PHOEBE WORTH MEDICAL CENTER INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- PHOEBE WORTH MEDICAL CENTER INC (EIN 38-3647394)
- Tax period
- 2012-08-01 to 2013-07-31
- Filed
- 2014-06-04
- IRS object ID
- 201401559349300025
- Schema version
- 2012v2.3
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-06-04T13:27:14-05:00 | Timestamp |
| Tax Period End Date | 2013-07-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRAFFIN & TUCKER LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71309 | AddressLine1 |
| City | ALBANY | City |
| State | GA | State |
| ZIP Code | 317081309 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-08-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383647394 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHOEBE WORTH MEDICAL CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PHOE | NameControl |
| Phone | 2297766961 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 807 SOUTH ISABELLAPO BOX 545 | AddressLine1 |
| City | SYLVESTER | City |
| State | GA | State |
| ZIP Code | 31791 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KERRY LOUDERMILK | Name |
| Title | PPHS CFO | Title |
| Phone | 2297766961 | Phone |
| Date Signed | 2014-06-03 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LINTON A HARRIS | Name |
| Phone | 2298837878 | Phone |
| Date Prepared | 2014-06-03 | DatePrepared |
| Self Employed | X | SelfEmployed |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | KIM GILMAN CAO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 545 | AddressLine1 |
| City | SYLVESTER | City |
| State | GA | State |
| ZIP Code | 31791 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 14993784 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.PHOEBEPUTNEY.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2002 | YearFormation |
| State Legal Domicile | GA | StateLegalDomicile |
| Activity Or Mission Description | PROVIDING CHARITABLE HEALTHCARE ACTIVITIES | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 273 | TotalNbrEmployees |
| Total Nbr Volunteers | 8 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 468000 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 468000 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 18151025 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 13267651 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -56981 | InvestmentIncomePriorYear |
| Investment Income Current Year | 12800 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 555612 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1193170 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 19117656 | TotalRevenuePriorYear |
| Total Revenue Current Year | 14941621 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 45619 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9549376 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 9093714 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 10512093 | OtherExpensePriorYear |
| Other Expenses Current Year | 7700699 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 20061469 | TotalExpensesPriorYear |
| Total Expenses Current Year | 16840032 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -943813 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1898411 | RevenuesLessExpensesCY |
| Total Assets BOY | 9152218 | TotalAssetsBOY |
| Total Assets EOY | 11304470 | TotalAssetsEOY |
| Total Liabilities BOY | 10503511 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 14554174 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -1351293 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -3249704 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROVIDING CHARITABLE HEALTHCARE ACTIVITIES | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 13067251 | Expense |
| Grants | 45619 | Grants |
| Revenue | 14301580 | Revenue |
| Description | TO BE THE LEADING PROVIDER OF QUALITY, COST EFFECTIVE, PATIENT-CENTERED HEALTH CARE SERVICES TO ALL RESIDENTS OF SOUTHWEST GEORGIA. PWMC PURSUES ITS MISSION THROUGH A PATIENT-CENTERED ENVIRONMENT OF CARE REFLECTING HIGH STANDARDS AND PROMOTING A BALANCE OF PROFESSIONAL PREPARATION AND SERVICE, CONTINUOUS IMPROVEMENT BASED ON OUR CORE VALUES OF PEOPLE, RELATIONSHIPS, REPUTATION, EXCELLENCE, EFFICIENCY AND COMMITMENT. | Description |
| Total Program Service Expense | 13067251 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 185 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 273 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | GA | StatesWhereCopyOfReturnIsFiled |
| Own Website | X | OwnWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KERRY LOUDERMILK PPHS CFO | NamePerson |
| Telephone Number | 2293124068 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3770 | AddressLine1 |
| City | ALBANY | City |
| State | GA | State |
| ZIP Code | 31706 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| JOEL WERNICK | |||||||||
| BD MEMBER/PP | 1.00 | 53.00 | X | X | 0 | 957191 | 914342 | ||
| JOE AUSTIN | |||||||||
| BOARD MEMBER | 1.00 | 51.00 | X | 0 | 538683 | 102919 | |||
| JOHNNY COCHRAN | |||||||||
| VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | |||
| LARRY DAUGHERTY DMD | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| MARY KING GIVENS | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| IRENE HALL | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| DON MONK | |||||||||
| CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | |||
| NATU PATEL MD | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| SHIRLEY THOMAS | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| KERRY LOUDERMILK | |||||||||
| PPHS CFO | 1.00 | 53.00 | X | 0 | 495904 | 124517 | |||
| KIM GILMAN | |||||||||
| CAO | 40.00 | X | 0 | 155527 | 4057 | ||||
| JOHN GRAHAM | |||||||||
| CFO | 40.00 | X | 0 | 113949 | 7131 | ||||
| CANDACE GUARNIERI | |||||||||
| CFO | 40.00 | X | 0 | 3674 | 8446 | ||||
| TIM TROTTIER | |||||||||
| SVP REG OPER | 15.00 | 35.00 | 0 | 344472 | 86768 | X | |||
| TINA JENKINS | |||||||||
| REHAB DIRECT | 40.00 | 154887 | 0 | 12708 | X | ||||
| DEENA HOOD | |||||||||
| PHARM DIRECT | 40.00 | 123506 | 0 | 15889 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 278393 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2609400 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1276777 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| WORTH EMERGENCY GROUP LLC | |||||
| PO BOX 82368 | LAFAYETTE | LA | 705982368 | ER PHYSICIANS | 388638 |
| AMERISOURCE BERGEN | |||||
| PO BOX 959 | VALLEY FORGE | PA | 19482 | PHARMACEUTICALS | 348898 |
| SIEMENS HEALTHCARE DIAGNOSTICS | |||||
| 1717 DEERFIELD ROAD | DEERFIELD | IL | 600150778 | LAB EQUIPMENT | 157227 |
| THE ROSE GROUP INC | |||||
| PO BOX 567 | LAKE BUTLER | FL | 32054 | NURSING SERVICE | 142752 |
| US FOODSERVICE INC | |||||
| PO BOX 281945 | ATLANTA | GA | 303841945 | FOOD SERVICES | 126810 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
| Government Grants | 468000 | GovernmentGrants |
| Total Contributions | 468000 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE REVENUE | Description |
| Business Code | 623000 | BusinessCode |
| Total Revenue Column | 13267651 | TotalRevenueColumn |
| Related Or Exempt Function Income | 13267651 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 13267651 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12800 | TotalRevenueColumn |
| Exclusion | $12,800 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 52367 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 52163 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 204 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 204 | TotalRevenueColumn |
| Exclusion | $204 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| EHR REVENUE | 621990 | 1028521 | 1028521 | |
| CAFETERIA | 722513 | 143346 | $143,346 | |
| MEDICAL RECORDS | 621990 | 10640 | $10,640 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10459 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5408 | RelatedOrExemptFunctionIncome |
| Exclusion | $5,051 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1192966 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14941621 | TotalRevenueColumn |
| Related Or Exempt Function Income | 14301580 | RelatedOrExemptFunctionIncome |
| Exclusion | $172,041 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45619 | Total |
| Program Services | 45619 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6887968 | Total |
| Program Services | 5699509 | ProgramServices |
| Management And General | 1188459 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 205951 | Total |
| Program Services | 170416 | ProgramServices |
| Management And General | 35535 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1488825 | Total |
| Program Services | 1231941 | ProgramServices |
| Management And General | 256884 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 510970 | Total |
| Program Services | 422807 | ProgramServices |
| Management And General | 88163 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 261058 | Total |
| Management And General | 261058 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1000 | Total |
| Management And General | 1000 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 86061 | Total |
| Management And General | 86061 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2634 | Total |
| Management And General | 2634 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2834403 | Total |
| Program Services | 2310328 | ProgramServices |
| Management And General | 524075 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32306 | Total |
| Program Services | 14005 | ProgramServices |
| Management And General | 18301 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1218914 | Total |
| Program Services | 958425 | ProgramServices |
| Management And General | 260489 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 350841 | Total |
| Program Services | 308038 | ProgramServices |
| Management And General | 42803 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43983 | Total |
| Program Services | 33507 | ProgramServices |
| Management And General | 10476 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 707518 | Total |
| Program Services | 621201 | ProgramServices |
| Management And General | 86317 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 616707 | Total |
| Program Services | 228669 | ProgramServices |
| Management And General | 388038 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| REPAIRS & MAINTENANCE | 838369 | 435593 | 402776 |
| MEDICAL SUPPLIES | 532119 | 532119 | |
| MISCELLANEOUS | 112433 | 33776 | 78657 |
| DUES & SUBSCRIPTIONS | 62353 | 21298 | 41055 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16840032 | Total |
| Program Services | 13067251 | ProgramServices |
| Management And General | 3772781 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2567408 | BOY |
| EOY | 3752984 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 388199 | BOY |
| EOY | 388679 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2589869 | BOY |
| EOY | 1985286 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 156750 | BOY |
| EOY | 137791 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 151542 | BOY |
| EOY | 196077 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 11203905 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 6360252 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3298450 | BOY |
| EOY | 4843653 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9152218 | BOY |
| EOY | 11304470 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1818657 | BOY |
| EOY | 2185778 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8684854 | BOY |
| EOY | 12368396 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10503511 | BOY |
| EOY | 14554174 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -1351293 | BOY |
| EOY | -3249704 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -1351293 | BOY |
| EOY | -3249704 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9152218 | BOY |
| EOY | 11304470 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -1898411 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Both | X | FinancialStatementBoth |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $2,634 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 2634 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | SCHEDULE C, PART II-B, LINE 1 | ReturnReference |
| Explanation | THE ORGANIZATION PAYS MEMBERSHIP DUES TO NATIONAL AND STATE HEALTHCARE ORGANIZATIONS. A PORTION OF THOSE DUES IS ALLOCATED TO LOBBYING ACTIVITIES IN WHICH THESE NATIONAL AND STATE HEALTHCARE ORGANIZATIONS PARTICIPATE. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 175676 | OtherCostOrOtherBasis |
| Book Value | 175676 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4200052 | OtherCostOrOtherBasis |
| Depreciation | 1995845 | Depreciation |
| Book Value | 2204207 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 149829 | OtherCostOrOtherBasis |
| Depreciation | 82051 | Depreciation |
| Book Value | 67778 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6678348 | OtherCostOrOtherBasis |
| Depreciation | 4282356 | Depreciation |
| Book Value | 2395992 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 4843653 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO PHOEBE PUTNEY HEALTH SYSTEMS | Description |
| Amount | $12,368,396 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 12368396 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 14993784 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 52163 | OtherRevenues |
| Revenue Not Rptd F990 | 52163 | RevenueNotRptdF990 |
| Revenue Subtotal | 14941621 | RevenueSubtotal |
| Total Revenue Per Form990 | 14941621 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 16892195 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 52163 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 52163 | ExpensesNotRptdF990 |
| Expenses Subtotal | 16840032 | ExpensesSubtotal |
| Total Expenses Per Form990 | 16840032 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| LIABILITY UNDER FIN 48 FOOTNOTE | SCHEDULE D, PAGE 3, PART X | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)3 OF THE INTERNAL REVENUE CODE. THE HOSPITAL APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE HOSPITAL ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENT'S EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF JULY 31, 2013 AND 2012 OR FOR THE YEARS THEN ENDED. THE HOSPITAL'S OPEN AUDIT PERIODS ARE FOR TAX YEARS ENDED 2010-2012. |
| REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER | SCHEDULE D, PAGE 4, PART XI, LINE 2D | RENTAL EXPENSES 52,163 |
| EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHER | SCHEDULE D, PAGE 4, PART XII, LINE 2D | RENTAL EXPENSES 52,163 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 2.25000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1957735 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 859745 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1097990 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06500 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1957735 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 859745 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1097990 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06500 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4044276 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2616099 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1428177 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08450 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 45619 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 45619 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00270 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4089895 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2616099 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1473796 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08720 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6047630 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3475844 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2571786 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.15220 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $1,438,637 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 4990944 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 4945876 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 45068 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHOEBE WORTH MEDICAL CENTER INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 807 S ISABELLA STREET | AddressLine1 |
| City | SYLVESTER | City |
| State | GA | State |
| ZIP Code | 31791 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWWPHOEBEPUTNEYCOM | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
| Other | SWB SNF | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHOEBE WORTH MEDICAL CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Other | X | Other |
| Needs Assessment Conducted | 13 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | false | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Other Method | X | OtherMethod |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | false | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200.0 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 225.0 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| PHOEBE FAMILY MEDICAL CENTER | ||||
| 354 E WASHINGTON AVENUE | ASHBURN | GA | 31714 | RHC |
| PHOEBE WORTH FAMILY MEDICAL CENTER | ||||
| 1014 WEST FRANKLIN STREET | SYLVESTER | GA | 31791 | RHC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SUBSIDIZED HEALTH SERVICES EXPLANATION | PART I LINE 7G | THE NET COST ASSOCIATED WITH THE EMERGENCY ROOM DEPARTMENT REPORTED ON SCHEDULE H PART 7G IS 1416559 |
| EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE | PART I LINE 7 COLUMN F | IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN F THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990 PART IX LINE 25 FORM 990 PART IX LINE 25 16840032 ADD EXPENSES REPORTED IN PART VIII 52163 DENOMINATOR FOR COLUMN F 16892195 |
| COSTING METHODOLOGY EXPLANATION | PART I LINE 7 | THE COST OF FINANCIAL ASSISTANCE AND SUBSIDIZED HEALTH SERVICES WAS CALCULATED USING THE COSTTOCHARGE RATIO FROM WORKSHEET 2 OF THE IRS FORM 990 INSTRUCTIONS THE COST OF ON LINE 7I WAS GENERATED FROM THE ORGANIZATIONS ACCOUNTING RECORDS |
| BAD DEBT EXPENSE EXPLANATION | PART III LINE 4 | THE AMOUNT ON PART III LINE 2 WAS CALCULATED USING THE RCC AS DEFINED IN WORKSHEET 2 ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRDPARTY COVERAGE THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS IF NECESSARY FOR EXAMPLE FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD PARTY PAYOR HAS NOT YET PAID OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY FOR RECEIVABLES ASSOCIATED WITH SELFPAY PATIENTS WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRDPARTY COVERAGE EXISTS FOR PART OF THE BILL THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE THE DIFFERENCE BETWEEN THE STANDARD RATES OR THE DISCOUNTED RATES IF NEGOTIATED AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS THE HOSPITALS ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR FISCAL YEAR 2013 INCREASED APPROXIMATELY 5 AS A PERCENTAGE OF ACCOUNTS RECEIVABLE COMPARED TO FISCAL YEAR 2012 THE INCREASE WAS DUE TO SEVERAL FACTORS INCLUDING AN INCREASE IN THE ACCOUNTS RECEIVABLE DUE IN PART TO THE IMPLEMENTATION OF A NEW HOSPITALWIDE INFORMATION SYSTEM IN JULY OF 2012 IN ADDITION THE HOSPITAL EXPERIENCED AN INCREASE IN SELFPAY VOLUME DURING FISCAL YEAR 2013 ANOTHER FACTOR THAT LED TO THE INCREASE IS THE RESULT OF NEGATIVE TRENDS RELATED TO THE COLLECTABILITY OF AMOUNTS DUE FROM SELFPAY PATIENTS DURING FISCAL YEAR 2013 THE HEALTHCARE INDUSTRY IS ALSO EXPERIENCING A MOVEMENT OF MORE PATIENTS FAVORING THE HIGH DEDUCTIBLE INSURANCE PLANS WITH LOWER PREMIUM COSTS ALTHOUGH THESE PATIENTS ARE INSURED COLLECTION IS OFTEN DIFFICULT WHEN THE PATIENT IS LEFT WITH THE RESPONSIBILITY OF THE ACCOUNT BALANCE AFTER INSURANCE HAS PAID THE CLAIM |
| MEDICARE EXPLANATION | PART III LINE 8 | MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS |
| COLLECTION PRACTICES EXPLANATION | PART III LINE 9B | THE ORGANIZATION WRITES OFF PATIENT ACCOUNTS RECEIVABLE BALANCES FOR PATIENTS QUALIFYING FOR CHARITY CARE OR FINANCIAL ASSISTANCE AND DOES NOT MAKE FURTHER COLLECTION EFFORTS |
| NEEDS ASSESSMENT | PART VI | NEEDS ASSESSMENTS HAVE TRADITIONALLY LED TO THE CREATION OF COMMUNITYBASED DELIVERY SYSTEMS THAT EXPAND ACCESS TO HEALTH CARE MEET THE NEEDS OF THE PEOPLE AND BUILD HEALTHY COMMUNITIES IN THE BROADEST SENSE BY IMPACTING MAJOR DETERMINANTS SUCH AS ECONOMIC DEVELOPMENT EMPLOYMENT CHILDRENS SAFETY EDUCATION AND ADEQUATE HOUSING THE ORGANIZATION CONDUCTS REGULAR NEEDS ASSESSMENT THROUGH FORMAL AND INFORMAL SURVEYS AND PROCESSES INCLUDING COLLABORATIONS WITH PUBLIC AND COMMUNITY AGENCIES THROUGH STRATEGIC PLANNING AND COMMUNITY INTERVIEWS THE ORGANIZATION DEVELOPS PROGRAMS AND SERVICES THAT CONSIDER THE ECONOMIC IMPERATIVES OF THE REGION THE EFFECT OF LEGISLATION AND THE INVOLVEMENT OF OTHER COMMUNITYBASED ORGANIZATIONS AND PARTNERS THE ORGANIZATION REGULARLY CONDUCTS FOCUS GROUPS IN THE COMMUNITY TO UNDERSTAND ISSUES AFFECTING ITS PATIENTS AND HAS CREATED PROGRAMS IN RESPONSE TO HEALTH DISPARITIES PREVALENT IN THE AREA THE ORGANIZATION ALSO COLLECTS HEALTH NEEDS INFORMATION FROM NURSES WHO PROVIDE DIRECT CARE TO STUDENTS AND STAFF AND WHO COLLABORATE WITH OTHER AGENCIES TO DEVELOP HEALTH AWARENESS AND DISEASE PREVENTION PROGRAMS THE ORGANIZATION ALSO CONDUCTS REGULAR PHYSICIAN WORKFORCE STUDIES THROUGH ITS STRATEGIC PLANNING ARM TO DETERMINE UNMET PHYSICIAN NEEDS AND BARRIERS TO ACCESSING CARE THE ORGANIZATION MEASURES THE SUCCESS OF ITS COMMITMENT BY HOW WELL IT KEEPS PEOPLE HEALTHY AND HOW WELL IT IMPACTS THE SOCIALCULTURAL BONDS THAT WILL SECURE THE COMMUNITIES OF THE FUTURE THE HOSPITAL LAST CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2013 |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI | THE BOARD HAS CLEARLY WRITTEN INDIGENT AND CHARITY CARE POLICIES THAT ARE AVAILABLE ON THE ORGANIZATION WEB SITE AND THROUGH THE BUSINESS OFFICE SIGNS ARE PROMINENTLY POSTED ON THE AVAILABILITY OF FREE AND CHARITY CARE PATIENT EDUCATION ON THE ORGANIZATIONS INDIGENT AND CHARITY CARE PROGRAMS ARE CONDUCTED DURING PREREGISTRATION THROUGH FLOOR VISITS BY BUSINESS OFFICE REPRESENTATIVES FOR PATIENTS THAT STRESS CONCERN IN MEETING THE FINANCIAL OBLIGATIONS FOR THEIR SERVICES THROUGH OUR CUSTOMER SERVICE DEPARTMENT AND THE PHOEBE CARES DEPARTMENT BROCHURES ARE PROMINENTLY DISPLAYED AT EACH REGISTRATION BOOTH THE BUSINESS OFFICE CONTINUOUSLY PROVIDES UPDATED MATERIAL TO PHYSICIAN OFFICES FOR ISSUANCE TO THEIR PATIENTS THAT HIGHLIGHT THE FINANCIAL ASSISTANCE PROGRAM AND POLICIES THE PATIENT STATEMENTS HIGHLIGHT THE ORGANIZATIONS CHARITY PROGRAM AND ENCOURAGE PATIENTS TO CALL FOR FINANCIAL ASSISTANCE |
| COMMUNITY INFORMATION | PART VI | WORTH COUNTY IS LOCATED IN THE SOUTHWESTERN PART OF GEORGIA THE CITY OF ALBANY IS IN CLOSE PROXIMITY TO THE COUNTY WORTH COUNTY HAS A TOTAL LAND AREA OF 570 SQUARE MILES WORTH COUNTY INCLUDES THE CITIES AND TOWNS OF SYLVESTER POULAN OAKFIELD SUMNER AND WARWICK THE POPULATION DISTRIBUTION IS 308 PERCENT URBAN AND 692 PERCENT RURAL ALMOST ALL OF WORTH COUNTYS LAND AREA IS RURAL IN 2010 WORTH COUNTYS RESIDENT POPULATION WAS 21630 WHICH WAS A SLIGHT DECREASE FROM 2000 FROM 2010 TO 2015 THE POPULATION IS PREDICTED TO INCREASE BY 29 PERCENT THE POPULATION IS PREDICTED TO INCREASE TO 22258 IN 2015 AND 22700 IN 2020 ACCORDING TO THE 2010 CENSUS 14 PERCENT OF WORTH COUNTYS POPULATION WAS AGE 65 AND OVER IN GEORGIA THE AVERAGE PERCENTAGE OF THE POPULATION AGE 65 OR OLDER WAS 107 PERCENT COMPARED TO 131 PERCENT FOR THE US POPULATION PROJECTIONS INDICATE THAT THE COUNTY POPULATION WILL INCREASE BY 29 PERCENT FROM 2010 TO 2015 ACCORDING TO 2010 US CENSUS RECORDS WORTH COUNTYS POPULATION WAS 703 PERCENT WHITE 276 PERCENT BLACK AND 15 PERCENT HISPANIC THE HISPANIC POPULATION ALTHOUGH SMALL INCREASED BY 36 PERCENT FROM 2000 TO 2010 MOST OF THE PRIMARY JOBS 6470 LOCATED WITHIN WORTH COUNTY WERE CENTERED WITHIN THE MOST POPULOUS CITY IN THE COUNTY WHICH IS SYLVESTER HEALTH CARE AND SOCIAL ASSISTANCE WAS THE MAJOR INDUSTRY SECTOR BY JOB COUNT IN WORTH COUNTY AT 144 PERCENT OF THE JOBS THIS WAS FOLLOWED BY RETAIL 134 PERCENT AND MANUFACTURING 112 PERCENT |
| HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE | PART VI | THE ORGANIZATION AND ALL ITS VOLUNTEER BOARDS ARE COMPOSED OF COMMUNITY MEMBERS WITH DIVERSE PROFESSIONAL AND COMMUNITY SERVICE BACKGROUNDS AS WELL AS PHYSICIAN MEMBERS IN ALL FACILITIES EMERGENCY CENTERS ARE OPERATED 247 AND OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY THE BOARD MAINTAINS OPEN MEDICAL STAFF POLICIES WITH PRIVILEGES AVAILABLE TO ALL QUALIFYING PHYSICIANS THE BOARD HAS CLEARLY WRITTEN FINANCIAL ASSISTANCE POLICIES THAT ARE AVAILABLE ON THE ORGANIZATION WEB SITE AND THROUGH THE BUSINESS OFFICE SIGNS ARE PROMINENTLY POSTED ON THE AVAILABILITY OF FREE AND CHARITY CARE THE ORGANIZATION HAS A MULTIPRONGED APPROACH TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES INCREASING ACCESS BUILDING CAPACITY INVESTING IN UPSTREAM PROGRAMS THAT GET AT THE CAUSE OF DISEASE AND ILLNESS BUILDING COMMUNITY PARTNERSHIPS ADVOCATING CHANGE AND DEVELOPING LEADERSHIP SURPLUS FUNDS ARE REINVESTED IN RESOURCES TO IMPROVE THE DELIVERY OF MEDICAL AND HEALTH CARE SERVICES PRIMARY CARE IS FIRST AND CREATES A PROFOUND IMPACT ON THE COMMUNITIES SERVED PRIMARY CARE SERVICES ARE ESTABLISHED IN AREAS WHERE RESIDENTS ARE MOST LIKELY TO SUFFER FROM SEVERE MANPOWER SHORTAGES HIGH POVERTY LEVELS AND A LACK OF ACCESS TO CARE THE ORGANIZATION ALSO EASES THE BURDEN ON TAXPAYERS WITH SPECIFIC PROGRAMMING THAT INCLUDES EXERCISE SEMINARS AND LIFESTYLE PROGRAMS FOR FIREFIGHTERS AND EMTS WHO MUST MEET HEALTH BIOMETRIC REQUIREMENTS WITHIN THE NEXT YEAR THESE PROGRAMS AND SERVICES SUCCESSFULLY REDUCE INAPPROPRIATE USE OF EMERGENCY CENTER SERVICES AND PROVIDE RESIDENTS WITH PRIMARY CARE AT THE LOCAL LEVEL WHERE IT IS MOST EFFECTIVE AND LEAST COSTLY |
| AFFILIATED HEALTH CARE INFORMATION | PART VI | HAVING JOINED PHOEBE PUTNEY HEALTH SYSTEM IN 2002 PWMC COMBINES THE INNOVATIONS OF A PROGRESSIVE HEALTH CARE SYSTEM WITH PERSONALIZED CARE IN A HOMETOWN SETTING PWMC IS DESIGNATED AS ONE OF THE STATES CRITICAL ACCESS HOSPITALS PWMC PROVIDES STATEOFTHEART HEALTH CARE SERVICES FOR THE COMMUNITY IT SERVES |
| LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED | PART VI | GEORGIA |
| ADDITIONAL INFORMATION | PART VI | SERVICE TO THE COMMUNITY PHOEBE WORTH MEDICAL CENTER IS A NOTFORPROFIT HEALTH CARE ORGANIZATION THAT EXISTS TO SERVE THE COMMUNITY THE HOSPITAL HAS NO STOCKHOLDERS OR OWNERS AND IS PART OF THE NOTFORPROFIT PHOEBE PUTNEY HEALTH SYSTEM INC AFTER OPERATING EXPENSES ARE COVERED ANY REMAINING REVENUES ARE REINVESTED IN THE OPERATION OF THE HOSPITAL IN ORDER TO ENHANCE OUR ABILITY TO CARRY OUT OUR LOCAL MISSION OF TAKING CARE OF OUR COMMUNITIES CITIZENS IN 2013 WE WORKED WITH THE WORTH COUNTY HEALTH DEPARTMENT TO ENABLE THEM TO SUPPORT TWO HEALTH PREVENTION TYPE PROGRAMS ONE PROGRAM WAS STROKE AND HEART ATTACK PREVENTION SHAPP THE SECOND PROGRAM WAS A DIABETES PROGRAM THE COST TO THE HOSPITAL WAS 45619 THE HOSPITAL PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS WHICH COVER MANY GEORGIANS HEALTH CARE NEEDS AND BY SO DOING FOREGOES SOME CHARGES AND HAS UNREIMBURSED EXPENSES CHARGES FOREGONE DESCRIBED AS CONTRACTUAL ADJUSTMENTS AND COSTS NOT REIMBURSED DESCRIBED AS INDIGENT OR CHARITY CARE ARE OUTLINED BELOW THE MEDICAL CENTER ALSO OPERATES TWO RURAL HEALTH CLINICS RHCS WHICH ALSO FOREGO SOME CHARGES AND HAVE COSTS NOT REIMBURSED THROUGH PATIENTS QUALIFYING FOR THESE SAME INDIGENT AND CHARITY PROGRAMS THE AMOUNTS LISTED BELOW ARE ALL INCLUSIVE OF BOTH HOSPITAL AND CLINIC ACTIVITIES ESTIMATED UNREIMBURSED MEDICARE 4162760 ESTIMATED UNREIMBURSED MEDICAID 2512285 ESTIMATED INDIGENT AND CHARITY CARE 3539178 TOTALS 10214223 PATIENTS WHOSE INCOME FALLS BELOW 225 OF FEDERAL POVERTY GUIDELINES ARE ELIGIBLE TO APPLY FOR ASSISTANCE THROUGH THE INDIGENT PROGRAM COST TO SUPPORT THE COMMUNITY HEALTH NEEDS ASSESSMENT AND REPORTING WAS 25133 |
| PHOEBE WORTH MEDICAL CENTER INC LINE NUMBER 1 PART V LINE 3 | PART V LINE 3 | THE HOSPITALS CHIEF ADMINISTRATIVE OFFICER APPOINTED INDIVIDUALS TO SERVE ON THE CHNA HOSPITAL STEERING COMMITTEE CHSC THE CHSC IDENTIFIED COMMUNITY LEADERS PARTNERS AND REPRESENTATIVES TO INCLUDE IN THE CHNA PROCESS INDIVIDUALS AGENCIES PARTNERS POTENTIAL PARTNERS AND OTHERS WERE REQUESTED TO WORK WITH THE HOSPITAL TO 1 ASSESS THE NEEDS OF THE COMMUNITY 2 REVIEW AVAILABLE COMMUNITY RESOURCES AND 3 PRIORITIZE THE HEALTH NEEDS OF THE COMMUNITY GROUPS OR INDIVIDUALS WHO REPRESENT MEDICALLYUNDERSERVED POPULATIONS LOW INCOME POPULATIONS MINORITY POPULATIONS AND POPULATIONS WITH CHRONIC DISEASES WERE INCLUDED THE HOSPITAL IDENTIFIED OVER 40 COMMUNITY MEMBERS TO PARTICIPATE IN THE CHNA PROCESS TWOHOUR COMMUNITY HEALTH INPUT MEETINGS COMMUNITY MEETINGS AND ONEHOUR COMMUNITY STAKEHOLDER INTERVIEWS STAKEHOLDER INTERVIEWS WERE ESSENTIAL PARTS OF THE CHNA PROCESS TWO COMMUNITY MEETINGS AND FIVE STAKEHOLDER INTERVIEWS WERE CONDUCTED IN ORDER TO OBTAIN THE COMMUNITYS INPUT INTO THE HEALTH NEEDS OF WORTH COUNTY EACH COMMUNITY MEETING WAS DRIVEN BY AN AGENDA PLANNED IN ADVANCE SIGNIN SHEETS AND EVALUATIONS WERE ALSO USED THE COMMUNITY HEALTH PROFILE WAS SHARED WITH THE PARTICIPANTS AT EACH MEETING PARTICIPANTS WERE ASKED ABOUT THEIR OBSERVATIONS ON THE HEALTH DATA PRESENTED IN THE PROFILE IN ADDITION PARTICIPANTS WERE REQUESTED TO PROVIDE INPUT AS TO NEEDS THAT MAY NOT HAVE BEEN IDENTIFIED IN THE PROFILE QUESTIONS AND DISCUSSIONS WERE ENCOURAGED WITH THE OBJECTIVE THAT PARTICIPANTS WOULD INCREASE THEIR UNDERSTANDING OF WHAT THE DATA MEANT IN TERMS OF THE BURDEN OF CHRONIC DISEASES THE IMPACT OF THE DEMOGRAPHICS OF THE POPULATION ON HEALTH SERVICES AND HEALTH STATUS HEALTH BEHAVIORS AS WELL AS ACCESS TO HEALTHCARE AS THE GROUP DISCUSSED THE HEALTH PROBLEMS OR HEALTH ISSUES THE FACILITATOR MADE A LIST OF THE HEALTH PROBLEMS THE COMMUNITY PARTICIPANTS INDICATED WERE IMPORTANT AT THE END OF THE DISCUSSION PRIORITY ISSUES WERE IDENTIFIED THESE PRIORITIES DID NOT REFLECT PROGRAMS SERVICES OR APPROACHES TO RESOLVING PROBLEMS BUT RATHER HEALTH ISSUES TO BE ADDRESSED COMMUNITY PARTICIPANTS INCLUDED PHYSICIANS AND OTHER MEDICAL PROFESSIONALS EDUCATORS ENTREPRENEURS AND OTHER BUSINESSMEN AND WOMEN PROFESSIONALS REPRESENTATIVES FROM THE DEPARTMENT OF FAMILY AND CHILDREN SERVICES HOUSING AUTHORITY AND THE HEALTH DEPARTMENT |
| PHOEBE WORTH MEDICAL CENTER INC LINE NUMBER 1 PART V LINE 5C | PART V LINE 5C | A COMPLETE COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE FOUND AT HTTPWWWPHOEBEPUTNEYCOMMEDIAFILEPHOEBEWORTHCHNAPHOEBE 20WORTH2013PDF |
| PHOEBE WORTH MEDICAL CENTER INC LINE NUMBER 1 PART V LINE 7 | PART V LINE 7 | COMMUNITY WORK PLAN FOR ACCESS TO CARE TRANSPORTATION CHNA PAGE REFERENCE PAGES 91 9394 IT IS BEYOND THE HOSPITALS MISSION AND FINANCIAL RESOURCES TO PROVIDE TRANSPORTATION THE HOSPITAL WILL INCREASE ACCESS TO HEALTH SERVICES BY PROVIDING SCREENINGS AND OTHER FORMS OF PREVENTIVE CARE IN COMMUNITY LOCATIONS OTHER THAN THE HOSPITALS MAIN CAMPUS THE HOSPITAL WILL PROVIDE A COMMUNITY RESOURCE DIRECTORY THAT WILL GUIDE INDIVIDUALS TO TRANSPORTATION SERVICES |
| PHOEBE WORTH MEDICAL CENTER INC LINE NUMBER 1 PART V LINE 20D | PART V LINE 20D | UNDER THE ORGANIZATIONS FINANCIAL ASSISTANCE POLICY FOR 2013 ALMOST ALL ELIGIBLE PATIENTS QUALIFIED FOR 100 FREE CARE |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WORTH COUNTY HEALTH DEPARTMENT | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1012 W FRANKLIN STREET | AddressLine1 |
| City | SYLVESTER | City |
| State | GA | State |
| ZIP Code | 31791 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 581568404 | EINOfRecipient |
| Amount Of Cash Grant | 45619 | AmountOfCashGrant |
| Purpose Of Grant | SEE PART IV | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of Other Organizations | 1 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE I, PAGE 4, PART IV | ReturnReference |
| Explanation | IN 2013, PWMC WORKED WITH THE WORTH COUNTY HEALTH DEPARTMENT TO ENABLE THEM TO SUPPORT TWO HEALTH PREVENTION TYPE PROGRAMS. ONE PROGRAM WAS STROKE AND HEART ATTACK PREVENTION (SHAPP), THE SECOND PROGRAM WAS A DIABETES PROGRAM. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| TitleTitle | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOEL WERNICK | ||||||||||||
| BD MEMBERPPHS CEO | 744316 | 205312 | 7563 | 901513 | 12829 | 1871533 | ||||||
| JOE AUSTIN | ||||||||||||
| BOARD MEMBER | 429591 | 97391 | 11701 | 88097 | 14822 | 641602 | ||||||
| KERRY LOUDERMILK | ||||||||||||
| PPHS CFO | 395303 | 90794 | 9807 | 108963 | 15554 | 620421 | ||||||
| KIM GILMAN | ||||||||||||
| CAO | 133465 | 18281 | 3781 | 2908 | 1149 | 159584 | ||||||
| TIM TROTTIER | ||||||||||||
| SVP REG OPERATIONS | 277595 | 64927 | 1950 | 69897 | 16871 | 431240 | ||||||
| TINA JENKINS | ||||||||||||
| REHAB DIRECTOR | 98297 | 56448 | 142 | 3072 | 9636 | 167595 | ||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION | SCHEDULE J, PAGE 1, PART I, LINE 3 | NONE OF THE INDIVIDUAL BOARD MEMBERS OR OFFICERS ARE COMPENSATED BY THE FILING ORGANIZATION AND THE ORGANIZATION MUST RELY ON THE METHODS EMPLOYED BY THE RELATED ORGANIZATION, PHOEBE PUTNEY HEALTH SYSTEMS, INC (PPHS), TO DETERMINE REASONABLE COMPENSATION FOR THE INDIVIDUALS. |
| SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS | SCHEDULE J, PAGE 1, PART I, LINE 4 | JOEL WERNICK 0 854,100 0 JOE AUSTIN 0 71,400 0 KERRY LOUDERMILK 0 71,100 0 TIM TROTTIER 0 53,200 0 |
| OTHER ADDITIONAL INFORMATION | SCHEDULE J, PART III | PART I, LINE 4 - DEFERRED COMPENSATION PLAN 457(B) THE DEFERRED COMPENSATION PLAN IS AN ADDITIONAL RETIREMENT PLAN OFFERED THROUGH PHOEBE PUTNEY. THE 457(B) PLAN IS A NON-QUALIFIED RETIREMENT PLAN THAT ALLOWS ONE TO DEFER ADDITIONAL DOLLARS TOWARDS RETIREMENT. HIGHLIGHTS INCLUDE: O NOT LIMITED BY THE AMOUNTS DEFERRED INTO THE PHOEBE 403(B) O PLAN IS SUBJECT TO ANNUAL DEFERRAL LIMITS SET BY THE IRS O PER IRS REGULATIONS, EACH PARTICIPANT IS A GENERAL UNSECURED CREDITOR OF THE PLAN SPONSOR, CREATING A RISK OF FORFEITURE SENIOR VICE PRESIDENTS AND ABOVE AND PHYSICIANS MAKING OVER 115,000 ARE ELIGIBLE TO PARTICIPATE IN THE 457(B) PLAN. SCHEDULE J, PART II, COLUMN C A SUBSTANTIAL PORTION OF THE AMOUNT REPORTED IN COLUMN C OF SCHEDULE J, PART II (RETIREMENT AND OTHER DEFERRED COMPENSATION) FOR EMPLOYEES IDENTIFIED ABOVE IS A SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM. THE PURPOSE OF THE PLAN IS TO PROVIDE A RETIREMENT BENEFIT FOR AFFECTED EXECUTIVES CONSISTENT WITH THE BENEFIT AVAILABLE TO EMPLOYEES NOT IMPACTED BY IRS COMPENSATION LIMITS ON DEFINED BENEFIT PLANS. THE AMOUNTS REPORTED AS SUPPLEMENTAL EXECUTIVE RETIREMENT COMPENSATION FOR AFFECTED EMPLOYEES REPRESENTS CREDITED, BUT NOT VESTED, RETIREMENT BENEFITS AND IS AVAILABLE IN FUTURE PERIODS TO THE EMPLOYEE SUBJECT TO CONTINUING EMPLOYMENT. PPHS MAINTAINS OWNERSHIP OF THE FUNDS ALLOCATED TO THE PARTICIPANT. PRIOR TO NORMAL RETIREMENT AGE, PPHS RETAINS AT LEAST THREE YEARS OF DEPOSITS WHICH ARE SUBJECT TO CONTINUING EMPLOYMENT FOR THE PARTICIPANT TO RECEIVE THE FUNDS. THIS PLAN IS A DEFINED CONTRIBUTION ACCOUNT BASED AND PARTICIPANT DIRECTED INVESTMENT PROGRAM THAT IS EMPLOYEE FUNDED. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ELECTION OF MEMBERS AND THEIR RIGHTS | FORM 990, PAGE 6, PART VI, LINE 7A | THE BOARD OF DIRECTORS OF PHOEBE PUTNEY HEALTH SYSTEM, INC. (PPHS), THE PARENT ORGANIZATION, HAS THE RIGHT TO APPOINT DIRECTORS OF THE FILING ORGANIZATION. |
| DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PAGE 6, PART VI, LINE 7B | THE MEMBER SHALL HAVE THE FOLLOWING RESPONSIBILITIES: - THE MEMBER SHALL SELECT OR REMOVE THE ORGANIZATION'S OFFICERS. - THE MEMBER SHALL APPROVE ALL AMENDMENTS TO THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS BEFORE THEY MAY BECOME EFFECTIVE. - THE MEMBER SHALL APPROVE ANY ANNUAL OPERATING OR CAPITAL BUDGETS. - THE MEMBER SHALL APPOINT OR REMOVE THE INDEPENDENT AUDITORS. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE INDEPENDENT ACCOUNTING FIRM THAT PREPARES THE FORM 990 (BASED UPON INFORMATION PROVIDED BY THE ORGANIZATION) PROVIDES A COPY OF THE RETURN TO BE REVIEWED BY MANAGEMENT. UPON REVIEW, THE FORM 990 IS THEN FORWARDED TO THE FINANCE COMMITTEE FOR THEIR REVIEW, TO GAIN THEIR COMMENTS AND APPROVAL. UPON APPROVAL FROM THE FINANCE COMMITTEE, THE FORM 990 AND RELATED SCHEDULES ARE PROVIDED TO ALL BOARD MEMBERS FOR REVIEW AND FEEDBACK. ONCE THE FORM 990 IS REVIEWED BY ALL APPLICABLE PARTIES, A COPY OF THE FINAL VERSION IS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO FILING. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | ON AN ANNUAL BASIS, PHOEBE WORTH MEDICAL CENTER, INC. (PWMC) BOARD MEMBERS AS WELL AS ALL OFFICERS COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. THIS QUESTIONNAIRE IS ADMINISTERED BY THE PHOEBE PUTNEY HEALTH SYSTEM (PPHS) COMPLIANCE DEPARTMENT AND THE DOCUMENT ASKS EACH INDIVIDUAL TO DISCLOSE ANY PERSONAL, BUSINESS, OR OTHER AFFILIATIONS AND MONETARY AMOUNT IF APPLICABLE THAT THEY OR THEIR IMMEDIATE FAMILY MEMBERS HAVE HAD WITHIN THE PAST 12 MONTHS WITH PWMC OR ANY RELATED ENTITIES. ALL RESPONSES ARE THEN EVALUATED BY THE PPHS COMPLIANCE DEPARTMENT. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | THE ORGANIZATION'S FORMAL PROCESS FOR DETERMINING TOTAL COMPENSATION FOR THE CEO IS INTENDED TO PROVIDE REASONABLE COMPENSATION FOR ACCOMPLISHING THE ORGANIZATION'S MISSION, ACHIEVE ITS STRATEGIC GOALS, TO RECOGNIZE PERFORMANCE, AND TO OPERATE IN KEEPING WITH THE ORGANIZATION'S OBLIGATIONS AS A TAX-EXEMPT CHARITABLE ORGANIZATION. THE EXECUTIVE COMPENSATION COMMITTEE OF PPHS'S BOARD OF DIRECTORS CONDUCTS AN ANNUAL REVIEW OF THE COMPENSATION OF THE CEO. THE COMMITTEE RETAINS A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT TO CONDUCT COMPETITIVE MARKET ANALYSIS OF THE MARKET RANGES OF BASE, INCENTIVE AND TOTAL CASH COMPENSATION. THE INFORMATION THE COMMITTEE MAY CONSIDER CAN INCLUDE BUT IS NOT LIMITED TO THE PERFORMANCE OF AN INDIVIDUAL, THE PERFORMANCE OF THE ORGANIZATION, AN INDIVIDUAL'S LENGTH OF SERVICE, CREDENTIALS AND EXPERIENCE, THE ELEMENTS OF TOTAL COMPENSATION AND SALARY HISTORY, THE ORGANIZATION'S COMPENSATION TARGETS, AND COMPARABILITY DATA, INCLUDING THE DATA PREPARED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE COMMITTEE. THE COMMITTEE INCORPORATES A FORMAL PERFORMANCE APPRAISAL PROCESS IN THE CEO COMPENSATION REVIEW. IT UTILIZES A MULTI-PERSPECTIVE APPROACH AND PERFORMANCE MEASURES WHICH ARE LINKED TO THE ORGANIZATION'S LONG-TERM STRATEGIC PLAN AND ACHIEVEMENT OF ANNUAL SYSTEM OBJECTIVES. THE CEO IS NOT PRESENT WHEN THE COMMITTEE DISCUSSES AND ESTABLISHES HIS COMPENSATION. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | SEE NARRATIVE FOR 15A. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION MAKES AVAILABLE TO THE PUBLIC ITS CONFLICT OF INTEREST AND AUDITED FINANCIAL STATEMENTS ON THE ORGANIZATION'S WEBSITE, BY PROVIDING COPIES UPON REQUEST, AND BY INSPECTION AT THE ADMINISTRATIVE OFFICES OF THE ORGANIZATION. |
| OTHER FEES FOR SERVICES | FORM 990, PART IX, LINE 11G | PHYSICIAN FEES 2,043,706 0 0 CONSULTANT FEES 266,622 403,861 0 COLLECTION SERVICES 0 120,214 0 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| PHOEBE PUTNEY HEALTH SYSTEMS INC | ||||||||||
| PO BOX 3770 | ALBANY | GA | 31706 | 582001014 | HEALTHCARE | GA | 501C3 | 11A | NA | false |
| PHOEBE PUTNEY MEMORIAL HOSPITAL INC | ||||||||||
| PO BOX 3770 | ALBANY | GA | 31706 | 581928247 | HEALTHCARE | GA | 501C3 | 3 | PPHS | false |
| PHOEBE PHYSICIAN GROUP INC | ||||||||||
| PO BOX 3770 | ALBANY | GA | 31706 | 263792403 | HEALTHCARE | GA | 501C3 | 9 | PPHS | false |
| PHOEBE SUMTER MEDICAL CENTER INC | ||||||||||
| 126 HIGHWAY 280 WEST | AMERICUS | GA | 31719 | 263975185 | HEALTHCARE | GA | 501C3 | 3 | PPHS | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | true | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |