COFFEE REGIONAL MEDICAL CENTER INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
COFFEE REGIONAL MEDICAL CENTER INC (EIN 65-0543088)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-02
IRS object ID
201633079349300603
Schema version
2015v2.1
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)
Return2016-11-02T07:21:53-05:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN621517792PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PERSHING YOAKLEY & ASSOCIATES P CBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12220 SUTHERLAND AVEAddressLine1Txt
CityKNOXVILLECityNm
State AbbreviationTNStateAbbreviationCd
ZIP37919ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN650543088EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COFFEE REGIONAL MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOFFBusinessNameControlTxt
Phone9123841900PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11101 OCILLA ROAD/PO BOX 1287AddressLine1Txt
CityDOUGLASCityNm
State AbbreviationGAStateAbbreviationCd
ZIP315332207ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonVICKI LEWISPersonNm
Person TitlePRESIDENT AND CEOPersonTitleTxt
Phone9123841900PhoneNum
Signature2016-11-02SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDEBORAH O ERNSBERGERPreparerPersonNm
PTINP00364912PTIN
Phone8656730844PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerVICKI LEWISPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11101 OCILLA ROAD/PO BOX 1287AddressLine1Txt
CityDOUGLASCityNm
State AbbreviationGAStateAbbreviationCd
ZIP315332207ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$126,066,607GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.COFFEEREGIONAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1995FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTO BE A LEADING PROVIDER OF A COMPREHENSIVE RANGE OF HIGH-QUALITY, REASONABLY PRICED HEALTH CARE SERVICES IN COFFEE COUNTY, GEORGIA, AND THE SURROUNDING REGION. THESE HEALTH CARE SERVICES ARE PROVIDED TO ALL PERSONS REGARDLESS OF ABILITY TO PAY.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee931TotalEmployeeCnt
Total Volunteers77TotalVolunteersCnt
Total Gross UBI$53,591TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$15,789NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$279,000PYContributionsGrantsAmt
CY Contributions Grants$522,277CYContributionsGrantsAmt
PY Program Service Revenue$95,288,956PYProgramServiceRevenueAmt
CY Program Service Revenue$116,292,031CYProgramServiceRevenueAmt
PY Investment Income$2,778,311PYInvestmentIncomeAmt
CY Investment Income$1,870,700CYInvestmentIncomeAmt
PY Other Revenue$3,485,672PYOtherRevenueAmt
CY Other Revenue$3,090,544CYOtherRevenueAmt
PY Total Revenue$101,831,939PYTotalRevenueAmt
CY Total Revenue$121,775,552CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$52,517,924PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$51,067,588CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$50,219,338PYOtherExpensesAmt
CY Other Expenses$65,351,477CYOtherExpensesAmt
PY Total Expenses$102,737,262PYTotalExpensesAmt
CY Total Expenses$116,419,065CYTotalExpensesAmt
PY Revenues Less Expenses-$905,323PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,356,487CYRevenuesLessExpensesAmt
Total Assets BOY$77,178,672TotalAssetsBOYAmt
Total Assets EOY$80,243,205TotalAssetsEOYAmt
Total Liabilities BOY$51,992,034TotalLiabilitiesBOYAmt
Total Liabilities EOY$50,167,522TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$25,186,638NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$30,075,683NetAssetsOrFundBalancesEOYAmt
MissionTO BE A LEADING PROVIDER OF A COMPREHENSIVE RANGE OF HIGH-QUALITY, REASONABLY PRICED HEALTH CARE SERVICES IN COFFEE COUNTY, GEORGIA, AND THE SURROUNDING REGION. THESE HEALTH CARE SERVICES ARE PROVIDED TO ALL PERSONS REGARDLESS OF ABILITY TO PAY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$102,530,275ExpenseAmt
Revenue$118,843,260RevenueAmt
DescHOSPITAL SERVICES - SHORT TERM CARE FOR INPATIENT AND OUTPATIENT SERVICES FOR DOUGLAS AND COFFEE COUNTY. COFFEE REGIONAL MEDICAL CENTER (CRMC) SERVED 4,596 PATIENTS FOR A TOTAL OF 18,345 DAYS IN 2015. NURSERY DAYS WERE 996 IN 2015. COFFEE REGIONAL MEDICAL CENTER PROVIDED APPROXIMATELY $11,092,818 OF INDIGENT AND CHARITY SERVICES IN 2015.Desc
Total Program Service Expenses$102,530,275TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign ActivitiesYes (1)ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document46IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee931EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial AccountYes (1)ForeignFinancialAccountInd
Foreign CountryCJForeignCountryCd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonLAVONDA CRAVEYPersonNm
Phone9123841900PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11101 OCILLA ROADAddressLine1Txt
CityDOUGLASCityNm
State AbbreviationGAStateAbbreviationCd
ZIP315332207ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
THAD CARTER
SECRETARY1.00Yes (X)Yes (X)$0$0$0
GARY EVANS
DIRECTOR1.00Yes (X)$0$0$0
BRANDY WILKES
DIRECTOR1.00Yes (X)$0$0$01.00
GREG GOGGANS
DIRECTOR1.00Yes (X)$0$0$0
MATT GREER
CHAIR1.00Yes (X)Yes (X)$0$0$0
MIKE WILLS
DIRECTOR1.00Yes (X)$0$0$01.00
ANNIE FARRAR
VICE CHAIR1.00Yes (X)Yes (X)$0$0$0
RUEBEN SPEIGHT
DIRECTOR1.00Yes (X)$0$0$01.00
GABE EVANS
DIRECTOR1.00Yes (X)$0$0$0
DARREL COLLINS DO
DIRECTOR20.00Yes (X)$179,617$0$0
JEFFERY DOCKERY MD
DIRECTOR1.00Yes (X)$0$0$0
VICKI LEWIS
PRESIDENT/CEO50.00Yes (X)$327,085$0$37,0092.00
SHERRY THOMAS
EXECUTIVE VP/CNE50.00$241,559$0$25,1332.00Yes (X)
BARRY BLOOM
VP/EXEC. DIRECTOR OF FOUNDATION50.00$205,653$0$19,9332.00Yes (X)
BRADLEY GOLDBERG
OB/GYN PHYSICIAN50.00$506,207$0$29,943Yes (X)
STEVEN DIAMOND
OB/GYN PHYSICIAN50.00$478,448$0$19,933Yes (X)
THOMAS HENRIS
ANESTHESIOLOGIST50.00$478,003$0$42,917Yes (X)
KHONDKER ISLAM
GASTROENTEROLOGIST50.00$452,027$0$42,933Yes (X)
THOMAS WEHMANN
SURGEON50.00$429,207$0$24,000Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,297,806TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$241,801TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K50IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
REHABILITATION SERVICES OF SOUTH GA
169 MEADOWLARK LANEFITZGERALDGA31750CONTRACT PHYSICAL THERAPY$562,180
JOSEPH T CHAVLOVICH
7409 CHELTNAM COURTNEW PORT RICHEYFL34655CONTRACT SERVICES$153,000
PHILIPS FINANCIAL LLC
2425 SETTLERS STREETCHARLESTONSC34655MANAGEMENT SERVICES$131,358
DRAFFIN & TUCKER
PO BOX 71309ALBANYGA31708AUDITING SERVICES$108,800
CHARLES WOEPPEL
329 WHITWORTH WAYNASHVILLETN37205CONTRACT SERVICES$108,277
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Government Grants$275,000GovernmentGrantsAmt
All Other Contributions$247,277AllOtherContributionsAmt
Total Contributions$522,277TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT REVENUE621990$116,238,440$116,238,440
REFERENCE LAB621500$53,591$53,591
FieldValueIRS element (for citing)
Total Program Service Revenue$116,292,031TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,193,027TotalRevenueColumnAmt
Exclusion$2,193,027ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$144,100RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$144,100RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$144,100TotalRevenueColumnAmt
Exclusion$144,100ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$3,968,728SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$4,238,423SecuritiesAmt
Other$52,632OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$269,695SecuritiesAmt
Other-$52,632OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$322,327TotalRevenueColumnAmt
Exclusion-$322,327ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
PHARMACY REVENUE621990$1,341,068$1,341,068
EHR PAYMENT621990$595,378$595,378
CAFETERIA722514$395,215$395,215

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$614,783TotalRevenueColumnAmt
Related Or Exempt Func Income$614,783RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,946,444OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$121,775,552TotalRevenueColumnAmt
Related Or Exempt Func Income$118,789,669RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$53,591UnrelatedBusinessRevenueAmt
Exclusion$2,410,015ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$779,497TotalAmt
Program Services$127,405ProgramServicesAmt
Management And General$652,092ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$38,974,081TotalAmt
Program Services$34,913,081ProgramServicesAmt
Management And General$4,061,000ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$73,924TotalAmt
Program Services$65,917ProgramServicesAmt
Management And General$8,007ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$8,613,622TotalAmt
Program Services$7,521,068ProgramServicesAmt
Management And General$1,092,554ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,626,464TotalAmt
Program Services$2,272,185ProgramServicesAmt
Management And General$354,279ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$220,296TotalAmt
Management And General$220,296ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$142,160TotalAmt
Management And General$142,160ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$8,247TotalAmt
Program Services$8,247ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$127,804TotalAmt
Management And General$127,804ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$14,975,235TotalAmt
Program Services$12,611,201ProgramServicesAmt
Management And General$2,364,034ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$246,162TotalAmt
Program Services$70,140ProgramServicesAmt
Management And General$176,022ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,567,813TotalAmt
Program Services$3,986,897ProgramServicesAmt
Management And General$580,916ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,018,101TotalAmt
Program Services$1,747,272ProgramServicesAmt
Management And General$270,829ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$214,628TotalAmt
Program Services$174,883ProgramServicesAmt
Management And General$39,745ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$185,748TotalAmt
Program Services$179,306ProgramServicesAmt
Management And General$6,442ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,593,821TotalAmt
Program Services$1,593,821ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,683,167TotalAmt
Program Services$4,920,486ProgramServicesAmt
Management And General$762,681ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,701,933TotalAmt
Program Services$284,260ProgramServicesAmt
Management And General$1,417,673ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
BAD DEBT$14,174,537$14,174,537
SUPPLIES$10,478,548$10,478,548
DEVELOPMENT$2,888,601$2,888,601
UBTI$6,556$6,556

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$6,118,120TotalAmt
Program Services$4,505,864ProgramServicesAmt
Management And General$1,612,256ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$116,419,065TotalAmt
Program Services$102,530,275ProgramServicesAmt
Management And General$13,888,790ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,595,967BOYAmt
EOY$4,982,310EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$11,241,391BOYAmt
EOY$13,320,878EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$213,314BOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$898,624BOYAmt
EOY$1,898,349EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$898,615BOYAmt
EOY$627,058EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$98,225,611LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$70,013,139LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$27,704,096BOYAmt
EOY$28,212,472EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$29,886,497BOYAmt
EOY$30,059,362EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,740,168BOYAmt
EOY$1,142,776EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$77,178,672BOYAmt
EOY$80,243,205EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$20,875,450BOYAmt
EOY$18,992,205EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$28,649,148BOYAmt
EOY$28,274,305EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,467,436BOYAmt
EOY$2,901,012EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$51,992,034BOYAmt
EOY$50,167,522EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$25,186,638BOYAmt
EOY$30,075,683EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$25,186,638BOYAmt
EOY$30,075,683EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$77,178,672BOYAmt
EOY$80,243,205EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$5,356,487ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$452,077NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$15,365OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$8,247OtherActivitiesAmt
Total Lobbying Expenditures$8,247TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1FormAndLineReferenceDesc
ExplanationA PORTION OF THE ANNUAL DUES PAID TO THE GEORGIA HOSPITAL ASSOCIATION IS ALLOCATED TO THE LOBBYING ACTIVITIES OF THESE ASSOCIATIONS.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$441,214OtherCostOrOtherBasisAmt
Book Value$441,214BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$55,353,371OtherCostOrOtherBasisAmt
Depreciation$32,559,008DepreciationAmt
Book Value$22,794,363BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$146,203OtherCostOrOtherBasisAmt
Depreciation$125,490DepreciationAmt
Book Value$20,713BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$40,903,551OtherCostOrOtherBasisAmt
Depreciation$37,328,641DepreciationAmt
Book Value$3,574,910BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,381,272OtherCostOrOtherBasisAmt
Book Value$1,381,272BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$28,212,472TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationCRH HEALTHCARE, INC., EXCLUDING COFFEE REGIONAL MEDICAL CENTER SEGREGATED PORTFOLIO, CRH VENTURES, INC. AND SOUTHEASTERN MANAGED CARE, INC. IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. COFFEE REGIONAL MEDICAL CENTER SEGREGATED PORTFOLIO IS AN EXEMPTED SEGREGATED PORTFOLIO COMPANY THAT WAS INCORPORATED UNDER THE PROVISIONS OF THE COMPANIES LAW OF THE CAYMAN ISLANDS AND HAS RECEIVED AN UNDERTAKING FROM THE CAYMAN ISLANDS GOVERNMENT EXEMPTING IT FROM ALL LOCAL INCOME, PROFITS AND CAPITAL GAINS TAXES. CRH VENTURES, INC. AND SOUTHEASTERN MANAGED CARE, INC. ARE TAXABLE ENTITIES AND ARE, THEREFORE, SUBJECT TO FEDERAL INCOME TAXES. CRH VENTURES, INC. AND SOUTHEASTERN MANAGED CARE, INC. FILE SEPARATE FEDERAL INCOME TAX RETURNS. THE CORPORATION APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE 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 CORPORATION 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 MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF DECEMBER 31, 2015 AND 2014 OR FOR THE YEARS THEN ENDED. THE CORPORATION'S 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.ExplanationTxt

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

FieldValueIRS element (for citing)
RegionCENTRAL AMERICA AND THE CARIBBEANRegionTxt
Offices1OfficesCnt
Employee1EmployeeCnt
Type Of Activities ConductedINVESTMENTSTypeOfActivitiesConductedTxt
Region Total Expenditures$11,250,044RegionTotalExpendituresAmt
FieldValueIRS element (for citing)
Subtotal Offices1SubtotalOfficesCnt
Subtotal Employees1SubtotalEmployeesCnt
Continutation Total Office0ContinutationTotalOfficeCnt
Continutation Total Employee0ContinutationTotalEmployeeCnt
Total Office1TotalOfficeCnt
Total Employee1TotalEmployeeCnt
Subtotal Spent$11,250,044SubtotalSpentAmt
Continuation Spent$0ContinuationSpentAmt
Total Spent$11,250,044TotalSpentAmt
Transfer To Foreign Corp0TransferToForeignCorpInd
Interest In Foreign Trust0InterestInForeignTrustInd
Foreign Corp OwnershipYes (1)ForeignCorpOwnershipInd
Passive Foreign Investmest Co0PassiveForeignInvestmestCoInd
Foreign Partnership0ForeignPartnershipInd
Boycott Countries0BoycottCountriesInd

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other125.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,657,971TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,657,971NetCommunityBenefitExpnsAmt
Total Expense0.03140TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,444,364TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,313,280DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,131,084NetCommunityBenefitExpnsAmt
Total Expense0.04410TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,102,335TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,313,280DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,789,055NetCommunityBenefitExpnsAmt
Total Expense0.07550TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$23,785TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$23,785NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,400TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,400NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,185TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$26,185NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,128,520TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,313,280DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,815,240NetCommunityBenefitExpnsAmt
Total Expense0.07570TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,500TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,500NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,840TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,840NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,900TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,900NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,240TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$9,240NetCommunityBenefitExpnsAmt
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$14,174,537BadDebtExpenseAmt
Bad Debt Expense Attributable$10,630,902BadDebtExpenseAttributableAmt
Reimbursed By Medicare$21,270,097ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$19,823,168CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$1,446,929MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COFFEE REGIONAL MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11101 OCILLA ROAD PO BOX 1287AddressLine1Txt
CityDOUGLASCityNm
State AbbreviationGAStateAbbreviationCd
ZIP31533ZIPCd
FieldValueIRS element (for citing)
State License034-490StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherPHYSICIAN OFFICES, RURAL HEALTH CLINICOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1COFFEE REGIONAL MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.COFFEEREGIONAL.ORGOwnWebsiteURLTxt
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt13ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.COFFEEREGIONAL.ORGStrategyWebsiteURLTxt
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.COFFEEREGIONAL.ORGFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.COFFEEREGIONAL.ORGFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.COFFEEREGIONAL.ORGFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
COFFEE REGIONAL MEDICAL CENTER INCPART V, SECTION B, LINE 5: IN 2012, CRMC DEVELOPED A COMMUNITY SURVEY QUESTIONNAIRE TO PROVIDE TO PERSONS WITHIN ITS SERVICE AREA. PAPER COPIES AS WELL AS AN ONLINE SURVEY WERE MADE AVAILABLE IN BOTH ENGLISH AND SPANISH. CRMC PROVIDED THE SURVEY TO ALL PATIENTS WHO PRESENTED TO CRMC THROUGH FRONT ADMISSIONS AND TO ALL PATIENTS WHO PRESENTED TO THE THREE LARGEST PRIMARY CARE CLINICS: COFFEE WOMEN'S CARE CENTER, CRH OB/GYN, AND CRH PEDIATRICS. PATIENTS WERE INCENTIVIZED TO PARTICIPATE.A WRITTEN SURVEY WAS PROVIDED TO PHYSICIANS AND LEADERS WITHIN THE COMMUNITY TO ASSESS THE HEALTH OF THE COMMUNITY, AS WELL AS ITS SPECIFIC NEEDS. THE LEADER BASE WAS DRAWN FROM COUNTY BOARD OF COMMISSIONERS, DFACS TECHNICAL COLLEGE, ENTREPRENEURS, COMMUNITY VOLUNTEERS AND MINISTRY.
COFFEE REGIONAL MEDICAL CENTER INCPART V, SECTION B, LINE 11: COFFEE REGIONAL MEDICAL CENTER IDENTIFIED THE FOUR TOP AREAS TO FOCUS ON OUT OF ALL NEEDS IDENTIFIED BY THE COMMUNITY HEALTH NEEDS ASSESMENT. THESE FOUR ARE CONSIDERED THE MOST SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY AND WILL BE COVERED BY THE IMPACT INITIATIVES. OTHER HEALTH NEEDS IDENTIFIED IN THE ASSESSMENT BUT NOT DEEMED SIGNIFICANT MAY BE INDIRECTLY IMPACTED BY THE INITIATIVES, BUT RESOURCE CONSTRAINTS PREVENT CRMC FROM DIRECTLY ADDRESSING THESE INITIATIVES.GOAL #1: ADDITIONAL PRIMARY CARE SERVICESCRMC HAS IMPLEMENTED A 24 HOUR A DAY, SEVEN DAY A WEEK HOSPITALIST PROGRAM TO AID PRIMARY CARE PHYSICIANS WITH THE TRANSITION OF CLINIC PATIENTS TO INPATIENT CARE. THE HOSPITALIST PROGRAM ALLOWS THE PRIMARY CARE PHYSICIANS THE ABILITY TO STAY IN THE PRACTICE SETTING VERSUS ROUNDING ON PATIENTS IN THE HOSPITAL, CREATING MORE OPEN CLINIC VISIT SLOTS ON THE SCHEDULE WHICH ENHANCES PATIENT ACCESS TO CARE.GOAL #2: ACCESS TO CARE/TRANSPORTATION- CRMC PROVIDED COMMUNITY EDUCATION AND ON-SITE ASSISTANCE FOR THE HEALTHCARE INSURANCE EXCHANGE IN AN EFFORT TO PROVIDE THE UNINSURED GREATER ACCESS TO CARE.- ADDITIONAL TRANSPORTATION SERVICES HAVE BEEN ADDED TO THE AREA TO BETTER SERVICE THE COMMUNITY.- TWO NEW HOME HEALTH CARE AGENCIES HAVE ALSO BEEN ADDED TO THE AREA TO SECURE A GREATER CONTINUUM OF CARE POST-HOSPITALIZATION.- PRIMARY CARE IS PROVIDED TO STUDENTS AT THE LOCAL STATE COLLEGE THROUGH THE CRMC WALK-IN CLINIC.- CRMC CONTINUES TO WORK WITH THE LOCAL RURAL HEALTH CLINIC, TRANSPORT COMPANIES, HOME HEALTH AGENCIES AND OTHER LOCAL WALK-IN CLINICS TO HELP PROVIDE ACCESS TO CARE WHEN POSSIBLE.- CAB VOUCHERS ARE PROVIDED TO PATIENTS POST-HOSPITAL DISCHARGE WHEN NECESSARY.GOAL #3: HEALTH EDUCATION/OBESITY/DIET AND NUTRITION/PREVENTIVE CARE- IN 2015 CRMC PROVIDED ONGOING MONTHLY SUPPORT GROUPS INCLUDING A DIABETIC SUPPORT GROUP AND CHILD BIRTH CLASSES. THESE CLASSES OR SUPPORT GROUPS ARE PROVIDED AT NO COST TO THE COMMUNITY IN AN EFFORT TO EDUCATE THE COMMUNITY ON HEALTHY EATING HABITS, PREVENTIVE CARE AND HEALTHY LIFESTYLES.- THE CRMC WELLNESS CENTER ORGANIZED A NUMBER OF FITNESS EVENTS IN 2015 TO ENCOURAGE A HEALTHY COMMUNITY AND BRING WELLNESS AWARENESS TO THE COMMUNITY THROUGHOUT THE YEAR.- THROUGH THE CRMC WELLNESS CENTER, WELLNESS EDUCATION WAS PROVIDED TO 150 PLUS STUDENTS AT THE BOYS AND GIRLS CLUB OF COFFEE COUNTY.- CRMC ALSO OFFERS A LOW COST, HEALTHY MEAL OPTION IN THE CAFETERIA DAILY AND IS OPEN TO THE PUBLIC.- THE ANNUAL COMMUNITY HEALTH FESTIVAL OFFERS FREE AND REDUCED COST SCREENINGS, INCLUDING BLOOD SUGAR, BMI, BLOOD PRESSURE, AND CBC. THE FESTIVAL ALSO PROVIDES THE COMMUNITY WITH NUMEROUS HEALTH RESOURCES AND EDUCATION. OVER 1000 PARTICIPANTS TOOK PART IN THE FAIR IN 2015.- ONGOING COMMUNITY EDUCATION ON HEALTH AND WELLNESS IS PROVIDED THROUGH COMMUNITY LUNCH AND LEARN EDUCATIONAL SESSIONS, PUBLIC SERVICE ANNOUNCEMENTS AND COMMUNITY EVENTS IN AN EFFORT TO BETTER EDUCATE COFFEE COUNTY.GOAL #4: CANCER TREATMENT OPTIONS- COFFEE COUNTY NOW HAS THE PRESENCE OF TWO PART-TIME ONCOLOGISTS IN THE AREA.- CRMC SUPPORTS EVIDENCE-BASED PROSTATE CANCER SCREENINGS AND EARLY DETECTION THROUGH ANNUAL, REDUCED FEE PROSTATE SCREENING FOR THE MEMBERS OF THE COMMUNITY, AS WELL AS PSA SCREENING THROUGH LOCAL PHYSICIANS.- CRMC CONTINUES TO PROVIDE THE LATEST IN TECHNOLOGY TO AID IN THE EARLY DETECTION OF BREAST CANCER THROUGH ITS RECENT PURCHASE OF THE HOLOGIC 3D MAMMOGRAPHY TECHNOLOGY, KNOWN AS "TOMOSYNTHESIS".- CRMC REACHED OUT TO A REGIONAL FACILITY FOR ADDITIONAL ASSISTANCE IN FURTHER DEVELOPING THE ONCOLOGY SERVICES IN COFFEE COUNTY.
COFFEE REGIONAL MEDICAL CENTER INCPART V, SECTION B, LINE 22D: THE HOSPITAL FACILITY DISCOUNTS CHARGES BASED ON A SLIDING FEE SCALE WHICH COMPARES THE APPLICANT'S ANNUAL HOUSEHOLD INCOME TO FEDERAL POVERTY GUIDELINES. CHARGES ARE REDUCED AS MUCH AS 55% IN ACCORDANCE WITH THE FACILITY'S FINANCIAL ASSISTANCE POLICY.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line11 - COFFEE REGIONAL FIRST CAREBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11101 OCILLA ROADAddressLine1Txt
CityDOUGLASCityNm
State AbbreviationGAStateAbbreviationCd
ZIP31533ZIPCd
FieldValueIRS element (for citing)
FacilityRURAL HEALTH CLINICFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LN 7 COL(F):THERE IS $14,174,537 OF BAD DEBT EXPENSE WHICH IS INCLUDED IN FORM 990, PART IX, LINE 24(B). THIS AMOUNT WAS REMOVED IN THE CALCULATION OF THE PERCENT OF TOTAL EXPENSE ON SCHEDULE H LINE 7F.
PART II, COMMUNITY BUILDING ACTIVITIES:HEART TO HEART 5K RUN - FEBRUARY 20, 2015CRMC'S ANNUAL FALL FITNESS 5K RUN/FUN WALK WAS HELD IN FEBRUARY 2015 WITH OVER 231 PARTICIPANTS. IN ADDITION TO THE 5K EVENT, A ONE MILE FUN RUN WAS HELD FOR THE YOUTH IN OUR COMMUNITY. A CHECK FOR $5,148 WAS DONATED TO THE CARDIAC REHAB AWARENESS PROGRAM. (APPROXIMATELY 40 HOURS AT A COST OF $800)HEALTH FAIR - OCTOBER 3, 2015THE ANNUAL HEALTH & SAFETY FESTIVAL HELD OCTOBER 4, 2015 ATTRACTED APPROXIMATELY 1000 VISITORS. WITH OVER 80 EXHIBITORS, DEMONSTRATIONS AND HEALTH SCREENS, THE FESTIVAL OFFERED WONDERFUL, INTERACTIVE WAYS TO PROMOTE A HEALTHY LIFESTYLE. 430 VISITORS TOOK ADVANTAGE OF THE COMPLETE BIOCHEMICAL BLOOD PROFILES OFFERED AT A REDUCED FEE OF $30 (ACTUAL CHARGE OF $535) RESULTING IN A COMMUNITY SAVINGS $217,150. (APPROXIMATELY 100 HOURS AT A COST OF $2,000)PROSTATE CANCER SCREENING - SEPTEMBER 17TH & 19TH, 2015THE EARLIER PROSTATE CANCER IS DISCOVERED, THE BETTER THE CHANCES ARE THAT IT CAN BE TREATED EFFECTIVELY. WHEN PROSTATE CANCER IS IN ITS EARLIEST STAGES (STILL CONFINED TO THE PROSTATE GLAND), IT USUALLY CAUSES NO PAIN OR OTHER SYMPTOMS. THAT IS WHY EACH YEAR COFFEE REGIONAL MEDICAL CENTER OFFERS LOW COST PROSTATE CANCER SCREENINGS (DRE AND PSA BLOOD TESTS) TO OUR COMMUNITY FOR A REDUCED LAB FEE OF ONLY $10 (ACTUAL CHARGE $147) RESULTING IN A COMMUNITY SAVINGS OF $15,481. IN 2015, 113 MEN TOOK ADVANTAGE OF THIS LIFE-SAVING SCREENING. (APPROXIMATELY 13.5 PHYSICIAN HOURS AND 36 STAFF HOURS AT A COST OF $2,745)SPORTS PHYSICALS - APRIL 21, 2015ATHLETIC PHYSICALS ARE REQUIRED BY BOTH THE GEORGIA HIGH SCHOOL AND GEORGIA INDEPENDENT SCHOOL ASSOCIATIONS FOR STUDENTS PLANNING ON PARTICIPATING IN SCHOOL ATHLETIC PROGRAMS. EACH YEAR CRMC PROVIDES OVER 600 SPORTS PHYSICALS TO STUDENTS PARTICIPATING IN INTERSCHOLASTIC SPORTS DURING THE SUMMER AND THROUGHOUT THE FOLLOWING YEAR. THIS EVENT RESULTED IN A TOTAL COST SAVINGS TO THE COMMUNITY OF OVER $15,000. (APPROXIMATELY 40 PHYSICIAN HOURS AND 32 STAFF HOURS AT A COST OF $6,640.)PROJECT SEARCH 2015PROJECT SEARCH IS A ONE-YEAR EDUCATIONAL PROGRAM FOR STUDENTS WITH DISABILITIES IN THEIR LAST YEAR OF HIGH SCHOOL. IT IS TARGETED FOR STUDENTS WHOSE MAIN GOAL IS COMPETITIVE EMPLOYMENT. COFFEE REGIONAL MEDICAL CENTER PROVIDES THE SETTING FOR TWELVE PROJECT SEARCH STUDENTS, THUS ALLOWING TOTAL IMMERSION IN THE WORKPLACE TO FACILITATE THE TEACHING AND LEARNING PROCESS THROUGH CONTINUOUS FEEDBACK AND APPLICATION OF NEW SKILLS. INDIVIDUALIZED JOB DEVELOPMENT AND PLACEMENT BEGINS AFTER ROTATIONS AT ONE OR MORE WORKSTATIONS ARE COMPLETED. STUDENTS RECEIVE SUPPORT THROUGH ON-THE-JOB COACHING AND WORKSITE ACCOMMODATIONS PROVIDED BY CRMC. THE PROGRAM IS DEDICATED TO WORKFORCE DEVELOPMENT THAT BENEFITS THE INDIVIDUAL, COMMUNITY AND WORKPLACE. (CLASSROOM SPACE AT $300/MONTH TOTAL OF $2,700 AND APPROXIMATELY 60 STAFF HOURS OF TRAINING, MENTORING AND EDUCATION OF 12 STUDENTS PER YEAR AT A COST OF $1,200)BREAST CANCER SUPPORT GROUP - MONTHLY 2015IN 2015, CRMC OFFERED A FREE MONTHLY BREAST CANCER SUPPORT GROUP FOR WOMEN IN THE COMMUNITY RECENTLY DIAGNOSED WITH BREAST CANCER, THOSE UNDERGOING TREATMENT, AND THOSE WHO HAVE COMPLETED TREATMENT. CRMC'S CLINICAL EDUCATION DEPARTMENT LEADS AND ORGANIZES EACH MEETING PROVIDING SUPPORT, EDUCATION, RESOURCES AND EXPERT SPEAKERS AT EACH MEETING. APPROXIMATELY 10-15 PEOPLE ATTEND EACH MONTHLY MEETING. (144 HOURS PER YEAR AT A COST OF $2,800)DIABETES SUPPORT GROUP - MONTHLY 2015CRMC OFFERS A FREE MONTHLY DIABETES SUPPORT GROUP FOR THE GENERAL PUBLIC. CRMC'S CLINICAL EDUCATION DEPARTMENT LEADS AND ORGANIZES EACH MEETING PROVIDING SUPPORT, EDUCATION, RESOURCES AND EXPERT SPEAKERS AT EACH MEETING. EXPERTS SUCH AS DIETICIANS, PODIATRISTS AND PHYSICIANS PROVIDE VALUABLE EDUCATION TO OUR COMMUNITY REGARDING DIABETES. APPROXIMATELY 30 PEOPLE ATTEND EACH MONTHLY MEETING. (144 HOURS PER YEAR AT A COST OF $2,800)AMERICAN CANCER SOCIETY (RELAY FOR LIFE) - APRIL 2015CRMC PROVIDES A CORPORATE SPONSOR OF $1,000 ANNUALLY TO THE AMERICAN CANCER SOCIETY FOR CANCER RESEARCH, TREATMENT, AND RESOURCES. EACH YEAR MANY OF COFFEE REGIONAL EMPLOYEES PROVIDE NUMEROUS MAN HOURS FOR THE COMMUNITY WIDE RELAY FOR LIFE EVENT IN EFFORT TO RAISE MONEY AND AWARENESS. (APPROXIMATELY 180 HOURS AT A COST OF $3,600)COMMUNITY CHILDBIRTH CLASSES - BIMONTHLY 2015 CRMC PROVIDES WEEKLY CHILDBIRTH CLASSES EVERY OTHER MONTH FOR THE COMMUNITY. THE WEEKLY SESSIONS ARE FACILITATED BY THE LABOR AND DELIVERY RN STAFF. THE CLASSES PROVIDE EDUCATIONAL LESSONS ABOUT NUTRITIONAL NEEDS OF MOTHER AND FETUS, ANESTHESIA, DELIVERY, BREASTFEEDING AND MANY OTHER INFORMATIVE TOPICS. (2 RN STAFF, 8 HOURS PER MONTH FOR 6 MONTHS AT $25 PER HOUR FOR A TOTAL ANNUAL COST OF $2,400).COFFEE COUNTY CHILDHOOD CANCER SUPPORT GROUP - 2015CRMC PROVIDES SPACE MONTHLY FOR THE COFFEE COUNTY CHILDHOOD CANCER SUPPORT GROUP AT NO COST TO THEM. THE CHILDHOOD CANCER SUPPORT GROUP IS A NON-PROFIT ORGANIZATION THAT PROVIDES FAMILIES AND PATIENTS WITH CHILDHOOD CANCER SUPPORT, EDUCATION, RESOURCES AND EXPERT SPEAKERS AT EACH MONTHLY MEETING. (CLASSROOM SPACE $100 PER MONTH FOR A TOTAL OF $1,200 ANNUALLY)ALZHEIMER'S DISEASE SUPPORT GROUP OF COFFEE COUNTY - 2015CRMC PROVIDES SPACE MONTHLY FOR THE ALZHEIMER'S DISEASE SUPPORT GROUP OF COFFEE COUNTY AT NO COST TO THEM. THE SUPPORT GROUP IS A NON-PROFIT ORGANIZATION THAT PROVIDES FAMILIES SUPPORT, EDUCATION, RESOURCES AND EXPERT SPEAKERS AT EACH MONTHLY MEETING. (CLASSROOM SPACE $100 PER MONTH FOR A TOTAL OF $1,200 ANNUALLY)SIDELINE SERVICE - 2015 CRMC PROVIDES SIDELINE SERVICE FOR EACH HIGH SCHOOL FOOTBALL GAME IN COFFEE COUNTY. A FULLY EQUIPPED AMBULANCE, EMT, AND PARAMEDIC ARE PROVIDED FOR EACH HOME FOOTBALL GAME AS A COURTESY TO THE SCHOOL SYSTEM AND SPECTATORS. (AT A COST OF $250 PER GAME FOR A TOTAL OF $1,500 ANNUALLY)COFFEE COUNTY CHAMBER OF COMMERCE NEW CENTURY LEADERS - 2015 PARTICIPANTS IN NEW CENTURY LEADERS COMMIT TO AN EIGHT MONTH PROJECT THAT ALLOWS THEM TO TAKE A CLOSE LOOK AT GOVERNMENT, EDUCATION, ECONOMIC DEVELOPMENT, AND ALL ISSUES DEALING WITH QUALITY OF LIFE ON A LOCAL AND STATE LEVEL. THE PROGRAM IS DESIGNED TO HELP PARTICIPANTS DEVELOP LEADERSHIP SKILLS FOR THE WORKPLACE AND THE COMMUNITY. CRMC SPONSORED 2 EMPLOYEES IN 2015 FOR THE NEW CENTURY LEADER PROGRAM. STAFF TIME, TRAVEL AND EXPENSES FOR THE PROGRAM IS APPROXIMATELY $3,840. (2 EMPLOYEES, 12 DAYS OF TRAINING AT 8 HOURS PER DAY = 192 STAFF HOURS AT $20 PER HOUR FOR A TOTAL OF $3,840)STUDENTS - 2015IN 2015 THE MEDICAL CENTER SUPPORTED HEALTHCARE EXCELLENCE THROUGHOUT GEORGIA BY TRAINING OVER 250 STUDENTS. - ABAC (TIFTON, GA) - NURSING (RN)- ALBANY STATE UNIVERSITY (ALBANY, GA) - MASTERS IN NURSING - COFFEE HIGH SCHOOL (DOUGLAS, GA) - HEALTH OCCUPATION STUDENTS, PROJECT SEARCH, STEM STUDENTS- GA HEALTH SCIENCE UNIVERSITY (AUGUSTA, GA) - PHYSICIAN ASSISTANT - GA SOUTHERN UNIVERSITY (STATESBORO, GA) - NURSING, NURSE PRACTITIONER, DIETICIAN - MERCER (MACON, GA) - MEDICAL STUDENTS - OKEFENOKEE TECHNICAL COLLEGE (WAYCROSS, GA) - LAB, NURSING (LPN), RADIOLOGY TECHNOLOGY, RESPIRATORY THERAPY- SOUTHEASTERN TECH (VIDALIA, GA) - SURGICAL TECHNOLOGY- SOUTH GEORGIA STATE COLLEGE (DOUGLAS, GA) - NURSING (RN) 1ST YR & 2ND YR - SOUTH UNIVERSITY (SAVANNAH, GA) - PHARMACY, PHYSICIAN ASSISTANT - VALDOSTA STATE UNIVERSITY - NURSING (RN), EXERCISE PHYSIOLOGY - WALDEN UNIVERSITY (ONLINE) - MASTERS IN NURSING - WIREGRASS (DOUGLAS, GA) - CNA, EMT, HIT CODING, LPN, PHLEBOTOMY, RADIOLOGY
PART III, LINE 2:AMOUNTS ON PART III, LINES 2 AND 3 REPRESENT CHARGES WRITTEN OFF AS UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT AND WRITTEN OFF TO BAD DEBT EXPENSE. LINE 3 IS ESTIMATED AT 75% OF THE AMOUNT ON LINE 2.
PART III, LINE 4:ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE CORPORATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY FOR THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE CORPORATION'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS APPROXIMATELY 97% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2015 AND 2014. THE CORPORATION DID NOT HAVE A MATERIAL CHANGE IN THE ALLOWANCE PERCENTAGE FOR MEDICARE OR MEDICAID DURING 2015 OR 2014. THE ALLOWANCES DISCLOSED ON THE CONSOLIDATED BALANCE SHEETS REPRESENT THE ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS WITH THIRD-PARTY PAYORS, AS WELL AS THE ESTIMATED ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE CORPORATION'S PROVISION FOR BAD DEBTS INCREASED APPROXIMATELY $2,018,000 FROM APPROXIMATELY $12,157,000 FOR 2014 TO APPROXIMATELY $14,175,000 FOR 2015. THIS WAS THE RESULT OF INCREASED SELF-PAY PATIENT VOLUME. THE CORPORATION HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING FISCAL YEARS 2015 OR 2014.
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.
PART III, LINE 9B:THE ORGANIZATION WRITES OFF PATIENT ACCOUNTS RECEIVABLE BALANCES FOR PATIENTS QUALIFYING FOR CHARITY CARE OR FINANCIAL ASSISTANCE AND DOES NOT MAKE FURTHER COLLECTION EFFORTS.
PART VI, LINE 2:COFFEE REGIONAL MEDICAL CENTER EVALUATES THE NEEDS OF ITS PATIENT BASE THROUGH THE NUMBER OF PATIENTS REFERRED TO OTHER FACILITIES FOR SERVICES NOT PROVIDED BY THE FACILITY ITSELF AND THROUGH OTHER INDICATORS. IN 2013, THE HOSPITAL ORGANIZATION COMPLETED ITS COMMUNITY HEALTH NEEDS ASSESSMENT. THE FINAL REPORT CAN BE FOUND AT THE FOLLOWING LINK:HTTP://WWW.COFFEEREGIONAL.ORG/THE IMPLEMENTATION STRATEGY PLAN IS INCLUDED AS A PART OF THE CHNA ON PAGES 25 THROUGH 29.
PART VI, LINE 3:THE FINANCIAL COUNSELING DEPARTMENT WILL PROVIDE INFORMATION AND APPLICATIONS TO ALL PATIENT OR GUARANTORS SEEKING FINANCIAL ASSISTANCE FOR SERVICES RENDERED AT COFFEE REGIONAL MEDICAL CENTER THAT ARE DEEMED MEDICALLY NECESSARY.FINANCIAL COUNSELORS WILL DISCUSS ELIGIBILITY FOR MEDICAL ASSISTANCE PROGRAMS THROUGH THE DEPARTMENT OF FAMILY & CHILDREN SERVICES AND THE SOCIAL SECURITY ADMINISTRATION. IF ELIGIBILITY IS NOT MET FOR ANY MEDICALASSISTANCE PROGRAM, THE FINANCIAL COUNSELING DEPARTMENT WILL SEEK ELIGIBILITY THROUGH COFFEE REGIONAL MEDICAL CENTER'S INDIGENT CARE TRUST FUND PROGRAM.PATIENTS OR GUARANTORS REQUESTING FINANCIAL ASSISTANCE ARE REFERRED TO THE FINANCIAL COUNSELORS (FC) OR THE BENEFIT SPECIALIST CONTACT THE PATIENT AT THE TIME OF REGISTRATION FOR OUTPATIENT SERVICES OR IN THE EMERGENCY DEPARTMENT (AFTER MEDICAL SCREENING HAS BEEN COMPLETED). THE FC WILL ALSO CONTACT AN INDIVIDUAL IF THERE IS A REQUEST FROM SOCIAL SERVICES, A PHYSICIAN OFFICE, OR THE PATIENT FINANCIAL SERVICES DEPARTMENT. PATIENTS ADMITTED FOR INPATIENT OR OBSERVATION SERVICES MAY BE VISITED BY THE FC AFTER THE PATIENT HAS BEEN PLACED IN A ROOM AND STABILIZED.THE FC WILL DISCUSS WITH THE PATIENT OR GUARANTOR THE INDIGENT CARE TRUST FUND PROGRAM REQUIREMENTS AND APPLICATION PROCESS. THE PATIENT OR GUARANTOR WILL BE REQUIRED TO COMPLETE AN INDIGENT APPLICATION, PROVIDE PROOF OF IDENTITY, PROVIDE BIRTH CERTIFICATES OR PROOF OF DEPENDENCY FOR CHILDREN WITH NO IDENTITY, AND PROVIDE VERIFICATION OF INCOME (I.E. W-2'S, FEDERAL TAX RETURN, PAY STUBS, ETC.). IF VERIFICATION IS NOT PROVIDED AT THE TIME OF THE INTERVIEW, THE PATIENT OR GUARANTOR WILL BE REQUIRED TO PROVIDE WITHIN 30 DAYS. APPLICATIONS MADE ON BEHALF OF DECEASED PATIENTS MUST HAVE VERIFICATION OF INCOME AND INFORMATION CONCERNING THE VALUE OF THE PATIENT'S ESTATE.PATIENTS WHO CHOOSE NOT TO UTILIZE CURRENT BENEFITS THEY ARE ELIGIBLE FOR (I.E. VETERANS BENEFITS, MEDICARE, AND COMMERCIAL INSURANCE) WILL NOT BE CONSIDERED FOR THE INDIGENT PROGRAM. UPON RECEIPT OF THE COMPLETED APPLICATION INCLUDING NECESSARY DOCUMENTATION, CALCULATION OF THE HOUSEHOLD SIZE AND ANNUAL HOUSEHOLD INCOME IS COMPUTED AND COMPARED TO THE FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE THE PERCENTAGE OF ASSISTANCE A PATIENT OR GUARANTOR IS ELIGIBLE TO RECEIVE. PATIENTS WHOSE ANNUAL HOUSEHOLD INCOME IS BELOW THE GROSS INCOME CEILING FOR POTENTIAL MEDICAID ELIGIBILITY ARE REQUIRED TO APPLY FOR MEDICAID. ASSISTANCE IS PROVIDED TO PATIENTS IN FILING FOR OTHER BENEFITS AND COMPLETING MEDICAID APPLICATIONS. PATIENTS WHO CHOOSE NOT TO APPLY FOR OTHER BENEFITS TO WHICH THEY MAY BE ENTITLED (I.E. MEDICAID) WILL NOT BE CONSIDERED FOR THE INDIGENT PROGRAM. PATIENTS WHO CHOOSE TO APPLY COFFEE REGIONAL MEDICAL CENTER'S ACCOUNTS FOR THE PURPOSE OF MEETING MEDICALLY NEEDY SPEND DOWN TO RECEIVE ONGOING MEDICAID WILL NOT BE ALLOWED TO APPLY FOR THE INDIGENT PROGRAM FOR THAT ACCOUNT.PATIENTS OR GUARANTORS OVER 18 YEARS OF AGE BUT CLASSIFIED AS DEPENDENTS FOR TAX PURPOSES DUE TO STUDENT ELIGIBILITY WILL HAVE A TOTAL HOUSEHOLD SIZE THAT INCLUDES PARENTS AND SUBSEQUENT INCOME. PATIENTS OR GUARANTORS NOT ELIGIBLE FOR OTHER MEDICAL ASSISTANCE PROGRAMS WILL BE PROCESSED UNDER THE INDIGENT CARE TRUST FUND GUIDELINES USING THE FOLLOWING CATEGORIES:- INDIGENT - FOR PATIENTS WHOSE ANNUAL HOUSEHOLD INCOME IS BELOW 125% OF THE FPG, THE APPLICABLE ACCOUNTS WILL BE ADJUSTED TO ZERO BALANCES.- CHARITY - FOR PATIENTS WHOSE ANNUAL HOUSEHOLD INCOME IS GREATER THAN OR EQUAL TO 125% BUT NOT GREATER THAN 200% OF THE FPG, THE APPLICABLE ACCOUNTS WILL BE ADJUSTED BY THE APPROPRIATE PERCENTAGES. - AN ADJUSTMENT OF 85% OF APPLICABLE CHARGES FOR PATIENTS WHOSE ANNUAL HOUSEHOLD INCOME IS BETWEEN 125% AND 150% OF FPG - AN ADJUSTMENT OF 70% OF APPLICABLE CHARGES FOR PATIENTS WHOSE ANNUAL HOUSEHOLD INCOME IS BETWEEN 150% AND 175% OF FPG - AN ADJUSTMENT OF 55% OF APPLICABLE CHARGES FOR PATIENTS WHOSE ANNUAL HOUSEHOLD INCOME IS BETWEEN 175% AND 200% OF FPG- CATASTROPHIC - PATIENTS WHOSE ANNUAL HOUSEHOLD INCOME IS GREATER THAN 200% FPG MAY QUALIFY FOR CHARITY ADJUSTMENTS ON APPLICABLE ACCOUNTS, IF CONSIDERATION OF THE CRMC PATIENT OBLIGATIONS REDUCES THE ANNUAL HOUSEHOLD INCOME TO THE APPROPRIATE FPG.NOTIFICATION OF STATUS OF COMPLETED APPLICATION IS PROVIDED TO THE PATIENT OR GUARANTOR WITHIN 5 WORKING DAYS OF RECEIPT OF NEEDED INFORMATION. APPROVED APPLICATIONS ARE VALID FOR 30 DAYS FROM DATE OF SIGNATURE. INCOMPLETE APPLICATIONS ARE HELD FOR 30 DAYS. IF NO DOCUMENTATION IS PROVIDED TO COMPLETE THE APPLICATION, A DENIAL LETTER IS SENT TO THE PATIENT OR GUARANTOR. THE APPLICATION MAY BE COMPLETED IF THE PATIENT OR GUARANTOR PROVIDES THE REQUESTED INFORMATION WITHIN 15 WORKING DAYS OF THE DENIAL. NOTIFICATION OF STATUS OF COMPLETED APPLICATION WILL BE MAILED WITHIN 15 WORKING DAYS OF RECEIPT OF NEEDED INFORMATION.THE APPLICATION AND DOCUMENTATION WILL BECOME PROPERTY OF COFFEE REGIONAL MEDICAL CENTER AND IS TO BE KEPT CONFIDENTIAL IN THE SAME MANNER AS MEDICAL RECORDS. HOWEVER, THIS INFORMATION WILL BE USED FOR AGGREGATE REPORTING PURPOSES ONLY.
PART VI, LINE 4:COFFEE REGIONAL MEDICAL CENTER'S PRIMARY SERVICE AREA IS COFFEE COUNTY, GEORGIA. THE COUNTY HAD A POPULATION OF 43,108 CITIZENS IN 2015, OF WHICH APPROXIMATELY 28.1% FALL BELOW GOVERNMENTAL DEFINED POVERTY GUIDELINES. COFFEE COUNTY'S UNEMPLOYMENT RATE AT YEAR-END WAS 8.1%.
PART VI, LINE 5:COFFEE REGIONAL MEDICAL CENTER IS GOVERNED BY A BOARD OF DIRECTORS CONSISTING OF 11 MEMBERS. CRH HEALTHCARE, INC., THE SOLE MEMBER, ELECTS ALL BOARD MEMBERS OF CRMC. THE BOARD IS MADE UP OF NINE COMMUNITY MEMBERS REFLECTING THE DIVERSITY OF THE COMMUNITY. THE REMAINING TWO MEMBERS ARE THE CHIEF OF STAFF OF CRMC AND THE CHIEF OF STAFF ELECT. IT IS THE PHILOSOPHY OF CRMC TO ASSURE THE CONTINUATION AND ENHANCEMENT OF PATIENT CARE BY REINVESTING EXCESS FUNDS BACK INTO THE OPERATIONS OF THE FACILITY.THIS INCLUDES GREATER ACCESSIBILITY OF CARE THROUGH THE CREATION OF A RURAL HEALTH CENTER, IMPLEMENTATION OF A TELEMEDICINE PROGRAM AND RECRUITMENT OF PHYSICIANS TO THE UNDERSERVED ENVIRONMENT. ENHANCEMENT OF TECHNOLOGY IS ALSO IMPERATIVE TO ASSURE APPROPRIATE DIAGNOSTIC AND THERAPEUTIC OPTIONS FOR THE COMMUNITY. UPDATING THE AMBULANCE FLEET IS CONSISTENTLY HIGH ON THE FUNDING PRIORITY LIST TO ASSURE SERVICE TO THE MOST REMOTE AREAS OF THE COUNTY, WHICH IN SQUARE MILES IS THE SECOND LARGEST COUNTY IN THE STATE OF GEORGIA. CRMC HAS AN OPEN MEDICAL STAFF POLICY EXTENDING PRIVILEGES TO PROFESSIONALLY COMPETENT PRACTITIONERS WHO CONTINUOUSLY MEET THE QUALIFICATIONS, STANDARDS AND REQUIREMENTS OF CRMC.
PART VI, LINE 6:N/A
PART VI, LINE 7, REPORTS FILED WITH STATESGA

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DARREL COLLINS DO
DIRECTOR$179,617$0$0$0$0$0$0$0$0$0$179,617$0$0$0
VICKI LEWIS
PRESIDENT/CEO$327,006$0$0$0$79$0$0$0$37,009$0$364,094$0$0$0
SHERRY THOMAS
EXECUTIVE VP/CNE$241,464$0$0$0$95$0$5,200$0$19,933$0$266,692$0$0$0
BARRY BLOOM
VP/EXEC. DIRECTOR OF FOUNDATION$205,591$0$0$0$62$0$0$0$19,933$0$225,586$0$0$0
BRADLEY GOLDBERG
OB/GYN PHYSICIAN$425,837$0$80,348$0$22$0$10,010$0$19,933$0$536,150$0$0$0
STEVEN DIAMOND
OB/GYN PHYSICIAN$349,286$0$129,100$0$62$0$0$0$19,933$0$498,381$0$0$0
THOMAS HENRIS
ANESTHESIOLOGIST$475,336$0$2,605$0$62$0$22,984$0$19,933$0$520,920$0$0$0
KHONDKER ISLAM
GASTROENTEROLOGIST$451,999$0$0$0$28$0$23,000$0$19,933$0$494,960$0$0$0
THOMAS WEHMANN
SURGEON$421,188$0$7,940$0$79$0$17,500$0$6,500$0$453,207$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 6FormAndLineReferenceDesc
ExplanationCERTAIN EXECUTIVE OFFICERS AND PHYSICIANS ARE ELIGIBLE FOR BONUS/INCENTIVE PAYMENTS. THESE PAYMENTS ARE RELIANT ON VARIOUS ORGANIZATIONAL AND PERSONAL GOALS ESTABLISHED BY THE GOVERNING BODY. WHETHER A BONUS/INCENTIVE PAYMENT IS AWARDED IS DEPENDENT UPON THE NET PROFIT OF THE ORGANIZATION.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1COFFEE COUNTY HOSPITAL AUTHORITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN586003116BondIssuerEIN
CUSIP192137DJ3CUSIPNum
Bond Issued2004-11-16BondIssuedDt
Issue Price$39,213,858IssuePriceAmt
PurposeDEFEASANCE OF PREVIOUS BONDSPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$10,564,710RetiredAmt
Total Proceeds$39,213,858TotalProceedsAmt
Issuance Costs From Proceeds$767,435IssuanceCostsFromProceedsAmt
Other Spent Proceeds$38,446,423OtherSpentProceedsAmt
Substantial Completion2004SubstantialCompletionYr
Current Refunding0CurrentRefundingInd
Advance RefundingYes (1)AdvanceRefundingInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6CRH HEALTHCARE, INC., THE PARENT ORGANIZATION, HAS THE AUTHORITY TO APPOINT OR REMOVE BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7ABOARD MEMBERS OF THE ORGANIZATION ARE APPOINTED, AND CAN BE REMOVED, BY CRH HEALTHCARE, INC., THE PARENT ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7BDECISIONS OF THE BOARD ARE SUBJECT TO APPROVAL BY CRH HEALTHCARE, INC., THE PARENT ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11FORM 990 IS PREPARED BY AN INDEPENDENT FIRM AND IS PROVIDED TO THE BOARD PRIOR TO FILING WITH THE IRS. THE MANAGEMENT OF COFFEE REGIONAL MEDICAL CENTER, INC. PERFORMS A REVIEW OF FORM 990 BEFORE THE FILING DATE AND INCLUDES A REVIEW OF FINANCIAL DATA AND OTHER DETAILS.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS ANNUALLY. THIS IS REVIEWED BY THE CEO AND BOARD CHAIRMAN, IF NEEDED. MEMBERS RECUSE THEMSELVES FROM CERTAIN DISCUSSIONS/DECISIONS AS A RESULT OF ANY CONFLICTS.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION OF THE CEO AND EXECUTIVE OFFICERS OF CRMC IS DETERMINED BY AN INDEPENDENT COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT AND SURVEYS, AND BOARD APPROVAL. THESE METHODS ARE WELL DOCUMENTED.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS OF THE ORGANIZATION ARE ALL AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ORGANIZATION'S CORPORATE HEADQUARTERS.
FORM 990, PART IX, LINE 11GPROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 8,313,092. MANAGEMENT AND GENERAL EXPENSES 146,386. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,459,478. CONSULTING FEES: PROGRAM SERVICE EXPENSES 139,816. MANAGEMENT AND GENERAL EXPENSES 661,280. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 801,096. RECRUITMENT FEES: PROGRAM SERVICE EXPENSES 1,402. MANAGEMENT AND GENERAL EXPENSES 47,706. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 49,108. PURCHASED SERVICE FEES: PROGRAM SERVICE EXPENSES 4,156,891. MANAGEMENT AND GENERAL EXPENSES 1,476,662. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,633,553. MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 32,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,000.
FORM 990, PART XI, LINE 9:PARTNERSHIP INCOME -15,365.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
CRH PHYSICIAN PRACTICES LLC
1101 OCILLA ROADDOUGLASGA315332207205778734PHYSICIANS OFFICESGA-$3,498,391$2,297,814CRMC
EMERGENCY PHYSICIANS OF COFFEE CO LLC
PO BOX 1287DOUGLASGA315341287451775790ER PHYSICIANSGA-$777,780$182,938CRMC
ORTHOPEDIC SURGEONS OF GEORGIA LLC
PO BOX 1287DOUGLASGA315341287452786844PHYSICIANS OFFICESGA-$4,106,905$837,255CRMC
COFFEE REGIONAL MEDICAL CENTER SEGREGATED PORTFOLIO
INSURANCE-$564,218$11,268,032CRMC62 FORUM LANE 3RD FLOOR BOX 30600CAMANA BAYCJCJ

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
CRH HEALTHCARE INC
1101 OCILLA ROADDOUGLASGA315332207582163724MANAGEMENT SERVICESGA501(C)(3)LINE 11C, III-FIN/A0
CRH HEALTH SERVICES INC
1101 OCILLA ROADDOUGLASGA315332207582165827FOUNDATIONGA501(C)(3)LINE 11B, IIN/A0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
CRH VENTURES INC
1101 OCILLA ROADDOUGLASGA315332207582165279OFFICE RENTALGAN/AC0
SOUTHEASTERN MANAGED CARE INC
1101 OCILLA ROADDOUGLASGA315332207582236627MANAGED CAREGAN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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