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A PORTION OF THOSE DUES IS ALLOCATED TO LOBBYING ACTIVITIES IN WHICH THESE NATIONAL AND STATE HEALTHCARE ORGANIZATIONS PARTICIPATE. 175676 175676 4200052 1995845 2204207 149829 82051 67778 6678348 4282356 2395992 4843653 DUE TO PHOEBE PUTNEY HEALTH SYSTEMS 12368396 12368396 X 14993784 52163 52163 14941621 14941621 16892195 52163 52163 16840032 16840032 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. 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RHC 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 true WORTH COUNTY HEALTH DEPARTMENT 1012 W FRANKLIN STREET SYLVESTER GA 31791 581568404 45619 SEE PART IV 1 ADDITIONAL INFORMATION SCHEDULE I, PAGE 4, PART IV 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. false true false false false false false false false JOEL WERNICK 744316 205312 7563 901513 12829 1871533 JOE AUSTIN 429591 97391 11701 88097 14822 641602 KERRY LOUDERMILK 395303 90794 9807 108963 15554 620421 KIM GILMAN 133465 18281 3781 2908 1149 159584 TIM TROTTIER 277595 64927 1950 69897 16871 431240 TINA JENKINS 98297 56448 142 3072 9636 167595 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. 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 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 false false false false true false false false false false false false true false true false true false false