SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
PHOEBE PUTNEY MEMORIAL HOSPITAL
INC
Employer identification number

58-1928247
Return Reference Explanation
FORM 990 FORM 990, PART IX, LINE 24B SUBSIDY TO PHYSICIAN CLINICS FOR LOSSES ASSOCIATED WITH LOW-INCOME PATIENTS.
FORM 990, PAGE 2, PART III, LINE 4A PHOEBE PUTNEY MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL WITH 691 LICENSED BEDS AND HAD PATIENT DAYS OF 109,500 IN THE CURRENT YEAR. INTENSIVE CARE, NEONATAL INTENSIVE CARE, NURSERY, REHAB, AND PSYCHIATRY SERVICES ARE INCLUDED IN THE SERVICES PROVIDED. THE HOSPITAL ALSO OPERATES A HOME HEALTH AGENCY AND A 12 BED HOSPICE. OTHER: 18,473 INPATIENT ADMISSIONS, 1,990 BIRTHS, 59,442 EMERGENCY VISITS, AND 810,400 CLINIC VISITS. SEE SCHEDULE H, PART VI, ADDITIONAL INFORMATION, WHICH INCLUDES DETAILED DISCUSSIONS ON ALL CHARITABLE AND COMMUNITY ACTIVITIES OF THE HOSPITAL. AS A RESULT OF THE COVID PANDEMIC, PPMH RECORDED THE VALUE OF DONATED SERVICES IN THE AMOUNT OF 31,770,780, AMOUNTS WHICH ARE NOT RECOGNIZED IN THE STATEMENT OF REVENUES OR STATEMENT OF FUNCTIONAL EXPENSES FOR TAX PURPOSES.
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 STAFFING FEES 107,193,528 1,315,075 0 INTERCOMPANY ALLOCATED COST 26,161,645 22,718,341 0 OTHER PATIENT RELATED SERV 11,456,313 1,314,752 0 CONTRACT SERVICE FEES 4,556,737 2,125,989 0 CONSULTANT FEES 390,041 1,139,568 0 PROFESSIONAL FEES 309,475 0 0 COLLECTION FEES 616 4,769,562 0 TOTAL 150,068,355 33,383,287 0
FORM 990, PART XI, LINE 9 NET ACTUARIAL GAIN 59,125,046 AMORTIZATION OF NET GAIN 4,987,185 CHANGE IN INTEREST IN NET ASSETS OF PHOEBE FND -1,514,052 TOTAL 62,598,179
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2020


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