2025-06-11T11:05:17-04:00 2024-07-31 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2023-08-01 383647394 PHOEBE WORTH MEDICAL CENTER INC PHOE 2297766961 807 SOUTH ISABELLAPO BOX 545 SYLVESTER GA 317910545 CANDACE GUARNIERI VP OF FINANCE, PWMC 2297766961 2025-06-11 true false STEPHEN D HARRELL P01554887 2298837878 2025-06-09 X 2023 2025-03-06 01:10:19Z KIM GILMAN PO BOX 545 SYLVESTER GA 317910545 25694170 false X WWW.PHOEBEHEALTH.COM X 2002 GA WE EMPOWER EVERY MEMBER OF THE PHOEBE FAMILY TO SAFEGUARD THE HEALTH OF OUR COMMUNITIES - EMBRACING A CULTURE THAT DELIVERS GREAT PATIENT EXPERIENCES, INNOVATIVE TREATMENTS, AND ACCESS TO SUPERIOR CARE. 8 5 229 8 18351 12350 1233382 772615 23006538 24076110 9069 17722 468269 807869 24717258 25674316 45619 58331 0 8918974 9802084 0 0 11940106 11782510 20904699 21642925 3812559 4031391 19105949 20251737 15503209 12617606 3602740 7634131 WE EMPOWER EVERY MEMBER OF THE PHOEBE FAMILY TO SAFEGUARD THE HEALTH OF OUR COMMUNITIES - EMBRACING A CULTURE THAT DELIVERS GREAT PATIENT EXPERIENCES, INNOVATIVE TREATMENTS, AND ACCESS TO SUPERIOR CARE. false false 16364442 58331 24656519 TO BE THE LEADING PROVIDER OF QUALITY, COST EFFECTIVE, PATIENT-CENTERED HEALTH CARE SERVICES TO ALL RESIDENTS OF SOUTHWEST GEORGIA. PWMC PURSUES ITS MISSION THROUGH A PATIENT-CENTERED ENVIRONMENT OF CARE REFLECTING HIGH STANDARDS AND PROMOTING A BALANCE OF PROFESSIONAL PREPARATION AND SERVICE, CONTINUOUS IMPROVEMENT BASED ON OUR CORE VALUES OF PEOPLE, RELATIONSHIPS, REPUTATION, EXCELLENCE, EFFICIENCY AND COMMITMENT. FOR FURTHER INFORMATION, PLEASE SEE SCHEDULE H PART VI COMMUNITY INFORMATION SECTION. 16364442 true true false true false false false false false false true false false false true true true true false false false false false false false false true true true false true false false false false false false false false false false false false false true false false false true 23 0 229 true true true false false false false false false false false false false false X 8 5 false false false false true true true true true false false true true true true true true false false false GA X X CANDACE GUARNIERI 2297766961 PO BOX 545 SYLVESTER GA 317910545 SCOTT STEINER BD MBR/PPHS 1.00 55.00 X X 0 1644766 288557 BRIAN CHURCH BD MBR/PPHS 1.00 55.00 X X 0 851457 188268 DAWN BENSON SVP- GENERAL 1.00 52.00 X 0 655137 76877 JOE AUSTIN PPMH CEO 40.00 X 0 567757 0 KIM GILMAN PRESIDENT. P 50.00 X 0 362632 80131 CANDACE GUARNIERI VP OF FINANC 50.00 X 0 187193 44798 KELLY DORMINEY TEAM LEAD/AC 40.00 X 164221 0 34988 BENJAMIN LEE HUDSON PHARMACIST 40.00 X 169529 0 27171 STACEY BARBEE DIR BUS/CLIN 40.00 X 0 150795 31673 TAMMY HOLLOWAY RN/TEAM LEAD 40.00 X 143618 0 18667 LAURIE MARTIN PHYSICAL THE 40.00 X 141435 0 4050 DAWN BEAN EC RN-PWMC E 40.00 X 118311 0 14904 GRACE DAVIS MD BOARD MEMBER 1.00 40.00 X 0 122853 0 JOHNNY COCHRAN VICE CHAIR 1.00 0.00 X X 0 0 0 MARY KING GIVENS BOARD MEMBER 1.00 1.00 X 0 0 0 JOHN A NESMITH JR BOARD MEMBER 1.00 0.00 X 0 0 0 DON MONK CHAIRMAN 1.00 1.00 X X 0 0 0 CHRIS SHIPP BOARD MEMBER 1.00 0.00 X 0 0 0 737114 4542590 810084 10 true true false POWELL CONTRACT SERVICES PO BOX 84 SYLVESTER GA 31791 CONSTRUCTION 1773475 MEDICAL SOLUTIONS LLC P O BOX 310737 DES MOINES IA 503310737 CONTRACT STAFF 211868 ALLY HEALTHCARE STAFFING PO BOX 393 GRAY GA 31032 CONTRACT STAFF 121060 3 110350 6000 656265 772615 NET PATIENT SERVICE REVENUE 623000 24057759 24057759 REFERENCE LAB 621500 18351 18351 24076110 17722 17722 39360 19854 19506 19506 19506 340B PHARMACY 621990 569171 569171 CAFETERIA 722514 176889 176889 MISCELLANEOUS REVENUES 621990 21299 21299 21004 8290 12714 788363 25674316 24656519 18351 226831 X 55000 55000 3331 3331 7567282 6537265 1030017 148574 128368 20206 1530321 1310191 220130 555907 481570 74337 90690 90690 6155953 4018012 2137941 7397 7397 907183 861347 45836 -3682 -3682 351729 199142 152587 17578 5562 12016 15768 12283 3485 974198 550048 424150 712378 35619 676759 MEDICAL SUPPLIES 1169290 1169290 REPAIRS & MAINTENANCE 615244 488866 126378 CLINIC LOSS 302632 255495 47137 MISCELLANEOUS 252529 155663 96866 213623 97390 116233 21642925 16364442 5278483 0 7964037 7344807 2769496 4014758 237919 238888 144335 148565 19824444 11333569 7973073 8490875 17089 13844 19105949 20251737 2063609 1655194 379035 273888 13060565 10688524 15503209 12617606 X 3602740 7634131 3602740 7634131 19105949 20251737 4031391 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 6309 6309 false SCHEDULE C, PART II-B, LINE 1 PART II-B, LINE 1I THE ORGANIZATION PAYS MEMBERSHIP DUES TO A NATIONAL HEALTHCARE ORGANIZATION. A PORTION OF THOSE DUES IS ALLOCATED TO LOBBYING ACTIVITIES IN WHICH THE NATIONAL HEALTHCARE ORGANIZATION PARTICIPATE. 175676 175676 8743036 3779455 4963581 10616572 7554114 3062458 289160 289160 8490875 DUE TO PHOEBE PUTNEY HEALTH SYSTEM 10124895 THIRD PARTY SETTLEMENTS 563629 10688524 X 25694170 25694170 -19854 -19854 25674316 21662779 19854 19854 21642925 21642925 SCHEDULE D, PAGE 3, PART X THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE HOSPITAL ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEETS FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF JULY 31, 2024 AND 2023 OR FOR THE YEARS THEN ENDED. THE HOSPITAL'S TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAXING AUTHORITIES. FOR FEDERAL INCOME TAX PURPOSES, THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. SCHEDULE D, PAGE 4, PART XI, LINE 4B RENTAL EXPENSES -19,854 SCHEDULE D, PAGE 4, PART XII, LINE 2D RENTAL EXPENSES 19,854 true true X true X true X true true false true true 2200817 2200817 0.10160 3133450 3731737 5334267 3731737 2200817 0.10160 41096 41096 0.00190 50043 50043 0.00230 7569095 6839321 729774 0.03370 67398 67398 0.00310 7727632 6839321 888311 0.04100 13061899 10571058 3089128 0.14260 true 4517692 3192080 3218108 -26028 X true true 1 1 PHOEBE WORTH MEDICAL CENTER INC 807 S ISABELLA STREET SYLVESTER GA 31791 WWW.PHOEBEHEALTH.COM 159-603 X X X X SWB, SNF PHOEBE WORTH MEDICAL CENTER INC 1 false false true X X X X X X X X X X 22 true false false true X WWW.PHOEBEHEALTH.COM X true 22 true WWW.PHOEBEHEALTH.COM false false true X 200.000000000000 400.000000000000 X X X X X true true X X X X true X WWW.PHOEBEHEALTH.COM X WWW.PHOEBEHEALTH.COM X WWW.PHOEBEHEALTH.COM X X X X X X true X false X X X X X true X false false FACILITY 1, PHOEBE WORTH MEDICAL CENTER, INC. - PART V, LINE 3E PHOEBE WORTH MEDICAL CENTER (PWMC) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN COMPLIANCE WITH THE PROVISIONS OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA). THAT LAW REQUIRES ALL NON-PROFIT HOSPITALS IN THE UNITED STATES TO CONDUCT A CHNA EVERY THREE YEARS TO IDENTIFY HEALTH PRIORITIES AND ADOPT AN IMPLEMENTATION STRATEGY TO MEET THE IDENTIFIED COMMUNITY HEALTH NEEDS. THE ASSESSMENT PROCESS REQUIRES HOSPITALS TO GATHER AND UTILIZE INPUT FROM INDIVIDUALS WHO REPRESENT A BROAD INTEREST OF THE COMMUNITY SERVED, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH. THIS WORK RESULTED IN IDENTIFYING THREE PRIORITIES THAT WERE APPROVED BY THE PWMC BOARD OF DIRECTORS AT THEIR MEETING ON JULY 28, 2022. THOSE PRIORITIES ARE: 1. MENTAL HEALTH & MENTAL DISORDERS 2. DIABETES MANAGEMENT AND PREVENTION 3. ACCESS TO & QUALITY OF HEALTHCARE SERVICES FACILITY 1, PHOEBE WORTH MEDICAL CENTER, INC. - PART V, LINE 5 TO ENSURE THE PERSPECTIVES OF COMMUNITY MEMBERS WERE CONSIDERED, INPUT WAS COLLECTED FROM THE SERVICE AREA COUNTY OF PHOEBE WORTH. PRIMARY DATA USED IN THIS ASSESSMENT CONSISTED OF AN ONLINE COMMUNITY SURVEY, FOCUS GROUP, AND KEY INFORMANT INTERVIEWS. THE FINDINGS FROM THIS DATA EXPANDED UPON INFORMATION GATHERED FROM THE SECONDARY DATA ANALYSIS TO INFORM THIS COMMUNITY HEALTH NEEDS ASSESSMENT. COMMUNITY INPUT WAS COLLECTED VIA AN ONLINE COMMUNITY SURVEY AVAILABLE IN ENGLISH AND SPANISH, AS WELL AS PAPER COPIES AVAILABLE, FROM MAY 2022 THROUGH JUNE 2022. THE SURVEY CONSISTED OF 56 QUESTIONS RELATED TO TOP HEALTH NEEDS IN THE COMMUNITY, INDIVIDUALS PERCEPTION OF THEIR OVERALL HEALTH, INDIVIDUALS ACCESS TO HEALTHCARE SERVICES, AS WELL AS SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH. THE SURVEY WAS SHARED VIA HEALTH SYSTEMS WEBSITES, SOCIAL MEDIA, EMAIL DISTRIBUTION, AND OTHER LOCAL COMMUNITY PARTNERS. PAPER COPIES WERE ALSO DISTRIBUTED AT SEVERAL COMMUNITY OUTREACH EVENTS AND DIRECTLY TO PATIENTS AT PHOEBE HEALTH SYSTEM VIA QR CODE OR CARE COORDINATION TEAM MEMBERS. A TOTAL OF 428 RESPONSES WERE COLLECTED. WORTH COUNTY HAD 35 SURVEY RESPONDENTS. THE PROJECT TEAM DEVELOPED A FOCUS GROUP GUIDE MADE UP OF A SERIES OF QUESTIONS AND PROMPTS ABOUT THE HEALTH AND WELL-BEING OF RESIDENTS IN THE PHOEBE WORTH SERVICE AREA. THE GUIDE CAN BE FOUND IN APPENDIX B OF THE CHNA. ALL PARTICIPANTS VOLUNTEERED. PARTICIPANTS WERE ASKED TO SPEAK TO BARRIERS AND ASSETS TO THEIR HEALTH AND ACCESS TO HEALTHCARE. A TOTAL OF 15 PARTICIPANTS TOOK PART IN THE KEY LEADER FOCUS GROUP, WHICH EACH LASTED APPROXIMATELY 45-60 MINUTES. FACILITATORS IMPLEMENTED TECHNIQUES TO ENSURE THAT EVERYONE WAS ABLE TO PARTICIPATE IN THE DISCUSSIONS. HCI CONSULTANTS CONDUCTED KEY INFORMANT INTERVIEWS TO COLLECT COMMUNITY INPUT. INTERVIEWEES WHO WERE ASKED TO PARTICIPATE WERE RECOGNIZED AS HAVING EXPERTISE IN PUBLIC HEALTH, SPECIAL KNOWLEDGE OF COMMUNITY HEALTH NEEDS, AND/ OR REPRESENTED THE BROAD INTEREST OF THE COMMUNITY SERVED BY THE HOSPITALS AND HEALTH DEPARTMENTS, AND/OR COULD SPEAK TO THE NEEDS OF MEDICALLY UNDERSERVED OR VULNERABLE POPULATIONS. A TOTAL OF 18 KEY INFORMANT INTERVIEWS WERE CONDUCTED DURING APRIL 2022-MAY 2022. SECONDARY DATA USED FOR THIS ASSESSMENT WERE COLLECTED AND ANALYZED WITH THE CONDUENT HEALTHY COMMUNITIES INSTITUTE (HCI) COMMUNITY DASHBOARD A WEB-BASED COMMUNITY HEALTH PLATFORM DEVELOPED BY CONDUENT COMMUNITY HEALTH SOLUTIONS. THE COMMUNITY DASHBOARD BRINGS DATA, LOCAL RESOURCES, AND A WEALTH OF INFORMATION TO ONE ACCESSIBLE, USER-FRIENDLY LOCATION. IT INCLUDES OVER 300 COMMUNITY INDICATORS COVERING MORE THAN 25 TOPICS IN THE AREAS OF HEALTH, DETERMINANTS OF HEALTH, AND QUALITY OF LIFE. THE DATA ARE PRIMARILY DERIVED FROM STATE AND NATIONAL PUBLIC SECONDARY DATA SOURCES. THE VALUE FOR EACH OF THESE INDICATORS IS COMPARED TO OTHER COMMUNITIES, NATIONALLY OR LOCALLY SET TARGETS, AND TO PREVIOUS TIME PERIODS. FACILITY 1, PHOEBE WORTH MEDICAL CENTER, INC. - PART V, LINE 11 THE CHNA RESULTED IN THE IDENTIFICATION OF THREE PRIORITIES THAT WERE APPROVED BY THE PWMC BOARD OF DIRECTORS AT THEIR MEETING ON JULY 28TH, 2022. THOSE PRIORITIES ARE: 1. MENTAL HEALTH & MENTAL DISORDERS 2. DIABETES MANAGEMENT AND PREVENTION 3. ACCESS TO & QUALITY OF HEALTHCARE SERVICES A DETAILED DISCUSSION OF EACH SIGNIFICANT HEALTH NEED CAN BE FOUND BEGINNING ON PAGE 40 OF THE 2022 CHNA. THE FOLLOWING SIGNIFICANT HEALTH NEEDS, PRESENTED IN ALPHABETICAL ORDER, EMERGED FROM A REVIEW OF THE PRIMARY AND SECONDARY DATA. HOWEVER, PHOEBE WORTH WILL NOT FOCUS DIRECTLY ON THESE TOPICS IN THEIR IMPLEMENTATION STRATEGY/COMMUNITY HEALTH IMPROVEMENT PLANS. THE BOARD DETERMINED TO FOCUS ON THE 3 AREAS NAMED ABOVE WHERE THE HOSPITAL COULD HAVE THE BEST IMPACT WITH THE RESOURCES AVAILABLE. 1) HEART DISEASE AND STROKE 2) MATERNAL AND CHILD HEALTH 3) NUTRITION AND HEALTHY EATING SEVERAL OF THE NON-PRIORITIZED NEEDS ARE RELATED TO THE THREE PRIMARY PRIORITY AREAS, AND IMPLEMENTATION OF ACTIVITIES UNDER THOSE PRIORITIES WILL HAVE AN INDIRECT IMPACT ON MANY OF THESE NEEDS. KEY THEMES FROM COMMUNITY INPUT ARE INCLUDED WHERE RELEVANT FOR EACH NON-PRIORITIZED HEALTH NEED ALONG WITH THE SECONDARY DATA SCORE AND WARNING INDICATORS. FACILITY 1, PHOEBE WORTH MEDICAL CENTER, INC. - PART V, LINE 20E WRITTEN NOTICE OF THE AVAILABILITY OF FINANCIAL ASSISTANCE IS INCLUDED ON HOSPITAL PATIENT STATEMENTS, AND ON WRITTEN COMMUNICATIONS SENT BY CONTRACTED THIRD PARTY COLLECTION AGENCIES. THESE AGENCIES MAY REFER ACCOUNTS FOR REPORTING TO MAJOR CREDIT BUREAUS, AFTER A SERIES OF STATEMENTS AND LETTERS ARE SENT THROUGHOUT MULTIPLE COLLECTION CYCLES. 1 PHOEBE WORTH FAMILY MEDICAL CENTER 1014 WEST FRANKLIN STREET SYLVESTER GA 31791 RHC SCHEDULE H, PART I, LINE 7, COLUMN (F) IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN (F), THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25: FORM 990, PART IX, LINE 25 21,642,925 ADD: EXPENSES REPORTED IN PART VIII 19,854 DENOMINATOR FOR COLUMN (F) 21,662,779 SCHEDULE H, PART I, LINE 7 THE COST WAS CALCULATED USING THE COST-TO-CHARGE RATIO AS CALCULATED USING WORKSHEET 2 FROM THE IRS FORM 990 INSTRUCTIONS. THE COST ON LINE 7I WAS GENERATED FROM THE ORGANIZATION'S ACCOUNTING RECORDS. SCHEDULE H, PART III, LINE 2 THE BAD DEBT EXPENSE (OR PRICE CONCESSION) AMOUNT REPRESENTS THE DIFFERENCE BETWEEN AMOUNTS BILLED AND THE ESTIMATED CONSIDERATION THE HOSPITAL EXPECTS TO RECEIVE FROM PATIENTS, WHICH ARE DETERMINED BASED ON HISTORICAL COLLECTION EXPERIENCE, CURRENT MARKET CONDITIONS, AND OTHER FACTORS. CONSISTENT WITH THE HOSPITAL'S MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, THE HOSPITAL HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES (FOR EXAMPLE, COPAYS AND DEDUCTIBLES.) SCHEDULE H, PART III, LINE 4 SEE FOOTNOTE 2 PAGES 12-17 ON THE ACCOMPANYING AUDITED FINANCIAL STATEMENTS FOR THE DISCUSSION OF IMPLICIT PRICE CONCESSIONS, BAD DEBT EXPENSE, AND UNINSURED PATIENTS. SCHEDULE H, PART III, LINE 8 MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. SCHEDULE H, PART III, LINE 9B THE ORGANIZATION PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE ORGANIZATION WRITES OFF PATIENT ACCOUNTS RECEIVABLE BALANCES FOR PATIENTS QUALIFYING FOR CHARITY CARE OR FINANCIAL ASSISTANCE AND DOES NOT MAKE FURTHER COLLECTION EFFORTS. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENTS HAVE TRADITIONALLY LED TO THE CREATION OF COMMUNITY-BASED DELIVERY SYSTEMS THAT EXPAND ACCESS TO HEALTH CARE, MEET THE NEEDS OF THE PEOPLE AND BUILD HEALTHY COMMUNITIES IN THE BROADEST SENSE BY IMPACTING MAJOR DETERMINANTS, SUCH AS ECONOMIC DEVELOPMENT, EMPLOYMENT, CHILDREN'S SAFETY, EDUCATION AND ADEQUATE HOUSING. THE ORGANIZATION CONDUCTS REGULAR NEEDS ASSESSMENT THROUGH FORMAL AND INFORMAL SURVEYS AND PROCESSES, INCLUDING COLLABORATIONS WITH PUBLIC AND COMMUNITY AGENCIES. THROUGH STRATEGIC PLANNING AND COMMUNITY INTERVIEWS, THE ORGANIZATION DEVELOPS PROGRAMS AND SERVICES THAT CONSIDER THE ECONOMIC IMPERATIVES OF THE REGION, THE EFFECT OF LEGISLATION AND THE INVOLVEMENT OF OTHER COMMUNITY-BASED ORGANIZATIONS AND PARTNERS. THE ORGANIZATION REGULARLY CONDUCTS FOCUS GROUPS IN THE COMMUNITY TO UNDERSTAND ISSUES AFFECTING ITS PATIENTS, AND HAS CREATED PROGRAMS IN RESPONSE TO HEALTH DISPARITIES PREVALENT IN THE AREA. THE ORGANIZATION ALSO COLLECTS HEALTH NEEDS INFORMATION FROM NURSES, WHO PROVIDE DIRECT CARE TO STUDENTS AND STAFF AND WHO COLLABORATE WITH OTHER AGENCIES TO DEVELOP HEALTH AWARENESS AND DISEASE PREVENTION PROGRAMS. THE ORGANIZATION ALSO CONDUCTS REGULAR PHYSICIAN WORKFORCE STUDIES THROUGH ITS STRATEGIC PLANNING ARM TO DETERMINE UNMET PHYSICIAN NEEDS AND BARRIERS TO ACCESSING CARE. THE ORGANIZATION MEASURES THE SUCCESS OF ITS COMMITMENT BY HOW WELL IT KEEPS PEOPLE HEALTHY AND HOW WELL IT IMPACTS THE SOCIAL/CULTURAL BONDS THAT WILL SECURE THE COMMUNITIES OF THE FUTURE. THE HOSPITAL LAST CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2022. A COMPLETE COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, COMMUNITY PRIORITIES, AND IMPLEMENTATION PLAN CAN BE FOUND AT HTTPS://WWW.PHOEBEHEALTH.COM/MEDIA/FILE/PHOEBEWORTH/CHNA_PWMC2022.PDF SCHEDULE H, PART VI, LINE 3 THE BOARD HAS CLEARLY WRITTEN FINANCIAL ASSISTANCE POLICY THAT IS AVAILABLE ON THE ORGANIZATION'S WEB SITE AND THROUGH THE BUSINESS OFFICE. SIGNS ARE PROMINENTLY POSTED ON THE AVAILABILITY OF FREE AND CHARITY CARE. PATIENT EDUCATION ON THE ORGANIZATION'S FINANCIAL ASSISTANCE IS CONDUCTED DURING PRE-REGISTRATION, THROUGH FLOOR VISITS BY BUSINESS OFFICE REPRESENTATIVES FOR PATIENTS THAT STRESS CONCERN IN MEETING THE FINANCIAL OBLIGATIONS FOR THEIR SERVICES, AND THROUGH OUR CUSTOMER SERVICE DEPARTMENT. BROCHURES ARE PROMINENTLY DISPLAYED AT EACH REGISTRATION BOOTH. THE BUSINESS OFFICE CONTINUOUSLY PROVIDES UPDATED MATERIAL TO PHYSICIAN OFFICES FOR ISSUANCE TO THEIR PATIENTS THAT HIGHLIGHT THE FINANCIAL ASSISTANCE PROGRAM AND POLICIES. THE PATIENT STATEMENTS HIGHLIGHT THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY AND ENCOURAGES PATIENTS TO CALL FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART VI, LINE 4 WORTH COUNTY IS PHOEBE WORTH'S PRIMARY SERVICE AREA. WORTH COUNTY HAS AN ESTIMATED POPULATION SIZE OF 20,262 IN 2024. THIS REPRESENTS A DECREASE OF 2.5% SINCE 2020. WORTH COUNTY POPULATION CONSISTS OF 68% CAUCASIAN, 29% AFRICAN AMERICAN, 3% HISPANIC/LATINO, AND 3% OTHER. THE OVERALL COUNTY'S HOUSEHOLD MEDIAN INCOME IS 57,201, WHICH IS BELOW BOTH THE GEORGIA AND US VALUES. LIKEWISE, THERE IS SIGNIFICANT PER CAPITA INCOME DIFFERENCE BETWEEN WORTH COUNTY (28,059) AND BOTH THE GEORGIA (39,525) AND US (43,289) VALUE. SCHEDULE H, PART VI, LINE 5 THE ORGANIZATION AND ITS VOLUNTEER BOARD IS COMPOSED OF COMMUNITY MEMBERS WITH DIVERSE PROFESSIONAL AND COMMUNITY SERVICE BACKGROUNDS, AS WELL AS PHYSICIAN MEMBERS. THE ORGANIZATION'S EMERGENCY CENTER IS OPERATED 24/7 AND OPEN TO ALL PERSONS, REGARDLESS OF ABILITY TO PAY. THE BOARD MAINTAINS OPEN MEDICAL STAFF POLICIES WITH PRIVILEGES AVAILABLE TO ALL QUALIFYING PHYSICIANS. THE BOARD HAS A CLEARLY WRITTEN FINANCIAL ASSISTANCE POLICY THAT IS AVAILABLE ON THE ORGANIZATION'S WEB SITE AND THROUGH THE BUSINESS OFFICE. SIGNS ARE PROMINENTLY POSTED ON THE AVAILABILITY OF FREE AND CHARITY CARE. THE ORGANIZATION HAS A MULTI-PRONGED APPROACH TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES: INCREASING ACCESS, BUILDING CAPACITY, INVESTING IN "UPSTREAM" PROGRAMS THAT GET AT THE CAUSE OF DISEASE AND ILLNESS, BUILDING COMMUNITY PARTNERSHIPS, ADVOCATING CHANGE, AND DEVELOPING LEADERSHIP. SURPLUS FUNDS ARE REINVESTED IN RESOURCES TO IMPROVE THE DELIVERY OF MEDICAL AND HEALTH CARE SERVICES. PRIMARY CARE IS FIRST AND CREATES A PROFOUND IMPACT ON THE COMMUNITIES SERVED. PRIMARY CARE SERVICES ARE ESTABLISHED IN AREAS WHERE RESIDENTS ARE MOST LIKELY TO SUFFER FROM SEVERE MANPOWER SHORTAGES, HIGH POVERTY LEVELS AND A LACK OF ACCESS TO CARE. SCHEDULE H, PART VI, LINE 6 PHOEBE PUTNEY HEALTH SYSTEM, INC. (PPHS) IS THE NOT-FOR-PROFIT PARENT COMPANY OF PHOEBE PUTNEY MEMORIAL HOSPITAL, INC. (PPMH), A NOT-FOR-PROFIT ENTITY, PHOEBE PUTNEY HEALTH VENTURES, INC. (PPHV), A FOR-PROFIT CORPORATION, PHOEBE PHYSICIAN GROUP, INC. (PPG), A NOT-FOR-PROFIT CORPORATION, PHOEBE WORTH MEDICAL CENTER, INC. (PWMC), A NOT-FOR-PROFIT ENTITY, PHOEBE SUMTER MEDICAL CENTER, INC. (PSMC), A NOT-FOR-PROFIT ENTITY, AND PHOEBE FOUNDATION, INC. (PF), A NOT-FOR-PROFIT ENTITY. PPMH IS LOCATED IN ALBANY, GEORGIA, IS AN ACUTE CARE HOSPITAL, WHICH OPERATES SATELLITE CLINICS IN THE SURROUNDING COUNTIES. IT PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF SOUTHWEST GEORGIA. ADMITTING PHYSICIANS ARE PRIMARILY PRACTITIONERS IN THE LOCAL AREA. PPHV ENGAGES IN HEALTHCARE AND RELATED ACTIVITIES IN FURTHERANCE OF THE EXEMPT PURPOSES OF PPHS AND PPMH. PWMC, LOCATED IN SYLVESTER, GEORGIA, IS A 25 BED RURAL CRITICAL ACCESS HOSPITAL. IT PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF WORTH COUNTY, GEORGIA. PSMC, LOCATED IN AMERICUS, GEORGIA, IS AN ACUTE CARE HOSPITAL. IT PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF SUMTER COUNTY, GEORGIA. PPG WAS ESTABLISHED TO ORGANIZE AND OPERATE MEDICAL PRACTICES EXCLUSIVELY FOR THE BENEFIT OF PPMH, PWMC, AND PSMC. PF WAS ESTABLISHED TO RAISE FUNDS OF ANY KIND OR CHARACTER TO BE USED EXCLUSIVELY FOR CHARITABLE, MEDICAL, EDUCATIONAL AND SCIENTIFIC PURPOSES AT OR IN CONNECTION WITH EACH AND EVERY NON-PROFIT ORGANIZATION OF WHICH PPHS IS THE SOLE MEMBER, AND ANY OTHER NON-PROFIT HOSPITAL WHICH IS MANAGED OR CONTROLLED BY PPHS WHETHER THROUGH OWNERSHIP, MANAGEMENT CONTRACT OR OTHERWISE. SCHEDULE H, PART VI, LINE 7 GEORGIA SCHEDULE H, PART VI SERVICE TO THE COMMUNITY PHOEBE WORTH MEDICAL CENTER (HOSPITAL) IS A NOT-FOR-PROFIT HEALTH CARE ORGANIZATION THAT EXISTS TO SERVE THE COMMUNITY. THE HOSPITAL HAS NO STOCKHOLDERS OR OWNERS, AND IS PART OF THE NOT-FOR-PROFIT PHOEBE PUTNEY HEALTH SYSTEM, INC. AFTER OPERATING EXPENSES ARE COVERED, ANY REMAINING REVENUES ARE REINVESTED IN THE OPERATION OF THE HOSPITAL IN ORDER TO ENHANCE OUR ABILITY TO CARRY OUT OUR LOCAL MISSION OF TAKING CARE OF OUR COMMUNITIES CITIZENS. THE HOSPITAL PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS WHICH COVER MANY GEORGIANS HEALTH CARE NEEDS, AND BY SO DOING, FOREGOES SOME CHARGES AND HAS UNREIMBURSED EXPENSES. THE HOSPITAL ALSO OFFERS FINANCIAL ASSISTANCE TO INDIVIDUALS UNABLE TO PAY FOR THEIR HEALTHCARE SERVICES. INDIGENT FINANCIAL ASSISTANCE, OR FREE CARE, IS OFFERED TO PATIENTS WHOSE HOUSEHOLD INCOME IS AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES. PATIENTS WHOSE INCOME LEVEL IS OVER 200% TO 400% OF THE FEDERAL POVERTY LEVELS WILL BE CLASSIFIED AS CHARITY AND RECEIVE THEIR NEEDED HEALTHCARE SERVICES AT A DISCOUNTED RATE. THE FOLLOWING TABLE SUMMARIZES THE AMOUNTS OF CHARGES FOREGONE (I.E., CONTRACTUAL ADJUSTMENTS) AND ESTIMATES THE LOSSES INCURRED BY THE HOSPITAL DUE TO INADEQUATE PAYMENTS BY THESE PROGRAMS AND FOR INDIGENT/CHARITY SERVICES. THE HOSPITAL ALSO OPERATES A RURAL HEALTH CLINIC (RHC) WHICH ALSO FOREGOES SOME CHARGES AND HAS COSTS NOT REIMBURSED THROUGH PATIENTS QUALIFYING FOR THESE SAME INDIGENT AND CHARITY PROGRAMS. THE AMOUNTS LISTED BELOW ARE ALL INCLUSIVE OF BOTH HOSPITAL AND CLINIC ACTIVITIES. ESTIMATED CHARGES UNREIMBURSED FOREGONE COST MEDICARE 12,000,000 4,000,000 MEDICAID 6,000,000 2,000,000 INDIGENT/CHARITY CARE 7,000,000 2,000,000 TOTALS 25,000,000 8,000,000 THE FOLLOWING IS A SUMMARY OF THE COMMUNITY BENEFIT ACTIVITIES OFFERED BY THE HOSPITAL AND ILLUSTRATES THE ACTIVITIES AND DONATIONS DURING FISCAL YEAR 2024. I. SUBSIDIZED HEALTH SERVICES INDIGENT DRUG PROGRAM - RX PLUS THE HOSPITAL PROVIDED ACCESS TO NEEDED MEDICATIONS FOR 121 PATIENTS DURING FISCAL YEAR 2024. THE HOSPITAL'S RX PLUS PROGRAM IS A PROGRAM FOR INDIGENT PATIENTS TO GAIN ACCESS TO MEDICATIONS AT NO CHARGE THROUGH DRUG MANUFACTURERS. THIS INCLUDES CRITICAL MEDICATIONS FOR DIABETES, COPD/ASTHMA, AND OTHER DISEASE STATES. PATIENTS ARE REFERRED TO RX PLUS THROUGH PHOEBE WORTH FAMILY MEDICINE PROVIDERS. RX PLUS THEN ASSISTS THE PATIENTS WITH THE MANUFACTURERS' PROCESS FOR OBTAINING THE MEDICATION. ONCE APPROVED BY THE MANUFACTURERS, MEDICATIONS ARE SENT TO THE PATIENT'S HOME OR TO RX PLUS FOR PICKUP. AFTER INITIAL APPROVAL, RX PLUS REQUESTS NEW PRESCRIPTIONS FROM THE PROVIDER WHEN NEEDED. RX PLUS ALSO TRACKS DATES FOR WHEN REFILLS AND RENEWAL APPLICATIONS ARE NEEDED BY THE MANUFACTURER. THE GOAL OF RX PLUS IS TO MAKE IT POSSIBLE FOR OUR PATIENTS TO GET THE MEDICATIONS THEY NEED FOR BETTER HEALTH AND QUALITY OF LIFE. THE HOSPITAL INVESTED APPROXIMATELY 32,000 TO PROVIDE THIS DRUG SERVICE TO THE COMMUNITY. II. FINANCIAL AND IN-KIND SUPPORT THE HOSPITAL SUPPORTS THE COMMUNITY THROUGH PROVIDING SPACE TO THE WORTH COUNTY BOARD OF COMMISSIONERS. THE COUNTY UTILIZES THE SPACE AS ONE OF THE COUNTY'S EMERGENCY MANAGEMENT SERVICE (EMS) LOCATIONS. THE 2,710 SQUARE FEET OF SPACE INCLUDES A GARAGE/BAY, HOUSING AREA AND STORAGE SPACE. THE FAIR MARKET VALUE OF THE HOSPITAL'S CONTRIBUTION OF SPACE TOTALS 6,444 FOR FISCAL YEAR 2024. THE HOSPITAL SUPPORTS THE COMMUNITY THROUGH PROVIDING OFFICE SPACE FOR ASPIRE BEHAVIORAL HEALTH SO THAT THEY ARE ABLE TO OFFER MORE BEHAVIORAL HEALTH SERVICES TO THE CITIZENS OF WORTH COUNTY. THE SUPPORT PROVIDES MUCH NEEDED MENTAL HEALTH SERVICES AS DETERMINED BY OUR COMMUNITY HEALTH NEEDS ASSESSMENT. THE FAIR MARKET VALUE OF THE HOSPITAL'S CONTRIBUTION OF SPACE TOTALS 102 PER YEAR. THE HOSPITAL SUPPORTS THE HEALTH DEPARTMENT THROUGH CONTRIBUTIONS TOWARDS THEIR PROGRAMS DIRECTED AT EDUCATING, SCREENING, TREATING, AND ASSISTING WITH THE COSTS OF SUPPLIES AND MEDICATIONS FOR LOW INCOME INDIVIDUALS BATTLING HIGH BLOOD PRESSURE AND DIABETES. THE FINANCIAL SUPPORT ENABLES THE HEALTH DEPARTMENT TO OPERATE ITS STROKE AND HEART ATTACK PREVENTION (SHAPP) AND DIABETES PROGRAM. THE HOSPITAL'S CONTRIBUTION TOTALED 55,000. THE HOSPITAL SUPPORTS THE VILLAGE COMMUNITY GARDEN (GARDEN) IN MULTIPLE CAPACITIES. THE GARDEN IS A BRIGHT SPOT TO OUR SYLVESTER/WORTH COUNTY RESIDENTS AND PROVIDES A UNIQUE FOOD AND EDUCATION EXPERIENCE. THE GARDEN IS FULL YEAR-ROUND WITH A SUPPLY OF SEASONAL PRODUCE. THE HOSPITAL SUPPORTS ALL THE VARIOUS SEASONS BY SUPPLYING VEGETABLE SIGNAGE WHICH IDENTIFIES THE PRODUCE AND EXPLAINS THE HEALTH BENEFITS OF THE VEGETABLE. THE HOSPITAL ALSO ALLOWS DEPARTMENTS AND THEIR STAFF TO SPEND ONE FRIDAY A MONTH WORKING AT THE GARDEN. ADDITIONALLY, THE HOSPITAL PROVIDES SPEAKERS AND TOPICS FOR THE MONTHLY 4-H VILLAGE LIVING THURSDAYS EVENTS THAT THE GARDEN HOSTS AND PROVIDED FUNDING FOR THE MAY DAY EVENT THAT THE GARDEN HOSTS. ALSO, THIS FISCAL YEAR, THE HOSPITAL SUPPLIED THE GARDEN WITH EMERGENCY LIFE SAVING EQUIPMENT AND HOSTED A TRAINING ON USING THE AED DEFIBRILLATOR IF AND WHEN NECESSARY. THE VALUE OF THE HOSPITAL'S CONTRIBUTIONS TO THE GARDEN TOTALED APPROXIMATELY 5,850. THE HOSPITAL ENGAGES WITH THE COMMUNITY IN VARIOUS OTHER WAYS AS WELL, INCLUDING PARTICIPATION IN LOCAL EVENTS RANGING FROM THE LOCAL LAW ENFORCEMENT "NIGHT OUT AGAINST CRIME" TO THE ANNUAL COMMUNITY PEANUT FESTIVAL. THE HOSPITAL ACTS AS CORPORATE SPONSORS TO ENSURE THE COMMUNITY CAN OFFER THESE TYPES OF EVENTS. THE HOSPITAL ALSO PROVIDES STAFFING FOR THE INFORMATIONAL TENTS, WHICH INFORM THE COMMUNITY ABOUT THE SERVICE OFFERINGS AT THE HOSPITAL. THE HOSPITAL PARTICIPATES IN LOCAL CIVIC CLUBS AND SUPPORTS LEADERSHIP IN THEIR ROLES ON THE LOCAL CHAMBER BOARDS AND OTHER COMMUNITY CLUBS. true WORTH COUNTY HEALTH DEPARTMENT 1012 W FRANKLIN STREET SYLVESTER GA 317911978 581568404 GOV 55000 SEE PART IV 1 SCHEDULE I, PAGE 1, PART I, LINE 2 THE WORTH COUNTY HEALTH DEPARTMENT SENDS A LETTER TO PWMC ASKING FOR FINANCIAL ASSISTANCE RELATED TO SPECIFIC PROGRAMS THAT ARE PROVIDED BY THE HEALTH DEPARTMENT. ONCE RECEIVED, PWMC'S BOARD APPROVES THE AMOUNT OF ASSISTANCE TO THE HEALTH DEPARTMENT. THE FUNDS THAT ARE GIVEN TO THE HEALTH DEPARTMENT ARE DEEMED TO BE USED FOR THE SPECIFIC PURPOSES MENTIONED IN THE ORIGINAL LETTER FROM THE HEALTH DEPARTMENT. IN 2024, PWMC WORKED WITH THE HEALTH DEPARTMENT TO ENABLE THEM TO SUPPORT TWO HEALTH PREVENTION TYPE PROGRAMS. ONE PROGRAM WAS STROKE AND HEART ATTACK PREVENTION (SHAPP), THE SECOND PROGRAM WAS A DIABETES PROGRAM. true true false false false false false false false SCOTT STEINER BD MBR/PPHS PRES/CEO 913089 359661 372016 245402 43155 1933323 228125 BRIAN CHURCH BD MBR/PPHS CFO/CAO 639571 191846 20040 143311 44957 1039725 131572 DAWN BENSON SVP- GENERAL COUNSEL 436014 129693 89430 76877 732014 66712 JOE AUSTIN PPMH CEO 567757 567757 KIM GILMAN PRESIDENT. PWMC 257458 81538 23636 61959 18172 442763 52774 CANDACE GUARNIERI VP OF FINANCE, PWMC 150743 36317 133 4815 39983 231991 KELLY DORMINEY TEAM LEAD/ACUTE CARE 161463 2493 265 5078 29910 199209 BENJAMIN LEE HUDSON PHARMACIST 160917 8484 128 4866 22305 196700 STACEY BARBEE DIR BUS/CLINIC OPS 136785 13830 180 3438 28235 182468 TAMMY HOLLOWAY RN/TEAM LEAD 142753 600 265 4377 14290 162285 SCHEDULE J, PAGE 1, PART I, LINE 3 NONE OF THE INDIVIDUAL BOARD MEMBERS OR OFFICERS ARE COMPENSATED BY THE FILING ORGANIZATION. THE FILING ORGANIZATION, INSTEAD, RELIES ON THE METHODS USED BY PPHS, THE SOLE MEMBER, TO ESTABLISH COMPENSATION OF THE CEO AND EXECUTIVE OFFICERS. COMPENSATION DETERMINATION BY PPHS INCLUDES AN INDEPENDENT COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT AND SURVEYS, AND BOARD APPROVAL. THESE METHODS ARE WELL DOCUMENTED. SCHEDULE J, PAGE 1, PART I, LINE 4 SCOTT STEINER 0 587,046 0 BRIAN CHURCH 0 134,761 0 DAWN BENSON 0 135,039 0 JOE AUSTIN 567,757 0 0 KIM GILMAN 0 54,054 0 SCHEDULE J, PART III SCHEDULE J, PART I, LINE 4 - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS: DEFERRED COMPENSATION PLAN 457(B): THE DEFERRED COMPENSATION PLAN IS AN ADDITIONAL RETIREMENT PLAN OFFERED THROUGH PHOEBE PUTNEY. THE 457(B) PLAN IS AN ELIGIBLE DEFERRED COMPENSATION PLAN THAT ALLOWS ONE TO DEFER ADDITIONAL DOLLARS TOWARDS RETIREMENT. HIGHLIGHTS INCLUDE: O NOT LIMITED BY THE AMOUNTS DEFERRED INTO THE PHOEBE 403(B) O PLAN IS SUBJECT TO ANNUAL DEFERRAL LIMITS SET BY THE IRS O PER IRS REGULATIONS, EACH PARTICIPANT IS A GENERAL UNSECURED CREDITOR OF THE PLAN SPONSOR. AN ELIGIBLE EMPLOYEE IS ONE WHO IS DETERMINED BY THE EMPLOYER TO BE A MEMBER OF A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES WITHIN THE MEANING OF SECTIONS 201(2), 301(A)(3), AND 401(A)(1) OF ERISA. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) 457(F): PPHS RELIES ON AN INDEPENDENT COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, SURVEYS, WELL DOCUMENTED METHODS AND BOARD APPROVAL TO ESTABLISH TOTAL COMPENSATION OF THE CEO AND EXECUTIVE OFFICERS. CERTAIN BOARD APPROVED EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN A SERP THAT PROVIDES CERTAIN DEFINED ANNUAL PAY CREDITS THAT ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. THE PURPOSE OF THE SERP IS TO PROVIDE A LONG-TERM INCENTIVE AND RETIREMENT BENEFIT FOR AFFECTED EXECUTIVES CONSISTENT WITH THE BENEFIT AVAILABLE TO EMPLOYEES NOT IMPACTED BY IRS COMPENSATION LIMITS ON DEFINED BENEFIT PLANS. THE AMOUNTS REPORTED AS SUPPLEMENTAL EXECUTIVE RETIREMENT COMPENSATION FOR ELIGIBLE EMPLOYEES IN SCHEDULE J REPRESENT CREDITED, BUT NOT VESTED, BENEFITS, AND THE AMOUNTS ARE AVAILABLE IN FUTURE PERIODS TO THE EMPLOYEE SUBJECT TO CONTINUING EMPLOYMENT. PPHS MAINTAINS OWNERSHIP OF THE FUNDS ALLOCATED TO EACH PARTICIPANT UNTIL VESTING AND PAYMENT. FOR A PARTICIPANT IN THE SERP PRIOR TO 1/1/2017 (A "GRANDFATHERED PARTICIPANT"), WITH PAY CREDITS FOR PLAN YEARS BEGINNING PRIOR TO 1/1/2020, THE INITIAL VESTING DATE WILL OCCUR ON THE DATE THE PARTICIPANT ATTAINS FIVE YEARS OF PARTICIPATION UNDER THE PLAN. AFTER THE INITIAL VESTING DATE, A GRANDFATHERED PARTICIPANT SHALL HAVE A NEW VESTING DATE ONCE EVERY 5 YEARS. THESE ADDITIONAL VESTING DATES WILL OCCUR ON THE 5TH ANNIVERSARY OF EACH VESTING DATE AFTER THE INITIAL VESTING DATE. ON EACH VESTING DATE, A GRANDFATHERED PARTICIPANT WILL BECOME 100% VESTED IN AN AMOUNT EQUAL TO THE PARTICIPANT'S ACCOUNT BALANCE REDUCED BY ANY PAY CREDITS CREDITED TO THE ACCOUNT FOR THE 2 MOST RECENT PLAN YEARS. GRANDFATHERED PARTICIPANTS WITH PAY CREDITS FOR PLAN YEARS BEGINNING ON OR AFTER 1/1/2020, EACH YEAR'S ANNUAL PAY CREDIT PLUS SUBSEQUENT EARNINGS AND/OR LOSSES WILL VEST AFTER 5 YEARS OF CONTINUOUS EMPLOYMENT. EACH CONTRIBUTION IS SUBJECT TO A SEPARATE AND INDEPENDENT 5 YEAR CONTINUOUS EMPLOYMENT REQUIREMENT. FOR PARTICIPANTS INITIALLY PARTICIPATING IN THE SERP AFTER 12/31/2016 (A "CONTEMPORARY PARTICIPANT"), EACH YEAR'S ANNUAL PAY CREDIT PLUS SUBSEQUENT EARNINGS AND/OR LOSSES WILL 100% VEST ON THAT PAY CREDITS' 5TH ANNIVERSARY, PROVIDED THAT THE PARTICIPANT REMAINS IN THE CONTINUOUS EMPLOYMENT THROUGHOUT THE 5-YEAR PERIOD FOR EACH ANNUAL PAY CREDIT. IF ANY ELIGIBLE PARTICIPANT ATTAINS NORMAL RETIREMENT AGE PRIOR TO SEPARATION FROM SERVICE, THEY SHALL VEST IN 100% OF THE ACCOUNT BALANCE. ONCE VESTED, EACH PARTICIPANT SHALL RECEIVE A DISTRIBUTION OF THEIR ENTIRE VESTED AMOUNT WITHIN A REASONABLE PERIOD NOT TO EXCEED 2.5 MONTHS. THIS DISTRIBUTION IS TREATED AS REPORTABLE COMPENSATION TO THE PARTICIPANT AND IS INCLUDED IN PART II, COLUMN B(III). THEREFORE, PART II, COLUMN B(III) INCLUDES PRIOR YEAR SERP DEFERRALS PREVIOUSLY REPORTED IN PART II, COLUMN C. ANY DISTRIBUTION AMOUNT INCLUDED IN PART II, COLUMN B(III) THAT WAS PREVIOUSLY REPORTED IN PRIOR PERIODS AS DEFERRED COMPENSATION IN PART II, COLUMN C IS DISCLOSED IN PART II, COLUMN F. SCHEDULE J, PART II, COLUMN B(II) CERTAIN EXECUTIVE OFFICERS AND PHYSICIANS ARE ELIGIBLE FOR BONUS/INCENTIVE PAYMENTS. THESE BONUSES ARE DETERMINED BASED ON THE ACHIEVEMENT OF VARIOUS ORGANIZATIONAL AND PERSONAL PERFORMANCE GOALS ESTABLISHED BY A FORMAL PROCESS IN KEEPING WITH THE ORGANIZATION'S TAX-EXEMPT STATUS. COMPENSATION PROCESS FOR TOP OFFICIAL AS DETERMINED BY PPHS THE ORGANIZATION'S FORMAL PROCESS FOR DETERMINING TOTAL COMPENSATION FOR THE CEO IS INTENDED TO PROVIDE REASONABLE COMPENSATION FOR ACCOMPLISHING THE ORGANIZATION'S MISSION, ACHIEVE ITS STRATEGIC GOALS, TO RECOGNIZE PERFORMANCE, AND TO OPERATE IN KEEPING WITH THE ORGANIZATION'S OBLIGATIONS AS A TAX-EXEMPT CHARITABLE ORGANIZATION. THE EXECUTIVE COMPENSATION COMMITTEE OF THE PPHS'S BOARD OF DIRECTORS CONDUCTS AN ANNUAL REVIEW OF THE COMPENSATION OF THE CEO. THE COMMITTEE RETAINS A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT TO CONDUCT COMPETITIVE MARKET ANALYSIS OF THE MARKET RANGES OF BASE, INCENTIVE AND TOTAL CASH COMPENSATION. THE INFORMATION THE COMMITTEE MAY CONSIDER CAN INCLUDE BUT IS NOT LIMITED TO THE PERFORMANCE OF AN INDIVIDUAL, THE PERFORMANCE OF THE ORGANIZATION, AN INDIVIDUAL'S LENGTH OF SERVICE, CREDENTIALS AND EXPERIENCE, THE ELEMENTS OF TOTAL COMPENSATION AND SALARY HISTORY, THE ORGANIZATION'S COMPENSATION TARGETS, AND COMPARABILITY DATA, INCLUDING THE DATA PREPARED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE COMMITTEE. THE COMMITTEE INCORPORATES A FORMAL PERFORMANCE APPRAISAL PROCESS IN THE CEO COMPENSATION REVIEW. IT UTILIZES A MULTI-PERSPECTIVE APPROACH AND PERFORMANCE MEASURES WHICH ARE LINKED TO THE ORGANIZATION'S LONG-TERM STRATEGIC PLAN AND ACHIEVEMENT OF ANNUAL SYSTEM OBJECTIVES. THE CEO IS NOT PRESENT WHEN THE COMMITTEE DISCUSSES AND ESTABLISHES HIS COMPENSATION. FORM 990, PAGE 6, PART VI, LINE 6 THE SOLE MEMBER OF PHOEBE WORTH MEDICAL CENTER, INC. SHALL BE PHOEBE PUTNEY HEALTH SYSTEM, INC. (PPHS). FORM 990, PAGE 6, PART VI, LINE 7A THE BOARD OF DIRECTORS OF PPHS, THE SOLE MEMBER, SHALL APPOINT ALL DIRECTORS OF THE FILING ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 7B THE SOLE MEMBER, PPHS, SHALL HAVE THE FOLLOWING RESPONSIBILITIES: - THE MEMBER SHALL APPOINT OR REMOVE THE ORGANIZATION'S DIRECTORS. - THE MEMBER SHALL SELECT OR REMOVE THE ORGANIZATION'S OFFICERS. - THE MEMBER SHALL APPROVE ALL AMENDMENTS TO THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS BEFORE THEY MAY BECOME EFFECTIVE. - THE MEMBER SHALL APPROVE ANY ANNUAL OPERATING OR CAPITAL BUDGETS. - THE MEMBER SHALL APPOINT OR REMOVE THE INDEPENDENT AUDITORS. FORM 990, PAGE 6, PART VI, LINE 11B THE INDEPENDENT ACCOUNTING FIRM THAT PREPARES THE FORM 990 (BASED UPON INFORMATION PROVIDED BY THE ORGANIZATION) PROVIDES A COMPLETE COPY OF THE RETURN WITH APPLICABLE SCHEDULES TO BE REVIEWED BY MANAGEMENT. MANAGEMENT PERFORMS A DETAILED REVIEW WHICH CONSISTS OF REVIEWING THE FINANCIAL DATA, THE NARRATIVES DISCLOSED, AND OTHER FACTS PRESENTED ON THE RETURN. UPON REVIEW, THE FORM 990 IS THEN FORWARDED TO THE FINANCE COMMITTEE FOR THEIR REVIEW, TO GAIN THEIR COMMENTS AND APPROVAL. UPON APPROVAL FROM THE FINANCE COMMITTEE, THE FORM 990 AND RELATED SCHEDULES ARE PROVIDED TO ALL BOARD MEMBERS FOR REVIEW AND FEEDBACK. ONCE THE FORM 990 IS REVIEWED BY ALL APPLICABLE PARTIES, A COPY OF THE FINAL VERSION IS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PAGE 6, PART VI, LINE 12C ON AN ANNUAL BASIS, PHOEBE WORTH MEDICAL CENTER, INC. (PWMC) BOARD MEMBERS AS WELL AS ALL OFFICERS COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. THIS QUESTIONNAIRE IS ADMINISTERED BY THE PHOEBE PUTNEY HEALTH SYSTEM (PPHS) COMPLIANCE DEPARTMENT AND THE DOCUMENT ASKS EACH INDIVIDUAL TO DISCLOSE ANY PERSONAL, BUSINESS, OR OTHER AFFILIATIONS AND MONETARY AMOUNT IF APPLICABLE THAT THEY OR THEIR IMMEDIATE FAMILY MEMBERS HAVE HAD WITHIN THE PAST 12 MONTHS WITH PWMC OR ANY RELATED ENTITIES. ALL RESPONSES ARE THEN EVALUATED BY THE PPHS COMPLIANCE DEPARTMENT. IN THE CASE OF AN EXISTING CONFLICT, THE INDIVIDUAL WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL TO SUCH TRANSACTIONS. FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION MAKES AVAILABLE TO THE PUBLIC ITS CONFLICT OF INTEREST AND AUDITED FINANCIAL STATEMENTS ON THE ORGANIZATION'S WEBSITE, BY PROVIDING COPIES UPON REQUEST, AND BY INSPECTION AT THE ADMINISTRATIVE OFFICES OF THE ORGANIZATION. FORM 990, PART IX, LINE 11G PHYSICIAN FEES 3,396,155 43,214 0 CONSULTANT FEES 458,567 27,067 0 CONTRACT STAFFING 23,976 0 0 CONTRACT SERVICES 119,383 2,031,665 0 COLLECTION SERVICES 19,931 35,995 0 TOTAL 4,018,012 2,137,941 0 PHOEBE PUTNEY HEALTH SYSTEM INC PO BOX 3770 ALBANY GA 317063770 582001014 HEALTHCARE GA 501C3 12C NA false PHOEBE PUTNEY MEMORIAL HOSPITAL INC PO BOX 3770 ALBANY GA 317063770 581928247 HEALTHCARE GA 501C3 3 PPHS false PHOEBE PHYSICIAN GROUP INC PO BOX 3770 ALBANY GA 317063770 263792403 HEALTHCARE GA 501C3 10 PPHS false PHOEBE SUMTER MEDICAL CENTER INC 126 HIGHWAY 280 WEST AMERICUS GA 317198645 263975185 HEALTHCARE GA 501C3 3 PPHS false PHOEBE FOUNDATION INC PO BOX 3770 ALBANY GA 317063770 581847104 FOUNDATION GA 501C3 12A PPHS false PHOEBE DORMINY MEDICAL CENTER INC PO BOX 3770 ALBANY GA 317063770 452041878 HEALTHCARE GA 501C3 3 PPHS false PHOEBE PUTNEY HEALTH VENTURES INC PO BOX 3770 ALBANY GA 317063770 581963401 HEALTHCARE GA N/A false PHOEBE PUTNEY INDEMNITY LTD 113 S CHURCH ST 5TH FL QUEENSGATE GRAND CAYMAN CJ KY1-1102 981492026 INSURANCE CJ N/A false false false true false true false false false false false false false true false true false true false false PHOEBE FOUNDATION C 110350 GL DETAIL