FURP.ORG / PUBLIC DATA EXPLORER

TAYLOR REGIONAL HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
TAYLOR REGIONAL HOSPITAL (EIN 58-0655369)
Tax period
2011-04-01 to 2012-03-31
Filed
2013-02-14
IRS object ID
201330459349300513
Schema version
2011v1.5
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)
Timestamp2013-02-14T07:53:54-06:00Timestamp
Tax Period End Date2012-03-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DRAFFIN & TUCKER LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 71309AddressLine1
CityALBANYCity
StateGAState
ZIP Code317081309ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-04-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN580655369EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1TAYLOR REGIONAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlTAYLNameControl
Phone4787830200Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1297AddressLine1
CityHAWKINSVILLECity
StateGAState
ZIP Code31036ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDAN MADDOCKName
TitleCEOTitle
Phone4787830200Phone
Date Signed2013-02-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJACQUELINE G ATKINSName
Phone2298837878Phone
Date Prepared2013-02-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDAN MADDOCK CEONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1297AddressLine1
CityHAWKINSVILLECity
StateGAState
ZIP Code31036ZIPCode
FieldValueIRS element (for citing)
Gross Receipts32218898GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.TAYLORREGIONAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1936YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionTAYLOR REGIONAL HOSPITAL IS A 55 BED, GENERAL, ACUTE-CARE HEALTH INSTITUTION OFFERING A WIDE RANGE OF SPECIALIZED SERVICES AND PROGRAMS.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees446TotalNbrEmployees
Total Nbr Volunteers10TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year664565ContributionsGrantsPriorYear
Contributions Grants Current Year621766ContributionsGrantsCurrentYear
Program Service Revenue Prior Year29581534ProgramServiceRevenuePriorYear
Program Service Revenue CY30843336ProgramServiceRevenueCY
Investment Income Prior Year40780InvestmentIncomePriorYear
Investment Income Current Year43323InvestmentIncomeCurrentYear
Other Revenue Prior Year461489OtherRevenuePriorYear
Other Revenue Current Year587878OtherRevenueCurrentYear
Total Revenue Prior Year30748368TotalRevenuePriorYear
Total Revenue Current Year32096303TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year19918953SalariesEtcPriorYear
Salaries Etc Current Year18431895SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year14141435OtherExpensePriorYear
Other Expenses Current Year16677244OtherExpensesCurrentYear
Total Expenses Prior Year34060388TotalExpensesPriorYear
Total Expenses Current Year35109139TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-3312020RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-3012836RevenuesLessExpensesCY
Total Assets BOY20847809TotalAssetsBOY
Total Assets EOY18323315TotalAssetsEOY
Total Liabilities BOY8286034TotalLiabilitiesBOY
Total Liabilities EOY9488807TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY12561775NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY8834508NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTAYLOR REGIONAL HOSPITAL IS A 55 BED, GENERAL, ACUTE-CARE HEALTH INSTITUTION OFFERING A WIDE RANGE OF SPECIALIZED SERVICES AND PROGRAMS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense31590695Expense
Revenue30988832Revenue
DescriptionTAYLOR REGIONAL HOSPITAL IS A 55 BED, GENERAL, ACUTE-CARE HEALTH INSTITUTION OFFERING A WIDE RANGE OF SPECIALIZED SERVICES AND PROGRAMS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.Description
Total Program Service Expense31590695TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
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 InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
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
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109691NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees446NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
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 VenturetrueInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSANDRA HERNDONNamePerson
Telephone Number4787830200TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1297AddressLine1
CityHAWKINSVILLECity
StateGAState
ZIP Code31036ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
WENDELL DUNAWAY
DIRECTOR1.00X000
RICHARD COLEY
CHAIRMAN1.00X000X
BOB LAMAR
BOARD MEMBER1.00X000
JENNIFER BAKER DVM
BOARD MEMBER1.00X000
MIKE PENN
BOARD MEMBER1.00X000
JOHN D WAY
BOARD MEMBER1.00X000
ROYCE CONNER
SECRETARY/TR1.00X000X
DENNIS VICKERS
VICE CHAIRMA1.00X000X
TED COLEMAN MD
BOARD MEMBER1.00X000
DAN MADDOCK
CEO40.001648321650000X
MELISSA JOHNSON
CNO40.00867820348X
SANDRA HERNDON
COMPTROLLER40.00226820429X
MARTIN ALAN BAGGETT MD
PHYSICIAN40.0041752700X
SANDRA S KOPACZ MD
PHYSICIAN40.0040093600X
MONTE SLATER MD
PHYSICIAN40.0027236400X
ROBERT HEATH MD
PHYSICIAN40.0026963600X
MARK SENGER
PHYSICIAN40.0022127300X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1856032TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs165000TotalReportableCompFrmRltdOrgs
Total Other Compensation777TotalOtherCompensation
Number Individuals GT100 K18NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
EAGLE HOSPITAL PHYSICIANS
1600 NORTH DALLAS PKWY STE 450DALLASTX75248HOSPITALISTS1429402
SOUTHERN CRESCENT ANESTHESIOLOGY
3025 HWY 154 BLDG BNEWNANGA30265ANESTHETIST502422
INNOVATIVE THERAPY CONCEPTS LLC
2 MASHBURN STREET SUITE 102HAWKINSVILLEGA31036PHYSICAL THERAP393760
KING'S MEDICAL COMPANY
1894 GEORGETOWN ROADHUDSONOH44236RADIOLOGY SV289479
HAWKINSVILLE PHYSICIANS SERVICES LLC
PO BOX 82368LAFAYETTELA70598EMERGENCY SV121300
FieldValueIRS element (for citing)
Number Of Contractors GT100 K6NumberOfContractorsGT100K
Government Grants343357GovernmentGrants
All Other Contributions278409AllOtherContributions
Total Contributions621766TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPROGRAM SERVICE REVENUEDescription
Business Code623000BusinessCode
Total Revenue Column30843336TotalRevenueColumn
Related Or Exempt Function Income30843336RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue30843336TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column45108TotalRevenueColumn
Exclusion$45,108ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real39939Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real32562Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real7377Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column7377TotalRevenueColumn
Exclusion$7,377ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other350Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other2135Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-1785Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-1785TotalRevenueColumn
Exclusion-$1,785ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory147293GrossSalesOfInventory
Cost Of Goods Sold87898CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column59395TotalRevenueColumn
Related Or Exempt Function Income59395RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
NONOPER. REV.561000201341$201,341
CAFETERIA SALES722210114855$114,855
WELLNESS CENTER62199090570$90,570

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column114340TotalRevenueColumn
Related Or Exempt Function Income86101RelatedOrExemptFunctionIncome
Exclusion$28,239ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue521106TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column32096303TotalRevenueColumn
Related Or Exempt Function Income30988832RelatedOrExemptFunctionIncome
Exclusion$485,705ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total263713Total
Management And General263713ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total15134941Total
Program Services13708017ProgramServices
Management And General1426924ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1973290Total
Program Services1756623ProgramServices
Management And General216667ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1059951Total
Program Services943568ProgramServices
Management And General116383ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total147275Total
Management And General147275ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total17038Total
Management And General17038ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total108810Total
Management And General108810ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total3962Total
Management And General3962ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4777529Total
Program Services4328320ProgramServices
Management And General449209ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total26288Total
Management And General26288ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1281154Total
Program Services1031982ProgramServices
Management And General249172ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total768542Total
Program Services683809ProgramServices
Management And General84733ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total73304Total
Program Services55954ProgramServices
Management And General17350ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total28683Total
Program Services28397ProgramServices
Management And General286ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total182149Total
Management And General182149ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total976987Total
Program Services869616ProgramServices
Management And General107371ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total300533Total
Program Services300533ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PROVISION FOR BAD DEBTS39429303942930
MEDICAL SUPPLIES26048552604855
REPAIRS AND MAINT77115975594315216
PROVIDER TAXES373605373605

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total292441Total
Program Services206543ProgramServices
Management And General85898ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total35109139Total
Program Services31590695ProgramServices
Management And General3518444ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY692972BOY
EOY311450EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY5830100BOY
EOY3683806EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2469995BOY
EOY3290951EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY13114EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY323300BOY
EOY304485EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY539735BOY
EOY360239EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis28207459LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec20919825LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY6762872BOY
EOY7287634EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY784210BOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY130000BOY
EOY130000EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3314625BOY
EOY2941636EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY20847809BOY
EOY18323315EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4144709BOY
EOY4955395EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY3448416BOY
EOY3953138EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY692909BOY
EOY580274EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY8286034BOY
EOY9488807EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY12561775BOY
EOY8834508EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY12561775BOY
EOY8834508EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY20847809BOY
EOY18323315EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-3012836ReconcilationRevenueExpenses
Reconcilation Other Changes-714431ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade
Form1120 Pol FiledfalseForm1120PolFiled
Form4720 FiledfalseForm4720Filed
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$3,962OtherActivitiesAmount
Total Lobbying Expenditures IIB3962TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax
Substantially All Dues NondeductfalseSubstantiallyAllDuesNondeduct
Only In House LobbyingfalseOnlyInHouseLobbying
Agree To Carryover Prior YearfalseAgreeToCarryoverPriorYear

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
Return ReferenceSCHEDULE C, PART II-B, LINE 1ReturnReference
ExplanationTAYLOR REGIONAL HOSPITAL IS A MEMBER OF INDUSTRY ASSOCIATIONS WHICH LOBBY STATE AND FEDERAL OFFICIALS ON BEHALF OF THE ASSOCIATION'S MEMBERSHIP.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis402337OtherCostOrOtherBasis
Book Value402337BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis12844258OtherCostOrOtherBasis
Depreciation8740760Depreciation
Book Value4103498BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis13212422OtherCostOrOtherBasis
Depreciation12179065Depreciation
Book Value1033357BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1748442OtherCostOrOtherBasis
Book Value1748442BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings7287634TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
CASH VALUE OF LIFE INSURANCE PLAN1463398
INTERCOMPANY RECEIVABLES1276352
PHYSICIAN NOTES RECEIVABLE201886
FieldValueIRS element (for citing)
Total Book Value Other Assets2941636TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
DUE RELATED PARTIES$453,587
THIRD PARTY SETTLEMENTS$126,687
FieldValueIRS element (for citing)
Total Of Amounts580274TotalOfAmounts
Total Revenue32096303TotalRevenue
Total Expenses35109139TotalExpenses
Excess Or Deficit For Year-3012836ExcessOrDeficitForYear
Other$125,177OtherAmount
Total Adjustments125177TotalAdjustments
Excess Or Deficit Per FS-2887659ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt32263789TotRevenueEtcAuditedFinclStmt
Other Revenues167486OtherRevenues
Revenue Not Rptd F990167486RevenueNotRptdF990
Revenue Subtotal32096303RevenueSubtotal
Total Revenue Per Form99032096303TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt35151448TotExpensesEtcAuditedFinclStmt
Other Expenses Included42309OtherExpensesIncluded
Expenses Not Rptd F99042309ExpensesNotRptdF990
Expenses Subtotal35109139ExpensesSubtotal
Total Expenses Per Form99035109139TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
LIABILITY UNDER FIN 48 FOOTNOTESCHEDULE D, PAGE 3, PART XTHE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE. THE HOSPITAL'S WHOLLY OWNED SUBSIDIARY, TAYLOR DEVELOPMENT CORPORATION IS A TAXABLE ENTITY AND IS, THEREFORE, SUBJECT TO FEDERAL INCOME TAXES. TAYLOR DEVELOPMENT CORPORATION FILES A SEPARATE INCOME TAX RETURN. THE HOSPITAL APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE 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 HOSPITAL 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 AND 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 INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF MARCH 31, 2012 AND 2011 OR FOR THE YEARS THEN ENDED. THE HOSPITAL'S OPEN AUDIT PERIODS ARE FOR TAX YEARS ENDED 2009-2011.
RECONCILIATION OF CHANGES - OTHERSCHEDULE D, PAGE 4, PART XI, LINE 8CHANGE IN CASH VALUE OF SERP LIFE INSURANCE 103,721 TAYLOR DEVELOPMENT RENTAL INCOME 31,203 RENTAL EXPENSES 32,562 TAYLOR DEVELOPMENT EXPENSES -9,747 RENTAL EXPENSES -32,562
REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 2DCHANGE IN CASH VALUE OF SERP LIFE INSURANCE 103,721 TAYLOR DEVELOPMENT RENTAL INCOME 31,203 RENTAL EXPENSES 32,562
EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XIII, LINE 2DTAYLOR DEVELOPMENT EXPENSES 9,747 RENTAL EXPENSES 32,562

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CarefalseAmountsBudgetedForCharityCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense387249TotalCommunityBenefitExpense
Net Community Benefit Expense387249NetCommunityBenefitExpense
Percent Of Total Expense0.01240PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense4967283TotalCommunityBenefitExpense
Direct Offsetting Revenue3137622DirectOffsettingRevenue
Net Community Benefit Expense1829661NetCommunityBenefitExpense
Percent Of Total Expense0.05850PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense270875TotalCommunityBenefitExpense
Direct Offsetting Revenue136119DirectOffsettingRevenue
Net Community Benefit Expense134756NetCommunityBenefitExpense
Percent Of Total Expense0.00430PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense5625407TotalCommunityBenefitExpense
Direct Offsetting Revenue3273741DirectOffsettingRevenue
Net Community Benefit Expense2351666NetCommunityBenefitExpense
Percent Of Total Expense0.07520PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense3218589TotalCommunityBenefitExpense
Direct Offsetting Revenue1488374DirectOffsettingRevenue
Net Community Benefit Expense1730215NetCommunityBenefitExpense
Percent Of Total Expense0.05530PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3218589TotalCommunityBenefitExpense
Direct Offsetting Revenue1488374DirectOffsettingRevenue
Net Community Benefit Expense1730215NetCommunityBenefitExpense
Percent Of Total Expense0.05530PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense8843996TotalCommunityBenefitExpense
Direct Offsetting Revenue4762115DirectOffsettingRevenue
Net Community Benefit Expense4081881NetCommunityBenefitExpense
Percent Of Total Expense0.13050PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$3,942,930BadDebtExpenseAmount
Amount Reimbursed By Medicare5626816AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare5051195CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall575621MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
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 Line1TAYLOR REGIONAL HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1PO BOX 1297AddressLine1
Address Line2222 PERRY HIGHWAYAddressLine2
CityHAWKINSVILLECity
StateGAState
ZIP Code31036ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours
OtherHHA, SNF, CLINICSOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1TAYLOR REGIONAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent100.0FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent250.0FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Average Negotiated RatesXAverageNegotiatedRates
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
TAYLOR REGIONAL HOSP SWING BED SNF
P O BOX 1297HAWKINSVILLEGA31036SWING BED SNF
TAYLOR REGIONAL HHA
P O BOX 1297HAWKINSVILLEGA31036HOME HEALTH AGENCY

Form990 Schedule H Part VI Form990ScheduleHPartVI (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
EXCLUSIONS FROM PERCENT OF TOTAL EXPENSEPART I LINE 7 COLUMN FIN 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 35109139 LESS BAD DEBTS IN PART IX 3942930 ADD EXPENSES REPORTED IN PART VIII 120460 DENOMINATOR FOR COLUMN F 31286669
COSTING METHODOLOGY EXPLANATIONPART I LINE 7THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATIONS A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS 2008 SEE ALSO THE DESCRIPTION FOR PART III LINE 4
BAD DEBT EXPENSE EXPLANATIONPART III LINE 4AMOUNTS INCLUDED ON PART II LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT AND WRITTEN OFF TO BAD DEBT EXPENSE EXCERPT FROM AUDITED FINANCIAL STATEMENTS ALLOWANCE FOR DOUBTFUL ACCOUNTS THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE EVALUATION OF THE OVERALL COLLECTIBILITY OF THE ACCOUNTS RECEIVABLE AS ACCOUNTS ARE KNOWN TO BE UNCOLLECTIBLE THE ACCOUNT IS CHARGED AGAINST THE ALLOWANCE
MEDICARE EXPLANATIONPART III LINE 8COSTS FOR PART I LINE 7A AND 7B AND PART III SECTION A LINE 2 WERE CALCULATED USING THE RCC CALCULATED IN WORKSHEET 2
NEEDS ASSESSMENTPART VITHE ORGANIZATION CONDUCTS REGULAR NEEDS ASSESSMENTS THROUGH FORMAL AND INFORMAL SURVEYS AND PROCESSES TAYLOR REGIONAL HAS ONGOING COLLABORATIONS WITH BOTH PUBLIC AND COMMUNITY AGENCIES IN DEVELOPMENT OF A COMMUNITY ASSESSMENT BASED UPON FEEDBACK FROM BOTH TELEPHONE SATISFACTION SURVEYS AS WELL AS COMPLETION OF PAPER SURVEYS OUR TEAM DEVELOPS PLANS TO MEET THE NEEDS OF OUR CLIENTS AND FAMILIES SERVING AN AGING POPULATION THE ORGANIZATION PARTICIPATES WITH THE SILVER SNEAKERS PROGRAM TO ASSIST OUR COMMUNITY MEMBERS WITH A MEANS OF ENHANCING WELLNESS THROUGH EXERCISE AND FELLOWSHIP WITH OTHER PARTICIPANTS OF THE PROGRAM TAYLOR REGIONAL HOSPITAL CONTRIBUTES BOTH FINANCIALLY AND WITH PERSONNEL TO THE ANNUAL RELAY FOR LIFE CANCER PROGRAM THE HOSPITAL BOARD MEMBERS ARE ACTIVE RESIDENTS IN THE COMMUNITY REPRESENTING MANY WALKS OF LIFE INCLUDING LOCAL BUSINESS OWNERS AGRICULTURISTS VETERINARIANS RETIRED PHYSICIANS BOARD MEMBERS REPRESENT THE COMMUNITY PROVIDING FEEDBACK AND RECOMMENDATIONS BASED UPON NEEDS TAYLOR REGIONAL HOSPITAL ACTIVELY PARTICIPATES WITH ARCHWAY PARTNERSHIP A COMMUNITY PROGRAM FROM THE UNIVERSITY SYSTEM OF GEORGIA AS A COMMUNITY PARTNER WORKING WITH ARCHWAY IN HAWKINSVILLEPULASKI COUNTY THE HOSPITAL INTERACTS WITH OTHER REPRESENTATIVES INCLUDING PULASKI COUNTY GOVERNMENT THE HAWKINSVILLE CITY COMMISSION UNITED PULASKI THE BOARD OF EDUCATION AND OTHER LOCAL BUSINESSES AMONG THE ISSUES THE COMMUNITY WILL TAKE ON AS PART OF ARCHWAY ARE EDUCATION LEADERSHIP DEVELOPMENT COMMUNITY HEALTH WORKFORCE HOUSING GOVERNMENT SERVICE DELIVERY AND ECONOMIC DEVELOPMENT
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VIWHEN A PATIENT IS ADMITTED TO TAYLOR REGIONAL HOSPITAL OR TOTAL CHARGES WILL BE GREATER THAN 150000 CASE MANAGEMENT ANDOR REGISTRATION NOTIFIES THE COLLECTIONS COORDINATOR THE COLLECTIONS COORDINATOR MEETS WITH THE PATIENT TO EXPLAIN OUR INDIGENT CARE PROGRAM AND REFERS THE PATIENT TO FIRST SOURCE TAYLOR REGIONAL HOSPITAL IS CONTRACTED WITH FIRST SOURCE WHICH ASSISTS THE PATIENTS WITH COMPLETION OF APPLICATIONS FOR STATE AND FEDERAL ASSISTANCE PROGRAMS IF NEEDED BY THE PATIENT FIRST SOURCE WILL ACCOMPANY THE PATIENTS TO DFCS IF THE PATIENT IS DENIED FOR ASSISTANCE THROUGH ALL LOCAL STATE AND FEDERAL PROGRAMS AND RESIDES IN PULASKI DOOLY WILCOX OR BLECKLEY COUNTY AN INDIGENT CARE APPLICATION IS PROCESSED ACCORDING TO THE FEDERAL POVERTY GUIDELINES IF THE PATIENT DOES NOT QUALIFY FOR ANY OF THE ABOVE ASSISTANCE THE BUSINESS OFFICE WORKS WITH THE PATIENT TO SET UP MONTHLY PAYMENTS
COMMUNITY INFORMATIONPART VITAYLOR REGIONAL HOSPITAL REACHES A PATIENT BASE OF OVER 189000 AND PROVIDES PATIENTS WITH ACCESS TO OVER 94 CREDENTIALED PHYSICIANS REPRESENTING TWENTY FIVE MAJOR SPECIALTIES COMPRISED OF A HOME HEALTH AGENCY DURABLE MEDICAL EQUIPMENT AND OUTREACH PHYSICIAN CLINICS THE ORGANIZATION HAS A SERVICE AREA REACHING COCHRAN VIENNA KATHLEEN EASTMAN ROCHELLE UNADILLA ALONG WITH OTHER OUTLYING COUNTIES
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSEPART VISERVING AN AGING POPULATION THE ORGANIZATION PARTICIPATES WITH THE SILVER SNEAKERS PROGRAM TO ASSIST OUR COMMUNITY MEMBERS WITH A MEANS OF ENHANCING WELLNESS THROUGH EXERCISE AND FELLOWSHIP WITH OTHER PARTICIPANTS OF THE PROGRAM TAYLOR REGIONAL SUPPORTS THE FIGHT AGAINST CANCER BY CONTRIBUTING BOTH FINANCIALLY AND WITH PERSONNEL TO THE ANNUAL RELAY FOR LIFE CANCER PROGRAM THE HOSPITAL BOARD MEMBERS ARE ACTIVE RESIDENTS IN THE COMMUNITY REPRESENTING MANY WALKS OF LIFE INCLUDING LOCAL BUSINESS OWNERS AGRICULTURISTS VETERINARIANS RETIRED PHYSICIANS BOARD MEMBERS REPRESENT THE COMMUNITY PROVIDING FEEDBACK AND RECOMMENDATIONS BASED UPON NEEDS THE MEDICAL STAFF AND VARIOUS HOSPITAL STAFF MEMBERS PARTICIPATE IN COMMUNITY HEALTH FAIRS PROVIDING EDUCATION AND SCREENINGS TO THE PUBLIC

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
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 OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrg
DAN MADDOCK
164832165000164832165000164832
MARTIN ALAN BAGGETT MD
417527417527
SANDRA S KOPACZ MD
400936400936
MONTE SLATER MD
272364272364
ROBERT HEATH MD
269636269636
MARK SENGER
221273221273

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTSIdentifier
Return ReferenceSCHEDULE J, PAGE 1, PART I, LINE 4ReturnReference
ExplanationDAN MADDOCK 0 164,832 0Explanation

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonMARK SENGERNamePerson
Purpose Of LoanSCHOLARSHIP LOANPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$75,000OriginalPrincipalAmount
Balance Due13114BalanceDue
DefaultfalseDefault
Approved By BoardtrueApprovedByBoard
Written AgreementtrueWrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due13114TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
JOHN WAY
BD/BANK BD MBR103484BANK LOANS PYMTSfalse
JOHN WAY
BD/BANK BD MBR1142313BANK CASH BALANCESfalse
ROYCE CONNER
BD/BANK BD MBR56310BANK LOANS PAYMTSfalse
ROYCE CONNER
BD/BANK BD MBR486703BANK CASH BALANCESfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE L PART VReturnReference
ExplanationROYCE CONNER BOARD MEMBER ALSO SERVES AS A MEMBER OF THE BOARD FOR SUNMARK BANK A LOCAL BANK WHICH PROVIDES A NUMBER OF LOANS TO THE ORGANIZATION ADDITIONALLY THE ORGANIZATION MAINTAINS CASH ACCOUNTS WITH THE BANK JOHN WAY BOARD MEMBER ALSO SERVES AS A MEMBER OF THE BOARD FOR PLANTERS BANK A LOCAL BANK WHICH PROVIDES A NUMBER OF LOANS TO THE ORGANIZATION ADDITIONALLY THE ORGANIZATION MAINTAINS CASH ACCOUNTS WITH THE BANKExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ADDITIONAL INFORMATIONFORM 990, PART IIISERVICES AND PROGRAMS INCLUDE ACUTE MEDICAL/SURGICAL, INTENSIVE CARE, MAGNETIC RESONANCE IMAGING, OB/GYN, OUTPATIENT SURGERY CENTER, PHARMACY, DIAGNOSTIC RADIOLOGY, 24-HOUR EMERGENCY SERVICE, SURGERY, PHYSICAL THERAPY, POST-OPERATIVE RECOVERY ROOM, RESPIRATORY SERVICES AND HOME CARE SERVICES. DURING FISCAL YEAR 2012, PATIENT DAYS AT TAYLOR REGIONAL HOSPITAL TOTALED 5,225; DISCHARGES TOTALED 1,550 AND HOME HEALTH VISITS TOTALED 5,604.
MANAGEMENT DELEGATEDFORM 990, PAGE 6, PART VI, LINE 3THE CEO IS EMPLOYED AND COMPENSATED BY TAYLOR MANAGEMENT SERVICES, A FOR PROFIT CORPORATION PROVIDING MANAGEMENT SERVICES TO THE HOSPITAL AND RELATED ORGANIZATIONS.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BA COPY OF THE FORM 990 IS REVIEWED DURING THE BOARD MEETING BY BOARD MEMBERS AND MANAGEMENT BEFORE FILING WITH THE INTERNAL REVENUE SERVICE.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CCONFLICTS ARE DISCLOSED TO THE PRESIDENT OF TAYLOR REGIONAL HOSPITAL OR THE CHAIRMAN OF THE BOARD. A RECOMMENDATION IS MADE BY THE PRESIDENT TO THE BOARD AS TO ACTIONS TO BE TAKEN TO RESOLVE THE CONFLICT. DISMISSAL OF THE INDIVIDUAL OR REMOVAL OF THE CONFLICTED INDIVIDUAL ARE POSSIBLE OPTIONS OUTLINED IN THE CONFLICT OF INTEREST POLICY.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. THE BOARD REVIEWS THE PROPOSED COMPENSATION AGAINST COMPARATIVE DATA. MINUTES OF THE DELIBERATION AND APPROVAL OF THE CEO'S COMPENSATION ARE MAINTAINED.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BTHE CEO OF THE ORGANIZATION REVIEWS AND DETERMINES THE COMPENSATION FOR ALL OTHER MEMBERS OF THE ORGANIZATION.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19TAYLOR REGIONAL HOSPITAL PROVIDES COPIES OF ITS FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST.
RELATED ORGANIZATIONSFORM 990, PAGE 7, PART VIIAVERAGE WEEKLY HOURS DEVOTED TO RELATED ORGANIZATIONS: RICHARD COLEY 1 HOUR ROYCE CONNER 1 HOUR DENNIS VICKERS 1 HOUR TED COLEMAN 1 HOUR BOB LAMAR 1 HOUR MIKE PENN 1 HOUR JOHN WAY 1 HOUR JENNIFER BAKER 1 HOUR DAN MADDOCK 2 HOURS SANDRA HERNDON 1 HOUR
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 5CHANGE IN VALUE OF SERP 103,721 PRIOR PERIOD ADJUSTMENTS ( 818,152) NET DECREASE IN NET ASSETS ( 714,431)

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1TAYLOR MEMORIAL CARE FOUNDATION INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1297AddressLine1
CityHAWKINSVILLECity
StateGAState
ZIP Code31036ZIPCode
FieldValueIRS element (for citing)
EIN581733602EIN
Primary ActivitiesFUNDRSNGPrimaryActivities
Legal Domicile StateGALegalDomicileState
Exempt Code Section501C3ExemptCodeSection
Public Charity Status11APublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1TRHBusinessNameLine1
Business Name Line2TAYLOR REGIONAL HOSPITALBusinessNameLine2
FieldValueIRS element (for citing)
Controlled OrgtrueControlledOrg

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1TAYLOR REGIONAL HEALTH NETWORK LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1297AddressLine1
CityHAWKINSVILLECity
StateGAState
ZIP Code31035ZIPCode
FieldValueIRS element (for citing)
EIN582371021EIN
Primary ActivityMGMTPrimaryActivity
Legal Domicile StateGALegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1TRHBusinessNameLine1
Business Name Line2TAYLOR REGIONAL HOSPITALBusinessNameLine2
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeType
Share Of Total Income7273ShareOfTotalIncome
Share Of EOY Assets143127ShareOfEOYAssets
Disproportionate AllocationsfalseDisproportionateAllocations
General Or Managing PartnerfalseGeneralOrManagingPartner
Percentage Ownership1.00000PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNABusiness Name Line1DirectControllingEntityName/BusinessNameLine1Business Name Line2DirectControllingEntityName/BusinessNameLine2Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
TAYLOR MANAGEMENT SERVICES INC
PO BOX 1297HAWKINSVILLEGA31036582371969MGMTGAN/A
TAYLOR DEVELOPMENT CORP
PO BOX 1297HAWKINSVILLEGA31036581310513MGMTGATRHTAYLOR REGIONAL HOSPITALC CORP31204546121.00000
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
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 OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
TAYLOR MEMORIAL CARE FOUNDATION
L12113NET FUNDS RAISED
TAYLOR MEM CARE FDN TAYLOR DEV COR
MAMOUNTS UNDETERMINED
TAYLOR MANAGEMENT SERVICES
N165000ACTUAL COMPENSATION
TAYLOR MEM CARE FDN TAYLOR DEV COR
NAMOUNTS UNDETERMINED
TAYLOR MNGMT SVCS TAYLOR REG NETWK
MAMOUNTS UNDETERMINED