2026-08-04T07:59:43-04:00 2025-09-30 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2024-10-01 580566121 JOHN D ARCHBOLD MEMORIAL HOSPITAL INC JOHN 2292282853 P O BOX 1018 THOMASVILLE GA 317991018 DARCY M CRAVEN PRESIDENT/CEO 2292282737 2026-07-21 true false WILLIAM EDWARD PHILLIPS P00451499 2298837878 2026-07-28 2024 2025-03-06 01:10:19Z DARCY M CRAVEN P O BOX 1018 THOMASVILLE GA 317991018 561835631 false X WWW.ARCHBOLD.ORG X 1923 GA HEALTHCARE SERVICES 18 10 0 123178 6937846 12460410 480597443 526508437 19787653 16203016 4213727 5524441 511536669 560696304 255767 282289 0 188700578 196343625 0 0 267276699 292304723 456233044 488930637 55303625 71765667 1122703892 1206276051 169869495 161126707 952834397 1045149344 X HEALTHCARE SERVICES false false 362736381 282289 451516230 ARCHBOLD MEMORIAL IN THOMASVILLE GEORGIA OPERATES WITH 264 LICENSED BEDS; OF WHICH 226 ARE MED/SURG, 18 BEDS ARE DESIGNATED TO A PSYCH UNIT, 20 BEDS ARE REHAB. IN ADDITION, IT OPERATES A 64 BED SKILLED NURSING FACILITY, ARCHBOLD LIVING THOMASVILLE. ARCHBOLD MEMORIAL IS A RURAL REFERRAL CENTER COVERING THOMAS COUNTY AND SURROUNDING COUNTIES IN SOUTHERN GEORGIA AND NORTHERN FLORIDA. 65.1% OF PATIENTS WERE COVERED BY MEDICARE AND MEDICAID, AND 2.5% OF PATIENT REVENUE WAS PROVIDED AS INDIGENT CARE. IN FY 2025, ARCHBOLD MEMORIAL PROVIDED AN ESTIMATED 29.2 MILLION IN INDIGENT CARE CHARGES. ARCHBOLD MEMORIAL TREATS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. ARCHBOLD MEMORIAL PROVIDED APPROXIMATELY 28.5 MILLION IN ADDITIONAL UNCOMPENSATED CARE. THROUGHOUT THE YEAR, ARCHBOLD MEMORIAL PRODUCES OR SPONSORS MANY SPECIAL PROGRAMS FOR THE COMMUNITY TO EDUCATE THEM ON IMPORTANT HEALTH NEEDS. JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. ALSO OPERATES HOSPITALS IN GRADY, BROOKS, AND MITCHELL COUNTIES OF GEORGIA FILING UNDER EIN 58-0566121. 32652160 26935734 ARCHBOLD MITCHELL OPERATES IN CAMILLA, GEORGIA AS A CRITICAL ACCESS HOSPITAL WITH 25 ACUTE CARE BEDS. ARCHBOLD LIVING CAMILLA, AND ARCHBOLD LIVING PELHAM (LOCATED IN CAMILLA, GEORGIA AND PELHAM, GEORGIA, RESPECTIVELY) OPERATE AS LONG-TERM CARE FACILITIES WITH COMBINED 156 NURSING HOME BEDS. THESE FACILITIES SERVE MITCHELL COUNTY, AND 59.3% OF THE PATIENTS WERE MEDICARE/MEDICAID. IN FY 2025, APPROXIMATELY 3.4 MILLION OF INDIGENT CARE WAS PROVIDED TO THE COMMUNITY. IN ADDITION, ARCHBOLD'S MITCHELL COUNTY FACILITIES PROVIDED AN ESTIMATED 5.4 MILLION IN ADDITIONAL UNCOMPENSATED CARE. THE HOSPITAL AUTHORITY OF MITCHELL COUNTY (EIN 58-6001307) IS FILED UNDER EIN 58-0566121 FOR FORM 990 PURPOSES. 10798937 40959069 ARCHBOLD GRADY IN CAIRO, GEORGIA OPERATES A 60 LICENSED BED ACUTE CARE FACILITY. TEN BEDS CAN BE USED AS SWING BEDS. IN ADDITION, IT OPERATES A 75 BED SKILLED NURSING FACILITY, ARCHBOLD LIVING CAIRO. THESE FACILITIES SERVE GRADY COUNTY, AND 54.1% OF THE PATIENTS WERE MEDICARE/MEDICAID. IN FY 2025, ARCHBOLD GRADY PROVIDED APPROXIMATELY 5.3 MILLION IN INDIGENT CARE. ARCHBOLD GRADY PROVIDED AN ESTIMATED 5.9 MILLION IN ADDITIONAL UNCOMPENSATED CARE. EIN 58-1646537 IS FILED UNDER EIN 58-0566121 FOR FORM 990 PURPOSES. 31886599 11329389 ARCHBOLD BROOKS OPERATES IN QUITMAN, GEORGIA AS A CRITICAL ACCESS HOSPITAL WITH 25 ACUTE CARE BEDS. IT SERVES BROOKS COUNTY AND 55.2% OF ITS PATIENTS WERE MEDICARE/MEDICAID. IN FY 2025, AN ESTIMATED 2 MILLION OF INDIGENT CARE WAS PROVIDED TO THE COMMUNITY. IN ADDITION, ARCHBOLD BROOKS PROVIDED APPROXIMATELY 2.2 MILLION IN ADDITIONAL UNCOMPENSATED CARE. EIN 58- 6002830 IS FILED UNDER EIN 58-0566121 FOR FORM 990 PURPOSES. 31886599 11329389 438074077 true true false true false false false false false true true false false true true true false true false false false false false false false false true true false true true true false false false false false false false true true true false false false false false true false false false true 167 0 0 true true false false false false false false false false false false false X 18 10 true false false false true true true true true false false true true true true true true true true false GA X LOREN RIALS 2292282853 PO BOX 1018 THOMASVILLE GA 317991018 DARCY M CRAVEN PRESIDENT/CE 1.00 51.00 X X 0 1118584 203424 JIM CARTER COO/SVP 40.00 X 1034484 0 88352 JOSH D SIMMONS MD TRUSTEE 1.00 40.00 X 0 779542 24154 KRISTOPHER PALMER DO VP MEDICAL A 40.00 X 580014 0 80913 GREG HEMBREE ASEC/SVP/CFO 1.00 40.00 X 0 618833 33884 EUGENE SUN MD PHYSICIAN 40.00 X 538827 0 25147 AMY GRIFFIN SVP PATIENT 40.00 X 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RIGHT-OF-USE-FINANCING 2094283 RIGHT-OF- USE OPERATING 1735366 3829649 X SCHEDULE D, PAGE 2, PART V, LINE 4 ENDOWMENT FUNDS RESTRICTED BY DONORS ARE HELD IN A PERMANENT HEALTHCARE ENDOWMENT FUND WHICH WAS ESTABLISHED TO SUPPORT HEALTH CARE SERVICES. SCHEDULE D, PAGE 3, PART X THE MEDICAL CENTER IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEDICAL CENTER APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE CONSOLIDATED FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE MEDICAL CENTER ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF SEPTEMBER 30, 2025 AND 2024 OR FOR THE YEARS THEN ENDED. THE MEDICAL CENTER'S TAX RETURNS ARE SUBJECT TO RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. 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ARCHBOLD MEM HOSP - PART V, LINE 3E THE COMMUNITY HEALTH NEEDS ASSESSMENT IS CONDUCTED EVERY THREE YEARS. THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN 2025- 2026 FOR EACH COUNTY IN THE SERVICE AREA. THE TOP 3 SIGNIFICANT HEALTH NEEDS FOR BROOKS, GRADY, MITCHELL AND THOMAS COUNTIES WERE - DIABETES, OBESITY AND HIGH BLOOD PRESSURE. OTHER SIGNIFICANT HEALTH NEEDS IDENTIFIED BY THE COMMUNITY INCLUDE HEART DISEASE, MENTAL HEALTH, CANCER, DRUG ADDICTION, BACK OR JOINT PAIN, ALCOHOL ABUSE, STROKE, TOBACCO USE, LUNG DISEASE, AND ACCESS TO VACCINES. A COMPLETE DISCUSSION OF THE HEALTH NEEDS FOR EACH COUNTY MAY BE FOUND AT - HTTPS://WWW.ARCHBOLD.ORG/DOCUMENTS/CONTENT/CHNA/2025-2026/ARCHBOLD-CHNA- GRADY-2025-R2.1).PDF HTTPS://WWW.ARCHBOLD.ORG/DOCUMENTS/CONTENT/CHNA/2025-2026/ARCHBOLD-CHNA- MITCHELL-2025-R4.1).PDF HTTPS://WWW.ARCHBOLD.ORG/DOCUMENTS/CONTENT/CHNA/2025-2026/ARCHBOLD-CHNA- THOMAS-2025-R3.1).PDF HTTPS://WWW.ARCHBOLD.ORG/DOCUMENTS/CONTENT/CHNA/2025-2026/ARCHBOLD-CHNA- BROOKS-2025-R3.1).PDF THE NEXT COMMUNITY HEALTH NEEDS ASSESSMENT WILL BE COMPLETED IN 2028. GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 5 INPUT FROM COMMUNITY MEMBERS REPRESENTING THE BROADER INTERESTS OF THE COUNTY WAS GATHERED THROUGH A COMBINATION OF ONLINE AND WRITTEN SURVEYS. THESE EFFORTS YIELDED INFORMATION THAT WILL BE USED IN ADDRESSING BARRIERS, ALLOCATING RESOURCES AND ASSETS AND DETERMINING OPPORTUNITIES TO SUPPORT THE COMMUNITY. INPUT WAS CONSIDERED IN DETERMINING GAPS IN SERVICES AND IDENTIFYING WHETHER DEVELOPING NEW RELATIONSHIPS AND PARTNERSHIPS WAS NECESSARY TO MEET THE NEEDS OF THE COMMUNITY. THIS YEAR, WE CONTINUED TO ENHANCE OUR APPROACH TO OBTAINING THIS INFORMATION FROM OUR COMMUNITIES. A SURVEY LINK AND/OR PRINTED COPIES OF THE SURVEY WERE DISTRIBUTED TO THE FOLLOWING ENTITIES: O DOUGLASS HIGH SCHOOL ALUMNI ASSOCIATIONO MAGNOLIA HIGH SCHOOL ALUMNI O SOUTHWEST GEORGIA TECHNICAL COLLEGE O THOMAS COUNTY FAMILY CONNECTION O THOMAS/GRADY UGA EXTENSION O THOMAS COUNTY HEALTH DEPARTMENT O PRIMARY CARE OF SOUTHWEST GEORGIA O ARCHBOLD EMPLOYEESO THOMAS COUNTY GOVERNMENT EMPLOYEES O CITY OF THOMASVILLE EMPLOYEES O THOMASVILLE-THOMAS COUNTY CHAMBER OF COMMERCE O COMMUNITY OUTREACH TRAINING CENTER O JACK HADLEY BLACK HISTORY MUSEUM IN ADDITION, ARCHBOLD ATTENDED MEETINGS OF KEY CIVIC AND COMMUNITY ORGANIZATIONS TO PROMOTE THE CHNA SURVEY, EXPLAIN THE PURPOSE OF THE ASSESSMENT AND ENCOURAGE MEMBERS TO SHARE THE SURVEY WITHIN THEIR NETWORKS. PARTICIPATING GROUPS INCLUDED THE AMERICAN BEAUTY CHAPTER 214 OES, THOMAS COUNTY CHAMBER LEADERSHIP GROUP, KIDNEY HEALTH FAIR ATTENDEES, EXCHANGE CLUB OF THOMASVILLE, VETERANS SUPPORT GROUP, THOMASVILLE KIWANIS AND THOMASVILLE ROTARY. QR CODE CARDS LINKING DIRECTLY TO THE SURVEY WERE ALSO DISTRIBUTED AT ARCHBOLD MEDICAL GROUP PHYSICIAN PRACTICES, THE THOMAS COUNTY LIBRARY AND SMALL BUSINESSES IN DOWNTOWN THOMASVILLE. A PRESS RELEASE WAS SUBMITTED TO THE THOMASVILLE TIMES-ENTERPRISE ENCOURAGING RESIDENTS TO PARTICIPATE IN THE SURVEY AND MAKE THEIR VOICES HEARD. GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 6A THE NEEDS ASSESSMENT WAS CONDUCTED FOR ARCHBOLD MEMORIAL, ALONG WITH ARCHBOLD GRADY, ARCHBOLD BROOKS, AND ARCHBOLD MITCHELL. GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 7D DISTRIBUTED COPIES TO THE COMMUNITY; AVAILABLE ONLINE GROUP A, FACILITY 1, JOHN D. ARCHBOLD MEM HOSP - PART V, LINE 11 QUALITATIVELY, THE GREATEST MEDICAL NEEDS ACCORDING TO COMMUNITY PERCEPTION INCLUDED: 1. DIABETES 2. OVERWEIGHT/OBESITY 3. HIGH BLOOD PRESSURE 4. HEART DISEASE 5. MENTAL HEALTH ISSUES 6. CANCER 7. DRUG ADDICTION 8. BACK/JOINT PAIN 9. ALCOHOL ABUSE 10. STROKE 11. TOBACCO USE 12. LUNG DISEASE 13. ACCESS TO VACCINES NEEDS NOT ADDRESSED NOT ALL HEALTH NEEDS ARE EASILY ADDRESSED BY ARCHBOLD. FURTHER, KEEPING TOO BROAD OF A FOCUS WILL DILUTE THE IMPACT WE CAN HAVE ON EACH HEALTH NEED. THESE ARE SOME OF THE PRIMARY REASONS WE AREN'T ADDRESSING SOME HEALTH NEEDS IN OUR IMPLEMENTATION PLAN. OUR BIGGEST OPPORTUNITY IS TO HELP WITH IMPROVING DISEASE STATES BY ADDRESSING OBESITY AND REMAINING AVAILABLE FOR ASSISTANCE WITH OTHER HEALTH NEEDS AS REQUESTED AND AS TIME AND FINANCES PERMIT. 9 ARCHBOLD LIVING 10629 US HIGHWAY 19S THOMASVILLE GA 31792 SKILLED NURSING HOME JDA PSYCHIATRIC UNIT DBA ARCHBOLD NORTHSIDE P O BOX 1018 THOMASVILLE GA 31792 PSYCHIATRIC UNIT JDA REHABILITATION UNIT DBA ARCHBOLD MEMORIAL REHAB P O BOX 1018 THOMASVILLE GA 31792 REHABILITATION UNIT ARCHBOLD LIVING CAMILLA 90 STEPHENS STREET CAMILLA GA 31728 SKILLED NURSING HOME CAMILLA PEDIATRICS CENTER DBA ARCHBOLD PEDIATRICS CAMILLA P O BOX 360 CAMILLA GA 31728 RURAL HEALTH CLINIC MEDICAL GROUP OF MITCHELL COUNTY DBA ARCHBOLD PRIMARY CARE CAMILLA P O BOX 360 CAMILLA GA 31728 RURAL HEALTH CLINIC ARCHBOLD PELHAM PRIMARY CARE CLINIC DBA ARCHBOLD PRIMARY CARE PELHAM P O BOX 360 CAMILLA GA 31728 RURAL HEALTH CLINIC ARCHBOLD LIVING PELHAM 608 DOGWOOD DRIVE NE PELHAM GA 31797 SKILLED NURSING HOME ARCHBOLD LIVING CAIRO 1155 FIFTH STREET SE CAIRO GA 31728 SKILLED NURSING HOME SCHEDULE H, PART I, LINE 7 THE ORGANIZATION USES THE COST TO CHARGE RATIO USING THE IRS' RECOMMENDED FORMAT IN WORKSHEET 2. OTHER COSTS IN PART I LINES 7E THROUGH 7I WERE OBTAINED FROM THE ORGANIZATION'S ACCOUNTING RECORDS. SCHEDULE H, PART III, LINE 2 AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AND INCLUDES IMPLICIT PRICE CONCESSIONS. SEE THE DISCUSSION OF IMPLICIT PRICE CONCESSIONS IN FOOTNOTE 2 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, LINE 4 SEE THE DISCUSSION OF PRICE CONCESSIONS AND NET PATIENT SERVICE REVENUE IN FOOTNOTE 2 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, LINE 8 MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. SCHEDULE H, PART III, LINE 9B PATIENTS THAT ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE ARE APPROVED FOR A PERIOD OF 6 MONTHS. THE PATIENTS ARE REQUIRED TO CONTACT THE FINANCIAL ASSISTANCE OFFICE DURING THIS POINT IF THEY INCUR ADDITIONAL CHARGES THAT QUALIFY FOR FINANCIAL ASSISTANCE DURING THIS TIME PERIOD. THE SAME PROCESS IS IN EFFECT FOR THE PATIENTS WHO QUALIFY FOR THE SLIDING FEE DISCOUNT. THIS DISCOUNT WILL LIMIT THE PATIENTS TO AN OUT OF POCKET MAXIMUM AMOUNT IN THE GIVEN TIME PERIOD. WE DO NOT HAVE ANY AUTOMATIC ADJUSTMENTS OR AN AUTOMATED SYSTEM TO TRACK THE PREVIOUSLY APPROVED PATIENTS. SCHEDULE H, PART VI, LINE 2 REVIEW OF ASSESSMENTS OF OTHER ORGANIZATIONS THAT IDENTIFY NEEDS AND ONGOING PARTICIPATION WITH THOSE ORGANIZATIONS. COLLECT, REVIEW AND USE PRIMARY, SECONDARY AND QUALITATIVE DATA IN DETERMINING NEEDS. UPDATE COMMUNITY HEALTH STATUS AS LOCAL, STATE AND FEDERAL DATA IS REPORTED. REVIEW INTERNAL DATA SUCH AS SCREENING OUTCOMES, PATIENT VOLUMES AND TRENDS. RESPOND TO CONCERNS AND REQUESTS FROM COMMUNITY MEMBERS. THE ORGANIZATION ANALYZES QUANTITATIVE FEDERAL, STATE AND LOCAL DATA AND SEEKS QUALITATIVE INPUT FROM MEMBERS OF THE COMMUNITY, PARTICULARLY INDIVIDUALS AND GROUPS THAT HAVE BEEN HISTORICALLY UNDERSERVED OR UNDERESTIMATED. COMMUNITY INPUT WAS GATHERED THROUGH ONLINE AND WRITTEN SURVEYS, IN-PERSON OUTREACH TO KEY CIVIC AND COMMUNITY ORGANIZATIONS, GRASSROOTS PROMOTION AND MEDIA OUTREACH. THE ORGANIZATION ALSO ASSESSES THE NEEDS OF THE COMMUNITY BY UTILIZING ASSESSMENTS CONDUCTED BY PARTNER ORGANIZATIONS, REVIEWING INTERNAL DATA ON PATIENT VOLUMES, SCREENING OUTCOMES AND TRENDS, ENGAGING WITH COMMUNITY ORGANIZATIONS THAT ACTIVELY MONITOR AND ADDRESS HEALTH NEEDS, AND RESPONDING DIRECTLY TO CONCERNS AND REQUESTS VOICED BY MEMBERS OF THE COMMUNITY. COPIES OF THE 20252026 CHNAS AND THE RELATED IMPLEMENTATION PLANS CAN BE FOUND AT THE FOLLOWING WEB ADDRESS: HTTPS://WWW.ARCHBOLD.ORG/DOCUMENTS/CONTENT/CHNA/2025-2026/ARCHBOLD-CHNA- THOMAS-2025-R3.1).PDF HTTPS://WWW.ARCHBOLD.ORG/DOCUMENTS/CONTENT/CHNA/2025-2026/ARCHBOLD-CHNA- MITCHELL-2025-R4.1).PDF HTTPS://WWW.ARCHBOLD.ORG/DOCUMENTS/CONTENT/CHNA/2025-2026/ARCHBOLD-CHNA- GRADY-2025-R2.1).PDF HTTPS://WWW.ARCHBOLD.ORG/DOCUMENTS/CONTENT/CHNA/2025-2026/ARCHBOLD-CHNA- BROOKS-2025-R3.1).PDF SCHEDULE H, PART VI, LINE 3 UNINSURED AND MEDICALLY INDIGENT PATIENTS ARE OFFERED THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND APPLICATION FORMS DURING REGISTRATION. INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND HOW TO APPLY IS INCLUDED ON PATIENT ACCOUNT STATEMENTS. THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND APPLICATION FORMS ARE AVAILABLE FREE OF CHARGE AT HOSPITAL FACILITY ADMISSIONS OR REGISTRATION AREAS, BY MAIL UPON REQUEST AND ELECTRONICALLY THROUGH THE ARCHBOLD WEBSITE. THE FINANCIAL ASSISTANCE PROGRAM AND APPLICATION PROCESS ARE ALSO DISCUSSED DURING TELEPHONE CALLS CONCERNING SELF-PAY ACCOUNTS. ARCHBOLD STAFF ARE AVAILABLE TO PROVIDE INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAMS AND ASSIST PATIENTS WITH COMPLETING THE APPLICATION PROCESS. SCHEDULE H, PART VI, LINE 4 COUNTIES SERVED IN GEORGIA INCLUDE BROOKS, GRADY, MITCHELL, THOMAS. THE COMMUNITIES SERVED INCLUDE POPULATIONS WITH DISPROPORTIONATE HEALTHCARE NEEDS, INCLUDING RESIDENTS OF FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS (MUAS) OR HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS), LOW-INCOME INDIVIDUALS, PUBLIC HOUSING RESIDENTS, SENIORS, MIGRANT WORKERS, UNINSURED AND UNDERINSURED INDIVIDUALS, A MIXTURE OF ETHNICITIES AND AGE GROUPS, AND INDIVIDUALS WITH VARYING EDUCATIONAL LEVELS. BROOKS COUNTY: ESTIMATED POPULATION 16,101, 60.0% WHITE/34.8% BLACK, MEDIAN HH INCOME 46,807, 19.4% LIVING IN POVERTY, 14.9% UNDER 65 UNINSURED GRADY COUNTY: ESTIMATED POPULATION 26,590, 64.0% WHITE/28.8% BLACK, MEDIAN HH INCOME 58,980, 19.5% LIVING IN POVERTY, 17.9% UNDER 65 UNINSURED MITCHELL COUNTY: ESTIMATED POPULATION 21,114, 50.1% WHITE/46.5% BLACK, MEDIAN HH INCOME 51,908, 23.8% LIVING IN POVERTY, 14.1% UNDER 65 UNINSURED THOMAS COUNTY: ESTIMATED POPULATION 45,649, 60.3% WHITE/36.3% BLACK, MEDIAN HH INCOME 60,140, 18.4% LIVING IN POVERTY, 13.4% UNDER 65 UNINSURED INFORMATION OBTAINED FROM WWW.CENSUS.GOV - QUICK FACTS UPDATED 7/01/2025 SCHEDULE H, PART VI, LINE 5 LIVE BETTER IS THE ARCHBOLD-LED INITIATIVE FOCUSED ON IMPROVING THE HEALTH OF THE CITIZENS OF THOMAS COUNTY. LIVE BETTER WORKS PRIMARILY WITH LOCAL SCHOOL SYSTEMS IN PROVIDING MONTHLY HEALTH EDUCATION MATERIAL TO ALL K-5 STUDENTS IN THOMAS COUNTY. LIVE BETTER ALSO PROVIDES OPPORTUNITIES FOR BOTH KIDS AND ADULTS TO STAY ACTIVE THROUGH ANNUAL 5K AND ONE-MILE FUN RUNS. OUTSIDE OF THE LIVE BETTER INITIATIVE, ARCHBOLD PROVIDES FREE HEALTH SCREENS AND EDUCATIONAL HEALTH TALKS TO THE COMMUNITY THROUGHOUT THE YEAR. OBESITY IS A PREVENTABLE CONDITION, YET THE COMMON RISK FACTOR WITH THE MOST PROMINENT HEALTH ISSUES IN THOMAS COUNTY: HEART DISEASE, HYPERTENSION, STROKE, COPD, VASCULAR DISEASE, DIABETES AND CANCER. SCHEDULE H, PART VI, LINE 6 ARCHBOLD MEDICAL CENTER, INC. AS THE PARENT CORPORATION, HAS SOLE CONTROL OVER ITS NONPROFIT SUBSIDIARIES: JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC., ARCHBOLD FOUNDATION, INC., AND ARCHBOLD MEDICAL GROUP, INC. JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. OPERATES HOSPITALS (ARCHBOLD MEMORIAL, ARCHBOLD GRADY, ARCHBOLD BROOKS, AND ARCHBOLD MITCHELL), AND LONG-TERM CARE FACILITIES ARCHBOLD LIVING THOMASVILLE, ARCHBOLD LIVING CAMILLA, ARCHBOLD LIVING PELHAM, AND ARCHBOLD LIVING CAIRO. ARCHBOLD FOUNDATION, INC. IS A SUPPORT FOUNDATION WITH THE SOLE PURPOSE OF BUILDING AND SUSTAINING A FINANCIAL LEGACY THAT SUPPORTS JOHN D. ARCHBOLD MEMORIAL HOSPITAL AND ITS AFFILIATED ENTITIES. ARCHBOLD MEDICAL GROUP, INC. EMPLOYS PHYSICIANS AND OTHER SUPPORT PERSONNEL TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES ESSENTIAL TO THE PREVENTION AND TREATMENT OF DISEASE FOR THE BENEFIT OF ALL INDIVIDUALS IN THE SERVICE AREA. ARCHBOLD MEDICAL GROUP, INC. ALSO SERVES AS THE SOLE MEMBER OF CCSG, INC. AND AMGIR, INC., BOTH OF WHICH ARE 501(C)(3) ORGANIZATIONS THAT OPERATE MEDICAL CLINICS. true 1 SCHOLARSHP/TUITION PROG 161612 MED STUDENT HOUSING 362 120677 FMV HOUSING/UTIL. SCHEDULE I, PAGE 1, PART I, LINE 2 THE ORGANIZATION OFFERS A TUITION REIMBURSEMENT PROGRAM AND A SCHOLARSHIP PROGRAM FOR QUALIFIED INDIVIDUALS BASED ON SATISFACTORY COMPLETION OF APPROVED COURSES. THE PURPOSE IS TO ENCOURAGE AND ENABLE EMPLOYEES TO ACQUIRE ADDITIONAL EDUCATION IN A HEALTH CARE OR JOB-RELATED FIELD WHICH WILL PROMOTE CAREER ADVANCEMENT AND/OR PROVIDE ADVANCED CREDENTIALING OF EMPLOYEES IN AREAS OF NEED. THE ORGANIZATION EVALUATES CERTAIN MEDICAL EDUCATION PROGRAMS AT AREA EDUCATIONAL INSTITUTIONS (SOUTHERN REGIONAL TECHNICAL COLLEGE AND THOMAS UNIVERSITY) AND PROVIDES FINANCIAL SUPPORT DIRECTLY TO THE EDUCATIONAL INSTITUTIONS AS APPROVED BY MANAGEMENT. CONDITIONS OF ELIGIBILITY: FOR THE TUITION REIMBURSEMENT PROGRAM, INDIVIDUALS MUST BE A FULL-TIME EMPLOYEE FOR AT LEAST SIX MONTHS WITH SATISFACTORY WORK RECORD AND PERFORMANCE EVALUATION. SCHOLARSHIP PROGRAM RECIPIENTS DO NOT HAVE TO BE EMPLOYEES; HOWEVER, THEY MUST AGREE TO A WORK-COMMITMENT UPON COMPLETION OF THE SCHOLARSHIP PROGRAM. COMPLETION OF THE RELEVANT EDUCATION PROGRAM REQUIRES THE APPLICANT TO COMMIT TO: -ONE YEAR, FULL-TIME WORK REQUIREMENT FOR EVERY 5,000 RECEIVED FROM THE TUITION REIMBURSEMENT PROGRAM. -FULL-TIME WORK COMMITMENT DEPENDENT ON THE AMOUNT OF SCHOLARSHIP RECEIVED. (RECIPIENTS OF A 10,000 SCHOLARSHIP HAVE A 3 YEAR WORK COMMITMENT; A 5,000 SCHOLARSHIP HAS A 1.5 YEAR WORK COMMITMENT). FAILURE TO COMPLY WITH THE REQUIREMENTS OF ELIGIBILITY SUBJECTS THE EMPLOYEE TO FULL OR PARTIAL REIMBURSEMENT OF THE FUNDS RECEIVED FROM THE ORGANIZATION. FAILURE TO FULFILL WORK COMMITMENT REQUIRES PAYBACK FOR BOTH PROGRAMS. TO BE REIMBURSED THROUGH THE TUITION REIMBURSEMENT PROGRAM, THE EMPLOYEE MUST PROVIDE A COPY OF A RECEIPT SHOWING ACTUAL PAYMENT OF TUITION FEES. APPLICANTS MUST MAINTAIN A C OR HIGHER GRADE AND SUBMIT A RECORD OF GRADES AND HOURS CREDIT (TRANSCRIPT) TO THE ORGANIZATION. X X true true X X X X X true true false false false false false false false DARCY M CRAVEN PRESIDENT/CEO 841092 273490 4002 193980 9444 1322008 JIM CARTER COO/SVP 366958 101060 566466 77998 10354 1122836 JOSH D SIMMONS MD TRUSTEE 528744 249998 800 13800 10354 803696 KRISTOPHER PALMER DO VP MEDICAL AFFAIRS 456166 123443 405 80339 574 660927 GREG HEMBREE ASEC/SVP/CFOLEFT8/25 441665 120528 56640 20700 13184 652717 EUGENE SUN MD PHYSICIAN 287777 250607 443 14793 10354 563974 AMY GRIFFIN SVP PATIENT CARE 324331 87604 37042 73830 7604 530411 JASON NESMITH MD TRUSTEE 221924 286975 217 9200 10354 528670 DINESH B PATEL MD PHYSICIAN 232870 251948 980 16799 10354 512951 MARK L CATTERSON MD PHYSICIAN 287769 148816 1948 13313 10354 462200 STEPHEN RUBENDALL MD PHYSICIAN 250718 157448 378 13000 10354 431898 CHRIS NEWMAN VP CLINICAL 246459 52540 540 61871 574 361984 JAMIE WOMACK VP CRITICAL ACCESS 226756 46508 810 41792 10354 326220 SHANE HERRIN MD PHYSICIAN 288195 7831 678 17796 10354 324854 JAMES BUE FORMER VP FACILITY S 104138 193815 7305 574 305832 JULIE DUMAS VP QUALITY 165921 35926 540 32621 10950 245958 SCHEDULE J, PAGE 1, PART I, LINE 4 DARCY M. CRAVEN 0 180,180 0 JIM CARTER 0 57,298 0 KRISTOPHER PALMER, D.O. 0 69,989 0 AMY GRIFFIN 0 51,169 0 CHRIS NEWMAN 0 49,500 0 JAMIE WOMACK 0 32,302 0 JAMES BUE 193,815 0 0 JULIE DUMAS 0 24,000 0 SCHEDULE J, PART III THE IRS RULES & REGULATIONS REQUIRE THAT CERTAIN NON-CURRENT, NON-CASH ITEMS ARE REPORTED IN PART VII, COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, HIGHEST COMPENSATED EMPLOYEES, AND INDEPENDENT CONTRACTORS, OF THE CORE FORM 990 REGARDLESS OF THE CURRENT BENEFIT TO THE EMPLOYEE. THESE SAME RULES, IN SOME CASES, REQUIRE THE COMPENSATION AND BENEFITS TO BE REPORTED TWICE IN PART VII, ONCE WHEN THE ENTITY ACCRUES FOR A FUTURE PAYMENT AND ONCE WHEN THE PAYMENT IS ACTUALLY MADE TO THE EMPLOYEE. THEREFORE, AN EMPLOYEE'S STATED TOTAL COMPENSATION AND BENEFITS REPORTED ON PART VII ARE SUBSTANTIALLY HIGHER THAN THE ACTUAL CASH COMPENSATION RECEIVED IN THE CURRENT YEAR. AMOUNTS REPORTED AS BENEFITS INCLUDE AMOUNTS FOR LIFE INSURANCE, HEALTH INSURANCE, THRIFT PLAN CONTRIBUTIONS, AND PENSION CONTRIBUTIONS. BENEFITS RELATED TO PENSION AND RETIREMENT PLANS REFLECT AMOUNTS ACCUMULATED, BUT NOT PAID, TO THE INDIVIDUAL IN RECOGNITION OF TOTAL YEARS OF EMPLOYMENT, NOT JUST THE CURRENT YEAR. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ONE EXECUTIVE PARTICIPATES IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WHICH IS ACCRUED BUT UNFUNDED IN AN AMOUNT WHICH, WHEN ADDED TO OTHER SOURCES OF RETIREMENT INCOME, WILL AFFORD A RETIREMENT INCOME AT A TARGETED PERCENTAGE OF PRE-RETIREMENT COMPENSATION. THE SERP IS A NONQUALIFIED RETIREMENT PLAN. AMC 457(F) RETIREMENT PLAN CERTAIN EXECUTIVES WHO ARE NOT ELIGIBLE FOR THE SERP MAY BE ELIGIBLE TO PARTICIPATE IN A 457(F) PLAN TO HELP THEM ACCUMULATE FUNDS FOR THEIR LONG- TERM FINANCIAL NEEDS. THE ORGANIZATION MAY CONTRIBUTE A PERCENTAGE OF ITS BASE SALARY INTO AN INDIVIDUAL EXECUTIVE'S ACCOUNT IF THE ORGANIZATION MEETS CERTAIN FINANCIAL TARGETS. THE ORGANIZATION OWNS ANY PLAN ASSETS UNTIL THEY ARE PAID TO THE EMPLOYEE AND ALL FUNDS ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. VESTING BEGINS AT AGE 55 WITH FIVE YEARS OF SERVICE AT A RATE OF 90% AND THEN INCREASES TO 100% AT AGE 60. PAYMENTS ARE MADE ANNUALLY UPON VESTING. BONUS AWARDS: OFFICERS AND PHYSICIANS ARE AWARDED BONUSES/INCENTIVES CONTINGENT IN PART ON MEETING MANAGEMENT-BY-OBJECTIVE INCENTIVE PLAN GOALS AND EXCESS OF REVENUE OVER EXPENSES. A HOSP AUTH OF THE CITY OF THOMASVILL 2017C REVENUE BONDS 581719301 NONENONEN 2017-07-12 82750000 CONSTRUCTION BLDG AND EQUIPMENT false true false B HOSP AUTH OF THE CITY OF THOMASVILL 2017A REVENUE BONDS 581719301 NONENONEN 2017-07-12 17985000 CONSTRUCTION PROJECT DEPOSIT false true false A 29285000 82850000 82522324 327676 2017 false true false true B 17985000 17985000 2017 false false true true A false false false false false false true B false false false false false false true A false false true false false false false false true B false false true false true false false false true A false B false PURPOSE OF ISSUE DESCRIPTION HOSP AUTH OF THE CITY OF THOMASVILLE CONSTRUCTION BLDG AND EQUIPMENT PURPOSE OF ISSUE DESCRIPTION HOSP AUTH OF THE CITY OF THOMASVILLE CONSTRUCTION PROJECT DEPOSIT JAMES W FALCONER III MD BOARD TRUSTEE 318221 RENTAL, PATIENT SVCS false JAMI STEPHENSON FAMILY MEMBER 145368 COMPENSATION false DAVID MEDEROS DO BOARD TRUSTEE 5754504 PROFESSIONAL MED SVC false TIMOTHY B DANIEL MD BOARD TRUSTEE 4069776 SERVICE AGREEMENT false JESSE R WARREN DO BOARD TRUSTEE 8801938 PROFESSIONAL MED SVC false KAREN M BRAMBLETT MD BOARD TRUSTEE 8801938 PROFESSIONAL MED SVC false CHRISTOPHER L DANIELS MD BOARD TRUSTEE 19470394 PROFESSIONAL MED SVC false ANDREA K COLLINS BOARD TRUSTEE 221601 PROFESSIONAL MED SVC false SCHEDULE L, PART V JAMES W. FALCONER, III, MD - RENT OF PROPERTY; MEDICAL SERVICES TO PRACTICE; PAYMENTS TO TREAT UNINSURED EMERGENCY PATIENTS. JAMI STEPHENSON IS THE SON OF SUE STEPHENSON, FORMER BOARD TRUSTEE, AND IS EMPLOYED AND COMPENSATED BY JDAMH. DAVID MEDEROS, D.O., FORMER BOARD TRUSTEE, PROVIDES HOSPITALIST COVERAGE FOR HOSPITAL, INPATIENT REHAB AND IS A MEMBER OF THE MEDICAL STAFF LEADERSHIP COMMITTEE. TIMOTHY B. DANIEL, M.D. SERVED ON THE BOARD AS A TRUSTEE DURING FY 2025, AND HE WAS A PRACTICE PARTNER IN AN INTERVENTIONAL RADIOLOGY PRACTICE WHICH HAS A PROFESSIONAL SERVICES AGREEMENT WITH THE HOSPITAL. AMOUNT REFLECTS PAYMENTS ASSOCIATED WITH INTERVENTIONAL RADIOLOGY SERVICES PERFORMED UNDER THE PROFESSIONAL SERVICES AGREEMENT AND A MEDICAL SERVICES AGREEMENT, ALLOCATED PAYMENTS FROM STATE OF GEORGIA TRAUMA FUNDING, AND PHYSICIAN RECRUITMENT INCOME GUARANTEE FOR AN INTERVENTIONAL PRACTICE PARTNER. KAREN L. BRAMBLETT, MD, SERVED ON THE BOARD AS A TRUSTEE DURING FY 2025 AND SHE WAS A PRACTICE PARTNER IN AN ANESTHESIA SERVICES AND MEDICAL DIRECTORSHIP WHICH HAS A PROFESSIONAL SERVICES AGREEMENT WITH THE HOSPITAL. JESSE R. WARREN, DO, SERVED ON THE BOARD AS A TRUSTEE DURING FY 2025 AND SHE WAS A PRACTICE PARTNER IN AN ANESTHESIA SERVICES AND MEDICAL DIRECTORSHIP WHICH HAS A PROFESSIONAL SERVICES AGREEMENT WITH THE HOSPITAL. CHRISTOPHER L. DANIELS, MD, SERVED ON THE BOARD AS A TRUSTEE DURING FY 2025 AND HE WAS A PRACTICE PARTNER IN AN CARDIOVASCULAR SERVICES AND MEDICAL DIRECTORSHIP WHICH HAS A PROFESSIONAL SERVICES AGREEMENT WITH THE HOSPITAL. ANDREA K. COLLINS SERVED ON THE BOARD AS A TRUSTEE DURING FY 2025 AND WAS NURSING INSTRUCTOR AT SRTC, WHICH IS FUNDED BY ARCHBOLD AND SCHOLARSHIPS WERE GRANTED TO SRTC FROM THE ARCHBOLD FOUNDATION. FORM 990, PAGE 2, PART III, LINE 4A ARCHBOLD MEMORIAL IN THOMASVILLE GEORGIA OPERATES WITH 264 LICENSED BEDS; OF WHICH 226 ARE MED/SURG, 18 BEDS ARE DESIGNATED TO A PSYCH UNIT, 20 BEDS ARE REHAB. IN ADDITION, IT OPERATES A 64 BED SKILLED NURSING FACILITY, ARCHBOLD LIVING THOMASVILLE. ARCHBOLD MEMORIAL IS A RURAL REFERRAL CENTER COVERING THOMAS COUNTY AND SURROUNDING COUNTIES IN SOUTHERN GEORGIA AND NORTHERN FLORIDA. 65.1% OF PATIENTS WERE COVERED BY MEDICARE AND MEDICAID, AND 2.5% OF PATIENT REVENUE WAS PROVIDED AS INDIGENT CARE. IN FY 2025, ARCHBOLD MEMORIAL PROVIDED AN ESTIMATED 29.2 MILLION IN INDIGENT CARE CHARGES. ARCHBOLD MEMORIAL TREATS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. ARCHBOLD MEMORIAL PROVIDED APPROXIMATELY 28.5 MILLION IN ADDITIONAL UNCOMPENSATED CARE. THROUGHOUT THE YEAR, ARCHBOLD MEMORIAL PRODUCES OR SPONSORS MANY SPECIAL PROGRAMS FOR THE COMMUNITY TO EDUCATE THEM ON IMPORTANT HEALTH NEEDS. JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. ALSO OPERATES HOSPITALS IN GRADY, BROOKS, AND MITCHELL COUNTIES OF GEORGIA FILING UNDER EIN 58-0566121. FORM 990, PAGE 2, PART III, LINE 4D ARCHBOLD BROOKS OPERATES IN QUITMAN, GEORGIA AS A CRITICAL ACCESS HOSPITAL WITH 25 ACUTE CARE BEDS. IT SERVES BROOKS COUNTY AND 55.2% OF ITS PATIENTS WERE MEDICARE/MEDICAID. IN FY 2025, AN ESTIMATED 2 MILLION OF INDIGENT CARE WAS PROVIDED TO THE COMMUNITY. IN ADDITION, ARCHBOLD BROOKS PROVIDED APPROXIMATELY 2.2 MILLION IN ADDITIONAL UNCOMPENSATED CARE. EIN 58- 6002830 IS FILED UNDER EIN 58-0566121 FOR FORM 990 PURPOSES. FORM 990, PAGE 6, PART VI, LINE 2 KAREN L. BRAMBLETT, MD JESSE R. WARREN, DO TRUSTEE BUSINESS FORM 990, PAGE 6, PART VI, LINE 6 THE ORGANIZATION HAS A SOLE MEMBER, ARCHBOLD MEDICAL CENTER, INC. (AMC), WITH THE POWER TO ELECT OR REPLACE AND TO REMOVE THE TRUSTEES OF THE GOVERNING BODY, AS WELL AS THE AUTHORITY TO APPROVE THE DECISIONS OF THE GOVERNING BODY. FORM 990, PAGE 6, PART VI, LINE 7A THE BOARD OF TRUSTEES OF THE FILING ENTITY ARE ELECTED ANNUALLY BY THE SOLE MEMBER, AMC. IN ADDITION, AMC HAS THE POWER TO ELECT OR REPLACE AND TO REMOVE THE TRUSTEES OF THE GOVERNING BODY. THE CEO OF AMC SHALL BE A MEMBER OF THE BOARD WITH THE POWER TO VOTE. FORM 990, PAGE 6, PART VI, LINE 7B THE SOLE MEMBER, AMC, HAS THE AUTHORITY TO APPROVE THE DECISIONS OF THE GOVERNING BODY, INCLUDING BUT NOT LIMITED TO, CAPITAL AND OPERATING BUDGETS, MERGERS OR ACQUISITIONS, CONTRACTS AND TRANSACTIONS OVER A CERTAIN AMOUNT, DISSOLUTION, ETC FORM 990, PAGE 6, PART VI, LINE 11B MANAGEMENT REVIEWS THE FORM 990 AS PREPARED BY ITS EXTERNAL AUDITOR, AND THEN MAKES A COMPLETE COPY AVAILABLE ELECTRONICALLY TO TRUSTEES PRIOR TO FILING THE RETURN. IF TRUSTEES HAVE QUESTIONS ABOUT THE RETURN, MANAGEMENT IS AVAILABLE AND ACCESSIBLE TO PROVIDE APPLICABLE EXPLANATIONS TO TRUSTEES. FORM 990, PAGE 6, PART VI, LINE 12C ON AN ANNUAL BASIS, THE ORGANIZATION DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE AND DISCLOSURE STATEMENT TO EACH TRUSTEE. THIS QUESTIONNAIRE INCLUDES QUESTIONS RELATED TO FINANCIAL INTERESTS, OUTSIDE INTERESTS OR ACTIVITIES, AND GIFTS, MEALS, AND ENTERTAINMENT. IN ADDITION TO DISCLOSING ANY APPLICABLE INFORMATION ON THE QUESTIONNAIRE, THE TRUSTEE ACKNOWLEDGES THAT (S)HE HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ, UNDERSTANDS, AND AGREES TO COMPLY WITH IT, AND UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. RESPONSES ARE SUMMARIZED AND COLLECTIVELY REVIEWED BY THE BOARD OF TRUSTEES OF ARCHBOLD MEDICAL CENTER, INC., THE SOLE MEMBER. DURING EACH BOARD MEETING, THE CHAIRMAN INQUIRES IF ANY TRUSTEE HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST RELATED TO ANY AGENDA ITEM. IF THE TRUSTEE DISCLOSES ANY SUCH INTEREST, THE TRUSTEE IS EXCUSED FROM THE MEETING WHILE THE DETERMINATION AS TO WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS IS DISCUSSED AND VOTED UPON BY DISINTERESTED MEMBERS OF THE BOARD AND COMMITTEE. IF INVITED TO DO SO, THE TRUSTEE WITH A POTENTIAL CONFLICT MAY RESPOND TO QUESTIONS PUT FORTH BY FELLOW DISINTERESTED TRUSTEES REGARDING ANY PROPOSED TRANSACTION OR ARRANGEMENT. THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS DOCUMENTS THE NAME OF ANY INTERESTED PERSON/TRUSTEE WHO DISCLOSED OR WAS FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH A TRANSACTION OR ARRANGEMENT RESULTING IN AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; AND THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATED TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSIONS, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH. FORM 990, PAGE 6, PART VI, LINE 15A ARCHBOLD MEDICAL CENTER'S (AMC) COMPENSATION COMMITTEE (COMMITTEE) OF THE AMC BOARD OF TRUSTEES MAKES RECOMMENDATIONS TO THE FULL AMC BOARD ON THE FOLLOWING POSITIONS: THE PRESIDENT OF AMC AND THE PRESIDENT OF THE ARCHBOLD FOUNDATION. AMC'S PRESIDENT PRESENTS RECOMMENDATIONS FOR ALL SENIOR VICE PRESIDENTS, VICE PRESIDENTS, AND OTHER KEY EMPLOYEES OF AMC AND ALL RELATED ARCHBOLD ENTITIES TO THE COMMITTEE. SINCE AMC HAS RESERVE POWERS FOR ARCHBOLD RELATED ENTITIES, THE COMMITTEE SERVES AS THE COMPENSATION COMMITTEE FOR EACH APPLICABLE ARCHBOLD ENTITY. THE COMMITTEE CONSIDERS THE AMC PRESIDENT'S RECOMMENDATIONS, BUT IT ALSO CONSIDERS RECOMMENDATIONS AND INDEPENDENT MARKET DATA ANALYSIS FROM AN INDEPENDENT COMPENSATION CONSULTANT. THE AMC BOARD UTILIZES AN INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE EXECUTIVE COMPENSATION PROGRAM AND MAKE RECOMMENDATIONS REGARDING PLAN DESIGN AND ACTUAL COMPENSATION INCLUDING BENEFITS. FORM 990, PAGE 6, PART VI, LINE 15B SEE 15A ABOVE. FORM 990, PAGE 6, PART VI, LINE 19 NO DOCUMENTS ARE OR WILL BE MADE AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G CONTRACT SERVICES JDAMH 40,782,618 2,159,405 0 CONTRACT SERVICES BROOKS 1,342,366 0 0 CONTRACT SERVICES GRADY 5,589,322 257,400 0 CONTRACT SERVICES MITCHELL 4,099,896 13,365 0 OUTSIDE LAB REFERRAL FEES JDA 1,634,864 0 0 OUTSIDE LAB REFERRAL GRADY 25,814 0 0 OUTSIDE LAB REFERRAL BROOKS 2,064 0 0 PROFESSIONAL FEES JDAMH 19,977,831 1,727,332 0 PROFESSIONAL FEES GRADY 3,809,601 162,967 0 PROFESSIONAL FEES BROOKS 1,281,269 67,765 0 PROFESSIONAL FEES MITCHELL 2,106,476 242,019 0 CONSULTANT GRADY 0 820,919 0 OUTSIDE LAB REFERRAL MITCHELL 1,719 0 0 TOTAL 80,653,840 5,451,172 0 FORM 990, PART XI, LINE 9 AUXILLARY AND OTHER ADJUSTMENTS 363,912 TRANSFER TO FOUNDATION -25,772 TOTAL 338,140 ARCHBOLD FOUNDATION INC PO BOX 620 THOMASVILLE GA 317990620 581559677 FOUNDATION GA 501C3 12B AMC ARCHBOLD MEDICAL CENTER INC false ARCHBOLD MEDICAL CENTER INC PO BOX 1018 THOMASVILLE GA 317991018 581552650 H/C MGMT GA 501C3 12C NA false ARCHBOLD MEDICAL GROUP INC P O BOX 620 THOMASVILLE GA 317990620 262988454 PHYSICIANS GA 501C3 3 AMC ARCHBOLD MEDICAL CENTER INC false CCSG INC 915 GORDON AVENUE THOMASVILLE GA 317926614 473501366 MED CLINIC GA 501C3 3 AMG false AMGIR INC 915 GORDON AVENUE THOMASVILLE GA 317926614 821188691 MED CLINIC GA 501C3 3 AMG false GEORGIA-FLORIDA PREFERRED INC 915 GORDON AVE THOMASVILLE GA 31792 581744334 HEALTHCARE GA JDAMH C CORP false false true true true false false false false false true false true true true true false false true false