2012-05-15T17:19:36-05:00 2011-06-30 ERNST & YOUNG US LLC 55 IVAN ALLEN JR BLVD STE 1000 ATLANTA GA 30308 990 2010-07-01 580566213 Piedmont Hospital Inc PIED 4044251303 1968 PEACHTREE ROAD NW ATLANTA GA 303091285 CHARLIE HALL 2012-05-15 4048748300 2010 2016-02-24 21:20:13Z R TIMOTHY STACK 1968 PEACHTREE ROAD NW ATLANTA GA 30309 940236146 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. 12 10 4925 400 7343892 -3771819 7081071 6093577 682293710 706531500 -12354019 20014761 12930101 11724574 689950863 744364412 865613 367486 0 0 251374640 255649503 0 0 0 362020449 405541941 614260702 661558930 75690161 82805482 1075778927 1401215248 674945883 833929688 400833044 567285560 X 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. false false 105750831 0 150876148 PIEDMONT HOSPITAL CARDIOVASCULAR SERVICES HAD 15,825 INPATIENT AND 48,919 OUTPATIENT ENCOUNTERS DURING THE FISCAL YEAR ENDING 6/30/2011, AND RECEIVED CERTIFICATION BY THE JOINT COMMISSION FOR CONGESTIVE HEART FAILURE AND LEFT VENTRICULAR ASSIST DEVICE FOR DESTINATION THERAPY. FOR THE SECOND YEAR IN A ROW, PIEDMONT HOSPITAL WAS NAMED BEST IN ATLANTA FOR OVERALL CARDIAC CARE, CARDIAC SURGERY AND CORONARY INTERVENTION BY HEALTHGRADES, AND EARNED THE DISTINCTION OF "AMERICA'S 100 BEST". IN ADDITION, THE HOSPITAL RECEIVED THE AMERICAN HEART ASSOCIATION'S "GOLD" AWARD FOR GUIDELINE DRIVEN CARE, AND HEALTHGRADES' "DISTINGUISHED HOSPITAL AWARD FOR CLINICAL EXCELLENCE". 40124475 0 52236790 PIEDMONT HOSPITAL TRANSPLANT SERVICES PERFORMED A TOTAL OF 958 INPATIENT CASES DURING THE FISCAL YEAR ENDING 6/30/2011, AND HAD 13,136 OUTPATIENT ENCOUNTERS. 21327728 0 37890078 Piedmont Hospital Orthopedic Services performed a total of 2,332 Inpatient cases during the fiscal year ending 6/30/2011. 341116252 367486 469982405 508319286 true true false true false false false false true true false false true true true false true false false false false false false false false true true true true true true false false false false false false false false false false false false false false false true true false false false true 399 0 true 4925 true true true false false false false false false false false false X 12 10 false false false false true true true true true false false false true true true true true true true true false GA X CHARLIE HALL 4044251303 1968 PEACHTREE ROAD NW ATLANTA GA 303091285 X Dr William Blincoe 1.0 X 0 594499 43187 Dr Carol T Aitcheson 1.0 X 0 0 0 Dr Letha Yurko Griffin 1.0 X 0 0 0 Mr David G Hanna 1.0 X 0 0 0 Mr Gary T Jones 1.0 X 0 0 0 Dr Louise 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 Mr Gregory B Morrison 1.0 X 0 0 0 Dr Jay J Singh 1.0 X 0 0 0 Dr Patrick M Battey 2.0 X 0 455170 34430 Dr Hewitt W Matthews 1.0 X 0 0 0 Mr Charlie Hall 2.0 X 0 610821 83119 Ms Debbie W Gramling 2.0 X 0 148811 32636 Mr Leslie A Donahue 55.0 X 298237 0 21378 Ms Denise Ray 55.0 X 403446 0 37018 Ms Connie Whittington 55.0 X 274808 0 29402 Mr Thomas Arnold 55.0 X 353369 0 60257 Mr Wright Alcorn 55.0 X 299943 0 34640 Mr Everett Thompson 55.0 X 320669 0 52843 Dr Matthew Schreiber 55.0 X 430559 0 74146 Mr Robert W Maynard 0.0 X 1562793 0 1103639 3943824 1809301 1606695 187 true true false SKANSKA USA BUILDING INC 55 Ivan Allen jr Blvd Ste 600 ATLANTA GA 30308 CONSTRUCTION 3311027 EMORY MEDICAL LABORATORIES PO BOX 403054 ATLANTA GA 30384 DIALYSIS 2208534 ALLIANCE LAUNDRY AND TEXTILE SERVIC 7990 Second Flags Drive Suite A AUSTELL GA 30168 LAUNDRY SERVICES 2318775 DELOITTE CONSULTING LLP PO BOX 7247 6447 PHILADELPHIA PA 19170 CONSULTING SERVICES 2310907 SPECIALTY LABS INC FILE 51048 LOS ANGELES CA 90074 LAB SERVICES 1772487 42 156926 5936651 6093577 HEALTHCARE SERVICES 622110 696659025 696659025 OUTSIDE LAB 621500 6970948 6970948 PARKING 900099 2901527 2901527 706531500 1103449 0 0 1103449 0 0 10455901 5629036 4826865 4826865 4453921 372944 0 209043228 110782 190132155 110543 18911073 239 18911312 0 0 18911312 0 0 0 CAFETERIA 722210 3200957 3200957 FITNESS CENTER 713940 847692 847692 COFFEE CART 900099 128143 128143 2720917 2720917 6897709 744364412 704014473 7343892 26912470 305334 305334 62152 62152 0 0 805272 805272 0 208769540 197430882 11338658 12599138 11869648 729490 17348964 16344459 1004505 16126589 15192859 933730 11039660 11039660 1885414 1885414 0 0 0 0 17605636 16500235 1105401 4074866 4074866 166185946 165376656 809290 15808930 15808930 0 23068693 19120963 3947730 137994 122974 15020 0 230942 207528 23414 7297275 7297275 20606998 20606998 36763506 36763506 5925102 5925102 BAD DEBT EXPENSE 46087016 46087016 COLLECTIONS EXPENSE 7225445 7225445 LAB FEES 4321092 4321092 GEORGIA PROVIDER FEE 8152043 8152043 MISCELLANEOUS 29125383 29125383 661558930 508319286 153239644 0 157682865 185994924 1804000 0 3047314 2359701 110492319 110959425 2145946 2707966 11477694 12063445 6475836 5125822 728933247 452929961 291791104 276003286 361183527 434864453 5299256 2652597 15417924 124379066 353065705 1075778927 1401215248 54466559 50586054 374820006 466922801 27693138 28460499 217966180 287960334 674945883 833929688 X 364820689 530441527 14410528 14096222 21601827 22747811 400833044 567285560 1075778927 1401215248 X 82805482 83647034 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 408111 false false 408111 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. 343861628 18073893 -361479 362297000 293945492 49633360 -282776 343861628 347223727 149534 -53718394 -290625 293945492 1.00000 0.00000 0.00000 true false 12990987 12990987 462020636 267910680 194109956 252617537 185019281 67598156 1304087 1304087 276003186 BENEFICIAL INT IN PERP TRUST 8301497 DUE FROM RELATED PARTIES 296060387 A/R PROFESSIONAL BUILDING 604217 STOP / LOSS GA ADS 146002 PCL CON AND NON-COMPETE 701900 CASH HELD BY TRUSTEE 41479503 UNAMORTIZED LOAN DISCOUNT 5772199 353065705 0 DUE TO RELATED PARTIES 196585502 ACCRUED PENSION COSTS 42422607 SELF INSURANCE RESERVES 19755362 INTEREST SWAPS 18494536 SERP PAYABLE 4993118 OTHER DEFERRALS 5709209 287960334 ASC 740 FOOTNOTE (FKA FIN 48) SCHEDULE D, PART X, LINE 2 On July 1, 2007, Piedmont Hospital adopted ASC 740 (FKA FIN 48). 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, 2011. true true X true X 125. true X true true false true true 11887020 0 11887020 0.01930 18605568 13239591 5365977 0.00870 30492588 13239591 17252997 0.02800 1383025 0 1383025 0.00220 5000 0 5000 3133492 0 3133492 0.00510 507592 0 507592 0.00080 5029109 0 5029109 0.00810 35521697 13239591 22282106 0.03610 true 12627961 631398 210568679 228060502 -17491823 X true true Peachtree Orthopedi Orthopedic Surgery 0.15000 0.85000 Digestive Healthcare Endo/GI Surgery 0.14959 0.85041 Piedmont West ASC ambulatory surgery 0.83500 0.16500 1 1 Piedmont Hospital Inc

1968 Peachtree Road NW Atlanta GA 30309

X X X Piedmont Hospital Inc 1 1. REQUIRED DESCRIPTIONS SCHEDULE H, PART VI, LINE 1: REQUIRED DESCRIPTIONS PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6A PIEDMONT HEALTHCARE, INC. (PIEDMONT HOSPITAL'S SOLE MEMBER) PREPARES A WRITTEN COMMUNITY BENEFIT REPORT WHICH CONTAINS THE COMMUNITY BENEFIT REPORT FOR PIEDMONT HOSPITAL. THIS REPORT IS MADE AVAILABLE TO THE PUBLIC. 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 $661,558,930, LESS BAD DEBT EXPENSE OF $46,087,016 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 VI, 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. 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. PH 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 THE ENTIRE $17,491,823 OF MEDICARE SHORTFALL REPORTED ON LINE 7 OF SCHEDULE H, PART III SHOULD BE CONSIDERED COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: FIRST, THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. IRS REVENUE RULING 69-545 PROVIDES, IN PART, THAT HOSPITALS SERVING PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING, FOR EXAMPLE, MEDICARE, IS AN INDICATION THAT THE HOSPITAL OPERATES FOR THE PROMOTION OF HEALTH IN THE COMMUNITY. SECOND, DURING FISCAL YEAR 2011, MEDICARE ACCOUNTED FOR 30.2 PERCENT OF PH'S PATIENT SERVICE REVENUE. PIEDMONT HOSPITAL'S POLICY IS TO TREAT MEDICARE PATIENTS REGARDLESS OF THE EXTENT TO WHICH MEDICARE ACTUALLY COVERS THE COSTS OF THAT TREATMENT. FOR MANY OF THE MEDICAL SERVICES PROVIDED BY THE HOSPITAL, MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE TO THE PATIENTS. RESULTING MEDICARE SHORTFALLS MUST BE ABSORBED BY PIEDMONT HOSPITAL IN ORDER TO CONTINUE TREATING ELDERLY MEDICARE PATIENTS IN THE METROPOLITAN ATLANTA COMMUNITY. FURTHER, IT IS EXPECTED THAT REIMBURSEMENT UNDER THE MEDICARE PROGRAM WILL CONTINUE TO DECLINE AND THEREFORE MAY FURTHER LIMIT ACCESS TO CARE FOR ELDERLY PATIENTS DUE TO THE ANTICIPATED REDUCTION OF PARTICIPATION IN THE MEDICARE PROGRAM BY HEALTHCARE PROVIDERS IN THE COMMUNITY. AS A RESULT, NONPROFIT HOSPITALS AND/OR COUNTY HOSPITAL DISTRICTS WILL LIKELY BEAR THE MAJORITY OF THE FINANCIAL BURDEN OF TREATING MEDICARE PATIENTS. THIRD, PIEDMONT HOSPITAL RELIEVES A FINANCIAL BURDEN ON THE FEDERAL AND STATE GOVERNMENTS TO PAY FOR ALL OF THE SERVICES PROVIDED TO MEDICARE PATIENTS. FOURTH, THE STATE OF GEORGIA REQUIRES NON-PROFIT HOSPITALS TO PROVIDE A MINIMAL LEVEL OF COMMUNITY BENEFIT IN ORDER TO OBTAIN EXEMPTION FROM STATE AND LOCAL TAXES. ACCORDING TO GEORGIA STATE LAW, THE UNREIMBURSED COST OF MEDICARE IS CONSIDERED TO BE COMMUNITY BENEFIT. FIFTH, MANY OF THE MEDICARE PARTICIPANTS HAVE LOW, FIXED INCOMES AND THEREFORE WOULD QUALIFY FOR CHARITY CARE OR OTHER MEANS-TESTED GOVERNMENT PROGRAMS, ABSENT BEING ENROLLED IN THE MEDICARE PROGRAM. 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 INDENTIFYING 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 PIEDMONT HEALTHCARE HAS PARTNERED WITH THE GEORGIA STATE UNIVERSITY PUBLIC HEALTH DEPARTMENT TO ASSESS THE HEALTHCARE NEEDS OF OUR COMMUNITY. IN MARCH 2010, PIEDMONT HEALTHCARE PARTNERED WITH THE GEORGIA STATE UNIVERSITY INSTITUTE OF PUBLIC HEALTH AS TO FORMALLY ASSESS THE HEALTHCARE NEEDS OF THE METROPOLITAN ATLANTA COMMUNITY THROUGH THE USE OF PRIMARY AND SECONDARY DATA AND STAKEHOLDER INPUT TO ESTABLISH COMMUNITY NEED WITH A FOCUS ON THE FOLLOWING AREAS: POPULATION DEMOGRAPHIC PROFILE; HEALTH BURDENS; COMMUNITY-BASED HEALTH CARE AND SOCIAL SERVICE ASSETS AND NEEDS; COMMUNITY MEMBERS AND PIEDMONT STAFF PERCEPTIONS; AND, EMERGENCY DEPARTMENT USE TRENDS. THE INFORMATION WAS THEN USED TO DESIGN AND EXECUTE A SYSTEMATIC APPROACH TO PHC'S COMMUNITY BENEFITS PROGRAMMING AS TO BETTER ADDRESS THE HEALTH NEEDS THAT WERE IDENTIFIED, WITH A PARTICULAR FOCUS ON THE MORE VULNERABLE MEMBERS OF THE COMMUNITY. PHC USED THE COMMUNITY HEALTH NEEDS ASSESSMENT AS ITS BENCHMARK IN ESTABLISHING STANDARDS FOR PROGRAMMATIC EFFECTIVENESS, WHICH ARE REGULARLY REVIEWED AND EVALUATED. 3. PATIENT EDUCATION OF ASSISTANCE ELIGIBILITY SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ASSISTANCE ELIGIBILITY IN ORDER TO INFORM AND EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS, OR UNDER THE HOSPITAL'S CHARITY CARE POLICY, THE HOSPITAL FOLLOWS THE FOLLOWING PROCEDURES: - REGISTRARS REVIEW PROGRAM GUIDELINES WITH PATIENTS; - BROCHURES THAT EXPLAIN PAYMENT AND FINANCIAL ASSISTANCE OPTIONS ARE AVAILABLE IN REGISTRATION AREAS; - THE HOSPITAL'S WEBSITE AND ALL BILLING STATEMENTS PROVIDE CONTACT INFORMATION FOR PATIENT FINANCIAL SERVICES; - PATIENT FINANCIAL SERVICES REPRESENTATIVES EXPLAIN THE PERTINENT POLICY TO THE PATIENT AND PROVIDE ANY FORMS THAT NEED TO BE COMPLETED BY THE PATIENT; - ALL UNINSURED PATIENTS ARE SCREENED FOR CHARITY ELIGIBILITY WITH AN AUTOMATIC ONLINE SERVICE (SEARCH AMERICA), AND FOR MEDICAID ELIGIBILITY USING A THIRD PARTY (BOTH SERVICES ARE FREE OF CHARGE TO THE PATIENT); - INDIGENT CARE CAN BE AUTHORIZED AT REGISTRATION. 4. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4: COMMUNITY INFORMATION PIEDMONT HOSPITAL PRIMARILY FOCUSES ON THE COMMUNITY WITHIN A 20 MILE RADIUS OF THE HOSPITAL ADDRESS AND SERVES THOSE WHO ARE UNINSURED, UNDERINSURED, AND UNDERSERVED, AS WELL AS THOSE IN NEED OF HEALTH EDUCATION. 5. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH PIEDMONT HEALTHCARE WORKS WITH COMMUNITY PARTNERS THAT COMBINE EDUCATION AND SUPPORT TO PROMOTE HEALTHY LIFESTYLES TO MEMBERS OF THE COMMUNITY. THROUGH ONE SUCH PROGRAM, HEALTHMPOWERS, PHC PROVIDES NUTRITION AND FITNESS MATERIALS TO STUDENTS AND TEACHERS AT GARDEN HILLS ELEMENTARY SCHOOL IN ATLANTA, AS WELL AS TRAINING FOR THE TEACHERS TO INCORPORATE INTO REGULAR CURRICULUM. HEALTHMPOWERS, SPECIALIZES IN THE DEVELOPMENT OF THE MATERIALS AND MONITORS THE PROGRESS OF THE TEACHERS AND STUDENTS OVER THE ENTIRE SCHOOL YEAR. WITH NO EXTRA WORK ON THE SCHOOL'S PART, STUDENTS LEARN WAYS TO INCORPORATE FRUITS AND VEGETABLES INTO THEIR DIETS, AS WELL THE IMPORTANCE OF EXERCISING EACH DAY. THE STUDENTS ARE THEN ABLE TO SHARE THIS KNOWLEDGE WITH THEIR PARENTS AND ENCOURAGE THEM TO DEVELOP HEALTHIER LIFESTYLES. ADDITIONAL PROGRAMS OFFERED TO THE COMMUNITY INCLUDE WOMEN, MEN, AND FAMILY-FOCUSED HEALTH EXPOS, AS WELL AS MINORITY COMMUNITY FAIRS, WHERE PARTICIPANTS RECEIVE FREE HEALTH SCREENINGS AND CAN ATTEND EDUCATIONAL SEMINARS. A LONG-STANDING PROGRAM WITH MEDSHARE INTERNATIONAL OFFERS MEDICAL EQUIPMENT AND SUPPLIES TO VULNERABLE AREAS, NATIONWIDE AND WORLDWIDE, WHICH PIEDMONT HOSPITALS ARE ABLE TO DONATE RATHER THAN WASTE WHEN THEY ARE CONSIDERED TO NOT BE IN OPTIMAL CONDITION OR HAVE EXPIRED. 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 FOUR 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. 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 HEALTHCARE, INC., FILES THE COMMUNITY BENEFIT REPORT FOR ITS HEALTHCARE SYSTEM IN THE STATE OF GEORGIA. true American Diabetes Association 225 PEACHTREE STREET NE Atlanta GA 30303 131623888 501(c)(3) 6550 CHARITABLE EVENT SPONSORSHIP American Heart Association PO BOX 4002900 DES MOINES IA 50340 135613797 501(c)(3) 17000 Charitable/Community Service Good Samaritan Heatlh Center 1015 Donald Lee Hollowell Pkwy Atlanta GA 30318 582373395 501(c)(3) 55500 Charitable/Community Service ARTHRITIS FOUNDATION 2970 PEACHTREE ROAD NW Atlanta GA 30305 586011830 501(c)(3) 10000 "CRYSTAL BALL" EVENT SPONSORSHIP Skyland Trail 1961 North Druid Hills Road Atlanta GA 30329 581489941 501(c)(3) 6000 "BENEFITS OF LAUGHTER" EVENT SPONSORSHIP HENRY MEDICAL CENTER FOUNDATION 1133 EAGLES LANDING PARKWAY STOCKBRIDGE GA 30281 581502600 501(c)(3) 15000 CHARITABLE GOLF TOURNAMENT SPONSORSHIP HENRYS HUFFIN FOR STUFFIN INC 5136 HERON BAY BLVD LOCUS GROVE GA 30248 581025691 501(C)(3) 5510 THANKSGIVING 5K EVENT SPONSORSHIP METRO SOUTH GOLF CHARITIES INC 100 EAGLES LANDING WAY STOCKBRIDGE GA 30281 582144566 501(C)(3) 7500 CHARITABLE GOLF TOURNAMENT SPONSORSHIP NATIONAL MARFAN FOUNDATION 22 MANHASSET AVENUE PORT WASHINGTON NY 11050 521265361 501(C)(3) 10000 "HEARTWORKS ATLANTA" EVENT SPONSORSHIP SUSAN G KOMEN FOR THE CURE 4840 ROSWELL ROAD BLDG D STE 100 ATLANTA GA 30342 751835298 501(C)(3) 11000 "RACE FOR THE CURE" SPONSORSHIP THE LEUKEMIA & LYMPHOMA SOCIETY 3715 NORTHSIDE PARKWAY BLDG 400 S ATLANTA GA 30327 135644916 501(C)(3) 25000 "LIGHT THE NIGHT" EVENT SPONSORSHIP WOMENETICS 99 W Paces Ferry Rd NW Suite 200 ATLANTA GA 30305 270362469 501(C)(3) 9700 GLOBAL WOMEN'S PROGRAM SPONSORSHIP YMCA OF METRO ATLANTA 100 EDGEWOOD AVE NE STE 1100 ALTANTA GA 30303 580566253 501(C)(3) 6000 CHARITABLE GOLF TOURNAMENT SPONSORSHIP 13 0 Nursing education scholarship 5 62152 MONITORING THE USE OF GRANT FUNDS SCHEDULE I, PART I, LINE 2 SCHOLARSHIPS: NURSING EDUCATION SCHOLARSHIPS ARE GIVEN TO INDIVIDUALS WHO ARE JUNIORS OR SENIORS IN AN ACCREDITED NURSING SCHOOL. INDIVIDUALS INTERESTED IN A SCHOLARSHIP MUST COMPLETE AN APPLICATION BEFORE JUNE 1ST OF THE YEAR. APPLICANTS ARE INTERVIEWED BY A TWO PERSON NURSING COMMITTEE AND CHOSEN BASED UPON GPA (MUST BE GREATER THAN 3.0), LEADERSHIP, FINANCIAL NEED, REFERENCE LETTERS (TWO REQUIRED), AND A 500 WORD ESSAY DESCRIBING WHAT NURSING MEANS TO THEM. APPLICANTS DO NOT NEED TO HAVE ANY CURRENT AFFILIATION WITH THE HOSPITAL. HOWEVER, IN ORDER TO RECEIVE THE SCHOLARSHIPS, APPLICANTS MUST AGREE TO SIGN A 1 OR 2 YEAR EMPLOYMENT CONTRACT UPON COMPLETION OF SCHOOL. NURSING ADMINISTRATION MONITORS COMPLIANCE WITH THE PROGRAM. SPONSORSHIPS: MONEY IS ALSO GIVEN TO CHARITABLE ORGANIZATIONS. ORGANIZATIONS THAT RECEIVE MONEY ARE PRIMARILY CHARITABLE ORGANIZATIONS WHICH 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. SCHOLARSHIPS: NURSING EDUCATION SCHOLARSHIPS ARE GIVEN TO INDIVIDUALS WHO ARE JUNIORS OR SENIORS IN AN ACCREDITED NURSING SCHOOL. INDIVIDUALS INTERESTED IN A SCHOLARSHIP MUST COMPLETE AN APPLICATION BEFORE JUNE 1ST OF THE YEAR. APPLICANTS ARE INTERVIEWED BY A TWO PERSON NURSING COMMITTEE AND CHOSEN BASED UPON GPA (MUST BE GREATER THAN 3.0), LEADERSHIP, FINANCIAL NEED, REFERENCE LETTERS (TWO REQUIRED), AND A 500 WORD ESSAY DESCRIBING WHAT NURSING MEANS TO THEM. APPLICANTS DO NOT NEED TO HAVE ANY CURRENT AFFILIATION WITH THE HOSPITAL. HOWEVER, IN ORDER TO RECEIVE THE SCHOLARSHIPS, APPLICANTS MUST AGREE TO SIGN A 1 OR 2 YEAR EMPLOYMENT CONTRACT UPON COMPLETION OF SCHOOL. NURSING ADMINISTRATION MONITORS COMPLIANCE WITH THE PROGRAM. SPONSORSHIPS: MONEY IS ALSO GIVEN TO CHARITABLE ORGANIZATIONS. ORGANIZATIONS THAT RECEIVE MONEY ARE PRIMARILY CHARITABLE ORGANIZATIONS WHICH 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. X true true true true false false false true true false false Dr William Blincoe 0 559987 0 30750 0 3762 0 31800 0 11387 0 637686 0 0 Mr Robert W Maynard 341902 0 163730 0 1057161 0 1097599 0 6040 0 2666432 0 0 0 Mr Charlie Hall 0 407719 0 156975 0 46127 0 73201 0 9918 0 693940 0 0 Ms Debbie W Gramling 0 120396 0 24802 0 3613 0 22132 0 10504 0 181447 0 0 Ms Connie Whittington 211736 0 45177 0 17895 0 23874 0 5528 0 304210 0 0 0 Mr Thomas Arnold 270608 0 58715 0 24046 0 47609 0 12648 0 413626 0 0 0 Mr Wright Alcorn 223319 0 49792 0 26832 0 23291 0 11349 0 334583 0 0 0 Mr Everett Thompson 228591 0 49818 0 42260 0 42356 0 10487 0 373512 0 0 0 Dr Matthew Schreiber 349098 0 75275 0 6186 0 62078 0 12068 0 504705 0 0 0 Dr Patrick M Battey 0 407110 0 4973 0 43087 0 26415 0 8015 0 489600 0 0 Ms Denise Ray 319848 0 68757 0 14841 0 26010 0 11008 0 440464 0 0 0 Mr Leslie A Donahue 228358 0 40000 0 29879 0 17767 0 3611 0 319615 0 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 2011IN THE AMOUNT OF $277,804. CHARLIE HALL, LESLIE DONAHUE, MATTHEW SCHREIBER, AND THOMAS ARNOLD PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS. ROBERT MAYNARD, FORMER PRESIDENT & CEO, RECEIVED A PAYMENT FROM HIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN IN THE AMOUNT OF $1,027,869. 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 V - SUPPLEMENTAL INFO false false false HOSPITAL AUTHORITY OF FAYETTE COUNTY 582629223 31222TAJ2 2009-11-24 79849335 SEE PART V - 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 57902721 0 41479502 false false false true false true true false true 0.00000 0.00000 0.00000 true false true true false true 0.00000 0.00000 0.00000 true false false false false true 0.00000 0.00000 0.00000 true false true false false false false false true false false false false false false false false false false 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 1, 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. HOWEVER, FOR PURPOSES OF SCHEDULE K REPORTING, PIEDMONT HAS BROKEN OUT THE BOND ISSUES 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 ("PH") Service Lines for FY 2011 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, 2011. 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 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 HAS UTILIZED THE SERVICES OF INTEGRATED HEALTHCARE STRATEGIES (FORMERLY CLARK CONSULTING) FOR THE PAST SEVERAL YEARS. -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. CURRENTLY DOES NOT HAVE A WRITTEN POLICY IN PLACE PERTAINING SPECIFICALLY TO THE EVALUATION OF JOINT VENTURE ARRANGEMENTS. 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., IS CURRENTLY IN THE PROCESS OF DRAFTING A WRITTEN POLICY OUTLINING ITS HISTORIC PRACTICE OF CAREFULLY CONSIDERING PARTNERSHIPS AND JOINT VENTURES. 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 INCOME (APPROXIMATELY $55.1 MILLION), ADJUSTMENT OF THE INTEREST RATE SWAPS TO MARKET VALUE (APPROXIMATELY $7 MILLION) AND PENSION LIABILITY TRUE UP (APPROXIMATELY $42.2 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 OF APPROXIMATELY $15.1 MILLION AND RESTRICTED CONTRIBUTIONS OF APPROXIMATELY $6 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:Dr. Patrick M. Battey TITLE:Chairman HOURS:53 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 Piedmont Healthcare INC 1968 Peactree Road NW Atlanta GA 30309 581503902 HC Management GA 501(C)(3) 11 III-OTH NA FAYETTE COMMUNITY HOSPITAL INC 1255 HIGHWAY 154 WEST FAYETTEVILLE GA 30214 582232328 HOSPITAL GA 501(C)(3) 3 PHC PIEDMONT MOUNTAINSIDE HOSPITAL INC 1266 HIGHWAY 515 SOUTH JASPER GA 30143 352228583 HOSPITAL GA 501(C)(3) 3 PHC PIEDMONT NEWNAN HOSPITAL INC 745 POPLAR ROAD NEWNAN GA 30265 205077249 HOSPITAL GA 501(C)(3) 3 PHC PIEDMONT HEALTHCARE FOUNDATION INC 1968 PEACHTREE ROAD NW ATLANTA GA 30309 581272768 FUNDRAISING GA 501(C)(3) 11 III-0TH PHC PIEDMONT HEART INSTITUTE INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 263553500 HEALTHCARE GA 501(C)(3) 7 PHC Piedmont Surgical Management Company c/o Gates Moore 3340 Peachtree Road Atlanta GA 30326 205109540 Management Svcs GA NA RELATED 322962 0 false 0 false 0.00000 Peachtree Orthopedic Surgery Center 2001 Peachtree Road NE Suite 705 Atlanta GA 30309 582562721 Orthopedic Surgry GA NA RELATED 563816 579553 false 0 false 0.15000 Digestive Healthcare of Georgia 95 Collier Road NW suite 4075 Atlanta GA 303091721 582406657 Endo / GI sur GA NA RELATED 356170 235982 false 0 false 0.14959 PIEDMONT WEST AMBULATORY SURGERY CENTER 1800 Howell Mill Rd Ste 200 Atlanta GA 30318 264422348 ambulatory suRG GA NA C-CORP -2491971 5182812 0.83500 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 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 5555840