Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
TANNER MEDICAL CENTER
Employer identification number
58-1790149
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
TANNER MEDICAL CENTER
Employer identification number
58-1790149
Identifier
Return Reference
Explanation
ADDITIONAL INFORMATION
FORM 990
AS OF JUNE 30, 2011, TANNER MEDICAL CENTER, INC. IS A REGIONAL HEALTHCARE PROVIDER WITH ALMOST 300 PHYSICIANS REPRESENTING 46 MEDICAL SPECIALTIES. TANNER PROVIDES A WIDE RANGE OF COMPREHENSIVE MEDICAL SERVICES FOR RESIDENTS IN A REGION OF WEST GEORGIA AND EAST ALABAMA. TANNER'S FACILITIES INCLUDE THE 202-BED ACUTE CARE TANNER MEDICAL CENTER/CARROLLTON; THE ROY RICHARDS, SR. CANCER CENTER, TANNER HEART AND VASCULAR CENTER, TANNER BREAST HEALTH, THE TANNER ADVANCED WOUND CENTER, EMPLOYEE ASSISTANCE PROGRAM (TANNER EAP) AND MORE. MORE INFORMATION ON TANNER MEDICAL CENTER, INC. IS AVAILABLE IN THE HEALTH SYSTEM'S ANNUAL COMMUNITY BENEFIT REPORT, WHICH CAN BE DOWNLOADED AT HTTP://WWW.TANNER.ORG/MAIN/HEALTHYLIVINGMAGAZINE.ASPX. TANNER MEDICAL CENTER, INC. IS A NOT-FOR-PROFIT HEALTHCARE SYSTEM. THE MEDICAL CENTER PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO RESIDENTS OF WEST GEORGIA AND SURROUNDING AREAS. ADMITTING PHYSICIANS ARE PRIMARILY PRACTITIONERS IN THE LOCAL AREA AND EMPLOYED PHYSICIANS. TANNER MEDICAL CENTER, INC. INCLUDES THE FOLLOWING: TANNER MEDICAL CENTER/CARROLLTON, ESTABLISHED TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES THROUGH THE OPERATION OF A 180-BED ACUTE CARE HOSPITAL AND A 21-BED SKILLED NURSING FACILITY IN CARROLLTON, GEORGIA. TANNER MEDICAL CENTER/VILLA RICA, ESTABLISHED TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES THROUGH THE OPERATION OF A 40-BED ACUTE CARE HOSPITAL AND WILLOWBROOK AT TANNER/VILLA RICA, A 52 BED PSYCHIATRIC FACILITY IN VILLA RICA, GEORGIA. TANNER MEDICAL CENTER/HIGGINS GENERAL HOSPITAL, ESTABLISHED TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES THROUGH THE OPERATION OF A 25-BED CRITICAL ACCESS HOSPITAL IN BREMEN, GEORGIA. TANNER MEDICAL GROUP, ESTABLISHED TO OPERATE PHYSICIAN PRACTICES IN WEST GEORGIA AND EASTERN ALABAMA. TANNER MEDICAL CENTER, INC. IS RESPONSIBLE FOR ALLOCATING RESOURCES AND FOR APPROVING BUDGETS, MAJOR CONTRACTS AND DEBT FINANCING FOR ALL ENTITIES.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
THE ORGANIZATION'S VP OF FINANCE GATHERS INFORMATION FOR THE FORM 990 AND CONSULTS WITH THE CFO AND COMPLIANCE OFFICER ON CERTAIN MATTERS. A DRAFT COPY IS REVIEWED BY THE VP OF FINANCE AND CFO FOR ACCURACY. THE FINAL VERSION IS PRESENTED TO THE EXECUTIVE COMMITTEE FOR REVIEW AND QUESTIONS. THE CHAIRMAN OF THE EXECUTIVE COMMITTEE THEN PRESENTS THIS AT THE NEXT BOARD MEETING TO THE FULL BOARD. THE 2010 FORM 990 (FYE JUNE 30, 2011) WAS PRESENTED TO THE BOARD AFTER FILING DUE TO TIME CONSTRAINTS.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
THE POLICY COVERS ALL EMPLOYEES, SUPPLIERS, MEDICAL STAFF AND VOLUNTEERS. CONFLICTS ARE REVIEWED BY THE COMPLIANCE OFFICER FOR RESOLUTION. THE COMPLIANCE OFFICER THEN CONSULTS WITH THE EXECUTIVE TEAM AND THE CEO FOR FINAL RESOLUTION. PER THE POLICY, ANY PERSON WITH A CONFLICT WILL EXCUSE THEMSELVES FROM THE DECISION MAKING PROCESS COMPLETELY. BOARD MEMBERS PHYSICALLY LEAVE THE ROOM WHEN DISCUSSIONS OCCUR THAT ARE POTENTIAL CONFLICTS. TANNER BIDS OUT SERVICES AND IF A COMPANY OWNED BY A BOARD MEMBER CHOOSES TO BID, THERE ARE ADDITIONAL STEPS FOR TRANSPARENCY SUCH AS ADVERTISING THE BIDDING PROCESS IN THE NEWSPAPER. ALL SERVICES ARE COMPARED TO FAIR MARKET VALUE.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
THE ORGANIZATION'S COMPENSATION COMMITTEE REVIEWS RECOMMENDATIONS AND APPROVES COMPENSATION PACKAGES FOR ALL SENIOR MANAGEMENT. TMC USES AN OUTSIDE, NATIONALLY KNOWN COMPENSATION AND BENEFITS FIRM THAT USES SURVEY INFORMATION; REVIEWS JOB STANDARDS; ETC. FOR ALL SENIOR MANAGEMENT. THE OUTSIDE FIRM ANALYZES COMPARABLE COMPENSATION DATA FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS; AND PRESENTS THE DATA TO THE COMPENSATION COMMITTEE. WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENT, OFFICIAL MINUTES ARE KEPT. THE EXECUTIVE ASSISTANT TO THE CEO MAINTAINS THE MINUTES. THIS PROCESS LAST COMPLETED IN 2011.
COMPENSATION PROCESS FOR OFFICERS
FORM 990, PAGE 6, PART VI, LINE 15B
SEE LINE 15A NARRATIVE. THE PROCESS IS COMPLETED FOR ALL SENIOR EXECUTIVE LEVEL POSITIONS AND ABOVE.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
THE ORGANIZATION MAKES AVAILABLE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS TO MEMBERS OF THE PUBLIC WHO MAKE THEIR REQUEST AT THE ADMINISTRATIVE OFFICE OF THE ORGANIZATION.
RELATED ORGANIZATIONS
FORM 990, PAGE 7, PART VII
JEFFREY LINDSEY, DMD 1 HOUR JOHN BURSON III, MD 1 HOUR MARY COVINGTON 1 HOUR DANIEL JACKSON 1 HOUR JERRY CLAYTON 1 HOUR LARRY BOGGS 1 HOUR NITA PRICE 1 HOUR NORMAN BANKS 1 HOUR ROBERT PITTS, MD 1 HOUR STEPHEN KAHLER, MD 1 HOUR STEVE ADAMS 1 HOUR LOY HOWARD 17 HOURS WILLIAM WATERS 17 HOURS LARRY STEED 17 HOURS JEFF JENNINGS 17 HOURS LEE SHERSETH 17 HOURS DALE DREILING 17 HOURS DENISE TAYLOR 28 HOURS
OTHER CHANGES IN NET ASSETS EXPLANATION
FORM 990, PART XI, LINE 5
UNREALIZED GAINS/LOSSES 8,362,044 CHANGE IN INTEREST OF FOUNDATION 32,600 OTHER NET ASSET ADJUSTMENTS ( 697,384) TOTAL NET 7,697,260
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.