COMMUNITY SERVICES GROUP INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY SERVICES GROUP INC (EIN 58-0633978)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-12
- IRS object ID
- 201303169349305045
- Schema version
- 2012v2.3
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule H
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-12T15:40:54-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRAFFIN & TUCKER LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71309 | AddressLine1 |
| City | ALBANY | City |
| State | GA | State |
| ZIP Code | 317081309 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 580633978 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TY COBB HEALTHCARE SYSTEM INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | TYCO | NameControl |
| Phone | 7062451850 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 367 CLEAR CREEK PARKWAY | AddressLine1 |
| City | LAVONIA | City |
| State | GA | State |
| ZIP Code | 30553 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GREGORY HEARN | Name |
| Title | CEO | Title |
| Phone | 7062451850 | Phone |
| Date Signed | 2013-11-07 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WILLIAM EDWARD PHILLIPS | Name |
| Phone | 2298837878 | Phone |
| Date Prepared | 2013-11-12 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | X | AddressChange |
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TY COBB REGIONAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | GREGORY HEARN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 367 CLEAR CREEK PARKWAY | AddressLine1 |
| City | LAVONIA | City |
| State | GA | State |
| ZIP Code | 30553 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 76940706 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | TYCOBBHEALTHCARE.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1950 | YearFormation |
| State Legal Domicile | GA | StateLegalDomicile |
| Activity Or Mission Description | TO CONTINUOUSLY IMPROVE THE QUALITY OF PRIMARY, LONG-TERM AND HOME CARE WITHIN OUR RESOURCE CAPABILITIES AND TO PROMOTE HEALTHIER LIFESTYLES THROUGH EDUCATION CONSISTENT WITH INDIVIDUAL AND COMMUNITY NEEDS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 947 | TotalNbrEmployees |
| Total Nbr Volunteers | 82 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 78389 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 8933393 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 36407727 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 45401261 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 974576 | InvestmentIncomePriorYear |
| Investment Income Current Year | 798282 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2404958 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2950709 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 39865650 | TotalRevenuePriorYear |
| Total Revenue Current Year | 58083645 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 1347665 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 20801094 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 25468181 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 20009679 | OtherExpensePriorYear |
| Other Expenses Current Year | 30477346 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 40810773 | TotalExpensesPriorYear |
| Total Expenses Current Year | 57293192 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -945123 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 790453 | RevenuesLessExpensesCY |
| Total Assets BOY | 62646905 | TotalAssetsBOY |
| Total Assets EOY | 67648351 | TotalAssetsEOY |
| Total Liabilities BOY | 32048891 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 39572716 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 30598014 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 28075635 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO CONTINUOUSLY IMPROVE THE QUALITY OF PRIMARY, LONG-TERM AND HOME CARE WITHIN OUR RESOURCE CAPABILITIES AND TO PROMOTE HEALTHIER LIFESTYLES THROUGH EDUCATION CONSISTENT WITH INDIVIDUAL AND COMMUNITY NEEDS. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | true | SignificantChange |
| Expense | 53310290 | Expense |
| Grants | 1347665 | Grants |
| Revenue | 47227167 | Revenue |
| Description | TY COBB HEALTHCARE SYSTEM, INC. (THE SYSTEM) OPERATES COBB MEMORIAL HOSPITAL, A 71-BED ACUTE CARE HOSPITAL, BROWN MEMORIAL CONVALESCENT CENTER, A 144-BED LONG-TERM CARE FACILITY, COBB HEALTHCARE CENTER, A 116-BED LONG-TERM CARE FACILITY, THE GABLES AT COBB VILLAGE, A 48-BED ASSISTED LIVING FACILITY, AND TY COBB REGIONAL MEDICAL CENTER, A 56-BED ACUTE CARE HOSPITAL. COBB MEMORIAL HOSPITAL PROVIDED INPATIENT, SWINGBED, OUTPATIENT AND EMERGENCY CARE SERVICES TO RESIDENTS OF FRANKLIN, HART, AND MADISON COUNTIES AND THE SURROUNDING AREAS. THE HOSPITAL HAD 1,566 INPATIENT DAYS AND 6,430 EMERGENCY ROOM VISITS DURING 2012. COBB MEMORIAL HOSPITAL CLOSED IN JUNE 2012 AND THE SYSTEM OPENED TY COBB REGIONAL MEDICAL CENTER. TY COBB REGIONAL MEDICAL CENTER HAD 4,614 INPATIENT DAYS AND 10,763 EMERGENCY ROOM VISITS DURING 2012. THE HOSPITALS PARTICIPATED IN THE MEDICARE AND MEDICAID GOVERNMENT INSURANCE PROGRAMS DURING 2012. UNDER THESE PROGRAMS, THE HOSPITALS PROVIDE CARE TO PATIENTS AT PAYMENT RATES WHICH ARE DETERMINED BY THE FEDERAL AND STATE GOVERNMENTS, REGARDLESS OF THE HOSPITAL'S ACTUAL CHARGES. IN SOME CASES, THESE PROGRAMS PAY THE HOSPITALS AT AMOUNTS WHICH ARE LESS THAN THE COST OF PROVIDING THE SERVICES. THE HOSPITALS ALSO PROVIDE CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS INDIGENT AND CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. CHARGES FOREGONE, AT ESTABLISHED RATES, UNDER THE INDIGENT AND CHARITY CARE POLICY APPROXIMATED 954,000 FOR COBB MEMORIAL HOSPITAL AND 1,148,000 FOR TY COBB REGIONAL MEDICAL CENTER. IN ADDITION, THE HOSPITALS HAD BAD DEBT EXPENSE (PATIENT BILLS THAT WERE NOT COLLECTED) OF APPROXIMATELY 1,770,000 FOR COBB MEMORIAL HOSPITAL AND 5,438,000 FOR TY COBB REGIONAL MEDICAL CENTER. BROWN MEMORIAL CONVALESCENT CENTER PROVIDED OVER 51,300 RESIDENT DAYS DURING 2012. OF THESE DAYS, APPROXIMATELY 88% WERE COVERED BY THE MEDICAID AND MEDICARE INSURANCE PROGRAMS. COBB HEALTHCARE CENTER PROVIDED OVER 39,600 RESIDENT DAYS DURING 2012. OF THESE DAYS, APPROXIMATELY 85% WERE COVERED BY THE MEDICAID AND MEDICARE INSURANCE PROGRAMS. | Description |
| Total Program Service Expense | 53310290 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | true | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | true | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | true | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 168 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 947 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | true | ForeignFinancialAccount |
| Name Of Foreign Country | CJ | NameOfForeignCountry |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | false | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | false | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | GA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KIMBERLY MASSEY | NamePerson |
| Telephone Number | 7062451850 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 367 CLEAR CREEK PARKWAY | AddressLine1 |
| City | LAVONIA | City |
| State | GA | State |
| ZIP Code | 30553 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| GREGORY HEARN | |||||||||
| CHIEF EXEC O | 30.00 | 15.00 | X | X | 18862 | 500 | 0 | ||
| JACK EDMUNDS | |||||||||
| BOARD CHAIR | 3.00 | X | X | 17300 | 500 | 0 | |||
| FORT OGLESBY | |||||||||
| BOARD VICE C | 3.00 | X | X | 11300 | 750 | 0 | |||
| DEBORAH HARBIN | |||||||||
| BOARD MEMBER | 2.00 | X | 10000 | 0 | 0 | ||||
| DON JOHNSON | |||||||||
| BOARD MEMBER | 2.00 | X | 10000 | 0 | 0 | ||||
| HARRIS LITTLE | |||||||||
| BOARD MEMBER | 2.00 | X | 10000 | 0 | 0 | ||||
| F MAYES DAVISON | |||||||||
| BOARD MEMBER | 2.00 | X | 3600 | 0 | 0 | ||||
| MIKE GREEN | |||||||||
| BOARD MEMBER | 2.00 | X | 3200 | 0 | 0 | ||||
| SCOTT HARDIGREE | |||||||||
| BOARD SECRET | 3.00 | X | X | 1600 | 0 | 0 | |||
| CHARLES T ADAMS | |||||||||
| CHIEF EXEC O | 30.00 | 15.00 | X | 623559 | 0 | 31088 | |||
| STEVE BARBER | |||||||||
| CFO | 30.00 | 15.00 | X | 162662 | 0 | 25809 | |||
| DAVID SEAGRAVES | |||||||||
| ADMINISTRATO | 30.00 | 15.00 | 141333 | 70667 | 26101 | X | |||
| JERRY WISE | |||||||||
| ADMINISTRATO | 30.00 | 15.00 | 94987 | 47493 | 24026 | X | |||
| DONNA TONEY | |||||||||
| PHARMACIST | 30.00 | 10.00 | 94862 | 31620 | 23682 | X | |||
| JENNIFER DICKERSON | |||||||||
| PHARMACIST | 30.00 | 10.00 | 82563 | 27521 | 7038 | X | |||
| SANDRA SHUGART | |||||||||
| PHARMACIST | 30.00 | 10.00 | 79245 | 26415 | 18032 | X | |||
| ANGELA HARPOLD | |||||||||
| PHARMACIST | 30.00 | 10.00 | 78433 | 26144 | 20487 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1443506 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 231610 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 176263 | TotalOtherCompensation |
| Number Individuals GT100 K | 9 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation | Address Line2AddressOfContractor/AddressUS/AddressLine2 |
|---|---|---|---|---|---|---|
| GEORGIA ANESTHESIA SERVICES | ||||||
| 1179 MELODY LANE | HARTWELL | GA | 30643 | CRNA/ANESTHESIA | 749997 | |
| THE LONGSTREET CLINIC | ||||||
| 725 JESSE JEWEL PARKWAY | GAINESVILLE | GA | 30301 | 413438 | ||
| CPSI | ||||||
| 6600 WALL STREET | MOBILE | AL | 36695 | BUSINESS OFFICE | 377841 | |
| MORRIS MANNING MARTIN | ||||||
| 1600 ATLANTA FINANCIAL CENTER | ATLANTA | GA | 30326 | LAW FIRM | 320894 | 3343 PEACHTREE RD NE |
| METZ CULINARY | ||||||
| 2 WOODLAND DR | DALLAS | PA | 18612 | FOOD SERVICE | 294746 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 13 | NumberOfContractorsGT100K |
| All Other Contributions | 8933393 | AllOtherContributions |
| Noncash Contributions | 8839898 | NoncashContributions |
| Total Contributions | 8933393 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE REVENUE, NET | Description |
| Total Revenue Column | 45401261 | TotalRevenueColumn |
| Related Or Exempt Function Income | 45401261 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 45401261 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 926045 | TotalRevenueColumn |
| Exclusion | $926,045 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 397133 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 816533 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -419400 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -419400 | TotalRevenueColumn |
| Exclusion | -$419,400 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 17912765 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 18040528 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -127763 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -127763 | TotalRevenueColumn |
| Exclusion | -$127,763 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|
| EHR MEANINGFUL USE INCENTIVE | 1825906 | 1825906 | |
| MANAGEMENT & LAUNDRY FEES | 807231 | $807,231 | |
| CAFETERIA & VENDING | 262166 | $262,166 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 474806 | TotalRevenueColumn |
| Exclusion | $474,806 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 3370109 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 58083645 | TotalRevenueColumn |
| Related Or Exempt Function Income | 47227167 | RelatedOrExemptFunctionIncome |
| Exclusion | $1,923,085 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1347665 | Total |
| Program Services | 1347665 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1096414 | Total |
| Management And General | 1096414 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18792731 | Total |
| Program Services | 17929746 | ProgramServices |
| Management And General | 862985 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 179710 | Total |
| Program Services | 161909 | ProgramServices |
| Management And General | 17801 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3831904 | Total |
| Program Services | 3465428 | ProgramServices |
| Management And General | 366476 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1567422 | Total |
| Program Services | 1445149 | ProgramServices |
| Management And General | 122273 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 125970 | Total |
| Management And General | 125970 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 114250 | Total |
| Management And General | 114250 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 312587 | Total |
| Management And General | 312587 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5200812 | Total |
| Program Services | 4723759 | ProgramServices |
| Management And General | 477053 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10500166 | Total |
| Program Services | 10404849 | ProgramServices |
| Management And General | 95317 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1666910 | Total |
| Program Services | 1566895 | ProgramServices |
| Management And General | 100015 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 206206 | Total |
| Program Services | 113473 | ProgramServices |
| Management And General | 92733 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1604115 | Total |
| Program Services | 1507868 | ProgramServices |
| Management And General | 96247 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 760255 | Total |
| Program Services | 760255 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBTS | 7208275 | 7208275 | |
| MEDICAID PROVIDER TAX | 1646077 | 1646077 | |
| REPAIRS & MAINTENANCE | 903876 | 895107 | 8769 |
| DUES & SUBSCRIPTIONS | 152544 | 58532 | 94012 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 75303 | Total |
| Program Services | 75303 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57293192 | Total |
| Program Services | 53310290 | ProgramServices |
| Management And General | 3982902 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 247021 | BOY |
| EOY | 1563551 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5089 | BOY |
| EOY | 5096 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2761526 | BOY |
| EOY | 4311910 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15761092 | BOY |
| EOY | 7236683 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 843473 | BOY |
| EOY | 1237394 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48759 | BOY |
| EOY | 686976 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 35185055 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 8118018 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10090301 | BOY |
| EOY | 27067037 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27871628 | BOY |
| EOY | 19923067 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3277750 | BOY |
| EOY | 3973717 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 608010 | BOY |
| EOY | 608010 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1132256 | BOY |
| EOY | 1034910 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 62646905 | BOY |
| EOY | 67648351 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3807272 | BOY |
| EOY | 6513876 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27826190 | BOY |
| EOY | 31521154 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 415429 | BOY |
| EOY | 1537686 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32048891 | BOY |
| EOY | 39572716 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30598014 | BOY |
| EOY | 28075635 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30598014 | BOY |
| EOY | 28075635 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 62646905 | BOY |
| EOY | 67648351 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 790453 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 1389860 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -4702692 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $3,156 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 3156 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | SCHEDULE C, PART II-B, LINE 1 | ReturnReference |
| Explanation | TY COBB HEALTHCARE SYSTEM PARTICIPATED IN LOBBYING ACTIVITIES THROUGH MEMBERSHIP IN THE GEORGIA HOSPITAL ASSOCIATION. A PORTION OF THE SYSTEM'S YEARLY DUES IS ALLOCATED TO LOBBYING ACTIVITIES. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1250016 | OtherCostOrOtherBasis |
| Book Value | 1250016 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 20776195 | OtherCostOrOtherBasis |
| Depreciation | 4716704 | Depreciation |
| Book Value | 16059491 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13054428 | OtherCostOrOtherBasis |
| Depreciation | 3358237 | Depreciation |
| Book Value | 9696191 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 104416 | OtherCostOrOtherBasis |
| Depreciation | 43077 | Depreciation |
| Book Value | 61339 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 27067037 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (3 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| TY COBB SEGREGATED PORTFOLIO | 2335846 | F |
| NGTC HEALTH PROPERTIES, LLC | 1370868 | C |
| HOMETOWN HEALTH, LLC | 267003 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 3973717 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| OTHER PAYABLES | $1,347,665 |
| MEDICARE/MEDICAID COST REPORT SETTLE | $190,021 |
| DEFERRED COMPENSATION PLAN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1537686 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | LIABILITY UNDER FIN 48 FOOTNOTE | Identifier |
| Return Reference | SCHEDULE D, PAGE 3, PART X | ReturnReference |
| Explanation | THE SYSTEM APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE SYSTEM ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AN INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF DECEMBER 31, 2012 AND 2011 OF FOR THE YEARS THEN ENDED. THE SYSTEM'S OPEN AUDIT PERIODS ARE FOR THE TAX YEARS ENDED 2009-2011. | Explanation |
Schedule F IRS990ScheduleF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintained |
Accts Actvs Out US Table AcctsActvsOutUSTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | CAYMAN ISLANDS | Region |
| Type Of Activities Conducted | INVESTMENT | TypeOfActivitiesConducted |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Amount Spent | 2771151 | SubtotalAmountSpent |
| Total Amount Spent | 2771151 | TotalAmountSpent |
| Transfer To Foreign Corp | false | TransferToForeignCorp |
| Interest In Foreign Trust | false | InterestInForeignTrust |
| Own Foreign Corp | true | OwnForeignCorp |
| Passive Foreign Invest Co | false | PassiveForeignInvestCo |
| Foreign Partnership | false | ForeignPartnership |
| Boycott Countries | false | BoycottCountries |
Form990 Schedule F Part V Form990ScheduleFPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ACTIVITIES PER REGION | Identifier |
| Return Reference | SCHEDULE F, PAGE 1, PART I, LINE 3 | ReturnReference |
| Explanation | CAYMAN ISLANDS 0 2,771,151 | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 1.25000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 994954 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 994954 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01950 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4932431 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2550030 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2382401 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04680 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 191427 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 104063 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 87364 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00170 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6118812 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2654093 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3464719 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06800 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6118812 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2654093 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3464719 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06800 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1647 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1647 | NetCommunityBuildingExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1647 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1647 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $7,208,275 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 5561172 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 7074210 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1513038 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NGTC HEALTH PROPERT | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | LEASE HOSPITAL FIXED ASSETS | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.18000 | OrganizationProfitOrOwnership |
| Physicans Profit Or Ownership | 0.82000 | PhysicansProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 2 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Website AddressWebsiteAddress | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours |
|---|---|---|---|---|---|---|---|---|
| COBB MEMORIAL HOSPITAL | ||||||||
| 1 | PO BOX 589 | ROYSTON | GA | 30662 | TYCOBBHEALTHCARECOM | X | X | X |
| TY COBB REGIONAL MEDICAL CENTER | ||||||||
| 2 | 367 CLEAR CREEK PARKWAY | LAVONIA | GA | 30553 | TYCOBBHEALTHCARECOM | X | X | X |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)
| Hospital Facility NumberHospitalFacilityNumber | Eligibility Criteria ExplainedEligibilityCriteriaExplained | Uses FPG FreeUsesFPGFree | FPG Free PercentFPGFreePercent | Uses FPG DiscountedUsesFPGDiscounted | FPG Discount PercentFPGDiscountPercent | Explains BasisExplainsBasis | Income LevelIncomeLevel | Explains Application MethodExplainsApplicationMethod | Includes Publicity MeasuresIncludesPublicityMeasures | Posted In Emergency RoomPostedInEmergencyRoom | Posted In Admission OfficePostedInAdmissionOffice | Available On RequestAvailableOnRequest | Actions On NonpaymentActionsOnNonpayment | Collection ActivitiesCollectionActivities | Notified All PatientsNotifiedAllPatients | Nondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicy | Used Other MethodUsedOtherMethod | Amounts Generally BilledAmountsGenerallyBilled | Gross ChargesGrossCharges |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COBB MEMORIAL HOSPITAL | |||||||||||||||||||
| 1 | true | true | 125.0 | true | 200.0 | true | X | true | true | X | X | X | true | false | X | true | X | false | false |
| TY COBB REGIONAL MEDICAL CENTER | |||||||||||||||||||
| 2 | true | true | 125.0 | true | 200.0 | true | X | true | true | X | X | X | true | false | X | true | X | false | false |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 3 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| BROWN MEMORIAL CONVALESCENT CENTER | ||||
| PO BOX 589 | ROYSTON | GA | 30662 | SKILLED NURSING FACILITY |
| COBB HEALTHCARE CENTER | ||||
| PO BOX 589 | ROYSTON | GA | 30662 | SKILLED NURSING FACILITY |
| THE GABLES AT COBB VILLAGE | ||||
| PO BOX 589 | ROYSTON | GA | 30662 | ASSISTED LIVING FACILITY |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE | PART I LINE 7 COLUMN F | IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN F THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990 PART IX LINE 25 FORM 990 PART IX LINE 25 57293192 LESS BAD DEBTS IN PART IX 7208275 ADD EXPENSES REPORTED IN PART VIII 816533 DENOMINATOR FOR COLUMN F 50901450 |
| COSTING METHODOLOGY EXPLANATION | PART I LINE 7 | TY COBB HEALTHCARE SYSTEM INC USED THE WORKSHEETS 12 AND 3 LOCATED IN THE IRS INSTRUCTIONS TO SCHEDULE H OF FORM 990 TO CALCULATE THE COMMUNITY BENEFIT EXPENSE REPORTED IN THE TABLE ON LINE 7 |
| COMMUNITY BUILDING ACTIVITIES | PART II | TY COBB HEALTHCARE SYSTEM INC PROVIDES FREE MONTHLY HEALTH EDUCATION PROGRAMS TO THE PUBLIC TO PROMOTE WELLNESS AND HEALTHIER LIFESTYLES THE OCCUPATIONAL MEDICINE AND WELLNESS DEPARTMENT ALSO PARTICIPATES IN LUNCH AND LEARN AND HEALTH FAIRS THROUGHOUT THE YEAR THAT PROVIDE HEALTH EDUCATION AND SCREENING OPPORTUNITIES FOR EMPLOYEES OF LOCAL BUSINESSES AS WELL AS THE PUBLIC AT LARGE TCHS EMPLOYEES ARE ACTIVE IN AND PROMOTE WELLNESS TO LOCAL CIVIC GROUPS INCLUDING BUT NOT LIMITED TO THE TRICOUNTY DIABETES TASK FORCE CHAMBER OF COMMERCE ROTARY CLUB KIWANIS CLUB AND SERVICE LEAGUES |
| BAD DEBT EXPENSE EXPLANATION | PART III LINE 4 | THE FOLLOWING IS FROM THE FOOTNOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS ALLOWANCE FOR DOUBTFUL ACCOUNTS THE SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE EVALUATION OF THE OVERALL COLLECTIBILITY OF ACCOUNTS RECEIVABLE AS ACCOUNTS ARE KNOWN TO BE UNCOLLECTIBLE THE ACCOUNT IS CHARGED AGAINST THE ALLOWANCE AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT AND WRITTEN OFF TO BAD DEBT EXPENSE |
| MEDICARE EXPLANATION | PART III LINE 8 | MEDICARE SHORTFALL THE FULL AMOUNT OF MEDICARE SHORTFALL 1513038 REPORTED ON LINE 7 SHOULD BE CONSIDERED AS COMMUNITY BENEFIT COBB MEMORIAL HOSPITAL HAS RECEIVED MEDICARE DEPENDENT HOSPITAL STATUS FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES MEDICARE DEPENDENT HOSPITAL STATUS MEANS THAT THE MAJORITY OF THE HOSPITALS INPATIENTS ARE INSURED BY THE MEDICARE PROGRAM THEREFORE THE HOSPITAL IS THE PRIMARY AND A VITAL SOURCE OF HEALTHCARE SERVICES TO MEDICARE PATIENTS IN ITS SERVICE AREA MEDICARE ALLOWABLE COSTS MEDICARE ALLOWABLE COSTS OF CARE REPORTED ON LINE 6 WAS DETERMINED FROM THE MEDICARE COST REPORT FOR COBB MEMORIAL HOSPITAL |
| COLLECTION PRACTICES EXPLANATION | PART III LINE 9B | THE HOSPITAL NOTIFIES PATIENTS OF THE FINANCIAL ASSISTANCE POLICY IN COMMUNICATIONS WITH THE PATIENTS REGARDING THE PATIENTS BILLS NORMAL COLLECTION PRACTICES BASED ON THE PATIENTS RESPONSE WOULD BE CEASED ONCE IT IS DETERMINED THE PATIENT QUALIFIES FOR CHARITY CARE OR FINANCIAL ASSISTANCE |
| NEEDS ASSESSMENT | PART VI | TY COBB HEALTHCARE SYSTEM INC USES DISCHARGE DATA MARKET ANALYSES AND INFORMATION FROM INDIVIDUALS IN THE COMMUNITY TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES RECENTLY THE SYSTEM CONDUCTED A THOROUGH AND ACCURATE MARKET AND NEEDS ASSESSMENT USING BOTH INTERNAL RESOURCES AND PERSONNEL AS WELL AS A QUALIFIED EXTERNAL ORGANIZATION CONSULTANT EXPERIENCED IN COLLECTING ORGANIZING AND ANALYZING THE APPROPRIATE MARKET DEMOGRAPHIC AND HEALTH RELATED INFORMATION NECESSARY TO HELP MAKE THE CORRECT DECISIONS ABOUT THE HEALTHCARE SERVICES NEEDED IN OUR MARKET THE FOLLOWING DATA ELEMENTS WERE OBTAINED DEMOGRAPHIC INFORMATION ECONOMIC DATA HEALTHCARE UTILIZATION DATA HOUSING DATA AND ECONOMIC AND INDUSTRIAL DEVELOPMENT DATA AND TRENDS THE SYSTEMS BOARD INCLUDES COMMUNITY REPRESENTATIVES WHO VOICE THE NEEDS OF THE COMMUNITY SUGGESTION BOXES ARE ALSO AVAILABLE TO PATIENTS VISITORS AND EMPLOYEES TO SUBMIT THOUGHTS OR IDEAS IN 2012 TY COBB HEALTHCARE SYSTEM ALSO ENTERED INTO AN ENGAGEMENT WITH DRAFFIN TUCKER TO OVERSEE THE CHNA FOR 2013 |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI | SELF PAY PATIENTS ARE REFERRED TO A PATIENT FINANCIAL COUNSELOR THE PATIENT FINANCIAL COUNSELOR WILL ASSIST THE PATIENT OR GUARANTOR IN APPLYING FOR FINANCIAL ASSISTANCE IF NO SOURCE OF FINANCIAL ASSISTANCE IS AVAILABLE THE HOSPITAL WILL REVIEW THE ACCOUNT FOR INDIGENT OR CHARITY ALLOWANCE ALSO PATIENTS ARE NOTIFIED OF THE FACILITYS FINANCIAL ASSISTANCE POLICY IN COMMUNICATIONS WITH THE PATIENT ABOUT THEIR BILL |
| COMMUNITY INFORMATION | PART VI | TY COBB HEALTHCARE SYSTEM INC SERVES PRIMARILY FRANKLIN AND HART COUNTIES IN NORTHEAST GEORGIA FRANKLIN COUNTY HAS A POPULATION OF OVER 22000 AND IS HOME TO TY COBB REGIONAL MEDICAL CENTER TCRMC A 56BED COMMUNITY HOSPITAL WHICH OPENED JULY 1 2012 TCRMC WAS BUILT AS A REPLACEMENT HOSPITAL FOR HART COUNTY HOSPITAL IN HARTWELL GA AND COBB MEMORIAL HOSPITAL IN ROYSTON GA HART COUNTY BORDERS FRANKLIN COUNTY AND HAS A POPULATION OF OVER 25000 BOTH HART AND FRANKLIN COUNTY ARE CONSIDERED RURAL AREAS WITH A LOT OF FARMLAND MORE THAN 17 OF FRANKLIN COUNTYS POPULATION AND 18 OF HART COUNTYS POPULATION IS OVER THE AGE OF 65 ABOUT 50 OF THE MARKET IS FEMALE AND ABOUT 80 OF THE TWO COUNTY AREA IS CAUCASIAN |
| HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE | PART VI | TY COBB HEALTHCARE SYSTEM INC HAS AN OPEN MEDICAL STAFF AND THE BOARD OF DIRECTORS CONSIST OF COMMUNITY LEADERS AN EMERGENCY ROOM WAS OPEN 24 HOURS A DAY 7 DAYS A WEEK TO THE PUBLIC REGARDLESS OF THE PATIENTS ABILITY TO PAY |
| LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED | PART VI | GEORGIA |
| ADDITIONAL INFORMATION | PART VI | TY COBB HEALTHCARE SYSTEM INC PROVIDES FREE MONTHLY HEALTH EDUCATION PROGRAMS TO THE PUBLIC TO PROMOTE WELLNESS AND HEALTHIER LIFESTYLES THE OCCUPATIONAL MEDICINE AND WELLNESS DEPARTMENT ALSO PARTICIPATES IN LUNCH AND LEARNS AND HEALTH FAIRS THROUGHOUT THE YEAR THAT PROVIDE HEALTH EDUCATION AND SCREENING OPPORTUNITIES FOR EMPLOYEES OF LOCAL BUSINESSES AS WELL AS THE PUBLIC AT LARGE SYSTEM EMPLOYEES ARE ACTIVE IN AND PROMOTE WELLNESS TO LOCAL CIVIC GROUPS INCLUDING BUT NOT LIMITED TO THE TRI COUNTY DIABETES TASK FORCE CHAMBER OF COMMERCE ROTARY CLUB KIWANIS CLUB AND SERVICE LEAGUES |
| COBB MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 20D | PART V LINE 20D | THE HOSPITAL FACILITY DISCOUNTS GROSS CHARGES FOR FAPELIGIBLE PATIENTS BASED ON A SLIDING SCALE UTILIZING A COMPARISON OF THE PATIENTS HOUSEHOLD INCOME TO FEDERAL POVERTY GUIDELINES |
| TY COBB REGIONAL MEDICAL CENTER LINE NUMBER 2 PART V LINE 20D | PART V LINE 20D | THE HOSPITAL FACILITY DISCOUNTS GROSS CHARGES FOR FAPELIGIBLE PATIENTS BASED ON A SLIDING SCALE UTILIZING A COMPARISON OF THE PATIENTS HOUSEHOLD INCOME TO FEDERAL POVERTY GUIDELINES |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | false | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HART COUNTY HOSPITAL AUTHORITY | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 280 | AddressLine1 |
| City | HARTWELL | City |
| State | GA | State |
| ZIP Code | 30643 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | GOV | IRCSection |
| Amount Of Cash Grant | 1347665 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE I, PAGE 4, PART IV | ReturnReference |
| Explanation | THE CONTIBUTION TO HART COUNTY HOSPITAL AUTHORITY WAS PART OF THE TRANSACTION THAT ALLOWED FOR THE CLOSURE OF TWO AGING FACILITIES: HART COUNTY HOSPITAL IN HARTWELL, GA; AND COBB MEMORIAL HOSPITAL IN ROYSTON, GA; AND THE OPENING OF TY COBB REGIONAL MEDICAL CENTER, A NEW 56-BED ACUTE CARE FACILITY IN LAVONIA, GA, IN ORDER TO BETTER SERVE THE RESIDENTS OF HART, ELBERT, FRANKLIN AND MADISON COUNTIES AND SURROUNDING AREAS. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Discretionary Spending Account | X | DiscretionarySpendingAccount |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | false | SubstantiationRequired |
| Written Employment Contract | X | WrittenEmploymentContract |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|
| CHARLES T ADAMS | ||||||||||
| CHIEF EXEC OFFICER | 233390 | 62500 | 327669 | 9496 | 21592 | 654647 | 240000 | |||
| STEVE BARBER | ||||||||||
| CFO | 153983 | 7815 | 864 | 4815 | 20994 | 188471 | ||||
| DAVID SEAGRAVES | ||||||||||
| ADMINISTRATOR | 133333 | 8000 | 6420 | 19681 | 167434 | 66667 | 4000 | 70667 | ||
| JERRY WISE | ||||||||||
| ADMINISTRATOR | 91069 | 3918 | 3510 | 20516 | 119013 | 45534 | 1959 | 47493 | ||
| DONNA TONEY | ||||||||||
| PHARMACIST | 94862 | 3684 | 19998 | 118544 | 31620 | 31620 | ||||
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| FRINGE OR EXPENSE EXPLANATION | SCHEDULE J, PAGE 1, PART I, LINE 1A | A DISCRETIONARY SPENDING ACCOUNT OF 6,600 WAS PROVIDED TO THE ORGANIZATION'S CEO. IT WAS TREATED AS TAXABLE INCOME. |
| SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS | SCHEDULE J, PAGE 1, PART I, LINE 4 | CHARLES T ADAMS 0 304,069 0 |
| OTHER ADDITIONAL INFORMATION | SCHEDULE J, PART III | CHARLES ADAMS SEPARATED FROM SERVICE DURING THE YEAR AND RECEIVED A LUMP- SUM DISTRIBUTION FROM HIS 457(F) DEFERRED COMPENSATION PLAN. |
Schedule M IRS990ScheduleM
Real Estate Commercial RealEstateCommercial
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 2 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 8839000 | NoncashContribsRptdF990 |
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 898 | NoncashContribsRptdF990 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DOING BUSINESS AS | FORM 990, PAGE 1, ITEM C | BROWN MEMORIAL CONVALESCENT CENTER, COBB HEALTHCARE CENTER, THE GABLES AT COBB VILLAGE, THE FITNESS FIRM OF TCHS, HEALTH WORKS OF TCHS, HOME BASE HEALTH SERVICES, CARNESVILLE FAMILY PRACTICE, TY COBB MUSEUM, COBB MEMORIAL HOSPITAL |
| ANY SIGNIFICANT CHANGES IN CONDUCT FOR PROGRAM SERVICES | FORM 990, PAGE 2, PART III, LINE 3 | COBB MEMORIAL HOSPITAL, LOCATED IN ROYSTON, GA CLOSED IN JUNE 2012. A NEW FACILITY, TY COBB REGIONAL MEDICAL CENTER (OPERATED BY A WHOLLY OWNED DISREGARDED ENTITY, TY COBB REGIONAL MEDICAL CENTER, LLC) OPENED IN LAVONIA, GA. THE NEW FACILITY IS A 56-BED ACUTE CARE HOSPITAL THAT SERVES THE COMMUNITIES PREVIOUSLY SERVED BY COBB MEMORIAL HOSPITAL AND HART COUNTY HOSPITAL. HART COUNTY HOSPITAL, LOCATED IN NEARBY HARTWELL, GA, WAS OPERATED BY THE COBB FOUNDATION, INC., A RELATED PARTY. HART COUNTY HOSPITAL CLOSED IN MAY 2012. |
| FIRST ACCOMPLISHMENT DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4A | COBB REGIONAL MEDICAL CENTER. TY COBB REGIONAL MEDICAL CENTER HAD 4,614 INPATIENT DAYS AND 10,763 EMERGENCY ROOM VISITS DURING 2012. THE HOSPITALS PARTICIPATED IN THE MEDICARE AND MEDICAID GOVERNMENT INSURANCE PROGRAMS DURING 2012. UNDER THESE PROGRAMS, THE HOSPITALS PROVIDE CARE TO PATIENTS AT PAYMENT RATES WHICH ARE DETERMINED BY THE FEDERAL AND STATE GOVERNMENTS, REGARDLESS OF THE HOSPITAL'S ACTUAL CHARGES. IN SOME CASES, THESE PROGRAMS PAY THE HOSPITALS AT AMOUNTS WHICH ARE LESS THAN THE COST OF PROVIDING THE SERVICES. THE HOSPITALS ALSO PROVIDE CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS INDIGENT AND CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. CHARGES FOREGONE, AT ESTABLISHED RATES, UNDER THE INDIGENT AND CHARITY CARE POLICY APPROXIMATED 954,000 FOR COBB MEMORIAL HOSPITAL AND 1,148,000 FOR TY COBB REGIONAL MEDICAL CENTER. IN ADDITION, THE HOSPITALS HAD BAD DEBT EXPENSE (PATIENT BILLS THAT WERE NOT COLLECTED) OF APPROXIMATELY 1,770,000 FOR COBB MEMORIAL HOSPITAL AND 5,438,000 FOR TY COBB REGIONAL MEDICAL CENTER. BROWN MEMORIAL CONVALESCENT CENTER PROVIDED OVER 51,300 RESIDENT DAYS DURING 2012. OF THESE DAYS, APPROXIMATELY 88% WERE COVERED BY THE MEDICAID AND MEDICARE INSURANCE PROGRAMS. COBB HEALTHCARE CENTER PROVIDED OVER 39,600 RESIDENT DAYS DURING 2012. OF THESE DAYS, APPROXIMATELY 85% WERE COVERED BY THE MEDICAID AND MEDICARE INSURANCE PROGRAMS. |
| FINANCIAL ACCOUNTS IN FOREIGN COUNTRIES | FORM 990, PART V, LINE 4B | CAYMAN ISLANDS |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | AFTER MANAGEMENT REVIEW AND APPROVAL, AN ELECTRONIC COPY OF THE FORM 990 WAS EMAILED TO ALL MEMBERS OF THE TYCOBB HEALTHCARE SYSTEM, INC.'S BOARD OF DIRECTORS FOR APPROVAL PRIOR TO SUBMISSION. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | THE BOARD OF DIRECTORS AND CEO MONITOR AND ENFORCE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | THE COMPENSATION OF TY COBB HEALTHCARE SYSTEM, INC.'S CEO IS REVIEWED AND APPROVED BY THE INDEPENDENT BOARD OF DIRECTORS. EXTERNAL COMPARABILITY REPORTING WAS ALSO USED IN THE DETERMINATION OF COMPENSATION OF THE CEO. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | THE COMPENSATION OF TY COBB HEALTHCARE SYSTEM, INC.'S CFO IS REVIEWED AND APPROVED BY THE INDEPENDENT BOARD OF DIRECTORS. EXTERNAL COMPARABILITY REPORTING WAS ALSO USED IN THE DETERMINATION OF COMPENSATION OF THE CFO. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE TY COBB HEALTHCARE SYSTEM, INC.'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE FOR THE PUBLIC TO REVIEW AT THE SYSTEM'S CORPORATE OFFICE UPON REQUEST. |
| OTHER CHANGES IN NET ASSETS EXPLANATION | FORM 990, PART XI, LINE 9 | WHOLLY OWNED CAPTIVE CONSOLIDATED GAIN 629,954 EQUITY TRANSFER - RELATED PARTY 5,332,646 SEE ABOVE |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|
| TY COBB REGIONAL MEDICAL CENTER LLC | |||||||
| 461 COOK STREET | ROYSTON | GA | 30662 | 264541857 | HEALTHCARE | GA | TY COBB |
| COBB ENTERPRISES | |||||||
| 461 COOK STREET | ROYSTON | GA | 30662 | 208356011 | COLLECTION | GA | TY COBB |
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE COBB FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 280 | AddressLine1 |
| City | HARTWELL | City |
| State | GA | State |
| ZIP Code | 30643 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581634125 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivities |
| Legal Domicile State | GA | LegalDomicileState |
| Exempt Code Section | 501C3 | ExemptCodeSection |
| Public Charity Status | 3 | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TY COBB | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | true | ControlledOrg |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOME TOWN HEALTH LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3280 CHERRY OAK LANE SUITE 100 | AddressLine1 |
| City | CUMMING | City |
| State | GA | State |
| ZIP Code | 30041 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 582403678 | EIN |
| Primary Activity | EDUCATION | PrimaryActivity |
| Legal Domicile State | GA | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TY COBB | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeType |
| Share Of Total Income | 82120 | ShareOfTotalIncome |
| Share Of EOY Assets | 267003 | ShareOfEOYAssets |
| Disproportionate Allocations | false | DisproportionateAllocations |
| General Or Managing Partner | false | GeneralOrManagingPartner |
| Percentage Ownership | 0.53710 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| COBB FOUNDATION | ||
| O | 62225 | ACTUAL EXPENSE REIMBURSED |
| COBB FOUNDATION | ||
| P | 10603836 | ACTUAL EXPENSE REIMBURSED |
| COBB FOUNDATION | ||
| B | 5332646 | EQUITY TRANSFER |
| HOME TOWN HEALTH | ||
| F | 53708 | DISTRIBUTION |