STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

PIEDMONT MOUNTAINSIDE HOSPITAL INC: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
PIEDMONT MOUNTAINSIDE HOSPITAL INC (EIN 35-2228583)
Tax period
2023-07-01 to 2024-06-30
Filed
2025-05-15
IRS object ID
202521359349313977
Schema version
2023v6.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2025-05-15T15:44:30+00:00ReturnTs
Tax Period End2024-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN135565207PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1303 Peachtree St NE Suite 2000AddressLine1Txt
CityAtlantaCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30308ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN352228583EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Piedmont Mountainside Hospital IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPIEDBusinessNameControlTxt
Phone7066922441PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11266 highway 515 southAddressLine1Txt
CityJASPERCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30143ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMS DENISE RAYPersonNm
Person TitleCEOPersonTitleTxt
Signature2025-05-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWhitney B HebronPreparerPersonNm
PTINP01226647PTIN
Phone4042223000PhoneNum
Preparation2025-05-15PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1MS DENISE RAYBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11266 highway 515 southAddressLine1Txt
CityJASPERCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30143ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$156,045,493GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressPIEDMONT.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2004FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee675TotalEmployeeCnt
Total Volunteers155TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,941,931PYContributionsGrantsAmt
CY Contributions Grants$2,222,718CYContributionsGrantsAmt
PY Program Service Revenue$143,733,194PYProgramServiceRevenueAmt
CY Program Service Revenue$153,312,161CYProgramServiceRevenueAmt
PY Investment Income-$191,619PYInvestmentIncomeAmt
CY Investment Income-$99,260CYInvestmentIncomeAmt
PY Other Revenue$426,642PYOtherRevenueAmt
CY Other Revenue$509,926CYOtherRevenueAmt
PY Total Revenue$146,910,148PYTotalRevenueAmt
CY Total Revenue$155,945,545CYTotalRevenueAmt
PY Grants And Similar Paid$52,185PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$109,004CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$51,253,255PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$54,971,389CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$73,646,623PYOtherExpensesAmt
CY Other Expenses$68,279,259CYOtherExpensesAmt
PY Total Expenses$124,952,063PYTotalExpensesAmt
CY Total Expenses$123,359,652CYTotalExpensesAmt
PY Revenues Less Expenses$21,958,085PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$32,585,893CYRevenuesLessExpensesAmt
Total Assets BOY$78,701,998TotalAssetsBOYAmt
Total Assets EOY$85,004,418TotalAssetsEOYAmt
Total Liabilities BOY$27,633,622TotalLiabilitiesBOYAmt
Total Liabilities EOY$31,931,690TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$51,068,376NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$53,072,728NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE IN A PROGRESSIVE ENVIRONMENT, GUIDED BY PHYSICIANS, DELIVERED BY PROFESSIONALS, AND INSPIRED BY THE COMMUNITIES WE SERVE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$111,176,377ExpenseAmt
Grant$109,004GrantAmt
Revenue$153,328,653RevenueAmt
DescPIEDMONT MOUNTAINSIDE HOSPITAL ("PMH") IS A 76-BED FACILITY LOCATED IN THE CITY OF JASPER IN PICKENS COUNTY, GEORGIA. OVER 200 PRIMARY CARE AND SPECIALTY PHYSICIANS ON THE MEDICAL STAFF MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SENIORS WITHIN THE COMMUNITY, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY FOR SERVICES. FOR THE YEAR ENDED JUNE 30, 2024, THE HOSPITAL HAD 4,251 IN-PATIENT ADMISSIONS WITH A TOTAL OF 17,932 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 33,667 AND OUTPATIENT VISITS TOTALED 61,194. SURGICAL SERVICES WERE PROVIDED TO 2,935 PATIENTS.Desc
Total Program Service Expenses$111,176,377TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee675EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MARIE GAFFNEYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4702716007PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12727 PACES FERRY ROAD BLDG 2 STEAddressLine1Txt
CityATLANTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP30339ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
MS DENISE RAY
CEO/BOARD MEMBER/CHAIR55.00Yes (X)Yes (X)$906,562$0$37,773
DR JOHN SCHNARS
BOARD MEMBER1.039.0Yes (X)$0$707,772$34,996
DR LEIGH HAMBY
BOARD MEMBER1.054.0Yes (X)$0$1,346,397$37,793
DR ROSEMARIE SPILLANE
BOARD MEMBER1.00Yes (X)$0$0$0
MR GREGORY HURST
BOARD MEMBER1.00Yes (X)$0$0$0
MR JASON SMITH
BOARD MEMBER1.00Yes (X)$0$0$0
MR PAUL NEALEY
BOARD MEMBER1.00Yes (X)$0$0$0
MR RICHARD HUBBARD III
BOARD MEMBER1.00Yes (X)$0$0$0
MR THOMAS ARNOLD
TREASURER/CFO PHC1.054.0Yes (X)$0$1,268,098$39,510
MS ELIZABETH LEDDY
SECRETARY/CLO PHC1.054.0Yes (X)$0$1,164,523$40,350
MS LINDSEY GARD
CFO55.00$213,883$0$37,707Yes (X)
DR MOIZ MASTER
PHYSICIAN38.02.0$555,248$0$42,164Yes (X)
MR JUSTIN LEAL
SR. DIR. OPERATIONS40.00$307,220$0$22,604Yes (X)
MR WILLIAM MATTHEWS
STAFF NURSE40.00$186,627$0$4,510Yes (X)
MS MICHELLE BREITFELDER
CNO40.00$297,821$0$34,905Yes (X)
MS PATRICIA HOPKINS
DIRECTOR - PHARMACY40.00$222,907$0$33,620Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,690,268TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$4,486,790TotReportableCompRltdOrgAmt
Total Other Compensation$365,932TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K79IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
AYA HEALTHCARE INC
5930 CORNERSTONE CT W STE 300SAN DIEGOCA92121HEALTHCARE STAFFING$3,386,379
FORTIS HEALTH LLC
3950 AUSTELL RDAUSTELLGA30106SKILLED NURSING$2,433,053
SOUTHEASTERN PATHOLOGY PC
311 W 8TH ST NEROMEGA30165PATHOLOGY SERVICES$654,182
EMERGENCY COVERAGE CORPORATION
1200 MEMORIAL DRDALTONGA30720EMERGENCY CARE$642,709
INSIGHT HEALTH CORPORATION
1001 N HIGHLAND AVEMURFREESBOROTN37130RADIOLOGY SERVICES$432,054
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
All Other Contributions$2,222,718AllOtherContributionsAmt
Noncash Contributions$97,871NoncashContributionsAmt
Total Contributions$2,222,718TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
PATIENT SERVICE REVENUE621110$152,753,040$152,753,040$0$0
OTHER OPERATING REVENUE900099$559,121$559,121$0$0

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$153,312,161TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$688TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$688ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$99,948OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other-$99,948OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$99,948TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$99,948ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
CAFETERIA SALES722310$354,403$0$0$354,403
GIFT SHOP900099$139,031$0$0$139,031
FEE REVENUE900099$16,492$16,492$0$0

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$509,926OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$155,945,545TotalRevenueColumnAmt
Related Or Exempt Func Income$153,328,653RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$394,174ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$109,004TotalAmt
Program Services$109,004ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,098,963TotalAmt
Program Services$965,219ProgramServicesAmt
Management And General$133,744ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$43,039,939TotalAmt
Program Services$37,801,978ProgramServicesAmt
Management And General$5,237,961ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$8,015,184TotalAmt
Program Services$7,039,736ProgramServicesAmt
Management And General$975,448ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,817,303TotalAmt
Program Services$2,474,437ProgramServicesAmt
Management And General$342,866ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$19,697TotalAmt
Program Services$19,697ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total-$9,671TotalAmt
Program Services-$9,381ProgramServicesAmt
Management And General-$290ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,726,879TotalAmt
Program Services$8,726,879ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$270,001TotalAmt
Program Services$270,001ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$6,856,571TotalAmt
Program Services$6,764,980ProgramServicesAmt
Management And General$91,591ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,565,349TotalAmt
Program Services$1,518,398ProgramServicesAmt
Management And General$46,951ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,827,632TotalAmt
Program Services$2,389,290ProgramServicesAmt
Management And General$438,342ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$33,221TotalAmt
Program Services$24,494ProgramServicesAmt
Management And General$8,727ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$878,402TotalAmt
Program Services$851,307ProgramServicesAmt
Management And General$27,095ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$2,771,874TotalAmt
Program Services$0ProgramServicesAmt
Management And General$2,771,874ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,154,756TotalAmt
Program Services$4,030,114ProgramServicesAmt
Management And General$124,642ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,180,169TotalAmt
Program Services$1,144,764ProgramServicesAmt
Management And General$35,405ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
DRUGS AND MEDICAL SUPPLIES$17,895,253$17,895,253$0$0
ALL OTHER EXPENSES$13,773,281$11,824,362$1,948,919$0
BAD DEBT EXPENSE$5,834,851$5,834,851$0$0
HOSPITAL TAX$1,500,994$1,500,994$0$0

All Other Expenses AllOtherExpensesGrp

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

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$123,359,652TotalAmt
Program Services$111,176,377ProgramServicesAmt
Management And General$12,183,275ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$50,339BOYAmt
EOY$41,026EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$24,728,036BOYAmt
EOY$18,573,919EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,061,402BOYAmt
EOY$2,060,044EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$494,272BOYAmt
EOY$473,434EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$110,422,728LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$63,747,216LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$34,187,466BOYAmt
EOY$46,675,512EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$17,180,483BOYAmt
EOY$17,180,483EOYAmt

Other Assets Total OtherAssetsTotalGrp

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

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$78,701,998BOYAmt
EOY$85,004,418EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,616,605BOYAmt
EOY$12,478,499EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$18,017,017BOYAmt
EOY$19,453,191EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$27,633,622BOYAmt
EOY$31,931,690EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$44,156,067BOYAmt
EOY$53,041,916EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,912,309BOYAmt
EOY$30,812EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$51,068,376BOYAmt
EOY$53,072,728EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$78,701,998BOYAmt
EOY$85,004,418EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$32,585,893ReconcilationRevenueExpnssAmt
Prior Period Adjustments-$48,409PriorPeriodAdjustmentsAmt
Other Changes In Net Assets-$30,533,132OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$1,897,200OtherCostOrOtherBasisAmt
Book Value$1,897,200BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$43,384,839OtherCostOrOtherBasisAmt
Depreciation$22,795,729DepreciationAmt
Book Value$20,589,110BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$2,536,751OtherCostOrOtherBasisAmt
Depreciation$2,456,848DepreciationAmt
Book Value$79,903BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$44,058,388OtherCostOrOtherBasisAmt
Depreciation$33,342,321DepreciationAmt
Book Value$10,716,067BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$18,545,550OtherCostOrOtherBasisAmt
Depreciation$5,152,318DepreciationAmt
Book Value$13,393,232BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$46,675,512TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Medicare Liabilities$12,214,551
Other Liabilities$7,238,640
FieldValueIRS element (for citing)
Total Liability$19,453,191TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteFormAndLineReferenceDesc
ExplanationPHC ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF ASC 740, INCOME TAXES (ASC 740). UNDER THE REQUIREMENTS OF ASC 740, TAX-EXEMPT ORGANIZATIONS MAY BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS UNCERTAIN TAX EXPOSURE ITEMS. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AT JUNE 30, 2024 AND 2023.ExplanationTxt

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,089,748TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,089,748NetCommunityBenefitExpnsAmt
Total Expense0.0263TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,111,791TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,920,072DirectOffsettingRevenueAmt
Net Community Benefit Expns$191,719NetCommunityBenefitExpnsAmt
Total Expense0.0016TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,306,683TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,917,484DirectOffsettingRevenueAmt
Net Community Benefit Expns$389,199NetCommunityBenefitExpnsAmt
Total Expense0.0033TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$8,508,222TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,837,556DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,670,666NetCommunityBenefitExpnsAmt
Total Expense0.0312TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$75,427TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$75,427NetCommunityBenefitExpnsAmt
Total Expense0.0006TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$798,319TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$798,319NetCommunityBenefitExpnsAmt
Total Expense0.0068TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$54,051TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$54,051NetCommunityBenefitExpnsAmt
Total Expense0.0005TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$21,240TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$21,240NetCommunityBenefitExpnsAmt
Total Expense0.0002TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$949,037TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$949,037NetCommunityBenefitExpnsAmt
Total Expense0.0081TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$9,457,259TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,837,556DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,619,703NetCommunityBenefitExpnsAmt
Total Expense0.0393TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,834TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$18,834NetCommunityBenefitExpnsAmt
Total Expense0.0002TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$130,950TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$130,950NetCommunityBenefitExpnsAmt
Total Expense0.0011TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,596TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,596NetCommunityBenefitExpnsAmt
Total Expense0.0000TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,616TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,616NetCommunityBenefitExpnsAmt
Total Expense0.0001TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$164,996TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$164,996NetCommunityBenefitExpnsAmt
Total Expense0.0014TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$2,135,280BadDebtExpenseAmt
Reimbursed By Medicare$26,916,568ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$26,744,506CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$172,062MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PIEDMONT MOUNTAINSIDE HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11266 HIGHWAY 515 SOUTHAddressLine1Txt
CityJASPERCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30145ZIPCd
FieldValueIRS element (for citing)
Website AddressHTTPS://WWW.PIEDMONT.ORG/WebsiteAddressTxt
State License056-550StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PIEDMONT MOUNTAINSIDE HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttps://www.piedmont.org/media/file/2022-11-PMH-Community-Health-Needs-Assessment.pdfOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLTHE BOARD OF DIRECTORS FOR PIEDMONT MOUNTAINSIDE HOSPITAL APPROVED ITS IMPLEMENTATION STRATEGY FOR TStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care300.0FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.0FPGFamilyIncmLmtDscntCarePct
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttps://www.piedmont.org/media/file/2024-05-PHC-Financial-Assistance-Policy-English.pdfFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://www.piedmont.org/media/file/2024-05-PHC-Financial-Assistance-Application-English.pdfFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLwww.piedmont.org/media/file/2020-10-PHC-Financial-Assistance-Plain-Language-Summary-English.pdfFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 Facility , 1Facility , 1 - PIEDMONT MOUNTAINSIDE HOSPITAL, INC.. 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 8 STAKEHOLDERS WITHIN THE PICKENS AND GILMER COMMUNITIES, 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 , 1Facility , 1 - PIEDMONT MOUNTAINSIDE HOSPITAL, INC.. IN ADDITION TO MAKING ITS CHNA REPORTS AVAILABLE ON ITS WEBSITE AND BY REQUEST, PIEDMONT MOUNTAINSIDE 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 , 1Facility , 1 - PIEDMONT MOUNTAINSIDE HOSPITAL, INC.. PIEDMONT MOUNTAINSIDE 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 MOUNTAINSIDE 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 MOUNTAINSIDE HOSPITAL IS CURRENTLY FOCUSING ON: (1) ENSURING AFFORDABLE ACCESS TO HEALTH, MENTAL, AND DENTAL CARE (2) PROMOTING MENTAL WELL-BEING (3) PROMOTING HEALTH BEHAVIORS TO REDUCE INSTANCES OF PREVENTABLE CONDITIONS
FieldValueIRS element (for citing)
Facility0FacilityNum

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part I, Line 7f PERCENT OF TOTAL EXPENSETHE 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 $123,359,652, LESS BAD DEBT EXPENSE OF $5,834,851 FROM FORM 990, PART IX, LINE 24(B).
Schedule H, Part I, Line 7 FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COSTA 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 FOOTNOTEThe 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. PMH 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 BENEFITThe 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 PRACTICESINITIAL SCREENINGS OF ALL INPATIENT, EMERGENCY, AND SURGERY ENCOUNTERS, AS WELL AS MOST OUTPATIENT VISITS, ARE CONDUCTED BY FINANCIAL COUNSELORS IN ORDER TO IDENTIFY ANY AVAILABLE INSURANCE OR OTHER COVERAGE FOR EACH PATIENT. COUNSELORS CONTACT PATIENTS AND THEIR FAMILIES DIRECTLY, EITHER IN PERSON OR BY LETTER, TO ASSIST THE FAMILY IN IDENTIFYING ANY PROGRAMS FOR WHICH THE PATIENT/SERVICE MAY QUALIFY (INCLUDING MEDICAID, STATE CHILDREN'S HEALTH INSURANCE PROGRAM ("SCHIP"), PRIVATE OR GOVERNMENT INSURANCE COVERAGE, AND CHARITY ASSISTANCE). IF THE FAMILY CANNOT BE TIMELY LOCATED OR IS UNCOOPERATIVE, RELATED ACCOUNTS ARE TRANSFERRED TO AN INTERNAL COLLECTION DEPARTMENT FOR FURTHER ATTEMPTS TO OBTAIN PAYMENT OR, IF THE PATIENT MAY QUALIFY FOR ASSISTANCE, TO SECURE A FINANCIAL ASSISTANCE APPLICATION. THE ORGANIZATION'S DEBT COLLECTION POLICY AND PROCEDURES PROHIBIT ANY COLLECTION EFFORTS FOR THE PORTION OF A PATIENT ACCOUNT BALANCE THAT QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY.
Schedule H, Part VI, Line 2 NEEDS ASSESSMENTAs a designated 501(c)(3) nonprofit hospital, 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 and dental care - Promote healthy behaviors to reduce instances of chronic conditions - Promote mental well-being 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 designed to be 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 ELIGIBILITYPiedmont 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 5 PROMOTION OF COMMUNITY HEALTHPiedmont Mountainside actively promotes the health of its 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 Mountainside provided care to low-income patients at a cost of $3.3 million. Of that amount, Piedmont provided $3 million in direct financial assistance and covered $191,719 in shortfalls from providing care to patients with Medicaid coverage. Piedmont Mountainside also trained future healthcare professionals at a cost of approximately $800,000, 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. Throughout FY24, Piedmont Mountainside staff volunteered at the Bethesda Community Clinic once a month at the mobile clinic in nearby Ellijay. Bethesda Community Clinic is a nonprofit charitable clinic that provides health care services to low-income, uninsured, and underinsured community members. In FY24, Piedmont Mountainside donated medical supplies and over-the-counter medications to school nurses at Pickens and Gilmer County schools throughout the school year at a cost of $6,000. In July 2023, Piedmont Mountainside sponsored Keep Pickens Beautiful, which supports sustainable litter reduction programs and promotes voluntary recycling within the community. And improve solid waste management. In August 2023, Piedmont Mountainside participated in the 1st Jamboree Day in partnership with Good Samaritan Health and Wellness and taught hands-on CPR. The hospital also sponsored the Artwalk Downtown Jasper event. Staff provided information regarding signs and symptoms of stroke and heart attack to attendees during these events. In August and September 2023, Piedmont Mountainside sponsored Jeepfest at a cost of nearly $6,000. Piedmont Mountainside provided a baby care station for parents of babies and young children so they have a safe place for feeding and caring for their children. In August 2023, for $1,500, Piedmont Mountainside sponsored Chatt Tech's event to fund the foundation to provide much-needed scholarships and grants to students in need throughout Cobb, Cherokee, Bartow, Gilmer, Paulding, and Pickens counties. In October 2023, Piedmont Mountainside participated in a breast cancer panel discussion in partnership with the Prestige Medical Foundation at a cost of nearly $500. The proceeds from the event benefitted the Breast Cancer Thrive Fund. That month, the hospital also sponsored and attended the Zombie Fest 2023, benefiting youth mental health for the local community at a cost of $1,500. In October 2023, Piedmont Mountainside participated in the annual Home Depot Safety Day by providing information regarding the signs and symptoms of stroke and heart attacks. The event features all the emergency service providers in the community. The hospital sponsored the Georgia Apple Festival and the Marble Festival that month. Piedmont Mountainside also provided a baby care station for parents of babies and young children, so they have a safe place for feeding and caring for their children. In November 2023, Piedmont Mountainside partnered with numerous businesses in Pickens County, such as Coca Cola of Pickens County, Rocco's Pub, State Farm, and others, to provide a free lunch and door prizes to North Georgia Veterans and their families for $500. In April 2024, Piedmont Mountainside volunteered and participated in the 3rd annual Breast Cancer Thrive 5K. All proceeds helped with expenses for breast cancer education classes and access to SOZO lymphedema and body composition screens. SOZO is a digital health platform from ImpediMed that aids in the early detection of lymphedema. A body composition scan provides an in-depth analysis of a person's body composition by measuring various components such as bone density, muscle mass, and body fat. Piedmont Mountainside hosted the Inaugural Ladies Night Out Event. This new annual event offered education about breast health and exams and what patients should do if they have a cancer diagnosis, along with treatment options. All proceeds from the event benefit the Piedmont Mountainside Thrive Breast Cancer Fund. Piedmont Mountainside conducted a Mass Casualty Triage Training event for Pickens County School District nurses. ED Director Kayla Weaver and Clinical Manager Pete Petrin provided hands-on training to help school officials prepare for any emergency. Piedmont Mountainside Emergency leaders worked with the Pickens County Sheriff's Department, local EMS, Pickens County School System and Chattahoochee Technical College to conduct a planning meeting for a countywide mass casualty drill.
Schedule H, Part VI, Line 6 AFFILIATED HEALTH CARE SYSTEMPiedmont Mountainside 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 REPORTPiedmont 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 I, Line 6a PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORTPiedmont 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 VI, Line 4 COMMUNITY INFORMATIONWhile Piedmont Mountainside serves patients from all over northeast Georgia, the hospital considers its community to be Pickens and Gilmer counties in recognition of the direct impact of the hospital's tax-exempt status on county residents. In both counties, an average of 65,000 people lived in the nearly 660-square-mile area yearly between 2018 and 2022. The population density for this area, estimated at 100 people per square mile, is much lower than the state average population density of nearly 200 people per square mile and is on par with the national average population density. The two counties are primarily rural, with 80 percent of the population living in a designated rural area and only 20 percent of community members living within an urban setting. Like most of Georgia, these rural populations are white and between 18 and 64. Both counties are growing, with an average population jump of 12 percent between the 2010 and 2020 census. Between 2018 and 2022, an average of 10 percent of the population were veterans, and the most common age range of veterans was between 65 and 74. Nearly 20 percent of the population - about 12,000 people - lived with a disability, and most of that population was over the age of 65. Between 2018 and 2022, about 90 percent of Gilmer and Pickens residents were white, about one percent were African American, less than one percent were Asian, and about eight percent were Hispanic/Latino. About four percent of the population were born outside of the US, and about 2 percent of those did not have citizenship status. Nearly two percent of households did not speak English at home. In an average year from 2018 to 2022, nearly 15 percent - about 9,200 community members - had no 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. Throughout Georgia, adults ages 18 to 64 are most likely to be uninsured, and that's true in both Gilmer and Pickens counties. On average, nearly 22 percent of non-elderly adults were uninsured from 2018 to 2022, a rate higher than the state and national averages of about 18 percent and 12 percent, respectively. Between 2018 and 2022, the median household income in Gilmer County was $70,334, and the median household income in Pickens County was $72,558. Of employers in the community, the largest sector (by number of employees) in 2022 was retail trade, which employed 3,482 community members at an average wage of $32,890, according to the US Department of Commerce. Construction was the second largest sector, with 2,966 people employed at an average salary of $21,334. Manufacturing was the third largest sector, with 2,461 people employed at an average wage of $59,449. According to the US Department of Labor, in November of 2024, nearly 30,000 people in the community were part of the labor force, and only 955 - about three percent - were unemployed. This rate is on par with the state average but less than the national average of four percent. From 2018 to 2022, 14 percent of the two counties' population lived at or below 100 percent of the federal poverty guidelines. However, Gilmer families are more likely to live in poverty than those in Pickens County. Of the nearly 26,000 total occupied households in both counties, an average of about 5,600 - 22 percent - of the population lived in cost-burdened households each year from 2018 to 2022, meaning their housing costs were 30 percent or more of the total household income. Gilmer and Pickens comprised similar percentages of cost-burdened households. Approximately nine percent of combined county households had costs that exceeded 50 percent of the household income, which places a household in significant financial strain. 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, 18 percent of both counties' populations have low food access, meaning about 10,000 community members may struggle to access healthy foods, lower than the state and national rates of about 31 percent and 22 percent, respectively. In 2022, 78 percent of adults ages 18 and older saw a doctor for a routine checkup the previous year in both counties combined. This measure is likely overreported and is more significant than state and national averages. For Medicare recipients, this number jumps to 88 percent of adult beneficiaries, which is above both state and national averages. Heart disease is a leading cause of death in both Gilmer and Pickens counties. Between 2018 and 2022, the age-adjusted rate was 308 deaths for every 100,000 people, which is higher than both state and national rates, which were 193 and 207 heart-related deaths per 100,000 people, respectively. When adjusting for gender, men are far more likely to die from heart disease than women, at a rate of nearly 342 male deaths per 100,000 people, compared to a rate of about 275 deaths for women. Between 2018 and 2022, there were almost 180 deaths due to stroke, representing an age-adjusted death rate of 54 deaths per 100,000 people combined for both counties. The hospitalization rates for heart disease and stroke among Medicare recipients have generally decreased over the last five years. The average cardiovascular disease hospitalization rate between 2019 and 2021 was 11 hospitalizations per 1,000 Medicare beneficiaries combined for both counties, higher than the state and national rates of about 10. The hospitalization rate for stroke is nine hospitalizations per 1,000 Medicare beneficiaries, as compared to the state and national rates of about nine and eight percent, respectively. Breast screening rates have remained relatively steady over the last few years; in 2022, the previous year for which data are available, nearly 74 percent of all women ages 50-74 reported having had a mammogram within the two previous years, below the state and national averages of 76 percent and 77 percent, respectively. In 2021, about 6,000 adults ages 20 and older had a diagnosis of diabetes, equaling nearly nine percent of the combined counties' population. Diabetes is a prevalent problem in the US and often indicates an unhealthy lifestyle and a greater risk of further health issues. That same year, nearly four percent of the combined counties' population had a diagnosis of kidney disease, a rate slightly more significant than the state and national averages of three. In 2021, 42 percent of adults ages 18 and older reported having high cholesterol combined for both counties. Too much cholesterol increases the risk of heart disease and stroke, two of the leading causes of death within the community. In 2021, 40 percent of adults ages 18 and older had a diagnosis of high blood pressure combined for both counties. High blood pressure can damage arteries by making them less elastic, which decreases blood and oxygen flow to the heart and leads to heart disease.
Schedule H, Part V, Section B, Line 16a FAP website- PIEDMONT MOUNTAINSIDE HOSPITAL: 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 MOUNTAINSIDE HOSPITAL: 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 MOUNTAINSIDE HOSPITAL: Line 16c URL: www.piedmont.org/media/file/2020-10-PHC-Financial-Assistance-Plain-Language-Summary-English.pdf;

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
PICKENS COUNTY CHAMBER OF COMMERCE
500 VETERANS MEMORIAL BLVDJASPERGA30143581376367501(C)(6)$15,000PROGRAM SUPPORT
CITY OF JASPER GA
200 BURNT MOUNTAIN RDJASPERGA30143GOVERNMENT$7,500PROGRAM SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org1TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule I, Part I, Line 2 Procedures for monitoring use of grant funds.FormAndLineReferenceDesc
ExplanationMONEY IS GIVEN TO CHARITABLE ORGANIZATIONS WHICH PRIMARILY PROMOTE HEALTH CARE CAUSES. THE GRANTS ARE ADMINISTERED AND MONITORED THROUGH THE ORGANIZAITON'S PUBLIC RELATIONS DEPARTMENT.ExplanationTxt

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MS DENISE RAY
CEO/BOARD MEMBER/CHAIR$501,831$0$269,310$0$135,421$0$19,800$0$17,973$0$944,335$0$71,294$0
DR LEIGH HAMBY
BOARD MEMBER$0$715,933$0$439,771$0$190,693$0$19,800$0$17,993$0$1,384,190$0$108,680
DR JOHN SCHNARS
BOARD MEMBER$0$533,116$0$0$0$174,656$0$18,120$0$16,876$0$742,768$0$0
MR THOMAS ARNOLD
TREASURER/CFO PHC$0$711,656$0$360,250$0$196,192$0$19,800$0$19,710$0$1,307,608$0$107,975
MS ELIZABETH LEDDY
SECRETARY/CLO PHC$0$612,535$0$395,529$0$156,459$0$19,800$0$20,550$0$1,204,873$0$93,683
MS LINDSEY GARD
CFO$171,509$0$35,680$0$6,694$0$0$0$37,707$0$251,590$0$0$0
DR MOIZ MASTER
PHYSICIAN$403,697$0$131,816$0$19,735$0$17,132$0$25,032$0$597,412$0$0$0
MS MICHELLE BREITFELDER
CNO$211,708$0$72,255$0$13,858$0$17,425$0$17,480$0$332,726$0$0$0
MR JUSTIN LEAL
SR. DIR. OPERATIONS$254,677$0$51,141$0$1,402$0$12,915$0$9,689$0$329,824$0$0$0
MS PATRICIA HOPKINS
DIRECTOR - PHARMACY$193,951$0$26,861$0$2,095$0$9,165$0$24,455$0$256,527$0$0$0
MR WILLIAM MATTHEWS
STAFF NURSE$93,141$0$0$0$93,486$0$4,283$0$227$0$191,137$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 1a Discretionary spending accountELIZABETH LEDDY, THOMAS ARNOLD, DENISE RAY, AND DR. LEIGH HAMBY 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 compensationCOMPENSATION OF THE CEO/EXECUTIVE DIRECTOR THE COMPENSATION FOR THE PRESIDENT/CEO OF PIEDMONT MOUNTAINSIDE 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 planTHE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THEIR SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: LEIGH HAMBY $108,680 THOMAS ARNOLD $107,975 ELIZABETH LEDDY $93,683 DENISE RAY $71,294
Schedule J, Part I, Line 7 Non-fixed paymentsNON-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.

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution5ContributionCnt
Noncash Contributions Rpt F990$97,871NoncashContributionsRptF990Amt
Method Of Determining RevenuesMarket valueMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (true)ReviewProcessUnusualNCGiftsInd
Third Parties UsedYes (true)ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule M, Part I, Line 32b Third parties used to solicit, process, or sell noncash contributionsFormAndLineReferenceDesc
ExplanationPIEDMONT HEALTHCARE ENGAGES SUNTRUST BANK TO ASSIST WITH THE MANAGEMENT AND SALE OF ITS NON-CASH STOCK GIFTS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part V, Line 1aALL CALENDAR YEAR 2023 FORMS 1099 WERE FILED ON BEHALF OF PIEDMONT MOUNTAINSIDE 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 stockholdersPIEDMONT HEALTHCARE, INC., (EIN 58 1503902) IS THE SOLE MEMBER OF PIEDMONT MOUNTAINSIDE HOSPITAL ("PMH").
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyTHE BOARD OF PIEDMONT HEALTHCARE, PIEDMONT MOUNTAINSIDE HOSPITAL'S SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF PIEDMONT MOUNTAINSIDE HOSPITAL.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersPIEDMONT MOUNTAINSIDE 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 MOUNTAINSIDE 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 bodyINFORMATION NEEDED TO PREPARE PIEDMONT MOUNTAINSIDE HOSPITAL'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PMH'S CONTROLLER AND VP/CFO. THE 990 IS THENPREPARED INTERNALLY BY PIEDMONT HEALTHCARE, INC.'S TAX DIRECTOR AND SUBMITTED TO AN EXTERNAL TAX PREPARER FOR REVIEW. PRIOR TO FILING, COPIES OF FORM 990 ARE PROVIDED TO THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC., THE ORGANIZATION'S SOLE MEMBER, FOR BOARD REVIEW.
Form 990, Part VI, Line 12c Conflict of interest policyCOMPLIANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY ORGANIZATION MANAGEMENT IN COORDINATION WITH PIEDMONT HEALTHCARE'S CHIEF COMPLIANCE OFFICER. ALL SENIOR LEADERS, BOARD MEMBERS, PHYSICIAN EMPLOYEES, NURSE PRACTITIONERS/PHYSICIAN ASSISTANTS AND EMPLOYEES AND NON-EMPLOYEES ENGAGED IN RESEARCH ARE REQUIRED TO ANNUALLY DISCLOSE ALL MATTERS WHICH COULD POTENTIALLY CONSTITUTE A CONFLICT OF INTEREST. MATTERS DISCLOSED UNDER THE POLICY MUST BE REVIEWED IN WRITING BY THE PIEDMONT HEALTHCARE CONFLICT OF INTEREST COMMITTEE IN ORDER TO DETERMINE WHETHER A CONFLICT EXISTS AND, IF SO, WHETHER TO ELIMINATE OR MANAGE THE CONFLICT. ALL BOARD MEMBERS AND EMPLOYEES OF PIEDMONT MOUNTAINSIDE 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 officialCOMPENSATION FOR EXECUTIVES OF PIEDMONT MOUNTAINSIDE 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 employeesPLEASE SEE DISCLOSURE FOR FORM 990, PART VI, LINE 15A, ABOVE.
Form 990, Part VI, Line 19 Required documents available to the publicGOVERNING 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 Other changes in net assets or fund balancesCONTRIBUTIONS - -2165593; UNALLOCATED EXPENSES - -5538091; BOOK/TAX DIFFERENCES - -52743; CHANGE IN TEMP - 2047760; INTERCOMPANY TRANSFER - -24824465;

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1SLEEP SERVICES OF JASPER LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11266 HIGHWAY 515 SOUTHAddressLine1Txt
CityJASPERCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30143ZIPCd
FieldValueIRS element (for citing)
Primary ActivitiesMEDICALPrimaryActivitiesTxt
Legal Domicile StateGALegalDomicileStateCd
Total Income$0TotalIncomeAmt
End Of Year Assets$0EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1PMHBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (35 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndAddress Line2USAddress/AddressLine2Txt
COLUMBUS REGIONAL SENIOR LIVING INC
707 CENTER STREETCOLUMBUSGA31901582628502HEALTHCAREGA501(c)(3)Type III-FIphcfalse
PIEDMONT HOSPITAL INC
1968 PEACHTREE ROAD NWATLANTAGA30309580566213HOSPITALGA501(c)(3)3PHCfalse
FAYETTE COMMUNITY HOSPITAL INC
1255 HIGHWAY 54 WESTFAYETTEVILLEGA30214582232328HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT NEWNAN HOSPITAL INC
745 POPLAR ROADNEWNANGA30265205077249HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT HEALTHCARE FOUNDATION INC
2001 PEACHTREE ROAD NE SUITE 400ATLANTAGA30309581272768FUNDRAISINGGA501(c)(3)Type IPHCfalse
PIEDMONT HENRY HOSPITAL INC
1133 EAGLES LANDING PKWYSTOCKBRIDGEGA30281582200195HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT NEWTON HOSPITAL INC
5126 HOSPITAL DRIVE NECOVINGTONGA30014582155150HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT ATHENS REGIONAL FOUNDATION INC
1199 PRINCE AVENUEATHENSGA30606581978389FUNDRAISINGGA501(c)(3)Type IIPARMCfalse
PIEDMONT ATHENS REGIONAL HEALTH RESOURCE
1199 PRINCE AVENUEATHENSGA30606581930580DEVELOPMENTGA501(c)(3)Type IIPARMCfalse
PIEDMONT ATHENS REGIONAL MEDICAL CENTER
1199 PRINCE AVENUEATHENSGA30606582179986HOSPITALGA501(c)(3)3PHCfalse
HUGHSTON HOSPITAL INC
707 CENTER STREETCOLUMBUSGA31901331216751HOSPITALGA501(c)(3)3CRHSfalse
ATHENS REGIONAL PHYSICIAN SERVICES INC
1199 PRINCE AVENUEATHENSGA30606582332921HEALTHCAREGA501(c)(3)Type IIPARMCfalse
REGIONAL FIRSTCARE INC
1199 PRINCE AVENUEATHENSGA30606582362733URGENT CAREGA501(c)(3)Type IIPARMCfalse
THE MEDICAL CENTER INC
707 CENTER STREETCOLUMBUSGA31901581685139HOSPITALGA501(c)(3)3CRHSfalse
COLUMBUS AMBULATORY HEALTHCARE SERVICES
707 CENTER STREETCOLUMBUSGA31901581719867AMBULATORYGA501(c)(3)3CRHSfalse
COLUMBUS REGIONAL MEDICAL FOUNDATION INC
707 CENTER STREETCOLUMBUSGA31901581501642FUNDRAISINGGA501(c)(3)7CRHSfalse
COLUMBUS REGIONAL HEALTHCARE SYSTEM INC
707 CENTER STREETCOLUMBUSGA31901581719994MANAGEMENTGA501(c)(3)Type IIPHCfalse
PIEDMONT ROCKDALE HOSPITAL INC
1412 MILSTEAD AVECONYERSGA30012300999841HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT WALTON HOSPITAL INC
2151 WEST SPRING STMONROEGA30655824194264HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT HEALTHCARE INC
1800 HOWELL MILL RD STE 850ATLANTAGA30318581503902MANAGEMENTGA501(c)(3)Type III-FINAfalse
PIEDMONT CARTERSVILLE HOSPITAL INC
960 JOE FRANK HARRIS PKWY SECARTERSVILLEGA30120870963633HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT EASTSIDE HOSPITAL INC
1700 MEDICAL WAYSNELLVILLEGA30078870982886HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT MACON HOSPITAL INC
350 HOSPITAL DRMACONGA31217871006981HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT MACON NORTH HOSPITAL INC
400 CHARTER BLVDMACONGA31210871031034HOSPITALGA501(c)(3)3PHCfalse
UNIVERSITY HEALTH SERVICES INC
1350 WALTON WAYAUGUSTAGA30901581581103HOSPITALGA501(c)(3)3PHCfalse
UNIVERSITY MCDUFFIE COUNTY REG MED CTR
1350 WALTON WAYAUGUSTAGA30901454166209HOSPITALGA501(c)(3)3PHCfalse
UNIVERSITY HEALTH CARE FOUNDATION INC
2260 WRIGHTSBORO ROADAUGUSTAGA30904581343550FUNDRAISINGGA501(c)(3)7UHSfalse
UNIVERSITY EXTENDED CARE INC
1350 WALTON WAYAUGUSTAGA30901581581105HEALTHCAREGA501(c)(3)3UHSfalse
AUGUSTA RESOURCE CENTER ON AGING INC
1350 WALTON WAYAUGUSTAGA30901581728812HEALTHCAREGA501(c)(3)10PHCfalse
ATHENS REGIONAL SPECIALTY SERVICES INC
1199 PRINCE AVENUEATHENSGA30606271975001HEALTHCAREGA501(c)(3)3PARMCfalse
COLISEUM MEDICAL CENTER INC
350 HOSPITAL DRMACONGA31217621736983HOSPITALGA501(c)(3)3PHCfalse
MACON NORTHSIDE HOSPITAL INC
400 CHARTER BLVDMACONGA31210621736985HOSPITALGA501(c)(3)3PHCfalse
FIRST CALL PROFESSIONAL SOLUTIONS INC
2727 PACES FERRY RDATLANTAGA30339993505425STAFFINGGA501(c)(3)Type IPHCfalseSTE 2-700
FIRST CALL STAFFING SOLUTIONS INC
2727 PACES FERRY RDATLANTAGA30339933887830STAFFINGGA501(c)(3)Type IPHCfalseSTE 2-700
PIEDMONT HEART INSTITUTE INC
95 COLLIER ROAD NWATLANTAGA30309263553500HEALTHCAREGA501(c)(3)10PHCfalseSTE 2045

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndAddress Line2USAddress/AddressLine2Txt
GA SURG CTR PCHTREE
2061 PEACHTREE RD STE 100 ATLATLANTAGA30309582394271SURGERYGANAN/Afalsefalse
ORTHOATLANTA SURGERY CENTER FAYETTEVILLE
900 CIRCLE 75 PKWY SE STE 1700ATLANTAGA30339202961633SURGERYGANAN/Afalsefalse
ATHENS ASC HOLDINGS LLC
2142 W BROAD STATHENSGA30606454014891SURGERYGANAN/AfalsefalseBLDG 100 STE 100
COLUMBUS DIAGNOSTIC IMAGING CTR
116 INTRACOASTAL POINTE DR 300JUPITERFL33477262291768IMAGINGGANAN/Afalsefalse
THE SURGERY CENTER LLC
100 FIRST COURTCOLUMBUSGA31909582520623SURGERYGANAN/Afalsefalse
PIEDMONT ENCOMPASS REHABILITATION HOSPITALS
9001 LIBERTY PKWYBIRMINGHAMAL35242853544795HEALTHCAREDENAN/Afalsefalse
COLISEUM SAME DAY SURGERY CTR
340 HOSPITAL DRMACONGA31217621805346SURGERYGANAN/Afalsefalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
PIEDMONT MEDICAL CARE CORPORATION
2727 PACES FERRY ROAD SUITE 1-1100ATLANTAGA30339582092768HEALTHCAREGANAC Corporationfalse
THE PIEDMONT CLINIC INC
2727 PACES FERRY ROAD SUITE 1-1100ATLANTAGA30339582005358HEALTHCAREGANAC Corporationfalse
PIEDMONT HEART INSTITUTE PHYSICIANS INC
95 COLLIER ROAD NW STE 2045ATLANTAGA30339260593850HEALTHCAREGANAC Corporationfalse
AMSTER MCRAE INSURANCE COMPANY SPC
981734069RELATED INSURANCENAC CorporationfalseCJ
COLUMBUS HEALTHCARE RESOURCES
PO BOX 790COLUMBUSGA31902581717754HEALTHCAREGANAC Corporationfalse
COLUMBUS HEALTH SERVICES INC
PO BOX 790COLUMBUSGA31902581640939HEALTHCAREGANAC Corporationfalse
UNIVERSITY HEALTH RESOURCES INC
1350 WALTON WAYAUGUSTAGA30901581601372HEALTHCAREGANAC Corporationfalse
UNIVERSITY HOSPITAL AIKEN INC
1350 WALTON WAYAUGUSTAGA30901472713774HOSPITALSCNAC Corporationfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule R, Part I, Column (a) DISREGARDED ENTITIESFormAndLineReferenceDesc
ExplanationTHE LIMITED LIABILITY COMPANY LISTED IN SCHEDULE R, PART I, OPERATES AS A DEPARTMENT OF PIEDMONT MOUNTAINSIDE HOSPITAL AND IS INCORPORATED INTO THE HOSPITAL'S BOOKS AND RECORDS. SEPARATE BOOKS AND RECORDS ARE NOT MAINTAINED FOR THE LLC AND ASSETS AND INCOME CANNOT BE READILY DETERMINED. AS SUCH, COLUMNS (D) AND (E) IN PART I HAVE BEEN LEFT BLANK.ExplanationTxt