2015-11-13T11:20:38-06:00 2014-12-31 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2014-01-01 582460001 MEMORIAL HEALTH INC MEMO 9123508000 PO BOX 20389 SAVANNAH GA 314033089 LAURA DOW VP OF FINANCE 9123508000 2015-11-13 1 AMY BIBBY P00445891 8282542254 2014 2016-03-07 17:11:31Z MARGARET GILL PO BOX 20389 SAVANNAH GA 314033089 42146656 0 X WWW.MEMORIALHEALTH.COM X 1997 GA TO SUPPORT MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER, INC. 17 16 301 15 0 0 0 0 24952289 41868275 0 0 10 278381 24952299 42146656 0 60721 0 0 10717053 17640131 0 0 0 14235246 35795804 24952299 53496656 0 -11350000 11532624 44919367 6656669 48004049 4875955 -3084682 X TO PROVIDE ADMINISTRATIVE SUPPORT BY ENGAGING IN SUCH OTHER ACTIVITIES THAT BENEFIT, PERFORM THE FUNCTIONS OF, OR CARRY OUT THE PURPOSES OF MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER, INC. AND AFFILIATES. 0 0 38723321 60721 42204552 TO PROVIDE ADMINISTRATIVE SUPPORT BY ENGAGING IN SUCH OTHER ACTIVITIES THAT BENEFIT, PERFORM THE FUNCTIONS OF, OR CARRY OUT THE PURPOSES OF MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER, INC.THE ORGANIZATION ADMINISTERS AN ELECTRONIC MEDICAL RECORDS SOFTWARE PROGRAM INTENDED TO BENEFIT ITS SUPPORTED ORGANIZATION. EXPENSES TO BE REPORTED WITHIN THIS ENTITY ARE RELATED TO THE OPERATION AND MAINTENANCE OF THIS SOFTWARE SYSTEM AND ARE ALLOCATED TO THE ORGANIZATION BASED UPON ANNUAL TIME STUDIES. REVENUE TO BE RECOGNIZED IN CONJUNCTION WITH THIS SERVICE IS INTENDED TO DIRECTLY OFFSET OPERATIONAL EXPENSES AND WILL BE RECEIVED FROM SUPPORTED AND RELATED ORGANIZATIONS. 38723321 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 301 1 0 0 0 0 0 0 0 0 0 0 X 17 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 GA X LAURA DOW 9123508613 4600 WATERS AVENUE SAVANNAH GA 31404 J HARRY HASLAM JR CHAIRMAN 1.00 2.00 X X 0 0 0 KAY A FORD VICE CHAIRMAN (THROUGH 3/1/14) 1.00 1.00 X X 0 0 0 MARILYN BUCK SECRETARY 1.00 1.00 X X 0 0 0 ARTHUR B DANA CPA CVS TREASURER 1.00 1.00 X X 0 0 0 IRA BERMAN BOARD MEMBER 1.00 1.00 X 0 0 0 ROBERT F BROWN JR BOARD MEMBER 1.00 40.00 X 0 365809 40221 LEROY BURKE III BOARD MEMBER 1.00 1.00 X 0 0 0 GERALD CAPLAN BOARD MEMBER 1.00 1.00 X 0 0 0 WILLIAM T DANIEL BOARD MEMBER 1.00 1.00 X 0 0 0 HELEN DOWNING BOARD MEMBER 1.00 1.00 X 0 0 0 JAY D GOLDSTEIN BOARD MEMBER 1.00 1.00 X 0 0 0 CURTIS LEWIS III BOARD MEMBER 1.00 1.00 X 0 0 0 CHARLES F MCMILLAN SR BOARD MEMBER 1.00 1.00 X 0 0 0 MARK E MURPHY BOARD MEMBER 1.00 1.00 X 0 0 0 JACKIE RABINOWITZ BOARD MEMBER 1.00 2.00 X 0 0 0 FRANK ROSSITER JR BOARD MEMBER 1.00 1.00 X 0 0 0 W REX TEMPLETON BOARD MEMBER 1.00 1.00 X 0 0 0 CHRISTOPHER L WIXON BOARD MEMBER (THROUGH 2/28/14) 1.00 1.00 X 0 0 0 SUSAN WILLETTS BOARD MEMBER 1.00 1.00 X 0 0 0 MARGARET GILL PRESIDENT & CEO 1.00 40.00 X 891466 0 61011 LAURA DOW VP OF FINANCE 1.00 40.00 X 200295 0 36503 RAMON V MEGUIAR MD CHIEF MEDICAL OFFICER 1.00 40.00 X 445814 0 58302 MARY CHATMAN PHD RN CHIEF NURSING OFFICER 1.00 40.00 X 463721 0 56186 WILLIAM LEE MHA MBA CHIEF STRATEGY OFFICER 1.00 40.00 X 362370 0 24499 ROBERT M TYNAN VP, CHIEF INFORMATION OFFICER 1.00 40.00 X 269971 0 35624 REBECCA KEIGHTLEY VP, CHIEF COMMUNICATIONS OFFICER 1.00 40.00 X 189676 0 38336 JEFF WILSON GENERAL COUNSEL 1.00 40.00 X 127763 0 2817 2951076 365809 353499 2 0 1 0 0 INFORMATION TECHNOLOGY 900099 24295038 24295038 PROGRAM SERVICE 900099 13902334 13902334 ACCOUNTING AND FINANCE 900099 3670903 3670903 41868275 FITNESS CENTER 900099 146166 146166 MISCELLANEOUS REVENUE 900099 132215 132215 278381 42146656 42146656 0 0 X 60721 60721 3264354 3264354 12296082 12296082 258268 238529 19739 582541 538018 44523 1238886 1144199 94687 11350032 11350032 324031 324031 8736056 8736056 2520704 2520704 10292496 10292496 494450 494450 479791 479791 13659 13659 54654 54654 1385651 1385651 MEDICAL SUPPLIES 144280 144280 53496656 38723321 14773335 0 199869 2235326 3745632 42776322 1819025 9253125 40957297 44173 16569 11532624 44919367 1809151 19768952 4847518 3661856 0 24573241 6656669 48004049 X 4875955 -3084682 4875955 -3084682 11532624 44919367 X -11350000 3389363 X X 0 1 X 1 0 X X 1 MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER 311126469 3 1 0 38723321 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 16400 2870 13530 23500 8225 15275 13679561 1807930 11871631 29056861 29056861 40957297 DUE TO AFFILIATES 24573241 24573241 X PART X, LINE 2: THE HEALTH SYSTEM IS PARTIALLY COMPRISED OF ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAX PURSUANT TO SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. WITH RESPECT TO ANY UNRELATED BUSINESS INCOME GENERATED BY ITS FOR-PROFIT SUBSIDIARIES, THE HEALTH SYSTEM RECORDS INCOME TAXES USING THE LIABILITY METHOD UNDER WHICH THE 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 PERIOD THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR TO BE SETTLED. THE HEALTH SYSTEM HAS EVALUATED ITS TAX POSITIONS AND HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2014. FISCAL YEARS ENDED ON OR AFTER DECEMBER 31, 2011 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENT IN CAPTIVE INSURANCE 1490241 CENTRAL AMERICA AND THE CARIBBEAN 0 0 SELF INSURANCE PREMIUMS 5366772 0 0 0 0 0 0 6857013 0 6857013 0 0 1 0 0 0 X X X X X 0 0 0 0 0 1 0 0 0 ROBERT F BROWN JR BOARD MEMBER 0 365809 0 0 0 0 0 22859 0 17362 0 406030 0 0 MARGARET GILL PRESIDENT & CEO 645011 0 245250 0 1205 0 36019 0 24992 0 952477 0 0 0 LAURA DOW VP OF FINANCE 196295 0 4000 0 0 0 20253 0 16250 0 236798 0 0 0 RAMON V MEGUIAR MD CHIEF MEDICAL OFFICER 359595 0 82125 0 4094 0 39297 0 19005 0 504116 0 0 0 MARY CHATMAN PHD RN CHIEF NURSING OFFICER 375604 0 86625 0 1492 0 32400 0 23786 0 519907 0 0 0 WILLIAM LEE MHA MBA CHIEF STRATEGY OFFICER 293869 0 67500 0 1001 0 4385 0 20114 0 386869 0 0 0 ROBERT M TYNAN VP, CHIEF INFORMATION OFFICER 234045 0 7500 0 28426 0 20372 0 15252 0 305595 0 0 0 REBECCA KEIGHTLEY VP, CHIEF COMMUNICATIONS OFFICER 173476 0 16200 0 0 0 23000 0 15336 0 228012 0 0 0 PART I, LINE 6 A BALANCED SCORECARD APPROACH RELATED TO SENIOR MANAGEMENT INCENTIVE THAT INCLUDES QUALITY, SAFETY, ACHIEVEMENTS, AND FINANCIAL RESULTS. FORM 990, PART VI, SECTION B, LINE 11 THE TAX RETURN IS PREPARED BY AN UNRELATED, INDEPENDENT ACCOUNTING FIRM AND THEN SUBMITTED TO SENIOR MANAGEMENT WITHIN THE ORGANIZATION'S ACCOUNTING DEPARTMENT FOR INTERNAL REVIEW. A DRAFT IS THEN PROVIDED TO THE FINANCE COMMITTEE AND THE ENTIRE BOARD FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO UPDATE AND SUBMIT A NEW CONFLICT OF INTEREST STATEMENT ANNUALLY. THE CHAIRMAN OF THE BOARD, PRESIDENT, AND CHIEF EXECUTIVE OFFICER AND THE CORPORATE COMPLIANCE OFFICER SHALL BECOME FAMILIAR WITH THE STATEMENTS OF THE BOARD MEMBERS IN ORDER TO GUIDE THEIR CONDUCT SHOULD A CONFLICT ARISE AT SUCH TIMES AS ANY MATTER COMES BEFORE THE BOARD THAT MAY POTENTIALLY RESULT IN A CONFLICT OF INTEREST. THE AFFECTED BOARD MEMBER SHALL MAKE KNOWN THE POTENTIAL CONFLICT, WHETHER OR NOT DISCLOSED IN A WRITTEN STATEMENT. THE AFFECTED BOARD MEMBER MAY MAKE A PRESENTATION TO THE BOARD OR A COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION, HE OR SHE MUST LEAVE THE MEETING DURING THE DISCUSSION OF AND THE VOTE ON THE TRANSACTION OR ARRANGEMENT CONSIDERED TO BE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USES SULLIVAN-COTTER (AN UNRELATED, INDEPENDENT THIRD PARTY COMPANY) TO ANALYZE APPROPRIATE COMPENSATION FOR THE CEO, EXECUTIVES, DIRECTORS AND TOP MANAGEMENT. FOR ALL OTHER POSITIONS, THE ORGANIZATION USES COMPENSATION ANALYST, SALARY.COM, TO ANALYZE COMPENSATION AND COMPILE DATA FOR COMPARABILITY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS OF THE ORGANIZATION ARE HELD AS PUBLIC RECORDS OF THE STATE OF GEORGIA SECRETARY OF STATE OFFICE. AS SUCH, THESE DOCUMENTS ARE OPEN TO THE PUBLIC. THE CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC AS THIS IS NOT A REQUIREMENT. FORM 990, PART IX, LINE 11G CONSULTING: PROGRAM SERVICE EXPENSES 2,674,997. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,674,997. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 6,061,059. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,061,059. FORM 990, PART XI, LINE 9: NET EQUITY TRANSFERS FROM AFFILIATES 3,389,363. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER FOUNDATION PO BOX 23089 SAVANNAH GA 314033089 581618486 SUPPORT OF MHUMC GA 501(C)(3) LINE 11A, I MEMORIAL HEALTH INC 1 MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER INC PO BOX 23089 SAVANNAH GA 314033089 311126469 HEALTH CARE PROVIDER GA 501(C)(3) LINE 3 MEMORIAL HEALTH INC 1 PAULSEN STREET SURGERY CENTER LLC 4425 PAULSEN STREET 2ND FLOOR SAVANNAH GA 31405 454517515 HEALTH CARE GA MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER INC RELATED 448904 1188242 0 0 0.51000 4600 WATERS AVE PROFESSIONAL CONDO ASSOCIATION INC PO BOX 23089 SAVANNAH GA 314033089 581990705 CONDO ASSOCIATION GA PROVIDENT HEALTH SERVICES INC C 63216 0.52000 1 MEMORIAL HEALTH PARTNERS INC PO BOX 23089 SAVANNAH GA 314033089 581707311 MANAGED CARE GA PROVIDENT HEALTH SERVICES INC C 1340809 153906 1.00000 1 MEMORIAL HEALTH ANESTHETISTS INC PO BOX 23089 SAVANNAH GA 314033089 431985441 MEDICAL SERVICES GA PROVIDENT HEALTH SERVICES INC C 1.00000 1 MPPG INC PO BOX 23089 SAVANNAH GA 314033089 582162071 PHYSICIANS PRACTICE GA PROVIDENT HEALTH SERVICES INC C 61557204 9347460 1.00000 1 PROVIDENT HEALTH SERVICES INC PO BOX 23089 SAVANNAH GA 314033089 581611969 MEDICAL SERVICES/ CONSOLIDATING ENTITY GA MEMORIAL HEALTH INC C 1614378 19471065 1.00000 1 PROVIDENT PROFESSIONAL BUILDING CONDO ASSOCIATION INC PO BOX 23089 SAVANNAH GA 314033089 581845972 CONDO ASSOCIATION GA PROVIDENT HEALTH SERVICES INC C 117522 0.69560 1 SAVANNAH MIDTOWN PROPERTIES INC PO BOX 23089 SAVANNAH GA 314033089 582537941 REAL ESTATE HOLDING GA PROVIDENT HEALTH SERVICES INC C 236782 2062274 1.00000 1 MEMORIAL PROFESSIONAL ASSURANCE COMPANY PO BOX 1100 GRAND CAYMAN GRAND CAYMAN CJ KY1-1005 999999999 OTHER INSURANCE CJ N/A C 6094408 17687407 1.00000 1 MEMORIAL HEALTH CORPORATE SERVICES INC 4700 WATERS AVE SAVANNAH GA 31404 900963434 CORPORATE SERVICES GA PROVIDENT HEALTH SERVICES INC C 1.00000 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 1 0 MEMORIAL PROFESSIONAL ASSURANCE COMPANY R 5366772 CASH