2013-05-15T16:17:42-05:00 2012-06-30 ERNST & YOUNG US LLP 55 IVAN ALLEN JR BLVD STE 1000 ATLANTA GA 30308 990 2011-07-01 580566213 Piedmont Hospital Inc % MARIE GAFFNEY PIED 4044251303 1968 PEACHTREE ROAD NW ATLANTA GA 303091285 CHARLIE HALL 2013-05-15 4048748300 2011 2016-02-24 21:20:13Z Dr Patrick M Battey 1968 PEACHTREE ROAD NW ATLANTA GA 30309 1015718599 false X WWW.PIEDMONT.ORG X 1905 GA TO PROVIDE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE IN A PROGRESSIVE ENVIRONMENT, GUIDED BY PHYSICIANS, DELIVERED BY EXCEPTIONAL PROFESSIONALS, AND INSPIRED BY THE COMMUNITIES WE SERVE. 16 12 4185 400 4814973 6093577 2206036 706531500 719031160 20014761 22476129 11724574 12336889 744364412 756050214 367486 269452 0 0 255649503 247684057 0 0 0 405541941 387630113 661558930 635583622 82805482 120466592 1401215248 1973577308 833929688 1397259921 567285560 576317387 X TO PROVIDE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE IN A PROGRESSIVE ENVIRONMENT, GUIDED BY 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false false false false false X 16 12 false false false false true true true true true false false true true true true true true true true true false GA X MARIE GAFFNEY 6788426007 2727 PACES FERRY RD BUILDING 2 ST ATLANTA GA 30339 X Dr William Blincoe 1.0 X 0 626988 44553 Mr Bill Linginfelter 1.0 X 0 0 0 Dr Carol T Aitcheson 1.0 X 0 473017 41465 Dr Letha Yurko Griffin 1.0 X 0 0 0 Mr Gary T Jones 1.0 X 0 0 0 Dr Louis H Jacobs 1.0 X 0 0 0 Ms Nell Long 1.0 X 0 0 0 Dr Bryant Wilson 1.0 X 0 0 0 Dr Philip Brachman 1.0 X 0 0 0 Mr Shouky Shaheen 1.0 X 0 0 0 Dr Patrick M Battey 2.0 X X 0 447357 35786 Mr Leslie A Donahue 55.0 X X 881387 0 61075 Dr Hewitt W Matthews 1.0 X 0 0 0 Mr Douglas Stuart 1.0 X 0 0 0 Dr Jay Singh 1.0 X 0 0 0 Dr Robert Miller 1.0 X 0 0 0 Mr Charlie Hall 2.0 X 0 678646 88941 Ms Debbie W Gramling 2.0 X 0 161197 34899 Mr Thomas Arnold 52.0 X 353478 0 62559 Ms Denise Ray 55.0 X 389425 0 38302 Mr Robert Merz 55.0 X 194308 0 35114 Ms Connie Whittington 55.0 X 402005 0 66146 Mr 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15417924 15761021 353065705 931763929 1401215248 1973577308 50586054 45614594 0 0 0 0 466922801 463905000 0 0 0 0 28460499 72517169 0 0 287960334 815223158 833929688 1397259921 X 530441527 539592810 14096222 14293843 22747811 22430734 567285560 576317387 1401215248 1973577308 X 120466592 -111434765 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 285489 false false 285489 false Lobbying Activities SCHEDULE C, PART II-B, LINE 1(G) HEALTH CARE POLICY IS CRITICAL TO ALL AMERICANS, AND PIEDMONT HOSPITAL BELIEVES THAT HEALTH CARE PROVIDERS MUST PARTICIPATE IN SHAPING HEALTH CARE POLICY BY INTERACTING WITH NATIONAL, STATE, AND LOCAL REPRESENTATIVES AND THEIR STAFF MEMBERS TO HELP THEM BETTER UNDERSTAND THE COMPLEXITIES AND RAMIFICATIONS OF KEY HEALTH CARE POLICIES INCLUDING, WITHOUT LIMITATION, THOSE RELATED TO UNINSURED AND INDIGENT PATIENT NEEDS, AS WELL AS THE IMPORTANCE OF ASSURING THE DELIVERY OF COST-EFFICIENT, QUALITY HEALTH CARE. PIEDMONT HEALTHCARE'S VICE PRESIDENT OF GOVERNMENT AND EXTERNAL AFFAIRS REPRESENTED THE INTERESTS OF PIEDMONT HEALTHCARE (EIN 58-1503902), PIEDMONT HOSPITAL (58-0566213), AND RELATED ENTITIES BEFORE FEDERAL, STATE, AND LOCAL ELECTED OFFICIALS AND REGULATORS. 362297000 8173300 -378705 370849005 343861628 18073893 -361479 362297000 293945492 49633360 -282776 343861628 347223727 149534 -53718394 -290625 293945492 1.00000 0.00000 0.00000 true false 11747623 11747623 452094254 280979223 171115031 17663866 315821 17348046 251945616 199219783 52725833 1090469 0 1090469 254027002 BENEFICIAL INT IN PERP TRUST 7939146 DUE FROM RELATED PARTIES 912588447 UNAMORTIZED LOAN DISCOUNT 11236336 931763929 0 DUE TO RELATED PARTIES 674266494 ACCRUED PENSION COSTS 67637999 SELF INSURANCE RESERVES 34541974 INTEREST SWAPS 34904213 SERP PAYABLE 1181546 OTHER DEFERRALS 2690932 815223158 ASC 740 FOOTNOTE (FKA FIN 48) SCHEDULE D, PART X, LINE 2 THE COMPANY ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF THE INCOME TAXES TOPIC OF ASC (ASC 740). UNDER THE REQUIREMENTS OF ASC 740, TAX-EXEMPT ORGANIZATIONS MAY BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2012. true true X true X true X true true false true true 10466716 0 10466716 0.01750 22568132 15561186 7006946 0.01170 8964845 1619236 7345609 0.01230 41999693 17180422 24819271 0.04150 481524 0 481524 0.00080 398472 0 398472 0.00070 461635 0 461635 0.00080 4027984 2046496 1981488 0.00330 117457 0 117457 0.00020 5487072 2046496 3440576 0.00580 47486765 19226918 28259847 0.04730 true 36091557 1082747 152654100 166639952 -13985852 X true true Peachtree Orthopedic Orthopedic Surgery 0.15000 0.85000 Digestive Healthcare Endo/GI Surgery 0.15000 0.85000 Piedmont West ASC ambulatory surgery 0.73500 0.26500 1 1 Piedmont Hospital Inc

1968 Peachtree Road NW Atlanta GA 30309

X X X Piedmont Hospital Inc 1 true true 200. true 300. true X X X X true true X X X X X X true false true X false false 1. REQUIRED DESCRIPTIONS SCHEDULE H, PART VI, LINE 1: REQUIRED DESCRIPTIONS PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6A A REPORT ON PIEDMONT FAYETTE HOSPITAL'S COMMUNITY BENEFITS IS FOUND WITHIN PIEDMONT HEALTHCARE, INC.'S (PIEDMONT FAYETTE HOSPITAL'S SOLE MEMBER) ANNUAL REPORT, WHICH IS WIDELY DISTRIBUTED TO THE PUBLIC BOTH THROUGH PRINTED COPIES MADE AVAILABLE TO COMMUNITY MEMBERS UPON REQUEST AND THROUGH PUBLICATION ON THE PIEDMONT HEALTHCARE'S WEBSITE. ADDITIONALLY, THE REPORT WAS MAILED TO PIEDMONT FAYETTE HOSPITAL AND PIEDMONT HEALTHCARE BOARD MEMBERS, STATE AND LOCAL ELECTED OFFICIALS, AND OTHER KEY STAKEHOLDERS. PERCENT OF TOTAL EXPENSE SCHEDULE H, PART I, LINE 7(F) THE DENOMINATOR USED FOR THE CALCULATION OF COLUMN (F), PERCENT OF TOTAL EXPENSE, WAS THE AMOUNT OF TOTAL FUNCTIONAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) OF $635,583,622, LESS BAD DEBT EXPENSE OF $36,091,557 FROM FORM 990, PART IX, LINE 24(A). FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST SCHEDULE H, PART I, LINE 7 A RATIO OF PATIENT CARE COST TO CHARGES, CONSISTENT WITH WORKSHEET 2, WAS USED TO REPORT THE AMOUNTS IN PART I, LINES 7A-7D. FOR AMOUNTS ON LINES 7E-7K, ACTUAL EXPENSES FOR EACH COMMUNITY BENEFIT ACTIVITY ARE TRACED AND REPORTED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. BAD DEBT EXPENSE CALCULATION AND FOOTNOTE SCHEDULE H, PART III, LINE 4 BASED ON PRIOR EXPERIENCE AND CERTAIN DEMOGRAPHICS AND OTHER INFORMATION OBTAINED DURING ADMISSION, THE ORGANIZATION BELIEVES A PORTION OF THE BAD DEBT EXPENSES AT COST IS ATTRIBUTABLE TO PATIENTS THAT WOULD OTHERWISE QUALIFY FOR CHARITY CARE. DESPITE ITS BEST EFFORTS TO EDUCATE PATIENTS ABOUT QUALIFYING FOR ITS CHARITY CARE PROGRAM (AS DISCUSSED IN PART IV, QUESTION 3 BELOW), MANY UNINSURED PATIENTS EITHER REFUSE OR FAIL TO COMPLETE A CHARITY CARE APPLICATION OR PROVIDE SUFFICIENT INFORMATION AT THE TIME OF ADMISSION, DURING THEIR STAY, OR AFTER BEING DISCHARGED TO QUALIFY FOR ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. THE AMOUNT REPORTED ON PART III, LINE 3, WAS DETERMINED BY TAKING THE AVERAGE ACCEPTANCE RATE FOR ALL CHARITY CARE APPLICATIONS RECEIVED DURING THE YEAR MULTIPLIED BY THE NUMBER OF DENIALS THAT WERE ATTRIBUTABLE TO INSUFFICIENT INFORMATION. THAT TOTAL WAS THEN ADJUSTED DOWNWARD FOR THE ORGANIZATION'S USE OF PRESUMPTIVE ELIGIBILITY WHEN DETERMINING ITS COMMUNITY BENEFITS. BAD DEBT EXPENSE FOOTNOTE FROM CONSOLIDATED, AUDITED FINANCIAL STATEMENTS: THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYER CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. PIEDMONT HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE ARE NOT REPORTED AS REVENUE. MEDICARE SHORTFALLS AS COMMUNITY BENEFIT SCHEDULE H, PART III, LINE 8 THE AMOUNT REPORTED ON PART III, SECTION B, LINE 6 WAS CALCULATED IN ACCORDANCE WITH THE SCHEDULE H INSTRUCTIONS AND UTILIZING THE ORGANIZATION'S ALLOWABLE MEDICARE COST AS REPORTED IN THE MEDICARE COST REPORT, WHICH IS BASED ON A COST TO CHARGE RATIO. HOWEVER, THE ALLOWABLE COSTS IN THE MEDICARE COST REPORT DO NOT REFLECT THE ACTUAL COST OF PROVIDING CARE TO PATIENTS SINCE THE MEDICARE COST REPORT EXCLUDES MANY DIRECT PATIENT CARE COSTS THAT ARE ESSENTIAL TO PROVIDING QUALITY HEALTHCARE FOR MEDICARE PATIENTS. FOR EXAMPLE, CERTAIN COVERAGE FEES TO PHYSICIANS, COST OF MEDICARE C AND D, AND OTHER SIMILAR DIRECT PATIENT CARE EXPENSES ARE SPECIFICALLY EXCLUDED FROM ALLOWABLE COST IN THE MEDICARE COST REPORT. THE ORGANIZATION BELIEVES THAT PIEDMONT HOSPITAL'S MEDICARE SHORTFALL REPORTED ON PART III, LINE 7 OF SCHEDULE H, SHOULD BE CONSIDERED A COMMUNITY BENEFIT AS THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO ELDERLY AND MEDICARE PATIENTS. IRS REVENUE RULING 69-545 PROVIDES, IN PART, THAT HOSPITALS SERVING PATIENTS WITH GOVERNMENTAL HEALTH INSURANCE, SUCH AS MEDICARE, IS AN INDICATION THE HOSPITAL OPERATES TO PROMOTE HEALTH IN THE COMMUNITY. ADDITIONALLY, MEDICARE ACCOUNTED FOR 21.6 PERCENT OF PIEDMONT HOSPITAL'S PATIENT SERVICE REVENUE. PIEDMONT HOSPITAL'S POLICY IS TO TREAT MEDICARE PATIENTS, REGARDLESS OF THE EXTENT TO WHICH MEDICARE ACTUALLY PAYS FOR THE TREATMENT. FOR MANY SERVICES, MEDICARE'S REIMBURSEMENT IS LESS THAN THE COST OF THE CARE PROVIDED, RESULTING IN SHORTFALLS THAT ARE TO BE ABSORBED BY THE HOSPITAL IN HONOR OF PIEDMONT HOSPITAL'S COMMITMENT TO TREAT ELDERLY PATIENTS. MANY OF THESE PATIENTS LIVE ON A LOW, FIXED INCOME, AND WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER MEANS-TESTED PROGRAMS, ABSENT THEIR ENROLLMENT IN MEDICARE. COLLECTION PRACTICES SCHEDULE H, PART III, LINE 9(B) INITIAL SCREENINGS OF ALL INPATIENT, EMERGENCY, AND SURGERY ENCOUNTERS, AS WELL AS MOST OUTPATIENT VISITS, ARE CONDUCTED BY FINANCIAL COUNSELORS IN ORDER TO IDENTIFY ANY AVAILABLE INSURANCE OR OTHER COVERAGE FOR EACH PATIENT. COUNSELORS CONTACT PATIENTS AND THEIR FAMILIES DIRECTLY, EITHER IN PERSON OR BY LETTER, TO ASSIST THE FAMILY IN IDENTIFYING ANY PROGRAMS FOR WHICH THE PATIENT/SERVICE MAY QUALIFY (INCLUDING MEDICAID, STATE CHILDREN'S HEALTH INSURANCE PROGRAM ("SCHIP"), PRIVATE OR GOVERNMENT INSURANCE COVERAGE, AND CHARITY ASSISTANCE). IF THE FAMILY CANNOT BE TIMELY LOCATED OR IS UNCOOPERATIVE, RELATED ACCOUNTS ARE TRANSFERRED TO AN INTERNAL COLLECTION DEPARTMENT FOR FURTHER ATTEMPTS TO OBTAIN PAYMENT OR, IF THE PATIENT MAY QUALIFY FOR ASSISTANCE, TO SECURE A FINANCIAL ASSISTANCE APPLICATION. THE ORGANIZATION'S DEBT COLLECTION POLICY AND PROCEDURES PROHIBIT ANY COLLECTION EFFORTS FOR THE PORTION OF A PATIENT ACCOUNT BALANCE THAT QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. 2. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2: NEEDS ASSESSMENT IN FY 2012, PIEDMONT HOSPITAL BEGAN THE PRELIMINARY STEPS TO CONDUCT A FORMAL NEEDS ASSESSMENT, WHICH COMMENCED IN FY 2013. THOSE STEPS INCLUDED A THOROUGH REVIEW OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT REGULATIONS REGARDING COMMUNITY HEALTH NEEDS ASSESSMENTS; THE FORMATION OF AN IMPLEMENTATION PLAN; IDENTIFICATION OF KEY STAKEHOLDERS TO ENGAGE IN THE PROCESS; AND THE ESTABLISHMENT OF A COMMUNITY BENEFITS DEPARTMENT TO EXECUTE THE ASSESSMENT. 3. PATIENT EDUCATION OF ASSISTANCE ELIGIBILITY SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ASSISTANCE ELIGIBILITY PIEDMONT HEALTHCARE UNDERSTANDS THAT NOT EVERYONE WILL HAVE THE ABILITY TO PAY THEIR HOSPITAL BILL DUE TO THEIR INSURANCE STATUS OR A LIMITED INCOME, AND BECAUSE OF THIS, PIEDMONT HOSPITAL OFFERS FINANCIAL ASSISTANCE TO QUALIFYING PATIENTS. INFORMATION ABOUT AND CONTACT NUMBERS FOR FINANCIAL ASSISTANCE ARE PROVIDED IN NOTICES INSERTED IN PATIENT BILLS AND POSTED IN EMERGENCY ROOMS, IN THE CONDITIONS OF ADMISSION FORM, AT ADMITTING AND REGISTRATION DEPARTMENTS, AT HOSPITAL BUSINESS OFFICES, AT PATIENT FINANCIAL SERVICES OFFICES THAT ARE LOCATED ON FACILITY CAMPUSES, AND AT OTHER PUBLIC PLACES THE HOSPITAL MAY ELECT, INCLUDING LOCAL LOW-COST CLINICS PRIMARILY TREATING UNINSURED POPULATIONS. PIEDMONT HOSPITAL WILL ALSO PUBLISH AND WIDELY PUBLICIZE A SUMMARY OF THIS FINANCIAL ASSISTANCE CARE POLICY ON ITS FACILITY WEBSITE, WHICH WILL INCLUDE A LINK TO THE FULL POLICY. REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY STAFF OR MEDICAL STAFF MEMBER AT THE HOSPITAL, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS AND RELIGIOUS SPONSORS. A REQUEST FOR FINANCIAL ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. 4. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4: COMMUNITY INFORMATION PIEDMONT HOSPITAL IS LOCATED IN FULTON COUNTY, AND ITS PRIMARY SERVICE COMMUNITIES ARE FULTON COUNTY AND NEARBY DEKALB COUNTY. IN 2010, APPROXIMATELY 1.6 MILLION PEOPLE LIVED IN FULTON AND DEKALB COUNTIES, WITH THE MAJORITY RESIDING IN FULTON. BOTH ARE URBAN COMMUNITIES, AND TOGETHER COMPRISE THE CITY OF ATLANTA. IN BOTH COUNTIES, ABOUT 27 PERCENT OF ADULTS WERE UNINSURED IN 2012, AND OF THOSE INSURED, ABOUT ONE-THIRD RELY ON PUBLIC ASSISTANCE. OF THE PRIVATELY INSURED, AN ESTIMATED ONE-THIRD IS UNDERINSURED. APPROXIMATELY 14 PERCENT OF THE OVERALL ADULT POPULATION IN BOTH COUNTIES REPORTED THEY WERE UNABLE TO SEE A DOCTOR IN 2011 DUE TO COST AND, THAT YEAR, 13 PERCENT REPORTED THEY WERE IN POOR OR FAIR HEALTH, A FIGURE HIGHER THAN THE NATIONAL BENCHMARK OF 10 PERCENT REPORTING THAT LOW LEVEL OF HEALTH. SLIGHTLY LESS THAN 10 PERCENT OF ADULT RESIDENTS HAVE BEEN DIAGNOSED WITH DIABETES, AN AMOUNT ON PAR WITH GEORGIA'S AVERAGE OF 10 PERCENT. VIOLENCE IS A SIGNIFICANT ISSUE IN BOTH FULTON AND DEKALB COUNTIES, WITH RATES THAT THAT SOAR ABOVE BOTH STATE AND NATIONAL BENCHMARKS. IN DEKALB COUNTY, THERE WERE ABOUT 746 VIOLENT CRIME INCIDENTS PER EVERY 100,000 RESIDENTS IN 2011. THAT SAME YEAR, IN FULTON COUNTY, THERE WERE 953 VIOLENT CRIME INCIDENTS PER EVERY 100,000 RESIDENTS, A FIGURE MORE THAN DOUBLE THE STATE AVERAGE AND MORE THAN 13 TIMES THE NATIONAL AVERAGE. THE TEEN BIRTH RATE IN FULTON AND DEKALB COUNTIES IS 47 BIRTHS PER 1,000 TEENAGED WOMEN AND 48 BIRTHS PER 1,000 TEENAGED WOMEN, RESPECTIVELY. COMPARED TO THE NATIONAL AVERAGE OF ONLY 21 BIRTHS PER 1,000 TEENAGED WOMEN, THIS FIGURE IS EXTREMELY HIGH FOR BOTH COUNTIES. ONE IN FIVE ADULTS ARE NOTABLY PHYSICALLY INACTIVE IN BOTH COUNTIES, AND ONE IN FOUR IS OBESE. ACCESS TO HEALTHY FOODS COULD BE AN ISSUE AS ABOUT 7 PERCENT OF FULTON COUNTY'S POPULATION DOES NOT LIVE WITHIN CLOSE PROXIMITY OF A GROCERY STORE THAT SELLS FRESH FRUIT AND VEGETABLES, AND APPROXIMATELY HALF OF THE COUNTY'S RESTAURANTS ARE FAST FOOD ESTABLISHMENTS. 5. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH PIEDMONT HOSPITAL ACTIVELY PROMOTES THE HEALTH OF ITS COMMUNITY THROUGH COMMUNITY-BASED HEALTH SCREENINGS; EDUCATIONAL ACTIVITIES; THE OPERATION OF A 24-HOUR EMERGENCY DEPARTMENT AVAILABLE TO THE ENTIRE COMMUNITY; THE OPERATION OF AN EMERGENCY ROOM OPEN TO ALL MEMBERS OF THE COMMUNITY WITHOUT REGARD TO ABILITY TO PAY; A GOVERNANCE BOARD COMPOSED OF COMMUNITY MEMBERS; USE OF SURPLUS REVENUE FOR FACILITIES IMPROVEMENT, PATIENT CARE, AND MEDICAL TRAINING, EDUCATION, AND RESEARCH; THE PROVISION OF INPATIENT HOSPITAL CARE FOR ALL PERSONS IN THE COMMUNITY ABLE TO PAY, INCLUDING THOSE COVERED BY MEDICARE AND MEDICAID; AND AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFYING PHYSICIANS. 6. AFFILIATED HEALTH CARE SYSTEM SCHEDULE H, PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM THE ORGANIZATION IS PART OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM") SERVING THE HEALTHCARE NEEDS OF NORTH GEORGIA AND, SPECIFICALLY, THE METROPOLITAN ATLANTA AREA. THE SYSTEM EXISTS TO PROVIDE PROGRESSIVE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE TO ALL MEMBERS OF ITS COMMUNITY. COMMUNITY BENEFITS ARE GENERATED THROUGH THE PROVISION OF CHARITY CARE, GOVERNMENT-SPONSORED PROGRAMS (SUCH AS MEDICAID AND MEDICARE), MEDICAL RESEARCH, MEDICAL EDUCATION, COMMUNITY HEALTH IMPROVEMENT SERVICES, DONATIONS TO OTHER NONPROFIT HEALTH CARE PROVIDERS, AND MANY OTHER COMMUNITY SERVICE ACTIVITIES. IN FISCAL YEAR 2011, THE PIEDMONT HEALTHCARE SYSTEM INCLUDED FIVE FULL-SERVICE HOSPITALS, A PHILANTHROPIC FOUNDATION, A CARDIOVASCULAR RESEARCH INSTITUTE, A PHYSICIAN NETWORK, AMBULATORY SURGERY CENTERS, AND OTHER HEALTH CARE PROVIDERS, ALL OF WHICH FALL UNDER THE COMMON CONTROL OF PIEDMONT HEALTHCARE, INC., PIEDMONT HOSPITAL'S SOLE MEMBER. THE SYSTEM'S FIVE HOSPITALS ARE PIEDMONT HOSPITAL, A 488-BED ACUTE TERTIARY CARE FACILITY IN ATLANTA; PIEDMONT FAYETTE HOSPITAL, A 157-BED, ACUTE-CARE COMMUNITY HOSPITAL IN FAYETTEVILLE; PIEDMONT MOUNTAINSIDE HOSPITAL, A 42-BED COMMUNITY HOSPITAL IN JASPER; PIEDMONT NEWNAN HOSPITAL, A 136-BED, ACUTE-CARE COMMUNITY HOSPITAL IN NEWNAN; AND PIEDMONT HENRY HOSPITAL, A 215-BED ACUTE-CARE COMMUNITY HOSPITAL IN STOCKBRIDGE. AS PART OF THE PIEDMONT HEALTHCARE SYSTEM, CERTAIN AFFILIATES MAKE GRANTS AND/OR CONTRIBUTIONS TO OTHER RELATED NONPROFIT AFFILIATES TO HELP FINANCIALLY SUPPORT AND/OR FUND WORTHY COMMUNITY BENEFITS ACTIVITIES. 7. STATE OF FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI, LINE 7: STATE OF FILING OF COMMUNITY BENEFIT REPORT PIEDMONT HOSPITAL IS NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT; HOWEVER THE HOSPITAL IS REQUIRED TO FILE WITH THE GEORGIA DEPARTMENT OF COMMUNITY HEALTH INFORMATION ON ITS INDIGENT AND CHARITY CARE, AS WELL AS ITS MEDICAID AND MEDICARE SHORTFALLS. true Good Samaritan Health Center 1015 Donald Lee Hollowell Pkwy Atlanta GA 30318 582373395 501(c)(3) 17500 Community Service THE LEUKEMIA & LYMPHOMA SOCIETY 3715 NORTHSIDE PARKWAY BLDG 400 S ATLANTA GA 30327 135644916 501(C)(3) 15100 "LIGHT THE NIGHT" EVENT SPONSORSHIP YMCA OF METRO ATLANTA 100 EDGEWOOD AVE NE STE 1100 ALTANTA GA 30303 580566253 501(C)(3) 6000 CHARITABLE GOLF TOURNAMENT SPONSOR GEORGIA TRANSPLANT FOUNDATION 500 Sugar Mill Road Suite 170A ATLANTA GA 30350 582075193 501(C)(3) 10000 Tom Glavine Spring Training Event Alzheimer's Association 41 Perimeter Center East Suite 550 Atlanta GA 30346 581492046 501(C)(3) 15200 Dancing with the Stars event Hands of Hope Clinic Inc 1010 Hospital Dr Bldg B Stockbridge GA 30281 421591970 501(C)(3) 5750 Goblin Gallop Event HINRI Labs Inc 641 Loridans Drive NE Atlanta GA 30342 270169289 501(C)(3) 15000 Military Assistance Henry County Chamber of Commerce 1709 Hwy 20 West McDonough GA 30253 581025691 501(C)(6) 18500 Charitable Events It's the Journey Inc 180 Allen Road Ste 201 South Atlanta GA 30328 470897591 501(C)(3) 15000 2 day walk Men's Health and Wellness Center 1 Glenlake Pkwy Ste 700 Sandy Springs GA 30328 830512342 501(C)(3) 10000 Men's wellness events Mercer University Center for Health and Learning 3001 Mercer University Dr Atlanta GA 303414155 262442849 501(C)(3) 6000 PA Program 10 1 MONITORING THE USE OF GRANT FUNDS SCHEDULE I, PART I, LINE 2 SPONSORSHIPS: MONEY IS GIVEN TO CHARITABLE ORGANIZATIONS WHICH PRIMARILY PROMOTE HEALTH CARE CAUSES. OCCASIONALLY, MONEY IS GIVEN TO CHARITABLE ORGANIZATIONS WHICH ARE NOT HEALTHCARE ORGANIZATIONS. THESE ORGANIZATIONS PROMOTE OTHER WORTHY CAUSES IN THE SURROUNDING COMMUNITY. THE GRANTS ARE ADMINISTERED IN THE PUBLIC RELATIONS DEPARTMENT. FEDERAL GRANTS: GRANT FUNDS ARE MONITORED IN THE GRANTS MANAGEMENT DEPARTMENT. ELIGIBILITY, SELECTION CRITERIA AND ALL NECESSARY RECORDS ARE MAINTAINED BY THIS DEPARTMENT TO ENSURE COMPLIANCE WITH THE RELEVANT REGULATIONS. X true true true true false false false true true false false Dr William Blincoe 0 603821 0 19405 0 3762 0 31800 0 12753 0 671541 0 Mr Charlie Hall 0 416712 0 85046 0 176888 0 75776 0 13165 0 767587 0 Ms Debbie W Gramling 0 126320 0 30972 0 3905 0 23779 0 11120 0 196096 0 Dr Carol T Aitcheson 0 466422 0 500 0 6095 0 23935 0 17530 0 514482 0 Mr Robert Merz 178663 0 0 0 15645 0 25689 0 9425 0 229422 0 0 Ms Connie Whittington 132719 0 0 0 269286 0 61653 0 4493 0 468151 0 0 Mr Thomas Arnold 283922 0 36609 0 32947 0 48300 0 14259 0 416037 0 0 Mr Wright Alcorn 10840 0 0 0 277887 0 10093 0 489 0 299309 0 0 Mr Everett Thompson 209987 0 0 0 324243 0 54242 0 5500 0 593972 0 0 Dr Matthew Schreiber 360952 0 46935 0 27961 0 42454 0 13630 0 491932 0 0 Dr Patrick M Battey 0 410223 0 4991 0 32143 0 30403 0 5383 0 483143 0 Ms Denise Ray 330753 0 42870 0 15802 0 26569 0 11733 0 427727 0 0 Mr Leslie A Donahue 523752 0 216369 0 141266 0 47698 0 13377 0 942462 0 0 Ms Irene Coletta 122365 0 0 0 70571 0 24868 0 9534 0 227338 0 0 FIRST CLASS TRAVEL SCHEDULE J, PART I, LINE 1A EXPENSES FOR FIRST CLASS TRAVEL ARE PAID ON BEHALF OF CERTAIN EXECUTIVES. THESE ITEMS ARE NOT REPORTED ON THE EMPLOYEE'S FORM W-2, HOWEVER, THE COMPANY IS REIMBURSED FOR ANY PERSONAL EXPENSES INCURRED BY THE EMPLOYEE. COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR SCHEDULE J, PART I, LINE 3 THE COMPENSATION FOR THE PRESIDENT/CEO OF PIEDMONT HOSPITAL IS SET BY THE ENTITY'S PARENT, PIEDMONT HEALTHCARE, INC. PLEASE SEE THE SCHEDULE O NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 15A & 15B FOR ADDITIONAL INFORMATION. SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, LINES 4A & 4B WRIGHT ALCORN TERMINATED ON DECEMBER 31, 2010, AND RECEIVED A SEVERANCE PAYMENT FROM THE ORGANIZATION IN 2011 IN THE AMOUNT OF $277,804. CHARLIE HALL AND LESLIE DONAHUE PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS. BONUSES FORM 990, PART VII AND SCHEDULE J, PART I LINES 6A & 6B BONUSES ARE PAID ANNUALLY TO CERTAIN EMPLOYEES BASED ON VARIOUS METRICS, INCLUDING NET EARNINGS. DEVELOPMENT AUTHORITY OF FULTON COUNTY 581639487 359900ZX8 2009-11-24 248554761 See Part VI - Supplemental Info false false false HOSPITAL AUTHORITY OF FAYETTE COUNTY 582629223 31222TAJ2 2009-11-24 79849335 See Part VI - Supplemental Info false false false COWETA COUNTY DEVELOPMENT AUTHORITY 581057672 223658PW9 2010-10-27 99459357 Construct and Equip a New Hospital false false false 2940000 0 299999726 0 0 0 7212 0 0 0 299992514 0 2009 true false true true 8250000 0 78404371 0 0 0 1885 0 0 0 78402486 0 2009 true false true true 0 0 99459357 0 0 0 0 0 0 99459357 0 0 2012 false false true true false true true true false 0 true false true true true false 0 true false true true true false 0 true false true false 0 false 0 false false false true false 0 false 0 false false false false false 0 false 0 false false X DEVELOPMENT AUTHORITY OF FULTON COUNTY BONDS ISSUED 11/24/2009 SCHEDULE K, PART I, LINE A ON NOVEMBER 24, 2009, PIEDMONT HEALTHCARE, INC., (PIEDMONT HOSPITAL'S SOLE MEMBER, EIN: 58-1503902) ENTERED INTO A BOND ISSUANCE AGREEMENT WITH THE DEVELOPMENT AUTHORITY OF FULTON COUNTY CONSISTING OF THE FOLLOWING SERIES: SERIES 2009A; CUSIP # 359900ZX8; ISSUE PRICE $166,454,761 (FIXED RATE) SERIES 2009B; CUSIP # 359900ZY6; ISSUE PRICE $70,000,000 (VARIABLE RATE) SERIES 2009C; CUSIP # NONE; ISSUE PRICE $62,100,000 (FIXED RATE) THE ISSUE WAS USED TO REFUND BONDS ISSUED ON 04/07/1999, 06/14/2001, 04/13/2003, 12/15/2005, AND 12/13/2007. THE 2009C BONDS WERE USED TO REPAY A LINE OF CREDIT (SUN TRUST NOTE) THAT FUNDED CONSTRUCTION AND RENOVATION PROJECTS. HOSPITAL AUTHORITY OF FAYETTE COUNTY BONDS ISSUED 11/24/2009 SCHEDULE K, PART I, LINE B ON NOVEMBER 24, 2009, PIEDMONT HEALTHCARE, INC., (PIEDMONT HOSPITAL'S SOLE MEMBER, EIN: 58-1503902) ENTERED INTO A BOND ISSUANCE AGREEMENT WITH THE HOSPITAL AUTHORITY OF FAYETTE COUNTY CONSISTING OF THE FOLLOWING SERIES: SERIES 2009A; CUSIP # 31222TAJ2; ISSUE PRICE $36,204,335 (FIXED RATE) SERIES 2009B; CUSIP # 31222TAH6; ISSUE PRICE $36,645,000 (VARIABLE RATE) SERIES 2009C; CUSIP # NONE; ISSUE PRICE $7,000,000 (FIXED RATE) THE ISSUE WAS USED TO REFUND BONDS ISSUED ON 04/07/1999, 06/14/2001, 04/13/2003, 12/15/2005, AND 12/13/2007. THE 2009C BONDS WERE USED TO REPAY A LINE OF CREDIT (SUN TRUST NOTE) THAT FUNDED CONSTRUCTION AND RENOVATION PROJECTS. TOTAL PROCEEDS OF ISSUE SCHEDULE K, PART II, LINE 3, COLUMNS A & B THE 2009 BOND ISSUES LISTED IN COLUMNS A & B OF PART I ARE COMBINED ON THE FORM 8038 FILED BY PIEDMONT HOSPITAL. HOWEVER, FOR PURPOSES OF SCHEDULE K REPORTING, PIEDMONT HOSPITAL HAS BROKEN OUT THE BOND ISSUED BASED ON THE AUTHORITY (I.E. FAYETTE OR FULTON) THAT ISSUED THE BONDS. CONSEQUENTLY, THE REPORTING IN COLUMNS A & B WILL NOT TIE TO THE FORM 8038 FILED WITH THE IRS AT THE TIME OF ISSUANCE. Program Services FORM 990, PART III, LINE 4D THE TOP THREE PIEDMONT HOSPITAL SERVICE LINES FOR FY 2012 WERE CARDIOVASCULAR, TRANSPLANT, AND ORTHOPEDIC SERVICES. THE REMAINING PROGRAM SERVICE REVENUES AND EXPENSES CONSIST OF OTHER INPATIENT AND OUTPATIENT SERVICE LINES FOR THE FISCAL YEAR ENDED JUNE 30, 2012. ORGANIZATION'S SOLE MEMBER FORM 990, PART VI, SECTION A, LINE 6 PIEDMONT HEALTHCARE, INC., (EIN 58-1503902) IS THE SOLE MEMBER OF PIEDMONT HOSPITAL, INC ("PH"). ELECTION OF GOVERNING BODY FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF PIEDMONT HEALTHCARE APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF PIEDMONT HOSPITAL. DECISIONS OF GOVERNING BODY FORM 990, PART VI, SECTION A, LINE 7B PIEDMONT HOSPITAL'S BOARD POLICIES AND DECISIONS MUST BE FILED, IMMEDIATELY AFTER ADOPTION, WITH THE SECRETARY OF THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS. SUCH POLICIES AND DECISIONS OF THE PIEDMONT HOSPITAL BOARD OF DIRECTORS ARE NOT SUBJECT TO THE APPROVAL OF OR RATIFICATION BY THE PIEDMONT HEALTHCARE BOARD, BUT SHOULD THE NEED ARISE, THEY MAY BE RESCINDED BY THE PIEDMONT HEALTHCARE BOARD THROUGH A MAJORITY VOTE OF ITS DIRECTORS. 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11B INFORMATION NEEDED TO PREPARE PIEDMONT HOSPITAL'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PH'S CONTROLLER AND VP/CFO. THE 990 IS THEN PREPARED INTERNALLY BY PIEDMONT HEALTHCARE, INC.'S TAX COMPLIANCE MANAGER AND SUBMITTED TO AN EXTERNAL TAX PREPARER FOR REVIEW. COPIES OF FORM 990 ARE PROVIDED TO THE ORGANIZATION'S GOVERNING BOARD, AS WELL AS THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC., PRIOR TO FILING. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY ORGANIZATION MANAGEMENT IN COORDINATION WITH PIEDMONT HEALTHCARE'S VICE PRESIDENT OF COMPLIANCE. ALL SENIOR LEADERS, BOARD MEMBERS, PHYSICIAN EMPLOYEES, AND EMPLOYEES ENGAGED IN RESEARCH ARE REQUIRED TO ANNUALLY DISCLOSE ALL MATTERS WHICH COULD POTENTIALLY CONSTITUTE A CONFLICT OF INTEREST. MATTERS DISCLOSED UNDER THE POLICY MUST BE REVIEWED IN WRITING BY THE REPORTING INDIVIDUAL'S SUPERVISING MANAGER AND THEN BY THE PIEDMONT HEALTHCARE CONFLICT OF INTEREST COMMITTEE IN ORDER TO DETERMINE WHETHER A CONFLICT EXISTS AND, IF SO, WHETHER TO ELIMINATE OR MANAGE THE CONFLICT. ALL BOARD MEMBERS AND EMPLOYEES OF PIEDMONT HOSPITAL ARE PROVIDED TRAINING ON THE REQUIREMENTS OF THE CONFLICT OF INTEREST POLICY AT NEW-EMPLOYEE ORIENTATION AND AT LEAST ANNUALLY THEREAFTER. NONCOMPLIANCE WITH THE CONFLICT OF INTEREST POLICY MUST BE REPORTED TO PIEDMONT HEALTHCARE'S VICE PRESIDENT OF COMPLIANCE FOR INVESTIGATION AND REMEDIAL STEPS MUST BE TAKEN AS APPROPRIATE UNDER THE PIEDMONT HEALTHCARE DISCIPLINARY POLICIES. EXECUTIVE COMPENSATION FORM 990, PART VI, SECTION B, LINES 15A & 15B COMPENSATION FOR EXECUTIVES OF PIEDMONT HOSPITAL IS SET BY THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC. THE PIEDMONT HEALTHCARE, INC., BOARD OF DIRECTORS EXECUTIVE PERFORMANCE AND COMPENSATION COMMITTEE ("THE COMMITTEE") IS COMPOSED OF AT LEAST THREE MEMBERS, SERVING TERMS OF THREE YEARS, AND THE MAJORITY OF WHICH ARE COMMUNITY DIRECTORS WHO GENERALLY DO NOT HAVE CONFLICTS OF INTEREST RELATED TO FULFILLMENT OF THE DUTIES AS OUTLINED BELOW. THE COMMITTEE HAS BEEN AUTHORIZED BY THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS TO PERFORM THE FOLLOWING FUNCTIONS: -SELECT AN EXTERNAL EXECUTIVE COMPENSATION CONSULTANT ("THE CONSULTANT"). THE COMMITTEE CURRENTLY UTILIZES TOWERS WATSON FOR EXECUTIVE COMPENSATION CONSULTING SERVICES. -WORK WITH THE PRESIDENT/CEO TO FORMULATE AND IMPLEMENT ANNUAL PERFORMANCE OBJECTIVES. THE COMMITTEE MEETS ANNUALLY WITH PIEDMONT HEALTHCARE'S CEO AND KEY SENIOR EXECUTIVES. -TO REVIEW AND APPROVE EXECUTIVE PERFORMANCE OBJECTIVES FOR THE FISCAL YEAR. -ANNUALLY ASSESS PRESIDENT/CEO PERFORMANCE. THE COMMITTEE MEETS ANNUALLY WITH THE CEO AND KEY SENIOR EXECUTIVES. -TO REVIEW THE ACCOMPLISHMENTS OF THE EXECUTIVE PERFORMANCE OBJECTIVES AFTER THE CLOSE OF THE FISCAL YEAR. -ASSESS AND IMPLEMENT POLICIES REGARDING PRESIDENT/CEO PERFORMANCE AND COMPENSATION. THE COMMITTEE HAS DEVELOPED AN EXECUTIVE COMPENSATION PHILOSOPHY AND REVIEWS THE PHILOSOPHY ANNUALLY. THE COMMITTEE SEEKS INPUT AND GUIDANCE FROM THE CONSULTANT TO ENSURE THAT THE PHILOSOPHY IS REASONABLE AND COMPARABLE TO THAT OF SIMILAR ORGANIZATIONS. -APPROVE LONG- AND SHORT-TERM GOALS TO BE USED IN CONNECTION WITH EXECUTIVE STAFF COMPENSATION PROGRAM AS RECOMMENDED BY THE PRESIDENT/CEO AND VALIDATED BY THE COMPENSATION CONSULTANT. THE COMMITTEE MEETS ANNUALLY WITH THE CEO AND KEY SENIOR EXECUTIVES AS WELL AS THE CONSULTANT TO REVIEW SALARY ADJUSTMENTS AND INCENTIVE PAY FOR THE CEO, SENIOR EXECUTIVES, AND EXECUTIVES THROUGHOUT THE ORGANIZATION. THE COMMITTEE MEETS WITH THE CONSULTANT ANNUALLY TO RECEIVE INPUT AND RECOMMENDATIONS TO ENSURE THAT SALARY ADJUSTMENTS, INCENTIVES, AND BENEFITS ARE REASONABLE AND COMPARABLE TO THOSE OF LIKE ORGANIZATIONS. -PERFORM ANY TASKS RELATED TO EXECUTIVE PERFORMANCE AND COMPENSATION, INCLUDING BUT NOT LIMITED TO, APPROVAL OF EXECUTIVE EMPLOYMENT CONTRACTS, AND EXECUTIVE BENEFITS. THE COMMITTEE SEEKS INPUT FROM THE CONSULTANT, AS WELL AS EXTERNAL LEGAL ADVISORS, WHEN IT IS NECESSARY TO DEVELOP AND/OR AMEND EXECUTIVE EMPLOYMENT CONTRACTS AND BENEFITS. JOINT VENTURE ARRANGEMENTS FORM 990, PART VI, LINE 16B PIEDMONT HOSPITAL, INC. DID NOT HAVE A WRITTEN POLICY PERTAINING SPECIFICALLY TO THE EVALUATION OF JOINT VENTURE ARRANGEMENTS IN PLACE IN FISCAL YEAR 2012. HOWEVER, IT HAS ALWAYS BEEN, AND REMAINS, PIEDMONT HOSPITAL'S PRACTICE TO CAREFULLY CONSIDER EACH POTENTIAL JOINT VENTURE IN LIGHT OF THE HOSPITAL'S EXEMPT STATUS, AND TO DECLINE PARTICIPATION IN ANY OPPORTUNITY THAT POSES A THREAT TO THAT STATUS. FURTHER, PIEDMONT HOSPITAL, THROUGH ITS PARENT ORGANIZATION PIEDMONT HEALTHCARE, INC., HAS NOW INSTATED A WRITTEN JOINT VENTURE POLICY OUTLINING ITS HISTORIC PRACTICE OF CAREFULLY CONSIDERING PARTNERSHIPS AND JOINT VENTURES. THAT POLICY WENT INTO EFFECT IN FISCAL YEAR 2013. DISCLOSURE OF GOVERNING, CONFLICT OF INTEREST AND FINANCIAL DOCUMENTS FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THESE DOCUMENTS SHOULD BE REQUESTED FROM PIEDMONT HEALTHCARE, INC'S LEGAL COUNSEL. RECONCILIATION OF NET ASSETS FORM 990, PART XI, LINE 5 CHANGES TO NET ASSETS REPORTED ON PART XI, LINE 5 ARE PRIMARILY COMPRISED OF UNREALIZED INVESTMENT LOSSES (APPROXIMATELY $41.5 MILLION), AND A PENSION LIABILITY TRUE UP (APPROXIMATELY $72.8 MILLION) WHICH ARE RECORDED FOR GAAP REPORTING PURPOSES BUT ARE NOT INCLUDED IN TAXABLE INCOME. THESE AMOUNTS ARE OFFSET BY TRANSFERS BETWEEN THE ORGANIZATION AND ITS PARENT OR OTHER RELATED ORGANIZATIONS AND RESTRICTED CONTRIBUTIONS OF APPROXIMATELY $1.0 MILLION, WHICH ARE EXCLUDED FROM INCOME. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. William Blincoe TITLE:Board member HOURS:39 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mr. Bill Linginfelter TITLE:Board Member HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Carol T. Aitcheson TITLE:Board member HOURS:39 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Letha Yurko Griffin TITLE:Board member HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mr. Gary T. Jones TITLE:Board member HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Louis H. Jacobs TITLE:Board member HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Ms. Nell Long TITLE:Board member HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Bryant Wilson TITLE:Board member HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Philip Brachman TITLE:Board member HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mr. Shouky Shaheen TITLE:Board member HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Patrick M. Battey TITLE:Chairman HOURS:38 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mr. Leslie A. Donahue TITLE:President and CEO HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Hewitt W. Matthews TITLE:Board member HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mr. Douglas Stuart TITLE:Board Member HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Jay Singh TITLE:Board member HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Robert Miller TITLE:Board member HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mr. Charlie Hall TITLE:Treasurer HOURS:53 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Ms. Debbie W. Gramling TITLE:Secretary HOURS:53 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mr. Thomas Arnold TITLE:VP Chief Financial Officer HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Ms. Denise Ray TITLE:VP Chief Operating Officer HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mr. Robert Merz TITLE:Lead Pharmacist HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Ms. Connie Whittington TITLE:Chief Nursing Officer HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mr. Everett Thompson TITLE:VP Facility Services HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Dr. Matthew Schreiber TITLE:VP and Chief Medical Officer HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Ms. Irene Coletta TITLE:Manager - Pharmacy HOURS: HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mr. Wright Alcorn TITLE:VP Patient Services HOURS: Piedmont Healthcare INC 1968 Peactree Road NW Atlanta GA 30309 581503902 HC Management GA 501(c)(3) 11 C NA false FAYETTE COMMUNITY HOSPITAL INC 1255 HIGHWAY 154 WEST FAYETTEVILLE GA 30214 582232328 HOSPITAL GA 501(c)(3) 3 PHC false PIEDMONT MOUNTAINSIDE HOSPITAL INC 1266 HIGHWAY 515 SOUTH JASPER GA 30143 352228583 HOSPITAL GA 501(c)(3) 3 PHC false PIEDMONT NEWNAN HOSPITAL INC 745 POPLAR ROAD NEWNAN GA 30265 205077249 HOSPITAL GA 501(c)(3) 3 PHC false PIEDMONT HEALTHCARE FOUNDATION INC 1968 PEACHTREE ROAD NW ATLANTA GA 30309 581272768 FUNDRAISING GA 501(c)(3) 11 D PHC false PIEDMONT HEART INSTITUTE INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 263553500 HEALTHCARE GA 501(c)(3) 7 PHC false PIEDMONT HENRY HOSPITAL INC 1133 EAGLES LANDING PARKWAY STOCKBRIDGE GA 30281 582200195 Hospital GA 501(C) 3 PHC false HENRY MEDICAL CENTER FOUNDATION INC 1133 EAGLES LANDING PKWY STOCKBRIDGE GA 30281 581502600 FUNDRAISING GA 501(C)(3) 11 D NA false HENRY DEVELOPMENT VENTURES INC 1133 EAGLES LANDING PKWY Stockbridge GA 30281 582200734 RE Holding GA 501(c)(2) N/A PHH false Peachtree Orthopedic Surgery Center 2001 Peachtree Road NE Suite 705 Atlanta GA 30309 582562721 Orthopedic Surg. GA NA Related 757222 579553 false 0 false 0.15000 Digestive Healthcare of Georgia 95 Collier Road NW suite 4075 Atlanta GA 303091721 582406657 Endo / GI surgery GA NA Related 402868 193557 false 0 false 0.15000 PIEDMONT WEST AMBULATORY SURGERY CENTER 1800 Howell Mill Rd Ste 200 Atlanta GA 30318 264422348 Ambulatory Surg. GA NA Related -1155054 4614501 true true 0.75172 PIEDMONT MEDICAL CARE CORPORATION 2727 PACES FERRY RD SUITE 1-1100 ATLANTA GA 30339 582092768 HEALTHCARE GA NA C-CORP 0 0 0.00000 THE PIEDMONT CLINIC INC 2727 PACES FERRY ROAD SUITE 1-1100 ATLANTA GA 30339 582005358 HEALTHCARE GA NA C-CORP 0 0 0.00000 PIEDMONT HEART INSTITUTE PHYSICIANS INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 260593850 HEALTHCARE GA NA C-CORP 0 0 0.00000 AMSTER MCRAE INSURANCE COMPANY Related Insurance CJ NA C-CORP 0 0 0.00000 true false false true false false false false true false false false false false true true false false PIEDMONT WEST AMBULATORY SURGERY CENTER D 5614149 ACTUAL DISREGARDED ENTITIES SCHEDULE R, PART I, LINE 1 THE LIMITED LIABILITY COMPANIES LISTED IN SCHEDULE R, PART I, OPERATE AS DEPARTMENTS OF PIEDMONT HOSPITAL AND ARE INCORPORATED INTO THE HOSPITAL'S BOOKS AND RECORDS. SEPARATE BOOKS AND RECORDS ARE NOT MAINTAINED FOR THE LIMITED LIABILITY COMPANIES AND ASSETS AND INCOME CANNOT BE READILY DETERMINED. AS SUCH, COLUMNS (D) AND (E) IN PART I HAVE BEEN LEFT BLANK.