EVANS MEMORIAL HOSPITAL INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- EVANS MEMORIAL HOSPITAL INC (EIN 58-2257925)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-07-25
- IRS object ID
- 201102069349300300
- Schema version
- 2009v1.7
- 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 K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-07-25T07:15:11-05:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | 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 | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 582257925 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EVANS MEMORIAL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | EVAN | NameControl |
| Phone | 9127395105 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 N RIVER ST PO BOX 518 | AddressLine1 |
| City | CLAXTON | City |
| State | GA | State |
| ZIP Code | 30417 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN WIGGINS | Name |
| Title | CFO | Title |
| Phone | 9127395105 | Phone |
| Date Signed | 2011-08-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JACQUELINE G ATKINS | Name |
| Phone | 2298837878 | Phone |
| Date Prepared | 2011-07-22 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MARTHA TATUM CEO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 N RIVER ST PO BOX 518 | AddressLine1 |
| City | CLAXTON | City |
| State | GA | State |
| ZIP Code | 30417 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 27907957 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | EVANSMEMORIAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1996 | YearFormation |
| State Legal Domicile | GA | StateLegalDomicile |
| Activity Or Mission Description | PROVIDES SHORT TERM ACUTE CARE FOR RESIDENTS OF THE SURROUNDING COMMUNITIES REGARDLESS OF THEIR ABILITY TO PAY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 6 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 453 | TotalNbrEmployees |
| Total Nbr Volunteers | 14 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 162096 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 207197 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 24957019 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 27368546 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 67922 | InvestmentIncomePriorYear |
| Investment Income Current Year | 55933 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 254003 | OtherRevenuePriorYear |
| Other Revenue Current Year | 255345 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 25441040 | TotalRevenuePriorYear |
| Total Revenue Current Year | 27887021 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 13396409 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 13700508 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 13439692 | OtherExpensePriorYear |
| Other Expenses Current Year | 13876159 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 26836101 | TotalExpensesPriorYear |
| Total Expenses Current Year | 27576667 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1395061 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 310354 | RevenuesLessExpensesCY |
| Total Assets BOY | 17709971 | TotalAssetsBOY |
| Total Assets EOY | 17769294 | TotalAssetsEOY |
| Total Liabilities BOY | 15236820 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 14985789 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2473151 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2783505 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROVIDES SHORT TERM ACUTE CARE FOR RESIDENTS OF THE SURROUNDING COMMUNITIES REGARDLESS OF THEIR ABILITY TO PAY. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 24231414 | Expense |
| Revenue | 27382498 | Revenue |
| Description | HOSPITAL AND NURSING HOME SERVICES; SHORT-TERM ACUTE CARE FOR INPATIENT AND OUTPATIENT SERVICES FOR THE LOCAL COUNTY AND ADJACENT COUNTIES. PATIENT DAYS FOR THE FISCAL YEAR ENDED 9/30/10 WERE 3,973. | Description |
| Total Program Service Expense | 24231414 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | true | 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 |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| 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 | true | 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 |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 453 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| 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 |
| Nbr Voting Governing Body Members | 6 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | 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 | JOHN WIGGINS CFO | NamePerson |
| Telephone Number | 9127395105 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 518 | AddressLine1 |
| City | CLAXTON | City |
| State | GA | State |
| ZIP Code | 30417 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (12 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 |
|---|---|---|---|---|---|---|---|
| CARROLL ANDERSON | |||||||
| CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| MARTY GILBRETH | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| PAUL R HAWKINS MD | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| KEITH MILLER | |||||||
| VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | |
| PATSY ROGERS | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| DAVID WOMACK | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| MARTHA TATUM | |||||||
| CEO | 40.00 | X | 141180 | 0 | 0 | ||
| JOHN WIGGINS | |||||||
| CFO | 40.00 | X | 96303 | 0 | 0 | ||
| LOY COWART MD | |||||||
| PHYSICIAN | 40.00 | 499279 | 0 | 0 | X | ||
| HUGH PARKS MD | |||||||
| PHYSICIAN | 40.00 | 400356 | 0 | 0 | X | ||
| PAUL HAWKINS MD | |||||||
| PHYSICIAN | 40.00 | 281411 | 0 | 0 | X | ||
| WILLIS MCVAY MD | |||||||
| PHYSICIAN | 40.00 | 240011 | 0 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1658540 | TotalReportableCompFromOrg |
| Number Individuals GT100 K | 8 | 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 | Address Line2AddressOfContractor/AddressUS/AddressLine2 |
|---|---|---|---|---|---|---|
| S & S FOOD ADMINISTRATORS | ||||||
| PO BOX 4688 | MACON | GA | 31208 | DIETARY SERVICE | 1452022 | |
| HEALTHCARE SERVICES GROUP | ||||||
| 3220 TILLMAN DRIVE | BENSALEM | GA | 19020 | ENVIRONMENTAL | 439568 | SUITE 300 |
| BTT PHARMACY SERVICES INC | ||||||
| PO BOX 577 | CLAXTON | GA | 30417 | PHARMACY | 266634 | |
| EVANS EMERGENCY GROUP | ||||||
| PO BOX 82368 | LAFAYETTE | LA | 70598 | ER PHYSICIANS | 190085 | |
| PLATINUM ANESTHESIA COASTAL | ||||||
| PO BOX 187 | SANDERSVILLE | GA | 31082 | ANESTHESIA | 173000 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 10 | NumberOfContractorsGT100K |
| Related Organizations | 2000 | RelatedOrganizations |
| Government Grants | 151009 | GovernmentGrants |
| All Other Contributions | 54188 | AllOtherContributions |
| Total Contributions | 207197 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE REVENUE | Description |
| Total Revenue Column | 27368546 | TotalRevenueColumn |
| Related Or Exempt Function Income | 27368546 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 27368546 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 55933 | TotalRevenueColumn |
| Exclusion | $55,933 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 99240 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 20936 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 78304 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 78304 | TotalRevenueColumn |
| Exclusion | $78,304 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| CAFETERIA | 147074 | $147,074 | |
| PHYSICAL THERAPY WELLNESS | 15066 | $15,066 | |
| OTHER REVENUES | 13952 | 13952 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 949 | TotalRevenueColumn |
| Exclusion | $949 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 177041 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 27887021 | TotalRevenueColumn |
| Related Or Exempt Function Income | 27382498 | RelatedOrExemptFunctionIncome |
| Exclusion | $297,326 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 423250 | Total |
| Management And General | 423250 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11418303 | Total |
| Program Services | 10454210 | ProgramServices |
| Management And General | 964093 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 76055 | Total |
| Program Services | 67144 | ProgramServices |
| Management And General | 8911 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 955392 | Total |
| Program Services | 843459 | ProgramServices |
| Management And General | 111933 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 827508 | Total |
| Program Services | 730558 | ProgramServices |
| Management And General | 96950 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17406 | Total |
| Management And General | 17406 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 112856 | Total |
| Management And General | 112856 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3755417 | Total |
| Program Services | 3175907 | ProgramServices |
| Management And General | 579510 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26661 | Total |
| Program Services | 565 | ProgramServices |
| Management And General | 26096 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2298945 | Total |
| Program Services | 2202747 | ProgramServices |
| Management And General | 96198 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1038836 | Total |
| Program Services | 992504 | ProgramServices |
| Management And General | 46332 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42821 | Total |
| Program Services | 32831 | ProgramServices |
| Management And General | 9990 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13767 | Total |
| Management And General | 13767 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1610467 | Total |
| Program Services | 1538640 | ProgramServices |
| Management And General | 71827 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 238467 | Total |
| Program Services | 238467 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PROVISION FOR BAD DEBT | 3488928 | 3488928 | |
| DUES & SUBSCRIPTIONS | 669663 | 95656 | 574007 |
| REPAIRS & MAINTENANCE | 488910 | 359512 | 129398 |
| RECRUITING | 60893 | 60893 | |
| MISCELLANEOUS | 10439 | 10189 | 250 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1683 | Total |
| Program Services | 97 | ProgramServices |
| Management And General | 1586 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27576667 | Total |
| Program Services | 24231414 | ProgramServices |
| Management And General | 3345253 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1593 | BOY |
| EOY | 1790 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2095761 | BOY |
| EOY | 2279325 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2622617 | BOY |
| EOY | 3361352 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 112408 | BOY |
| EOY | 203254 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 131956 | BOY |
| EOY | 138905 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 188447 | BOY |
| EOY | 205875 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 23550974 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 12566640 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11926254 | BOY |
| EOY | 10984334 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 273338 | BOY |
| EOY | 263488 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 357597 | BOY |
| EOY | 330971 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17709971 | BOY |
| EOY | 17769294 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1967384 | BOY |
| EOY | 1913654 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7075000 | BOY |
| EOY | 6980000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5974217 | BOY |
| EOY | 5527978 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 220219 | BOY |
| EOY | 564157 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15236820 | BOY |
| EOY | 14985789 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2420896 | BOY |
| EOY | 2731224 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52255 | BOY |
| EOY | 52281 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2473151 | BOY |
| EOY | 2783505 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17709971 | BOY |
| EOY | 17769294 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
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 | $4,183 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 4183 | 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 BELONGS TO NATIONAL AND STATE INDUSTRY ASSOCIATIONS AND AS PART OF THEIR ANNUAL DUES, PAYS A SMALL PERCENTAGE TO SUPPORT THE LOBBYING EFFORTS BY THESE ASSOCIATIONS. | 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) |
|---|---|---|
| Other Cost Or Other Basis | 468592 | OtherCostOrOtherBasis |
| Book Value | 468592 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11435284 | OtherCostOrOtherBasis |
| Depreciation | 6120407 | Depreciation |
| Book Value | 5314877 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3949648 | OtherCostOrOtherBasis |
| Depreciation | 801949 | Depreciation |
| Book Value | 3147699 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7697450 | OtherCostOrOtherBasis |
| Depreciation | 5644284 | Depreciation |
| Book Value | 2053166 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 10984334 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO MEDICARE/MEDICAID | Description |
| Amount | $564,157 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 564157 | TotalOfAmounts |
| Total Revenue | 27887021 | TotalRevenue |
| Total Expenses | 27576667 | TotalExpenses |
| Excess Or Deficit For Year | 310354 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 310354 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 27887021 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 27887021 | RevenueSubtotal |
| Total Revenue Per Form990 | 27887021 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 27576667 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 27576667 | ExpensesSubtotal |
| Total Expenses Per Form990 | 27576667 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL FINANCIAL INFORMATION | Identifier |
| Return Reference | SCHEDULE D, PAGE 4, PART XIV | ReturnReference |
| Explanation | PART X, LINE 2 - FIN 48 FOOTNOTE THE HOSPITAL 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 HOSPITAL 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, 2010 AND 2009 OR FOR THE YEARS THEN ENDED. THE HOSPITAL'S OPEN AUDIT PERIODS ARE FOR TAX YEARS ENDED 2007-2009. | 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 |
| Pcent200 | X | Pcent200 |
| 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 | 194591 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 194591 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00810 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2069620 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1891120 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 178500 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00740 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2264211 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1891120 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 373091 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01550 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2264211 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1891120 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 373091 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01550 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $1,417,255 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 5018156 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5447643 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -429487 | MedicareSurplusOrShortfall |
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 |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EVANS MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 N RIVER STREET | AddressLine1 |
| City | CLAXTON | City |
| State | GA | State |
| ZIP Code | 30417 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Critical Access Hospital | X | CriticalAccessHospital |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Costing Method Used | THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATION'S "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS, 2008". SEE ALSO THE DESCRIPTION FOR PART III, LINE 4. | CostingMethodUsed |
| Percent Of Total Expense Expln | 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 27,576,667 LESS: BAD DEBTS IN PART IX 3,488,928 ADD: AMOUNTS REPORTED IN PART VIII 20,936 DENOMINATOR FOR COLUMN (F) 24,108,675 | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE EVALUATION OF THE OVERALL COLLECTABILITY OF THE ACCOUNTS RECEIVABLE. AS ACCOUNTS ARE KNOWN TO BE UNCOLLECTIBLE THE ACCOUNT IS CHARGED AGAINST THE ALLOWANCE. | BadDebtFootnote |
| Shortfall As Community Benefit | COSTS FOR PART 1, 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 AUDITED FINANCIALS. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | THE HOSPITAL WRITES OFF PATIENT BALANCES FOR PATIENTS QUALIFYING FOR CHARITY CARE OR FINANCIAL ASSISTANCE AND DOES NOT MAKE FURTHER COLLECTION EFFORTS. PATIENT FINANCIAL COUNSELORS VISIT PATIENTS WHO HAVE NO INSURANCE, LIMITED COVERAGE AND MEDICAID PATIENTS WITHOUT SUPPLEMENTAL INSURANCE TO DISCUSS ASSISTANCE AND REFER THOSE PATIENTS TO OUR MEDICAID ELIGIBILITY VENDOR WHO SCREENS THESE PATIENTS FOR MEDICAID AND OTHER FEDERAL, STATE OR LOCAL PROGRAMS FOR ASSISTANCE. CUSTOMER SERVICE AT THE HOSPITAL AND AT EXTENDED BUSINESS OFFICE WHICH DOES SELF-PAY BILLING AND COLLECTION, INFORM PATIENTS ABOUT OUR FINANCIAL ASSISTANCE PROGRAM AND ASSIST THEM IN MAKING AN APPLICATION. BILLING STATEMENTS PROVIDE A MESSAGE AND TELEPHONE NUMBER TO CALL IF THE PATIENT HAS DIFFICULTY MAKING PAYMENT. FOR PATIENTS WHO QUALIFY FOR CHARITY CARE AND FULL FINANCIAL ASSISTANCE, THERE IS NO FINANCIAL OBLIGATION. FOR THOSE WHO QUALIFY FOR PARTIAL FINANCIAL ASSISTANCE, COLLECTIONS PROCEDURES FOLLOW THE SAME PROCESS AS ALL OTHER PATIENTS WHO ARE RESPONSIBLE FOR UNPAID BALANCES. THOSE PATIENTS WHO HAVE NOT MADE PAYMENT ARRANGEMENTS FOR THEIR REMAINING BALANCES ARE SENT LETTERS WHERE THEY ARE PAST DUE 30, 60 AND 90 DAYS. IF PAYMENT ARRANGEMENTS ARE STILL NOT MADE AFTER 90 DAYS, THEN THOSE ACCOUNTS ARE REFERRED TO COLLECTIONS. | DebtCollectionPolicy |
| Needs Assessment | THE SYSTEM CONTINUALLY CONDUCTS VARIOUS TYPES OF ASSESSMENTS TO DETERMINE THE COMMUNITYS NEEDS FOR HEALTH AND PERSONAL SUPPORT SERVICES. OUR SYSTEM COLLABORATES WITH NUMEROUS NOT-FOR-PROFIT AGENCIES AND PROGRAMS TO EXTEND AND STRENGTHEN OUR MISSION. OUR PROGRAMS ARE SUCCESSFUL DUE IN LARGE PART BECAUSE OF THESE COLLABORATIONS. ONE EXAMPLE OF THIS IS EVANS COUNTY CARES. MANY OF OUR SYSTEM CO-WORKERS ARE ALSO INVOLVED AT EVERY LEVEL OF THE COMMUNITY THROUGH THEIR WORK AS SYSTEM REPRESENTATIVES ON NOT-FOR-PROFIT BOARDS. WITH OUR PARTNERS, WE LISTEN TO OUR PATIENTS AND CLIENTS AS WELL AS ACCESS EXISTING NEEDS ASSESSMENTS AND STUDIES IN ORDER TO DETERMINE THE COMMUNITYS MOST PRESSING NEEDS. THE SYSTEM USES FEDERAL INFORMATION AND REPORTS FROM AGENCIES SUCH AS THE U.S. CENSUS BUREAU AND BUREAU OF LABOR STATISTICS AS WELL AS RESOURCES SUCH AS DEMOGRAPHICS NOW THAT PROVIDE A WIDE ARRAY OF DEMOGRAPHICS, HOUSEHOLD INCOME AND SERVICES, RETAIL OUTLETS, ETC. IN DEFINED ZIP CODES. THIS INFORMATION, COMBINED WITH OUR EXTENSIVE COLLABORATIONS AND OUR ROLE AS A LEADER IN THE COMMUNITY, PROVIDES US THE MEANS TO UNDERSTAND AND ADDRESS THE COMMUNITYS NEEDS AND ENSURES OUR OUTREACH PROGRAMS ARE FOCUSED ON THE POPULATIONS WHO NEED OUR SERVICES THE MOST. | NeedsAssessment |
| Patient Education Assistance | CUSTOMER SERVICE PERSONNEL AT THE HOSPITALS AND THE SYSTEMS EXTENDED BUSINESS OFFICE INFORM PATIENTS ABOUT OUR FINANCIAL ASSISTANCE PROGRAM AND ASSIST THEM IN MAKING AN APPLICATION. FOR PATIENTS WHO HAVE NO INSURANCE, LIMITED COVERAGE AND MEDICAID PATIENTS WITHOUT SUPPLEMENTAL INSURANCE, PATIENT FINANCIAL COUNSELORS DISCUSS THE FINANCIAL ASSISTANCE AND VARIOUS GOVERNMENT BENEFITS WHICH MAY BE AVAILABLE TO THEM. PATIENT FINANCIAL COUNSELORS ALSO REFER APPROPRIATE PATIENTS TO A MEDICAID ELIGIBILITY VENDOR WHO SCREENS THEM FOR MEDICAID AND OTHER FEDERAL, STATE OR LOCAL PROGRAMS FOR ASSISTANCE. THE SYSTEM POSTS FINANCIAL ASSISTANCE INFORMATION AT ITS REGISTRATION AREAS. IN ADDITION, THE BILLING STATEMENTS SENT TO PATIENTS PROVIDE A MESSAGE AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN THE EVENT THE PATIENT HAS DIFFICULTY PAYING THE BALANCE DUE. | PatientEducationAssistance |
| Community Information | THE ORGANIZATION SERVES A PREDOMINATELY RURAL AREA IN SOUTH-EAST GEORGIA. THE PRIMARY SERVICE AREA CONSISTS OF EVANS AND TATTNALL COUNTIES. THE CITY OF CLAXTON IS THE ECONOMIC HUB FOR THE REGION, AND THE ORGANIZATION DRAWS FROM A POPULATION OF 32,000 RESIDENTS FOR HEALTH CARE SERVICES. THE REGION IS MARKED BY VAST DICHOTOMIES OF WEALTH, EDUCATION AND HEALTH STATUS. THE ORGANIZATION SERVES A POPULATION THAT HAS A HIGH PROPORTION OF LOW-INCOME INDIVIDUALS. MAJOR HEALTH ISSUES ARE DIABETES, OBESITY, AND HEART DISEASE. | CommunityInformation |
| Other Information | ALL OF THE SYSTEMS HEALTHCARE FACILITIES, INCLUDING ITS HOSPITALS, FURTHER THEIR EXEMPT PURPOSES BY PROMOTING THE HEALTH IN OUR COMMUNITY IN A VARIETY OF WAYS AS WELL AS THOSE ALREADY DESCRIBED. THE GOVERNING BODIES OF ALL OF OUR ORGANIZATIONS ARE PRIMARILY COMPRISED OF PERSONS WHO ARE NOT EMPLOYEES, CONTRACTORS (NOR FAMILY MEMBERS THEREOF), AND WHO RESIDE IN THE SYSTEMS PRIMARY SERVICE AREA. THE HOSPITALS MEDICAL STAFFS ARE OPEN TO ALL QUALIFIED PHYSICIANS IN THE REGION. FOR THOSE PHYSICIANS IN THE REGION WHO DO NOT HAVE PRIVILEGES, THE SYSTEM PROVIDES A PROCESS FOR ADMITTING PATIENTS VIA THE HOSPITALISTS OR THROUGH OTHER PHYSICIANS. FUNDS RECEIVED FROM THE OPERATIONS OF THE SYSTEM HOSPITALS AND FACILITIES (AFTER OPERATING EXPENSES) ARE USED TO SUPPORT VARIOUS OUTREACH EFFORTS AND ALLOWS PATIENTS TO RECEIVE HIGH QUALITY CARE IN THEIR OWN COMMUNITY. IT ALSO ALLOWS US TO CONTINUALLY IMPROVE PATIENT SAFETY BY IMPLEMENTING TECHNOLOGY THAT PREVENTS MEDICATION ERRORS, ETC. | OtherInformation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | true | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|
| LOY COWART MD | ||
| 279762 | 219517 | 499279 |
| HUGH PARKS MD | ||
| 192273 | 208083 | 400356 |
| PAUL HAWKINS MD | ||
| 281411 | 281411 | |
| WILLIS MCVAY MD | ||
| 240011 | 240011 | |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | COMPENSATION CONTINGENT UPON NET EARNINGS OF RELATED ORG | Identifier |
| Return Reference | SCHEDULE J, PAGE 1, PART I, LINE 6B | ReturnReference |
| Explanation | EACH PHYSICIAN RECEIVES A PERCENTAGE OF THE AMOUNT OF THEIR NET REVENUE OVER THEIR PORTION OF PRACTICE EXPENSES. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPITAL AUTHORITY OF EVANS COUNTY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 580979172 | IssuerEIN |
| CUSIP Number | 229142DZ9 | CUSIPNumber |
| Date Issued | 2006-12-28 | DateIssued |
| Issue Price | 7075000 | IssuePrice |
| Description Of Purpose | REFUND SERIES 1996; | DescriptionOfPurpose |
| Defeased | false | Defeased |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 6980000 | TotalProceeds |
| Amount In Reserve Fund | 487000 | AmountInReserveFund |
| Amount Defeased | 1504769 | AmountDefeased |
| Issuance Costs From Proceeds | 431881 | IssuanceCostsFromProceeds |
| Capital Expenditures | 4695000 | CapitalExpenditures |
| Current Refunding | true | CurrentRefunding |
| Advance Refunding | false | AdvanceRefunding |
| Final Allocation Made | true | FinalAllocationMade |
| Adequate Books And Recds Maintaind | true | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | false | OwningBondFinancedProperty |
| Any Lease Arrangements | false | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | false | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | false | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | true | BondCounselRoutinelyEngaged |
| Post Issuance Compliance Procdrs | true | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | false | Form8038TFiled |
| Variable Rate Issue | false | VariableRateIssue |
| Hedge Identified In Books And Recds | false | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | false | GrossProceedsInvested |
| Exception To Rebate | false | ExceptionToRebate |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | BECKY CONLEY | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | FAMILY | Relationship |
| Amount Of Transaction | 17370 | AmountOfTransaction |
| Description Of Transaction | ER ROOM CONSTRUCTION | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
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 11 | THE 990 IS FIRST REVIEWED IN DETAIL BY THE CFO AND CEO. FINAL FORM 990 IS PROVIDED TO THE BOARD DURING REGULAR SCHEDULED MEETINGS BEFORE FILING. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | MANAGEMENT REVIEWS CONFLICT OF INTEREST POLICY WITH BOARD. ANY CHANGES PROPOSED DURING REVIEW ARE HELD TO A VOTE. PERSONNEL, BOARD MEMBERS, AND PHYSICIANS MUST SIGN A CONFICT OF INTEREST STATEMENT UPON HIRE. BUSINESS DEALINGS ARE REVIEWED BY CFO AND CEO AND AT LEAST 3 QUOTES FOR SERVICE MUST BE ACQUIRED. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION IS DETERMINED USING COMPARABLE HOSPITAL DATA, AND SOUTH EASTERN US SALARY DATA. THE BOARD REVIEWS AND APPROVES COMPENSATION FOR THE CEO. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION IS DETERMINED USING COMPARABLE HOSPITAL DATA, AND SOUTH EASTERN US SALARY DATA. THE BOARD AND CEO REVIEW AND APPROVE COMPENSATION FOR THE CEO AND OTHER OFFICERS. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| PURPOSE OF ISSUE DESCRIPTION | SCHEDULE K | HOSPITAL AUTHORITY OF EVANS COUNTY ACCOUNT TO SECURE THE SERIES 2006 CERTIFICATES; PAY THE COSTS OF ISSUANCE OF THE SERIES 2006 CERTIFICATES. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | Address Line2AddressUS/AddressLine2 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|
| EVANS MEMORIAL HEALTH ORGANIZATION | ||||||||||
| 200 N RIVER STREET | PO BOX 518 | CLAXTON | GA | 30417 | 582257919 | HEALTHCARE | GA | 501 | 11B | NA |
| EVANS MEMORIAL FOUNDATION | ||||||||||
| 200 N RIVER STREET | PO BOX 518 | CLAXTON | GA | 30417 | 582258177 | HEALTHCARE | GA | 501 | 11D | NA |
| 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 | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | 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 | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |