2021-11-15T15:44:43-06:00 2020-12-31 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2020-01-01 560952737 PIEDMONT HEALTH SERVICES INC % LYDIA F MASON PIED 9199338494 88 VILCOM CENTER DRIVE Suite 110 CHAPEL HILL NC 27514 LYDIA F MASON CFO 9199338494 2021-11-15 true LYDIA F MASON 999009999 Krystal K Creach P01248198 4178658701 2 2020 2022-09-23 18:48:47Z BRIAN TOOMEY 88 VILCOM CENTER DRIVE CHAPEL HILL NC 27514 69489704 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. 14 14 740 18 0 0 12826119 16590698 51299784 52897837 5522 1169 -45617 0 64085808 69489704 199491 62646 0 0 39690196 41251910 0 0 0 25491651 24361359 65381338 65675915 -1295530 3813789 28139939 37381073 16667014 22095739 11472925 15285334 TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY BY PROVIDING HIGH QUALITY, AFFORDABLE, AND COMPREHENSIVE PRIMARY HEALTH CARE. false false 52429042 62646 52897837 AMBULATORY HEALTH CARE SERVICES TO THE GENERAL PUBLIC IN CHAPEL HILL, NC AND SURROUNDING AREAS. DURING 2020, THE ORGANIZATION HAD OVER 115,000 MEDICAL ENCOUNTERS. 52429042 true true false true false false false false false false true false false true true 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 42 0 true 740 true false false false false false false false false false false false false X 14 14 false false false false false false false true true false false true true true true true true true false false X LYDIA F MASON 9199338494 88 VILCOM CENTER DR STE 110 CHAPEL HILL NC 27514 BRIAN TOOMEY CEO 40.0 0.0 X 270248 0 24417 ABIGAIL DEVRIES CMO 40.0 0.0 X 247052 0 23041 SHARON REILLY PACE MEDICAL DIRECTOR 40.0 0.0 X 222727 0 21569 RHONDA KROLL PHYSICIAN 40.0 0.0 X 205227 0 20511 KATRINA MATTISON-CHALWE DENTAL DIRECTOR 40.0 0.0 X 204520 0 20465 JOAN EAST PHYSICIAN 40.0 0.0 X 202114 0 20323 LYDIA MASON CFO 40.0 0.0 X 191782 0 19697 HARRIETT BURNS ASST MEDICAL DIRECTOR 40.0 0.0 X 188363 0 19488 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 BOARD CHAIR 0.75 0.0 X X 0 0 0 CATHERINE LIAO BOARD MEMBER 0.75 0.0 X 0 0 0 MARIA SASSANO BOARD VICE-CHAIR 0.75 0.0 X X 0 0 0 LESLI VILLA-SOLORZANO BOARD MEMBER 0.75 0.0 X 0 0 0 MARIELA HERNANDEZ BOARD MEMBER 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 LEENA MEHTA SECRETARY 0.75 0.0 X 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 END 10/2020 0.75 0.0 X 0 0 0 EDNA MARKS BOARD MEMBER 0.75 0.0 X 0 0 0 VIRGINIA DICKIE BOARD MEMBER 0.75 0.0 X 0 0 0 1732033 0 169511 78 false true false 0 10104 14551227 2029367 99972 16590698 NET PATIENT SERVICE REVENUE 621400 26292876 26292876 CAPITATION REVENUE 621400 25973979 25973979 OTHER INCOME 621400 630982 630982 52897837 1169 1169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69489704 52897837 1169 X 62646 62646 0 0 0 776237 270065 506172 0 31272250 24577226 6695024 1434881 1151798 283083 5480433 4338762 1141671 2288109 1806761 481348 348342 348342 15226 15226 199689 199689 0 0 0 11414913 11057944 356969 0 3672535 1799433 1873102 0 0 1822051 1064330 757721 197165 135923 61242 0 56973 29700 27273 313254 279034 34220 0 1543279 1415181 128098 234277 135035 99242 MEDICAL SUPPLIES & DRUGS 4140363 4140363 LICENSES, DUES, SUBSCRIPTIONS 312126 140669 171457 RECRUITING & RETENTION 91166 24172 66994 65675915 52429042 13246873 0 1021553 10761196 5527990 6766671 681101 1694590 952220 1635664 0 0 0 0 0 0 744607 676381 540224 371672 27495814 17236139 11733524 10259675 803928 979297 0 0 61698 1698 0 0 6073094 4234229 28139939 37381073 9547804 9070673 0 0 0 1440248 0 0 0 0 0 0 7119210 10861666 0 0 0 723152 16667014 22095739 X 10846300 14402612 626625 882722 11472925 15285334 28139939 37381073 3813789 -1380 X false true X true true true X 12707771 13221346 11910443 12826119 16590598 67256277 0 0 12707771 13221346 11910443 12826119 16590598 67256277 1655552 65600725 2115 3540 5297 5272 1169 17393 0 0 67273670 241058874 0.97513 0.96377 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 $11,350. ALL OF THE 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 20618060 13121103 7496957 5303468 4115036 1188432 10259675 AMOUNTS DUE FROM THIRD PARTIES 3600000 DEPOSITS 15832 OTHER RECEIVABLES 522004 PACE RECEIVABLE 96393 4234229 0 CONTRACT LIABILITIES 360544 ESTIMATED SELF INSURANCE COSTS 362608 723152 69232227 -1380 551409 550029 68682198 807506 807506 69489704 65675915 65675915 65675915 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: $ 551,409 NET ASSETS RELEASED FROM RESTRICTION SCHEDULE D, PART XI, LINE 4B OTHER REVENUE ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 807,506 TEMPORARILY RESTRICTED CONTRIBUTIONS true UNIVERSITY OF NORTH CAROLINA CHAPEL HILL 104 AIRPORT DR CHAPEL HILL NC 275991350 566001393 GOVT 62646 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 270248 0 0 0 0 0 16215 0 8202 0 294665 0 LYDIA MASON CFO 191782 0 0 0 0 0 11507 0 8190 0 211479 0 HARRIETT BURNS ASST MEDICAL DIRECTOR 188363 0 0 0 0 0 11302 0 8186 0 207851 0 RHONDA KROLL PHYSICIAN 205227 0 0 0 0 0 12314 0 8197 0 225738 0 SHARON REILLY PACE MEDICAL DIRECTOR 222727 0 0 0 0 0 13364 0 8205 0 244296 0 JOAN EAST PHYSICIAN 202114 0 0 0 0 0 12127 0 8196 0 222437 0 KATRINA MATTISON-CHALWE DENTAL DIRECTOR 204520 0 0 0 0 0 12271 0 8194 0 224985 0 ABIGAIL DEVRIES CMO 247052 0 0 0 14823 0 8218 0 270093 0 X 1 99972 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 DESCRIPTION:MEDICAL SERVICES TOTAL FEES:8766450 FORM 990 PART IX LINE 11G DESCRIPTION:NON-PATIENT CARE TOTAL FEES:924183 FORM 990 PART IX LINE 11G DESCRIPTION:LABORATORY SERVICES TOTAL FEES:554515 FORM 990 PART IX LINE 11G DESCRIPTION:PROCESSING COST TOTAL FEES:436239 FORM 990 PART IX LINE 11G DESCRIPTION:MEAL SERVICES TOTAL FEES:245147 FORM 990 PART IX LINE 11G DESCRIPTION:DENTAL SERVICES TOTAL FEES:167070 FORM 990 PART IX LINE 11G DESCRIPTION:TRANSCRIPTION SERVICES TOTAL FEES:192260 FORM 990 PART IX LINE 11G DESCRIPTION:TRANSPORTATION SERVICES TOTAL FEES:38871 FORM 990 PART IX LINE 11G DESCRIPTION:RADIOLOGY SERVICES TOTAL FEES:35586 FORM 990 PART IX LINE 11G DESCRIPTION:PHARMACY SERVICES TOTAL FEES:32345 FORM 990 PART IX LINE 11G DESCRIPTION:REHAB SERVICES TOTAL FEES:22247