2018-05-15T19:25:44-05:00 2017-06-30 KPMG LLP 300 North Greene Street Suite 400 Greensboro NC 27401 990 2016-07-01 582155150 Piedmont Newton Hospital Inc % MARIE GAFFNEY PIED 7707867053 5126 Hospital Drive NE Covington GA 300142566 MARIE GAFFNEY VP CORPORATE FINANCE 4702716007 2018-05-15 SHAWN M HUTCHINSON P01048557 3362753394 2018-05-15 2016 2022-09-23 18:48:47Z JAMES WEADICK 5126 Hospital Drive NE Covington GA 300142566 97729816 false X www.piedmont.org X 1995 GA TO PROVIDE COMPASSIONATE AND SUSTAINABLE HEALTHCARE IN A PROGRESSIVE ENVIRONMENT. SEE PART III. 10 7 923 230 0 36231 34166 39913235 95160737 13875087 85870 1068504 2152113 54893057 97432886 0 0 0 0 21305478 46402079 0 0 0 24824402 67300438 46129880 113702517 8763177 -16269631 46754574 40882766 27233431 23367341 19521143 17515425 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 97355207 0 96452266 PIEDMONT NEWTON HOSPITAL ("PNtH") IS A 97-BED, NON-PROFIT HOSPITAL LOCATED IN THE CITY OF COVINGTON IN NEWTON COUNTY, GEORGIA. OVER 250 PRIMARY CARE AND SPECIALTY PHYSICIANS COMPRISE THE MEDICAL STAFF AND MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SNIORS WITHIN NEWTON COUNTY AND THE GREATER METROPOLITAN ATLANTA MARKET, REGARDLESS OF NAY INDIVIDUAL'S ABILITY TO PAY FOR SERVICES. FOR THE YEAR ENDED JUNE 30, 2017, THE HOSPITAL HAD 5,417 IN-PATIENT ADMISSIONS WITH A TOTAL OF 17,983 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 40,218 AND OUTPATIENT VISITS TOTALED 38,474. SURGICAL SERVICES WERE PROVIDED TO 3,855 PATIENTS. 97355207 true 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 true false false false false false false false false false false false false false false false true false false false true X 0 0 true 923 true false false false false false false false false false false X 10 7 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 GREGORY HURST CHAIRMAN 1.0 54.0 X X 0 1916833 25593 DR LEIGH HAMBY BOARD MEMBER 1.0 54.0 X 0 933786 145597 JAMES WEADICK PRESIDENT & CEO 55.0 0.0 X X 660548 0 25006 DR CARTER ROGERS BOARD MEMBER/PHYSICIAN 1.0 0.0 X 0 0 0 DR STEVE MCINTOSH BOARD MEMBER 1.0 0.0 X 0 0 0 DR BRAD JACOBY BOARD MEMBER 1.0 0.0 X 0 0 0 WILLIAM D FORTSON JR BOARD MEMBER 1.0 0.0 X 0 0 0 ESTHER WILLIAMS BOARD MEMBER 1.0 0.0 X 0 0 0 GEORGE HART BOARD MEMBER 1.0 0.0 X 0 0 0 SAMUEL HAY III BOARD MEMBER 1.0 0.0 X 0 0 0 JAY MITCHELL SECRETARY thru 10/14/16 1.0 54.0 X 0 980956 31321 MICHAEL MCANDER sec: 10/14/16-2/27/17 & Treas 1.0 54.0 X 0 969938 113846 Elizabeth Leddy Secretary from 2/27/17 1.0 54.0 X 0 0 0 TROY BROOKS CFO 55.0 0.0 X 298301 0 28822 William Little CMO 55.0 0.0 X 297680 0 11142 Patricia Waller CNO thru 05/13/17 55.0 0.0 X 219538 0 23885 Greg Richardson HR DIRECTOR 55.0 0.0 X 77537 91143 34582 William Love Exec Director Patient Services 55.0 0.0 X 177779 0 10468 Robert Halliday Director of Pharmacy 55.0 0.0 X 159042 0 17511 Bradley Collier Director of Finance 55.0 0.0 X 143680 0 22746 Steven Spillers Pharmacy Operations Manager 55.0 0.0 X 138048 0 15338 Theodore Hsu Pharmacist 55.0 0.0 X 131458 0 15131 2303611 4892656 520988 23 false true false MEDICAL SOLUTIONS LLC 1010 NORTH 102ND STREET SUITE 300 OMAHA NE 68114 NURSING SERVICES 2250169 MILSTEAD PATHOLOGY PC 3248 AVALON BLVD CONYERS GA 30013 LAB SERVICES 740000 RIVERDALE ANESTHESIA ASSOCIATES PC PO BOX 961270 RIVERDALE GA 30296 ANESTHESIOLOGY 474196 CLARUS LINEN SYSTEMS 7990 SECOND FLAGS DRIVE SUITE A AUSTELL GA 30168 LAUNDRY SERVICES 346462 ALLIED UNIVERSAL SECURITY SERVICES 1551 N TUSTIN AVENUE SANTA ANA CA 92705 SECURITY SERVICES 173806 10 11290 22876 34166 PATIENT SERVICE REVENUE 622110 95073916 95073916 OTHER OPERATING REVENUE 900099 86821 86821 95160737 84190 84190 0 0 608885 189108 419777 0 419777 419777 12768 11088 1680 1680 1680 0 0 0 0 0 0 180919 96734 84185 84185 CAFETERIA SALES 722310 356622 356622 FEE REVENUE 900099 50509 50509 COUNTY TAX REVENUE 900099 1241020 1241020 1648151 97432886 96452266 946454 0 0 0 0 1156570 277944 878626 0 37800074 33817759 3982315 0 5103895 4456364 647531 2341540 2010915 330625 0 67249 67228 21 180861 180861 0 0 0 9324661 7584632 1740029 413493 32961 380532 5944454 4505802 1438652 2033486 1541382 492104 0 1544783 1433618 111165 40100 25048 15052 0 0 499450 499450 3795635 3795635 1594081 1481955 112126 1211183 906338 304845 BAD DEBT EXPENSE 23599575 23599575 DRUGS & MEDICAL SUPPLIES 12631851 12631851 HOSPITAL TAX 966988 966988 MISC 3452588 2014847 1437741 113702517 97355207 16347310 0 5491267 1164346 0 0 610 0 10365205 10063459 0 0 0 0 0 0 2428312 2707435 710255 553680 26660948 2401608 22173677 24259340 0 0 0 0 3132700 0 0 0 2452548 2134506 46754574 40882766 10857735 6614658 0 0 0 0 16036502 14341502 0 0 0 0 0 0 0 0 339194 2411181 27233431 23367341 X 19520533 19167188 610 -1651763 0 0 19521143 17515425 46754574 40882766 X -16269631 19618 14244295 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1270100 1270100 17335502 1196450 16139052 692128 115088 577040 6421187 1090070 5331117 942031 0 942031 24259340 OTHER ASSETS 2134506 2134506 0 OTHER LIABILITIES 230446 MEDICARE PAYABLE 2180735 2411181 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 TAX EXPOSURE ITEMS. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AT JUNE 30, 2017 AND 2016. true true X true X true X true true false true true 4409821 0 4409821 0.04890 3591526 3852531 0 1118044 491055 626989 0.00700 9119391 4343586 5036810 0.05590 37228 0 37228 0.00040 944282 0 944282 0.01050 5548 0 5548 0.00010 987058 0 987058 0.01100 10106449 4343586 6023868 0.06690 true 23599575 707987 13507296 12040084 1467212 X true true 1 1 PIEDMONT NEWTON HOSPITAL INC 5126 HOSPITAL DRIVE NE COVINGTON GA 300142566 WWW.PIEDMONT.ORG X X X PHYSICIAN CLINICS PIEDMONT NEWTON HOSPITAL INC 1 false true true X X X X X X X X 16 true true false true X WWW.PIEDMONT.ORG X X true 17 true WWW.PIEDMONT.ORG false true X 200. 300. X X true true X X X X true X WWW.PIEDMONT.ORG X WWW.PIEDMONT.ORG X WWW.PIEDMONT.ORG X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, LINE 5: COMMUNITY REPRESENTATION PIEDMONT NEWTON HOSPITAL'S ("PNtH") ORIGINAL CHNA WAS CONDUCTED DURING THE HOSPITAL'S FISCAL YEAR 2013. IN ADDITION, ONE-HOUR COMMUNITY STAKEHOLDER INTERVIEWS WERE CONDUCTED. A TOTAL OF 20 STAKEHOLDER INTERVIEWS WERE INCLUDED IN THE ASSESSMENT PROCESS. PARTICIPANTS WERE GIVEN AN OUTLINE OF HEALTH NEEDS TOPICS BUT ALSO ENCOURAGED TO IDENTIFY OTHER NEEDS WHICH MAY NOT APPEAR ON THE LIST FOR DISCUSSION. TOPICS INCLUDED: DEMOGRAPHICS, HEALTH STATUS, CHRONIC DISEASES, HEALTH BEHAVIORS, AND ACCESS TO CARE AMONG OTHERS. PARTICIPANTS IN THE HEALTH INPUT MEETINGS WERE REPRESENTATIVE OF A CROSS-SECTION OF PROVIDERS AND PUBLIC INTEREST INDIVIDUALS, SUCH AS: HOSPITAL PERSONNEL FROM EDUCATION, EMERGENCY DEPARTMENT, DIETITIAN; SCHOOL SYSTEM PERSONNEL TEACHERS, SUPERINTENDENT, MENTAL HEALTH CLINICIAN; MENTAL HEALTH PERSONNEL - DIRECTOR OF BUSINESS DEVELOPMENT; COUNTY COMMISSION COMMISSIONER WHO IS ALSO A RN BY TRAINING; PHYSICIANS HOSPITALISTS, FAMILY PRACTICE. OTHER SPECIALTY SERVICES SUCH AS DFACS, REFUGE PREGNANCY CENTER, FAITHWORKS, SENIOR SERVICES CENTER, AND THE CHAMBER OF COMMERCE WERE ALSO REPRESENTED IN THE PANEL OF PARTICIPANTS. PIEDMONT NEWTON HOSPITAL CONDUCTED ITS SECOND CHNA DURING FISCAL YEAR 2016. STAKEHOLDERS WERE CONTINUALLY ENGAGED DURING BOTH ASSESSMENTS, WITH A PARTICULAR FOCUS ON THOSE GROUPS, ORGANIZATIONS, AND INDIVIDUALS REPRESENTING THE MOST VULNERABLE MEMBERS OF THE HOSPITALS COMMUNITY. SPECIFICALLY, PIEDMONT NEWTON HOSPITAL INTERVIEWED REPRESENTATIVES OF LOCAL AND REGIONAL PUBLIC HEALTH ENTITIES, MINORITY POPULATIONS, THE FAITH-BASED COMMUNITIES, LOCAL BUSINESS OWNERS, THE PHILANTHROPIC COMMUNITY, MENTAL HEALTH AGENCIES, ELECTED OFFICIALS, AND OTHER RELEVANT COMMUNITY STAKEHOLDERS. ADDITIONALLY, THE HOSPITAL CONDUCTED FOCUS GROUPS MADE UP OF LOW-INCOME AND UNINSURED PATIENTS, AS WELL AS CONSUMER AND PATIENT ADVOCATES REPRESENTING A VARIETY OF VULNERABLE PATIENTS. ALL INTERVIEWS, FOCUS GROUPS AND MEETINGS INFORMED THE CHNA PROCESSES, INCLUDING THE IDENTIFICATION OF KEY HEALTH PRIORITIES AND DEVELOPMENT OF IMPLEMENTATION PLAN STRATEGIES. SCHEDULE H, PART V, LINE 6A: HOSPITALS INCLUDED IN CURRENT CHNA PROCESS DURING FY16, THE PIEDMONT HEALTHCARE SYSTEM CONDUCTED THE SECOND CHNA FOR SIX OF ITS TAX-EXEMPT HOSPITALS. EACH INDIVIDUAL HOSPITALS COMMUNITY WAS ASSESSED AND PRIORITY NEEDS WERE IDENTIFIED BASED ON THE SIX COMMUNITIES DISCREET CHARACTERISTICS. THE RESULTS OF THE ASSESSMENTS WERE COMPILED AND PUBLISHED IN A SINGLE CHNA REPORT. THE HOSPITALS INCLUDED IN THE PROCESS WERE PIEDMONT HOSPITAL (EIN: 58-1503902); PIEDMONT FAYETTE HOSPITAL (EIN: 58-2322328); PIEDMONT HENRY HOSPITAL (EIN: 58-2200195); PIEDMONT MOUNTAINSIDE HOSPITAL (EIN: 35-2228583); PIEDMONT NEWNAN HOSPITAL (EIN: 20-5077249); AND PIEDMONT NEWTON HOSPITAL (EIN: 58-2155150). SCHEDULE H, PART V, LINE 7D: PUBLIC AVAILABILITY OF CHNA IN ADDITION TO MAKING ITS CHNA AVAILABLE ON ITS WEBSITE AND BY REQUEST, PIEDMONT NEWTON 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 11: ADDRESSING COMMUNITY HEALTH NEEDS IN 2013 PNtH PARTNERED WITH THE NEWTON COUNTY COMMUNITY PARTNERSHIP (NCCP) AND HEALTHY NEWTON TO CHANGE THE APPROACH FROM A MULTIPLE AND A PARALLEL EFFORT TO A COORDINATED AN COLLABORATIVE PROCESS WITH A UNITED GOAL OF FULLY IMPLEMENTING THE NEWTON COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN. THE PLAN WAS FINALIZED FEBRUARY 2014 AND IS POSTED ON THE GWINNETT, NEWTON, ROCKDALE HEALTH DEPARTMENT SITE (WWW.GNRHEALTH.COM) AND ON THE NCCP SITE (WWW.NEWTONPARTNERSHIP.ORG). THE CORE LEADERSHIP TEAM WAS IDENTIFIED IN FEBRUARY, 2014, TO COORDINATE THE IMPLEMENTATION OF WORKABLE INITIATIVES AND ACTIVITIES. THE TEAM MEETS MONTHLY ON THE 2ND TUESDAY OF EACH MONTH. THE CORE LEADERSHIP TEAM CONSISTS OF : NCCP, GNR HEALTH DEPARTMENT, NMC, NEWTON COUTNY SCHOOLS, VIEW POINT HEALTH (MENTAL HEALTH) AND HEARTS FOR FAMILIES. TEAM IDENTIFIED 5 PRIORITY TOPICS FROM TOP 9 IDENTIFIED IN NMC COMMUNITY ASSESSMENT: 1. ACCESS TO CARE (NMC LEAD) 2. ACCESS TO MENTAL HEALTH SERVICES (VPH LEAD) 3. OBESITY & DIABETES WITH A FOCUS ON HEALTHY BODY WEIGHT FOR CHILDREN (NCCP AND PUBLIC HEALTH LEAD) 4. TOBACCO USE PREVENTION (PUBLIC HEALTH AND NCCP) 5. TEEN LIFESTYLE ISSUES (NCCP LEAD) DURING FY16, PIEDMONT NEWTON HOSPITAL CONDUCTED ITS SECOND CHNA, BY ASSESSING PUBLICLY AVAILABLE DATA, INTERVIEWING COMMUNITY MEMBERS AND STAKEHOLDERS, CONDUCTING FOCUS GROUPS OF VULNERABLE POPULATIONS, INTERVIEWING PIEDMONT BOARD MEMBERS, AND SURVEYING PIEDMONT EMPLOYEES. THROUGH THIS PROCESS, PIEDMONT NEWTON HOSPITAL DETERMINED AND PRIORITIZED THE COMMUNITY HEALTH NEEDS IT WOULD ADDRESS BASED ON THE NUMBER OF PERSONS AFFECTED, THE SERIOUSNESS OF THE ISSUE, WHETHER THE HEALTH NEED AFFECTED VULNERABLE POPULATIONS, AND THE AVAILABILITY OF COMMUNITY AND HOSPITAL RESOURCES NECESSARY TO ADDRESS THE ISSUE. BASED ON THE CHNA, PIEDMONT NEWTON HOSPITAL IS CURRENTLY FOCUSING ON: (1) MAINTAINING AND INCREASING ACCESS TO AFFORDABLE CARE FOR LOW- AND NO-INCOME PATIENTS, INCLUDING INCREASED EFFORTS AT ELIMINATING HEALTH DISPARITIES; (2) INCREASING ACCESS TO AND AWARENESS OF CANCER-RELATED PROGRAMMING, INCLUDING LOW-COST MAMMOGRAMS, TO QUALIFYING WOMEN THROUGH PARTNERSHIP PROGRAMS; (3) REDUCING PREVENTABLE READMISSIONS AND EMERGENCY DEPARTMENT RE-ENCOUNTERS, PARTICULARLY AMONG HIGH-RISK PATIENTS, WITH A FOCUS ON CHRONIC DISEASE MANAGEMENT; (4) MAINTAINING AND GROWING EFFORTS AROUND SENIOR HEALTH; AND (5) REDUCING PREVENTABLE INSTANCES OF HEART DISEASE, HYPERTENSION, AND STROKE THROUGH EDUCATIONAL AWARENESS AND PROMOTION OF HEALTHY BEHAVIORS, INCLUDING EFFORTS TO REDUCE TOBACCO USE. PIEDMONT NEWTON HOSPITAL DEVELOPED THE IMPLEMENTATION STRATEGY TO ADDRESS THESE PRIORITY NEEDS DURING FY17. 1 NEWTON MEDICAL CENTER HOME HEALTH 5126 HOSPITAL DRIVE COVINGTON GA 30209 HOME HEALTH AGENCY SCHEDULE H, PART VI, LINE 1: REQUIRED DESCRIPTIONS PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6A A REPORT ON PIEDMONT NEWTON HOSPITAL, INC.'S ("PNTH") COMMUNITY BENEFITS IS FOUND WITHIN PIEDMONT HEALTHCARE, INC.S (PIEDMONT NEWTON HOSPITAL'S SOLE MEMBER) ANNUAL REPORT, WHICH IS WIDELY DISTRIBUTED TO THE PUBLIC BOTH THROUGH PRINTED COPIES MADE AVAILABLE TO COMMUNITY MEMBERS UPON REQUEST AND THROUGH PUBLICATION ON THE PIEDMONT HEALTHCARE WEBSITE. ADDITIONALLY, THE REPORT WAS MAILED TO PNtH AND PIEDMONT HEALTHCARE BOARD MEMBERS, STATE AND LOCAL ELECTED OFFICIALS, AND OTHER KEY STAKEHOLDERS. 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 $113,702,516, LESS BAD DEBT EXPENSE OF $23,599,575 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 BASED ON PRIOR EXPERIENCE AND CERTAIN DEMOGRAPHICS AND OTHER INFORMATION OBTAINED DURING ADMISSION, THE ORGANIZATION BELIEVES A PORTION OF THE BAD DEBT EXPENSES AT COST IS ATTRIBUTABLE TO PATIENTS THAT WOULD OTHERWISE QUALIFY FOR CHARITY CARE. DESPITE ITS BEST EFFORTS TO EDUCATE PATIENTS ABOUT QUALIFYING FOR ITS CHARITY CARE PROGRAM (AS DISCUSSED IN PART IV, QUESTION 3 BELOW), MANY UNINSURED PATIENTS DO NOT COMPLETE A CHARITY CARE APPLICATION OR PROVIDE SUFFICIENT INFORMATION AT THE TIME OF ADMISSION, DURING THEIR STAY, OR AFTER BEING DISCHARGED TO QUALIFY FOR ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. 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 ORGANIZATIONS 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 MANAGEMENTS 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 PAYER CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. PHCS PRESENTATION OF THE PROVISION FOR BAD DEBT AT THE REPORTING ENTITY LEVEL IS BASED ON AN ENTITY-WIDE ASSESSMENT OF SIGNIFICANCE. PNtH 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. 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 DURING FISCAL YEAR 2016, PIEDMONT NEWTON HOSPITAL CONDUCTED AND RATIFIED ITS SECOND FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT. THE ASSESSMENT BEGAN WITH A REVIEW OF PUBLICLY AVAILABLE HEALTH AND SOCIOECONOMIC DATA THAT WAS THEN COMPILED AND ANALYZED IN COOPERATION WITH GEORGIA STATE UNIVERSITYS GEORGIA HEALTH POLICY CENTER (GHPC). DATA WAS GATHERED FOR THE ENTIRE PIEDMONT HEALTHCARE SERVICE REGION, WHICH WAS DETERMINED TO COVER APPROXIMATELY 20 COUNTIES. THE OVERALL HEALTH NEEDS ASSESSMENT EFFORT WAS LED BY THE PIEDMONT HEALTHCARE COMMUNITY BENEFITS TEAM WITH ASSISTANCE PROVIDED THROUGHOUT BY THE GHPC. STAKEHOLDERS WERE CONTINUALLY ENGAGED DURING THIS PROCESS, WITH A PARTICULAR FOCUS ON THOSE GROUPS, ORGANIZATIONS, AND INDIVIDUALS REPRESENTING THE MOST VULNERABLE MEMBERS OF THE HOSPITALS COMMUNITY. SPECIFICALLY, PIEDMONT FAYETTE HOSPITAL INTERVIEWED REPRESENTATIVES OF LOCAL AND REGIONAL PUBLIC HEALTH ENTITIES, MINORITY POPULATIONS, THE FAITH-BASED COMMUNITIES, LOCAL BUSINESS OWNERS, THE PHILANTHROPIC COMMUNITY, MENTAL HEALTH AGENCIES, ELECTED OFFICIALS, AND OTHER RELEVANT COMMUNITY STAKEHOLDERS. FURTHER, THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS AND EXECUTIVE LEADERSHIP FROM EACH OF THE HOSPITALS IN THE PIEDMONT HEALTHCARE SYSTEM WERE ACTIVELY INFORMED AND ENGAGED THROUGHOUT THE ASSESSMENT. PIEDMONT NEWTON HOSPITAL ALSO CONDUCTED TWO FOCUS GROUPS MADE UP OF LOW-INCOME AND UNINSURED PATIENTS. THESE FOCUS GROUPS PROVIDED THE HOSPITAL WITH INPUT ON THE EFFECTIVENESS OF ITS COMMUNITY BENEFIT EFFORTS TO DATE AND SUGGESTED FOCUS AREAS AND OPPORTUNITIES FOR IMPROVEMENT. IN ADDITION, AN INTERNAL SURVEY WAS CONDUCTED THROUGHOUT THE HEALTHCARE SYSTEM FOR BOTH CLINICAL AND NON-CLINICAL EMPLOYEES. INFORMATION WAS GATHERED ON THE EMPLOYEES KNOWLEDGE AND UNDERSTANDING OF COMMUNITY BENEFIT AND PIEDMONT HEALTHCARES CURRENT PROGRAMS, AS WELL AS SUGGESTIONS FOR HOW THE SYSTEM CAN BETTER SERVE ITS PATIENTS AND COMMUNITIES. APPROXIMATELY 775 EMPLOYEES FROM ACROSS THE PIEDMONT HEALTHCARE SYSTEM RESPONDED TO THE SURVEY. THE PIEDMONT NEWTON HOSPITAL BOARD OF DIRECTORS APPROVED ITS CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT IN JUNE, 2016. A FORMAL IMPLEMENTATION STRATEGY WAS COMPLETED FOR EACH PIEDMONT HEALTHCARE HOSPITAL FACILITY, INCLUDING PIEDMONT NEWTON HOSPITAL, DURING FY17. THE IMPLEMENTATION POLICY WAS DEVELOPED IN PARTNERSHIP WITH HOSPITAL LEADERSHIP AND COMMUNITY STAKEHOLDERS TO ADDRESS THE IDENTIFIED PRIORITIES LISTED IN THE 2016 CHNA. THE IMPLEMENTATION STRATEGY WILL BE EXECUTED OVER THE NEXT THREE FISCAL YEARS. IT UTILIZES COMMUNITY FEEDBACK FROM THE CHNA AND THE ASSISTANCE OF THE PIEDMONT HEALTHCARE SYSTEMS COMMUNITY BENEFITS DEPARTMENT, PIEDMONT NEWTON HOSPITAL EXECUTIVE LEADERSHIP, AND THE ORGANIZATIONS BOARD OF DIRECTORS. PRIORITIES ADDRESSED IN THE IMPLEMENTATION STRATEGY INCLUDE INCREASING ACCESS TO HEALTHCARE SERVICES FOR LOW- AND NO-INCOME PATIENTS; REDUCING PREVENTABLE RE-ADMISSIONS AND EMERGENCY DEPARTMENT RE-ENCOUNTERS; INCREASING ACCESS TO AND AWARENESS OF BREAST CANCER PROGRAMMING; REDUCING PREVENTABLE INSTANCES OF HEART DISEASE, STROKE, OBESITY AND OBESITY-RELATED DISEASES; AND GROWING EFFORTS AROUND SENIOR HEALTH. PRIORITIES WERE CHOSEN BASED ON THE NUMBER OF PERSONS AFFECTED, THE SERIOUSNESS OF THE ISSUE, WHETHER THE HEALTH NEED AFFECTED VULNERABLE POPULATIONS, AND AVAILABILITY OF COMMUNITY AND HOSPITAL RESOURCES TO ADDRESS THE NEED. THE PIEDMONT NEWTON HOSPITAL BOARD OF DIRECTORS APPROVED THE IMPLEMENTATION STRATEGY TO ADDRESS IDENTIFIED HEALTH ISSUES ON SEPTEMBER 23, 2016. SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ASSISTANCE ELIGIBILITY PIEDMONT HEALTHCARE UNDERSTANDS THAT NOT EVERYONE WILL HAVE THE ABILITY TO PAY THEIR HOSPITAL BILL DUE TO THEIR INSURANCE STATUS OR A LIMITED INCOME, AND BECAUSE OF THIS, PIEDMONT NEWTON HOSPITAL OFFERS FINANCIAL ASSISTANCE TO QUALIFYING PATIENTS. INFORMATION ABOUT AND CONTACT NUMBERS FOR FINANCIAL ASSISTANCE ARE PROVIDED IN NOTICES INSERTED IN PATIENT BILLS AND POSTED IN EMERGENCY ROOMS, IN THE CONDITIONS OF ADMISSION FORM, AT ADMITTING AND REGISTRATION DEPARTMENTS, AT HOSPITAL BUSINESS OFFICES, AT PATIENT FINANCIAL SERVICES OFFICES THAT ARE LOCATED ON FACILITY CAMPUSES, AND AT OTHER PUBLIC PLACES THE HOSPITAL MAY ELECT, INCLUDING LOCAL LOW-COST CLINICS PRIMARILY TREATING UNINSURED POPULATIONS. PIEDMONT NEWTON HOSPITAL ALSO PUBLISHES AND WIDELY PUBLICIZES A SUMMARY OF THIS FINANCIAL ASSISTANCE CARE POLICY ON ITS FACILITY WEBSITE, WHICH INCLUDES A LINK TO THE FULL POLICY AND APPLICATION. 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. IN FY16, PIEDMONT HEALTHCARE WORKED TO IMPROVE ITS EXISTING FINANCIAL ASSISTANCE POLICY TO COVER MORE OF ITS PATIENT POPULATION AND IMPLEMENTED THE NEW POLICY DURING FY17. SCHEDULE H, PART VI, LINE 4: COMMUNITY INFORMATION PIEDMONT NEWTON HOSPITAL IS LOCATED IN COVINGTON, GEORGIA. IN 2017, OVER 105,473 PEOPLE LIVED IN NEWTON COUNTY. ABOUT ONE IN FIVE ADULTS IN NEWTON COUNTY IS UNINSURED AND EIGHT PERCENT OF CHILDREN ARE UNINSURED. MORE THAN 69 PERCENT OF THE CHILDREN IN NEWTON COUNTY QUALIFY FOR FREE LUNCH. UNEMPLOYMENT IN THE COUNTY IS AT 6.6 PERCENT, WHICH IS SLIGHTLY HIGHER THAN GEORGIAS PERCENTAGE OF 5.9. IN 2017, APPROXIMATELY 81 PERCENT OF THE COUNTYS HIGH SCHOOL STUDENTS ARE ON TRACK TO GRADUATE WITHIN FOUR YEARS. THERE IS ONE PRIMARY CARE PHYSICIAN IN NEWTON COUNTY FOR EVERY 2,880 RESIDENTS OF THE COUNTY, COMPARED TO ONE PRIMARY CARE PHYSICIAN FOR EVERY 1,530 RESIDENTS OF THE STATE. APPROXIMATELY 18 PERCENT OF ADULTS REPORTED THEY WERE IN POOR OR FAIR HEALTH, A FIGURE IN LINE WITH THE GEORGIA AVERAGE OF 17 PERCENT. MORE THAN 10 PERCENT OF ADULT RESIDENTS OF NEWTON COUNTY HAVE BEEN DIAGNOSED WITH DIABETES. IN 2017, NEARLY ONE IN THREE ADULT COUNTY RESIDENTS ARE NOTABLY PHYSICALLY INACTIVE, AND MORE THAN ONE IN THREE ARE CONSIDERED OBESE. SCHEDULE H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH PIEDMONT NEWTON HOSPITAL ACTIVELY PROMOTES THE HEALTH OF ITS COMMUNITY THROUGH COMMUNITY-BASED HEALTH SCREENINGS; EDUCATIONAL 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 COMPRISED 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 FISCAL YEAR 2017, PIEDMONT NEWTON HOSPITAL OFFERED VARIOUS PROACTIVE COMMUNITY BENEFIT PROGRAMS. SOME OF THESE PROGRAMS INCLUDED: LAUNCHING THE PIEDMONT COMMUNITY BENEFIT GRANTS PROGRAM WHICH OFFERS GRANT OPPORTUNITIES TO LOCAL NONPROFIT ORGANIZATIONS THAT PROVIDE SPECIFIC TO HEALTH-RELATED SERVICES AND PROGRAMS THAT ADDRESS THE UNMET HEALTH NEEDS IDENTIFIED IN THE HOSPITALS 2016 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY; PROVIDING SERVICES THROUGH THE WOMENS DIAGNOSTIC CENTER, INCLUDING NAVIGATION SERVICES, SUPPORT GROUPS, THE HOPE BOUTIQUE, EDUCATIONAL PROGRAMMING, AND BREAST CANCER AWARENESS AND PREVENTION EVENTS; AND COMPOSING A LOW-INCOME COMMUNITY RESOURCE GUIDE TO BE DISTRIBUTED IN BOTH ENGLISH AND SPANISH TO HOSPITALS, PATIENTS, AND THROUGHOUT THE COMMUNITY. SCHEDULE H, PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM THE ORGANIZATION IS PART OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM") SERVING THE HEALTHCARE NEEDS OF NORTH GEORGIA AND SPECIFICALLY, THE METROPOLITAN ATLANTA AREA. THE SYSTEM EXISTS TO PROVIDE PROGRESSIVE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE TO ALL MEMBERS OF ITS COMMUNITY. COMMUNITY BENEFITS ARE GENERATED THROUGH THE PROVISION OF CHARITY CARE, GOVERNMENT-SPONSORED PROGRAMS (SUCH AS MEDICAID AND MEDICARE), MEDICAL RESEARCH, MEDICAL EDUCATION, COMMUNITY HEALTH IMPROVEMENT SERVICES, DONATIONS TO OTHER NONPROFIT HEALTH CARE PROVIDERS, AND MANY OTHER COMMUNITY SERVICE ACTIVITIES. IN FISCAL YEAR 2017, THE PIEDMONT HEALTHCARE SYSTEM INCLUDED SEVEN FULL-SERVICE HOSPITALS, TWO PHILANTHROPIC FOUNDATIONS, A CARDIOVASCULAR RESEARCH INSTITUTE, A PHYSICIAN NETWORK, AMBULATORY SURGERY CENTERS, AND OTHER HEALTH CARE PROVIDERS, ALL OF WHICH FALL UNDER THE COMMON CONTROL OF PIEDMONT HEALTHCARE, INC., PIEDMONT FAYETTE HOSPITALS SOLE MEMBER. THE SYSTEMS SEVEN HOSPITALS ARE PIEDMONT HOSPITAL, A 643-BED ACUTE TERTIARY CARE FACILITY IN ATLANTA; PIEDMONT FAYETTE HOSPITAL, A 221-BED, ACUTE-CARE COMMUNITY HOSPITAL IN FAYETTEVILLE; PIEDMONT MOUNTAINSIDE HOSPITAL, A 52-BED COMMUNITY HOSPITAL IN JASPER; PIEDMONT NEWNAN HOSPITAL, A 136-BED, ACUTE-CARE COMMUNITY HOSPITAL IN NEWNAN; PIEDMONT HENRY HOSPITAL, A 215-BED ACUTE-CARE COMMUNITY HOSPITAL IN STOCKBRIDGE; PIEDMONT NEWTON HOSPITAL, A 97-BED ACUTE-CARE COMMUNITY HOSPITAL IN COVINGTON; AND PIEDMONT ATHENS REGIONAL MEDICAL CENTER, A 360-BED ACUTE-CARE HOSPITAL AND REGIONAL REFERRAL CENTER. AS PART OF THE PIEDMONT HEALTHCARE SYSTEM, CERTAIN AFFILIATES MAKE GRANTS AND/OR CONTRIBUTIONS TO OTHER RELATED NONPROFIT AFFILIATES TO HELP FINANCIALLY SUPPORT AND/OR FUND WORTHY COMMUNITY BENEFITS ACTIVITIES. SCHEDULE H, PART VI, LINE 7: STATE OF FILING OF COMMUNITY BENEFIT REPORT PIEDMONT NEWTON 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 true false GREGORY HURST CHAIRMAN 0 729306 0 455448 0 732079 0 15900 0 9693 0 1942426 684530 DR LEIGH HAMBY BOARD MEMBER 0 540329 0 341065 0 52392 0 126505 0 19092 0 1079383 JAMES WEADICK PRESIDENT & CEO 286849 0 121800 0 251899 0 15900 0 9106 0 685554 0 40600 JAY MITCHELL SECRETARY thru 10/14/16 0 364196 0 283927 0 332833 0 15900 0 15421 0 1012277 297318 MICHAEL MCANDER sec: 10/14/16-2/27/17 & Treas 0 564255 0 356500 0 49183 0 104390 0 9456 0 1083784 TROY BROOKS CFO 229444 0 61688 0 7169 0 15900 0 12922 0 327123 0 William Little CMO 252012 0 36167 0 9501 0 0 0 11142 0 308822 0 Patricia Waller CNO thru 05/13/17 167570 0 45938 0 6030 0 10429 0 13456 0 243423 0 Greg Richardson HR DIRECTOR 72598 72598 0 15751 4939 2794 15900 4404 7520 6758 100957 102305 William Love Exec Director Patient Services 153127 0 24335 0 317 0 9063 0 1405 0 188247 0 Robert Halliday Director of Pharmacy 136485 0 15191 0 7366 0 9582 0 7929 0 176553 0 Bradley Collier Director of Finance 114227 0 15817 0 13636 0 8466 0 14280 0 166426 0 Steven Spillers Pharmacy Operations Manager 128079 0 6880 0 3089 0 7662 0 7676 0 153386 0 SCHEDULE J, PART I, LINE 1A: OTHER COMPENSATION ITEMS JAMES WEADICK RECEIVED A DISCRETIONARY SPENDING ACCOUNT TOTALING $12,000.04, A FIXED AMOUNT DETERMINED BY HIS JOB LEVEL. THIS SPENDING ACCOUNT WAS INCLUDED IN MR. WEADICKS TAXABLE WAGES. SCHEDULE J, PART I, LINE 3: COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR THE COMPENSATION FOR THE PRESIDENT/CEO OF PIEDMONT NEWTON 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 JAY MITCHELL, JAMES WEADICK, AND GREGORY HURST RECEIVED SERP PAYMENTS IN THE AMOUNTS OF $297,318, $40,600, AND $684,530, RESPECTIVELY. THE FOLLOWING EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS: MICHAEL MCANDER LEIGH HAMBY TROY BROOKS 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. DIFFERENT PERFORMANCE METRICS. A NEWTON COUNTY HOSPITAL AUTHORITY 586004174 2006-04-27 8930000 4TH FLOOR ADDITION TO HOSPITAL false false false B NEWTON COUNTY HOSPITAL AUTHORITY 586004174 2007-05-30 17225000 ADVANCED REFUND OF 1999 BONDS false false false A 3525000 0 9010590 1239285 0 0 178600 0 0 8751400 0 0 2007 false false true true B 5239998 0 17225000 1114219 0 16989001 235999 0 0 0 0 0 2002 false true true true A false false false false 0.00000 0.00000 0.00000 false false false true B false false false false 0.00000 0.00000 0.00000 false false false true A false false false true false false 0 false 0 false true B false false false true false false 0 false 0 false true A true B true SCHEDULE K, PART II, LINE 3: TOTAL PROCEEDS FROM ISSUE TOTAL PROCEEDS INCLUDES TOTAL INVESTMENT EARNING FROM SINKING FUND OF $80,590. SCHEDULE K, PART IV, LINE 2C: REBATE CALCULATION NEWTON COUNTY HOSPITAL AUTHORITY 04/27/17 NEWTON COUNTY HOSPITAL AUTHORITY 03/06/17 FORM 990, PART V, LINE 1A: NUMBER OF FORMS 1099 FILED ALL CALENDAR YEAR 2016 FORMS 1099 WERE FILED ON BEHALF OF PIEDMONT NEWTON 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 NEWTON HOSPITAL ("PNtH"). FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF GOVERNING BODY THE BOARD OF PIEDMONT HEALTHCARE, PIEDMONT NEWTON HOSPITALS SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF PIEDMONT NEWTON HOSPITAL. FORM 990, PART VI, SEC A, LINE 7B: DECISIONS OF GOVERNING BODY PIEDMONT NEWTON HOSPITALS 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 NEWTON 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 NEWTON HOSPITALS FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATIONS FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PNTHS 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 ORGANIZATIONS 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 HEALTHCARES 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 NEWTON 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 HEALTHCARES 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 NEWTON HOSPITAL IS SET BY THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC. THE PIEDMONT HEALTHCARE, INC., BOARD OF DIRECTORS EXECUTIVE PERFORMANCE AND COMPENSATION COMMITTEE ("THE COMMITTEE") IS COMPOSED OF AT LEAST THREE MEMBERS OF THE PHC BOARD OF DIRECTORS, SERVING TERMS OF THREE YEARS, AND THE MAJORITY OF WHICH ARE COMMUNITY DIRECTORS WHO GENERALLY DO NOT HAVE CONFLICTS OF INTEREST RELATED TO FULFILLMENT OF THE DUTIES AS OUTLINED BELOW. THE EXECUTIVE PERFORMANCE AND COMPENSATION COMMITTEE (COMMITTEE) OVERSEES EXECUTIVE PERFORMANCE AND COMPENSATION ON BEHALF OF THE PHC BOARD, SUBJECT TO THE ULTIMATE AUTHORITY AND OVERSIGHT OF THE BOARD. THE COMMITTEE ALSO FORMULATES POLICIES AND MAKES DECISIONS IN ORDER TO ENSURE A HIGH LEVEL OF EXECUTIVE PERFORMANCE. THE COMMITTEE IS AUTHORIZED TO ACT ON BEHALF OF THE PHC BOARD AS SET OUT IN ITS CHARTER, AND THE COMMITTEE IS ALSO CHARGED WITH PROVIDING RECOMMENDATIONS AND PERIODIC REPORTS TO THE PHC BOARD REGARDING EXECUTIVE PERFORMANCE AND COMPENSATION. ALL DECISIONS AND COMPARABILITY DATA ARE DOCUMENTED IN THE COMMITTEE MEETING MINUTES. FUNCTIONS OF THE COMMITTEE - ASSESS AND IMPLEMENT POLICIES REGARDING PERFORMANCE, COMPENSATION AND BENEFITS OF THE PRESIDENT/CEO AND OTHER EXECUTIVES AS DETERMINED BY THE COMMITTEE - SELECT AN EXECUTIVE COMPENSATION CONSULTANT WHO REPORTS TO THE COMMITTEE - ANNUALLY REVIEW THE PRESIDENT/CEO SUCCESSION PLAN - FORMULATE AND IMPLEMENT ANNUAL PERFORMANCE OBJECTIVES FOR THE PRESIDENT/CEO, AND REVIEW AND APPROVE ANNUALLY RECOMMENDATIONS FROM THE PRESIDENT/CEO RELATING TO COMPENSATION, PERFORMANCE OBJECTIVES, AND SUCCESSION PLANS FOR EVP EXECUTIVES - ANNUALLY ASSESS PRESIDENT/CEO PERFORMANCE; IF NECESSARY, IMPLEMENT ACTION PLAN WITH PRESIDENT/CEO INPUT TO IMPROVE HIS/HER PERFORMANCE; ADJUST COMPENSATION AS APPROPRIATE; THE COMMITTEE CHAIR SHALL CONSULT WITH THE PHC GOVERNANCE COMMITTEE CHAIR AND THE PHC BOARD CHAIR AND SHALL COORDINATE THE ANNUAL PERFORMANCE REVIEW OF THE PHC PRESIDENT/CEO, UNLESS THE PHC BOARD CHAIR HAS A REAL OR PERCEIVED CONFLICT OF INTEREST, IN WHICH CASE THE COMMITTEE CHAIR SHALL DETERMINE THE PROPER REVIEW PROCESS - REVIEW AND APPROVE LONG TERM AND SHORT TERM GOALS TO BE USED IN CONNECTION WITH EVP COMPENSATION PROGRAMS AS RECOMMENDED BY THE PRESIDENT/CEO AND VALIDATED BY THE COMPENSATION CONSULTANT - PERIODICALLY REVIEW COMPENSATION, IF ANY, FOR THE PHC BOARD CHAIR AND ALL BOARD CHAIRS OF THE PHC SUBSIDIARIES - ESTABLISH OTHER POLICIES AND PROCEDURES, AND PERFORM OTHER TASKS, RELATED TO EXECUTIVE PERFORMANCE AND COMPENSATION, INCLUDING BUT NOT LIMITED TO, APPROVAL OF EXECUTIVE EMPLOYMENT CONTRACTS AND BENEFITS - PERIODICALLY REPORT SIGNIFICANT DECISIONS AND ANY ADDITIONAL REQUESTED INFORMATION TO THE PHC BOARD FORM 990, PART VI, SECTION C, LINE 19: DISCLOSURE OF DOCUMENTS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THESE DOCUMENTS SHOULD BE REQUESTED FROM PIEDMONT HEALTHCARE, INC.'S LEGAL COUNSEL. FORM 990, PART XI, LINE 9: RECONCILIATION OF NET ASSETS CHANGES TO NET ASSETS REPORTED ON PART XI, LINE 9 ARE COMPRISED OF $13,978,395 OF INTERCOMPANY TRANSFERS OF LIABILITIES; AND BOOK/TAX DIFFERENCES RELATED TO REVENUE RECOGNITION OF $265,900. 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