2024-08-14T12:51:10-05:00 2023-09-30 621517792 PYA P C 2220 SUTHERLAND AVE KNOXVILLE TN 37919 990 2022-10-01 581519913 HAMILTON HEALTH CARE SYSTEM INC HAMI 7062726115 PO BOX 1168 DALTON GA 307221168 JULIE A SOEKORO VP/CFO 7062726115 2024-08-14 1 0 DEBORAH O ERNSBERGER P00364912 8656730844 2022 2024-08-08 14:25:15Z JEFFREY D MYERS PO BOX 1168 DALTON GA 307221168 65710009 0 X WWW.HAMILTONHEALTH.COM X 1983 GA TO PROVIDE SUPPORT FOR AFFILIATED TAX-EXEMPT ORGANIZATIONS. 11 9 148 0 0 0 0 112500 19707479 20316244 2260069 3441432 1077154 1044279 23044702 24914455 0 0 0 0 17305348 16064892 0 0 0 8249453 8667791 25554801 24732683 -2510099 181772 135712006 151459629 7584976 11524133 128127030 139935496 WE PROVIDE LEADERSHIP, PARTNERSHIPS AND SEAMLESS RESOURCE COORDINATION TO MEET HEALTH CARE NEEDS THAT ADVANCE THE QUALITY AND DIGNITY OF LIFE. 0 0 24182128 21452728 PROVIDE SUPPORT FOR AFFILIATED TAX-EXEMPT ORGANIZATIONS LISTED IN SCHEDULE A, PART I. 24182128 1 0 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 43 0 1 148 1 0 0 0 0 0 0 0 0 0 0 1 0 X 11 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 GA X JULIE A SOEKORO 7062782105 1200 MEMORIAL DRIVE DALTON GA 30720 G LAMAR LYLE CHAIRMAN 1.00 X X 0 0 0 DON W ADCOCK TRUSTEE 1.00 X 0 0 0 ROBERT M CHANDLER VICE CHAIRMAN 1.00 X X 0 0 0 CHARLES N DOBBINS JR TRUSTEE 1.00 X 0 0 0 MICHAEL C HARTLEY MD TRUSTEE 1.00 40.00 X 0 771363 42320 ERIC E JENSEN MD TRUSTEE 1.00 X 0 0 0 BRYAN E MCALLISTER SECRETARY/TREASURER 1.00 X X 0 0 0 GARY A MIDDLETON TRUSTEE 1.00 X 0 0 0 JEFFREY D MYERS PRESIDENT/CEO 40.00 X X 1609084 0 135112 JOHN P NEAL III TRUSTEE 1.00 X 0 0 0 HENRY C THARPE JR TRUSTEE 1.00 X 0 0 0 JULIE A SOEKORO CFO/TREASURER 40.00 X 721943 0 112436 RANDALL F FOSTER ASSISTANT TREASURER 40.00 X 246469 0 12592 SANDRA D MCKENZIE PRESIDENT OF OPERATIONS 40.00 X 636061 0 52898 JOHN FORRESTER VICE PRESIDENT/CIO 40.00 X 443957 0 23962 TYLER S KENDALL VICE PRESIDENT 40.00 X 364260 0 20664 TODD HARRISON EXEC, DIR, GOV'T & COMMUNITY AFFAIRS 40.00 1.00 X 226891 0 12485 LISA LOVELACE VICE PRESIDENT 1.00 40.00 X 470625 0 46297 KRISTINE GODFREY VICE PRESIDENT 12.00 28.00 X 63080 144227 3730 VALERIE BRANTLEY VICE PRESIDENT 40.00 X 570962 0 41196 ALANA SULLIVAN DIRECTOR OF CORPORATE COMPLIANCE 40.00 X 216702 0 4951 SAVANNAH MOORE DEPUTY GENERAL COUNSEL 40.00 X 193742 0 13288 STEVEN P BRIDENSTINE DIRECTOR FINANCE 40.00 X 190514 0 2534 YVETTE LEE DIRECTOR CBO 40.00 X 181665 0 12595 6135955 915590 537060 24 0 1 0 HSI FINANCIAL SERVICES INC CO PHOENI 1000 CIRCLE 75 PKWY ATLANTA GA 30339 PURCHASED SERVICES 670131 NATIONWIDE RECOVERY SERVICE INC 5655 PEACHTREE PKWY STE 211 NORCROSS GA 30092 COLLECTION SERVICES 509197 CREDITORS BUREAU ASSOCIATES 112 WARD STREET MACON GA 31204 COLLECTION SERVICES 437331 NEMADJI RESEARCH CORPORATION 7564 BIRCH STREET PO BOX 100 BRUNO MN 55712 COLLECTION SERVICES 316938 ADVENT HEALTH PARTNERS INC 301 PLUS PARK BLVD SUITE 500 NASHVILLE TN 37217 COLLECTION SERVICES 307569 16 112500 112500 MANAGEMENT FEES 900099 20316244 20316244 20316244 2304948 2304948 41932038 40795554 1136484 1136484 1136484 MISCELLANEOUS REVENUE 900099 1044279 1044279 1044279 24914455 20316244 0 4485711 X 9677117 9677117 477438 477438 5282922 5282922 627415 627415 225000 225000 145533 145533 131515 131515 26319 26319 299236 299236 3034954 3034954 1016530 1016530 2301215 2301215 155721 155721 933462 933462 49900 49900 MISCELLANEOUS 348406 348406 24732683 24182128 550555 0 4037966 11466400 9303002 22829208 5108626 6353257 64227 82130 26170698 4993822 21881249 21176876 84379374 80242931 10868830 9273389 68732 35438 135712006 151459629 6084981 9467119 1499995 2057014 7584976 11524133 X 120912561 119560496 7214469 20375000 128127030 139935496 135712006 151459629 X 181772 3254664 225 8371805 X X 0 1 X 1 1 1 X X 9 HAMILTON AMBULATORY SURGERY CENTER 582654791 3 1 0 0 HAMILTON MEDICAL CENTER INC 581519911 3 1 0 0 HAMILTON EMERGENCY MEDICAL SERVICES INC 581651002 10 1 3350000 0 HLTC INC 582341574 10 1 500000 0 ROYAL OAK COMMUNITY LTD 582373427 3 1 550000 0 WHITFIELD HEALTHCARE FOUNDATION INC 510175056 3 1 200000 0 WHITFIELD PLACE INC 582103085 10 1 35000 0 HAMILTON CHILDREN'S INSTITUTE 823312912 10 1 1800000 0 DALTON SENIOR HOUSING INC 581518011 10 1 105000 0 9 6540000 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 26319 26319 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND THE GEORGIA HOSPITAL ASSOCIATION. EACH YEAR, A PORTION OF DUES PAID TO THESE ORGANIZATONS IS ALLOCATED TO LOBBYING EFFORTS ENGAGED BY THESE ORGANIZATIONS ON BEHALF OF THEIR MEMBERSHIP BODIES. THE AMOUNT ON LINE 1(I) ABOVE IS AN ESTIMATION OF THE LOBBYING PORTION OF DUES PAID FOR THE FISCAL YEAR. 1141372 1141372 21982961 3190923 18792038 521368 250682 270686 2524997 1552217 972780 21176876 TIMBERLAND INVESTMENTS 3407707 F REAL ESTATE 5865682 F 9273389 DEFERRED COMPENSATION 99107 ASSETS HELD ON BEHALF OF OTHERS 1957907 2057014 X PART X, LINE 2: THE SYSTEM HAS ADOPTED PROCEDURES FOR DETERMINING THE EXISTENCE OF UNCERTAIN TAX POSITIONS, AND THE RELATED TIMING AND AMOUNT OF THEIR IMPACT ON THE CONSOLIDATED FINANCIAL STATEMENTS, AND DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2023 AND 2022. X X 1 1 X X X 0 1 0 0 0 0 0 0 0 JEFFREY D MYERS PRESIDENT/CEO 955987 0 479272 0 173825 0 59300 0 75812 0 1744196 0 44050 0 JULIE A SOEKORO CFO/TREASURER 391721 0 188023 0 142199 0 31097 0 81339 0 834379 0 15593 0 MICHAEL C HARTLEY MD TRUSTEE 0 487717 0 261675 0 21971 0 36014 0 6306 0 813683 0 20764 SANDRA D MCKENZIE PRESIDENT OF OPERATIONS 400619 0 174381 0 61061 0 27158 0 25740 0 688959 0 11908 0 VALERIE BRANTLEY VICE PRESIDENT 320480 0 153840 0 96642 0 10488 0 30708 0 612158 0 3597 0 LISA LOVELACE VICE PRESIDENT 269848 0 111388 0 89389 0 15250 0 31047 0 516922 0 0 0 JOHN FORRESTER VICE PRESIDENT/CIO 228865 0 99541 0 115551 0 13766 0 10196 0 467919 0 2405 0 TYLER S KENDALL VICE PRESIDENT 206275 0 86707 0 71278 0 11668 0 8996 0 384924 0 0 0 RANDALL F FOSTER ASSISTANT TREASURER 185361 0 31063 0 30045 0 11569 0 1023 0 259061 0 0 0 TODD HARRISON EXEC, DIR, GOV'T & COMMUNITY AFFAIRS 146202 0 18904 0 61785 0 8144 0 4341 0 239376 0 0 0 ALANA SULLIVAN DIRECTOR OF CORPORATE COMPLIANCE 183988 0 21510 0 11204 0 4451 0 500 0 221653 0 0 0 KRISTINE GODFREY VICE PRESIDENT 30008 142267 32293 0 779 1960 631 593 995 1511 64706 146331 0 0 SAVANNAH MOORE DEPUTY GENERAL COUNSEL 152420 0 20682 0 20640 0 9765 0 3523 0 207030 0 0 0 YVETTE LEE DIRECTOR CBO 148943 0 17859 0 14863 0 8979 0 3616 0 194260 0 0 0 STEVEN P BRIDENSTINE DIRECTOR FINANCE 168585 0 21040 0 889 0 123 0 2411 0 193048 0 0 0 PART I, LINE 1A THE PERSONAL USE PORTION OF BOTH SPOUSAL TRAVEL AND SOCIAL CLUB DUES ARE INCLUDED IN THE RECIPIENTS TAXABLE WAGES. PART I, LINE 4B THE FOLLOWING PERSONS RECEIVED CURRENT YEAR DEFERRED COMPENSATION ACCRUALS FROM NON-QUALIFIED PLANS: - JEFFREY D. MYERS - $44,050 - SANDRA D. MCKENZIE - $11,908 - JULIE A. SOEKORO - $15,593 - JOHN FORRESTER - $2,405 - MICHAEL C. HARTLEY, M.D. - $20,764 THE FOLLOWING PERSONS RECEIVED CURRENT YEAR DEFERRED COMPENSATION ACCRUALS FROM NON-QUALIFIED SERP PLANS: - JEFFREY D. MYERS - $405,000 - SANDRA D. MCKENZIE - $75,000 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT CPA FIRM AND REVIEWED BY EXECUTIVE MANAGEMENT. SUBSEQUENTLY, A DRAFT COPY OF THE UNFILED FORM 990 IS POSTED TO A SECURE PAGE ON THE HAMILTON HEALTH CARE SYSTEM WEBSITE FOR REVIEW AND COMMENT BY ALL MEMBERS OF THE BOAD OF TRUSTEES PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CLEAR AND DETAILED CONFLICT OF INTEREST POLICY WHICH ESTABLISHES A PROCEDURE FOR IDENTIFYING, REVIEWING AND ADDRESSING CONFLICTS OF INTEREST. THIS POLICY ALSO REQUIRED EACH TRUSTEE AND OFFICER OF THE ORGANIZATION TO ANNUALLY SIGN A STATEMENT ACKNOWLEDGING RECEIPT OF THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 UNDER A BOARD RESOLUTION, THE FINANCE & AUDIT COMMITTEE OF HAMILTON HEALTH CARE SYSTEM HAS THE AUTHORITY TO TAKE ACTION ON BEHALF OF THE BOARD WITH RESPECT TO THE COMPENSATION OF OFFICERS AND KEY EMPLOYEES. THE FINANCE & AUDIT COMMITTEE OF HAMILTON HEALTH CARE SYSTEM MAINTAINS MINUTES OF ITS PROCEDURES. ON AN ANNUAL BASIS THE FINANCE & AUDIT COMMITTEE OF HAMILTON HEALTH CARE SYSTEM WILL MEET TO SET THE ANNUAL COMPENSATION OF THE PRESIDENT/CEO. THIS ACTION IS BASED ON CONSULTATION WITH A THIRD PARTY CONSULTING FIRM TO REVIEW THE TOTAL COMPENSATION OF THE CEO AND KEY EMPLOYEES SUCH THAT TOTAL COMPENSATION PACKAGES ARE CONSIDERED FAIR MARKET AND NOT EXCESSIVE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,584,085. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,584,085. CONSULTING FEES: PROGRAM SERVICE EXPENSES 450,869. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 450,869. FORM 990, PART XI, LINE 9: EQUITY TRANSFER TO HLTC, INC. -1,342,925. EQUITY TRANSFER TO HEMS, INC. -3,445,580. CHANGE IN TEMPORARILY RESTRICTED NET ASSETS 13,160,310. FORM 990, PART XII, LINE 2 THE FINANCIAL STATEMENTS OF HAMILTON HEALTH CARE SYSTEM, INC. ARE AUDITED ON A CONSOLIDATED BASIS TO INCLUDE ALL AFFILIATES OF THE SYSTEM. DALTON SENIOR HOUSING INC 519 WEST HAWTHORNE STREET DALTON GA 30720 581518011 LOW-INCOME HOUSING GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON AMBULATORY SURGERY CENTER INC PO BOX 1168 DALTON GA 30722 582654791 SURGICAL SERVICES GA 501(C)(3) LINE 3 HAMILTON MEDICAL CENTER INC 1 HAMILTON EMERGENCY MEDICAL SERVICES INC PO BOX 1168 DALTON GA 30722 581651002 EMERGENCY MEDICAL GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON MEDICAL CENTER INC PO BOX 1168 DALTON GA 30722 581519911 HEALTHCARE GA 501(C)(3) LINE 3 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON PHYSICIAN GROUP INC PO BOX 1168 DALTON GA 30722 271198701 PHYSICIAN PRACTICE GA 501(C)(3) LINE 3 HAMILTON MEDICAL CENTER INC 1 HLTC INC PO BOX 1168 DALTON GA 30722 582341574 LONG TERM ELDERLY CARE GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 1 ROYAL OAK COMMUNITY LTD PO BOX 1900 DALTON GA 30722 581970228 SENIOR LIVING SERVICES GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 1 WHITFIELD PLACE INC PO BOX 1168 DALTON GA 30722 582103085 LOW-INCOME HOUSING GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 1 DALTON-WHITFIELD COUNTY HOSPITAL LIABILITY TRUST PO BOX 1168 DALTON GA 30722 581331514 LIABILITY CLAIMS COVERAGE GA 501(C)(3) LINE 12C, III-FI HAMILTON HEALTH CARE SYSTEM INC 1 WHITFIELD HEALTHCARE FOUNDATION INC PO BOX 1168 DALTON GA 30722 510175056 FUNDS FOR HEALTHCARE GA 501(C)(3) LINE 12B, II HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON CHILDREN'S INSTITUTE PO BOX 1168 DALTON GA 30722 823312912 PEDIATRIC DEVELOPMENTAL/BEHAVIORAL HEALTH TREATMENT GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON ORTHOPEDIC SURGERY CENTER 1104 PROFESSIONAL BLVD DALTON GA 30720 873430438 ORTHOPEDIC SURGERY CENTER GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 1 HAMILTON ORTHOPEDIC SURGERY CENTER PO BOX 1168 DALTON GA 30720 873430438 ORTHOPEDIC SURGERY CENTER GA N/A 0 0 HAMILTON HEALTH FIRST INC PO BOX 1168 DALTON GA 307221168 581694713 PREFERRED PROVIDER ORGANIZATION GA N/A C 0 HMC HOLDINGS INC PO BOX 1168 DALTON GA 307221168 TITLE HOLDING GA N/A C 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 DALTON SENIOR HOUSING D 105000 Y/E BALANCE HLTC INC D 500000 Y/E BALANCE HAMILTON CHILDREN'S INSTITUTE D 1800000 Y/E BALANCE HAMILTON EMERGENCY MEDICAL SERVICES D 3350000 Y/E BALANCE ROYAL OAK COMMUNITY LTD D 550000 Y/E BALANCE WHITFIELD HEALTHCARE FOUNDATION D 200000 Y/E BALANCE WHITFIELD PLACE E 35000 Y/E BALANCE ROYAL OAK COMMUNITY LTD E 400000 Y/E BALANCE DALTON SENIOR HOUSING E 75000 Y/E BALANCE WHITFIELD PLACE E 15000 Y/E BALANCE HAMILTON MEDICAL CENTER O 10164752 FMV HAMILTON MEDICAL CENTER P 10159634 FMV HAMILTON EMERGENCY MEDICAL SERVICES P 33812 FMV ROYAL OAK COMMUNITY LTD P 57120 FMV HAMILTON CHILDREN'S INSTITUTE P 34643 FMV DALTON SENIOR HOUSING K 30465 FMV WHITFIELD PLACE K 18852 FMV HAMILTON MEDICAL CENTER K 17331000 FMV HAMILTON EMERGENCY MEDICAL SERVICES K 144000 FMV HLTC INC K 660000 FMV WHITFIELD HEALTHCARE FOUNDATION K 236427 FMV ROYAL OAK COMMUNITY LTD K 210000 FMV HAMILTON CHILDREN'S INSTITUTE K 99996 FMV HAMILTON EMERGENCY MEDICAL SERVICES R 3445577 FMV HLTC INC R 1342924 FMV