2025-05-15T16:28:47+00:00 2024-06-30 135565207 KPMG LLP 303 Peachtree St NE Suite 2000 Atlanta GA 30308 990 2023-07-01 870963633 Piedmont Cartersville Hospital Inc PIED 4044251303 960 JOE FRANK HARRIS PKWY SE CARTERSVILLE GA 30120 MARIE GAFFNEY VP CORPORATE FINANCE 2025-05-15 true Whitney B Hebron P01226647 4042223000 2024-05-13 2023 2025-03-06 01:10:19Z LORI RAKES 2727 PACES FERRY RD STE 2-700 ATLANTA GA 30339 229977816 false X WWW.PIEDMONT.ORG X 2021 GA TO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT. 12 8 1081 100 0 0 89310 253 189191600 226775774 647927 504004 1398433 2555197 191327270 229835228 100475 0 68485737 81818739 0 0 130578497 125728351 199064234 207647565 -7736964 22187663 536548436 504404261 26353611 34211962 510194825 470192299 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 175683270 100475 226775774 PIEDMONT CARTERSVILLE HOSPITAL, INC. IS A 139-BED FACILITY LOCATED IN THE CITY OF CARTERSVILLE IN BARTOW COUNTY, GEORGIA. OUR PRIMARY CARE AND SPECIALTY PHYSICIANS ON THE MEDICAL STAFF MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SENIORS WITHIN CARTERSVILLE AND THE GREATER METROPOLITAN ATLANTA MARKET, REGARDLESS OF ANY INDIVIUAL'S ABILITY TO PAY FOR SERVICES. FOR THE YEAR ENDED JUNE 30, 2024, THE HOSPITAL HAD 8,111 IN-PATIENT ADMISSIONS WITH A TOTAL OF 38,714 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 50,236 AND OUTPAITENT VISITS TOTALED 36,399. SURGICAL SERVICES WERE PROVIDED TO 5,003 PATIENTS. 175683270 true false false false false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false true true false false false true X 0 0 1081 true false false false false false false false false false false false false X 12 8 false false false false true true true true true false false false true true true true true true true false GA X MARIE GAFFNEY 4702716007 2727 PACES FERRY RDBLDG 2 STE700 ATLANTA GA 30339 MR MARTY SONENSHINE BOARD MEMBER/CHAIR 1.0 0 X X 0 0 0 MS LORI RAKES CEO & BOARD MEMBER 55.0 0 X X 447454 0 42989 DR JEFFREY BRANT BOARD MEMBER 1.0 0 X 0 0 0 DR RAJEEVE SUBBIAH BOARD MEMBER 1.0 0 X 20000 0 0 DR STEVEN SPIVEY BOARD MEMBER 1.0 0 X 40333 0 0 MR BALLARD MAULDIN BOARD MEMBER 1.0 0 X 0 0 0 MR RICHARD DANIEL BOARD MEMBER 1.0 0 X 0 0 0 MR VICTOR MORGAN BOARD MEMBER 1.0 0 X 0 0 0 MR WAYNE MOORE BOARD MEMBER 1.0 0 X 0 0 0 MS CONNIE MORRIS BOARD MEMBER 1.0 0 X 0 0 0 MS DANA NICHOLS BOARD MEMBER 1.0 0 X 0 0 0 MS KATIE LOGAN BOARD MEMBER 1.0 54.0 X 0 503565 32199 MR THOMAS ARNOLD TREASURER/CFO PHC 1.0 54.0 X 0 1268098 39510 MS ELIZABETH LEDDY SECRETARY/CLO PHC 1.0 54.0 X 0 1164523 40350 MR BENJAMIN MCDONALD CFO 55.0 0 X 404143 0 26764 MR MARK SENGER CMO 40.0 0 X 410219 0 35167 MR TIAN CHEN MEDICAL PHYSICIST 40.0 0 X 191712 0 5969 MR WELLINGTON ROLLE ED FLOW COORDINATOR 40.0 0 X 199977 0 26429 MS JAN TIDWELL CNO 40.0 0 X 346690 0 44148 MS SHANNON SIMS DIRECTOR - PHARMACY 40.0 0 X 212228 0 27034 MR JEFFREY MOSLEY CEO (UNTIL 2/2023) 0.0 0 X 121069 0 12213 2393825 2936186 332772 103 true true false AYA HEALTHCARE INC 5930 CORNERSTONE CT W STE 300 SAN DIEGO CA 92121 HEALTHCARE STAFFING 28007497 DPI MANAGEMENT COMPANY LLC 1860 SANDY PLAINS RD MARIETTA GA 30066 MANAGEMENT SERVICES 3742948 ALLATOONA PHYSICIAN SERVICES PC 960 JOE FRANK HARRIS PKWY SE CARTERSVILLE GA 30120 PHYSICIAN SERVICES 2926214 HARBIN CLINIC LLC 221 TECHNOLOGY PKWY ROME GA 30165 PHYSICIAN SERVICES 1344711 HHS ENVIRONMENTAL SERVICES LLC 3902 HWY 78 W SNELLVILLE GA 30039 FACILITY MGMT SVCS 1237181 30 253 253 PATIENT SERVICE REVENUE 622110 226757977 226757977 0 0 OTHER OPERATING REVENUE 900099 17797 17797 0 0 0 0 0 0 226775774 646592 0 0 646592 2079590 0 0 0 2079590 0 2079590 0 0 2079590 0 0 0 142588 0 -142588 -142588 0 0 -142588 CAFETERIA SALES 722310 475607 0 0 475607 0 0 0 0 475607 229835228 226775774 0 3059201 X 100475 100475 766272 622903 143369 0 65634490 53354277 12280213 0 10641701 8650639 1991062 0 4776276 3882635 893641 0 10000 0 10000 0 18975 0 18975 0 33697076 27392353 6304723 0 400977 325954 75023 0 8652833 7033888 1618945 0 3151036 2561477 589559 0 5629482 4576206 1053276 0 39485 32097 7388 0 2722253 0 2722253 0 158980 0 158980 0 6191266 5032880 1158386 0 1734436 0 1734436 0 DRUGS & MEDICAL SUPPLIES 31954675 31954675 0 0 BAD DEBT EXPENSE 22469754 22469754 0 0 MISC 6435415 5231349 1204066 0 HOSPITAL TAX 2461708 2461708 0 0 0 0 0 0 207647565 175683270 31964295 0 189642050 118596170 -119823394 -100453081 0 0 0 0 3534653 4216277 578231 1176301 130482334 15363396 96897878 115118938 99378 128016 0 0 365619640 365621640 536548436 504404261 26274589 34132940 0 0 79022 79022 26353611 34211962 X 510181509 470171212 13316 21087 510194825 470192299 536548436 504404261 X 22187663 -62190189 X false true X true false X 0 6830000 6830000 0 81548897 4798173 76750724 0 2714728 1200329 1514399 0 30955391 9364894 21590497 0 8433318 0 8433318 115118938 Goodwill 365621640 Other Assets 365621640 OTHER LIABILITIES 79022 79022 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote PHC ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF ASC 740, INCOME TAXES (ASC 740). UNDER THE REQUIREMENTS OF ASC 740, TAX-EXEMPT ORGANIZATIONS MAY BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS UNCERTAIN TAX EXPOSURE ITEMS. THERE WERE NO MATERIAL 30, 2024 AND 2023. true true X true X 300 true X true true false true true 6721990 0 6721990 0.0363 8458650 5515669 2942981 0.0159 4030757 3766528 264229 0.0014 0 0 19211397 9282197 9929200 0.0536 46315 0 46315 0.0003 1105867 0 1105867 0.0060 0 0.0 0 0.0 153973 0 153973 0.0008 0 0 1306155 0 1306155 0.0071 0 0 20517552 9282197 11235355 0.0607 0 0.0 4992 0 4992 0.0000 44507 0 44507 0.0002 0 0.0 0 0.0 0 0.0 0 0.0 22387 0 22387 0.0001 0 0.0 0 0 71886 0 71886 0.0004 true 2370251 30148065 31854916 -1706851 X true true 1 1 PIEDMONT CARTERSVILLE HOSPITAL INC 960 JOE FRANK HARRIS PKWY SE CARTERSVILLE GA 30120 https://www.piedmont.org/ 007-567 X X X PIEDMONT CARTERSVILLE HOSPITAL INC 1 false false true X X X X X X X X 21 true false false true X https://www.piedmont.org/media/file/2022-11-PCH-Community-Health-Needs-Assessment.pdf X X true 22 true THE BOARD OF DIRECTORS FOR PIEDMONT CARTERSVILLE MEDICAL CENTER APPROVED ITS IMPLEMENTATION STRATEGY false true X 300.0 300.0 X X true true X X X X true X https://www.piedmont.org/media/file/2024-05-PHC-Financial-Assistance-Policy-English.pdf X https://www.piedmont.org/media/file/2024-05-PHC-Financial-Assistance-Application-English.pdf X www.piedmont.org/media/file/2020-10-PHC-Financial-Assistance-Plain-Language-Summary-English.pdf X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - PIEDMONT CARTERSVILLE HOSPITAL, INC.. AS A PART OF OUR PROCESS, WE INTERVIEWED NEARLY 245 STAKEHOLDERS, POLICY MAKERS AND LAWMAKERS REPRESENTING PUBLIC HEALTH, LOW-INCOME POPULATIONS, MINORITIES, CHRONIC CONDITIONS, OLDER ADULTS, AND OUR COMMUNITIES. THESE INCLUDED 10 STAKEHOLDERS WITHIN THE PIEDMONT CARTERSVILLE COMMUNITY, WHO GAVE THEIR PERSPECTIVES ON COMMUNITY HEALTH THROUGH THE LENS OF THEIR ROLE WITHIN THE COMMUNITY. THESE INTERVIEWS WERE CONDUCTED FOR PEOPLE REPRESENTING THE ENTIRE REGION. SPECIFICALLY, WE INTERVIEWED REPRESENTATIVES OF LOCAL AND REGIONAL PUBLIC HEALTH ENTITIES, MINORITY POPULATIONS, FAITH-BASED COMMUNITIES, LOCAL BUSINESS OWNERS, THE PHILANTHROPIC COMMUNITY, MENTAL HEALTH AGENCIES, ELECTED OFFICIALS AND INDIVIDUALS REPRESENTING OUR MOST VULNERABLE PATIENTS. THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS AND LEADERSHIP FROM ALL 19 HOSPITALS WERE ACTIVELY INFORMED AND ENGAGED THROUGHOUT THIS PROCESS. Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - PIEDMONT CARTERSVILLE HOSPITAL, INC.. IN ADDITION TO MAKING ITS CHNA REPORTS AVAILABLE ON ITS WEBSITE AND BY REQUEST, PIEDMONT CARTERSVILLE MEDICAL CENTER SENT COPIES TO EACH PARTICIPANT IN THE CHNA PROCESS, DISTRIBUTED THE ASSESSMENTS TO COMMUNITY CENTERS AND OTHER LOCATIONS THAT PRIMARILY SERVE AN UNINSURED POPULATION, SENT COPIES TO LEGISLATIVE AND ELECTED OFFICIALS, AND WIDELY DISTRIBUTED THE ASSESSMENTS TO OTHER PIEDMONT HEALTHCARE HOSPITALS. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - PIEDMONT CARTERSVILLE HOSPITAL, INC.. PIEDMONT CARTERSVILLE MEDICAL CENTER CONDUCTED ITS FOURTH CHNA DURING FY22, AGAIN BY ASSESSING PUBLICLY AVAILABLE DATA, INTERVIEWING COMMUNITY MEMBERS AND STAKEHOLDERS, CONDUCTING FOCUS GROUPS OF VULNERABLE POPULATIONS, INTERVIEWING PIEDMONT BOARD MEMBERS, AND SURVEYING PIEDMONT EMPLOYEES. THROUGH THIS PROCESS, PIEDMONT CARTERSVILLE MEDICAL CENTER DETERMINED AND PRIORITIZED THE COMMUNITY HEALTH NEEDS IT WOULD ADDRESS BASED ON THE NUMBER OF PERSONS AFFECTED, THE SERIOUSNESS OF THE ISSUE, WHETHER THE HEALTH NEED AFFECTED VULNERABLE POPULATIONS, AND THE AVAILABILITY OF COMMUNITY AND HOSPITAL RESOURCES NECESSARY TO ADDRESS THE ISSUE. ALL PRIORITIES ARE VIEWED THROUGH THE LENS OF HEALTH DISPARITIES, WITH PARTICULAR ATTENTION PAID TO IMPROVING OUTCOMES FOR THOSE MOST VULNERABLE DUE TO INCOME AND RACE. BASED ON THE CHNA, PIEDMONT CARTERSVILLE MEDICAL CENTER IS CURRENTLY FOCUSING ON: (1) ENSURING AFFORDABLE ACCESS TO HEALTH, MENTAL, AND DENTAL CARE (2) REDUCING PREVENTABLE INSTANCES OF, AND DEATHS FROM, CANCER (3) PROMOTING HEALTHY BEHAVIORS TO REDUCE PREVENTABLE CONDITIONS, DISEASES, AND ADDICTION (4) REDUCING PREVENTABLE INSTANCES OF, AND DEATHS FROM, HEART DISEASE 0 Schedule H, Part I, Line 6a PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT Piedmont regularly reports its community benefit activities to the community in several ways. Each year, Piedmont prepares a systemwide community benefit report that is available to the public through publication on its website. Piedmont also makes its IRS Form 990 Schedule H available on its website and provides copies to anyone upon request. Piedmont also provides information on community benefit programming to local, state, and federal lawmakers through its government affairs office and online at piedmont.org. Schedule H, Part I, Line 7f PERCENT OF TOTAL EXPENSE 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 $207,647,565, LESS BAD DEBT EXPENSE OF $22,469,754 FROM FORM 990, PART IX, LINE 24(B). Schedule H, Part I, Line 7 FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST 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. Schedule H, Part III LINES 2-4 - BAD DEBT EXPENSE CALCULATION AND FOOTNOTE The provision for bad debts is based upon leadership's assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage, and other collection indicators. Hospital and system leadership periodically assesses the adequacy of the allowance for doubtful accounts based on historical write-off experience by payor category. The review results are then used to modify the provision for bad debts to establish an appropriate allowance for uncollectible receivables. 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 leadership's assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage, and other collection indicators. Hospital and system leadership periodically assesses the adequacy of the allowance for doubtful accounts based on historical write-off experience by payor category. The review results are then used to modify the provision for bad debts to establish an appropriate allowance for uncollectible receivables. PCH 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. Schedule H, Part III, Line 8 MEDICARE SHORTFALLS AS COMMUNITY BENEFIT The amount reported in Part III, Line 6, was calculated following Schedule H instructions by utilizing allowable Medicare costs as reported in the Medicare cost report, which Piedmont bases 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, specific coverage fees to physicians, Medicare C and D costs, and other similar direct patient care expenses are expressly excluded from allowable costs in the Medicare Cost Report. Piedmont believes its Medicare shortfall reported in Part III, Line 7 of Schedule H, should be considered a community benefit as the IRS community benefit standard includes providing 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, are an indication the hospital operates to promote health in the community. Piedmont's policy is to treat Medicare patients regardless of how much Medicare pays for the treatment. For many services, Medicare's reimbursement is less than the cost of the care provided, resulting in shortfalls the hospital will absorb in honor of its commitment to treating elderly patients. Many of these patients live on a low, fixed income and would qualify for financial assistance or other means-tested programs, absent from their enrollment in Medicare. Schedule H, Part III, Line 9b COLLECTION PRACTICES 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. Schedule H, Part VI, Line 2 NEEDS ASSESSMENT As a designated 501(c)(3) nonprofit hospital, the Internal Revenue Service requires us to conduct a triennial community health needs assessment (CHNA) following regulations put forth by the IRS following the 2010 Patient Protection and Affordable Care Act (ACA). Through this assessment, Piedmont hopes to understand local health challenges better, identify health trends in the community, determine gaps in the current health delivery system, and craft a plan to address those gaps and the identified health needs. In FY22, Piedmont conducted its fourth triennial CHNA, and FY24 was the second year of activities outlined in its subsequent Implementation Strategy. The CHNA was led by the Piedmont Healthcare community benefits team and consulting organization Public Goods Group (PGG), with input and direction from Piedmont leadership and Piedmont Healthcare's Department of External Affairs. Process The CHNA defined its community as its home county due to the impact of its tax-exempt status. Property taxes comprise a hospital's largest tax exemption segment, impacting county revenues. Because of this, Piedmont aims to ensure it provides ample benefit to its county and community. Additionally, Piedmont considers patient origin, especially that of lower-income patients who qualify for financial assistance or receive insurance coverage through Medicaid. Piedmont's secondary communities are considered the areas with the highest concentration of patients fitting that criterion, including those from nearby communities. Once Piedmont established its primary and secondary communities, it analyzed available public health data, including resources from the US Census, US Health and Human Services Community Health Status Indicators, US Department of Agriculture, Economic Research Service, National Center for Education Statistics, Kaiser Family Foundation's State Health Facts, American Heart Association, County Health Rankings and Georgia Online Analytical Statistical Information System (OASIS). All figures within the CHNA were for 2020 unless otherwise noted. Health indicators are estimates provided by County Health Rankings and the team internally sourced hospital data. PGG then interviewed key stakeholders with particular expertise or knowledge of the community. Specifically, PGG interviewed representatives of local and regional public health entities, minority populations, faith-based communities, local business owners, philanthropic communities, mental health agencies, elected officials, and individuals representing the community's most vulnerable patients. Piedmont conducted an internal survey system for both clinical and non-clinical employees. Piedmont gathered information on knowledge and understanding of community benefits, current programs, and suggestions for better serving patients and the overall community, regardless of where they receive care. Approximately 1,050 employees spanning the system responded. Additionally, Piedmont conducted a community-based survey that was widely advertised to the community. Once Piedmont gathered qualitative and quantitative data, Piedmont authored the preliminary report, which was vetted and reviewed by hospital and health system leadership. This report identified several key community health needs during the assessment process. The community benefits department recommended priorities with sign-off from hospital and board leadership. Piedmont used the following criteria to establish the priorities: - The number of people affected; - The seriousness of the issue; - Whether the health need particularly affected people living in poverty or reflected health disparities; and, - Availability of community and/or hospital resources to address the need. Piedmont views all priorities through the lens of health disparities, with particular attention paid to improving outcomes for those most vulnerable due to income and race. The chosen priorities reflected a collective agreement on what hospital leadership, staff, and the community felt was most important and within its ability to impact the issue positively. Once leadership approved the priorities, Piedmont authored the CHNA. Piedmont presented its findings and recommendations to the hospital's board of directors for their input and approval. FY22 priorities A key CHNA component is identifying the top health priorities the hospital will address over fiscal years 2023, 2024, and 2025. These priorities will guide the hospital's community benefit work. They are, in no order: - Ensure affordable access to health, mental, and dental care - Reduce preventable instances of and deaths from cancer - Promote healthy behaviors to reduce avoidable conditions, diseases, and addiction - Reduce preventable cases of and deaths from heart disease With each priority, Piedmont will work to achieve more significant health equity by reducing the impact of poverty and other socioeconomic indicators, building health equity into its work, which the hospital demonstrates through its implementation strategies. Hospital leadership and staff then developed the subsequent implementation strategy to address the identified priorities in the FY22 community health needs assessment. The implementation strategy was designed to be executed over three years. It included specific metrics by which hospital staff and the community could evaluate its work and impact. Piedmont developed the implementation strategy by utilizing community feedback from the assessment in partnership with the system community benefits department, system leadership, and the hospital's board of directors. Piedmont included proven and successful interventions and programming, investing further in work with the best chance of creating positive, sustainable change. Schedule H, Part VI, Line 3 PATIENT EDUCATION OF ASSISTANCE ELIGIBILITY Piedmont understands that not everyone can pay their hospital bill due to their insurance status or limited income, and because of this, each hospital offers financial assistance to qualifying patients. Notification about financial assistance includes, but is not limited to, a dedicated contact number, notices within inpatient bills, and posted notices in key hospital areas. These locations are the emergency room, admitting and registration departments, business office, and patient financial services offices on site. Piedmont also publishes and widely publicizes a plain language summary of this financial assistance care policy and its full policy on its website. Any staff member can refer a patient to the financial assistance department, including physicians, nurses, financial counselors, social workers, case managers, chaplains, and religious sponsors. The patient may request financial assistance from a family member, close friend, or associate of the patient, subject to applicable privacy laws. Additionally, Piedmont provides copies of its financial assistance policy to partner clinics and others who work closely with low-income populations. Piedmont helps its partners understand the policy and how it relates to their populations, and it receives feedback on improving its financial assistance programming. Schedule H, Part VI, Line 4 COMMUNITY INFORMATION While Piedmont Cartersville serves patients from a 10-county area, the hospital considers its community to be Bartow County in recognition of the direct impact of its tax-exempt status on county residents. In Bartow County, approximately 109,410 people lived in the 460-square-mile area annually between 2018 and 2022. The population density for this area, estimated at 238 people per square mile, is greater than the state average population density of 186 people per square mile and the national average population density of 94 people per square mile. Bartow County is primarily urban, as about 61 percent of community members live within an urban setting. Like in most of Georgia, rural populations in Bartow are overwhelmingly white. Bartow County is growing, having seen a nine percent increase in total population between 2010 and 2020. Approximately seven percent of the county's population were veterans on a yearly average from 2018 to 2022, and most were non-elderly adults. About 12 percent of the population - nearly 13,000 people - lived with a disability in Bartow County. Most of that population was under the age of 65. In Bartow County, about 24 percent of the population was 17 or younger, 14 percent were over 65, and the remaining was between 18 and 64. Between 2018 and 2022, on a yearly average, about 75 percent of all Bartow County residents were white, 11 percent were African American, and about ten percent were Hispanic/Latino. In Bartow County, about 24 percent of the population was 17 or younger, 14 percent were over 65, and the remaining was between 18 and 64. Between 2018 and 2022, on a yearly average, about 75 percent of all Bartow County residents were white, 11 percent were African American, and about ten percent were Hispanic/Latino. On average, between the years 2018 and 2022, about 14 percent of the population had no form of insurance. Insurance status and health are inextricably linked. Being uninsured is generally a marker of low income, as the overwhelming majority of those who are uninsured are also within specific ranges of the federal poverty guidelines, meaning these populations are also likely to face myriad other social determinants of health (SDH), like housing and food insecurity. Between 2018 and 2022, the median household income was $74,812, more significant than the state level but lower than the national level of $75,149. Income disparities are evident when broken down by the four dominant races in the community. Of employers in the community, the largest sector by number of employees is manufacturing, which employed more than 11,000 community members at an average annual wage of $79,109 in 2022, according to the US Department of Commerce. Retail trade was the second largest sector, with about 6,500 people employed at an average annual wage of $36,417. Government and government enterprises were the third largest sector, with about 5,400 people employed at an average yearly salary of $71,666. According to the 2018-2022 American Community Survey, more than 55,200 people in the community were part of the labor force, and more than 1,900 - about four percent - were unemployed as of November 2024. This figure has steadily increased since July 2022, when less than three percent of the labor force was unemployed. In 2023, 10 percent of the county's population lived at or below the federal poverty guidelines, and about 91 percent lived at 200 percent of these guidelines. In Bartow County, like most of the state, minorities are more likely to live in poverty. For example, on average, about 14 percent of Hispanic/Latino populations and 19 percent of Black populations were living at or below poverty, as compared to 10 percent of the white population. Of the more than 38,400 average total occupied households in Bartow County from 2018 to 2022, nearly 9,500 - about 25 percent of the population - lived in cost-burdened households, in which housing costs are 30 percent or more of total household income. Approximately 10 percent of households had costs that exceeded 50 percent of the household income, which places the household in significant financial strain. In Bartow County, in 2019, four of the county's 15 census tracts were food deserts, as shown in the map to the right. More than 23,000 people lived within these census tracts. These tracts almost directly correspond with census tracts, demonstrating retailers authorized to take SNAP benefits. In Bartow County, like most of the state, those retailers tend to be convenience and discount stores that carry limited, if any, healthy foods. Increasingly, discount stores like Dollar General have some sort of produce section, which is inconsistent among communities. Low food access means living more than one mile (urban) or 10 miles (rural) from the nearest supermarket, supercenter, or large grocery store. This indicator is relevant because it highlights populations and geographies facing food insecurity. According to the 2019 Food Access Research Atlas database, about 30 percent of the total population in the county has low food access, meaning about 30,300 county residents may struggle to access healthy foods, which is on par with the state rate. In 2022, about 75 percent of adults aged 18 or older saw a doctor for a routine checkup the previous year. This measure is likely over-reported and is lower than state and national averages. For Medicare recipients, this number jumps to about 88 percent of adult beneficiaries, which is above both state and national averages. Routine checkups are critical to maintaining good health and identifying conditions that can be treated affordably in a community-based setting. Absent that, even simple-to-treat conditions can escalate to deeper issues, eventually requiring more intensive care, later-stage diagnoses, or reduced life expectancy. Heart disease is a leading cause of death for both women and men in Bartow County. On a yearly average from 2018 to 2022, the age-adjusted death rate was about 249 deaths for every 100,000 people, which is greater than the state and national averages of 193 and 207 heart-related deaths per 100,000 people, respectively. In 2022, nearly seven percent of county adults had a diagnosis of heart disease. Between 2018 and 2022, there were approximately 250 deaths due to stroke, representing a death rate of about 46 deaths per every 100,000 people. The yearly average rate of hospitalization due to cardiovascular disease from 2019 to 2021 was 17 hospitalizations per every 1,000 Medicare beneficiaries, which is much higher than the state and national rates of about 10. The hospitalization rate for stroke is also above state and national rates, with 10 hospitalizations per every 1,000 Medicare beneficiaries, as compared to the state rate of about nine and the national rate of eight. These hospitalization rates for heart disease and stroke among Medicare recipients have remained relatively steady over the last five years. Although heart disease leads to county deaths, cancer remains a critical issue within the community. The cancer incidence rate for Bartow County each year on average between 2016 and 2020 was about 486 per every 100,000, which equates to an average diagnosis rate of nearly 600 new cases each year. Screening rates among Medicare beneficiaries are in line with state and national rates, except for breast cancer screening. In 2022, 31 percent of Medicare beneficiaries had a mammogram, compared to the state and national rates of 34 percent and 35 percent, respectively. In 2021, nine percent of county adults aged 20 and older had diabetes, a figure lower than the state rate of 10 percent but on par with the national rate of 9 percent. Diabetes is a prevalent problem in the US, often indicating an unhealthy lifestyle, and it puts individuals at risk for further health issues. Chronic kidney disease, also called chronic kidney failure, involves a gradual loss of kidney function. The kidneys filter waste and excess fluids from the blood, which are then removed in the urine. Advanced chronic kidney disease can cause dangerous levels of fluid, electrolytes, and waste to build up in the body. In 2021, three percent of the county's population had a diagnosis of kidney disease, a rate on par with state and national percentages. In 2021, about 35 percent of adults 18 and older reported having high cholesterol. Too much cholesterol puts one at risk for heart disease and stroke, two of the leading causes of death within the county. That same year, more than 38 percent of adults 18 and older had a diagnosis of high blood pressure. High blood pressure can damage the arteries by making them less elastic, which decreases blood and oxygen flow to the heart and leads to heart disease. Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH Piedmont actively promotes the health of its community through clinic-hospital partnerships, community-based health screenings, educational activities, community-building activities, the operation of a 24-hour emergency department available to the community as a whole, 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. In FY24, Piedmont Cartersville provided care to low-income patients at a cost of nearly $10 million. Of that amount, Piedmont provided $6.7 million in direct financial assistance and covered almost $3 million in shortfalls from providing care to patients with Medicaid coverage. Piedmont Cartersville also trained future healthcare professionals at a cost of $1.1 million, which included more than two dozen specialties within the hospital, such as physical therapy and pharmacy technician training. In FY24, Piedmont further built the Empowering You platform to connect community members and patients with resources to address social determinants of health issues. Powered by FindHelp.org, Piedmont clinicians and case managers can search and refer patients to supporting organizations, including referrals to local food banks and housing resources. Throughout the year, the hospital volunteered at key community events, often providing structured education on key health topics. In November 2023, Piedmont Cartersville staff volunteered at Advocates for Children's Prevention and Advocacy Center by stuffing baby bags for Hope in Your Home and organizing clothes for THRIVE Family Resource Center. In March 2024, Piedmont Cartersville sponsored Kids Helping Kids, a child abuse awareness and prevention program benefiting Advocates for Children. In total, Piedmont sponsored $5,000. In April 2024, Piedmont Cartersville sponsored the Alzheimer Association's Ride to End Alzheimer's at a cost of $500. Staff attended the event. In May 2024, Piedmont Cartersville staff provided CPR, AED, First Aid, Stop the Bleed, and Narcan training for Aromatic Fragrances International, Cartersville City Schools, and Creekside Fellowship Church. Approximately 65 community members attended. In April 2024, Piedmont Cartersville trauma services staff and Bartow County Fire, Bartow County Schools Security, and Life Force Helicopter Services presented a mock crash scene for over 200 Bartow County College and Career Academy students. The team discussed the dangers of drinking, drug use, and phone use while driving. Also that month, Piedmont Cartersville provided a first aid tent for Bartow County Special Olympics at Adairsville High School. There was a total of 200 participants. In August 2023, Piedmont Cartersville partnered with Blood Assurance and hosted an employee and community blood drive responding to an urgent community need for O-positive blood. There were 40 community members present, and Piedmont spent $1,500. In March 2024, PCH staff met with community and state leadership of Recovery Bartow and Georgia Council for Recovery on strategies to support additional care options for ED patients with substance use disorders. Piedmont spent a total of $1,762. In February 2024, PCH staff discussed signs, symptoms, and prevention of heart disease and essential emergency and trauma-related information for the community on the WBHF Radio Show: Heart Health Awareness Month. A total of $298.78 was spent, with an unknown number of listeners. In September 2023, Piedmont partnered with Crosspoint City Church and hosted the Compassion Center Mobile Medical Clinic service awareness day for all clinical roles. Compassion Center brings primary care to vulnerable populations in Bartow County that are uninsured or underinsured. During the 9th Annual EMS Summit in November 2023, which targeted first responders, law enforcement and fire personnel, nurses, and physicians, Piedmont Cartersville provided a full day of trauma-related health education and offered continuing education credit. Approximately 120 community members attended. In March 2024, Piedmont Cartersville contributed $3,000 to Good Neighbor Homeless Shelter and Backpack Buddies Cartersville Dances with The Stars 2024, supporting homeless populations and hungry children. In November 2023, Piedmont Cartersville partnered with New Frontier of Bartow County to feed over 3,000 people for Thanksgiving Dinner. During the meal, staff assisted Piedmont Urgent Care to provide free blood pressure and blood glucose screenings to community members attending the dinner. In March 2023, Piedmont Cartersville sponsored and attended the Northwest Georgia Women's Expo and provided awareness and education about women's services, diabetes, and stroke. Approximately 300 community members participated in the event. In April 2024, Piedmont Cartersville conducted sports physicals for 70 students at Cass Middle School and provided education on concussions and sports safety. Schedule H, Part VI, Line 6 AFFILIATED HEALTH CARE SYSTEM Piedmont Cartersville is part of Piedmont Healthcare, a regional not-for-profit organization and the parent company of 19 hospitals, the Piedmont Physicians Group, the Piedmont Heart Institute, the Piedmont Clinic, and the Piedmont Healthcare Foundation. The Piedmont Community Benefit Department oversees the community benefit activities on behalf of all hospitals throughout the system, and this includes conducting the triennial CHNA and subsequent implementation strategy, ensuring the financial assistance policy is communicated to the community, maintaining the community benefit webpage, authoring the community benefit annual report, preparing board materials, developing and executing the community benefit grants program and compiling all community benefit figures. Each hospital and specific department of Piedmont Healthcare executes community benefit programming, such as its revenue department, which oversees the financial assistance program. Schedule H, Part VI, Line 7 STATE OF FILING OF COMMUNITY BENEFIT REPORT Piedmont is not required to file a community benefit report; however, Piedmont must file information on its indigent and charity care, as well as its Medicaid and Medicare shortfalls, with the Georgia Department of Community Health. Schedule H, Part V, Section B, Line 16a FAP website - PIEDMONT CARTERSVILLE HOSPITAL, INC.: Line 16a URL: https://www.piedmont.org/media/file/2024-05-PHC-Financial-Assistance-Policy-English.pdf; Schedule H, Part V, Section B, Line 16b FAP Application website - PIEDMONT CARTERSVILLE HOSPITAL, INC.: Line 16b URL: https://www.piedmont.org/media/file/2024-05-PHC-Financial-Assistance-Application-English.pdf; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - PIEDMONT CARTERSVILLE HOSPITAL, INC.: Line 16c URL: www.piedmont.org/media/file/2020-10-PHC-Financial-Assistance-Plain-Language-Summary-English.pdf; true BARTOW HEALTH ACCESS INC 32 CLEARVIEW DR CARTERSVILLE GA 30121 208092710 501(C)(3) 60000 PROGRAM SUPPORT CARTERSVILLE-BARTOW COUNTY CHAMBER OF COMMERCE PO BOX 307 CARTERSVILLE GA 30120 580185875 501(C)(6) 10000 PROGRAM SUPPORT BARTOW COUNTY SHERIFF'S OFFICE 104 ZENA DR CARTERSVILLE GA 30121 GOVERNMENT 6000 PROGRAM SUPPORT 2 1 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. MONEY IS GIVEN TO CHARITABLE ORGANIZATIONS WHICH PRIMARILY PROMOTE HEALTH CARE CAUSES. THE GRANTS ARE ADMINISTERED AND MONITORED THROUGH THE ORGANIZAITON'S PUBLIC RELATIONS DEPARTMENT. X true true false true false false false false false true false MS LORI RAKES CEO & BOARD MEMBER 305876 0 114187 0 27391 0 19800 0 23189 0 490443 0 0 0 MS KATIE LOGAN BOARD MEMBER 0 308199 0 133747 0 61619 0 19372 0 12827 0 535764 0 0 MR JEFFREY MOSLEY CEO (UNTIL 2/2023) 72362 0 45964 0 2743 0 7180 0 5033 0 133282 0 0 0 MR THOMAS ARNOLD TREASURER/CFO PHC 0 711656 0 360250 0 196192 0 19800 0 19710 0 1307608 0 107975 MS ELIZABETH LEDDY SECRETARY/CLO PHC 0 612535 0 395529 0 156459 0 19800 0 20550 0 1204873 0 93683 MR BENJAMIN MCDONALD CFO 265813 0 78715 0 59615 0 12413 0 14351 0 430907 0 0 0 MR MARK SENGER CMO 317180 0 81429 0 11610 0 18180 0 16987 0 445386 0 0 0 MR WELLINGTON ROLLE ED FLOW COORDINATOR 59835 0 0 0 140142 0 12230 0 14199 0 226406 0 0 0 MS SHANNON SIMS DIRECTOR - PHARMACY 189245 0 19550 0 3433 0 12769 0 14265 0 239262 0 0 0 MR TIAN CHEN MEDICAL PHYSICIST 163743 0 416 0 27553 0 0 0 5969 0 197681 0 0 0 MS JAN TIDWELL CNO 232587 0 60967 0 53136 0 18064 0 26084 0 390838 0 0 0 Schedule J, Part I, Line 1a Discretionary spending account THOMAS ARNOLD AND ELIZABETH LEDDY RECEIVED A DISCRETIONARY SPENDING ACCOUNT TOTALING $12,000, A FIXED AMOUNT DETERMINED BY THEIR JOB LEVEL. KATIE LOGAN RECEIVED A DISCRETIONARY SPENDING ACCOUNT TOTALING $9,230. LORI RAKES RECEIVED A DISCRETIONARY SPENDING ACCOUNT TOTALING $9,692. JEFFREY MOSLEY RECEIVED A DISCRETIONARY SPENDING ACCOUNT TOTALING $1,846. THIS SPENDING ACCOUNT WAS INCLUDED IN THEIR TAXABLE WAGES. Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation THE COMPENSATION FOR THE PRESIDENT/CEO OF PIEDMONT CARTERSVILLE 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. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THEIR SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: THOMAS ARNOLD $107,975 ELIZABETH LEDDY $93,683 LORI RAKES PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN BUT DID NOT RECEIVE A CURRENT YEAR PAYMENT. Schedule J, Part I, Line 7 Non-fixed payments CERTAIN EMPLOYEES PARTICIPATED IN AN "ANNUAL INCENTIVE PLAN" UNDER WHICH THEY RECEIVED NON-FIXED BONUS PAYMENTS BASED ON JOB LEVEL AND SEVERAL DIFFERENT PERFORMANCE METRICS. Form 990, Part V, Line 1a NUMBER OF FORMS 1099 FILED ALL CALENDAR YEAR 2023 FORMS 1099 WERE FILED ON BEHALF OF PIEDMONT CARTERSVILLE HOSPITAL BY ITS SOLE MEMBER, PIEDMONT HEALTHCARE, INC. (EIN: 58-1503902), PURSUANT TO AN AGREEMENT WITH THE IRS TO FILE ALL FORMS 1099 FOR THE PIEDMONT HEALTHCARE SYSTEM ON A COMBINED BASIS. Form 990, Part VI, Line 6 Classes of members or stockholders PIEDMONT HEALTHCARE, INC., (EIN 58 1503902) IS THE SOLE MEMBER OF PIEDMONT CARTERSVILLE HOSPITAL ("PCH"). Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE BOARD OF PIEDMONT HEALTHCARE, PIEDMONT CARTERSVILLE HOSPITAL'S SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF PIEDMONT CARTERSVILLE HOSPITAL. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders PIEDMONT CARTERSVILLE 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 CARTERSVILLE 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. Form 990, Part VI, Line 11b Review of form 990 by governing body INFORMATION NEEDED TO PREPARE PIEDMONT CARTERSVILLE HOSPITAL'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PCH'S CONTROLLER AND VP/CFO. THE 990 IS THEN PREPARED INTERNALLY BY PIEDMONT HEALTHCARE, INC.'S TAX DEPARTMENT AND SUBMITTED TO AN EXTERNAL TAX PREPARER FOR REVIEW. PRIOR TO FILING, COPIES OF FORM 990 ARE PROVIDED TO THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC., THE ORGANIZATION'S SOLE MEMBER, FOR BOARD REVIEW. Form 990, Part VI, Line 12c Conflict of interest policy COMPLIANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY ORGANIZATION MANAGEMENT IN COORDINATION WITH PIEDMONT HEALTHCARE'S CHIEF COMPLIANCE OFFICER. ALL SENIOR LEADERS, BOARD MEMBERS, PHYSICIAN EMPLOYEES, NURSE PRACTITIONERS/PHYSICIAN ASSISTANTS AND EMPLOYEES AND NON-EMPLOYEES ENGAGED IN RESEARCH ARE REQUIRED TO ANNUALLY DISCLOSE ALL MATTERS WHICH COULD POTENTIALLY CONSTITUTE A CONFLICT OF INTEREST. MATTERS DISCLOSED UNDER THE POLICY MUST BE REVIEWED IN WRITING BY THE PIEDMONT HEALTHCARE CONFLICT OF INTEREST COMMITTEE IN ORDER TO DETERMINE WHETHER A CONFLICT EXISTS AND, IF SO, WHETHER TO ELIMINATE OR MANAGE THE CONFLICT. ALL BOARD MEMBERS AND EMPLOYEES OF PIEDMONT CARTERSVILLE HOSPITAL ARE PROVIDED TRAINING ON CONFLICT OF INTEREST ISSUES, INCLUDING REPORTING REQUIREMENTS, AT NEW EMPLOYEE ORIENTATION AND AT LEAST ANNUALLY THEREAFTER. NONCOMPLIANCE WITH THE CONFLICT OF INTEREST POLICY MUST BE REPORTED TO PIEDMONT HEALTHCARE'S CHIEF COMPLIANCE OFFICER FOR INVESTIGATION, AND REMEDIAL STEPS MUST BE TAKEN AS APPROPRIATE UNDER THE PIEDMONT HEALTHCARE DISCIPLINARY POLICIES. Form 990, Part VI, Line 15a Process to establish compensation of top management official COMPENSATION FOR EXECUTIVES OF PIEDMONT CARTERSVILLE HOSPITAL IS SET BY THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC. THE PIEDMONT HEALTHCARE, INC., BOARD OF DIRECTOR'S EXECUTIVE PERFORMANCE AND COMPENSATION COMMITTEE ("THE COMMITTEE") IS COMPOSED OF AT LEAST THREE MEMBERS OF THE PHC BOARD OF DIRECTORS, SERVING TERMS OF THREE YEARS, ANDTHE 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 OVERSEES EXECUTIVE PERFORMANCE AND COMPENSATION ON BEHALF OF THE PHC BOARD, SUBJECT TO THE ULTIMATE AUTHORITY AND OVERSIGH OF THE BOARD. THE COMMITTEE ALSO FORMULATES POLICIES AND MAKES DECISIONS IN ORDER TO ENSURE A HIGH LEVEL OF EXECUTIVE PERFORMANCE. THE COMMITTEE IS AUTHORIZED TO ACT ON BEHALF OF THE PHC BOARD AS SET OUT IN ITS CHARTER, AND THE COMMITTEE IS ALSO CHARGED WITH PROVIDING RECOMMENDATIONS AND PERIODIC REPORTS TO THE PHC BOARD REGARDING EXECUTIVE PERFORMANCE AND COMPENSATION. ALL DECISIONS AND COMPARABILITY DATE ARE DOCUMENTED IN THE COMMITTEE MEETING MINUTES. FUNCTIONS OF THE COMMITTEE - ASSESS AND IMPLEMENT POLICIES REGARDING PERFORMANCE, COMPENSATION AND BENEFITS OF THE PRESIDENT/CEO AND OTHER EXECUTIVES AS DETERMINED BY THE COMMITTEE - SELECT AN EXECUTIVE COMPENSATION CONSULTANT WHO REPORTS TO THE COMMITTEE - ANNUALLY REVIEW THE PRESIDENT/CEO SUCCESSION PLAN - FORMULATE AND IMPLEMENT ANNUAL PERFORMANCE OBJECTIVES FOR THE PRESIDENT/CEO, AND REVIEW AND APPROVE ANNUALLY RECOMMENDATIONS FROM THE PRESIDENT/CEO RELATING TO COMPENSATION, PERFORMANCE OBJECTIVES, AND SUCCESSION PLANS FOR EVP EXECUTIVES - ANNUALLY ASSESS PRESIDENT/CEO PERFORMANCE; IF NECESSARY, IMPLEMENT ACTION PLAN WITH PRESIDENT/CEO INPUT TO IMPROVE HIS/HER PERFORMANCE; ADJUST COMPENSATION AS APPROPRIATE; THE COMMITTEE CHAIR SHALL CONSULT WITH THE PHC GOVERNANCE COMMITTEE CHAIR AND THE PHC BOARD CHAIR AND SHALL COORDINATE THE ANNUAL PERFORMANCE REVIEW OF THE PHC PRESIDENT/CEO, UNLESS THE PHC BOARD CHAIR HAS A REAL OR PERCEIVED CONFLICT OF INTEREST, IN WHICH CASE THE COMMITTEE CHAIR SHALL DETERMINE THE PROPER REVIEW PROCESS - REVIEW AND APPROVE LONG-TERM AND SHORT-TERM GOALS TO BE USED IN CONNECTION WITH EVP COMPENSATION PROGRAMS AS RECOMMENDED BY THE PRESIDENT/CEO AND VALIDATED BY THE COMPENSATION CONSULTANT - PERIODICALLY REVIEW COMPENSATION, IF ANY, FOR THE PHC BOARD CHAIR AND ALL BOARD CHAIRS OF THE PHC SUBSIDIARIES - ESTABLISH OTHER POLICIES AND PROCEDURES, AND PERFORM OTHER TASKS, RELATED TO EXECUTIVE PERFORMANCE AND COMPENSATION, INCLUDING BUT NOT LIMITED TO, APPROVAL OF EXECUTIVE EMPLOYMENT CONTRACTS AND BENEFITS - PERIODICALLY REPORT SIGNIFICANT DECISIONS AND ANY ADDITIONAL REQUESTED INFORMATION TO THE PHC BOARD. Form 990, Part VI, Line 15b Process to establish compensation of other employees PLEASE SEE DISCLOSURE FOR FORM 990, PART VI, LINE 15A, ABOVE. Form 990, Part VI, Line 19 Required documents available to the public GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THESE DOCUMENTS SHOULD BE REQUESTED FROM PIEDMONT HEALTHCARE, INC.'S LEGAL COUNSEL. Form 990, Part IX, Line 11g Other Fees GENERAL CONTRACT LABOR - Total Expense: 23683736, Program Service Expense: 19252509, Management and General Expenses: 4431227, Fundraising Expenses: 0; PHYSICIAN SUPPORT - Total Expense: 8642966, Program Service Expense: 7025867, Management and General Expenses: 1617099, Fundraising Expenses: 0; MAINTENANCE CONTRACT LABOR - Total Expense: 1370374, Program Service Expense: 1113977, Management and General Expenses: 256397, Fundraising Expenses: 0; Form 990, Part XI, Line 9 Other changes in net assets or fund balances INTERCOMPANY TRANSFER - -62123723; CHANGE IN TEMP RESTRICTED FUNDS - 7772; UNALLOCATED AMOUNTS - -74118; CONTRIBUTIONS - -120; CARTERSVILLE MEDICAL CENTER LLC 960 JOE FRANK HARRIS PKWY CARTERSVILLE GA 30120 582433438 HEALTHCARE GA 0 0 PCH INC CARTERSVILLE OCCUPATIONAL MEDICAL CENTER LLC 1800 HOWELL MILL ROAD STE 850 ATLANTA GA 30318 582513472 HEALTHCARE GA 0 0 CMC LLC AR HOLDING 2 LLC 1800 HOWELL MILL RD STE 850 ATLANTA GA 30318 Holding Co. 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false PIEDMONT HEART INSTITUTE INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 263553500 HEALTHCARE GA 501(c)(3) 10 PHC false GA SURG CTR PCHTREE 2061 PEACHTREE RD STE 100 ATL ATLANTA GA 30309 582394271 SURGERY GA NA N/A false false ORTHOATLANTA SURGERY CENTER FAYETTEVILLE 900 CIRCLE 75 PKWY SE STE 1700 ATLANTA GA 30339 202961633 SURGERY GA NA N/A false false ATHENS ASC HOLDINGS LLC 2142 W BROAD ST BLDG 100 STE 100 ATHENS GA 30606 454014891 SURGERY GA NA N/A false false COLUMBUS DIAGNOSTIC IMAGING CTR 116 INTRACOASTAL POINTE DR 300 JUPITER FL 33477 262291768 IMAGING GA NA N/A false false THE SURGERY CENTER LLC 100 FIRST COURT COLUMBUS GA 31909 582520623 SURGERY GA NA N/A false false PIEDMONT ENCOMPASS REHABILITATION HOSPITALS 9001 LIBERTY PKWY BIRMINGHAM AL 35242 853544795 HEALTHCARE DE NA N/A false false COLISEUM SAME DAY SURGERY CTR 340 HOSPITAL DR MACON GA 31217 621805346 SURGERY GA NA N/A false false PIEDMONT MEDICAL CARE CORPORATION 2727 PACES FERRY ROAD SUITE 1-1100 ATLANTA GA 30339 582092768 HEALTHCARE GA NA C Corporation false THE PIEDMONT CLINIC INC 2727 PACES FERRY ROAD SUITE 1-1100 ATLANTA GA 30339 582005358 HEALTHCARE GA NA C Corporation false PIEDMONT HEART INSTITUTE PHYSICIANS INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30339 260593850 HEALTHCARE GA NA C Corporation false AMSTER MCRAE INSURANCE COMPANY SPC 981734069 RELATED INSURANCE CJ NA C Corporation false COLUMBUS HEALTHCARE RESOURCES PO BOX 790 COLUMBUS GA 31902 581717754 HEALTHCARE GA NA C Corporation false COLUMBUS HEALTH SERVICES INC PO BOX 790 COLUMBUS GA 31902 581640939 HEALTHCARE GA NA C Corporation false UNIVERSITY HEALTH RESOURCES INC 1350 WALTON WAY AUGUSTA GA 30901 581601372 HEALTHCARE GA NA C Corporation false UNIVERSITY HOSPITAL AIKEN INC 1350 WALTON WAY AUGUSTA GA 30901 472713774 HOSPITAL SC NA C Corporation false false false false false false false false false false false false false false false false true true false false Schedule R, Part I Line 1: Disregarded Entities THE LIMITED LIABILITY COMPANIES LISTED IN SCHEDULE R, PART I, OPERATE AS DEPARTMENTS OF PIEDMONT CARTERSVILLE HOSPITAL AND ARE INCORPORATED INTO THE HOSPITAL'S BOOKS AND RECORDS. SEPARATE BOOKS AND RECORDS ARE NO 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.