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
2011
Open to Public Inspection
Name of the organization
METHODIST HOME OF THE SOUTH GEORGIA CONFERENCE INC
Employer identification number
58-0622971
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
3,276,953
2,656,009
2,529,811
2,346,657
2,332,787
13,142,217
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..
3,276,953
2,656,009
2,529,811
2,346,657
2,332,787
13,142,217
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)..
31,442
6
Public Support. Subtract line 5 from line 4.
13,110,775
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
7
Amounts from line 4..
3,276,953
2,656,009
2,529,811
2,346,657
2,332,787
13,142,217
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
1,677,363
1,610,492
1,430,601
8,548
8,686
4,735,690
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..
3,705,849
53,838
62,339
42,589
47,900
3,912,515
11
Total support (Add lines 7 through 10).
21,790,422
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
9,217,535
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
60.170 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
62.790 %
16a
33 1/3% support test—2011.
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—2010.
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—2011.
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—2010.
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(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) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(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 2011 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2011.
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—2010.
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2011
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
2011
Open to Public Inspection
Name of the organization
METHODIST HOME OF THE SOUTH GEORGIA CONFERENCE INC
Employer identification number
58-0622971
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION
FORM 990 - ORGANIZATION'S MISSION
THE METHODIST HOME OF THE SOUTH GEORGIA CONFERENCE, INC. IS A MULTI-SITE, MULTI-SERVICE ORGANIZATION THAT PROVIDES RESIDENTIAL CARE AND TREATMENT FOR UP TO 130 YOUTH DAILY IN 13 COTTAGES LOCATED IN MACON, COLUMBUS, WAVERLY HALL, ST. MARYS, AMERICUS AND VALDOSTA, GEORGIA. FOR THE LAST YEAR, AVERAGE OCCUPANCY WAS 90%. THE MISSION IS TO RESTORE CHILDHOODS, STRENGTHEN FAMILIES AND TO BE A PEOPLE BUILDING ORGANIZATION. IN ADDITIONAL TO RESIDENTIAL CARE AND TREATMENT, THE ORGANIZATION PROVIDES THERAPEUTIC FOSTER CARE, COMMUNITY MENTAL HEALTH SERVICES, INTENSIVE VISITATION, AN ON CAMPUS SCHOOL, INDEPENDENT LIVING SERVICES AND ASSISTANCE IN HIGHER EDUCATION. FOR THE PAST FISCAL YEAR, 321 WERE SERVED IN RESIDENTIAL PROGRAMS AND 532 IN VARIOUS COMMUNITY SERVICES. CURRENTLY THE HOME IS ASSISTING 10 OF OUR FORMER RESIDENTS IN COLLEGE AND VOCATIONAL SCHOOLS. THE METHODIST HOME IS FULLY LICENSED IN GEORGIA AND HAS NATIONAL ACCREDITATION FROM THE COUNCIL ON ACCREDITATION IN NEW YORK AND THE EAGLE ACCREDITATION OF THE UNITED METHODIST ASSOCIATION OF HEALTH AND WELFARE. THE RESIDENTIAL PROGRAMS ENJOY A WIDE RANGE OF SUPPORT PROGRAMS INCLUDING RECREATIONAL, EDUCATIONAL, SPIRITUAL LIFE AND COMMUNITY ACTIVITIES. THE MAIN CAMPUS HAS EXCELLENT RECREATION FACILITIES INCLUDING A GYM, POOL AND TENNIS COURTS, AND HAS BECOME A STATEWIDE CENTER FOR TRAINING.
FIRST ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4A
IN MACON, COLUMBUS AND ST. MARYS, WE ALSO PROVIDE COMPREHENSIVE COMMUNITY MENTAL HEALTH SERVICES OR THE MEDICAID REHAB OPTION. THE HOME HAS OPERATING LICENSES FROM THE GEORGIA DEPARTMENT OF HUMAN RESOURCES IN EACH REQUIRED AREA AND IS FULLY ACCREDITED BY THE COUNCIL ON ACCREDITATION IN NEW YORK, AND THE EAGLE ACCREDITATION PROGRAM OF UNITED METHODIST ASSOCIATION. OUR RESIDENTIAL PROGRAMS ENJOY A WIDE RANGE OF SUPPORT PROGRAMS INCLUDING RECREATIONAL, EDUCATIONAL, SPIRITUAL LIFE AND COMMUNITY ACTIVITIES. OUR MAIN CAMPUS HAS EXCELLENT RECREATION FACILITIES INCLUDING A GYM, POOL AND TENNIS COURTS. OUR REGIONAL OFFICES ENJOY BROAD COMMUNITY SUPPORT. IN ALL LOCATIONS, WE DEVELOP COLLABORATIVE PARTNERSHIPS WITH OTHER AGENCIES AND INTERESTED PARTIES.
POLICIES AND PROCEDURES GOVERNING CHAPTERS
FORM 990, PAGE 6, PART VI, LINE 10B
ALL BRANCHES OF THE METHODIST HOME OF THE SOUTH GEORGIA CONFERENCE, INC. ABIDE BY THE SAME WRITTEN POLICIES AND PROCEDURES.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
THE FORM 990 WAS SUBMITTED TO EACH OFFICER AND TRUSTEE FOR REVIEW PRIOR TO FILING.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
A CONFLICT OF INTEREST STATEMENT IS SIGNED BY EACH BOARD MEMBER ANNUALLY. THIS POLICY IS EXPLAINED TO NEW BOARD MEMBERS DURING ORIENTATION AND A COMPLETED CORPORATE COMPLIANCE MANUAL IS GIVEN TO EACH BOARD MEMBER.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
A PERSONNEL COMMITTEE ESTABLISHES SALARIES AND POSSIBLE RAISES USING SALARY STUDIES FROM THE ALLIANCE FOR CHILDREN AND YOUTH, GEORGIA ASSOCIATION OF HOMES AND SERVICES FOR CHILDREN AND THE UNITED METHODIST ASSOCIATION OF HEALTH AND WELFARE MINISTRIES. THE PERSONNEL COMMITTEE RECOMMENDS COMPENSATION TO THE EXECUTIVE COMMITTEE WHO THEN MAKES RECOMMENDATIONS TO THE ENTIRE BOARD IN MAY FOR JULY 1 IMPLEMENTATION. EXECUTIVE COMMITTEE RECOMMENDS CONTINUED EMPLOYMENT AND COMPENSATION OF CEO AT THE MAY SPRING MEETING.
COMPENSATION PROCESS FOR OFFICERS
FORM 990, PAGE 6, PART VI, LINE 15B
THE BUDGET PROCESS BEGINS WITH STAFF IN FEBRUARY AND IS REVIEWED BY BOARD FINANCE COMMITTEE IN MARCH. THE FINANCE COMMITTEE AND PERSONNEL COMMITTEE MAKE RECOMMENDATIONS FOR ORGANIZATIONAL RAISES AFTER HEARING STAFF RECOMMENDATIONS. THE PERSONNEL COMMITTEE ESTABLISHES SALARIES AND POSSIBLE RAISES USING SALARY STUDIES FROM THE ALLIANCE FOR CHILDREN AND YOUTH, GEORGIA ASSOCIATION OF HOMES AND SERVICES FOR CHILDREN AND THE UNITED METHODIST ASSOCIATION OF HEALTH AND WELFARE MINISTRIES. THE PERSONNEL COMMITTEE RECOMMENDS COMPENSATION TO THE EXECUTIVE COMMITTEE WHO THEN MAKES RECOMMENDATIONS TO THE ENTIRE BOARD IN MAY FOR JULY 1 IMPLEMENTATION.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.