FAYETTE COMMUNITY HOSPITAL INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- FAYETTE COMMUNITY HOSPITAL INC (EIN 58-2322328)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-14
- IRS object ID
- 201931349349309678
- Schema version
- 2017v2.3
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-14T21:52:04-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 North Greene Street Suite 400 | AddressLine1Txt |
| City | Greensboro | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 582322328 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Fayette Community Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % MARIE GAFFNEY | InCareOfNm |
| Business Name Control | FAYE | BusinessNameControlTxt |
| Phone | 7707197073 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1255 Highway 54 West | AddressLine1Txt |
| City | Fayetteville | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30214 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARIE GAFFNEY | PersonNm |
| Person Title | VP CORPORATE FINANCE | PersonTitleTxt |
| Phone | 4702716007 | PhoneNum |
| Signature | 2019-05-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WHITNEY E BLAIR | PreparerPersonNm |
| PTIN | P01226647 | PTIN |
| Phone | 3362753394 | PhoneNum |
| Preparation | 2019-05-14 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.102.5 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 56038220191345000026 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2019-05-14 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | A44B9C37BFA5EF1264A4312BD3172D9227A45E08 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 5D7B52A41C2226A5E4849843C7D809138903E6FF | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2020-01-14 16:20:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | J MICHAEL BURNETT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1255 Highway 54 West | AddressLine1Txt |
| City | Fayetteville | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30214 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $399,323,507 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PIEDMONTFAYETTE.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 2277 | TotalEmployeeCnt |
| Total Volunteers | 270 | TotalVolunteersCnt |
| Total Gross UBI | $8,044 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $7,044 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $67,402 | PYContributionsGrantsAmt |
| CY Contributions Grants | $37,238 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $379,117,271 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $393,589,230 | CYProgramServiceRevenueAmt |
| PY Investment Income | $215,903 | PYInvestmentIncomeAmt |
| CY Investment Income | -$31,081 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,524,441 | PYOtherRevenueAmt |
| CY Other Revenue | $4,404,827 | CYOtherRevenueAmt |
| PY Total Revenue | $383,925,017 | PYTotalRevenueAmt |
| CY Total Revenue | $398,000,214 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $54,179 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $81,050 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $130,822,643 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $136,796,890 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $216,877,421 | PYOtherExpensesAmt |
| CY Other Expenses | $218,378,777 | CYOtherExpensesAmt |
| PY Total Expenses | $347,754,243 | PYTotalExpensesAmt |
| CY Total Expenses | $355,256,717 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $36,170,774 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $42,743,497 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $195,786,300 | TotalAssetsBOYAmt |
| Total Assets EOY | $209,332,377 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $33,836,049 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $38,755,791 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $161,950,251 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $170,576,586 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE IN A PROGRESSIVE ENVIRONMENT, GUIDED BY PHYSICIANS, DELIVERED BY EXCEPTIONAL PROFESSIONALS, AND INSPIRED BY THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $327,985,488 | ExpenseAmt |
| Grant | $81,050 | GrantAmt |
| Revenue | $393,589,230 | RevenueAmt |
| Desc | PIEDMONT FAYETTE HOSPITAL ("PFH") IS A 221-BED FACILITY LOCATED IN FAYETTE COUNTY, GEORGIA. OVER 500 PRIMARY CARE AND SPECIALTY PHYSICIANS COMPRISE THE MEDICAL STAFF AND MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SENIORS WITHIN FAYETTEVILLE AND THE GREATER METROPOLITAN ATLANTA MARKET, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY FOR SERVICES. FOR THE YEAR ENDED JUNE 30, 2018, THE HOSPITAL HAD 16,018 IN-PATIENT ADMISSIONS WITH A TOTAL OF 69,717 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 80,676 AND OUTPATIENT VISITS TOTALED 100,097. SURGICAL SERVICES WERE PROVIDED TO 11,971 PATIENTS. | Desc |
| Total Program Service Expenses | $327,985,488 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 2277 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARIE GAFFNEY | PersonNm |
| Phone | 4702716007 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2727 PACES FERRY RD BLDG 2 STE 70 | AddressLine1Txt |
| City | Atlanta | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30339 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Mr Michael Behr | ||||||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $6,412 | $0 | $0 | ||||
| Mr J Michael Burnett | ||||||||||
| PRESIDENT & CEO/Board Member | 55.0 | 0.0 | Yes (X) | $996,924 | $0 | $118,910 | Yes (X) | |||
| Mr Mark Gray | ||||||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Mr Gregory A Hurst | ||||||||||
| Board Member (END 12-30-17) | 1.0 | 54.0 | Yes (X) | $0 | $1,973,760 | $23,776 | ||||
| Ms Lacy S Curry | ||||||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Dr Dave C Lee | ||||||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Dr Elizabeth W Killebrew | ||||||||||
| Board Member (END 12-31-17) | 1.0 | 0.0 | Yes (X) | $20,582 | $0 | $0 | ||||
| Mr Douglas B Warner | ||||||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Dr Russell A Wilson | ||||||||||
| Chairman/Physician | 7.0 | 0.0 | Yes (X) | $114,750 | $0 | $0 | Yes (X) | |||
| Mr Robert Reeves | ||||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Dr C Howell Tucker | ||||||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Dr Geetha Rao | ||||||||||
| Board Member (Eff. 7-1-17) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| Mr Michael McAnder | ||||||||||
| Treasurer | 1.0 | 54.0 | $0 | $1,029,023 | $124,751 | Yes (X) | ||||
| Ms Elizabeth Leddy | ||||||||||
| Secretary | 1.0 | 54.0 | $0 | $552,329 | $65,569 | Yes (X) | ||||
| Dr Frederick Willms | ||||||||||
| VP of Medical Affairs | 55.0 | 0.0 | $495,612 | $0 | $23,813 | Yes (X) | ||||
| Mr Scott Wolfe | ||||||||||
| CFO | 55.0 | 0.0 | $404,584 | $0 | $24,957 | Yes (X) | ||||
| Mr David Nipper | ||||||||||
| COO | 55.0 | 0.0 | $363,890 | $0 | $32,462 | Yes (X) | ||||
| Ms Rhonda Manos | ||||||||||
| Director of Pharmacy | 55.0 | 0.0 | $204,039 | $0 | $19,930 | Yes (X) | ||||
| Ms Cheryl Beard | ||||||||||
| Nursing Admin Supervisor | 55.0 | 0.0 | $183,102 | $0 | $5,543 | Yes (X) | ||||
| Ms Merry Heath | ||||||||||
| CNO | 55.0 | 0.0 | $247,488 | $0 | $18,704 | Yes (X) | ||||
| Ms Mary McFarland | ||||||||||
| Sr Dir Cardiovasc. Svcs | 55.0 | 0.0 | $175,184 | $0 | $20,825 | Yes (X) | ||||
| Ms Sandra Biles | ||||||||||
| Dir Inpatient Services | 55.0 | 0.0 | $171,426 | $0 | $23,978 | Yes (X) | ||||
| Mr John Miles | ||||||||||
| Former CFO | 0.0 | 55.0 | $0 | $365,519 | $32,379 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,383,993 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,920,631 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $535,597 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 111 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ALLIED UNIVERSAL SECURITY SERVICES | |||||
| 1551 N TUSTIN AVE | SANTA ANA | CA | 92705 | SECURITY Services | $710,139 |
| Brasfield and Gorrie LLC | |||||
| PO Box 11407 | BIRMINGHAM | AL | 352460351 | Construction | $6,337,979 |
| BDR PARTNERS LLC | |||||
| 1756 CENTURY BLVD NE | ATLANTA | GA | 30345 | BUSINESS DEVELOPMENT | $455,668 |
| MEDICAL SOLUTIONS INC | |||||
| 1010 N 102ND STE 300 | OMAHA | NE | 68114 | NURSING SERVICES | $1,805,166 |
| MEDMANAGEMENT LLC | |||||
| 1500 URBAN CENTER DR | BIRMINGHAM | AL | 35242 | MEDICARE COMPLIANCE | $236,470 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $37,238 | AllOtherContributionsAmt |
| Total Contributions | $37,238 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $393,369,814 | $393,369,814 |
| FITNESS CENTER REHAB | 621300 | $136,189 | $136,189 |
| OTHER OPERATING REVENUE | 900099 | $83,227 | $83,227 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $393,589,230 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $172,326 | TotalRevenueColumnAmt |
| Exclusion | $172,326 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,841,044 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,041,940 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,799,104 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,799,104 | TotalRevenueColumnAmt |
| Exclusion | $2,799,104 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $203,407 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$203,407 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$203,407 | TotalRevenueColumnAmt |
| Exclusion | -$203,407 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $339,600 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $77,946 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $261,654 | TotalRevenueColumnAmt |
| Exclusion | $261,654 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| CAFETERIA SALES | 900099 | $1,277,898 | $1,277,898 | |
| VENDING SALES | 900099 | $58,127 | $58,127 | |
| QUALIFIED TRANSPORT. FRINGE | 900099 | $8,044 | $8,044 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,344,069 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $398,000,214 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $393,589,230 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $8,044 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,365,702 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,050 | TotalAmt |
| Program Services | $81,050 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,173,286 | TotalAmt |
| Program Services | $1,803,827 | ProgramServicesAmt |
| Management And General | $369,459 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,456,526 | TotalAmt |
| Program Services | $91,678,917 | ProgramServicesAmt |
| Management And General | $18,777,609 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,108,173 | TotalAmt |
| Program Services | $14,199,783 | ProgramServicesAmt |
| Management And General | $2,908,390 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,058,905 | TotalAmt |
| Program Services | $5,858,891 | ProgramServicesAmt |
| Management And General | $1,200,014 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,140 | TotalAmt |
| Management And General | $102,140 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,023,011 | TotalAmt |
| Program Services | $25,023,011 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,105,470 | TotalAmt |
| Management And General | $1,105,470 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,966,505 | TotalAmt |
| Program Services | $23,785,148 | ProgramServicesAmt |
| Management And General | $181,357 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,534,625 | TotalAmt |
| Program Services | $6,142,547 | ProgramServicesAmt |
| Management And General | $392,078 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,534,977 | TotalAmt |
| Program Services | $4,353,578 | ProgramServicesAmt |
| Management And General | $181,399 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,640 | TotalAmt |
| Program Services | $36,214 | ProgramServicesAmt |
| Management And General | $19,426 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,881 | TotalAmt |
| Program Services | $38,690 | ProgramServicesAmt |
| Management And General | $7,191 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,107,135 | TotalAmt |
| Program Services | $6,893,921 | ProgramServicesAmt |
| Management And General | $213,214 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,312,971 | TotalAmt |
| Program Services | $10,312,971 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,196,959 | TotalAmt |
| Program Services | $8,645,142 | ProgramServicesAmt |
| Management And General | $551,817 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,906,631 | TotalAmt |
| Program Services | $2,732,233 | ProgramServicesAmt |
| Management And General | $174,398 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $56,016,121 | $56,016,121 | |
| BAD DEBT EXPENSE | $49,374,452 | $49,374,452 | |
| HOSPITAL TAX | $3,975,165 | $3,975,165 | |
| ADMINISTRATIVE EXPENSE | $18,121,094 | $17,033,827 | $1,087,267 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $355,256,717 | TotalAmt |
| Program Services | $327,985,488 | ProgramServicesAmt |
| Management And General | $27,271,229 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $651,011 | BOYAmt |
| EOY | $560,340 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,994 | BOYAmt |
| EOY | $43,261 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,049,778 | BOYAmt |
| EOY | $46,618,179 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,825,966 | BOYAmt |
| EOY | $4,874,827 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,098,993 | BOYAmt |
| EOY | $1,268,385 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $304,096,965 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $149,037,568 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $147,185,570 | BOYAmt |
| EOY | $155,059,397 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $907,988 | BOYAmt |
| EOY | $907,988 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,786,300 | BOYAmt |
| EOY | $209,332,377 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,841,030 | BOYAmt |
| EOY | $24,646,145 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,738,197 | BOYAmt |
| EOY | $13,878,619 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $256,822 | BOYAmt |
| EOY | $231,027 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,836,049 | BOYAmt |
| EOY | $38,755,791 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $160,970,421 | BOYAmt |
| EOY | $169,625,898 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $979,830 | BOYAmt |
| EOY | $950,688 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $161,950,251 | BOYAmt |
| EOY | $170,576,586 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,786,300 | BOYAmt |
| EOY | $209,332,377 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $42,743,497 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$34,117,162 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,525,840 | OtherCostOrOtherBasisAmt |
| Book Value | $8,525,840 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $158,508,235 | OtherCostOrOtherBasisAmt |
| Depreciation | $57,019,826 | DepreciationAmt |
| Book Value | $101,488,409 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,059,329 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,697,535 | DepreciationAmt |
| Book Value | $361,794 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $121,101,525 | OtherCostOrOtherBasisAmt |
| Depreciation | $88,320,207 | DepreciationAmt |
| Book Value | $32,781,318 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,902,036 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $11,902,036 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $155,059,397 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS LIABILITIES | Desc |
| Amt | $231,027 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $231,027 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2: ASC 740 FOOTNOTE (FKA FIN 48) | FormAndLineReferenceDesc |
| Explanation | PHC ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF THE INCOME TAXES TOPIC OF THE ASC (ASC 740). UNDER THE REQUIREMENTS OF ASC 740, TAX-EXEMPT ORGANIZATIONS MAY BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS UNCERTAIN TAX EXPOSURE ITEMS. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AT JUNE 30, 2018 AND 2017. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,604,778 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $18,604,778 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06080 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,676,049 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,415,031 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $261,018 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,327,153 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $470,320 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,856,833 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01260 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $31,607,980 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,885,351 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $22,722,629 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07420 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $36,071 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $36,071 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,325,493 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,325,493 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00760 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $31,834 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $31,834 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,393,398 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,393,398 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00780 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $34,001,378 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,885,351 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $25,116,027 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08200 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $11,612,753 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $754,945 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $74,493,645 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $75,648,045 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,154,400 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Piedmont Fayette Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1255 Highway 54 West | AddressLine1Txt |
| City | Fayetteville | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30214 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.piedmontfayette.com | WebsiteAddressTxt |
| State License | 056-550 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Piedmont Fayette Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART VI | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART VI | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300. | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART VI | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART VI | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART VI | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, LINE 5: COMMUNITY REPRESENTATION | PIEDMONT FAYETTE HOSPITALS ORIGINAL CHNA WAS CONDUCTED DURING THE HOSPITALS FISCAL YEAR 2013 IN PARTNERSHIP WITH THE HAYSLETT GROUP, THE LEAD CONVENER OF GEORGIAS PARTNER UP FOR PUBLIC HEALTH CAMPAIGN. THE OVERALL HEALTH NEEDS ASSESSMENT EFFORT WAS LED BY THE PIEDMONT HEALTHCARE COMMUNITY BENEFITS TEAM, AND ASSISTED BY COMMUNITY HEALTH ADVISORS (FOR STAKEHOLDER INTERVIEWS). PIEDMONT FAYETTE HOSPITAL CONDUCTED ITS SECOND CHNA DURING FISCAL YEAR 2016. STAKEHOLDERS WERE CONTINUALLY ENGAGED DURING BOTH ASSESSMENTS, WITH A PARTICULAR FOCUS ON THOSE GROUPS, ORGANIZATIONS, AND INDIVIDUALS REPRESENTING THE MOST VULNERABLE MEMBERS OF THE HOSPITALS COMMUNITY. SPECIFICALLY, PIEDMONT FAYETTE HOSPITAL INTERVIEWED REPRESENTATIVES OF LOCAL AND REGIONAL PUBLIC HEALTH ENTITIES, MINORITY POPULATIONS, THE FAITH-BASED COMMUNITIES, LOCAL BUSINESS OWNERS, THE PHILANTHROPIC COMMUNITY, MENTAL HEALTH AGENCIES, ELECTED OFFICIALS, AND OTHER RELEVANT COMMUNITY STAKEHOLDERS. ADDITIONALLY, THE HOSPITAL CONDUCTED FOCUS GROUPS MADE UP OF LOW-INCOME AND UNINSURED PATIENTS, AS WELL AS CONSUMER AND PATIENT ADVOCATES REPRESENTING A VARIETY OF VULNERABLE PATIENTS. ALL INTERVIEWS, FOCUS GROUPS AND MEETINGS INFORMED THE CHNA PROCESSES, INCLUDING THE IDENTIFICATION OF KEY HEALTH PRIORITIES AND DEVELOPMENT OF IMPLEMENTATION PLAN STRATEGIES. |
| SCHEDULE H, PART V, LINE 6A: HOSPITALS INCLUDED IN CURRENT CHNA PROCESS | DURING FY16, THE PIEDMONT HEALTHCARE SYSTEM CONDUCTED THE SECOND CHNA FOR SIX OF ITS TAX-EXEMPT HOSPITALS. EACH INDIVIDUAL HOSPITAL'S COMMUNITY WAS ASSESSED AND PRIORITY NEEDS WERE IDENTIFIED BASED ON THE SIX COMMUNITIES' DISCREET CHARACTERISTICS. THE RESULTS OF THE ASSESSMENTS WERE COMPILED AND PUBLISHED IN A SINGLE CHNA REPORT. THE HOSPITALS INCLUDED IN THE PROCESS WERE PIEDMONT HOSPITAL (EIN: 58-1503902); PIEDMONT FAYETTE HOSPITAL (EIN: 58-2322328); PIEDMONT HENRY HOSPITAL (EIN: 58-2200195); PIEDMONT MOUNTAINSIDE HOSPITAL (EIN: 35-2228583); PIEDMONT NEWNAN HOSPITAL (EIN: 20-5077249); AND PIEDMONT NEWTON HOSPITAL (EIN: 58-2155150). SCHEDULE H, PART V, SECTION B, LINE 7A: COMMUNITY HEALTH NEEDS ASSESSMENT WEBSITE https://www.piedmont.org/media/file/2016-CHNA-Full-Report.pdf |
| SCHEDULE H, PART V, LINE 7D: PUBLIC AVAILABILITY OF CHNA | IN ADDITION TO MAKING ITS CHNA AVAILABLE ON ITS WEBSITE AND BY REQUEST, PIEDMONT FAYETTE 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, SECTION B, LINE 10A: IMPLEMENTATION STRATEGIES WEBSITE https://www.piedmont.org/media/file/2017-19-Implementation-Strategies.pdf |
| SCHEDULE H, PART V, LINE 11: ADDRESSING COMMUNITY HEALTH NEEDS | WHEN PIEDMONT FAYETTE HOSPITAL PERFORMED ITS INITIAL CHNA DURING FY13, IT FOCUSED ON THREE MAIN PRIORITIES AND STARTED WORK ON THOSE PRIORITIES DURING FY14. FIRST, THE HOSPITAL FOCUSED ON INCREASING ACCESS TO APPROPRIATE AND AFFORDABLE CARE FOR LOW- AND NO-INCOME PATIENTS BY DEVELOPING AND EXECUTING A PLAN TO STRENGTHEN ACCESS POINTS TO THOSE PATIENTS. SECOND, THE HOSPITAL SOUGHT OUT TO REDUCE PREVENTABLE READMISSIONS AND EMERGENCY DEPARTMENT RE-ENCOUNTERS, PARTICULARLY AMONG HIGH-RISK PATIENTS, BY INCREASING CARE COORDINATION EFFORTS BETWEEN THE HOSPITAL AND COMMUNITY- BASED PROVIDERS. LASTLY, PIEDMONT FAYETTE HOSPITAL FOCUSED ON REDUCING INSTANCES OF PREVENTABLE HEART DISEASE, OBESITY, AND OBESITY-RELATED DISEASES, INCLUDING DIABETES, BY UTILIZING COMMUNITY-WIDE AWARENESS CAMPAIGNS AND PROVIDING EDUCATION THAT ENCOURAGES COMMUNITY MEMBERS TO REDUCE THEIR HEART DISEASE RISKS THROUGH HEALTHY BEHAVIORS. DURING FY16, PIEDMONT FAYETTE HOSPITAL CONDUCTED ITS SECOND CHNA, AGAIN BY ASSESSING PUBLICLY AVAILABLE DATA, INTERVIEWING COMMUNITY MEMBERS AND STAKEHOLDERS, CONDUCTING FOCUS GROUPS OF VULNERABLE POPULATIONS, INTERVIEWING PIEDMONT BOARD MEMBERS, AND SURVEYING PIEDMONT EMPLOYEES. THROUGH THIS PROCESS, PIEDMONT FAYETTE HOSPITAL DETERMINED AND PRIORITIZED THE COMMUNITY HEALTH NEEDS IT WOULD ADDRESS BASED ON THE NUMBER OF PERSONS AFFECTED, THE SERIOUSNESS OF THE ISSUE, WHETHER THE HEALTH NEED AFFECTED VULNERABLE POPULATIONS, AND THE AVAILABILITY OF COMMUNITY AND HOSPITAL RESOURCES NECESSARY TO ADDRESS THE ISSUE. BASED ON THE CHNA, PIEDMONT FAYETTE HOSPITAL IS CURRENTLY FOCUSING ON: (1) MAINTAINING AND INCREASING ACCESS TO AFFORDABLE CARE FOR LOW- AND NO-INCOME PATIENTS, INCLUDING INCREASED EFFORTS AT ELIMINATING HEALTH DISPARITIES; (2) INCREASING ACCESS TO AND AWARENESS OF CANCER-RELATED PROGRAMMING, INCLUDING LOW-COST MAMMOGRAMS, TO QUALIFYING WOMEN THROUGH PARTNERSHIP PROGRAMS; (3) REDUCING PREVENTABLE READMISSIONS AND EMERGENCY DEPARTMENT RE-ENCOUNTERS, PARTICULARLY AMONG HIGH-RISK PATIENTS, WITH A FOCUS ON CHRONIC DISEASE MANAGEMENT; (4) MAINTAINING AND GROWING EFFORTS AROUND SENIOR HEALTH; AND (5) REDUCING PREVENTABLE INSTANCES OF HEART DISEASE, HYPERTENSION, AND STROKE THROUGH EDUCATIONAL AWARENESS AND PROMOTION OF HEALTHY BEHAVIORS, INCLUDING EFFORTS TO REDUCE TOBACCO USE. PIEDMONT FAYETTE HOSPITAL DEVELOPED THE IMPLEMENTATION STRATEGY TO ADDRESS THESE PRIORITY NEEDS DURING FY18. |
| SCHEDULE H, PART V, LINE 16: FINANCIAL ASSISTANCE POLICY WEBSITES | FINANCIAL ASSISTANCE POLICY - https://www.piedmont.org/media/file/Financial-Assistance-Policy.pdf FINANCIAL ASSISTANCE APPLICATION - https://www.piedmont.org/media/file/Financial-Assistance-Application.pdf FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY - https://www.piedmont.org/media/file/Financial-Assistance-Plain-Language-Su mmary-English.pdf |
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART VI, LINE 1: REQUIRED DESCRIPTIONS | PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6A A report on our community benefit activities can be found online, it 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. A report on Piedmont Fayette Hospital's community benefits is also found both 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. 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 $355,256,717, LESS BAD DEBT EXPENSE OF $49,374,452 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. PFH 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 and 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 exclude from allowable cost in the Medicare Cost Report. The organization believes that the hospital's Medicare shortfall reported on Part III, Line 7 of Schedule H, should be considered a community benefit as the IRS community benefit standard includes the provision of care to elderly and Medicare patients. IRS Revenue Ruling 69-545 provides, in part, that hospitals serving patients with governmental health insurance, such as Medicare, is an indication the hospital operates to promote health in the community. Additionally, Medicare accounted for 47.51% of the hospital's patient service revenue. The hospital's policy is to treat Medicare patients, regardless of the extent to which Medicare actually pays for the treatment. For many services, Medicare's reimbursement is less than the cost of the care provided, resulting in shortfalls that are to be absorbed by the hospital in honor of the hospital's commitment to treat elderly patients. 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 | In FY16, Piedmont Fayette Hospital conducted its second triennial community health needs assessment (CHNA), which was accomplished by analyzing publicly-available community and internal patient data, interviewing community members and stakeholders (including those with a special knowledge of public health and vulnerable populations), conducting focus groups of vulnerable populations, interviewing Piedmont board members and surveying Piedmont employees on the health issues they feel our community and patients face. For the purposes of this CHNA, we defined vulnerable community members as those who are uninsured, underinsured, have low or no incomes, have chronic conditions, are elderly, who face housing and/or food instability, those who don't speak English well or at all, and/or face particular challenges when attempting to access the health care system. We also focused primarily on our home county of Fayette County. In the CHNA, we identified our top health priorities to address over a three-year period. These were: increase access to care and health services for low- and no-income patients; reduce preventable re-admissions and emergency department re-encounters; increase access to and awareness of breast and lung cancer programming; and reduce preventable instances of heart disease, hypertension, obesity and stroke. Priorities were chosen based on the number of persons affected, the seriousness of the issue, whether the health need affected vulnerable populations, and availability of community and hospital resources to address the need. The Piedmont Fayette Hospital Board of Directors ratified the CHNA on May 11, 2016. The FY18 Piedmont Fayette Hospital implementation strategy was developed in partnership with hospital leadership and community stakeholders to address the identified priorities listed in the FY16 community health needs assessment. 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 Fayette Hospital leadership and the Piedmont Fayette Hospital Board of Directors. The Piedmont Fayette Hospital Board of Directors approved the implementation strategy to address identified health issues on August 10, 2016. |
| SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ASSISTANCE ELIGIBILITY | Patient education of availability of assistance: Piedmont Healthcare understands that not everyone will have 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 Fayette 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 Fayette Hospital also publishes and widely publicizes a plain language summary of this financial assistance care policy on its facility website, which will include 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. 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. This guide is widely distributed to the community via hardcopy, is available within our hospitals and is digitally available online. Copies are provided in both English and Spanish. |
| SCHEDULE H, PART VI, LINE 4: COMMUNITY INFORMATION | Piedmont Fayette Hospital is located in Fayetteville, Georgia. In 2017, approximately 110,306 people live in Fayette County. About one in ten adults in Fayette County were uninsured that year. Approximately 26 percent Fayette County children qualify for free lunch. Unemployment in the county is at 3 percent, which is lower than Georgia's percentage of 5.9. In 2017, approximately 92 percent of the county's high school students will graduate in four years (University of Wisconsin Population Health Institute, County Health Rankings, 2017). There is one primary physician in Fayette for every 910 residents of the county, compared to one for 1,530 for the state. Approximately 13 percent of adults reported they were in poor or fair health, a figure better than the Georgia benchmark of 17 percent. Eleven percent of adult residents have been diagnosed with diabetes. In 2017, one in five adults are notably physically inactive, and a third of adults are considered obese in Fayette County (University of Wisconsin Population Health Institute, County Health Rankings, 2017). |
| SCHEDULE H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH | Piedmont Fayette Hospital actively promotes the health of its community through community-based health screenings, educational 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. In FY18, Piedmont Fayette offered various proactive community benefit programs, including the continuation of the Piedmont community benefit grants program, which offers grant opportunities to local nonprofit organizations providing specific to health-related services and programs that address the unmet health needs identified in our FY16 CHNA and implementation strategy. FY18 grant recipients were Fayette Senior Services and the Healing Bridge Clinic. The hospital also processes all laboratory tests for the Fayette C.A.R.E. Clinic and the Healing Bridge Clinic at no cost to the clinics or their patients. The hospital also provides Thomas F. Chapman Family Cancer Wellness program free of charge to all community members, regardless of if they are a Piedmont patient. These services include cancer education, disease-specific nutrition workshops and cooking demonstrations, support groups, counseling and online classes to help support recovery. The hospital also provides Sixty Plus services free of charge to all community members, regardless of if they are a Piedmont patient. These services promote healthy aging by providing a continuum of geriatric specific services, programs, education, support and counseling for older adults and their family caregivers. Piedmont Fayette Hospital also provided health professions education to students and residents training to be health professionals. In FY18, Piedmont Fayette Hospital medical staff oversaw a total 83,649 hours of training at a cost of $2,325,493. |
| SCHEDULE H, PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM | Piedmont Fayette 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, 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. This includes our revenue department, which oversees and executes the financial assistance policy and program. |
| SCHEDULE H, PART VI, LINE 7: STATE OF FILING OF COMMUNITY BENEFIT REPORT | Piedmont Fayette Hospital is not required to file a community benefit report; however, the hospital is required to file with the Georgia Department of Community Health information on its indigent and charity care, as well as its Medicaid and Medicare shortfalls. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Discretionary Spending Acct | Yes (X) | DiscretionarySpendingAcctInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Dr Frederick Willms | ||||||||||||||
| VP of Medical Affairs | $360,811 | $0 | $111,708 | $0 | $23,093 | $0 | $15,900 | $0 | $7,913 | $0 | $519,425 | $0 | $0 | $0 |
| Mr J Michael Burnett | ||||||||||||||
| PRESIDENT & CEO/Board Member | $423,912 | $0 | $191,630 | $0 | $381,382 | $0 | $102,306 | $0 | $16,604 | $0 | $1,115,834 | $0 | $346,221 | $0 |
| Ms Rhonda Manos | ||||||||||||||
| Director of Pharmacy | $181,010 | $0 | $20,534 | $0 | $2,495 | $0 | $9,753 | $0 | $10,177 | $0 | $223,969 | $0 | $0 | $0 |
| Mr Gregory A Hurst | ||||||||||||||
| Board Member (END 12-30-17) | $0 | $764,367 | $0 | $491,328 | $0 | $718,065 | $0 | $15,900 | $0 | $7,876 | $0 | $1,997,536 | $0 | $639,577 |
| Mr John Miles | ||||||||||||||
| Former CFO | $0 | $266,159 | $0 | $83,373 | $0 | $15,987 | $0 | $16,200 | $0 | $16,179 | $0 | $397,898 | $0 | $0 |
| Mr Scott Wolfe | ||||||||||||||
| CFO | $308,786 | $0 | $87,042 | $0 | $8,756 | $0 | $13,666 | $0 | $11,291 | $0 | $429,541 | $0 | $0 | $0 |
| Mr Michael McAnder | ||||||||||||||
| Treasurer | $0 | $581,223 | $0 | $379,072 | $0 | $68,728 | $0 | $117,128 | $0 | $7,623 | $0 | $1,153,774 | $0 | $0 |
| Mr David Nipper | ||||||||||||||
| COO | $277,152 | $0 | $79,538 | $0 | $7,200 | $0 | $16,200 | $0 | $16,262 | $0 | $396,352 | $0 | $0 | $0 |
| Ms Cheryl Beard | ||||||||||||||
| Nursing Admin Supervisor | $97,538 | $0 | $1,110 | $0 | $84,454 | $0 | $3,946 | $0 | $1,597 | $0 | $188,645 | $0 | $0 | $0 |
| Ms Merry Heath | ||||||||||||||
| CNO | $190,400 | $0 | $53,391 | $0 | $3,697 | $0 | $11,943 | $0 | $6,761 | $0 | $266,192 | $0 | $0 | $0 |
| Ms Elizabeth Leddy | ||||||||||||||
| Secretary | $0 | $344,306 | $0 | $90,667 | $0 | $117,356 | $0 | $53,125 | $0 | $12,444 | $0 | $617,898 | $0 | $0 |
| Ms Mary McFarland | ||||||||||||||
| Sr Dir Cardiovasc. Svcs | $151,669 | $0 | $21,897 | $0 | $1,618 | $0 | $10,769 | $0 | $10,056 | $0 | $196,009 | $0 | $0 | $0 |
| Ms Sandra Biles | ||||||||||||||
| Dir Inpatient Services | $151,509 | $0 | $17,619 | $0 | $2,298 | $0 | $8,777 | $0 | $15,201 | $0 | $195,404 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 1A: OTHER COMPENSATION ITEMS | JAMES MICHAEL BURNETT RECEIVED A DISCRETIONARY SPENDING ACCOUNT TOTALING $12,000, A FIXED AMOUNT DETERMINED BY HIS JOB LEVEL. THIS SPENDING ACCOUNT WAS INCLUDED IN MR. BURNETT'S TAXABLE WAGES. |
| SCHEDULE J, PART I, LINE 3: COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR | THE COMPENSATION FOR THE PRESIDENT/CEO OF PIEDMONT FAYETTE HOSPITAL IS SET BY THE ENTITY'S PARENT, PIEDMONT HEALTHCARE, INC. PLEASE SEE THE SCHEDULE O NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 15A & 15B FOR ADDITIONAL INFORMATION. |
| SCHEDULE J, PART I, LINE 4B: SUPPLEMENTAL COMPENSATION INFORMATION | J. MICHAEL BURNETT RECEIVED A SERP PAYMENT IN THE AMOUNT OF $346,221. THE FOLLOWING EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS: MICHAEL MCANDER JOHN MILES SCOTT WOLFE DAVID NATHAN NIPPER FREDERICK WILLMS ELIZABETH LEDDY SHERYL KLINK |
| SCHEDULE J, PART I, LINE 7: NON-FIXED PAYMENTS | CERTAIN EMPLOYEES PARTICIPATED IN AN "ANNUAL INCENTIVE PLAN" UNDER WHICH THEY RECEIVED NON-FIXED BONUS PAYMENTS BASED ON JOB LEVEL AND SEVERAL DIFFERENT PERFORMANCE METRICS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 1A: NUMBER OF FORMS 1099 FILED | ALL CALENDAR YEAR 2017 FORMS 1099 WERE FILED ON BEHALF OF PIEDMONT FAYETTE 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 FAYETTE HOSPITAL ("PFH"). |
| FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF GOVERNING BODY | THE BOARD OF PIEDMONT HEALTHCARE, PIEDMONT FAYETTE HOSPITAL'S SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF PIEDMONT FAYETTE HOSPITAL. |
| FORM 990, PART VI, SEC A, LINE 7B: DECISIONS OF GOVERNING BODY | PIEDMONT FAYETTE 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 FAYETTE 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 FAYETTE HOSPITALS FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATIONS FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PFHS 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 ORGANIZATIONS SOLE MEMBER, FOR BOARD REVIEW. |
| FORM 990, PART VI, SEC B, LINE 12C: conflict of interest policy | COMPLIANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY ORGANIZATION MANAGEMENT IN COORDINATION WITH PIEDMONT HEALTHCARES 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 FAYETTE 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 HEALTHCARES 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 FAYETTE HOSPITAL IS SET BY THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC. THE PIEDMONT HEALTHCARE, INC., BOARD OF DIRECTORS EXECUTIVE PERFORMANCE AND COMPENSATION COMMITTEE ("THE COMMITTEE") IS COMPOSED OF AT LEAST THREE MEMBERS OF THE PHC BOARD OF DIRECTORS, SERVING TERMS OF THREE YEARS, AND THE MAJORITY OF WHICH ARE COMMUNITY DIRECTORS WHO GENERALLY DO NOT HAVE CONFLICTS OF INTEREST RELATED TO FULFILLMENT OF THE DUTIES AS OUTLINED BELOW. THE EXECUTIVE PERFORMANCE AND COMPENSATION COMMITTEE (COMMITTEE) OVERSEES EXECUTIVE PERFORMANCE AND COMPENSATION ON BEHALF OF THE PHC BOARD, SUBJECT TO THE ULTIMATE AUTHORITY AND OVERSIGHT OF THE BOARD. THE COMMITTEE ALSO FORMULATES POLICIES AND MAKES DECISIONS IN ORDER TO ENSURE A HIGH LEVEL OF EXECUTIVE PERFORMANCE. THE COMMITTEE IS AUTHORIZED TO ACT ON BEHALF OF THE PHC BOARD AS SET OUT IN ITS CHARTER, AND THE COMMITTEE IS ALSO CHARGED WITH PROVIDING RECOMMENDATIONS AND PERIODIC REPORTS TO THE PHC BOARD REGARDING EXECUTIVE PERFORMANCE AND COMPENSATION. ALL DECISIONS AND COMPARABILITY DATA ARE DOCUMENTED IN THE COMMITTEE MEETING MINUTES. FUNCTIONS OF THE COMMITTEE - ASSESS AND IMPLEMENT POLICIES REGARDING PERFORMANCE, COMPENSATION AND BENEFITS OF THE PRESIDENT/CEO AND OTHER EXECUTIVES AS DETERMINED BY THE COMMITTEE - SELECT AN EXECUTIVE COMPENSATION CONSULTANT WHO REPORTS TO THE COMMITTEE - ANNUALLY REVIEW THE PRESIDENT/CEO SUCCESSION PLAN - FORMULATE AND IMPLEMENT ANNUAL PERFORMANCE OBJECTIVES FOR THE PRESIDENT/CEO, AND REVIEW AND APPROVE ANNUALLY RECOMMENDATIONS FROM THE PRESIDENT/CEO RELATING TO COMPENSATION, PERFORMANCE OBJECTIVES, AND SUCCESSION PLANS FOR EVP EXECUTIVES - ANNUALLY ASSESS PRESIDENT/CEO PERFORMANCE; IF NECESSARY, IMPLEMENT ACTION PLAN WITH PRESIDENT/CEO INPUT TO IMPROVE HIS/HER PERFORMANCE; ADJUST COMPENSATION AS APPROPRIATE; THE COMMITTEE CHAIR SHALL CONSULT WITH THE PHC GOVERNANCE COMMITTEE CHAIR AND THE PHC BOARD CHAIR AND SHALL COORDINATE THE ANNUAL PERFORMANCE REVIEW OF THE PHC PRESIDENT/CEO, UNLESS THE PHC BOARD CHAIR HAS A REAL OR PERCEIVED CONFLICT OF INTEREST, IN WHICH CASE THE COMMITTEE CHAIR SHALL DETERMINE THE PROPER REVIEW PROCESS - REVIEW AND APPROVE LONG TERM AND SHORT TERM GOALS TO BE USED IN CONNECTION WITH EVP COMPENSATION PROGRAMS AS RECOMMENDED BY THE PRESIDENT/CEO AND VALIDATED BY THE COMPENSATION CONSULTANT - PERIODICALLY REVIEW COMPENSATION, IF ANY, FOR THE PHC BOARD CHAIR AND ALL BOARD CHAIRS OF THE PHC SUBSIDIARIES - ESTABLISH OTHER POLICIES AND PROCEDURES, AND PERFORM OTHER TASKS, RELATED TO EXECUTIVE PERFORMANCE AND COMPENSATION, INCLUDING BUT NOT LIMITED TO, APPROVAL OF EXECUTIVE EMPLOYMENT CONTRACTS AND BENEFITS - PERIODICALLY REPORT SIGNIFICANT DECISIONS AND ANY ADDITIONAL REQUESTED INFORMATION TO THE PHC BOARD |
| 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: CONTRIBUTIONS ($14,061) BOOK/TAX DIFF $26,902 CHANGES IN TEMP. ($29,142) INTERCOMPANY TRANS. ($34,110,415) CHANGES IN UNRESTR. FUND $9,554 -------------------- TOTAL ($34,117,162) |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAYETTE SURGERY CENTER LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1255 HIGHWAY 54 WEST | AddressLine1Txt |
| City | Fayetteville | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30214 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | Surgery | PrimaryActivitiesTxt |
| Legal Domicile State | GA | LegalDomicileStateCd |
| End Of Year Assets | $0 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PFH | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (23 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| PIEDMONT HEALTHCARE INC | ||||||||||
| 1800 HOWELL MILL ROAD SUITE 850 | Atlanta | GA | 30318 | 581503902 | Management | GA | 501(c)(3) | 12C, III-FI | NA | false |
| PIEDMONT HOSPITAL INC | ||||||||||
| 1968 PEACHTREE ROAD NW | Atlanta | GA | 30309 | 580566213 | Hospital | GA | 501(c)(3) | 3 | PHC | false |
| 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 |
| HENRY DEVELOPMENT VENTURES INC | ||||||||||
| 1133 EAGLES LANDING PKWY | Stockbridge | GA | 30281 | 582200734 | RE HOLDING | GA | 501(c)(2) | N/a | PHH | false |
| PIEDMONT HEART INSTITUTE INC | ||||||||||
| 95 COLLIER ROAD NW STE 2045 | Atlanta | GA | 30309 | 263553500 | Healthcare | GA | 501(c)(3) | 7 | PHC | false |
| PIEDMONT NEWNAN HOSPITAL INC | ||||||||||
| 745 POPLAR ROAD | Newnan | GA | 30265 | 205077249 | 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 |
| CENTER FOR HEALTH AND LEARNING INC | ||||||||||
| 3001 MERCER UNIVERSITY DR | ATLANTA | GA | 30341 | 262442849 | EDUCATION | GA | 501(C)(3) | 12A, I | NA | false |
| PIEDMONT NEWTON HOSPITAL INC | ||||||||||
| 5126 HOSPITAL DRIVE NE | COVINGTON | GA | 30014 | 582155150 | HOSPITAL | GA | 501(C)(3) | 3 | PHC | false |
| PIEDMONT ATHENS REGIONAL FOUNDATION INC | ||||||||||
| 1199 PRINCE AVENUE | ATHENS | GA | 30606 | 581978389 | FUNDRAISING | GA | 501(C)(3) | 12B, II | ARMC | false |
| PIEDMONT ATHENS REGIONAL HEALTH RESOURCE | ||||||||||
| 1199 PRINCE AVENUE | ATHENS | GA | 30606 | 581930580 | DEVELOPMENT | GA | 501(C)(3) | 12B, II | ARMC | false |
| PIEDMONT ATHENS REGIONAL MEDICAL CENTER | ||||||||||
| 1199 PRINCE AVENUE | ATHENS | GA | 30606 | 582179986 | HOSPITAL | GA | 501(C)(3) | 3 | PHC | false |
| ATHENS REGIONAL PHYSICIAN SERVICES INC | ||||||||||
| 1199 PRINCE AVENUE | ATHENS | GA | 30606 | 582332921 | HEALTHCARE | GA | 501(C)(3) | 12B, II | ARMC | false |
| ATHENS REGIONAL SPECIALTY SERVICES INC | ||||||||||
| 1199 PRINCE AVENUE | ATHENS | GA | 30606 | 271975001 | HEALTHCARE | GA | 501(C)(3) | 3 | ARMC | false |
| REGIONAL FIRSTCARE INC | ||||||||||
| 1199 PRINCE AVENUE | ATHENS | GA | 30606 | 582362733 | URGENT CARE | GA | 501(C)(3) | 12B, II | ARMC | false |
| COLUMBUS AMBULATORY HEALTHCARE SERVICES | ||||||||||
| 707 CENTER ST | COLUMBUS | GA | 31901 | 581719867 | AMBULATORY | GA | 501(C)(3) | 3 | 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 AVE | CONYERS | GA | 30012 | 300999841 | HOSPITAL | GA | 501(C)(3) | 3 | PHC | false |
| PIEDMONT WALTON HOSPITAL INC | ||||||||||
| 2151 WEST SPRING ST | MONROE | GA | 30655 | 824194264 | HOSPITAL | GA | 501(C)(3) | 3 | PHC | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | UBI Code VUBICodeVAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HENRY RADIATION ONCOLOGY CENTER LLC | ||||||||||||
| 275 PROFESSIONAL COURT STE A | STOCKBRIDGE | GA | 30281 | 582200195 | HEALTHCARE | GA | NA | N/A | $0 | $0 | false | $0 |
| PEACHTREE ORTHOPAEDIC SURGERY CENTER | ||||||||||||
| 2001 PEACHTREE RD NE STE 705 | ATLANTA | GA | 30309 | 582562721 | SURGERY | GA | NA | N/A | $0 | $0 | false | $0 |
| DIGESTIVE HEALTHCARE OF GA ENDOSCOPY CTR | ||||||||||||
| 95 COLLIER RD NW STE 4075 | ATLANTA | GA | 30309 | 582406657 | HEALTHCARE | GA | NA | N/A | $0 | $0 | false | $0 |
| SOUTHERN CRESCENT RADIATION ONCOLOGY CTR | ||||||||||||
| 275 PROFESSIONAL COURT STE A | RIVERDALE | GA | 30274 | 464307929 | RADIATION | GA | NA | N/A | $0 | $0 | false | $0 |
| GRIFFIN RADIATION ONCOLOGY CENTER LLC | ||||||||||||
| 275 PROFESSIONAL COURT STE A | RIVERDALE | GA | 30274 | 464307692 | RADIATION | GA | NA | N/A | $0 | $0 | false | $0 |
| FOUR WINDS HEALTH LLC | ||||||||||||
| 3350 RIVERWOOD PKWY STE 1850 | ATLANTA | GA | 30339 | 451273930 | HEALTHCARE | GA | NA | N/A | $0 | $0 | false | $0 |
| GEORGIA HEALTH COLLABORATIVE LLC | ||||||||||||
| 2727 PACES FERRY RD BLDG 2 STE 70 | ATLANTA | GA | 30339 | 461500639 | HEALTHCARE | GA | NA | N/A | $0 | $0 | false | $0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PIEDMONT MEDICAL CARE CORPORATION | ||||||||||||||||
| 2727 PACES FERRY RD STE 1-1100 | Atlanta | GA | 30339 | 582092768 | Healthcare | GA | phc | C Corp | $0 | $0 | false | |||||
| THE PIEDMONT CLINIC INC | ||||||||||||||||
| 2727 PACES FERRY RD STE 1-1100 | Atlanta | GA | 30339 | 582005358 | Healthcare | GA | phc | C Corp | $0 | $0 | false | |||||
| PIEDMONT HEART INSTITUTE PHYSICIANS INC | ||||||||||||||||
| 95 COLLIER ROAD NW STE 2045 | Atlanta | GA | 30309 | 260593850 | Healthcare | GA | NA | C Corp | $0 | $0 | false | |||||
| AMSTER MCRAE INSURANCE COMPANY | ||||||||||||||||
| 980427603 | Related INSURANCE | phc | C Corp | $0 | $0 | false | PO BOX 1159 | Grand Cayman KY | CJ | CJ | ||||||
| PIEDMONT WELLSTAR HEALTHPLANS INC | ||||||||||||||||
| 2859 PACES FERRY RD STE 600 | ATLANTA | GA | 30339 | 461922499 | HEALTH INSURANCE | GA | phc | C CORP | $0 | $0 | false | |||||
| COLUMBUS HEALTHCARE RESOURCES | ||||||||||||||||
| PO BOX 790 | COLUMBUS | GA | 31902 | 581717754 | HEALTHCARE | GA | CRHS | C CORP | $0 | $0 | false | 0.00000 | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART I, LINE 1: DISREGARDED ENTITIES | FormAndLineReferenceDesc |
| Explanation | THE LIMITED LIABILITY COMPANY LISTED IN SCHEDULE R, PART I, OPERATES AS A DEPARTMENT OF PIEDMONT FAYETTE HOSPITAL AND IS INCORPORATED INTO THE HOSPITAL'S BOOKS AND RECORDS. SEPARATE BOOKS AND RECORDS ARE NOT MAINTAINED FOR THE LLC AND ASSETS AND INCOME CANNOT BE READILY DETERMINED. AS SUCH, COLUMNS (D) AND (E) IN PART I HAVE BEEN LEFT BLANK. | ExplanationTxt |