2012-11-14T14:28:56-06:00 2011-12-31 DRAFFIN & TUCKER LLP PO BOX 6 ALBANY GA 317020006 990 2011-01-01 580633978 TY COBB HEALTHCARE SYSTEM INC TYCO 7062451850 PO BOX 589 ROYSTON GA 30662 J STEVEN BARBER 7062451850 2012-11-15 true WILLIAM EDWARD PHILLIPS 2298837878 2012-11-12 2011 2016-02-24 21:20:13Z COBB MEMORIAL HOSPITAL BROWN CHARLES ADAMS PO BOX 589 ROYSTON GA 30662 50846713 false X TYCOBBHEALTHCARE.COM X 1950 GA TO CONTINUOUSLY IMPROVE THE QUALITY OF PRIMARY, LONG-TERM AND HOME CARE WITHIN OUR RESOURCE CAPABILITIES AND TO PROMOTE HEALTHIER LIFESTYLES THROUGH EDUCATION CONSISTENT WITH INDIVIDUAL AND COMMUNITY NEEDS. 7 7 742 17 0 41245 78389 37287699 36407727 4575875 974576 1930585 2404958 43835404 39865650 0 0 20850792 20801094 0 0 19088655 20009679 39939447 40810773 3895957 -945123 64051128 62646905 30910717 32048891 33140411 30598014 X TO CONTINUOUSLY IMPROVE THE QUALITY OF PRIMARY, LONG-TERM AND HOME CARE WITHIN OUR RESOURCE CAPABILITIES AND TO PROMOTE HEALTHIER LIFESTYLES THROUGH EDUCATION CONSISTENT WITH INDIVIDUAL AND COMMUNITY NEEDS. false false 37522916 36590340 TY COBB HEALTHCARE SYSTEM, INC. (THE SYSTEM) OPERATES COBB MEMORIAL HOSPITAL, A 71-BED ACUTE CARE HOSPITAL,BROWN MEMORIAL CONVALESCENT CENTER, A 144-BED LONG-TERM CARE FACILITY, COBB HEALTHCARE CENTER, A 116-BED LONG-TERM CARE FACILITY, AND THE GABLES AT COBB VILLAGE, A 48-BED ASSISTED LIVING FACILITY. COBB MEMORIAL HOSPITAL (THE HOSPITAL) PROVIDES INPATIENT, SWINGBED, OUTPATIENT AND EMERGENCY CARE SERVICES TO RESIDENTS OF FRANKLIN, HART, AND MADISON COUNTIES AND THE SURROUNDING AREAS. THE HOSPITAL HAD 4,937 INPATIENT DAYS, 3 SWINGBED DAYS, AND 11,431 EMERGENCY ROOM VISITS DURING 2011. THE HOSPITAL PARTICIPATES IN THE MEDICARE AND MEDICAID GOVERNMENT INSURANCE PROGRAMS. UNDER THESE PROGRAMS, THE HOSPITAL PROVIDES CARE TO PATIENTS AT PAYMENT RATES WHICH ARE DETERMINED BY THE FEDERAL AND STATE GOVERNMENTS, REGARDLESS OF THE HOSPITAL'S ACTUAL CHARGES. IN SOME CASES, THESE PROGRAMS PAY THE HOSPITAL AT AMOUNTS WHICH ARE LESS THAN THE COST OF PROVIDING THE SERVICES. THE HOSPITAL ALSO PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS INDIGENT AND CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. CHARGES FOREGONE, AT ESTABLISHED RATES, UNDER THE INDIGENT AND CHARITY CARE POLICY APPROXIMATED 1,869,000. IN ADDITION, THE HOSPITAL HAD BAD DEBT EXPENSE (PATIENT BILLS THAT WERE NOT COLLECTED) OF APPROXIMATELY 3,178,000. BROWN MEMORIAL CONVALESCENT CENTER PROVIDED OVER 51,300 RESIDENT DAYS DURING 2011. OF THESE DAYS, APPROXIMATELY 86% WERE COVERED BY THE MEDICAID AND MEDICARE INSURANCE PROGRAMS. COBB HEALTHCARE CENTER PROVIDED OVER 39,600 RESIDENT DAYS DURING 2011. OF THESE DAYS, APPROXIMATELY 80% WERE COVERED BY THE MEDICAID AND MEDICARE INSURANCE PROGRAMS. 37522916 true true false true false false false false false false true true false false true true false true false false true false false false false false true true false false true false false false false false false false false false false false false true true true true false false true 119 0 true 742 true false true CJ false false false false false false false false X 7 7 false false false false false false false true true false false true true false true true false true true true false GA X J STEVEN BARBER 7062451850 PO BOX 589 ROYSTON GA 30662 X JACK EDMUNDS 3.00 X X 17200 1200 0 FORT OGLESBY 3.00 X X 11200 1950 0 GREGORY HEARN 3.00 X X 11200 1200 0 MIKE GREEN 2.00 X 10000 0 0 DEBORAH HARBIN 2.00 X 10000 0 0 DON JOHNSON 2.00 X 10000 0 0 HARRIS LITTLE 2.00 X 10000 0 0 CHARLES T ADAMS 20.00 X 316540 0 53844 STEVE BARBER 20.00 X 160499 0 23109 DAVID SEAGRAVES 20.00 X 107000 107000 15888 JERRY WISE 20.00 X 71731 71731 19398 DONNA TONEY 20.00 X 61393 61393 16177 JENNIFER DICKERSON 27.00 X 73168 34432 2629 ANGELA HARPOLD 25.00 X 66078 40499 15100 SANDRA SHUGART 24.00 X 64454 41209 12604 1000463 360614 158749 10 false true false CPSI 6600 WALL STREET MOBILE AL 36695 BUSINESS OFFICE 602941 PRODIGY HEALTHCARE 200 ARIZONA AVE NE SUITE 200 ATLANTA GA 30307 RADIOLOGISTS 519352 SELECT MEDICAL REHABILITATION SERV PO BOX 643920 PITTSBURGH PA 15264 REHABILITATION 513247 GEORGIA ANESTHESIA SERVICES 1179 MELODY LANE HARTWELL GA 30643 CRNA/ANESTHESIA 499998 FTI CAMBIO HEALTH SOLUTIONS PO BOX 4180005 BOSTON MA 02109 CONSULTANTS 297712 12 78389 8523 78389 PATIENT SERVICE REVENUE, NET 36407727 36407727 36407727 911662 911662 408006 184216 223790 223790 223790 10859761 10796847 62914 62914 62914 MANAGEMENT & LAUNDRY FEES 1398735 1398735 CAFETERIA & VENDING 214008 214008 MISCELLANEOUS 172875 172875 395550 119699 275851 2181168 39865650 36590340 3196921 756479 756479 16338306 15746972 591334 83239 80273 2966 2355780 2271833 83947 1267290 1199680 67610 341472 341472 139027 139027 335087 335087 3889306 3376076 513230 6024473 5899092 125381 1616221 1519248 96973 147590 72142 75448 1197835 1125965 71870 342299 342299 BAD DEBTS 3178402 3178402 MEDICAID PROVIDER TAX 1314593 1314593 REPAIRS & MAINTENANCE 897272 882525 14747 LOSS ON DEBT EXTINGUISHME 432365 432365 153737 81451 72286 40810773 37522916 3287857 0 186373 247021 5079 5089 3042007 2761526 14039584 15761092 865721 843473 56666 48759 41075036 30984735 10531741 10090301 29688369 27871628 3436789 3277750 608010 608010 1590789 1132256 64051128 62646905 4217778 3807272 16335045 10039941 27826190 317953 415429 30910717 32048891 X 33140411 30598014 33140411 30598014 64051128 62646905 X -945123 -1597274 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false false false true 2903 2903 false false false false false SCHEDULE C, PART II-B, LINE 1 TY COBB HEALTHCARE SYSTEM PARTICIPATED IN LOBBYING ACTIVITIES THROUGH MEMBERSHIP IN THE GEORGIA HOSPITAL ASSOCIATION. A PORTION OF THE SYSTEM'S YEARLY DUES IS ALLOCATED TO LOBBYING ACTIVITIES. false false false false false false false false false false 1180016 1180016 20469881 13780965 6688916 18382847 16504333 1878514 1042292 699437 342855 10090301 TY COBB SEGREGATED PORTFOLIO 1705892 C NGTC HEALTH PROPERTIES, LLC 1451948 C HOMETOWN HEALTH, LLC 119910 C 3277750 DEFERRED COMPENSATION PLAN 240000 MEDICARE/MEDICAID COST REPORT SETTLE 175429 415429 39865650 40810773 -945123 -1722780 -2683441 -4406221 -5351344 55913904 -1722780 17997912 16275132 39638772 335087 -108209 226878 39865650 61265248 20605346 20605346 40659902 335087 -184216 150871 40810773 LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X EXCERPT FROM AUDITED FINANCIAL STATEMENTS - INCOME TAXES. THE SYSTEM AND THE FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE SEGREGATED PORFOLIO INTENDS TO CONDUCT ITS AFFAIRS IN A MANNER IN WHICH IT WILL NOT BE SUBJECT TO U.S. FEDERAL INCOME TAX OR GEORGIA INCOME TAX. REGIONAL IS CONSIDERED A DISREGARDED ENTITY OF THE SYSTEM. THE SYSTEM 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 SYSTEM 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 ACCCRUED OR CHARGED TO EXPENSE AS OF DECEMBER 31, 2011 OR 2010 OR FOR THE YEARS THEN ENDED. THE SYSTEM'S OPEN AUDIT PERIODS ARE FOR THE TAX YEARS ENDED 2008-2010. RECONCILIATION OF CHANGES - OTHER SCHEDULE D, PAGE 4, PART XI, LINE 8 COBB FOUNDATION 19,110,456 TY COBB HEALTHCARE SEGREGATED PORTFOLIO 471,458 INTERCOMPANY ELIMINATIONS -1,584,002 RENTAL PROPERTY EXPENSES 184,216 HOMETOWN HEALTH GAIN -74,170 NGTC LOSS -1,837 COBB FOUNDATION -21,779,059 TY COBB HEALTHCARE SEGREGATED PORTFOLIO -552,954 INTERCOMPANY ELIMINATIONS 1,726,667 RENTAL PROPERTY EXPENSES -184,216 REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER SCHEDULE D, PAGE 4, PART XII, LINE 2D COBB FOUNDATION 19,110,456 TY COBB HEALTHCARE SEGREGATED PORTFOLIO 471,458 INTERCOMPANY ELIMINATIONS -1,584,002 REVENUE AMOUNTS INCLUDED ON RETURN - OTHER SCHEDULE D, PAGE 4, PART XII, LINE 4B RENTAL PROPERTY EXPENSES -184,216 HOMETOWN HEALTH GAIN 74,170 NGTC LOSS 1,837 EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHER SCHEDULE D, PAGE 4, PART XIII, LINE 2D COBB FOUNDATION 21,779,059 TY COBB HEALTHCARE SEGREGATED PORTFOLIO 552,954 INTERCOMPANY ELIMINATIONS -1,726,667 EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER SCHEDULE D, PAGE 4, PART XIII, LINE 4B RENTAL PROPERTY EXPENSES -184,216 false CAYMAN ISLANDS INVESTMENT CAYMAN ISLANDS INVESTMENT 4061264 4061264 CAYMAN ISLANDS 0 1,705,892 CAYMAN ISLANDS 0 2,355,372 true true true X 1.25000 true X true true true false true true 779145 779145 0.02110 2939082 3054118 -115036 95120 70684 24436 0.00070 3813347 3124802 688545 0.02180 3813347 3124802 688545 0.02180 46573 4225 42348 0.00110 46573 4225 42348 0.00110 true 3178402 4572352 5040193 -467841 X true true 1 1 COBB MEMORIAL HOSPITAL

PO BOX 589 ROYSTON GA 30662

X X X COBB MEMORIAL HOSPITAL 1 true true 125.0 true 200.0 true X true true X X X true false X true X false false 3 BROWN MEMORIAL CONVALESCENT CENTER

PO BOX 589 ROYSTON GA 30662

SKILLED NURSING FACILITY COBB HEALTHCARE CENTER

PO BOX 589 ROYSTON GA 30662

SKILLED NURSING FACILITY THE GABLES AT COBB VILLAGE

PO BOX 589 ROYSTON GA 30662

ASSISTED LIVING FACILITY 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 40810773 LESS BAD DEBTS IN PART IX 3178402 ADD EXPENSES REPORTED IN PART VIII 184216 DENOMINATOR FOR COLUMN F 37816587 COSTING METHODOLOGY EXPLANATION PART I LINE 7 TY COBB HEALTHCARE SYSTEM INC USED THE WORKSHEETS 12 AND 3 LOCATED IN THE INSTRUCTIONS TO SCHEDULE H OF FORM 990 TO CALCULATE THE COMMUNITY BENEFIT EXPENSE REPORTED IN THE TABLE ON LINE 7 COMMUNITY BUILDING ACTIVITIES PART II TY COBB HEALTHCARE SYSTEM INC PROVIDES FREE MONTHLY HEALTH EDUCATION PROGRAMS TO THE PUBLIC TO PROMOTE WELLNESS AND HEALTHIER LIFESTYLES THE OCCUPATIONAL MEDICINE AND WELLNESS DEPARTMENT ALSO PARTICIPATES IN LUNCH AND LEARN AND HEALTH FAIRS THROUGHOUT THE YEAR THAT PROVIDE HEALTH EDUCATION AND SCREENING OPPORTUNITIES FOR EMPLOYEES OF LOCAL BUSINESSES AS WELL AS THE PUBLIC AT LARGE TCHS EMPLOYEES ARE ACTIVE IN AND PROMOTE WELLNESS TO LOCAL CIVIC GROUPS INCLUDING BUT NOT LIMITED TO THE TRICOUNTY DIABETES TASK FORCE CHAMBER OF COMMERCE ROTARY CLUB KIWANIS CLUB AND SERVICE LEAGUES BAD DEBT EXPENSE EXPLANATION PART III LINE 4 THE FOLLOWING IS FROM THE FOOTNOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS ALLOWANCE FOR DOUBTFUL ACCOUNTS THE SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE EVALUATION OF THE OVERALL COLLECTIBILITY OF ACCOUNTS RECEIVABLE AS ACCOUNTS ARE KNOWN TO BE UNCOLLECTIBLE THE ACCOUNT IS CHARGED AGAINST THE ALLOWANCE MEDICARE EXPLANATION PART III LINE 8 MEDICARE SHORTFALL THE FULL AMOUNT OF MEDICARE SHORTFALL 183355 REPORTED ON LINE 7 SHOULD BE CONSIDERED AS COMMUNITY BENEFIT COBB MEMORIAL HOSPITAL HAS RECEIVED MEDICARE DEPENDENT HOSPITAL STATUS FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES MEDICARE DEPENDENT HOSPITAL STATUS MEANS THAT THE MAJORITY OF THE HOSPITALS INPATIENTS ARE INSURED BY THE MEDICARE PROGRAM THEREFORE THE HOSPITAL IS THE PRIMARY AND A VITAL SOURCE OF HEALTHCARE SERVICES TO MEDICARE PATIENTS IN ITS SERVICE AREA MEDICARE ALLOWABLE COSTS MEDICARE ALLOWABLE COSTS OF CARE REPORTED ON LINE 6 WAS DETERMINED FROM THE MEDICARE COST REPORT FOR COBB MEMORIAL HOSPITAL COLLECTION PRACTICES EXPLANATION PART III LINE 9B THE HOSPITAL NOTIFIES PATIENTS OF THE FINANCIAL ASSISTANCE POLICY IN COMMUNICATIONS WITH THE PATIENTS REGARDING THE PATIENTS BILLS NORMAL COLLECTION PRACTICES BASED ON THE PATIENTS RESPONSE WOULD BE CEASED ONCE IT IS DETERMINED THE PATIENT QUALIFIES FOR CHARITY CARE OR FINANCIAL ASSISTANCE NEEDS ASSESSMENT PART VI TY COBB HEALTHCARE SYSTEM INC USES DISCHARGE DATA MARKET ANALYSES AND INFORMATION FROM INDIVIDUALS IN THE COMMUNITY TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES RECENTLY THE SYSTEM CONDUCTED A THOROUGH AND ACCURATE MARKET AND NEEDS ASSESSMENT USING BOTH INTERNAL RESOURCES AND PERSONNEL AS WELL AS A QUALIFIED EXTERNAL ORGANIZATION CONSULTANT EXPERIENCED IN COLLECTING ORGANIZING AND ANALYZING THE APPROPRIATE MARKET DEMOGRAPHIC AND HEALTH RELATED INFORMATION NECESSARY TO HELP MAKE THE CORRECT DECISIONS ABOUT THE HEALTHCARE SERVICES NEEDED IN OUR MARKET THE FOLLOWING DATA ELEMENTS WERE OBTAINED DEMOGRAPHIC INFORMATION ECONOMIC DATA HEALTHCARE UTILIZATION DATA HOUSING DATA AND ECONOMIC AND INDUSTRIAL DEVELOPMENT DATA AND TRENDS THE SYSTEMS BOARD INCLUDES COMMUNITY REPRESENTATIVES WHO VOICE THE NEEDS OF THE COMMUNITY SUGGESTION BOXES ARE ALSO AVAILABLE TO PATIENTS VISITORS AND EMPLOYEES TO SUBMIT THOUGHTS OR IDEAS PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI SELF PAY PATIENTS ARE REFERRED TO A PATIENT FINANCIAL COUNSELOR THE PATIENT FINANCIAL COUNSELOR WILL ASSIST THE PATIENT OR GUARANTOR IN APPLYING FOR FINANCIAL ASSISTANCE IF NO SOURCE OF FINANCIAL ASSISTANCE IS AVAILABLE THE HOSPITAL WILL REVIEW THE ACCOUNT FOR INDIGENT OR CHARITY ALLOWANCE COMMUNITY INFORMATION PART VI TY COBB HEALTHCARE SYSTEM INC OPERATES FOUR FACILITIES LOCATED IN TWO RURAL COUNTIES FRANKLIN AND MADISON COUNTIES EACH OF WHICH HAVE POPULATIONS LESS THAN 35000 PEOPLE THE COUNTIES ARE LOCATED IN THE RURAL NORTHEAST PART OF GEORGIA ALONG THE INTERSTATE 85 CORRIDOR HALFWAY BETWEEN ATLANTA GA AND GREENVILLE SC THE SYSTEM OPERATES THE ONLY ACUTE CARE HOSPITAL LOCATED IN THE TWO COUNTIES EACH COUNTY COULD BE SUMMARIZED WITH COMMON CHARACTERISTICS AS HAVING ABOUT 25000 RESIDENTS HAVING A HIGHER THAN STATE AVERAGE MEDIAN AGE LOWER THAN STATE AVERAGE EDUCATION LEVEL AND HIGHER RATES OF CHRONIC DISEASE THE REGION HAS EXPERIENCED MINIMAL GROWTH IN POPULATION JOB CREATION AND INDUSTRIAL DEVELOPMENT FORECASTERS ARE PREDICTING THE REGION WILL GROW AT A FASTER RATE IN ALL OF THESE AREAS IN THE FUTURE AS DEVELOPMENT ALONG THE I85 CORRIDOR CONTINUES AND NEW GROWTH WILL OCCUR AS HWY 17 IS WIDENED TO FOUR LANES HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI TY COBB HEALTHCARE SYSTEM INC HAS AN OPEN MEDICAL STAFF AND THE BOARD OF DIRECTORS CONSIST OF COMMUNITY LEADERS LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED PART VI GEORGIA ADDITIONAL INFORMATION PART VI TY COBB HEALTHCARE SYSTEM INC PROVIDES FREE MONTHLY HEALTH EDUCATION PROGRAMS TO THE PUBLIC TO PROMOTE WELLNESS AND HEALTHIER LIFESTYLES THE OCCUPATIONAL MEDICINE AND WELLNESS DEPARTMENT ALSO PARTICIPATES IN LUNCH AND LEARNS AND HEALTH FAIRS THROUGHOUT THE YEAR THAT PROVIDE HEALTH EDUCATION AND SCREENING OPPORTUNITIES FOR EMPLOYEES OF LOCAL BUSINESSES AS WELL AS THE PUBLIC AT LARGE SYSTEM EMPLOYEES ARE ACTIVE IN AND PROMOTE WELLNESS TO LOCAL CIVIC GROUPS INCLUDING BUT NOT LIMITED TO THE TRI COUNTY DIABETES TASK FORCE CHAMBER OF COMMERCE ROTARY CLUB KIWANIS CLUB AND SERVICE LEAGUES COBB MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 19D PART V LINE 19D PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE CHARGED A DISCOUNTED RATE BASED UPON HOSPITAL POLICY X true true X X false true false false false false false false false CHARLES T ADAMS 247040 62500 7000 37500 16344 370384 STEVE BARBER 145848 10500 4151 6765 16344 183608 DAVID SEAGRAVES 98751 98751 7000 7000 1249 1249 15888 122888 107000 JERRY WISE 68302 68302 3429 3429 3510 15888 71731 91129 FRINGE OR EXPENSE EXPLANATION SCHEDULE J, PAGE 1, PART I, LINE 1A CEO IS PROVIDED WITH A DISCRETIONARY SPENDING ACCOUNT OF 600 EACH MONTH. SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 CHARLES T ADAMS 0 30,000 0 OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III TCHS AND ITS RELATED PARTY, COBB FOUNDATION, INC., EACH OPERATE AN ACUTE CARE HOSPITAL. TCHS IS IN THE PROCESS OF BUILDING A NEW ACUTE CARE HOSPITAL. THE TWO HOSPITALS OPERATED BY TCHS AND COBB FOUNDATION WILL CLOSE WHEN THE NEW HOSPITAL OPENS. THE CONVERSION FROM TWO HOSPITALS TO ONE WILL CAUSE OVERLAP IN SOME POSITIONS. TOP MANAGEMENT OFFICERS OF TCHS WERE OFFERED RETENTION INCENTIVES TO STAY FOR TWO YEARS DURING THE CONVERSION PROCESS. DOING BUSINESS AS FORM 990, PAGE 1, ITEM C MEMORIAL CONVALESCENT CENTER, COBB HEALTHCARE CENTER, THE GABLES AT COBB VILLAGE, THE FITNESS FIRM OF TCHS, HEALTH WORKS OF TCHS, HOME BASE HEALTH SERVICES, CARNESVILLE FAMILY PRACTICE, TY COBB MUSEUM FIRST ACCOMPLISHMENT DESCRIPTION FORM 990, PAGE 2, PART III, LINE 4A PATIENTS AT PAYMENT RATES WHICH ARE DETERMINED BY THE FEDERAL AND STATE GOVERNMENTS, REGARDLESS OF THE HOSPITAL'S ACTUAL CHARGES. IN SOME CASES, THESE PROGRAMS PAY THE HOSPITAL AT AMOUNTS WHICH ARE LESS THAN THE COST OF PROVIDING THE SERVICES. THE HOSPITAL ALSO PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS INDIGENT AND CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. CHARGES FOREGONE, AT ESTABLISHED RATES, UNDER THE INDIGENT AND CHARITY CARE POLICY APPROXIMATED 1,869,000. IN ADDITION, THE HOSPITAL HAD BAD DEBT EXPENSE (PATIENT BILLS THAT WERE NOT COLLECTED) OF APPROXIMATELY 3,178,000. BROWN MEMORIAL CONVALESCENT CENTER PROVIDED OVER 51,300 RESIDENT DAYS DURING 2011. OF THESE DAYS, APPROXIMATELY 86% WERE COVERED BY THE MEDICAID AND MEDICARE INSURANCE PROGRAMS. COBB HEALTHCARE CENTER PROVIDED OVER 39,600 RESIDENT DAYS DURING 2011. OF THESE DAYS, APPROXIMATELY 80% WERE COVERED BY THE MEDICAID AND MEDICARE INSURANCE PROGRAMS. FINANCIAL ACCOUNTS IN FOREIGN COUNTRIES FORM 990, PART V, LINE 4B CAYMAN ISLANDS ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B AFTER MANAGEMENT REVIEW AND APPROVAL, AN ELECTRONIC COPY OF THE FORM 990 WAS EMAILED TO ALL MEMBERS OF THE TYCOBB HEALTHCARE SYSTEM, INC.'S BOARD OF DIRECTORS FOR APPROVAL PRIOR TO SUBMISSION. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C THE BOARD OF DIRECTORS AND CEO MONITOR AND ENFORCE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A THE COMPENSATION OF TY COBB HEALTHCARE SYSTEM, INC.'S CEO IS REVIEWED AND APPROVED BY THE INDEPENDENT BOARD OF DIRECTORS. EXTERNAL COMPARABILITY REPORTING WAS ALSO USED IN THE DETERMINATION OF COMPENSATION OF THE CEO. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B THE COMPENSATION OF TY COBB HEALTHCARE SYSTEM, INC.'S CFO IS REVIEWED AND APPROVED BY THE INDEPENDENT BOARD OF DIRECTORS. EXTERNAL COMPARABILITY REPORTING WAS ALSO USED IN THE DETERMINATION OF COMPENSATION OF THE CFO. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 THE TY COBB HEALTHCARE SYSTEM, INC.'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE FOR THE PUBLIC TO REVIEW AT THE SYSTEM'S CORPORATE OFFICE UPON REQUEST. ADDITIONAL INFORMATION FORM 990, PART VII HOURS SPENT AT RELATED ORGANIZATIONS BY LISTED INDIVIDUALS INCLUDE DAVID SEAGRAVES 20 HOURS DONNA TONEY 7 HOURS WILLIAM ROGERS 33 HOURS CHARLES ADAMS 20 HOURS STEVE BARBER 20 HOURS OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 5 CHANGE IN NET UNREALIZED GAIN AND LOSSES ON OTHER THAN TRADING SECURITIES AND BOOK-TAX DIFFERENCES FROM PARTNERSHIP ACTIVITIES. UNREALIZED GAINS AND LOSSES < 1,521,267 > BOOK-TAX DIFFERENCES FROM PARTNERSHIPS < 76,007 > ------------- TOTAL - OTHER CHANGES IN NET ASSETS < 1,597,274 > ============= TY COBB REGIONAL MEDICAL CENTER LLC 461 COOK STREET ROYSTON GA 30662 264541857 HEALTHCARE GA 743417 TY COBB THE COBB FOUNDATION PO BOX 280 HARTWELL GA 30643 581634125 HEALTHCARE GA 501C3 3 TY COBB true HOME TOWN HEALTH LLC 3280 CHERRY OAK LANE SUITE 100 CUMMING GA 30041 582403678 EDUCATION GA TY COBB EXCLUDED 146809 239821 false false 0.53710 false false false false false false false false false false false false false true true true false false COBB FOUNDATION O 82034 ACTUAL EXPENSE REIMBURSED COBB FOUNDATION P 9703621 ACTUAL EXPENSE REIMBURSED COBB FOUNDATION N 238520 ALLOCATION OF SALARIES