Archbold Brooks
In support of providing transparency of relevant organizational and financial
information, please see below for the required reporting materials.
To learn more about the documents, see the
Document Information section below.
Last updated 1/27/25
2024 Federal Related Disclosures
2024 Georgia Supplemental Disclosures
- Annual Hospital Questionnaire
- Disproportionate Share Hospital Survey
- Real Property Holdings of the Hospital
- Listing of any Ownership or Interest
- Bond Indebtedness, Outstanding Loans, and Bond Defaults
- Report of Ending Fund Balances
- Legal Chart of Corporate Structure
- Report of Top 10 Administrative Positions - Salaries
- Evidence of Accreditation
- Hospital's Policies Regarding Charity Care and Reduced Cost Services
For documentation records of previous years, visit our archive below:
Document Information
2024 Federal Related Disclosures
Audited Financial Statement
Audited financial statements are the basic financial statements of an organization
that have been examined by an independent certified public accountant
(CPA). Audited financial statements include the basic financial statements
of an organization along with an opinion from the auditor, indicating
whether or not the financial statements present fairly the results of
operations, financial position, and cash flows of the issuing entity.
Internal Revenue Service Form 990
Form 990 is an informational return that certain tax-exempt organizations
must file with the Internal Revenue Service (IRS) on an annual basis.
Form 990 is the primary tool of the IRS for gathering information about
tax-exempt organizations.
2024 Organizational Related Disclosures
Annual Hospital Questionnaire
The Annual Hospital Questionnaire was developed to report basic facility
and operating data including the types and amount of services provided
by a hospital for state health planning purposes.
Community Benefit Report
A report of the cost of indigent and charity care provided annually pursuant
to O.C.G.A. 31-7-90.1.
Disproportionate Share Hospital Survey
Disproportionate Share Hospital (DSH) is a federal program that seeks to
increase health care access for the medically indigent. Georgia's DSH
payments are distributed based upon each hospital's uncompensated cost
of services provided to Medicaid patients and the uninsured. The Department
of Community Health collects the information necessary to determine these
payments annually via this survey.
Going Concern Statement
"Going concern" is an accounting term used to describe a business
that is expected to operate for the foreseeable future or at least the
next 12 months. It assumes that the business can generate income, meet
its obligations and doesn't plan or won't need to liquidate in the coming year.
Real Property Holdings of the Hospital
A listing and certain information related to all real properties (land
and buildings) owned by the hospital.
Listing of any Ownership or Interest
A listing and certain information related to any ownership or interest
the hospital has in any joint venture, partnership or subsidiary company.
Bond Indebtedness, Outstanding Loans, and Bond Defaults
A listing and certain information related to the outstanding debt of the
organization.
Report of Ending Fund Balances
A report providing information related to the ending net assets of the
organization including the purpose of any donor or otherwise restricted
net assets.
Legal Chart of Corporate Structure
A chart providing information related to the organization and its parents,
subsidiaries and/or commonly controlled organizations.
Report of Top 10 Administrative Positions - Salaries
A report listing the ten highest paid administrative positions including
the compensation and benefits for each position.
Evidence of Accreditation
Accreditation is the official review process administered by an approved
national accreditation organization demonstrating the hospital's compliance
with the conditions of participation from CMS and other established standards.
Hospital's Policies Regarding Charity Care and Reduced Cost Services
A copy of the hospital's financial assistance policy which provides information
to patients disclosing the hospital's method for evaluating and discounting
charges for services rendered when the patient meets certain financial criteria.
