2023-11-13T13:12:58-05:00 2022-12-31 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2022-01-01 872546864 FLOYD-POLK HEALTHCARE FOUNDATION IN FLOY 7065093287 304 TURNER MCCALL BLVD ROME GA 30165 PAUL C WHITE PRESIDENT 3107121310 2023-11-08 true PAUL WHITE 999009999 false WILLIAM EDWARD PHILLIPS P00451499 2298837878 2023-11-13 2022 2023-04-26 12:10:37Z PAUL C WHITE 304 TURNER MCCALL BLVD ROME GA 30165 155664307 false X X 2021 GA THE FLOYD-POLK HEALTHCARE FOUNDATION, INC. (THE "FOUNDATION"), IS ORGANIZED AND OPERATED EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF AND TO CARRY OUT THE PURPOSES OF FLOYD HEALTHCARE MANAGEMENT, INC., POLK MEDICAL CENTER, INC., THE HOSPITAL AUTHORITY OF FLOYD COUNTY AND THE CEDARTOWN-POLK COUNTY HOSPITAL AUTHORITY. THE FOUNDATION WILL PROMOTE THE HEALTH OF THE COMMUNITIES SERVED BY EACH OF THE SUPPORTED ORGANIZATIONS, PROVIDE RELIEF TO THE POOR, DISTRESSED AND UNDERPRIVILEGED AND LESSEN THE BURDENS OF GOVERNMENT BY ENGAGING IN ACTIVITIES SUCH AS THE FOLLOWING: 1) PROVIDING FUNDING TO THE SUPPORTED ORGANIZATIONS TO ESTABLISH OR EXPAND PROGRAMS THAT ADDRESS HEALTH DISPARITIES; 2) MAKING CONTRIBUTIONS TO THE SUPPORTED ORGANIZATIONS TO FACILITATE THE DELIVERY OF HEALTHCARE SERVICES TO THE UNDERINSURED OR UNINSURED; AND 3) SAFEGUARDING ASSETS TO ENSURE THE CONTINUED OPERATION OF FLOYD MEDICAL CENTER AND POLK MEDICAL CENTER. 16 11 0 0 152772439 0 2891868 0 155664307 0 0 0 0 0 283210 283210 155381097 155054894 274427 154780467 X THE FLOYD-POLK HEALTHCARE FOUNDATION, INC. (THE "FOUNDATION"), IS ORGANIZED AND OPERATED EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF AND TO CARRY OUT THE PURPOSES OF FLOYD HEALTHCARE MANAGEMENT, INC., POLK MEDICAL CENTER, INC., THE HOSPITAL AUTHORITY OF FLOYD COUNTY AND THE CEDARTOWN-POLK COUNTY HOSPITAL AUTHORITY. THE FOUNDATION WILL PROMOTE THE HEALTH OF THE COMMUNITIES SERVED BY EACH OF THE SUPPORTED ORGANIZATIONS, PROVIDE RELIEF TO THE POOR, DISTRESSED AND UNDERPRIVILEGED AND LESSEN THE BURDENS OF GOVERNMENT BY ENGAGING IN ACTIVITIES SUCH AS THE FOLLOWING: 1) PROVIDING FUNDING TO THE SUPPORTED ORGANIZATIONS TO ESTABLISH OR EXPAND PROGRAMS THAT ADDRESS HEALTH DISPARITIES; 2) MAKING CONTRIBUTIONS TO THE SUPPORTED ORGANIZATIONS TO FACILITATE THE DELIVERY OF HEALTHCARE SERVICES TO THE UNDERINSURED OR UNINSURED; AND 3) SAFEGUARDING ASSETS TO ENSURE THE CONTINUED OPERATION OF FLOYD MEDICAL CENTER AND POLK MEDICAL CENTER. false false THE FOUNDATION WILL PROMOTE THE HEALTH OF THE COMMUNITIES SERVED BY EACH OF THE 4 SUPPORTED ORGANIZATIONS, PROVIDE RELIEF TO THE POOR, DISTRESSED AND UNDERPRIVILEGED AND LESSEN THE BURDENS OF GOVERNMENT BY ENGAGING IN ACTIVITIES THAT FURTHER PUBLIC HEALTH IN THE COMMUNITIES SERVED, PROVIDE FUNDS TO THE 4 SUPPORTED ORGANIZATIONS, AND SAFEGUARD ASSETS TO ENSURE THE CONTINUED OPERATION OF FLOYD MEDICAL CENTER AND POLK MEDICAL CENTER. true true false false false false false false false false false true false false true false false false false false true false false false false false false false false true false false false false false false false false false false false false false true false false false true 48 0 false 0 false false false false false false false false false false false false false false X 16 11 false false false false true true false true true false false true true true false false false false false false GA X CLARICE CABLE 7065096074 304 TURNER MCCALL BLVD ROME GA 30165 BRIDGETTE DINGLE MD TRUSTEE 1.00 40.00 X X 0 449568 23584 NEIL GORDON MD TRUSTEE 1.00 40.00 X X 0 226731 14705 KAY CHUMBLER TRUSTEE 1.00 X X 0 8450 0 W FRANK SHELLEY TRUSTEE 1.00 X X 0 5500 0 DAVID JOHNSON TRUSTEE 1.00 X 0 4100 0 DENISE DOWNER-MCKINNEY TRUSTEE 1.00 X 0 3850 0 LAURIE ATKINS TRUSTEE 1.00 X X 0 0 0 DAN BAKER TRUSTEE 1.00 X X 0 0 0 JOEY BALDWIN TRUSTEE 1.00 X X 0 0 0 ROGER GOSS TREASURER 1.00 X X 0 0 0 MARY HELEN HEANER CHAIR/PRESID 1.00 X X 0 0 0 DONALD JONAS TRUSTEE 1.00 X X 0 0 0 HIMANSHU PATEL MD TRUSTEE 1.00 X X 0 0 0 STEPHEN R BRIGGS MD TRUSTEE 1.00 X 0 0 0 CHANTZ MCCLINIC TRUSTEE 1.00 X X 0 0 0 KURT STEUNKEL SECRETARY 1.00 X X 0 0 0 CHRIS TWYMAN TRUSTEE 1.00 X X 0 0 0 PHILIP WHEELER CFO 1.00 45.00 X 0 0 0 PAUL C WHITE PRESIDENT 40.00 X 0 0 0 698199 38289 false true false 152772439 152772439 2777204 2777204 114664 114664 114664 114664 155664307 2891868 X 8783 8783 270640 270640 MISCELLANOUS 3787 3787 283210 0 283210 0 10907666 123598487 20548741 0 155054894 274427 0 274427 X 154780467 0 154780467 0 155054894 155381097 -600630 X false false X X 4 FLOYD HEALTHCARE MANAGEMENT INC 581973570 3 true 0 0 POLK MEDICAL CENTER INC 453957368 3 true 0 0 HOSPITAL AUTHORITY OF FLOYD COUNTY 586001173 6 true 0 0 CEDARTOWN-POLK COUNTY HOSPITAL AUTHORITY 580603152 6 true 0 0 4 0 true false false false false false false false false false false false false false false true false RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 20548741 F 20548741 DUE TO FLOYD 274427 274427 false CENTRAL AMERICA & THE CARIBBEAN INVESTMENTS 5045969 5045969 5045969 true false true true false false SCHEDULE F, PAGE 1, PART I, LINE 3 CENTRAL AMERICA & THE CARIBBEAN 0 5,045,969 SCHEDULE F, PAGE 5, PART V FLOYD-POLK HEALTHCARE FOUNDATION HAS AN INVESTMENT IN NUT TREE OFFSHORE FUND, LTD., A CAYMAN ISLANDS EXEMPTED COMPANY. FLOYD-POLK HEALTHCARE FOUNDATION IS A TAX-EXEMPT ENTITY DESCRIBED IN IRC SECTION 501(C)(3). PURSUANT TO TREASURY REGULATIONS SECTION 1.1298-1(C), FORM 8621 IS NOT REQUIRED TO BE FILED WITH RESPECT TO THIS INVESTMENT. false false false false false false false false false BRIDGETTE DINGLE MD TRUSTEE 448571 72 925 23584 473152 NEIL GORDON MD TRUSTEE 221240 72 5419 14705 241436 FORM 990 - ORGANIZATION'S MISSION THE FLOYD-POLK HEALTHCARE FOUNDATION, INC. (THE "FOUNDATION"), IS ORGANIZED AND OPERATED EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF AND TO CARRY OUT THE PURPOSES OF FLOYD HEALTHCARE MANAGEMENT, INC., POLK MEDICAL CENTER, INC., THE HOSPITAL AUTHORITY OF FLOYD COUNTY AND THE CEDARTOWN-POLK COUNTY HOSPITAL AUTHORITY. THE FOUNDATION WILL PROMOTE THE HEALTH OF THE COMMUNITIES SERVED BY EACH OF THE SUPPORTED ORGANIZATIONS, PROVIDE RELIEF TO THE POOR, DISTRESSED AND UNDERPRIVILEGED AND LESSEN THE BURDENS OF GOVERNMENT BY ENGAGING IN ACTIVITIES SUCH AS THE FOLLOWING: 1) PROVIDING FUNDING TO THE SUPPORTED ORGANIZATIONS TO ESTABLISH OR EXPAND PROGRAMS THAT ADDRESS HEALTH DISPARITIES; 2) MAKING CONTRIBUTIONS TO THE SUPPORTED ORGANIZATIONS TO FACILITATE THE DELIVERY OF HEALTHCARE SERVICES TO THE UNDERINSURED OR UNINSURED; AND 3) SAFEGUARDING ASSETS TO ENSURE THE CONTINUED OPERATION OF FLOYD MEDICAL CENTER AND POLK MEDICAL CENTER. FORM 990, PAGE 6, PART VI, LINE 6 THE FLOYD-POLK HEALTHCARE FOUNDATION, INC. (THE "FOUNDATION"), IS ORGANIZED AND OPERATED EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF AND TO CARRY OUT THE PURPOSES OF FLOYD HEALTHCARE MANAGEMENT, INC. ("FLOYD"), POLK MEDICAL CENTER, INC. ("POLK"), THE HOSPITAL AUTHORITY OF FLOYD COUNTY ("FLOYD HA") AND THE CEDARTOWN-POLK COUNTY HOSPITAL AUTHORITY ("POLK HA"). FLOYD, POLK, THE FLOYD HA AND THE POLK HA ARE EACH MEMBERS OF THE FOUNDATION AND, AS SET FORTH IN THE BYLAWS, APPOINT A MAJORITY OF THE FOUNDATION'S BOARD OF DIRECTORS. FORM 990, PAGE 6, PART VI, LINE 7A THE INITIAL BOARD OF DIRECTORS OF THE CORPORATION SHALL CONSIST OF BETWEEN TEN (10) AND SEVENTEEN (17) DIRECTORS, ALL OF WHICH SHALL BE APPOINTED BY THE MEMBERS. FOLLOWING THE EFFECTIVE DATE, THE MEMBERS MAY APPOINT ADDITIONAL INDIVIDUALS TO THE INITIAL BOARD OF DIRECTORS UP TO A MAXIMUM NUMBER OF SEVENTEEN (17) DIRECTORS. THEREAFTER, THE BOARD OF DIRECTORS SHALL CONSIST OF SEVENTEEN (17) DIRECTORS AND WILL BE COMPOSED OF THE FOLLOWING: - TWO (2) DIRECTORS APPOINTED BY THE FLOYD HA, BOTH OF WHOM SHALL BE MEMBERS OF THE FLOYD HA, AND AT LEAST ONE OF WHOM SHALL ALSO SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF FLOYD; - TWO (2) DIRECTORS APPOINTED BY THE FLOYD HA, BOTH OF WHOM SHALL BE RESIDENTS OF FLOYD COUNTY AND NOT MEMBERS OF THE FLOYD HA; - TWO (2) DIRECTORS APPOINTED BY THE POLK HA, BOTH OF WHOM SHALL BE MEMBERS OF THE POLK HA, AND AT LEAST ONE OF WHOM SHALL ALSO SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF POLK; - TWO (2) DIRECTORS APPOINTED BY THE POLK HA, BOTH OF WHOM SHALL BE RESIDENTS OF POLK COUNTY AND NOT MEMBERS OF THE POLK HA; PROVIDED, HOWEVER, THAT AT THE POLK HA'S SOLE OPTION AND ABSOLUTE DISCRETION, NOT MORE THAN ONE (1) MEMBER OF THE DIRECTORS MAY BE A NON-RESIDENT OF POLK COUNTY; - THREE (3) DIRECTORS APPOINTED BY FLOYD, ALL OF WHOM SHALL BE SELECTED FROM NOMINATIONS MADE BY THE NOMINATING COMMITTEE; - ONE (1) DIRECTOR APPOINTED BY POLK WHO SHALL BE SELECTED FROM NOMINATIONS MADE BY THE NOMINATING COMMITTEE; - FOUR (4) DIRECTORS WHO ARE NON-INTERESTED PERSONS, AS DEFINED BELOW, ELECTED BY THE BOARD FROM NOMINATIONS MADE BY THE NOMINATING COMMITTEE; AND - ONE (1) DIRECTOR WHO SHALL BE THE CHIEF EXECUTIVE OFFICER OF FLOYD (OR HIS/HER DESIGNEE), AND WHO SHALL SERVE AS A VOTING EX OFFICIO MEMBER. FORM 990, PAGE 6, PART VI, LINE 11B THE RETURN WAS PREPARED BY AN INDEPENDENT CPA FROM INFORMATION PROVIDED BY THE BOARD OF DIRECTORS. THE BOARD REVIEWED THE RETURN PRIOR TO IT BEING FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PAGE 6, PART VI, LINE 19 DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONSULTING FEES 0 270,640 0 FLOYD HEALTHCARE MANAGEMENT INC 304 TURNER MCCALL BLVD ROME GA 301620233 581973570 HOSPITAL GA 501C3 3 N/A false POLK MEDICAL CENTER INC 420 E SECOND AVENUE SUITE 102 ROME GA 301613210 453957368 HOSPITAL GA 501C3 3 N/A false HOSPITAL AUTHORITY OF FLOYD COUNTY 304 TURNER MCCALL BLVD ROME GA 301620233 586001173 HEALTHCARE GA 501C3 3 N/A false CEDARTOWN-POLK COUNTY HOSP AUTHORIT 424 N MAIN STREET CEDARTOWN GA 30125 580603152 HEALTHCARE GA 115 N/A false false false true false false false false false false false false false false false false false false false false