2011-07-25T07:15:11-05:00 2010-09-30 DRAFFIN & TUCKER LLP PO BOX 6 ALBANY GA 317020006 990 2009-10-01 582257925 EVANS MEMORIAL HOSPITAL INC EVAN 9127395105 200 N RIVER ST PO BOX 518 CLAXTON GA 30417 JOHN WIGGINS 9127395105 2011-08-15 true JACQUELINE G ATKINS 2298837878 2011-07-22 2009 2016-02-24 21:20:13Z MARTHA TATUM CEO 200 N RIVER ST PO BOX 518 CLAXTON GA 30417 27907957 false X EVANSMEMORIAL.ORG X 1996 GA PROVIDES SHORT TERM ACUTE CARE FOR RESIDENTS OF THE SURROUNDING COMMUNITIES REGARDLESS OF THEIR ABILITY TO PAY. 6 5 453 14 0 162096 207197 24957019 27368546 67922 55933 254003 255345 25441040 27887021 0 0 13396409 13700508 0 0 13439692 13876159 26836101 27576667 -1395061 310354 17709971 17769294 15236820 14985789 2473151 2783505 PROVIDES SHORT TERM ACUTE CARE FOR RESIDENTS OF THE SURROUNDING COMMUNITIES REGARDLESS OF THEIR ABILITY TO PAY. false false 24231414 27382498 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. 24231414 true true false true false false false false false true true true false false false false false false false false true false false true true false false false false false false false false true false false false false false false true false false false true 0 0 true 453 true false false false false false false false false false false false false false false 6 5 false false false false false false false true true false false true true true true true true true true false GA X JOHN WIGGINS CFO 9127395105 PO BOX 518 CLAXTON GA 30417 CARROLL ANDERSON 1.00 X X 0 0 0 MARTY GILBRETH 1.00 X 0 0 0 PAUL R HAWKINS MD 1.00 X 0 0 0 KEITH MILLER 1.00 X X 0 0 0 PATSY ROGERS 1.00 X 0 0 0 DAVID WOMACK 1.00 X 0 0 0 MARTHA TATUM 40.00 X 141180 0 0 JOHN WIGGINS 40.00 X 96303 0 0 LOY COWART MD 40.00 X 499279 0 0 HUGH PARKS MD 40.00 X 400356 0 0 PAUL HAWKINS MD 40.00 X 281411 0 0 WILLIS MCVAY MD 40.00 X 240011 0 0 1658540 8 false true false S & S FOOD ADMINISTRATORS PO BOX 4688 MACON GA 31208 DIETARY SERVICE 1452022 HEALTHCARE SERVICES GROUP 3220 TILLMAN DRIVE SUITE 300 BENSALEM GA 19020 ENVIRONMENTAL 439568 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 10 2000 151009 54188 207197 NET PATIENT SERVICE REVENUE 27368546 27368546 27368546 55933 55933 99240 20936 78304 78304 78304 CAFETERIA 147074 147074 PHYSICAL THERAPY WELLNESS 15066 15066 OTHER REVENUES 13952 13952 949 949 177041 27887021 27382498 297326 423250 423250 11418303 10454210 964093 76055 67144 8911 955392 843459 111933 827508 730558 96950 17406 17406 112856 112856 3755417 3175907 579510 26661 565 26096 2298945 2202747 96198 1038836 992504 46332 42821 32831 9990 13767 13767 1610467 1538640 71827 238467 238467 PROVISION FOR BAD DEBT 3488928 3488928 DUES & SUBSCRIPTIONS 669663 95656 574007 REPAIRS & MAINTENANCE 488910 359512 129398 RECRUITING 60893 60893 MISCELLANEOUS 10439 10189 250 1683 97 1586 27576667 24231414 3345253 0 1593 1790 2095761 2279325 2622617 3361352 112408 203254 131956 138905 188447 205875 23550974 12566640 11926254 10984334 273338 263488 357597 330971 17709971 17769294 1967384 1913654 7075000 6980000 5974217 5527978 220219 564157 15236820 14985789 X 2420896 2731224 52255 52281 2473151 2783505 17709971 17769294 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false false false true 4183 4183 false false false false false SCHEDULE C, PART II-B, LINE 1I 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. false false false false false false false false false false 468592 468592 11435284 6120407 5314877 3949648 801949 3147699 7697450 5644284 2053166 10984334 DUE TO MEDICARE/MEDICAID 564157 564157 27887021 27576667 310354 310354 27887021 27887021 27887021 27576667 27576667 27576667 SUPPLEMENTAL FINANCIAL INFORMATION SCHEDULE D, PAGE 4, PART XIV 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. true true true X true X true true true false false 194591 194591 0.00810 2069620 1891120 178500 0.00740 2264211 1891120 373091 0.01550 2264211 1891120 373091 0.01550 true 1417255 5018156 5447643 -429487 X true true EVANS MEMORIAL HOSPITAL

200 N RIVER STREET CLAXTON GA 30417

X 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. 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 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. 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. 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. 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. 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. 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. 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. X X false false false false false false true false false LOY COWART MD 279762 219517 499279 HUGH PARKS MD 192273 208083 400356 PAUL HAWKINS MD 281411 281411 WILLIS MCVAY MD 240011 240011 COMPENSATION CONTINGENT UPON NET EARNINGS OF RELATED ORG SCHEDULE J, PAGE 1, PART I, LINE 6B EACH PHYSICIAN RECEIVES A PERCENTAGE OF THE AMOUNT OF THEIR NET REVENUE OVER THEIR PORTION OF PRACTICE EXPENSES. HOSPITAL AUTHORITY OF EVANS COUNTY 580979172 229142DZ9 2006-12-28 7075000 REFUND SERIES 1996; false false 6980000 487000 1504769 431881 4695000 true false true true false false false false true true false false false false false false BECKY CONLEY FAMILY 17370 ER ROOM CONSTRUCTION false 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. 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 false false true false false false false false false false false true true true false false false false