NAVICENT HEALTH INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
NAVICENT HEALTH INC (EIN 58-2149127)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-14
IRS object ID
201412269349303536
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-14T17:00:52-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN580914992EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DRAFFIN & TUCKER LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1FIVE CONCOURSE PARKWAY SUITE 1250AddressLine1
CityATLANTACity
StateGAState
ZIP Code30328ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN582149127EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CENTRAL GEORGIA HEALTH SYSTEMS INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCENTNameControl
Phone4786331407Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1691 CHERRY STREETAddressLine1
CityMACONCity
StateGAState
ZIP Code31201ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRHONDA S PERRYName
TitleEXECUTIVE VICE PRESIDENT/CFOTitle
Date Signed2014-08-14DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameW Edward PhillipsName
PTINP00451499PTIN
Phone4042208494Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

FieldValueIRS element (for citing)
Business Name Line1NINFA M SAUNDERSBusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1691 CHERRY STREET SUITE 400AddressLine1
CityMACONCity
StateGAState
ZIP Code31201ZIPCode
FieldValueIRS element (for citing)
Gross Receipts46845984GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MCCG.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1994YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionCENTRAL GEORGIA HEALTH SYSTEMS, INC. IS A NONPROFIT CORPORATION WHOSE PRIMARY PURPOSE IS TO SERVE AS A PARENT CORPORATION PROVIDING STRATEGIC DIRECTION TO THE MEDICAL CENTER OF CENTRAL GEORGIA, INC. AND OTHER AFFILIATES IN SUPPORT OF THEIR MISSION OF PROVIDING A COMPREHENSIVE RANGE OF HIGH-QUALITY, REASONABLY PRICED HEALTH CARE SERVICES TO THE CENTRAL GEORGIA COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees455TotalNbrEmployees
Total Gross UBI120548TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year40004876ProgramServiceRevenuePriorYear
Program Service Revenue CY36690120ProgramServiceRevenueCY
Investment Income Prior Year-1167516InvestmentIncomePriorYear
Investment Income Current Year10001189InvestmentIncomeCurrentYear
Other Revenue Prior Year3872062OtherRevenuePriorYear
Other Revenue Current Year154675OtherRevenueCurrentYear
Total Revenue Prior Year42709422TotalRevenuePriorYear
Total Revenue Current Year46845984TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year56000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY3488687GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year38438500SalariesEtcPriorYear
Salaries Etc Current Year34746058SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year10369529OtherExpensePriorYear
Other Expenses Current Year8275576OtherExpensesCurrentYear
Total Expenses Prior Year48864029TotalExpensesPriorYear
Total Expenses Current Year46510321TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-6154607RevenuesLessExpensesPriorYear
Revenues Less Expenses CY335663RevenuesLessExpensesCY
Total Assets BOY52036669TotalAssetsBOY
Total Assets EOY54876334TotalAssetsEOY
Total Liabilities BOY9171000TotalLiabilitiesBOY
Total Liabilities EOY11675001TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY42865669NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY43201333NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionCENTRAL GEORGIA HEALTH SYSTEMS, INC. (CGHS) PRIMARY PURPOSE IS TO SERVE AS A CONTROLLING BODY FOR THE MEDICAL CENTER OF CENTRAL GEORGIA, INC., HEALTH SERVICES OF CENTRAL GEORGIA, INC., CENTRAL GEORGIA SENIOR HEALTH, INC., MEDCEN COMMUITY HEALTH FOUNDATION, INC., AND THE MEDICAL CENTER OF PEACH COUNTY, INC. AND OTHER AFFILIATED ENTITIES IN SUPPORT OF THEIR MISSION TO PROVIDE HEALTHCARE SERVICES IN CENTRAL GEORGIA.MissionDescription
Significant New Program ServicestrueSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense22121009Expense
Grants3488687Grants
Revenue32463858Revenue
DescriptionCENTRAL GEORGIA HEALTH SYSTEMS, INC. ("CGHS") PRIMARY PURPOSE IS TO SERVE AS A CONTROLLING BODY FOR THE MEDICAL CENTER OF CENTRAL GEORGIA, INC., HEALTH SERVICES OF CENTRAL GEORGIA, INC., CENTRAL GEORGIA SENIOR HEALTH, INC. AND MEDCEN COMMUNITY HEALTH FOUNDATION, INC. AND OTHER AFFILIATED ENTITIES AND TO PROVIDE STRATEGIC DIRECTION, FINANCIAL MANAGEMENT, RESOURCE ALLOCATION AND OTHER SUPPORT TO ITS AFFILIATES IN THE PROVISION OF HEALTHCARE SERVICES TO THE CENTRAL GEORGIA COMMUNITY.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense15016316Expense
Revenue14105714Revenue
DescriptionCENTRAL GEORGIA HEALTH SYSTEMS, INC. OPERATES CENTRAL GEORGIA REHABILITATION HOSPITAL, LLC, THE FIRST REHABILITATION FACILITY ESTABLISHED IN CENTRAL GEORGIA AND ONE OF TWO FREE-STANDING REHABILITATION HOSPITALS IN THE STATE. THE REHABILITATION HOSPITAL PROVIDES COMPREHENSIVE PHYSICAL REHABILITATION SERVICES ON AN INPATIENT AND OUTPATIENT BASIS. IT IS LICENSED FOR 58 BEDS.Description
FieldValueIRS element (for citing)
Total Program Service Expense37137325TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvesttrueReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiestrueForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees455NumberOfEmployees
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccounttrueForeignFinancialAccount
Name Of Foreign CountryCJNameOfForeignCountry
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1RHONDA S PERRYBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4786331452TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1777 HEMLOCK STREETAddressLine1
CityMACONCity
StateGAState
ZIP Code31201ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
CONNIE CATER
DIRECTOR1.001.00X000
HELEN RHEA STUMBO
DIRECTOR1.00X000
HENRY KOPLIN
DIRECTOR1.00X000
JOAN WALTON
DIRECTOR1.00X000
MICK ANDERSON MD
DIRECTOR1.00X000
RUTH KNOX
DIRECTOR1.00X000
STARR PURDUE
CHAIRMAN1.00X000
TIMOTHY JACKSON
VICE CHAIRMAN1.002.00X000
KENNETH B BANKS
GEN COUNSEL/SEC45.005.004695390313176X
NINFA M SAUNDERS
PRESIDENT & CEO47.003.001788470166312X
RHONDA S PERRY
VP/TREASURER45.005.009221700505880X
A DONALD FAULK JR
CEO (TRANSITION)40.00105658209671X
ELBERT T MCQUEEN
VP/CEO CGRH48.002.00279291047348X
JUDY K WARE
CHIEF COMPLIANCE OFFICER50.00171995015659X
KAREN M FARR
AVP FINANCIAL SERVICES50.00189778027429X
KATHERINE L BOWEN
AVP FIN PLANNING BUDGET50.00176101026458X
LORI W CASSIDY
AVP HUMAN RESOURCES50.00228282036082X
TIQUELLA S KING-WHITBY
PHYSICIAN50.00172255012367X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3844840TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation1160382TotalOtherCompensation
Number Individuals GT100 K41NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HEWITT ASSOCIATES
PO BOX 95135CHICAGOIL606945135CONSULTING FEES621427
MACON OCCUPATIONAL MEDICINE
124 THIRD STREETMACONGA31201CONTRACT SERVICES-NURSES, PA, NP, CLERICAL496705
DIXON HUGHES PLLC
P O BOX 602828CHARLOTTENC282602828AUDIT SERVICES377514
KAUFMAN HALL
5202 OLD ORCHARD RD ST N700SKOKIEIL60077CONSULTING SERVICES354293
KING AND SPALDING
P O BOX 116133ATLANTAGA303686133LEGAL SERVICES353800
FieldValueIRS element (for citing)
Number Of Contractors GT100 K13NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
MEDICARE.MEDICAID REVENUE6219901281275012812750
PATIENT REVENUE62199012403581240358
REBATE REVENUE621990507201507201
CAFETERIA SALES6219904032440324
SUPPORT REVENUE5412002206058421948324112260

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column28903TotalRevenueColumn
Related Or Exempt Function Income20615RelatedOrExemptFunctionIncome
Unrelated Business Revenue8288UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue36690120TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column10001189TotalRevenueColumn
Related Or Exempt Function Income10000000RelatedOrExemptFunctionIncome
Exclusion$1,189ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other0Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
PARTNERSHIP INVESTMENTS154675$154,675
0
0

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue154675TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column46845984TotalRevenueColumn
Related Or Exempt Function Income46569572RelatedOrExemptFunctionIncome
Unrelated Business Revenue120548UnrelatedBusinessRevenue
Exclusion$155,864ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total3488687Total
Program Services3488687ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2573464Total
Management And General2573464ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total21350097Total
Program Services18678046ProgramServices
Management And General2672051ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4030206Total
Program Services3744872ProgramServices
Management And General285334ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5091689Total
Program Services4548891ProgramServices
Management And General542798ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1700602Total
Program Services1390077ProgramServices
Management And General310525ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total859856Total
Management And General859856ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total438371Total
Management And General438371ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total43826Total
Management And General43826ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total841638Total
Program Services841638ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2710922Total
Program Services2089789ProgramServices
Management And General621133ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total221100Total
Program Services64526ProgramServices
Management And General156574ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total229340Total
Program Services184801ProgramServices
Management And General44539ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total593924Total
Program Services311241ProgramServices
Management And General282683ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total455691Total
Program Services386384ProgramServices
Management And General69307ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total158584Total
Program Services99148ProgramServices
Management And General59436ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total148328Total
Program Services135571ProgramServices
Management And General12757ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total227858Total
Program Services193083ProgramServices
Management And General34775ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total-2023676Total
Program Services-2040127ProgramServices
Management And General16451ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES926782926117665
MINOR EQ, EQ RENTAL & MAINT1887821183198255839
TAXES & LICENSES357789255014102775
DUES & SUBSCRIPTIONS1388033751135052

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total58619Total
Program Services3834ProgramServices
Management And General54785ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total46510321Total
Program Services37137325ProgramServices
Management And General9372996ManagementAndGeneral
Fundraising0Fundraising

Total Joint Costs TotalJointCosts

FieldValueIRS element (for citing)
Total0Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1245022BOY
EOY2746760EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2417102BOY
EOY2959437EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY94938BOY
EOY98775EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY530612BOY
EOY677996EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis6147385LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1853326LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY478356BOY
EOY4294059EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY22698480BOY
EOY22404478EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY24572159BOY
EOY21694829EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY52036669BOY
EOY54876334EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1848235BOY
EOY2082296EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY7322765BOY
EOY9592705EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY9171000BOY
EOY11675001EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY42865669BOY
EOY43201333EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY42865669BOY
EOY43201333EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY52036669BOY
EOY54876334EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses335663ReconcilationRevenueExpenses
Reconcilation Other Changes1ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type3 Func IntXSupportingOrg509a3Type3FuncInt
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1MEDICAL CENTER OF CENTRAL GEORGIABusinessNameLine1
FieldValueIRS element (for citing)
EIN582149128EIN
Type Of Organization3TypeOfOrganization
Listed In Governing DoctrueListedInGoverningDoc
Supported Organization NotifiedtrueSupportedOrganizationNotified
Organized In UStrueOrganizedInUS
Amount$3,478,687Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts3478687SumOfAmounts
General ExplanationSCHEDULE A, PART I, LINE 11H, DESCRIPTION OF NON-MONETARY SUPPORT, MEDICAL CENTER OF CENTRAL GEORGIA: CENTRAL GEORGIA HEALTH SYSTEMS, INC. IS THE FUNCTIONALLY INTEGRATED PARENT OF A MULTI-ENTITY HEALTHCARE SYSTEM WHICH INCLUDES ITS SUPPORTED ORGANIZATION, THE MEDICAL CENTER OF CENTRAL GEORGIA, INC. CGHS IS RESPONSIBLE FOR STRATEGIC PLANNING, FINANCIAL MANAGEMENT AND RESOURCE ALLOCATION FOR THE MULTI-ENTITY SYSTEM.GeneralExplanation

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$44,155OtherActivitiesAmount
Total Lobbying Expenditures IIB44155TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierDescription of the activities reported on Lines 1a through 1iIdentifier
Return ReferenceSchedule C, Part II-B, Line 1ReturnReference
ExplanationLOBBYING EXPENSES THRU DUES PAID TO THE GEORGIA CHAMBER OF COMMERCE AND THE GEORGIA HOSPITAL ASSOC. , ALSO THE LOBBYIST ANNUAL REGISTRATION OF $320 PAID TO THE CAMPAIGN FINANCE COMMISSION.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Book Value0BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Book Value0BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis6147385OtherCostOrOtherBasis
Depreciation1853326Depreciation
Book Value4294059BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Book Value0BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4294059TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
INVESTMENTS IN AFFILIATES20418784C
INVESTMENTS IN SUBSIDARY1985694C
FieldValueIRS element (for citing)
Total Of Book Value Program Related22404478TotalOfBookValueProgramRelated

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
WORKERS COMP ESCROW275000
MISCELLANEOUS RECEIVABLE518069
THIRD PARTY MEDICARE SETTLEMENT59476
DUE FROM AFFILIATES13009405
CAA DEFERRED COMPENSATION7832879
FieldValueIRS element (for citing)
Total Book Value Other Assets21694829TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
CAA DEFERRED COMPENSATION$7,832,879
SERP LIABILITY$1,595,626
DC SEBP LIABILITY$164,200
FieldValueIRS element (for citing)
Total Of Amounts9592705TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierFIN 48 (ASC 740) footnoteIdentifier
Return ReferenceSchedule D, Part X, Line 2ReturnReference
ExplanationCENTRAL GEORGIA HEALTH SYSTEMS, INC., MCCG, HSCG, CGSH, 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 THE TAX IN THE UNITED STATES. PET, CGRH 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. CGHS'S SHARE OF INCOME FROM PET, CGRH AND SHPG OPERATIONS IS NOT CONSIDERED UNRELATED BUSINESS INCOME ("UBI") AND IS THEREFORE, NOT SUBJECT TO TAX. CGHV AND AMERICAN EAGLE ARE SUBJECT TO INCOME TAX. WITH RESPECT TO ITS FOR-PROFIT SUBSIDIARIES, CGHS 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 RECOGNIZED. CGHS AND 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, 2013. FISCAL YEARS ENDING ON AFTER SEPTEMBER 30, 2010 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES.Explanation

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCENTRAL AMERICA AND THE CARIBBEANRegion
Number Of Offices0NumberOfOffices
Number Of Employees0NumberOfEmployees
Type Of Activities ConductedINVESTMENTSTypeOfActivitiesConducted
Total Expenditures106986174TotalExpenditures
FieldValueIRS element (for citing)
Total Number Of Offices0TotalNumberOfOffices
Total Number Of Employees0TotalNumberOfEmployees
Total Amount Spent106986174TotalAmountSpent
Transfer To Foreign CorptrueTransferToForeignCorp
Interest In Foreign TrustfalseInterestInForeignTrust
Own Foreign CorptrueOwnForeignCorp
Passive Foreign Invest CotruePassiveForeignInvestCo
Foreign PartnershiptrueForeignPartnership
Boycott CountriesfalseBoycottCountries

Form990 Schedule F Part V Form990ScheduleFPartV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
INVESTMENTSCHEDULE F, PART I, LINE 3(F)CENTRAL GEORGIA HEALTH SYSTEMS IS THE OWNER OF VARIOUS FOREIGN INVESTMENTS WHICH ARE HELD FOR THE BENEFIT OF THE MEDICAL CENTER OF CENTRAL GEORGIA, INC., AN AFFILIATED CONTROLLED TAX EXEMPT ORGANIZATION. FOR ACCOUNTING PURPOSES, THESE INVESTMENTS ARE REFLECTED ON THE BALANCE SHEET OF THE MEDICAL CENTER OF CENTRAL GEORGIA.
QUALIFIED ELECTING FUNDSCHEDULE F, PART IV, LINE 4BLACKSTONE PARK AVENUE NON-TAXABLE, L.P. HAS MADE A TIMELY IRC SEC. 1295 ELECTION WITH RESPECT TO VARIOUS INVESTMENTS IN PASSIVE FOREIGN INVESTMENT COMPANIES AND HAS FILED FORM 8621 ON BEHALF OF THE PARTNERSHIP. NO UNRELATED TAXABLE INCOME IS EARNED OR REPORTED AS A RESULT OF THIS INVESTMENT.
Method used to account for expenditures on organization's financial statementsSchedule F, Part I, Line 3CENTRAL AMERICA AND THE CARIBBEAN: ACCRUAL
Method used to account for expenditures on organization's financial statementsSchedule F, Part I, Line 3CENTRAL AMERICA AND THE CARIBBEAN: ACCRUAL

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage1.25FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense638753TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense638753NetCommunityBenefitExpense
Percent Of Total Expense0.01370PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense233543TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense233543NetCommunityBenefitExpense
Percent Of Total Expense0.00500PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense872296TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense872296NetCommunityBenefitExpense
Percent Of Total Expense0.01870PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense872296TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense872296NetCommunityBenefitExpense
Percent Of Total Expense0.01870PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$288,991BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare11573027AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare8805600CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall2767427MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1CENTRAL GA REHABILITATION HOSPITAL INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line13351 NORTHSIDE DRIVEAddressLine1
CityMACONCity
StateGAState
ZIP Code31210ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
OtherREHABILITATIONOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1CENTRAL GA REHABILITATION HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiestrueOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Other MethodXOtherMethod
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs AddressedfalseAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent125FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent200FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (19 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
BAD DEBTSCHEDULE H, PART I, LINE 7BAD DEBT EXPENSE IN THE AMOUNT OF $288,991 HAS BEEN REMOVED FROM TOTAL EXPENSE AND RECLASSIFED AS A REVENUE OFFSET IN THE AUDITED FINANCIAL STATEMENTS. THEREFORE, IT IS UNNECESSARY TO REDUCE THE EXPENSES REFLECTED IN FORM 990 PART IX, LINE 29 FOR PURPOSES OF CALCULATING THE SCHEDULE H, LINE 7, COLUMN (F) PERCENT OF TOTAL EXPENSES SINCE THE PRESENTATION IN PART IX FOLLOWS THE ORGANIZATION'S FINANCIAL ACCOUNTING RECORDS.
Community benefit report prepared by related organizationSchedule H, Part I, Line 6aMEDICAL CENTER OF CENTRAL GEORGIA
Costing Methodology used to calculate financial assistanceSchedule H, Part I, Line 7COST TO CHARGE RATIO FROM WORKSHEET 2. LOSS ON MEDICAID IS ACTUAL HOSPITAL TAXES PAID FROM GENERAL LEDGER. HOSPITAL NOT ELIGIBLE TO PARTICIPATE IN GEORGIA MEDICAID PROGRAM DUE TO CURRENT RULES RELATED TO REHABILITATION HOSPITAL PARTICIPATION.
Bad Debt Expense excluded from financial assistance calculationSchedule H, Part I, Line 7, column(f)0
Bad debt expense - methodology used to estimate amountSchedule H, Part III, Line 2THE AMOUNT OF BAD DEBT EXPENSE AND OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS ARE BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS
Bad debt expense - financial statement footnoteSchedule H, Part III, Line 4THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. CGHS'S S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS 98% OF SELF-PAY ACCOUNTS RECEIVABLE AT SEPTEMBER 30, 2013 AND 2012.
Community benefit & methodology for determining medicare costsSchedule H, Part III, Line 8THE COSTING METHODOLOGY IS TO USE THE ACTUAL COSTS INCLUDED IN THE COST REPORT WHICH ARE CALCULATED USING A DEPARTMENTAL SPECIFIC COST TO CHARGE RATIO AS COMPARED TO ACTUAL MEDICARE PAYMENTS.
Collection practices for patients eligible for financial assistanceSchedule H, Part III, Line 9bONCE A PATIENT IS DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE, IT IS NOTED IN THE PATIENT'S FINANCIAL RECORD AND ANY COLLECTION EFFORTS CEASE. ANY PREVIOUS AMOUNTS BILLED ARE WRITTEN OFF AS PROVIDED IN THE FINANCIAL ASSISTANCE POLICY. THE ASSISTANT VICE PRESIDENT OF REVENUE CYCLE OF THE ORGANIZATION REVIEWS THE FINANCIAL ACTIVITY ON OTHER ACCOUNTS TO DETERMINE IF AN ACCOUNT SHOULD BE TURNED OVER TO OUTSIDE COLLECTIONS. IF A PATIENT ACCOUNT TURNED OVER TO COLLECTIONS IS LATER DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE, THE ACCOUNT IS BROUGHT BACK FROM COLLECTIONS AND THE ACCOUNT WRITTEN OFF.
Community Served by Needs AssessmentSchedule H, Part V Section B, Line 3(1) CENTRAL GA REHABILITATION HOSPITAL INC - A STRATIFIED RANDOM TELEPHONE SURVEY OF 1,000 INDIVIDUALS AGE 18 OR OLDER WAS CONDUCTED ACROSS BIBB, HOUSTON, PEACH, JONES, TWIGGS MONROE AND CRAWFORD COUNTIES. AS PART OF THE ASSESSMENT, FIVE FOCUS GROUPS WERE HELD THOROUGHOUT THE REGION. PARTICPANTS INCLUDED 34 KEY INFORMANTS, INCLUDING SOCIAL SERVICE PROVIDERS, PHYSICIANS BUSINESS LEADERS AND OTHERS. PARTIPANTS ALSO INCLUDED A PUBLIC HEALTH REPRESENTATIVE AND SEVERAL INDIVIDUALS WHO WORK WITH LOW-INCOME, MINORITY AND OTHER MEDICALLY UNDERSERVED POPULATIONS. A VARIETY OF SECONDARY DATA SOURCES WAS CONSULTED TO COMPLEMENT THE ASSESSMENT, INCLUDING CENTERS FOR DISEASE CONTROL AND PREVENTION, GEOLYTICS DEMPGRAPHIC ESTIMATES & PROJECTIONS, NATIONAL CENTER FOR HEALTH STATISTICS, GEORGIA BUREAU OF INVESTIGATION, US CENSUS DATA, US DEPARTMENT OF HEALTH AND HUMAN SERVICES, THE FBI AND THE US DEPARTMENT OF JUSTICE. PROFESSION RESEARCH CONSULTANTS, INC. CONDUCTED THE COMMUNITY NEEDS ASSESSMENT ON BEHALF OF THE ORGANIZATION.;
Other Hospital Facilities included in Needs AssessmentSchedule H, Part V Section B, Line 4(1) CENTRAL GA REHABILITATION HOSPITAL INC - THE MEDICAL CENTER OF CENTRAL GEORGIA.;
Availability of Needs AssessmentSchedule H, Part V Section B, Line 5c(1) CENTRAL GA REHABILITATION HOSPITAL INC - A COPY OF THE ASSESSMENT WAS PROVIDED TO MANY COMMUNITY LEADERS AND ORGANIZATIONS.;
Needs not addressed in Needs AssessmentSchedule H, Part V Section B, Line 7(1) CENTRAL GA REHABILITATION HOSPITAL INC - CENTRAL GEORGIA REHABILITATION HOSPITAL IS A LIMITED PURPOSE FACILITY. THE ORGANIZATION AND THE MEDICAL CENTER OF CENTRAL GEORGIA, A RELATED 501 (C)(3) ORGANIZATION, IDENTFIED THE FOLLOWING NEEDS THAT WERE NOT TO BE ADDRESSED IN FISCAL YEAR 2013: 1) MENTAL HEALTH - LACK OF EXPERTISE, RESOURCES AND EXISTENCE OF OTHER PROVIDERS BETTER SUITED TO ADDRESS THIS NEED. 2) ORAL HEALTH - OTHER COMMUNITY ORGANIZATIONS ARE CURRENTLY BETTER SUITED TO ADDRESS THIS NEED. 3) SEXUALLY TRANSMITTED DISEASES - LIMITED RESOURCES AND EXPERTISE. ADDITIONALLY, WE DETERMINED THIS NEED IS BETTER ADDRESSED BY OTHER COMMUNITY ORGANIZATIONS INCLUDING THE PUBLIC HEALTH DEPARTMENT, A VOLUNTEER CLINIC AND LOCAL SCHOOL SYSTEMS. 4) CANCER - MCCG IS BUILDING A CANCER CENTER. TREATMENT OF PATIENTS WILL BEGIN NOVEMBER 2014.;
Means used to determine amounts billedSchedule H, Part V Section B, Line 20d(1) CENTRAL GA REHABILITATION HOSPITAL INC - THE HOSPITAL FACILITY USED AN ESTIMATE OF THE AVERAGE OF THE THREE LOWEST COMMERCIALLY INSURED RATES.;
Needs assessment.Schedule H, Part VI, Line 2A COMMUNITY NEEDS ASSESSMENT WAS PERFORMED IN 2012 ON BEHALF OF THE HOSPITALS OF CENTRAL GEORGIA HEALTH SYSTEM (CGHS) BY PROFESSIONAL RESEARCH CONSULTANTS, INC. (PRC). PRC IS A NATIONALLY RECOGNIZED HEALTHCARE CONSULTING FIRM WHICH HAS CONDUCTED HUNDREDS OF COMMUNITY NEEDS ASSESSMENTS SINCE 1994. THE SURVEY AREA INCLUDED THE PRIMARY SERVICE AREA FOR CGHS HOSPITALS INCLUDING BIBB, CRAWFORD, HOUSTON, JONES, MONROE, PEACH AND TWIGGS COUNTIES. THE SURVEY INCLUDED 1,000 LAND LINE AND CELL PHONE SURVEYS AND FIVE KEY INFORMANT FOCUS GROUPS WHICH INCLUDED HEALTHCARE PROVIDERS AND OTHER COMMUNITY LEADERS. ADDITIONALLY, PUBLIC HEALTH, VITAL STATISTICS AND BENCHMARK DATA INCLUDING GEORGIA AND NATIONWIDE RISK FACTOR DATA AND HEALTHLY PEOPLE 2020 WERE USED.
Patient education of eligibility for assistance.Schedule H, Part VI, Line 3PATIENTS ARE INFORMED OF AVAILABLE ASSISTANCE BY THE FOLLOWING METHODS: THE PATIENT IS NOTIFIED UPON ADMISSION OF THE FINANCIAL ASSISTANCE POLICY; SIGNAGE IN ADMISSION AREAS NOTIFIES HOSPITAL PATIENTS AND GUESTS OF THE POLICY; AND THE CGRH BUSINESS OFFICE LIAISON OR DESIGNATED PATIENT ACCOUNT REPRESENTATIVE (PAR) WILL INTERVIEW PATIENTS WHO HAVE LITTLE OR NO THIRD PARTY COVERAGE AND WILL REQUEST DOCUMENTS TO SUPPORT THEIR NEED VIA A FINANCIAL DISCLOSURE FORM. THE FINANCIAL DISCLOSURE FORM WILL ASCERTAIN MONTHLY BILLS AND ASSETS IN THE DETERMINATION OF PATIENT ABILITY TO PAY.
Community information.Schedule H, Part VI, Line 4THE PRIMARY SERVICE AREA IS BIBB, CRAWFORD, HOUSTON, JONES, MONROE, PEACH AND TWIGGS COUNTIES. THERE ARE TWENTY-ONE COUNTIES IN THE SECONDARY SERVICE AREA. A RECENT ESTIMATE OF POPULATION IN THE PRIMARY SERVICE AREA IS 406,725 AND THE SECONDARY SERVICE AREA HAS A POPULATION OF 389,460.
Promotion of community healthSchedule H, Part VI, Line 5THE ORGANIZATION IS PART OF A MULTI ENTITY HOSPITAL SYSTEM THAT PROVIDES MEDICAL SERVICES TO THE COMMUNITY. THE ORGANIZATION HAS A BOARD COMPRISED OF MEMBERS OF THE COMMUNITY. THE MEDICAL STAFF OF THE HOSPTIAL IS OPEN TO ALL QUALIFIED PHYSICIAN APPLICANTS. ANY SURPLUS FUNDS ARE REINVESTED IN THE ORGANIZATION AND USED FOR PROGRAM SERVICES. AN EMERGENCY ROOM OPEN 24/7/365 IS AVAILABLE AT OUR SISTER ORGANIZATION, THE MEDICAL CENTER OF CENTRAL GEORGIA, A GENERAL SHORT TERM ACUTE CARE FACILITY AND ONE OF FIVE LEVEL 1 TRAUMA CENTER'S IN THE STATE OF GEORGIA.
Affiliated health care systemSchedule H, Part VI, Line 6PART VI, LINE 7: THE ORGANIZATION IS PART OF CENTRAL GEORGIA HEALTH SYSTEMS, INC., A MULTI-ENTITY HEALTHCARE SYSTEM. OTHER ORGANIZATIONS IN THE SYSTEM INCLUDE: MEDICAL CENTER OF CENTRAL GEORGIA, INC. - A 637 BED GENERAL SHORT TERM ACUTE CARE HOSPITAL FACILITY THAT IS DESIGNATED AS A LEVEL 1 TRAUMA CENTER AND MAGNET HOSPITAL FOR NURSING. HEALTH SERVICES OF CENTRAL GEORGIA, INC. - PROVIDES FACULTY PHYSICIANS TO THE RESIDENCY TRAINING PROGRAMS OF THE MEDICAL CENTER OF CENTRAL GEORGIA AS WELL AS OTHER PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN ASSISTANTS. CENTRAL GEORGIA SENIOR HEALTH, INC. - IS A CONTINUING CARE RETIREMENT COMMUNITY (CCRC) OFFERING INDEPENDENT LIVING, ASSISTED LIVING, MEMORY SUPPORT AND SKILLED NURSING. MEDCEN FOUNDATION, INC. -PROVIDES FUNDRAISING AND SUPPORT FOR CENTRAL GEORGIA HEALTH SYSTEMS, INC. AND ITS AFFILIATES.
State filing of community benefit reportSchedule H, Part VI, Line 7GA

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
MIDDLE GEORGIA STATE COLLEGE FOUNDATION
100 COLLEGE STATION DR A-217MACONGA312065145237066010501(C)(3)10000STUDENT SCHOLARSHIP
THE MEDICAL CENTER OF CENTRAL GEORGIA INC
691 CHERRY STREET SUITE 400MACONGA31201582149128501(C)(3)3478687SUPPORT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedures for monitoring use of grant fundsIdentifier
Return ReferenceSchedule I, Part I, Line 2ReturnReference
ExplanationCGHS REQUIRES ALL ORGANIZATIONS THAT RECEIVE SPONSORSHIPS TO PROVIDE PROOF OF THEIR NON PROFIT STATUS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
A DONALD FAULK JR
CEO (TRANSITION)7286160232096095870021609455010662530211280
KENNETH B BANKS
GEN COUNSEL/SEC3007690581420110628029811601506007827150902090
RHONDA S PERRY
VP/TREASURER415583010762903989580500940049400142805003944510
ELBERT T MCQUEEN
VP/CEO CGRH225934042899010458039153081950326639000
JUDY K WARE
CHIEF COMPLIANCE OFFICER170255015000240039480117110187654000
KAREN M FARR
AVP FINANCIAL SERVICES1583750253240607902705303760217207000
KATHERINE L BOWEN
AVP FIN PLANNING BUDGET15071802512902540147470117110202559000
LORI W CASSIDY
AVP HUMAN RESOURCES19272303185003709027362087200264364000
NINFA M SAUNDERS
PRESIDENT & CEO15908700019760016555507570345159000
TIQUELLA S KING-WHITBY
PHYSICIAN1721740008103560120110184622000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Supplemental nonqualified retirement planSchedule J, Part I, Line 4bMCCG 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 HAVE NOT PERFORMED AS ANTICIPATED. DURING 2009 MCCG DETERMINED THAT IT WOULD SUSPEND ALL PREMIUM PAYMENTS AND REEVALUATE 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 $441,235 KEN BANKS $256,213 A PORTION OF THIS ACCRUAL IS A CATCH-UP ACCRUAL DETERMINED FOR SERVICES RENDERED SINCE JANUARY 1, 2010 THAT HAVE NOT BEEN PREVIOUSLY ACCRUED. 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 $29,634 KEN BANKS $17,309 ELBERT MCQUEEN $7,819 IN ADDITION, CGHS ADOPTED A DC SERP PLAN EFFECTIVE OCTOBER 1, 2012 DESIGNED TO ENCOURAGE DESIGNATED EMPLOYEES TO CONTINUE THEIR EMPLOYMENT. DURING THE YEAR THE FOLLOWING BENEFITS ACCRUED UNDER THIS PLAN: NINFA SAUNDERS $164,200
Non-fixed paymentsSchedule J, Part I, Line 7THIS PROGRAM IS ADMINISTERED BY THE CEO. A BUDGET FOR THE PROGRAM IS ESTABLISHED FOR REWARD AND RECOGNITION OF EXECUTIVES AND ORGANIZATIONAL LEADERS WHO GO ABOVE AND BEYOND THE SCOPE OF THEIR RESPONSIBILITIES. FOR EXAMPLE, THEY MAY COMPLETE A PROJECT, LEAD AN ORGANIZATIONAL INITIATIVE, OR EXCEL IN AN AREA THAT REPRESENTS EXCELLENCE UNDER ONE OF OUR ORGANIZATIONAL PILLARS - QUALITY, SERVICE EXCELLENCE, OUR PEOPLE, GROWTH, FINANCIAL PERFORMANCE. NEAR THE END OF THE FISCAL YEAR, NOMINATIONS ARE SOLICITED FROM THE LEADERSHIP TEAM. A PROPOSAL FOR ALLOCATION OF THE AWARD IS DEVELOPED AND PRESENTED TO THE HR COMMITTEE OF THE BOARD FOR REVIEW, DISCUSSION, AND APPROVAL (PRIOR TO DISTRIBUTION).

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
New program servicesForm 990, Part III, Line 2IN JANUARY 2013, THE MEDICAL CENTER OF PEACH COUNTY, INC. (MCPC) BEGAN OPERATING A 25 BED CRITICAL ACCESS HOSPITAL PURSUANT TO A LEASE AND TRANSFER AGREEMENT WITH THE HOSPITAL AUTHORITY OF PEACH COUNTY. MCPC IS A CONTROLLED AFFILIATE OF CENTRAL GEORGIA HEALTH SYSTEMS, INC. CGHS IS RESPONSIBLE FOR THE STRATEGIC DIRECTION, FINANCIAL MANAGEMENT AND ALLOCATION OF RESOURCES AMONG THE ENTITIES OF THE AFFILIATED HEALTHCARE SYSTEM INCLUDING MCPC.
Review of form 990 by governing bodyForm 990, Part VI, Section B, Line 11bTHE FORM 990 WAS PREPARED BY HOSPITAL PERSONNEL FROM INFORMATION PROVIDED BY MANAGEMENT AND FROM CONSOLIDATED FINANCIAL STATEMENTS (AUDITED BY AN INDEPENDENT CPA FIRM). IT IS REVIEWED IN DETAIL BOTH BY OUR OUTSIDE TAX ADVISOR (ANOTHER INDEPENDENT CPA) AND BY FINANCIAL MANAGEMENT OF CENTRAL GEORGIA HEALTH SYSTEMS. A COPY OF THE FORM 990 WAS PROVIDED TO EACH BOARD MEMBER PRIOR TO FILING THE RETURN WITH THE INTERNAL REVENUE SERVICE.
Conflict of interest policyForm 990, Part VI, Section B, Line 12cTHE DEPARTMENT OF AUDIT AND COMPLIANCE ISSUES COI DISCLOSURE FORMS ANNUALLY TO OUR BOARD MEMBERS, ADMINISTRATION AND DIRECTORS. AUDIT AND COMPLIANCE RECEIVES, REVIEWS AND DOCUMENTS ALL POTENTIAL CONFLICTS (PERCEIVED AND REAL.) THE RESULTS ARE TAKEN TO THE COMPLIANCE COMMITTEE WHERE THE REAL CONFLICTS OF INTEREST ARE DISCUSSED AND A PLAN FOR CORRECTIVE ACTION IS DEVELOPED. THE CORRECTIVE ACTION RECOMMENDATIONS ARE TAKEN TO THE VARIOUS BOARDS AND ADMINISTRATION FOR IMPLEMENTATION. ANY TIME A CHANGE IN A RELATIONSHIP OR NEW POTENTIAL CONFLICT EVOLVES, THE INDIVIDUALS MUST AMEND THEIR COI DISCLOSURE FORM. CONFLICTED INDIVIDUALS ARE PROHIBITED FROM PARTICIPATING IN DELIBERATIONS AND DECISIONS REGARDING SUCH TRANSACTIONS, BUT MAY PROVIDE INFORMATION IF REQUESTED BY THE COMPLIANCE COMMITTEE.
Process used to establish compensation of top management officialForm 990, Part VI, Section B, Line 15aTHE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS ENGAGES AN EXECUTIVE CONSULTING FIRM EVERY 2-3 YEARS 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 CURRENTLY 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. KEY EMPLOYEES AND OTHERS OUTSIDE OF THE EXECUTIVE LEADERSHIP TEAM HAVE COMPENSATION SET BY HR GUIDELINES AND/OR MARKET COMPENSATION STUDIES.
Process used to establish compensation of other officers/key employeesForm 990, Part VI, Section B, Line 15bTHE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS ENGAGES AN EXECUTIVE CONSULTING FIRM EVERY 2-3 YEARS 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 CURRENTLY 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. KEY EMPLOYEES AND OTHERS OUTSIDE OF THE EXECUTIVE LEADERSHIP TEAM HAVE COMPENSATION SET BY HR GUIDELINES AND/OR MARKET COMPENSATION STUDIES.
Governing documents, conflict of interest policy and financial statements available to the publicForm 990, Part VI, Section C, Line 19CGHS PROVIDES COPIES OF ITS GOVERNING AND OTHER CORPORATE DOCUMENTS UPON REQUEST.
Other changes in net assets or fund balancesForm 990 , Part XI, Line 9ROUNDING - 1;

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1CENTRAL GA REHAB HOSPITAL LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13351 NORTHSIDE DRIVEAddressLine1
CityMACONCity
StateGAState
ZIP Code31210ZIPCode
FieldValueIRS element (for citing)
EIN300371539EIN
Primary ActivitiesREHABILITATION SERVICESPrimaryActivities
Legal Domicile StateGALegalDomicileState
Total Income14106903TotalIncome
EOY Assets16414671EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CENTRAL GEORGIA HEALTH SYSTEMSBusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodePrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
CENTRAL GEORGIA SENIOR HEALTH INC
691 CHERRY STREET SUTIE 400MACONGA31201RETIREMENT COMMUNITYGA501(C)(3)11 - Type IICENTRAL GEORGIA HEALTH SYSTEMStrue
HEALTH SERVICES OF CENTRAL GEORGIA INC
691 CHERRY STREET SUTIE 400MACONGA31201HEALTHCARE SERVICESGA501(C)(3)3CENTRAL GEORGIA HEALTH SYSTEMStrue
MEDCEN COMMUNITY HEALTH FOUNDATION INC
858 HIGH STREETMACONGA31201FUNDRAISINGGA501(C)(3)7NAtrue
MEDICAL CENTER OF GEORGIA INC
691 CHERRY STREET SUTIE 400MACONGA31201HOSPITALGA501(C)(3)3CENTRAL GEORGIA HEALTH SYSTEMStrue
THE MEDICAL CENTER OF PEACH COUNTY INC
1960 HWY 247BYRONGA31008HOSPITALGA501(C)(3)3CENTRAL GEORGIA HEALTH SYSTEMStrue

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNABusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
CENTRAL GEORGIA PET LLC
1650 HARDEMAN AVENUEMACONGA31201371464470MEDICAL IMAGING CENTERGAN/A
SECURE HEALTH PLANS OF GEORGIA LLC
577 MULBERRY STREET SUITE 1000MACONGA31201582306549MANAGED CAREGACENTRAL GEORGIA HEALTH SYSTEMS INCRELATED3549982339201false$0false0.50388

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1Province Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
CENTRAL GEORGIA HEALTH VENTURES INC
691 CHERRY STREET SUITE 400MACONGA31201582164989MANAGEMENT & HOME CARE SERVICESGACENTRAL GEORGIA HEALTH SYSTEMSC CORPORATION375534955303631
CENTRA PROFESSIONAL INDEMNITY LTD
INSURANCECENTRAL GEORGIA HEALTH SYSTEMSC CORPORATION6760137931311101PO BOX 1363GRAND CAYMANCJCJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationtrueDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (48 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MEDICAL CENTER OF CENTRAL GEORGIA INC
P32741429CASH
MEDICAL CENTER OF CENTRAL GEORGIA INC
B3478687CASH
MEDICAL CENTER OF CENTRAL GEORGIA INC
K1300000FMV
MEDICAL CENTER OF CENTRAL GEORGIA INC
Q1027455CASH
CENTRAL GEORGIA HEALTH VENTURES INC
Q599741CASH
MEDICAL CENTER OF CENTRAL GEORGIA INC
Q27529427CASH
MEDICAL CENTER OF PEACH COUNTY INC
Q1467363CASH
MEDICAL CENTER OF CENTRAL GEORGIA INC
P1467363CASH
MEDICAL CENTER OF CENTRAL GEORGIA INC
E96735FMV
MEDICAL CENTER OF PEACH COUNTY INC
D96735FMV
CENTRA PROFESSIONAL INDEMNITY
S11074605CASH
CENTRA PROFESSIONAL INDEMNITY
R9423289CASH
MEDICAL CENTER OF CENTRAL GEORGIA INC
S9423289CASH
CENTRA PROFESSIONAL INDEMNITY
R915427CASH
CENTRAL GEORGIA SENIOR HEALTH INC
S222196CASH
CENTRA PROFESSIONAL INDEMNITY
R222196CASH
HEALTH SERVICES OF CENTRAL GEORGIA INC
S1809813CASH
CENTRA PROFESSIONAL INDEMNITY
R1809813CASH
CENTRAL GEORGIA REHABILITATION SERVICES
S151558CASH
CENTRA PROFESSIONAL INDEMNITY
R151558CASH
MEDICAL CENTER OF PEACH COUNTY INC
Q139306CASH
MEDICAL CENTER OF CENTRAL GEORGIA INC
P139306CASH
MEDICAL CENTER OF PEACH COUNTY INC
D25523304CASH
MEDICAL CENTER OF CENTRAL GEORGIA INC
E25523304CASH
MEDICAL CENTER OF CENTRAL GEORGIA INC
P24280817CASH
HEALTH SERVICES OF CENTRAL GEORGIA INC
Q24280817CASH
MEDICAL CENTER OF CENTRAL GEORGIA INC
P1056497CASH
HEALTH SERVICES OF CENTRAL GEORGIA INC
Q1056497CASH
MEDICAL CENTER OF CENTRAL GEORGIA INC
C16638863CASH
HEALTH SERVICES OF CENTRAL GEORGIA INC
B16638863CASH
MEDICAL CENTER OF CENTRAL GEORGIA INC
J1051769FMV
HEALTH SERVICES OF CENTRAL GEORGIA INC
K1051769FMV
MEDICAL CENTER OF CENTRAL GEORGIA INC
J63365FMV
HEALTH SERVICES OF CENTRAL GEORGIA INC
K63365FMV
MEDICAL CENTER OF CENTRAL GEORGIA INC
P1080085CASH
MEDCEN FOUNDATION INC
Q1080085CASH
MEDICAL CENTER OF CENTRAL GEORGIA INC
K54994FMV
MEDCEN FOUNDATION INC
J54994FMV
MEDICAL CENTER OF CENTRAL GEORGIA INC
C1135079CASH
MEDCEN FOUNDATION INC
B1135079CASH
MEDICAL CENTER OF CENTRAL GEORGIA INC
P6060025CASH
CENTRAL GEORGIA SENIOR HEALTH INC
Q6060025CASH
MEDICAL CENTER OF CENTRAL GEORGIA INC
P87868CASH
CENTRAL GEORGIA HEALTH VENTURES INC
Q87868CASH
MEDICAL CENTER OF CENTRAL GEORGIA INC
Q2539163CASH
CENTRAL GEORGIA HEALTH VENTURES INC
P2539163CASH
MEDICAL CENTER OF CENTRAL GEORGIA INC
K88426FMV
CENTRAL GEORGIA HEALTH VENTURES INC
J88426FMV

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