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FAYETTE COMMUNITY HOSPITAL INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
FAYETTE COMMUNITY HOSPITAL INC (EIN 58-2322328)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-05-12
IRS object ID
202341329349305929
Schema version
2021v4.2
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 ReturnHeader

FieldValueIRS element (for citing)
Return2023-05-12T12:52:29-05:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 W 5TH ST STE 800AddressLine1Txt
CityWINSTON SALEMCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27101ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN582322328EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FAYETTE COMMUNITY HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% MARIE GAFFNEYInCareOfNm
Business Name ControlFAYEBusinessNameControlTxt
Phone7707197073PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11255 Highway 54 WestAddressLine1Txt
CityFayettevilleCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30214ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARIE GAFFNEYPersonNm
Person TitleVP CORPORATE FINANCEPersonTitleTxt
Phone4702716007PhoneNum
Signature2023-05-11SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMARIEPersonFirstNm
Person LastGAFFNEYPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSHAWN M HUTCHINSONPreparerPersonNm
PTINP01048557PTIN
Phone3362753394PhoneNum
Preparation2023-05-10PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMR STEPHEN PORTERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11255 Highway 54 WestAddressLine1Txt
CityFayettevilleCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30214ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$606,626,828GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PIEDMONTFAYETTE.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1997FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee2588TotalEmployeeCnt
Total Volunteers325TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$796,399PYContributionsGrantsAmt
CY Contributions Grants$2,013,313CYContributionsGrantsAmt
PY Program Service Revenue$547,507,826PYProgramServiceRevenueAmt
CY Program Service Revenue$598,556,421CYProgramServiceRevenueAmt
PY Investment Income$65,214PYInvestmentIncomeAmt
CY Investment Income$92,902CYInvestmentIncomeAmt
PY Other Revenue$4,826,190PYOtherRevenueAmt
CY Other Revenue$5,695,329CYOtherRevenueAmt
PY Total Revenue$553,195,629PYTotalRevenueAmt
CY Total Revenue$606,357,965CYTotalRevenueAmt
PY Grants And Similar Paid$10,550PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$40,645CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$164,086,021PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$176,586,513CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$300,428,913PYOtherExpensesAmt
CY Other Expenses$349,746,627CYOtherExpensesAmt
PY Total Expenses$464,525,484PYTotalExpensesAmt
CY Total Expenses$526,373,785CYTotalExpensesAmt
PY Revenues Less Expenses$88,670,145PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$79,984,180CYRevenuesLessExpensesAmt
Total Assets BOY$249,474,622TotalAssetsBOYAmt
Total Assets EOY$336,672,736TotalAssetsEOYAmt
Total Liabilities BOY$95,361,970TotalLiabilitiesBOYAmt
Total Liabilities EOY$154,576,261TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$154,112,652NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$182,096,475NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE IN A PROGRESSIVE ENVIRONMENT, GUIDED BY PHYSICIANS, DELIVERED BY EXCEPTIONAL PROFESSIONALS, AND INSPIRED BY THE COMMUNITIES WE SERVE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$492,671,652ExpenseAmt
Grant$40,645GrantAmt
Revenue$598,556,421RevenueAmt
DescPIEDMONT FAYETTE HOSPITAL ("PFH") IS A 282-BED FACILITY LOCATED IN FAYETTE COUNTY, GEORGIA. OVER 750 PRIMARY CARE AND SPECIALTY PHYSICIANS COMPRISE THE MEDICAL STAFF AND MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SENIORS WITHIN FAYETTEVILLE AND THE GREATER METROPOLITAN ATLANTA MARKET, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY FOR SERVICES. FOR THE YEAR ENDED JUNE 30, 2022, THE HOSPITAL HAD 18,322 IN-PATIENT ADMISSIONS WITH A TOTAL OF 93,463 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 82,762 AND OUTPATIENT VISITS TOTALED 113,314. SURGICAL SERVICES WERE PROVIDED TO 12,635 PATIENTS.Desc
Total Program Service Expenses$492,671,652TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee2588EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARIE GAFFNEYPersonNm
Phone4702716007PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12727 PACES FERRY RD BLDG 2 STE 70AddressLine1Txt
CityAtlantaCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30339ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndKey EmployeeKeyEmployeeInd
Mr Michael Mandl
Board Member1.054.0Yes (X)$0$1,529,720$193,580
Dr Patrick Battey MD
Board Member1.054.0Yes (X)$0$1,352,653$143,231
Mr Thomas Arnold
TREASURER/CFO PHC1.054.0$0$1,131,535$124,798Yes (X)
Ms Elizabeth Leddy
Secretary/CLO PHC1.054.0$0$883,982$140,202Yes (X)
Mr Michael McAnder
FORMER TREASURER/CFO PHC0.00.0$0$972,687$0Yes (X)
Mr Stephen D Porter
Board Member/Chair/CEO55.00.0Yes (X)$745,217$0$114,002Yes (X)
Dr Angela Swayne MD
CMO55.00.0$514,471$0$15,983Yes (X)
Mr Scott Wolfe
CFO55.00.0$484,846$0$29,358Yes (X)
Mr David Nipper
COO55.00.0$418,270$0$37,814Yes (X)
Ms Merry Heath
CNO55.00.0$298,089$0$23,851Yes (X)
Ms Rhonda Manos
Dir Pharmacy40.00.0$241,628$0$17,418Yes (X)
Ms Ruby Villafranca
Registered Nurse40.00.0$231,241$0$23,571Yes (X)
Ms Regina Boston
Nursing Admin Supervisor40.00.0$224,472$0$27,503Yes (X)
Dr Mironda Williams MD
Board Member1.00.0Yes (X)$4,050$0$0
Dr Michael Behr MD
Board Member1.00.0Yes (X)$0$0$0
Mr Mark Gray
Board Member1.00.0Yes (X)$0$0$0
Ms Janet Moon
Board Member1.00.0Yes (X)$0$0$0
Mr Matthew Ramsey
Board Member1.00.0Yes (X)$0$0$0
Dr Geetha Rao MD
Board Member1.00.0Yes (X)$0$0$0
Mr Robert Reeves
Board Member1.00.0Yes (X)$0$0$0
Mr William Scott
Board Member1.00.0Yes (X)$0$0$0
Dr Matthew Ralsten MD
Board Member1.00.0Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,162,284TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$5,870,577TotReportableCompRltdOrgAmt
Total Other Compensation$891,311TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K197IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MEDICAL SOLUTIONS LLC
1010 N 102ND STREET SUITE 300OMAHANE68114NURSING SERVICES$13,074,399
POWER WELLNESS MANAGEMENT LLC
851 Oak Creek DrLOMBARDIL60184FITNESS MGMT$2,316,330
AYA HEALTHCARE INC
5930 CORNERSTONE CT W STE 300SAN DIEGOCA92121NURSING STAFFING$1,653,298
NEOGENOMICS LABORATORIES INC
12701 COMMONWEALTH DRFT MYERSFL33913LABORATORY SERVICES$770,640
GEORGIA UROLOGY PA
35 COLLIER RD NW STE M-245ATLANTAGA30309UROLOGY$475,400
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K19CntrctRcvdGreaterThan100KCnt
Government Grants$2,000,813GovernmentGrantsAmt
All Other Contributions$12,500AllOtherContributionsAmt
Total Contributions$2,013,313TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE621110$595,952,532$595,952,532
FITNESS CENTER REHAB621300$2,592,887$2,592,887
OTHER OPERATING REVENUE900099$11,002$11,002
FieldValueIRS element (for citing)
Total Program Service Revenue$598,556,421TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,366TotalRevenueColumnAmt
Exclusion$11,366ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$4,831,445RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$133,118RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$4,698,327RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,698,327TotalRevenueColumnAmt
Exclusion$4,698,327ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$81,536OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$81,536OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$81,536TotalRevenueColumnAmt
Exclusion$81,536ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$278,427GrossSalesOfInventoryAmt
Cost Of Goods Sold$135,745CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$142,682TotalRevenueColumnAmt
Exclusion$142,682ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIA SALES722514$773,393$773,393
VENDING SALES900099$80,927$80,927
FieldValueIRS element (for citing)
Other Revenue Total$854,320OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$606,357,965TotalRevenueColumnAmt
Related Or Exempt Func Income$598,556,421RelatedOrExemptFuncIncomeAmt
Exclusion$5,788,231ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$40,645TotalAmt
Program Services$40,645ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,634,376TotalAmt
Program Services$1,356,532ProgramServicesAmt
Management And General$277,844ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$140,423,738TotalAmt
Program Services$116,551,703ProgramServicesAmt
Management And General$23,872,035ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$25,511,820TotalAmt
Program Services$21,174,810ProgramServicesAmt
Management And General$4,337,010ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$9,016,579TotalAmt
Program Services$7,483,761ProgramServicesAmt
Management And General$1,532,818ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$77,877TotalAmt
Management And General$77,877ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$66,259,596TotalAmt
Program Services$66,259,596ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$41,475TotalAmt
Management And General$41,475ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$23,042,055TotalAmt
Program Services$22,867,693ProgramServicesAmt
Management And General$174,362ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$6,502,507TotalAmt
Program Services$6,112,357ProgramServicesAmt
Management And General$390,150ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$8,376,035TotalAmt
Program Services$8,040,994ProgramServicesAmt
Management And General$335,041ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$25,558TotalAmt
Program Services$16,635ProgramServicesAmt
Management And General$8,923ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$15,029TotalAmt
Program Services$12,673ProgramServicesAmt
Management And General$2,356ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$6,262,504TotalAmt
Program Services$6,074,629ProgramServicesAmt
Management And General$187,875ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$11,953,081TotalAmt
Program Services$11,953,081ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$13,687,558TotalAmt
Program Services$12,866,305ProgramServicesAmt
Management And General$821,253ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$4,566,645TotalAmt
Program Services$4,292,646ProgramServicesAmt
Management And General$273,999ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
BAD DEBT EXPENSE$99,863,492$99,863,492$0$0
MEDICAL SUPPLIES$80,667,958$80,667,958$0$0
HOSPITAL TAX$5,586,709$5,586,709$0$0
MISCELLANEOUS$22,818,548$21,449,433$1,369,115$0

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$526,373,785TotalAmt
Program Services$492,671,652ProgramServicesAmt
Management And General$33,702,133ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$623,509BOYAmt
EOY$1,405,909EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$85,205EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$61,497,190BOYAmt
EOY$147,529,056EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$6,724,384BOYAmt
EOY$7,401,642EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,040,254BOYAmt
EOY$1,961,732EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$371,508,916LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$194,238,574LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$177,521,041BOYAmt
EOY$177,270,342EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$1,068,244BOYAmt
EOY$1,018,850EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$249,474,622BOYAmt
EOY$336,672,736EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$45,361,033BOYAmt
EOY$51,476,509EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$34,402,547BOYAmt
EOY$33,440,435EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$12,564,199BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,034,191BOYAmt
EOY$69,659,317EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$95,361,970BOYAmt
EOY$154,576,261EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$152,418,411BOYAmt
EOY$180,336,039EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,694,241BOYAmt
EOY$1,760,436EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$154,112,652BOYAmt
EOY$182,096,475EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$249,474,622BOYAmt
EOY$336,672,736EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$79,984,180ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$52,000,357OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,449,265OtherCostOrOtherBasisAmt
Book Value$9,449,265BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$172,204,546OtherCostOrOtherBasisAmt
Depreciation$69,443,506DepreciationAmt
Book Value$102,761,040BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,824,860OtherCostOrOtherBasisAmt
Depreciation$3,969,044DepreciationAmt
Book Value$855,816BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$156,826,677OtherCostOrOtherBasisAmt
Depreciation$120,826,024DepreciationAmt
Book Value$36,000,653BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$28,203,568OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$28,203,568BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$177,270,342TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS LIABILITIESDesc
Amt$69,659,317Amt
FieldValueIRS element (for citing)
Total Liability$69,659,317TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PART X, LINE 2: ASC 740 FOOTNOTE (FKA FIN 48)FormAndLineReferenceDesc
ExplanationPHC ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF ASC 740, INCOME TAXES (ASC 740). UNDER THE REQUIREMENTS OF ASC 740, TAX-EXEMPT ORGANIZATIONS MAY BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS UNCERTAIN TAX EXPOSURE ITEMS. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AT JUNE 30, 2022 AND 2021.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300.FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,671,877TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,671,877NetCommunityBenefitExpnsAmt
Total Expense0.02030TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,603,806TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,199,924DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,403,882NetCommunityBenefitExpnsAmt
Total Expense0.00330TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,415,564TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,298,152DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,117,412NetCommunityBenefitExpnsAmt
Total Expense0.01200TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$27,691,247TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,498,076DirectOffsettingRevenueAmt
Net Community Benefit Expns$15,193,171NetCommunityBenefitExpnsAmt
Total Expense0.03560TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$41,036TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$41,036NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,945,930TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,945,930NetCommunityBenefitExpnsAmt
Total Expense0.00460TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,986,966TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,986,966NetCommunityBenefitExpnsAmt
Total Expense0.00470TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$29,678,213TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,498,076DirectOffsettingRevenueAmt
Net Community Benefit Expns$17,180,137NetCommunityBenefitExpnsAmt
Total Expense0.04030TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$5,875,657BadDebtExpenseAmt
Reimbursed By Medicare$82,350,875ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$76,293,519CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$6,057,356MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Piedmont Fayette HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11255 Highway 54 WestAddressLine1Txt
CityFayettevilleCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30214ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.piedmontfayette.comWebsiteAddressTxt
State License056-550StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Piedmont Fayette HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART VOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART VStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care300.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.FPGFamilyIncmLmtDscntCarePct
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART VFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART VFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART VFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, LINE 5: COMMUNITY REPRESENTATIONAS A PART OF OUR PROCESS, WE INTERVIEWED NEARLY 245 STAKEHOLDERS, POLICY MAKERS AND LAWMAKERS REPRESENTING PUBLIC HEALTH, LOW-INCOME POPULATIONS, MINORITIES, CHRONIC CONDITIONS, OLDER ADULTS, AND OUR COMMUNITIES. THESE INCLUDED 13 STAKEHOLDERS WITHIN THE FAYETTE COMMUNITY, WHO GAVE THEIR PERSPECTIVES ON COMMUNITY HEALTH THROUGH THE LENS OF THEIR ROLE WITHIN THE COMMUNITY. THESE INTERVIEWS WERE CONDUCTED FOR PEOPLE REPRESENTING THE ENTIRE REGION. SPECIFICALLY, WE INTERVIEWED REPRESENTATIVES OF LOCAL AND REGIONAL PUBLIC HEALTH ENTITIES, MINORITY POPULATIONS, FAITH-BASED COMMUNITIES, LOCAL BUSINESS OWNERS, THE PHILANTHROPIC COMMUNITY, MENTAL HEALTH AGENCIES, ELECTED OFFICIALS AND INDIVIDUALS REPRESENTING OUR MOST VULNERABLE PATIENTS. THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS AND LEADERSHIP FROM ALL 19 HOSPITALS WERE ACTIVELY INFORMED AND ENGAGED THROUGHOUT THIS PROCESS.
SCHEDULE H, PART V, LINE 7A: COMMUNITY HEALTH NEEDS ASSESSMENThttps://www.piedmont.org/media/file/Community-Benefit-Needs-Assessment-PFH .pdf
SCHEDULE H, PART V, LINE 7D: PUBLIC AVAILABILITY OF CHNAIN ADDITION TO MAKING ITS CHNA REPORTS AVAILABLE ON ITS WEBSITE AND BY REQUEST, PIEDMONT FAYETTE HOSPITAL SENT COPIES TO EACH PARTICIPANT IN THE CHNA PROCESS, DISTRIBUTED THE ASSESSMENTS TO COMMUNITY CENTERS AND OTHER LOCATIONS THAT PRIMARILY SERVE AN UNINSURED POPULATION, SENT COPIES TO LEGISLATIVE AND ELECTED OFFICIALS, AND WIDELY DISTRIBUTED THE ASSESSMENTS TO OTHER PIEDMONT HEALTHCARE HOSPITALS.
SCHEDULE H, PART V, LINE 10A: IMPLEMENTATION STRATEGIES WEBSITETHE BOARD OF DIRECTORS FOR PIEDMONT FAYETTE HOSPITAL APPROVED ITS IMPLEMENTATION STRATEGY FOR THE THREE-YEAR PERIOD BEGINNING WITH FY23 ON SEPTEMBER 14, 2022, WITHIN THE GRACE PERIOD FOLLOWING THE APPROVAL OF THE NEW COMMUNITY HEALTH NEEDS ASSESSMENT. THE FOLLOWING LINK IS FOR THE IMPLEMENTATION STRATEGY EFFECTIVE THROUGH JUNE 30, 2025. https://www.piedmont.org/media/file/Community-Benefit-Implementation-Strat egy-PFH.pdf
SCHEDULE H, PART V, LINE 11: ADDRESSING COMMUNITY HEALTH NEEDSDURING FY22, PIEDMONT FAYETTE HOSPITAL CONDUCTED ITS FOURTH CHNA, AGAIN BY ASSESSING PUBLICLY AVAILABLE DATA, INTERVIEWING COMMUNITY MEMBERS AND STAKEHOLDERS, CONDUCTING FOCUS GROUPS OF VULNERABLE POPULATIONS, INTERVIEWING PIEDMONT BOARD MEMBERS, AND SURVEYING PIEDMONT EMPLOYEES. THROUGH THIS PROCESS, PIEDMONT FAYETTE HOSPITAL DETERMINED AND PRIORITIZED THE COMMUNITY HEALTH NEEDS IT WOULD ADDRESS BASED ON THE NUMBER OF PERSONS AFFECTED, THE SERIOUSNESS OF THE ISSUE, WHETHER THE HEALTH NEED AFFECTED VULNERABLE POPULATIONS, AND THE AVAILABILITY OF COMMUNITY AND HOSPITAL RESOURCES NECESSARY TO ADDRESS THE ISSUE. ALL PRIORITIES ARE VIEWED THROUGH THE LENS OF HEALTH DISPARITIES, WITH PARTICULAR ATTENTION PAID TO IMPROVING OUTCOMES FOR THOSE MOST VULNERABLE DUE TO INCOME AND RACE. BASED ON THE CHNA, PIEDMONT FAYETTE HOSPITAL IS CURRENTLY FOCUSING ON: (1) ENSURING AFFORDABLE ACCESS TO HEALTH, MENTAL, AND DENTAL CARE (2) REDUCING PREVENTABLE INSTANCES OF, AND DEATHS FROM, CANCER (3) REDUCING PREVENTABLE INSTANCES OF, AND DEATHS FROM, HEART DISEASE (4) REDUCING PREVENTABLE INSTANCES OF DIABETES AND ICREASING ACCESS TO CARE FOR THOSE LIVING WITH THE DISEASE (5) REDUCING RATES OF OBESITY AND INCREASING ACCESS TO HEALTHY FOODS AND RECREATIONAL ACTIVITIES
SCHEDULE H, PART V, LINE 16: FINANCIAL ASSISTANCE POLICY WEBSITESFINANCIAL ASSISTANCE POLICY - HTTPS://WWW.PIEDMONT.ORG/MEDIA/FILE/FINANCIAL-ASSISTANCE-POLICY.PDF FINANCIAL ASSISTANCE APPLICATION - HTTPS://WWW.PIEDMONT.ORG/MEDIA/FILE/FINANCIAL-ASSISTANCE-APPLICATION.PDF FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY - HTTPS://WWW.PIEDMONT.ORG/MEDIA/FILE/FINANCIAL-ASSISTANCE-PLAIN-LANGUAGE-SU MMARY-ENGLISH.PDF

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART VI, LINE 1: REQUIRED DESCRIPTIONSSCHEDULE H, PART I, LINE 6A PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT We regularly report to the community our community benefit activities in several ways. Each year, we prepare a systemwide community benefit report that is available to the public through publication on our website. We also make available our IRS Form 990 Schedule H on our website and provide copies to anyone upon request. We also provide information on community benefit programming to local, state, and federal lawmakers through our government affairs office and online at piedmont.org.
SCHEDULE H, PART I, LINE 7(F)PERCENT OF TOTAL EXPENSE THE DENOMINATOR USED FOR THE CALCULATION OF COLUMN (F), PERCENT OF TOTAL EXPENSE, WAS THE AMOUNT OF TOTAL FUNCTIONAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) OF $526,373,785, LESS BAD DEBT EXPENSE OF $99,863,492 FROM FORM 990, PART IX, LINE 24(B).
SCHEDULE H, PART I, LINE 7FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST A RATIO OF PATIENT CARE COST TO CHARGES, CONSISTENT WITH WORKSHEET 2, WAS USED TO REPORT THE AMOUNTS IN PART I, LINES 7A-7D. FOR AMOUNTS ON LINES 7E-7K, ACTUAL EXPENSES FOR EACH COMMUNITY BENEFIT ACTIVITY ARE TRACED AND REPORTED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM.
SCHEDULE H, PART III, LINES 2-4BAD DEBT EXPENSE CALCULATION AND FOOTNOTE The provision for bad debts is based upon leadership's assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage and other collection indicators. Periodically, leadership assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category. The results of the review are then used to make any modifications to the provision for bad debts to establish an appropriate allowance for uncollectible receivables. THE AMOUNT REPORTED ON PART III, LINE 3, WAS DETERMINED BY TAKING THE AVERAGE ACCEPTANCE RATE FOR ALL CHARITY CARE APPLICATIONS RECEIVED DURING THE YEAR MULTIPLIED BY THE NUMBER OF DENIALS THAT WERE ATTRIBUTABLE TO INSUFFICIENT INFORMATION. THAT TOTAL WAS THEN ADJUSTED DOWNWARD FOR THE ORGANIZATION'S USE OF PRESUMPTIVE ELIGIBILITY WHEN DETERMINING ITS COMMUNITY BENEFITS. BAD DEBT EXPENSE FOOTNOTE FROM CONSOLIDATED, AUDITED FINANCIAL STATEMENTS: THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBT TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. PFH PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE ARE NOT REPORTED AS REVENUE.
SCHEDULE H, PART III, LINE 8MEDICARE SHORTFALLS AS COMMUNITY BENEFIT The amount reported on Part III, Line 6, was calculated in accordance with Schedule H instructions by utilizing our allowable Medicare cost as reported in the Medicare cost report, which is based on a cost to charge ratio. However, the allowable costs in the Medicare cost report do not reflect the actual cost of providing care to patients since the Medicare cost report excludes many direct patient care costs that are essential to provide quality healthcare for Medicare patients. For example, certain coverage fees to physicians, cost of Medicare C and D, and other similar direct patient care expenses are specifically excluded from allowable cost in the Medicare Cost Report. IRS Revenue Ruling 69-545 provides, in part, that hospitals serving patients with governmental health insurance, such as Medicare, is an indication we operate to promote health in the community. Our policy is to treat Medicare patients, regardless of the extent to which Medicare pays for the treatment. For many services, Medicare's reimbursement is less than the cost of the care provided, resulting in shortfalls that are to be absorbed by us in honor of our commitment to treat elderly patients. Many of these patients live on a low, fixed income, and would qualify for financial assistance or other means-tested programs, absent from their enrollment in Medicare.
SCHEDULE H, PART III, LINE 9(B)COLLECTION PRACTICES INITIAL SCREENINGS OF ALL INPATIENT, EMERGENCY, AND SURGERY ENCOUNTERS, AS WELL AS MOST OUTPATIENT VISITS, ARE CONDUCTED BY FINANCIAL COUNSELORS IN ORDER TO IDENTIFY ANY AVAILABLE INSURANCE OR OTHER COVERAGE FOR EACH PATIENT. COUNSELORS CONTACT PATIENTS AND THEIR FAMILIES DIRECTLY, EITHER IN PERSON OR BY LETTER, TO ASSIST THE FAMILY IN IDENTIFYING ANY PROGRAMS FOR WHICH THE PATIENT/SERVICE MAY QUALIFY (INCLUDING MEDICAID, STATE CHILDREN'S HEALTH INSURANCE PROGRAM ("SCHIP"), PRIVATE OR GOVERNMENT INSURANCE COVERAGE, AND CHARITY ASSISTANCE). IF THE FAMILY CANNOT BE TIMELY LOCATED OR IS UNCOOPERATIVE, RELATED ACCOUNTS ARE TRANSFERRED TO AN INTERNAL COLLECTION DEPARTMENT FOR FURTHER ATTEMPTS TO OBTAIN PAYMENT OR, IF THE PATIENT MAY QUALIFY FOR ASSISTANCE, TO SECURE A FINANCIAL ASSISTANCE APPLICATION. THE ORGANIZATION'S DEBT COLLECTION POLICY AND PROCEDURES PROHIBIT ANY COLLECTION EFFORTS FOR THE PORTION OF A PATIENT ACCOUNT BALANCE THAT QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY.
SCHEDULE H, PART VI, LINE 2: NEEDS ASSESSMENTAs a designated 501(c)(3) nonprofit hospital, we are required by the Internal Revenue System to conduct a triennial community health needs assessment (CHNA), in accordance with regulations put forth by the IRS following the 2010 Patient Protection and Affordable Care Act (ACA). Through this assessment, we hope to better understand local health challenges, identify health trends in our community, determine gaps in the current health delivery system and craft a plan to address those gaps and the identified health needs. In FY22, we conducted our fourth triennial CHNA. FY22 also marked the third year of our FY19 Implementation Strategy. The CHNA was led by the Piedmont Healthcare community benefits team and consulting organization Public Goods Group, with input and direction from Piedmont leadership and Piedmont Healthcare's Department of External Affairs. Process The CHNA started with a definition of our community, which is our home county due to the impact of our tax-exempt status. Property taxes make up the largest segment of a hospital's tax exemption, which impacts county revenues. Because of this, we aim to ensure that we are providing ample benefit to our county and its residents. Additionally, we take into consideration patient origin, especially that of our lower-income patients such as those who qualify for financial assistance or receive insurance coverage through Medicaid. Our secondary communities are considered the areas in which we have the highest concentration of patients fitting that criterion, including ones from nearby communities. Once we established our primary and secondary communities, we then conducted an analysis of available public health data. This included resources from: US Census, US Health and Human Services' Community Health Status Indicators, US Department of Agriculture, Economic Research Service, National Center for Education Statistics, Kaiser Family Foundation's State Health Facts, American Heart Association, County Health Rankings and Georgia Online Analytical Statistical Information System (OASIS). All figures within the CHNA were for 2017, unless otherwise noted. Health indicators are estimates provided by County Health Rankings and hospital data were internally sourced. We then interviewed key stakeholders who have a particular expertise or knowledge of our communities. Specifically, we interviewed representatives of local and regional public health entities, minority populations, faith-based communities, local business owners, the philanthropic community, mental health agencies, elected officials and individuals representing our most vulnerable patients. An internal survey was also conducted throughout the healthcare system for both clinical and non-clinical employees. Information was gathered on knowledge and understanding of community benefit and current programs, as well as suggestions for how we can better serve our patients and communities. Approximately 1,053 employees spanning the system responded. Additionally, we conducted a community-based survey that was widely advertised to the community. Once both qualitative and quantitative data was gathered, we authored the preliminary report, which was then vetted and reviewed by hospital and health system leadership. In this report, we identified several key community health needs that emerged during the assessment process. The chosen priorities were recommended by the community benefit department with sign-off from hospital and board leadership. The following criteria were used to establish the priorities: - The number of persons affected; - The seriousness of the issue; - Whether the health need particularly affected persons living in poverty or reflected health disparities; and, - Availability of community and/or hospital resources to address the need. All priorities are viewed through the lens of health disparities, with particular attention paid to improving outcomes for those most vulnerable due to income and race. The priorities we chose reflected a collective agreement on what hospital leadership, staff and the community felt was most important and within our ability to positively impact the issue. Once priorities were approved by the board of directors, we then authored the CHNA and presented our findings and recommendations to the hospital's board of directors for their input and approval. Our priorities A key component of the CHNA is to identify the top health priorities we will address over fiscal years 2023, 2024, and 2025. These priorities will guide our community benefit work. They are, in no order: - Ensure affordable access to health, mental, and dental care - Reduce preventable instances of and deaths from cancer - Reduce preventable instances of and deaths from heart disease - Reduce preventable instances of diabetes and increase access to care for those living with the disease - Reduce rates of obesity and increase access to healthy foods and recreational activities With each priority, we work to achieve greater health equity by reducing the impact of poverty and other socioeconomic indicators. This means that health equity is built into each priority, which is demonstrated through our implementation strategies. Our subsequent implementation strategy was developed in partnership with hospital leadership and community stakeholders to address the identified priorities in our FY22 community health needs assessment. The implementation strategy was designed to be executed over a three-year period and included specific metrics by which we would be able to evaluate our work and its impact. The implementation strategy was developed by utilizing community feedback from the assessment in partnership with the system community benefits department, our leadership, and our board of directors. We included proven and successful interventions and programming, investing further in work we felt was successful in addressing unmet health needs.
SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ASSISTANCE ELIGIBILITYWe understand that not everyone can pay their hospital bill due to their insurance status or a limited income, and because of this, we offer financial assistance to qualifying patients. Notification about financial assistance includes, but is not limited to, a dedicated contact number, notices in patient bills, and posted notices in key areas of the hospital. These locations are the emergency room, admitting and registration departments, our business office, and patient financial services offices that are located on site. We also publish and widely publicize a plain language summary of this financial assistance care policy on our website, as well as the full policy. Referral of patients for financial assistance may be made by any staff or medical staff member at the hospital, including physicians, nurses, financial counselors, social workers, case managers, chaplains, and religious sponsors. A request for financial assistance may be made by the patient or a family member, close friend, or associate of the patient, subject to applicable privacy laws. Additionally, we provide copies of our financial assistance policy to our partner clinics and others who work closely with low-income populations. We help our partners in understanding the policy, how it relates to their populations, and receive feedback in ways our financial assistance programming could be improved.
SCHEDULE H, PART VI, LINE 4: COMMUNITY INFORMATIONWhile Piedmont Fayette serves patients throughout Georgia, we consider our community to be Fayette County. We do this in recognition of the direct impact of our tax-exempt status on county residents. In Fayette County, 113,544 people lived in the 194.56 square mile area in 2020. The population density for this area, estimated at 584 persons per square mile, is more than the national average population density of 91.93 persons per square mile. Fayette County is mostly urban, as 82 percent were living in an urban setting in 2020. The median age of people living within the county was 43, a little older than state and national averages. About 23 percent of the population were 18 or younger, 18 percent were over the age of 65, and the rest were between the ages of 18-64. Ten percent of the population identified as being born outside of the US and five percent did not possess US citizenship status. The Hispanic population within the community is growing and now represents approximately 7.5 percent of the community. About 12 percent of county residents were veterans in 2020, with the highest concentration living in the ZIP code 30214 (Fayetteville). The majority were over the age of 65. About 11 percent of the county population lived with a disability in 2020, and most were over the age of 65. The community is growing, and about 12,600 people moved into Fayette County between 2010 and 2020, representing a 12 percent growth rate. With this growth comes increased diversity, as white populations decreased and all other race and ethnicities increased. Specifically, there was a six percent decrease in white populations, a 38 percent increase in black or African American populations, a 55 percent increase in Asian populations, and a 40 percent increase in Hispanic or Latino populations. In 2020, the median household income was $93,777, which is significantly higher than state and national median incomes, which are $61,224 and $64,994, respectively. Of employers in the community, in 2020, the largest sector by employment size was retail trade, which employed 8,471 people at an average wage of $25,828. Health care and social assistance was the next largest sector, employing 8,301 people at an average wage of $54,784. Accommodation and food services was the third largest sector, employing 6,763 people at an average wage of $22,552. In 2020, of the 91,094 working-age population, 56,065 were included in the labor force, and the labor force participation rate was 61.55 percent. Total unemployment in the county in March 2022 equaled 1,618, or 2.7 percent of the civilian non-institutionalized population age 16 and older. Low food access is defined as living more than 0.5 mile from the nearest supermarket, supercenter, or large grocery store. This indicator is relevant because it highlights populations and geographies facing food insecurity. According to the 2021 Food Access Research Atlas database, 37 percent of the total population in the county have low food access, meaning about 39,118 county residents may struggle to access healthy foods. The county has a food insecurity rate of 8.4 percent, meaning about 9,260 people have been unsure how they will access adequate food at some point over the last year. Unfortunately, many of these community members are ineligible for public assistance via SNAP, WIC (Special Supplemental Nutrition Program for Women, Infants and Children), free or reduced-cost school meals, the Commodity Supplemental Food Program (CSFP), or The Emergency Food Assistance Program (TEFAP). In 2020, of the 3,890 food insecure children in the county, 56 percent were ineligible for public assistance programs. In 2019, 80 percent of adults aged 18 or older saw a doctor for a routine check-up the previous year, a measure that is higher than both state and national averages. For Medicare recipients, this number jumps to 88 percent of adult beneficiaries, which is above both state and national averages. Routine check-ups are a critical component to maintaining good health and identifying conditions that can be treated affordably in a community-based setting. Absent that, even simple-to-treat conditions can escalate to deeper issues, eventually requiring more intensive care, later stage diagnoses, or reduced life expectancy. Heart disease is the leading cause of death in Fayette County. Between 2016 and 2020, the age-adjusted death rate was 131.9 deaths for every 100,000 people, which is better than both state and national averages, and a number that has steadily decreased over the last ten years. Broken down by ZIP code, we see higher death rates in both 30215 and 30238, which could indicate higher rates of poverty and higher rates of uninsurance. We see similar trends with stroke deaths. Between 2016 and 2020, there were 246 deaths due to stroke, resulting in an age-adjusted death rate of 34.3 deaths per every 100,000 people. This is better than the state and national rates of 43.2 and 37.6 deaths, respectively. Like with heart disease, we see higher rates of stroke death in community members living in ZIP codes 30215 and 30238. The hospitalization rates for heart disease and stroke among Medicare recipients have steadily decreased over the last five years. The cardiovascular disease hospitalization rate in 2018 was 8.8 hospitalizations per every 1,000 Medicare beneficiaries, which is below the state and national rates of 12.2 and 11.8, respectively. The hospitalization rate for stroke is also below state and national rates, at 8 hospitalizations per every 1,000 Medicare beneficiaries versus the state rate of 9.3 and the national rate of 8.4. Although heart disease leads in county deaths, cancer remains a critical issue within the community. When broken down by cancer site, the breast cancer incidence rate is much lower than state and national rates, which are 128.4 and 126.8 diagnoses per every 100,000 people, on average each year. Other diagnosed cancer sites are also below state and national averages. In 2019, 8,150 adults aged 20 and older had diabetes, equaling 7.7 percent of the county's population, which was lower than the state rate of 9.8 percent. Diabetes is a prevalent problem in the US, often indicating an unhealthy lifestyle and puts individuals at risk for further health issues. This figure has steadily increased year over year. In 2019, 3 percent of the county's population had a diagnosis of kidney disease, a rate better than the state and national percentages of 3.22 percent and 3.1 percent, respectively. In 2019, 27.30 percent of adults 18 and older reported having high cholesterol of the total population. Too much cholesterol puts you at risk for heart disease and stroke, two of the main causes of death within the county. That year, 36.2 percent of adults 18 and older had a diagnosis of high blood pressure.
SCHEDULE H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHWe actively promote the health of our community through clinic-hospital partnerships; community-based health screenings; educational activities; community building activities; the operation of a 24-hour emergency department available to the entire community; the operation of an emergency room open to all members of the community without regard to ability to pay; a governance board composed of community members; use of surplus revenue for facilities improvement, patient care, medical training, education, and research; the provision of inpatient hospital care for all persons in the community able to pay, including those covered by Medicare and Medicaid; and an open medical staff with privileges available to all qualifying physicians. However, COVID-19 continued to have an impact on programming, with many activities postponed or held virtually to accommodate ongoing health concerns. For example, The Piedmont Fayette Family Advisory Council (PFAC), a group comprised of community members from a diverse population, was unable to meet in FY22 due to the pandemic and in-person meeting restrictions. In the interim, the group received bi-monthly hospital communications via Community eNewsletters. Piedmont Community Resource Guides, with contact information for Fayette mental health resource McIntosh Trail Community Service Board, were discontinued in FY22. However, approximately 200 guides were distributed to in-house patients and families, as either electronic links or printed pamphlets via Case Management. We work collaboratively and on an ongoing basis with community support groups to give input on the importance of the mental health of our community, including youth and veteran groups. As a source of action, mental health facility partner Riverwoods Behavioral Health System receives referrals for mental health screenings, reporting more than 1,375 mental health screenings in FY22. Our director of case management serves as a member of the district 4 Department of Public Health Board, overseeing and providing guidance regarding mental health issues for the community. In addition, Spiritual Care Services (SCS), a continued source for patients and families in the hospital and community to connect with mental health resources that meet their needs, provides short-term grief counseling, and helps connect people to support groups and counselors in the community. Spiritual Care Services (SCS) extends beyond mental health needs. SCS also serves as a resource to surrounding hospices through the provision of training and education regarding chaplain roles and services, as well as providing Clinical Pastoral Education to chaplains, upon request. SCS also continues to support nonprofit and support group efforts for families suffering the loss of a baby during, or shortly after, pregnancy. Aiding in the combating of such grief, SCS holds once-a-month Zoom support sessions and an annual memorial service for all families who have lost a child at the hospital. Spiritual Care has also had a presence in the community providing Advance Directive documents and instruction, with emphasis on the importance of these documents throughout a person's lifetime, and not just at an end-of life stage. This work continues through the year, with the SCS Office open to aid in form completion and steps for Medical Records inclusion. We are an ongoing partner and resource to Drug Free Fayette (DFF), a community collaborative focused on substance abuse and reducing teen and adult substance abuse across Fayette County. Our community relations manager also serves as an advisor to the DFF coalition members. In partnership with Drug Free Fayette, Community Relations also widely distributed almost 1,000 Deterra Drug Disposal pouches at community events and education sessions. Distribution includes education on the importance of safe drug disposal. In October 2021, we promoted the annual Drug Take Back to hospital employees and community partners and provided more than 20 Drug Safes to Drug Free Fayette to distribute at community events. Year-round DEA Drug Take Back Day drop-off opportunities were communicated internally to our employees. We continued our partnership with DFF through providing the organization a letter of support for to be considered for a $100,000 grant for the Comprehensive Secure and Responsible Drug Disposal Program, overseen by the Institute for Intergovernmental Research and Bureau of Justice Assistance. We continued our work with Drug Free Fayette through the mutual working with of AVPRIDE on the importance of smoking cessation for community members, especially parents of Fayette County students. Offered onsite smoking cessation classes to low-wage employees of local large employers. Cancer care and wellness is another primary focus of our community benefit work. Our Spiritual Care Services promotes Cancer Wellness to patients and faith-based community members through a manner of ways. While providing Spiritual Care Services to cancer patients on units, staff hands out Cancer Wellness information to emphasize all Cancer Wellness offerings and support services. Since exercise during cancer treatment is shown to help manage side effects, aid in treatment recovery, and improve survival, we engage in the MyFit RX Exercise Program; an eight-week, medically integrated exercise program offered to all oncology patients at no charge using philanthropic funds. Additional benefits include improvement in fatigue, strength, sleep, body composition, anxiety, depression, pain, and body image. This program includes an initial assessment with a fitness specialist who designs a personalized exercise program which participants are required to do twice per week, however, they may fully utilize the Piedmont Wellness Center during the extent of the program. The MyFit program launched April 2021, with 205 patient referrals in FY22. During the height of the COVID-19 pandemic, we worked to ensure programming was still available for patients who needed it most: patients in active treatment and patients admitted to the hospital. To achieve this, we implemented and continued to provide therapy through adaptive yoga and art therapy. Our Cancer Wellness programs and services are available free of charge to all persons and their caregivers affected by cancer, regardless of where they receive cancer care and with no referral necessary. In October 2021, The Cancer Wellness Coordinator spoke at New Hope Baptist Church, Fayetteville, providing information on Cancer Wellness programming with a specific focus on breast cancer prevention initiatives. The onset of COVID-19 presented an opportunity for Cancer Wellness to adjust its business model to include both safe face-to-face consultations and virtual programming options. As a result of this adjustment, our Cancer Wellness has remained open throughout the pandemic. The transition to virtual programming through the pandemic also allowed us to offer online classes and educational courses. Additionally, this format has benefitted those with barriers to transportation. There were 20 Cancer Wellness programs offered with approximately 11,340 encounters for 4,450 community members. There were 921 nutrition consultations and more than 195 social work consultations. Cancer Wellness community business partner 180 Degree Farm held a Farmer's Market on campus in June 2022 for staff, patients, and community members. Cancer Wellness community business partner the Skin Society held a skin cancer educational seminar for Cancer Wellness participants in July 2021. Cancer Wellness community business partner Piedmont Wellness Center holds all exercise programming including weekly yoga classes along with the MyFitRX program. We participated in 19 community and business, manufacturing companies with low-income wage earners, events to promote cancer awareness, prevention, screenings, and education. Ten of those events were physician-led events to patients in community to promote cancer awareness, screenings, and wellness information. We also held Walk with a Doc events on October 10, 2021, to promote the importance of breast cancer, and on June 18, 2022, to promote prostate awareness as well as a celebration of cancer survivorship. Fifty-five community members participated in the physician-led 2.5-mile walk held at a local farmers market. Our Cancer Wellness Coordinator was on site to provide prevention education materials. Participants learned the most important cancer risk factors that can be changed are body weight, diet, and physical activity. We hosted one mammogram event in October 2021 for employees of the Fayette County Government. Twenty-four women received a screening mammogram, with one patient requiring a follow-up ultrasound. We also held two lung cancer education sessions to approximately 76 attendees. All attendees were invited to sign up for a virtual Lung Cancer screening session to gauge the risk for lung cancer and to be referred for a Low-
SCHEDULE H, PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMWe are part of Piedmont Healthcare, a regional not-for-profit organization and the parent company of 19 hospitals, the Piedmont Physicians Group, the Piedmont Heart Institute, the Piedmont Clinic and the Piedmont Healthcare Foundation. Our community relations team works directly with the community. Our community benefit department oversees the community benefit activities on behalf of all hospitals throughout the system, and this includes conducting the triennial CHNA and subsequent implementation strategy, ensuring the financial assistance policy is communicated to the community, maintaining the community benefit webpage, authoring the community benefit annual report, preparing board materials, developing and executing the community benefit grants program and compiling all community benefit figures. Each hospital and certain departments of Piedmont Healthcare execute community benefit programming, such as our revenue department, which oversees the financial assistance program.
SCHEDULE H, PART VI, LINE 7: STATE OF FILING OF COMMUNITY BENEFIT REPORTWe are not required to file a community benefit report; however, we are required to file with the Georgia Department of Community Health information on our indigent and charity care, as well as our Medicaid and Medicare shortfalls.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Discretionary Spending AcctYes (X)DiscretionarySpendingAcctInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Dr Patrick Battey MD
Board Member$0$735,279$0$386,848$0$230,526$0$128,890$0$14,341$0$1,495,884$0$111,490
Mr Michael Mandl
Board Member$0$874,041$0$548,422$0$107,257$0$180,936$0$12,644$0$1,723,300$0$0
Mr Stephen D Porter
Board Member/Chair/CEO$463,160$0$226,176$0$55,881$0$93,556$0$20,446$0$859,219$0$0$0
Mr Scott Wolfe
CFO$349,123$0$105,834$0$29,889$0$17,400$0$11,958$0$514,204$0$0$0
Mr David Nipper
COO$311,521$0$96,249$0$10,500$0$17,400$0$20,414$0$456,084$0$0$0
Ms Merry Heath
CNO$225,799$0$67,506$0$4,784$0$15,659$0$8,192$0$321,940$0$0$0
Dr Angela Swayne MD
CMO$372,880$0$109,787$0$31,804$0$14,680$0$1,303$0$530,454$0$0$0
Ms Rhonda Manos
Dir Pharmacy$210,994$0$25,528$0$5,106$0$10,555$0$6,863$0$259,046$0$0$0
Ms Ruby Villafranca
Registered Nurse$87,670$0$525$0$143,046$0$12,496$0$11,075$0$254,812$0$0$0
Ms Regina Boston
Nursing Admin Supervisor$103,844$0$1,205$0$119,423$0$13,548$0$13,955$0$251,975$0$0$0
Mr Michael McAnder
FORMER TREASURER/CFO PHC$0$0$0$0$0$972,687$0$0$0$0$0$972,687$0$0
Mr Thomas Arnold
TREASURER/CFO PHC$0$589,164$0$343,028$0$199,343$0$111,150$0$13,648$0$1,256,333$0$93,750
Ms Elizabeth Leddy
Secretary/CLO PHC$0$500,109$0$317,466$0$66,407$0$122,353$0$17,849$0$1,024,184$0$0

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1A: OTHER COMPENSATION ITEMSELIZABETH LEDDY, THOMAS ARNOLD, STEPHEN PORTER, DR. PATRICK BATTEY AND MICHAEL MANDL RECEIVED A DISCRETIONARY SPENDING ACCOUNT TOTALING $13,385, A FIXED AMOUNT DETERMINED BY THEIR JOB LEVEL. THIS SPENDING ACCOUNT WAS INCLUDED IN THEIR TAXABLE WAGES.
SCHEDULE J, PART I, LINE 3: COMPENSATION OF THE CEO/EXECUTIVE DIRECTORTHE COMPENSATION FOR THE PRESIDENT/CEO OF PIEDMONT FAYETTE HOSPITAL IS SET BY THE ENTITY'S PARENT, PIEDMONT HEALTHCARE, INC. PLEASE SEE THE SCHEDULE O NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 15A & 15B FOR ADDITIONAL INFORMATION.
SCHEDULE J, PART I, LINE 4A: SEVERANCE PAYMENTSMICHAEL MCANDER RECEIVED A SEVERANCE PAYMENT DURING CALENDAR YEAR 2021 IN THE AMOUNT OF $972,687.
SCHEDULE J, PART I, LINE 4B: SUPPLEMENTAL COMPENSATION INFORMATIONTHE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THEIR SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: PATRICK BATTEY $111,490 THOMAS ARNOLD $ 93,750 ELIZABETH LEDDY, MICHAEL MANDL, AND STEPHEN PORTER PARTICPATED IN SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS.
SCHEDULE J, PART I, LINE 7: NON-FIXED PAYMENTSCERTAIN EMPLOYEES PARTICIPATED IN AN "ANNUAL INCENTIVE PLAN" UNDER WHICH THEY RECEIVED NON-FIXED BONUS PAYMENTS BASED ON JOB LEVEL AND SEVERAL DIFFERENT PERFORMANCE METRICS.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
Hospital Authority of Fayette County
A58262922331222TAT02019-11-07$31,380,000SEE PART VIfalsefalsefalse
Hospital Authority of Fayette County
B58262922331222tas22016-11-16$47,580,000EMERG. DEPT. CONSTRUCTION & EQUIPMfalsefalsefalse
Hospital Authority of Fayette County
C5826292230000000002014-11-19$30,640,000SEE PART VIfalsefalsefalse
Hospital Authority of Fayette County
D58262922331222TAL72014-11-19$11,420,000EQUIPMENTfalsefalsefalse

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtBond DefeasedBondDefeasedAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtCapitalized InterestCapitalizedInterestAmtRefunding EscrowRefundingEscrowAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtWorking Capital ExpendituresWorkingCapitalExpendituresAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtUnspentUnspentAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$0$0$35,812,739$0$0$0$0$0$0$0$35,895,000$02019Yes (true)falseYes (true)Yes (true)
B$0$0$54,828,175$0$0$0$2,286$0$0$54,825,889$0$02016falsefalseYes (true)Yes (true)
C$4,985,000$0$30,640,000$0$0$0$0$0$0$0$30,640,000$02014Yes (true)falseYes (true)Yes (true)
D$0$0$12,640,087$0$0$0$1,856$0$0$12,638,231$0$02014falsefalseYes (true)Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndRemedial Action TakenRemedialActionTakenIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdIndEngage Bond Counsel ContractsEngageBondCounselContractsInd
Afalsefalsefalsefalse0.010000.01000falsefalsefalseYes (true)
BfalseYes (true)Yes (true)false0.010000.01000Yes (true)falsefalseYes (true)Yes (true)
Cfalsefalsefalsefalse0.010000.01000falsefalsefalseYes (true)
Dfalsefalsefalsefalse0.010000.01000falsefalsefalseYes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndBusiness Name Line1GICProviderName/BusinessNameLine1TxtGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
AfalseYes (true)falsefalseYes (true)falsefalse0falseYes (true)
0
BfalsefalsefalseYes (true)falsefalsefalse0falseYes (true)
0
CfalsefalsefalseYes (true)Yes (true)falsefalse0falseYes (true)
0
DfalsefalsefalseYes (true)Yes (true)falsefalse0falseYes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (true)
BYes (true)
CYes (true)
DYes (true)

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCH K, PART I, COL FBOND A - THIS BOND IS REFUNDING THE FAYETTE 2009A BOND ISSUED ON NOVEMBER 24, 2009. BOND C - THIS BOND IS REFUNDING THE FAYETTE 2009B BOND ISSUED ON NOVEMBER 24, 2009.
SCH K, PART II, LINE 3BOND B - TOTAL PROCEEDS INCLUDES TOTAL INVESTMENT FROM SINKING FUND OF $325,888.90. BOND D - TOTAL PROCEEDS INCLUDES TOTAL INVESTMENT FROM SINKING FUND OF $38,230.92.
SCH K, PART IV, LINE 2Bond B: The rebate calculation was last performed on 11/19/2019. No rebate due. BOND C: THE REBATE CALCULATION WAS LAST PERFORMED ON 11/19/2019. NO REBATE DUE. Bond D: The rebate calculation was last performed on 11/19/2019. No rebate due.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINE 1A: NUMBER OF FORMS 1099 FILEDALL CALENDAR YEAR 2021 FORMS 1099 WERE FILED ON BEHALF OF PIEDMONT FAYETTE HOSPITAL BY ITS SOLE MEMBER, PIEDMONT HEALTHCARE, INC. (EIN 58-1503902), PURSUANT TO AN AGREEMENT WITH THE IRS TO FILE ALL FORMS 1099 FOR THE PIEDMONT HEALTHCARE SYSTEM ON A COMBINED BASIS.
FORM 990, PART VI, SECTION A, LINE 6: ORGANIZATION'S SOLE MEMBERPIEDMONT HEALTHCARE, INC., (EIN 58-1503902) IS THE SOLE MEMBER OF PIEDMONT FAYETTE HOSPITAL ("PFH").
FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF GOVERNING BODYTHE BOARD OF PIEDMONT HEALTHCARE, PIEDMONT FAYETTE HOSPITAL'S SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF PIEDMONT FAYETTE HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7B: DECISIONS OF GOVERNING BODYPIEDMONT FAYETTE HOSPITAL'S BOARD POLICIES AND DECISIONS MUST BE FILED, IMMEDIATELY AFTER ADOPTION, WITH THE SECRETARY OF THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS. SUCH POLICIES AND DECISIONS OF THE PIEDMONT FAYETTE HOSPITAL BOARD OF DIRECTORS ARE NOT SUBJECT TO THE APPROVAL OF OR RATIFICATION BY THE PIEDMONT HEALTHCARE BOARD, BUT SHOULD THE NEED ARISE, THEY MAY BE RESCINDED BY THE PIEDMONT HEALTHCARE BOARD THROUGH A MAJORITY VOTE OF ITS DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11B: 990 REVIEW PROCESSINFORMATION NEEDED TO PREPARE PIEDMONT FAYETTE HOSPITAL'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PFH'S CONTROLLER AND VP/CFO. THE 990 IS THEN PREPARED INTERNALLY BY PIEDMONT HEALTHCARE, INC.'S TAX DIRECTOR AND SUBMITTED TO AN EXTERNAL TAX PREPARER FOR REVIEW. PRIOR TO FILING, COPIES OF FORM 990 ARE PROVIDED TO THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC., THE ORGANIZATION'S SOLE MEMBER, FOR BOARD REVIEW.
FORM 990, PART VI, SECTION B, LINE 12C: CONFLICT OF INTEREST POLICYCOMPLIANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY ORGANIZATION MANAGEMENT IN COORDINATION WITH PIEDMONT HEALTHCARE'S CHIEF COMPLIANCE OFFICER. ALL SENIOR LEADERS, BOARD MEMBERS, PHYSICIAN EMPLOYEES, NURSE PRACTITIONERS/PHYSICIAN ASSISTANTS AND EMPLOYEES AND NON-EMPLOYEES ENGAGED IN RESEARCH ARE REQUIRED TO ANNUALLY DISCLOSE ALL MATTERS WHICH COULD POTENTIALLY CONSTITUTE A CONFLICT OF INTEREST. MATTERS DISCLOSED UNDER THE POLICY MUST BE REVIEWED IN WRITING BY THE PIEDMONT HEALTHCARE CONFLICT OF INTEREST COMMITTEE IN ORDER TO DETERMINE WHETHER A CONFLICT EXISTS AND, IF SO, WHETHER TO ELIMINATE OR MANAGE THE CONFLICT. ALL BOARD MEMBERS AND EMPLOYEES OF PIEDMONT FAYETTE HOSPITAL ARE PROVIDED TRAINING ON CONFLICT OF INTEREST ISSUES, INCLUDING REPORTING REQUIREMENTS, AT NEW EMPLOYEE ORIENTATION AND AT LEAST ANNUALLY THEREAFTER. NONCOMPLIANCE WITH THE CONFLICT OF INTEREST POLICY MUST BE REPORTED TO PIEDMONT HEALTHCARE'S CHIEF COMPLIANCE OFFICER FOR INVESTIGATION, AND REMEDIAL STEPS MUST BE TAKEN AS APPROPRIATE UNDER THE PIEDMONT HEALTHCARE DISCIPLINARY POLICIES.
FORM 990, PART VI, SECTION B, LINE 15A, 15B: EXECUTIVE COMPENSATIONCOMPENSATION FOR EXECUTIVES OF PIEDMONT FAYETTE HOSPITAL IS SET BY THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC. THE PIEDMONT HEALTHCARE, INC., BOARD OF DIRECTOR'S EXECUTIVE PERFORMANCE AND COMPENSATION COMMITTEE ("THE COMMITTEE") IS COMPOSED OF AT LEAST THREE MEMBERS OF THE PHC BOARD OF DIRECTORS, SERVING TERMS OF THREE YEARS, AND THE MAJORITY OF WHICH ARE COMMUNITY DIRECTORS WHO GENERALLY DO NOT HAVE CONFLICTS OF INTEREST RELATED TO FULFILLMENT OF THE DUTIES AS OUTLINED BELOW. THE COMMITTEE OVERSEES EXECUTIVE PERFORMANCE AND COMPENSATION ON BEHALF OF THE PHC BOARD, SUBJECT TO THE ULTIMATE AUTHORITY AND OVERSIGHT OF THE BOARD. THE COMMITTEE ALSO FORMULATES POLICIES AND MAKES DECISIONS IN ORDER TO ENSURE A HIGH LEVEL OF EXECUTIVE PERFORMANCE. THE COMMITTEE IS AUTHORIZED TO ACT ON BEHALF OF THE PHC BOARD AS SET OUT IN ITS CHARTER, AND THE COMMITTEE IS ALSO CHARGED WITH PROVIDING RECOMMENDATIONS AND PERIODIC REPORTS TO THE PHC BOARD REGARDING EXECUTIVE PERFORMANCE AND COMPENSATION. ALL DECISIONS AND COMPARABILITY DATA ARE DOCUMENTED IN THE COMMITTEE MEETING MINUTES. FUNCTIONS OF THE COMMITTEE - ASSESS AND IMPLEMENT POLICIES REGARDING PERFORMANCE, COMPENSATION AND BENEFITS OF THE PRESIDENT/CEO AND OTHER EXECUTIVES AS DETERMINED BY THE COMMITTEE - SELECT AN EXECUTIVE COMPENSATION CONSULTANT WHO REPORTS TO THE COMMITTEE - ANNUALLY REVIEW THE PRESIDENT/CEO SUCCESSION PLAN - FORMULATE AND IMPLEMENT ANNUAL PERFORMANCE OBJECTIVES FOR THE PRESIDENT/CEO, AND REVIEW AND APPROVE ANNUALLY RECOMMENDATIONS FROM THE PRESIDENT/CEO RELATING TO COMPENSATION, PERFORMANCE OBJECTIVES, AND SUCCESSION PLANS FOR EVP EXECUTIVES - ANNUALLY ASSESS PRESIDENT/CEO PERFORMANCE; IF NECESSARY, IMPLEMENT ACTION PLAN WITH PRESIDENT/CEO INPUT TO IMPROVE HIS/HER PERFORMANCE; ADJUST COMPENSATION AS APPROPRIATE; THE COMMITTEE CHAIR SHALL CONSULT WITH THE PHC GOVERNANCE COMMITTEE CHAIR AND THE PHC BOARD CHAIR AND SHALL COORDINATE THE ANNUAL PERFORMANCE REVIEW OF THE PHC PRESIDENT/CEO, UNLESS THE PHC BOAR CHAIR HAS A REAL OR PERCEIVED CONFLICT OF INTEREST, IN WHICH CASE THE COMMITTEE CHAIR SHALL DETERMINE THE PROPER REVIEW PROCESS - REVIEW AND APPROVE LONG-TERM AND SHORT-TERM GOALS TO BE USED IN CONNECTION WITH EVP COMPENSATION PROGRAMS AS RECOMMENDED BY THE PRESIDENT/CEO AND VALIDATED BY THE COMPENSATION CONSULTANT - PERIODICALLY REVIEW COMPENSATION, IF ANY, FOR THE PHC BOARD CHAIR AND ALL BOARD CHAIRS OF THE PHC SUBSIDIARIES - ESTABLISH OTHER POLICIES AND PROCEDURES, AND PERFORM OTHER TASKS, RELATED TO EXECUTIVE PERFORMANCE AND COMPENSATION, INCLUDING BUT NOT LIMITED TO, APPROVAL OF EXECUTIVE EMPLOYMENT CONTRACTS AND BENEFITS - PERIODICALLY REPORT SIGNIFICANT DECISIONS AND ANY ADDITIONAL REQUESTED INFORMATION TO THE PHC BOARD.
FORM 990, PART VI, SECTION C, LINE 19: DISCLOSURE OF DOCUMENTSGOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THESE DOCUMENTS SHOULD BE REQUESTED FROM PIEDMONT HEALTHCARE, INC.'S LEGAL COUNSEL.
FORM 990, PART XI, LINE 9: RECONCILIATION OF NET ASSETSCONTRIBUTIONS ($ 12,500) CHANGES IN TEMP. $ 66,195 INTERCOMPANY TRANS. ($46,092,773) UNALLOCATED EXPENSES ($ 6,137,782) CHANGES IN UNRESTR. FUND $ 176,503 ---------------------------------------------- TOTAL ($52,000,357)
FORM 990 PART IX LINE 11GDESCRIPTION:GENERAL CONTRACT LABOR TOTAL FEES:49921131
FORM 990 PART IX LINE 11GDESCRIPTION:PROFESSIONAL CONTRACT LABOR TOTAL FEES:14603802
FORM 990 PART IX LINE 11GDESCRIPTION:OTHER FEES TOTAL FEES:1734663

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
FAYETTE SURGERY CENTER LLC
1255 HIGHWAY 54 WESTFayettevilleGA30214SurgeryGA$0$0PFH
PFH 1267 MOB LLC
1255 HIGHWAY 54 WESTFAYETTEVILLEGA30214LAND HOLDINGGA$0$0PFH

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (30 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
PIEDMONT HEALTHCARE INC
1800 HOWELL MILL RD STE 850ATLANTAGA30318581503902MANAGEMENTGA501(c)(3)12C, III-FINAfalse
PIEDMONT HOSPITAL Inc
1968 PEACHTREE ROAD NWATLANTAGA30309580566213HOSPITALGA501(c)(3)3PHCfalse
COLUMBUS REGIONAL SENIOR LIVING INC
707 CENTER STREETCOLUMBUSGA31901582628502HEALTHCAREGA501(c)(3)12C, III-FIPHCfalse
PIEDMONT MOUNTAINSIDE HOSPITAL INC
1266 HIGHWAY 515 SOUTHJASPERGA30143352228583HOSPITALGA501(c)(3)3phcfalse
PIEDMONT NEWNAN HOSPITAL INC
745 POPLAR ROADNEWNANGA30265205077249HOSPITALGA501(c)(3)3phcfalse
PIEDMONT HEALTHCARE FOUNDATION INC
2001 PEACHTREE ROAD NE SUITE 400ATLANTAGA30309581272768FUNDRAISINGGA501(c)(3)12B, IIphcfalse
PIEDMONT HENRY HOSPITAL INC
1133 EAGLES LANDING PKWYSTOCKBRIDGEGA30281582200195HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT NEWTON HOSPITAL INC
5126 HOSPITAL DRIVE NECOVINGTONGA30014582155150HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT ATHENS REGIONAL FOUNDATION INC
1199 PRINCE AVENUEATHENSGA30606581978389fundraisingGA501(c)(3)12B, IIPARMCfalse
PIEDMONT ATHENS REGIONAL HEALTH RESOURCE
1199 PRINCE AVENUEathensGA30606581930580developmentGA501(c)(3)12B, IIPARMCfalse
PIEDMONT ATHENS REGIONAL MEDICAL CENTER
1199 PRINCE AVENUEATHENSGA30606582179986HospitalGA501(c)(3)3PHCfalse
ATHENS REGIONAL PHYSICIAN SERVICES INC
1199 PRINCE AVENUEATHENSGA30606582332921HealthcareGA501(c)(3)12B, IIPARMCfalse
ATHENS REGIONAL SPECIALTY SERVICES INC
1199 PRINCE AVENUEAthensGA30606271975001HealthcareGA501(c)(3)3PARMCfalse
REGIONAL FIRSTCARE INC
1199 PRINCE AVENUEAthensGA30606582362733Urgent CareGA501(c)(3)12B, IIPARMCfalse
THE MEDICAL CENTER INC
707 CENTER STREETCOLUMBUSGA31901581685139HOSPITALGA501(C)(3)3CRHSfalse
COLUMBUS REGIONAL HEALTHCARE SYSTEM INC
707 CENTER STREETCOLUMBUSGA31901581719994MANAGEMENTGA501(C)(3)12B, IIPHCfalse
COLUMBUS REGIONAL MEDICAL FOUNDATIONINC
707 CENTER STREETCOLUMBUSGA31901581501642FUNDRAISINGGA501(C)(3)7CRHSfalse
HUGHSTON HOSPITAL INC
707 CENTER STREETCOLUMBUSGA31901331216751HOSPITALGA501(C)(3)3CRHSfalse
PIEDMONT ROCKDALE HOSPITAL INC
1412 MILSTEAD AVECONYERSGA30012300999841HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT WALTON HOSPITAL INC
2151 WEST SPRING STMONROEGA30655824194264HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT HEART INSTITUTE INC
95 COLLIER ROAD NW STE 2045ATLANTAGA30309263553500healthcareGA501(C)(3)10PHCfalse
COLUMBUS AMBULATORY HEALTHCARE SERVICES
707 CENTER STREETCOLUMBUSGA31901581719867AMBULATORYGA501(C)(3)3CRHSfalse
PIEDMONT CARTERSVILLE HOSPITAL INC
960 JOE FRANK HARRIS PKWY SECARTERSVILLEGA30120870963633HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT EASTSIDE HOSPITAL INC
1700 MEDICAL WAYsnellvilleGA30078870982886HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT MACON HOSPITAL INC
350 HOSPITAL DRMACONGA31217871006981HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT MACON NORTH HOSPITAL INC
400 CHARTER BLVDMACONGA31210871031034HOSPITALGA501(C)(3)3PHCfalse
UNIVERSITY HEALTH SERVICES INC
1350 WALTON WAYAUGUSTAGA30901581581103HOSPITALGA501(C)(3)3PHCfalse
UNIVERSITY MCDUFFIE COUNTY REG MED CTR
1350 WALTON WAYAUGUSTAGA30901454166209HOSPITALGA501(C)(3)3PHCfalse
UNIVERSITY HEALTH CARE FOUNDATION INC
2260 WRIGHTSBORO ROADAUGUSTAGA30904581343550FUNDRAISINGGA501(C)(3)7UHSfalse
UNIVERSITY EXTENDED CARE INC
1350 WALTON WAYAUGUSTAGA30901581581105HEALTHCAREGA501(C)(3)3UHSfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndUBI Code VUBICodeVAmtGeneral Or Managing PartnerGeneralOrManagingPartnerInd
GA SURGICAL CTR ON PEACHTREE
2061 PEACHTREE RD STE 100ATLANTAGA30309582394271SURGERYGANANONE$0$0false$0false
ORTHOATLANTA SURGERY CTR OF FAYETTEVILLE
900 CIRCLE 75 PKWY SE STE 1700ATLANTAGA30339202961633SURGERYGANANONE$0$0false$0false
ATHENS ASC HOLDINGS LLC
2142 W BROAD ST BLDG 100 STE 100ATHENSGA30606454014891SURGERYGANANONE$0$0false$0false
COLUMBUS DIAGNOSTIC IMAGING CTR
116 INTRACOASTAL POINTE DR 300JUPITERFL33477262291768IMAGINGGANANONE$0$0false$0false
THE SURGERY CTR LLC
100 FIRST COURTCOLUMBUSGA31909582520623SURGERYGANANONE$0$0false$0false
PIEDMONT ENCOMPASS REHAB HOSPITALS LLC
9001 LIBERTY PKWYBIRMINGHAMAL35242853544795HEALTHCAREDENANONE$0$0false$0false
COLISEUM SAME DAY SURGERY CTR LP
340 HOSPITAL DRMACONGA31217621805346SURGERYGANANONE$0$0false$0false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
PIEDMONT MEDICAL CARE CORPORATION
2727 PACES FERRY ROAD SUITE 1-1100ATLANTAGA30339582092768HEALTHCAREGANAC-CORP$0$0false
THE PIEDMONT CLINIC INC
2727 PACES FERRY ROAD SUITE 1-1100ATLANTAGA30339582005358HEALTHCAREGANAC-CORP$0$0false
PIEDMONT HEART INSTITUTE PHYSICIANS INC
95 COLLIER ROAD NW STE 2045ATLANTAGA30309260593850HEALTHCAREGANAC-CORP$0$0false
AMSTER MCRAE INSURANCE COMPANY
980427603Related InsuranceNAC-CORP$0$0falsePO BOX 1159Grand Cayman KYCJCJ
COLUMBUS HEALTHCARE RESOURCES
PO BOX 790COLUMBUSGA31902581717754HEALTHCAREGANAC-CORP$0$0false
COLUMBUS HEALTH SERVICES INC
PO BOX 790COLUMBUSGA31902581640939HEALTHCAREGANAC-CORP$0$0false
UNIVERSITY HEALTH RESOURCES INC
1350 WALTON WAYAUGUSTAGA30901581601372HEALTHCAREGANAC-CORP$0$0false
UNIVERSITY HOSPITAL AIKEN INC
1350 WALTON WAYAUGUSTAGA30901472713774HOSPTIALSCNAC-CORP$0$0false
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART I, LINE 1: DISREGARDED ENTITIESFormAndLineReferenceDesc
ExplanationTHE LIMITED LIABILITY COMPANIES LISTED IN SCHEDULE R, PART I, OPERATE AS DEPARTMENTS OF FAYETTE COMMUNITY HOSPITAL AND ARE INCORPORATED INTO THE HOSPITAL'S BOOKS AND RECORDS. SEPARATE BOOKS AND RECORDS ARE NOT MAINTAINED FOR THE LIMITED LIABILITY COMPANIES AND ASSETS AND INCOME CANNOT BE READILY DETERMINED. AS SUCH, COLUMNS (D) AND (E) IN PART I HAVE BEEN LEFT BLANK.ExplanationTxt