PIEDMONT HEALTHCARE INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
PIEDMONT HEALTHCARE INC (EIN 58-0566213)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-16
IRS object ID
201121369349306577
Schema version
2009v1.7
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

FieldValueIRS element (for citing)
Timestamp2011-05-16T17:46:26-04:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line155 IVAN ALLEN JR BLVD SUITE 1000AddressLine1
CityATLANTACity
StateGAState
ZIP Code30308ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN580566213EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Piedmont Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPIEDNameControl
Phone4044251303Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11968 PEACHTREE ROAD NWAddressLine1
CityATLANTACity
StateGAState
ZIP Code303091285ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCHARLIE HALLName
TitleCFOTitle
Date Signed2011-05-16DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone4048748300Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonR TIMOTHY STACKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11968 PEACHTREE ROAD NWAddressLine1
CityATLANTACity
StateGAState
ZIP Code30309ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1054525599GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.PIEDMONT.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1905YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionPIEDMONT HOSPITAL PROVIDES INPATIENT BEDS, DIAGNOSIS AND TREATMENT OF PATIENTS, SCIENTIFIC RESEARCH, AND VARIOUS ACTIVITIES TO PROMOTE COMMUNITY HEALTH AND WELL BEING.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees4508TotalNbrEmployees
Total Nbr Volunteers435TotalNbrVolunteers
Total Gross UBI5877802TotalGrossUBI
Net Unrelated Business Txbl Income-11265NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year7705456ContributionsGrantsPriorYear
Contributions Grants Current Year7081071ContributionsGrantsCurrentYear
Program Service Revenue Prior Year611711411ProgramServiceRevenuePriorYear
Program Service Revenue CY682293710ProgramServiceRevenueCY
Investment Income Prior Year-12508327InvestmentIncomePriorYear
Investment Income Current Year-12354019InvestmentIncomeCurrentYear
Other Revenue Prior Year12816905OtherRevenuePriorYear
Other Revenue Current Year12930101OtherRevenueCurrentYear
Total Revenue Prior Year619725445TotalRevenuePriorYear
Total Revenue Current Year689950863TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1002812GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY865613GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year246994705SalariesEtcPriorYear
Salaries Etc Current Year251374640SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year308996361OtherExpensePriorYear
Other Expenses Current Year362020449OtherExpensesCurrentYear
Total Expenses Prior Year556993878TotalExpensesPriorYear
Total Expenses Current Year614260702TotalExpensesCurrentYear
Revenues Less Expenses Prior Year62731567RevenuesLessExpensesPriorYear
Revenues Less Expenses CY75690161RevenuesLessExpensesCY
Total Assets BOY984280173TotalAssetsBOY
Total Assets EOY1075778927TotalAssetsEOY
Total Liabilities BOY627294096TotalLiabilitiesBOY
Total Liabilities EOY674945883TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY356986077NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY400833044NetAssetsOrFundBalancesEOY
Mission DescriptionPIEDMONT HOSPITAL PROVIDES INPATIENT BEDS, DIAGNOSIS AND TREATMENT OF PATIENTS, SCIENTIFIC RESEARCH, AND VARIOUS ACTIVITIES TO PROMOTE COMMUNITY HEALTH AND WELL BEING.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense128291544Expense
Grants0Grants
Revenue199412451Revenue
DescriptionPiedmont Hospital Cardiovascular Services had 7,230 inpatient and 48,919 outpatient encounters during the fiscal year ending 6/30/2010, and was named Best in Atlanta for Overall Cardiac Care, Cardiac Surgery and Coronary Intervention by Healthgrades.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense38050870Expense
Grants0Grants
Revenue49824711Revenue
DescriptionPiedmont Hospital Transplant Services performed a total of 883 Inpatient cases during the fiscal year ending 6/30/2010, and had 11,353 outpatient encounters.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense18168730Expense
Grants0Grants
Revenue27751446Revenue
DescriptionPiedmont Hospital Orthopedic Services performed a total of 2,186 Inpatient cases during the fiscal year ending 6/30/2010.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp284471378TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt865613TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev403443309TotalOfOtherProgramServiceRev
Total Program Service Expense468982522TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096369NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees4508NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCHARLIE HALLNamePerson
Telephone Number4044251303TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11968 PEACHTREE ROAD NWAddressLine1
CityATLANTACity
StateGAState
ZIP Code303091285ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Dr William Blincoe
Boardmember2.0X0210000
Mr Robert W Maynard
President and CEO Ex-Officio55.0X6538910213235X
Dr Carol T Aitcheson
Boardmember2.0X000
Dr Phillip S Brachman
Boardmember Ex-Officio2.0X000
Dr Letha Yurko Griffin
Boardmember2.0X000
Mr David G Hanna
Boardmember2.0X000
Ms Lila Hertz
Boardmember2.0X000
Dr Louise H Jacobs
Boardmember2.0X000
Ms Nell Long
Boardmember2.0X000
Dr Stephan M McCollum
Boardmember2.0X000
Mr Gregory B Morrison
Boardmember2.0X000
Dr Jay J Singh
Boardmember2.0X000
Dr Patrick M Battey
Chairman5.0X600000X
Dr Douglas S Stuart
Boardmember2.0X000
Mr Charlie Hall
Treasurer2.00655751187707X
Ms Debbie W Gramling
Secretary2.0014186131501X
Ms Connie Whittington
Chief Nursing Officer55.0277641029791X
Mr Thomas Arnold
VP Chief Financial Officer55.0305689072093X
Mr Wright Alcorn
VP Patient Services55.0274691034969X
Mr Everett Thompson
VP Facility Services55.0299226050799X
Dr Miguel Tan
Physician55.0376583052333X
Ms Denise Ray
VP Chief Operating Officer55.0361855032168X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2555576TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs818612TotalReportableCompFrmRltdOrgs
Total Other Compensation704596TotalOtherCompensation
Number Individuals GT100 K154NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SKANSKA USA BUILDING INC
55 Ivan Allen jr Blvd Ste 600ATLANTAGA30308CONSTRUCTION9250434
RJ GRIFFIN AND COMPANY
800 MOUNT VERNON HIGHWAYATLANTAGA30328CONSTRUCTION3834962
EMORY LABORATORIES
PO BOX 403054ATLANTAGA30384DIALYSIS2210713
ALLIANCE LAUNDRY AND TEXTILE SERVIC
7990 Second Flags Drive Suite AAUSTELLGA30168LAUNDRY SERVICES1904729
PIEDMONT SURGICAL MANAGEMENT CO LLC
3340 PEACHTREE ROAD NE SUITE 600ATLANTAGA30326SURGICAL MGT1595453
FieldValueIRS element (for citing)
Number Of Contractors GT100 K41NumberOfContractorsGT100K
Government Grants134729GovernmentGrants
All Other Contributions6946342AllOtherContributions
Noncash Contributions84428NoncashContributions
Total Contributions7081071TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
HEALTHCARE SERVICES900099673665491673665491
OUTSIDE LAB62150055048585504858
PARKING90009931233613123361
FieldValueIRS element (for citing)
Total Program Service Revenue682293710TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1256315TotalRevenueColumn
Exclusion$1,256,315ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real9654190Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real5638181Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real4016009Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column4016009TotalRevenueColumn
Related Or Exempt Function Income3643065RelatedOrExemptFunctionIncome
Unrelated Business Revenue372944UnrelatedBusinessRevenue

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities344024796Securities
Other1301425Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities357434752Securities
Other1501803Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-13409956Securities
Other-200378Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-13610334TotalRevenueColumn
Exclusion-$13,610,334ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
CAFETERIA9000993348623$3,348,623
FITNESS CENTER900099827316$827,316
COFFEE CART900099119746$119,746

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column4618407TotalRevenueColumn
Exclusion$4,618,407ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue8914092TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column689950863TotalRevenueColumn
Related Or Exempt Function Income680431917RelatedOrExemptFunctionIncome
Unrelated Business Revenue5877802UnrelatedBusinessRevenue
Exclusion-$3,439,927ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total865613Total
Program Services865613ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1029982Total
Management And General1029982ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total202876417Total
Program Services195737267ProgramServices
Management And General7139150ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total12663873Total
Management And General12663873ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total17714629Total
Program Services69127ProgramServices
Management And General17645502ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total17089739Total
Management And General17089739ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total9989795Total
Program Services3856033ProgramServices
Management And General6133762ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1606115Total
Management And General1606115ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total18671322Total
Program Services16422789ProgramServices
Management And General2248533ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total5131951Total
Program Services13491ProgramServices
Management And General5118460ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total158666222Total
Program Services157678004ProgramServices
Management And General988218ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total15004359Total
Management And General15004359ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total20892599Total
Program Services18005920ProgramServices
Management And General2886679ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total186868Total
Program Services139923ProgramServices
Management And General46945ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total319375Total
Program Services255180ProgramServices
Management And General64195ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total8219935Total
Management And General8219935ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total19729260Total
Management And General19729260ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total39067294Total
Program Services37666117ProgramServices
Management And General1401177ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total614284Total
Management And General614284ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE2802151328021513
COLLECTIONS EXPENSE66196306619630
LAB FEES36319153631915
MISCELLANEOUS2564801225648012

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total614260702Total
Program Services468982522ProgramServices
Management And General145278180ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY106292391BOY
EOY157682865EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3365783BOY
EOY1804000EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY4492583BOY
EOY3047314EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY103103126BOY
EOY110492319EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY2301025BOY
EOY2145946EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY13641793BOY
EOY11477694EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY13265116BOY
EOY6475836EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis725688282LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec433897178LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY302423915BOY
EOY291791104EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY311021343BOY
EOY361183527EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY2590297BOY
EOY5299256EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY121782801BOY
EOY124379066EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY984280173BOY
EOY1075778927EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY61912988BOY
EOY54466559EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY302650000BOY
EOY374820006EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY92693138BOY
EOY27693138EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY170037970BOY
EOY217966180EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY627294096BOY
EOY674945883EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY325925618BOY
EOY364820689EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY10501371BOY
EOY14410528EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY20559088BOY
EOY21601827EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY356986077BOY
EOY400833044EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY984280173BOY
EOY1075778927EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementtruePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$389,129DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB389129TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLobbying ActivitiesIdentifier
Return ReferenceForm 990 Part IV # 4ReturnReference
ExplanationHealth care policy is critical to all Americans, and Piedmont Hospital believes that health care providers must participate in forming health care policy by interacting with national, state and local representatives and their staff members to help them better understand the complexities and ramifications of key health care policies including, without limitation, those related to uninsured and indigent patient needs as well as the legislative and regulatory needs to assure the delivery of cost-efficient, quality health care. The Vice President of Government and External Affairs represented the interests of Piedmont Healthcare (EIN 58-1503902), Piedmont Hospital (58-0566213), and related entities before Federal, State, and local elected officials and regulators.Explanation

Schedule D IRS990ScheduleD

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

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance293945492BeginningOfYearBalance
Investment Earnings Or Losses-5237213InvestmentEarningsOrLosses
Administrative Expenses-282776AdministrativeExpenses
End Of Year Balance288991055EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

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

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis12954104OtherCostOrOtherBasis
Book Value12954104BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis455106770OtherCostOrOtherBasis
Depreciation249248061Depreciation
Book Value205858709BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Depreciation0Depreciation

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis253268692OtherCostOrOtherBasis
Depreciation184649117Depreciation
Book Value68619575BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4358716OtherCostOrOtherBasis
Book Value4358716BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings291791104TotalOfBookValueLandBuildings

Other Assets OtherAssets (7 entries)

DescriptionDescriptionBook ValueBookValue
BENEFICIAL INT IN PERP TRUST7139018
DUE FROM RELATED PARTIES100400463
A/R PROFESSIONAL BUILDING761545
STOP / LOSS GA ADS146002
ST PAUL LOSS RETENTION56629
PHI GOODWILL15173509
PCL CON AND NON-COMPETE701900
FieldValueIRS element (for citing)
Total Book Value Other Assets124379066TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
DUE TO RELATED PARTIES$69,050,926
ACCRUED PENSION COSTS$93,514,701
SELF INSURANCE RESERVES$18,693,384
INTEREST SWAPS$23,282,503
OTHER SERP PAYABLES/DEFERRALS$13,424,666
FieldValueIRS element (for citing)
Total Of Amounts217966180TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierFIN 48 FootnoteIdentifier
Return ReferenceSchedule D, Part X, Line 2ReturnReference
ExplanationOn July 1, 2007, Piedmont Hospital adopted FIN 48. There were no material uncertain tax positions as of June 30, 2010.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage125.FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense13056070TotalCommunityBenefitExpense
Net Community Benefit Expense13056070NetCommunityBenefitExpense
Percent Of Total Expense0.02230PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense14839517TotalCommunityBenefitExpense
Direct Offsetting Revenue10318384DirectOffsettingRevenue
Net Community Benefit Expense4521133NetCommunityBenefitExpense
Percent Of Total Expense0.00770PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense27895587TotalCommunityBenefitExpense
Direct Offsetting Revenue10318384DirectOffsettingRevenue
Net Community Benefit Expense17577203NetCommunityBenefitExpense
Percent Of Total Expense0.03000PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1474721TotalCommunityBenefitExpense
Direct Offsetting Revenue127500DirectOffsettingRevenue
Net Community Benefit Expense1347221NetCommunityBenefitExpense
Percent Of Total Expense0.00230PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense40417TotalCommunityBenefitExpense
Net Community Benefit Expense40417NetCommunityBenefitExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense202400TotalCommunityBenefitExpense
Net Community Benefit Expense202400NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense4274985TotalCommunityBenefitExpense
Direct Offsetting Revenue2427972DirectOffsettingRevenue
Net Community Benefit Expense1847013NetCommunityBenefitExpense
Percent Of Total Expense0.00320PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense536982TotalCommunityBenefitExpense
Net Community Benefit Expense536982NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense6529505TotalCommunityBenefitExpense
Direct Offsetting Revenue2555472DirectOffsettingRevenue
Net Community Benefit Expense3974033NetCommunityBenefitExpense
Percent Of Total Expense0.00670PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense34425092TotalCommunityBenefitExpense
Direct Offsetting Revenue12873856DirectOffsettingRevenue
Net Community Benefit Expense21551236NetCommunityBenefitExpense
Percent Of Total Expense0.03670PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense410591TotalCommunityBuildingExpense
Net Community Building Expense410591NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense410591TotalCommunityBuildingExpense
Net Community Building Expense410591NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$7,849,743BadDebtExpenseAmount
Amount Attributable To392000AmountAttributableTo
Amount Reimbursed By Medicare215774059AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare237200879CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-21426820MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part IV Form990ScheduleHPartIV (4 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
Piedmont Surgical Ma
Management services0.500000.50000
Peachtree Orthopedi
Orthopedic Surgery0.150000.85000
Digestive Healthcare
Endo/GI Surgery0.149590.85041
Piedmont West ASC
ambulatory surgery0.835000.16500

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1Piedmont Hospital IncBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11968 Peachtree Road NWAddressLine1
CityAtlantaCity
StateGAState
ZIP Code30309ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Annual Community Benefit ExplnPiedmont Healthcare, Inc. (Piedmont Hospital's sole member) prepares a written community benefit report which contains the community benefit report for Piedmont Hospital. This report is made available to the public.AnnualCommunityBenefitExpln
Costing Method UsedA 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 7a-7k actual expenses for each community benefit activity are traced and reported using the organization's cost accounting system.CostingMethodUsed
Percent Of Total Expense ExplnThe denominator used for the calculation of total expense was the amount on Form 990, Part IX, line 25, column (A) less bad debt expense of $28,021,513.PercentOfTotalExpenseExpln
Bad Debt FootnoteTHE PROVISION FOR BAD DEBT 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 PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBT TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES.BadDebtFootnote
Shortfall As Community BenefitTHE METHOD USED IS THE METHOD USED TO PREPARE THE MEDICARE COST REPORT. The hospital believes that all of the $21.4 million shortfall should be considered as community benefit. The IRS Community Benefit Standard includes the provision of care to the elderly and Medicare patients. Medicare shortfalls must be absorbed by the hospital in order to continue treating the elderly in our community. This year, Medicare accounted for 40.7% of hospital revenues. The hospital provides care regardless of this shortfall and thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries. Caring for Medicare patients fulfills a community need and relieves a government burden as these patients typically have low and/or fixed incomes. Medicare does not provide sufficient reimbursement to cover the cost of providing care for these patients and that shortfall of $21.4 million should be counted as community benefit. Our state requires non-profit hospitals to provide a minimal level of community benefit in order to obtain exemption from state and local taxes. According to our state law, the unreimbursed cost of Medicare is considered to be community benefit - that amount was $21.4 million. Medicare shortfall should be considered a community benefit because our mission is to promote health in the community and we do not limit the care available to any patients, including those covered by Medicare. We are relieving a government burden by providing care to Medicare patients even though costs exceed reimbursements by $21.4 million. Tax exempt hospitals are expected to participate in the Medicare program. 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 forcing the hospital to use other funds to cover the deficit of $21.4 million.ShortfallAsCommunityBenefit
Debt Collection PolicyFinancial Assistance Policy Purpose: Piedmont Hospitals seek to treat all patients equitably, with dignity, with respect and with compassion. To ensure continued service to all patients, Piedmont Hospitals have a responsibility to seek payment from those patients who have the ability to pay. However, Piedmont Hospitals understand that certain patients may not be able to pay their hospital bills due to unfortunate financial circumstances. Piedmont Hospitals will therefore assist patients who cannot pay for all or part of their care and will balance financial assistance to such patients with the Hospitals' responsibilities to remain viable health care providers for the community. Piedmont Hospitals will provide Indigent Care, Charity Care and Catastrophic Charity Care in keeping with the procedures described below. In order for Piedmont Hospitals to apply these policies and procedures fairly and consistently, patients and their families have a duty to help Piedmont Hospitals qualify them for the appropriate level or type of financial assistance given their specific circumstances. Piedmont Hospitals remain committed to serving the emergency needs of all patients, regardless of ability to pay, as required by law. Definitions: 1. Indigent Care - Indigent care is available when the family incomes of a patient and any Guarantor are both equal to or less than 125% of the current Federal Poverty Guidelines. See attached Financial Assistance Determination Grid. 2. Charity Care - Charity Care is available when the family incomes of a patient and any Guarantor are both in excess of 125% and lower than 250% of the current Federal Poverty Guidelines. See attached Financial Assistance Determination Grid. 3. Catastrophic Charity Care - Catastrophic Charity Care is available when the family income of a patient and/or Guarantor exceeds 125% of the current Federal Poverty Guidelines and, after any payments from third parties, the patient liability exceeds 25% of the family's annual incomes. See attached Financial Assistance Determination Grid. 4. Family Income - The combined income of all adults within the household. 5. Co-payments and deductibles - The amount determined by the patient's insurance policy as being due from the patient and any Guarantor. This amount is normally a required payment due from the patient or Guarantor by contract. 6. Guarantor - Individual other than the patient who is responsible for payment of the patient's bill. 7. Private Liability - Private Liability is the amount owed by the patient and any guarantor after application of all insurance benefits. IF the person is a pure self-pay patient it is the entire balance. 8. Pure Self-Pay - Pure self-pay exists when neither a patient nor any Guarantor has any insurance coverage available and must pay the hospital account from his or her own funds. Eligibility: Indigent, Charity and Catastrophic Charity Care discounts as described above are available to eligible persons receiving emergent and/or urgent treatment but unable to pay for the services. Indigent, Charity and Catastrophic Charity Care discounts do not apply to elective, cosmetic, or non-life threatening procedures. Patients that are insured but will incur a large out-of-pocket balance due will be considered provided they meet the Indigent or Charity guidelines set forth herein. The application must be completed in its entirety and any requested back-up documentation is considered part of the application. An application may be considered valid for up to six months. The patient/guarantor may still be asked to verify income on an application within that six-month time frame. .Eligibility for indigent or charity status must be approved for each spell of illness. If denied eligibility you may re-apply after thirty days or if your status has changed prior to the thirty days. In addition to the manual application, Piedmont Healthcare will use in place of or as a supplement to the hardcopy application the Search America products Payment Advisor and Charity Advisor to identify Indigent and Charity eligible accounts. The Hospital may still need supporting documentation and ask that the paper application be submitted with specific income and/or expense back-up documentation. In any case in which a patient, together with any Guarantor, appears to possess insufficient income or resources to pay any Private Liability, the patient or such Guarantor may request financial assistance consideration based on a determination that they meet the Indigent, Charity, or Catastrophic Charity Care guidelines set forth herein. Determination of the amount of an Indigent, Charity or Catastrophic Charity Care adjustment is based upon an individual review of each case. Piedmont Hospitals will take into account factors such as unavailability of assets, loss of employment, an income level inadequate to meet the charges incurred, subsequent illness or death, family obligations, imprisonment, and other circumstances in determining the percentage (if any) of an account to be adjusted. Financial counselors shall be reasonably available at Piedmont Hospitals to provide financial counseling, which includes providing assistance with the Financial Assistance Application. The Financial Assistance Application must be completed in its entirety and any requested back-up documentation is considered part of the application. If denied eligibility, a person may re-apply after thirty days or at any time upon a change in status. Income Verification: All applicants must provide proof of household income by providing any or all of the following that are applicable: a) Pay stub b) Most current Income Tax Return c) W-2 withholding form d) Unemployment receipts e) Unemployment denial letter f) Government agency letter g) Notarized letter from person(s) attesting to the income status providing financial support of the applicant For the purposes of determining financial eligibility for the Indigent and Charity program, income includes all monies received before taxes from all sources, including but not limited to estate payments, net rental income, alimony, military family allotments, employee pensions or retirement plans, military retirement pay, veteran's payments, self-employment income, royalties, social security payments, railroad retirements, unemployment compensation, regular insurance or annuity payments, interest income, private pensions, workers compensation benefits and employment wages. In the absence of a hard copy application and proof of the income levels, the SearchAmerica Payment Advisor and Charity Advisor will also qualify as proof of income. The Hospital may still need supporting documentation and ask that the paper application be submitted with specific income and/or expense back-up documentation. Income does not include Medicare, Medicaid, Food stamps, heat assistance funds, school lunches or housing assistance, capital gains, employer-paid or union-paid portion of health insurance or other employee fringe benefits, food or housing received in lieu of wages, gifts, loans, need-based assistance from non-profit organizations, child support or foster care payments, compensation for injury or disaster relief assistance. Procedure: 1. Physicians desiring indigent, charity, or catastrophic charity care consideration for a patient can direct these patients to the attention of the hospital's Financial Counselors. The hospital's Financial Counselors are available to speak with these patients prior to, during, or after a patient's admission to the hospital. 2. Patients desiring indigent, charity, or catastrophic charity care assistance will be referred to the hospital's Financial Counselors. This may happen prior to, during, or after a patient's admission. A completed Financial Assistance Application and/or the SearchAmerica application and data will be required for the hospital to make a determination on assistance. 3. Requests for charity care will be evaluated based on the financial guidelines described in this policy. 4. Approved charity consideration will be applicable to the patient's current episode of care with the hospital and those visits in the subsequent six months. 5. Approved charity consideration will be applicable only to the charges of Piedmont Hospital, Piedmont Fayette Hospital, Piedmont Mountainside Hospital and Newnan Hospital. The hospital cannot make any financial arrangements for the charges of any private physician practices and patients will need to make payment arrangements directly with these physician practices. 6. Non-citizens of the US without a permanent visa are not excluded from receiving financial assistance. 7. Emergency Department Admissions - hospital's financial counselors may consider self-pay patients admitted through the hospital's emergency room for charity care. 8. Out Patient Testing areas will have available and pass out Financial Assistance Applications during the registration process to Pure Self-pay (Financial ClassDebtCollectionPolicy
General ExplanationBASED ON PRIOR EXPERIENCE AND CERTAIN DEMOGRAPHICS AND OTHER INFORMATION OBTAINED DURING ADMISSION, THE ORGANIZATION BELIEVES A PORTION OF THE BAD DEBT EXPENSES AT COST WOULD BE ATTRIBUTABLE TO PATIENTS THAT WOULD OTHERWISE QUALIFY FOR CHARITY CARE. DESPITE ALL OF THE EFFORT AND WAYS THE ORGANIZATION EDUCATES PATIENTS ABOUT QUALIFYING FOR ITS CHARITY CARE PROGRAM AS DEMONSTRATED IN PART IV, QUESTION 3 BELOW, MANY UNINSURED PATIENTS EITHER REFUSE OR FAIL TO COMPLETE A CHARITY CARE APPLICATION OR PROVIDE SUFFICIENT INFORMATION AT THE TIME OF ADMISSION, DURING THEIR STAY OR AFTER BEING DISCHARGED TO QUALIFY FOR ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. THE AMOUNT REPORTED ON PART III, LINE 3 WAS DETERMINED BY TAKING THE AVERAGE ACCEPTANCE RATE FOR ALL CHARITY CARE APPLICATIONS RECEIVED DURING THE YEAR MULTIPLIED BY THE NUMBER OF DENIALS THAT WERE ATTRIBUTABLE TO INSUFFICIENT INFORMATION.GeneralExplanation
Needs AssessmentPiedmont Healthcare has partnered with the Georgia State University Public Health Department to assess the healthcare needs of our community.NeedsAssessment
Patient Education AssistanceIn 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 the guidelines - Brochures are available in registration areas that explain payment and financial assistance options - The hospital's website gives the phone number for customer service in patient financial services - Patient financial services representatives explain the policy and provide any forms that need to be completed - All billing statements give information on where to call for financial assistance - All uninsured patients are screened for charity eligibility with an automatic online service (Search America) and for medicaid eligibility using a third party (free of charge to the patient) - Indigent care can be authorized at registrationPatientEducationAssistance
Community InformationPiedmont 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.CommunityInformation
Community Building ActivitiesScholarships are given to individuals who are juniors or seniors in an accredited Nursing school. Individuals interested in a scholarship must complete an application before June 1st of the year. Applicants are interviewed by a two person nursing committee and chosen based upon GPA, leadership, financial need, reference letters, and a 500 word essay describing what nursing means to them. Applicants do not need to have any current affiliation with the hospital. However, in order to receive the scholarships, applicants must agree to sign a 1 or 2 year employment contract upon completion of school.CommunityBuildingActivities
Affiliated Health Care SystemPiedmont Hospital is one of four hospitals in the Piedmont Healthcare system. The hospitals in the system promote the health of the communities served by providing care and other services to the uninsured, underinsured and underserved as well as those in need of health education.AffiliatedHealthCareSystem
Reports Filed With StatesGAReportsFiledWithStates

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
Mercer University
301 Mercer University DriveAtlantaGA30341580566167501(c)(3)410591Nursing education scholarship
Alfred and Adele Davis Academy
8105 Roberts DriveAtlantaGA30350581970181501(c)(3)7500Charitable/Community Service
American Diabetes Association
17 Executive Park Drive NE Suite 11AtlantaGA30329131623888501(c)(3)8000Charitable/Community Service
American Heart Association
1101 Norhtchase Parkway Suite 1MariettaGA30067135613797501(c)(3)65002Charitable/Community Service
Good Samaritan Heatlh Center
1015 Donald Lee Hollowell PkwyAtlantaGA30318582373395501(c)(3)70000Charitable/Community Service
It's The Journey
180 Allen Rd Suite 201 SouthAtlantaGA30328470897591501(c)(3)37000Charitable/Community Service
National Kidney Foundation of Georgia
2951 Flowers Road South Suite 211AtlantaGA30341131673104501(c)(3)13000Charitable/Community Service
Skyland Trail
1961 North Druid Hills RoadAtlantaGA30329581489941501(c)(3)6000Charitable/Community Service
St Josephs Mercy Foundation
5673 Peachtree Dunwoody Road SuiteAtlantaGA30342581448522501(c)(3)30000Charitable/Community Service
Visiting Nurse Health System
54775 Glenridge DriveAtlantaGA30328580566250501(c)(3)8500Charitable/Community Service
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants10TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierGrants and ScholarshipsIdentifier
Return ReferenceForm 990 Schedule IReturnReference
ExplanationFederal Grants: Grant funds are monitored in the Grants Management Department. Eligibility, selection criteria and all necessary records are maintained by this Department to ensure compliance with the relevant regulations. Scholarships: Nursing Education Scholarships are given to individuals who are juniors or seniors in an accredited Nursing school. Individuals interested in a scholarship must complete an application before June 1st of the year. Applicants are interviewed by a two person nursing committee and chosen based upon GPA (must be greater than 3.0), leadership, financial need, reference letters (two required), and a 500 word essay describing what nursing means to them. Applicants do not need to have any current affiliation with the hospital. However, in order to receive the scholarships, applicants must agree to sign a 1 or 2 year employment contract upon completion of school. Nursing Administration monitors compliance with the program. Sponsorships: Money is also given to charitable organizations. Organizations that receive money are primarily charitable organizations which promote health care causes. Occasionally, money is given to charitable organizations which are not healthcare organizations. These organizations promote other worthy causes in the surrounding community. The grants are administered in the Public Relations Department.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelXFirstClassOrCharterTravel
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgtrueCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgstrueCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Mr Robert W Maynard
49283901037240573280204280089550867126000
Mr Charlie Hall
0394037014108301206310176917010790084345800
Ms Debbie W Gramling
011681802322701816021000010501017336200
Ms Connie Whittington
223313028348025980023588062030307432000
Mr Thomas Arnold
2573030371960111900603560117370377782000
Mr Wright Alcorn
2216380318500212030225050124640309660000
Mr Everett Thompson
223706031866043654041136096630350025000
Dr Miguel Tan
3184130577910379045193071400428916000
Ms Denise Ray
3032020435590150940208170113510394023000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Bonuses990 PART VIIBonuses are accrued and paid on various metrics including Net Earnings versus Budget.
First Class TravelForm 990 Schedule J Part IPiedmont Hospital allows First Class travel for certain Senior Executives. These items are not reported on the W-2, however, the company is reimbursed for any personal use. Supplemental Compensation Information Charlie Hall and Robert Maynard participated in a supplemental nonqualified retirement plan, but did not receive current year payments.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1SEE SCHEDULE OBusinessNameLine1
FieldValueIRS element (for citing)
Date Issued2009-11-24DateIssued
Issue Price378404097IssuePrice
Description Of PurposeSEE SCHEDULE ODescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds378404097TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Amount Defeased0AmountDefeased
Amount Unspent0AmountUnspent
Issuance Costs From Proceeds9097IssuanceCostsFromProceeds
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures0CapitalExpenditures
Year Of Subst Completion2009YearOfSubstCompletion
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Bond Counsel Routinely EngagedtrueBondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuetrueVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArt
Art Historical TreasuresArtHistoricalTreasures
Art Fractional InterestArtFractionalInterest
Books And PublicationsBooksAndPublications
Clothing And Household GoodsClothingAndHouseholdGoods
Cars And Other VehiclesCarsAndOtherVehicles
Boats And PlanesBoatsAndPlanes
Intellectual PropertyIntellectualProperty

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions6NumberOfContributions
Noncash Contribs Rptd F99084428NoncashContribsRptdF990
Method Of Determining Revenuesmarket valueMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Securities Closely Held StockSecuritiesCloselyHeldStock
Securities Prtnrshp Trust IntrstsSecuritiesPrtnrshpTrustIntrsts
Securities MiscellaneousSecuritiesMiscellaneous
Qualified Contrib Hist StructQualifiedContribHistStruct
Qualified Contrib OtherQualifiedContribOther
Real Estate ResidentialRealEstateResidential
Real Estate CommercialRealEstateCommercial
Real Estate OtherRealEstateOther
CollectiblesCollectibles
Food InventoryFoodInventory
Drugs And Medical SuppliesDrugsAndMedicalSupplies
TaxidermyTaxidermy
Historical ArtifactsHistoricalArtifacts
Scientific SpecimensScientificSpecimens
Archaeological ArtifactsArchaeologicalArtifacts
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftstrueReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Program ServicesForm 990 Part III Program Service AccomplishmentsThe top three Piedmont Hospital Service Lines for FY 2010 were Cardiovascular, Transplant, and Orthopedic Services. The remaining Program Service Revenues and expenses consist of other Inpatient and Outpatient Service Lines for the fiscal year ended June 30, 2010.
Community Benefit Report - Piedmont HospitalForm 990 PArt III Community BenefitAbout Piedmont Hospital: A private, not-for-profit organization with over 4,000 employees and a medical staff of over 900 physicians, Piedmont Hospital is a 481-bed acute tertiary care facility located on 26 acres in the North Atlanta community of Buckhead. It offers all major medical, surgical and diagnostic services. Free Skin Cancer Screening Saves Lives Angela Green knew for years that she had a suspicious spot on her lower back. Even when it grew last year from a freckle to a quarter-size lesion that bled, she still ignored it. You see, Green was unemployed and uninsured so she assumed she couldn't afford treatment. "I was watching 'The Dr. Oz Show' and I learned that May was free cancer screening month," Green said, "so I went with a friend to get it checked out." Jodi Ganz, M.D., a dermatologist at Piedmont Hospital, performed the visual examination with proper lighting and a magnifier. "Each year, a group of doctors and I screen as many people as we can-as many as 200 people in May," she said. "We educate them about skin care and distribute free sunscreen. While we hope that no one has melanoma, a few usually do." Dr. Ganz was concerned with that large, deep spot so she arranged for it to be biopsied and diagnosed at no charge. Green had a very thick melanoma which was likely to metastasize. The diagnosis was devastating, made even worse by her financial situation. The highest cure rate for melanoma is surgical intervention so Dr. Ganz referred Green to Scott Davidson, M.D., a surgical oncologist at Piedmont Hospital. "I knew I was at risk since I used tanning beds as a teen and my mom died from ovarian cancer," Green said. "I was determined to do whatever it took to beat this." Dr. Davidson removed the tumor from Green's back and the lymph nodes in her left armpit and both groins to see if it had spread to those lymph nodes. Fortunately, it had not. A tube in her back drained the fluids for three weeks. Because Green qualified as a charity case, the expenses were written off. "Uninsured patients will not always seek medical attention because they fear high medical bills," said Dr. Davidson. "It's very rewarding to see a patient in need and look her in the eyes and let her know we will take care of her." "It's important to know how to be safe in the sun and get regular screenings based on your risk factors, like skin tone, family history, and sun exposure history," said Dr. Ganz. "These free screenings, supported by Piedmont Hospital and the American Academy of Dermatology, are often the first time people think about skin cancer." "I'm feeling fine and will continue to get regular checkups to stay that way," Green said. "I'm so grateful for this program and my life." Making Sense of the Health Insurance Puzzle It can be a nightmare to navigate the As, Bs and Cs of Medicare, Medigap, Medicaid, long-term care insurance and prescription drug assistance programs. Sixty Plus Older Adult Services program specialist Anita Richards helps Piedmont Hospital patients and employees make sense of the health insurance puzzle. Richards is a volunteer of GeorgiaCares, the Georgia State Health Insurance Assistance Program (SHIP) administered by the Georgia Department of Human Services Division of Aging Services. This volunteer-based program provides free, unbiased information and assistance to Medicare beneficiaries and caregivers. Not all plans cover all medications and coverage can change. "We are pretty savvy people and still find the Plan D process to be overwhelming," said Winship Durrett, a retired Piedmont nurse and a contributor to Sixty Plus. Durrett and her husband, Bill, consult with Richards every year regarding their healthcare plan options. "Anita is a God-send. We make a list of all our current medications-brand and generic-and then Anita researches all the available plans and recommends the ones that are most cost-effective. She is so patient and thorough. We don't know what we would do without her." This service helps patients stay compliant with their medication. "As a retired nurse, I know how common and dangerous it is for older adults to stop taking necessary drugs because they cannot afford them," Durrett said. "They need an advocate." "All of this is done with the help of Sixty Plus," said Richards. "Sixty Plus allows me to be that conduit that is needed to connect older adults with programs they may not be aware of." In addition to helping patients choose the right plan, the Medicare insurance assistance program also helps people with Medigap, long-term care insurance, Medicaid and prescription drug assistance information. Another service helps patients better understand how their care is provided and coordinated. "The hospital experience keeps changing and, in many ways, is very different than it was years ago," said Sixty Plus director Nancy Morrison, M.Ed. "We offer informational sessions and materials throughout the community to enhance our consumers' healthcare experience when they visit the emergency department, hospital and their physicians' offices." Sixty Plus Older Adult Services helped more than 5,000 adults and family members in 2010. Cancer Wellness Programs Massage and nutrition are two free core programs at Cancer Wellness at Piedmont Hospital. Chair massages for patients help lower stress and improve immune functioning while reducing pain and anxiety. "Many patients have a difficult time finding a therapist in the community who has knowledge of special issues created by cancer and cancer treatment and may not be comfortable treating them," said Carolyn Helmer, LCSW, manager of Cancer Wellness at Piedmont. "We offer this service for free to anyone in the Atlanta area affected by cancer." Another free Cancer Wellness service is nutrition counseling for cancer survivors during and after treatment to assist with preventing or correcting nutrition deficiencies, minimizing side effects from cancer treatment, improving their ability to tolerate treatment, and bolster their immune system for ongoing recovery. Pink Heals When Lisa Vingerling was diagnosed with advanced breast cancer in 2008 at the age of 30, she received all her treatment at Piedmont Hospital. Recognizing a need for a cancer support group for young women, Vingerling met with Carolyn Helmer at Cancer Wellness and created Pink Heals Foundation, a 501(c)(3) nonprofit organization. "At Cancer Wellness, they have so many great programs like yoga and drumming," said Vingerling. "All free to cancer patients. Who knew that cancer had benefits?" Vingerling continued, "I wanted to do something specifically for women like me. When a woman gets cancer, it's like a sorority you don't want to join but, once you're in it, you might as well make the best of it. We don't focus on cancer and rehash our stories. It's about being whole and healthy and getting on with our lives to that 'new normal.'" Pink Heals features Salsa classes and motivational speakers, and experts on travel, photography and cooking. "We remind women that they have so much life to enjoy." In addition to ongoing support from Piedmont Hospital, Pink Heals events are hosted by Saks Fifth Avenue and Dior. "I've gotten to see the compassionate, generous side of people," she said.
Community Benefit Report - Piedmont HospitalForm 990 PArt III Community Benefit ContinuedWhy Pink Heals? "When I was going through chemo," Vingerling explained, "I wanted to cheer myself up so I would walk around in my pajamas and high heels." She said she reserved the name and website address, www.pinkheals.org, even before she knew what she would do with it. Chemoflage Meetings Help Empower Women Going Through Chemotherapy Have you heard the story of the woman who looked in the mirror and saw she only had three strands of hair? She braided it and had a good day. The next day, she only had two strands so she parted it down the middle and had a good day. The next day, she only had one strand so she put it in a ponytail and had a good day. On the fourth day, she had no hair and thought, "Thank goodness I don't have to worry about my hair today!" That's how vibrant breast cancer survivor Cookie Aftergut begins each meeting of Chemoflage, an educational program she established in 2006 for women undergoing chemotherapy. The meetings take place twice a month and alternate between Cancer Wellness at Piedmont and Nordstrom at Perimeter Mall. Healthcare professionals and community volunteers offer advice on combatting the effects of chemotherapy through nutrition, relaxation and visualization techniques, fashion and make-up. The small, intimate setting of the meetings-typically 10 to 15 women per group-encourages the women to bond and share their fears and experiences with others. "When I was going through chemotherapy, there wasn't much information out there. I didn't even know what questions to ask, let alone who to ask," Aftergut said. "There are so many things to consider that many of us learned the hard way. For example, after chemotherapy, I noticed my nose was running and my eyes were watery. Allergy medications didn't help. Then it dawned on me that I had no nose hair and eyelashes and that's why. So, now I share that revelation with others." Then there's the importance of thoroughly washing fruits and vegetables to avoid infections because of a compromised immune system. And that chemobrain-short-term memory loss and difficulty concentrating-is a real issue that usually subsides after treatment is complete. "I tell women to use it as an excuse for why they can't remember someone's name," she said with a laugh. "We advise them not to skip any medication doses, especially anti-nausea drugs; to use child-sized toothbrushes that are gentler on sensitive teeth; and to counter the metallic taste of food by eating with plastic utensils." More than 600 women have attended a Chemoflage program. "We love meeting at Cancer Wellness and appreciate Piedmont's ongoing support," she said. "It's a lovely facility and it gives us an opportunity to introduce women to so many of the other valuable resources there." Like many cancer survivors, Aftergut sees the blessings in her journey. "For 61 years, I existed. Since cancer, I am fully living. It's like, before cancer, I don't think the birds knew where I lived. Now, I take great joy in hearing their sweet songs in my garden. It's an honor to help women who are scared. I've been there and I'm okay, and they'll be okay too." Dinner with Friends at Cancer Wellness Spanish-speaking patients and their families who are affected by blood cancers have a place to call their own at Cancer Wellness at Piedmont Hospital. The Atlanta Hispanic/Latino Family Support Group, known as Cena con Amigos (Dinner with Friends), meets monthly for support, information and connection. Dinner is served since many members travel there from throughout the state. Sponsored by the Georgia Chapter of the Leukemia and Lymphoma Society, Piedmont provides the space, an art therapist and supplies. Nurses, counselors and social workers from around Atlanta volunteer. "There is so much fear, confusion and lack of access to information, care and services within this underserved population," said Rosalinda Ramirez, Ph.D., the patient services manager for the Leukemia and Lymphoma Society and a clinical psychologist. "Many tell me this is the first time they have had someone to talk to." While the adults meet, the young patients, their siblings and children of patients can express their emotions in a safe, creative environment through pediatric art therapy. "We've found that this therapy helps reduce fear and anger and resolve sibling problems," she said. "Many of the young patients are teased and ostracized at school because they look different. Here, they get to meet other children like them and they don't feel so alone." Cynthia Tatis was 18 when she was diagnosed with Hodgkin's Lymphoma. Once in remission a year later, she and her family began attending meetings. "I felt like I was okay, but my parents really needed to speak with other Hispanic parents who had been through this," she said. "My brother, Joshua, also came to show his support. Rosalinda does an amazing job of making us all feel safe and welcome. I was the youngest of the adult patients and the most positive and upbeat. I felt like I gave others hope." She continues to come to meetings where she speaks and also mentors through the First Connection peer-to-peer mentoring program. "It's really cool," she said. "A cancer patient or survivor can request a match through the Leukemia and Lymphoma Society and, if I am chosen, I answer their questions or just hear them out. There's such a roller coaster of emotions, and I reassure them that it will be okay. It feels good to be on the other side of it." Tatis is in college where she is studying to be an interpreter. "My goal is to work for a government organization that educates and supports the Hispanic community," she said. "I know from my experience with Cena con Amigos that the need is great and there is so much good that comes from it." The Mercer Family Therapy Center Provides Low-cost Support Families, couples and individuals in the Atlanta area who can't afford to pay typical therapy fees now have a place to turn. Advanced students from Mercer University School of Medicine's Family Therapy Graduate Program, under the close supervision of the Marriage and Family Therapy faculty, provide low-cost outpatient counseling services to the community. Piedmont contributes operational funding for the Center for Health and Learning, a partnership between Piedmont Healthcare and Mercer University formed in 2005 to create innovative solutions to today's challenging healthcare dilemmas. "The center has been instrumental in helping the Mercer Marriage and Family Therapy program develop relationships within the Piedmont system to benefit patients who wish to access these counseling services on the Piedmont campus," said Sharon Nieb, executive director at the Center for Health and Learning. The Mercer Family Therapy Center addresses a wide range of issues, including abuse, addiction, depression, divorce prevention/recovery, grief and parent-child relationship stress. "Piedmont recognizes the importance of addressing the psycho-social ramifications of illness," said Robyn L. Mowery, Ph.D., LMFT, assistant professor and clinical director of the Marriage and Family Therapy Program. "We help patients and their families cope with the diagnosis and progression of illness, whether it's acute, chronic or terminal." Patients pay as little as $5 a session, based on a sliding scale determined by household income and family size. Marriage and Family Therapy faculty also work in partnership with Piedmont Hospital staff to support their success. For example, members of the faculty consult with Piedmont administration on unit staff issues and provide support, debriefing and training services for Piedmont's clinical staff. "We look forward to another exciting year of collaboration with Piedmont staff and patients," said Steve Livingston, Ph.D., LMFT, program director and associate professor of the Marriage and Family Therapy Program. "This program provides an excellent learning environment for our students and service opportunities for our faculty."
Community Benefit Report - Piedmont HospitalForm 990 PArt III Community Benefit ContinuedThe Count Me In Program Employees of the Piedmont Healthcare family know that charity begins at home. They joined forces again in fiscal year 2010 on the Count Me In employee giving campaign. This program raises money to benefit the community, fellow employees and Piedmont patients. With Piedmont Mountainside Hospital and Piedmont Newnan Hospital joining Piedmont Hospital and Piedmont Fayette Hospital in the campaign, employee participants and dollars raised grew by 30 percent. There were 1,568 people who donated $293,070. Contributions are designated to support three resources: United Way; Piedmont Sharing Club, which helps staff whose families need support; and selected direct funds within Piedmont Healthcare. Gregory A. Hurst, executive vice president and chief operating officer of Piedmont Healthcare, served as the chair and worked with the Piedmont Philanthropy team. They recruited more than 100 ambassadors who helped make the campaign a success. "Employee giving at Piedmont Healthcare is a testament to those closest to our organization not only living the Piedmont Promise, but also investing in it," said Hurst. "The generosity of our employees shows they believe in the Piedmont mission and support its success." Community Leader Quote: "Every year, Piedmont Hospital helps us plan and implement a health fair for Latinos in Atlanta. We rely on their flu shots, healthcare supplies and clinical staff to make this event a big success. Their generosity and professionalism is outstanding." Flavia Mercado, M.D., Medical Director of the Department of Multicultural Affairs and the International Medical Center Grady Health System Corporate Sole Member Form 990 Part VI # 6 Piedmont Healthcare is the sole member of Piedmont Hospital. Board Member Elections and Board Decisions Form 990 Part VI # 7A and 7B 7a - The Board of Piedmont Healthcare (Piedmont Hospital's sole member - EIN 58-1503902) appoints the members of the Board of Piedmont Hospital. 7b - Piedmont Hospital Board policies and decisions must be filed, immediately after adoption, with the Secretary of the Piedmont Healthcare Board. Such policies and decisions of the Piedmont Hospital Board are not subject to approval/ratification of the Piedmont Healthcare Board, but should the need arise, may be rescinded by the Piedmont Healthcare Board through a majority vote of its directors.
990 Preparation and ReviewForm 990 PArt VI # 11AThe Piedmont Hospital 990 is prepared and reviewed internally by the Piedmont Healthcare Finance Department. After drafts are completed, the returns are reviewed by our paid preparer, Ernst & Young. Copies of the 990 were provided to the Board of Piedmont Healthcare (parent org EIN 58-1503902)prior to filing.
Conflict of InterestForm 990 Part VI # 12cCompliance with the organization's conflict of interest policy is monitored and enforced by organization management in coordination with the Piedmont Healthcare Vice President of Compliance, and General Counsel as requested. Annual disclosures of all matters which could be a potential conflict are required from all senior leaders, board members, physician employees and employees engaged in research. Matters disclosed under the policy must be reviewed in writing by the 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 accept, alter, or remove the conflict. All board members and employees of the Company are trained on the requirements of the conflict of interest policy at orientation and at least annually thereafter. Non-compliance with the conflict of interest policy must be reported to the Vice President of Compliance for investigation and actions as appropriate under Piedmont Healthcare disciplinary policies.
Compensation of Executives and Key EmployeesForm 990 part VI # 15A & 15BThe Piedmont Healthcare (PHC) Board Executive Performance and Compensation Committee ("the committee") has been authorized by the PHC 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 the 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 like organizations. - Approve long-term 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 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 advice, when it is necessary to develop and/or amend executive employment contracts and benefits. The majority of the committee members are community board directors who generally do not have conflicts of interest related to fulfillment of the duties as outlined above.
Disclosure of Governing, Conflict of Interest and Financial DocumentsForm 990 Part VI # 19Governing documents, Conflict of Interest policy and Financial statements are available upon request. They should be requested from Piedmont Healthcare, Inc's Legal Counsel.
Audit CommitteeForm 990 Part XI # 2cThe Audit Committee for the parent organization, Piedmont Healthcare (EIN 58-1503902)is responsible for oversight of the Audit, and selection of the independent auditor.
TAX EXEMPT BONDSSCHEDULE K PART I COLUMNS A, B, C & PART IV, LINE 2ON NOVEMBER 24, 2009, PIEDMONT HEALTHCARE, INC. (PIEDMONT HOSPITAL'S SOLE MEMBER, EIN - 58-1503902) ENTERED INTO A BOND ISSUANCE CONSISTING OF THE FOLLOWING SERIES: ISSUER NAME: DEVELOPMENT AUTHORITY OF FULTON COUNTY (EIN 58-1639487): SERIES 2009A CUSIP # 359900ZX8 ISSUE PRICE $166,454,761 (FIXED RATE) SERIES 2009B CUSIP # 359900ZY6 ISSUE PRICE $70,000,000 (VARIABLE RATE) SERIES 2009C CUSIP # NONE ISSUE PRICE $62,100,000 (FIXED RATE) ISSUER NAME: HOSPITAL AUTHORITY OF FAYETTE COUNTY (EIN 58-2629223): SERIES 2009A CUSIP # 31222TAJ2 ISSUE PRICE $36,204,335 (FIXED RATE) SERIES 2009B CUSIP # 31222TAH6 ISSUE PRICE $36,645,000 (VARIABLE RATE) SERIES 2009C CUSIP # NONE ISSUE PRICE $7,000,000 (FIXED RATE)
TAX-EXEMPT BONDS DESCRIPTION OF PURPOSESCHEDULE K, PART I, COLUMN FTHE ISSUE WAS USED TO REFUND THE 4/7/1999, 6/14/2001, 4/13/2003, 12/15/2005 AND 12/13/2007 BONDS. ADDITIONALLY, DEVELOPMENT AUTHORITY OF FULTON COUNTY - 2009C AND HOSPITAL AUTHORITY OF FAYETTE COUNTY - 2009C BONDS WERE USED TO REPAY A LINE OF CREDIT (SUN TRUST NOTE) THAT FUNDED CONSTRUCTION AND RENOVATION PROJECTS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Piedmont Healthcare
1968 Peactree Road NWAtlantaGA30309581503902HC ManagementGA501(C)(3)11DNA
PIEDMONT FAYETTE HOSPITAL
1255 HIGHWAY 154 WESTFAYETTEVILLEGA30214582232328HOSPITALGA501(C)(3)3PIEDMONT HC
PIEDMONT MOUNTAINSIDE HOSPITAL
1266 HIGHWAY 515 SOUTHJASPERGA30143353339583HOSPITALGA510(C)(3)3PIEDMONT HC
PIEDMONT NEWNAN HOSPITAL
60 HOSPITAL ROADNEWNANGA30263205077249HOSPITALGA501(C)(3)3PIEDMONT HC
PIEDMONT HOSPITAL FOUNDATION
1968 PEACHTREE ROAD NWATLANTAGA30309581272768FUNDRAISINGGA501(C)(3)11DPIEDMONT HC
PIEDMONT HEART INSTITUTE INC
2727 PACES FERRYRD SUITE 1-1100ATLANTAGA30339263553500HEALTHCAREGA501(C)(3)7PIEDMONT HC
PIEDMONT HOSPTIAL OUTPATIENT SERVICES
1968 PEACHTREE ROAD NWATLANTAGA30309581692454FITNESSGA501(C)(3)9PIEDMONT HC

Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartner
Piedmont Surgical Management Company
c/o Gates Moore 3340 Peachtree RoadAtlantaGA30326205109540Management SvGANArelated4932451688561false$0false
Peachtree Orthopedic Surgery Center
2001 Peachtree Road NE Suite 705AtlantaGA30309582562721Orthopedic SuGANArelated493786571769false$0false
Digestive Healthcare of Georgia
95 Collier Road NW suite 4075AtlantaGA303091721582406657Endo / GI surGANArelated314627225246false$0false

Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Legal Domicile Foreign CountryLegalDomicileForeignCountry
Piedmont West Ambulatory Surgery Ctr LLC
1800 Howell Mill Rd Ste 200AtlantaGA30318264422348ambulatory surgGAN/AC000.83500
PIEDMONT MEDICAL CARE CORPORATION
2727 PACES FERRY RD SUITE 1-1100ATLANTAGA30339582092768HEALTHCAREGAC000.00000PIEDMONT HC
PIEDMONT CLINIC
2727 PACES FERRY ROAD SUITE 1-1100ATLANTAGA30339582005358HEALTHCAREGAC000.00000PIEDMONT HC
PIEDMONT HEART INSTITUTE PHYSICIANS
2727 PACES FERRY ROAD SUITE 1-1100ATLANTAGA30339260593850HEALTHCAREGAC000.00000PIEDMONT HC
AMSTER MCRAE INSURANCE COMPANY
INVESTMENTSC000.00000PIEDMONT HCCJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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