2015-11-16T14:08:34-06:00 2015-06-30 580692043 Mauldin & Jenkins LLC P O Box 1877 Macon GA 312021877 990 2014-07-01 201220860 Magnolia Manor of Marion County Inc MAGN 2299249352 2001 South Lee Street Americus GA 31709 Mark Todd President 2299249352 2015-11-13 1 Linda Corty P00221297 4784648000 2015-11-12 X 2014 2016-03-07 17:11:31Z Mark Todd 2001 South Lee Street Americus GA 31709 4937934 0 X www.magnoliamanor.com X 2004 GA The Corporation is organized to provide long-term care to the sick and elderly in a spiritual setting through operation of a 70-bed skilled nursing facility located in Buena Vista, Georgia. 13 13 94 28 0 0 0 0 4631778 4908711 845 1106 48831 28117 4681454 4937934 0 0 0 0 1844774 1932958 0 0 0 1642778 1773339 3487552 3706297 1193902 1231637 3175308 1658051 323815 298691 2851493 1359360 The Corporation is organized to provide long-term care to the sick and elderly in a spiritual setting through the operation of a 70-bed skilled nursing facility located in Buena Vista, Georgia. 0 0 3327740 4904082 Provided long-term care for the sick and elderly in a spiritual setting in a 70-bed skilled nursing facility. The Organization provided 21,477 patient days of service during the year. 3327740 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 13 0 94 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 1 1 GA X The Organization 2299249352 2001 South Lee Street Americus GA 31709 James R Buchanan Jr Trustee 0.00 X 0 0 0 Eloise Paschal Secretary 0.00 X X 0 0 0 Ann Harris Trustee 0.00 X 0 0 0 Mark Johnson Chairman 0.00 X X 0 0 0 Edie Vinson Trustee 0.00 X 0 0 0 Hal Weathers Trustee 0.00 X 0 0 0 Jean Wheeler Trustee 0.00 X 0 0 0 Chuck Reeves Vice Chairman 0.00 X X 0 0 0 Schley Gatewood Jr Trustee 0.00 X 0 0 0 Robert Beckum Trustee 0.00 X 0 0 0 Will Peterson Trustee 0.00 X 0 0 0 Cindy Higdon Trustee 0.00 X 0 0 0 Russ Carreker Trustee 0.00 X 0 0 0 Mark Todd President/CEO 4.00 36.00 X 0 240500 11545 Scott Adkins SVP Finance 4.00 36.00 X 0 146140 7974 Hill Fort SVP Operations 4.00 36.00 X 0 189039 10516 Diane Wade SVP Marketing 4.00 36.00 X 0 109418 8877 James Griffith SVP of Information Systems 4.00 36.00 X 0 101692 8620 Jerry Vick Former SVP Finance 4.00 36.00 X 0 111063 5589 0 897852 53121 0 1 1 0 Core Roofing Systems 1360 Union Hill Rd Suite 11B Alpharetta GA 30004 Roof repairs 142319 1 Medicare/Medicaid Paym 623000 4571255 4571255 Routine Room/Board 623000 337456 337456 4908711 1106 1106 Share of LLC investmen 900099 21427 21427 Miscellaneous 623000 3370 3370 Food Sale Revenue 623000 3320 3320 28117 4937934 4915401 0 22533 1525287 1415722 109565 20758 18655 2103 267710 257062 10648 119203 110744 8459 9636 9636 3874 3874 23521 23521 1442 1442 275939 275939 12183 5992 6191 45532 45532 64197 64197 Georgia Provider Fee 368730 368730 Contracted Services 255903 255903 Supplies 243460 243460 Management Fees 165420 165420 303502 265804 37698 3706297 3327740 378557 0 130662 116057 1812775 113199 5225 5439 6558 12820 572470 144208 271915 428262 36408 39835 911765 942439 3175308 1658051 323815 298691 323815 298691 X 2851493 1359360 2851493 1359360 3175308 1658051 X 1231637 -2723770 X X 0 1 X 1 0 X 4191696 4354128 4806252 4631778 4897392 22881246 4191696 4354128 4806252 4631778 4897392 22881246 0 0 0 22881246 67241 57113 62163 5958 1106 193581 67241 57113 62163 5958 1106 193581 32934 22111 34995 43718 28183 161941 4291871 4433352 4903410 4681454 4926681 23236768 0.98470 0.98120 0.00830 0.01140 X Schedule A, Part III, Line 12, Explanation of Other Income: Employee cafeteria sales - 2010 Amount: $ 4,803. 2011 Amount: $ 5,008. 2012 Amount: $ 3,945. 2013 Amount: $ 3,320. 2014 Amount: $ 3,320. Share of income from joint venture - 2010 Amount: $ 26,402. 2011 Amount: $ 15,832. 2012 Amount: $ 22,005. 2013 Amount: $ 23,185. 2014 Amount: $ 21,493. Miscellaneous receipts - 2010 Amount: $ 1,729. 2011 Amount: $ 1,271. 2012 Amount: $ 9,045. 2013 Amount: $ 17,213. 2014 Amount: $ 3,370. 218601 20053 198548 353869 124155 229714 428262 Related party accounts receivable 942439 942439 X Part X, Line 2: The Corporation and certain of its affiliates are not-for-profit corporations and have been recognized as tax-exempt persuant to Sec. 501(c)(3) of the Internal Revenue Code. Georgia Pharmacy Ventures, LLC files as a Partnership. The Corporation files its Forms 990, Return of Organizations Exempt from Income Tax, in the U.S. federal jurisdiction and with the State of Georgia. This form is open for public inspection. The Organization believes that it has appropriate support for all tax positions taken and, as such, does not have any uncertain tax positions that are material to the financial statements. As of June 30, 2015, tax years that remain subject to examination by taxing authorities begin with 2011. Tax returns for 2011, 2012, 2013 and 2014 remain open to examination by taxing authorities. Management believes that all positions taken in those returns would be sustained if examined by taxing authorities. X 0 0 0 0 0 0 0 0 0 Mark Todd President/CEO 0 240500 0 0 0 0 0 4810 0 6735 0 252045 0 0 Scott Adkins SVP Finance 0 146140 0 0 0 0 0 2923 0 5051 0 154114 0 0 Hill Fort SVP Operations 0 189039 0 0 0 0 0 3781 0 6735 0 199555 0 0 Jerry Vick Former SVP Finance 0 111063 0 0 0 0 0 2221 0 3368 0 116652 0 0 Form 990, Part VI, Section B, line 11 The Form 990 was reviewed by the Organization's President and Senior Vice President for Finance prior to filing. A copy of Form 990 was also provided to all members of the Executive of the Board of Trustees for their review and approval. Form 990, Part VI, Section B, line 12c Board members in general and Finance Committee members in particular are aware of potential conflicts and consider these potential conflicts in making decisions. Form 990, Part VI, Section B, line 15a The CEO is paid entirely from a related tax-exempt organization. The Board of Trustees establishes the CEO's salary based on industry norms and compensation studies for similar type organizations. Form 990, Part VI, Section C, line 18 The Organization makes its Form 990 available to the public upon request at the Magnolia Manor, Inc. Corporate office in Americus, Georgia. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request at the Magnolia Manor, Inc. Corporate office in Americus, Georgia. Form 990, Part XI, line 9: Transfers from related parties - forgiveness of debt -2,723,770. Form 990, Part XII, Line 2c Review of financial statements - The process for the review and oversight of the audit process and audited financial statements has not changed from the prior year. Magnolia Manor Inc 2001 S Lee Street Americus GA 31709 580911706 Elderly affordable long-term care and assisted living GA 501(c)(3) Line 9 0 Magnolia Manor of St Simons Inc 2255 Frederica Rd St Simons Island GA 31522 201364957 Elderly affordable long-term care and assisted living GA 501(c)(3) Line 9 0 Magnolia Manor of Macon Supportive Housing Inc 190 Pierce Ave Macon GA 31204 311651955 Assisted Living GA 501(c)(3) Line 9 0 Magnolia Manor of Columbus Inc 2010 Warm Springs Rd Columbus GA 31904 208034409 Elderly affordable long-term care and assisted living GA 501(c)(3) Line 9 0 Magnolia Manor of Macon Inc 190 Pierce Ave Macon GA 31204 261311379 Assisted Living GA 501(c)(3) Line 9 0 MMI Assurance Ltd 2001 S Lee Street Americus GA 31709 981082342 Captive Insurance company CJ Magnolia Manor Inc 1 Georgia Pharmacy Ventures LLC 440 Industrial Boulevard Hawkinsville GA 31036 261918757 Provision of pharmacy-related products and services GA Magnolia Manor Inc Related 21493 54276 0 0 0.07500 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 Magnolia Manor Inc M 165420 Amounts charged