PIEDMONT HEART INSTITUTE INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
PIEDMONT HEART INSTITUTE INC (EIN 26-3553500)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-05-15
IRS object ID
201841359349313804
Schema version
2016v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-05-15T19:16:52-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1300 North Greene Street Suite 400AddressLine1Txt
CityGreensboroCityNm
State AbbreviationNCStateAbbreviationCd
ZIP27401ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN263553500EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Piedmont Heart Institute IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% MARIE GAFFNEYInCareOfNm
Business Name ControlPIEDBusinessNameControlTxt
Phone4046055234PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line195 Collier Road NW Suite 2045AddressLine1Txt
CityAtlantaCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30309ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARIE GAFFNEYPersonNm
Person TitleVP CORPORATE FINANCEPersonTitleTxt
Phone4702716007PhoneNum
Signature2018-05-15SignatureDt

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSHAWN M HUTCHINSONPreparerPersonNm
PTINP01048557PTIN
Phone3362753394PhoneNum
Preparation2018-05-15PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.102.5IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id56038220181355000017FederalOriginalSubmissionId
Federal Original Submission Id2018-05-15FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id498B586BA7294F0056B739F61C7EBDEFFF7F5BB8AtSubmissionCreationDeviceId
At Submission Filing Device Id9DC12A2BFBD0952806A513A2DFE339E4C2D22F2EAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDR CHARLES BROWNPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line195 Collier Road NW Ste 2045AddressLine1Txt
CityAtlantaCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30309ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$4,878,197GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.piedmontheart.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2008FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTO ADVANCE CARDIOVASCULAR RESEARCH AND TO PROVIDE EDUCATION AND EXCELLENCE IN CARDIAC TREATMENT and disease prevention.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee45TotalEmployeeCnt
Total Volunteers1TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$2,552,599PYContributionsGrantsAmt
CY Contributions Grants$1,817,066CYContributionsGrantsAmt
PY Program Service Revenue$3,270,436PYProgramServiceRevenueAmt
CY Program Service Revenue$2,870,258CYProgramServiceRevenueAmt
PY Investment Income-$1,252PYInvestmentIncomeAmt
CY Investment Income-$50CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$190,873CYOtherRevenueAmt
PY Total Revenue$5,821,783PYTotalRevenueAmt
CY Total Revenue$4,878,147CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,090,010PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,952,656CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,340,180PYOtherExpensesAmt
CY Other Expenses$2,814,937CYOtherExpensesAmt
PY Total Expenses$11,430,190PYTotalExpensesAmt
CY Total Expenses$8,767,593CYTotalExpensesAmt
PY Revenues Less Expenses-$5,608,407PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$3,889,446CYRevenuesLessExpensesAmt
Total Assets BOY$2,027,934TotalAssetsBOYAmt
Total Assets EOY$1,890,665TotalAssetsEOYAmt
Total Liabilities BOY$6,846,406TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,370,293TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$4,818,472NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$6,479,628NetAssetsOrFundBalancesEOYAmt
MissionPIEDMONT HEART INSTITUTE, INC., WAS FORMED BY PIEDMONT HEALTHCARE, INC., TO ADVANCE CARDIOVASCULAR RESEARCH AND TO PROVIDE EDUCATION AND EXCELLENCE IN CARDIAC TREATMENT AND DISEASE PREVENTION.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$8,128,871ExpenseAmt
Grant$0GrantAmt
Revenue$2,870,258RevenueAmt
DescPIEDMONT HEART INSTITUTE, INC. ("PHI"), DEVELOPS EDUCATIONAL PROGRAMS FOR PHYSICIANS, EMPLOYERS, AND THE LAY COMMUNITY. THESE PROGRAMS ARE FOCUSED ON THE IDENTIFICATION OF PERSONS AT RISK FOR HEART DISEASE, AS WELL AS ON APPROPRIATE TREATMENT OPTIONS. IN ADDITION, PHI HAS ESTABLISHED A ROBUST RESEARCH PLATFORM AIMED AT ADVANCING THE UNDERSTANDING OF CARDIOVASCULAR DISEASES AND CONDITIONS AND THEIR TREATMENT AND PREVENTION. PHI IS CURRENTLY ENGAGED IN STUDIES OF INNOVATIVE NEW TREATMENT METHODS FOR CARDIOVASCULAR DISEASES SUCH AS ARRHYTHMIA, PERIPHERAL VASCULAR DISEASE, CORONARY ARTERY DISEASE, VALVULAR DISEASE, AND CONGESTIVE HEART FAILURE.Desc
Total Program Service Expenses$8,128,871TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee45EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARIE GAFFNEYPersonNm
Phone4202716007PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12727 PACES FERRY RD BLDG 2 STE 70AddressLine1Txt
CityATLANTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP30339ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Mr Gregory A Hurst
Board Member1.054.0Yes (X)$0$1,916,833$25,593
Dr Charles Brown
CEO From 8/31/1615.040.0Yes (X)$0$882,688$35,018Yes (X)
Mr Richard Tanzella
Board Member1.054.0Yes (X)$0$400,917$34,618
Mr Jay D Mitchell
Secretary thru 10/14/161.054.0$0$980,956$31,321Yes (X)
Mr Michael McAnder
Sec: 10/14/16-2/27/17 & Treas1.054.0$0$969,938$113,846Yes (X)
Mr Craig Wright
Interim CEO thru 8/31/1615.040.0$0$258,007$0Yes (X)
Ms Elizabeth Leddy
Secretary from 2/27/171.054.0$0$0$0Yes (X)
Dr Peter Barrett
Cardiologist40.00.0$759,824$0$35,039Yes (X)
DR FEDERICO MILLA
CARDIO SURGEON40.00.0$1,038,130$0$25,854Yes (X)
DR RANDOLPH MARTIN
CARDIOLOGIST40.00.0$258,160$0$28,392Yes (X)
Ms Zhen Qian
Director of Oncology Strategy40.00.0$116,114$0$18,574Yes (X)
Ms Jayne Morgan
Director Research Development40.00.0$152,857$0$2,057Yes (X)
Mr Sidney Kirschner
FORMER CHAIRMAN AND CEO0.055.0$0$1,109,869$30,271Yes (X)
DR WILLIAM KNOPF
FORMER BOARD MEMBER0.00.0$0$850,000$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,325,085TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$7,369,208TotReportableCompRltdOrgAmt
Total Other Compensation$380,583TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K8IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Luckie and Company
600 Luckie DriveBIRMINGHAMAL35223MARKETING$225,150
Beth Israel Medical Center
353 East 17th Street Apt 6ANEW YORKNY10003Physician Services$127,500
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
All Other Contributions$1,817,066AllOtherContributionsAmt
Total Contributions$1,817,066TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EDUCATION ACTIVITIES900099$293,146$293,146
RESEARCH REVENUE900099$2,577,112$2,577,112
FieldValueIRS element (for citing)
Total Program Service Revenue$2,870,258TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$50OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$50OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$50TotalRevenueColumnAmt
Exclusion-$50ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescREBATESDesc
Business900099BusinessCd
Total Revenue Column$190,873TotalRevenueColumnAmt
Exclusion$190,873ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$190,873OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,878,147TotalRevenueColumnAmt
Related Or Exempt Func Income$2,870,258RelatedOrExemptFuncIncomeAmt
Exclusion$190,823ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,319,988TotalAmt
Program Services$5,319,988ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$398,551TotalAmt
Program Services$398,551ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$234,117TotalAmt
Program Services$234,117ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,168,482TotalAmt
Program Services$963,387ProgramServicesAmt
Management And General$205,095ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$97,588TotalAmt
Program Services$97,588ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$270,226TotalAmt
Program Services$270,226ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$216,972TotalAmt
Program Services$216,972ProgramServicesAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$115,235TotalAmt
Program Services$115,235ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$40,068TotalAmt
Program Services$40,068ProgramServicesAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$433,627TotalAmt
Management And General$433,627ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$148,065TotalAmt
Program Services$148,065ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$64,831TotalAmt
Program Services$64,831ProgramServicesAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS EXPENSEDesc
Total$259,843TotalAmt
Program Services$259,843ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$8,767,593TotalAmt
Program Services$8,128,871ProgramServicesAmt
Management And General$638,722ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$52,994BOYAmt
EOY$54,687EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,411,575BOYAmt
EOY$1,300,406EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$67,589BOYAmt
EOY$42,322EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$911,294LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$525,693LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$404,168BOYAmt
EOY$385,601EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$91,608BOYAmt
EOY$107,649EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,027,934BOYAmt
EOY$1,890,665EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$746,231BOYAmt
EOY$495,778EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$6,100,175BOYAmt
EOY$7,874,515EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,846,406BOYAmt
EOY$8,370,293EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$5,183,606BOYAmt
EOY-$6,828,254EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$365,134BOYAmt
EOY$348,626EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$4,818,472BOYAmt
EOY-$6,479,628EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,027,934BOYAmt
EOY$1,890,665EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$3,889,446ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$2,228,290OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$100,158CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$361,873CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,350CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,000CurrentTaxYearMinus1YearAmt
Current Tax Year$12,515CurrentTaxYearAmt
Total$495,896TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$100,158CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$361,873CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,350CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,000CurrentTaxYearMinus1YearAmt
Current Tax Year$12,515CurrentTaxYearAmt
Total$495,896TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$282,983SubstantialContributorsTotAmt
Public Support Total170$212,913PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year-$1,310CurrentTaxYearMinus1YearAmt
Total-$1,310TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$494,586TotalSupportAmt
Gross Receipts Rltd Activities$12,992,781GrossReceiptsRltdActivitiesAmt
Public Support CY1700.43049PublicSupportCY170Pct
Public Support PY1700.25180PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp
BuildingsBuildingsGrp

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$116,942OtherCostOrOtherBasisAmt
Depreciation$48,449DepreciationAmt
Book Value$68,493BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$655,527OtherCostOrOtherBasisAmt
Depreciation$477,244DepreciationAmt
Book Value$178,283BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$138,825OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$138,825BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$385,601TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescDUE FROM RELATED PARTIESDesc
Book Value$107,649BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$107,649TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt
Total Liability$0TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PART X, LINE 2: ASC 740 FOOTNOTE (FKA FIN 48)FormAndLineReferenceDesc
ExplanationPHC 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.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Mr Sidney Kirschner
FORMER CHAIRMAN AND CEO$0$518,911$0$326,800$0$264,158$0$15,900$0$14,371$0$1,140,140$79,064
Mr Gregory A Hurst
Board Member$0$729,306$0$455,448$0$732,079$0$15,900$0$9,693$0$1,942,426$684,530
Mr Jay D Mitchell
Secretary thru 10/14/16$0$364,196$0$283,927$0$332,833$0$15,900$0$15,421$0$1,012,277$297,318
Dr Peter Barrett
Cardiologist$599,340$0$0$0$160,484$0$15,900$0$19,139$0$794,863$0
DR WILLIAM KNOPF
FORMER BOARD MEMBER$0$0$0$0$0$850,000$0$0$0$0$0$850,000
DR FEDERICO MILLA
CARDIO SURGEON$962,761$0$0$0$75,369$0$15,900$0$9,954$0$1,063,984$0
DR RANDOLPH MARTIN
CARDIOLOGIST$242,210$0$0$0$15,950$0$14,423$0$13,969$0$286,552$0
Dr Charles Brown
CEO From 8/31/16$0$654,323$0$49,038$0$179,327$0$15,900$0$19,118$0$917,706
Mr Michael McAnder
Sec: 10/14/16-2/27/17 & Treas$0$564,255$0$356,500$0$49,183$0$104,390$0$9,456$0$1,083,784
Mr Richard Tanzella
Board Member$0$302,771$0$85,501$0$12,645$0$15,900$0$18,718$0$435,535
Mr Craig Wright
Interim CEO thru 8/31/16$0$258,007$0$0$0$0$0$0$0$0$0$258,007
Ms Jayne Morgan
Director Research Development$139,605$0$12,717$0$535$0$1,409$0$648$0$154,914$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 3: COMPENSATION OF THE CEO/EXECUTIVE DIRECTORTHE COMPENSATION FOR THE PRESIDENT/CEO OF PIEDMONT HEART INSTITUTE IS SET AND PAID BY THE ENTITYS 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 4A: SUPPLEMENTAL COMPENSATION INFORMATIONWILLIAM KNOPF RECEIVED SEVERANCE PAYMENTS TOTALING $817,308 DURING CALENDAR YEAR 2016.
SCHEDULE J, PART I, LINE 4B: SUPPLEMENTAL COMPENSATION INFORMATIONTHE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THEIR SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: SIDNEY KIRSCHNER $79,064 JAY MITCHELL $297,318 GREG HURST $684,530 MICHAEL MCANDER, CHARLES BROWN, AND RICHARD TANZELLA PARTICIPATED IN SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS.
SCHEDULE J, PART I, LINE 7: NON-FIXED PAYMENTSCERTAIN EMPLOYEES PARTICIPATED IN AN "ANNUAL INCENTIVE PLAN" UNDER WHICH THEY RECEIVED NON-FIXED BONUS PAYMENTS BASED ON JOB LEVEL AND SEVERAL DIFFERENT PERFORMANCE METRICS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 4 AND PART VI, LINE 1B: INDEPENDENT BOARD MEMBERSPIEDMONT HEART INSTITUTE'S ("PHI") BOARD OF DIRECTORS IS COMPRISED OF THREE VOTING MEMBERS, NONE OF WHICH ARE INDEPENDENT BASED UPON IRS GUIDELINES. WHILE PHI ITSELF DOES NOT HAVE AN INDEPENDENT BOARD OF DIRECTORS, ANY DECISIONS MADE BY THE PHI BOARD MAY BE RESCINDED BY THE BOARD OF DIRECTORS OF PHIS SOLE MEMBER, PIEDMONT HEALTHCARE, INC. IN ADDITION, PIEDMONT HEALTHCARE APPOINTS THE MEMBERS OF THE PHI BOARD, SETS COMPENSATION FOR PHIS EXECUTIVES, AND MONITORS PHIS COMPLIANCE WITH PIEDMONT HEALTHCARE POLICIES AND PROCEDURES. THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS IS COMPRISED OF A MAJORITY OF INDEPENDENT MEMBERS, AND THEREFORE PHI IS EFFECTIVELY GOVERNED BY AN INDEPENDENT BOARD.
FORM 990, PART V, LINE 1A: NUMBER OF FORMS 1099 FILEDALL CALENDAR YEAR 2016 FORMS 1099 WERE FILED ON BEHALF OF PIEDMONT HEART INSTITUTE 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 MEMBERPIEDMONT HEALTHCARE, INC., (EIN 58-1503902) IS THE SOLE MEMBER OF PIEDMONT HEART INSTITUTE, INC. ("PHI").
FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF GOVERNING BODYTHE BOARD OF PIEDMONT HEALTHCARE APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF PIEDMONT HEART INSTITUTE.
FORM 990, PART VI, SEC A, LINE 7B: DECISIONS OF GOVERNING BODYPIEDMONT HEART INSTITUTES 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 HEART INSTITUTE 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 PROCESSINFORMATION NEEDED TO PREPARE PIEDMONT HEART INSTITUTES FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATIONS FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PHIS CONTROLLER AND VP/CFO. THE 990 IS THEN PREPARED INTERNALLY BY PIEDMONT HEALTHCARE, INC.S TAX DEPARTMENT 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, SEC B, LINE 12C: CONFLICT OF INTEREST POLICYCOMPLIANCE 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 HEART INSTITUTE 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 COMPENSATIONCOMPENSATION FOR EXECUTIVES OF PIEDMONT HEART INSTITUTE IS SET BY THE BOARD OF DIRECTORS OF ITS SOLE MEMBER, PIEDMONT HEALTHCARE, INC., AND PAID ON BEHALF OF THE ORGANIZATION BY 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 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 DOCSGOVERNING 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 IX, LINE 11G: OTHER PURCHASED SERVICESOTHER PURCHASED SERVICES LISTED ON PART IX, LINE 11G INCLUDE THE FOLLOWING: MANAGEMENT CONSULTING - $205,095 LAB & IMAGING - $350,306 CONFERENCES & EVENTS - $364,279 RESEARCH - $57,586 MISCELLANEOUS OTHER SERVICES - $191,216
FORM 990, PART XI, LINE 9: RECONCILIATION OF NET ASSETSCHANGES TO NET ASSETS REPORTED ON PART XI, LINE 9 ARE COMPRISED OF $3,872,938 OF BOOK/TAX DIFFERENCES RELATED TO TIMING OF REVENUE RECOGNITION AND $(1,644,648) OF INTERCOMPANY TRANSFERS OF LIABILITIES.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
PIEDMONT HEALTHCARE INC
1800 HOWELL MILL ROAD SUITE 850ATLANTAGA30318581503902MANAGEMENTGA501(c)(3)11 CNAfalse
PIEDMONT HOSPITAL Inc
1968 PEACHTREE ROAD NWATLANTAGA30309580566213HOSPITALGA501(c)(3)3PHCfalse
FAYETTE COMMUNITY HOSPITAL INC
1255 HIGHWAY 54 WESTFAYETTEVILLEGA30214582232328HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT MOUNTAINSIDE HOSPITAL INC
1266 HIGHWAY 515 SOUTHJASPERGA30143352228583HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT NEWNAN HOSPITAL INC
745 POPLAR ROADNEWNANGA30265205077249HOSPITALGA501(c)(3)3PHCfalse
PIEDMONT HEALTHCARE FOUNDATION INC
2001 PEACHTREE ROAD NE SUITE 400ATLANTAGA30309581272768FUNDRAISINGGA501(c)(3)11 BPHCfalse
PIEDMONT HENRY HOSPITAL INC
1133 EAGLES LANDING PKWYSTOCKBRIDGEGA30281582200195HOSPITALGA501(c)(3)3PHCfalse
HENRY DEVELOPMENT VENTURES INC
1133 EAGLES LANDING PKWYSTOCKBRIDGEGA30281582200734RE HOLDINGGA501(c)(2)N/APHHfalse
CENTER FOR HEALTH AND LEARNING INC
3001 MERCER UNIVERSITY DRATLANTAGA30341262442849EDUCATIONGA501(C)(3)11 ANAfalse
PIEDMONT NEWTON HOSPITAL INC
5126 HOSPITAL DRIVE NECOVINGTONGA30014582155150HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT ATHENS REGIONAL FOUNDATION INC
1199 PRINCE AVENUEATHENSGA30606581978389fundraisingGA501(c)(3)11BNAfalse
PIEDMONT ATHENS REGIONAL HEALTH RESOURCE
1199 PRINCE AVENUEathensGA30606581930580developmentGA501(c)(3)11BNAfalse
PIEDMONT ATHENS REGIONAL MEDICAL CENTER
1199 PRINCE AVENUEAthensGA30606582179986HospitalGA501(c)(3)3PHCfalse
ATHENS REGIONAL PHYSICIAN SERVICES INC
1199 PRINCE AVENUEAthensGA30606582332921HealthcareGA501(c)(3)11BNAfalse
ATHENS REGIONAL SPECIALTY SERVICES INC
1199 PRINCE AVENUEAthensGA30606271975001HealthcareGA501(c)(3)3NAfalse
REGIONAL FIRSTCARE INC
1199 PRINCE AVENUEAthensGA30606582362733Urgent CareGA501(c)(3)11BNAfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndUBI Code VUBICodeVAmtGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPct
HENRY RADIATION ONCOLOGY CENTER LLC
275 PROFESSIONAL COURT STE ASTOCKBRIDGEGA30281582200195HEALTHCAREGANAN/A$0$0false$0false0.00000
PEACHTREE ORTHOPAEDIC SURGERY CENTER
2001 PEACHTREE RD NE STE 705ATLANTAGA30309582562721SURGERYGANAN/A$0$0false$0false0.00000
DIGESTIVE HEALTHCARE OF GA SURGERY CTR
95 COLLIER RD NW STE 4075ATLANTAGA30309582406657HEALTHCAREGANAN/A$0$0false$0false0.00000
SOUTHERN CRESCENT RADIATION ONCOLGY CENT
275 PROFESSIONAL COURT STE ARIVERDALEGA30274464307929RADIATIONGANAN/A$0$0false$0false0.00000
GRIFFIN RADIATION ONCOLOGY CENTER LLC
275 PROFESSIONAL COURT STE ARIVERDALEGA30274464307692RADIATIONGANAN/A$0$0false$0false0.00000
FOUR WINDS HEALTH LLC
3350 RIVERWOOD PKWY STE 1850ATLANTAGA30339451273930HEALTHCAREGANAN/A$0$0false$0false0.00000
GEORGIA HEALTH COLLABORATIVE LLC
2727 PACES FERRY RD BLDG 2 STE 20ATLANTAGA30339461500639HEALTHCAREGANAN/A$0$0false$0false0.00000

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
PIEDMONT MEDICAL CARE CORPORATION
2727 PACES FERRY ROAD SUITE 1-1100ATLANTAGA30339582092768HEALTHCAREGANAC-CORP$0$00.00000
THE PIEDMONT CLINIC INC
2727 PACES FERRY ROAD SUITE 1-1100ATLANTAGA30339582005358HEALTHCAREGANAC-CORP$0$00.00000false
PIEDMONT HEART INSTITUTE PHYSICIANS INC
95 COLLIER ROAD NW STE 2045ATLANTAGA30309260593850HEALTHCAREGANAC-CORP
AMSTER MCRAE INSURANCE COMPANY
980427603Related InsurNAC-CORP$0$00.00000falsePO BOX 1159GRAND CAYMANGrand CaymanCJKY 1-1102CJ
PIEDMONT WELLSTAR HEALTHPLANS INC
2859 PACES FERRY RD STE 600ATLANTAGA30339461922499HEALTH INSURAnceGANAC-CORP$0$00.00000false
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

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