2021-06-11T12:37:29-05:00 2020-07-31 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2019-08-01 581928247 PHOEBE PUTNEY MEMORIAL HOSPITAL INC PHOE 2293121000 417 3RD AVENUE ALBANY GA 317036801 BRIAN CHURCH CFO 2293121000 2021-06-10 true STEPHEN HARRELL P01554887 2298837878 2021-06-10 X 2019 2022-09-23 18:48:47Z SCOTT STEINER PO BOX 3770 ALBANY GA 317063770 608971308 false X WWW.PHOEBEHEALTH.COM X 1990 GA TO DELIVER SUPERIOR HEALTH CARE SERVICES THAT IMPROVES THE HEALTH AND WELLNESS OF THE PEOPLE AND COMMUNITIES WE SERVE. 13 11 3469 291 247173 6175391 13258717 558135907 574575975 2202854 1086081 16397342 17709230 582911494 606630003 992609 1120098 0 199360410 192689602 0 0 367432456 401223673 567785475 595033373 15126019 11596630 628147360 770600773 466403364 633500199 161743996 137100574 TO DELIVER SUPERIOR HEALTH CARE SERVICES THAT IMPROVES THE HEALTH AND WELLNESS OF THE PEOPLE AND COMMUNITIES WE SERVE. false false 461894351 1120098 581806440 PHOEBE PUTNEY MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL WITH 691 LICENSED BEDS AND HAD PATIENT DAYS OF 109,541 IN THE CURRENT YEAR. INTENSIVE CARE, NEONATAL INTENSIVE CARE, NURSERY, REHAB, AND PSYCHIATRY SERVICES ARE INCLUDED IN THE SERVICES PROVIDED. THE HOSPITAL ALSO OPERATES A HOME HEALTH AGENCY AND A 12 BED HOSPICE. OTHER: 17,225 INPATIENT ADMISSIONS, 2,152 BIRTHS, 66,753 EMERGENCY VISITS, AND 721,091 CLINIC VISITS. SEE SCHEDULE H, PART VI, ADDITIONAL INFORMATION, WHICH INCLUDES DETAILED DISCUSSIONS ON ALL CHARITABLE AND COMMUNITY ACTIVITIES OF THE HOSPITAL. 461894351 true true false true false false false false false true true false false false true true true true false false false false false false false false true true true true true true false false false false false false false false false false false false false false false true false false false true 196 0 3469 true true true false false false false false false false false false false false X 13 11 false false false false true true true true true false false true true true true true true false false true true GA X X BRIAN CHURCH CFO 2293124068 PO BOX 3770 ALBANY GA 317063770 JOEL WERNICK PAST CEO/PRE 0.00 0.00 X 0 1358367 17551 JAMES E BLACK MED DIR - EM 50.00 X 482670 446875 24136 SCOTT STEINER PPHS CEO 25.00 30.00 X X 0 751780 169937 JOE AUSTIN PPMH CEO 25.00 28.00 X 0 618459 166974 BRIAN CHURCH CFO 25.00 30.00 X 0 600343 129233 KATHERINE HUDSON MD BOARD MEMBER 1.00 41.00 X 0 645052 29575 DAWN BENSON SVP GENERAL 25.00 25.00 X 0 519805 129295 JEFFERY FLOWERS PPMH COO 25.00 25.00 X 0 501139 80555 WILLIAM M SEWELL III MEDICAL DIRE 50.00 X 417347 0 30695 EVELYN M OLENICK SVP CNO 25.00 25.00 X 316696 0 69648 THOMAS SULLIVAN SVP NORTH CA 25.00 25.00 X 0 314961 68260 JESSE DIAZ VP INFO SYST 50.00 X 262878 0 24332 BIPIN AGARWAL CHIEF PHYSIC 50.00 X 241152 0 25892 KIM WHITLEY VP PT LOGIST 50.00 X 237465 0 15744 CLAY BANKS VICE CHAIR 1.00 0.00 X X 0 0 0 JOHN CULBREATH CHAIRMAN 1.00 0.00 X X 0 0 0 LEMUEL EDWARDS BOARD MEMBER 1.00 0.00 X 0 0 0 KAREN ILER BOARD MEMBER 1.00 0.00 X 0 0 0 MARVIN LASTER BOARD MEMBER 1.00 0.00 X 0 0 0 BERNARD P SCOGGINS MD BOARD MEMBER 1.00 0.00 X 0 0 0 WILLIAM J MCAFEE MD BOARD MEMBER 1.00 0.00 X 0 0 0 SALLY WHATLEY PHD BOARD MEMBER 1.00 0.00 X 0 0 0 JAY SHARPE BOARD MEMBER 1.00 0.00 X 0 0 0 JAMES WEBB BOARD MEMBER 1.00 0.00 X 0 0 0 JOE WEST BOARD MEMBER 1.00 0.00 X 0 0 0 1958208 5756781 981827 172 true true false MEDICAL SOLUTIONS LLC 1010 N 2ND ST STE 300 OMAHA NE 68114 MEDICAL SVCS 15125358 RADIATION ONCOLOGY ASSOCIATES 425 3RD AVENUE SUITE 50 ALBANY GA 317011955 MEDICAL SVCS 2635606 DIALYSIS CLINIC INC P O BOX 2508 ALBANY GA 31702 MEDICAL SVCS 2005693 OBHG GEORGIA 1010 PC PO BOX 16717 GREENVILLE SC 296067717 MEDICAL SVCS 1272854 CHANGE HEALTHCARE 3055 LEBANON PIKE STE 1000 NASHVILLE TN 37214 CONSULTING SVCS 1228247 27 1756159 7596021 3906537 13258717 PATIENT SERVICE REVENUE 623000 574328802 574328802 RETAIL SALES 561499 185741 185741 REFERENCE LAB 621500 61432 61432 574575975 1309188 1309188 3132899 844156 2288743 2288743 2288743 850281 1073388 -223107 -223107 -223107 420705 423761 -3056 -3056 EMPLOYEE PHARMACY REVENUE 621990 4895392 4895392 MISCELLANEOUS REVENUE 621990 3835676 3835676 PURCHASE DISCOUNTS 621990 3638377 3638377 3054098 3585 3050513 15423543 606630003 581806440 247173 11317673 X 907479 907479 212619 212619 386344 386344 148831771 120477309 28354462 4684931 3791983 892948 27942012 27615576 326436 10844544 9072146 1772398 6526610 1403100 5123510 -813876 -813876 216439 216439 116625484 84515732 32109752 143405 80716 62689 15141491 12165442 2976049 12721242 1688546 11032696 13124256 5495126 7629130 804330 691310 113020 4452860 1864412 2588448 26234779 10984502 15250277 8331011 42137 8288874 MEDICAL SUPPLIES 110822464 109761895 1060569 CLINIC LOSS (SEE SCH O) 69912748 57775560 12137188 REPAIRS & MAINTENANCE 8597304 5496707 3100597 PROVIDER TAX 6697152 6697152 1685974 1154902 531072 595033373 461894351 133139022 0 15225 15225 95122311 212867586 83358236 82792742 5783842 5631607 14864609 19889815 8272177 9815594 761300906 473020938 276633498 288279968 124991769 124777806 19105693 26530430 628147360 770600773 52703489 57697748 271575701 264442148 6666671 142124174 304693632 466403364 633500199 X 151700321 123848522 10043675 13252052 161743996 137100574 628147360 770600773 X 11596630 -3207985 -33032067 X X false true X true true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 40673 40673 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. 10429328 5805319 134081 2726395 13642333 9042871 2790371 117282 1521196 10429328 8557540 1359797 27907 902373 9042871 10829593 1616457 112390 4000900 8557540 9596093 1259203 38690 64393 10829593 0.02860 0.14830 0.82310 false false 12274402 12274402 321195402 171810990 149384412 401879263 301209948 100669315 25951839 25951839 288279968 ACCRUED PENSION COST 140969620 MEDICARE ADVANCE PAYMENTS 132927510 DUE TO RELATED PARTY 17045560 INTEREST RATE SWAPS 13906868 THIRD PARTY SETTLEMENTS 1091771 BOND ISSUE COSTS -1247697 304693632 X 604483061 -3207985 1267916 -1940069 606423130 206873 206873 606630003 595951289 1267916 1267916 594683373 350000 350000 595033373 SCHEDULE D, PAGE 2, PART V, LINE 4 THE INTENDED USE OF THE FUNDS IS TO FURTHER THE ORGANIZATION'S TAX-EXEMPT PURPOSE. SCHEDULE D, PAGE 3, PART X THE CORPORATION 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 CORPORATION 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 CORPORATION 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 MANAGEMENTS 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, 2020 AND 2019 OR FOR THE YEARS THEN ENDED. THE CORPORATIONS 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 2D GIFT SHOP COGS 423,761 RENTAL EXPENSES 844,155 SCHEDULE D, PAGE 4, PART XI, LINE 4B CAPITAL CONTRIBUTIONS 206,873 SCHEDULE D, PAGE 4, PART XII, LINE 2D GIFT SHOP COGS 423,761 RENTAL EXPENSES 844,155 SCHEDULE D, PAGE 4, PART XII, LINE 4B ASSISTANCE TO PHOEBE FOUNDATION 350,000 true true X true X 1.250000000000 true X true true false true true 19862056 19862056 0.03330 50203893 36127941 14075952 0.02360 42346114 32199347 10146767 0.01700 112412063 68327288 44084775 0.07390 1691499 1691499 0.00280 1477996 1477996 0.00250 25148306 22411583 2736723 0.00460 135205 135205 0.00020 395147 395147 0.00070 28848153 22411583 6436570 0.01080 141260216 90738871 50521345 0.08470 true 114231576 227978346 275813698 -47835352 X true true 1 1 PHOEBE PUTNEY MEMORIAL HOSPITAL INC PO BOX 3770 ALBANY GA 317063770 WWW.PHOEBEHEALTH.COM 047-682 X X X X HHA, HOSPICE PHOEBE PUTNEY MEMORIAL HOSPITAL INC 1 false false true X X X X X X X X X X 19 true false false true X WWW.PHOEBEHEALTH.COM X true 19 true WWW.PHOEBEHEALTH.COM false false true X 125.000000000000 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 PUTNEY MEMORIAL HOSPITAL INC - PART V, LINE 3E THE PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IS IDENTIFIED AND THE METHODOLOGY FOR PRIORITIZING EACH NEED IS DESCRIBED ON PAGE 25 OF THE 2019 CHNA. FACILITY 1, PHOEBE PUTNEY MEMORIAL HOSPITAL INC - PART V, LINE 5 THE INTERNAL ASSESSMENT TEAM, 21 MEMBERS IN ALL, WAS A BLEND OF HOSPITAL STAFF, AND STRATEGIC COMMUNITY PARTNERS LOCATED IN DOUGHERTY COUNTY, GA. EARLY ON, HOSPITAL LEADERSHIP MADE THE DECISION TO USE THE MULTIPLE ORGANIZATION PARTNERSHIP MODEL AS THE APPROACH TO DETERMINE HOW THE COMMUNITY HEALTH NEEDS ASSESSMENT WILL BE CONDUCTED. THIS APPROACH ENGAGES MULTIPLE ORGANIZATIONS, PROVIDES A BROADER FOCUS, AND ALLOWS GREATER INPUT IN NEED IDENTIFICATION AND DETERMINING APPROPRIATE STRATEGY FOR ACTION. MEMBERS OF THE INTERNAL ASSESSMENT TEAM PERFORMED KEY LEADER INTERVIEWS, THE PURPOSE OF WHICH WAS TO GATHER INFORMATION, GAIN KNOWLEDGE AND RECEIVE INPUT REGARDING HEALTH ISSUES FACING THE ORGANIZATION'S SERVICE AREA. THE INTERVIEW SELECTION PROCESS WAS CAREFUL TO INCLUDE REPRESENTATION THAT REFLECTS THE MAKE-UP OF PATIENTS RECEIVING SERVICES IN THE ORGANIZATION'S SERVICE AREA (RELIGIOUS, MEDICAL PRACTICES, COMMUNITY VOLUNTEERS, BUSINESS, POLITICAL, PUBLIC HEALTH, AND THE ELDERLY). FACILITY 1, PHOEBE PUTNEY MEMORIAL HOSPITAL INC - PART V, LINE 11 USING THE CATHOLIC HEALTH ASSOCIATIONS SELECTION FILTER AS A MEANS TO PRIORITIZE COMPETING SIGNIFICANT NEEDS, BELOW IS A LIST OF NEEDS THAT WERE NOT INCLUDED AS PRIORITIES BUT REMAIN A CONCERN TO THE COMMUNITY. 1) QUALITY, AFFORDABLE HOUSING: THIS IS A SIGNIFICANT PROBLEM AND BEST SOLVED BY LOCAL AND STATE GOVERNMENTS. 2) HOMELESSNESS: THIS IS STRATEGICALLY ALIGNED WITH A LOCAL NON-PROFIT. 3) AFFORDABLE AND QUALITY CHILDCARE: STATEWIDE ISSUE AND FUNDS ARE PROVIDED TO REGIONS THROUGHOUT THE STATE TO PROVIDE RESOURCES. 4) CRIME AND PREVENTION: NOT WITHIN THE SCOPE OF THE HOSPITAL'S STRATEGIC DIRECTION. 5) OBESITY: VERY COMPLEX ISSUE REQUIRING A CULTURE SHIFT. 6) INPATIENT ADOLESCENT CRISIS STABILIZATION UNIT: NOT IN ALIGNMENT WITH THE HOSPITAL'S CURRENT STRATEGIC DIRECTION. A COMPLETE COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, COMMUNITY PRIORITIES, AND IMPLEMENTATION PLAN CAN BE FOUND AT HTTPS://WWW.PHOEBEHEALTH.COM/HEALTH-MATTERS/BUILDING-HEALTHY-COMMUNITIES FACILITY 1, PHOEBE PUTNEY MEMORIAL HOSPITAL 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. 2 PHOEBE HOME CARE 417 THIRD AVENUE ALBANY GA 317011943 HOME HEALTH AGENCY ALBANY COMMUNITY HOSPICE 320 FOUNDATION LANE ALBANY GA 317075862 HOSPICE 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 25 595,033,373 ADD: EXPENSES REPORTED IN PART VIII 1,267,917 DENOMINATOR FOR COLUMN (F) 596,301,290 SCHEDULE H, PART I, LINE 7 THE COST OF MEDICAID AND CHARITY CARE WAS CALCULATED USING THE COST-TO- CHARGE RATIO AS CALCULATED USING WORKSHEET 2 FROM THE IRS FORM 990 INSTRUCTIONS. THE COST OF OTHER BENEFITS WAS THE DIRECT COST OF THE SERVICES. SCHEDULE H, PART III, LINE 2 THE AMOUNT ON PART III, LINE 2 REPRESENTS THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 4 SEE PAGES 19-20 ON THE ACCOMPANYING AUDITED FINANCIAL STATEMENTS FOR THE FOOTNOTE DISCLOSURE RELATING TO UNINSURED PATIENTS AND BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 8 THE MEDICARE SHORTFALL WAS CALCULATED USING THE COST-TO-CHARGE RATIO FROM WORKSHEET 2 OF THE IRS FORM 990 INSTRUCTIONS. 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, WHICH FUNDS NURSES IN 26 SCHOOLS IN DOUGHERTY COUNTY, 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 ORGANIZATION COMPLETED THE LATEST COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY PLAN IN 2019. A COMPLETE COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, COMMUNITY PRIORITIES, AND IMPLEMENTATION PLAN CAN BE FOUND AT HTTPS://WWW.PHOEBEHEALTH.COM/HEALTH-MATTERS/BUILDING- HEALTHY-COMMUNITIES. 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 PROGRAM 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, THROUGH THE CUSTOMER SERVICE DEPARTMENT, AND THE FINANCIAL ASSISTANCE 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 PROGRAM AND ENCOURAGE PATIENTS TO CALL FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART VI, LINE 4 THE ORGANIZATION'S PRIMARY SERVICE AREA INCLUDES DOUGHERTY, LEE, MITCHELL, TERRELL AND WORTH COUNTIES. THE FIVE COUNTY AREA EXPECTS LITTLE GROWTH UP THROUGH 2023. IN THE LAST ASSESSMENT THE PROJECTED POPULATION WAS SAID TO BE 190,329 THROUGH 2020, BUT ACTUAL NUMBERS FOR 2018 WERE 178,133. THE PROJECTED RATE OF GROWTH THROUGH 2023 IS LESS THAN ONE PERCENT , WITH 65 TO 84 YEAR OLDS AND 85+ SEEING THE GROWTH. CURRENT POPULATION IS 53.2% AFRICAN AMERICAN, 43.7% CAUCASIAN, AND 3.1% ALL OTHERS. THE AVERAGE CENSUS TRACT PER CAPITA INCOME IS 21,232 OR 63% OF THE NATIONAL AVERAGE. SCHEDULE H, PART VI, LINE 5 THE ORGANIZATION AND ALL ITS VOLUNTEER BOARDS ARE COMPOSED OF COMMUNITY MEMBERS WITH DIVERSE PROFESSIONAL AND COMMUNITY SERVICE BACKGROUNDS, AS WELL AS PHYSICIAN MEMBERS. IN ALL FACILITIES, EMERGENCY CENTERS ARE OPERATED 24/7 AND OPEN TO ALL PERSONS, REGARDLESS OF ABILITY TO PAY. THE BOARDS MAINTAIN OPEN MEDICAL STAFF POLICIES WITH PRIVILEGES AVAILABLE TO ALL QUALIFYING PHYSICIANS. THE BOARD HAS CLEARLY WRITTEN INDIGENT AND CHARITY CARE POLICIES THAT ARE AVAILABLE ON THE ORGANIZATION WEB SITE AND THROUGH THE BUSINESS OFFICE. SIGNS ARE PROMINENTLY POSTED ON THE AVAILABILITY OF FREE AND CHARITY CARE. THE ORGANIZATION ALSO UTILIZES SURPLUS FUNDS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION AND RESEARCH. 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., A NOT-FOR-PROFIT ENTITY, PHOEBE PUTNEY HEALTH VENTURES, INC., A FOR-PROFIT CORPORATION, PHOEBE PHYSICIAN GROUP, INC., A NOT-FOR-PROFIT CORPORATION, PHOEBE WORTH MEDICAL CENTER, INC., A NOT-FOR-PROFIT ENTITY, PHOEBE SUMTER MEDICAL CENTER, INC., A NOT-FOR-PROFIT ENTITY, AND PHOEBE FOUNDATION, INC., A NOT-FOR-PROFIT ENTITY. PHOEBE PUTNEY MEMORIAL HOSPITAL, INC. (PPMH), 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. PHOEBE PUTNEY HEALTH VENTURES, INC. ENGAGES IN HEALTHCARE AND RELATED ACTIVITIES IN FURTHERANCE OF THE EXEMPT PURPOSES OF PPHS AND PPMH. PHOEBE WORTH MEDICAL CENTER, INC. (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. PHOEBE SUMTER MEDICAL CENTER, INC. (PSMC), LOCATED IN AMERICUS, GEORGIA, IS A 76 BED ACUTE CARE HOSPITAL. IT PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF SUMTER COUNTY, GEORGIA. PHOEBE PHYSICIAN GROUP, INC. WAS ESTABLISHED TO ORGANIZE AND OPERATE MEDICAL PRACTICES EXCLUSIVELY FOR THE BENEFIT OF PPMH, PWMC, AND PSMC. PHOEBE FOUNDATION, INC. 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 PPMH OR THE HOSPITAL AUTHORITY OF ALBANY-DOUGHERTY COUNTY, GEORGIA. THE FOUNDATION ALSO MAY RAISE FUNDS FOR ANY ORGANIZATION FOR WHICH PPHS IS THE SOLE MEMBER. SCHEDULE H, PART VI, LINE 7 GEORGIA SCHEDULE H, PART VI SERVICE TO THE COMMUNITY PHOEBE PUTNEY MEMORIAL HOSPITAL, INC. (PPMH) IS A NOT-FOR-PROFIT HEALTH CARE ORGANIZATION THAT EXISTS TO SERVE THE COMMUNITY. PPMH OPENED IN 1911 TO SERVE THE COMMUNITY BY CARING FOR THE SICK REGARDLESS OF ABILITY TO PAY. AS A TAX-EXEMPT HOSPITAL, PPMH HAS NO STOCKHOLDERS OR OWNERS. ALL REVENUE AFTER EXPENSES IS REINVESTED IN THE MISSION TO CARE FOR THE CITIZENS OF THE COMMUNITY - INTO CLINICAL CARE, HEALTH PROGRAMS, STATE-OF-THE-ART TECHNOLOGY AND FACILITIES, RESEARCH, AND TEACHING AND TRAINING OF MEDICAL PROFESSIONALS NOW AND FOR THE FUTURE. PPMH OPERATES AS A CHARITABLE ORGANIZATION CONSISTENT WITH THE REQUIREMENTS OF INTERNAL REVENUE CODE SECTION 501(C)(3) AND THE "COMMUNITY BENEFIT STANDARD" OF IRS REVENUE RULING 69-545. PPMH TAKES SERIOUSLY ITS RESPONSIBILITY AS THE COMMUNITY'S SAFETY NET HOSPITAL AND HAS A STRONG RECORD OF MEETING AND EXCEEDING THE CHARITABLE CARE AND THE ORGANIZATIONAL AND OPERATIONAL STANDARDS REQUIRED FOR FEDERAL TAX-EXEMPT STATUS. PPMH DEMONSTRATES A CONTINUED AND EXPANDING COMMITMENT TO MEETING ITS MISSION AND SERVING THE CITIZENS BY PROVIDING COMMUNITY BENEFITS. A COMMUNITY BENEFIT IS A PLANNED, MANAGED, ORGANIZED, AND MEASURED APPROACH TO MEETING IDENTIFIED COMMUNITY HEALTH NEEDS, REQUIRING A PARTNERSHIP BETWEEN THE HEALTHCARE ORGANIZATION AND THE COMMUNITY TO BENEFIT RESIDENTS THROUGH PROGRAMS AND SERVICES THAT IMPROVE HEALTH STATUS AND QUALITY OF LIFE. PPMH IMPROVES THE HEALTH AND WELL-BEING OF SOUTHWEST GEORGIA THROUGH CLINICAL SERVICES, EDUCATION, RESEARCH AND PARTNERSHIPS THAT BUILD HEALTH CAPACITY IN THE COMMUNITY. PPMH PROVIDES COMMUNITY BENEFITS FOR EVERY CITIZEN IN ITS SERVICE AREA AS WELL AS FOR THE MEDICALLY UNDERSERVED. PPMH CONDUCTS COMMUNITY NEEDS ASSESSMENTS AND PAYS CLOSE ATTENTION TO THE NEEDS OF LOW INCOME AND OTHER VULNERABLE PERSONS AND THE COMMUNITY AT LARGE. PPMH OFTEN WORKS WITH COMMUNITY GROUPS TO IDENTIFY NEEDS, STRENGTHEN EXISTING COMMUNITY PROGRAMS AND PLAN NEWLY NEEDED SERVICES. IT PROVIDES A WIDE- RANGING ARRAY OF COMMUNITY BENEFIT SERVICES DESIGNED TO IMPROVE COMMUNITY HEALTH AND THE HEALTH OF INDIVIDUALS AND TO INCREASE ACCESS TO HEALTH CARE, IN ADDITION TO PROVIDING FREE AND DISCOUNTED SERVICES TO PEOPLE WHO ARE UNINSURED AND UNDERINSURED. PPMH'S EXCELLENCE IN COMMUNITY BENEFIT PROGRAMS WAS RECOGNIZED BY THE PRESTIGIOUS FOSTER MCGAW PRIZE AWARDED TO PPMH IN 2003 FOR ITS BROAD-BASED OUTREACH IN BUILDING COLLABORATIVES THAT MAKE MEASURABLE IMPROVEMENTS IN HEALTH STATUS, EXPAND ACCESS TO CARE AND BUILD COMMUNITY CAPACITY, SO THAT PATIENTS RECEIVE CARE CLOSEST TO THEIR OWN NEIGHBORHOODS. DRAWING ON A DYNAMIC AND FLEXIBLE STRUCTURE, THE COMMUNITY BENEFIT PROGRAMS ARE DESIGNED TO RESPOND TO ASSESSED NEEDS AND ARE FOCUSED ON UPSTREAM PREVENTION. AS SOUTHWEST GEORGIA'S LEADING PROVIDER OF COST-EFFECTIVE, PATIENT-CENTERED HEALTH CARE, PPMH IS ALSO THE REGION'S LARGEST EMPLOYER WITH MORE THAN 3,600 MEMBERS OF PPMH FAMILY CARING FOR PATIENTS. PPMH PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS AND IS ONE OF THE LEADING PROVIDERS OF MEDICAID SERVICES IN GEORGIA. THE FOLLOWING TABLE SUMMARIZES THE AMOUNTS OF CHARGES FOREGONE (I.E., CONTRACTUAL ADJUSTMENTS) AND ESTIMATES THE LOSSES (COMPUTED BY APPLYING A TOTAL COST FACTOR TO CHARGES FOREGONE) INCURRED BY PPMH DUE TO INADEQUATE PAYMENTS BY THESE PROGRAMS AND FOR INDIGENT/CHARITY. THIS TABLE DOES NOT INCLUDE DISCOUNTS OFFERED BY PPMH UNDER MANAGED CARE AND OTHER AGREEMENTS: CHARGES ESTIMATED FOREGONE UNREIMBURSED COST MEDICARE 714,000,000 220,000,000 MEDICAID 264,000,000 81,000,000 INDIGENT/CHARITY 68,000,000 21,000,000 1,046,000,000 322,000,000 INDIGENT/CHARITY CARE BY COUNTY PPMH PROVIDED CARE TO A TOTAL OF 7,453 INDIGENT/CHARITY PATIENTS DURING 2020. THESE PATIENTS CAME FROM NUMEROUS COUNTIES THROUGHOUT GEORGIA AND SURROUNDING STATES. THE FOLLOWING TABLE SUMMARIZES THE AMOUNTS OF CHARGES FOREGONE AND ESTIMATES THE LOSSES INCURRED BY PPMH BY COUNTY. CHARGES ESTIMATED COUNTY FOREGONE UNREIMBURSED COST DOUGHERTY 33,000,000 10,200,000 LEE 8,500,000 2,600,000 WORTH 3,800,000 1,200,000 TERRELL 3,200,000 1,000,000 MITCHELL 2,800,000 900,000 SUMTER 2.800,000 900,000 RANDOLPH 1,400,000 500,000 CRISP 1,100,000 400,000 CALHOUN 900,000 300,000 COLQUITT 1,500,000 300,000 OTHER GEORGIA 8,000,000 2,500,000 OUT OF STATE 1,000,000 200,000 TOTAL 68,000,000 21,000,000 THE FOLLOWING IS A SUMMARY OF THE COMMUNITY BENEFIT ACTIVITIES AND HEALTH IMPROVEMENT SERVICES OFFERED BY PPMH AND ILLUSTRATES THE ACTIVITIES AND DONATIONS DURING FISCAL YEAR 2020. I. COMMUNITY HEALTH IMPROVEMENT SERVICES A. COMMUNITY HEALTH EDUCATION PPMH PROVIDED HEALTH EDUCATION SERVICES IN 2019-2020.THESE SERVICES INCLUDED THE FOLLOWING FREE CLASSES AND SEMINARS: - COVID 19 HOTLINE - COVID 19 UPDATES TO THE COMMUNITY - HEALTH TEACHER TRAINING - CPR TRAINING - SAFE SITTER CLASSES - OPIOID COMMUNITY TASK FORCE MEETINGS AND CAMPAIGN LAUNCH - SCHOOL-BASED OPIOID PREVENTION PROGRAM - SCHOOL STAFF EDUCATION IN ELEMENTARY SCHOOLS - DIABETES AWARENESS SEMINARS - PARTICIPATED IN COMMUNITY GARDEN ACTIVITIES AT ALL THE PUBLIC SCHOOLS IN DOUGHERTY COUNTY. MEN'S AND WOMEN'S HEALTH CONFERENCES THE MENS AND WOMENS CONFERENCES ATTRACTED 791 PARTICIPANTS. THESE CONFERENCES PROVIDED BLOOD PRESSURE, GLUCOSE, AND CHOLESTEROL, PSA FOR MEN AND BMI SCREENINGS FOR EACH PARTICIPANT AND WAS MADE POSSIBLE BY A BROAD COALITION OF PROVIDERS SUCH AS THE FAITH-BASED INITIATIVE, HEART AND CANCER SOCIETY, HORIZONS COMMUNITY SOLUTIONS, PUBLIC HEALTH AMONG OTHERS. THE TOTAL COST FOR ALL HEALTH FAIRS WAS 25,200. THE MENS CONFERENCE WAS HELD OUTSIDE BECAUSE OF COVID RESTRICTIONS IN PLACE. NETWORK OF TRUST THIS IS A NATIONALLY RECOGNIZED PROGRAM AIMED AT TEEN MOTHERS TO PROVIDE PARENTING SKILLS, ATTEMPT TO REDUCE REPEAT PREGNANCIES, AND COMPLETE HIGH SCHOOL. THIS PROGRAM ALSO INCLUDES A TEEN FATHER PROGRAM ALONG WITH OTHER TEENAGED CHILDREN PROGRAMS. INTERNAL EVALUATION SHOWS TEENS PARTICIPATING IN THE PROGRAM ARE LESS LIKELY TO REPEAT A PREGNANCY PRIOR TO GRADUATION. NETWORK OF TRUST ENROLLED 50 TEEN PARENTS DURING THE 2019/2020 SCHOOL YEAR AT A COST OF 268,790. PROJECT RESULTS DEMONSTRATE TEENS THAT GRADUATED FROM THE TWO-SEMESTER PROGRAM ARE LESS LIKELY TO HAVE A SECOND PREGNANCY PRIOR TO AGE 21. 21 OF THE 24 NETWORK OF TRUST SENIORS GRADUATED AND THERE WAS 1 REPEAT PREGNANCY. IN ADDITION, NETWORK OF TRUST AND THE SCHOOL NURSE PROGRAM PROVIDED HEALTH FAIRS TO CHILDREN AT VARIOUS PUBLIC SCHOOLS WITH 504 STUDENTS PARTICIPATING AND AN ADDITIONAL 5,711 STUDENTS PARTICIPATING IN THE OPIOID PREVENTION PROJECT. COVID 19 UPDATES TO THE MEDIA AND COMMUNITY THE PHOEBE COMMAND CENTER PROVIDED DAILY UPDATES OF CONFIRMED COVID CASES AND HOSPITALIZATIONS THROUGH THE MEDIA AND ON PHOEBES WEBSITE. IN ADDITION, PHOEBE PHYSICIANS AND ADMINISTRATIVE STAFF ATTENDED CITY AND COUNTY PRESS CONFERENCES TO PROVIDE UPDATES TO THE COMMUNITY AT LARGE. PHYSICIANS AND EXECUTIVE STAFF PROVIDED NUMEROUS INTERVIEWS TO MAJOR NEWS OUTLETS SUCH AS ABC, NBC, CNN AND OTHERS. THE ESTIMATED COST TO PHOEBE WAS 33,387. B. COMMUNITY BASED CLINICAL SERVICES FLU SHOTS PPMH PROVIDES FREE FLU SHOTS TO VOLUNTEERS, STUDENTS AND HOMELESS SHELTERS. IN 2020, THE CORPORATION ADMINISTERED 373 FLU SHOTS AT AN UNREIMBURSED COST OF 7,180. SCHOOL NURSE PROGRAM PPMH PLACES NURSES IN SIXTEEN ELEMENTARY SCHOOLS, SIX MIDDLE SCHOOLS, AND FOUR HIGH SCHOOLS IN DOUGHERTY COUNTY WITH A GOAL OF CREATING ACCESS TO CARE FOR STUDENTS AND STAFF, ASSESSING THE HEALTH CARE STATUS OF EACH POPULATION REPRESENTED AND EFFECTIVELY ESTABLISHING REFERRALS FOR ALL HEALTH CARE NEEDS. NURSES ALSO CONDUCTED THE EIGHTH GRADE HEALTH FAIRS, CPR TRAINING AND SAFE SITTER CLASSES. DURING THE 2019/2020 SCHOOL YEAR, THE SCHOOL NURSE PROGRAM COVERED APPROXIMATELY 13,000 STUDENT LIVES. THIS PROGRAM OPERATED AT A COST OF 376,371 IN 2020. MAMMOGRAPHY PPMH PROVIDED 100 MAMMOGRAMS TO THE UNINSURED IN 2019/2020 AT A COST OF 14,000. C. HEALTH CARE SUPPORT SERVICES COVID 19 NURSE HOTLINE IN RESPONSE TO AN UNPRECEDENTED EARLY SURGE OF COVID-19 CASES IN OUR COMMUNITY, PPMH ADDED A NURSE HOTLINE. SUMMARY DOCUMENTS SHOW APPROXIMATELY 4,000 FIELDED CALLS COVERING 1,720 HOURS OF NURSE TIME DURING THE SURGE. THE COST TO THE ORGANIZATION WAS 81,748. GOVERNMENT SPONSORED ELIGIBILITY APPLICATIONS TO THE POOR AND NEEDY PPMH CONTRACTS FOR ELIGIBILITY APPLICATIONS ON BEHALF OF THE POOR AND NEEDY THAT MAY BE ELIGIBLE FOR MEDICAID. IN SOME CASES, IT CAN TAKE UP TO TWO YEARS TO BE DEEMED ELIGIBLE. IN 2020 PPMH PAID 781,419 TO PROCESS THESE APPLICATIONS. - FINANCIAL ASSISTANCE POLICY (FAP) PPHS WILL EXTEND FREE OR DISCOUNTED CARE TO ELIGIBLE INDIVIDUALS FOR ALL URGENT, EMERGENT, OR OTHERWISE MEDICALLY NECESSARY SERVICES. PATIENTS WHOSE HOUSEHOLD INCOME IS AT OR BELOW 125% OF THE FEDERAL POVERTY GUIDELINES ARE ELIGIBLE FOR FREE CARE. PATIENTS WHOSE HOUSEHOLD INCOME IS BETWEEN 126% AND 400% OF THE FEDERAL POVERTY GUIDELINES QUALIFY FOR DISCOUNTED CHARGES BASED ON A SLIDING FEE SCHEDULE IN THE FAP. PPMH W true HOSPITAL AUTHORITY OF ALBANY DOUGHERTY COUNTY PO BOX 3770 ALBANY GA 317063770 450825965 GOV 52000 GENERAL SUPPORT HORIZONS COMMUNITY SOLUTIONS 810 13TH AVE SUITE 105 ALBANY GA 317012512 820567901 501C3 146250 GENERAL SUPPORT PHOEBE FOUNDATION PO BOX 3770 ALBANY GA 317063770 581847104 501C3 154522 GENERAL SUPPORT ALBANY CHAMBER FOUNDATION 225 W BROAD AVENUE ALBANY GA 317012512 580134930 GOV 100000 GENERAL SUPPORT AMERICAN CANCER SOCIETY 250 WILLIAMS ST NW 400 ATLANTA GA 303031002 580659875 501C3 10000 GENERAL SUPPORT FLINT RIVER FRESH 125 PINE AVE STE 150 ALBANY GA 31701 823202212 GOV 6500 FMV SUPPLIES GENERAL SUPPORT 5 EDUCATIONAL ASSISTANCE 49 212619 SCHEDULE I, PAGE 1, PART I, LINE 2 CONTRIBUTIONS ARE MADE ONLY TO TAX EXEMPT ENTITIES. BOARD APPROVAL IS REQUIRED FOR MAJOR CONTRIBUTIONS AND A FOLLOW-UP WITH THE TAX EXEMPT ENTITY IS REQUIRED FOR MONITORING THE USE OF THE FUNDS. TUITION POLICY: EMPLOYEE MUST BE EMPLOYED AS A REGULAR FULL TIME EMPLOYEE (64+ HOURS PER PAY PERIOD) FOR AT LEAST ONE YEAR, 12 MONTHS. THEY MUST SCORE A "MEETS EXPECTATIONS- OR GREATER ON THEIR LAST EVALUATION. THE EMPLOYEE MUST MAINTAIN A SEMESTER OR QUARTER GPA OF 2.5 FOR UNDERGRADUATE STUDIES AND 3.0 FOR GRADUATE STUDIES TO RECEIVE TUITION ASSISTANCE. EMPLOYEE MUST SUBMIT A COPY OF GRADE TO THE BENEFITS DEPARTMENT AND MANAGER AFTER THE COMPLETION OF EACH COURSE. AN EMPLOYEE RECEIVING TUITION ASSISTANCE IS REQUIRED TO WORK FOR PHOEBE ONE YEAR, FULL-TIME UPON DEGREE COMPLETION OR CESSATION FROM THE DEGREE PROGRAM. false true false false false false false false false JOEL WERNICK PAST CEO/PRES/BD MEM 484128 847462 26777 7873 9678 1375918 JAMES E BLACK MED DIR - EMERG SVCS 427639 35924 19107 446875 8324 10381 5431 501375 452306 SCOTT STEINER PPHS CEO 628405 97805 25570 151535 18402 921717 JOE AUSTIN PPMH CEO 474100 120452 23907 144739 22235 785433 BRIAN CHURCH CFO 469857 110996 19490 105680 23553 729576 KATHERINE HUDSON MD BOARD MEMBER 333365 51519 260168 8400 21175 674627 DAWN BENSON SVP GENERAL COUNSEL 397279 100618 21908 129295 649100 JEFFERY FLOWERS PPMH COO 266736 53884 180519 61496 19059 581694 152914 WILLIAM M SEWELL III MEDICAL DIRECTOR-W&C 333298 82510 1539 8267 22428 448042 EVELYN M OLENICK SVP CNO 242539 53388 20769 48432 21216 386344 THOMAS SULLIVAN SVP NORTH CAMPUS 250768 51884 12309 47535 20725 383221 JESSE DIAZ VP INFO SYSTEMS 220183 41276 1419 5064 19268 287210 BIPIN AGARWAL CHIEF PHYSICIST 239655 1497 6868 19024 267044 KIM WHITLEY VP PT LOGISTICS/CARE 200340 35926 1199 5775 9969 253209 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 0 143,135 0 JOE AUSTIN 0 136,339 0 BRIAN CHURCH 0 100,626 0 DAWN BENSON 0 121,137 0 JEFFERY FLOWERS 0 53,574 0 EVELYN M. OLENICK 0 40,924 0 THOMAS SULLIVAN 0 39,332 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"), THE FIRST 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. FOR PARTICIPANTS INITIALLY PARTICIPATING IN THE SERP AFTER 12/31/2016, 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 THIS 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. A HOSP AUTH OF ALBANY-DO CO GA 2012 450825965 012170EC6 2012-12-13 114306593 SEE PART VI false false false B HOSP AUTH OF ALBANY-DO CO GA 2018 450825965 2018-11-01 172865000 SEE PART VI false false false A 16980100 114306593 906593 113400000 2012 false false true true B 4130000 172865000 172865000 2012 true false true true A false true false false 0.00890 0.00890 false false true B false true false false 0.00160 0.00160 false false true A false false true true false false false false false B false false true false true false false false false A true B true PURPOSE OF ISSUE DESCRIPTION HOSP AUTH OF ALBANY-DO CO, GA 2012 SEE PART VI PURPOSE OF ISSUE DESCRIPTION HOSP AUTH OF ALBANY-DO CO, GA 2018 SEE PART VI DATE REBATE COMPUTATION PERFORMED HOSP AUTH OF ALBANY-DO CO, GA 2012 06/13/13 ADDITIONAL INFORMATION HOSP AUTH OF ALBANY-DO CO, GA 2012 PART I, COLUMN F, SERIES 2012 FINANCING THE COSTS OF MAKING CERTAIN ADDITIONS, EXTENSIONS, AND CAPITAL IMPROVEMENTS TO THE HEALTH CARE SYSTEM. ADDITIONAL INFORMATION HOSP AUTH OF ALBANY-DO CO, GA 2018 PART I, COLUMN F, SERIES 2018 REISSUANCE OF PRIOR BONDS (7/9/10, 12/7/12, 2/2/15) PART IV, LINE 2C SINCE THE 2012 AND 2018 BOND PROCEEDS HAVE BEEN SPENT, A SPENDING EXCEPTION WAS MET, AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATION IS NECESSARY. FORM 990 FORM 990, PART IX, LINE 24A SUBSIDY TO PHYSICIAN CLINICS FOR LOSSES ASSOCIATED WITH LOW-INCOME PATIENTS. FORM 990, PAGE 6, PART VI, LINE 6 THE SOLE MEMBER OF PHOEBE PUTNEY MEMORIAL HOSPITAL, INC. SHALL BE PHOEBE PUTNEY HEALTH SYSTEM, INC. (PPHS). FORM 990, PAGE 6, PART VI, LINE 7A THE BOARD OF DIRECTORS OF PPHS HAS THE RIGHT TO APPOINT DIRECTORS OF THE FILING ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 7B THE MEMBER 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 PUTNEY MEMORIAL HOSPITAL (PPMH) 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 PPMH 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 SO 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 CONTRACT STAFFING FEES 43,529,892 566,915 0 INTERCOMPANY ALLOCATED COST 23,014,440 19,654,969 0 OTHER PATIENT RELATED SERV 9,399,492 4,075,122 0 CONTRACT SERVICE FEES 7,852,661 3,347,261 0 CONSULTANT FEES 384,162 979,228 0 PROFESSIONAL FEES 335,085 0 0 COLLECTION FEES 0 3,486,257 0 TOTAL 84,515,732 32,109,752 0 FORM 990, PART XI, LINE 9 NET ACTUARIAL LOSS -39,905,138 AMORTIZATION OF NET LOSS 3,620,511 CHANGE IN INTEREST IN NET ASSETS OF PHOEBE FND 3,953,070 IMPLEMENTATION OF ASU 842 - LEASES -700,510 TOTAL -33,032,067 THE CHANGE IN NET ASSETS IS RELATED TO NONCASH TRANSACTIONS AS DETAILED ABOVE. RECENTLY ADOPTED ACCOUNTING PRONOUNCEMENTS IN FEBRUARY 2016, THE FASB ISSUED ASU NO. 2016-02, LEASES (TOPIC 842), WHICH IS A NEW COMPREHENSIVE LEASE ACCOUNTING MODEL. THE NEW STANDARD CLARIFIES THE DEFINITION OF A LEASE AND REQUIRES LESSEES TO RECOGNIZE RIGHT-OF-USE ASSETS AND RELATED LEASE LIABILITIES FOR ALL LEASES WITH TERMS GREATER THAN TWELVE MONTHS. AS PART OF THE TRANSITION TO THE NEW STANDARD, THE CORPORATION WAS REQUIRED TO MEASURE AND RECOGNIZE LEASES THAT EXISTED AT AUGUST 1, 2019 USING A MODIFIED RETROSPECTIVE APPROACH. THE CORPORATION APPLIED THE NEW STANDARD AT THE ADOPTION DATE AND RECOGNIZED A CUMULATIVE-EFFECT ADJUSTMENT TO THE OPENING BALANCE OF NET ASSETS IN THE PERIOD OF ADOPTION. THE CORPORATION ELECTED THE PACKAGE OF PRACTICAL EXPEDIENTS PERMITTED UNDER THE NEW STANDARD THAT ALLOWED THE CORPORATION TO CARRY FORWARD HISTORICAL LEASE CLASSIFICATION. THE CORPORATION ALSO ELECTED THE PRACTICAL EXPEDIENT THATW ALLOWED THE CORPORATION TO NOT SEPARATE NONLEASE COMPONENTS FROM THE ASSOCIATED LEASE COMPONENTS. FORM 990, PAGE 12, PART XII, LINE 3B DURING FISCAL YEAR 2020, FEDERAL AWARDS EXPENDED EXCEEDED THE 750,000 THRESHOLD REQUIRING A SINGLE AUDIT (PREVIOUSLY KNOWN AS THE OMB CIRCULAR A-133 AUDIT). THE SUBSTANTIAL PORTION OF THESE FEDERAL EXPENDITURES RELATED TO THE FUNDING ASSOCIATED WITH THE CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY ACT (CARES ACT). TYPICALLY, THE SINGLE AUDIT DUE DATE WOULD BE NINE MONTHS FROM THE END OF THE FISCAL YEAR BEING REPORTED ON (APRIL 30, 2021). HOWEVER, THE DEADLINE TO SUBMIT THE REQUIRED SINGLE AUDIT HAS BEEN EXTENDED BY THE OFFICE OF MANAGEMENT AND BUDGET (OMB) TO INCLUDE AN ADDITIONAL SIX MONTHS BEYOND THE ORIGINAL NINE-MONTH PERIOD (NOVEMBER 1, 2021). AS SUCH, PPMH HAS NOT UNDERGONE THE SINGLE AUDIT ASSOCIATED WITH ITS FISCAL YEAR 2020, BUT ARRANGEMENTS HAVE BEEN MADE TO UNDERGO THIS SINGLE AUDIT AND TO ENSURE ITS COMPLETION PRIOR TO THE EXTENDED DEADLINE. PHOEBE PUTNEY HEALTH SYSTEM INC PO BOX 3770 ALBANY GA 317063770 582001014 HEALTHCARE GA 501C3 12C NA false PHOEBE FOUNDATION INC PO BOX 3770 ALBANY GA 317063770 581847104 FOUNDATION GA 501C3 12A PPHS false PHOEBE PHYSICIAN GROUP INC PO BOX 3770 ALBANY GA 317063770 263792403 HEALTHCARE GA 501C3 10 PPHS false PHOEBE WORTH MEDICAL CENTER INC PO BOX 545 SYLVESTER GA 317910545 383647394 HEALTHCARE GA 501C3 3 PPHS false PHOEBE SUMTER MEDICAL CENTER INC 126 HIGHWAY 280 WEST AMERICUS GA 317198645 263975185 HEALTHCARE GA 501C3 3 PPHS false SOUTH GEORGIA SHARED SERVICES INC 417 WEST THIRD AVENUE ALBANY GA 317011943 462746977 COOPERATIV GA 501C3 3 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 true true true true false false false false true true true true false true false false true false