2012-08-15T12:00:13-05:00 2011-09-30 DRAFFIN & TUCKER LLP FIVE CONCOURSE PARKWAY SUITE 1250 ATLANTA GA 30328 990 2010-10-01 582149127 CENTRAL GEORGIA HEALTH SYSTEMS INC CENT 4786331407 691 CHERRY STREET MACON GA 31201 RHONDA S PERRY 2012-08-14 true W Edward Phillips 4042208494 2010 2016-02-24 21:20:13Z A DONALD FAULK JR 691 CHERRY STREET SUITE 400 MACON GA 31201 41099886 false X WWW.MCCG.ORG X 1994 GA CENTRAL GEORGIA HEALTH SYSTEMS, INC. IS A NONPROFIT CORPORATION WHOSE PRIMARY PURPOSE IS TO SERVE AS A PARENT CORPORATION PROVIDING STRATEGIC DIRECTION TO THE MEDICAL CENTER OF CENTRAL GEORGIA, INC. AND OTHER AFFILIATES IN SUPPORT OF THEIR MISSION OF PROVIDING A COMPREHENSIVE RANGE OF HIGH-QUALITY, REASONABLY PRICED HEALTH CARE SERVICES TO THE CENTRAL GEORGIA COMMUNITY. 7 5 423 0 160315 0 0 0 30313999 36232984 5709690 -2396 -2442689 4864423 33581000 41095011 10500221 62400 0 0 23670135 27690138 0 0 0 7848863 10268904 42019219 38021442 -8438219 3073569 39722867 42029443 1166997 854516 38555870 41174927 CENTRAL GEORGIA HEALTH SYSTEMS, INC. (CGHS) PRIMARY PURPOSE IS TO SERVE AS A CONTROLLING BODY FOR THE MEDICAL CENTER OF CENTRAL GEORGIA, INC., HEALTH SERVICES OF CENTRAL GEORGIA, INC., CENTRAL GEORGIA SENIOR HEALTH, INC. AND MEDCEN COMMUNITY HEALTH FOUNDATION, INC. AND OTHER AFFILIATED ENTITIES IN SUPPORT OF THEIR MISSION TO PROVIDE HEALTHCARE SERVICES IN CENTRAL GEORGIA. false false 13985127 62400 19902726 CENTRAL GEORGIA HEALTH SYSTEMS, INC. ("CGHS") PRIMARY PURPOSE IS TO SERVE AS A CONTROLLING BODY FOR THE MEDICAL CENTER OF CENTRAL GEORGIA, INC., HEALTH SERVICES OF CENTRAL GEORGIA, INC., CENTRAL GEORGIA SENIOR HEALTH, INC. AND MEDCEN COMMUNITY HEALTH FOUNDATION, INC. AND OTHER AFFILIATED ENTITIES AND TO PROVIDE STRATEGIC DIRECTION, FINANCIAL MANAGEMENT, RESOURCE ALLOCATION AND OTHER SUPPORT TO ITS AFFILIATES IN THE PROVISION OF HEALTHCARE SERVICES TO THE CENTRAL GEORGIA COMMUNITY. 12796147 16397353 CENTRAL GEORGIA HEALTH SYSTEMS, INC. OPERATES CENTRAL GEORGIA REHABILITATION HOSPITAL, LLC, THE FIRST REHABILITATION FACILITY ESTABLISHED IN CENTRAL GEORGIA AND ONE OF TWO FREE-STANDING REHABILITATION HOSPITALS IN THE STATE. THE REHABILITATION HOSPITAL PROVIDES COMPREHENSIVE PHYSICAL REHABILITATION SERVICES ON AN INPATIENT AND OUTPATIENT BASIS. IT IS LICENSED FOR 58 BEDS. 26781274 true false false true false false false false false true false true true false true true true false false false false false false false false true true true false true false false false false false false false false false false false false true true true true false false true 0 0 423 true true true true CJ false false false false false false false false X 7 5 false false false false false false false true true false false true true true true true true true true true false GA X RHONDA S PERRY 4786331452 777 HEMLOCK STREET MACON GA 31201 KIM W JOHNSTON MD 1 X 0 0 0 CONNIE CATER 1 X 0 0 0 HENRY KOPLIN 1 X 0 0 0 JAMES TIMOTHY JACKSON 1 X 0 0 0 JOAN WALTON 1 X 0 0 0 RUTH KNOX 1 X 0 0 0 STARR PURDUE 1 X 0 0 0 A DONALD FAULK JR 40 X 7940312 0 61400 KENNETH B BANKS 40 X 404251 0 411427 RHONDA S PERRY 40 X 552478 0 1681095 ELBERT T MCQUEEN 40 X 276123 0 28316 HARRIS BRYAN FORLINES 40 X 142180 0 16035 KAREN M FARR 40 X 181727 0 28091 KATHERINE L BOWEN 40 X 174749 0 24432 TRACY GRAY 40 X 168350 0 14771 LORI W CASSIDY 40 X 211734 0 31224 10051904 0 2296792 32 false true false KING AND SPALDING P O BOX 116133 ATLANTA GA 303686133 LEGAL SERVICES 788743 KAUFMAN HALL 5202 OLD ORCHARD RD ST N700 SKOKIE IL 60077 CONSULTING SERVICES 240000 MUNDER CAPITAL 480 PIERCE ST BIRMINGHAM MI 48009 INVESTMENT MANAGEMENT SERVICE 186076 DIXON HUGHES PLLC P O BOX 3049 ASHEVILLE NC 288023049 AUDIT SERVICES 157820 DAVITA 5200 VIRGINIA WAY BRENTWOOD TN 37024 DIALYSIS SERVICES 150456 11 0 MEDICARE.MEDICAID REVENUE 621990 15291083 15291083 PATIENT REVENUE 621990 1050666 1050666 REBATE REVENUE 621990 431367 431367 CAFETERIA SALES 621990 37831 37831 SUPPORT REVENUE 541200 19395864 19243837 152027 26173 17885 8288 0 36232984 1536 1536 0 0 0 0 0 943 4875 0 -3932 -3932 -3932 0 0 0 PARTNERSHIP INVESTMENTS 4864423 67095 4797328 0 0 0 0 4864423 41095011 36139764 160315 4794932 62400 62400 0 0 0 2322548 2322548 0 19520303 16512927 3007376 947342 947342 3265463 2514065 751398 1634482 1208242 426240 0 1661914 1661914 460177 460177 230 230 0 736660 736660 1955761 1202436 753325 103630 103574 56 1236353 1192661 43692 8521 6425 2096 0 490238 407544 82694 176828 128381 48447 0 674 215 459 0 0 90961 77264 13697 791874 206795 585079 EQUIPMENT RENTAL & MAINT 1791326 1778948 12378 TAXES & LICENSES 297070 64898 232172 BAD DEBTS 191855 191855 GIFTS/ ENTERTAINMENT & AWARDS 61905 61465 440 DUES & SUBSCRIPTIONS 41064 5481 35583 171863 108356 63507 0 38021442 26781274 11240168 0 0 1030485 3372305 2031261 2236745 93934 93770 668718 129198 1933197 1517307 463467 415890 0 0 26362402 26425270 9072600 9356265 39722867 42029443 1166997 854516 0 0 1166997 854516 X 38555870 41174927 38555870 41174927 39722867 42029443 X 3073569 -454512 X false true true X false X X X false false false MEDICAL CENTER OF CENTRAL GEORGIA 582149128 3 true true true 0 1 0 AMOUNT OF SUPPORT, SCHEDULE A, PART IH(VII), CENTRAL GEORGIA HEALTH SYSTEMS, INC. IS THE FUNCTIONALLY INTERGRATED PARENT ENTITY OF THE MEDICAL CENTER OF CENTRAL GEORGIA, INC. CGHS IS RESPONSIBLE FOR STRATEGIC PLANNING, FINANCIAL MANAGEMENT AND RESOURCE ALLOCATION FOR MCCG AND ITS AFFILIATED ENTITIES., false false false false false false false false true 230 230 false Description of other lobbying activities Schedule C, Part II-B, Line 1i LOBBYING EXPENSES FOR DUES PAID TO THE GEORGIA CHAMBER OF COMMERCE. 0 0 0 1933197 1517307 415890 0 415890 INVESTMENTS IN SUBSIDIARIES 23318784 C INVESTMENT IN AMERICAN EAGLE 1519469 C INVESTMENT IN SECURE HEALTH PLAN OF CENTRAL GA 1587017 C 26425270 MISCELLANEOUS RECEIVABLE 155820 THIRD PARTY MEDICARE SETTLEMENT 385983 DUE FROM AFFILIATES 8814462 9356265 0 0 41095011 38021442 3073569 -453569 -453569 2620000 16261000 0 0 16261000 736660 24097351 24834011 41095011 17888000 0 0 17888000 736660 19396782 20133442 38021442 FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 CGHS AND ITS AFFILIATES HAVE EVALUATED THEIR TAX POSITIONS AND HAVE DETERMINED THAT THEY DO NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2011. FISCAL YEARS ENDING ON OR AFTER SEPTEMBER 30, 2008 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. true true X true X 1.25 true X true true false true true 494147 0 494147 0.01300 205384 0 205384 0.00540 0 0 0 0.00000 0 0 699531 0 699531 0.01840 0 0 0 0.00000 0 0 0 0.00000 0 0 0 0.00000 0 0 0 0.00000 0 0 0 0.00000 0 0 0 0 0 0.00000 0 0 699531 0 699531 0.01840 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0 0 0 0 0.00000 91745 0 12741260 10111123 2630137 X true true 1 1 CENTRAL GA REHABILITATION HOSPITAL INC

3351 NORTHSIDE DRIVE MACON GA 31210

X REHABILITATION CENTRAL GA REHABILITATION HOSPITAL INC 1 Community benefit report prepared by related organization Schedule H, Part I, Line 6a MEDICAL CENTER OF CENTRAL GEORGIA Bad Debt Expense excluded from financial assistance calculation Schedule H, Part I, Line 7, column(f) 0 Costing Methodology used to calculate financial assistance Schedule H, Part I, Line 7 COST TO CHARGE RATIO FROM WORKSHEET 2. LOSS ON MEDICAID IS ACTUAL HOSPITAL TAXES PAID FROM GENERAL LEDGER. HOSPITAL NOT ELIGIBLE TO PARTICIPATE IN GEORGIA MEDICAID PROGRAM DUE TO CURRENT RULES RELATED TO REHABILITATION HOSPITAL PARTICIPATION. Bad debt expense - financial statement footnote Schedule H, Part III, Line 4 THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 7 IS THE COST TO CHARGE RATIO CALCULATED PURSUANT TO THE IRS FORM 990 SCHEDULE H WORKSHEET 2 INSTRUCTIONS FOR THE SINGLE MEMBER LIMITED LIABILITY COMPANY THAT OPERATES THE REHAB FACILITY. Collection practices for patients eligible for financial assistance Schedule H, Part III, Line 9b ONCE A PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE, IT IS NOTED IN THE PATIENT'S FINANCIAL CHART AND ANY COLLECTION EFFORTS CEASE. THE CONTROLLER OF THE ORGANIZATION REVIEWS THE FINANCIAL ACTIVITY ON OTHER ACCOUNTS TO DETERMINE IF THE ACCOUNT SHOULD BE TURNED OVER TO OUTSIDE COLLECTIONS. IF A PATIENT ACCOUNT TURNED OVER TO COLLECTIONS IS LATER DETERMINED TO QUALIFY AS CHARITY CARE, THE ACCOUNT IS BROUGHT BACK FROM COLLECTIONS AND THE ACCOUNT WRITTEN OFF. Needs assessment. Schedule H, Part VI, Line 2 WE HAVE NOT YET PERFORMED A COMMUNITY HEALTH ASSESSMENT. WE DO WORK WITH COMMUNITY HEALTH WORKS (A REGIONAL HEALTH PROMOTION ORGANIZATION) TO IMPROVE THE HEALTH IN THE REGION. Patient education of eligibility for assistance. Schedule H, Part VI, Line 3 PATIENTS ARE INFORMED OF AVAILABLE ASSISTANCE BY THE FOLLOWING METHOD: THE CGRH BUSINESS OFFICE LIAISON OR DESIGNATED PATIENT ACCOUNT REPRESENTATIVE (PAR) WILL INTERVIEW PATIENTS WHO HAVE LITTLE OR NO THIRD PARTY COVERAGE AND WILL REQUEST DOCUMENTS TO SUPPORT THEIR NEED VIA A FINANCIAL DISCLOSURE FORM. THE FINANCIAL DISCLOSURE FORM WILL ASCERTAIN MONTHLY BILLS AND ASSETS IN THE DETERMINATION OF PATIENT ABILITY TO PAY. Community information. Schedule H, Part VI, Line 4 THE PRIMARY SERVICE AREA IS BIBB, CRAWFORD, HOUSTON, JONES, MONROE, PEACH AND TWIGGS COUNTIES. THERE ARE TWENTY-ONE COUNTIES IN THE SECONDARY SERVICE AREA. THE CURRENT POPULATION IN THE PRIMARY SERVICE AREA IS 406,725 AND THE SECONDARY SERVICE AREA HAS A POPULATION OF 389,460. Promotion of community health Schedule H, Part VI, Line 5 THE ORGANIZATION IS PART OF A MULTI ENTITY HOSPITAL SYSTEM THAT PROVIDES MEDICAL SERVICES TO THE COMMUNITY. THE ORGANIZATION HAS A BOARD COMPRISED OF MEMBERS OF THE COMMUNITY. ANY SURPLUS FUNDS ARE USED FOR PROGRAM SERVICES. AN EMERGENCY ROOM OPEN 24/7/365 IS AVAILABLE AT OUR SISTER ORGANIZATION, THE MEDICAL CENTER OF CENTRAL GEORGIA, ONE OF 5 LEVEL 1 TRAUMA CENTER'S IN THE STATE OF GEORGIA. Affiliated health care system Schedule H, Part VI, Line 6 PART VI, LINE 7: THE ORGANIZATION IS PART OF CENTRAL GEORGIA HEALTH SYSTEMS, INC., A MULTI-ENTITY HEALTHCARE SYSTEM. OTHER ORGANIZATIONS IN THE SYSTEM INCLUDE: MEDICAL CENTER OF CENTRAL GEORGIA, INC. - A 637 BED HOSPITAL FACILITY THAT IS DESIGNATED AS A LEVEL 1 TRAUMA CENTER AND MAGNET HOSPITAL FOR NURSING. HEALTH SERVICES OF CENTRAL GEORGIA, INC. - PROVIDES FACULTY PHYSICIANS TO THE RESIDENCY TRAINING PROGRAMS OF THE MEDICAL CENTER OF CENTRAL GEORGIA AS WELL AS OTHER PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN ASSISTANTS. CENTRAL GEORGIA SENIOR HEALTH, INC. - A CONTINUING CARE RETIREMENT COMMUNITY (CCRC) OFFERS INDEPENDENT LIVING, ASSISTED LIVING, MEMORY SUPPORT AND SKILLED NURSING. MEDCEN FOUNDATION, INC. -PROVIDES FUNDRAISING AND SUPPORT FOR .CENTRAL GEORGIA HEALTH SYSTEMS, INC. AND ITS AFFILIATES. State filing of community benefit report Schedule H, Part VI, Line 7 GA FEDERAL POVERTY GUIDELINES PART I, LINE 3C TOTAL GROSS INCOME FOR THE PREVIOUS THREE MONTHS WILL BE USED TO DETERMINE ANNUAL INCOME. PATIENT CLASSIFICATIONS WILL BE DETERMINED IN ACCORDANCE WITH THE MCCG SLIDING SCALE FOR INDIGENT/CHARITY PATIENTS. THIS SCALE HAS BEEN ADOPTED BY CGRH AND WAS BASED ON THE MOST RECENTLY PUBLISHED FEDERAL POVERTY GUIDELINES. RELATED ORGANIZATION PART I, LINE 6A THE COMMUNITY BENEFIT INFORMATION FOR CENTRAL GEORGIA REHABILIATION HOSPITAL, INC. IS INCLUDED IN THE MEDICAL CENTER OF CENTRAL GEORGIA'S ANNUAL REPORT TO THE COMMUNITY. COST TO CHARGE RATIO PART I, LINE 7 THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 7 IS THE COST TO CHARGE RATIO CALCULATED PURSUANT TO THE IRS FORM 990 SCHEDULE H WORKSHEET 2 INSTRUCTIONS. BAD DEBT PART I, LINE 7F BAD DEBT EXPENSE IN THE AMOUNT OF $96,427 HAS BEEN REMOVED FROM TOTAL EXPENSE. true AMERICAN CANCER SOCIETY PO BOX 4406 MACON GA 31208 580659875 501(C)(3) 6400 TO PROMOTE CANCER AWARENESS EDUCATION FIRST 577 MULBERRY ST SUITE 1030 MACON GA 31201 311815650 501(C)(3) 6000 CHILDREN EDUCATION AND RECOGNITION SUSAN G KOMEN BREAST CANCER INC 248 TOM HILL SR BLVD MACON GA 31210 752881536 501(C)(3) 10000 RACE FOR THE CURE- BREAST CANCER AWARENESS COMMUNITY HEALTH WORKS 300 MULBERRY ST STE 603 MACON GA 31201 582624455 501 (C)(3) 40000 CONTINUING ED., CHILDHOOD OBESITY & TRAINING 4 0 Procedures for monitoring use of grant funds Schedule I, Part I, Line 2 CGHS REQUIRES ALL ORGANIZATIONS THAT RECEIVE SPONSORSHIPS TO PROVIDE PROOF OF THEIR NON PROFIT STATUS. X X X X X false true false false false false false true false A DONALD FAULK JR 705046 0 210066 0 7025200 0 50716 0 10684 0 8001712 0 0 0 KENNETH B BANKS 300047 0 62041 0 42163 0 397030 0 14397 0 815678 0 0 0 RHONDA S PERRY 413105 0 111218 0 28155 0 1676164 0 4931 0 2233573 0 0 0 ELBERT T MCQUEEN 206284 0 48800 0 21039 0 20196 0 8120 0 304439 0 0 0 HARRIS BRYAN FORLINES 121659 0 15245 0 5276 0 7673 0 8362 0 158215 0 0 0 KAREN M FARR 158833 0 22463 0 431 0 27509 0 582 0 209818 0 0 0 KATHERINE L BOWEN 153173 0 21539 0 37 0 13191 0 11241 0 199181 0 0 0 TRACY GRAY 142233 0 17771 0 8346 0 11403 0 3368 0 183121 0 0 0 LORI W CASSIDY 180176 0 22735 0 8823 0 22862 0 8362 0 242958 0 0 0 Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b EMPLOYER PAYMENT FROM 457(F) EXECUTIVE SUPPLEMENTAL RETIREMENT PLAN DON FAULK $6,945,614 MCCG HAD A SUPPLEMENTAL EXECUTIVE BENEFIT PROGRAM ("SEBP") FOR CERTAIN EXECUTIVES THAT WAS DESIGNED AS A LOAN REGIME SPLIT DOLLAR LIFE INSURANCE PROGRAM. THIS PROGRAM WAS EXPECTED TO PROVIDE DEATH AND OTHER BENEFITS TO EXECUTIVES AND TO PROVIDE REPAYMENT OF LIFE INSURANCE PREMIUMS TO THE ORGANIZATION. AS A RESULT OF ECONOMIC CONDITIONS, THE LIFE INSURANCE POLICIES DID NOT PERFORM AS ANTICIPATED. DURING 2009 MCCG DETERMINED THAT IT WOULD SUSPEND ALL PREMIUM PAYMENTS AND REEVALUATE THE EFFECTIVENESS OF THE PROGRAM FOR ALL CURRENT PARTICIPANTS. DURING CALENDAR YEAR 2009 THE MCCG BOARD OF DIRECTORS, AFTER CONSULTATION WITH COMPENSATION AND LEGAL ADVISERS, ADOPTED A RESOLUTION TO MAKE PAYMENTS TO THE RETIRED PARTICIPANTS IN THE SEBP. IN CONSIDERATION FOR THE RECEIPT OF SUCH PAYMENT, THE RETIRED EXECUTIVES SURRENDERED SUBSTANTIALLY ALL RIGHTS AND BENEFITS (OTHER THAN A SMALL DEATH BENEFIT) UNDER THE SEBP TO THE ORGANIZATION. SUBSEQUENTLY, A SIMILAR DECISION WAS MADE FOR THE CURRENT (EMPLOYED) PARTICIPANTS WITH ANY PAYMENTS TO BE MADE DEPENDENT ON THE INDIVIDUAL CONTINUING TO PROVIDE SUBSTANTIAL SERVICES TO A SPECIFIED FUTURE DATE. IN ADDITION, MCCG AND ITS AFFILIATED ORGANIZATIONS ADOPTED A SERP PROGRAM FOR CERTAIN EXECUTIVES EFFECTIVE FOR SERVICES RENDERED ON OR AFTER JANUARY 1, 2010. THIS PROGRAM PROVIDES FOR ANNUAL ACCOUNT VESTING IF THE PARTICIPANT IS EMPLOYED ON DECEMBER 31 OF THE THIRD YEAR AFTER THE ACCOUNT IS CREATED. THE BENEFIT EQUALS THE ANNUAL INCREASE IN THE PRESENT VALUE OF A LIFETIME ANNUITY PAYABLE COMMENCING AT A SPECIFIED TARGETED FUTURE DATE. THE ANNUTIY IS EQUAL TO 60% OF FINAL AVERAGE EARNINGS LESS (1) THE EXPECTED ANNUAL SEBP PAYMENT USED IN CALCULATING THE SEBP LUMP SUM PAYMENT, (2) THE ANNUAL BENEFIT PROVIDED UNDER THE DEFINED BENEFIT PLAN, AND (3) 100% OF THE PARTICIPANT'S SOCIAL SECURITY BENEFIT. AN ACTUARIAL CACULATION HAS NOT YET BEEN MADE FOR THESE BENEFITS. Non-fixed payments Schedule J, Part I, Line 7 THIS PROGRAM IS ADMINISTERED BY THE CEO. A BUDGET FOR THE PROGRAM IS ESTABLISHED FOR REWARD AND RECOGNITION OF EXECUTIVES AND ORGANIZATIONAL LEADERS WHO GO ABOVE AND BEYOND THE SCOPE OF THEIR RESPONSIBILITIES. FOR EXAMPLE, THEY MAY COMPLETE A PROJECT, LEAD AN ORGANIZATIONAL INITIATIVE, OR EXCEL IN AN AREA THAT REPRESENTS EXCELLENCE UNDER ONE OF OUR ORGANIZATIONAL PILLARS - QUALITY, SERVICE EXCELLENCE, OUR PEOPLE, GROWTH, FINANCIAL PERFORMANCE. NEAR THE END OF THE FISCAL YEAR, NOMINATIONS ARE SOLICITED FROM THE LEADERSHIP TEAM. A PROPOSED FOR ALLOCATION OF THE AWARD IS DEVELOPED AND PRESENTED TO THE HR COMMITTEE OF THE BOARD FOR REVIEW, DISCUSSION, AND APPROVAL (PRIOR TO DISTRIBUTION). IN ADDITION, A MANAGMENT INCENTIVE PLAN IS OFFERED TO CERTAIN KEY MEMBERS OF MANAGEMENT TO REWARD QUALITY PATIENT CARE AND OPTIMUM UTILIZATION OF FINANCIAL RESOURCES. ELIGIBILITY TO PARTICIPATE IN THE PLAN IS DEPENDENT ON RECOMMENDATIONS BY THE ASSISTANT VICE PRESIDENT OF HUMAN RESOURCES AND THE CEO OF CENTRAL GEORGIA HEALTH SYSTEMS. AN INCENTIVE COMMITTEE SELECTS THE PARTICIPANTS WHO MUST HOLD DIRECTOR OR ASSISTANT VICE PRESIDENT POSITIONS. THESHOLD PERFORMANCE LEVELS FOR THE SYSTEM AND INDIVIDUAL PERFORMANCE GOALS MUST BE MET TO RECEIVE AN INCENTIVE. NET OPERATING MARGIN IS USED AS A CIRCUIT BREAKER TO PREVENT ANY PAYMENTS IF FINANCIAL PERFORMANCE IS BELOW AN ESTABLISHED THRESHOLD IN ORDER TO PROTECT THE FINANCIAL INTEGRITY OF THE SYSTEM. FINALLY, AN INCENTIVE OF UP TO $500 IS OFFERED TO OTHER PERMANENT AND PART TIME EMPLOYESS NOT ELIGIBLE FOR THE MANAGEMENT INCENTIVE PLAN (WITH CERTAIN OTHER PARTICIPATION RESTRICTIONS RELATED PRIMARILY TO ACTIVE STATUS, PROBATIONARY STATUS, ETC.). Review of form 990 by governing body Form 990, Part VI, Section B, Line 11a THE FORM 990 WAS PREPARED BY HOSPITAL PERSONNEL FROM INFORMATION PROVIDED BY MANAGEMENT AND FROM AUDITED FINANCIAL STATEMENTS (AUDITED BY AN INDEPENDENT ACCOUNTANT). IT IS REVIEWED BY OUR OUTSIDE TAX ADVISOR (ANOTHER INDEPENDENT CPA) AND BY MANAGEMENT OF CENTRAL GEORGIA HEALTH SYSTEMS. A COPY OF THE FORM 990 WAS PROVIDED TO EACH BOARD MEMBER PRIOR TO FILING THE RETURN WITH THE INTERNAL REVENUE SERVICE. Conflict of interest policy Form 990, Part VI, Section B, Line 12c THE DEPARTMENT OF AUDIT AND COMPLIANCE ISSUES COL DISCLOSURE FORMS ANNUALLY TO OUR BOARD MEMBERS, ADMINISTRATION AND DIRECTORS. AUDIT AND COMPLIANCE RECEIVES, REVIEWS AND DOCUMENTS ALL POTENTIAL CONFLICTS (PERCEIVED AND REAL.) THE RESULTS ARE TAKEN TO THE COMPLIANCE COMMITTEE WHERE THE REAL CONFLICTS OF INTEREST ARE DISCUSSED AND A PLAN FOR CORRECTIVE ACTION IS DEVELOPED. THE CORRECTIVE ACTION RECOMMENDATIONS ARE TAKE TO THE VARIOUS BOARDS AND ADMINISTRATION FOR IMPLEMENTATION. ANY TIME A CHANGE IN A RELATIONSHIP OR NEW POTENTIAL CONFLICT EVOLVES, THE INDIVIDUAL MUST AMEND THEIR COI DISCLOSURE FORM. Process used to establish compensation of top management official Form 990, Part VI, Section B, Line 15a THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS ENGAGES AN EXECUTIVE CONSULTING FIRM EVERY 2-3 YEARS TO REVIEW AND PROVIDE RECOMMENDATIONS REGARDING TOTAL COMPENSATION AND BENEFITS FOR THE EXECUTIVE LEADERSHIP TEAM. BASE COMPENSATION, INCENTIVE COMPENSATION, AND BENEFITS ARE INCLUDED IN THE REVIEW. THE EXECUTIVE CONSULTANTS REVIEW ORGANIZATION STRUCTURE, INDIVIDUAL JOB DESCRIPTIONS, AND DISCUSS SCOPE OF LEADERSHIP AND SPAN OF CONTROL WITH HR, THE COO, AND THE CEO AS A PART OF THE PROCESS TO DETERMINE PROPER PLACEMENT OF THE PAY GRADE AND LEVEL OF PARTICIPATION IN INCENTIVE AND BENEFITS PROGRAMS. THE COMPENSATION COMMITTEE PERIODICALLY REAFFIRMS THE TOTAL COMPENSATION PHILOSOPHY WHICH CURRENTLY TARGETS THE 75TH PERCENTILE OF TOTAL COMPENSATION FOR OUR LEADERSHIP TEAM. THE PEER GROUP USED IS NATIONAL HOSPITALS AND HEALTH SYSTEMS OF SIMILAR SIZE AND SCOPE. KEY EMPLOYEES AND OTHERS OUTSIDE OF THE EXECUTIVE LEADERSHIP TEAM HAVE COMPENSATION SET BY HR GUIDELINES AND/OR MARKET COMPENSATION STUDIES. Process used to establish compensation of other officers/key employees Form 990, Part VI, Section B, Line 15b THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS ENGAGES AN EXECUTIVE CONSULTING FIRM EVERY 2-3 YEARS TO REVIEW AND PROVIDE RECOMMENDATIONS REGARDING TOTAL COMPENSATION AND BENEFITS FOR THE EXECUTIVE LEADERSHIP TEAM. BASE COMPENSATION, INCENTIVE COMPENSATION, AND BENEFITS ARE INCLUDED IN THE REVIEW. THE EXECUTIVE CONSULTANTS REVIEW ORGANIZATION STRUCTURE, INDIVIDUAL JOB DESCRIPTIONS, AND DISCUSS SCOPE OF LEADERSHIP AND SPAN OF CONTROL WITH HR, THE COO, AND THE CEO AS A PART OF THE PROCESS TO DETERMINE PROPER PLACEMENT OF THE PAY GRADE AND LEVEL OF PARTICIPATION IN INCENTIVE AND BENEFITS PROGRAMS. THE COMPENSATION COMMITTEE PERIODICALLY REAFFIRMS THE TOTAL COMPENSATION PHILOSOPHY WHICH CURRENTLY TARGETS THE 75TH PERCENTILE OF TOTAL COMPENSATION FOR OUR LEADERSHIP TEAM. THE PEER GROUP USED IS NATIONAL HOSPITALS AND HEALTH SYSTEMS OF SIMILAR SIZE AND SCOPE. KEY EMPLOYEES AND OTHERS OUTSIDE OF THE EXECUTIVE LEADERSHIP TEAM HAVE COMPENSATION SET BY HR GUIDELINES AND/OR MARKET COMPENSATION STUDIES. Public Disclosure Form 990, Part VI, Section C, Line 19 CGHS PROVIDES COPIES OF ITS GOVERNING AND OTHER CORPORATE DOCUMENTS UPON REQUEST. Other changes in net assets or fund balances Form 990, Part XI, Line 5 EQUITY FROM THE MEDICAL CENTER OF CENTRAL GEORGIA - 4246618; ROUNDING - -5; TAX OVER BOOK PARTNERSHIP INCOME - -4701125; CENTRAL GA REHAB HOSPITAL LLC 3351 NORTHSIDE DRIVE MACON GA 31210 300371539 REHABILITATION SERVICES GA 16394819 14095225 NA CENTRAL GEORGIA SENIOR HEALTH INC 691 CHERRY STREET SUTIE 400 MACON GA 31201 582345439 RETIREMENT COMMUNITY GA 501(C)(3) 11 - Type II CENTRAL GEORGIA HEALTH SYSTEMS true HEALTH SERVICES OF CENTRAL GEORGIA INC 691 CHERRY STREET SUTIE 400 MACON GA 31201 582307485 HEALTHCARE SERVICES GA 501(C)(3) 3 CENTRAL GEORGIA HEALTH SYSTEMS true MEDCEN COMMUNITY HEALTH FOUNDATION INC 858 HIGH STREET MACON GA 31201 237363555 FUNDRAISING GA 501(C)(3) 7 NA false MEDICAL CENTER OF GEORGIA INC 691 CHERRY STREET SUTIE 400 MACON GA 31201 582149128 HOSPITAL GA 501(C)(3) 3 CENTRAL GEORGIA HEALTH SYSTEMS true CENTRAL GEORGIA PET LLC 1650 HARDEMAN AVENUE MACON GA 31201 371464470 MEDICAL IMAGING CENTER GA MEDICAL CENTER OF CENTRAL GEORGIA INC RELATED false false SECURE HEALTH PLANS OF GEORGIA INC 577 MULBERRY STREET SUITE 1000 MACON GA 31201 582306549 MANAGED CARE GA NA RELATED 236380 3231845 false false 0.50388 CENTRAL GEORGIA HEALTH VENTURES INC 691 CHERRY STREET SUITE 400 MACON GA 31201 582164989 MANAGEMENT GA NA C CORPORATION 4161889 8403935 1 CENTRAL GEORGIA HOME CARE SERVICES INC 691 CHERRY STREET SUITE 400 MACON GA 31201 582457422 MED. EQUP. SALE GA NA C CORPORATION 1191097 0 1 AMERICAN EAGLE INSURANCE CO RRG 40 MAIN STREET SUITE 500 BURLINGTON VT 05401 161645557 RISK MGMT. 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