2014-11-17T11:32:32-06:00 2013-12-31 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2013-01-01 582460001 MEMORIAL HEALTH INC MEMO 9123508000 PO BOX 20389 SAVANNAH GA 314033089 LAURA DOW VP OF FINANCE 9123508000 2014-11-17 1 AMY BIBBY P00445891 8282542254 2013 2015-11-30 17:44:51Z MARGARET GILL PO BOX 20389 SAVANNAH GA 314033089 24952299 0 X WWW.MEMORIALHEALTH.COM X 1997 GA TO SUPPORT MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER, INC. 17 15 162 15 0 0 0 0 506882 24952289 0 0 0 10 506882 24952299 0 0 0 0 0 10717053 0 0 0 506882 14235246 506882 24952299 0 0 6631414 11532624 3985578 6656669 2645836 4875955 X TO PROVIDE ADMINISTRATIVE SUPPORT BY ENGAGING IN SUCH OTHER ACTIVITIES THAT BENEFIT, PERFORM THE FUNCTIONS OF, OR CARRY OUT THE PURPOSES OF MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER, INC. 0 0 23813677 24952289 TO PROVIDE ADMINISTRATIVE SUPPORT BY ENGAGING IN SUCH OTHER ACTIVITIES THAT BENEFIT, PERFORM THE FUNCTIONS OF, OR CARRY OUT THE PURPOSES OF MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER, INC.THE ORGANIZATION ADMINISTERS AN ELECTRONIC MEDICAL RECORDS SOFTWARE PROGRAM INTENDED TO BENEFIT ITS SUPPORTED ORGANIZATION. EXPENSES TO BE REPORTED WITHIN THIS ENTITY ARE RELATED TO THE OPERATION AND MAINTENANCE OF THIS SOFTWARE SYSTEM AND ARE ALLOCATED TO THE ORGANIZATION BASED UPON ANNUAL TIME STUDIES. REVENUE TO BE RECOGNIZED IN CONJUNCTION WITH THIS SERVICE IS INTENDED TO DIRECTLY OFFSET OPERATIONAL EXPENSES AND WILL BE RECEIVED FROM SUPPORTED AND RELATED ORGANIZATIONS. 23813677 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 162 1 0 0 0 0 0 0 0 0 0 0 X 17 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 GA X LAURA DOW 9123508613 4600 WATERS AVENUE SAVANNAH GA 31404 J HARRY HASLAM JR CHAIR 1.00 2.00 X X 0 0 0 KAY A FORD VICE CHAIR 1.00 1.00 X X 0 0 0 MARILYN BUCK EDD SECRETARY 1.00 1.00 X X 0 0 0 ARTHUR B DANA CPA CVA TREASURER 1.00 1.00 X X 0 0 0 IRA BERMAN BOARD MEMBER 1.00 1.00 X 0 0 0 ROBERT F BROWN JR MD BOARD MEMBER 1.00 40.00 X 0 360081 82843 LEROY BURKE III BOARD MEMBER 1.00 1.00 X 0 0 0 GERALD CAPLAN MD BOARD MEMBER 1.00 1.00 X 0 0 0 WILLIAM T DANIEL BOARD MEMBER 1.00 1.00 X 0 0 0 HELEN DOWNING BOARD MEMBER 1.00 1.00 X 0 0 0 CURTIS LEWIS III BOARD MEMBER 1.00 1.00 X 0 0 0 WILLIAM LD LYGHT BOARD MEMBER (THRU 2/28/13) 1.00 1.00 X 0 0 0 CHARLES F MCMILLAN SR BOARD MEMBER 1.00 1.00 X 0 0 0 MARK E MURPHY MD BOARD MEMBER 1.00 1.00 X 0 0 0 JACKIE RABINOWITZ BOARD MEMBER 1.00 2.00 X 0 0 0 FRANK ROSSITER JR BOARD MEMBER 1.00 1.00 X 0 0 0 W REX TEMPLETON JR BOARD MEMBER 1.00 1.00 X 0 0 0 CHRISTOPHER L WIXON MD BOARD MEMBER 1.00 1.00 X 0 0 0 MARGARET GILL PRESIDENT AND CEO 1.00 40.00 X 643155 0 61153 LAURA DOW VP OF FINANCE 1.00 40.00 X 195991 0 35178 839146 360081 179174 9 0 1 0 0 INFORMATION TECHNOLOGY 900099 21387961 21387961 ACCOUNTING AND FINANCE 900099 3564328 3564328 24952289 PURCHASE DISCOUNTS 900099 10 10 10 24952299 24952289 0 10 935478 935478 7869527 7869527 73365 65570 7795 1152614 1030156 122458 686069 613178 72891 3106 3106 304296 304296 2132410 2132410 60970 60970 2144999 2144999 8653679 8653679 198781 198781 142626 142626 320 320 160594 160594 433374 433374 MISCELLANEOUS 91 91 24952299 23813677 1138622 0 429403 2235326 9686499 433374 6157501 9253125 44510 44173 6631414 11532624 3985 1809151 3981593 4847518 3985578 6656669 X 2645836 4875955 2645836 4875955 6631414 11532624 X 0 2230119 X X 0 1 X 1 0 X X X 0 0 0 MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER 311126469 3 1 0 1 0 16400 1230 15170 23500 3525 19975 5665295 428619 5236676 3981304 3981304 9253125 X PART X, LINE 2: THE HEALTH SYSTEM IS PARTIALLY COMPRISED OF ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAX PURSUANT TO SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. WITH RESPECT TO ANY UNRELATED BUSINESS INCOME GENERATED BY ITS FOR-PROFIT SUBSIDIARIES, THE HEALTH SYSTEM RECORDS INCOME TAXES USING THE LIABILITY METHOD UNDER WHICH THE DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASES OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIOD THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR TO BE SETTLED. THE HEALTH SYSTEM HAS EVALUATED ITS TAX POSITIONS AND HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2013. FISCAL YEARS ENDED ON OR AFTER DECEMBER 31, 2010 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. 0 0 0 0 0 0 0 0 0 ROBERT F BROWN JR MD BOARD MEMBER 0 360081 0 0 0 0 0 56473 0 26370 0 442924 0 0 MARGARET GILL PRESIDENT AND CEO 641950 0 0 0 1205 0 34786 0 26367 0 704308 0 0 0 LAURA DOW VP OF FINANCE 195991 0 0 0 0 0 17948 0 17230 0 231169 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE TAX RETURN IS PREPARED BY AN UNRELATED, INDEPENDENT ACCOUNTING FIRM AND THEN SUBMITTED TO SENIOR MANAGEMENT WITHIN THE ORGANIZATION'S ACCOUNTING DEPARTMENT FOR INTERNAL REVIEW. A DRAFT IS THEN PROVIDED TO THE FINANCE COMMITTEE AND THE ENTIRE BOARD FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO UPDATE AND SUBMIT A NEW CONFLICT OF INTEREST STATEMENT 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 19 THE GOVERNING DOCUMENTS OF THE ORGANIZATION ARE HELD AS PUBLIC RECORDS OF THE STATE OF GEORGIA SECRETARY OF STATE OFFICE. AS SUCH, THESE DOCUMENTS ARE OPEN TO THE PUBLIC. THE CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC AS THIS IS NOT A REQUIREMENT. FORM 990, PART XI, LINE 9: NET EQUITY TRANSFERS FROM AFFILIATES 2,230,119. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER FOUNDATION PO BOX 23089 SAVANNAH GA 314033089 581618486 SUPPORT OF MHUMC GA 501(C)(3) LINE 11A, I MEMORIAL HEALTH INC 1 MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER INC PO BOX 23089 SAVANNAH GA 314033089 311126469 HEALTH CARE PROVIDER GA 501(C)(3) LINE 3 MEMORIAL HEALTH INC 1 PAULSEN STREET SURGERY CENTER LLC 4425 PAULSEN STREET 2ND FLOOR SAVANNAH GA 31405 454517515 HEALTH CARE GA MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER INC RELATED -19481 856987 0 0 0.51000 4600 WATERS AVE PROFESSIONAL CONDO ASSOCIATION INC PO BOX 23089 SAVANNAH GA 314033089 581990705 CONDO ASSOCIATION GA PROVIDENT HEALTH SERVICES INC C 64007 47 0.52000 1 MEMORIAL HEALTH PARTNERS INC PO BOX 23089 SAVANNAH GA 314033089 581707311 MANAGED CARE GA PROVIDENT HEALTH SERVICES INC C 1.00000 1 MEMORIAL HEALTH ANESTHETISTS INC PO BOX 23089 SAVANNAH GA 314033089 431985441 MEDICAL SERVICES GA PROVIDENT HEALTH SERVICES INC C 1.00000 1 MPPG INC PO BOX 23089 SAVANNAH GA 314033089 582162071 PHYSICIANS PRACTICE GA PROVIDENT HEALTH SERVICES INC C 1.00000 1 PROVIDENT EYE PHYSICIANS INC PO BOX 23089 SAVANNAH GA 314033089 010601599 MEDICAL SERVICES GA PROVIDENT HEALTH SERVICES INC C 1.00000 1 PROVIDENT HEALTH SERVICES INC PO BOX 23089 SAVANNAH GA 314033089 581611969 MEDICAL SERVICES/ CONSOLIDATING ENTITY GA MEMORIAL HEALTH INC C 61448248 21346023 1.00000 1 PROVIDENT PROFESSIONAL BUILDING CONDO ASSOCIATION INC PO BOX 23089 SAVANNAH GA 314033089 581845972 CONDO ASSOCIATION GA PROVIDENT HEALTH SERVICES INC C 103196 0.69560 1 SAVANNAH MIDTOWN PROPERTIES INC PO BOX 23089 SAVANNAH GA 314033089 582537941 REAL ESTATE HOLDING GA PROVIDENT HEALTH SERVICES INC C 1.00000 1 MEMORIAL PROFESSIONAL ASSURANCE COMPANY PO BOX 1100 GRAND CAYMAN GRAND CAYMAN CJ KY1-1005 999999999 OTHER INSURANCE CJ N/A C 1.00000 1 SAVANNAH PEDIATRIC SPECIALISTS INC PO BOX 23089 SAVANNAH GA 314033089 270788131 MEDICAL SERVICES GA PROVIDENT HEALTH SERVICES INC C 1.00000 1 MEMORIAL HEALTH CORPORATE SERVICES INC 4700 WATERS AVE SAVANNAH GA 31404 900963434 CORPORATE SERVICES GA PROVIDENT HEALTH SERVICES INC C 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER INC S 24764427 SCHEDULE R, PART IV, TAXABLE SUBSIDIARY REPORTING: PROVIDENT 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.