2021-05-17T15:42:30-05:00 2020-06-30 KPMG LLP 303 PEACHTREE ST STE 2000 ATLANTA GA 30308 990 2019-07-01 582179986 PIEDMONT ATHENS REGIONAL MEDICAL CENTER INC % MARIE GAFFNEY PIED 7064757000 1199 PRINCE AVENUE ATHENS GA 30606 MARIE GAFFNEY VP CORP. FINANCE 4702716007 2021-05-17 true WHITNEY B HEBRON P01226647 4042223000 2021-05-13 2019 2022-09-23 18:48:47Z MR J MICHAEL BURNETT 1199 PRINCE AVENUE ATHENS GA 30606 502152951 false X WWW.PIEDMONT.ORG/LOCATIONS/PIEDMONT-ATHENS/ X 1987 GA PROVISION OF HEALTHCARE SERVICES. 12 8 3194 675 0 0 197606 29407699 531541086 482099674 -19638628 335398 4975239 -9689820 517075303 502152951 1283568 980700 0 0 212566677 217748974 0 0 0 324377864 273207457 538228109 491937131 -21152806 10215820 397504662 420292220 234742822 297785095 162761840 122507125 THE MISSION OF PIEDMONT ATHENS REGIONAL MEDICAL CENTER IS TO IMPROVE THE LIVES AND HEALTH OF THOSE WE TOUCH. false false 450286334 980700 467614128 PIEDMONT ATHENS REGIONAL MEDICAL CENTER ("PAR") IS A 360-BED FACILITY LOCATED IN THE CITY OF ATHENS IN CLARKE COUNTY, GEORGIA. OVER 500 PRIMARY CARE AND SPECIALTY PHYSICIANS COMPRISE THE MEDICAL STAFF AND MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SENIORS WITHIN ATHENS AND THE SURROUNDING NORTHEAST GEORGIA MARKET, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY FOR SERVICES. FOR THE FISCAL YEAR ENDED JUNE 30, 2020, THE HOSPITAL HAD 20,242 PATIENT ADMISSIONS WITH A TOTAL OF 89,991 OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 77,952 OUTPATIENT VISITS TOTALED 207,443. SURGICAL SERVICES WERE PROVIDED TO 12,582 PATIENTS. 450286334 true false false false false false false false false false true false false false false true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true false false false true X 0 0 3194 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 RD BLDG 2 STE 70 ATLANTA GA 30339 X Mr Michael McAnder Treasurer 1.0 54.0 X 0 1036007 130895 Mr J Michael Burnett CEO 52.0 3.0 X 891386 0 109446 Ms Elizabeth Leddy Secretary 1.0 54.0 X 0 843536 107225 Mr Robert Sinyard VP MEDICAL AFFAIRS 40.0 0.0 X 571078 0 34176 Ms Wendy Cook Chief Financial Officer 55.0 0.0 X 501371 0 33818 Dr Geoffrey Cole VP, ANCILLARY SVCS 40.0 0.0 X 451128 0 27912 Mr Jason Smith COO 40.0 0.0 X 373380 0 28632 Mr Larry Ebert FORMER EXC DIR STRAT OPS 0.0 55.0 X 0 360737 26927 Mr James Appiah-Pippim faculty 40.0 0.0 X 357288 0 19360 Ms Jody Corry VP IN HOUSE LEGAL 40.0 0.0 X 335734 0 27675 Ms Tamara Jackson CNO 40.0 0.0 X 331050 0 17502 Ms Catherine Apaloo FACULTY PROGRAM DIRECTOR 40.0 0.0 X 321148 0 23927 Mr Louis Duhe VP AND CIO 40.0 0.0 X 281390 0 24243 Mr Norman Burkett VP, PROFESSIONAL SERVICES 40.0 0.0 X 270140 0 33109 Ms Diane Todd VP CORP - COMPLIANCE & OPS 40.0 0.0 X 242654 0 19460 Ms Keisha Bonhomme PHYSICIAN 40.0 0.0 X 249849 0 9916 Ms Tammy Gilland VP FOUNDATION 40.0 0.0 X 223038 0 20253 Dr Charles Peck FORMER CEO 55.0 0.0 X 164895 0 11256 Dr Carolann Eisenhart Board Member 10.0 4.0 X 95220 0 0 Dr David Sailors Board Member 10.0 4.0 X 58764 0 0 Dr Jane M Parks Board Member 1.0 8.0 X 0 16188 0 Mr Dexter L Fisher Board Member 1.0 4.0 X 0 0 0 Dr Wlliam Brad Harper Board Member 1.0 4.0 X 0 0 0 Ms Cheryl Legette Board Member 1.0 5.0 X 0 0 0 Mr Alan Reddish Board Member 1.0 4.0 X 0 0 0 Ms Kim Ripps Board Member 1.0 4.0 X 0 0 0 Dr Samuel K Thomason Board Member 1.0 4.0 X 0 0 0 Mr Tony Townley Board Member 1.0 4.0 X 0 0 0 Dr Jonathan D Woody Board Member 1.0 4.0 X 0 0 0 5719513 2256468 705732 146 true true false MEDICAL CENTER ANESTHESIOLOGY OF AT 1199 Prince Ave ATHENS GA 30606 ANESTHESIA 46958363 GEORGIA EMERGENCY MEDICINE SPECIALI 1199 Prince Ave ATHENS GA 30606 ER SERVICES 24088479 ATHENS PULMONARY ALLERGY PC 3320 Old Jefferson Rd ATHENS GA 30607 MEDICAL SERVICES 16823372 ATHENS RADIOLOGY ASSOCIATES PC 1199 PRINCE AVE ATHENS GA 30606 RADIOLOGY 7204757 DPR CONSTRUCTION 3301 Windy Ridge Pkwy ATLANTA GA 30339 CONSTRUCTION 21993528 38 29407699 29407699 HEALTHCARE SERVICES 622110 471610581 471610581 PHARMACY 900099 5921435 5921435 PARKING 900099 131569 131569 OTHER OPERATING REVENUE 900099 4436089 4436089 482099674 335398 335398 0 0 2603694 2603694 0 2603694 2603694 0 0 0 0 0 0 0 345710 0 345710 345710 CAFETERIA SALES 722210 1714753 1714753 PARTNERSHIP GAIN/LOSS 900099 -14545037 -14545037 RESEARCH 900099 16371 16371 174689 174689 -12639224 502152951 467614128 5131124 980700 980700 0 0 0 4074362 3838456 235906 0 171618025 161681341 9936684 0 31247214 29438000 1809214 10809373 10183510 625863 212524 212524 656850 656850 0 0 0 0 44273428 41493643 2779785 1550477 1162858 387619 35438805 35266226 172579 11762977 8822233 2940744 0 11298262 9364798 1933464 70009 62389 7620 0 82336 73988 8348 7106214 7106214 0 16472671 12354503 4118168 3954048 3954048 MEDICAL SUPPLIES & DRUGS 88902466 88902466 BAD DEBT EXPENSE 33983370 33983370 TAXES 5530103 5530103 OTHER EXPENSES 11912917 7147750 4765167 491937131 450286334 41650797 0 7470670 26615004 0 0 0 0 67792352 61007418 0 0 0 0 0 0 10478037 10581636 7605090 5041520 369356548 56484162 294738838 312872386 0 0 4149015 0 0 0 0 0 5270660 4174256 397504662 420292220 53085474 123236629 0 0 264486 326859 181392862 174221607 0 0 0 0 0 0 0 0 0 0 234742822 297785095 X 162761840 122507125 0 0 162761840 122507125 397504662 420292220 X 10215820 -50470535 X false true X true false X 30368855 30368855 181185364 25582287 155603077 2180 491 1689 89336759 29216806 60119953 68463390 1684578 66778812 312872386 0 0 X Schedule D, Part X, Line 2 ASC 740 Footnote PHC ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF THE INCOME TAXES TOPIC OF THE ASC (ASC 740). UNDER THE REQUIREMENTS OF ASC 740, TAX-EXEMPT ORGANIZATIONS MAY BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS UNCERTAIN TAX EXPOSURE ITEMS. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AT JUNE 30, 2020 AND 2019. true true X true X 300. true X true true true false true true 36434460 36434460 0.07960 19232387 17111409 2120978 0.00460 6394849 6683559 -288710 0.00000 62061696 23794968 38266728 0.08420 202333 202333 0.00040 1332841 1332841 0.00290 1125111 1125111 0.00250 0 0 0.00000 175000 175000 0.00040 2835285 2835285 0.00620 64896981 23794968 41102013 0.09040 25000 0 25000 0.00010 25000 0 25000 0.00010 true 16335236 0 106505911 105434275 1071636 X true true NONE 1 1 PIEDMONT ATHENS REGIONAL MED CENTER 1199 PRINCE AVENUE ATHENS GA 30606 WWW.PIEDMONT.ORG 029-007 X X X 1 PIEDMONT ATHENS REGIONAL MED CENTER 1 false false true X X X X X X X X 18 true false false true X SEE PART VI X X true 19 true SEE PART VI false true X 300. 300. X true true X X X X true X SEE PART VI X SEE PART VI X SEE PART VI X X X X X X true X false X X X X true X false false SCH H, PART V, SECTION B, LINE 5 As a part of our process to represent the broad interests of the community, we interviewed 31 state and regional stakeholders and policy makers that represent public health, low-income populations, uninsured and uninsured persons, minorities, chronic conditions and older adults, as well as elected officials and lawmakers. These stakeholders have a particular expertise or knowledge of the community. 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. These interviews were conducted for people representing the entire region, including Clarke County. The Piedmont Healthcare board of directors and leadership from all 11 hospitals were actively informed and engaged throughout this process. SCH H, PART V, SECTION B, LINE 7A COMMUNITY HEALTH NEEDS ASSESSMENT WEBSITE https://www.piedmont.org/media/file/PAR-FY19-CHNA-Strategy.pdf SCHEDULE H, PART V, LINE 7D: PUBLIC AVAILABILITY OF CHNA IN ADDITION TO MAKING ITS CHNA REPORTS AVAILABLE ON ITS WEBSITE AND BY REQUEST, PIEDMONT ATHENS REGIONAL 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. SCH H, PART V, SECTION B, LINE 10A IMPLEMENTATION STRATEGY THE BOARD OF DIRECTORS FOR PIEDMONT ATHENS REGIONAL MEDICAL CENTER UNANIMOUSLY APPROVED ITS IMPLEMENTATION STRATEGY FOR THE THREE YEAR PERIOD BEGINNING WITH FY20 ON OCTOBER 24, 2019, WITHIN THE GRACE PERIOD FOLLOWING THE APPROVAL OF THE NEW COMMUNITY HEALTH NEEDS ASSESSMENT. THE FOLLOWING LINK IS FOR THE IMPLEMENTATION STRATEGY EFFECTIVE THROUGH JUNE 30, 2022. THE IMPLEMENTATION POLICY IS LOCATED AFTER THE COMMUNITY HEALTH NEEDS ASSESSMENT IN THE FOLLOWING LINK. https://www.piedmont.org/media/file/PAR-FY19-CHNA-Strategy.pdf SCH H, PART V, SECTION B, LINE 11 In 2015, the then-Athens Regional Health System administration and board approved the hospital's Community Health Needs Assessment (CHNA), which was developed using primary and secondary data, internal hospital data, findings from key stakeholder interviews and other relevant community-based information. The CHNA identified several key health priorities, which were developed using four key criteria: 1) the number of people affected, 2) the severity of the problem, 3) the health system's ability to impact, and 4) the extent to which other organizations are already meeting the need. From the CHNA findings, and in partnership with hospital leadership and community stakeholders, Athens Regional Health System developed its implementation strategy to address the identified priorities listed in the 2015 CHNA. The initial implementation strategy was approved by the Athens Regional Health System Board of Directors on November 24, 2015. Athens Regional joined the Piedmont Healthcare system as Piedmont Athens Regional Medical Center ("PARMC") in October 2016. In March 2017, the Piedmont Health System community benefit team, in partnership with PAR leadership, redrafted the implementation strategy to align it with system priorities and to reflect the shift in ownership. Core strategies from the original were maintained, and several priorities were combined as they share strategies. PARMC has attempted to increase access to care and services by providing financial assistance and covering any short-falls for low and no-income populations through free and reduced-cost care to qualifying patients through Piedmont Healthcare's Financial Assistance Policy. PARMC has also continued to support care for Medicaid populations through coverage of cost shortfalls and by enrolling qualifying patients with vendors. PARMC has also maintained a partnership with Mercy Clinic for the provision of free pharmaceuticals. PARMC also identified supporting cardiovascular, cerebrovascular, and respiratory health and combating obesity and diabetes as a community need. PARMC provides grant funding to community based non-profits to help at-risk populations directly. Further, PARMC provides a variety of healthy lifestyle community education programing, including nutrition counseling, smoke-free campaigns, and other lifestyle classes at the local YMCA. PARMC has also remained accredited for stroke and cardiovascular services. The PARMC Board of Directors unanimously approved the new CHNA on May 23, 2019. Based on the CHNA, PARMC will focus on the following: (1) INCREASE ACCESS TO APPROPRIATE AND AFFORDABLE HEALTH AND MENTAL CARE FOR ALL COMMUNITY MEMBERS, AND ESPECIALLY THOSE WHO ARE UNINSURED AND THOSE WITH LOW INCOMES; (2) REDUCE OPIOID AND RELATED SUBSTANCE ABUSE AND OVERDOSE DEATHS; (3) DECREASE DEATHS FROM LUNG AND BREAST CANCER AND INCREASE ACCESS TO CANCER PROGRAMMING FOR THOSE LIVING WITH THE DISEASE; AND (4) PROMOTE HEALTHY WEIGHTS AND BEHAVIORS AS TO DECREASE PREVENTABLE INSTANCES OF HEART DISEASE, STROKE, DIABETES, HYPERTENSION, AND OTHER RELATED CHRONIC CONDITIONS. SCH H, PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITES FINANCIAL ASSISTANCE POLICY - https://www.piedmont.org/media/file/Financial-Assistance-Policy.pdf FINANCIAL ASSISTANCE APPLICATION - https://www.piedmont.org/media/file/Financial-Assistance-Application.pdf FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY - https://www.piedmont.org/media/file/Financial-Assistance-Plain-Language-Su mmary-English.pdf PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT SCH H, PART I, LINE 6A Piedmont Athens Regional Medical Center regularly reports to the community its community benefit activities in several ways. Each year, the hospital prepares a systemwide community-benefit report that is widely distributed to the public through emailed versions sent to community stakeholders and community organizations, printed copies made available to community members upon request, and publication on the system's website. The hospital also makes available copies of its IRS Form 990 Schedule H on its website and available to anyone upon request. Additionally, the hospital presents its community benefit work within the health care system's annual report and the health care system's foundation annual report, which is widely distributed to the public through both printed copies made available to community members upon request and through publication on the system's website. Additionally, the report was mailed to hospital and system board members, state and local elected officials and other key stakeholders. The hospital provides information on community benefit programming to local, state and federal lawmakers through our government affairs office. Finally, the hospital issues media alerts on key community benefit programming, such as its community benefit grants program, to the public, and provides an annual impact report demonstrating the outcomes from those grants. PERCENT OF TOTAL EXPENSE SCHEDULE H, PART I, LINE 7(F) THE DENOMINATOR USED FOR THE CALCULATION OF COLUMN (F), PERCENT OF TOTAL EXPENSE, WAS THE AMOUNT OF TOTAL FUNCTIONAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) OF $491,937,131, LESS BAD DEBT EXPENSE OF $33,983,370 FROM FORM 990, PART IX, LINE 24(B). FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST SCHEDULE H, PART I, LINE 7 A RATIO OF PATIENT CARE COST TO CHARGES, CONSISTENT WITH WORKSHEET 2, WAS USED TO REPORT THE AMOUNTS IN PART I, LINES 7A-7D. FOR AMOUNTS ON LINES 7E-7K, ACTUAL EXPENSES FOR EACH COMMUNITY BENEFIT ACTIVITY ARE TRACED AND REPORTED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. BAD DEBT EXPENSE CALCULATION AND FOOTNOTE SCHEDULE H, PART III, LINES 2-4 The provision for bad debts is based upon management's assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage and other collection indicators. Periodically, management assesses the adequacy of the allowance for double accounts based upon historical write-off experience by payer category. The results of the review are then used to make any modifications to 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 INCOMPLETE INFORMATION. THAT TOTAL WAS THEN ADJUSTED DOWNWARD FOR THE ORGANIZATION'S USE OF PRESUMPTIVE ELIGIBILITY WHEN DETERMINING ITS COMMUNITY BENEFITS. BAD DEBT EXPENSE FOOTNOTE FROM CONSOLIDATED, AUDITED FINANCIAL STATEMENTS: THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBT TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. PIEDMONT ATHENS REGIONAL MEDICAL CENTER 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. BAD DEBT METHODOLOGY SCH H, PART III, LINE 4 The provision for bad debts is based upon management's assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage and other collection indicators. Periodically, management assesses the adequacy of the allowance for double accounts based upon historical write-off experience by payer category. The results of the review are then used to make any modifications to the provision for bad debts to establish an appropriate allowance for uncollectible receivables. MEDICARE SHORTFALLS AS COMMUNITY BENEFIT SCH H, PART III, LINE 8 The amount reported on Part III, Line 6, was calculated in accordance with Schedule H instructions by utilizing the organization's allowable Medicare cost as reported in the Medicare cost report, which is based on a cost to charge ratio. However, the allowable costs in the Medicare cost report do not reflect the actual cost of providing care to patients since the Medicare cost report excludes many direct patient care costs that are essential to provide quality healthcare for Medicare patients. For example, certain coverage fees to physicians, cost of Medicare C and D, and other similar direct patient care expenses are specifically excluded from allowable cost in the Medicare Cost Report. The organization believes that Piedmont Athens' Medicare shortfall reported on Part III, Line 7 of Schedule H, should be considered a community benefit as the IRS community benefit standard includes the provision of care to elderly and Medicare patients. IRS Revenue Ruling 69-545 provides, in part, that hospitals serving patients with governmental health insurance, such as Medicare, is an indication the hospital operates to promote health in the community. Additionally, Medicare accounted for 49.63 percent of Piedmont Athens' patient service revenue. Charity care accounts for an additional 7.66 percent of Piedmont Athens' patient service revenue. Piedmont Athens' policy is to treat Medicare patients, regardless of the extent to which Medicare actually pays for the treatment. For many services, Medicare's reimbursement is less than the cost of the care provided, resulting in shortfalls that are to be absorbed by the hospital in honor of Piedmont Athens' commitment to treat elderly patients. Many of these patients live on a low, fixed income, and would qualify for financial assistance or other means-tested programs, absent from their enrollment in Medicare. COLLECTION PRACTICES SCHEDULE H, PART III, LINE 9(B) INITIAL SCREENINGS OF ALL INPATIENT, EMERGENCY, AND SURGERY ENCOUNTERS, 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 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. SCH H, PART VI, LINE 2 As a designated 501(c)(3) nonprofit hospital, Piedmont Athens is required by the Internal Revenue System to provide to conduct a triennial community health needs assessment (CHNA), in accordance with regulations put forth by the IRS following the 2010 Patient Protection and Affordable Care Act (ACA). Through this assessment, we hope to better understand local health challenges, identify health trends in our community, determine gaps in the current health delivery system and craft a plan to address those gaps and the identified health needs. In FY19, Piedmont Athens conducted its third triennial community health needs assessment (CHNA). FY20 marked Year One of the subsequent Implementation Strategy. The Piedmont Athens CHNA was led by the Piedmont Healthcare community benefits team, with significant input and direction from Piedmont Athens leadership, including the director of community relations and the Piedmont Athens Board of Directors, which formed a subcommittee to help determine final priorities. Process The CHNA started first with a definition of our community. We started first with the hospital's home county, due to the impact of our tax-exempt status. We estimate property taxes make up the largest segment of a hospital's tax exemption. Because of this, we want to ensure that we are providing equal benefit to our county. Additionally, we take into consideration patient origin, and especially that of our lower-income patients, such as those who qualify for financial assistance or receive insurance coverage through Medicaid. Our secondary communities are considered the areas in which we have the highest concentration of patients fitting that criteria, including ones from nearby communities. Once we established our primary and secondary community, we then conducted an analysis of available public health data. This included resources from: 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 are for 2017, unless otherwise noted. Health indicators are estimates provided by County Health Rankings and hospital data were provided by the hospital. An internal survey was also conducted throughout the healthcare system for both clinical and non-clinical employees. Information was gathered on knowledge and understanding of community benefit and current programs, as well as suggestions for how we can better serve our patients and communities. Nearly 900 employees spanning the system responded. Additionally, we conducted a community-based survey in which local stakeholders were asked their thoughts on unmet community health needs and the hospital's role in addressing those needs. These stakeholders included local leaders, nonprofit representatives, elected officials and those with a unique knowledge of the challenges vulnerable populations face. We also evaluated previous community benefit, hospital and community interventions identified in our last CHNA implementation strategies through three lenses: impact, outcomes and sustainability. Interventions and programming considered to have a high score on all three were included in this CHNA and our subsequent strategy. This included our community benefit grants program, our charitable clinic-hospital partnerships and our heart- and stroke-focused community programming. Finally, we conducted direct interviews with 31 state and regional stakeholders and policymakers, with each representing a specific group that tends to be adversely impacted by issues of health equity. These groups included but are not limited to Georgians for a Healthy Future, Georgia Watch, ConsiderHealth, the Community Foundation for Greater Atlanta, the Georgia Charitable Care Network, the Medical Association of Georgia and Healthy Mothers, Healthy Babies. Additionally, we sought and received feedback on our CHNA from public health. Our priorities A key component of the CHNA is to identify the top health priorities we'll address over fiscal years 2020, 2021 and 2022. These priorities will guide our community benefit work. They are, in no order: . Increase access to appropriate and affordable health and mental care for all community members, and especially those who are uninsured and those with low incomes . Decrease deaths from cancer and increase access to cancer programming for those with living the disease, with a focus on lung and breast cancer . Promote healthy weights and behaviors as to decrease preventable instances of heart disease, stroke, diabetes, hypertension and other related chronic conditions . Reduce opioid and related substance abuse and overdose deaths With each priority, we work to achieve greater health equity by reducing the impact of poverty and other socioeconomic indicators. This means that health equity is built into each priority, and that is demonstrated through our implementation strategies. How we determined our priorities: Several key community health needs emerged during the assessment process. The chosen priorities were recommended by the community benefit department with sign-off from hospital and board leadership. The following criteria were used to establish the priorities: . The number of persons affected; . The seriousness of the issue; . Whether the health need particularly affected persons living in poverty or reflected health disparities; and, . Availability of community and/or hospital resources to address the need. The priorities we chose reflected a collective agreement on what hospital leadership, staff and the community felt was most important and within our ability to positively impact the issue. While the priorities reflect clinical access and certain conditions, 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. The CHNA was unanimously approved by the Piedmont Athens Board of Directors on May 23, 2019. The Piedmont Athens implementation strategy was developed in partnership with hospital leadership and community stakeholders to address the identified priorities in our FY19 community health needs assessment. The implementation strategy was designed to be executed over a three-year period and included specific metrics by which we would be able to evaluate our work and its impact. The implementation strategy was developed by utilizing community feedback from the assessment in partnership with the system community benefits department, Piedmont Athens leadership and the Piedmont Athens Board of Directors. As mentioned above, we included proven and successful interventions and programming, investing further in work we felt was successful in addressing unmet health needs. The CHNA implementation strategy was unanimously approved October 24, 2019. SCH H, PART VI, LINE 3 Piedmont Athens understands that not everyone has the ability to pay their hospital bill due to their insurance status or a limited income, and because of this, we offer financial assistance to qualifying patients. Notification about financial assistance available at Piedmont Athens includes providing a dedicated contact number, which is disseminated by the hospital to patients by various means. These include but are not limited to the publication of notices in patient bills and by posting notices in emergency rooms, in the Conditions of Admission form, at admitting and registration departments, hospital business offices, and patient financial services offices that are located on facility campuses, and at other public places the hospital may elect, including availability at local low-cost clinics primarily treating uninsured populations. Piedmont Athens also publishes and widely publicizes a plain language summary of this financial assistance care policy on its facility website, which includes a link to full policy. Referral of patients for financial assistance may be made by any staff or medical staff member at the hospital, including physicians, nurses, financial counselors, social workers, case managers, chaplains and religious sponsors. A request for financial assistance may be made by the patient or a family member, close friend, or associate of the patient, subject to applicable privacy laws. Finally, we provide copies of our financial assistance policy to our partner clinics and others who work closely with low-income populations. We offer assistance in understanding the policy, how it relates to their populations and receive feedback in ways our financial assistance programming could be improved. Additionally, Piedmont Healthcare annually publishes a directory of services and programs for low-income community members, and within this resource guide are extensive directions and advice on how to apply for patient financial assistance. Also, in this guide is information on how to apply for certain government assistance programs, resources to help prepare and file tax returns, as well as detailed resources for local sliding scale and free mental, dental and health resources. This guide is widely distributed to the community via hardcopy, is available within our hospitals and is digitally available online. Copies are provided in both English and Spanish. In FY20, we distributed approximately 3,000 copies of this guide throughout the Athens community. SCH H, PART VI, LINE 4 Piedmont Athens is located in Athens-Clarke County, which we consider to be our primary community. A total of 126,176 people live in the 119.22 square mile report area defined for this assessment according to the U.S. Census Bureau American Community Survey 2015-19 5-year estimates. The population density for this area, estimated at 1,058.36 persons per square mile, is greater than the national average population density of 91.93 persons per square mile. During those years, about 63 percent of all Athens-Clarke County residents were white, 28 percent were African American, and other races made up the remaining 9 percent. The median age of people living within the county was 27, much lower than state and national averages. Seventeen percent of the population were 18 or younger, 11 percent were over the age of 65 and the rest were in between. Between 2015 and 2019, the median household income was $38,623. African Americans had a much lower median household income at $29,394. Sixty-eight percent of the population has, at a minimum, attended some college (with 51 percent having obtained an associate degree or higher), and 12 percent did not graduate high school. Generally speaking, household income and educational attainment are related. Five percent of adults were unemployed in 2020, a figure slightly lower than the national average of 5.4 percent. Forty-two percent of households had housing costs that exceeded more than 30 percent of total household income in 2017, indicating a cost burdened household more likely to face overall financial difficulty. Thirty percent of the county - about 38,000 people - lived in poverty each year on average between 2015 and 2019. During that same time, 33 percent of children in Athens-Clarke County lived in poverty, a figure that has steadily increased over the last ten years. It is significantly higher than the state average of 22 percent. When broken down by race, 51 percent of African American children and 12 percent of white children lived in poverty. Ninety-two percent of public school children were eligible for the free or reduced priced lunch program during the 2018-2019 school year, which is higher than the state average of 60 percent. Poor children are statistically less likely to graduate high school or attend college and are nearly twice as likely to become poor adults than their non-poor counterparts. In Athens-Clarke County, 13.5 percent of residents were uninsured in 2019, and minorities were far more likely as their white counterparts to be uninsured. Non-elderly adults by far were the most likely to be uninsured, with 17 percent of those age 18 to 64 as having no insurance coverage during that time period. About 5.76 percent of the population had Limited English Proficiency, which references the populations aged 5 and older who speak a language other than English at home and speak English less than "very well." In Athens-Clarke County, like with the rest of Georgia, heart disease was the number one cause of age-adjusted death between 2015 and 2019, and this holds true for all races. Age-adjusted allows communities with different age structures to be compared. Premature death is when death happens before the average age for a given community. Suicide was the leading cause of death in Athens-Clarke County between 2015 and 2018, with a total 2,474 deaths during that time. There were five designated health professional shortage areas in the community in 2021: two primary care shortage areas, two mental health shortage areas and one dental health shortage area. There was one dentist for every 1,720 people in 2019, one primary care physician for every 1,520 people and one mental health provider for every 370 people. Community members have reported an average 4.3 and 4.4 poor physical and mental health days, respectively. Both measures increased since our last CHNA, and poor mental days jumped by about a day, indicating a worsening situation. Twenty-three percent of Athens-Clarke residents reported their health as poor or fair. Approximately 410 people lived with HIV in 2018, resulting in a rate of 369.9 infections per every 100,000 people. HIV is a life-threatening communicable disease that disproportionately affects minority populations and may also indicate the prevalence of unsafe sex practices. Chlamydia rates were much higher than both and national averages in 2018, with 887.4 infections per every 100,000 people. This is most prevalent among African American populations. In 2019, there were approximately 138.2 retail opioid prescriptions dispensed per 100 persons, according to the CDC. We aren't able to tell how many prescriptions are going to a single person, just the overall figure. It's important to note that this number increased sharply in 2019 and is among the worst in the state. For every 1,000 teen girls aged 15 to 18 in Athens-Clarke County, 13 birth gave birth to a child on average each year between 2012 and 2018. African American teens were twice as likely to have a baby than their white counterparts. Children born to teenS are statistically much more likely to experience adverse health and socioeconomic issues as they grow older. Sources for all statistics in this section: U.S. Census 2017 ACS Demographic and Housing Estimate, University of Wisconsin Population Health Institute, County Health Rankings, 2018, with indicators ranging from 2012 to 2019, and the Georgia Online Analytical Statistical Information System. SCH H, PART VI, LINE 5 Piedmont Athens actively promotes the health of its community through clinic-hospital partnerships, our community benefit grants programs, community-based health screenings, educational activities, community building activities, the operation of a 24-hour emergency department available to the entire community, the operation of an emergency room open to all members of the community without regard to ability to pay, a governance board composed of community members, use of surplus revenue for facilities improvement, patient care, and medical training, education, and research, the provision of inpatient hospital care for all persons in the community able to pay, including those covered by Medicare and Medicaid, and an open medical staff with privileges available to all qualifying physicians. It's important to note that COVID-19 did have a significant impact on our proactive community benefit programs, as all in-person events and classes were canceled as of early March 2020. We worked to create programming that was responsive to the pandemic, including our migrating to online platforms for vital community-based programming. In FY20, Piedmont Athens offered numerous proactive community benefit programs meant to boost the health of the community it serves. This includes housing and staffing the Community Care Clinic, a full-service community-based clinic that treats patients at no charge. Services include preventative and specialty care, as well as ophthalmology. This came at a cost of $852,214 in FY20. The hospital also provides lab services at no charge to Mercy Health Center, a not-for-profit charitable clinic. The clinic provides significant ongoing financial assistance to not-for-profit charitable clinic Athens Nurses' Clinic - approximately $140,000 in FY20. The hospital also covered approximately $17,605 in transportation-related costs for low-income and/or mobility-challenged community members access necessary health services. The hospital provides funding to other organizations as well, tallying approximately $1.25 million in subsidized health services in FY20. Additionally, we support the community through our community benefit grants program, which provides funding to local not-for-profit organizations whose programs and mission align with Piedmont Athens' CHNA. In FY20, these organizations were: The Tree House, for its mental health services; the Athens Community Council on Aging's transportation services; New Neighbors Network, for its coordination of refugee care; People Living in Recovery, for addiction-related mental health services; and, Mercy Health Center, for health care services for low-income patients. Additionally, and as mentioned above, Piedmont Athens provided to the general public a bilingual community resource guide, which gives information on community resources for lower income populations as well as plain language details on our financial assistance programs. In FY20, Piedmont Athens also provided health professions education to students and residents training to be health professionals. That year, the hospital oversaw training at a cost of $1.3 million. Piedmont Athens also provided extensive one-on-one support through our cancer program, with a total 464 program participants with 756 total interactions. All on-site programs ceased as of March 16 at the Center. The numbers highlight the decrease in program activity and community events with a concurrent increase in individual contacts to our cancer patient population. Adaptation has meant intensive one-to-one outreach in order to ensure high risk clients still get the support they need. The hospital also provided 34 mammograms to low-income women through March 2020. As part of a Piedmont Healthcare systemwide effort, Piedmont Athens was an active participant in anti-opioid work, which included: active participation on the systemwide task force, tracking opioid prescriptions within the hospital and by providers, utilizing Epic EMR tools to monitor opioid use, offering patients and the community ways to safely dispose of unused medication, and providing ongoing education on opioid prescribing. The advent of COVID-19 precluded local take-back day activities, in which we'd traditionally partner with local law enforcement to host an event in which local residents were encouraged to bring in any unused prescriptions for safe disposal. SCH H, PART VI, LINE 6 Piedmont Athens is a part of Piedmont Healthcare, a regional not-for-profit organization and the parent company of 11 hospitals, the Piedmont Physicians Group, the Piedmont Heart Institute, the Piedmont Clinic and the Piedmont Healthcare Foundation. Piedmont Healthcare's community benefit department coordinates the community benefit activities on behalf of all hospitals throughout the system. 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 certain departments of Piedmont Healthcare provide key input and execute programming, such as our revenue department, which oversees and executes the financial assistance policy and program. SCH H, PART VI, LINE 7 Piedmont Athens is not required to file a community benefit report; however, the hospital is required to file with the Georgia Department of Community Health information on its indigent and charity care, as well as its Medicaid and Medicare shortfalls. true UNIVERSITY OF GEORGIA ATHLETIC ASSOCIATION PO BOX 1472 ATHENS GA 30603 580652518 501(C)(3) 15000 PROGRAM SUPPORT ATHENS NURSES CLINIC 240 NORTH AVE ATHENS GA 30601 582490925 501(c)(3) 423941 PROGRAM SUPPORT ATHENS UNITED SOCCER ASSOCIATION 2350 Prince Ave Ste 1 ATHENS GA 30606 581924578 501(C)(3) 25000 PROGRAM SUPPORT AMERICAN CANCER SOCIETY 105 WEST PARK DR ATHENS GA 30606 131788491 501(C)(3) 10000 PROGRAM SUPPORT ATHENS ACADEMY 1281 SPARTAN LANE ATHENS GA 30606 586055242 501(C)(3) 7500 PROGRAM SUPPORT ATHENS TECHNICAL COLLEGE 800 US HWY 29 N ATHENS GA 30601 581824771 501(C)(3) 250000 PROGRAM SUPPORT ATHENS AREA CHAMBER OF COMMERCE 246 W HANCOCK AVE ATHENS GA 30601 580144673 501(C)(3) 10000 PROGRAM SUPPORT BARROW COUNTY SCHOOL SYSTEM 179 West Athens St WINDER GA 30680 GOV'T 6380 PROGRAM SUPPORT OCONEE COUNTY GOVERNMENT 23 N Main St WATKINSVILLE GA 30677 GOV'T 15000 PROGRAM SUPPORT TOUCHDOWN CLUB OF ATHENS PO BOX 6831 ATHENS GA 30604 582078712 501(C)(3) 10000 PROGRAM SUPPORT 10 SCHEDULE I, PART I, LINE 2 MONITORING THE USE OF GRANT FUNDS MONEY IS GIVEN TO CHARITABLE ORGANIZATIONS WHICH PRIMARILY PROMOTE HEALTH CARE CAUSES. THE GRANTS ARE ADMINISTERED AND MONITORED THROUGH THE ORGANIZATION'S PUBLIC RELATIONS DEPARTMENT. SCHEDULE I, PART III, LINE 1B NUMBER OF RECIPIENTS GRANTS TO INDIVIDUALS WERE MADE TO RESIDENTS OF THE GREATER ATHENS CLARKE COMMUNITY IN SUPPORT OF PARMC'S COMMUNITY BENEFIT. PROGRAMS WERE CONDUCTED IN SUPPORT OF PARMC'S IMPLEMENTATION STRATEGY AND TO COMBAT THE LARGEST IDENTIFIED NEEDS OF THE COMMUNITY. X X false true false true false false false false false false false Mr Robert Sinyard VP MEDICAL AFFAIRS 427791 0 112279 0 31008 0 0 0 34176 0 605254 0 0 0 Dr Geoffrey Cole VP, ANCILLARY SVCS 356833 0 71199 0 23096 0 16800 0 11112 0 479040 0 0 0 Ms Jody Corry VP IN HOUSE LEGAL 284825 0 48958 0 1951 0 16492 0 11183 0 363409 0 0 0 Mr Norman Burkett VP, PROFESSIONAL SERVICES 223070 0 35690 0 11380 0 16307 0 16802 0 303249 0 0 0 Mr Louis Duhe VP AND CIO 239284 0 41730 0 376 0 11750 0 12493 0 305633 0 0 0 Ms Diane Todd VP CORP - COMPLIANCE & OPS 203577 0 31828 0 7249 0 12597 0 6863 0 262114 0 0 0 Ms Tammy Gilland VP FOUNDATION 188280 0 29356 0 5402 0 13447 0 6806 0 243291 0 0 0 Mr Larry Ebert FORMER EXC DIR STRAT OPS 0 267153 0 87602 0 5982 0 9618 0 17309 0 387664 0 0 Dr Charles Peck FORMER CEO 105527 0 37308 0 22060 0 0 0 11256 0 176151 0 0 0 Mr J Michael Burnett CEO 494660 0 216563 0 180163 0 91350 0 18096 0 1000832 0 74550 0 Ms Wendy Cook Chief Financial Officer 383426 0 100802 0 17143 0 16800 0 17018 0 535189 0 0 0 Ms Catherine Apaloo FACULTY PROGRAM DIRECTOR 287115 0 0 0 34033 0 12388 0 11539 0 345075 0 0 0 Ms Tamara Jackson CNO 251815 0 68511 0 10724 0 9663 0 7839 0 348552 0 0 0 Mr James Appiah-Pippim faculty 324450 0 0 0 32838 0 4072 0 15288 0 376648 0 0 0 Mr Jason Smith COO 283957 0 74263 0 15160 0 16800 0 11832 0 402012 0 0 0 Ms Keisha Bonhomme PHYSICIAN 248177 0 0 0 1672 0 2308 0 7608 0 259765 0 0 0 Mr Michael McAnder Treasurer 0 613592 0 345604 0 76811 0 123395 0 7500 0 1166902 0 0 Ms Elizabeth Leddy Secretary 0 448895 0 251848 0 142793 0 89849 0 17376 0 950761 0 0 SCHEDULE J, Part I, Line 1a COMPANION TRAVEL AND CLUB DUES BOARD TRUSTEES ARE PROVIDED COMPANION TRAVEL - TAXABLE AMOUNT INCLUDED IN COMPENSATION. OFFICERS ARE PROVIDED SOCIAL CLUB DUES - TAXABLE AMOUNT INCLUDED IN COMPENSATION. OTHER COMPENSATION ITEMS THE FOLLOWING INDIVIDUALS RECEIVED A DISCRETIONARY SPENDING ACCOUNT, A FIXED AMOUNT DETERMINED BY JOB LEVEL. THIS RESPECTIVE AMOUNTS WERE INCLUDED IN THE INDIVIDUAL'S TAXABLE WAGES. DR. CHARLES PECK: $2,307 J. MICHAEL BURNETT: $12,923 ELIZABETH LEDDY: $12,923 MICHAEL MCANDER: $12,923 SCHEDULE J, Part I, Line 1b PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC. DOES NOT HAVE A WRITTEN POLICY REGARDING PAYMENTS OR REIMBURSEMENT OF EXPENSES ON LINE 1A. HOWEVER, COMPANION TRAVEL FOR BOARD MEMBERS ATTENDING OVERNIGHT EVENTS WAS APPROVED BY DR. CHARLES PECK, CEO OF ATHENS REGIONAL HEALTH SERVICES, INC. SCHEDULE J, PART I, LINE 3 COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR THE COMPENSATION FOR THE PRESIDENT/CEO OF PIEDMONT ATHENS REGIONAL MEDICAL CENTER 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 COMPENSATION INFORMATION DR. CHARLES PECK RECEIVED PAYMENTS TOTALING $83,250. KEVIN BROWN RECEIVED PAYMENTS TOTALING $1,653,134. J. MICHAEL BURNETT RECEIVED PAYMENTS TOTALING $62,388. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS: MICHAEL MCANDER ELIZABETH LEDDY WENDY COOK LARRY EBERT SCHEDULE J, PART I, LINE 5A & 6A CONTINGENT COMPENSATION EXECUTIVE AND LEADERSHIP POSITIONS ARE ELIGIBLE TO PARTICIPATE IN A VARIABLE PAY PLAN. GROSS REVENUES AND NET EARNINGS ARE VARIABLE PAY PLAN FACTORS. THIS PLAN PROVIDES INCENTIVES BASED ON SYSTEM PERFORMANCE. THE RESULTS ARE BASED ON THE ACCOMPLISHMENT OF SPECIFIC STRATEGIC OBJECTIVES INVOLVING: (1) SUSTAINED AND IMPROVED FINANCIAL PERFORMANCE AND EFFICIENCY; (2) EMPLOYEE SATISFACTION AND RETENTION; (3) IMPROVED CUSTOMER SATISFACTION INCLUDING MEMBERS, PHYSICIANS, PATIENTS, AND EMPLOYEES; (4) MAINTENANCE AND IMPROVEMENT IN QUALITY AND CLINICAL OUTCOMES. THE PERFORMANCE SCORECARD IS DETERMINED ANNUALLY AND APPROVED BY THE BENEFITS AND COMPENSATION COMMITTEE OF THE BOARD. THE PLAN WILL BE DISALLOWED BASED ON LOSS OF THE JOINT COMMISSION ACCREDITATION OR A VIOLATION OF THE BOND COVENANTS. SCHEDULE J, PART I, LINE 7 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. A THE HOSPITAL AUTHORITY OF CLARKE COUNTY GA 586003375 181685JM1 2016-11-16 178225000 SEE PART VI false false false A 12525000 0 208099492 0 0 208092160 7332 0 0 0 0 0 2016 false true true true A false false false false 0 false false false true A false true false false false false 0 false 0 false true A true SCHEDULE K, PART I, COLUMN F The proceeds of the Series 2019 bonds were used to redeem the Series 2007 bonds issued in January, 2007, and the Series 2012 Bonds issued in March, 2012. FORM 990, PART V, LINE 1A FORM 1096 FILINGS ALL FORM 1096 FILINGS FOR THE ORGANIZATION ARE FILED BY PIEDMONT HEALTHCARE, INC. (EIN 58-1503902) FORM 990, PART VI, SECTION A, LINE 6 ORGANIZATION'S SOLE MEMBER PIEDMONT HEALTHCARE, INC., (EIN 58-1503902) IS THE SOLE MEMBER OF PIEDMONT ATHENS REGIONAL MEDICAL CENTER ("PAR"). FORM 990, PART VI, SECTION A, LINE 7A ELECTION OF GOVERNING BODY THE BOARD OF PIEDMONT HEALTHCARE, PIEDMONT ATHENS REGIONAL MEDICAL CENTER'S SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF PIEDMONT ATHENS REGIONAL MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF GOVERNING BODY PIEDMONT ATHENS REGIONAL MEDICAL CENTER'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 ATHENS REGIONAL MEDICAL CENTER 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 INFORMATION NEEDED TO PREPARE PIEDMONT ATHENS REGIONAL MEDICAL CENTER'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. The INFORMATION IS REVIEWED BY PNH'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, SECTION B, 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 MOUNTAINSIDE 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 SENIOR VICE PRESIDENT OF COMPLIANCE FOR INVESTIGATION, AND REMEDIAL STEPS MUST BE TAKEN AS APPROPRIATE UNDER THE PIEDMONT HEALTHCARE DISCIPLINARY POLICIES. FORM 990, PART VI, SECTION B, LINE 15A, 15B EXECUTIVE COMPENSATION COMPENSATION FOR EXECUTIVES OF PIEDMONT ATHENS REGIONAL MEDICAL CENTER 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, AND THE MAJORITY OF WHICH ARE COMMUNITY DIRECTORS WHO GENERALLY DO NOT HAVE CONFLICTS OF INTEREST RELATED TO FULFILLMENT OF THE DUTIES AS OUTLINED BELOW. THE COMMITTEE OVERSEES EXECUTIVE PERFORMANCE AND COMPENSATION ON BEHALF OF THE PHC BOARD, SUBJECT TO THE ULTIMATE AUTHORITY AND OVERSIGHT 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 DATA 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, INCLUDING BUT NOT LIMITED TO, APPROVAL OF EXECUTIVE EMPLOYMENT CONTRACTS AND BENEFITS. FORM 990, PART VI, SECTION C, LINE 19 DISCLOSURE OF GOVERNING, CONFLICT OF INTEREST AND FINANCIAL DOCUMENTS 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 XI, LINE 9 CHANGES TO NET ASSETS REPORTED ON PART XI, LINE 9 ARE COMPRISED OF: UNALLOCATED EXPENSES ($11,513,658) BOOK/TAX DIFF $354,461 CHANGES IN TEMP. $335,937 INTERCOMPANY TRANS. ($39,707,450) CHANGES IN UNRESTR. FUND $60,175 -------------------- TOTAL ($50,470,535) PIEDMONT HEALTHCARE INC 1800 HOWELL MILL ROAD SUITE 850 ATLANTA GA 30318 581503902 MANAGEMENT GA 501(c)(3) 12B, III-F NA false PIEDMONT HOSPITAL Inc 1968 PEACHTREE ROAD NW ATLANTA GA 30309 580566213 HOSPITAL GA 501(c)(3) 3 PHC false FAYETTE COMMUNITY HOSPITAL INC 1255 HIGHWAY 54 WEST FAYETTEVILLE GA 30214 582232328 HOSPITAL GA 501(c)(3) 3 PHC false PIEDMONT MOUNTAINSIDE HOSPITAL INC 1266 HIGHWAY 515 SOUTH JASPER GA 30143 352228583 HOSPITAL GA 501(c)(3) 3 PHC false PIEDMONT NEWNAN HOSPITAL INC 745 POPLAR ROAD NEWNAN GA 30265 205077249 HOSPITAL GA 501(c)(3) 3 PHC false PIEDMONT HEALTHCARE FOUNDATION INC 2001 PEACHTREE ROAD NE SUITE 400 ATLANTA GA 30309 581272768 FUNDRAISING GA 501(c)(3) 12B, II PHC false PIEDMONT HENRY HOSPITAL INC 1133 EAGLES LANDING PKWY STOCKBRIDGE GA 30281 582200195 HOSPITAL GA 501(c)(3) 3 PHC false PIEDMONT NEWTON HOSPITAL INC 5126 HOSPITAL DRIVE NE COVINGTON GA 30014 582155150 HOSPITAL GA 501(C)(3) 3 PHC false PIEDMONT HEART INSTITUTE INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 263553500 HOSPITAL GA 501(C)(3) 10 PHC false PIEDMONT ATHENS REGIONAL HEALTH RESOURCE 1199 PRINCE AVENUE ATHENS GA 30606 581930580 DEVELOPMENT GA 501(C)(3) 12B, II PARMC true PIEDMONT ATHENS REGIONAL FOUNDATION INC 1199 PRINCE AVENUE ATHENS GA 30606 581978389 FUNDRAISING GA 501(C)(3) 12B, II PARMC true ATHENS REGIONAL SPECIALTY SERVICES INC 1199 PRINCE AVENUE ATHENS GA 30606 271975001 HEALTHCARE GA 501(C)(3) 3 PARMC true ATHENS REGIONAL PHYSICIAN SERVICES INC 1199 PRINCE AVENUE ATHENS GA 30606 582332921 HEALTHCARE GA 501(C)(3) 12B, II PARMC true REGIONAL FIRSTCARE INC 1199 PRINCE AVENUE ATHENS GA 30606 582362733 URGENT CARE GA 501(C)(3) 12B, II PARMC true COLUMBUS AMBULATORY HEALTHCARE SERVICES 707 CENTER ST COLUMBUS GA 31901 581719867 AMBULATORY GA 501(C)(3) 3 CRHS false COLUMBUS REGIONAL HEALTHCARE SYSTEM INC 707 CENTER ST COLUMBUS GA 31901 581719994 HEALTHCARE GA 501(C)(3) 12B, II PHC false COLUMBUS REGIONAL MEDICAL FOUNDATION INC 707 CENTER ST COLUMBUS GA 31901 581501642 FUNDRAISING GA 501(C)(3) 7 CRHS false THE MEDICAL CENTER INC 710 CENTER ST COLUMBUS GA 31901 581685139 HOSPITAL GA 501(C)(3) 3 CRHS false HUGHSTON HOSPITAL INC 707 CENTER ST COLUMBUS GA 31901 331216751 HOSPITAL GA 501(C)(3) 3 CRHS false PIEDMONT ROCKDALE HOSPITAL INC 1412 MILSTEAD AVE CONYERS GA 30012 300999841 HOSPITAL GA 501(C)(3) 3 PHC false PIEDMONT WALTON HOSPITAL INC 2151 WEST SPRING ST MONROE GA 30655 824194264 HOSPITAL GA 501(C)(3) 3 PHC false PEACHTREE ORTHOPAEDIC SURGERY CENTER 2001 PEACHTREE RD NE STE 705 ATLANTA GA 30309 582562721 SURGERY GA NA N/A 0 0 false 0 false 0.00000 DIGESTIVE HEALTHCARE OF GA SURGERY CTR 95 COLLIER RD NW STE 4075 ATLANTA GA 30309 582406657 HEALTHCARE GA NA N/A 0 0 false 0 false 0.00000 FOUR WINDS HEALTH LLC 3350 RIVERWOOD PKWY STE 1850 ATLANTA GA 30339 451273930 HEALTHCARE GA NA N/A 0 0 false 0 false 0.00000 GEORGIA HEALTH COLLABORATIVE LLC 2727 PACES FERRY RD BLDG 2 STE 20 ATLANTA GA 30339 461500639 HEALTHCARE GA NA N/A 0 0 false 0 false 0.00000 PIEDMONT MEDICAL CARE CORPORATION 2727 PACES FERRY ROAD SUITE 1-1100 ATLANTA GA 30339 582092768 HEALTHCARE GA PHC C-CORP 0 0 0.00000 false THE PIEDMONT CLINIC INC 2727 PACES FERRY ROAD SUITE 1-1100 ATLANTA GA 30339 582005358 HEALTHCARE GA PHC C-CORP 0 0 0.00000 false PIEDMONT HEART INSTITUTE PHYSICIANS INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 260593850 HEALTHCARE GA PHC C-CORP 0 0 0.00000 false AMSTER MCRAE INSURANCE COMPANY PO BOX 1159 GRAND CAYMAN CJ ky1-1102 980427603 Related Insur CJ PHC C-CORP 0 0 0.00000 false PIEDMONT WELLSTAR HEALTHPLANS INC 2859 PACES FERRY ROAD SUITE 600 ATLANTA GA 30339 461922499 HEALTH INSUR. GA PHC C-CORP 0 0 0.00000 false COLUMBUS HEALTHCARE RESOURCES PO BOX 790 COLUMBUS GA 31902 581717754 HEALTHCARE GA CRHS C CORP 0 0 0.00000 false Columbus Health Services Inc PO BOX 790 COLUMBUS GA 31902 581640939 HEALTHCARE GA CRHS C CORP 0 0 0.00000 false false false false false false false false false false false false false false false false true true false false PIEDMONT ATHENS REGIONAL PHYSICIANS SERVICES Q 1475674 FMV PIEDMONT ATHENS REGIONAL SPECIALTY PHYSICIANS Q 10868537 FMV REGIONAL FIRSTCARE P 830554 FMV