Financial and Organizational Information Regarding Our Hospital
Transparency Completeness Checklist (HB 321 & HB 186) Prepared by the Georgia Alliance of Community Hospitals and Georgia Hospital Association |
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HB 321 Document/List/Report Required: | Special Requirements/Notes: | Date Posted: |
Contains HB 321 required note (gross patient revenue, allowances, charity care, and net patient revenue) | 06/26/20 | |
Combining or Consolidating Schedules/Financial Information break out for Hospital Subsidiaries |
Contains GAAS required report: see Independent Auditor's Report in Audited Financials | 06/26/20 |
Copies of Schedule H and other filed Schedules (except Schedule B) | 06/26/20 | |
248 Annual Hospital Questionnaire Final and Filed | 06/26/20 | |
Disproportionate Share Hospital (DSH) Examination Parts I & II | 06/26/20 | |
List of Real Property Holdings Owned by Hospital | 10/01/19 | |
List of Hospital Indebtedness |
Does not include names of any bond disclosure sites to which hospital submitted info | 06/26/20 |
Report of End of Year Net Assets (see Audited Financials, Note 8) |
Includes assets for hospital, parent, subsidiaries, and foundation controlled or owned by hospital or parent | 06/26/20 |
01/11/21 | ||
06/26/20 | ||
Evidence of Hospital Accreditation (e.g. the Joint Commission or DNV) | 10/01/19 | |
06/26/20 | ||
06/26/20 | ||
Audited Financial Statements - Hospital | N/A | 06/26/20 |
Audited Financial Statements - Hospital Parent Company | N/A | 06/26/20 |
Combining or Consolidating Schedules/Financial Information break out for Hospital & Brother/Sister Co. | N/A | 06/26/20 |
Audited Financial Statements - Hospital Subsidiaries | N/A | 06/26/20 |
Alternative IRS Form 990 (if available) | N/A | 10/01/19 |
Community Benefit Report | N/A | 01/11/21 |
List of Hospital JVs and Ownership Interests | N/A | 10/01/19 |
Statement that there is no going concern disclosure in the hospital's audited financial statements | N/A | 10/01/19 |
Copy of any "going concern" note in Hospital Financial Statements | N/A | 10/01/19 |
HB 186 Documents Required: | Special Requirements: | Date Posted: |
Shepherd Center Financial Survey | N/A | 11/02/20 |
Any ASC Surveys Filed by Hospital | N/A | 06/26/20 |
Any Imaging Center Surveys by Hospital | N/A | 10/01/19 |