2021-05-17T15:18:20-05:00 2020-06-30 KPMG LLP 303 PEACHTREE ST STE 2000 ATLANTA GA 30308 990 2019-07-01 300999841 Piedmont Rockdale Hospital % MARIE GAFFNEY PIED 7709183000 1412 Milstead Avenue Conyers GA 30012 MARIE GAFFNEY VP CORPORATE FINANCE 4702716007 2021-05-17 true WHITNEY B HEBRON P01226647 4042223000 2021-05-13 2019 2022-09-23 18:48:47Z MR RICHARD TANZELLA 1412 Milstead Avenue Conyers GA 30012 174296432 false X www.piedmont.org/locations/piedmont-rockdale/ X 2017 GA TO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT. 14 10 1264 135 0 0 4162 13539467 177444627 159909272 79624 36432 822649 811261 178351062 174296432 0 0 0 0 76944011 77953663 0 0 0 123265862 94218715 200209873 172172378 -21858811 2124054 103827007 101587949 9528015 100876496 94298992 711453 X 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 147227992 0 159911577 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, 2020, THE HOSPITAL HAD 8,603 IN-PATIENT ADMISSIONS WITH A TOTAL OF 37,522 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 48,054 AND OUTPATIENT VISITS TOTALED 42,408. SURGICAL SERVICES WERE PROVIDED TO 4,591 PATIENTS. 147227992 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 1264 true false false false false false false false false false false false false X 14 10 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 DR Leigh Hamby Board Member 1.0 54.0 X 0 1097513 126333 Mr Michael McAnder Treasurer 1.0 54.0 X 0 1036007 130895 MR J Michael Burnett Board Member 1.0 54.0 X 0 891386 109446 Ms Elizabeth Leddy Secretary 1.0 54.0 X 0 843536 107225 MR Richard Tanzella CEO & Board Member 55.0 0.0 X X 526190 0 82559 Dr Geoffrey Cole CMO 55.0 0.0 X 451128 0 27912 Mr Marvin Wynn CFO 55.0 0.0 X 267900 0 27649 Ms Leigha Fallis CNO 40.0 0.0 X 225510 0 31891 Mr Blakely Watts Exec. Dir. - Operations 40.0 0.0 X 209613 0 28795 Ms Melanie Mcgriff Exec. Dir - Patient Svcs 40.0 0.0 X 179054 0 22718 Ms Amanda Miller DIRECTOR - PHARMACY 40.0 0.0 X 172100 0 16987 Ms Karen Bowers DIRECTOR - LAB 40.0 0.0 X 152474 0 15750 DR Timothy Cowthorn Board Member 1.0 0.0 X 24500 0 0 DR Benetta Duhart Board Member 1.0 0.0 X 12510 0 0 DR Steven Durocher Board Member 1.0 0.0 X 0 2400 0 MS Ethel R Boyle Board Member 1.0 0.0 X 0 0 0 DR Michael P Cecil Board Member 1.0 0.0 X 0 0 0 MR Wm Ronald Duffey Board Member 1.0 4.0 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 2220979 3870842 728160 53 false true false WALKER LAKE PHYSICIAN SERVICES PC 1412 MILSTEAD AVE CONYERS GA 30012 HOSPITALIST SERVICES 2639152 MEDICAL SOLUTIONS LLC 1010 NORTH 102ND STREET SUITE 300 OMAHA NE 68114 STAFFING SERVICES 1719317 GREYSTONE OBGYN 3240 AVALON BLVD CONYERS GA 30013 OB/GYN SERVICES 670030 TOTAL RENAL CARE INC 601 HAWAII ST EL SEGUNDO CA 90245 DIALYSIS 962106 INSIGHT HEALTH CORPORATION 26250 Enterprise Court LAKE FOREST CA 92360 DIAGNOSTIC IMAGING 429336 17 13538496 971 13539467 PATIENT SERVICE REVENUE 622110 159606734 159606734 OTHER OPERATING REVENUE 900099 302538 302538 159909272 36432 0 36432 0 0 295927 295927 0 295927 295927 0 0 0 0 0 0 0 0 0 0 CAFETERIA SALES 722310 513029 513029 FEE REVENUE 900099 2305 2305 515334 174296432 159911577 0 845388 0 0 0 0 1593410 382925 1210485 0 61949143 55422674 6526469 0 10225950 8928584 1297366 4185160 3594216 590944 139858 139814 44 16078 16078 0 0 0 0 16177062 13158340 3018722 510071 40659 469412 12483577 9462353 3021224 2997722 2272273 725449 0 2128131 1974987 153144 8344 5212 3132 0 0 1840677 1840677 3093097 3093097 4771640 4436009 335631 2596783 1943194 653589 DRUGS & MEDICAL SUPPLIES 22862822 22862822 BAD DEBT EXPENSE 19041634 19041634 HOSPITAL TAX 775023 775023 ADMINISTRATIVE EXPENSES 4776196 2787273 1988923 172172378 147227992 24944386 0 19868 108511 0 0 0 0 24998450 23331811 0 0 0 0 0 0 3236541 3369604 640992 480906 56303280 9744743 47778017 46558537 0 0 0 0 0 0 0 0 27153139 27738580 103827007 101587949 9457053 10624419 0 0 0 0 0 75432905 0 0 0 0 0 0 0 0 70962 14819172 9528015 100876496 X 94306186 701911 -7194 9542 94298992 711453 103827007 101587949 X 2124054 -95711593 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3958141 3958141 35619009 3590249 32028760 0 0 0 15062807 6154494 8908313 1663323 0 1663323 46558537 GOODWILL 27738580 27738580 0 INTERUNIT PAYABLE 616032 MEDICARE PAYABLE 14203140 14819172 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, 2020 AND 2019. true true X true X 300. true X true true false true true 13444567 0 13444567 0.08780 6447551 5790753 656798 0.00430 1488360 366772 1121588 0.00730 21380478 6157525 15222953 0.09940 136700 0 136700 0.00090 1432311 0 1432311 0.00940 545000 0 545000 0.00360 0 0 0 0.00000 71000 0 71000 0.00050 2185011 0 2185011 0.01440 23565489 6157525 17407964 0.11380 true 6415845 0 26692132 27649557 -957425 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 true true 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, LINES 1 AND 2: NEW HOSPITAL ENTITY PIEDMONT ROCKDALE HOSPITAL, INC. ("PRH") WAS CREATED AS A NEW ENTITY ON AUGUST 7, 2017, FOLLOWING THE PURCHASE OF THE ASSETS OF ROCKDALE MEDICAL CENTER, INC. FROM LIFEPOINT HEALTH, LLC, A FOR-PROFIT COMPANY. DURING FY18, THE INTERNAL REVENUE SERVICE GRANTED PRH'S TAX-EXEMPT STATUS, RETROACTIVE TO ITS DATE OF ORGANIZATION, AUGUST 7, 2017. 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, WITHIN THE GRACE PERIOD. 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 Piedmont Rockdale Hospital regularly reports to the community its community benefit activities in several ways. Each year, the hospital prepares a systemwide community-benefit report that is widely distributed to the public through emailed versions sent to community stakeholders and community organizations, printed copies made available to community members upon request, and publication on the system's website. The hospital also makes available copies of its IRS Form 990 Schedule H on its website and available to anyone upon request. Additionally, the hospital presents its community benefit work within the health care system's annual report and the health care system's foundation annual report, which is widely distributed to the public through both printed copies made available to community members upon request and through publication on the system's website. Additionally, the report was mailed to hospital and system board members, state and local elected officials and other key stakeholders. The hospital provides information on community benefit programming to local, state and federal lawmakers through our government affairs office. Finally, the hospital issues media alerts on key community benefit programming, such as its community benefit grants program, to the public, and provides an annual impact report demonstrating the outcomes from those grants. 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 $172,172,378, LESS BAD DEBT EXPENSE OF $19,041,634 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 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 double accounts based upon historical write-off experience by payer 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 the organization's 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. The organization believes that Piedmont Rockdale Hospital's 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 the hospital operates to promote health in the community. Additionally, Medicare accounted for 41.13% percent of Piedmont Rockdale Hospital's patient service revenue and charity care accounted for an additional 8.39% of total revenue. Piedmont Rockdale Hospital's 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 the hospital in honor of Piedmont Rockdale Hospital's 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, Piedmont Rockdale Hospital is 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, the hospital aimed to 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, Piedmont Rockdale Hospital conducted its first triennial CHNA, as the entity was a for-profit previously. The Piedmont Rockdale Hospital CHNA was led by the Piedmont Healthcare community benefits team, with input and direction from Piedmont Rockdale Hospital leadership and direct input from board members both at a March 2018 board meeting and through individual meetings with hospital leadership, including the hospital's chief executive officer. Process The CHNA started first with a definition of its community. We defined the hospital's primary population as the hospital's home county, due to the impact of its tax-exempt status. We estimate property taxes make up the largest segment of a hospital's tax exemption. Because of this, we want to ensure that we are providing equal benefit to our county. 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 criteria, including ones from nearby counties. 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 are for 2017, unless otherwise noted. Health indicators are estimates provided by County Health Rankings and hospital data was provided by the hospital. 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 the hospital's 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. 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 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. How we determined our priorities: 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 the Piedmont Rockdale Hospital Board of Directors on April 18, 2019. The Piedmont Rockdale Hospital implementation strategy was developed in partnership with hospital leadership and community stakeholders to address the identified priorities in our FY19 CHNA. 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, Piedmont Rockdale Hospital leadership and the Piedmont Rockdale Hospital Board of Directors. 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 Piedmont Rockdale Hospital understands that not everyone has the ability to 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 available at Piedmont Rockdale Hospital includes providing a dedicated contact number, which is disseminated by the hospital to patients by various means. These include, but are not limited to: the publication of notices in patient bills and by posting notices in emergency rooms, in the Conditions of Admission form, at admitting and registration departments, hospital business offices, and patient financial services offices that are located on facility campuses, and at other public places the hospital may elect, including availability at local low-cost clinics primarily treating uninsured populations. Piedmont Rockdale Hospital also publishes and widely publicizes a plain language summary of this financial assistance care policy on its facility website, which includes a link to 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. Finally, we provide copies of our financial assistance policy to our partner clinics and others who work closely with low-income populations. We offer assistance in understanding the policy, how it relates to their populations and receive feedback in ways our financial assistance programming could be improved. Additionally, 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 patient financial assistance. 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. Copies are provided in both English and Spanish. In FY20, we distributed approximately 2,875 copies of this guide throughout the Rockdale community. SCHEDULE H, PART VI, LINE 4: COMMUNITY INFORMATION Piedmont Rockdale Hospital is located in Rockdale County, which we consider to be our primary community. A total of 89,717 people live in the 129.81 square mile report area defined for this assessment according to the U.S. Census Bureau American Community Survey 2015-19 5-year estimates. The population density for this area, estimated at 691.13 persons per square mile, is greater than the national average population density of 91.93 persons per square mile. During those years, about 39 percent of all Rockdale County residents were white, 55 percent were African American, and other races made up the remaining 6 percent. The median age of people living within the county was 37, on par with state and national averages. Twenty-five percent of the population were 18 or younger, 62 percent were between the ages of 18 and 64 and 13 percent were 65 and older. Between 2015 and 2019, the median household income was $60,189. Fifty-seven percent of the population has, at a minimum, attended some college (with 36 percent having obtained an associate degree or higher), and 9 percent had only a high school diploma. Just over 11 percent did not graduate high school Generally speaking, household income and educational attainment are related. Nearly 6 percent of adults were unemployed in 2020, a figure higher than the national average of 5.4 percent. Thirty percent of households had housing costs that exceeded more than 30 percent of total household income in 2017, indicating a cost burdened household more likely to face overall financial difficulty. Thirteen percent of the county - about 11,665 people - lived in poverty each year on average between 2015 and 2019. During that same time, 21 percent of children in Rockdale County lived in poverty, a figure that is in line with the state average of 22 percent. Seventy percent of public school children were eligible for the free or reduced priced lunch program during the 2018-2019 school year, which is lower than the state average of 60 percent. Poor children are statistically less likely to graduate high school or attend college and are nearly twice as likely to become poor adults than their non-poor counterparts. In Rockdale County, nearly 14 percent of county residents were uninsured in 2019, which is lower than the state and national averages of 13.2 and 8.8 percent, respectively. Non-elderly adults by far were the most likely to be uninsured, with 18 percent of those age 18 to 64 as having no insurance coverage during that time period, as compared to 11 percent of children and less than 1 percent of seniors and elderly adults. About 6 percent of the population were 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." This is relevant as those without the ability to speak English well or at all generally face more barriers when accessing care, understanding care instructions and in talking with their doctor. In Rockdale County, like with the rest of Georgia, heart disease was the number one cause of both age-adjusted and premature death between 2015 and 2019, and this holds true for all races. 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. Newborn deaths were the second leading cause of premature death in Rockdale County between 2015 and 2018, and suicide was the third. There were three federally designated health professional shortage areas in the community in 2021: one mental health shortage area, one primary care health shortage area and one dental health shortage area. There was one dentist for every 1,350 people in 2019, one primary care physician for every 1,370 people, and one mental health provider for every 710 people. Both dental and primary care physician rates are twice as worse as the state average. Community members have reported an average 3.7 and 4.0 poor physical and mental health days, respectively. Twenty-one percent of Rockdale residents reported their health as poor or fair. Approximately 358 people lived with HIV in 2018. HIV is a life-threatening communicable disease that disproportionately affects minority populations and may also indicate the prevalence of unsafe sex practices. To that point, Chlamydia rates were below both and national averages in 2018, with 757.4 infections per every 100,000 people and 189.3 gonorrhea infections per every 100,000 people. In 2019, there were approximately 53.8 retail opioid prescriptions dispensed per 100 persons, according to the CDC. We aren't able to tell how many prescriptions are going to a single person, just the overall figure. This represents a decline from 2018, when there were 73.5 prescriptions per every 100 people. For every 1,000 teen girls aged 15 to 18 in Rockdale County, 20 birth gave birth to a child on average each year between 2012 and 2018. African American and Hispanic teens were more likely to have a baby than their white counterparts. Children born to teen are statistically much more likely to experience adverse health and socioeconomic issues as they grow older. 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 Piedmont Rockdale Hospital actively promotes the health of its community through clinic-hospital partnerships, our community benefit grants programs, community-based health screenings, educational activities, community building activities, the operation of a 24-hour emergency department available to the entire community, the operation of an emergency room open to all members of the community without regard to ability to pay, a governance board composed of community members, use of surplus revenue for facilities improvement, patient care, and medical training, education, and research, the provision of inpatient hospital care for all persons in the community able to pay, including those covered by Medicare and Medicaid, and an open medical staff with privileges available to all qualifying physicians. It's important to note that COVID-19 did have a significant impact on our proactive community benefit programs, as all in-person events and classes were canceled as of early March 2020. We worked to create programming that was responsive to the pandemic, including our migrating to online platforms for vital community-based programming. In FY20, Piedmont Rockdale Hospital provided grants to community-based organizations whose programming aligns with our FY19 CHNA. Recipients were: Mercy Heart, Rockdale County, Rockdale County Sheriff's Department and Helping Hands charitable clinic. In FY20, Piedmont Rockdale provided health professions education to students and residents training to be health professionals. That year, the hospital oversaw training at total a cost of $1.4 million. As part of a Piedmont Healthcare systemwide effort, Piedmont Rockdale Hospital was an active participant in anti-opioid work, which included: active participation on the systemwide task force, tracking opioid prescriptions within the hospital and by providers, utilizing Epic EMR tools to monitor opioid use, offering patients and the community ways to safely dispose of unused medication, and providing ongoing education on opioid prescribing. The advent of COVID-19 precluded local take-back day activities, in which we'd traditionally partner with local law enforcement to host an event in which local residents were encouraged to bring in any unused prescriptions for safe disposal. SCHEDULE H, PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM Piedmont Rockdale Hospital is a part of Piedmont Healthcare, a regional not-for-profit organization and the parent company of 11 hospitals, the Piedmont Physicians Group, the Piedmont Heart Institute, the Piedmont Clinic and the Piedmont Healthcare Foundation. Piedmont Healthcare's community benefit department coordinates the community benefit activities on behalf of all hospitals throughout the system. 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 provide key input and execute programming, such as our revenue department, which oversees and executes the financial assistance policy and program. SCHEDULE H, PART VI, LINE 7: STATE OF FILING OF COMMUNITY BENEFIT REPORT Piedmont Rockdale Hospital is not required to file a community benefit report; however, the hospital is required to file with the Georgia Department of Community Health information on its indigent and charity care, as well as its Medicaid and Medicare shortfalls. X true true false true false false false false false false false MR J Michael Burnett Board Member 0 494660 0 216563 0 180163 0 91350 0 18096 0 1000832 0 74550 DR Leigh Hamby Board Member 0 603164 0 337910 0 156439 0 108957 0 17376 0 1223846 0 92157 MR Richard Tanzella CEO & Board Member 372740 0 119301 0 34149 0 71983 0 10576 0 608749 0 0 0 Mr Marvin Wynn CFO 221546 0 44754 0 1600 0 16251 0 11398 0 295549 0 0 0 Dr Geoffrey Cole CMO 356833 0 71199 0 23096 0 16800 0 11112 0 479040 0 0 0 Ms Leigha Fallis CNO 186701 0 37634 0 1175 0 10541 10541 10809 0 246860 10541 0 0 Ms Karen Bowers DIRECTOR - LAB 132969 0 10665 0 8840 0 9160 0 6590 0 168224 0 0 0 Mr Blakely Watts Exec. Dir. - Operations 185366 0 22896 0 1351 0 12115 0 16680 0 238408 0 0 0 Ms Amanda Miller DIRECTOR - PHARMACY 155939 0 13035 0 3126 0 10316 0 6671 0 189087 0 0 0 Ms Melanie Mcgriff Exec. Dir - Patient Svcs 157925 0 19624 0 1505 0 0 0 22718 0 201772 0 0 0 Mr Michael McAnder Treasurer 0 613592 0 345604 0 76811 0 123395 0 7500 0 1166902 0 0 Ms Elizabeth Leddy Secretary 0 448895 0 251848 0 142793 0 89849 0 17376 0 950761 0 0 SCHEDULE J, PART I, LINE 1A: DISCRETIONARY SPENDING RICHARD TANZELLA, DR. LEIGH HAMBY, AND J. MICHAEL BURNETT RECEIVED A DISCRETIONARY SPENDING ACCOUNT TOTALING $12,923, A FIXED AMOUNT DETERMINED BY THEIR JOB LEVEL. 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 AND DR. LEIGH HAMBY RECEIVED SERP PAYMENTS IN THE AMOUNT OF $74,550 AND $92,157, RESPECTIVELY. THE FOLLOWING EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS: MICHAEL MCANDER 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 2019 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 EXECUTIVE PERFORMANCE AND COMPENSATION COMMITTEE ("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. 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 DISCLOSURE OF GOVERNING, CONFLICT OF INTEREST AND FINANCIAL 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 $16,736 INTERCOMPANY TRANSFERS ($88,347,486) UNALLOCATED EXPENSES ($7,389,480) GRANT REVENUE $8,637 ------------------ TOTAL ($95,711,593) 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 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 FOUR WINDS HEALTH LLC 3350 RIVERWOOD PKWY STE 1850 ATLANTA GA 30339 451273930 HEALTHCARE 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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