ATHENS REGIONAL SPECIALTY SERVICES INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- ATHENS REGIONAL SPECIALTY SERVICES INC (EIN 27-1975001)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-14
- IRS object ID
- 201931349349310038
- 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 | 2019-05-14T17:50:16-05:00 | 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 | 271975001 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ATHENS REGIONAL SPECIALTY SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % MARIE GAFFNEY | InCareOfNm |
| Business Name Control | ATHE | BusinessNameControlTxt |
| Phone | 7064757000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1199 PRINCE AVENUE | AddressLine1Txt |
| City | ATHENS | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30606 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARIE GAFFNEY | PersonNm |
| Person Title | VP CORP. FINANCE | PersonTitleTxt |
| Phone | 7064757000 | PhoneNum |
| Signature | 2019-05-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SHAWN HUTCHINSON CPA | PreparerPersonNm |
| PTIN | P01048557 | 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 | 56038220191345000016 | 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 | 3BDC32D82005B4FB5A5B30B5BF6243933C14C3D8 | 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 | CHARLES PECK PRESIDENT CEO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1199 PRINCE AVENUE | AddressLine1Txt |
| City | ATHENS | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $65,052,202 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PIEDMONT.ORG/LOCATIONS/PIEDMONT-ATHENS/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2010 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | TO SERVE AND PROMOTE THE PUBLIC HEALTH OF THE GENERAL POPULATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 307 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,010,084 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $65,043,517 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$1,683,243 | PYInvestmentIncomeAmt |
| CY Investment Income | $8,685 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $13,326,841 | PYTotalRevenueAmt |
| CY Total Revenue | $65,052,202 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,721,467 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $45,696,879 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,013,551 | PYOtherExpensesAmt |
| CY Other Expenses | $19,353,431 | CYOtherExpensesAmt |
| PY Total Expenses | $22,735,018 | PYTotalExpensesAmt |
| CY Total Expenses | $65,050,310 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$9,408,177 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,892 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,813,276 | TotalAssetsBOYAmt |
| Total Assets EOY | $25,405,532 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,276,422 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,807,982 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$1,463,146 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $20,597,550 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $64,391,948 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $65,043,517 | RevenueAmt |
| Desc | SPECIALTY PHYSICIAN PRACTICES: THE 90 PHYSICIANS INCLUDING 38 SPECIALIZED PHYSICIANS OF ATHENS REGIONAL SPECIALTY SERVICES, INC. (ARSS) DELIVERED HEALTH CARE TO THE GENERAL PUBLIC BY PROVIDING SERVICES AND RESOURCES FOR 192,084 PATIENT VISITS IN THE 17 COUNTY NORTHEAST GEORGIA AREA SERVED BY ATHENS REGIONAL MEDICAL CENTER IN THE PERIOD FROM JULY 1, 2017 THROUGH JUNE 30, 2018 DURING THE SAME PERIOD, ARSS INC. PROVIDED $735,446 IN LOW INCOME ASSISTANCE. | Desc |
| Total Program Service Expenses | $64,391,948 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | 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 | false | 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 | false | OperateHospitalInd |
| 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 | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 307 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30339 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DR CHARLES PECK MD | ||||||||
| PRESIDENT/CEO | 3.0 | 52.0 | Yes (X) | Yes (X) | $0 | $1,248,666 | $120,700 | |
| DR SAMUEL K THOMASON DMD | ||||||||
| CHAIR | 3.0 | 15.0 | Yes (X) | $0 | $0 | $0 | ||
| DEXTER L FISHER | ||||||||
| Trustee | 3.0 | 15.0 | Yes (X) | $0 | $0 | $0 | ||
| ALAN REDDISH | ||||||||
| Trustee | 3.0 | 15.0 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL D GARRETT | ||||||||
| TRUSTEE | 3.0 | 15.0 | Yes (X) | $0 | $0 | $0 | ||
| CHERYL K LEGETTE | ||||||||
| Trustee | 3.0 | 15.0 | Yes (X) | $0 | $0 | $0 | ||
| DR CHARLES L OGBURN III MD | ||||||||
| TRUSTEE | 3.0 | 15.0 | Yes (X) | $0 | $0 | $0 | ||
| DR JANE M PARKS MD | ||||||||
| TRUSTEE | 3.0 | 15.0 | Yes (X) | $0 | $0 | $0 | ||
| RICHARD B RUSSELL JR | ||||||||
| TRUSTEE | 3.0 | 15.0 | Yes (X) | $0 | $0 | $0 | ||
| DR DAVID M SAILORS MD | ||||||||
| TRUSTEE | 3.0 | 15.0 | Yes (X) | $0 | $0 | $0 | ||
| TRACEY WORTHINGTON STICE | ||||||||
| TRUSTEE | 3.0 | 15.0 | Yes (X) | $0 | $0 | $0 | ||
| G MICHAEL SMITH | ||||||||
| TRUSTEE | 3.0 | 15.0 | Yes (X) | $0 | $0 | $0 | ||
| KEVIN BROWN | ||||||||
| CEO, PHC | 3.0 | 52.0 | Yes (X) | Yes (X) | $0 | $2,033,444 | $389,020 | |
| WENDY J COOK | ||||||||
| CHIEF FINANCIAL OFFICER | 3.0 | 52.0 | Yes (X) | $0 | $515,450 | $36,024 | ||
| ELIZABETH LEDDY | ||||||||
| SECRETARY | 1.0 | 54.0 | Yes (X) | $0 | $552,329 | $65,569 | ||
| DR BENJAMIN HOLLAND MD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $922,303 | $0 | $36,731 | Yes (X) | ||
| DR JONATHAN PATTON MD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $918,692 | $0 | $33,813 | Yes (X) | ||
| DR PARKER GROW MD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $911,492 | $0 | $25,968 | Yes (X) | ||
| DR JARED GRIFFIS MD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $906,750 | $0 | $29,840 | Yes (X) | ||
| DR F KHAN POHLEL MD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $906,109 | $0 | $36,758 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,565,346 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,349,889 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $774,423 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 92 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MUKESH KUMAR MD LLC | |||||
| 743 SPRING ST NE | GAINESVILLE | GA | 30501 | PHYSICIAN SERVICES | $285,780 |
| ALICE IRENE LAWVER | |||||
| 1199 PRINCE AVE | ATHENS | GA | 30606 | PHYSICIAN SERCICES | $205,500 |
| JACKSON COKER LOCUMTENENS LLC | |||||
| 2655 NORTHWINDS PKWY | ALPHARETTA | GA | 30009 | MEDICAL SERVICES | $191,030 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 900099 | $43,986,046 | $43,986,046 |
| OTHER OPERATING REVENUE | 900099 | $20,778,724 | $20,778,724 |
| RESEARCH REVENUE | 900099 | $278,747 | $278,747 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $65,043,517 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,685 | TotalRevenueColumnAmt |
| Exclusion | $8,685 | 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 |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $65,052,202 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $65,043,517 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $8,685 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
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 | $41,002,490 | TotalAmt |
| Program Services | $40,559,663 | ProgramServicesAmt |
| Management And General | $442,827 | 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 | $2,855,620 | TotalAmt |
| Program Services | $2,824,779 | ProgramServicesAmt |
| Management And General | $30,841 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,838,769 | TotalAmt |
| Program Services | $1,818,910 | ProgramServicesAmt |
| Management And General | $19,859 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,697 | TotalAmt |
| Program Services | $19,853 | ProgramServicesAmt |
| Management And General | $1,844 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,330 | TotalAmt |
| Program Services | $4,330 | ProgramServicesAmt |
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 | $4,308,070 | TotalAmt |
| Program Services | $4,308,070 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,579 | TotalAmt |
| Program Services | $5,579 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,386,158 | TotalAmt |
| Program Services | $2,299,302 | ProgramServicesAmt |
| Management And General | $86,856 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,566,284 | TotalAmt |
| Program Services | $1,507,705 | ProgramServicesAmt |
| Management And General | $58,579 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,384 | TotalAmt |
| Program Services | $91,384 | ProgramServicesAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3 | TotalAmt |
| Program Services | $3 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $214,099 | TotalAmt |
| Program Services | $196,543 | ProgramServicesAmt |
| Management And General | $17,556 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $791,920 | TotalAmt |
| Program Services | $791,920 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| BAD DEBT | $9,957,616 | $9,957,616 |
| TAXES | $6,291 | $6,291 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,050,310 | TotalAmt |
| Program Services | $64,391,948 | ProgramServicesAmt |
| Management And General | $658,362 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,051,611 | BOYAmt |
| EOY | $18,513,710 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,008,816 | BOYAmt |
| EOY | $4,898,686 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $198,989 | BOYAmt |
| EOY | $570,178 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,708,434 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $285,476 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $553,860 | BOYAmt |
| EOY | $1,422,958 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,813,276 | BOYAmt |
| EOY | $25,405,532 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,645,911 | BOYAmt |
| EOY | $4,807,982 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,630,511 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,276,422 | BOYAmt |
| EOY | $4,807,982 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,463,146 | BOYAmt |
| EOY | $20,597,550 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | 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 | -$1,463,146 | BOYAmt |
| EOY | $20,597,550 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,813,276 | BOYAmt |
| EOY | $25,405,532 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,892 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $22,058,804 | 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 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 | |
| Buildings | BuildingsGrp | |
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,147,978 | OtherCostOrOtherBasisAmt |
| Depreciation | $285,476 | DepreciationAmt |
| Book Value | $862,502 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $560,456 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $560,456 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,422,958 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO RELATED PARTIES | Desc |
| Amt | $0 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $0 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM SCH D PART X LINE 2 | FormAndLineReferenceDesc |
| Explanation | ASC 740 FOOTNOTE (FKA FIN 48) PHC ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF THE INCOME TAXES TOPIC OF THE ASC (ASC 740). UNDER THE REQUIREMENTS OF ASC 740, TAX-EXEMPT ORGANIZATIONS MAY BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS UNCERTAIN TAX EXPOSURE ITEMS. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AT JUNE 30, 2018 AND 2017. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (true) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (true) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 CHARLES PECK MD | ||||||||||||||
| PRESIDENT/CEO | $0 | $586,715 | $0 | $190,412 | $0 | $471,539 | $0 | $83,250 | $0 | $37,450 | $0 | $1,369,366 | $0 | $83,250 |
| KEVIN BROWN | ||||||||||||||
| CEO, PHC | $0 | $1,071,546 | $0 | $831,267 | $0 | $130,631 | $0 | $372,452 | $0 | $16,568 | $0 | $2,422,464 | $0 | $0 |
| WENDY J COOK | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $0 | $355,371 | $0 | $62,544 | $0 | $97,535 | $0 | $18,000 | $0 | $18,024 | $0 | $551,474 | $0 | $0 |
| ELIZABETH LEDDY | ||||||||||||||
| SECRETARY | $0 | $344,306 | $0 | $90,667 | $0 | $117,356 | $0 | $53,125 | $0 | $12,444 | $0 | $617,898 | $0 | $0 |
| DR BENJAMIN HOLLAND MD | ||||||||||||||
| PHYSICIAN | $493,036 | $0 | $0 | $0 | $429,267 | $0 | $18,000 | $0 | $18,731 | $0 | $959,034 | $0 | $0 | $0 |
| DR JONATHAN PATTON MD | ||||||||||||||
| PHYSICIAN | $490,341 | $0 | $0 | $0 | $428,351 | $0 | $15,274 | $0 | $18,539 | $0 | $952,505 | $0 | $0 | $0 |
| DR PARKER GROW MD | ||||||||||||||
| PHYSICIAN | $498,140 | $0 | $0 | $0 | $413,352 | $0 | $0 | $0 | $25,968 | $0 | $937,460 | $0 | $0 | $0 |
| DR JARED GRIFFIS MD | ||||||||||||||
| PHYSICIAN | $493,509 | $0 | $0 | $0 | $413,241 | $0 | $0 | $0 | $29,840 | $0 | $936,590 | $0 | $0 | $0 |
| DR F KHAN POHLEL MD | ||||||||||||||
| PHYSICIAN | $493,036 | $0 | $0 | $0 | $413,073 | $0 | $0 | $0 | $36,758 | $0 | $942,867 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCH J PART I LINE 4A | SEVERANCE PAYMENT CERTAIN OFFICERS HAVE WRITTEN SEVERANCE AGREEMENTS WITH THE EMPLOYER. THIS SEVERANCE AGREEMENT TYPICALLY PROVIDES THAT IN THE EVENT OF INVOLUNTARY TERMINATION THE OFFICER WILL CONTINUE TO RECEIVE THE OFFICER'S BASE COMPENSATION FOR A PERIOD OF 24 MONTHS FOLLOWING THE OFFICER'S DATE OF DETERMINATION. THE OFFICER IS ALSO ENTITLED AS ADDITIONAL SEVERANCE ANY OTHER BENEFITS TO WHICH HE WOULD HAVE BEEN ENTITLED HAD THE EXECUTIVE REMAINED AN EMPLOYEE. THE VALUE OF THE OTHER BENEFITS ARE MADE AVAILABLE TO THE OFFICER IN ACTUAL BENEFITS OR EQUIVALENT VALUE TO THE EXTENT PERMITTED IN LAW AND BY UNDERLYING CONTRACTS THAT MAY SUPPORT SUCH BENEFITS. NO SEVERANCE PAYMENTS WERE MADE IN 2017. |
| SCH. J PART I LINE 4B | SUPPLEMENTAL COMPENSATION INFORMATION DR. CHARLES PECK RECEIVED PAYMENTS TOTALING $83,250 THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS: KEVIN BROWN WENDY COOK ELIZABETH LEDDY |
| SCH J PART I LINE 5A & 6A | CONTINGENT COMPENSATION EXECUTIVE AND LEADERSHIP POSITIONS ARE ELIGIBLE TO PARTICIPATE IN A VARIABLE PAY PLAN. GROSS REVENUES AND NET EARNINGS ARE VARIABLE PAY PLAN FACTORS. THIS PLAN PROVIDES INCENTIVES BASED ON SYSTEM PERFORMANCE. THE RESULTS ARE BASED ON THE ACCOMPLISHMENT OF SPECIFIC STRATEGIC OBJECTIVES INVOLVING (1) SUSTAINED AND IMPROVED FINANCIAL PERFORMANCE AND EFFICIENCY (2) EMPLOYEE SATISFACTION AND RETENTION (3) IMPROVED CUSTOMER SATISFACTION INCLUDING MEMBERS, PHYSICIANS, PATIENTS, AND EMPLOYEES (4) MAINTENANCE AND IMPROVEMENT IN QUALITY AND CLINICAL OUTCOMES. THE PERFORMANCE SCORECARD IS DETERMINED ANNUALLY AND APPROVED BY THE BENEFITS AND COMPENSATION COMMITTEE OF THE BOARD. THE PLAN WILL BE DISALLOWED BASED ON LOSS OF THE JOINT COMMISSION ACCREDITATION OR A VIOLATION OF THE BOND COVENANTS. PHYSICIANS RECEIVE A BASE SALARY PLUS AN INCENTIVE WHICH IS CALCULATED AS A PERCENTAGE OF NET PRODUCTION. NET PRODUCTION IS BASED ON WORK RVU PRODUCTION AND AN ESTABLISHED COMPENSATION PER WORK RVU RATE BASED ON FAIR MARKET VALUE. THE CALCULATION OF NET PRODUCTION IS SUBJECT ALWAYS TO COMPLIANCE WITH ALL APPLICABLE FEDERAL AND STATE LAWS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 Part III Line 1 | MISSION STATEMENT EXPLANATION ATHENS REGIONAL SPECIALTY SERVICES, INC. (ARSS) WAS INCORPORATED ON FEBRUARY 18, 2010. ARSS WAS FORMED TO SUPPORT THE EFFORTS OF ATHENS REGIONAL MEDICAL CENTER BY STRIVING TO IMPROVE THE HEALTH OF THE GENERAL POPULATION OF THE AREA SERVED BY ENSURING THE AVAILABILITY OF QUALITY SPECIALTY MEDICAL SERVICES. ARSS CURRENTLY EMPLOYS 90 PHYSICIANS INCLUDING 38 SPECIALIZED PHYSICIANS WITH EXPERTISE IN CARDIOLOGY, OBSTETRICS, PSYCHIATRY, PHYSICAL MEDICINE AND REHABILITATION, PEDIATRICS, HYPERBARIC MEDICINE AND GENERAL AND COLORECTAL SURGERY. ARSS PROVIDES SPECIALTY MEDICAL SERVICES TO THE GENERAL PUBLIC THROUGH ITS EMPLOYEE PHYSICIANS, REGARDLESS OF EACH PATIENT'S ABILITY TO PAY. FORM 990 PART V LINE 1A FORM 1096 FILINGS ALL FORM 1096 FILINGS FOR THE ORGANIZATION ARE FILED BY PIEDMONT HEALTHCARE, INC. (EIN 58-1503902) |
| Form 990 Part VI Line 6 | ORGANIZATIONS SOLE MEMBER PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC., (EIN 58-2179986) IS THE SOLE MEMBER OF ATHENS REGIONAL SPECIALTY SERVICES, INC. |
| Form 990 Part VI Line 7a | ELECTION OF GOVERNING BODY THE BOARD OF PIEDMONT HEALTHCARE, ATHENS REGIONAL SPECIALTY SERVICES, INC.S SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF ATHENS REGIONAL SPECIALTY SERVICES, INC. |
| Form 990 Part VI Line 7B | DECISIONS OF GOVERNING BODY ATHENS REGIONAL SPECIALTY SERVICES, INC.S BOARD POLICIES AND DECISIONS MUST BE FILED, IMMEDIATELY AFTER ADOPTION, WITH THE SECRETARY OF THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS. SUCH POLICIES AND DECISIONS OF THE ATHENS REGIONAL SPECIALTY SERVICES, INC. BOARD OF DIRECTORS ARE NOT SUBJECT TO THE APPROVAL OF OR RATIFICATION BY THE PIEDMONT HEALTHCARE BOARD, BUT SHOULD THE NEED ARISE, THEY MAY BE RESCINDED BY THE PIEDMONT HEALTHCARE BOARD THROUGH A MAJORITY VOTE OF ITS DIRECTORS. |
| Form 990 Part VI Line 11a | PRIOR TO FILING, COPIES OF FORM 990 ARE PROVIDED TO THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC. |
| Form 990 Part VI 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 ATHENS REGIONAL SPECIALTY SERVICES, INC. ARE PROVIDED TRAINING ON CONFLICT OF INTEREST ISSUES, INCLUDING REPORTING REQUIREMENTS, AT NEW-EMPLOYEE ORIENTATION AND AT LEAST ANNUALLY THEREAFTER. NONCOMPLIANCE WITH THE CONFLICT OF INTEREST POLICY MUST BE REPORTED TO PIEDMONT 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 Line 15a | EXECUTIVE COMPENSATION COMPENSATION FOR EXECUTIVES OF ATHENS REGIONAL SPECIALTY SERVICES, INC. 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 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. 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 Line 19 | DISCLOSURE OF GOVERNING, CONFLICT OF INTEREST AND FINANCIAL DOCUMENTS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THESE DOCUMENTS SHOULD BE REQUESTED FROM PIEDMONT HEALTHCARE, INC.'S LEGAL COUNSEL. |
| Form 990 Part XI, Line 9 | RECONCILIATION OF NET ASSETS CHANGES TO NET ASSETS REPORTED ON PART XI, LINE 9 ARE COMPRISED OF $22,058,804 INTERCOMPANY TRANSFERS OF LIABILITIES |
Schedule R IRS990ScheduleR
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) | 12B, III-F | NA | false |
| PIEDMONT HOSPITAL Inc | ||||||||||
| 1968 PEACHTREE ROAD NW | ATLANTA | GA | 30309 | 580566213 | HOSPITAL | GA | 501(c)(3) | 3 | PHC | false |
| FAYETTE COMMUNITY HOSPITAL INC | ||||||||||
| 1255 HIGHWAY 54 WEST | FAYETTEVILLE | GA | 30214 | 582232328 | 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 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 |
| 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 |
| 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 HEART INSTITUTE INC | ||||||||||
| 95 COLLIER ROAD NW STE 2045 | ATLANTA | GA | 30309 | 263553500 | HOSPITAL | GA | 501(C)(3) | 7 | PHC | false |
| PIEDMONT ATHENS REGIONAL HEALTH RESOURCE | ||||||||||
| 1199 PRINCE AVENUE | ATHENS | GA | 30606 | 581930580 | DEVELOPMENT | GA | 501(C)(3) | 12B, II | PARMC | false |
| PIEDMONT ATHENS REGIONAL FOUNDATION INC | ||||||||||
| 1199 PRINCE AVENUE | ATHENS | GA | 30606 | 581978389 | FUNDRAISING | GA | 501(C)(3) | 12B, II | PARMC | 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 | PARMC | false |
| REGIONAL FIRSTCARE INC | ||||||||||
| 1199 PRINCE AVENUE | ATHENS | GA | 30606 | 582362733 | URGENT CARE | GA | 501(C)(3) | 12B, II | PARMC | 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 | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HENRY RADIATION ONCOLOGY CENTER LLC | |||||||||||||
| 275 PROFESSIONAL COURT STE A | STOCKBRIDGE | GA | 30281 | 582200195 | HEALTHCARE | GA | NA | N/A | $0 | $0 | false | $0 | false |
| PEACHTREE ORTHOPAEDIC SURGERY CENTER | |||||||||||||
| 2001 PEACHTREE RD NE STE 705 | ATLANTA | GA | 30309 | 582562721 | SURGERY | GA | NA | N/A | $0 | $0 | false | $0 | false |
| DIGESTIVE HEALTHCARE OF GA SURGERY CTR | |||||||||||||
| 95 COLLIER RD NW STE 4075 | ATLANTA | GA | 30309 | 582406657 | HEALTHCARE | GA | NA | N/A | $0 | $0 | false | $0 | false |
| SOUTHERN CRESCENT RADIATION ONCOLGY CENT | |||||||||||||
| 275 PROFESSIONAL COURT STE A | RIVERDALE | GA | 30274 | 464307929 | RADIATION | GA | NA | N/A | $0 | $0 | false | $0 | false |
| GRIFFIN RADIATION ONCOLOGY CENTER LLC | |||||||||||||
| 275 PROFESSIONAL COURT STE A | RIVERDALE | GA | 30274 | 464307692 | RADIATION | GA | NA | N/A | $0 | $0 | false | $0 | false |
| FOUR WINDS HEALTH LLC | |||||||||||||
| 3350 RIVERWOOD PKWY STE 1850 | ATLANTA | GA | 30339 | 451273930 | HEALTHCARE | GA | NA | N/A | $0 | $0 | false | $0 | false |
| GEORGIA HEALTH COLLABORATIVE LLC | |||||||||||||
| 2727 PACES FERRY RD BLDG 2 STE 20 | ATLANTA | GA | 30339 | 461500639 | HEALTHCARE | GA | NA | N/A | $0 | $0 | false | $0 | false |
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 | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PIEDMONT MEDICAL CARE CORPORATION | ||||||||||||||||
| 2727 PACES FERRY ROAD SUITE 1-1100 | ATLANTA | GA | 30339 | 582092768 | HEALTHCARE | GA | NA | C-CORP | $0 | $0 | false | |||||
| THE PIEDMONT CLINIC INC | ||||||||||||||||
| 2727 PACES FERRY ROAD SUITE 1-1100 | ATLANTA | GA | 30339 | 582005358 | HEALTHCARE | GA | NA | 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 | NA | C-CORP | $0 | $0 | false | PO BOX 1159 GRAND CAYMAN | GRAND CAYMAN | CJ | KY 1-1102 | CJ | |||||
| PIEDMONT WELLSTAR HEALTHPLANS INC | ||||||||||||||||
| 2859 PACES FERRY RD STE 600 | ATLANTA | GA | 30339 | 461922499 | HEALTH INSURANCE | GA | NA | C-CORP | $0 | $0 | false | |||||
| COLUMBUS HEALTHCARE RESOURCES | ||||||||||||||||
| PO BOX 790 | COLUMBUS | GA | 31902 | 581717754 | HEALTHCARE | GA | NA | C CORP | $0 | $0 | false | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | 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 |