SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBulletGo to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047
2017
Open to Public Inspection
Name of the organization
HOME & COMMUNITY SERVICES INC
 
Employer identification number

43-2007492
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)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) H&CS SERVICES LLC
PO BOX 1803
MACON,GA31202
45-5012031
HEALTHCARE GA     NA
 
(2) MGAS HOLDINGS LLC
PO BOX 1803
MACON,GA31202
45-3639743
HEALTHCARE GA 15,605,453 5,253,226 NA
 
(3) JACKSON COUNTY HC HOLDINGS LLC
PO BOX 1037
MACON,GA31202
46-4302674
HEALTHCARE GA   5,253,226 NA
 
(4) UPSON AMBULANCE COMPANY LLC
PO BOX 1803
MACON,GA31202
20-5095675
AMBULANCE GA     NA
 
(5) RESTORATION HEALTHCARE COMMERCELLC
70 MEDICAL CENTER DRIVE
COMMERCE,GA30529
27-1914362
HOSPITAL GA 24,115,782 5,983,632 NA
 
(6) RHC REAL ESTATE LLC
PO BOX 1037
MACON,GA31202
27-2146759
REALESTATE GA 793,025 3,357,829 NA
 
(7) COMMERCE PHYSICIAN GROUP LLC
PO BOX 1037
MACON,GA31202
36-4737947
HEALTHCARE GA     NA
 
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?
Yes No
(1)CLINICAL SERVICES INC
1005 BOULDER DRIVE

GRAY,GA31032
57-1157115
CLINICAL & GA 501C 10 CHSI
 
 
No
(2)COMMUNITY HEALTH FOUNDATION INC
PO BOX 1833

MACON,GA31202
57-1157153
FINANCIAL GA 501C 10 CHSI
 
 
No
(3)COMMUNITY HEALTH SYSTEMS INC
PO BOX 1037

MACON,GA31202
74-3083593
SUPPORT SE GA 501C 12A NA
 
 
No
(4)COMMUNITY REHABILITATION SERVICES
PO BOX 1804

MACON,GA31202
20-3253779
REHABILITA GA 501C 10 CHSI
 
 
No
(5)HEALTH SCHOLARSHIPS INC
1005 BOULDER DRIVE

GRAY,GA31032
58-1805305
OPERATION GA 501C 10 CHSI
 
 
No
(6)HEALTH SYSTEMS REAL ESTATE INC
1005 BOULDER DRIVE

GRAY,GA31032
43-2007488
RE GA 501C 10 CHSI
 
 
No
(7)HEALTH SYSTEMS FACILITIES INC
1005 BOULDER DRIVE

GRAY,GA31032
74-3083594
OPERATION GA 501C 10 CHSI
 
 
No
(8)COMMUNITY ANCILLARY SERVICES INC
213 THIRD STREET

MACON,GA31201
43-2007496
PHAR GA 501C 10 CHSI
 
 
No
(9)PIEDMONT REGIONAL HEALTH INC
1005 BOULDER DRIVE

GRAY,GA31032
43-2007498
OPERATION GA 501C 10 CHSI
 
 
No
(10)STEWARD HEALTH SERVICES INC
213 THIRD STREET

MACON,GA31201
43-2007486
HOSPICE GA 501C 10 CHSI
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2017
Page 2
Schedule R (Form 990) 2017
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



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(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?



(k)
Percentage
ownership


Yes No Yes 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
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) COMMUNITY HEALTH VENTURES INC

213 THIRD STREET
MACON,GA31201
20-1392241
RISK MGMT. GA CHSI
 
C CORP         No












Schedule R (Form 990) 2017
Page 3
Schedule R (Form 990) 2017
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
No
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 .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
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
(1) COMMUNITY HEATH SYSTEMS INC

M 1,666,295  
(2) CLINICAL SERVICES INC

M 923,484  
(3) COMMUNITY ANCILLARY SERVICES INC

M 360,244  
(4) COMMUNITY REHABILITATION SERVICES

M 810,740  


Schedule R (Form 990) 2017
Page 4
Schedule R (Form 990) 2017
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)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2017
Page 5
Schedule R (Form 990) 2017
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) 2017

Additional Data


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