FURP.ORG / PUBLIC DATA EXPLORER

PIEDMONT NEWNAN HOSPITAL INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
PIEDMONT NEWNAN HOSPITAL INC (EIN 20-5077249)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-15
IRS object ID
201311359349301596
Schema version
2011v1.5
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)
Timestamp2013-05-15T09:18:12-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

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 JR BLVD STE 1000AddressLine1
CityATLANTACity
StateGAState
ZIP Code30308ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN205077249EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Piedmont Newnan Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% MARIE GAFFNEYInCareOfName
Name ControlPIEDNameControl
Phone6788542470Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1745 Poplar RoadAddressLine1
CityNewnanCity
StateGAState
ZIP Code30265ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMR JOHN MILESName
TitleCFOTitle
Date Signed2013-05-13DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone4048748300Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMr G Michael BassNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1745 Poplar RoadAddressLine1
CityNewnanCity
StateGAState
ZIP Code30265ZIPCode
FieldValueIRS element (for citing)
Gross Receipts117967519GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.piedmontnewnanhospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2007YearFormation
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 Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members3NbrIndependentVotingMembers
Total Nbr Employees1032TotalNbrEmployees
Total Nbr Volunteers113TotalNbrVolunteers
Total Gross UBI424312TotalGrossUBI
Contributions Grants Prior Year5425952ContributionsGrantsPriorYear
Contributions Grants Current Year2046257ContributionsGrantsCurrentYear
Program Service Revenue Prior Year112769914ProgramServiceRevenuePriorYear
Program Service Revenue CY114678680ProgramServiceRevenueCY
Investment Income Prior Year230565InvestmentIncomePriorYear
Investment Income Current Year13145InvestmentIncomeCurrentYear
Other Revenue Prior Year1322465OtherRevenuePriorYear
Other Revenue Current Year1094061OtherRevenueCurrentYear
Total Revenue Prior Year119748896TotalRevenuePriorYear
Total Revenue Current Year117832143TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year67765GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY73625GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year49985999SalariesEtcPriorYear
Salaries Etc Current Year52351922SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year61559409OtherExpensePriorYear
Other Expenses Current Year59591399OtherExpensesCurrentYear
Total Expenses Prior Year111613173TotalExpensesPriorYear
Total Expenses Current Year112016946TotalExpensesCurrentYear
Revenues Less Expenses Prior Year8135723RevenuesLessExpensesPriorYear
Revenues Less Expenses CY5815197RevenuesLessExpensesCY
Total Assets BOY148892119TotalAssetsBOY
Total Assets EOY219433659TotalAssetsEOY
Total Liabilities BOY60928615TotalLiabilitiesBOY
Total Liabilities EOY120131895TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY87963504NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY99301764NetAssetsOrFundBalancesEOY
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
Expense102056070Expense
Grants73625Grants
Revenue114254368Revenue
DescriptionPIEDMONT NEWNAN HOSPITAL ("PNH") IS A 136-BED FACILITY LOCATED IN NEWNAN, GEORGIA, AND IS THE SOLE HOSPITAL PROVIDER IN COWETA COUNTY. APPROXIMATELY 150 PRIMARY CARE AND SPECIALTY PHYSICIANS ON THE MEDICAL STAFF MEET THE PROFESSIONAL CLINICAL NEEDS OF CHILDREN, ADULTS, AND SENIORS WITHIN THE COMMUNITY, REGARDLESS OF ANY INDIVIDUAL'S ABILITY TO PAY FOR SERVICES. FOR THE YEAR ENDED JUNE 30, 2012, THE HOSPITAL HAD 5,636 IN-PATIENT ADMISSIONS WITH A TOTAL OF 22,313 DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED 42,846 AND OUTPATIENT VISITS TOTALED 41,914. SURGICAL SERVICES WERE PROVIDED TO 4,679 PATIENTS.Description
Total Program Service Expense102056070TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
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 IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
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 EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109655NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1032NumberOfEmployees
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 Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members3NumberIndependentVotingMembers
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 BodytrueForm990ProvidedToGoverningBody
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 BUILDING 2 STAddressLine1
CityAtlantaCity
StateGAState
ZIP Code30339ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
MR Gregory A Hurst
Chairman1.0XX01325068106373
MR G Michael Bass
President & CEO55.0XX461760057619
DR Truett Jarrard
Board Member1.0X000
MR WM RONALD DUFFEY
Board Member1.0X000
DR Timothy W Baker
Board Member1.0X000
DR STANLEY W SMITH
Board Member1.0X017859423361
MS Debbie Gramling
Secretary1.0X016119734899
MR Charlie Hall
TREASURER1.0X067864688941
MR NATHAN NIPPER
CHIEF OPERATING OFFICER55.0224335064022X
MS COURTNEY REECE
CFO55.0245069040399X
MS MARGARET LAWSON
VP OF NURSING55.0289087012868X
MS VIRGINIA LYLES
VP OF HUMAN RESOURCES55.0187676026130X
MR Jeffrey Folk
CMO55.0187357042503X
Ms Anna Ivory
VP Organizational Quality55.0149125026845X
Mr Cheong-Lamg W Lam
Director of Pharmacy55.015895100X
Ms Alison L Middleton
Neonatal Nurse Manager55.012928600X
Ms Paula Darden
Assistant Pharmacy Director55.012828500X
Ms Cynthia A Finney
Director of Physical Therapy55.012808000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2289011TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2343505TotalReportableCompFrmRltdOrgs
Total Other Compensation523960TotalOtherCompensation
Number Individuals GT100 K21NumberIndividualsGT100K
Formers ListedfalseFormersListed
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
BEK BUILDING GROUP LLC
10 CADILLAC DR SUITE 40BRENTWOODTN37027CONSTRUCTION51503698
Perkins Will Inc
1382 Peachtree Street NEATLANTAGA30309Architectural1461451
Richardson Technology Systems
70 CRESTRIDGE DRIVE 100SUWANEEGA30024Technology1279173
Morrison's Health Care Division
PO Box 102289ATLANTAGA303682289Food Services695835
Alliance Laundry Textile Services
3120 S Martin Street Suite 100EAST POINTGA30344Laundry Services373537
FieldValueIRS element (for citing)
Number Of Contractors GT100 K12NumberOfContractorsGT100K
All Other Contributions2046257AllOtherContributions
Total Contributions2046257TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICE REVENUE900099114254368114254368
ADMINISTRATIVE SERVICES561000424312424312
FieldValueIRS element (for citing)
Total Program Service Revenue114678680TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column13145TotalRevenueColumn
Exclusion$13,145ExclusionAmount

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)
Real236158Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real236158Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column236158TotalRevenueColumn
Exclusion$236,158ExclusionAmount

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

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
FieldValueIRS element (for citing)
Gross Sales Of Inventory131279GrossSalesOfInventory
Cost Of Goods Sold135376CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-4097TotalRevenueColumn
Exclusion-$4,097ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
CAFETERIA SALES722100548141$548,141
VENDING52592020999$20,999
WELLNESS REVENUE900099201243$201,243

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column91617TotalRevenueColumn
Exclusion$91,617ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue862000TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column117832143TotalRevenueColumn
Related Or Exempt Function Income114254368RelatedOrExemptFunctionIncome
Unrelated Business Revenue424312UnrelatedBusinessRevenue
Exclusion$1,107,206ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total73625Total
Program Services73625ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

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)
Total1761809Total
Program Services1550391ProgramServices
Management And General211418ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total41505104Total
Program Services36524492ProgramServices
Management And General4980612ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total728399Total
Program Services640991ProgramServices
Management And General87408ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5237968Total
Program Services4609412ProgramServices
Management And General628556ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3118642Total
Program Services2744405ProgramServices
Management And General374237ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total41655Total
Management And General41655ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2755Total
Management And General2755ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

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)
Total10472474Total
Program Services8467796ProgramServices
Management And General2004678ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total508618Total
Program Services501729ProgramServices
Management And General6889ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total5539180Total
Program Services5224583ProgramServices
Management And General314597ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1287791Total
Program Services965843ProgramServices
Management And General321948ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3389443Total
Program Services2842789ProgramServices
Management And General546654ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total56583Total
Program Services39096ProgramServices
Management And General17487ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total900499Total
Program Services900499ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3967077Total
Program Services3657687ProgramServices
Management And General309390ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1531127Total
Program Services1531127ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE1576181515761815
MEDICAL SUPPLIES & DRUGS1593769615937696
DUES906674279947868
MISCELLANEOUS1040193929564724

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total112016946Total
Program Services102056070ProgramServices
Management And General9960876ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1182558BOY
EOY5828971EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY15684539BOY
EOY17456553EOY

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)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY887441BOY
EOY1941939EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1188606BOY
EOY768597EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis204042670LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec22145864LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY121945406BOY
EOY181896806EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY8003569BOY
EOY11540793EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY148892119BOY
EOY219433659EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY55904199BOY
EOY13705885EOY

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)
BOY0BOY
EOY0EOY

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)
BOY2624820BOY
EOY379280EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2399596BOY
EOY106046730EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY60928615BOY
EOY120131895EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY83023504BOY
EOY92340477EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4940000BOY
EOY6961287EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY87963504BOY
EOY99301764EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY148892119BOY
EOY219433659EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses5815197ReconcilationRevenueExpenses
Reconcilation Other Changes5523063ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
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 D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis16365049OtherCostOrOtherBasis
Book Value16365049BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis122549543OtherCostOrOtherBasis
Depreciation5509816Depreciation
Book Value117039727BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1782840OtherCostOrOtherBasis
Depreciation402915Depreciation
Book Value1379925BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis53802850OtherCostOrOtherBasis
Depreciation13474904Depreciation
Book Value40327946BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis9542387OtherCostOrOtherBasis
Depreciation2758228Depreciation
Book Value6784159BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings181896806TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionDUE FROM RELATED PARTIESDescription
Book Value11540793BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets11540793TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
DUE TO RELATED PARTIES$105,926,859
OTHER CURRENT LIABILITIES$119,871
FieldValueIRS element (for citing)
Total Of Amounts106046730TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierASC 740 FOOTNOTE (FKA FIN 48)Identifier
Return ReferenceSCHEDULE D, PART X, LINE 2ReturnReference
ExplanationTHE 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, 2012.Explanation

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 Expense6941196TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense6941196NetCommunityBenefitExpense
Percent Of Total Expense0.07210PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense13218861TotalCommunityBenefitExpense
Direct Offsetting Revenue11602551DirectOffsettingRevenue
Net Community Benefit Expense1616310NetCommunityBenefitExpense
Percent Of Total Expense0.01680PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense1106705TotalCommunityBenefitExpense
Direct Offsetting Revenue1223636DirectOffsettingRevenue
Net Community Benefit Expense-116931NetCommunityBenefitExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense21266762TotalCommunityBenefitExpense
Direct Offsetting Revenue12826187DirectOffsettingRevenue
Net Community Benefit Expense8440575NetCommunityBenefitExpense
Percent Of Total Expense0.08890PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense15546TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense15546NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense491212TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense491212NetCommunityBenefitExpense
Percent Of Total Expense0.00510PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense297625TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense297625NetCommunityBenefitExpense
Percent Of Total Expense0.00310PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense804383TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense804383NetCommunityBenefitExpense
Percent Of Total Expense0.00840PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense22071145TotalCommunityBenefitExpense
Direct Offsetting Revenue12826187DirectOffsettingRevenue
Net Community Benefit Expense9244958NetCommunityBenefitExpense
Percent Of Total Expense0.09730PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$15,761,815BadDebtExpenseAmount
Amount Attributable To472854AmountAttributableTo
Amount Reimbursed By Medicare28796979AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare30383675CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1586696MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
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 Newnan HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1745 POPLAR ROADAddressLine1
CityNewnanCity
StateGAState
ZIP Code30265ZIPCode
FieldValueIRS element (for citing)
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 Newnan HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
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
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 1: REQUIRED DESCRIPTIONSPUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6A A REPORT ON PIEDMONT NEWNAN HOSPITAL, INC'S ("PNH") COMMUNITY BENEFITS IS FOUND WITHIN PIEDMONT HEALTHCARE, INC.'S (PIEDMONT NEWNAN 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 PIEDMONT HEALTHCARE'S WEBSITE. ADDITIONALLY, THE REPORT WAS MAILED TO PNH 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 $112,016,946, LESS BAD DEBT EXPENSE OF $15,761,815 FROM FORM 990, PART IX, LINE 24(A). FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST SCHEDULE H, PART I, LINE 7 A RATIO OF PATIENT CARE COST TO CHARGES, CONSISTENT WITH WORKSHEET 2, WAS USED TO REPORT THE AMOUNTS IN PART I, LINES 7A-7D. FOR AMOUNTS ON LINES 7E-7K, ACTUAL EXPENSES FOR EACH COMMUNITY BENEFIT ACTIVITY ARE TRACED AND REPORTED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. BAD DEBT EXPENSE 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. PNH 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 NEWNAN 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 25.2 PERCENT OF PNH'S PATIENT SERVICE REVENUE. PNH'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 PNH'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.
2. NEEDS ASSESSMENTSCHEDULE H, PART VI, LINE 2: NEEDS ASSESSMENTIN FY 2012, PIEDMONT NEWNAN HOSPITAL BEGAN THE PRELIMINARY STEPS TO CONDUCT A FORMAL NEEDS ASSESSMENT, WHICH COMMENCED IN FY 2013. THOSE STEPS INCLUDED A THOROUGH REVIEW OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT REGULATIONS REGARDING COMMUNITY HEALTH NEEDS ASSESSMENTS; THE FORMATION OF AN IMPLEMENTATION PLAN; IDENTIFICATION OF KEY STAKEHOLDERS TO ENGAGE IN THE PROCESS; AND THE ESTABLISHMENT OF A COMMUNITY BENEFITS DEPARTMENT TO EXECUTE THE ASSESSMENT.
3. PATIENT EDUCATION OF ASSISTANCE ELIGIBILITYSCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ASSISTANCE ELIGIBILITYPIEDMONT 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 NEWNAN 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 NEWNAN HOSPITAL WILL ALSO PUBLISH AND WIDELY PUBLICIZE A SUMMARY OF THIS FINANCIAL ASSISTANCE CARE POLICY ON ITS FACILITY WEBSITE, WHICH WILL INCLUDE A LINK TO THE FULL POLICY. 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 4: COMMUNITY INFORMATIONPIEDMONT NEWNAN HOSPITAL IS LOCATED SOUTHWEST OF ATLANTA IN COWETA COUNTY. IN 2010, NEARLY 127,000 PEOPLE LIVED IN COWETA COUNTY. THE COUNTY SEAT IS NEWNAN, AND ALTHOUGH CONSIDERED AN URBAN COUNTY DUE TO ITS POPULATION, OVER HALF THE POPULATION LIVES IN RURAL AREAS OF THE COUNTY. ABOUT ONE IN FIVE ADULTS IN COWETA COUNTY 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 18 PERCENT OF THE OVERALL ADULT POPULATION HAS REPORTED THEY WERE UNABLE TO SEE A DOCTOR IN 2011 DUE TO COST AND, THAT YEAR, 17 PERCENT REPORTED THEY WERE IN POOR OR FAIR HEALTH, A FIGURE MUCH HIGHER THAN THE NATIONAL BENCHMARK OF 10 PERCENT. ABOUT 10 PERCENT OF COWETA COUNTY'S ADULT RESIDENTS HAVE BEEN DIAGNOSED WITH DIABETES, WHICH IS EQUAL TO GEORGIA'S DIAGNOSIS RATE OF 10 PERCENT. UNHEALTHY BEHAVIORS ARE PREVALENT IN COWETA COUNTY. FOR EXAMPLE, 18 PERCENT OF THE COUNTY'S ADULT POPULATION REPORTS THAT IT SMOKES, WHICH IS A FIGURE LOWER THAN THE STATE AVERAGE OF 19 PERCENT, BUT HIGHER THAN THE NATIONAL AVERAGE OF 14 PERCENT. THE MOTOR VEHICLE CRASH RATE IS ONLY 1 PERCENT HIGHER THAN THE STATE AVERAGE, BUT 4 PERCENT HIGHER THAN THE NATIONAL AVERAGE. APPROXIMATELY 15 PERCENT OF THE COUNTY REPORTS HEAVY AND/OR BINGE DRINKING, A PERCENTAGE NEARLY TWICE THE NATIONAL BENCHMARK OF 8 PERCENT. THE TEEN BIRTH RATE IN COWETA COUNTY IS ALSO HIGH AT 47 BIRTHS PER 1,000 TEENAGED WOMEN, AS COMPARED TO THE NATIONAL AVERAGE OF ONLY 21 BIRTHS PER 1,000 WOMEN. ONE IN FOUR ADULTS ARE NOTABLY PHYSICALLY INACTIVE, AND CLOSE TO ONE IN THREE ARE CONSIDERED OBESE. ACCESS TO HEALTHY FOODS IS AN ISSUE, AS ABOUT 15 PERCENT OF THE POPULATION DOES NOT LIVE WITHIN CLOSE PROXIMITY OF A GROCERY STORE THAT SELLS FRESH FRUIT AND VEGETABLES. DATA SHOWS THAT CONTRIBUTORS TO THE OBESITY AND INACTIVITY RATES COULD BE INFLUENCED BY THE FACT THAT HALF OF THE RESTAURANTS IN THE AREA SERVE FAST FOOD. IN ADDITION, THERE IS A MARKED LACK OF RECREATIONAL FACILITY ACCESS IN THE AREA, WITH ONLY NINE FACILITIES PER 100,000 RESIDENTS.
5. PROMOTION OF COMMUNITY HEALTHSCHEDULE H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHPIEDMONT NEWNAN 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 6: AFFILIATED HEALTH CARE SYSTEMTHE 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 2012, 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 NEWNAN 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 FILING OF COMMUNITY BENEFIT REPORTSCHEDULE H, PART VI, LINE 7: STATE OF FILING OF COMMUNITY BENEFIT REPORTPIEDMONT NEWNAN 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 (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
NEWNAN COWETA CHAMBER OF COMMERCE
23 BULLSBORO DRNEWNANGA30263131846366501(c)(3)8625SPONSORSHIP
WEST GEORGIA TECHNICAL COLLEGE Foundation
160 MARTIN LUTHER KING JR DRIVENEWNANGA30265581839803501(c)(3)60000CONTRIBUTION
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierDocumentation of GrantsIdentifier
Return ReferenceSCHEDULE I, PART I, LINE 2ReturnReference
ExplanationTHE PIEDMONT NEWNAN HOSPITAL PUBLIC RELATIONS DEPARTMENT MONITORS THE ISSUANCE OF GRANTS AND ASSISTANCE AND MAINTAINS RECORDS OF ALL GRANTS MADE OR ASSISTANCE PROVIDED.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgtrueCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgstrueCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

Base 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 OrgsTotalCompensationRelatedOrgs
MR Gregory A Hurst
06342140317567037328709587601049701431441
MR G Michael Bass
3269980783310564310483000931905193790
DR STANLEY W SMITH
0178282000312015898074630201955
MS Debbie Gramling
0126320030972039050237790111200196096
MR Charlie Hall
041671208504601768880757760131650767587
MR NATHAN NIPPER
1915650294740329605148701253502883570
MS COURTNEY REECE
19780503192801533602982501057402854680
MS MARGARET LAWSON
839270002051600106800218803019550
MS VIRGINIA LYLES
1532280243580100900247920133802138060
MR Jeffrey Folk
18097500063820348410766202298600
Ms Anna Ivory
126146020114028650212490559601759700
Mr Cheong-Lamg W Lam
1589510000000001589510

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SOCIAL CLUB DUESSCHEDULE J, PART I, LINE 1ASOCIAL CLUB DUES ARE PAID ON BEHALF OF G. MICHAEL BASS AND ARE INCLUDED IN HIS TAXABLE INCOME.
COMPENSATION OF THE CEO/EXECUTIVE DIRECTORSCHEDULE J, PART I, LINE 3THE COMPENSATION FOR THE PRESIDENT/CEO OF PIEDMONT NEWNAN 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, LINE 4BCHARLIE HALL AND GREGORY HURST PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN BUT DID NOT RECEIVE PAYMENTS DURING CY2011.
BONUSESFORM 990, PART VII AND SCHEDULE J, PART I LINE 6A & 6BBONUSES ARE PAID ANNUALLY TO CERTAIN EMPLOYEES BASED ON VARIOUS METRICS, INCLUDING NET EARNINGS.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (27 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
INDEPENDENT BOARD MEMBERSFORM 990, PART I, LINE 4 AND PART VI, LINE 1BPIEDMONT NEWNAN HOSPITAL'S ("PNH") BOARD OF DIRECTORS IS COMPRISED OF SIX VOTING MEMBERS, THREE OF WHICH ARE INDEPENDENT BASED UPON IRS GUIDELINES. WHILE PNH'S INDEPENDENT BOARD MEMBERS DO NOT CONSTITUTE A MAJORITY OF THE BOARD OF DIRECTORS, ANY DECISIONS MADE BY THE PNH BOARD MAY BE RESCINDED BY THE BOARD OF DIRECTORS OF PNH'S SOLE MEMBER, PIEDMONT HEALTHCARE, INC. IN ADDITION, PIEDMONT HEALTHCARE APPOINTS THE MEMBERS OF THE PNH BOARD, SETS COMPENSATION FOR PNH'S EXECUTIVES, AND MONITORS PNH'S COMPLIANCE WITH PIEDMONT HEALTHCARE POLICIES AND PROCEDURES. THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS IS COMPRISED OF A MAJORITY OF INDEPENDENT MEMBERS, AND THEREFORE PNH IS EFFECTIVELY GOVERNED BY AN INDEPENDENT BOARD.
ORGANIZATION'S SOLE MEMBERFORM 990, PART VI, SECTION A, LINE 6PIEDMONT HEALTHCARE, INC., (EIN 58-1503902) IS THE SOLE MEMBER OF PIEDMONT NEWNAN HOSPITAL ("PNH").
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 NEWNAN HOSPITAL.
DECISIONS OF GOVERNING BODYFORM 990, PART VI, SECTION A, LINE 7BPIEDMONT NEWNAN 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 NEWNAN 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 NEWNAN HOSPITAL'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PNH'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. COPIES OF FORM 990 ARE PROVIDED TO THE ORGANIZATION'S GOVERNING BOARD, AS WELL AS THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC., PRIOR TO FILING.
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 VICE PRESIDENT OF COMPLIANCE. ALL SENIOR LEADERS, BOARD MEMBERS, PHYSICIAN EMPLOYEES, AND 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 REPORTING INDIVIDUAL'S SUPERVISING MANAGER AND THEN 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 NEWNAN HOSPITAL ARE PROVIDED TRAINING ON THE REQUIREMENTS OF THE CONFLICT OF INTEREST POLICY AT NEW-EMPLOYEE ORIENTATION AND AT LEAST ANNUALLY THEREAFTER. NONCOMPLIANCE WITH THE CONFLICT OF INTEREST POLICY MUST BE REPORTED TO PIEDMONT HEALTHCARE'S 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, LINE 15A & 15BCOMPENSATION FOR EXECUTIVES OF PIEDMONT NEWNAN 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 5THE OTHER CHANGES TO NET ASSETS OR FUND BALANCES OF $5,523,063, REPORTED ON PART XI, LINE 5, ARE COMPRISED PRIMARILY OF CAPITAL CONTRIBUTIONS FROM PNH'S PARENT CORPORATION AND OTHER RELATED ORGANIZATIONS, AND TEMPORARILY RESTRICTED CONTRIBUTIONS IN THE AMOUNT OF $2,021,000, AS WELL AS OTHER IMMATERIAL ADJUSTMENTS TO THE FUNDS.
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MR Gregory A. Hurst TITLE:Chairman HOURS:54
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MR G Michael Bass TITLE:President & CEO HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DR Truett Jarrard TITLE:Board Member HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MR WM RONALD DUFFEY TITLE:Board Member HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DR Timothy W Baker TITLE:Board Member HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DR STANLEY W SMITH TITLE:Board Member HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MS Debbie Gramling TITLE:Secretary HOURS:54
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MR Charlie Hall TITLE:TREASURER HOURS:54
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MR NATHAN NIPPER TITLE:CHIEF OPERATING OFFICER HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MS COURTNEY REECE TITLE:CFO HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MS MARGARET LAWSON TITLE:VP OF NURSING HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MS VIRGINIA LYLES TITLE:VP OF HUMAN RESOURCES HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MR Jeffrey Folk TITLE:CMO HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Ms Anna Ivory TITLE:VP Organizational Quality HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Mr Cheong-Lamg W. Lam TITLE:Director of Pharmacy HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Ms Alison L. Middleton TITLE:Neonatal Nurse Manager HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Ms Paula Darden TITLE:Assistant Pharmacy Director HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Ms Cynthia A. Finney TITLE:Director of Physical Therapy HOURS:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
PIEDMONT HEALTHCARE INC
2001 PEACHTREE ROAD STE 400ATLANTAGA30309581503902ManagementGA501(C)(3)11 CNAfalse
PIEDMONT HOSPITAL INC
1968 PEACHTREE ROAD NWATLANTAGA30309580566213HOSPITALGA501(C)(3)3PHCfalse
FAYETTE COMMUNITY HOSPITAL INC
1255 HIGHWAY 54 WESTFAYETTEVILLEGA30214582232328HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT MOUNTAINSIDE HOSPITAL INC
1266 HIGHWAY 515 SOUTHJASPERGA30143352228583HOSPITALGA501(C)(3)3PHCfalse
PIEDMONT 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 PkwyStockbridgeGA30281582200195HospitalGA501 (C)(3)3PHCfalse
HENRY MEDICAL CENTER FOUNDATION INC
1133 Eagles Landing PkwyStockbridgeGA30281581502600FundraisingGA501 (C)(3)11 DNAfalse
HENRY DEVELOPMENT VENTURES INC
1133 Eagles Landing PkwyStockbridgeGA30281582200734RE HoldingGA501(C)(2)N/APHHfalse

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 AssetsShareOfEOYAssetsAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountryPercentage OwnershipPercentageOwnership
PIEDMONT MEDICAL CARE CORPORATION
2727 PACES FERRY ROAD SUITE 1-1100ATLANTAGA30339582092768HEALTHCAREGANAC-CORP00
THE PIEDMONT CLINIC INC
2727 PACES FERRY ROADATLANTAGA30339582005358HEALTHCAREGANAC-CORP00
PIEDMONT HEART INSTITUTE PHYSICIANS INC
95 COLLIER ROAD NW STE 2045ATLANTAGA30309260593850HEALTHCAREGANAC-CORP00
AMSTER MCRAE INSURANCE COMPANY
Related InsuranceNAC-CORP00GOVERNORS SQUARE 2ND FLOOR BLDG 3GRAND CAYMANCJKY 1-1102CJ0.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
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 OrgsfalseRentalOfFacilitiesToOtherOrgs
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