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ATHENS REGIONAL SPECIALTY SERVICES INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
ATHENS REGIONAL SPECIALTY SERVICES INC (EIN 27-1975001)
Tax period
2018-07-01 to 2019-06-30
Filed
2020-05-15
IRS object ID
202001369349301715
Schema version
2018v3.3
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 ReturnHeader

FieldValueIRS element (for citing)
Return2020-05-15T08:43:11-05:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1300 North Greene Street Suite 400AddressLine1Txt
CityGreensboroCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27401ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN271975001EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ATHENS REGIONAL SPECIALTY SERVICES INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% MARIE GAFFNEYInCareOfNm
Business Name ControlATHEBusinessNameControlTxt
Phone7064757000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11199 PRINCE AVENUEAddressLine1Txt
CityATHENSCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30606ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARIE GAFFNEYPersonNm
Person TitleVP CORP. FINANCEPersonTitleTxt
Phone7064757000PhoneNum
Signature2020-05-11SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSHAWN HUTCHINSONPreparerPersonNm
PTINP01048557PTIN
Phone3362753394PhoneNum
Preparation2020-05-14PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address199.206.0.5IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id56038220201365000001FederalOriginalSubmissionId
Federal Original Submission Id2020-05-15FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id1272C807EE2CFB18DB9032F475C1250F2D6A8CEAAtSubmissionCreationDeviceId
At Submission Filing Device Id1272C807EE2CFB18DB9032F475C1250F2D6A8CEAAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-11-19 02:30:22ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCHARLES PECK PRESIDENT CEOPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11199 PRINCE AVENUEAddressLine1Txt
CityATHENSCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30606ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$62,135,117GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PIEDMONT.ORG/LOCATIONS/PIEDMONT-ATHENS/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2010FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTO SERVE AND PROMOTE THE PUBLIC HEALTH OF THE GENERAL POPULATION.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee307TotalEmployeeCnt
Total Volunteers13TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$65,043,517PYProgramServiceRevenueAmt
CY Program Service Revenue$62,126,027CYProgramServiceRevenueAmt
PY Investment Income$8,685PYInvestmentIncomeAmt
CY Investment Income$9,090CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$65,052,202PYTotalRevenueAmt
CY Total Revenue$62,135,117CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$45,696,879PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$50,464,621CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$19,353,431PYOtherExpensesAmt
CY Other Expenses$10,148,432CYOtherExpensesAmt
PY Total Expenses$65,050,310PYTotalExpensesAmt
CY Total Expenses$60,613,053CYTotalExpensesAmt
PY Revenues Less Expenses$1,892PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,522,064CYRevenuesLessExpensesAmt
Total Assets BOY$25,405,532TotalAssetsBOYAmt
Total Assets EOY$35,147,199TotalAssetsEOYAmt
Total Liabilities BOY$4,807,982TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,418,126TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$20,597,550NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$28,729,073NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$59,889,141ExpenseAmt
Grant$0GrantAmt
Revenue$62,126,027RevenueAmt
DescSPECIALTY PHYSICIAN PRACTICES: THE 90 PHYSICIANS INCLUDING 38 SPECIALIZED PHYSICIANS OF ATHENS REGIONAL SPECIALTY SERVICES, INC. (ARSS) DELIVERED HEALTH CARE TO THE GENERAL PUBLIC BY PROVIDING SERVICES AND RESOURCES FOR 198,533 PATIENT VISITS IN THE 17 COUNTY NORTHEAST GEORGIA AREA SERVED BY ATHENS REGIONAL MEDICAL CENTER DURING THE FISCAL YEAR ENDED JUNE 30, 2019. DURING THE SAME PERIOD, ARSS INC. PROVIDED $4,583,048 IN LOW INCOME ASSISTANCE.Desc
Total Program Service Expenses$59,889,141TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee307EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARIE GAFFNEYPersonNm
Phone4702716007PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12727 PACES FERRY RD BLDG 2 STEAddressLine1Txt
CityATLANTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP30339ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Mr Kevin Brown
Board Member & CEO, PHC1.054.0Yes (X)$0$3,936,217$224,155
Mr Dexter L Fisher
Board Member1.04.0Yes (X)$0$0$0
Mr Michael D Garrett
Board Member1.04.0Yes (X)$0$0$0
Ms Cheryl Legette
Board Member1.04.0Yes (X)$0$0$0
Dr Charles L Ogburn III
Board Member1.04.0Yes (X)$0$0$0
Dr Jane M Parks
Board Member1.04.0Yes (X)$0$0$0
Mr Alan Reddish
Board Member1.04.0Yes (X)$0$0$0
Ms Kim Ripps
Board Member1.04.0Yes (X)$0$0$0
Mr Richard B Russell Jr
Board Member1.04.0Yes (X)$0$0$0
Dr David Sailors
Board Member1.09.0Yes (X)$0$53,600$0
Mr G Michael Smith
Chairman1.04.0Yes (X)$0$0$0Yes (X)
Ms Tracey Worthington Stice
Board Member1.04.0Yes (X)$0$0$0
Dr Samuel K Thomason
Board Member1.04.0Yes (X)$0$0$0
Mr Tony Townley
Board Member1.04.0Yes (X)$0$0$0
Dr Jonathan D Woody
Board Member1.04.0Yes (X)$0$0$0
Dr Charles Peck
PARMC CEO (THROUGH 1/19)1.054.0$0$1,273,952$111,621Yes (X)
Mr J Michael Burnett
PARMC CEO (From 4/19)1.054.0$0$755,604$95,430Yes (X)
Ms Wendy Cook
PARMC CFO1.054.0$0$489,933$32,588Yes (X)
Mr Michael McAnder
Treasurer1.054.0$0$1,103,610$128,676Yes (X)
Ms Elizabeth Leddy
Secretary1.054.0$0$752,241$100,515Yes (X)
Dr Kimberly Walpert
PHYSICIAN55.00.0$1,233,808$0$9,701Yes (X)
Dr Shashikant Patil
PHYSICIAN55.00.0$928,714$0$14,524Yes (X)
Dr Parker Grow
PHYSICIAN55.00.0$780,760$0$24,040Yes (X)
Dr Steven Scott
PHYSICIAN55.00.0$862,007$0$22,278Yes (X)
Dr Cullen Morris
PHYSICIAN55.00.0$899,129$0$25,525Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,704,418TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$8,365,157TotReportableCompRltdOrgAmt
Total Other Compensation$789,053TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K108IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MUKESH KUMAR MD LLC
743 SPRING ST NEGAINESVILLEGA30501PHYSICIAN SERVICES$293,160
PEACHFORD BEHAVIORAL HEALTH SYSTEMS
2151 Peachford RdATLANTAGA30338BEHAVIORAL HEALTH$1,430,590
HAYES LOCUMS LLC
6700 N Andrews Ave Ste 600FT LAUDERDALEFL33309PHYSICIAN STAFFING$429,816
HARRIS MEDICAL HOSPITALISTS
1180 Satellite Blvd Ste 200SUWANEEGA30024HOSPITALIST$312,813
HEALTH MOUNT LLC
211 E 7TH ST Ste 620AUSTINTX78701PHYSICIAN RECRUITING$243,343
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K9CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE900099$38,091,398$38,091,398
OTHER OPERATING REVENUE900099$23,763,217$23,763,217
RESEARCH REVENUE900099$271,412$271,412
FieldValueIRS element (for citing)
Total Program Service Revenue$62,126,027TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,090TotalRevenueColumnAmt
Exclusion$9,090ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$62,135,117TotalRevenueColumnAmt
Related Or Exempt Func Income$62,126,027RelatedOrExemptFuncIncomeAmt
Exclusion$9,090ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$44,158,268TotalAmt
Program Services$43,681,359ProgramServicesAmt
Management And General$476,909ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,346,200TotalAmt
Program Services$4,341,511ProgramServicesAmt
Management And General$4,689ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,960,153TotalAmt
Program Services$1,938,983ProgramServicesAmt
Management And General$21,170ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$1,860,430TotalAmt
Program Services$1,702,313ProgramServicesAmt
Management And General$158,117ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$331,126TotalAmt
Program Services$331,126ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$8,702TotalAmt
Program Services$8,702ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,069,436TotalAmt
Program Services$1,030,509ProgramServicesAmt
Management And General$38,927ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,746,176TotalAmt
Program Services$1,746,176ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$147,465TotalAmt
Program Services$147,465ProgramServicesAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$206,907TotalAmt
Program Services$206,907ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$293,906TotalAmt
Program Services$269,806ProgramServicesAmt
Management And General$24,100ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$377,444TotalAmt
Program Services$377,444ProgramServicesAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
BAD DEBT$2,970,298$2,970,298
MISC. EXPENSES$1,136,542$1,136,542

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$60,613,053TotalAmt
Program Services$59,889,141ProgramServicesAmt
Management And General$723,912ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$18,513,710BOYAmt
EOY$91,016EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,898,686BOYAmt
EOY$20,507,272EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$570,178BOYAmt
EOY-$1,736,381EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,924,364LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$578,631LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,422,958BOYAmt
EOY$1,345,733EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$14,939,559EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$25,405,532BOYAmt
EOY$35,147,199EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,807,982BOYAmt
EOY$6,388,653EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$29,473EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,807,982BOYAmt
EOY$6,418,126EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$20,597,550BOYAmt
EOY$28,729,073EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$20,597,550BOYAmt
EOY$28,729,073EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$25,405,532BOYAmt
EOY$35,147,199EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,522,064ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$6,609,459OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$288,140OtherCostOrOtherBasisAmt
Depreciation$35,031DepreciationAmt
Book Value$253,109BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,467,214OtherCostOrOtherBasisAmt
Depreciation$507,759DepreciationAmt
Book Value$959,455BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$169,010OtherCostOrOtherBasisAmt
Depreciation$35,841DepreciationAmt
Book Value$133,169BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,345,733TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescDUE FROM RELATED PARTIESDesc
Book Value$14,939,559BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$14,939,559TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
DUE TO RELATED PARTIES$5,736
SALES TAX PAYABLE$22,032
OTHER LIABILITIES$1,705
FieldValueIRS element (for citing)
Total Liability$29,473TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM SCH D PART X LINE 2FormAndLineReferenceDesc
ExplanationASC 740 FOOTNOTE (FKA FIN 48) PHC ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF THE INCOME TAXES TOPIC OF THE ASC (ASC 740). UNDER THE REQUIREMENTS OF ASC 740, TAX-EXEMPT ORGANIZATIONS MAY BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS UNCERTAIN TAX EXPOSURE ITEMS. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AT JUNE 30, 2019 AND 2018.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgYes (true)CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (true)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Mr Kevin Brown
Board Member & CEO, PHC$0$1,181,659$0$959,433$0$1,795,125$0$207,649$0$16,506$0$4,160,372$0$1,653,134
Dr Charles Peck
PARMC CEO (THROUGH 1/19)$0$548,968$0$299,700$0$425,284$0$83,250$0$28,371$0$1,385,573$0$83,250
Mr J Michael Burnett
PARMC CEO (From 4/19)$0$437,689$0$219,248$0$98,667$0$78,888$0$16,542$0$851,034$0$62,388
Ms Wendy Cook
PARMC CFO$0$372,313$0$102,617$0$15,003$0$16,500$0$16,088$0$522,521$0$0
Dr Kimberly Walpert
PHYSICIAN$815,393$0$0$0$418,415$0$1,892$0$7,809$0$1,243,509$0$0$0
Dr Shashikant Patil
PHYSICIAN$744,631$0$0$0$184,083$0$2,058$0$12,466$0$943,238$0$0$0
Dr Parker Grow
PHYSICIAN$498,225$0$0$0$282,535$0$0$0$24,040$0$804,800$0$0$0
Dr Steven Scott
PHYSICIAN$842,322$0$0$0$19,685$0$5,865$0$16,413$0$884,285$0$0$0
Dr Cullen Morris
PHYSICIAN$846,240$0$0$0$52,889$0$14,177$0$11,348$0$924,654$0$0$0
Mr Michael McAnder
Treasurer$0$598,784$0$408,746$0$96,080$0$121,042$0$7,634$0$1,232,286$0$0
Ms Elizabeth Leddy
Secretary$0$422,090$0$288,072$0$42,079$0$84,235$0$16,280$0$852,756$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCH J PART I LINE 4ASEVERANCE PAYMENT CERTAIN OFFICERS HAVE WRITTEN SEVERANCE AGREEMENTS WITH THE EMPLOYER. THIS SEVERANCE AGREEMENT TYPICALLY PROVIDES THAT IN THE EVENT OF INVOLUNTARY TERMINATION THE OFFICER WILL CONTINUE TO RECEIVE THE OFFICER'S BASE COMPENSATION FOR A PERIOD OF 24 MONTHS FOLLOWING THE OFFICER'S DATE OF DETERMINATION. THE OFFICER IS ALSO ENTITLED AS ADDITIONAL SEVERANCE ANY OTHER BENEFITS TO WHICH HE WOULD HAVE BEEN ENTITLED HAD THE EXECUTIVE REMAINED AN EMPLOYEE. THE VALUE OF THE OTHER BENEFITS ARE MADE AVAILABLE TO THE OFFICER IN ACTUAL BENEFITS OR EQUIVALENT VALUE TO THE EXTENT PERMITTED IN LAW AND BY UNDERLYING CONTRACTS THAT MAY SUPPORT SUCH BENEFITS. NO SEVERANCE PAYMENTS WERE MADE IN 2018.
SCH J PART I LINE 4BSUPPLEMENTAL COMPENSATION INFORMATION DR. CHARLES PECK RECEIVED PAYMENTS TOTALING $83,250; KEVIN BROWN RECEIVED PAYMENTS TOTALING $1,653,134; J. MICHAEL BURNETT RECEIVED PAYMENTS TOTALING $62,388. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS: WENDY COOK ELIZABETH LEDDY MICHAEL MCANDER
SCH J PART I LINE 5A & 6ACONTINGENT COMPENSATION EXECUTIVE AND LEADERSHIP POSITIONS ARE ELIGIBLE TO PARTICIPATE IN A VARIABLE PAY PLAN. GROSS REVENUES AND NET EARNINGS ARE VARIABLE PAY PLAN FACTORS. THIS PLAN PROVIDES INCENTIVES BASED ON SYSTEM PERFORMANCE. THE RESULTS ARE BASED ON THE ACCOMPLISHMENT OF SPECIFIC STRATEGIC OBJECTIVES INVOLVING: (1) SUSTAINED AND IMPROVED FINANCIAL PERFORMANCE AND EFFICIENCY (2) EMPLOYEE SATISFACTION AND RETENTION (3) IMPROVED CUSTOMER SATISFACTION INCLUDING MEMBERS, PHYSICIANS, PATIENTS, AND EMPLOYEES (4) MAINTENANCE AND IMPROVEMENT IN QUALITY AND CLINICAL OUTCOMES. THE PERFORMANCE SCORECARD IS DETERMINED ANNUALLY AND APPROVED BY THE BENEFITS AND COMPENSATION COMMITTEE OF THE BOARD. THE PLAN WILL BE DISALLOWED BASED ON LOSS OF THE JOINT COMMISSION ACCREDITATION OR A VIOLATION OF THE BOND COVENANTS. PHYSICIANS RECEIVE A BASE SALARY PLUS AN INCENTIVE WHICH IS CALCULATED AS A PERCENTAGE OF NET PRODUCTION. NET PRODUCTION IS BASED ON WORK RVU PRODUCTION AND AN ESTABLISHED COMPENSATION PER WORK RVU RATE BASED ON FAIR MARKET VALUE. THE CALCULATION OF NET PRODUCTION IS SUBJECT ALWAYS TO COMPLIANCE WITH ALL APPLICABLE FEDERAL AND STATE LAWS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 Part III Line 1MISSION STATEMENT EXPLANATION ATHENS REGIONAL SPECIALTY SERVICES, INC. (ARSS) WAS INCORPORATED ON FEBRUARY 18, 2010. ARSS WAS FORMED TO SUPPORT THE EFFORTS OF ATHENS REGIONAL MEDICAL CENTER BY STRIVING TO IMPROVE THE HEALTH OF THE GENERAL POPULATION OF THE AREA SERVED BY ENSURING THE AVAILABILITY OF QUALITY SPECIALTY MEDICAL SERVICES. ARSS CURRENTLY EMPLOYS 90 PHYSICIANS INCLUDING 38 SPECIALIZED PHYSICIANS WITH EXPERTISE IN CARDIOLOGY, OBSTETRICS, PSYCHIATRY, PHYSICAL MEDICINE AND REHABILITATION, PEDIATRICS, HYPERBARIC MEDICINE AND GENERAL AND COLORECTAL SURGERY. ARSS PROVIDES SPECIALTY MEDICAL SERVICES TO THE GENERAL PUBLIC THROUGH ITS EMPLOYEE PHYSICIANS, REGARDLESS OF EACH PATIENT'S ABILITY TO PAY. FORM 990 PART V LINE 1A FORM 1096 FILINGS ALL FORM 1096 FILINGS FOR THE ORGANIZATION ARE FILED BY PIEDMONT HEALTHCARE, INC. (EIN 58-1503902).
Form 990 Part VI Line 6MEMBERS OR SHAREHOLDERS ORGANIZATION'S SOLE MEMBER PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC., (EIN 58-2179986) IS THE SOLE MEMBER OF ATHENS REGIONAL SPECIALTY SERVICES, INC.
Form 990 Part VI Line 7aELECTION OF GOVERNING BODY THE BOARD OF PIEDMONT HEALTHCARE, ATHENS REGIONAL SPECIALTY SERVICES, INC.'S SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF ATHENS REGIONAL SPECIALTY SERVICES, INC.
Form 990 Part VI Line 7BDECISIONS OF GOVERNING BODY ATHENS REGIONAL SPECIALTY SERVICES, INC.'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 ATHENS REGIONAL SPECIALTY SERVICES, INC. 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 Line 11a990 REVIEW PROCESS PRIOR TO FILING, COPIES OF FORM 990 ARE PROVIDED TO THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC.
Form 990 Part VI Line 12cCONFLICT OF INTEREST POLICY 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 ATHENS REGIONAL SPECIALTY SERVICES, INC. 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 SENIOR VICE PRESIDENT OF COMPLIANCE FOR INVESTIGATION, AND REMEDIAL STEPS MUST BE TAKEN AS APPROPRIATE UNDER THE PIEDMONT HEALTHCARE DISCIPLINARY POLICIES.
Form 990 Part VI Line 15aEXECUTIVE COMPENSATION COMPENSATION FOR EXECUTIVES OF ATHENS REGIONAL SPECIALTY SERVICES, INC. IS SET BY THE BOARD OF DIRECTORS OF AND PAID ON BEHALF OF THE ORGANIZATION BY 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 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 LIMITED TO, APPROVAL OF EXECUTIVE EMPLOYMENT CONTRACTS AND BENEFITS.
Form 990 Part VI Line 19DISCLOSURE OF DOCUMENTS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THESE DOCUMENTS SHOULD BE REQUESTED FROM PIEDMONT HEALTHCARE, INC.'S LEGAL COUNSEL.
Form 990 Part XI, Line 9RECONCILIATION OF NET ASSETS CHANGES TO NET ASSETS REPORTED ON PART XI, LINE 9 ARE COMPRISED OF THE FOLLOWING: CHANGE IN EQUITY $12,541 INTERCOMPANY TRANSFERS $8,118,101 BOOK/TAX DIFFERENCES ($1,521,183) ------------------------ TOTAL $6,609,459

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (21 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
PIEDMONT HEALTHCARE INC
1800 HOWELL MILL ROAD SUITE 850ATLANTAGA30318581503902MANAGEMENTGA501(c)(3)12B, III-FNAfalse
PIEDMONT HOSPITAL Inc
1968 PEACHTREE ROAD NWATLANTAGA30309580566213HOSPITALGA501(c)(3)3PHCfalse
FAYETTE COMMUNITY HOSPITAL INC
1255 HIGHWAY 54 WESTFAYETTEVILLEGA30214582232328HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT MOUNTAINSIDE HOSPITAL INC
1266 HIGHWAY 515 SOUTHJASPERGA30143352228583HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT NEWNAN HOSPITAL INC
745 POPLAR ROADNEWNANGA30265205077249HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT HEALTHCARE FOUNDATION INC
2001 PEACHTREE ROAD NE SUITE 400ATLANTAGA30309581272768FUNDRAISINGGA501(c)(3)12B, IIPHCfalse
PIEDMONT HENRY HOSPITAL INC
1133 EAGLES LANDING PKWYSTOCKBRIDGEGA30281582200195HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT NEWTON HOSPITAL INC
5126 HOSPITAL DRIVE NECOVINGTONGA30014582155150HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT HEART INSTITUTE INC
95 COLLIER ROAD NW STE 2045ATLANTAGA30309263553500HOSPITALGA501(C)(3)10PHCfalse
PIEDMONT ATHENS REGIONAL HEALTH RESOURCE
1199 PRINCE AVENUEATHENSGA30606581930580DEVELOPMENTGA501(C)(3)12B, IIPARMCfalse
PIEDMONT ATHENS REGIONAL FOUNDATION INC
1199 PRINCE AVENUEATHENSGA30606581978389FUNDRAISINGGA501(C)(3)12B, IIPARMCfalse
PIEDMONT ATHENS REGIONAL MEDICAL CENTER
1199 PRINCE AVENUEATHENSGA30606582179986HOSPITALGA501(C)(3)3PHCfalse
ATHENS REGIONAL PHYSICIAN SERVICES INC
1199 PRINCE AVENUEATHENSGA30606582332921HEALTHCAREGA501(C)(3)12B, IIPARMCfalse
REGIONAL FIRSTCARE INC
1199 PRINCE AVENUEATHENSGA30606582362733URGENT CAREGA501(C)(3)12B, IIPARMCfalse
COLUMBUS AMBULATORY HEALTHCARE SERVICES
707 CENTER STCOLUMBUSGA31901581719867AMBULATORYGA501(C)(3)3CRHSfalse
COLUMBUS REGIONAL HEALTHCARE SYSTEM INC
707 CENTER STCOLUMBUSGA31901581719994HEALTHCAREGA501(C)(3)12B, IIPHCfalse
COLUMBUS REGIONAL MEDICAL FOUNDATION INC
707 CENTER STCOLUMBUSGA31901581501642FUNDRAISINGGA501(C)(3)7CRHSfalse
THE MEDICAL CENTER INC
710 CENTER STCOLUMBUSGA31901581685139HOSPITALGA501(C)(3)3CRHSfalse
HUGHSTON HOSPITAL INC
707 CENTER STCOLUMBUSGA31901331216751HOSPITALGA501(C)(3)3CRHSfalse
PIEDMONT ROCKDALE HOSPITAL INC
1412 MILSTEAD AVECONYERSGA30012300999841HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT WALTON HOSPITAL INC
2151 WEST SPRING STMONROEGA30655824194264HOSPITALGA501(C)(3)3PHCfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndUBI Code VUBICodeVAmtGeneral Or Managing PartnerGeneralOrManagingPartnerInd
PEACHTREE ORTHOPAEDIC SURGERY CENTER
2001 PEACHTREE RD NE STE 705ATLANTAGA30309582562721SURGERYGANAN/A$0$0false$0false
DIGESTIVE HEALTHCARE OF GA SURGERY CTR
95 COLLIER RD NW STE 4075ATLANTAGA30309582406657HEALTHCAREGANAN/A$0$0false$0false
FOUR WINDS HEALTH LLC
3350 RIVERWOOD PKWY STE 1850ATLANTAGA30339451273930HEALTHCAREGANAN/A$0$0false$0false
GEORGIA HEALTH COLLABORATIVE LLC
2727 PACES FERRY RD BLDG 2 STE 20ATLANTAGA30339461500639HEALTHCAREGANAN/A$0$0false$0false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
PIEDMONT MEDICAL CARE CORPORATION
2727 PACES FERRY ROAD SUITE 1-1100ATLANTAGA30339582092768HEALTHCAREGAPHCC-CORP$0$00.00000false
THE PIEDMONT CLINIC INC
2727 PACES FERRY ROAD SUITE 1-1100ATLANTAGA30339582005358HEALTHCAREGAPHCC-CORP$0$00.00000false
PIEDMONT HEART INSTITUTE PHYSICIANS INC
95 COLLIER ROAD NW STE 2045ATLANTAGA30309260593850HEALTHCAREGAPHCC-CORP$0$00.00000false
AMSTER MCRAE INSURANCE COMPANY
980427603Related Insur.PHCC-CORP$0$00.00000falsePO BOX 1159 GRAND CAYMANGRAND CAYMANCJKY 1-1102CJ
PIEDMONT WELLSTAR HEALTHPLANS INC
2859 PACES FERRY RD STE 600ATLANTAGA30339461922499HEALTH INSUR.GAPHCC-CORP$0$00.00000false
COLUMBUS HEALTHCARE RESOURCES
PO BOX 790COLUMBUSGA31902581717754HEALTHCAREGACRHSC CORP$0$00.00000false
Columbus Health Services Inc
PO BOX 790ATLANTAGA31902581640939HEALTHCAREGACRHSC CORP$0$00.00000false
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd