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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

FieldValueIRS element (for citing)
Return2019-05-14T21:52:04-05:00ReturnTs
Tax Period End2018-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1300 North Greene Street Suite 400AddressLine1Txt
CityGreensboroCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27401ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN582322328EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Fayette Community Hospital IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% MARIE GAFFNEYInCareOfNm
Business Name ControlFAYEBusinessNameControlTxt
Phone7707197073PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11255 Highway 54 WestAddressLine1Txt
CityFayettevilleCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30214ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARIE GAFFNEYPersonNm
Person TitleVP CORPORATE FINANCEPersonTitleTxt
Phone4702716007PhoneNum
Signature2019-05-14SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWHITNEY E BLAIRPreparerPersonNm
PTINP01226647PTIN
Phone3362753394PhoneNum
Preparation2019-05-14PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.102.5IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id56038220191345000026FederalOriginalSubmissionId
Federal Original Submission Id2019-05-14FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdA44B9C37BFA5EF1264A4312BD3172D9227A45E08AtSubmissionCreationDeviceId
At Submission Filing Device Id5D7B52A41C2226A5E4849843C7D809138903E6FFAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2020-01-14 16:20:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJ MICHAEL BURNETTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11255 Highway 54 WestAddressLine1Txt
CityFayettevilleCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30214ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$399,323,507GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PIEDMONTFAYETTE.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1997FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee2277TotalEmployeeCnt
Total Volunteers270TotalVolunteersCnt
Total Gross UBI$8,044TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$7,044NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$67,402PYContributionsGrantsAmt
CY Contributions Grants$37,238CYContributionsGrantsAmt
PY Program Service Revenue$379,117,271PYProgramServiceRevenueAmt
CY Program Service Revenue$393,589,230CYProgramServiceRevenueAmt
PY Investment Income$215,903PYInvestmentIncomeAmt
CY Investment Income-$31,081CYInvestmentIncomeAmt
PY Other Revenue$4,524,441PYOtherRevenueAmt
CY Other Revenue$4,404,827CYOtherRevenueAmt
PY Total Revenue$383,925,017PYTotalRevenueAmt
CY Total Revenue$398,000,214CYTotalRevenueAmt
PY Grants And Similar Paid$54,179PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$81,050CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$130,822,643PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$136,796,890CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$216,877,421PYOtherExpensesAmt
CY Other Expenses$218,378,777CYOtherExpensesAmt
PY Total Expenses$347,754,243PYTotalExpensesAmt
CY Total Expenses$355,256,717CYTotalExpensesAmt
PY Revenues Less Expenses$36,170,774PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$42,743,497CYRevenuesLessExpensesAmt
Total Assets BOY$195,786,300TotalAssetsBOYAmt
Total Assets EOY$209,332,377TotalAssetsEOYAmt
Total Liabilities BOY$33,836,049TotalLiabilitiesBOYAmt
Total Liabilities EOY$38,755,791TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$161,950,251NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$170,576,586NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO 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 SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$327,985,488ExpenseAmt
Grant$81,050GrantAmt
Revenue$393,589,230RevenueAmt
DescPIEDMONT 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$327,985,488TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee2277EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARIE GAFFNEYPersonNm
Phone4702716007PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12727 PACES FERRY RD BLDG 2 STE 70AddressLine1Txt
CityAtlantaCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30339ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Mr Michael Behr
Board Member1.00.0Yes (X)$6,412$0$0
Mr J Michael Burnett
PRESIDENT & CEO/Board Member55.00.0Yes (X)$996,924$0$118,910Yes (X)
Mr Mark Gray
Board Member1.00.0Yes (X)$0$0$0
Mr Gregory A Hurst
Board Member (END 12-30-17)1.054.0Yes (X)$0$1,973,760$23,776
Ms Lacy S Curry
Board Member1.00.0Yes (X)$0$0$0
Dr Dave C Lee
Board Member1.00.0Yes (X)$0$0$0
Dr Elizabeth W Killebrew
Board Member (END 12-31-17)1.00.0Yes (X)$20,582$0$0
Mr Douglas B Warner
Board Member1.00.0Yes (X)$0$0$0
Dr Russell A Wilson
Chairman/Physician7.00.0Yes (X)$114,750$0$0Yes (X)
Mr Robert Reeves
BOARD MEMBER1.00.0Yes (X)$0$0$0
Dr C Howell Tucker
Board Member1.00.0Yes (X)$0$0$0
Dr Geetha Rao
Board Member (Eff. 7-1-17)1.00.0Yes (X)$0$0$0
Mr Michael McAnder
Treasurer1.054.0$0$1,029,023$124,751Yes (X)
Ms Elizabeth Leddy
Secretary1.054.0$0$552,329$65,569Yes (X)
Dr Frederick Willms
VP of Medical Affairs55.00.0$495,612$0$23,813Yes (X)
Mr Scott Wolfe
CFO55.00.0$404,584$0$24,957Yes (X)
Mr David Nipper
COO55.00.0$363,890$0$32,462Yes (X)
Ms Rhonda Manos
Director of Pharmacy55.00.0$204,039$0$19,930Yes (X)
Ms Cheryl Beard
Nursing Admin Supervisor55.00.0$183,102$0$5,543Yes (X)
Ms Merry Heath
CNO55.00.0$247,488$0$18,704Yes (X)
Ms Mary McFarland
Sr Dir Cardiovasc. Svcs55.00.0$175,184$0$20,825Yes (X)
Ms Sandra Biles
Dir Inpatient Services55.00.0$171,426$0$23,978Yes (X)
Mr John Miles
Former CFO0.055.0$0$365,519$32,379Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,383,993TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,920,631TotReportableCompRltdOrgAmt
Total Other Compensation$535,597TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K111IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ALLIED UNIVERSAL SECURITY SERVICES
1551 N TUSTIN AVESANTA ANACA92705SECURITY Services$710,139
Brasfield and Gorrie LLC
PO Box 11407BIRMINGHAMAL352460351Construction$6,337,979
BDR PARTNERS LLC
1756 CENTURY BLVD NEATLANTAGA30345BUSINESS DEVELOPMENT$455,668
MEDICAL SOLUTIONS INC
1010 N 102ND STE 300OMAHANE68114NURSING SERVICES$1,805,166
MEDMANAGEMENT LLC
1500 URBAN CENTER DRBIRMINGHAMAL35242MEDICARE COMPLIANCE$236,470
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K13CntrctRcvdGreaterThan100KCnt
All Other Contributions$37,238AllOtherContributionsAmt
Total Contributions$37,238TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE621110$393,369,814$393,369,814
FITNESS CENTER REHAB621300$136,189$136,189
OTHER OPERATING REVENUE900099$83,227$83,227
FieldValueIRS element (for citing)
Total Program Service Revenue$393,589,230TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$172,326TotalRevenueColumnAmt
Exclusion$172,326ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$3,841,044RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$1,041,940RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$2,799,104RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,799,104TotalRevenueColumnAmt
Exclusion$2,799,104ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$203,407OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$203,407OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$203,407TotalRevenueColumnAmt
Exclusion-$203,407ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$339,600GrossSalesOfInventoryAmt
Cost Of Goods Sold$77,946CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$261,654TotalRevenueColumnAmt
Exclusion$261,654ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
CAFETERIA SALES900099$1,277,898$1,277,898
VENDING SALES900099$58,127$58,127
QUALIFIED TRANSPORT. FRINGE900099$8,044$8,044
FieldValueIRS element (for citing)
Other Revenue Total$1,344,069OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$398,000,214TotalRevenueColumnAmt
Related Or Exempt Func Income$393,589,230RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$8,044UnrelatedBusinessRevenueAmt
Exclusion$4,365,702ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$81,050TotalAmt
Program Services$81,050ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,173,286TotalAmt
Program Services$1,803,827ProgramServicesAmt
Management And General$369,459ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$110,456,526TotalAmt
Program Services$91,678,917ProgramServicesAmt
Management And General$18,777,609ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$17,108,173TotalAmt
Program Services$14,199,783ProgramServicesAmt
Management And General$2,908,390ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$7,058,905TotalAmt
Program Services$5,858,891ProgramServicesAmt
Management And General$1,200,014ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$102,140TotalAmt
Management And General$102,140ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$25,023,011TotalAmt
Program Services$25,023,011ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,105,470TotalAmt
Management And General$1,105,470ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$23,966,505TotalAmt
Program Services$23,785,148ProgramServicesAmt
Management And General$181,357ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$6,534,625TotalAmt
Program Services$6,142,547ProgramServicesAmt
Management And General$392,078ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$4,534,977TotalAmt
Program Services$4,353,578ProgramServicesAmt
Management And General$181,399ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$55,640TotalAmt
Program Services$36,214ProgramServicesAmt
Management And General$19,426ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$45,881TotalAmt
Program Services$38,690ProgramServicesAmt
Management And General$7,191ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$7,107,135TotalAmt
Program Services$6,893,921ProgramServicesAmt
Management And General$213,214ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$10,312,971TotalAmt
Program Services$10,312,971ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$9,196,959TotalAmt
Program Services$8,645,142ProgramServicesAmt
Management And General$551,817ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,906,631TotalAmt
Program Services$2,732,233ProgramServicesAmt
Management And General$174,398ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement 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

FieldValueIRS element (for citing)
Total$355,256,717TotalAmt
Program Services$327,985,488ProgramServicesAmt
Management And General$27,271,229ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$651,011BOYAmt
EOY$560,340EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

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

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$66,994BOYAmt
EOY$43,261EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$41,049,778BOYAmt
EOY$46,618,179EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$4,825,966BOYAmt
EOY$4,874,827EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,098,993BOYAmt
EOY$1,268,385EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$304,096,965LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$149,037,568LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$147,185,570BOYAmt
EOY$155,059,397EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$907,988BOYAmt
EOY$907,988EOYAmt

Other Assets Total OtherAssetsTotalGrp

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

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$195,786,300BOYAmt
EOY$209,332,377EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$19,841,030BOYAmt
EOY$24,646,145EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$13,738,197BOYAmt
EOY$13,878,619EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$256,822BOYAmt
EOY$231,027EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$33,836,049BOYAmt
EOY$38,755,791EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$160,970,421BOYAmt
EOY$169,625,898EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$979,830BOYAmt
EOY$950,688EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$161,950,251BOYAmt
EOY$170,576,586EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$195,786,300BOYAmt
EOY$209,332,377EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$42,743,497ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$34,117,162OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

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

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,525,840OtherCostOrOtherBasisAmt
Book Value$8,525,840BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$158,508,235OtherCostOrOtherBasisAmt
Depreciation$57,019,826DepreciationAmt
Book Value$101,488,409BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,059,329OtherCostOrOtherBasisAmt
Depreciation$3,697,535DepreciationAmt
Book Value$361,794BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$121,101,525OtherCostOrOtherBasisAmt
Depreciation$88,320,207DepreciationAmt
Book Value$32,781,318BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,902,036OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$11,902,036BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$155,059,397TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS LIABILITIESDesc
Amt$231,027Amt
FieldValueIRS element (for citing)
Total Liability$231,027TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PART X, LINE 2: ASC 740 FOOTNOTE (FKA FIN 48)FormAndLineReferenceDesc
ExplanationPHC 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

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,604,778TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$18,604,778NetCommunityBenefitExpnsAmt
Total Expense0.06080TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,676,049TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,415,031DirectOffsettingRevenueAmt
Net Community Benefit Expns$261,018NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,327,153TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$470,320DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,856,833NetCommunityBenefitExpnsAmt
Total Expense0.01260TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$31,607,980TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,885,351DirectOffsettingRevenueAmt
Net Community Benefit Expns$22,722,629NetCommunityBenefitExpnsAmt
Total Expense0.07420TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$36,071TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$36,071NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,325,493TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,325,493NetCommunityBenefitExpnsAmt
Total Expense0.00760TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$31,834TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$31,834NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,393,398TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,393,398NetCommunityBenefitExpnsAmt
Total Expense0.00780TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$34,001,378TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,885,351DirectOffsettingRevenueAmt
Net Community Benefit Expns$25,116,027NetCommunityBenefitExpnsAmt
Total Expense0.08200TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$11,612,753BadDebtExpenseAmt
Bad Debt Expense Attributable$754,945BadDebtExpenseAttributableAmt
Reimbursed By Medicare$74,493,645ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$75,648,045CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,154,400MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Piedmont Fayette HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11255 Highway 54 WestAddressLine1Txt
CityFayettevilleCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30214ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.piedmontfayette.comWebsiteAddressTxt
State License056-550StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Piedmont Fayette HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART VIOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt17ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART VIStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART VIFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART VIFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART VIFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back MedicareYes (X)LookBackMedicareInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, LINE 5: COMMUNITY REPRESENTATIONPIEDMONT 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 PROCESSDURING 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 CHNAIN 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 NEEDSWHEN 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 WEBSITESFINANCIAL 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 ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART VI, LINE 1: REQUIRED DESCRIPTIONSPUBLIC 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 ASSESSMENTIn 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 ELIGIBILITYPatient 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 INFORMATIONPiedmont 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 HEALTHPiedmont 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 SYSTEMPiedmont 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 REPORTPiedmont 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

FieldValueIRS element (for citing)
Discretionary Spending AcctYes (X)DiscretionarySpendingAcctInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
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 ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1A: OTHER COMPENSATION ITEMSJAMES 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 DIRECTORTHE 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 INFORMATIONJ. 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 PAYMENTSCERTAIN 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 ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINE 1A: NUMBER OF FORMS 1099 FILEDALL 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 MEMBERPIEDMONT 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 BODYTHE 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 BODYPIEDMONT 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 PROCESSINFORMATION 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 policyCOMPLIANCE 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 COMPENSATIONCOMPENSATION 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 DOCUMENTSGOVERNING 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 ASSETSCHANGES 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

FieldValueIRS element (for citing)
Business Name Line1FAYETTE SURGERY CENTER LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11255 HIGHWAY 54 WESTAddressLine1Txt
CityFayettevilleCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30214ZIPCd
FieldValueIRS element (for citing)
Primary ActivitiesSurgeryPrimaryActivitiesTxt
Legal Domicile StateGALegalDomicileStateCd
End Of Year Assets$0EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1PFHBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (23 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
PIEDMONT HEALTHCARE INC
1800 HOWELL MILL ROAD SUITE 850AtlantaGA30318581503902ManagementGA501(c)(3)12C, III-FINAfalse
PIEDMONT HOSPITAL INC
1968 PEACHTREE ROAD NWAtlantaGA30309580566213HospitalGA501(c)(3)3PHCfalse
PIEDMONT MOUNTAINSIDE HOSPITAL INC
1266 HIGHWAY 515 SOUTHJasperGA30143352228583HospitalGA501(c)(3)3PHCfalse
PIEDMONT HENRY HOSPITAL INC
1133 EAGLES LANDING PKWYStockbridgeGA30281582200195HospitalGA501(c)(3)3PHCfalse
HENRY DEVELOPMENT VENTURES INC
1133 EAGLES LANDING PKWYStockbridgeGA30281582200734RE HOLDINGGA501(c)(2)N/aPHHfalse
PIEDMONT HEART INSTITUTE INC
95 COLLIER ROAD NW STE 2045AtlantaGA30309263553500HealthcareGA501(c)(3)7PHCfalse
PIEDMONT NEWNAN HOSPITAL INC
745 POPLAR ROADNewnanGA30265205077249HospitalGA501(c)(3)3PHCfalse
PIEDMONT HEALTHCARE FOUNDATION INC
2001 PEACHTREE ROAD NE SUITE 400AtlantaGA30309581272768FUNDRAISINGGA501(c)(3)12B, IIPHCfalse
CENTER FOR HEALTH AND LEARNING INC
3001 MERCER UNIVERSITY DRATLANTAGA30341262442849EDUCATIONGA501(C)(3)12A, INAfalse
PIEDMONT NEWTON HOSPITAL INC
5126 HOSPITAL DRIVE NECOVINGTONGA30014582155150HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT ATHENS REGIONAL FOUNDATION INC
1199 PRINCE AVENUEATHENSGA30606581978389FUNDRAISINGGA501(C)(3)12B, IIARMCfalse
PIEDMONT ATHENS REGIONAL HEALTH RESOURCE
1199 PRINCE AVENUEATHENSGA30606581930580DEVELOPMENTGA501(C)(3)12B, IIARMCfalse
PIEDMONT ATHENS REGIONAL MEDICAL CENTER
1199 PRINCE AVENUEATHENSGA30606582179986HOSPITALGA501(C)(3)3PHCfalse
ATHENS REGIONAL PHYSICIAN SERVICES INC
1199 PRINCE AVENUEATHENSGA30606582332921HEALTHCAREGA501(C)(3)12B, IIARMCfalse
ATHENS REGIONAL SPECIALTY SERVICES INC
1199 PRINCE AVENUEATHENSGA30606271975001HEALTHCAREGA501(C)(3)3ARMCfalse
REGIONAL FIRSTCARE INC
1199 PRINCE AVENUEATHENSGA30606582362733URGENT CAREGA501(C)(3)12B, IIARMCfalse
COLUMBUS AMBULATORY HEALTHCARE SERVICES
707 CENTER STCOLUMBUSGA31901581719867AMBULATORYGA501(C)(3)3PHCfalse
COLUMBUS REGIONAL HEALTHCARE SYSTEM INC
707 CENTER STCOLUMBUSGA31901581719994HEALTHCAREGA501(C)(3)12B, IIPHCfalse
COLUMBUS REGIONAL MEDICAL FOUNDATION INC
707 CENTER STCOLUMBUSGA31901581501642FUNDRAISINGGA501(C)(3)7PHCfalse
THE MEDICAL CENTER INC
710 CENTER STCOLUMBUSGA31901581685139HOSPITALGA501(C)(3)3PHCfalse
HUGHSTON HOSPITAL INC
707 CENTER STCOLUMBUSGA31901331216751HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT ROCKDALE HOSPITAL INC
1412 MILSTEAD AVECONYERSGA30012300999841HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT WALTON HOSPITAL INC
2151 WEST SPRING STMONROEGA30655824194264HOSPITALGA501(C)(3)3PHCfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndUBI Code VUBICodeVAmt
HENRY RADIATION ONCOLOGY CENTER LLC
275 PROFESSIONAL COURT STE ASTOCKBRIDGEGA30281582200195HEALTHCAREGANAN/A$0$0false$0
PEACHTREE ORTHOPAEDIC SURGERY CENTER
2001 PEACHTREE RD NE STE 705ATLANTAGA30309582562721SURGERYGANAN/A$0$0false$0
DIGESTIVE HEALTHCARE OF GA ENDOSCOPY CTR
95 COLLIER RD NW STE 4075ATLANTAGA30309582406657HEALTHCAREGANAN/A$0$0false$0
SOUTHERN CRESCENT RADIATION ONCOLOGY CTR
275 PROFESSIONAL COURT STE ARIVERDALEGA30274464307929RADIATIONGANAN/A$0$0false$0
GRIFFIN RADIATION ONCOLOGY CENTER LLC
275 PROFESSIONAL COURT STE ARIVERDALEGA30274464307692RADIATIONGANAN/A$0$0false$0
FOUR WINDS HEALTH LLC
3350 RIVERWOOD PKWY STE 1850ATLANTAGA30339451273930HEALTHCAREGANAN/A$0$0false$0
GEORGIA HEALTH COLLABORATIVE LLC
2727 PACES FERRY RD BLDG 2 STE 70ATLANTAGA30339461500639HEALTHCAREGANAN/A$0$0false$0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCdOwnershipOwnershipPct
PIEDMONT MEDICAL CARE CORPORATION
2727 PACES FERRY RD STE 1-1100AtlantaGA30339582092768HealthcareGAphcC Corp$0$0false
THE PIEDMONT CLINIC INC
2727 PACES FERRY RD STE 1-1100AtlantaGA30339582005358HealthcareGAphcC Corp$0$0false
PIEDMONT HEART INSTITUTE PHYSICIANS INC
95 COLLIER ROAD NW STE 2045AtlantaGA30309260593850HealthcareGANAC Corp$0$0false
AMSTER MCRAE INSURANCE COMPANY
980427603Related INSURANCEphcC Corp$0$0falsePO BOX 1159Grand Cayman KYCJCJ
PIEDMONT WELLSTAR HEALTHPLANS INC
2859 PACES FERRY RD STE 600ATLANTAGA30339461922499HEALTH INSURANCEGAphcC CORP$0$0false
COLUMBUS HEALTHCARE RESOURCES
PO BOX 790COLUMBUSGA31902581717754HEALTHCAREGACRHSC CORP$0$0false0.00000
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART I, LINE 1: DISREGARDED ENTITIESFormAndLineReferenceDesc
ExplanationTHE 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