2019-06-28T10:45:33-05:00 2018-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2017-10-01 823312912 HAMILTON CHILDREN'S INSTITUTE INC HAMI 7062782105 1200 MEMORIAL DRIVE DALTON GA 30720 JOSEPH L MCGUIRE VP/CFO 7062726115 2019-06-28 1 AMY BIBBY P00445891 8282542254 2019-06-28 24.241.144.70 2019-06-28 10:24:20 ED P 6DA4B0C79C306AA0BD087F1CE311720CD318C7AF 3C4A73C7F70BFF54BAAC11A85090BDFB39FC8B01 2017 2019-02-21 02:37:17Z X ANNA SHAW CHILDREN'S INSTITUTE JEFFREY D MYERS 1200 MEMORIAL DRIVE DALTON GA 30720 320060 0 X X 2017 GA CHAMPION CARE TO CHILDREN AND FAMILIES FOR HAPPY, HEALTHY LIVES. 6 4 0 0 0 0 320060 0 0 0 320060 0 0 139313 0 0 180747 320060 0 0 0 0 CHAMPION CARE TO CHILDREN AND FAMILIES FOR HAPPY, HEALTHY LIVES. 0 0 178933 THE FISCAL YEAR ENDED SEPTEMBER 30, 2018 WAS THE INITIAL START-UP YEAR FOR THE ORGANIZATION. ACCORDINGLY, ACTIVITIES INCLUDED PLANNING AND RECRUITING FOR FUTURE OPERATIONS AND SERVICES. 178933 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 4 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 GA X JOSEPH L MCGUIRE 7062726000 PO BOX 1168 DALTON GA 307221168 ROBERT M CHANDLER CHAIRMAN 1.00 X X 0 0 0 W NORRIS LITTLE VICE CHAIRMAN 1.00 X X 0 0 0 GARY A MIDDLETON TRUSTEE 1.00 X 0 0 0 JOHN P NEAL III TRUSTEE 1.00 X 0 0 0 SUSAN S YOUNG TRUSTEE 1.00 X 0 0 0 JEFFREY D MYERS PRESIDENT/CEO/VICE CHAIR 1.00 40.00 X X 0 1176982 114023 JOSEPH L MCGUIRE VP/CFO/TREASURER 1.00 40.00 X 0 585223 55902 SANDRA D MCKENZIE EVP/COO/SECRETARY 1.00 40.00 X 0 554469 75758 STEVEN P BRIDENSTINE ASSISTANT TREASURER 1.00 40.00 X 0 130519 12697 0 2447193 258380 0 0 1 0 HIMFORMATICS LLC 1579 MONROE DRIVE NE SUITE F BOX 1 ATLANTA GA 30324 SERVICES ANALYSIS AND CONSULTING 144619 1 320060 320060 320060 0 0 0 X 129870 129870 9443 9443 1814 1814 173889 173889 1957 1957 1524 1524 1563 1563 320060 178933 141127 0 0 0 0 0 X 0 0 0 0 0 0 0 0 0 0 0 0 X 0 1 X 1 0 X 320060 320060 320060 320060 0 0 0 320060 320060 320060 X 0 X PART X, LINE 2: THE ORGANIZATION HAS ADOPTED PROCEDURES FOR DETERMINING THE EXISTENCE OF UNCERTAIN TAX POSITIONS, AND THE RELATED TIMING AND AMOUNT OF THEIR IMPACT ON THE FINANCIAL STATEMENTS, AND DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2018. 0 1 0 0 0 0 0 0 0 JEFFREY D MYERS PRESIDENT/CEO/VICE CHAIR 0 673911 0 299431 0 203640 0 46385 0 67638 0 1291005 0 32885 JOSEPH L MCGUIRE VP/CFO/TREASURER 0 307121 0 160703 0 117399 0 13500 0 42402 0 641125 0 92522 SANDRA D MCKENZIE EVP/COO/SECRETARY 0 310467 0 107152 0 136850 0 16129 0 59629 0 630227 0 3967 PART I, LINE 4B THE FOLLOWING PERSONS RECEIVED CURRENT YEAR DEFERREED COMPENSATION ACCRUALS FROM NON-QUALIFIED PLANS: - JEFFREY D. MYERS - $32,885 - SANDRA D. MCKENZIE - $3,967 FORM 990, PART VI, SECTION A, LINE 7A THE REGULAR TRUSTEES OF THE ORGANIZATION ARE APPOINTED BY THE BOARD OF TRUSTEES OF HAMILTON HEALTH CARE SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN CAPITAL EXPENDITURE AND CONTRACTUAL COMMITMENT DECISIONS MUST BE SUBSEQUENTLY APPROVED BY THE HAMILTON HEALTH CARE SYSTEM BOARD OF TRUSTEES FORM 990, PART VI, SECTION B, LINE 11B FOLLOWING MANAGEMENT PREPARATION AND REVIEW, THE FORM 990 IS REVIEWED BY AN INDEPENDENT CPA FIRM. SUBSEQUENTLY, A DRAFT COPY OF THE UNFILED FORM 990 IS POSTED TO A SECURE PAGE ON THE HAMILTON HEALTH CARE SYSTEM WEBSITE FOR REVIEW AND COMMENT BY ALL MEMBERS OF THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CLEAR AND DETAILED CONFLICT OF INTEREST POLICY WHICH ESTABLISHES A PROCEDURE FOR IDENTIFYING, REVIEWING AND ADDRESSING CONFLICTS OF INTEREST. THE POLICY ALSO REQUIRES EACH TRUSTEE AND OFFICER OF THE ORGANIZATION TO ANNUALLY SIGN A STATEMENT ACKNOWLEDGING RECEIPT FOR THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 13,756. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,756. CONSULTING FEES: PROGRAM SERVICE EXPENSES 118,217. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 118,217. EMPLOYEE RECRUITMENT: PROGRAM SERVICE EXPENSES 41,355. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,355. MINOR EQUIPMENT: PROGRAM SERVICE EXPENSES 561. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 561. HAMILTON HEALTH CARE SYSTEM INC PO BOX 1168 DALTON GA 30722 581519913 SUPPORT RELATED ENTITIES GA 501(C)(3) LINE 12B, II N/A 0 DALTON SENIOR HOUSING INC 519 WEST HAWTHORNE STREET DALTON GA 30720 581518011 LOW-INCOME HOUSING GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 0 HAMILTON AMBULATORY SURGERY CENTER INC PO BOX 1168 DALTON GA 30722 582654791 SURGICAL SERVICES GA 501(C)(3) LINE 3 HAMILTON MEDICAL CENTER INC 0 HAMILTON EMERGENCY MEDICAL SERVICES INC PO BOX 1168 DALTON GA 30722 581651002 EMERGENCY MEDICAL GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 0 HAMILTON MEDICAL CENTER INC PO BOX 1168 DALTON GA 30722 581519911 HEALTHCARE GA 501(C)(3) LINE 3 HAMILTON HEALTH CARE SYSTEM INC 0 HAMILTON PHYSICIAN GROUP INC PO BOX 1168 DALTON GA 30722 271198701 PHYSICIAN PRACTICE GA 501(C)(3) LINE 3 HAMILTON MEDICAL CENTER INC 0 MURRAY MEDICAL CENTER INC PO BOX 1168 DALTON GA 30722 582373427 HOSPITAL CARE / SERVICES GA 501(C)(3) LINE 3 HAMILTON HEALTH CARE SYSTEM INC 0 ROYAL OAK COMMUNITY LTD PO BOX 1900 DALTON GA 30722 581970228 SENIOR LIVING SERVICES GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 0 WHITFIELD PLACE INC PO BOX 1168 DALTON GA 30722 582103085 LOW-INCOME HOUSING GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 0 DALTON-WHITFIELD COUNTY HOSPITAL LIABILITY TRUST PO BOX 1168 DALTON GA 30722 581331514 LIABILITY CLAIMS COVERAGE GA 501(C)(3) LINE 12D, III-O HAMILTON HEALTH CARE SYSTEM INC 0 WHITFIELD HEALTHCARE FOUNDATION INC PO BOX 1900 DALTON GA 30722 510175056 FUNDS FOR HEALTHCARE GA 501(C)(3) LINE 12B, II HAMILTON HEALTH CARE SYSTEM INC 0 HLTC INC PO BOX 1168 DALTON GA 30722 582341574 LONG TERM ELDERLY CARE GA 501(C)(3) LINE 10 0 HAMILTON HEALTH FIRST INC PO BOX 1168 DALTON GA 307221168 581694713 PREFERRED PROVIDER ORGANIZATION GA N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0