WELLSTAR HEALTH SYSTEM INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
WELLSTAR HEALTH SYSTEM INC (EIN 58-1649541)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-03-28
IRS object ID
201230889349300103
Schema version
2010v3.7
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

FieldValueIRS element (for citing)
Timestamp2012-03-28T08:11:05-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PricewaterhouseCoopers LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12001 MARKET ST SUITE 1700AddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code19103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN581649541EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1WELLSTAR HEALTH SYSTEM INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWELLNameControl
Phone7707925023Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1805 SANDY PLAINS ROADSAddressLine1
CityMARIETTACity
StateGAState
ZIP Code300666340ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJAMES M SWARTZName
TitleVP, ACCOUNTING & TREASURYTitle
Date Signed2012-03-27DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone2673303000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonA JAMES BUDZINSKINameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1805 Sandy Plains RoadAddressLine1
CityMariettaCity
StateGAState
ZIP Code300666340ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1139975867GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.wellstar.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1994YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE CHARITABLE HEALTHCARE TO THE COMMUNITYActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees4294TotalNbrEmployees
Total Nbr Volunteers800TotalNbrVolunteers
Total Gross UBI415021TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year409133863ProgramServiceRevenuePriorYear
Program Service Revenue CY551662318ProgramServiceRevenueCY
Investment Income Prior Year67685InvestmentIncomePriorYear
Investment Income Current Year41013220InvestmentIncomeCurrentYear
Other Revenue Prior Year1826536OtherRevenuePriorYear
Other Revenue Current Year2990869OtherRevenueCurrentYear
Total Revenue Prior Year411028084TotalRevenuePriorYear
Total Revenue Current Year595666407TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year422143GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY831081GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year291538491SalariesEtcPriorYear
Salaries Etc Current Year303447688SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year1477655TotalFundrsngExpCurrentYear
Other Expense Prior Year155395659OtherExpensePriorYear
Other Expenses Current Year154842868OtherExpensesCurrentYear
Total Expenses Prior Year447356293TotalExpensesPriorYear
Total Expenses Current Year459121637TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-36328209RevenuesLessExpensesPriorYear
Revenues Less Expenses CY136544770RevenuesLessExpensesCY
Total Assets BOY1456919936TotalAssetsBOY
Total Assets EOY1617727279TotalAssetsEOY
Total Liabilities BOY670003978TotalLiabilitiesBOY
Total Liabilities EOY592743679TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY786915958NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1024983600NetAssetsOrFundBalancesEOY
Mission DescriptionTO CREATE AND DELIVER HIGH QUALITY HOSPITAL, PHYSICIAN AND OTHER HEALTHCARE RELATED SERVICES THAT IMPROVE THE HEALTH AND WELL-BEING OF THE INDIVIDUALS AND COMMUNITIES THAT WE SERVE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense382035475Expense
Revenue552561352Revenue
DescriptionWELLSTAR HEALTH SYSTEM IS A VERTICALLY INTEGRATED HEALTH CARE DELIVERY SYSTEM WHICH PROVIDES THROUGH AFFILIATED BUSINESS ORGANIZATIONS A FULL SPECTRUM OF HEALTH SERVICES, INCLUDING WELLNESS PROGRAMS, PHYSICIAN OFFICE VISITS, OUTPATIENT CARE, INPATIENT CARE, AND POST-ACUTE SERVICES SUCH AS HOME HEALTH AND LONG TERM NURSING CARE. THE SYSTEM THROUGH ITS AFFILIATED BUSINESS ORGANIZATIONS OPERATES FIVE HOSPITALS(KENNESTONE, COBB, PAULDING MEDICAL, DOUGLAS AND WINDY HILL), MULTIPLE PHYSICIAN OFFICES, PRIMARY CARE CENTERS, OUTPATIENT CARE FACILITIES, A NURSING HOME AND OTHER HEALTH RELATED SERVICES. THE SYSTEM IS SUPPORTED FINANCIALLY BY A FUND-RAISING ORGANIZATION, WELLSTAR FOUNDATION, INC. THE SERVICE AREA FOR THE SYSTEM ENCOMPASSES PARTS OF THE NORTHWESTERN SECTION OF THE STATE OF GEORGIA - THE PRIMARY AREA BEING IN BARTOW, CHEROKEE, COBB, DOUGLAS AND PAULDING COUNTIES. APPROXIMATELY 90% OF INPATIENT DISCHARGES AND OUTPATIENTS SERVED ARE FROM THE AFOREMENTIONED COUNTIES. THE WELLSTAR VISION IS TO DELIVER WORLD CLASS HEALTHCARE. OUR MISSION IS TO CREATE AND DELIVER HIGH QUALITY HOSPITAL, PHYSICIAN AND OTHER HEALTHCARE RELATED SERVICES THAT IMPROVE THE HEALTH AND WELL-BEING OF THE INDIVIDUALS AND COMMUNITIES WE SERVE. HISTORY ------- IN 1993, WHAT WAS THEN KNOWN AS THE COBB HEALTH SYSTEM, THE KENNESTONE REGIONAL HEALTH CARE SYSTEM, AND THE DOUGLAS GENERAL HOSPITAL AFFILIATED TO FORM THE NORTHWEST GEORGIA HEALTH SYSTEM. PAULDING MEMORIAL MEDICAL CENTER AFFILIATED WITH NORTHWEST GEORGIA HEALTH SYSTEM IN 1994. IN 1994, THE NORTHWEST GEORGIA HEALTH SYSTEM HELPED FORM THE PROMINA HEALTH SYSTEM AND CHANGED ITS NAME TO PROMINA NORTHWEST HEALTH SYSTEM. IN 1998, PROMINA NORTHWEST HEALTH SYSTEM CHANGED ITS NAME TO WELLSTAR HEALTH SYSTEM. WELLSTAR DISASSOCIATED FROM AND BECAME TOTALLY INDEPENDENT OF PROMINA IN 1999. WELLSTAR HEALTH SYSTEM IS A PARENT CORPORATION WHICH PROVIDES OVERALL COORDINATION INCLUDING GOVERNING BODY TO ITS SEVEN SUBORDINATE AFFILIATES: 1) COBB HOSPITAL, INC; 2) CHS FOUNDATION, INC (INVESTMENT MANAGEMENT); 3) DOUGLAS HOSPITAL INC; 4) KENNESTONE HOSPITAL, INC; 5) PAULDING MEDICAL CENTER, INC; 6) WELLSTAR FOUNDATION INC. AND 7)COMMUNITY ASSURANCE COMPANY, LTD. (A CAPTIVE SELF-INSURANCE ORGANIZATION). SERVICES -------- WELLSTAR HEALTH SYSTEM IS ABLE TO OFFER A FULL RANGE OF HEALTHCARE SERVICES THROUGH ITS AFFILIATES. THE SERVICES OFFERED INCLUDE BUT ARE NOT LIMITED TO: MOST MAJOR INPATIENT CLINICAL SERVICES, OUTPATIENT SERVICES, DIAGNOSTIC AND THERAPEUTIC SERVICES, ANCILLIARY AND SUPPORT SERVICES, URGENT CARE SERVICES AND HOME HEALTH SERVICES. THE SYSTEM INCLUDES A RESIDENTIAL FACILITY ON THE KENNESTONE HOSPITAL CAMPUS, CALLED ATHERTON PLACE. ARTHERTON PLACE ALSO HOUSES AN ASSISTED LIVING UNIT AS AN ADDITIONAL LEVEL OF CARE. THE FIVE HOSPITALS ARE ACUTE CARE FACILITIES WITH INPATIENT, OUTPATIENT, AND EMERGENCY SERVICES. PAULDING MEDICAL CENTER IS HOME TO A FULL CARE NURSING HOME, PAULDING NURSING CENTER. COBB HOSPITAL IS HOME TO A HOME HEALTH AGENCY AND A RESIDENTIAL HOSPICE FACILITY CALLED TRANQUILITY FOR THOSE PATIENTS IN THE END STAGES OF LIFE. THE SYSTEM IS COMPLIMENTED WITH APPROXIMATELY 85 PHYSICIAN PRACTICES AND SEVERAL URGENT CARE CENTERS. THE SYSTEM IS THUS ABLE TO PROVIDE A COMPLETE CONTINUUM OF CARE FOR THE COMMUNITY ITS SERVES. The following statements of community benefit and program service accomplishments represent system-wide activity for Wellstar Health System, Inc. (the "System") - EIN 58-1649541. All affiliated entities of the system except the Physician Hospital Organization (EIN 58-2116179) operate as charitable organizations consistent with the requirements of Internal Revenue Code Section 501(c)(3) and the "Community Benefit Standard" of IRS Revenue Ruling 69-545. The following excerpt from the audited financial statements identifies a broad overview of the charitable purpose for the System. "The System maintains records to identify and monitor the level of charity care it provides through its affiliates. These records include the amount of charges foregone for services and supplies furnished under its charity care policy. Charges foregone, based on established rates, totaled approximately $170.3 million and $222.8 million in 2010 and 2011 respectively. During 2010, the State of Georgia adopted into law the Provider Payment Agreement Act. The Act provides that each hospital shall be assessed a provider payment in the amount of 1.45% of net patient service revenue of the hospital based on the annual financial survey filed with the State of Georgia Department of Community Health and such payments be recognized as a community benefit. In fiscal 2011, Wellstar affiliate hospitals made $14.0 million in provider payments and recognized such payments as a reduction in net patient service revenue in the accompanying combined financial statements. The System also participates in certain governmental insurance programs, including Medicare and Medicaid. Under these programs, the System provides care to patients at payment rates which are determined by the Federal and State governments, regardless of the System's actual charges. In some cases, these programs pay the System at amounts which are less than its cost of providing services. The System offers many wellness and educational services at little or no cost to the community. Health fairs are held throughout the year at convenient locations, providing various health screenings, such as mammograms, blood pressure and cholesterol checks. A large number of educational programs are offered for all ages. These programs include bicycle safety, car seat safety, defensive driving, CPR and first-aid classes. Flu shots are available to the community during flu season. Health screenings, medical supplies, and immunizations are provided to children through local health departments and health fairs with System sponsorship in many cases. The costs of these services are included in operating expenses. The System promotes health education and activities for students, parents, and teachers through its Partner-in-Education programs. The physicians of the System make significant contributions to improve the health status of the community, including involvement in many community activities promoting health awareness and improvement, emergency room care, and delivery of care to the indigent population of the System's service area. The System also made significant contributions to the nursing program at a local university. This financial support has helped to grow the program, which benefits the System as well as the community. The System and all but one of its affiliates have been recognized as organizations exempt from Federal income tax under Internal Revenue Code Section 501 ( a ) as organizations described in Section 501(c)(3) and, therefore, related income is generally not subject to Federal or state income taxes. One of the System's affiliates is a controlled foreign corporation not subject to Federal income tax. The Physician Hospital Organization (EIN 58-2116179) is a taxable affiliate of the System and files IRS Form 1120 US Corporation Income Tax Return." Financial Data and Statistics (Services Provided System-Wide) Prior Year Staffed Beds 1,144 1,143 Licensed Beds 1,321 1,321 Discharges 66,585 64,667 Newborn Deliveries 10,117 10,646 Emergency Room Visits 255,077 242,890 Pediatric ER Visits 51,269 49,714 Surgeries 42,328 42,804 Cath Lab/Pacemakers/EP 11,231 12,001 Non-ED O/P Radiology Procedures 285,318 311,003 Medical Group Visits 1,101,530 1,105,303 COMMUNITY BENEFITS ------------------ Wellstar Health System participates and collaborates with patients and residents in meeting health needs and improving the overall quality of life in the community. This is especially important in responding to the needs of the underserved regardless of the system's ability to generate a positive margin. Some services would possibly be discontinued if based on a purely financial basis. The following are some examples of the system's services that provide community benefits (and a monetary value of those benefits if known). Clinics Wellstar is affiliated with several clinics which provide free or discounted health services to persons who cannot afford to pay or those who are not expected to pay. During FY2011 the clinics at Kennestone and Cobb Hospitals experienced a combined total of 9,000 patient visits at a cost of $3.2 million. Some of the Wellstar physicians provide services in these clinics. One of Wellstar's own physicians, Dr Jose Rodriquez of the Wellstar Kennestone Pediatrics Associates, was recognized by a local business periodical for his volunteer work outside his normal work with Wellstar. He worked with a local organization to strengthen Hispanic families; taught a 10-week parenting class for the Hispanic community; and coordinated an annual meningococal vaccination program for over 600 area Hispanic high school seniors. Community Health/Education Wellstar's Marketing and PubDescription
Total Program Service Expense382035475TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficetrueForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees4294NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccounttrueForeignFinancialAccount
Name Of Foreign CountryCJNameOfForeignCountry
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJAMES M SWARTZNamePerson
Telephone Number7707925023TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1805 SANDY PLAINS ROADAddressLine1
CityMARIETTACity
StateGAState
ZIP Code300666340ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (72 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
RANDALL BENTLEY SR
TRUSTEE- CHAIRMAN1.0X1724200
ROBERT N CROSS MD
TRUSTEE1.0X467800
TE RUSTY DURHAM
TRUSTEE10.0X3175101255
DAVID HAFNER MD
BOARD MEMBER EX OFFICIO1.0X1601100
THOMAS E GEARHARD MD
TRUSTEE50.0X389972028532
OTIS BRUMBY III
TRUSTEE1.0X172700
JANIE MADDDOX
TRUSTEE VICE CHAIR1.0X1460900
STEVEN W OWEIDA MD
TRUSTEE1.0X1724200
TOM PHILLIPS
TRUSTEE1.0X275400
WALTER G ROBINSON
TRUSTEE1.0X706500
CONNIE KIRK
TRUSTEE1.0X504400
W ALLEN SEPARK
TRUSTEE1.0X798400
T FITZ JOHNSON
TRUSTEE1.0X174200
GARY A MILLER
TRUSTEE1.0X272100
JEFFREY THARP MD
TRUSTEE50.0X446816028567
CHARLES WOOD
TRUSTEE1.0X1287200
ROBERT WARNER MD
TRUSTEE1.0X314200
CHARLES JONES
TRUSTEE1.0X1312300
GREGORY L SIMONE MD
CEO50.039722450172966X
RONALD J STRACHAN
SR VP/CIO50.0417826027923X
BARBARA COREY
SR VP MANAGED CARE50.0353270021091X
DAVID ANDERSON
EXEC VP HR/OL/CCO512652029200X
KIMBERLY MENEFEE
SR VP PUBLIC & GOVT AFFAIRS50.0330316022272X
LOU LITTLE
VP POST ACUTE SRVCS & HOSP ADM2.0028321024158X
T MARK HANEY
SR VP BUSINESS DEVELOPMENT50.0331882023979X
DAROLD ETHERIDGE
VP FINANCE50.0231132014571X
LEE EVINS
VP REV CYCLE MGMT50.0248506018089X
CHRISTOPHER KANE
SR VP STRATEGIC PLANNING50.0400365026918X
RANDY COOK
SR VP & ADMINISTRATOR2.0033767923480X
ROBERT MANDLER
VP DIAGNOSTIC OUTREACH50.0262785018444X
CANDICE L SAUNDERS
SR VP ADMINISTRATOR2.0048049729392X
PATRICK JANSEN
VP CARDIAC SERVICES2.05222503163X
TRACEY ATWATER
VP & FOUNDATION PRES.50.0254974020336X
DON CAMPBELL
SR VP TECHNICAL SOLUTIONS50.0392680024541X
MARCIA DELK
SR VP MED AFFAIRS/CQO50.0424457033113X
BONNIE WILSON
EXEC VP & GENERAL COUNSEL50.01480015071627X
KENNETH C KUNZE MD
SR VP CHIEF MEDICAL OFFICER50.0687208037043X
BRUCE DEAN
VP & ASST GENERAL COUNSEL50.0246466019958X
A JAMES BUDZINSKI
EXEC VP & CFO-ACTING CEO50.0585666033803X
JONATHAN B MORRIS MD
VP & CHIEF MED INFO OFFICER50.0334194023933X
MICHAEL GRAUE
EXEC VP COO50.0691292044574X
ANTHONY M TRUPIANO
VP SUPPLY CHAIN50.0285303016534X
ELLEN LANGFORD
VP MED AFFAIRS50.0228643016661X
CRAIG OWENS
SR VP & ADMIN2.0031169421752X
ROBIN WILSON MD
VP Medical Management50.0340020024726X
JOSEPH L BRYWCZYNSKI
Sr VP Health Parks Admin50.0216142014427X
ELIZABETH A HOFFMANN
VP Budget & Analysis50.0230428010860X
RICHARD T LOPES MD
Sr VP & President Medical Grp50.0513606028822X
JAMES M SWARTZ
VP Accounting50.016953209148X
MARY L WESLEY
Sr VP Nursing Services & CNE50.0294140014070X
BARBARA G BALLARD
VP HOMECARE & HOSPICE50.012082707602X
CAROL S EDWARDS
VP CARDIAC SERVICES50.011786906022X
ROBERT D JANSEN MD
VP MEDICAL AFFAIRS50.0368959020365X
BETH KOST
VP COMPLIANCE/CH PRIVACY OFFR50.0244509016135X
C BRETT SCULLEN
VP PULMONOLOGY OPERATIONS50.08031203785X
ADAM C THOMPSON
VP SURGERY50.017695709710X
LEO E REICHERT
EXEC VP & GENERAL COUNSEL50.0000X
DEBORAH ROEGGE DE VITA
VP WOMEN'S & NEWBORN SERVICES50.0000X
MARY L TAVERNARO
VP HUMAN RESOURCES OPERATIONS50.0202544012732X
BARRY MANGEL MD
Chief of Cardiology50.0723993045611X
WILLIAM MAYFIELD MD
Chief of Surgery50.0898604043544X
AVRIL BECKFORD MD
CHIEF PEDIATRIC SERVICES50.0403675021616X
PERRY BUSBEE MD
CHIEF OB-GYN OFFICER50.0350280026981X
ALAN MUSTER MD
CHIEF PULMONARY OFFICER50.0587153034062X
Stephen J Odom MD
Physician50.0788831040192X
Nydia Bladuell
Physician50.0788508037623X
Amar Patel
Physician50.0760002051468X
Donald A Page Jr MD
Physician50.0765451041639X
Howard Snapper
Physician50.0755752051292X
MARSHA BURKE
Former EXEC VP / CFO1.0190475012395X
LINDA CLARK
EVEC VP COO1.0255306010595X
BRUCE HARRISON
SR VP PHYS ALIGNMENT & DEV50.0455869022304X
FieldValueIRS element (for citing)
Total Reportable Comp From Org24520341TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1413080TotalReportableCompFrmRltdOrgs
Total Other Compensation1495601TotalOtherCompensation
Number Individuals GT100 K492NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
McKESSON INFORMATION SOLUTIONS
POBOX 98347CHICAGOIL606938347INFORMATION TECH SRV8784605
MINDPOWER INC
337 GEORGIA AVENUEATLANTAGA30312MARKETING3155143
WEBMEDX INC
5901 C PEACHTREE DUNWOODY ROAD STEATLANTAGA30328TRANSCRIPTION SRV2048409
CHAMBERLIN EDMONDS AND ASSOCIATES
PO BOX 572490MURRAYUT841572490COLLECTION SERVICE2319655
HARKINS AND HENRY LAW OFFICES
4901 OLDE TOWNE PKWY 300MARIETTAGA30068LEGAL SERVICES1904389
FieldValueIRS element (for citing)
Number Of Contractors GT100 K109NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT REVENUE621910191509212191509212
EQUITY IN EARNINGS OF HOSP AFFILIATES621990145142086145142086
COBB COUNTY DETENTION CENTER62199013399191339919
SHARED SERVICES COSTS RECOUPMENT621990202449451202449451
WELLNESS CENTER62140022628982262898

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column8958752TotalRevenueColumn
Related Or Exempt Function Income8958752RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue551662318TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column13001840TotalRevenueColumn
Exclusion$13,001,840ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real453522Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real453522Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column453522TotalRevenueColumn
Exclusion$453,522ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities571884485Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities543873105Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities28011380Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column28011380TotalRevenueColumn
Exclusion$28,011,380ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory1335389GrossSalesOfInventory
Cost Of Goods Sold436355CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column899034TotalRevenueColumn
Related Or Exempt Function Income899034RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
LAUNDRY812300262366262366
DISTRIBUTION FEES493000152655152655
SEMINAR REVENUE103795$103,795

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column1119497TotalRevenueColumn
Exclusion$1,119,497ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1638313TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column595666407TotalRevenueColumn
Related Or Exempt Function Income552561352RelatedOrExemptFunctionIncome
Unrelated Business Revenue415021UnrelatedBusinessRevenue
Exclusion$42,690,034ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total761321Total
Program Services761321ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total69760Total
Program Services69760ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total20497549Total
Program Services18058101ProgramServices
Management And General2227678ManagementAndGeneral
Fundraising211770Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total227887940Total
Program Services203289394ProgramServices
Management And General23941357ManagementAndGeneral
Fundraising657189Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total21777783Total
Program Services18965890ProgramServices
Management And General2713771ManagementAndGeneral
Fundraising98122Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total18362659Total
Program Services15738043ProgramServices
Management And General2530041ManagementAndGeneral
Fundraising94575Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total14921757Total
Program Services12955511ProgramServices
Management And General1904441ManagementAndGeneral
Fundraising61805Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total625657Total
Program Services495462ProgramServices
Management And General130195ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total301640Total
Management And General301640ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total48703521Total
Program Services42126049ProgramServices
Management And General6439731ManagementAndGeneral
Fundraising137741Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total7539472Total
Program Services4686745ProgramServices
Management And General2800624ManagementAndGeneral
Fundraising52103Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total16912719Total
Program Services16028920ProgramServices
Management And General767107ManagementAndGeneral
Fundraising116692Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total15361576Total
Program Services13575061ProgramServices
Management And General1776998ManagementAndGeneral
Fundraising9517Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total1770946Total
Program Services1123555ProgramServices
Management And General640139ManagementAndGeneral
Fundraising7252Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total2876810Total
Program Services2232721ProgramServices
Management And General632321ManagementAndGeneral
Fundraising11768Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total15091750Total
Management And General15091750ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total22602426Total
Program Services14332071ProgramServices
Management And General8251371ManagementAndGeneral
Fundraising18984Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total6734428Total
Program Services6200744ProgramServices
Management And General533684ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
REPAIRS & MAINTENANCE15740919109758014765118
OTHER OPERATING EXPENSE581004420326160541137

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total459121637Total
Program Services382035475ProgramServices
Management And General75608507ManagementAndGeneral
Fundraising1477655Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY47641BOY
EOY47641EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY44866668BOY
EOY21586577EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY20819336BOY
EOY29736597EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5248530BOY
EOY5048749EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY10926568BOY
EOY11931631EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis326516304LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec213392313LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY98370551BOY
EOY113123991EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY606426626BOY
EOY725275891EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY28909277BOY
EOY29719477EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY641304739BOY
EOY681256725EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1456919936BOY
EOY1617727279EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY69899306BOY
EOY63043520EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY347069865BOY
EOY339767680EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY3040626BOY
EOY1707717EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY249994181BOY
EOY188224762EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY670003978BOY
EOY592743679EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY778199385BOY
EOY1013738745EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5023769BOY
EOY7544640EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3692804BOY
EOY3700215EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY786915958BOY
EOY1024983600EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1456919936BOY
EOY1617727279EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses136544770ReconcilationRevenueExpenses
Reconcilation Other Changes101522872ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (4 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
COBB HOSPITALINC
58096838203truetruetrue$58,012,343
PAULDING MEDICAL CENTER INC
58209588403truetruetrue$11,090,682
KENNESTONE HOSPITAL INC
58203290403truetruetrue$113,769,696
DOUGLAS HOSPITALINC
58202675003truetruetrue$19,686,730
FieldValueIRS element (for citing)
Total Number Of Supported Orgs4TotalNumberOfSupportedOrgs
Sum Of Amounts202559451SumOfAmounts

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteerstrueVolunteers
Paid Staff Or ManagementtruePaidStaffOrManagement
Media AdvertisementstrueMediaAdvertisements
Media Advertisements$8,000MediaAdvertisementsAmount
Mailings MemberstrueMailingsMembers
Mailings Members$3,000MailingsMembersAmount
Publications Or BroadcasttruePublicationsOrBroadcast
Publications Or Broadcast$383PublicationsOrBroadcastAmount
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$268,629GrantsOtherOrganizationsAmount
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$146,921DirectContactLegislatorsAmount
Rallies DemonstrationstrueRalliesDemonstrations
Rallies Demonstrations$90RalliesDemonstrationsAmount
Other ActivitiestrueOtherActivities
Other Activities$122,196OtherActivitiesAmount
Total Lobbying Expenditures IIB549219TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierOther Lobbying ExpensesIdentifier
Return ReferenceForm 990 Schedule C Part IVReturnReference
ExplanationDuring the reporting period Wellstar Health System, Inc. held a retainer for a local firm to provide professional services for community related activities including support in community benefit reporting and legislative healthcare initiatives affecting the system hospitals. Wellstar is also a party to several healthcare related coalitions that protect the interests of all member hospitals.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance3810000BeginningOfYearBalance
Contributions24000Contributions
Investment Earnings Or Losses-70000InvestmentEarningsOrLosses
Other Expenditures652000OtherExpenditures
End Of Year Balance4416000EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance3578000BeginningOfYearBalance
Contributions19000Contributions
Investment Earnings Or Losses-8000InvestmentEarningsOrLosses
Other Expenditures221000OtherExpenditures
End Of Year Balance3810000EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3013000BeginningOfYearBalance
Contributions615000Contributions
Investment Earnings Or Losses20000InvestmentEarningsOrLosses
Other Expenditures-70000OtherExpenditures
End Of Year Balance3578000EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.84000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.16000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis21399555OtherCostOrOtherBasis
Book Value21399555BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis73625361OtherCostOrOtherBasis
Depreciation39896149Depreciation
Book Value33729212BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis9208492OtherCostOrOtherBasis
Depreciation6775038Depreciation
Book Value2433454BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis219462130OtherCostOrOtherBasis
Depreciation166721126Depreciation
Book Value52741004BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2820766OtherCostOrOtherBasis
Book Value2820766BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings113123991TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
UNAMORTIZED BORROWING COSTS5563950
OTHER RECEIVABLES7604675
OTHER PREPAIDS406610
EQUITY IN AFFILIATES667681490
FieldValueIRS element (for citing)
Total Book Value Other Assets681256725TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
ACCRUED PENSION LIABILITY$102,379,847
OTHER LONG TERM LIABILITIES$19,413,160
INSURANCE RESERVES$64,932,787
UNCLAIMED PROPERTY (ALLOCATED)$1,124,119
ASSET RETIREMENT OBLIGATION LT$374,849
FieldValueIRS element (for citing)
Total Of Amounts188224762TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Endowment FundsForm 990 Schedule D Part V Line 4The endowment funds held on Wellstar Health System are intended to be held in perpetuity and the earnings thereon are to be used for financial assistance for patients in the Wellstar Hospice Program. All funds were expended during the fiscal year for the Wellstar Hospice Program and a new inpatient Hospice facility at Kennestone Hospital
SCHEDULE D PART X, LINE 2 TAX LIABILITYThe following footnote from the WellStar Health System and Affiliates audited financial statements details the income tax position for the reporting period: "WellStar 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. CAC 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."

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedfalseRecordsMaintained

Recipient Table RecipientTable (13 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
American Cancer Society
1825 Barrett Lakes Blvd Suite 280KennesawGA30144131623888501 (c) (3)15345Sponsor Fundraiser
American Heart Association
1101 Northchase Parkway Suite 1MariettaGA30067580198114501 (c) (3)50000Sponsor Fundraiser
Foundation of North Metro Technical College
5198 Ross RoadAcworthGA30102581920498501 (c) (3)128477Student Affliation Agree/PT
March of Dimes
1775 The Exchange Suite 515AtlantaGA30339131846366501 (c) (3)15000Sponsor Fundraiser
MUST Ministries
PO Box 1717MariettaGA30061582034725501 (c) (3)30500Sponsor Fundraiser
The Center for Family Resources
995 Roswell St Suite 100MariettaGA30060580876634501 (c) (3)25000Sponsor Fundraiser
Tommy Nobis Center
1480 Bells Ferry RdMariettaGA30060582080817501 (c) (3)7500Sponsor Fundraiser
YMCA of Northwest Georgia
48 Henderson StMariettaGA30064580617782501 (c) (3)20000Sponsor Fundraiser
Chattahoochee Tech College Foundation
980 South Cobb DriveMariettaGA30060581684206501 (c) (3)15867Grant for Agreement with school
United Way Cobb County
995 Roswell Rd Suite 338MariettaGA30060501 (c) (3)44000Contribution
Rotary Club of East Cobb
PO Box 72081MariettaGA30007581654204501 (c) (3)7500Sponsorship
Yes 2 Save Lives
805 SANDY PLAINS ROADMARIETTAGA30066273310216501 (c) (4)125000State Trauma Program Coalition
Susan G Komen for the Cure Atlanta
4840 Roswell Road Bldg D Suite 100AtlantaGA30342581959763501 (c) (3)7500Sponsorship of Race for Cure
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants51TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations2TotalNbrOfOtherOrganizations

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelXFirstClassOrCharterTravel
Travel For CompanionsXTravelForCompanions
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Discretionary Spending AccountXDiscretionarySpendingAccount
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensesfalseWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (50 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
THOMAS E GEARHARD MD
242155013975508062021262072700418504000
JEFFREY THARP MD
2755800119178052058023584049830475383000
GREGORY L SIMONE MD
81455203726000278509301695330343304145211000
MARSHA BURKE
19047500010655017400202870000
RONALD J STRACHAN
278129073374066323021239066840445749000
BARBARA COREY
271931070439010900019591015000374361000
DAVID ANDERSON
3790360118871014745025947032530541852000
KIMBERLY MENEFEE
252707066022011587018694035780352588000
LOU LITTLE
021964805276201080001682207336030736800
T MARK HANEY
250475067625013782018815051640355861000
DAROLD ETHERIDGE
1919950304370870001363009410245703000
LEE EVINS
183954036757027795014120039690266595000
CHRISTOPHER KANE
308673080630011062021648052700427283000
LINDA CLARK
2553060001059500265901000
RANDY COOK
026923605582701261601900704473036115900
ROBERT MANDLER
195977037704029104014866035780281229000
CANDICE L SAUNDERS
0343988012365601285302489504497050988900
TRACEY ATWATER
20387204167309429015128052080275310000
DON CAMPBELL
304092077660010928021047034940417221000
MARCIA DELK
3267360865810111400228540102590457570000
BRUCE HARRISON
283156045640168149020737015670478173000
BONNIE WILSON
414885012655609385740663570527001551642000
KENNETH C KUNZE MD
5323590142962011887033411036320724251000
BRUCE DEAN
19730803992809230014509054490266424000
A JAMES BUDZINSKI
4344100138539012717029307044960619469000
Stephen J Odom MD
3782750330179080377037636025560829023000
Nydia Bladuell
43586203514960115003762300826131000
Amar Patel
4060850348917050000364400150280811470000
Donald A Page Jr MD
408325035418702939036666049730807090000
Howard Snapper
4093160341436050000362640150280807044000
JONATHAN B MORRIS MD
256833050211027150018905050280358127000
MICHAEL GRAUE
51365701649270127080338590107150735866000
ANTHONY M TRUPIANO
2303110456920930001653400301837000
ELLEN LANGFORD
18206603787708700014188024730245304000
CRAIG OWENS
024138805891101139501796003792033344600
ROBIN WILSON MD
277804053016092000144560102700364746000
BARRY MANGEL MD
295863011840503097250353410102700769604000
WILLIAM MAYFIELD MD
4780870641080356409040550029940942148000
JOSEPH L BRYWCZYNSKI
1678380048304012397020300230569000
ELIZABETH A HOFFMANN
17189501566904286409605012550241288000
RICHARD T LOPES MD
40547300108133026209026130542428000
JAMES M SWARTZ
1473990149730716007113020350178680000
MARY L WESLEY
214845019059060236012190018800308210000
ROBERT D JANSEN MD
31138904865308917015337050280389324000
BETH KOST
20931103024804950014503016320260644000
ADAM C THOMPSON
14875901699601120207351023590186667000
AVRIL BECKFORD MD
24822808033407511302161600425291000
PERRY BUSBEE MD
1860370583920105851019711072700377261000
ALAN MUSTER MD
2860040780060223143029426046360621215000
MARY L TAVERNARO
17483902650501200011180015520215276000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
NON-FIXED PAYMENTS TO OFFICERSFORM 990 SCHEDULE J LINE 7Wellstar has instituted an annual incentive plan for key leaders in the company. On an annual basis performance measures are proposed by management and recommended and approved by the compensation committee of the Board. The plan is designed to retain and reward leaders with incentives that keep them competitive with the market and comparable health systems. The criteria used to measure the performance consists of weighted factors in the areas of financial performance, customer service, employee engagement and quality indicatiors. Upon successful acheivement at various targeted levels for each factor an overall performance payout is recommended and approved by the Board after the annual financial audit is completed.
SEVERANCE PAYMENTSPursuant to their respective employment agreements, the following groups of officers are entitled to severance payments based on their base salary and wages at that time in the event of certain identified circumstances. The officers with a severance payment period of 24 months as per their contractual agreement are: David Anderson, Marsha Burke, Linda Clark, Gregory Simone MD, and Bonnie Wilson. The officers with a severance payment period of 18 months as per their respective agreements are: Joseph Brywczynski, A James Budzinski, Donald Campbell MD, Barbara Corey, Marcia Delk MD, Michael Graue, T Mark Haney, Bruce Harrison, Robert Jansen MD, Christopher Kane, Kenneth Kunze MD, Lou Little, Richard Lopes MD, Kimberly Menefee, Craig Owens, Tarey Ray, Leo E Reichert, Ron Strachan, Mary L Wesley The officers with a severance payment period of 12 months as per their agreement: Barbara Ballard, Bruce Dean, Carol Edwards, Darold Etheridge, Lee Evins, Robert Hamilton, Elizabeth Hoffmann, Beth Kost, Ellen Langford, Robert Mandler, Jonathan Morris MD, Deborah Roegge DeVita, C Brett Scullen, James Swartz, Mary L Tavernaro, Adam Thompson, Anthony Trupiano, Robin Wilson MD During the calendar year, the following individuals received a payout in the amounts listed in accordance with their severance agreements as set forth above: Marsha Burke $ 190,475 Linda Clark $ 255,306 Teresa Ray $ 99,120 Bruce Harrison $ 455,868 Gregory L Simone $3,518,524 Bonnie Wilson $1,124,436
OTHER COMPENSATIONForm 990, Schedule J, Part I, Line 1b & 2While Wellstar Health System and its affiliates do not have a written policy regarding payment or reimbursement for the items listed in Part 1 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 K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Hospital Authority of Cobb County
58246460019081PDR42003-04-30132210370Constructionfalsefalsefalse
Hospital Authority of Cobb County
58246460019081PEM42004-04-3025000000Equipment Poolfalsefalsefalse
Cobb County Kennestone Hospital Authority
581147004190813LN32005-10-3160000000Capital Improvements (Series Afalsefalsefalse
Cobb County Kennestone Hospital Authority
581147004190813LM52005-10-3160000000Capital Improvements (Series Bfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Amount RetiredAmountRetiredTotal ProceedsTotalProceedsRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
92800001322103705316316615667677457397629064612005truetruetruetrue
25000000250000002004falsefalsetruetrue
60000000583650584741379422122007falsefalsetruetrue
60000000583650584741389422122007falsefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersTotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsefalsefalsetrue0.000200.00020true
falsefalsefalsefalsetruetrue
falsefalsefalsefalsetrue0.000200.00020true
falsefalsefalsefalsetrue0.000200.00020true

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
(no name)
falsefalsefalsefalsefalsetrue
(no name)
falsetruefalsefalsefalsetrue
UBS
falsetruetruefalsefalsetrue
(no name)
falsetruefalsefalsefalsetrue

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (11 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
PAMELA ETHERIDGE
WIFE OF OFFICER53737EMPLOYEE OF WELLSTARfalse
GREG FORTGANG
SON-IN-LAW OF TRUSTEE102382EMPLOYEE OF WELLSTARfalse
AMY SIMONE
DAUGHTER OF OFFICER72052EMPLOYEE OF WELLSTARfalse
GEORGE FLEMING
BROTHER OF OFFICER59478EMPLOYEE OF WELLSTAR/COBBfalse
THOMAS E GEARHARD MD
BOARD MEMBER135874BUILDING LEASEfalse
GREYSTONE POWER
BOARD MEMBER952578EXPLANATION IN SCH Ofalse
MATTHEW MADDOX
SON OF BOARD MEMBER38489EMPLOYEE OF WELLSTARfalse
PUCKETT EMS AMBULANCE SERVICE
BROTHER-IN-LAW OF OFFICER316544EXPLANATION IN SCH Ofalse
H S I FINANCIAL SERVICES
OFFICER IS DIR OF AGENCY442799EXPLANATION IN SCH Ofalse
BONNIE MILLER
WIFE OF BOARD MEMBER28417EMPLOYEE OF WELLSTARfalse
GREG SEPARK
SON OF BOARD MEMBER25847EMPLOYEE OF WELLSTARfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (17 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
COMPENSATION INFORMATION ON FORM 990FORM 990 PART VII COMPENSATION, PART IX LINES 5-7 & SCHEDULE J & J-1ALL COMPENSATION AMOUNTS REPORTED ON FORM 990, PART VII; PART IX, LINES 5-7; AND SCHEDULE J REPRESENT COMPENSATION PROVIDED TO INDIVIDUALS THAT PROVIDE SERVICES TO THE ORGANIZATION. LIKEWISE, THE NUMBER OF EMPLOYEES REPORTED ON PART V, LINE 2A REPRESENTS 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).
CONFLICT OF INTEREST POLICYFORM 990 PART VI SECTION B Line 12Our 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.
PROCESS OF EXEC COMPENSATIONFORM 990 PART VI SECTION B Line 15a & bWellStar 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 current members of the WellStar committee are: Pete Wood Janie Maddox Al Separk Wellstar Board Chair Ex Officio CEO--Ex Officio In committtee discussions about the compensation for the Chief Executive Officer, the CEO will recuse himself from that process but 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 at the following committee meeting.
DISCLOSURE OF FINANCIAL DOCUMENTSFORM 990 PART VI SECTION C Line 19The 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.
VOLUNTEERSForm 990 Part I General InformationWellStar Health System, Inc. through its affiliated business organizations operates five hospitals and throughout the system there are approximately 800 volunteers who make up the network of people who donate their time to serving our healthcare community. Kennestone Hospital, Inc. has approximately 400 volunteers between Kennestone and Windy Hill. The Cobb Auxiliary has approximately 200 volunteers. Douglas Hospital and Paulding Hospital have approximately 100 volunteers each in their respective auxiliaries.
AUDITED FINANCIAL STATEMENTSForm 990 Part IV Line 12 and Part XIWellStar Health System, 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."
PROCESS OF 990 BOARD REVIEWForm 990 PART VI LINE 11AInternal staff prepare the organization's Form 990. Before filing the return with the Internal Revenue Service an external accounting firm, PricewaterhouseCoopers, reviews and sign-offs on the completed return of each organization. Generally, 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.
CURRENT OFFICERS/DIRECTORS RELATIONSHIPSFORM 990 PART VI, SECTION A LINE 2For a portion of the tax year two officers and directors for WellStar Health System, Inc. --EIN 58-1649541 are related to each other through family. Lou Little, Sr VP Post Acute Services and Administrator of Windy Hill Hospital is the brother-in-law of Gregory Simone, former President and CEO for the system.
OFFICERS HOURS WORKEDFORM 990 GENERAL STATEMENT & SCHEDULE JThe officers devote their time to all of the organizations with WellStar Health System that are listed in Schedule R, Part II. As such, the total hours worked by the officers across all of the organizations exceeds 40 hours per week.
BYLAWS CHANGESFORM 990, PART VI, LINE 4In November 2010 the bylaws of Wellstar Health System were amended to reflect that any retired trustees be provided benefits upon their retirement from service on the Board.
Transactions with Related OrganizationsForm 990 Schedule R Part V Line 2The dollar amounts reported on Form 990 Schedule R Part V Line 2 for WellStar Health System, Inc. include the overhead allocations to affiliates and consists of the following types of transactions as listed in Line 1 (a-r): h) Exchange of Assets i) Lease of facilities, equipment, or other assets to other organizations j) Lease of facilities, equipment, or other assets from other organizations n) Sharing of paid employees o) Reimbursement paid to other organizations q) Other transfers of cash or property to other organizations r) Other transfers of cash or property from other organizations
SCH L PART IV EXPLANATIONSOn Schedule L Part IV we have several interested parties that require additional explanation for the transactions: Board Trustee Gary Miller is President of Greystone Power which provides electric service to certain Wellstar Hospitals and Physician practices in the normal course of business. The total amount of the transactions with Greystone is $952,500 with $65,000 related to Paulding Hospital; $739,000 related to Douglas Hospital and $148,000 related to Wellstar Medical Group. Steve Puckett is the brother-in-law of Ellen Langford, an officer with Wellstar Health System. Mr. Puckett is the President of Puckett EMS Ambulance Service which provides ambulance services to several Wellstar Health System affiliates. Individually all of the entity specific transactions are less than $100,000 but in aggregate total $316,544. These services are in the normal course of business with our hospitals. H.S.I. Financial Services is a local billing agency which provides services to Wellstar Health System in the form of routine collection services of outstanding patient balances. Lee Evins, an officer of Wellstar Health System is also a director on the H.S.I. board. The total amount of the transactions with H.S.I. equal $442,799 for the reporting period.
Changes In Net AssetsForm 990 Part XI Line 5The changes in net assets for Wellstar Health System, Inc are as follows: Unrealized Gains $42,201,705 Pension Adjustment 58,562,000 Other Changes 759,168 Total $101,522,873
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:LOU LITTLE TITLE:VP POST ACUTE SRVCS & HOSP ADM HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:RANDY COOK TITLE:SR VP & ADMINISTRATOR HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:CANDICE L SAUNDERS TITLE:SR VP ADMINISTRATOR HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:CRAIG OWENS TITLE:SR VP & ADMIN HOURS:50

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (86 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Wellstar Medical Group LLC
805 Sandy Plains RoadMariettaGA30066273818647HealthcareGA16590112753375066WHS Inc
Cobb Gynecologists 2 LLC
805 Sandy Plains RoadMariettaGA30066020808099HealthcareGA0NA
South Cobb OB-GYN 2 LLC
805 Sandy Plains RoadMariettaGA30066020808071HealthcareGA0NA
WellStar Acworth Family Practice LLC
805 Sandy Plains RoadMariettaGA30066412243451HealthcareGA0NA
WellStar Atlanta General Surgery LLC
805 Sandy Plains RoadMariettaGA30066264271578HealthcareGA0NA
WellStar Behavioral Health LLC
805 Sandy Plains RoadMariettaGA30066582500211HealthcareGA0NA
Wellstar Cardiovascular Medicine LLC
805 Sandy Plains RoadMariettaGA30066263557639HealthcareGA225384723428577NA
WellStar Cherokee Street Internal and Pr
805 Sandy Plains RoadMariettaGA30066161735178HealthcareGA0NA
WellStar Cobb Family Medicine LLC
805 Sandy Plains RoadMariettaGA30066582560699HealthcareGA0NA
WellStar Cobb Gynecologists LLC
805 Sandy Plains RoadMariettaGA30066582502440HealthcareGA0NA
WellStar Cobb Hospitalists LLC
805 Sandy Plains RoadMariettaGA30066753140245HealthcareGA0NA
WellStar Cobb Medical Group LLC
805 Sandy Plains RoadMariettaGA30066582586050HealthcareGA0NA
WellStar Cobb Rehabilitation Medicine L
805 Sandy Plains RoadMariettaGA30066582587322HealthcareGA0NA
WellStar Cobb Surgical Associates LLC
805 Sandy Plains RoadMariettaGA30066562469675HealthcareGA0NA
WellStar Cooper Lake Family Medicine LL
805 Sandy Plains RoadMariettaGA30066264295540HealthcareGA0NA
WellStar Cornerstone Family Medicine LL
805 Sandy Plains RoadMariettaGA30066061745258HealthcareGA0NA
WellStar Cousins and Cantrell LLC
805 Sandy Plains RoadMariettaGA30066582586291HealthcareGA0NA
WellStar Creekside Pediatrics LLC
805 Sandy Plains RoadMariettaGA30066582499179HealthcareGA0NA
WellStar Douglas Surgical Associates LL
805 Sandy Plains RoadMariettaGA30066300364595HealthcareGA0NA
WellStar Douglasville Medical Center at
805 Sandy Plains RoadMariettaGA30066753245214HealthcareGA0NA
WellStar Douglasville Medical Center LL
805 Sandy Plains RoadMariettaGA30066582577971HealthcareGA0NA
WellStar East Cobb Medical Center LLC
805 Sandy Plains RoadMariettaGA30066582598851HealthcareGA0NA
WellStar East Paulding Pediatric Center
805 Sandy Plains RoadMariettaGA30066582598855HealthcareGA0NA
WellStar East Paulding Primary Care Cent
805 Sandy Plains RoadMariettaGA30066582598856HealthcareGA0NA
WellStar Infectious Disease LLC
805 Sandy Plains RoadMariettaGA30066582502436HealthcareGA0NA
WellStar Internal Medicine Associates of
805 Sandy Plains RoadMariettaGA30066582586054HealthcareGA0NA
WellStar Internal Medicine at Douglasvil
805 Sandy Plains RoadMariettaGA30066582598842HealthcareGA0NA
WellStar Internal Medicine at Paulding
805 Sandy Plains RoadMariettaGA30066300355547HealthcareGA0NA
WellStar Internal Medicine of Cobb LLC
805 Sandy Plains RoadMariettaGA30066562445102HealthcareGA0NA
WellStar KenMar Pediatrics LLC
805 Sandy Plains RoadMariettaGA30066582577974HealthcareGA0NA
WellStar Kennesaw Medical Center LLC
805 Sandy Plains RoadMariettaGA30066582568534HealthcareGA0NA
WellStar Kennestone OBGYN 2 LLC
805 Sandy Plains RoadMariettaGA30066300355553HealthcareGA0NA
WellStar Kennestone OBGYN LLC
805 Sandy Plains RoadMariettaGA30066582499183HealthcareGA0NA
WellStar Kennestone Pediatric Associates
805 Sandy Plains RoadMariettaGA30066582586286HealthcareGA0NA
WellStar Marietta Adult Medicine Associa
805 Sandy Plains RoadMariettaGA30066582635392HealthcareGA0NA
WellStar Marietta Family Medicine LLC
805 Sandy Plains RoadMariettaGA30066582577972HealthcareGA0NA
WellStar Marietta Internal Medicine LLC
805 Sandy Plains RoadMariettaGA30066582586289HealthcareGA0NA
WellStar Marietta Pediatrics LLC
805 Sandy Plains RoadMariettaGA30066582598854HealthcareGA0NA
WellStar Marietta Primary Care LLC
805 Sandy Plains RoadMariettaGA30066582577979HealthcareGA0NA
WellStar Marietta Pulmonary Medicine LL
805 Sandy Plains RoadMariettaGA30066582586292HealthcareGA0NA
WellStar Medical Specialists 2 LLC
805 Sandy Plains RoadMariettaGA30066753261729HealthcareGA0NA
WellStar Medical Specialists LLC
805 Sandy Plains RoadMariettaGA30066582586293HealthcareGA0NA
WellStar Midani Pediatric Practice LLC
805 Sandy Plains RoadMariettaGA30066582598853HealthcareGA0NA
WellStar Neurosurgery LLC
805 Sandy Plains RoadMariettaGA30066300067488HealthcareGA0NA
WellStar North Cobb Pediatrics LLC
805 Sandy Plains RoadMariettaGA30066582518119HealthcareGA0NA
WellStar North Cobb Women's Health 2 LL
805 Sandy Plains RoadMariettaGA30066412243450HealthcareGA0NA
WellStar North Cobb Women's Health LLC
805 Sandy Plains RoadMariettaGA30066582499178HealthcareGA0NA
WellStar North Douglas OBGYN LLC
805 Sandy Plains RoadMariettaGA30066582598852HealthcareGA0NA
WellStar Northwest Women's Care LLC
805 Sandy Plains RoadMariettaGA30066582499181HealthcareGA0NA
WellStar Occupational Health LLC
805 Sandy Plains RoadMariettaGA30066582510194HealthcareGA0NA
WellStar Palliative Medicine LLC
805 Sandy Plains RoadMariettaGA30066223972021HealthcareGA0NA
WellStar Paulding Surgical Associates L
805 Sandy Plains RoadMariettaGA30066743130874HealthcareGA0NA
WellStar Pediatric & Adolescent Center
805 Sandy Plains RoadMariettaGA30066582570392HealthcareGA0NA
WellStar Pediatric & Family Wellness Cen
805 Sandy Plains RoadMariettaGA30066264687089HealthcareGA0NA
WellStar Pediatric Professionals LLC
805 Sandy Plains RoadMariettaGA30066320093335HealthcareGA0NA
WellStar Pediatrics at Brookstone LLC
805 Sandy Plains RoadMariettaGA30066582598844HealthcareGA0NA
WellStar Phillips Women's Care LLC
805 Sandy Plains RoadMariettaGA30066582586058HealthcareGA0NA
WellStar Physicians Group Douglas Hospit
805 Sandy Plains RoadMariettaGA30066161735192HealthcareGA0NA
WellStar Physicians Group ENT LLC
805 Sandy Plains RoadMariettaGA30066582473668HealthcareGA0NA
WellStar Physicians Group Hospitalists
805 Sandy Plains RoadMariettaGA30066582461494HealthcareGA0NA
WellStar Physicians Group Pathologists
805 Sandy Plains RoadMariettaGA30066582461493HealthcareGA0NA
WellStar Powder Springs Medical Center
805 Sandy Plains RoadMariettaGA30066582586052HealthcareGA0NA
WellStar Rehab Medicine LLC
805 Sandy Plains RoadMariettaGA30066582532917HealthcareGA0NA
WellStar Rheumatology Associates of Mari
805 Sandy Plains RoadMariettaGA30066450559274HealthcareGA0NA
WellStar Shallowford Medical Center LLC
805 Sandy Plains RoadMariettaGA30066582598849HealthcareGA0NA
WellStar Smyrna Primary Care Center LLC
805 Sandy Plains RoadMariettaGA30066582598843HealthcareGA0NA
WellStar South Cobb Primary Care LLC
805 Sandy Plains RoadMariettaGA30066582586290HealthcareGA0NA
WellStar South Cobb Rheumatology LLC
805 Sandy Plains RoadMariettaGA30066412243448HealthcareGA0NA
WellStar Surgical Associates of Marietta
805 Sandy Plains RoadMariettaGA30066562469677HealthcareGA0NA
WellStar Thoracic Surgery Associates LLC
805 Sandy Plains RoadMariettaGA30066263540626HealthcareGA0NA
WellStar Towne Lake Medical Center LLC
805 Sandy Plains RoadMariettaGA30066582586287HealthcareGA0NA
WellStar Towne Lake Pediatrics LLC
805 Sandy Plains RoadMariettaGA30066582577980HealthcareGA0NA
WellStar Urgent Care at Cooper Lake LLC
805 Sandy Plains RoadMariettaGA30066300378808HealthcareGA0NA
WellStar Urgent Care at Towne Lake LLC
805 Sandy Plains RoadMariettaGA30066582586061HealthcareGA0NA
WellStar Urgent Care in Kennesaw LLC
805 Sandy Plains RoadMariettaGA30066582568565HealthcareGA0NA
WellStar Urgent Care on Delk Road LLC
805 Sandy Plains RoadMariettaGA30066582577976HealthcareGA0NA
WellStar Urgent Care on Sandy Plains Roa
805 Sandy Plains RoadMariettaGA30066582598845HealthcareGA0NA
WellStar West Cobb Medical Center LLC
805 Sandy Plains RoadMariettaGA30066582586288HealthcareGA0NA
WellStar Woodlawn Commons Family Practic
805 Sandy Plains RoadMariettaGA30066582586053HealthcareGA0NA
Homecare Billing Services LLC
805 Sandy Plains RoadMariettaGA30066582479534HealthcareGA9385503818090NA
Wellstar Windy Hill Apothecary LLC
805 Sandy Plains RoadMariettaGA30066562511925HealthcareGA1172733198172NA
Wellstar Bi-County ENT LLC
805 Sandy Plains RoadMariettaGA30066272258194HealthcareGA0NA
Wellstar Comprehensive Bariatric Srv LLC
805 Sandy Plains RoadMariettaGA30066271716783HealthcareGA0NA
Wellstar Family Medicine LLC
805 Sandy Plains RoadMariettaGA30066273565358HealthcareGA0NA
Wellstar Home Health LLC
805 Sandy Plains RoadMariettaGA30066270277843HealthcareGAWHS Inc
Wellstar Health Network LLC
805 Sandy Plains RoadMariettaGA30066HealthcareGAWHS Inc

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
CHS Foundation Inc
805 Sandy Plains RoadMariettaGA30066581649540FoundationGA501 (c) (3)11NA
Cobb Hospital Inc
805 Sandy Plains RoadMariettaGA30066580968382HealthcareGA501 (c) (3)3NA
Douglas Hospital Inc
805 Sandy Plains RoadMariettaGA30066582026750HealthcareGA501 (c) (3)3NA
Kennestone Hospital Inc
805 Sandy Plains RoadMariettaGA30066582032904HealthcareGA501 (c) (3)3NA
Paulding Medical Center Inc
805 Sandy Plains RoadMariettaGA30066582095884HealthcareGA501 (c) (3)3NA
Wellstar Foundation Inc
805 Sandy Plains RoadMariettaGA30066581627413FoundationGA501 (c) (3)11NA

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
Kennestone South Parking Deck
805 Sandy Plains RoadMariettaGA300666340581649541PARKINGGANAINVESTMENT1050481853336falsefalse
Cobb Hospital Parking Company LLC
805 Sandy Plains RoadMariettaGA300666340752999669PARKINGGANAINVESTMENT26313808030falsefalse

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Community Assurance CoBusinessNameLine1

Address Foreign AddressForeign

FieldValueIRS element (for citing)
Address Line13rd Fl Barclays House Shedden RdAddressLine1
CityGeorge TownCity
Province Or StateCayman Islands, BWIProvinceOrState
CountryCJCountry
FieldValueIRS element (for citing)
EIN581649541EIN
Primary ActivityINSURANCEPrimaryActivity
Legal Domicile Foreign CountryCJLegalDomicileForeignCountry

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1WHS INCBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
Share Of EOY Assets58594426ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetstrueExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Cobb Hospital Inc
q58012343
Douglas Hospital Inc
q19686730
Kennestone Hospital Inc
q113769696
Paulding Medical Center Inc
q11090682

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