TY 2018 Form 990

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

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.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

TIFT REGIONAL HEALTH SYSTEM INC

Employer identification number

45-3072990

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 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. 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 ....................... right arrow

33 1/3% support test—2017. If the organization did not check a 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 ..................... right arrow

17a

10%-facts-and-circumstances test—2018. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. 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 ....... right arrow

33 1/3% support tests—2017. 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 .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2018

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2018 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation
SUPPLEMENTAL INFORMATION	EFFECTIVE MARCH 1, 2019, TIFT REGIONAL HEALTH SYSTEM, INC. (TRHS) EXECUTED A 40-YEAR LEASE AGREEMENT WITH THE TIFT COUNTY HOSPITAL AUTHORITY (THE "AUTHORITY"), A GOVERNMENTAL HOSPITAL AUTHORITY ORGANIZED UNDER THE HOSPITAL AUTHORITIES PROVISIONS OF THE OFFICIAL CODE OF GEORGIA. UNDER THE AGREEMENT, TRHS ASSUMED SUBSTANTIALLY ALL OF THE OPERATIONS, ASSETS AND LIABILITIES OF THE AUTHORITY. AS A RESULT, TRHS IS PROPERLY CLASSIFIED AS A HOSPITAL FOR PURPOSES OF ITS PUBLIC CHARITY STATUS.

Return Reference

Explanation

SUPPLEMENTAL INFORMATION

EFFECTIVE MARCH 1, 2019, TIFT REGIONAL HEALTH SYSTEM, INC. (TRHS) EXECUTED A 40-YEAR LEASE AGREEMENT WITH THE TIFT COUNTY HOSPITAL AUTHORITY (THE "AUTHORITY"), A GOVERNMENTAL HOSPITAL AUTHORITY ORGANIZED UNDER THE HOSPITAL AUTHORITIES PROVISIONS OF THE OFFICIAL CODE OF GEORGIA. UNDER THE AGREEMENT, TRHS ASSUMED SUBSTANTIALLY ALL OF THE OPERATIONS, ASSETS AND LIABILITIES OF THE AUTHORITY. AS A RESULT, TRHS IS PROPERLY CLASSIFIED AS A HOSPITAL FOR PURPOSES OF ITS PUBLIC CHARITY STATUS.

Schedule A (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Name of the organization

TIFT REGIONAL HEALTH SYSTEM INC

Employer identification number

45-3072990

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization TIFT REGIONAL HEALTH SYSTEM INC

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization TIFT REGIONAL HEALTH SYSTEM INC		Employer identification number 45-3072990

Part II	Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization TIFT REGIONAL HEALTH SYSTEM INC			Employer identification number 45-3072990
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

TIFT REGIONAL HEALTH SYSTEM INC

Employer identification number

45-3072990

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2018

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...............................
c	Total lobbying expenditures (add lines 1a and 1b) ...................................................................
d	Other exempt purpose expenditures ........................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2018

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

29,768

Total. Add lines 1c through 1i ....................................................................................................

29,768

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
SCHEDULE C, PART II-B, LINE 1	TIFT REGIONAL HEALTH SYSTEM IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION, THE GEORGIA HOSPITAL ASSOCIATION AND CERTAIN OTHER MEMBERSHIP ORGANIZATIONS. THE LOBBYING EXPENSE REFLECTED REPRESENTS THE ESTIMATED PORTION OF DUES PAID TO THESE ORGANIZATIONS SPENT ON LOBBYING ACTIVTIES AT THE FEDERAL, STATE AND LOCAL LEVELS OF GOVERNMENT.

Schedule C (Form 990 or 990EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

TIFT REGIONAL HEALTH SYSTEM INC

Employer identification number

45-3072990

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2018

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	9,748,500		9,748,500
b	Buildings ....	266,440,030	88,594,683	177,845,347
c	Leasehold improvements
d	Equipment ....	333,313,653	251,211,522	82,102,131
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				269,695,978

Schedule D (Form 990) 2018

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
ESTIMATED THIRD PARTY SETTLEMENTS	3,286,005
ACCRUED PROFESSIONAL LIABILITY	1,542,934
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	4,828,939
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2018

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	281,128,223
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	8,852,216
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	-124,956
e	Add lines 2a through 2d .....................			2e	8,727,260
3	Subtract line 2e from line 1..................			3	272,400,963
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	272,400,963

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	257,323,530
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................			2e
3	Subtract line 2e from line 1...................			3	257,323,530
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b	124,956
c	Add lines 4a and 4b.....................			4c	124,956
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	257,448,486

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
SCHEDULE D, PAGE 3, PART X	SOUTHWELL AND THE SYSTEM ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACO IS CONSIDERED A DISREGARDED ENTITY TO THE SYSTEM. SOUTHWELL APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE 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, SOUTHWELL ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT MORE THAN IS 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 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 BALANCE SHEET FOR UNRECOGNIZED TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF SEPTEMBER 30, 2019 OR FOR THE YEAR THEN ENDED. SOUTHWELL'S TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAXING AUTHORITIES. FOR FEDERAL INCOME TAX PURPOSES, THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. LEGEND SOUTHWELL - SOUTHWELL, INC. (PARENT) SYSTEM - TIFT REGIONAL HEALTH SYSTEM, INC. ACO - CARE ALLIANCE: AN ACCOUNTABLE CARE ORGANIZATION, LLC
SCHEDULE D, PAGE 4, PART XI, LINE 2D	RECLASSIFIED RENTAL EXPENSES -124,956
SCHEDULE D, PAGE 4, PART XII, LINE 4B	RECLASSIFIED RENTAL EXPENSES 124,956

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

TIFT REGIONAL HEALTH SYSTEM INC

Employer identification number

45-3072990

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 225.0000000000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	15,837,617		15,837,617	6.150 %
b	Medicaid (from Worksheet 3, column a) . . . . .	27,059,334	18,838,671	8,220,663	3.190 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	333,584	146,824	186,760	0.070 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	43,230,535	18,985,495	24,245,040	9.420 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	699,072	37,952	661,120	0.260 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	699,072	37,952	661,120	0.260 %
k	Total. Add lines 7d and 7j .	43,929,607	19,023,447	24,906,160	9.670 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

32,534,411

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

62,051,723

Enter Medicare allowable costs of care relating to payments on line 5.....

69,110,166

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-7,058,443

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)					Facility reporting group
1	TIFT REGIONAL MEDICAL CENTER 901 E 18TH STREET TIFTON,GA31793 137-180	X	X	X	A

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

Yes

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url):

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Indicate the tax year the hospital facility last adopted an implementation strategy: 20

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

If "Yes" (list url):

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 225.000000000000% and FPG family income limit for eligibility for discounted care of %

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

HTTP://WWW.TIFTREGIONAL.COM/FINANCIALA

The FAP application form was widely available on a website (list url):

HTTP://WWW.TIFTREGIONAL.COM/FINANCIALA

A plain language summary of the FAP was widely available on a website (list url):
HTTP://WWW.TIFTREGIONAL.COM/FINANCIALA

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	A
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
GROUP A, FACILITY 1, TIFT REGIONAL MEDICAL CENTER - PART V, LINE 2	EFFECTIVE MARCH 1, 2019, THE TIFT COUNTY HOSPITAL AUTHORITY (THE "AUTHORITY") TRANSFERRED VIA A 40-YEAR LEASE SUBSTANTIALLY ALL OF ITS OPERATIONS, ASSETS AND LIABILITIES TO TIFT REGIONAL HEALTH SYSTEM, INC. THE AUTHORITY IS A GOVERNMENTAL HOSPITAL AUTHORITY ORGANIZED PURSUANT TO THE HOSPITAL AUTHORITY PROVISIONS OF THE OFFICIAL CODE OF GEORGIA. TIFT REGIONAL HEALTH SYSTEM, INC. IS A TAX-EXEMPT ORGANIZATION PURSUANT TO INTERNAL REVENUE CODE SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3).

Schedule H (Form 990) 2018

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?33
Name and address		Type of Facility (describe)
1	TIFT REGIONAL DIALYSIS CENTER 1010 EDGEFIELD DRIVE TIFTON,GA31794	END STAGE RENAL DIALYSIS
2	AFFINITY CLINIC 2225 US HIGHWAY 41N TIFTON,GA31794	MULTI-SPECIALTY CLINIC
3	GEORGIA SPORTS MEDICINE 2227 US HIGHWAY 41N TIFTON,GA31794	ORTHOPAEDIC SURGERY
4	TIFT REGIONAL ANESTHESIA 2227 US HIGHWAY 41N TIFTON,GA31794	ANESTHESIOLOGY
5	SOUTHWELL HEALTH & REHABILITATION 260 MJ TAYLOR ROAD ADEL,GA31620	SKILLED NURSING
6	SOUTH GEORGIA SURGICAL 1007 GREENFIELD DRIVE TIFTON,GA31794	GENERAL SURGERY
7	TIFT REGIONAL UROLOGY 1815 OLD OCILLA ROAD TIFTON,GA31794	UROLOGY
8	AFFINITY PEDIATRICS 39 KENT ROAD SUITE 5 TIFTON,GA31794	PEDIATICS
9	HOSPICE OF TIFT AREA 618 N CENTRAL AVENUE TIFTON,GA31794	HOSPICE
10	TIFT REGIONAL WOUND CARE CENTER 907 E 18TH STREET SUITE 140 TIFTON,GA31794	OUTPATIENT WOUND CARE
11	TIFT REGIONAL OUTPATIENT THERAPY 2227 US HIGHWAY 41N TIFTON,GA31794	OUTPATIENT PT/OT/SPEECH THERAPY
12	AFFINITY PHYSICIANS FOR WOMEN 1493 KENNEDY ROAD SUITE C TIFTON,GA31794	OBSTETRICS AND GYNECOLOGY
13	SOUTHWELL MEDICAL ADEL PRIMARY CARE 172 MJ TAYLOR ROAD ADEL,GA31620	FAMILY MEDICINE
14	ALLURE PLASTIC & RECONSTRUCTIVE 907 E 18TH STREET SUITE 340 TIFTON,GA31794	PLASTIC SURGERY
15	TIFT REGIONAL VASCULAR 1641 MADISON AVENUE TIFTON,GA31794	VASCULAR SURGERY
16	SOUTHWELL NEPHROLOGY 39 KENT ROAD SUITE 1 TIFTON,GA31794	NEPHROLOGY
17	TIFT REGIONAL OPTHALMOLOGY 1803 OLD OCILLA ROAD TIFTON,GA31794	OPTHALMOLOGY/OPTICAL
18	TIFT FAMILY MEDICINE 907 E 18TH STREET SUITE 130 TIFTON,GA31794	FAMILY MEDICINE
19	ARTHRITIS & OSTEOPOROSIS CENTER 2227 US HIGHWAY 41N TIFTON,GA31794	RHEUMATOLOGY
20	AFFINITY CLINICNEUROLOGY 227 US HIGHWAY 41N TIFTON,GA31794	NEUROLOGY
21	OCILLA PEDIATRICS 813 IRWIN AVENUE OCILLA,GA31794	PEDIATRICS
22	AFFINITY PEDIATRICS 3007 2ND STREET NE MOULTRIE,GA31768	PEDIATRICS
23	NASHVILLE PRIMARY CARE 416A E MCPHERSON AVENUE NASHVILLE,GA31639	FAMILY MEDICINE
24	ASHBURN PRIMARY CARE 611 E WASHINGTON AVENUE ASHBURN,GA31714	FAMILY MEDICINE
25	TRMC ONCOLOGY PROFESSIONALS 1623 MADISON AVENUE TIFTON,GA31794	ONCOLOGY
26	AFFINITY CLINIC MOULTRIE 2 HOSPITAL PARK MOULTRIE,GA31768	MULTI-SPECIALTY CLINIC
27	AFFINITY PHYSICIANS FOR WOMEN MOULT 2 HOSPITAL PARK MOULTRIE,GA31768	OBSTETRICS AND GYNECOLOGY
28	SOUTHWELL CENTER FOR HEALING & WELL 39 KENT ROAD SUITE 2 TIFTON,GA31794	FAMILY MEDICINE
29	SOUTHWELL SCHOOL CLINIC 1464 CARPENTER ROAD S TIFTON,GA31794	SCHOOL BASED CLINIC
30	SOUTHWELL SCHOOL CLINIC 700 8TH STREET W TIFTON,GA31794	SCHOOL BASED CLINIC
31	SYLVESTER FAMILY PRACTICE 1010 W FRANKLIN STREET SYLVESTER,GA31791	FAMILY MEDICINE
32	TIFT COMMUNITY HEALTH CENTER 2735 S CENTRAL AVENUE TIFTON,GA31794	FAMILY MEDICINE
33	WORKSMART OCCUPATION HEALTH 4468 UNION ROAD TIFTON,GA31794	OCCUPATIONAL HEALTH

Schedule H (Form 990) 2018

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE	PRICE CONCESSIONS OF 32,534,411 ARE TREATED AS A REDUCTION IN REVENUE ON THE ORGANIZATION'S FINANCIAL STATEMENTS. PRICE CONCESSIONS ARE NOT INCLUDED IN OPERATING EXPENSES. BAD DEBTS (CHARGES CONSIDERED UNCOLLECTIBLE IN THE PERIOD BASED ON A CHANGE IN CREDIT ISSUES THAT WERE NOT ASSESSED AT THE DATE OF SERVICE) ARE INCLUDED IN OPERATING EXPENSES. THERE WERE NO SUCH BAD DEBTS RECORDED DURING THE YEAR. THUS, THERE IS NO NEED TO EXCLUDE AN AMOUNT FROM TOTAL EXPENSES.
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION	A COST-TO-CHARGE RATIO IS CALCULATED USING WORKSHEET 2 FROM THE INSTRUCTIONS TO FORM 990, SCHEDULE H.
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY	IN THE FINANCIAL STATEMENTS, CHANGES IN CREDIT ISSUES THAT ARE NOT ASSESSED AT THE DATE OF SERVICE ARE RECOGNIZED AS BAD DEBT EXPENSE AND ARE INCLUDED AS A COMPONENT OF OPERATING EXPENSES. CREDIT ISSUES THAT ARE ASSESSED AT THE DATE OF SERVICE ARE TREATED AS PRICE CONCESSIONS THAT REDUCE THE TRANSACTION PRICE, WHICH ARE REPORTED AS PART OF NET PATIENT SERVICE REVENUES. THE AMOUNT REPORTED AS BAD DEBTS ON SCHEDULE H, PART III, LINE 2 REPRESENTS THE AMOUNT REPORTED AS PRICE CONCESSIONS. THERE WERE NO BAD DEBTS RECORDED IN OPERATING EXPENSES. BASED UPON MANAGEMENT'S JUDGEMENT AND EXPERIENCE, 100% OF SELF-PAY ACCOUNT BALANCES ARE RECORDED AS PRICE CONCESSIONS.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS	IN 2019, SOUTHWELL, INC. (INCLUDING TIFT REGIONAL HEALTH SYSTEM, INC.) ADOPTED FASB ASU NO. 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606), WHICH IS A NEW COMPREHENSIVE REVENUE RECOGNITION STANDARD. THE CORE PRINCIPLE OF THE REVENUE MODEL IS THAT AN ENTITY RECOGNIZES REVENUE TO DEPICT THE TRANSFER OF PROMISED GOODS OR SERVICES TO CUSTOMERS IN AN AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE ENTITY EXPECTS TO BE ENTITLED IN EXCHANGE FOR THOSE GOODS OR SERVICES. SOUTHWELL ADOPTED ASU NO. 2014-09 ON OCTOBER 1, 2018 USING THE MODIFIED RETROSPECTIVE METHOD OF TRANSITION AND PRACTICAL EXPEDIENT IN FASB ASC 606-10-65-1(F)(4) WITH NO SIGNIFICANT IMPACT. THE NEW GUIDANCE WAS APPLIED ONLY TO CONTRACTS THAT ARE NOT COMPLETED AT THE DATE OF THE INITIAL APPLICATION. SOUTHWELL PERFORMED AN ANALYSIS OF REVENUE STREAMS AND TRANSACTIONS UNDER ASU NO. 2014-09. IN PARTICULAR, FOR NET PATIENT SERVICE REVENUE, SOUTHWELL PERFORMED AN ANALYSIS INTO THE APPLICATION OF THE PORTFOLIO APPROACH AS A PRACTICAL EXPEDIENT TO GROUP PATIENT CONTRACTS WITH SIMILAR CHARACTERISTICS, SUCH THAT REVENUE FOR A GIVEN PORTFOLIO WOULD NOT BE MATERIALLY DIFFERENT THAN IF IT WERE EVALUATED ON A CONTRACT-BY-CONTRACT BASIS. UPON ADOPTION, THE MAJORITY OF WHAT WAS PREVIOUSLY CLASSIFIED AS PROVISION FOR BAD DEBTS AND PRESENTED AS A REDUCTION TO NET PATIENT SERVICE REVENUE ON THE STATEMENTS OF OPERATION IS NOW TREATED AS A PRICE CONCESSION THAT REDUCES THE TRANSACTION PRICE, WHICH IS REPORTED AS NET PATIENT SERVICE REVENUE. CHANGES IN CREDIT ISSUES NOT ASSESSED AT THE DATE OF SERVICE, ARE RECOGNIZED AS BAD DEBT EXPENSE AND INCLUDED AS A COMPONENT OF OPERATING EXPENSES ON THE STATEMENT OF OPERATIONS. THE NEW STANDARD ALSO REQUIRES ENHANCED DISCLOSURES RELATED TO THE DISAGGREGATION OF REVENUE AND SIGNIFICANT JUDGMENTS MADE IN MEASUREMENT AND RECOGNITION. THE ADOPTION OF THIS GUIDANCE DID NOT MATERIALLY IMPACT TOTAL OPERATING REVENUES, EXCESS OF REVENUES OVER EXPENSES, OR NET ASSETS.
PART III, LINE 8 - MEDICARE EXPLANATION	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. THE FULL AMOUNT OF THE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT. MEDICARE IS A FEDERAL PROGRAM WHICH DICTATES PAYMENT RATES AND CONDITIONS OF PARTICIPATION FOR SERVING CERTAIN ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. SERVING THE NEEDS OF OUR CITIZENS AT BELOW MEDICARE'S COMPUTATION OF COSTS PROVIDES NECESSARY LOCAL CARE FOR A SEGMENT OF THE POPULATION THAT CONSTITUTES A CHARITABLE CLASS.
PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION	PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY ("FAP") RECIEVE A 100% DISCOUNT. THERE ARE NO COLLECTION ACTIVITIES FOR QUALIFYING FAP-ELIGIBLE PATIENTS.
PART VI, LINE 2 - NEEDS ASSESSMENT	AS A GOVERNMENTAL ORGANIZATION OPERATED UNDER THE GEORGIA HOSPITAL AUTHORITIES LAW PRIOR TO MARCH 1, 2019, THE HOSPITAL WAS NOT SUBJECT TO INTERNAL REVENUE CODE SECTION 501(R). NEVERTHELESS, THE HOSPITAL AUTHORITY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENTS IN 2014 AND 2017 FOR ITS TIFTON CAMPUS. IN ADDITION, AS PART OF THE STRATEGIC PLANNING PROCESS FOR EACH CAMPUS, COMMUNITY INPUT RELATED TO HEALTH NEEDS IS RECEIVED FROM A VARIETY OF SOURCES, INCLUDING PHYSICIANS, NURSING STAFF AND COMMUNITY MEMBERS.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY ("FAP"), PLAIN LANGUAGE SUMMARY AND FINANCIAL ASSISTANCE APPLICATION ARE AVAILABLE ONLINE AND UPON REQUEST AT THE 2 HOSPITAL CAMPUSES (TRMC AND SOUTHWELL MEDICAL). A PLAIN LANGUAGE SUMMARY OF THE POLICY IS OFFERED TO EACH PATIENT UPON ADMISSION AND SIGNAGE IS POSTED THROUGHOUT BOTH CAMPUSES REGARDING THE FAP.
PART VI, LINE 4 - COMMUNITY INFORMATION	TIFT REGIONAL HEALTH SYSTEM, INC. SERVES A 12-COUNTY AREA OF SOUTHWEST GEORGIA WITH A TOTAL POPULATION IN EXCESS OF A QUARTER OF A MILLION INDIVIDUALS. THE POPULATION FOR THE COUNTIES IN THE PRIMARY SERVICE AREA (2010 US CENSUS) ARE - TIFT COUNTY (40,787), TURNER COUNTY (8,338), AND COOK COUNTY (17,033). THE 9 COUNTIES IN THE SECONDARY SERVICE AREA INCLUDE ATKINSON, BENHILL, BERRIEN, COFFEE, COLQUITT, CRISP, IRWIN, WILCOX AND WORTH COUNTIES HAVE A 2010 TOTAL POPULATION OF 196,667. THIS AREA OF GEORGIA HAS A MEDIAN AGE SIMILAR TO THE STATE AVERAGE, LOWER MEDIAN HOUSEHOLD INCOMES, LOWER EDUCATIONAL ATTAINMENT AND HIGHER DISABILITY RATES. IN THE PRIMARY SERVICE AREA, OVER 50% OF THE POPULATION LIVES BELOW 200% OF THE FEDERAL POVERTY LINE. MORE THAN A THIRD OF THE POPULATION OF TIFT COUNTY AND COOK COUNTY ARE OBESE, AND THE OBESITY RATE IN TURNER COUNTY IS 31.1%. HEART DISEASE IS THE LEADING CAUSE OF DEATH IN THE PRIMARY SERVICE AREA AND MORE THAN 30% HIGHER THAN THE AVERAGE FOR THE STATE.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH	TIFT REGIONAL HEALTH SYSTEM, INC. IS GOVERNED BY AN INDEPENDENT BOARD OF DIRECTORS COMPRISED OF COMMUNITY REPRESENTATIVES. THE ORGANIZATION IS A NOT-FOR-PROFIT ORGANIZATION UNDER GEORGIA LAW AND ANY EXCESS REVENUES OVER EXPENSES ARE REINVESTED INTO SERVING THE HEALTHCARE NEEDS OF THE COMMUNITY. TIFT REGIONAL MEDICAL CENTER ("TRMC") IS A 181-BED REGIONAL REFERRAL HOSPITAL THAT OPERATES AN EMERGENCY ROOM 24/7/365. SOUTHWELL MEDICAL IS A 60-BED HOSPITAL CAMPUS OF TRMC (INCLUDING 12 GERIATRIC PSYCHIATRIC BEDS). A 95-BED SKILLED NURSING FACILITY (SOUTHWELL HEALTH & REHABILITATION) IS ALSO LOCATED ON THIS CAMPUS. TRMC, SOUTHWELL MEDICAL, AND SOUTHWELL HEALTH & REHABILITATION PARTICIPATE IN THE MEDICARE AND MEDICAID PROGRAMS, AND TREAT ALL PATIENTS IN A NONDISCRIMINATORY MANNER WITHOUT REGARD TO THEIR ABILITY TO PAY FOR ANY EMERGENCY OR MEDICALLY NECESSARY CARE. THE MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM	TIFT REGIONAL HEALTH SYSTEM, INC. OPERATES TIFT REGIONAL MEDICAL CENTER, A 181-BED REGIONAL REFERRAL HOSPITAL LOCATED IN TIFTON, GEORGIA; AND SOUTHWELL MEDICAL (FORMERLY COOK MEDICAL CENTER), A 60-BED HOSPITAL CAMPUS OF TRMC (INCLUDING 12 GERIATRIC PSYCHIATRIC BEDS) AND A 95-BED SKILLED NURSING FACILITY, LOCATED IN ADEL, GEORGIA. TIFT REGIONAL MEDICAL CENTER FOUNDATION, INC. IS RESPONSIBLE FOR FUNDRAISING EFFORTS BENEFITING TIFT REGIONAL HEALTH SYSTEM, INC. SOUTHWELL, INC. SERVES AS THE PARENT ORGANIZATION AND IS RESPONSIBLE FOR STRATEGIC AND FINANCIAL PLANNING FOR TIFT REGIONAL HEALTH SYSTEM, INC. AND AFFILATED ENTITIES, AND RESOURCE ALLOCATION BETWEEN THE AFFILIATED ENTITIES. TIFT ENTERPRISES, INC. IS A FOR PROFIT SUBSIDIARY OF SOUTHWELL, INC. IT SERVES AS A HOLDING COMPANY FOR CERTAIN INVESTMENTS AND PROVIDES LIMITED MANAGEMENT SERVICES.
PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT	GEORGIA
ADDITIONAL INFORMATION	THE FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFITS PRESENTED ON LINES 7A-K IN PART I OF SCHEDULE H INCLUDE BENEFITS GENERATED FROM BOTH TIFT REGIONAL MEDICAL CENTER AND THE SOUTHWELL MEDICAL CAMPUS. THE ESTIMATED MEDICAID SHORTFALL FOR TIFT REGIONAL MEDICAL CENTER ("TRMC") WAS CALCULATED USING PRORATED AMOUNTS FROM ITS MEDICARE COST REPORT FOR THE 7 MONTHS TRMC WAS OPERATED BY TIFT REGIONAL HEALTH SYSTEM, INC. (SINCE THE COST REPORT WAS FILED FOR A 12-MONTH PERIOD INCLUDING THE PERIOD THE FACILITY WAS OPERATED BY THE TIFT COUNTY HOSPITAL AUTHORITY). THE ESTIMATED MEDICAID SHORTFALL FOR THE SOUTHWELL MEDICAL CAMPUS WAS ESTIMATED FROM ITS TRIAL BALANCE. THE MEDICARE COST REPORT FOR THE SOUTHWELL MEDICAL CAMPUS IS PREPARED ON A DIFFERENT FISCAL YEAR END FROM THAT OF THE TIFT REGIONAL MEDICAL CENTER. PRIOR TO BEING PURCHASED BY THE TIFT COUNTY HOSPITAL AUTHORITY, SOUTHWELL MEDICAL WAS KNOWN AS MEMORIAL HOSPITAL OF ADEL, AND OPERATED AS AN UNRELATED ORGANIZATION. MEMORIAL HOSPITAL OF ADEL FACED CLOSURE DUE TO SIGNIFICANT FINANCIAL LOSSES. THE TIFT COUNTY HOSPITAL AUTHORITY ACQUIRED MEMORIAL HOSPITAL OF ADEL, BUILT AND REOPENED A NEW FACILITY, SOUTHWELL MEDICAL, A CAMPUS OF TIFT REGIONAL MEDICAL CENTER (SOUTHWELL MEDICAL WAS FORMERLY WAS KNOWN AS COOK MEDICAL CENTER, A CAMPUS OF TIFT REGIONAL MEDICAL CENTER). TRMC AND SOUTHWELL MEDICAL, A CAMPUS OF TRMC, WERE TRANSFERRED TO TIFT REGIONAL HEALTH SYSTEM AS PART OF THE 40-YEAR LEASE AGREEMENT.

Schedule H (Form 990) 2018

Additional Data

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
TIFT REGIONAL HEALTH SYSTEM INC

Employer identification number
45-3072990

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	TIFT COUNTY HOSPITAL AUTHORITY	58-6001719	886640HS3	03-01-2019	81,326,130	FINANCE/REFINANCE ADDITIONS AND IMPROVEMENTS TO HOSPITAL FACILITY; REFUND		X		X		X
B	TD BANK MASTER NOTES	58-6001719	NONENONEN	03-01-2019	38,200,000	BRIDGE LOANS FOR CONSTRUCTION OF SOUTHWELL HOSPITAL FACILITY		X		X		X
C	BANK OF AMERICA LEASE OBLIGATIONS	58-6001719	NONENONEN	03-01-2019	31,862,844	ACQUISITION, INSTALLATION AND IMPLEMENTATION OF EMR SYSTEM		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	81,326,130		38,200,000		31,862,844
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............	81,326,130		38,200,000		31,862,844
7 Issuance costs from proceeds ...............
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............
11 Other spent proceeds .............
12 Other unspent proceeds .............
13 Year of substantial completion .............	2017		2019		2017
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X		X		X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X
16 Has the final allocation of proceeds been made? ..........		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X		X		X
b Exception to rebate? ........		X		X		X
c No rebate due? .........		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X	X			X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference

Explanation

SCHEDULE K - PURPOSE OF ISSUE DESCRIPTION

TIFT COUNTY HOSPITAL AUTHORITY OUTSTANDING 2002 BONDS; REPAY A BANK LOAN; AND PAY ISSUANCE COST OF 2013 BONDS.

SCHEDULE K - ADDITIONAL INFORMATION

TIFT COUNTY HOSPITAL AUTHORITY EFFECTIVE MARCH 1, 2019 THE OPERATIONS, ASSETS AND LIABILITIES OF THE TIFT COUNTY HOSPITAL AUTHORITY AN INSTRUMENTALITY OF THE STATE OF GEORGIA, WERE TRANSFERRED TO TIFT REGIONAL HEALTH SYSTEM, INC., AN ORGANIZATION EXEMPT FROM INCOME TAXES PURSUANT TO IRC SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3). AS A RESULT, THE EXISTING TAX-EXEMPT DEBT OF THE HOSPITAL AUTHORITY WAS REISSUED AS QUALIFIED 501(C)(3) DEBT. AS A RESULT OF THE REISSUANCE, THE NEW OBLIGATIONS ARE TREATED AS CURRENTLY REFUNDING THE AUTHORITY'S DEBT AT THE DATE OF THE TRANSFER.

Schedule K (Form 990) 2018

Additional Data

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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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

TIFT REGIONAL HEALTH SYSTEM INC

Employer identification number

45-3072990

Return Reference	Explanation
FORM 990, PAGE 2, PART III, LINE 2	EFFECTIVE MARCH 1, 2019, TIFT REGIONAL HEALTH SYSTEM, INC. (TRHS) EXECUTED A 40-YEAR LEASE AGREEMENT WITH THE TIFT COUNTY HOSPITAL AUTHORITY (THE "AUTHORITY"), A GOVERNMENTAL HOSPITAL AUTHORITY ORGANIZED UNDER THE HOSPITAL AUTHORITIES PROVISIONS OF THE OFFICIAL CODE OF GEORGIA. UNDER THE AGREEMENT, TRHS ASSUMED SUBSTANTIALLY ALL OF THE OPERATIONS, ASSETS AND LIABILITIES OF THE AUTHORITY. BEGINNING MARCH 1, 2019, TRHS OPERATES TIFT REGIONAL MEDICAL CENTER, A NONPROFIT 181-BED REGIONAL REFERRAL HOSPITAL LOCATED IN TIFTON, GEORGIA. THIS CAMPUS SERVES 12 COUNTIES OF SOUTH-CENTRAL GEORGIA. TRHS ALSO OPERATES SOUTHWELL MEDICAL, A CAMPUS OF TIFT REGIONAL MEDICAL CENTER (FORMERLY KNOWN AS COOK MEDICAL CENTER). LOCATED IN ADEL, GEORGIA, THIS ACUTE CARE HOSPITAL WAS PURCHASED BY THE TIFT COUNTY HOSPITAL AUTHORITY ON JULY 1, 2012. IT OPENED AT ITS NEW CAMPUS ON OCTOBER 1, 2019, AND WAS TRANSFERRED TO TRHS AS PART OF THE 40-YEAR LEASE ON MARCH 1, 2019. THIS HOSPITAL OPERATES AS A CAMPUS OF TIFT REGIONAL MEDICAL CENTER. WITH 60 BEDS, IT IS NOT A SEPARATELY LICENSED FACILITY. A 95-BED SKILLED NURSING FACILITY, SOUTHWELL HEALTH & REHABILITATION, IS ALSO LOCATED ON THE SOUTHWELL MEDICAL CAMPUS. TRHS IS THE SOLE MEMBER OF CARE ALLIANCE: AN ACCOUNTABLE CARE ORGANIZATION, LLC.
FORM 990, PAGE 2, PART III, LINE 4A	TIFT REGIONAL HEALTH SYSTEM (TRHS) IS A GROWING, NOT-FOR-PROFIT HOSPITAL SYSTEM. ITS MAIN CAMPUS SERVES 12 COUNTIES IN SOUTH CENTRAL GEORGIA. TRHS OFFERS MORE THAN 135 PHYSICIANS WITH EXPERTISE IN OVER 30 SPECIALTIES. TRHS PROVIDES A WIDE RANGE OF CARE, INCLUDING SIGNATURE SERVICES IN SURGERY, ONCOLOGY, CARDIOVASCULAR CARE, WOMENS HEALTH, NEURODIAGNOSTICS, GERIATRIC PSYCHIATRIC CARE, RADIOLOGY AND MORE. THE MAIN CAMPUS IS TIFT REGIONAL MEDICAL CENTER (TRMC), A 181-BED REGIONAL REFERRAL HOSPITAL LOCATED IN TIFTON AT 901 EAST 18TH STREET. TIFT REGIONAL MEDICAL CENTERS WEST CAMPUS, LOCATED IN TIFTON AT 2225 HIGHWAY 41 NORTH, IS AN OUTPATIENT FACILITY WHICH HOUSES VARIOUS DIAGNOSTIC SERVICES AND THE REGIONS LARGEST MULTI-SPECIALTY PHYSICIAN PRACTICE. LOCATED IN ADEL, SOUTHWELL MEDICAL, A CAMPUS OF TRMC, IS A 60-BED HOSPITAL (THAT IS NOT SEPARATELY LICENSED) INCLUDING A 12-BED GERIATRIC PSYCHIATRIC UNIT. A 95-BED SKILLED NURSING REHABILITATION FACILITY, SOUTHWELL HEALTH & REHABILITATION, IS LOCATED ON THE SOUTHWELL MEDICAL CAMPUS. TRHS IS ALSO THE SOLE MEMBER OF CARE ALLIANCE: AN ACCOUNTABLE CARE ORGANIZATION, LLC.
FORM 990, PAGE 6, PART VI, LINE 4	THE ARTICLES OF INCORPORATION WERE AMENDED AND RESTATED ON DECEMBER 21, 2018 TO ADD PROVIDE FULL POWER AND AUTHORITY FOR THE ORGANIZATION TO OPERATE TIFT REGIONAL MEDICAL CENTER, COOK SENIOR LIVING CENTER (NOW SOUTHWELL HEALTH & REHABILITATION), COOK MEDICAL CENTER (NOW SOUTHWELL MEDICAL), VARIOUS PHYSICIAN PRACTICES AND CLINICS, AND OTHER HEALTH CARE FACILITIES. THE RESTATED ARTICLES OF INCORPORATION NAME AND ESTABLISH SOUTHWELL, INC. (A RELATED TAX-EXEMPT ORGANIZATION DESCRIBED IN IRC SECTION 501(C)(3)) AS THE SOLE MEMBER OF THE ORGANIZATION; RESERVE CERTAIN ACTIONS REQUIRING THE APPROVAL OF THE SOLE MEMBER (WHICH ARE IDENTIFIED IN RESPONSE TO FORM 990, PART VI, QUESTION 7B); AND CLARIFY THAT UPON DISSOLUTION, THE ASSETS REMAINING AFTER PAYMENT OF ALL LIABILITIES ARE TO BE DISTRIBUTED TO THE MEMBER, ONE OR MORE AFFILIATES OF THE MEMBER, OR TO TIFT REGIONAL MEDICAL CENTER FOUNDATION PROVIDED ANY SUCH RECIPIENT IS DESCRIBED IN IRC SECTION 501(C)(3) AT THAT TIME. IF NONE OF THESE ORGANIZATIONS ARE ABLE TO ACCEPT TITLE TO THE ASSETS FOR ANY REASON (INCLUDING NOT BEING A 501(C)(3) TAX- EXEMPT ENTITY), ALL OF THE ASSETS ARE TO BE DISTRIBUTED TO ANOTHER ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OR CORRESPONDING SECTION OF ANY FUTURE FEDERAL TAX CODE. ANY ASSETS NOT DISPOSED OF IN THIS MANNER, SHALL BE DISPOSED OF BY A COURT OF COMPETENT JURISDICTION IN THE COUNTY IN WHICH THE PRINCIPAL OFFICE OF THE CORPORATION IS LOCATED.
FORM 990, PAGE 6, PART VI, LINE 6	SOUTHWELL, INC. IS THE SOLE MEMBER OF TIFT REGIONAL HEALTH SYSTEM, INC. SOUTHWELL IS A 501(C)(3) TAX-EXEMPT ORGANIZATION.
FORM 990, PAGE 6, PART VI, LINE 7A	APPOINTMENT TO THE BOARD OF DIRECTORS IS SUBJECT TO THE APPROVAL OF THE SOLE MEMBER, SOUTHWELL, INC.
FORM 990, PAGE 6, PART VI, LINE 7B	SOUTHWELL, INC. IS THE SOLE MEMBER OF TIFT REGIONAL HEALTH SYSTEM, INC. THE FOLLOWING ACTIONS CANNOT BE TAKEN WITHOUT THE APPROVAL OF THE MEMBER: 1) FILL VACANCIES IN, NOMINATE AND APPROVE THE ELECTION OF AND APPROVE OR DIRECT THE REMOVAL OF DIRECTORS OF TRHS; 2) APPROVE ALL AMENDMENTS, MODIFICATIONS, RESTATEMENTS AND ALTERATIONS OF TRHS'S ARTICLES OF INCORPORATION OR BYLAWS; 3) APPROVE MERGERS, CONSOLIDATIONS, ACQUISITIONS, JOINT VENTURES, AFFILIATIONS OR ANY OTHER REORGANIZATION OF TRHS; 4) APPROVE THE SALE, TRANSFER, LONG-TERM LEASE, LONG-TERM ENCUMBRANCE, MORTGAGE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL ASSETS OF TRHS AND OF ANY REAL PROPERTY OWNED BY TRHS; 5) APPROVE ANY PLAN OF DISSOLUTION; 6) APPROVE AND DETERMINE THE DISTRIBUTION OF ASSETS OF THE CORPORATION UPON DISSOLUTION OF TRHS SUBJECT TO ARTICLE V OF THE TRHS'S ARTICLES OF INCORPORATION; 7) ADD OR REMOVE MEMBERS OF TRHS; 8) APPROVE ANY MATERIAL INCURRENCE OF DEBT THAT REQUIRES AN ADDENDUM TO THE MASTER TRUST INDENTURE, EXCLUDING CAPITAL LEASES OF LESS THAN 1,000,001; 9) APPOINT OR REMOVE THE CHAIR OF THE BOARD OF DIRECTORS OF TRHS; 10) APPROVE THE ANNUAL BUDGET OF TRHS; 11) SELECT THE AUDITOR FIRM FOR TRHS AND APPROVE THE ANNUAL AUDIT PERFORMED BY SUCH FIRM; 12) APPROVE CAPITAL EXPENDITURES BY TRHS OF 1,000,001 OR GREATER; 13) APPROVE SCOPE OF SERVICES PROVIDED BY TRHS; 14) APPOINT OR REMOVE THE PRESIDENT/CEO OF TRHS; AND 15) APPROVE ANY AMENDMENT TO THE LEASE BETWEEN THE HOSPITAL AUTHORITY OF TIFT COUNTY AND TRHS.
FORM 990, PAGE 6, PART VI, LINE 11B	INFORMATION FOR PREPARATION OF THIS RETURN WAS PROVIDED TO AN INDEPENDENT CERTIFIED PUBLIC ACCOUNTANT. AFTER THE RETURN WAS PREPARED AND PRIOR TO FILING, IT WAS REVIEWED IN DETAIL BY SENIOR FINANCIAL MANAGEMENT. A COPY OF THE RETURN WAS THEN MADE AVAILABLE TO ALL BOARD MEMBERS TO REVIEW PRIOR TO FILING.
FORM 990, PAGE 6, PART VI, LINE 12C	TRHS ANNUALLY DISTRIBUTES A CONFLICT OF INTEREST QUESTIONNAIRE TO EACH MEMBER OF THE BOARD OF DIRECTORS. BOARD MEMBERS MUST DISCLOSE ANY POTENTIAL CONFLICTS. ANY BOARD MEMBER WITH A POTENTIAL CONFLICT MUST RECUSE THEMSELVES FROM THE MEETING AT WHICH ANY POTENTIAL CONFLICT IS DISCUSSED. ONLY NON-CONFLICTED MEMBERS MAY DECIDE TO PURSUE A TRANSACTION INVOLVING A CONFLICT IF A MAJORITY DETERMINES THE TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST. VIOLATION OF THE COI POLICY IS SUBJECT TO CORRECTIVE ACTION.
FORM 990, PAGE 6, PART VI, LINE 15A	THE TIFT REGIONAL HEALTH SYSTEM, INC.("TRHS") BOARD OF DIRECTORS HAS APPOINTED A COMMITTEE OF INDEPENDENT, CONFLICT-FREE BOARD MEMBERS TO DEVOTE THEIR TIME AND ATTENTION TO THE OVERSIGHT OF TRHSS EXECUTIVE COMPENSATION PROGRAMS. THE COMMITTEE ANNUALLY RETAINS INDEPENDENT ADVISORS (INCLUDING HEALTH CARE COMPENSATION CONSULTANTS) TO PROVIDE THIRD-PARTY INFORMATION AND ADVICE, TO ENSURE EXECUTIVE COMPENSATION IS REASONABLE WHEN COMPARED TO THE PRACTICES OF OTHER SIMILARLY SITUATED ORGANIZATIONS, AND THAT THE PROGRAM HAS SIGNIFICANT AND APPROPRIATE COMPENSATION THAT IS SUBJECT TO MEETING ORGANIZATIONAL AND INDIVIDUAL GOALS (TO ENSURE THE ALIGNMENT OF PAY AND PERFORMANCE). COMPENSATION IS APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD, WHO ARE INDEPENDENT WITH NO FINANCIAL INTEREST IN THE COMPENSATION THEY REVIEW AND APPROVE. INCENTIVE BASED COMPENSATION IS CALCULATED BASED ON ACHIEVEMENTS AGAINST GOALS AND METRICS THAT WERE PRE-APPROVED BY THE BOARD. THE GOALS AND METRICS SPAN TRHS'S FIVE PILLARS OF SERVICE: QUALITY, FINANCE, PEOPLE, GROWTH AND COMMUNITY. THE PERFORMANCE PAY PLAN IS INTENDED TO REWARD EXECUTIVES FOR EXEMPLARY PERFORMANCE AND TO BE PART OF A COMPETITIVE TOTAL COMPENSATION PACKAGE. TOTAL COMPENSATION (INCLUDING THE PERFORMANCE PAY PLAN) IS DETERMINED TO BE REASONABLE AND STRICTLY COMPLIANT WITH ALL RULES AND REGULATIONS THAT GOVERN EXECUTIVE PAY AT A TAX-EXEMPT ORGANIZATION LIKE TRHS.
FORM 990, PAGE 6, PART VI, LINE 15B	SEE THE RESPONSE TO 15A ABOVE.
FORM 990, PAGE 6, PART VI, LINE 19	GOVERNING DOCUMENTS ARE FILED WITH AND AVAILABLE ON THE GEORGIA SECRETARY OF STATE WEBSITE OR THROUGH THAT OFFICE. GOVERNING DOCUMENTS CAN ALSO BE OBTAINED BY CONTACTING TRHS. TRHS IS UNDER OBLIGATION TO DISCLOSE TO BOND HOLDERS PERTINENT FINANCIAL INFORMATION. A PUBLIC INSPECTION COPY OF FORM 990 IS AVAILABLE UPON REQUEST AND UPON THE TRHS WEBSITE.
FORM 990, PART VII	THE EMPLOYEES OF THE TIFT COUNTY HOSPITAL AUTHORITY (THE "AUTHORITY") WERE TRANSFERRED TO THE TIFT REGIONAL HEALTH SYSTEM, INC. ("TRHS"), EFFECTIVE JANUARY 1, 2019. THERE WAS NO REPORTABLE COMPENSATION PAID BY TRHS FOR CALENDAR YEAR 2018 TO REPORT IN PART VII OF FORM 990. THE HOSPITAL DID NOT BEGIN OPERATING AS PART OF TRHS UNTIL MARCH 1, 2019. (TIFT COUNTY HOSPITAL AUTHORITY TRANSFERRED SUBSTANTIALLY ALL OPERATIONS, ASSETS AND LIABILITIES TO TRHS VIA LEASE ON THAT DATE). PRIOR TO JANUARY 1, 2019, THE HOSPITAL WAS OWNED AND OPERATED BY THE AUTHORITY AND ALL EMPLOYEES WERE EMPLOYED BY THE AUTHORITY. THE AUTHORITY AND TRHS ARE NOT RELATED ORGANIZATIONS.
FORM 990, PART XI, LINE 9	TRANSFER FROM TIFT COUNTY HOSPITAL AUTHORITY 541,866,611 EQUITY TRANSFER - SOUTHWELL, INC. 311,133 TOTAL 542,177,744

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

TIFT REGIONAL HEALTH SYSTEM INC

Employer identification number

45-3072990

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) End-of-year assets	(f) Direct controlling entity
(1) CARE ALLIANCE AN ACCOUNTABLE CARE ORGANIZATION PO BOX 2650 TIFTON,GA31793 47-4357229	ACO	GA	10,000	TRHS

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)SOUTHWELL INC PO BOX 747 TIFTON,GA31793 58-1772605	PARENT	GA	501C3	12C	N/A		No
(2)TIFT REGIONAL MEDICAL CENTER FND PO BOX 747 TIFTON,GA31793 58-1705285	FUNDRAISIN	GA	501C3	7	N/A		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2018

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) COASTAL PLAINS HEALTH ALLIANCE LLC PO DRAWER 1287 TIFTON,GA31793 58-2412081	HEALTHCARE	GA	N/A				No			No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) TIFT ENTERPRISES INC PO BOX 747 TIFTON,GA31793 58-1986064	MGMT. SVCS	GA	N/A					No

Schedule R (Form 990) 2018

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2018

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2018

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: OUR MISSION IS TO DELIVER A LIFETIME OF QUALITY AND COMPASSIONATE CARE FOR EACH PATIENT WE SERVE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	8
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	6
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	1
6	Total number of volunteers (estimate if necessary) .............	6	99
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........		1,118,273
9	Program service revenue (Part VIII, line 2g) .........		253,173,677
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	77	14,764,121
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-49,031	3,344,892
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	-48,954	272,400,963
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)		152,220,028
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....		105,228,458
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)		257,448,486
19	Revenue less expenses. Subtract line 18 from line 12.......	-48,954	14,952,477
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	666,250	904,950,801
21	Total liabilities (Part X, line 26).............		338,302,114
22	Net assets or fund balances. Subtract line 21 from line 20.....	666,250	566,648,687

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 214,699,413 including grants of $ ) (Revenue $ 255,115,393 )
	TIFT REGIONAL HEALTH SYSTEM (TRHS) IS A GROWING, NOT-FOR-PROFIT HOSPITAL SYSTEM. ITS MAIN CAMPUS SERVES 12 COUNTIES IN SOUTH CENTRAL GEORGIA. TRHS OFFERS MORE THAN 135 PHYSICIANS WITH EXPERTISE IN OVER 30 SPECIALTIES. TRHS PROVIDES A WIDE RANGE OF CARE, INCLUDING SIGNATURE SERVICES IN SURGERY, ONCOLOGY, CARDIOVASCULAR CARE, WOMENS HEALTH, NEURODIAGNOSTICS, GERIATRIC PSYCHIATRIC CARE, RADIOLOGY AND MORE. THE MAIN CAMPUS IS TIFT REGIONAL MEDICAL CENTER (TRMC), A 181-BED REGIONAL REFERRAL HOSPITAL LOCATED IN TIFTON AT 901 EAST 18TH STREET. TIFT REGIONAL MEDICAL CENTERS WEST CAMPUS, LOCATED IN TIFTON AT 2225 HIGHWAY 41 NORTH, IS AN OUTPATIENT FACILITY WHICH HOUSES VARIOUS DIAGNOSTIC SERVICES AND THE REGIONS LARGEST MULTI-SPECIALTY PHYSICIAN PRACTICE. LOCATED IN ADEL, SOUTHWELL MEDICAL, A CAMPUS OF TRMC, IS A 60-BED HOSPITAL (THAT IS NOT SEPARATELY LICENSED) INCLUDING A 12-BED GERIATRIC PSYCHIATRIC UNIT. A 95-BED SKILLED NURSING REHABILITATION FACILITY, SOUTHWELL HEALTH & REHABILITATION, IS LOCATED ON THE SOUTHWELL MEDICAL CAMPUS. TRHS IS ALSO THE SOLE MEMBER OF CARE ALLIANCE: AN ACCOUNTABLE CARE ORGANIZATION, LLC.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses214,699,413

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) JOHN BROWNLEE...................................................................... CHAIRMAN	2.00 .................	X	X	0	0	0
(2) DALLAS HUNT...................................................................... VICE CHARIMA	2.00 .................	X	X	0	0	0
(3) JESSICA BEIER MD...................................................................... DIRECTOR	2.00 .................	X		0	0	0
(4) WILLIAM BOWEN...................................................................... DIRECTOR	2.00 .................	X		0	0	0
(5) JOYCE MIMS...................................................................... SECRETARY	2.00 .................	X	X	0	0	0
(6) CHASE DAUGHTREY...................................................................... DIRECTOR	2.00 .................	X		0	0	0
(7) SCOTT FULP...................................................................... DIRECTOR	2.00 .................	X		0	0	0
(8) JAMES SCOTT MD...................................................................... DIRECTOR	2.00 .................	X		0	0	0
(9) CHRISTOPHER DORMAN...................................................................... PRESIDENT &	40.00 .................		X	0	0	0
(10) KAREN SUMMERLIN...................................................................... SVP & GEN. C	40.00 .................		X	0	0	0
(11) KIMBERLY WILLS...................................................................... SVP & CFO	40.00 .................		X	0	0	0
(12) CAROL SMITH...................................................................... SVP & CNO	40.00 .................		X	0	0	0
(13) CLAIRE BYRNES...................................................................... SVP AMBULATO	40.00 .................		X	0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	434,301
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	683,972

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		1,118,273

		Business Code
2a	NET PATIENT SERVICE REVENUE	623000	225,507,670	225,507,670
b	EMPLOYEE LEASE - HOSP. AUTH.	623000	27,394,346	27,394,346
c	CLINIC AND OTHER PATIENT REV.	621110	182,389	182,389
d	MOB & DATA CENTER	531190	89,272	89,272
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		253,173,677

3 Investment income (including dividends, interest, and othersimilar amounts) ......			5,187,860			5,187,860
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	25,368	138,410,497
b	Less: cost or other basis and sales expenses	14,376	128,845,228
c	Gain or (loss)	10,992	9,565,269
d	Net gain or (loss).....			9,576,261			9,576,261
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	EMPLOYEE PHARMACY		623000	1,403,176			1,403,176
b	CAFETERIA & VENDING		722514	893,376	893,376
c	REBATES AND DISCOUNTS		623000	830,424	830,424
d	All other revenue ....			217,916	217,916
e	Total. Add lines 11a–11d ......			3,344,892
12	Total revenue. See Instructions......			272,400,963	255,115,393		16,167,297

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21
2	Grants and other assistance to domestic individuals. See Part IV, line 22
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	2,501,464	1,124,910	1,376,554
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	120,462,619	96,188,865	24,273,754
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	2,600,064	2,057,691	542,373
9	Other employee benefits .......	20,321,072	16,082,096	4,238,976
10	Payroll taxes ...........	6,334,809	5,013,368	1,321,441
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	92,164		92,164
c	Accounting ...........	100,335		100,335
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	19,472,623	15,243,997	4,228,626
12	Advertising and promotion ....	330,708		330,708
13	Office expenses .......	2,601,099	1,861,873	739,226
14	Information technology ......	7,397,980	5,854,761	1,543,219
15	Royalties ..
16	Occupancy ...........	5,002,589	4,552,856	449,733
17	Travel ............	394,774	394,774
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	276,085	276,085
20	Interest ...........	2,601,182	2,367,336	233,846
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	20,214,474	18,529,202	1,685,272
23	Insurance ...	325,901	296,603	29,298
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL & SURGICAL SUPP.	21,702,140	21,702,140
b	PHARMACY & DRUGS	19,175,734	19,175,734
c	PROVIDER TAXES	2,723,101	2,723,101
d	OTHER	992,579	278,418	714,161
e	All other expenses	1,824,990	975,603	849,387
25	Total functional expenses. Add lines 1 through 24e	257,448,486	214,699,413	42,749,073	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			29,039	1	61,187,178
2	Savings and temporary cash investments .........			64,177	2	5,258,571
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............				4	56,667,200
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
					6
7	Notes and loans receivable, net ....				7	1,771,228
8	Inventories for sale or use ........				8	2,912,332
9	Prepaid expenses and deferred charges ......				9	6,753,866
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	609,502,183
b	Less: accumulated depreciation	10b	339,806,205	573,034	10c	269,695,978
11	Investments—publicly traded securities .				11	493,975,658
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13	1,047,186
14	Intangible assets ...............				14	4,490,886
15	Other assets. See Part IV, line 11 ...........				15	1,190,718
16	Total assets. Add lines 1 through 15 (must equal line 34)...			666,250	16	904,950,801

17	Accounts payable and accrued expenses .....		17	52,375,273
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20	149,034,015
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23	132,063,887
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D		25	4,828,939
26	Total liabilities. Add lines 17 through 25..	0	26	338,302,114

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	666,250	27	566,648,687
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	666,250	33	566,648,687
34	Total liabilities and net assets/fund balances ........	666,250	34	904,950,801