2020-05-15T08:57:48-05:00 2019-06-30 KPMG LLP 300 North Greene Street Suite 400 Greensboro NC 27401 990 2018-07-01 582179986 PIEDMONT ATHENS REGIONAL MEDICAL CENTER INC % MARIE GAFFNEY PIED 7064757000 1199 PRINCE AVENUE ATHENS GA 30606 MARIE GAFFNEY VP CORP. 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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, 2019, THE HOSPITAL HAD 21,336 ATIENT ADMISSIONS WITH A TOTAL OF 96,730OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 85,069 OUTPATIENT VISITS TOTALED 210,304. 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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. true true X true X 300. true X true true true false true true 23035785 23035785 0.04880 23702673 19815897 3886776 0.00820 6972520 5221629 1750891 0.00370 53710978 25037526 28673452 0.06070 98196 98196 0.00020 1332843 1332843 0.00280 1032156 1032156 0.00220 1039972 1039972 0.00220 3503167 3503167 0.00740 57214145 25037526 32176619 0.06810 true 65708046 19815897 23702673 -3886776 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 17 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, 2019. https://www.piedmont.org/media/file/2017-19-Implementation-Strategies.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 $538,228,109, LESS BAD DEBT EXPENSE OF $65,708,046 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. 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 Regional Medical Center's 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. Medicare accounted for 26.40% of the hospital's patient service revenue. Piedmont Athens Regional Medical Center's 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 Piedmont Athens Regional Medical Center in honor of the hospital's 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. SCH H, PART VI, LINE 2 As a designated 501(c)(3) nonprofit hospital, Piedmont Athens Regional Medical Center 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 Regional Medical Center conducted its third triennial community health needs assessment (CHNA). 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 Regional Medical Center Board of Directors on May 23, 2019. The Piedmont Athens Regional Medical Center 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 Regional Medical Center leadership and the Piedmont Athens Regional Medical Center 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 Regional Medical Center 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 Regional Medical Center 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 Regional Medical Center 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 FY19, we distributed approximately 3,500 copies of this guide throughout the Athens community. SCH H, PART VI, LINE 4 Piedmont Athens Regional Medical Center is located in Athens-Clarke County, and serves patients from a wide area. For the purposes of our CHNA, and this disclosure, we consider our home county to be our primary community. We do this in consideration of our status as a county authority-owned hospital and in recognition of the direct impact of our tax-exempt status on county residents. In 2017, approximately 123,554 people lived in Clarke County's 119 square miles. The majority of the community is white-more than twice of all other minorities combined. The county slightly skews female. The median age is 27, much younger than the rest of the state. Clarke County is also shrinking, with a drop of about 6 percent in population between 2000 and 2010. Hispanic or Latino populations alone grew by 51 percent during that time. In 2017, the median household income was $34,557, much lower than both state and national averages of $52,977 and $57,652, respectively. In 2017, 34 percent of the county lived at or below the poverty level - about 38,618 people. A majority of people rent their homes in Clarke County-about 61 percent in 2017, a rate much higher than state and national averages. Nearly 4 percent of adults were unemployed in 2018, a figure slightly better than state and national averages. There were 4,513 veterans living in Clarke County in 2017. The majority were non-elderly adults, and approximately 17 percent lived with some sort of disability. In Clarke 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 death rates allows communities with different age structures to be compared. In comparison, premature death is when death happens before the average age for a given community. Between 2013 and 2017, the number one cause of premature death were certain conditions during the perinatal period. Other top causes, in order, included heart disease, suicide, accidental poisoning, motor vehicle accidents, hypertension/hypertensive renal and heart disease, lung cancer, cerebrovascular disease, all other diseases of the nervous system and diabetes. As evidenced in this list, the impact of issues related to unhealthy behaviors was significant, indicating a clear need for more aggressive interventions. In Clarke County, 15 percent of the total population was uninsured in 2017, and 19 percent of the adult population was uninsured in 2017. Rates for children and elderly populations were much lower at 9 percent for children and 1 percent for those 65 and older. There were three designated health professional shortage areas in the community in 2016: one primary care shortage area, one mental health shortage area and one dental 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 was particularly true for minorities, whose rates of not having a doctor are much higher than that of their white counterparts. There were 54 dentists and 238 mental health providers for every 100,000 people in 2015, figures above average and national rates. Even so, mental and dental providers are often priced out of reach for many consumers and, generally speaking, consumers are less likely to have insurance coverage for these services. Community members have reported an average 4.6 poor or fair physical and 4.3 poor mental health days. A total 23 percent of Clarke County residents reported their health as poor or fair. All three indicators have worsened since our last CHNA, and all are worse than the state average. Preventable hospital stays among Medicare enrollees averaged 39.5 preventable hospital events per every 1,000 enrollees in 2015. This figure is better than state and national averages. Medicare enrollees tend to receive proper health screenings, with rates above state and national averages. Eleven percent of the population lived with at least one disability in 2017, which was lower than the state average of 12 percent. The highest concentration of disabled populations in the western part of the county. The infant mortality rate in Clarke County is far less than state and national averages, at 5.2 infant deaths per every 1,000 births in 2017. That year, 10 percent of all babies born were at a low birth weight, and with African American infants most likely to be born at a low birth weight. The number one cause of age-adjusted deaths and premature deaths for both men and women each year between 2013 and 2017 in Clarke County was ischemic heart and vascular disease. During that time, an average 284 people died from heart disease annually. Between 2013 and 2017, an average 216 Clarke County community members died from stroke each year, making it the third leading cause of age-adjusted death. Approximately 11 percent of adults lived with diabetes in Clarke County in 2015, a figure in line with state and national averages (11 percent and 9 percent, respectively). In 2015, 24 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 Clarke County. In 2017 alone, 156 people died from cancer. Of those, lung cancer kills the most Clarke County community members - 44 in 2017. Overall, between 2013 and 2017, it was the fourth leading cause of age-adjusted death and the 7th leading cause of premature death. Breast cancer was the 12th leading cause of age-adjusted death and colon, rectum and anal cancers were the 14th leading cause of death. Even though fewer women now die from the disease, female breast cancer incidence rate is higher than state and national averages, with a rate of 134 incidences per every 100,000 people. There are an average 68 new cases diagnosed annually, and about 5,078 women lived with the disease in 2015. The lung cancer incidence rate is lower at 58 incidences per every 100,000 people; however, this is higher than national averages. An estimated 9,169 people had lung cancer in 2015, and there are an average 53 new cases annually. Adult obesity rates were high in Clarke County, with one-quarter of county residents as obese. This contributes to a number of diseases, including heart disease, stroke and diabetes. Smoking rates were lower than the state average, though smoking is still an issue as it is a key contributor to cancer, and in particular lung cancer, which has a devastating effect on Clarke County residents. Long commutes aren't as big of an issue in Clarke County as it is in the rest of the state. Approximately 5 percent of residents drove more than 60 minutes in 2016. The majority of commuters from Clarke County drive alone, which contributes to depression. The violent crime rate was 372 per every 100,000 county residents, a figure in line with state and national averages. Mental health and behavioral disorders were the second leading cause of age-adjusted death for all county residents between 2013 and 2017. Suicide was the third leading cause of premature deaths for all races between 2013 and 2017, and the 11th leading cause of age-adjusted death. It was most common among white males aged 25 to 34 years of age. There was one mental health provider for every 402 residents in the county in 2017, a rate much better than the state and national averages of one provider for every 813 and 493 residents, respectively. Like in the rest of the state, opioid prescriptions are an issue in the Clarke County community, with a total 90.9 opioids prescriptions written per every 100 people in 2017. Please note we aren't able to tell how many scripts were written to a single person. We only know the overall figure, meaning a single person could have several prescriptions. There were 12 deaths from all overdoses in Clarke County in 2017, and eight were directly related to opioids. Like in the rest of the state, opioid prescriptions are an issue in the Clarke County community, with a total 90.9 opioids prescriptions written per every 100 people in 2017. Please note we aren't able to tell how many scripts were written to a single person. We only know the overall figure, meaning a single person could have several prescriptions. There were 12 deaths from all overdoses in Clarke County in 2017, and eight were directly related to opioids. As defined by the World Health Organization, social determinants of health (SDHs are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. Included among these is economic stability, housing stability, food security, adequate income to pay for core services such as utilities, literacy, access to healthy food, access to safe recreational spaces, access to health care and access to services in languages the person understands. SDHs often carry negative health impa SCH H, PART VI, LINE 5 Piedmont Athens Regional Medical Center 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 Athens Regional Medical Center 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. 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 $350,000 in FY19 - and support for a local school-based clinic ($25,000 in FY19). The hospital also provides more than $120,000 annually to support local transportation services 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 million annually in community support as well more than $1 million in subsidized health services. This includes support for programming through the system's community benefit grants program, which provides funding to local not-for-profit organizations whose programs and mission align with Piedmont Athens Regional Medical Center's CHNA. In FY19, these organizations were: The Tree House, for its mental health services; the Cancer Foundation's financial assistance program; the University of Georgia Research Foundation's Lazos Hispanos Hispanic outreach program; the Athens Community Council on Aging's transportation services; and A Child's Voice Advocacy Center for forensic medical examinations. Additionally, and as mentioned above, Piedmont Athens Regional Medical Center 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 FY18, Piedmont Athens Regional Medical Center also provided health professions education to students and residents training to be health professionals. That year, the hospital oversaw training at a cost of $1,332,843. As part of a Piedmont Healthcare systemwide effort, Piedmont Athens Regional Medical Center 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 Athens Regional Medical Center 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. SCH H, PART VI, LINE 6 Piedmont Athens Regional Medical Center 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 Regional Hospital 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 AREA COMMUNITY FOUNDATION PO BOX 1543 ATHENS GA 30603 261838979 501(c)(3) 10000 PROGRAM SUPPORT ENVISION ATHENS 301 COLLEGE AVE ATHENS GA 30601 000000000 GOVT 11000 PROGRAM SUPPORT ATHENS NURSES CLINIC 240 NORTH AVE ATHENS GA 30601 582490925 501(c)(3) 183389 PROGRAM SUPPORT FAMILY CONNECTION OF ATHENS PO BOX 1904 ATHENS GA 30603 582204209 501(c)(3) 10000 PROGRAM SUPPORT ACC-SANE 3035 LEXINGTON RD ATHENS GA 30605 582203027 501(c)(3) 55000 PROGRAM SUPPORT UNITED WAY OF NORTHEAST GEORGIA 1 Huntington Rd Ste 805 ATHENS GA 30606 586008133 501(C)(3) 36943 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) 25980 PROGRAM SUPPORT AMERICAN HEART ASSOCIATION 7272 Greenville Avenue DALLAS TX 75231 135613797 501(C)(3) 12500 PROGRAM SUPPORT UNIVERSITY OF GEORGIA FOUNDATION 394 SOUTH MILLEDGE AVE ATHENS GA 30605 586033837 501(C)(3) 15000 PROGRAM SUPPORT TITAN CLUB PO BOX 7 BOGART GA 30622 200809652 501(C)(3) 7000 PROGRAM SUPPORT BOY SCOUTS OF AMERICA 1325 W WALNUT HILL LANE IRVING TX 75038 200809652 501(C)(3) 5250 PROGRAM SUPPORT ATHENS ACADEMY 1281 SPARTAN LANE ATHENS GA 30606 586055242 501(C)(3) 7500 PROGRAM SUPPORT EXTRA SPECIAL PEOPLE PO BOX 615 WATKINSVILLE GA 30677 581710803 501(C)(3) 10000 PROGRAM SUPPORT BARROW COUNTY CHAMBER OF COMMERCE 6 PORTER ST WINDER GA 30680 580620869 501(C)(3) 5050 PROGRAM SUPPORT HOSPITAL AUTHORITY OF CLARKE COUNTY GEORGIA 2500 DANIELLS BRG RD ATHENS GA 30606 586003375 501(C)(3) 20580 PROGRAM SUPPORT LEAD ATHENS PO BOX 1832 ATHENS GA 30603 580144673 501(C)(3) 7000 PROGRAM SUPPORT ATHENS TECHNICAL COLLEGE 800 US HWY 29 N ATHENS GA 30601 581824771 501(C)(3) 250000 PROGRAM SUPPORT 19 0 COMMUNITY BENEFIT 117207 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 Kevin Brown Board Member & CEO, PHC 0 1181659 0 959433 0 1795125 0 207649 0 16506 0 4160372 0 1653134 Mr Robert Sinyard VP MEDICAL AFFAIRS 417005 0 132615 0 26820 0 0 0 30752 0 607192 0 0 0 Dr Geoffrey Cole VP ANCILLARY SVCS 113177 213454 0 65528 3538 33780 16500 16500 3928 6414 137143 335676 0 0 Ms Jody Corry VP IN HOUSE LEGAL 278762 0 46170 0 8149 0 16420 0 10360 0 359861 0 0 0 Mr Robert Finch VP HUMAN RESOURCES 14028 0 0 0 288889 0 16500 0 492 0 319909 0 0 0 Mr Norman Burkett VP PROFESSIONAL SERVICES 223327 0 37423 0 8549 0 16407 0 15410 0 301116 0 0 0 Mr Louis Duhe VP AND CIO 183478 54124 39143 0 1237 16262 12932 439 4944 2082 241734 72907 0 0 Ms Diane Todd VP CORP - COMPLIANCE & OPS 200039 0 33373 0 7197 0 12299 0 8921 0 261829 0 0 0 Mr James Appiah-Pippim Phys-Dir Trans Residency 323056 0 0 0 29624 0 16500 0 7237 0 376417 0 0 0 Ms Tammy Gilland VP FOUNDATION 188222 0 30781 0 3929 0 13444 0 6363 0 242739 0 0 0 Mr Larry Ebert FORMER EXC DIR STRAT OPS 0 254657 0 54338 0 14477 0 10915 0 15717 0 350104 0 0 Dr Charles Peck CEO (THROUGH 1/19) 548968 0 299700 0 425284 0 83250 0 28371 0 1385573 0 83250 0 Mr J Michael Burnett CEO (From 4/19) 0 437689 0 219248 0 98667 0 78888 0 16542 0 851034 0 62388 Ms Wendy Cook Chief Financial Officer 372313 0 102617 0 15003 0 16500 0 16088 0 522521 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 Ms Wendi Lovenvirth Phys-GME Program 235111 0 0 0 19489 0 0 0 8236 0 262836 0 0 0 Mr Paul Collar DIR, MANAGED CARE 199387 0 28505 0 25417 0 10651 0 14957 0 278917 0 0 0 Mr Michael McAnder Treasurer 0 598784 0 408746 0 96080 0 121042 0 7634 0 1232286 0 0 Ms Elizabeth Leddy Secretary 0 422090 0 288072 0 42079 0 84235 0 16280 0 852756 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. KEVIN BROWN: $40,102 DR. CHARLES PECK: $12,923 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 REFINANCING false false false A 8810000 0 208099492 0 0 208092160 7332 0 0 0 0 0 2016 true false 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 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 PARMC'S CONTROLLER AND VP/CFO. THE 990 IS THEN PREPARED INTERNALLY BY PIEDMONT HEALTHCARE, INC.'S TAX DIRECTOR 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 ATHENS REGIONAL MEDICAL CENTER 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 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. 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 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 ($12,766,831) BOOK/TAX DIFF $801,412 CHANGES IN TEMP. ($354,304) INTERCOMPANY TRANS. ($15,712,241) CHANGES IN UNRESTR. FUND $314,041 -------------------- TOTAL ($27,717,923) 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 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 FOUR WINDS HEALTH LLC 3350 RIVERWOOD PKWY STE 1850 ATLANTA GA 30339 451273930 HEALTHCARE GA NA N/A 0 0 false 0 false 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 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 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 true false false true true true true true true false false PIEDMONT ATHENS REGIONAL PHYSICIANS SERVICES Q 2952913 FMV PIEDMONT ATHENS REGIONAL SPECIALTY PHYSICIANS Q 10535006 FMV REGIONAL FIRSTCARE P 721088 FMV