FURP.ORG / PUBLIC DATA EXPLORER

SOUTHEAST GEORGIA HEALTH SYSTEM INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
SOUTHEAST GEORGIA HEALTH SYSTEM INC (EIN 58-1911751)
Tax period
2012-05-01 to 2013-04-30
Filed
2013-12-13
IRS object ID
201323479349300712
Schema version
2012v2.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-12-13T07:44:03-08:00Timestamp
Tax Period End Date2013-04-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-05-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN581911751EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1KINGS BAY COMM HOSPITALINCBusinessNameLine1
Business Name Line2dba S E GA HEALTH SYSTEM-CAMDENBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlKINGNameControl
Phone9124663395Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12000 Dan Proctor DrAddressLine1
CitySt MarysCity
StateGAState
ZIP Code31558ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMichael D ScherneckName
TitleExec Vice Pres, CFOTitle
Date Signed2013-12-13DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGary R Colberg FACHENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line15030 Riverside DrAddressLine1
CityBrunswickCity
StateGAState
ZIP Code31520ZIPCode
FieldValueIRS element (for citing)
Gross Receipts46547148GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitesghs.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1990YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionSoutheast Georgia Health System will provide safe, quality, accessible, and cost-effective care to meet the health needs of the people and communities it serves.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees335TotalNbrEmployees
Total Nbr Volunteers191TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year37755ContributionsGrantsPriorYear
Contributions Grants Current Year46875ContributionsGrantsCurrentYear
Program Service Revenue Prior Year41985968ProgramServiceRevenuePriorYear
Program Service Revenue CY45876225ProgramServiceRevenueCY
Investment Income Prior Year162143InvestmentIncomePriorYear
Investment Income Current Year157983InvestmentIncomeCurrentYear
Other Revenue Prior Year378541OtherRevenuePriorYear
Other Revenue Current Year466065OtherRevenueCurrentYear
Total Revenue Prior Year42564407TotalRevenuePriorYear
Total Revenue Current Year46547148TotalRevenueCurrentYear
Grants And Similar Amnts CY4050GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year18575063SalariesEtcPriorYear
Salaries Etc Current Year18919732SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year18920713OtherExpensePriorYear
Other Expenses Current Year19369750OtherExpensesCurrentYear
Total Expenses Prior Year37495776TotalExpensesPriorYear
Total Expenses Current Year38293532TotalExpensesCurrentYear
Revenues Less Expenses Prior Year5068631RevenuesLessExpensesPriorYear
Revenues Less Expenses CY8253616RevenuesLessExpensesCY
Total Assets BOY72546646TotalAssetsBOY
Total Assets EOY82443406TotalAssetsEOY
Total Liabilities BOY35568949TotalLiabilitiesBOY
Total Liabilities EOY37569325TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY36977697NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY44874081NetAssetsOrFundBalancesEOY
Mission DescriptionSoutheast Georgia Health System will provide safe, quality, accessible, and cost-effective care to meet the health needs of the people and communities it serves.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense36842155Expense
Revenue45876225Revenue
DescriptionKing's Bay Hospital, D/B/A Southeast Georgia Health System - Camden Campus, is a 40 bed hospital located in southeast Georgia in the city of St. Marys. For the 12 month fiscal period beginning 05/01/2012 and ended 04/30/2013, the medical center had 6,561 inpatient patient days and 758 births. We served 48,599 patients on an outpatient basis and an additional 31,480 patients were seen in the emergency room. Our financial statements include over $14.2 million in free care (includes indigent care, charity care and bad debts).Description
Total Program Service Expense36842155TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvesttrueReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109644NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees335NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMichael DScherneckExecVPCFONamePerson
Telephone Number9124667049TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12415 Parkwood DrAddressLine1
CityBrunswickCity
StateGAState
ZIP Code31520ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
MH Woody Woodside
Board Member2.000.00X000
Robert C Turner
Board Member2.000.00X000
Joanne M Matukaitis FAACVPR
Board Member2.002.00X000
Mitchell T Jones MD
Board Member2.004.00X000
J Vance Hughes
Board Member2.000.00X000X
Michael Hodges
Treasurer4.002.00X000X
Walter McNeely
Secretary2.000.00X000
Mark Bedner
Vice Chair3.000.00X000X
Carl Alexander
Chairman6.000.00X000X
Michael D Scherneck
Exec VP/CFO40.000.000363709114945X
Gary R Colberg FACHE
President & CEO40.000.000672136100020X
Howard Sepp
Assistant Administrator40.000.00026158293529X
Patrick D Ebri
VP, Human Resources40.000.00021566171050X
Elizabeth Gunn
VP, Patient Care Services40.000.00017918958243X
Kevin Smiley
Pharmacy Manager40.000.00131199042585X
Robert D Moore
Pharmicist40.000.00117090047502X
Jeffrey Zawislak
MGR, Rehab Svcs40.000.00106097045768X
Teresa L Meeks
Pt Care Svcs-Op/RN40.000.00103952040225X
Lisa Dickerson
Pt Care Svcs-Admst40.000.0098710044641X
FieldValueIRS element (for citing)
Total Reportable Comp From Org557048TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1692277TotalReportableCompFrmRltdOrgs
Total Other Compensation658508TotalOtherCompensation
Number Individuals GT100 K8NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Cross Country StaffingBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1P O Box 404674AddressLine1
CityAtlantaCity
StateGAState
ZIP Code303844674ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesContract NursingDescriptionOfServices
Compensation125000Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions46875AllOtherContributions
Total Contributions46875TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNet Patient Svc RevenueDescription
Business Code621400BusinessCode
Total Revenue Column45876225TotalRevenueColumn
Related Or Exempt Function Income45876225RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue45876225TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column157583TotalRevenueColumn
Exclusion$157,583ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real294374Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real294374Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column294374TotalRevenueColumn
Exclusion$294,374ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other400Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other400Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column400TotalRevenueColumn
Exclusion$400ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
Other Revenue90009949135$49,135
Cafeteria Sales722210122556$122,556
FieldValueIRS element (for citing)
Total Other Revenue171691TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column46547148TotalRevenueColumn
Related Or Exempt Function Income45876225RelatedOrExemptFunctionIncome
Exclusion$624,048ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total4050Total
Program Services4050ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total14207298Total
Program Services13479632ProgramServices
Management And General727666ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total501514Total
Program Services476840ProgramServices
Management And General24674ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3304041Total
Program Services3141482ProgramServices
Management And General162559ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total906879Total
Program Services862261ProgramServices
Management And General44618ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total14950Total
Management And General14950ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total15465Total
Management And General15465ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5161039Total
Program Services5219937ProgramServices
Management And General-58898ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total434552Total
Management And General434552ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total7224855Total
Program Services7153418ProgramServices
Management And General71437ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total878210Total
Program Services878210ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total53837Total
Program Services42558ProgramServices
Management And General11279ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total1670606Total
Program Services1670606ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2929107Total
Program Services2929107ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total362414Total
Program Services362414ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Employee Recruiting94399439
Licenses/Permits28296252213075
Ambulance5969759697
Provider Taxes519386519386

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total7897Total
Program Services7897ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total38293532Total
Program Services36842155ProgramServices
Management And General1451377ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY426417BOY
EOY1263406EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY6956155BOY
EOY7417876EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY803133BOY
EOY955122EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY242042BOY
EOY281319EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis67927388LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec22523927LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY46301065BOY
EOY45403461EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY3956400BOY
EOY4522324EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY13425662BOY
EOY21956451EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY435772BOY
EOY643447EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY72546646BOY
EOY82443406EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5053212BOY
EOY7067281EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
EOY370167EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY30382675BOY
EOY30046163EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY133062BOY
EOY85714EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY35568949BOY
EOY37569325EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY36977697BOY
EOY44874081EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY36977697BOY
EOY44874081EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY72546646BOY
EOY82443406EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses8253616ReconcilationRevenueExpenses
Reconcilation Prior Adjustment-357232ReconcilationPriorAdjustment
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1156762OtherCostOrOtherBasis
Book Value1156762BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis43430276OtherCostOrOtherBasis
Depreciation7138377Depreciation
Book Value36291899BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis21292662OtherCostOrOtherBasis
Depreciation15236447Depreciation
Book Value6056215BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2047688OtherCostOrOtherBasis
Depreciation149103Depreciation
Book Value1898585BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings45403461TotalOfBookValueLandBuildings
Total Of Book Value Program Related21956451TotalOfBookValueProgramRelated

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
Description2000-3500 Lease Obligation L/TDescription
Amount$85,714Amount
FieldValueIRS element (for citing)
Total Of Amounts85714TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt46547148TotRevenueEtcAuditedFinclStmt
Revenue Subtotal46547148RevenueSubtotal
Total Revenue Per Form99046547148TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt38293532TotExpensesEtcAuditedFinclStmt
Expenses Subtotal38293532ExpensesSubtotal
Total Expenses Per Form99038293532TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierPart XIdentifier
Return ReferencePart X : FIN48 FootnoteReturnReference
ExplanationOn May 1, 2009, Southeast Georgia Health System adopted the uncertain tax positions provisions of FASB ASC Topic 740 ("ASC 740"), Income Taxes, which addresses the determination of whether tax benefits claimed or expected to be claimed on a tax return should be recorded in the combined financial statements. Under ASC 740-10-25, Southeast Georgia Health System may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by taxing authorities based on the technical merits of the position. The tax benefits recognized in the combined financial statements from such a position are measured based on the largest benefit that has a greater than fifty percent likelihood of being realized upon ultimate settlement. ASC 740 also provides guidance on de-recognition, classification, interest and penalties on income taxes, and accounting in interim periods. The System has determined that it does not have any material unrecognized tax benefits or obligations as of April 30, 2013 and 2012, respectively. Fiscal years ending on and after April 30, 2010 remain subject to examination by federal and state tax authorities.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage125.000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2638264TotalCommunityBenefitExpense
Direct Offsetting Revenue1620508DirectOffsettingRevenue
Net Community Benefit Expense1017756NetCommunityBenefitExpense
Percent Of Total Expense0.02660PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense4736818TotalCommunityBenefitExpense
Direct Offsetting Revenue4111131DirectOffsettingRevenue
Net Community Benefit Expense625687NetCommunityBenefitExpense
Percent Of Total Expense0.01630PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense114717TotalCommunityBenefitExpense
Direct Offsetting Revenue89477DirectOffsettingRevenue
Net Community Benefit Expense25240NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense7489799TotalCommunityBenefitExpense
Direct Offsetting Revenue5821116DirectOffsettingRevenue
Net Community Benefit Expense1668683NetCommunityBenefitExpense
Percent Of Total Expense0.04360PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense16200TotalCommunityBenefitExpense
Net Community Benefit Expense16200NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense16200TotalCommunityBenefitExpense
Net Community Benefit Expense16200NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense7505999TotalCommunityBenefitExpense
Direct Offsetting Revenue5821116DirectOffsettingRevenue
Net Community Benefit Expense1684883NetCommunityBenefitExpense
Percent Of Total Expense0.04400PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$3,225,685BadDebtExpenseAmount
Amount Attributable To522561AmountAttributableTo
Amount Reimbursed By Medicare8588746AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare8687656CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-98910MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Kings Bay Comm Hospital IncBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1d/b/a SGHS-Camden 2000 Dan ProAddressLine1
CitySt MarysCity
StateGAState
ZIP Code31558ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Kings Bay Comm Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into AccountfalseTakeIntoAccount
Other FacilitiesfalseOtherFacilities
CHNA Widely AvailablefalseCHNAWidelyAvailable
All Needs AddressedtrueAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
File Form4720 Report Excise TaxfalseFileForm4720ReportExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent125.0000FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent200.0000FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Other FactorsXOtherFactors
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On NonpaymenttrueActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Collection ActivitiesfalseCollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Other Actions TakenXOtherActionsTaken
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part VI - States Where Community Benefit Report FiledGA
Part VI - Community Building ActivitiesOur community efforts resulted in patients being served by our Wellness on Wheels (WOW) mobile health vehicle which provides free screening (mammography, dexascan, blood pressure and blood sugar, hearing, vaccinations), and Community Care Center, a pediatric center that is dedicated to the health care needs of our Medicaid population. These programs and many others form the foundation of our commitment to community health improvement.Wellness on Wheels (WOW) mobile health vehicle is our mobile "health care on wheels" that travels and delivers care throughout the nine county region. The WOW operates mostly Monday through Saturday and some Sunday's, as requested and serves a different location each week.. Staffed by our expert providers; the WOW provides a broad range of free services: mammography, dexascan, blood pressure and blood sugar, hearing, cholesterol screenings to basic health care check-ups, medical exams, and vaccinations. In addition to providing medical care, our financial counselor assist patients in applying for a variety of community assistance programs. Our financial counselors work with individuals to understand their unique needs and assist them in applying for federal, state, and local programs they may qualify for, including Medicaid and pharmaceutical assistance, food stamps, and the Women, Infants and Children (WIC) program. Our community partners are critical to helping us improve the health and well-being of the greater coastal Georgia region. Together, we can combine resources and strengths, positively impacting the greatest number of people. By working closely with community leaders, we also build a greater sense of community and a shared commitment toward our common goal of improving the community's health. We're proud of our partners.Community partners include:Coastal Medical Access ProgramCoastal Health DistrictCoastal Coalition of ChildrenGolden Isles Child Advocacy CenterOur vice president responsible for ancillary services and our administrative resident coordinates with area high schools to offer an Explorer Post program that brings awareness to high school students of the job opportunities in the health care field. Our director of volunteer services also coordinates and works with area high school students on a shadowing program and promote health careers at their annual information fairs at the local high schools. Employees in the CommunityEvery year, Southeast Georgia Health System unites around corporate-wide efforts: Ringing bells for the Salvation Army; fundraising for the American Cancer Society, participating in our local United Way Campaign and so much more.At Southeast Georgia Health System, it's important to us to give back to our community. In addition to team member United Way donations and volunteer time at Relay For Life and other sponsored events, our team members participate in a variety of community service initiatives, from Habitat for Humanity to the Boys and Girls Club of Southeast Georgia to local student mentoring programs.
Part VI - Community InformationKing's Bay Community Hospital, Inc., is located in St.Marys, Georgia. The primary service area for the King's Bay Community Hospital, Inc., is Camden County which had an approximate population of 50,513 according to the U.S. Census Bureau estimates for 2010. King's Bay Community Hospital, Inc., derived approximately 87 % of its admissions from Camden County. The King's Bay Community Hospital, Inc., secondary service area includes Charlton and Brantley Counties in Georgia and Nassau County in Northeast Florida, with a combined population of 103,896 according to the U.S. Census Bureau estimates for 2010. King's Bay Community Hospital, Inc., is the only hospital in Camden County. Other hospitals in the secondary service area are Charlton Memorial Hospital, a 25 bed critical access hospital located in Folkston(Charlton County), Georgia, and Baptist Medical Center, Nassau, a 54 bed primary care hospital located in Fernandina Beach, Florida.
Part VI - Patient Education of Eligibility for Assistance*Southeast Georgia Health System's Financial Assistance Program (Indigent/Charity Policy) is advertised by signage in Admissions, the Emergency Care Center and the Business Office. Program information is also contained periodically in Southeast Georgia Health System's healthcare magazine which is distributed throughout the community.*The standard registration packet for all patients contains a printed form describing the Financial Assistance Program and the application process. The Financial Assistance process is further explained to the patients by the Registrars during the registration process. Additionally, patients being admitted as an inpatient are provided an information booklet which further details the Financial Assistance Program relating to the inability to pay for medical costs.*Financial Counselors in Admissions engage patients/financially responsible persons and investigate repayment options for medical costs incurred by patients being admitted to an inpatient status who display no identifiable means of paying for medical services through a third party insurer or other source. Contract staff are available to assist patients with United States Social Security Disability and/or Supplemental Income programs. Financial Counselors will assist patients in the application process for other federal and state public assistance programs and if ineligible, will promote Southeast Georgia Health System's internal financial assistance program as an additional option.*All billing statements address the patient's potential inability to pay for medical services by advertising Southeast Georgia Health System's Financial Assistance Program on the front and back of each statement mailer.*Business Office reception and telephone inquiry staff educate and promote Southeast Georgia Health System's Financial Assistance Program and distribute applications when a patient has indicated financial hardship, unemployment or the need for a low monthly repayment plan.*Financial Assistance Program information is contained on Southeast Georgia Health System's website with the ability for the patient to print an application for their use.*Financial Assistance Program information and applications are also provided by collection staff and collection subcontractors upon indication of a patient's financial need or inability to pay for medical services. Federal and state public assistance programs are suggested as well.
Part VI - Needs AssessmentAt King's Bay Community Hospital,Inc., our goal is to strengthen the health and well-being of our patients and neighbors, as well as the broader community. King's Bay Community Hospital,Inc., D/B/A Southeast Georgia Health System-Camden Campus, provided over $2.7 million in community benefits, which is more important to building the vitality of our community than ever. The services we provide are essential to not only the community's overall health, but also to the quality of life of every resident. This belief is ingrained in our culture, from our volunteer King's Bay Community Hospital,Inc., board to our physicians and nurses, staff, auxiliary volunteers, and our Southeast Georgia Health System Foundation.We participate in informal community needs assessments regularly, collaborating with local agencies, schools, and community groups. The results help us determine our short- and long-term priorities as well as strategies for improving community health. Our leadership team is involved with several community activities and on boards. These range from the Rotaries to the International Seafarers program to the Coastal Medical Access Program which serves the under-and uninsured in our community and beyond.
Part V, Line 20d - Other Billing Determination of Individuals Without InsuranceSoutheast Georgia Health System medical charges are the same for all patients and are not tiered by payer source. Patients incurring financial liabilities whether insured or uninsured are provided discount incentives for resolving outstanding balances. A substantial prompt pay discount which is the equivalent of our average managed care insurance contracted discount rate is offered for patient balances. Also, patients demonstrating a diminished ability to pay through full financial disclosure and repayment analysis are considered for settlement discounts which may exceed or be equivalent to Medicare rates.Number of Hospital Faciltiy - 1
Part V, Line 18e - Other Actions Took Before Any Collection ActionsCollection agencies are required to promote Southeast Georgia Health System's Financial Assistance Program when the debtor has demonstrated an inability to pay in response to collection activity. Repayment plans are allowed and monthly payments can be modified to align with the debtor's resources. At the end of ninety days of collection activity from the date of debt referral, collection agencies are required to assess the debtor's ability to pay based upon their response or lack of response in meeting their financial obligation. Debt identified as having no collection potential or an identifiable source for repayment will be closed and returned to Southeast Georgia Health System as "uncollectible" and all collection activity ceases.Number of Hospital Faciltiy - 1
Part V, Line 14g - Other Means Hospital Facility Publicized the PolicyFor patients seeking medical care, Southeast Georgia Health System does process applications and issue approvals prior to the rendering of services upon completion of a financial assistance application and provision of supporting documentation. In situations where medical care is emergent and the patient is receiving or has just received services, the application process can be initiated at the time of service but processing and adjudication cannot occur until supporting documentation such as the most current tax return, paycheck stubs, social security payments and financial assets such as savings, investments, rental income or income producing property are investigated. Household income and dependents supported are factored into the eligibility criteria. The patient's residence is not considered in the determination of eligibility.Number of Hospital Faciltiy - 1
Part V, Line 12h - Other Factors Used in Determing Amounts Charged PatientsSoutheast Georgia Health System medical charges are the same for all patients and are not tiered by payer source. Patients incurring financial liabilities whether insured or uninsured are provided discount incentives for resolving outstanding balances.Number of Hospital Faciltiy - 1
Part III, Line 8 - Explanation Of Shortfall As Community BenefitThe Hospital Authority believes that the shortfall in Medicare program funding does represent a community benefit as the shortfall has arisen primarily as a result of the Hospital Authority's decision to support the community with certain programs and services which would not otherwise be available if it were not for the Hospital Authority's decision to support the range of services irrespective of the payments provided under the Medicare program.
Part III, Line 4 - Bad Debt ExpenseNet patient service revenue is reported at the estimated net realizable amounts from patients, third-party payors, and others as services are rendered, including estimated retroactive adjustments under reimbursement agreements with third-party payors, and provision for bad debts. Retroactive third-party payor settlements and bad debt adjustments are accrued on an estimated basis in the period the related services are rendered and adjusted in future periods as final settlements are determined. The cost value of Bad Debts was determined by multiplying Bad Debt measured on a gross charge basis by the overall cost to charge ratio developed on the Medicare Cost Report. The amount estimated to have been elibible for financial assistance was determined by multiplying Bad Debt Expense,(at cost), by the poverty rate for Camden County, Georgia.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgtrueCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgstrueCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Robert D Moore
Pharmicist11529018001322334279164592
Patrick D Ebri
VP, Human Resources17975735904337453730528671110346
Michael D Scherneck
Exec VP/CFO30086762842892042574147865452105
Kevin Smiley
Pharmacy Manager131199787234713173784
Jeffrey Zawislak
MGR, Rehab Svcs10196441331207533693151865
Howard Sepp
Assistant Administrator230197313855972633803355111
Gary R Colberg FACHE
President & CEO4828351893014870051320772156
Elizabeth Gunn
VP, Patient Care Services17581533743816720076237432

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSch J, Part I, Line 6bIdentifier
Return ReferencePart I, Line 6b: Explanation of organization compensation contingent on net earnings from related orReturnReference
ExplanationCompensation contingent on Net Earnings of the organization: Certain members of Management participate in a Management Incentive Plan which is based on a variety of managerial, quality and financial performance indicators. However, compensation is provided under that plan only if a certain net earnings threshold is met.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableExcept through the normal I.R.S/ Form 990 inspection process, King's Bay Community Hospital D/B/A Southeast Georgia Helath System Camden has not established a standard process for making its governing documents, conflict of interest policy and financial statements available to the public.
Form 990, Part VI, Line 15bForm 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesAs employees of Southeast Georgia Health System, the compensation amounts paid to the individual serving in the capacity as Chief Executive Officer, Executive Director and/or other top management officials and officers are determined based on comparative survey/market data compiled by an independent consulting firm specializing in executive and employee compensation matters. The findings and recommendation of the consultant are reviewed with the Compensation Committee and/or the Executive Compensation Committee of Southeast Georgia Health System which in turn makes recommendations to the full Authority (i.e., Board) of Southeast Georgia Health System which ultimately approves those compensation amounts. In addition, the compensation amounts for those key employees included on Schedule J who receive compensation directly from the organization are determined based on comparative survey/market data compiled by an independent consulting firm specializing in executive and employee compensation matters. The findings and recommendation of the consultant are reviewed with the Human Resource Committee of Southeast Georgia Health System which in turn makes recommendations to the full Authority (i.e., Board) of Southeast Georgia Health System which ultimately approves those compensation amounts.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsKing's Bay Community Hospital,Inc d/b/a Southeast Georgia Health System Camden has adopted the conflict-of-interest, whistleblower, and document retention and destruction policies of The Glynn-Brunswick Memorial Hospital Authority d/b/a Southeast Georgia Health System, the sole corporate member of King's Bay Community Hospital, Inc. Services,Inc. Under the conflict-of-interest policy, the Compliance Department requires all members of the Board of Directors, officers and key employees to report any potential conflicts on an annual basis.
Form 990, Part VI, Line 11bForm 990, Part VI, Line 11b: Form 990 Review ProcessA draft electronic copy of Form 990 was provided to the members of the Board of Directors prior to being filed with the Internal Revenue Service. Management reviewed Form 990 with the Hospital Authority at a subsequent meeting and addressed all questions and recommendations that the Hospital Authority raised.
Form 990, Part VI, Line 6Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderGlynn-Brunswick Memorial Hospital Authority, EIN (58-6000498), is the sole corporate member of King's Bay Community Hospital, Inc.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
SE Georgia Health System Foundation Inc
2415 Parkwood DrBrunswickGA31520582125644Charitable FoundationGA501(c)(3)11Glynn-Brunswick Memorial Hosp Authorityfalse
Cooperative Healthcare Svcs Inc
2415 Parkwood DrBrunswickGA31520010594994Physician and Immediate Care FacilitiesGA501(c)(3)11Glynn-Brunswick Memorial Hosp Authorityfalse
Glynn-Bwk Mem Hosp DBA
SE GA Health System-BrunswickBrunswickGA31520586000498Inpatient and Outpatient Healthcare ServicesGA501(c)(3)3falseN/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg