2020-05-15T10:00:45-05:00 2019-06-30 KPMG LLP 300 North Greene Street Suite 400 Greensboro NC 27401 990 2018-07-01 581503902 Piedmont Healthcare Inc % MARIE GAFFNEY PIED 4044251303 1800 Howell Mill Road Suite 850 Atlanta GA 30318 MARIE GAFFNEY VP CORPORATE FINANCE 4044251303 2020-05-11 true SHAWN HUTCHINSON P01048557 3362753394 2020-05-14 199.206.0.5 56038220201365000019 2020-05-15 P 1272C807EE2CFB18DB9032F475C1250F2D6A8CEA 1272C807EE2CFB18DB9032F475C1250F2D6A8CEA 2018 2020-09-23 17:36:50Z Mr Kevin Brown 1800 Howell Mill Rd Ste 850 Atlanta GA 30318 164545111 false X www.piedmont.org X 1983 GA PIEDMONT HEALTHCARE, INC. ("PHC") IS ORGANIZED TO BENEFIT, MANAGE THE FUNCTIONS OF, AND CARRY OUT THE CHARITABLE PURPOSES OF ITS SUBSIDIARY ORGANIZATIONS. 20 14 3427 12 0 0 217135 3734527 118433426 158911577 2373181 118259 1990023 1780748 123013765 164545111 947455 1312827 0 0 46788619 41575348 0 0 0 72518148 120664918 120254222 163553093 2759543 992018 738170199 872469199 665421595 597220905 72748604 275248294 PIEDMONT HEALTHCARE, INC., ("PHC") IS ORGANIZED EXCLUSIVELY FOR THE BENEFIT OF, TO MANAGE THE FUNCTIONS OF, AND TO CARRY OUT THE CHARITABLE, SCIENTIFIC, AND EDUCATIONAL PURPOSES OF ITS SUBSIDIARY ORGANIZATIONS. false false 141402663 1312827 159716797 PIEDMONT HEALTHCARE, INC. ("PHC"), IS THE TAX-EXEMPT PARENT OF ITS PUBLICLY SUPPORTED SUBSIDIARIES (LISTED IN SCHEDULE R ATTACHED). PHC PROVIDES CENTRALIZED MANAGEMENT SERVICES TO ITS SUBSIDIARIES, INCLUDING ACCOUNTING, HUMAN RESOURCES, IT, FINANCIAL MANAGEMENT, AND ADVISORY SUPPORT. THESE CENTRALIZED SERVICES RESULT IN GREATER OPERATING EFFICIENCIES AND ALLOW ITS SUBSIDIARY ORGANIZATIONS TO BETTER PROVIDE OUTSTANDING HEALTHCARE AND EDUCATION TO THEIR SURROUNDING COMMUNITIES. 141402663 true true false true false false false false false false true false true true true true false true false true true false false false false false false true false true false false false false false false false false false false false false false true true true false false true X 1690 0 true 3427 true false true CJ false false false false false false false false false false true false X 20 14 false false false false false false false true true false false true 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 Kevin Brown Board Member & CEO, PHC 49.0 6.0 X X 3936217 0 224155 Mr Tye Darland Board Member 1.0 0.0 X 0 0 0 Mr Wm Ronald Duffey Chair 1.0 0.0 X X 0 0 0 Mr David Hanna Board Member 1.0 0.0 X 0 0 0 Mr Samuel Burney Hay III Board Member 1.0 0.0 X 0 0 0 Mr James H Hopkins Board Member 1.0 0.0 X 0 0 0 Dr Monica Hum MD Board Member 1.0 9.0 X 0 14250 0 Mr Gary T Jones Board Member 1.0 0.0 X 0 0 0 Ms Cheryl Legette Board Member 1.0 0.0 X 0 0 0 Ms Amy Medendorp Board Member 1.0 0.0 X 0 0 0 Dr Moiz Master MD Board Member 1.0 0.0 X 0 0 0 Mr Charles J Jeff Mills Board Member 1.0 0.0 X 0 0 0 Mr Greg Morrison Board Member 1.0 0.0 X 0 0 0 Dr David Sailors MD Board Member 1.0 9.0 X 0 53600 0 Dr Todd Schmidt MD Vice Chair 1.0 9.0 X 0 24600 0 Dr Jay Singh MD Board Member 1.0 9.0 X 0 64275 0 Mr John Somerhalder Board Member 1.0 0.0 X 0 0 0 Mr Warren Steele Board Member 1.0 0.0 X 0 0 0 Dr Ramon Suarez MD Board Member 1.0 9.0 X 0 17400 0 Dr Craig Wright MD Board Member 3.0 0.0 X 0 0 0 Mr Michael McAnder CFO & Treasurer 40.0 15.0 X 1103610 0 128676 Ms Elizabeth Leddy CHIEF LEGAL OFFicer/Secretary 40.0 15.0 X 752241 0 100515 Mr Gregory Hurst CHIEF OPERATING OFFICER 55.0 0.0 X 587571 0 18635 Mr Michael Mandl Exec. Vice President 55.0 0.0 X 938721 0 99386 Dr Leigh Hamby MD PHC CHIEF MEDICAL OFFICER 55.0 0.0 X 1125728 0 121832 Ms Michelle Fisher Pres. Prim Care & Ret Svcs 55.0 0.0 X 662735 0 101173 Mr Christopher Lloyd President Piedmont Clinic 55.0 0.0 X 906217 0 87826 Mr Sidney Kirschner Chief Philanthropy Officer 1.0 54.0 X 1187382 0 110544 Mr John Henson Chief of Oncology 55.0 0.0 X 673645 0 23106 Mr Thomas Arnold VP - Financial Operations 55.0 0.0 X 748541 0 86920 Mr Geoffrey Brown Chief Information Officer 55.0 0.0 X 681704 0 96583 Ms Vicki Cansler Chief HR Officer 55.0 0.0 X 991090 0 61254 Mr Matthew Gove Chief Marketing Officer 55.0 0.0 X 671914 0 87198 14967316 174125 1347803 437 false true false FELDMAN SHEPHERD 1845 Walnut St PHILADELPHIA PA 19103 legal Services 4512060 CUMBERLAND GROUP 300 GALLERIA PARKWAY ATLANTA GA 30339 CONSULTING SERVICES 6385615 HOLLIS COBB ASSOCIATES INC 4366 PARK DRIVE NORCROSS GA 30093 BILLING & COLLECTION 3604667 HEALTHCARE FINANCIAL RESOURCES LLC 830 N MEACHAM ROAD SCHAUMBURG IL 60173 REVENUE CYCLE MGT 2949939 KING AND SPALDING PO Box 116133 ATLANTA GA 30368 LEGAL SERVICES 2697914 88 3734527 3734527 MANAGEMENT SERVICES TO AFFILIATES 561000 95174186 95174186 COST OF CAPITAL ALLOCATION 900099 49244077 49244077 EPIC IMPLEMENTATION 900099 999450 999450 OTHER OPERATING REVENUE 900099 13493864 13493864 158911577 118259 118259 0 0 805220 805220 0 805220 805220 0 0 0 0 0 0 0 0 0 0 RESEARCH REVENUE 900099 975528 975528 975528 164545111 159716797 1093787 X 1312827 1312827 0 0 0 11128116 7233275 3894841 0 22560049 14664032 7896017 0 5792414 3765069 2027345 2094769 1361600 733169 3061523 3061523 3895872 3895872 358873 358873 325384 325384 0 282790 282790 25490821 25490821 3220157 3220157 8311064 8311064 1589126 1589126 0 14709032 14709032 722548 722548 0 0 21696191 21696191 0 30079140 30079140 5850006 5850006 PHO ASSESSMENT 1009973 1009973 SUBSCRIPTIONS 62418 62418 163553093 141402663 22150430 0 319826495 291391917 0 0 561656 8037377 1177303 4254105 0 0 0 0 0 0 0 0 38887680 49580541 432744193 230067475 131112710 202676718 0 0 0 0 89069261 89068330 189378 189378 157345716 227270833 738170199 872469199 207686879 280987931 0 0 11303848 7445518 307600000 307600000 0 0 0 0 0 0 0 0 138830868 1187456 665421595 597220905 X 72177461 275249890 571143 -1596 0 0 72748604 275248294 738170199 872469199 X 992018 30647044 -3714428 174575056 X false true X true false X X 12 PIEDMONT HOSPITAL INC 580566213 3 true 13651319 0 FAYETTE COMMUNITY HOSPITAL INC DBA PIEDMONT FAYETTE HOSPITAL 582322328 3 true 6424072 0 PIEDMONT MOUNTAINSIDE HOSPITAL INC 352228583 3 true 1076700 0 PIEDMONT NEWNAN HOSPITAL INC 205077249 3 true 6068708 0 PIEDMONT HEART INSTITUTE INC 263553500 7 true 157711 0 PIEDMONT HENRY HOSPITAL INC 582200195 3 true 6615083 0 PIEDMONT NEWTON HOSPITAL INC 582155150 3 false 1153655 0 PIEDMONT ATHENS REGIONAL MEDICAL CENTER INC 582179986 3 false 13112552 0 PIEDMONT ROCKDALE HOSPITAL INC 300999841 3 false 3389959 0 PIEDMONT WALTON HOSPITAL INC 824194264 3 false 1694979 0 THE MEDICAL CENTER INC 581685139 3 false 0 0 HUGHSTON HOSPITAL INC 331216751 3 false 0 0 12 53344738 false false false false false false false false false false false false false false false true true false X true true SCHEDULE A, PART IV, SECTION A, LINE 1: NOT LISTED IN GOVERNING DOCUMENTS DURING FISCAL YEARS 2016 THROUGH 2018, PIEDMONT HEALTHCARE PURCHASED THE FOLLOWING ENTITIES: PIEDMONT NEWTON HOSPITAL, INC. (EIN: 58-2155150, FKA NEWTON MEDICAL CENTER); PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC. (EIN: 58-2179986, FKA ATHENS REGIONAL MEDICAL CENTER) AND ITS SUBSIDIARIES; PIEDMONT WALTON HOSPITAL, INC. (EIN: 82-4194264, FKA CLEARVIEW REGIONAL MEDICAL CENTER); PIEDMONT ROCKDALE HOSPITAL, INC. (EIN: 30-0999841, FKA ROCKDALE MEDICAL CENTER); THE MEDICAL CENTER, INC. (EIN: 58-1685139) AND ITS SUBSIDIARIES, AND; HUGHSTON HOSPITAL, INC. (EIN: 33-1216751) AND ITS SUBSIDIARIES. WHILE THE AFOREMENTIONED ORGANIZATIONS ARE NOT EXPLICITLY NAMED AS SUPPORTED ORGANIZATIONS IN PHC'S GOVERNING DOCUMENTS, THEY ARE INCORPORATED INTO THE DOCUMENTS BY VIRTUE OF REFERENCE TO PHC'S EXEMPT PURPOSE OF SUPPORTING ITS TAX-EXEMPT SUBSIDIARIES. AS OF THEIR PURCHASE BY PHC, THE ENTITIES BECAME WHOLLY-OWNED SUBSIDIARIES AND SUPPORTED ORGANIZATIONS OF PIEDMONT HEALTHCARE. SCHEDULE A, PART IV, SECTION E, LINE 3A: POWER TO ELECT SUBSIDIARY BOARDS PURSUANT TO THE PROVISIONS OF ITS CHARTER AND BYLAWS, THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE APPOINTS ALL OF THE MEMBERS OF THE BOARDS OF DIRECTORS OF EACH OF ITS SUPPORTED SUBSIDIARY ENTITIES. SCHEDULE A, PART IV, SECTION E, LINE 3B: DIRECTION OVER SUPPORTED ORGS THE POLICIES AND DECISIONS OF EACH OF PIEDMONT HEALTHCARE'S SUPPORTED SUBSIDIARY ENTITY BOARDS OF DIRECTORS MUST BE FILED, IMMEDIATELY AFTER ADOPTION, WITH THE SECRETARY OF THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS. SUCH POLICIES AND DECISIONS OF THE SUBSIDIARY BOARDS 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. THE PROGRAMS AND ACTIVITIES OF EACH OF PIEDMONT HEALTHCARE'S SUPPORTED SUBSIDIARY ORGANIZATIONS, INCLUDING SERVICES OFFERED, ANNUAL OPERATING BUDGETS, AND APPOINTMENT AND COMPENSATION OF SENIOR EXECUTIVES, ARE DETERMINED BY OR SUBJECT TO THE REVIEW OF PIEDMONT HEALTHCARE'S EXECUTIVE LEADERSHIP AND BOARD OF DIRECTORS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false 325384 false false 325384 false SCHEDULE C, PART II-B, LINE 1(G): LOBBYING ACTIVITIES HEALTH CARE POLICY IS CRITICAL TO ALL AMERICANS, AND PIEDMONT HEALTHCARE BELIEVES THAT HEALTH CARE PROVIDERS MUST PARTICIPATE IN SHAPING HEALTH CARE POLICY BY INTERACTING WITH NATIONAL, STATE, AND LOCAL REPRESENTATIVES AND THEIR STAFF MEMBERS TO HELP THEM BETTER UNDERSTAND THE COMPLEXITIES AND RAMIFICATIONS OF KEY HEALTH CARE POLICIES INCLUDING, WITHOUT LIMITATION, THOSE RELATED TO UNINSURED AND INDIGENT PATIENT NEEDS, AS WELL AS THE IMPORTANCE OF ASSURING THE DELIVERY OF COST-EFFICIENT, QUALITY HEALTH CARE. DURING FISCAL YEAR 2019, PIEDMONT HEALTHCARE ENGAGED A CONTRACT LOBBYIST TO, ALONG WITH PIEDMONT HEALTHCARE'S VICE PRESIDENT OF GOVERNMENT RELATIONS, REPRESENT THE INTERESTS OF THE ORGANIZATION AND ITS SUBSIDIARIES BEFORE FEDERAL, STATE, AND LOCAL ELECTED OFFICIALS AND REGULATORS. LOBBYING EXPENSE REPORTED HEREIN INCLUDES A PORTION OF THE SALARY PROVIDED TO THE VICE PRESIDENT OF GOVERNMENT RELATIONS, AS WELL AS EXPENSES RELATED TO THE ACTIVITIES OF OUTSIDE LOBBYISTS. 820769 820769 19038309 10209775 8828534 5304002 2422484 2881518 310220768 217435216 92785552 97360345 0 97360345 202676718 FAYETTE COMMUNITY HOSPITAL 43679729 C PIED MOUNTAINSIDE HOSPITAL 43407781 C AMSTER-MCRAE INSURANCE COMPANY 120000 C CENTER FOR HEALTH & LEARNING 1425000 C COLUMBUS REG. HEALTH SYS. 435820 C 89068330 DUE FROM RELATED PARTIES 208500897 OTHER CURRENT ASSETS 12589244 INVEST ONCOLOGY PARTNERSHIP 6178870 INVEST GA HEALTH COLLABORATIVE 1822 227270833 0 DUE TO RELATED PARTIES 1187456 1187456 X SCHEDULE D, PART X, LINE 2: ASC 740 FOOTNOTE (FKA FIN 48) 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, 2019 AND 2018. Central America and the Caribbean 0 0 Investments 67370652 Central America and the Caribbean 0 0 Program Services INSURANCE PREMIUMS 26286539 0 0 0 0 93657191 93657191 true false true false false false true American Heart Association 7272 GREENVILLE AVE Dallas TX 75231 135613797 501(C)(3) 155000 CMTY BENEFIT Atlanta Track Club 201 ARMOUS DR ATLANTA GA 30324 581367422 501(C)(3) 50000 CMTY BENEFIT Susan G Komen Greater Atlanta 5005 LBJ FREEWAY DALLAS TX 75244 751835298 501(C)(3) 30000 CMTY BENEFIT Fayette Senior Services 4 CENTER DR FAYETTEVILLE GA 30214 581364158 501(C)(3) 25000 CMTY BENEFIT Georgia Transplant Foundation 2201 MACY DR ROSWELL GA 30076 582075193 501(C)(3) 25000 CMTY BENEFIT Good Samaritan Health and Wellness Center 175 SAMARITAN DR JASPER GA 30143 582576315 501(C)(3) 25000 CMTY BENEFIT Mercy Heart Inc 2340 MAGNOLIA DR NW CONYERS GA 30012 263786470 501(C)(3) 25000 CMTY BENEFIT FAITH IN SERVING HUMANITY PO BOX 1838 MONROE GA 30655 460901738 501(C)(3) 20000 CMTY BENEFIT Walton County Senior Citizens Council PO BOX 764 MONROE GA 30655 581076363 501(C)(3) 20000 CMTY BENEFIT Hands of Hope Clinic 1010 HOSPITAL DR STOCKBRIDGE GA 30281 421591970 501(C)(3) 19750 CMTY BENEFIT Newton County Community Partnership PO BOX 445 COVINGTON GA 30015 581838997 501(C)(3) 16750 CMTY BENEFIT Willing Helpers Medical Clinic 8111 BROWN BRIDGE RD COVINGTON GA 30014 562602392 501(C)(3) 16750 CMTY BENEFIT Coweta Samaritan Clinic PO BOX 963 NEWNAN GA 30264 800518912 501(C)(3) 15000 CMTY BENEFIT HENRY W GRADY HEALTH SYSTEM FDN INC 191 PEACHTREE ST ATLANTA GA 30303 582130437 501(C)(3) 15000 CMTY BENEFIT Leukemia & Lymphoma Society 3 INTERNATIONAL DR RYE BROOK NY 10573 135644916 501(C)(3) 15000 CMTY BENEFIT MAP International 4700 GLYNCO PKWY BRUNSWICK GA 31525 362586390 501(C)(3) 15000 CMTY BENEFIT Mercy Health Center 700 OGLETHORPE AVE ATHENS GA 30606 582603523 501(C)(3) 15000 CMTY BENEFIT Pickens County Council on Child Abuse 1222C E CHURCH ST JASPER GA 30143 582132470 501(C)(3) 15000 CMTY BENEFIT The Tree House PO BOX 949 WINDER GA 30680 581950554 501(C)(3) 15000 CMTY BENEFIT Urban Health and Wellness 859 METROPOLITAN PKWY SW ATLANTA GA 30310 813845426 501(C)(3) 15000 CMTY BENEFIT Mercy Med of Columbus 3702 2ND AVE COLUMBUS GA 31904 275011913 501(C)(3) 12500 CMTY BENEFIT Sexual Assault Center of Columbus 909 Talbotton Rd COLUMBUS GA 31904 581612814 501(C)(3) 12500 CMTY BENEFIT Stone Mountain Park 1000 Robert E Lee Blvd STONE MOUNTAIN GA 30083 000000000 GOVT 12500 CMTY BENEFIT Coweta Force 316 Winchester Dr SHARPSBURG GA 30277 824885366 501(C)(3) 10125 CMTY BENEFIT Fayette CARE Clinic 1260 HIGHWAY 54 W FAYETTEVILLE GA 30214 200314897 501(C)(3) 10125 CMTY BENEFIT Bridging the Gap Community Outreach PO BOX 223 NEWNAN GA 30264 453482143 501(C)(3) 10000 CMTY BENEFIT Covington-Newton County Chamber of Comm 2101 CLARK ST SW COVINGTON GA 30014 580899717 501(C)(3) 10000 CMTY BENEFIT Girls on the Run 1904 Monroe DR ATLANTA GA 30324 582568271 501(C)(3) 10000 CMTY BENEFIT Healing Bridge Clinic 215 WILLOW BEND RD PEACHTREE CITY GA 30269 263555799 501(C)(3) 10000 CMTY BENEFIT It's The Journey Inc 270 Carpenter Drive Suite 515 ATLANTA GA 30328 470897591 501(C)(3) 10000 CMTY BENEFIT March Of Dimes 1550 CRYSTAL DR ARLINGTON VA 22202 131846366 501(C)(3) 10000 CMTY BENEFIT Meals on Wheels of Coweta PO BOX 73437 NEWNAN GA 30271 581274374 501(C)(3) 10000 CMTY BENEFIT Mercy Housing Southeast 1600 BROADWAY DENVER CO 80202 470646706 501(C)(3) 10000 CMTY BENEFIT National Kidney Foundation 30 E 33RD ST NEW YORK NY 10016 131673104 501(C)(3) 10000 CMTY BENEFIT Southern Crescent Sexual Assault Advocacy Ctr 2 W MAIN ST HAMPTON GA 30228 582451479 501(C)(3) 10000 CMTY BENEFIT Team Up Mentoring PO BOX 523 MONROE GA 30655 204927509 501(C)(3) 10000 CMTY BENEFIT University of Georgia Research Foundation 456 E BROAD ST ATHENS GA 30602 581353149 501(C)(3) 10000 CMTY BENEFIT Peachtree Road Farmers Market 2744 Peachtree Rd NW ATLANTA GA 30305 000000000 501(C)(3) 15000 CMTY BENEFIT Atlanta Charity Clays 780 JOHNSON FERRY RD ATLANTA GA 30342 472835630 501(C)(3) 7000 CMTY BENEFIT A Child's Voice Advocacy Center 216 BROOKSTONE PLACE SOCIAL CIRCLE GA 30025 753214817 501(C)(3) 6500 CMTY BENEFIT Cabbagetown Initiative 177 ESTORIA STREET ATLANTA GA 30316 582580550 501(C)(3) 6500 CMTY BENEFIT American College of Cardiology 2400 N STREET NW WASHINGTON DC 20037 311781555 501(C)(3) 6000 CMTY BENEFIT Atlanta Pride Committee 1530 Dekalb Ave NE Atlanta GA 30307 582032010 501(C)(3) 10000 Cmty Benefit Camp Kudzu 5885 Glenridge Dr Atlanta GA 30328 582449646 501(C)(3) 10000 CMTY BENEFIT 44 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. X X X true true X X X X false true false false false false false true false Mr Kevin Brown Board Member & CEO, PHC 1181659 0 959433 0 1795125 0 207649 0 16506 0 4160372 0 1653134 0 Mr Michael McAnder CFO & Treasurer 598784 0 408746 0 96080 0 121042 0 7634 0 1232286 0 0 0 Ms Elizabeth Leddy CHIEF LEGAL OFFicer/Secretary 422090 0 288072 0 42079 0 84235 0 16280 0 852756 0 0 0 Dr Leigh Hamby MD PHC CHIEF MEDICAL OFFICER 581251 0 396758 0 147719 0 105326 0 16506 0 1247560 0 88826 0 Mr Gregory Hurst CHIEF OPERATING OFFICER 88949 0 0 0 498622 0 0 0 18635 0 606206 0 0 0 Ms Michelle Fisher Pres. Prim Care & Ret Svcs 406749 0 222440 0 33546 0 84667 0 16506 0 763908 0 0 0 Mr Michael Mandl Exec. Vice President 585596 0 161917 0 191208 0 90625 0 8761 0 1038107 0 0 0 Mr Christopher Lloyd President Piedmont Clinic 548606 0 219450 0 138161 0 80712 0 7114 0 994043 0 0 0 Mr Sidney Kirschner Chief Philanthropy Officer 538482 0 367281 0 281619 0 98727 0 11817 0 1297926 0 82227 0 Mr John Henson Chief of Oncology 462076 0 175959 0 35610 0 16500 0 6606 0 696751 0 0 0 Mr Thomas Arnold VP - Financial Operations 417136 0 230856 0 100549 0 75478 0 11442 0 835461 0 58978 0 Mr Geoffrey Brown Chief Information Officer 407643 0 227420 0 46641 0 84584 0 11999 0 778287 0 0 0 Ms Vicki Cansler Chief HR Officer 391971 0 211633 0 387486 0 53351 0 7903 0 1052344 0 345151 0 Mr Matthew Gove Chief Marketing Officer 379217 0 207477 0 85220 0 70692 0 16506 0 759112 0 54192 0 SCHEDULE J, PART I, LINE 1A: OTHER COMPENSATION ITEMS FIRST-CLASS TRAVEL: THE FOLLOWING INDIVIDUALS WERE PERMITTED (PURSUANT TO THEIR CONTRACTS) TO FLY FIRST-CLASS DURING CALENDAR YEAR 2018. FIRST-CLASS TRAVEL IS NOT REPORTED ON THE EMPLOYEE'S FORM W-2, HOWEVER, THE COMPANY IS REIMBURSED FOR ANY PERSONAL EXPENSES INCURRED BY THE EMPLOYEE. KEVIN BROWN TRAVEL FOR COMPANIONS: CERTAIN EXECUTIVES ARE PERMITTED TO TRAVEL WITH COMPANIONS WHEN IT IS APPROPRIATE FOR THE BUSINESS EVENT AND PURPOSE. TRAVEL FOR COMPANIONS IS REVIEWED ON A CASE BY CASE BASIS AND IS REIMBURSED BY THE EMPLOYEE, PAID ON BEHALF OF THE EMPLOYEE, OR TREATED AS TAXABLE INCOME, AS APPROPRIATE AND IN COMPLIANCE WITH COMPANY POLICY. DISCRETIONARY SPENDING ACCOUNTS: THE FOLLOWING EMPLOYEES RECEIVED DISCRETIONARY SPENDING ACCOUNTS IN FIXED AMOUNTS DETERMINED BY JOB LEVEL. THESE SPENDING ACCOUNTS WERE INCLUDED IN EACH EMPLOYEE'S TAXABLE WAGES: KEVIN BROWN $40,102 VICKI CANSLER $12,923 THOMAS ARNOLD $12,923 MATTHEW GOVE $12,923 DR. LEIGH HAMBY $12,923 GEOFFREY BROWN $12,923 SIDNEY KIRSCHNER $12,923 MICHAEL MCANDER $12,923 ELIZABETH LEDDY $12,923 THOMAS WORTHY $32,308 MICHELLE FISHER $12,923 MICHAEL MANDL $11,077 CHRISTOPHER LLOYD $12,923 SCHEDULE J, PART I, LINE 4B: SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS THE FOLLOWING EMPLOYEES RECEIVED PAYMENTS FROM THEIR SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: THOMAS ARNOLD $58,978 MATTHEW GOVE $54,192 DR. LEIGH HAMBY $88,826 SIDNEY KIRSCHNER $82,227 KEVIN BROWN $1,653,134 VICKI CANSLER $345,151 THE FOLLOWING EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS: MICHAEL MCANDER GEOFFREY BROWN JOHN HENSON MICHELLE FISHER CHRISTOPHER LLOYD MICHAEL MANDL THOMAS WORTHY SCHEDULE J, PART I, LINE 7: NON-FIXED PAYMENTS CERTAIN EMPLOYEES PARTICIPATED IN AN "ANNUAL INCENTIVE PLAN" UNDER WHICH THEY RECEIVED NON-FIXED BONUS PAYMENTS BASED ON JOB LEVEL AND SEVERAL DIFFERENT PERFORMANCE METRICS. FORM 990, PART V, LINE 1A: NUMBER OF FORMS 1099 FILED IN CALENDAR YEAR 2018, PIEDMONT HEALTHCARE, INC., FILED FORMS 1099 ON BEHALF OF ITSELF AND EACH OF ITS SUBSIDIARIES, 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 7B: DECISIONS OF GOVERNING BODY ALL RESOLUTIONS ADOPTED AND ALL BUSINESS TRANSACTED BY PHC'S BOARD OF DIRECTORS REQUIRES THE AFFIRMATIVE VOTE OF A MAJORITY OF THE DIRECTORS PRESENT AT THE TIME OF VOTING, AS LONG AS A QUORUM (MAJORITY OF DIRECTORS CURRENTLY IN OFFICE) IS REPRESENTED AT THE MEETING. FORM 990, PART VI, SECTION B, LINE 11B: 990 REVIEW PROCESS INFORMATION NEEDED TO PREPARE PIEDMONT HEALTHCARE'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT AND REVIEWED BY PHC'S CONTROLLER AND VP/CFO. THE 990 IS THEN PREPARED INTERNALLY BY PIEDMONT HEALTHCARE'S TAX DEPARTMENT AND SUBMITTED TO AN EXTERNAL TAX PREPARER FOR REVIEW. COPIES OF FORM 990 ARE PROVIDED TO THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SEC 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 HEALTHCARE 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, SEC B, LINE 15A & 15B: EXECUTIVE COMPENSATION COMPENSATION FOR EXECUTIVES OF PIEDMONT HEALTHCARE IS SET BY ITS BOARD OF DIRECTORS AND BY THE BOARD'S EXECUTIVE PERFORMANCE AND COMPENSATION COMMITTEE. 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 ("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. FORM 990, PART VI, SECTION C, LINE 19: DISCLOSURE OF 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: RECONCILIATION OF NET ASSETS CHANGES TO NET ASSETS REPORTED ON PART XI, LINE 9 ARE COMPRISED OF: BOOK/TAX DIFFERENCES ($573,324) CHANGE IN EQUITY $62,607 TRANSFER OF LIABILITIES $175,085,773 ------------------------- TOTAL $174,575,056 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT SERVICES TOTAL FEES:16086265 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION FEES TOTAL FEES:7169586 FORM 990 PART IX LINE 11G DESCRIPTION:ADMINISTRATIVE SERVICES TOTAL FEES:1460094 FORM 990 PART IX LINE 11G DESCRIPTION:PRINTING TOTAL FEES:246310 FORM 990 PART IX LINE 11G DESCRIPTION:TRANSCRIPTION TOTAL FEES:109695 FORM 990 PART IX LINE 11G DESCRIPTION:DOCUMENT STORAGE TOTAL FEES:127368 FORM 990 PART IX LINE 11G DESCRIPTION:LAB SERVICES TOTAL FEES:69088 FORM 990 PART IX LINE 11G DESCRIPTION:MISCELLANEOUS SERVICES TOTAL FEES:222415 Piedmont Hospital Inc 1968 Peachtree Road NW Atlanta GA 30309 580566213 Hospital GA 501(c)(3) 3 PHC true FAYETTE COMMUNITY HOSPITAL INC 1255 Highway 154 West Fayetteville GA 30214 582322328 Hospital GA 501(c)(3) 3 PHC true Piedmont Mountainside Hospital INC 1266 Highway 515 South Jasper GA 30143 352228583 Hospital GA 501(c)(3) 3 PHC true Piedmont Newnan Hospital INC 745 POPLAR ROAD Newnan GA 30265 205077249 Hospital GA 501(c)(3) 3 PHC true Piedmont HEALTHCARE Foundation INC 2001 PEACHTREE ROAD NE SUITE 400 Atlanta GA 30309 581272768 Fundraising GA 501(c)(3) 12B, II PHC true Piedmont Heart Institute Inc 95 COLLIER ROAD NW STE 2045 Atlanta GA 30309 263553500 Healthcare GA 501(c)(3) 10 PHC true PIEDMONT HENRY HOSPITAL INC 1133 EAGLES LANDING PARKWAY STOCKBRIDGE GA 30281 582200195 HOSPITAL GA 501(c)(3) 3 PHC true PIEDMONT NEWTON HOSPITAL INC 5126 HOSPITAL DRIVE NE COVINGTON GA 30014 582155150 HOSPITAL GA 501(C)(3) 3 PHC true PIEDMONT ATHENS REGIONAL FOUNDATIONINC 1199 PRINCE AVENUE ATHENS GA 30606 581978389 FUNDRAISING GA 501(C)(3) 12B, II PARMC false PIEDMONT ATHENS REGIONAL HLTH RESOURCES 1199 PRINCE AVENUE ATHENS GA 30606 581930580 DEVELOPMENT GA 501(C)(3) 12B, II PARMC false PIEDMONT ATHENS REGIONAL MEDICAL CENTER 1199 PRINCE AVENUE ATHENS GA 30606 582179986 HOSPITAL GA 501(C)(3) 3 PHC true ATHENS REGIONAL PHYSICIAN SERVICES INC 1199 PRINCE AVENUE ATHENS GA 30606 582332921 HEALTHCARE GA 501(C)(3) 12B, II PARMC false ATHENS REGIONAL SPECIALTY SERVICES INC 1199 PRINCE AVENUE ATHENS GA 30606 271975001 HEALTHCARE GA 501(C)(3) 3 PARMC false REGIONAL FIRSTCARE INC 1199 PRINCE AVENUE ATHENS GA 30606 582362733 URGENT CARE GA 501(C)(3) 12B, II PARMC false 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 true 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 true PIEDMONT WALTON HOSPITAL INC 2151 WEST SPRING ST MONROE GA 30655 824194264 HOSPITAL GA 501(C)(3) 3 PHC true PEACHTREE ORTHOPAEDIC SURGERY CENTER 2001 PEACHTREE ROAD NE STE 705 ATLANTA GA 30309 582562721 SURGERY GA NA N/A 0 0 false 0 false DIGESTIVE HEALTHCARE OF GA ENDOSCOPY CTR 95 COLLIER ROAD NW STE 4075 ATLANTA GA 30309 582406657 HEALTHCARE GA NA N/A 0 0 false 0 false FOUR WINDS HEALTH LLC 3350 RIVERWOOD PKWY STE 1850 ATLANTA GA 30339 451273930 HEALTHCARE GA NA related 0 0 false 0 false 0.01910 GEORGIA HEALTH COLLABORATIVE LLC 2727 PACES FERRY RD BLDG 2 STE 70 ATLANTA GA 30339 461500639 HEALTHCARE GA NA related -5510 1837 false 0 false 0.50000 Piedmont Medical Care Corporation 2727 Paces Ferry Road suite 1-1100 Atlanta GA 30339 582092768 Healthcare GA PHC C-CORP -78373517 101351741 1.00000 true THE PIEDMONT CLINIC INC 2727 Paces Ferry Road suite 1-1100 Atlanta GA 30339 582005358 Healthcare GA PHC C-CORP -3702825 10474126 1.00000 true PIEDMONT HEART INSTITUTE PHYSICIANS INC 95 COLLIER ROAD NW STE 2045 Atlanta GA 30309 260593850 Healthcare GA PHC C-CORP -31478489 53119152 1.00000 true Amster McRae Insurance Company PO BOX 1159 Grand Cayman Grand Cayman CJ KY 1-1102 980427603 Related Insur. CJ PHC C-CORP 2257517 94660961 1.00000 true PIEDMONT WELLSTAR HEALTHPLANS INC 2859 PACES FERRY RD STE 600 ATLANTA GA 30339 461922499 HEALTH INSUR. 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