2024-05-13T12:32:57-04:00 2023-06-30 581094351 MCNAIR MCLEMORE MIDDLEBROOKS & CO LLC POST OFFICE BOX ONE MACON GA 312020001 990 2022-07-01 432007492 HOME & COMMUNITY SERVICES INC HOME 4786212070 110 STONE BROOKE DRIVE GRAY GA 31032 TERESA MOODY SECRETARY 4786212070 2024-05-10 true TERESA MOODY 999009999 false WILLIAM R ROUNTREE P01231836 4787466277 2024-05-13 2022 2023-04-26 12:10:37Z TERESA MOODY 110 STONE BROOKE DRIVE GRAY GA 31032 64100868 false X WWW.SOURCE-GA.ORG X 2003 GA TO PROVIDE A CENTRAL, EFFICIENT, AND COST-EFFECTIVE HEALTH CARE TRANSPORTATION SERVICES AS A MEMBER OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. TO PROVIDE PHYSICIAN'S CARE TO OTHER ENTITIES WHICH ARE A PART OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM. TO PROVIDE ACUTE CARE SERVICES (HOSPITAL), EMERGENCY CARE SERVICES AND SKILLED NURSING SERVICES FOR RESIDENTS IN COMMERCE, GEORGIA AND SURROUNDING AREAS. TO PROVIDE HOME HEALTH AND HOSPICE SERVICES AS A MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. 3 3 843 0 4011667 0 61104299 63289903 3774 2046 1499406 808919 66619146 64100868 0 0 30838472 31860962 0 0 31284866 30395978 62123338 62256940 4495808 1843928 21054551 22349716 10720999 8145935 10333552 14203781 X TO PROVIDE A CENTRAL, EFFICIENT, AND COST-EFFECTIVE HEALTH CARE TRANSPORTATION SERVICES AS A MEMBER OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. TO PROVIDE PHYSICIAN'S CARE TO OTHER ENTITIES WHICH ARE A PART OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM. TO PROVIDE ACUTE CARE SERVICES (HOSPITAL), EMERGENCY CARE SERVICES AND SKILLED NURSING SERVICES FOR RESIDENTS IN COMMERCE, GEORGIA AND SURROUNDING AREAS. TO PROVIDE HOME HEALTH AND HOSPICE SERVICES AS A MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. false false 62256940 PROVIDED A CENTRAL, EFFICIENT, AND COST-EFFECTIVE HEALTH CARE TRANSPORTATION SERVICES AS A MEMBER OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED PHYSICIAN'S CARE TO OTHER ENTITIES WHICH ARE A PART OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS IN COMMERCE, GEORGIA AND SURROUNDING AREAS. PROVIDED HOME HEALTH AND HOSPICE SERVICES TO OTHER ENTITIES WHICH ARE A PART OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM. CONSISTENT WITH THE POLICIES AND PROCEDURES PREVIOUSLY ADOPTED BY THE BOARD OF DIRECTORS OF COMMUNITY HEALTH SYSTEMS, INC., THE SECTION 509(A)(3) SUPPORTING ORGANIZATION AND PARENT ENTITY OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM OF WHICH THE ORGANIZATION IS A MEMBER, THE ORGANIZATION PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITIES IT SERVES PURSUANT TO BOTH COMMUNITY BENEFIT GUIDELINES AND A CHARITY CARE POLICY. THE ORGANIZATION CONTINUES TO ASSESS AND DEVELOP PROGRAMS TO BENEFIT THE COMMUNITY. 62256940 true false false false false false false false false false true false false false true false true false false false false false false false false false false false false true true false false false false false false false false false false false false false false true true false false false true 204 0 true 843 true false false false false false false false false X 3 3 false false false false true true false true true false false true true true true true true true true false GA X HOME COMMUNITY SERVICES INC 4786212100 PO BOX 1803 MACON GA 31202 LORRAINE T TAYLOR SECRETARY 0.00 40.00 X 0 746048 25137 RALPH WARNOCK DIRECTOR 0.00 4.00 X 0 315369 18002 ANGELA HAMMACK CORPORATE SE 0.00 40.00 X 0 290941 18410 MICHELLE MOORE-ANDREWS SENIOR VP 40.00 0.00 X 262524 0 21282 KIMBERLY SHEFFIELD PRESIDENT 4.00 40.00 X 0 225616 20131 TERESA MOODY SECRETARY 4.00 40.00 X 0 218891 20021 HUNTER HURST VICE PRESIDE 40.00 0.00 X 210085 0 15429 TRACIE CLARK VICE PRESIDE 40.00 0.00 X 197938 0 11815 YVELAURE PREVOT LPN 40.00 0.00 X 176669 0 19494 SARAH THOMPSON VICE PRESIDE 40.00 0.00 X 163584 0 17250 JOEL ROBINSON VICE PRESIDE 40.00 0.00 X 158883 0 16513 PHILLIPS WIGGINS PARAMEDIC 40.00 0.00 X 134186 0 17777 TAMMY SMITH DINING SVCS 40.00 0.00 X 127875 0 14004 CHRISTIE SHAW VICE PRESIDE 40.00 0.00 X 110170 5201 11731 COLLEEN BUTLER ADMINISTRATO 40.00 0.00 X 109757 0 1812 PAUL A CABLE DIRECTOR 4.00 1.00 X 0 24000 0 KATHRYN DENNIS DIRECTOR 4.00 1.00 X 0 24000 0 JOSEPH A WALL CHAIRMAN 4.00 1.00 X 0 24000 0 HERBERT M PONDER JR DIRECTOR 0.00 0.00 X 0 12000 0 LUCY ROGERS DIRECTOR 0.00 0.00 X 0 12000 0 1651671 1898066 248808 10 true true false INTEGRA REHABILITATION 1013 RIVERBURCH PKWY SUITE 2 DALTON GA 30721 REHAB SERVICES 946188 RHC REAL ESTATE LLC PO BOX 1037 MACON GA 31201 REAL ESTATE 904874 BROWN HEALTH AND REHABILITATION 545 COOK STREET ROYSTON GA 30662 HEALTHCARE 638339 GORDON HEALTH AND REHABILITATION 1280 MAULDIN ROAD NW CALHOUN GA 307018615 HEALTHCARE 533661 OAKVIEW HEALTH AND REHABILITATION 960 HIGHLAND AVENUE SUMMERVILLE GA 30747 HEALTHCARE 482467 15 X GOVERNMENTAL PROGRAMS REV 56830376 56830376 PROGRAM REVENUES 6459527 6459527 63289903 2046 2046 OTHER 808919 808919 808919 64100868 64098822 2046 1202405 1202405 25765625 25765625 524661 524661 2429825 2429825 1938446 1938446 3477001 3477001 287362 287362 81232 81232 1125722 1125722 210011 210011 1149154 1149154 1068026 1068026 NURSING SERVICES 15061948 15061948 PLANT SUPPLIES / REPAIRS 2757716 2757716 TRAVEL 1316968 1316968 CONTRACTED SERVICES 1306580 1306580 2554258 2554258 62256940 62256940 0 0 28835 6607153 8828964 693056 450168 23581478 11247780 13432117 12333698 293390 736886 21054551 22349716 6322801 5107983 3548070 2865412 850128 172540 10720999 8145935 X 10333552 14203781 10333552 14203781 21054551 22349716 X 1843928 2026301 X false true X true false X 3236009 4011667 7247676 31153675 30156875 45910567 62603705 64098822 233923644 31153675 30156875 49146576 66615372 64098822 241171320 241171320 1488 3255 2627 3774 2046 13190 1488 3255 2627 3774 2046 13190 31155163 30160130 49149203 66619146 64100868 241184510 0.99990 0.99990 0.00000 0.00000 X 1571789 1571789 11531189 1705193 9825996 10478500 9542587 935913 12333698 OPERATING LEASE OBLIGATION 127743 ADVANCE PAYMENTS UNAPPLIED 44797 172540 64100868 64100868 64100868 62256940 62256940 62256940 X X X X X false false false false false false false false false LORRAINE T TAYLOR SECRETARY 731274 14774 25137 771185 RALPH WARNOCK DIRECTOR 295421 19948 18002 333371 ANGELA HAMMACK CORPORATE SECRETARY 279741 11200 18410 309351 MICHELLE MOORE-ANDREWS SENIOR VP 249208 13316 21282 283806 KIMBERLY SHEFFIELD PRESIDENT 214172 11444 20131 245747 TERESA MOODY SECRETARY 206516 12375 20021 238912 HUNTER HURST VICE PRESIDENT 201956 8129 15429 225514 TRACIE CLARK VICE PRESIDENT 186262 11676 11815 209753 YVELAURE PREVOT LPN 169680 6989 19494 196163 SARAH THOMPSON VICE PRESIDENT 155105 8479 17250 180834 JOEL ROBINSON VICE PRESIDENT 148879 10004 16513 175396 PHILLIPS WIGGINS PARAMEDIC 128855 5331 17777 151963 HERBERT M PONDER JR DIRECTOR 12000 12000 LUCY ROGERS DIRECTOR 12000 12000 A CENTRAL GEORGIA JOINT DEV AUTH BANK OF OKLAHOMA 611416768 2012-07-01 8000000 ACQUISITION OF RE false false false A false false true true A false false false false false false false A false false false false false false false false true A false PURPOSE OF ISSUE DESCRIPTION CENTRAL GEORGIA JOINT DEV AUTH ACQUISITION OF RE FORM 990 - ORGANIZATION'S MISSION TO PROVIDE A CENTRAL, EFFICIENT, AND COST-EFFECTIVE HEALTH CARE TRANSPORTATION SERVICES AS A MEMBER OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. TO PROVIDE PHYSICIAN'S CARE TO OTHER ENTITIES WHICH ARE A PART OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM. TO PROVIDE ACUTE CARE SERVICES (HOSPITAL), EMERGENCY CARE SERVICES AND SKILLED NURSING SERVICES FOR RESIDENTS IN COMMERCE, GEORGIA AND SURROUNDING AREAS. TO PROVIDE HOME HEALTH AND HOSPICE SERVICES AS A MEMBERS OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. FORM 990, PAGE 2, PART III, LINE 4A PROVIDED A CENTRAL, EFFICIENT, AND COST-EFFECTIVE HEALTH CARE TRANSPORTATION SERVICES AS A MEMBER OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED PHYSICIAN'S CARE TO OTHER ENTITIES WHICH ARE A PART OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM. PROVIDED INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS IN COMMERCE, GEORGIA AND SURROUNDING AREAS. PROVIDED HOME HEALTH AND HOSPICE SERVICES TO OTHER ENTITIES WHICH ARE A PART OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM. CONSISTENT WITH THE POLICIES AND PROCEDURES PREVIOUSLY ADOPTED BY THE BOARD OF DIRECTORS OF COMMUNITY HEALTH SYSTEMS, INC., THE SECTION 509(A)(3) SUPPORTING ORGANIZATION AND PARENT ENTITY OF THE INTEGRATED HEALTH CARE DELIVERY SYSTEM OF WHICH THE ORGANIZATION IS A MEMBER, THE ORGANIZATION PROVIDES SUBSTANTIAL COMMUNITY BENEFIT TO THE COMMUNITIES IT SERVES PURSUANT TO BOTH COMMUNITY BENEFIT GUIDELINES AND A CHARITY CARE POLICY. THE ORGANIZATION CONTINUES TO ASSESS AND DEVELOP PROGRAMS TO BENEFIT THE COMMUNITY. FORM 990, PAGE 6, PART VI, LINE 6 THE ORGANIZATION HAS A SOLE MEMBER, COMMUNITY HEALTH SYSTEMS, INC., A NONPROFIT GEORGIA CORPORATION. FORM 990, PAGE 6, PART VI, LINE 7A UNDER THE ORGANIZATION'S BYLAWS, WHILE IT IS THE SOLE MEMBER OF THE ORGANIZATION, COMMUNITY HEALTH SYSTEMS, INC., AS A TYPE I SECTION 509(A)(3) AND SECTION 501(C)(3) SUPPORTING ORGANIZATION, HAS THE SOLE RIGHT TO ELECT, REPLACE AND TO REMOVE THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS AND SHALL ENSURE THAT AT ALL TIMES, A MAJORITY OF THE MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS SHALL BE COMPOSED OF PERSONS WHO ARE CONCURRENTLY SERVING AS MEMBERS OF THE BOARD OF DIRECTORS OF COMMUNITY HEALTH SYSTEMS, INC. FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 FOR HOME & COMMUNITY SERVICE, INC. IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. UPON COMPLETION, THE INDEPENDENT ACCOUNTING FIRM PROVIDES A DRAFT OF THE FORM 990 TO THE AUDIT COMMITTEE OF THE ORGANIZATION FOR ITS REVIEW. ALLOWING ADEQUATE TIME FOR REVIEW, THE INDEPENDENT ACCOUNTING FIRM SUBSEQUENTLY MEETS WITH THE AUDIT COMMITTEE OF THE ORGANIZATION TO REVIEW AND DISCUSS THE DRAFT FORM 990. FOLLOWING THE AUDIT COMMITTEE'S REVIEW, DISCUSSION AND APPROVAL OF THE DRAFT FORM 990, THE AUDIT COMMITTEE THEN PROVIDES THE DRAFT FORM 990 TO THE ORGANIZATION'S BOARD OF DIRECTORS WITH A RECOMMENDATION TO REVIEW AND APPROVE THE FORM 990. SUBSEQUENT TO RECEIPT OF THE DRAFT FORM 990, A MEETING OF THE ORGANIZATION'S BOARD OF DIRECTORS IS HELD TO DISCUSS THE RECOMMENDATION FROM ITS AUDIT COMMITTEE AND TO ASK QUESTIONS OF THE INDEPENDENT ACCOUNTING FIRM AND THE ORGANIZATION'S MANAGEMENT. FOLLOWING REVIEW AND DISCUSSION, THE BOARD THEN APPROVES THE FORM 990 TO BE FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PAGE 6, PART VI, LINE 12C COMPLIANCE WITH THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY IS EFFECTUATED BY, AT A MINIMUM, THE BOARD OF DIRECTOR'S ANNUAL REVIEW OF CONFLICT DISCLOSURE STATEMENTS PROVIDED BY THE ORGANIZATION'S DIRECTORS AND OFFICERS. ALSO, THE ORGANIZATION'S BOARD OF DIRECTORS REVIEW CONFLICT DISCLOSURE STATEMENTS PRIOR TO TAKING ACTION ON PROPOSED TRANSACTIONS AND CONTRACTUAL ARRANGEMENTS. THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY PROVIDES THE PROCEDURE FOR WHICH INTERESTED PERSONS ARE EVALUATED TO DETERMINE IF A CONFLICT EXISTS. IF IT IS DETERMINED THAT A BOARD MEMBER HAS A CONFLICT OF INTEREST, THEN SUCH BOARD MEMBERS ARE NOT ALLOWED TO PARTICIPATE IN DELIBERATIONS ON THE SPECIFIC MATTER AND IS EXCUSED FROM, AND NOT ALLOWED TO PARTICIPATE IN, ANY BOARD VOTE ON THE MATTER. FORM 990, PAGE 6, PART VI, LINE 15A THE ORGANIZATION REGULARLY AND CONSISTENTLY COMPLIES WITH THE COMPENSATION APPROVAL PROCESS, AS DEFINED BY ITS CONFLICTS OF INTEREST POLICY, THROUGH A COMPREHENSIVE ENGAGEMENT CONDUCTED BY ITS COMPENSATION COMMITTEE. A THIRD-PARTY COMPENSATION CONSULTANT IS ENGAGED TO GATHER COMPARABILITY DATA FOR THE ORGANIZATION'S SENIOR MANAGEMENT AND ITS KEY OR HIGHLY COMPENSATED EMPLOYEES. FOLLOWING COMPLETION OF THE ENGAGEMENT, THE THIRD-PARTY CONSULTANT ISSUES A WRITTEN REPORT REFLECTING ITS OPINION CONCERNING WHETHER THE ORGANIZATION'S PROPOSED COMPENSATION ARRANGEMENTS CONSTITUTE REASONABLE COMPENSATION UNDER SECTION 4958 OF THE INTERNAL REVENUE CODE. UPON RECEIPT AND REVIEW OF THE CONSULTANT'S WRITTEN REPORT AND SUPPORTING MATERIALS, THE ORGANIZATION'S COMPENSATION COMMITTEE THEN PROVIDES ALL SUCH MATERIALS ALONG WITH RECOMMENDATIONS TO ITS BOARD OF DIRECTORS FOR CONSIDERATION. SUBSEQUENTLY, THE BOARD OF DIRECTORS HOLDS A MEETING TO REVIEW THE MATERIALS AND RECOMMENDATIONS FROM ITS COMPENSATION COMMITTEE AT WHICH TIME THE BOARD WILL VOTE ON THE REASONABLENESS OF COMPENSATION FOR EACH INDIVIDUAL INCLUDED IN THE COMPENSATION ENGAGEMENT. IF ANY DISQUALIFIED OR OTHERWISE CONFLICTED BOARD MEMBERS ARE PRESENT AT THE MEETING, THEY DO NOT PARTICIPATE IN THE DELIBERATIONS AND ARE EXCUSED FROM VOTING ON SUCH MATTERS. THE COMPENSATION APPROVAL PROCESS IS CARRIED OUT BY THE ORGANIZATION'S BOARD OF DIRECTORS IN A MANNER DESIGNED TO SATISFY ALL THREE OF THE REQUIREMENTS NECESSARY TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS WITH RESPECT TO COMPENSATION ARRANGEMENTS FOR DISQUALIFIED PERSONS UNDER SECTION 53.4958-6 OF THE INTERNAL REVENUE CODE. AS PART OF THE PROCESS, THE ORGANIZATION'S BOARD OF DIRECTORS RETAINS THIRD-PARTY LEGAL COUNSEL TO FURTHER ADVISE THE BOARD ON THE REBUTTABLE PRESUMPTION PROCESS AND TO PROVIDE THE BOARD WITH A LEGAL OPINION REGARDING THE SAME. THE FINAL STEP IN THE PROCESS IS PREPARATION OF DOCUMENTATION REQUIRED TO ESTABLISH THE REBUTTABLE PRESUMPTION UTILIZING THE REBUTTABLE PRESUMPTION CHECKLIST ISSUED BY THE INTERNAL REVENUE SERVICE. FORM 990, PAGE 6, PART VI, LINE 15B THE ORGANIZATION REGULARLY AND CONSISTENTLY COMPLIES WITH THE COMPENSATION APPROVAL PROCESS, AS DEFINED BY ITS CONFLICTS OF INTEREST POLICY, THROUGH A COMPREHENSIVE ENGAGEMENT CONDUCTED BY ITS COMPENSATION COMMITTEE. A THIRD-PARTY COMPENSATION CONSULTANT IS ENGAGED TO GATHER COMPARABILITY DATA FOR THE ORGANIZATION'S SENIOR MANAGEMENT AND ITS KEY OR HIGHLY COMPENSATED EMPLOYEES. FOLLOWING COMPLETION OF THE ENGAGEMENT, THE THIRD-PARTY CONSULTANT ISSUES A WRITTEN REPORT REFLECTING ITS OPINION CONCERNING WHETHER THE ORGANIZATION'S PROPOSED COMPENSATION ARRANGEMENTS CONSTITUTE REASONABLE COMPENSATION UNDER SECTION 4958 OF THE INTERNAL REVENUE CODE. UPON RECEIPT AND REVIEW OF THE CONSULTANT'S WRITTEN REPORT AND SUPPORTING MATERIALS, THE ORGANIZATION'S COMPENSATION COMMITTEE THEN PROVIDES ALL SUCH MATERIALS ALONG WITH RECOMMENDATIONS TO ITS BOARD OF DIRECTORS FOR CONSIDERATION. SUBSEQUENTLY, THE BOARD OF DIRECTORS HOLDS A MEETING TO REVIEW THE MATERIALS AND RECOMMENDATIONS FROM ITS COMPENSATION COMMITTEE AT WHICH TIME THE BOARD WILL VOTE ON THE REASONABLENESS OF COMPENSATION FOR EACH INDIVIDUAL INCLUDED IN THE COMPENSATION ENGAGEMENT. IF ANY DISQUALIFIED OR OTHERWISE CONFLICTED BOARD MEMBERS ARE PRESENT AT THE MEETING, THEY DO NOT PARTICIPATE IN THE DELIBERATIONS AND ARE EXCUSED FROM VOTING ON SUCH MATTERS. THE COMPENSATION APPROVAL PROCESS IS CARRIED OUT BY THE ORGANIZATION'S BOARD OF DIRECTORS IN A MANNER DESIGNED TO SATISFY ALL THREE OF THE REQUIREMENTS NECESSARY TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS WITH RESPECT TO COMPENSATION ARRANGEMENTS FOR DISQUALIFIED PERSONS UNDER SECTION 53.4958-6 OF THE INTERNAL REVENUE CODE. AS PART OF THE PROCESS, THE ORGANIZATION'S BOARD OF DIRECTORS RETAINS THIRD-PARTY LEGAL COUNSEL TO FURTHER ADVISE THE BOARD ON THE REBUTTABLE PRESUMPTION PROCESS AND TO PROVIDE THE BOARD WITH A LEGAL OPINION REGARDING THE SAME. THE FINAL STEP IN THE PROCESS IS PREPARATION OF DOCUMENTATION REQUIRED TO ESTABLISH THE REBUTTABLE PRESUMPTION UTILIZING THE REBUTTABLE PRESUMPTION CHECKLIST ISSUED BY THE INTERNAL REVENUE SERVICE. FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST IN ACCORDANCE WITH THE SECTION 6104(D) DISCLOSURE REQUIREMENTS. FORM 990, PART VIII PART VIII, LINE 1E -- THE PROVIDER RELIEF FUND WAS ESTABLISHED THROUGH THE CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY ACT (CARES ACT)AND THE PAYCHECK PROTECTION PROGRAM AND HEALTHCARE ENHANCEMENT ACT (PPCHE). THIS LEGISLATION AUTHORIZED THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES TO MAKE GENERAL AND TARGETED DISTRIBUTIONS TO QUALIFYING HEALTHCARE PROVIDERS BASED ON THE VARIOUS FORMULAS AND CRITERIA DESIGNATED IN THE LEGISLATION. THE CORPORATION RECEIVED 3,236,009 UNDER THESE PROGRAMS FOR THE YEAR ENDED JUNE 30, 2021. OF THIS AMOUNT, THE CORPORATION UTILIZED FUNDS TOTALING 3,236,009 DURING THE YEAR ENDED JUNE 30, 2021. THIS AMOUNT IS INCLUDED ON LINE 1E ON THE FORM 990 STATEMENT OF REVENUE. FORM 990, PART XI, LINE 9 RECEIPT OF NET ASSETS 2,026,301 H&CS SERVICES LLC PO BOX 1803 MACON GA 31202 455012031 HEALTHCARE GA 206724 4205586 NA MGAS HOLDINGS LLC PO BOX 1803 MACON GA 31202 453639743 HEALTHCARE GA NA JACKSON COUNTY HC HOLDINGS LLC PO BOX 1037 MACON GA 31202 464302674 HEALTHCARE GA 4669908 NA COMMUNITY AMBULANCE COMPANY LLC PO BOX 1803 MACON GA 31202 455012031 AMBULANCE GA 13954375 2817808 NA RESTORATION HEALTHCARE COMMERCELLC 70 MEDICAL CENTER DRIVE COMMERCE GA 30529 271914362 HOSPITAL GA 8709656 1369011 NA RHC REAL ESTATE LLC PO BOX 1037 MACON GA 31202 272146759 REALESTATE GA 1620493 5049887 NA COMMERCE PHYSICIAN GROUP LLC PO BOX 1037 MACON GA 31202 364737947 HEALTHCARE GA NA SOURCE CARE MANAGEMENT LLC PO BOX 1803 MACON GA 31202 582651175 CASE MGMT GA 13056108 952834 NA AMICITA HOME HEALTH 213 THIRD STREET MACON GA 31201 271563270 HOME HEALT GA 2001535 1292860 NA AFFINIS HOSPICE 213 THIRD STREET MACON GA 31201 271452535 HOSPICE GA 26798302 5946565 NA STONEBROOKE SUITES LLC 1005 BOULDER DRIVE GRAY GA 31032 542101866 HEALTHCARE GA 11866 NA CLINICAL SERVICES INC 1005 BOULDER DRIVE GRAY GA 31032 571157115 CLINICAL & GA 501C 10 CHSI false COMMUNITY HEALTH FOUNDATION INC 110 STONE BROOKE DRIE GRAY GA 31032 571157153 FINANCIAL GA 501C 10 CHSI false COMMUNITY HEALTH SYSTEMS INC PO BOX 1037 MACON GA 31202 743083593 SUPPORT SE GA 501C 12A NA false COMMUNITY REHABILITATION SERVICES 110 STONE BROOKE DRIVE GRAY GA 31032 203253779 REHABILITA GA 501C 10 CHSI false HEALTH SCHOLARSHIPS INC 1005 BOULDER DRIVE GRAY GA 31032 581805305 OPERATION GA 501C 10 CHSI false HEALTH SYSTEMS REAL ESTATE INC 110 STONE BROOKE DRIVE GRAY GA 31032 432007488 RE GA 501C 10 CHSI false HEALTH SYSTEMS FACILITIES INC 1005 BOULDER DRIVE GRAY GA 31032 743083594 OPERATION GA 501C 10 CHSI false COMMUNITY ANCILLARY SERVICES INC 110 STONE BROOKE DRIVE GRAY GA 31032 432007496 PHAR GA 501C 10 CHSI false PIEDMONT REGIONAL HEALTH INC 1005 BOULDER DRIVE GRAY GA 31032 432007498 OPERATION GA 501C 10 CHSI false STEWARD HEALTH SERVICES INC 110 STONE BROOKE DRIVE GRAY GA 31032 432007486 HOSPICE GA 501C 10 CHSI false COMMUNITY HEALTH VENTURES INC 4875 RIVERSIDE DRIVE SUITE 105 MACON GA 31210 201392241 RISK MGMT. GA CHSI C CORP false false false false false false false false false false false true false true false false false false false false COMMUNITY HEATH SYSTEMS INC M 2761204 CLINICAL SERVICES INC M 715797 COMMUNITY ANCILLARY SERVICES INC M 726801 COMMUNITY REHABILITATION SERVICES M 720633 HEATLH SCHOLARSHIPS INC K 8800000 HEALTH SYSTEMS FACILITIES INC K 2182000 PIEDMONT REGIONAL HEALTH INC K 660000