CLAYTON GENERAL INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- CLAYTON GENERAL INC (EIN 58-1955423)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-16
- IRS object ID
- 201111369349305656
- 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 D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-16T14:38:26-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | 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 | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581955423 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHERN REGIONAL HEALTH SYSTEMINC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SOUT | NameControl |
| Phone | 7709918010 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 UPPER RIVERDALE ROAD SW | AddressLine1 |
| City | RIVERDALE | City |
| State | GA | State |
| ZIP Code | 302742600 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | S LEE BOLES JR | Name |
| Title | CFO | Title |
| Phone | 7709918010 | Phone |
| Date Signed | 2011-05-16 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JACQUELINE G ATKINS | Name |
| Phone | 2298837878 | Phone |
| Date Prepared | 2011-05-16 | 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 | STEPHEN MAHAN CEO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 UPPER RIVERDALE RD SW | AddressLine1 |
| City | RIVERDALE | City |
| State | GA | State |
| ZIP Code | 302742600 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 281534165 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.SOUTHERNREGIONAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1991 | YearFormation |
| State Legal Domicile | GA | StateLegalDomicile |
| Activity Or Mission Description | SOUTHERN REGIONAL HEALTH SYSTEM, INC. EXISTS TO SERVE THE COMMUNITIES OF THE SOUTHERN CRESCENT OF THE METRO ATLANTA AREA BY IMPROVING THE HEALTH STATUS AND QUALITY OF LIFE OF ITS CITIZENS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 23 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 23 | NbrIndependentVotingMembers |
| Total Nbr Employees | 2445 | TotalNbrEmployees |
| Total Nbr Volunteers | 90 | TotalNbrVolunteers |
| Total Gross UBI | 326680 | TotalGrossUBI |
| Contributions Grants Prior Year | 2120744 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 921992 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 257088896 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 259468386 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 5371237 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1827403 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 3413074 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2435160 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 267993951 | TotalRevenuePriorYear |
| Total Revenue Current Year | 264652941 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 1978140 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 3995791 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 116243051 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 114036024 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 153466599 | OtherExpensePriorYear |
| Other Expenses Current Year | 153016302 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 271687790 | TotalExpensesPriorYear |
| Total Expenses Current Year | 271048117 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -3693839 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -6395176 | RevenuesLessExpensesCY |
| Total Assets BOY | 176872790 | TotalAssetsBOY |
| Total Assets EOY | 167420168 | TotalAssetsEOY |
| Total Liabilities BOY | 122530461 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 122617628 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 54342329 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 44802540 | NetAssetsOrFundBalancesEOY |
| Mission Description | SOUTHERN REGIONAL HEALTH SYSTEM, INC. EXISTS TO SERVE THE COMMUNITIES OF THE SOUTHERN CRESCENT OF THE METRO ATLANTA AREA BY IMPROVING THE HEALTH STATUS AND QUALITY OF LIFE OF ITS CITIZENS. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 220050028 | Expense |
| Grants | 3995791 | Grants |
| Revenue | 259458383 | Revenue |
| Description | SOUTHERN REGIONAL HEALTH SYSTEM, INC. PROVIDED 74,475 DAYS OF ACUTE AND INTENSIVE CARE, TREATED MORE THAN 145,000 OUTPATIENTS, AND PROVIDED EMERGENCY CARE TO MORE THAN 78,000 PATIENTS IN ITS EMERGENCY ROOM. SRHS ALSO PROVIDED 5,913 DAYS OF CARE TO THE MORE THAN 3,853 BABIES BORN AT SRHS. | Description |
| Total Program Service Expense | 220050028 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | 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 | false | 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 | true | GrantsToOrganizations |
| Grants To Individuals | true | 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 | false | 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 | true | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | true | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 93 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 2445 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| 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 | 23 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 23 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | 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 | LEE BOLES CFO | NamePerson |
| Telephone Number | 7709918010 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 UPPER RIVERDALE ROAD SW | AddressLine1 |
| City | RIVERDALE | City |
| State | GA | State |
| ZIP Code | 302742600 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (40 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| BENNY WHITMORE | |||||||||
| SECRETARY | 4.00 | X | X | 11440 | 0 | 0 | |||
| RONALD M DODSON | |||||||||
| CHAIRMAN | 3.00 | X | X | 11300 | 0 | 0 | |||
| DANIEL T MCDEVITT | |||||||||
| MEMBER | 3.00 | X | 11050 | 0 | 0 | ||||
| REV ED J BEST JR | |||||||||
| MEMBER | 3.00 | X | 9500 | 0 | 0 | ||||
| ANDREA CALLAWAY | |||||||||
| MEMBER | 2.00 | X | 8730 | 0 | 0 | ||||
| JAY R PRAKASH MD | |||||||||
| MEMBER | 2.00 | X | 8000 | 0 | 0 | ||||
| WILLIAM C MCBERRY | |||||||||
| MEMBER | 2.00 | X | 7900 | 0 | 0 | ||||
| RAMESH REDDY MD | |||||||||
| MEMBER | 1.00 | X | 7600 | 0 | 0 | ||||
| HOMAYOUN AMIN MD | |||||||||
| MEMBER | 1.00 | X | 6800 | 0 | 0 | ||||
| JAMES G ADAMS | |||||||||
| TREASURER | 3.00 | X | X | 6300 | 0 | 0 | |||
| RAJU M VANAPALLI | |||||||||
| MEMBER | 2.00 | X | 6100 | 0 | 0 | ||||
| SHERRY HANCOCK | |||||||||
| MEMBER | 3.00 | X | 5600 | 0 | 0 | ||||
| GARY J LAGGIS | |||||||||
| MEMBER | 2.00 | X | 4000 | 0 | 0 | ||||
| JAMES O WATKINS | |||||||||
| MEMBER | 1.00 | X | 3800 | 0 | 0 | ||||
| PRAVEEN RASTOGI | |||||||||
| MEMBER | 1.00 | X | 2800 | 0 | 0 | ||||
| GLYNDA B KING | |||||||||
| MEMBER | 2.00 | X | 2000 | 0 | 0 | ||||
| RONALD SHIPMAN | |||||||||
| MEMBER | 1.00 | X | 2000 | 0 | 0 | ||||
| ALLAN VIGIL | |||||||||
| MEMBER | 1.00 | X | 1800 | 0 | 0 | ||||
| ANGELA JACKSON | |||||||||
| MEMBER | 2.00 | X | 800 | 0 | 0 | ||||
| RALPH WOLFE | |||||||||
| MEMBER | 1.00 | X | 800 | 0 | 0 | ||||
| REV CHARLES GRANT | |||||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| RICHARD PROKESCH MD | |||||||||
| V. CHAIRMAN | 3.00 | X | X | 0 | 0 | 0 | |||
| STARR S HELMS | |||||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| CLINT MATTHEWS | |||||||||
| PAST CEO | 40.00 | X | 0 | 0 | 0 | ||||
| JOHN SCHIBLER | |||||||||
| CFO | 40.00 | X | 0 | 0 | 0 | ||||
| CATHY KENNEY | |||||||||
| CNO | 40.00 | X | 0 | 0 | 0 | ||||
| STEVE MAHAN | |||||||||
| CEO | 40.00 | X | 0 | 0 | 0 | ||||
| THERESE SUCHER | |||||||||
| COO | 40.00 | X | 0 | 0 | 0 | ||||
| MARY KAY GARDENIER | |||||||||
| SR. VP OPER. | 40.00 | 299106 | 0 | 14507 | X | ||||
| WILLIE COCHRAN | |||||||||
| VP MEDICAL A | 40.00 | 250432 | 0 | 3412 | X | ||||
| JAMES CRISSEY | |||||||||
| VP FACILITIE | 40.00 | 199920 | 0 | 15800 | X | ||||
| KAREN MOORE | |||||||||
| VP IT & CIO | 40.00 | 165778 | 0 | 2245 | X | ||||
| NORMA ADAMS | |||||||||
| VP HUMAN RES | 40.00 | 161665 | 0 | 2912 | X | ||||
| ROY GILLELAND | |||||||||
| VP CORP PURC | 40.00 | 370050 | 0 | 14267 | X | ||||
| NICHOLAS MAIDA | |||||||||
| LAB CLINIC S | 66.00 | 162621 | 0 | 7729 | X | ||||
| MELODY MENA | |||||||||
| MANAGE DIR S | 40.00 | 153438 | 0 | 3326 | X | ||||
| WILLIAM APPLEGATE | |||||||||
| DIRECTOR MAR | 40.00 | 153289 | 0 | 9285 | X | ||||
| DANIEL HOODIN | |||||||||
| VP, MANAGED | 40.00 | 149893 | 0 | 7638 | X | ||||
| EDWARD BONN | |||||||||
| FORMER CEO | 40.00 | 486164 | 0 | 13609 | X | ||||
| RICHARD G STOVALL | |||||||||
| FORMER CFO | 40.00 | 194688 | 0 | 11292 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2865364 | TotalReportableCompFromOrg |
| Total Other Compensation | 106022 | TotalOtherCompensation |
| Number Individuals GT100 K | 83 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | true | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| COMPLETERX | |||||
| 3100 S GESSNER SUITE 640 | HOUSTON | TX | 77063 | PHARMACY MGMT | 12236199 |
| FTI HEALTHCARE | |||||
| PO BOX 630391 | BALTIMORE | MD | 21263 | MANAGEMENT | 5122579 |
| MCKESSON INFORMATION SOLUTIONS | |||||
| PO BOX 98347 | CHICAGO | IL | 60693 | IT SUPPORT | 1735886 |
| AGFA FINANCE CORPORATION | |||||
| PO BOX 223531 | PITTSBURGH | PA | 15251 | EQUIPMENT FINAN | 1351730 |
| GE HEALTHCARE | |||||
| PO BOX 402076 | ATLANTA | GA | 30384 | IMAGING SERVICE | 1302578 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 84 | NumberOfContractorsGT100K |
| Related Organizations | 921992 | RelatedOrganizations |
| Total Contributions | 921992 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Business CodeBusinessCode | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| PATIENT REVENUE | 259141706 | 259141706 | ||
| LAB OUTREACH | 326680 | 621500 | 326680 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 259468386 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1553283 | TotalRevenueColumn |
| Related Or Exempt Function Income | 134596 | RelatedOrExemptFunctionIncome |
| Exclusion | $1,418,687 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 566277 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 566277 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 566277 | TotalRevenueColumn |
| Exclusion | $566,277 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 17155344 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 16881224 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 274120 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 274120 | TotalRevenueColumn |
| Exclusion | $274,120 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| CAFETERIA | 1126479 | $1,126,479 | |
| PAID PARKING REVENUE | 521983 | $521,983 | |
| MISCELLANEOUS | 98137 | 98137 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 122284 | TotalRevenueColumn |
| Related Or Exempt Function Income | 83944 | RelatedOrExemptFunctionIncome |
| Exclusion | $38,340 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1868883 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 264652941 | TotalRevenueColumn |
| Related Or Exempt Function Income | 259458383 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 326680 | UnrelatedBusinessRevenue |
| Exclusion | $3,945,886 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3875728 | Total |
| Program Services | 3875728 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 120063 | Total |
| Program Services | 120063 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1336968 | Total |
| Management And General | 1336968 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 705753 | Total |
| Management And General | 705753 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 92408247 | Total |
| Program Services | 77238482 | ProgramServices |
| Management And General | 15169765 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3297564 | Total |
| Program Services | 2765327 | ProgramServices |
| Management And General | 532237 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9269091 | Total |
| Program Services | 7874538 | ProgramServices |
| Management And General | 1394553 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7018401 | Total |
| Program Services | 5769593 | ProgramServices |
| Management And General | 1248808 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5122579 | Total |
| Management And General | 5122579 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1357501 | Total |
| Management And General | 1357501 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 496464 | Total |
| Management And General | 496464 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19540369 | Total |
| Program Services | 10769257 | ProgramServices |
| Management And General | 8771112 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 720333 | Total |
| Program Services | 20898 | ProgramServices |
| Management And General | 699435 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48107057 | Total |
| Program Services | 46931915 | ProgramServices |
| Management And General | 1175142 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3202673 | Total |
| Management And General | 3202673 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5122156 | Total |
| Program Services | 4538107 | ProgramServices |
| Management And General | 584049 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 130152 | Total |
| Program Services | 58500 | ProgramServices |
| Management And General | 71652 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19973 | Total |
| Program Services | 13075 | ProgramServices |
| Management And General | 6898 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2121450 | Total |
| Management And General | 2121450 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10687004 | Total |
| Program Services | 9468686 | ProgramServices |
| Management And General | 1218318 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 822080 | Total |
| Management And General | 822080 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT | 48953145 | 48953145 | |
| REPAIRS AND MAINTENANCE | 4808441 | 778495 | 4029946 |
| MISCELLANEOUS | 1161846 | 752677 | 409169 |
| DUES AND SUBSCRIPTIONS | 222194 | 69210 | 152984 |
| TAXES AND LICENSES | 216538 | 10617 | 205921 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 204347 | Total |
| Program Services | 41715 | ProgramServices |
| Management And General | 162632 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 271048117 | Total |
| Program Services | 220050028 | ProgramServices |
| Management And General | 50998089 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8750 | BOY |
| EOY | 8750 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4930730 | BOY |
| EOY | 12215007 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33335544 | BOY |
| EOY | 30623132 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 418227 | BOY |
| EOY | 264990 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3505047 | BOY |
| EOY | 3588340 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2414127 | BOY |
| EOY | 1361331 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 264422961 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 194301678 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 75064160 | BOY |
| EOY | 70121283 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 51726881 | BOY |
| EOY | 42653220 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2909716 | BOY |
| EOY | 2775571 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 286549 | BOY |
| EOY | 271129 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2273059 | BOY |
| EOY | 3537415 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 176872790 | BOY |
| EOY | 167420168 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28099662 | BOY |
| EOY | 28593098 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 53607863 | BOY |
| EOY | 50172147 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 871278 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40822936 | BOY |
| EOY | 42981105 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 122530461 | BOY |
| EOY | 122617628 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54177675 | BOY |
| EOY | 44613698 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 164654 | BOY |
| EOY | 188842 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54342329 | BOY |
| EOY | 44802540 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 176872790 | BOY |
| EOY | 167420168 | 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 | false | FederalGrantAuditRequired |
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 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 | 7215082 | OtherCostOrOtherBasis |
| Book Value | 7215082 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 124932251 | OtherCostOrOtherBasis |
| Depreciation | 83063670 | Depreciation |
| Book Value | 41868581 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 131930891 | OtherCostOrOtherBasis |
| Depreciation | 111238008 | Depreciation |
| Book Value | 20692883 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 344737 | OtherCostOrOtherBasis |
| Book Value | 344737 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 70121283 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| UNFUNDED PENSION LIABILITY | $26,956,871 |
| SELF INSURANCE RESERVE | $15,629,847 |
| ACCRUED BOND INTEREST PAYABLE | $222,985 |
| MORRISION'S DEBT FORGIVENESS | $150,019 |
| PROFESSIONAL FEES PAYABLE | $21,383 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 42981105 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | LIABILITY UNDER FIN 48 FOOTNOTE | Identifier |
| Return Reference | SCHEDULE D, PAGE 3, PART X | ReturnReference |
| Explanation | THE SOUTHERN REGIONAL HEALTH SYSTEM, INC., SOUTHERN CRESCENT PHYSICIANS GROUP, SOUTHERN CRESCENT REAL ESTATE, INC., SOUTHERN REGIONAL AMBULATORY SURGERY, AND SOUTHERN REGIONAL MEDICAL CENTER FOUNDATION (ALL RELATED/SUPPORTING ORGANIZATIONS) HAVE BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501 (A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3), AND THEREFORE, RELATED INCOME IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. INCOME TAX FROM THE SYSTEM'S TAXABLE AFFILIATES NETWORK AND MEDICAL SERVICES IS NOT SIGNIFICANT. THE SYSTEM'S COMBINED AFFILIATES, SCRE AND SSASC, ARE ORGANIZED AS A LIMITED LIABILITY COMPANY AND LIMITED PARTNERSHIP, RESPECTIVELY, AND THEREFORE, THE SYSTEM'S PROPORTIONATE SHARE OF EARNINGS AND LOSSES FROM THESE AFFILIATES IS REFLECTED IN THE SYSTEM'S TAX REPORTING. INCOME TAXES ASSOCIATED WITH THESE AFFILIATES ARE IMMATERIAL TO THE SYSTEM'S COMBINED FINANCIAL STATEMENTS. THE SYSTEM FOLLOWS FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES. ASC 740 ADDRESSES ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS AND GUIDANCE ON WHEN TAX POSITIONS, ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. THERE IS CURRENTLY NO IMPACT ON THE SYSTEM'S COMBINED FINANCIAL STATEMENTS AS A RESULT OF ASC 740. | 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 |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 1.25000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7176692 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 7176692 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03230 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 49155185 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 44666791 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4488394 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02020 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 56331877 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 44666791 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11665086 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05250 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 5 | NumberOfActivitiesOrPrograms |
| Persons Served | 1027 | PersonsServed |
| Total Community Benefit Expense | 7445 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 7445 | NetCommunityBenefitExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 423 | PersonsServed |
| Total Community Benefit Expense | 108723 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 51900 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 56823 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 20665843 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 16961601 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3704242 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01670 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 17400 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 17400 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 1450 | PersonsServed |
| Total Community Benefit Expense | 20799411 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 17013501 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3785910 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01710 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 1450 | PersonsServed |
| Total Community Benefit Expense | 77131288 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 61680292 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 15450996 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06960 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $13,441,897 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 54214244 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 51694888 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 2519356 | 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 IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPIVEY STATION ASC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | REAL ESTATE MGMT | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.45000 | OrganizationProfitOrOwnership |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHERN REGIONAL HEALTH SYSTEM INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 UPPER RIVERDALE ROAD SW | AddressLine1 |
| City | RIVERDALE | City |
| State | GA | State |
| ZIP Code | 30274 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Critical Access Hospital | X | CriticalAccessHospital |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Annual Community Benefit Expln | THE ORGANIZATION PREPARED A COMMUNITY BENEFITS REPORT AND IT WAS PROVIDED TO THE CLAYTON COUNTY HOSPITAL AUTHORITY AND FILED WITH THE CLERK OF THE SUPERIOR COURT. THE COMMUNITY BENEFIT REPORT IS AVAILABLE TO THE PUBLIC THROUGH THESE PUBLIC ENTITIES. | AnnualCommunityBenefitExpln |
| Costing Method Used | UTILIZED THE RATIO OF COST TO CHARGE INFORMATION FROM WORKSHEET C OF THE FY 2010 COST REPORT. | 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 25 271,048,117 LESS: BAD DEBTS IN PART IX ( 48,953,145) DENOMINATOR FOR COLUMN (F) 222,094,972 | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | THE ORGANIZATION FOLLOWS THE METHOD DESCRIBED IN HFMA STATEMENT 15. THE COSTING METHODOLOGY WAS BASED ON THE WORKSHEET C FROM THE FY 2010 COST REPORT AND THE COST TO CHARGE RATIO WAS APPLIED TO BAD DEBT EXPENSE TO CALCULATE BAD DEBT EXPENSE AT COST. | BadDebtFootnote |
| Shortfall As Community Benefit | THE METHODOLOGY USED FOR THIS SECTION WAS THE MEDICARE COST REPORT RATIO OF COST TO CHARGE APPROACH. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | PATIENTS ARE SCREENED BASED ON COUNTY OF RESIDENCE, INCOME LEVELS, AND IF THE MEDICAL CARE IS CONSIDERED CATASTROPHIC IN NATURE. DEPENDING ON THE CRITERIA, PATIENT'S BILLS ARE REDUCED BY ADJUSTMENTS TO CHARITY OR INDIGENT CARE USING THE SPECIFIC GUIDELINES IN THE POLICY. INCOME CRITERIA ARE BASED ON VARIOUS PERCENTAGES OF FEDERAL POVERTY GUIDELINES (FPG). THE ORGANIZATION WRITES OFF PATIENT ACCOUNTS RECEIVABLE BALANCES WHEN THEY QUALIFY FOR INDIGENT / CHARITY CARE AND DOES NOT MAKE FURTHER COLLECTION EFFORTS. | DebtCollectionPolicy |
| General Explanation | PART IV - MANAGEMENT COMPANIES AND JOINT VENTURES SURGERY CENTER REAL ESTATE INVESTORS ("SCREI") OWNS A 49.59% OF SPIVEY STATION ASC BUILDING, LLP. PHYSICIANS, WHO ARE EITHER EMPLOYEES OF SOUTHERN CRESCENT PHYSICIANS GROUP (A RELATED ORGANIZATION) OR HAVE ADMITTING PRIVILEGES TO THE FILING ORGANIZATION, OWN APPROXIMATELY 48% OF SCREI. | GeneralExplanation |
| Needs Assessment | HEALTH NEEDS ARE GENERALLY ASSESSED THROUGH A STRATEGIC PLANNING PROCESS THAT LOOKS AT THE PRIMARY AND SECONDARY SERVICE AREAS FOR TRENDS IN AGE, INCOME, AND USE RATES FOR VARIOUS SERVICES OR ILLNESSES. COMMUNITY NEEDS ARE ALSO BASED ON A NEEDS ASSESSMENT RELATED TO VARIOUS PHYSICIAN SPECIALTIES, FOR EXAMPLE, THE SERVICE AREA HAS NEEDS FOR PRIMARY CARE PHYSICIANS. THE ORGANIZATION WORKS WITH LOCAL PHYSICIAN PRACTICES TO SHARE THIS INFORMATION AND ENCOURAGE VARIOUS PHYSICIAN RECRUITMENT ACTIVITIES. HEALTH NEEDS ARE ALSO INDIRECTLY ASSESSED BY ANALYZING TRENDS FOR SERVICES OFFERED AT THE ORGANIZATION AND THE HEALTH STATUS OF THOSE PATIENTS. | NeedsAssessment |
| Patient Education Assistance | THE ORGANIZATION INFORMS AND EDUCATES PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE BY POSTED SIGNS, FORMS, AND EMAILS. | PatientEducationAssistance |
| Community Information | THE ORGANIZATION SERVES THE PATIENTS IN THE SOUTHERN CRESCENT OF THE METRO ATLANTA AREA. OUR PRIMARY SERVICE AREA INCLUDES CLAYTON COUNTY, FAYETTE COUNTY, HENRY COUNTY, AND PORTIONS OF SOUTH FULTON COUNTY. THE SOUTHERN CRESCENT IS A LARGE DIVERSE COMMUNITY AND THE ORGANIZATION OFFERS SERVICES TO MEET THESE VARIED NEEDS. THE MAJOR SERVICES THE ORGANIZATION OFFERS IN THE SOUTHERN CRESCENT ARE OB SERVICES, NEONATOLOGY, GYNECOLOGICAL, ONCOLOGY & HEMATOLOGY, NEUROLOGY, NEUROSURGERY, ORTHOPEDICS, VASCULAR CARE, CARDIOLOGY AND INTERVENTIONAL CARDIOLOGY, ACUTE REHABILITATION, OP IMAGING, OP SURGERY & GASTROENTEROLOGY, EMERGENCY CARE, AND WOMEN'S COMMUNITY CARE. | CommunityInformation |
| Other Information | THE ORGANIZATION PROMOTES HEALTH IN THE COMMUNITY THROUGH 90 SECOND HEALTH BREAK COMMERCIALS, SPRING INTO HEALTHY LIVING CONFERENCE, HEALTH SCREENINGS AND SPONSORSHIPS. THE ORGANIZATION HAS A COMMUNITY BASED BOARD OF DIRECTORS AND IS ALSO LINKED TO THE COMMUNITY THROUGH THE CLAYTON COUNTY HOSPITAL AUTHORITY (CCHA), WHICH IS A GOVERNMENTAL ENTITY. EXCESS FUNDS FROM THE OPERATION OF THE ORGANIZATION ARE REDIRECTED BACK TO THE MISSION OF THE ORGANIZATION THROUGH THE PURCHASE OF EQUIPMENT, MAINTAINING / UPGRADING THE FACILITIES, DEVELOPING NEW SERVICES TO BENEFIT THE COMMUNITY, OR FUNDING OPERATIONS. | OtherInformation |
| Reports Filed With States | GA | ReportsFiledWithStates |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant | Business Name Line2RecipientNameBusiness/BusinessNameLine2 |
|---|---|---|---|---|---|---|---|---|
| UNITED WAY | ||||||||
| 107 WESTRIDGE INDUSTRIAL BLVD | MCDONOUGH | GA | 30253 | 580566194 | 3 | 5200 | DONATION | |
| PROPS DESIGN GROUP | ||||||||
| 11392 AZALEA TRAIL | HAMPTON | GA | 30228 | 17712 | DONATION | |||
| SOUTHERN REGIONAL AMBULATORY | ||||||||
| 11 UPPER RIVERDALE ROAD SW | RIVERDALE | GA | 30274 | 582541044 | 3 | 62286 | OPERATIONS | SURGERY INC |
| SOUTHERN CRESCENT PHYSCIAN GROUP | ||||||||
| 11 UPPER RIVERDALE ROAD SW | RIVERDALE | GA | 30274 | 581955425 | 3 | 1384802 | OPERATIONS | |
| SOUTHERN CRESCENT REAL ESTATE INC | ||||||||
| 11 UPPER RIVERDALE ROAD SW | RIVERDALE | GA | 30274 | 581955424 | 3 | 2396487 | OPERATIONS | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 4 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 1 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | TUITION ASSISTANCE | TypeOfGrant |
| Number Of Recipients | 73 | NumberOfRecipients |
| Amount Of Cash Grant | 120063 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES | SCHEDULE I, PAGE 1, PART I, LINE 2 | THE FILING ORGANIZATION MONITORS TAX EXEMPT PURPOSE COMPLIANCE FOR THE USE OF FUNDS GRANTED TO ITS SUPPORTED ORGANIZATION THROUGH A SHARED MANAGEMENT TEAM. |
| ADDITIONAL INFORMATION | SCHEDULE I, PAGE 4, PART IV | SOUTHERN REGIONAL HEALTH SYSTEM, INC. OFFERS ITS EMPLOYEES A TUITION REIMBURSEMENT AND STUDENT SCHOLARSHIP PROGRAM. THE PROGRAM PROVIDES TUITION ASSISTANCE TO EMPLOYEES SEEKING CERTIFICATION OR DEGREES AT ACCREDITED, APPROVED SCHOOLS AND SCHOLARSHIP ASSISTANCE TO STUDENTS IN APPROVED EDUCATION PROGRAMS DURING PERIODS OF SIGNIFICANT LABOR SHORTAGES. TO BE CONSIDERED FOR TUITION REIMBURSEMENT, EMPLOYEES MUST APPLY PRIOR TO THE START OF THE COURSE. WITHIN 30 DAYS OF SUCCESSFUL COMPLETION OF THE COURSE, (PASSING GRADE OF "C" OR BETTER FOR UNDERGRADUATE PROGRAMS; "B" OR BETTER FOR GRADUATE PROGRAMS) THE EMPLOYEE MUST SUBMIT A COPY OF THEIR GRADE AND THE ORIGINAL TUITION RECEIPT FROM THE INSTITUTION TO THE HUMAN RESOURCES DEPARTMENT FOR PROCESSING. EMPLOYEES MUST COMPLETE THE COURSE WHILE EMPLOYED AT THE FACILITY IN ORDER TO RECEIVE REIMBURSEMENT. FAILURE TO ABIDE BY THE POLICY MAY REQUIRE FULL OR PARTIAL RECOVERY OF AMOUNTS PAID TO THE EMPLOYEE UNDER THE PROGRAM. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | X | TravelForCompanions |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | true | 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 | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)
| Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg |
|---|---|---|---|---|
| CLINT MATTHEWS | ||||
| JOHN SCHIBLER | ||||
| CATHY KENNEY | ||||
| THERESE SUCHER | ||||
| MARY KAY GARDENIER | ||||
| 299106 | 14507 | 313613 | ||
| WILLIE COCHRAN | ||||
| 4714 | 3412 | 253844 | 245718 | |
| JAMES CRISSEY | ||||
| 3152 | 15800 | 215720 | 196768 | |
| KAREN MOORE | ||||
| 879 | 2245 | 168023 | 164899 | |
| NORMA ADAMS | ||||
| 1685 | 2912 | 164577 | 159980 | |
| ROY GILLELAND | ||||
| 1996 | 14267 | 384317 | 275638 | 92416 |
| NICHOLAS MAIDA | ||||
| 6218 | 7729 | 170350 | 156403 | |
| MELODY MENA | ||||
| 2656 | 3326 | 156764 | 150782 | |
| WILLIAM APPLEGATE | ||||
| 647 | 9285 | 162574 | 152642 | |
| DANIEL HOODIN | ||||
| 149893 | 7638 | 157531 | ||
| EDWARD BONN | ||||
| 486164 | 13609 | 499773 | ||
| RICHARD G STOVALL | ||||
| 194688 | 11292 | 205980 | ||
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| FRINGE OR EXPENSE EXPLANATION | SCHEDULE J, PAGE 1, PART I, LINE 1A | SPOUSAL TRAVEL EXPENSES ARE REIMBURSED WHEN HIS/HER ATTENDANCE IS NECESSARY AND ESSENTIAL. SPOUSAL TRAVEL EXPENSES REQUIRE PRIOR APPROVAL. REIMBURSEMENT SHALL BE LIMITED TO TRANSPORTATION EXPENSE NOT TO EXCEED THE AIR TRAVEL RATE IN COACH CLASS AND OUT-OF-POCKET EXPENSES WITH RESPECT TO LODGING AND FOOD. REIMBURSEMENT SHALL BE LIMITED TO LODGING BASED ON DOUBLE ACCOMMODATION. THE POLICY RECOGNIZES THAT GOVERNING BOARD MEMBERS ARE OFTEN PLACED IN SOCIAL SITUATIONS AT SUCH MEETINGS AND WOULD REPRESENT THE HOSPITAL OPTIMALLY WITH THE ASSISTANCE OF THEIR SPOUSES. ADDITIONALLY, SOUTHERN REGIONAL HEALTH SYSTEM, INC. HAS A CORPORATE MEMBERSHIP TO A LOCAL COUNTRY CLUB FOR WHICH SELECTED OFFICERS AND KEY EMPLOYEES PARTICIPATE IN SOCIAL CLUB MEMBERSHIP. THE ORGANIZATION INTENDS FOR THESE PRIVILEGES TO BE BUSINESS USE ONLY AND CONSEQUENTLY, THESE BENEFITS ARE NOT INCLUDED IN THEIR TAXABLE WAGES. A FORMAL POLICY EXISTS, AND RECEIPTS AND APPROVAL ARE REQUIRED BEFORE REIMBURSEMENT FORMS ARE PROCESSED THROUGH THE ACCOUNTING DEPARTMENT FOR PAYMENT. |
| SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS | SCHEDULE J, PAGE 1, PART I, LINE 4 | MARY KAY GARDENIER 299,106 0 0 DANIEL HOODIN 149,893 0 0 EDWARD BONN 486,164 0 0 RICHARD G. STOVALL 194,688 0 0 |
| OTHER ADDITIONAL INFORMATION | SCHEDULE J, PART III | FTI CONSULTING, INC., AN UNRELATED ORGANIZATION, IS A CONSULTING FIRM PROVIDING RESTRUCTURING AND OPERATIONAL IMPROVEMENT SERVICES TO SOUTHERN REGIONAL HEALTH SYSTEM, INC. ("SRHS"). ADDITIONALLY DURING THE FISCAL YEAR, FTI PROVIDED MANAGEMENT SERVICES INCLUDING THE FOLLOWING EXECUTIVE POSITIONS: CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, CHIEF OPERATING OFFICER, AND CHIEF NURSING OFFICER. THE AMOUNT PAID TO FTI CONSULTING, INC. BY SRHS DURING THE FISCAL YEAR ENDING JUNE 30, 2010 INCLUDES COMPENSATION FOR SERVICES PROVIDED BY CLINT MATTHEWS, PAST CEO; CATHY KENNEY, CNO; THERESE SUCHER, COO; AND JOHN SCHIBLER, CFO. CLINT MATTHEWS, PAST CEO, LEFT SRHS 4/26/10 WITH THE TERMINATION OF THE FTI MANAGEMENT CONTRACT. AS PART OF THE PERMANENT EXECUTIVE MANAGEMENT TEAM, SRHS HIRED STEVE MAHAN AS THE CEO ON APRIL 26, 2010. SINCE COMPENSATION IN PART VII, SECTION A IS REPORTED ON A CALENDAR YEAR BASIS, NO COMPENSATION IS REPORTED FOR HIM THIS YEAR. PART I LINE 4 - SEVERANCE SEVERANCE COMPENSATION IS IN ACCORDANCE WITH EACH INDIVIDUAL'S EMPLOYMENT AGREEMENT. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLAYTON COUNTY HOSPITAL AUTHORITY | BusinessNameLine1 |
| Business Name Line2 | 2009 SERIES BONDS | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 582016041 | IssuerEIN |
| CUSIP Number | 184153ED2 | CUSIPNumber |
| Date Issued | 2009-04-01 | DateIssued |
| Issue Price | 40200000 | IssuePrice |
| Description Of Purpose | REFINANCE 1998B BOND | DescriptionOfPurpose |
| Defeased | false | Defeased |
| On Behalf Of Issuer | true | OnBehalfOfIssuer |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 39675000 | TotalProceeds |
| Year Of Subst Completion | 2009 | YearOfSubstCompletion |
| 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 | true | 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 O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| MANAGEMENT DELEGATED | FORM 990, PAGE 6, PART VI, LINE 3 | EFFECTIVE 10/07/08, SOUTHERN REGIONAL HEALTH SYSTEM, INC. ("SRHS") ENTERED INTO AN AGREEMENT WITH FTI CONSULTING, INC. ("FTI"), AN UNRELATED ORGANIZATION, FOR INTERIM MANAGEMENT AND SUPPORT SERVICES. UNDER THIS AGREEMENT, FTI ASSIGNED THREE EMPLOYEES TO PROVIDE FULL-TIME, ON-SITE SERVICES FOR THE FOLLOWING POSITIONS: CHIEF RESTRUCTURING OFFICER (CRO), VICE PRESIDENT OPERATIONS (VPO), AND CHIEF NURSING OFFICER (CNO). AS PART OF THE SUPPORT SERVICES COMPONENT OF THIS AGREEMENT, A FINANCIAL ADVISOR (FA) WAS ALSO PROVIDED TWO DAYS PER WEEK. AS OF 12/19/08, THE CRO ASSUMED THE ROLE OF CHIEF EXECUTIVE OFFICER (CEO). UNDER THE GUIDANCE AND DIRECTION OF THE BOARD, THE CEO, AS AN INDEPENDENT CONTRACTOR OF SRHS AND AN EMPLOYEE OF FTI, ASSUMED THE RESPONSIBILITY OF OVERSEEING THE DUTIES OF PREVIOUS CHIEF EXECUTIVE OFFICERS OF SRHS. AN AGREEMENT DATED 1/15/09 TRANSITIONED THE VPO TO THE ROLE OF CHIEF OPERATING OFFICER (COO), AND ALSO CHANGED THE FA TO THE ROLE OF CHIEF FINANCIAL OFFICER (CFO). THE COO, UNDER THE DIRECTION OF THE CEO, IS RESPONSIBLE FOR DAY-TO-DAY FUNCTIONING OF SRHS DEPARTMENTS. THE CFO, ALSO UNDER THE DIRECTION OF THE CEO, IS RESPONSIBLE FOR THE FINANCIAL FUNCTIONS OF SRHS, CONSISTENT WITH THE DUTIES GIVEN TO PRIOR CHIEF FINANCIAL OFFICERS OF SRHS. DURING THE LAST HALF OF FY 2010, SRHS BEGAN HIRING PERMANENT EXECUTIVE MANAGEMENT AND WAS ABLE TO HIRE THE CEO ON APRIL 26, 2010. THE FTI ASSIGNED COO AND CNO LEFT THE ORGANIZATION ON APRIL 23, 2010. THE FTI ASSIGNED CFO AND CONTROLLER LEFT THE ORGANIZATION ON JULY 7, 2010. THE PERMANENT CFO, COO, AND CNO WERE HIRED IN FY 2011. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11 | THE COMPLETED IRS FORM 990 TAX RETURN, ALONG WITH ALL SUPPORTING SCHEDULES, ARE POSTED TO THE SRHS EXTRANET FOR BOARD MEMBER ACCESS AND REVIEW. NOTIFICATION OF THIS POSTING WAS SENT VIA EMAIL. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | THE CONFLICT OF INTEREST POLICY COVERS ALL BOARD MEMBERS AND SENIOR MANAGEMENT. THE POTENTIAL CONFLICT IS DISCUSSED WITH THE BOARD OF DIRECTORS (ABSENT THE MEMBER WITH THE POTENTIAL CONFLICT). IF IT IS DETERMINED THAT CONFLICT EXISTS, THEN THE BOARD MAY HAVE THE MEMBER EITHER RESIGN, REMOVE THE CONFLICT, OR THEY MOVE FORWARD WITH THE TRANSACTION IF SPECIFIC FACTS ARE PRESENT. IF THE LATTER SITUATION TAKES PLACE, THEN THE MEMBER IS EXCLUDED FROM DISCUSSIONS AND THE VOTE FOR THAT TRANSACTION. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AUTHORIZES THE COMPENSATION PACKAGE OF EXECUTIVES UTILIZING THE VHA GEORGIA SURVEY OF EXECUTIVE COMPENSATION AND OTHER APPROPRIATE SURVEYS. THE SURVEY IS REVIEWED TO ENSURE COMPETITIVE WAGES AND BENEFITS FOR THE CEO. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AUTHORIZES THE COMPENSATION PACKAGE OF EXECUTIVES UTILIZING THE VHA GEORGIA SURVEY OF EXECUTIVE COMPENSATION AND OTHER APPROPRIATE SURVEYS. THE SURVEY IS REVIEWED TO ENSURE COMPETITIVE WAGES AND BENEFITS FOR THE CFO AND OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE SOUTHERN REGIONAL HEALTH SYSTEM, INC.'S BOARD OF DIRECTORS COMPLIES WITH THE OPEN RECORDS LAW. UPON WRITTEN REQUEST, GOVERNING DOCUMENTS DEEMED ACCESSIBLE TO THE PUBLIC UNDER THE LAW CAN BE VIEWED IN THE OFFICE OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER. |
| ADDITIONAL INFORMATION | SCHEDULE O | FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS IN ADDITION, SOUTHERN REGIONAL PARTICIPATED IN COMMUNITY WELLNESS SERVICES FREE OR AT REDUCED COSTS TO THE COMMUNITY, INCLUDING: DIET CONSULTATIONS AND WEIGHT LOSS CLASSES, PAIN MANAGEMENT PROGRAMS, OCCUPATIONAL HEALTH, INFLUENZA VIRUS VACCINATION DRIVE, MAMMOGRAPHY SCREENINGS, DIABETES EDUCATION AND CONSULTATION, CHILDBIRTH PREPARATION CLASSES, CPR AND FIRST AID COURSES, AND MEDICAL LIBRARY SERVICES. CORE 990, PART VII, SECTION A LINE 5 - UNRELATED ORGANIZATION COMPENSATION STEVE MAHAN, CURRENT CFO, WAS HIRED APRIL 26, 2010; THE DATE THE PREVIOUS CFO CLINT MATTHEWS TERMINATED. THE ORGANIZATION'S CEO AND CFO, AS WELL AS VARIOUS OTHER HIGH-LEVEL INDIVIDUALS, WERE PROVIDED UNDER A MANAGEMENT CONTRACT WITH FTI CONSULTING, INC. THIS UNRELATED ENTITY PROVIDED ADDITIONAL SERVICES TO THE ORGANIZATION AND AN OVERHEAD FEE IS INCLUDED IN AMOUNTS CHARGED TO THE ENTITY FOR MANAGEMENT TEAM COMPENSATION. AFTER MULTIPLE ATTEMPTS BY THE ORGANIZATION ITSELF TO OBTAIN THIS INFORMATION, FTI IS STILL UNWILLING TO PROVIDE THE INDIVIDUAL'S COMPENSATION OR COPIES OF THE W-2 FOR FORM 990 PURPOSES. THEREFORE, SUCH DATA IS NOT AVAILABLE. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| SOUTHERN REGIONAL MED CTR AUXILIARY | |||||||||
| 11 UPPER RIVERDALE ROAD SW | RIVERDALE | GA | 302742600 | 582027384 | VOLUNTEER | GA | 501 | 11B | NA |
| SOUTHERN REG MED CNT FOUNDATION INC | |||||||||
| 11 UPPER RIVERDALE ROAD SW | RIVERDALE | GA | 302742600 | 581983516 | FUNDRSG | GA | 501 | 11B | NA |
| SOUTHERN CRESCENT REAL ESTATE INC | |||||||||
| 11 UPPER RIVERDALE ROAD SW | RIVERDALE | GA | 302742600 | 581955424 | REAL EST | GA | 501 | 11B | NA |
| SOUTHERN REG AMBULATORY SURGERY | |||||||||
| 11 UPPER RIVERDALE ROAD SW | RIVERDALE | GA | 302742600 | 582541044 | SURGICAL | GA | 501 | 11B | NA |
| CLAYTON CO HOSP AUTH TRUST CO LIAB | |||||||||
| 11 UPPER RIVERDALE ROAD SW | RIVERDALE | GA | 302742600 | 582016041 | LIAB CLAIM | GA | 501 | 11B | NA |
| SOUTHERN CRESCENT PHYSICIANS GROUP | |||||||||
| 11 UPPER RIVERDALE ROAD SW | RIVERDALE | GA | 302742600 | 581955425 | PHYS PRACT | GA | 501 | 3 | NA |
| PROMINA HEALTH SYSTEM INC | |||||||||
| P O BOX 500428 | ATLANTA | GA | 31550 | 582135501 | PURCHASING | GA | 501 | 11A | NA |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SPIVEY STATION ASC BUILDING LP | ||||||||||||
| TWO SUN COURT SUITE 350 | NORCROSS | GA | 30092 | 263323060 | RENTAL | GA | NA | RELATED | 134596 | 5814858 | false | false |
| SOUTHLAKE AMBULATORY SURGERY CENTER | ||||||||||||
| 4000 CORPORATE CENTER DR | MORROW | GA | 30260 | 582272588 | SURGICAL | GA | SRAS | RELATED | -1461626 | 1553607 | false | true |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | 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 | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
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