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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-05-15T15:44:30+00:00 | ReturnTs |
| Tax Period End | 2024-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135565207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 303 Peachtree St NE Suite 2000 | AddressLine1Txt |
| City | Atlanta | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30308 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352228583 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Piedmont Mountainside Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PIED | BusinessNameControlTxt |
| Phone | 7066922441 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1266 highway 515 south | AddressLine1Txt |
| City | JASPER | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30143 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MS DENISE RAY | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Signature | 2025-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Whitney B Hebron | PreparerPersonNm |
| PTIN | P01226647 | PTIN |
| Phone | 4042223000 | PhoneNum |
| Preparation | 2025-05-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MS DENISE RAY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1266 highway 515 south | AddressLine1Txt |
| City | JASPER | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30143 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $156,045,493 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | PIEDMONT.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 675 | TotalEmployeeCnt |
| Total Volunteers | 155 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,941,931 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,222,718 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $143,733,194 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $153,312,161 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$191,619 | PYInvestmentIncomeAmt |
| CY Investment Income | -$99,260 | CYInvestmentIncomeAmt |
| PY Other Revenue | $426,642 | PYOtherRevenueAmt |
| CY Other Revenue | $509,926 | CYOtherRevenueAmt |
| PY Total Revenue | $146,910,148 | PYTotalRevenueAmt |
| CY Total Revenue | $155,945,545 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $52,185 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $109,004 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $51,253,255 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $54,971,389 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $73,646,623 | PYOtherExpensesAmt |
| CY Other Expenses | $68,279,259 | CYOtherExpensesAmt |
| PY Total Expenses | $124,952,063 | PYTotalExpensesAmt |
| CY Total Expenses | $123,359,652 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $21,958,085 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $32,585,893 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $78,701,998 | TotalAssetsBOYAmt |
| Total Assets EOY | $85,004,418 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $27,633,622 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $31,931,690 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $51,068,376 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $53,072,728 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO 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 Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $111,176,377 | ExpenseAmt |
| Grant | $109,004 | GrantAmt |
| Revenue | $153,328,653 | RevenueAmt |
| Desc | PIEDMONT 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 | $111,176,377 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 675 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARIE GAFFNEY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4702716007 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2727 PACES FERRY ROAD BLDG 2 STE | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30339 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| MS DENISE RAY | |||||||||
| CEO/BOARD MEMBER/CHAIR | 55.0 | 0 | Yes (X) | Yes (X) | $906,562 | $0 | $37,773 | ||
| DR JOHN SCHNARS | |||||||||
| BOARD MEMBER | 1.0 | 39.0 | Yes (X) | $0 | $707,772 | $34,996 | |||
| DR LEIGH HAMBY | |||||||||
| BOARD MEMBER | 1.0 | 54.0 | Yes (X) | $0 | $1,346,397 | $37,793 | |||
| DR ROSEMARIE SPILLANE | |||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| MR GREGORY HURST | |||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| MR JASON SMITH | |||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| MR PAUL NEALEY | |||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| MR RICHARD HUBBARD III | |||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | |||
| MR THOMAS ARNOLD | |||||||||
| TREASURER/CFO PHC | 1.0 | 54.0 | Yes (X) | $0 | $1,268,098 | $39,510 | |||
| MS ELIZABETH LEDDY | |||||||||
| SECRETARY/CLO PHC | 1.0 | 54.0 | Yes (X) | $0 | $1,164,523 | $40,350 | |||
| MS LINDSEY GARD | |||||||||
| CFO | 55.0 | 0 | $213,883 | $0 | $37,707 | Yes (X) | |||
| DR MOIZ MASTER | |||||||||
| PHYSICIAN | 38.0 | 2.0 | $555,248 | $0 | $42,164 | Yes (X) | |||
| MR JUSTIN LEAL | |||||||||
| SR. DIR. OPERATIONS | 40.0 | 0 | $307,220 | $0 | $22,604 | Yes (X) | |||
| MR WILLIAM MATTHEWS | |||||||||
| STAFF NURSE | 40.0 | 0 | $186,627 | $0 | $4,510 | Yes (X) | |||
| MS MICHELLE BREITFELDER | |||||||||
| CNO | 40.0 | 0 | $297,821 | $0 | $34,905 | Yes (X) | |||
| MS PATRICIA HOPKINS | |||||||||
| DIRECTOR - PHARMACY | 40.0 | 0 | $222,907 | $0 | $33,620 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,690,268 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,486,790 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $365,932 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 79 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| AYA HEALTHCARE INC | |||||
| 5930 CORNERSTONE CT W STE 300 | SAN DIEGO | CA | 92121 | HEALTHCARE STAFFING | $3,386,379 |
| FORTIS HEALTH LLC | |||||
| 3950 AUSTELL RD | AUSTELL | GA | 30106 | SKILLED NURSING | $2,433,053 |
| SOUTHEASTERN PATHOLOGY PC | |||||
| 311 W 8TH ST NE | ROME | GA | 30165 | PATHOLOGY SERVICES | $654,182 |
| EMERGENCY COVERAGE CORPORATION | |||||
| 1200 MEMORIAL DR | DALTON | GA | 30720 | EMERGENCY CARE | $642,709 |
| INSIGHT HEALTH CORPORATION | |||||
| 1001 N HIGHLAND AVE | MURFREESBORO | TN | 37130 | RADIOLOGY SERVICES | $432,054 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $2,222,718 | AllOtherContributionsAmt |
| Noncash Contributions | $97,871 | NoncashContributionsAmt |
| Total Contributions | $2,222,718 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $152,753,040 | $152,753,040 | $0 | $0 |
| OTHER OPERATING REVENUE | 900099 | $559,121 | $559,121 | $0 | $0 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $153,312,161 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $688 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $688 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $99,948 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | -$99,948 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$99,948 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$99,948 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| CAFETERIA SALES | 722310 | $354,403 | $0 | $0 | $354,403 |
| GIFT SHOP | 900099 | $139,031 | $0 | $0 | $139,031 |
| FEE REVENUE | 900099 | $16,492 | $16,492 | $0 | $0 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $509,926 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $155,945,545 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $153,328,653 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $394,174 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $109,004 | TotalAmt |
| Program Services | $109,004 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,098,963 | TotalAmt |
| Program Services | $965,219 | ProgramServicesAmt |
| Management And General | $133,744 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,039,939 | TotalAmt |
| Program Services | $37,801,978 | ProgramServicesAmt |
| Management And General | $5,237,961 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,015,184 | TotalAmt |
| Program Services | $7,039,736 | ProgramServicesAmt |
| Management And General | $975,448 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,817,303 | TotalAmt |
| Program Services | $2,474,437 | ProgramServicesAmt |
| Management And General | $342,866 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,697 | TotalAmt |
| Program Services | $19,697 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$9,671 | TotalAmt |
| Program Services | -$9,381 | ProgramServicesAmt |
| Management And General | -$290 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,726,879 | TotalAmt |
| Program Services | $8,726,879 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $270,001 | TotalAmt |
| Program Services | $270,001 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,856,571 | TotalAmt |
| Program Services | $6,764,980 | ProgramServicesAmt |
| Management And General | $91,591 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,565,349 | TotalAmt |
| Program Services | $1,518,398 | ProgramServicesAmt |
| Management And General | $46,951 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,827,632 | TotalAmt |
| Program Services | $2,389,290 | ProgramServicesAmt |
| Management And General | $438,342 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,221 | TotalAmt |
| Program Services | $24,494 | ProgramServicesAmt |
| Management And General | $8,727 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $878,402 | TotalAmt |
| Program Services | $851,307 | ProgramServicesAmt |
| Management And General | $27,095 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,771,874 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $2,771,874 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,154,756 | TotalAmt |
| Program Services | $4,030,114 | ProgramServicesAmt |
| Management And General | $124,642 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,180,169 | TotalAmt |
| Program Services | $1,144,764 | ProgramServicesAmt |
| Management And General | $35,405 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,359,652 | TotalAmt |
| Program Services | $111,176,377 | ProgramServicesAmt |
| Management And General | $12,183,275 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,339 | BOYAmt |
| EOY | $41,026 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,728,036 | BOYAmt |
| EOY | $18,573,919 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,061,402 | BOYAmt |
| EOY | $2,060,044 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $494,272 | BOYAmt |
| EOY | $473,434 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $110,422,728 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $63,747,216 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,187,466 | BOYAmt |
| EOY | $46,675,512 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,180,483 | BOYAmt |
| EOY | $17,180,483 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,701,998 | BOYAmt |
| EOY | $85,004,418 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,616,605 | BOYAmt |
| EOY | $12,478,499 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,017,017 | BOYAmt |
| EOY | $19,453,191 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,633,622 | BOYAmt |
| EOY | $31,931,690 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,156,067 | BOYAmt |
| EOY | $53,041,916 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,912,309 | BOYAmt |
| EOY | $30,812 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,068,376 | BOYAmt |
| EOY | $53,072,728 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,701,998 | BOYAmt |
| EOY | $85,004,418 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $32,585,893 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$48,409 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$30,533,132 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $1,897,200 | OtherCostOrOtherBasisAmt |
| Book Value | $1,897,200 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $43,384,839 | OtherCostOrOtherBasisAmt |
| Depreciation | $22,795,729 | DepreciationAmt |
| Book Value | $20,589,110 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $2,536,751 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,456,848 | DepreciationAmt |
| Book Value | $79,903 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $44,058,388 | OtherCostOrOtherBasisAmt |
| Depreciation | $33,342,321 | DepreciationAmt |
| Book Value | $10,716,067 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $18,545,550 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,152,318 | DepreciationAmt |
| Book Value | $13,393,232 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $46,675,512 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Medicare Liabilities | $12,214,551 |
| Other Liabilities | $7,238,640 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $19,453,191 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | PHC ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF ASC 740, INCOME TAXES (ASC 740). UNDER THE REQUIREMENTS OF ASC 740, TAX-EXEMPT ORGANIZATIONS MAY BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS UNCERTAIN TAX EXPOSURE ITEMS. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AT JUNE 30, 2024 AND 2023. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,089,748 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,089,748 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0263 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,111,791 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,920,072 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $191,719 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0016 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,306,683 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,917,484 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $389,199 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0033 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $8,508,222 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,837,556 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,670,666 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0312 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $75,427 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $75,427 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0006 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $798,319 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $798,319 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0068 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $54,051 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $54,051 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0005 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,240 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $21,240 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0002 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $949,037 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $949,037 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0081 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $9,457,259 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,837,556 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,619,703 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0393 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,834 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,834 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0002 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $130,950 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $130,950 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0011 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,596 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,596 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,616 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,616 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $164,996 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $164,996 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0014 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,135,280 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $26,916,568 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $26,744,506 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $172,062 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PIEDMONT MOUNTAINSIDE HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1266 HIGHWAY 515 SOUTH | AddressLine1Txt |
| City | JASPER | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30145 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTPS://WWW.PIEDMONT.ORG/ | WebsiteAddressTxt |
| State License | 056-550 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PIEDMONT MOUNTAINSIDE HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://www.piedmont.org/media/file/2022-11-PMH-Community-Health-Needs-Assessment.pdf | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | THE BOARD OF DIRECTORS FOR PIEDMONT MOUNTAINSIDE HOSPITAL APPROVED ITS IMPLEMENTATION STRATEGY FOR T | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.0 | FPGFamilyIncmLmtDscntCarePct |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.piedmont.org/media/file/2024-05-PHC-Financial-Assistance-Policy-English.pdf | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.piedmont.org/media/file/2024-05-PHC-Financial-Assistance-Application-English.pdf | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.piedmont.org/media/file/2020-10-PHC-Financial-Assistance-Plain-Language-Summary-English.pdf | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 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 , 1 | Facility , 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 , 1 | Facility , 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 0 | FacilityNum |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 7f PERCENT OF TOTAL EXPENSE | THE DENOMINATOR USED FOR THE CALCULATION OF COLUMN (F), PERCENT OF TOTAL EXPENSE, WAS THE AMOUNT OF TOTAL FUNCTIONAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) OF $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 COST | A RATIO OF PATIENT CARE COST TO CHARGES, CONSISTENT WITH WORKSHEET 2, WAS USED TO REPORT THE AMOUNTS IN PART I, LINES 7A-7D. FOR AMOUNTS ON LINES 7E-7K, ACTUAL EXPENSES FOR EACH COMMUNITY BENEFIT ACTIVITY ARE TRACED AND REPORTED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. |
| Schedule H, Part III LINES 2-4 - BAD DEBT EXPENSE CALCULATION AND FOOTNOTE | The provision for bad debts is based upon leadership's assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage, and other collection indicators. Hospital and system leadership periodically assesses the adequacy of the allowance for doubtful accounts based on historical write-off experience by payor category. The review results are then used to modify the provision for bad debts to establish an appropriate allowance for uncollectible receivables. THE AMOUNT REPORTED ON PART III, LINE 3, WAS DETERMINED BY TAKING THE AVERAGE ACCEPTANCE RATE FOR ALL CHARITY CARE APPLICATIONS RECEIVED DURING THE YEAR MULTIPLIED BY THE NUMBER OF DENIALS THAT WERE ATTRIBUTABLE TO INSUFFICIENT INFORMATION. THAT TOTAL WAS THEN ADJUSTED DOWNWARD FOR THE ORGANIZATION'S USE OF PRESUMPTIVE ELIGIBILITY WHEN DETERMINING ITS COMMUNITY BENEFITS BAD DEBT EXPENSE FOOTNOTE FROM CONSOLIDATED, AUDITED FINANCIAL STATEMENTS: The provision for bad debts is based upon leadership's assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage, and other collection indicators. Hospital and system leadership periodically assesses the adequacy of the allowance for doubtful accounts based on historical write-off experience by payor category. The review results are then used to modify the provision for bad debts to establish an appropriate allowance for uncollectible receivables. 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 BENEFIT | The amount reported in Part III, Line 6, was calculated following Schedule H instructions by utilizing allowable Medicare costs as reported in the Medicare cost report, which Piedmont bases on a cost-to-charge ratio. However, the allowable costs in the Medicare cost report do not reflect the actual cost of providing care to patients since the Medicare cost report excludes many direct patient care costs that are essential to providing quality healthcare for Medicare patients. For example, specific coverage fees to physicians, Medicare C and D costs, and other similar direct patient care expenses are expressly excluded from allowable costs in the Medicare Cost Report. IRS Revenue Ruling 69-545 provides, in part, that hospitals serving patients with governmental health insurance, such as Medicare, are an indication the hospital operates to promote health in the community. Piedmont's policy is to treat Medicare patients regardless of how much Medicare pays for the treatment. For many services, Medicare's reimbursement is less than the cost of the care provided, resulting in shortfalls the hospital will absorb in honor of its commitment to treating elderly patients. Many of these patients live on a low, fixed income and would qualify for financial assistance or other means-tested programs, absent from their enrollment in Medicare. |
| Schedule H, Part III, Line 9b COLLECTION PRACTICES | INITIAL SCREENINGS OF ALL INPATIENT, EMERGENCY, AND SURGERY ENCOUNTERS, AS WELL AS MOST OUTPATIENT VISITS, ARE CONDUCTED BY FINANCIAL COUNSELORS IN ORDER TO IDENTIFY ANY AVAILABLE INSURANCE OR OTHER COVERAGE FOR EACH PATIENT. COUNSELORS CONTACT PATIENTS AND THEIR FAMILIES DIRECTLY, EITHER IN PERSON OR BY LETTER, TO ASSIST THE FAMILY IN IDENTIFYING ANY PROGRAMS FOR WHICH THE PATIENT/SERVICE MAY QUALIFY (INCLUDING MEDICAID, STATE CHILDREN'S HEALTH INSURANCE PROGRAM ("SCHIP"), PRIVATE OR GOVERNMENT INSURANCE COVERAGE, AND CHARITY ASSISTANCE). IF THE FAMILY CANNOT BE TIMELY LOCATED OR IS UNCOOPERATIVE, RELATED ACCOUNTS ARE TRANSFERRED TO AN INTERNAL COLLECTION DEPARTMENT FOR FURTHER ATTEMPTS TO OBTAIN PAYMENT OR, IF THE PATIENT MAY QUALIFY FOR ASSISTANCE, TO SECURE A FINANCIAL ASSISTANCE APPLICATION. THE ORGANIZATION'S DEBT COLLECTION POLICY AND PROCEDURES PROHIBIT ANY COLLECTION EFFORTS FOR THE PORTION OF A PATIENT ACCOUNT BALANCE THAT QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. |
| Schedule H, Part VI, Line 2 NEEDS ASSESSMENT | As a designated 501(c)(3) nonprofit hospital, the Internal Revenue Service requires us to conduct a triennial community health needs assessment (CHNA) following regulations put forth by the IRS following the 2010 Patient Protection and Affordable Care Act (ACA). Through this assessment, Piedmont hopes to understand local health challenges better, identify health trends in the community, determine gaps in the current health delivery system, and craft a plan to address those gaps and the identified health needs. In FY22, Piedmont conducted its fourth triennial CHNA, and FY24 was the second year of activities outlined in its subsequent Implementation Strategy. The CHNA was led by the Piedmont Healthcare community benefits team and consulting organization Public Goods Group (PGG), with input and direction from Piedmont leadership and Piedmont Healthcare's Department of External Affairs. Process: The CHNA defined its community as its home county due to the impact of its tax-exempt status. Property taxes comprise a hospital's largest tax exemption segment, impacting county revenues. Because of this, Piedmont aims to ensure it provides ample benefit to its county and community. Additionally, Piedmont considers patient origin, especially that of lower-income patients who qualify for financial assistance or receive insurance coverage through Medicaid. Piedmont's secondary communities are considered the areas with the highest concentration of patients fitting that criterion, including those from nearby communities. Once Piedmont established its primary and secondary communities, it analyzed available public health data, including resources from the US Census, US Health and Human Services Community Health Status Indicators, US Department of Agriculture, Economic Research Service, National Center for Education Statistics, Kaiser Family Foundation's State Health Facts, American Heart Association, County Health Rankings and Georgia Online Analytical Statistical Information System (OASIS). All figures within the CHNA were for 2020 unless otherwise noted. Health indicators are estimates provided by County Health Rankings and the team internally sourced hospital data. PGG then interviewed key stakeholders with particular expertise or knowledge of the community. Specifically, PGG interviewed representatives of local and regional public health entities, minority populations, faith-based communities, local business owners, philanthropic communities, mental health agencies, elected officials, and individuals representing the community's most vulnerable patients. Piedmont conducted an internal survey system for both clinical and non-clinical employees. Piedmont gathered information on knowledge and understanding of community benefits, current programs, and suggestions for better serving patients and the overall community, regardless of where they receive care. Approximately 1,050 employees spanning the system responded. Additionally, Piedmont conducted a community-based survey that was widely advertised to the community. Once Piedmont gathered qualitative and quantitative data, Piedmont authored the preliminary report, which was vetted and reviewed by hospital and health system leadership. This report identified several key community health needs during the assessment process. The community benefits department recommended priorities with sign-off from hospital and board leadership. Piedmont used the following criteria to establish the priorities: - The number of people affected; - The seriousness of the issue; - Whether the health need particularly affected people living in poverty or reflected health disparities; and, - Availability of community and/or hospital resources to address the need. Piedmont views all priorities through the lens of health disparities, with particular attention paid to improving outcomes for those most vulnerable due to income and race. The chosen priorities reflected a collective agreement on what hospital leadership, staff, and the community felt was most important and within its ability to impact the issue positively. Once leadership approved the priorities, Piedmont authored the CHNA. Piedmont presented its findings and recommendations to the hospital's board of directors for their input and approval. FY22 priorities: A key CHNA component is identifying the top health priorities the hospital will address over fiscal years 2023, 2024, and 2025. These priorities will guide the hospital's community benefit work. They are, in no order: - Ensure affordable access to health 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 ELIGIBILITY | Piedmont understands that not everyone can pay their hospital bill due to their insurance status or limited income, and because of this, each hospital offers financial assistance to qualifying patients. Notification about financial assistance includes, but is not limited to, a dedicated contact number, notices within inpatient bills, and posted notices in key hospital areas. These locations are the emergency room, admitting and registration departments, business office, and patient financial services offices on site. Piedmont also publishes and widely publicizes a plain language summary of this financial assistance care policy and its full policy on its website. Any staff member can refer a patient to the financial assistance department, including physicians, nurses, financial counselors, social workers, case managers, chaplains, and religious sponsors. The patient may request financial assistance from a family member, close friend, or associate of the patient, subject to applicable privacy laws. Additionally, Piedmont provides copies of its financial assistance policy to partner clinics and others who work closely with low-income populations. Piedmont helps its partners understand the policy and how it relates to their populations, and it receives feedback on improving its financial assistance programming. |
| Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH | Piedmont 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 SYSTEM | Piedmont 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 REPORT | Piedmont is not required to file a community benefit report; however, Piedmont must file information on its indigent and charity care, as well as its Medicaid and Medicare shortfalls, with the Georgia Department of Community Health. |
| Schedule H, Part I, Line 6a PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT | Piedmont regularly reports its community benefit activities to the community in several ways. Each year, Piedmont prepares a systemwide community benefit report that is available to the public through publication on its website. Piedmont also makes its IRS Form 990 Schedule H available on its website and provides copies to anyone upon request. Piedmont also provides information on community benefit programming to local, state, and federal lawmakers through its government affairs office and online at piedmont.org. |
| Schedule H, Part VI, Line 4 COMMUNITY INFORMATION | While 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| PICKENS COUNTY CHAMBER OF COMMERCE | |||||||
| 500 VETERANS MEMORIAL BLVD | JASPER | GA | 30143 | 581376367 | 501(C)(6) | $15,000 | PROGRAM SUPPORT |
| CITY OF JASPER GA | |||||||
| 200 BURNT MOUNTAIN RD | JASPER | GA | 30143 | GOVERNMENT | $7,500 | PROGRAM SUPPORT | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. | FormAndLineReferenceDesc |
| Explanation | MONEY 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Discretionary Spending Acct | Yes (X) | DiscretionarySpendingAcctInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp 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 ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 1a Discretionary spending account | ELIZABETH 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 compensation | COMPENSATION 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 plan | THE 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 payments | NON-FIXED PAYMENTS CERTAIN EMPLOYEES PARTICIPATED IN AN "ANNUAL INCENTIVE PLAN" UNDER WHICH THEY RECEIVED NON-FIXED PAYMENTS BASED ON JOB LEVEL AND SEVERAL DIFFERENT PERFORMANCE METRICS. |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 5 | ContributionCnt |
| Noncash Contributions Rpt F990 | $97,871 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Market value | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | Yes (true) | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule M, Part I, Line 32b Third parties used to solicit, process, or sell noncash contributions | FormAndLineReferenceDesc |
| Explanation | PIEDMONT 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 ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part V, Line 1a | ALL 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 stockholders | PIEDMONT 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 body | THE 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 stockholders | PIEDMONT 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 body | INFORMATION 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 policy | COMPLIANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY ORGANIZATION MANAGEMENT IN COORDINATION WITH PIEDMONT HEALTHCARE'S CHIEF COMPLIANCE OFFICER. ALL SENIOR LEADERS, BOARD MEMBERS, PHYSICIAN EMPLOYEES, NURSE PRACTITIONERS/PHYSICIAN ASSISTANTS AND EMPLOYEES AND NON-EMPLOYEES ENGAGED IN RESEARCH ARE REQUIRED TO ANNUALLY DISCLOSE ALL MATTERS WHICH COULD POTENTIALLY CONSTITUTE A CONFLICT OF INTEREST. MATTERS DISCLOSED UNDER THE POLICY MUST BE REVIEWED IN WRITING BY THE PIEDMONT HEALTHCARE CONFLICT OF INTEREST COMMITTEE IN ORDER TO DETERMINE WHETHER A CONFLICT EXISTS AND, IF SO, WHETHER TO ELIMINATE OR MANAGE THE CONFLICT. ALL BOARD MEMBERS AND EMPLOYEES OF PIEDMONT 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 official | COMPENSATION 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 employees | PLEASE SEE DISCLOSURE FOR FORM 990, PART VI, LINE 15A, ABOVE. |
| Form 990, Part VI, Line 19 Required documents available to the public | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THESE DOCUMENTS SHOULD BE REQUESTED FROM PIEDMONT HEALTHCARE, INC.'S LEGAL COUNSEL. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | CONTRIBUTIONS - -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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SLEEP SERVICES OF JASPER LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1266 HIGHWAY 515 SOUTH | AddressLine1Txt |
| City | JASPER | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30143 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | MEDICAL | PrimaryActivitiesTxt |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Total Income | $0 | TotalIncomeAmt |
| End Of Year Assets | $0 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PMH | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (35 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| COLUMBUS REGIONAL SENIOR LIVING INC | |||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 582628502 | HEALTHCARE | GA | 501(c)(3) | Type III-FI | phc | false | |
| PIEDMONT HOSPITAL INC | |||||||||||
| 1968 PEACHTREE ROAD NW | ATLANTA | GA | 30309 | 580566213 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false | |
| FAYETTE COMMUNITY HOSPITAL INC | |||||||||||
| 1255 HIGHWAY 54 WEST | FAYETTEVILLE | GA | 30214 | 582232328 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false | |
| PIEDMONT NEWNAN HOSPITAL INC | |||||||||||
| 745 POPLAR ROAD | NEWNAN | GA | 30265 | 205077249 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false | |
| PIEDMONT HEALTHCARE FOUNDATION INC | |||||||||||
| 2001 PEACHTREE ROAD NE SUITE 400 | ATLANTA | GA | 30309 | 581272768 | FUNDRAISING | GA | 501(c)(3) | Type I | PHC | false | |
| PIEDMONT HENRY HOSPITAL INC | |||||||||||
| 1133 EAGLES LANDING PKWY | STOCKBRIDGE | GA | 30281 | 582200195 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false | |
| PIEDMONT NEWTON HOSPITAL INC | |||||||||||
| 5126 HOSPITAL DRIVE NE | COVINGTON | GA | 30014 | 582155150 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false | |
| PIEDMONT ATHENS REGIONAL FOUNDATION INC | |||||||||||
| 1199 PRINCE AVENUE | ATHENS | GA | 30606 | 581978389 | FUNDRAISING | GA | 501(c)(3) | Type II | PARMC | false | |
| PIEDMONT ATHENS REGIONAL HEALTH RESOURCE | |||||||||||
| 1199 PRINCE AVENUE | ATHENS | GA | 30606 | 581930580 | DEVELOPMENT | GA | 501(c)(3) | Type II | PARMC | false | |
| PIEDMONT ATHENS REGIONAL MEDICAL CENTER | |||||||||||
| 1199 PRINCE AVENUE | ATHENS | GA | 30606 | 582179986 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false | |
| HUGHSTON HOSPITAL INC | |||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 331216751 | HOSPITAL | GA | 501(c)(3) | 3 | CRHS | false | |
| ATHENS REGIONAL PHYSICIAN SERVICES INC | |||||||||||
| 1199 PRINCE AVENUE | ATHENS | GA | 30606 | 582332921 | HEALTHCARE | GA | 501(c)(3) | Type II | PARMC | false | |
| REGIONAL FIRSTCARE INC | |||||||||||
| 1199 PRINCE AVENUE | ATHENS | GA | 30606 | 582362733 | URGENT CARE | GA | 501(c)(3) | Type II | PARMC | false | |
| THE MEDICAL CENTER INC | |||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 581685139 | HOSPITAL | GA | 501(c)(3) | 3 | CRHS | false | |
| COLUMBUS AMBULATORY HEALTHCARE SERVICES | |||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 581719867 | AMBULATORY | GA | 501(c)(3) | 3 | CRHS | false | |
| COLUMBUS REGIONAL MEDICAL FOUNDATION INC | |||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 581501642 | FUNDRAISING | GA | 501(c)(3) | 7 | CRHS | false | |
| COLUMBUS REGIONAL HEALTHCARE SYSTEM INC | |||||||||||
| 707 CENTER STREET | COLUMBUS | GA | 31901 | 581719994 | MANAGEMENT | GA | 501(c)(3) | Type II | PHC | false | |
| PIEDMONT ROCKDALE HOSPITAL INC | |||||||||||
| 1412 MILSTEAD AVE | CONYERS | GA | 30012 | 300999841 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false | |
| PIEDMONT WALTON HOSPITAL INC | |||||||||||
| 2151 WEST SPRING ST | MONROE | GA | 30655 | 824194264 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false | |
| PIEDMONT HEALTHCARE INC | |||||||||||
| 1800 HOWELL MILL RD STE 850 | ATLANTA | GA | 30318 | 581503902 | MANAGEMENT | GA | 501(c)(3) | Type III-FI | NA | false | |
| PIEDMONT CARTERSVILLE HOSPITAL INC | |||||||||||
| 960 JOE FRANK HARRIS PKWY SE | CARTERSVILLE | GA | 30120 | 870963633 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false | |
| PIEDMONT EASTSIDE HOSPITAL INC | |||||||||||
| 1700 MEDICAL WAY | SNELLVILLE | GA | 30078 | 870982886 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false | |
| PIEDMONT MACON HOSPITAL INC | |||||||||||
| 350 HOSPITAL DR | MACON | GA | 31217 | 871006981 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false | |
| PIEDMONT MACON NORTH HOSPITAL INC | |||||||||||
| 400 CHARTER BLVD | MACON | GA | 31210 | 871031034 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false | |
| UNIVERSITY HEALTH SERVICES INC | |||||||||||
| 1350 WALTON WAY | AUGUSTA | GA | 30901 | 581581103 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false | |
| UNIVERSITY MCDUFFIE COUNTY REG MED CTR | |||||||||||
| 1350 WALTON WAY | AUGUSTA | GA | 30901 | 454166209 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false | |
| UNIVERSITY HEALTH CARE FOUNDATION INC | |||||||||||
| 2260 WRIGHTSBORO ROAD | AUGUSTA | GA | 30904 | 581343550 | FUNDRAISING | GA | 501(c)(3) | 7 | UHS | false | |
| UNIVERSITY EXTENDED CARE INC | |||||||||||
| 1350 WALTON WAY | AUGUSTA | GA | 30901 | 581581105 | HEALTHCARE | GA | 501(c)(3) | 3 | UHS | false | |
| AUGUSTA RESOURCE CENTER ON AGING INC | |||||||||||
| 1350 WALTON WAY | AUGUSTA | GA | 30901 | 581728812 | HEALTHCARE | GA | 501(c)(3) | 10 | PHC | false | |
| ATHENS REGIONAL SPECIALTY SERVICES INC | |||||||||||
| 1199 PRINCE AVENUE | ATHENS | GA | 30606 | 271975001 | HEALTHCARE | GA | 501(c)(3) | 3 | PARMC | false | |
| COLISEUM MEDICAL CENTER INC | |||||||||||
| 350 HOSPITAL DR | MACON | GA | 31217 | 621736983 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false | |
| MACON NORTHSIDE HOSPITAL INC | |||||||||||
| 400 CHARTER BLVD | MACON | GA | 31210 | 621736985 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false | |
| FIRST CALL PROFESSIONAL SOLUTIONS INC | |||||||||||
| 2727 PACES FERRY RD | ATLANTA | GA | 30339 | 993505425 | STAFFING | GA | 501(c)(3) | Type I | PHC | false | STE 2-700 |
| FIRST CALL STAFFING SOLUTIONS INC | |||||||||||
| 2727 PACES FERRY RD | ATLANTA | GA | 30339 | 933887830 | STAFFING | GA | 501(c)(3) | Type I | PHC | false | STE 2-700 |
| PIEDMONT HEART INSTITUTE INC | |||||||||||
| 95 COLLIER ROAD NW | ATLANTA | GA | 30309 | 263553500 | HEALTHCARE | GA | 501(c)(3) | 10 | PHC | false | STE 2045 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| GA SURG CTR PCHTREE | |||||||||||
| 2061 PEACHTREE RD STE 100 ATL | ATLANTA | GA | 30309 | 582394271 | SURGERY | GA | NA | N/A | false | false | |
| ORTHOATLANTA SURGERY CENTER FAYETTEVILLE | |||||||||||
| 900 CIRCLE 75 PKWY SE STE 1700 | ATLANTA | GA | 30339 | 202961633 | SURGERY | GA | NA | N/A | false | false | |
| ATHENS ASC HOLDINGS LLC | |||||||||||
| 2142 W BROAD ST | ATHENS | GA | 30606 | 454014891 | SURGERY | GA | NA | N/A | false | false | BLDG 100 STE 100 |
| COLUMBUS DIAGNOSTIC IMAGING CTR | |||||||||||
| 116 INTRACOASTAL POINTE DR 300 | JUPITER | FL | 33477 | 262291768 | IMAGING | GA | NA | N/A | false | false | |
| THE SURGERY CENTER LLC | |||||||||||
| 100 FIRST COURT | COLUMBUS | GA | 31909 | 582520623 | SURGERY | GA | NA | N/A | false | false | |
| PIEDMONT ENCOMPASS REHABILITATION HOSPITALS | |||||||||||
| 9001 LIBERTY PKWY | BIRMINGHAM | AL | 35242 | 853544795 | HEALTHCARE | DE | NA | N/A | false | false | |
| COLISEUM SAME DAY SURGERY CTR | |||||||||||
| 340 HOSPITAL DR | MACON | GA | 31217 | 621805346 | SURGERY | GA | NA | N/A | false | false | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|
| PIEDMONT MEDICAL CARE CORPORATION | ||||||||||
| 2727 PACES FERRY ROAD SUITE 1-1100 | ATLANTA | GA | 30339 | 582092768 | HEALTHCARE | GA | NA | C Corporation | false | |
| THE PIEDMONT CLINIC INC | ||||||||||
| 2727 PACES FERRY ROAD SUITE 1-1100 | ATLANTA | GA | 30339 | 582005358 | HEALTHCARE | GA | NA | C Corporation | false | |
| PIEDMONT HEART INSTITUTE PHYSICIANS INC | ||||||||||
| 95 COLLIER ROAD NW STE 2045 | ATLANTA | GA | 30339 | 260593850 | HEALTHCARE | GA | NA | C Corporation | false | |
| AMSTER MCRAE INSURANCE COMPANY SPC | ||||||||||
| 981734069 | RELATED INSURANCE | NA | C Corporation | false | CJ | |||||
| COLUMBUS HEALTHCARE RESOURCES | ||||||||||
| PO BOX 790 | COLUMBUS | GA | 31902 | 581717754 | HEALTHCARE | GA | NA | C Corporation | false | |
| COLUMBUS HEALTH SERVICES INC | ||||||||||
| PO BOX 790 | COLUMBUS | GA | 31902 | 581640939 | HEALTHCARE | GA | NA | C Corporation | false | |
| UNIVERSITY HEALTH RESOURCES INC | ||||||||||
| 1350 WALTON WAY | AUGUSTA | GA | 30901 | 581601372 | HEALTHCARE | GA | NA | C Corporation | false | |
| UNIVERSITY HOSPITAL AIKEN INC | ||||||||||
| 1350 WALTON WAY | AUGUSTA | GA | 30901 | 472713774 | HOSPITAL | SC | NA | C Corporation | false | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule R, Part I, Column (a) DISREGARDED ENTITIES | FormAndLineReferenceDesc |
| Explanation | THE 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 |