PIEDMONT WALTON HOSPITAL INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- PIEDMONT WALTON HOSPITAL INC (EIN 82-4194264)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-05-17
- IRS object ID
- 202141379349307719
- Schema version
- 2019v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-05-17T15:17:31-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 North Greene Street Suite 400 | AddressLine1Txt |
| City | Greensboro | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 824194264 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Piedmont Walton Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % MARIE GAFFNEY | InCareOfNm |
| Business Name Control | PIED | BusinessNameControlTxt |
| Phone | 7702678461 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2151 West Spring Street | AddressLine1Txt |
| City | MONROE | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30655 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARIE GAFFNEY | PersonNm |
| Person Title | VP CORPORATE FINANCE | PersonTitleTxt |
| Signature | 2021-05-17 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WHITNEY B HEBRON | PreparerPersonNm |
| PTIN | P01226647 | PTIN |
| Phone | 3362753394 | PhoneNum |
| Preparation | 2021-05-13 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MR LARRY EBERT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2151 West Spring Street | AddressLine1Txt |
| City | MONROE | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30655 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $71,826,183 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.piedmont.org/locations/piedmont-walton/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2018 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 451 | TotalEmployeeCnt |
| Total Volunteers | 80 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,923 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,514,606 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $57,891,379 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $69,894,045 | CYProgramServiceRevenueAmt |
| PY Investment Income | $29,418 | PYInvestmentIncomeAmt |
| CY Investment Income | $42,227 | CYInvestmentIncomeAmt |
| PY Other Revenue | $369,831 | PYOtherRevenueAmt |
| CY Other Revenue | $375,305 | CYOtherRevenueAmt |
| PY Total Revenue | $58,292,551 | PYTotalRevenueAmt |
| CY Total Revenue | $71,826,183 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $27,941,201 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $29,907,449 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $43,719,664 | PYOtherExpensesAmt |
| CY Other Expenses | $44,165,319 | CYOtherExpensesAmt |
| PY Total Expenses | $71,660,865 | PYTotalExpensesAmt |
| CY Total Expenses | $74,072,768 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$13,368,314 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,246,585 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $49,671,640 | TotalAssetsBOYAmt |
| Total Assets EOY | $51,912,402 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,816,970 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $61,490,558 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $42,854,670 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$9,578,156 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | 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. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $62,723,445 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $69,905,928 | RevenueAmt |
| Desc | PIEDMONT WALTON HOSPITAL ("PWH") IS A 77-BED, NON-PROFIT HOSPITAL LOCATED IN THE CITY OF CONYERS IN WALTON COUNTY, GEORGIA. OVER 250 PRIMARY CARE AND SPECIALTY PHYSICIANS COMPRISE THE MEDICAL STAFF AND MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SENIORS WITHIN WALTON COUNTY AND THE GREATER METROPOLITAN ATLANTA MARKET, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY FOR SERVICES. FOR THE YEAR ENDED JUNE 30, 2020, THE HOSPITAL HAD 3,005 IN-PATIENT ADMISSIONS WITH A TOTAL OF 10,840 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 31,829 AND OUTPATIENT VISITS TOTALED 16,225. SURGICAL SERVICES WERE PROVIDED TO 2,532 PATIENTS. | Desc |
| Total Program Service Expenses | $62,723,445 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 451 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARIE GAFFNEY | PersonNm |
| Phone | 4702716007 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2727 PACES FERRY RD BLDG 2 STE 70 | AddressLine1Txt |
| City | Atlanta | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30339 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Mr Michael McAnder | |||||||||
| Treasurer | 1.0 | 54.0 | Yes (X) | $0 | $1,036,007 | $130,895 | |||
| Mr J Michael Burnett | |||||||||
| Board Member | 1.0 | 54.0 | $0 | $891,386 | $109,446 | Yes (X) | |||
| Ms Elizabeth Leddy | |||||||||
| Secretary | 1.0 | 54.0 | Yes (X) | $0 | $843,536 | $107,225 | |||
| Ms Vicki A Cansler | |||||||||
| Board Member | 1.0 | 54.0 | $0 | $693,346 | $81,884 | Yes (X) | |||
| Dr Robert Sinyard | |||||||||
| CMO | 20.0 | 35.0 | $0 | $571,078 | $34,176 | Yes (X) | |||
| Mr Larry Ebert | |||||||||
| CEO & Board Member | 55.0 | 0.0 | Yes (X) | $360,737 | $0 | $26,927 | Yes (X) | ||
| Mr Marvin Wynn | |||||||||
| CFO (EFF. 5/20) | 5.0 | 50.0 | $0 | $267,900 | $27,649 | Yes (X) | |||
| Mr Michael Wynne | |||||||||
| DIRECTOR - PHARMACY | 40.0 | 0.0 | $168,121 | $0 | $20,969 | Yes (X) | |||
| Ms Rose Dennis | |||||||||
| exec. Dir. - patient svcs | 40.0 | 0.0 | $164,252 | $0 | $22,082 | Yes (X) | |||
| Ms Candice Frix | |||||||||
| CNO | 55.0 | 0.0 | $142,908 | $0 | $19,027 | Yes (X) | |||
| Mr Jeffrey Braswell | |||||||||
| dir. - emergency svcs | 40.0 | 0.0 | $148,470 | $0 | $5,047 | Yes (X) | |||
| Mr Venel Pierre Louis | |||||||||
| RN | 40.0 | 0.0 | $129,846 | $0 | $6,660 | Yes (X) | |||
| Mr Dan Curry | |||||||||
| Board Member | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| Mr Patrick Dally | |||||||||
| Board Member | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| Mr Wm Ronald Duffey | |||||||||
| Board Member | 1.0 | 4.0 | $0 | $0 | $0 | Yes (X) | |||
| Mr Coleman Landers | |||||||||
| Chair | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,114,334 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,303,253 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $591,987 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 18 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WALTON ANESTHESIA ASSOCIATES PC | |||||
| 2151 West Spring St | MONROE | GA | 30655 | ANESTHESIA | $753,100 |
| THERAPEUTIC GI ASSOCIATES LLC | |||||
| 2151 W SPRING ST | MONROE | GA | 30655 | GASTROENTEROLOGY SVC | $607,500 |
| HHS ENVIRONMENTAL SERVICES | |||||
| 12495 Silver Creek Road | DRIPPING SPRINGS | TX | 78620 | JANITORIAL SERVICES | $488,693 |
| DIVERSIFIED CLINICAL SERVICES INC | |||||
| 5220 Belfort Rd | JACKSONVILLE | FL | 32256 | HEALTHCARE SERVICES | $454,928 |
| ATHENS ORTHOPEDIC CLINIC PA | |||||
| 1765 Old West Broad St | ATHENS | GA | 30606 | ORTHOPEDIC SERVICES | $290,649 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,514,483 | GovernmentGrantsAmt |
| All Other Contributions | $123 | AllOtherContributionsAmt |
| Total Contributions | $1,514,606 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 622110 | $69,823,016 | $69,823,016 |
| OTHER OPERATING REVENUE | 900099 | $71,029 | $71,029 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $69,894,045 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $42,227 | TotalRevenueColumnAmt |
| Exclusion | $42,227 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $363,422 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $363,422 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $363,422 | TotalRevenueColumnAmt |
| Exclusion | $363,422 | ExclusionAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | FEE REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $11,883 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,883 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $11,883 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $71,826,183 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $69,905,928 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $405,649 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $366,212 | TotalAmt |
| Program Services | $88,007 | ProgramServicesAmt |
| Management And General | $278,205 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,358,859 | TotalAmt |
| Program Services | $21,792,603 | ProgramServicesAmt |
| Management And General | $2,566,256 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,574,188 | TotalAmt |
| Program Services | $3,120,731 | ProgramServicesAmt |
| Management And General | $453,457 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,608,190 | TotalAmt |
| Program Services | $1,381,114 | ProgramServicesAmt |
| Management And General | $227,076 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,873 | TotalAmt |
| Management And General | $21,873 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,489,813 | TotalAmt |
| Program Services | $6,092,215 | ProgramServicesAmt |
| Management And General | $1,397,598 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,940 | TotalAmt |
| Program Services | $19,923 | ProgramServicesAmt |
| Management And General | $230,017 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,459,669 | TotalAmt |
| Program Services | $3,380,358 | ProgramServicesAmt |
| Management And General | $1,079,311 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,526,076 | TotalAmt |
| Program Services | $1,914,766 | ProgramServicesAmt |
| Management And General | $611,310 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,371,752 | TotalAmt |
| Program Services | $2,201,077 | ProgramServicesAmt |
| Management And General | $170,675 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,918 | TotalAmt |
| Program Services | $4,946 | ProgramServicesAmt |
| Management And General | $2,972 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $828,826 | TotalAmt |
| Management And General | $828,826 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,535,293 | TotalAmt |
| Management And General | $2,535,293 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,059,960 | TotalAmt |
| Program Services | $1,915,065 | ProgramServicesAmt |
| Management And General | $144,895 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $854,944 | TotalAmt |
| Program Services | $639,762 | ProgramServicesAmt |
| Management And General | $215,182 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DRUGS & MEDICAL SUPPLIES | $9,140,293 | $9,140,293 | |
| BAD DEBT EXPENSE | $9,087,351 | $9,087,351 | |
| HOSPITAL TAX | $1,123,487 | $1,123,487 | |
| ADMINISTRATIVE EXPENSES | $1,408,124 | $821,747 | $586,377 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,072,768 | TotalAmt |
| Program Services | $62,723,445 | ProgramServicesAmt |
| Management And General | $11,349,323 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,577,311 | BOYAmt |
| EOY | $45,517,979 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$50,135,310 | BOYAmt |
| EOY | -$35,864,869 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,225,961 | BOYAmt |
| EOY | $1,202,163 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $314,146 | BOYAmt |
| EOY | $199,926 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $25,257,367 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,617,325 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,473,028 | BOYAmt |
| EOY | $21,640,042 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,216,504 | BOYAmt |
| EOY | $19,217,161 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,671,640 | BOYAmt |
| EOY | $51,912,402 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,320,035 | BOYAmt |
| EOY | $7,367,953 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $37,759,547 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $496,935 | BOYAmt |
| EOY | $16,363,058 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,816,970 | BOYAmt |
| EOY | $61,490,558 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,854,530 | BOYAmt |
| EOY | -$9,577,626 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140 | BOYAmt |
| EOY | -$530 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,854,670 | BOYAmt |
| EOY | -$9,578,156 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,671,640 | BOYAmt |
| EOY | $51,912,402 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,246,585 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$50,186,241 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,189,458 | OtherCostOrOtherBasisAmt |
| Book Value | $2,189,458 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,651,933 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,160,647 | DepreciationAmt |
| Book Value | $13,491,287 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,332,771 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,456,678 | DepreciationAmt |
| Book Value | $4,876,093 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,083,205 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $1,083,204 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $21,640,042 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| GOODWILL | $18,938,257 |
| UNAMORTIZED ISSUE COSTS | $278,904 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $19,217,161 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEDICARE PAYABLE | Desc |
| Amt | $16,363,058 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $16,363,058 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2: ASC 740 FOOTNOTE (FKA FIN 48) | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300. | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,460,931 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,460,931 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09940 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,958,223 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,691,761 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,649,984 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08690 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,118,480 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $326,072 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,444,552 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02220 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,537,634 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,017,833 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,555,467 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.20850 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,700 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $23,700 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $619,067 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $619,067 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00950 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $87,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $87,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $30,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $30,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $759,767 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $759,767 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01160 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,297,401 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,017,833 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $14,315,234 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.22010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,862,232 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $11,528,200 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $14,096,852 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,568,652 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PIEDMONT WALTON HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2151 WEST SPRING STREET | AddressLine1Txt |
| City | MONROE | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30655 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.piedmont.org | WebsiteAddressTxt |
| State License | 147-613 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Facility Reporting Group | 1 | FacilityReportingGroupCd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PIEDMONT WALTON HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | Yes (true) | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (true) | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART VI | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART VI | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300. | FPGFamilyIncmLmtDscntCarePct |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART VI | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART VI | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART VI | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, LINES 1 AND 2: NEW HOSPITAL ENTITY | PIEDMONT WALTON HOSPITAL, INC. ("PWH") WAS CREATED AS A NEW ENTITY ON JANUARY 26, 2018, FOLLOWING THE PURCHASE OF THE ASSETS OF CLEARVIEW REGIONAL MEDICAL CENTER, INC. FROM QUORUM HEALTH CORP., A FOR-PROFIT COMPANY. PIEDMONT WALTON HOSPITAL WAS GRANTED ITS TAX EXEMPT STATUS ON JUNE 11, 2019, RETROACTIVE TO THE HOSPITAL'S DATE OF ORGANIZATION, JANUARY 26, 2018. |
| SCHEDULE H, PART V, LINE 7A: COMMUNITY HEALTH NEEDS ASSESSMENT WEBSITE | https://www.piedmont.org/media/file/PWH-FY19-CHNA-Strategy.pdf |
| SCHEDULE H, PART V, LINE 7D: PUBLIC AVAILABILITY OF CHNA | IN ADDITION TO MAKING ITS CHNA REPORTS AVAILABLE ON ITS WEBSITE AND BY REQUEST, PIEDMONT WALTON HOSPITAL SENT COPIES TO EACH PARTICIPANT IN THE CHNA PROCESS, DISTRIBUTED THE ASSESSMENTS TO COMMUNITY CENTERS AND OTHER LOCATIONS THAT PRIMARILY SERVE AN UNINSURED POPULATION, SENT COPIES TO LEGISLATIVE AND ELECTED OFFICIALS, AND WIDELY DISTRIBUTED THE ASSESSMENTS TO OTHER PIEDMONT HEALTHCARE HOSPITALS. |
| SCHEDULE H, PART V, LINE 10A: IMPLEMENTATION STRATEGY | THE BOARD OF DIRECTORS FOR PIEDMONT WALTON HOSPITAL, INC. UNANIMOUSLY APPROVED ITS IMPLEMENTATION STRATEGY FOR THE THREE YEAR PERIOD BEGINNING WITH FY20 ON OCTOBER 16, 2019, WITHIN THE GRACE PERIOD FOLLOWING THE APPROVAL OF THE NEW COMMUNITY HEALTH NEEDS ASSESSMENT. THE FOLLOWING LINK IS FOR THE IMPLEMENTATION STRATEGY EFFECTIVE THROUGH JUNE 30, 2022, WHICH IS CONTAINED AT THE END OF THE DOCUMENT https://www.piedmont.org/media/file/PWH-FY19-CHNA-Strategy.pdf |
| SCHEDULE H, PART V, LINE 11: ADDRESSING COMMUNITY HEALTH NEEDS | WHEN PIEDMONT HEALTHCARE, INC. FIRST ACQUIRED THE ASSETS OF PIEDMONT WALTON HOSPITAL, INC., THE HOSPITAL HAD A GRACE PERIOD FOR PIEDMONT HEALTHCARE TO PREPARE AND APPROVE A COMMUNITY HEALTH NEEDS ASSESSMENT FOR PIEDMONT WALTON HOSPITAL. THE INITIAL CHNA FOR PIEDMONT WALTON HOSPITAL WAS UNANIMOUSLY APPROVED BY ITS BOARD OF DIRECTORS ON APRIL 17, 2019, WITHIN THE GRACE PERIOD. BASED ON THE CHNA, PIEDMONT WALTON HOSPITAL WILL FOCUS ON: (1) INCREASE ACCESS TO APPROPRIATE AND AFFORDABLE HEALTH AND MENTAL CARE FOR ALL COMMUNITY MEMBERS, AND ESPECIALLY THOSE WHO ARE UNINSURED AND THOSE WITH LOW INCOMES; (2) REDUCE OPIOID AND RELATED SUBSTANCE ABUSE AND OVERDOSE DEATHS; (3) DECREASE DEATHS FROM CANCER AND INCREASE ACCESS TO CANCER PROGRAMMING FOR THOSE LIVING WITH THE DISEASE, WITH A FOCUS ON LUNG CANCER; AND (4) PROMOTE HEALTHY WEIGHTS AND BEHAVIORS AS TO DECREASE PREVENTABLE INSTANCES OF HEART DISEASE AND DIABETES. |
| SCHEDULE H, PART V, LINE 16: FINANCIAL ASSISTANCE 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 |
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART VI, LINE 1: REQUIRED DISCLOSURES | PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6A Piedmont Walton 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 its 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 $74,072,768, LESS BAD DEBT EXPENSE OF $9,087,351 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. PIEDMONT WALTON HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE ARE NOT REPORTED AS REVENUE. MEDICARE SHORTFALLS AS COMMUNITY BENEFIT SCHEDULE H, PART III, LINE 8 The amount reported on Part III, Line 6, was calculated in accordance with Schedule H instructions by utilizing 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 Walton 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 43.75% percent of Piedmont Walton Hospital's patient service revenue. Piedmont Walton 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 Walton 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 Walton 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 worked to better understand local health challenges, identify health trends in its community, determine gaps in the current health delivery system and create a plan to address those gaps and the identified health needs. In FY19, Piedmont Walton Hospital conducted its first triennial CHNA, as the entity was previously a for-profit organization. FY20 marked Year One of the three-year implementation strategy. The Piedmont Walton Hospital CHNA was led by the Piedmont Healthcare community benefits team, with input and direction from Piedmont Walton Hospital leadership, with the hospital's chief executive officer as the primary responsible party. 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. The hospital 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 its county. Additionally, the hospital takes into consideration patient origin, and especially that of its lower-income patients, such as those who qualify for financial assistance or receive insurance coverage through Medicaid. The hospital's secondary communities are considered the areas in which we have the highest concentration of patients fitting that criteria, including ones from nearby counties. Once the hospital established its primary and secondary community, it 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 were for 2017, unless otherwise noted. Health indicators are estimates provided by County Health Rankings and hospital data were 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, evaluation of current programs, as well as suggestions for how we can better serve its 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 its CHNA from public health. Our priorities A key component of the CHNA is to identify the top health priorities the hospital will address over fiscal years 2020, 2021 and 2022. These priorities guide all community benefit work. They are, in no order: . Increase access points for appropriate and affordable health, dental and mental care for all community members, and especially those who are uninsured and those with low incomes . Decrease deaths from cancer and increase access to cancer programming for those with living the disease, with a focus on lung cancer . Promote healthy weights and behaviors as to decrease preventable instances of heart disease and diabetes . 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, and that is demonstrated through the hospital's 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 the hospital's 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 Piedmont Walton 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 Walton Hospital leadership and the Piedmont Walton Hospital Board of Directors. The hospital included proven and successful interventions and programming, investing further in work we felt was successful in addressing unmet health needs. The implementation strategy was unanimously approved by the Piedmont Walton Hospital Board of Directors on October 16, 2019. |
| SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ASSISTANCE ELIGIBILITY | Piedmont Walton 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 Walton 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 Walton 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 the hospital's financial assistance policy to partner clinics and others who work closely with low-income populations. The hospital provides assistance in understanding the policy, how it relates to their populations and receive feedback in ways 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 all Piedmont Healthcare hospitals and is digitally available online. Copies are provided in both English and Spanish. In FY20, we distributed approximately 5,500 copies of this guide throughout the Walton community, which was updated to reflect any changes brought on by the advent of COVID-19, as many nonprofits serving vulnerable populations shifted or ceased operations. We continue to update this guide, to the best of our ability. |
| SCHEDULE H, PART VI, LINE 4: COMMUNITY INFORMATION | Piedmont Walton Hospital is located in Monroe, Georgia, and considers its primary community to be its home county of Walton County. On average, between 2015 and 2019, approximately 91,442 people lived in Walton County's 327 square miles. The majority of the community is white -- about 78 percent. The county slightly skewed female. Walton County is growing, with an increase of about 38 percent in population between 2000 and 2010. Hispanic or Latino populations alone grew by 131 percent during that time. On average, between 2015 and 2019, the median household income was $61,599, in line with the state and national averages of $52,977 and $57,652, respectively. During those years, the median age was 39. On average, between 2015 and 2019,12 percent of the county lived at or below the poverty level - about 10,901 people. Approximately 4.3 percent of adults were unemployed in 2020, a figure better than state and national averages. Eighteen percent of children in Walton County lived in poverty between 2015 and 2019, on average. Poor children are statistically less likely to graduate high school and are nearly twice as likely to become poor adults and, should they have children, continue a circle of poverty that's difficult to break. These children are also more likely to experience dental issues, anxiety problems and higher rates of accidental injury. There were 4,783 veterans living in Walton County on average each year between 2015 and 2019, making up about 7 percent of the population, and the largest age group for veterans was 35 to 54, and the overwhelming majority were male. Most lived with some sort of disability. In Walton 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. Age-adjusted death rates allows communities with different age structures to be compared. In comparison, premature death is when death happens before the average age for a given community. Between 2015 and 2019, the second leading cause of premature death was accidental poisoning and exposure to noxious substances. Other top causes, in order, were motor vehicle accidents, suicide, lung cancer, hypertension/hypertensive renal and heart disease, certain conditions originating in the perinatal period, all COPD except asthma, cerebrovascular disease and diabetes. As evidenced in this list, the impact of issues related to unhealthy behaviors was significant, indicating a clear need for more aggressive interventions. In Walton County, 12 percent of the total population was uninsured each year on average between 2015 and 2019, and 17 percent of the adult population was uninsured during that time. Rates for children and elderly populations were much lower at 6 percent for children and less than 2 percent for those 65 and older. This equals about 10,620 people who have no form of insurance coverage to pay for necessary care. Community members have reported an average 3.4 poor or fair physical and 3.8 poor mental health days. A total 17 percent of Walton County residents reported their health as poor or fair. These are all on par with the state average. Preventable hospital stays among Medicare enrollees averaged 4,974 preventable hospital events per every 100,000 enrollees in 2017. This figure is better than state and national rates. Thirteen percent of the population lived with at least one disability on average each year between 2015 and 2019. The highest concentration of disabled populations in the central part of the county. On average, between 2006 and 2012, 8.3 percent of all babies born were at a low birth weight, and with African American infants far more likely to be born at a low birth weight than any other race. In 2017, 228 Walton County community members died from cerebrovascular disease, which includes stroke. While stroke impacts all patients, like with most health measures, the lower income and less educated a person is, a the more likely he or she is to experience more severe repercussions, such as death, for several reasons, including limited health literacy, difficulty affording care and necessary prescriptions and unhealthy behaviors. Overall, between 2015 and 2019, lung cancer was the second leading cause of age-adjusted death and the 4th leading cause of premature death. Colon, rectum and anal cancers were the 12th leading cause of premature death and breast cancer was the 15th leading cause of premature death. Below is a map of age-adjusted cancer deaths by census tract those years. The darker the color, the more deaths that occurred in that area of the county. Knowing where these deaths occur helps us focus hospital efforts on screening and care for patients at high-risk for cancer, as there are likely underlying social determinants of health contributing to death rates. Adult obesity rates were high in Walton County at 28 percent of all county residents as obese. This contributes to a number of diseases, including heart disease, stroke and diabetes. Seventeen percent of residents smoke, which is the state average as well. Smoking is a key contributor to cancer, and in particular lung cancer, which has a devastating effect on Walton County residents. Fifty-three percent of county residents commute more than 60 minutes or more to work, a rate far higher than the state average of 42 percent. Eighty-three percent of commuters from Walton County drive alone, which contributes to depression. The violent crime rate was 302 per every 100,000 county residents, a figure less than the state average rate of 388. Mental health and behavioral disorders were the 5th leading cause of age-adjusted death for all county residents between 2015 and 2019. Suicide was the 4th leading cause of premature deaths for all races between 2015 and 2019. It was most common among white males aged 25 to 34 years of age. There was one mental health provider for every 1,420 residents in the county in 2017, a rate far worse than the state average of one provider for every 730 residents. Like in the rest of the state, opioid prescriptions are an issue in the Walton County community, with a total 23.5 opioids prescriptions written per every 100 people in 2019. Please note we aren't able to tell how many scripts were written to a single person. We only know the overall figure, meaning a single person could have several prescriptions. Twenty-eight percent of households live in substandard housing, meaning it has at least one major issue, such as no plumbing or too many occupants. In 2016, 51 percent of the population had no reasonable access to healthy foods in 2015. These patients live in what's called a food desert, meaning there is no food outlet with healthy food options, such as produce, within a reasonable travel time. Of the 15 census tracts in Walton County, seven were in a food desert. There were 54 fast food restaurants in Walton County in 2018, a figure that's better, per capita, than state and national averages. There are nine grocery stores, and the per capita rate is worse than state and national averages. Twenty-nine percent of households had housing costs that exceeded more than 30 percent of total household income between 2015 and 2019, indicating a cost burdened household more likely to face overall financial difficulty. This is directly linked to having trouble paying medical bills. Approximately 974 Walton County households had no motor vehicle in 2017, which can present significant barriers to accessing care and other primary needs, such as groceries, due to very limited public transportation options in the county. Thirty-six percent of children lived in single-parent homes in 2019, a statistic that can indicate financial insecurity at home. In the 2018 to 2019 school year, 46 percent of children qualified for free or reduced cost lunch, a statistic that represents poverty and food instability. The state average was 62 percent. For every 1,000 teen girls aged 15 to 18 in Walton County, 27 gave birth to a child on average each year between 2012 and 2018. 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 Walton Hospital actively promotes the health of its community through clinic-hospital partnerships, the 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. Piedmont Walton actively partners with groups in the community, including local charitable clinics. In FY20, we continued to provide funding for a full-time nurse practitioner working at not-for-profit charitable clinic F.I.S.H. Medical and Dental Clinic, with a total 1,550 patients seen during that time. The annual cost for that nurse practitioner was approximately $87,000 in FY20. Additionally, each month, a Piedmont physician leads a community-based walking program in which the doctor also answers general health questions and promote overall healthiness. In FY20, Piedmont Walton Hospital awarded approximately $30,000 in funding to two not-for-profit organizations whose programs aligned with the hospital's FY19 CHNA. Recipients and funded programs were: Team Up Mentoring, for their Team Up for Wellness program and Walton County Senior Citizen's Council, non-emergency transport programming. Both organizations successfully completed work that was fully in-line with our CHNA. In FY20, Piedmont Walton also provided health professions education to students and residents training to be health professionals. That year, the hospital oversaw health professions training hours at a total cost of $619,067. This is an increase over FY19, despite COVID-19 impacting some educational programs. As part of a Piedmont Healthcare systemwide effort, Piedmont Walton 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. That said, the Walton County Sheriff's Office does maintain a box year-round in the lobby of their precinct, and we actively routed community members to that box. In FY20, we began cancer support group that meets once a month. This program held its first support group in January 2020. In person meetings were delayed due to COVID, but we were able to resume these meetings via video during the fall. We have a relationship with The Cancer Foundation of Northeast Georgia, which provides services in our community, and we are actively working on ways to help connect community members with the resources available through The Cancer Foundation. In line with our goal of reducing the impact of stroke, our Stroke/Trauma/EMS Coordinator did a presentation at the Loganville TRIAD meeting about stroke signs and symptoms as well as fall awareness and prevention in January 2020. There were approximately 40 seniors in attendance. Additionally, our Stroke/Trauma/EMS Coordinator did a Lunch and Learn presentation on stroke signs and symptoms as well as fall awareness and prevention in Loganville in February 2020 to a group of approximately 35 seniors. Finally, stroke awareness educational materials have been passed out at numerous community events, and our coordinator provides a Stroke Core Curriculum class that is open to our facility, other healthcare facilities and EMS monthly. It is held at least twice a month, and sometimes up to four times per month, when possible. Our Outpatient Nutrition Services Team hosts three support groups that address weight management - two directly and one a bit more indirectly: Weight2Go (general weight management), bariatric-surgical weight management, and the Diabetes Support Group with topics often covering portion control and weight management for disease management. In total, they had 179 participants attend a 2019 support group session. Of those, 112 were Caucasian and 67 were African American. Classes are free and open to the public. Additionally, and as mentioned above, Piedmont Walton Hospital provided to the general public a bilingual community resource guide, which gives information on community resources for lower income populations as well as plain language details on the hospital's financial assistance program. |
| SCHEDULE H, PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM | Piedmont Walton 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 the hospital's 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 Walton Hospital is not required to file a community benefit report; however, the hospital is required to file with the Georgia Department of Community Health information on its indigent and charity care, as well as its Medicaid and Medicare shortfalls. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mr J Michael Burnett | ||||||||||||||
| Board Member | $0 | $494,660 | $0 | $216,563 | $0 | $180,163 | $0 | $91,350 | $0 | $18,096 | $0 | $1,000,832 | $0 | $74,550 |
| Ms Vicki A Cansler | ||||||||||||||
| Board Member | $0 | $406,708 | $0 | $180,243 | $0 | $106,395 | $0 | $74,150 | $0 | $7,734 | $0 | $775,230 | $0 | $57,350 |
| Mr Larry Ebert | ||||||||||||||
| CEO & Board Member | $267,153 | $0 | $87,602 | $0 | $5,982 | $0 | $9,618 | $0 | $17,309 | $0 | $387,664 | $0 | $0 | $0 |
| Mr Marvin Wynn | ||||||||||||||
| CFO (EFF. 5/20) | $0 | $221,546 | $0 | $44,754 | $0 | $1,600 | $0 | $16,251 | $0 | $11,398 | $0 | $295,549 | $0 | $0 |
| Dr Robert Sinyard | ||||||||||||||
| CMO | $0 | $427,791 | $0 | $112,279 | $0 | $31,008 | $0 | $0 | $0 | $34,176 | $0 | $605,254 | $0 | $0 |
| Ms Candice Frix | ||||||||||||||
| CNO | $119,199 | $0 | $23,360 | $0 | $349 | $0 | $8,809 | $0 | $10,218 | $0 | $161,935 | $0 | $0 | $0 |
| Mr Michael Wynne | ||||||||||||||
| DIRECTOR - PHARMACY | $148,728 | $0 | $19,207 | $0 | $186 | $0 | $10,288 | $0 | $10,681 | $0 | $189,090 | $0 | $0 | $0 |
| Ms Rose Dennis | ||||||||||||||
| exec. Dir. - patient svcs | $135,418 | $0 | $27,360 | $0 | $1,474 | $0 | $10,613 | $0 | $11,469 | $0 | $186,334 | $0 | $0 | $0 |
| Mr Jeffrey Braswell | ||||||||||||||
| dir. - emergency svcs | $130,000 | $0 | $16,380 | $0 | $2,090 | $0 | $4,583 | $0 | $464 | $0 | $153,517 | $0 | $0 | $0 |
| Mr Michael McAnder | ||||||||||||||
| Treasurer | $0 | $613,592 | $0 | $345,604 | $0 | $76,811 | $0 | $123,395 | $0 | $7,500 | $0 | $1,166,902 | $0 | $0 |
| Ms Elizabeth Leddy | ||||||||||||||
| Secretary | $0 | $448,895 | $0 | $251,848 | $0 | $142,793 | $0 | $89,849 | $0 | $17,376 | $0 | $950,761 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 3: COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR | THE COMPENSATION FOR THE PRESIDENT/CEO OF PIEDMONT WALTON HOSPITAL IS SET BY THE ENTITY'S PARENT, PIEDMONT HEALTHCARE, INC. PLEASE SEE THE SCHEDULE O NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 15A & 15B FOR ADDITIONAL INFORMATION. |
| SCHEDULE J, PART I, LINE 4B: SUPPLEMENTAL COMPENSATION INFORMATION | VICKI CANSLER RECEIVED A PAYMENT OF $57,350 FROM HER SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. J. MICHAEL BURNETT RECEIVED A PAYMENT OF $74,550 FROM HIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THE FOLLOWING EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS: LARRY EBERT MICHAEL MCANDER ELIZABETH LEDDY |
| 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. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Development Authority of Walton County | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 582137690 | BondIssuerEIN |
| CUSIP | 933413AY2 | CUSIPNum |
| Bond Issued | 2019-11-07 | BondIssuedDt |
| Issue Price | $31,085,000 | IssuePriceAmt |
| Purpose | ASSET PURCHASE | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $0 | RetiredAmt |
| Bond Defeased | $0 | BondDefeasedAmt |
| Total Proceeds | $37,383,406 | TotalProceedsAmt |
| In Reserve Fund | $0 | InReserveFundAmt |
| Capitalized Interest | $0 | CapitalizedInterestAmt |
| Refunding Escrow | $0 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $0 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $0 | CreditEnhancementAmt |
| Working Capital Expenditures | $0 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $0 | CapitalExpendituresAmt |
| Other Spent Proceeds | $37,383,406 | OtherSpentProceedsAmt |
| Unspent | $0 | UnspentAmt |
| Substantial Completion | 2019 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | false | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | false | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | false | MgmtContractBondFincdPropInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.01000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.01000 | TotalPrivateBusinessUsePct |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Remedial Action Taken | false | RemedialActionTakenInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (true) | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
GIC Provider Name GICProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (true) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 1A: NUMBER OF FORMS 1099 FILED | ALL CALENDAR YEAR 2019 FORMS 1099 WERE FILED ON BEHALF OF PIEDMONT WALTON HOSPITAL BY ITS SOLE MEMBER, PIEDMONT HEALTHCARE, INC. (EIN 58-1503902), PURSUANT TO AN AGREEMENT WITH THE IRS TO FILE ALL FORMS 1099 FOR THE PIEDMONT HEALTHCARE SYSTEM ON A COMBINED BASIS. |
| FORM 990, PART VI, SECTION A, LINE 6: ORGANIZATION'S SOLE MEMBER | PIEDMONT HEALTHCARE, INC., (EIN 58-1503902) IS THE SOLE MEMBER OF PIEDMONT WALTON HOSPITAL ("PWH"). |
| FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF GOVERNING BODY | THE BOARD OF PIEDMONT HEALTHCARE, PIEDMONT WALTON HOSPITAL'S SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF PIEDMONT WALTON HOSPITAL. |
| FORM 990, PART VI, SEC A, LINE 7B: DECISIONS OF GOVERNING BODY | PIEDMONT WALTON HOSPITAL'S BOARD POLICIES AND DECISIONS MUST BE FILED, IMMEDIATELY AFTER ADOPTION, WITH THE SECRETARY OF THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS. SUCH POLICIES AND DECISIONS OF THE PIEDMONT WALTON HOSPITAL 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 WALTON HOSPITAL'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PWH'S CONTROLLER AND VP/CFO. THE 990 IS THEN PREPARED INTERNALLY BY PIEDMONT HEALTHCARE, INC.'S TAX DIRECTOR AND SUBMITTED TO AN EXTERNAL TAX PREPARER FOR REVIEW. PRIOR TO FILING, COPIES OF FORM 990 ARE PROVIDED TO THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC., THE ORGANIZATION'S SOLE MEMBER, FOR BOARD REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C: CONFLICT OF 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 WALTON HOSPITAL IS SET BY THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC. THE PIEDMONT HEALTHCARE, INC., BOARD OF DIRECTOR'S EXECUTIVE PERFORMANCE AND COMPENSATION COMMITTEE ("THE COMMITTEE") IS COMPOSED OF AT LEAST THREE MEMBERS OF THE PHC BOARD OF DIRECTORS, SERVING TERMS OF THREE YEARS, AND THE MAJORITY OF WHICH ARE COMMUNITY DIRECTORS WHO GENERALLY DO NOT HAVE CONFLICTS OF INTEREST RELATED TO FULFILLMENT OF THE DUTIES AS OUTLINED BELOW. THE 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 ($669) INTERCOMPANY TRANSFERS ($47,444,222) UNALLOCATED EXPENSES ($2,790,751) BOOK/TAX DIFFERENCES $49,401 ------------------ TOTAL ($50,186,241) |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT SERVICES TOTAL FEES:4261266 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PHYSICIAN SUPPORT TOTAL FEES:1980682 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:865710 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MAINTENANCE TOTAL FEES:252785 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MEDICAL DIRECTOR TOTAL FEES:77450 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:TRANSPORTATION TOTAL FEES:48683 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PRINTING TOTAL FEES:3237 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (21 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| PIEDMONT HEALTHCARE INC | ||||||||||
| 1800 HOWELL MILL ROAD SUITE 850 | ATLANTA | GA | 30318 | 581503902 | HEALTHCARE | 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) | 12B, II | 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 | PHC | 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 | PHC | false |
| THE MEDICAL CENTER INC | ||||||||||
| 710 CENTER ST | COLUMBUS | GA | 31901 | 581685139 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false |
| HUGHSTON HOSPITAL INC | ||||||||||
| 707 CENTER ST | COLUMBUS | GA | 31901 | 331216751 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false |
| PIEDMONT ROCKDALE HOSPITAL INC | ||||||||||
| 1412 Milstead Avenue | CONYERS | GA | 30112 | 300999841 | HOSPITAL | GA | 501(C)(3) | 3 | PHC | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | UBI Code VUBICodeVAmt | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | |||||||||||||||||
| 980427603 | RELATED INSUR | PHC | C CORP | $0 | $0 | 0.00000 | false | PO BOX 1159 | GRAND CAYMAN | CJ | KY1-1102 | CJ | |||||
| PIEDMONT WELLSTAR HEALTHPLANS INC | |||||||||||||||||
| 2859 PACES FERRY RD STE 600 | ATLANTA | GA | 30339 | 461922499 | HEALTH INSUR. | GA | PHC | C CORP | $0 | $0 | 0.00000 | false | |||||
| COLUMBUS HEALTHCARE RESOURCES | |||||||||||||||||
| PO BOX 790 | COLUMBUS | GA | 31902 | 581717754 | HEALTHCARE | GA | CRHS | C CORP | $0 | $0 | 0.00000 | false | |||||
| Columbus Health Services Inc | |||||||||||||||||
| PO BOX 790 | COLUMBUS | GA | 31902 | 581640939 | HEALTHCARE | GA | CRHS | C CORP | $0 | $0 | 0.00000 | false | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |