2012-06-07T09:30:53-05:00 2011-09-30 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2010-10-01 581519913 HAMILTON HEALTH CARE SYSTEM INC HAMI 7062726115 PO BOX 1168 DALTON GA 307221168 GARY L HOWARD 7062726115 2012-05-30 MICHAEL RAUCHWARG 8282542254 2010 2016-02-24 21:20:13Z GARY L HOWARD PO BOX 1168 DALTON GA 307221168 57440240 0 X WWW.HAMILTONHEALTH.COM X 1983 GA TO PROVIDE SUPPORT FOR AFFILIATED TAX-EXEMPT ORGANIZATIONS. 11 9 596 11 0 0 0 0 13389400 12626823 8814989 7374931 0 0 22204389 20001754 0 0 0 0 10682608 9898643 0 0 0 4419826 3061139 15102434 12959782 7101955 7041972 123248382 124575804 3829178 3622166 119419204 120953638 X THE SYSTEM PROVIDES LEADERSHIP TO MEET THE HEALTH CARE NEEDS OF THE AREA WITH SERVICES THAT ADVANCE THE QUALITY AND DIGNITY OF LIFE. THE ORGANIZATION SERVES AS THE PARENT CORPORATION FOR HAMILTON MEDICAL CENTER AND OTHER HEALTH-RELATED ENTITIES. THE ORGANIZATION MANAGES RESOURCES IN A MANNER THAT PROMOTES COMMUNITY TRUST AND ASSURES CONTINUED FINANCIAL VIABILITY. 0 0 12439674 12626823 SUPPORT OF AFFILIATED TAX-EXEMPT ORGANIZATIONS LISTED IN SCHEDULE R, PART 2. 12439674 1 0 0 1 0 0 0 0 0 0 1 1 1 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 18 0 1 596 1 0 0 0 0 0 0 0 0 0 0 0 X 11 9 1 0 0 0 0 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 GA X JOSEPH L MCGUIRE 7062782105 1200 MEMORIAL DRIVE DALTON GA 30720 G LAMAR LYLE 1.00 X X 0 0 0 ROBERT M CHANDLER 1.00 X X 0 0 0 DON W ADCOCK 1.00 X 0 0 0 CHARLES H HERNDON JR MD 1.00 X 0 0 0 BRYAN MCALLISTER 1.00 X X 0 0 0 WILLIAM H PULLEN MD 1.00 X 0 0 0 DOROTHY B REICH 1.00 X 0 0 0 HENRY C THARPE JR 1.00 X 0 0 0 JACKSON P TURNER 1.00 X 0 0 0 LUIS M VIAMONTE MD 1.00 X 0 0 0 JEFFREY D MYERS 40.00 X X 378247 0 110947 GARY L HOWARD 40.00 X 382983 0 120327 JOSEPH L MCGUIRE 40.00 X 172999 0 65820 KAREN J WISDOM 40.00 X 0 403110 54241 MARCIA P CASTEEL 40.00 X 124876 0 6074 JOHN S BOWLING 40.00 X 270838 0 185612 1329943 403110 543021 5 1 1 0 INTEGRITY HOSPITAL COMPANY PO BOX 228 SOUTHWEST HARBOR MD 21279 CONSULTING FEES 155360 TRUE NORTH CUSTOM PUBLISH PO BOX 886573 ATLANTA GA 30368 PURCHASED SERVICES 143894 SIEMENS MEDICAL SOLUTIONS PO BOX 120001 DALLAS TX 75312 PURCHASED SERVICES 133528 3 STAFFING SERVICE 900099 6430917 6430917 MANAGEMENT FEES 900099 6195906 6195906 12626823 4999735 4999735 39813682 37438486 2375196 2375196 2375196 20001754 12626823 0 7374931 1690462 1690462 7103506 7103506 119858 119858 352040 352040 632777 632777 130180 130180 15777 15777 16159 16159 325517 325517 636389 636389 404889 404889 248510 248510 71738 71738 4772 4772 60809 60809 24740 24740 CONSULTING FEES 459504 459504 DUES & SUBSCRIPTIONS 312749 312749 MANAGEMENT FEE TO HAMIL 200004 200004 EMPLOYEE RECRUITMENT 102097 102097 MISCELLANEOUS 47305 12439674 -12392369 12959782 12439674 520108 0 153192 1934994 1613942 2070440 5256681 6178449 8468224 8132459 39182 120851 1809781 424469 1437434 1385312 73368665 72223931 32911062 32529368 123248382 124575804 1032312 855263 2796866 2766903 3829178 3622166 X 119419204 120953638 119419204 120953638 123248382 124575804 X 7041972 -5507538 X 0 1 1 X 0 X X X 0 0 0 HAMILTON AMBULATORY SURGERY CENTER 582654791 3 1 1 1 0 HAMILTON MEDICAL CENTER INC 581519911 3 1 1 1 0 HAMILTON EMERGENCY MEDICAL SERVICES INC 581651002 9 1 1 1 200000 HLTC INC 582341574 9 1 1 1 950000 MURRAY MEDICAL CENTER INC 582341574 3 1 1 1 0 ROYAL OAK COMMUNITY LTD 582373427 3 1 1 1 0 WHITFIELD HEALTHCARE FOUNDATION INC 510175056 3 1 1 1 0 WHITFIELD PLACE INC 582103085 9 1 1 1 0 DALTON SENIOR HOUSING INC 581518011 9 1 1 1 0 9 1150000 0 0 0 0 0 1 16159 0 0 0 16159 0 1141372 1141372 33505 32338 1167 634904 392131 242773 1385312 INTEREST RECEIVABLE 532395 F TIMBERLAND INVESTMENTS 4818756 F REAL ESTATE 4309386 F LONG/SHORT FUND OF FUNDS 8507042 F US TREASURY 14361789 F 32529368 DEFERRED COMPENSATION 1771069 ACCRUED PENSION COST 995834 2766903 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION HAS ADOPTED PROCEDURES FOR DETERMINING THE EXISTENCE OF UNCERTAIN TAX POSITIONS, AND THE RELATED TIMING AND AMOUNT OF THEIR IMPACT ON THE FINANCIAL STATEMENTS, AND DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2011. X X 1 1 X X X 0 1 0 0 0 1 1 0 0 JEFFREY D MYERS 339225 0 0 0 39022 0 18825 0 92122 0 489194 0 0 0 GARY L HOWARD 271522 0 0 0 111461 0 19705 0 100622 0 503310 0 67350 0 JOSEPH L MCGUIRE 145733 0 0 0 27266 0 7787 0 58033 0 238819 0 17977 0 KAREN J WISDOM 0 299198 0 0 0 103912 0 15992 0 38249 0 457351 0 58138 JOHN S BOWLING 249055 0 0 0 21783 0 111463 0 74149 0 456450 0 104878 0 PART I, LINE 4B JOHN S. BOWLING - $110,520; GARY L. HOWARD - $4,038; JEFFREY D. MYERS - $3,741 PART I, LINE 6 THE ORGANIZATION HAS A MANAGEMENT PERFORMANCE INCENTIVE PLAN FOR ELIGIBLE PARTICIPANTS TO FOCUS ON SPECIFIC STRATEGIC, ORGANIZATIONAL AND FINANCIAL GOALS. THE TOTAL AWARDS UNDER THE PLAN CANNOT EXCEED TEN PERCENT OF THE HAMILTON HEALTH CARE SYSTEM COMBINED EXCESS OF REVENUES OVER EXPENSES EXCLUDING INVESTMENT INCOME. INDIVIDUAL INCENTIVES ARE BASED UPON ACHIEVING CERTAIN ORGANIZATIONAL AND INDIVIDUAL SERVICE QUALITY, FINANCIAL RESULTS AND CUSTOMER SATISFACTION GOALS. FORM 990, PART IV, LINE 12: FINANCIAL STATEMENTS OF HAMILTON HEALTH CARE SYSTEM, INC ARE AUDITED ON A CONSOLIDATED BASIS TO INCLUDE ALL AFFILIATES OF THE SYSTEM. FORM 990, PART VI, SECTION A, LINE 2 CHAIRMAN OF THE BOARD G. LAMAR LYLE HAS A BUSINESS RELATIONSHIP WITH BOARD MEMBER JACKSON P. TURNER. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN CAPITAL EXPENDITURE AND CONTRACTUAL COMMITMENT DECISIONS MUST BE SUBSEQUENTLY APPROVED BY THE HAMILTON HEALTH CARE SYSTEM BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11 FOLLOWING MANAGEMENT PREPARATION AND REVIEW, THE FORM 990 IS REVIEWED BY AN INDEPENDENT CPA FIRM. SUBSEQUENTLY, A DRAFT OF THE UNFILED FORM 990 IS POSTED TO A SECURE PAGE ON THE HAMILTON HEALTH CARE SYSTEM WEBSITE FOR REVIEW AND COMMENT BY ALL MEMBER OF THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CLEAR AND DETAILED CONFLICT OF INTEREST POLICY WHICH ESTABLISHES A PROCEDURE FOR IDENTIFYING, REVIEWING AND ADDRESSING CONFLICTS OF INTEREST. THIS POLICY ALSO REQUIRED EACH TRUSTEE AND OFFICER OF THE ORGANIZATION TO ANNUALLY SIGN A STATEMENT ACKNOWLEDGING RECEIPT OF THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 UNDER A BOARD RESOLUTION, THE ORGANIZATION'S COMPENSATION COMMITTEE HAS THE AUTHORITY TO TAKE ACTION ON BEHALF OF THE BOARD WITH RESPECT TO THE COMPENSATION OF OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE MAINTAINS MINUTES OF ITS PROCEEDINGS. ON AN ANNUAL BASIS THE COMPENSATION COMMITTEE WILL MEET TO SET THE ANNUAL COMPENSATION OF THE PRESIDENT/CEO. THIS ACTION IS BASED ON CONSULTATION WITH A THIRD PARTY CONSULTING FIRM TO REVIEW THE TOTAL COMPENSATION OF THE CEO AND KEY EMPLOYEES SUCH THAT TOTAL COMPENSATION PACKAGES ARE CONSIDERED FAIR MARKET AND NOT EXCESSIVE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -5,507,538. DALTON SENIOR HOUSING INC 519 WEST HAWTHORNE STREET DALTON GA 30720 581518011 LOW-INCOME HOUSING GA 501(C)(3) LINE 9 HAMILTON HEALTH CARE SYSTEM INC 1 DALTON-WHITFIELD COUNTY HOSPITAL LIABILITY TRUST PO BOX 1168 DALTON GA 30722 581331514 LIABILITY CLAIMS COVERAGE GA 501(C)(3) LINE 11D, III-O HAMILTON HEALTH CARE SYSTEM INC 1 DALTON-WHITFIELD ADDITIONAL TRUST PO BOX 1168 DALTON GA 30722 586345013 FUNDS FOR INDIGENT CARE GA 501(C)(3) LINE 11A, I HAMILTON HEALTH CARE SYSTEM INC 1 DALTON-WHITFIELD INDIGENT CARE TRUST PO BOX 1168 DALTON GA 30722 586345011 FUNDS FOR INDIGENT CARE GA 501(C)(3) LINE 11A, I HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON AMBULATORY SURGERY CENTER INC PO BOX 1168 DALTON GA 30722 582654791 SURGICAL SERVICES GA 501(C)(3) LINE 3 HAMILTON MEDICAL CENTER INC 0 HAMILTON MEDICAL CENTER INC PO BOX 1168 DALTON GA 30722 581519911 HOPSITAL GA 501(C)(3) LINE 3 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON EMERGENCY MEDICAL SERVICES INC PO BOX 1168 DALTON GA 30722 581651002 EMERGENCY MEDICAL GA 501(C)(3) LINE 9 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON PHYSICIANS GROUP INC PO BOX 1168 DALTON GA 30722 271198701 PHYSICIAN PRACTICE GA 501(C)(3) LINE 3 HAMILTON MEDICAL CENTER INC 0 HLTC INC PO BOX 1168 DALTON GA 30722 582341574 LONG TERM ELDERLY CARE GA 501(C)(3) LINE 9 HAMILTON HEALTH CARE SYSTEM INC 1 MURRAY MEDICAL CENTER INC PO BOX 1406 CHATSWORTH GA 30705 582373427 HOSPITAL CARE / SERVICES GA 501(C)(3) LINE 3 HAMILTON HEALTH CARE SYSTEM INC 1 ROYAL OAK COMMUNITY LTD PO BOX 1900 DALTON GA 30722 581970228 SENIOR LIVING SERVICES GA 501(C)(3) LINE 9 HAMILTON HEALTH CARE SYSTEM INC 1 WHITFIELD HEALTHCARE FOUNDATION INC PO BOX 1900 DALTON GA 30722 510175056 FUNDS FOR HEALTHCARE GA 501(C)(3) LINE 11A, I HAMILTON HEALTH CARE SYSTEM INC 1 WHITFIELD PLACE INC PO BOX 1168 DALTON GA 30722 582103085 LOW-INCOME HOUSING GA 501(C)(3) LINE 9 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON HEALTH FIRST INC PO BOX 1168 DALTON GA 30722 581694713 PREFERRED PROVIDER GA HAMILTON HEALTH CARE SYSTEM INC C 1.00000 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 MURRAY MEDICAL CENTER INC A 290547 FMV HAMILTON EMERGENCY MEDICAL SERVICES INC D -125000 FMV HLTC INC D 350000 FMV ROYAL OAK COMMUNITY LTD R 6008407 FMV HAMILTON MEDICAL CENTER INC R 7374437 FMV ROYAL OAK COMMUNITY LTD R 223902 FMV WHITFIELD HEALTHCARE FOUNDATION INC R -396224 FMV HAMILTON MEDICAL CENTER INC R 3329506 FMV DALTON SENIOR HOUSING INC R 95000 FMV HLTC INC R 140000 FMV ROYAL OAK COMMUNITY LTD R 50000 FMV WHITFIELD HEALTHCARE FOUNDATION INC R 203226 FMV WHITFIELD PLACEINC R 98000 FMV