COBB HOSPITAL: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- COBB HOSPITAL (EIN 58-0968382)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-13
- IRS object ID
- 201611349349304941
- Schema version
- 2014v6.0
- 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 | 2016-05-13T13:20:49-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | 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 | 2014-07-01 | 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 | 7707925023 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 Sandy Plains Road | AddressLine1Txt |
| City | Marietta | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 300666340 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES M SWARTZ | PersonNm |
| Person Title | VP, ACCOUNTING | PersonTitleTxt |
| Phone | 2673303000 | PhoneNum |
| Signature | 2016-05-12 | 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 | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CANDICE L SAUNDERS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 Sandy Plains Road | AddressLine1Txt |
| City | Marietta | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 300666340 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $339,620,313 | 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 | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 2567 | 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 | $324,507,645 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $331,306,932 | CYProgramServiceRevenueAmt |
| PY Investment Income | $247,125 | PYInvestmentIncomeAmt |
| CY Investment Income | -$187,198 | CYInvestmentIncomeAmt |
| PY Other Revenue | $6,966,308 | PYOtherRevenueAmt |
| CY Other Revenue | $8,313,381 | CYOtherRevenueAmt |
| PY Total Revenue | $331,721,078 | PYTotalRevenueAmt |
| CY Total Revenue | $339,433,115 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $3,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $11,200 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $136,619,685 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $145,975,592 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $181,261,779 | PYOtherExpensesAmt |
| CY Other Expenses | $184,182,283 | CYOtherExpensesAmt |
| PY Total Expenses | $317,884,464 | PYTotalExpensesAmt |
| CY Total Expenses | $330,169,075 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $13,836,614 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $9,264,040 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $212,397,174 | TotalAssetsBOYAmt |
| Total Assets EOY | $189,509,262 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $115,259,589 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $109,315,901 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $97,137,585 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $80,193,361 | 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 | $276,541,830 | ExpenseAmt |
| Grant | $11,200 | GrantAmt |
| Revenue | $331,306,932 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
| Total Program Service Expenses | $276,541,830 | 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 | false | 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 | 2567 | 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 | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | 7707925023 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 SANDY PLAINS ROAD | AddressLine1Txt |
| City | Marietta | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 300666340 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (85 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Avril P Beckford MD | |||||||||
| TRUSTEE | 2.0 | 48.0 | Yes (X) | $0 | $484,008 | $29,400 | |||
| Jeffrey L Tharp MD | |||||||||
| TRUSTEE | 2.0 | 48.0 | Yes (X) | $0 | $630,869 | $74,725 | |||
| RANDALL BENTLEY SR | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $19,268 | $0 | |||
| OTIS A BRUMBY III | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $14,475 | $0 | |||
| ROBERT N CROSS MD | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $14,446 | $0 | |||
| TE RUSTY DURHAM | |||||||||
| TRUSTEE EMERITUS | 1.0 | 5.0 | Yes (X) | $0 | $661 | $0 | |||
| THOMAS E GEARHARD MD | |||||||||
| TRUSTEE | 2.0 | 48.0 | Yes (X) | $0 | $347,375 | $73,211 | |||
| DAVID H HAFNER MD | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $26,223 | $0 | |||
| T FITZ JOHNSON | |||||||||
| TRUSTEE | 1.0 | 7.0 | Yes (X) | $0 | $20,712 | $0 | |||
| CHARLES J JONES | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $4,075 | $0 | |||
| JANIE MADDOX | |||||||||
| TRUSTEE - CHAIR | 1.0 | 5.0 | Yes (X) | $0 | $8,850 | $0 | |||
| GARY A MILLER | |||||||||
| TRUSTEE - VICE CHAIR | 1.0 | 5.0 | Yes (X) | $0 | $4,387 | $0 | |||
| MITZI MOORE | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $1,730 | $0 | |||
| TOM PHILLIPS | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $2,903 | $0 | |||
| WALTER ROBINSON | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $4,672 | $0 | |||
| FRANK ROS | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $2,820 | $0 | |||
| ORIN SWAYZE MD | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $4,624 | $0 | |||
| GREG MORGAN | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $1,624 | $0 | |||
| WILLIAM C BROCK | |||||||||
| Trustee | 1.0 | 5.0 | Yes (X) | $0 | $20,247 | $0 | |||
| STEVEN W OWEIDA MD | |||||||||
| TRUSTEE EMERITUS | 1.0 | 5.0 | Yes (X) | $0 | $31,409 | $0 | |||
| W ALLEN SEPARK | |||||||||
| TRUSTEE EMERITUS | 1.0 | 7.0 | Yes (X) | $0 | $8,177 | $0 | |||
| Valery A Akopov MD | |||||||||
| VP & Chief of Hospitalist Svcs | 2.0 | 48.0 | $0 | $399,745 | $53,663 | Yes (X) | |||
| David W Anderson | |||||||||
| EVP HR OL CCO | 2.0 | 48.0 | $0 | $648,929 | $70,290 | Yes (X) | |||
| Nicole V Ashe | |||||||||
| VP Finance & CFO WMG | 2.0 | 48.0 | $0 | $262,185 | $45,885 | Yes (X) | |||
| Barbara G Ballard | |||||||||
| VP Homecare & Hospice | 2.0 | 48.0 | $0 | $282,836 | $64,915 | Yes (X) | |||
| Joseph L Brywczynski | |||||||||
| SVP Health Parks Development | 2.0 | 48.0 | $0 | $570,096 | $70,144 | Yes (X) | |||
| Anthony J Budzinski | |||||||||
| EVP & CFO | 2.0 | 50.0 | $0 | $689,236 | $71,096 | Yes (X) | |||
| Donald Campbell MD | |||||||||
| SVP Phys Educ & Student Aff | 2.0 | 48.0 | $0 | $513,317 | $62,483 | Yes (X) | |||
| Jill M Case-Wirth | |||||||||
| SVP Nursing SRVS.(BEGIN. 12/1) | 2.0 | 48.0 | $0 | $72,410 | $4,759 | Yes (X) | |||
| James E Clements | |||||||||
| VP Bus Dev & Strategic Prtnrsp | 2.0 | 48.0 | $0 | $264,016 | $17,453 | Yes (X) | |||
| Lee R Cook | |||||||||
| VP Med & Behavioral Health | 2.0 | 48.0 | $0 | $592,708 | $45,052 | Yes (X) | |||
| Barbara B Corey | |||||||||
| SVP Managed Care | 2.0 | 48.0 | $0 | $379,163 | $48,129 | Yes (X) | |||
| Bruce A Dean | |||||||||
| VP Real Estate Deputy Gen Cnsl | 2.0 | 48.0 | $0 | $282,461 | $69,841 | Yes (X) | |||
| Sarath Degala | |||||||||
| VP Revenue Cycle Management | 2.0 | 48.0 | $0 | $19,850 | $2,923 | Yes (X) | |||
| Marcia Delk-Payne MD | |||||||||
| SVP Med Affair & Chf Qlty Ofcr | 2.0 | 48.0 | $0 | $925,812 | $49,890 | Yes (X) | |||
| Kevin W Deter | |||||||||
| VP Operations & COO | 50.0 | 0.0 | $318,639 | $0 | $58,603 | Yes (X) | |||
| Nancy R Doelling | |||||||||
| VP Pediatric SRVS.(BEGIN. 8/4) | 2.0 | 48.0 | $0 | $141,009 | $11,811 | Yes (X) | |||
| Kenneth D Etheridge | |||||||||
| VP Finance & Hospital CFO | 50.0 | 0.0 | $250,590 | $0 | $39,241 | Yes (X) | |||
| Jimmy E Francis | |||||||||
| VP Info Technology Operations | 2.0 | 48.0 | $0 | $257,027 | $36,192 | Yes (X) | |||
| Steven L Grace | |||||||||
| VP Talent Acquisition | 2.0 | 48.0 | $0 | $266,953 | $32,731 | Yes (X) | |||
| Kristyn M Greifer MD | |||||||||
| VP Population Management | 2.0 | 48.0 | $0 | $369,983 | $28,680 | Yes (X) | |||
| Joel W Helmke | |||||||||
| VP Oncology (BEGIN. 7/21) | 2.0 | 48.0 | $0 | $165,514 | $28,875 | Yes (X) | |||
| Robert D Jansen MD | |||||||||
| EVP & Pres Medical Group | 2.0 | 48.0 | $0 | $782,540 | $75,243 | Yes (X) | |||
| Reynold J Jennings | |||||||||
| PRESIDENT & CEO | 2.0 | 48.0 | $0 | $1,701,981 | $2,056 | Yes (X) | |||
| Peter R Jungblut MD | |||||||||
| SVP & Medical Dir WMG | 2.0 | 48.0 | $0 | $398,803 | $69,399 | Yes (X) | |||
| Christopher M Kane | |||||||||
| SVP Strategic Plan & Bus Dev | 2.0 | 48.0 | $0 | $806,400 | $42,332 | Yes (X) | |||
| Beth Kost | |||||||||
| VP Compliance Chf Privacy Ofcr | 2.0 | 48.0 | $0 | $331,700 | $34,022 | Yes (X) | |||
| Ellen Langford | |||||||||
| SVP & COO WellStar Med Group | 2.0 | 48.0 | $0 | $279,307 | $58,966 | Yes (X) | |||
| Elizabeth H Loudermilk | |||||||||
| VP Ent Intelligence & Intgrtn | 2.0 | 48.0 | $0 | $308,160 | $25,651 | Yes (X) | |||
| Sandra Lucius | |||||||||
| VP Info Technology Apps | 2.0 | 48.0 | $0 | $224,424 | $46,993 | Yes (X) | |||
| Robert Mandler | |||||||||
| VP Diagnostic Outreach | 2.0 | 48.0 | $0 | $290,840 | $61,524 | Yes (X) | |||
| Veronica Martin | |||||||||
| VP CNO Patient Care Services | 50.0 | 0.0 | $269,445 | $0 | $17,716 | Yes (X) | |||
| Patricia A Mayne | |||||||||
| VP Emergency Services | 2.0 | 48.0 | $0 | $311,329 | $50,119 | Yes (X) | |||
| Thomas W McNamara | |||||||||
| VP Medical Affairs | 50.0 | 0.0 | $373,293 | $0 | $51,861 | Yes (X) | |||
| Kimberly W Menefee | |||||||||
| SVP Strategic Community Dev | 2.0 | 48.0 | $0 | $362,955 | $46,026 | Yes (X) | |||
| Christopher L Morgan | |||||||||
| VP & Admin. CLIO (BEGIN. 7/7) | 2.0 | 48.0 | $0 | $168,139 | $21,747 | Yes (X) | |||
| Jonathan B Morris MD | |||||||||
| SVP Chief Info Officer | 2.0 | 48.0 | $0 | $462,389 | $50,258 | Yes (X) | |||
| Kem M Mullins | |||||||||
| SVP & Hospital President | 50.0 | 0.0 | $477,879 | $0 | $50,745 | Yes (X) | |||
| Bradford B Newton | |||||||||
| VP Information Technology Admi | 2.0 | 48.0 | $0 | $232,340 | $47,711 | Yes (X) | |||
| Michael G Paul | |||||||||
| VP Facilities Eng Support Svcs | 2.0 | 48.0 | $0 | $220,953 | $24,150 | Yes (X) | |||
| Leo E Reichert | |||||||||
| EVP & General Counsel | 2.0 | 48.0 | $0 | $752,077 | $29,200 | Yes (X) | |||
| Bethany Robertson | |||||||||
| VP & Chief Learning Officer | 2.0 | 48.0 | $0 | $218,673 | $41,608 | Yes (X) | |||
| Michelle M Robinson | |||||||||
| VP Mktng/PR/Internal Comm | 2.0 | 48.0 | $0 | $238,847 | $40,651 | Yes (X) | |||
| Wanda Y Robinson | |||||||||
| VP Compliance PWHP(BEGIN.9/15) | 2.0 | 48.0 | $0 | $82,927 | $2,538 | Yes (X) | |||
| Deborah Roegge De Vita | |||||||||
| VP Women & Newborn Svc Line | 2.0 | 48.0 | $0 | $231,925 | $31,900 | Yes (X) | |||
| Candice L Saunders | |||||||||
| President & CEO | 2.0 | 48.0 | $0 | $812,226 | $72,916 | Yes (X) | |||
| Christopher B Scullen | |||||||||
| VP Pulmonology Operations | 2.0 | 48.0 | $0 | $292,246 | $17,839 | Yes (X) | |||
| Richard S Siegel | |||||||||
| VP Cardiology & CVM Admin | 2.0 | 48.0 | $0 | $323,664 | $70,462 | Yes (X) | |||
| Jeffery D Stanley | |||||||||
| VP Pharmacy & System Coor | 2.0 | 48.0 | $0 | $216,271 | $30,238 | Yes (X) | |||
| Daniel J Styf | |||||||||
| SVP PW Health Plan | 2.0 | 48.0 | $0 | $337,033 | $27,733 | Yes (X) | |||
| James M Swartz | |||||||||
| VP Accounting | 2.0 | 48.0 | $0 | $272,353 | $42,262 | Yes (X) | |||
| Mary L Tavernaro | |||||||||
| VP Human Resources Operations | 2.0 | 48.0 | $0 | $259,157 | $49,126 | Yes (X) | |||
| Adam C Thompson | |||||||||
| VP Surgery | 2.0 | 48.0 | $0 | $228,073 | $21,830 | Yes (X) | |||
| Anthony M Trupiano | |||||||||
| SVP Supply Chain | 2.0 | 48.0 | $0 | $345,219 | $47,596 | Yes (X) | |||
| Sean P Turner | |||||||||
| VP Rev.Cycle MGMT (BEGIN.9/28) | 2.0 | 48.0 | $0 | $273,082 | $46,665 | Yes (X) | |||
| Robin Wilson MD | |||||||||
| SVP Chief Hlth Innov Officer | 2.0 | 48.0 | $0 | $637,993 | $22,144 | Yes (X) | |||
| Chester A Zborowski | |||||||||
| VP Health Parks Operations | 2.0 | 48.0 | $0 | $223,151 | $24,265 | Yes (X) | |||
| JOSEPH W HERZBERG | |||||||||
| AVP Human Resources | 50.0 | 0.0 | $215,130 | $0 | $40,922 | Yes (X) | |||
| YONA D ROBERTS | |||||||||
| Mgr Pharmacy | 50.0 | 0.0 | $195,512 | $0 | $31,349 | Yes (X) | |||
| CHRISTOPHER A BRIDGERS | |||||||||
| Dir Pharmacy | 50.0 | 0.0 | $170,434 | $0 | $26,152 | Yes (X) | |||
| HEATHER S ROCHFORD | |||||||||
| Mgr Pharmacy | 50.0 | 0.0 | $157,104 | $0 | $36,271 | Yes (X) | |||
| GLORIA NWAGBARA | |||||||||
| RN Charge Nurse | 50.0 | 0.0 | $154,892 | $0 | $40,488 | Yes (X) | |||
| Michael L Graue | |||||||||
| FORMER EVP & COO | 0.0 | 0.0 | $0 | $522,266 | $0 | Yes (X) | |||
| Kenneth C Kunze MD | |||||||||
| FRMR SVP CHIEF MEDICAL OFFICER | 0.0 | 0.0 | $0 | $383,389 | $0 | Yes (X) | |||
| Ilona L Wozniak | |||||||||
| FORMER VP Operations & COO | 0.0 | 0.0 | $403,746 | $0 | $474 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,986,664 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $22,289,637 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,661,140 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 116 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Martin General Contracting Inc | |||||
| 3633 Ivy Gulledge Rd | DALLAS | GA | 30132 | General Contracting | $1,827,034 |
| Quest Diagnostics | |||||
| PO BOX 740736 | ATLANTA | GA | 30384 | MEDICAL SERVICEs | $1,064,928 |
| INGLETT AND STUBBS LLC | |||||
| PO BOX 932506 | ATLANTA | GA | 311932506 | GENERAL CONTRACTOR | $1,075,440 |
| FRESENIUS MEDICAL CARE DBA RCC MARI | |||||
| PO BOX 101518 | ATLANTA | GA | 303921518 | MEDICAL SERVICEs | $974,300 |
| BRASFIELD AND GORRIE | |||||
| 1990 VAUGH RD SUITE 100 | KENNESAW | GA | 30144 | GENERAL CONTRACTING | $2,768,784 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 24 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REVENUE | 621990 | $331,253,985 | $331,253,985 |
| PATIENT EDUCATION | 621990 | $52,757 | $52,757 |
| MEDICAL RECORDS | 621990 | $190 | $190 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $331,306,932 | 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) |
|---|---|---|
| Personal | $28,720 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | $0 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | $28,720 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,720 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $28,720 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $187,198 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$187,198 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$187,198 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$187,198 | 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 | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA | 621990 | $1,776,279 | $1,776,279 |
| PARKING | 621990 | $882,754 | $882,754 |
| PHARMACY REVENUE | 621990 | $3,369,787 | $3,369,787 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,255,841 | TotalRevenueColumnAmt |
| Exclusion | $2,255,841 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $8,284,661 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $339,433,115 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $331,306,932 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $8,126,183 | 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 | $11,200 | TotalAmt |
| Program Services | $11,200 | 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 | $1,625,902 | TotalAmt |
| Program Services | $1,403,433 | ProgramServicesAmt |
| Management And General | $222,469 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $278,936 | TotalAmt |
| Program Services | $245,464 | ProgramServicesAmt |
| Management And General | $33,472 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,024,695 | TotalAmt |
| Program Services | $98,385,271 | ProgramServicesAmt |
| Management And General | $15,639,424 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,599,876 | TotalAmt |
| Program Services | $4,832,064 | ProgramServicesAmt |
| Management And General | $767,812 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,103,693 | TotalAmt |
| Program Services | $13,895,678 | ProgramServicesAmt |
| Management And General | $2,208,015 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,342,490 | TotalAmt |
| Program Services | $7,198,632 | ProgramServicesAmt |
| Management And General | $1,143,858 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,290 | TotalAmt |
| Management And General | $16,290 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,974,212 | TotalAmt |
| Program Services | $16,426,553 | ProgramServicesAmt |
| Management And General | $1,547,659 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,968 | TotalAmt |
| Program Services | $13,952 | ProgramServicesAmt |
| Management And General | $4,016 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,280,805 | TotalAmt |
| Program Services | $9,907,743 | ProgramServicesAmt |
| Management And General | $2,373,062 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,809,149 | TotalAmt |
| Program Services | $343,256 | ProgramServicesAmt |
| Management And General | $3,465,893 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,952 | TotalAmt |
| Program Services | $71,235 | ProgramServicesAmt |
| Management And General | $31,717 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,632 | TotalAmt |
| Program Services | $59,583 | ProgramServicesAmt |
| Management And General | $17,049 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,037,431 | TotalAmt |
| Management And General | $4,037,431 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,219,348 | TotalAmt |
| Program Services | $58,002,748 | ProgramServicesAmt |
| Management And General | $9,216,600 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,179,467 | TotalAmt |
| Program Services | $5,443,813 | ProgramServicesAmt |
| Management And General | $7,735,654 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,109,372 | TotalAmt |
| Management And General | $3,109,372 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| REPAIRS & MAINTENANCE | $5,509,643 | $3,493,299 | $2,016,344 |
| MEDICAL SUPPLIES | $56,573,227 | $56,549,956 | $23,271 |
| OTHER EXPENSES | $275,787 | $257,950 | $17,837 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $330,169,075 | TotalAmt |
| Program Services | $276,541,830 | ProgramServicesAmt |
| Management And General | $53,627,245 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,850 | BOYAmt |
| EOY | $333,961 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,877 | 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 | $79,669,445 | BOYAmt |
| EOY | $57,685,075 | 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 | $7,048,020 | BOYAmt |
| EOY | $7,411,096 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,752,510 | BOYAmt |
| EOY | $593,402 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $295,503,484 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $181,991,863 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $115,957,825 | BOYAmt |
| EOY | $113,511,621 | 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 | $7,944,647 | BOYAmt |
| EOY | $9,974,107 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $212,397,174 | BOYAmt |
| EOY | $189,509,262 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,519,950 | BOYAmt |
| EOY | $11,989,141 | 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 | $99,739,639 | BOYAmt |
| EOY | $97,326,760 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $115,259,589 | BOYAmt |
| EOY | $109,315,901 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,137,585 | BOYAmt |
| EOY | $80,193,361 | 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 | $97,137,585 | BOYAmt |
| EOY | $80,193,361 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $212,397,174 | BOYAmt |
| EOY | $189,509,262 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $9,264,040 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$26,208,264 | 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 | $145,101,445 | OtherCostOrOtherBasisAmt |
| Depreciation | $79,089,032 | DepreciationAmt |
| Book Value | $66,012,413 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,523,425 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,975,351 | DepreciationAmt |
| Book Value | $1,548,074 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $138,404,659 | OtherCostOrOtherBasisAmt |
| Depreciation | $99,460,965 | DepreciationAmt |
| Book Value | $38,943,694 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,137,399 | OtherCostOrOtherBasisAmt |
| Depreciation | $466,515 | DepreciationAmt |
| Book Value | $2,670,884 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $113,511,621 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| C&E MEDICAID PENDING REC. | $2,562,704 |
| OTHER RECEIVABLES (CORP ALLOC) | $7,411,403 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $9,974,107 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT-OTHER LT LIAB | $620,325 |
| TAX EXEMPT BOND LIAB-DUE TO WH | $96,693,679 |
| OTHER LIABILITIES | $12,756 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $97,326,760 | 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 (including COBB HOSPITAL, INC.) and all but one of 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. Community Assurance Corporation is a controlled foreign corporation not subject to Federal tax. 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 entity's financial statements and how the values of these positions are determined. There is no impact on Wellstar's 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 | $35,583,316 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $35,583,316 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10780 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $53,972,374 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $47,108,736 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,863,638 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02080 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $89,555,690 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $47,108,736 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $42,446,954 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12860 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $613,524 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $613,524 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $613,524 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $613,524 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $90,169,214 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $47,108,736 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $43,060,478 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13050 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $12,711,147 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $2,019,674 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $111,236,737 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $128,576,842 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$17,340,105 | 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 | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | 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 |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | SEE PART V, SECTION C | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 12 | 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 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 |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE H, PART V, SECTION B, LINE 3J | FormAndLineReferenceDesc |
| Explanation | OTHER DESCRIPTIONS FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA): The Community Health Needs Assessment for COBB HOSPITAL, INC. provideS a list of WellStar Health System 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: COBB HOSPITAL, INC. integrated multiple sources of data from national and state web-based data platforms with multiple primary data gathering methods (see list below). As a partner in the strategic planning process utilized by Cobb & Douglas Public Health (CDPH) called Mobilizing for Action through Planning and Partners (MAPP) from the National Association of County & City Health Officials, the hospital leveraged the findings from THE community health needs assessments conducted in tax year 2012. Through a grant by the Centers for Disease Control and Prevention, COBB HOSPITAL, INC. partnered with CDPH and formed a coalition, Cobb 2020, to conduct its needs assessment via multiple modalities: MAPP workgroups, focus groups, surveys, Key Informant interviews, and implementation teams to act upon identified strategic issues in the community. To collect robust data for counties WellStar serves outside of Cobb, WellStar enlisted expertise of county and regional public health officials, independent consultants, and other Key Informants. A listing of collaborators can be found in the Appendix of the hospital facility's CHNA report publicly available at wellstar.org. Quantitative Data Sources Including: 1. Georgia Department of Public Health, OASIS 2. Centers for Disease Control and Prevention (CDC) Vital Statistics 3. Agency for Healthcare Research and Quality (AHRQ) 4. U.S. Census Bureau 5. U.S. Department of Health and Human Services 6. Kaiser Permanente Web - Based CHNA Platform 7. Catholic Health Association CHNA resources 8. County Health Rankings & Roadmaps, University of Wisconsin 9. Healthy People 2020 10. Behavioral Risk Factor Surveillance System (BRFSS) 11. WellStar Health System - COBB Hospital, INC.'s FY2012 utilization data to assess service area zip codes accounting for 90 percent of hospital admissions and visits and primary service areas. Qualitative Data Sources Including: 1. Cobb County Focus Group Report - 58 people participated in six focus group representing 14 zip codes. Demographics varied among the groups indicative of the zip codes represented. Two groups were conducted in Spanish and reflected low-income, low education attainment and medically underserved populations. 2. MAPP Assessment Workgroups with representatives from Douglas and Cobb counties conducted four community assessments which helped develop the Cobb 2020 Community Health Improvement Plan. This included the 2011 Field Test Local Public Health System Assessment by the National Public Health Performance Standards Program (NPHPSP). 3. Cobb Key Informant Interview Report - 20 participants identified by Cobb 2020's Community Strengths and Themes Workgroup to represent different sectors of the Cobb community who possessed above average knowledge of the healthcare issues, healthcare system or the community. 4. Cobb MAPP Community Survey Report - A 44 question telephone survey of 1,244 adults ages 18-94 performed by the A.L. Burruss Institute for Public Service and Research, Kennesaw State University. 5. Cobb County 2010 - How Healthy Are We? 6. Cobb County MAPP Forces of Change Assessment Summary Report 7. Bartow, Cherokee and Paulding County Key Informant interviews of community stakeholders led by Ron Chapman, Principal, Magnetic North, LLC, a third-party consultanT. SCHEDULE H, PART V, SECTION B, LINE 6A ORGANIZATIONS INCLUDED IN COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA): While COBB HOSPITAL, INC. conducted its own community health needs assessment there may be some overlap with the other hospitals in WellStar Health System simply because of the geographic constraints and structure of the organization. The community served therefore is defined by similar zip codes and areas of services. SCHEDULE H, PART V, SECTION B, LINES 7A & 7B THE COBB HOSPITAL, INC. CHNA CAN BE FOUND at the following websites: COBB HOSPITAL, INC. WEBSITE: http://www.wellstar.org/about-us/documents/chna/cobb_chna_06172013.pdf AND WELLSTAR HEALTH SYSTEM WEBSITE: http://www.wellstar.org/pages/default.aspx SCHEDULE H, PART V, SECTION B, LINE 10A COBB HOSPITAL's MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY CAN BE FOUND ON its WEBSITE AT: http://www.wellstar.org/about-us/Documents/Implementation_Strategy/cobb_im plementation_strategy_11112013.pdf SCHEDULE H, PART V, SECTION B, LINE 11 PROGRAMS & STRATEGIES TO ADDRESS THE NEEDS OF THE COMMUNITY: COBB HOSPITAL Based on the prioritized health needs, WellStar will implement a five-year, two-phased Community Benefit program that is sustainable and strategically aligned with the WellStar Health System mission and vision to address the prioritized health needs of the uninsured and low-income populations. This is accomplished through expanding provider participation, education, outreach and prevention activities/programs to promote healthy lifestyles and access to care (Phase 1) and creating a collaborative safety net organization for shared accountability to leverage and maximize complementary skills and capacity building (Phase 2). Currently, Phase 2 has shifted from creating an organization to integrating this type of care delivery into the community benefit services WellStar delivers at a health system-level across all hospitals. Progress ongoing in Phase 2: Strategy: Improve access to care to vulnerable populations - Strengthen collaborative partnerships with community stakeholders to increase access to preventative and primary care, improve quality and reduce costs. - Reduce preventable hospital admissions, re-admissions and Emergency Department visits by redirecting care to community clinics and primary care. - Increase the number of hospital-affiliated/WellStar Physicians Group primary care providers and specialists providing free or low-cost healthcare programs/clinics via a Graduate Medical Education program. (Commences in 2017) - Improve medication access through centralized reduced cost Pharmaceutical Patient Access Programs and the Federal 340B Drug Pricing Program for the management of chronic disease and to reduce complications. (cUrrently being assessed) - Evaluate hospital-based subsidized health services to more effectively and efficiently allocate assets addressing prioritized needs of the medically underserved and uninsured. Strategy: Promote healthy lifestyles via preventative care, programs and activities - Engage faith-based organizations in coordination and provision of care (MEMPHIS Model). (pilot to be conducted at WellStar Paulding Hospital.) - Expand free health screenings to the underserved and uninsured through WellStar Corporate & Community Health. - Provide at-risk, low income first time moms with care and education for healthy pregnancies via nurse home visiting program. (initiative not being pursued at this time.) - Collaborate with Cobb2020 Healthy Lifestyle initiatives (including physical activity, healthy eating, and obesity). - Provide community benefit leadership/consultation for the prevention and management of diabetes, cancer and cardiovascular disease. - Increase cancer prevention and education community outreach (including smoking cessation program) utilizing WellStar Cancer Program team. (In progress) - Improve prevention-based educational resources and the referral process to free or low-cost healthcare clinics for continuity of care within the Emergency Department (including nurse navigator training and bi-lingual materials). UNADDRESSED CHNA NEEDS - Selection criteria for COBB HOSPITAL'S prioritized health needs were primarily based upon the bandwidth to build a sustainable community benefit model focused on preventable health behaviors and access to care. Sexually transmitted infections and teen pregnancy are not addressed leaving awareness education with schools, family and churches since the health needs are more cultural and societal. Improvement to health needs stemming from socioeconomic and physical environmental FACTORS such as air quality and transportation, gain traction from public policy and education. A health system can complement efforts to impact policy, but has to rely on public health, state and local municipalities and federal governmental agencies to drive these types of health improvements. Key questions when addressing health needs are: 1.) Do we have existing facilities and resources dedicated to the health needs showing clear disparities and poor performance? And, 2.) Do we have effective and feasible interventions, a successful solution that has the potential to solve multiple problems, | ExplanationTxt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE H, PART I, LINE 6A | FormAndLineReferenceDesc |
| Explanation | 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 service area of the health system. It is also annually filed with Cobb County and the state of Georgia Department of Community Health. Additionally the information on community benefit is included in aggregate for Wellstar Health System, Inc. and affiliated hospitals as part of the Georgia Hospital Association's annual 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. THE COMMUNITY BENEFIT REPORT CAN BE FOUND ON THE WELLSTAR WEBSITE AT: http://www.wellstar.org/about-us/documents/chna/cobb_chna_06172013.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 COBB HOSPITAL) 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 METHOLODOGY & 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 charge 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 A, Line 4 FOOTNOTE ON BAD DEBT & RATIONALE FOR COMMUNITY BENEFIT: The following footnote is detailed in the Wellstar Health System, Inc. and Affiliates Combined Financial Statements related to bad debt or uncollectible accounts: "During 2011, Wellstar adopted the provisions of FASB Accounting Standards Update (2011-07), Healthcare Entities (Topic 954). ASU 2011-07 requires the reclassification of the provision for uncollectible accounts associated with patient service revenue from an operating expense to a deduction from patient service revenue (net of contractual allowances and discounts)." "Wellstar recognizes patient service revenue associated with services provided to patients with third-party payor coverage on the basis of contractual rates for the services rendered. For uninsured patients that do not qualify for community financial aid, Wellstar recognizes revenue on the basis of its discounted rates for services provided. On the basis of historical experience, a significant portion of Wellstar's uninsured patients are unable or unwilling to pay for the services provided. Thus, Wellstar records a significant provision for uncollectible accounts related to uninsured patients in the period the services are provided." Subsequent to the end of the reporting period a propensity to pay review of patient accounts often results in prior year bad debt accounts which are deemed eligible for the organization's financial assistance policy. Those bad debt accounts are reclassified as charity and thus our rationale for including in community benefit. 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., AND COBB HOSPITAL conducted a Community Health Needs Assessment (CHNA), a collaborative effort involving hospital leadership, public health agencies, Cobb2020, and a diverse coalition of community stakeholders. Partners represented a broad knowledge base of the hospital's primary service area comprising Bartow, Douglas, Cherokee, Cobb, 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, collaborators engaged IN a strategic process called Mobilizing for Action Through Planning and Partnerships (MAPP) launched by Cobb & Douglas Public Health (CDPH). MAPP provides the framework for creating a community-driven health improvement plan through different assessments to evaluate: - Prevalent health issues - Health issues that are important to the community members - Availability of health services - Forces that impact community health Wellstar Health System (and affiliates) is a key stakeholder in MOBLIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS ("MAPP"). MAPP, developed by the National Association of County and City Health Officials ("NACCHO") in collaboration with the CDC, provides a structured guidance on creating and implementing a community-wide strategic planning process focused on improving the health and safety of our population. Through MAPP, a broad collection of community partners and residents come together to identify and prioritize health and safety issues and to identify resources for addressing them. The process results in an actionable community health improvement plan (CHIP) for measurable improvements in the community's health and quality of life as well as a scorecard for implementation and evaluation. The resulting community plan does not focus on one agency or community health challenge; rather, MAPP provides a long-term strategy that addresses the multiple factors that affect health in the community. Community involvement throughout the creation and the implementation of a health improvement plan results in creative solutions to community health problems with an improved focus on priorities, reduced duplication of services, increased collaboration on projects and activities, and increased capacity to garner additional resources. Moreover, continuous community involvement leads to community ownership of the process. Community ownership, in turn, increases the credibility and sustainability of the health improvement efforts. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: The hospital provides notice of the availability of community financial Assistance via: - Signage - PATIENT Brochure - Billing Statement - Collection Action Letter - Online at http://www.wellstar.org/pages/online-bill-pay.aspx COBB Hospital provide 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 patie | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Valery A Akopov MD | ||||||||||||||
| VP & Chief of Hospitalist Svcs | $0 | $329,534 | $0 | $59,170 | $0 | $11,041 | $0 | $28,200 | $0 | $25,463 | $0 | $453,408 | $0 | $0 |
| David W Anderson | ||||||||||||||
| EVP HR OL CCO | $0 | $414,523 | $0 | $205,272 | $0 | $29,134 | $0 | $45,700 | $0 | $24,590 | $0 | $719,219 | $0 | $0 |
| Nicole V Ashe | ||||||||||||||
| VP Finance & CFO WMG | $0 | $219,898 | $0 | $32,783 | $0 | $9,504 | $0 | $22,403 | $0 | $23,482 | $0 | $308,070 | $0 | $0 |
| Barbara G Ballard | ||||||||||||||
| VP Homecare & Hospice | $0 | $238,742 | $0 | $33,691 | $0 | $10,403 | $0 | $43,913 | $0 | $21,002 | $0 | $347,751 | $0 | $0 |
| Joseph L Brywczynski | ||||||||||||||
| SVP Health Parks Development | $0 | $266,989 | $0 | $285,443 | $0 | $17,664 | $0 | $45,700 | $0 | $24,444 | $0 | $640,240 | $0 | $0 |
| Anthony J Budzinski | ||||||||||||||
| EVP & CFO | $0 | $539,386 | $0 | $134,954 | $0 | $14,896 | $0 | $45,700 | $0 | $25,396 | $0 | $760,332 | $0 | $0 |
| Donald Campbell MD | ||||||||||||||
| SVP Phys Educ & Student Aff | $0 | $327,517 | $0 | $167,537 | $0 | $18,263 | $0 | $45,700 | $0 | $16,783 | $0 | $575,800 | $0 | $0 |
| James E Clements | ||||||||||||||
| VP Bus Dev & Strategic Prtnrsp | $0 | $207,563 | $0 | $49,762 | $0 | $6,691 | $0 | $0 | $0 | $17,453 | $0 | $281,469 | $0 | $0 |
| Lee R Cook | ||||||||||||||
| VP Med & Behavioral Health | $0 | $256,547 | $0 | $327,425 | $0 | $8,736 | $0 | $27,624 | $0 | $17,428 | $0 | $637,760 | $0 | $0 |
| Barbara B Corey | ||||||||||||||
| SVP Managed Care | $0 | $301,454 | $0 | $65,765 | $0 | $11,944 | $0 | $21,292 | $0 | $26,837 | $0 | $427,292 | $0 | $0 |
| Bruce A Dean | ||||||||||||||
| VP Real Estate Deputy Gen Cnsl | $0 | $227,781 | $0 | $40,345 | $0 | $14,335 | $0 | $45,675 | $0 | $24,166 | $0 | $352,302 | $0 | $0 |
| Marcia Delk-Payne MD | ||||||||||||||
| SVP Med Affair & Chf Qlty Ofcr | $0 | $370,531 | $0 | $544,886 | $0 | $10,395 | $0 | $45,700 | $0 | $4,190 | $0 | $975,702 | $0 | $0 |
| Kevin W Deter | ||||||||||||||
| VP Operations & COO | $223,662 | $0 | $86,191 | $0 | $8,786 | $0 | $38,507 | $0 | $20,096 | $0 | $377,242 | $0 | $0 | $0 |
| Nancy R Doelling | ||||||||||||||
| VP Pediatric SRVS.(BEGIN. 8/4) | $0 | $117,427 | $0 | $16,910 | $0 | $6,672 | $0 | $11,120 | $0 | $691 | $0 | $152,820 | $0 | $0 |
| Kenneth D Etheridge | ||||||||||||||
| VP Finance & Hospital CFO | $206,502 | $0 | $33,072 | $0 | $11,016 | $0 | $27,569 | $0 | $11,672 | $0 | $289,831 | $0 | $0 | $0 |
| Jimmy E Francis | ||||||||||||||
| VP Info Technology Operations | $0 | $205,005 | $0 | $42,280 | $0 | $9,742 | $0 | $33,822 | $0 | $2,370 | $0 | $293,219 | $0 | $0 |
| Steven L Grace | ||||||||||||||
| VP Talent Acquisition | $0 | $200,013 | $0 | $52,892 | $0 | $14,048 | $0 | $14,653 | $0 | $18,078 | $0 | $299,684 | $0 | $0 |
| Michael L Graue | ||||||||||||||
| FORMER EVP & COO | $0 | $0 | $0 | $0 | $0 | $522,266 | $0 | $0 | $0 | $0 | $0 | $522,266 | $0 | $0 |
| Kristyn M Greifer MD | ||||||||||||||
| VP Population Management | $0 | $307,528 | $0 | $52,230 | $0 | $10,225 | $0 | $18,722 | $0 | $9,958 | $0 | $398,663 | $0 | $0 |
| Joel W Helmke | ||||||||||||||
| VP Oncology (BEGIN. 7/21) | $0 | $110,000 | $0 | $51,610 | $0 | $3,904 | $0 | $20,081 | $0 | $8,794 | $0 | $194,389 | $0 | $0 |
| Robert D Jansen MD | ||||||||||||||
| EVP & Pres Medical Group | $0 | $591,219 | $0 | $170,344 | $0 | $20,977 | $0 | $45,700 | $0 | $29,543 | $0 | $857,783 | $0 | $0 |
| Reynold J Jennings | ||||||||||||||
| PRESIDENT & CEO | $0 | $975,000 | $0 | $708,390 | $0 | $18,591 | $0 | $0 | $0 | $2,056 | $0 | $1,704,037 | $0 | $0 |
| Peter R Jungblut MD | ||||||||||||||
| SVP & Medical Dir WMG | $0 | $307,528 | $0 | $78,959 | $0 | $12,316 | $0 | $40,200 | $0 | $29,199 | $0 | $468,202 | $0 | $0 |
| Christopher M Kane | ||||||||||||||
| SVP Strategic Plan & Bus Dev | $0 | $341,744 | $0 | $454,243 | $0 | $10,413 | $0 | $21,954 | $0 | $20,378 | $0 | $848,732 | $0 | $0 |
| Beth Kost | ||||||||||||||
| VP Compliance Chf Privacy Ofcr | $0 | $244,733 | $0 | $77,006 | $0 | $9,961 | $0 | $22,318 | $0 | $11,704 | $0 | $365,722 | $0 | $0 |
| Kenneth C Kunze MD | ||||||||||||||
| FRMR SVP CHIEF MEDICAL OFFICER | $0 | $0 | $0 | $0 | $0 | $383,389 | $0 | $0 | $0 | $0 | $0 | $383,389 | $0 | $0 |
| Ellen Langford | ||||||||||||||
| SVP & COO WellStar Med Group | $0 | $220,376 | $0 | $46,995 | $0 | $11,936 | $0 | $36,643 | $0 | $22,323 | $0 | $338,273 | $0 | $0 |
| Elizabeth H Loudermilk | ||||||||||||||
| VP Ent Intelligence & Intgrtn | $0 | $225,680 | $0 | $73,283 | $0 | $9,197 | $0 | $6,309 | $0 | $19,342 | $0 | $333,811 | $0 | $0 |
| Sandra Lucius | ||||||||||||||
| VP Info Technology Apps | $0 | $185,834 | $0 | $30,026 | $0 | $8,564 | $0 | $44,758 | $0 | $2,235 | $0 | $271,417 | $0 | $0 |
| Robert Mandler | ||||||||||||||
| VP Diagnostic Outreach | $0 | $214,261 | $0 | $58,412 | $0 | $18,167 | $0 | $45,249 | $0 | $16,275 | $0 | $352,364 | $0 | $0 |
| Veronica Martin | ||||||||||||||
| VP CNO Patient Care Services | $225,493 | $0 | $35,099 | $0 | $8,853 | $0 | $0 | $0 | $17,716 | $0 | $287,161 | $0 | $0 | $0 |
| Patricia A Mayne | ||||||||||||||
| VP Emergency Services | $0 | $177,986 | $0 | $122,895 | $0 | $10,448 | $0 | $26,305 | $0 | $23,814 | $0 | $361,448 | $0 | $0 |
| Thomas W McNamara | ||||||||||||||
| VP Medical Affairs | $316,722 | $0 | $42,173 | $0 | $14,398 | $0 | $28,200 | $0 | $23,661 | $0 | $425,154 | $0 | $0 | $0 |
| Kimberly W Menefee | ||||||||||||||
| SVP Strategic Community Dev | $0 | $282,547 | $0 | $66,726 | $0 | $13,682 | $0 | $28,200 | $0 | $17,826 | $0 | $408,981 | $0 | $0 |
| Christopher L Morgan | ||||||||||||||
| VP & Admin. CLIO (BEGIN. 7/7) | $0 | $110,770 | $0 | $52,731 | $0 | $4,638 | $0 | $20,102 | $0 | $1,645 | $0 | $189,886 | $0 | $0 |
| Jonathan B Morris MD | ||||||||||||||
| SVP Chief Info Officer | $0 | $369,512 | $0 | $80,613 | $0 | $12,264 | $0 | $23,553 | $0 | $26,705 | $0 | $512,647 | $0 | $0 |
| Kem M Mullins | ||||||||||||||
| SVP & Hospital President | $380,078 | $0 | $85,723 | $0 | $12,078 | $0 | $22,700 | $0 | $28,045 | $0 | $528,624 | $0 | $0 | $0 |
| Bradford B Newton | ||||||||||||||
| VP Information Technology Admi | $0 | $192,691 | $0 | $30,661 | $0 | $8,988 | $0 | $20,598 | $0 | $27,113 | $0 | $280,051 | $0 | $0 |
| Michael G Paul | ||||||||||||||
| VP Facilities Eng Support Svcs | $0 | $181,401 | $0 | $27,532 | $0 | $12,020 | $0 | $0 | $0 | $24,150 | $0 | $245,103 | $0 | $0 |
| Leo E Reichert | ||||||||||||||
| EVP & General Counsel | $0 | $489,341 | $0 | $247,184 | $0 | $15,552 | $0 | $0 | $0 | $29,200 | $0 | $781,277 | $0 | $0 |
| Bethany Robertson | ||||||||||||||
| VP & Chief Learning Officer | $0 | $178,067 | $0 | $31,215 | $0 | $9,391 | $0 | $13,097 | $0 | $28,511 | $0 | $260,281 | $0 | $0 |
| Michelle M Robinson | ||||||||||||||
| VP Mktng/PR/Internal Comm | $0 | $196,373 | $0 | $33,264 | $0 | $9,210 | $0 | $14,300 | $0 | $26,351 | $0 | $279,498 | $0 | $0 |
| Deborah Roegge De Vita | ||||||||||||||
| VP Women & Newborn Svc Line | $0 | $195,728 | $0 | $27,621 | $0 | $8,576 | $0 | $25,759 | $0 | $6,141 | $0 | $263,825 | $0 | $0 |
| Candice L Saunders | ||||||||||||||
| President & CEO | $0 | $621,461 | $0 | $174,240 | $0 | $16,525 | $0 | $45,334 | $0 | $27,582 | $0 | $885,142 | $0 | $0 |
| Christopher B Scullen | ||||||||||||||
| VP Pulmonology Operations | $0 | $172,411 | $0 | $112,906 | $0 | $6,929 | $0 | $0 | $0 | $17,839 | $0 | $310,085 | $0 | $0 |
| Richard S Siegel | ||||||||||||||
| VP Cardiology & CVM Admin | $0 | $271,627 | $0 | $40,496 | $0 | $11,541 | $0 | $45,700 | $0 | $24,762 | $0 | $394,126 | $0 | $0 |
| Jeffery D Stanley | ||||||||||||||
| VP Pharmacy & System Coor | $0 | $176,156 | $0 | $30,945 | $0 | $9,170 | $0 | $21,580 | $0 | $8,658 | $0 | $246,509 | $0 | $0 |
| Daniel J Styf | ||||||||||||||
| SVP PW Health Plan | $0 | $281,902 | $0 | $39,983 | $0 | $15,148 | $0 | $18,663 | $0 | $9,070 | $0 | $364,766 | $0 | $0 |
| James M Swartz | ||||||||||||||
| VP Accounting | $0 | $200,242 | $0 | $63,140 | $0 | $8,971 | $0 | $16,856 | $0 | $25,406 | $0 | $314,615 | $0 | $0 |
| Mary L Tavernaro | ||||||||||||||
| VP Human Resources Operations | $0 | $212,056 | $0 | $37,659 | $0 | $9,442 | $0 | $27,690 | $0 | $21,436 | $0 | $308,283 | $0 | $0 |
| Adam C Thompson | ||||||||||||||
| VP Surgery | $0 | $166,858 | $0 | $51,698 | $0 | $9,517 | $0 | $0 | $0 | $21,830 | $0 | $249,903 | $0 | $0 |
| Anthony M Trupiano | ||||||||||||||
| SVP Supply Chain | $0 | $268,258 | $0 | $61,742 | $0 | $15,219 | $0 | $45,700 | $0 | $1,896 | $0 | $392,815 | $0 | $0 |
| Sean P Turner | ||||||||||||||
| VP Rev.Cycle MGMT (BEGIN.9/28) | $0 | $233,395 | $0 | $36,468 | $0 | $3,219 | $0 | $20,091 | $0 | $26,574 | $0 | $319,747 | $0 | $0 |
| Robin Wilson MD | ||||||||||||||
| SVP Chief Hlth Innov Officer | $0 | $395,907 | $0 | $232,368 | $0 | $9,718 | $0 | $0 | $0 | $22,144 | $0 | $660,137 | $0 | $0 |
| Ilona L Wozniak | ||||||||||||||
| FORMER VP Operations & COO | $244,818 | $0 | $0 | $0 | $158,928 | $0 | $474 | $0 | $0 | $0 | $404,220 | $0 | $0 | $0 |
| Chester A Zborowski | ||||||||||||||
| VP Health Parks Operations | $0 | $165,755 | $0 | $45,188 | $0 | $12,208 | $0 | $0 | $0 | $24,265 | $0 | $247,416 | $0 | $0 |
| Avril P Beckford MD | ||||||||||||||
| TRUSTEE | $0 | $395,084 | $0 | $86,393 | $0 | $2,531 | $0 | $27,460 | $0 | $1,940 | $0 | $513,408 | $0 | $0 |
| Jeffrey L Tharp MD | ||||||||||||||
| TRUSTEE | $0 | $480,597 | $0 | $147,676 | $0 | $2,596 | $0 | $45,700 | $0 | $29,025 | $0 | $705,594 | $0 | $0 |
| THOMAS E GEARHARD MD | ||||||||||||||
| TRUSTEE | $0 | $293,273 | $0 | $48,916 | $0 | $5,186 | $0 | $42,668 | $0 | $30,543 | $0 | $420,586 | $0 | $0 |
| JOSEPH W HERZBERG | ||||||||||||||
| AVP Human Resources | $185,203 | $0 | $22,132 | $0 | $7,795 | $0 | $15,038 | $0 | $25,884 | $0 | $256,052 | $0 | $0 | $0 |
| YONA D ROBERTS | ||||||||||||||
| Mgr Pharmacy | $194,770 | $0 | $66 | $0 | $676 | $0 | $20,480 | $0 | $10,869 | $0 | $226,861 | $0 | $0 | $0 |
| CHRISTOPHER A BRIDGERS | ||||||||||||||
| Dir Pharmacy | $150,010 | $0 | $20,000 | $0 | $424 | $0 | $12,478 | $0 | $13,674 | $0 | $196,586 | $0 | $0 | $0 |
| HEATHER S ROCHFORD | ||||||||||||||
| Mgr Pharmacy | $148,054 | $0 | $8,584 | $0 | $466 | $0 | $20,639 | $0 | $15,632 | $0 | $193,375 | $0 | $0 | $0 |
| GLORIA NWAGBARA | ||||||||||||||
| RN Charge Nurse | $154,658 | $0 | $66 | $0 | $168 | $0 | $18,567 | $0 | $21,921 | $0 | $195,380 | $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 2014 CALENDAR YEAR FROM EITHER THE ORGANIZATION OR A RELATED ORGANIZATION: KENNETH C. KUNZE, MD $ 383,389 MICHAEL L. GRAUE, MD 522,266 SCHEDULE J, PART I, LINE 4B The following officers/KEY EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN DURING THE YEAR. Valery Akopov Nicole Ashe JOSEPH L. BRYWCZYNSKI ANTHONY J. BUDZINSKI James Clements BARBARA B. COREY BRUCE ALAN DEAN Sarath Degala Marcia Delk-Payne KENNETH D. ETHERIDGE JIMMY E. FRANCIS KRISTYN M. GREIFER ROBERT D. JANSEN PETER R. JUNGBLUT CHRISTOPHER MICHAEL KANE Beth Kost Ellen Langford LEE R. COOK Elizabeth Loudermilk Veronica Martin PATRICIA A. MAYNE Thomas McNamara KIMBERLY W. MENEFEE JONATHAN B. MORRIS Kem Mullins Bradford Newton Leo Reichert Bethany Robertson Michelle Robinson CANDICE LYNN SAUNDERS CHRISTOPHER B. SCULLEN Richard Siegel Jeffery Stanley Daniel Styf JAMES M. SWARTZ MARY LOUISE TAVERNARO Adam Thompson ANTHONY MICHAEL TRUPIANO Robin Wilson ILONA L. WOZNIAK DONALD CAMPBELL ROBERT MANDLER DEBORAH ROEGGE DE VITA DAVID W. ANDERSON CHESTER ZBOROWSKI BARBARA BALLARD SCHEDULE J, PART I, LINE 7B 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: People & Customer Service goal for employee "Trust Index", Quality & Safety goal for clinical excellence and patient satisfaction, 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 (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A | PROGRAM SERVICE ACCOMPLISHMENTS As discussed herein, Cobb Hospital, Inc. (an affiliate of Wellstar Health System, Inc.) operates as a charitable organization consistent with the requirements of Internal Revenue Code Section 501(c)(3) and the "community benefit standard" of IRS Revenue 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; the hospital operates a full-time emergency room open to all regardless of ability to pay; the hospital provides care to the needy members of the community consistent with its charity care policy regardless of their ability to pay for these services. 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 benefits activity, and charity care. Cobb Hospital reinvested a total of approximately $13.0 million in capital expenditures for equipment upgrades and other capital improvements to better serve the community. Cobb Hospital was organized in 1984. The hospital affiliated with the Northwest Georgia Health System in 1993. In 1994, Northwest Georgia Health System helped form the PROMINA Health System and changed its name to Promina Northwest Health System. In 1998 Promina Northwest changed its name to Wellstar Health System and is now totally independent of Promina. Cobb Hospital is subordinate to, and subject to the authority of Wellstar Health System and its governing boards including the Hospital Authority of Cobb County. Cobb Hospital provides a full range of inpatient and outpatient services characteristic of a community hospital. The hospital is licensed to operate 382 beds and is presently staffed to operate 370 beds. The original hospital was constructed in 1968 and several major structural additions have happened since that time. The following stats constitute the overall program services provided during the reporting period ended June 30, 2015: Adult Discharges - 20,557 Newborn Discharges - 3,647 Med & Surgical Short Stay Cases - 15 Emergency Room Visits - 99,443 Total Surgical Cases - 11,825 Outpatient Procedures Non-ED OP Radiology - 57,237 GI Laboratory - 824 Cath Lab Procedures - 1,962 Total FTEs Paid - 1,965 Community Benefit Reporting Community Outreach - $ 613,524 Unreimbursed Charity Care (at cost) - $ 35,583,316 Medicaid Shortfalls (at cost) - $ 6,863,638 Total Community Benefit - $ 43,060,478 As an affiliate of Wellstar Health System, Cobb Hospital participates in many community and educational programs for the overall health and benefit of the area that they serve. Some examples of those programs are: Community Health/Education - Screenings and educational opportunities such as defensive driving for teens (offered at a minimal cost or at no cost), smoking cessation, heart smart school, CPR and others. System-wide over 54,000 residents from the community participated in these various screenings. More than 65,000 students learned about important health topics through our elementary and adolescent school health programs. The Public Relations department notifies the public of these offerings by publishing a quarterly mailer to community residents which costs the system over $80,000. Community Activities - Sponsors blood drives, provides funding to school health programs for medical and dental preventive care. Community Events - Wellstar has an annual day for the Latino community geared at screenings and educational activities on a variety of health issues specifically for the Hispanic community. Sponsorships A group of employees also participated in the annual "Relay for Life" an event to raise funds and awareness for cancer research and prevention (held in conjunction with the American Cancer Society). System-wide a total of $22,000 was raised to support cancer research, education and patient services. Efforts are planned to expand this support in the coming years. Recognition and Accomplishments - Cobb Hospital and Kennestone Hospital operate full-service clinics on the respective campuses to provide health related services to uninsured and underinsured who might not otherwise receive care. In FY2013 the clinics served a combined 8,000 patient visitors at a cost of almost $2.8 million. A clinic for senior wellness also opened in Cobb County. WellStar Cobb Hospital is ranked in the US News and World Report's Best Hospitals in Atlanta. The hospital was ranked as ninth in Atlanta and 15th in the state of Georgia in this annual report. Only nine hospitals were chosen from Atlanta's 60 institutions WellStar Cobb and Kennestone Hospitals received the United Total Joint Replacement Specialty Center Designation in recognition of the quality care in their respective units. Both hospitals received three-star ratings which is the highest possible. The hospitals met extensive quality and outcomes criteria based on nationally recognized medical standards and expert advice. In addition the total hip and knee joint replacement programs are certified by the Joint Commission. In October 2012 WellStar completed the system wide implementation of a new cleaning process called Xenex. The process use ultraviolet light technology/machines to decontaminate rooms in five to 12 minutes. This includes patient rooms, emergency departments, public restrooms, supply rooms and nursing stations. Independent studies and lab samples have shown that the system is 20 times more effective than regular cleaning protocols for eliminating bacteria and many other organisms. All hospitals have a least one machine in operation. WellStar Cobb Hospital received four Joint Commission Disease-Specific Certifications (some mentioned previously). The hospital was recertified for hip replacement, knee replacement and primary stroke and received an initial certification for spinal surgery. The hospital has to demonstrate compliance with consensus-based national standards, effective use of appropriate, evidence-based clinical practice guidelines and collection and analysis of a minimum of four performance measures specific to the specialty care provided. WellStar Cobb expanded the innovative STAT Cancer Clinic concept that previously was only available at Kennestone Hospital. In this clinic patients see all members of the treatment and support team in one place and in one afternoon for an initial diagnosis. These clinics are the only true multidisciplinary services of their kind in metro Atlanta. With specialists in thoracic surgery, pulmonary, medical and radiation oncology the patient is guided through a treatment protocol that happens in days, not weeks or months. WellStar Cobb Hospital experienced such great success with the daVinci surgical system that it was able to add a second system during the reporting period. The state of the art minimally invasive technology is used by gynecologic, urologic, thoracic, colorectal and general surgeons. The surgeons are able to work through smaller incisions, less pain for the patient, and faster recoveries with this technology. The Partnership for Health and Accountability of the Georgia Hospital Association presented two of its prestigious Quality and Patient Safety Awards to WellStar Cobb Hospital. One award relates to the timely and appropriate administration of antibiotics and the second relates to re-engineering discharge. Cobb Hospital also was presented with the Circle of Excellence Award for hospitals that demonstrate a sustained commitment to quality and safety having won multiple awards over the previous five years. To better serve behavioral health patients who visit WellStar Douglas Hospital's Emergency Department, the system began using an innovative technology to offer telemedicine. The technology is provided in a partnership with TeleHealth and allow psychiatrists at WellStar Cobb Hospital to securely and conveniently evaluate Douglas patients and expedite their discharge. With the success of the pilot program the system plans to expand to Paulding Hospital, which, like Douglas Hospital does not have on-site psychiatrists. WellStar Kennestone Hospital launched an initiative called Best In Georgia (BIG) with a goal to improve patient safety and well-being across the system. A multidisciplinary team of physicians and other team members meets on a monthly basis to elevate performance measures at the hospital. As many consumers research healthcare performance measures in sources such as Health Grades, and US News and World Report it is important to focus on raising the hospitals position in the public. Cobb, Douglas, Paulding and Windy Hill hospitals have also joined in this initiative. Cobb Hospital has instituted an inpatient medical stabilization service called New Vision. This service for adults with drug, alcohol a |
| FORM 990, PART I, LINES 7A & 7B | UNRELATED BUSINESS INCOME COBB Hospital, INC. generated no unrelated business income for the reporting period. As a result the attached 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, 2015. 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 Affiliates. "The independent auditors report includes the accounts of Wellstar and its controlled affiliates, Kennestone Hospital, Inc., Cobb Hospital, Inc., Douglas Hospital, Inc., Paulding Medical Center, Inc., Wellstar 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 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 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 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 ($26,208,264) 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 (6 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 | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 581649540 | Foundation | GA | 501(C)(3) | 11 TYPE 2 | WHS | Yes (true) |
| Douglas Hospital Inc | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 582026750 | Healthcare | GA | 501(C)(3) | 3 | WHS | Yes (true) |
| Kennestone Hospital Inc | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 582032904 | Healthcare | GA | 501(C)(3) | 3 | WHS | Yes (true) |
| Paulding Medical Center Inc | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 582095884 | Healthcare | GA | 501(C)(3) | 3 | WHS | Yes (true) |
| Wellstar Foundation Inc | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 581627413 | Foundation | GA | 501(C)(3) | 11 Type 2 | WHS | Yes (true) |
| Wellstar Health System Inc | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 581649541 | Healthcare | GA | 501(C)(3) | 11 Type 2 | NA | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | UBI Code VUBICodeVAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Cobb Hospital Parking Company LLC | |||||||||||
| 805 Sandy Plains Road | Marietta | GA | 300666340 | 752999669 | PARKING | GA | WHS | N/A | $0 | $0 | $0 |
| KENNESTONE EAST PARKING DECK LLC | |||||||||||
| 793 SAWYER ROAD | MARIETTA | GA | 30060 | 200537100 | PARKING | GA | WHS | N/A | $0 | $0 | $0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Community Assurance Co | BusinessNameLine1Txt |
Foreign Address ForeignAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3rd Fl Barclays Hse Shedden Rd | AddressLine1Txt |
| City | George Town | CityNm |
| Province Or State | Grand Cayman | ProvinceOrStateNm |
| Country | CJ | CountryCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581649541 | EIN |
| Primary Activities | INSURANCE | PrimaryActivitiesTxt |
| Legal Domicile Foreign Country | CJ | LegalDomicileForeignCountryCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WHS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C-CORP | EntityTypeTxt |
| 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 | $197,025 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |
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