2024-05-14T12:59:26-05:00 2023-06-30 KPMG LLP 303 PEACHTREE ST STE 2000 ATLANTA GA 30308 990 2022-07-01 581503902 Piedmont Healthcare Inc % MARIE GAFFNEY PIED 4044251303 1800 Howell Mill Road Suite 850 Atlanta GA 30318 MARIE GAFFNEY VP CORPORATE FINANCE 4044251303 2024-05-13 true MARIE GAFFNEY 999009999 WHITNEY B HEBRON P01226647 4042223000 2024-05-13 3 2022 2023-04-26 12:10:37Z KEVIN BROWN 1800 Howell Mill Road Ste 850 Atlanta GA 30318 295269925 false X www.piedmont.org X 1983 GA PIEDMONT HEALTHCARE, INC. ("PHC") IS ORGANIZED TO BENEFIT, MANAGE THE FUNCTIONS OF, AND CARRY OUT THE CHARITABLE PURPOSES OF ITS SUBSIDIARY ORGANIZATIONS. 18 13 5024 13 0 0 28164 36774 210287996 249262965 26079708 24515151 24917971 21455035 261313839 295269925 0 0 0 0 40939130 59453346 0 0 0 180054481 226831308 220993611 286284654 40320228 8985271 3702177942 2529861901 2233060215 1474476848 1469117727 1055385053 PIEDMONT HEALTHCARE, INC., ("PHC") IS ORGANIZED EXCLUSIVELY FOR THE BENEFIT OF, TO MANAGE THE FUNCTIONS OF, AND TO CARRY OUT THE CHARITABLE, SCIENTIFIC, AND EDUCATIONAL PURPOSES OF ITS SUBSIDIARY ORGANIZATIONS. false false 262367669 0 269069932 PIEDMONT HEALTHCARE, INC. ("PHC"), IS THE TAX-EXEMPT PARENT OF ITS PUBLICLY SUPPORTED SUBSIDIARIES (LISTED IN SCHEDULE R ATTACHED). PHC PROVIDES CENTRALIZED MANAGEMENT SERVICES TO ITS SUBSIDIARIES, INCLUDING ACCOUNTING, HUMAN RESOURCES, IT, FINANCIAL MANAGEMENT, AND ADVISORY SUPPORT. THESE CENTRALIZED SERVICES RESULT IN GREATER OPERATING EFFICIENCIES AND ALLOW ITS SUBSIDIARY ORGANIZATIONS TO BETTER PROVIDE OUTSTANDING HEALTHCARE AND EDUCATION TO THEIR SURROUNDING COMMUNITIES. 262367669 true true false true false false false false false false true false true true true true false true false true true false false false false false false false false true false false false false false false false false false false false false false true true true false false true X 1763 0 true 5024 true false true CJ false false false false false false false false false false true false X 18 13 false false false false false false false true true false false true true true true true true true true false GA X MARIE GAFFNEY 4702716007 2727 PACES FERRY RD BLDG 2 STE 70 ATLANTA GA 30339 X Mr Kevin Brown Board Member & CEO, PHC 54.0 1.0 X X 3185079 0 423467 Mr Michael Mandl Exec. Vice President 53.0 2.0 X 1580598 0 196054 Mr Christopher Lloyd President Piedmont Clinic 50.0 5.0 X 0 1427921 130812 Ms Elizabeth Leddy CHIEF LEGAL OFF & Sec. 38.0 17.0 X 1389485 0 138711 Dr Leigh Hamby MD PHC CMO 52.0 3.0 X 1188028 0 140776 DR CHARLES BROWN MD PHYSICIAN 50.0 5.0 X 0 1170962 138163 Mr Thomas Arnold TREASURER/CFO PHC 38.0 17.0 X 1173444 0 130741 Mr Sidney Kirschnerthru 103122 Chief Philanthropy Officer 53.0 2.0 X 1191069 0 109586 Mr Geoffrey Brown Chief Information Officer 55.0 0.0 X 833762 0 100739 Ms Vicki Cansler Chief HR Officer 54.0 1.0 X 779176 0 94102 Ms Michelle Fisher Pres. Prim Care & Ret Svcs 54.0 1.0 X 0 755838 105844 Mr Douwe Bergsma Chief Marketing Officer 54.0 1.0 X 691954 0 96092 MR JOHN TILLMAN CHIEF REAL ESTATE OFFICER 55.0 0.0 X 684130 0 97560 MR JOSEPH COLONNA CHIEF SUPPLY CHAIN OFFICER 55.0 0.0 X 691386 0 40093 Dr Moiz Master MD Board Member 1.0 39.0 X 0 508854 24785 Dr Monica Hum MD Board Member 1.0 39.0 X 0 432061 18736 Mr Michael McAnder FORMER TREASURER/CFO PHC 0.0 0.0 X 150106 0 0 Dr David Sailors MD Board Member 1.0 20.0 X 0 55294 0 Dr Todd Schmidt MD BOARD MEMBER 1.0 20.0 X 0 29400 0 Dr Craig Wright MD Board Member/VICE CHAIR 1.0 0.0 X 5426 0 0 Dr Fred Willms MD Board Member 1.0 5.0 X 1486 0 0 Mr Tye Darland Board Member 1.0 0.0 X 0 0 0 Mr Martin Davis Board Member 1.0 0.0 X 0 0 0 Mr David Hanna BOARD MEMBER/Chair 1.0 0.0 X X 0 0 0 Mr Samuel Burney Hay III Board Member 1.0 0.0 X 0 0 0 Mr James H Hopkins Board Member 1.0 0.0 X 0 0 0 Mr Gary T Jones Board Member 1.0 0.0 X 0 0 0 Ms Cheryl Legette Board Member 1.0 5.0 X 0 0 0 Mr John Somerhalder Board Member 1.0 0.0 X 0 0 0 Mr Warren Steele Board Member 1.0 4.0 X 0 0 0 MR HUGH HAMILTON BOARD MEMBER 1.0 1.0 X 0 0 0 MR LEVI HILL IV BOARD MEMBER 1.0 1.0 X 0 0 0 13545129 4380330 1986261 703 true true false CUMBERLAND GROUP 300 GALLERIA PARKWAY ATLANTA GA 30339 CONSULTING SERVICES 10547062 CLOUDMED 1100 PEACHTREE ST STE 1900 ATLANTA GA 30309 IT SERVICES 3795553 MODUSONE HEALTH LLC 2170 DEFOOR HILLS RD NW ATLANTA GA 30078 HEALTHCARE CONSULT. 2858750 PARAREV 2500 WESTFIELD DR STE 2-300 ELGIN IL 60124 REVENUE CYCLE MGMT. 2825379 BROOKSOURCE MEDASOURCE 6215 N COLLEGE AVE INDIANAPOLIS IN 46220 HEALTHCARE IT 2800943 113 36774 36774 MANAGEMENT SERVICES TO AFFILIATES 561000 173196309 173196309 0 0 COST OF CAPITAL ALLOCATION 900099 75220508 75220508 0 0 EPIC IMPLEMENTATION 900099 846148 846148 0 0 249262965 24515151 0 0 24515151 0 0 7974552 0 7974552 0 7974552 7974552 0 0 0 0 0 0 0 0 0 0 0 0 RESEARCH REVENUE 900099 1648068 0 0 1648068 OTHER OPERATING REVENUE 900099 11832415 11832415 0 0 13480483 295269925 269069932 0 26163219 X 0 0 0 0 10224571 6645971 3578600 0 0 35269072 22924897 12344175 0 -1516120 -985478 -530642 0 12717340 8266271 4451069 0 2758483 1793014 965469 0 258193 0 258193 0 1578264 0 1578264 0 777961 0 777961 0 470019 470019 0 0 0 493896 0 493896 0 45062398 45062398 0 0 6243760 6243760 0 0 19327641 19327641 0 0 2650751 2650751 0 0 0 25485172 25485172 0 0 471417 471417 0 0 0 0 66977061 66977061 0 0 0 42897299 42897299 0 0 7427938 7427938 0 0 PHO ASSESSMENT 6677658 6677658 0 0 SUBSCRIPTIONS 31880 31880 0 0 286284654 262367669 23916985 0 849317194 1058761399 0 0 171169984 53920572 5199026 10412132 0 0 0 0 0 0 0 0 34472001 84593569 805358416 419227208 349837543 386131208 0 0 0 0 136989871 158342187 189378 189378 2155002945 777511456 3702177942 2529861901 278728141 432410894 0 0 45264878 42065954 0 0 0 0 0 0 0 0 0 0 1909067196 1000000000 2233060215 1474476848 X 1468447636 1053294571 670091 2090482 1469117727 1055385053 3702177942 2529861901 X 8985271 16642222 -35274 -439324893 X false true X true false X X 21 PIEDMONT HOSPITAL INC 580566213 3 true 24129369 0 FAYETTE COMMUNITY HOSPITAL INC DBA PIEDMONT FAYETTE HOSPITAL 582322328 3 true 6055218 0 PIEDMONT MOUNTAINSIDE HOSPITAL INC 352228583 3 true 865852 0 PIEDMONT NEWNAN HOSPITAL INC 205077249 3 true 4948646 0 PIEDMONT HEART INSTITUTE INC 263553500 7 true 391972 0 PIEDMONT HENRY HOSPITAL INC 582200195 3 true 5632444 0 PIEDMONT NEWTON HOSPITAL INC 582155150 3 false 1204738 0 PIEDMONT ATHENS REGIONAL MEDICAL CENTER INC 582179986 3 false 13538154 0 PIEDMONT ROCKDALE HOSPITAL INC 300999841 3 false 1727355 0 PIEDMONT WALTON HOSPITAL INC 824194264 3 false 688145 0 THE MEDICAL CENTER INC 581685139 3 false 4878649 0 HUGHSTON HOSPITAL INC 331216751 3 false 1837710 0 PIEDMONT CARTERSVILLE HOSPITAL INC 870963633 3 false 1949993 0 PIEDMONT EASTSIDE HOSPITAL INC 870982886 3 false 3050346 0 PIEDMONT MACON HOSPITAL INC 871006981 3 false 1994440 0 PIEDMONT MACON NORTH HOSPITAL INC 871031034 3 false 505971 0 UNIVERSITY HEALTH SERVICES INC 581581103 3 false 9049809 0 UNIVERSITY MCDUFFIE COUNTY REG MED CTR 454166209 3 false 378631 0 UNIVERSITY HEALTH CARE FOUNDATION INC 581343550 7 false 0 0 UNIVERSITY EXTENDED CARE INC 581581105 3 false 0 0 AUGUSTA RESOURCE CENTER ON AGING INC 581728812 10 false 0 0 21 82827442 0 false false false false false false false false false false false false false false false true true false X true true SCHEDULE A, PART IV, SECTION A, LINE 1: NOT LISTED IN GOVERNING DOCUMENTS DURING FISCAL YEARS 2016 THROUGH 2018, PIEDMONT HEALTHCARE PURCHASED THE FOLLOWING ENTITIES: PIEDMONT NEWTON HOSPITAL, INC. (EIN: 58-2155150, FKA NEWTON MEDICAL CENTER); PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC. (EIN: 58-2179986, FKA ATHENS REGIONAL MEDICAL CENTER) AND ITS SUBSIDIARIES; PIEDMONT WALTON HOSPITAL, INC. (EIN: 82-4194264, FKA CLEARVIEW REGIONAL MEDICAL CENTER); PIEDMONT ROCKDALE HOSPITAL, INC. (EIN: 30-0999841, FKA ROCKDALE MEDICAL CENTER); THE MEDICAL CENTER, INC. (EIN: 58-1685139) AND ITS SUBSIDIARIES, AND; HUGHSTON HOSPITAL, INC. (EIN: 33-1216751) AND ITS SUBSIDIARIES. DURING FISCAL YEAR 2021, PIEDMONT HEALTHCARE CREATED FOUR NEW ENTITIES TO ULTIMATELY OPERATE 501(C)(3) HOSPITALS: PIEDMONT CARTERSVILLE HOSPITAL, INC. (EIN: 87-0963633) PIEDMONT EASTSIDE HOSPITAL, INC. (EIN: 87-0982886) PIEDMONT MACON HOSPITAL, INC. (EIN: 87-1006981) PIEDMONT MACON NORTH HOSPITAL, INC. (EIN: 87-1031034) DURING FISCAL YEAR 2022, PIEDMONT HEALTHCARE PURCHASED THE FOLLOWING ENTITIES: UNIVERSITY HEALTH SERVICES, INC. (EIN: 58-1581103, DBA PIEDMONT AUGUSTA HOSPITAL) UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER (EIN: 45-4166209) UNIVERSITY HEALTH CARE FOUNDATION, INC. (EIN: 58-1343550) UNIVERSITY EXTENDED CARE, INC. (EIN: 58-1581105) AUGUSTA RESOURCE CENTER ON AGING, INC. (EIN: 58-1728812) WHILE THE AFOREMENTIONED ORGANIZATIONS ARE NOT EXPLICITLY NAMED AS SUPPORTED ORGANIZATIONS IN PHC'S GOVERNING DOCUMENTS, THEY ARE INCORPORATED INTO THE DOCUMENTS BY VIRTUE OF REFERENCE TO PHC'S EXEMPT PURPOSE OF SUPPORTING ITS TAX-EXEMPT SUBSIDIARIES. AS OF THEIR PURCHASE BY PHC, THE ENTITIES BECAME WHOLLY-OWNED SUBSIDIARIES AND SUPPORTED ORGANIZATIONS OF PIEDMONT HEALTHCARE. SCHEDULE A, PART IV, SECTION E, LINE 3A: POWER TO ELECT SUBSIDIARY BOARDS PURSUANT TO THE PROVISIONS OF ITS CHARTER AND BYLAWS, THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE APPOINTS ALL OF THE MEMBERS OF THE BOARDS OF DIRECTORS OF EACH OF ITS SUPPORTED SUBSIDIARY ENTITIES. SCHEDULE A, PART IV, SECTION E, LINE 3B: DIRECTION OVER SUPPORTED ORGS THE POLICIES AND DECISIONS OF EACH OF PIEDMONT HEALTHCARE'S SUPPORTED SUBSIDIARY ENTITY BOARDS OF DIRECTORS MUST BE FILED, IMMEDIATELY AFTER ADOPTION, WITH THE SECRETARY OF THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS. SUCH POLICIES AND DECISIONS OF THE SUBSIDIARY BOARDS 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. THE PROGRAMS AND ACTIVITIES OF EACH OF PIEDMONT HEALTHCARE'S SUPPORTED SUBSIDIARY ORGANIZATIONS, INCLUDING SERVICES OFFERED, ANNUAL OPERATING BUDGETS, AND APPOINTMENT AND COMPENSATION OF SENIOR EXECUTIVES, ARE DETERMINED BY OR SUBJECT TO THE REVIEW OF PIEDMONT HEALTHCARE'S EXECUTIVE LEADERSHIP AND BOARD OF DIRECTORS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 470019 false false 470019 false SCHEDULE C, PART II-B, LINE 1(G): LOBBYING ACTIVITIES HEALTH CARE POLICY IS CRITICAL TO ALL AMERICANS, AND PIEDMONT HEALTHCARE BELIEVES THAT HEALTH CARE PROVIDERS MUST PARTICIPATE IN SHAPING HEALTH CARE POLICY BY INTERACTING WITH NATIONAL, STATE, AND LOCAL REPRESENTATIVES AND THEIR STAFF MEMBERS TO HELP THEM BETTER UNDERSTAND THE COMPLEXITIES AND RAMIFICATIONS OF KEY HEALTH CARE POLICIES INCLUDING, WITHOUT LIMITATION, THOSE RELATED TO UNINSURED AND INDIGENT PATIENT NEEDS, AS WELL AS THE IMPORTANCE OF ASSURING THE DELIVERY OF COST-EFFICIENT, QUALITY HEALTH CARE. DURING FISCAL YEAR 2023, PIEDMONT HEALTHCARE ENGAGED A CONTRACT LOBBYIST TO, ALONG WITH PIEDMONT HEALTHCARE'S VICE PRESIDENT OF GOVERNMENT RELATIONS, REPRESENT THE INTERESTS OF THE ORGANIZATION AND ITS SUBSIDIARIES BEFORE FEDERAL, STATE, AND LOCAL ELECTED OFFICIALS AND REGULATORS. LOBBYING EXPENSE REPORTED HEREIN INCLUDES A PORTION OF THE SALARY PROVIDED TO THE VICE PRESIDENT OF GOVERNMENT RELATIONS, AS WELL AS EXPENSES RELATED TO THE ACTIVITIES OF OUTSIDE LOBBYISTS. 820769 820769 24888096 15609359 9278737 109012139 30542720 78469419 516376049 373075129 143300920 154261363 154261363 386131208 FAYETTE COMMUNITY HOSPITAL 43679729 C PIED MOUNTAINSIDE HOSPITAL 43407781 C AMSTER-MCRAE INSURANCE COMPANY 120000 C CENTER FOR HEALTH & LEARNING 1425000 C COLUMBUS REG. HEALTH SYS. 435820 C BUCKHEAD SURG. CTR. 2612157 C ENCOMPASS REHAB JV 66661700 C 158342187 DUE FROM RELATED PARTIES -298341224 OTHER CURRENT ASSETS 81677657 INVEST ONCOLOGY PARTNERSHIP 6178870 UNAMORTIZED ISSUE COST 4758740 INVESTMENT - OTHER 983237413 777511456 0 DUE TO RELATED PARTIES 0 TAXABLE BOND LIABILITY 1000000000 1000000000 X SCHEDULE D, PART X, LINE 2: ASC 740 FOOTNOTE (FKA FIN 48) PHC ACCOUNTS FOR INCOME TAXES UNDER THE PROVISIONS OF ASC 740, INCOME TAXES (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 UNCERTAIN TAX EXPOSURE ITEMS. THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS AT JUNE 30, 2023 AND 2022. Central America and the Caribbean 0 0 Program Services Insurance Premiums 37714098 Central America and the Caribbean 0 0 Investments 125312769 0 0 0 0 163026867 163026867 true false true false false false SCHEDULE F, PART I: ACCOUNTING METHOD USED ALL AMOUNTS REPORTED ON SCHEDULE F, PART I, LINE 3 WERE DETERMINED USING THE ACCRUAL METHOD OF ACCOUNTING. X X X true true X X X X true true false false false false false true false Mr Kevin Brown Board Member & CEO, PHC 1586846 0 1024812 0 573421 0 401674 0 21793 0 3608546 0 383374 0 Dr Monica Hum MD Board Member 0 356066 0 67981 0 8014 0 1685 0 17051 0 450797 0 0 Dr Moiz Master MD Board Member 0 396206 0 88250 0 24398 0 10579 0 14206 0 533639 0 0 Mr Michael McAnder FORMER TREASURER/CFO PHC 0 0 0 0 150106 0 0 0 0 0 150106 0 0 0 Mr Thomas Arnold TREASURER/CFO PHC 640918 0 356487 0 176039 0 115097 0 15644 0 1304185 0 96797 0 Ms Elizabeth Leddy CHIEF LEGAL OFF & Sec. 547780 0 295524 0 546181 0 117950 0 20761 0 1528196 0 490447 0 Dr Leigh Hamby MD PHC CMO 686405 0 306142 0 195481 0 122549 0 18227 0 1328804 0 104249 0 Ms Michelle Fisher Pres. Prim Care & Ret Svcs 0 459775 0 191383 0 104680 0 84051 0 21793 0 861682 0 65751 Mr Michael Mandl Exec. Vice President 964313 0 515975 0 100310 0 181350 0 14704 0 1776652 0 0 0 Mr Christopher Lloyd President Piedmont Clinic 0 608197 0 253321 0 566403 0 121240 0 9572 0 1558733 0 493344 Mr Sidney Kirschnerthru 10312 Chief Philanthropy Officer 534771 0 336351 0 319947 0 96606 0 12980 0 1300655 0 78306 0 Mr Douwe Bergsma Chief Marketing Officer 408995 0 195527 0 87432 0 81388 0 14704 0 788046 0 0 0 MR JOHN TILLMAN CHIEF REAL ESTATE OFFICER 384771 0 169380 0 129979 0 76811 0 20749 0 781690 0 0 0 Mr Geoffrey Brown Chief Information Officer 488624 0 211710 0 133428 0 86057 0 14682 0 934501 0 69546 0 Ms Vicki Cansler Chief HR Officer 467245 0 181815 0 130116 0 84147 0 9955 0 873278 0 65847 0 DR CHARLES BROWN MD PHYSICIAN 0 657588 0 322611 0 190763 0 118174 0 19989 0 1309125 0 99874 MR JOSEPH COLONNA CHIEF SUPPLY CHAIN OFFICER 450627 0 116437 0 124322 0 18300 0 21793 0 731479 0 0 0 SCHEDULE J, PART I, LINE 1A: OTHER COMPENSATION ITEMS FIRST-CLASS TRAVEL: THE FOLLOWING INDIVIDUAL WAS PERMITTED (PURSUANT TO THEIR CONTRACTS) TO FLY FIRST-CLASS DURING CALENDAR YEAR 2022. FIRST-CLASS TRAVEL IS NOT REPORTED ON THE EMPLOYEE'S FORM W-2, HOWEVER, THE COMPANY IS REIMBURSED FOR ANY PERSONAL EXPENSES INCURRED BY THE EMPLOYEE. KEVIN BROWN TRAVEL FOR COMPANIONS: CERTAIN EXECUTIVES ARE PERMITTED TO TRAVEL WITH COMPANIONS WHEN IT IS APPROPRIATE FOR THE BUSINESS EVENT AND PURPOSE. TRAVEL FOR COMPANIONS IS REVIEWED ON A CASE BY CASE BASIS AND IS REIMBURSED BY THE EMPLOYEE, PAID ON BEHALF OF THE EMPLOYEE, OR TREATED AS TAXABLE INCOME, AS APPROPRIATE AND IN COMPLIANCE WITH COMPANY POLICY. DISCRETIONARY SPENDING ACCOUNTS: THE FOLLOWING EMPLOYEES RECEIVED DISCRETIONARY SPENDING ACCOUNTS IN FIXED AMOUNTS DETERMINED BY JOB LEVEL. THESE SPENDING ACCOUNTS WERE INCLUDED IN EACH EMPLOYEE'S TAXABLE WAGES: KEVIN BROWN $37,700 MICHAEL MANDL $12,000 LEIGH HAMBY $12,000 CHARLES BROWN $12,000 THOMAS ARNOLD $12,000 SIDNEY KIRSCHNER $10,154 CHRISTOPHER LLOYD $12,000 ELIZABETH LEDDY $12,000 MICHELLE FISHER $12,000 GEOFFREY BROWN $12,000 VICKI CANSLER $12,000 DOUWE BERGSMA $12,000 JOHN TILLMAN $12,000 SCHEDULE J, PART I, LINE 4A: SEVERANCE PAYMENTS MICHAEL MCANDER RECEIVED A SEVERANCE PAYMENT DURING CALENDAR YEAR 2022 IN THE AMOUNT OF $150,106. SCHEDULE J, PART I, LINE 4B: SUPPLEMENTAL COMPENSATION INFORMATION THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THEIR SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS: KEVIN BROWN: $383,374 THOMAS ARNOLD: $ 96,797 ELIZABETH LEDDY: $490,447 LEIGH HAMBY: $104,249 MICHELLE FISHER: $ 65,751 CHRISTOPHER LLOYD: $493,344 SIDNEY KIRSCHNER: $ 78,306 GEOFFREY BROWN: $ 69,546 VICKI CANSLER: $ 65,847 CHARLES BROWN: $ 99,874 THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, BUT DID NOT RECEIVE CURRENT YEAR PAYMENTS: MICHAEL MANDL DOUWE BERGSMA JOHN TILLMAN SCHEDULE J, PART I, LINE 7: NON-FIXED PAYMENTS CERTAIN EMPLOYEES PARTICIPATED IN AN "ANNUAL INCENTIVE PLAN" UNDER WHICH THEY RECEIVED NON-FIXED PAYMENTS BASED ON JOB LEVEL AND SEVERAL DIFFERENT PERFORMANCE METRICS. FORM 990, PART V, LINE 1A: NUMBER OF FORMS 1099 FILED IN CALENDAR YEAR 2022, PIEDMONT HEALTHCARE, INC., FILED FORMS 1099 ON BEHALF OF ITSELF AND EACH OF ITS SUBSIDIARIES, PURSUANT TO AN AGREEMENT WITH THE IRS TO FILE ALL FORMS 1099 FOR THE PIEDMONT HEALTHCARE SYSTEM ON A COMBINED BASIS. FORM 990, PART VI, SECTION A, LINE 7B: DECISIONS OF GOVERNING BODY ALL RESOLUTIONS ADOPTED AND ALL BUSINESS TRANSACTED BY PHC'S BOARD OF DIRECTORS REQUIRES THE AFFIRMATIVE VOTE OF A MAJORITY OF THE DIRECTORS PRESENT AT THE TIME OF VOTING, AS LONG AS A QUORUM (MAJORITY OF DIRECTORS CURRENTLY IN OFFICE) IS REPRESENTED AT THE MEETING. FORM 990, PART VI, SECTION B, LINE 11B: 990 REVIEW PROCESS INFORMATION NEEDED TO PREPARE PIEDMONT HEALTHCARE'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT AND REVIEWED BY PHC'S CONTROLLER AND VP/CFO. THE 990 IS THEN PREPARED INTERNALLY BY PIEDMONT HEALTHCARE'S TAX DEPARTMENT AND SUBMITTED TO AN EXTERNAL TAX PREPARER FOR REVIEW. COPIES OF FORM 990 ARE PROVIDED TO THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C: CONFLICT OF INTEREST POLICY COMPLIANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY ORGANIZATION MANAGEMENT IN COORDINATION WITH PIEDMONT HEALTHCARE'S CHIEF COMPLIANCE OFFICER. ALL SENIOR LEADERS, BOARD MEMBERS, PHYSICIAN EMPLOYEES, NURSE PRACTITIONERS/PHYSICIAN ASSISTANTS AND EMPLOYEES AND NON-EMPLOYEES ENGAGED IN RESEARCH ARE REQUIRED TO ANNUALLY DISCLOSE ALL MATTERS WHICH COULD POTENTIALLY CONSTITUTE A CONFLICT OF INTEREST. MATTERS DISCLOSED UNDER THE POLICY MUST BE REVIEWED IN WRITING BY THE PIEDMONT HEALTHCARE CONFLICT OF INTEREST COMMITTEE IN ORDER TO DETERMINE WHETHER A CONFLICT EXISTS AND, IF SO, WHETHER TO ELIMINATE OR MANAGE THE CONFLICT. ALL BOARD MEMBERS AND EMPLOYEES OF PIEDMONT HEALTHCARE ARE PROVIDED TRAINING ON CONFLICT OF INTEREST ISSUES, INCLUDING REPORTING REQUIREMENTS, AT NEW-EMPLOYEE ORIENTATION AND AT LEAST ANNUALLY THEREAFTER. NONCOMPLIANCE WITH THE CONFLICT OF INTEREST POLICY MUST BE REPORTED TO PIEDMONT HEALTHCARE'S SENIOR VICE PRESIDENT OF COMPLIANCE FOR INVESTIGATION, AND REMEDIAL STEPS MUST BE TAKEN AS APPROPRIATE UNDER THE PIEDMONT HEALTHCARE DISCIPLINARY POLICIES. FORM 990, PART VI, SECTION B, LINE 15A & 15B: EXECUTIVE COMPENSATION COMPENSATION FOR EXECUTIVES OF PIEDMONT HEALTHCARE IS SET BY ITS BOARD OF DIRECTORS AND BY THE BOARD'S EXECUTIVE PERFORMANCE AND COMPENSATION COMMITTEE. THE PIEDMONT HEALTHCARE, INC., BOARD OF DIRECTOR'S EXECUTIVE PERFORMANCE AND COMPENSATION COMMITTEE ("COMMITTEE") IS COMPOSED OF AT LEAST THREE MEMBERS OF THE PHC BOARD OF DIRECTORS, 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 OVERSEES EXECUTIVE PERFORMANCE AND COMPENSATION ON BEHALF OF THE PHC BOARD, SUBJECT TO THE ULTIMATE AUTHORITY AND OVERSIGHT OF THE BOARD. THE COMMITTEE ALSO FORMULATES POLICIES AND MAKES DECISIONS IN ORDER TO ENSURE A HIGH LEVEL OF EXECUTIVE PERFORMANCE. THE COMMITTEE IS AUTHORIZED TO ACT ON BEHALF OF THE PHC BOARD AS SET OUT IN ITS CHARTER, AND THE COMMITTEE IS ALSO CHARGED WITH PROVIDING RECOMMENDATIONS AND PERIODIC REPORTS TO THE PHC BOARD REGARDING EXECUTIVE PERFORMANCE AND COMPENSATION. ALL DECISIONS AND COMPARABILITY DATA ARE DOCUMENTED IN THE COMMITTEE MEETING MINUTES. FUNCTIONS OF THE COMMITTEE: - ASSESS AND IMPLEMENT POLICIES REGARDING PERFORMANCE, COMPENSATION AND BENEFITS OF THE PRESIDENT/CEO AND OTHER EXECUTIVES AS DETERMINED BY THE COMMITTEE - SELECT AN EXECUTIVE COMPENSATION CONSULTANT WHO REPORTS TO THE COMMITTEE - ANNUALLY REVIEW THE PRESIDENT/CEO SUCCESSION PLAN - FORMULATE AND IMPLEMENT ANNUAL PERFORMANCE OBJECTIVES FOR THE PRESIDENT/CEO, AND REVIEW AND APPROVE ANNUALLY RECOMMENDATIONS FROM THE PRESIDENT/CEO RELATING TO COMPENSATION, PERFORMANCE OBJECTIVES, AND SUCCESSION PLANS FOR EVP EXECUTIVES - ANNUALLY ASSESS PRESIDENT/CEO PERFORMANCE; IF NECESSARY, IMPLEMENT ACTION PLAN WITH PRESIDENT/CEO INPUT TO IMPROVE HIS/HER PERFORMANCE; ADJUST COMPENSATION AS APPROPRIATE; THE COMMITTEE CHAIR SHALL CONSULT WITH THE PHC GOVERNANCE COMMITTEE CHAIR AND THE PHC BOARD CHAIR AND SHALL COORDINATE THE ANNUAL PERFORMANCE REVIEW OF THE PHC PRESIDENT/CEO, UNLESS THE PHC BOARD CHAIR HAS A REAL OR PERCEIVED CONFLICT OF INTEREST, IN WHICH CASE THE COMMITTEE CHAIR SHALL DETERMINE THE PROPER REVIEW PROCESS - REVIEW AND APPROVE LONG-TERM AND SHORT-TERM GOALS TO BE USED IN CONNECTION WITH EVP COMPENSATION PROGRAMS AS RECOMMENDED BY THE PRESIDENT/CEO AND VALIDATED BY THE COMPENSATION CONSULTANT - PERIODICALLY REVIEW COMPENSATION, IF ANY, FOR THE PHC BOARD CHAIR AND ALL BOARD CHAIRS OF THE PHC SUBSIDIARIES - ESTABLISH OTHER POLICIES AND PROCEDURES, AND PERFORM OTHER TASKS, RELATED TO EXECUTIVE PERFORMANCE AND COMPENSATION, INCLUDING BUT NOT LIMITED TO, APPROVAL OF EXECUTIVE EMPLOYMENT CONTRACTS AND BENEFITS - PERIODICALLY REPORT SIGNIFICANT DECISIONS AND ANY ADDITIONAL REQUESTED INFORMATION TO THE PHC BOARD. FORM 990, PART VI, SECTION C, LINE 19: DISCLOSURE OF DOCUMENTS 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. FORM 990, PART XI, LINE 9: RECONCILIATION OF NET ASSETS BOOK/TAX DIFFERENCES $ 2,623,923 CHANGE IN EQUITY $ 19,329,220 TRANSFER OF LIABILITIES ($461,278,036) ------------------------------------------- TOTAL ($439,324,893) FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT SERVICES TOTAL FEES:32946494 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION FEES TOTAL FEES:9070676 FORM 990 PART IX LINE 11G DESCRIPTION:ADMINISTRATIVE SERVICES TOTAL FEES:1977829 FORM 990 PART IX LINE 11G DESCRIPTION:PRINTING TOTAL FEES:671571 FORM 990 PART IX LINE 11G DESCRIPTION:LAB SERVICES TOTAL FEES:127085 FORM 990 PART IX LINE 11G DESCRIPTION:DOCUMENT STORAGE TOTAL FEES:196484 FORM 990 PART IX LINE 11G DESCRIPTION:TRANSCRIPTIONS TOTAL FEES:72259 PIEDMONT HOSPITAL Inc 1968 PEACHTREE ROAD NW ATLANTA GA 30309 580566213 HOSPITAL GA 501(c)(3) 3 PHC false FAYETTE COMMUNITY HOSPITAL INC 1255 HIGHWAY 54 WEST FAYETTEVILLE GA 30214 582232328 HOSPITAL GA 501(c)(3) 3 phc false PIEDMONT MOUNTAINSIDE HOSPITAL INC 1266 HIGHWAY 515 SOUTH JASPER GA 30143 352228583 HOSPITAL GA 501(c)(3) 3 phc false PIEDMONT NEWNAN HOSPITAL INC 745 POPLAR ROAD NEWNAN GA 30265 205077249 HOSPITAL GA 501(c)(3) 3 phc false PIEDMONT HEALTHCARE FOUNDATION INC 2001 PEACHTREE ROAD NE SUITE 400 ATLANTA GA 30309 581272768 FUNDRAISING GA 501(c)(3) 12B, II phc false PIEDMONT HENRY HOSPITAL INC 1133 EAGLES LANDING PKWY STOCKBRIDGE GA 30281 582200195 HOSPITAL GA 501(c)(3) 3 PHC false PIEDMONT NEWTON HOSPITAL INC 5126 HOSPITAL DRIVE NE COVINGTON GA 30014 582155150 HOSPITAL GA 501(C)(3) 3 PHC false PIEDMONT ATHENS REGIONAL FOUNDATION INC 1199 PRINCE AVENUE ATHENS GA 30606 581978389 fundraising GA 501(c)(3) 12B, II PARMC false PIEDMONT ATHENS REGIONAL HEALTH RESOURCE 1199 PRINCE AVENUE athens GA 30606 581930580 development GA 501(c)(3) 12B, II PARMC false PIEDMONT ATHENS REGIONAL MEDICAL CENTER 1199 PRINCE AVENUE ATHENS GA 30606 582179986 Hospital GA 501(c)(3) 3 PHC false ATHENS REGIONAL PHYSICIAN SERVICES INC 1199 PRINCE AVENUE ATHENS GA 30606 582332921 Healthcare GA 501(c)(3) 12B, II PARMC false ATHENS REGIONAL SPECIALTY SERVICES INC 1199 PRINCE AVENUE Athens GA 30606 271975001 Healthcare GA 501(c)(3) 3 PARMC false REGIONAL FIRSTCARE INC 1199 PRINCE AVENUE Athens GA 30606 582362733 Urgent Care GA 501(c)(3) 12B, II PARMC false THE MEDICAL CENTER INC 707 CENTER STREET COLUMBUS GA 31901 581685139 HOSPITAL GA 501(C)(3) 3 CRHS false COLUMBUS REGIONAL HEALTHCARE SYSTEM INC 707 CENTER STREET COLUMBUS GA 31901 581719994 MANAGEMENT GA 501(C)(3) 12B, II PHC false COLUMBUS REGIONAL MEDICAL FOUNDATIONINC 707 CENTER STREET COLUMBUS GA 31901 581501642 FUNDRAISING GA 501(C)(3) 7 CRHS false HUGHSTON HOSPITAL INC 707 CENTER STREET COLUMBUS GA 31901 331216751 HOSPITAL GA 501(C)(3) 3 CRHS false PIEDMONT ROCKDALE HOSPITAL INC 1412 MILSTEAD AVE CONYERS GA 30012 300999841 HOSPITAL GA 501(C)(3) 3 PHC false PIEDMONT WALTON HOSPITAL INC 2151 WEST SPRING ST MONROE GA 30655 824194264 HOSPITAL GA 501(C)(3) 3 PHC false PIEDMONT HEART INSTITUTE INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 263553500 healthcare GA 501(C)(3) 10 PHC false COLUMBUS AMBULATORY HEALTHCARE SERVICES 707 CENTER STREET COLUMBUS GA 31901 581719867 AMBULATORY GA 501(C)(3) 3 CRHS false PIEDMONT CARTERSVILLE HOSPITAL INC 960 JOE FRANK HARRIS PKWY SE CARTERSVILLE GA 30120 870963633 HOSPITAL GA 501(C)(3) 3 PHC false PIEDMONT EASTSIDE HOSPITAL INC 1700 MEDICAL WAY snellville GA 30078 870982886 HOSPITAL GA 501(C)(3) 3 PHC false PIEDMONT MACON HOSPITAL INC 350 HOSPITAL DR MACON GA 31217 871006981 HOSPITAL GA 501(C)(3) 3 PHC false PIEDMONT MACON NORTH HOSPITAL INC 400 CHARTER BLVD MACON GA 31210 871031034 HOSPITAL GA 501(C)(3) 3 PHC false UNIVERSITY HEALTH SERVICES INC 1350 WALTON WAY AUGUSTA GA 30901 581581103 HOSPITAL GA 501(C)(3) 3 PHC false UNIVERSITY MCDUFFIE COUNTY REG MED CTR 1350 WALTON WAY AUGUSTA GA 30901 454166209 HOSPITAL GA 501(C)(3) 3 PHC false UNIVERSITY HEALTH CARE FOUNDATION INC 2260 WRIGHTSBORO ROAD AUGUSTA GA 30904 581343550 FUNDRAISING GA 501(C)(3) 7 UHS false UNIVERSITY EXTENDED CARE INC 1350 WALTON WAY AUGUSTA GA 30901 581581105 HEALTHCARE GA 501(C)(3) 3 UHS false COLUMBUS REGIONAL SENIOR LIVING INC 707 CENTER STREET COLUMBUS GA 31901 582628502 HEALTHCARE GA 501(C)(3) 12C, III-FI PHC false AUGUSTA RESOURCE CENTER ON AGING INC 1350 WALTON WAY AUGUSTA GA 30901 581728812 HEALTHCARE GA 501(C)(3) 10 PHC false GA SURG CTR PCHTREE 2061 PEACHTREE RD STE 100 ATLANTA GA 30309 582394271 SURGERY GA NA NONE 0 0 false 0 false ORTHOATLANTA SURGERY CENTER FAYETTEVILLE 900 CIRCLE 75 PKWY SE STE 1700 ATLANTA GA 30339 202961633 SURGERY GA NA NONE 0 0 false 0 false ATHENS ASC HOLDINGS LLC 2142 W BROAD ST BLDG 100 STE 100 ATHENS GA 30606 454014891 SURGERY GA NA NONE 0 0 false 0 false COLUMBUS DIAGNOSTIC IMAGING CTR 116 INTRACOASTAL POINTE DR 300 JUPITER FL 33477 262291768 IMAGING GA NA NONE 0 0 false 0 false THE SURGERY CTR LLC 100 FIRST COURT COLUMBUS GA 31909 582520623 SURGERY GA NA NONE 0 0 false 0 false PIEDMONT ENCOMPASS REHAB HOSPITALS LLC 9001 LIBERTY PKWY BIRMINGHAM AL 35242 853544795 HEALTHCARE DE PHC NONE 0 0 false 0 false COLISEUM SAME DAY SURGERY CTR LP 340 HOSPITAL DR MACON GA 31217 621805346 SURGERY GA NA NONE 0 0 false 0 false PIEDMONT MEDICAL CARE CORPORATION 2727 PACES FERRY ROAD SUITE 1-1100 ATLANTA GA 30339 582092768 HEALTHCARE GA PHC C-CORP -113391219 394105351 1.00000 true THE PIEDMONT CLINIC INC 2727 PACES FERRY ROAD SUITE 1-1100 ATLANTA GA 30339 582005358 HEALTHCARE GA PHC C-CORP 2454952 24730731 1.00000 true PIEDMONT HEART INSTITUTE PHYSICIANS INC 95 COLLIER ROAD NW STE 2045 ATLANTA GA 30309 260593850 HEALTHCARE GA PHC C-CORP -23841569 135442137 1.00000 true AMSTER MCRAE INSURANCE COMPANY SPC PO BOX 1159 Grand Cayman CJ KY 1-1102 981734069 Related Insur CJ PHC C-CORP 33089705 216736589 1.00000 true COLUMBUS HEALTHCARE RESOURCES PO BOX 790 COLUMBUS GA 31902 581717754 HEALTHCARE GA NA C-CORP 0 0 false COLUMBUS HEALTH SERVICES INC PO BOX 790 COLUMBUS GA 31902 581640939 HEALTHCARE GA NA C-CORP 0 0 false UNIVERSITY HEALTH RESOURCES INC 1350 WALTON WAY AUGUSTA GA 30901 581601372 HEALTHCARE GA NA C-CORP 0 0 false UNIVERSITY HOSPITAL AIKEN INC 1350 WALTON WAY AUGUSTA GA 30901 472713774 HOSPITAL SC NA C-CORP 0 0 false true false false true true false false false false false false false false false false true false false false PIEDMONT HOSPITAL INC P 31591007 ACTUAL FAYETTE COMMUNITY HOSPITAL INC P 13630550 ACTUAL PIEDMONT MEDICAL CARE CORPORATION A(iv) 1666963 ESTIMATE PIEDMONT HEART INSTITUTE PHYSICIANS A(iv) 227307 ACTUAL PIEDMONT HOSPITAL INC A(iv) 836308 ESTIMATE PIEDMONT MOUNTAINSIDE HOSPITAL INC P 3065575 ACTUAL PIEDMONT NEWNAN HOSPITAL INC P 8278784 ACTUAL Piedmont Henry Hospital Inc P 11188482 ACTUAL PIEDMONT NEWTON HOSPITAL INC P 3775680 ACTUAL PIEDMONT ATHENS REGIONAL MEDICAL CENTER INC P 21562940 ACTUAL PIEDMONT ROCKDALE HOSPITAL INC P 6390944 ACTUAL PIEDMONT WALTON HOSPITAL INC P 2494027 ACTUAL ATHENS REGIONAL PHYSICIAN SVCS INC P 1039178 ACTUAL ATHENS REGIONAL SPECIALTY SVCS P 2494027 ACTUAL PIEDMONT HEART INSTITUTE INC P 2251552 ACTUAL HUGHSTON HOSPITAL P 2927018 ACTUAL The Medical Center p 14306015 ACTUAL COLUMBUS AMBULATORY HEALTHCARE SERVICES p 1749283 ACTUAL PIEDMONT CLINIC A(iv) 13131 ACTUAL PIEDMONT CARTERSVILLE HOSPITAL INC p 4970734 ACTUAL PIEDMONT EASTSIDE HOSPITAL INC p 6823935 ACTUAL PIEDMONT MACON HOSPITAL INC p 7256925 ACTUAL PIEDMONT MACON NORTH HOSPITAL INC p 1853201 ACTUAL SCHEDULE R, PART I, LINE 1: DISREGARDED ENTITIES THE LIMITED LIABILITY COMPANIES LISTED IN SCHEDULE R, PART I, OPERATE AS DEPARTMENTS OF PIEDMONT HEALTHCARE AND ARE INCORPORATED INTO PIEDMONT HEALTHCARE'S BOOKS AND RECORDS. SEPARATE BOOKS AND RECORDS ARE NOT MAINTAINED FOR THE LIMITED LIABILITY COMPANIES AND ASSETS AND INCOME CANNOT BE READILY DETERMINED. AS SUCH, COLUMNS (D) AND (E) IN PART I HAVE BEEN LEFT BLANK.