2024-08-14T13:22:01-05:00 2023-09-30 621517792 PYA P C 2220 SUTHERLAND AVE KNOXVILLE TN 37919 990 2022-10-01 582341574 HLTC INC HLTC 7062726115 PO BOX 1168 DALTON GA 307221168 JULIE A SOEKORO ASSISTANT TREASURER 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 28643745 0 X WWW.HAMILTONHEALTH.COM X 1997 GA HLTC, INC. OPERATES FOUR SKILLED-NURSING FACILITIES IN DALTON, GA. DURING THE YEAR ENDED SEPTEMBER 30, 2023 HLTC HAD 89, PATIENT DAYS, 90.3% OF WHICH WERE REIMBURSED BY MEDICARE OR MEDICAID. SERVICES PROVIDED BY HLTC INCLUDE PHYSICIAN CONSULTATION, LAB SERVICES, REHABILITIATION AND DIETARY SERVICES. 11 9 481 0 0 0 559116 0 27443633 28443934 35848 0 12068 199811 28050665 28643745 0 0 0 0 19636819 19325356 0 0 0 10115885 9372475 29752704 28697831 -1702039 -54086 12856115 13127359 10990001 10585967 1866114 2541392 AS AN AFFILIATE OF HALMILTON HEALTH CARE SYSTEM, HLTC, INC. SUPPORTS THE SYSTEM MISSION OF PROVIDING LEADERSHIP, PARTNERSHIPS AND SEAMLESS RESOURCE COORDINATION TO MEET HEALTHCARE NEEDS THAT ADVANCE THE QUALITY AND DIGNITY OF LIFE. 0 0 27943048 28578934 HLTC, INC. OPERATES FOUR SKILLED NURSING FACILITIES IN DALTON, GA WHOSE PURPOSE IS TO PROVIDE LONG-TERM CARE SERVICES TO THE ELDERLY AND THE INFIRM. DURING THE YEAR ENDED SEPTEMBER 30, 2023, HLTC, INC. HAD 89,595 PATIENT DAYS WHICH INCLUDED 12,022 DAYS REIMBURSED BY MEDICARE AND 68,867 DAYS REIMBURSED BY MEDICAID. MEDICARE AND MEDICAID REPRESENT 90.3% OF TOTAL PATIENT DAYS. HLTC PROVIDES ON-SITE SERVICES TO PATIENTS INCLUDING BUT NOT LIMITED TO PHYSICIAN SERVICES, LAB SERVICES, REHABILITIATION SERVICES, AND DIETARY SERVICES. HLTC'S GOAL IS TO SERVE THE NEEDS OF AREA RESIDENTS BY PROVIDING SERVICES WITHOUT DISCRIMINATION AND REGARDLESS OF ABILITY TO PAY. 27943048 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 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 37 0 1 481 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 9 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 GA X JULIE A SOEKORO 7062782105 1200 MEMORIAL DRIVE DALTON GA 30720 G LAMAR LYLE CHAIRMAN 1.00 X X 0 0 0 JEFFREY D MYERS VICE CHAIRMAN/PRESIDENT 1.00 40.00 X X 0 1609084 135112 WILLIAM L MCDANIEL JR MD SECRETARY/TREASURER 1.00 X X 0 0 0 DON W ADCOCK TRUSTEE 1.00 X 0 0 0 LAURA J ALLGOOD TRUSTEE 1.00 X 0 0 0 OLIVER F COBB TRUSTEE 1.00 X 0 0 0 ROBERT K ESTES TRUSTEE 1.00 X 0 0 0 SANDRA D MCKENZIE TRUSTEE 1.00 40.00 X 0 636061 52898 ZABDIEL MENDEZ TRUSTEE 1.00 X 0 0 0 W SCOTT SELLERS TRUSTEE 1.00 X 0 0 0 LARRY E WINTER TRUSTEE 1.00 X 0 0 0 JULIE A SOEKORO ASSISTANT TREASURER 1.00 40.00 X 0 721943 112436 STEVEN P BRIDENSTINE ASSISTANT TREASURER 1.00 40.00 X 0 190514 2534 JOHN M CUMMINGS DIRECTOR 40.00 X 166720 0 15856 LORI BROWN DIRECTOR OF HEALTH SERVICES 40.00 X 138669 0 8190 KEITH COLLINS DIRECTOR OF REHAB 40.00 X 139438 0 7471 JEREMY GRAVELL ADMINISTRATOR 40.00 X 128076 0 10558 ROBERT PIERCE REGENCY PARK LPN 40.00 X 150828 0 9585 723731 3157602 354640 14 0 1 0 BLU MEDSTAFF LLC 11919 GRANT ST SUITE 203 OMAHA NE 68164 NURSE STAFFING 548297 INTEGRITY NURSING SOLUTIONS 2004 SOUTHCREST DR DALTON GA 30720 NURSE STAFFING 522882 YOUR HOSPITAL NURSING TEAM CARE LLC 300 NORTH WINSTON RD STE 403 KNOXVILLE TN 37919 NURSE STAFFING 478006 ASSIST HEALTHCARE SERVICES INC PO BOX 2530 BLUE RIDGE GA 30513 NURSE STAFFING 410522 SNF SOLUTIONS 10506 SE 420TH AVE NORTH BEND WA 98045 NURSE STAFFING 233480 10 NET RESIDENT SERVICE 623000 28443934 28443934 28443934 135000 0 135000 135000 135000 OTHER INCOME 900099 64811 64811 64811 28643745 28578934 0 64811 15646127 15646127 544907 544907 2122318 2122318 1012004 1012004 660000 660000 52977 52977 13006 13006 1203402 1174602 28800 10608 10608 2605269 2605269 718617 718617 6924 6924 10725 10725 217955 217955 734261 734261 587871 587871 PROVIDER TAX 1340316 1340316 CONSULTING FEES 641676 641676 MEDICAL SUPPLIES 464216 464216 DUES & SUBSCRIPTIONS 89158 89158 15494 15494 28697831 27943048 754783 0 817559 1023170 1803651 2444359 46112 46112 86393 103026 29017537 19506845 10102400 9510692 12856115 13127359 3187967 4447878 7802034 6138089 10990001 10585967 X 1866114 2541392 1866114 2541392 12856115 13127359 X -54086 348989 380375 X 0 1 X 1 0 X 4000 2000 2558214 559116 0 3123330 29762589 33346181 29746746 28289534 29252082 150397132 29766589 33348181 32304960 28848650 29252082 153520462 0 0 0 153520462 28428 46640 38524 103508 127768 344868 28428 46640 38524 103508 127768 344868 29795017 33394821 32343484 28952158 29379850 153865330 0.99780 0.99820 0.00220 0.00180 X 1561840 1561840 21015158 14347062 6668096 6438223 5159783 1278440 2316 2316 9510692 ASSET RETIREMENT OBLIGATION 235329 SUPPORTING NOTE TO HAMILTON MEDICAL CENTER 5902760 6138089 X 28992734 348989 348989 28643745 0 28643745 28697831 0 28697831 0 28697831 PART X, LINE 2: HLTC HAS ADOPTED PROCEDURES FOR DETERMINING THE EXISTENCE OF UNCERTAIN TAX POSITIONS, AND THE RELATED TIMING AND AMOUNT OF THEIR IMPACT ON THE FINANCIAL STATEMENTS, AND DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2023. PART XI, LINE 2D - OTHER ADJUSTMENTS: LIABILITY CLAIMS INVESTMENT INCOME 363,776. LIABILITY CLAIMS INVESTMENT FEES -14,787. 0 1 0 0 0 0 0 0 0 JEFFREY D MYERS VICE CHAIRMAN/PRESIDENT 0 955987 0 479272 0 173825 0 59300 0 75812 0 1744196 0 44050 JULIE A SOEKORO ASSISTANT TREASURER 0 391721 0 188023 0 142199 0 31097 0 81339 0 834379 0 15593 SANDRA D MCKENZIE TRUSTEE 0 400619 0 174381 0 61061 0 27158 0 25740 0 688959 0 11908 STEVEN P BRIDENSTINE ASSISTANT TREASURER 0 168585 0 21040 0 889 0 123 0 2411 0 193048 0 0 JOHN M CUMMINGS DIRECTOR 137572 0 16730 0 12418 0 8612 0 7244 0 182576 0 0 0 ROBERT PIERCE REGENCY PARK LPN 121310 0 17200 0 12318 0 7618 0 1967 0 160413 0 0 0 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 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 A, LINE 7A THE REGULAR TRUSTEES OF THE ORGANIZATION ARE PAPOINTED BY THE BOARD OF TRUSTEES OF HAMILTON HEALTH CARE SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN CAPITAL EXPENDITURE AND CONTRACTUAL COMMITMENT DECISIONS MUST BE SUBSEQUENTLY APPROVED BY THE HAMILTON HEALTH CARE SYSTEM BOARD OF TRUSTEES. 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 ORGANIZAION HAS A CLEAR AND DETAILED CONFLICT ON INTEREST POLICY WHICH ESTABLISHES A PROCEDURE FOR IDENTIFYING, REVIEWING, AND ADDRESSING CONFLICTS OF INTEREST. THIS POLICY ALSO REQUIRES EACH TRUSTEE AND OFFICER OF THE ORGANIZATION TO ANNUALLY SIGN A STATEMENT ACKNOWLEDGING RECEIPT FOR 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 THRID 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, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: EQUITY TRANSFER FROM HAMILTON HEALTH CARE SYSTEM 1,342,925. (INCREASE) DECREASE IN LIABILITY CLAIMS FUNDING -962,550. HAMILTON HEALTH CARE SYSTEM INC PO BOX 1168 DALTON GA 30722 581519913 SUPPORT RELATED ENTITIES GA 501(C)(3) LINE 12B, II N/A 0 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 0 HAMILTON AMBULATORY SURGERY CENTER INC PO BOX 1168 DALTON GA 30722 582654791 SURGICAL SERVICES GA 501(C)(3) LINE 3 HAMILTON MEDICAL CENTER INC 0 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 0 HAMILTON MEDICAL CENTER INC PO BOX 1168 DALTON GA 30722 581519911 HEALTHCARE GA 501(C)(3) LINE 3 HAMILTON HEALTH CARE SYSTEM INC 0 HAMILTON PHYSICIAN GROUP INC PO BOX 1168 DALTON GA 30722 271198701 PHYSICIAN PRACTICE GA 501(C)(3) LINE 3 HAMILTON MEDICAL CENTER INC 0 ROYAL OAK COMMUNITY LTD PO BOX 1168 DALTON GA 30722 581970228 SENIOR LIVING SERVICES GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 0 WHITFIELD PLACE INC PO BOX 1168 DALTON GA 30722 582103085 LOW-INCOME HOUSING GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 0 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 0 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 0 HAMILTON CHILDREN'S INSTITUTE PO BOX 1168 DALTON GA 30722 823312912 PEDIATRIC DEVELOPMENTAL/BEHAVIORAL INSTITUTE GA 501(C)(3) LINE 10 HAMILTON HEALTH CARE SYSTEM INC 0 HAMILTON ORTHOPEDIC SURGERY CENTER PO BOX 1168 DALTON GA 30720 ORTHOPEDIC SURGERY CENTER GA N/A 0 0 HAMILTON HEALTH FIRST INC PO BOX 1168 DALTON GA 30722 581694713 PREFERRED PROVIDER ORGANIZATION GA N/A C 0 HMC HOLDINGS INC PO BOX 1168 DALTON GA 30722 TITLE HOLDINGS GA N/A C 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0