COBB HOSPITAL: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- COBB HOSPITAL (EIN 58-0968382)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-15
- IRS object ID
- 201701359349307715
- Schema version
- 2015v3.0
- Note
- A later return for the same period supersedes this one.
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-15T14:21:30-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PricewaterhouseCoopers LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2001 MARKET ST SUITE 1800 | AddressLine1Txt |
| City | PHILADELPHIA | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 580968382 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COBB HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JAMES M SWARTZ | InCareOfNm |
| Business Name Control | COBB | BusinessNameControlTxt |
| Phone | 7709567827 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 793 SAWYER ROAD | AddressLine1Txt |
| City | Marietta | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 300622222 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES M SWARTZ | PersonNm |
| Person Title | VP, ACCOUNTING | PersonTitleTxt |
| Phone | 7709567827 | PhoneNum |
| Signature | 2017-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOANNE KRUEGER | PreparerPersonNm |
| PTIN | P01235586 | PTIN |
| Phone | 2673303000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLSTAR COBB HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CANDICE L SAUNDERS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 793 SAWYER ROAD | AddressLine1Txt |
| City | Marietta | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 300622222 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $370,320,930 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.wellstar.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE WORLD-CLASS CHARITABLE HEALTHCARE TO THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 20 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 2516 | TotalEmployeeCnt |
| Total Volunteers | 225 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $331,306,932 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $362,025,415 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$187,198 | PYInvestmentIncomeAmt |
| CY Investment Income | $248,578 | CYInvestmentIncomeAmt |
| PY Other Revenue | $8,313,381 | PYOtherRevenueAmt |
| CY Other Revenue | $8,046,937 | CYOtherRevenueAmt |
| PY Total Revenue | $339,433,115 | PYTotalRevenueAmt |
| CY Total Revenue | $370,320,930 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $11,200 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $5,800 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $145,975,592 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $152,552,696 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $184,182,283 | PYOtherExpensesAmt |
| CY Other Expenses | $188,191,281 | CYOtherExpensesAmt |
| PY Total Expenses | $330,169,075 | PYTotalExpensesAmt |
| CY Total Expenses | $340,749,777 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $9,264,040 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $29,571,153 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $189,509,262 | TotalAssetsBOYAmt |
| Total Assets EOY | $193,184,625 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $109,315,901 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $113,226,332 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $80,193,361 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $79,958,293 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO CREATE AND DELIVER HIGH QUALITY HOSPITAL, PHYSICIAN AND OTHER HEALTHCARE RELATED SERVICES THAT IMPROVE THE HEALTH AND WELL-BEING OF THE INDIVIDUALS AND COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $287,899,230 | ExpenseAmt |
| Grant | $5,800 | GrantAmt |
| Revenue | $362,025,415 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
| Total Program Service Expenses | $287,899,230 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 2516 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 20 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES M SWARTZ | PersonNm |
| Phone | 7709567827 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 793 SAWYER ROAD | AddressLine1Txt |
| City | Marietta | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 300622222 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (96 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| AVRIL P BECKFORD MD | |||||||||
| TRUSTEE & CHIEF PEDIATRIC OFF. | 2.0 | 48.0 | Yes (X) | Yes (X) | $0 | $553,416 | $30,618 | ||
| CHARLES J JONES | |||||||||
| TRUSTEE | 1.0 | 9.0 | Yes (X) | $0 | $4,079 | $0 | |||
| DAVID H HAFNER MD | |||||||||
| TRUSTEE | 1.0 | 9.0 | Yes (X) | $0 | $23,923 | $0 | |||
| FRANK ROS | |||||||||
| TRUSTEE | 1.0 | 9.0 | Yes (X) | $0 | $3,478 | $0 | |||
| GARY A MILLER | |||||||||
| TRUSTEE - CHAIR | 1.0 | 9.0 | Yes (X) | $0 | $4,120 | $0 | |||
| GREG MORGAN MD | |||||||||
| TRUSTEE | 1.0 | 9.0 | Yes (X) | $0 | $2,324 | $0 | |||
| H SPEER BURDETTE III | |||||||||
| TRUSTEE | 1.0 | 9.0 | Yes (X) | $0 | $0 | $0 | |||
| JANIE MADDOX | |||||||||
| TRUSTEE | 1.0 | 9.0 | Yes (X) | $0 | $7,842 | $0 | |||
| JEFFREY L THARP MD MPH | |||||||||
| TRUSTEE & CHIEF MEDICINE SRVS | 2.0 | 48.0 | Yes (X) | Yes (X) | $0 | $593,302 | $79,458 | ||
| MICHAEL B PATTON | |||||||||
| TRUSTEE | 1.0 | 9.0 | Yes (X) | $0 | $0 | $0 | |||
| MITZI MOORE | |||||||||
| TRUSTEE | 1.0 | 9.0 | Yes (X) | $0 | $3,074 | $0 | |||
| O SCOTT SWAYZE MD | |||||||||
| TRUSTEE | 1.0 | 9.0 | Yes (X) | $0 | $4,304 | $0 | |||
| OTIS A BRUMBY III | |||||||||
| TRUSTEE | 1.0 | 9.0 | Yes (X) | $0 | $16,930 | $0 | |||
| RANDALL BENTLEY SR | |||||||||
| TRUSTEE | 1.0 | 9.0 | Yes (X) | $0 | $20,441 | $0 | |||
| ROBERT N CROSS MD | |||||||||
| TRUSTEE | 1.0 | 9.0 | Yes (X) | $0 | $14,803 | $0 | |||
| T FITZ JOHNSON | |||||||||
| TRUSTEE | 1.0 | 11.0 | Yes (X) | $0 | $17,999 | $0 | |||
| THOMAS E GEARHARD MD | |||||||||
| TRUSTEE | 1.0 | 9.0 | Yes (X) | $0 | $2,070 | $0 | |||
| THOMAS M PHILLIPS | |||||||||
| TRUSTEE | 1.0 | 9.0 | Yes (X) | $0 | $2,638 | $0 | |||
| W CHARLES BROCK | |||||||||
| TRUSTEE | 1.0 | 9.0 | Yes (X) | $0 | $21,470 | $0 | |||
| WALTER G ROBINSON | |||||||||
| TRUSTEE | 1.0 | 9.0 | Yes (X) | $0 | $4,348 | $0 | |||
| SHAN COOPER | |||||||||
| TRUSTEE EMERITUS | 1.0 | 5.0 | Yes (X) | $0 | $126 | $0 | |||
| T E RUSTY DURHAM | |||||||||
| TRUSTEE EMERITUS | 1.0 | 5.0 | Yes (X) | $0 | $0 | $0 | |||
| STEVEN OWEIDA MD | |||||||||
| TRUSTEE EMERITUS | 1.0 | 5.0 | Yes (X) | $0 | $787 | $0 | |||
| W ALLEN SEPARK | |||||||||
| TRUSTEE EMERITUS | 1.0 | 5.0 | Yes (X) | $0 | $1,059 | $0 | |||
| AMY ELLEN F CARRIER | |||||||||
| SVP HOSPITAL PRESIDENT | 48.0 | 2.0 | Yes (X) | $144,589 | $0 | $18,782 | |||
| ANTHONY J BUDZINSKI | |||||||||
| EVP & CFO | 2.0 | 50.0 | Yes (X) | $0 | $793,732 | $76,107 | |||
| ANTHONY M TRUPIANO | |||||||||
| SVP SUPPLY CHAIN | 2.0 | 48.0 | Yes (X) | $0 | $377,102 | $49,343 | |||
| BARBARA B COREY | |||||||||
| SVP MANAGED CARE | 2.0 | 48.0 | Yes (X) | $0 | $416,030 | $47,665 | |||
| BETH KOST | |||||||||
| SVP COMPLIANCE CHF PRIVACY OFF | 2.0 | 48.0 | Yes (X) | $0 | $331,271 | $34,355 | |||
| BETHANY ROBERTSON | |||||||||
| VP & CHIEF LEARNING OFFICER | 2.0 | 48.0 | Yes (X) | $0 | $300,438 | $46,673 | |||
| BRADFORD B NEWTON | |||||||||
| VP INFO. TECHNOLOGY ADMIN. | 2.0 | 48.0 | Yes (X) | $0 | $251,598 | $50,475 | |||
| BRUCE A DEAN | |||||||||
| VP REAL ESTATE DEPUTY GEN CNSL | 2.0 | 48.0 | Yes (X) | $0 | $304,967 | $72,423 | |||
| CANDICE L SAUNDERS | |||||||||
| PRESIDENT & CEO | 2.0 | 50.0 | Yes (X) | $0 | $1,180,672 | $77,248 | |||
| CARRIE O PLIETZ | |||||||||
| EVP & COO HOSP. (BEGIN. 2/16) | 2.0 | 48.0 | Yes (X) | $0 | $0 | $0 | |||
| CATHERINE ANDREWS | |||||||||
| VP OPERATIONS & COO | 50.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| DANIEL J STYF | |||||||||
| SVP PW HEALTH PLAN | 2.0 | 48.0 | Yes (X) | $0 | $401,787 | $30,738 | |||
| DAVID W ANDERSON | |||||||||
| EVP/HR/OL/CCO | 2.0 | 48.0 | Yes (X) | $0 | $636,243 | $73,566 | |||
| DOUGLAS ARVIN CPA MBA | |||||||||
| SVP FINANCE (BEGIN. 3/2016) | 2.0 | 48.0 | Yes (X) | $0 | $0 | $0 | |||
| DOUGLAS S FOSTER | |||||||||
| VP FINANCIAL PLAN. (BEG.3/16) | 2.0 | 48.0 | Yes (X) | $0 | $0 | $0 | |||
| ELIZABETH H LOUDERMILK | |||||||||
| VP ENT INTELLIGENCE & INTGRTN | 2.0 | 48.0 | Yes (X) | $0 | $293,860 | $42,566 | |||
| ELLEN LANGFORD | |||||||||
| SVP & COO WELLSTAR MED GROUP | 2.0 | 48.0 | Yes (X) | $0 | $330,231 | $71,209 | |||
| FREDA LYON | |||||||||
| VP SYSTEM EMERGENCY & TRAUMA | 2.0 | 48.0 | Yes (X) | $0 | $148,720 | $21,078 | |||
| JAMES M SWARTZ | |||||||||
| VP ACCOUNTING | 2.0 | 48.0 | Yes (X) | $0 | $265,746 | $44,824 | |||
| JILL M CASE-WIRTH | |||||||||
| SVP & CHIEF NURSE EXECUTIVE | 2.0 | 48.0 | Yes (X) | $0 | $424,761 | $56,220 | |||
| JIMMY E FRANCIS | |||||||||
| VP INFO TECHNOLOGY OPERATIONS | 2.0 | 48.0 | Yes (X) | $0 | $266,152 | $49,549 | |||
| JOEL W HELMKE | |||||||||
| VP ONCOLOGY | 2.0 | 48.0 | Yes (X) | $0 | $319,000 | $70,175 | |||
| JOHN A BRENNAN | |||||||||
| EVP CHIEF CLNC.OFF (BEG. 4/16) | 2.0 | 48.0 | Yes (X) | $0 | $0 | $0 | |||
| JONATHAN B MORRIS MD | |||||||||
| SVP CHIEF INFO OFFICER | 2.0 | 48.0 | Yes (X) | $0 | $511,024 | $53,680 | |||
| JOSEPH L BRYWCZYNSKI | |||||||||
| SVP HEALTH PARKS DEVELOPMENT | 2.0 | 48.0 | Yes (X) | $0 | $375,861 | $72,424 | |||
| KAY B KENNEDY | |||||||||
| VP CNO PTNT CARE (BEG. 8/2015) | 50.0 | 0.0 | Yes (X) | $117,146 | $0 | $12,915 | |||
| KEM M MULLINS | |||||||||
| EVP COO AMBULATORY & BUS DEV | 2.0 | 48.0 | Yes (X) | $0 | $596,655 | $52,732 | |||
| KENNETH D ETHERIDGE | |||||||||
| VP FINANCE & HOSPITAL CFO | 50.0 | 0.0 | Yes (X) | $258,279 | $0 | $38,959 | |||
| KIMBERLY W MENEFEE | |||||||||
| SVP STRATEGIC COMMUNITY DEV | 2.0 | 50.0 | Yes (X) | $0 | $385,571 | $50,772 | |||
| KRISTEN S TRICE | |||||||||
| VP DIAG. OUTREACH (BEG. 1/16) | 2.0 | 48.0 | Yes (X) | $0 | $0 | $0 | |||
| KRISTYN M GREIFER | |||||||||
| VP POPULATION MANAGEMENT | 2.0 | 48.0 | Yes (X) | $0 | $397,576 | $18,767 | |||
| LEO E REICHERT | |||||||||
| EVP & GENERAL COUNSEL | 2.0 | 48.0 | Yes (X) | $0 | $717,317 | $63,211 | |||
| MARY L TAVERNARO | |||||||||
| VP HUMAN RESOURCES OPERATIONS | 2.0 | 48.0 | Yes (X) | $0 | $283,376 | $51,130 | |||
| MICHAEL G PAUL | |||||||||
| VP FACILITIES ENG SUPPORT SVCS | 2.0 | 48.0 | Yes (X) | $0 | $233,220 | $24,754 | |||
| MICHELLE M ROBINSON | |||||||||
| VP MKTNG/PR/INTERNAL COMM | 2.0 | 48.0 | Yes (X) | $0 | $253,969 | $42,237 | |||
| NICOLE V ASHE | |||||||||
| VP FINANCE & CFO WMG | 2.0 | 48.0 | Yes (X) | $0 | $284,586 | $49,175 | |||
| PETER R JUNGBLUT MD MBA | |||||||||
| SVP & MEDICAL DIR WMG | 2.0 | 48.0 | Yes (X) | $0 | $422,089 | $71,361 | |||
| REBECCA l RUHL | |||||||||
| VP FACILITY CMPL. (BEG. 4/16) | 2.0 | 48.0 | Yes (X) | $0 | $0 | $0 | |||
| REYNOLD J JENNINGS MD | |||||||||
| CHIEF STRATEGY OFFICER | 2.0 | 48.0 | Yes (X) | $0 | $1,651,584 | $2,064 | |||
| RICHARD S SIEGEL | |||||||||
| VP CARDIOLOGY & CVM ADMIN | 2.0 | 48.0 | Yes (X) | $0 | $353,273 | $76,096 | |||
| ROBERT J DECOUX | |||||||||
| VP CORPORATE MED STAFF SVCS | 2.0 | 48.0 | Yes (X) | $0 | $195,690 | $45,418 | |||
| ROBERT MANDLER | |||||||||
| VP DIAGNOSTIC OUTREACH | 2.0 | 48.0 | Yes (X) | $0 | $274,022 | $63,575 | |||
| ROBIN G BOEHRINGER | |||||||||
| VP TOTAL REWARDS (BEG. 11/15) | 2.0 | 48.0 | Yes (X) | $0 | $0 | $0 | |||
| SANDRA LUCIUS | |||||||||
| VP INFO TECHNOLOGY APPS | 2.0 | 48.0 | Yes (X) | $0 | $262,637 | $49,160 | |||
| SEAN P TURNER | |||||||||
| VP REVENUE CYCLE MANAGEMENT | 2.0 | 48.0 | Yes (X) | $0 | $317,142 | $51,201 | |||
| SNEHAL H DOSHI | |||||||||
| VP SYSTEM PHARMACIST | 2.0 | 48.0 | Yes (X) | $0 | $175,084 | $26,331 | |||
| STEPHEN L BADGER | |||||||||
| CHIEF ADMIN. OFF. (BEG. 2/16) | 2.0 | 48.0 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS W MCNAMARA | |||||||||
| VP MEDICAL AFFAIRS | 50.0 | 0.0 | Yes (X) | $404,049 | $0 | $54,808 | |||
| VALERY A AKOPOV MD | |||||||||
| SVP HOSPITAL DIVISION WMG | 2.0 | 48.0 | Yes (X) | $0 | $460,432 | $54,453 | |||
| WANDA Y ROBINSON | |||||||||
| VP COMPLIANCE PWHP | 2.0 | 48.0 | Yes (X) | $0 | $226,225 | $23,315 | |||
| KEVIN W DETER | |||||||||
| VP OPS. & COO | 50.0 | 0.0 | Yes (X) | $300,047 | $0 | $52,231 | |||
| JOSEPH W HERZBERG | |||||||||
| AVP HUMAN RESOURCES | 50.0 | 0.0 | $230,197 | $0 | $6,190 | Yes (X) | |||
| PAULA G PINYAN | |||||||||
| EXECUTIVE DIRECTOR - NURSING | 50.0 | 0.0 | $165,084 | $0 | $48,613 | Yes (X) | |||
| TAWANA MOSES | |||||||||
| EXEC DIR SURGICAL SVCS KH/CH | 50.0 | 0.0 | $159,183 | $0 | $28,883 | Yes (X) | |||
| TIMOTHY W FULLARD | |||||||||
| PHARMACEUTICAL CARE PHARMACIST | 50.0 | 0.0 | $163,109 | $0 | $35,165 | Yes (X) | |||
| YONA D ROBERTS | |||||||||
| MANAGER - PHARMACY | 50.0 | 0.0 | $159,922 | $0 | $31,069 | Yes (X) | |||
| BARBARA G BALLARD | |||||||||
| FORMER VP HOMECARE & HOSPICE | 0.0 | 0.0 | $0 | $168,038 | $0 | Yes (X) | |||
| CHESTER A ZBOROWSKI | |||||||||
| FORMER VP HEALTH PARKS OPS. | 0.0 | 0.0 | $0 | $205,315 | $10,185 | Yes (X) | |||
| CHRISTOPHER B SCULLEN | |||||||||
| FORMER VP PULMONOLOGY OPS. | 0.0 | 0.0 | $0 | $121,351 | $0 | Yes (X) | |||
| CHRISTOPHER M KANE | |||||||||
| FRMR SVP STRAT.PLAN & BUS DEV | 0.0 | 0.0 | $0 | $341,744 | $0 | Yes (X) | |||
| DEBORAH ROEGGE DE VITA | |||||||||
| FRMR VP WOMEN&NEWBORN SVC LINE | 0.0 | 0.0 | $0 | $137,762 | $0 | Yes (X) | |||
| DONALD CAMPBELL MD | |||||||||
| FRMR. SVP PHYS ED&STUDENT AFF | 0.0 | 0.0 | $0 | $363,405 | $0 | Yes (X) | |||
| JAMES E CLEMENTS | |||||||||
| FRMR VP BUS DEV & STRAT. PSHIP | 0.0 | 0.0 | $0 | $148,488 | $0 | Yes (X) | |||
| JEFFERY D STANLEY | |||||||||
| FORMER VP PHARM. & SYSTEM CORD | 0.0 | 0.0 | $0 | $212,980 | $14,507 | Yes (X) | |||
| LEE R COOK | |||||||||
| FRMR. VP MED & BEHAVIORAL HLTH | 0.0 | 0.0 | $0 | $105,339 | $0 | Yes (X) | |||
| LOUIS W LITTLE | |||||||||
| FRMR SVP POST ACUTE SVC & PRES | 0.0 | 0.0 | $0 | $174,084 | $0 | Yes (X) | |||
| MARCIA DELK-PAYNE | |||||||||
| FORMER SVP MED AFF., CQO | 0.0 | 0.0 | $0 | $370,531 | $0 | Yes (X) | |||
| NANCY R DOELLING | |||||||||
| FORMER VP WS PED. ACUTE CARE | 0.0 | 0.0 | $0 | $382,950 | $8,158 | Yes (X) | |||
| ROBERT D JANSEN | |||||||||
| FORMER EVP & PRES. MED. GROUP | 0.0 | 0.0 | $0 | $750,312 | $65,599 | Yes (X) | |||
| ROBIN WILSON | |||||||||
| FORMER SVP CHIEF HEALTH OFF. | 0.0 | 0.0 | $0 | $350,907 | $0 | Yes (X) | |||
| STEVEN L GRACE | |||||||||
| FORMER VP TALENT ACQUISITION | 0.0 | 0.0 | $0 | $161,549 | $0 | Yes (X) | |||
| Patricia A Mayne | |||||||||
| FORMER VP Emergency Services | 0.0 | 0.0 | $0 | $179,810 | $5,244 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,101,605 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $20,896,741 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,397,454 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 127 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| PATIENT REVENUE | 621990 | $362,001,747 | $362,001,747 | $0 | $0 |
| PATIENT EDUCATION | 621990 | $22,018 | $22,018 | $0 | $0 |
| MEDICAL RECORDS | 621990 | $1,650 | $1,650 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $362,025,415 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $135,160 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $135,160 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $135,160 | TotalRevenueColumnAmt |
| Exclusion | $135,160 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $248,578 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $248,578 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $248,578 | TotalRevenueColumnAmt |
| Exclusion | $248,578 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| CAFETERIA | 621990 | $2,143,560 | $0 | $0 | $2,143,560 |
| PARKING | 621990 | $874,962 | $0 | $0 | $874,962 |
| PHARMACY REVENUE | 621990 | $3,215,726 | $0 | $0 | $3,215,726 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,677,529 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,677,529 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $7,911,777 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $370,320,930 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $362,025,415 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $8,295,515 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,800 | TotalAmt |
| Program Services | $5,800 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,264,167 | TotalAmt |
| Program Services | $1,974,250 | ProgramServicesAmt |
| Management And General | $289,917 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,885,656 | TotalAmt |
| Program Services | $104,534,835 | ProgramServicesAmt |
| Management And General | $15,350,821 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,282,968 | TotalAmt |
| Program Services | $6,350,417 | ProgramServicesAmt |
| Management And General | $932,551 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,389,189 | TotalAmt |
| Program Services | $12,546,718 | ProgramServicesAmt |
| Management And General | $1,842,471 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,730,716 | TotalAmt |
| Program Services | $7,612,787 | ProgramServicesAmt |
| Management And General | $1,117,929 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,979 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $28,979 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,976,758 | TotalAmt |
| Program Services | $17,214,569 | ProgramServicesAmt |
| Management And General | $1,762,189 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,715 | TotalAmt |
| Program Services | $26,754 | ProgramServicesAmt |
| Management And General | $12,961 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,929,115 | TotalAmt |
| Program Services | $10,495,584 | ProgramServicesAmt |
| Management And General | $2,433,531 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,444,779 | TotalAmt |
| Program Services | $370,840 | ProgramServicesAmt |
| Management And General | $3,073,939 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,242 | TotalAmt |
| Program Services | $48,143 | ProgramServicesAmt |
| Management And General | $30,099 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,636 | TotalAmt |
| Program Services | $58,752 | ProgramServicesAmt |
| Management And General | $15,884 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,993,244 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $3,993,244 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,958,957 | TotalAmt |
| Program Services | $59,257,117 | ProgramServicesAmt |
| Management And General | $8,701,840 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,582,788 | TotalAmt |
| Program Services | $5,864,454 | ProgramServicesAmt |
| Management And General | $7,718,334 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,040,425 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $3,040,425 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| REPAIRS & MAINTENANCE | $5,816,820 | $3,414,614 | $2,402,206 | $0 |
| MEDICAL SUPPLIES | $57,779,772 | $57,742,385 | $37,387 | $0 |
| OTHER EXPENSES | $447,051 | $381,211 | $65,840 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $340,749,777 | TotalAmt |
| Program Services | $287,899,230 | ProgramServicesAmt |
| Management And General | $52,850,547 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $333,961 | BOYAmt |
| EOY | $26,561 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,685,075 | BOYAmt |
| EOY | $65,362,884 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,411,096 | BOYAmt |
| EOY | $7,865,685 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $593,402 | BOYAmt |
| EOY | $846,140 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $303,634,370 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $195,421,259 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $113,511,621 | BOYAmt |
| EOY | $108,213,111 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,974,107 | BOYAmt |
| EOY | $10,870,244 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $189,509,262 | BOYAmt |
| EOY | $193,184,625 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,989,141 | BOYAmt |
| EOY | $9,130,760 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,326,760 | BOYAmt |
| EOY | $104,095,572 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $109,315,901 | BOYAmt |
| EOY | $113,226,332 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,193,361 | BOYAmt |
| EOY | $79,958,293 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,193,361 | BOYAmt |
| EOY | $79,958,293 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $189,509,262 | BOYAmt |
| EOY | $193,184,625 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $29,571,153 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$29,806,221 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,336,556 | OtherCostOrOtherBasisAmt |
| Book Value | $4,336,556 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $145,972,210 | OtherCostOrOtherBasisAmt |
| Depreciation | $84,496,781 | DepreciationAmt |
| Book Value | $61,475,429 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,535,925 | OtherCostOrOtherBasisAmt |
| Depreciation | $31,366,788 | DepreciationAmt |
| Book Value | $1,399,137 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $141,189,390 | OtherCostOrOtherBasisAmt |
| Depreciation | $106,604,898 | DepreciationAmt |
| Book Value | $34,584,492 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,600,291 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,182,794 | DepreciationAmt |
| Book Value | $6,417,497 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $108,213,111 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| C&E MEDICAID PENDING REC. | $3,413,000 |
| OTHER RECEIVABLES (CORP ALLOC) | $7,457,244 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $10,870,244 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT-OTHER LT LIAB | $636,264 |
| TAX EXEMPT BOND LIAB-DUE TO WHS,INC. | $103,407,627 |
| OTHER LIABILITIES | $51,681 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $104,095,572 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | The following footnote is related to the organization's application of FIN 48 (ASC 740): WELLSTAR AND ITS AFFILIATES HAVE BEEN RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3), AND THEREFORE, RELATED INCOME IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES, EXCEPT FOR CAC AND WGHP, A TAXABLE NOT-FOR-PROFIT. WELLSTAR APPLIES FASB ASC 740, INCOME TAXES, WHICH ADDRESSES ACCOUNTING FOR UNCERTAINTIES IN INCOME TAX POSITIONS. IT ALSO PROVIDES GUIDANCE ON WHEN TAX POSITIONS ARE RECOGNIZED IN AN ENTITYS FINANCIAL STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. THERE IS NO IMPACT ON WELLSTARS COMBINED FINANCIAL STATEMENTS AS A RESULT OF THE APPLICATION OF ASC 740. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 125. | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $37,854,080 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $37,854,080 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11110 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $58,270,694 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $49,676,902 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,593,792 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02520 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $96,124,774 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $49,676,902 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $46,447,872 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13630 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $229,864 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $229,864 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $229,864 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $229,864 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $96,354,638 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $49,676,902 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $46,677,736 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13700 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $21,868,109 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,355,258 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $109,896,594 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $126,965,211 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$17,068,617 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COBB HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3950 AUSTELL ROAD | AddressLine1Txt |
| City | AUSTELL | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30106 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.wellstar.org | WebsiteAddressTxt |
| State License | 033-432 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COBB HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 125. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300. | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 3J | OTHER DESCRIPTIONS FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA): The 2015 Joint Community Health Needs Assessment (www.wellstar.org/chna) of the WellStar Health System legacy hospital community - encompassing WellStar Cobb, Douglas, Kennestone, Paulding and Windy Hill hospitals - provides a list of multi-sector CHNA collaborators including individuals, organizations, and governmental agencies that were consulted and contributed special knowledge of medically underserved and low income populations and/or expertise in public health. |
| SCHEDULE H, PART V, SECTION B, LINE 5 | INPUT FROM COMMUNITY REPRESENTATIVES & COMMUNITY SOURCES: WELLSTAR COBB HOSPITAL integrated multiple sources of data from national and state web-based data platforms with multiple primary data gathering methods. To support the development of the 2015 CHNA and to foster broad collaboration among health systems and hospitals, WellStar engaged Georgia Health Policy Center (GHPC) in the Andrew Young School of Policy Studies at Georgia State University to work with its third-party CHNA consultant to leverage the quantitative and some of its qualitative (focus group) research it does for Kaiser Permanente. As a result, GPHCs data collection and analysis contributed to the CHNAs of four health systems (WellStar Health System, Grady Health System, Kaiser Permanente, and Piedmont Healthcare), a health plan and an urban county health department. WellStars third-party consultant solicited community input via photo testimonies, interviewing/surveying community stakeholders (representing a broad array of community-based organizations and other institutional asset engaged in socioeconomic determinants of health and health improvement), community members utilizing listening sessions at WellStars partnering community safety net clinics and Hispanic congregations/organizations and an online survey, and WellStar Medical Group providers. A comprehensive and expansive listing of CHNA collaborators can be found on page 39 of the joint legacy hospital CHNA report accessible to the public at www.wellstar.org/chna. Quantitative data sources include: 1. Community Commons (through Kaiser Permanente's web portal: www.chna.org/kp) 2. Georgia Department of Public Health's Online Analytical Statistical Information System (OASIS) 3. U.S. Census Bureau American Community Survey 5-Year Dataset 4. University of Wisconsin's County Health Rankings 5. Georgia Area Resource File 6. Staff from the Georgia Health Policy Center reviewed more than 60 data elements and developed county profiles and maps to understand the status of health and healthcare in the service region included in the Appendices of the 2015 Joint CHNA 7. WellStar Health Systems Enterprise Intelligence 8. Cobb Douglas Public Health 9. Behavioral Risk Factor Surveillance System (BRFSS) 10. Centers for Disease Control and Prevention for various indicators Qualitative data sources include: 1. Insights from 99 WellStar Medical Group (WMG) representatives regarding patient health status and community resources were gleaned from an online survey tool sent to WMG providers (MDs and nurse practitioners) and registered nurses. 2. A wide net was cast for community input with an online survey tool (available in English and Spanish) capturing demographics and overall personal health status and behaviors of 447 community members. Community clinics, health e-newsletters, workplace partners, a Public Health Department, a school system, a Hispanic non-profit, and faith-based organizations disseminated the online link via email and social media. Its approximated the survey link was distributed to 5,000 people. 3. 61 key informant surveys/interviews (all WellStar driven except eight by GHPC) were conducted with multi-sector leaders representing diverse organizations including Public Health Departments, governmental agencies, safety net clinics, business leaders, and regional health board representatives. Collecting information from a wide range of experts with first-hand knowledge about the community provided insight on health issues and care barriers along with recommended interventions. 4. To provide a broader base of input and use the CHNA process as a means to strengthen community partnerships, seven listening sessions (three in Spanish) were conducted with 58 medically underserved and uninsured community members. Sites for the sessions were partnering safety net clinic patients (Bethesda Community Clinic in Cherokee, Good Samaritan Health Center in Cobb, The CarePlace in Douglas), Latino community members (WellStar Congregational Health Network members Iglesia de Dios in South Cobb and McEachern UMC in Powder Springs), Ser Familia community members, and the Paulding County Health Department. In each listening session, a few community members provided: 5. photo testimonies from participants in listening sessions were taken to communicate the individuals greatest health-related need. 6. To fortify the seven listening sessions and gain a broader base of input, GPHC also conducted five focus groups with 41 participants in high need areas in each county in WellStars primary service area. |
| SCHEDULE H, PART V, SECTION B, LINE 6A | ORGANIZATIONS INCLUDED IN COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA): As an integrated health system, WellStar Health System submitted a joint 2015 CHNA for the five legacy hospitals (WellStar Cobb, Douglas, Kennestone, Paulding, and Windy Hill) located in its primary service area defined as one community. This varied approach from the individual 2013 CHNA reports and implementation strategies is attributed to WellStars System-wide delivery system of community benefit services and the ability to best leverage its economies of scale and services to address the prioritized health needs of the community, especially the most vulnerable. For the WellStar hospitals and its collaborative community partners, the joint approach to addressing priority health needs maximizes resources to enhance care access, strengthens partnerships for shared responsibility and helps improve overall community health. (Also, note there were no variances on the priority health needs of each individual hospital in the 2013 reports except for the data included. Due to hospital and community collaboration, the information and implementation strategy were basically the same for each hospital to be delivered and lead at the System-level.) (1) The joint WellStar legacy hospital CHNA report meets the requirements of paragraph (b)(6)(i) of this section. WellStars five legacy hospitals collaborated in conducting the 2015 CHNA, and, for specified quantitative and qualitative data, other hospital systems including Kaiser Permanente, Piedmont and Grady. Guided at the System level, WellStar hospitals solicited the help of state and local health departments and key informants to assess the health needs of the community and collaborated in conducting community surveys and hosting listening sessions and focus groups to solicit and receive input from residents, including its medically underserved, low-income, and minority populations. The 2015 CHNA report documents the joint CHNA process and contains all of the elements described in paragraph (b)(6)(i) of the IRSs 501(r) section in the Code of Regulations as it relates to community health needs assessments. The WellStar Health System Board of Trustees adopted the joint CHNA and its implementation strategy on June 2, 2016. (2) The joint CHNA report is clearly identified as applying to the hospital facility. All five WellStar legacy hospitals, WellStar Cobb, Douglas, Kennestone, Paulding, and Windy Hill hospitals, are noted on the cover of the joint CHNA and each hospitals president is listed as members of the WellStar Community Benefit Oversight Committee within the CHNA, along with a hospital-specific profiles and county-specific primary and secondary data and noted in the Tracking Progress section (2015 CHNA, page 62). (3) All of the collaborating hospital facilities and organizations included in the joint CHNA report define their community to be the same. Yes, based upon WellStars: 1. System-based model for delivering most all community benefit services and evaluating its impact (again, to leverage the economies of scale and services to deliver program that address the priority needs) 2. Overlapping hospital 90 percent catchment areas 3. Similar community health needs key findings and themes (access to care and healthy lifestyles prevalence of chronic disease) based upon intensive quantitative and qualitative data and the work of the WellStar Community Health Collaborative task force to identify the priority needs of the overall community (representatives from WellStar services lines, hospitals, departments and the community stakeholders) based on the severity of the need and assets of WellStar and its community stakeholders and partners to address the need. |
| SCHEDULE H, PART V, SECTION B, LINE 7a | The hospitals CHNA can be found online at the following web address: www.wellstar.org/chna and clicking on the 2015 Joint Community Health Needs Assessment (CHNA) link under the WellStar Legacy Hospitals header or directly: https://www.yumpu.com/en/document/view/55617879/wellstar-chna-report-2016 AND on the wellstar health SYSTEM WEBSITE: www.wellstar.org. |
| SCHEDULE H, PART V, SECTION B, LINE 10A | cobb hospital's MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY CAN BE found ON ITS WEBSITE AT: www.wellstar.org/chna and clicking on the Implementation Strategy link under the header WellStar Legacy Hospital header. or directly at: HTTPS://WWW.WELLSTAR.ORG/ABOUT-US/DOCUMENTS/CHNA/ CHNA_IMPLEMENTATION_STRATEGY_2016.PDF. |
| SCHEDULE H, PART V, SECTION B, LINE 11 | PROGRAMS & STRATEGIES TO ADDRESS THE NEEDS OF THE COMMUNITY: WellStar IS implementing two new System-wide WCHC programs, WellStar 4-1 Care Network and Live Well, to address the priority health needs of the 2015 Joint CHNA. The programs are designed to: - Provide organization, framework and leadership to the delivery of community benefit services and enables us to more effectively evaluate and measure the impact on community health - Strengthen WellStars strategic community partnerships in public AND PRIVATE SECTORS THROUGH FORMALIZED ENGAGEMENT AS AS "PARTNERS IN HEALTH" LEVERAGING EXPERTISE, RESOURCES AND SERVICES TO COMPLEMENT AND/OR BRIDGE INTERVENTION GAPS AND ADDRESS HEALTH DISPARITIES - Boost WellStars ability to replicate and deliver community benefit services across an expanding health system footprint - Maximize the investment in WellStars safety net clinic/non-profit partners by better aligning our services and resources to address priority health needs - Improve overall community health, especially among the vulnerable. The WellStar 4-1 Care Network and Live Well programs provide organizational structure and accountability to WellStar and its legacy hospitals efforts to reach out to those in need, to improve the health of the communities we serve and to enhance access to care. These efforts flow from the WellStar mission and vision and to meet the requirements of federal government (Affordable Care Act Section 9007) of system-wide oversight and guidance regarding tracking community benefit activities, assessing community health needs and developing strategic plans that prioritize community benefit programming. 1. WellStar 4-1 Care Network: Clinical Care Intervention Program - Priority Need Addressed from the 2015 Joint CHNA: Underuse of Primary Care: includes ED utilization and increased care capacity at community safety net clinics Goals: - Expand the WellStar patient experience to partnering community safety net clinics to reduce health disparities through improved access to volunteer primary care physicians and other specialty medical services to vulnerable populations - Build a cost-efficient model of care - Develop and educate about available health resources and facilities to "prescribe" to the medically underserved and uninsured - Decrease ED utilization and readmissions for non-emergent needs to deliver the right care at the right place to the medically underserved and uninsured. THE NAME REFERS TO THE AIM OF THE LOW-COST HEALTHCARE DELIVERY SYSTEM IN THE COMMUNITY TO CARE "FOR ONE" ANOTHER BY ADDRESSING THE UNDERUSE OF PRIMARY CARE AND REDUCING ED UTILIZATION AND READMISSIONS FOR NON-EMERGENT ISSUES THAT POTENTIALLY COULD BE TREATED IN AN OUTPATIENT SETTING. It also reflects increasing safety net clinic capacity, education and resources via WellStar Medical Group (WMG) citizenship, with MDs and NPs volunteering four hours one time per month. 2. Live Well: Healthy Behaviors Intervention Program - Priority Health Needs Addressed from the 2015 Joint CHNA: Cancer, Cardiovascular Disease, COPD/Asthma, Obesity, Type 2 Diabetes Goal: - Improve the health of medically underserved and uninsured residents through targeted preventive services, education and outreach. Live Wells targeted outreach to vulnerable populations to address healthy lifestyle-related priority health needs leverages the WellStar 4-1 Care Network partners by delivering health need-specific education, events and preventive screenings on-site and in other high-need site locations. Live Well works in tandem with 4-1 Care and other collaborative partnerships to help reduce the prevalence of chronic disease and its complications through prevention and wellness activities and the promotion of healthy lifestyles. Aligning the resources of the WellStar Community Education & Outreach team, Live Well also will partner with other community groups and organizations proximate to community safety net clinics for volunteerism, health navigation, transportation, and other supportive services. UNADDRESSED CHNA NEEDS - Health needs not identified as priority fall into one of three categories: 1) Beyond the scope of WellStar services, e.g. dental care which is addressed by safety nets clinics 2) Needs further intervention, but no plans for expanding current community benefit services at this time, e.g. maternal/infant health 3) Relying on community partners to lead efforts with expertise in these areas with WellStar in a supportive role, e.g. substance abuse, violence, suicide, STDs, transportation. To identify the six priority health needs WellStars legacy hospitals will address, leaders of Kennesaw State Universitys A.L. Burruss Institute of Public Service & Research were solicited to guide the WellStar Community Health Collaborative task force (made up of WellStar internal team members and community stakeholders) through the prioritization process. Health needs data summaries were advanced ahead of the Health Needs Summit on February 25, 2016 for review. From the significant health needs identified by CHNA research conducted in the fall/winter of 2015, the priority health needs were determined via an online survey tool for the community WellStar legacy hospitals serve. |
| SCHEDULE H, PART V, SECTION B, LINE 13B | FAP ELIGIBILITY CRITERIA - INCOME LEVEL OTHER THAN FPG: The hospital abides by the financial assistance requirements under IRC 501(R)(5). IRC 501(R)(5) requires health care facilities to limit the amounts charged for emergency and other medically necessary care that is provided to individuals eligible for assistance under the health care facilities financial assistance policy to not more than the amounts generally billed to individuals who have insurance. The hospital extends its sliding scale for Financial Assistance Policy (FAP) eligibility well beyond the minimum government levels to 300% of FPG. WellStar has chosen to use the average of the three best negotiated commercial rates as the trigger to not exceed in the application of the discounts/amounts charged to patients, on our sliding scale. |
| SCHEDULE H, PART V, SECTION B, LINE 13H | FAP ELIGIBILITY CRITERIA - OTHER CRITERIA: Other special circumstances may qualify a patient for full indigent or sliding scale charity benefits. Special circumstances may include but not limited to: - Patient deceased, with verification that there is no estate. - Unable to contact patient but Propensity to Pay software returns a low ability/low propensity designation. |
| SCHEDULE H, PART V, SECTION B, LINE 15E | METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE: In order to qualify for Financial Assistance, cooperation with WellStar Health System hospital Financial Assistance staff is necessary in identifying and determining alternative sources of payment or coverage from public and private payment programs. In particular, all applicants filing a FAP Application for Financial Assistance must provide proof of Household Income and Household Assets by providing any or all of the following that are applicable: - Provide three (3) months of the most recent paycheck stubs or a statement from employer verifying gross wages - IRS W-2 issued during the past year - Most recent IRS Form 1040 - Most recent two (2) months of bank statements for each checking, savings, money market or other bank or investment account - Written statements for the most recent two (2) months for all other income (e.g., unemployment compensation, disability, retirement, student loans, award letter from Social Security Office, current Profit and Loss report for all self-employed applicants, alimony documentation, child support documentation, etc.) - Unemployment compensation denial letter - Documentation of asset values, including, without limitation, property tax statements, Certificates of Deposit, 401k, 403b, IRA and other investment statements - Contribution statements from individuals who contribute income or in-kind assistance to the patient. Financial Assistance Policy eligibility will be determined based on a thorough review of the submitted information. |
| SCHEDULE H, PART V, SECTION B, LINE 16A | THE WELLSTAR HEALTH SYSTEM COMMUNITY FINANCIAL ASSISTANCE POLICY CAN BE FOUND ON ITS WEBSITE: https://www.wellstar.org/about-us/policies-procedures/pages/community- FINANCIAL-ASSISTANCE-POLICY.ASPX. SCHEDULE H, PART V, SECTION B, LINE 16B THE WELLSTAR HEALTH SYSTEM FINANCIAL ASSISTANCE APPLICATION CAN BE FOUND ON ITS WEBSITE: https://www.wellstar.org/about-us/policies-Procedures/documents/financial- aid-program-application.pdf and clicking Application in the right navigation box titled Related Documents. A window will appear that allow you to scroll to the appropriate WellStar hospital and click for a PDF version of the application to print or download. SCHEDULE H, PART V, SECTION B, LINE 16C A PLAIN LANGUAGE SUMMARY OF THE WELLSTAR HEALTH SYSTEM FINANCIAL ASSISTANCE APPLICATION CAN BE FOUND ON ITS WEBSITE: https://www.wellstar.org/about-us/policies-procedures/documents/fap-plain- language-summary-wgh.pdf. |
| SCHEDULE H, PART V, SECTION B, LINE 16I | PUBLICATION OF THE FINANCIAL ASSISTANCE POLICY (FAP): In addition to the other methods of posting the financial assistance policy, the hospital makes available for patients in admissions and outpatient registration areas a prominently displayed sign stating financial assistance is available and a brochure including frequently asked questions. |
| SCHEDULE H, PART V, SECTION B, LINE 20E | ADDITIONAL EFFORTS MADE BEFORE COLLECTIONS ACTION INITIATED: The hospital facility also notified individuals of the financial assistance policy online at: http://www.wellstar.org/pages/online-bill-pay.aspx. Furthermore, the hospital facility utilizes a propensity to pay software. Individuals with a low ability/low propensity designation may qualify for full indigent or sliding scale charity benefits. |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 6A | PUBLICATION OF COMMUNITY BENEFIT REPORT: COBB HOSPITAL, INC. IS AN affiliate of Wellstar Health System, Inc. which on an annual basis issues a community benefit report. This report is subsequently distributed in and around the five-county primary service area of the health system. On an annual basis the hospital reportS ITS community health benefits report to the Georgia Hospital Association (GHA). GHA aggregates the hospital specific reports into a statewide community health benefit report. The State of Georgia also requires hospitals to file the Hospital Financial Survey and the Indigent Care Trust Fund Survey so that it can collect information on hospital financial class categories and also to determine the amount of uncompensated care by hospital. THE COMMUNITY BENEFIT REPORT CAN BE FOUND AT THE FOLLOWING LINK: https://www.wellstar.org/community/documents/wellstar- COMMUNITY-BENEFITS-REPORTS.PDF. |
| SCHEDULE H, PART I, LINE 7 | COST TO CHARGE RATIO: For purposes of the IRS Form 990, Schedule H, Wellstar Health System and Affiliates (including Kennestone and Windy Hill Hospitals) have estimated the current year cost to charge ratio for each hospital as it is reported in the annual community benefit report and as it will be reported in the state's Annual Hospital Financial Survey. |
| SCHEDULE H, PART III, SECTION A, LINE 2 | METHODOLOGY USED TO ESTIMATE BAD DEBT: The reported bad debt charges is derived from the unpaid balances of patient accounts that are deemed uncollectible after 120 days of collection effort by the hospital's patient financial services staff. The unpaid patient accounts are then sent to collection agencies and any collected amount is deemed as bad debt recovery. The source of this data is the hospital's detailed financial trial balance. The net reported bad debt charges are then multiplied by the Hospital Financial Survey calculated cost to charge ratio to arrive at the estimated bad debt expense. |
| SCHEDULE H, PART III, SECTION A, LINE 3 | METHODOLOGY & RATIONALE USED TO DETERMINE BAD DEBT ATTRIBUTABLE TO PATIENT'S ELIGIBLE UNDER ORGANIZATION'S FAP: The bad debt attributable to patients eligible under the hospital's financial assistance program is determined using a weekly bad debt conversion report for a period of twelve months. The conversion rate for this period is used to determine this bad debt category. The total reported conversion charges is multiplied by a calculated cost to charge ratio to arrive at the cost of bad debt attributable to patient's eligible under the hospital's FAP. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | MEDICARE SHORTFALLS: COBB HOSPITAL IS A provider of inpatient and outpatient services to Medicare program beneficiaries at determined rates. Without the participation in the Medicare program these patients may not have had convenient access to those services. The Medicare shortfall on SCHEDULE H, Part III, Section B, line 7 represents the uncompensated difference between the expected reimbursement and the Medicare charges for those services stated at cost. We determine a cost to charge ratio for Medicare patients as part of the annual filing of the Medicare cost report. |
| SCHEDULE H, PART III, SECTION C, LINE 9B | COLLECTION PRACTICES: The policy written for collection practices that applies to all Wellstar Health System entities incorporates guidelines for personnel in the admissions and patient access areas to be trained in identifying patients that might qualify for financial assistance. It is also the policy of all Wellstar facilities to have at least one employee or contractor available at all times, especially in the hospitals with emergency rooms, who can provide assistance with the paperwork necessary to help patients who would qualify for governmental and other assistance programs. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS ASSESSMENT: To assess the current health and well-being of the community served, WellStar Health System, Inc. conducted a Joint Community Health Needs Assessment (CHNA) for its five legacy hospital community including COBB HOSPITAL, INC. The CHNA was a collaborative effort involving WellStar executive leadership, hospital leadership, public health agencies, and a multi-sector coalition of community stakeholders. Collaborators represented a broad knowledge base of the hospital's primary service area comprising Bartow, Cherokee, Cobb, Douglas, and Paulding counties and some outlying zip codes determined by utilization. To assess the current community health status and capture a broad base of input, WellStar used the following questions to guide the CHNA process and research: 1. What is the current health status of the community WellStar serves? 2. What are the major risk factors and causes of poor health in our community? 3. What actions by WellStar and its partners are needed to address the risk factors and causes? 4. What are the existing WellStar and community assets, programs and services that can help address the needs? 5. Who are the partners or potential partners with the expertise and resources to help expedite a connection to healthcare, education and resources? |
| SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: The hospital provides notice of the availability of community financial assistance through the Financial Assistance Policy (FAP) via: - Signage - Patient Brochure - Billing Statement - Collection Action Letter - Online at: HTTPS://WWW.WELLSTAR.ORG/ABOUT-US/POLICIES- PROCEDURES/PAGES/COMMUNITY-FINANCIAL-ASSISTANCE-POLICY.ASPX. COBB HOSPITAL provideS its patients with hospital personnel or contracted personnel who are trained in all aspects of governmental programs, payments plans, charity discounts, and other financial assistance offered to assist them in their hospital bills. If the patient is eligible for federal or state assistance programs, a staff member is knowledgeable in the steps necessary to qualify those individuals. If a patient is indigent or charity eligible they will be offered assistance through the hospital's charity and indigent care policy including the state's indigent care trust fund. If the patient has no other insurance and fails to qualify for indigent care assistance, the financial counselor can then offer the patient an opportunity to accept a payment plan with discounted payment options based on their ability to pay immediately or over time. All patientS are afforded these opportunities. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION: As part of an integrated health system, WellStar Health system, inc. and COBB HOSPITALS service area overlaps with the other WellStar legacy hospitals. This intersecting impact across WellStar's five-county primary service area of approximately 1.5 million residents in Bartow, Cherokee, Cobb, Douglas, and Paulding counties is not easily determined by a county by county analysis and as such is deemed as one community. The majority of patient volume comes from this service area although other health systems have a presence in the area as well. Demographically, the region is one of the fastest growing in the state as well as the country and the expansion of the services for the patient population reflects a desire to offer healthcare "closer to home" since WellStar is considered a part of a larger metropolitan Atlanta MARKET. ECONOMICALLY, the region is strong in per capita income but given recent trends a rise in the uninsured and indigent population has occurred. COBB HOSPITAL IS ONE of five hospitals that are affiliated with Wellstar Health System. The primary service area of the system is located in the Northwest Georgia area and receives the majority of its patients from one of five counties (Cherokee, Cobb, Douglas, Bartow and Paulding). Generally about 85% to 90% of the patient volume comes from this service area although other health systems have a presence in the area as well. |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH: COBB HOSPITAL (AN affiliate of Wellstar Health System, Inc.) operates as charitable organizations consistent with the requirements of Internal Revenue Code SECTION 501(c)(3) and the "community benefit standard" of IRS Ruling 69-545. In this regard the governing body of the organization and/or its parent is composed of prominent citizens in the community, medical staff privileges in the hospital are available to all qualified physicians in the area consistent with the size and nature of the facility; COBB HOSPITAL operates a full-time emergency room open to all regardless of ability to pay; COBB HOSPITAL provides care to the needy members of the community consistent with its charity care policy. The hospital's excess funds are generally applied to expansion and replacement of existing facilities and equipment, amortization of indebtedness, improvement of patient care, community benefit activities including health education, preventive screenings and health fairs, research, subsidized health services, and charity care. COBB HOSPITAL, INC. committed $8,854,454 in capital expenditures for the year to meet those needs. |
| SCHEDULE H, PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM: WellStar Health System, the largest health system in Georgia, is known nationally for its innovative care models, focused on improving quality and access to healthcare. WellStar consists of WellStar Medical Group, 240 medical office locations, outpatient centers, health parks, a pediatric center, nursing centers, hospice, homecare, as well as 11 inpatient hospitals: WellStar Atlanta Medical Center, WellStar Atlanta Medical Center South, WellStar Kennestone Regional Medical Center (anchored by WellStar Kennestone Hospital), WellStar West Georgia Medical Center, and WellStar Cobb, Douglas, North Fulton, Paulding, Spalding Regional, Sylvan Grove and Windy Hill hospitals. As a not-for-profit, WellStar continues to reinvest in the health of the communities it serves with new technologies and treatments. For more information, visit wellstar.org. |
| SCHEDULE H, PART VI, LINE 7 | STATE FILING OF COMMUNITY HEALTH BENEFIT REPORT: On an annual basis the hospital reports its community health benefits report to the Georgia Hospital Association (GHA). GHA aggregates the hospital specific reports into a statewide community health benefit report. The State of Georgia also requires hospitals to file the Hospital Financial Survey and the Indigent Care Trust Fund Survey so that it can collect information on hospital financial class categories and also to determine the amount of uncompensated care by hospital. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS | GrantTypeTxt |
| Cash Grant | $5,800 | CashGrantAmt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
| Non Cash Assistance | N/A | NonCashAssistanceDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | PROCEDURE FOR MONITORING THE USE OF GRANTS/SCHOLARSHIP FUNDS: WELLSTAR HEALTH SYSTEM, INC. AND ITS AFFILIATES HAVE SET ASIDE FUNDS FOR CONTRIBUTIONS AND SPONSORSHIPS ON AN ANNUAL BASIS THAT PROVIDE ASSISTANCE TO NATIONAL AND LOCAL ORGANIZATIONS AND INDIVIDUALS IN THE FURTHERANCE OF THE COMMUNITY NEEDS. WELLSTAR ALSO HAS SEVERAL AGREEMENTS WITH AREA COLLEGES AND UNIVERSITIES TO PROMOTE HEALTHCARE RELATED CAREER OPPORTUNITIES. ALL SCHOLARSHIPS ARE AWARDED BASED ON SPECIFIC QUALIFICATIONS WITHOUT REGARD TO AGE, GENDER, OR ETHNICITY. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | Yes (X) | FirstClassOrCharterTravelInd |
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Discretionary Spending Acct | Yes (X) | DiscretionarySpendingAcctInd |
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | false | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (64 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AMY ELLEN F CARRIER | ||||||||||||||
| SVP HOSPITAL PRESIDENT | $74,464 | $0 | $68,000 | $0 | $2,125 | $0 | $17,302 | $0 | $1,480 | $0 | $163,371 | $0 | $0 | $0 |
| ANTHONY J BUDZINSKI | ||||||||||||||
| EVP & CFO | $0 | $606,611 | $0 | $162,569 | $0 | $24,552 | $0 | $47,300 | $0 | $28,807 | $0 | $869,839 | $0 | $0 |
| ANTHONY M TRUPIANO | ||||||||||||||
| SVP SUPPLY CHAIN | $0 | $288,371 | $0 | $73,361 | $0 | $15,370 | $0 | $47,300 | $0 | $2,043 | $0 | $426,445 | $0 | $0 |
| AVRIL P BECKFORD MD | ||||||||||||||
| TRUSTEE & CHIEF PEDIATRIC OFF. | $0 | $492,548 | $0 | $58,415 | $0 | $2,453 | $0 | $28,660 | $0 | $1,958 | $0 | $584,034 | $0 | $0 |
| BARBARA B COREY | ||||||||||||||
| SVP MANAGED CARE | $0 | $321,048 | $0 | $81,823 | $0 | $13,159 | $0 | $21,392 | $0 | $26,273 | $0 | $463,695 | $0 | $0 |
| BARBARA G BALLARD | ||||||||||||||
| FORMER VP HOMECARE & HOSPICE | $0 | $36,730 | $0 | $0 | $0 | $131,308 | $0 | $0 | $0 | $0 | $0 | $168,038 | $0 | $0 |
| BETH KOST | ||||||||||||||
| SVP COMPLIANCE CHF PRIVACY OFF | $0 | $271,419 | $0 | $49,750 | $0 | $10,102 | $0 | $22,418 | $0 | $11,937 | $0 | $365,626 | $0 | $0 |
| BETHANY ROBERTSON | ||||||||||||||
| VP & CHIEF LEARNING OFFICER | $0 | $203,392 | $0 | $87,926 | $0 | $9,120 | $0 | $17,301 | $0 | $29,372 | $0 | $347,111 | $0 | $0 |
| BRADFORD B NEWTON | ||||||||||||||
| VP INFO. TECHNOLOGY ADMIN. | $0 | $202,322 | $0 | $40,120 | $0 | $9,156 | $0 | $22,555 | $0 | $27,920 | $0 | $302,073 | $0 | $0 |
| BRUCE A DEAN | ||||||||||||||
| VP REAL ESTATE DEPUTY GEN CNSL | $0 | $242,590 | $0 | $48,105 | $0 | $14,272 | $0 | $47,300 | $0 | $25,123 | $0 | $377,390 | $0 | $0 |
| CANDICE L SAUNDERS | ||||||||||||||
| PRESIDENT & CEO | $0 | $929,590 | $0 | $231,348 | $0 | $19,734 | $0 | $46,319 | $0 | $30,929 | $0 | $1,257,920 | $0 | $889,660 |
| CHESTER A ZBOROWSKI | ||||||||||||||
| FORMER VP HEALTH PARKS OPS. | $0 | $139,238 | $0 | $26,427 | $0 | $39,650 | $0 | $0 | $0 | $10,185 | $0 | $215,500 | $0 | $0 |
| CHRISTOPHER B SCULLEN | ||||||||||||||
| FORMER VP PULMONOLOGY OPS. | $0 | $13,262 | $0 | $0 | $0 | $108,089 | $0 | $0 | $0 | $0 | $0 | $121,351 | $0 | $0 |
| CHRISTOPHER M KANE | ||||||||||||||
| FRMR SVP STRAT.PLAN & BUS DEV | $0 | $52,576 | $0 | $0 | $0 | $289,168 | $0 | $0 | $0 | $0 | $0 | $341,744 | $0 | $0 |
| DANIEL J STYF | ||||||||||||||
| SVP PW HEALTH PLAN | $0 | $290,368 | $0 | $96,256 | $0 | $15,163 | $0 | $21,353 | $0 | $9,385 | $0 | $432,525 | $0 | $0 |
| DAVID W ANDERSON | ||||||||||||||
| EVP/HR/OL/CCO | $0 | $460,491 | $0 | $152,440 | $0 | $23,312 | $0 | $47,185 | $0 | $26,381 | $0 | $709,809 | $0 | $92,098 |
| DEBORAH ROEGGE DE VITA | ||||||||||||||
| FRMR VP WOMEN&NEWBORN SVC LINE | $0 | $30,112 | $0 | $0 | $0 | $107,650 | $0 | $0 | $0 | $0 | $0 | $137,762 | $0 | $0 |
| DONALD CAMPBELL MD | ||||||||||||||
| FRMR. SVP PHYS ED&STUDENT AFF | $0 | $50,387 | $0 | $35,888 | $0 | $277,130 | $0 | $0 | $0 | $0 | $0 | $363,405 | $0 | $0 |
| ELIZABETH H LOUDERMILK | ||||||||||||||
| VP ENT INTELLIGENCE & INTGRTN | $0 | $239,990 | $0 | $43,990 | $0 | $9,880 | $0 | $23,251 | $0 | $19,315 | $0 | $336,426 | $0 | $0 |
| ELLEN LANGFORD | ||||||||||||||
| SVP & COO WELLSTAR MED GROUP | $0 | $253,469 | $0 | $64,482 | $0 | $12,280 | $0 | $41,525 | $0 | $29,684 | $0 | $401,440 | $0 | $0 |
| FREDA LYON | ||||||||||||||
| VP SYSTEM EMERGENCY & TRAUMA | $0 | $117,693 | $0 | $25,000 | $0 | $6,027 | $0 | $8,903 | $0 | $12,175 | $0 | $169,798 | $0 | $0 |
| JAMES E CLEMENTS | ||||||||||||||
| FRMR VP BUS DEV & STRAT. PSHIP | $0 | $31,933 | $0 | $0 | $0 | $116,555 | $0 | $0 | $0 | $0 | $0 | $148,488 | $0 | $0 |
| JAMES M SWARTZ | ||||||||||||||
| VP ACCOUNTING | $0 | $215,613 | $0 | $41,138 | $0 | $8,995 | $0 | $18,573 | $0 | $26,251 | $0 | $310,570 | $0 | $0 |
| JEFFERY D STANLEY | ||||||||||||||
| FORMER VP PHARM. & SYSTEM CORD | $0 | $146,681 | $0 | $27,840 | $0 | $38,459 | $0 | $10,802 | $0 | $3,705 | $0 | $227,487 | $0 | $56,284 |
| JEFFREY L THARP MD MPH | ||||||||||||||
| TRUSTEE & CHIEF MEDICINE SRVS | $0 | $512,199 | $0 | $78,598 | $0 | $2,505 | $0 | $47,185 | $0 | $32,273 | $0 | $672,760 | $0 | $0 |
| JILL M CASE-WIRTH | ||||||||||||||
| SVP & CHIEF NURSE EXECUTIVE | $0 | $336,440 | $0 | $73,003 | $0 | $15,318 | $0 | $46,319 | $0 | $9,901 | $0 | $480,981 | $0 | $0 |
| JIMMY E FRANCIS | ||||||||||||||
| VP INFO TECHNOLOGY OPERATIONS | $0 | $215,259 | $0 | $41,071 | $0 | $9,822 | $0 | $46,420 | $0 | $3,129 | $0 | $315,701 | $0 | $0 |
| JOEL W HELMKE | ||||||||||||||
| VP ONCOLOGY | $0 | $260,000 | $0 | $49,580 | $0 | $9,420 | $0 | $41,300 | $0 | $28,875 | $0 | $389,175 | $0 | $0 |
| JONATHAN B MORRIS MD | ||||||||||||||
| SVP CHIEF INFO OFFICER | $0 | $397,155 | $0 | $101,035 | $0 | $12,834 | $0 | $25,576 | $0 | $28,104 | $0 | $564,704 | $0 | $0 |
| JOSEPH L BRYWCZYNSKI | ||||||||||||||
| SVP HEALTH PARKS DEVELOPMENT | $0 | $283,379 | $0 | $74,924 | $0 | $17,558 | $0 | $47,300 | $0 | $25,124 | $0 | $448,285 | $0 | $42,507 |
| JOSEPH W HERZBERG | ||||||||||||||
| AVP HUMAN RESOURCES | $24,188 | $0 | $14,378 | $0 | $191,631 | $0 | $2,238 | $0 | $3,952 | $0 | $236,387 | $0 | $0 | $0 |
| KEM M MULLINS | ||||||||||||||
| EVP COO AMBULATORY & BUS DEV | $0 | $496,864 | $0 | $87,504 | $0 | $12,287 | $0 | $23,300 | $0 | $29,432 | $0 | $649,387 | $0 | $0 |
| KENNETH D ETHERIDGE | ||||||||||||||
| VP FINANCE & HOSPITAL CFO | $212,701 | $0 | $35,535 | $0 | $10,043 | $0 | $26,978 | $0 | $11,981 | $0 | $297,238 | $0 | $0 | $0 |
| KIMBERLY W MENEFEE | ||||||||||||||
| SVP STRATEGIC COMMUNITY DEV | $0 | $293,842 | $0 | $77,691 | $0 | $14,038 | $0 | $29,300 | $0 | $21,472 | $0 | $436,343 | $0 | $0 |
| KRISTYN M GREIFER | ||||||||||||||
| VP POPULATION MANAGEMENT | $0 | $333,466 | $0 | $54,496 | $0 | $9,614 | $0 | $9,013 | $0 | $9,754 | $0 | $416,343 | $0 | $0 |
| LEE R COOK | ||||||||||||||
| FRMR. VP MED & BEHAVIORAL HLTH | $0 | $19,734 | $0 | $0 | $0 | $85,605 | $0 | $0 | $0 | $0 | $0 | $105,339 | $0 | $0 |
| LEO E REICHERT | ||||||||||||||
| EVP & GENERAL COUNSEL | $0 | $531,190 | $0 | $168,916 | $0 | $17,211 | $0 | $29,300 | $0 | $33,911 | $0 | $780,528 | $0 | $27,209 |
| LOUIS W LITTLE | ||||||||||||||
| FRMR SVP POST ACUTE SVC & PRES | $0 | $38,051 | $0 | $0 | $0 | $136,033 | $0 | $0 | $0 | $0 | $0 | $174,084 | $0 | $0 |
| MARCIA DELK-PAYNE | ||||||||||||||
| FORMER SVP MED AFF., CQO | $0 | $57,005 | $0 | $0 | $0 | $313,526 | $0 | $0 | $0 | $0 | $0 | $370,531 | $0 | $0 |
| MARY L TAVERNARO | ||||||||||||||
| VP HUMAN RESOURCES OPERATIONS | $0 | $227,968 | $0 | $45,205 | $0 | $10,203 | $0 | $29,060 | $0 | $22,070 | $0 | $334,506 | $0 | $34,242 |
| MICHAEL G PAUL | ||||||||||||||
| VP FACILITIES ENG SUPPORT SVCS | $0 | $186,846 | $0 | $34,053 | $0 | $12,321 | $0 | $0 | $0 | $24,754 | $0 | $257,974 | $0 | $0 |
| MICHELLE M ROBINSON | ||||||||||||||
| VP MKTNG/PR/INTERNAL COMM | $0 | $204,235 | $0 | $40,499 | $0 | $9,235 | $0 | $15,206 | $0 | $27,031 | $0 | $296,206 | $0 | $0 |
| NANCY R DOELLING | ||||||||||||||
| FORMER VP WS PED. ACUTE CARE | $0 | $242,323 | $0 | $80,333 | $0 | $60,294 | $0 | $5,179 | $0 | $2,979 | $0 | $391,108 | $0 | $0 |
| NICOLE V ASHE | ||||||||||||||
| VP FINANCE & CFO WMG | $0 | $234,187 | $0 | $41,156 | $0 | $9,243 | $0 | $23,487 | $0 | $25,688 | $0 | $333,761 | $0 | $0 |
| PAULA G PINYAN | ||||||||||||||
| EXECUTIVE DIRECTOR - NURSING | $150,010 | $0 | $14,073 | $0 | $1,001 | $0 | $40,467 | $0 | $8,146 | $0 | $213,697 | $0 | $0 | $0 |
| PETER R JUNGBLUT MD MBA | ||||||||||||||
| SVP & MEDICAL DIR WMG | $0 | $322,899 | $0 | $86,624 | $0 | $12,566 | $0 | $41,300 | $0 | $30,061 | $0 | $493,450 | $0 | $0 |
| REYNOLD J JENNINGS MD | ||||||||||||||
| CHIEF STRATEGY OFFICER | $0 | $975,000 | $0 | $656,466 | $0 | $20,118 | $0 | $0 | $0 | $2,064 | $0 | $1,653,648 | $0 | $0 |
| RICHARD S SIEGEL | ||||||||||||||
| VP CARDIOLOGY & CVM ADMIN | $0 | $289,286 | $0 | $53,009 | $0 | $10,978 | $0 | $47,300 | $0 | $28,796 | $0 | $429,369 | $0 | $0 |
| ROBERT D JANSEN | ||||||||||||||
| FORMER EVP & PRES. MED. GROUP | $0 | $530,908 | $0 | $171,132 | $0 | $48,272 | $0 | $42,129 | $0 | $23,470 | $0 | $815,911 | $0 | $380,649 |
| ROBERT J DECOUX | ||||||||||||||
| VP CORPORATE MED STAFF SVCS | $0 | $167,823 | $0 | $23,013 | $0 | $4,854 | $0 | $20,316 | $0 | $25,102 | $0 | $241,108 | $0 | $0 |
| ROBERT MANDLER | ||||||||||||||
| VP DIAGNOSTIC OUTREACH | $0 | $214,261 | $0 | $42,487 | $0 | $17,274 | $0 | $46,766 | $0 | $16,809 | $0 | $337,597 | $0 | $21,426 |
| ROBIN WILSON | ||||||||||||||
| FORMER SVP CHIEF HEALTH OFF. | $0 | $60,909 | $0 | $0 | $0 | $289,998 | $0 | $0 | $0 | $0 | $0 | $350,907 | $0 | $0 |
| SANDRA LUCIUS | ||||||||||||||
| VP INFO TECHNOLOGY APPS | $0 | $209,269 | $0 | $41,497 | $0 | $11,871 | $0 | $46,691 | $0 | $2,469 | $0 | $311,797 | $0 | $0 |
| SEAN P TURNER | ||||||||||||||
| VP REVENUE CYCLE MANAGEMENT | $0 | $248,019 | $0 | $59,082 | $0 | $10,041 | $0 | $22,462 | $0 | $28,739 | $0 | $368,343 | $0 | $0 |
| SNEHAL H DOSHI | ||||||||||||||
| VP SYSTEM PHARMACIST | $0 | $102,312 | $0 | $68,000 | $0 | $4,772 | $0 | $14,909 | $0 | $11,422 | $0 | $201,415 | $0 | $0 |
| STEVEN L GRACE | ||||||||||||||
| FORMER VP TALENT ACQUISITION | $0 | $30,771 | $0 | $0 | $0 | $130,778 | $0 | $0 | $0 | $0 | $0 | $161,549 | $0 | $0 |
| TAWANA MOSES | ||||||||||||||
| EXEC DIR SURGICAL SVCS KH/CH | $146,120 | $0 | $11,117 | $0 | $1,946 | $0 | $20,577 | $0 | $8,306 | $0 | $188,066 | $0 | $0 | $0 |
| THOMAS W MCNAMARA | ||||||||||||||
| VP MEDICAL AFFAIRS | $335,733 | $0 | $56,089 | $0 | $12,227 | $0 | $29,300 | $0 | $25,508 | $0 | $458,857 | $0 | $43,027 | $0 |
| TIMOTHY W FULLARD | ||||||||||||||
| PHARMACEUTICAL CARE PHARMACIST | $159,969 | $0 | $247 | $0 | $2,893 | $0 | $11,877 | $0 | $23,288 | $0 | $198,274 | $0 | $0 | $0 |
| VALERY A AKOPOV MD | ||||||||||||||
| SVP HOSPITAL DIVISION WMG | $0 | $364,063 | $0 | $78,508 | $0 | $17,861 | $0 | $28,177 | $0 | $26,276 | $0 | $514,885 | $0 | $0 |
| WANDA Y ROBINSON | ||||||||||||||
| VP COMPLIANCE PWHP | $0 | $207,043 | $0 | $7,312 | $0 | $11,870 | $0 | $6,692 | $0 | $16,623 | $0 | $249,540 | $0 | $0 |
| YONA D ROBERTS | ||||||||||||||
| MANAGER - PHARMACY | $154,149 | $0 | $5,072 | $0 | $701 | $0 | $20,793 | $0 | $10,276 | $0 | $190,991 | $0 | $0 | $0 |
| Patricia A Mayne | ||||||||||||||
| FORMER VP Emergency Services | $0 | $27,999 | $0 | $0 | $0 | $151,811 | $0 | $2,659 | $0 | $2,585 | $0 | $185,054 | $0 | $0 |
| KEVIN W DETER | ||||||||||||||
| VP OPS. & COO | $201,583 | $0 | $41,696 | $0 | $56,768 | $0 | $36,104 | $0 | $16,127 | $0 | $352,278 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 1B | FormAndLineReferenceDesc |
| Explanation | REIMBURSEMENT POLICY: While WellStar Health System and its affiliates do not have a written policy regarding payment or reimbursement of the items listed in Part I Line 1a, the organization follows IRS guidelines in the payment of any of these items to individuals listed in Form 990 Part VII Section A. These items are added as taxable wages on the individual's Form W-2 as appropriate. SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS: Pursuant to their respective employment agreements, the following groups of officers are entitled to severance payments based on their compensation at that time in the event of certain identified circumstances. The severance payment periods are 24 months for Executive Vice Presidents, 18 months for Senior Vice Presidents, and 12 months for Vice Presidents. The following officers/KEY EMPLOYEES received severance pay during the 2015 CALENDAR YEAR FROM EITHER THE ORGANIZATION OR A RELATED ORGANIZATION: MARCIA DELK-PAYNE $313,526 ROBIN WILSON 289,998 CHRISTOPHER M. KANE 289,168 DONALD CAMPBELL, MD 277,130 PATRICIA MAYNE 150,603 LOUIS W. LITTLE 136,033 BARBARA G. BALLARD 131,308 STEVEN L. GRACE 130,778 JAMES E. CLEMENTS 116,555 CHRISTOPHER B. SCULLEN 108,089 DEBORAH ROEGGE DE VITA 107,650 LEE R. COOK 88,605 NANCY R. DOELLING 57,696 KEVIN W. DETER 47,996 ROBERT D. JANSEN 32,542 JEFFERY D. STANLEY 34,924 CHESTER A. ZBOROWSKI 33,152 JOSEPH W. HERZBERG 190,570 SCHEDULE J, PART I, LINE 4B PARTICIPATION IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: During the year, Vice Presidents, Senior Vice Presidents, Executive Vice Presidents and certain physicians participated in a supplemental nonqualified retirement plan sponsored by WellStar Health System, Inc. The amounts related to this plan are included in Schedule J, Part II, Column (C). The following individuals received payments from the plan included in Schedule J, Part II, Column (B): CANDICE L. SAUNDERS $889,660 ROBERT D. JANSEN 380,649 DAVID W. ANDERSON 92,098 JEFFERY D. STANLEY 56,284 THOMAS W. MCNAMARA 43,027 JOSEPH L. BRYWCZYNSKI 42,507 MARY L. TAVERNARO 34,242 LEO E. REICHERT 27,209 ROBERT MANDLER 21,426 SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS TO OFFICERS: As part of the WellStar Executive Compensation Philosophy a performance pay plan was instituted several years ago whereby the WellStar Board of Trustees approves an annual incentive plan which consists of several performance goals or factors that upon attainment will result in payouts to eligible plan participants. Those factors are: (1) People & Customer Service goal for employee "Trust Index (2) Quality & Safety goal for clinical excellence and patient satisfaction; AND (3) Financial goal for attaining a positive operating margin. Confirmation of achieving these goals is typically received through the annual external audit process and approved by the Board of Trustees at that time. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A | PROGRAM SERVICE ACCOMPLISHMENTS Wellstar health system is a vertically integrated health care delivery system which provides through affiliated business organizations a full spectrum of health services, including wellness programs, physician office visits, outpatient care, inpatient care, and post-acute services such as home health and long term nursing care. The system through its affiliated business organizations operates 11 hospitals (kennestone, cobb, paulding medical, douglas, windy hill, atlanta medical center downtown and south, north fulton, spalding, sylvan grove and west georgia), multiple physician offices, primary care centers, outpatient care facilities, a nursing home and other health related services including two inpatient hospice facilities. The system is supported financially by a fundraising organization, wellstar foundation, inc. The service area for the system encompasses parts of the northwestern, central and western sections of the state of georgia - the primary area being in bartow, cherokee, cobb, douglas, Paulding, fulton, butts, spalding and troup counties. Approximately more than 90% of inpatient discharges and outpatients served are from the aforementioned counties. The wellstar vision is to deliver world class healthcare. Our mission is to create and deliver high quality hospital, physician and other healthcare related services that improve the health and well-being of the individuals and communities we serve. History- In 1993, what was then known as the cobb health system, the kennestone regional health care system, and the douglas general hospital affiliated to form the northwest georgia health system. Paulding memorial medical center affiliated with northwest georgia health system in 1994. In 1994, the northwest georgia health system helped form the promina health system and changed its name to promina northwest health system. In 1998, promina northwest health system changed its name to wellstar health system. Wellstar disassociated from and became totally independent of promina in 1999. In 2016 WellStar acquired atlanta medical center, north fulton hospital, spalding hospital, sylvan grove hospital and west georgia medical center. Wellstar health system is a parent corporation which provides overall coordination including governing body to its 11 subordinate affiliates: - cobb hospital, inc.; - chs foundation, inc. (investment management); - douglas hospital inc.; - kennestone hospital, inc.; - paulding medical center, inc.; - wellstar foundation inc.; - wellStar atlanta medical center, inc.; - wellstar north fulton hospital, inc.; - wellstar spalding regional hospital, inc.; - wellstar sylvan grove hospital, inc.; - wellstar west georgia health services, inc . Services - Wellstar health system is able to offer a full range of healthcare services through its affiliates. The services offered include but are not limited to: - most major inpatient clinical services, - outpatient services, - diagnostic and therapeutic services, - ancillary and support services, - urgent care services, - home health services, - skilled nursing services and - hospice services. The system includes a residential facility on the kennestone hospital campus, called atherton place. Atherton place also houses an assisted living unit as an additional level of care. The 11 hospital locations are acute care facilities with inpatient, outpatient, and emergency services. Paulding medical center is home to a full care nursing home, paulding nursing center and west georgia medical center also home to two full care nursing homes. Cobb hospital is home to a home health agency and a residential hospice facility called tranquility for those patients in the end stages of life. Kennestone hospital also opened a residential hospice facility not far from its main campus. The system is complimented with approximately 100 physician practices and several urgent care centers. The system is thus able to provide a complete continuum of care for the community it serves. The following statements of community benefit and program service accomplishments represent system-wide activity for wellstar health system, inc. (the "system") - ein 58-1649541. All affiliated entities of the system except the physician hospital organization (ein 58-2116179) operate as charitable organizations consistent with the requirements of internal revenue code section 501(c)(3) and the "community benefit standard" of irs revenue ruling 69-545. The following excerpt from the audited financial statements identifies a broad overview of the charitable purpose for the system. "the system maintains records to identify and monitor the level of charity care it provides through its affiliates. These records include the amount of charges foregone for services and supplies furnished under its charity care policy. In fiscal year 2016 and 2015, wellstar affiliate hospitals made $147.9 million and $100.9 million, respectively, in provider payments and recognized such payments as a reduction in net patient service revenue in the accompanying combined financial statements. The system also participates in certain governmental insurance programs, including medicare and medicaid. Under these programs, the system provides care to patients at payment rates which are determined by the federal and state governments, regardless of the system's actual charges. In most cases, these programs pay the system at amounts which are less than its cost of providing services. The system offers many wellness and educational services at little or no cost to the community. Health fairs are held throughout the year at convenient locations, providing various health screenings, such as mammograms, blood pressure and cholesterol checks. A large number of educational programs are offered for all ages. These programs include bicycle safety, car seat safety, defensive driving, cpr and first-aid classes. Flu shots are available to the community during flu season. Health screenings, medical supplies, and immunizations are provided to children through local health departments and health fairs with system sponsorship in many cases. The costs of these services are included in operating expenses. The system promotes health education and activities for students, parents, and teachers through its partner-in-education programs. The physicians of the system make significant contributions to improve the health status of the community, including involvement in many community activities promoting health awareness and improvement, emergency room care, and delivery of care to the indigent population of the system's service area. The system also made significant contributions to the nursing program at a local university. This financial support has helped to grow the program, which benefits the system as well as the community. The system and all but one of its affiliates have been recognized as organizations exempt from federal income tax under internal revenue code section 501(a) as organizations described in section 501(c)(3) and, therefore, related income is generally not subject to federal or state income taxes. One of the System's affiliates is a controlled foreign corporation not subject to Federal income tax. The Physician Hospital Organization (EIN 58-2116179) is a taxable affiliate of the System and files IRS Form 1120 US Corporation Income Tax Return." Financial Data and Statistics (Services Provided System-Wide): Licensed Beds 2,775 Adult Discharges 80,835 Newborn Discharges 10,896 Emergency Room Visits - 453,429 Surgeries - 52,301 Cath Lab/Pacemakers/EP 11,238 Non-ED O/P Radiology Procedures - 373,364 Med/Surg. Short Stay Cases - 355 GI Lab Procedures - 6,790 Radiology Oncology Procedures - 24,431 COMMUNITY BENEFITS Wellstar Health System participates and collaborates with patients and residents in meeting health needs and improving the overall quality of life in the community. This is especially important in responding to the needs of the underserved regardless of the system's ability to generate a positive margin. Some services would possibly be discontinued if based on a purely financial basis. The following are some examples of the system's services that provide community benefits (and a monetary value of those benefits if known). Clinics: Wellstar is affiliated with several clinics which provide free or discounted health services to persons who cannot afford to pay or those who are not expected to pay. Community Health/Education: Wellstar's Marketing and Public Relations department provides free brochures on a variety of health-related issues. On a quarterly basis Wellstar sends out a wellness magazine entitled "Health and You" to significant number of homes in the community/service area. The magazine provides information on health issues and a schedule of health related classes/seminars available throughout the system. While the magazine is an excellent referral source for Wellstar's varied services, it provides fre |
| FORM 990, PART I, LINES 7A & 7B | UNRELATED BUSINESS INCOME COBB Hospital, INC. GENERATED NO UNRELATED BUSINESS INCOME ("UBI") FOR THE REPORTING YEAR. AS A RESULT THE FILED 990-T SHOWS NO ACTIVITY. IF SUBSEQUENT REVIEW OF THE BOOKS REVEALS ANY UNREPORTED UBI WE WILL FILE AN AMENDED RETURN FOR THE TAX PERIOD ENDED JUNE 30, 2016. FORM 990, PART IV, LINE 12B AUDITED FINANCIAL STATEMENTS COBB Hospital, Inc. is audited on an annual basis by an outside auditing firm, KPMG, and as part of that audit a consolidated financial statement is issued for all of WellStar Health System, Inc. and its CONTROLLED Affiliates. The independent auditors report includes the accounts of Wellstar and its controlled affiliates, WELLSTAR Kennestone Hospital, Inc., WELLSTAR Cobb Hospital, Inc., WELLSTAR Douglas Hospital, Inc., WELLSTAR Paulding Medical Center, Inc., WELLSTAR ATLANTA MEDICAL CENTER, INC., WELLSTAR NORTH FULTON HOSPITAL, INC., WELLSTAR SPALDING REGIONAL HOSPITAL, INC., WELLSTAR SYLVAN GROVE HOSPITAL, INC., WELLSTAR WEST GEORGIA HEALTH SERVICES, INC., WELLSTAR WEST GEORGIA MEDICAL CENTER, INC., Wellstar Foundation, Inc., WELLSTAR WEST GEORGIA FOUNDATION, INC., CHS Foundation, Inc., Community Assurance Company, Ltd., various Wellstar owned physician practices, a hospice facility, a nursing facility, home health business, and entities for infusion therapy and durable medical equipment. All significant intercompany accounts and transactions have been eliminated in combination. The Board of Trustees of Wellstar HEALTH SYSTEM, INC. has the authority to approve appointments of the members of the board of trustees of all affiliate corporations. FORM 990, PART IV, LINE 24A TAX EXEMPT BOND REPORTING For purposes of the Form 990 reporting, WellStar Health System, Inc. (EIN 58-1649541) will list all tax-exempt bonds issued since January 1, 2003 on Schedule K as it typically allocates the proceeds of the bonds to members of the Obligated Group (including the hospitals and physician group). COBB Hospital, Inc. will report this tax exempt bond liability on FORM 990, Part X, Line 25 Other Liabilities DUE TO WHS, INC. FORM 990, PART VI, SECTION A, LINE 7B POWERS OF THE BOARD As per the Articles of Incorporation, the sole member of the organization is Wellstar Health System, Inc., a GEORGIA nonprofit corporation. As sole member, Wellstar Health System, Inc. holds certain powers of election and approval in connection with the governing body of the organization. These powers are presented in detail in the governing documents which the company makes available to the public upon request. FORM 990, PART B, SECTION B, LINE 11B BOARD REVIEW OF FORM 990 Internal staff prepareS the organization's Form 990. Before filing the return with the Internal Revenue Service an external accounting firm, PricewaterhouseCoopers LLP, reviews and sign-offs on the completed return of each organization. The current year Form 990 is then reviewed by the Finance Committee along with a question and answer session. A motion is then made by the Finance committee to approve the returns and present to the full board copies of the forms in an electronic (pdf. format) version as well as a hard copy. The organization's CFO or designee subsequently signs the return for either manual or electronic filing by the appropriate due date. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY Our conflict of interest policy requires all covered persons to annually review the policy and then complete, sign and return the Conflicts of Interest Survey and Attestation to the Compliance Office. The Policy requires an on-going disclosure obligation in the event a conflict arises during the year. The following is our process to regularly and consistently monitor and enforce the policy: Compliance identifies all covered persons who must complete the Survey and Attestation. Compliance verifies that the Survey and Attestation is distributed to these persons. Compliance verifies that these persons return a fully completed and signed Survey and Attestation. Compliance reviews each completed and signed Survey and Attestation to identify all conflicts listed in the document. All conflicts, potential conflicts and incidences of non-compliance are referred to the Chief Compliance Officer. The CCO takes appropriate action to completely resolve all identified conflicts and incidences of non-compliance. FORM 990, PART VII, SECTION B, LINES 15A & 15B COMPENSATION OF OFFICERS Wellstar HEALTH SYSTEM, INC. engages the Hay Group to work with the governing board to review and recommend executive compensation. The executive compensation process at Wellstar is overseen by a committee of independent trustees, which follows a board-approved executive compensation philosophy. The compensation committee consists of five trustees as well as the CEO in an advisory role and not a voting member. Further in committee discussions about the compensation for the Chief Executive Officer, The CEO will recuse him/herself from that process and is a non-voting committee member for discussions on all other officers. The executive compensation philosophy empowers the committee to oversee the executive compensation process and administer the executive compensation program on behalf of the full board of trustee of Wellstar; provided, however, the full Board of Trustees evaluates and approves the compensation of the Chief Executive Officer. The philosophy requires annual disclosure of the committee's actions and decisions to the full board, which it has done. The committee is guided by the board-approved philosophy. Overall, the philosophy is intended to reward for organizational and individual performance. When performance is at a predetermined targeted level, the compensation is intended to be at or around the median of compensation paid to similar positions at similar organizations (the "market"). Wellstar's executive compensation philosophy defines the market as being comprised of comparable not-for-profit health care delivery systems, i.e., not-for-profit organizations similar in complexity and scale to Wellstar. To assist the committee in fulfilling its duties, the committee engaged the Hay Group to provide market compensation data to compare to the Wellstar positions whose compensation the committee oversees. The committee uses this data to provide context when making decisions in administering the compensation program. Accurate minutes of the committee's discussion and decisions are recorded during each committee meeting, and reviewed and approved by the full Board of Trustees at its next scheduled meeting. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS MADE AVAILABLE TO THE PUBLIC The organization and its subsidiaries are subject to the Open Records Law in the State of Georgia. Therefore, by law, citizens are permitted to inspect and copy its governing documents, policies and financial statements as may be requested from time to time. Additionally, the organization's Form 990 is made readily available on the Guidestar website. Periodically, the organization publishes its financial performance in the local newspaper for citizens to review, and it also publishes a community benefit report once a year for distribution to the public. FORM 990, PART VII OFFICERS HOURS WORKED THE OFFICERS DEVOTE THEIR TIME TO ALL OF THE ORGANIZATIONS WITHIN WELLSTAR HEALTH SYSTEM THAT ARE LISTED IN SCHEDULE R, PART II. AS SUCH, THE TOTAL HOURS WORKED BY THE OFFICERS ACROSS ALL ORGANIZATIONS EXCEEDS 40 HOURS A WEEK. FORM 990, PART VII & FORM 990, SCHEDULE J COMPENSATION ALL COMPENSATION AMOUNTS REPORTED ON FORM 990, PART V, PART VII, AND PART IX AS WELL AS SCHEDULE J REPRESENT COMPENSATION PROVIDED TO INDIVIDUALS THAT PROVIDE SERVICES TO THE ORGANIZATION. LIKEWISE, THE NUMBER OF EMPLOYEES REPORTED ON FORM 990 REPRESENT THE NUMBER OF INDIVIDUALS PROVIDING SERVICES TO THE ORGANIZATION. ALL FEDERAL EMPLOYMENT TAX RESPONSIBILITIES FOR THESE INDIVIDUALS (INCLUDING FEDERAL EMPLOYMENT TAX REPORTING RESPONSIBILITIES) ARE HANDLED BY WELLSTAR HEALTH SYSTEM, INC. (EIN 58-1649541). |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS FOR THE REPORTING PERIOD COBB HOSPITAL, INC. HAD A CHANGE IN NET ASSETS OF ($29,806,221) RELATED TO TRANSFERS TO AFFILIATES AS PART OF THE ALLOCATION OF INCOME STATEMENT AND BALANCE SHEET TRANSACTIONS OVER THE YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CHS Foundation Inc | ||||||||||
| 793 SAWYER ROAD | Marietta | GA | 300622222 | 581649540 | Foundation | GA | 501(C)(3) | 11 TYPE 2 | WHS INC | Yes (true) |
| Douglas Hospital Inc | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | 582026750 | Healthcare | GA | 501(C)(3) | 3 | WHS INC | Yes (true) |
| Kennestone Hospital Inc | ||||||||||
| 793 SAWYER ROAD | Marietta | GA | 300622222 | 582032904 | Healthcare | GA | 501(C)(3) | 3 | WHS INC | Yes (true) |
| Paulding Medical Center Inc | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | 582095884 | Healthcare | GA | 501(C)(3) | 3 | WHS INC | Yes (true) |
| Wellstar Foundation Inc | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | 581627413 | Foundation | GA | 501(C)(3) | 11 Type 2 | WHS INC | Yes (true) |
| Wellstar Health System Inc | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | 581649541 | Healthcare | GA | 501(C)(3) | 11 Type 2 | NA | false |
| WELLSTAR ATLANTA MEDICAL CENTER INC | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | 810837031 | HEALTHCARE | GA | 501(C)(3) | 3 | WHS INC | Yes (true) |
| WELLSTAR NORTH FULTON HOSPTIAL INC | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | 810851756 | HEALTHCARE | GA | 501(C)(3) | 3 | WHS INC | Yes (true) |
| WELLSTAR SPALDING REGIONAL HOSPITALINC | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | 810864789 | HEALTHCARE | GA | 501(C)(3) | 3 | WHS INC | Yes (true) |
| WELLSTAR SYLVAN GROVE HOSPITAL INC | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | 810875069 | HEALTHCARE | GA | 501(C)(3) | 3 | WHS INC | Yes (true) |
| WEST GEORGIA HEALTH SERVICES INC | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | 205497622 | HEALTHCARE | GA | 501(C)(3) | 11 TYPE 3FI | WHS INC | Yes (true) |
| WEST GEORGIA MEDICAL CENTER INC | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | 205497506 | HEALTHCARE | GA | 501(C)(3) | 3 | WHS INC | Yes (true) |
| VERNON WOODS RETIREMENT COMMUNITY INC | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | 582575049 | HEALTHCARE | GA | 501(C)(3) | 9 | WHS INC | Yes (true) |
| WEST GEORGIA HEALTH FOUNDATION INC | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | 200936376 | FOUNDATION | GA | 501(C)(3) | 7 | WHS INC | Yes (true) |
| MEDICAL PARK FOUNDATION INC | ||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | 581303478 | FOUNDATION | GA | 501(C)(3) | 7 | WHS INC | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt |
|---|---|---|---|---|---|---|---|---|
| COBB SOUTH PARKING DECK | ||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | 752999669 | PARKING | GA | NA | N/A |
| KENNESTONE EAST PARKING DECK LLC | ||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | 200537100 | PARKING | GA | NA | N/A |
| GRIFFIN IMAGING LLC | ||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | IMAGING | GA | NA | N/A | |
| TENET EMSSPALDING 911 LLC | ||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | OFF BLDG/EMS CTR | GA | NA | N/A | |
| NORTH FULTON PARKING DECK LP | ||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 300622222 | PARKING | GA | NA | N/A | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Community Assurance Co | ||||||||||||
| 3rd Fl Barclays Hse Shedden Rd | George Town | CJ | 581649541 | INSURANCE | CJ | WHS INC | C CORP | |||||
| WEST GEORGIA HEALTH PHYSICIANS INC | ||||||||||||
| 275125341 | PHYSICIAN PRAC. | WHS INC | C CORP | 793 SAWYER ROAD | MARIETTA | GA | 300622222 | GA | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHS Foundation Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | K | TransactionTypeTxt |
| Involved | $214,588 | InvolvedAmt |
| Method Of Amount Determination | ACTUAL COST | MethodOfAmountDeterminationTxt |
Comments