PHOEBE WORTH MEDICAL CENTER INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- PHOEBE WORTH MEDICAL CENTER INC (EIN 38-3647394)
- Tax period
- 2014-08-01 to 2015-07-31
- Filed
- 2016-05-02
- IRS object ID
- 201611239349300141
- Schema version
- 2014v6.0
- 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 B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-02T10:35:13-05:00 | ReturnTs |
| Tax Period End | 2015-07-31 | 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 | 31708 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-08-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383647394 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHOEBE WORTH MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PHOE | BusinessNameControlTxt |
| Phone | 2297766961 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 807 SOUTH ISABELLAPO BOX 545 | AddressLine1Txt |
| City | SYLVESTER | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317910545 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRIAN CHURCH | PersonNm |
| Person Title | PPHS CFO | PersonTitleTxt |
| Phone | 2297766961 | PhoneNum |
| Signature | 2016-04-29 | 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 | 2016-05-02 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KIM GILMAN CEO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 545 | AddressLine1Txt |
| City | SYLVESTER | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317910545 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,484,839 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PHOEBEPUTNEY.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2002 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDING CHARITABLE HEALTHCARE ACTIVITIES | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 243 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $468,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $475,353 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,764,102 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $14,550,480 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$20,353 | PYInvestmentIncomeAmt |
| CY Investment Income | $7,024 | CYInvestmentIncomeAmt |
| PY Other Revenue | $600,104 | PYOtherRevenueAmt |
| CY Other Revenue | $434,787 | CYOtherRevenueAmt |
| PY Total Revenue | $14,811,853 | PYTotalRevenueAmt |
| CY Total Revenue | $15,467,644 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $50,869 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $45,619 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,050,841 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,252,536 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,716,588 | PYOtherExpensesAmt |
| CY Other Expenses | $8,491,356 | CYOtherExpensesAmt |
| PY Total Expenses | $15,818,298 | PYTotalExpensesAmt |
| CY Total Expenses | $15,789,511 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,006,445 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$321,867 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $9,596,180 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,957,980 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $13,852,329 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $13,535,996 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$4,256,149 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$4,578,016 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDING CHARITABLE HEALTHCARE ACTIVITIES | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $13,036,704 | ExpenseAmt |
| Grant | $45,619 | GrantAmt |
| Revenue | $14,793,116 | RevenueAmt |
| Desc | TO BE THE LEADING PROVIDER OF QUALITY, COST EFFECTIVE, PATIENT-CENTERED HEALTH CARE SERVICES TO ALL RESIDENTS OF SOUTHWEST GEORGIA. PWMC PURSUES ITS MISSION THROUGH A PATIENT-CENTERED ENVIRONMENT OF CARE REFLECTING HIGH STANDARDS AND PROMOTING A BALANCE OF PROFESSIONAL PREPARATION AND SERVICE, CONTINUOUS IMPROVEMENT BASED ON OUR CORE VALUES OF PEOPLE, RELATIONSHIPS, REPUTATION, EXCELLENCE, EFFICIENCY AND COMMITMENT. | Desc |
| Total Program Service Expenses | $13,036,704 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | 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 | false | 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 | Yes (true) | 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 | false | 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 | 22 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 243 | 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | 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 PPHS CFO | 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 (13 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 | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| JOEL WERNICK | ||||||||
| BD MEMBER/PP | 1.00 | 54.00 | Yes (X) | Yes (X) | $0 | $826,090 | $928,219 | |
| JOE AUSTIN | ||||||||
| BD MEMBER/PP | 1.00 | 52.00 | Yes (X) | Yes (X) | $0 | $587,292 | $171,118 | |
| NATU PATEL MD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $9,225 | $0 | |||
| JOHNNY COCHRAN | ||||||||
| VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CHRIS SHIPP | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARY KING GIVENS | ||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WAYNE SENKBEIL | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DON MONK | ||||||||
| CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SHIRLEY THOMAS | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KERRY LOUDERMILK | ||||||||
| PPHS CFO | 1.00 | 54.00 | Yes (X) | $0 | $441,039 | $190,998 | ||
| KIM GILMAN | ||||||||
| CEO | 40.00 | Yes (X) | $0 | $158,129 | $3,696 | |||
| CANDACE GUARNIERI | ||||||||
| CFO | 40.00 | Yes (X) | $0 | $102,944 | $21,031 | |||
| TIM TROTTIER | ||||||||
| SVP REG OPER | 0.00 | 0.00 | $0 | $236,568 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Reportable Comp Rltd Org | $2,361,287 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,315,062 | TotalOtherCompensationAmt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ARAMARK CORPORATION | |||||
| 25271 NETWORK PLACE | CHICAGO | IL | 606731252 | DIETARY SERVICE | $334,345 |
| THE ROSE GROUP | |||||
| 817 NW 56TH TERRACE SUITE A | GAINESVILLE | FL | 326056401 | NURSING SERVICE | $181,626 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $468,000 | GovernmentGrantsAmt |
| All Other Contributions | $7,353 | AllOtherContributionsAmt |
| Total Contributions | $475,353 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $14,550,480 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,550,480 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $14,550,480 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,024 | TotalRevenueColumnAmt |
| Exclusion | $7,024 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $51,660 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $17,195 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $34,465 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,465 | TotalRevenueColumnAmt |
| Exclusion | $34,465 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| EHR REVENUE | 621990 | $238,449 | $238,449 | |
| CAFETERIA | 722513 | $139,351 | $139,351 | |
| MEDICAL RECORDS | 621990 | $11,645 | $11,645 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,877 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,187 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $6,690 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $400,322 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,467,644 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,793,116 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $199,175 | 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 | $45,619 | TotalAmt |
| Program Services | $45,619 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,745,056 | TotalAmt |
| Program Services | $5,061,604 | ProgramServicesAmt |
| Management And General | $683,452 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,197 | TotalAmt |
| Program Services | $82,110 | ProgramServicesAmt |
| Management And General | $11,087 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $977,036 | TotalAmt |
| Program Services | $860,804 | ProgramServicesAmt |
| Management And General | $116,232 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $437,247 | TotalAmt |
| Program Services | $385,231 | ProgramServicesAmt |
| Management And General | $52,016 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $278,793 | TotalAmt |
| Management And General | $278,793 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,998 | TotalAmt |
| Management And General | $62,998 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,396,951 | TotalAmt |
| Program Services | $3,714,632 | ProgramServicesAmt |
| Management And General | $682,319 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,405 | TotalAmt |
| Program Services | $5,089 | ProgramServicesAmt |
| Management And General | $19,316 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,072,675 | TotalAmt |
| Program Services | $993,963 | ProgramServicesAmt |
| Management And General | $78,712 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $326,183 | TotalAmt |
| Program Services | $257,745 | ProgramServicesAmt |
| Management And General | $68,438 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,757 | TotalAmt |
| Program Services | $13,618 | ProgramServicesAmt |
| Management And General | $10,139 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $701,477 | TotalAmt |
| Program Services | $554,296 | ProgramServicesAmt |
| Management And General | $147,181 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $383,214 | TotalAmt |
| Program Services | $43,281 | ProgramServicesAmt |
| Management And General | $339,933 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| REPAIRS & MAINTENANCE | $550,330 | $471,223 | $79,107 |
| MEDICAL SUPPLIES | $447,989 | $447,989 | |
| DUES & SUBSCRIPTIONS | $119,527 | $72,783 | $46,744 |
| MISCELLANEOUS | $103,057 | $26,717 | $76,340 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,789,511 | TotalAmt |
| Program Services | $13,036,704 | ProgramServicesAmt |
| Management And General | $2,752,807 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,206,833 | BOYAmt |
| EOY | $2,453,505 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $388,667 | BOYAmt |
| EOY | $387,841 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,919,257 | BOYAmt |
| EOY | $1,888,121 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $141,742 | BOYAmt |
| EOY | $168,373 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $134,147 | BOYAmt |
| EOY | $98,739 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $10,418,635 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,504,750 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,336,637 | BOYAmt |
| EOY | $3,913,885 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $468,897 | BOYAmt |
| EOY | $47,516 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,596,180 | BOYAmt |
| EOY | $8,957,980 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,008,081 | BOYAmt |
| EOY | $1,972,727 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,844,248 | BOYAmt |
| EOY | $11,563,269 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,852,329 | BOYAmt |
| EOY | $13,535,996 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$4,256,149 | BOYAmt |
| EOY | -$4,578,016 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$4,256,149 | BOYAmt |
| EOY | -$4,578,016 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,596,180 | BOYAmt |
| EOY | $8,957,980 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$321,867 | ReconcilationRevenueExpnssAmt |
| 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 B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $175,676 | OtherCostOrOtherBasisAmt |
| Book Value | $175,676 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,400,413 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,572,363 | DepreciationAmt |
| Book Value | $2,828,050 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,842,546 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,932,387 | DepreciationAmt |
| Book Value | $910,159 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,913,885 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO PHOEBE PUTNEY HEALTH SYSTEM | Desc |
| Amt | $11,563,269 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $11,563,269 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $15,484,839 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $15,484,839 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$17,195 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$17,195 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $15,467,644 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $15,806,706 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $17,195 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $17,195 | ExpensesNotReportedAmt |
| Expenses Subtotal | $15,789,511 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $15,789,511 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 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, 2015 AND 2014 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 4B | RENTAL EXPENSES -17,195 |
| SCHEDULE D, PAGE 4, PART XII, LINE 2D | RENTAL EXPENSES 17,195 |
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 | $1,153,081 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $340,289 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $812,792 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05140 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $900,229 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $588,546 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $311,683 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01970 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,874,727 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,062,484 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $812,243 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05140 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,928,037 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,991,319 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,936,718 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12250 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,857 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,857 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4044 | PersonsServedCnt |
| Total Community Benefit Expns | $3,771,169 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,494,736 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $276,433 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01750 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $47,619 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $47,619 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4044 | PersonsServedCnt |
| Total Community Benefit Expns | $3,822,645 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,494,736 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $327,909 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02070 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4044 | PersonsServedCnt |
| Total Community Benefit Expns | $7,750,682 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,486,055 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,264,627 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14320 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,647,228 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $4,495,215 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $2,931,873 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $1,563,342 | 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 WORTH MEDICAL CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 807 S ISABELLA STREET | AddressLine1Txt |
| City | SYLVESTER | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31791 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PHOEBEPUTNEY.COM | WebsiteAddressTxt |
| State License | 159-603 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | SWB SNF | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHOEBE WORTH 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 | 13 | 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.PHOEBEPUTNEY.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | false | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (true) | 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 |
| 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 | WWWPHOEBEPUTNEYCOM | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWWPHOEBEPUTNEYCOM | FAPAppAvailableOnWebsiteURLTxt |
| 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 |
| 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 |
| 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 (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, PHOEBE WORTH MEDICAL CENTER, INC. - PART V, LINE 5 | THE HOSPITAL'S CHIEF EXECUTIVE OFFICER APPOINTED INDIVIDUALS TO SERVE ON THE CHNA HOSPITAL STEERING COMMITTEE (CHSC). THE CHSC IDENTIFIED COMMUNITY LEADERS, PARTNERS, AND REPRESENTATIVES TO INCLUDE IN THE CHNA PROCESS. INDIVIDUALS, AGENCIES, PARTNERS, POTENTIAL PARTNERS, AND OTHERS WERE REQUESTED TO WORK WITH THE HOSPITAL TO 1) ASSESS THE NEEDS OF THE COMMUNITY, 2) REVIEW AVAILABLE COMMUNITY RESOURCES AND 3) PRIORITIZE THE HEALTH NEEDS OF THE COMMUNITY. GROUPS OR INDIVIDUALS, WHO REPRESENT MEDICALLY-UNDERSERVED POPULATIONS, LOW INCOME POPULATIONS, MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASES, WERE INCLUDED. THE HOSPITAL IDENTIFIED OVER 40 COMMUNITY MEMBERS TO PARTICIPATE IN THE CHNA PROCESS. TWO-HOUR COMMUNITY HEALTH INPUT MEETINGS (COMMUNITY MEETINGS) AND ONE-HOUR COMMUNITY STAKEHOLDER INTERVIEWS (STAKEHOLDER INTERVIEWS) WERE ESSENTIAL PARTS OF THE CHNA PROCESS. TWO COMMUNITY MEETINGS AND FIVE STAKEHOLDER INTERVIEWS WERE CONDUCTED IN ORDER TO OBTAIN THE COMMUNITY'S INPUT INTO THE HEALTH NEEDS OF WORTH COUNTY. EACH COMMUNITY MEETING WAS DRIVEN BY AN AGENDA PLANNED IN ADVANCE. SIGN-IN SHEETS AND EVALUATIONS WERE ALSO USED. THE COMMUNITY HEALTH PROFILE WAS SHARED WITH THE PARTICIPANTS AT EACH MEETING. PARTICIPANTS WERE ASKED ABOUT THEIR OBSERVATIONS ON THE HEALTH DATA PRESENTED IN THE PROFILE. IN ADDITION, PARTICIPANTS WERE REQUESTED TO PROVIDE INPUT AS TO NEEDS THAT MAY NOT HAVE BEEN IDENTIFIED IN THE PROFILE. QUESTIONS AND DISCUSSIONS WERE ENCOURAGED, WITH THE OBJECTIVE THAT PARTICIPANTS WOULD INCREASE THEIR UNDERSTANDING OF WHAT THE DATA MEANT IN TERMS OF THE BURDEN OF CHRONIC DISEASES, THE IMPACT OF THE DEMOGRAPHICS OF THE POPULATION ON HEALTH SERVICES, AND HEALTH STATUS, HEALTH BEHAVIORS, AS WELL AS, ACCESS TO HEALTHCARE. AS THE GROUP DISCUSSED THE HEALTH PROBLEMS OR HEALTH ISSUES, THE FACILITATOR MADE A LIST OF THE HEALTH PROBLEMS THE COMMUNITY PARTICIPANTS INDICATED WERE IMPORTANT. AT THE END OF THE DISCUSSION PRIORITY ISSUES WERE IDENTIFIED. THESE PRIORITIES DID NOT REFLECT PROGRAMS, SERVICES OR APPROACHES TO RESOLVING PROBLEMS, BUT RATHER HEALTH ISSUES TO BE ADDRESSED. COMMUNITY PARTICIPANTS INCLUDED PHYSICIANS AND OTHER MEDICAL PROFESSIONALS; EDUCATORS; ENTREPRENEURS AND OTHER BUSINESSMEN AND WOMEN; PROFESSIONALS; REPRESENTATIVES FROM THE DEPARTMENT OF FAMILY AND CHILDREN SERVICES, HOUSING AUTHORITY, AND THE HEALTH DEPARTMENT. |
| FACILITY 1, PHOEBE WORTH MEDICAL CENTER, INC. - PART V, LINE 11 | THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT AND RELATED IMPLEMENTATION PLAN ARE WIDELY PUBLICIZED ON THE HOSPITAL'S WEBSITE AT HTTP://WWW.PHOEBEPUTNEY.COM/PHOEBE-WORTH-MEDICAL-CENTER/PHOEBE-WORTH- MEDICAL-CENTER-CHNA PROGRESS ON CHNA IMPLEMENTATION STRATEGIES 2014-2015 PRIORITY: ADOLESCENT LIFESTYLE INCLUDING ALCOHOL, TOBACCO AND DRUGS 1. "A NIGHT OUT AGAINST CRIME" IS A COMMUNITY EVENT HELD AND HOSTED BY THE SYLVESTER POLICE DEPARTMENT ON THE FIRST FRIDAY IN AUGUST. THIS ANNUAL EVENT IS AN EFFORT ON THE PART OF LOCAL LAW ENFORCEMENT TO EDUCATE THE COMMUNITY OF CRIME PREVENTION. EACH YEAR, PWMC PARTICIPATES AS A SPONSOR FOR THE EVENT IN THE FORM OF MONETARY DONATIONS. 2. ANNUALLY, PWMC COLLABORATES WITH COUNTY EMS AND HELPS SPONSOR THE FUNCTIONING OF A SAFETY AWARENESS DAY. THIS IS A DAY WHERE OUR COUNTY EMS ALONG WITH OTHER PUBLIC SAFETY GROUPS, PUT ON A FULL-SCALE DISASTER FOR OUR COUNTY'S HIGH SCHOOL KIDS. THE REENACTMENT USES REAL CARS AND KIDS, ACTING AS VICTIMS. THIS YEAR THE EMPHASIS WAS ON DRINKING AND DRIVING, LAST YEAR'S FOCUS WAS MARIJUANA AND DRIVING. THIS IS FULL SCALE ACCIDENT WITH FIRE/RESCUE, POLICE, THE CORONER AND HELICOPTERS. AS PART OF THE PRESENTATION AND IN KEEPING WITH THE FULLNESS OF REALITY, THE CARS ARE CUT OPEN AND KIDS ARE TRANSPORTED AWAY VIA AMBULANCE, CORONER VAN OR HELICOPTER. THE PRESENTATION IS FOLLOWED BY SPEAKING TO THE KIDS ABOUT THESE TYPES OF LIFESTYLE DECISIONS AND THE CONSEQUENCES OF SUCH DECISIONS. PRIORITY: OBESITY AND DIABETES 1. PWMC HOSTED ITS FIRST WOMEN'S HEALTH FAIR ON OCTOBER 25TH. THE FAIR OFFERED OUR COMMUNITY'S LADIES WITH A FREE HEALTH SCREEN, COMPLIMENTARY BREAKFAST AND LUNCH, AN EXERCISE DEMONSTRATION, A NUTRITIONAL DEMONSTRATION, A BREAST SELF-EXAM DEMONSTRATION AND THEN A Q&A SESSION WITH A LOCAL PHYSICIAN SPECIALIZING IN BREAST HEALTH. THE FREE HEALTH SCREENS PROVIDED ACCESS TO MULTIPLE HEALTH FACTORS INCLUDING, BMI, BLOOD PRESSURE, CHOLESTEROL LEVELS, AND BLOOD SUGAR LEVELS. 2. PWMC MAKES ANNUAL CONTRIBUTIONS TO THE WORTH COUNTY HEALTH DEPARTMENT FOR THE OPERATIONS OF THEIR STROKE AND HEART ATTACK PREVENTION PROGRAM (SHAPP) AND DIABETES PROGRAM. OUR ANNUAL CONTRIBUTION OF 45,619 ALLOWS THE HEALTH DEPARTMENT TO PROVIDE PROGRAMS TO EDUCATE, SCREEN AND TREAT LOW- INCOME, UNINSURED, OR UNDERINSURED PATIENTS AGE 18 YEARS OR OLDER WHO ARE DIAGNOSED WITH PRIMARY HYPERTENSION AND/OR DIABETES. PATIENTS ARE PROVIDED ACCESS TO OBTAINING NECESSARY LAB WORK, MEDICATIONS, EXTENSIVE EDUCATION, AND FOLLOW UP. OUR FUNDING ALSO ALLOWS THE PROGRAM TO OFFER 24 HOUR PHONE COVERAGE TO DEAL WITH CRITICAL LABS. PRIORITY: ACCESS TO CARE-PROVIDERS AND PREVENTION 1. DURING THE WINTER OF 2014, PWMC HOSTED AN AFFORDABLE CARE ACT EVENT FOCUSING ON THE HEALTH INSURANCE EXCHANGE - OUR HOSPITAL PARTNERED WITH A FEDERALLY FUNDED TEAM TASKED WITH ENROLLING PEOPLE IN THE HEALTH INSURANCE EXCHANGE FOR A ONE DAY EVENT. AT THE EVENT WE SPOKE WITH OVER 50 ATTENDEES, ASSISTED OVER 20 ATTENDEES, AND ENROLLED 8. WE ALSO OFFERED THE ASSISTANCE OF A STAFF MEMBER AND THE TECHNOLOGY REQUIRED FOR ENROLLING IN THE EXCHANGE AT OUR HOSPITAL 2 DAYS A WEEK FOR SEVERAL MONTHS. 2. THROUGH PWMC'S FINANCIAL ASSISTANCE POLICY, WE OFFER UNINSURED/UNDERINSURED INDIVIDUALS ACCESS TO FINANCIAL ASSISTANCE TO HELP WITH THE COST OF NEEDED MEDICAL SERVICES. BASED ON OUR FINANCIAL ASSISTANCE POLICY GUIDELINES, CERTAIN INDIVIDUALS QUALIFY FOR FREE OR REDUCED COSTS FOR THEIR HEALTHCARE NEEDS. THIS POLICY ALLOWS INDIVIDUALS WHO HAVE DEMONSTRATED THEIR INABILITY TO PAY ACCESS TO NEEDED HEALTHCARE. PRIORITY: MENTAL HEALTH 1. PWMC IS CURRENTLY WORKING ON COMPILING A DRAFT RESOURCE DIRECTORY. OUR PLANS ARE TO CREATE A BOUND DIRECTORY TO PROVIDE TO LOCAL HEALTHCARE FACILITIES FOR DISTRIBUTION TO THE COMMUNITY. PRIORITY: HEART DISEASE AND STROKE 1. FREE BLOOD PRESSURE SCREENINGS WERE OFFERED AT OUR RURAL HEALTH CLINIC ON FEBRUARY 24, 2015 IN HONOR THE AMERICAN HEART MONTH. PRIORITY: SENIOR HEALTH 1. PWMC SEEKS OPPORTUNITIES TO PARTICIPATE IN ACTIVITIES ORGANIZED BY THE LOCAL SENIOR CENTER AND/OR NURSING HOME. ON AUGUST 25TH, THE SENIOR CENTER PROVIDED OUR HOSPITAL WITH AN OPPORTUNITY TO COME SPEAK TO THE SENIORS ABOUT THEIR HEALTHCARE NEEDS. MANY TOPICS AND TIPS WERE COVERED INCLUDING THE IMPORTANCE OF KNOWING THEIR MEDICATIONS, USING THE SAME PHARMACY FOR THEIR MEDICATIONS, WRITING DOWN QUESTIONS BEFORE HAND FOR THEIR DOCTOR VISITS, ETC. PWMC ALSO PROVIDES FUNDING FOR THE SENIOR CENTER BANQUETS AND OTHER ACTIVITIES. NEEDS NOT BEING ADDRESSED: COMMUNITY WORK PLAN FOR ACCESS TO CARE - TRANSPORTATION CHNA PAGE REFERENCE - PAGES 91, 93-94 IT IS BEYOND THE HOSPITAL'S MISSION AND FINANCIAL RESOURCES TO PROVIDE TRANSPORTATION. THE HOSPITAL WILL INCREASE ACCESS TO HEALTH SERVICES BY PROVIDING SCREENINGS AND OTHER FORMS OF PREVENTIVE CARE IN COMMUNITY LOCATIONS OTHER THAN THE HOSPITAL'S MAIN CAMPUS. THE HOSPITAL WILL PROVIDE A COMMUNITY RESOURCE DIRECTORY THAT WILL GUIDE INDIVIDUALS TO TRANSPORTATION SERVICES. |
| FACILITY 1, PHOEBE WORTH MEDICAL CENTER, INC. - PART V, LINE 22D | PWMC DETERMINES THE PATIENT'S ABILITY TO PAY BASED ON THE FINANCIAL ASSISTANCE POLICY (FAP) AND PROVIDES FREE OR DISCOUNTED CARE AS INDICATED. PATIENTS WHO ARE ELIGIBLE FOR THE FAP WILL NOT BE BILLED GROSS CHARGES FOR EMERGENCY AND MEDICALLY NECESSARY CARE. THE CHARGES BILLED FAP-APPROVED PATIENTS WILL BE DISCOUNTED BY A PERCENTAGE DETERMINED IN ACCORDANCE WITH IRS REGULATIONS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHOEBE WORTH FAMILY MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1014 WEST FRANKLIN STREET | AddressLine1Txt |
| City | SYLVESTER | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31791 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | RHC | FacilityTxt |
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 15,789,511 ADD: EXPENSES REPORTED IN PART VIII 17,195 DENOMINATOR FOR COLUMN (F) 15,806,706 |
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | THE COST WAS CALCULATED USING THE COST-TO-CHARGE RATIO AS CALCULATED USING WORKSHEET 2 FROM THE IRS FORM 990 INSTRUCTIONS. THE COST OF ON LINE 7I WAS GENERATED FROM THE ORGANIZATION'S ACCOUNTING RECORDS. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | THE AMOUNTS ON PART III, LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD- PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS APPROXIMATELY 98% OF SELF-PAY ACCOUNTS RECEIVABLE AT JULY 31, 2015 AND 2014. DUE TO AN INCREASE IN SELF-PAY REVENUE, THE HOSPITAL'S SELF-PAY WRITE-OFFS INCREASED 1,402,000 FROM 1,379,000 FOR FISCAL YEAR 2014 TO 2,781,000 FOR FISCAL YEAR 2015. FOR SIMILAR REASONS, THE PROVISION FOR BAD DEBTS INCREASED FROM 3,758,000 IN 2014 TO 5,647,000 IN 2015. |
| 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 2013. THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT AND RELATED IMPLEMENTATION PLAN ARE WIDELY PUBLICIZED ON THE HOSPITAL'S WEBSITE AT HTTP://WWW.PHOEBEPUTNEY.COM/PHOEBE-WORTH-MEDICAL-CENTER/PHOEBE-WORTH- MEDICAL-CENTER-CHNA |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | THE BOARD HAS CLEARLY WRITTEN INDIGENT AND CHARITY CARE POLICIES THAT ARE AVAILABLE ON THE ORGANIZATION 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 INDIGENT AND CHARITY CARE PROGRAMS ARE CONDUCTED DURING PRE-REGISTRATION, THROUGH FLOOR VISITS BY BUSINESS OFFICE REPRESENTATIVES FOR PATIENTS THAT STRESS CONCERN IN MEETING THE FINANCIAL OBLIGATIONS FOR THEIR SERVICES, THROUGH OUR CUSTOMER SERVICE DEPARTMENT, AND THE PHOEBE CARES 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 CHARITY PROGRAM AND ENCOURAGE PATIENTS TO CALL FOR FINANCIAL ASSISTANCE. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | WORTH COUNTY IS LOCATED IN THE SOUTHWESTERN PART OF GEORGIA. THE CITY OF ALBANY IS IN CLOSE PROXIMITY TO THE COUNTY. WORTH COUNTY HAS A TOTAL LAND AREA OF 570 SQUARE MILES. WORTH COUNTY INCLUDES THE CITIES AND TOWNS OF SYLVESTER, POULAN, OAKFIELD, SUMNER, AND WARWICK. THE POPULATION DISTRIBUTION IS 30.8 PERCENT URBAN AND 69.2 PERCENT RURAL. ALMOST ALL OF WORTH COUNTY'S LAND AREA IS RURAL. IN 2010, WORTH COUNTY'S RESIDENT POPULATION WAS 21,630, WHICH WAS A SLIGHT DECREASE FROM 2000. FROM 2010 TO 2015, THE POPULATION IS PREDICTED TO INCREASE BY 2.9 PERCENT. THE POPULATION IS PREDICTED TO INCREASE TO 22,258 IN 2015 AND 22,700 IN 2020. ACCORDING TO THE 2010 CENSUS, 14 PERCENT OF WORTH COUNTY'S POPULATION WAS AGE 65 AND OVER. IN GEORGIA, THE AVERAGE PERCENTAGE OF THE POPULATION AGE 65 OR OLDER WAS 10.7 PERCENT COMPARED TO 13.1 PERCENT FOR THE U.S. POPULATION PROJECTIONS INDICATE THAT THE COUNTY POPULATION WILL INCREASE BY 2.9 PERCENT FROM 2010 TO 2015. ACCORDING TO 2010 U.S. CENSUS RECORDS, WORTH COUNTY'S POPULATION WAS 70.3 PERCENT WHITE, 27.6 PERCENT BLACK, AND 1.5 PERCENT HISPANIC. THE HISPANIC POPULATION, ALTHOUGH SMALL, INCREASED BY 36 PERCENT FROM 2000 TO 2010. MOST OF THE PRIMARY JOBS (6,470) LOCATED WITHIN WORTH COUNTY WERE CENTERED WITHIN THE MOST POPULOUS CITY IN THE COUNTY WHICH IS SYLVESTER. HEALTH CARE AND SOCIAL ASSISTANCE WAS THE MAJOR INDUSTRY SECTOR BY JOB COUNT IN WORTH COUNTY AT 14.4 PERCENT OF THE JOBS. THIS WAS FOLLOWED BY RETAIL (13.4 PERCENT) AND MANUFACTURING (11.2 PERCENT). |
| 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., A NOT-FOR-PROFIT ENTITY, PHOEBE PUTNEY HEALTH VENTURES, INC., A FOR-PROFIT CORPORATION, PHOEBE PHYSICIAN GROUP, INC., A NOT-FOR-PROFIT CORPORATION, PHOEBE WORTH MEDICAL CENTER, INC., A NOT-FOR-PROFIT ENTITY, PHOEBE SUMTER MEDICAL CENTER, INC., A NOT-FOR-PROFIT ENTITY, AND PHOEBE FOUNDATION, INC., A NOT-FOR-PROFIT ENTITY. PHOEBE PUTNEY MEMORIAL HOSPITAL, INC. (PPMH), 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. PHOEBE PUTNEY HEALTH VENTURES, INC. ENGAGES IN HEALTHCARE AND RELATED ACTIVITIES IN FURTHERANCE OF THE EXEMPT PURPOSES OF PPHS AND PPMH. PHOEBE WORTH MEDICAL CENTER, INC. (PWMC), 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. PHOEBE SUMTER MEDICAL CENTER, INC. (PSMC), LOCATED IN AMERICUS, GEORGIA, IS AN ACUTE CARE HOSPITAL. IT PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF SUMTER COUNTY, GEORGIA. PHOEBE PHYSICIAN GROUP, INC. WAS ESTABLISHED TO ORGANIZE AND OPERATE MEDICAL PRACTICES EXCLUSIVELY FOR THE BENEFIT OF PPMH, PWMC, AND PSMC. PHOEBE FOUNDATION, INC. 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 PHOEBE PUTNEY MEMORIAL HOSPITAL, INC. OR THE HOSPITAL AUTHORITY OF ALBANY-DOUGHERTY COUNTY, GEORGIA. |
| PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT | GEORGIA |
| ADDITIONAL INFORMATION | SERVICE TO THE COMMUNITY PHOEBE WORTH MEDICAL CENTER (PWMC) IS A NOT-FOR-PROFIT HEALTH CARE ORGANIZATION THAT EXISTS TO SERVE THE COMMUNITY. PWMC HAS NO STOCKHOLDERS OR OWNERS, AND IS PART OF THE NOT-FOR-PROFIT PHOEBE PUTNEY HEALTH SYSTEM, INC. AFTER OPERATING EXPENSES ARE COVERED, ANY REMAINING REVENUES ARE REINVESTED IN THE OPERATION OF PWMC IN ORDER TO ENHANCE OUR ABILITY TO CARRY OUT OUR LOCAL MISSION OF TAKING CARE OF OUR COMMUNITIES' CITIZENS. IN 2015, PWMC WORKED WITH THE WORTH COUNTY HEALTH DEPARTMENT TO ENABLE THEM TO SUPPORT TWO HEALTH PREVENTION TYPE PROGRAMS. ONE PROGRAM WAS STROKE AND HEART ATTACK PREVENTION (SHAPP), THE SECOND PROGRAM WAS A DIABETES PROGRAM. THE COST TO PWMC WAS 45,619. PWMC PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS WHICH COVER MANY GEORGIAN'S HEALTH CARE NEEDS, AND BY SO DOING, FOREGOES SOME CHARGES AND HAS UNREIMBURSED EXPENSES. CHARGES FOREGONE, DESCRIBED AS CONTRACTUAL ADJUSTMENTS, AND COSTS NOT REIMBURSED, DESCRIBED AS INDIGENT OR CHARITY CARE ARE OUTLINED BELOW. PWMC ALSO OPERATES A RURAL HEALTH CLINIC (RHC) WHICH ALSO FOREGO SOME CHARGES AND HAVE COSTS NOT REIMBURSED THROUGH PATIENTS QUALIFYING FOR THESE SAME INDIGENT AND CHARITY PROGRAMS. THE AMOUNTS LISTED BELOW ARE ALL INCLUSIVE OF BOTH HOSPITAL AND CLINIC ACTIVITIES. ESTIMATED CHARGES UNREIMBURSED FOREGONE COST MEDICARE 7,000,000 3,000,000 MEDICAID 5,000,000 2,000,000 INDIGENT/CHARITY CARE 3,000,000 1,000,000 TOTALS 15,000,000 6,000,000 PATIENTS WHOSE INCOME FALLS BELOW 125% OF FEDERAL POVERTY GUIDELINES ARE ELIGIBLE TO APPLY FOR ASSISTANCE THROUGH THE INDIGENT PROGRAM. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WORTH COUNTY HEALTH DEPARTMENT | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1012 W FRANKLIN STREET | AddressLine1Txt |
| City | SYLVESTER | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 317911978 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 581568404 | RecipientEIN |
| IRC Section | GOV | IRCSectionDesc |
| Cash Grant | $45,619 | CashGrantAmt |
| Purpose Of Grant | SEE PART IV | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | THE WORTH COUNTY HEALTH DEPARTMENT SENDS A LETTER TO PWMC ASKING FOR FINANCIAL ASSISTANCE RELATED TO SPECIFIC PROGRAMS THAT ARE PROVIDED BY THE HEALTH DEPARTMENT. ONCE RECEIVED, PWMC'S BOARD APPROVES THE AMOUNT OF ASSISTANCE TO THE HEALTH DEPARTMENT. THE FUNDS THAT ARE GIVEN TO THE HEALTH DEPARTMENT ARE DEEMED TO BE USED FOR THE SPECIFIC PURPOSES MENTIONED IN THE ORIGINAL LETTER FROM THE HEALTH DEPARTMENT. IN 2015, PWMC WORKED WITH THE HEALTH DEPARTMENT TO ENABLE THEM TO SUPPORT TWO HEALTH PREVENTION TYPE PROGRAMS. ONE PROGRAM WAS STROKE AND HEART ATTACK PREVENTION (SHAPP), THE SECOND PROGRAM WAS A DIABETES PROGRAM. | ExplanationTxt |
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 (5 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt |
|---|---|---|---|---|---|---|
| JOEL WERNICK | ||||||
| BD MEMBER/PPHS CEO | $817,914 | $8,176 | $904,664 | $23,555 | $1,754,309 | |
| JOE AUSTIN | ||||||
| BD MEMBER/PPHS COO | $480,882 | $6,410 | $147,284 | $23,834 | $758,410 | $100,000 |
| KERRY LOUDERMILK | ||||||
| PPHS CFO | $431,048 | $9,991 | $167,309 | $23,689 | $632,037 | |
| KIM GILMAN | ||||||
| CEO | $150,447 | $7,682 | $2,533 | $1,163 | $161,825 | |
| TIM TROTTIER | ||||||
| SVP REG OPERATIONS | $236,568 | $236,568 | ||||
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. THE FILING ORGANIZATION, INSTEAD, RELIES ON THE METHODS USED BY PPHS, THE SOLE MEMBER, TO ESTABLISH COMPENSATION OF THE CEO AND EXECUTIVE OFFICERS. COMPENSATION DETERMINATION BY PPHS INCLUDES AN INDEPENDENT COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT AND SURVEYS, AND BOARD APPROVAL. THESE METHODS ARE WELL DOCUMENTED. |
| SCHEDULE J, PAGE 1, PART I, LINE 4 | JOEL WERNICK 0 851,200 0 JOE AUSTIN 0 126,900 0 KERRY LOUDERMILK 0 131,800 0 TIM TROTTIER 236,568 0 0 |
| SCHEDULE J, PART III | PART I, LINE 4 - DEFERRED COMPENSATION PLAN 457(B) THE DEFERRED COMPENSATION PLAN IS AN ADDITIONAL RETIREMENT PLAN OFFERED THROUGH PHOEBE PUTNEY. THE 457(B) PLAN IS A NON-QUALIFIED RETIREMENT 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, CREATING A RISK OF FORFEITURE SENIOR VICE PRESIDENTS AND ABOVE AND PHYSICIANS MAKING OVER 120,000 ARE ELIGIBLE TO PARTICIPATE IN THE 457(B) PLAN. SCHEDULE J, PART II, COLUMN B(II) CERTAIN EXECUTIVE OFFICERS AND PHYSICIANS ARE ELIGIBLE FOR BONUS/INCENTIVE PAYMENTS. THESE PAYMENTS ARE RELIANT ON VARIOUS ORGANIZATIONAL AND PERSONAL GOALS ESTABLISHED BY A FORMAL PROCESS TO RECOGNIZE PERFORMANCE, AND TO OPERATE IN KEEPING WITH THE ORGANIZATION'S OBLIGATIONS AS A TAX-EXEMPT CHARITABLE ORGANIZATION. SCHEDULE J, PART II, COLUMN C A SUBSTANTIAL PORTION OF THE AMOUNT REPORTED IN COLUMN C OF SCHEDULE J, PART II (RETIREMENT AND OTHER DEFERRED COMPENSATION) FOR EMPLOYEES IDENTIFIED IN THE EXPLANATION ABOVE FOR PART I, LINE 4 IS A SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM. THE PURPOSE OF THE PLAN 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 AMOUNTS REPORTED AS SUPPLEMENTAL EXECUTIVE RETIREMENT COMPENSATION FOR AFFECTED EMPLOYEES REPRESENTS CREDITED, BUT NOT VESTED, RETIREMENT BENEFITS AND IS AVAILABLE IN FUTURE PERIODS TO THE EMPLOYEE SUBJECT TO CONTINUING EMPLOYMENT. PPHS MAINTAINS OWNERSHIP OF THE FUNDS ALLOCATED TO THE PARTICIPANT. PRIOR TO NORMAL RETIREMENT AGE, PPHS RETAINS AT LEAST THREE YEARS OF DEPOSITS WHICH ARE SUBJECT TO CONTINUING EMPLOYMENT FOR THE PARTICIPANT TO RECEIVE THE FUNDS. THIS PLAN IS A DEFINED CONTRIBUTION ACCOUNT BASED AND PARTICIPANT DIRECTED INVESTMENT PROGRAM THAT IS EMPLOYER FUNDED. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 6 | THE SOLE MEMBER OF PHOEBE WORTH MEDICAL CENTER, INC. SHALL BE PHOEBE PUTNEY HEALTH SYSTEM, INC. (PPHS). |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE BOARD OF DIRECTORS OF PPHS, THE SOLE MEMBER, SHALL APPOINT ALL DIRECTORS OF THE FILING ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 7B | THE SOLE MEMBER, PPHS, SHALL HAVE THE FOLLOWING RESPONSIBILITIES: - THE MEMBER SHALL APPOINT OR REMOVE THE ORGANIZATION'S DIRECTORS. - THE MEMBER SHALL SELECT OR REMOVE THE ORGANIZATION'S OFFICERS. - THE MEMBER SHALL APPROVE ALL AMENDMENTS TO THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS BEFORE THEY MAY BECOME EFFECTIVE. - THE MEMBER SHALL APPROVE ANY ANNUAL OPERATING OR CAPITAL BUDGETS. - THE MEMBER SHALL APPOINT OR REMOVE THE INDEPENDENT AUDITORS. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE INDEPENDENT ACCOUNTING FIRM THAT PREPARES THE FORM 990 (BASED UPON INFORMATION PROVIDED BY THE ORGANIZATION) PROVIDES A COMPLETE COPY OF THE RETURN WITH APPLICABLE SCHEDULES TO BE REVIEWED BY MANAGEMENT. MANAGEMENT PERFORMS A DETAILED REVIEW WHICH CONSISTS OF REVIEWING THE FINANCIAL DATA, THE NARRATIVES DISCLOSED, AND OTHER FACTS PRESENTED ON THE RETURN. UPON REVIEW, THE FORM 990 IS THEN FORWARDED TO THE FINANCE COMMITTEE FOR THEIR REVIEW, TO GAIN THEIR COMMENTS AND APPROVAL. UPON APPROVAL FROM THE FINANCE COMMITTEE, THE FORM 990 AND RELATED SCHEDULES ARE PROVIDED TO ALL BOARD MEMBERS FOR REVIEW AND FEEDBACK. ONCE THE FORM 990 IS REVIEWED BY ALL APPLICABLE PARTIES, A COPY OF THE FINAL VERSION IS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ON AN ANNUAL BASIS, PHOEBE WORTH MEDICAL CENTER, INC. (PWMC) BOARD MEMBERS AS WELL AS ALL OFFICERS COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. THIS QUESTIONNAIRE IS ADMINISTERED BY THE PHOEBE PUTNEY HEALTH SYSTEM (PPHS) COMPLIANCE DEPARTMENT AND THE DOCUMENT ASKS EACH INDIVIDUAL TO DISCLOSE ANY PERSONAL, BUSINESS, OR OTHER AFFILIATIONS AND MONETARY AMOUNT IF APPLICABLE THAT THEY OR THEIR IMMEDIATE FAMILY MEMBERS HAVE HAD WITHIN THE PAST 12 MONTHS WITH PWMC OR ANY RELATED ENTITIES. ALL RESPONSES ARE THEN EVALUATED BY THE PPHS COMPLIANCE DEPARTMENT. IN THE CASE OF AN EXISTING CONFLICT, THE INDIVIDUAL WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL TO SUCH TRANSACTIONS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION MAKES AVAILABLE TO THE PUBLIC ITS CONFLICT OF INTEREST AND AUDITED FINANCIAL STATEMENTS ON THE ORGANIZATION'S WEBSITE, BY PROVIDING COPIES UPON REQUEST, AND BY INSPECTION AT THE ADMINISTRATIVE OFFICES OF THE ORGANIZATION. |
| FORM 990, PART IX, LINE 11G | PHYSICIAN FEES 3,405,976 0 0 CONSULTANT FEES 308,656 559,184 0 COLLECTION SERVICES 0 123,135 0 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| PHOEBE PUTNEY HEALTH SYSTEM INC | ||||||||||
| PO BOX 3770 | ALBANY | GA | 317063770 | 582001014 | HEALTHCARE | GA | 501C3 | 11C | NA | false |
| PHOEBE PUTNEY MEMORIAL HOSPITAL INC | ||||||||||
| PO BOX 3770 | ALBANY | GA | 317063770 | 581928247 | HEALTHCARE | GA | 501C3 | 3 | PPHS | false |
| PHOEBE PHYSICIAN GROUP INC | ||||||||||
| PO BOX 3770 | ALBANY | GA | 317063770 | 263792403 | HEALTHCARE | GA | 501C3 | 9 | PPHS | false |
| PHOEBE SUMTER MEDICAL CENTER INC | ||||||||||
| 126 HIGHWAY 280 WEST | AMERICUS | GA | 317198645 | 263975185 | HEALTHCARE | GA | 501C3 | 3 | PPHS | false |
| PHOEBE FOUNDATION INC | ||||||||||
| PO BOX 3770 | ALBANY | GA | 317063770 | 581847104 | FOUNDATION | GA | 501C3 | 11A | PPHS | false |
| SOUTH GEORGIA SHARED SERVICES INC | ||||||||||
| 417 WEST THIRD AVENUE | ALBANY | GA | 317011943 | 462746977 | COOPERATIV | GA | 501C3 | 3 | PPHS | false |
| PHOEBE DORMINY MEDICAL CENTER INC | ||||||||||
| PO BOX 3770 | ALBANY | GA | 317063770 | 452041878 | HEALTHCARE | GA | 501C3 | 3 | PPHS | false |
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 | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |