2023-05-12T12:52:30-05:00 2022-06-30 KPMG LLP 500 W 5th St Suite 800 Winston Salem NC 27401 990 2021-07-01 870963633 Piedmont Cartersville Hospital Inc % MARIE GAFFNEY PIED 4044251303 960 JOE FRANK HARRIS PKWY SE CARTERSVILLE GA 30120 MARIE GAFFNEY VP CORPORATE FINANCE 4702716007 2023-05-11 true MARIE GAFFNEY 999009999 SHAWN M HUTCHINSON P01048557 3362753394 2023-05-11 3 2021 2023-04-26 12:10:37Z Chris Mosley 2727 PACES FERRY RD STE 2-700 ATLANTA GA 30339 228121206 false X www.piedmont.org X 2021 GA TO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT. 9 8 834 100 0 0 0 0 0 227209898 0 562475 0 348833 0 228121206 0 0 0 0 0 54980173 0 0 0 0 163579439 0 218559612 0 9561594 0 561135082 0 56862382 0 504272700 TO PROVIDE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE IN A PROGRESSIVE ENVIRONMENT, GUIDED BY PHYSICIANS, DELIVERED BY EXCEPTIONAL PROFESSIONALS, AND INSPIRED BY THE COMMUNITIES WE SERVE. false false 196742831 227209898 PIEDMONT CARTERSVILLE HOSPITAL, INC. IS A 119-BED FACILITY LOCATED IN THE CITY OF CARTERSVILLE IN BARTOW COUNTY, GEORGIA. OUR PRIMARY CARE AND SPECIALTY PHYSICIANS ON THE MEDICAL STAFF MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SENIORS WITHIN CARTERSVILLE AND THE GREATER METROPOLITAN ATLANTA MARKET, REGARDLESS OF ANY INDIVIUAL'S ABILITY TO PAY FOR SERVICES. FOR THE YEAR ENDED JUNE 30, 2022, THE HOSPITAL HAD 7,229 IN-PATIENT ADMISSIONS WITH A TOTAL OF 37,311 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 44,365 AND OUTPAITENT VISITS TOTALED 32,092. SURGICAL SERVICES WERE PROVIDED TO 3,689 PATIENTS. 196742831 true false false false false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false true true false false false true X 0 0 834 true false false false false false false false false false false false false X 9 8 false false false false true true true true true false false false true true true true true true true false GA X MARIE GAFFNEY 4702716007 2727 PACES FERRY RD BLDG 2 STE 70 ATLANTA GA 30339 X Mr Thomas Arnold Treasurer/CFO PHC 1.0 54.0 X 0 1131535 124798 Ms Elizabeth Leddy Secretary/CLO PHC 1.0 54.0 X 0 883982 140202 Ms Katie Logan Board Member 1.0 54.0 X 0 542454 79459 Mr Jeffrey Mosley CEO 55.0 0.0 X 187672 0 31707 Mr Mark Senger CMO 55.0 0.0 X 134744 0 13564 Mr Benjamin McDonald CFO 55.0 0.0 X 131592 0 11999 Ms Lori Rakes COO 55.0 0.0 X 122104 0 15189 Dr Jeffrey Brant Board Member 1.0 0.0 X 0 0 0 Mr Ballard Mauldin Board Member 1.0 0.0 X 0 0 0 Mr Wayne Moore Board Member 1.0 0.0 X 0 0 0 Mr Victor Morgan Board Member 1.0 0.0 X 0 0 0 Ms Connie Morris Board Member 1.0 0.0 X 0 0 0 Ms Dana Nichols Board Member 1.0 0.0 X 0 0 0 Mr Marty Sonenshire Board Member, Chair 1.0 0.0 X 0 0 0 Mr Steven Spivey MD Board Member 1.0 0.0 X 0 0 0 576112 2557971 416918 4 false true false AYA HEALTHCARE INC 5930 CORNERSTONE CT W STE 300 SAN DIEGO CA 92121 HEALTHCARE STAFFING 689793 1 0 PATIENT SERVICE REVENUE 622110 226644306 226644306 OTHER OPERATING REVENUE 900099 565592 565592 227209898 556475 556475 0 0 102488 102488 0 102488 102488 6000 6000 6000 6000 0 0 0 0 0 0 0 0 0 CAFETERIA SALES 722310 246345 246345 246345 228121206 227209898 0 911308 X 0 0 0 0 432388 351488 80900 0 44242754 35964935 8277819 0 6641241 5398665 1242576 3663790 2978295 685495 0 19862 19862 15760 15760 0 0 0 44473361 36174632 8298729 0 124051 100841 23210 3772032 3066285 705747 234961 191000 43961 0 3689873 2999498 690375 6835 5556 1279 0 0 0 0 3363587 2734260 629327 1057235 1057235 BAD DEBT EXPENSE 76407916 76407916 DRUGS & MEDICAL SUPPLIES 25578810 25578810 HOSPITAL TAX 4597283 4597283 MISC. 237873 193367 44506 218559612 196742831 21816781 0 0 281968993 0 0 0 0 0 -170138602 0 0 0 0 0 0 0 3438622 0 696963 83210366 3303555 0 79906811 0 21194 0 0 0 0 0 0 0 365241101 0 561135082 0 28511394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28350988 0 56862382 X 0 504271360 0 1340 0 504272700 0 561135082 X 9561594 494711106 X false true X true false X 9910106 9910106 42325452 1102192 41223260 19815610 1760042 18055568 11159198 441321 10717877 79906811 GOODWILL 365241101 365241101 0 DUE TO RELATED PARTIES 28350964 OTHER LIABILITIES 24 28350988 X SCHEDULE D, PART X, LINE 2: ASC 740 FOOTNOTE (FKA FIN 48) PHC ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF ASC 740, INCOME TAXES (ASC 740). UNDER THE REQUIREMENTS OF ASC 740, TAX-EXEMPT ORGANIZATIONS MAY BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS UNCERTAIN TAX EXPOSURE ITEMS. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AT JUNE 30, 2022 and 2021. true true X true X 300. true X true true false true true 1687270 1687270 0.01190 5811911 5774297 37614 0.00030 4026405 844230 3182175 0.02240 11525586 6618527 4907059 0.03460 18846 18846 0.00010 313597 313597 0.00220 15500 15500 0.00010 107708 107708 0.00080 455651 455651 0.00320 11981237 6618527 5362710 0.03780 8500 8500 12550 12550 7000 7000 1750 1750 29800 29800 true 7787832 22356780 23929561 -1572781 X true true 1 1 PIEDMONT CARTERSVILLE HOSPITAL INC 960 JOE FRANK HARRIS PKWY SE CARTERSVILLE GA 30120 HTTPS://WWW.PIEDMONT.ORG/ 007-567 X X X PIEDMONT CARTERSVILLE HOSPITAL INC 1 true true true X X X X X X X X 21 true false false true X SEE PART V, SECTION C X X true 22 true SEE PART V, SECTION C false true X 300. 300. X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINES 1 AND 2: NEW HOSPITAL ENTITY Piedmont Cartersville Hospital, Inc. ("PCH") was created as a new entity on May 24, 2021 and is the 501(c)(3) tax-exempt parent of Cartersville Medical Center LLC, a disregarded entity, which was acquired from HCA Healthcare, a for-profit company. Piedmont filed the PCH Form 1023 application for recognition of exemption under Section 501(c)(3) of the Internal Revenue Code on July 27, 2021, and received its IRS Determination Letter reflecting PCH's status as a 501(c)(3) organization with public charity status 170(b)(1)(A)(iii) on March 21, 2022. The IRS 501(c)(3) status per the Determination Letter is retroactive with an effective date of exemption of May 24, 2021. SCHEDULE H, PART V, SECTION B, LINE 5: COMMUNITY REPRESENTATION AS A PART OF OUR PROCESS, WE INTERVIEWED NEARLY 245 STAKEHOLDERS, POLICY MAKERS AND LAWMAKERS REPRESENTING PUBLIC HEALTH, LOW-INCOME POPULATIONS, MINORITIES, CHRONIC CONDITIONS, OLDER ADULTS, AND OUR COMMUNITIES. THESE INCLUDED 10 STAKEHOLDERS WITHIN THE PIEDMONT CARTERSVILLE COMMUNITY, WHO GAVE THEIR PERSPECTIVES ON COMMUNITY HEALTH THROUGH THE LENS OF THEIR ROLE WITHIN THE COMMUNITY. THESE INTERVIEWS WERE CONDUCTED FOR PEOPLE REPRESENTING THE ENTIRE REGION. SPECIFICALLY, WE INTERVIEWED REPRESENTATIVES OF LOCAL AND REGIONAL PUBLIC HEALTH ENTITIES, MINORITY POPULATIONS, FAITH-BASED COMMUNITIES, LOCAL BUSINESS OWNERS, THE PHILANTHROPIC COMMUNITY, MENTAL HEALTH AGENCIES, ELECTED OFFICIALS AND INDIVIDUALS REPRESENTING OUR MOST VULNERABLE PATIENTS. THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS AND LEADERSHIP FROM ALL 19 HOSPITALS WERE ACTIVELY INFORMED AND ENGAGED THROUGHOUT THIS PROCESS. SCHEDULE H, PART V, SECTION B, LINE 7A: COMMUNITY HEALTH NEEDS ASSESSMENT https://www.piedmont.org/media/file/Community-Benefit-Needs-Assessment-PCH .pdf SCHEDULE H, PART V, LINE 7D: PUBLIC AVAILABILITY OF CHNA IN ADDITION TO MAKING ITS CHNA REPORTS AVAILABLE ON ITS WEBSITE AND BY REQUEST, PIEDMONT CARTERSVILLE MEDICAL CENTER SENT COPIES TO EACH PARTICIPANT IN THE CHNA PROCESS, DISTRIBUTED THE ASSESSMENTS TO COMMUNITY CENTERS AND OTHER LOCATIONS THAT PRIMARILY SERVE AN UNINSURED POPULATION, SENT COPIES TO LEGISLATIVE AND ELECTED OFFICIALS, AND WIDELY DISTRIBUTED THE ASSESSMENTS TO OTHER PIEDMONT HEALTHCARE HOSPITALS. SCHEDULE H, PART V, LINE 10A: IMPLEMENTATION STRATEGIES WEBSITE THE BOARD OF DIRECTORS FOR PIEDMONT CARTERSVILLE MEDICAL CENTER APPROVED ITS IMPLEMENTATION STRATEGY FOR THE THREE-YEAR PERIOD BEGINNING WITH FY23 ON SEPTEMBER 20, 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-PCH.pdf SCHEDULE H, PART V, LINE 11: ADDRESSING COMMUNITY HEALTH NEEDS DURING FY22, PIEDMONT CARTERSVILLE MEDICAL CENTER 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 CARTERSVILLE MEDICAL CENTER 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 CARTERSVILLE MEDICAL CENTER IS CURRENTLY FOCUSING ON: (1) ENSURING AFFORDABLE ACCESS TO HEALTH, MENTAL, AND DENTAL CARE (2) REDUCING PREVENTABLE INSTANCES OF, AND DEATHS FROM, CANCER (3) PROMOTING HEALTHY BEHAVIORS TO REDUCE PREVENTABLE CONDITIONS, DISEASES, AND ADDICTION (4) REDUCING PREVENTABLE INSTANCES OF, AND DEATHS FROM, HEART DISEASE SCHEDULE H, PART V, LINE 16: FINANCIAL ASSISTANCE POLICY WEBSITES FINANCIAL ASSISTANCE POLICY - HTTPS://WWW.PIEDMONT.ORG/MEDIA/FILE/FINANCIAL-ASSISTANCE-POLICY.PDF FINANCIAL ASSISTANCE APPLICATION - HTTPS://WWW.PIEDMONT.ORG/MEDIA/FILE/FINANCIAL-ASSISTANCE-APPLICATION.PDF FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY - HTTPS://WWW.PIEDMONT.ORG/MEDIA/FILE/FINANCIAL-ASSISTANCE-PLAIN-LANGUAGE-SU MMARY-ENGLISH.PDF SCHEDULE H, PART VI, LINE 1: REQUIRED DESCRIPTIONS SCHEDULE H, PART I, LINE 6A PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT WE REGULARLY REPORT TO THE COMMUNITY OUR COMMUNITY BENEFIT ACTIVITIES IN SEVERAL WAYS. EACH YEAR, WE PREPARE A SYSTEMWIDE COMMUNITY BENEFIT REPORT THAT IS AVAILABLE TO THE PUBLIC THROUGH PUBLICATION ON OUR WEBSITE. WE ALSO MAKE AVAILABLE OUR IRS FORM 990 SCHEDULE H ON OUR WEBSITE AND PROVIDE COPIES TO ANYONE UPON REQUEST. WE ALSO PROVIDE INFORMATION ON COMMUNITY BENEFIT PROGRAMMING TO LOCAL, STATE, AND FEDERAL LAWMAKERS THROUGH OUR GOVERNMENT AFFAIRS OFFICE AND ONLINE AT PIEDMONT.ORG. SCHEDULE H, PART I, LINE 7(F) PERCENT OF TOTAL EXPENSE THE DENOMINATOR USED FOR THE CALCULATION OF COLUMN (F), PERCENT OF TOTAL EXPENSE, WAS THE AMOUNT OF TOTAL FUNCTIONAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) OF $218,559,612, LESS BAD DEBT EXPENSE OF $76,407,916 FROM FORM 990, PART IX, LINE 24(A). SCHEDULE H, PART I, LINE 7 FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST A RATIO OF PATIENT CARE COST TO CHARGES, CONSISTENT WITH WORKSHEET 2, WAS USED TO REPORT THE AMOUNTS IN PART I, LINES 7A-7D. FOR AMOUNTS ON LINES 7E-7K, ACTUAL EXPENSES FOR EACH COMMUNITY BENEFIT ACTIVITY ARE TRACED AND REPORTED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. SCHEDULE H, PART III, LINES 2-4 BAD DEBT EXPENSE CALCULATION AND FOOTNOTE THE PROVISION FOR BAD DEBTS IS BASED UPON LEADERSHIP'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. PERIODICALLY, LEADERSHIP ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYER 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. PCH 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. Part III, Section B, line 8 MEDICARE SHORTFALLS AS COMMUNITY BENEFIT The amount reported on Part III, Line 6, was calculated in accordance with Schedule H instructions by utilizing our allowable Medicare cost as reported in the Medicare cost report, which is based on a cost to charge ratio. However, the allowable costs in the Medicare cost report do not reflect the actual cost of providing care to patients since the Medicare cost report excludes many direct 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. We believe our Medicare shortfall reported on Part III, Line 7 of Schedule H, should be considered a community benefit as the IRS community benefit standard includes the provision of care to elderly and Medicare patients. IRS Revenue Ruling 69-545 provides, in part, that hospitals serving patients with governmental health insurance, such as Medicare, is an indication we operate to promote health in the community. Our policy is to treat Medicare patients, regardless of the extent to which Medicare pays for the treatment. For many services, Medicare's reimbursement is less than the cost of the care provided, resulting in shortfalls that are to be absorbed by us in honor of our commitment to treat elderly patients. Many of these patients live on a low, fixed income, and would qualify for financial assistance or other means-tested programs, absent from their enrollment in Medicare. SCHEDULE H, PART III, LINE 9(B) COLLECTION PRACTICES INITIAL SCREENINGS OF ALL INPATIENT, EMERGENCY, AND SURGERY ENCOUNTERS, AS WELL AS MOST OUTPATIENT VISITS, ARE CONDUCTED BY FINANCIAL COUNSELORS IN ORDER TO IDENTIFY ANY AVAILABLE INSURANCE OR OTHER COVERAGE FOR EACH PATIENT. COUNSELORS CONTACT PATIENTS AND THEIR FAMILIES DIRECTLY, EITHER IN PERSON OR BY LETTER, TO ASSIST THE FAMILY IN IDENTIFYING ANY PROGRAMS FOR WHICH THE PATIENT/SERVICE MAY QUALIFY (INCLUDING MEDICAID, STATE CHILDREN'S HEALTH INSURANCE PROGRAM ("SCHIP"), PRIVATE OR GOVERNMENT INSURANCE COVERAGE, AND CHARITY ASSISTANCE). IF THE FAMILY CANNOT BE TIMELY LOCATED OR IS UNCOOPERATIVE, RELATED ACCOUNTS ARE TRANSFERRED TO AN INTERNAL COLLECTION DEPARTMENT FOR FURTHER ATTEMPTS TO OBTAIN PAYMENT OR, IF THE PATIENT MAY QUALIFY FOR ASSISTANCE, TO SECURE A FINANCIAL ASSISTANCE APPLICATION. THE ORGANIZATION'S DEBT COLLECTION POLICY AND PROCEDURES PROHIBIT ANY COLLECTION EFFORTS FOR THE PORTION OF A PATIENT ACCOUNT BALANCE THAT QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. SCHEDULE H, PART VI, LINE 2: NEEDS ASSESSMENT As a designated 501(c)(3) nonprofit hospital, we are required by the Internal Revenue System to conduct a triennial community health needs assessment (CHNA), in accordance with regulations put forth by the IRS following the 2010 Patient Protection and Affordable Care Act (ACA). Through this assessment, we hope to better understand local health challenges, identify health trends in our community, determine gaps in the current health delivery system and craft a plan to address those gaps and the identified health needs. In FY22, we conducted our fourth triennial CHNA. 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; - Promote healthy behaviors to reduce preventable conditions, diseases, and addiction; and, - Reduce preventable instances of and deaths from heart disease. With each priority, we work to achieve greater health equity by reducing the impact of poverty and other socioeconomic indicators. This means that health equity is built into each priority, which is demonstrated through our implementation strategies. Our subsequent implementation strategy was developed in partnership with hospital leadership and community stakeholders to address the identified priorities in our FY22 community health needs assessment. The implementation strategy was designed to be executed over a three-year period and included specific metrics by which we would be able to evaluate our work and its impact. The implementation strategy was developed by utilizing community feedback from the assessment in partnership with the system community benefits department, our leadership, and our board of directors. We included proven and successful interventions and programming, investing further in work we felt was successful in addressing unmet health needs. SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ASSISTANCE ELIGIBILITY We understand that not everyone can pay their hospital bill due to their insurance status or a limited income, and because of this, we offer financial assistance to qualifying patients. Notification about financial assistance includes, but is not limited to, a dedicated contact number, notices in patient bills, and posted notices in key areas of the hospital. These locations are the emergency room, admitting and registration departments, our business office, and patient financial services offices that are located on site. We also publish and widely publicize a plain language summary of this financial assistance care policy on our website, as well as the full policy. Referral of patients for financial assistance may be made by any staff or medical staff member at the hospital, including physicians, nurses, financial counselors, social workers, case managers, chaplains, and religious sponsors. A request for financial assistance may be made by the patient or a family member, close friend, or associate of the patient, subject to applicable privacy laws. Additionally, we provide copies of our financial assistance policy to our partner clinics and others who work closely with low-income populations. We help our partners in understanding the policy, how it relates to their populations, and receive feedback in ways our financial assistance programming could be improved. SCHEDULE H, PART VI, LINE 4: COMMUNITY INFORMATION While Piedmont Cartersville serves patients from a ten-county area, for purposes of this CHNA, we consider our community to be Bartow County. We do this in recognition of the direct impact of our tax-exempt status on county residents. In Bartow County, an average 104,519 people lived in the 459.52 square mile area each year between 2015 and 2019. The population density for this area, estimated at 228 persons per square mile, is greater than the state average population density of 181 people per square mile and the national average population density of 92 persons per square mile. The ZIP code with the highest concentration of people was 30101, where 57 percent of the county's population called home. Bartow is mostly urban, as 65 percent of community members live within an urban setting. The ZIP code with the highest concentration of the rural population was 30104 and, like in most of Georgia, rural populations in Bartow are overwhelmingly white. Bartow County is growing, having seen a 9 percent increase in total population between 2010 and 2020. About 7.7 percent of the population were veterans in 2020, and most were non-elderly adults. Fourteen percent of the population - about 14,500 people - lived with a disability. Most of that population were under the age of 65. About 24.4 percent of the population were 17 or younger, 14 percent were over the age of 65, and the remaining population were between the ages of 18-64. Between 2015 to 2019, about 84 percent of all Bartow County residents were white, 10 percent were African American, and about 6 percent were Hispanic/Latino. About 5.4 percent identified as being born outside of the US and 3.6 percent of the county's population does not have citizenship status. In 2020, 15 percent of the population had no form of insurance. Insurance status and health are inextricably linked. Being uninsured is generally a marker of low-income, as the overwhelming majority of those that are uninsured are also within certain ranges of the Federal Poverty Level. This means these populations are also likely to face the myriad of other social determinants of health (SDH), like housing and food insecurity. Between 2015 and 2019, the median household income was $57,423, which is much lower than state and national levels, which are $58,700 and $62,843, respectively. When broken down by the four dominant races in the community, income disparities are evident. Of employers in the community, the largest sector by employment size is manufacturing, which employed 10,524 community members at an average annual wage of $67,978 in 2019, according to the US Department of Commerce. Retail trade was the second largest sector, with 5,914 people employed at an average annual wage of $32,213. Government and government enterprises was the third largest sector, with 5,363 people employed at an average annual wage of $63,798. According to the 2015-2019 American Community Survey, 52,849 people in the community were part of the labor force, and only 1,578 -- about 3 percent -- were unemployed as of January 2022. This figure has steadily decreased since last year, when in January 2021, 4.2 percent of the labor force was unemployed. When looking back further, the rate is three time less than the unemployment rate in 2012. In FY22, 14 percent of the county's population lived at or below the Federal Poverty Level (FPL), and 37 percent lived at 200 percent of the FPL. In 2022, the FPL placed at family of four has having a total household income of $27,750. Even when living at twice the FPL, families are likely unable to afford many of life's basics. By far, the poorest ZIP code within Bartow County is 30137, where nearly 48 percent of the population lived at or below 200 percent of poverty in 2020. In Bartow County, like most of the state, minorities are more likely to live in poverty. For example, in 2020, 33 percent of Hispanic/Latino populations and 18 percent of blacks in Bartow County were living at or below poverty, as compared to 13 percent of whites. Of the 37,627 total occupied households in Bartow County in 2020, 10,641 -- about 28 percent -- of the population live in cost burdened households, in which housing costs are 30 percent or more of total household income. Approximately 12.34 percent of households had costs that exceeded 50 percent of the household income, which places the household in significant financial strain. In Bartow County, in 2019, four of the county's 15 census tracts were food deserts, as shown in the map to the right. About 23,223 people lived within these census tracts. These tracts almost directly correspond with census tracts demonstrating retailers who are authorized to take SNAP benefits. In Bartow County, like with most of the state, those retailers tend to be convenience and discount stores that carry limited, if any, healthy foods. Increasingly, discount stores like Dollar General do have some sort of produce section, but that is inconsistent among communities. 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, nearly 30 percent of the total population in the county have low food access, meaning about 30,341 county residents may struggle to access healthy foods. This is on par with the state 30.89 percent. ZIP code 30102 has the worst rate of low food access at 50 percent of the population. In 2019, about 76 percent of adults aged 18 or older saw a doctor for a routine check-up the previous year, a measure that is likely over-reported and is lower than both state and national averages. For Medicare recipients, this number jumps to 88.26 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 a leading cause of death for both women and men in Bartow County. In 2020, the age-adjusted death rate was 83.8 persons for every 100,000 people, which is between the state and national averages, which were 72.4 and 91.5 heart-related deaths per 100,000 people, respectively. In 2020, 7 percent of adults had a diagnosis with heart disease. Between 2016 and 2020, there were 249 deaths due to stroke, representing an age-adjusted death rate of 47.3 deaths per every 100,000 people. Men are far more likely to die from stroke than women, as are black populations. The cardiovascular disease hospitalization rate in 2018 was 18.4 hospitalizations per every 1,000 Medicare beneficiaries, which is much higher than the state and national rates of 12.2 and 11.8, respectively. The hospitalization rate for stroke is also above state and national rates, with 10 hospitalizations per every 1,000 Medicare beneficiaries, as compared to the state rate of 9.3 and the US rate of 8.4. These hospitalization rates for heart disease and stroke among Medicare recipients have remained relatively steady over the last five years. Although heart disease leads in county deaths, cancer remains a critical issue within the community. The cancer incidence rate for Bartow County each year, on average between 2014 and 2018, was 472.4 per every 100,000, which equates to a diagnosis rate of an average 539 new cases each year. Screening rates among Medicare beneficiaries is in-line with state and national rates except for breast cancer screening. In 2019, 73 percent of Medicare beneficiaries had a mammogram, as compared the state and national rates of 77 percent and 78 percent, respectively. In 2019, 8.8 percent of county adults aged 20 and older had diabetes, a figure 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. When looking at ZIP codes, rates shift. For example, ZIP 30104 had a diabetes diagnosis rate of ten percent. Chronic kidney disease, also called chronic kidney failure, involves a gradual loss of kidney function. Your kidneys filter waste and excess fluids from your blood, which are then removed in your urine. Advanced chronic kidney disease can cause dangerous levels of fluid, electrolytes and wastes to build up in your body. In 2019, 3.2 percent of the county's population had a diagnosis of kidney disease, a rate on par with state and national percentages of 3.22 percent and 3.1 percent, respectively. In 2019, 34.6 percent of adults 18 and older who 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 SCHEDULE H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH We actively promote the health of our community through clinic-hospital partnerships; community-based health screenings; educational activities; community building activities; the operation of a 24-hour emergency department available to the entire community; the operation of an emergency room open to all members of the community without regard to ability to pay; a governance board composed of community members; use of surplus revenue for facilities improvement, patient care, medical training, education, and research; the provision of inpatient hospital care for all persons in the community able to pay, including those covered by Medicare and Medicaid; and an open medical staff with privileges available to all qualifying physicians. Please note that Piedmont Cartersville became a nonprofit organization in August 2021 and therefore did not have a robust community benefit plan in place due to its previous status as a for-profit hospital. That said, we did conduct several activities within the community. COVID-19 continued to have an impact on our proactive community benefit programs, as we canceled many in-person events and classes in 2022. We created programming responsive to the pandemic, including our migration to online platforms for vital community-based programming. We offered stroke awareness educational materials and blood pressure screenings and Early Heart Attack Care education/CPR training at employer and community events to achieve and maintain stroke certification and chest pain center accreditations. We offered free childbirth education, breastfeeding and newborn care classes to expectant parents and free diabetes education classes that included healthy nutrition information for patients with diabetes. We increased local awareness of lung cancer screening through radio show interviews, social media, and community outreach opportunities. We offered affordable, reduced rate low dose CT scans to screen for lung cancer. Our lung nodule navigator collaborated with the health department and primary care physician offices who treat low- and no-insurance patients to identify eligible candidates for screening. We provided $60,000 in funding to the Tonsmeire Community Clinic to provide dental care services for low-income families in Bartow County. Additionally, we supported education to build the health workforce. We provided training, education, resources, and equipment to students in Work Based Learning and CNA programs at Cartersville City Schools and Bartow County Schools. We were actively involved in helping Cartersville High School develop their CNA program. Our staff volunteered to participate in an interview panel and observed end of year presentations by work-based learning and career pathway students (including health science students). Piedmont Cartersville provided hands-on training, support and supplies for Stop the Bleed, CPR, Early Heart Attack Care and Narcan to school systems and law enforcement personnel. We donated 1,500 COVID-19 rapid test kits to six community agencies, including Allatoona Resource Center, North Bartow Community Service, Bartow County Resource Office, Highland Rivers Health, Good Neighbor Homeless Shelter, and Bartow Family Resources. Piedmont Cartersville supported a community warming shelter at Tabernacle Baptist Church for several days in January by providing cots and food for area homeless individuals. We sponsored events or programs that benefited the community, including but not limited to: individuals seeking or in substance abuse recovery - as well as families negatively affected by substance abuse (Bartow Recovery); child abuse prevention ("Kids Helping Kids" - Advocates for Children and Cartersville Elementary School); homelessness and hungry children (Good Neighbor Homeless Shelter and Backpack Buddies); college scholarships (Etowah Scholarship Foundation); and community employees with disabilities (Euharlee Resolution). Our youth targeted outreach efforts included a prom night crash scene with enactment of injuries; fatalities; arrest, with the goal to discourage teen drinking, texting, vaping, and driving. We also participated in a REAL Skills Workshop, where students are in a program to simulate REAL life. We participated in Teen Maze, a collaborative effort from several combined agencies and organizations to give Middle and High School aged children a chance to have first-hand experience in the results and sometimes consequences of decisions they make. Upon entry, they receive a life path that can show them the results as they proceed through the maze. Piedmont Cartersville operated a booth set up like an emergency room where we demonstrated the results of traumatic events as well as situations such as overdose. Participation ranges from 800-1200 students annually. Over the past two years, through use of a trauma grant, Piedmont Cartersville has been the presenting sponsor as well as a participant. We provided free sports participation physicals for Bartow County children for Special Olympics. 110 physicals were completed. Free First Aid and/or hydration stations were provided at a community car show, a Chamber of Commerce picnic, a First Responders 5K and more. Piedmont Cartersville sponsored the 8th Annual EMS Summit, a free event for first responders including EMS, fire, and law enforcement personnel. Approximately 200 were in attendance and continuing education hours were offered. We also provided resources for low-income cancer patients treated at The Hope Center, including transportation/gas cards, lodging and wigs. Piedmont Cartersville partnered with a local dermatology practice to offer a one-day free skin cancer screening. SCHEDULE H, PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM We are part of Piedmont Healthcare, a regional not-for-profit organization and the parent company of 19 hospitals, the Piedmont Physicians Group, the Piedmont Heart Institute, the Piedmont Clinic and the Piedmont Healthcare Foundation. Our community relations team works directly with the community. Our community benefit department oversees the community benefit activities on behalf of all hospitals throughout the system, and this includes conducting the triennial CHNA and subsequent implementation strategy, ensuring the financial assistance policy is communicated to the community, maintaining the community benefit webpage, authoring the community benefit annual report, preparing board materials, developing and executing the community benefit grants program and compiling all community benefit figures. Each hospital and certain departments of Piedmont Healthcare execute community benefit programming, such as our revenue department, which oversees the financial assistance program. SCHEDULE H, PART VI, LINE 7: STATE OF FILING OF COMMUNITY BENEFIT REPORT We are not required to file a community benefit report; however, we are required to file with the Georgia Department of Community Health information on our indigent and charity care, as well as our Medicaid and Medicare shortfalls. X true true false true false false false false false true false Mr Thomas Arnold Treasurer/CFO PHC 0 589164 0 343028 0 199343 0 111150 0 13648 0 1256333 0 93750 Ms Elizabeth Leddy Secretary/CLO PHC 0 500109 0 317466 0 66407 0 122353 0 17849 0 1024184 0 0 Ms Katie Logan Board Member 0 341022 0 160384 0 41048 0 67994 0 11465 0 621913 0 0 Mr Jeffrey Mosley CEO 142002 0 34250 0 11420 0 21875 0 9832 0 219379 0 0 0 Schedule J, Part I, Line 1A: Other Compensation Items Elizabeth Leddy, Thomas Arnold, and Katie Logan received a discretionary spending account totaling $13,385, a fixed amount determined by their job level. Jeffrey Mosley received a discretionary spending account totaling $6,000. This spending account was included in their taxable wages. Schedule J, Part I, Line 3: Compensation of the CEO/Executive Director The compensation for the President/CEO of Piedmont Cartersville Hospital is set by the entity's parent, Piedmont Healthcare, Inc. Please see the Schedule O narrative for Form 990, Part VI, Section B, Line 15a & 15b for additional information. SCHEDULE J, PART I, LINE 4B: SUPPLEMENTAL COMPENSATION INFORMATION THOMAS ARNOLD RECEIVED A PAYMENT OF $93,750 FROM HIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THE FOLLOWING EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS: ELIZABETH LEDDY Katie Logan Jeffrey Mosley Schedule J, Part I, Line 7: Non-Fixed Payments Certain employees participated in an "annual incentive plan" under which they received non-fixed bonus payments based on job level and several different performance metrics. Form 990, Part V, Line 1A: Number of Forms 1099 Filed All calendar year 2021 Forms 1099 were filed on behalf of Piedmont Cartersville Hospital by its sole member, Piedmont Healthcare, Inc. (EIN: 58-1503902), pursuant to an agreement with the IRS to file all Forms 1099 for the Piedmont Healthcare system on a combined basis. FORM 990, PART VI, SECTION A, LINE 6: ORGANIZATION'S SOLE MEMBER PIEDMONT HEALTHCARE, INC., (EIN 58-1503902) IS THE SOLE MEMBER OF PIEDMONT CARTERSVILLE HOSPITAL ("PCH"). FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF GOVERNING BODY THE BOARD OF PIEDMONT HEALTHCARE, PIEDMONT CARTERSVILLE HOSPITAL'S SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF PIEDMONT CARTERSVILLE HOSPITAL. FORM 990, PART VI, SEC A, LINE 7B: DECISIONS OF GOVERNING BODY PIEDMONT CARTERSVILLE 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 CARTERSVILLE HOSPITAL BOARD OF DIRECTORS ARE NOT SUBJECT TO THE APPROVAL OF OR RATIFICATION BY THE PIEDMONT HEALTHCARE BOARD, BUT SHOULD THE NEED ARISE, THEY MAY BE RESCINDED BY THE PIEDMONT HEALTHCARE BOARD THROUGH A MAJORITY VOTE OF ITS DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B: 990 REVIEW PROCESS INFORMATION NEEDED TO PREPARE PIEDMONT CARTERSVILLE HOSPITAL'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PCH'S CONTROLLER AND VP/CFO. THE 990 IS THEN PREPARED INTERNALLY BY PIEDMONT HEALTHCARE, INC.'S TAX DEPARTMENT AND SUBMITTED TO AN EXTERNAL TAX PREPARER FOR REVIEW. PRIOR TO FILING, COPIES OF FORM 990 ARE PROVIDED TO THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC., THE ORGANIZATION'S SOLE MEMBER, FOR BOARD REVIEW. FORM 990, PART VI, SEC B, LINE 12C: CONFLICT OF INTEREST POLICY COMPLIANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY ORGANIZATION MANAGEMENT IN COORDINATION WITH PIEDMONT HEALTHCARE'S CHIEF COMPLIANCE OFFICER. ALL SENIOR LEADERS, BOARD MEMBERS, PHYSICIAN EMPLOYEES, NURSE PRACTITIONERS/PHYSICIAN ASSISTANTS AND EMPLOYEES AND NON-EMPLOYEES ENGAGED IN RESEARCH ARE REQUIRED TO ANNUALLY DISCLOSE ALL MATTERS WHICH COULD POTENTIALLY CONSTITUTE A CONFLICT OF INTEREST. MATTERS DISCLOSED UNDER THE POLICY MUST BE REVIEWED IN WRITING BY THE PIEDMONT HEALTHCARE CONFLICT OF INTEREST COMMITTEE IN ORDER TO DETERMINE WHETHER A CONFLICT EXISTS AND, IF SO, WHETHER TO ELIMINATE OR MANAGE THE CONFLICT. ALL BOARD MEMBERS AND EMPLOYEES OF PIEDMONT CARTERSVILLE HOSPITAL ARE PROVIDED TRAINING ON CONFLICT OF INTEREST ISSUES, INCLUDING REPORTING REQUIREMENTS, AT NEW EMPLOYEE ORIENTATION AND AT LEAST ANNUALLY THEREAFTER. NONCOMPLIANCE WITH THE CONFLICT OF INTEREST POLICY MUST BE REPORTED TO PIEDMONT HEALTHCARE'S chief compliance officer FOR INVESTIGATION, AND REMEDIAL STEPS MUST BE TAKEN AS APPROPRIATE UNDER THE PIEDMONT HEALTHCARE DISCIPLINARY POLICIES. Form 990, Part VI, Sec B, Line 15a, 15b: Executive Compensation Compensation for executives of Piedmont Cartersville Hospital is set by the board of directors of Piedmont Healthcare, Inc. The Piedmont Healthcare, Inc., board of director's executive performance and compensation committee ("The Committee") is composed of at least three members of the PHC board of directors, serving terms of three years, and the majority of which are community directors who generally do not have conflicts of interest related to fulfillment of the duties as outlined below. The committee oversees executive performance and compensation on behalf of the PHC board, subject to the ultimate authority and oversight of the board. The committee also formulates policies and makes decisions in order to ensure a high level of executive performance. The committee is authorized to act on behalf of the PHC board as set out in its charter, and the committee is also charged with providing recommendations and periodic reports to the PHC board regarding executive performance and compensation. All decisions and comparability date are documented in the committee meeting minutes. Functions of the committee - Assess and implement policies regarding performance, compensation and benefits of the president/CEO and other executives as determined by the committee - Select an executive compensation consultant who reports to the committee - Annually review the President/CEO succession plan - Formulate and implement annual performance objectives for the President/CEO, and review and approve annually recommendations from the President/CEO relating to compensation, performance objectives, and succession plans for EVP executives - Annually assess President/CEO performance; If necessary, implement action plan with President/CEO input to improve his/her performance; adjust compensation as appropriate; the committee chair shall consult with the PHC governance committee chair and the PHC board chair and shall coordinate the annual performance review of the PHC president/CEO, unless the PHC board chair has a real or perceived conflict of interest, in which case the committee chair shall determine the proper review process - Review and approve long-term and short-term goals to be used in connection with EVP compensation programs as recommended by the President/CEO and validated by the compensation consultant - Periodically review compensation, if any, for the PHC board chair and all board chairs of the PHC subsidiaries - Establish other policies and procedures, and perform other tasks, related to executive performance and compensation, including but not limited to, approval of executive employment contracts and benefits - Periodically report significant decisions and any additional requested information to the PHC board. FORM 990, PART VI, SECTION C, LINE 19: DISCLOSURE OF DOCUMENTS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THESE DOCUMENTS SHOULD BE REQUESTED FROM PIEDMONT HEALTHCARE, INC.'S LEGAL COUNSEL. FORM 990, PART XI, LINE 9: RECONCILIATION OF NET ASSETS CHANGES TO NET ASSETS REPORTED ON PART XI, LINE 9 ARE COMPRISED OF: INTERCOMPANY TRANSFER OF LIABILITIES $494,709,766 CHANGE IN UNRESTRICTED FUNDS $1,340 --------------------------- TOTAL $494,711,106 FORM 990 PART IX LINE 11G DESCRIPTION:GENERAL CONTRACT LABOR TOTAL FEES:25626656 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASE/CONTRACT SERVICES TOTAL FEES:11920147 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL SERVICE CONTRACT TOTAL FEES:485 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PHYSICIAN SUPPORT TOTAL FEES:6282497 FORM 990 PART IX LINE 11G DESCRIPTION:SERVICE/MAINTENANCE CONTRACTS TOTAL FEES:643576 CARTERSVILLE MEDICAL CENTER LLC 960 JOE FRANK HARRIS PARKWAY SE CARTERSVILLE GA 30120 582433438 HEALTHCARE GA 0 0 PCH INC CARTERSVILLE OCCUPATIONAL MED CENTER LL 1800 HOWELL MILL ROAD STE 850 ATLANTA GA 30318 582513472 HEALTHCARE GA 0 0 CMC LLC AR HOLDING 2 LLC 1800 HOWELL MILL ROAD STE 850 ATLANTA GA 30318 611512503 HOLDING CO. 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CHARTER BLVD MACON GA 31210 871031034 HOSPITAL GA 501(C)(3) 3 PHC false UNIVERSITY HEALTH SERVICES INC 1350 WALTON WAY AUGUSTA GA 30901 581581103 HOSPITAL GA 501(C)(3) 3 PHC false UNIVERSITY MCDUFFIE COUNTY REG MED CTR 1350 WALTON WAY AUGUSTA GA 30901 454166209 HOSPITAL GA 501(C)(3) 3 PHC false UNIVERSITY HEALTH CARE FOUNDATION INC 2260 WRIGHTSBORO ROAD AUGUSTA GA 30904 581343550 FUNDRAISING GA 501(C)(3) 7 UHS false UNIVERSITY EXTENDED CARE INC 1350 WALTON WAY AUGUSTA GA 30901 581581105 HEALTHCARE GA 501(C)(3) 3 UHS false GA SURG CTR PCHTREE 2061 PEACHTREE RD STE 100 ATLANTA GA 30309 582394271 SURGERY GA NA NONE 0 0 false 0 false ORTHOATLANTA SURGERY CENTER FAYETTEVILLE 900 CIRCLE 75 PKWY SE STE 1700 ATLANTA GA 30339 202961633 SURGERY GA NA NONE 0 0 false 0 false ATHENS ASC HOLDINGS LLC 2142 W BROAD ST BLDG 100 STE 100 ATHENS GA 30606 454014891 SURGERY GA NA NONE 0 0 false 0 false COLUMBUS DIAGNOSTIC IMAGING CTR 116 INTRACOASTAL POINTE DR 300 JUPITER FL 33477 262291768 IMAGING GA NA NONE 0 0 false 0 false THE SURGERY CTR LLC 100 FIRST COURT COLUMBUS GA 31909 582520623 SURGERY GA NA NONE 0 0 false 0 false PIEDMONT ENCOMPASS REHAB HOSPITALS LLC 9001 LIBERTY PKWY BIRMINGHAM AL 35242 853544795 HEALTHCARE DE NA NONE 0 0 false 0 false COLISEUM SAME DAY SURGERY CTR LP 340 HOSPITAL DR MACON GA 31217 621805346 SURGERY GA NA NONE 0 0 false 0 false Piedmont Medical Care Corporation 2727 Paces Ferry Road suite 1-1100 Atlanta GA 30339 582092768 Healthcare GA NA C CORP 0 0 false THE PIEDMONT CLINIC INC 2727 Paces Ferry Road suite 1-1100 Atlanta GA 30339 582005358 Healthcare GA NA C CORP 0 0 false PIEDMONT HEART INSTITUTE PHYSICIANS INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 260593850 Healthcare GA NA C CORP 0 0 false COLUMBUS HEALTHCARE RESOURCES PO BOX 790 COLUMBUS GA 31902 581717754 Healthcare GA NA C CORP 0 0 false Columbus Health Services Inc PO BOX 790 COLUMBUS GA 31902 581640939 Healthcare GA NA C CORP 0 0 false Amster McRae Insurance Company PO BOX 1159 GRAND CAYMAN CJ KY1-1102 980427603 RELATED INSUR CJ NA C CORP 0 0 false UNIVERSITY HEALTH RESOURCES INC PO BOX 790 COLUMBUS GA 31901 581601372 HEALTHCARE GA NA C-CORP 0 0 false UNIVERSITY HOSPITAL AIKEN INC 1350 WALTON WAY AUGUSTA GA 30901 472713774 HOSPITAL SC NA C-CORP 0 0 false false false false false false false false false false false false false false false true true false false SCHEDULE R, PART I, LINE 1: DISREGARDED ENTITIES THE LIMITED LIABILITY COMPANIES LISTED IN SCHEDULE R, PART I, OPERATE AS DEPARTMENTS OF PIEDMONT CARTERSVILLE 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.