2024-05-13T12:25:56-04:00 2023-06-30 581094351 MCNAIR MCLEMORE MIDDLEBROOKS & CO LLC POST OFFICE BOX ONE MACON GA 312020001 990 2022-07-01 743083594 HEALTH SYSTEMS FACILITIES INC HEAL 4786212100 1005 BOULDER DRIVE GRAY GA 31032 TERESA W MOODY SECRETARY 4786212100 2024-05-10 true TERESA MOODY XXX-XX-XXXX false WILLIAM R ROUNTREE P01231836 4787466277 2024-05-13 2022 2023-04-26 12:10:37Z TERESA W MOODY 1005 BOULDER DRIVE GRAY GA 31032 70826008 false X WWW.ETHICAHEALTH.ORG X 2003 GA THE DEVELOPMENT, CONSTRUCTION, ACQUISITION, OWNERSHIP, LEASING, MANAGEMENT, AND OPERATION OF SKILLED HEALTH CARE FACILITIES. 3 3 1074 0 7532548 0 88187844 70699440 -69890 649 432594 125919 96083096 70826008 0 0 49910414 50655517 0 0 48999945 33369804 98910359 84025321 -2827263 -13199313 12852239 28466231 7768691 26688239 5083548 1777992 THE DEVELOPMENT, CONSTRUCTION, ACQUISITION, OWNERSHIP, LEASING, MANAGEMENT, AND OPERATION OF SKILLED HEALTH CARE FACILITIES. false false 84025321 LEASED AND OPERATED SKILLED CARE, INTERMEDIATE CARE, AND OTHER HEALTH CARE RELATED FACILITIES AS PART OF AN 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 COMMUITY 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. 84025321 true false false false false false false false false false true false false true true false true false false false false false false false false false false false false true false false false false false false false false false false false false true true false false false true 234 0 true 1074 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 HEALTH SYSTEMS FACILITIES INC 4786212100 1005 BOULDER DRIVE GRAY GA 31032 RALPH WARNOCK DIRECTOR 4.00 1.00 X 0 315369 18002 ANGELA HAMMACK CORPORATE SE 0.00 40.00 X 0 290941 18410 KIMBERLY SHEFFIELD PRESIDENT 4.00 40.00 X 0 225616 20131 TERESA W MOODY SECRETARY 4.00 40.00 X 0 218891 20021 KAREN MCMICHAEL ADMINISTRATO 40.00 0.00 X 182658 0 13613 KEZIA HULING RN COORDINAT 40.00 0.00 X 128630 0 16822 MICHAEL BARRY ADMINISTRATO 40.00 0.00 X 130279 0 14170 THERESA GOODIN LPN 40.00 0.00 X 128135 0 14820 TINA LANE ADMINISTRATO 40.00 0.00 X 125147 0 14178 KATHRYN DENNIS CHAIRMAN 4.00 1.00 X 0 24000 0 JOSEPH A WALL DIRECTOR 4.00 1.00 X 0 24000 0 PAUL A CABLE DIRECTOR 0.00 4.00 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 694849 1146817 150167 8 true true false INTEGRA REHABILITATION 1013 RIVERBURCH PKWY SUITE 2 DALTON GA 30721 REHAB SERVICES 1375786 ASSIST HEALTHCARE SERVICES INC PO BOX 2530 BLUE RIDGE GA 30513 STAFFING 950974 LIGHTHOUSE NURSING AGENCY INC 1040 KEITH DRIVE PERRY GA 31069 HEALTHCARE 733281 HI BARNESVILLE PO BOX 1035 SANDERSVILLE GA 31082 HEALTHCARE 419912 CLINICAL RESOURCES LLC 3338 PEACHTREE RD 102 ATLANTA GA 30326 STAFFING 403316 21 X GOVERNMENTAL PROGRAMS REV 61986253 61986253 SERVICE REVENUES 8713187 8713187 70699440 649 649 OTHER REVENUE 93919 93919 RENTAL INCOME 32000 32000 125919 70826008 70825359 649 42740607 42740607 750816 750816 4169274 4169274 2994820 2994820 5711162 5711162 112351 112351 68640 68640 3772308 3772308 360555 360555 472790 472790 933214 933214 PLANT SUPPLIES 7968121 7968121 TAXES 5389076 5389076 NURSING SERVICES 3736978 3736978 UTILITIES 1665772 1665772 3178837 3178837 84025321 84025321 0 0 32932 25508 9262377 4113425 145542 107145 8121064 5777958 3404383 2343106 230 259 6775 21876788 12852239 28466231 7491551 4267229 277140 22421010 7768691 26688239 X 5083548 1777992 5083548 1777992 12852239 28466231 X -13199313 9893757 X false true X true false X 8675627 7532548 16208175 97517098 99944139 79021109 88620438 70825359 435928143 97517098 99944139 87696736 96152986 70825359 452136318 452136318 20657 9758 104471 -69890 649 65645 20657 9758 104471 -69890 649 65645 97537755 99953897 87801207 96083096 70826008 452201963 0.99990 0.99980 0.00000 0.00000 X 60000 60000 295439 144721 150718 4792255 3684664 1107591 2973370 1948573 1024797 2343106 RIGHT-OF-USE ASSET FINANCING 14881891 RIGHT-OF-USE ASSET OPERATING 6967210 CONSTRUCTION IN PROGRESS 21962 DEPOSITS 5725 21876788 FINANCING LEASE OBLIGATION 15404386 OPERATING LEASE OBLIGATION 7016624 22421010 70826008 70826008 70826008 84025321 84025321 84025321 X X X X X false false false false false false false false false RALPH WARNOCK DIRECTOR 295421 19948 18002 333371 ANGELA HAMMACK CORPORATE SECRETARY 279741 11200 18410 309351 KIMBERLY SHEFFIELD PRESIDENT 214172 11444 20131 245747 TERESA W MOODY SECRETARY 206516 12375 20021 238912 KAREN MCMICHAEL ADMINISTRATOR 177754 4904 13613 196271 PAUL A CABLE DIRECTOR 24000 24000 HERBERT M PONDER JR DIRECTOR 12000 12000 LUCY ROGERS DIRECTOR 12000 12000 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 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 HEALTH SYSTEMS FACILITIES, 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 UTILIZED FUNDS TOTALING 8,675,627 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 RECEIVED FROM SUPPORTING ORGANIZATION 10,995,178 TRANSFER OF NET ASSETS -1,101,421 TOTAL 9,893,757 BRENTWOOD TERRACE HC LLC 1005 BOULDER DRIVE GRAY GA 31032 522370897 HEALTHCARE GA 2840055 1153892 NA CHERRY BLOSSOM HC LLC 1005 BOULDER DRIVE GRAY GA 31032 522370797 HEALTHCARE GA 4597617 2737377 NA DAWSON MANOR NURSING HOME LLC 1005 BOULDER DRIVE GRAY GA 31032 043707964 HEALTHCARE GA 4240858 1588831 NA FOUR COUNTY HEALTH CARE LLC 1005 BOULDER DRIVE GRAY GA 31032 522370812 HEALTHCARE GA 4887164 11012989 NA GOLDEN AGE OAK VIEW HOME LLC 1005 BOULDER DRIVE GRAY GA 31032 522370783 HEALTHCARE GA 5299163 8535980 NA HERITAGE INN - BARNESVILLE LLC 1005 BOULDER DRIVE GRAY GA 31032 522370690 HEALTHCARE GA 6225098 13271103 NA HERITAGE INN - SANDERSVILLE LLC 1005 BOULDER DRIVE GRAY GA 31032 522370701 HEALTHCARE GA 5137106 4805889 NA LEE COUNTY HEALTH CARE LLC 1005 BOULDER DRIVE GRAY GA 31032 522370705 HEALTHCARE GA 5249607 720019 NA LILLIAN G CARTER NC LLC 1005 BOULDER DRIVE GRAY GA 31032 522370709 HEALTHCARE GA 3443272 1224366 NA OCONEE HEALTH CARE LLC 1005 BOULDER DRIVE GRAY GA 31032 200000553 HEALTHCARE GA 1799994 1086809 NA SPARTA HEALTH CARE LLC 1005 BOULDER DRIVE GRAY GA 31032 200000561 HEALTHCARE GA 3869000 856726 NA TAYLOR COUNTY HEALTH CARE LLC 1005 BOULDER DRIVE GRAY GA 31032 200000559 HEALTHCARE GA 4901066 10837597 NA TOOMBS NURSING HOME LLC 1005 BOULDER DRIVE GRAY GA 31032 200000558 HEALTHCARE GA 5297072 745133 NA GLASCOCK COUNTY HEATLH CARE LLC 1005 BOULDER DRIVE GRAY GA 31032 261272595 HEALTHCARE GA 4373958 1752882 NA WARE COUNTY HEALTH CARE LLC 1005 BOULDER DRIVE GRAY GA 31032 261272561 HEALTHCARE GA 4554105 3950943 NA PUTNAM COUNTY HEALTH CARE LLC 1005 BOULDER DRIVE GRAY GA 31032 261641277 HEALTHCARE GA 4314807 2218106 NA CLINICAL SERVICES INC 1005 BOULDER DRIVE GRAY GA 31032 571157115 CLINICAL & GA 501C 10 CHSI false COMMUNITY HEALTH FOUNDATION INC 110 STONE BROOKE DRIVE 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 HOME & COMMUNITY SERVICES INC 110 STONE BROOKE DRIVE GRAY GA 31032 432007492 TRANS 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 true true false true false false false false true false CLINICAL SERVICES INC M 5954502 COMMUNITY REHABILITATION SERV INC M 1918115 COMMUNITY ANCILLARY SERV INC M 5081479 COMMUNITY HEALTH FOUNDATION INC R 2895 HOME & COMMUNITY SERVICES INC J 2182000 HEATLH SYSTEMS REAL ESTATE INC K 419799