GEORGIA REGIONAL ACADEMIC COMMUNITY HEALTH INFORMATION EXCHANGE INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
GEORGIA REGIONAL ACADEMIC COMMUNITY HEALTH INFORMATION EXCHANGE INC (EIN 45-4091895)
Tax period
2018-07-01 to 2019-06-30
Filed
2020-06-24
IRS object ID
202011769349301816
Schema version
2018v3.1
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)
Return2020-06-24T14:54:33-07:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

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
ZIP309091826ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-07-01TaxPeriodBeginDt

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
Signature2020-06-24SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWALTER R JONES CPAPreparerPersonNm
PTINP00534335PTIN
Phone4786257775PhoneNum
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

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$726,307GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
All Affiliates IncludedfalseAllAffiliatesIncludedInd
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
CY Contributions Grants$74,830CYContributionsGrantsAmt
PY Program Service Revenue$525,683PYProgramServiceRevenueAmt
CY Program Service Revenue$646,077CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$5,400PYOtherRevenueAmt
CY Other Revenue$5,400CYOtherRevenueAmt
PY Total Revenue$531,083PYTotalRevenueAmt
CY Total Revenue$726,307CYTotalRevenueAmt
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$669,051PYOtherExpensesAmt
CY Other Expenses$809,158CYOtherExpensesAmt
PY Total Expenses$669,051PYTotalExpensesAmt
CY Total Expenses$809,158CYTotalExpensesAmt
PY Revenues Less Expenses-$137,968PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$82,851CYRevenuesLessExpensesAmt
Total Assets BOY$787,646TotalAssetsBOYAmt
Total Assets EOY$632,252TotalAssetsEOYAmt
Total Liabilities BOY$328,817TotalLiabilitiesBOYAmt
Total Liabilities EOY$256,274TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$458,829NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$375,978NetAssetsOrFundBalancesEOYAmt
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$580,023ExpenseAmt
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$580,023TotalProgramServiceExpensesAmt
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
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
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
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
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 With Officer EntfalseBusinessRlnWithOfficerEntInd
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
Employment Tax Returns FiledfalseEmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Form990 T FiledfalseForm990TFiledInd
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
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Org Filed In Lieu Of Form1041falseOrgFiledInLieuOfForm1041Ind
Licensed More Than One StatefalseLicensedMoreThanOneStateInd
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 OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
OMER AWAN
PRESIDENT/CHAIR2.000.00Yes (X)Yes (X)$0$0$0
MICHAEL CASDORPH
Secretary0.250.00Yes (X)Yes (X)$0$0$0
PHILIP COULE MD
Vice President1.500.00Yes (X)Yes (X)$0$0$0
KATHY BOWEN
Director0.250.00Yes (X)$0$0$0
JOSEPH THORNTON
Treasurer0.250.00Yes (X)Yes (X)$0$0$0
THOMAS OLIVER
Director0.250.00Yes (X)$0$0$0
TARA B CRAMER
Executive Dir.40.000.00Yes (X)$0$81,470$18,202
FieldValueIRS element (for citing)
Tot Reportable Comp Rltd Org$81,470TotReportableCompRltdOrgAmt
Total Other Compensation$18,202TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$74,830AllOtherContributionsAmt
Total Contributions$74,830TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
HIE CONNECTION FEES519100$201,988$201,988
HIE ACCESS FEE-PHYSICIANS
HIE ACCESS FEES519100$403,589$403,589
HIE SETUP FEES519100$40,500$40,500
FieldValueIRS element (for citing)
Total Program Service Revenue$646,077TotalProgramServiceRevenueAmt

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$726,307TotalRevenueColumnAmt
Related Or Exempt Func Income$651,477RelatedOrExemptFuncIncomeAmt
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$99,672TotalAmt
Program Services$49,836ProgramServicesAmt
Management And General$49,836ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$3,527TotalAmt
Management And General$3,527ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$18,301TotalAmt
Management And General$18,301ManagementAndGeneralAmt

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$244,040TotalAmt
Program Services$141,543ProgramServicesAmt
Management And General$102,497ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$9,995TotalAmt
Program Services$7,496ProgramServicesAmt
Management And General$2,499ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,481TotalAmt
Management And General$5,481ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$356,274TotalAmt
Program Services$356,274ProgramServicesAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$7,050TotalAmt
Management And General$7,050ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$12,682TotalAmt
Program Services$9,512ProgramServicesAmt
Management And General$3,170ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

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$25,131TotalAmt
Management And General$25,131ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
INTERMEDIARY EXPENSE$15,362$15,362
DUES AND SUBSCRIPTIONS$11,000$11,000
MISCELLANEOUS EXPENSE$584$584
BANK CHARGES$59$59

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$809,158TotalAmt
Program Services$580,023ProgramServicesAmt
Management And General$229,135ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$476,378BOYAmt
EOY$364,576EOYAmt

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$145,626BOYAmt
EOY$102,035EOYAmt

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$165,642BOYAmt
EOY$165,641EOYAmt

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$787,646BOYAmt
EOY$632,252EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$51,039BOYAmt
EOY$60,198EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$277,778BOYAmt
EOY$196,076EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$328,817BOYAmt
EOY$256,274EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$458,829BOYAmt
EOY$375,978EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$458,829BOYAmt
EOY$375,978EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$787,646BOYAmt
EOY$632,252EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$82,851ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
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$163,098CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$320,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$431,693CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$525,683CurrentTaxYearMinus1YearAmt
Current Tax Year$720,907CurrentTaxYearAmt
Total$2,161,381TotalAmt

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 Minus3 Years$5,400CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,400CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,400CurrentTaxYearMinus1YearAmt
Current Tax Year$5,400CurrentTaxYearAmt
Total$21,600TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$163,098CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$325,400CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$437,093CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$531,083CurrentTaxYearMinus1YearAmt
Current Tax Year$726,307CurrentTaxYearAmt
Total$2,182,981TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$2,182,981PublicSupportTotal170Amt

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$2,182,981TotalSupportAmt
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.: PHILLIP COULE, JOSEPH THORNTON, AND MICHAEL CASDORPH. THE FOLLOWING THREE BOARD MEMBERS ARE ALL OFFICERS AND/OR EMPLOYEES OF NAVICENT HEALTH: KATHY BOWEN, OMER AWAN, AND THOMAS OLIVER.
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

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1AU MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypepTransactionTypeTxt
Involved$377,949InvolvedAmt
Method Of Amount DeterminationFMVMethodOfAmountDeterminationTxt

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