$375,978NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$300,357NetAssetsOrFundBalancesEOYAmt
MissionGEORGIA REGIONAL ACADEMIC COMMUNITY HEALTH INFORMATION EXCHANGE (GRACHIE) IS AN ELECTRONIC HEALTH INFORMATION EXCHANGE, WHICH WAS FOUNDED AS A 501(C)(3) IN 2012 THROUGH A JOINT VENTURE BETWEEN CENTRAL GEORGIA HEALTH SYSTEM AND GEORGIA REGENTS HEALTH SYSTEM. GRACHIE'S MEMBERS UTILIZE ITS ELECTRONIC PLATFORM TO SUPPORT CARE COORDINATION THROUGH AN EFFICIENT AND MEANINGFUL SHARING OF HEALTH INFORMATION TO PROVIDE IMPROVED HEALTH CARE QUALITY, AFFORDABILITY, AND OUTCOMES.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$671,172ExpenseAmt
DescGEORGIA REGIONAL ACADEMIC COMMUNITY HEALTH INFORMATION EXCHANGE, INC. (GRACHIE) IS AN ELECTRONIC HEALTH INFORMATION EXCHANGE (HIE) THAT LINKS AU MEDICAL CENTER, INC., NAVICENT HEALTH, AFFILIATED PHYSICIANS, AND OTHER MEDICAL CARE PROVIDERS TO IMPROVE THE COORDINATION, TIMELINESS, AND SAFETY OF PATIENT CARE.THIS SECURE COMPUTER NETWORK PROVIDES ACCESS TO PATIENT INFORMATION INCLUDING LAB AND PATHOLOGY RESULTS, X-RAY, MRI, AND OTHER IMAGING REPORTS, MEDICATION AND IMMUNIZATION RECORDS, ALLERGY AND DRUG REACTION HISTORY, AND PHYSICIAN TRANSCRIPTION REPORTS.PATIENT BENEFITS INCLUDE IMPROVED SAFETY, CONVENIENCE, AND COLLABORATION AMONG PROVIDERS. FOR PROVIDERS, THE ABILITY TO SHARE CLINICAL INFORMATION ELECTRONICALLY HELPS REDUCE COST BY ELIMINATING UNNECCESARY DUPLICATION OF TESTS AND PROCEDURES WHILE PROVIDING CRITICAL PATIENT INFORMATION FROM ONE POINT OF ACCESS.Desc
Total Program Service Expenses$671,172TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonTARA B CRAMERPersonNm
Phone4785532498PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11726 KAOLIN ROADAddressLine1Txt
CitySANDERSVILLECityNm
State AbbreviationGAStateAbbreviationCd
ZIP31082ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
TARA B CRAMER
Executive Dir.40.000.00Yes (X)$0$78,017$19,695
PATRICE WALKER MD
PRESIDENT/CHAIR2.000.00Yes (X)$0$0$0Yes (X)
LAUREN WILLIAMS
Secretary0.250.00Yes (X)$0$0$0Yes (X)
DAVID FALLAW MD
Vice President1.500.00Yes (X)$0$0$0Yes (X)
CINDY HUTCHENSON
Director0.250.00$0$0$0Yes (X)
WAYNE SELLERS
Treasurer0.250.00Yes (X)$0$0$0Yes (X)
HEATHER WALKER
Director0.250.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Tot Reportable Comp Rltd Org$78,017TotReportableCompRltdOrgAmt
Total Other Compensation$19,695TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
HIE CONNECTION FEES519100$194,225$194,225
HIE ACCESS FEE-PHYSICIANS
HIE ACCESS FEES519100$465,507$465,507
HIE SETUP FEES519100$113,500$113,500
FieldValueIRS element (for citing)
Total Program Service Revenue$773,232TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER REVENUESDesc
Total Revenue Column$5,400TotalRevenueColumnAmt
Related Or Exempt Func Income$5,400RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$5,400OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$778,632TotalRevenueColumnAmt
Related Or Exempt Func Income$778,632RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$97,713TotalAmt
Program Services$48,857ProgramServicesAmt
Management And General$48,856ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$2,604TotalAmt
Management And General$2,604ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$6,840TotalAmt
Management And General$6,840ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$196,871TotalAmt
Program Services$114,185ProgramServicesAmt
Management And General$82,686ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$5,033TotalAmt
Program Services$3,775ProgramServicesAmt
Management And General$1,258ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,109TotalAmt
Management And General$5,109ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$478,029TotalAmt
Program Services$478,029ProgramServicesAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$12,675TotalAmt
Management And General$12,675ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$7,535TotalAmt
Program Services$5,651ProgramServicesAmt
Management And General$1,884ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$533TotalAmt
Program Services$533ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$26,736TotalAmt
Program Services$20,142ProgramServicesAmt
Management And General$6,594ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmt
DUES AND SUBSCRIPTIONS$13,509$13,509
MISCELLANEOUS EXPENSE$973$973
BANK CHARGES$93$93

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$854,253TotalAmt
Program Services$671,172ProgramServicesAmt
Management And General$183,081ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$364,576BOYAmt
EOY$415,230EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$102,035BOYAmt
EOY$36,310EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$165,641BOYAmt
EOY$106,208EOYAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$632,252BOYAmt
EOY$557,748EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$60,198BOYAmt
EOY$28,923EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$196,076BOYAmt
EOY$228,468EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$256,274BOYAmt
EOY$257,391EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$375,978BOYAmt
EOY$300,357EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$375,978BOYAmt
EOY$300,357EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$632,252BOYAmt
EOY$557,748EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$75,621ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$320,000CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$431,693CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$525,683CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$720,907CurrentTaxYearMinus1YearAmt
Current Tax Year$773,232CurrentTaxYearAmt
Total$2,771,515TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,400CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,400CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,400CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,400CurrentTaxYearMinus1YearAmt
Current Tax Year$5,400CurrentTaxYearAmt
Total$27,000TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$325,400CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$437,093CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$531,083CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$726,307CurrentTaxYearMinus1YearAmt
Current Tax Year$778,632CurrentTaxYearAmt
Total$2,798,515TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$2,798,515PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$2,798,515TotalSupportAmt
Public Support CY1701.00000PublicSupportCY170Pct
Public Support PY1701.00000PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, EtBOARD MEMBERS HAVE BUSINESS RELATIONSHIPS AS FOLLOWS: THE FOLLOWING THREE BOARD MEMBERS ARE ALL OFFICERS AND/OR EMPLOYEES OF AU MEDICAL CENTER, INC.: WAYNE SELLERS, LAUREN WILLIAMS, AND DAVID FALLAW, MD. THE FOLLOWING THREE BOARD MEMBERS ARE ALL OFFICERS AND/OR EMPLOYEES OF NAVICENT HEALTH: CINDY HUTCHESON, HEATHER WALKER, AND PATRICE WALKER, MD.
Form 990, Part VI, Line 11b: Form 990 Review ProcessTHE FORM 990 RETURN WAS REVIEWED IN DETAIL BY THE EXECUTIVE DIRECTOR WITH ASSISTANCE FROM THE FINANCE DEPARTMENT AT AU MEDICAL CENTER, INC. AND THE FINANCE COMMITTEE PRIOR TO FILING. THE FORM 990 RETURN WAS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsIN ACCORDANCE WITH GRACHIE'S CONFLICT OF INTEREST POLICY, EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON: A) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, B) HAS READ AND UNDERSTANDS THE POLICY, C) HAS AGREED TO COMPLY WITH THE POLICY, D) UNDERSTANDS THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL INCOME TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES, AND E)DISCLOSES ANY KNOWN, OR POTENTIAL, CONFLICTS OF INTEREST.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableTHE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND POLICIES AVAILABLE UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
AU MEDICAL CENTER INC
1120 15th StreetAUGUSTAGA30912582144788HEALTH CARE SERVICESGA501(C)(3)PFN/Afalse
NAVICENT HEALTH
777 Hemlock StreetMACONGA31201582149127HEALTH CARE SERVICESGA501(C)(3)PFN/Afalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
AU MEDICAL CENTER INC
p$178,215FMV
NAVICENT HEALTH
p$151,055FMV

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