2025-05-15T15:36:49+00:00 2024-06-30 135565207 KPMG LLP 303 Peachtree St NE Suite 2000 Atlanta GA 30308 990 2023-07-01 582200195 Piedmont Henry Hospital Inc PIED 6786041001 1133 EAGLES LANDING PARKWAY STOCKBRIDGE GA 30281 MARIE GAFENEY VP CORPORATE FINANCE 4712716007 2025-05-15 true Whitney B Hebron P01226647 4042223000 2025-05-15 2023 2025-03-06 01:10:19Z MR DAVID KENT 1133 EAGLES LANDING PARKWAY STOCKBRIDGE GA 30281 672523915 false X HTTPS://WWW.PIEDMONT.ORG/ X 1995 GA TO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT. 13 9 2435 200 0 0 36412 560727926 661219017 14241 8006518 2268258 2812872 563010425 672074819 8700 28355 0 159771388 186104683 0 0 337134669 375425936 496914757 561558974 66095668 110515845 281944813 276133748 97292777 108539840 184652036 167593908 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 498096108 28355 661276623 PIEDMONT HENRY HOSPITAL ("PHH") IS A 259-BED FACILITY LOCATED IN THE CITY OF STOCKBRIDGE IN HENRY COUNTY, GEORGIA. OVER 1,200 PRIMARY CARE AND SPECIALTY PHYSICIANS ON THE MEDICAL STAFF MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SENIORS WITHIN STOCKBRIDGE AND THE GREATER METROPOLITAN ATLANTA MARKET, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY FOR SERVICES. FOR THE YEAR ENDED JUNE 30, 2024, THE HOSPITAL HAD 18,523 IN-PATIENT ADMISSIONS WITH A TOTAL OF 88,944 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 90,143 AND OUTPATIENT VISITS TOTALED 74,078. SURGICAL SERVICES WERE PROVIDED TO 9,359 PATIENTS. 498096108 true false false false false false false false false true false false false true true false true false false false false false false false false true true true false true true false false false false false false false false true false false false false false true true false false false true X 0 0 2435 true false false false false false false false false false false false false X 13 9 false false false false true true true true true false false false true true true true true true true true true GA X MARIE GAFFNEY 4702716007 2727 PACES FERRY RD BLDG 2 STE 70 ATLANTA GA 30339 MR DAVID KENT CEO (AS OF 1/2023) & BOARD MEMBER 55.0 0.0 X X 647828 39304 38614 MR LEONARD MORELAND BOARD MEMBER/CHAIR 1.0 0 X X 0 0 0 DR AKSHAY GUPTA BOARD MEMBER 1.0 0 X 0 0 0 DR DERRELL ANGLYN BOARD MEMBER 1.0 0.0 X 0 41274 0 DR HITESH CHOKSHI BOARD MEMBER 1.0 0 X 0 0 0 DR PATRICK BATTEY BOARD MEMBER 1.0 54.0 X 0 1477293 34226 DR TARSEM GUPTA BOARD MEMBER/VICE CHAIR 1.0 0 X 0 0 0 MR JIM CHAFIN BOARD MEMBER 1.0 0 X 0 0 0 MR SCOTT MAHONE BOARD MEMBER 1.0 0 X 0 0 0 MS DANA LEMON BOARD MEMBER 1.0 0 X 0 0 0 MS MICHELLE AMARRA BOARD MEMBER 1.0 0 X 0 0 0 MS MICHELLE FISHER BOARD MEMBER 1.0 54.0 X 0 811773 44832 MS SHARON PONDER BOARD MEMBER 1.0 0 X 0 0 0 MR THOMAS ARNOLD TREASURER/CFO PHC 1.0 54.0 X 0 1268098 39510 MS ELIZABETH LEDDY SECRETARY/CLO PHC 1.0 54.0 X 0 1164523 40350 MR JAMES ATKINS COO 55.0 0 X 466306 0 44733 MR WESLEY JAMES CFO 55.0 0 X 566930 0 20919 DR WILLIAM WATKINS CMO 40.0 0 X 511356 0 37459 MR LUIS VAZQUEZ QUINO MEDICAL PHYSICIST 40.0 0 X 214106 0 33395 MR WALTER WILLIAMS DIRECTOR - PHARMACY 40.0 0 X 215159 0 37838 MS HEIDI HURST MEDICAL PHYSICIST 40.0 0 X 253880 0 31133 MS PAULA BUTTS CNO 40.0 0 X 308902 0 35274 3184467 4802265 438283 265 false true false AYA HEALTHCARE INC 5930 CORNERSTONE CT W STE 300 SAN DIEGO CA 92121 HEALTHCARE STAFFING 22329737 AVANT HEALTHCARE PROFESSIONALS LLC 1211 STATE RD 436 STE 227 CASSELBERRY FL 32707 HEALTHCARE STAFFING 9810454 ACUTE CARE SURGERY MEDICAL GROUP INC 1133 EAGLES LANDING PKWY STOCKBRIDGE GA 30281 SURGERY SERVICES 2649319 PRUITTHEALTH - LAUREL PARK LLC 1626 JEURGENS CT NORCROSS GA 30093 PATIENT SERVICES 2637271 INSIGHT HEALTH CORPORATION 2500 NORTHWINDS PKWY ALPHARETTA GA 30009 PATIENT SERVICES 861052 22 36412 36412 PATIENT SERVICE REVENUE 621110 658858358 658858358 0 0 MANAGEMENT FEE REVENUE 900099 10000 10000 0 0 OTHER OPERATING REVENUE 900099 2350659 2350659 0 0 0 0 0 0 661219017 1448697 449096 999601 0 999601 0 0 999601 0 8006518 0 0 0 8006518 8006518 0 0 8006518 CAFETERIA REVENUE 722514 1755665 0 0 1755665 OTHER REVENUE 900099 57606 57606 0 0 0 0 0 0 1813271 672074819 661276623 0 10761784 X 28355 28355 1746988 1501615 245373 0 38663 0 38663 0 150143574 129055208 21088366 0 24371806 20948697 3423109 0 9803652 8426692 1376960 0 35923 0 35923 0 186986 0 186986 0 58089243 38859165 19230078 0 929500 621795 307705 0 26393445 26193229 200216 0 6061058 6015080 45978 0 4659511 4281625 377886 0 102367 63990 38377 0 5394870 0 5394870 0 9803087 9803087 0 0 12649158 11623311 1025847 0 5245456 384177 4861279 0 BAD DEBT EXPENSE 161611561 161611561 0 0 MEDICAL SUPPLIES & DRUGS 72257575 72257575 0 0 OTHER EXPENSES 14621072 9035822 5585250 0 HOSPITAL TAX -2614876 -2614876 0 0 0 0 0 0 561558974 498096108 63462866 0 328669 644533 4987 110421 99513567 73294559 0 0 0 0 7116941 8163598 1228598 1676871 324002968 135120975 170390277 188881993 0 0 1375301 1375301 1986473 1986472 281944813 276133748 40037820 48688602 50396108 48622946 0 0 6858849 11228292 97292777 108539840 X 183848629 166322165 803407 1271743 184652036 167593908 281944813 276133748 X 110515845 -127573973 X false true X true false X 0 11140000 11140000 0 180891390 58443831 122447559 0 0 0 0 0 112857266 73853049 39004217 0 19114312 2824095 16290217 188881993 OTHER LIABILITIES 11228292 11228292 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote 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, 2024 AND 2023. true true X true X 300 true X true true false true true 6490323 0 6490323 0.0162 13448755 12575606 873149 0.0022 7420026 6916283 503743 0.0013 0 0 27359104 19491889 7867215 0.0197 111863 0 111863 0.0003 3659123 0 3659123 0.0091 0 0.0 167 0 167 0.0000 466964 0 466964 0.0012 0 0 4238117 0 4238117 0.0106 0 0 31597221 19491889 12105332 0.0303 0 0.0 12103 0 12103 0.0000 160197 0 160197 0.0004 0 0.0 8832 0 8832 0.0000 0 0.0 466964 0 466964 0.0012 44311 0 44311 0.0001 0 0.0 0 0 692407 0 692407 0.0017 true 3173970 56881772 50630476 6251296 X true true 1 1 PIEDMONT HENRY HOSPITAL INC 1133 EAGLES LANDING PARKWAY STOCKBRIDGE GA 30281 PIEDMONT.ORG/ 075-315 X X X SNF, REHAB SERVIces CLINIC PIEDMONT HENRY HOSPITAL INC 1 false false true X X X X X X X X 21 true false false true X https://www.piedmont.org/media/file/2022-11-PHH-Community-Health-Needs-Assessment.pdf X X true 22 true THE BOARD OF DIRECTORS FOR PIEDMONT HENRY HOSPITAL APPROVED ITS IMPLEMENTATION STRATEGY FOR THE THRE false true X 300.0 300.0 X X true true X X X X true X https://www.piedmont.org/media/file/2024-05-PHC-Financial-Assistance-Policy-English.pdf X https://www.piedmont.org/media/file/2024-05-PHC-Financial-Assistance-Application-English.pdf X www.piedmont.org/media/file/2020-10-PHC-Financial-Assistance-Plain-Language-Summary-English.pdf X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - 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 16 STAKEHOLDERS WITHIN THE PIEDMONT HENRY 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 7 Facility , 1 Facility , 1 - PUBLIC AVAILABILITY OF CHNA. IN ADDITION TO MAKING ITS CHNA REPORTS AVAILABLE ON ITS WEBSITE AND BY REQUEST, PIEDMONT HENRY 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, Section B, Line 11 Facility , 1 Facility , 1 - ADDRESSING COMMUNITY HEALTH NEEDS. PIEDMONT HENRY HOSPITAL CONDUCTED ITS FOURTH CHNA DURING FY22, AGAIN BY ASSESSING PUBLICLY AVAILABLE DATA, INTERVIEWING COMMUNITY MEMBERS AND STAKEHOLDERS, CONDUCTING FOCUS GROUPS OF VULNERABLE POPULATIONS, INTERVIEWING PIEDMONT BOARD MEMBERS, AND SURVEYING PIEDMONT EMPLOYEES. THROUGH THIS PROCESS, PIEDMONT HENRY 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 HENRY HOSPITAL IS CURRENTLY FOCUSING ON: (1) ENSURING AFFORDABLE ACCESS TO HEALTH, MENTAL, AND DENTAL CARE (2) REDUCING PREVENTABLE INSTANCES OF, AND DEATHS FROM, CANCER (3) PROMOTING HEALTH BEHAVIORS TO REDUCE PREVENTABLE CONDITIONS AND DISEASES (4) REDUCING PREVENTABLE INSTANCES OF, AND DEATHS FROM, HEART DISEASE 1 LAUREL PARK 1133 EAGLES LANDING PARKWAY STOCKBRIDGE GA 30281 SKILLED NURSING FACILITY Schedule H, Part I, Line 6a PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT Piedmont regularly reports its community benefit activities to the community in several ways. Each year, Piedmont prepares a systemwide community benefit report that is available to the public through publication on its website. Piedmont also makes its IRS Form 990 Schedule H available on its website and provides copies to anyone upon request. Piedmont also provides information on community benefit programming to local, state, and federal lawmakers through its government affairs office and online at piedmont.org. Schedule H, Part I, Line 7f 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 $561,558,974, LESS BAD DEBT EXPENSE OF $161,611,561 FROM FORM 990, PART IX, LINE 24(B). 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. Hospital and system leadership periodically assesses the adequacy of the allowance for doubtful accounts based on historical write-off experience by payor category. The review results are then used to modify 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 leadership's assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage, and other collection indicators. Hospital and system leadership periodically assesses the adequacy of the allowance for doubtful accounts based on historical write-off experience by payor category. The review results are then used to modify the provision for bad debts to establish an appropriate allowance for uncollectible receivables. PHH PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE ARE NOT REPORTED AS REVENUE. Schedule H, Part III, Line 8 MEDICARE SHORTFALLS AS COMMUNITY BENEFIT The amount reported in Part III, Line 6, was calculated following Schedule H instructions by utilizing allowable Medicare costs as reported in the Medicare cost report, which Piedmont bases 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 providing quality healthcare for Medicare patients. For example, specific coverage fees to physicians, Medicare C and D costs, and other similar direct patient care expenses are expressly excluded from allowable costs in the Medicare Cost Report. IRS Revenue Ruling 69-545 provides, in part, that hospitals serving patients with governmental health insurance, such as Medicare, are an indication the hospital operates to promote health in the community. Piedmont's policy is to treat Medicare patients regardless of how much Medicare pays for the treatment. For many services, Medicare's reimbursement is less than the cost of the care provided, resulting in shortfalls the hospital will absorb in honor of its commitment to treating 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 9b 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, the Internal Revenue Service requires us to conduct a triennial community health needs assessment (CHNA) following regulations put forth by the IRS following the 2010 Patient Protection and Affordable Care Act (ACA). Through this assessment, Piedmont hopes to understand local health challenges better, identify health trends in the community, determine gaps in the current health delivery system, and craft a plan to address those gaps and the identified health needs. In FY22, Piedmont conducted its fourth triennial CHNA, and FY24 was the second year of activities outlined in its subsequent Implementation Strategy. The CHNA was led by the Piedmont Healthcare community benefits team and consulting organization Public Goods Group (PGG), with input and direction from Piedmont leadership and Piedmont Healthcare's Department of External Affairs. Process The CHNA defined its community as its home county due to the impact of its tax-exempt status. Property taxes comprise a hospital's largest tax exemption segment, impacting county revenues. Because of this, Piedmont aims to ensure it provides ample benefit to its county and community. Additionally, Piedmont considers patient origin, especially that of lower-income patients who qualify for financial assistance or receive insurance coverage through Medicaid. Piedmont's secondary communities are considered the areas with the highest concentration of patients fitting that criterion, including those from nearby communities. Once Piedmont established its primary and secondary communities, it analyzed available public health data, including resources from the US Census, US Health and Human Services Community Health Status Indicators, US Department of Agriculture, Economic Research Service, National Center for Education Statistics, Kaiser Family Foundation's State Health Facts, American Heart Association, County Health Rankings and Georgia Online Analytical Statistical Information System (OASIS). All figures within the CHNA were for 2020 unless otherwise noted. Health indicators are estimates provided by County Health Rankings and the team internally sourced hospital data. PGG then interviewed key stakeholders with particular expertise or knowledge of the community. Specifically, PGG interviewed representatives of local and regional public health entities, minority populations, faith-based communities, local business owners, philanthropic communities, mental health agencies, elected officials, and individuals representing the community's most vulnerable patients. Piedmont conducted an internal survey system for both clinical and non-clinical employees. Piedmont gathered information on knowledge and understanding of community benefits, current programs, and suggestions for better serving patients and the overall community, regardless of where they receive care. Approximately 1,050 employees spanning the system responded. Additionally, Piedmont conducted a community-based survey that was widely advertised to the community. Once Piedmont gathered qualitative and quantitative data, Piedmont authored the preliminary report, which was vetted and reviewed by hospital and health system leadership. This report identified several key community health needs during the assessment process. The community benefits department recommended priorities with sign-off from hospital and board leadership. Piedmont used the following criteria to establish the priorities: - The number of people affected; - The seriousness of the issue; - Whether the health need particularly affected people living in poverty or reflected health disparities; and, - Availability of community and/or hospital resources to address the need. Piedmont views all priorities through the lens of health disparities, with particular attention paid to improving outcomes for those most vulnerable due to income and race. The chosen priorities reflected a collective agreement on what hospital leadership, staff, and the community felt was most important and within its ability to impact the issue positively. Once leadership approved the priorities, Piedmont authored the CHNA. Piedmont presented its findings and recommendations to the hospital's board of directors for their input and approval. FY22 priorities A key CHNA component is identifying the top health priorities the hospital will address over fiscal years 2023, 2024, and 2025. These priorities will guide the hospital's 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 avoidable conditions, diseases, and addiction - Reduce preventable cases of and deaths from heart disease With each priority, Piedmont will work to achieve more significant health equity by reducing the impact of poverty and other socioeconomic indicators, building health equity into its work, which the hospital demonstrates through its implementation strategies. Hospital leadership and staff then developed the subsequent implementation strategy to address the identified priorities in the FY22 community health needs assessment. The implementation strategy was executed over three years. It included specific metrics by which hospital staff and the community could evaluate its work and impact. Piedmont developed the implementation strategy by utilizing community feedback from the assessment in partnership with the system community benefits department, system leadership, and the hospital's board of directors. Piedmont included proven and successful interventions and programming, investing further in work with the best chance of creating positive, sustainable change. Schedule H, Part VI, Line 3 PATIENT EDUCATION OF ASSISTANCE ELIGIBILITY Piedmont understands that not everyone can pay their hospital bill due to their insurance status or limited income, and because of this, each hospital offers financial assistance to qualifying patients. Notification about financial assistance includes, but is not limited to, a dedicated contact number, notices within inpatient bills, and posted notices in key hospital areas. These locations are the emergency room, admitting and registration departments, business office, and patient financial services offices on site. Piedmont also publishes and widely publicizes a plain language summary of this financial assistance care policy and its full policy on its website. Any staff member can refer a patient to the financial assistance department, including physicians, nurses, financial counselors, social workers, case managers, chaplains, and religious sponsors. The patient may request financial assistance from a family member, close friend, or associate of the patient, subject to applicable privacy laws. Additionally, Piedmont provides copies of its financial assistance policy to partner clinics and others who work closely with low-income populations. Piedmont helps its partners understand the policy and how it relates to their populations, and it receives feedback on improving its financial assistance programming. Schedule H, Part VI, Line 4 COMMUNITY INFORMATION While Piedmont Henry serves patients from all over middle Georgia, the hospital considers its primary community as Henry County in recognition of the direct impact the hospital's tax-exempt status has on county residents. In Henry County, an average of 240,853 people lived in the 319-square-mile area each year between 2018 and 2022. The population density for this area, estimated at 756 people per square mile, is much greater than the state and national average population density of 186 and 94 people per square mile, respectively. Henry County is growing, seeing an 18 percent jump in total population between 2010 and 2020. An average of about 10 percent of the population were veterans from 2018 to 2022. Approximately 10 percent of the population - about 22,500 people - lived with a disability. Most of that population were between the ages of 18 and 64. About 25 percent of the population was 17 or younger, about 12 percent were over 65, and the remaining population was between the ages of 18-64. Between 2018 and 2022, a yearly average of about 40 percent of all Henry County residents were white, 49 percent were African American, 8 percent were Hispanic/Latino, about three percent were Asian, and about 1 percent were comprised of other races. About eight percent identified as being born outside of the US, and more than two percent do not have citizenship status. On average, between the years 2018 and 2022, about 10 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 who are uninsured are also within specific ranges of the federal poverty guidelines, meaning these populations are also likely to face myriad other social determinants of health (SDH), like housing and food insecurity. Adults ages 18 to 64 are most likely to be uninsured, and that's true in Henry County. Around 13 percent of nonelderly adults were uninsured, as compared to less than 8 percent of those under age 18 and 2 percent of those 65 and older. As with other indicators, race matters. Approximately 20 percent of Hispanic/Latino populations were uninsured, 14 percent of Asians were uninsured, 9 percent of the Black population was uninsured, and 10 percent of the white population were uninsured. Between 2018 and 2022, the median household income was $79,663, much higher than the state and national levels of $71,355 and $75,149, respectively. Of employers in the community, the largest sector by number of employees is retail trade, which employed 15,946 community members at an average annual wage of $31,049 in 2022, according to the US Department of Commerce. Transportation and warehousing were the second largest sector, with 15,406 people employed at an average annual wage of $32,406. Administrative and support, waste management, and remediation services were the third largest sector, with 13,580 people employed at an average yearly salary of $28,859. According to the 2018-2022 American Community Survey, 125,700 people in the community were part of the labor force, and only 4,900 - about four percent - were unemployed as of November 2024. In Henry County, like most of the state, minorities are more likely to live in poverty. For example, nine percent of Black or African American populations and twelve percent of Asian populations were living at or below poverty, as compared to seven percent of white populations. Of the nearly 82,300 total occupied households on average in Henry County from 2018 to 2022, more than 24,000 - about 30 percent of the population - lived in cost-burdened households, in which housing costs were 30 percent or more of total household income. Approximately 11 percent of households had costs that exceeded 50 percent of the household income, which places the household in significant financial strain. In Henry County, in 2019, only three of the county's 25 census tracts were food deserts. About 17,800 people lived within these census tracts. These tracts almost directly correspond with census tracts, demonstrating retailers authorized to take SNAP benefits. In Henry County, like 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 have some sort of produce section, which is inconsistent among communities. Low food access means living more than one mile (urban) or 10 miles (rural) from the nearest supermarket, supercenter, or large grocery store. This indicator is relevant because it highlights populations and geographies facing food insecurity. According to the 2019 Food Access Research Atlas database, nearly 50 percent of the total population in the county has low food access, meaning more than 100,000 county residents may struggle to access healthy foods, which was much higher than the state and national rates of about 31 percent and 22 percent, respectively. In 2022, about 78 percent of adults aged 18 or older saw a doctor for a routine checkup the previous year. This measure is likely over-reported and more significant than state and national averages. For Medicare recipients, this number jumps to more than 82 percent of adult beneficiaries, which is below state. Routine checkups are critical 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 Henry County. Between 2018 and 2022, the age-adjusted death rate was 173 deaths for every 100,000 people, which is lower than the state and national averages of 193 and 207 heart-related deaths per 100,000 people, respectively. This rate has declined steadily over the last few years. Between 2018 and 2022, there were 474 deaths due to stroke, representing an age-adjusted death rate of approximately 40 deaths per every 100,000 people. The hospitalization rates for heart disease and stroke among Medicare recipients have decreased steadily over the last five years. The yearly average rate of hospitalization due to cardiovascular disease from 2019 to 2021 was nine hospitalizations per every 1,000 Medicare beneficiaries, which is less than the state rate of 10 and the national rate of about 10. The hospitalization rate for stroke is below the state rate and on par with the national rates, with eight hospitalizations per every 1,000 Medicare beneficiaries, as compared to the state rate of more than nine and the national rate of eight. Although heart disease leads to county deaths, cancer remains a critical issue within the community. The cancer incidence rate for Henry County each year on average between 2016 and 2020 was more than 478 per every 100,000 people, which equates to a diagnosis rate of an average of 1,135 new cases each year. When broken down by cancer site, though, the prostate cancer incidence rate of about 157 is higher than state and national rates, which are about 135 and 110 diagnoses per every 100,000 people, respectively, on average each year. In 2021, 17,400 adults aged 20 and older had diabetes, equaling 9 percent of the county's population, less than the state rate of about 10 percent. Diabetes is a prevalent problem in the US, often indicating an unhealthy lifestyle, and it puts individuals at risk for further health issues. In 2021, three percent of the county's population had a diagnosis of kidney disease, a rate lower than the state and national percentages. In 2021, about 35 percent of adults 18 and older reported having high cholesterol. Too much cholesterol puts one at risk for heart disease and stroke, two of the leading causes of death within the county. In 2021, about 40 percent of adults 18 and older had a diagnosis of high blood pressure. High blood pressure can damage the arteries by making them less elastic, which decreases blood and oxygen flow to the heart and leads to heart disease. Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH Piedmont actively promotes the health of the 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 community as a whole, the operation of an emergency room open to all members of the community without regard to ability to pay, a governance board composed of community members, use of surplus revenue for facilities improvement, patient care, and medical training, education, and research, the provision of inpatient hospital care for all persons in the community able to pay, including those covered by Medicare and Medicaid, and an open medical staff with privileges available to all qualifying physicians. In FY24, Piedmont Henry provided care to low-income patients at a cost of $7.4 million. Of that amount, Piedmont provided $6.5 million in direct financial assistance and covered approximately $873,149 in shortfalls from providing care to patients with Medicaid coverage. Piedmont Henry also trained future healthcare professionals at a cost of $3.7 million, which included more than two dozen specialties within the hospital, such as physical therapy and pharmacy technician training. In FY24, Piedmont further built the Empowering You platform to connect community members and patients with resources to address social determinants of health issues. Powered by FindHelp.org, Piedmont clinicians and case managers can search and refer patients to supporting organizations, including referrals to local food banks and housing resources. The hospital prioritized access to appropriate and affordable health and mental care for all community members, especially those with low incomes, by supporting the Hands of Hope, an on-site charitable clinic that serves uninsured, low-income county residents. Each year, the hospital provides space and utilities for the clinic and shares access to patient medical records through the Epic Electronic Medical Records system free of charge. The hospital also donated $265,000 to the clinic to support operations. Piedmont Henry's Chief Nursing Officer (CNO) regularly met with the Hands of Hope Executive Director and served on the board of directors to discuss opportunities and issues periodically. The hospital also provides Hands of Hope with free diagnostic tests, including mammograms, radiological studies, and lab services, as needed. In FY24, Henry County was top among Georgia counties for low birth rates. To address this, in partnership with Amerigroup and Connecting Henry's Low Birth Rate Initiative, clinical leaders from Piedmont Henry attended multiple county community baby showers to educate attendees on health and nutrition, lactation, breast health pre-natal health, and smoking cessation. The hospital continued to better serve low-income, uninsured patients through its work with Hands of Hope by partnering to develop a mechanism to schedule follow-up appointments from Hands of Hope immediately upon leaving the hospital. The hospital worked with the clinic to track referrals via Epic, and case management regularly reviewed patient information to determine who qualifies for Hands of Hope services. For services not covered with Hands of Hope, patient access staff worked with patients to complete financial aid applications based on Piedmont Healthcare guidelines. Additionally, all admitted patients and Change Healthcare screened uninsured patients for assistance with their Medicare and/or Medicaid services application. The hospital provides a managed care program for low-income patients that utilizes a licensed medical social worker and RN to work with high-risk, low-income patients who have presented at the emergency department with conditions that need ongoing care. Together, the social worker and RN worked to prevent unnecessary admissions, provide pertinent resources, and assist with accessing the resources when deemed necessary and beneficial while working to empower the patient. The hospital worked to decrease deaths from cancer and increase access to cancer programming for those living with the disease by supporting smoking cessation by providing tools and education to all community members. The hospital developed a flyer with free resources for smoking cessation and distributed these flyers digitally to local community groups, Hands of Hope, and the Health Department. The hospital continued its work to reduce opioid and related substance abuse and overdose deaths by providing meaningful leadership in its community by partnering with others in combating opioid abuse. Local leaders were part of a systemwide initiative to address the numerous aspects of opioid addiction. The hospital worked with providers to remove certain medications from the hospital drug formulary. The hospital worked with its anesthesiologists to provide more patient blocks for appropriate surgeries to decrease the need for opioid medications. The hospital educated staff and the community on prescription storage and safe waste procedures, including a medication take-back program in the county. It also maintained a detailed report, with assistance from the emergency department medical director, depicting opioid trends, including which providers are actively prescribing. The hospital continued its Little Free Food Pantry because of the recent increase in the unhoused population near campus. Supplies for the pantry are donated through the community and employees and are replenished as needed. In additional support, the emergency department maintained its clothes closet with socks, underwear, coats, pants, and shirts to provide to patients in need. In September 2023, Piedmont Henry sponsored the county food festival, A Taste of Henry, which supported the nonprofit organization A Friends House. The organization provides shelter for foster children who are survivors of abuse, sex trafficking, and neglect. About 500 community members attended the event, and Piedmont donated $3,210. In September 2023, Piedmont Henry Hospital sponsored the annual city festival, Bridgefest, which promotes health and wellness and community collaboration. Over 2,000 people participated in the festival, and Piedmont spent $5,500 to support the event. In September 2023, Piedmont Henry was a sponsor for the annual Henry County Fair, which supports the needs of children in Henry County. Approximately 500 community members attended the fair, and Piedmont spent $3,000 supporting the event. In October 2023, Piedmont Hospital employees participated in the Hands of Hope Charity Football event to raise funds for the clinic, which provides medical, dental, and mental health services to the indigent population in Henry County. Piedmont invested a total of $9,570 through staff support at the event. In December 2023, in partnership with Connecting Henry, Piedmont Henry Hospital employees donated five shopping carts of games and toys to benefit 150 students in Henry County during the holiday season. In FY24, Piedmont Henry sponsored the Flint River Council Golden Eagle Dinner, which supports the local Boy Scouts of America. There were 200 community members present, and Piedmont donated $2,500. In February 2024, Piedmont Henry sponsored Gordon State College's A Heart for Gordon Gala to raise awareness about heart disease. The gala hosted 200 community members, with a $6,500 donation made by Piedmont. In February 2024, Piedmont Henry hosted a community education program discussing heart health and the various tests for arrhythmias. A Piedmont physician led the discussion with the 150 community members present. In March 2024, Piedmont Henry sponsored the Henry County Chamber Women's Summit. That month, the hospital sponsored the City of Stockbridge's 9th Annual Women's History Honors Dinner, donating $2,500. Approximately 125 community members attended the dinner. Schedule H, Part VI, Line 6 AFFILIATED HEALTH CARE SYSTEM Piedmont Henry is 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. The Piedmont 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 specific department of Piedmont Healthcare executes community benefit programming, such as its revenue department, which oversees the financial assistance program. Schedule H, Part VI, Line 7 STATE OF FILING OF COMMUNITY BENEFIT REPORT Piedmont is not required to file a community benefit report; however, Piedmont must file information on its indigent and charity care, as well as its Medicaid and Medicare shortfalls, with the Georgia Department of Community Health. Schedule H, Part V, Section B, Line 16a FAP website - PIEDMONT HENRY HOSPITAL, INC.: Line 16a URL: https://www.piedmont.org/media/file/2024-05-PHC-Financial-Assistance-Policy-English.pdf; Schedule H, Part V, Section B, Line 16b FAP Application website - PIEDMONT HENRY HOSPITAL, INC.: Line 16b URL: https://www.piedmont.org/media/file/2024-05-PHC-Financial-Assistance-Application-English.pdf; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - PIEDMONT HENRY HOSPITAL, INC.: Line 16c URL: www.piedmont.org/media/file/2020-10-PHC-Financial-Assistance-Plain-Language-Summary-English.pdf; true GEORGIA TRAUMA FOUNDATION INC 8491 HOSPITAL DR 419 DOUGLASVILLE GA 30134 462625957 501(C)(3) 5300 PROGRAM SUPPORT 1 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. MONEY IS GIVEN TO CHARITABLE ORGANIZATIONS WHICH PRIMARILY PROMOTE HEALTH CAUSES. THE GRANTS ARE ADMINISTERED AND MONITORED THROUGH THE ORGANIZAITON'S PUBLIC RELATIONS DEPARTMENT. X true true false true false false false false false true false MR DAVID KENT CEO (AS OF 1/2023) & BOARD MEMBER 385702 37645 182274 0 79852 1659 13595 0 22184 2835 683607 42139 0 0 DR PATRICK BATTEY BOARD MEMBER 0 791328 0 447537 0 238428 0 19800 0 14426 0 1511519 0 120006 MS MICHELLE FISHER BOARD MEMBER 0 477978 0 225882 0 107913 0 19800 0 25032 0 856605 0 68381 MR THOMAS ARNOLD TREASURER/CFO PHC 0 711656 0 360250 0 196192 0 19800 0 19710 0 1307608 0 107975 MS ELIZABETH LEDDY SECRETARY/CLO PHC 0 612535 0 395529 0 156459 0 19800 0 20550 0 1204873 0 93683 MR JAMES ATKINS COO 351621 0 98497 0 16188 0 19800 0 24933 0 511039 0 0 0 MR WESLEY JAMES CFO 428837 0 116347 0 21746 0 19800 0 1119 0 587849 0 0 0 DR WILLIAM WATKINS CMO 382501 0 105463 0 23392 0 19800 0 17659 0 548815 0 0 0 MS PAULA BUTTS CNO 237359 0 66119 0 5424 0 18015 0 17259 0 344176 0 0 0 MS HEIDI HURST MEDICAL PHYSICIST 246889 0 1093 0 5898 0 15196 0 15937 0 285013 0 0 0 MR WALTER WILLIAMS DIRECTOR - PHARMACY 192360 0 21751 0 1048 0 0 0 37838 0 252997 0 0 0 MR LUIS VAZQUEZ QUINO MEDICAL PHYSICIST 211409 0 1093 0 1604 0 13370 0 20025 0 247501 0 0 0 Schedule J, Part I, Line 1a Discretionary spending account DR. PATRICK BATTEY, THOMAS ARNOLD, ELIZABETH LEDDY, MICHELLE FISHER, AND DAVID KENT RECEIVED A DISCRETIONARY SPENDING ACCOUNT TOTALING $12,000, A FIXED AMOUNT DETERMINED BY THEIR JOB LEVEL. THIS SPENDING ACCOUNT WAS INCLUDED IN THEIR TAXABLE WAGES. Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation THE COMPENSATION FOR THE PRESIDENT/CEO OF PIEDMONT HENRY 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 nonqualified retirement plan THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THEIR SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: PATRICK BATTEY $120,006 THOMAS ARNOLD $107,975 ELIZABETH LEDDY $93,683 MICHELLE FISHER $68,381 DAVID KENT PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN BUT DID NOT RECEIVE A CURRENT YEAR PAYMENT. Schedule J, Part I, Line 7 Non-fixed payments CERTAIN EMPLOYEES PARTICIPATED IN AN "ANNUAL INCENTIVE PLAN" UNDER WHICH THEY RECEIVED NON-FIXED PAYMENTS BASED ON JOB LEVEL AND SEVERAL DIFFERENT PERFORMANCE METRICS. A HOSPITAL AUTHORITY OF HENRY COUNTY 581274549 426357GE3 2014-11-19 53420000 EMERGENCY DEPARTMENT EXPANSION & EQUIPMENT false false false A 8735000 61642037 58272853 9428 3359756 2014 false false true true A false true true true false 0.01 0.01 false false true A false false false true true false false false true A true Schedule K, Part IV, Line 2c REBATE CALCULATION THE REBATE CALCULATION FOR THE 2014 SERIES A HOSPITAL AUTHORITY OF HENRY COUNTY BOND ISSUE WAS LAST PERFORMED ON NOVEMBER 19, 2019. NO REBATE IS DUE. MS BARBARA CHAFIN FAMILY MEMBER OF JIM CHAFIN, BOARD MEMBER 38663 FISCAL YEAR COMPENSATION false Form 990, Part V, Line 1a NUMBER OF FORMS 1099 FILED ALL CALENDAR YEAR 2023 FORMS 1099 WERE FILED ON BEHALF OF PIEDMONT HENRY 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, Line 6 Classes of members or stockholders PIEDMONT HEALTHCARE, INC., (EIN 58-1503902) IS THE SOLE MEMBER OF PIEDMONT HENRY HOSPITAL, INC. ("PHH"). Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE BOARD OF PIEDMONT HEALTHCARE, PIEDMONT HENRY HOSPITAL'S SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF PIEDMONT HENRY HOSPITAL. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders PIEDMONT HENRY 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 HENRY 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, Line 11b Review of form 990 by governing body INFORMATION NEEDED TO PREPARE PIEDMONT HENRY HOSPITAL'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PHH'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, 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 HENRY 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 SENIOR VICE PRESIDENT OF COMPLIANCE FOR INVESTIGATION, AND REMEDIAL STEPS MUST BE TAKEN AS APPROPRIATE UNDER THE PIEDMONT HEALTHCARE DISCIPLINARY POLICIES. Form 990, Part VI, Line 15a Process to establish compensation of top management official COMPENSATION FOR EXECUTIVES OF PIEDMONT HENRY 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 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, Line 15b Process to establish compensation of other employees PLEASE SEE DISCLOSURE FOR FORM 990, PART VI, LINE 15A, ABOVE. Form 990, Part VI, Line 19 Required documents available to the public 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 IX, Line 11g Other Fees GENERAL CONTRACT LABOR - Total Expense: 29416794, Program Service Expense: 19678550, Management and General Expenses: 9738244, Fundraising Expenses: 0; PROFESSIONAL CONTRACT LABOR - Total Expense: 24396696, Program Service Expense: 16320323, Management and General Expenses: 8076373, Fundraising Expenses: 0; OTHER PURCHASED SERVICES - Total Expense: 4275753, Program Service Expense: 2860292, Management and General Expenses: 1415461, Fundraising Expenses: 0; Form 990, Part XI, Line 9 Other changes in net assets or fund balances INTERCOMPANY TRANSFER OF LIABILITIES - -XXX-XX-XXXX; UNALLOCATED EXPENSES - -3212700; BOOK/TAX DIFFERENCE - 3392; CHANGE IN UNRESTRICTED FUNDS - -127393; CHANGE IN TEMP RESTRICED FUNDS - 468336; CONTRIBUTIONS - -300; HENRY RADIATION ONCOLOGY CENTER LLC 960 HOSPITAL DR STOCKBRIDGE GA 30281 RADIATION GA 0 0 PHH PIEDMONT HENRY RADIATION ONCOLOGY CENTER AT RIVERDALE LLC 225 PROFESSIONAL CT RIVERDALE GA 30274 RADIATION GA 0 0 PHH 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HEALTHCARE DE NA N/A false false COLISEUM SAME DAY SURGERY CTR 340 HOSPITAL DR MACON GA 31217 621805346 SURGERY GA NA N/A false false PIEDMONT MEDICAL CARE CORPORATION 2727 PACES FERRY ROAD SUITE 1-1100 ATLANTA GA 30339 582092768 HEALTHCARE GA NA C Corporation false THE PIEDMONT CLINIC INC 2727 PACES FERRY ROAD SUITE 1-1100 ATLANTA GA 30339 582005358 HEALTHCARE GA NA C Corporation false PIEDMONT HEART INSTITUTE PHYSICIANS INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30339 260593850 HEALTHCARE GA NA C Corporation false AMSTER MCRAE INSURANCE COMPANY SPC 981734069 RELATED INSURANCE CJ NA C Corporation false COLUMBUS HEALTHCARE RESOURCES PO BOX 790 COLUMBUS GA 31902 581717754 HEALTHCARE GA NA C Corporation false COLUMBUS HEALTH SERVICES INC PO BOX 790 COLUMBUS GA 31902 581640939 HEALTHCARE GA NA C Corporation false UNIVERSITY HEALTH RESOURCES INC 1350 WALTON WAY AUGUSTA GA 30901 581601372 HEALTHCARE GA NA C Corporation false UNIVERSITY HOSPITAL AIKEN INC 1350 WALTON WAY AUGUSTA GA 30901 472713774 HOSPITAL SC NA C Corporation false false false false false false false false false false false false false false false false true true false false Schedule R, Part I DISREGARDED ENTITIES THE LIMITED LIABILITY COMPANIES LISTED IN SCHEDULE R, PART I, OPERATE AS DEPARTMENTS OF PIEDMONT HENRY 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.