2024-05-14T12:59:26-05:00 2023-06-30 KPMG LLP 303 PEACHTREE ST STE 2000 ATLANTA GA 30308 990 2022-07-01 871031034 Piedmont Macon North Hospital Inc % MARIE GAFFNEY PIED 4044251303 400 Charter Blvd MACON GA 31210 MARIE GAFFNEY VP CORPORATE FINANCE 4702716007 2024-05-13 true MARIE GAFFNEY 999009999 WHITNEY B HEBRON P01226647 4042223000 2024-05-13 3 2022 2023-04-26 12:10:37Z MR Stephen Daugherty 400 Charter Blvd MACON GA 31210 82663901 false X www.piedmont.org X 2021 GA TO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT. 11 7 338 100 0 0 0 0 90846395 81903787 0 -2155 473436 760114 91319831 82661746 0 0 0 0 15545105 19762227 0 0 0 78001717 65511808 93546822 85274035 -2226991 -2612289 112978743 73610254 21450617 6999645 91528126 66610609 TO PROVIDE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE IN A PROGRESSIVE ENVIRONMENT, GUIDED BY PHYSICIANS, DELIVERED BY EXCEPTIONAL PROFESSIONALS, AND INSPIRED BY THE COMMUNITIES WE SERVE. false false 78674714 0 81903787 PIEDMONT MACON NORTH HOSPITAL, INC. IS A 103-BED FACILITY LOCATED IN THE CITY OF MACON IN BIBB COUNTY, GEORGIA. OUR PRIMARY CARE AND SPECIALTY PHYSICIANS ON THE MEDICAL STAFF MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SENIORS WITHIN MACON AND THE SURROUNDING MIDDLE GEORGIA MARKET, REGARDLESS OF ANY INDIVIUAL'S ABILITY TO PAY FOR SERVICES. FOR THE YEAR ENDED JUNE 30, 2023, THE HOSPITAL HAD 2,048 IN-PATIENT ADMISSIONS WITH A TOTAL OF 5,768 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 41,194 AND OUTPAITENT VISITS TOTALED 8,188. SURGICAL SERVICES WERE PROVIDED TO 1,997 PATIENTS. 78674714 true false false false false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false true true false false false true X 0 0 338 true false false false false false false false false false false false false X 11 7 false false false false true true true true true false false false true true true true true true true false GA X MARIE GAFFNEY 4702716007 2727 PACES FERRY RD BLDG 2 STE 70 ATLANTA GA 30339 X Ms Elizabeth Leddy Secretary/CLO PHC 1.0 54.0 X 0 1389485 138711 Mr Thomas Arnold Treasurer/CFO PHC 1.0 54.0 X 0 1173444 130741 MR STEPHEN DAUGHERTY CEO 25.0 30.0 X X 0 824400 98216 Mr Stephen D Porter Board Member 1.0 54.0 X 0 763523 115746 MR SCOTT STRONG COO 25.0 30.0 X 0 379896 42558 DR CESAR FIGUEROA BOARD MEMBER, VICE CHAIR 1.0 54.0 X 0 381196 25648 MS ALISHA NEAL CFO 25.0 30.0 X 0 336232 24756 MR RUSTY MERRITT ED FLOW COORDINATOR 40.0 0.0 X 157076 0 32461 MR SCOTT BISCAN ED FLOW COORDINATOR 40.0 0.0 X 147749 0 27947 MS CLARA MALONE MANAGER - PHARMACY OPS 40.0 0.0 X 154846 0 16055 MR MICHAEL CRUTCHFIELD PHARMACIST 40.0 0.0 X 147751 0 22317 MS GIDGET FARLEY OCCUPATIONAL THERAPIST 40.0 0.0 X 152952 0 9160 DR JOSEPH BURNETTE BOARD MEMBER 1.0 1.0 X 36000 0 0 DR GEORGE ARIMAH BOARD MEMBER 1.0 1.0 X 0 0 0 MR JEFF BATTCHER BOARD MEMBER 1.0 1.0 X 0 0 0 MR GRANT GREENWOOD BOARD MEMBER, CHAIR 1.0 1.0 X X 0 0 0 MS MALLORY JONES BOARD MEMBER 1.0 1.0 X 0 0 0 MR TODD JONES BOARD MEMBER 1.0 1.0 X 0 0 0 DR GARRY SIMONS BOARD MEMBER 1.0 1.0 X 0 0 0 MS TARA UNDERWOOD BOARD MEMBER 1.0 1.0 X 0 0 0 796374 5248176 684316 19 false true false MEDICAL SOLUTIONS LLC 1010 N 102ND STREET SUITE 300 OMAHA NE 68114 HEALTHCARE STAFFING 3374730 AYA HEALTHCARE INC 5903 CORNERSTONE CT W STE 300 SAN DIEGO CA 92121 HEALTHCARE STAFFING 2368646 HEALTHCARE WORKFORCE LOGISTICS LLC 2655 NORTHWINDS PKWY ALPHARETTA GA 30009 HEALTHCARE STAFFING 705425 PARAGON EMERGENCY SERVICES LLC 200 AVENUE F NE WINGER HAVEN FL 33881 EMERGENCY MED SVCS 646347 HHS ENVIRONMENTAL SERVICES LLC 3902 HWY 78 W SNELLVILLE GA 30039 FACILITY MGMT SVCS 518428 11 0 PATIENT SERVICE REVENUE 622110 81881102 81881102 0 0 OTHER OPERATING REVENUE 900099 22685 22685 0 0 81903787 0 0 0 628762 0 628762 0 628762 0 0 628762 0 2155 -2155 -2155 0 0 -2155 0 0 0 0 0 0 0 0 0 CAFETERIA SALES 722310 131352 0 0 131352 131352 82661746 81903787 0 757959 X 0 0 0 0 0 0 15158575 13333483 1825092 0 0 3602282 3168567 433715 0 1001370 880805 120565 0 0 0 0 0 0 0 12180518 10713983 1466535 0 153610 135115 18495 0 3016689 2653480 363209 0 984457 865928 118529 0 0 4840678 4257860 582818 0 2290 2014 276 0 0 0 505971 0 505971 0 0 2261071 1988838 272233 0 564190 0 564190 0 BAD DEBT EXPENSES 22682878 22682878 0 0 DRUGS & MEDICAL SUPPLIES 14274122 14274122 0 0 HOSPITAL TAX 1323630 1323630 0 0 MISCELLANEOUS 2721704 2394011 327693 0 85274035 78674714 6599321 0 78997844 47423532 0 0 0 0 -2864346 -9190587 0 0 0 0 0 0 2458144 2250656 58529 76493 32120101 4605629 28644445 27514472 0 0 0 0 0 0 0 0 5684127 5535688 112978743 73610254 11164319 6831343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10286298 168302 21450617 6999645 X 91528051 66609543 75 1066 91528126 66610609 112978743 73610254 X -2612289 -22305228 X false true X true false X 4904272 4904272 14618418 1195935 13422483 1190671 698504 492167 10595678 2711190 7884488 811062 811062 27514472 GOODWILL 5535688 5535688 0 DUE TO RELATED PARTIES 168302 168302 X SCHEDULE D, PART X, LINE 2: ASC 740 FOOTNOTE (FKA FIN 48) PHC ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF ASC 740, INCOME TAXES (ASC 740). UNDER THE REQUIREMENTS OF ASC 740, TAX-EXEMPT ORGANIZATIONS MAY BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS UNCERTAIN TAX EXPOSURE ITEMS. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AT JUNE 30, 2023 and 2022. true true X true X 300. true X true true false true true 2336530 2336560 0.03730 1818359 1878472 1998473 704657 1293816 0.02070 6153362 2583129 3630376 0.05800 248270 248270 0.00400 248270 248270 0.00400 6401632 2583129 3878646 0.06200 true 2460981 9840531 9087570 752961 X true true 1 1 PIEDMONT MACON NORTH HOSPITAL INC 400 CHARTER BOULEVARD MACON GA 31210 HTTPS://WWW.PIEDMONT.ORG/ 011-373 X X X PIEDMONT MACON NORTH HOSPITAL INC 1 true true true X X X X X X X X 21 true true false true X SEE PART V, SECTION C X X true 22 true SEE PART V, SECTION C false true X 300. 300. X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINES 1 AND 2: NEW HOSPITAL ENTITY Piedmont Macon North Hospital, Inc. ("PMN") was created as a new entity on May 24, 2021 and is the 501(c)(3) tax-exempt parent of Macon Northside Hospital LLC, a disregarded entity, which was acquired from HCA Healthcare, a for-profit company. Piedmont filed the PMN Form 1023 application for recognition of exemption under Section 501(c)(3) of the Internal Revenue Code on July 27, 2021, and received its IRS Determination Letter reflecting PMN's status as a 501(c)(3) organization with public charity status 170(b)(1)(A)(iii) on March 21, 2022. The IRS 501(c)(3) status per the Determination Letter is retroactive with an effective date of exemption of May 24, 2021. SCHEDULE H, PART V, SECTION B, LINE 5: COMMUNITY REPRESENTATION AS A PART OF OUR PROCESS, WE INTERVIEWED NEARLY 245 STAKEHOLDERS, POLICY MAKERS AND LAWMAKERS REPRESENTING PUBLIC HEALTH, LOW-INCOME POPULATIONS, MINORITIES, CHRONIC CONDITIONS, OLDER ADULTS, AND OUR COMMUNITIES. THESE INCLUDED 12 STAKEHOLDERS WITHIN THE MACON-BIBB COUNTY COMMUNITY, WHO GAVE THEIR PERSPECTIVES ON COMMUNITY HEALTH THROUGH THE LENS OF THEIR ROLE WITHIN THE COMMUNITY. THESE INTERVIEWS WERE CONDUCTED FOR PEOPLE REPRESENTING THE ENTIRE REGION. SPECIFICALLY, WE INTERVIEWED REPRESENTATIVES OF LOCAL AND REGIONAL PUBLIC HEALTH ENTITIES, MINORITY POPULATIONS, FAITH-BASED COMMUNITIES, LOCAL BUSINESS OWNERS, THE PHILANTHROPIC COMMUNITY, MENTAL HEALTH AGENCIES, ELECTED OFFICIALS AND INDIVIDUALS REPRESENTING OUR MOST VULNERABLE PATIENTS. THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS AND LEADERSHIP FROM ALL 19 HOSPITALS WERE ACTIVELY INFORMED AND ENGAGED THROUGHOUT THIS PROCESS. SCHEDULE H, PART V, SECTION B, LINE 6A: COMMUNITY HEALTH NEEDS ASSESSMENT THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED FOR BOTH PIEDMONT MACON HOSPITAL, INC. (EIN: 87-1006981) AND PIEDMONT MACON NORTH HOSPITAL, INC. (EIN: 87-1031034). SCHEDULE H, PART V, SECTION B, LINE 7A: COMMUNITY HEALTH NEEDS ASSESSMENT https://www.piedmont.org/media/file/Community-Benefit-Needs-Assessment-PMM .pdf SCHEDULE H, PART V, LINE 7D: PUBLIC AVAILABILITY OF CHNA IN ADDITION TO MAKING ITS CHNA REPORTS AVAILABLE ON ITS WEBSITE AND BY REQUEST, PIEDMONT MACON NORTH HOSPITAL SENT COPIES TO EACH PARTICIPANT IN THE CHNA PROCESS, DISTRIBUTED THE ASSESSMENTS TO COMMUNITY CENTERS AND OTHER LOCATIONS THAT PRIMARILY SERVE AN UNINSURED POPULATION, SENT COPIES TO LEGISLATIVE AND ELECTED OFFICIALS, AND WIDELY DISTRIBUTED THE ASSESSMENTS TO OTHER PIEDMONT HEALTHCARE HOSPITALS. SCHEDULE H, PART V, LINE 10A: IMPLEMENTATION STRATEGIES WEBSITE THE BOARD OF DIRECTORS FOR PIEDMONT MACON NORTH HOSPITAL APPROVED ITS IMPLEMENTATION STRATEGY FOR THE THREE-YEAR PERIOD BEGINNING WITH FY23 ON SEPTEMBER 26, 2022, WITHIN THE GRACE PERIOD FOLLOWING THE APPROVAL OF THE NEW COMMUNITY HEALTH NEEDS ASSESSMENT. THE FOLLOWING LINK IS FOR THE IMPLEMENTATION STRATEGY EFFECTIVE THROUGH JUNE 30, 2025. https://www.piedmont.org/media/file/Community-Benefit-Implementation-Strat egy-PMM.pdf SCHEDULE H, PART V, LINE 11: ADDRESSING COMMUNITY HEALTH NEEDS PIEDMONT MACON NORTH HOSPITAL CONDUCTED ITS FOURTH CHNA DURING FY22, AGAIN BY ASSESSING PUBLICLY AVAILABLE DATA, INTERVIEWING COMMUNITY MEMBERS AND STAKEHOLDERS, CONDUCTING FOCUS GROUPS OF VULNERABLE POPULATIONS, INTERVIEWING PIEDMONT BOARD MEMBERS, AND SURVEYING PIEDMONT EMPLOYEES. THROUGH THIS PROCESS, PIEDMONT MACON NORTH HOSPITAL DETERMINED AND PRIORITIZED THE COMMUNITY HEALTH NEEDS IT WOULD ADDRESS BASED ON THE NUMBER OF PERSONS AFFECTED, THE SERIOUSNESS OF THE ISSUE, WHETHER THE HEALTH NEED AFFECTED VULNERABLE POPULATIONS, AND THE AVAILABILITY OF COMMUNITY AND HOSPITAL RESOURCES NECESSARY TO ADDRESS THE ISSUE. ALL PRIORITIES ARE VIEWED THROUGH THE LENS OF HEALTH DISPARITIES, WITH PARTICULAR ATTENTION PAID TO IMPROVING OUTCOMES FOR THOSE MOST VULNERABLE DUE TO INCOME AND RACE. BASED ON THE CHNA, PIEDMONT MACON NORTH HOSPITAL IS CURRENTLY FOCUSING ON: (1) ENSURING AFFORDABLE ACCESS TO HEALTH, MENTAL, AND DENTAL CARE (2) REDUCING PREVENTABLE INSTANCES OF, AND DEATHS FROM, CANCER (3) PROMOTING HEALTHY BEHAVIORS TO REDUCE PREVENTABLE CONDITIONS, DISEASES, AND ADDICTION, AND (4) REDUCING PREVENTABLE INSTANCES OF, AND DEATHS FROM, HEART DISEASE SCHEDULE H, PART V, LINE 16: FINANCIAL ASSISTANCE POLICY WEBSITES FINANCIAL ASSISTANCE POLICY - HTTPS://WWW.PIEDMONT.ORG/MEDIA/FILE/FINANCIAL-ASSISTANCE-POLICY.PDF FINANCIAL ASSISTANCE APPLICATION -HTTPS://WWW.PIEDMONT.ORG/MEDIA/FILE/FINANCIAL-ASSISTANCE-APPLICATION.PDF FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY - HTTPS://WWW.PIEDMONT.ORG/MEDIA/FILE/FINANCIAL-ASSISTANCE-PLAIN-LANGUAGE-SU MMARY-ENGLISH.PDF SCHEDULE H, PART VI, LINE 1: REQUIRED DESCRIPTIONS SCHEDULE H, PART I, LINE 6A PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT We regularly report to the community our community benefit activities in several ways. Each year, we prepare a systemwide community benefit report that is available to the public through publication on our website. We also make available our IRS Form 990 Schedule H on our website and provide copies to anyone upon request. We also provide information on community benefit programming to local, state, and federal lawmakers through our government affairs office and online at piedmont.org. SCHEDULE H, PART I, LINE 7(F) PERCENT OF TOTAL EXPENSE THE DENOMINATOR USED FOR THE CALCULATION OF COLUMN (F), PERCENT OF TOTAL EXPENSE, WAS THE AMOUNT OF TOTAL FUNCTIONAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) OF $85,274,035, LESS BAD DEBT EXPENSE OF $22,682,878 FROM FORM 990, PART IX, LINE 24(A). SCHEDULE H, PART I, LINE 7 FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST A RATIO OF PATIENT CARE COST TO CHARGES, CONSISTENT WITH WORKSHEET 2, WAS USED TO REPORT THE AMOUNTS IN PART I, LINES 7A-7D. FOR AMOUNTS ON LINES 7E-7K, ACTUAL EXPENSES FOR EACH COMMUNITY BENEFIT ACTIVITY ARE TRACED AND REPORTED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. SCHEDULE H, PART III, LINES 2-4 BAD DEBT EXPENSE CALCULATION AND FOOTNOTE The provision for bad debts is based upon leadership's assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage and other collection indicators. Periodically, leadership assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category. The results of the review are then used to make any modifications to the provision for bad debts to establish an appropriate allowance for uncollectible receivables. THE AMOUNT REPORTED ON PART III, LINE 3, WAS DETERMINED BY TAKING THE AVERAGE ACCEPTANCE RATE FOR ALL CHARITY CARE APPLICATIONS RECEIVED DURING THE YEAR MULTIPLIED BY THE NUMBER OF DENIALS THAT WERE ATTRIBUTABLE TO INSUFFICIENT INFORMATION. THAT TOTAL WAS THEN ADJUSTED DOWNWARD FOR THE ORGANIZATION'S USE OF PRESUMPTIVE ELIGIBILITY WHEN DETERMINING ITS COMMUNITY BENEFITS. BAD DEBT EXPENSE FOOTNOTE FROM CONSOLIDATED, AUDITED FINANCIAL STATEMENTS: THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBT TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. PMN PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE ARE NOT REPORTED AS REVENUE. SCHEDULE H, PART III, LINE 8 MEDICARE SHORTFALLS AS COMMUNITY BENEFIT The amount reported on Part III, Line 6, was calculated in accordance with Schedule H instructions by utilizing our allowable Medicare cost as reported in the Medicare cost report, which is based on a cost to charge ratio. However, the allowable costs in the Medicare cost report do not reflect the actual cost of providing care to patients since the Medicare cost report excludes many direct costs that are essential to provide quality healthcare for Medicare patients. For example, certain coverage fees to physicians, cost of Medicare C and D, and other similar direct patient care expenses are specifically excluded from allowable cost in the Medicare Cost Report. IRS Revenue Ruling 69-545 provides, in part, that hospitals serving patients with governmental health insurance, such as Medicare, is an indication we operate to promote health in the community. Our policy is to treat Medicare patients, regardless of the extent to which Medicare pays for the treatment. For many services, Medicare's reimbursement is less than the cost of the care provided, resulting in shortfalls that are to be absorbed by us in honor of our commitment to treat elderly patients. Many of these patients live on a low, fixed income, and would qualify for financial assistance or other means-tested programs, absent from their enrollment in Medicare. SCHEDULE H, PART III, LINE 9(B) COLLECTION PRACTICES INITIAL SCREENINGS OF ALL INPATIENT, EMERGENCY, AND SURGERY ENCOUNTERS, AS WELL AS MOST OUTPATIENT VISITS, ARE CONDUCTED BY FINANCIAL COUNSELORS IN ORDER TO IDENTIFY ANY AVAILABLE INSURANCE OR OTHER COVERAGE FOR EACH PATIENT. COUNSELORS CONTACT PATIENTS AND THEIR FAMILIES DIRECTLY, EITHER IN PERSON OR BY LETTER, TO ASSIST THE FAMILY IN IDENTIFYING ANY PROGRAMS FOR WHICH THE PATIENT/SERVICE MAY QUALIFY (INCLUDING MEDICAID, STATE CHILDREN'S HEALTH INSURANCE PROGRAM ("SCHIP"), PRIVATE OR GOVERNMENT INSURANCE COVERAGE, AND CHARITY ASSISTANCE). IF THE FAMILY CANNOT BE TIMELY LOCATED OR IS UNCOOPERATIVE, RELATED ACCOUNTS ARE TRANSFERRED TO AN INTERNAL COLLECTION DEPARTMENT FOR FURTHER ATTEMPTS TO OBTAIN PAYMENT OR, IF THE PATIENT MAY QUALIFY FOR ASSISTANCE, TO SECURE A FINANCIAL ASSISTANCE APPLICATION. THE ORGANIZATION'S DEBT COLLECTION POLICY AND PROCEDURES PROHIBIT ANY COLLECTION EFFORTS FOR THE PORTION OF A PATIENT ACCOUNT BALANCE THAT QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. SCHEDULE H, PART VI, LINE 2: NEEDS ASSESSMENT As a designated 501(c)(3) nonprofit hospital, we are required by the Internal Revenue System to conduct a triennial community health needs assessment (CHNA), in accordance with regulations put forth by the IRS following the 2010 Patient Protection and Affordable Care Act (ACA). Through this assessment, we hope to better understand local health challenges, identify health trends in our community, determine gaps in the current health delivery system and craft a plan to address those gaps and the identified health needs. In FY22, we conducted our fourth triennial CHNA and FY23 was the first year for activities outlined in its subsequent Implementation Strategy. The CHNA was led by the Piedmont Healthcare community benefits team and consulting organization Public Goods Group, with input and direction from Piedmont leadership and Piedmont Healthcare's Department of External Affairs. Process The CHNA started with a definition of our community, which is our home county due to the impact of our tax-exempt status. Property taxes make up the largest segment of a hospital's tax exemption, which impacts county revenues. Because of this, we aim to ensure that we are providing ample benefit to our county and its residents. Additionally, we take into consideration patient origin, especially that of our lower-income patients such as those who qualify for financial assistance or receive insurance coverage through Medicaid. Our secondary communities are considered the areas in which we have the highest concentration of patients fitting that criterion, including ones from nearby communities. Once we established our primary and secondary communities, we then conducted an analysis of available public health data. This included resources from: US Census, US Health and Human Services' Community Health Status Indicators, US Department of Agriculture, Economic Research Service, National Center for Education Statistics, Kaiser Family Foundation's State Health Facts, American Heart Association, County Health Rankings and Georgia Online Analytical Statistical Information System (OASIS). All figures within the CHNA were for 2020, unless otherwise noted. Health indicators are estimates provided by County Health Rankings and hospital data were internally sourced. We then interviewed key stakeholders who have a particular expertise or knowledge of our communities. Specifically, we interviewed representatives of local and regional public health entities, minority populations, faith-based communities, local business owners, the philanthropic community, mental health agencies, elected officials and individuals representing our most vulnerable patients. An internal survey was also conducted throughout the healthcare system for both clinical and non-clinical employees. Information was gathered on knowledge and understanding of community benefit and current programs, as well as suggestions for how we can better serve our patients and communities. Approximately 1,050 employees spanning the system responded. Additionally, we conducted a community-based survey that was widely advertised to the community. Once both qualitative and quantitative data was gathered, we authored the preliminary report, which was then vetted and reviewed by hospital and health system leadership. In this report, we identified several key community health needs that emerged during the assessment process. The chosen priorities were recommended by the community benefit department with sign-off from hospital and board leadership. The following criteria were used to establish the priorities: - The number of persons affected; - The seriousness of the issue; - Whether the health need particularly affected persons living in poverty or reflected health disparities; and, - Availability of community and/or hospital resources to address the need. All priorities are viewed through the lens of health disparities, with particular attention paid to improving outcomes for those most vulnerable due to income and race. The priorities we chose reflected a collective agreement on what hospital leadership, staff and the community felt was most important and within our ability to positively impact the issue. Once priorities were approved by the board of directors, we then authored the CHNA and presented our findings and recommendations to the hospital's board of directors for their input and approval. Our priorities A key component of the CHNA is to identify the top health priorities we will address over fiscal years 2023, 2024, and 2025. These priorities will guide our community benefit work. They are, in no order: - Ensure affordable access to health, mental, and dental care; - Reduce preventable instances of and deaths from cancer; - Promote healthy behaviors to reduce preventable conditions, diseases, and addiction; and, - Reduce preventable instances of and deaths from heart disease. With each priority, we work to achieve greater health equity by reducing the impact of poverty and other socioeconomic indicators. This means that health equity is built into each priority, which is demonstrated through our implementation strategies. Our subsequent implementation strategy was developed in partnership with hospital leadership and community stakeholders to address the identified priorities in our FY22 community health needs assessment. The implementation strategy was designed to be executed over a three-year period and included specific metrics by which we would be able to evaluate our work and its impact. The implementation strategy was developed by utilizing community feedback from the assessment in partnership with the system community benefits department, our leadership, and our board of directors. We included proven and successful interventions and programming, investing further in work we felt was successful in addressing unmet health needs. SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ASSISTANCE ELIGIBILITY We understand that not everyone can pay their hospital bill due to their insurance status or a limited income, and because of this, we offer financial assistance to qualifying patients. Notification about financial assistance includes, but is not limited to, a dedicated contact number, notices in patient bills, and posted notices in key areas of the hospital. These locations are the emergency room, admitting and registration departments, our business office, and patient financial services offices that are located on site. We also publish and widely publicize a plain language summary of this financial assistance care policy on our website, as well as the full policy. Referral of patients for financial assistance may be made by any staff or medical staff member at the hospital, including physicians, nurses, financial counselors, social workers, case managers, chaplains, and religious sponsors. A request for financial assistance may be made by the patient or a family member, close friend, or associate of the patient, subject to applicable privacy laws. Additionally, we provide copies of our financial assistance policy to our partner clinics and others who work closely with low-income populations. We help our partners in understanding the policy, how it relates to their populations, and receive feedback in ways our financial assistance programming could be improved. SCHEDULE H, PART VI, LINE 4: COMMUNITY INFORMATION While Piedmont Macon serves patients from all over middle Georgia, for the purposes of this CHNA, we consider our community to be Macon-Bibb County. We do this in recognition of the direct impact of our tax-exempt status on county residents. In Macon-Bibb County, an average of 156,700 people lived in the 249-square-mile area each year from 2017 to 2021. The population density for this area, estimated at nearly 630 people per square mile, is much greater than the state average population density of about 184 people per square mile and the average national population density of 93 people per square mile. The ZIP code with the highest concentration of people was 31207 (Macon), with a population density of about 10,000 people per square mile. Macon-Bibb County is mostly urban, as 86 percent of community members lived within an urban setting in 2020. The ZIP code with the highest concentration of the rural population was 31066 (Musella) and, like in most of Georgia, rural populations in Macon-Bibb are overwhelmingly white. About eight percent of the population were veterans in 2020, and the majority of those were age 65 and older. On average, approximately 16 percent of the population - about 23,900 people - lived with a disability each year from 2017 to 2021. Most of that population was age 65 and older. The average median age of people living within Macon-Bibb County each year from 2017 to 2021 was 36, a little older than the state and national averages. Approximately 25 percent of the population were 17 or younger, 16 percent were over the age of 65, and the remaining population were between the ages of 18 and 64. About 54 percent of the total population were Black or African American, about 37 percent were white, four percent were Hispanic/Latino, two percent were Asian, and the remaining three percent were comprised of other races. About three percent identified as being born outside of the US, and a little more than one percent of the total population did not have citizenship status. According to the 2017-2021 American Community Survey, 13 percent of the population had no form of insurance. Insurance status and health are inextricably linked. Adults ages 18 to 64 are most likely to be uninsured, and that's true in Macon-Bibby County. About 20 percent of non-elderly adults were uninsured, as compared to nearly six percent of those under age 18 and less than one percent of those 65 and older. As with other indicators, race matters. Approximately 28 percent of Hispanic/Latino populations, 14 percent of Black or African American populations, and about 10 percent of white populations were uninsured. Between 2017 and 2021, the median household income was $43,862, which is much lower than the state and national levels of $65,030 and $69,021, respectively. When broken down by the four dominant races in the community, income disparities are evident. Of employers in the community, the largest sector by number of employees was health care and social assistance, which employed a little more than 19,000 community members at an average annual wage of $59,124 in 2019, according to the US Department of Commerce. Retail trade was the second largest sector, with about 12,000 people employed at an average annual wage of $32,287. Finance and insurance made up the third largest sector, with nearly 12,000 people employed at an average annual wage of $59,634. According to the 2017-2021 American Community Survey, approximately 70,100 people in the community were part of the labor force, with a 57 percent participation rate. Approximately four percent of the population were unemployed as of May 2023, a rate higher than state and national averages. This figure has increased steadily since last year, when, in May 2022, 3.5 percent of the labor force was unemployed. When looking back further, the rate is over half of the unemployment rate in 2012. Each year from 2017 to 2021, an average of 25 percent of the county lived at or below the federal poverty guidelines, a startlingly high number. By far, the poorest ZIP code within Macon-Bibb County is 31201 (Macon), where nearly 43 percent of the population, on average, lived in poverty. In Macon-Bibb County, like most of the state, minorities are more likely to live in poverty. For example, on average, 34 percent of the Black population and 30 percent of Hispanic/Latino populations lived at or below poverty, as compared to 12 percent of the white population. Between 2017 and 2021, an average of nearly 12,300 households - about 21 percent of households in Macon-Bibb County - received SNAP benefits. Black populations are far more likely to receive SNAP benefits than any other demographic. Only eight percent of SNAP beneficiaries were white, and the remaining 94 percent were minority households. The ZIP code with the highest number of SNAP recipients was 31206 (Macon), where more than a third of residents received SNAP benefits. Of the nearly 59,000 total occupied households in Macon-Bibb County from the years 2017 to 2021, an average of about 36 percent lived in cost-burdened households, in which housing costs were 30 percent or more of total household income. Approximately 18 percent of households had costs that exceeded 50 percent of the household income, which places households in significant financial strain. In Macon-Bibb County, in 2019, 15 of the county's 44 census tracts were food deserts. About 47,000 people lived within these census tracts. These tracts almost directly correspond with census tracts demonstrating retailers who are authorized to take SNAP benefits. In Macon-Bibb County, like in most of the state, those retailers tend to be convenience and discount stores that carry limited, if any, healthy foods. Low food access is defined as living more than one mile (urban) or 10 miles (rural) from the nearest supermarket, supercenter or large grocery store. This indicator is relevant because it highlights populations and geographies facing food insecurity. According to the 2019 Food Access Research Atlas database, about 28 percent of the total population in the county have low food access, meaning about 20,300 county residents may struggle to access healthy foods. This is on par with the state average, and above the national average of about 20 percent. ZIP code 31066 (Musella) has the worst rate of low food access at 83 percent. In 2020, more than 80 percent of adults aged 18 or older saw a doctor for a routine checkup the previous year, a measure that is slightly higher than both state and national averages. For Medicare recipients, this number jumps to nearly 90 percent of adult beneficiaries, which is above both state and national averages. Heart disease is a leading cause of death for both women and men in Macon-Bibb County. During the years 2016 to 2020, the age-adjusted death rate was 273 deaths for every 100,000 people, which is far worse than both state and national rates, which were about 178 and 165 heart-related deaths per 100,000 people, respectively. Between 2016 and 2020, there were nearly 400 deaths due to stroke, representing an age-adjusted death rate of 44 deaths per every 100,000 people. Men are more likely to die from stroke than women, as are Black populations. The hospitalization rates for heart disease and stroke among Medicare recipients have decreased steadily over the last five years. The average cardiovascular disease hospitalization rate from the years 2017 to 2019 was 16 hospitalizations per every 1,000 Medicare beneficiaries, which is higher than the state and national rates of approximately 12 and 11, respectively. The hospitalization rate for stroke was on par with the state rate at nine hospitalizations per every 1,000 Medicare beneficiaries, but above the national rate of eight. Although heart disease is the leading cause of death in the county, cancer remains a critical issue within the community. The average cancer incidence rate for Macon-Bibb County each year between 2016 and 2020 was nearly 470 per every 100,000, which equates to an average diagnosis rate of 845 new cases each year. In 2019, nearly 13 percent of adults ages 20 and older had diabetes, which is higher than the state rate of about 10 percent. Diabetes is a prevalent problem in the US, often indicating an unhealthy lifestyle, and it puts individuals at risk for further health issues. Diabetes itself is often a killer, and is the leading cause of death for minorities, particularly Hispanic/Latino populations. In 2020, approximately four percent of the county's population had a diagnosis of kidney disease, a rate slightly above the state and national percentages of about three percent. In 2019, 30 percent of adults ages 18 and older reported having high cholesterol. Too much cholesterol puts increases the risk for heart disease and stroke, two of the main causes of death within the county. That same year, nearly 40 percent of adults ages 18 and older had a diagnosis of high blood pressure. High blood SCHEDULE H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH We actively promote the health of our community through clinic-hospital partnerships, community-based health screenings, educational activities, community-building activities, the operation of a 24-hour emergency department available to the entire community, the operation of an emergency room open to all members of the community without regard to ability to pay, a governance board composed of community members, use of surplus revenue for facilities improvement, patient care, and medical training, education, and research, the provision of inpatient hospital care for all persons in the community able to pay, including those covered by Medicare and Medicaid, and an open medical staff with privileges available to all qualifying physicians. Please note Piedmont Macon North's community benefit activities were done in partnership with Piedmont Macon Medical Center. In FY23, Piedmont Healthcare launched the Empowering You platform to connect community members and patients with resources to address social determinant of health issues. Powered by FindHelp.org, Piedmont clinicians and case managers can search and refer patients to supporting organizations. In FY23, Piedmont Macon focused on enhancing access to affordable healthcare through various initiatives. We supported Community Health Care Systems by offering pro bono physician services and funding for 30 internal medicine residents' salaries at $452,000. Additionally, we allocated $200,000 for diagnostic imaging services at the Macon Volunteer Clinic and provided strategic guidance via board participation from our chief medical officer. Our efforts extended to mental health support, with approximately 265 individuals benefiting from our Behavioral Health support groups. Piedmont Macon also hosted events promoting mental health awareness. We offered free mental health assessments and referrals through our Lifeline "crisis line" department. Additionally, we supplied psychiatry support to residents at Daybreak, a shelter for Macon's homeless population. We also facilitated grief support sessions through our Helping Hands Grief Support services, reaching 150 grieving community members throughout the year. We provided emotional and pastoral care through both group and individual sessions, as well as weekly debriefing sessions. In FY23, we provided evidence-based psychosocial support to cancer patients and their families, totaling over 500 hours of assistance. During National Heart Month, we conducted free health screenings, attended by nearly 70 community members, focusing on heart health, diabetes, and stroke education. We also emphasized reducing lung and breast cancer deaths by enhancing access to cancer programming, including discounted mammograms and lung screenings held in October, November, and May. In our efforts to enhance healthcare outcomes, we implemented the CHOICE program (Creating Healthier Outcomes by Increasing Clinical Experience). This program offered on-site training and a $4,000 scholarship to seven senior-level registered nursing students. Additionally, we sustained a physician residency program, accommodating internal medicine, psychiatry, transition year and emergency medicine physicians. Throughout the year, we provided placement for 88 residents, incurring a total expense of just under $9 million. Throughout the year, Piedmont Macon actively engaged with the community, demonstrating a commitment to accessible healthcare and holistic wellness. Participation in events like the Community Health Care Systems' Hispanic Health Fair allowed us to offer general medical consultations and distribute educational healthcare materials, fostering health awareness among diverse populations. We extended our outreach efforts by participating in approximately 75 community events, where we provided preventive education, chronic disease management guidance, screenings, and referrals to health and social services. Our involvement in health fairs and community gatherings included offering stroke awareness materials and blood pressure screenings, aligning with our pursuit of stroke certification and proactive health promotion. Recognizing the vital role of nutrition in cancer treatment, we implemented various programs focusing on healthy eating and balanced nutrition for individuals affected by cancer. These programs were conducted at multiple community locations throughout the year, contributing to overall well-being. At Middle Georgia State University's Health Fair, we disseminated information on cardiac, diabetes, stroke prevention, nutrition, oncology, and behavioral health, showcasing our comprehensive approach to healthcare education and awareness. In support of healthy aging, we actively participated in the annual 41 NBC Health and Senior Expo in Houston County. Piedmont Macon Rehab provided valuable resources on stroke education and prevention, emphasizing the importance of healthy lifestyles for seniors. In FY23, Piedmont Macon hosted a Suicide Symposium in September, drawing 120 attendees from the community. The symposium aimed to focus on presentations and discussions about suicide prevention, promoting resources, and raising awareness. Thereby fostering a supportive community network for suicide prevention efforts. In February, Piedmont Macon actively participated in Daybreak's Sleep Out event, spending the night outdoors in tents to raise awareness about Macon's homeless situation. Our team raised funds for the shelter during this event and afterward, donated our tents and sleeping bags to assist others in need. To address the challenges faced by low-income, underserved, and high-risk populations during the COVID-19 pandemic, we distributed COVID-19 test kits to two middle Georgia organizations. Recipient agencies included the Brookdale Resource Center and Macon-Bibb Economic Opportunity Council. Through volunteer efforts, 40 Piedmont Macon and Piedmont Macon North employees and their families supported Rebuilding Macon, a local nonprofit dedicated to repairing homes for elderly and disabled community members. As longtime supporters of Macon's backpack ministry initiative, Piedmont employees packed backpacks monthly with essential items like drinks, protein, fruit, and snacks. These backpacks, totaling more than 2,200, were distributed to local children identified as at-risk for weekend hunger. Additionally, 20 Piedmont volunteers delivered the filled backpacks to schools monthly. Piedmont Macon played a significant role in the United Way of Central Georgia's annual fundraising campaign, raising over $49,000. Employees from Piedmont Macon Medical and Macon North personally pledged more than $26,000 towards this initiative. This continued support for United Way aims to disrupt the cycle of family poverty in middle Georgia. Continuing our strong partnership with the American Red Cross, Piedmont Macon hosted and provided space for ongoing blood drives, contributing to life-saving donations within the community. Furthermore, Piedmont Macon and its associated organizations participated in Bibb County's Back to School Bash, donating over 800 bags of school supplies and providing health information to attendees, further demonstrating our commitment to enhancing community well-being. SCHEDULE H, PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM We are part of Piedmont Healthcare, a regional not-for-profit organization and the parent company of 19 hospitals, the Piedmont Physicians Group, the Piedmont Heart Institute, the Piedmont Clinic and the Piedmont Healthcare Foundation. Our community relations team works directly with the community. Our community benefit department oversees the community benefit activities on behalf of all hospitals throughout the system, and this includes conducting the triennial CHNA and subsequent implementation strategy, ensuring the financial assistance policy is communicated to the community, maintaining the community benefit webpage, authoring the community benefit annual report, preparing board materials, developing and executing the community benefit grants program and compiling all community benefit figures. Each hospital and certain departments of Piedmont Healthcare execute community benefit programming, such as our revenue department, which oversees the financial assistance program. SCHEDULE H, PART VI, LINE 7: STATE OF FILING OF COMMUNITY BENEFIT REPORT We are not required to file a community benefit report; however, we are required to file with the Georgia Department of Community Health information on our indigent and charity care, as well as our Medicaid and Medicare shortfalls. X true true false true false false false false false true false Mr Stephen D Porter Board Member 0 482082 0 168409 0 113032 0 93953 0 21793 0 879269 0 0 Mr Thomas Arnold Treasurer/CFO PHC 0 640918 0 356487 0 176039 0 115097 0 15644 0 1304185 0 96797 Ms Elizabeth Leddy Secretary/CLO PHC 0 547780 0 295524 0 546181 0 117950 0 20761 0 1528196 0 490447 MS ALISHA NEAL CFO 0 268632 0 65272 0 2328 0 5283 0 19473 0 360988 0 0 MR SCOTT STRONG COO 0 288016 0 69325 0 22555 0 18300 0 24258 0 422454 0 0 MR STEPHEN DAUGHERTY CEO 0 454218 0 172960 0 197222 0 83789 0 14427 0 922616 0 0 DR CESAR FIGUEROA BOARD MEMBER, VICE CHAIR 0 262826 0 0 0 118370 0 11138 0 14510 0 406844 0 0 MR RUSTY MERRITT ED FLOW COORDINATOR 79761 0 240 0 77075 0 9793 0 22668 0 189537 0 0 0 MS CLARA MALONE MANAGER - PHARMACY OPS 130161 0 7020 0 17665 0 8764 0 7291 0 170901 0 0 0 MS GIDGET FARLEY OCCUPATIONAL THERAPIST 111117 0 120 0 41715 0 9160 0 0 0 162112 0 0 0 MR MICHAEL CRUTCHFIELD PHARMACIST 137178 0 240 0 10333 0 9012 0 13305 0 170068 0 0 0 MR SCOTT BISCAN ED FLOW COORDINATOR 79519 0 240 0 67990 0 9125 0 18822 0 175696 0 0 0 SCHEDULE J, PART I, LINE 1A: OTHER COMPENSATION ITEMS Elizabeth Leddy, Thomas Arnold, Stephen Porter, and Stephen Daugherty received a discretionary spending account totaling $12,000, a fixed amount determined by their job level. This spending account was included in their taxable wages. SCHEDULE J, PART I, LINE 3: COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR The compensation for the President/CEO of Piedmont Macon North Hospital is set by the entity's parent, Piedmont Healthcare, Inc. Please see the Schedule O narrative for Form 990, Part VI, Section B, Line 15a & 15b for additional information. SCHEDULE J, PART I, LINE 4B: SUPPLEMENTAL COMPENSATION INFORMATION THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THEIR SUPPLEMENTAL EXECUTIVE RETIRMENT PLANS: THOMAS ARNOLD $ 96,797 ELIZABETH LEDDY $490,447 THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS: STEPHEN DAUGHERTY STEPHEN PORTER SCHEDULE J, PART I, LINE 7: NON-FIXED PAYMENTS Certain employees participated in an "annual incentive plan" under which they received non-fixed bonus payments based on job level and several different performance metrics. Form 990, Part V, Line 1A: Number of Forms 1099 Filed All calendar year 2022 Forms 1099 were filed on behalf of Piedmont Macon North Hospital by its sole member, Piedmont Healthcare, Inc. (EIN: 58-1503902), pursuant to an agreement with the IRS to file all Forms 1099 for the Piedmont Healthcare system on a combined basis. FORM 990, PART VI, SECTION A, LINE 6: Organization's Sole Member PIEDMONT HEALTHCARE, INC., (EIN 58-1503902) IS THE SOLE MEMBER OF PIEDMONT MACON NORTH HOSPITAL ("PMN"). FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF GOVERNING BODY THE BOARD OF PIEDMONT HEALTHCARE, PIEDMONT MACON NORTH HOSPITAL'S SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF PIEDMONT MACON NORTH HOSPITAL. FORM 990, PART VI, SEC A, LINE 7B: DECISIONS OF GOVERNING BODY PIEDMONT MACON NORTH HOSPITAL'S BOARD POLICIES AND DECISIONS MUST BE FILED, IMMEDIATELY AFTER ADOPTION, WITH THE SECRETARY OF THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS. SUCH POLICIES AND DECISIONS OF THE PIEDMONT MACON NORTH HOSPITAL BOARD OF DIRECTORS ARE NOT SUBJECT TO THE APPROVAL OF OR RATIFICATION BY THE PIEDMONT HEALTHCARE BOARD, BUT SHOULD THE NEED ARISE, THEY MAY BE RESCINDED BY THE PIEDMONT HEALTHCARE BOARD THROUGH A MAJORITY VOTE OF ITS DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B: 990 REVIEW PROCESS INFORMATION NEEDED TO PREPARE PIEDMONT MACON NORTH HOSPITAL'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PMNH'S CONTROLLER AND VP/CFO. THE 990 IS THEN PREPARED INTERNALLY BY PIEDMONT HEALTHCARE, INC.'S TAX DEPARTMENT AND SUBMITTED TO AN EXTERNAL TAX PREPARER FOR REVIEW. PRIOR TO FILING, COPIES OF FORM 990 ARE PROVIDED TO THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC., THE ORGANIZATION'S SOLE MEMBER, FOR BOARD REVIEW. FORM 990, PART VI, SEC B, LINE 12C: CONFLICT OF INTEREST POLICY COMPLIANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY ORGANIZATION MANAGEMENT IN COORDINATION WITH PIEDMONT HEALTHCARE'S CHIEF COMPLIANCE OFFICER. ALL SENIOR LEADERS, BOARD MEMBERS, PHYSICIAN EMPLOYEES, NURSE PRACTITIONERS/PHYSICIAN ASSISTANTS AND EMPLOYEES AND NON-EMPLOYEES ENGAGED IN RESEARCH ARE REQUIRED TO ANNUALLY DISCLOSE ALL MATTERS WHICH COULD POTENTIALLY CONSTITUTE A CONFLICT OF INTEREST. MATTERS DISCLOSED UNDER THE POLICY MUST BE REVIEWED IN WRITING BY THE PIEDMONT HEALTHCARE CONFLICT OF INTEREST COMMITTEE IN ORDER TO DETERMINE WHETHER A CONFLICT EXISTS AND, IF SO, WHETHER TO ELIMINATE OR MANAGE THE CONFLICT. ALL BOARD MEMBERS AND EMPLOYEES OF PIEDMONT MACON NORTH HOSPITAL ARE PROVIDED TRAINING ON CONFLICT OF INTEREST ISSUES, INCLUDING REPORTING REQUIREMENTS, AT NEW EMPLOYEE ORIENTATION AND AT LEAST ANNUALLY THEREAFTER. NONCOMPLIANCE WITH THE CONFLICT OF INTEREST POLICY MUST BE REPORTED TO PIEDMONT HEALTHCARE'S CHIEF COMPLIANCE OFFICER FOR INVESTIGATION, AND REMEDIAL STEPS MUST BE TAKEN AS APPROPRIATE UNDER THE PIEDMONT HEALTHCARE DISCIPLINARY POLICIES. Form 990, Part VI, Sec B, Line 15a, 15b: Executive Compensation Compensation for executives of Piedmont Macon North Hospital is set by the board of directors of Piedmont Healthcare, Inc. The Piedmont Healthcare, Inc., board of director's executive performance and compensation committee ("The Committee") is composed of at least three members of the PHC board of directors, serving terms of three years, and the majority of which are community directors who generally do not have conflicts of interest related to fulfillment of the duties as outlined below. The committee oversees executive performance and compensation on behalf of the PHC board, subject to the ultimate authority and oversight of the board. The committee also formulates policies and makes decisions in order to ensure a high level of executive performance. The committee is authorized to act on behalf of the PHC board as set out in its charter, and the committee is also charged with providing recommendations and periodic reports to the PHC board regarding executive performance and compensation. All decisions and comparability date are documented in the committee meeting minutes. Functions of the committee - Assess and implement policies regarding performance, compensation and benefits of the president/CEO and other executives as determined by the committee - Select an executive compensation consultant who reports to the committee - Annually review the President/CEO succession plan - Formulate and implement annual performance objectives for the President/CEO, and review and approve annually recommendations from the President/CEO relating to compensation, performance objectives, and succession plans for EVP executives - Annually assess President/CEO performance; If necessary, implement action plan with President/CEO input to improve his/her performance; adjust compensation as appropriate; the committee chair shall consult with the PHC governance committee chair and the PHC board chair and shall coordinate the annual performance review of the PHC president/CEO, unless the PHC board chair has a real or perceived conflict of interest, in which case the committee chair shall determine the proper review process - Review and approve long-term and short-term goals to be used in connection with EVP compensation programs as recommended by the President/CEO and validated by the compensation consultant - Periodically review compensation, if any, for the PHC board chair and all board chairs of the PHC subsidiaries - Establish other policies and procedures, and perform other tasks, related to executive performance and compensation, including but not limited to, approval of executive employment contracts and benefits - Periodically report significant decisions and any additional requested information to the PHC board. FORM 990, PART VI, SECTION C, LINE 19: DISCLOSURE OF DOCUMENTS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THESE DOCUMENTS SHOULD BE REQUESTED FROM PIEDMONT HEALTHCARE, INC.'S LEGAL COUNSEL. FORM 990, PART XI, LINE 9: CHANGE IN NET ASSETS INTERCOMPANY TRANSFER ($14,733,483) CHANGE IN TEMPORARILY RESTRICTED FUNDS $ 991 TIMING DIFFERENCES ($ 7,572,736) -------------------------------------------------------------- TOTAL ($22,305,228) FORM 990 PART IX LINE 11G DESCRIPTION:GENERAL CONTRACT LABOR TOTAL FEES:6272896 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED/CONTRACT SERVICES TOTAL FEES:2717174 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PHYSICIAN SUPPORT TOTAL FEES:2640022 FORM 990 PART IX LINE 11G DESCRIPTION:SERVICE/MAINTENANCE CONTRACTS TOTAL FEES:550426 MACON NORTHSIDE HOSPITAL LLC 400 Charter Blvd MACON FL 31210 621736985 HEALTHCARE GA 0 0 PMnH LLC PIEDMONT HEALTHCARE INC 1800 HOWELL MILL RD STE 850 ATLANTA GA 30318 581503902 HC MANAGEMENT GA 501(c)(3) 12C, III-FI NA false PIEDMONT HOSPITAL Inc 1968 PEACHTREE ROAD NW ATLANTA GA 30309 580566213 HOSPITAL GA 501(c)(3) 3 PHC false FAYETTE COMMUNITY HOSPITAL INC 1255 HIGHWAY 54 WEST FAYETTEVILLE GA 30214 582232328 HOSPITAL 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AL 35242 853544795 HEALTHCARE DE NA NONE 0 0 false 0 false COLISEUM SAME DAY SURGERY CTR LP 340 HOSPITAL DR MACON GA 31217 621805346 SURGERY GA NA NONE 0 0 false 0 false Piedmont Medical Care Corporation 2727 Paces Ferry Road suite 1-1100 Atlanta GA 30339 582092768 Healthcare GA NA C CORP 0 0 false THE PIEDMONT CLINIC INC 2727 Paces Ferry Road suite 1-1100 Atlanta GA 30339 582005358 Healthcare GA NA C CORP 0 0 false PIEDMONT HEART INSTITUTE PHYSICIANS INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 260593850 Healthcare GA NA C CORP 0 0 false COLUMBUS HEALTHCARE RESOURCES PO BOX 790 COLUMBUS GA 31902 581717754 Healthcare GA NA C CORP 0 0 false Columbus Health Services Inc PO BOX 790 COLUMBUS GA 31902 581640939 Healthcare GA NA C CORP 0 0 false Amster McRae Insurance Company SPC PO BOX 1159 GRAND CAYMAN CJ KY1-1102 981734069 RELATED INSUR CJ NA C CORP 0 0 false UNIVERSITY HEALTH RESOURCES INC PO BOX 790 COLUMBUS GA 31901 581601372 HEALTHCARE GA NA C-CORP 0 0 false UNIVERSITY HOSPITAL AIKEN INC 1350 WALTON WAY AUGUSTA GA 30901 472713774 HOSPITAL SC NA C-CORP 0 0 false false false false false false false false false false false false false false false false true true false false SCHEDULE R, PART I, LINE 1: DISREGARDED ENTITIES THE LIMITED LIABILITY COMPANY LISTED IN SCHEDULE R, PART I, OPERATES AS A DEPARTMENT OF PIEDMONT MACON NORTH HOSPITAL AND IS INCORPORATED INTO THE HOSPITAL'S BOOKS AND RECORDS. SEPARATE BOOKS AND RECORDS ARE NOT MAINTAINED FOR THE LIMITED LIABILITY COMPANY AND ASSETS AND INCOME CANNOT BE READILY DETERMINED. AS SUCH, COLUMNS (D) AND (E) IN PART I HAVE BEEN LEFT BLANK.