PHOEBE SUMTER MEDICAL CENTER INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- PHOEBE SUMTER MEDICAL CENTER INC (EIN 26-3975185)
- Tax period
- 2022-08-01 to 2023-07-31
- Filed
- 2024-06-14
- IRS object ID
- 202411669349301106
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-06-14T10:36:00-04:00 | ReturnTs |
| Tax Period End | 2023-07-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 580914992 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRAFFIN & TUCKER LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71309 | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317081309 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-08-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263975185 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHOEBE SUMTER MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PHOE | BusinessNameControlTxt |
| Phone | 2299246011 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 126 HWY 280 WEST | AddressLine1Txt |
| City | AMERICUS | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317198645 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRIAN CHURCH | PersonNm |
| Person Title | BD MBR/PPHS CFO/CAO | PersonTitleTxt |
| Phone | 2299246011 | PhoneNum |
| Signature | 2024-06-03 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | BRIAN | PersonFirstNm |
| Person Last | CHURCH | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | false | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | STEPHEN D HARRELL | PreparerPersonNm |
| PTIN | P01554887 | PTIN |
| Phone | 2298837878 | PhoneNum |
| Preparation | 2024-06-14 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CARLYLE WALTON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 126 HWY 280 WEST | AddressLine1Txt |
| City | AMERICUS | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317198645 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $113,173,886 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PHOEBEHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2009 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | WE EMPOWER EVERY MEMBER OF THE PHOEBE FAMILY TO SAFEGUARD THE HEALTH OF OUR COMMUNITIES - EMBRACING A CULTURE THAT DELIVERS GREAT PATIENT EXPERIENCES, INNOVATIVE TREATMENTS, AND ACCESS TO SUPERIOR CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 635 | TotalEmployeeCnt |
| Total Volunteers | 42 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $11,145,355 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,775,892 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $96,885,710 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $100,957,941 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,771,054 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,169,058 | CYInvestmentIncomeAmt |
| PY Other Revenue | $5,345,458 | PYOtherRevenueAmt |
| CY Other Revenue | $6,383,322 | CYOtherRevenueAmt |
| PY Total Revenue | $115,147,577 | PYTotalRevenueAmt |
| CY Total Revenue | $111,286,213 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $206,600 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $253,877 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $32,107,245 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $32,741,471 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $70,968,765 | PYOtherExpensesAmt |
| CY Other Expenses | $69,590,619 | CYOtherExpensesAmt |
| PY Total Expenses | $103,282,610 | PYTotalExpensesAmt |
| CY Total Expenses | $102,585,967 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $11,864,967 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $8,700,246 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $160,506,223 | TotalAssetsBOYAmt |
| Total Assets EOY | $172,310,863 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $14,693,921 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,686,613 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $145,812,302 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $156,624,250 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WE EMPOWER EVERY MEMBER OF THE PHOEBE FAMILY TO SAFEGUARD THE HEALTH OF OUR COMMUNITIES - EMBRACING A CULTURE THAT DELIVERS GREAT PATIENT EXPERIENCES, INNOVATIVE TREATMENTS, AND ACCESS TO SUPERIOR CARE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $82,127,250 | ExpenseAmt |
| Grant | $253,877 | GrantAmt |
| Revenue | $105,381,381 | RevenueAmt |
| Desc | TO BE THE LEADING PROVIDER OF QUALITY, COST EFFECTIVE, PATIENT- CENTERED HEALTH CARE SERVICES TO RESIDENTS OF THE COMMUNITY, REGARDLESS OF ABILITY TO PAY, PSMC PURSUES ITS MISSION THROUGH A PATIENT-CENTERED ENVIRONMENT OF CARE REFLECTING HIGH STANDARDS AND PROMOTING A BALANCE OF PROFESSIONAL PREPARATION AND SERVICE, CONTINUOUS IMPROVEMENT BASED ON OUR CORE VALUES OF SAFETY, COMMUNITY, COMPASSION, SERVICE AND COMMITMENT. | Desc |
| Total Program Service Expenses | $82,127,250 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (true) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 45 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 635 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRIAN CHURCH | PersonNm |
| Phone | 2293124068 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3770 | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317063770 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SCOTT STEINER | ||||||||||
| BD MBR PPHS | 1.00 | 55.00 | Yes (X) | Yes (X) | $0 | $1,185,685 | $270,693 | |||
| BRIAN CHURCH | ||||||||||
| BD MBR/PPHS | 1.00 | 55.00 | Yes (X) | Yes (X) | $0 | $843,332 | $178,095 | |||
| JOHN CRISP | ||||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| SANDRA DANIEL PHD RN | ||||||||||
| VICE CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JOHN FENNESSY MD | ||||||||||
| BOARD MEMBER | 1.00 | 40.00 | Yes (X) | $0 | $1,557,880 | $46,523 | ||||
| G BARDIN HOOKS JR | ||||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| EDWARD F JACKSON JR | ||||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| ALTON MARCUS SR | ||||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| FREDRICK MCLAUGHLIN EDD | ||||||||||
| CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| SANDRA LEE ZORNES MD | ||||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| DALE LAWSON MD | ||||||||||
| BOARD MEM/PH | 1.00 | 0.00 | Yes (X) | $94,380 | $216,237 | $0 | ||||
| TARANG VIC PATEL | ||||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOE AUSTIN | ||||||||||
| PPMH CEO | 0.00 | 40.00 | $0 | $1,097,950 | $36,394 | Yes (X) | ||||
| MICHELLE DOGGETT | ||||||||||
| CONTROLLER P | 50.00 | 0.00 | Yes (X) | $132,782 | $0 | $35,970 | ||||
| CARLYLE WALTON | ||||||||||
| CEO PSMC | 50.00 | 0.00 | Yes (X) | $0 | $143,597 | $21,632 | ||||
| SUSAN BRUNS | ||||||||||
| CNO PSMC | 50.00 | 0.00 | Yes (X) | $0 | $213,072 | $25,477 | ||||
| DAWN BENSON | ||||||||||
| SVP- GENERAL | 1.00 | 52.00 | $0 | $579,794 | $75,262 | Yes (X) | ||||
| TOMOMI COLQUITT | ||||||||||
| RN | 50.00 | 0.00 | $185,215 | $0 | $2,457 | Yes (X) | ||||
| DARRYL HAWKINS | ||||||||||
| DIRECTOR OF | 40.00 | 0.00 | $158,908 | $0 | $41,008 | Yes (X) | ||||
| CHRISTY HARDIN | ||||||||||
| ASST. DIR PH | 40.00 | 0.00 | $158,079 | $0 | $4,631 | Yes (X) | ||||
| DIANNA WINDHAM | ||||||||||
| RN | 50.00 | 0.00 | $173,497 | $0 | $22,890 | Yes (X) | ||||
| DEBORAH MCWILLIAMS | ||||||||||
| RN | 50.00 | 0.00 | $191,666 | $0 | $5,631 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,094,527 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,837,547 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $766,663 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 39 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MEDICAL SOLUTIONS LLC | |||||
| PO BOX 310737 | DES MOINES | IA | 50331 | CONTRACT STAFF | $7,761,953 |
| HEALTH CAROUSEL LLC | |||||
| P O BOX 714216 | CINCINNATI | OH | 452714216 | CONTRACT STAFF | $2,104,159 |
| INNOVATIVE THERAPY CONCEPTS LLC | |||||
| 2 MASHBURN ST SUITE 102 | HAWKINSVILLE | GA | 31036 | THERAPY | $1,463,502 |
| POWELL CONTRACT SERVICES LLC | |||||
| PO BOX 84 | SYLVESTER | GA | 31791 | CONSTRUCTION | $1,250,493 |
| SENTRY ANESTHESIA MANAGEMENT LLC | |||||
| 6225 N STATE HIGHWAY 161 STE 200 | IRVING | TX | 75038 | ANESTHESIA SVCS | $888,565 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $108,876 | RelatedOrganizationsAmt |
| Government Grants | $258,376 | GovernmentGrantsAmt |
| All Other Contributions | $1,408,640 | AllOtherContributionsAmt |
| Total Contributions | $1,775,892 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROGRAM SERVICE REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $100,957,941 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $100,957,941 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $100,957,941 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,824,761 | TotalRevenueColumnAmt |
| Exclusion | $1,824,761 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,003,407 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $25,306 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $978,101 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $978,101 | TotalRevenueColumnAmt |
| Exclusion | $978,101 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,206,664 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,862,367 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $344,297 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $344,297 | TotalRevenueColumnAmt |
| Exclusion | $344,297 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| 340B PROGRAM | 621990 | $2,671,493 | $2,671,493 | |
| MIGRANT HEALTH REVENUE | 621990 | $1,425,938 | $1,425,938 | |
| EMPLOYEE PHARMACY REVENUE | 621990 | $548,450 | $548,450 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $759,340 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $326,009 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $433,331 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $5,405,221 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $111,286,213 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $105,381,381 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $4,128,940 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $208,918 | TotalAmt |
| Program Services | $208,918 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,959 | TotalAmt |
| Program Services | $44,959 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $263,132 | TotalAmt |
| Program Services | $94,380 | ProgramServicesAmt |
| Management And General | $168,752 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,297,101 | TotalAmt |
| Program Services | $22,822,924 | ProgramServicesAmt |
| Management And General | $3,474,177 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $529,656 | TotalAmt |
| Program Services | $459,688 | ProgramServicesAmt |
| Management And General | $69,968 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,713,024 | TotalAmt |
| Program Services | $3,222,534 | ProgramServicesAmt |
| Management And General | $490,490 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,938,558 | TotalAmt |
| Program Services | $1,654,268 | ProgramServicesAmt |
| Management And General | $284,290 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $339 | TotalAmt |
| Management And General | $339 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,310 | TotalAmt |
| Management And General | $101,310 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,206 | TotalAmt |
| Management And General | $169,206 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,251,340 | TotalAmt |
| Program Services | $25,421,575 | ProgramServicesAmt |
| Management And General | $9,829,765 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,978 | TotalAmt |
| Management And General | $63,978 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,655,754 | TotalAmt |
| Program Services | $2,275,978 | ProgramServicesAmt |
| Management And General | $379,776 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $498,199 | TotalAmt |
| Program Services | $267,009 | ProgramServicesAmt |
| Management And General | $231,190 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,409,020 | TotalAmt |
| Program Services | $749,599 | ProgramServicesAmt |
| Management And General | $659,421 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,271 | TotalAmt |
| Program Services | $76,118 | ProgramServicesAmt |
| Management And General | $23,153 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,692 | TotalAmt |
| Program Services | $40,438 | ProgramServicesAmt |
| Management And General | $254 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,928,949 | TotalAmt |
| Program Services | $2,090,201 | ProgramServicesAmt |
| Management And General | $1,838,748 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,523,763 | TotalAmt |
| Management And General | $1,523,763 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $19,787,078 | $19,787,078 | |
| REPAIRS & MAINTENANCE | $2,192,201 | $1,671,818 | $520,383 |
| PROVIDER TAX | $1,092,473 | $1,092,473 | |
| MISCELLANEOUS | $610,124 | $72,023 | $538,101 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,922 | TotalAmt |
| Program Services | $75,269 | ProgramServicesAmt |
| Management And General | $91,653 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,585,967 | TotalAmt |
| Program Services | $82,127,250 | ProgramServicesAmt |
| Management And General | $20,458,717 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,060,905 | BOYAmt |
| EOY | $48,726,202 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,188,989 | BOYAmt |
| EOY | $13,340,372 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,857 | BOYAmt |
| EOY | $10,857 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,775,970 | BOYAmt |
| EOY | $2,660,489 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $318,035 | BOYAmt |
| EOY | $277,094 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $95,710,936 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $42,349,321 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,946,044 | BOYAmt |
| EOY | $53,361,615 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,758,726 | BOYAmt |
| EOY | $48,900,377 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,446,697 | BOYAmt |
| EOY | $5,033,857 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $160,506,223 | BOYAmt |
| EOY | $172,310,863 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,760,294 | BOYAmt |
| EOY | $10,008,501 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $783,888 | BOYAmt |
| EOY | $745,708 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,149,739 | BOYAmt |
| EOY | $4,932,404 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,693,921 | BOYAmt |
| EOY | $15,686,613 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $141,812,302 | BOYAmt |
| EOY | $152,624,250 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,000,000 | BOYAmt |
| EOY | $4,000,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,812,302 | BOYAmt |
| EOY | $156,624,250 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $160,506,223 | BOYAmt |
| EOY | $172,310,863 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $8,700,246 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,964,676 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $147,026 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $15,603 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $15,603 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | PART II-B, LINE 1I THE ORGANIZATION PAYS MEMBERSHIP DUES TO A NATIONAL HEALTHCARE ORGANIZATION. A PORTION OF THOSE DUES IS ALLOCATED TO LOBBYING ACTIVITIES IN WHICH THE NATIONAL HEALTHCARE ORGANIZATION PARTICIPATE. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,000,000 | BeginningYearBalanceAmt |
| End Year Balance | $4,000,000 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,000,000 | BeginningYearBalanceAmt |
| End Year Balance | $4,000,000 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,000,000 | BeginningYearBalanceAmt |
| End Year Balance | $4,000,000 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,000,000 | BeginningYearBalanceAmt |
| End Year Balance | $4,000,000 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,000,000 | BeginningYearBalanceAmt |
| End Year Balance | $4,000,000 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,039,360 | OtherCostOrOtherBasisAmt |
| Book Value | $2,039,360 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $56,749,049 | OtherCostOrOtherBasisAmt |
| Depreciation | $22,779,022 | DepreciationAmt |
| Book Value | $33,970,027 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,373,758 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,570,299 | DepreciationAmt |
| Book Value | $15,803,459 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,548,769 | OtherCostOrOtherBasisAmt |
| Book Value | $1,548,769 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $53,361,615 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| RELATED PARTY PAYABLES | $4,765,465 |
| CARES ACT REFUNDABLE ADVANCE | $166,939 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,932,404 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $113,276,195 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $1,964,676 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $1,964,676 | RevenueNotReportedAmt |
| Revenue Subtotal | $111,311,519 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$25,306 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$25,306 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $111,286,213 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $102,611,273 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $25,306 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $25,306 | ExpensesNotReportedAmt |
| Expenses Subtotal | $102,585,967 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $102,585,967 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 2, PART V, LINE 4 | DURING FISCAL YEAR 2007, SUMTER REGIONAL HOSPITAL, AS OPERATED BY THE AUTHORITY, WAS DESTROYED IN A TORNADO. THE AMERICUS-SUMTER COUNTY HOSPITAL AUTHORITY (AUTHORITY) ENTERED INTO A LEASE AND TRANSFER AGREEMENT WHICH INCLUDED THE CONSTRUCTION OF A NEW HOSPITAL FACILITY. THE AUTHORITY HAS RECEIVED PROCEEDS FROM THE FEDERAL EMERGENCY MANAGEMENT AGENCY (FEMA) AND THE GEORGIA EMERGENCY MANAGEMENT AGENCY (GEMA) FOR A PORTION OF THE CONSTRUCTION COSTS OF THE NEW HOSPITAL AND INTENDS TO PURSUE FURTHER REIMBURSEMENT FROM FEMA AND GEMA TO THE FULLEST EXTENT POSSIBLE. IT IS ANTICIPATED, BASED ON GUIDANCE RECEIVED FROM AN INDEPENDENT CONSULTANT, THAT THE PROJECT AUDITS ARE LIKELY TO BE CONDUCTED BY FEMA AND GEMA ONCE ALL OUTSTANDING CLAIMS ARE CLOSED, WHICH COULD RESULT IN DEMAND(S) TO RECOVER A PORTION OF THE FUNDS PAID TO THE AUTHORITY. EFFECTIVE WITH AN AMENDMENT TO THE LEASE AND TRANSFER AGREEMENT (AMENDMENT) DATED SEPTEMBER 27, 2016, THE AUTHORITY TRANSFERRED APPROXIMATELY 11,745,000 OF RECEIPTS FROM FEMA AND GEMA TO THE HOSPITAL. THE AMENDMENT SPECIFIES THAT THE FEMA AND GEMA FUNDS MAY BE USED FOR THE FOLLOWING PURPOSES: .... FIRST, TO PAY FEMA AND GEMA ALL SUMS DETERMINED TO BE OWED AS A RESULT OF ANY AUDITS. .... SECOND, AND ONLY AFTER ADEQUATE PROVISION FOR THE FUNDING OF THE FIRST BULLET POINT, THE FUNDS CAN BE USED TO FUND PHYSICIAN DEVELOPMENT IN THE HOSPITALS SERVICE AREA. .... THIRD, AND ONLY AFTER ADEQUATE PROVISION FOR THE FIRST TWO BULLET POINTS ABOVE, THE FUNDS CAN BE USED BY THE HOSPITAL FOR ANY PURPOSES PERMITTED UNDER THE LEASE AND TRANSFER AGREEMENT. ALSO IN ACCORDANCE WITH THE AMENDMENT, THE HOSPITAL AGREED TO ESTABLISH A SEPARATE ACCOUNT TO HOLD THE SUM OF 4,000,000 OF THE ABOVE FUNDS UNTIL THE CONCLUSION OF THE EXPECTED FEMA AND GEMA AUDITS TO ENSURE THE IMMEDIATE AVAILABILITY OF FUNDS TO REPAY ANY AMOUNTS FINALLY DETERMINED TO BE OWED TO FEMA AND GEMA AS A RESULT OF THE AUDITS. SHOULD THE 4,000,000 NOT BE SUFFICIENT TO REPAY ANY AMOUNTS DUE TO FEMA AND GEMA, THE HOSPITAL AGREES THAT IT WILL PAY IN FULL AND FULLY INDEMNIFY THE AUTHORITY FOR ALL RELATED SUMS FINALLY DETERMINED TO BE OWED TO FEMA AND GEMA. THE AMENDMENT STATES THAT THE ADEQUATE PROVISION OF BOTH THE FEMA AND GEMA FUND REPAYMENT AND THE ADEQUATE PROVISION TO FUND PHYSICIAN DEVELOPMENT ARE TO BE DETERMINED AT THE SOLE DISCRETION OF THE HOSPITAL. PER A HOSPITAL BOARD OF DIRECTORS RESOLUTION DATED NOVEMBER 1, 2016, THE HOSPITAL BELIEVES THE 4,000,000 IS ADEQUATE PROVISION FOR THE REPAYMENT OF THE FEMA AND GEMA FUNDS. ALSO, BASED ON THE CURRENT AND LONG-TERM PHYSICIAN DEVELOPMENT PLAN, COUPLED WITH THE REQUIREMENT THAT THE HOSPITAL CHIEF EXECUTIVE OFFICER REPORT ON THE EFFORTS AND RESULTS OF PHYSICIAN DEVELOPMENT AT EACH BOARD OF DIRECTORS MEETING, AND THE REQUIREMENT THAT THE HOSPITALS BOARD OF DIRECTORS APPROVE THE BUDGET AND STRATEGIC PLAN EACH YEAR, THE HOSPITAL BELIEVES THIS CONSTITUTES ADEQUATE PROVISION FOR THE FUNDING OF PHYSICIAN DEVELOPMENT. |
| SCHEDULE D, PAGE 3, PART X | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE HOSPITAL ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEETS FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF JULY 31, 2023 AND 2022 OR FOR THE YEARS THEN ENDED. THE HOSPITAL'S TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAXING AUTHORITIES. FOR FEDERAL INCOME TAX PURPOSES, THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. |
| SCHEDULE D, PAGE 4, PART XI, LINE 4B | RENTAL EXPENSES -25,306 CAPITAL CONTRIBUTION 0 |
| SCHEDULE D, PAGE 4, PART XII, LINE 2D | RENTAL EXPENSES 25,306 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,928,808 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,928,808 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04800 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,905,878 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,868,652 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,037,226 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01010 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,834,686 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,868,652 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,966,034 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05810 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $77,864 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $77,864 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $277,331 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $277,331 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,902,514 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,219,584 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,682,930 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01640 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $58,903 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $58,903 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,316,612 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,219,584 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,097,028 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02050 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $36,151,298 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $28,088,236 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,063,062 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07860 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $210,668 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $210,668 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $210,668 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $210,668 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $13,028,074 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $12,670,695 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $13,726,634 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,055,939 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHOEBE SUMTER MEDICAL CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 126 HIGHWAY 280 WEST | AddressLine1Txt |
| City | AMERICUS | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31719 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PHOEBEHEALTH.COM | WebsiteAddressTxt |
| State License | 129-663 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | HOSPICE, RHC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHOEBE SUMTER MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.PHOEBEHEALTH.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.PHOEBEHEALTH.COM | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.PHOEBEHEALTH.COM | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.PHOEBEHEALTH.COM | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.PHOEBEHEALTH.COM | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, PHOEBE SUMTER MEDICAL CENTER, INC. - PART V, LINE 3E | ELEVEN SIGNIFICANT HEALTH NEEDS ARE IDENTIFIED IN THE CHNA: 1) MENTAL HEALTH AND MENTAL DISORDERS 2) NUTRITION AND HEALTHY EATING 3) MATERNAL AND CHILD HEALTH 4) CANCER 5) QUALITY OF HEALTHCARE SERVICES 6) WEIGHT STATUS 7) DIABETES 8) INJURY AND VIOLENCE 9) ACCESS TO AFFORDABLE HEALTH CARE SERVICES 10) HEART DISEASE AND STROKE 11) ALCOHOL AND DRUG USE |
| FACILITY 1, PHOEBE SUMTER MEDICAL CENTER, INC. - PART V, LINE 5 | TO COLLECT COMMUNITY INPUT - - 1 FOCUS GROUP WAS CONDUCTED WITH KEY COMMUNITY MEMBERS TO INTEGRATE THEIR PERSPECTIVE AND LIVED EXPERIENCE INTO THE DATA; MAYORS AND CITY MANAGERS WERE SURVEYED AS WELL. - 153 RESIDENTS FROM MACON, MARION, SCHLEY AND SUMTER COUNTY PARTICIPATED IN THE COMMUNITY SURVEY. SURVEY WAS AVAILABLE IN ENGLISH AND SPANISH. SECONDARY DATA, OR NUMERICAL HEALTH INDICATORS, FROM NATIONAL, STATE, AND LOCAL SOURCES WERE ANALYZED. |
| FACILITY 1, PHOEBE SUMTER MEDICAL CENTER, INC. - PART V, LINE 11 | THE FOLLOWING 3 NEEDS WERE RANKED HIGHEST BASED ON THE CHNA RESULTS: MATERNAL & CHILD HEALTH, NUTRITION AND HEALTHY EATING, AND MENTAL HEALTH AND MENTAL DISORDERS. SIGNIFICANT HEALTH NEEDS WERE PRIORITIZED BASED ON THE SCOPE AND SEVERITY OF EACH HEALTH ISSUE, AND THE ABILITY FOR POSITIVE IMPACT ON EACH HEALTH ISSUE. ANY NEEDS NOT ADDRESSED AS PRIORITIES WERE DUE TO RESOURCE LIMITATIONS AND/OR STRATEGIC FIT. |
| FACILITY 1, PHOEBE SUMTER MEDICAL CENTER, INC. - PART V, LINE 20E | WRITTEN NOTICE OF THE AVAILABILITY OF FINANCIAL ASSISTANCE IS INCLUDED ON HOSPITAL PATIENT STATEMENTS, AND ON WRITTEN COMMUNICATIONS SENT BY CONTRACTED THIRD PARTY COLLECTION AGENCIES. THESE AGENCIES MAY REFER ACCOUNTS FOR REPORTING TO MAJOR CREDIT BUREAUS, AFTER A SERIES OF STATEMENTS AND LETTERS ARE SENT THROUGHOUT MULTIPLE COLLECTION CYCLES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| PHOEBE SUMTER HOSPICE | ||||
| 126 HWY 280 WEST | AMERICUS | GA | 31719 | HOSPICE |
| ELLAVILLE PRIMARY MEDICINE | ||||
| 339 S BROAD STREET | ELLAVILLE | GA | 31806 | RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7, COLUMN (F) | IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN (F), THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25: FORM 990, PART IX, LINE 25 102,585,967 ADD: EXPENSES REPORTED IN PART VIII 25,306 DENOMINATOR FOR COLUMN (F) 102,611,273 |
| SCHEDULE H, PART I, LINE 7 | THE COST OF MEDICAID AND CHARITY CARE WAS CALCULATED USING THE COST-TO- CHARGE RATIO AS CALCULATED USING WORKSHEET 2 FROM THE IRS FORM 990 INSTRUCTIONS. THE COST OF OTHER BENEFITS WAS THE DIRECT COST OF THE SERVICES. |
| SCHEDULE H, PART III, LINE 2 | THE BAD DEBT EXPENSE (OR PRICE CONCESSION) AMOUNT REPRESENTS THE DIFFERENCE BETWEEN AMOUNTS BILLED AND THE ESTIMATED CONSIDERATION THE HOSPITAL EXPECTS TO RECEIVE FROM PATIENTS, WHICH ARE DETERMINED BASED ON HISTORICAL COLLECTION EXPERIENCE, CURRENT MARKET CONDITIONS, AND OTHER FACTORS. CONSISTENT WITH THE HOSPITAL'S MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, THE HOSPITAL HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES (FOR EXAMPLE, COPAYS AND DEDUCTIBLES.) |
| SCHEDULE H, PART III, LINE 4 | SEE FOOTNOTE 2 PAGES 15-20 ON THE ACCOMPANYING AUDITED FINANCIAL STATEMENTS FOR THE DISCUSSION OF IMPLICIT PRICE CONCESSIONS, BAD DEBT EXPENSE, AND UNINSURED PATIENTS. |
| SCHEDULE H, PART III, LINE 8 | MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. |
| SCHEDULE H, PART III, LINE 9B | THE ORGANIZATION WRITES OFF PATIENT ACCOUNTS RECEIVABLE BALANCES FOR PATIENTS QUALIFYING FOR CHARITY CARE OR FINANCIAL ASSISTANCE AND DOES NOT MAKE FURTHER COLLECTION EFFORTS. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS ASSESSMENTS HAVE TRADITIONALLY LED TO THE CREATION OF COMMUNITY-BASED DELIVERY SYSTEMS THAT EXPAND ACCESS TO HEALTH CARE, MEET THE NEEDS OF THE PEOPLE AND BUILD HEALTHY COMMUNITIES IN THE BROADEST SENSE BY IMPACTING MAJOR DETERMINANTS, SUCH AS ECONOMIC DEVELOPMENT, EMPLOYMENT, CHILDREN'S SAFETY, EDUCATION AND ADEQUATE HOUSING. THE ORGANIZATION CONDUCTS REGULAR NEEDS ASSESSMENT THROUGH FORMAL AND INFORMAL SURVEYS AND PROCESSES, INCLUDING COLLABORATIONS WITH PUBLIC AND COMMUNITY AGENCIES. THROUGH STRATEGIC PLANNING AND COMMUNITY INTERVIEWS, THE ORGANIZATION DEVELOPS PROGRAMS AND SERVICES THAT CONSIDER THE ECONOMIC IMPERATIVES OF THE REGION, THE EFFECT OF LEGISLATION AND THE INVOLVEMENT OF OTHER COMMUNITY-BASED ORGANIZATIONS AND PARTNERS. THE ORGANIZATION REGULARLY CONDUCTS FOCUS GROUPS IN THE COMMUNITY TO UNDERSTAND ISSUES AFFECTING ITS PATIENTS, AND HAS CREATED PROGRAMS IN RESPONSE TO HEALTH DISPARITIES PREVALENT IN THE AREA. THE ORGANIZATION ALSO COLLECTS HEALTH NEEDS INFORMATION FROM NURSES, WHO PROVIDE DIRECT CARE TO STUDENTS AND STAFF AND WHO COLLABORATE WITH OTHER AGENCIES TO DEVELOP HEALTH AWARENESS AND DISEASE PREVENTION PROGRAMS. THE ORGANIZATION ALSO CONDUCTS REGULAR PHYSICIAN WORKFORCE STUDIES THROUGH ITS STRATEGIC PLANNING ARM TO DETERMINE UNMET PHYSICIAN NEEDS AND BARRIERS TO ACCESSING CARE. THE ORGANIZATION MEASURES THE SUCCESS OF ITS COMMITMENT BY HOW WELL IT KEEPS PEOPLE HEALTHY AND HOW WELL IT IMPACTS THE SOCIAL/CULTURAL BONDS THAT WILL SECURE THE COMMUNITIES OF THE FUTURE. THE HOSPITAL LAST CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2022. A COMPLETE COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, COMMUNITY PRIORITIES, AND IMPLEMENTATION PLAN CAN BE FOUND AT - HTTPS://WWW.PHOEBEHEALTH.COM/MEDIA/FILE/PHOEBE%20SUMTER%20MEDICAL %20CENTER/CHNA_PSMC2022.PDF |
| SCHEDULE H, PART VI, LINE 3 | THE BOARD HAS CLEARLY WRITTEN FINANCIAL ASSISTANCE POLICY THAT IS AVAILABLE ON THE ORGANIZATION'S WEB SITE AND THROUGH THE BUSINESS OFFICE. SIGNS ARE PROMINENTLY POSTED ON THE AVAILABILITY OF FREE AND CHARITY CARE. PATIENT EDUCATION ON THE ORGANIZATION'S FINANCIAL ASSISTANCE IS CONDUCTED DURING PRE-REGISTRATION, THROUGH FLOOR VISITS BY BUSINESS OFFICE REPRESENTATIVES FOR PATIENTS THAT STRESS CONCERN IN MEETING THE FINANCIAL OBLIGATIONS FOR THEIR SERVICES, AND THROUGH OUR CUSTOMER SERVICE DEPARTMENT. BROCHURES ARE PROMINENTLY DISPLAYED AT EACH REGISTRATION BOOTH. THE BUSINESS OFFICE CONTINUOUSLY PROVIDES UPDATED MATERIAL TO PHYSICIAN OFFICES FOR ISSUANCE TO THEIR PATIENTS THAT HIGHLIGHT THE FINANCIAL ASSISTANCE PROGRAM AND POLICIES. THE PATIENT STATEMENTS HIGHLIGHT THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY AND ENCOURAGES PATIENTS TO CALL FOR FINANCIAL ASSISTANCE. |
| SCHEDULE H, PART VI, LINE 4 | PSMC IS LOCATED IN SUMTER COUNTY, GEORGIA. THERE ARE APPROXIMATELY 28,864 RESIDENTS OF SUMTER COUNTY WITH A RACIAL MIX OF 53% AFRICAN AMERICAN, 39% CAUCASIAN, AND 8% OTHER. POPULATION PROJECTIONS FOR SUMTER COUNTY SHOW OVERALL POPULATION GROWTH OF APPROXIMATELY 0.09% IN THE NEXT FEW YEARS. THE HOUSEHOLD MEDIAN INCOME FOR SUMTER COUNTY AVERAGED 38,899 IN 2022 DOLLARS, AND ABOUT 22.3% OF INDIVIDUALS OF THE POPULATION WERE BELOW THE POVERTY LINE. IN ADDITION TO SUMTER COUNTY, PSMC HAS A SERVICE AREA THAT INCLUDES MARION, MACON, DOOLY, STEWART, WEBSTER, SCHLEY AND TAYLOR COUNTIES. PSMC HAS A GOOD RELATIONSHIP WITH THESE COUNTIES, AND IMPLEMENTED A REGIONAL ADVISORY COUNCIL IN 2015 TO BETTER SERVE THE NEEDS OF THESE COMMUNITIES AND THEREFORE PRACTICE A TRUE POPULATION HEALTH METHODOLOGY. |
| SCHEDULE H, PART VI, LINE 5 | THE ORGANIZATION AND ITS VOLUNTEER BOARD IS COMPOSED OF COMMUNITY MEMBERS WITH DIVERSE PROFESSIONAL AND COMMUNITY SERVICE BACKGROUNDS, AS WELL AS PHYSICIAN MEMBERS. THE ORGANIZATION'S EMERGENCY CENTER IS OPERATED 24/7 AND OPEN TO ALL PERSONS, REGARDLESS OF ABILITY TO PAY. THE BOARD MAINTAINS OPEN MEDICAL STAFF POLICIES WITH PRIVILEGES AVAILABLE TO ALL QUALIFYING PHYSICIANS. THE BOARD HAS A CLEARLY WRITTEN FINANCIAL ASSISTANCE POLICY THAT IS AVAILABLE ON THE ORGANIZATION'S WEB SITE AND THROUGH THE BUSINESS OFFICE. SIGNS ARE PROMINENTLY POSTED ON THE AVAILABILITY OF FREE AND CHARITY CARE. THE ORGANIZATION HAS A MULTI-PRONGED APPROACH TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES: INCREASING ACCESS, BUILDING CAPACITY, INVESTING IN "UPSTREAM" PROGRAMS THAT GET AT THE CAUSE OF DISEASE AND ILLNESS, BUILDING COMMUNITY PARTNERSHIPS, ADVOCATING CHANGE, AND DEVELOPING LEADERSHIP. SURPLUS FUNDS ARE REINVESTED IN RESOURCES TO IMPROVE THE DELIVERY OF MEDICAL AND HEALTH CARE SERVICES. PRIMARY CARE IS FIRST AND CREATES A PROFOUND IMPACT ON THE COMMUNITIES SERVED. PRIMARY CARE SERVICES ARE ESTABLISHED IN AREAS WHERE RESIDENTS ARE MOST LIKELY TO SUFFER FROM SEVERE MANPOWER SHORTAGES, HIGH POVERTY LEVELS AND A LACK OF ACCESS TO CARE. |
| SCHEDULE H, PART VI, LINE 6 | PHOEBE PUTNEY HEALTH SYSTEM, INC. (PPHS) IS THE NOT-FOR-PROFIT PARENT COMPANY OF PHOEBE PUTNEY MEMORIAL HOSPITAL, INC. (PPMH), A NOT-FOR-PROFIT ENTITY, PHOEBE PUTNEY HEALTH VENTURES, INC. (PPHV), A FOR-PROFIT CORPORATION, PHOEBE PHYSICIAN GROUP, INC. (PPG), A NOT-FOR-PROFIT CORPORATION, PHOEBE WORTH MEDICAL CENTER, INC. (PWMC), A NOT-FOR-PROFIT ENTITY, PHOEBE SUMTER MEDICAL CENTER, INC. (PSMC), A NOT-FOR-PROFIT ENTITY, PHOEBE PUTNEY INDEMNITY, LTD. (PPI), A WHOLLY-OWNED SUBSIDIARY,AND PHOEBE FOUNDATION, INC. (PF), A NOT-FOR-PROFIT ENTITY. PPMH IS LOCATED IN ALBANY, GEORGIA, IS AN ACUTE CARE HOSPITAL, WHICH OPERATES SATELLITE CLINICS IN THE SURROUNDING COUNTIES. IT PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF SOUTHWEST GEORGIA. ADMITTING PHYSICIANS ARE PRIMARILY PRACTITIONERS IN THE LOCAL AREA. PPHV ENGAGES IN HEALTHCARE AND RELATED ACTIVITIES IN FURTHERANCE OF THE EXEMPT PURPOSES OF PPHS AND PPMH. PWMC, LOCATED IN SYLVESTER, GEORGIA, IS A 25 BED RURAL CRITICAL ACCESS HOSPITAL. IT PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF WORTH COUNTY, GEORGIA. PSMC, LOCATED IN AMERICUS, GEORGIA, IS AN ACUTE CARE HOSPITAL. IT PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF SUMTER COUNTY, GEORGIA. PPG WAS ESTABLISHED TO ORGANIZE AND OPERATE MEDICAL PRACTICES EXCLUSIVELY FOR THE BENEFIT OF PPMH, PWMC, AND PSMC. PPI WAS INCORPORATED ON NOVEMBER 14, 2018 AS AN EXEMPTED COMPANY UNDER THE COMPANIES LAW OF THE CAYMAN ISLANDS. PPI IS A WHOLLY-OWNED SUBSIDIARY OF PPHS ESTABLISHED TO PROVIDE GENERAL LIABILITY, PROFESSIONAL LIABILITY, PERSONAL INJURY LIABILITY, ADVERTISING INJURY LIABILITY, CONTRACTUAL LIABILITY, AND AUTO PHYSICAL DAMAGE COVERAGE TO PPHS. PF WAS ESTABLISHED TO RAISE FUNDS OF ANY KIND OR CHARACTER TO BE USED EXCLUSIVELY FOR CHARITABLE, MEDICAL, EDUCATIONAL AND SCIENTIFIC PURPOSES AT OR IN CONNECTION WITH PPMH OR THE HOSPITAL AUTHORITY OF ALBANY-DOUGHERTY COUNTY, GEORGIA (AUTHORITY). PHOEBE SUMTER FOUNDATION, INC. WAS ESTABLISHED TO RAISE FUNDS TO SUPPORT PSMC. PHOEBE SUMTER FOUNDATION, INC.'S BYLAWS PROVIDE THAT THE MAJORITY OF ALL FUNDS RAISED, EXCEPT FOR FUNDS ACQUIRED FOR THE OPERATION OF THE FOUNDATION, BE DISTRIBUTED TO OR BE HELD FOR THE BENEFIT OF THE HOSPITAL. |
| SCHEDULE H, PART VI, LINE 7 | GEORGIA |
| SCHEDULE H, PART VI | PHOEBE SUMTER MEDICAL CENTER, INC. (PSMC), FORMERLY SUMTER REGIONAL HOSPITAL, IS A NOT-FOR-PROFIT HEALTH CARE ORGANIZATION THAT EXISTS TO SERVE THE COMMUNITY. PSMC OPENED IN 1953 TO SERVE THE COMMUNITY BY CARING FOR THE SICK REGARDLESS OF THEIR ABILITY TO PAY. AS A NOT-FOR-PROFIT HOSPITAL, PSMC HAS NO STOCKHOLDERS OR OWNERS. ALL REVENUE AFTER EXPENSES IS REINVESTED IN THE MISSION TO CARE FOR THE CITIZENS OF THE COMMUNITY - INTO CLINICAL CARE, HEALTH PROGRAMS, STATE-OF-THE-ART TECHNOLOGY AND FACILITIES, RESEARCH, AND TEACHING AND TRAINING OF MEDICAL PROFESSIONALS NOW AND FOR THE FUTURE. PSMC OPERATES AS A CHARITABLE ORGANIZATION CONSISTENT WITH THE REQUIREMENTS OF INTERNAL REVENUE CODE SECTION 501(C)(3) AND THE "COMMUNITY BENEFIT STANDARD" OF IRS REVENUE RULING 69-545. PSMC TAKES SERIOUSLY ITS RESPONSIBILITY AS THE COMMUNITY'S SAFETY NET HOSPITAL AND HAS A STRONG RECORD OF MEETING AND EXCEEDING THE CHARITABLE CARE AND THE ORGANIZATIONAL AND OPERATIONAL STANDARDS REQUIRED FOR FEDERAL TAX-EXEMPT STATUS. PSMC DEMONSTRATES A CONTINUED AND EXPANDING COMMITMENT TO MEETING ITS MISSION AND SERVING THE CITIZENS BY PROVIDING COMMUNITY BENEFITS. A COMMUNITY BENEFIT IS A PLANNED, MANAGED, ORGANIZED, AND MEASURED APPROACH TO MEETING IDENTIFIED COMMUNITY HEALTH NEEDS, REQUIRING A PARTNERSHIP BETWEEN THE HEALTHCARE ORGANIZATION AND THE COMMUNITY TO BENEFIT RESIDENTS THROUGH PROGRAMS AND SERVICES THAT IMPROVE HEALTH STATUS AND QUALITY OF LIFE. PSMC IMPROVES THE HEALTH AND WELL BEING OF SOUTHWEST GEORGIA THROUGH CLINICAL SERVICES, EDUCATION, RESEARCH, AND PARTNERSHIPS THAT BUILD HEALTH CAPACITY IN THE COMMUNITY. PSMC PROVIDES COMMUNITY BENEFITS FOR ALL CITIZENS, AS WELL AS FOR THE MEDICALLY UNDERSERVED. PSMC CONDUCTS COMMUNITY NEEDS ASSESSMENTS AND PAYS CLOSE ATTENTION TO THE NEEDS OF LOW INCOME AND OTHER VULNERABLE PERSONS AND THE COMMUNITY AT LARGE. PSMC OFTEN WORKS WITH COMMUNITY GROUPS TO IDENTIFY NEEDS, STRENGTHEN EXISTING COMMUNITY PROGRAMS, AND PLAN NEWLY NEEDED SERVICES. IT PROVIDES A WIDE- RANGING ARRAY OF COMMUNITY BENEFIT SERVICES DESIGNED TO IMPROVE COMMUNITY HEALTH AND THE HEALTH OF INDIVIDUALS AND TO INCREASE ACCESS TO HEALTH CARE, IN ADDITION TO PROVIDING FREE AND DISCOUNTED SERVICES TO PEOPLE WHO ARE UNINSURED AND UNDERINSURED. DRAWING ON A DYNAMIC AND FLEXIBLE STRUCTURE, THE COMMUNITY BENEFIT PROGRAMS ARE DESIGNED TO RESPOND TO ASSESSED NEEDS AND ARE FOCUSED ON UPSTREAM PREVENTION. PSMC PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS AND IS ONE OF THE LEADING PROVIDERS OF MEDICAID SERVICES IN GEORGIA. THE FOLLOWING TABLE SUMMARIZES THE AMOUNTS OF CHARGES FOREGONE (I.E., CONTRACTUAL ADJUSTMENTS) AND ESTIMATES THE LOSSES (COMPUTED BY APPLYING A TOTAL COST FACTOR TO CHARGES FOREGONE) INCURRED BY PSMC DUE TO INADEQUATE PAYMENTS BY THESE PROGRAMS AND FOR INDIGENT/CHARITY SERVICES. THIS TABLE DOES NOT INCLUDE DISCOUNTS OFFERED BY PSMC UNDER MANAGED CARE AND OTHER AGREEMENTS: CHARGES ESTIMATED FOREGONE UNREIMBURSED COST MEDICARE 131,000,000 37,000,000 MEDICAID 51,000,000 14,000,000 INDIGENT/CHARITY 19,000,000 5,000,000 201,000,000 56,000,000 THE FOLLOWING IS A SUMMARY OF THE COMMUNITY BENEFIT ACTIVITIES AND HEALTH IMPROVEMENT SERVICES OFFERED BY PSMC AND ILLUSTRATES THE ACTIVITIES AND DONATIONS DURING FISCAL YEAR 2023. I. COMMUNITY HEALTH IMPROVEMENT SERVICES HEALTHY SUMTER IS A HEALTH AND WELLNESS CAMPAIGN THAT IS A COLLABORATIVE EFFORT CO-CONVENED BY PHOEBE SUMTER AND THE ONE SUMTER ECONOMIC DEVELOPMENT FOUNDATION. WITH MORE THAN 25 ORGANIZATIONS AND COUNTING, HEALTHY SUMTER IS A SIMPLE BRAND, ALIGNED WITH THE SUMTER COUNTY BRAND, UNDER WHICH EFFORTS OF MANY NON-PROFITS AND AGENCIES CAN BE ORGANIZED TO RAISE PUBLIC AWARENESS. AREAS OF FOCUS FALL UNDER 3 CATEGORIES: HEALTHY MINDS (I.E. MENTAL HEALTH AWARENESS, LITERACY, ETC.); HEALTHY BODIES (COLORECTAL CANCER AWARENESS, OVERALL FITNESS, ETC.); HEALTHY COMMUNITY (BIKE & TRAIL ACCESS AND OTHER TRANSPORTATION, JOBS AVAILABILITY, HOUSING, CRIME PREVENTION, ETC.). DURING FY2023 THE FOLLOWING HEALTH EDUCATION ACTIVITIES REACHED APPROXIMATELY 1,020 INDIVIDUALS: -SUMTER PINK WALK -ANNUAL HEART WALK -MIDDLE FLINT SENIOR PICNIC -TIES THAT BIND LUNCHEON -CHILDREN'S MENTAL HEALTH DAY -SUMTER COUNTY HEALTH DEPARTMENT HEALTH FAIR THE WELLABLE APP IS AN OPPORTUNITY FOR LOCAL COMMUNITY MEMBERS TO TRACK THEIR PHYSICAL ACTIVITIES AS WELL AS LEARN ABOUT AND ENGAGING IN BEHAVIORS ASSOCIATED WITH A NEW HOLISTIC WELLNESS TOPIC EACH MONTH. PARTICIPANTS ALSO HAVE AN OPPORTUNITY TO EARN POINTS THAT CAN BE REDEEMED FOR HEALTHY SUMTER SWAG, SUCH AS WATER BOTTLES, TUMBLERS, AND T-SHIRTS. SUMTER COUNTY HAS A HIGH RATE OF FOOD INSECURITY, WHICH IS ASSOCIATED WITH CHRONIC HEALTH PROBLEMS IN ADULTS INCLUDING DIABETES, HEART DISEASE, HIGH BLOOD PRESSURE, OBESITY AND MENTAL HEALTH ISSUES INCLUDING MAJOR DEPRESSION. ALSO, SUMTER COUNTY HAS A HIGH NUMBER OF FOOD DESERTS, MEANING THAT RESIDENTS IN THOSE RESPECTIVE AREAS HAVE LITTLE OR NO ACCESS TO FRESH FRUITS AND VEGETABLES. WITH THESE FACTS IN MIND, THE IDEA OF CREATING COMMUNITY GARDENS IN SUMTER AND SURROUNDING AREAS CAME TO PASS. BAGS OF FRESH PRODUCE FROM OUR COMMUNITY GARDENS ALONG WITH FLINT RIVER FRESH AND KONONIA FARMS WAS DISTRIBUTED TO OVER 1,410 INDIVIDUALS AT A COST OF 25,310. PHOEBE SUMTER HOSTED A CHILDREN'S HEALTH FAIR FOR 320 PARTICIPANTS WHO WERE PROVIDED WEIGHT, BMI AND BLOOD PRESSURE READINGS IN ADDITION TO FREE COVID VACCINES. ALSO PROVIDED AT THE EVENT WERE GAMES, A HEALTHY LUNCH, FRUIT AND VEGETABLE BOXES, AS WELL AS BACK-TO-SCHOOL SUPPLIES. THE TOTAL COST FOR THIS EVENT WAS 6,000. PHOEBE SUMTER PROVIDED 58 MAMMOGRAMS TO UNINSURED WOMEN IN 2023 FOR AN ESTIMATED COST OF 8,120. II. HEALTH CARE SUPPORT SERVICES INDIGENT FINANCIAL ASSISTANCE PATIENTS WHOSE INCOME IS BELOW 125% OF THE FEDERAL POVERTY LEVELS ARE CLASSIFIED AS INDIGENT AND RECEIVE CARE AT NO COST. CHARITY FINANCIAL ASSISTANCE PATIENTS WHOSE INCOME LEVEL IS BETWEEN 126% - 400% OF THE FEDERAL POVERTY LEVELS WILL BE CLASSIFIED AS CHARITY. THESE PATIENTS WILL BE RESPONSIBLE FOR A PERCENTAGE OF THE HOSPITAL CHARGES. THIS PERCENTAGE WILL BE BASED ON CALCULATIONS USING THE FEDERAL POVERTY LEVELS THAT ARE PUBLISHED IN THE FEDERAL REGISTER EACH YEAR. IF IT IS DETERMINED THE PATIENT RESPONSIBILITY WILL BE AN UNDUE HARDSHIP ON THE PATIENT/GUARANTOR, THESE CASES WILL BE REVIEWED ON AN INDIVIDUAL BASIS WITH THE PHOEBE CARES SUPERVISOR FOR POSSIBLE CATASTROPHIC CHARITY BASED ON SLIDING SCALE GUIDELINES. CATASTROPHIC FINANCIAL ASSISTANCE PATIENTS WHOSE INCOME EXCEEDS 400% OF THE FEDERAL POVERTY LEVELS AND WHOSE HOSPITAL CHARGES EXCEED 25% OF THEIR ANNUAL INCOME, RESULTING IN EXCESSIVE HARDSHIP, ARE ELIGIBLE FOR A DISCOUNT UP TO 75% OF THE PATIENT BALANCE. THE PATIENT MAY PAY THE REMAINING BALANCE OVER 24 MONTHS. DURING FISCAL YEAR 2023, 402 PATIENTS WERE APPROVED FOR FINANCIAL ASSISTANCE. III. HEALTH PROFESSIONS EDUCATION NURSING STUDENTS IN 2023, PHOEBE SUMTER PROVIDED 237,174 IN CLINICAL SUPERVISION AND TRAINING TO 142 NURSING STUDENTS. OTHER STUDENTS IN 2023, PHOEBE SUMTER PROVIDED 40,157 IN CLINICAL SUPERVISION OF OTHER HEALTHCARE STUDENTS. IV. FINANCIAL AND IN-KIND SUPPORT IN 2023, PHOEBE SUMTER PROVIDED 58,903 FOR ADVERTISING AND PROMOTION OF THE WELLABLE APP. V. COMMUNITY BENEFIT OPERATIONS PSMC INCURRED 38,434 IN SUPPORT STAFF COSTS TO SUPPORT ITS COMMUNITY BENEFIT EFFORTS. VI. WORKFORCE DEVELOPMENT PHOEBE SUMTER MEDICAL CENTER RECOGNIZES THE HEALTHCARE WORKERS SHORTAGE AND IS TAKING STEPS TO HELP ALLEVIATE THAT SHORTAGE. FIRST, PSMC CONTRIBUTED FUNDS TO THE GEORGIA SOUTHWESTERN FOUNDATION TO SUPPORT THE REINSTATEMENT OF THE ASN PROGRAM. SECOND, PSMC HAS CONTRIBUTED FUNDING TO THE IGNITE COLLEGE AND CAREER ACADEMY IN SUPPORT OF THE HEALTH SCIENCES PROGRAM. THE IGNITE COLLEGE AND CAREER ACADEMY HAS A WORK-BASED LEARNING PROGRAM IN WHICH HIGH SCHOOL STUDENTS CAN WORK AND RECEIVE HIGH SCHOOL CREDITS. PHOEBE SUMTER IS ONE OF MANY LOCAL BUSINESSES THAT PARTICIPATE IN THIS PROGRAM ENCOURAGING STUDENTS TO PREPARE FOR WORK IN THE HEALTHCARE FIELD. FINALLY, PSMC HAS CONTRIBUTED FUNDS TO ONE SUMTER ECONOMIC DEVELOPMENT TO SUPPORT THEIR EFFORTS IN WORKFORCE DEVELOPMENT. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| GEORGIA SOUTHWESTERN FOUNDATION | |||||||
| 800 GEORGIA SOUTHWESTERN | AMERICUS | GA | 317094379 | 581386358 | 501C3 | $169,168 | GENERAL SUPPORT |
| IGNITE COLLEGE AND CAREER ACADEMY | |||||||
| 903 S GEORGIA TECH PKWY | AMERICUS | GA | 317098105 | 871839270 | 501C3 | $37,500 | COLLEGE/CAREER ACADE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 10 | RecipientCnt |
| Cash Grant | $44,959 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PROVIDES OVERSIGHT AND MONITORS THE PROGRAM BASED ON UTILIZATION EACH BUDGET YEAR. TUITION POLICY: EMPLOYEE MUST BE EMPLOYED AS A REGULAR FULL TIME EMPLOYEE (64+ HOURS PER PAY PERIOD) FOR AT LEAST ONE YEAR, 12 MONTHS. THEY MUST SCORE A "MEETS EXPECTATIONS- OR GREATER ON THEIR LAST EVALUATION. THE EMPLOYEE MUST MAINTAIN A SEMESTER OR QUARTER GPA OF 2.5 FOR UNDERGRADUATE STUDIES AND 3.0 FOR GRADUATE STUDIES TO RECEIVE TUTITION ASSISTANCE. EMPLOYEE MUST SUBMIT A COPY OF GRADE TO THE BENEFITS DEPARTMENT AND MANAGER AFTER THE COMPLETION OF EACH COURSE. AN EMPLOYEE RECEIVING TUITION ASSISTANCE IS REQUIRED TO WORK FOR PHOEBE ONE YEAR, FULL-TIME UPON DEGREE COMPLETION OR CESSATION FROM THE DEGREE PROGRAM. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SCOTT STEINER | |||||||||||||
| BD MBR PPHS CEO/PRES | $879,828 | $285,000 | $20,857 | $236,675 | $34,018 | $1,456,378 | |||||||
| BRIAN CHURCH | |||||||||||||
| BD MBR/PPHS CFO/CAO | $624,591 | $198,679 | $20,062 | $140,122 | $37,973 | $1,021,427 | |||||||
| JOHN FENNESSY MD | |||||||||||||
| BOARD MEMBER/PHYS. | $1,008,879 | $516,882 | $32,119 | $8,550 | $37,973 | $1,604,403 | |||||||
| DALE LAWSON MD | |||||||||||||
| BOARD MEM/PHYS(12/22 | $216,237 | $216,237 | $94,380 | $94,380 | |||||||||
| JOE AUSTIN | |||||||||||||
| PPMH CEO | $377,686 | $85,164 | $635,100 | $8,550 | $27,844 | $1,134,344 | $181,267 | ||||||
| MICHELLE DOGGETT | |||||||||||||
| CONTROLLER PSMC | $408 | $168,752 | $120,517 | $11,857 | $3,850 | $32,120 | |||||||
| CARLYLE WALTON | |||||||||||||
| CEO PSMC | $106,219 | $30,000 | $7,378 | $17,809 | $3,823 | $165,229 | |||||||
| SUSAN BRUNS | |||||||||||||
| CNO PSMC | $195,137 | $17,119 | $816 | $4,565 | $20,912 | $238,549 | |||||||
| DAWN BENSON | |||||||||||||
| SVP- GENERAL COUNSEL | $425,246 | $66,712 | $87,836 | $75,262 | $655,056 | $46,052 | |||||||
| TOMOMI COLQUITT | |||||||||||||
| RN | $56 | $187,672 | $157,313 | $27,846 | $2,457 | ||||||||
| DARRYL HAWKINS | |||||||||||||
| DIRECTOR OF PHARMACY | $947 | $199,916 | $157,361 | $600 | $5,073 | $35,935 | |||||||
| CHRISTY HARDIN | |||||||||||||
| ASST. DIR PHARMACY | $185 | $162,710 | $157,294 | $600 | $4,631 | ||||||||
| DIANNA WINDHAM | |||||||||||||
| RN | $122 | $196,387 | $151,420 | $21,955 | $22,890 | ||||||||
| DEBORAH MCWILLIAMS | |||||||||||||
| RN | $187 | $197,297 | $165,001 | $26,478 | $5,631 | ||||||||
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 4 | SCOTT STEINER 0 228,125 0 BRIAN CHURCH 0 131,572 0 JOE AUSTIN 165,960 0 0 CARLYLE WALTON 0 17,231 0 DAWN BENSON 0 66,712 0 |
| SCHEDULE J, PART III | SCHEDULE J, PART I, LINE 4 - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS: DEFERRED COMPENSATION PLAN 457(B): THE DEFERRED COMPENSATION PLAN IS AN ADDITIONAL RETIREMENT PLAN OFFERED THROUGH PHOEBE PUTNEY. THE 457(B) PLAN IS AN ELIGIBLE DEFERRED COMPENSATION PLAN THAT ALLOWS ONE TO DEFER ADDITIONAL DOLLARS TOWARDS RETIREMENT. HIGHLIGHTS INCLUDE: O NOT LIMITED BY THE AMOUNTS DEFERRED INTO THE PHOEBE 403(B) O PLAN IS SUBJECT TO ANNUAL DEFERRAL LIMITS SET BY THE IRS O PER IRS REGULATIONS, EACH PARTICIPANT IS A GENERAL UNSECURED CREDITOR OF THE PLAN SPONSOR. AN ELIGIBLE EMPLOYEE IS ONE WHO IS DETERMINED BY THE EMPLOYER TO BE A MEMBER OF A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES WITHIN THE MEANING OF SECTIONS 201(2), 301(A)(3), AND 401(A)(1) OF ERISA. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) 457(F): PPHS RELIES ON AN INDEPENDENT COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, SURVEYS, WELL DOCUMENTED METHODS AND BOARD APPROVAL TO ESTABLISH TOTAL COMPENSATION OF THE CEO AND EXECUTIVE OFFICERS. CERTAIN BOARD APPROVED EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN A SERP THAT PROVIDES CERTAIN DEFINED ANNUAL PAY CREDITS THAT ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. THE PURPOSE OF THE SERP IS TO PROVIDE A LONG-TERM INCENTIVE AND RETIREMENT BENEFIT FOR AFFECTED EXECUTIVES CONSISTENT WITH THE BENEFIT AVAILABLE TO EMPLOYEES NOT IMPACTED BY IRS COMPENSATION LIMITS ON DEFINED BENEFIT PLANS. THE AMOUNTS REPORTED AS SUPPLEMENTAL EXECUTIVE RETIREMENT COMPENSATION FOR ELIGIBLE EMPLOYEES IN SCHEDULE J REPRESENT CREDITED, BUT NOT VESTED, BENEFITS, AND THE AMOUNTS ARE AVAILABLE IN FUTURE PERIODS TO THE EMPLOYEE SUBJECT TO CONTINUING EMPLOYMENT. PPHS MAINTAINS OWNERSHIP OF THE FUNDS ALLOCATED TO EACH PARTICIPANT UNTIL VESTING AND PAYMENT. FOR A PARTICIPANT IN THE SERP PRIOR TO 1/1/2017 (A "GRANDFATHERED PARTICIPANT"), WITH PAY CREDITS FOR PLAN YEARS BEGINNING PRIOR TO 1/1/2020, THE INITIAL VESTING DATE WILL OCCUR ON THE DATE THE PARTICIPANT ATTAINS FIVE YEARS OF PARTICIPATION UNDER THE PLAN. AFTER THE INITIAL VESTING DATE, A GRANDFATHERED PARTICIPANT SHALL HAVE A NEW VESTING DATE ONCE EVERY 5 YEARS. THESE ADDITIONAL VESTING DATES WILL OCCUR ON THE 5TH ANNIVERSARY OF EACH VESTING DATE AFTER THE INITIAL VESTING DATE. ON EACH VESTING DATE, A GRANDFATHERED PARTICIPANT WILL BECOME 100% VESTED IN AN AMOUNT EQUAL TO THE PARTICIPANT'S ACCOUNT BALANCE REDUCED BY ANY PAY CREDITS CREDITED TO THE ACCOUNT FOR THE 2 MOST RECENT PLAN YEARS. GRANDFATHERED PARTICIPANTS WITH PAY CREDITS FOR PLAN YEARS BEGINNING ON OR AFTER 1/1/2020, EACH YEAR'S ANNUAL PAY CREDIT PLUS SUBSEQUENT EARNINGS AND/OR LOSSES WILL VEST AFTER 5 YEARS OF CONTINUOUS EMPLOYMENT. EACH CONTRIBUTION IS SUBJECT TO A SEPARATE AND INDEPENDENT 5 YEAR CONTINUOUS EMPLOYMENT REQUIREMENT. FOR PARTICIPANTS INITIALLY PARTICIPATING IN THE SERP AFTER 12/31/2016 (A "CONTEMPORARY PARTICIPANT"), EACH YEAR'S ANNUAL PAY CREDIT PLUS SUBSEQUENT EARNINGS AND/OR LOSSES WILL 100% VEST ON THAT PAY CREDITS' 5TH ANNIVERSARY, PROVIDED THAT THE PARTICIPANT REMAINS IN THE CONTINUOUS EMPLOYMENT THROUGHOUT THE 5-YEAR PERIOD FOR EACH ANNUAL PAY CREDIT. IF ANY ELIGIBLE PARTICIPANT ATTAINS NORMAL RETIREMENT AGE PRIOR TO SEPARATION FROM SERVICE, THEY SHALL VEST IN 100% OF THE ACCOUNT BALANCE. ONCE VESTED, EACH PARTICIPANT SHALL RECEIVE A DISTRIBUTION OF THEIR ENTIRE VESTED AMOUNT WITHIN A REASONABLE PERIOD NOT TO EXCEED 2.5 MONTHS. THIS DISTRIBUTION IS TREATED AS REPORTABLE COMPENSATION TO THE PARTICIPANT AND IS INCLUDED IN PART II, COLUMN B(III). THEREFORE, PART II, COLUMN B(III) INCLUDES PRIOR YEAR SERP DEFERRALS PREVIOUSLY REPORTED IN PART II, COLUMN C. ANY DISTRIBUTION AMOUNT INCLUDED IN PART II, COLUMN B(III) THAT WAS PREVIOUSLY REPORTED IN PRIOR PERIODS AS DEFERRED COMPENSATION IN PART II, COLUMN C IS DISCLOSED IN PART II, COLUMN F. SCHEDULE J, PART II, COLUMN B(II) CERTAIN EXECUTIVE OFFICERS AND PHYSICIANS ARE ELIGIBLE FOR BONUS/INCENTIVE PAYMENTS. THESE BONUSES ARE DETERMINED BASED ON THE ACHIEVEMENT OF VARIOUS ORGANIZATIONAL AND PERSONAL PERFORMANCE GOALS ESTABLISHED BY A FORMAL PROCESS IN KEEPING WITH THE ORGANIZATION'S TAX-EXEMPT STATUS. COMPENSATION PROCESS FOR TOP OFFICIAL AS DETERMINED BY PPHS THE ORGANIZATION'S FORMAL PROCESS FOR DETERMINING TOTAL COMPENSATION FOR THE CEO IS INTENDED TO PROVIDE REASONABLE COMPENSATION FOR ACCOMPLISHING THE ORGANIZATION'S MISSION, ACHIEVE ITS STRATEGIC GOALS, TO RECOGNIZE PERFORMANCE, AND TO OPERATE IN KEEPING WITH THE ORGANIZATION'S OBLIGATIONS AS A TAX-EXEMPT CHARITABLE ORGANIZATION. THE EXECUTIVE COMPENSATION COMMITTEE OF THE PPHS'S BOARD OF DIRECTORS CONDUCTS AN ANNUAL REVIEW OF THE COMPENSATION OF THE CEO. THE COMMITTEE RETAINS A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT TO CONDUCT COMPETITIVE MARKET ANALYSIS OF THE MARKET RANGES OF BASE, INCENTIVE AND TOTAL CASH COMPENSATION. THE INFORMATION THE COMMITTEE MAY CONSIDER CAN INCLUDE BUT IS NOT LIMITED TO THE PERFORMANCE OF AN INDIVIDUAL, THE PERFORMANCE OF THE ORGANIZATION, AN INDIVIDUAL'S LENGTH OF SERVICE, CREDENTIALS AND EXPERIENCE, THE ELEMENTS OF TOTAL COMPENSATION AND SALARY HISTORY, THE ORGANIZATION'S COMPENSATION TARGETS, AND COMPARABILITY DATA, INCLUDING THE DATA PREPARED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE COMMITTEE. THE COMMITTEE INCORPORATES A FORMAL PERFORMANCE APPRAISAL PROCESS IN THE CEO COMPENSATION REVIEW. IT UTILIZES A MULTI-PERSPECTIVE APPROACH AND PERFORMANCE MEASURES WHICH ARE LINKED TO THE ORGANIZATION'S LONG-TERM STRATEGIC PLAN AND ACHIEVEMENT OF ANNUAL SYSTEM OBJECTIVES. THE CEO IS NOT PRESENT WHEN THE COMMITTEE DISCUSSES AND ESTABLISHES HIS COMPENSATION. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHERN PATHOLOGY AND LABORATORY | BusinessNameLine1Txt |
| Business Name Line2 | SERVICES PC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | CONTROL ENTITY | RelationshipDescriptionTxt |
| Transaction | $158,233 | TransactionAmt |
| Transaction | LAB DIRECTOR FEE | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V | FormAndLineReferenceDesc |
| Explanation | SANDRA ZORNES, M.D., A BOARD MEMBER, OWNS SOUTHERN PATHOLOGY AND LABORATORY SERVICES, P.C. THE FILING ORGANIZATION CONTRACTS WITH SOUTHERN PATHOLOGY AND LABORATORY SERVICES, P.C. FOR DR. ZORNES' SERVICES AS LAB DIRECTOR. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 6 | THE SOLE MEMBER OF PHOEBE SUMTER MEDICAL CENTER, INC. SHALL BE PHOEBE PUTNEY HEALTH SYSTEM, INC. (PPHS). |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE BOARD OF DIRECTORS OF PPHS, THE SOLE MEMBER, SHALL APPOINT ALL DIRECTORS OF THE FILING ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 7B | THE SOLE MEMBER, PPHS, SHALL HAVE THE FOLLOWING RESPONSIBILITIES: - THE MEMBER SHALL APPOINT OR REMOVE THE ORGANIZATION'S DIRECTORS. - THE MEMBER SHALL SELECT OR REMOVE THE ORGANIZATION'S OFFICERS. - THE MEMBER SHALL APPROVE ALL AMENDMENTS TO THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS BEFORE THEY MAY BECOME EFFECTIVE. - THE MEMBER SHALL APPROVE ANY ANNUAL OPERATING OR CAPITAL BUDGETS. - THE MEMBER SHALL APPOINT OR REMOVE THE INDEPENDENT AUDITORS. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE INDEPENDENT ACCOUNTING FIRM THAT PREPARES THE FORM 990 (BASED UPON INFORMATION PROVIDED BY THE ORGANIZATION) PROVIDES A COMPLETE COPY OF THE RETURN WITH APPLICABLE SCHEDULES TO BE REVIEWED BY MANAGEMENT. MANAGEMENT PERFORMS A DETAILED REVIEW WHICH CONSISTS OF REVIEWING THE FINANCIAL DATA, THE NARRATIVES DISCLOSED, AND OTHER FACTS PRESENTED ON THE RETURN. UPON REVIEW, THE FORM 990 IS THEN FORWARDED TO THE FINANCE COMMITTEE FOR THEIR REVIEW, TO GAIN THEIR COMMENTS AND APPROVAL. UPON APPROVAL FROM THE FINANCE COMMITTEE, THE FORM 990 AND RELATED SCHEDULES ARE PROVIDED TO ALL BOARD MEMBERS FOR REVIEW AND FEEDBACK. ONCE THE FORM 990 IS REVIEWED BY ALL APPLICABLE PARTIES, A COPY OF THE FINAL VERSION IS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ON AN ANNUAL BASIS, PHOEBE SUMTER MEDICAL CENTER, INC. (PSMC) BOARD MEMBERS AS WELL AS ALL OFFICERS COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. THIS QUESTIONNAIRE IS ADMINISTERED BY THE PHOEBE PUTNEY HEALTH SYSTEM (PPHS) COMPLIANCE DEPARTMENT AND THE DOCUMENT ASKS EACH INDIVIDUAL TO DISCLOSE ANY PERSONAL, BUSINESS, OR OTHER AFFILIATIONS AND MONETARY AMOUNT IF APPLICABLE THAT THEY OR THEIR IMMEDIATE FAMILY MEMBERS HAVE HAD WITHIN THE PAST 12 MONTHS WITH PSMC OR ANY RELATED ENTITIES. ALL RESPONSES ARE THEN EVALUATED BY THE PPHS COMPLIANCE DEPARTMENT. IN THE CASE OF AN EXISTING CONFLICT, THE INDIVIDUAL WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL TO SUCH TRANSACTIONS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION MAKES AVAILABLE TO THE PUBLIC ITS CONFLICT OF INTEREST AND AUDITED FINANCIAL STATEMENTS ON THE ORGANIZATION'S WEBSITE, BY PROVIDING COPIES UPON REQUEST, AND BY INSPECTION AT THE ADMINISTRATIVE OFFICES OF THE ORGANIZATION. |
| FORM 990, PART IX, LINE 11G | PHYSICIAN FEES 9,021,904 1,448,105 0 CONTRACT LABOR 8,678,870 624,672 0 COLLECTION FEES 0 328,906 0 PURCHASED SERVICES 7,718,598 6,386,929 0 INTERCOMPANY ALLOCATED COST 2,203 1,041,153 0 TOTAL 25,421,575 9,829,765 0 |
| FORM 990, PART XI, LINE 9 | INTEREST IN NET ASSETS OF SUMTER FOUNDATION 147,026 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| PHOEBE PUTNEY HEALTH SYSTEMS INC | ||||||||||
| PO BOX 3770 | ALBANY | GA | 317063770 | 582001014 | HEALTHCARE | GA | 501C3 | 12C | NA | false |
| PHOEBE PHYSICIAN GROUP INC | ||||||||||
| PO BOX 3770 | ALBANY | GA | 317063770 | 263792403 | HEALTHCARE | GA | 501C3 | 10 | PPHS | false |
| PHOEBE SUMTER FOUNDATION INC | ||||||||||
| 126 HIGHWAY 280 WEST | AMERICUS | GA | 317198645 | 581607727 | FOUNDATION | GA | 501C3 | 12A | PSMC | Yes (true) |
| PHOEBE PUTNEY MEMORIAL HOSPITAL INC | ||||||||||
| PO BOX 3770 | ALBANY | GA | 317063770 | 581928247 | HEALTHCARE | GA | 501C3 | 3 | PPHS | false |
| PHOEBE WORTH MEDICAL CENTER INC | ||||||||||
| PO BOX 545 | SYLVESTER | GA | 317910545 | 383647394 | HEALTHCARE | GA | 501C3 | 3 | PPHS | false |
| PHOEBE FOUNDATION INC | ||||||||||
| PO BOX 3770 | ALBANY | GA | 317063770 | 581847104 | FOUNDATION | GA | 501C3 | 12A | PPHS | false |
| PHOEBE DORMINY MEDICAL CENTER INC | ||||||||||
| PO BOX 3770 | ALBANY | GA | 317063770 | 452041878 | HEALTHCARE | GA | 501C3 | 3 | PPHS | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PHOEBE PUTNEY HEALTH VENTURES INC | |||||||||||||
| PO BOX 3770 | ALBANY | GA | 317063770 | 581963401 | HEALTHCARE | GA | N/A | false | |||||
| PHOEBE PUTNEY INDEMNITY LTD | |||||||||||||
| 981492026 | INSURANCE | N/A | false | 113 S CHURCH ST 5TH FL QUEENSGATE | GRAND CAYMAN | CJ | KY1-1102 | CJ | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (7 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PHOEBE SUMTER FOUNDATION INC | ||
| C | $108,876 | CASH |
| PHOEBE SUMTER FOUNDATION INC | ||
| M | VALUE UNDETERMINED | |
| PHOEBE SUMTER FOUNDATION INC | ||
| N | VALUE UNDETERMINED | |
| PHOEBE SUMTER FOUNDATION INC | ||
| O | VALUE UNDETERMINED | |
| PHOEBE SUMTER FOUNDATION INC | ||
| P | VALUE UNDETERMINED | |
| PHOEBE SUMTER FOUNDATION INC | ||
| Q | VALUE UNDETERMINED | |
| PHOEBE SUMTER FOUNDATION INC | ||
| E | $12,864 | G/L DETAIL |