PHOEBE SUMTER MEDICAL CENTER INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- PHOEBE SUMTER MEDICAL CENTER INC (EIN 26-3975185)
- Tax period
- 2015-08-01 to 2016-07-31
- Filed
- 2017-06-09
- IRS object ID
- 201701609349300610
- Schema version
- 2015v3.0
- 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
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-06-09T09:37:39-04:00 | ReturnTs |
| Tax Period End | 2016-07-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 580914992 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DRAFFIN & TUCKER LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 71309 | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317081309 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-08-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263975185 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHOEBE SUMTER MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PHOE | BusinessNameControlTxt |
| Phone | 2299246011 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 126 HWY 280 WEST | AddressLine1Txt |
| City | AMERICUS | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317198645 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRIAN CHURCH | PersonNm |
| Person Title | BD MEMBER/PPHS CFO | PersonTitleTxt |
| Phone | 2299246011 | PhoneNum |
| Signature | 2017-06-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFFREY S WRIGHT | PreparerPersonNm |
| PTIN | P00226270 | PTIN |
| Phone | 2298837878 | PhoneNum |
| Preparation | 2017-06-09 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BRANDI LUNNEBORG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 126 HWY 280 WEST | AddressLine1Txt |
| City | AMERICUS | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317198645 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $73,389,593 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PHOEBEHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2009 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDING CHARITABLE HEALTHCARE ACTIVITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 499 | TotalEmployeeCnt |
| Total Volunteers | 132 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $40,689 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $64,145,936 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $70,090,622 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$17,909 | PYInvestmentIncomeAmt |
| CY Investment Income | $133,534 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,890,403 | PYOtherRevenueAmt |
| CY Other Revenue | $2,086,425 | CYOtherRevenueAmt |
| PY Total Revenue | $66,059,119 | PYTotalRevenueAmt |
| CY Total Revenue | $72,310,581 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $8,075 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $21,983,811 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $25,099,023 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $37,943,050 | PYOtherExpensesAmt |
| CY Other Expenses | $40,193,067 | CYOtherExpensesAmt |
| PY Total Expenses | $59,926,861 | PYTotalExpensesAmt |
| CY Total Expenses | $65,300,165 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,132,258 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $7,010,416 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $80,113,663 | TotalAssetsBOYAmt |
| Total Assets EOY | $89,012,396 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,128,076 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,900,606 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $73,985,587 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $81,111,790 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDING CHARITABLE HEALTHCARE ACTIVITIES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $53,641,856 | ExpenseAmt |
| Grant | $8,075 | GrantAmt |
| Revenue | $70,986,701 | RevenueAmt |
| Desc | TO BE THE LEADING PROVIDER OF QUALITY, COST EFFECTIVE, PATIENT-CENTERED HEALTH CARE SERVICES TO ALL RESIDENTS OF SOUTHWEST GEORGIA. PSMC 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. | Desc |
| Total Program Service Expenses | $53,641,856 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 75 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 499 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRIAN CHURCH | PersonNm |
| Phone | 2293124068 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3770 | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317063770 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| JOEL WERNICK | |||||||||
| BD MEMBER/PP | 1.00 | 54.00 | Yes (X) | Yes (X) | $0 | $1,023,106 | $1,166,168 | ||
| JOE AUSTIN | |||||||||
| BD MEMBER/PP | 1.00 | 52.00 | Yes (X) | Yes (X) | $0 | $848,171 | $180,931 | ||
| BRIAN CHURCH | |||||||||
| BD MEMBER/PP | 1.00 | 54.00 | Yes (X) | Yes (X) | $0 | $268,655 | $18,925 | ||
| DALE LAWSON MD | |||||||||
| BD MMBR/CHF | 40.00 | 0.00 | Yes (X) | $99,000 | $0 | $0 | |||
| WALLACE MAYS MD | |||||||||
| PAST BOARD M | 1.00 | 40.00 | Yes (X) | $0 | $63,114 | $0 | |||
| BRAD LAFEVERS | |||||||||
| CHAIRMAN | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ROBBIE LATIMORE EDD | |||||||||
| VICE CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SANDRA LEE ZORNES MD | |||||||||
| BOARD MEMBER | 1.00 | 40.00 | Yes (X) | $0 | $0 | $0 | |||
| RANDY JONES | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| FREDRICK MCLAUGHLIN EDD | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| REGINA MCDUFFIE | |||||||||
| BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| LARA GILL | |||||||||
| PAST BOARD M | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BRANDI LUNNEBORG | |||||||||
| CEO | 50.00 | 1.00 | Yes (X) | $0 | $281,388 | $17,157 | |||
| MICHELLE DOGGETT | |||||||||
| DIRECTOR OF | 50.00 | 0.00 | Yes (X) | $88,373 | $0 | $17,099 | |||
| DEBORAH MCWILLIAMS | |||||||||
| RN | 40.00 | 0.00 | $161,026 | $0 | $3,128 | Yes (X) | |||
| DARRYL HAWKINS | |||||||||
| PHARMACY DIR | 40.00 | 0.00 | $135,777 | $12,648 | $21,237 | Yes (X) | |||
| CHRISTY HARDIN | |||||||||
| ASST. DIR PH | 40.00 | 0.00 | $143,096 | $1,200 | $2,761 | Yes (X) | |||
| LORI PAYNE | |||||||||
| PHARMACIST | 40.00 | 0.00 | $134,362 | $600 | $17,241 | Yes (X) | |||
| SUSAN JOHNSON | |||||||||
| PHARMACIST | 40.00 | 0.00 | $130,482 | $0 | $16,688 | Yes (X) | |||
| KERRY LOUDERMILK | |||||||||
| FORMER PPHS | 0.00 | 0.00 | $0 | $912,481 | $18,633 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $892,116 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,411,363 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,479,968 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 16 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SENTRY ANESTHESIA MANAGEMENT LLC | |||||
| 80 NEWNAN STATION DRIVE SUITE A | NEWNAN | GA | 302653194 | ANESTHESIA SVCS | $1,007,987 |
| SOUTHERN REHABILITATION | |||||
| PO BOX 1066 | AMERICUS | GA | 317091066 | THERAPY SVCS | $650,811 |
| GEORGIA PREMIER SONOGRAPHY | |||||
| 213 TRADERS PASS | WARNER ROBINS | GA | 310882211 | ULTRASOUND SVCS | $483,420 |
| SOUTHERN PATHOLOGY & LABORATORY SERV | |||||
| 126 HWY 280 WEST | AMERICUS | GA | 317198645 | DIRECTOR FEE | $120,000 |
| EXECUTIVE HEALTH RESOURCES INC | |||||
| 15 CAMPUS BLVD SUITE 200 | NEWTOWN SQUARE | PA | 190733200 | CONSULTING SRVC | $114,970 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROGRAM SERVICE REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $70,090,622 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $70,090,622 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $70,090,622 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $108,896 | TotalRevenueColumnAmt |
| Exclusion | $108,896 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $507,410 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $31,414 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $475,996 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $475,996 | TotalRevenueColumnAmt |
| Exclusion | $475,996 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $933,159 | SecuritiesAmt |
| Other | $139,077 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $937,999 | SecuritiesAmt |
| Other | $109,599 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$4,840 | SecuritiesAmt |
| Other | $29,478 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,638 | TotalRevenueColumnAmt |
| Exclusion | $24,638 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| MIGRANT HEALTH REVENUE | 621990 | $661,311 | $661,311 | |
| EMPLOYEE PHARMACY REVENUE | 621990 | $397,096 | $397,096 | |
| NUTRITION SERVICE REVENUE | 722513 | $317,254 | $317,254 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $234,768 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $234,768 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,610,429 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $72,310,581 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $70,986,701 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,323,880 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,075 | TotalAmt |
| Program Services | $8,075 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,472 | TotalAmt |
| Program Services | $99,000 | ProgramServicesAmt |
| Management And General | $105,472 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,723,898 | TotalAmt |
| Program Services | $16,244,178 | ProgramServicesAmt |
| Management And General | $2,479,720 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $378,175 | TotalAmt |
| Program Services | $326,550 | ProgramServicesAmt |
| Management And General | $51,625 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,437,248 | TotalAmt |
| Program Services | $3,831,512 | ProgramServicesAmt |
| Management And General | $605,736 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,355,230 | TotalAmt |
| Program Services | $1,170,225 | ProgramServicesAmt |
| Management And General | $185,005 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,100 | TotalAmt |
| Management And General | $137,100 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,141 | TotalAmt |
| Management And General | $7,141 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,997,258 | TotalAmt |
| Program Services | $14,055,250 | ProgramServicesAmt |
| Management And General | $4,942,008 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,228 | TotalAmt |
| Management And General | $34,228 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,721,446 | TotalAmt |
| Program Services | $1,590,646 | ProgramServicesAmt |
| Management And General | $130,800 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $448,041 | TotalAmt |
| Management And General | $448,041 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $830,300 | TotalAmt |
| Program Services | $769,524 | ProgramServicesAmt |
| Management And General | $60,776 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,241 | TotalAmt |
| Program Services | $81,326 | ProgramServicesAmt |
| Management And General | $32,915 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,312,288 | TotalAmt |
| Program Services | $3,996,638 | ProgramServicesAmt |
| Management And General | $315,650 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,053,109 | TotalAmt |
| Management And General | $1,053,109 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $10,256,826 | $10,256,826 | |
| REPAIRS & MAINTENANCE | $1,279,245 | $1,123,452 | $155,793 |
| LICENSES | $787,559 | $49,245 | $738,314 |
| MISCELLANEOUS | $152,482 | $9,035 | $143,447 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,803 | TotalAmt |
| Program Services | $30,374 | ProgramServicesAmt |
| Management And General | $31,429 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,300,165 | TotalAmt |
| Program Services | $53,641,856 | ProgramServicesAmt |
| Management And General | $11,658,309 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,822,372 | BOYAmt |
| EOY | $24,891,725 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,543,642 | BOYAmt |
| EOY | $9,640,829 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $251,578 | BOYAmt |
| EOY | $209,549 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $914,279 | BOYAmt |
| EOY | $1,371,555 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $278,725 | BOYAmt |
| EOY | $489,410 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $68,963,654 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $25,181,409 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,930,614 | BOYAmt |
| EOY | $43,782,245 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,092,394 | BOYAmt |
| EOY | $4,174,737 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,280,059 | BOYAmt |
| EOY | $4,452,346 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,113,663 | BOYAmt |
| EOY | $89,012,396 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,170,271 | BOYAmt |
| EOY | $4,936,686 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,957,805 | BOYAmt |
| EOY | $2,963,920 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,128,076 | BOYAmt |
| EOY | $7,900,606 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,985,587 | BOYAmt |
| EOY | $81,111,790 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,985,587 | BOYAmt |
| EOY | $81,111,790 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,113,663 | BOYAmt |
| EOY | $89,012,396 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $7,010,416 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $37,488 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $78,299 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $3,409 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,409 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,745,565 | OtherCostOrOtherBasisAmt |
| Book Value | $1,745,565 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $45,085,748 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,650,790 | DepreciationAmt |
| Book Value | $33,434,958 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,132,341 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,530,619 | DepreciationAmt |
| Book Value | $8,601,722 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $43,782,245 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| BENEFICIAL INTEREST IN FOUNDATION | $3,238,097 |
| UPL RECEIVABLE | $348,540 |
| OTHER RECEIVABLES | $333,853 |
| DUE FROM AMERICUS-SUMTER CO HOSP AUT | $284,133 |
| EHR RECEIVABLE | $247,723 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,452,346 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RELATED PARTY PAYABLES | Desc |
| Amt | $2,963,920 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,963,920 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $72,334,854 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$7,141 | OtherRevenueAmt |
| Revenue Not Reported | -$7,141 | RevenueNotReportedAmt |
| Revenue Subtotal | $72,341,995 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$31,414 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$31,414 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $72,310,581 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $65,324,438 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $31,414 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $31,414 | ExpensesNotReportedAmt |
| Expenses Subtotal | $65,293,024 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $7,141 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $7,141 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $65,300,165 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 MANAGEMENT'S 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, 2016 AND 2015 OR FOR THE YEARS THEN ENDED. THE HOSPITAL'S 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 2D | INVESTMENT MANAGEMENT FEES -7,141 |
| SCHEDULE D, PAGE 4, PART XI, LINE 4B | RENTAL EXPENSES -31,414 |
| SCHEDULE D, PAGE 4, PART XII, LINE 2D | RENTAL EXPENSES 31,414 |
| SCHEDULE D, PAGE 4, PART XII, LINE 4B | INVESTMENT MANAGEMENT FEES 7,141 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 1.250000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,607,310 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $627,974 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $979,336 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01500 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,587,923 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,271,273 | DirectOffsettingRevenueAmt |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,096,858 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,487,444 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $609,414 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00930 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,292,091 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,386,691 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,588,750 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02430 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 16801 | PersonsServedCnt |
| Total Community Benefit Expns | $275,969 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $82,815 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $193,154 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 74 | PersonsServedCnt |
| Total Community Benefit Expns | $2,310 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,310 | NetCommunityBenefitExpnsAmt |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 16875 | PersonsServedCnt |
| Total Community Benefit Expns | $278,279 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $82,815 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $195,464 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 16875 | PersonsServedCnt |
| Total Community Benefit Expns | $14,570,370 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,469,506 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,784,214 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02730 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $19,976,153 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $13,938,518 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $16,597,799 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,659,281 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHOEBE SUMTER MEDICAL CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 126 HIGHWAY 280 WEST | AddressLine1Txt |
| City | AMERICUS | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31719 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PHOEBEHEALTH.COM | WebsiteAddressTxt |
| State License | 129-663 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | HOSPICE, RHC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHOEBE SUMTER MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.PHOEBEHEALTH.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.PHOEBEHEALTH.COM | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 125.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWWPHOEBEHEALTHCOM | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWWPHOEBEHEALTHCOM | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWWPHOEBEHEALTHCOM | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | Yes (true) | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, PHOEBE SUMTER MEDICAL CENTER, INC. - PART V, LINE 5 | MEMBERS OF THE INTERNAL ASSESSMENT TEAM PERFORMED NINE (9) KEY LEADER INTERVIEWS. 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, PHYSICIANS AND AFTERSCHOOL PROGRAMS). ELEVEN (11) OTHER PARTICIPANTS, ALL MEMBERS OF THE AMERICUS ROTARY CLUB, RECEIVED MODIFIED WRITTEN VERSIONS OF A SURVEY AND COMPLETED DURING AN OFFICIAL MEETING. ALSO, APPROXIMATELY 100 INVITATIONS WERE SENT OUT TO INDIVIDUALS IN THE COMMUNITY WITH ALMOST HALF ACCEPTING AND PARTICIPATING IN ONE OF TWO INPUT SESSIONS. THE COMMUNITY INPUT SESSIONS WERE ALSO HELD TO REVIEW DATA AND PROVIDE FEEDBACK ON THE COMMUNITYS VIEW OF PRIORITIES. 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. COMMUNITY PARTICIPANTS INCLUDED PHYSICIANS AND OTHER MEDICAL PROFESSIONALS; EDUCATORS; PROFESSIONALS; REPRESENTATIVES FROM THE THE BOYS AND GIRLS CLUB, THE CITY OF AMERICUS, CHAMBER OF COMMERCE, AND THE SUMTER COUNTY HEALTH DEPARTMENT; RELIGIOUS LEADERS. |
| FACILITY 1, PHOEBE SUMTER 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) ACCESS TO HEALTHY FOODS: THIS PRIORITY IS BEING ADDRESSED WITH OTHER PRIORITIES, SUCH AS OBESITY AND DIABETES. 2) SMOKING CESSATION: THIS PRIORITY IS NOT ALIGNED WITH PSMC'S CURRENT STRENGTHS AND PRIORITIES. 3) ALZHEIMER'S DISEASE: OTHER AGENCIES IN THE COMMUNITY ARE CURRENTLY PROVIDING EDUCATION AND SUPPORT FOR CAREGIVERS. 4) SEXUALLY TRANSMITTED DISEASES (STD): COMPLEX ISSUE FOR PSMC TO ADDRESS IN REGARDS TO OUR CURRENT STRENGTHS AND PRIORITIES. 5) HEALTH LITERACY AND EDUCATION: ALTHOUGH EDUCATION IS IMPORTANT TO PSMC, IT IS NOT ONE OF OUR STRENGTHS AT THIS TIME. 6) PROSTATE CANCER: THIS PRIORITY IS ALREADY BEING ADDRESSED THROUGH OUR MEN'S HEALTH FAIR, WHICH IS HOSTED ANNUALLY. 7) SPECIALTY CARE: PSMC IS CURRENTLY SEARCHING FOR SPECIALIST TO BRING INTO THE COMMUNITY. A COMPLETE COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, COMMUNITY PRIORITIES, AND IMPLEMENTATION PLAN CAN BE FOUND AT HTTP://WWW.PHOEBEHEALTH.COM/LOCATIONS/PHOEBE-SUMTER-MEDICAL-CENTER/PHOEBE- SUMTER-MEDICAL-CENTER-CHNA |
| FACILITY 1, PHOEBE SUMTER 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 SUMTER MEDICAL CENTER, INC. - PART V, LINE 20E | PAYMENT PLANS WERE MADE AVAILABLE FOR THOSE NOT ELIGIBLE FOR ASSISTANCE. |
| FACILITY 1, PHOEBE SUMTER MEDICAL CENTER, INC. - PART V, LINE 22D | THE MINIMUM PERCENTAGE DISCOUNT APPLIED TO FAP ELIGIBLE INDIVIDUALS SHALL BE CALCULATED ON AN ANNUAL BASIS. AMOUNTS GENERALLY BILLED IS DETERMINED BY DIVIDING THE SUM OF CLAIMS PAID THE PREVIOUS FISCAL YEAR BY MEDICARE FEE- FOR-SERVICE AND ALL PRIVATE HEALTH INSURANCE, INCLUDING PAYMENTS RECEIVED FROM BENEFICIARIES AND INSURED PATIENTS, BY THE SUM OF THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| PHOEBE SUMTER HOSPICE | ||||
| 126 HWY 280 WEST | AMERICUS | GA | 31719 | HOSPICE |
| ELLAVILLE PRIMARY MEDICINE | ||||
| 72 BROAD STREET | ELLAVILLE | GA | 31806 | RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 65,300,165 ADD: EXPENSES REPORTED IN PART VIII 31,414 DENOMINATOR FOR COLUMN (F) 65,331,579 |
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | THE COST OF MEDICAID AND CHARITY CARE WAS CALCULATED USING THE COST-TO- CHARGE RATIO AS CALCULATED USING WORKSHEET 2 FROM THE IRS FORM 990 INSTRUCTIONS. THE COST OF OTHER BENEFITS WAS THE DIRECT COST OF THE SERVICES. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | AMOUNTS INCLUDED 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 8 AND 9 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 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-SUMTER-MEDICAL-CENTER/PHOEBE- SUMTER-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 | PSMC IS LOCATED IN SUMTER COUNTY, GEORGIA. THERE ARE APPROXIMATELY 32,819 RESIDENTS OF SUMTER COUNTY WITH A RACIAL MIX OF 52% AFRICAN AMERICAN AND 42% WHITE. POPULATION PROJECTIONS FOR SUMTER COUNTY SHOW OVERALL POPULATION LOSS IN THE NEXT FEW YEARS, WITH AGES 65+ HAVING THE GREATEST GROWTH RATE. THE HOUSEHOLD MEDIAN INCOME FOR SUMTER COUNTY AVERAGED 32,430 IN 2010, AND ABOUT 21.7% OF FAMILIES AND 26.9% OF THE POPULATION WERE BELOW THE POVERTY LINE. IN ADDITION TO SUMTER COUNTY, PSMC HAS A SERVICE AREA THAT INCLUDES MARION, MACON, DOOLY, STEWART, WEBSTER, SCHLEY AND TAYLOR COUNTIES. PSMC HAS A GOOD RELATIONSHIP WITH THESE COUNTIES, AND IMPLEMENTED A REGIONAL ADVISORY COUNCIL IN 2015 TO BETTER SERVE THE NEEDS OF THESE COMMUNITIES AND THEREFORE PRACTICE A TRUE POPULATION HEALTH METHODOLOGY. |
| 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. SUMTER REGIONAL HOSPITAL FOUNDATION, INC. WAS ESTABLISHED TO RAISE FUNDS TO SUPPORT PSMC. SUMTER REGIONAL HOSPITAL FOUNDATION, INC.'S BYLAWS PROVIDE THAT THE MAJORITY OF ALL FUNDS RAISED, EXCEPT FOR FUNDS ACQUIRED FOR THE OPERATION OF THE FOUNDATION, BE DISTRIBUTED TO OR BE HELD FOR THE BENEFIT OF THE HOSPITAL. |
| PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT | GEORGIA |
| ADDITIONAL INFORMATION | PHOEBE SUMTER MEDICAL CENTER, INC. (PSMC), FORMERLY SUMTER REGIONAL HOSPITAL, IS A NOT-FOR-PROFIT HEALTH CARE ORGANIZATION THAT EXISTS TO SERVE THE COMMUNITY. PSMC OPENED IN 1953 TO SERVE THE COMMUNITY BY CARING FOR THE SICK REGARDLESS OF THEIR ABILITY TO PAY. AS A NOT-FOR-PROFIT HOSPITAL, PSMC HAS NO STOCKHOLDERS OR OWNERS. ALL REVENUE AFTER EXPENSES IS REINVESTED IN THE MISSION TO CARE FOR THE CITIZENS OF THE COMMUNITY - INTO CLINICAL CARE, HEALTH PROGRAMS, STATE-OF-THE-ART TECHNOLOGY AND FACILITIES, RESEARCH, AND TEACHING AND TRAINING OF MEDICAL PROFESSIONALS NOW AND FOR THE FUTURE. PSMC OPERATES AS A CHARITABLE ORGANIZATION CONSISTENT WITH THE REQUIREMENTS OF INTERNAL REVENUE CODE SECTION 501(C)(3) AND THE "COMMUNITY BENEFIT STANDARD" OF IRS REVENUE RULING 69-545. PSMC TAKES SERIOUSLY ITS RESPONSIBILITY AS THE COMMUNITY'S SAFETY NET HOSPITAL AND HAS A STRONG RECORD OF MEETING AND EXCEEDING THE CHARITABLE CARE AND THE ORGANIZATIONAL AND OPERATIONAL STANDARDS REQUIRED FOR FEDERAL TAX-EXEMPT STATUS. PSMC DEMONSTRATES A CONTINUED AND EXPANDING COMMITMENT TO MEETING ITS MISSION AND SERVING THE CITIZENS BY PROVIDING COMMUNITY BENEFITS. A COMMUNITY BENEFIT IS A PLANNED, MANAGED, ORGANIZED, AND MEASURED APPROACH TO MEETING IDENTIFIED COMMUNITY HEALTH NEEDS, REQUIRING A PARTNERSHIP BETWEEN THE HEALTHCARE ORGANIZATION AND THE COMMUNITY TO BENEFIT RESIDENTS THROUGH PROGRAMS AND SERVICES THAT IMPROVE HEALTH STATUS AND QUALITY OF LIFE. PSMC IMPROVES THE HEALTH AND WELLBEING OF SOUTHWEST GEORGIA THROUGH CLINICAL SERVICES, EDUCATION, RESEARCH, AND PARTNERSHIPS THAT BUILD HEALTH CAPACITY IN THE COMMUNITY. PSMC PROVIDES COMMUNITY BENEFITS FOR ALL CITIZENS AS WELL AS FOR THE MEDICALLY UNDERSERVED. PSMC CONDUCTS COMMUNITY NEEDS ASSESSMENTS AND PAYS CLOSE ATTENTION TO THE NEEDS OF LOW INCOME AND OTHER VULNERABLE PERSONS AND THE COMMUNITY AT LARGE. PSMC OFTEN WORKS WITH COMMUNITY GROUPS TO IDENTIFY NEEDS, STRENGTHEN EXISTING COMMUNITY PROGRAMS, AND PLAN NEWLY NEEDED SERVICES. IT PROVIDES A WIDE- RANGING ARRAY OF COMMUNITY BENEFIT SERVICES DESIGNED TO IMPROVE COMMUNITY HEALTH AND THE HEALTH OF INDIVIDUALS AND TO INCREASE ACCESS TO HEALTH CARE, IN ADDITION TO PROVIDING FREE AND DISCOUNTED SERVICES TO PEOPLE WHO ARE UNINSURED AND UNDERINSURED. DRAWING ON A DYNAMIC AND FLEXIBLE STRUCTURE, THE COMMUNITY BENEFIT PROGRAMS ARE DESIGNED TO RESPOND TO ASSESSED NEEDS AND ARE FOCUSED ON UPSTREAM PREVENTION. PSMC PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS AND IS ONE OF THE LEADING PROVIDERS OF MEDICAID SERVICES IN GEORGIA. THE FOLLOWING TABLE SUMMARIZES THE AMOUNTS OF CHARGES FOREGONE (I.E., CONTRACTUAL ADJUSTMENTS) AND ESTIMATES THE LOSSES INCURRED BY PSMC DUE TO INADEQUATE PAYMENTS BY THESE PROGRAMS AND FOR INDIGENT/CHARITY SERVICES. THIS TABLE DOES NOT INCLUDE DISCOUNTS OFFERED BY PSMC UNDER MANAGED CARE AND OTHER AGREEMENTS: CHARGES ESTIMATED FOREGONE UNREIMBURSED COST MEDICARE 81,000,000 23,000,000 MEDICAID 29,000,000 8,000,000 INDIGENT/CHARITY 6,000,000 2,000,000 116,000,000 33,000,000 THE FOLLOWING IS A SUMMARY OF THE COMMUNITY BENEFIT ACTIVITIES AND HEALTH IMPROVEMENT SERVICES OFFERED BY PSMC AND ILLUSTRATES THE ACTIVITIES AND DONATIONS DURING FISCAL YEAR 2016. I. COMMUNITY HEALTH IMPROVEMENT SERVICES A. COMMUNITY HEALTH EDUCATION MEN'S HEALTH CONFERENCES PSMC HELD THE 6TH ANNUAL MEN'S HEALTH CONFERENCE ON SEPTEMBER 19, 2015 THAT PROVIDED HEALTH SCREENINGS FOR PSA, CHOLESTEROL, BLOOD PRESSURE, HEARING AND VISION, HEALTH INFORMATION, SPEAKERS, AND FELLOWSHIP TO MORE THAN 200 ATTENDEES. THE HEALTH CONFERENCE PROGRAMS PROVIDE OUTREACH, HEALTH SCREENINGS, EDUCATIONAL PROGRAMS, AND HEALTH CONFERENCES AND EVENTS. THESE PROGRAMS TARGET MEN AT RISK OF POOR HEALTH STATUS. THE PROGRAMS TARGET UNINSURED OR UNDERINSURED MEN WITHOUT A PRIMARY CARE PHYSICIAN OR KNOWLEDGE OF RECOMMENDED PREVENTIVE HEALTH CARE SERVICES. PSMC INCURRED EXPENSES OF 11,228 FOR THIS EVENT. WOMEN'S HEALTH CONFERENCES PSMC HELD ITS ANNUAL WOMEN'S HEALTH CONFERENCE ON MAY 14, 2016 THAT PROVIDED SCREENINGS FOR GLUCOSE AND CHOLESTEROL, BLOOD PRESSURE, HEARING AND VISION, HEALTH INFORMATION, SPEAKERS AND FELLOWSHIP FOR MORE THAN 200 ATTENDEES. THE HEALTH CONFERENCE PROGRAMS PROVIDE OUTREACH, HEALTH SCREENINGS, EDUCATIONAL PROGRAMS, AND HEALTH CONFERENCES AND EVENTS. THESE PROGRAMS TARGET WOMEN AT RISK OF POOR HEALTH STATUS. THE PROGRAMS TARGET UNINSURED OR UNDERINSURED WOMEN WITHOUT A PRIMARY CARE PHYSICIAN OR KNOWLEDGE OF RECOMMENDED PREVENTIVE HEALTH CARE SERVICES. PSMC INCURRED EXPENSES OF 7,228 FOR THIS EVENT. B. COMMUNITY BASED CLINICAL SERVICES FLU SHOTS AND HEALTH SCREENINGS PSMC PROVIDES FREE FLU SHOTS TO VOLUNTEERS AND STUDENTS. IN 2016, PSMC ADMINISTERED 1,080 FLU SHOTS AT AN UNREIMBURSED COST OF 16,524. SCHOOL NURSE PROGRAM PSMC PROVIDES A NURSE AND TWO TECHS IN THE SUMTER COUNTY SCHOOL SYSTEM. DURING THE 2015/2016 SCHOOL YEAR, THE SCHOOL NURSE PROGRAM HAD 15,321 CLINIC VISITS AND ADMINISTERED 33,170 DOSES OF MEDICATION AT A COST OF 94,796. C. HEALTH CARE SUPPORT SERVICES INDIGENT FINANCIAL ASSISTANCE PATIENTS WHOSE HOUSEHOLD INCOME IS AT OR BELOW 125% OF THE FEDERAL POVERTY GUIDELINES ARE CLASSIFIED AS INDIGENT AND ARE ELIGIBLE FOR FREE CARE AS PROVIDED IN THE FINANCIAL ASSISTANCE POLICY. CHARITY FINANCIAL ASSISTANCE PATIENTS WHOSE HOUSEHOLD INCOME IS BETWEEN 126% - 200% OF THE FEDERAL POVERTY GUIDELINES QUALIFY FOR DISCOUNTED CHARGES FOR CARE BASED ON A SLIDING SCHEDULE IN THE FINANCIAL ASSISTANCE POLICY. CATASTROPHIC FINANCIAL ASSISTANCE PATIENTS WHOSE INCOME EXCEEDS 200% OF THE FEDERAL POVERTY GUIDELINES, AND WHOSE BALANCE OWED EXCEED 25% OF THEIR ANNUAL INCOME, RESULTING IN EXCESSIVE HARDSHIP, QUALIFY FOR DISCOUNTED CHARGES ON A SLIDING SCALE BASIS RANGING FROM 89% TO 60% BASED ON INCOME AND NUMBER OF DEPENDENTS. TERMS AND CONDITIONS ARE DETAILED IN THE FINANCIAL ASSISTANCE POLICY. II. HEALTH PROFESSIONS EDUCATION PSMC RECOGNIZES THAT TO CONTINUOUSLY IMPROVE THE ORGANIZATION'S LONG-TERM VALUE TO OUR COMMUNITY AND OUR CUSTOMERS, TO ENCOURAGE LIFE-LONG LEARNING AMONG EMPLOYEES AND TO ACHIEVE A WORLD-CLASS EMPLOYER STATUS, IT IS IN THE ORGANIZATION'S BEST INTEREST TO PROVIDE OPPORTUNITIES THAT WILL ASSIST ELIGIBLE EMPLOYEES IN PURSUING FORMAL, HEALTHCARE RELATED EDUCATIONAL OPPORTUNITIES. IN FISCAL YEAR 2016, PSMC PROVIDED CLINICAL SUPERVISION AND TRAINING TO NURSING STUDENTS. APPROXIMATELY 74 STUDENTS RECEIVED CLINICAL INSTRUCTION FROM OUR FACILITY. III. COMMUNITY BENEFIT OPERATIONS PSMC INCURRED 63,378 IN SUPPORT STAFF COSTS TO SUPPORT ITS COMMUNITY BENEFIT EFFORTS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOEL WERNICK | |||||||||||||
| BD MEMBER/PPHS CEO | $784,703 | $227,910 | $10,493 | $1,149,207 | $16,961 | $2,189,274 | |||||||
| JOE AUSTIN | |||||||||||||
| BD MEMBER/PPHS COO | $459,214 | $111,249 | $277,708 | $160,561 | $20,370 | $1,029,102 | $274,470 | ||||||
| BRIAN CHURCH | |||||||||||||
| BD MEMBER/PPHS CFO | $244,907 | $23,529 | $219 | $4,769 | $14,156 | $287,580 | |||||||
| BRANDI LUNNEBORG | |||||||||||||
| CEO | $219,523 | $42,975 | $18,890 | $2,017 | $15,140 | $298,545 | |||||||
| DEBORAH MCWILLIAMS | |||||||||||||
| RN | $159,773 | $789 | $464 | $3,128 | $164,154 | ||||||||
| DARRYL HAWKINS | |||||||||||||
| PHARMACY DIRECTOR | $12,648 | $12,648 | $134,852 | $665 | $260 | $2,466 | $157,014 | $18,771 | |||||
| LORI PAYNE | |||||||||||||
| PHARMACIST | $600 | $600 | $133,068 | $1,178 | $116 | $1,259 | $151,603 | $15,982 | |||||
| KERRY LOUDERMILK | |||||||||||||
| FORMER PPHS CFO | $243,688 | $100,599 | $568,194 | $5,393 | $13,240 | $931,114 | |||||||
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 3 | NONE OF THE INDIVIDUAL BOARD MEMBERS OR OFFICERS ARE COMPENSATED BY THE FILING ORGANIZATION AND THE ORGANIZATION MUST RELY 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 1,094,723 0 JOE AUSTIN 0 154,899 0 KERRY LOUDERMILK 558,324 0 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. THE PURPOSE OF THE SERP IS TO PROVIDE A RETIREMENT BENEFIT FOR AFFECTED EXECUTIVES CONSISTENT WITH THE BENEFIT AVAILABLE TO EMPLOYEES NOT IMPACTED BY IRS COMPENSATION LIMITS ON DEFINED BENEFIT PLANS. THE SERP BENEFITS FOR ELIGIBLE EMPLOYEES ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. THE AMOUNTS REPORTED AS SUPPLEMENTAL EXECUTIVE RETIREMENT COMPENSATION FOR ELIGIBLE EMPLOYEES REPRESENT CREDITED, BUT NOT VESTED, RETIREMENT 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. PRIOR TO NORMAL RETIREMENT AGE, PPHS RETAINS AT LEAST TWO YEARS OF BENEFITS WHICH ARE SUBJECT TO CONTINUING EMPLOYMENT FOR THE PARTICIPANT TO RECEIVE THE FUNDS AT THE NEXT VESTING DATE. THE PLAN IS A DEFINED CONTRIBUTION ACCOUNT BASED AND PARTICIPANT DIRECTED INVESTMENT PROGRAM THAT IS EMPLOYER FUNDED. A SUBSTANTIAL PORTION OF THE AMOUNTS REPORTED IN COLUMN C OF SCHEDULE J, PART II (RETIREMENT AND OTHER DEFERRED COMPENSATION) ARE THE CURRENT YEAR DEFERRALS FOR ELIGIBLE PARTICIPANTS IN THE SERP. THE CURRENT YEAR DEFERRALS ARE REPORTED IN THE PART I, LINE 4 TABLE ABOVE. A PARTICIPANT'S FIRST VESTING DATE WILL OCCUR ON THE DATE THE PARTICIPANT ATTAINS FIVE YEARS OF PARTICIPATION UNDER THE PLAN. IF AN 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 2015 CALENDAR YEAR. JOE AUSTIN 274,470 (PARTIAL VESTING - MULTI-YEAR VESTED AMOUNT) 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. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHERN PATHOLOGY AND LABORATORY | BusinessNameLine1Txt |
| Business Name Line2 | SERVICES PC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | CONTROL ENTITY | RelationshipDescriptionTxt |
| Transaction | $120,000 | TransactionAmt |
| Transaction | LAB DIRECTOR FEE | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V | FormAndLineReferenceDesc |
| Explanation | SANDRA ZORNES, M.D. IS A BOARD MEMBER AND THE LAB DIRECTOR OF THE FILING ORGANIZATION. DR. ZORNES IS ALSO THE OWNER OF SOUTHERN PATHOLOGY AND LABORATORY SERVICES, P.C. THE FILING ORGANIZATION CONTRACTS WITH SOUTHERN PATHOLOGY AND LABORATORY SERVICES, P.C. FOR DR. ZORNES' SERVICES AS LAB DIRECTOR. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 6 | THE SOLE MEMBER OF PHOEBE SUMTER 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 SUMTER MEDICAL CENTER, INC. (PSMC) 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 PSMC 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 | PURCHASED SERVICES 3,684,548 4,580,157 0 PHYSICIAN FEES 5,587,677 0 0 CONTRACT LABOR 4,783,025 7,930 0 COLLECTION FEES 0 353,921 0 |
| FORM 990, PART XI, LINE 9 | INTEREST IN NET ASSETS OF SUMTER FOUNDATION 78,299 TOTAL 78,299 THE NET INCREASE IN NET ASSETS IS DUE TO THE AMOUNT DETAILED ABOVE. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Business Name Line2DisregardedEntityName/BusinessNameLine2Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| PHOEBE PUTNEY HEALTH SYSTEMS INC | |||||||||||
| PO BOX 3770 | ALBANY | GA | 317063770 | 582001014 | HEALTHCARE | GA | 501C3 | 11C | NA | false | |
| PHOEBE PHYSICIAN GROUP INC | |||||||||||
| PO BOX 3770 | ALBANY | GA | 317063770 | 263792403 | HEALTHCARE | GA | 501C3 | 9 | PPHS | false | |
| SUMTER REGIONAL HOSPITAL FOUNDATION | |||||||||||
| 126 HIGHWAY 280 WEST | AMERICUS | GA | 317198645 | 581607727 | FOUNDATION | GA | 501C3 | 11A | PSMC | Yes (true) | INC |
| PHOEBE PUTNEY MEMORIAL HOSPITAL INC | |||||||||||
| PO BOX 3770 | ALBANY | GA | 317063770 | 581928247 | HEALTHCARE | GA | 501C3 | 3 | PPHS | false | |
| PHOEBE WORTH MEDICAL CENTER INC | |||||||||||
| PO BOX 545 | SYLVESTER | GA | 317910545 | 383647394 | HEALTHCARE | GA | 501C3 | 3 | PPHS | false | |
| SOUTH GEORGIA SHARED SERVICES INC | |||||||||||
| 417 WEST THIRD AVENUE | ALBANY | GA | 317011943 | 462746977 | COOPERATIV | GA | 501C3 | 3 | PPHS | false | |
| PHOEBE FOUNDATION INC | |||||||||||
| PO BOX 3770 | ALBANY | GA | 317063770 | 581847104 | FOUNDATION | GA | 501C3 | 11A | PPHS | false | |
| PHOEBE DORMINY MEDICAL CENTER INC | |||||||||||
| PO BOX 3770 | ALBANY | GA | 317063770 | 452041878 | HEALTHCARE | GA | 501C3 | 3 | PPHS | false | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHOEBE PUTNEY HEALTH VENTURES INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3770 | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317063770 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581963401 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUMTER REGIONAL HOSPITAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | N | TransactionTypeTxt |
| Method Of Amount Determination | VALUE UNDETERMINED | MethodOfAmountDeterminationTxt |
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