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

OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
MEDICAL CENTER OF CENTRAL GEORGIA INC
 
Employer identification number

58-2149128
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) CENTRAL GEORGIA MEDICAL PROPERTIES LLC
777 HEMLOCK STREET MSC 111
MACON,GA31201
 PHYSICIAN RELATIONSHIPS GA 0 0 MEDICAL CENTER OF CENTRAL GEORGIA
 
(2) CENTRAL GEORGIA CVI PROPERTIES LLC
777 HEMLOCK ST MSC 111
MACON,GA31201
 PHYSICIAN RELATIONSHIPS GA 0 0 MEDICAL CENTER OF CENTRAL GEORGIA
 








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)CENTRAL GEORGIA SENIOR HEALTH INC
777 Hemlock Street MSC 111

MACON,GA31201
58-2345439 		CONTINUING CARE RETIREMENT COMMUNITY GA 501(c)(3) Type II NAVICENT HEALTH INC
 
 
No
(2)HEALTH SERVICES OF CENTRAL GEORGIA INC
777 Hemlock Street MSC 111

MACON,GA31201
58-2307485 		HEALTH SERVICES GA 501(c)(3) 3 NAVICENT HEALTH INC
 
 
No
(3)NAVICENT HEALTH INC
777 Hemlock Street MSC 111

MACON,GA31201
58-2149127 		HEALTHCARE SERVICES, PARENT ENTITY/STRATEGIC & FINANCIAL MANAGEMENT GA 501(c)(3) Type III-FI AHNH Georgia Inc
 
 
No
(4)THE MEDICAL CENTER OF PEACH COUNTY INC
777 Hemlock Street MSC 111

Macon,GA31201
45-3765471 		HOSPITAL GA 501(c)(3) 3 NAVICENT HEALTH INC
 
 
No
(5)NAVICENT HEALTH BALDWIN INC
777 Hemlock Street MSC 111

MACON,GA31201
82-3914925 		HOSPITAL GA 501(c)(3) 3 NAVICENT HEALTH INC
 
 
No
(6)AHNH Georgia Inc
PO Box 32862

Charlotte,NC282322861
83-1707383 		Sole Member Navicent Health NC 501(c)(3) 7 The Charolotte-Mecklenburg Hospital Authority
 
 
No
(7)The Charlotte-Mecklenburg Hospital Authority
1000 Blythe Blvd

Charlotte,NC28203
56-0529945 		Healthcare NC     NA
 
 
No
(8)  
 
 
        N/A
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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
(1) SECURE HEALTH PLANS OF GEORGIA LLC

577 MULBERRY STREET SUITE 1000
MACON,GA31201
58-2306549 		MANAGED CARE GA NA
  		N/A                
(2) CENTRAL GEORGIA PET LLC

1650 HARDEMAN AVENUE
MACON,GA31201
37-1464470 		MEDICAL IMAGING CENTER GA MEDICAL CENTER OF CENTRAL GEORGIA
  		Related 1,153,253 1,303,165   No     No 66.67 %
(3) Cowles Clinic Realty LLC

1000 Cowles Clinic Way C100
Greensboro,GA30642
81-0636590 		Real Estate GA NA
  		N/A                








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) CENTRAL GEORGIA HEALTH VENTURES INC

777 Hemlock Street MSC 111
MACON,GA31201
58-2164989 		MANAGEMENT & HOME CARE SERVICES GA NA
  		C Corporation         No
(2) CENTRA PROFESSIONAL INDEMNITY LTD

PO BOX 1363
  GRAND CAYMAN  
CJ
Self-INSURANCE CJ NA
  		C Corporation         No
(3) Navicent HealthPlan Inc

777 Hemlock Street MSC 111
Macon,GA31201
20-2467391 		Insurance GA NA
  		C Corporation         No








Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
Yes
 
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
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
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
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
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) Central Georgia PET LLC

 S 1,191,000 Cash Distribution Payment Received
(2) Central Georgia PET LLC

 Q 440,813 Cash




Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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) 2020
Schedule R (Form 990) 2020
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) 2020

Additional Data


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