| FORM 990 |
FORM 990, PART IX, LINE 24A SUBSIDY TO PHYSICIAN CLINICS FOR LOSS ASSOCIATED TO LOW-INCOME PATIENTS |
| FORM 990, PART V, LINE 4B |
CAYMAN ISLANDS, BERMUDA, BRITISH VIRGIN ISLANDS |
| FORM 990, PAGE 6, PART VI, LINE 6 |
THE SOLE MEMBER OF PHOEBE PUTNEY MEMORIAL HOSPITAL, INC. SHALL BE PHOEBE PUTNEY HEALTH SYSTEM, INC. |
| FORM 990, PAGE 6, PART VI, LINE 7A |
THE BOARD OF DIRECTORS OF PPHS HAS THE RIGHT TO APPOINT DIRECTORS OF THE FILING ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 7B |
THE MEMBER SHALL HAVE THE FOLLOWING RESPONSIBILITIES: - THE MEMBER SHALL SELECT OR REMOVE THE ORGANIZATION'S OFFICERS. - THE MEMBER SHALL APPROVE ALL AMENDMENTS TO THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS BEFORE THEY MAY BECOME EFFECTIVE. - THE MEMBER SHALL APPROVE ANY ANNUAL OPERATING OR CAPITAL BUDGETS. - THE MEMBER SHALL APPOINT OR REMOVE THE INDEPENDENT AUDITORS. |
| FORM 990, PAGE 6, PART VI, LINE 11B |
THE INDEPENDENT ACCOUNTING FIRM THAT PREPARES THE FORM 990 (BASED UPON INFORMATION PROVIDED BY THE ORGANIZATION) PROVIDES A COMPLETE COPY OF THE RETURN WITH APPLICABLE SCHEDULES TO BE REVIEWED BY MANAGEMENT. MANAGEMENT PERFORMS A DETAILED REVIEW WHICH CONSISTS OF REVIEWING THE FINANCIAL DATA, THE NARRATIVES DISCLOSED, AND OTHER FACTS PRESENTED ON THE RETURN. UPON REVIEW, THE FORM 990 IS THEN FORWARDED TO THE FINANCE COMMITTEE FOR THEIR REVIEW, TO GAIN THEIR COMMENTS AND APPROVAL. UPON APPROVAL FROM THE FINANCE COMMITTEE, THE FORM 990 AND RELATED SCHEDULES ARE PROVIDED TO ALL BOARD MEMBERS FOR REVIEW AND FEEDBACK. ONCE THE FORM 990 IS REVIEWED BY ALL APPLICABLE PARTIES, A COPY OF THE FINAL VERSION IS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PAGE 6, PART VI, LINE 12C |
ON AN ANNUAL BASIS, PHOEBE PUTNEY MEMORIAL HOSPITAL (PPMH) BOARD MEMBERS AS WELL AS ALL OFFICERS COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. THIS QUESTIONNAIRE IS ADMINISTERED BY THE PHOEBE PUTNEY HEALTH SYSTEM (PPHS) COMPLIANCE DEPARTMENT AND THE DOCUMENT ASKS EACH INDIVIDUAL TO DISCLOSE ANY PERSONAL, BUSINESS, OR OTHER AFFILIATIONS AND MONETARY AMOUNT IF APPLICABLE THAT THEY OR THEIR IMMEDIATE FAMILY MEMBERS HAVE HAD WITHIN THE PAST 12 MONTHS WITH PPMH OR ANY RELATED ENTITIES. ALL RESPONSES ARE THEN EVALUATED BY THE PPHS COMPLIANCE DEPARTMENT. IN THE CASE OF AN EXISTING CONFLICT, THE INDIVIDUAL WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL SO SUCH TRANSACTIONS. |
| FORM 990, PAGE 6, PART VI, LINE 19 |
THE ORGANIZATION MAKES AVAILABLE TO THE PUBLIC ITS CONFLICT OF INTEREST AND AUDITED FINANCIAL STATEMENTS ON THE ORGANIZATION'S WEBSITE, BY PROVIDING COPIES UPON REQUEST, AND BY INSPECTION AT THE ADMINISTRATIVE OFFICES OF THE ORGANIZATION. |
| FORM 990, PART IX, LINE 11G |
CONTRACT SERVICE FEES 16,154,850 7,542,436 0 CONTRACT STAFFING FEES 2,490,845 119,954 0 CONSULTANT FEES 418,402 1,097,239 0 PROFESSIONAL FEES 1,362,255 2,175 0 INTERCOMPANY ALLOCATED COST 17,143,325 7,679,732 0 OTHER PATIENT RELATED SERV 4,901,927 0 0 |
| FORM 990, PART XI, LINE 9 |
GIFT SHOP COGS 458,764 RENTAL EXPENSES 507,560 GIFT SHOP COGS -458,764 RENTAL EXPENSES -507,560 |
| FORM 990, PART XI, LINE 9 |
AMORTIZATION OF NET GAIN 1,071,559 AMORTIZATION OF PRIOR SERVICE COST 224,715 CHANGE IN INTEREST IN NET ASSETS OF PHOEBE FND 3,661,146 NET ACTUARIAL GAIN 27,616,806 OTHER CHANGES IN NET ASSETS 131,242 TOTAL CHANGES IN NET ASSETS 32,705,468 |
Attach to Form 990 or 990-EZ.