2012-05-15T16:12:15-04:00 2011-06-30 ERNST & YOUNG US LLP 55 IVAN ALLEN JR BLVD STE 1000 ATLANTA GA 30308 990 2010-07-01 205077249 Piedmont Newnan Hospital Inc PIED 6788542470 745 Poplar Road Newnan GA 30265 COURTNEY REECE 2012-05-15 4048748300 2010 2016-02-24 21:20:13Z X Michael Bass 60 Hospital Rd Newnan GA 30263 119923629 false X www.piedmontnewnanhospital.org X 2007 GA TO 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. 5 4 708 100 424312 248713 64279 5425952 117279415 112769914 112705 230565 1227039 1322465 118683438 119748896 62445 67765 0 0 51179854 49985999 0 0 0 66228102 61559409 117470401 111613173 1213037 8135723 72929258 148892119 36868881 60928615 36060377 87963504 X TO 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. false false 101063170 67765 112769914 PIEDMONT NEWNAN HOSPITAL ("PNH") IS A 143-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. DURING FISCAL YEAR 2011, PNH PROVIDED INPATIENT AND OUTPATIENT SERVICES TOTALING $17,389,598 TO _____ INDIGENT OR CHARITY CASES. FOR THE YEAR ENDED JUNE 30, 2011, THE HOSPITAL HAD ______ IN-PATIENT ADMISSIONS WITH A TOTAL OF ______ DAYS OF IN-PATIENT HOSPITALIZATION. ER VISITS TOTALED ________ AND OUTPATIENT VISITS TOTALED ________. SURGICAL SERVICES WERE PROVIDED TO ______ PATIENTS. 0 0 0 MANY OF PIEDMONT NEWNAN HOSPITAL'S EMPLOYEES REGARD THEIR WORK AS MORE THAN A JOB. THEY SEE IT AS A CALLING. THAT IS WHY THEY INVEST THOUSANDS OF HOURS EACH YEAR VOLUNTEERING THROUGHOUT THE NEWNAN COMMUNITY. WITH THE SUPPORT OF PIEDMONT NEWNAN HOSPITAL, EMPLOYEES VOLUNTEER FOR PROGRAMS SUCH AS: MENTORING AT THE COWETA COUNTY SCHOOL SYSTEM, PUBLIC SPEAKING FOR SUPPORT GROUPS AND AT HEALTH FAIRS, PROVIDING FIRST AID INSTRUCTION FOR THE BOY SCOUTS, AND SINGING AT NURSING HOMES. 101063170 true true false false false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false false true false false false false true false false false false true 69 0 708 true true true false false false false false false false false false X 5 4 false false false false true true true true true false false false true true true true true true true false GA X COURTNEY REECEPIEDMONT NEWNAN 6788542470 745 POPLAR ROAD NEWNAN GA 30265 X MR Greg Hurst 1.0 X 0 880367 191733 DR Truett Jarrard 1.0 X 0 0 0 MR WM RONALD DUFFEY 1.0 X 0 0 0 DR Timothy W Baker 1.0 X 0 0 0 DR STANLEY W SMITH 1.0 X 0 0 0 MR G Michael Bass 55.0 X 488777 0 55833 MS Debbie Gramling 1.0 X 0 148811 32636 MR Charlie Hall 1.0 X 0 610821 83119 MR NATHAN NIPPER 55.0 X 229014 0 60802 MS COURTNEY REECE 55.0 X 258823 0 39914 MS MARGARET LAWSON 55.0 X 213862 0 33947 MS VIRGINIA LYLES 55.0 X 199233 0 25495 MR EDWARD RACHT 55.0 X 183266 0 26974 MR WIlliam Lam 55.0 X 147847 0 0 MS Allison Middleton 55.0 X 142325 0 0 MS Nancy Mothrope 55.0 X 138905 0 0 MS Cinthia Finney 55.0 X 133568 0 0 2135620 1639999 550453 27 false true false Morrison's Health Care Division PO Box 102289 ATLANTA GA 303682289 Food Services 639472 BEK BUILDING GROUP LLC 10 CADILLAC DR SUITE 40 BRENTWOOD TN 37027 CONSTRUCTION 57729066 RICHARDSON TECHNOLOGY SYSTEMS 70 CRESTRIDGE DRIVE 100 SUWANEE GA 30024 TECHNOLOGY 826932 Alliance Laundry Textile Services 3120 S Martin Street Suite 100 EAST POINT GA 30344 Laundry services 364407 Perkins Will inc 1382 Peachtree Street NE ATLANTA GA 30309 Architectural 1101895 16 65502 5360450 840000 5425952 PATIENT SERVICE REVENUE 622110 112769914 112345602 424312 0 112769914 269922 0 0 269922 0 0 269782 0 269782 269782 0 0 269782 0 39357 -39357 -39357 0 0 -39357 0 0 131279 135376 -4097 0 0 -4097 CAFETERIA SALES 722100 324969 0 0 324969 VENDING 525920 12172 0 0 12172 INTEREST ON ACCOUNTS RECEIVABLE 900099 11819 0 0 11819 707820 0 0 707820 1056780 119748896 112345602 424312 1553030 67765 67765 0 0 0 544610 0 544610 0 0 41930683 36763687 5166996 0 721426 717057 4369 0 3907847 3767463 140384 0 2881433 2612761 268672 0 0 0 0 0 0 0 11519002 9313994 2205008 0 248084 244724 3360 0 18657545 17597891 1059654 0 19146 3145 16001 0 0 4506008 3779273 726735 0 53127 36708 16419 0 0 0 948050 948050 0 0 0 3598170 3317551 280619 0 925491 925491 0 0 BAD DEBT EXPENSE 20896452 20896452 0 0 MISCELLANEOUS 85504 13638 71866 0 DUES 68979 32561 36418 0 EDUCATION 33851 24959 8892 0 111613173 101063170 10550003 0 0 1182558 2533297 0 10264592 15684539 787529 887441 1093094 1188606 140630373 18684967 58250746 121945406 0 8003569 72929258 148892119 36469140 55904199 399741 2624820 0 2399596 36868881 60928615 X 36060377 83023504 0 4940000 0 0 36060377 87963504 72929258 148892119 X 8135723 43767404 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 6180000 6180000 0 12611360 3478990 9132370 0 288200 288200 0 0 17801701 12159549 5642152 0 103749112 2758228 100990884 121945406 DUE FROM RELATED PARTIES 5771393 OTHER CURRENT ASSETS 2232176 8003569 0 DUE TO RELATED PARTIES 487227 OTHER CURRENT LIABILITIES 1912369 2399596 ASC 740 FOOTNOTE (FKA FIN 48) SCHEDULE D, PART X, LINE 2 ON JULY 1, 2007, PIEDMONT NEWNAN HOSPITAL ADOPTED ASC 740 (FKA FIN 48). THE 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, 2011. true true X true X 125. true X true true false true true 4764795 0 4764795 0.05250 12311607 11182587 1129020 0.01240 0 0 0 0.00000 17076402 11182587 5893815 0.06490 39539 0 39539 0.00040 579683 0 579683 0.00640 0 0 0 0.00000 0 0 0 0.00000 186814 0 186814 0.00210 806036 0 806036 0.00890 17882438 11182587 6699851 0.07380 true 5725682 286284 35289438 36151251 -861813 X true true 1 1 Piedmont Newnan Hospital

745 POPLAR ROAD Newnan GA 30265

X X X Piedmont Newnan Hospital 1 1. REQUIRED DESCRIPTIONS SCHEDULE H, PART VI, LINE 1: REQUIRED DESCRIPTIONS PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6A PIEDMONT HEALTHCARE, INC. (PIEDMONT NEWNAN HOSPITAL'S SOLE MEMBER) PREPARES A WRITTEN COMMUNITY BENEFIT REPORT WHICH CONTAINS THE COMMUNITY BENEFIT REPORT FOR PIEDMONT NEWNAN HOSPITAL ("PNH"). THIS REPORT IS MADE AVAILABLE TO THE PUBLIC. 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 $111,613,173, LESS BAD DEBT EXPENSE OF $20,896,452 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 VI, 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. 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 THE ENTIRE $861,813 OF MEDICARE SHORTFALL REPORTED ON LINE 7 OF SCHEDULE H, PART III SHOULD BE CONSIDERED COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: FIRST, THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. IRS REVENUE RULING 69-545 PROVIDES, IN PART, THAT HOSPITALS SERVING PATIENTS WITH GOVERNMENTAL HEALTH BENEFITS, INCLUDING, FOR EXAMPLE, MEDICARE, IS AN INDICATION THAT THE HOSPITAL OPERATES FOR THE PROMOTION OF HEALTH IN THE COMMUNITY. SECOND, DURING FISCAL YEAR 2011, MEDICARE ACCOUNTED FOR 31 PERCENT OF PNH'S PATIENT SERVICE REVENUE. PIEDMONT NEWNAN HOSPITAL'S POLICY IS TO TREAT MEDICARE PATIENTS REGARDLESS OF THE EXTENT TO WHICH MEDICARE ACTUALLY COVERS THE COSTS OF THAT TREATMENT. FOR MANY OF THE MEDICAL SERVICES PROVIDED BY THE HOSPITAL, MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE TO THE PATIENTS. RESULTING MEDICARE SHORTFALLS MUST BE ABSORBED BY PIEDMONT NEWNAN HOSPITAL IN ORDER TO CONTINUE TREATING ELDERLY MEDICARE PATIENTS IN THE NEWNAN COMMUNITY. FURTHER, IT IS EXPECTED THAT REIMBURSEMENT UNDER THE MEDICARE PROGRAM WILL CONTINUE TO DECLINE AND THEREFORE MAY FURTHER LIMIT ACCESS TO CARE FOR ELDERLY PATIENTS DUE TO THE ANTICIPATED REDUCTION OF PARTICIPATION IN THE MEDICARE PROGRAM BY HEALTHCARE PROVIDERS IN THE COMMUNITY. AS A RESULT, NONPROFIT HOSPITALS AND/OR COUNTY HOSPITAL DISTRICTS WILL LIKELY BEAR THE MAJORITY OF THE FINANCIAL BURDEN OF TREATING MEDICARE PATIENTS. THIRD, PIEDMONT NEWNAN HOSPITAL RELIEVES A FINANCIAL BURDEN ON THE FEDERAL AND STATE GOVERNMENTS TO PAY FOR ALL OF THE SERVICES PROVIDED TO MEDICARE PATIENTS. FOURTH, THE STATE OF GEORGIA REQUIRES NON-PROFIT HOSPITALS TO PROVIDE A MINIMAL LEVEL OF COMMUNITY BENEFIT IN ORDER TO OBTAIN EXEMPTION FROM STATE AND LOCAL TAXES. ACCORDING TO GEORGIA STATE LAW, THE UNREIMBURSED COST OF MEDICARE IS CONSIDERED TO BE COMMUNITY BENEFIT. FIFTH, MANY OF THE MEDICARE PARTICIPANTS HAVE LOW, FIXED INCOMES AND THEREFORE WOULD QUALIFY FOR CHARITY CARE OR OTHER MEANS-TESTED GOVERNMENT PROGRAMS, ABSENT BEING ENROLLED IN THE MEDICARE PROGRAM. 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 IDENTIFYING 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 ASSESSMENT SCHEDULE H, PART VI, LINE 2: NEEDS ASSESSMENT PIEDMONT HEALTHCARE HAS PARTNERED WITH THE GEORGIA STATE UNIVERSITY PUBLIC HEALTH DEPARTMENT TO ASSESS THE HEALTHCARE NEEDS OF OUR COMMUNITY. IN MARCH 2010, PIEDMONT HEALTHCARE PARTNERED WITH THE GEORGIA STATE UNIVERSITY INSTITUTE OF PUBLIC HEALTH AS TO FORMALLY ASSESS THE HEALTHCARE NEEDS OF THE METROPOLITAN ATLANTA COMMUNITY THROUGH THE USE OF PRIMARY AND SECONDARY DATA AND STAKEHOLDER INPUT TO ESTABLISH COMMUNITY NEED WITH A FOCUS ON THE FOLLOWING AREAS: POPULATION DEMOGRAPHIC PROFILE; HEALTH BURDENS; COMMUNITY-BASED HEALTH CARE AND SOCIAL SERVICE ASSETS AND NEEDS; COMMUNITY MEMBERS AND PIEDMONT STAFF PERCEPTIONS; AND, EMERGENCY DEPARTMENT USE TRENDS. THE INFORMATION WAS THEN USED TO DESIGN AND EXECUTE A SYSTEMATIC APPROACH TO PHC'S COMMUNITY BENEFITS PROGRAMMING AS TO BETTER ADDRESS THE HEALTH NEEDS THAT WERE IDENTIFIED, WITH A PARTICULAR FOCUS ON THE MORE VULNERABLE MEMBERS OF THE COMMUNITY. PHC USED THE COMMUNITY HEALTH NEEDS ASSESSMENT AS ITS BENCHMARK IN ESTABLISHING STANDARDS FOR PROGRAMMATIC EFFECTIVENESS, WHICH ARE REGULARLY REVIEWED AND EVALUATED. 3. PATIENT EDUCATION OF ASSISTANCE ELIGIBILITY SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ASSISTANCE ELIGIBILITY IN ORDER TO INFORM AND EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS, OR UNDER THE HOSPITAL'S CHARITY CARE POLICY, THE HOSPITAL FOLLOWS THE FOLLOWING PROCEDURES: - REGISTRARS REVIEW PROGRAM GUIDELINES WITH PATIENTS; - BROCHURES THAT EXPLAIN PAYMENT AND FINANCIAL ASSISTANCE OPTIONS ARE AVAILABLE IN REGISTRATION AREAS; - THE HOSPITAL'S WEBSITE AND ALL BILLING STATEMENTS PROVIDE CONTACT INFORMATION FOR PATIENT FINANCIAL SERVICES; - PATIENT FINANCIAL SERVICES REPRESENTATIVES EXPLAIN THE PERTINENT POLICY TO THE PATIENT AND PROVIDE ANY FORMS THAT NEED TO BE COMPLETED BY THE PATIENT; - ALL UNINSURED PATIENTS ARE SCREENED FOR CHARITY ELIGIBILITY WITH AN AUTOMATIC ONLINE SERVICE (SEARCH AMERICA), AND FOR MEDICAID ELIGIBILITY USING A THIRD PARTY (BOTH SERVICES ARE FREE OF CHARGE TO THE PATIENT); - INDIGENT CARE CAN BE AUTHORIZED AT REGISTRATION. 4. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4: COMMUNITY INFORMATION PIEDMONT NEWNAN HOSPITAL PRIMARILY FOCUSES ON THE COMMUNITY WITHIN A 20 MILE RADIUS OF THE HOSPITAL ADDRESS AND SERVES THOSE WHO ARE UNINSURED, UNDERINSURED, AND UNDERSERVED, AS WELL AS THOSE IN NEED OF HEALTH EDUCATION. 5. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH PIEDMONT HEALTHCARE WORKS WITH COMMUNITY PARTNERS THAT COMBINE EDUCATION AND SUPPORT TO PROMOTE HEALTHY LIFESTYLES TO MEMBERS OF THE COMMUNITY. THROUGH ONE SUCH PROGRAM, HEALTHMPOWERS, PHC PROVIDES NUTRITION AND FITNESS MATERIALS TO STUDENTS AND TEACHERS AT GARDEN HILLS ELEMENTARY SCHOOL IN ATLANTA, AS WELL AS TRAINING FOR THE TEACHERS TO INCORPORATE INTO REGULAR CURRICULUM. HEALTHMPOWERS, SPECIALIZES IN THE DEVELOPMENT OF THE MATERIALS AND MONITORS THE PROGRESS OF THE TEACHERS AND STUDENTS OVER THE ENTIRE SCHOOL YEAR. WITH NO EXTRA WORK ON THE SCHOOL'S PART, STUDENTS LEARN WAYS TO INCORPORATE FRUITS AND VEGETABLES INTO THEIR DIETS, AS WELL THE IMPORTANCE OF EXERCISING EACH DAY. THE STUDENTS ARE THEN ABLE TO SHARE THIS KNOWLEDGE WITH THEIR PARENTS AND ENCOURAGE THEM TO DEVELOP HEALTHIER LIFESTYLES. ADDITIONAL PROGRAMS OFFERED TO THE COMMUNITY INCLUDE WOMEN, MEN, AND FAMILY-FOCUSED HEALTH EXPOS, AS WELL AS MINORITY COMMUNITY FAIRS, WHERE PARTICIPANTS RECEIVE FREE HEALTH SCREENINGS AND CAN ATTEND EDUCATIONAL SEMINARS. A LONG-STANDING PROGRAM WITH MEDSHARE INTERNATIONAL OFFERS MEDICAL EQUIPMENT AND SUPPLIES TO VULNERABLE AREAS, NATIONWIDE AND WORLDWIDE, WHICH PIEDMONT HOSPITALS ARE ABLE TO DONATE RATHER THAN WASTE WHEN THEY ARE CONSIDERED TO NOT BE IN OPTIMAL CONDITION OR HAVE EXPIRED. 6. AFFILIATED HEALTH CARE SYSTEM SCHEDULE H, PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM THE 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 2011, THE PIEDMONT HEALTHCARE SYSTEM INCLUDED FOUR 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. 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 REPORT SCHEDULE H, PART VI, LINE 7: STATE OF FILING OF COMMUNITY BENEFIT REPORT PIEDMONT HEALTHCARE, INC., FILES THE COMMUNITY BENEFIT REPORT FOR ITS HEALTHCARE SYSTEM IN THE STATE OF GEORGIA. true NEWNAN COWETA CHAMBER OF COMMERCE 23 BULLSBORO DR NEWNAN GA 30263 131846366 501(c)(3) 7765 SPONSORSHIP WEST GEORGIA TECHNICAL COLLEGE 160 MARTIN LUTHER KING JR DRIVE NEWNAN GA 30265 581839803 501(c)(3) 60000 CONTRIBUTION 2 0 Documentation of Grants SCHEDULE I, PART I, LINE 2 THE PIEDMONT NEWNAN HOSPITAL PUBLIC RELATIONS DEPARTMENT MONITORS THE ISSUANCE OF GRANTS AND ASSISTANCE AND MAINTAINS RECORDS OF ALL GRANTS MADE OR ASSISTANCE PROVIDED. X true true false true false false false true true false false MR Greg Hurst 0 581404 0 167910 0 131053 0 181955 0 9778 0 1072100 0 0 MR G Michael Bass 316589 0 129140 0 43048 0 47841 0 7992 0 544610 0 0 0 MS Debbie Gramling 0 120396 0 24802 0 3613 0 22132 0 10504 0 181447 0 0 MR Charlie Hall 0 407719 0 156975 0 46127 0 73201 0 9918 0 693940 0 0 MR NATHAN NIPPER 173710 0 48590 0 6714 0 49778 0 11024 0 289816 0 0 0 MS COURTNEY REECE 190984 0 52639 0 15200 0 28299 0 11615 0 298737 0 0 0 MS MARGARET LAWSON 159579 0 44034 0 10249 0 28273 0 5674 0 247809 0 0 0 MS VIRGINIA LYLES 149032 0 40152 0 10049 0 24130 0 1365 0 224728 0 0 0 MR EDWARD RACHT 175496 0 0 0 7770 0 17328 0 9646 0 210240 0 0 0 SOCIAL CLUB DUES SCHEDULE J, PART I, LINE 1A SOCIAL CLUB DUES 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 EXPENSES INCURRED BY THE EMPLOYEE FOR PERSONAL USE. COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR SCHEDULE J, PART I, LINE 3 THE 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, LINES 15A & 15B FOR ADDITIONAL INFORMATION. SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 4B G MICHAEL BASS, CHARLIE HALL, AND GREG HURST PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS. BONUSES FORM 990, PART VII AND SCHEDULE J, PART I LINES 6A & 6B BONUSES ARE PAID ANNUALLY TO CERTAIN EMPLOYEES BASED ON VARIOUS METRICS, INCLUDING NET EARNINGS. X 1 840000 APPRAISAL false true false ORGANIZATION'S SOLE MEMBER FORM 990, PART VI, SECTION A, LINE 6 PIEDMONT HEALTHCARE, INC., (EIN 58-1503902) IS THE SOLE MEMBER OF PIEDMONT NEWNAN HOSPITAL ("PNH"). ELECTION OF GOVERNING BODY FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF PIEDMONT HEALTHCARE APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF PIEDMONT NEWNAN HOSPITAL. DECISIONS OF GOVERNING BODY FORM 990, PART VI, SECTION A, LINE 7B PIEDMONT 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 PROCESS FORM 990, PART VI, SECTION B, LINE 11B INFORMATION 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 BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC., PRIOR TO FILING. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE 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 COMPENSATION FORM 990, PART VI, SECTION B, LINES 15A & 15B COMPENSATION 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 HAS UTILIZED THE SERVICES OF INTEGRATED HEALTHCARE STRATEGIES (FORMERLY CLARK CONSULTING) FOR THE PAST SEVERAL YEARS. -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 DOCUMENTS FORM 990, PART VI, SECTION C, LINE 19 GOVERNING 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 ASSETS FORM 990, PART XI, LINE 5 THE OTHER CHANGES TO NET ASSETS OR FUND BALANCES OF $48,607,404, REPORTED ON PART XI, LINE 5, ARE COMPRISED PRIMARILY OF CAPITAL CONTRIBUTIONS FROM PNH'S PARENT CORPORATION AND TEMPORARILY RESTRICTED CONTRIBUTIONS IN THE AMOUNT OF $4,940,000, AS WELL AS OTHER IMMATERIAL ADJUSTMENTS TO THE FUNDS. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MR Greg Hurst TITLE:Chairman HOURS:54 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MR WM RONALD DUFFEY TITLE:Board Member HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MS Debbie Gramling TITLE:Secretary HOURS:54 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MR Charlie Hall TITLE:TREASURER HOURS:54 PIEDMONT HEALTHCARE INC 2001 PEACHTREE ROAD STE 400 ATLANTA GA 30309 581503902 Management GA 501(C)(3) 11 III-OTH N/A PIEDMONT HOSPITAL INC 1968 PEACHTREE ROAD NW ATLANTA GA 30309 580566213 HOSPITAL GA 501(C)(3) 3 PHC FAYETTE COMMUNITY HOSPITAL INC 1255 HIGHWAY 54 WEST FAYETTEVILLE GA 30214 582232328 HOSPITAL GA 501(C)(3) 3 PHC PIEDMONT MOUNTAINSIDE HOSPITAL INC 1266 HIGHWAY 515 SOUTH JASPER GA 30143 352228583 HOSPITAL GA 501(C)(3) 3 PHC PIEDMONT HEALTHCARE FOUNDATION INC 1968 PEACHTREE ROAD NW ATLANTA GA 30309 581272768 FUNDRAISING GA 501(C)(3) 11 III-OTH PHC PIEDMONT HEART INSTITUTE INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 263553500 HEALTHCARE GA 501(C)(3) 7 PHC PIEDMONT MEDICAL CARE CORPORATION 2727 PACES FERRY ROAD SUITE 1-1100 ATLANTA GA 30339 582092768 HEALTHCARE GA NA C-CORP 0 0 0.00000 THE PIEDMONT CLINIC INC 2727 PACES FERRY ROAD ATLANTA GA 30339 582005358 HEALTHCARE GA NA C-CORP 0 0 0.00000 PIEDMONT HEART INSTITUTE PHYSICIANS INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 260593850 HEALTHCARE GA NA C-CORP 0 0 0.00000 AMSTER MCRAE INSURANCE COMPANY GOVERNORS SQUARE 2ND FLOOR BLDG 3 GRAND CAYMAN CJ KY 1-1102 INSURANCE CJ NA C-CORP 0 0 0.00000 false true true false false false false false false false false false false false true true false false