2013-05-14T17:33:14-05:00 2012-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2011-10-01 581519913 HAMILTON HEALTH CARE SYSTEM INC HAMI 7062726115 PO BOX 1168 DALTON GA 307221168 GARY L HOWARD 7062726115 2013-05-14 AMY BIBBY P00445891 8282542254 2011 2016-02-24 21:20:13Z GARY L HOWARD PO BOX 1168 DALTON GA 307221168 65635232 0 X WWW.HAMILTONHEALTH.COM X 1983 GA TO PROVIDE SUPPORT FOR AFFILIATED TAX-EXEMPT ORGANIZATIONS. 11 10 584 11 0 0 0 0 12626823 12069133 7374931 4036715 0 0 20001754 16105848 0 0 0 0 9898643 9500459 0 0 0 3061139 3639926 12959782 13140385 7041972 2965463 124575804 130585524 3622166 4158368 120953638 126427156 X THE SYSTEM PROVIDES LEADERSHIP TO MEET THE HEALTH CARE NEEDS OF THE AREA WITH SERVICES THAT ADVANCE THE QUALITY AND DIGNITY OF LIFE. THE ORGANIZATION SERVES AS THE PARENT CORPORATION FOR HAMILTON MEDICAL CENTER AND OTHER HEALTH-RELATED ENTITIES. THE ORGANIZATION MANAGES RESOURCES IN A MANNER THAT PROMOTES COMMUNITY TRUST AND ASSURES CONTINUED FINANCIAL VIABILITY. 0 0 12614770 12069133 PROVIDED SUPPORT FOR AFFILIATED TAX-EXEMPT ORGANIZATIONS LISTED IN SCHEDULE A, PART I. 12614770 1 0 0 1 0 0 0 0 0 0 1 1 1 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 24 0 1 584 1 0 0 0 0 0 0 0 0 0 0 0 X 11 10 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 GA X JOSEPH L MCGUIRE 7062782105 1200 MEMORIAL DRIVE DALTON GA 30720 G LAMAR LYLE 1.00 X X 0 0 0 ROBERT M CHANDLER 1.00 X X 0 0 0 DON W ADCOCK 1.00 X 0 0 0 CHARLES H HERNDON JR MD 1.00 X 0 0 0 BRYAN E MCALLISTER 1.00 X 0 0 0 WILLIAM H PULLEN MD 1.00 X 0 0 0 DOROTHY B REICH 1.00 X 0 0 0 HENRY C THARPE JR 1.00 X 0 0 0 JACKSON P TURNER 1.00 X 0 0 0 LUIS M VIAMONTE MD 1.00 X 0 0 0 GARY A MIDDLETON 1.00 X 0 0 0 JEFFREY D MYERS 40.00 X X 562536 0 129255 GARY L HOWARD 40.00 X 416982 0 94021 JOSEPH L MCGUIRE 40.00 X 194039 0 53427 MARCIA P CASTEEL 40.00 X 133547 0 6008 PATRICE FERKO 40.00 X 107742 0 16313 1414846 0 299024 5 0 1 0 ADVISORY BOARD CO PO BOX 79461 BALTIMORE MD 21279 CONSULTING FEES 314975 MINOR BELL NEAL PC PO BOX 2586 DALTON GA 30722 LEGAL 282615 SIEMENS MEDICAL SOLUTIONS PO BOX 120001 DALLAS TX 75312 PURCHASED SERVICES 142640 LAMAR TEXTILES LTD PS PO BOX 96030 BATON ROUGE LA 70896 PURCHASED SERVICES 109022 4 MANAGEMENT FEES 900099 6148026 6148026 AFFILIATE STAFFING 900099 5921107 5921107 12069133 1715370 1715370 51849889 840 49529384 0 2320505 840 2321345 2321345 16105848 12069133 0 4036715 1173557 1173557 7330429 7330429 122283 122283 262038 262038 612152 612152 200004 200004 302672 302672 28454 28454 16141 16141 318395 318395 1440492 1440492 502325 502325 640577 640577 59595 59595 7568 7568 60133 60133 27113 27113 MISCELLANEOUS 36457 45382 -8925 13140385 12614770 525615 0 1934994 788257 2070440 6809313 6178449 7011059 8132459 4259036 120851 94165 1817516 484602 1385312 1332914 72223931 91789292 32529368 18501488 124575804 130585524 855263 876420 2766903 3281948 3622166 4158368 X 120953638 126427156 120953638 126427156 124575804 130585524 X 2965463 2508055 X X 0 1 1 X 0 X X X 0 0 0 HAMILTON AMBULATORY SURGERY CENTER 582654791 3 1 1 1 0 HAMILTON MEDICAL CENTER INC 581519911 3 1 1 1 0 HAMILTON EMERGENCY MEDICAL SERVICES INC 581651002 9 1 1 1 475000 HLTC INC 582341574 9 1 1 1 750000 MURRAY MEDICAL CENTER INC 582341574 3 1 1 1 0 ROYAL OAK COMMUNITY LTD 582373427 3 1 1 1 300000 WHITFIELD HEALTHCARE FOUNDATION INC 510175056 3 1 1 1 0 WHITFIELD PLACE INC 582103085 9 1 1 1 25000 DALTON SENIOR HOUSING INC 581518011 9 1 1 1 25000 9 1575000 0 0 0 0 0 0 0 0 1 16141 16141 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND THE GEORGIA HOSPITAL ASSOCIATION. EACH YEAR, A PORTION OF DUES PAID TO THESE ORGANIZATONS IS ALLOCATED TO LOBBYING EFFORTS ENGAGED BY THESE ORGANIZATIONS ON BEHALF OF THEIR MEMBERSHIP BODIES. THE AMOUNT ON LINE 1(I) ABOVE IS AN ESTIMATION OF THE LOBBYING PORTION OF DUES PAID FOR THE FISCAL YEAR. 1141372 1141372 36267 32476 3791 639877 452126 187751 1332914 TIMBERLAND INVESTMENTS 4542843 F REAL ESTATE 4716990 F LONG/SHORT FUND OF FUNDS 9241655 F 18501488 DEFERRED COMPENSATION 1649852 ACCRUED PENSION COST 1632096 3281948 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION HAS ADOPTED PROCEDURES FOR DETERMINING THE EXISTENCE OF UNCERTAIN TAX POSITIONS, AND THE RELATED TIMING AND AMOUNT OF THEIR IMPACT ON THE FINANCIAL STATEMENTS, AND DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2012. X X 1 1 X X X 0 1 0 0 0 1 1 0 0 JEFFREY D MYERS 395800 0 120488 0 46248 0 19769 0 109486 0 691791 0 0 0 GARY L HOWARD 274997 0 45508 0 96477 0 12824 0 81197 0 511003 0 46989 0 JOSEPH L MCGUIRE 147536 0 22827 0 23676 0 9730 0 43697 0 247466 0 11773 0 PART I, LINE 4B THE FOLLOWING PERSON RECEIVED CURRENT YEAR DEFERRED COMPENSATION ACCRUALS FROM NON-QUALIFIED PLANS: - JEFFREY D. MYERS - $ 6,500 PART I, LINE 6 THE ORGANIZATION HAS A MANAGEMENT PERFORMANCE INCENTIVE PLAN FOR ELIGIBLE PARTICIPANTS TO FOCUS ON SPECIFIC STRATEGIC, ORGANIZATIONAL AND FINANCIAL GOALS. THE TOTAL AWARDS UNDER THE PLAN CANNOT EXCEED TEN PERCENT OF THE HAMILTON HEALTH CARE SYSTEM COMBINED EXCESS OF REVENUES OVER EXPENSES EXCLUDING INVESTMENT INCOME. INDIVIDUAL INCENTIVES ARE BASED UPON ACHIEVING CERTAIN ORGANIZATIONAL AND INDIVIDUAL SERVICE QUALITY, FINANCIAL RESULTS AND CUSTOMER SATISFACTION GOALS. FORM 990, PART VI, SECTION A, LINE 2 CHAIRMAN OF THE BOARD G. LAMAR LYLE HAS A BUSINESS RELATIONSHIP WITH BOARD MEMBER JACKSON P. TURNER. FORM 990, PART VI, SECTION B, LINE 11 FOLLOWING MANAGEMENT PREPARATION AND REVIEW, THE FORM 990 IS REVIEWED BY AN INDEPENDENT CPA FIRM. SUBSEQUENTLY, A DRAFT OF THE UNFILED FORM 990 IS POSTED TO A SECURE PAGE ON THE HAMILTON HEALTH CARE SYSTEM WEBSITE FOR REVIEW AND COMMENT BY ALL MEMBER OF THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CLEAR AND DETAILED CONFLICT OF INTEREST POLICY WHICH ESTABLISHES A PROCEDURE FOR IDENTIFYING, REVIEWING AND ADDRESSING CONFLICTS OF INTEREST. THIS POLICY ALSO REQUIRED EACH TRUSTEE AND OFFICER OF THE ORGANIZATION TO ANNUALLY SIGN A STATEMENT ACKNOWLEDGING RECEIPT OF THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 UNDER A BOARD RESOLUTION, THE ORGANIZATION'S COMPENSATION COMMITTEE HAS THE AUTHORITY TO TAKE ACTION ON BEHALF OF THE BOARD WITH RESPECT TO THE COMPENSATION OF OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE MAINTAINS MINUTES OF ITS PROCEEDINGS. ON AN ANNUAL BASIS THE COMPENSATION COMMITTEE WILL MEET TO SET THE ANNUAL COMPENSATION OF THE PRESIDENT/CEO. THIS ACTION IS BASED ON CONSULTATION WITH A THIRD PARTY CONSULTING FIRM TO REVIEW THE TOTAL COMPENSATION OF THE CEO AND KEY EMPLOYEES SUCH THAT TOTAL COMPENSATION PACKAGES ARE CONSIDERED FAIR MARKET AND NOT EXCESSIVE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 8,495,389. LOSS ON DISCONTINUED OPERATIONS -5,987,334. TOTAL TO FORM 990, PART XI, LINE 5: 2,508,055. FORM 990, PART XII, LINE 2: THE FINANCIAL STATEMENTS OF HAMILTON HEALTH CARE SYSTEM, INC. ARE AUDITED ON A CONSOLIDATED BASIS TO INCLUDE ALL AFFILIATES OF THE SYSTEM. DALTON SENIOR HOUSING INC 519 WEST HAWTHORNE STREET DALTON GA 30720 581518011 LOW-INCOME HOUSING GA 501(C)(3) LINE 9 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON AMBULATORY SURGERY CENTER INC PO BOX 1168 DALTON GA 30722 582654791 SURGICAL SERVICES GA 501(C)(3) LINE 3 HAMILTON MEDICAL CENTER INC 1 HAMILTON EMERGENCY MEDICAL SERVICES INC PO BOX 1168 DALTON GA 30722 581651002 EMERGENCY MEDICAL GA 501(C)(3) LINE 9 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON MEDICAL CENTER INC PO BOX 1168 DALTON GA 30722 581519911 HEALTHCARE GA 501(C)(3) LINE 3 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON PHYSICIAN GROUP INC PO BOX 1168 DALTON GA 30722 271198701 PHYSICIAN PRACTICE GA 501(C)(3) LINE 3 HAMILTON MEDICAL CENTER INC 1 HLTC INC PO BOX 1168 DALTON GA 30722 582341574 LONG TERM ELDERLY CARE GA 501(C)(3) LINE 9 HAMILTON HEALTH CARE SYSTEM INC 1 MURRAY MEDICAL CENTER INC PO BOX 1406 CHATSWORTH GA 30705 582373427 HOSPITAL CARE / SERVICES GA 501(C)(3) LINE 3 HAMILTON HEALTH CARE SYSTEM INC 1 ROYAL OAK COMMUNITY LTD PO BOX 1900 DALTON GA 30722 581970228 SENIOR LIVING SERVICES GA 501(C)(3) LINE 9 HAMILTON HEALTH CARE SYSTEM INC 1 WHITFIELD PLACE INC PO BOX 1168 DALTON GA 30722 582103085 LOW-INCOME HOUSING GA 501(C)(3) LINE 9 HAMILTON HEALTH CARE SYSTEM INC 1 DALTON-WHITFIELD COUNTY HOSPITAL LIABILITY TRUST PO BOX 1168 DALTON GA 30722 581331514 LIABILITY CLAIMS COVERAGE GA 501(C)(3) LINE 11D, III-O HAMILTON HEALTH CARE SYSTEM INC 1 DALTON-WHITFIELD ADDITIONAL TRUST PO BOX 1168 DALTON GA 30722 586345013 FUNDS FOR INDIGENT CARE GA 501(C)(3) LINE 11A, I HAMILTON HEALTH CARE SYSTEM INC 1 DALTON-WHITFIELD INDIGENT CARE TRUST PO BOX 1168 DALTON GA 30722 586345011 FUNDS FOR INDIGENT CARE GA 501(C)(3) LINE 11A, I HAMILTON HEALTH CARE SYSTEM INC 1 WHITFIELD HEALTHCARE FOUNDATION INC PO BOX 1900 DALTON GA 30722 510175056 FUNDS FOR HEALTHCARE GA 501(C)(3) LINE 11A, I HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON HEALTH FIRST INC PO BOX 1168 DALTON GA 30722 581694713 PREFERRED PROVIDER GA HAMILTON HEALTH CARE SYSTEM INC C 1.00000 1 0 0 1 1 0 0 0 0 0 0 0 0 1 1 1 1 1 HLTC INC A 64438 FMV HAMILTON EMERGENCY MEDICAL SERVICES A 112095 FMV HLTC INC D 750000 Y/E BALANCE HAMILTON EMERGENCY MEDICAL SERVICES D 475000 Y/E BALANCE ROYAL OAK COMMUNITY LTD D 300000 Y/E BALANCE HAMILTON EMERGENCY MEDICAL SERVICES E 130000 Y/E BALANCE ROYAL OAK COMMUNITY LTD E 180000 Y/E BALANCE HLTC INC E 150000 Y/E BALANCE DALTON SENIOR HOUSING E 71000 Y/E BALANCE WHITFIELD PLACE E 93000 Y/E BALANCE HAMILTON MEDICAL CENTER O 3220053 FMV HAMILTON MEDICAL CENTER P 15526911 FMV HAMILTON EMERGENCY MEDICAL SERVICES P 390260 FMV ROYAL OAK COMMUNITY LTD P 211962 FMV HAMILTON MEDICAL CENTER Q 1301506 FMV MURRAY MEDICAL CENTER K 197025 FMV DALTON SENIOR HOUSING K 70998 FMV WHITFIELD PLACE K 86776 FMV HAMILTON MEDICAL CENTER K 5260008 FMV HAMILTON EMERGENCY MEDICAL SERVICES K 135004 FMV HLTC INC K 140016 FMV WHITFIELD HEALTHCARE FOUNDATION K 188198 FMV ROYAL OAK COMMUNITY LTD K 50000 FMV