2018-11-15T08:18:19-06:00 2017-12-31 570381582 ELLIOTT DAVIS LLCPLLLC ONE 10TH STREET SUITE 400 AUGUSTA GA 30901 990 2017-01-01 581728812 AUGUSTA RESOURCE CENTER ON AGING INC AUGU 7068689800 4275 OWENS ROAD EVANS GA 30809 DAVE BELKOSKI UHS CFO 7068689800 2018-11-12 1 JESSICA C CAIN P01276209 7067229090 2018-11-12 24.181.201.165 2018-11-12 12:41:57 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 D9C45B12E74E3E126437FD430A1A3CA8815D446F 2017 2019-02-21 02:37:17Z JAMES R DAVIS 1350 WALTON WAY EVANS GA 30901 20396925 0 X WWW.BRANDONWILDE.COM X 1986 GA TO DEVELOP AND OPERATE COMPREHENSIVE PROGRAMS FOR THE AGING POPULATION IN THE AREA SURROUNDING AUGUSTA, GA INCLUDING DEVELOPMENT AND OPERATION OF A CONTINUING CARE RETIREMENT COMMUNITY AND NURSING HOME. 6 2 316 83 0 0 132749 17090 18895859 19319948 718899 1016177 10725 25177 19758232 20378392 0 0 0 0 7678795 6758828 0 0 0 8183894 9198724 15862689 15957552 3895543 4420840 81485811 85753763 55647766 52963165 25838045 32790598 RETIREMENT COMMUNITY - RETIREMENT CENTER SPECIFICALLY DESIGNED TO SATISFY THREE PRIMARY NEEDS OF THE AGING - HOUSING, HEALTH CARE, AND FINANCIAL SECURITY. 0 0 13335726 18530464 RETIREMENT COMMUNITY - RETIREMENT CENTER SPECIFICALLY DESIGNED TO SATISFY THREE PRIMARY NEEDS OF THE AGING - HOUSING, HEALTH CARE, AND FINANCIAL SECURITY. 13335726 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 1 38 0 316 1 0 0 0 0 0 0 0 0 0 0 X 6 2 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 GA X X MIKE BYRD 7068282406 1350 WALTON WAY AUGUSTA GA 30901 TOM DOZIER CHAIRMAN 1.00 X 0 0 0 GERALD MATHEIS BOARD MEMBER 1.00 X 0 0 0 CHRISTA MICHAEL ACTING RESIDENT COUNCIL CH 1.00 X 0 0 0 JAMES R DAVIS BOARD MEMBER 1.00 50.00 X 0 1589553 316866 DAVE BELKOSKI BOARD MEMBER 1.00 50.00 X 0 680853 10771 MARILYN A BOWCUTT BOARD MEMBER 1.00 50.00 X 0 712861 16794 WILLIAM L FARR JR CMO 40.00 50.00 X 0 542564 17838 EDWARD L BURR CAO 40.00 50.00 X 0 576630 21922 CHERYL TAYLOR EMPLOYEE 40.00 X 135673 0 11918 PAM KAUFFMAN CURRENT EXECUTIVE DIRECTOR 40.00 X 111760 0 11653 WILLIAM MCGAHEE EMPLOYEE 40.00 X 100282 0 10007 347715 4102461 417769 3 0 1 0 MORRISON COMMUNITY LIVING PO BOX 102289 ATLANTA GA 30368 FOOD SUPPLIER 1854478 HEAVENER CONSTRUCTION CO PO BOX 14129 AUGUSTA GA 30909 CONSTRUCTION 401964 AEGIS THERAPIES INC PO BOX 8103 FT SMITH AR 72902 STAFFING 367139 BRIAR WOOD GROUP INC PO BOX 16423 AUGUSTA GA 30919 LANDSCAPING 346259 US FOOD SERVICEINC PO BOX 602220 CHARLOTTE NC 28260 FOOD SUPPLIER 322570 16 17090 17090 PATIENT CARE SERVICES 623000 13703649 13703649 ENTRANCE FEES 623000 4384258 4384258 MEALS 623000 589424 589424 OTHER PROGRAM SERVICE 623000 487822 301647 186175 MEDICAL SUPPLIES 623000 154795 154795 19319948 592993 592993 29825 4648 25177 25177 25177 437069 0 13885 437069 -13885 423184 -13885 437069 20378392 18530464 0 1830838 347715 290585 57130 4970716 4154027 816689 77177 64497 12680 950144 794035 156109 413076 345208 67868 7658 6400 1258 27442 22933 4509 72187 60327 11860 212145 177290 34855 54065 45182 8883 948666 792800 155866 10088 8431 1657 219283 183255 36028 2569660 2147465 422195 186839 156141 30698 CONTRACT LABOR AND EXPE 2462835 2058191 404644 MISCELLANEOUS 903430 754996 148434 REPAIRS AND MAINTENANCE 847269 708063 139206 SUPPLIES 677157 565900 111257 15957552 13335726 2621826 0 2856657 3962040 1494232 1520573 87435 50946 2333405 2830605 90212739 43732249 47270284 46480490 27443798 30909109 81485811 85753763 18349672 17122033 28078369 28726239 9219725 7114893 55647766 52963165 X 25838045 32790598 25838045 32790598 81485811 85753763 4420840 2531713 0 X 0 1 X 1 0 X 853850 132749 17090 1003689 16680911 17801044 19048381 18895859 19319948 91746143 16680911 18654894 19048381 19028608 19337038 92749832 0 0 0 92749832 425127 1360940 438268 1041354 3265689 425127 1360940 438268 1041354 3265689 17106038 20015834 19048381 19466876 20378392 96015521 0.96600 0.97480 0.03400 0.02520 X 8851067 8851067 68515490 34236184 34279306 12846182 9496065 3350117 46480490 STATE STREET INVESTMENTS 30909109 C 30909109 DEPOSITS 599499 DUE TO UHI 6323336 DUE TO UHS 192058 7114893 X X 0 0 0 0 0 1 0 0 0 JAMES R DAVIS BOARD MEMBER 0 746360 0 224697 0 618496 0 298649 0 18217 0 1906419 0 0 DAVE BELKOSKI BOARD MEMBER 0 424781 0 138195 0 117877 0 1405 0 9366 0 691624 0 0 MARILYN A BOWCUTT BOARD MEMBER 0 448378 0 144922 0 119561 0 7350 0 9444 0 729655 0 0 WILLIAM L FARR JR CMO 0 386872 0 111378 0 44314 0 8079 0 9759 0 560402 0 0 EDWARD L BURR CAO 0 383412 0 123125 0 70093 0 8104 0 13818 0 598552 0 0 PART I, LINE 6 YEARLY INCENTIVE PLAN IS APPROVED BY THE BOARD EARLY IN THE YEAR. IN THE CALCULATION OF THE AWARD, 20% OF THE AWARD IS BASED ON THE NET INCOME VARIANCE. THOMAS DOZIER BOARD CHAIRMAN 70013 THOMAS DOZIER IS 71% OWNER OF GOLD MECH SERVICES, INC. THE ORGANIZATION PAID GOLD MECH SERVICES, INC. FOR MECHANICAL SERVICES. 0 THOMAS DOZIER BOARD CHAIRMAN 15763 THOMAS DOZIER IS 63% OWNER OF GOLD MECH, INC. THE ORGANIZATION PAID GOLD MECH, INC. FOR MECHANICAL SERVICES. 0 THOMAS DOZIER III SON OF BOARD CHAIRMAN 34427 THOMAS DOZIER, III OWNS 27% OF GOLD MECH, INC. AND 29% OF GOLD MECH SERVICES, INC. THE ORGANIZATION PAID BOTH OF THESE ORGNAIZATIONS FOR MECHANICAL SERVICES. 0 FORM 990, PART VI, SECTION A, LINE 6 SOLE CORPORATE MEMBER IS UNIVERSITY HEALTH, INC. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT REVIEWED THE ORGANIZATION'S FORM 990. A COPY OF THE 990 WAS PROVIDED TO EACH BOARD MEMBER PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR A CONFLICT OF INTEREST QUESTIONNAIRE SHALL BE DISTRIBUTED TO ALL BOARD MEMBERS AND SENIOR MANAGEMENT FOR COMPLETION. QUESTIONNAIRES SHALL BE REVIEWED BY THE CHAIRMAN OF THE BOARD OF DIRECTORS AND ANY CONFLICTS SHALL BE DISCUSSED WITH THE FULL BOARD. THE FULL BOARD SHALL DISCUSS THE POTENTIAL CONFLICT AND SHALL DETERMINE IF THE CONFLICT REQUIRES ACTION IN ACCORDANCE WITH THE NOT FOR PROFIT STATUTES OF THE STATE OF GEORGIA. SHOULD A CONFLICT EXIST THAT REQUIRES ACTION, THE BOARD OF DIRECTORS AT ITS SOLE DISCRETION SHALL HAVE THE AUTHORITY TO, BY MAJORITY VOTE, TAKE ANY AND ALL ACTIONS REQUIRED TO ADDRESS THE CONFLICT. THE BOARD OF DIRECTORS SHALL ALSO HAVE THE AUTHORITY TO DIRECT MANAGEMENT TO TAKE ACTIONS ON A CONSULTATIVE BASIS TO MODIFY, LESSEN, OR CONTROL THE CONFLICT WHERE IT MAY DEEM SUCH ACTION AS PRUDENT. IF A BOARD MEMBER HAS A CONFLICT OF INTEREST, THEY RECUSE THEMSELVES FROM THE DELIBERATION. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S SIX-MEMBER BOARD SETS THE EXECUTIVE DIRECTOR'S SALARY, WHICH IS BASED ON THE AMERICAN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING (AAHSA) SALARY SURVEY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION WILL PROVIDE COPIES OF THE FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY TO THE PUBLIC UPON REQUEST. HOWEVER, THE ORGANIZATION WILL NOT MAKE ITS GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC. UNIVERSITY HEALTH INC 1350 WALTON WAY AUGUSTA GA 30901 581581102 CONSOLIDATING PARENT GA 501(C)(3) LINE 11 N/A 0 RICHMOND COUNTY HOSPITAL AUTHORITY 1350 WALTON WAY AUGUSTA GA 30901 586001901 LEASED FACILITIES GA 501(C)(3) LINE 3 N/A 0 UNIVERSITY HEALTH CARE FOUNDATION INC 2100 CENTRAL AVE SUITE D-1 AUGUSTA GA 30904 581343550 PHILANTHROPY GA 501(C)(3) LINE 7 UNIVERSITY HEALTH INC 0 UNIVERSITY EXTENDED CARE INC 1350 WALTON WAY AUGUSTA GA 30901 581581105 SKILLED NURSING FACILITIES GA 501(C)(3) LINE 3 UNIVERSITY HEALTH INC 0 UNIVERSITY HEALTH SERVICES INC 1350 WALTON WAY AUGUSTA GA 30901 581581103 HOSPITAL GA 501(C)(3) LINE 3 UNIVERSITY HEALTH INC 0 UNIVERSITY MCDUFFIE COUNTY REGIONAL 1350 WALTON WAY AUGUSTA GA 30901 454166209 HOSPITAL GA 501(C)(3) LINE 3 UNIVERSITY HEALTH INC 0 UNIVERSITY HEALTH RESOURCES INC 1350 WALTON WAY AUGUSTA GA 30901 581601372 SERVICES TO PHYSICIAN PRACTICES GA UNIVERSITY HEALTH INC C 0 UNIVERSITY HOSPITAL AIKEN INC 1350 WALTON WAY AUGUSTA GA 30901 472713774 HOSPITAL SC UNIVERSITY HEALTH INC C 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 1 1 0 0 0 UNIVERSITY HEALTH SERVICES O 428053 COST UNIVERSITY HEALTH INC E 6323336 BOOK VALUE UNIVERSITY HEALTH SERVICES P 1595895 COST UNIVERSITY HEALTH SERVICES E 192058 BOOK VALUE