| FORM 990 |
FORM 990, PART IX, LINE 24A SUBSIDY TO PHYSICIAN CLINICS FOR LOSSES ASSOCIATED WITH LOW-INCOME PATIENTS. |
| FORM 990, PAGE 6, PART VI, LINE 4 |
DIRECTOR QUALIFICATIONS WERE EXPANDED TO EMPHASIZE A DIRECTOR'S INVOLVEMENT AND INTEREST IN THE COMMUNITY OF WHICH THE CORPORATION IS A PART. BYLAWS ADDED "DIRECTORS MUST RESIDE IN THE SERVICE AREA OF THE CORPORATION OR BE REGULARLY INVOLVED IN A BUSINESS OR PERSONAL CAPACITY IN THE SERVICE AREA TO A SUFFICIENT EXTENT, IN THE REASONABLE JUDGMENT OF PPHS (THE SOLE MEMBER), TO MAINTAIN PERSONAL KNOWLEDGE AND EXPERTISE CONCERNING THE CURRENT BUSINESS/ECONOMIC, CULTURAL AND POLITICAL CLIMATE OF THE SERVICE AREA." THE BYLAWS ALSO EXPANDED THE ROLE OF CERTAIN BOARD COMMITTEES. THE PROFESSIONAL AFFAIRS COMMITTEE NOW HAS THE EXPANDED DUTY TO WATCH OVER AND REPORT TO THE BOARD ON MATTERS OF QUALITY AND SAFETY WITHIN THE HOSPITAL, INCLUDING PEER REVIEW AND SUCH OTHER ANALYSIS AND REVIEW OF QUALITY AND SAFETY ISSUES AS THE COMMITTEE DEEMS APPROPRIATE. |
| FORM 990, PAGE 6, PART VI, LINE 6 |
THE SOLE MEMBER OF PHOEBE PUTNEY MEMORIAL HOSPITAL, INC. SHALL BE PHOEBE PUTNEY HEALTH SYSTEM, INC. (PPHS). |
| 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 APPOINT OR REMOVE THE ORGANIZATION'S DIRECTORS. - 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 14,734,270 4,974,202 0 CONTRACT STAFFING FEES 19,217,313 685,859 0 CONSULTANT FEES 169,133 1,540,578 0 PROFESSIONAL FEES 315,231 130 0 INTERCOMPANY ALLOCATED COST 20,592,560 15,640,458 0 OTHER PATIENT RELATED SERV 8,521,641 0 0 COLLECTION FEES 0 3,852,968 0 TOTAL 63,550,148 26,694,195 0 |
| FORM 990, PART XI, LINE 9 |
AMORTIZATION OF NET GAIN 2,816,131 CHANGE IN INTEREST IN NET ASSETS OF PHOEBE FND 752,939 EQUITY TRANSFER FROM PPHS 47,137,631 NET ACTUARIAL GAIN 8,677,303 TOTAL 59,384,004 THE CHANGE IN NET ASSETS IS RELATED TO NONCASH TRANSACTIONS AS DETAILED ABOVE. IN ADDITION, EFFECTIVE MARCH 8, 2018 PPHSS BOARD OF DIRECTORS (THE PARENT) APPROVED ACTION TO PROVIDE MISSION SUPPORT TO PPMH IN THE AMOUNT OF 47,137,631 FOR THE BENEFIT OF PPMH IN ACCORDANCE WITH ITS CHARITABLE MISSION TO SUPPORT, PROMOTE, ADVANCE AND STRENGTHEN, WITHIN THE MEANING OF SECTION 509(A)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, PPMH AND OTHER CHARITABLE HEALTH CARE PROVIDERS, FORGIVING ANY AMOUNT STILL DUE FROM PPMH TO PPHS FOR THE NEW EHR SYSTEM. THE AMOUNTS FORGIVEN ARE REPORTED AS AN EQUITY TRANSFER FROM PPHS. |
Attach to Form 990 or 990-EZ.