LANIER HEALTH SERVICES INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- LANIER HEALTH SERVICES INC (EIN 58-2018658)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-14
- IRS object ID
- 201212279349300011
- Schema version
- 2010v3.7
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-14T06:59:03-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRAFFIN & TUCKER LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 6 | AddressLine1 |
| City | ALBANY | City |
| State | GA | State |
| ZIP Code | 317020006 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 582018658 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LANIER HEALTH SERVICES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LANI | NameControl |
| Phone | 2294823110 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 116 WEST THIGPEN AVENUE | AddressLine1 |
| City | LAKELAND | City |
| State | GA | State |
| ZIP Code | 31635 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GREG HEMBREE | Name |
| Title | CFO/TREASURER | Title |
| Phone | 2294823110 | Phone |
| Date Signed | 2012-08-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JACQUELINE G ATKINS | Name |
| Phone | 2298837878 | Phone |
| Date Prepared | 2012-08-08 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | GREG HEMBREE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 116 WEST THIGPEN AVENUE | AddressLine1 |
| City | LAKELAND | City |
| State | GA | State |
| ZIP Code | 31635 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 11711007 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1992 | YearFormation |
| State Legal Domicile | GA | StateLegalDomicile |
| Activity Or Mission Description | HEALTHCARE SERVICES | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 244 | TotalNbrEmployees |
| Total Nbr Volunteers | 1 | TotalNbrVolunteers |
| Total Gross UBI | 37847 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 4648 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 186933 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 8144 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 11093695 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 11035860 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3427 | InvestmentIncomePriorYear |
| Investment Income Current Year | 977 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 599262 | OtherRevenuePriorYear |
| Other Revenue Current Year | 617650 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 11883317 | TotalRevenuePriorYear |
| Total Revenue Current Year | 11662631 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 5633878 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5501750 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 7751707 | OtherExpensePriorYear |
| Other Expenses Current Year | 7318653 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 13385585 | TotalExpensesPriorYear |
| Total Expenses Current Year | 12820403 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1502268 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1157772 | RevenuesLessExpensesCY |
| Total Assets BOY | 4553691 | TotalAssetsBOY |
| Total Assets EOY | 4118242 | TotalAssetsEOY |
| Total Liabilities BOY | 10007277 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 10729600 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -5453586 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -6611358 | NetAssetsOrFundBalancesEOY |
| Mission Description | HEALTHCARE SERVICES | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 10902725 | Expense |
| Revenue | 11331207 | Revenue |
| Description | LANIER HEALTH SERVICES OPERATES LOUIS SMITH HOSPITAL A 25 BED CRITICAL ACCESS HOSPITAL THAT PROVIDES NURSING AND PROFESSIONAL CARE ON A SHORT TERM BASIS. 323 PATIENTS WERE ADMITTED AND THERE WERE 2,649 PATIENT DAYS IN FISCAL YEAR 2011. LANIER HEALTH SERVICES ALSO OPERATES LAKELAND VILLA CONVALESCENT CENTER, A 62 BED SKILLED NURSING FACILITY THAT PROVIDES LONG-TERM CARE FOR THE ELDERLY. OCCUPANCY PERCENTAGE FOR FISCAL YEAR 2011 IS 94.75%. | Description |
| Total Program Service Expense | 10902725 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 27 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 244 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | GA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | TEENA BUCHANAN | NamePerson |
| Telephone Number | 2294828413 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 116 W THIGPEN AVE | AddressLine1 |
| City | LAKELAND | City |
| State | GA | State |
| ZIP Code | 31635 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| JAMES MCGAHEE | |||||||
| PRES/CEO AUT | 1.00 | X | X | 0 | 451945 | 33664 | |
| RANDY SAULS | |||||||
| SECRETARY | 2.00 | X | X | 0 | 286191 | 28737 | |
| BEN COPELAND | |||||||
| CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | |
| E CAMERON HICKMAN | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| SUZANNE MATHIS | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| FRANK MORMAN | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DUB MUSIC | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JAY SHAW | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JIMMY BENEFIELD | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| GREG HEMBREE | |||||||
| CFO/TREASURE | 2.00 | X | 0 | 269372 | 27845 | ||
| NEIL GINTY | |||||||
| ADMSTR. | 40.00 | X | 0 | 126423 | 18989 | ||
| TEENA BUCHANAN | |||||||
| ASST. TREASU | 40.00 | X | 0 | 89994 | 15321 | ||
| ELIZABETH FLEMMING | |||||||
| ASST TREASUR | 40.00 | X | 0 | 42487 | 0 | ||
| SYED BASHEER | |||||||
| PHYSICIAN | 40.00 | 114510 | 0 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 114510 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1266412 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 124556 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MORRISON'S MANAGEMENT | |||||
| PO BOX 102289 | ATLANTA | GA | 303682289 | DIETARY SERVICE | 933074 |
| EMCARE PHYSICIANS SERVICES INC | |||||
| 1717 MAIN ST SUITE 5200 | DALLAS | TX | 75201 | ER PHYSICIANS | 909681 |
| PSI PHARMACY SERVICES INC | |||||
| PO BOX 1357 | REIDSVILLE | GA | 30453 | PHARMACY MGMT. | 220032 |
| REDDY SOLUTIONS | |||||
| 621 N AVENUE NE SUITE C30 | ATLANTA | GA | 30308 | RADIOLOGIST | 144080 |
| SHARED IMAGING | |||||
| 2186 BAYSPHERE CR | CHICAGO | IL | 60674 | CT/MRI SERVICE | 139800 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Government Grants | 8000 | GovernmentGrants |
| All Other Contributions | 144 | AllOtherContributions |
| Total Contributions | 8144 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PROGRAM SERVICE REVENUE | Description |
| Business Code | 623000 | BusinessCode |
| Total Revenue Column | 11035860 | TotalRevenueColumn |
| Related Or Exempt Function Income | 11035860 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 11035860 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 877 | TotalRevenueColumn |
| Exclusion | $877 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 33126 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 48376 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -15250 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -15250 | TotalRevenueColumn |
| Exclusion | -$15,250 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 100 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 100 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 100 | TotalRevenueColumn |
| Exclusion | $100 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|---|
| CAFETERIA | 624200 | 284386 | $284,386 | ||
| RETAIL PHARMACY NONPATIENT | 621990 | 270475 | 270475 | ||
| FOOD SRVC COMMUNITY FUNCTIONS | 722320 | 37847 | 37847 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 40192 | TotalRevenueColumn |
| Related Or Exempt Function Income | 24872 | RelatedOrExemptFunctionIncome |
| Exclusion | $15,320 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 632900 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11662631 | TotalRevenueColumn |
| Related Or Exempt Function Income | 11331207 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 37847 | UnrelatedBusinessRevenue |
| Exclusion | $285,433 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4442432 | Total |
| Program Services | 3698485 | ProgramServices |
| Management And General | 743947 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19594 | Total |
| Program Services | 16313 | ProgramServices |
| Management And General | 3281 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 714355 | Total |
| Program Services | 594726 | ProgramServices |
| Management And General | 119629 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 325369 | Total |
| Program Services | 270881 | ProgramServices |
| Management And General | 54488 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9763 | Total |
| Management And General | 9763 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 82214 | Total |
| Management And General | 82214 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 548 | Total |
| Management And General | 548 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2153306 | Total |
| Program Services | 1549321 | ProgramServices |
| Management And General | 603985 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5671 | Total |
| Management And General | 5671 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1019087 | Total |
| Program Services | 967241 | ProgramServices |
| Management And General | 51846 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 264725 | Total |
| Program Services | 213686 | ProgramServices |
| Management And General | 51039 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78101 | Total |
| Program Services | 41816 | ProgramServices |
| Management And General | 36285 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39357 | Total |
| Program Services | 18977 | ProgramServices |
| Management And General | 20380 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 258900 | Total |
| Program Services | 208984 | ProgramServices |
| Management And General | 49916 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72039 | Total |
| Program Services | 58251 | ProgramServices |
| Management And General | 13788 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PROVISION FOR BAD DEBTS | 1644590 | 1644590 | |
| REPAIR & MAINTENANCE | 959204 | 955724 | 3480 |
| MEDICAL SUPPLIES | 655696 | 655696 | |
| RECRUITING | 28213 | 28213 | |
| LICENSE AND PERMITS | 20831 | 6094 | 14737 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26408 | Total |
| Program Services | 1940 | ProgramServices |
| Management And General | 24468 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12820403 | Total |
| Program Services | 10902725 | ProgramServices |
| Management And General | 1917678 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 242633 | BOY |
| EOY | 518134 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 82398 | BOY |
| EOY | 31455 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1701485 | BOY |
| EOY | 1351934 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28567 | BOY |
| EOY | 14592 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 160070 | BOY |
| EOY | 168440 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47982 | BOY |
| EOY | 37790 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 7312607 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 5528976 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1941778 | BOY |
| EOY | 1783631 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 348778 | BOY |
| EOY | 212266 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4553691 | BOY |
| EOY | 4118242 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 879105 | BOY |
| EOY | 911967 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1750 | BOY |
| EOY | 1936 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9083139 | BOY |
| EOY | 9815697 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43283 | BOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10007277 | BOY |
| EOY | 10729600 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -5492701 | BOY |
| EOY | -6644224 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39115 | BOY |
| EOY | 32866 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -5453586 | BOY |
| EOY | -6611358 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4553691 | BOY |
| EOY | 4118242 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -1157772 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form4720 Filed4955 Tax | false | Form4720Filed4955Tax |
| Correction Made | false | CorrectionMade |
| Form1120 Pol Filed | false | Form1120PolFiled |
| Form4720 Filed | false | Form4720Filed |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $548 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 548 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
| Form4720 Filed4912 Tax | false | Form4720Filed4912Tax |
| Substantially All Dues Nondeduct | false | SubstantiallyAllDuesNondeduct |
| Only In House Lobbying | false | OnlyInHouseLobbying |
| Agree To Carryover Prior Year | false | AgreeToCarryoverPriorYear |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | SCHEDULE C, PART II-B, LINE 1I | ReturnReference |
| Explanation | THE ORGANIZATION PAYS MEMBERSHIP DUES TO NATIONAL AND STATE ORGANIZATIONS. A PORTION OF THOSE DUES IS ALLOCATED TO LOBBYING ACTIVITIES IN WHICH THOSE ORGANIZATIONS PARTICIPATE. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Orgs Legal Control | false | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | false | DisclosedForCharitablePurposes |
| Written Policy Monitoring | false | WrittenPolicyMonitoring |
| Sect170h Requirements Satisfied | false | Sect170hRequirementsSatisfied |
| Solicited Assets For Sale | false | SolicitedAssetsForSale |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | false | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 128897 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 192543 | OtherCostOrOtherBasis |
| Book Value | 321440 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4010806 | OtherCostOrOtherBasis |
| Depreciation | 2934131 | Depreciation |
| Book Value | 1076675 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 184739 | OtherCostOrOtherBasis |
| Depreciation | 83365 | Depreciation |
| Book Value | 101374 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2795622 | OtherCostOrOtherBasis |
| Depreciation | 2511480 | Depreciation |
| Book Value | 284142 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1783631 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| THIRD PARTY SETTLEMENTS | 210482 |
| DUE FROM FOUNDATION | 1784 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 212266 | TotalBookValueOtherAssets |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | LIABILITY UNDER FIN 48 FOOTNOTE | Identifier |
| Return Reference | SCHEDULE D, PAGE 3, PART X | ReturnReference |
| Explanation | EXCERPT FROM FINANCIAL STATEMENTS - INCOME TAXES: THE COMPANY IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX-EXEMEPT PURSUANT TO SECTION 501(C)3 OF THE INTERNAL REVENUE CODE. THE COMPANY 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 COMPANY 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 SEPTEMBER 30, 2011 AND 2010 OR FOR THE YEARS THEN ENDED. THE COMPANY'S OPEN AUDIT PERIODS ARE FOR TAX YEARS ENDED 2008-2010. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 1.25000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 627303 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 627303 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05590 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3716906 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4311515 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -594609 | NetCommunityBenefitExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4344209 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4311515 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 32694 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05590 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 241194 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 38566 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 202628 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01800 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 241194 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 38566 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 202628 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01800 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4585403 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4350081 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 235322 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07390 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 6614 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6614 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 6614 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6614 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $935,900 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 2780549 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 2780549 | CostOfCareReimbursedByMedicare |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LOUIS SMITH MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 116 W THIGPEN AVE | AddressLine1 |
| City | LAKELAND | City |
| State | GA | State |
| ZIP Code | 31635 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
| Other | PHY OFC, CLINICS, SNF | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LOUIS SMITH MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKELAND VILLA CONVALESCENT CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 852 W THIGPEN AVENUE | AddressLine1 |
| City | LAKELAND | City |
| State | GA | State |
| ZIP Code | 31635 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | SKILLED NURSING FACILITY | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SUBSIDIZED HEALTH SERVICES EXPLANATION | PART I LINE 7G | THIS SECTION INCLUDES A PHYSICIANS OFFICE WHICH PROVIDES CARE TO THE COMMUNITY REGARDLESS OF ABILITY TO PAY THE ORGANIZATIONS SERVICE AREA IS A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA |
| EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE | PART I LINE 7 COLUMN F | IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN F THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990 PART IX LINE 25 FORM 990 PART IX LINE 25 12812403 LESS BAD DEBTS IN PART IX 1644590 ADD EXPENSES REPORTED IN PART VIII 48376 DENOMINATOR FOR COLUMN F 11216189 |
| COSTING METHODOLOGY EXPLANATION | PART I LINE 7 | COSTS FOR PART I LINE 7A AND 7B AND PART III SECTION A LINE 2 WERE CALCULATED USING THE RCC CALCULATED IN WORKSHEET 2 OTHER COSTS WERE OBTAINED FROM THE ORGANIZATIONS ACCOUNTING RECORDS |
| BAD DEBT EXPENSE EXPLANATION | PART III LINE 4 | EXCERPT FROM AUDITED FINANCIAL STATEMENTS ALLOWANCE FOR DOUBTFUL ACCOUNTS THE COMPANY PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON AN EVALUATION OF THE OVERALL COLLECTIBILITY OF THE ACCOUNTS RECEIVABLE AS ACCOUNTS ARE KNOWN TO BE UNCOLLECTIBLE THE ACCOUNT IS CHARGED AGAINST THE ALLOWANCE AMOUNTS ON PART III LINES 2 AND 3 WERE CALCULATED USING THE RCC AS DEFINED IN WORKSHEET 2 |
| MEDICARE EXPLANATION | PART III LINE 8 | MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS |
| COLLECTION PRACTICES EXPLANATION | PART III LINE 9B | SELFPAY PATIENTS ARE GIVEN A PATIENT ACCOUNT PAYMENT AGREEMENT AT THE TIME OF ADMISSION THEY ARE ALSO GIVEN INFORMATION THROUGH A BROCHURE REGARDING INDIGENT AND CHARITY CARE TO SEE IF THEY WOULD QUALIFY |
| NEEDS ASSESSMENT | PART VI | THE ORGANIZATION CONDUCTS REGULAR NEEDS ASSESSMENT THROUGH FORMAL AND INFORMAL SURVEYS AND PROCESSES INCLUDING COLLABORATIONS WITH PUBLIC AND COMMUNITY AGENCIES THE HOSPITAL ADMINISTRATOR SERVES ON THE HEALTH DEPARTMENT BOARD THEREFORE THE ORGANIZATION IS AWARE OF NEEDS AND HELPS AVOID DUPLICATION OF SERVICES THE ORGANIZATION IS ALSO INVOLVED IN THE CHAMBER OF COMMERCE AND OTHER COMMUNITY AND CIVIC ORGANIZATIONS AND PARTICIPATES IN CITY AND COUNTY GOVERNMENT MEETINGS WITH REPRESENTATIVES FROM EMS |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI | PATIENTS ARE EDUCATED ON ELIGIBILITY FOR ASSISTANCE ON SERVICES AT TIME OF ADMISSION SELFPAY PATIENTS RECEIVE INFORMATION REGARDING INDIGENT AND CHARITY POLICY AND INFORMATION REQUIRED TO BE SUBMITTED TO DETERMINE IF ELIGIBLE ONCE PATIENTS RECEIVE THEIR STATEMENT THEY CAN CONTACT CUSTOMER SERVICE REGARDING PAYMENT ARRANGEMENTS AND ASSISTANCE THAT IS AVAILABLE |
| COMMUNITY INFORMATION | PART VI | THE ORGANIZATION IS LOCATED IN LAKELAND GEORGIA WHICH IS LOCATED 20 MILES FROM VALDOSTA GEORGIA THE HOUSEHOLD INCOME IS ABOUT HALF OF THE STATE AVERAGE AND THE UNEMPLOYMENT RATE IS SLIGHTLY BELOW THE STATE AVERAGE BASED ON 2010 DATA 366 OF HOUSEHOLDS ARE LIVING IN POVERTY THE REGIONS CITIZENS EXPERIENCE HIGH LEVELS OF DIABETES AND OBESITY RATES ARE ABOVE THE STATE AVERAGE |
| HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE | PART VI | PRIMARY CARE IS FIRST AND CREATES A PROFOUND IMPACT ON THE COMMUNITIES SERVED PRIMARY CARE SERVICES ARE ESTABLISHED IN AREAS WHERE RESIDENTS ARE MOST LIKELY TO SUFFER FROM SEVERE MANPOWER SHORTAGES HIGH PROVERTY LEVELS AND A LACK OF ACCESS TO CARE THE ORGANIZATION MAINTAINS AN EMS PROGRAM WITH LIMITED FUNDS COMING FROM THE COUNTY AND PARTICIPATES WITH RED CROSS IN HOSTING BLOOD DRIVES |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs |
|---|---|---|---|---|
| JAMES MCGAHEE | ||||
| 368134 | 83811 | 21508 | 12156 | 485609 |
| RANDY SAULS | ||||
| 241122 | 45069 | 16141 | 12596 | 314928 |
| GREG HEMBREE | ||||
| 242790 | 26582 | 15949 | 11896 | 297217 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE CONTROLLERS FROM LANIER HEALTH SERVICES AND THE HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY DBA SOUTH GEORGIA MEDICAL CENTER ("AUTHORITY"), A RELATED ORGANIZATION, REVIEW THE REPORT AND WORK WITH THE PREPARER TO MAKE ANY NECESSARY CHANGES OR CORRECTIONS PRIOR TO THE FILING OF THE REPORT. THEN, THE REPORT IS PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW. THE FORM 990 IS THEN SUBMITTED TO THE IRS IN A TIMELY MANNER. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | ALL KEY MANAGEMENT PERSONNEL, THE ADMINISTRATOR, DIRECTORS, AND BOARD MEMBERS OF LANIER HEALTH SERVICES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST CERTIFICATION FORM ANNUALLY. WHEN A POTENTIAL CONFLICT OF INTEREST OCCURS, A MANAGER COMPLETES A CONFLICT OF INTEREST CERTIFICATION FORM FOR REVIEW. ALL POTENTIAL CONFLICTS OR ACTIVITIES INVOLVING KEY MANAGEMENT PERSONNEL HAVE TO BE APPROVED BY THE BOARD OF DIRECTORS. ALL OTHER POTENTIAL CONFLICTS OF INTEREST WILL BE APPROVED BY THE LANIER HEALTH SERVICES ADMINISTRATOR. INDIVIDUALS WITH CONFLICTS ARE REQUIRED TO REFRAIN FROM DISCUSSION AND VOTING ON THE ISSUE AND MUST LEAVE THE MEETING DURING DISCUSSIONS. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | THE CEO OF THE AUTHORITY IS NOT COMPENSATED BY THE ORGANIZATION. THE HOSPITAL AUTHORITY SETS THE COMPENSATION FOR THE EXECUTIVE EMPLOYEES OF THE AUTHORITY. THIS WORK IS ACCOMPLISHED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE AUTHORITY. THIS COMMITTEE IS MADE UP OF FOUR MEMBERS OF THE AUTHORITY. THEY ARE INDEPENDENT, VOLUNTARY BOARD MEMBERS THAT ARE APPOINTED BY THE CITY OR COUNTY. THEY USE VARIOUS SALARY SURVEYS TO ASSIST THEM IN SETTING THE COMPENSATION LEVELS. THE EXECUTIVE COMPENSATION COMMITTEE KEEPS MINUTES OF ITS RECOMMENDATIONS ON SALARY DECISIONS. COMPENSATION FOR THE ORGANIZATION'S ADMINISTRATOR IS ADJUSTED ANNUALLY BY THE AUTHORITY. MARKET STUDIES ARE CONDUCTED EVERY FEW YEARS. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | THE CFO OF THE AUTHORITY IS NAMED IN THE BYLAWS AS THE CFO OF THE ORGANIZATION. HE IS NOT COMPENSATED BY THE ORGANIZATION. THE AUTHORITY SETS THE COMPENSATION FOR THE EXECUTIVE EMPLOYEES OF THE AUTHORITY. THIS WORK IS ACCOMPLISHED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE AUTHORITY. THIS COMMITTEE IS MADE UP OF FOUR MEMBERS OF THE AUTHORITY. THEY ARE INDEPENDENT, VOLUNTARY BOARD MEMBERS THAT ARE APPOINTED BY THE CITY OR COUNTY. THEY USE VARIOUS SALARY SURVEYS TO ASSIST THEM IN SETTING THE COMPENSATION LEVELS. THE EXECUTIVE COMPENSATION COMMITTEE KEEPS MINUTES OF ITS RECOMMENDATIONS ON SALARY DECISIONS. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | UPON ANY REQUEST FOR DOCUMENTS, THE ORGANIZATION IS REQUIRED TO OBTAIN BOARD APPROVAL AND LEGAL COUNSEL BEFORE ANY DOCUMENTS WILL BE RELEASED. |
| RELATED ORGANIZATIONS | FORM 990, PAGE 7, PART VII | AVERAGE WEEKLY HOURS DEVOTED TO RELATED ORGANIZATIONS: JAMES MCGAHEE 40 HOURS RANDY SAULS 40 HOURS GREG HEMBREE 40 HOURS E. CAMERON HICKMAN 1 HOUR |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSP AUTH OF VAL & LOWNDES CO | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2501 N PATTERSON STREET | AddressLine1 |
| City | VALDOSTA | City |
| State | GA | State |
| ZIP Code | 31601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 586004467 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivities |
| Legal Domicile State | GA | LegalDomicileState |
| Exempt Code Section | 501C3 | ExemptCodeSection |
| Public Charity Status | 6 | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | false | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | true | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Comments