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PIEDMONT WALTON HOSPITAL INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
PIEDMONT WALTON HOSPITAL INC (EIN 82-4194264)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-05-11
IRS object ID
202201319349305280
Schema version
2020v4.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-05-11T15:15:51-05:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1303 PEACHTREE STAddressLine1Txt
CityATLANTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP30308ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN824194264EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Piedmont Walton Hospital IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% MARIE GAFFNEYInCareOfNm
Business Name ControlPIEDBusinessNameControlTxt
Phone7702678461PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12151 West Spring StreetAddressLine1Txt
CityMONROECityNm
State AbbreviationGAStateAbbreviationCd
ZIP30655ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARIE GAFFNEYPersonNm
Person TitleVP CORPORATE FINANCEPersonTitleTxt
Phone4702716007PhoneNum
Signature2022-05-10SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMARIEPersonFirstNm
Person LastGAFFNEYPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWHITNEY B HEBRONPreparerPersonNm
PTINP01226647PTIN
Phone4042223000PhoneNum
Preparation2022-05-10PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMR LARRY EBERTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12151 West Spring StreetAddressLine1Txt
CityMONROECityNm
State AbbreviationGAStateAbbreviationCd
ZIP30655ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$113,861,474GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.piedmont.org/locations/piedmont-walton/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2018FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee520TotalEmployeeCnt
Total Volunteers100TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,514,606PYContributionsGrantsAmt
CY Contributions Grants$2,802,683CYContributionsGrantsAmt
PY Program Service Revenue$69,894,045PYProgramServiceRevenueAmt
CY Program Service Revenue$110,665,364CYProgramServiceRevenueAmt
PY Investment Income$42,227PYInvestmentIncomeAmt
CY Investment Income$7,633CYInvestmentIncomeAmt
PY Other Revenue$375,305PYOtherRevenueAmt
CY Other Revenue$385,794CYOtherRevenueAmt
PY Total Revenue$71,826,183PYTotalRevenueAmt
CY Total Revenue$113,861,474CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$29,907,449PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$34,273,754CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$44,165,319PYOtherExpensesAmt
CY Other Expenses$48,258,820CYOtherExpensesAmt
PY Total Expenses$74,072,768PYTotalExpensesAmt
CY Total Expenses$82,532,574CYTotalExpensesAmt
PY Revenues Less Expenses-$2,246,585PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$31,328,900CYRevenuesLessExpensesAmt
Total Assets BOY$51,912,402TotalAssetsBOYAmt
Total Assets EOY$55,011,766TotalAssetsEOYAmt
Total Liabilities BOY$61,490,558TotalLiabilitiesBOYAmt
Total Liabilities EOY$60,157,225TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$9,578,156NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$5,145,459NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE IN A PROGRESSIVE ENVIRONMENT, GUIDED BY PHYSICIANS, DELIVERED BY EXCEPTIONAL PROFESSIONALS, AND INSPIRED BY THE COMMUNITIES WE SERVE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$70,642,363ExpenseAmt
Grant$0GrantAmt
Revenue$110,684,622RevenueAmt
DescPIEDMONT WALTON HOSPITAL ("PWH") IS A 77-BED, NON-PROFIT HOSPITAL LOCATED IN THE CITY OF CONYERS IN WALTON COUNTY, GEORGIA. OVER 250 PRIMARY CARE AND SPECIALTY PHYSICIANS COMPRISE THE MEDICAL STAFF AND MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SENIORS WITHIN WALTON COUNTY AND THE GREATER METROPOLITAN ATLANTA MARKET, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY FOR SERVICES. FOR THE YEAR ENDED JUNE 30, 2021, THE HOSPITAL HAD 3,226 IN-PATIENT ADMISSIONS WITH A TOTAL OF 12,949 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 30,021 AND OUTPATIENT VISITS TOTALED 17,960. SURGICAL SERVICES WERE PROVIDED TO 2,700 PATIENTS.Desc
Total Program Service Expenses$70,642,363TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee520EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARIE GAFFNEYPersonNm
Phone4702716007PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12727 PACES FERRY RD BLDG 2 STE 70AddressLine1Txt
CityAtlantaCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30339ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Mr Michael McAnder
Treasurer (End 7/20)1.054.0Yes (X)$0$1,284,929$72,127
Mr Michael Burnett
Board Member1.054.0$0$1,022,934$119,889Yes (X)
Ms Elizabeth Leddy
Secretary1.054.0Yes (X)$0$843,802$126,625
Mr Thomas Arnold
Treasurer (Eff 7/20)1.054.0Yes (X)$0$827,550$92,917
Ms Vicki A Cansler
Board Member1.054.0$0$735,257$85,138Yes (X)
Dr Robert Sinyard
CMO20.035.0$0$609,035$29,577Yes (X)
Mr Larry Ebert
CEO & Board Member55.00.0Yes (X)$371,688$0$34,258Yes (X)
Mr Marvin Wynn
CFO25.030.0$0$334,226$31,291Yes (X)
Mr Michael Wynne
DIRECTOR - PHARMACY40.00.0$171,513$0$22,923Yes (X)
Ms Rose Dennis
exec. Dir. - patient svcs40.00.0$169,172$0$23,954Yes (X)
Ms Candice Frix
CNO55.00.0$152,370$0$19,739Yes (X)
Mr Jeffrey Braswell
dir. - emergency svcs40.00.0$150,209$0$9,378Yes (X)
Ms Rose Crawford
Respiratory Therapist40.00.0$125,200$0$13,530Yes (X)
Ms Gwendolyn Lyon
RN40.00.0$129,969$0$7,889Yes (X)
Mr Dan Curry
Board Member1.00.0$0$0$0Yes (X)
Mr Patrick Dally
Board Member1.00.0$0$0$0Yes (X)
Dr Steven Durocher
Board Member1.00.0$0$0$0Yes (X)
Mr Coleman Landers
Chair1.00.0Yes (X)$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,270,121TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$5,657,733TotReportableCompRltdOrgAmt
Total Other Compensation$689,235TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K26IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
WALTON ANESTHESIA ASSOCIATES PC
2151 West Spring StMONROEGA30655ANESTHESIA$836,966
THERAPEUTIC GI ASSOCIATES LLC
2151 W SPRING STMONROEGA30655GASTROENTEROLOGY SVC$466,250
HHS ENVIRONMENTAL SERVICES
12495 Silver Creek RoadDRIPPING SPRINGSTX78620JANITORIAL SERVICES$573,680
DIVERSIFIED CLINICAL SERVICES INC
5220 Belfort RdJACKSONVILLEFL32256HEALTHCARE SERVICES$255,225
ALLIED UNIVERSAL SECURITY SERVICES
1438 West Peachtree Street Suite 10ATLANTAGA30309security SERVICES$431,108
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K12CntrctRcvdGreaterThan100KCnt
Government Grants$2,800,000GovernmentGrantsAmt
All Other Contributions$2,683AllOtherContributionsAmt
Total Contributions$2,802,683TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE622110$110,399,403$110,399,403
OTHER OPERATING REVENUE900099$265,961$265,961
FieldValueIRS element (for citing)
Total Program Service Revenue$110,665,364TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,633TotalRevenueColumnAmt
Exclusion$7,633ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$366,536RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$366,536RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$366,536TotalRevenueColumnAmt
Exclusion$366,536ExclusionAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescFEE REVENUEDesc
Business900099BusinessCd
Total Revenue Column$19,258TotalRevenueColumnAmt
Related Or Exempt Func Income$19,258RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$19,258OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$113,861,474TotalRevenueColumnAmt
Related Or Exempt Func Income$110,684,622RelatedOrExemptFuncIncomeAmt
Exclusion$374,169ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$409,257TotalAmt
Program Services$98,352ProgramServicesAmt
Management And General$310,905ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$27,663,376TotalAmt
Program Services$24,748,983ProgramServicesAmt
Management And General$2,914,393ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,258,364TotalAmt
Program Services$3,718,106ProgramServicesAmt
Management And General$540,258ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,942,757TotalAmt
Program Services$1,668,440ProgramServicesAmt
Management And General$274,317ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$32,054TotalAmt
Management And General$32,054ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,741,044TotalAmt
Program Services$6,296,526ProgramServicesAmt
Management And General$1,444,518ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$192,804TotalAmt
Program Services$15,369ProgramServicesAmt
Management And General$177,435ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,360,687TotalAmt
Program Services$3,305,331ProgramServicesAmt
Management And General$1,055,356ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,194,194TotalAmt
Program Services$905,199ProgramServicesAmt
Management And General$288,995ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,781,191TotalAmt
Program Services$1,653,013ProgramServicesAmt
Management And General$128,178ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$29TotalAmt
Program Services$18ProgramServicesAmt
Management And General$11ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$838,281TotalAmt
Management And General$838,281ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$2,112,476TotalAmt
Management And General$2,112,476ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,026,716TotalAmt
Program Services$1,884,159ProgramServicesAmt
Management And General$142,557ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$887,673TotalAmt
Program Services$664,253ProgramServicesAmt
Management And General$223,420ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
DRUGS & MEDICAL SUPPLIES$11,694,687$11,694,687
BAD DEBT EXPENSE$11,621,053$11,621,053
HOSPITAL TAX$397,027$397,027
ADMINISTRATIVE EXPENSES$3,378,904$1,971,847$1,407,057

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$82,532,574TotalAmt
Program Services$70,642,363ProgramServicesAmt
Management And General$11,890,211ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$45,517,979BOYAmt
EOY$48,376,665EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

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

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY-$35,864,869BOYAmt
EOY-$37,618,935EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,202,163BOYAmt
EOY$1,396,668EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$199,926BOYAmt
EOY$203,326EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$30,030,170LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$6,575,063LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$21,640,042BOYAmt
EOY$23,455,107EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$19,217,161BOYAmt
EOY$19,198,935EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$51,912,402BOYAmt
EOY$55,011,766EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,367,953BOYAmt
EOY$11,919,695EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$37,759,547BOYAmt
EOY$36,752,336EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

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

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,363,058BOYAmt
EOY$11,485,194EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$61,490,558BOYAmt
EOY$60,157,225EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$9,577,626BOYAmt
EOY-$5,142,900EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$530BOYAmt
EOY-$2,559EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$9,578,156BOYAmt
EOY-$5,145,459EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$51,912,402BOYAmt
EOY$55,011,766EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$31,328,900ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$26,896,203OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,189,458OtherCostOrOtherBasisAmt
Book Value$2,189,458BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,651,933OtherCostOrOtherBasisAmt
Depreciation$1,729,186DepreciationAmt
Book Value$12,922,747BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,249,654OtherCostOrOtherBasisAmt
Depreciation$931,030DepreciationAmt
Book Value$1,318,624BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,052,108OtherCostOrOtherBasisAmt
Depreciation$3,914,847DepreciationAmt
Book Value$6,137,261BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$887,017OtherCostOrOtherBasisAmt
Book Value$887,017BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$23,455,107TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
GOODWILL$18,938,257
UNAMORTIZED ISSUE COSTS$260,678
FieldValueIRS element (for citing)
Total Book Value Other Assets$19,198,935TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
MEDICARE PAYABLE$11,250,606
OTHER LIABILITIES$234,588
FieldValueIRS element (for citing)
Total Liability$11,485,194TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PART X, LINE 2: ASC 740 FOOTNOTE (FKA FIN 48)FormAndLineReferenceDesc
ExplanationPHC ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF THE INCOME TAXES TOPIC OF THE ASC (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, 2021 AND 2020.ExplanationTxt

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300.FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,873,131TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,873,131NetCommunityBenefitExpnsAmt
Total Expense0.05460TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,588,006TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,434,457DirectOffsettingRevenueAmt
Net Community Benefit Expns$153,549NetCommunityBenefitExpnsAmt
Total Expense0.00220TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$465,712TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$320,273DirectOffsettingRevenueAmt
Net Community Benefit Expns$145,439NetCommunityBenefitExpnsAmt
Total Expense0.00210TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,926,849TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,754,730DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,172,119NetCommunityBenefitExpnsAmt
Total Expense0.05890TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$22,000NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$609,210TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$609,210NetCommunityBenefitExpnsAmt
Total Expense0.00860TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$105,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$105,000NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$736,210TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$736,210NetCommunityBenefitExpnsAmt
Total Expense0.01040TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,663,059TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,754,730DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,908,329NetCommunityBenefitExpnsAmt
Total Expense0.06930TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$3,598,153BadDebtExpenseAmt
Reimbursed By Medicare$17,630,081ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$15,661,600CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$1,968,481MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PIEDMONT WALTON HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12151 WEST SPRING STREETAddressLine1Txt
CityMONROECityNm
State AbbreviationGAStateAbbreviationCd
ZIP30655ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.piedmont.orgWebsiteAddressTxt
State License147-613StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Facility Reporting Group1FacilityReportingGroupCd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PIEDMONT WALTON HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART VIOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART VIStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care300.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.FPGFamilyIncmLmtDscntCarePct
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART VIFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART VIFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART VIFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, LINE 5: COMMUNITY REPRESENTATIONAs a part of our process, we interviewed 31 key stakeholders and policy makers that represent public health, low-income populations, uninsured and uninsured persons, minorities, chronic conditions, older adults, and lawmakers. Further, in December 2018 and December 2019, 50 key stakeholders within the Piedmont Walton community provided their thoughts on community health, community assets and the role of the hospital in addressing unmet community health needs via a web survey. Below are the results of that survey. These interviews were conducted for people representing the entire region, including Walton County. 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 11 hospitals were actively informed and engaged throughout this process. SCHEDULE H, PART V, LINE 7A: COMMUNITY HEALTH NEEDS ASSESSMENT WEBSITE https://www.piedmont.org/media/file/PWH-FY19-CHNA-Strategy.pdf
SCHEDULE H, PART V, LINE 7D: PUBLIC AVAILABILITY OF CHNAIN ADDITION TO MAKING ITS CHNA REPORTS AVAILABLE ON ITS WEBSITE AND BY REQUEST, PIEDMONT WALTON 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, LINE 10A: IMPLEMENTATION STRATEGYTHE BOARD OF DIRECTORS FOR PIEDMONT WALTON HOSPITAL, INC. UNANIMOUSLY APPROVED ITS IMPLEMENTATION STRATEGY FOR THE THREE YEAR PERIOD BEGINNING WITH FY20 ON OCTOBER 16, 2019, WITHIN THE GRACE PERIOD FOLLOWING THE APPROVAL OF THE NEW COMMUNITY HEALTH NEEDS ASSESSMENT. THE FOLLOWING LINK IS FOR THE IMPLEMENTATION STRATEGY EFFECTIVE THROUGH JUNE 30, 2022, WHICH IS CONTAINED AT THE END OF THE DOCUMENT https://www.piedmont.org/media/file/PWH-FY19-CHNA-Strategy.pdf
SCHEDULE H, PART V, LINE 11: ADDRESSING COMMUNITY HEALTH NEEDSWHEN PIEDMONT HEALTHCARE, INC. FIRST ACQUIRED THE ASSETS OF PIEDMONT WALTON HOSPITAL, INC., THE HOSPITAL HAD A GRACE PERIOD FOR PIEDMONT HEALTHCARE TO PREPARE AND APPROVE A COMMUNITY HEALTH NEEDS ASSESSMENT FOR PIEDMONT WALTON HOSPITAL. THE INITIAL CHNA FOR PIEDMONT WALTON HOSPITAL WAS UNANIMOUSLY APPROVED BY ITS BOARD OF DIRECTORS ON APRIL 17, 2019, WITHIN THE GRACE PERIOD. BASED ON THE CHNA, PIEDMONT WALTON HOSPITAL WILL FOCUS ON: (1) INCREASE ACCESS TO APPROPRIATE AND AFFORDABLE HEALTH AND MENTAL CARE FOR ALL COMMUNITY MEMBERS, AND ESPECIALLY THOSE WHO ARE UNINSURED AND THOSE WITH LOW INCOMES; (2) REDUCE OPIOID AND RELATED SUBSTANCE ABUSE AND OVERDOSE DEATHS; (3) DECREASE DEATHS FROM CANCER AND INCREASE ACCESS TO CANCER PROGRAMMING FOR THOSE LIVING WITH THE DISEASE, WITH A FOCUS ON LUNG CANCER; AND (4) PROMOTE HEALTHY WEIGHTS AND BEHAVIORS AS TO DECREASE PREVENTABLE INSTANCES OF HEART DISEASE AND DIABETES.
SCHEDULE H, PART V, LINE 16: FINANCIAL ASSISTANCE WEBSITESFINANCIAL ASSISTANCE POLICY - https://www.piedmont.org/media/file/Financial-Assistance-Policy.pdf FINANCIAL ASSISTANCE APPLICATION - https://www.piedmont.org/media/file/Financial-Assistance-Application.pdf FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY - https://www.piedmont.org/media/file/Financial-Assistance-Plain-Language-Su mmary-English.pdf

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART VI, LINE 1: REQUIRED DISCLOSURESPUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6A We regularly report to the community our community benefit activities in several ways. Each year, we prepare a systemwide community benefit report that is available to the public through publication on our website. We also make available copies of our IRS Form 990 Schedule H on our website and available to anyone upon request. We also provide information on community benefit programming to local, state, and federal lawmakers through our government affairs office. PERCENT OF TOTAL EXPENSE SCHEDULE H, PART I, LINE 7(F) 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 $82,532,574, LESS BAD DEBT EXPENSE OF $11,621,053 FROM FORM 990, PART IX, LINE 24(B). FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST SCHEDULE H, PART I, LINE 7 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. BAD DEBT EXPENSE CALCULATION AND FOOTNOTE SCHEDULE H, PART III, LINES 2-4 The provision for bad debts is based upon leadership's assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage and other collection indicators. Periodically, leadership assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category. The results of the review are then used to make any modifications to the provision for bad debts to establish an appropriate allowance for uncollectible receivables. THE AMOUNT REPORTED ON PART III, LINE 3, WAS DETERMINED BY TAKING THE AVERAGE ACCEPTANCE RATE FOR ALL CHARITY CARE APPLICATIONS RECEIVED DURING THE YEAR MULTIPLIED BY THE NUMBER OF DENIALS THAT WERE ATTRIBUTABLE TO INSUFFICIENT INFORMATION. THAT TOTAL WAS THEN ADJUSTED DOWNWARD FOR THE ORGANIZATION'S USE OF PRESUMPTIVE ELIGIBILITY WHEN DETERMINING ITS COMMUNITY BENEFITS. BAD DEBT EXPENSE FOOTNOTE FROM CONSOLIDATED, AUDITED FINANCIAL STATEMENTS: THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBT TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. PIEDMONT WALTON HOSPITAL 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. MEDICARE SHORTFALLS AS COMMUNITY BENEFIT SCHEDULE H, PART III, LINE 8 The amount reported on Part III, Line 6, was calculated in accordance with Schedule H instructions by utilizing our allowable Medicare cost as reported in the Medicare cost report, which is based on a cost to charge ratio. However, the allowable costs in the Medicare cost report do not reflect the actual cost of providing care to patients since the Medicare cost report excludes many direct patient care costs that are essential to provide quality healthcare for Medicare patients. For example, certain coverage fees to physicians, cost of Medicare C and D, and other similar direct patient care expenses are specifically excluded from allowable cost in the Medicare Cost Report. We believe our Medicare shortfall reported on Part III, Line 7 of Schedule H, should be considered a community benefit as the IRS community benefit standard includes the provision of care to elderly and Medicare patients. IRS Revenue Ruling 69-545 provides, in part, that hospitals serving patients with governmental health insurance, such as Medicare, is an indication we operate to promote health in the community. Our policy is to treat Medicare patients, regardless of the extent to which Medicare actually pays for the treatment. For many services, Medicare's reimbursement is less than the cost of the care provided, resulting in shortfalls that are to be absorbed by us in honor of our commitment to treat elderly patients. Many of these patients live on a low, fixed income, and would qualify for financial assistance or other means-tested programs, absent from their enrollment in Medicare. COLLECTION PRACTICES SCHEDULE H, PART III, LINE 9(B) 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 ASSESSMENTAs a designated 501(c)(3) nonprofit hospital, we are required by the Internal Revenue System to provide to conduct a triennial community health needs assessment (CHNA), in accordance with regulations put forth by the IRS following the 2010 Patient Protection and Affordable Care Act (ACA). Through this assessment, we hope to better understand local health challenges, identify health trends in our community, determine gaps in the current health delivery system and craft a plan to address those gaps and the identified health needs. In FY19, we conducted our third triennial community health needs assessment (CHNA). FY21 marked Year Two of the subsequent Implementation Strategy. Our CHNA was led by the Piedmont Healthcare community benefits team, with significant input and direction from hospital leadership, including the director of community relations and our hospital Board of Directors, which formed a subcommittee to help determine final priorities. Process The CHNA started first with a definition of our community, of which we determined was our home county, due to the impact of our tax-exempt status. Property taxes make up the largest segment of a hospital's tax exemption which impacts county revenues. Because of this, we aim to ensure that we are providing ample benefit to our county and its residents. Additionally, we take into consideration patient origin, and especially that of our lower-income patients, such as those who qualify for financial assistance or receive insurance coverage through Medicaid. Our secondary communities are considered the areas in which we have the highest concentration of patients fitting that criterion, including ones from nearby communities. Once we established our primary and secondary community, we then conducted an analysis of available public health data. This included resources from: US Census, US Health and Human Services' Community Health Status Indicators, US Department of Agriculture, Economic Research Service, National Center for Education Statistics, Kaiser Family Foundation's State Health Facts, American Heart Association, County Health Rankings and Georgia Online Analytical Statistical Information System (OASIS). All figures within the CHNA were for 2017, unless otherwise noted. Health indicators are estimates provided by County Health Rankings and hospital data were internally sourced. An internal survey was also conducted throughout the healthcare system for both clinical and non-clinical employees. Information was gathered on knowledge and understanding of community benefit and current programs, as well as suggestions for how we can better serve our patients and communities. Nearly 900 employees spanning the system responded. Additionally, we conducted a community-based survey in which local stakeholders were asked their thoughts on unmet community health needs and our role in addressing those needs. These stakeholders included local leaders, nonprofit representatives, elected officials and those with a unique knowledge of the challenges vulnerable populations face. We also evaluated previous community benefit, hospital and community interventions identified in our last CHNA implementation strategies through three lenses: impact, outcomes and sustainability. Interventions and programming considered to have a high score on all three were included in this CHNA and our subsequent strategy. This included our community benefit grants program, our charitable clinic-hospital partnerships and our heart- and stroke-focused community programming. Finally, we conducted direct interviews with 31 state and regional stakeholders and policymakers, with each representing a specific group that tends to be adversely impacted by issues of health equity. These groups included but are not limited to Georgians for a Healthy Future, Georgia Watch, ConsiderHealth, the Community Foundation for Greater Atlanta, the Georgia Charitable Care Network, the Medical Association of Georgia and Healthy Mothers, Healthy Babies. Additionally, we sought and received feedback on our CHNA from public health. Our priorities A key component of the CHNA is to identify the top health priorities we'll address over fiscal years 2020, 2021 and 2022. These priorities will guide our community benefit work. They are, in no order: . Increase access points for appropriate and affordable health, dental and mental care for all community members, and especially those who are uninsured and those with low incomes; . Decrease deaths from cancer and increase access to cancer programming for those with living the disease, with a focus on lung cancer; . Promote healthy weights and behaviors as to decrease preventable instances of heart disease and diabetes; and . Reduce opioid and related substance abuse and overdose deaths With each priority, we work to achieve greater health equity by reducing the impact of poverty and other socioeconomic indicators. This means that health equity is built into each priority, and that is demonstrated through our implementation strategies. Several key community health needs emerged during the assessment process. The chosen priorities were recommended by the community benefit department with sign-off from hospital and board leadership. The following criteria were used to establish the priorities: . The number of persons affected; . The seriousness of the issue; . Whether the health need particularly affected persons living in poverty or reflected health disparities; and, . Availability of community and/or hospital resources to address the need. The priorities we chose reflected a collective agreement on what hospital leadership, staff and the community felt was most important and within our ability to positively impact the issue. While the priorities reflect clinical access and certain conditions, 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. Our implementation strategy was developed in partnership with hospital leadership and community stakeholders to address the identified priorities in our FY19 community health needs assessment. The implementation strategy was designed to be executed over a three-year period and included specific metrics by which we would be able to evaluate our work and its impact. The implementation strategy was developed by utilizing community feedback from the assessment in partnership with the system community benefits department, our leadership, and our board of directors. As mentioned above, we included proven and successful interventions and programming, investing further in work we felt was successful in addressing unmet health needs. The implementation strategy was unanimously approved by the Piedmont Walton Hospital Board of Directors on October 16, 2019.
SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ASSISTANCE ELIGIBILITYWe understand that not everyone can pay their hospital bill due to their insurance status or a limited income, and because of this, we offer financial assistance to qualifying patients. Notification about financial assistance includes, but is not limited to, a dedicated contact number, notices in patient bills, within the Conditions of Admission form, and posted notices in key areas of the hospital. These locations are the emergency room, at admitting and registration departments, our business office, and patient financial services office that are located on site. We also publish and widely publicize a plain language summary of this financial assistance care policy on our website, as well as the full policy. Referral of patients for financial assistance may be made by any staff or medical staff member at the hospital, including physicians, nurses, financial counselors, social workers, case managers, chaplains, and religious sponsors. A request for financial assistance may be made by the patient or a family member, close friend, or associate of the patient, subject to applicable privacy laws. Additionally, we provide copies of our financial assistance policy to our partner clinics and others who work closely with low-income populations. We help our partners understand the policy and how it relates to their populations and receive feedback in ways our financial assistance programming could be improved. Finally, Piedmont Healthcare annually publishes a directory of services and programs for low-income community members, and within this resource guide are extensive directions and advice on how to apply for our patient financial assistance program. Also, in this guide is information on how to apply for certain government assistance programs, resources to help prepare and file tax returns, as well as detailed resources for local sliding scale and free mental, dental and health resources. This guide is widely distributed to the community via hardcopy, is available within our hospitals and is digitally available online. This guide is available in both English and Spanish.
SCHEDULE H, PART VI, LINE 4: COMMUNITY INFORMATIONWe are in Walton County, where an average 91,442 people lived in the 326.79 square mile area between 2015 and 2019. The population density for this area, estimated at 279.82 persons per square mile, is greater than the national average population density of 94 people per square mile. Walton County is 57.34 percent urban and 43 percent is rural. The median age of people living within Walton County was 39, and the county skews slightly female. Twenty-five percent of the population were 18 or younger, 60 percent were between ages 18 and 64, and 15 percent were over the age of 65. In Walton County, 7 percent of the population over 18 identify as a veteran and 13 percent of those identified as have a disability. About 2 percent of the population had limited English proficiency, which references the populations aged 5 and older who speak a language other than English at home and speak English less than "very well." Most of those households spoke Spanish. About 5 percent of the population were born outside of the United States and are considered foreign born and 2 percent do not hold US citizen status. This does not include individuals who may hold Green Card permissions. Between 2015 and 2019, the median income was $61,599 and the per capita income was $27,889. Twelve percent of Walton County lived in poverty between 2015 and 2019. During that same period, 18 percent of children in Walton County lived in poverty, a figure that has steadily increased over the last ten years. It is slightly lower than the state average of 18.5 percent. Nearly 46 percent of public-school children were eligible for the free or reduced priced lunch program during the 2018-2019 school year, which is lower than the 2014-15 state average of 62 percent. Between 2015 and 2019, on average, 13 percent of the population did not graduate high school, 36 percent did, 21 percent went on to attend some college, and 30 percent obtained an associate degree or higher. During those years, about 6 percent of young people were not enrolled in school and were also unemployed. In Walton County, between 2015 and 2019 there were 31,670 households. Of those households, 28 percent were occupied by renters. Three-fourths of all households were occupied by families, and 57 percent were married family households. The percent of all households with children in Walton County was 38 percent and married family households with children was 24 percent. The median age of housing units in Walton County was 1994 and the percentage of households with no motor vehicle was 3 percent. Twenty-nine percent of households had housing costs that exceeded more than 30 percent of total household income between 2015 and 2019, which indicates a cost burdened household more likely to face overall financial difficulty. More than half of all rental households in the county were cost-burdened, and about a fourth of all owner-occupied houses faced the same financial struggle. Housing quality of occupied units with one or more substandard condition was 29 percent, and 2 percent of households completely lacked kitchen facilities and/or plumbing. In Walton County, 12 percent of county residents were uninsured from 2015-19. Roughly 13 percent of the population received SNAP benefits. For every 1,000 teen girls aged 15 to 18 in Walton County, roughly 25 gave birth to a child on average each year between 2013 and 2019. Children born to teens are statistically much more likely to experience adverse health and socioeconomic issues as they grow older. Approximately, 9 percent of all live births were considered low birth weight births. In 2019, there were 65 fast food restaurants in Walton County and 20 percent of census tracts (three tracts) in Walton County were considered a food desert. A food desert is an area where it is difficult to buy affordable and/or good-quality fresh food. As of 2019, there were about 13 grocery store establishments per 100,000 people in Walton County and 10 retailers per 10,000 people that were SNAP-authorized food stores. Various health behavior indicators showed that 16 percent of adults reported excessive drinking of alcohol and 16 percent binge drinking in the last 30 days. In 2018, about 20 percent of adults were current smokers (higher than the national average). About a quarter of the population reported having no time for physical activity. Chronic condition health indicators for Walton County showed that 5 percent of Medicare beneficiaries had asthma, 28 percent had diabetes, 27 percent had heart disease and 64 percent had high blood pressure. Nine percent of adults diagnosed with diabetes in 2019. In Walton County, cancer was the number one cause of both age-adjusted and premature death between 2015 and 2019. Age-adjusted allows communities with different age structures to be compared. Premature death is when death happens before the average age for a given community. Between 2015 and 2019, Walton County had 1,344 premature deaths and 21,486 years of potential life lost. Additionally, a quarter of all adults had a BMI higher than 39, indicating obesity. Twenty-one percent of Walton County reported their health as poor or fair. In 2021, Walton County reported 15,525 COVID-19 cases and 355 COVID-19 related deaths. In Walton County, about 30 percent of adults were fully vaccinated and 16 percent of adults were hesitant about receiving the vaccine. The COVID-19 vaccine Coverage index (CVAC) ranks states and counties on barriers to coverage through 28 indicators across 5 themes: historic under vaccination, sociodemographic barriers, resource-constrained health system, healthcare accessibility barriers, and irregular care-seeking behaviors. The CVAC can help contextualize progress to widespread COVID-19 vaccine coverage, identifying underlying community-level factors that could be driving suboptimal rollout to inform precision solutions. Walton County had a vaccine coverage index of 0.53 as reported by the CDC, 2021. Sources for all statistics in this section: U.S. Census 2017 ACS Demographic and Housing Estimate, University of Wisconsin Population Health Institute, County Health Rankings, 2018, with indicators ranging from 2012 to 2019, the Centers for Disease Control and Prevention, and the Georgia Online Analytical Statistical Information System.
SCHEDULE H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHIn FY21, we actively promoted the health of our community through clinic-hospital partnership, community-based health screenings, educational activities, community-building activities, the operation of a 24-hour emergency department available to the entire community, a governance board composed of community members, use of surplus revenue for facilities improvement, patient care, and medical training, education, 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. It's important to note that COVID-19 had a significant impact on Piedmont Walton proactive community benefit programs, as We canceled all in-person events and classes as of early March 2020. We created programming responsive to the pandemic, including migrating vital community-based programming online. We prioritized increasing access to appropriate and affordable health and mental care by providing funding support for a full-time nurse practitioner to treat low-income and uninsured patients. We provided funding for a full-time nurse practitioner at F.I.S.H. MD charitable clinic in Monroe. The APP's salary is $105,000, working 36 hours per week. In FY21, we implemented Leadership Rounding every morning after Safety Huddle. Leaders were assigned two inpatient rooms to monitor daily, with the intention to ensure all standards of care were both met and exceeded, allowing leadership to communicate any issues immediately. We maintained our Level III trauma center designation in FY21. Our trauma and stroke coordinator tracked opportunities for improvement when reviewing charts and reported those to peer review if significant. Trauma surgeon timeliness was discussed at Trauma Peer Review every even month. Stroke Core Curriculum meetings were held twice a month for staff and emergency medical services partners. We also were actively involved in other emergency services meetings, including the Emergency Management Committee, the Emergency Operations Center, Region 10 EMS, and the COVID-19 Task Force. We worked to reduce opioid and related substance abuse and overdose deaths by providing meaningful leadership in the community and partnering with others in combating opioid abuse. The Walton County Sheriff's Office has a box present year-round to take back unused prescription medications, and we regularly referred patients to this box. We also helped promote the Monroe Police Department's annual Take Back Day event, which is an advertised opportunity for community members to safely dispose of any medications. In April 2021, our pharmacy director convened 16 community leaders to discuss the local opioid and substance abuse issue, providing an opportunity for community input to ensure we are working collaboratively to combat this deadly issue. Attendees included representatives from: Walton County Chamber of Commerce, Northeast Georgia Medical Center Barrow, Uniting Hope 4 Children, Department of Community Supervision, and The Walton Tribune. We actively provided cancer support services, having partnered with the Cancer Foundation of Northeast Georgia, and we worked to help connect community members with resources through The Cancer Foundation and The Partnership of Families, Children, and Youth. Unfortunately, our Cancer Support Group was placed on hold in FY21 due to COVID-19. There are plans to restart these meetings once a month, once it is safe to do so. We promoted healthy weights and behaviors by working with Walton Wellness, a community collaboration within the county, to promote Food Rx, a program targeting low-income county residents who are obese, hypertensive, or diabetic to receive fresh produce and nutrition education during a six-month period. In FY21, 14 residents participated in the program. Finally, we hosted Diabetes Support Groups, led by a dietician, who met once per month and supported five participants in FY21.
SCHEDULE H, PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMWe are part of Piedmont Healthcare, a regional not-for-profit organization and the parent company of 16 hospitals, the Piedmont Physicians Group, the Piedmont Heart Institute, the Piedmont Clinic and the Piedmont Healthcare Foundation. Our community relations team works directly with the community. Our system community benefit department oversees the community benefit activities on behalf of all hospitals throughout the system, and this includes conducting the triennial CHNA and subsequent implementation strategy, ensuring the financial assistance policy is communicated to the community, maintaining the community benefit webpage, authoring the community benefit annual report, preparing board materials, developing and executing the community benefit grants program and compiling all community benefit figures. Each hospital and certain departments of Piedmont Healthcare execute community benefit programming, such as our revenue department, which oversees the financial assistance program.
SCHEDULE H, PART VI, LINE 7: STATE OF FILING OF COMMUNITY BENEFIT REPORTPiedmont Walton Hospital is not required to file a community benefit report; however, the hospital is required to file with the Georgia Department of Community Health information on its indigent and charity care, as well as its Medicaid and Medicare shortfalls.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Mr Michael Burnett
Board Member$0$508,307$0$374,282$0$140,345$0$99,024$0$20,865$0$1,142,823$0$81,924
Ms Vicki A Cansler
Board Member$0$398,542$0$226,964$0$109,751$0$76,466$0$8,672$0$820,395$0$59,366
Mr Larry Ebert
CEO & Board Member$266,166$0$99,131$0$6,391$0$16,733$0$17,525$0$405,946$0$0$0
Mr Marvin Wynn
CFO$0$229,720$0$89,477$0$15,029$0$17,100$0$14,191$0$365,517$0$0
Dr Robert Sinyard
CMO$0$422,667$0$153,517$0$32,851$0$0$29,577$0$638,612$0$0
Ms Candice Frix
CNO$125,067$0$27,172$0$131$0$9,378$0$10,361$0$172,109$0$0$0
Mr Michael Wynne
DIRECTOR - PHARMACY$149,737$0$21,583$0$193$0$10,477$0$12,446$0$194,436$0$0$0
Ms Rose Dennis
exec. Dir. - patient svcs$136,084$0$30,892$0$2,196$0$10,553$0$13,401$0$193,126$0$0$0
Mr Jeffrey Braswell
dir. - emergency svcs$130,206$0$18,361$0$1,642$0$8,914$0$464$0$159,587$0$0$0
Mr Michael McAnder
Treasurer (End 7/20)$0$357,162$0$0$0$927,767$0$66,931$0$5,196$0$1,357,056$0$498,228
Mr Thomas Arnold
Treasurer (Eff 7/20)$0$424,857$0$245,916$0$156,777$0$79,670$0$13,247$0$920,467$0$62,570
Ms Elizabeth Leddy
Secretary$0$459,494$0$335,067$0$49,241$0$109,035$0$17,590$0$970,427$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 3: COMPENSATION OF THE CEO/EXECUTIVE DIRECTORTHE COMPENSATION FOR THE PRESIDENT/CEO OF PIEDMONT WALTON 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. FOR ADDITIONAL INFORMATION. FOR ADDITIONAL INFORMATION.
SCHEDULE J, PART I, LINE 4B: SUPPLEMENTAL COMPENSATION INFORMATIONVICKI CANSLER RECEIVED A PAYMENT OF $59,366 FROM HER SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. J. MICHAEL BURNETT RECEIVED A PAYMENT OF $81,924 FROM HIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. MICHAEL MCANDER RECEIVED A PAYMENT OF $498,228 FROM HIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THOMAS ARNOLD RECEIVED A PAYMENT OF $62,570 FROM HIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THE FOLLOWING EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS: LARRY EBERT ELIZABETH LEDDY

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Development Authority of Walton CountyBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN582137690BondIssuerEIN
CUSIP933413AY2CUSIPNum
Bond Issued2019-11-07BondIssuedDt
Issue Price$31,085,000IssuePriceAmt
PurposeASSET PURCHASEPurposeDesc
DefeasedfalseDefeasedInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Pool FinancingfalsePoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$0RetiredAmt
Bond Defeased$0BondDefeasedAmt
Total Proceeds$37,383,406TotalProceedsAmt
In Reserve Fund$0InReserveFundAmt
Capitalized Interest$0CapitalizedInterestAmt
Refunding Escrow$0RefundingEscrowAmt
Issuance Costs From Proceeds$0IssuanceCostsFromProceedsAmt
Credit Enhancement$0CreditEnhancementAmt
Working Capital Expenditures$0WorkingCapitalExpendituresAmt
Capital Expenditures$0CapitalExpendituresAmt
Other Spent Proceeds$37,383,406OtherSpentProceedsAmt
Unspent$0UnspentAmt
Substantial Completion2019SubstantialCompletionYr
Refunding Tax Exempt BondsfalseRefundingTaxExemptBondsInd
Refunding Taxable BondsfalseRefundingTaxableBondsInd
Final Allocation MadeYes (true)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsfalseAnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropfalseMgmtContractBondFincdPropInd
Any Research AgreementsfalseAnyResearchAgreementsInd
Private Bus Use By Others0.01000PrivateBusUseByOthersPct
Total Private Business Use0.01000TotalPrivateBusinessUsePct
Change In Use Bond Financed PropfalseChangeInUseBondFinancedPropInd
Remedial Action TakenfalseRemedialActionTakenInd
Procs Nonqualified Bond RemdtdYes (true)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetYes (true)RebateNotDueYetInd
Exception To RebatefalseExceptionToRebateInd
No Rebate DuefalseNoRebateDueInd
Variable Rate IssuefalseVariableRateIssueInd
Hedge Identified In Bks And RecfalseHedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (true)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (true)ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINE 1A: NUMBER OF FORMS 1099 FILEDALL CALENDAR YEAR 2020 FORMS 1099 WERE FILED ON BEHALF OF PIEDMONT WALTON HOSPITAL BY ITS SOLE MEMBER, PIEDMONT HEALTHCARE, INC. (EIN 58-1503902), PURSUANT TO AN AGREEMENT WITH THE IRS TO FILE ALL FORMS 1099 FOR THE PIEDMONT HEALTHCARE SYSTEM ON A COMBINED BASIS.
FORM 990, PART VI, SECTION A, LINE 6: ORGANIZATION'S SOLE MEMBERPIEDMONT HEALTHCARE, INC., (EIN 58-1503902) IS THE SOLE MEMBER OF PIEDMONT WALTON HOSPITAL ("PWH").
FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF GOVERNING BODYTHE BOARD OF PIEDMONT HEALTHCARE, PIEDMONT WALTON HOSPITAL'S SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF PIEDMONT WALTON HOSPITAL.
FORM 990, PART VI, SEC A, LINE 7B: DECISIONS OF GOVERNING BODYPIEDMONT WALTON 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 WALTON HOSPITAL'S, INC. BOARD OF DIRECTORS ARE NOT SUBJECT TO THE APPROVAL OF OR RATIFICATION BY THE PIEDMONT HEALTHCARE BOARD, BUT SHOULD THE NEED ARISE, THEY MAY BE RESCINDED BY THE PIEDMONT HEALTHCARE BOARD THROUGH A MAJORITY VOTE OF ITS DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11B: 990 REVIEW PROCESSINFORMATION NEEDED TO PREPARE PIEDMONT WALTON HOSPITAL'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PWH'S CONTROLLER AND VP/CFO. THE 990 IS THEN PREPARED 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, SECTION B, LINE 12C: CONFLICT OF INTERESTCOMPLIANCE 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 WALTON HOSPITAL ARE PROVIDED TRAINING ON CONFLICT OF INTEREST ISSUES, INCLUDING REPORTING REQUIREMENTS, AT NEW EMPLOYEE ORIENTATION AND AT LEAST ANNUALLY THEREAFTER. NONCOMPLIANCE WITH THE CONFLICT OF INTEREST POLICY MUST BE REPORTED TO PIEDMONT HEALTHCARE'S CHIEF COMPLIANCE OFFICER FOR INVESTIGATION, AND REMEDIAL STEPS MUST BE TAKEN AS APPROPRIATE UNDER THE PIEDMONT HEALTHCARE DISCIPLINARY POLICIES.
FORM 990, PART VI, SEC B, LINE 15A, 15B: EXECUTIVE COMPENSATIONCOMPENSATION FOR EXECUTIVES OF PIEDMONT WALTON 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, SECTION C, LINE 19: DISCLOSURE OF DOCUMENTSGOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THESE DOCUMENTS SHOULD BE REQUESTED FROM PIEDMONT HEALTHCARE, INC.'S LEGAL COUNSEL.
FORM 990, PART XI, LINE 9: RECONCILIATION OF NET ASSETSCHANGES TO NET ASSETS REPORTED ON PART XI, LINE 9 ARE COMPRISED OF: CHANGE IN TEMP ($2,059) INTERCOMPANY TRANSFERS ($25,367,800) UNALLOCATED EXPENSES ($1,526,344) ------------------ TOTAL ($26,896,203)

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
PIEDMONT HEALTHCARE INC
1800 HOWELL MILL ROAD SUITE 850ATLANTAGA30318581503902HEALTHCAREGA501(C)(3)12C, III-FINAfalse
PIEDMONT HOSPITAL INC
1968 PEACHTREE ROAD NWATLANTAGA30309580566213HOSPITALGA501(C)(3)3PHCfalse
FAYETTE COMMUNITY HOSPITAL INC
1255 HIGHWAY 54 WESTFAYETTEVILLEGA30214582322328hospitalGA501(C)(3)3PHCfalse
PIEDMONT MOUNTAINSIDE HOSPITAL INC
1266 HIGHWAY 515 SOUTHJASPERGA30143352228583HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT HENRY HOSPITAL INC
1133 EAGLES LANDING PKWYSTOCKBRIDGEGA30281582200195HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT HEART INSTITUTE INC
95 COLLIER ROAD NW STE 2045ATLANTAGA30309263553500HEALTHCAREGA501(C)(3)10PHCfalse
PIEDMONT NEWNAN HOSPITAL INC
745 POPLAR ROADNEWNANGA30265205077249HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT NEWTON HOSPITAL INC
5126 HOSPITAL DRIVE NECOVINGTONGA30014582155150HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT HEALTHCARE FOUNDATION INC
2001 PEACHTREE ROAD NE SUITE 400ATLANTAGA30309581272768FUNDRAISINGGA501(C)(3)12B, IIPHCfalse
PIEDMONT ATHENS REGIONAL FOUNDATION INC
1199 PRINCE AVENUEATHENSGA30606581978389FUNDRAISINGGA501(C)(3)12B, IIARMCfalse
PIEDMONT ATHENS REGIONAL HEALTH RESOURCE
1199 PRINCE AVENUEATHENSGA30606581930580DEVELOPMENTGA501(C)(3)12B, IIARMCfalse
PIEDMONT ATHENS REGIONAL MEDICAL CENTER
1199 PRINCE AVENUEATHENSGA30606582179986HOSPITALGA501(C)(3)3PHCfalse
ATHENS REGIONAL PHYSICIAN SERVICES INC
1199 PRINCE AVENUEATHENSGA30606582332921HEALTHCAREGA501(C)(3)12B, IIARMCfalse
ATHENS REGIONAL SPECIALTY SERVICES INC
1199 PRINCE AVENUEATHENSGA30606271975001HEALTHCAREGA501(C)(3)12B, IIARMCfalse
REGIONAL FIRSTCARE INC
1199 PRINCE AVENUEATHENSGA30606582362733URGENT CAREGA501(C)(3)12B, IIARMCfalse
COLUMBUS AMBULATORY HEALTHCARE SERVICES
707 CENTER STCOLUMBUSGA31901581719867AMBULATORYGA501(C)(3)3PHCfalse
COLUMBUS REGIONAL HEALTHCARE SYSTEM INC
707 CENTER STCOLUMBUSGA31901581719994HEALTHCAREGA501(C)(3)12B, IIPHCfalse
COLUMBUS REGIONAL MEDICAL FOUNDATION INC
707 CENTER STCOLUMBUSGA31901581501642FUNDRAISINGGA501(C)(3)7PHCfalse
THE MEDICAL CENTER INC
710 CENTER STCOLUMBUSGA31901581685139HOSPITALGA501(c)(3)3PHCfalse
HUGHSTON HOSPITAL INC
707 CENTER STCOLUMBUSGA31901331216751HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT ROCKDALE HOSPITAL INC
1412 Milstead AvenueCONYERSGA30112300999841HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT CARTERSVILLE HOSPITAL INC
960 JOE FRANK HARRIS PKWY SECARTERSVILLEGA30120870963633HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT EASTSIDE HOSPITAL INC
1700 MEDICAL WAYSNELLVILLEGA30078870982886HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT MACON HOSPITAL INC
350 HOSPITAL DRMACONGA31217871006981HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT MACON NORTH HOSPITAL INC
400 CHARTER BLVDMACONGA31210871031034HOSPITALGA501(C)(3)3PHCfalse
COLUMBUS REGIONAL SENIOR LIVING INC
707 CENTER STCOLUMBUSGA31901582628502HEALTHCAREGA501(C)(3)12C, III-FIPHCfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndUBI Code VUBICodeVAmtGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPct
PEACHTREE ORTHOPAEDIC SURGERY CENTER
2001 PEACHTREE RD NE STE 705ATLANTAGA30309582562721ORTHOPAEDICGAnaNONE$0$0false$0false0.00000
DIGESTIVE HEALTHCARE OF GA ENDOSCOPY CEN
95 COLLIER RD NW STE 4075ATLANTAGA30309582406657HEALTHCAREGAnaNONE$0$0false$0false0.00000
PIED URG CARE WELL
3350 RIVERWOOD PKWY STE 1850ATLANTAGA30339841916875urgent careGAnaNONE$0$0false$0false0.00000
GEORGIA HEALTH COLLABORATIVE LLC
2727 PACES FERRY RD BLDG 2 STE 70ATLANTAGA30339461500639HEALTHCAREGAnaNONE$0$0false$0false0.00000

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
PIEDMONT MEDICAL CARE CORPORATION
2727 PACES FERRY RD STE 1-1100ATLANTAGA30339582092768HEALTHCAREGAPHCC CORP$0$00.00000false
THE PIEDMONT CLINIC INC
2727 PACES FERRY RD STE 1-1100ATLANTAGA30339582005358HEALTHCAREGAPHCC CORP$0$00.00000false
PIEDMONT HEART INSTITUTE PHYSICIANS INC
95 COLLIER ROAD NW STE 2045ATLANTAGA30309260593850HEALTHCAREGAPHCC CORP$0$00.00000false
AMSTER MCRAE INSURANCE COMPANY
980427603RELATED INSURPHCC CORP$0$00.00000falsePO BOX 1159GRAND CAYMANCJKY1-1102CJ
PIEDMONT WELLSTAR HEALTHPLANS INC
2859 PACES FERRY RD STE 600ATLANTAGA30339461922499HEALTH INSUR.GAPHCC CORP$0$00.00000false
COLUMBUS HEALTHCARE RESOURCES
PO BOX 790COLUMBUSGA31902581717754HEALTHCAREGACRHSC CORP$0$00.00000false
Columbus Health Services Inc
PO BOX 790COLUMBUSGA31902581640939HEALTHCAREGACRHSC CORP$0$00.00000false
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd