2020-05-15T09:44:43-05:00 2019-06-30 KPMG LLP 300 North Greene Street Suite 400 Greensboro NC 27401 990 2018-07-01 300999841 Piedmont Rockdale Hospital % MARIE GAFFNEY PIED 7709183000 1412 Milstead Avenue Conyers GA 30012 MARIE GAFFNEY VP CORPORATE FINANCE 4702716007 2020-05-11 true SHAWN HUTCHINSON P01048557 3362753394 2020-05-14 199.206.0.5 56038220201365000020 2020-05-15 P 5C42669FF65CEAC0E0AB263A7A36DA99F633A498 1272C807EE2CFB18DB9032F475C1250F2D6A8CEA 2018 2021-01-29 14:40:06Z RICHARD TANZELLA 1412 Milstead Avenue Conyers GA 30012 178355447 false X www.piedmont.org/locations/piedmont-rockdale/ X 2017 GA TO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT. 13 9 1372 115 0 0 14411 4162 145512095 177444627 9020 79624 603394 822649 146138920 178351062 0 0 0 0 49674864 76944011 0 0 0 103949599 123265862 153624463 200209873 -7485543 -21858811 99880028 103827007 91135187 9528015 8744841 94298992 X TO PROVIDE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE IN A PROGRESSIVE ENVIRONMENT, GUIDED BY PHYSICIANS, DELIVERED BY EXCEPTIONAL PROFESSIONALS, AND INSPIRED BY THE COMMUNITIES WE SERVE. false false 176780535 0 177446652 PIEDMONT ROCKDALE HOSPITAL ("PRH") IS A 138-BED, NON-PROFIT HOSPITAL LOCATED IN THE CITY OF CONYERS IN ROCKDALE COUNTY, GEORGIA. OVER 250 PRIMARY CARE AND SPECIALTY PHYSICIANS COMPRISE THE MEDICAL STAFF AND MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SENIORS WITHIN ROCKDALE COUNTY AND THE GREATER METROPOLITAN ATLANTA MARKET, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY FOR SERVICES. FOR THE YEAR ENDED JUNE 30, 2019, THE HOSPITAL HAD 8,892 IN-PATIENT ADMISSIONS WITH A TOTAL OF 41,571 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 51,520 AND OUTPATIENT VISITS TOTALED 46,004. SURGICAL SERVICES WERE PROVIDED TO 4,811 PATIENTS. 176780535 true false false false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true X 0 0 1372 true false false false false false false false false false false false false X 13 9 false false false false true true true true true false false false true true true true true true true false GA X MARIE GAFFNEY 4702716007 2727 PACES FERRY RD BLDG 2 STE 70 ATLANTA GA 30339 X MR RICK SIMONS CHAIRMAN 1.0 0.0 X X 0 0 0 MR AL SADLER BOARD MEMBER 1.0 0.0 X 0 0 0 DR BENETTA DUHART MD BOARD MEMBER 1.0 0.0 X 0 0 0 MR J MICHAEL BURNETT BOARD MEMBER 1.0 54.0 X 0 755604 95430 MS ETHEL BOYLE BOARD MEMBER 1.0 0.0 X 0 0 0 DR FRANK PATTON MD BOARD MEMBER 1.0 0.0 X 0 0 0 DR JIM DEGIVE MD BOARD MEMBER 1.0 9.0 X 0 111548 12890 DR LEIGH HAMBY MD BOARD MEMBER 1.0 54.0 X 0 1125728 121832 MS LESLIE WEST BOARD MEMBER 1.0 0.0 X 0 0 0 MR RICHARD TANZELLA CEO 55.0 0.0 X X 587417 0 85079 MR VINCE EVANS BOARD MEMBER 1.0 0.0 X 0 0 0 DR MICHAEL CECIL BOARD MEMBER 1.0 0.0 X 0 0 0 DR TIMOTHY COWTHORN BOARD MEMBER 1.0 0.0 X 0 0 0 MR MICHAEL MCANDER TREASURER 1.0 54.0 X 0 1103610 128676 MS ELIZABETH LEDDY SECRETARY 1.0 54.0 X 0 752241 100515 MR MARTY WYNN CFO 55.0 0.0 X 174599 0 20467 DR GEOFFREY COLE MD CMO 35.0 20.0 X 312763 116715 26842 MS LEIGHA FALLIS RN CNO 35.0 20.0 X 176759 47756 16078 DR LISA GILLESPIE PHYSICIAN 55.0 0.0 X 331904 0 2565 MR BLAKE WATTS Exec Dir - Operations 55.0 0.0 X 209138 0 25500 MS AMANDA MILLER DIRECTOR - PHARMACY 55.0 0.0 X 149779 0 15319 MS MELANIE MCGRIFF EXEC. DIR. - PATIENT SERVICES 45.0 10.0 X 147891 22905 21174 MS DENISE HUET PHARMACIST 55.0 0.0 X 142929 0 11355 MS ELEANOR POST FORMER CNO 55.0 0.0 X 271345 0 3284 2504524 4036107 687006 43 true true false MEDICAL SOLUTIONS LLC 1010 NORTH 102ND STREET SUITE 300 OMAHA NE 68114 NURSING SERVICES 4231185 EPIC LLC 3045 Chastain Meadows Pkwy NW MARIETTA GA 30066 DISASTER RECOVERY 441013 IN COMPASS HEALTH INC 318 Maxwell Rd ALPHARETTA GA 30009 HOSPITALIST SVCS 2440497 TOTAL RENAL CARE INC 601 HAWAII ST EL SEGUNDO CA 90245 DIALYSIS 516837 INSIGHT HEALTH CORPORATION 26250 Enterprise Court LAKE FOREST CA 92360 DIAGNOSTIC IMAGING 436105 14 4162 4162 PATIENT SERVICE REVENUE 622110 177190349 177190349 OTHER OPERATING REVENUE 900099 254278 254278 177444627 84009 84009 0 0 213276 213276 0 213276 213276 4385 -4385 -4385 -4385 0 0 0 0 0 0 65182 0 65182 65182 CAFETERIA SALES 722310 542166 542166 FEE REVENUE 900099 2025 2025 544191 178351062 177446652 900248 0 0 0 0 1496804 359708 1137096 0 61574575 55087568 6487007 0 9651647 8427143 1224504 4220985 3624982 596003 55448 55431 17 37954 37954 0 0 0 0 15056245 12246673 2809572 491712 39196 452516 13985129 10600505 3384624 4557842 3454844 1102998 0 2164473 2008714 155759 35987 22479 13508 0 0 0 4473187 4473187 3197206 2972319 224887 2655527 1987153 668374 BAD DEBT EXPENSE 48362510 48362510 DRUGS & MEDICAL SUPPLIES 23969801 23969801 HOSPITAL TAX 2634723 2634723 ADMINISTRATIVE EXPENSES 1588118 926786 661332 200209873 176780535 23429338 0 17825 19868 0 0 0 0 19292889 24998450 0 0 0 0 0 0 3436798 3236541 677130 640992 52704127 4926110 49302247 47778017 0 0 0 0 0 0 0 0 27153139 27153139 99880028 103827007 11210515 9457053 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79924672 70962 91135187 9528015 X 8759177 94306186 -14336 -7194 0 0 8744841 94298992 99880028 103827007 X -21858811 107412962 X false true X true false X 3958141 3958141 35124122 1754336 33369786 12894664 3171774 9722890 727200 0 727200 47778017 GOODWILL 27153139 27153139 0 INTERUNIT PAYABLE -732580 MEDICARE PAYABLE 803542 70962 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. true true X true X 300. true X true true false true true 5739833 5739833 0.03780 7365069 6679378 685691 0.00450 2200162 608667 1591495 0.01050 15305064 7288045 8017019 0.05280 22200 22200 0.00010 696603 696603 0.00460 560089 560089 0.00370 55000 55000 0.00040 1333892 1333892 0.00880 16638956 7288045 9350911 0.06160 true 48362510 0 28967115 29687510 -720395 X true true 1 1 PIEDMONT ROCKDALE HOSPITAL INC 1412 MILSTEAD AVENUE CONYERS GA 30012 WWW.PIEDMONT.ORG 122-726 X X X 1 PIEDMONT ROCKDALE HOSPITAL INC 1 true true true X X X X X X X X 18 true true 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 SCHEDULE H, PART V, LINES 1 AND 2: NEW HOSPITAL ENTITY PIEDMONT ROCKDALE HOSPITAL, INC. ("PRH") WAS CREATED AS A NEW ENTITY ON AUGUST 1, 2017, FOLLOWING THE PURCHASE OF THE ASSETS OF ROCKDALE MEDICAL CENTER, INC. FROM LIFEPOINT HEALTH, LLC, A FOR-PROFIT COMPANY. DURING FY18, THE INTERNAL REVENUE SERVICE GRANTED PRH'S TAX-EXEMPT STATUS, RETROACTIVE TO ITS DATE OF ORGANIZATION, AUGUST 7, 2017. SCHEDULE H, PART V, LINE 7A: COMMUNITY HEALTH NEEDS ASSESSMENT WEBSITE https://www.piedmont.org/media/file/PRH-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 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, LINE 10A: IMPLEMENTATION STRATEGY THE BOARD OF DIRECTORS FOR PIEDMONT ROCKDALE HOSPITAL, INC. UNANIMOUSLY APPROVED ITS IMPLEMENTATION STRATEGY FOR THE THREE YEAR PERIOD BEGINNING WITH FY20 ON OCTOBER 17, 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 SCHEDULE H, PART V, LINE 11: ADDRESSING COMMUNITY HEALTH NEEDS WHEN PIEDMONT HEALTHCARE, INC. FIRST ACQUIRED THE ASSETS OF PIEDMONT ROCKDALE HOSPITAL, INC., THE HOSPITAL HAD A GRACE PERIOD FOR PIEDMONT HEALTHCARE TO PREPARE AND APPROVE A COMMUNITY HEALTH NEEDS ASSESSMENT FOR PIEDMONT ROCKDALE HOSPITAL. THE INITIAL CHNA FOR PIEDMONT ROCKDALE HOSPITAL WAS UNANIMOUSLY APPROVED BY ITS BOARD OF DIRECTORS ON APRIL 18, 2019, WITHIN THE GRACE PERIOD. BASED ON THE CHNA, PIEDMONT ROCKDALE HOSPITAL WILL FOCUS ON: (1) TO MAINTAIN AND, WHEN POSSIBLE, INCREASE ACCESS TO NECESSARY AND AFFORDABLE CARE FOR LOW TO NO INCOME PATIENTS; (2) REDUCE PREVENTABLE READMISSIONS AND EMERGENCY DEPARTMENT RE-ENCOUNTERS; (3) INCREASE ACCESS TO AND AWARENESS OF BREAST AND LUNG CANCER-RELATED PROGRAMMING; AND (4) REDUCE PREVENTABLE INSTANCES OF HEART DISEASE, HYPERTENSION, AND STROKE. SCHEDULE H, PART V, LINE 16: FINANCIAL ASSISTANCE 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 SCHEDULE H, PART VI, LINE 1: REQUIRED DISCLOSURES PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6A Piedmont Rockdale Hospital 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 $200,209,873, LESS BAD DEBT EXPENSE OF $48,362,510 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. PRH 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. MEDICARE SHORTFALLS AS COMMUNITY BENEFIT SCHEDULE 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 the hospital'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. Additionally, Medicare accounted for 25.58% of the hospital's patient service revenue. The hospital'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 the hospital in honor of the hospital's commitment to treat elderly patients. 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 Rockdale Hospital 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, the hospital aimed to 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 Rockdale Hospital conducted its first triennial CHNA, as the entity was a for-profit previously. The Piedmont Rockdale Hospital CHNA was led by the Piedmont Healthcare community benefits team, with input and direction from Piedmont Rockdale Hospital leadership and direct input from board members both at a March 2018 board meeting and through individual meetings with hospital leadership, including the hospital's chief executive officer. Process The CHNA started first with a definition of its community. We defined the hospital's primary population as the hospital's home county, due to the impact of its 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 counties. 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 was 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. 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 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 and diabetes - 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 Rockdale Hospital Board of Directors on April 18, 2019. The Piedmont Rockdale Hospital 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 Rockdale Hospital leadership and the Piedmont Rockdale Hospital Board of Directors. 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 17, 2019. SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ASSISTANCE ELIGIBILITY Piedmont Rockdale Hospital 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 Rockdale Hospital 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 Rockdale Hospital 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 Rockdale community. SCHEDULE H, PART VI, LINE 4: COMMUNITY INFORMATION Piedmont Rockdale Hospital is located in Conyers, Georgia. In 2017, the last year for which Census data were available, approximately 88,482 people lived in Rockdale County's 130 square miles. The majority of the community is African American -- about 57 percent. Whites and Hispanic or Latino groups compromise a total 41 percent and Asian populations represent about 2 percent of the county. The county slightly skewed female. Rockdale County is growing, with a 22 percent increase in population between 2000 and 2010. Hispanic and Latino populations alone grew by 93 percent during that time. In 2017, the median household income was $54,175, which falls in line with the state and national averages of $52,977 and $57,652, respectively. In Rockdale County, 16 percent of the total population was uninsured in 2017, and 22 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. In Rockdale County, like with the rest of Georgia, heart disease is the number one cause of age-adjusted death. 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. There were 74 dentists and 126.2 mental health providers per every 100,000 people in Rockdale County in 2015. These are ratios at or below state and national averages, meaning more providers are needed to adequately address mental and dental health. Community members have reported an average 3.9 poor or fair physical and 3.8 poor mental health days monthly, stats in line with state averages. A total 19 percent of Rockdale County residents reported their health as poor or fair. Both health indicators have worsened since our last CHNA. Preventable hospital stays among Medicare enrollees averaged 62 preventable hospital events per every 1,000 enrollees in 2015. This figure is worse than state and national averages. Medicare enrollees tend to receive proper diabetes screenings, though still lag in mammograms. Ten 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 northwestern part of the county. The infant mortality rate in Rockdale County is less than state and national averages, at 6.5 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 Rockdale County was ischemic heart and vascular disease. In 2017 alone, 197 people died from a major cardiovascular disease. In 2017, 29 Rockdale County community members died from stroke, making it the fifth leading cause of age-adjusted death. Stroke can be caused from several reasons, including a blocked artery, high blood pressure, diabetes, high cholesterol, certain heart conditions, obesity and unhealthy lifestyle choices. While stroke impacts all patients, like with most health measures, the lower income and less educated a person is, the more likely he or she is to experience more severe repercussions, such as death, for several reasons, including limited health literacy, difficulty affording care and necessary prescriptions and unhealthy behaviors. Approximately 21 percent of adults lived with diabetes in Rockdale County in 2015, a figure higher than state and national averages (11 percent and 9 percent, respectively). In 2015, a staggering 29 percent of Medicare beneficiaries lived with diabetes. The numbers may be higher for Medicare beneficiaries because that population is more likely to be routinely tested. Adult obesity rates were high in Rockdale County, as more than a third of county residents are 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 Rockdale County residents. Thirteen percent of county residents commute more than 60 minutes to work each day. The majority of commuters from Rockdale County drive alone, which contributes to depression. The violent crime rate was 334 per every 100,000 county residents, a figure lower than state and national averages. Mental health and behavioral disorders were the 2nd leading cause of age-adjusted death for all county residents between 2013 and 2017. Suicide was the fourth leading cause of premature deaths for all races between 2013 and 2017. It was most common among white males aged 25 to 34 years of age. The rate of suicides has steadily ticked up over the last ten years, as it has in Georgia and the rest of the country. There was one mental health provider for every 921 residents in the county in 2017, a rate far worse than the state and national averages of one provider for every 813 and 493 residents, respectively. In 2015, 15 percent of the Medicare population was diagnosed with depression, slightly better than state and national averages. Like in the rest of the state, opioid prescriptions are an issue in the Rockdale County community, with a total 73.5 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 Rockdale County in 2017, and half were directly related to opioids. In 2016, 41 percent of the population had what's considered to be low healthy food access. An additional 10 percent have no access to healthy foods. These patients live in what's called a food desert, meaning there is no food outlet with healthy food options, such as produce, within a reasonable travel time. Of the 15 census tracts in Rockdale County, 11 were in a food desert. There were 78 fast food restaurants in Rockdale County in 2016, a figure that's far more, per capita, than state and national averages. There are 17 grocery stores, though they tend to be concentrated in the eastern part of the county. Thirty-three 33 percent of households had housing costs that exceeded more than 30 percent of total household income in 2017, indicating a cost burdened household more likely to face overall financial difficulty. This is directly linked to having trouble paying medical bills. Approximately 1,355 Rockdale County households had no motor vehicle in 2017, which can present significant barriers to accessing care and other primary needs, such as groceries, due to very limited public transportation options in the county. Forty-six percent of children lived in single-parent homes in 2017, a statistic that can indicate financial insecurity at home. Seventy-one percent of children qualified for free or reduced cost lunch in the 2015-2016 school year, a statistic that represents poverty and food instability. Rockdale County is much more than the 2017 state average of 62 percent. For every 1,000 teen girls aged 15 to 18 in Rockdale County, 39 gave birth to a child on average each year between 2010 and 2016. African Americans and Hispanic or Latina teen birth rates were 34 and 109 births per every 1,000 teen women, respectively. Children born to teen are statistically much more likely to experience adverse health and socioeconomic issues as they grow older. Twenty-five percent of children in Rockdale County lived in poverty in 2017. Poor children are statistically less likely to graduate high school and are nearly twice as likely to become poor adults and, should they have children, continue a circle of poverty that's difficult to break. These children are also more likely to experience dental issues, anxiety problems and higher rates of accidental injury. Sources for all statistics in this section: U.S. Census 2017 ACS Demographic and Housing Estimate, University of Wisconsin Population Health Institute, County Health Rankings, 2018, with indicators ranging from 2012 to 2019, and the Georgia Online Analytical Statistical Information System. SCHEDULE H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH Piedmont Rockdale Hospital 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. Additionally, in FY19, Piedmont Rockdale Hospital provided lab services free of charge to Mercy Heart, a local not-for-profit charitable clinic. That year, the hospital also gave the clinic $25,000 to support staff and clinic operations. The hospital also provided free or reduced-cost mammograms are provided to women that do not have insurance to receive diagnostic care and prevention of breast cancer. In FY19, Piedmont Rockdale provided health professions education to students and residents training to be health professionals. That year, the hospital oversaw training at total a cost of $696,603. As part of a Piedmont Healthcare systemwide effort, Piedmont Rockdale Hospital 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 Rockdale Hospital 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. SCHEDULE H, PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM Piedmont Rockdale Hospital 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. SCHEDULE H, PART VI, LINE 7: STATE OF FILING OF COMMUNITY BENEFIT REPORT Piedmont Rockdale 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. X true true false true false false false false false false false MR J MICHAEL BURNETT BOARD MEMBER 0 437689 0 219248 0 98667 0 78888 0 16542 0 851034 0 62388 DR LEIGH HAMBY MD BOARD MEMBER 0 581251 0 396758 0 147719 0 105326 0 16506 0 1247560 0 88826 MR RICHARD TANZELLA CEO 358695 0 196098 0 32624 0 68573 0 16506 0 672496 0 0 0 MR MARTY WYNN CFO 174015 0 0 0 584 0 10341 0 10126 0 195066 0 0 0 DR GEOFFREY COLE MD CMO 213454 113177 65528 0 33781 3538 9497 7003 6414 3928 328674 127646 0 0 MS LEIGHA FALLIS RN CNO 119458 47100 25784 0 31517 656 7524 1621 4798 2135 189081 51512 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 DR LISA GILLESPIE PHYSICIAN 40382 0 0 0 291522 0 1229 0 1336 0 334469 0 0 0 MR BLAKE WATTS Exec Dir - Operations 181233 0 0 0 27905 0 10650 0 14850 0 234638 0 0 0 MS AMANDA MILLER DIRECTOR - PHARMACY 148164 0 0 0 1615 0 9136 0 6183 0 165098 0 0 0 MS MELANIE MCGRIFF EXEC. DIR. - PATIENT SERVICES 117174 22770 30150 0 567 135 0 584 17690 2900 165581 26389 0 0 MS DENISE HUET PHARMACIST 115784 0 0 0 27145 0 5231 0 6124 0 154284 0 0 0 MS ELEANOR POST FORMER CNO 32854 0 0 0 238491 0 2004 0 1280 0 274629 0 0 0 SCHEDULE J, PART I, LINE 1A: DISCRETIONARY SPENDING RICHARD TANZELLA RECEIVED A DISCRETIONARY SPENDING ACCOUNT TOTALING $12,923, A FIXED AMOUNT DETERMINED BY HIS JOB LEVEL. THIS SPENDING ACCOUNT WAS INCLUDED IN RICHARD TANZELLA'S TAXABLE WAGES. SCHEDULE J, PART I, LINE 3: COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR THE COMPENSATION FOR THE PRESIDENT/CEO OF PIEDMONT ROCKDALE 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 J. MICHAEL BURNETT AND DR. LEIGH HAMBY RECEIVED SERP PAYMENTS IN THE AMOUNT OF $62,388 AND $88,826, RESPECTIVELY. THE FOLLOWING EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS: MICHAEL MCANDER ELIZABETH LEDDY RICHARD TANZELLA 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 ALL CALENDAR YEAR 2018 FORMS 1099 WERE FILED ON BEHALF OF PIEDMONT ROCKDALE 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 PIEDMONT ROCKDALE HOSPITAL ("PRH"). FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF GOVERNING BODY THE BOARD OF PIEDMONT HEALTHCARE, PIEDMONT ROCKDALE HOSPITAL'S SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF PIEDMONT ROCKDALE HOSPITAL. FORM 990, PART VI, SEC A, LINE 7B: DECISIONS OF GOVERNING BODY PIEDMONT ROCKDALE HOSPITAL'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 ROCKDALE HOSPITAL 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, SECTION B, LINE 11B: 990 REVIEW PROCESS INFORMATION NEEDED TO PREPARE PIEDMONT ROCKDALE HOSPITAL'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PRH'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 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 ROCKDALE HOSPITAL ARE PROVIDED TRAINING ON CONFLICT OF INTEREST ISSUES, INCLUDING REPORTING REQUIREMENTS, AT NEW-EMPLOYEE ORIENTATION AND AT LEAST ANNUALLY THEREAFTER. NONCOMPLIANCE WITH THE CONFLICT OF INTEREST POLICY MUST BE REPORTED TO PIEDMONT HEALTHCARE'S SENIOR VICE PRESIDENT OF COMPLIANCE FOR INVESTIGATION, AND REMEDIAL STEPS MUST BE TAKEN AS APPROPRIATE UNDER THE PIEDMONT HEALTHCARE DISCIPLINARY POLICIES. FORM 990, PART VI, SEC B, LINE 15A, 15B: EXECUTIVE COMPENSATION COMPENSATION FOR EXECUTIVES OF PIEDMONT ROCKDALE HOSPITAL IS SET BY THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC. THE PIEDMONT HEALTHCARE, INC., BOARD OF DIRECTOR'S EXECUTIVE PERFORMANCE AND COMPENSATION COMMITTEE ("THE COMMITTEE") IS COMPOSED OF AT LEAST THREE MEMBERS OF THE PHC BOARD OF DIRECTORS, SERVING TERMS OF THREE YEARS, AND THE MAJORITY OF WHICH ARE COMMUNITY DIRECTORS WHO GENERALLY DO NOT HAVE CONFLICTS OF INTEREST RELATED TO FULFILLMENT OF THE DUTIES AS OUTLINED BELOW. THE COMMITTEE OVERSEES EXECUTIVE PERFORMANCE AND COMPENSATION ON BEHALF OF THE PHC BOARD, SUBJECT TO THE ULTIMATE AUTHORITY AND OVERSIGHT OF THE BOARD. THE COMMITTEE ALSO FORMULATES POLICIES AND MAKES DECISIONS IN ORDER TO ENSURE A HIGH LEVEL OF EXECUTIVE PERFORMANCE. THE COMMITTEE IS AUTHORIZED TO ACT ON BEHALF OF THE PHC BOARD AS SET OUT IN ITS CHARTER, AND THE COMMITTEE IS ALSO CHARGED WITH PROVIDING RECOMMENDATIONS AND PERIODIC REPORTS TO THE PHC BOARD REGARDING EXECUTIVE PERFORMANCE AND COMPENSATION. ALL DECISIONS AND COMPARABILITY DATA ARE DOCUMENTED IN THE COMMITTEE MEETING MINUTES. FUNCTIONS OF THE COMMITTEE - ASSESS AND IMPLEMENT POLICIES REGARDING PERFORMANCE, COMPENSATION AND BENEFITS OF THE PRESIDENT/CEO AND OTHER EXECUTIVES AS DETERMINED BY THE COMMITTEE - SELECT AN EXECUTIVE COMPENSATION CONSULTANT WHO REPORTS TO THE COMMITTEE - ANNUALLY REVIEW THE PRESIDENT/CEO SUCCESSION PLAN - FORMULATE AND IMPLEMENT ANNUAL PERFORMANCE OBJECTIVES FOR THE PRESIDENT/CEO, AND REVIEW AND APPROVE ANNUALLY RECOMMENDATIONS FROM THE PRESIDENT/CEO RELATING TO COMPENSATION, PERFORMANCE OBJECTIVES, AND SUCCESSION PLANS FOR EVP EXECUTIVES - ANNUALLY ASSESS PRESIDENT/CEO PERFORMANCE; IF NECESSARY, IMPLEMENT ACTION PLAN WITH PRESIDENT/CEO INPUT TO IMPROVE HIS/HER PERFORMANCE; ADJUST COMPENSATION AS APPROPRIATE; THE COMMITTEE CHAIR SHALL CONSULT WITH THE PHC GOVERNANCE COMMITTEE CHAIR AND THE PHC BOARD CHAIR AND SHALL COORDINATE THE ANNUAL PERFORMANCE REVIEW OF THE PHC PRESIDENT/CEO, UNLESS THE PHC BOARD CHAIR HAS A REAL OR PERCEIVED CONFLICT OF INTEREST, IN WHICH CASE THE COMMITTEE CHAIR SHALL DETERMINE THE PROPER REVIEW PROCESS - REVIEW AND APPROVE LONG TERM AND SHORT TERM GOALS TO BE USED IN CONNECTION WITH EVP COMPENSATION PROGRAMS AS RECOMMENDED BY THE PRESIDENT/CEO AND VALIDATED BY THE COMPENSATION CONSULTANT - PERIODICALLY REVIEW COMPENSATION, IF ANY, FOR THE PHC BOARD CHAIR AND ALL BOARD CHAIRS OF THE PHC SUBSIDIARIES - ESTABLISH OTHER POLICIES AND PROCEDURES, AND PERFORM OTHER TASKS, RELATED TO EXECUTIVE PERFORMANCE AND COMPENSATION, INCLUDING BUT NOT LIMITED TO, APPROVAL OF EXECUTIVE EMPLOYMENT CONTRACTS AND BENEFITS - PERIODICALLY REPORT SIGNIFICANT DECISIONS AND ANY ADDITIONAL REQUESTED INFORMATION TO THE PHC BOARD. 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: CHANGE IN TEMP $7,141 INTERCOMPANY TRANSFERS $110,838,271 UNALLOCATED EXPENSES ($3,434,628) GRANT REVENUE $2,178 ------------------ TOTAL $107,412,962 PIEDMONT HEALTHCARE INC 1800 HOWELL MILL ROAD SUITE 850 ATLANTA GA 30318 581503902 MANAGEMENT GA 501(c)(3) 12C, III-FI 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 582322328 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 HENRY HOSPITAL INC 1133 EAGLES LANDING PKWY STOCKBRIDGE GA 30281 582200195 HOSPITAL GA 501(C)(3) 3 PHC false PIEDMONT HEART INSTITUTE INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 263553500 HEALTHCARE GA 501(C)(3) 10 PHC false PIEDMONT NEWNAN HOSPITAL INC 745 POPLAR ROAD NEWNAN GA 30265 205077249 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 HEALTHCARE FOUNDATION INC 2001 PEACHTREE ROAD NE SUITE 400 ATLANTA GA 30309 581272768 FUNDRAISING GA 501(C)(3) 12B, II PHC false PIEDMONT ATHENS REGIONAL FOUNDATION INC 1199 PRINCE AVENUE ATHENS GA 30606 581978389 FUNDRAISING GA 501(c)(3) 12B, II ARMC false PIEDMONT ATHENS REGIONAL HEALTH RESOURCE 1199 PRINCE AVENUE ATHENS GA 30606 581930580 DEVELOPMENT GA 501(C)(3) 12B, II ARMC false PIEDMONT ATHENS REGIONAL MEDICAL CENTER 1199 PRINCE AVENUE ATHENS GA 30606 582179986 HOSPITAL GA 501(C)(3) 3 PHC false ATHENS REGIONAL PHYSICIAN SERVICES INC 1199 PRINCE AVENUE ATHENS GA 30606 582332921 HEALTHCARE GA 501(C)(3) 12B, II ARMC false ATHENS REGIONAL SPECIALTY SERVICES INC 1199 PRINCE AVENUE ATHENS GA 30606 271975001 HEALTHCARE GA 501(C)(3) 3 ARMC false REGIONAL FIRSTCARE INC 1199 PRINCE AVENUE ATHENS GA 30606 582362733 URGENT CARE GA 501(C)(3) 12B, II ARMC 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 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 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 ORTHOPAEDIC GA NA N/A 0 0 false 0 false DIGESTIVE HEALTHCARE OF GA ENDOSCOPY CEN 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 70 ATLANTA GA 30339 461500639 HEALTHCARE GA NA N/A 0 0 false 0 false PIEDMONT MEDICAL CARE CORPORATION 2727 PACES FERRY RD STE 1-1100 ATLANTA GA 30339 582092768 HEALTHCARE GA PHC C CORP 0 0 0.00000 false THE PIEDMONT CLINIC INC 2727 PACES FERRY RD STE 1-1100 ATLANTA GA 30339 582005358 HEALTHCARE GA PHC C CORP 0 0 0.00000 false PIEDMONT HEART INSTITUTE PHYSICIANS INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 260593850 HEALTHCARE GA PHC C CORP 0 0 0.00000 false AMSTER MCRAE INSURANCE COMPANY PO BOX 1159 GRAND CAYMAN CJ KY1-1102 980427603 RELATED INSUR. 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