2020-05-15T11:16:40-05:00 2019-06-30 KPMG LLP 300 North Greene Street Suite 400 Greensboro NC 27401 990 2018-07-01 331216751 Hughston Hospital INC % MARIE GAFFNEY HUGH 7066606103 707 Center Street Columbus GA 31901 MARIE GAFFNEY VP CORPORATE FINANCE 4044251303 2020-05-14 true SHAWN M HUTCHINSON P01048557 3362753394 2020-05-14 199.206.0.5 56038220201365000025 2020-05-15 P 2F91BA52B61FEB008F3980E6EE57B14852305A4E 1272C807EE2CFB18DB9032F475C1250F2D6A8CEA 2018 2020-09-23 17:36:50Z PIEDMONT COLUMBUS REGIONAL-NORTHSIDE SCOTT HILL 707 Center Street Columbus GA 31901 91455018 false X www.piedmont.org X 2008 GA TO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT. 13 11 745 371 0 0 0 0 71328071 90860153 448177 594865 0 0 71776248 91455018 16250 15208 0 0 22394286 28017105 0 0 0 46857472 55144392 69268008 83176705 2508240 8278313 87913701 83582749 63489635 56343641 24424066 27239108 X TO PROVIDE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE IN A PROGRESSIVE ENVIRONMENT, GUIDED BY PHYSICIANS, DELIVERED BY PROFESSIONALS, AND INSPIRED BY THE COMMUNITIES WE SERVE. false false 77676744 15208 90860153 HUGHSTON HOSPITAL ("PH") IS A 100-BED FACILITY THAT SERVES THE CITY OF COLUMBUS IN MUSCOGEE COUNTY, GEORGIA. OUR PRIMARY CARE AND SPECIALTY PHYSICIANS ON THE MEDICAL STAFF MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SENIORS WITHIN THE CITY AND THE GREATER COLUMBUS MARKET, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY FOR SERVICES. FOR THE YEAR ENDED JUNE 30, 2019, THE HOSPITAL HAD 3,891 IN-PATIENT ADMISSIONS WITH A TOTAL OF 18,265 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 21,136 AND OUTPATIENT VISITS TOTALED 9,945. SURGICAL SERVICES WERE PROVIDED TO 4,848 PATIENTS. 77676744 true false false true false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true false false false true X 0 0 745 true false false false false false false false false false false false false X 13 11 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 Scott Hill President & CEO CRHS 2.5 47.5 X X 0 1256604 58967 Warren Steele II Chairman 2.0 6.0 X 0 0 0 Max Brabson Jr Director 2.0 6.0 X 0 0 0 Cecil Cheves Director 2.0 6.0 X 0 0 0 Dr Shane Darrah Director 2.0 6.0 X 0 0 0 W Ronald Duffey DIRECTOR 2.0 6.0 X 0 0 0 John Dale Hester Director 2.0 6.0 X 0 0 0 Dr Todd Jarrell Director 2.0 6.0 X 0 0 0 Joey Loudermilk Director 2.0 6.0 X 0 0 0 Michael Mandl Director 2.0 53.0 X 0 938721 99386 Liliana McDaniel Director 2.0 6.0 X 0 0 0 Dr Susan McWhirter Director 2.0 6.0 X 0 0 0 Dr William Roundtree Director 2.0 6.0 X 0 0 0 KAREN SMITH CORPORATE SECRETARY 2.0 38.0 X 0 77531 17650 LAURA DREW COO HUGHSTON HOSPITAL 20.0 35.0 X 0 444628 31674 Allen Holladay CFO - beg. 5/1/19 2.0 48.0 X 0 399506 25497 Allen Butcher Executive VP & CFO end 4/30/19 2.0 48.0 X 0 637961 13708 Holly Lehmberg Assistant CNO 40.0 0.0 X 219602 0 11629 Diane Morris Director - Surgical Services 40.0 0.0 X 166433 0 23208 Judith Hill Clinical Pharmacist 40.0 0.0 X 143441 0 29794 Timara Rembert Clinical Pharmacist 40.0 0.0 X 138559 0 28870 Sherry Martin MGR Pharmacy 40.0 0.0 X 170038 0 20641 838073 3754951 361024 5 false true false HSS Systems 12901 Starkey Rd LARGO FL 33773 Management Services 1644909 Healthtrust Workforce 3322 West End Ave 201 NASHVILLE TN 37203 Staffing Services 596041 Parallon Technology 6640 Carothers Parkway FRANKLIN TN 37067 Management Services 462178 Crown Healthcare Laundry 25 W Cedar St Suite 405 PENSACOLA FL 32502 Laundry Services 223404 Renal Treatment Center 601 Hawaii Street El SEGUNDO CA 90245 Dialysis Services 196395 10 0 PATIENT SERVICE 621400 90859181 90859181 CORPORATE SERVICE FEES 900099 972 972 90860153 594865 0 0 594865 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91455018 90860153 0 594865 15208 15208 0 0 0 0 0 23291014 19331542 3959472 0 3241804 2690697 551107 1484287 1231958 252329 0 9217 9217 0 0 0 0 9905744 9905744 167874 167874 3133044 3109336 23708 0 0 4256391 4086135 170256 36251 23594 12657 0 3867 3261 606 1676793 1626489 50304 0 2543838 2391208 152630 122863 115491 7372 BAD DEBT EXPENSE 9951088 9951088 MEDICAL SUPPLIES & DRUGS 19560214 19560214 TAXES 889260 889260 PHYSICIAN SUPPORT 514136 514136 2373812 2231383 142429 83176705 77676744 5499961 0 346092 96726 0 0 0 0 9534290 12362456 0 0 0 0 0 0 4845429 5177186 166361 19733 55895488 3145079 52296141 52750409 12616248 13168599 0 0 0 0 0 0 8109140 7640 87913701 83582749 5431326 7543763 0 0 0 0 0 0 0 0 0 0 58008512 48783180 0 0 49797 16698 63489635 56343641 X 24424066 27239108 0 0 0 0 24424066 27239108 87913701 83582749 X 8278313 493944 4287172 -10244387 X X false true X true false X X 0 0 0 0 0 0 0 0 0 1000000 1000000 1000000 3000000 4500000 25509 24675 2250 52434 250000 250000 250000 750000 1125000 5030000 5030000 36148200 1387372 34760828 13906343 1757707 12148636 810945 810945 52750409 0 CAPITAL LEASE OBLIGATION 16698 16698 X PART X, LINE 2: The System accounts for income taxes under the provisions of ASC 740, Income Taxes (ASC 740). Under the requirements of ASC 740, tax-exempt organizations may be required to record an obligation as the result of a tax position they have historically taken on various uncertain tax exposure items. There were no material uncertain tax positions at June 30, 2019. true true true X 300. true X true true true false true true 158125 158125 0.00190 1087489 1087572 0 0.00000 958936 27893 931043 0.01120 2204550 1115465 1089168 0.01310 2204550 1115465 1089168 0.01310 true 9951088 18425083 18932742 -507659 X true true 1 1 HUGHSTON HOSPITAL INC 707 CENTER STREET COLUMBUS GA 31901 WWW.piedmont.org 106-659 X X X HUGHSTON HOSPITAL INC 1 false false true X X X X X X X X 18 true false false true X SEE PART V X X true 17 true SEE PART V false true X 300. 300. X true true X X X X true X SEE PART V X SEE PART V X SEE PART V X X X X X X true X false X X X X true X false false HUGHSTON HOSPITAL, INC.: Schedule H, PART V, SECTION B, LINE 5: COMMUNITY REPRESENTATION As a part of our process, we interviewed 31 key stakeholders and policy makers that represent public health, low-income populations, uninsured and uninsured persons, minorities, chronic conditions, older adults, and lawmakers. Further, in December 2018 and December 2019, 133 key stakeholders within the Piedmont Columbus Hospital community, including Hughston Hospital, provided their thoughts on community health, community assets and the role of the hospital in addressing unmet community health needs via a web survey. Below are the results of that survey. These interviews were conducted for people representing the entire region, including Muscogee County. Specifically, we interviewed representatives of local and regional public health entities, minority populations, faith-based communities, local business owners, the philanthropic community, mental health agencies, elected officials and individuals representing our most vulnerable patients. The Piedmont Healthcare board of directors and leadership from all 11 hospitals were actively informed and engaged throughout this process. Schedule H, PART V, SECTION B, LINE 6A: COMMUNITY HEALTH NEEDS ASSESSMENT THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED FOR PIEDMONT COLUMBUS REGIONAL HEALTHCARE SYSTEM, FEIN 58-1719994, WHICH INCLUDES THE MEDICAL CENTER, INC., FEIN 58-1685139, AND HUGHSTON HOSPITAL, INC., FEIN 33-1216751. Schedule H, PART V, SECTION B, LINE 7a: CHNA REPORT WEBSITE https://www.piedmont.org/media/file/PCR-FY19-CHNA-Strategy.pdf Schedule H, PART V, SECTION B, LINE 7d: PUBLIC AVAILABILITY OF CHNA IN ADDITION TO MAKING ITS CHNA AVAILABLE ON ITS WEBSITE AND BY REQUEST, HUGHSTON HOSPITAL SENT COPIES TO EACH PARTICIPANT IN THE CHNA PROCESS, DISTRIBUTED THE ASSESSMENTS TO COMMUNITY CENTERS AND OTHER LOCATIONS THAT PRIMARILY SERVE AN UNINSURED POPULATION, SENT COPIES TO LEGISLATIVE AND ELECTED OFFICIALS, AND WIDELY DISTRIBUTED THE ASSESSMENTS TO OTHER PIEDMONT HEALTHCARE HOSPITALS. Schedule H, PART V, SECTION B, LINE 10a: IMPLEMENTATION STRATEGY THE BOARD OF DIRECTORS FOR HUGHSTON HOSPITAL UNANIMOUSLY APPROVED ITS IMPLEMENTATION STRATEGY FOR THE THREE YEAR PERIOD BEGINNING WITH FY20 ON OCTOBER 3, 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, 2019. https://columbusregional.com/media/1588/2015-chna-report-muscogee-county-g apdf.pdf THE IMPLEMENTATION STRATEGY APPROVED ON OCTOBER 3, 2019 WAS THE FIRST SINCE PIEDMONT HEALTHCARE ACQUIRED HUGHSTON HOSPITAL. THAT IMPLEMENTATION STRATEGY IS AVAILABLE ON PAGE 18 OF THE PDF AT THE FOLLOWING LINK: https://www.piedmont.org/media/file/PCR-FY19-CHNA-Strategy.pdf Schedule H, PART V, SECTION B, LINE 11: ADDRESSING COMMUNITY HEALTH NEEDS PIEDMONT HEALTHCARE ACQUIRED HUGHSTON HOSPITAL IN THE MIDST OF ITS THREE YEAR CHNA AND IMPLEMENTATION STRATEGY CYCLE UNDER ITS PREVIOUS OWNER. PIEDMONT HEALTHCARE IN CONJUNCTION WITH HUGHSTON HOSPITAL DEVELOPED THE NEW IMPLEMENTATION STRATEGY TO ADDRESS THE REGIONS PRIORITY NEEDS DURING FY20-22. THE HUGHSTON HOSPITAL BOARD OF DIRECTORS UNANIMOUSLY APPROVED THE NEW CHNA ON JUNE 6, 2019. BASED ON THE CHNA, HUGHSTON HOSPITAL 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 CANCER AND INCREASE ACCESS TO CANCER PROGRAMMING FOR THOSE LIVING WITH THE DISEASE (4) DECREASE THE IMPACT OF AND DEATHS FROM STROKE; (5) REDUCE RATES OF OBESITY AND INCREASE ACCESS TO HEALTHY FOODS AND RECREATIONAL ACTIVITIES; AND (6) DECREASE PREVENTABLE INSTANCES OF DIABETES AND DECREASE THE NUMBER OF PATIENTS WITH UNCONTROLLED DIABETES. Schedule H, PART V, LINE 16A: FINANCIAL ASSISTANCE POLICY WEBSITE https://www.piedmont.org/media/file/Financial-Assistance-Policy.pdf Schedule H, PART V, LINE 16B: FINANCIAL ASSISTANCE POLICY WEBSITE https://www.piedmont.org/media/file/Financial-Assistance-Application.pdf Schedule H, PART V, LINE 16C: FAP PLAIN LANGUAGE SUMMARY WEBSITE https://www.piedmont.org/media/file/Financial-Assistance-Plain-Language-Su mmary-English.pdf SCHEDULE H, PART VI, LINE 1: REQUIRED DESCRIPTIONS PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT Schedule H, Part I, line 6a Piedmont Columbus Regional 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 systems 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 systems annual report and the health care systems 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 systems 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 $83,176,705 LESS BAD DEBT EXPENSE OF $9,951,088 FROM FORM 990, PART IX, LINE 24(a). FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST SCHEDULE H, PART I, LINE 7 A RATIO OF PATIENT CARE COST TO CHARGES, CONSISTENT WITH WORKSHEET 2, WAS USED TO REPORT THE AMOUNTS IN PART I, LINES 7A-7D. FOR AMOUNTS ON LINES 7E-7K, ACTUAL EXPENSES FOR EACH COMMUNITY BENEFIT ACTIVITY ARE TRACED AND REPORTED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. BAD DEBT EXPENSE CALCULATION AND FOOTNOTE SCHEDULE H, PART III, 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 INSUFFICIENT INFORMATION. THAT TOTAL WAS THEN ADJUSTED DOWNWARD FOR THE ORGANIZATION'S USE OF PRESUMPTIVE ELIGIBILITY WHEN DETERMINING ITS COMMUNITY BENEFITS. BAD DEBT EXPENSE FOOTNOTE FROM CONSOLIDATED, AUDITED FINANCIAL STATEMENTS: THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY 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. HUGHSTON HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE ARE NOT REPORTED AS REVENUE. BAD DEBT METHODOLOGY SCHEDULE 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 Schedule H, Part III, Section B, line 8 The amount reported on Part III, Line 6, was calculated in accordance with Schedule H instructions by utilizing the organizations 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 Columbus Regionals 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 27.28% percent of Piedmont Columbus Regionals patient service revenue. Piedmont Columbus Regionals policy is to treat Medicare patients, regardless of the extent to which Medicare actually pays for the treatment. For many services, Medicares 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 Columbus Regionals 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, AS WELL AS MOST OUTPATIENT VISITS, ARE CONDUCTED BY FINANCIAL COUNSELORS IN ORDER TO IDENTIFY ANY AVAILABLE INSURANCE OR OTHER COVERAGE FOR EACH PATIENT. COUNSELORS CONTACT PATIENTS AND THEIR FAMILIES DIRECTLY, EITHER IN PERSON OR BY LETTER, TO ASSIST THE FAMILY IN IDENTIFYING ANY PROGRAMS FOR WHICH THE PATIENT/SERVICE MAY QUALIFY (INCLUDING MEDICAID, STATE CHILDREN'S HEALTH INSURANCE PROGRAM ("SCHIP"), PRIVATE OR GOVERNMENT INSURANCE COVERAGE, AND CHARITY ASSISTANCE). IF THE FAMILY CANNOT BE TIMELY LOCATED OR IS UNCOOPERATIVE, RELATED ACCOUNTS ARE TRANSFERRED TO AN INTERNAL COLLECTION DEPARTMENT FOR FURTHER ATTEMPTS TO OBTAIN PAYMENT OR, IF THE PATIENT MAY QUALIFY FOR ASSISTANCE, TO SECURE A FINANCIAL ASSISTANCE APPLICATION. THE ORGANIZATION'S DEBT COLLECTION POLICY AND PROCEDURES PROHIBIT ANY COLLECTION EFFORTS FOR THE PORTION OF A PATIENT ACCOUNT BALANCE THAT QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. SCHEDULE H, PART VI, LINE 2: NEEDS ASSESSMENT As a designated 501(c)(3) nonprofit hospital, Piedmont Columbus Regional 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 Columbus Regional conducted its third triennial CHNA. As in the past, hospital conducted a joint CHNA for both its campuses. The Piedmont Columbus Regional CHNA was led by the Piedmont Healthcare community benefits team, with significant input and direction from Piedmont Columbus leadership, including the hospital's community outreach team. Process The CHNA started first with a definition of our community. We started first with the hospitals home county, due to the impact of our tax-exempt status. We estimate property taxes make up the largest segment of a hospitals 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 DeKalb County. 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. In March 2019, the Piedmont Columbus community outreach team convened a meeting of key stakeholders to discuss health challenges and needs in the local community. Among the 47 stakeholders present were representatives from MercyMed of Columbus charitable clinic, Valley Healthcare System, the Muscogee County School District, the Muscogee County Health Department and Columbus Consolidated Government. The goal of this meeting was to establish community consensus on top unmet health needs the hospital should address. 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 guide our community benefit work. They are, in no order: -Increase access to appropriate and affordable health 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 -Decrease preventable instances of diabetes and decrease the number of patients with uncontrolled diabetes -Reduce rates of obesity and increase access to healthy foods and recreational activities -Decrease the impact of and deaths from stroke -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 is viewed through the lens of health disparities, with particular attention paid to improving outcomes for those most vulnerable due to income and race. This community health needs assessment was unanimously approved by the Piedmont Columbus Regional Board of Directors on June 06, 2019. The Piedmont Columbus Regional implementation strategy was developed in partnership with hospital leadership and community stakeholders to address the identified priorities in our FY19 CHNA. 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 Columbus Regional leadership and the Piedmont Columbus Regional 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 03, 2019. SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSIST. Piedmont Columbus Regional 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 Columbus Regional 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 Columbus Regional 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. SCHEDULE H, PART VI, LINE 4: COMMUNITY INFORMATION Piedmont Columbus Regional is located in Muscogee County, which we consider to be our primary community. In 2017, the last year for which Census data were available, approximately 198,647 people lived in Muscogee County and 97 percent lived in an urban area. That year, about 41 percent of all Muscogee County residents were white, 45 percent were African American, 8 percent were Hispanic or Latino, 2 percent were Asian, and 4 percent were another race. In 2017, the median household income was $43,239, which is lower than both state and national averages. African Americans specifically had a much lower median household income at $31,907. The median age of people living within the county was 34. A quarter of the population were 18 or younger, 18 percent were over the age of 65 and the rest were in between. The population skewed slightly female. Sixty percent of the population has, at a minimum, attended some college and 26 percent has received their bachelors degree or higher. Thirty-six percent of those living in poverty in the county did not graduate high school. In 2017, an estimated 87 percent of county residents graduated high school, right on par with the state average. Of the estimated 46,324 who were employed in 2017, most worked in health care/social assistance, retail and the hospitality industry, in that order. About 20,891 veterans lived in the county in 2017, with more than two-thirds having served in the Gulf War and 29 percent having served in Vietnam. Twenty-two percent of those veterans lived with a disability and about 19 percent lived below the poverty level. About 5 percent of households spoke a language other than English at home in 2017, with the majority of those households speaking Spanish. Most people - about 52 percent - rented their home in 2017, a number much higher than the state average of 37 percent. In Muscogee County, like with the rest of Georgia, heart disease is the number one cause of both age-adjusted and premature death, 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. While COPD is the second leading cause of death for all races combined, diabetes is the second leading cause of death for African Americans. COPD is the second leading cause of death for whites. Information about other races, including Hispanic, Latino and Asian populations, was not available. Heart disease was the leading cause of premature death among all ages and races in aggregate between 2013 and 2017. Certain conditions originating in the perinatal period (the first 28 days of life) was the second leading cause of premature death for African Americans and suicide was the second leading cause of premature death for whites. In Muscogee County, 14 percent of adults were uninsured in 2017, and minorities comprise 90 percent of that figure. There were four designated health professional shortage areas in the community in 2016, all of which are located just north of Columbus: two primary care shortage areas, one mental health shortage area and a dental health shortage area. Throughout Georgia, more than a fifth of all women and a third of all men report having no personal doctor or health home. This is particularly true for minorities, whose rates of not having a doctor are double and triple that of their white counterparts. There were 54 dentists for every 100,000 people in 2015, a figure slightly better than the state average and significantly below the national rate. Seventy-four percent of adults had a routine check-up within the previous year in 2015. Preventable hospital stays among Medicare enrollees significantly has decreased over the last few years (from 51 preventable stays per 1,000 enrollees in 2007 to 37 preventable stays in 2015). Community members have reported an average 4.3 and 4.0 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-two percent of Muscogee residents reported their health as poor or fair. This is an improvement from 17 percent since our last CHNA. Long commutes are also much lower in Muscogee County than in the rest of the state. Only 16 percent drove more than 30 minutes in 2016 to get to work, as opposed to a 40 percent state average. Eighteen percent of the population lived with at least one disability in 2017, which is significantly higher than the state average of 12 percent. Those age 18 to 64 comprised nearly 60 percent of total disabled. The infant mortality rate is twice as high in Muscogee County than the national average. During that same time, 11 percent of all babies born were at a low birth weight, with African American children more likely to be born at a low birth weight than their white, Asian and Hispanic or Latino counterparts. In 2017, 92 county residents died from stroke. The age-adjusted death rate for stroke was 46.5 per every 100,000 residents that year, a figure that has steadily improved the last three years. For example, in 2015, the age-adjusted death rate for stroke was 50.3 deaths per every 100,000 people. Approximately 14 percent of adults lived with diabetes in Muscogee County in 2015, a figure higher than state and national averages (11 percent and 9 percent, respectively). In 2015, 32 percent of Medicare beneficiaries lived with diabetes. The numbers may be higher for Medicare beneficiaries because that population is more likely to be tested routinely for the disease. Cancer continues to have a devastating impact in Muscogee County. Among all cancers, lung cancer is the most devastating in Muscogee County, having claimed approximately 450 lives between 2013 and 2017. Lung cancer was the fourth cause of death in Muscogee County between 2013 and 2017 for all residents, and the age-adjusted death rate remains high above state and national averages. The overall cancer incidence rate was 134.9 per 100,000 people, which is higher than both state and national averages between 2011 and 2015. Lung cancer rates were particularly high, with an average 133 new cases annually between 2011 and 2015. Chronic obstructive pulmonary disease is the second leading cause of age-adjusted death and is caused almost exclusively from smoking. Violence is an issue in Muscogee County. Homicide was the 9th leading cause of all deaths for African Americans within the county between 2013 and 2017, and the third leading cause of premature deaths. The violent crime rate is far above both state and national averages, with 517 violent crimes per every 100,000 residents. Chlamydia and gonorrhea rates were far above state averages and nearly double national averages in 2016, with both being most prevalent in African American populations. Approximately 913 people lived with HIV in 2015. HIV is a life-threatening communicable disease that disproportionately affects minority populations and may also indicate the prevalence of unsafe sex practices. The Muscogee rate is lower than the state average but about 40 percent higher than the national average. Mental health and behavioral disorders were the 7th leading cause of death for all county residents between 2013 and 2017. We see this particularly in premature death. Suicide was the second leading cause of premature deaths for whites between 2013 and 2017. It is most common among males aged 25 to 34 years of age. There was one mental health provider for every 370 residents in the county in 2017, a rate better than the state average of just one provider for every 870 residents. Opioid prescriptions have decreased over the last few years. In 2007, there were approximately 108.2 retail opioid prescriptions dispensed per 100 persons, according to the CDC. That number has dropped to 86.5 in 2017. Even so, Muscogee County remains much higher than the national average of 58.7 per 100 people and state average of 70.9. We aren't able to tell how many prescriptions are going to a single person, just the overall figure. Drug overdoses in Muscogee County are lower than state averages, with only 10 overdoses per 100,000 people in 2016, versus the state average of 12. Opioid use is directly correlated with increased rates of Hepatitis C, according to numerous studies. Georgia still remains one of the worst states for drug overdose deaths in the country, and this has only gotten worse. For example, there was a 10.5 percent increase in overdose deaths in the state between 2016 and 2017. Six percent of adults were unemployed in 2017, a figure just above the national average of 5 percent. 36 percent of those living in poverty in the county did not graduate high school in the 2015-2016 school year. In 2015, 36 percent of the population had limited access to healthy foods and 21 percent reported having extended periods when they aren't sure how they or their families will eat. There were 109 fast fo SCHEDULE H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH Piedmont Columbus Regional 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. In FY19, Piedmont Columbus Regional offered various proactive community benefit programs meant to boost the health of the community it serves. This includes its mobile unit, which regularly serves low-income communities throughout Muscogee and surrounding areas. The mobile unit works on monthly rotation schedule to provide blood pressure checks, stroke, diabetes, cancer and opioid education to schools, faith-based organizations, housing areas and other community organizations. The hospital also conducted weekly clinics at Safe House and Valley (alternating locations) to provide medical care to homeless population. Hospital staff partners with key staff members at each location (i.e. case workers) to help establish a continuum of care plan for the individuals. In FY19, the hospital maintained its accredited Diabetes Prevention Program, which focuses on at-risk populations as identified in its CHNA. Activities included: ongoing diabetes education includes information on diabetes management, physical activity, medication usage, complication prevention and how to cope with this chronic disease; nutrition education that focuses on food choices and improving blood sugar control; and education to reduce negative impact of diabetes reduce heart disease risk factors and improve weight management. The hospital also regularly offered stroke awareness educational materials and blood pressure screenings at health fairs and community events to achieve and maintain stroke certification, community awareness. As part of a Piedmont Healthcare systemwide effort, Piedmont Columbus Regional 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. Piedmont Columbus Regional also actively participated in local take-back day activities in FY19 by promoting and supporting a community drive for local residents to safely dispose of medications and needles. SCHEDULE H, PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM Piedmont Columbus Regional 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 Healthcares community benefit department coordinates the community benefit activities on behalf of all hospitals throughout the system: 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. This includes our revenue department, which oversees and executes the financial assistance policy and program. SCHEDULE H, PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT Piedmont Columbus Regional 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 GREATER COLUMBUS GA CHAMBER OF COMMERCE PO BOX 1200 COLUMBUS GA 31902 580201875 501(C)(6) 5338 CMTY BENEFIT RiverCenter FOR THE PERFORMING ARTS PO BOX 2425 COLUMBUS GA 31902 582305233 501(C)(3) 8750 CMTY BENEFIT 1 1 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. false true false false false false false true false Holly Lehmberg Assistant CNO 183241 0 35568 0 793 0 9302 0 2327 0 231231 0 0 0 Diane Morris Director - Surgical Services 146326 0 15872 0 4235 0 11138 0 12070 0 189641 0 0 0 Judith Hill Clinical Pharmacist 143240 0 0 0 201 0 7454 0 22340 0 173235 0 0 0 Timara Rembert Clinical Pharmacist 137737 0 533 0 289 0 6554 0 22316 0 167429 0 0 0 Sherry Martin MGR Pharmacy 167893 0 553 0 1592 0 8947 0 11694 0 190679 0 0 0 Scott Hill President & CEO CRHS 0 758528 0 278980 0 219096 0 29901 0 29066 0 1315571 0 0 Michael Mandl Director 0 585596 0 161917 0 191208 0 90625 0 8761 0 1038107 0 0 LAURA DREW COO HUGHSTON HOSPITAL 0 321841 0 79498 0 43289 0 12003 0 19671 0 476302 0 0 Allen Holladay CFO - beg. 5/1/19 0 267550 0 60000 0 71956 0 22753 0 2744 0 425003 0 0 Allen Butcher Executive VP & CFO end 4/30/19 0 506040 0 119823 0 12098 0 0 0 13708 0 651669 0 0 SCHEDULE J, PART I, LINE 3: COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR THE COMPENSATION FOR THE PRESIDENT/CEO OF HUGHSTON HOSPITAL IS SET BY THE ENTITY'S PARENT, PIEDMONT HEALTHCARE, INC. PLEASE SEE THE SCHEDULE O NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 15A & 15B FOR ADDITIONAL INFORMATION. SCHEDULE J, PART I, LINE 4B: Supplemental Compensation Information The following individuals participated in a supplemental nonqualified retirement plan, but did not receive current year payments: Michael Mandl PIEDMONT COLUMBUS REGIONAL MAINTAINS A SERP PLAN THAT VESTS EVERY THREE YEARS FOR ITS PARTICIPATING OFFICERS. THE LAST VESTING OCCURED ON JUNE 30, 2017; THEREFORE, NO PAYMENT WAS MADE IN THE FISCAL YEAR ENDED JUNE 30, 2019. THERE WERE NO EMPLOYER CONTRIBUTIONS TO 457(F) EXECUTIVE RETIREMENT BENEFIT PLANS IN THE FISCAL YEAR ENDED JUNE 30, 2019. SCHEDULE J, PART I, LINE 7: non-fixed payments CERTAIN EMPLOYEES PARTICIPATED IN AN "ANNUAL INCENTIVE PLAN" UNDER WHICH THEY received non-fixed bonus payments based on job level and several different performace metrics. Form 990, PART V, LINE 1A: NUMBER OF FORMS 1099 FILED ALL CALENDAR YEAR 2018 FORMS 1099 WERE FILED ON BEHALF OF HUGHSTON HOSPITAL BY ITS SOLE MEMBER, PIEDMONT HEALTHCARE, INC. (EIN 58-1503902), PURSUANT TO AN AGREEMENT WITH THE IRS TO FILE ALL FORMS 1099 FOR THE PIEDMONT HEALTHCARE SYSTEM ON A COMBINED BASIS. FORM 990, PART VI, SECTION A, LINE 6: ORGANIZATION'S SOLE MEMBER PIEDMONT HEALTHCARE, INC. (EIN 58-1503902) IS THE SOLE MEMBER OF HUGHSTON HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF GOVERNING BODY THE BOARD OF PIEDMONT HEALTHCARE, PIEDMONT COLUMBUS REGIONAL HEALTH SYSTEM'S SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF HUGHSTON HOSPITAL, INC. FORM 990 PART VI, SECTION A, LINE 7B: DECISIONS OF GOVERNING BODY HUGHSTON HOSPITAL, INC.'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 HUGHSTON HOSPITAL, INC. 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: 990 REVIEW PROCESS INFORMATION NEEDED TO PREPARE HUGHSTON HOSPITAL'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY HUGHSTON HOSPITAL'S CONTROLLER AND VP/CFO. THE 990 IS THEN PREPARED BY AN EXTERNAL TAX PREPARER. PRIOR TO FILING, COPIES OF FORM 990 ARE PROVIDED TO THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC., THE ORGANIZATION'S SOLE MEMBER, FOR BOARD REVIEW. Form 990, Part VI, Line 12c: CONFLICT OF INTEREST POLICY COMPLIANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY ORGANIZATION MANAGEMENT IN COORDINATION WITH PIEDMONT HEALTHCARE'S CHIEF COMPLIANCE OFFICER. ALL SENIOR LEADERS, BOARD MEMBERS, PHYSICIAN EMPLOYEES, NURSE PRACTITIONERS/PHYSICIAN ASSISTANTS AND EMPLOYEES AND NON-EMPLOYEES ENGAGED IN RESEARCH ARE REQUIRED TO ANNUALLY DISCLOSE ALL MATTERS WHICH COULD POTENTIALLY CONSTITUTE A CONFLICT OF INTEREST. MATTERS DISCLOSED UNDER THE POLICY MUST BE REVIEWED IN WRITING BY THE PIEDMONT HEALTHCARE CONFLICT OF INTEREST COMMITTEE IN ORDER TO DETERMINE WHETHER A CONFLICT EXISTS AND, IF SO, WHETHER TO ELIMINATE OR MANAGE THE CONFLICT. ALL BOARD MEMBERS AND EMPLOYEES OF HUGHSTON HOSPITAL, INC. 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, LINE 15A: EXECUTIVE COMPENSATION COMPENSATION FOR EXECUTIVES OF HUGHSTON HOSPITAL, INC. IS SET BY THE BOARD OF DIRECTORS OF AND PAID ON BEHALF OF THE ORGANIZATION BY 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 EXECUTIVE PERFORMANCE AND COMPENSATION 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 LIMITED TO, APPROVAL OF EXECUTIVE EMPLOYMENT CONTRACTS AND BENEFITS. FORM 990, PART VI, SECTION C, LINE 19: DOCUMENTS AND POLICIES 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. 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