2013-01-11T09:11:51-06:00 2012-06-30 580692043 Mauldin & Jenkins LLC P O Box 1877 Macon GA 312021877 990 2011-07-01 208034409 Magnolia Manor of Columbus Inc MAGN 2299249352 2001 South Lee Street Americus GA 31709 Mark Todd 2299249352 2013-01-07 1 Rick Alibozek P00108158 4784648000 2013-01-02 X 2011 2016-03-07 17:11:31Z Mark Todd 2001 South Lee Street Americus GA 31709 18212565 0 X www.magnoliamanor.com X 2007 GA The Corporation is organized to provide long-term care and assisted living services to the sick and elderly in a spiritual setting through the operation of 376 long-term care beds and 44 assisted living beds on a single campus located in Columbus, Georgia. 11 11 534 245 0 0 0 0 19838078 18034588 2555 2306 432743 175671 20273376 18212565 0 0 0 0 8957646 8893589 0 0 0 11495977 10229955 20453623 19123544 -180247 -910979 19738506 22243402 25642801 29058676 -5904295 -6815274 X The Corporation is organized to provide long-term care and assisted living services to the sick and elderly in a spiritual setting through the operation of 376 long-term care beds and 44 assisted living beds on a single campus located in Columbus, Georgia. 0 0 15872934 18210259 Provided long-term care and assisted living services in a spiritual setting. The Corporation has two nursing facilities with a combined 376 beds, along with a 44-bed assisted living facility. The Corporation provided approximately 110,000 days of service during the year. 15872934 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 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 0 0 0 0 1 18 0 534 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 1 1 GA X The Organization 2299249352 2001 South Lee Street Americus GA 31709 James R Buchanan Jr 0.00 X 0 0 0 Ann Harris 0.00 X 0 0 0 Mark Johnson 0.00 X X 0 0 0 Eloise Paschal 0.00 X X 0 0 0 Hon J Taylor Phillips 0.00 X 0 0 0 Chuck Reeves 0.00 X 0 0 0 Edie Vinson 0.00 X 0 0 0 John Stephens 0.00 X 0 0 0 Dr Connie Blanchard 0.00 X 0 0 0 Jean Wheeler 0.00 X 0 0 0 Kip Smith 0.00 X 0 0 0 Mark Todd 40.00 X 0 223846 9976 Diane Wade 40.00 X 0 107789 7288 Jerry Vick 40.00 X 0 164769 8771 Hill Fort 40.00 X 0 176784 9025 Angela Rose 40.00 X 120016 0 7650 120016 673188 42710 1 0 1 0 Aegis Therapies Inc PO Box 8103 Fort Smith AR 72919 Therapy 1381450 Honeywell International Inc 12490 Collections Center Dr Chicago IL 60693 HVAC equipment maintenance 292993 Magnolia Manor Pharmacy PO Box 988 Hawkinsville GA 31036 Pharmaceuticals and consultations 111438 3 Medicare/Medicaid Paym 623000 14433026 14433026 Routine Room/Board 623000 3601562 3601562 18034588 2306 2306 Share of Pharmacy vent 900099 100269 100269 Beauty Shop Revenue 900099 33539 33539 Food Sale Revenue 623000 25479 25479 16384 16384 175671 18212565 18210259 0 2306 7178651 6574087 604564 132248 115148 17100 990356 933006 57350 592334 544723 47611 40816 40816 51612 51612 49569 49569 641 641 1615548 1615548 22875 7787 15088 2159 2159 658103 658103 309871 309871 Contracted Services 3267601 3267601 Supplies 1378888 1378888 Georgia Provider Fee 1176447 1176447 Management Fees 719981 719981 935844 778043 157801 19123544 15872934 3250610 0 354671 109626 2979432 1869304 19535 21620 47531 47465 20498699 576029 16056228 19922670 281109 210379 62338 19738506 22243402 3216838 2762529 1083 1583 17552146 21095811 4872734 5198753 25642801 29058676 X -5904295 -6815274 -5904295 -6815274 19738506 22243402 -910979 0 X X 0 1 1 X 0 X 17929270 17962317 18926848 19838078 18034588 92691101 17929270 17962317 18926848 19838078 18034588 92691101 0 0 0 92691101 1140 541 293 2555 2306 6835 1140 541 293 2555 2306 6835 244155 115616 207487 252666 175671 995595 18174565 18078474 19134628 20093299 18212565 93693531 0.98930 0.98850 0.00010 0.00010 X 1800000 1800000 16772636 390297 16382339 1743207 185732 1557475 182856 182856 19922670 Due to/from related parties 5198753 5198753 Description of Uncertain Tax Positions Under FIN 48: Part X: It is the Corporation's policy to account for any uncertainties in income tax law in accordance with FASB ASC 740-10 "Accounting for Uncertainty in Income Taxes". ASC 740-10 clarifies the accounting for uncertain income tax positions and requires that the Corporation recognize the impact of such a tax position in its financial statements if, upon ultimate settlement, that position is more likely than not to be sustained. Management has evaluated the Corporation's tax positions and concluded that the Corporation has maintained its tax-exempt status and has taken no uncertain tax positions that require adjustment of the financial statements. X 0 0 0 0 0 0 0 0 0 Mark Todd 0 223846 0 0 0 0 0 4477 0 5499 0 233822 0 0 Jerry Vick 0 164769 0 0 0 0 0 3295 0 5476 0 173540 0 0 Hill Fort 0 176784 0 0 0 0 0 3536 0 5489 0 185809 0 0 Form 990, Part VI, Section A, line 3 Management functions are performed by Magnolia Manor, Inc., a related Section 501(c)(3) organization. Magnolia Manor, Inc. is related through common management and governing board. Form 990, Part VI, Section B, line 11 The Form 990 was reviewed by the Organization's President and Senior Vice President for Finance prior to filing. The contents of the Form 990 were presented and explained to the members of the Executive Committee for their review and approval. Form 990, Part VI, Section B, line 12c Board members in general and the Finance Committee in particular are aware of potential conflicts of interest and consider these potential conflicts in making decisions. Form 990, Part VI, Section B, line 15a The CEO is paid entirely from a related Section 501(c)(3) organization. The Board of Trustees establishes the CEO's salary based on industry norms and compensation studies for other similar type organizations. Form 990, Part VI, Section C, line 18 The Organization makes its Form 1023 and Form 990 available to the public upon request at the Organization's Corporate office in Americus, Georgia. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents and conflict of interest policy available to the public upon request at the Organization's Corporate office in Americus, Georgia. The Organization does not receive separate audited financial statements. Review of Financial Statements Form 990, Part XII, Line 2c There was no change in the process for the review of financial statements from the prior year. Magnolia Manor Inc 2001 South Lee Street Americus GA 31709 580911706 Management and operation of long-term care and retirement facilities GA 501(c)(3) Line 9 N/A 0 Magnolia Manor of Macon Supportive Housing Inc 2001 South Lee Street Americus GA 31709 311651955 HUD Supportive housing facility GA 501(c)(3) Line 9 Magnolia Manor Inc 0 Magnolia Manor of Marion County Inc 2001 South Lee Street Americus GA 31709 201220860 Lease and operation of a long-term care facility GA 501(c)(3) Line 9 Magnolia Manor Inc 0 Magnolia Manor of St Simons Inc 2001 South Lee Street Americus GA 31709 201364957 Lease and operation of a long-term care facility and a retirement community GA 501(c)(3) Line 9 Magnolia Manor Inc 0 Magnolia Manor of Macon Inc 2001 South Lee Street Americus GA 31709 261311379 Operation of a retirement facility GA 501(c)(3) Line 9 Magnolia Manor Inc 0 Georgia Pharmacy Ventures 440 Industrial Boulevard Hawkinsville GA 31036 261918757 Provides pharmacy related products and services to Magnolia Manor residents GA Magnolia Manor Inc Related 100269 312599 0 0 0.47500 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1