2020-05-15T09:48:36-05:00 2019-06-30 KPMG LLP 300 North Greene Street Suite 400 Greensboro NC 27401 990 2018-07-01 824194264 Piedmont Walton Hospital Inc % MARIE GAFFNEY PIED 7702678461 2151 West Spring Street MONROE GA 30655 MARIE GAFFNEY VP CORPORATE FINANCE 2020-05-11 true SHAWN HUTCHINSON P01048557 3362753394 2020-05-14 199.206.0.5 56038220201365000021 2020-05-15 P EBCFF78EDDD3A39828B2CE874C533A3E905ED70A 1272C807EE2CFB18DB9032F475C1250F2D6A8CEA 2018 2021-01-29 14:40:06Z LARRY EBERT 2151 West Spring Street MONROE GA 30655 58292551 false X www.piedmont.org/locations/piedmont-walton/ X 2018 GA TO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT. 7 4 421 60 0 0 4270 1923 17607180 57891379 0 29418 14494 369831 17625944 58292551 0 0 0 0 5679236 27941201 0 0 0 11609141 43719664 17288377 71660865 337567 -13368314 51692892 49671640 4186103 6816970 47506789 42854670 X TO PROVIDE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE IN A PROGRESSIVE ENVIRONMENT, GUIDED BY PHYSICIANS, DELIVERED BY EXCEPTIONAL PROFESSIONALS, AND INSPIRED BY THE COMMUNITIES WE SERVE. false false 62526547 0 57897275 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, 2019, THE HOSPITAL HAD 2,646 IN-PATIENT ADMISSIONS WITH A TOTAL OF 9,065 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 32,149 AND OUTPATIENT VISITS TOTALED 16,777. SURGICAL SERVICES WERE PROVIDED TO 2,577 PATIENTS. 62526547 true false false false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true X 0 0 421 true false false false false false false false false false false false X 7 4 false false false false true true true true true false false false true true true true true true true false GA X MARIE GAFFNEY 4702716007 2727 PACES FERRY RD BLDG 2 STE 70 Atlanta GA 30339 X Ms VICKI CANSLER BOARD MEMBER 1.0 54.0 X 0 991090 61254 MR DAN CURRY BOARD MEMBER 1.0 0.0 X 0 0 0 MR PATRICK DALLY BOARD MEMBER 1.0 0.0 X 0 0 0 MR LARRY EBERT CEO 35.0 20.0 X X 0 323998 25632 DR STEVEN DUROCHER BOARD MEMBER 1.0 0.0 X 0 0 0 RET CAPT COLEMAN LANDERS CHAIRMAN & BOARD MEMBER 1.0 0.0 X X 0 0 0 MR J MICHAEL BURNETT BOARD MEMBER 1.0 54.0 X 0 755604 95430 MR MICHAEL MCANDER TREASURER 1.0 54.0 X 0 1103610 128676 MS ELIZABETH LEDDY SECRETARY 1.0 54.0 X 0 752240 100515 MR VENEL PIERRE LOUIS RN 40.0 0.0 X 116517 0 3009 MR MICHAEL WYNNE Dir Pharmacy 40.0 0.0 X 104140 0 10097 220657 3926542 424613 2 false true false WALTON ANESTHESIA ASSOCIATES PC 2151 West Spring St MONROE GA 30655 ANESTHESIA 666329 MEDICAL SOLUTIONS LLC 1010 n 102nd st OMAHA NE 68114 NURSE STAFFING 546340 THERAPEUTIC GI ASSOCIATES LLC 2151 W SPRING ST MONROE GA 30655 GASTROENTEROLOGY SVC 421250 CLINICAL MANAGEMENT SOLUTIONS 17806 Grey Brooke Dr TAMPA FL 33647 MEDICAL CONSULTING 324570 CHSPSC LLC 4000 Meridian Boulevard FRANKLIN TN 37067 HEALTHCARE SVCS 316792 10 1923 1923 PATIENT SERVICE REVENUE 622110 57891084 57891084 OTHER OPERATING REVENUE 900099 295 295 57891379 6025 6025 0 0 359659 359659 0 359659 359659 23393 23393 23393 23393 0 0 0 0 0 0 4276 0 4276 FEE REVENUE 900099 5896 5896 5896 58292551 57897275 389077 0 0 0 0 342105 82214 259891 0 22611751 20229557 2382194 0 3400643 2969204 431439 1586702 1362660 224042 23100 23093 7 0 0 0 0 0 7628036 6197914 1430122 261846 20872 240974 4136971 3135758 1001213 1437476 1089607 347869 0 2496811 2317136 179675 4332 2706 1626 0 0 4692 4692 1322099 1322099 1331655 1237988 93667 1053698 788491 265207 BAD DEBT EXPENSE 12509426 12509426 DRUGS & MEDICAL SUPPLIES 7427460 7427460 HOSPITAL TAX 1801687 1801687 ADMINISTRATIVE EXPENSES 2280375 1330774 949601 71660865 62526547 9134318 0 82279725 58577311 0 0 0 0 -70130063 -50135310 0 0 0 0 0 0 1137775 1225961 388772 314146 16060799 1587771 19632343 14473028 0 0 0 0 0 0 0 0 18384340 25216504 51692892 49671640 4442158 6320035 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -256055 496935 4186103 6816970 X 47511059 42854530 -4270 140 0 0 47506789 42854670 51692892 49671640 X -13368314 8716195 X false true X true false X 1022422 1022422 15347433 573308 14774125 327657 19124 308533 -636713 995339 -1632052 14473028 GOODWILL 25216504 25216504 0 MEDICARE PAYABLE 496935 496935 X SCHEDULE D, PART X, LINE 2: ASC 740 FOOTNOTE (FKA FIN 48) PHC ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF THE INCOME TAXES TOPIC OF THE ASC (ASC 740). UNDER THE REQUIREMENTS OF ASC 740, TAX-EXEMPT ORGANIZATIONS MAY BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS UNCERTAIN TAX EXPOSURE ITEMS. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AT JUNE 30, 2019 AND 2018. true true X true X 300. true X true true false true true 2598328 2598328 0.04390 2732427 2435540 296887 0.00500 1139436 387173 752263 0.01270 6470191 2822713 3647478 0.06160 22200 22200 0.00040 581422 581422 0.00980 40000 40000 0.00070 643622 643622 0.01090 7113813 2822713 4291100 0.07250 true 12509426 11700231 13711850 -2011619 X true true 1 1 PIEDMONT WALTON HOSPITAL INC 2151 WEST SPRING STREET MONROE GA 30655 www.piedmont.org 147-613 X X X 1 PIEDMONT WALTON HOSPITAL INC 1 true true true X X X X X X X X 18 true true false true X SEE PART VI X X true 17 true SEE PART VI false true X 300. 300. X true true X X X X true X SEE PART VI X SEE PART VI X SEE PART VI X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, LINES 1 AND 2: NEW HOSPITAL ENTITY PIEDMONT 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, 2019. HTTPS://WWW.PIEDMONT.ORG/MEDIA/FILE/2017-19-IMPLEMENTATION-STRATEGIES.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 18, 2019, WITHIN THE GRACE PERIOD. BASED ON THE CHNA, PIEDMONT ROCKDALE 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 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 $71,660,865, LESS BAD DEBT EXPENSE OF $12,509,426 FROM FORM 990, PART IX, LINE 24(A). 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. Medicare accounted for 18.76% of the 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 Piedmont Walton Hospital in honor of the 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. 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 FY19, we distributed approximately 4,500 copies of this guide throughout the Walton community. 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. In 2017, the last year for which Census data were available, approximately 88,695 people lived in Walton County's 327 square miles. The majority of the community is white -- about 80 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. In 2017, the median household income was $55,876, in line with the state and national averages of $52,977 and $57,652, respectively. That year, the median age was 39. In 2017, 13 percent of the county lived at or below the poverty level - about 11,200 people. Seventy-three percent of people owned their own home in 2017, a rate much higher than state and national averages. Approximately 3.4 percent of adults were unemployed in 2018, a figure better than state and national averages. There were 5,075 veterans living in Walton County in 2017. The majority served in Vietnam, and approximately 30 percent 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 2013 and 2017. 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 2013 and 2017, the second leading cause of premature death was accidental poisoning and exposure to noxious substances. Other top causes, in order, were suicide, motor vehicle accidents, lung cancer, certain conditions originating in the perinatal period, hypertension/hypertensive renal and heart disease, 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 in 2017, and 18 percent of the adult population was uninsured in 2017. Rates for children and elderly populations were much lower at 5 percent for children and 2 percent for those 65 and older. This equals about 10,676 people who have no form of insurance coverage to pay for necessary care. Approximately 16 percent of county residents 18 or older have had six or more of their permanent teeth removed due to tooth decay, gum disease or infection. Community members have reported an average 3.7 poor or fair physical and 3.8 poor mental health days. A total 15 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 55 preventable hospital events per every 1,000 enrollees in 2015. This figure is worse than state and national averages. Twelve percent of the population lived with at least one disability in 2017. The highest concentration of disabled populations in the central part of the county. The infant mortality rate in Walton County was far less than state and national averages, at six infant deaths per every 1,000 births in 2017. That year, 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, 45 Walton County community members died from 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. Approximately 11 percent of adults lived with diabetes in Walton County in 2015, a figure in line with state and national averages (11 percent and 9 percent, respectively). In 2015, 29 percent of Medicare beneficiaries lived with diabetes. The numbers may be higher for Medicare beneficiaries because that population is more likely to be tested routinely for the disease. Overall, between 2013 and 2017, 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 11th leading cause of premature death and breast cancer was the 13th 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. Female breast cancer incidence rate is lower than state and national averages, with an average rate of 120 incidences per every 100,000 people between 2010 and 2015. There are an average 61 new breast cancer cases diagnosed annually, and about 5,087 women lived with the disease in 2015. The lung cancer incidence rate is higher at 70 incidences per every 100,000 people, which is above both state and national averages. An estimated 9,566 people had lung cancer in 2015, and there are an average 64 new cases annually. Adult obesity rates were high in Walton County, with nearly a third of all county residents as obese. This contributes to a number of diseases, including heart disease, stroke and diabetes. Smoking rates were slightly lower than the state average, though smoking is still an issue as it is a key contributor to cancer, and in particular lung cancer, which has a devastating effect on Walton County residents. Seventeen percent of county residents commute more than 60 minutes or more to work, a rate far higher than state and national averages. The majority 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 in line with state and national averages. Mental health and behavioral disorders were the 4th leading cause of age-adjusted death for all county residents between 2013 and 2017. Suicide was the 2nd leading cause of premature deaths for all races between 2013 and 2017, and the third leading cause of age-adjusted death. It was most common among white males aged 25 to 34 years of age. There was one mental health provider for every 1,666 residents in the county in 2017, a rate far worse than the state and national averages of one provider for every 813 and 493 residents, respectively. Like in the rest of the state, opioid prescriptions are an issue in the Walton County community, with a total 100.9 opioids prescriptions written per every 100 people in 2017. 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. There were 15 deaths from all overdoses in Walton County in 2017, and ten were directly related to opioids. Thirty 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, 33 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 52 fast food restaurants in Walton County in 2016, 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. Thirty percent of households had housing costs that exceeded more than 30 percent of total household income in 2017, indicating a cost burdened household more likely to face overall financial difficulty. This is directly linked to having trouble paying medical bills. Approximately 1,057 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-five percent of children lived in single-parent homes in 2017, a statistic that can indicate financial insecurity at home. Nearly 50 percent of children qualified for free or reduced cost lunch in the 2015-2016 school year, a statistic that represents poverty and food instability. Walton County is much more than the 2017 state average of 62 percent. For every 1,000 teen girls aged 15 to 18 in Walton County, 44 gave birth to a child on average each year between 2010 and 2016. In Walton County, African Americans and Hispanic or Latina teen birth rates were 67 and 131 births per every 1,000 teen women, respectively. Children 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. Piedmont Walton actively partners with groups in the community, including local charitable clinics. In FY19, we continued to provide funding for a full-time nurse practitioner working at the F.I.S.H. Medical and Dental Clinic. 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 Also, in FY19, Piedmont Walton Hospital awarded approximately $40,000 in funding to eight not-for-profit organizations whose programs aligned with the hospital's FY16 CHNA. Recipients and funded programs were: Team Up Mentoring, for their Team Up for Wellness program; F.I.S.H. medical and dental continuum of care programming; MedLink's blindness is preventable screening program; and, Walton County Senior Citizen's Council, non-emergency transport programming. In FY19, Piedmont Walton also provided health professions education to students and residents training to be health professionals. That year, the hospital oversaw 16,824 total training hours at a cost of $581,422. 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. Piedmont Walton Hospital also actively participated in local take-back day activities in FY19 by promoting and supporting a community drive for local residents to safely dispose of medications. 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. false true false false false false false true false Ms VICKI CANSLER BOARD MEMBER 0 391971 0 211633 0 387486 0 53351 0 7903 0 1052344 0 345151 MR LARRY EBERT CEO 0 254657 0 54338 0 15003 0 10915 0 14717 0 349630 0 0 MR J MICHAEL BURNETT BOARD MEMBER 0 437689 0 219248 0 98667 0 78888 0 16542 0 851034 0 62388 MR MICHAEL MCANDER TREASURER 0 598784 0 408746 0 96080 0 121042 0 7634 0 1232286 0 0 MS ELIZABETH LEDDY SECRETARY 422090 288072 42078 84235 16280 852755 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 $345,151 FROM HER SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. J. MICHAEL BURNETT RECEIVED A PAYMENT OF $62,388 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. FORM 990, PART V, LINE 1A: NUMBER OF FORMS 1099 FILED ALL CALENDAR YEAR 2018 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 WALTON 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 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, 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 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. FORM 990, PART VI, SECTION C, LINE 19: DISCLOSURE 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 9: RECONCILIATION OF NET ASSETS CHANGES TO NET ASSETS REPORTED ON PART XI, LINE 9 ARE COMPRISED OF: CHANGE IN TEMP $4,410 INTERCOMPANY TRANSFERS $10,861,363 UNALLOCATED EXPENSES ($2,149,578) ------------------ TOTAL $8,716,195 FORM 990 PART IX LINE 11G DESCRIPTION:GENERAL CONTRACT LABOR TOTAL FEES:486786 FORM 990 PART IX LINE 11G DESCRIPTION:PRINTING TOTAL FEES:141 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT SERVICES TOTAL FEES:3933522 FORM 990 PART IX LINE 11G DESCRIPTION:TRANSPORTATION TOTAL FEES:11866 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL DIRECTOR TOTAL FEES:82632 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN CALL PAY TOTAL FEES:783570 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN SUPPORT TOTAL FEES:1635750 FORM 990 PART IX LINE 11G DESCRIPTION:MAINTENANCE TOTAL FEES:691499 FORM 990 PART IX LINE 11G DESCRIPTION:CLERICAL SERVICES TOTAL FEES:295 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL SERVICES TOTAL FEES:1975 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 PEACHTREE ORTHOPAEDIC SURGERY CENTER 2001 PEACHTREE RD NE STE 705 ATLANTA GA 30309 582562721 ORTHOPAEDIC GA PHC n/a 0 0 false 0 false DIGESTIVE HEALTHCARE OF GA ENDOSCOPY CEN 95 COLLIER RD NW STE 4075 ATLANTA GA 30309 582406657 HEALTHCARE GA PHC N/A 0 0 false 0 false FOUR WINDS HEALTH LLC 3350 RIVERWOOD PKWY STE 1850 ATLANTA GA 30339 451273930 HEALTHCARE GA PHC N/A 0 0 false 0 false GEORGIA HEALTH COLLABORATIVE LLC 2727 PACES FERRY RD BLDG 2 STE 70 ATLANTA GA 30339 461500639 HEALTHCARE GA PHC N/A 0 0 false 0 false PIEDMONT MEDICAL CARE CORPORATION 2727 PACES FERRY RD STE 1-1100 ATLANTA GA 30339 582092768 HEALTHCARE GA PHC C CORP 0 0 0.00000 false THE PIEDMONT CLINIC INC 2727 PACES FERRY RD STE 1-1100 ATLANTA GA 30339 582005358 HEALTHCARE GA PHC C CORP 0 0 0.00000 false PIEDMONT HEART INSTITUTE PHYSICIANS INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 260593850 HEALTHCARE GA PHC C CORP 0 0 0.00000 false AMSTER MCRAE INSURANCE COMPANY PO BOX 1159 GRAND CAYMAN CJ KY1-1102 980427603 RELATED INSUR. 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