COMMUNITY SERVICES GROUP INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY SERVICES GROUP INC (EIN 58-0633978)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-16
IRS object ID
201503209349304910
Schema version
2014v5.0
Note
A later return for the same period supersedes this one.
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)
Return2015-11-16T10:41:22-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN580914992PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DRAFFIN & TUCKER LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 71309AddressLine1Txt
CityALBANYCityNm
State AbbreviationGAStateAbbreviationCd
ZIP317081309ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN580633978EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TY COBB HEALTHCARE SYSTEM INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlTYCOBusinessNameControlTxt
Phone7062457272PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 9AddressLine1Txt
CityFRANKLIN SPRINGSCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30639ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonGREGORY HEARNPersonNm
Person TitleCEOPersonTitleTxt
Phone7062457272PhoneNum
Signature2015-11-09SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWILLIAM EDWARD PHILLIPSPreparerPersonNm
PTINP00451499PTIN
Phone2298837878PhoneNum
Preparation2015-11-16PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1TY COBB REGIONAL MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerGREGORY HEARNPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O BOX 9AddressLine1Txt
CityFRANKLIN SPRINGSCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30639ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$44,907,361GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressTYCOBBHEALTHCARE.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1950FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTO CONTINUOUSLY IMPROVE THE QUALITY OF PRIMARY, LONG-TERM AND HOME CARE WITHIN OUR RESOURCE CAPABILITIES AND TO PROMOTE HEALTHIER LIFESTYLES THROUGH EDUCATION CONSISTENT WITH INDIVIDUAL AND COMMUNITY NEEDS.ActivityOrMissionDesc
Contract TerminationYes (X)ContractTerminationInd
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee917TotalEmployeeCnt
Total Gross UBI$4,415,801TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$6,473NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$53,880PYContributionsGrantsAmt
CY Contributions Grants$118,554CYContributionsGrantsAmt
PY Program Service Revenue$49,045,169PYProgramServiceRevenueAmt
CY Program Service Revenue$37,284,700CYProgramServiceRevenueAmt
PY Investment Income$92,679PYInvestmentIncomeAmt
CY Investment Income$5,681,540CYInvestmentIncomeAmt
PY Other Revenue$1,497,091PYOtherRevenueAmt
CY Other Revenue$1,092,420CYOtherRevenueAmt
PY Total Revenue$50,688,819PYTotalRevenueAmt
CY Total Revenue$44,177,214CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$27,455,120PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$18,764,010CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$32,288,660PYOtherExpensesAmt
CY Other Expenses$30,085,991CYOtherExpensesAmt
PY Total Expenses$59,743,780PYTotalExpensesAmt
CY Total Expenses$48,850,001CYTotalExpensesAmt
PY Revenues Less Expenses-$9,054,961PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$4,672,787CYRevenuesLessExpensesAmt
Total Assets BOY$60,872,485TotalAssetsBOYAmt
Total Assets EOY$27,177,166TotalAssetsEOYAmt
Total Liabilities BOY$44,543,385TotalLiabilitiesBOYAmt
Total Liabilities EOY$19,673,899TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$16,329,100NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$7,503,267NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO CONTINUOUSLY IMPROVE THE QUALITY OF PRIMARY, LONG-TERM AND HOME CARE WITHIN OUR RESOURCE CAPABILITIES AND TO PROMOTE HEALTHIER LIFESTYLES THROUGH EDUCATION CONSISTENT WITH INDIVIDUAL AND COMMUNITY NEEDS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangeYes (true)SignificantChangeInd
Expense$45,935,856ExpenseAmt
Revenue$33,939,998RevenueAmt
DescDURING 2014,TY COBB HEALTHCARE SYSTEM, INC. (THE SYSTEM) OPERATED BROWN MEMORIAL CONVALESCENT CENTER, A 144-BED LONG-TERM CARE FACILITY, COBB HEALTHCARE CENTER, A 116 BED LONG-TERM CARE FACILITY, THE GABLES AT COBB VILLAGE, A 48 BED ASSISTED LIVING FACILITY, AND TY COBB REGIONAL MEDICAL CENTER, A 56 BED ACUTE CARE HOSPITAL. TY COBB REGIONAL MEDICAL CENTER HAD 6,150 INPATIENT DAYS AND 17,651 EMERGENCY ROOM VISITS DURING 2014. THE HOSPITAL PARTICIPATED IN THE MEDICARE AND MEDICAID GOVERNMENT INSURANCE PROGRAMS DURING 2014. UNDER THESE PROGRAMS, THE HOSPITAL PROVIDES CARE TO PATIENTS AT PAYMENT RATES WHICH ARE DETERMINED BY THE FEDERAL AND STATE GOVERNMENTS, REGARDLESS OF THE HOSPITAL'S ACTUAL CHARGES. IN SOME CASES, THESE PROGRAMS PAY THE HOSPITAL AT AMOUNTS WHICH ARE LESS THAN THE COST OF PROVIDING THE SERVICES. THE HOSPITAL ALSO PROVIDE CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS INDIGENT AND CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. CHARGES FOREGONE, AT ESTABLISHED RATES, UNDER THE INDIGENT AND CHARITY CARE POLICY APPROXIMATED 2,121,000. IN ADDITION, THE HOSPITAL HAD BAD DEBT EXPENSE (PATIENT BILLS THAT WERE NOT COLLECTED) OF APPROXIMATELY 7,232,000, TY COBB SOLD BROWN MEMORIAL CONVALESCENT CENTER AND COBB HEALTHCARE CENTER DURING 2014.Desc
Total Program Service Expenses$45,935,856TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtYes (true)CollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstYes (true)ReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesYes (true)ForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationYes (true)PartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document146IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee917EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountYes (true)ForeignFinancialAccountInd
Foreign CountryCJForeignCountryCd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnfalseAnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedurefalseWrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonBETH DALTONPersonNm
Phone7062453119PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 9AddressLine1Txt
CityFRANKLIN SPRINGSCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30639ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
HARRIS LITTLE
VICE CHAIR1.002.00Yes (X)$10,800$0$0
DON JOHNSON
BOARD MEMBER1.00Yes (X)$9,600$0$0
FORT OGLESBY
BOARD CHAIR1.002.00Yes (X)$7,000$0$0Yes (X)
DEBORAH HARBIN
BOARD MEMBER1.00Yes (X)$4,000$0$0
F MAYES DAVISON
BOARD MEMBER1.00Yes (X)$0$0$0
SCOTT HARDIGREE
BOARD SECRET1.002.00Yes (X)$0$0$0Yes (X)
GREGORY HEARN
CEO48.002.00$202,676$0$27,036Yes (X)
EVELYN MURPHY
CHIEF CLINIC40.00$117,007$0$14,956Yes (X)
TIMOTHY VICKERY
CHIEF INFORM48.002.00$98,615$0$3,307Yes (X)
MATT R MCREE
CFO48.002.00$87,565$0$16,339Yes (X)
LAUREN PAPKA
ADMINISTRATO40.00$70,689$0$35,905Yes (X)
JAMES BAUERBAND MD
PHYSICIAN40.00$220,944$0$39,146Yes (X)
DONNA TONEY
DIRECTOR OF40.00$122,677$0$25,658Yes (X)
ANGELA HARPOLD
PHARMACIST40.00$110,846$0$5,505Yes (X)
ANGELA R HOOPER
DIRECTOR OF40.00$109,688$0$1,898Yes (X)
JENNIFER DICKERSON
PHARMACIST40.00$100,721$0$33,006Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,272,828TotalReportableCompFromOrgAmt
Total Other Compensation$202,756TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K7IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
STERIGEN LLC
PO BOX 11407BIRMINGHAMAL35246HOUSEKEEPING$851,486
METZ CULINARY
TWO WOODLAND DRIVEDALLASPA18612FOOD SERVICES$760,816
US ANESTHESIA
PO BOX 68TENNILLEGA31089PHYSICIAN$705,000
MCDERMOTT WILL & EMORY
PO BOX 6043CHICAGOIL60680LEGAL$622,358
INNOVATIVE THERAPY CONCEPTS
2 MASHBURN STREET SUITE 102HAWKINSVILLEGA31036PHYSICAL THERAP$600,989
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K16CntrctRcvdGreaterThan100KCnt
All Other Contributions$118,554AllOtherContributionsAmt
Total Contributions$118,554TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUES621990$32,868,899$32,868,899
MEDIA519100$4,415,801$4,415,801
FieldValueIRS element (for citing)
Total Program Service Revenue$37,284,700TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$275,033TotalRevenueColumnAmt
Exclusion$275,033ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$428,836RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$730,147RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$301,311RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$301,311TotalRevenueColumnAmt
Exclusion-$301,311ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$5,406,507SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$5,406,507SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,406,507TotalRevenueColumnAmt
Exclusion$5,406,507ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
EHR MEANINGFUL USE INCENTIVE$859,759$859,759
CAFETERIA & VENDING$183,117$183,117
OTHER$168,025$168,025

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$182,830TotalRevenueColumnAmt
Related Or Exempt Func Income$43,315RelatedOrExemptFuncIncomeAmt
Exclusion$139,515ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,393,731OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$44,177,214TotalRevenueColumnAmt
Related Or Exempt Func Income$33,939,998RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$4,415,801UnrelatedBusinessRevenueAmt
Exclusion$5,702,861ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$739,331TotalAmt
Program Services$220,944ProgramServicesAmt
Management And General$518,387ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$14,012,059TotalAmt
Program Services$13,863,163ProgramServicesAmt
Management And General$148,896ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$21,806TotalAmt
Program Services$21,806ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,582,341TotalAmt
Program Services$3,557,654ProgramServicesAmt
Management And General$24,687ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$408,473TotalAmt
Program Services$380,470ProgramServicesAmt
Management And General$28,003ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$14,807TotalAmt
Management And General$14,807ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$25,370TotalAmt
Management And General$25,370ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$109,807TotalAmt
Management And General$109,807ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,235,418TotalAmt
Program Services$6,882,138ProgramServicesAmt
Management And General$353,280ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$13,310,910TotalAmt
Program Services$11,941,426ProgramServicesAmt
Management And General$1,369,484ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,250,390TotalAmt
Program Services$1,250,390ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$119,750TotalAmt
Program Services$75,435ProgramServicesAmt
Management And General$44,315ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$32,710TotalAmt
Program Services$32,710ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,082,209TotalAmt
Program Services$1,878,436ProgramServicesAmt
Management And General$203,773ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$762,341TotalAmt
Program Services$762,341ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
COGS$2,869,598$2,869,598
REPAIRS & MAINTENANCE$1,131,736$1,116,663$15,073
MEDICAID PROVIDER TAX$698,522$698,522
DUES & SUBSCRIPTIONS$175,315$117,052$58,263

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$267,108TotalAmt
Program Services$267,108ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$48,850,001TotalAmt
Program Services$45,935,856ProgramServicesAmt
Management And General$2,914,145ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$5,266,063BOYAmt
EOY$1,024,309EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$855,285BOYAmt
EOY$190,000EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,334,868BOYAmt
EOY$3,547,321EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$3,188,580BOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,798,284BOYAmt
EOY$1,443,414EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$317,704BOYAmt
EOY$336,680EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$20,226,591LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$6,672,674LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$25,168,957BOYAmt
EOY$13,553,917EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$15,029,160BOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$2,020,380BOYAmt
EOY$1,610,732EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$782,210BOYAmt
EOY$1,396,586EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$677,277BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,433,717BOYAmt
EOY$4,074,207EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$60,872,485BOYAmt
EOY$27,177,166EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,526,789BOYAmt
EOY$6,447,183EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$3,073,414EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$33,620,839BOYAmt
EOY$3,404,117EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,395,757BOYAmt
EOY$6,749,185EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$44,543,385BOYAmt
EOY$19,673,899EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$16,329,100BOYAmt
EOY$7,503,267EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,329,100BOYAmt
EOY$7,503,267EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$60,872,485BOYAmt
EOY$27,177,166EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$4,672,787ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$4,153,046OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$6,312OtherActivitiesAmt
Total Lobbying Expenditures$6,312TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1FormAndLineReferenceDesc
ExplanationTY COBB HEALTHCARE SYSTEM IS A MEMBER OF THE GEORGIA HOSPITAL SYSTEM. A PORTION OF THE ANNUAL DUES ARE ALLOCATED TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Collection Used Pub ExhibitionYes (X)CollectionUsedPubExhibitionInd
Collection Used PreservationYes (X)CollectionUsedPreservationInd
Solicited Assets SalefalseSolicitedAssetsSaleInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,120,516OtherCostOrOtherBasisAmt
Book Value$1,120,516BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,060,121OtherCostOrOtherBasisAmt
Depreciation$1,956,861DepreciationAmt
Book Value$6,103,260BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,045,954OtherCostOrOtherBasisAmt
Depreciation$4,715,813DepreciationAmt
Book Value$6,330,141BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$13,553,917TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (4 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
NGTC HEALTH PROPERTIES, LLC$1,320,984C
HOMETOWN HEALTH, LLC$289,748C
ALTERNATIVE INVESTMENTSF
TY COBB SEGREGATED PORTFOLIOF
FieldValueIRS element (for citing)
Total Book Value Securities$1,610,732TotalBookValueSecuritiesAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

FieldValueIRS element (for citing)
DescEQUITY IN CAPTIVE INSURANCE SUBSIDIADesc
Book Value$1,396,586BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Program Rltd$1,396,586TotalBookValueProgramRltdAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
RELATED PARTY RECEIVABLE$3,495,561
THIRD PARTY SETTLEMENTS$467,629
OTHER RECEIVABLE$111,017
FINANCING COSTS
FieldValueIRS element (for citing)
Total Book Value Other Assets$4,074,207TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
DUE TO RELATED PARTIES$5,217,465
DUE TO HART COUNTY$1,078,132
MEDICARE/MEDICAID COST REPORT SETTLE$453,588
FieldValueIRS element (for citing)
Total Liability$6,749,185TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 2, PART III, LINE 4TY COBB HEALTHCARE SYSTEM OPERATES THE TY COBB MUSEUM. ARTICLES AND MEMORABILIA FROM TY COBB'S BASEBALL CAREER (MUCH OF WHICH IS ON LOAN FROM OWNERS OTHER THAN TY COBB HEALTHCARE SYSTEM) ARE DISPLAYED.
SCHEDULE D, PAGE 3, PART XTHE AUDITED FINANCIAL STATEMENTS FOR CALENDAR YEAR ENDED 12/31/2014 HAD NOT BEEN ISSUED AT THE TIME THIS RETURN WAS FILED. WHEN ISSUED, THE FINANCIAL STATEMENTS WILL ADDRESS FIN 45 (ASC 740). AT THIS TIME, IT IS ANTICIPATED THAT NO LIABILITY WILL BE RECORDED FOR UNRECOGNIZED TAX POSITIONS.

Schedule F IRS990ScheduleF

FieldValueIRS element (for citing)
Grant Records MaintainedfalseGrantRecordsMaintainedInd

Account Activities Outside US AccountActivitiesOutsideUSGrp

FieldValueIRS element (for citing)
RegionCAYMAN ISLANDSRegionTxt
Type Of Activities ConductedINVESTMENTTypeOfActivitiesConductedTxt
Region Total Expenditures$1,396,586RegionTotalExpendituresAmt
FieldValueIRS element (for citing)
Subtotal Spent$1,396,586SubtotalSpentAmt
Total Spent$1,396,586TotalSpentAmt
Transfer To Foreign CorpfalseTransferToForeignCorpInd
Interest In Foreign TrustfalseInterestInForeignTrustInd
Foreign Corp OwnershipYes (true)ForeignCorpOwnershipInd
Passive Foreign Investmest CofalsePassiveForeignInvestmestCoInd
Foreign PartnershipfalseForeignPartnershipInd
Boycott CountriesfalseBoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE F, PAGE 1, PART I, LINE 3FormAndLineReferenceDesc
ExplanationCAYMAN ISLANDS 0 1,396,586ExplanationTxt

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other1.250000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$853,418TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$853,418NetCommunityBenefitExpnsAmt
Total Expense0.01750TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,708,549TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,153,546DirectOffsettingRevenueAmt
Net Community Benefit Expns-$444,997NetCommunityBenefitExpnsAmt

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$249,508TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$168,298DirectOffsettingRevenueAmt
Net Community Benefit Expns$81,210NetCommunityBenefitExpnsAmt
Total Expense0.00170TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,811,475TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,321,844DirectOffsettingRevenueAmt
Net Community Benefit Expns$489,631NetCommunityBenefitExpnsAmt
Total Expense0.01910TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,811,475TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,321,844DirectOffsettingRevenueAmt
Net Community Benefit Expns$489,631NetCommunityBenefitExpnsAmt
Total Expense0.01910TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$7,231,623BadDebtExpenseAmt
Reimbursed By Medicare$7,499,437ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$11,007,464CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$3,508,027MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line1NGTC HEALTH PROPERTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesLEASE HOSPITAL FIXED ASSETSPrimaryActivitiesTxt
Org Profit Or Ownership0.18000OrgProfitOrOwnershipPct
Physicians Profit Or Ownership0.82000PhysiciansProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TY COBB REGIONAL MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1367 CLEAR CREEK PARKWAYAddressLine1Txt
CityLAVONIACityNm
State AbbreviationGAStateAbbreviationCd
ZIP30553ZIPCd
FieldValueIRS element (for citing)
Website AddressTYCOBBHEALTHCARE.COMWebsiteAddressTxt
State License059-677StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1TY COBB REGIONAL MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)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
Information GapsYes (X)InformationGapsInd
OtherYes (X)OtherInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLTYCOBBHEALTHCARE.COMOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt13ImplementationStrategyAdptYr
Strategy Posted WebsitefalseStrategyPostedWebsiteInd
Strategy AttachedYes (true)StrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care125.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
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
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesYes (true)CollectionActivitiesInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FACILITY 1, TY COBB REGIONAL MEDICAL CENTER - PART V, LINE 5THE CHIEF FINANCIAL OFFICER (CFO) OF TY COBB REGIONAL MEDICAL CENTER DEVELOPED THE CHNA HOSPITAL STEERING COMMITTEE (CHSC). THE CHSC IDENTIFIED COMMUNITY LEADERS, PARTNERS, AND REPRESENTATIVES TO INCLUDE IN THE CHNA PROCESS. INDIVIDUALS, AGENCIES, PARTNERS, POTENTIAL PARTNERS, AND OTHERS WERE REQUESTED TO WORK WITH THE HOSPITAL TO 1) ASSESS THE NEEDS OF THE COMMUNITY, 2) REVIEW AVAILABLE COMMUNITY RESOURCES AND 3) PRIORITIZE THE HEALTH NEEDS OF THE COMMUNITY. GROUPS OR INDIVIDUALS WHO REPRESENTED MEDICALLY-UNDERSERVED POPULATIONS, LOW INCOME POPULATIONS, MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASES WERE INCLUDED. COMMUNITY STAKEHOLDERS, ALSO CALLED KEY INFORMANTS, ARE PEOPLE INVESTED OR INTERESTED IN THE WORK OF THE HOSPITAL, PEOPLE WHO HAVE SPECIAL KNOWLEDGE OF HEALTH ISSUES, PEOPLE IMPORTANT TO THE SUCCESS OF ANY HOSPITAL OR HEALTH PROJECT, OR ARE FORMAL OR INFORMAL COMMUNITY LEADERS. THE HOSPITAL IDENTIFIED OVER 60 COMMUNITY MEMBERS TO PARTICIPATE IN THE CHNA PROCESS.
FACILITY 1, TY COBB REGIONAL MEDICAL CENTER - PART V, LINE 11ALL NEEDS IDENTIFIED IN THE CHNA ARE ADDRESSED IN THE IMPLEMENTATION STRATEGIES.
FACILITY 1, TY COBB REGIONAL MEDICAL CENTER - PART V, LINE 16ITY COBB HEALTHCARE SYSTEM MADE ITS FINANCIAL ASSISTANCE POLICY AVAILABLE ON ITS WEBSITE. AFTER THE END OF THE 2014 TAX YEAR AND PRIOR TO FILING THIS TAX RETURN, TY COBB HEALTHCARE SYSTEM SOLD THE HOSPITAL FACILITY TO AN UNRELATED TAX EXEMPT ORGANIZATION. THE FAP IS NO LONGER ON THE TY COBB WEBSITE SINCE THE ORGANIZATION NO LONGER OPERATES A HOSPITAL FACILITY.
FACILITY 1, TY COBB REGIONAL MEDICAL CENTER - PART V, LINE 22DTHE HOSPITAL FACILITY DISCOUNTS GROSS CHARGES FOR FAP-ELIGIBLE PATIENTS BASED ON A SLIDING SCALE UTILIZING A COMPARISON OF THE PATIENT'S HOUSEHOLD INCOME TO FEDERAL POVERTY GUIDELINES.
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
BROWN MEMORIAL CONVALESCENT CENTER
PO BOX 589ROYSTONGA30662SKILLED NURSING FACILITY
COBB HEALTHCARE CENTER
PO BOX 589ROYSTONGA30662SKILLED NURSING FACILITY
THE GABLES AT COBB VILLAGE
PO BOX 589ROYSTONGA30662ASSISTED LIVING FACILITY

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSEBAD DEBTS ARE INCLUDED AS AN OFFSET TO PATIENT REVENUES. NO ADJUSTMENT IS NECESSARY FOR THE CALCULATING THE DENOMINATOR FOR PURPOSES OF DETERMINING THE COMMUNITY BENEFIT PERCENT OF TOTAL EXPENSES.
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATIONTY COBB HEALTHCARE SYSTEM, INC. USED WORKSHEETS 1,2, AND 3 LOCATED IN THE IRS INSTRUCTIONS TO FORM 990, SCHEDULE H TO CALCULATE THE COMMUNITY BENEFIT EXPENSE REPORTED IN THE TABLE ON LINE 7.
PART II - COMMUNITY BUILDING ACTIVITIESTY COBB HEALTHCARE SYSTEM, INC. PROVIDES FREE MONTHLY HEALTH EDUCATION PROGRAMS TO THE PUBLIC TO PROMOTE WELLNESS AND HEALTHIER LIFESTYLES. THE OCCUPATIONAL MEDICINE AND WELLNESS DEPARTMENT ALSO PARTICIPATES IN LUNCH AND LEARN AND HEALTH FAIRS THROUGHOUT THE YEAR THAT PROVIDE HEALTH EDUCATION AND SCREENING OPPORTUNITIES FOR EMPLOYEES OF LOCAL BUSINESSES AS WELL AS THE PUBLIC AT LARGE. TCHS EMPLOYEES ARE ACTIVE IN AND PROMOTE WELLNESS TO LOCAL CIVIC GROUPS INCLUDING, BUT NOT LIMITED TO THE TRI-COUNTY DIABETES TASK FORCE, CHAMBER OF COMMERCE, ROTARY CLUB, KIWANIS CLUB, AND SERVICE LEAGUES.
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGYIN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE SYSTEM 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 OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS." AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTSTHE AUDITED FINANCIAL STATEMENTS HAD NOT BEEN ISSUED WHEN THIS RETURN WAS FILED. FOLLOWING IS THE PRIOR YEAR FOOTNOTE: ALLOWANCE FOR DOUBTFUL ACCOUNTS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE SYSTEM 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 OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A 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 (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEM 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 SYSTEM'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY WAS 99% FOR 2013 AND 2012. THE SYSTEM'S PROVISION FOR BAD DEBTS INCREASED APPROXIMATELY 2,345,000 FROM APPROXIMATELY 7,070,000 FOR 2012 TO APPROXIMATELY 9,415,000 FOR 2013, DUE PRIMARILY TO REGIONAL PROVIDING A FULL YEAR OF SERVICES IN 2013. THE PROVISION FOR BAD DEBTS INCLUDED IN DISCONTINUED OPERATIONS IS APPROXIMATELY 1,015,000 AND 374,000 FOR 2012 AND 2013, RESPECTIVELY. THE SYSTEM HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING 2013 OR 2012. THE SYSTEM DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITEOFFS FOR THIRD-PARTY PAYORS.
PART III, LINE 8 - MEDICARE EXPLANATIONTY COBB HEALTHCARE SYSTEM, INC. USED THE MEDICARE COST REPORT FOR THE HOSPITAL TO IDENTIFY THE ALLOWABLE COSTS.
PART III, LINE 9B - COLLECTION PRACTICES EXPLANATIONTHE HOSPITAL NOTIFIES PATIENTS OF THE FINANCIAL ASSISTANCE POLICY IN COMMUNICATIONS WITH THE PATIENTS REGARDING THE PATIENTS' BILLS. NORMAL COLLECTION PRACTICES, BASED ON THE PATIENT'S RESPONSE, WOULD CEASE ONCE IT IS DETERMINED THE PATIENT QUALIFIES FOR CHARITY CARE OR FINANCIAL ASSISTANCE.
PART VI, LINE 2 - NEEDS ASSESSMENTTHE CHIEF FINANCIAL OFFICER (CFO) OF TY COBB REGIONAL MEDICAL CENTER DEVELOPED THE CHNA HOSPITAL STEERING COMMITTEE (CHSC). THE CFO APPOINTED 11 EMPLOYEES TO THE CHSC. THE CHSC SELECTED A GEOGRAPHIC SERVICE AREA DEFINITION. THIS DEFINITION WAS BASED UPON THE HOSPITAL'S PRIMARY SERVICE AREA IN A MANNER THAT INCLUDED THE BROAD INTERESTS OF THE COMMUNITY SERVED AND INCLUDED MEDICALLY- UNDERSERVED POPULATIONS, LOW-INCOME PERSONS, MINORITY GROUPS, OR THOSE WITH CHRONIC DISEASE NEEDS. FRANKLIN AND HART COUNTY WERE SELECTED AS THE COMMUNITY FOR INCLUSION IN THIS REPORT. THE CHSC IDENTIFIED COMMUNITY LEADERS, PARTNERS, AND REPRESENTATIVES TO INCLUDE IN THE CHNA PROCESS. INDIVIDUALS, AGENCIES, PARTNERS, POTENTIAL PARTNERS, AND OTHERS WERE REQUESTED TO WORK WITH THE HOSPITAL TO: 1) ASSESS THE NEEDS OF THE COMMUNITY; 2) REVIEW AVAILABLE COMMUNITY RESOURCES, AND 3) PRIORITIZE THE HEALTH NEEDS OF THE COMMUNITY. GROUPS OR INDIVIDUALS WHO REPRESENTED MEDICALLY-UNDERSERVED POPULATIONS, LOW INCOME POPULATIONS, MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASES WERE INCLUDED. COMMUNITY STAKEHOLDERS, ALSO CALLED KEY INFORMANTS, ARE PEOPLE INVESTED OR INTERESTED IN THE WORK OF THE HOSPITAL, PEOPLE WHO HAVE SPECIAL KNOWLEDGE OF HEALTH ISSUES, PEOPLE IMPORTANT TO THE SUCCESS OF ANY HOSPITAL OR HEALTH PROJECT, OR ARE FORMAL OR INFORMAL COMMUNITY LEADERS. THE HOSPITAL IDENTIFIED OVER 60 COMMUNITY MEMBERS TO PARTICIPATE IN THE CHNA PROCESS. A COMMUNITY HEALTH PROFILE (PROFILE) WAS PREPARED BY DRAFFIN & TUCKER, LLP, A PROFESSIONAL SERVICES FIRM THAT FACILITATED THE CHNA PROCESS, TO REFLECT THE MAJOR HEALTH PROBLEMS AND HEALTH NEEDS OF FRANKLIN AND HART COUNTY. THE PROFILE ADDRESSED: - ACCESS TO PREVENTIVE HEALTH SERVICES, - UNDERLYING CAUSES OF HEALTH PROBLEMS, AND - MAJOR CHRONIC DISEASES OF THE POPULATION. QUANTITATIVE DATA, SUCH AS HEALTH DATA FROM A VARIETY OF SOURCES INCLUDING VITAL RECORDS, HEALTH STATUS DATA FROM A VARIETY OF STATE AND NATIONAL SOURCES AND HOSPITAL UTILIZATION DATA, COMPRISED THE DATA AND INDICATORS USED FOR THE PROFILE. TWO-HOUR COMMUNITY HEALTH INPUT MEETINGS (COMMUNITY MEETINGS) AND ONE-HOUR COMMUNITY STAKEHOLDER INTERVIEWS (STAKEHOLDER INTERVIEWS) WERE ESSENTIAL PARTS OF THE CHNA PROCESS. THREE COMMUNITY MEETINGS AND 15 STAKEHOLDER INTERVIEWS WERE CONDUCTED IN ORDER TO OBTAIN THE COMMUNITY'S INPUT INTO THE HEALTH NEEDS OF FRANKLIN AND HART COUNTY. PARTICIPANTS WERE ASKED TO PROVIDE THEIR OBSERVATIONS ON THE HEALTH DATA PRESENTED IN THE PROFILE. IN ADDITION, PARTICIPANTS WERE REQUESTED TO PROVIDE INPUT AS TO NEEDS THAT WERE NOT IDENTIFIED IN THE PROFILE. QUESTIONS AND DISCUSSIONS WERE ENCOURAGED, WITH THE OBJECTIVE THAT PARTICIPANTS WOULD INCREASE THEIR UNDERSTANDING OF WHAT THE DATA MEANT IN TERMS OF THE BURDEN OF CHRONIC DISEASES, THE IMPACT OF THE DEMOGRAPHICS OF THE POPULATION ON HEALTH SERVICES, HEALTH STATUS, HEALTH BEHAVIORS, AND ACCESS TO HEALTHCARE. THE GROUP DISCUSSED THE HEALTH PROBLEMS OR HEALTH ISSUES AND THE FACILITATOR MADE A LIST OF THE HEALTH PROBLEMS THE COMMUNITY PARTICIPANTS INDICATED WERE IMPORTANT. PRIORITY ISSUES WERE IDENTIFIED AT THE END OF THE DISCUSSION. THESE PRIORITIES DID NOT REFLECT PROGRAMS, SERVICES OR APPROACHES TO RESOLVING PROBLEMS, BUT RATHER HEALTH ISSUES TO BE ADDRESSED.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCESELF PAY PATIENTS ARE REFERRED TO A PATIENT FINANCIAL COUNSELOR. THE PATIENT FINANCIAL COUNSELOR WILL ASSIST THE PATIENT OR GUARANTOR IN APPLYING FOR FINANCIAL ASSISTANCE. IF NO SOURCE OF FINANCIAL ASSISTANCE IS AVAILABLE, THE HOSPITAL WILL REVIEW THE ACCOUNT FOR INDIGENT OR CHARITY ALLOWANCE. ALSO PATIENTS ARE NOTIFIED OF THE FACILITY'S FINANCIAL ASSISTANCE POLICY IN COMMUNICATIONS WITH THE PATIENT ABOUT THEIR BILL.
PART VI, LINE 4 - COMMUNITY INFORMATIONFRANKLIN COUNTY AND HART COUNTY ARE LOCATED IN THE NORTHEASTERN PART OF GEORGIA. FRANKLIN COUNTY HAS A POPULATION OF 22,048 AND IS HOME TO TY COBB REGIONAL MEDICAL CENTER, A 56 BED COMMUNITY HOSPITAL. HART COUNTY BORDERS FRANKLIN COUNTY AND HAS A POPULATION OF 25,217. THE HOSPITAL HAS MULTIPLE LOCATIONS THROUGHOUT FRANKLIN AND HART COUNTY. THE SURROUNDING AREAS IN FRANKLIN ARE DIVERSE AS FAR AS POPULATION OF RURAL AND URBAN AREAS. CARNESVILLE AND MARTIN ARE LESS POPULATED THAN ROYSTON AND CANON. THE POPULATION DISTRIBUTION IN FRANKLIN COUNTY AMONG RURAL AND URBAN AREAS IS 11.1 PERCENT URBAN AND 88.9 RURAL. IN HART COUNTY 25.5 PERCENT OF THE POPULATION IS URBAN AND 74.5 PERCENT IS RURAL. ONLY .9 PERCENT OF FRANKLIN COUNTY'S LAND AREA IS URBAN WHILE 99.1 PERCENT IS RURAL. IN HART COUNTY 2.7 PERCENT OF THE LAND IS URBAN AND 97.3 PERCENT IS RURAL. THE CITY OF HARTWELL IS THE MOST POPULATED PART OF THE COUNTY. FRANKLIN COUNTY'S POPULATION IS PREDICTED TO INCREASE TO 22,590 RESIDENTS BY 2015. HART COUNTY'S POPULATION IS PREDICTED TO INCREASE TO 25,851 BY 2015. THE PERCENTAGE OF RESIDENTS AGED 55 AND OLDER INCREASED IN BOTH COUNTIES FROM 2000 TO 2010. THIS INCREASE IDENTIFIED AN IMMEDIATE NEED FOR DELIVERY OF HEALTHCARE THAT SERVES INDIVIDUALS WITH CHRONIC CONDITIONS. THE HISPANIC POPULATION ALSO INCREASED, ALTHOUGH THIS SEGMENT REMAINED A SMALL PORTION OF THE POPULATION.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTHTY COBB HEALTHCARE SYSTEM, INC. HAS AN OPEN MEDICAL STAFF AND THE BOARRD OF DIRECTORS CONSIST OF COMMUNITY LEADERS. THE EMERGENCY ROOM IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, TO THE PUBLIC WITHOUT REGARD TO A PATIENT'S ABILTY TO PAY.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEMTY COBB HEALTHCARE SYSTEM, INC. OPERATES TY COBB REGIONAL MEDICAL CENTER, A 56 BED ACUTE CARE FACILITY. THE SYSTEM ALSO OPERATES BROWN MEMORIAL CONVALESCENT CENTER, A 116 BED LONG-TERM CARE FACILITY, AND THE GABLES AT COBB VILLAGE, A 48 BED ASSISTED LIVING FACILITY. COBB FOUNDATION, INC. OPERATES HARTWELL HEALTHCARE CENTER, A SKILLED NURSING FACILITY, THAT PROVIDED OVER 31,800 RESIDNET DAYS DURING 2013 TO THE COMMUNITY.
PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORTGEORGIA
ADDITIONAL INFORMATIONTY COBB HEALTHCARE SYSTEM, INC. PROVIDES FREE MONTHLY HEALTH EDUCATION PROGRAMS TO THE PUBLIC TO PROMOTE WELLNESS AND HEALTHIER LIFESTYLES. THE OCCUPATIONAL MEDICINE AND WELLNESS DEPARTMENT ALSO PARTICIPATE IN LUNCH AND LEARN PRESENTATIONS AND HEALTH FAIRS THROUGHOUT THE YEAR THAT PROVIDE HEALTH EDUCATION AND SCREENING OPPORTUNITIES FOR EMPLOYEES OF LOCAL BUSINESSES AS WELL AS THE PUBLIC AT LARGE. SYSTEM EMPLOYEES ARE ACTIVE IN AND PROMOTE WELLNESS TO LOCAL CIVIC GROUPS INCLUDING, BUT NOT LIMITED TO, THE TRI-COUNTY DIABETES TASK FORCE, CHAMBER OF COMMERCE, ROTARY CLUB, KIEANIS CLUB, AND SERVICE LEAGUES.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
GREGORY HEARN
CEO$202,676$7,120$19,916$229,712
JAMES BAUERBAND MD
PHYSICIAN$220,944$4,543$34,603$260,090

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART IIIFormAndLineReferenceDesc
ExplanationTHE FOLLOWING EMPLOYEES RECEIVED SEVERANCE PAYMENTS DURING THE TAX REPORTING YEAR: DAVID SEAGRAVES 107,692 JERRY WISE 35,624ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
TYLER R DAVISON
FAMILY MEMBER$55,770RN IN EMERGENCY ROOMfalse
JODI A DAVISON
FAMILY MEMBER$20,334OCCUPATIONAL THERAPIfalse

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE L, PART VFormAndLineReferenceDesc
ExplanationSCHEDULE L, PART IV, LINE 1 - TYLER DAVISON IS THE SON OF A BOARD MEMBER. HE WORKS AS AN RN IN THE EMERGENCY ROOM OF THE HOSPITAL. HIS WAGES ARE AT FAIR MARKET VALUE FOR THE SERVICES PROVIDED. SCHEDULE L, PART IV, LINE 1 - JODI DAVISON IS THE DAUGHTER IN-LAW OF A BOARD MEMBER. HER WAGES ARE AT FAIR MARKET VALUEFOR THE SERVICES PROVIDED.ExplanationTxt

Schedule N IRS990ScheduleN

Disposition Of Assets Detail DispositionOfAssetsDetail

FieldValueIRS element (for citing)
Assets Distri Or Expnss PaidTRANSFER - RELATED ORGAssetsDistriOrExpnssPaidDesc
Distribution2014-08-14DistributionDt
Fair Market Value Of Asset$5,019,117FairMarketValueOfAssetAmt
Method Of FMV DeterminationCASH VALUEMethodOfFMVDeterminationTxt
EIN465502814EIN
PersonLAKE HARTWELL HEALTHCARE FOUNDATIONPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 9AddressLine1Txt
CityFRANKLIN SPRINGSCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30639ZIPCd
FieldValueIRS element (for citing)
IRC Section501C3IRCSectionTxt
FieldValueIRS element (for citing)
Director Of Successor2Yes (true)DirectorOfSuccessor2Ind
Employee Of Successor2falseEmployeeOfSuccessor2Ind
Owner Of Successor2falseOwnerOfSuccessor2Ind
Receive Compensation2falseReceiveCompensation2Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE N, PART II, PAGE 2, LINE 2EFormAndLineReferenceDesc
ExplanationFOLLOWING A SALE OF ITS NURSING HOMES TO AN INDEPENDENT UNRELATED TAX EXEMPT ORGANIZATION, TY COBB HEALTHCARE SYSTEM FORMED A SUPPORTING ORGANIZATION, LAKE HARTWELL HEALTHCARE FOUNDATION. THE CEO AND CERTAIN BOARD MEMBERS SERVE BOTH TY COBB HEALTHCARE AND ITS SUPPORTING ORGANIZATION. TY COBB HEALTHCARE SYSTEM IS THE SOLE MEMBER OF THE NEW RELATED ENTITY.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 1, ITEM CBROWN MEMORIAL CONVALESCENT CENTER, COBB HEALTHCARE CENTER, THE GABLES AT COBB VILLAGE, THE FITNESS FIRM OF TCHS, HELATH WORKS OF TCHS, HOME BASE HEALTH SERVICES, CARNESVILLE FAMILY PRACTICE, TY COBB MUSEUM
FORM 990, PAGE 2, PART III, LINE 3TY COBB HEALTHCARE SYSTEM SOLD TWO NURSING HOMES AT THEIR FAIR MARKET VALUES TO AN UNRELATED TAX EXEMPT ORGANIZATION DURING 2014.
FORM 990, PAGE 2, PART III, LINE 4ATHE HOSPITAL'S ACTUAL CHARGES. IN SOME CASES, THESE PROGRAMS PAY THE HOSPITAL AT AMOUNTS WHICH ARE LESS THAN THE COST OF PROVIDING THE SERVICES. THE HOSPITAL ALSO PROVIDE CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS INDIGENT AND CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. CHARGES FOREGONE, AT ESTABLISHED RATES, UNDER THE INDIGENT AND CHARITY CARE POLICY APPROXIMATED 2,121,000. IN ADDITION, THE HOSPITAL HAD BAD DEBT EXPENSE (PATIENT BILLS THAT WERE NOT COLLECTED) OF APPROXIMATELY 7,232,000, TY COBB SOLD BROWN MEMORIAL CONVALESCENT CENTER AND COBB HEALTHCARE CENTER DURING 2014.
FORM 990, PART V, LINE 4BCAYMAN ISLANDS
FORM 990, PAGE 6, PART VI, LINE 11BAFTER MANAGEMENT REVIEW AND APPROVAL, AN ELECTRONIC COPY OF THE FORM 990 WAS EMAILED TO ALL MEMBERS OF THE TYCOBB HEALTHCARE SYSTEM, INC.'S BOARD OF DIRECTORS FOR APPROVAL PRIOR TO SUBMISSION.
FORM 990, PAGE 6, PART VI, LINE 12CTHE BOARD OF DIRECTORS AND CEO MONITOR AND ENFORCE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY.
FORM 990, PAGE 6, PART VI, LINE 15ATHE COMPENSATION OF TY COBB HEALTHCARE SYSTEM, INC.'S CEO IS REVIEWED AND APPROVED BY THE INDEPENDENT BOARD OF DIRECTORS. EXTERNAL COMPARABILITY REPORTING WAS ALSO USED IN THE DETERMINATION OF COMPENSATION OF THE CEO.
FORM 990, PAGE 6, PART VI, LINE 15BTHE COMPENSATION OF TY COBB HEALTHCARE SYSTEM, INC.'S CFO IS REVIEWED AND APPROVED BY THE INDEPENDENT BOARD OF DIRECTORS. EXTERNAL COMPARABILITY REPORTING WAS ALSO USED IN THE DETERMINATION OF COMPENSATION OF THE CFO.
FORM 990, PAGE 6, PART VI, LINE 19THE TY COBB HEALTHCARE SYSTEM, INC.'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE FOR THE PUBLIC TO REVIEW AT THE SYSTEM'S CORPORATE OFFICE UPON REQUEST.
FORM 990, PART VIITHE BOARD OF DIRECTORS OF TY COBB REGIONAL MEDICAL CENTER, LLC HAS OVERSIGHT OF THE OPERATIONS OF THE HOSPITAL FACILITY. THIS BOARD IS UNDER THE CONTROL OF TY COBB HEALTHCARE SYSTEM, INC. THE SOLE OWNER OF THE LLC. THE MEMBERS OF THIS OVERSIGHT BOARD INCLUDE THE FOLLOWING INDIVIDUALS: LESLIE FORDHAM; JODON GARRINGER, M.D.; DEBORAH HARBIN; HUGH JENKINS, M.D.; HARRIS LITTLE; JEFF MARSHALL, M.D.; RAM REDDY, M.D.; BOB RIDGWAY, AND DIANE TONEY.
FORM 990, PART IX, LINE 11GPURCHASED SERVICES 6,882,138 353,280 0
FORM 990, PART XI, LINE 9BOOK / TAX DEPRECIATION DIFFERENCE 408,711
FORM 990, PART XI, LINE 9WHOLLY OWNED CAPTIVE CONSOLIDATED GAIN 614,376 EQUITY TRANSFERS -5,019,117 BOOK TAX DIFFERENCES FOR 990-T -61,763 OTHER CHANGES -95,253

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtDirect Controlling NADirectControllingNACd
TY COBB REGIONAL MEDICAL CENTER LLC
PO BOX 9FRANKLIN SPRINGSGA30639264541857HEALTHCAREGA$8,791,016$13,707,525TY COBB
COBB ENTERPRISES LLC
PO BOX 9FRANKLIN SPRINGSGA30639208356011COLLECTIONGATY COBB
SPRINGS MEDIA LLC
PO BOX 9FRANKLIN SPRINGSGA30639462299364PRINTINGGA$10,859$1,148,458N/A

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
THE COBB FOUNDATION
PO BOX 9FRANKLIN SPRINGSGA30639581634125HEALTHCAREGA501C33TY COBBYes (true)
LAKE HARTWELL HEALTHCARE FOUNDATION
PO BOX 9FRANKLIN SPRINGSGA30639465502814SUPPORTGA501C311BTY COBBfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1HOME TOWN HEALTH LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13280 CHERRY OAK LANE SUITE 100AddressLine1Txt
CityCUMMINGCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30041ZIPCd
FieldValueIRS element (for citing)
EIN582403678EIN
Primary ActivitiesEDUCATIONPrimaryActivitiesTxt
Legal Domicile StateGALegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1TY COBBBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income$118,360ShareOfTotalIncomeAmt
Share Of EOY Assets$289,748ShareOfEOYAssetsAmt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
General Or Managing PartnerYes (true)GeneralOrManagingPartnerInd
Ownership0.53710OwnershipPct
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
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 SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
COBB FOUNDATION
Q$957,588ACTUAL EXPENSE REIMBURSED
COBB FOUNDATION
C$6,010,553NET EQUITY TRANSFER
HOME TOWN HEALTH
F$80,562DISTRIBUTION
COBB FOUNDATION
R$8,533LAB SERVICES
LAKE HARTWELL HEALTHCARE FOUNDATION
R$7,365,282FMV TRANSFER

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