2012-12-14T08:54:19-08:00 2012-04-30 990 2011-05-01 581911751 KINGS BAY COMM HOSPITALINC dba S E GA HEALTH SYSTEM-CAMDEN KING 9124663395 2000 Dan Proctor Dr St Marys GA 31558 Michael D Scherneck 2012-12-14 2011 2016-02-24 21:20:13Z Gary R Colberg FACHE 5030 Riverside Dr Brunswick GA 31520 42564407 false false X sghs.org X 1990 GA Southeast Georgia Health System will provide safe, quality, accessible, and cost-effective care to meet the health needs of the people and communities it serves. 9 9 342 176 0 33200 37755 38129831 41985968 155540 162143 256457 378541 38575028 42564407 0 0 17437362 18575063 0 0 16371998 18920713 33809360 37495776 4765668 5068631 66959339 72546646 35050273 35568949 31909066 36977697 Southeast Georgia Health System will provide safe, quality, accessible, and cost-effective care to meet the health needs of the people and communities it serves. false false 36041476 41985968 King's Bay Hospital, D/B/A Southeast Georgia Health System - Camden Campus, is a 40 bed hospital located in southeast Georgia in the city of St. Marys. For the 12 month fiscal period beginning 05/01/2011 and ended 04/30/2012, the medical center had 6,261 inpatient patient days and 716 births. We served 46,356 patients on an outpatient basis and an additional 30,723 patients were seen in the emergency room. Our financial statements include over $13.7 million in free care (includes indigent care, charity care and bad debts). 36041476 true true false false false false false false false false true false true false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false false false false true true false false false true 44 0 true 342 true false false false false false false false false false false false 0 false false false false false false false false false false false X 9 9 false false false false true true false true true false false false true true true true true true true true false false GA X X Michael DScherneckExecVPCFO 9124667049 2415 Parkwood Dr Brunswick GA 31520 Carla L Yarbrough 2.00 X 0 0 0 Walter C McNeely 2.00 X 0 0 0 Mark Bedner 2.00 X 0 0 0 Vance Hughes 2.00 X 0 0 0 MHWoodyWoodside 2.00 X X 0 0 0 Laura Cross-McKinley 2.00 X X 0 0 0 Mitchell Jones MD 2.00 X 0 0 0 Carl Alexander 2.00 X X 0 0 0 Michael Hodges 5.00 X X 0 0 0 Michael D Scherneck 40.00 X 0 340222 50897 Gary R Colberg FACHE 40.00 X 0 710031 106567 Howard Sepp 40.00 X 0 239321 62772 Patrick D Ebri 40.00 X 0 188180 52468 Elizabeth Gunn 40.00 X 0 168003 35647 Kevin Smiley 40.00 X 133504 0 39822 Christie Foddrell 40.00 X 95626 0 19656 Robert D Moore 40.00 X 101845 0 53142 Jeffrey Zawislak 40.00 X 94502 0 40828 John Cox 40.00 X 77893 0 45141 Ellen Hamilton 40.00 X 0 190813 44927 503370 1836570 551867 2 true true false Cross Country Staffing P O Box 404674 Atlanta GA 303844674 Contract Nursing 130509 1 37755 37755 Net Patient Svc Revenue 621400 41985968 41985968 41985968 162143 162143 0 0 237811 237811 237811 237811 0 0 0 0 Other Revenue 900099 17889 17889 Cafeteria Sales 722210 122841 122841 140730 42564407 41985968 540684 0 0 0 0 0 0 14266349 13564546 701803 440296 418633 21663 2946152 2801201 144951 922266 876891 45375 0 25543 25543 13406 13406 0 0 0 5076325 5085436 -9111 421512 421512 6514505 6449504 65001 0 0 992182 992182 81716 57568 24148 0 0 1747856 1747856 0 3008426 3008426 530762 530762 Provider Taxes 450004 450004 Other Taxes 4320 4320 Licenses/Permits 17210 17210 Employee Recruiting 1732 1732 Ambulance 35122 35122 92 83 9 37495776 36041476 1454300 0 0 3262019 426417 0 6164022 6956155 0 0 0 856135 803133 242970 242042 66134757 19833692 45918112 46301065 6857484 3956400 0 3503397 13425662 0 155200 435772 66959339 72546646 4080358 5053212 266400 30524256 30382675 179259 133062 35050273 35568949 X 31909066 36977697 31909066 36977697 66959339 72546646 5068631 X false true true X false false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1156762 1156762 43479477 5813858 37665619 21098197 13892812 7205385 400321 127022 273299 46301065 13425662 Rounding 1 2000-3500 Lease Obligation L/T 133061 133062 42564407 37495776 5068631 5068631 42564407 42564407 42564407 37495776 37495776 37495776 Part X Part X : FIN48 Footnote On May 1, 2009, Southeast Georgia Health System adopted the uncertain tax positions provisions of FASB ASC Topic 740 ("ASC 740"), Income Taxes, which addresses the determination of whether tax benefits claimed or expected to be claimed on a tax return should be recorded in the combined financial statements. Under ASC 740-10-25, Southeast Georgia Health System may recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by taxing authorities based on the technical merits of the position. The tax benefits recognized in the combined financial statements from such a position are measured based on the largest benefit that has a greater than fifty percent likelihood of being realized upon ultimate settlement. ASC 740 also provides guidance on de-recognition, classification, interest and penalties on income taxes, and accounting in interim periods. The System has determined that it does not have any material unrecognized tax benefits or obligations as of April 30, 2012 and 2011, respectively. Fiscal years ending on and after April 30, 2009 remain subject to examination by federal and state tax authorities. true true true X 125.000000000 true X true true true false true true 2608042 1297301 1310741 0.03500 4989895 3752109 1237786 0.03300 119248 86972 32276 0.00090 7717185 5136382 2580803 0.06890 25200 25200 0.00070 25200 25200 0.00070 7742385 5136382 2606003 0.06960 true 3611193 552513 7608281 6720265 888016 X true false 1 0 Kings Bay Comm HspInc dba

SE GA Health Sys Camden MD Ctr St Marys GA 31558

X X X Kings Bay Comm HspInc dba 1 false true true 125.0000 true 200.0000 true X X true true X X X X X X X true X X X true X X X X X X X X true X false true Part VI - States Where Community Benefit Report Filed GA Part VI - Community Building Activities Our community efforts resulted in patients being served by our Wellness on Wheels (WOW) mobile health vehicle which provides free screening (mammography, dexascan, blood pressure and blood sugar, hearing, vaccinations), and Community Care Center, a pediatric center that is dedicated to the health care needs of our Medicaid population. These programs and many others form the foundation of our commitment to community health improvement.Wellness on Wheels (WOW) mobile health vehicle is our mobile "health care on wheels" that travels and delivers care throughout the nine county region. The WOW operates mostly Monday through Saturday and some Sunday's, as requested and serves a different location each week.. Staffed by our expert providers; the WOW provides a broad range of free services: mammography, dexascan, blood pressure and blood sugar, hearing, cholesterol screenings to basic health care check-ups, medical exams, and vaccinations. In addition to providing medical care, our financial counselor assist patients in applying for a variety of community assistance programs. Our financial counselors work with individuals to understand their unique needs and assist them in applying for federal, state, and local programs they may qualify for, including Medicaid and pharmaceutical assistance, food stamps, and the Women, Infants and Children (WIC) program. Our community partners are critical to helping us improve the health and well-being of the greater coastal Georgia region. Together, we can combine resources and strengths, positively impacting the greatest number of people. By working closely with community leaders, we also build a greater sense of community and a shared commitment toward our common goal of improving the community's health. We're proud of our partners.Community partners include:Coastal Medical Access ProgramCoastal Health DistrictCoastal Coalition of ChildrenGolden Isles Child Advocacy CenterOur vice president responsible for ancillary services and our administrative resident coordinates with area high schools to offer an Explorer Post program that brings awareness to high school students of the job opportunities in the health care field. Our director of volunteer services also coordinates and works with area high school students on a shadowing program and promote health careers at their annual information fairs at the local high schools. Employees in the CommunityEvery year, Southeast Georgia Health System unites around corporate-wide efforts: Ringing bells for the Salvation Army; fundraising for the American Cancer Society, participating in our local United Way Campaign and so much more.At Southeast Georgia Health System, it's important to us to give back to our community. In addition to team member United Way donations and volunteer time at Relay For Life and other sponsored events, our team members participate in a variety of community service initiatives, from Habitat for Humanity to the Boys and Girls Club of Southeast Georgia to local student mentoring programs. Part VI - Community Information King's Bay Community Hospital, Inc., is located in St.Marys, Georgia. The primary service area for the King's Bay Community Hospital, Inc., is Camden County which had an approximate population of 50,513 according to the U.S. Census Bureau estimates for 2010. King's Bay Community Hospital, Inc., derived approximately 87 % of its admissions from Camden County. The King's Bay Community Hospital, Inc., secondary service area includes Charlton and Brantley Counties in Georgia and Nassau County in Northeast Florida, with a combined population of 103,896 according to the U.S. Census Bureau estimates for 2010. King's Bay Community Hospital, Inc., is the only hospital in Camden County. Other hospitals in the secondary service area are Charlton Memorial Hospital, a 25 bed critical access hospital located in Folkston(Charlton County), Georgia, and Baptist Medical Center, Nassau, a 54 bed primary care hospital located in Fernandina Beach, Florida. Part VI - Patient Education of Eligibility for Assistance *Southeast Georgia Health System's Financial Assistance Program (Indigent/Charity Policy) is advertised by signage in Admissions, the Emergency Care Center and the Business Office. Program information is also contained periodically in Southeast Georgia Health System's healthcare magazine which is distributed throughout the community.*The standard registration packet for all patients contains a printed form describing the Financial Assistance Program and the application process. The Financial Assistance process is further explained to the patients by the Registrars during the registration process. Additionally, patients being admitted as an inpatient are provided an information booklet which further details the Financial Assistance Program relating to the inability to pay for medical costs.*Financial Counselors in Admissions engage patients/financially responsible persons and investigate repayment options for medical costs incurred by patients being admitted to an inpatient status who display no identifiable means of paying for medical services through a third party insurer or other source. Contract staff are available to assist patients with United States Social Security Disability and/or Supplemental Income programs. Financial Counselors will assist patients in the application process for other federal and state public assistance programs and if ineligible, will promote Southeast Georgia Health System's internal financial assistance program as an additional option.*All billing statements address the patient's potential inability to pay for medical services by advertising Southeast Georgia Health System's Financial Assistance Program on the front and back of each statement mailer.*Business Office reception and telephone inquiry staff educate and promote Southeast Georgia Health System's Financial Assistance Program and distribute applications when a patient has indicated financial hardship, unemployment or the need for a low monthly repayment plan.*Financial Assistance Program information is contained on Southeast Georgia Health System's website with the ability for the patient to print an application for their use.*Financial Assistance Program information and applications are also provided by collection staff and collection subcontractors upon indication of a patient's financial need or inability to pay for medical services. Federal and state public assistance programs are suggested as well. Part VI - Needs Assessment At King's Bay Community Hospital,Inc., our goal is to strengthen the health and well-being of our patients and neighbors, as well as the broader community. King's Bay Community Hospital,Inc., D/B/A Southeast Georgia Health System-Camden Campus, provided over $2.6 million in community benefits, which is more important to building the vitality of our community than ever. The services we provide are essential to not only the community's overall health, but also to the quality of life of every resident. This belief is ingrained in our culture, from our volunteer King's Bay Community Hospital,Inc., board to our physicians and nurses, staff, auxiliary volunteers, and our Southeast Georgia Health System Foundation.We participate in informal community needs assessments regularly, collaborating with local agencies, schools, and community groups. The results help us determine our short- and long-term priorities as well as strategies for improving community health. Our leadership team is involved with several community activities and on boards. These range from the Rotaries to the International Seafarers program to the Coastal Medical Access Program which serves the under-and uninsured in our community and beyond. Number of Hospital Faciltiy - 0 Part V, Line 21 - Charge Patients Amount Equal Gross Charge for Services See attachment for line 19D Number of Hospital Faciltiy - 0 Part V, Line 19d - Other Billing Determination of Individuals Without Insurance Southeast Georgia Health System medical charges are the same for all patients and are not tiered by payer source. Patients incurring financial liabilities whether insured or uninsured are provided discount incentives for resolving outstanding balances. A substantial prompt pay discount which is the equivalent of our average managed care insurance contracted discount rate is offered for patient balances. Also, patients demonstrating a diminished ability to pay through full financial disclosure and repayment analysis are considered for settlement discounts which may exceed or be equivalent to Medicare rates. Number of Hospital Faciltiy - 0 Part V, Line 17e - Other Actions Took Before Any Collection Actions Collection agencies are required to promote Southeast Georgia Health System's Financial Assistance Program when the debtor has demonstrated an inability to pay in response to collection activity. Repayment plans are allowed and monthly payments can be modified to align with the debtor's resources. At the end of ninety days of collection activity from the date of debt referral, collection agencies are required to assess the debtor's ability to pay based upon their response or lack of response in meeting their financial obligation. Debt identified as having no collection potential or an identifiable source for repayment will be closed and returned to Southeast Georgia Health System as "uncollectible" and all collection activity ceases. Number of Hospital Faciltiy - 0 Part V, Line 16e - Other Collection Actions by Facility or Third Party Engaged Third party collection services are required to abide by a "Conduct Protocol For Collection Personnel" which deals with customer service standards Southeast Georgia Health System maintains and debt collection activity allowed by the protocol. Normal debt collection through statement mailers, telephone calls, credit reporting and legal suits for the purpose of wage garnishment are allowed. Rude or abusive collection behavior is not allowed nor is the filing of property liens. Number of Hospital Faciltiy - 0 Part V, Line 15e - Other Collection Actions Against a Patient The credit and collection policy defines the process which Southeast Georgia Health System uses to collect debt and is applied consistently to all patients regardless of being insured or uninsured. It is designed in accordance with the debtor's ability to pay and promotes the use of State and Government assistance programs and Southeast Georgia Health System's internal Financial Assistance Program. Number of Hospital Faciltiy - 0 Part V, Line 13g - Other Means Hospital Facility Publicized the Policy For patients seeking medical care, Southeast Georgia Health System does process applications and issue approvals prior to the rendering of services upon completion of a financial assistance application and provision of supporting documentation. In situations where medical care is emergent and the patient is receiving or has just received services, the application process can be initiated at the time of service but processing and adjudication cannot occur until supporting documentation such as the most current tax return, paycheck stubs, social security payments and financial assets such as savings, investments, rental income or income producing property are investigated. Household income and dependents supported are factored into the eligibility criteria. The patient's residence is not considered in the determination of eligibility. Number of Hospital Faciltiy - 0 Part V, Line 11h - Other Factors Used in Determing Amounts Charged Patients Southeast Georgia Health System medical charges are the same for all patients and are not tiered by payer source. Patients incurring financial liabilities whether insured or uninsured are provided discount incentives for resolving outstanding balances. Part III, Line 8 - Explanation Of Shortfall As Community Benefit To the extent that Medicare revenue is not sufficient to pay for the cost of providing that care, Southeast Georgia Health System believes that the full amount of that shortfall should be considered in the determination of community benefits. Part III, Line 4 - Bad Debt Expense Net patient service revenue is reported at the estimated net realizable amounts from patients, third-party payors, and others as services are rendered, including estimated retroactive adjustments under reimbursement agreements with third-party payors, and provision for bad debts. Retroactive third-party payor settlements and bad debt adjustments are accrued on an estimated basis in the period the related services are rendered and adjusted in future periods as final settlements are determined. The cost value of Bad Debts was determined by multiplying Bad Debt measured on a gross charge basis by the overall cost to charge ratio developed on the Medicare Cost Report. The amount estimated to have been elibible for financial assistance was determined by multiplying Bad Debt Expense,(at cost), by the poverty rate for Camden County, Georgia. true true false true false false false true true false false false Robert D Moore 97214 4631 22611 30531 154987 Patrick D Ebri 156589 18685 12906 18978 33490 240648 Michael D Scherneck 286148 39748 14326 26981 23916 391119 5000 Kevin Smiley 122138 6408 4958 8010 31812 173326 Howard Sepp 208289 22555 8477 32056 30716 302093 Gary R Colberg FACHE 398450 128294 183287 57096 49471 816598 Ellen Hamilton 176032 14781 15700 29227 235740 108482 Elizabeth Gunn 147072 17614 3317 17018 18629 203650 Sch J, Part I, Line 6b Part I, Line 6b: Explanation of organization compensation contingent on net earnings from related or Compensation contingent on Net Earnings of the organization: Certain members of Management participate in a Management Incentive Plan which is based on a variety of managerial, quality and financial performance indicators. However, compensation is provided under that plan only if a certain net earnings threshold is met. Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Except through the normal I.R.S/ Form 990 inspection process, King's Bay Community Hospital D/B/A Southeast Georgia Helath System Camden has not established a standard process for making its governing documents, conflict of interest policy and financial statements available to the public. Form 990, Part VI, Line 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees As employees of Southeast Georgia Health System, the compensation amounts paid to the individual serving in the capacity as Chief Executive Officer, Executive Director and/or other top management officials and officers are determined based on comparative survey/market data compiled by an independent consulting firm specializing in executive and employee compensation matters. The findings and recommendation of the consultant are reviewed with the Compensation Committee and/or the Executive Compensation Committee of Southeast Georgia Health System which in turn makes recommendations to the full Authority (i.e., Board) of Southeast Georgia Health System which ultimately approves those compensation amounts. In addition, the compensation amounts for those key employees included on Schedule J who receive compensation directly from the organization are determined based on comparative survey/market data compiled by an independent consulting firm specializing in executive and employee compensation matters. The findings and recommendation of the consultant are reviewed with the Human Resource Committee of Southeast Georgia Health System which in turn makes recommendations to the full Authority (i.e., Board) of Southeast Georgia Health System which ultimately approves those compensation amounts. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts King's Bay Community Hospital,Inc d/b/a Southeast Georgia Health System Camden has adopted the conflict-of-interest, whistleblower, and document retention and destruction policies of The Glynn-Brunswick Memorial Hospital Authority d/b/a Southeast Georgia Health System, the sole corporate member of King's Bay Community Hospital, Inc. Services,Inc. Under the conflict-of-interest policy, the Compliance Department requires all members of the Board of Directors, officers and key employees to report any potential conflicts on an annual basis. Form 990, Part VI, Line 11 Form 990, Part VI, Line 11: Form 990 Review Process A draft electronic copy of Form 990 was provided to the members of the Board of Directors prior to being filed with the Internal Revenue Service. Management reviewed Form 990 with the Hospital Authority at a subsequent meeting and addressed all questions and recommendations that the Hospital Authority raised. Form 990, Part VI, Line 6 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Glynn-Brunswick Memorial Hospital Authority, EIN (58-6000498), is the sole corporate member of King's Bay Community Hospital, Inc. SE Georgia Health System Foundation Inc 2415 Parkwood Dr Brunswick GA 31520 582125644 Charitable Foundation GA 501(c)(3) 11 Glynn-Brunswick Memorial Hosp Authority true Cooperative Healthcare Svcs Inc 2415 Parkwood Dr Brunswick GA 31520 010594994 Physician and Immediate Care Facilities GA 501(c)(3) 11 Glynn-Brunswick Memorial Hosp Authority true Glynn-Bwk Mem Hosp DBA SE GA Health System-Brunswick Brunswick GA 31520 586000498 Inpatient and Outpatient Healthcare Services GA 501(c)(3) 3 N/A false false false false false false false false false false false false false false true true false false false