2022-05-11T13:14:17-05:00 2021-06-30 KPMG LLP 303 PEACHTREE ST STE 2000 ATLANTA GA 30308 990 2020-07-01 300999841 Piedmont Rockdale Hospital % MARIE GAFFNEY PIED 7709183000 1412 Milstead Avenue Conyers GA 30012 MARIE GAFFNEY VP CORPORATE FINANCE 4702716007 2022-05-10 true MARIE GAFFNEY 999009999 WHITNEY B HEBRON P01226647 4042223000 2022-05-10 2 2020 2022-09-23 18:48:47Z MR BLAKE WATTS 1412 Milstead Avenue Conyers GA 30012 214837145 false X www.piedmont.org/locations/piedmont-rockdale/ X 2017 GA TO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT. 12 6 1290 150 0 0 13539467 5362393 159909272 208484510 36432 137894 811261 852348 174296432 214837145 0 0 0 0 77953663 94421018 0 0 0 94218715 108326791 172172378 202747809 2124054 12089336 101587949 106012518 100876496 94868799 711453 11143719 TO PROVIDE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE IN A PROGRESSIVE ENVIRONMENT, GUIDED BY PHYSICIANS, DELIVERED BY EXCEPTIONAL PROFESSIONALS, AND INSPIRED BY THE COMMUNITIES WE SERVE. false false 172576906 0 208492415 PIEDMONT ROCKDALE HOSPITAL ("PRH") IS A 138-BED, NON-PROFIT HOSPITAL LOCATED IN THE CITY OF CONYERS IN ROCKDALE 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 ROCKDALE 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 9,047 IN-PATIENT ADMISSIONS WITH A TOTAL OF 46,196 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 41,505 AND OUTPATIENT VISITS TOTALED 51,766. SURGICAL SERVICES WERE PROVIDED TO 5,150 PATIENTS. 172576906 true true false false false false false false false true false false true true true false true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true false false false true X 0 0 1290 true false false false false false false false false false false false false X 12 6 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 RD BLDG 2 STE 70 ATLANTA GA 30339 X Mr Michael McAnder Treasurer (End 7/20) 1.0 54.0 X 0 1284929 72127 DR Leigh Hamby Board Member 1.0 54.0 X 0 1177022 132747 MR J Michael Burnett Board Member 1.0 54.0 X 0 1022934 119889 Ms Elizabeth Leddy Secretary 1.0 54.0 X 0 843802 126625 Mr Thomas Arnold Treasurer (Eff 7/20) 1.0 54.0 X 0 827550 92917 MR Richard Tanzella CEO (End 12/20) & Board Member 55.0 0.0 X X 630947 0 96127 Dr Geoffrey Cole CMO 55.0 0.0 X 505510 0 27351 Mr Marvin Wynn CFO 30.0 25.0 X 334226 0 31291 Ms Leigha Fallis CNO 40.0 0.0 X 245411 0 21494 Mr Blake Watts CEO (Eff 6/21) & BOARD MEMBER 55.0 0.0 X X 225154 0 30839 Ms Melanie Mcgriff Exec. Dir - Patient Svcs 40.0 0.0 X 194686 0 25491 Ms Amanda Miller DIRECTOR - PHARMACY 40.0 0.0 X 186515 0 17996 Mr Jigneshkumar Shah MANAGER - PHARMACY 40.0 0.0 X 162249 0 27017 Ms Denise Huet PHARMACIST 40.0 0.0 X 155095 0 14103 Dr Neil Edgerton Board Member 1.0 0.0 X 20250 0 0 DR Benetta Duhart Board Member 1.0 0.0 X 18270 640 0 DR Michael P Cecil Board Member 1.0 0.0 X 0 15750 0 MS Ethel R Boyle Board Member 1.0 0.0 X 0 0 0 MR Vince Evans Board Member 1.0 0.0 X 0 0 0 DR Frank Patton Board Member 1.0 0.0 X 0 0 0 MR Al Sadler Sr Board Member 1.0 0.0 X 0 0 0 MR Rick Simons Board Member 1.0 0.0 X 0 0 0 MR Leslie West Board Member 1.0 0.0 X 0 0 0 2678313 5172627 836014 59 false true false WALKER LAKE PHYSICIAN SERVICES PC 1412 MILSTEAD AVE CONYERS GA 30012 HOSPITALIST SERVICES 4011081 MEDICAL SOLUTIONS LLC 1010 NORTH 102ND STREET SUITE 300 OMAHA NE 68114 STAFFING SERVICES 2894040 GREYSTONE OBGYN 3240 AVALON BLVD CONYERS GA 30013 OB/GYN SERVICES 1098000 TOTAL RENAL CARE INC 601 HAWAII ST EL SEGUNDO CA 90245 DIALYSIS 877827 INSIGHT HEALTH CORPORATION 26250 Enterprise Court LAKE FOREST CA 92360 DIAGNOSTIC IMAGING 440896 13 5350000 12393 5362393 PATIENT SERVICE REVENUE 622110 207242464 207242464 OTHER OPERATING REVENUE 900099 1242046 1242046 208484510 136894 136894 0 0 398810 398810 0 398810 398810 1000 1000 1000 1000 0 0 0 0 0 0 0 0 0 CAFETERIA SALES 722310 445633 445633 FEE REVENUE 900099 7905 7905 453538 214837145 208492415 982337 0 0 0 0 1418797 340962 1077835 0 0 77071046 68951454 8119592 0 11360116 9918859 1441257 4571059 3925626 645433 0 74398 74398 0 0 0 0 14696978 11954447 2742531 350147 27911 322236 9758368 7396688 2361680 3040944 2305036 735908 0 2350013 2180902 169111 1585 990 595 0 0 1850618 1850618 6421771 6421771 5253947 4884391 369556 2441869 1827271 614598 DRUGS & MEDICAL SUPPLIES 30355135 30355135 BAD DEBT EXPENSE 23294753 23294753 HOSPITAL TAX 694676 694676 ADMINISTRATIVE EXPENSES 7741589 4517805 3223784 202747809 172576906 30170903 0 108511 34842 0 0 0 0 23331811 27579874 0 0 0 0 0 0 3369604 3588418 480906 203120 62376485 15469287 46558537 46907198 0 0 0 0 0 0 0 0 27738580 27699066 101587949 106012518 10624419 12753106 0 0 0 0 75432905 74701863 0 0 0 0 0 0 0 0 14819172 7413830 100876496 94868799 X 701911 11152853 9542 -9134 711453 11143719 101587949 106012518 X 12089336 -1657070 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3958141 3958141 35704841 5385771 30319070 18572092 9617363 8954729 4141411 466153 3675258 46907198 GOODWILL 27153139 UNAMORTIZED ISSUE COST 545927 27699066 0 INTERUNIT PAYABLE 556275 MEDICARE PAYABLE 2475443 GRANT PAYABLE 29116 LEASE PAYABLE 1375602 RECOUPMENTS PAYABLE 2977394 7413830 X SCHEDULE D, PART X, LINE 2: ASC 740 FOOTNOTE (FKA FIN 48) PHC 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. true true X true X 300. true X true true false true true 9222433 9222433 0.05140 8375744 7311360 1064384 0.00590 1583194 517050 1066144 0.00590 19181371 7828410 11352961 0.06320 222000 222000 0.00120 747840 747840 0.00420 352500 352500 0.00200 1322340 1322340 0.00740 20503711 7828410 12675301 0.07060 true 8837489 30194004 28806159 1387845 X true true 1 1 PIEDMONT ROCKDALE HOSPITAL INC 1412 MILSTEAD AVENUE CONYERS GA 30012 WWW.PIEDMONT.ORG 122-726 X X X 1 PIEDMONT ROCKDALE HOSPITAL INC 1 false false true X X X X X X X X 18 true true false true X SEE PART VI X X true 19 true SEE PART VI false true X 300. 300. X true true X X X X true X SEE PART VI X SEE PART VI X SEE PART VI X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, LINE 5: COMMUNITY REPRESENTATION As 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, 16 key stakeholders within the Piedmont Rockdale 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 Newton 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/PRH-FY19-CHNA-Strategy.pdf SCHEDULE H, PART V, LINE 7D: PUBLIC AVAILABILITY OF CHNA IN ADDITION TO MAKING ITS CHNA REPORTS AVAILABLE ON ITS WEBSITE AND BY REQUEST, PIEDMONT 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 STRATEGY THE BOARD OF DIRECTORS FOR PIEDMONT ROCKDALE HOSPITAL, INC. UNANIMOUSLY APPROVED ITS IMPLEMENTATION STRATEGY FOR THE THREE YEAR PERIOD BEGINNING WITH FY20 ON OCTOBER 17, 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. THE IMPLEMENTATION IS CONTAINED FOLLOWING THE COMMUNITY HEALTH NEEDS ASSESSMENT IN THE LINK BELOW. https://www.piedmont.org/media/file/PRH-FY19-CHNA-Strategy.pdf SCHEDULE H, PART V, LINE 11: ADDRESSING COMMUNITY HEALTH NEEDS WHEN PIEDMONT HEALTHCARE, INC. FIRST ACQUIRED THE ASSETS OF PIEDMONT ROCKDALE HOSPITAL, INC., THE HOSPITAL HAD A GRACE PERIOD FOR PIEDMONT HEALTHCARE TO PREPARE AND APPROVE A COMMUNITY HEALTH NEEDS ASSESSMENT FOR PIEDMONT ROCKDALE HOSPITAL. THE INITIAL CHNA FOR PIEDMONT ROCKDALE HOSPITAL WAS UNANIMOUSLY APPROVED BY ITS BOARD OF DIRECTORS ON APRIL 18, 2019. BASED ON THE CHNA, PIEDMONT ROCKDALE HOSPITAL WILL FOCUS ON: (1) TO MAINTAIN AND, WHEN POSSIBLE, INCREASE ACCESS TO NECESSARY AND AFFORDABLE CARE FOR LOW TO NO INCOME PATIENTS; (2) REDUCE PREVENTABLE READMISSIONS AND EMERGENCY DEPARTMENT RE-ENCOUNTERS; (3) INCREASE ACCESS TO AND AWARENESS OF BREAST AND LUNG CANCER-RELATED PROGRAMMING; AND (4) REDUCE PREVENTABLE INSTANCES OF HEART DISEASE, HYPERTENSION, AND STROKE. SCHEDULE H, PART V, LINE 16: FINANCIAL ASSISTANCE WEBSITES FINANCIAL 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 SCHEDULE H, PART VI, LINE 1: REQUIRED DISCLOSURES PUBLIC 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 $202,747,809, LESS BAD DEBT EXPENSE OF $23,294,753 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. PRH 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 ASSESSMENT As 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 to appropriate and affordable health 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 and breast cancer . Promote healthy weights and behaviors as to decrease preventable instances of heart disease and diabetes . 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. The CHNA was unanimously approved by our board of directors on April 18, 2019. 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 CHNA implementation strategy was unanimously approved October 17, 2019. SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ASSISTANCE ELIGIBILITY We 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 INFORMATION We are in Rockdale County, where an average 89,717 people lived in the 129.81 square mile area each year between 2015 and 2019. The population density for this area, estimated at 691.13 persons per square mile, is greater than the national average population density of 94 people per square mile. Rockdale County is 85 percent urban and 15 percent is rural. The median age of people living within Rockdale County was 38. Twenty-five percent of the population were 18 or younger, 61 percent were over the age of 65, and 61 percent were between ages 18-64. In Rockdale County, 10 percent of the population over 18 identify as a veteran and 11 percent of those identified as have a disability. About 6 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 10 percent of the population were born outside of the United States and are considered foreign born while 4 percent do not hold US citizen status. This data point does not include individuals who may hold Green Card permissions. Three percent of adults were unemployed in 2021. Between 2015 and 2019, the median income was $60,189 and the per capita income was $28,319. Thirteen percent of Rockdale County lived in poverty between 2015 and 2019. During that same period, 21 percent of children in Rockdale County lived in poverty, a figure that has steadily increased over the last ten years. It is significantly higher than the state average of 18.5 percent. Nearly 70 percent of public-school children were eligible for the free or reduced priced lunch program during the 2018-2019 school year, which is higher than the 2014-15 state average of 62 percent. Twenty-two percent of the population has, at a minimum, attended some college, and 36 percent obtained an associate degree or higher. Thirty-two percent of the population graduated high school only and 11 percent did not graduate high school. The Rockdale County graduation rate (ACGR) during 2015-2019 was 83 percent. Between 2015 and 2019, there were about 10 percent of young people not enrolled in school and were also unemployed. In Rockdale County, between 2015 and 2019, there were 31,076 households, and about a third of those were occupied by renters. Of all households in in Rockdale County, 48 percent were married family households. The percent of all households with children in Rockdale County was 38 percent and married family households with children was 21 percent. During 2016, the eviction filing rate was 22 percent and the eviction rate was 7 percent. Nearly a third of households had housing costs that exceeded more than 30 percent of total household income between 2015 and 2019, indicating a cost burdened household that's more likely to face overall financial difficulty. Renters are most likely to be cost burdened, with nearly half facing substantial difficulty. In Rockdale County, 14 percent of county residents were uninsured between 2015 and 2019, and minorities were twice as likely as their white counterparts to be uninsured. Roughly 18 percent of the population received SNAP benefits. For every 1,000 teen girls aged 15 to 18 in Rockdale County, roughly 19 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, 10 percent of all live births were considered low birth weight births. In 2019, there were nine recreation and fitness facilities per 100,000 people. There were 104 fast food restaurants in Rockdale County in 2019 and 27 percent of census tracts (four tracts) in Rockdale 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 21 grocery store establishments per 100,000 people in Rockdale County and 10 retailers per 10,000 people that were SNAP-authorized food stores. Various health behavior indicators showed that 14 percent of adults reported excessive drinking of alcohol and 14 percent binge drinking in the last 30 days. In 2018, about 18 percent of adults were current smokers. There were nearly 23 percent of adults who reported not having enough time for leisure activities. In Rockdale County, the cancer incidence rate was at 474 incidences per 100,000 people, on average each year, between 2014 and 2018. Prostate cancer had the highest incidence rate during this period at 151 incidences per 100,000 people and 74 new cases annually, on average. Next, breast cancer had incidence rate at 136 incidences per 100,000 people and 77 new cases annually, on average. Lung and bronchus cancer had an incidence rate of 52 incidences per 100,000 people and 51 new cases annually, on average. Colon and rectum cancer had an incidence of 43 incidences per 100,000 people and 41 new cases annually, on average. Lastly, melanoma of the skin had an incidence of 21 incidences per 100,000 people and 22 new cases annually, on average. In Rockdale 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 2017 and 2019, there were 1,213 premature deaths and 21,141 years of potential life lost. Additionally, 32 percent of adults had a BMI higher than 39. indicating obesity. In 2021, Rockdale County reported 11,856 COVID-19 and 250 COVID-19 related deaths. In Rockdale County, about 24 percent of adults were fully vaccinated and 15 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. Rockdale County had a vaccine coverage index of 0.50 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, and the Georgia Online Analytical Statistical Information System. SCHEDULE H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH In FY21, we actively promoted the health of our community through our 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, 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. It's important to note that COVID-19 significantly impacted our 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 our migration to online platforms for vital community-based programming. In FY21, we worked to ensure patients at not-for-profit charitable clinic Mercy Heart have access to the care needed to get - and stay - healthy. Many staff members volunteer time at the clinic. Additionally, we donated funds money to organizations supporting Mercy Heart and provided referrals to the clinic. We created a patient and family advisory council to provide meaningful input on critical areas of care. Despite challenges faced by COVID-19, we met quarterly by WebEx and created ways to enhance communication with patients, family members, and the care team when needing to limit or restrict visitors. We purchased iPads for the Patient Experience Team to help allow the parties to communicate via facetime. Sadly, the council has lost several members to COVID-19. We made reducing opioid and related substance abuse and overdose deaths a priority by providing meaningful leadership in the community by partnering with others in combating opioid abuse. We promoted national Take-Back Day through media advertisement of drug disposal locations in the community and encouraged patients at discharge to properly dispose of medications. We worked with local law enforcement and pharmacies to maintain the disposal bins. We pharmacy hosted an education session on the importance of locking medication safely away from children. We created a free Mammogram Voucher Program (MVP) to underserved and underinsured women. We regularly offer donations to the Kim Atkins Foundation, and in return, the foundation has provided wigs, hats, and scarves for cancer patients free of cost. We reduced cultural barriers to cancer prevention and education for the Hispanic/Latino community. Currently, we have two Spanish-speaking providers. These providers have held numerous town hall events for the Latino community, focusing on the importance of the COVID-19 vaccine and general health and wellbeing. One provider has received an award from a local Latinx organization for their work with these populations. We made promoting healthy weight and behaviors to decrease preventable instances of heart disease and diabetes a priority by building and engaging community-based partnerships to identify and eliminate potential barriers to healthy weights and behaviors. We encouraged and promoted events in the community for physical activity and being outside and social in a fun way by being a stakeholder in the Live Well Rockdale effort. Events include little league sports, 5K marathons, and local farmers' markets. We have also partnered with local restaurants to highlight healthier choices at restaurants. We worked to reduce barriers to heart disease prevention and education for the Hispanic/Latino community. Our Spanish-speaking providers have participated in virtual Lunch & Learn with the community and town halls to discuss health topics. We developed a new prescription program for low-income patients. We provide vouchers for healthy foods at a local Farmer's Market or food bank. Local food pantries have increased their response and focus on healthy eating, and our providers have volunteered time to help pack bags and deliver them to families in the community. We provided staff and other resources to administer COVID-19 vaccines to the community and first responders and advised community groups to return to work and hold community meetings safely. Our providers have given information and advice to local school systems on safely returning to the classroom and vaccines for kids. We donated hand sanitizer to groups holding in-person events and encouraging COVID safety precautions. We hosted monthly Lunch & Learns with the community, and more than 60 participants attended. We provided flu vaccine clinics to businesses and hosted virtual diabetes and healthy eating Lunch & Learns with our diabetes educator. SCHEDULE H, PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM We 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 REPORT We are not required to file a community benefit report, however, we are required to file with the Georgia Department of Community Health information on our indigent and charity care, as well as our Medicaid and Medicare shortfalls. X true true false true false false false false false false false MR J Michael Burnett Board Member 0 508307 0 374282 0 140345 0 99024 0 20865 0 1142823 0 81924 DR Leigh Hamby Board Member 0 594907 0 418830 0 163285 0 112971 0 19776 0 1309769 0 92157 MR Richard Tanzella CEO (End 12/20) & Board Member 386797 0 208002 0 36148 0 82704 0 13423 0 727074 0 0 0 Mr Blake Watts CEO (Eff 6/21) & BOARD MEMBER 184906 0 39816 0 432 0 11742 0 19097 0 255993 0 0 0 Mr Marvin Wynn CFO 229720 0 89477 0 15029 0 17100 0 14191 0 365517 0 0 0 Dr Geoffrey Cole CMO 352427 0 123398 0 29685 0 17100 0 10251 0 532861 0 0 0 Ms Leigha Fallis CNO 178880 0 65288 0 1243 0 10370 0 11124 0 266905 0 0 0 Ms Amanda Miller DIRECTOR - PHARMACY 163138 0 22866 0 511 0 11389 0 6607 0 204511 0 0 0 Ms Melanie Mcgriff Exec. Dir - Patient Svcs 158785 0 34325 0 1576 0 0 0 25491 0 220177 0 0 0 Mr Jigneshkumar Shah MANAGER - PHARMACY 151455 0 10794 0 0 0 10237 0 16780 0 189266 0 0 0 Ms Denise Huet PHARMACIST 118492 0 450 0 36153 0 7571 0 6532 0 169198 0 0 0 Mr Michael McAnder Treasurer (End 7/20) 0 357162 0 0 0 927767 0 66931 0 5196 0 1357056 0 498228 Mr Thomas Arnold Treasurer (Eff 7/20) 0 424857 0 245916 0 156777 0 79670 0 13247 0 920467 0 62570 Ms Elizabeth Leddy Secretary 0 459494 0 335067 0 49241 0 109035 0 17590 0 970427 0 0 SCHEDULE J, PART I, LINE 1A: DISCRETIONARY SPENDING RICHARD TANZELLA, DR. LEIGH HAMBY, ELIZABETH LEDDY, THOMAS ARNOLD AND J. MICHAEL BURNETT RECEIVED A DISCRETIONARY SPENDING ACCOUNT TOTALING $12,000, A FIXED AMOUNT DETERMINED BY THEIR JOB LEVEL. MICHAEL MCANDER RECEIVED A DISCRETIONARY SPENDING AMOUNT TOTALING $7,385. THIS SPENDING ACCOUNT WAS INCLUDED IN THEIR TAXABLE WAGES. SCHEDULE J, PART I, LINE 3: COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR THE COMPENSATION FOR THE PRESIDENT/CEO OF PIEDMONT ROCKDALE 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 COMPENSATION INFORMATION J. MICHAEL BURNETT RECEIVED A PAYMENT OF $81,924 FROM HIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. DR. LEIGH HAMBY RECEIVED A PAYMENT OF $92,157 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: ELIZABETH LEDDY RICHARD TANZELLA SCHEDULE J, PART I, LINE 7: NON-FIXED PAYMENTS CERTAIN EMPLOYEES PARTICIPATED IN AN "ANNUAL INCENTIVE PLAN" UNDER WHICH THEY RECEIVED NON-FIXED BONUS PAYMENTS BASED ON JOB LEVEL AND SEVERAL DIFFERENT PERFORMANCE METRICS. A Development Authority of Rockdale County 521338356 773008BN6 2019-11-07 64565000 NEW ASSET PURCHASE false false false A 0 0 75851774 0 0 0 0 0 0 0 75851774 0 2019 false false true true A false false false false 0.01000 0.01000 false false false true A false true false false false false 0 false 0 false true A true FORM 990, PART V, LINE 1A: NUMBER OF FORMS 1099 FILED ALL CALENDAR YEAR 2020 FORMS 1099 WERE FILED ON BEHALF OF PIEDMONT ROCKDALE 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 MEMBER PIEDMONT HEALTHCARE, INC., (EIN 58-1503902) IS THE SOLE MEMBER OF PIEDMONT ROCKDALE HOSPITAL ("PRH"). FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF GOVERNING BODY THE BOARD OF PIEDMONT HEALTHCARE, PIEDMONT ROCKDALE HOSPITAL'S SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF PIEDMONT ROCKDALE HOSPITAL. FORM 990, PART VI, SEC A, LINE 7B: DECISIONS OF GOVERNING BODY PIEDMONT ROCKDALE 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 ROCKDALE 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, SECTION B, LINE 11B: 990 REVIEW PROCESS INFORMATION NEEDED TO PREPARE PIEDMONT ROCKDALE HOSPITAL'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PRH'S CONTROLLER AND VP/CFO. THE 990 IS THEN PREPARED INTERNALLY BY PIEDMONT HEALTHCARE, INC.'S TAX DEPARTMENT AND SUBMITTED TO AN EXTERNAL TAX PREPARER FOR REVIEW. PRIOR TO FILING, COPIES OF FORM 990 ARE PROVIDED TO THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC., THE ORGANIZATION'S SOLE MEMBER, FOR BOARD REVIEW. FORM 990, PART VI, SECTION B, LINE 12C: CONFLICT OF INTEREST 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 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 COMPENSATION COMPENSATION FOR EXECUTIVES OF PIEDMONT ROCKDALE 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 DOCUMENTS 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: RECONCILIATION OF NET ASSETS CHANGES TO NET ASSETS REPORTED ON PART XI, LINE 9 ARE COMPRISED OF: CHANGE IN TEMP ($18,675) INTERCOMPANY TRANSFERS $4,494,297 UNALLOCATED EXPENSES ($6,140,373) GRANT REVENUE $1,024 CHANGE IN UNRESTRICTED $6,659 ------------------ TOTAL ($1,657,068) PIEDMONT HEALTHCARE INC 1800 HOWELL MILL ROAD SUITE 850 ATLANTA GA 30318 581503902 MANAGEMENT GA 501(c)(3) 12C, III-FI NA 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 582322328 HOSPITAL GA 501(C)(3) 3 PHC false PIEDMONT MOUNTAINSIDE HOSPITAL INC 1266 HIGHWAY 515 SOUTH JASPER GA 30143 352228583 HOSPITAL GA 501(C)(3) 3 PHC false PIEDMONT HENRY HOSPITAL INC 1133 EAGLES LANDING PKWY STOCKBRIDGE GA 30281 582200195 HOSPITAL GA 501(C)(3) 3 PHC false PIEDMONT HEART INSTITUTE INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 263553500 HEALTHCARE GA 501(C)(3) 10 PHC false PIEDMONT NEWNAN HOSPITAL INC 745 POPLAR ROAD NEWNAN GA 30265 205077249 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 HEALTHCARE FOUNDATION INC 2001 PEACHTREE ROAD NE SUITE 400 ATLANTA GA 30309 581272768 FUNDRAISING GA 501(C)(3) 12B, II PHC false PIEDMONT ATHENS REGIONAL FOUNDATION INC 1199 PRINCE AVENUE ATHENS GA 30606 581978389 FUNDRAISING GA 501(c)(3) 12B, II ARMC false PIEDMONT ATHENS REGIONAL HEALTH RESOURCE 1199 PRINCE AVENUE ATHENS GA 30606 581930580 DEVELOPMENT GA 501(C)(3) 12B, II ARMC false PIEDMONT ATHENS REGIONAL MEDICAL CENTER 1199 PRINCE AVENUE ATHENS GA 30606 582179986 HOSPITAL GA 501(C)(3) 3 PHC false ATHENS REGIONAL PHYSICIAN SERVICES INC 1199 PRINCE AVENUE ATHENS GA 30606 582332921 HEALTHCARE GA 501(C)(3) 12B, II ARMC false ATHENS REGIONAL SPECIALTY SERVICES INC 1199 PRINCE AVENUE ATHENS GA 30606 271975001 HEALTHCARE GA 501(C)(3) 3 ARMC false REGIONAL FIRSTCARE INC 1199 PRINCE AVENUE ATHENS GA 30606 582362733 URGENT CARE GA 501(C)(3) 12B, II ARMC false COLUMBUS AMBULATORY HEALTHCARE SERVICES 707 CENTER ST COLUMBUS GA 31901 581719867 AMBULATORY GA 501(C)(3) 3 crhs false COLUMBUS REGIONAL HEALTHCARE SYSTEM INC 707 CENTER ST COLUMBUS GA 31901 581719994 HEALTHCARE GA 501(C)(3) 12B, II PHC false COLUMBUS REGIONAL MEDICAL FOUNDATION INC 707 CENTER ST COLUMBUS GA 31901 581501642 FUNDRAISING GA 501(C)(3) 7 crhs false THE MEDICAL CENTER INC 710 CENTER ST COLUMBUS GA 31901 581685139 HOSPITAL GA 501(c)(3) 3 crhs false HUGHSTON HOSPITAL INC 707 CENTER ST COLUMBUS GA 31901 331216751 HOSPITAL GA 501(C)(3) 3 crhs false PIEDMONT WALTON HOSPITAL INC 2151 WEST SPRING ST MONROE GA 30655 824194264 HOSPITAL GA 501(C)(3) 3 PHC false PIEDMONT CARTERSVILLE HOSPITAL INC 960 JOE FRANK HARRIS PKWY SE CARTERSVILLE GA 30120 870963633 hospital GA 501(C)(3) 3 PHC false PIEDMONT EASTSIDE HOSPITAL INC 1700 MEDICAL WAY SNELLVILLE GA 30078 870982886 HOSPITAL GA 501(C)(3) 3 PHC false PIEDMONT MACON HOSPITAL INC 350 HOSPITAL DR MACON GA 31217 871006981 HOSPITAL GA 501(C)(3) 3 PHC false PIEDMONT MACON NORTH HOSPITAL INC 400 CHARTER BLVD MACON GA 31210 871031034 HOSPTIAL GA 501(C)(3) 3 PHC false COLUMBUS REGIONAL SENIOR LIVING INC 707 CENTER ST COLUMBUS GA 31901 582628502 HEALTHCARE GA 501(C)(3) 12C, III-FI PHC false PEACHTREE ORTHOPAEDIC SURGERY CENTER 2001 PEACHTREE RD NE STE 705 ATLANTA GA 30309 582562721 ORTHOPAEDIC GA NA N/A 0 0 false 0 false 0.00000 DIGESTIVE HEALTHCARE OF GA ENDOSCOPY CEN 95 COLLIER RD NW STE 4075 ATLANTA GA 30309 582406657 HEALTHCARE GA NA N/A 0 0 false 0 false 0.00000 PIED URG CARE WELL 3350 RIVERWOOD PKWY STE 1850 ATLANTA GA 30339 841916875 urgent care GA NA N/A 0 0 false 0 false 0.00000 GEORGIA HEALTH COLLABORATIVE LLC 2727 PACES FERRY RD BLDG 2 STE 70 ATLANTA GA 30339 461500639 HEALTHCARE GA NA N/A 0 0 false 0 false 0.00000 PIEDMONT MEDICAL CARE CORPORATION 2727 PACES FERRY RD STE 1-1100 ATLANTA GA 30339 582092768 HEALTHCARE GA PHC C CORP 0 0 0.00000 false THE PIEDMONT CLINIC INC 2727 PACES FERRY RD STE 1-1100 ATLANTA GA 30339 582005358 HEALTHCARE GA PHC C CORP 0 0 0.00000 false PIEDMONT HEART INSTITUTE PHYSICIANS INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 260593850 HEALTHCARE GA PHC C CORP 0 0 0.00000 false AMSTER MCRAE INSURANCE COMPANY PO BOX 1159 GRAND CAYMAN CJ KY1-1102 980427603 RELATED INSUR CJ PHC C CORP 0 0 0.00000 false PIEDMONT WELLSTAR HEALTHPLANS INC 2859 PACES FERRY RD STE 600 ATLANTA GA 30339 461922499 HEALTH INSUR. 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