FAYETTE COMMUNITY HOSPITAL INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- FAYETTE COMMUNITY HOSPITAL INC (EIN 58-2322328)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-15
- IRS object ID
- 201231369349307253
- Schema version
- 2010v3.7
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-15T16:47:31-04:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 IVAN ALLEN JR BLVD STE 1000 | AddressLine1 |
| City | ATLANTA | City |
| State | GA | State |
| ZIP Code | 30308 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 582322328 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAYETTE COMMUNITY HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | FAYE | NameControl |
| Phone | 7707197073 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1255 HIGHWAY 54 WEST | AddressLine1 |
| City | FAYETTEVILLE | City |
| State | GA | State |
| ZIP Code | 30214 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN MILES | Name |
| Title | CFO | Title |
| Date Signed | 2012-05-15 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4048748300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PIEDMONT FAYETTE HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DARRELL CUTTS PRESIDENTCEO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1255 HIGHWAY 54 WEST | AddressLine1 |
| City | FAYETTEVILLE | City |
| State | GA | State |
| ZIP Code | 30214 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 243707633 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.FAYETTEHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1997 | YearFormation |
| State Legal Domicile | GA | StateLegalDomicile |
| Activity Or Mission Description | 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1577 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 257339 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 755377 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 202752535 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 237220104 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 27528 | InvestmentIncomePriorYear |
| Investment Income Current Year | -61129 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4320937 | OtherRevenuePriorYear |
| Other Revenue Current Year | 4747213 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 207358339 | TotalRevenuePriorYear |
| Total Revenue Current Year | 242661565 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 84423267 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 100603889 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 103784581 | OtherExpensePriorYear |
| Other Expenses Current Year | 117988063 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 188207848 | TotalExpensesPriorYear |
| Total Expenses Current Year | 218591952 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 19150491 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 24069613 | RevenuesLessExpensesCY |
| Total Assets BOY | 250315519 | TotalAssetsBOY |
| Total Assets EOY | 343384807 | TotalAssetsEOY |
| Total Liabilities BOY | 102424541 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 73975713 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 147890978 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 269409094 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 210142578 | Expense |
| Grants | 0 | Grants |
| Revenue | 237548842 | Revenue |
| Description | Fayette Community Hospital, Inc., hereafter referred to and Doing Business As Piedmont Fayette Hospital, Inc. ("PFH") provides needed medical care to the Fayetteville community regardless of any individual's ability to pay for services. During FY2011, PFH provided inpatient and outpatient services totaling $21,888,292 to 10,206 indigent or charity cases. For the year ended June 30, 2011, the Hospital had 12,188 in-patient admissions with a total 48,578 days of in-patient hospitalization. ER visits totaled 61,632 and outpatient visits totaled 133,803. Surgical services were provided to 10,539 patients. (See Schedule O for additional information.) | Description |
| Total Program Service Expense | 210142578 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 131 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1577 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | GA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | SHERYL KLINK CFO | NamePerson |
| Telephone Number | 7707197073 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1255 HIGHWAY 54 WEST | AddressLine1 |
| City | FAYETTEVILLE | City |
| State | GA | State |
| ZIP Code | 30214 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| DR FRANK N COLE | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | |||
| DR WILLIAM T COOK | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | |||
| MR JOEL H COWAN SR | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | |||
| DR WYNDHAM G MORTIMER | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | |||
| MS CINDY RAMPLEY | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | |||
| DR JAMES C SAMS | ||||||||
| CHAIRMAN | 1.0 | X | 0 | 0 | 0 | |||
| MS VICKI TURNER | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 35155 | 7975 | |||
| MR RONALD DUFFEY | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | |||
| MR W DARRELL CUTTS | ||||||||
| PRESident & CEO | 55.0 | 495046 | 0 | 58746 | X | |||
| MR CHARLIE HALL | ||||||||
| TREASURER | 1.0 | 0 | 610821 | 83119 | X | |||
| MS DEBBIE W GRAMLING | ||||||||
| SECRETARY | 1.0 | 0 | 148811 | 32636 | X | |||
| MR JOHN MILES | ||||||||
| CFO | 50.0 | 255772 | 0 | 47395 | X | |||
| MR MICHAEL BURNETT | ||||||||
| CHIEF OPERATING OFFICER | 55.0 | 268034 | 0 | 46246 | X | |||
| MS LISA HEDENSTROM | ||||||||
| CHIEF NURSING OFFICER | 55.0 | 228541 | 0 | 40202 | X | |||
| MR TRACEY COKER | ||||||||
| VP OF FACILITY OPERATIONS | 55.0 | 196575 | 0 | 24525 | X | |||
| DR FREDERICK WILLMS | ||||||||
| VP OF MEDICAL AFFAIRS | 55.0 | 349947 | 0 | 54297 | X | |||
| MR JAMES D COLEMAN | ||||||||
| DIRECTOR OF PHARMACY | 55.0 | 158438 | 0 | 42613 | X | |||
| MR THOMAS OBERST | ||||||||
| PHARMACIST | 40.0 | 145917 | 0 | 40518 | X | |||
| DR ANGELA SWAYNE | ||||||||
| Director of Palliative Care | 40.0 | 201778 | 0 | 24252 | X | |||
| MS CATHERINE CRISLER | ||||||||
| EXEC DIR OF HUMAN RESOURCES | 55.0 | 149318 | 0 | 29445 | X | |||
| MS JUDITH W DAVIS | ||||||||
| PHARMACY IS SPECIALIST | 55.0 | 140972 | 0 | 37387 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2590338 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 794787 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 569356 | TotalOtherCompensation |
| Number Individuals GT100 K | 52 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| E C PRICE GENERAL CONTRACTORS INC | |||||
| 3155 PRESIDENTIAL DR STE 100 | ATLANTA | GA | 30340 | GENERAL CONTRACTORS | 560913 |
| HARRIS FRITZ AND ASSOCIATES INC | |||||
| 141 SOUTH AVENUE | MARIETTA | GA | 30060 | ARCHITECTURAL | 457302 |
| BRASFIELD AND GORRIE LLC | |||||
| PO BOX 11407 | BIRMINGHAM | AL | 352460351 | CONSTRUCTION | 1642720 |
| EXECUTIVE HEALTH RESOURCES INC | |||||
| PO BOX 822688 | PHILADELPHIA | PA | 191822688 | Compliance Services | 364917 |
| ALLIANCE LAUNDRY AND TEXTILE SVCS | |||||
| 7990 SECOND FLAGS DRIVE STE A | AUSTELL | GA | 30168 | LAUNDRY | 892892 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 18 | NumberOfContractorsGT100K |
| All Other Contributions | 755377 | AllOtherContributions |
| Total Contributions | 755377 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 622110 | 236962459 | 236962459 |
| FITNESS CENTER REHAB SERVICES | 713940 | 257645 | 257645 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 237220104 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 4116375 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 585176 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 3531199 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3531199 | TotalRevenueColumn |
| Exclusion | $3,531,199 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 22605 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 83734 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -61129 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -61129 | TotalRevenueColumn |
| Exclusion | -$61,129 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 385500 | GrossSalesOfInventory |
| Cost Of Goods Sold | 377158 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8342 | TotalRevenueColumn |
| Exclusion | $8,342 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| CAFETERIA SALES | 722310 | 804869 | $804,869 | |
| VENDING SALES | 525920 | 38065 | $38,065 | |
| OTHER OPERATING | 900099 | 364738 | 364738 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1207672 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 242661565 | TotalRevenueColumn |
| Related Or Exempt Function Income | 237584842 | RelatedOrExemptFunctionIncome |
| Exclusion | $4,321,346 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2065326 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 2065326 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 83503979 | Total |
| Program Services | 81740422 | ProgramServices |
| Management And General | 1763557 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2857237 | Total |
| Program Services | 2371507 | ProgramServices |
| Management And General | 485730 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6985434 | Total |
| Program Services | 5797910 | ProgramServices |
| Management And General | 1187524 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5191913 | Total |
| Program Services | 4309288 | ProgramServices |
| Management And General | 882625 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 228536 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 228536 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7139032 | Total |
| Program Services | 7139032 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 328828 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 328828 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9780498 | Total |
| Program Services | 9706488 | ProgramServices |
| Management And General | 74010 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5577753 | Total |
| Program Services | 5354643 | ProgramServices |
| Management And General | 223110 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57389 | Total |
| Program Services | 37352 | ProgramServices |
| Management And General | 20037 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 67993 | Total |
| Program Services | 57336 | ProgramServices |
| Management And General | 10657 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7101730 | Total |
| Program Services | 6888678 | ProgramServices |
| Management And General | 213052 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4916559 | Total |
| Program Services | 4916559 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11454320 | Total |
| Program Services | 10767061 | ProgramServices |
| Management And General | 687259 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT | 27943415 | 27943415 | |
| PURCHASED LAB SERVICES | 1637939 | 1637939 | |
| MEDICAL SUPPLIES | 37102028 | 37102028 | |
| OTHER | 4652043 | 4372920 | 279123 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 218591952 | Total |
| Program Services | 210142578 | ProgramServices |
| Management And General | 8449374 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 360283 | BOY |
| EOY | 820944 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35754896 | BOY |
| EOY | 34428302 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28095 | BOY |
| EOY | 28095 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3767367 | BOY |
| EOY | 3330569 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1582517 | BOY |
| EOY | 1317513 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 195438873 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 76842221 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 124660204 | BOY |
| EOY | 118596652 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 1391607 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 84162157 | BOY |
| EOY | 183471125 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 250315519 | BOY |
| EOY | 343384807 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19531296 | BOY |
| EOY | 13654202 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17127613 | BOY |
| EOY | 17191473 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65765632 | BOY |
| EOY | 43130038 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 102424541 | BOY |
| EOY | 73975713 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 147872028 | BOY |
| EOY | 269267461 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18950 | BOY |
| EOY | 141633 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 147890978 | BOY |
| EOY | 269409094 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 250315519 | BOY |
| EOY | 343384807 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 24069613 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 97448503 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7419672 | OtherCostOrOtherBasis |
| Book Value | 7419672 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 82716570 | OtherCostOrOtherBasis |
| Depreciation | 37059357 | Depreciation |
| Book Value | 45657213 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4519532 | OtherCostOrOtherBasis |
| Depreciation | 658822 | Depreciation |
| Book Value | 3860710 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 99801450 | OtherCostOrOtherBasis |
| Depreciation | 39124042 | Depreciation |
| Book Value | 60677408 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 981649 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 981649 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 118596652 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM RELATED PARTIES | 183537263 |
| MISCELLANEOUS RECEIVABLES | -66138 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 183471125 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO RELATED PARTIES | $40,138,068 |
| MISCELLANEOUS | $77,220 |
| SELF INSURANCE RESERVES | $1,159,000 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $1,755,750 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 43130038 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ASC 740 FOOTNOTE (FKA FIN 48) | Identifier |
| Return Reference | SCHEDULE D, PART X, LINE 2 | ReturnReference |
| Explanation | ON JULY 1, 2007, PIEDMONT FAYETTE HOSPITAL ADOPTED 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. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 125. | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent250 | X | Pcent250 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5399162 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5399162 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02830 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13243657 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12130725 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1112932 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00580 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18642819 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12130725 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6512094 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03410 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 196291 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 196291 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 474917 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 474917 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00250 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 21707 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 21707 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 27219 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 27219 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 720134 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 720134 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00370 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 19362953 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12130725 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7232228 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03780 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $7,656,568 | BadDebtExpenseAmount |
| Amount Attributable To | 382828 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 67910590 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 72039710 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -4129120 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PIEDMONT FAYETTE HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1255 HIGHWAY 54 WEST | AddressLine1 |
| City | FAYETTEVILLE | City |
| State | GA | State |
| ZIP Code | 30214 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PIEDMONT FAYETTE HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part VI Form990ScheduleHPartVI (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| 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 FAYETTE HOSPITAL'S SOLE MEMBER), PREPARES A WRITTEN COMMUNITY BENEFIT REPORT WHICH CONTAINS THE COMMUNITY BENEFIT REPORT FOR PIEDMONT FAYETTE HOSPITAL ("PFH"). 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 $218,591,952, LESS BAD DEBT EXPENSE OF $27,943,415 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. PFH 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 $4,129,120 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 29 PERCENT OF PFH'S PATIENT SERVICE REVENUE. PIEDMONT FAYETTE 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 FAYETTE HOSPITAL IN ORDER TO CONTINUE TREATING ELDERLY MEDICARE PATIENTS IN THE FAYETTEVILLE 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 FAYETTE 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 ELIGIBILITY FOR ASSISTANCE | SCHEDULE H, PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBITY FOR ASSISTANCE | 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 FAYETTE HOSPITAL FOCUSES PRIMARILY ON THE COMMUNITY WITHIN A 20 MILE RADIUS OF THE HOSPITAL ADDRESS AND SERVES INDIVIDUALS IN THAT COMMUNITY 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 FAYETTE 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 OF 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. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | true | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | true | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MR W DARRELL CUTTS | |||||||||||||
| 347899 | 0 | 135183 | 0 | 11964 | 0 | 52392 | 0 | 6354 | 0 | 553792 | 0 | 0 | 0 |
| MR MICHAEL BURNETT | |||||||||||||
| 203318 | 0 | 53931 | 0 | 10785 | 0 | 35056 | 0 | 11190 | 0 | 314280 | 0 | 0 | 0 |
| MS LISA HEDENSTROM | |||||||||||||
| 176712 | 0 | 46464 | 0 | 5365 | 0 | 32039 | 0 | 8163 | 0 | 268743 | 0 | 0 | 0 |
| MR TRACEY COKER | |||||||||||||
| 148265 | 0 | 39008 | 0 | 9302 | 0 | 17347 | 0 | 7178 | 0 | 221100 | 0 | 0 | 0 |
| MR CHARLIE HALL | |||||||||||||
| 0 | 407719 | 0 | 156975 | 0 | 46127 | 0 | 73201 | 0 | 9918 | 0 | 693940 | 0 | 0 |
| MS DEBBIE W GRAMLING | |||||||||||||
| 0 | 120396 | 0 | 24802 | 0 | 3613 | 0 | 22132 | 0 | 10504 | 0 | 181447 | 0 | 0 |
| MR JAMES D COLEMAN | |||||||||||||
| 138624 | 0 | 9921 | 0 | 9893 | 0 | 32564 | 0 | 10049 | 0 | 201051 | 0 | 0 | 0 |
| MR THOMAS OBERST | |||||||||||||
| 136101 | 0 | 0 | 0 | 9816 | 0 | 30793 | 0 | 9725 | 0 | 186435 | 0 | 0 | 0 |
| DR ANGELA SWAYNE | |||||||||||||
| 194974 | 0 | 6650 | 0 | 154 | 0 | 17640 | 0 | 6612 | 0 | 226030 | 0 | 0 | 0 |
| MS CATHERINE CRISLER | |||||||||||||
| 130532 | 0 | 12592 | 0 | 6194 | 0 | 24255 | 0 | 5190 | 0 | 178763 | 0 | 0 | 0 |
| DR FREDERICK WILLMS | |||||||||||||
| 261209 | 0 | 68068 | 0 | 20670 | 0 | 48300 | 0 | 5997 | 0 | 404244 | 0 | 0 | 0 |
| MS JUDITH W DAVIS | |||||||||||||
| 139866 | 0 | 0 | 0 | 1106 | 0 | 32579 | 0 | 4808 | 0 | 178359 | 0 | 0 | 0 |
| MR JOHN MILES | |||||||||||||
| 198804 | 0 | 52764 | 0 | 4204 | 0 | 34270 | 0 | 13125 | 0 | 303167 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR | FORM 990, SCHEDULE J, PART I, LINE 3 | THE COMPENSATION FOR THE PRESIDENT/CEO OF PIEDMONT FAYETTE 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 INFORMATION FORM 990, SCHEDULE J, PART I, LINE 4B CHARLIE HALL 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. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PROGRAM SERVICES | FORM 990, PART III, LINE 4A | FAYETTE COMMUNITY HOSPITAL, INC., HEREAFTER REFERRED TO AND DOING BUSINESS AS PIEDMONT FAYETTE HOSPITAL, INC., ("PFH") IS A PRIVATE, NOT-FOR-PROFIT ORGANIZATION AND IS A MEMBER OF PIEDMONT HEALTHCARE. THE PIEDMONT PROMISE ASSURES THAT FAYETTEVILLE COMMUNITY RECEIVES WORLD-CLASS CARE THAT FEELS DOWN TO EARTH. PFH'S DOCTORS, NURSES, AND STAFF UNDERSTAND THAT TRUE HEALING COMES NOT ONLY FROM ADVANCED MEDICAL TECHNOLOGY, BUT ALSO FROM A WARM, CARING TOUCH. THAT TOUCH CAN BE FELT THROUGH PFH'S COMMUNITY OUTREACH PROGRAMS. PFH IS COMMITTED TO IDENTIFYING AND FULFILLING THE NEEDS OF THE UNDERSERVED IN ITS SURROUNDING COMMUNITY. THE HOSPITAL HAS MADE A COMMITMENT TO PROVIDE NO LESS THAN THREE PERCENT OF ITS REVENUE DIRECTLY TO THE COMMUNITY THROUGH OUTREACH PROGRAMS AND INDIGENT AND CHARITY CARE. THIS COMMITMENT IS FULFILLED THROUGH DIRECT FINANCIAL SUPPORT, IN ADDITION TO PROGRAMS, EVENTS, AND SERVICES DESIGNED TO IMPROVE THE OVERALL HEALTH OF THE FAYETTEVILLE COMMUNITY. PFH PARTICIPATES IN HEALTH EDUCATION PROGRAMS, SCREENINGS, AND HEALTH FAIRS, AND PROVIDES SUPPORT ACTIVITIES FOR INDIVIDUALS IN THE COMMUNITY LIVING WITH SERIOUS OR CHRONIC HEALTH CONDITIONS. FURTHER, TO MAXIMIZE ITS IMPACT ON THE SURROUNDING AREA, PFH PARTNERS WITH SEVERAL NON-PROFIT ORGANIZATIONS SUCH AS THE AMERICAN RED CROSS AND THE SOUTH REGION SERVICE CENTER TO GAUGE AND FULFILL THE NEEDS OF ITS COMMUNITY. |
| ORGANIZATION'S SOLE MEMBER | FORM 990, PART VI, SECTION A, LINE 6 | PIEDMONT HEALTHCARE, INC., (EIN 58-1503902) IS THE SOLE MEMBER OF PIEDMONT FAYETTE HOSPITAL. |
| 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 FAYETTE HOSPITAL. |
| DECISIONS OF GOVERNING BODY | FORM 990, PART VI, SECTION A, LINE 7B | PIEDMONT FAYETTE 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 FAYETTE 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 FAYETTE HOSPITAL'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PFH'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 FAYETTE 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 FAYETTE 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 | CHANGES TO NET ASSETS REPORTED ON PART XI, LINE 5 ARE PRIMARILY COMPRISED OF TRANSFERS BETWEEN THE ORGANIZATION AND ITS PARENT OR OTHER RELATED ORGANIZATIONS OF APPROXIMATELY $96.7 MILLION, AS WELL AS RESTRICTED CONTRIBUTIONS OF APPROXIMATELY $100,000. |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MS VICKI TURNER TITLE:BOARD MEMBER HOURS:39 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MR RONALD DUFFEY TITLE:BOARD MEMBER HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MR CHARLIE HALL TITLE:TREASURER HOURS:54 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MS DEBBIE W GRAMLING TITLE:SECRETARY HOURS:54 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| PIEDMONT HEALTHCARE INC | |||||||||
| 1968 PEACHTREE ROAD NW | ATLANTA | GA | 30309 | 581503902 | MANAGEMENT | GA | 501(C)(3) | 11 III-OTH | NA |
| PIEDMONT HOSPITAL INC | |||||||||
| 1968 PEACHTREE ROAD | ATLANTA | GA | 30309 | 580566213 | 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 NEWNAN HOSPITAL INC | |||||||||
| 745 POPLAR ROAD | NEWNAN | GA | 30265 | 205077249 | HOSPITAL | GA | 501(C)(3) | 3 | PHC |
| PIEDMONT HEALTHCARE FOUNDATION INC | |||||||||
| 1968 PEACHTREE ROAD | 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 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Postal CodeAddressForeign/PostalCode | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PIEDMONT MEDICAL CARE CORPORATION | ||||||||||||||||
| 2727 PACES FERRY ROAD SUITE 1-1100 | ATLANTA | GA | 30339 | 264422348 | HEALTHCARE | GA | NA | C-CORP | 0 | 0 | 0.00000 | |||||
| THE PIEDMONT CLINIC INC | ||||||||||||||||
| 2727 PACES FERRY ROAD SUITE 1-1100 | 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 | ||||||||||||||||
| INSURANCE | NA | C-CORP | 0 | 0 | 0.00000 | GOVERNORS SQUARE 2ND FLOOR BLDG 3 | GRAND CAYMAN | CJ | KY 1-1102 | CJ | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
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