2018-06-14T13:04:33-04:00 2017-07-31 580914992 DRAFFIN & TUCKER LLP PO BOX 71309 ALBANY GA 317081309 990 2016-08-01 383647394 PHOEBE WORTH MEDICAL CENTER INC PHOE 2297766961 807 SOUTH ISABELLAPO BOX 545 SYLVESTER GA 317910545 CANDACE GUARNIERI CFO 2297766961 2018-06-15 true JEFFREY S WRIGHT P00226270 2298837878 2018-06-01 X 2016 2022-09-23 18:48:47Z KIM GILMAN PO BOX 545 SYLVESTER GA 317910545 15225387 false X WWW.PHOEBEHEALTH.COM X 2002 GA PROVIDING CHARITABLE HEALTHCARE ACTIVITIES 9 5 219 9 0 464312 41019 14628814 14963739 39827 -6323 191477 184350 15324430 15182785 51476 45619 0 8192960 6151152 0 0 8735303 9140768 16979739 15337539 -1655309 -154754 9768791 9157888 16002116 15545967 -6233325 -6388079 PROVIDING CHARITABLE HEALTHCARE ACTIVITIES false false 12550500 45619 14968210 TO BE THE LEADING PROVIDER OF QUALITY, COST EFFECTIVE, PATIENT-CENTERED HEALTH CARE SERVICES TO ALL RESIDENTS OF SOUTHWEST GEORGIA. PWMC PURSUES ITS MISSION THROUGH A PATIENT-CENTERED ENVIRONMENT OF CARE REFLECTING HIGH STANDARDS AND PROMOTING A BALANCE OF PROFESSIONAL PREPARATION AND SERVICE, CONTINUOUS IMPROVEMENT BASED ON OUR CORE VALUES OF PEOPLE, RELATIONSHIPS, REPUTATION, EXCELLENCE, EFFICIENCY AND COMMITMENT. 12550500 true true false true false false false false false false true false false false true true true true false false false false false false false false true true true false true false false false false false false false false false false false false false true false false false true 29 0 219 true false false false false false false false false false false X 9 5 false false false false true true true true true false false true true true true true true false false false GA X X CANDACE GUARNIERI CFO 2297766961 PO BOX 545 SYLVESTER GA 317910545 JOEL WERNICK BD MEMBER/PP 1.00 54.00 X X 0 6742356 383408 JOE AUSTIN BD MEMBER/PP 1.00 52.00 X X 0 464796 151955 DON MONK CHAIRMAN 1.00 0.00 X X 0 0 0 JOHNNY COCHRAN VICE CHAIR 1.00 0.00 X X 0 0 0 CHRIS SHIPP BOARD MEMBER 1.00 0.00 X 0 0 0 MARY KING GIVENS BOARD MEMBER 1.00 1.00 X 0 0 0 WAYNE SENKBEIL BOARD MEMBER 1.00 0.00 X 0 0 0 NATU PATEL MD BOARD MEMBER 1.00 0.00 X 0 0 0 SHIRLEY THOMAS BOARD MEMBER 1.00 0.00 X 0 0 0 BRIAN CHURCH PPHS CFO 1.00 54.00 X 0 341217 71327 KIM GILMAN CEO/CNO 25.00 25.00 X 0 199160 55604 CANDACE GUARNIERI CFO 25.00 25.00 X 0 110347 14964 BENJAMIN LEE HUDSON PHARMACIST 40.00 0.00 X 143206 0 5911 MISSY EAST MID-LEVEL PR 40.00 0.00 X 119277 0 14459 262483 7857876 697628 2 false true false ARAMARK CORPORATION 25271 NETWORK PLACE CHICAGO IL 606731252 DIETARY SERVICE 442885 THE ROSE GROUP 817 NW 56TH TERRACE SUITE A GAINESVILLE FL 326056401 NURSING SERVICE 107272 2 629 40390 41019 NET PATIENT SERVICE REVENUE 623000 14963739 14963739 14963739 12563 12563 51660 23205 28455 28455 28455 511 19397 -18886 -18886 -18886 CAFETERIA 722513 135981 135981 MEDICAL RECORDS 621990 10057 10057 EMPLOYEE PHARMACY 621990 5386 5386 4471 4471 155895 15182785 14968210 173556 X 45619 45619 4906624 4392717 513907 889783 798571 91212 354745 318380 36365 42000 42000 4922201 4016200 906001 62705 4266 58439 920430 865654 54776 304287 240443 63844 23160 9451 13709 907719 717265 190454 449799 449799 REPAIRS & MAINTENANCE 468033 318112 149921 MEDICAL SUPPLIES 427320 427320 MISCELLANEOUS 278877 130420 148457 CLINIC LOSS 193112 193112 141125 72970 68155 15337539 12550500 2787039 0 3092350 2463101 1721800 1715264 161803 131861 165839 82570 11250352 6499115 4560891 4751237 66108 13855 9768791 9157888 1321798 1492577 14680318 14053390 16002116 15545967 X -6233325 -6388079 -6233325 -6388079 9768791 9157888 -154754 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 609 609 false SCHEDULE C, PART II-B, LINE 1 PART II-B, LINE 1I THE ORGANIZATION PAYS MEMBERSHIP DUES TO A NATIONAL HEALTHCARE ORGANIZATION. A PORTION OF THOSE DUES IS ALLOCATED TO LOBBYING ACTIVITIES IN WHICH THE NATIONAL HEALTHCARE ORGANIZATION PARTICIPATE. 175676 175676 4471039 1831591 2639448 6603637 4667524 1936113 4751237 DUE TO PHOEBE PUTNEY HEALTH SYSTEM 14053390 14053390 X 15205990 15205990 -23205 -23205 15182785 15360744 23205 23205 15337539 15337539 SCHEDULE D, PAGE 3, PART X THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION THAT HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL APPLIES ACCOUNTING POLICIES THAT PRESCRIBE WHEN TO RECOGNIZE AND HOW TO MEASURE THE FINANCIAL STATEMENT EFFECTS OF INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON ITS INCOME TAX RETURNS. THESE RULES REQUIRE MANAGEMENT TO EVALUATE THE LIKELIHOOD THAT, UPON EXAMINATION BY THE RELEVANT TAXING JURISDICTIONS, THOSE INCOME TAX POSITIONS WOULD BE SUSTAINED. BASED ON THAT EVALUATION, THE HOSPITAL ONLY RECOGNIZES THE MAXIMUM BENEFIT OF EACH INCOME TAX POSITION THAT IS MORE THAN 50% LIKELY OF BEING SUSTAINED. TO THE EXTENT THAT ALL OR A PORTION OF THE BENEFITS OF AN INCOME TAX POSITION ARE NOT RECOGNIZED, A LIABILITY WOULD BE RECOGNIZED FOR THE UNRECOGNIZED BENEFITS, ALONG WITH ANY INTEREST AND PENALTIES THAT WOULD RESULT FROM DISALLOWANCE OF THE POSITION. SHOULD ANY SUCH PENALTIES AND INTEREST BE INCURRED, THEY WOULD BE RECOGNIZED AS OPERATING EXPENSES. BASED ON THE RESULTS OF MANAGEMENTS EVALUATION, NO LIABILITY IS RECOGNIZED IN THE ACCOMPANYING BALANCE SHEET FOR UNRECOGNIZED INCOME TAX POSITIONS. FURTHER, NO INTEREST OR PENALTIES HAVE BEEN ACCRUED OR CHARGED TO EXPENSE AS OF JULY 31, 2017 AND 2016 OR FOR THE YEARS THEN ENDED. THE HOSPITALS TAX RETURNS ARE SUBJECT TO POSSIBLE EXAMINATION BY THE TAXING AUTHORITIES. FOR FEDERAL INCOME TAX PURPOSES, THE TAX RETURNS ESSENTIALLY REMAIN OPEN FOR POSSIBLE EXAMINATION FOR A PERIOD OF THREE YEARS AFTER THE RESPECTIVE FILING DEADLINES OF THOSE RETURNS. SCHEDULE D, PAGE 4, PART XI, LINE 4B RENTAL EXPENSES -23,205 SCHEDULE D, PAGE 4, PART XII, LINE 2D RENTAL EXPENSES 23,205 true true X true X 1.250000000000 true X true true false true true 2549132 581815 1967317 0.12810 2997910 2584277 413633 0.02690 5547042 3166092 2380950 0.15500 1300 1300 0.00010 3653 3707996 3224980 483016 0.03140 46819 46819 0.00300 3653 3756115 3224980 531135 0.03450 3653 9303157 6391072 2912085 0.18950 true 3018726 4235456 1865747 2369709 X true true 1 1 PHOEBE WORTH MEDICAL CENTER INC 807 S ISABELLA STREET SYLVESTER GA 31791 WWW.PHOEBEHEALTH.COM 159-603 X X X X SWB, SNF PHOEBE WORTH MEDICAL CENTER INC 1 false false true X X X X X X X X X 16 true false false true X WWW.PHOEBEHEALTH.COM X true 17 true WWW.PHOEBEHEALTH.COM false false true X 125.000000000000 200.000000000000 X X X X X X true true X X X X true X WWW.PHOEBEHEALTH.COM X WWW.PHOEBEHEALTH.COM X WWW.PHOEBEHEALTH.COM X X X X X X true X false X X X X X true X false false FACILITY 1, PHOEBE WORTH MEDICAL CENTER, INC. - PART V, LINE 5 MEMBERS OF THE INTERNAL ASSESSMENT TEAM PERFORMED TEN (10) KEY LEADER INTERVIEWS OF APPROXIMATELY 30 TO 60 MINUTES IN LENGTH. THE PURPOSE OF THE KEY LEADER INTERVIEWS WAS TO GATHER INFORMATION, GAIN KNOWLEDGE AND RECEIVE INPUT REGARDING HEALTH ISSUES FACING THE ORGANIZATION'S SERVICE AREA. THE INTERVIEW SELECTION PROCESS WAS CAREFUL TO INCLUDE REPRESENTATION THAT REFLECTS THE MAKE-UP OF PATIENTS RECEIVING SERVICES IN THE ORGANIZATION'S SERVICE AREA (RELIGIOUS, BUSINESS, POLITICAL, PUBLIC HEALTH, THE ELDERLY, AND AFTER SCHOOL PROGRAMS). A COMMUNITY INPUT SESSION WAS ALSO HELD TO REVIEW DATA AND PROVIDE FEEDBACK ON THE COMMUNITYS VIEW OF PRIORITIES. FOURTEEN (14) INDIVIDUALS PARTICIPATED IN THE INPUT SESSION. PARTICIPANTS WERE ASKED TO MAKE A LIST OF IDEAS THAT COULD IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY. THE PARTICIPANTS WERE THEN PUT INTO SMALL GROUPS TO DISCUSS AND DEVELOP 8 TO 10 IDEAS TO BRING TO THE WHOLE GROUP. FINALLY, ONCE ALL THE IDEAS WERE GATHERED AND PLACED ON A STICKY WALL, EACH PARTICIPANT HAD TO MARK 2 IDEAS THAT THEY CONSIDERED TO BE SIGNIFICANT ISSUES FACING THE COMMUNITY. THE SESSION INCLUDED COMMUNITY PARTICIPANTS SUCH AS: COMMUNITY VOLUNTEERS; MEDICAL PROFESSIONALS; REPRESENTATIVES FROM SOUTHWEST GEORGIA COUNCIL ON AGING, AND WORTH COUNTY CHAMBER OF COMMERCE. FACILITY 1, PHOEBE WORTH MEDICAL CENTER, INC. - PART V, LINE 11 USING THE CATHOLIC HEALTH ASSOCIATIONS SELECTION FILTER AS A MEANS TO PRIORITIZE COMPETING SIGNIFICANT NEEDS, BELOW IS A LIST OF NEEDS THAT WERE NOT INCLUDED AS PRIORITIES BUT REMAIN A CONCERN TO THE COMMUNITY. 1) TRANSPORTATION: VULNERABLE POPULATIONS HAVE ACCESS TO MEDICAID VAN OPTION. 2) CHILD AND ADULT OBESITY: THE COUNTY HEALTH DEPARTMENT AND SCHOOL SYSTEM ARE ADDRESSING THIS NEED. 3) ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD): THE COMMUNITY DID NOT ADDRESS IT AS A SIGNIFICANT NEED. 4) TEEN PREGNANCY AND UNPLANNED PREGNANCY: THE TEEN PREGNANCY RATE IN WORTH COUNTY IS BELOW THE 2020 WORLD HEALTH ORGANIZATION BENCHMARK. 5) LOW BIRTH WEIGHT INFANTS: THERE ARE NO BIRTHING CENTERS OR OB/GYN PHYSICIANS LOCATED IN WORTH COUNTY. 6) LUNG CANCER: THE WORTH COUNTY CANCER INCIDENT RATE IS NOTABLY BETTER THAN THE SURROUNDING COUNTIES AND THE U.S. 50 PERCENTILE. 7) BREAST CANCER: THE WORTH COUNTY CANCER INCIDENT RATE IS NOTABLY BETTER THAN THE SURROUNDING COUNTIES AND THE U.S. 50 PERCENTILE. 8) ALZHEIMER'S DISEASE: THE SOUTHWEST GEORGIA COUNCIL ON AGING OFFERS EDUCATION AND SUPPORT FOR CAREGIVERS IN THE COMMUNITY. 9) SEXUALLY TRANSMITTED DISEASES (STD): THE STD RATE HAS BEEN NOTED TO BE ON THE DECLINE FOR WORTH COUNTY. A COMPLETE COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, COMMUNITY PRIORITIES, AND IMPLEMENTATION PLAN CAN BE FOUND AT HTTP://WWW.PHOEBEHEALTH.COM/LOCATIONS/PHOEBE-WORTH-MEDICAL-CENTER/PHOEBE- WORTH-MEDICAL-CENTER-CHNA FACILITY 1, PHOEBE WORTH MEDICAL CENTER, INC. - PART V, LINE 13B HOUSEHOLD INCOMES OVER 200% OF FPG WHERE THE PATIENT HAS A CATASTROPHIC ILLNESS IS ELIGIBLE FOR CASTASTROPHIC STATUS WHICH PROVIDES FOR DISCOUNTED CHARGES FOR CARE. FACILITY 1, PHOEBE WORTH MEDICAL CENTER, INC. - PART V, LINE 20E WRITTEN NOTICE OF THE AVAILABILITY OF FINANCIAL ASSISTANCE IS INCLUDED ON HOSPITAL PATIENT STATEMENTS, AND ON WRITTEN COMMUNICATIONS SENT BY CONTRACTED THIRD PARTY COLLECTION AGENCIES. THESE AGENCIES MAY REFER ACCOUNTS FOR REPORTING TO MAJOR CREDIT BUREAUS, AFTER A SERIES OF STATEMENTS AND LETTERS ARE SENT THROUGHOUT MULTIPLE COLLECTION CYCLES. 1 PHOEBE WORTH FAMILY MEDICAL CENTER 1014 WEST FRANKLIN STREET SYLVESTER GA 31791 RHC PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN (F), THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25: FORM 990, PART IX, LINE 25 15,337,539 ADD: EXPENSES REPORTED IN PART VIII 23,205 DENOMINATOR FOR COLUMN (F) 15,360,744 PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION THE COST WAS CALCULATED USING THE COST-TO-CHARGE RATIO AS CALCULATED USING WORKSHEET 2 FROM THE IRS FORM 990 INSTRUCTIONS. THE COST OF ON LINE 7I WAS GENERATED FROM THE ORGANIZATION'S ACCOUNTING RECORDS. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY THE AMOUNTS ON PART III, LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS SEE PAGES 6 AND 7 ON THE ACCOMPANYING AUDITED FINANCIAL STATEMENTS FOR THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE DISCLOSURE. PART III, LINE 8 - MEDICARE EXPLANATION MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION THE ORGANIZATION PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE ORGANIZATION WRITES OFF PATIENT ACCOUNTS RECEIVABLE BALANCES FOR PATIENTS QUALIFYING FOR CHARITY CARE OR FINANCIAL ASSISTANCE AND DOES NOT MAKE FURTHER COLLECTION EFFORTS. PART VI, LINE 2 - NEEDS ASSESSMENT NEEDS ASSESSMENTS HAVE TRADITIONALLY LED TO THE CREATION OF COMMUNITY-BASED DELIVERY SYSTEMS THAT EXPAND ACCESS TO HEALTH CARE, MEET THE NEEDS OF THE PEOPLE AND BUILD HEALTHY COMMUNITIES IN THE BROADEST SENSE BY IMPACTING MAJOR DETERMINANTS, SUCH AS ECONOMIC DEVELOPMENT, EMPLOYMENT, CHILDREN'S SAFETY, EDUCATION AND ADEQUATE HOUSING. THE ORGANIZATION CONDUCTS REGULAR NEEDS ASSESSMENT THROUGH FORMAL AND INFORMAL SURVEYS AND PROCESSES, INCLUDING COLLABORATIONS WITH PUBLIC AND COMMUNITY AGENCIES. THROUGH STRATEGIC PLANNING AND COMMUNITY INTERVIEWS, THE ORGANIZATION DEVELOPS PROGRAMS AND SERVICES THAT CONSIDER THE ECONOMIC IMPERATIVES OF THE REGION, THE EFFECT OF LEGISLATION AND THE INVOLVEMENT OF OTHER COMMUNITY-BASED ORGANIZATIONS AND PARTNERS. THE ORGANIZATION REGULARLY CONDUCTS FOCUS GROUPS IN THE COMMUNITY TO UNDERSTAND ISSUES AFFECTING ITS PATIENTS, AND HAS CREATED PROGRAMS IN RESPONSE TO HEALTH DISPARITIES PREVALENT IN THE AREA. THE ORGANIZATION ALSO COLLECTS HEALTH NEEDS INFORMATION FROM NURSES, WHO PROVIDE DIRECT CARE TO STUDENTS AND STAFF AND WHO COLLABORATE WITH OTHER AGENCIES TO DEVELOP HEALTH AWARENESS AND DISEASE PREVENTION PROGRAMS. THE ORGANIZATION ALSO CONDUCTS REGULAR PHYSICIAN WORKFORCE STUDIES THROUGH ITS STRATEGIC PLANNING ARM TO DETERMINE UNMET PHYSICIAN NEEDS AND BARRIERS TO ACCESSING CARE. THE ORGANIZATION MEASURES THE SUCCESS OF ITS COMMITMENT BY HOW WELL IT KEEPS PEOPLE HEALTHY AND HOW WELL IT IMPACTS THE SOCIAL/CULTURAL BONDS THAT WILL SECURE THE COMMUNITIES OF THE FUTURE. THE HOSPITAL LAST CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2016. A COMPLETE COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, COMMUNITY PRIORITIES, AND IMPLEMENTATION PLAN CAN BE FOUND AT HTTP://WWW.PHOEBEHEALTH.COM/LOCATIONS/PHOEBE-WORTH- MEDICAL-CENTER/PHOEBE- WORTH-MEDICAL-CENTER-CHNA PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE BOARD HAS CLEARLY WRITTEN FINANCIAL ASSISTANCE POLICY THAT IS AVAILABLE ON THE ORGANIZATION'S WEB SITE AND THROUGH THE BUSINESS OFFICE. SIGNS ARE PROMINENTLY POSTED ON THE AVAILABILITY OF FREE AND CHARITY CARE. PATIENT EDUCATION ON THE ORGANIZATION'S FINANCIAL ASSISTANCE IS CONDUCTED DURING PRE-REGISTRATION, THROUGH FLOOR VISITS BY BUSINESS OFFICE REPRESENTATIVES FOR PATIENTS THAT STRESS CONCERN IN MEETING THE FINANCIAL OBLIGATIONS FOR THEIR SERVICES, AND THROUGH OUR CUSTOMER SERVICE DEPARTMENT. BROCHURES ARE PROMINENTLY DISPLAYED AT EACH REGISTRATION BOOTH. THE BUSINESS OFFICE CONTINUOUSLY PROVIDES UPDATED MATERIAL TO PHYSICIAN OFFICES FOR ISSUANCE TO THEIR PATIENTS THAT HIGHLIGHT THE FINANCIAL ASSISTANCE PROGRAM AND POLICIES. THE PATIENT STATEMENTS HIGHLIGHT THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY AND ENCOURAGES PATIENTS TO CALL FOR FINANCIAL ASSISTANCE. PART VI, LINE 4 - COMMUNITY INFORMATION WORTH COUNTY IS PHOEBE WORTHS PRIMARY SERVICE AREA. THERE ARE APPROXIMATELY 21,678 RESIDENTS OF WORTH COUNTY WITH A RACIAL MIX OF 70% WHITE, 28% AFRICAN AMERICAN AND 2% ALL OTHERS. POPULATION PROJECTIONS FOR WORTH COUNTY SHOW OVERALL POPULATION GROWTH, WITH AGES 65+ HAVING THE GREATEST GROWTH RATE. THE HOUSEHOLD MEDIAN INCOME FOR WORTH COUNTY AVERAGED 38,800 DURING 2012 WHICH IS A THIRD LESS THAN THE GEORGIA STATE AVERAGE. THE AVERAGE CENSUS TRACT PER CAPITA INCOME IS 19,073 OR 78% OF THE NATIONAL AVERAGE. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH THE ORGANIZATION AND ITS VOLUNTEER BOARD IS COMPOSED OF COMMUNITY MEMBERS WITH DIVERSE PROFESSIONAL AND COMMUNITY SERVICE BACKGROUNDS, AS WELL AS PHYSICIAN MEMBERS. THE ORGANIZATION'S EMERGENCY CENTER IS OPERATED 24/7 AND OPEN TO ALL PERSONS, REGARDLESS OF ABILITY TO PAY. THE BOARD MAINTAINS OPEN MEDICAL STAFF POLICIES WITH PRIVILEGES AVAILABLE TO ALL QUALIFYING PHYSICIANS. THE BOARD HAS A CLEARLY WRITTEN FINANCIAL ASSISTANCE POLICY THAT IS AVAILABLE ON THE ORGANIZATION'S WEB SITE AND THROUGH THE BUSINESS OFFICE. SIGNS ARE PROMINENTLY POSTED ON THE AVAILABILITY OF FREE AND CHARITY CARE. THE ORGANIZATION HAS A MULTI-PRONGED APPROACH TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES: INCREASING ACCESS, BUILDING CAPACITY, INVESTING IN "UPSTREAM" PROGRAMS THAT GET AT THE CAUSE OF DISEASE AND ILLNESS, BUILDING COMMUNITY PARTNERSHIPS, ADVOCATING CHANGE, AND DEVELOPING LEADERSHIP. SURPLUS FUNDS ARE REINVESTED IN RESOURCES TO IMPROVE THE DELIVERY OF MEDICAL AND HEALTH CARE SERVICES. PRIMARY CARE IS FIRST AND CREATES A PROFOUND IMPACT ON THE COMMUNITIES SERVED. PRIMARY CARE SERVICES ARE ESTABLISHED IN AREAS WHERE RESIDENTS ARE MOST LIKELY TO SUFFER FROM SEVERE MANPOWER SHORTAGES, HIGH POVERTY LEVELS AND A LACK OF ACCESS TO CARE. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM PHOEBE PUTNEY HEALTH SYSTEM, INC. (PPHS) IS THE NOT-FOR-PROFIT PARENT COMPANY OF PHOEBE PUTNEY MEMORIAL HOSPITAL, INC. (PPMH), A NOT-FOR-PROFIT ENTITY, PHOEBE PUTNEY HEALTH VENTURES, INC. (PPHV), A FOR-PROFIT CORPORATION, PHOEBE PHYSICIAN GROUP, INC. (PPG), A NOT-FOR-PROFIT CORPORATION, PHOEBE WORTH MEDICAL CENTER, INC. (PWMC), A NOT-FOR-PROFIT ENTITY, PHOEBE SUMTER MEDICAL CENTER, INC. (PSMC), A NOT-FOR-PROFIT ENTITY, AND PHOEBE FOUNDATION, INC. (PF), A NOT-FOR-PROFIT ENTITY. PPMH IS LOCATED IN ALBANY, GEORGIA, IS AN ACUTE CARE HOSPITAL, WHICH OPERATES SATELLITE CLINICS IN THE SURROUNDING COUNTIES. IT PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF SOUTHWEST GEORGIA. ADMITTING PHYSICIANS ARE PRIMARILY PRACTITIONERS IN THE LOCAL AREA. PPHV ENGAGES IN HEALTHCARE AND RELATED ACTIVITIES IN FURTHERANCE OF THE EXEMPT PURPOSES OF PPHS AND PPMH. PWMC IS LOCATED IN SYLVESTER, GEORGIA, IS A 25 BED RURAL CRITICAL ACCESS HOSPITAL. IT PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF WORTH COUNTY, GEORGIA. PSMC IS LOCATED IN AMERICUS, GEORGIA, IS AN ACUTE CARE HOSPITAL. IT PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF SUMTER COUNTY, GEORGIA. PPG WAS ESTABLISHED TO ORGANIZE AND OPERATE MEDICAL PRACTICES EXCLUSIVELY FOR THE BENEFIT OF PPMH, PWMC, AND PSMC. PF WAS ESTABLISHED TO RAISE FUNDS OF ANY KIND OR CHARACTER TO BE USED EXCLUSIVELY FOR CHARITABLE, MEDICAL, EDUCATIONAL AND SCIENTIFIC PURPOSES AT OR IN CONNECTION WITH EACH AND EVERY NON-PROFIT ORGANIZATION OF WHICH PPHS IS THE SOLE MEMBER, AND ANY OTHER NON-PROFIT HOSPITAL WHICH IS MANAGED OR CONTROLLED BY PPHS WHETHER THROUGH OWNERSHIP, MANAGEMENT CONTRACT OR OTHERWISE. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT GEORGIA ADDITIONAL INFORMATION SERVICE TO THE COMMUNITY PHOEBE WORTH MEDICAL CENTER (PWMC) IS A NOT-FOR-PROFIT HEALTH CARE ORGANIZATION THAT EXISTS TO SERVE THE COMMUNITY. PWMC HAS NO STOCKHOLDERS OR OWNERS, AND IS PART OF THE NOT-FOR-PROFIT PHOEBE PUTNEY HEALTH SYSTEM, INC. AFTER OPERATING EXPENSES ARE COVERED, ANY REMAINING REVENUES ARE REINVESTED IN THE OPERATION OF PWMC IN ORDER TO ENHANCE OUR ABILITY TO CARRY OUT OUR LOCAL MISSION OF TAKING CARE OF OUR COMMUNITIES' CITIZENS. THE HOSPITAL PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS WHICH COVER MANY GEORGIANS HEALTH CARE NEEDS, AND BY SO DOING, FOREGOES SOME CHARGES AND HAS UNREIMBURSED EXPENSES. THE HOSPITAL ALSO OFFERS FINANCIAL ASSISTANCE TO INDIVIDUALS UNABLE TO PAY FOR THEIR HEALTHCARE SERVICES. INDIGENT FINANCIAL ASSISTANCE, OR FREE CARE, IS OFFERED TO PATIENTS WHOSE HOUSEHOLD INCOME IS AT OR BELOW 125% OF THE FEDERAL POVERTY GUIDELINES. PATIENTS WHOSE INCOME LEVEL IS BETWEEN 126% - 200% OF THE FEDERAL POVERTY LEVELS WILL BE CLASSIFIED AS CHARITY AND RECEIVE THEIR NEEDED HEALTHCARE SERVICES AT A DISCOUNTED RATE. THE FOLLOWING TABLE SUMMARIZES THE AMOUNTS OF CHARGES FOREGONE (I.E., CONTRACTUAL ADJUSTMENTS) AND ESTIMATES THE LOSSES (COMPUTED BY APPLYING A TOTAL COST FACTOR TO THE CHARGES FOREGONE) INCURRED BY PPMH DUE TO INADEQUATE PAYMENTS BY THESE PROGRAMS AND FOR INDIGENT/CHARITY. THE HOSPITAL ALSO OPERATES A RURAL HEALTH CLINIC (RHC) WHICH ALSO FOREGOES SOME CHARGES AND HAS COSTS NOT REIMBURSED THROUGH PATIENTS QUALIFYING FOR THESE SAME INDIGENT AND CHARITY PROGRAMS. THE AMOUNTS LISTED BELOW ARE ALL INCLUSIVE OF BOTH HOSPITAL AND CLINIC ACTIVITIES. ESTIMATED CHARGES UNREIMBURSED FOREGONE COST MEDICARE 7,000,000 3,000,000 MEDICAID 4,000,000 2,000,000 INDIGENT/CHARITY CARE 6,000,000 3,000,000 TOTALS 17,000,000 8,000,000 THE FOLLOWING IS A SUMMARY OF THE COMMUNITY BENEFIT ACTIVITIES AND HEALTH IMPROVEMENT SERVICES OFFERED BY THE HOSPITAL AND ILLUSTRATES THE ACTIVITIES AND DONATIONS DURING FISCAL YEAR 2017. I. COMMUNITY HEALTH IMPROVEMENT SERVICES A. COMMUNITY HEALTH EDUCATION WOMENS HEALTH FAIR THE HOSPITAL HOSTED A WOMENS HEALTH FAIR WHERE COMMUNITY LADIES HAD THE OPPORTUNITY TO HAVE A HEALTH SCREENING, ENGAGE WITH LOCAL BUSINESSES WHO STAFFED VENDOR TABLES, TRY A GROUP EXERCISE CALLED SHABAM, AND LISTEN TO A LOCAL MOTIVATIONAL SPEAKER. THE EVENT WAS HELD AT UNITY BAPTIST CHURCH IN OCTOBER 2016. THE HOSPITAL INCURRED EXPENSES OF 1,000 FOR THIS EVENT. SENIOR CENTER HEALTH FAIR THE HOSPITAL PROVIDES TIME THROUGHOUT THE YEAR TO SPEAK TO OUR SENIORS ABOUT SERVICES OFFERED AT PHOEBE WORTH AND VARIOUS OTHER HEALTH AND WELLNESS TOPICS. WE ALSO OFFER MEDICAL SCREENINGS AT THESE EVENTS. THE HOSPITAL INCURRED EXPENSES OF 300 FOR THESE SERVICES. BEHAVIORAL AND MENTAL HEALTH SERVICES THE HOSPITAL ORGANIZED TWO COMMUNITY-WIDE MEETINGS TO CONDUCT OPEN DISCUSSIONS ABOUT MENTAL HEALTH, WHICH ACCORDING TO OUR LATEST COMMUNITY HEALTH NEEDS ASSESSMENT, IS A LARGE UNMET HEALTH NEED IN OUR COMMUNITY. AT THE FIRST MEETING, EFFORTS WERE GEARED TOWARDS BUILDING A MENTAL HEALTH COALITION THAT WOULD IDENTIFY STRATEGIES AND GOALS TO ULTIMATELY CREATE A HEALTH SETTING FOR COMMUNITY MEMBERS IN NEED OF SERVICES. THE FIRST MEETING INCLUDED TWELVE KEY STAKEHOLDERS. ATTENDEES INCLUDED LEADERSHIP FROM OUR COUNTY CHAMBER, LOCAL HEALTH DEPARTMENT, BEHAVIORAL HEALTH PROVIDERS, FAMILY CONNECTIONS, AND PHOEBE REPRESENTATIVES. AN ACTION PLAN WAS CREATED AND THE HOSPITAL IDENTIFIED COALITION MEMBERS TO ENHANCE THEIR EFFORTS. AN AGENDA WAS CREATED FOR THE FIRST COALITION MEETING. THE SECOND MEETING INCLUDED TWENTY-TWO ATTENDEES AND WAS MADE UP OF LAW ENFORCEMENT, CITY OFFICIALS, ASPIRE (A BEHAVIORAL HEALTH PROVIDER), AND THE ORIGINAL KEY STAKEHOLDERS. THE AGENDA FOR THE EVENT INCLUDED REVIEWING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND OUTLINING THE IDENTIFIED NEED TO ADDRESS BEHAVIORAL AND MENTAL HEALTH ISSUES, A PRESENTATION BY ASPIRE HIGHLIGHTING THE VARIOUS RESOURCES AND SERVICES THEY OFFER, AND OUTLINING NEXT STEPS. THE NEXT STEPS INCLUDED FINDING SPACE FOR ASPIRE TO UTILIZE ON A MORE FREQUENT BASIS, APPLYING FOR A GRANT UNDER THE 2 GEORGIA INITIATIVE, AND CONTINUING TO BUILD THE COALITION. BETWEEN THE SECOND MEETING AND THE FISCAL YEAR END, THERE WERE SEVERAL SMALLER GROUP MEETINGS AND/OR EMAIL CORRESPONDENCES AS WE WORKED THROUGH THE GRANT APPLICATION AND CONTINUED TO WORK TOWARDS MEETING OUR OTHER STATED NEXT STEPS. AS OF FISCAL YEAR END 2017, THE GROUP WAS NOTIFIED FUNDING VIA THE GRANT HAD BEEN DENIED BUT EFFORTS TO ADDRESS THE UNMET HEALTH NEED WOULD CONTINUE AND WE WOULD ACHIEVE MEETING OUR COMMUNITYS HEALTH NEED. II. FINANCIAL AND IN-KIND SUPPORT THE HOSPITAL SUPPORTS THE HEALTH DEPARTMENT THROUGH CONTRIBUTIONS TOWARDS THEIR PROGRAMS DIRECTED AT EDUCATING, SCREENING, TREATING, AND ASSISTING WITH THE COSTS OF SUPPLIES AND MEDICATIONS FOR LOW INCOME INDIVIDUALS BATTLING HIGH BLOOD PRESSURE AND DIABETES. THE FINANCIAL SUPPORT ENABLES THE HEALTH DEPARTMENT TO OPERATE ITS STROKE AND HEART ATTACK PREVENTION (SHAPP) AND DIABETES PROGRAM. THE HOSPITALS CONTRIBUTION TOTALED 45,619. DURING THE FISCAL YEAR, THE COMMUNITY EXPERIENCED DEVASTATING WEATHER AND DURING RECOVERY, THE COMMUNITY PULLED TOGETHER TO ENSURE FAMILIES WERE FED AND HAD PLACES TO GO. THE HOSPITAL RESPONDED TO THE COMMUNITY BY DONATING TIME AND PROVIDING HOT MEALS OR FOOD SUPPLIES. MEMBERS OF OUR TEAM DONATED THEIR TIME TO HELP WITH STAFFING THE MAIN HEADQUARTER SHELTER AND PREPARING MEALS. THE HOSPITAL INCURRED EXPENSES OF 600. THE HOSPITAL SUPPORTS THE LOCAL SYLVESTER/WORTH COUNTY CANCER COALITION AND THE EVENTS THEY OFFER THE COMMUNITY. DURING THE CHRISTMAS SEASON, THE HOSPITAL HOSTED THE COALITION AND COMMUNITY AT A TREE-LIGHTING EVENT WHERE THEY OFFERED SNACKS AND HOT CHOCOLATE. THEY COORDINATED A LOCAL SPEAKER WHO PROVIDED HER TESTIMONIAL OF HER EXPERIENCE WITH CANCER AND HER STORY OF SURVIVAL. THE HOSPITAL HAS ALSO PROVIDED STAFF AND ALL FOOD PRODUCTS AND MEAL PREPARATION FOR THE ANNUAL WORTH COUNTY CANCER SURVIVOR DINNER. THIS EVENT IS INSPIRING FOR THE COMMUNITY AND THE HOSPITAL HOSTED COMMUNITY SURVIVORS UNDER A CHRISTMAS THEMED EVENING EVENT WITH A WONDERFUL MEAL TO HELP CELEBRATE EACH OF THEIR SURVIVOR STORIES. THE HOSPITAL INCURRED EXPENSES OF 600 FOR THE DINNER. THE HOSPITAL ENGAGES WITH THE COMMUNITY IN VARIOUS OTHER WAYS AS WELL. THEY SUPPORT THE COMMUNITY BY PARTICIPATING IN LOCAL EVENTS RANGING FROM THE LOCAL LAW ENFORCEMENT NIGHT OUT AGAINST CRIME TO THE ANNUAL COMMUNITY PEANUT FESTIVAL. THE HOSPITAL ACTS AS CORPORATE SPONSORS TO ENSURE THE COMMUNITY CAN OFFER THESE TYPES OF EVENTS. THE HOSPITAL ALSO PROVIDES STAFFING FOR THE INFORMATIONAL TENTS, WHICH INFORM THE COMMUNITY ABOUT THE SERVICE OFFERINGS AT THE HOSPITAL. THE HOSPITAL PARTICIPATES IN LOCAL CIVIC CLUBS AND SUPPORTS LEADERSHIP IN THEIR ROLES ON THE LOCAL CHAMBER BOARDS AND OTHER COMMUNITY CLUBS. true WORTH COUNTY HEALTH DEPARTMENT 1012 W FRANKLIN STREET SYLVESTER GA 317911978 581568404 GOV 45619 SEE PART IV 1 SCHEDULE I, PAGE 1, PART I, LINE 2 THE WORTH COUNTY HEALTH DEPARTMENT SENDS A LETTER TO PWMC ASKING FOR FINANCIAL ASSISTANCE RELATED TO SPECIFIC PROGRAMS THAT ARE PROVIDED BY THE HEALTH DEPARTMENT. ONCE RECEIVED, PWMC'S BOARD APPROVES THE AMOUNT OF ASSISTANCE TO THE HEALTH DEPARTMENT. THE FUNDS THAT ARE GIVEN TO THE HEALTH DEPARTMENT ARE DEEMED TO BE USED FOR THE SPECIFIC PURPOSES MENTIONED IN THE ORIGINAL LETTER FROM THE HEALTH DEPARTMENT. IN 2017, PWMC WORKED WITH THE HEALTH DEPARTMENT TO ENABLE THEM TO SUPPORT TWO HEALTH PREVENTION TYPE PROGRAMS. ONE PROGRAM WAS STROKE AND HEART ATTACK PREVENTION (SHAPP), THE SECOND PROGRAM WAS A DIABETES PROGRAM. false true false false false false false false false JOEL WERNICK BD MEMBER/PPHS CEO 765840 5976516 365415 17993 7125764 5497409 JOE AUSTIN BD MEMBER/PPHS COO 442064 22732 132200 19755 616751 BRIAN CHURCH PPHS CFO 322892 18325 54150 17177 412544 KIM GILMAN CEO/CNO 198743 417 54334 1270 254764 SCHEDULE J, PAGE 1, PART I, LINE 3 NONE OF THE INDIVIDUAL BOARD MEMBERS OR OFFICERS ARE COMPENSATED BY THE FILING ORGANIZATION. THE FILING ORGANIZATION, INSTEAD, RELIES ON THE METHODS USED BY PPHS, THE SOLE MEMBER, TO ESTABLISH COMPENSATION OF THE CEO AND EXECUTIVE OFFICERS. COMPENSATION DETERMINATION BY PPHS INCLUDES AN INDEPENDENT COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT AND SURVEYS, AND BOARD APPROVAL. THESE METHODS ARE WELL DOCUMENTED. SCHEDULE J, PAGE 1, PART I, LINE 4 JOEL WERNICK 0 360,115 0 JOE AUSTIN 0 126,900 0 BRIAN CHURCH 0 50,400 0 KIM GILMAN 0 51,603 0 SCHEDULE J, PART III SCHEDULE J, PART I, LINE 4 - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS: DEFERRED COMPENSATION PLAN 457(B): THE DEFERRED COMPENSATION PLAN IS AN ADDITIONAL RETIREMENT PLAN OFFERED THROUGH PHOEBE PUTNEY. THE 457(B) PLAN IS AN ELIGIBLE DEFERRED COMPENSATION PLAN THAT ALLOWS ONE TO DEFER ADDITIONAL DOLLARS TOWARDS RETIREMENT. HIGHLIGHTS INCLUDE: O NOT LIMITED BY THE AMOUNTS DEFERRED INTO THE PHOEBE 403(B) O PLAN IS SUBJECT TO ANNUAL DEFERRAL LIMITS SET BY THE IRS O PER IRS REGULATIONS, EACH PARTICIPANT IS A GENERAL UNSECURED CREDITOR OF THE PLAN SPONSOR. SENIOR VICE PRESIDENTS AND ABOVE AND PHYSICIANS MAKING OVER 120,000 ARE ELIGIBLE TO PARTICIPATE IN THE 457(B) PLAN. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) 457(F): PPHS RELIES ON AN INDEPENDENT COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, SURVEYS, WELL DOCUMENTED METHODS AND BOARD APPROVAL TO ESTABLISH TOTAL COMPENSATION OF THE CEO AND EXECUTIVE OFFICERS. CERTAIN BOARD APPROVED EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN A SERP THAT PROVIDES CERTAIN DEFINED ANNUAL PAY CREDITS THAT ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. THE PURPOSE OF THE SERP IS TO PROVIDE A LONG-TERM INCENTIVE AND RETIREMENT BENEFIT FOR AFFECTED EXECUTIVES CONSISTENT WITH THE BENEFIT AVAILABLE TO EMPLOYEES NOT IMPACTED BY IRS COMPENSATION LIMITS ON DEFINED BENEFIT PLANS. THE AMOUNTS REPORTED AS SUPPLEMENTAL EXECUTIVE RETIREMENT COMPENSATION FOR ELIGIBLE EMPLOYEES IN SCHEDULE J REPRESENT CREDITED, BUT NOT VESTED, BENEFITS, AND THE AMOUNTS ARE AVAILABLE IN FUTURE PERIODS TO THE EMPLOYEE SUBJECT TO CONTINUING EMPLOYMENT. PPHS MAINTAINS OWNERSHIP OF THE FUNDS ALLOCATED TO EACH PARTICIPANT UNTIL VESTING AND PAYMENT. FOR A PARTICIPANT IN THE SERP PRIOR TO 1/1/2017 (A "GRANDFATHERED PARTICIPANT"), THE FIRST VESTING DATE WILL OCCUR ON THE DATE THE PARTICIPANT ATTAINS FIVE YEARS OF PARTICIPATION UNDER THE PLAN. AFTER THE INITIAL VESTING DATE, A GRANDFATHERED PARTICIPANT SHALL HAVE A NEW VESTING DATE ONCE EVERY 5 YEARS. THESE ADDITIONAL VESTING DATES WILL OCCUR ON THE 5TH ANNIVERSARY OF EACH VESTING DATE AFTER THE INITIAL VESTING DATE. ON EACH VESTING DATE, A GRANDFATHERED PARTICIPANT WILL BECOME 100% VESTED IN AN AMOUNT EQUAL TO THE PARTICIPANT'S ACCOUNT BALANCE REDUCED BY ANY PAY CREDITS CREDITED TO THE ACCOUNT FOR THE 2 MOST RECENT PLAN YEARS. FOR PARTICIPANTS INITIALLY PARTICIPATING IN THE SERP AFTER 12/31/2016, EACH YEAR'S ANNUAL PAY CREDIT PLUS SUBSEQUENT EARNINGS AND/OR LOSSES WILL 100% VEST ON THAT PAY CREDITS' 5TH ANNIVERSARY, PROVIDED THAT THE PARTICIPANT REMAINS IN THE CONTINUOUS EMPLOYMENT THROUGHOUT THE 5-YEAR PERIOD FOR EACH ANNUAL PAY CREDIT. IF ANY ELIGIBLE PARTICIPANT ATTAINS NORMAL RETIREMENT AGE PRIOR TO THIS SEPARATION FROM SERVICE, THEY SHALL VEST IN 100% OF THE ACCOUNT BALANCE. ONCE VESTED, EACH PARTICIPANT SHALL RECEIVE A DISTRIBUTION OF THEIR ENTIRE VESTED AMOUNT WITHIN A REASONABLE PERIOD NOT TO EXCEED 2.5 MONTHS. THIS DISTRIBUTION IS TREATED AS REPORTABLE COMPENSATION TO THE PARTICIPANT AND IS INCLUDED IN PART II, COLUMN B(III). THEREFORE, PART II, COLUMN B(III) INCLUDES PRIOR YEAR SERP DEFERRALS PREVIOUSLY REPORTED IN PART II, COLUMN C. ANY DISTRIBUTION AMOUNT INCLUDED IN PART II, COLUMN B(III) THAT WAS PREVIOUSLY REPORTED IN PRIOR PERIODS AS DEFERRED COMPENSATION IN PART II, COLUMN C IS DISCLOSED IN PART II, COLUMN F. THE FOLLOWING PARTICIPANT VESTED AND RECEIVED PAYMENT OF SERP BENEFITS IN THE 2016 CALENDAR YEAR. JOEL WERNICK 5,947,873 (MULTI-YEAR VESTED AMOUNT)(NORMAL RETIREMENT AGE) SCHEDULE J, PART II, COLUMN B(II) CERTAIN EXECUTIVE OFFICERS AND PHYSICIANS ARE ELIGIBLE FOR BONUS/INCENTIVE PAYMENTS. THESE BONUSES ARE DETERMINED BASED ON THE ACHIEVEMENT OF VARIOUS ORGANIZATIONAL AND PERSONAL PERFORMANCE GOALS ESTABLISHED BY A FORMAL PROCESS IN KEEPING WITH THE ORGANIZATION'S TAX-EXEMPT STATUS. COMPENSATION PROCESS FOR TOP OFFICIAL AS DETERMINED BY PPHS THE ORGANIZATION'S FORMAL PROCESS FOR DETERMINING TOTAL COMPENSATION FOR THE CEO IS INTENDED TO PROVIDE REASONABLE COMPENSATION FOR ACCOMPLISHING THE ORGANIZATION'S MISSION, ACHIEVE ITS STRATEGIC GOALS, TO RECOGNIZE PERFORMANCE, AND TO OPERATE IN KEEPING WITH THE ORGANIZATION'S OBLIGATIONS AS A TAX-EXEMPT CHARITABLE ORGANIZATION. THE EXECUTIVE COMPENSATION COMMITTEE OF THE PPHS'S BOARD OF DIRECTORS CONDUCTS AN ANNUAL REVIEW OF THE COMPENSATION OF THE CEO. THE COMMITTEE RETAINS A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT TO CONDUCT COMPETITIVE MARKET ANALYSIS OF THE MARKET RANGES OF BASE, INCENTIVE AND TOTAL CASH COMPENSATION. THE INFORMATION THE COMMITTEE MAY CONSIDER CAN INCLUDE BUT IS NOT LIMITED TO THE PERFORMANCE OF AN INDIVIDUAL, THE PERFORMANCE OF THE ORGANIZATION, AN INDIVIDUAL'S LENGTH OF SERVICE, CREDENTIALS AND EXPERIENCE, THE ELEMENTS OF TOTAL COMPENSATION AND SALARY HISTORY, THE ORGANIZATION'S COMPENSATION TARGETS, AND COMPARABILITY DATA, INCLUDING THE DATA PREPARED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE COMMITTEE. THE COMMITTEE INCORPORATES A FORMAL PERFORMANCE APPRAISAL PROCESS IN THE CEO COMPENSATION REVIEW. IT UTILIZES A MULTI-PERSPECTIVE APPROACH AND PERFORMANCE MEASURES WHICH ARE LINKED TO THE ORGANIZATION'S LONG-TERM STRATEGIC PLAN AND ACHIEVEMENT OF ANNUAL SYSTEM OBJECTIVES. THE CEO IS NOT PRESENT WHEN THE COMMITTEE DISCUSSES AND ESTABLISHES HIS COMPENSATION. FORM 990, PAGE 6, PART VI, LINE 6 THE SOLE MEMBER OF PHOEBE WORTH MEDICAL CENTER, INC. SHALL BE PHOEBE PUTNEY HEALTH SYSTEM, INC. (PPHS). FORM 990, PAGE 6, PART VI, LINE 7A THE BOARD OF DIRECTORS OF PPHS, THE SOLE MEMBER, SHALL APPOINT ALL DIRECTORS OF THE FILING ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 7B THE SOLE MEMBER, PPHS, SHALL HAVE THE FOLLOWING RESPONSIBILITIES: - THE MEMBER SHALL APPOINT OR REMOVE THE ORGANIZATION'S DIRECTORS. - THE MEMBER SHALL SELECT OR REMOVE THE ORGANIZATION'S OFFICERS. - THE MEMBER SHALL APPROVE ALL AMENDMENTS TO THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS BEFORE THEY MAY BECOME EFFECTIVE. - THE MEMBER SHALL APPROVE ANY ANNUAL OPERATING OR CAPITAL BUDGETS. - THE MEMBER SHALL APPOINT OR REMOVE THE INDEPENDENT AUDITORS. FORM 990, PAGE 6, PART VI, LINE 11B THE INDEPENDENT ACCOUNTING FIRM THAT PREPARES THE FORM 990 (BASED UPON INFORMATION PROVIDED BY THE ORGANIZATION) PROVIDES A COMPLETE COPY OF THE RETURN WITH APPLICABLE SCHEDULES TO BE REVIEWED BY MANAGEMENT. MANAGEMENT PERFORMS A DETAILED REVIEW WHICH CONSISTS OF REVIEWING THE FINANCIAL DATA, THE NARRATIVES DISCLOSED, AND OTHER FACTS PRESENTED ON THE RETURN. UPON REVIEW, THE FORM 990 IS THEN FORWARDED TO THE FINANCE COMMITTEE FOR THEIR REVIEW, TO GAIN THEIR COMMENTS AND APPROVAL. UPON APPROVAL FROM THE FINANCE COMMITTEE, THE FORM 990 AND RELATED SCHEDULES ARE PROVIDED TO ALL BOARD MEMBERS FOR REVIEW AND FEEDBACK. ONCE THE FORM 990 IS REVIEWED BY ALL APPLICABLE PARTIES, A COPY OF THE FINAL VERSION IS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PAGE 6, PART VI, LINE 12C ON AN ANNUAL BASIS, PHOEBE WORTH MEDICAL CENTER, INC. (PWMC) BOARD MEMBERS AS WELL AS ALL OFFICERS COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. THIS QUESTIONNAIRE IS ADMINISTERED BY THE PHOEBE PUTNEY HEALTH SYSTEM (PPHS) COMPLIANCE DEPARTMENT AND THE DOCUMENT ASKS EACH INDIVIDUAL TO DISCLOSE ANY PERSONAL, BUSINESS, OR OTHER AFFILIATIONS AND MONETARY AMOUNT IF APPLICABLE THAT THEY OR THEIR IMMEDIATE FAMILY MEMBERS HAVE HAD WITHIN THE PAST 12 MONTHS WITH PWMC OR ANY RELATED ENTITIES. ALL RESPONSES ARE THEN EVALUATED BY THE PPHS COMPLIANCE DEPARTMENT. IN THE CASE OF AN EXISTING CONFLICT, THE INDIVIDUAL WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL TO SUCH TRANSACTIONS. FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION MAKES AVAILABLE TO THE PUBLIC ITS CONFLICT OF INTEREST AND AUDITED FINANCIAL STATEMENTS ON THE ORGANIZATION'S WEBSITE, BY PROVIDING COPIES UPON REQUEST, AND BY INSPECTION AT THE ADMINISTRATIVE OFFICES OF THE ORGANIZATION. FORM 990, PART IX, LINE 11G PHYSICIAN FEES 3,307,408 0 0 COLLECTION SERVICES 0 104,514 0 CONSULTANT FEES 428,247 0 0 CONTRACT SERVICES 61,508 801,487 0 CONTRACT STAFFING 219,037 0 0 TOTAL 4,016,200 906,001 0 PHOEBE PUTNEY HEALTH SYSTEM INC PO BOX 3770 ALBANY GA 317063770 582001014 HEALTHCARE GA 501C3 12C NA false PHOEBE PUTNEY MEMORIAL HOSPITAL INC PO BOX 3770 ALBANY GA 317063770 581928247 HEALTHCARE GA 501C3 3 PPHS false PHOEBE PHYSICIAN GROUP INC PO BOX 3770 ALBANY GA 317063770 263792403 HEALTHCARE GA 501C3 10 PPHS false PHOEBE SUMTER MEDICAL CENTER INC 126 HIGHWAY 280 WEST AMERICUS GA 317198645 263975185 HEALTHCARE GA 501C3 3 PPHS false PHOEBE FOUNDATION INC PO BOX 3770 ALBANY GA 317063770 581847104 FOUNDATION GA 501C3 12A PPHS false SOUTH GEORGIA SHARED SERVICES INC 417 WEST THIRD AVENUE ALBANY GA 317011943 462746977 COOPERATIV GA 501C3 3 PPHS false PHOEBE DORMINY MEDICAL CENTER INC PO BOX 3770 ALBANY GA 317063770 452041878 HEALTHCARE GA 501C3 3 PPHS false PHOEBE PUTNEY HEALTH VENTURES INC PO BOX 3770 ALBANY GA 317063770 581963401 HEALTHCARE GA N/A false false false false false true false false false false false false false true false true false true false false