2019-11-11T11:30:04-06:00 2018-12-31 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2018-01-01 560952737 PIEDMONT HEALTH SERVICES INC % LYDIA F MASON PIED 9199338494 127 KINGSTON DRIVE CHAPEL HILL NC 27514 LYDIA F MASON CFO 9199338494 2019-10-10 true Krystal K Creach P01248198 4178658701 167.68.126.162 43032920193155000016 2019-11-11 P 6E3BF1A273F4D2D415220A75E2A13B135D872BD9 34FEC733D9517700F77F9305E895A80725933709 2018 2020-03-31 21:24:44Z BRIAN TOOMEY 127 KINGSTON DRIVE CHAPEL HILL NC 27514 62539835 false X WWW.PIEDMONTHEALTH.ORG X 1970 NC TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY BY PROVIDING HIGH QUALITY, AFFORDABLE, AND COMPREHENSIVE PRIMARY HEALTH CARE. 16 16 681 16 0 9015 13221346 11910443 47023354 50758125 3540 -2857 0 -134030 60248240 62531681 0 255052 0 0 33812450 35542284 0 0 0 26254224 25250661 60066674 61047997 181566 1483684 28174019 27258684 16889606 14492161 11284413 12766523 TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY BY PROVIDING HIGH QUALITY, AFFORDABLE, AND COMPREHENSIVE PRIMARY HEALTH CARE. false false 51062963 255052 50758125 AMBULATORY HEALTH CARE SERVICES TO THE GENERAL PUBLIC IN CARRBORO, NC AND SURROUNDING AREAS. DURING 2018, THE ORGANIZATION HAD OVER 112,106 MEDICAL ENCOUNTERS. 51062963 true true false true false false false false false false true false false true false false true false false false false false false false false false false true false true false false false false false false false false true false false false false false false false false true 48 0 true 681 true true true false false false false false false false false false false false X 16 16 false false false false false false false true true false false true true true true true true true true false X LYDIA F MASON 9199338494 127 KINGSTION DRIVE CHAPEL HILL NC 27514 GEORGE PINK TREASURER 0.75 0.0 X X 0 0 0 RANDAL STEWART BOARD MEMBER 0.75 0.0 X 0 0 0 REGINALD TYSON SECRETARY 0.75 0.0 X X 0 0 0 CATHERINE LIAO BOARD MEMBER BEG 07/18 0.75 0.0 X 0 0 0 KENNETH REEB CHAIR 0.75 0.0 X X 0 0 0 MARIA SASSANO BOARD MEMBER 0.75 0.0 X 0 0 0 VICTORIA FREEMAN VICE CHAIR 0.75 0.0 X X 0 0 0 MARIELA HERNANDEZ BOARD MEMBER BEG 07/18 0.75 0.0 X 0 0 0 CAMILLE BERRY BOARD MEMBER 0.75 0.0 X 0 0 0 BARBARA JESSIE BLACK BOARD MEMBER 0.75 0.0 X 0 0 0 MARIA JIMENEZ BOARD MEMBER 0.75 0.0 X 0 0 0 LEENA MEHTA BOARD MEMBER 0.75 0.0 X 0 0 0 ROCIO V SAENZ BOARD MEMBER 0.75 0.0 X 0 0 0 BERTHE MAIROUNGA BOARD MEMBER 0.75 0.0 X 0 0 0 IVAN REMNITZ BOARD MEMBER 0.75 0.0 X 0 0 0 STEPHANIE TRIANTAFILLOU BOARD MEMBER BEG 01/18 0.75 0.0 X 0 0 0 ROBERT REIVES BOARD MEMBER END 06/18 0.75 0.0 X 0 0 0 KEVIN FARRELL BOARD MEMBER END 11/18 0.75 0.0 X 0 0 0 BRIAN TOOMEY CEO 40.0 0.0 X 270200 0 19717 LYDIA MASON CFO 40.0 0.0 X 183812 0 20249 ABIGAIL DEVRIES MD CMO 32.0 0.0 X 227464 0 14298 CARL TAYLOR PHARMACY DIRECTOR 40.0 0.0 X 155952 0 17791 RHONDA KROLL PHYSICIAN 40.0 0.0 X 196662 0 22045 SHARON REILLY PACE MEDICAL DIRECTOR 40.0 0.0 X 205817 0 19280 MARIANNE RATCLIFFE PACE EXECUTIVE DIRECTOR 40.0 0.0 X 158036 0 18727 KATRINA MATTISON-CHALWE DENTAL DIRECTOR 40.0 0.0 X 200838 0 22296 1598781 0 154403 62 false true false 0 20000 10597820 1292623 915314 11910443 NET PATIENT SERVICE REVENUE 621400 26100665 26100665 CAPITATION REVENUE 621400 24258280 24258280 OTHER INCOME 621400 254680 254680 EHR INCENTIVE REVENUE 621400 144500 144500 50758125 5297 5297 0 0 0 0 0 8154 -8154 -8154 -8154 0 0 0 0 0 0 0 0 0 LOSS ON INVESTMENT IN EQUITY INVESTEE 900099 -134030 -134030 -134030 62531681 50758125 -136887 X 255052 255052 0 0 0 735740 241762 493978 0 27830681 23235857 4594824 1303986 891096 412890 3627477 2767463 860014 2044400 1739425 304975 390226 390226 12128 12128 165382 165382 0 0 0 11119611 10851825 267786 0 2506444 1487958 1018486 388129 110972 277157 0 1531472 1141050 390422 708664 518428 190236 0 119920 71878 48042 350468 312604 37864 0 1559834 1432681 127153 239978 127963 112015 MEDICAL SUPPLIES & DRUGS 5208605 5208605 BAD DEBT 400522 400522 LICENSES, DUES, SUBSCRIPTIONS 306994 174476 132518 RECRUITING & RETENTION 242284 93346 148938 61047997 51062963 9985034 0 2362140 2145280 4756165 5331680 1764999 999154 804839 930576 0 0 0 0 0 0 743834 744755 78812 173842 27025812 14627923 13830431 12397889 685530 667210 0 0 1698 17668 0 0 3145571 3850630 28174019 27258684 8710842 7642240 0 0 11065 0 0 0 0 0 0 0 8167699 6849921 0 0 0 0 16889606 14492161 X 9932860 12266699 1351553 499824 0 0 11284413 12766523 28174019 27258684 1483684 -1574 X false true X true true true X 9098702 1203409 12707771 13221346 11910443 48141671 0 0 9098702 1203409 12707771 13221346 11910443 48141671 2158998 45982673 1684 165 2115 3540 5297 12801 0 0 48154472 174843509 0.95490 0.96038 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true false SCHEDULE C, PART II-B, LINE 1(I) OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS ANNUAL MEMBERSHIP DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS IN THE AMOUNT OF $20,000 AND THE NORTH CAROLINA PRIMARY HEALTH CARE ASSOCIATION IN THE AMOUNT OF $8,500. BOTH ORGANIZATIONS LOBBY ON BEHALF OF MEMBER HEALTH CENTERS; HOWEVER, THE AMOUNT OR PERCENTAGE OF DUES EXPENDED BY THOSE ORGANIZATIONS FOR LOBBYING ACTIVITIES IS UNKNOWN. 1574286 1574286 19925897 11176048 8749849 5525629 3451875 2073754 12397889 AMOUNTS DUE FROM THIRD PARTIES 2975000 DEPOSITS 70730 OTHER RECEIVABLES 176736 PACE RECEIVABLE 628164 3850630 62990668 -1574 1200 934185 933811 62056857 474824 474824 62531681 60656829 1200 8154 9354 60647475 400522 400522 61047997 SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D OTHER REVENUE ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ 1,334,707 NET ASSETS RELEASED FROM RESTRICTION (400,522) PROVISIONS FOR UNCOLLECTIBLE ACCOUNTS ------------ $ 934,185 SCHEDULE D, PART XI, LINE 4B OTHER REVENUE ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 482,978 TEMPORARILY RESTRICTED CONTRIBUTIONS (8,154) LOSS ON DISPOSAL OF PROPERTY & EQUIPMENT ------------ $ 474,824 SCHEDULE D, PART XII, LINE 2D OTHER EXPENSES ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 8,154 LOSS ON DISPOSAL OF PROPERTY & EQUIPMENT SCHEDULE D, PART XIII, LINE 4B OTHER EXPENSES ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 400,522 PROVISIONS FOR UNCOLLECTIBLE ACCOUNTS true UNIVERSITY OF NORTH CAROLINA CHAPEL HILL 104 AIRPORT DR CHAPEL HILL NC 275991350 566001393 GOVT 255052 SUPPORT 1 SCHEDULE I, PART I, LINE 2 MONITORING USE OF GRANT FUNDS: PIEDMONT ASSIGNS A DESIGNATED GRANT CODE TO EACH GRANT. ELIGIBILITY OF EXPENSES AND REVENUE ARE REVIEWED AND POSTED TO THE FINANCIALS BIWEEKLY AND/OR MONTHLY. GRANT FUNDS ARE DISPERSED BASED UPON THE REVIEW AND ARE EITHER INVOICED OR DRAWN DOWN PER THE GRANT AGREEMENTS SCHEDULE. PIEDMONT MONITORS AND REVIEWS EACH CODE ON A ROUTINE BASIS. INTERNAL SPREADSHEETS DOCUMENT REVENUE AND EXPENSE DETAILS AND ARE REVIEWED FOR ACCURACY, COMPLIANCE, AND CONTRACTUAL OBLIGATIONS. THE FINANCE STAFF COMPLETES THE INTERNAL SPREADSHEETS DAILY/WEEKLY AND THE GRANT WRITER REVIEWS ON A MONTHLY BASIS. THE FINANCE MANAGER COMPLETES THEIR REVIEW MONTHLY AND AUTHORIZES GENERAL LEDGER ENTRIES. THE CFO REVIEWS THE GRANT ALLOCATIONS ON A QUARTER BASIS. ANY VARIANCES ARE RESOLVED VIA JOURNAL ENTRY TO THE GENERAL LEDGER. X X X false false false false false false false false false BRIAN TOOMEY CEO 270200 0 0 0 0 0 10722 0 8995 0 289917 0 0 0 LYDIA MASON CFO 183812 0 0 0 0 0 11029 0 9220 0 204061 0 0 0 CARL TAYLOR PHARMACY DIRECTOR 155952 0 0 0 0 0 8796 0 8995 0 173743 0 0 0 RHONDA KROLL PHYSICIAN 196662 0 0 0 0 0 11800 0 10245 0 218707 0 0 0 SHARON REILLY PACE MEDICAL DIRECTOR 205817 0 0 0 0 0 9035 0 10245 0 225097 0 0 0 MARIANNE RATCLIFFE PACE EXECUTIVE DIRECTOR 158036 0 0 0 0 0 9482 0 9245 0 176763 0 0 0 KATRINA MATTISON-CHALWE DENTAL DIRECTOR 200838 0 0 0 0 0 12051 0 10245 0 223134 0 0 0 ABIGAIL DEVRIES MD CMO 227464 0 0 0 0 0 13648 0 650 0 241762 0 0 0 X 1 915314 FMV false true false SCHEDULE M, PART I, COLUMN B NUMBER OF CONTRIBUTIONS: THE NUMBER OF CONTRIBUTIONS REPRESENTS THE NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 BOARD REVIEW POLICY: THE FORM 990 IS CHECKED BY THE CFO FOR ADDITION ERRORS AND BALANCED TO THE AUDITED FINANCIAL STATEMENTS BEFORE FILING. BOARD MEMBERS ARE PROVIDED A COPY OF THE FORM 990 BEFORE IT IS FILED VIA EMAIL. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY COMPLIANCE: THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS TRANSACTIONS THAT MAY INVOLVE THE PRIVATE INTEREST OF A DIRECTOR OR EMPLOYEE OF THE CORPORATION. A CONFLICT OF INTEREST TRANSACTION IS A TRANSACTION WITH THE CORPORATION IN WHICH A DIRECTOR OR EMPLOYEE (OR AN IMMEDIATE FAMILY MEMBER) HAS A DIRECT OR INDIRECT INTEREST BEYOND HIS OR HER INTEREST AS A DIRECTOR OR EMPLOYEE OF THE CORPORATION. EACH DIRECTOR, OFFICER AND EMPLOYEE OF THE CORPORATION SHALL HAVE AN AFFIRMATIVE DUTY TO DISCLOSE (EITHER TO THE BOARD OR TO THE CEO) ANY POTENTIAL INTEREST(S) THAT MAY EXIST OR WHICH SUCH INDIVIDUAL REASONABLY BELIEVES MAY EXIST, INCLUDING SUFFICIENT DETAILS ABOUT THE BASIS THERETO. THE CORPORATE COMPLIANCE AREA HAS A HOTLINE NUMBER TO REPORT POSSIBLE COMPLIANCE ISSUES WHICH INCLUDE CONFLICTS OF INTEREST. UPON BECOMING AWARE OF A POTENTIAL CONFLICT OF INTEREST, THE BOARD (OR COMMITTEE THEREOF) SHALL FIRST DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. BEFORE THE BOARD (OR COMMITTEE) MAKES A DETERMINATION WHETHER A CONFLICT OF INTEREST EXISTS, A POTENTIAL CONFLICTED DIRECTOR, OFFICER OR EMPLOYEE SHALL BE GIVEN AN OPPORTUNITY TO DISCLOSE FACTS RELEVANT TO THE DETERMINATION AND TO RESPOND TO ANY REQUESTS FOR ADDITIONAL OR CLARIFYING INFORMATION. AT THE TIME THE BOARD (OR COMMITTEE) DELIBERATES AND VOTES TO DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS, ANY POTENTIAL CONFLICTED DIRECTOR OR OFFICER SHALL BE EXCUSED FROM OR OTHERWISE SHALL BE ABSENT FROM THAT PORTION OF THE MEETING. IF A DIRECTOR OR OFFICER IS DETERMINED TO HAVE A CONFLICT OF INTEREST IN A TRANSACTION, SUCH INDIVIDUAL SHALL BE EXCUSED FROM OR OTHERWISE SHALL BE ABSENT FROM THAT PORTION OF THE MEETING WHERE THE BOARD DELIBERATES AND VOTES ON SUCH TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15A & 15b COMPENSATION DETERMINATION POLICY: THE BOARD AND UPPER MANAGEMENT USE THE NACHC SALARY SURVEY AS A GUIDE AS WELL AS OTHER MARKET INFORMATION SUPPLIED BY BOARD MEMBERS. THE ORGANIZATION SUBMITS TO THE NATIONAL FQHC SALARY SURVEY EACH YEAR AND EVERY 2-3 YEARS, REVIEWS AND COMPARES ITS SALARIES WITH ANOTHER NATIONAL SALARY SURVEY CONTAINING DATA ON COMPARABLE HEALTH ORGANIZATIONS. SALARY ADJUSTMENTS ARE MADE ONLY AFTER REVIEW AND APPROVAL BY THE EXECUTIVE COMMITTEE. THIS PROCESS IS DOCUMENTED IN THE BOARD MINUTES. FOR OTHER OFFICERS AND KEY EMPLOYEES, A REVIEW WAS CONDUCTED IN FEBRUARY 2018 BY THE CEO WITH ASSISTANCE FROM HUMAN RESOURCES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION PROVIDES TO INTERESTED PARTIES GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICES: $ 8,448,568 MEDICAL SERVICES 548,603 NON-PATIENT CARE 493,907 PROCESSING COSTS 492,045 LABORATORY SERVICES 417,838 MEAL SERVICES 212,482 DENTAL SERVICES 171,840 TRANSCRIPTION SERVICES 133,329 TRANSPORTATION SERVICES 82,734 RADIOLOGY SERVICES 79,776 REHAB SERVICES 38,161 PHARMACY SERVICES 328 PERINATAL SERVICES ------------- $ 11,119,611