JOHN D ARCHBOLD MEMORIAL HOSPITAL INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: JOHN D ARCHBOLD MEMORIAL HOSPITAL INC (EIN 58-0566121)
Tax period: 2019-10-01 to 2020-09-30
Filed: 2021-08-04
IRS object ID: 202142169349300104
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2021-08-04T07:56:38-05:00	ReturnTs
Tax Period End	2020-09-30	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	2019-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	580566121	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JOHN D ARCHBOLD MEMORIAL	BusinessNameLine1Txt
Business Name Line2	HOSPITAL INC	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	JOHN	BusinessNameControlTxt
Phone	2292282853	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	P O BOX 1018	AddressLine1Txt
City	THOMASVILLE	CityNm
State Abbreviation	GA	StateAbbreviationCd
ZIP	317991018	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DARCY M CRAVEN	PersonNm
Person Title	PRESIDENT/CEO (8/20)	PersonTitleTxt
Phone	2292282737	PhoneNum
Signature	2021-07-30	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JACQUELINE G ATKINS	PreparerPersonNm
PTIN	P00861721	PTIN
Phone	2298837878	PhoneNum
Preparation	2021-07-30	PreparationDt

Field	Value	IRS element (for citing)
Tax	2019	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	DARCY M CRAVEN	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	P O BOX 1018	AddressLine1Txt
City	THOMASVILLE	CityNm
State Abbreviation	GA	StateAbbreviationCd
ZIP	317991018	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$347,690,304	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.ARCHBOLD.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1923	FormationYr
Legal Domicile State	GA	LegalDomicileStateCd
Activity Or Mission	HEALTHCARE SERVICES	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	171	TotalVolunteersCnt
Total Gross UBI	$341,514	TotalGrossUBIAmt
PY Contributions Grants	$9,021,427	PYContributionsGrantsAmt
CY Contributions Grants	$5,274,021	CYContributionsGrantsAmt
PY Program Service Revenue	$336,661,267	PYProgramServiceRevenueAmt
CY Program Service Revenue	$327,140,092	CYProgramServiceRevenueAmt
PY Investment Income	$2,040,906	PYInvestmentIncomeAmt
CY Investment Income	$12,067,665	CYInvestmentIncomeAmt
PY Other Revenue	$2,316,929	PYOtherRevenueAmt
CY Other Revenue	$2,191,950	CYOtherRevenueAmt
PY Total Revenue	$350,040,529	PYTotalRevenueAmt
CY Total Revenue	$346,673,728	CYTotalRevenueAmt
PY Grants And Similar Paid	$532,028	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$551,636	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$135,766,711	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$147,610,361	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$179,212,556	PYOtherExpensesAmt
CY Other Expenses	$175,974,703	CYOtherExpensesAmt
PY Total Expenses	$315,511,295	PYTotalExpensesAmt
CY Total Expenses	$324,136,700	CYTotalExpensesAmt
PY Revenues Less Expenses	$34,529,234	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$22,537,028	CYRevenuesLessExpensesAmt
Total Assets BOY	$780,568,799	TotalAssetsBOYAmt
Total Assets EOY	$893,092,785	TotalAssetsEOYAmt
Total Liabilities BOY	$144,796,642	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$223,103,329	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$635,772,157	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$669,989,456	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	HEALTHCARE SERVICES	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$217,177,909	ExpenseAmt
Grant	$551,636	GrantAmt
Revenue	$266,189,063	RevenueAmt
Desc	JOHN D. ARCHBOLD MEMORIAL HOSPITAL (JDAMH) IN THOMASVILLE GEORGIA OPERATES WITH 264 LICENSED BEDS; OF WHICH 226 ARE MED/SURG, 18 BEDS ARE DESIGNATED TO A PSYCH UNIT, 20 BEDS ARE REHAB. IN ADDITION, THEY OPERATE A 64 BED SKILLED NURSING FACILITY. JDAMH IS A RURAL REFERRAL CENTER COVERING THOMAS COUNTY AND SURROUNDING COUNTIES IN SOUTHERN GEORGIA AND NORTHERN FLORIDA. 69% OF PATIENTS WERE COVERED BY MEDICARE AND MEDICAID, AND 4.0% OF PATIENT REVENUE WAS PROVIDED AS INDIGENT CARE. IN 2020, JDAMH PROVIDED AN ESTIMATED 33.6 MILLION IN INDIGENT CARE CHARGES. JDAMH TREATS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN ADDITION JDAMH PROVIDED APPROXIMATELY 37.7 MILLION IN ADDITIONAL UNCOMPENSATED CARE. THROUGHOUT THE YEAR, JDAMH PRODUCES OR SPONSORS MANY SPECIAL PROGRAMS FOR THE COMMUNITY TO EDUCATE THEM ON IMPORTANT HEALTH NEEDS. JDAMH, INC. ALSO MAINTAINS HOSPITALS IN GRADY COUNTY, BROOKS COUNTY, AND MITCHELL COUNTY, FILING UNDER EIN 58-0566121.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$17,949,859	ExpenseAmt
Revenue	$23,930,200	RevenueAmt
Desc	GRADY GENERAL HOSPITAL (GGH) IN CAIRO, GEORGIA OPERATES A 60 LICENSED BED ACUTE CARE FACILITY. TEN BEDS CAN BE USED AS SWING BEDS. IT SERVES GRADY COUNTY AND 59% OF ITS PATIENTS WERE MEDICARE/MEDICAID. IN 2020, GGH PROVIDED APPROXIMATELY 4.6 MILLION IN INDIGENT CARE. IN ADDITION, GRADY GENERAL HOSPITAL PROVIDED AN ESTIMATED 5.5 MILLION IN ADDITIONAL UNCOMPENSATED CARE. EIN 58-1646537 FILED UNDER EIN 58-0566121.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$8,258,180	ExpenseAmt
Revenue	$8,860,205	RevenueAmt
Desc	BROOKS COUNTY HOSPITAL OPERATES IN QUITMAN, GEORGIA AS A CRITICAL ACCESS HOSPITAL WITH 25 ACUTE CARE BEDS. IT SERVES BROOKS COUNTY AND 65% OF ITS PATIENTS WERE MEDICARE/MEDICAID. IN 2020, AN ESTIMATED 1.8 MILLION OF INDIGENT CARE WAS PROVIDED TO THE COMMUNITY. IN ADDITION, BROOKS COUNTY HOSPITAL PROVIDED APPROXIMATELY 2.4 MILLION IN ADDITIONAL UNCOMPENSATED CARE. EIN 58-6002830 FILED UNDER EIN 58-0566121.	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Expense	$23,316,022	ExpenseAmt
Revenue	$28,326,988	RevenueAmt
Desc	MITCHELL COUNTY HOSPITAL AND NURSING HOMES OPERATE IN CAMILLA, GEORGIA AS A CRITICAL ACCESS HOSPITAL WITH 25 ACUTE CARE BEDS AND 156 NURSING HOME BEDS. IT SERVES MITCHELL COUNTY AND 61% OF ITS PATIENTS WERE MEDICARE/MEDICAID. IN 2020, APPROXIMATELY 3.1 MILLION OF INDIGENT CARE WAS PROVIDED TO THE COMMUNITY. IN ADDITION, MITCHELL COUNTY HOSPITAL PROVIDED AN ESTIMATED 5.5 MILLION IN ADDITIONAL UNCOMPENSATED CARE. EIN 58-6001307 FILED UNDER EIN 58-0566121.	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$23,316,022	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue	$28,326,988	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$266,701,970	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	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	Yes (true)	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	false	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	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	Yes (true)	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
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	Yes (true)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	Yes (true)	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	218	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
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	15	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	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	Yes (true)	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	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	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	GREG HEMBREE	PersonNm
Phone	2292282853	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 1018	AddressLine1Txt
City	THOMASVILLE	CityNm
State Abbreviation	GA	StateAbbreviationCd
ZIP	317991018	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Key EmployeeKeyEmployeeInd
J PERRY MUSTIAN
PAST PRES/CE	1.00	51.00	Yes (X)	Yes (X)	$0	$883,789	$809,770
GREG HEMBREE
ASST SEC/SR	1.00	51.00		Yes (X)	$0	$440,376	$71,088
EUGENE SUN MD
PHYSICIAN	40.00				$461,500	$0	$20,300	Yes (X)
JIM CARTER
COO	40.00	1.00		Yes (X)	$386,419	$0	$60,946
COY IRVIN MD
VP MEDICAL A	40.00				$388,598	$0	$54,020		Yes (X)
STEPHEN RUBENDALL MD
PHYSICIAN	40.00				$357,371	$0	$18,208	Yes (X)
DINESH B PATEL MD
PHYSICIAN	40.00				$339,642	$0	$24,207	Yes (X)
AMY GRIFFIN
VP PATIENT C	40.00				$297,324	$0	$44,826		Yes (X)
JASON NESMITH MD
TRUSTEE	1.00	40.00	Yes (X)		$308,430	$0	$21,541
RAMESAN NAIR MD
PHYSICIAN	40.00				$265,777	$0	$25,418	Yes (X)
LISSA MURPHY MD
PHYSICIAN	40.00				$263,923	$0	$13,523	Yes (X)
KEN BROOKER
VP CLINICAL	20.00	20.00			$126,046	$126,046	$22,048		Yes (X)
CHRIS NEWMAN
VP ANCILLARY	40.00				$213,155	$0	$23,876		Yes (X)
JIM BUE
VP FACILITY	40.00				$222,988	$0	$11,188		Yes (X)
MARK LOWE
VP MARKETING	40.00				$155,341	$0	$22,320		Yes (X)
WILLIAM ELLIS MD
TRUSTEE	1.00	1.00	Yes (X)		$0	$5,800	$0
CHARLES R SANDERS JR MD
CHAIRMAN	1.00	1.00	Yes (X)	Yes (X)	$0	$0	$0
CLARK CONNELL MD
TRUSTEE (RES	1.00		Yes (X)		$0	$0	$0
DARYL CRENSHAW MD
TRUSTEE	1.00		Yes (X)		$0	$0	$0
DAVID I MEDEROS DO
TRUSTEE	1.00	1.00	Yes (X)		$0	$0	$0
DEBORAH GASKINS
TRUSTEE	1.00		Yes (X)		$0	$0	$0
HAILE MCCOLLUM
SECRETARY	1.00	1.00	Yes (X)	Yes (X)	$0	$0	$0
JAMES TREY W FALCONER III MD
TRUSTEE	1.00		Yes (X)		$0	$0	$0
JOE BROWN
TRUSTEE	1.00		Yes (X)		$0	$0	$0
NATHANIEL H ABRAMS JR
TREASURER	1.00	1.00	Yes (X)	Yes (X)	$0	$0	$0
SUE STEPHENSON
TRUSTEE	1.00	1.00	Yes (X)		$0	$0	$0
DARCY M CRAVEN
PRESIDENT/CE	1.00	51.00	Yes (X)	Yes (X)	$0	$0	$0
CRAIG R WENTWORTH EDD
VICE CHAIR	1.00	1.00	Yes (X)	Yes (X)	$0	$0	$0
SINA GRIFFITH
TRUSTEE	1.00		Yes (X)		$0	$0	$0
W GREGORY HAMIL
TRUSTEE	1.00	1.00	Yes (X)		$0	$0	$0
HENRY A STONE III
TRUSTEE	1.00	2.00	Yes (X)		$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$3,786,514	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,456,011	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,243,279	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	98	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
MORRISON MANAGEMENT SPECIALISTS
5801 PEACHTREE DUNWOODY RD	ATLANTA	GA	303421503	DIETARY SVCS	$7,123,430
RED HILLS RADIOLOGY
714 N DAWSON STREET	THOMASVILLE	GA	317924451	RADIOLOGY SVC	$5,913,124
SOUTHLAND HOSPITALIST GROUP
PO BOX 1276	THOMASVILLE	GA	317991276	HOSPITALIST SVC	$4,357,910
SOUTH GEORGIA EMERGENCY MEDICINE
P O BOX 1913	THOMASVILLE	GA	317991913	ER PHYSICIAN	$2,340,959
THOMASVILLE PHYSICAL THERAPY
P O BOX 2476	THOMASVILLE	GA	317992476	REHAB SVCS	$1,833,487

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	51	CntrctRcvdGreaterThan100KCnt
Related Organizations	$53,169	RelatedOrganizationsAmt
Government Grants	$3,647,126	GovernmentGrantsAmt
All Other Contributions	$1,573,726	AllOtherContributionsAmt
Total Contributions	$5,274,021	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICE REVENUE	623000	$326,798,578	$326,798,578
LAB SERVICES	621500	$341,514		$341,514

Field	Value	IRS element (for citing)
Total Program Service Revenue	$327,140,092	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$12,179,811	TotalRevenueColumnAmt
Exclusion	$12,179,811	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$1,845,655	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$546,522	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$1,299,133	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,299,133	TotalRevenueColumnAmt
Exclusion	$1,299,133	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$74,512	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$186,658	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$112,146	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$112,146	TotalRevenueColumnAmt
Exclusion	-$112,146	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$489,441	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$283,396	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$206,045	TotalRevenueColumnAmt
Exclusion	$206,045	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
MISCELLANOUS REVENUE	621990	$201,524	$201,524
MEDICAL RECORD TRANSCRIPT FEE	621990	$190,212	$190,212
DRUG SALES	623000	$178,870		$178,870

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$116,166	TotalRevenueColumnAmt
Related Or Exempt Func Income	$116,142	RelatedOrExemptFuncIncomeAmt
Exclusion	$24	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$686,772	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$346,673,728	TotalRevenueColumnAmt
Related Or Exempt Func Income	$327,306,456	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$341,514	UnrelatedBusinessRevenueAmt
Exclusion	$13,751,737	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$96,000	TotalAmt
Program Services	$96,000	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$455,636	TotalAmt
Program Services	$455,636	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$2,348,041	TotalAmt
Program Services	$329,971	ProgramServicesAmt
Management And General	$2,018,070	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$115,249,633	TotalAmt
Program Services	$95,687,404	ProgramServicesAmt
Management And General	$19,562,229	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,778,194	TotalAmt
Program Services	$1,610,571	ProgramServicesAmt
Management And General	$167,623	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$17,483,837	TotalAmt
Program Services	$14,334,387	ProgramServicesAmt
Management And General	$3,149,450	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$10,750,656	TotalAmt
Program Services	$8,795,112	ProgramServicesAmt
Management And General	$1,955,544	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$248,855	TotalAmt
Management And General	$248,855	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$42,463	TotalAmt
Management And General	$42,463	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$93,044	TotalAmt
Management And General	$93,044	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$49,436,252	TotalAmt
Program Services	$44,976,321	ProgramServicesAmt
Management And General	$4,459,931	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$159,793	TotalAmt
Program Services	$20,590	ProgramServicesAmt
Management And General	$139,203	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$22,941,332	TotalAmt
Program Services	$7,437,331	ProgramServicesAmt
Management And General	$15,504,001	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$775,298	TotalAmt
Program Services	$600,453	ProgramServicesAmt
Management And General	$174,845	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$6,817,378	TotalAmt
Program Services	$6,012,246	ProgramServicesAmt
Management And General	$805,132	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$744,706	TotalAmt
Program Services	$534,997	ProgramServicesAmt
Management And General	$209,709	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$30,227	TotalAmt
Program Services	$30,227	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$24,833,631	TotalAmt
Program Services	$21,900,779	ProgramServicesAmt
Management And General	$2,932,852	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$2,734,619	TotalAmt
Program Services	$2,734,619	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES JDAMH	$52,490,810	$52,490,377	$433
PROVIDER FEES	$5,106,103		$5,106,103
REPAIRS & MAINTENANCE JDA	$3,371,503	$2,759,347	$612,156
MEDICAL SUPPLIES GRADY	$2,146,694	$2,146,694

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,001,995	TotalAmt
Program Services	$3,748,908	ProgramServicesAmt
Management And General	$253,087	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$324,136,700	TotalAmt
Program Services	$266,701,970	ProgramServicesAmt
Management And General	$57,434,730	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$61,417,299	BOYAmt
EOY	$144,307,432	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$5,018,367	BOYAmt
EOY	$102,755	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$51,733,509	BOYAmt
EOY	$8,722,067	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$3,864,817	BOYAmt
EOY	$3,627,452	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$4,654,763	BOYAmt
EOY	$4,720,587	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$549,312,078	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$341,050,761	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$214,769,346	BOYAmt
EOY	$208,261,317	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$287,155,793	BOYAmt
EOY	$311,794,304	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$1,229,669	BOYAmt
EOY	$1,229,669	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$150,725,236	BOYAmt
EOY	$210,327,202	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$780,568,799	BOYAmt
EOY	$893,092,785	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$35,577,805	BOYAmt
EOY	$81,442,881	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$843,837	BOYAmt
EOY	$39,175,448	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$108,375,000	BOYAmt
EOY	$102,485,000	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$144,796,642	BOYAmt
EOY	$223,103,329	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	$633,774,607	BOYAmt
EOY	$667,798,932	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,997,550	BOYAmt
EOY	$2,190,524	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$635,772,157	BOYAmt
EOY	$669,989,456	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$780,568,799	BOYAmt
EOY	$893,092,785	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$22,537,028	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$13,995,586	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$2,315,315	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	Yes (true)	AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
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	false	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 C IRS990ScheduleC

Total Direct Lobbying TotalDirectLobbyingGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$12,686	FilingOrganizationsTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$12,686	FilingOrganizationsTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$266,689,284	FilingOrganizationsTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$266,701,970	FilingOrganizationsTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$1,000,000	FilingOrganizationsTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Filing Organizations Total	$250,000	FilingOrganizationsTotalAmt

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$1,000,000	CurrentYearMinus3Amt
Current Year Minus2	$1,000,000	CurrentYearMinus2Amt
Current Year Minus1	$1,000,000	CurrentYearMinus1Amt
Current Year	$1,000,000	CurrentYearAmt
Total	$4,000,000	TotalAmt

Field	Value	IRS element (for citing)
Lobbying Ceiling	$6,000,000	LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$5,484	CurrentYearMinus3Amt
Current Year Minus2	$11,616	CurrentYearMinus2Amt
Current Year Minus1	$12,512	CurrentYearMinus1Amt
Current Year	$12,686	CurrentYearAmt
Total	$42,298	TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

Field	Value	IRS element (for citing)
Current Year Minus3	$250,000	CurrentYearMinus3Amt
Current Year Minus2	$250,000	CurrentYearMinus2Amt
Current Year Minus1	$250,000	CurrentYearMinus1Amt
Current Year	$250,000	CurrentYearAmt
Total	$1,000,000	TotalAmt

Field	Value	IRS element (for citing)
Grassroots Ceiling	$1,500,000	GrassrootsCeilingAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,997,550	BeginningYearBalanceAmt
Investment Earnings Or Losses	$192,974	InvestmentEarningsOrLossesAmt
End Year Balance	$2,190,524	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,973,758	BeginningYearBalanceAmt
Investment Earnings Or Losses	$23,792	InvestmentEarningsOrLossesAmt
End Year Balance	$1,997,550	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,335,125	BeginningYearBalanceAmt
Investment Earnings Or Losses	$251,064	InvestmentEarningsOrLossesAmt
Other Expenditures	$2,612,431	OtherExpendituresAmt
End Year Balance	$1,973,758	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,798,338	BeginningYearBalanceAmt
Investment Earnings Or Losses	$536,787	InvestmentEarningsOrLossesAmt
End Year Balance	$4,335,125	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,363,351	BeginningYearBalanceAmt
Investment Earnings Or Losses	$434,987	InvestmentEarningsOrLossesAmt
End Year Balance	$3,798,338	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	1.00000	PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$9,478,119	OtherCostOrOtherBasisAmt
Book Value	$9,478,119	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$153,718,500	OtherCostOrOtherBasisAmt
Depreciation	$71,899,104	DepreciationAmt
Book Value	$81,819,396	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$28,447,750	OtherCostOrOtherBasisAmt
Depreciation	$17,994,396	DepreciationAmt
Book Value	$10,453,354	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$347,186,766	OtherCostOrOtherBasisAmt
Depreciation	$251,157,261	DepreciationAmt
Book Value	$96,029,505	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$10,480,943	OtherCostOrOtherBasisAmt
Book Value	$10,480,943	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$208,261,317	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (8 entries)

DescDesc	Book ValueBookValueAmt
DUE FROM RELATED PARTIES	$150,543,122
DUE FROM MEDICARE/MEDICAID	$42,948,411
OTHER RECEIVABLES	$12,355,667
PHYSICIAN RECEIVABLES	$1,577,061
SCHOLARSHIP/TUITION RECEIVABLE	$1,546,366
DUE FROM SELF INSURANCE TRUST	$854,005
INTEREST RECEIVABLE	$419,332
DEFERRED BOND ISSUE COST - 2003	$83,238

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$210,327,202	TotalBookValueOtherAssetsAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE D, PAGE 2, PART V, LINE 4

ENDOWMENT FUNDS RESTRICTED BY DONORS ARE HELD IN A PERMANENT HEALTHCARE ENDOWMENT FUND WHICH WAS ESTABLISHED TO SUPPORT HEALTH CARE SERVICES.

SCHEDULE D, PAGE 3, PART X

EXCERPT FROM CONSOLIDATED PARENT ORGANIZATION AUDITED FINANCIAL STATEMENTS. THE MEDICAL CENTER, WITH THE EXCEPTION OF ARCHBOLD MEDICAL ENTERPRISES, INC., IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX- EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEDICAL CENTER APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE CONSOLIDATED 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 MEDICAL CENTER 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 MANAGEMENTS EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF SEPTEMBER 30, 2020 AND 2019 OR FOR THE YEARS THEN ENDED. THE MEDICAL CENTERS 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. (THE MEDICAL CENTER REFERS TO ARCHBOLD MEDICAL CENTER, INC., THE PARENT CORPORATION.)

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
Most Hospitals Policy	Yes (X)	MostHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	3.250000000000	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	false	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$14,434,908	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$14,434,908	NetCommunityBenefitExpnsAmt
Total Expense	0.04440	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$41,369,204	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$34,918,553	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,450,651	NetCommunityBenefitExpnsAmt
Total Expense	0.01990	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$384,533	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$305,861	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$78,672	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$56,188,645	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$35,224,414	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$20,964,231	NetCommunityBenefitExpnsAmt
Total Expense	0.06450	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$176,718	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$176,718	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,226,275	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,226,275	NetCommunityBenefitExpnsAmt
Total Expense	0.00380	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$23,029,042	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$23,029,042	NetCommunityBenefitExpnsAmt
Total Expense	0.07090	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$96,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$96,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$24,528,035	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$24,528,035	NetCommunityBenefitExpnsAmt
Total Expense	0.07550	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$80,716,680	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$35,224,414	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$45,492,266	NetCommunityBenefitExpnsAmt
Total Expense	0.14000	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$60,750,416	BadDebtExpenseAmt
Reimbursed By Medicare	$80,312,600	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$85,238,176	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$4,925,576	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	4	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (4 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	OtherOtherDesc	Facility Reporting GroupFacilityReportingGroupCd	Critical Access HospitalCriticalAccessHospitalInd
JOHN D ARCHBOLD MEM HOSP
1	P O BOX 1018	THOMASVILLE	GA	317991018	WWW.ARCHBOLD.ORG	136-91	Yes (X)	Yes (X)	Yes (X)	PSYCH, REHAB, NURSING HOME	A
GRADY GENERAL HOSPITAL
2	1155 FIFTH STREET SE	CAIRO	GA	31728	WWW.ARCHBOLD.ORG	065-413	Yes (X)	Yes (X)	Yes (X)	SWING BED SNF	A
BROOKS COUNTY HOSPITAL
3	903 N COURT ST	QUITMAN	GA	31643	WWW.ARCHBOLD.ORG	014-028	Yes (X)		Yes (X)	RHC; SWING BED SNF	A	Yes (X)
MITCHELL COUNTY HOSPITAL
4	90 STEPHENS ST	CAMILLA	GA	31730	WWW.ARCHBOLD.ORG	101-120	Yes (X)		Yes (X)	NURSING HOME, RHC, SWING BED	A	Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	A	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1234	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	19	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	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.ARCHBOLD.ORG	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	19	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	WWW.ARCHBOLD.ORG	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	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	325.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
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.ARCHBOLD.ORG	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	WWW.ARCHBOLD.ORG	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	WWW.ARCHBOLD.ORG	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
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 Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 3E	THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IS IDENTIFIED AND THE METHODOLOGY FOR PRIORITIZING EACH NEED IS DESCRIBED ON PAGES 13-14 OF THE 2019 CHNAS.
GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 5	INPUT FROM COMMUNITY MEMBERS REPRESENTING THE BROADER INTERESTS OF THE COUNTY WAS GATHERED THROUGH A COMBINATION OF WRITTEN SURVEYS, TELEPHONE INTERVIEWS AND IN-PERSON MEETINGS. WE EXPANDED OUR WRITTEN SURVEYS FOR THIS CHNA THAN IN THE 2016-2017 CHNA TO FURTHER UNDERSTAND FACTORS AFFECTING THOSE IN THE COMMUNITY WE SERVE. SURVEY QUESTIONS INCLUDED MULTIPLE CHOICE AND OPEN-ENDED ANSWERS. INPUT WAS GATHERED FROM THE FOLLOWING SOURCES FROM FEBRUARY 28-JUNE 6, 2019: . MAGNOLIA HIGH SCHOOL ALUMNI ASSOCIATIONGROUP MEETING AND WRITTEN SURVEYS . BOSTON COMMUNITY SCREENWRITTEN SURVEYS . ARCHBOLD HOSPITAL HEALTH TALKWRITTEN SURVEYS . THOMAS COUNTY FAMILY CONNECTION WRITTEN SURVEYS . THOMAS COUNTY HEALTH DEPARTMENT(TYPICALLY REPRESENTING LOW- INCOME/MINORITY/MEDICALLY UNDERSERVED POPULATION)WRITTEN SURVEYS AND TELEPHONE INTERVIEW
GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 6A	THE NEEDS ASSESSMENT WAS CONDUCTED FOR JOHN D. ARCHBOLD MEMORIAL HOSPITAL ALONG WITH GRADY GENERAL HOSPITAL, BROOKS COUNTY HOSPITAL AND MITCHELL COUNTY HOSPITAL.
GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 7D	DISTRIBUTED COPIES TO THE COMMUNITY; AVAILABLE ONLINE
GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 11	QUALITATIVELY, THE GREATEST MEDICAL NEEDS ACCORDING TO COMMUNITY PERCEPTION INCLUDED: 1. HIGH BLOOD PRESSURE 2. DIABETES 3. HEART DISEASE 4. OBESITY 5. CANCER 6. BACK/JOINT PAIN 7. MENTAL HEALTH ISSUES 8. DRUG ADDICTION 9. LUNG DISEASE/ALCOHOL ABUSE/STROKE NEEDS NOT ADDRESSED A QUANTITATIVE ANALYSIS OF SOME OF THE HEALTH ISSUES WE FACE EVERY DAY IS INCLUDED IN THE KEY HEALTH NEEDS SECTION OF ACCESS TO CARE WITHIN THE CHNA. EVALUATING BOTH QUALITATIVE AND QUANTITATIVE INFORMATION, WE CHOSE AREAS TO FOCUS OUR EFFORTS ON WHERE WE WERE BEST SUITED TO HAVE IMPACT.

Field	Value	IRS element (for citing)
Facility	7	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
GLENN-MOR NURSING HOME
10629 U S HIGHWAY 19 S	THOMASVILLE	GA	31792	SKILLED NURSING HOME
JDA PSYCHIATRIC UNIT
P O BOX 1018	THOMASVILLE	GA	31792	PSYCHIATRIC UNIT
JDA REHABILITATION UNIT
P O BOX 1018	THOMASVILLE	GA	31792	REHABILITATION UNIT
MITCHELL CO CONVALESCENT CENTER
90 STEPHENS STREET	CAMILLA	GA	31728	SKILLED NURSING HOME
CAMILLA PEDIATRICS CENTER
P O BOX 360	CAMILLA	GA	31728	RURAL HEALTH CLINIC
MEDICAL GROUP OF MITCHELL COUNTY
P O BOX 360	CAMILLA	GA	31728	RURAL HEALTH CLINIC
ARCHBOLD PELHAM PRIMARY CARE CLINIC
P O BOX 360	CAMILLA	GA	31728	RURAL HEALTH CLINIC

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7, COLUMN (F)	IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN (F), THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25: FORM 990, PART IX, LINE 25 324,136,700 ADD: EXPENSES REPORTED IN PART VIII 829,918 DENOMINATOR FOR COLUMN (F) 324,966,618
SCHEDULE H, PART I, LINE 7	THE ORGANIZATION USES THE COST TO CHARGE RATIO USING THE IRS' RECOMMENDED FORMAT IN WORKSHEET 2. OTHER COSTS IN PART I LINES 7E THROUGH 7I WERE OBTAINED FROM THE ORGANIZATION'S ACCOUNTING RECORDS.
SCHEDULE H, PART III, LINE 2	AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE.
SCHEDULE H, PART III, LINE 4	SEE THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE ON PAGES 9-10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
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	PATIENTS THAT ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE ARE APPROVED FOR A PERIOD OF 6 MONTHS. THE PATIENTS ARE REQUIRED TO CONTACT THE FINANCIAL ASSISTANCE OFFICE DURING THIS POINT IF THEY INCUR ADDITIONAL CHARGES THAT QUALIFY FOR FINANCIAL ASSISTANCE DURING THIS TIME PERIOD. THE SAME PROCESS IS IN EFFECT FOR THE PATIENTS WHO QUALIFY FOR THE SLIDING FEE DISCOUNT. THIS DISCOUNT WILL LIMIT THE PATIENTS TO AN OUT OF POCKET MAXIMUM AMOUNT IN THE GIVEN TIME PERIOD. WE DO NOT HAVE ANY AUTOMATIC ADJUSTMENTS OR AN AUTOMATED SYSTEM TO TRACK THE PREVIOUSLY APPROVED PATIENTS.
SCHEDULE H, PART VI, LINE 2	REVIEW OF ASSESSMENTS OF OTHER ORGANIZATIONS THAT IDENTIFY NEEDS AND HAVE ON-GOING PARTICIPATION WITH THOSE ORGANIZATIONS. COLLECT, REVIEW AND USE PRIMARY,SECONDARY AND QUALITATIVE DATA IN DETERMINING NEEDS. UPDATE COMMUNITY HEALTH STATUS AS LOCAL, STATE AND FEDERAL DATA IS REPORTED. REVIEW INTERNAL DATA SUCH AS SCREENING OUTCOMES AND PATIENT VOLUMES FOR SERVICES. RESPONSE TO REQUESTS FROM COMMUNITY, INPUT FROM A GROUP MEETING OF THE DOUGLASS HIGH SCHOOL ALUMNI ASSOCIATION, SEVERAL WRITTEN SURVEYS AND A TELEPHONE INTERVIEW. THE ORGANIZATION ANALYZES QUANTITATIVE FEDERAL, STATE AND LOCAL DATA AS WELL AS SEEKS QUALITATIVE INPUT FROM MEMBERS OF THE COMMUNITY, ESPECIALLY THE UNDERSERVED. THE ORGANIZATION ALSO ASSESSES THE NEEDS OF THE COMMUNITY THROUGH UTILIZING ASSESSMENTS CONDUCTED BY OTHER COMMUNITY ORGANIZATIONS, REVIEWING INTERNAL DATA ON PATIENT VOLUMES AND SCREENING OUTCOMES, PARTICIPATING IN COMMUNITY ORGANIZATIONS THAT IDENTIFY NEEDS, SPONSORING COMMUNITY EDUCATION TASK FORCES THAT PROVIDE INPUT AND RESPONDING TO SPECIFIC REQUESTS FROM COMMUNITY MEMBERS. COPIES OF THE 2019-2020 CHNA'S AND THE RELATED IMPLEMENTATION PLAN CAN BE FOUND AT THE FOLLOWING WEB ADDRESSES: HTTPS://ARCHBOLD.ORG/ABOUT/PUBLIC-RELATIONS/PUBLICATIONS
SCHEDULE H, PART VI, LINE 3	ANNUAL NOTICES ARE PLACED IN THE NEWSPAPERS FOR THE COUNTIES WE SERVE WITH HEALTHCARE. NOTICE OF THE FAP PROGRAM IS CONTAINED IN THE PATIENT HANDBOOK, SIGNS AND BROCHURES OUTLINING THE AVAILABILITY OF THE FAP PROGRAM ARE AVAILABLE AT POINTS OF ACCESS FOR PATIENTS, PAPER APPLICATIONS ARE AVAILABLE AT ALL ADMISSION AREAS AND BUSINESS OFFICES, ELECTRONIC VERSION OF THE APPLICATION CAN BE DOWNLOADED FREE OF CHARGE VIA WEBSITE AND THE ASSISTANCE PROGRAM IS DISCUSSED IN DETAIL DURING COLLECTION CALLS WITH PATIENTS.
SCHEDULE H, PART VI, LINE 4	COUNTIES SERVED IN GEORGIA INCLUDE BROOKS, GRADY, MITCHELL, THOMAS. DISPROPORTIONATE HEALTHCARE NEEDS, FEDERALLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS(MUA) OR HEALTH PROFESSIONAL SHORTAGE AREAS(HSPA), LOW- INCOME, PUBLIC HOUSING RESIDENTS, SENIORS, MIGRANT WORKERS, UNINSURED, UNDERINSURED, MIXTURE OF ETHNICITIES, ALL AGES, MIXTURE OF EDUCATIONAL LEVELS. BROOKS COUNTY: ESTIMATED POPULATION 15,457; 61.4% WHITE/35.2% BLACK, MEDIAN HOUSEHOLD INCOME 38,285; 21.9% LIVING IN POVERTY; 20% UNDER 65 UNINSURED. GRADY COUNTY: ESTIMATED POPULATION 24,748; MEDIAN HOUSEHOLD INCOME 43,531; 21.7% LIVING IN POVERTY, 20.8% UNDER 65 UNINSURED. MITCHELL COUNTY: ESTIMATED POPULATION 21,863; 49.3% WHITE/48.0% BLACK; MEDIAN HOUSEHOLD INCOME 38,116; 30.7% LIVING IN POVERTY, 17.7% UNDER 65 UNINSURED. THOMAS COUNTY: ESTIMATED POPULATION 44,451; 60.6% WHITE/36.2% BLACK; MEDIAN HOUSEHOLD INCOME 43,740; 18% LIVING IN POVERTY, 17% UNDER 65 UNINSURED. INFORMATION OBTAINED FROM WWW.CENSUS.GOV 2019 ESTIMATES
SCHEDULE H, PART VI, LINE 5	LIVE BETTER IS THE NAME THAT REPRESENTS AN ARCHBOLD-LED EFFORT OF KEY COMMUNITY LEADERS AND COMMUNITY FOCUSED ON IMPROVING THE HEALTH OF THE CITIZENS OF THOMAS COUNTY. LIVE BETTER IS STEERED BY LEADERS OF MAJOR SECTORS OF THE COMMUNITY (GOVERNMENT, EDUCATION, MEDIA, BUSINESS) THAT ARE WORKING TOGETHER WITH ARCHBOLD TO LEVERAGE THE STRENGTHS OF THEIR ORGANIZATIONS TO ACHIEVE MEASURED HEALTH GOALS. THE GROUP HAS MEASURABLE GOALS TO REDUCE THE OBESITY RATE IN THOMAS COUNTY, THE BIGGEST COMMON DENOMINATOR OF POOR HEALTH. OBESITY IS A PREVENTABLE CONDITION, YET THE COMMON RISK FACTOR WITH THE MOST PROMINENT HEALTH ISSUES IN THOMAS COUNTY: HEART DISEASE, HYPERTENSION, STROKE, COPD, VASCULAR DISEASE, DIABETES AND CANCER. THE GOVERNING BODIES OF ALL JDAMH'S HOSPITAL FACILITIES ARE PRIMARILY COMPRISED OF PERSONS WHO ARE NOT EMPLOYEES OR CONTRACTORS (NOR FAMILY MEMBERS THEREOF) AND WHO REPRESENT A BROAD SPECTRUM OF THE COMMUNITY. THE HOSPITALS' MEDICAL STAFFS ARE OPEN TO ALL QUALIFIED PHYSICIANS IN THE REGION. SURPLUS FUNDS ARE REINVESTED IN THE FACILITIES AND OPERATIONS.
SCHEDULE H, PART VI, LINE 6	ARCHBOLD MEDICAL CENTER, INC. (MEDICAL CENTER) AS THE PARENT CORPORATION HAS SOLE CONTROL OVER ITS NONPROFIT SUBSIDIARIES, JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC., ARCHBOLD HEALTH SERVICES, INC., ARCHBOLD FOUNDATION, INC., ARCHBOLD MEDICAL GROUP, INC. AND SOLE OWNERSHIP OF ITS FOR-PROFIT SUBSIDIARY, ARCHBOLD MEDICAL ENTERPRISES, INC. JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. OPERATES JOHN D. ARCHBOLD MEMORIAL HOSPITAL, GRADY GENERAL HOSPITAL, BROOKS COUNTY HOSPITAL, AND MITCHELL COUNTY HOSPITAL AND NURSING HOMES. ARCHBOLD HEALTH SERVICES, INC. PROVIDES FACILITIES AND SUPPORT FOR HOME HEALTH CARE AND AMBULATORY HEALTH CARE SERVICES. ARCHBOLD FOUNDATION, INC. SOLICITS CONTRIBUTIONS AND MANAGES FUNDS FOR THE BENEFIT OF JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. AND ARCHBOLD HEALTH SERVICES, INC. ARCHBOLD MEDICAL GROUP, INC. EMPLOYS PHYSICIANS AND OTHER SUPPORT PERSONNEL TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES ESSENTIAL TO THE PREVENTION AND TREATMENT OF DISEASE FOR THE BENEFIT OF ALL INDIVIDUALS IN THE SERVICE AREA. ARCHBOLD MEDICAL GROUP, INC. ALSO SERVES AS THE SOLE MEMBER OF CCSG, INC. AND AMGIR, INC., BOTH 501(C)(3) ORGANIZATIONS WHICH OPERATE MEDICAL CLINICS.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
THOMAS UNIVERSITY
1501 MILLPOND ROAD	THOMASVILLE	GA	31792	580644897	501C3	$11,000	MEDICAL TECH ED PROG
THOMAS UNIVERSITY
1501 MILLPOND ROAD	THOMASVILLE	GA	31792	580644897	501C3	$85,000	NURSG LEADERSHIP ED

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
SCHOLARSHP/TUITION PROG	115	$379,157
MED STUDENT HOUSING	58		$76,479	FMV	HOUSING/UTIL.

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PAGE 1, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION OFFERS A TUITION/SCHOLARSHIP REIMBURSEMENT PROGRAM FOR QUALIFIED EMPLOYEES ON SATISFACTORY COMPLETION OF APPROVED COURSES. THE PURPOSE IS TO ENCOURAGE AND ENABLE EMPLOYEES TO ACQUIRE ADDITIONAL EDUCATION IN A HEALTH CARE OR JOB RELATED FIELD WHICH WILL PROMOTE CAREER ADVANCEMENT AND/OR PROVIDE ADVANCED CREDENTIALING OF EMPLOYEES IN AREAS OF NEED. CONDITIONS OF ELIGIBILITY: FULL-TIME EMPLOYMENT OF AT LEAST SIX MONTHS WITH SATISFACTORY WORK RECORD AND PERFORMANCE EVALUATION. COMPLETION OF THE RELEVANT EDUCATION PROGRAM REQUIRES THE APPLICANT TO COMMIT TO OBTAIN STATUS AS A FULL-TIME EMPLOYEE EQUAL TO THE AMOUNT OF TIME SPENT IN EDUCATION. FAILURE TO COMPLY WITH THE REQUIREMENTS OF ELIGIBILITY WOULD SUBJECT THE EMPLOYEE TO FULL OR PARTIAL REIMBURSEMENT OF THE FUNDS RECEIVED TO THE ORGANIZATION. FOR REIMBURSEMENT THE EMPLOYEE MUST PROVIDE A COPY OF A RECEIPT SHOWING ACTUAL PAYMENT OF TUITION FEES. APPLICANT MUST MAINTAIN A C OR HIGHER GRADE AND AN OFFICIAL RECORD OF GRADES AND HOURS CREDIT MAILED DIRECTLY TO THE ORGANIZATION.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Travel For Companions	Yes (X)	TravelForCompanionsInd
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	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 (15 entries)

TitleTitleTxt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
J PERRY MUSTIAN
PAST PRES/CEO(8/20)	$693,252	$167,438	$23,099	$796,800	$12,970	$1,693,559
GREG HEMBREE
ASST SEC/SR VP/CFO	$355,118	$78,126	$7,132	$58,118	$12,970	$511,464
EUGENE SUN MD
PHYSICIAN							$253,024	$178,221	$30,255	$10,492	$9,808	$481,800
JIM CARTER
COO							$301,837	$73,103	$11,479	$50,936	$10,010	$447,365
COY IRVIN MD
VP MEDICAL AFFAIRS							$328,105	$33,813	$26,680	$41,050	$12,970	$442,618
STEPHEN RUBENDALL MD
PHYSICIAN							$202,664	$141,315	$13,392	$8,400	$9,808	$375,579
DINESH B PATEL MD
PHYSICIAN							$233,670	$105,448	$524	$14,399	$9,808	$363,849
AMY GRIFFIN
VP PATIENT CARE							$260,706	$35,376	$1,242	$39,794	$5,032	$342,150
JASON NESMITH MD
TRUSTEE							$195,384	$104,381	$8,665	$6,082	$15,459	$329,971
RAMESAN NAIR MD
PHYSICIAN							$264,082		$1,695	$18,620	$6,798	$291,195
LISSA MURPHY MD
PHYSICIAN							$256,863		$7,060	$12,845	$678	$277,446
KEN BROOKER
VP CLINICAL SERVICES	$99,864	$16,400	$9,782	$7,535	$3,489	$137,070	$99,864	$16,400	$9,782	$7,535	$3,489	$137,070	$8,000	$8,000
CHRIS NEWMAN
VP ANCILLARY SVCS							$191,575	$21,094	$486	$23,047	$829	$237,031
JIM BUE
VP FACILITY SERVICES							$174,226	$31,291	$17,471	$10,479	$709	$234,176	$13,907
MARK LOWE
VP MARKETING							$130,186	$24,345	$810	$17,637	$4,683	$177,661

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PAGE 1, PART I, LINE 1A	SOCIAL CLUB DUES ARE PAID BY THE ORGANIZATION ON BEHALF OF OFFICERS AND EXECUTIVES OF THE FILING ORGANIZATION. THESE AMOUNTS ARE INCLUDED IN THE INDIVIDUAL'S TAXABLE INCOME AND REPORTED ON THEIR W-2. THE ORGANIZATION'S POLICY FOR COMPANION TRAVEL INCLUDES THE REIMBURSEMENT OF REGISTRATION, TRAVEL, AND ENTERTAINMENT EXPENSES FOR GUESTS WHO ACCOMPANY BOARD TRUSTEES TO EITHER OF TWO ANNUAL TRUSTEE CONFERENCES. RECEIPTS MUST BE SUBMITTED PRIOR TO REIMBURSEMENT AND THE AMOUNTS ARE NOT INCLUDED IN THE INDIVIDUAL'S TAXABLE INCOME.
SCHEDULE J, PAGE 1, PART I, LINE 4	J. PERRY MUSTIAN 0 780,000 0 GREG HEMBREE 0 44,118 0 JIM CARTER 0 36,936 0 COY IRVIN, MD 0 27,050 0 AMY GRIFFIN 0 21,120 0 CHRIS NEWMAN 0 15,341 0 MARK LOWE 0 10,820 0
SCHEDULE J, PART III	THE IRS RULES & REGULATIONS REQUIRE THAT CERTAIN NON-CURRENT, NON-CASH ITEMS ARE REPORTED IN PART VII, COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, HIGHEST COMPENSATED EMPLOYEES, AND INDEPENDENT CONTRACTORS, OF THE CORE FORM 990 REGARDLESS OF THE CURRENT BENEFIT TO THE EMPLOYEE. THESE SAME RULES, IN SOME CASES, REQUIRE THE COMPENSATION AND BENEFITS TO BE REPORTED TWICE IN PART VII, ONCE WHEN THE ENTITY ACCRUES FOR A FUTURE PAYMENT AND ONCE WHEN THE PAYMENT IS ACTUALLY MADE TO THE EMPLOYEE. THEREFORE, AN EMPLOYEE'S STATED TOTAL COMPENSATION AND BENEFITS REPORTED ON PART VII ARE SUBSTANTIALLY HIGHER THAN THE ACTUAL CASH COMPENSATION RECEIVED IN THE CURRENT YEAR. AMOUNTS REPORTED AS BENEFITS INCLUDE AMOUNTS FOR LIFE INSURANCE, HEALTH INSURANCE, THRIFT PLAN CONTRIBUTIONS, AND PENSION CONTRIBUTIONS. BENEFITS RELATED TO PENSION AND RETIREMENT PLANS REFLECT AMOUNTS ACCUMULATED, BUT NOT PAID, TO THE INDIVIDUAL IN RECOGNITION OF TOTAL YEARS OF EMPLOYMENT, NOT JUST THE CURRENT YEAR. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN TWO OF AMC'S TOP EXECUTIVES PARTICIPATE IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WHICH IS ACCRUED BUT UNFUNDED IN AN AMOUNT WHICH, WHEN ADDED TO OTHER SOURCES OF RETIREMENT INCOME, WILL AFFORD A RETIREMENT INCOME AT A TARGETED PERCENTAGE OF PRE-RETIREMENT COMPENSATION. THE SERP IS A NON-QUALIFIED RETIREMENT PLAN. AMC 457(F) RETIREMENT PLAN CERTAIN EXECUTIVES WHO ARE NOT ELIGIBLE FOR THE SERP MAY BE ELIGIBLE TO PARTICIPATE IN A 457(F) PLAN TO HELP THEM ACCUMULATE FUNDS FOR THEIR LONG TERM FINANCIAL NEEDS. THE ORGANIZATION MAY CONTRIBUTE A PERCENTAGE OF BASE SALARY INTO AN INDIVIDUAL EXECUTIVES ACCOUNT IF THE ORGANIZATION MEETS CERTAIN FINANCIAL TARGETS. THE ORGANIZATION OWNS ANY PLAN ASSETS UNTIL THEY ARE PAID TO THE EMPLOYEE AND ALL FUNDS ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. VESTING BEGINS AT AGE 55 WITH FIVE YEARS OF SERVICE AT A RATE OF 90% AND THEN INCREASES TO 100% AT AGE 60. PAYMENTS ARE MADE ANNUALLY UPON VESTING. BONUS AWARDS: OFFICERS AND PHYSICIANS ARE AWARDED BONUSES/INCENTIVES CONTINGENT IN PART ON MEETING MANAGEMENT-BY-OBJECTIVE INCENTIVE PLAN GOALS AND EXCESS OF REVENUE OVER EXPENSES.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCd	Business Name Line2IssuerName/BusinessNameLine2Txt	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
HOSP AUTH OF THE CITY OF THOMASVILL
A	2017C REVENUE BONDS	581719301	NONENONEN	2017-07-12	$82,750,000	CONSTRUCTION BLDG AND EQUIPMENT	false	Yes (true)	false
HOSP AUTH OF THE CITY OF THOMASVILL
B	2017A REVENUE BONDS	581719301	NONENONEN	2017-07-12	$17,985,000	CONSTRUCTION PROJECT DEPOSIT	false	Yes (true)	false
HOSP AUTH OF THE CITY OF THOMASVILL
C	2017B REVENUE BONDS	581719301	NONENONEN	2017-07-12	$15,435,000	CONSTRUCTION PROJECT DEPOSIT	false	Yes (true)	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr
A	$7,545,000	$82,850,000	$82,522,324	$327,676	false	Yes (true)	false	Yes (true)
B		$17,985,000			false	false	Yes (true)	Yes (true)	$17,985,000	2017
C	$6,140,000	$15,435,000			false	false	Yes (true)	Yes (true)	$15,435,000	2017

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	false	false	false	false	false	Yes (true)
B	false	false	false	false	false	false	Yes (true)
C	false	false	false	false	false	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	false	false	false	false	false	false	false	false	Yes (true)
B	false	false	false	false	Yes (true)	false	false	false	Yes (true)
C	false	false	false	false	Yes (true)	false	false	false	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)
C	Yes (true)

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
DIFFERENCES IN ISSUE PRICE EXPLANATION	HOSP AUTH OF THE CITY OF THOMASVILLE ORIGINAL ISSUE PRICE INCLUDES A PREMIUM OF 100,000.
PURPOSE OF ISSUE DESCRIPTION	HOSP AUTH OF THE CITY OF THOMASVILLE CONSTRUCTION BLDG AND EQUIPMENT
PURPOSE OF ISSUE DESCRIPTION	HOSP AUTH OF THE CITY OF THOMASVILLE CONSTRUCTION PROJECT DEPOSIT
PURPOSE OF ISSUE DESCRIPTION	HOSP AUTH OF THE CITY OF THOMASVILLE CONSTRUCTION PROJECT DEPOSIT

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
W CLARK CONNELL MD
BOARD TRUSTEE	$509,209	PROFESSIONAL MED SVC	false
JAMES W FALCONER III MD
BOARD TRUSTEE	$641,776	RENTAL, PATIENT SVCS	false
WILLIAM W ELLIS MD
BOARD TRUSTEE	$9,413,116	PROFESSIONAL MED SVC	false
JAMI STEPHENSON
FAMILY MEMBER	$121,812	COMPENSATION	false
DAVID MEDEROS DO
BOARD TRUSTEE	$4,400,485	PROFESSIONAL MED SVC	false

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE L, PART V	FormAndLineReferenceDesc
Explanation	W. CLARK CONNELL, MD, A BOARD TRUSTEE, IS PARTNER IN A GROUP WHICH PROVIDES EMERGENCY MEDICAL SERVICES. JAMES W. FALCONER, III, MD - RENT OF PROPERTY; MEDICAL SERVICES TO PRACTICE; PAYMENTS TO TREAT UNINSURED EMERGENCY PATIENTS. WILLIAM W. ELLIS, MD - OUTREACH SERVICES; MEDICAL SERVICES; PAYMENT TO TREAT UNINSURED EMERGENCY PATIENTS; CLAIMS SETTLEMENT GUARANTEE PAYMENTS; MEDICAL STAFF LEADERSHIP COMPENSATION; PROFESSIONAL SERVICES AGREEMENT. DAVID MEDEROS, D.O., BOARD TRUSTEE, PROVIDES HOSPITALIST COVERAGE FOR THE HOSPITAL, INPATIENT REHAB AND IS A MEMBER OF THE MEDICAL STAFF LEADERSHIP COMMITTEE. JAMI STEPHENSON IS THE SON OF SUE STEPHENSON, BOARD TRUSTEE, AND IS EMPLOYED AND COMPENSATED BY JDAMH. DAVID MEDEROS, D.O., BOARD TRUSTEE, PROVIDES HOSPITALIST COVERAGE FOR THE HOSPITAL, INPATIENT REHAB AND IS A MEMBER OF THE MEDICAL STAFF LEADERSHIP COMMITTEE.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PAGE 2, PART III, LINE 4A	JOHN D. ARCHBOLD MEMORIAL HOSPITAL (JDAMH) IN THOMASVILLE GEORGIA OPERATES WITH 264 LICENSED BEDS; OF WHICH 226 ARE MED/SURG, 18 BEDS ARE DESIGNATED TO A PSYCH UNIT, 20 BEDS ARE REHAB. IN ADDITION, THEY OPERATE A 64 BED SKILLED NURSING FACILITY. JDAMH IS A RURAL REFERRAL CENTER COVERING THOMAS COUNTY AND SURROUNDING COUNTIES IN SOUTHERN GEORGIA AND NORTHERN FLORIDA. 69% OF PATIENTS WERE COVERED BY MEDICARE AND MEDICAID, AND 4.0% OF PATIENT REVENUE WAS PROVIDED AS INDIGENT CARE. IN 2020, JDAMH PROVIDED AN ESTIMATED 33.6 MILLION IN INDIGENT CARE CHARGES. JDAMH TREATS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN ADDITION JDAMH PROVIDED APPROXIMATELY 37.7 MILLION IN ADDITIONAL UNCOMPENSATED CARE. THROUGHOUT THE YEAR, JDAMH PRODUCES OR SPONSORS MANY SPECIAL PROGRAMS FOR THE COMMUNITY TO EDUCATE THEM ON IMPORTANT HEALTH NEEDS. JDAMH, INC. ALSO MAINTAINS HOSPITALS IN GRADY COUNTY, BROOKS COUNTY, AND MITCHELL COUNTY, FILING UNDER EIN 58-0566121.
FORM 990, PAGE 2, PART III, LINE 4D	MITCHELL COUNTY HOSPITAL AND NURSING HOMES OPERATE IN CAMILLA, GEORGIA AS A CRITICAL ACCESS HOSPITAL WITH 25 ACUTE CARE BEDS AND 156 NURSING HOME BEDS. IT SERVES MITCHELL COUNTY AND 61% OF ITS PATIENTS WERE MEDICARE/MEDICAID. IN 2020, APPROXIMATELY 3.1 MILLION OF INDIGENT CARE WAS PROVIDED TO THE COMMUNITY. IN ADDITION, MITCHELL COUNTY HOSPITAL PROVIDED AN ESTIMATED 5.5 MILLION IN ADDITIONAL UNCOMPENSATED CARE. EIN 58-6001307 FILED UNDER EIN 58-0566121.
FORM 990, PAGE 6, PART VI, LINE 2	NATHANIEL ABRAMS, JR HAILE MCCOLLUM TRUSTEE TRUSTEE BUSINESS RELATIONSHIP NATHANIEL ABRAMS, JR HENRY STONE III TRUSTEE TRUSTEE BUSINESS RELATIONSHIP HAILE MCCOLLUM HENRY STONE III TRUSTEE TRUSTEE BUSINESS RELATIONSHIP SINA GRIFFITH WILLIAM ELLIS, MD TRUSTEE TRUSTEE FAMILY RELATIONSHIP
FORM 990, PAGE 6, PART VI, LINE 6	THE ORGANIZATION HAS A SOLE MEMBER, ARCHBOLD MEDICAL CENTER, INC. (AMC) WITH THE POWER TO ELECT OR REPLACE AND TO REMOVE THE TRUSTEES OF THE GOVERNING BODY, AS WELL AS THE AUTHORITY TO APPROVE THE DECISIONS OF THE GOVERNING BODY.
FORM 990, PAGE 6, PART VI, LINE 7A	THE BOARD OF TRUSTEES OF THE FILING ENTITY ARE ELECTED ANNUALLY BY THE SOLE MEMBER, AMC. IN ADDITION, AMC HAS THE POWER TO ELECT OR REPLACE AND TO REMOVE THE TRUSTEES OF THE GOVERNING BODY. THE CEO OF AMC SHALL BE A MEMBER OF THE BOARD WITH THE POWER TO VOTE.
FORM 990, PAGE 6, PART VI, LINE 7B	THE SOLE MEMBER, AMC HAS THE AUTHORITY TO APPROVE THE DECISIONS OF THE GOVERNING BODY, INCLUDING BUT NOT LIMITED TO, CAPITAL AND OPERATING BUDGETS, MERGERS OR ACQUISITIONS, CONTRACTS AND TRANSACTIONS OVER A CERTAIN AMOUNT, DISSOLUTION, ETC.
FORM 990, PAGE 6, PART VI, LINE 11B	MANAGEMENT REVIEWS THE FORM 990 AS PREPARED BY ITS EXTERNAL AUDITOR, AND THEN MAKES A COMPLETE COPY AVAILABLE ELECTRONICALLY TO TRUSTEES PRIOR TO FILING THE RETURN. IF TRUSTEES HAVE QUESTIONS ABOUT THE RETURN, MANAGEMENT IS AVAILABLE AND ACCESSIBLE TO PROVIDE APPLICABLE EXPLANATIONS TO TRUSTEES.
FORM 990, PAGE 6, PART VI, LINE 12C	ON AN ANNUAL BASIS, THE ORGANIZATION DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE AND DISCLOSURE STATEMENT TO EACH TRUSTEE. THIS QUESTIONNAIRE INCLUDES QUESTIONS RELATED TO FINANCIAL INTERESTS, OUTSIDE INTERESTS OR ACTIVITIES, AND GIFTS, MEALS, AND ENTERTAINMENT. IN ADDITION TO DISCLOSING ANY APPLICABLE INFORMATION ON THE QUESTIONNAIRE, THE TRUSTEE ACKNOWLEDGES THAT (S)HE HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ, UNDERSTANDS, AND AGREES TO COMPLY WITH IT, AND UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. RESPONSES ARE SUMMARIZED AND COLLECTIVELY REVIEWED BY THE AUDIT & COMPLIANCE COMMITTEE OF AMC, THE SOLE MEMBER. DURING EACH BOARD MEETING, THE CHAIRMAN INQUIRES IF ANY TRUSTEE HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST RELATED TO ANY AGENDA ITEM. IF THE TRUSTEE DISCLOSES ANY SUCH INTEREST, THE TRUSTEE IS EXCUSED FROM THE MEETING WHILE THE DETERMINATION AS TO WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS IS DISCUSSED AND VOTED UPON BY DISINTERESTED MEMBERS OF THE BOARD AND COMMITTEE. IF INVITED TO DO SO, THE TRUSTEE WITH A POTENTIAL CONFLICT MAY RESPOND TO QUESTIONS PUT FORTH BY FELLOW DISINTERESTED TRUSTEES REGARDING ANY PROPOSED TRANSACTION OR ARRANGEMENT. THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS DOCUMENTS THE NAME OF ANY INTERESTED PERSON/TRUSTEE WHO DISCLOSED OR WAS FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH A TRANSACTION OR ARRANGEMENT RESULTING IN AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; AND THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATED TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSIONS, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH.
FORM 990, PAGE 6, PART VI, LINE 15A	ARCHBOLD MEDICAL CENTER'S (AMC) COMPENSATION COMMITTEE (COMMITTEE) OF THE AMC BOARD OF TRUSTEES MAKES RECOMMENDATIONS TO THE FULL AMC BOARD ON THE FOLLOWING POSITIONS: THE PRESIDENT OF AMC AND THE PRESIDENT OF THE ARCHBOLD FOUNDATION. AMC'S PRESIDENT PRESENTS RECOMMENDATIONS FOR ALL SENIOR VICE PRESIDENTS, VICE PRESIDENTS, AND OTHER KEY EMPLOYEES OF AMC AND ALL RELATED ARCHBOLD ENTITIES TO THE COMMITTEE. SINCE AMC HAS RESERVE POWERS FOR ARCHBOLD RELATED ENTITIES, THE COMMITTEE SERVES AS THE COMPENSATION COMMITTEE FOR EACH APPLICABLE ARCHBOLD ENTITY. THE COMMITTEE CONSIDERS THE AMC PRESIDENT'S RECOMMENDATIONS, BUT IT ALSO CONSIDERS RECOMMENDATIONS AND INDEPENDENT MARKET DATA ANALYSIS FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE AMC BOARD UTILIZES AN INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE EXECUTIVE COMPENSATION PROGRAM AND MAKE RECOMMENDATIONS REGARDING PLAN DESIGN AND ACTUAL COMPENSATION INCLUDING BENEFITS.
FORM 990, PAGE 6, PART VI, LINE 15B	SEE 15A ABOVE.
FORM 990, PAGE 6, PART VI, LINE 19	NO DOCUMENTS ARE OR WILL BE MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11G	CONSULTANT FEES JDAMH 0 177,443 0 CONTRACT SERVICES JDAMH 18,515,914 1,463,583 0 CONTRACT SERVICES BROOKS 334,595 0 0 CONTRACT SERVICES GRADY 2,438,288 0 0 CONTRACT SERVICES MITCHELL 3,106,340 0 0 OUTSIDE LAB REFERRAL FEES JDA 871,147 0 0 OUTSIDE LAB REFERRAL GRADY 91,928 0 0 OUTSIDE LAB REFERRAL BROOKS 4,370 0 0 PROFESSIONAL FEES JDAMH 14,997,697 2,818,905 0 PROFESSIONAL FEES GRADY 2,176,805 0 0 PROFESSIONAL FEES BROOKS 866,652 0 0 PROFESSIONAL FEES MITCHELL 1,572,585 0 0 TOTAL 44,976,321 4,459,931 0
FORM 990, PART XI, LINE 9	ADOPTION OF ASU NO. 2016-01 -2,315,315 CHANGES IN NET ASSETS ARE THE RESULT OF NONCASH TRANSACTIONS AS DETAILED ABOVE. RECENTLY ADOPTED ACCOUNTING PRONOUNCEMENTS IN JANUARY 2016, THE FASB ISSUED ASU NO. 2016-01, FINANCIAL INSTRUMENTS- OVERALL (SUBTOPIC825-10): RECOGNITION AND MEASUREMENT OF FINANCIAL ASSETS AND FINANCIAL LIABILITIES. THE NEW GUIDANCE REQUIRES EQUITY INVESTMENTS (EXCEPT THOSE ACCOUNTED FOR UNDER THE EQUITY METHOD OR THOSE THAT RESULT IN CONSOLIDATION) TO BE MEASURED AT FAIR VALUE, WITH CHANGES IN FAIR VALUE RECOGNIZED IN NET INCOME; SIMPLIFIES THE IMPAIRMENT ASSESSMENT OF EQUITY INVESTMENTS WITHOUT READILY DETERMINABLE FAIR VALUES; AND AMENDS CERTAIN DISCLOSURE REQUIREMENTS ASSOCIATED WITH THE FAIR VALUE OF FINANCIAL INSTRUMENTS. THE MEDICAL CENTER ADOPTED ASU NO. 2016-01 ON OCTOBER 1, 2019 USING THE MODIFIED RETROSPECTIVE METHOD OF TRANSITION. PRIOR TO ADOPTION, THE MEDICAL CENTER CLASSIFIED EQUITY SECURITIES WITH READILY DETERMINABLE FAIR VALUES AS AVAILABLE-FOR-SALE WITH UNREALIZED GAINS AND LOSSES REFLECTED AS A CHANGE TO NET ASSETS. THE PRIMARY IMPACT OF THE NEW GUIDANCE IS THAT CHANGES IN THE FAIR VALUE OF EQUITY INVESTMENTS WILL BE RECOGNIZED WITHIN THE PERFORMANCE INDICATOR, EXCESS REVENUES, RATHER THAN BELOW AS A CHANGE TO NET ASSETS. THE CUMULATIVE EFFECT ADJUSTMENT MADE ON OCTOBER 1, 2019 WAS 2,315,315.
FORM 990, PAGE 12, PART XII, LINE 3B	DURING FISCAL YEAR 2020, FEDERAL AWARDS EXPENDED EXCEEDED THE 750,000 THRESHOLD REQUIRING A SINGLE AUDIT (PREVIOUSLY KNOWN AS THE OMB CIRCULAR A-133 AUDIT). THE SUBSTANTIAL PORTION OF THESE FEDERAL EXPENDITURES RELATED TO THE FUNDING ASSOCIATED WITH THE "CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY ACT" (CARES ACT). TYPICALLY, THE SINGLE AUDIT DUE DATE WOULD BE NINE MONTHS FROM THE END OF THE FISCAL YEAR BEING REPORTED ON (JUNE 30, 2021). HOWEVER, THE DEADLINE TO SUBMIT THE REQUIRED SINGLE AUDIT HAS BEEN EXTENDED BY THE OFFICE OF MANAGEMENT AND BUDGET (OMB) TO INCLUDE AN ADDITIONAL SIX MONTHS BEYOND THE ORIGINAL NINE-MONTH PERIOD (DECEMBER 31, 2021). AS SUCH, JDAMH HAS NOT UNDERGONE THE SINGLE AUDIT ASSOCIATED WITH ITS FISCAL YEAR 2020, BUT ARRANGEMENTS HAVE BEEN MADE TO UNDERGO THIS SINGLE AUDIT AND TO ENSURE ITS COMPLETION PRIOR TO THE EXTENDED DEADLINE.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Business Name Line2DirectControllingEntityName/BusinessNameLine2Txt	Controlled OrganizationControlledOrganizationInd
ARCHBOLD FOUNDATION INC
PO BOX 620	THOMASVILLE	GA	317990620	581559677	FOUNDATION	GA	501C3	12B	AMC	ARCHBOLD MEDICAL CENTER INC	false
ARCHBOLD HEALTH SERVICES INC
PO BOX 620	THOMASVILLE	GA	317990620	581376434	HEALTHCARE	GA	501C3	10	AMC	ARCHBOLD MEDICAL CENTER INC	false
ARCHBOLD MEDICAL CENTER INC
PO BOX 1018	THOMASVILLE	GA	317991018	581552650	H/C MGMT	GA	501C3	12C	NA		false
ARCHBOLD MEDICAL GROUP INC
P O BOX 620	THOMASVILLE	GA	317990620	262988454	PHYSICIANS	GA	501C3	3	AMC	ARCHBOLD MEDICAL CENTER INC	false
CCSG INC
915 GORDON AVENUE	THOMASVILLE	GA	317926614	473501366	MED CLINIC	GA	501C3	3	AMG		false
AMGIR INC
915 GORDON AVENUE	THOMASVILLE	GA	317926614	821188691	MED CLINIC	GA	501C3	3	AMG		false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	OwnershipOwnershipPct
ARCHBOLD MEDICAL ENTERPRISES
400 OLD ALBANY ROAD	THOMASVILLE	GA	317924013	581494513	HEALTHCARE	GA	N/A	false
GEORGIA-FLORIDA PREFERRED INC
915 GORDON AVE	THOMASVILLE	GA	31792	581744334	HEALTHCARE	GA		Yes (true)	JDAMH	C CORP	$13,720	1.00000

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	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	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	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd