POLK MEDICAL CENTER INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- POLK MEDICAL CENTER INC (EIN 45-3957368)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-14
- IRS object ID
- 202343189349305679
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-14T10:56:22-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 453957368 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | POLK MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | POLK | BusinessNameControlTxt |
| Phone | 7065096074 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 420 E SECOND AVENUE SUITE 102 | AddressLine1Txt |
| City | ROME | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 301613210 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PHILIP WHEELER | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7065096074 | PhoneNum |
| Signature | 2023-11-14 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | PHILIP | PersonFirstNm |
| Person Last | WHEELER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLOYD POLK MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KURT STUENKEL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 304 TURNER MCCALL BLVD | AddressLine1Txt |
| City | ROME | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 301620233 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $68,199,123 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.FLOYD.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE HEALTH, ELEVATE HOPE AND ADVANCE HEALING - FOR ALL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 8 | TotalVolunteersCnt |
| Total Gross UBI | $40,711 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $34,468 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $822,938 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,869,206 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $20,086,946 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $65,625,973 | CYProgramServiceRevenueAmt |
| PY Investment Income | $451,815 | PYInvestmentIncomeAmt |
| CY Investment Income | $663,707 | CYInvestmentIncomeAmt |
| PY Other Revenue | $96,826 | PYOtherRevenueAmt |
| CY Other Revenue | $40,237 | CYOtherRevenueAmt |
| PY Total Revenue | $21,458,525 | PYTotalRevenueAmt |
| CY Total Revenue | $68,199,123 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,067,057 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,074,963 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,472,933 | PYOtherExpensesAmt |
| CY Other Expenses | $33,118,739 | CYOtherExpensesAmt |
| PY Total Expenses | $13,539,990 | PYTotalExpensesAmt |
| CY Total Expenses | $49,193,702 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,918,535 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $19,005,421 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $97,824,042 | TotalAssetsBOYAmt |
| Total Assets EOY | $96,604,967 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $32,592,566 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $14,584,628 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $65,231,476 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $82,020,339 | NetAssetsOrFundBalancesEOYAmt |
| Mission | POLK MEDICAL CENTER IS A 25 BED CRITICAL ACCESS HOSPITAL WHOSE MISSION IS TO IMPROVE HEALTH, ELEVATE HOPE AND ADVANCE HEALING TO THE COMMUNITY IT SERVES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $46,835,048 | ExpenseAmt |
| Revenue | $65,625,973 | RevenueAmt |
| Desc | THE ORGANIZATION OPERATES A 25-BED, CRITICAL ACCESS HOSPITAL THAT PROVIDES HEALTH CARE SERVICES TO POLK COUNTY AND NORTHERN HARALSON COUNTY WITH SUPPORT FROM ATRIUM HEALTH FLOYD HEALTH SYSTEM'S COMPREHENSIVE NETWORK OF CARE. THE ORGANIZATION PROVIDES A LEVEL IV TRAUMA CENTER, INPATIENT REHABILITATION, IMAGING, LAB WORK, AND INFUSION THERAPY. DURING 2022, ATRIUM HEALTH POLK MEDICAL CENTER HAD APPROXIMATELY 7,900 PATIENT DAYS AND OVER 26,400 EMERGENCY ROOM VISITS. | Desc |
| Total Program Service Expenses | $46,835,048 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 13 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PHILLIP WHEELER | PersonNm |
| Phone | 7065096074 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 304 TURNER MCCALL BOULEVARD | AddressLine1Txt |
| City | ROME | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30161 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| KURT STUENKEL | |||||||||
| BOARD MEMBER, PRES/SCRTY | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $1,395,359 | $43,026 | ||
| FRANK SHELLEY | |||||||||
| CHAIR | 1.00 | 2.00 | Yes (X) | Yes (X) | $2,500 | $3,375 | $0 | ||
| GEORGE A BOSWORTH MD | |||||||||
| BOARD MEMBER | 1.00 | 2.00 | Yes (X) | $2,000 | $2,875 | $0 | |||
| KAY CHUMBLER | |||||||||
| BOARD MEMBER | 1.00 | 2.00 | Yes (X) | $2,700 | $5,825 | $0 | |||
| TODD BUSSEY | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $2,250 | $2,750 | $0 | |||
| BRITT MADDEN JR | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $2,750 | $0 | $0 | |||
| NEIL E GORDON MD | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $2,750 | $0 | $0 | |||
| SONDI SMITH VEST | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $2,750 | $0 | $0 | |||
| LEE CUMMINGS | |||||||||
| BOARD MEMBER (TO 6/22) | 1.00 | 0.00 | Yes (X) | $1,000 | $0 | $0 | |||
| DARROLL FREEMAN | |||||||||
| BOARD MEMBER (TO 6/22) | 1.00 | 0.00 | Yes (X) | $1,750 | $0 | $0 | |||
| DOUGLAS E ELLIOTT | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $2,000 | $0 | $0 | |||
| DARRIN KINES | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $500 | $0 | $0 | |||
| MARY MILLER | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $500 | $0 | $0 | |||
| DARCY MORRIS | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $2,500 | $0 | $0 | |||
| E CLARICE CABLE | |||||||||
| INTERIM CFO (TO 6/22) | 1.00 | 39.00 | Yes (X) | $0 | $429,809 | $61,008 | |||
| PHILIP WHEELER | |||||||||
| CFO (FR 6/22) | 1.00 | 39.00 | Yes (X) | $0 | $190,650 | $6,696 | |||
| TIFANI KINARD | |||||||||
| ADMINISTRATOR | 40.00 | 0.00 | $0 | $252,408 | $34,414 | Yes (X) | |||
| WARREN SONNY RIGAS | |||||||||
| COO (TO 6/22) | 15.00 | 25.00 | $0 | $653,472 | $42,615 | Yes (X) | |||
| TOMMY MANNING | |||||||||
| CORP COUNSEL | 1.00 | 39.00 | $0 | $565,628 | $77,947 | Yes (X) | |||
| MATTHEW GORMAN | |||||||||
| VP CORP/NTWRK ST | 39.00 | 1.00 | $0 | $475,437 | $62,656 | Yes (X) | |||
| DEANA OWEN | |||||||||
| PHARMACY DIRECTOR | 40.00 | 0.00 | $0 | $188,135 | $18,815 | Yes (X) | |||
| LEAH S ASHMORE | |||||||||
| THERAPIST | 40.00 | 0.00 | $0 | $162,459 | $25,837 | Yes (X) | |||
| LOVEJOY LEIGH | |||||||||
| PHARMACIST | 40.00 | 0.00 | $0 | $150,553 | $22,543 | Yes (X) | |||
| PHILLIP ROBERTS | |||||||||
| ER NURSE | 40.00 | 0.00 | $0 | $171,485 | $7,193 | Yes (X) | |||
| KENYA TEEMS | |||||||||
| RESP THERAPIST | 40.00 | 0.00 | $0 | $150,588 | $15,263 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $25,950 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,800,808 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $418,013 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HEALTHCARE WORKFORCE LOGISTICS | |||||
| PO BOX 860573 | MINNEAPOLIS | MN | 55486 | CONTRACT LABOR | $1,013,797 |
| ARAMARK MANAGEMENT SERVICE | |||||
| PO BOX 978839 | DALLAS | TX | 75397 | FACILITY SERVICES | $437,372 |
| MORRISON MANAGEMENT SPECIALISTS | |||||
| PO BOX 102289 | ATLANTA | GA | 303682289 | DIETARY SERVICES | $432,902 |
| WHITE COAT SCIENCES | |||||
| 315 BANKHEAD HWY | CARROLLTON | GA | 30117 | LAB SERVICES | $144,600 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,477,335 | GovernmentGrantsAmt |
| All Other Contributions | $391,871 | AllOtherContributionsAmt |
| Total Contributions | $1,869,206 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 622110 | $65,506,084 | $65,465,373 | $40,711 |
| OTHER HEALTHCARE REVENUE | 621990 | $119,889 | $119,889 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $65,625,973 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $571,773 | TotalRevenueColumnAmt |
| Exclusion | $571,773 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $91,934 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $91,934 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $91,934 | TotalRevenueColumnAmt |
| Exclusion | $91,934 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | GIFT SHOP REVENUE | Desc |
| Business | 459420 | BusinessCd |
| Total Revenue Column | $40,237 | TotalRevenueColumnAmt |
| Exclusion | $40,237 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $40,237 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $68,199,123 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $65,585,262 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $40,711 | UnrelatedBusinessRevenueAmt |
| Exclusion | $703,944 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,588 | TotalAmt |
| Program Services | $14,294 | ProgramServicesAmt |
| Management And General | $14,294 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,464,292 | TotalAmt |
| Program Services | $13,136,181 | ProgramServicesAmt |
| Management And General | $1,328,111 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $509,703 | TotalAmt |
| Program Services | $462,392 | ProgramServicesAmt |
| Management And General | $47,311 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,072,380 | TotalAmt |
| Program Services | $973,914 | ProgramServicesAmt |
| Management And General | $98,466 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,800 | TotalAmt |
| Management And General | $69,800 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $931 | TotalAmt |
| Program Services | $931 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,650 | TotalAmt |
| Program Services | $43,660 | ProgramServicesAmt |
| Management And General | $20,990 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,394,621 | TotalAmt |
| Program Services | $3,059,112 | ProgramServicesAmt |
| Management And General | $335,509 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,766 | TotalAmt |
| Program Services | $5,738 | ProgramServicesAmt |
| Management And General | $1,028 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,367 | TotalAmt |
| Program Services | $31,341 | ProgramServicesAmt |
| Management And General | $4,026 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,711 | TotalAmt |
| Program Services | $37,849 | ProgramServicesAmt |
| Management And General | $4,862 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,622,249 | TotalAmt |
| Program Services | $1,437,582 | ProgramServicesAmt |
| Management And General | $184,667 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,959 | TotalAmt |
| Program Services | $30,093 | ProgramServicesAmt |
| Management And General | $3,866 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,463 | TotalAmt |
| Program Services | $5,727 | ProgramServicesAmt |
| Management And General | $736 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,532 | TotalAmt |
| Program Services | $69,243 | ProgramServicesAmt |
| Management And General | $33,289 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,448,300 | TotalAmt |
| Program Services | $2,282,353 | ProgramServicesAmt |
| Management And General | $165,947 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $331,241 | TotalAmt |
| Program Services | $293,535 | ProgramServicesAmt |
| Management And General | $37,706 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| INCOME TAXES | $3,436 | $3,436 | |
| BAD DEBT | $22,176,329 | $22,176,329 | |
| MEDICAL SUPPLIES | $2,708,684 | $2,708,684 | |
| MISC | $38,466 | $34,089 | $4,377 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,234 | TotalAmt |
| Program Services | $28,565 | ProgramServicesAmt |
| Management And General | $3,669 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,193,702 | TotalAmt |
| Program Services | $46,835,048 | ProgramServicesAmt |
| Management And General | $2,358,654 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,106,578 | BOYAmt |
| EOY | $6,129,966 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,023,413 | BOYAmt |
| EOY | $24,190,031 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,718,470 | BOYAmt |
| EOY | $7,492,259 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $282,120 | BOYAmt |
| EOY | $281,177 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $585,975 | BOYAmt |
| EOY | $222,226 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $58,439,596 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $26,902,980 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,861,142 | BOYAmt |
| EOY | $31,536,616 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,190,041 | BOYAmt |
| EOY | $23,680,692 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,056,303 | BOYAmt |
| EOY | $3,072,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,824,042 | BOYAmt |
| EOY | $96,604,967 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,485,342 | BOYAmt |
| EOY | $1,816,182 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $32,999 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,657,523 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,687,881 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,761,820 | BOYAmt |
| EOY | $12,735,447 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,592,566 | BOYAmt |
| EOY | $14,584,628 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,231,476 | BOYAmt |
| EOY | $82,020,339 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,231,476 | BOYAmt |
| EOY | $82,020,339 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,824,042 | BOYAmt |
| EOY | $96,604,967 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $19,005,421 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,995,653 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$220,905 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $931 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $931 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAYS MEMBERSHIP DUES TO NATIONAL AND STATE ORGANIZATIONS. A PORTION OF THOSE DUES IS ALLOCATED TO LOBBYING ACTIVITIES IN WHICH THOSE ORGANIZATIONS PARTICIPATE. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $838,635 | OtherCostOrOtherBasisAmt |
| Book Value | $838,635 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $43,351,058 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,601,808 | DepreciationAmt |
| Book Value | $28,749,250 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,276,568 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,301,172 | DepreciationAmt |
| Book Value | $975,396 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $973,335 | OtherCostOrOtherBasisAmt |
| Book Value | $973,335 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $31,536,616 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| POLK FOUNDATION LIABILITY | $8,926,741 |
| THIRD PARTY SETTLEMENTS | $1,223,508 |
| OPERATING LEASE PAYABLE | $71,314 |
| CAPITAL LEASE | $2,513,884 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $12,735,447 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION HAS EVALUATED UNCERTAIN TAX POSITIONS FOR ITS CALENDAR YEAR ENDED DECEMBER 31, 2022 AND SHORT PERIOD ENDED DECEMBER 31, 2021, INCLUDING A QUANTIFICATION OF TAX RISK IN AREAS SUCH AS UNRELATED BUSINESS TAXABLE INCOME AND THE TAXATION OF ITS JOINT VENTURES. THIS EVALUATION DID NOT HAVE A MATERIAL EFFECT ON THE ORGANIZATION'S FINANCIAL STATEMENTS FOR THE CALENDAR YEAR ENDED DECEMBER 31, 2022 AND SHORT PERIOD ENDED DECEMBER 31, 2021. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,212,387 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,212,387 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08190 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,127,546 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,096,003 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,031,543 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03820 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,339,933 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,096,003 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,243,930 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12010 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,339,933 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,096,003 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,243,930 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,488,936 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $16,240,434 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,246,424 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $4,994,010 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | POLK MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2360 ROCKMART HIGHWAY | AddressLine1Txt |
| City | CEDARTOWN | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30125 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTPS://WWW.FLOYD.ORG | WebsiteAddressTxt |
| State License | 115-705 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | SWING BED SNF | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ATRIUM HEALTH POLK MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.FLOYD.ORG/ABOUT-FLOYD/PAGES/REPORTS.ASPX | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.FLOYD.ORG/ABOUT-FLOYD/PAGES/REPORTS.ASPX | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.FLOYD.ORG/PATIENTS-VISITORS/BILLING/PAGES/DEFAULT.ASPX | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.FLOYD.ORG/PATIENTS-VISITORS/BILLING/PAGES/DEFAULT.ASPX | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.FLOYD.ORG/PATIENTS-VISITORS/BILLING/PAGES/DEFAULT.ASPX | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ATRIUM HEALTH POLK MEDICAL CENTER | PART V, SECTION B, LINE 5: DURING THE CONDUCTION OF ITS MOST RECENT CHNA, THE HOSPITAL FACILITY SOUGHT COMMUNITY INPUT THROUGH A COMMUNITY HEALTH SURVEY CONDUCTED BY THE HOSPITAL FACILITY TO VALIDATE DATA, GIVE MEMBERS OF THE COMMUNITY AN OPPORTUNITY TO COMMENT ON THE PREVIOUS CHNA, AND TO PROVIDE COMMUNITY-LEVEL INSIGHT INTO THE HEALTH NEEDS OF THE PRIMARY SERVICE AREAS. THE SURVEY WAS SOLICITED ELECTRONICALLY AND PARTICIPANTS WERE RECRUITED FROM HOSPITAL PATIENT-FAMILY ADVISORY PANELS, VOLUNTEER ADVISORY AND ADVOCACY GROUPS, AND COMMUNITY LEADERS, BOTH ELECTED AND VOLUNTEER. ADDITIONALLY, THE HOSPITAL FACILITY USED SECONDARY DATA SOURCES INCLUDING NATIONAL AND STATE SOURCES PROVIDING TARGET VIEWS OF THE PROGRAM SERVICE AREA; AS WELL AS, HOSPITAL-SPECIFIC DATA. |
| ATRIUM HEALTH POLK MEDICAL CENTER | PART V, SECTION B, LINE 6A: THE CURRENT CHNA WAS CONDUCTED WITH ATRIUM HEALTH FLOYD MEDICAL CENTER, ATRIUM HEALTH FLOYD CHEROKEE MEDICAL CENTER AND ATRIUM HEALTH POLK MEDICAL CENTER, ALL RELATED HOSPITAL FACILITIES. |
| ATRIUM HEALTH POLK MEDICAL CENTER | PART V, SECTION B, LINE 11: THE HOSPITAL FACILITY'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") IDENTIFIED NUMEROUS COMMUNITY HEALTH NEEDS AND CONCERNS. EACH IDENTIFIED HEALTH NEED WAS REVIEWED AND PRIORITIZED BASED ON THE BURDEN OF THE HEALTH NEED, THE FEASIBILITY OF INTERVENTIONS, AND THE IMPORTANCE THE COMMUNITY PLACES ON ADDRESSING THE HEALTH NEED. THE FOLLOWING HEALTH NEEDS WERE PRIORITIZED BY THE HOSPITAL FACILITY IN ITS MOST RECENT CHNA INCLUDE ACCESS TO CARE, CARDIOVASCULAR DISEASE, MENTAL HEALTH SERVICES, AND NUTRITION. THE HOSPITAL FACILITY IMPLEMENTATION STRATEGY OUTLINES THE PROGRAMS AND RESOURCES THE HOSPITAL FACILITY WILL USE TO ADDRESS THE ABOVE MENTIONED PRIORITIZED HEALTH NEEDS. ALL EFFORTS IN COMBINATION WITH THE HOSPITAL'S VALUE OF NONDISCRIMINATION AND COMPASSIONATE CARE ARE DESIGNED TO MEET THE SIGNIFICANT HEALTH NEEDS OF THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. THE HOSPITAL FACILITY ACKNOWLEDGES THE IMPORTANCE OF ALL COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA; HOWEVER, THE HOSPITAL FACILITY'S RESOURCES AND ASSETS WERE BEST ALIGNED TO FOCUS ON THE PRIORITIZED NEEDS MENTIONED ABOVE. THE CHNA PROVIDES A COMPREHENSIVE LIST OF AVAILABLE RESOURCES IN THE COMMUNITY FOR THOSE NEEDS THAT WERE NOT PRIORITIZED BY THE HOSPITAL FACILITY. ALTHOUGH NOT PRIORITIZED, THE HOSPITAL FACILITY WILL CONTINUE TO PARTNER WITH COMMUNITY AND NON-PROFIT ORGANIZATIONS TO HELP ADDRESS THESE NEEDS. |
| ATRIUM HEALTH POLK MEDICAL CENTER | PART V, SECTION B, LINE 13B: THE HOSPITAL USES A PRESUMPTIVE PROCESS TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY FOR (CATEGORY II) SERVICES. |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THE FINANCIAL ASSISTANCE PROGRAMS ARE DESIGNED TO ENSURE ASSISTANCE IS PROVIDED TO PATIENTS DEMONSTRATING A FINANCIAL NEED AND TO ENSURE THE ORGANIZATION COMPLIES WITH ANY REQUIRED FEDERAL OR STATE REGULATIONS RELATED TO FINANCIAL ASSISTANCE. THOSE ELIGIBLE FOR FINANCIAL ASSISTANCE WILL NEVER BE BILLED MORE THAN THE AMOUNTS GENERALLY BILLED (AGB) TO ANINSURED PATIENT. THE ORGANIZATION USES THE LOOK-BACK METHOD TO CALCULATE AGB. |
| PART I, LINE 6A: | THE ORGANIZATION PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT THAT IS AVAILABLE ON ITS WEBSITE. |
| PART I, LN 7 COL(F): | THE ORGANIZATION'S PATIENT BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS WAS $22,176,329 FOR THE YEAR ENDED DECEMBER 31, 2022. THIS AMOUNT IS NOT INCLUDED IN THE CALCULATION OF CHARITY CARE FOR PART I, LINE 7. |
| PART III, LINE 2: | AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE. |
| PART III, LINE 4: | FOOTNOTE 2.J (PATIENT SERVICE REVENUE) ON PAGE 30 OF THE AUDITED FINANCIAL STATEMENTS DESCRIBES THE TREATMENT OF BAD DEBT. |
| PART III, LINE 8: | MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. |
| PART III, LINE 9B: | THE HOSPITAL MAKES A REASONABLE EFFORT TO DETERMINE AN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE ENGAGING IN ANY COLLECTION ACTIONS. ALL COLLECTION ACTIONS WILL BE SUSPENDED IF THE INDIVIDUAL SUBMITS A COMPLETED FAP APPLICATION DURING THE APPLICATION PERIOD, OR IF THE INDIVIDUAL SUBMITS AN INCOMPLETE APPLICATION DURING THE APPLICATION PERIOD THAT IS SUBSEQUENTLY COMPLETED WITHIN A REASONABLE TIME AFTER THE HOSPITAL REQUESTS FURTHER INFORMATION. IF THE INDIVIDUAL IS DETERMINED NOT TO BE ELIGIBLE FOR A FULL DISCOUNT UNDER THE FAP, ANY COLLECTION ACTIVITIES WILL BE RESUMED AS TO THE OUTSTANDING BALANCE OWED. IF THE INDIVIDUAL IS DETERMINED TO BE ELIGIBLE FOR ASSISTANCE UNDER THE FAP, APPROPRIATE MEASURES ARE TAKEN TO REFUND ANY AMOUNTS OWED TO THE INDIVIDUAL AND REVERSE OR MODIFY COLLECTION ACTIONS CONSISTENT WITH THE NEW BALANCE OWED AFTER APPLYING THE APPLICABLE FAP DISCOUNTS. |
| PART VI, LINE 2: | THE HOSPITAL FACILITY'S MOST RECENT CHNA WAS BASED ON A SET OF BEST PRACTICES FOR COMMUNITY HEALTH ASSESSMENTS WITH THE PURPOSE OF IDENTIFYING REGIONAL PRIORITY AREAS TO FOCUS ON FOR CY2022 TO CY2024. THE PROCESS WAS DESIGNED TO RELY ON EXISTING PUBLIC DATA, DIRECTLY ENGAGING COMMUNITY STAKEHOLDERS, AND COLLABORATE WITH LOCAL PUBLIC HEALTH AND OTHER HEALTH CARE PROVIDERS. COMMUNITY FEEDBACK IN THE FORM OF A COMMUNITY HEALTH SURVEY AND INTERVIEWS WITH COMMUNITY LEADERS, HEALTHCARE PROFESSIONALS, AND FOCUS GROUPS. THE HOSPITAL FACILITY DEVELOPED AN IMPLEMENTATION STRATEGY TO IDENTIFY THE MEANS THROUGH WHICH IT PLANS TO ADDRESS THOSE PRIORITIZED. BEYOND PROGRAMS ADDRESSED IN THE IMPLEMENTATION STRATEGY, THE HOSPITAL FACILITY WILL CONTINUE TO ADDRESS MANY OF THE PRIORITIES BY PROVIDING CARE TO ALL, REGARDLESS OF ABILITY TO PAY. |
| PART VI, LINE 3: | THE ORGANIZATION USES A VARIETY OF MEANS TO EDUCATE AND INFORM PATIENTS OF THEIR FINANCIAL ASSISTANCE OPTIONS. INFORMATION REGARDING FINANCIAL ASSISTANCE CAN BE FOUND ON THE HOSPITAL FACILITY'S WEBSITE, CONSPICUOUSLY DISPLAYED SIGNAGE THROUGHOUT THE HOSPITAL FACILITY, PATIENT BILL STATEMENTS, AND FROM TEAMMATES DURING CONVERSATIONS CONCERNING A PATIENT'S LIABILITY FOR SERVICES DURING PREADMISSION, DISCHARGE, AND THE "COLLECTION" PERIOD. |
| PART VI, LINE 4: | THE FILING ORGANIZATION ATRIUM HEALTH POLK MEDICAL CENTER, ALONG WITH RELATED ORGANIZATION FLOYD HEALTH CARE MANAGEMENT, INC. (DBA ATRIUM HEALTH FLOYD MEDICAL CENTER AND DBA ATRIUM HEALTH CHEROKEE MEDICAL CENTER), HAS A PRIMARY SERVICE AREA WHICH SERVES FOUR COUNTIES: CHATTOOGA, FLOYD, POLK, ALL LOCATED IN GEORGIA AND CHEROKEE COUNTY IN ALABAMA. BELOW IS A DEMOGRAPHIC SNAPSHOT OF THE POPULATION OF SERVICING AREA:TOTAL POPULATION: 192,096 (2021)INCOME:-MEDIAN HOUSEHOLD INCOME: $41,600 (CHATTOOGA), $50,500 (FLOYD), $47,900 (POLK), $46,000 (CHEROKEE)-PERCENT IN POVERTY: 19% (CHATTOOGA), 18% (FLOYD), 18% (POLK), 14% (CHEROKEE)EDUCATION: % OF HIGH SCHOOL GRADUATES: 86% (CHATTOOGA), 92% (FLOYD), 80% (POLK), 94% (CHEROKEE)PERCENT UNINSURED: 14% (CHATTOOGA), 13% (FLOYD), 16% (POLK), 9% (CHEROKEE) |
| PART VI, LINE 5: | THE ORGANIZATION IS COMMITTED TO BEING RESPONSIVE TO THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES THROUGH A NUMBER OF PROGRAM ACTIVITIES AND COMMUNITY HEALTH IMPROVEMENT INITIATIVES. THE ORGANIZATION HAS ADOPTED AND MAINTAINED A FINANCIAL ASSISTANCE POLICY, PROVIDES SUBSIDIZED HEALTH SERVICES TO PATIENTS IN NEED, AND ACCEPT ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OPERATES AN EMERGENCY ROOM THAT IS OPEN 24/7. THE GOVERNING BOARD IS COMPRISED OF LEADERS WITHIN THE COMMUNITY THE HOSPITAL SERVES. FUNDS ARE REINVESTED IN HEALTH IMPROVEMENT INITIATIVES TO BETTER SERVE THE COMMUNITY HEALTH NEEDS, INCLUDING PROVIDING SCHOOL-BASED CHILD SAFETY PROGRAMS, ATHLETIC TRAINERS TO POLK COUNTY HIGH SCHOOLS, MOBILE MAMMOGRAPHY, CPR TRAININGS, COMMUNITY HEALTH SCREENINGS AND HEALTH FAIRS, HEALTH CARE INTERNSHIPS, EXTERNSHIPS AND SHADOWING OPPORTUNITIES, AND SUPPORT FOR COMMUNITY-WIDE INITIATIVES WITH HEALTH PARTNERS. |
| PART VI, LINE 6: | THE FILING ORGANIZATION IS PART OF ADVOCATE HEALTH, WHICH IS HEADQUARTERED IN CHARLOTTE, NORTH CAROLINA, AND IS THE THIRD-LARGEST NONPROFIT HEALTH SYSTEM IN THE UNITED STATES, CREATED FROM THE COMBINATION OF ATRIUM HEALTH AND ADVOCATE AURORA HEALTH. TOGETHER WITH AN INTEGRATED GROUP OF 501(C)(3) HOSPITALS, PHYSICIAN NETWORKS, OTHER HEALTHCARE PROVIDERS, THE ORGANIZATION IS COMMITTED TO PROVIDING SIGNIFICANT BENEFITS TO THE COMMUNITIES IT SERVES ACROSS NORTHWEST GEORGIA AND NORTHEAST ALABAMA. EACH HOSPITAL ORGANIZATION IN THE ADVOCATE HEALTH SYSTEM REPORTS ITS OWN COMMUNITY BENEFIT ON FORM 990, SCHEDULE H. THE CONSOLIDATED COMMUNITY BENEFIT TOTAL OF THE HEALTH SYSTEM IS REPORTED AT HTTPS://WWW.FLOYD.ORG/ABOUT-FLOYD/PAGES/REPORTS.ASPX. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | GA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KURT STUENKEL | ||||||||||||||
| BOARD MEMBER, PRES/SCRTY | $0 | $842,379 | $0 | $357,510 | $0 | $195,470 | $0 | $12,200 | $0 | $30,826 | $0 | $1,438,385 | $0 | $0 |
| WARREN SONNY RIGAS | ||||||||||||||
| COO (TO 6/22) | $0 | $197,637 | $0 | $88,100 | $0 | $367,735 | $0 | $36,931 | $0 | $5,684 | $0 | $696,087 | $0 | $36,915 |
| TOMMY MANNING | ||||||||||||||
| CORP COUNSEL | $0 | $408,451 | $0 | $86,200 | $0 | $70,977 | $0 | $54,988 | $0 | $22,959 | $0 | $643,575 | $0 | $0 |
| MATTHEW GORMAN | ||||||||||||||
| VP CORP/NTWRK ST | $0 | $357,076 | $0 | $79,000 | $0 | $39,361 | $0 | $41,053 | $0 | $21,603 | $0 | $538,093 | $0 | $0 |
| E CLARICE CABLE | ||||||||||||||
| INTERIM CFO (TO 6/22) | $0 | $282,814 | $0 | $110,300 | $0 | $36,695 | $0 | $39,504 | $0 | $21,504 | $0 | $490,817 | $0 | $0 |
| TIFANI KINARD | ||||||||||||||
| ADMINISTRATOR | $0 | $232,393 | $0 | $13,718 | $0 | $6,297 | $0 | $21,645 | $0 | $12,769 | $0 | $286,822 | $0 | $0 |
| DEANA OWEN | ||||||||||||||
| PHARMACY DIRECTOR | $0 | $175,216 | $0 | $11,960 | $0 | $959 | $0 | $8,263 | $0 | $10,552 | $0 | $206,950 | $0 | $0 |
| PHILIP WHEELER | ||||||||||||||
| CFO (FR 6/22) | $0 | $154,104 | $0 | $25,000 | $0 | $11,546 | $0 | $2,776 | $0 | $3,920 | $0 | $197,346 | $0 | $0 |
| LEAH S ASHMORE | ||||||||||||||
| THERAPIST | $0 | $115,947 | $0 | $15,958 | $0 | $30,554 | $0 | $6,909 | $0 | $18,928 | $0 | $188,296 | $0 | $0 |
| PHILLIP ROBERTS | ||||||||||||||
| ER NURSE | $0 | $130,260 | $0 | $24,920 | $0 | $16,305 | $0 | $6,830 | $0 | $363 | $0 | $178,678 | $0 | $0 |
| LOVEJOY LEIGH | ||||||||||||||
| PHARMACIST | $0 | $148,812 | $0 | $1,073 | $0 | $668 | $0 | $6,309 | $0 | $16,234 | $0 | $173,096 | $0 | $0 |
| KENYA TEEMS | ||||||||||||||
| RESP THERAPIST | $0 | $115,841 | $0 | $11,383 | $0 | $23,364 | $0 | $6,196 | $0 | $9,067 | $0 | $165,851 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINES 4A-B | FormAndLineReferenceDesc |
| Explanation | CERTAIN DIRECTORS, OFFICERS, AND KEY EMPLOYEES OF THE FILING ORGANIZATION PARTICIPATED IN AND/OR RECEIVED PAYMENTS FROM A NON-QUALIFIED DEFERRED COMPENSATION PLAN (RESTORATION OR SERP) AND/OR RECEIVED PAYMENTS FOR SEVERANCE. THE DETERMINATION OF THE PAYMENT AMOUNT FROM NON-QUALIFIED DEFERRED COMPENSATION PLANS FOLLOWED THE EMPLOYMENT ORGANIZATION'S COMPENSATION PROCEDURES. THE FOLLOWING DIRECTORS, OFFICERS, AND KEY EMPLOYEES RECEIVED PAYMENTS FOR SEVERANCE AND/OR PAYMENTS FROM NON-QUALIFIED DEFERRED COMPENSATION PLANS DURING THE CURRENT TAX YEAR: SEVERANCE PAYMENTS: WARREN "SONNY" RIGAS $304,866 NON-QUALIFIED DEFERRED COMPENSATION PAYMENTS: TOMMY MANNING $46,173 WARREN "SONNY" RIGAS $37,893 MATTHEW GORMAN $38,535 E. CLARICE CABLE $14,651 KURT STUENKEL $168,949 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | FLOYD HEALTHCARE MANAGEMENT, INC. (FHMI) IS THE SOLE MEMBER OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | FLOYD HEALTHCARE MANAGEMENT, INC. (FHMI), A RELATED ORGANIZATION, HAS THE POWER TO APPOINT ELEVEN OF THE TWELVE MEMBER GOVERNING BODY WHILE THE PRESIDENT/CEO OF FHMI IS THE FINAL MEMBER OF THE BOARD. |
| FORM 990, PART VI, SECTION A, LINE 7B | PRIOR APPROVAL OF FHMI IS REQUIRED FOR ANY OF THE FOLLOWING ACTIONS: DISSOLUTION; SALE, MERGER OR DISPOSITION; ADOPTION OF CAPITAL OR OPERATING BUDGETS; SELECT OR REMOVE THE ADMINISTRATOR; INCUR INDEBTEDNESS IN EXCESS OF $1,000,000; TAKE ANY ACTION ON THE LEASE OR CONTRACT BETWEEN THE CORPORATION AND CEDARTOWN-POLK COUNTY HOSPITAL AUTHORITY; AMEND THE CORPORATE ARTICLES OF INCORPORATION OR BYLAWS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FILING ORGANIZATION'S BOARD OF DIRECTORS RECEIVES COPIES OF THE FORM 990 WITH SUFFICIENT TIME TO PERMIT REVIEW, COMMENT, AND QUESTIONS PRIOR TO ITS FILING. IF MODIFICATIONS ARE REQUIRED FOLLOWING SUCH REVIEW AND COMMENT, THE REVISED FORM 990 IS REDISTRIBUTED TO ALL DIRECTORS PRIOR TO ITS FILING WITH THE IRS, ALONG WITH A REPORT NOTING THE MODIFICATIONS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REQUIRES ITS OFFICERS, DIRECTORS AND KEY EMPLOYEES TO ANNUALLY REVIEW THE CONFLICT OF INTEREST POLICY AND DETERMINE ANY POTENTIAL CONFLICTS OF INTEREST. ANY POTENTIAL CONFLICTS NOTED IN THE QUESTIONNAIRE ARE REVIEWED BY A STANDING COMMITTEE FOR APPROPRIATE RESOLUTION. ALL MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED TO DETERMINE AND REPORT ANNUALLY, AND AS THEY ARISE, ANY POTENTIAL CONFLICTS OF INTEREST TO THE SECRETARY OF THE BOARD OF DIRECTORS. THE RESOLUTION OF POTENTIAL AND ACTUAL CONFLICTS IS SUBJECT TO THE APPROVAL OF THE CHAIR OF THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION PAYS NO COMPENSATION TO OFFICERS, DIRECTORS AND KEY EMPLOYEES. ALL COMPENSATION PAID TO OFFICERS, DIRECTORS AND KEY EMPLOYEES WAS PAID BY RELATED ORGANIZATIONS, CHARLOTTE MECKLENBURG HOSPITAL AUTHORITY (CMHA) AND FLOYD HEALTHCARE MANAGEMENT, INC. (FHMI) AND THE DETERMINATION OF THE COMPENSATION OF SUCH INDIVIDUALS IS CONDUCTED VIA THE PROCESS UTILIZED BY THE FLOYD HEALTHCARE MANAGEMENT (FHMI) BOARD, AS FOLLOWS: THE DIVERSITY, INCLUSION, & COMPENSATION COMMITTEE (THE "COMMITTEE") OF THE ATRIUM HEALTH, INC. BOARD OF DIRECTORS HAS AUTHORITY AS THE FHMI BOARD DELEGATES TO IT, FOR THE REVIEW AND APPROVAL OF SENIOR EXECUTIVE COMPENSATION, INCLUDING SENIOR EXECUTIVE INCENTIVE PLANS. NO MEMBER OF THE COMMITTEE IS AN EMPLOYEE OF THE FILING ORGANIZATION. THE COMMITTEE RELIES UPON AN EXTERNAL, INDEPENDENT COMPENSATION CONSULTANT EXPERIENCED IN HEALTHCARE TO PROVIDE THE COMMITTEE WITH COMPENSATION COMPARABILITY DATA FOR NEW EXECUTIVE POSITION APPOINTMENTS AND FOR COMPENSATION REVIEWS FOR EXISTING EXECUTIVES. THE CONSULTANT, WHICH IS RETAINED DIRECTLY BY THE COMMITTEE, PROVIDES THIRD-PARTY INFORMATION AND EVALUATES THE COMPETITIVENESS AND REASONABLENESS OF EXECUTIVE COMPENSATION AND BENEFITS PROGRAMS IN RELATION TO MARKET PRACTICES FOR SIMILARLY SITUATED HEALTHCARE ORGANIZATIONS. THE COMMITTEE MAKES ITS DECISIONS WITH RESPECT TO EXECUTIVE COMPENSATION IN ACCORDANCE WITH THE FILING ORGANIZATION POLICIES, IRS REGULATIONS, AND STANDARD CORPORATE GOVERNANCE PRACTICES. SUCH POLICIES INCLUDE ADHERENCE TO EXECUTIVE COMPENSATION PHILOSOPHY AND REVIEW PROCESSES; PROCESSES ENSURING COMMITTEE MEMBER AND COMPENSATION CONSULTANT INDEPENDENCE; USE OF VALID MARKET COMPARISONS OF DATA FROM HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE, STRUCTURE, AND COMPLEXITY AND ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS, PER IRS GUIDELINES. MINUTES OF THE DELIBERATIONS OF THE COMMITTEE ARE MAINTAINED IN THE ATRIUM HEALTH, INC. LEGAL DEPARTMENT. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE TO THE PUBLIC ON REQUEST. THE ORGANIZATION'S BYLAWS ARE NOT PUBLISHED, BUT PROVISIONS FROM THE BYLAWS ARE INCLUDED AS NECESSARY IN THE ORGANIZATION'S POLICIES AND ARE ATTACHED TO THE FORM 1023 FILED FOR THE ORGANIZATION WITH THE IRS, WHICH IS PUBLICLY AVAILABLE. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON REQUEST. |
| FORM 990, PART XI, LINE 9: | INTERCOMPANY TRANSFER -220,905. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| FLOYD HEALTHCARE MANAGEMENT INC | |||||||||||
| 304 TURNER MCCALL BLVD | ROME | GA | 301620233 | 581973570 | HEALTHCARE | GA | 501C3 | LINE 3 | AH GEORGIA | 0 | |
| FLOYD HEALTH CARE FOUNDATION INC | |||||||||||
| 304 TURNER MCCALL BLVD | ROME | GA | 301620233 | 581375074 | FOUNDATION | GA | 501C3 | LINE 12A, I | FHMI | 0 | |
| CANCER NAVIGATORS INC | |||||||||||
| 255 W 5TH STREET SUITE 300 | ROME | GA | 301652817 | 030397867 | EDUCATION | GA | 501C3 | LINE 7 | FHMI | 0 | |
| AH GEORGIA INC | |||||||||||
| PO BOX 32861 | CHARLOTTE | NC | 282322861 | 831707383 | HOLDING CO. | NC | 501C3 | LINE 7 | CMHA | 0 | |
| THE CHARLOTE-MECKLENBURG HOSPITAL AUTHORITY | |||||||||||
| 1000 BLYTHE BLVD | CHARLOTTE | NC | 28203 | 560529945 | HEALTHCARE | NC | NC POLITICAL SUBDIVI | 0 | N/A | ||
| FLOYD-POLK HEALTHCARE FOUNDATION | |||||||||||
| 304 TURNER MCCALL BLVD | ROME | GA | 301620233 | 872546864 | FOUNDATION | GA | 501C3 | LINE 12A, I | 0 | N/A | |
| ADVOCATE HEALTH INC | |||||||||||
| 1000 BLYTHE BLVD | CHARLOTTE | NC | 28203 | 884157429 | HEALTHCARE | NC | 501(C)(3) | LINE 12B, II | 0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |