2015-08-17T09:00:42-05:00 2014-09-30 580914992 DRAFFIN & TUCKER LLP FIVE CONCOURSE PARKWAY SUITE 1250 ATLANTA GA 30328 990 2013-10-01 237363555 MEDCEN COMMUNITY HEALTH FOUNDATION INC MEDC 4786337388 691 CHERRY STREET MACON GA 31201 RHONDA S PERRY EXECUTIVE VICE PRESIDENT/CFO 2015-08-13 true William E Phillips P00451499 4042208494 2013 2016-03-07 17:11:31Z RHONDA S PERRY 691 CHERRY STREET MACON GA 31201 64716972 false X MEDCENFOUNDATION.ORG X 1973 GA THE MEDCEN COMMUNITY HEALTH FOUNDATION'S MISSION IS TO MAXIMIZE DONOR RESOURCES TO IMPROVE THE HEALTH OF OUR REGION THROUGH COMMUNITY AND HOSPITAL PARTNERSHIPS. SEE PART III, LINE 1. 36 25 7 1713 0 0 3682778 7086746 0 0 4177458 7754005 -400081 -178575 7460155 14662176 1570168 1486866 0 0 472483 536374 0 0 0 659418 705734 2702069 2728974 4758086 11933202 82398445 94218779 239303 373265 82159142 93845514 THE MEDCEN COMMUNITY HEALTH FOUNDATION'S MISSION IS TO MAXIMIZE DONOR RESOURCES TO IMPROVE THE HEALTH OF OUR REGION THROUGH COMMUNITY AND HOSPITAL PARTNERSHIPS. THE FOUNDATION PRIMARILY SUPPORTS THE MEDICAL CENTER OF CENTRAL GEORGIA, INC. (MCCG), IN WHICH CONTRIBUTIONS ARE USED FOR CHARITABLE, MEDICAL, EDUCATIONAL AND SCIENTIFIC PURPOSES. false false 1486866 1486866 PROGRAM GRANTS WERE PRINCIPALLY TO SUPPORT THE MEDICAL CENTER OF CENTRAL GEORGIA, INC. (MCCG), IN WHICH FUNDS ARE USED FOR CHARITABLE, MEDICAL, EDUCATIONAL AND SCIENTIFIC PURPOSES. 1486866 true true false false false false false false true true true false false true true false true false false true false false false true false false true false true false false false false false false false false true false false false false true false false false false true X 2 0 true 7 true false true CJ false false false true true false false false false X 36 25 false false false false true true true true true false false true true true true true true false false false GA X MEDCEN COMMUNITY HEALTH FOUNDATION INC 4786337388 691 CHERRY STREET SUITE 400 MACON GA 31201 ELBERT T MCQUEEN CHIEF EXECUTIVE OFFICER (INTERIM)/ SVP POST ACUTE SERVICES 1.00 49.00 X X 0 233257 26263 KENNETH B BANKS CORPORATE SECRETARY/SVP/CHIEF LEGAL COUNSEL 1.00 49.00 X X 0 585748 179232 RHONDA S PERRY CHIEF FINANCIAL OFFICER/EVP 1.00 49.00 X X 0 1285717 88437 CAL HAYS VICE CHAIR 1.00 X 0 0 0 CHRIS R SHERIDAN TRUSTEE 1.00 X 0 0 0 CHRISTOPHER R GREENE TRUSTEE 1.00 X 0 0 0 CYNDEE BUSBEE TRUSTEE 1.00 X 0 0 0 DAN SPEIGHT TRUSTEE 1.00 X 0 0 0 DAVID ROZIER TRUSTEE 1.00 X 0 0 0 DENNIS ASHLEY MD TRUSTEE 1.00 X 0 0 0 DOTTIE HOUSER TRUSTEE 1.00 X 0 0 0 DUKE GROOVER TRUSTEE 1.00 X 0 0 0 EMORY JOHNSON MD TRUSTEE 1.00 X 0 0 0 FREDDY GATON MD TRUSTEE 1.00 X 0 0 0 GENE BATTLES MD TRUSTEE 1.00 X 0 0 0 HELEN RHEA STUMBO TRUSTEE 1.00 2.00 X 0 0 0 HENRY PERSONS TRUSTEE 1.00 X 0 0 0 IVAN ALLEN TRUSTEE 1.00 X 0 0 0 JAMES MANLEY TRUSTEE 1.00 X 0 0 0 JEFF RUTLEDGE TRUSTEE 1.00 X 0 0 0 JEFF THOMPSON TRUSTEE 1.00 X 0 0 0 JIM WANSLEY TRUSTEE 1.00 1.00 X 0 0 0 JOHN DRAUGHON TRUSTEE 1.00 X 0 0 0 KAREN SMITH TRUSTEE 1.00 X 0 0 0 KEN SAITOW TRUSTEE 1.00 X 0 0 0 LINDA CLAY TRUSTEE 1.00 X 0 0 0 NINFA M SAUNDERS TRUSTEE 1.00 49.00 X 0 768125 638299 PATSY BASS TRUSTEE 1.00 X 0 0 0 R EARL SMITH TRUSTEE 1.00 X 0 0 0 RHETT RAYBURN TRUSTEE 1.00 X 0 0 0 ROB BETZEL TRUSTEE 1.00 X 0 0 0 SCOTT SEIGEL CHAIR 1.00 X 0 0 0 SUE SANDA TRUSTEE 1.00 X 0 0 0 THOMAS WICKER TRUSTEE 1.00 X 0 0 0 TOM GIBBONS TRUSTEE 1.00 X 0 0 0 WADE KOVACS TRUSTEE 1.00 X 0 0 0 A DONALD FAULK JR FORMER TRUSTEE 2.00 X 0 171300 0 0 3044147 932231 0 true true false 0 1097195 983483 5006068 127296 7086746 0 0 0 0 0 0 0 0 0 0 789517 789517 0 0 0 0 0 56770662 49806174 6964488 0 6964488 6964488 70047 1097195 248622 -178575 -178575 0 0 0 0 0 0 0 0 0 0 14662176 0 0 7575430 1486866 1486866 0 0 0 0 0 442181 442181 44299 44299 17528 17528 32366 32366 0 0 2500 2500 0 0 258902 258902 0 0 0 0 250755 250755 2365 2365 0 0 67334 67334 39708 39708 0 33413 33413 0 0 502 502 2574 2574 RECRUITMENT EXPENSE 47681 47681 0 0 0 0 2728974 1486866 1242108 0 0 92400 389537 913858 3230203 109918 104620 0 0 0 0 233500 0 233500 233500 62904574 67000196 18056028 23174002 0 0 88167 86721 82398445 94218779 191803 34668 47500 33447 0 0 0 305150 239303 373265 X 8848420 9165798 73310722 84679716 82159142 93845514 82398445 94218779 11933202 -246830 0 X false true X true false X 3170103 2439430 2443831 3682778 7086746 18822888 0 0 3170103 2439430 2443831 3682778 7086746 18822888 1003674 17819214 1140423 1109625 1508877 1444988 789517 5993430 0 0 24816318 0 0.69500 0.69120 X Schedule A, Part II, Line 10, Other Income DESCRIPTION - , COLUMN A - , COLUMN B - , COLUMN C - , COLUMN D - , COLUMN E - , COLUMN F - 0; RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 73310722 7086746 5769114 1486866 84679716 63966098 2775419 8524451 1955246 73310722 54400390 2229769 9326628 1990689 63966098 53202798 2729345 475647 2007400 54400390 47685726 2753040 4067839 1303807 53202798 1.00000 false false 233500 233500 0 0 0 0 233500 0 0 OTHER SECURITIES 23174002 F 23174002 0 INTERCOMPANY DUE TO MEDICAL CENTER 305150 305150 X Schedule D, Part V, Line 4, Intended uses of endowment funds THE ORGANIZATION'S TEMPORARILY RESTRICTED NET ASSETS ARE HELD FOR THE BENEFIT AND SUPPORT OF THE MEDICAL CENTER OF CENTRAL GEORGIA, INC. Schedule D, Part X, Line 2, FIN 48 (ASC 740) footnote NAVICENT HEALTH, INC., THE MEDICAL CENTER, HSNH, CARLYLE PLACE, AND MEDCEN ARE ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAX, PURSUANT TO SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. CPI IS A FOREIGN CORPORATION NOT SUBJECT TO TAX IN THE UNITED STATES. PET, RHNH AND SHPG ARE ORGANIZED UNDER GEORGIA LAW AND THE INTERNAL REVENUE CODE AS LIMITED LIABILITY COMPANIES ("LLC"). THE MEMBERS OF AN LLC REPORT TAXABLE INCOME OR LOSS ON THEIR CORPORATE OR INDIVIDUAL TAX RETURNS. NAVICENT HEALTH'S SHARE OF INCOME FROM PET, RHNH AND SHPG OPERATIONS IS NOT CONSIDERED UNRELATED BUSINESS INCOME ("UBI") AND IS THEREFORE NOT SUBJECT TO TAX. HVNH IS SUBJECT TO INCOME TAX. WITH RESPECT TO ITS FOR-PROFIT SUBSIDIARIES, NAVICENT HEALTH ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH THE LIABILITY METHOD UNDER WHICH DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASES OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIODS THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR SETTLED. NAVICENT HEALTH AND ITS AFFILIATES HAVE EVALUATED THEIR TAX POSITIONS AND HAVE DETERMINED THAT THEY DO NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2014. FISCAL YEARS ENDING ON AND AFTER SEPTEMBER 30, 2011 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. CENTRAL AMERICA AND THE CARIBBEAN INVESTMENTS 9597000 9597000 true false true true true false SCHEDULE F, PART IV, LINE 4, QUALIFED ELECTING FUND BLACKSTONE PARK AVENUE NON-TAXABLE FUND, L.P. HAS MADE A TIMELY IRC SECTION 1295 ELECTION WITH RESPECT TO VARIOUS INVESTMENTS IN PASSIVE FOREIGN INVESTMENT COMPANIES AND HAS FILED FORM 8621 ON BEHALF OF THE PARTNERSHIP. NO UNRELATED BUSINESS TAXABLE INCOME IS EARNED OR REPORTED AS A RESULT OF THIS INVESTMENT. Schedule F, Part I, Line 3, Method to account for expenditures on org.'s financial statements CENTRAL AMERICA AND THE CARIBBEAN: ACCRUAL Schedule F, Part I, Line 3, Method to account for expenditures on org.'s financial statements CENTRAL AMERICA AND THE CARIBBEAN: ACCRUAL CMN BROADCAST 780174 780174 0 124546 CELEBRITY CLASSIC 299413 229366 70047 99138 2 87655 87655 0 24938 1167242 1097195 70047 0 0 0 0 0 248622 248622 -178575 true MEDICAL CENTER OF CENTRAL GEORGIA INC 691 CHERRY STREET SUITE 400 MACON GA 31201 582149128 501(C)(3) 1266443 SUPPORT MCCG YUNUS CREATIVE LAB 1420 PEACHTREE STREET NE SUITE 800 ATLANTA GA 303093053 453683977 501(C)(3) 100000 COMMUNITY AWARENESS WESLEYAN COLLEGE 4760 FORSYTH ROAD MACON GA 31210 580593438 501(C)(3) 50000 SUPPORT BSN DEGREE PROGRAM MUSEUM OF ARTS AND SCIENCES INC 4182 FORSYTH ROAD MACON GA 31210 580806933 501(C)(3) 10000 SUPPORT FIRST SATURDAY PROGRAM DAYBREAK CENTER DEPAUL USA 174 WALNUT STREET MACON GA 31201 352338110 501(C)(3) 5836 SUPPORT DAYBREAK CENTER 5 0 SCHEDULE I, PART I, LINE 2, MONITORING PROCEDURES PROGRAM GRANTS WERE PRINCIPALLY TO SUPPORT THE MEDICAL CENTER OF CENTRAL GEORGIA, INC. (MCCG), A RELATED TAX-EXEMPT ORGANIZATION, FOR USE IN CHARITABLE, MEDICAL, EDUCATIONAL AND SCIENTIFIC ACTIVITIES. THE DISTRIBUTION OF GRANT FUNDS IS APPROVED AND MONITORED BY MANAGEMENT AND THE BOARD OF TRUSTEES. Schedule I, Part I, Line 2, Procedures for monitoring use of grant funds PROGRAM GRANTS WERE PRINCIPALLY TO SUPPORT THE MEDICAL CENTER OF CENTRAL GEORGIA, INC. (MCCG), IN WHICH FUNDS ARE USED FOR CHARITABLE, MEDICAL, EDUCATIONAL AND SCIENTIFIC PURPOSES. THE USE OF GRANT FUNDS IS APPROVED AND MONITORED BY THE BOARD OF TRUSTEES. false true false false false false false false false NINFA M SAUNDERS TRUSTEE 0 732091 0 0 0 36034 0 615986 0 22313 0 1406424 0 0 ELBERT T MCQUEEN CHIEF EXECUTIVE OFFICER (INTERIM)/ SVP POST ACUTE SERVICES 0 227376 0 0 0 5881 0 13576 0 12687 0 259520 0 0 A DONALD FAULK JR FORMER TRUSTEE 0 171300 0 0 0 0 0 0 0 0 0 171300 0 0 KENNETH B BANKS CORPORATE SECRETARY/SVP/CHIEF LEGAL COUNSEL 0 282868 0 0 0 302880 0 157183 0 22049 0 764980 0 278853 RHONDA S PERRY CHIEF FINANCIAL OFFICER/EVP 0 415192 0 0 0 870525 0 79515 0 8922 0 1374154 0 870111 Schedule J, Part I, Line 3, Arrangement used to establish the top management official's compensation THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF CENTRAL GEORGIA HEALTH SYSTEMS, INC. ENGAGES AN EXECUTIVE CONSULTING FIRM PERIODICALLY TO REVIEW AND PROVIDE RECOMMENDATIONS REGARDING TOTAL COMPENSATION AND BENEFITS FOR THE EXECUTIVE LEADERSHIP TEAM. BASE COMPENSATION, INCENTIVE COMPENSATION, AND BENEFITS ARE INCLUDED IN THE REVIEW. THE EXECUTIVE CONSULTANTS REVIEW ORGANIZATION STRUCTURE, INDIVIDUAL JOB DESCRIPTIONS, AND DISCUSS SCOPE OF LEADERSHIP AND SPAN OF CONTROL WITH HR, THE COO, AND THE CEO AS A PART OF THE PROCESS TO DETERMINE PROPER PLACEMENT OF THE PAY GRADE AND LEVEL OF PARTICIPATION IN INCENTIVE AND BENEFITS PROGRAMS. THE COMPENSATION COMMITTEE PERIODICALLY REAFFIRMS THE TOTAL COMPENSATION PHILOSOPHY WHICH TARGETS THE 75TH PERCENTILE OF TOTAL COMPENSATION FOR OUR LEADERSHIP TEAM. THE PEER GROUP USED IS NATIONAL HOSPITALS AND HEALTH SYSTEMS OF SIMILAR SIZE AND SCOPE. OUR HUMAN RESOURCES DEPARTMENT SURVEYS THOSE EMPLOYED OUTSIDE OF THE EXECUTIVE LEADERSHIP TEAM USING TOOLS THAT PROVIDE COMPARABLE DATA IN OUR MARKET AREA TO ENSURE THE COMPENSATION IS IN LINE WITH OTHER HEALTH CARE ORGANIZATIONS. Schedule J, Part I, Line 4b, Supplemental nonqualified retirement plan MCCG HAD A SUPPLEMENTAL EXECUTIVE BENEFIT PROGRAM ("SEBP") FOR CERTAIN EXECUTIVES THAT WAS DESIGNED AS A LOAN REGIME SPLIT DOLLAR LIFE INSURANCE PROGRAM. THIS PROGRAM WAS EXPECTED TO PROVIDE DEATH AND OTHER BENEFITS TO EXECUTIVES AND TO PROVIDE REPAYMENT OF LIFE INSURANCE PREMIUMS TO THE ORGANIZATION. AS A RESULT OF ECONOMIC CONDITIONS, THE LIFE INSURANCE POLICIES DID NOT PERFORM AS ANTICIPATED. DURING 2009 MCCG SUSPENDED ALL PREMIUM PAYMENTS AND REEVALUATED THE EFFECTIVENESS OF THE PROGRAM FOR ALL CURRENT PARTICIPANTS. DURING CALENDAR YEAR 2009 THE MCCG BOARD OF DIRECTORS, AFTER CONSULTATION WITH COMPENSATION AND LEGAL ADVISERS, ADOPTED A RESOLUTION TO MAKE PAYMENTS TO THE RETIRED PARTICIPANTS IN THE SEBP. IN CONSIDERATION FOR THE RECEIPT OF SUCH PAYMENT, THE RETIRED EXECUTIVES SURRENDERED SUBSTANTIALLY ALL RIGHTS AND BENEFITS (OTHER THAN A SMALL DEATH BENEFIT) UNDER THE SEBP TO THE ORGANIZATION. SUBSEQUENTLY, A SIMILAR DECISION WAS MADE DURING FISCAL YEAR ENDED SEPTEMBER 30, 2011 FOR THE REMAINING (EMPLOYED) PARTICIPANTS WITH ANY PAYMENTS TO BE MADE DEPENDENT ON THE INDIVIDUAL CONTINUING TO PROVIDE SUBSTANTIAL SERVICES TO A SPECIFIED FUTURE DATE. IN ADDITION, MCCG AND ITS AFFILIATED ORGANIZATIONS ADOPTED A SERP PROGRAM FOR CERTAIN EXECUTIVES EFFECTIVE FOR SERVICES RENDERED ON OR AFTER JANUARY 1, 2010. THIS PROGRAM PROVIDES FOR ANNUAL ACCOUNT VESTING IF THE PARTICIPANT IS EMPLOYED ON DECEMBER 31 OF THE THIRD YEAR AFTER THE ACCOUNT IS CREATED. THE BENEFIT EQUALS THE ANNUAL INCREASE IN THE PRESENT VALUE OF A LIFETIME ANNUITY PAYABLE COMMENCING AT A SPECIFIED TARGETED FUTURE DATE. THE ANNUTIY IS EQUAL TO A SPECIFIC PERCENTAGE OF FINAL AVERAGE EARNINGS (GENERALLY 60%) LESS (1) THE EXPECTED ANNUAL SEBP PAYMENT USED IN CALCULATING THE SEBP LUMP SUM PAYMENT, (2) THE ANNUAL BENEFIT PROVIDED UNDER THE DEFINED BENEFIT PLAN, AND (3) 100% OF THE PARTICIPANT'S SOCIAL SECURITY BENEFIT. DURING THE YEAR, THE FOLLOWING BENEFITS WERE ACCRUED: RHONDA PERRY $ 46,523 KEN BANKS $137,154 IN ADDITION, CGHS ADOPTED A RETENTION PAYMENT PLAN EFFECTIVE OCTOBER 1, 2011 DESIGNED TO ENCOURAGE DESIGNATED EMPLOYEES TO CONTINUE THEIR EMPLOYMENT. UNDER THE PLAN, CGHS MAY SELECT A RETENTION CREDIT EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE SALARY. THE CREDIT IS REDUCED BY THE VALUE OF LIFE INSURANCE COVERAGE PROVIDED TO THE EXECUTIVE. IN GENERAL, THE PLAN IS SUBJECT TO VESTING AT THE END OF THE THIRD PLAN YEAR AFTER THE ACCOUNT WAS CREATED OR AGE 65 IF EARLIER, AND IS SUBJECT TO FORFEITURE IF THE EXECUTIVE VOLUNTARILY SEPARATES FROM SERVICE. DURING THE YEAR THE FOLLOWING BENEFITS ACCRUED UNDER THIS PLAN: RHONDA PERRY $31,986 KEN BANKS $18,083 ELBERT MCQUEEN $10,638 IN ADDITION, CGHS ADOPTED A NONQUALIFIED, UNFUNDED DEFERRED COMPENSATION PLAN DESIGNED TO ATTRACT AND RETAIN QUALIFIED MANAGEMENT PESONNEL. DURING THE YEAR THE FOLLOWING BENEFITS ACCRUED UNDER THIS PLAN: NINFA M. SAUNDERS $613,556 THE FOLLOWING NONQUALIFIED RETIREMENT PLAN BENEFITS WERE REPORTED AS TAXABLE INCOME TO VESTED INDIVIDUALS: RHONDA PERRY $870,111 KEN BANKS $278,853 A DONALD FAULK $126,644 X 4 127296 MARKET VALUE 0 false true false Schedule M, Part I, Explanations of reporting method for number of contributions SECURITIES - PUBLICLY TRADED: NUMBER OF CONTRIBUTIONS (4 SEPERATE CONTRIBUTIONS FROM 4 CONTRIBUTORS) Schedule M, part I, column (b), Line 9, Number of contributions or items contributed. NUMBER OF CONTRIBUTIONS (4 SEPERATE CONTRIBUTIONS FROM 4 CONTRIBUTORS) , ORGANIZATION EMPLOYEES COMPENSATION FOR FOUNDATION EMPLOYEES WAS PAID BY THE MEDICAL CENTER OF CENTRAL GEORGIA, INC. (MCCG; EIN: 58-2149128), AND W-2S WERE ISSUED BY MCCG AS AGENT FOR THE FOUNDATION. Form 990, Part VI, Sec A, Line 6, Classes of members or stockholders CENTRAL GEORGIA HEALTH SYSTEMS, INC., A RELATED 501(C)(3) ORGANIZATION, IS THE FOUNDATION'S SOLE MEMBER. THE SOLE MEMBER MUST APPROVE IN ADVANCE CHANGES IN GOVERNANCE, CHANGES IN ORGANIZATIONAL STRUCTURE (INCLUDING THE FORMATION OF SUBSIDIARIES OR JOINT VENTURES, DISSOLUTIONS OR LIQUDIATIONS, AND MERGERS OR CONSOLIDATIONS) AND AMENDING OR TERMINATING LEASE AGREEMENTS. Form 990, Part VI, Sec A, Line 7a, Members or stockholders electing members of governing body THE CHIEF EXECUTIVE OFFICER OF CENTRAL GEORGIA HEALTH SYSTEMS, INC. IS AN EX OFFICIO VOTING MEMBER OF THE BOARD OF THE FOUNDATION. IN ADDITON, OTHER BOARD MEMBERS ARE ELECTED BY ACTION OF THE FOUNDATIONS'S BOARD OF TRUSTEES, UPON APPROVAL BY THE SOLE MEMBER, CENTRAL GEORGIA HEALTH SYSTEMS, INC. Form 990, Part VI, Sec A, Line 7b, Decisions requiring approval by members or stockholders CERTAIN ORGANIZATIONAL ACTIONS OF THE BOARD OF TRUSTEES ARE SUBJECT TO APPROVAL BY THE FOUNDATION'S SOLE MEMBER, CENTRAL GEORGIA HEALTH SYSTEMS, INC. Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body THE FORM 990 WAS PREPARED BY HEALTH SYSTEM PERSONNEL FROM INFORMATION PROVIDED BY MANAGEMENT AND FROM CONSOLIDATED FINANCIAL STATEMENTS (AUDITED BY AN INDEPENDENT CPA FIRM). IT IS REVIEWED IN DETAIL BY OUR OUTSIDE TAX ADVISOR (ANOTHER INDEPENDENT CPA). THE FORM 990 WAS PROVIDED TO EACH MEMBER OF THE BOARD OF TRUSTEES PRIOR TO FILING THE RETURN WITH THE INTERNAL REVENUE SERVICE. Form 990, Part VI, Sec B, Line 12c, Conflict of interest policy THE CORPORATE DEPARTMENT OF AUDIT AND COMPLIANCE ISSUES CONFLICT OF INTEREST DISCLOSURE FORMS ANNUALLY TO OUR BOARD MEMBERS, ADMINISTRATION AND DIRECTORS. THE DEPARTMENT OF AUDIT AND COMPLIANCE RECEIVES, REVIEWS AND DOCUMENTS ALL POTENTIAL CONFLICTS (PERCEIVED AND REAL). THE RESULTS ARE TAKEN TO THE COMPLIANCE COMMITTEE WHERE THE REAL DISCLOSURES ARE DISCUSSED FOR CORRECTIVE ACTION. THE CORRECTIVE ACTION SUGGESTIONS ARE TAKEN TO THE VARIOUS BOARDS AND ADMINISTRATION FOR IMPLEMENTATION. ANY TIME A CHANGE IN A RELATIONSHIP OR NEW POTENTIAL CONFLICT EVOLVES, THE INDIVIDUAL MUST AMEND THEIR CONFLICT OF INTEREST DISCLOSURE FORM. Form 990, Part VI, Sec C, Line 19, Required documents available to the public INFORMATION WILL BE MADE AVAILABLE UPON REQUEST SUBMITTED TO THE BOARD OF TRUSTEES. , FOMER OFFICER COMPENSATION ETHEL CULLINAN, FORMER PRESIDENT AND CEO, RETIRED FROM HER POSITION AS CEO FROM BOTH CENTRAL GEORGIA SENIOR HEALTH AND MEDCEN COMMUNITY HEALTH FOUNDATION DURING APRIL 2012. SHE IMMEDIATELY BEGAN PROVIDING CONSULTING SERVICES TO CENTRAL GEORGIA HEALTH SYSTEMS, INC. FOR THE BENEFIT OF SEVERAL AFFILIATES OF CGHS. HER COMPENSATION ON FORM 990 REFLECTS SALARY AND BENEFITS THROUGH MARCH 2012 AND HER COMPENSATION AS A CONSULTANT. CENTRAL GEORGIA HEALTH SYSTEMS INC 691 CHERRY STREET SUITE 400 MACON GA 31201 582149127 PARENT COMPANY - MCCG GA 501(C)(3) 11 - Type III - FI NA false CENTRAL GEORGIA SENIOR HEALTH INC 691 CHERRY STREET SUITE 400 MACON GA 31201 582345439 RETIREMENT COMMUNITY GA 501(C)(3) 11 - Type II CENTRAL GEORIGA HEALTH SYSTEMS INC false HEALTH SERVICES OF CENTRAL GEORGIA INC 691 CHERRY STREET SUITE 400 MACON GA 31201 582307485 HEALTH CARE PROVIDER GA 501(C)(3) 3 CENTRAL GEORIGA HEALTH SYSTEMS INC false MEDICAL CENTER OF CENTRAL GEORGIA INC 691 CHERRY STREET SUITE 400 MACON GA 31201 582149128 HOSPITAL GA 501(C)(3) 3 CENTRAL GEORGIA HEALTH SYSTEMS false MEDICAL CENTER OF PEACH COUNTY INC 1960 HWY 247 BYRON GA 31008 453765471 HOSPITAL GA 501(C)(3) 3 CENTRAL GEORGIA HEALTH SYSTEMS false SECURE HEALTH PLANS OF GEORGIA LLC 577 MULBERRY STREET SUITE 1000 MACON GA 31201 582306549 MANAGED CARE GA NA N/A CENTRAL GEORGIA PET LLC 1650 HARDEMAN AVENUE MACON GA 31201 371464470 MEDICAL IMAGING CENTER GA NA N/A CENTRAL GEORGIA HEALTH VENTURES INC 691 CHERRY STREET SUITE 400 MACON GA 31201 582164989 MANAGEMENT & HOMECARE SERVICES GA NA C CORPORATION CENTRA PROFESSIONAL INDEMNITY LTD PO BOX 1363 GRAND CAYMAN CJ INSURANCE - FOREIGN CORP. 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