PIEDMONT HEALTHCARE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
PIEDMONT HEALTHCARE INC (EIN 58-0566213)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-14
IRS object ID
201441349349303219
Schema version
2012v2.3
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-14T11:18:21-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line155 IVAN ALLEN BLVD SUITE 1000AddressLine1
CityATLANTACity
StateGAState
ZIP Code30308ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN580566213EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Piedmont Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% MARIE GAFFNEYInCareOfName
Name ControlPIEDNameControl
Phone4044251303Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11968 PEACHTREE ROAD NWAddressLine1
Address Line2SuiteAddressLine2
CityATLANTACity
StateGAState
ZIP Code30309ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCHARLIE HALLName
TitleTreasurerTitle
Date Signed2014-05-15DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone4048748300Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDr Patrick M BatteyNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11968 PEACHTREE ROAD NWAddressLine1
CityATLANTACity
StateGAState
ZIP Code30309ZIPCode
FieldValueIRS element (for citing)
Gross Receipts833235108GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.PIEDMONT.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1905YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE IN A PROGRESSIVE ENVIRONMENT, GUIDED BY PHYSICIANS, DELIVERED BY EXCEPTIONAL PROFESSIONALS, AND INSPIRED BY THE COMMUNITIES WE SERVE.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees4012TotalNbrEmployees
Total Nbr Volunteers395TotalNbrVolunteers
Total Gross UBI5814166TotalGrossUBI
Net Unrelated Business Txbl Income-3199803NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2206036ContributionsGrantsPriorYear
Contributions Grants Current Year5481947ContributionsGrantsCurrentYear
Program Service Revenue Prior Year719031160ProgramServiceRevenuePriorYear
Program Service Revenue CY768031002ProgramServiceRevenueCY
Investment Income Prior Year22476129InvestmentIncomePriorYear
Investment Income Current Year1029735InvestmentIncomeCurrentYear
Other Revenue Prior Year12336889OtherRevenuePriorYear
Other Revenue Current Year9698892OtherRevenueCurrentYear
Total Revenue Prior Year756050214TotalRevenuePriorYear
Total Revenue Current Year784241576TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year269452GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY367628GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year247684057SalariesEtcPriorYear
Salaries Etc Current Year272221418SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year387630113OtherExpensePriorYear
Other Expenses Current Year479354987OtherExpensesCurrentYear
Total Expenses Prior Year635583622TotalExpensesPriorYear
Total Expenses Current Year751944033TotalExpensesCurrentYear
Revenues Less Expenses Prior Year120466592RevenuesLessExpensesPriorYear
Revenues Less Expenses CY32297543RevenuesLessExpensesCY
Total Assets BOY1973577308TotalAssetsBOY
Total Assets EOY2884534057TotalAssetsEOY
Total Liabilities BOY1397259921TotalLiabilitiesBOY
Total Liabilities EOY2271981101TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY576317387NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY612552956NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE IN A PROGRESSIVE ENVIRONMENT, GUIDED BY PHYSICIANS, DELIVERED BY EXCEPTIONAL PROFESSIONALS, AND INSPIRED BY THE COMMUNITIES WE SERVE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense623071128Expense
Grants367628Grants
Revenue770249209Revenue
DescriptionPIEDMONT HOSPITAL ("PH") IS A 488-BED FACILITY THAT HAS BEEN SERVING THE CITY OF ATLANTA IN FULTON COUNTY, GEORGIA, FOR MORE THAN A CENTURY. OVER 1,000 PRIMARY CARE AND SPECIALTY PHYSICIANS ON THE MEDICAL STAFF MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SENIORS WITHIN THE CITY AND THE GREATER METROPOLITAN ATLANTA MARKET, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY FOR SERVICES. FOR THE YEAR ENDED JUNE 30, 2013, THE HOSPITAL HAD 25,131 IN-PATIENT ADMISSIONS WITH A TOTAL OF 142,610 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 48,524 AND OUTPATIENT VISITS TOTALED 259,151. SURGICAL SERVICES WERE PROVIDED TO 22,763 PATIENTS.Description
Total Program Service Expense623071128TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Info In Schedule O Part VXInfoInScheduleOPartV
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees4012NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMARIE GAFFNEYNamePerson
Telephone Number6788426007TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12727 PACES FERRY RD BLDG 2 STE 70AddressLine1
CityATLANTACity
StateGAState
ZIP Code30339ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Dr Carol T Aitcheson
Board member1.039.0X059053729250
Dr Letha Yurko Griffin
Board member1.00.0X00
Mr Gary T Jones
Board member1.00.0X00
Dr Bryant Wilson
Board Member/Physician6.034.0X7179471367716120
Dr Philip Brachman
Board member1.00.0X00
Mr Shouky Shaheen
Board member1.00.0X00
Dr Patrick M Battey
Board Member1.039.0X051894627685
Mr Leslie A Donahue
President and CEO55.00.0X8635810135729X
Dr Hewitt W Matthews
Board member1.00.0X00
Mr Douglas Stuart
Board Member1.00.0X00
Dr Robert Miller
Board member1.00.0X00
Dr Adrian Douglass
Board Member1.039.0X037578937396
Dr Harry M McFarling III
Chairman/Physician6.02.0X4984012000X
Mr Walter Perrin
Board Member1.00.0X00
Mr William Linginfelter
Board Member1.00.0X00
Mr Charlie Hall
Treasurer1.054.00681955185689X
Mr Jay D Mitchell
Secretary1.054.0059185978751X
Mr Thomas Arnold
CFO54.01.0426559057730X
Dr William Knopf
Chief Operating Officer55.00.01202392022296X
Mr Hildred Robinson
Chief Nursing Officer55.00.0270323019798X
Mr Jyoti Prempeh
VP of Clinical Support Svcs55.00.0211749019031X
Mr Mark Cohen
Chief Quality Officer55.00.0515408027851X
Mr Paul Herd
Medical Director55.00.0242415014240X
Ms Sarah Mullis
Dir. of Pharmacy Utilization55.00.020806208702X
Ms Debbie Gramling
Former Secretary0.055.0015323114589X
Ms Denise Ray
Former Chief Operating Officer0.055.0049650762678X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4062123TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs4134501TotalReportableCompFrmRltdOrgs
Total Other Compensation757535TotalOtherCompensation
Number Individuals GT100 K219NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ALLIANCE LAUNDRY AND TEXTILE SERVIC
7990 Second Flags Drive Suite AAUSTELLGA30168LAUNDRY SERVICES2127432
JACKSON NURSE PROFESSIONALS LLC
PO BOX 404118ATLANTAGA30384NURSE STAFFING1558520
SKANSKA USA BUILDING INC
55 Ivan Allen jr Blvd Ste 600ATLANTAGA30308CONSTRUCTION1258788
TRINITY HEALTHCARE STAFFING GROUP
PO BOX 823473PHILADELPHIAPA19182STAFFING1166045
RADIOLOGY ASSOCIATES OF ATLANTA
1984 PEACHTREE RD STE 505ATLANTAGA30309RADIOLOGY SERVICES1131230
FieldValueIRS element (for citing)
Number Of Contractors GT100 K40NumberOfContractorsGT100K
Government Grants190859GovernmentGrants
All Other Contributions5291088AllOtherContributions
Total Contributions5481947TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
HEALTHCARE SERVICES622110757286357757286357
OUTSIDE LAB62151157078365707836
PARKING8129303329459$3,329,459
OTHER OPERATING REVENUE62199917073501707350
FieldValueIRS element (for citing)
Total Program Service Revenue768031002TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1063178TotalRevenueColumn
Exclusion$1,063,178ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real13587585Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real8039919Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real5547666Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column5547666TotalRevenueColumn
Related Or Exempt Function Income5441336RelatedOrExemptFunctionIncome
Unrelated Business Revenue106330UnrelatedBusinessRevenue

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities40665869Securities
Other254301Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities40283218Securities
Other670395Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities382651Securities
Other-416094Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-33443TotalRevenueColumn
Exclusion-$33,443ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
CAFETERIA7223102609321$2,609,321
FITNESS CENTER713940844706$844,706
COFFEE CART722310158603$158,603

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column538596TotalRevenueColumn
Exclusion$538,596ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue4151226TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column784241576TotalRevenueColumn
Related Or Exempt Function Income764435043RelatedOrExemptFunctionIncome
Unrelated Business Revenue5814166UnrelatedBusinessRevenue
Exclusion$8,510,420ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total188954Total
Program Services188954ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total178674Total
Program Services178674ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2272652Total
Program Services2141065ProgramServices
Management And General131587ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total224645581Total
Program Services211638602ProgramServices
Management And General13006979ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total30654746Total
Program Services28879836ProgramServices
Management And General1774910ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total14648439Total
Program Services13800294ProgramServices
Management And General848145ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1845857Total
Management And General1845857ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total509699Total
Management And General509699ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total134032Total
Program Services134032ProgramServices

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total35830199Total
Program Services33580537ProgramServices
Management And General2249662ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total3765564Total
Management And General3765564ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total30536207Total
Program Services30387502ProgramServices
Management And General148705ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total12451316Total
Program Services9338487ProgramServices
Management And General3112829ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total8921281Total
Program Services7394588ProgramServices
Management And General1526693ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total361607Total
Program Services322248ProgramServices
Management And General39359ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total124335Total
Program Services111729ProgramServices
Management And General12606ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total14689439Total
Management And General14689439ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total62485926Total
Management And General62485926ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total34615832Total
Program Services25961874ProgramServices
Management And General8653958ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total5188532Total
Management And General5188532ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
MEDICAL SUPPLIES AND DRUGS172036336172036336
BAD DEBT EXPENSE5957537959575379
GEORGIA PROVIDER FEE94348849434884
LAB FEES46424244642424

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total22206138Total
Program Services13323683ProgramServices
Management And General8882455ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total751944033Total
Program Services623071128ProgramServices
Management And General128872905ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY223570037BOY
EOY179195524EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1252711BOY
EOY59116EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY107911134BOY
EOY176890266EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY5998619BOY
EOY260170EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY12647625BOY
EOY15107732EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3620797BOY
EOY4905417EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis747456640LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec513513287LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY254027002BOY
EOY233943353EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY414632303BOY
EOY466785381EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY2392130BOY
EOY3022130EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY15761021BOY
EOY15641421EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY931763929BOY
EOY1788723547EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1973577308BOY
EOY2884534057EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY45614594BOY
EOY40071103EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY463905000BOY
EOY455390000EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY72517169BOY
EOY70802103EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY815223158BOY
EOY1705717895EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1397259921BOY
EOY2271981101EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY539592810BOY
EOY573494534EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY14293843BOY
EOY16349828EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY22430734BOY
EOY22708594EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY576317387BOY
EOY612552956EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1973577308BOY
EOY2884534057EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses32297543ReconcilationRevenueExpenses
Reconciliation Unrealized Invest2663356ReconciliationUnrealizedInvest
Reconcilation Prior Adjustment1598438ReconcilationPriorAdjustment
Reconcilation Other Changes-323768ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$134,032DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB134032TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLobbying ActivitiesIdentifier
Return ReferenceSCHEDULE C, PART II-B, LINE 1(G)ReturnReference
ExplanationHEALTH CARE POLICY IS CRITICAL TO ALL AMERICANS, AND PIEDMONT HOSPITAL BELIEVES THAT HEALTH CARE PROVIDERS MUST PARTICIPATE IN SHAPING HEALTH CARE POLICY BY INTERACTING WITH NATIONAL, STATE, AND LOCAL REPRESENTATIVES AND THEIR STAFF MEMBERS TO HELP THEM BETTER UNDERSTAND THE COMPLEXITIES AND RAMIFICATIONS OF KEY HEALTH CARE POLICIES INCLUDING, WITHOUT LIMITATION, THOSE RELATED TO UNINSURED AND INDIGENT PATIENT NEEDS, AS WELL AS THE IMPORTANCE OF ASSURING THE DELIVERY OF COST-EFFICIENT, QUALITY HEALTH CARE. DURING FISCAL YEAR 2013, PIEDMONT HOSPITAL ENGAGED A CONTRACT LOBBYIST TO REPRESENT THE INTERESTS OF PIEDMONT HEALTHCARE (EIN 58-1503902), PIEDMONT HOSPITAL (58-0566213), AND RELATED ENTITIES BEFORE FEDERAL, STATE, AND LOCAL ELECTED OFFICIALS AND REGULATORS.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance370849005BeginningOfYearBalance
Investment Earnings Or Losses13913440InvestmentEarningsOrLosses
Administrative Expenses279622AdministrativeExpenses
End Of Year Balance384482823EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance362297000BeginningOfYearBalance
Investment Earnings Or Losses8173300InvestmentEarningsOrLosses
Administrative Expenses-378705AdministrativeExpenses
End Of Year Balance370849005EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance343861628BeginningOfYearBalance
Investment Earnings Or Losses18073893InvestmentEarningsOrLosses
Administrative Expenses-361479AdministrativeExpenses
End Of Year Balance362297000EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance293945492BeginningOfYearBalance
Investment Earnings Or Losses49633360InvestmentEarningsOrLosses
Administrative Expenses-282776AdministrativeExpenses
End Of Year Balance343861628EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance347223727BeginningOfYearBalance
Contributions149534Contributions
Investment Earnings Or Losses-53718394InvestmentEarningsOrLosses
Administrative Expenses-290625AdministrativeExpenses
End Of Year Balance293945492EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance1.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgstrueEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis11747623OtherCostOrOtherBasis
Book Value11747623BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis453504755OtherCostOrOtherBasis
Depreciation296192911Depreciation
Book Value157311844BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis17667312OtherCostOrOtherBasis
Depreciation1740664Depreciation
Book Value15926648BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis263445911OtherCostOrOtherBasis
Depreciation215579712Depreciation
Book Value47866199BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1091039OtherCostOrOtherBasis
Book Value1091039BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings233943353TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
BENEFICIAL INT IN PERP TRUST8063922
DUE FROM RELATED PARTIES1769852191
UNAMORTIZED LOAN DISCOUNT10807434
FieldValueIRS element (for citing)
Total Book Value Other Assets1788723547TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
DUE TO RELATED PARTIES$1,578,073,981
ACCRUED PENSION COSTS$67,637,999
SELF INSURANCE RESERVES$33,536,029
INTEREST SWAPS$21,644,188
SERP PAYABLE$2,183,549
OTHER DEFERRALS$2,642,149
FieldValueIRS element (for citing)
Total Of Amounts1705717895TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
INTENDED USES FOR ENDOWMENT FUNDSSCHEDULE D, PART V, LINE 4ASSETS LIMITED AS TO USE PRIMARILY INCLUDE ASSETS UNDER INDENTURE AGREEMENTS AND DESIGNATED ASSETS SET ASIDE BY THE BOARD OF DIRECTORS FOR FUTURE CAPITAL ACQUISITIONS. THE BOARD RETAINS CONTROL OF DESIGNATED ASSETS AND MAY AT ITS DISCRETION SUBSEQUENTLY USE THESE ASSETS FOR OTHER PURPOSES.
ASC 740 FOOTNOTE (FKA FIN 48)SCHEDULE D, PART X, LINE 2THE COMPANY ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF THE INCOME TAXES TOPIC OF ASC (ASC 740). UNDER THE REQUIREMENTS OF ASC 740, TAX-EXEMPT ORGANIZATIONS MAY BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2013.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense14086272TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense14086272NetCommunityBenefitExpense
Percent Of Total Expense0.02040PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense21959890TotalCommunityBenefitExpense
Direct Offsetting Revenue16377406DirectOffsettingRevenue
Net Community Benefit Expense5582484NetCommunityBenefitExpense
Percent Of Total Expense0.00810PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense9434884TotalCommunityBenefitExpense
Direct Offsetting Revenue1848166DirectOffsettingRevenue
Net Community Benefit Expense7586718NetCommunityBenefitExpense
Percent Of Total Expense0.01100PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense45481046TotalCommunityBenefitExpense
Direct Offsetting Revenue18225572DirectOffsettingRevenue
Net Community Benefit Expense27255474NetCommunityBenefitExpense
Percent Of Total Expense0.03950PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense374302TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense374302NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense2730749TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense2730749NetCommunityBenefitExpense
Percent Of Total Expense0.00390PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense405859TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense405859NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense1586796TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense1586796NetCommunityBenefitExpense
Percent Of Total Expense0.00230PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense427913TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense427913NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense5525619TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense5525619NetCommunityBenefitExpense
Percent Of Total Expense0.00790PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense51006665TotalCommunityBenefitExpense
Direct Offsetting Revenue18225572DirectOffsettingRevenue
Net Community Benefit Expense32781093NetCommunityBenefitExpense
Percent Of Total Expense0.04740PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense4625TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense4625NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense4625TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense4625NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$59,575,379BadDebtExpenseAmount
Amount Attributable To1787261AmountAttributableTo
Amount Reimbursed By Medicare162228357AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare193597928CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-31369571MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
PIEDMONT ORTHOPAEDIC
Orthopedic Surgery0.150000.85000
Digestive Healthcare
Endo/GI Surgery0.150000.85000
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1PIEDMONT HOSPITAL INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11968 PEACHTREE ROAD NWAddressLine1
CityATLANTACity
StateGAState
ZIP Code30309ZIPCode
FieldValueIRS element (for citing)
Website AddressWWW.PIEDMONT.ORGWebsiteAddress
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PIEDMONT HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Needs Assessment Conducted13NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiesfalseOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Other MethodXOtherMethod
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs AddressedtrueAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent300.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Insurance StatusXInsuranceStatus
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Medicare RateXMedicareRate
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
1. REQUIRED DESCRIPTIONSSCHEDULE H, PART VI, LINE 1PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6A A REPORT ON PIEDMONT HOSPITAL, INC'S ("PH") COMMUNITY BENEFITS IS FOUND WITHIN PIEDMONT HEALTHCARE, INC'S (PIEDMONT HOSPITAL'S SOLE MEMBER) ANNUAL REPORT, WHICH IS WIDELY DISTRIBUTED TO THE PUBLIC BOTH THROUGH PRINTED COPIES MADE AVAILABLE TO COMMUNITY MEMBERS UPON REQUEST AND THROUGH PUBLICATION ON THE PIEDMONT HEALTHCARE WEBSITE. ADDITIONALLY, THE REPORT WAS MAILED TO PH AND PIEDMONT HEALTHCARE BOARD MEMBERS, STATE AND LOCAL ELECTED OFFICIALS, AND OTHER KEY STAKEHOLDERS. PERCENT OF TOTAL EXPENSE SCHEDULE H, PART I, LINE 7(F) THE DENOMINATOR USED FOR THE CALCULATION OF COLUMN (F), PERCENT OF TOTAL EXPENSE, WAS THE AMOUNT OF TOTAL FUNCTIONAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) of $751,944,033, LESS BAD DEBT EXPENSE OF $59,575,379 FROM FORM 990, PART IX, LINE 24(B). FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST SCHEDULE H, PART I, LINE 7 A RATIO OF PATIENT CARE COST TO CHARGES, CONSISTENT WITH WORKSHEET 2, WAS USED TO REPORT THE AMOUNTS IN PART I, LINES 7A-7D. FOR AMOUNTS ON LINES 7E-7K, ACTUAL EXPENSES FOR EACH COMMUNITY BENEFIT ACTIVITY ARE TRACED AND REPORTED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. COMMUNITY BUILDING ACTIVITIES SCHEDULE H, PART II PIEDMONT HOSPITAL PROVIDED EDUCATION AROUND CERTAIN PUBLIC HEALTH ISSUES (E.G. OBESITY) AND PROVIDED SPECIFIC TOOLS TO HELP ENABLE COMMUNITY GROUPS AND COALITIONS TO BEST ADDRESS THOSE ISSUES. THESE TOOLS INCLUDE GENERAL EDUCATIONAL MATERIALS AS WELL AS INFORMATION SPECIFIC TO THE LOCAL COMMUNITY, SUCH AS SUGGESTIONS FOR ACTIVITIES AND ACTIONS THE COMMUNITY COULD UNDERTAKE TO HELP ITS RESIDENTS BECOME MORE ACTIVE AND EMPOWERED IN THEIR HEALTH. BAD DEBT EXPENSE CALCULATION AND FOOTNOTE SCHEDULE H, PART III, LINE 4 BASED ON PRIOR EXPERIENCE AND CERTAIN DEMOGRAPHICS AND OTHER INFORMATION OBTAINED DURING ADMISSION, THE ORGANIZATION BELIEVES A PORTION OF THE BAD DEBT EXPENSES AT COST IS ATTRIBUTABLE TO PATIENTS THAT WOULD OTHERWISE QUALIFY FOR CHARITY CARE. DESPITE ITS BEST EFFORTS TO EDUCATE PATIENTS ABOUT QUALIFYING FOR ITS CHARITY CARE PROGRAM (AS DISCUSSED IN PART IV, QUESTION 3 BELOW), MANY UNINSURED PATIENTS EITHER REFUSE OR FAIL TO COMPLETE A CHARITY CARE APPLICATION OR PROVIDE SUFFICIENT INFORMATION AT THE TIME OF ADMISSION, DURING THEIR STAY, OR AFTER BEING DISCHARGED TO QUALIFY FOR ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. THE AMOUNT REPORTED ON PART III, LINE 3, WAS DETERMINED BY TAKING THE AVERAGE ACCEPTANCE RATE FOR ALL CHARITY CARE APPLICATIONS RECEIVED DURING THE YEAR MULTIPLIED BY THE NUMBER OF DENIALS THAT WERE ATTRIBUTABLE TO INSUFFICIENT INFORMATION. THAT TOTAL WAS THEN ADJUSTED DOWNWARD FOR THE ORGANIZATION'S USE OF PRESUMPTIVE ELIGIBILITY WHEN DETERMINING ITS COMMUNITY BENEFITS. BAD DEBT EXPENSE FOOTNOTE FROM CONSOLIDATED, AUDITED FINANCIAL STATEMENTS: THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYER CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. PH PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE ARE NOT REPORTED AS REVENUE. MEDICARE SHORTFALLS AS COMMUNITY BENEFIT SCHEDULE H, PART III, LINE 8 THE AMOUNT REPORTED ON PART III, SECTION B, LINE 6 WAS CALCULATED IN ACCORDANCE WITH THE SCHEDULE H INSTRUCTIONS AND UTILIZING THE ORGANIZATION'S ALLOWABLE MEDICARE COST AS REPORTED IN THE MEDICARE COST REPORT, WHICH IS BASED ON A COST TO CHARGE RATIO. HOWEVER, THE ALLOWABLE COSTS IN THE MEDICARE COST REPORT DO NOT REFLECT THE ACTUAL COST OF PROVIDING CARE TO PATIENTS SINCE THE MEDICARE COST REPORT EXCLUDES MANY DIRECT PATIENT CARE COSTS THAT ARE ESSENTIAL TO PROVIDING QUALITY HEALTHCARE FOR MEDICARE PATIENTS. FOR EXAMPLE, CERTAIN COVERAGE FEES TO PHYSICIANS, COST OF MEDICARE C AND D, AND OTHER SIMILAR DIRECT PATIENT CARE EXPENSES ARE SPECIFICALLY EXCLUDED FROM ALLOWABLE COST IN THE MEDICARE COST REPORT. THE ORGANIZATION BELIEVES THAT PIEDMONT HOSPITAL'S MEDICARE SHORTFALL REPORTED ON PART III, LINE 7 OF SCHEDULE H, SHOULD BE CONSIDERED A COMMUNITY BENEFIT AS THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO ELDERLY AND MEDICARE PATIENTS. IRS REVENUE RULING 69-545 PROVIDES, IN PART, THAT HOSPITALS SERVING PATIENTS WITH GOVERNMENTAL HEALTH INSURANCE, SUCH AS MEDICARE, IS AN INDICATION THE HOSPITAL OPERATES TO PROMOTE HEALTH IN THE COMMUNITY. ADDITIONALLY, MEDICARE ACCOUNTED FOR 21.26 PERCENT OF PH'S PATIENT SERVICE REVENUE. PH'S POLICY IS TO TREAT MEDICARE PATIENTS, REGARDLESS OF THE EXTENT TO WHICH MEDICARE ACTUALLY PAYS FOR THE TREATMENT. FOR MANY SERVICES, MEDICARE'S REIMBURSEMENT IS LESS THAN THE COST OF THE CARE PROVIDED, RESULTING IN SHORTFALLS THAT ARE TO BE ABSORBED BY THE HOSPITAL IN HONOR OF PH'S COMMITMENT TO TREAT ELDERLY PATIENTS. MANY OF THESE PATIENTS LIVE ON A LOW, FIXED INCOME, AND WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER MEANS-TESTED PROGRAMS, ABSENT THEIR ENROLLMENT IN MEDICARE. COLLECTION PRACTICES SCHEDULE H, PART III, LINE 9(B) INITIAL SCREENINGS OF ALL INPATIENT, EMERGENCY, AND SURGERY ENCOUNTERS, AS WELL AS MOST OUTPATIENT VISITS, ARE CONDUCTED BY FINANCIAL COUNSELORS IN ORDER TO IDENTIFY ANY AVAILABLE INSURANCE OR OTHER COVERAGE FOR EACH PATIENT. COUNSELORS CONTACT PATIENTS AND THEIR FAMILIES DIRECTLY, EITHER IN PERSON OR BY LETTER, TO ASSIST THE FAMILY IN INDENTIFYING ANY PROGRAMS FOR WHICH THE PATIENT/SERVICE MAY QUALIFY (INCLUDING MEDICAID, STATE CHILDREN'S HEALTH INSURANCE PROGRAM ("SCHIP"), PRIVATE OR GOVERNMENT INSURANCE COVERAGE, AND CHARITY ASSISTANCE). IF THE FAMILY CANNOT BE TIMELY LOCATED OR IS UNCOOPERATIVE, RELATED ACCOUNTS ARE TRANSFERRED TO AN INTERNAL COLLECTION DEPARTMENT FOR FURTHER ATTEMPTS TO OBTAIN PAYMENT OR, IF THE PATIENT MAY QUALIFY FOR ASSISTANCE, TO SECURE A FINANCIAL ASSISTANCE APPLICATION. THE ORGANIZATION'S DEBT COLLECTION POLICY AND PROCEDURES PROHIBIT ANY COLLECTION EFFORTS FOR THE PORTION OF A PATIENT ACCOUNT BALANCE THAT QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. COMMUNITY REPRESENTATION SCHEDULE H, PART V, LINE 3 PIEDMONT HOSPITAL'S MOST RECENT CHNA WAS CONDUCTED IN PARTNERSHIP WITH THE HAYSLETT GROUP, THE LEAD CONVENER OF GEORGIA'S PARTNER UP FOR PUBLIC HEALTH CAMPAIGN. THE OVERALL HEALTH NEEDS ASSESSMENT EFFORT WAS LED BY THE PIEDMONT HEALTHCARE COMMUNITY BENEFITS TEAM, AND ASSISTED BY COMMUNITY HEALTH ADVISORS (FOR STAKEHOLDER INTERVIEWS). STAKEHOLDERS WERE CONTINUALLY ENGAGED DURING THIS PROCESS, WITH A PARTICULAR FOCUS ON THOSE GROUPS, ORGANIZATIONS, AND INDIVIDUALS REPRESENTING THE MOST VULNERABLE MEMBERS OF THE HOSPITAL'S COMMUNITY. SPECIFICALLY, PIEDMONT HOSPITAL INTERVIEWED REPRESENTATIVES OF LOCAL AND REGIONAL PUBLIC HEALTH ENTITIES, MINORITY POPULATIONS, THE FAITH-BASED COMMUNITIES, LOCAL BUSINESS OWNERS, THE PHILANTHROPIC COMMUNITY, MENTAL HEALTH AGENCIES, ELECTED OFFICIALS, AND OTHER RELEVANT COMMUNITY STAKEHOLDERS. ADDITIONALLY, THE HOSPITAL CONDUCTED TWO FOCUS GROUPS MADE UP OF LOW-INCOME AND UNINSURED PATIENTS, AS WELL AS CONSUMER AND PATIENT ADVOCATES REPRESENTING A VARIETY OF VULNERABLE PATIENTS. ALL INTERVIEWS, FOCUS GROUPS AND MEETINGS INFORMED THE CHNA PROCESS, INCLUDING THE IDENTIFICATION OF KEY HEALTH PRIORITIES AND DEVELOPMENT OF IMPLEMENTATION PLAN STRATEGIES. PUBLIC AVAILABILITY OF CHNA SCHEDULE H, PART V, LINE 5C IN ADDITION TO MAKING ITS CHNA AVAILABLE ON ITS WEBSITE AND BY REQUEST, PIEDMONT HOSPITAL SENT A COPY TO EACH PARTICIPANT IN THE CHNA (ABOUT 200 PEOPLE), DISTRIBUTED THE ASSESSMENT TO COMMUNITY CENTERS AND OTHER LOCATIONS THAT PRIMARILY SERVE AN UNINSURED POPULATION, SENT A COPY TO LEGISLATIVE AND ELECTED OFFICIALS, AND WIDELY DISTRIBUTED THE ASSESSMENT TO OTHER PIEDMONT HEALTHCARE HOSPITALS.
2. NEEDS ASSESSMENTSCHEDULE H, PART VI, LINE 2DURING FISCAL YEAR 2013, PIEDMONT HOSPITAL CONDUCTED AND RATIFIED A FORMAL NEEDS ASSESSMENT AND IMPLEMENTATION PLAN. THE ASSESSMENT BEGAN WITH A REVIEW OF PUBLICLY AVAILABLE HEALTH AND SOCIOECONOMIC DATA THAT WAS THEN COMPILED AND ANALYZED BY THE HAYSLETT GROUP, THE LEAD CONVENER OF GEORGIA'S PARTNER UP FOR PUBLIC HEALTH CAMPAIGN. THE OVERALL HEALTH NEEDS ASSESSMENT EFFORT WAS LED BY THE PIEDMONT HEALTHCARE COMMUNITY BENEFITS TEAM, AND ASSISTED BY COMMUNITY HEALTH ADVISORS (FOR STAKEHOLDER INTERVIEWS). STAKEHOLDERS WERE CONTINUALLY ENGAGED DURING THIS PROCESS, WITH A PARTICULAR FOCUS ON THOSE GROUPS, ORGANIZATIONS, AND INDIVIDUALS REPRESENTING THE MOST VULNERABLE MEMBERS OF THE HOSPITAL'S COMMUNITY. SPECIFICALLY, PIEDMONT HOSPITAL INTERVIEWED REPRESENTATIVES OF LOCAL AND REGIONAL PUBLIC HEALTH ENTITIES, MINORITY POPULATIONS, THE FAITH-BASED COMMUNITIES, LOCAL BUSINESS OWNERS, THE PHILANTHROPIC COMMUNITY, MENTAL HEALTH AGENCIES, ELECTED OFFICIALS, AND OTHER RELEVANT COMMUNITY STAKEHOLDERS. ADDITIONALLY, THE HOSPITAL CONDUCTED TWO FOCUS GROUPS MADE UP OF LOW-INCOME AND UNINSURED PATIENTS, AS WELL AS CONSUMER AND PATIENT ADVOCATES REPRESENTING A VARIETY OF VULNERABLE PATIENTS. ALL INTERVIEWS, FOCUS GROUPS AND MEETINGS INFORMED THE CHNA PROCESS, INCLUDING THE IDENTIFICATION OF KEY HEALTH PRIORITIES AND DEVELOPMENT OF IMPLEMENTATION PLAN STRATEGIES. THE PIEDMONT HOSPITAL BOARD OF DIRECTORS APPROVED THIS COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN TO ADDRESS IDENTIFIED HEALTH ISSUES ON MAY 21, 2013.
3. PATIENT EDUCATION OF ASSISTANCE ELIGIBILITYSCHEDULE H, PART VI, LINE 3PIEDMONT HEALTHCARE UNDERSTANDS THAT NOT EVERYONE WILL HAVE THE ABILITY TO PAY THEIR HOSPITAL BILL DUE TO THEIR INSURANCE STATUS OR A LIMITED INCOME, AND BECAUSE OF THIS, PIEDMONT HOSPITAL OFFERS FINANCIAL ASSISTANCE TO QUALIFYING PATIENTS. INFORMATION ABOUT AND CONTACT NUMBERS FOR FINANCIAL ASSISTANCE ARE PROVIDED IN NOTICES INSERTED IN PATIENT BILLS AND POSTED IN EMERGENCY ROOMS, IN THE CONDITIONS OF ADMISSION FORM, AT ADMITTING AND REGISTRATION DEPARTMENTS, AT HOSPITAL BUSINESS OFFICES, AT PATIENT FINANCIAL SERVICES OFFICES THAT ARE LOCATED ON FACILITY CAMPUSES, AND AT OTHER PUBLIC PLACES THE HOSPITAL MAY ELECT, INCLUDING LOCAL LOW-COST CLINICS PRIMARILY TREATING UNINSURED POPULATIONS. PIEDMONT HOSPITAL ALSO PUBLISHES AND WIDELY PUBLICIZES A SUMMARY OF THIS FINANCIAL ASSISTANCE CARE POLICY ON ITS FACILITY WEBSITE, WHICH INCLUDES A LINK TO THE FULL POLICY AND APPLICATION. REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY STAFF OR MEDICAL STAFF MEMBER AT THE HOSPITAL, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR FINANCIAL ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS.
4. COMMUNITY INFORMATIONSCHEDULE H, PART VI, LINE 4PIEDMONT HOSPITAL IS LOCATED IN FULTON COUNTY, AND ITS PRIMARY SERVICE COMMUNITIES ARE FULTON COUNTY AND NEARBY DEKALB COUNTY. IN 2012, APPROXIMATELY 1.6 MILLION PEOPLE LIVED IN FULTON AND DEKALB COUNTIES, WITH THE MAJORITY RESIDING IN FULTON. BOTH ARE URBAN COMMUNITIES, AND TOGETHER COMPRISE THE CITY OF ATLANTA. IN BOTH COUNTIES, ABOUT 27 PERCENT OF ADULTS WAS UNINSURED IN 2012, AND OF THOSE INSURED, ABOUT ONE-THIRD RELY ON PUBLIC ASSISTANCE. OF THE PRIVATELY INSURED, AN ESTIMATED ONE-THIRD IS UNDERINSURED. APPROXIMATELY 14 PERCENT OF THE OVERALL ADULT POPULATION IN BOTH COUNTIES REPORTED THEY WERE UNABLE TO SEE A DOCTOR IN 2012 DUE TO COST AND, THAT YEAR, 13 PERCENT REPORTED THEY WERE IN POOR OR FAIR HEALTH, A FIGURE HIGHER THAN THE NATIONAL BENCHMARK OF 10 PERCENT REPORTING THAT LOW LEVEL OF HEALTH. ABOUT 8 PERCENT OF ADULT RESIDENTS IN FULTON COUNTY HAVE BEEN DIAGNOSED WITH DIABETES, WHICH IS AN AMOUNT SLIGHTLY LOWER THAN GEORGIA'S AVERAGE OF 10 PERCENT. VIOLENCE IS A SIGNIFICANT ISSUE IN BOTH FULTON AND DEKALB COUNTIES, WITH RATES THAT THAT SOAR ABOVE BOTH STATE AND NATIONAL BENCHMARKS. IN DEKALB COUNTY, THERE WERE ABOUT 746 VIOLENT CRIME INCIDENTS PER EVERY 100,000 RESIDENTS IN 2012. THAT SAME YEAR, IN FULTON COUNTY, THERE WERE 953 VIOLENT CRIME INCIDENTS PER EVERY 100,000 RESIDENTS, A FIGURE MORE THAN DOUBLE THE STATE AVERAGE AND MORE THAN 13 TIMES THE NATIONAL AVERAGE. THE TEEN BIRTH RATE IN FULTON AND DEKALB COUNTIES IS 47 BIRTHS PER 1,000 TEENAGED WOMEN AND 48 BIRTHS PER 1,000 TEENAGED WOMEN, RESPECTIVELY. COMPARED TO THE NATIONAL AVERAGE OF ONLY 21 BIRTHS PER 1,000 TEENAGED WOMEN, THIS FIGURE IS EXTREMELY HIGH FOR BOTH COUNTIES. ONE IN FIVE ADULTS ARE NOTABLY PHYSICALLY INACTIVE IN BOTH COUNTIES, AND ONE IN FOUR IS OBESE. ACCESS TO HEALTHY FOODS COULD BE AN ISSUE AS ABOUT 7 PERCENT OF FULTON COUNTY'S POPULATION DOES NOT LIVE WITHIN CLOSE PROXIMITY OF A GROCERY STORE THAT SELLS FRESH FRUIT AND VEGETABLES, AND APPROXIMATELY HALF OF THE COUNTY'S RESTAURANTS ARE FAST FOOD ESTABLISHMENTS.
5. PROMOTION OF COMMUNITY HEALTHSCHEDULE H, PART VI, LINE 5PIEDMONT HOSPITAL ACTIVELY PROMOTES THE HEALTH OF ITS COMMUNITY THROUGH COMMUNITY-BASED HEALTH SCREENINGS; EDUCATIONAL ACTIVITIES; THE OPERATION OF A 24-HOUR EMERGENCY DEPARTMENT AVAILABLE TO THE ENTIRE COMMUNITY; THE OPERATION OF AN EMERGENCY ROOM OPEN TO ALL MEMBERS OF THE COMMUNITY WITHOUT REGARD TO ABILITY TO PAY; A GOVERNANCE BOARD COMPOSED OF COMMUNITY MEMBERS; USE OF SURPLUS REVENUE FOR FACILITIES IMPROVEMENT, PATIENT CARE, AND MEDICAL TRAINING, EDUCATION, AND RESEARCH; THE PROVISION OF INPATIENT HOSPITAL CARE FOR ALL PERSONS IN THE COMMUNITY ABLE TO PAY, INCLUDING THOSE COVERED BY MEDICARE AND MEDICAID; AND AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFYING PHYSICIANS.
6. AFFILIATED HEALTH CARE SYSTEMSCHEDULE H, PART VI, LINE 6THE ORGANIZATION IS PART OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM") SERVING THE HEALTHCARE NEEDS OF NORTH GEORGIA AND, SPECIFICALLY, THE METROPOLITAN ATLANTA AREA. THE SYSTEM EXISTS TO PROVIDE PROGRESSIVE HEALTHCARE MARKED BY COMPASSION AND SUSTAINABLE EXCELLENCE TO ALL MEMBERS OF ITS COMMUNITY. COMMUNITY BENEFITS ARE GENERATED THROUGH THE PROVISION OF CHARITY CARE, GOVERNMENT-SPONSORED PROGRAMS (SUCH AS MEDICAID AND MEDICARE), MEDICAL RESEARCH, MEDICAL EDUCATION, COMMUNITY HEALTH IMPROVEMENT SERVICES, DONATIONS TO OTHER NONPROFIT HEALTH CARE PROVIDERS, AND MANY OTHER COMMUNITY SERVICE ACTIVITIES. IN FISCAL YEAR 2013, THE PIEDMONT HEALTHCARE SYSTEM INCLUDED FIVE FULL-SERVICE HOSPITALS, A PHILANTHROPIC FOUNDATION, A CARDIOVASCULAR RESEARCH INSTITUTE, A PHYSICIAN NETWORK, AMBULATORY SURGERY CENTERS, AND OTHER HEALTH CARE PROVIDERS, ALL OF WHICH FALL UNDER THE COMMON CONTROL OF PIEDMONT HEALTHCARE, INC., PIEDMONT HOSPITAL'S SOLE MEMBER. THE SYSTEM'S FIVE HOSPITALS ARE PIEDMONT HOSPITAL, A 488-BED ACUTE TERTIARY CARE FACILITY IN ATLANTA; PIEDMONT FAYETTE HOSPITAL, A 157-BED, ACUTE-CARE COMMUNITY HOSPITAL IN FAYETTEVILLE; PIEDMONT MOUNTAINSIDE HOSPITAL, A 42-BED COMMUNITY HOSPITAL IN JASPER; PIEDMONT NEWNAN HOSPITAL, A 136-BED, ACUTE-CARE COMMUNITY HOSPITAL IN NEWNAN; AND PIEDMONT HENRY HOSPITAL, A 215-BED ACUTE-CARE COMMUNITY HOSPITAL IN STOCKBRIDGE. AS PART OF THE PIEDMONT HEALTHCARE SYSTEM, CERTAIN AFFILIATES MAKE GRANTS AND/OR CONTRIBUTIONS TO OTHER RELATED NONPROFIT AFFILIATES TO HELP FINANCIALLY SUPPORT AND/OR FUND WORTHY COMMUNITY BENEFITS ACTIVITIES.
7. STATE OF FILING OF COMMUNITY BENEFIT REPORTSCHEDULE H, PART VI, LINE 7PIEDMONT HOSPITAL IS NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT; HOWEVER THE HOSPITAL IS REQUIRED TO FILE WITH THE GEORGIA DEPARTMENT OF COMMUNITY HEALTH INFORMATION ON ITS INDIGENT AND CHARITY CARE, AS WELL AS ITS MEDICAID AND MEDICARE SHORTFALLS.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
AMERICAN HEART ASSOCIATION
GREATER SOUTHEAST AFFILIATE PO BOXDES MOINESIA503402900135613797501(c)(3)80000HEART WALK SPONSORSHIP
THE LEUKEMIA & LYMPHOMA SOCIETY
3715 NORTHSIDE PARKWAY BLDG 400 SATLANTAGA30327135644916501(C)(3)15000"LIGHT THE NIGHT" EVENT SPONSORSHIP
CENTRAL ATLANTA PROGRESS INC
50 Hurt PlazaAtlantaGA30303580969893501(c)(4)10000SUPPORT
GEORGE WEST MENTAL HEALTH FOUNDATION
1961 N Druid Hills RdAtlantaGA30329581489941501(c)(3)10000BOL/SPONSORSHIP
GEORGIA ORGANICS INC
200A Ottley DrAtlantaGA30324582345310501(c)(3)7500SPONSORSHIP FARM RX
GEORGIA PROFESSIONALS HEALTH PROGRAM INC
1034 WINDING RIDGE COURTDUNWOODYGA30338274592137501(c)(3)8000SPONSORSHIP
MARCH OF DIMES FOUNDATION
1776 PEACHTREE ST NW STE 100AtlantaGA30309131846366501(c)(3)16500NURSE OF THE YEAR EVENT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants6TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantTuition ReimbursementTypeOfGrant
Number Of Recipients71NumberOfRecipients
Amount Of Cash Grant178674AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierMONITORING THE USE OF GRANT FUNDSIdentifier
Return ReferenceSCHEDULE I, PART I, LINE 2ReturnReference
ExplanationSPONSORSHIPS: MONEY IS GIVEN TO CHARITABLE ORGANIZATIONS WHICH PRIMARILY PROMOTE HEALTH CARE CAUSES. OCCASIONALLY, MONEY IS GIVEN TO CHARITABLE ORGANIZATIONS WHICH ARE NOT HEALTHCARE ORGANIZATIONS. THESE ORGANIZATIONS PROMOTE OTHER WORTHY CAUSES IN THE SURROUNDING COMMUNITY. THE GRANTS ARE ADMINISTERED THROUGH THE ORGANIZATION'S PUBLIC RELATIONS DEPARTMENT. TUITION REIMBURSEMENT: THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT APPROVES REQUESTS FOR TUITION REIMBURSEMENT. IF THERE IS A QUESTION CONCERNING THE JOB RELATEDNESS OF A COURSE, THE DIRECTOR OF HUMAN RESOURCES WILL CONSULT THE EDUCATION DIRECTOR AND THE INDIVIDUAL APPLICANT'S DEPARTMENT DIRECTOR. TOGETHER THEY WILL MAKE A RECOMMENDATION. THE DIRECTOR OF HUMAN RESOURCES WILL HAVE RESPONSIBILITY FOR ASSURING THAT THE TUITION REIMBURSEMENT REQUEST MEETS THE STANDARDS SET FORTH IN THE ORGANIZATION'S TUITION REIMBURSEMENT POLICY STATEMENT. IF THE EMPLOYEE DISAGREES WITH THE DIRECTOR OF HUMAN RESOURCES' EVALUATION, THE EMPLOYEE MAY TAKE THE REQUEST TO HIS/HER ADMINISTRATIVE REPRESENTATIVE. FINAL APPROVAL FOR ELIGIBILITY OF TUITION REIMBURSEMENT RESTS WITH ADMINISTRATION.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelXFirstClassOrCharterTravel
Discretionary Spending AccountXDiscretionarySpendingAccount
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Mr Charlie Hall
Treasurer04193450138502012410801597740259150867644
Dr Carol T Aitcheson
Board member0577988000125490150000142500619787
Dr Bryant Wilson
Board Member/Physician7179454938401338000304930001612071794729797
Mr Thomas Arnold
CFO29377308460504818103870201902804842890
Dr Patrick M Battey
Board Member051362900053170150000126850546631
Mr Leslie A Donahue
President and CEO53203902162120115330010898902674009993100
Dr Adrian Douglass
Board Member0360494028750124200242220131740413185
Dr William Knopf
Chief Operating Officer94954002500000285201500007296012246880
Mr Hildred Robinson
Chief Nursing Officer1942230469980291020113000849802901210
Mr Jay D Mitchell
Secretary040818101343320493460576760210750670610
Mr Jyoti Prempeh
VP of Clinical Support Svcs16248504112308141099390909202307800
Mr Mark Cohen
Chief Quality Officer4550980440630162470243750347605432590
Mr Paul Herd
Medical Director24241500000142400002566550
Ms Sarah Mullis
Dir. of Pharmacy Utilization178392014230015440028980580402167640
Ms Debbie Gramling
Former Secretary0139951092600402002995011594016782000
Ms Denise Ray
Former Chief Operating Officer0340934096161059412043121019557055918500

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
OTHER COMPENSATION ITEMSSCHEDULE J, PART I, LINE 1AEXPENSES FOR FIRST-CLASS TRAVEL ARE PAID ON BEHALF OF CERTAIN EXECUTIVES. THESE ITEMS ARE NOT REPORTED ON THE EMPLOYEE'S FORM W-2, HOWEVER, THE COMPANY IS REIMBURSED FOR ANY PERSONAL EXPENSES INCURRED BY THE EMPLOYEE. THE FOLLOWING EMPLOYEES RECEIVED DISCRETIONARY SPENDING ACCOUNTS IN FIXED AMOUNTS DETERMINED BY JOB LEVEL. THESE SPENDING ACCOUNTS WERE INCLUDED IN EACH EMPLOYEE'S TAXABLE WAGES: CHARLIE HALL LESLIE DONAHUE JAY MITCHELL THOMAS ARNOLD
COMPENSATION OF THE CEO/EXECUTIVE DIRECTORSCHEDULE J, PART I, LINE 3THE COMPENSATION FOR THE PRESIDENT/CEO OF PIEDMONT HOSPITAL IS SET BY THE ENTITY'S PARENT, PIEDMONT HEALTHCARE, INC. PLEASE SEE THE SCHEDULE O NARRATIVE FOR FORM 990, PART VI, SECTION B, LINE 15A & 15B FOR ADDITIONAL INFORMATION.
SUPPLEMENTAL COMPENSATION INFORMATIONSCHEDULE J, PART I, LINES 4BThe following employees participated in a supplemental nonqualified retirement plan, but did not receive current year payments: Charlie Hall Leslie Donahue Jay Mitchell Thomas Arnold Mark Cohen

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
DEVELOPMENT AUTHORITY OF FULTON COUNTY
A581639487359900ZX82009-11-24248554761See Part VI - Supplemental Infofalsefalsefalse
HOSPITAL AUTHORITY OF FAYETTE COUNTY
B58262922331222TAJ22009-11-2479849335See Part VI - Supplemental Infofalsefalsefalse
COWETA COUNTY DEVELOPMENT AUTHORITY
C581057672223658PW92010-10-2799459357Construct and Equip a New Hospitalfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A154900000299999726000721200029999251402009truefalsetruetrue
B1300500007840437100018850007840248602009truefalsetruetrue
C009945935700000099459357002012falsefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropRemedial Action TakenRemedialActionTakenNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
Afalsetruetruetruefalse0falsefalsefalsetrue
Bfalsetruetruetruefalse0falsefalsefalsetrue
Cfalsetruetruetruefalse0falsefalsefalsetrue

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Gross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
0
Afalsetruefalsefalsetruefalsefalse0falsetrue
0
Bfalsetruefalsefalsetruefalsefalse0falsetrue
0
Cfalsetruefalsefalsefalsefalsefalse0falsetrue

Form990 Schedule K Part V Form990ScheduleKPartV (3 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
Atrue
Btrue
Ctrue

Form990 Schedule K Part VI Form990ScheduleKPartVI (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DEVELOPMENT AUTHORITY OF FULTON COUNTY BONDS ISSUED 11/24/2009SCHEDULE K, PART I, LINE AON NOVEMBER 24, 2009, PIEDMONT HEALTHCARE, INC., (PIEDMONT HOSPITAL'S SOLE MEMBER, EIN: 58-1503902) ENTERED INTO A BOND ISSUANCE AGREEMENT WITH THE DEVELOPMENT AUTHORITY OF FULTON COUNTY CONSISTING OF THE FOLLOWING SERIES: SERIES 2009A; CUSIP # 359900ZX8; ISSUE PRICE $166,454,761 (FIXED RATE) SERIES 2009B; CUSIP # 359900ZY6; ISSUE PRICE $70,000,000 (VARIABLE RATE) SERIES 2009C; CUSIP # NONE; ISSUE PRICE $62,100,000 (FIXED RATE) THE ISSUE WAS USED TO REFUND BONDS ISSUED ON 04/07/1999, 06/14/2001, 04/13/2003, 12/15/2005, AND 12/13/2007. THE 2009C BONDS WERE USED TO REPAY A LINE OF CREDIT (SUN TRUST NOTE) THAT FUNDED CONSTRUCTION AND RENOVATION PROJECTS.
HOSPITAL AUTHORITY OF FAYETTE COUNTY BONDS ISSUED 11/24/2009SCHEDULE K, PART I, LINE BON NOVEMBER 24, 2009, PIEDMONT HEALTHCARE, INC., (PIEDMONT HOSPITAL'S SOLE MEMBER, EIN: 58-1503902) ENTERED INTO A BOND ISSUANCE AGREEMENT WITH THE HOSPITAL AUTHORITY OF FAYETTE COUNTY CONSISTING OF THE FOLLOWING SERIES: SERIES 2009A; CUSIP # 31222TAJ2; ISSUE PRICE $36,204,335 (FIXED RATE) SERIES 2009B; CUSIP # 31222TAH6; ISSUE PRICE $36,645,000 (VARIABLE RATE) SERIES 2009C; CUSIP # NONE; ISSUE PRICE $7,000,000 (FIXED RATE) THE ISSUE WAS USED TO REFUND BONDS ISSUED ON 04/07/1999, 06/14/2001, 04/13/2003, 12/15/2005, AND 12/13/2007. THE 2009C BONDS WERE USED TO REPAY A LINE OF CREDIT (SUN TRUST NOTE) THAT FUNDED CONSTRUCTION AND RENOVATION PROJECTS.
TOTAL PROCEEDS OF ISSUESCHEDULE K, PART II, LINE 3, COLUMNS A & BTHE 2009 BOND ISSUES LISTED IN COLUMNS A & B OF PART I ARE COMBINED ON THE FORM 8038 FILED BY PIEDMONT HOSPITAL. HOWEVER, FOR PURPOSES OF SCHEDULE K REPORTING, PIEDMONT HOSPITAL HAS BROKEN OUT THE BOND ISSUED BASED ON THE AUTHORITY (I.E. FAYETTE OR FULTON) THAT ISSUED THE BONDS. CONSEQUENTLY, THE REPORTING IN COLUMNS A & B WILL NOT TIE TO THE FORM 8038 FILED WITH THE IRS AT THE TIME OF ISSUANCE.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
NUMBER OF FORMS 1099 FILEDFORM 990, PART V, LINE 1AALL CALENDAR YEAR 2012 FORMS 1099 WERE FILED ON BEHALF OF PIEDMONT HOSPITAL BY ITS SOLE MEMBER, PIEDMONT HEALTHCARE, INC. (EIN 58-1503902), PURSUANT TO AN AGREEMENT WITH THE IRS TO FILE ALL FORMS 1099 FOR THE PIEDMONT HEALTHCARE SYSTEM ON A COMBINED BASIS.
ORGANIZATION'S SOLE MEMBERFORM 990, PART VI, SECTION A, LINE 6PIEDMONT HEALTHCARE, INC., (EIN 58-1503902) IS THE SOLE MEMBER OF PIEDMONT HOSPITAL, INC ("PH").
ELECTION OF GOVERNING BODYFORM 990, PART VI, SECTION A, LINE 7ATHE BOARD OF PIEDMONT HEALTHCARE APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF PIEDMONT HOSPITAL.
DECISIONS OF GOVERNING BODYFORM 990, PART VI, SECTION A, LINE 7BPIEDMONT HOSPITAL'S BOARD POLICIES AND DECISIONS MUST BE FILED, IMMEDIATELY AFTER ADOPTION, WITH THE SECRETARY OF THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS. SUCH POLICIES AND DECISIONS OF THE PIEDMONT HOSPITAL BOARD OF DIRECTORS ARE NOT SUBJECT TO THE APPROVAL OF OR RATIFICATION BY THE PIEDMONT HEALTHCARE BOARD, BUT SHOULD THE NEED ARISE, THEY MAY BE RESCINDED BY THE PIEDMONT HEALTHCARE BOARD THROUGH A MAJORITY VOTE OF ITS DIRECTORS.
990 REVIEW PROCESSFORM 990, PART VI, SECTION B, LINE 11BINFORMATION NEEDED TO PREPARE PIEDMONT HOSPITAL'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PH'S CONTROLLER AND VP/CFO. THE 990 IS THEN PREPARED INTERNALLY BY PIEDMONT HEALTHCARE, INC.'S TAX COMPLIANCE MANAGER AND SUBMITTED TO AN EXTERNAL TAX PREPARER FOR REVIEW. PRIOR TO FILING, COPIES OF FORM 990 ARE PROVIDED TO THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC., THE ORGANIZATION'S SOLE MEMBER, FOR BOARD REVIEW.
CONFLICT OF INTEREST POLICYFORM 990, PART VI, SECTION B, LINE 12CCOMPLIANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY ORGANIZATION MANAGEMENT IN COORDINATION WITH PIEDMONT HEALTHCARE'S SENIOR VICE PRESIDENT OF COMPLIANCE. ALL SENIOR LEADERS, BOARD MEMBERS, PHYSICIAN EMPLOYEES, NURSE PRACTITIONERS/PHYSICIAN ASSISTANTS AND EMPLOYEES AND NON-EMPLOYEES ENGAGED IN RESEARCH ARE REQUIRED TO ANNUALLY DISCLOSE ALL MATTERS WHICH COULD POTENTIALLY CONSTITUTE A CONFLICT OF INTEREST. MATTERS DISCLOSED UNDER THE POLICY MUST BE REVIEWED IN WRITING BY THE PIEDMONT HEALTHCARE CONFLICT OF INTEREST COMMITTEE IN ORDER TO DETERMINE WHETHER A CONFLICT EXISTS AND, IF SO, WHETHER TO ELIMINATE OR MANAGE THE CONFLICT. ALL BOARD MEMBERS AND EMPLOYEES OF PIEDMONT HOSPITAL ARE PROVIDED TRAINING ON CONFLICT OF INTEREST ISSUES, INCLUDING REPORTING REQUIREMENTS, AT NEW-EMPLOYEE ORIENTATION AND AT LEAST ANNUALLY THEREAFTER. NONCOMPLIANCE WITH THE CONFLICT OF INTEREST POLICY MUST BE REPORTED TO PIEDMONT HEALTHCARE'S SENIOR VICE PRESIDENT OF COMPLIANCE FOR INVESTIGATION, AND REMEDIAL STEPS MUST BE TAKEN AS APPROPRIATE UNDER THE PIEDMONT HEALTHCARE DISCIPLINARY POLICIES.
EXECUTIVE COMPENSATIONFORM 990, PART VI, SECTION B, LINES 15A & 15BCOMPENSATION FOR EXECUTIVES OF PIEDMONT HOSPITAL IS SET BY THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC. THE PIEDMONT HEALTHCARE, INC., BOARD OF DIRECTORS EXECUTIVE PERFORMANCE AND COMPENSATION COMMITTEE ("THE COMMITTEE") IS COMPOSED OF AT LEAST THREE MEMBERS, SERVING TERMS OF THREE YEARS, AND THE MAJORITY OF WHICH ARE COMMUNITY DIRECTORS WHO GENERALLY DO NOT HAVE CONFLICTS OF INTEREST RELATED TO FULFILLMENT OF THE DUTIES AS OUTLINED BELOW. THE COMMITTEE HAS BEEN AUTHORIZED BY THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS TO PERFORM THE FOLLOWING FUNCTIONS: -SELECT AN EXTERNAL EXECUTIVE COMPENSATION CONSULTANT ("THE CONSULTANT"). THE COMMITTEE CURRENTLY UTILIZES TOWERS WATSON FOR EXECUTIVE COMPENSATION CONSULTING SERVICES. -WORK WITH THE PRESIDENT/CEO TO FORMULATE AND IMPLEMENT ANNUAL PERFORMANCE OBJECTIVES. THE COMMITTEE MEETS ANNUALLY WITH PIEDMONT HEALTHCARE'S CEO AND KEY SENIOR EXECUTIVES. -TO REVIEW AND APPROVE EXECUTIVE PERFORMANCE OBJECTIVES FOR THE FISCAL YEAR. -ANNUALLY ASSESS PRESIDENT/CEO PERFORMANCE. THE COMMITTEE MEETS ANNUALLY WITH THE CEO AND KEY SENIOR EXECUTIVES. -TO REVIEW THE ACCOMPLISHMENTS OF THE EXECUTIVE PERFORMANCE OBJECTIVES AFTER THE CLOSE OF THE FISCAL YEAR. -ASSESS AND IMPLEMENT POLICIES REGARDING PRESIDENT/CEO PERFORMANCE AND COMPENSATION. THE COMMITTEE HAS DEVELOPED AN EXECUTIVE COMPENSATION PHILOSOPHY AND REVIEWS THE PHILOSOPHY ANNUALLY. THE COMMITTEE SEEKS INPUT AND GUIDANCE FROM THE CONSULTANT TO ENSURE THAT THE PHILOSOPHY IS REASONABLE AND COMPARABLE TO THAT OF SIMILAR ORGANIZATIONS. -APPROVE LONG- AND SHORT-TERM GOALS TO BE USED IN CONNECTION WITH EXECUTIVE STAFF COMPENSATION PROGRAM AS RECOMMENDED BY THE PRESIDENT/CEO AND VALIDATED BY THE COMPENSATION CONSULTANT. THE COMMITTEE MEETS ANNUALLY WITH THE CEO AND KEY SENIOR EXECUTIVES AS WELL AS THE CONSULTANT TO REVIEW SALARY ADJUSTMENTS AND INCENTIVE PAY FOR THE CEO, SENIOR EXECUTIVES, AND EXECUTIVES THROUGHOUT THE ORGANIZATION. THE COMMITTEE MEETS WITH THE CONSULTANT ANNUALLY TO RECEIVE INPUT AND RECOMMENDATIONS TO ENSURE THAT SALARY ADJUSTMENTS, INCENTIVES, AND BENEFITS ARE REASONABLE AND COMPARABLE TO THOSE OF LIKE ORGANIZATIONS. -PERFORM ANY TASKS RELATED TO EXECUTIVE PERFORMANCE AND COMPENSATION, INCLUDING BUT NOT LIMITED TO, APPROVAL OF EXECUTIVE EMPLOYMENT CONTRACTS, AND EXECUTIVE BENEFITS. THE COMMITTEE SEEKS INPUT FROM THE CONSULTANT, AS WELL AS EXTERNAL LEGAL ADVISORS, WHEN IT IS NECESSARY TO DEVELOP AND/OR AMEND EXECUTIVE EMPLOYMENT CONTRACTS AND BENEFITS.
DISCLOSURE OF GOVERNING, CONFLICT OF INTEREST AND FINANCIAL DOCUMENTSFORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THESE DOCUMENTS SHOULD BE REQUESTED FROM PIEDMONT HEALTHCARE, INC'S LEGAL COUNSEL.
RECONCILIATION OF NET ASSETSFORM 990, PART XI, LINE 9CHANGES TO NET ASSETS REPORTED ON PART XI, LINE 9 ARE COMPRISED OF: BOOK/TAX DIFFERENCES OF $(2,657,614) RELATED TO TIMING OF REVENUE RECOGNITION; NET CHANGES IN TEMPORARILY RESTRICTED FUNDS OF $2,055,985; AND AN INCREASE TO PERMANENTLY RESTRICTED FUNDS OF $277,861.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodePrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1EINEINTotal IncomeTotalIncomeEOY AssetsEOYAssets
CTMR MANAGEMENT LLC
1968 PEACHTREE RD NWATLANTAGA30309MEDICALGAPIEDMONT HOS
PCL-II LLC
1968 PEACHTREE RD NWATLANTAGA30309MEDICALGAPIEDMONT HOS
PIEDMONT WEST AMBULATORY SURGERY CENTER
1800 Howell Mill Rd Ste 200ATLANTAGA30318SURGERYGAPIEDMONT HOS264422348576309212295451

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Piedmont Healthcare INC
1968 Peactree Road NWAtlantaGA30309581503902HC ManagementGA501(C)(3)11 CNAfalse
FAYETTE COMMUNITY HOSPITAL INC
1255 HIGHWAY 154 WESTFAYETTEVILLEGA30214582232328HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT MOUNTAINSIDE HOSPITAL INC
1266 HIGHWAY 515 SOUTHJASPERGA30143352228583HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT NEWNAN HOSPITAL INC
745 POPLAR ROADNEWNANGA30265205077249HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT HEALTHCARE FOUNDATION INC
1968 PEACHTREE ROAD NWATLANTAGA30309581272768FUNDRAISINGGA501(C)(3)11 DPHCfalse
PIEDMONT HEART INSTITUTE INC
95 COLLIER ROAD NW STE 2045ATLANTAGA30309263553500HEALTHCAREGA501(C)(3)7PHCfalse
PIEDMONT HENRY HOSPITAL INC
1133 EAGLES LANDING PARKWAYSTOCKBRIDGEGA30281582200195HospitalGA501(C)(3)3PHCfalse
HENRY DEVELOPMENT VENTURES INC
1133 EAGLES LANDING PKWYStockbridgeGA30281582200734RE HoldingGA501(C)(2)N/APHHfalse

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
Peachtree OrthopAedic Surgery Center
2001 Peachtree Road NE Suite 705AtlantaGA30309582562721Orthopedic SuRG.GANARELATED641632586397false$0false0.15000
Digestive Healthcare of Georgia
95 Collier Road NW suite 4075AtlantaGA303091721582406657Endo / GI surGGANARELATED402112153884false$0false0.15000

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipControlled OrgControlledOrgAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
PIEDMONT MEDICAL CARE CORPORATION
2727 PACES FERRY RD SUITE 1-1100ATLANTAGA30339582092768HEALTHCAREGANAC-CORP000.00000false
THE PIEDMONT CLINIC INC
2727 PACES FERRY ROAD SUITE 1-1100ATLANTAGA30339582005358HEALTHCAREGANAC-CORP000.00000false
PIEDMONT HEART INSTITUTE PHYSICIANS INC
95 COLLIER ROAD NW STE 2045ATLANTAGA30309260593850HEALTHCAREGANAC-CORP000.00000false
AMSTER MCRAE INSURANCE COMPANY
980427603Related InsurANCENAC-CORP000.00000falsePO BOX 1159GRAND CAYMANGRAND CAYMANCJKY1-1102CJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierDISREGARDED ENTITIESIdentifier
Return ReferenceSCHEDULE R, PART I, LINE 1ReturnReference
ExplanationCTMR MANAGEMENT, LLC, AND PCL-II, LLC, OPERATE AS DEPARTMENTS OF PIEDMONT HOSPITAL AND ARE INCORPORATED INTO THE HOSPITAL'S BOOKS AND RECORDS. SEPARATE BOOKS AND RECORDS ARE NOT MAINTAINED FOR THE LIMITED LIABILITY COMPANIES AND ASSETS AND INCOME CANNOT BE READILY DETERMINED. AS SUCH, COLUMNS (D) AND (E) IN PART I HAVE BEEN LEFT BLANK FOR THESE TWO ENTITIES.Explanation

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