2013-11-12T15:40:54-06:00 2012-12-31 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2012-01-01 580633978 TY COBB HEALTHCARE SYSTEM INC TYCO 7062451850 367 CLEAR CREEK PARKWAY LAVONIA GA 30553 GREGORY HEARN 7062451850 2013-11-07 true WILLIAM EDWARD PHILLIPS 2298837878 2013-11-12 2012 2016-02-24 21:20:13Z X TY COBB REGIONAL MEDICAL CENTER GREGORY HEARN 367 CLEAR CREEK PARKWAY LAVONIA GA 30553 76940706 false X TYCOBBHEALTHCARE.COM X 1950 GA 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. 7 7 947 82 0 78389 8933393 36407727 45401261 974576 798282 2404958 2950709 39865650 58083645 1347665 0 20801094 25468181 0 0 20009679 30477346 40810773 57293192 -945123 790453 62646905 67648351 32048891 39572716 30598014 28075635 X 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. false true 53310290 1347665 47227167 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. 53310290 true true false true false false false false false false true true false false true true false true false false true false false false false false true true true false true false false false false false false false false true false false false true true true true false false true 168 0 947 true false true CJ false false false false false false false false X 7 7 false false false false false false false true true false false true true false true true false true true true false GA X KIMBERLY MASSEY 7062451850 367 CLEAR CREEK PARKWAY LAVONIA GA 30553 GREGORY HEARN 30.00 15.00 X X 18862 500 0 JACK EDMUNDS 3.00 X X 17300 500 0 FORT OGLESBY 3.00 X X 11300 750 0 DEBORAH HARBIN 2.00 X 10000 0 0 DON JOHNSON 2.00 X 10000 0 0 HARRIS LITTLE 2.00 X 10000 0 0 F MAYES DAVISON 2.00 X 3600 0 0 MIKE GREEN 2.00 X 3200 0 0 SCOTT HARDIGREE 3.00 X X 1600 0 0 CHARLES T ADAMS 30.00 15.00 X 623559 0 31088 STEVE BARBER 30.00 15.00 X 162662 0 25809 DAVID SEAGRAVES 30.00 15.00 X 141333 70667 26101 JERRY WISE 30.00 15.00 X 94987 47493 24026 DONNA TONEY 30.00 10.00 X 94862 31620 23682 JENNIFER DICKERSON 30.00 10.00 X 82563 27521 7038 SANDRA SHUGART 30.00 10.00 X 79245 26415 18032 ANGELA HARPOLD 30.00 10.00 X 78433 26144 20487 1443506 231610 176263 9 false true false 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 3343 PEACHTREE RD NE ATLANTA GA 30326 LAW FIRM 320894 METZ CULINARY 2 WOODLAND DR DALLAS PA 18612 FOOD SERVICE 294746 13 8933393 8839898 8933393 PATIENT SERVICE REVENUE, NET 45401261 45401261 45401261 926045 926045 397133 816533 -419400 -419400 -419400 17912765 18040528 -127763 -127763 -127763 EHR MEANINGFUL USE INCENTIVE 1825906 1825906 MANAGEMENT & LAUNDRY FEES 807231 807231 CAFETERIA & VENDING 262166 262166 474806 474806 3370109 58083645 47227167 1923085 1347665 1347665 1096414 1096414 18792731 17929746 862985 179710 161909 17801 3831904 3465428 366476 1567422 1445149 122273 125970 125970 114250 114250 312587 312587 5200812 4723759 477053 10500166 10404849 95317 1666910 1566895 100015 206206 113473 92733 1604115 1507868 96247 760255 760255 BAD DEBTS 7208275 7208275 MEDICAID PROVIDER TAX 1646077 1646077 REPAIRS & MAINTENANCE 903876 895107 8769 DUES & SUBSCRIPTIONS 152544 58532 94012 75303 75303 57293192 53310290 3982902 0 247021 1563551 5089 5096 2761526 4311910 15761092 7236683 843473 1237394 48759 686976 35185055 8118018 10090301 27067037 27871628 19923067 3277750 3973717 608010 608010 1132256 1034910 62646905 67648351 3807272 6513876 27826190 31521154 415429 1537686 32048891 39572716 X 30598014 28075635 30598014 28075635 62646905 67648351 X 790453 1389860 -4702692 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 3156 3156 false SCHEDULE C, PART II-B, LINE 1 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. 1250016 1250016 20776195 4716704 16059491 13054428 3358237 9696191 104416 43077 61339 27067037 TY COBB SEGREGATED PORTFOLIO 2335846 F NGTC HEALTH PROPERTIES, LLC 1370868 C HOMETOWN HEALTH, LLC 267003 C 3973717 OTHER PAYABLES 1347665 MEDICARE/MEDICAID COST REPORT SETTLE 190021 DEFERRED COMPENSATION PLAN 1537686 X LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X 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. false CAYMAN ISLANDS INVESTMENT 2771151 2771151 false false true false false false ACTIVITIES PER REGION SCHEDULE F, PAGE 1, PART I, LINE 3 CAYMAN ISLANDS 0 2,771,151 true true true X 1.25000 true X true true true false true true 994954 994954 0.01950 4932431 2550030 2382401 0.04680 191427 104063 87364 0.00170 6118812 2654093 3464719 0.06800 6118812 2654093 3464719 0.06800 1647 1647 1647 1647 true 7208275 5561172 7074210 -1513038 X true true NGTC HEALTH PROPERT LEASE HOSPITAL FIXED ASSETS 0.18000 0.82000 2 1 COBB MEMORIAL HOSPITAL

PO BOX 589 ROYSTON GA 30662

TYCOBBHEALTHCARECOM X X X 2 TY COBB REGIONAL MEDICAL CENTER

367 CLEAR CREEK PARKWAY LAVONIA GA 30553

TYCOBBHEALTHCARECOM X X X 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 3 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 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 false HART COUNTY HOSPITAL AUTHORITY PO BOX 280 HARTWELL GA 30643 GOV 1347665 ADDITIONAL INFORMATION SCHEDULE I, PAGE 4, PART IV 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. X true false X X false true false false false false false false false CHARLES T ADAMS 233390 62500 327669 9496 21592 654647 240000 STEVE BARBER 153983 7815 864 4815 20994 188471 DAVID SEAGRAVES 133333 66667 8000 4000 6420 19681 167434 70667 JERRY WISE 91069 45534 3918 1959 3510 20516 119013 47493 DONNA TONEY 94862 31620 3684 19998 118544 31620 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. X 2 8839000 X 1 898 false false false 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 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 THE COBB FOUNDATION PO BOX 280 HARTWELL GA 30643 581634125 HEALTHCARE GA 501C3 3 TY COBB true HOME TOWN HEALTH LLC 3280 CHERRY OAK LANE SUITE 100 CUMMING GA 30041 582403678 EDUCATION GA TY COBB RELATED 82120 267003 false false 0.53710 false true false false false false false false false false false false false false true true true false false 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