Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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 | ||||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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.) | ||||||
Calendar year
(or fiscal year beginning in)
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(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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 on 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.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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) |
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| 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): |
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| 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 0.015 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 0.035 | 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 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2024 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2024 |
(iii) Distributable Amount for 2024 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2024 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2024: | ||||
| a From 2019....... | ||||
| b From 2020....... | ||||
| c From 2021....... | ||||
| d From 2022....... | ||||
| e From 2023....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2024 distributable amount | ||||
|
i
Carryover from 2019 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2024 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2024 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2024, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2024. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2025. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2020..... | ||||
| b Excess from 2021..... | ||||
| c Excess from 2022..... | ||||
| d Excess from 2023..... | ||||
| e Excess from 2024..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
|---|---|
| FORM 990, PART I, LINE 1 | HEALTH SERVICES OF CENTRAL GEORGIA, INC. (HSCG) IS A NOT-FOR-PROFIT ORGANIZATION, AFFILIATED WITH NAVICENT HEALTH, INC. HSCG EMPLOYS A PREMIER NETWORK OF HEALTH CARE PROVIDERS SUCH AS PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN ASSISTANTS; AND PROVIDES FACULTY PHYSICIANS TO THE RESIDENCY TRAINING PROGRAMS OF THE MEDICAL CENTER, NAVICENT HEALTH (MCNH) AND PHYSICIAN SERVICES THAT ARE IN SHORT SUPPLY IN THE COMMUNITY. IT HAS BEEN THE MISSION OF HSCG TO PROVIDE CRITICALLY NEEDED PHYSICIANS AND EFFICIENT AND EFFECTIVE HEALTH SERVICES IN ORDER TO MAKE A POSITIVE IMPACT ON THE HEALTH OF THE COMMUNITIES IT SERVES. |
| FORM 990, PART III, LINE 4A | HEALTH SERVICES OF CENTRAL GEORGIA, INC. (HSCG) IS A NOT-FOR-PROFIT AFFILIATE OF NAVICENT HEALTH (FORMERLY CENTRAL GEORGIA HEALTH SYSTEM, INC.) WHICH EMPLOYS A PREMIER NETWORK OF HEALTH CARE PROVIDERS SUCH AS PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN ASSISTANTS. HSCG PROVIDES FACULTY PHYSICIANS TO THE RESIDENCY TRAINING PROGRAMS OF THE MEDICAL CENTER OF CENTRAL GEORGIA, AND PHYSICIAN SERVICES THAT ARE IN SHORT SUPPLY IN PRIVATE PRACTICE. IT HAS BEEN OUR MISSION TO PROVIDE CRITICALLY NEEDED PHYSICIANS AND EFFICIENT AND EFFECTIVE HEALTH SERVICES IN ORDER TO MAKE A POSITIVE IMPACT ON THE HEALTH OF THE COMMUNITIES WE SERVE. HSCG PROVIDES FACULTY PHYSICIANS AND PHYSICIAN EXTENDERS TO THE PEDIATRIC RESIDENCY TRAINING PROGRAM OF THE MEDICAL CENTER OF CENTRAL GEORGIA. DURING THE YEAR THIS GROUP OF PHYSICIANS PERFORMED APPROXIMATELY 35,000 PATIENT VISITS, PEDIATRIC PATIENTS FROM BIBB AND THE SURROUNDING COUNTIES. APPROXIMATELY 69% OF PATIENTS SEEN WERE COVERED BY GEORGIA STATE MEDICAID OR UNINSURED. THIS GROUP OF PHYSICIANS ALSO PROVIDED EDUCATION AND TRAINING TO 18 PEDIATRIC RESIDENTS AS WELL AS 120 MEDICAL STUDENTS FROM THE MERCER UNIVERSITY SCHOOL OF MEDICINE. HSCG ALSO PROVIDES FACULTY PHYSICIANS AND PHYSICIAN EXTENDERS TO THE SURGICAL RESIDENCY TRAINING PROGRAM OF THE MEDICAL CENTER OF CENTRAL GEORGIA. THEY PROVIDED EDUCATION AND TRAINING TO 23 SURGICAL RESIDENTS, IN ADDITION TO 120 MEDICAL STUDENTS FROM THE MERCER UNIVERSITY SCHOOL OF MEDICINE. THE FACULTY PHYSICIANS PROVIDED CARE FOR APPROXIMATELY 5,800 PATIENTS AT THE ANDERSON HEALTH CENTER AT THE MEDICAL CENTER OF CENTRAL GEORGIA. OF THOSE PATIENTS, APPROXIMATELY 53% WERE UNINSURED, MEMBERS OF THE MEDICAL CENTER OF CENTRAL GEORGIA'S MANAGED CARE PROGRAM FOR UNINSURED OR UNDER INSURED CITIZENS OR CONSIDERED SELF-PAY, AND 4% WERE MEDICARE PART B RECIPIENTS. THEY ALSO PROVIDED APPROXIMATELY $1,530,000 OF CARE IN OTHER OUTPATIENT SERVICES AND SURGICAL SERVICES TO INDIGENT AND UNINSURED PATIENTS DURING THIS TIME. THIS GROUP ALSO PROVIDED LEVEL I SURGICAL TRAUMA SERVICES AT THE MEDICAL CENTER OF CENTRAL GEORGIA. HSCG ALSO PROVIDES FACULTY PHYSICIANS AND PHYSICIAN EXTENDERS TO THE FAMILY MEDICINE RESIDENCY TRAINING PROGRAM. DURING THE YEAR THIS GROUP OF PHYSICIANS, IN CONJUNCTION WITH FACULTY FROM THE MERCER UNIVERSITY SCHOOL OF MEDICINE, SAW OUTPATIENTS FROM BIBB AND THE SURROUNDING COUNTIES. THIS GROUP OF PROVIDERS SAW A HIGH PERCENTAGE OF PATIENTS COVERED BY GEORGIA STATE MEDICAID AND MEDICARE PART B, AS WELL AS UNINSURED PATIENTS. THIS GROUP OF PHYSICIANS ALSO PROVIDED EDUCATION AND TRAINING TO 29 FAMILY PRACTICE RESIDENTS, AS WELL AS 120 MEDICAL STUDENTS FROM THE MERCER UNIVERSITY SCHOOL OF MEDICINE. OTHER HSCG ACCOMPLISHMENTS INCLUDE PROVIDING FACULTY PHYSICIANS TO EDUCATE AND TRAIN 15 OBSTETRIC AND GYNECOLOGIC RESIDENTS. THIS FACULTY DEPARTMENT PROVIDES SPECIALTY CARE, EDUCATION, AND TRAINING IN OB/GYN, UROGYNECOLOGY, GYNECOLOGIC ONCOLOGY, REPRODUCTIVE ENDOCRINOLOGY, AND MATERNAL FETAL MEDICINE WHILE PROVIDING PATIENT ENCOUNTERS. HSCG ALSO PROVIDED PHYSICIANS AND PHYSICIAN EXTENDERS IN GASTROENTEROLOGY, PEDIATRIC SURGERY, PEDIATRIC ORTHOPEDIC SURGERY, PEDIATRIC GASTROENTEROLOGY, PEDIATRIC HEMATOLOGY/ONCOLOGY, ORTHOPEDIC TRAUMA SURGERY, MAXILLOFACIAL TRAUMA SURGERY, BARIATRIC SURGERY, OPHTHALMOLOGY, PEDIATRIC ENDOCRINOLOGY, VASCULAR SURGERY, CARDIAC SURGERY, THORACIC SURGERY AND FAMILY MEDICINE, ALL AREAS OF HIGH NEED AND PHYSICIAN SHORTAGE IN THE COMMUNITIES THEY SERVE. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE FILING ORGANIZATION'S SOLE MEMBER IS NAVICENT HEALTH, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | NAVICENT HEALTH, INC., A RELATED 501 (C)(3) ORGANIZATION, HAS CERTAIN RESERVE POWERS AS WELL AS THE POWER TO APPOINT, APPROVE AND REMOVE BOARD MEMBERS OF HEALTH SERVICES OF CENTRAL GEORGIA, INC. |
| FORM 990, PART VI, SECTION A, LINE 7B | NAVICENT HEALTH, INC., A RELATED 501 (C)(3) ORGANIZATION, HAS CERTAIN RESERVE POWERS AS WELL AS THE POWER TO APPOINT, APPROVE AND REMOVE BOARD MEMBERS OF HEALTH SERVICES OF CENTRAL GEORGIA, INC. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVES COPIES OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL DIRECTORS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REQUIRES ITS OFFICERS, DIRECTORS AND KEY EMPLOYEES TO ANNUALLY REVIEW THE CONFLICT OF INTEREST POLICY AND DETERMINE ANY POTENTIAL CONFLICTS OF INTEREST. ANY POTENTIAL CONFLICTS NOTED IN THE QUESTIONNAIRE ARE REVIEWED BY A STANDING COMMITTEE FOR APPROPRIATE RESOLUTION. ALL MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED TO DETERMINE AND REPORT ANNUALLY, AND AS THEY ARISE, ANY POTENTIAL CONFLICTS OF INTEREST TO THE SECRETARY OF THE BOARD OF DIRECTORS. THE RESOLUTION OF POTENTIAL AND ACTUAL CONFLICTS IS SUBJECT TO THE APPROVAL OF THE CHAIR OF THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION AND BENEFITS COMMITTEE (THE "COMMITTEE") OF THE ADVOCATE HEALTH, INC. BOARD OF DIRECTORS HAS AUTHORITY AS THE NAVICENT HEALTH BOARD DELEGATES TO IT, FOR THE REVIEW AND APPROVAL OF SENIOR EXECUTIVE COMPENSATION, INCLUDING SENIOR EXECUTIVE INCENTIVE PLANS. NO MEMBER OF THE COMMITTEE IS AN EMPLOYEE OF NAVICENT HEALTH, INC. OR THE FILING ORGANIZATION. THE COMMITTEE RELIES UPON AN EXTERNAL, INDEPENDENT COMPENSATION CONSULTANT EXPERIENCED IN HEALTHCARE TO PROVIDE THE COMMITTEE WITH COMPENSATION COMPARABILITY DATA FOR NEW EXECUTIVE POSITION APPOINTMENTS AND FOR COMPENSATION REVIEWS FOR EXISTING EXECUTIVES. THE CONSULTANT, WHICH IS RETAINED DIRECTLY BY THE COMMITTEE, PROVIDES THIRD-PARTY INFORMATION AND EVALUATES THE COMPETITIVENESS AND REASONABLENESS OF EXECUTIVE COMPENSATION AND BENEFITS PROGRAMS IN RELATION TO MARKET PRACTICES FOR SIMILARLY SITUATED HEALTHCARE ORGANIZATIONS. THE COMMITTEE MAKES ITS DECISIONS WITH RESPECT TO EXECUTIVE COMPENSATION IN ACCORDANCE WITH NAVICENT HEALTH, INC. AND THE FILING ORGANIZATION'S POLICIES, IRS REGULATIONS, AND STANDARD CORPORATE GOVERNANCE PRACTICES. SUCH POLICIES INCLUDE ADHERENCE TO EXECUTIVE COMPENSATION PHILOSOPHY AND REVIEW PROCESSES; PROCESSES ENSURING COMMITTEE MEMBER AND COMPENSATION CONSULTANT INDEPENDENT; USE OF VALID MARKET COMPARISONS OF DATA FROM HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE, STRUCTURE, AND COMPLEXITY, AND ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS, PER IRS GUIDELINES. MINUTES OF THE DELIBERATIONS OF THE COMMITTEE ARE MAINTAINED IN THE ADVOCATE HEALTH, INC. LEGAL DEPARTMENT. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON REQUEST. |
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| Software Version: |