2024-05-08T07:55:04-05:00 2023-06-30 440160260 FORVIS LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2022-07-01 201364957 MAGNOLIA MANOR OF ST SIMONS INC MAGN 2299249352 2001 SOUTH LEE STREET AMERICUS GA 31709 MARK TODD PRESIDENT 2299249352 2024-05-07 1 MARK TODD XXX-XX-XXXX 0 AMY BIBBY P00445891 8282542254 2024-05-07 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MARK TODD 2001 SOUTH LEE STREET AMERICUS GA 31709 7683735 0 X WWW.MAGNOLIAMANOR.COM X 2004 GA THE CORPORATION IS ORGANIZED TO PROVIDE RESIDENTIAL AND LONG-TERM CARE SERVICES TO THE SICK AND ELDERLY IN A SPIRTUAL SETTING. THE MISSION IS ACCOMPLISHED THROUGH THE OPERATION OF A 125-BED LONG TERM CARE FACILITY AND A 94-UNIT RETIREMENT COMMUNITY LOCATED ON ST. SIMON'S ISLAND, GEORGIA. 14 14 124 16 0 0 1000 0 8069372 7563471 33 211 549871 120053 8620276 7683735 0 0 0 0 4115918 4395466 0 0 0 5621166 5901282 9737084 10296748 -1116808 -2613013 1182114 3748083 3323031 6176128 -2140917 -2428045 X THE CORPORATION IS ORGANIZED TO PROVIDE RESIDENTIAL AND LONG-TERM CARE SERVICES TO THE SICK AND ELDERLY IN A SPIRITUAL SETTING. THE MISSION IS ACCOMPLISHED THROUGH THE OPERATION OF A 125-BED LONG-TERM CARE FACILITY AND A 94-UNIT RETIREMENT COMMUNITY LOCATED ON ST. SIMON'S ISLAND, GEORGIA. 0 0 8662197 7569224 THE CORPORATION PROVIDED RESIDENTIAL SERVICES TO THE SICK AND AGED THROUGH THE OPERATION OF A 125-BED LONG TERM CARE FACILITY AND A 94-BED RETIREMENT COMMUNITY LOCATED IN ST. SIMONS, GEORGIA. THE CORPORATION PROVIDED APPROXIMATELY 47,085 PATIENT DAYS OF SERVICE DURING THE YEAR. 8662197 1 0 0 0 0 0 0 0 0 0 1 0 0 1 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 0 0 0 1 14 0 1 124 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 GA X THE ORGANIZATION 2299315907 2001 SOUTH LEE STREET AMERICUS GA 31709 MARK JOHNSON BOARD OF TRUSTEE CHAIRMAN 1.00 6.00 X X 0 0 0 CHUCK REEVES BOARD OF TRUSTEE VICE CHAIRMAN 1.00 6.00 X X 0 0 0 JEAN WHEELER BOARD OF TRUSTEE SECRETARY 1.00 6.00 X X 0 0 0 HAL WEATHERS BOARD TRUSTEE 1.00 6.00 X 0 0 0 EDIE VINSON BOARD TRUSTEE 1.00 6.00 X 0 0 0 WILL PETERSON BOARD TRUSTEE 1.00 6.00 X 0 0 0 ANN HARRIS BOARD TRUSTEE 1.00 6.00 X 0 0 0 CHARLES PRYOR BOARD TRUSTEE 1.00 6.00 X 0 0 0 GEORGE YOUMANS JR BOARD TRUSTEE 1.00 6.00 X 0 0 0 CHARLES SHEFFIELD BOARD TRUSTEE 1.00 6.00 X 0 0 0 ED COLLIER BOARD TRUSTEE 1.00 6.00 X 0 0 0 TY TURNER BOARD TRUSTEE 1.00 6.00 X 0 0 0 PETE CATES BOARD TRUSTEE 1.00 6.00 X 0 0 0 RICK WHALEY BOARD TRUSTEE 1.00 6.00 X 0 0 0 MARK TODD CEO 10.00 50.00 X 0 340665 9957 DAVID CHARTER CFO 10.00 50.00 X 0 130915 6461 JOHSLYN CHESTER LPN SUPERVISOR 40.00 X 126033 0 9304 JACQUELINE CRISP FACILITY ADMINISTRATOR 40.00 X 112702 0 9030 SVETLANA CAINE RN MDS NURSE 40.00 X 111962 0 9030 350697 471580 43782 3 0 1 0 0 ROUTINE ROOM/BOARD 623000 4436028 4436028 MEDICARE/MEDICAID PAYM 623000 3123027 3123027 STIMULUS REVENUE 623000 4416 4416 7563471 211 211 SHARE OF GPV INTEREST 900099 65605 65605 MISCELLANEOUS INCOME 900099 47954 47954 BEAUTY SHOP 623000 3471 3471 3023 2282 741 120053 7683735 7569224 0 114511 X 3617560 3210663 406897 55769 45873 9896 468215 413757 54458 253922 223168 30754 502467 502467 49637 49637 1172603 1081469 91134 43695 43695 252057 102933 149124 4160 4160 1978566 1978566 10447 4723 5724 6813 6813 77188 77188 479367 196518 282849 RAW FOOD 380882 380882 MEDICAID PROVIDER FEE 291093 291093 SUPPLIES 228724 224968 3756 BAD DEBT EXPENSE 194749 194749 228834 228834 10296748 8662197 1634551 0 122422 93787 429438 380043 11612 10309 5896 10846 1540959 1188872 353997 352087 150663 157867 108086 2743144 1182114 3748083 538810 697766 2784221 5478362 3323031 6176128 X -2140917 -2428045 -2140917 -2428045 1182114 3748083 X -2613013 2325885 X X 0 1 X 1 0 X 1000 1000 11660392 11835807 9343287 8562424 7569224 48971134 11660392 11835807 9343287 8563424 7569224 48972134 0 0 0 48972134 192 81 26 33 211 543 192 81 26 33 211 543 146250 152582 92781 56852 114300 562765 11806834 11988470 9436094 8620309 7683735 49535442 0.98860 0.98490 0.00000 X 422579 323834 98745 892396 670758 221638 225984 194280 31704 352087 SECURITY DEPOSITS 101800 OTHER RECEIVABLE 4450 ROU LEASES 2636894 2743144 DUE TO RELATED ORGANIZATION 2841468 ROU LEASE LIABILITY 2636894 5478362 X PART X, LINE 2: THE CORPORATION AND CERTAIN OF ITS AFFILIATES ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SEC. 501(C) (3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, A PROVISION FOR INCOME TAXES HAS NOT BEEN MADE ON THE FINANCIAL STATEMENTS. GEORGIA PHARMACY VENTURES, LLC FILES AS A PARTNERSHIP. THE CORPORATION FILES ITS FORM 990, RETURN OF ORGANIZATIONS EXEMPT FROM INCOME TAX, IN THE U.S. FEDERAL JURISDICTION AND WITH THE STATE OF GEORGIA. THIS FORM IS OPEN FOR PUBLIC INSPECTION. THE CORPORATION BELIEVES IT HAS APPROPRIATE SUPPORT FOR ALL TAX POSITIONS TAKEN, AND THE CORPORATION HAS EVALUATED ITS TAX POSITIONS AND HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF JUNE 30, 2023 AND 2022. X 0 0 0 0 0 0 0 0 0 MARK TODD CEO 0 340665 0 0 0 0 0 0 0 9957 0 350622 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS ELECTRONICALLY PROVIDED TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING THE RETURN WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C REVIEWED AT QUARTERLY COMPLIANCE COMMITTEE MEETINGS AND ANNUALLY AT BOARD OF DIRECTORS MEETING. FORM 990, PART VI, SECTION B, LINE 15A THE CEO IS PAID ENTIRELY FROM A RELATED SECTION 501(C)(3) ORGANIZATION. THE BOARD OF TRUSTEES ESTABLISHES THE CEO'S SALARY BASED ON INDUSTRY NORMS AND COMPENSATION STUDIES FOR SIMILAR TYPE ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ORGANIZATION'S CORPORATE OFFICE IN AMERICUS, GEORGIA. 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 AT THE ORGANIZATION'S CORPORATE OFFICE IN AMERICUS, GEORGIA. FORM 990, PART IX, LINE 11G CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,033,023. MANAGEMENT AND GENERAL EXPENSES 27,428. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,060,451. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 48,446. MANAGEMENT AND GENERAL EXPENSES 63,706. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 112,152. FORM 990, PART XI, LINE 9: CHANGE IN DUE TO/FROM INTERCOMPANY ACCOUNTS 2,325,885. FORM 990. PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MAGNOLIA MANOR INC 2001 SOUTH LEE STREET AMERICUS GA 31709 580911706 MANAGEMENT AND OPERATION OF LONG-TERM CARE AND RETIREMENT FACILITIES GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF COLUMBUS INC 2001 SOUTH LEE STREET AMERICUS GA 31709 208034409 OPERATION OF TWO (2) NURSING FACILITIES AND A RETIREMENT FACILITY GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF MACON SUPPORTIVE HOUSING INC 2001 SOUTH LEE STREET AMERICUS GA 31709 311651955 HUD SUPPORTIVE HOUSING FACILITY GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF MARION COUNTY INC 2001 SOUTH LEE STREET AMERICUS GA 31709 201220860 LEASE AND OPERATION OF A LONG-TERM CARE FACILITY GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF MACON INC 2001 SOUTH LEE STREET AMERICUS GA 31709 261311379 OPERATION OF AN ASSISTED LIVING FACILITY GA 501(C)(3) LINE 10 0 MAGNOLIA MANOR OF LIBERTY COUNTY INC 2001 SOUTH LEE STREET AMERICUS GA 31709 842738089 OPERATION OF A NURSING FACILITY GA 501(C)(3) LINE 10 0 GEORGIA PHARMACY VENTURES LLC 440 INDUSTRIAL BOULEVARD HAWKINSVILLE GA 31036 261918757 PROVIDES PHARMACY RELATED PRODUCTS AND SERVICES TO MAGNOLIA MANOR RESIDENTS GA N/A 0 0 MMI ASSURANCE LTD 2001 SOUTH LEE STREET AMERICUS GA 31709 981082342 CAPITVE INSURANCE COMPANY CJ N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0