SMHA HEALTHCARE INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
SMHA HEALTHCARE INC (EIN 58-2460001)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-11-17
IRS object ID
201423219349304902
Schema version
2013v3.0
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)
Return2014-11-17T11:32:32-06:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN560747981PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DIXON HUGHES GOODMAN LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 RIDGEFIELD COURTAddressLine1
CityASHEVILLECity
StateNCState
ZIP Code28806ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN582460001EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL HEALTH INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlMEMOBusinessNameControlTxt
Phone9123508000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 20389AddressLine1
CitySAVANNAHCity
StateGAState
ZIP Code314033089ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLAURA DOWPersonNm
Person TitleVP OF FINANCEPersonTitleTxt
Phone9123508000PhoneNum
Signature2014-11-17SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAMY BIBBYPreparerPersonNm
PTINP00445891PTIN
Phone8282542254PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARGARET GILLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 20389AddressLine1
CitySAVANNAHCity
StateGAState
ZIP Code314033089ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$24,952,299GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MEMORIALHEALTH.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1997FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTO SUPPORT MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER, INC.ActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee162TotalEmployeeCnt
Total Volunteers15TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$506,882PYProgramServiceRevenueAmt
CY Program Service Revenue$24,952,289CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$10CYOtherRevenueAmt
PY Total Revenue$506,882PYTotalRevenueAmt
CY Total Revenue$24,952,299CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$10,717,053CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$506,882PYOtherExpensesAmt
CY Other Expenses$14,235,246CYOtherExpensesAmt
PY Total Expenses$506,882PYTotalExpensesAmt
CY Total Expenses$24,952,299CYTotalExpensesAmt
PY Revenues Less Expenses$0PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$0CYRevenuesLessExpensesAmt
Total Assets BOY$6,631,414TotalAssetsBOYAmt
Total Assets EOY$11,532,624TotalAssetsEOYAmt
Total Liabilities BOY$3,985,578TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,656,669TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,645,836NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,875,955NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO 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.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$23,813,677ExpenseAmt
Revenue$24,952,289RevenueAmt
DescTO 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.Desc
Total Program Service Expenses$23,813,677TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee162EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LAURA DOWBusinessNameLine1
FieldValueIRS element (for citing)
Phone9123508613PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14600 WATERS AVENUEAddressLine1
CitySAVANNAHCity
StateGAState
ZIP Code31404ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
J HARRY HASLAM JR
CHAIR1.002.00Yes (X)Yes (X)$0$0$0
KAY A FORD
VICE CHAIR1.001.00Yes (X)Yes (X)$0$0$0
MARILYN BUCK EDD
SECRETARY1.001.00Yes (X)Yes (X)$0$0$0
ARTHUR B DANA CPA CVA
TREASURER1.001.00Yes (X)Yes (X)$0$0$0
IRA BERMAN
BOARD MEMBER1.001.00Yes (X)$0$0$0
ROBERT F BROWN JR MD
BOARD MEMBER1.0040.00Yes (X)$0$360,081$82,843
LEROY BURKE III
BOARD MEMBER1.001.00Yes (X)$0$0$0
GERALD CAPLAN MD
BOARD MEMBER1.001.00Yes (X)$0$0$0
WILLIAM T DANIEL
BOARD MEMBER1.001.00Yes (X)$0$0$0
HELEN DOWNING
BOARD MEMBER1.001.00Yes (X)$0$0$0
CURTIS LEWIS III
BOARD MEMBER1.001.00Yes (X)$0$0$0
WILLIAM LD LYGHT
BOARD MEMBER (THRU 2/28/13)1.001.00Yes (X)$0$0$0
CHARLES F MCMILLAN SR
BOARD MEMBER1.001.00Yes (X)$0$0$0
MARK E MURPHY MD
BOARD MEMBER1.001.00Yes (X)$0$0$0
JACKIE RABINOWITZ
BOARD MEMBER1.002.00Yes (X)$0$0$0
FRANK ROSSITER JR
BOARD MEMBER1.001.00Yes (X)$0$0$0
W REX TEMPLETON JR
BOARD MEMBER1.001.00Yes (X)$0$0$0
CHRISTOPHER L WIXON MD
BOARD MEMBER1.001.00Yes (X)$0$0$0
MARGARET GILL
PRESIDENT AND CEO1.0040.00Yes (X)$643,155$0$61,153
LAURA DOW
VP OF FINANCE1.0040.00Yes (X)$195,991$0$35,178
FieldValueIRS element (for citing)
Total Reportable Comp From Org$839,146TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$360,081TotReportableCompRltdOrgAmt
Total Other Compensation$179,174TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K9IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
INFORMATION TECHNOLOGY900099$21,387,961$21,387,961
ACCOUNTING AND FINANCE900099$3,564,328$3,564,328
FieldValueIRS element (for citing)
Total Program Service Revenue$24,952,289TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescPURCHASE DISCOUNTSDesc
Business900099BusinessCd
Total Revenue Column$10TotalRevenueColumnAmt
Exclusion$10ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$10OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$24,952,299TotalRevenueColumnAmt
Related Or Exempt Func Income$24,952,289RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$10ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$935,478TotalAmt
Management And General$935,478ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,869,527TotalAmt
Program Services$7,869,527ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$73,365TotalAmt
Program Services$65,570ProgramServicesAmt
Management And General$7,795ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,152,614TotalAmt
Program Services$1,030,156ProgramServicesAmt
Management And General$122,458ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$686,069TotalAmt
Program Services$613,178ProgramServicesAmt
Management And General$72,891ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$3,106TotalAmt
Program Services$3,106ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$304,296TotalAmt
Program Services$304,296ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,132,410TotalAmt
Program Services$2,132,410ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$60,970TotalAmt
Program Services$60,970ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,144,999TotalAmt
Program Services$2,144,999ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$8,653,679TotalAmt
Program Services$8,653,679ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$198,781TotalAmt
Program Services$198,781ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$142,626TotalAmt
Program Services$142,626ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$320TotalAmt
Program Services$320ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$160,594TotalAmt
Program Services$160,594ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$433,374TotalAmt
Program Services$433,374ProgramServicesAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Total$91TotalAmt
Program Services$91ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$24,952,299TotalAmt
Program Services$23,813,677ProgramServicesAmt
Management And General$1,138,622ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$429,403BOYAmt
EOY$2,235,326EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$9,686,499LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$433,374LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$6,157,501BOYAmt
EOY$9,253,125EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$44,510BOYAmt
EOY$44,173EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,631,414BOYAmt
EOY$11,532,624EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,985BOYAmt
EOY$1,809,151EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$3,981,593BOYAmt
EOY$4,847,518EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,985,578BOYAmt
EOY$6,656,669EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,645,836BOYAmt
EOY$4,875,955EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,645,836BOYAmt
EOY$4,875,955EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,631,414BOYAmt
EOY$11,532,624EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$0ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$2,230,119OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
CertificationYes (X)CertificationInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL HEALTH UNIVERSITY MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
EIN311126469EIN
Organization Type3OrganizationTypeDesc
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$0SupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$16,400OtherCostOrOtherBasisAmt
Depreciation$1,230DepreciationAmt
Book Value$15,170BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$23,500OtherCostOrOtherBasisAmt
Depreciation$3,525DepreciationAmt
Book Value$19,975BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,665,295OtherCostOrOtherBasisAmt
Depreciation$428,619DepreciationAmt
Book Value$5,236,676BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,981,304OtherCostOrOtherBasisAmt
Book Value$3,981,304BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$9,253,125TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE 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, 2013. FISCAL YEARS ENDED ON OR AFTER DECEMBER 31, 2010 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ROBERT F BROWN JR MD
BOARD MEMBER$0$360,081$0$0$0$0$0$56,473$0$26,370$0$442,924$0$0
MARGARET GILL
PRESIDENT AND CEO$641,950$0$0$0$1,205$0$34,786$0$26,367$0$704,308$0$0$0
LAURA DOW
VP OF FINANCE$195,991$0$0$0$0$0$17,948$0$17,230$0$231,169$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11THE 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 12CBOARD MEMBERS ARE REQUIRED TO UPDATE AND SUBMIT A NEW CONFLICT OF INTEREST STATEMENT BY JANUARY 31 OF EACH YEAR. 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 C, LINE 19THE 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 XI, LINE 9:NET EQUITY TRANSFERS FROM AFFILIATES 2,230,119.
FORM 990, PART XII, LINE 2CTHE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationInd
MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER FOUNDATION
PO BOX 23089SAVANNAHGA314033089581618486SUPPORT OF MHUMCGA501(C)(3)LINE 11A, IMEMORIAL HEALTH INCYes (1)
MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER INC
PO BOX 23089SAVANNAHGA314033089311126469HEALTH CARE PROVIDERGA501(C)(3)LINE 3MEMORIAL HEALTH INCYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1PAULSEN STREET SURGERY CENTER LLCBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line14425 PAULSEN STREET 2ND FLOORAddressLine1
CitySAVANNAHCity
StateGAState
ZIP Code31405ZIPCode
FieldValueIRS element (for citing)
EIN454517515EIN
Primary ActivitiesHEALTH CAREPrimaryActivitiesTxt
Legal Domicile StateGALegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income-$19,481ShareOfTotalIncomeAmt
Share Of EOY Assets$856,987ShareOfEOYAssetsAmt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd
Ownership0.51000OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Entity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1CityForeignAddress/CityProvince Or StateForeignAddress/ProvinceOrStateCountryForeignAddress/CountryPostal CodeForeignAddress/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountryCdDirect Controlling NADirectControllingNACd
4600 WATERS AVE PROFESSIONAL CONDO ASSOCIATION INC
PO BOX 23089SAVANNAHGA314033089581990705CONDO ASSOCIATIONGAPROVIDENT HEALTH SERVICES INCC$64,007$470.52000Yes (1)
MEMORIAL HEALTH PARTNERS INC
PO BOX 23089SAVANNAHGA314033089581707311MANAGED CAREGAPROVIDENT HEALTH SERVICES INCC1.00000Yes (1)
MEMORIAL HEALTH ANESTHETISTS INC
PO BOX 23089SAVANNAHGA314033089431985441MEDICAL SERVICESGAPROVIDENT HEALTH SERVICES INCC1.00000Yes (1)
MPPG INC
PO BOX 23089SAVANNAHGA314033089582162071PHYSICIANS PRACTICEGAPROVIDENT HEALTH SERVICES INCC1.00000Yes (1)
PROVIDENT EYE PHYSICIANS INC
PO BOX 23089SAVANNAHGA314033089010601599MEDICAL SERVICESGAPROVIDENT HEALTH SERVICES INCC1.00000Yes (1)
PROVIDENT HEALTH SERVICES INC
PO BOX 23089SAVANNAHGA314033089581611969MEDICAL SERVICES/ CONSOLIDATING ENTITYGAMEMORIAL HEALTH INCC$61,448,248$21,346,0231.00000Yes (1)
PROVIDENT PROFESSIONAL BUILDING CONDO ASSOCIATION INC
PO BOX 23089SAVANNAHGA314033089581845972CONDO ASSOCIATIONGAPROVIDENT HEALTH SERVICES INCC$103,1960.69560Yes (1)
SAVANNAH MIDTOWN PROPERTIES INC
PO BOX 23089SAVANNAHGA314033089582537941REAL ESTATE HOLDINGGAPROVIDENT HEALTH SERVICES INCC1.00000Yes (1)
MEMORIAL PROFESSIONAL ASSURANCE COMPANY
999999999OTHER INSURANCEC1.00000Yes (1)PO BOX 1100GRAND CAYMANGRAND CAYMANCJKY1-1005CJN/A
SAVANNAH PEDIATRIC SPECIALISTS INC
PO BOX 23089SAVANNAHGA314033089270788131MEDICAL SERVICESGAPROVIDENT HEALTH SERVICES INCC1.00000Yes (1)
MEMORIAL HEALTH CORPORATE SERVICES INC
4700 WATERS AVESAVANNAHGA31404900963434CORPORATE SERVICESGAPROVIDENT HEALTH SERVICES INCC1.00000Yes (1)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeSTransactionTypeTxt
Involved$24,764,427InvolvedAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART IV, TAXABLE SUBSIDIARY REPORTING:FormAndLineReferenceDesc
ExplanationPROVIDENT HEALTH SERVICES, INC. IS THE CONSOLIDATING PARENT CORPORATION FOR SEVERAL OTHER TAXABLE SUBSIDIARIES. AMOUNTS REPORTED ON SCHEDULE R, PART IV ARE RESPECTIVE OF THE CONSOLIDATED AMOUNTS FOR PROVIDENT HEALTH SERVICES AND SUBSIDIARIES.ExplanationTxt

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