2023-10-06T15:25:59-05:00 2022-12-31 FORVIS LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2022-01-01 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 2023-05-08 true LYDIA F MASON 999009999 Krystal K Creach P01248198 4178658701 3 2022 2023-04-26 12:10:37Z BRIAN TOOMEY 88 VILCOM CENTER DRIVE CHAPEL HILL NC 27514 80108444 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. 13 13 735 16 0 0 21142053 20190305 59940338 59804764 1311 113375 0 0 81083702 80108444 0 0 0 0 43651171 45590509 0 0 0 24986164 27465135 68637335 73055644 12446367 7052800 43266941 52844017 15537103 18061754 27729838 34782263 TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY BY PROVIDING HIGH QUALITY, AFFORDABLE, AND COMPREHENSIVE PRIMARY HEALTH CARE. false false 51477292 59804764 AMBULATORY HEALTH CARE SERVICES TO THE GENERAL PUBLIC IN CHAPEL HILL, NC AND SURROUNDING AREAS. DURING 2022, THE ORGANIZATION HAD OVER 111,000 MEDICAL ENCOUNTERS. 51477292 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 false false true false false false false false false false false false false false false false false false false false true 60 0 true 735 true false false false false false false false false false false false false X 13 13 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 303320 0 27589 JOAN EAST CMO 24.0 0.0 X 258377 0 24893 SHARON REILLY MEDICAL DIRECTOR 30.0 0.0 X 248336 0 24290 FAREEDAT OLUYADI PHYSICIAN 40.0 0.0 X 232131 0 23318 RHONDA KROLL PHYSICIAN 40.0 0.0 X 230260 0 23206 KATRINA MATTISON-CHALWE DENTAL DIRECTOR 10.0 0.0 X 228135 0 23078 ADRIAN MANCHENO PHYSICIAN 40.0 0.0 X 224309 0 22849 LYDIA MASON CFO 40.0 0.0 X 215632 0 21953 ANNIE BRAYBOY BOARD MEMBER 0.75 0.0 X 0 0 0 BARBARA JESSIE BLACK BOARD MEMBER 0.75 0.0 X 0 0 0 BERTHE MAIROUNGA BOARD MEMBER 0.75 0.0 X 0 0 0 CAMILLE BERRY BOARD MEMBER 0.75 0.0 X 0 0 0 EDNA MARKS BOARD VICE-CHAIR 0.75 0.0 X X 0 0 0 GEORGE PINK TREASURER 0.75 0.0 X X 0 0 0 GLORIA BROWN BOARD MEMBER 0.75 0.0 X 0 0 0 IVAN REMNITZ BOARD MEMBER 0.75 0.0 X 0 0 0 LEENA MEHTA SECRETARY 0.75 0.0 X X 0 0 0 MARIELA HERNANDEZ BOARD MEMBER 0.75 0.0 X 0 0 0 REGINALD TYSON BOARD CHAIR 0.75 0.0 X X 0 0 0 VIRGINIA DICKIE BOARD MEMBER 0.75 0.0 X 0 0 0 VICTORIA FREEMAN BOARD MEMBER BEG 02/22 0.75 0.0 X 0 0 0 1940500 0 191176 86 false true false 0 8000 19854052 328253 20190305 NET PATIENT SERVICE REVENUE 621400 32205102 32205102 CAPITATION REVENUE 621400 26989986 26989986 OTHER INCOME 621400 609676 609676 59804764 113375 113375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80108444 59804764 0 113375 X 0 0 0 0 851764 283270 568494 0 35706265 25467290 10238975 1812965 939324 873641 4336811 2231648 2105163 2882704 1480145 1402559 324873 324873 138032 138032 202120 202120 0 0 0 11975957 11757428 218529 0 6044039 2380458 3663581 0 0 1263553 686929 576624 244569 126203 118366 0 59510 39431 20079 237428 210954 26474 0 1545728 1364871 180857 373681 373681 MEDICAL SUPPLIES & DRUGS 4413319 4413319 LICENSES, DUES, SUBSCRIPTIONS 528350 95982 432368 RECRUITING & RETENTION 113976 40 113936 73055644 51477292 21578352 0 15271107 15359334 9030952 14531709 539992 1474330 1307467 1014929 0 0 0 0 0 0 596893 349204 278298 400990 29502896 19167763 9529229 10335133 1389550 1169054 0 0 0 0 0 0 5323453 8209334 43266941 52844017 9595830 9796437 0 0 0 5501 0 0 0 0 0 0 5583822 5240953 0 0 357451 3018863 15537103 18061754 X 26974267 34294032 755571 488231 27729838 34782263 43266941 52844017 7052800 -375 X false true X true true true X 11910443 12826119 16590698 21142053 20190305 82659618 0 0 11910443 12826119 16590698 21142053 20190305 82659618 0 82659618 5297 5272 1169 1311 113375 126424 0 0 82786042 274700848 0.99847 0.98843 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, THE NATIONAL PACE ASSOCIATION IN THE AMOUNT OF $49,000, AND THE NORTH CAROLINA PACE ASSOCIATION IN THE AMOUNT OF $25,000. ALL OF THE ORGANIZATIONS LOBBY ON BEHALF OF MEMBER HEALTH CENTER. HOWEVER, THE AMOUNT OR PERCENTAGE OF DUES EXPENDED BY THE ORGANIZATION FOR LOBBYING ACTIVITIES IS UNKNOWN. 1574286 1574286 22219721 15030481 7189240 5708889 4137282 1571607 10335133 AMOUNTS DUE FROM THIRD PARTIES 5000000 DEPOSITS 15832 OTHER RECEIVABLES 251297 PACE RECEIVABLE 196562 ROU LEASE ASSETS 2745643 8209334 0 Est Self-Insurance Costs 250000 ROU LEASE LIABILITIES 2768863 3018863 80375409 -375 1301980 1301605 79073804 1034640 1034640 80108444 73055644 73055644 73055644 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: $ 1,301,980 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: $ 1,034,640 TEMPORARILY RESTRICTED CONTRIBUTIONS X X X false false false false false false false false false BRIAN TOOMEY CEO 303320 0 0 0 0 0 18199 0 9390 0 330909 0 0 0 JOAN EAST CMO 258377 0 0 0 0 0 15503 0 9390 0 283270 0 0 0 LYDIA MASON CFO 215632 0 0 0 0 0 12938 0 9015 0 237585 0 0 0 FAREEDAT OLUYADI PHYSICIAN 232131 0 0 0 0 0 13928 0 9390 0 255449 0 0 0 KATRINA MATTISON-CHALWE DENTAL DIRECTOR 228135 0 0 0 0 0 13688 0 9390 0 251213 0 0 0 RHONDA KROLL PHYSICIAN 230260 0 0 0 0 0 13816 0 9390 0 253466 0 0 0 SHARON REILLY MEDICAL DIRECTOR 248336 0 0 0 0 0 14900 0 9390 0 272626 0 0 0 ADRIAN MANCHENO PHYSICIAN 224309 0 0 0 0 0 13459 0 9390 0 247158 0 0 0 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 ORGANIZATION ADJUSTS SALARIES AS NEEDED TO REMAIN COMPETITIVE IN THE INDUSTRY AND ITS MARKET. PAY PRACTICE CHANGES AND/OR SALARY GRADE ADJUSTMENTS MUST BE APPROVED BY THE CFO, CEO AND CHRO. ALL PAY PRACTICES AND PAY GRADE ADJUSTMENTS WILL BE REVIEWED BY THE FINANCE COMMITTEE (OR EXECUTIVE COMMITTEE) ANNUALLY. 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:9156110 FORM 990 PART IX LINE 11G DESCRIPTION:NONPATIENT CARE TOTAL FEES:785208 FORM 990 PART IX LINE 11G DESCRIPTION:LAB SERVICES TOTAL FEES:604188 FORM 990 PART IX LINE 11G DESCRIPTION:PROCESSING COSTS TOTAL FEES:463803 FORM 990 PART IX LINE 11G DESCRIPTION:TRANSCRIPTION SERVICES TOTAL FEES:303341 FORM 990 PART IX LINE 11G DESCRIPTION:MEAL SERVICES TOTAL FEES:296609 FORM 990 PART IX LINE 11G DESCRIPTION:DENTAL SERVICES TOTAL FEES:206319 FORM 990 PART IX LINE 11G DESCRIPTION:TRANSPORTATION SERVICES TOTAL FEES:87542 FORM 990 PART IX LINE 11G DESCRIPTION:PHARMACY SERVICES TOTAL FEES:35705 FORM 990 PART IX LINE 11G DESCRIPTION:RADIOLOGY SERVICES TOTAL FEES:27258 FORM 990 PART IX LINE 11G DESCRIPTION:REHAB SERVICES TOTAL FEES:9874