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        <Desc>PATIENT SERVICE</Desc>
        <BusinessCd>621110</BusinessCd>
        <TotalRevenueColumnAmt>33366145</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>33366145</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER OPERATING</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>937833</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>937833</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>34303978</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </RoyaltiesRevenueGrp>
      <LessRentalExpensesGrp>
        <RealAmt>15966</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>-15966</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>-15966</TotalRevenueColumnAmt>
        <ExclusionAmt>-15966</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>11028</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <OtherAmt>-11028</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-11028</TotalRevenueColumnAmt>
        <ExclusionAmt>-11028</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>0</FundraisingGrossIncomeAmt>
      <FundraisingDirectExpensesAmt>0</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <GamingGrossIncomeAmt>0</GamingGrossIncomeAmt>
      <GamingDirectExpensesAmt>0</GamingDirectExpensesAmt>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeFromGamingGrp>
      <GrossSalesOfInventoryAmt>0</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>0</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueTotalAmt>0</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>34276984</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>34303978</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>-26994</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>0</TotalAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>8232639</TotalAmt>
        <ProgramServicesAmt>7604489</ProgramServicesAmt>
        <ManagementAndGeneralAmt>628150</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>51280</TotalAmt>
        <ProgramServicesAmt>47367</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3913</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1062751</TotalAmt>
        <ProgramServicesAmt>981663</ProgramServicesAmt>
        <ManagementAndGeneralAmt>81088</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>584920</TotalAmt>
        <ProgramServicesAmt>540291</ProgramServicesAmt>
        <ManagementAndGeneralAmt>44629</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>-4624</TotalAmt>
        <ManagementAndGeneralAmt>-4624</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>9203</TotalAmt>
        <ManagementAndGeneralAmt>9203</ManagementAndGeneralAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>6505961</TotalAmt>
        <ProgramServicesAmt>6009556</ProgramServicesAmt>
        <ManagementAndGeneralAmt>496405</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>14027</TotalAmt>
        <ManagementAndGeneralAmt>14027</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>-97067</TotalAmt>
        <ProgramServicesAmt>-89661</ProgramServicesAmt>
        <ManagementAndGeneralAmt>-7406</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>221925</TotalAmt>
        <ProgramServicesAmt>204992</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16933</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>626675</TotalAmt>
        <ProgramServicesAmt>578860</ProgramServicesAmt>
        <ManagementAndGeneralAmt>47815</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>6083</TotalAmt>
        <ProgramServicesAmt>5619</ProgramServicesAmt>
        <ManagementAndGeneralAmt>464</ManagementAndGeneralAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>0</TotalAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>683048</TotalAmt>
        <ManagementAndGeneralAmt>683048</ManagementAndGeneralAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1388453</TotalAmt>
        <ProgramServicesAmt>1282514</ProgramServicesAmt>
        <ManagementAndGeneralAmt>105939</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>263498</TotalAmt>
        <ProgramServicesAmt>243393</ProgramServicesAmt>
        <ManagementAndGeneralAmt>20105</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>BAD DEBT EXPENSE</Desc>
        <TotalAmt>3985399</TotalAmt>
        <ProgramServicesAmt>3985399</ProgramServicesAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL SUPPLIES &amp; DRUGS</Desc>
        <TotalAmt>4450670</TotalAmt>
        <ProgramServicesAmt>4450670</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>HOSPITAL TAX</Desc>
        <TotalAmt>258811</TotalAmt>
        <ProgramServicesAmt>258811</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MISCELLANEOUS</Desc>
        <TotalAmt>127302</TotalAmt>
        <ProgramServicesAmt>117589</ProgramServicesAmt>
        <ManagementAndGeneralAmt>9713</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>28370954</TotalAmt>
        <ProgramServicesAmt>26221552</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2149402</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>6009943</BOYAmt>
        <EOYAmt>18165433</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>4886793</BOYAmt>
        <EOYAmt>4600053</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>622265</BOYAmt>
        <EOYAmt>986665</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>202667</BOYAmt>
        <EOYAmt>176958</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>26915887</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>1681604</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>25555436</BOYAmt>
        <EOYAmt>25234283</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>18268737</BOYAmt>
        <EOYAmt>21597030</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>55545841</BOYAmt>
        <EOYAmt>70760422</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>12266435</BOYAmt>
        <EOYAmt>11449834</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <GrantsPayableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </GrantsPayableGrp>
      <DeferredRevenueGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <EscrowAccountLiabilityGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </EscrowAccountLiabilityGrp>
      <LoansFromOfficersDirectorsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </LoansFromOfficersDirectorsGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>23461322</BOYAmt>
        <EOYAmt>21421207</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>883645</BOYAmt>
        <EOYAmt>785883</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>36611402</BOYAmt>
        <EOYAmt>33656924</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>18934439</BOYAmt>
        <EOYAmt>36990998</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>112500</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>18934439</BOYAmt>
        <EOYAmt>37103498</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>55545841</BOYAmt>
        <EOYAmt>70760422</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>5906030</ReconcilationRevenueExpnssAmt>
      <PriorPeriodAdjustmentsAmt>587514</PriorPeriodAdjustmentsAmt>
      <OtherChangesInNetAssetsAmt>11675515</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleC documentId="IRS990ScheduleC">
      <TotalGrassrootsLobbyingGrp />
      <TotalDirectLobbyingGrp />
      <TotalLobbyingExpendGrp />
      <OtherExemptPurposeExpendGrp />
      <TotalExemptPurposeExpendGrp />
      <LobbyingNontaxableAmountGrp />
      <GrassrootsNontaxableGrp />
      <TotLbbyngGrassrootMnsNonTxGrp />
      <TotLbbyExpendMnsLbbyngNonTxGrp />
      <VolunteersInd>false</VolunteersInd>
      <PaidStaffOrManagementInd>false</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>false</MediaAdvertisementsInd>
      <MailingsMembersInd>false</MailingsMembersInd>
      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>false</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>false</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <OtherActivitiesInd>true</OtherActivitiesInd>
      <OtherActivitiesAmt>9203</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>9203</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule C, Part II-B, Line 1, Lobbying Activities:</FormAndLineReferenceDesc>
        <ExplanationTxt>A part of various association dues include a percentage allocation for expenditures on lobbying activities. Dues paid to the Georgia Alliance of Community Hospitals and The American Hospital Association have a lobby component. For 2023 these fees amount to $9,203.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
      <ArtPublicExhibitionAmountsGrp />
      <HeldWorksArtGrp />
      <CYMinus3YrEndwmtFundGrp />
      <CYMinus4YrEndwmtFundGrp />
      <LandGrp>
        <InvestmentCostOrOtherBasisAmt>0</InvestmentCostOrOtherBasisAmt>
        <OtherCostOrOtherBasisAmt>2250000</OtherCostOrOtherBasisAmt>
        <BookValueAmt>2250000</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
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        <OtherCostOrOtherBasisAmt>20715332</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>872643</DepreciationAmt>
        <BookValueAmt>19842689</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
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        <DepreciationAmt>285747</DepreciationAmt>
        <BookValueAmt>394831</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
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        <OtherCostOrOtherBasisAmt>2877562</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>523214</DepreciationAmt>
        <BookValueAmt>2354348</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
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        <OtherCostOrOtherBasisAmt>392415</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>0</DepreciationAmt>
        <BookValueAmt>392415</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>25234283</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>PHYSICIAN GUARANTY RECEIVABLE</Desc>
        <BookValueAmt>124122</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>DUE FROM UHS</Desc>
        <BookValueAmt>21472908</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>21597030</TotalBookValueOtherAssetsAmt>
      <FederalIncomeTaxLiabilityAmt>0</FederalIncomeTaxLiabilityAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO RELATED PARTIES</Desc>
        <Amt>468187</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>MISCELLANEOUS</Desc>
        <Amt>317696</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>785883</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PART X, LINE 2: ASC 740 FOOTNOTE (FKA FIN 48)</FormAndLineReferenceDesc>
        <ExplanationTxt>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 OR 2022.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="IRS990ScheduleH">
      <FinancialAssistancePolicyInd>true</FinancialAssistancePolicyInd>
      <WrittenPolicyInd>true</WrittenPolicyInd>
      <FPGReferenceFreeCareInd>true</FPGReferenceFreeCareInd>
      <Percent200Ind>X</Percent200Ind>
      <FPGReferenceDiscountedCareInd>true</FPGReferenceDiscountedCareInd>
      <Percent400Ind>X</Percent400Ind>
      <FreeCareMedicallyIndigentInd>true</FreeCareMedicallyIndigentInd>
      <FinancialAssistanceBudgetInd>true</FinancialAssistanceBudgetInd>
      <ExpensesExceedBudgetInd>false</ExpensesExceedBudgetInd>
      <AnnualCommunityBnftReportInd>false</AnnualCommunityBnftReportInd>
      <FinancialAssistanceAtCostTyp>
        <TotalCommunityBenefitExpnsAmt>2079136</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>2079136</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.08530</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
        <TotalCommunityBenefitExpnsAmt>905883</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>812014</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>93869</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00380</TotalExpensePct>
      </UnreimbursedMedicaidGrp>
      <UnreimbursedCostsGrp>
        <TotalCommunityBenefitExpnsAmt>395634</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>478644</DirectOffsettingRevenueAmt>
      </UnreimbursedCostsGrp>
      <TotalFinancialAssistanceTyp>
        <TotalCommunityBenefitExpnsAmt>3380653</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>1290658</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>2173005</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.08910</TotalExpensePct>
      </TotalFinancialAssistanceTyp>
      <CommunityHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>23620</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>23620</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00100</TotalExpensePct>
      </CommunityHealthServicesGrp>
      <HealthProfessionsEducationGrp>
        <TotalCommunityBenefitExpnsAmt>22640</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>22640</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00090</TotalExpensePct>
      </HealthProfessionsEducationGrp>
      <TotalOtherBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>46260</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>46260</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00190</TotalExpensePct>
      </TotalOtherBenefitsGrp>
      <TotalCommunityBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>3426913</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>1290658</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>2219265</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.09100</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <EconomicDevelopmentGrp>
        <TotalCommunityBenefitExpnsAmt>585</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>585</NetCommunityBenefitExpnsAmt>
      </EconomicDevelopmentGrp>
      <EnvironmentalImprovementsGrp>
        <TotalCommunityBenefitExpnsAmt>15014</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>15014</NetCommunityBenefitExpnsAmt>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SCHEDULE H, PART V, SECTION B, LINE 5: COMMUNITY REPRESENTATION</FormAndLineReferenceDesc>
        <ExplanationTxt>A COMMUNITY LISTENING SESSION WAS HELD IN MCDUFFIE COUNTY. INDIVIDUALS FROM VARIOUS HEALTH AND SOCIAL SERVICE AGENCIES FROM MCDUFFIE, LINCOLN AND WARREN COUNTIES WERE INVITED TO ATTEND. THOSE AGENCIES THAT PARTICIPATED IN THE SESSIONS ARE: GEORGIA DEPARTMENT OF PUBLIC HEALTH, EAST CENTRAL HEALTH DISTRICT IV, CRAWFORD &amp; BREAZEALE DRUG CO., FAMILY CONNECTION OF WARREN COUNTY, FORWARD MCDUFFIE, THOMSON MCDUFFIE FIRE/EMS. THESE AGENCIES REPRESENT THE HOMELESS, THE ELDERLY AND INDIVIDUALS LIVING IN POVERTY, AS WELL AS THOSE FACING FOOD INSECURITY, MENTAL HEALTH ISSUES, OR ADDICTION. THOSE WHO WERE INVITED BUT DID NOT ATTEND WERE FROM THE FOLLOWING ORGANIZATIONS: THOMSON FAMILY YMCA, MCDUFFIE COUNTY EXTENSION SERVICE, FAMILY CARE GROUP, THOMSON DENTAL WELLNESS, ARCHWAY PARTNERSHIP, PARTNERS FOR SUCCESS, SHAW, LINCOLN COUNTY HEALTH DEPARTMENT, COMMUNITY MEDICAL ASSOCIATES, LINCOLNTON FAMILY DENTISTRY, LINCOLN COUNTY GOVERNMENT, LINCOLNTON FAMILY MEDICINE, LINCOLN COUNTY SCHOOLS, WARREN COUNTY HEALTH DEPARTMENT, FAMILY CONNECTION OF WARREN COUNTY, WARREN COUNTY SENIOR CENTER, HOMETOWN WARRENTON, COMMUNITY HEALTH CARE SYSTEM, CARE SOURCE, LINCOLN COUNTY OFFICE OF EMERGENCY SERVICES. REPRESENTATIVES FROM THESE ORGANIZATIONS WERE SENT AN EMAIL WITH THE LIST OF QUESTIONS FROM THE LISTENING SESSION AND INVITED TO PROVIDE FEEDBACK.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SCHEDULE H, PART V, SECTION B, LINE 7A: COMMUNITY HEALTH NEEDS ASSESSMENT</FormAndLineReferenceDesc>
        <ExplanationTxt>https://www.piedmont.org/media/file/Community-Benefit-Needs-Assessment-PMD .pdf</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SCHEDULE H, PART V, LINE 7D: PUBLIC AVAILABILITY OF CHNA</FormAndLineReferenceDesc>
        <ExplanationTxt>IN ADDITION TO MAKING ITS CHNA REPORTS AVAILABLE ON ITS WEBSITE AND BY REQUEST, PIEDMONT MCDUFFIE SENT COPIES TO EACH PARTICIPANT IN THE CHNA PROCESS, DISTRIBUTED THE ASSESSMENTS TO COMMUNITY CENTERS AND OTHER LOCATIONS THAT PRIMARILY SERVE AN UNINSURED POPULATION, SENT COPIES TO LEGISLATIVE AND ELECTED OFFICIALS, AND WIDELY DISTRIBUTED THE ASSESSMENTS TO OTHER PIEDMONT HEALTHCARE HOSPITALS.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SCHEDULE H, PART V, LINE 10A: IMPLEMENTATION STRATEGIES WEBSITE</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF DIRECTORS FOR PIEDMONT MCDUFFIE APPROVED ITS IMPLEMENTATION STRATEGY FOR THE THREE-YEAR PERIOD BEGINNING WITH FY23 ON OCTOBER 31, 2022, WITHIN THE GRACE PERIOD FOLLOWING THE APPROVAL OF THE NEW COMMUNITY HEALTH NEEDS ASSESSMENT. THE FOLLOWING LINK IS FOR THE IMPLEMENTATION STRATEGY EFFECTIVE THROUGH JUNE 30, 2025. https://www.piedmont.org/media/file/Community-Benefit-Implementation-Strat egy-PMD.pdf</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SCHEDULE H, PART V, LINE 11: ADDRESSING COMMUNITY HEALTH NEEDS</FormAndLineReferenceDesc>
        <ExplanationTxt>DURING FY22, PIEDMONT MCDUFFIE CONDUCTED ITS FIRST TRIENNIAL CHNA, BY ASSESSING PUBLICLY AVAILABLE DATA, INTERVIEWING COMMUNITY MEMBERS AND STAKEHOLDERS, CONDUCTING FOCUS GROUPS OF VULNERABLE POPULATIONS, INTERVIEWING PIEDMONT BOARD MEMBERS, AND SURVEYING PIEDMONT EMPLOYEES. THROUGH THIS PROCESS, PIEDMONT MCDUFFIE DETERMINED AND PRIORITIZED THE COMMUNITY HEALTH NEEDS IT WOULD ADDRESS BASED ON THE NUMBER OF PERSONS AFFECTED, THE SERIOUSNESS OF THE ISSUE, WHETHER THE HEALTH NEED AFFECTED VULNERABLE POPULATIONS, AND THE AVAILABILITY OF COMMUNITY AND HOSPITAL RESOURCES NECESSARY TO ADDRESS THE ISSUE. ALL PRIORITIES ARE VIEWED THROUGH THE LENS OF HEALTH DISPARITIES, WITH PARTICULAR ATTENTION PAID TO IMPROVING OUTCOMES FOR THOSE MOST VULNERABLE DUE TO INCOME AND RACE. BASED ON THE CHNA, PIEDMONT MCDUFFIE IS CURRENTLY FOCUSING ON: (1) ENSURING AFFORDABLE ACCESS TO HEALTH, MENTAL, AND DENTAL CARE (2) REDUCING PREVENTABLE INSTANCES OF, AND DEATHS FROM, CANCER (3) REDUCING PREVENTABLE INSTANCES OF, AND DEATHS FROM, HEART DISEASE (4) REDUCING PREVENTABLE INSTANCES OF DIABETES AND INCREASING ACCESS TO CARE FOR THOSE LIVING WITH THE DISEASE (5) REDUCING RATES OF OBESITY AND INCREASING ACCESS TO HEALTHY FOODS AND RECREATIONAL ACTIVITIES</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SCHEDULE H, PART V, LINE 16: FINANCIAL ASSISTANCE POLICY WEBSITES</FormAndLineReferenceDesc>
        <ExplanationTxt>FINANCIAL ASSISTANCE POLICY - HTTPS://WWW.PIEDMONT.ORG/MEDIA/FILE/FINANCIAL-ASSISTANCE-POLICY.PDF FINANCIAL ASSISTANCE APPLICATION - HTTPS://WWW.PIEDMONT.ORG/MEDIA/FILE/FINANCIAL-ASSISTANCE-APPLICATION.PDF FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY - HTTPS://WWW.PIEDMONT.ORG/MEDIA/FILE/FINANCIAL-ASSISTANCE-PLAIN-LANGUAGE-SU MMARY-ENGLISH.PDF</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>SCHEDULE H, PART V, LINE 21D: POLICY RELATING TO EMERGENCY MEDICAL CARE</FormAndLineReferenceDesc>
        <ExplanationTxt>FAP INCLUDED ER MEDICAL CARE CONDITIONS. IN ADDITION, PAM FOLLOWS EMTALA REGULATIONS.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART I, LINE 6A</FormAndLineReferenceDesc>
        <ExplanationTxt>PUBLIC AVAILABILITY OF COMMUNITY BENEFIT REPORT We regularly report to the community our community benefit activities in several ways. Each year, we prepare a systemwide community benefit report that is available to the public through publication on our website. We also make available our IRS Form 990 Schedule H on our website and provide copies to anyone upon request. We also provide information on community benefit programming to local, state, and federal lawmakers through our government affairs office and online at piedmont.org.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART I, LINE 7(F)</FormAndLineReferenceDesc>
        <ExplanationTxt>PERCENT OF TOTAL EXPENSE THE DENOMINATOR USED FOR THE CALCULATION OF COLUMN (F), PERCENT OF TOTAL EXPENSE, WAS THE AMOUNT OF TOTAL FUNCTIONAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) OF $28,370,954, LESS BAD DEBT EXPENSE OF $3,985,999 FROM FORM 990, PART IX, LINE 24(A).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST A RATIO OF PATIENT CARE COST TO CHARGES, CONSISTENT WITH WORKSHEET 2, WAS USED TO REPORT THE AMOUNTS IN PART I, LINES 7A-7D. FOR AMOUNTS ON LINES 7E-7K, ACTUAL EXPENSES FOR EACH COMMUNITY BENEFIT ACTIVITY ARE TRACED AND REPORTED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, LINES 2-4</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT EXPENSE CALCULATION AND FOOTNOTE THE PROVISION FOR BAD DEBTS IS BASED UPON LEADERSHIP'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. PERIODICALLY, LEADERSHIP ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THE REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. THE AMOUNT REPORTED ON PART III, LINE 3, WAS DETERMINED BY TAKING THE AVERAGE ACCEPTANCE RATE FOR ALL CHARITY CARE APPLICATIONS RECEIVED DURING THE YEAR MULTIPLIED BY THE NUMBER OF DENIALS THAT WERE ATTRIBUTABLE TO INSUFFICIENT INFORMATION. THAT TOTAL WAS THEN ADJUSTED DOWNWARD FOR THE ORGANIZATION'S USE OF PRESUMPTIVE ELIGIBILITY WHEN DETERMINING ITS COMMUNITY BENEFITS. BAD DEBT EXPENSE FOOTNOTE FROM CONSOLIDATED, AUDITED FINANCIAL STATEMENTS: THE PROVISION FOR BAD DEBTS IS BASED UPON LEADERSHIP'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY, leadership 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. PAM PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE ARE NOT REPORTED AS REVENUE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, LINE 8</FormAndLineReferenceDesc>
        <ExplanationTxt>MEDICARE SHORTFALLS AS COMMUNITY BENEFIT The amount reported on Part III, Line 6, was calculated in accordance with Schedule H instructions by utilizing our allowable Medicare cost as reported in the Medicare cost report, which is based on a cost to charge ratio. However, the allowable costs in the Medicare cost report do not reflect the actual cost of providing care to patients since the Medicare cost report excludes many direct patient care costs that are essential to provide quality healthcare for Medicare patients. For example, certain coverage fees to physicians, cost of Medicare C and D, and other similar direct patient care expenses are specifically excluded from allowable cost in the Medicare Cost Report. We believe our Medicare shortfall reported on Part III, Line 7 of Schedule H, should be considered a community benefit as the IRS community benefit standard includes the provision of care to elderly and Medicare patients. IRS Revenue Ruling 69-545 provides, in part, that hospitals serving patients with governmental health insurance, such as Medicare, is an indication we operate to promote health in the community. Our policy is to treat Medicare patients, regardless of the extent to which Medicare pays for the treatment. For many services, Medicare's reimbursement is less than the cost of the care provided, resulting in shortfalls that are to be absorbed by us in honor of our commitment to treat elderly patients. Many of these patients live on a low, fixed income, and would qualify for financial assistance or other means-tested programs, absent from their enrollment in Medicare.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, LINE 9(B)</FormAndLineReferenceDesc>
        <ExplanationTxt>COLLECTION PRACTICES INITIAL SCREENINGS OF ALL INPATIENT, EMERGENCY, AND SURGERY ENCOUNTERS, AS WELL AS MOST OUTPATIENT VISITS, ARE CONDUCTED BY FINANCIAL COUNSELORS IN ORDER TO IDENTIFY ANY AVAILABLE INSURANCE OR OTHER COVERAGE FOR EACH PATIENT. COUNSELORS CONTACT PATIENTS AND THEIR FAMILIES DIRECTLY, EITHER IN PERSON OR BY LETTER, TO ASSIST THE FAMILY IN IDENTIFYING ANY PROGRAMS FOR WHICH THE PATIENT/SERVICE MAY QUALIFY (INCLUDING MEDICAID, STATE CHILDREN'S HEALTH INSURANCE PROGRAM ("SCHIP"), PRIVATE OR GOVERNMENT INSURANCE COVERAGE, AND CHARITY ASSISTANCE). IF THE FAMILY CANNOT BE TIMELY LOCATED OR IS UNCOOPERATIVE, RELATED ACCOUNTS ARE TRANSFERRED TO AN INTERNAL COLLECTION DEPARTMENT FOR FURTHER ATTEMPTS TO OBTAIN PAYMENT OR, IF THE PATIENT MAY QUALIFY FOR ASSISTANCE, TO SECURE A FINANCIAL ASSISTANCE APPLICATION. THE ORGANIZATION'S DEBT COLLECTION POLICY AND PROCEDURES PROHIBIT ANY COLLECTION EFFORTS FOR THE PORTION OF A PATIENT ACCOUNT BALANCE THAT QUALIFIES FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 2: Needs Assessment</FormAndLineReferenceDesc>
        <ExplanationTxt>As a designated 501(c)(3) nonprofit hospital, we are required by the Internal Revenue System to conduct a triennial community health needs assessment (CHNA), in accordance with regulations put forth by the IRS following the 2010 Patient Protection and Affordable Care Act (ACA). Through this assessment, we hope to better understand local health challenges, identify health trends in our community, determine gaps in the current health delivery system and craft a plan to address those gaps and the identified health needs. In FY22, we conducted our first triennial CHNA and FY23 was the first year for activities outlined in its subsequent Implementation Strategy. The CHNA was led by the Piedmont Healthcare community benefits team and consulting organization Public Goods Group, with input and direction from Piedmont leadership and Piedmont Healthcare's Department of External Affairs. Process The CHNA started with a definition of our community, which is our home county due to the impact of our tax-exempt status. Property taxes make up the largest segment of a hospital's tax exemption, which impacts county revenues. Because of this, we aim to ensure that we are providing ample benefit to our county and its residents. Additionally, we take into consideration patient origin, especially that of our lower-income patients such as those who qualify for financial assistance or receive insurance coverage through Medicaid. Our secondary communities are considered the areas in which we have the highest concentration of patients fitting that criterion, including ones from nearby communities. Once we established our primary and secondary communities, we then conducted an analysis of available public health data. This included resources from: US Census, US Health and Human Services' Community Health Status Indicators, US Department of Agriculture, Economic Research Service, National Center for Education Statistics, Kaiser Family Foundation's State Health Facts, American Heart Association, County Health Rankings and Georgia Online Analytical Statistical Information System (OASIS). All figures within the CHNA were for 2020, unless otherwise noted. Health indicators are estimates provided by County Health Rankings and hospital data were internally sourced. We then interviewed key stakeholders who have a particular expertise or knowledge of our communities. Specifically, we interviewed representatives of local and regional public health entities, minority populations, faith-based communities, local business owners, the philanthropic community, mental health agencies, elected officials and individuals representing our most vulnerable patients. An internal survey was also conducted throughout the healthcare system for both clinical and non-clinical employees. Information was gathered on knowledge and understanding of community benefit and current programs, as well as suggestions for how we can better serve our patients and communities. Approximately 1,053 employees spanning the system responded. Additionally, we conducted a community-based survey that was widely advertised to the community. Once both qualitative and quantitative data was gathered, we authored the preliminary report, which was then vetted and reviewed by hospital and health system leadership. In this report, we identified several key community health needs that emerged during the assessment process. The chosen priorities were recommended by the community benefit department with sign-off from hospital and board leadership. The following criteria were used to establish the priorities: - The number of persons affected; - The seriousness of the issue; - Whether the health need particularly affected persons living in poverty or reflected health disparities; and, - Availability of community and/or hospital resources to address the need. All priorities are viewed through the lens of health disparities, with particular attention paid to improving outcomes for those most vulnerable due to income and race. The priorities we chose reflected a collective agreement on what hospital leadership, staff and the community felt was most important and within our ability to positively impact the issue. Once priorities were approved by the board of directors, we then authored the CHNA and presented our findings and recommendations to the hospital's board of directors for their input and approval. Our priorities A key component of the CHNA is to identify the top health priorities we will address over fiscal years 2023, 2024, and 2025. These priorities will guide our community benefit work. They are, in no order: - Ensure affordable access to health, mental, and dental care - Reduce preventable instances of and deaths from cancer - Reduce preventable instances of and deaths from heart disease - Reduce preventable instances of diabetes and increase access to care for those living with the disease - Reduce rates of obesity and increase access to healthy foods and recreational activities With each priority, we work to achieve greater health equity by reducing the impact of poverty and other socioeconomic indicators. This means that health equity is built into each priority, which is demonstrated through our implementation strategies. Our subsequent implementation strategy was developed in partnership with hospital leadership and community stakeholders to address the identified priorities in our FY22 community health needs assessment. The implementation strategy was designed to be executed over a three-year period and included specific metrics by which we would be able to evaluate our work and its impact. The implementation strategy was developed by utilizing community feedback from the assessment in partnership with the system community benefits department, our leadership, and our board of directors. We included proven and successful interventions and programming, investing further in work we felt was successful in addressing unmet health needs.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 3: Patient Education of Assistance Eligibility</FormAndLineReferenceDesc>
        <ExplanationTxt>We understand that not everyone can pay their hospital bill due to their insurance status or a limited income, and because of this, we offer financial assistance to qualifying patients. Notification about financial assistance includes, but is not limited to, a dedicated contact number, notices in patient bills, and posted notices in key areas of the hospital. These locations are the emergency room, admitting and registration departments, our business office, and patient financial services offices that are located on site. We also publish and widely publicize a plain language summary of this financial assistance care policy on our website, as well as the full policy. Referral of patients for financial assistance may be made by any staff or medical staff member at the hospital, including physicians, nurses, financial counselors, social workers, case managers, chaplains, and religious sponsors. A request for financial assistance may be made by the patient or a family member, close friend, or associate of the patient, subject to applicable privacy laws. Additionally, we provide copies of our financial assistance policy to our partner clinics and others who work closely with low-income populations. We help our partners in understanding the policy, how it relates to their populations, and receive feedback in ways our financial assistance programming could be improved.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 4: Community Information</FormAndLineReferenceDesc>
        <ExplanationTxt>While Piedmont McDuffie serves patients throughout Georgia, we consider our community to be McDuffie County. We do this in recognition of the direct impact of our tax-exempt status on county residents. In McDuffie County, an average of 21,700 people lived in the 257-square-mile area each year from 2017 to 2021. The population density for this area, estimated at 84 people per square mile, is less than the national average population density of 93 people per square mile. McDuffie County is mostly rural, as nearly 60 percent were living in a rural setting in 2020. The median age of people living within the county from 2017 to 2021 was 39, a little older than state and national averages. About 24 percent of the population were 17 or younger, 18 percent were over the age of 65, and the rest were between the ages of 18 and 64. Two percent of the population identified as being born outside of the US, and one percent did not possess US citizenship status. The Hispanic population within the community is growing and now represents approximately three percent of the community. An average of about eight percent of county residents were veterans each year from 2017 to 2021, with the highest concentration living in the ZIP code 30802 (Appling). The majority were below the age of 65. About 12 percent of the county population lived with a disability, and most were over the age of 65. The community in McDuffie is changing, with more than 240 people having moved out of the county between 2010 and 2020, representing a one percent decrease in population. With this decrease comes increased diversity, as white populations decreased and those of other races and ethnicities increased. Specifically, there was a seven percent decrease in white populations, a three percent increase in Asian populations, and a 66 percent increase in Hispanic or Latino populations. Between 2017 and 2021, the median household income was $50,721, which is lower than the state and national median incomes of $65,030 and $69,021, respectively. When broken down by the four dominant races in the community, income disparities are evident. Of employers in the community, the largest sector by number of employees was remanufacturing, which employed about 1,600 people at an average wage of $56,992 in 2019. Government and government enterprises was the next largest sector, employing nearly 1,400 people at an average wage of $62,892. Retail trade was the third largest sector, employing about 1,100 people at an average wage of $28,874. According to the 2017-2021 American Community Survey, of the nearly 17,000 working-age adults in McDuffie, approximately 9,600 were part of the labor force, yielding a labor force participation rate of approximately 56 percent. Total unemployment in the county in September 2023 equaled about 400 people, or five percent of the civilian non-institutionalized population aged 16 and older. Low food access is defined as living more than one mile (urban) or 10 miles (rural) from the nearest supermarket, supercenter, or large grocery store. This indicator is relevant because it highlights populations and geographies facing food insecurity. According to the 2019 Food Access Research Atlas database, nearly one percent of the total population in the county have low food access, meaning about 170 county residents may struggle to access healthy foods. In 2021, the county had a food insecurity rate of about 10 percent, meaning nearly 2,300 people had been unsure how they would access adequate food at some point during the year. Unfortunately, many of these community members are ineligible for public assistance via SNAP, WIC (Special Supplemental Nutrition Program for Women, Infants and Children), free or reduced-cost school meals, the Commodity Supplemental Food Program (CSFP), or The Emergency Food Assistance Program (TEFAP). Of the 1,000 food-insecure children in the county, eight percent were ineligible for public assistance programs. In 2021, nearly 77 percent of adults aged 18 or older saw a doctor for a routine check-up the previous year, a measure that is higher than both state and national averages. For Medicare recipients, this number jumps to 81 percent of adult beneficiaries, which is above both state and national averages. Routine check-ups are a critical component to maintaining good health and identifying conditions that can be treated affordably in a community-based setting. Absent that, even simple-to-treat conditions can escalate to deeper issues, eventually requiring more intensive care, later stage diagnoses, or reduced life expectancy. Heart disease is the leading cause of death in McDuffie County. Between 2016 and 2020, the age-adjusted death rate was 225 deaths for every 100,000 people, which is worse than both state and national averages, but a number that has decreased steadily over the last 10 years. Broken down by ZIP code, we see higher death rates in both 30808 (Dearing) and 30824 (Thomson), which could indicate higher rates of poverty and higher rates of uninsurance. We see similar trends with stroke deaths. Between 2016 and 2020, there were nearly 60 deaths due to stroke, resulting in an age-adjusted death rate of 45 deaths per every 100,000 people. This is worse than the state and national rates of about 43 and 38 deaths, respectively. Like with heart disease, we see higher rates of stroke death in community members living in ZIP codes 30808 (Dearing) and 30824 (Thomson). The hospitalization rates for heart disease and stroke among Medicare recipients have been decreasing steadily over the past five years. On average each year from 2017 to 2019, there were approximately 12 hospitalizations for cardiovascular disease for every 1,000 Medicare beneficiaries. This rate is on par with both the state and national averages, which were about 12 and 11 hospitalizations per 1,000 beneficiaries, respectively. Furthermore, the hospitalization rate for stroke is also on par with the state average, with nine hospitalizations per 1,000 Medicare beneficiaries. While heart disease remains the leading cause of death in the county, cancer remains a critical issue within the community. The cancer incidence rate for McDuffie County averaged nearly 570 cases per 100,000 people annually between 2016 and 2020, resulting in a total of 156 new cases each year. When broken down by cancer site, the breast cancer incidence rate stood at about 140 diagnoses per 100,000 females, which was notably higher than both the state and national averages of 129 and 127, respectively. Additionally, other diagnosed cancer sites rose above state and national averages. In 2019, a total of about 1,500 adults aged 20 and older had diabetes, equaling approximately eight percent of the county's population. This rate is lower than the state average of 10 percent. Diabetes is a prevalent issue in the US, often linked to an unhealthy lifestyle, and it poses risks for various health problems. This figure has fluctuated over the last five years. In 2021, about four percent of the county's population had a diagnosis of kidney disease, a rate slightly higher than the state and national percentages. That same year, 33 percent of the county's total population of adults 18 and older reported having high cholesterol. Too much cholesterol puts one at risk for heart disease and stroke, two of the main causes of death within the county. High blood pressure can damage the arteries by making them less elastic, which decreases the flow of blood and oxygen to the heart and leads to heart disease. In 2021, 39 percent of adults 18 and older in McDuffie County had a diagnosis of high blood pressure.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 5: Promotion of Community Health</FormAndLineReferenceDesc>
        <ExplanationTxt>We actively promote the health of our community through clinic-hospital partnerships, community-based health screenings, educational activities, community-building activities, the operation of a 24-hour emergency department available to the entire community, the operation of an emergency room open to all members of the community without regard to ability to pay, a governance board composed of community members, use of surplus revenue for facilities improvement, patient care, and medical training, education, and research, the provision of inpatient hospital care for all persons in the community able to pay, including those covered by Medicare and Medicaid, and an open medical staff with privileges available to all qualifying physicians. In FY23, Piedmont Healthcare launched the Empowering You platform to connect community members and patients with resources to address social determinant of health issues. Powered by FindHelp.org, Piedmont clinicians and case managers can search and refer patients to supporting organizations. In FY23, Piedmont McDuffie actively promoted nutritional guidance and diabetes education in the community through various events. At the Thomson Family YMCA, we hosted three open-to-the-public sessions covering topics such as reading labels and understanding nutrition. During the City of Thomson's monthly lunch, our diabetes educators conducted A1C checks for city employees upon request. Our involvement extended further to the employees of the City of Thomson through our Lunch and Learn program, where we provided diabetes education and prevention materials to all attendees. We prioritized annual health screenings for community well-being. We participated in a health fair with more than 100 community members at Springfield Baptist Church in Thomson. Staff offered health screenings and education on stroke prevention, diabetes, hypertension, and cholesterol. We also provided health screenings and education to the McDuffie County EMS and Fire Department Staff. Piedmont McDuffie partnered with The Family Connection of Warren County, The Georgia Department of Public Health, and the East Georgia Housing Authority at an event dedicated to bringing screenings and health education to this rural, underserved location.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 6: Affiliated Health Care System</FormAndLineReferenceDesc>
        <ExplanationTxt>We are part of Piedmont Healthcare, a regional not-for-profit organization and the parent company of 19 hospitals, the Piedmont Physicians Group, the Piedmont Heart Institute, the Piedmont Clinic and the Piedmont Healthcare Foundation. Our community relations team works directly with the community. Our community benefit department oversees the community benefit activities on behalf of all hospitals throughout the system, and this includes conducting the triennial CHNA and subsequent implementation strategy, ensuring the financial assistance policy is communicated to the community, maintaining the community benefit webpage, authoring the community benefit annual report, preparing board materials, developing and executing the community benefit grants program and compiling all community benefit figures. Each hospital and certain departments of Piedmont Healthcare execute community benefit programming, such as our revenue department, which oversees the financial assistance program.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 7: State of Filing of Community Benefit Report</FormAndLineReferenceDesc>
        <ExplanationTxt>We are not required to file a community benefit report; however, we are required to file with the Georgia Department of Community Health information on our indigent and charity care, as well as our Medicaid and Medicare shortfalls.</ExplanationTxt>
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    </IRS990ScheduleH>
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        <PersonNm>ELIZABETH R GALLUP</PersonNm>
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        <PersonNm>BARRY J JENKINS</PersonNm>
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        <PersonNm>JOHN BIELTZ</PersonNm>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 1A: Other Compensation Items</FormAndLineReferenceDesc>
        <ExplanationTxt>Thomas Arnold, Elizabeth Leddy, and Lily Henson received a discretionary spending account totaling $12,000, a fixed amount determined by their job level. This spending account was included in their taxable wages.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 3: Compensation of the CEO/Executive Director</FormAndLineReferenceDesc>
        <ExplanationTxt>The compensation for the president/CEO of UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC. is set by the entity's parent, Piedmont Healthcare, Inc. Please see the Schedule O narrative for Form 990, Part VI, Section B, Line 15A &amp; 15B for additional information.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4B: Supplemental compensation information</FormAndLineReferenceDesc>
        <ExplanationTxt>The following individuals received payments from their supplementary executive retirement plans: Thomas Arnold: $96,797 Elizabeth Leddy: $490,447 Lily Henson participated in a supplemental nonqualified retirement plan but did not receive a current year payment. The following individuals received a CAA redemption: James Davis: $339,489 Edward Burr: $7,000 These payments are included in the total reported on Form 990, Part VII as reportable compensation or other compensation, and have been included in the individuals' W-2. The following individuals received a Roth IUL payment: Dave Belkoski: $67,440 Elizabeth Gallup: $53,517 Barry Jenkins: $40,000 These payments are included in the total reported on Form 990, Part VII as reportable compensation or other compensation, and have been included in the individuals' W-2.</ExplanationTxt>
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    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 1: ORGANIZATION'S MISSION</FormAndLineReferenceDesc>
        <ExplanationTxt>PARTNERS, AND ENRICH THE LIVES WE TOUCH BY PROVIDING COMPASSIONATE QUALITY CARE IN A COST-EFFECTIVE MANNER. WE STRIVE TO BE UTILIZED AS THE HEALTHCARE PARTNER OF CHOICE FOR THE COMMUNITIES WE SERVE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6: ORGANIZATION'S SOLE MEMBER</FormAndLineReferenceDesc>
        <ExplanationTxt>PIEDMONT HEALTHCARE, INC., (EIN 58-1503902) IS THE SOLE MEMBER OF UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER, INC ("PAM").</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A: ELECTION OF GOVERNING BODY</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF PIEDMONT HEALTHCARE, UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER'S SOLE MEMBER, APPOINTS THE MEMBERS OF THE BOARD OF DIRECTORS OF UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SEC A, LINE 7B: DECISIONS OF GOVERNING BODY</FormAndLineReferenceDesc>
        <ExplanationTxt>UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER'S BOARD POLICIES AND DECISIONS MUST BE FILED, IMMEDIATELY AFTER ADOPTION, WITH THE SECRETARY OF THE PIEDMONT HEALTHCARE BOARD OF DIRECTORS. SUCH POLICIES AND DECISIONS OF THE UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER BOARD OF DIRECTORS ARE NOT SUBJECT TO THE APPROVAL OF OR RATIFICATION BY THE PIEDMONT HEALTHCARE BOARD, BUT SHOULD THE NEED ARISE, THEY MAY BE RESCINDED BY THE PIEDMONT HEALTHCARE BOARD THROUGH A MAJORITY VOTE OF ITS DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B: 990 REVIEW PROCESS</FormAndLineReferenceDesc>
        <ExplanationTxt>INFORMATION NEEDED TO PREPARE UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER'S FORM 990 IS COMPILED BY INDIVIDUALS IN THE ORGANIZATION'S FINANCE DEPARTMENT. THE INFORMATION IS REVIEWED BY PAM'S CONTROLLER AND VP/CFO. THE 990 IS THEN PREPARED INTERNALLY BY PIEDMONT HEALTHCARE, INC.'S TAX DEPARTMENT AND SUBMITTED TO AN EXTERNAL TAX PREPARER FOR REVIEW. PRIOR TO FILING, COPIES OF FORM 990 ARE PROVIDED TO THE BOARD OF DIRECTORS OF PIEDMONT HEALTHCARE, INC., THE ORGANIZATION'S SOLE MEMBER, FOR BOARD REVIEW.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SEC B, LINE 12C: CONFLICT OF INTEREST POLICY</FormAndLineReferenceDesc>
        <ExplanationTxt>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 UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER 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 chief compliance officer FOR INVESTIGATION, AND REMEDIAL STEPS MUST BE TAKEN AS APPROPRIATE UNDER THE PIEDMONT HEALTHCARE DISCIPLINARY POLICIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Sec B, Line 15a, 15b: Executive Compensation</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation for executives of UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER is set by the board of directors of Piedmont Healthcare, Inc. The Piedmont Healthcare, Inc., board of director's executive performance and compensation committee ("The 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 date 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19: DISCLOSURE OF DOCUMENTS</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, Part XI, LINE 9: RECONCILIATION OF NET ASSETS</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGES IN TEMP. $ 112,500 INTERCOMPANY TRANS. $11,957,840 CHANGES IN UNRESTR. FUND ($ 394,825) ---------------------------------------------- TOTAL $11,675,515</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:OTHER PHYSICIAN SUPPORT TOTAL FEES:1229218</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:SERVICE/MAINTENANCE CONTRACTS TOTAL FEES:547553</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:CONSULTING MGMT SERVICES TOTAL FEES:-6612</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:GENERAL CONTRACT LABOR TOTAL FEES:178454</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:PRINTING/DUPLICATION TOTAL FEES:178</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:PURCHASE SERV/CONTRACT SERV TOTAL FEES:4503170</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:PHYSICIAN CALL PAY TOTAL FEES:54000</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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          <AddressLine1Txt>1800 HOWELL MILL RD STE 850</AddressLine1Txt>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>FAYETTE COMMUNITY HOSPITAL INC</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PIEDMONT NEWNAN HOSPITAL INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>745 POPLAR ROAD</AddressLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PIEDMONT HEALTHCARE FOUNDATION INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>2001 PEACHTREE RD NE STE 400</AddressLine1Txt>
          <CityNm>ATLANTA</CityNm>
          <StateAbbreviationCd>GA</StateAbbreviationCd>
          <ZIPCd>30309</ZIPCd>
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        <PrimaryActivitiesTxt>FUNDRAISING</PrimaryActivitiesTxt>
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        <PublicCharityStatusTxt>12B, II</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>PHC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PIEDMONT HENRY HOSPITAL INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1133 EAGLES LANDING PKWY</AddressLine1Txt>
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          <StateAbbreviationCd>GA</StateAbbreviationCd>
          <ZIPCd>30281</ZIPCd>
        </USAddress>
        <EIN>582200195</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>GA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
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        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PIEDMONT NEWTON HOSPITAL INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5126 HOSPITAL DRIVE NE</AddressLine1Txt>
          <CityNm>COVINGTON</CityNm>
          <StateAbbreviationCd>GA</StateAbbreviationCd>
          <ZIPCd>30014</ZIPCd>
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        <EIN>582155150</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>PHC</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PIEDMONT ATHENS REGIONAL FOUNDATION INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>1199 PRINCE AVENUE</AddressLine1Txt>
          <CityNm>ATHENS</CityNm>
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          <BusinessNameLine1Txt>PARMC</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PIEDMONT ATHENS REGIONAL HEALTH RESOURCE</BusinessNameLine1Txt>
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          <AddressLine1Txt>1199 PRINCE AVENUE</AddressLine1Txt>
          <CityNm>athens</CityNm>
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          <ZIPCd>30606</ZIPCd>
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        <PrimaryActivitiesTxt>DEVELOPMENT</PrimaryActivitiesTxt>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>PIEDMONT ATHENS REGIONAL MEDICAL CENTER</BusinessNameLine1Txt>
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          <AddressLine1Txt>1199 PRINCE AVENUE</AddressLine1Txt>
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          <ZIPCd>30606</ZIPCd>
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          <BusinessNameLine1Txt>PHC</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ATHENS REGIONAL PHYSICIAN SERVICES INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>1199 PRINCE AVENUE</AddressLine1Txt>
          <CityNm>ATHENS</CityNm>
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          <ZIPCd>30606</ZIPCd>
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          <BusinessNameLine1Txt>PARMC</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ATHENS REGIONAL SPECIALTY SERVICES INC</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>1199 PRINCE AVENUE</AddressLine1Txt>
          <CityNm>Athens</CityNm>
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          <ZIPCd>30606</ZIPCd>
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        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>PARMC</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>REGIONAL FIRSTCARE INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>1199 PRINCE AVENUE</AddressLine1Txt>
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          <ZIPCd>30606</ZIPCd>
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        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PARMC</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>THE MEDICAL CENTER INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>707 CENTER STREET</AddressLine1Txt>
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          <ZIPCd>31901</ZIPCd>
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        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
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        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CRHS</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>COLUMBUS REGIONAL HEALTHCARE SYSTEM INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>707 CENTER STREET</AddressLine1Txt>
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          <ZIPCd>31901</ZIPCd>
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        <PublicCharityStatusTxt>12B, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>PHC</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>COLUMBUS REGIONAL MEDICAL FOUNDATIONINC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>707 CENTER STREET</AddressLine1Txt>
          <CityNm>COLUMBUS</CityNm>
          <StateAbbreviationCd>GA</StateAbbreviationCd>
          <ZIPCd>31901</ZIPCd>
        </USAddress>
        <EIN>581501642</EIN>
        <PrimaryActivitiesTxt>FUNDRAISING</PrimaryActivitiesTxt>
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        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
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        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CRHS</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>HUGHSTON HOSPITAL INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>707 CENTER STREET</AddressLine1Txt>
          <CityNm>COLUMBUS</CityNm>
          <StateAbbreviationCd>GA</StateAbbreviationCd>
          <ZIPCd>31901</ZIPCd>
        </USAddress>
        <EIN>331216751</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>GA</LegalDomicileStateCd>
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        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CRHS</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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          <AddressLine1Txt>1412 MILSTEAD AVE</AddressLine1Txt>
          <CityNm>CONYERS</CityNm>
          <StateAbbreviationCd>GA</StateAbbreviationCd>
          <ZIPCd>30012</ZIPCd>
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        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
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          <BusinessNameLine1Txt>PHC</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>PIEDMONT WALTON HOSPITAL INC</BusinessNameLine1Txt>
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          <CityNm>MONROE</CityNm>
          <StateAbbreviationCd>GA</StateAbbreviationCd>
          <ZIPCd>30655</ZIPCd>
        </USAddress>
        <EIN>824194264</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>PHC</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>PIEDMONT HEART INSTITUTE INC</BusinessNameLine1Txt>
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        <USAddress>
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          <CityNm>ATLANTA</CityNm>
          <StateAbbreviationCd>GA</StateAbbreviationCd>
          <ZIPCd>30309</ZIPCd>
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          <BusinessNameLine1Txt>PHC</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>COLUMBUS AMBULATORY HEALTHCARE SERVICES</BusinessNameLine1Txt>
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          <AddressLine1Txt>707 CENTER STREET</AddressLine1Txt>
          <CityNm>COLUMBUS</CityNm>
          <StateAbbreviationCd>GA</StateAbbreviationCd>
          <ZIPCd>31901</ZIPCd>
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        <EIN>581719867</EIN>
        <PrimaryActivitiesTxt>AMBULATORY</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>CRHS</BusinessNameLine1Txt>
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        <DisregardedEntityName>
          <BusinessNameLine1Txt>COLUMBUS REGIONAL SENIOR LIVING INC</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>707 CENTER STREET</AddressLine1Txt>
          <CityNm>COLUMBUS</CityNm>
          <StateAbbreviationCd>GA</StateAbbreviationCd>
          <ZIPCd>31901</ZIPCd>
        </USAddress>
        <EIN>582628502</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>GA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12C, III-FI</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>PHC</BusinessNameLine1Txt>
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      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PIEDMONT CARTERSVILLE HOSPITAL INC</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>960 JOE FRANK HARRIS PKWY SE</AddressLine1Txt>
          <CityNm>CARTERSVILLE</CityNm>
          <StateAbbreviationCd>GA</StateAbbreviationCd>
          <ZIPCd>30120</ZIPCd>
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        <EIN>870963633</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>GA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
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          <BusinessNameLine1Txt>PHC</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PIEDMONT EASTSIDE HOSPITAL INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>1700 MEDICAL WAY</AddressLine1Txt>
          <CityNm>snellville</CityNm>
          <StateAbbreviationCd>GA</StateAbbreviationCd>
          <ZIPCd>30078</ZIPCd>
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        <EIN>870982886</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>GA</LegalDomicileStateCd>
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          <BusinessNameLine1Txt>PHC</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>PIEDMONT MACON HOSPITAL INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>350 HOSPITAL DR</AddressLine1Txt>
          <CityNm>MACON</CityNm>
          <StateAbbreviationCd>GA</StateAbbreviationCd>
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        <LegalDomicileStateCd>GA</LegalDomicileStateCd>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>UNIVERSITY HEALTH SERVICES INC</BusinessNameLine1Txt>
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          <StateAbbreviationCd>GA</StateAbbreviationCd>
          <ZIPCd>30901</ZIPCd>
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        <LegalDomicileStateCd>GA</LegalDomicileStateCd>
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          <BusinessNameLine1Txt>GA SURG CTR PCHTREE</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>COLISEUM SAME DAY</BusinessNameLine1Txt>
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          <AddressLine1Txt>340 HOSP DR</AddressLine1Txt>
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          <AddressLine1Txt>2727 PACES FERRY ROAD STE 1-1100</AddressLine1Txt>
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        <EntityTypeTxt>C-CORP</EntityTypeTxt>
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          <BusinessNameLine1Txt>THE PIEDMONT CLINIC INC</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>PIEDMONT HEART INSTITUTE PHYSICIANS INC</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>AMSTER MCRAE INSURANCE COMPANY SPC</BusinessNameLine1Txt>
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          <AddressLine1Txt>PO BOX 1159</AddressLine1Txt>
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      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>true</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
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      <AssetExchangeInd>false</AssetExchangeInd>
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      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
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      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
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      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
