2025-05-15T15:44:30+00:00 2024-06-30 135565207 KPMG LLP 303 Peachtree St NE Suite 2000 Atlanta GA 30308 990 2023-07-01 352228583 Piedmont Mountainside Hospital Inc PIED 7066922441 1266 highway 515 south JASPER GA 30143 MS DENISE RAY CEO 2025-05-15 true Whitney B Hebron P01226647 4042223000 2025-05-15 2023 2025-03-06 01:10:19Z MS DENISE RAY 1266 highway 515 south JASPER GA 30143 156045493 false X PIEDMONT.ORG X 2004 GA TO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT. 8 5 675 155 0 0 2941931 2222718 143733194 153312161 -191619 -99260 426642 509926 146910148 155945545 52185 109004 0 51253255 54971389 0 0 73646623 68279259 124952063 123359652 21958085 32585893 78701998 85004418 27633622 31931690 51068376 53072728 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. false false 111176377 109004 153328653 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. 111176377 true true false false false false false false false true false false false true true false true false false false false false false false false true true true false true false false false false false false false false true false false false true true false false false true X 0 0 675 true false false false false false false false false false false false false X 8 5 false false false false true true true true true false false false true true true true true true true false GA X MARIE GAFFNEY 4702716007 2727 PACES FERRY ROAD BLDG 2 STE ATLANTA GA 30339 MS DENISE RAY CEO/BOARD MEMBER/CHAIR 55.0 0 X X 906562 0 37773 DR JOHN SCHNARS BOARD MEMBER 1.0 39.0 X 0 707772 34996 DR LEIGH HAMBY BOARD MEMBER 1.0 54.0 X 0 1346397 37793 DR ROSEMARIE SPILLANE BOARD MEMBER 1.0 0 X 0 0 0 MR GREGORY HURST BOARD MEMBER 1.0 0 X 0 0 0 MR JASON SMITH BOARD MEMBER 1.0 0 X 0 0 0 MR PAUL NEALEY BOARD MEMBER 1.0 0 X 0 0 0 MR RICHARD HUBBARD III BOARD MEMBER 1.0 0 X 0 0 0 MR THOMAS ARNOLD TREASURER/CFO PHC 1.0 54.0 X 0 1268098 39510 MS ELIZABETH LEDDY SECRETARY/CLO PHC 1.0 54.0 X 0 1164523 40350 MS LINDSEY GARD CFO 55.0 0 X 213883 0 37707 DR MOIZ MASTER PHYSICIAN 38.0 2.0 X 555248 0 42164 MR JUSTIN LEAL SR. 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OPERATIONS 40.0 0 X 307220 0 22604 MR WILLIAM MATTHEWS STAFF NURSE 40.0 0 X 186627 0 4510 MS MICHELLE BREITFELDER CNO 40.0 0 X 297821 0 34905 MS PATRICIA HOPKINS DIRECTOR - PHARMACY 40.0 0 X 222907 0 33620 2690268 4486790 365932 79 false true false AYA HEALTHCARE INC 5930 CORNERSTONE CT W STE 300 SAN DIEGO CA 92121 HEALTHCARE STAFFING 3386379 FORTIS HEALTH LLC 3950 AUSTELL RD AUSTELL GA 30106 SKILLED NURSING 2433053 SOUTHEASTERN PATHOLOGY PC 311 W 8TH ST NE ROME GA 30165 PATHOLOGY SERVICES 654182 EMERGENCY COVERAGE CORPORATION 1200 MEMORIAL DR DALTON GA 30720 EMERGENCY CARE 642709 INSIGHT HEALTH CORPORATION 1001 N HIGHLAND AVE MURFREESBORO TN 37130 RADIOLOGY SERVICES 432054 11 2222718 97871 2222718 PATIENT SERVICE REVENUE 621110 152753040 152753040 0 0 OTHER OPERATING REVENUE 900099 559121 559121 0 0 0 0 0 0 153312161 688 0 0 688 0 0 0 0 0 99948 0 -99948 -99948 0 0 -99948 CAFETERIA SALES 722310 354403 0 0 354403 GIFT SHOP 900099 139031 0 0 139031 FEE REVENUE 900099 16492 16492 0 0 0 0 0 0 509926 155945545 153328653 0 394174 109004 109004 1098963 965219 133744 0 43039939 37801978 5237961 0 8015184 7039736 975448 0 2817303 2474437 342866 0 19697 19697 0 0 -9671 -9381 -290 0 8726879 8726879 0 0 270001 270001 0 0 6856571 6764980 91591 0 1565349 1518398 46951 0 2827632 2389290 438342 0 33221 24494 8727 0 878402 851307 27095 0 2771874 0 2771874 0 4154756 4030114 124642 0 1180169 1144764 35405 0 DRUGS AND MEDICAL SUPPLIES 17895253 17895253 0 0 ALL OTHER EXPENSES 13773281 11824362 1948919 0 BAD DEBT EXPENSE 5834851 5834851 0 0 HOSPITAL TAX 1500994 1500994 0 0 0 0 0 0 123359652 111176377 12183275 0 50339 41026 24728036 18573919 0 0 0 0 2061402 2060044 494272 473434 110422728 63747216 34187466 46675512 0 0 17180483 17180483 0 0 78701998 85004418 9616605 12478499 0 0 18017017 19453191 27633622 31931690 X 44156067 53041916 6912309 30812 51068376 53072728 78701998 85004418 X 32585893 -48409 -30533132 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1897200 1897200 0 43384839 22795729 20589110 0 2536751 2456848 79903 0 44058388 33342321 10716067 0 18545550 5152318 13393232 46675512 Medicare Liabilities 12214551 Other Liabilities 7238640 19453191 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote PHC ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF ASC 740, INCOME TAXES (ASC 740). UNDER THE REQUIREMENTS OF ASC 740, TAX-EXEMPT ORGANIZATIONS MAY BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS UNCERTAIN TAX EXPOSURE ITEMS. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AT JUNE 30, 2024 AND 2023. true true X true X 300 true X true true false true true 3089748 0 3089748 0.0263 3111791 2920072 191719 0.0016 2306683 1917484 389199 0.0033 0 0 8508222 4837556 3670666 0.0312 75427 0 75427 0.0006 798319 0 798319 0.0068 0 0.0 54051 0 54051 0.0005 21240 0 21240 0.0002 0 0 949037 0 949037 0.0081 0 0 9457259 4837556 4619703 0.0393 0 0.0 18834 0 18834 0.0002 130950 0 130950 0.0011 0 0.0 1596 0 1596 0.0000 0 0.0 0 0.0 13616 0 13616 0.0001 0 0.0 0 0 164996 0 164996 0.0014 true 2135280 26916568 26744506 172062 X true true 1 1 PIEDMONT MOUNTAINSIDE HOSPITAL 1266 HIGHWAY 515 SOUTH JASPER GA 30145 HTTPS://WWW.PIEDMONT.ORG/ 056-550 X X X PIEDMONT MOUNTAINSIDE HOSPITAL 1 false false true X X X X X X X X 21 true false false true X https://www.piedmont.org/media/file/2022-11-PMH-Community-Health-Needs-Assessment.pdf X X true 22 true THE BOARD OF DIRECTORS FOR PIEDMONT MOUNTAINSIDE HOSPITAL APPROVED ITS IMPLEMENTATION STRATEGY FOR T false true X 300.0 300.0 X X true true X X X X true X https://www.piedmont.org/media/file/2024-05-PHC-Financial-Assistance-Policy-English.pdf X https://www.piedmont.org/media/file/2024-05-PHC-Financial-Assistance-Application-English.pdf X www.piedmont.org/media/file/2020-10-PHC-Financial-Assistance-Plain-Language-Summary-English.pdf X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 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 0 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; true PICKENS COUNTY CHAMBER OF COMMERCE 500 VETERANS MEMORIAL BLVD JASPER GA 30143 581376367 501(C)(6) 15000 PROGRAM SUPPORT CITY OF JASPER GA 200 BURNT MOUNTAIN RD JASPER GA 30143 GOVERNMENT 7500 PROGRAM SUPPORT 1 1 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. 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. X true true false true false false false false false true false MS DENISE RAY CEO/BOARD MEMBER/CHAIR 501831 0 269310 0 135421 0 19800 0 17973 0 944335 0 71294 0 DR LEIGH HAMBY BOARD MEMBER 0 715933 0 439771 0 190693 0 19800 0 17993 0 1384190 0 108680 DR JOHN SCHNARS BOARD MEMBER 0 533116 0 0 0 174656 0 18120 0 16876 0 742768 0 0 MR THOMAS ARNOLD TREASURER/CFO PHC 0 711656 0 360250 0 196192 0 19800 0 19710 0 1307608 0 107975 MS ELIZABETH LEDDY SECRETARY/CLO PHC 0 612535 0 395529 0 156459 0 19800 0 20550 0 1204873 0 93683 MS LINDSEY GARD CFO 171509 0 35680 0 6694 0 0 0 37707 0 251590 0 0 0 DR MOIZ MASTER PHYSICIAN 403697 0 131816 0 19735 0 17132 0 25032 0 597412 0 0 0 MS MICHELLE BREITFELDER CNO 211708 0 72255 0 13858 0 17425 0 17480 0 332726 0 0 0 MR JUSTIN LEAL SR. DIR. OPERATIONS 254677 0 51141 0 1402 0 12915 0 9689 0 329824 0 0 0 MS PATRICIA HOPKINS DIRECTOR - PHARMACY 193951 0 26861 0 2095 0 9165 0 24455 0 256527 0 0 0 MR WILLIAM MATTHEWS STAFF NURSE 93141 0 0 0 93486 0 4283 0 227 0 191137 0 0 0 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. X 5 97871 Market value false true true Schedule M, Part I, Line 32b Third parties used to solicit, process, or sell noncash contributions PIEDMONT HEALTHCARE ENGAGES SUNTRUST BANK TO ASSIST WITH THE MANAGEMENT AND SALE OF ITS NON-CASH STOCK GIFTS. 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; SLEEP SERVICES OF JASPER LLC 1266 HIGHWAY 515 SOUTH JASPER GA 30143 MEDICAL GA 0 0 PMH 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 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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 STE 2-700 ATLANTA GA 30339 993505425 STAFFING GA 501(c)(3) Type I PHC false FIRST CALL STAFFING SOLUTIONS INC 2727 PACES FERRY RD STE 2-700 ATLANTA GA 30339 933887830 STAFFING GA 501(c)(3) Type I PHC false PIEDMONT HEART INSTITUTE INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 263553500 HEALTHCARE GA 501(c)(3) 10 PHC false 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 BLDG 100 STE 100 ATHENS GA 30606 454014891 SURGERY GA NA N/A false false 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 PIEDMONT MEDICAL CARE CORPORATION 2727 PACES FERRY ROAD SUITE 1-1100 ATLANTA GA 30339 582092768 HEALTHCARE GA NA C Corporation false THE PIEDMONT CLINIC INC 2727 PACES FERRY ROAD SUITE 1-1100 ATLANTA GA 30339 582005358 HEALTHCARE GA NA C Corporation false PIEDMONT HEART INSTITUTE PHYSICIANS INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30339 260593850 HEALTHCARE GA NA C Corporation false AMSTER MCRAE INSURANCE COMPANY SPC 981734069 RELATED INSURANCE CJ NA C Corporation false COLUMBUS HEALTHCARE RESOURCES PO BOX 790 COLUMBUS GA 31902 581717754 HEALTHCARE GA NA C Corporation false COLUMBUS HEALTH SERVICES INC PO BOX 790 COLUMBUS GA 31902 581640939 HEALTHCARE GA NA C Corporation false UNIVERSITY HEALTH RESOURCES INC 1350 WALTON WAY AUGUSTA GA 30901 581601372 HEALTHCARE GA NA C Corporation false UNIVERSITY HOSPITAL AIKEN INC 1350 WALTON WAY AUGUSTA GA 30901 472713774 HOSPITAL SC NA C Corporation false false false false false false false false false false false false false false false false true true false false Schedule R, Part I, Column (a) DISREGARDED ENTITIES 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.