2018-05-15T16:21:27-05:00 2017-06-30 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2016-07-01 205497506 WEST GEORGIA MEDICAL CENTER INC % JAMES M SWARTZ WEST 7709567827 793 SAWYER ROAD Marietta GA 300622222 JAMES M SWARTZ VP, ACCOUNTING 7709567827 2018-05-15 true JOANNE KRUEGER P10235586 2673303000 2018-05-10 2016 2022-09-23 18:48:47Z X WELLSTAR WEST GEORGIA MEDICAL CENTER CANDICE L SAUNDERS 793 SAWYER ROAD Marietta GA 300622222 194131237 false X www.wellstar.org X 2006 GA TO PROVIDE WORLD-CLASS CHARITABLE HEALTHCARE TO THE COMMUNITY. 20 10 1354 133 24789 5693 275826 201400 166730567 185334849 1326200 5181985 2704277 3054376 171036870 193772610 89333 219522 0 0 61320990 87631557 0 0 280081 98425362 89159145 159835685 177010224 11201185 16762386 173044522 179374888 162980870 146517468 10063652 32857420 X 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. false false 101328206 219522 185334849 SEE SCHEDULE O 101328206 true true false true false false false true true true true false false false true true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true true false false false true 248 0 true 1354 true true true false false false false false false false false false X 20 10 false false false false true true true true true false false true true true true true true true true false GA X JAMES M SWARTZ 7709567827 793 SAWYER ROAD Marietta GA 300622222 X AMBICA YADAV TRUSTEE 1.0 13.0 X 0 0 0 AVRIL P BECKFORD MD TRUSTEE & CHIEF PEDIATRIC OFF. 1.0 49.0 X X 0 501784 30198 CHARLES J JONES TRUSTEE 1.0 13.0 X 0 8672 0 DAVID H HAFNER MD TRUSTEE 1.0 13.0 X 0 48713 0 FRANK ROS TRUSTEE 1.0 13.0 X 0 4406 0 GARY A MILLER TRUSTEE 1.0 13.0 X 0 5340 0 GREG MORGAN MD TRUSTEE 1.0 13.0 X 0 3063 0 H SPEER BURDETTE III TRUSTEE 1.0 13.0 X 0 1906 0 JEFFREY L THARP MD MPH TRUSTEE & CHIEF MEDICNE SRVS 1.0 49.0 X X 0 493911 79677 MICHAEL B PATTON TRUSTEE 1.0 13.0 X 0 1563 0 MITZI MOORE TRUSTEE 1.0 13.0 X 0 13175 0 O SCOTT SWAYZE MD TRUSTEE 1.0 13.0 X 0 6445 0 OTIS A BRUMBY III TRUSTEE 1.0 13.0 X 0 40016 0 PAUL DOUGLASS MD TRUSTEE & PHYSICIAN 1.0 49.0 X 0 329713 20355 R RANDALL BENTLEY SR ESQ TRUSTEE 1.0 13.0 X 0 41484 0 ROBERT N CROSS MD TRUSTEE 1.0 13.0 X 0 24103 0 T FITZ JOHNSON TRUSTEE 1.0 15.0 X 0 35232 0 THOMAS M PHILLIPS TRUSTEE 1.0 13.0 X 0 2518 0 W CHARLES BROCK TRUSTEE 1.0 13.0 X 0 42532 0 WALTER G ROBINSON TRUSTEE 1.0 13.0 X 0 6071 0 ALAN R MUSTER MD SVP SPECIALTY DIVISION WMG 1.0 51.0 X 0 633636 80751 ANDREW ALBERRY VP INFO TECH OPS (BEG. 6/2017) 1.0 49.0 X 0 0 0 ANTHONY J BUDZINSKI EVP & CFO 1.0 51.0 X 0 914834 76606 ANTHONY M TRUPIANO SVP SUPPLY CHAIN 1.0 49.0 X 0 388370 49435 BARBARA B COREY SVP MANAGED CARE 1.0 49.0 X 0 420994 41706 BETH KOST SVP COMPLIANCE CHF PRIVACY OFF 1.0 49.0 X 0 363421 37830 BETHANY ROBERTSON VP & CHIEF LEARNING OFFICER 1.0 49.0 X 0 246707 44872 BRADFORD B NEWTON VP INFO. 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(END. 6/2016) 1.0 49.0 X 0 177787 7297 LEO E REICHERT EVP & GENERAL COUNSEL 1.0 49.0 X 0 808514 64680 LIZA FRITCHLEY VP SENIOR CARE SERVICES 50.0 0.0 X 119943 0 7104 MARCUS P CHARLSON MD VP SURGERY 1.0 49.0 X 0 136340 13465 MARY L TAVERNARO VP HUMAN RESOURCES OPERATIONS 1.0 49.0 X 0 291022 51368 MAXWELL KAGAN VP FINANCE & CFO (BEG. 4/2017) 1.0 49.0 X 0 0 0 MICHELLE M ROBINSON VP MKTNG./PR/INTERNAL COMM. 1.0 49.0 X 0 291537 43884 PAUL R PERROTTI SVP CFO 50.0 0.0 X 219000 0 6903 PETER R JUNGBLUT MD MBA SVP & MEDICAL DIRECTOR 1.0 49.0 X 0 537169 77857 REBECCA L RUHL VP FACILITY COMPLIANCE OPS 1.0 49.0 X 0 110585 18603 REYNOLD J JENNINGS MD CHIEF STRATEGY OFF.(END. 1/17) 1.0 49.0 X 0 288675 79 RICHARD S SIEGEL VP CARDIOLOGY & CVM ADMIN. 1.0 49.0 X 0 372323 58796 ROBERT MANDLER VP DIAG. 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(BEG.10/2016) 1.0 49.0 X 0 59811 1661 TIMOTHY L MASEK VP FINANCE & CFO(END. 8/2016) 1.0 49.0 X 0 7149 0 TOM BONIECKI VP MUSCULSKELETAL NEURO. 1.0 49.0 X 0 164617 64340 TOMMY BRITT VP HUMAN RESOURCES 50.0 0.0 X 119136 0 16093 TRACY C GYNTHER VICE PRESIDENT, CNO 50.0 0.0 X 119562 0 17594 VALERY A AKOPOV MD SVP HOSPITAL DIVISION WMG 1.0 49.0 X 0 630442 56054 VARMA RAMESWAR MD VP PEDIATRIC OPS.(BEG.10/2016) 1.0 49.0 X 0 197012 51337 YVETTE BREWER MD VP PRIMARY CARE (BEG. 12/2016) 1.0 49.0 X 0 192442 51446 ROBERT TAYLOR PHYSICIAN 50.0 0.0 X 308533 0 6977 MICHAEL MYERS PHYSICIAN 50.0 0.0 X 263348 0 6899 WILLIAM TURTON PHYSICIAN 50.0 0.0 X 211006 0 7533 ASHLEY STEWART PHYSICIAN 50.0 0.0 X 167459 0 6829 JOHN COGGINS PHYSICIAN 50.0 0.0 X 151397 0 12496 JANIE MADDOX FORMER TRUSTEE 0.0 0.0 X 0 10379 0 WANDA Y ROBINSON FORMER VP COMPLIANCE 0.0 0.0 X 0 130109 10837 2516865 22206188 2437992 12 true true false CONIFER HEALTH SOLUTIONS LLC PO BOX 655025 DALLAS TX 752655025 OUTSIDE BILLING 5255829 C A INDUSTRIES 13609 CALIFORNIA STREET OMAHA NE 681545260 CONTRACT LABOR 582728 HEALOGICS WOUND CARE 5220 BELFORT ROAD JACKSONVILLE FL 32256 CONTRACT LABOR 425252 HMMG LLC PO BOX 400 FORTSON GA 318080400 CONTRACT LABOR 365919 MORPOWER LLC PO BOX 568 LAGRANGE GA 30241 REPAIRS/MAINTENANCE 331347 25 140000 11400 50000 201400 PATIENT REVENUE 621400 183084311 183084311 PREMIER PARTNERSHIP INCOME 900099 1048084 1048084 MEDICAL RECORDS 621900 584577 584577 PHARMACY REVENUE 621400 574834 574834 LAB TESTS 621400 38971 38971 4072 4072 185334849 5510870 5510870 0 0 37488 443733 37488 443733 481221 481221 -328885 -328885 -328885 -328885 0 0 0 0 0 0 583920 358627 225293 225293 MANAGEMENT FEES 900099 1411475 0 1411475 CAFETERIA AND VENDING 900099 795657 0 0 795657 OTHER REVENUE 900099 140730 0 24789 115941 2347862 193772610 185334849 24789 8211572 X 219522 219522 0 0 0 2594609 2154345 440264 0 0 0 0 0 59884182 49152783 10535150 196249 7997204 3311 7993893 12748848 17246 12731602 4406714 3718190 674914 13610 43634 13236 23079 7319 527004 527004 202635 73625 122948 6062 0 0 0 25744218 12097272 13618084 28862 320676 8605 312071 5907280 4739284 1159991 8005 0 0 2873305 476281 2395589 1435 309043 184580 119001 5462 0 837613 213547 620709 3357 2986744 2986744 0 12481913 373912 12108001 1812338 38335 1774003 REPAIRS AND MAINTENANCE 10314250 3315489 6989164 9597 MEDICAL SUPPLIES 24713305 24505789 207516 0 OTHER EXPENSES 85187 22854 62210 123 177010224 101328206 75401937 280081 9579998 7670179 0 0 0 0 21798282 19645116 0 0 0 0 0 0 2924310 3155524 2517600 4837832 82629796 13560589 74396112 69069207 54917496 69393366 0 0 0 0 0 0 6910724 5603664 173044522 179374888 18308439 14519654 0 0 0 0 63960798 61650798 0 0 0 0 0 0 0 0 80711633 70347016 162980870 146517468 X 3124161 25917929 0 0 6939491 6939491 10063652 32857420 173044522 179374888 X 16762386 6031382 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 33273 33273 false SCHEDULE C, PART II-B, LINE 1 OTHER LOBBYING EXPENSES: DURING THE REPORTING PERIOD, WEST GEORGIA MEDICAL CENTER, INC. WAS A PARTY TO SEVERAL HEALTHCARE RELATED COALITIONS THAT PROTECT THE INTERESTS OF ALL MEMBER HOSPITALS. X X false true 66800 1453 0 68253 false 6939491 0 6939491 7109298 169807 6939491 7332518 223220 7109298 7563602 231084 7332518 9277918 1714316 7563602 1.00000 false false 1760000 1760000 44195122 3285264 40909858 4463440 603670 3859770 460760 134259 326501 31750474 9537396 22213078 69069207 0 INSURANCE LIABILITY 2256372 PENSION PAYABLE 68090644 70347016 X SCHEDULE D, PART III, LINE 4 DESCRIPTION OF ORGANIZATION'S COLLECTIONS: WEST GEORGIA MEDICAL CENTER ("WGMC") HOLDS ART COLLECTIONS AND EXHIBITS THEM IN PUBLIC AREAS OF THE FACILITIES. THE EXHIBITS FURTHER WGMC'S EXEMPT PURPOSE BY ENHANCING THE HEALTH CARE EXPERIENCES FOR PATIENTS, PATIENT FAMILIES, AND VISITORS. SCHEDULE D, PART IV, LINE 1B CUSTODIAL ACCOUNT ARRANGEMENT: WEST GEORGIA MEDICAL CENTER SERVED IN A CUSTODIAL ROLE FOR FUNDS HELD FOR ITS NURSING HOME RESIDENTS. SCHEDULE D, PART V, LINE 4 USE OF ORGANIZATION'S ENDOWMENT FUNDS: PERMANENT ENDOWMENT FUNDS ARE TO BE USED FOR PROPERTY AND IMPROVEMENTS FOR HOSPITAL PURPOSES. SCHEDULE D, PART X, LINE 2 The following footnote is related to the organization's application of FIN 48 (ASC 740): WELLSTAR AND ITS AFFILIATES HAVE BEEN RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(A) AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3), AND THEREFORE, RELATED INCOME IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES, EXCEPT FOR CAC AND WGHP, A TAXABLE NOT-FOR-PROFIT. WELLSTAR APPLIES FASB ASC 740, INCOME TAXES, WHICH ADDRESSES ACCOUNTING FOR UNCERTAINTIES IN INCOME TAX POSITIONS. IT ALSO PROVIDES GUIDANCE ON WHEN TAX POSITIONS ARE RECOGNIZED IN AN ENTITYS FINANCIAL STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. THERE IS NO IMPACT ON WELLSTARS COMBINED FINANCIAL STATEMENTS AS A RESULT OF THE APPLICATION OF ASC 740. true true X true X 125. true X true true true false true true 13357414 13357414 0.07550 23996404 18019216 5977188 0.03380 37353818 18019216 19334602 0.10930 131197 131197 0.00070 1100499 1100499 0.00620 5439 5439 1237135 1237135 0.00690 38590953 18019216 20571737 0.11620 14037 14037 14037 14037 true 10356051 48638193 60530558 -11892365 X true true 1 1 WEST GEORGIA MEDICAL CENTER INC 1514 VERNON ROAD LAGRANGE GA 30240 www.wellstar.org 141-661 X X X WEST GEORGIA MEDICAL CENTER INC 1 false false true X X X X X X X X X X 15 true false false true X SEE PART V, SECTION C X true 15 true SEE PART V, SECTION C false false true X 125. 300. X X X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X true X false X X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 3J OTHER DESCRIPTIONS FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA): On April 1, 2016 West Georgia Health merged with the Marietta, GEORGIA based Wellstar Health System and became known as Wellstar West Georgia Medical Center ("WGMC"WELLSTAR WGMC"). Because of Wellstar Health System's merger with Wellstar WGMC and five additional, newly converted not-for-profit hospitals on April 1, 2016, Wellstar plans to conduct its next Community Health Needs Assessment (CHNA) and implementation strategy reporting to align with the requirements of the newly converted hospitals. This means that all hospitals within Wellstar Health System will submit a new collective CHNA report and implementation strategies to meet the 501(r) requirements by fiscal year ending June 30, 2019. SCHEDULE H, PART V, SECTION B, LINE 5 INPUT FROM COMMUNITY REPRESENTATIVES & COMMUNITY SOURCES: For the 2016 CHNA, Wellstar WGMC received and collected community input through 341 surveys, 9 stakeholder interviews and 15 focus groups(speaking with 151 people) representing: public health representatives; breast cancer patients; United Way agency directors; social workers; ER staff/primary care doctors/clinic administrators; dietitians; Troup County Center for Strategic Planning board members; underserved population members; senior citizens; LaGrange/Hogansville/West Point community members; community service agencies; Troup Cares; Troup County school board members; Conifer Health Services (WGMC's outsourced vendor overseeing patient access and financial assistance); and representatives from Troup County's Hispanic hispanic community. SCHEDULE H, PART V, SECTION B, LINE 7a THE HOSPITAL'S CHNA CAN BE FOUND ONLINE AT THE FOLLOWING WEB ADDRESS: http://www.wghealth.org/images/uploads/WGMC_CHNA_Report_ Final_Revised_10-10-10.pdf SCHEDULE H, PART V, SECTION B, LINE 10A WEST GEORGIA MEDICAL CENTER'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY CAN BE FOUND ON ITS WEBSITE AT: http://www.wghealth.org/images/uploads/Wellstar_West_Georgia_ Medical_Center_Implementation_Plan_FINAL_11-17-16.pdf SCHEDULE H, PART V, SECTION B, LINE 11 PROGRAMS & STRATEGIES TO ADDRESS THE NEEDS OF THE COMMUNITY: During July and August 2016, the Wellstar West Georgia Medical Center Community Health Needs Assessment (CHNA) steering committee conducted an evaluation of its implementation strategies for the 2015-2016 fiscal year ending June 30, 2016 (and based on the previous CHNA conducted in 2012-13). It should be noted that the aforementioned is fiscal year only represents nine (9) months of activities, due to the merger with Wellstar Health System, which included an adjustment in the fiscal year ending date. The evaluation process included: - status report of activities and compiling year-end outcome/ and impact metrics; - steering committee meeting to rate the accomplishments of each goal and determine if the current implementation strategies should be continued, discontinued or modified; and - action plan update for the upcoming fiscal year, which was not only based on the evaluation process, but also reflected the priority focus areas identified in the 2016 CHNA. The steering committee met on August 24, 2016 to review the statuses, outcomes, and impacts of the various implementation strategies accomplished throughout the previous fiscal year. Some highlights of the outcomes/impact data included: Goal 1: Access Highlights of the progress and outcomes included: - Wellstar WGMC recruited one pulmonary critical care specialist in September 2015, as well as a new urologist and a new endocrinologist, both of whom are scheduled to join West Georgia physicians in late 2016. - $52,826,055 for uncompensated care (charity care and bad debt) + $563,427 in care provided to Troup cares patients in FY 2016. - There are currently 100 active patients in community service clinic. We have not been tracking separately the outcomes of patients coming into our clinic. - The community resource directory is completed and in the process of being programmed to be available as an interactive map on the website. - Transportation continues to be a challenge for patients accessing care, particularly from Hogansville and West Point. Goal 2: Chronic disease prevention and management Highlights of the progress and outcomes included: - 1,191 participants completed screenings in the Wellstar WGMC employee wellness program (861 employees & 330 spouses). - 541 employees were at gold status or higher by 12/31/15. - Our new pulmonary critical care specialist, Dr. Salman Fidahussein, has accepted the role of physician champion to implement a lung CT screening program. - 355 smoking cessation brochures have been issued. 112 smokers received 2nd tier counseling. - 2600 colonoscopies have been performed. - 158 total people were screened in 3 quarterly health screenings at the active life center. - 250 participants in community and worksite health fairs. - Project Red readmission rate for 10/1/15-6/30/16= 16.03%. - 6440 people received stroke education. - 100% of newly diagnosed patients in both medical and radiation oncology had distress assessments with appropriate interventions. - WGMC achieved 1.79 median hours for the # minutes from acute myocardial infarction symptom onset to hospital presentation over the period of July 2015-June 2016. This achievement is below the U.S. median of 1.98 hours over a rolling four quarter period. Goal 3: Healthy Youth The highlights of the outcomes and progress included: - Due to poor attendance, the teen pregnancy classes were not offered. - Circle of girls classes were held two times during this reporting period with 15 daughter/mom couples served. - The Troup teen pregnancy prevention strategy team is still active; however, it only meets bi-annually at this time. During the second semester of the 2015-16 school year, the Troup county school district began teaching curriculum related to unsafe behaviors and health education. - Neither sex, truth and consequences class nor the teen maze class was held during this reporting period. - 352 patients screened; period of purple crying DVD given to all parents screened and discussed by first steps program. The coordinator did not utilize the measurement tool created to measure knowledge gained, but the team will study ways to ensure implementation in FY 2017. A total of 18 steering committee members participated in the rating process. Progress for each of the goals was rated on a 5-point scale where 5 = excellent and 1 = poor. The results of the evaluation included: - Access related objectives were given an average score of 3.9, with 83% of the participants rating progress excellent or very good. The majority (88%) of participants indicated that it was extremely important to continue these intervention strategies. Suggestions to improve efforts for the upcoming year included continuing to remove barriers to transportation, recruiting additional primary care providers and expanding service hours. - Chronic disease management objectives were given an average score of 3.9 with 74% of the participants providing excellent or very good ratings. Suggestions to improve effectiveness included focusing on strategies to truly eaffect change (not just offer programs) and improve data collection and community partnership efforts. - Healthy youth related objectives were not rated because they will not continue to be part of the focus areas for the 2016 implementation strategies. WGMC is continuing to work on the following action items that couldn't begin in 2016 due to time and/or resource constraints: - Active recruitment of an interventional cardiologist. Recruitment efforts are on hold for a dermatologist, a second pulmonary critical care specialist and primary care physicians are on hold until we receive the results of the new physician manpower study currently underway. - Finding a solution to involve more diabetes patients in educational/nutritional outreach. - Increasing participation in teen pregnancy education classes and beginning classes regarding teen-health related needs and issues. During the course of the CHNA year 1 evaluation in 2014, it was determined that implementing a mobile health clinic, along with breast cancer, colon cancer, prostate cancer, diabetes and stroke risk assessment products were not financially feasible and would not be pursued further. SCHEDULE H, PART V, SECTION B, LINE 13B FAP ELIGIBILITY CRITERIA - INCOME LEVEL OTHER THAN FPG: The hospital abides by the financial assistance requirements under IRC 501(R)(5). IRC 501(R)(5) requires health care facilities to limit the amounts charged for emergency and other medically necessary care that is provided to individuals eligible for assistance under the health care facilities financial assistance policy to not more than the amounts generally billed to individuals who have insurance. The hospital extends its sliding scale for Financial Assistance Policy (FAP) eligibility well beyond the minimum government levels to 300% of FPG. WellStar has chosen to use the average of the three best negotiated commercial rates as the trigger to not exceed in the application of the discounts/amounts charged to patients, on our sliding scale. SCHEDULE H, PART V, SECTION B, LINE 13H FAP ELIGIBILITY CRITERIA - OTHER CRITERIA: Other special circumstances may qualify a patient for full indigent or sliding scale charity benefits. Special circumstances may include but not limited to: - Patient deceased, with verification that there is no estate. - Unable to contact patient but Propensity to Pay software returns a low ability/low propensity designation. SCHEDULE H, PART V, SECTION B, LINE 15E METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE: IN ORDER TO QUALIFY FOR FINANCIAL ASSISTANCE, COOPERATION WITH WELLSTAR HEALTH SYSTEM HOSPITAL FINANCIAL ASSISTANCE STAFF IS NECESSARY IN IDENTIFYING AND DETERMINING ALTERNATIVE SOURCES OF PAYMENT OR COVERAGE FROM PUBLIC AND PRIVATE PAYMENT PROGRAMS. IN PARTICULAR, ALL APPLICANTS FILING A FAP APPLICATION FOR FINANCIAL ASSISTANCE MUST PROVIDE PROOF OF HOUSEHOLD INCOME AND HOUSEHOLD ASSETS BY PROVIDING ANY OR ALL OF THE FOLLOWING THAT ARE APPLICABLE: - PROVIDE THREE (3) MONTHS OF THE MOST RECENT PAYCHECK STUBS OR A STATEMENT FROM EMPLOYER VERIFYING GROSS WAGES - IRS W-2 ISSUED DURING THE PAST YEAR - MOST RECENT IRS FORM 1040 - MOST RECENT TWO (2) MONTHS OF BANK STATEMENTS FOR EACH CHECKING, SAVINGS, MONEY MARKET OR OTHER BANK OR INVESTMENT ACCOUNT - WRITTEN STATEMENTS FOR THE MOST RECENT TWO (2) MONTHS FOR ALL OTHER INCOME (E.G., UNEMPLOYMENT COMPENSATION, DISABILITY, RETIREMENT, STUDENT LOANS, AWARD LETTER FROM SOCIAL SECURITY OFFICE, CURRENT PROFIT AND LOSS REPORT FOR ALL SELF-EMPLOYED APPLICANTS, ALIMONY DOCUMENTATION, CHILD SUPPORT DOCUMENTATION, ETC.) - UNEMPLOYMENT COMPENSATION DENIAL LETTER - DOCUMENTATION OF ASSET VALUES, INCLUDING, WITHOUT LIMITATION, PROPERTY TAX STATEMENTS, CERTIFICATES OF DEPOSIT, 401K, 403B, IRA AND OTHER INVESTMENT STATEMENTS - CONTRIBUTION STATEMENTS FROM INDIVIDUALS WHO CONTRIBUTE INCOME OR IN-KIND ASSISTANCE TO THE PATIENT. FINANCIAL ASSISTANCE POLICY ELIGIBILITY WILL BE DETERMINED BASED ON A THOROUGH REVIEW OF THE SUBMITTED INFORMATION. SCHEDULE H, PART V, SECTION B, LINE 16A THE WELLSTAR HEALTH SYSTEM COMMUNITY FINANCIAL ASSISTANCE POLICY CAN BE FOUND ON ITS WEBSITE: https://www.wellstar.org/about-us/policies-procedures/pages/community- FINANCIAL-ASSISTANCE-POLICY.ASPX SCHEDULE H, PART V, SECTION B, LINE 16B THE WELLSTAR HEALTH SYSTEM FINANCIAL ASSISTANCE APPLICATION CAN BE FOUND ON ITS WEBSITE: HTTPS://WWW.WELLSTAR.ORG/ABOUT-US/POLICIES-PROCEDURES/PAGES/COMMUNITY- FINANCIAL-ASSISTANCE-POLICY.ASPX and clicking Application in the right navigation box titled Related Documents. A window will appear that allow you to scroll to the appropriate WellStar hospital and click for a PDF version of the application to print or download. SCHEDULE H, PART V, SECTION B, LINE 16C A PLAIN LANGUAGE SUMMARY OF THE WELLSTAR HEALTH SYSTEM FINANCIAL ASSISTANCE APPLICATION CAN BE FOUND ON ITS WEBSITE: https://www.wellstar.org/about-us/policies-procedures/documents/fap- PLAIN-LANGUAGE-SUMMARY-WGH.PDF SCHEDULE H, PART V, SECTION B, LINE 16J PUBLICATION OF THE FINANCIAL ASSISTANCE POLICY (FAP): In addition to the other methods of posting the financial assistance policy, the hospital makes available for patients in admissions and outpatient registration areas a prominently displayed sign stating financial assistance is available and a brochure including frequently asked questions. SCHEDULE H, PART V, SECTION B, LINE 20E ADDITIONAL EFFORTS MADE BEFORE COLLECTIONS ACTION INITIATED: The hospital facility also notified individuals of the financial assistance policy online at: http://www.wellstar.org/pages/online-bill-pay.aspx Furthermore, the hospital facility utilizes a propensity to pay software. Individuals with a low ability/low propensity designation may qualify for full indigent or sliding scale charity benefits. 6 FLORENCE HAND HOME 200 MEDICAL DRIVE LAGRANGE GA 30240 LONG TERM CARE TWIN FOUNTAINS HOME 1400 HOGANSVILLE ROAD LAGRANGE GA 30240 LONG TERM CARE HOSPICE LAGRANGE 1510 VERNON ROAD LAGRANGE GA 30240 HOSPICE WEST GEORGIA WOUND CARE 1600 VERNON RD SUITE G LAGRANGE GA 30240 WOUND CARE WEST GEORGIA HOME CARE 120 GLEN BASE ROAD LAGRANGE GA 30240 HOME HEALTH; SKILLED NURSING WOMEN'S HEALTH CENTER 1420 VERNON ROAD LAGRANGE GA 30240 WOMEN'S CENTER SCHEDULE H, PART I, LINE 6A PUBLICATION OF COMMUNITY BENEFIT REPORT: WEST GEORGIA MEDICAL CENTER, INC. IS AN AFFILIATE OF WELLSTAR HEALTH SYSTEM, INC. WHICH ON AN ANNUAL BASIS ISSUES A COMMUNITY BENEFIT REPORT. THIS REPORT IS SUBSEQUENTLY DISTRIBUTED IN AND AROUND THE FIVE-COUNTY PRIMARY SERVICE AREA OF THE HEALTH SYSTEM. ON AN ANNUAL BASIS THE HOSPITAL REPORTS ITS COMMUNITY HEALTH BENEFITS REPORT TO THE GEORGIA HOSPITAL ASSOCIATION (GHA). GHA AGGREGATES THE HOSPITAL SPECIFIC REPORTS INTO A STATEWIDE COMMUNITY HEALTH BENEFIT REPORT. THE STATE OF GEORGIA ALSO REQUIRES HOSPITALS TO FILE THE HOSPITAL FINANCIAL SURVEY AND THE INDIGENT CARE TRUST FUND SURVEY SO THAT IT CAN COLLECT INFORMATION ON HOSPITAL FINANCIAL CLASS CATEGORIES AND ALSO TO DETERMINE THE AMOUNT OF UNCOMPENSATED CARE BY HOSPITAL. THE COMMUNITY BENEFIT REPORT CAN BE FOUND AT THE FOLLOWING LINK: HTTPS://WWW.WELLSTAR.ORG/COMMUNITY/DOCUMENTS/WELLSTAR-COMMUNITY- BENEFITS-REPORT.PDF SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES: West Georgia Health has been the community hospital for Lagrange and the west central area of Georgia for over seventy years, always striving to provide excellent service to our patients. It is the only hospital within a 35 miles radius for many community members in the service area. WGMC and its employees supports their community through a variety of ways. In terms of sponsorships, WGMC has provided sponsor funding to several organizations that focus on health-related events that benefit our local community including: the American Cancer Society Relay for Life, March of Dimes march for babies, Heart of West Georgia golf tournament, Walk to End Alzheimer's, among others. In addition, WGMC coordinates two major community events each year: Paint the Town Pink breast cancer awareness event and the Heart Truth for Women luncheon. In addition, WGMC supports the Lagrange-Troup Ccounty Chamber of Commerce and its mission of improving economic development for the county with a chairman's level sponsorship each year. In terms of health promotion, WGMC participates in community health fairs, offering a variety of screenings (blood pressure, glucose, clinical breast exams, flu clinics) and information regarding prevention and awareness of numerous diseases prevalent in our community (stroke, diabetes, hypertension, heart disease, cancer, COPD, smoking). For the past 5 years, WGMC has provided manpower and planning expertise to Teen Maze, a Troup County Health Department initiative designed to lower teen pregnancy rates, to provide information on distracted and/or drunk driving, STDs, and risky behaviors, and to raise Troup county graduation rates. WGMC also offers low-cost ($5) prostate cancer screenings each year and partners with the West Central Georgia Cancer Coalition to offer vouchers for mammograms for underserved women who qualify. WGMC also hosted six blood drives in 2015, during which 293 units were donated primarily by WGMC employees. For more than 40 years, WGMC employees and physicians have volunteered their time to conduct free athletic physicals for all middle and high school athletes within the Troup County school district. WGMC hosts a variety of monthly or quarterly support groups including those for patients and/or families with cancer, breast cancer, Alzheimer's, and Parkinson's diseases. They WGMC also offers a breastfeeding support group for mothers with infants. WGMC staff routinely offer community classes for childbirth preparation, breastfeeding, infant CPR and safety, heartsaver CPR, safe babysitters, pre-teen classes on body changes, and BLS for healthcare providers. In addition to its lifesaving technology and treatments, WGMC's cancer program offers numerous compliementary therapies including art therapy, curvy yoga, nutrition classes for cancer patients and their families, as well as the American Cancer Society programs Look Good, Feel Better and Road to Recovery programs. Since 1996, West Georgia Hospice, a division of WGMC, has hosted a golf tournament each year to benefit the West Georgia Hospice Charitable fund. The money in this fund helps ensure that all families in need have access to comprehensive and compassionate hospice care, regardless of their ability to pay. In addition, West Georgia Hospice hosts Camp Dogwood, a free, three-day grief camp for 125 children in kindergarten through 8th grade who have experienced the loss of a close loved one. This program began in 1997. In addition to raising funds to support for a renovation/expansion of WGMC's cancer center, the West Georgia Foundation coordinates the West Georgia Insiders program. This program, which launched in 2013, hosts eight sessions each year for a class that is composed of 20 business and community leaders representing a good cross section of our community. Its purpose is to educate community leaders about the healthcare services available in Troup county, as well as the changes in healthcare policy that could affect local families and businesses. SCHEDULE H, PART III, SECTION A, LINE 2 METHODOLOGY USED TO ESTIMATE BAD DEBT: The reported bad debt charges is derived from the unpaid balances of patient accounts that are deemed uncollectible after 120 days of collection effort by the hospital's patient financial services staff. The unpaid patient accounts are then sent to collection agencies and any collected amount is deemed as bad debt recovery. The source of this data is the hospital's detailed financial trial balance. The net reported bad debt charges are then multiplied by the Hospital Financial Survey calculated cost to charge ratio to arrive at the estimated bad debt expense. SCHEDULE H, PART III, SECTION A, LINE 3 METHODOLOGY & RATIONALE USED TO DETERMINE BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER ORGANIZATION'S FAP: The bad debt attributable to patients eligible under the hospital's financial assistance program is determined using a weekly bad debt conversion report for a period of twelve months. The conversion rate for this period is used to determine this bad debt category. The total reported conversion charges is multiplied by a calculated cost to charge ratio to arrive at the cost of bad debt attributable to patient's eligible under the hospital's FAP. SCHEDULE H, PART III, SECTION B, LINE 8 MEDICARE SHORTFALLS: WELLSTAR WEST GEORGIA MEDICAL CENTER, Inc. 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: For its 2016 community health needs assessment, West Georgia Medical Center identified and assessed the health needs of the community through the following steps. 1.) The members of the existing CHNA steering committee established in 2012 continued their service on the 2016 CHNA steering committee. 2.) The committee defined the community as its primary service area - Troup county, GA. 3.) The committee identified and engaged community leaders and stakeholders in Lagrange, West Point and Hogansville, GA, as well as members of underserved populations, senior citizens, public health representatives, physicians, social workers, dietitians, emergency medical personnel and Troup county school board members. 4.) WGMC worked with consultants from strategy solutions to create a community health profile that addressed access to preventive health services, underlying causes of health problems, and major chronic diseases of the population. Secondary data came from a variety of sources including vital records, state and national health status data and hospital utilization data. 5.) The team gained community input via meetings with community leaders and stakeholders and others representing various populations, as well and an electronic survey. 6.) The team developed a prioritization of needs to address. 7.) The team developed implementation strategies to address the identified needs. The WGMC board of trustees approved the CHNA on June 20, 2016 and the implementation strategies on OCTOBER 17, 2016, and sent these documents to the Wellstar Health System board of trustees for its approval on NOVEMBER 3, 2016. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: WEST GEORGIA MEDICAL CENTER, INC. PROVIDES NOTICE OF THE AVAILABILITY OF COMMUNITY FINANCIAL ASSISTANCE THROUGH THE FINANCIAL ASSISTANCE POLICY (FAP) VIA: SIGNAGE PATIENT BROCHURE BILLING STATEMENT COLLECTION ACTION LETTER ONLINE AT: HTTPS://WWW.WELLSTAR.ORG/ABOUT-US/POLICIES- PROCEDURES/PAGES/COMMUNITY-FINANCIAL-ASSISTANCE-POLICY.ASPX WEST GEORGIA MEDICAL CENTER, INC. PROVIDES ITS PATIENTS WITH HOSPITAL PERSONNEL OR CONTRACTED PERSONNEL WHO ARE TRAINED IN ALL ASPECTS OF GOVERNMENTAL PROGRAMS, PAYMENTS PLANS, CHARITY DISCOUNTS, AND OTHER FINANCIAL ASSISTANCE OFFERED TO ASSIST THEM IN THEIR HOSPITAL BILLS. IF THE PATIENT IS ELIGIBLE FOR FEDERAL OR STATE ASSISTANCE PROGRAMS, A STAFF MEMBER IS KNOWLEDGEABLE IN THE STEPS NECESSARY TO QUALIFY THOSE INDIVIDUALS. IF A PATIENT IS INDIGENT OR CHARITY ELIGIBLE THEY WILL BE OFFERED ASSISTANCE THROUGH THE HOSPITAL'S CHARITY AND INDIGENT CARE POLICY INCLUDING THE STATE'S INDIGENT CARE TRUST FUND. IF THE PATIENT HAS NO OTHER INSURANCE AND FAILS TO QUALIFY FOR INDIGENT CARE ASSISTANCE, THE FINANCIAL COUNSELOR CAN THEN OFFER THE PATIENT AN OPPORTUNITY TO ACCEPT A PAYMENT PLAN WITH DISCOUNTED PAYMENT OPTIONS BASED ON THEIR ABILITY TO PAY IMMEDIATELY OR OVER TIME. ALL PATIENTS ARE AFFORDED THESE OPPORTUNITIES. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: WELLSTAR WEST GEORGIA MEDICAL CENTER, INC. ("WGMC") IS A 558-BED FACILITY LOCATED IN LAGRANGE, GEORGIA, APPROXIMATELY 70 MILES SOUTH OF ATLANTA. WGMC'S PRIMARY SERVICE AREA IS TROUP COUNTY WITH A POPULATION OF APPROXIMATELY 70,000 BUT, IT ALSO SERVES OTHER COUNTIES IN WEST CENTRAL GEORGIA AND EAST CENTRAL ALABAMA. APPROXIMATELY 19.3% OF THE POPULATION IN THE SERVICE AREA LIVE AT POVERTY LEVEL. ALMOST 25% OF THE POPULATION IS UNDER 18 YEARS OLD AND ABOUT 14% OF THE POPULATION IN THE SERVICE AREA IS OVER THE AGE OF 65. THE MEDIAN HOUSEHOLD INCOME IN THE PRIMARY SERVICE AREA IS APPROXIMATELY $41,000. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: AS STATED IN THE WELLSTAR HEALTH SYSTEM, INC. AND AFFILIATES AUDITED FINANCIAL STATEMENTS FOR THE PERIOD ENDED 6/30/2017 WEST GEORGIA MEDICAL CENTER, 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 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; WGMC OPERATES A FULL-TIME EMERGENCY ROOM OPEN TO ALL REGARDLESS OF ABILITY TO PAY; WGMC PROVIDES CARE TO THE NEEDY MEMBERS OF THE COMMUNITY CONSISTENT WITH ITS CHARITY CARE POLICY. THE HOSPITAL'S EXCESS FUNDS ARE GENERALLY APPLIED TO EXPANSION AND REPLACEMENT OF EXISTING FACILITIES AND EQUIPMENT, AMORTIZATION OF INDEBTEDNESS, IMPROVEMENT OF PATIENT CARE, COMMUNITY BENEFIT ACTIVITIES INCLUDING HEALTH EDUCATION, PREVENTIVE SCREENINGS AND HEALTH FAIRS, RESEARCH, SUBSIDIZED HEALTH SERVICES, AND CHARITY CARE. WEST GEORGIA MEDICAL CENTER, INC. COMMITTED APPROXIMATELY $7 MILLION IN CAPITAL EXPENDITURES FOR THE YEAR TO MEET TECHNOLOGY AND PROGRAM NEEDS OF THE COMMUNITY IT SERVES. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: WELLSTAR HEALTH SYSTEM, THE LARGEST HEALTH SYSTEM IN GEORGIA, IS KNOWN NATIONALLY FOR ITS INNOVATIVE CARE MODELS, FOCUSED ON IMPROVING QUALITY AND ACCESS TO HEALTHCARE. WELLSTAR CONSISTS OF WELLSTAR MEDICAL GROUP, 240 MEDICAL OFFICE LOCATIONS, OUTPATIENT CENTERS, HEALTH PARKS, A PEDIATRIC CENTER, NURSING CENTERS, HOSPICE, HOMECARE, AS WELL AS 11 INPATIENT HOSPITALS: WELLSTAR ATLANTA MEDICAL CENTER, WELLSTAR ATLANTA MEDICAL CENTER SOUTH, WELLSTAR KENNESTONE REGIONAL MEDICAL CENTER (ANCHORED BY WELLSTAR KENNESTONE HOSPITAL), WELLSTAR WEST GEORGIA MEDICAL CENTER, AND WELLSTAR COBB, DOUGLAS, NORTH FULTON, PAULDING, SPALDING REGIONAL, SYLVAN GROVE AND WINDY HILL HOSPITALS. AS A NOT-FOR-PROFIT, WELLSTAR CONTINUES TO REINVEST IN THE HEALTH OF THE COMMUNITIES IT SERVES WITH NEW TECHNOLOGIES AND TREATMENTS. FOR MORE INFORMATION, VISIT: HTTPS://WWW.WELLSTAR.ORG/PAGES/DEFAULT.ASPX SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY HEALTH BENEFIT REPORT: On an annual basis the hospital reports its community health benefits report to the Georgia Hospital Association (GHA). GHA aggregates the hospital specific reports into a statewide community health benefit report. The State of Georgia also requires hospitals to file the Hospital Financial Survey and the Indigent Care Trust Fund Survey so that it can collect information on hospital financial class categories and also to determine the amount of uncompensated care by hospital. true AMERICAN CANCER SOCIETY 233 12TH ST SUITE 710 COLUMBUS GA 31901 131788491 501(C)(3) 20000 0 FMV N/A SPONSORSHIP TROUP COUNTY CENTER FOR STRATEGIC PLANNING INC 1220 LAFAYETTE PKWY LAGRANGE GA 30241 270863139 501(C)(3) 30000 FMV N/A SPONSORSHIP THiNC COLLEGE AND CAREER ACADEMY 1 COLLEGE CIRCLE LAGRANGE GA 30240 463697983 501(C)(3) 15000 FMV N/A SPONSORSHIP TROUP CARES 301 MEDICAL DR 501 LAGRANGE GA 30240 209176300 501(C)(3) 50000 0 FMV N/A SPONSORSHIP FRIENDS OF THE THREAD TRAIL LAGRANGE GA INC PO Box 636 LAGRANGE GA 30241 813580329 501(c)(3) 15000 0 FMV N/A SPONSORSHIP WEST GEORGIA HEALTH FOUNDATION 1514 VERNON ROAD LAGRANGE GA 30240 200936376 501(C)(3) 55000 0 FMV N/A SPONSORSHIP LAGRANGE TROUP CO CHAMBER OF COMMERCE P O BOX 636 LAGRANGE GA 302410636 580318810 501(C)(6) 9522 0 FMV N/A SPONSORSHIP DOWNTOWN LAGRANGE DEVELOPMENT SWEETLAND AMPHITHEATRE 200 MAIN ST LAGRANGE GA 30240 582075688 GOV'T 20000 0 FMV N/A SPONSORSHIP 7 1 SCHEDULE I, PART I, LINE 2 PROCEDURE FOR MONITORING THE USE OF GRANTS/SCHOLARSHIP FUNDS: WELLSTAR HEALTH SYSTEM, INC. AND ITS AFFILIATES HAVE SET ASIDE FUNDS FOR CONTRIBUTIONS AND SPONSORSHIPS ON AN ANNUAL BASIS THAT PROVIDE ASSISTANCE TO NATIONAL AND LOCAL ORGANIZATIONS AND INDIVIDUALS IN THE FURTHERANCE OF THE COMMUNITY NEEDS. WELLSTAR ALSO HAS SEVERAL AGREEMENTS WITH AREA COLLEGES AND UNIVERSITIES TO PROMOTE HEALTHCARE RELATED CAREER OPPORTUNITIES. ALL SCHOLARSHIPS ARE AWARDED BASED ON SPECIFIC QUALIFICATIONS WITHOUT REGARD TO AGE, GENDER, OR ETHNICITY. X X X X X X false true X X X X X X true true false false false false false true false ALAN R MUSTER MD SVP SPECIALTY DIVISION WMG 0 245820 0 368505 0 19311 0 47300 0 33451 0 714387 0 0 ANTHONY J BUDZINSKI EVP & CFO 0 627848 0 261647 0 25339 0 47300 0 29306 0 991440 0 0 ANTHONY M TRUPIANO SVP SUPPLY CHAIN 0 301350 0 69055 0 17965 0 47300 0 2135 0 437805 0 0 AVRIL P BECKFORD MD TRUSTEE & CHIEF PEDIATRIC OFF. 0 251638 0 281281 0 -31135 0 28416 0 1782 0 531982 0 0 BARBARA B COREY SVP MANAGED CARE 0 335504 0 72393 0 13097 0 21392 0 20314 0 462700 0 0 BETH KOST SVP COMPLIANCE CHF PRIVACY OFF 0 295632 0 55726 0 12063 0 22418 0 15412 0 401251 0 0 BETHANY ROBERTSON VP & CHIEF LEARNING OFFICER 0 197371 0 35029 0 14307 0 14762 0 30110 0 291579 0 0 BRADFORD B NEWTON VP INFO. TECHNOLOGY ADMIN. 0 209394 0 39846 0 37693 0 22512 0 28247 0 337692 0 28517 BRUCE A DEAN VP R.E.DEP.GEN CNSL(END.1/17) 0 251077 0 46286 0 279905 0 47300 0 25618 0 650186 0 264569 CANDICE L SAUNDERS PRESIDENT & CEO 0 1202152 0 584908 0 326046 0 46319 0 31262 0 2190687 0 305375 CARRIE O PLIETZ EVP & COO HOSPITAL DIVISION 0 537130 0 148556 0 11434 0 19240 0 24616 0 740976 0 0 CHARIS L ACREE VICE PRESIDENT & COO 60692 0 131500 0 29968 0 0 0 5286 0 227446 0 26300 0 DAVID W ANDERSON EVP/HR/OL/COO 0 481208 0 223893 0 143911 0 47300 0 27163 0 923475 0 120302 DOUGLAS ARVIN CPA MBA SVP FINANCE (BEG. 4/2016) 0 240963 0 68000 0 9741 0 0 0 14600 0 333304 0 0 DOUGLAS S FOSTER VP FINANCIAL PLAN. (END. 6/17) 0 147125 0 25000 0 6422 0 0 0 5853 0 184400 0 0 ELIZABETH H LOUDERMILK VP ENT INTELLIGENCE & INTGRTN 0 246958 0 38241 0 9677 0 21739 0 25847 0 342462 0 0 ELIZABETH PAPETTI VP OPS HOSP. DIV.(BEG.12/2016) 0 171398 0 30184 0 1341 0 0 0 1985 0 204908 0 0 ELLEN LANGFORD SVP & COO 0 262350 0 61413 0 11748 0 44900 0 30512 0 410923 0 0 FREDA LYON VP SYSTEM EMERGENCY SERVICES 0 180001 0 31256 0 10330 0 13259 0 21888 0 256734 0 0 GERALD N FULKS SVP & HOSPITAL PRESIDENT 103846 0 281957 0 99596 0 0 0 5177 0 490576 0 90000 0 JANIE MADDOX FORMER TRUSTEE 0 10379 0 0 0 0 0 0 0 0 0 10379 0 0 JAMES M SWARTZ VP ACCOUNTING 0 223163 0 41974 0 8996 0 18992 0 26708 0 319833 0 0 JEFFREY L THARP MD MPH TRUSTEE & CHIEF MEDICNE SRVS 0 317599 0 266590 0 -90278 0 46626 0 33051 0 573588 0 0 JILL M CASE-WIRTH SVP NURSING SERVICES 0 343262 0 77269 0 15360 0 46830 0 11247 0 493968 0 0 JIMMY E FRANCIS VP INFO TECH. OPS (END. 12/16) 0 222789 0 40245 0 9926 0 37002 0 3307 0 313269 0 0 JOHN A BRENNAN EVP CHIEF CLNC. INTG. OFFICER 0 674922 0 204891 0 13347 0 0 0 23360 0 916520 0 0 JONATHAN B MORRIS MD SVP CHIEF INFO. OFF.(END 3/17) 0 411050 0 94664 0 376835 0 25934 0 28582 0 937065 0 362682 JOSEPH L BRYWCZYNSKI SVP HEALTH PARKS DEVELOPMENT 0 293301 0 64545 0 76331 0 47300 0 25526 0 507003 0 58660 KEM M MULLINS EVP AMBULATORY & BUS. DEV. 0 500011 0 223894 0 116836 0 23300 0 30800 0 894841 0 101800 KIMBERLY W MENEFEE SVP STRATEGIC COMM. DEVELOP. 0 307070 0 73247 0 14395 0 29300 0 22063 0 446075 0 0 KRISTEN S TRICE VP DIAGNOSTIC OUTREACH 0 171400 0 25582 0 8573 0 10179 0 26810 0 242544 0 0 KRISTYN M GREIFER MD VP POP. MGMT. (END. 6/2016) 0 164970 0 7500 0 5317 0 2100 0 5197 0 185084 0 0 LEO E REICHERT EVP & GENERAL COUNSEL 0 549786 0 241549 0 17179 0 29300 0 35380 0 873194 0 0 MARY L TAVERNARO VP HUMAN RESOURCES OPERATIONS 0 238222 0 42513 0 10287 0 28907 0 22461 0 342390 0 0 MICHELLE M ROBINSON VP MKTNG./PR/INTERNAL COMM. 0 213429 0 40470 0 37638 0 15756 0 28128 0 335421 0 27733 PAUL DOUGLASS MD TRUSTEE & PHYSICIAN 0 317284 0 9755 0 2674 0 14135 0 6220 0 350068 0 0 PAUL R PERROTTI SVP CFO 68077 0 147500 0 3423 0 0 0 6903 0 225903 0 0 0 PETER R JUNGBLUT MD MBA SVP & MEDICAL DIRECTOR 0 332259 0 50250 0 154660 0 47300 0 30557 0 615026 0 141932 REYNOLD J JENNINGS MD CHIEF STRATEGY OFF.(END. 1/17) 0 37500 0 250415 0 760 0 0 0 79 0 288754 0 0 RICHARD S SIEGEL VP CARDIOLOGY & CVM ADMIN. 0 299416 0 60155 0 12752 0 44675 0 14121 0 431119 0 0 ROBERT MANDLER VP DIAG. OUTREACH (END. 1/17) 0 223912 0 38881 0 44527 0 46646 0 17172 0 371138 0 22391 ROBERT J DECOUX VP CORPORATE MED STAFF SVCS 0 180086 0 34799 0 9217 0 22036 0 25668 0 271806 0 0 ROBIN G BOEHRINGER VP TOTAL REWARDS 0 185699 0 22056 0 7904 0 16979 0 8840 0 241478 0 0 SANDRA LUCIUS VP INFO TECHNOLOGY APPS 0 216590 0 40958 0 12599 0 46550 0 2595 0 319292 0 0 SEAN P TURNER VP REVENUE CYCLE MANAGEMENT 0 269888 0 62153 0 9736 0 21724 0 29369 0 392870 0 0 SNEHAL H DOSHI VP SYSTEM PHARMACIST 0 190008 0 36852 0 10927 0 22230 0 24322 0 284339 0 0 STEPHEN L BADGER SVP CHIEF ADMIN. OFFICER 0 464744 0 157297 0 125897 0 47300 0 23662 0 818900 0 112403 TOM BONIECKI VP MUSCULSKELETAL NEURO. 0 153941 0 8391 0 2285 0 30397 0 33943 0 228957 0 0 VALERY A AKOPOV MD SVP HOSPITAL DIVISION WMG 0 433132 0 115323 0 81987 0 29300 0 26754 0 686496 0 59811 VARMA RAMESWAR MD VP PEDIATRIC OPS.(BEG.10/2016) 0 175485 0 17885 0 3642 0 39573 0 11764 0 248349 0 0 WANDA Y ROBINSON FORMER VP COMPLIANCE 0 82021 0 42652 0 5436 0 3867 0 6970 0 140946 0 0 YVETTE BREWER MD VP PRIMARY CARE (BEG. 12/2016) 0 165601 0 24319 0 2522 0 31192 0 20254 0 243888 0 0 ROBERT TAYLOR PHYSICIAN 113077 0 194922 0 534 0 0 0 6977 0 315510 0 0 0 MICHAEL MYERS PHYSICIAN 156923 0 105971 0 454 0 0 0 6899 0 270247 0 0 0 WILLIAM TURTON PHYSICIAN 137998 0 72148 0 860 0 0 0 7533 0 218539 0 0 0 ASHLEY STEWART PHYSICIAN 137871 0 29474 0 114 0 0 0 6829 0 174288 0 0 0 JOHN COGGINS PHYSICIAN 148847 0 1500 0 1050 0 5431 0 7065 0 163893 0 0 0 SCHEDULE J, PART I, LINE 1B REIMBURSEMENT POLICY: WHILE WELLSTAR HEALTH SYSTEM AND ITS AFFILIATES DO NOT HAVE A WRITTEN POLICY REGARDING PAYMENT OR REIMBURSEMENT OF THE ITEMS LISTED IN SCHEDULE J, 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 OFFICER RECEIVED SEVERANCE PAY DURING THE 2016 CALENDAR YEAR FROM EITHER THE ORGANIZATION OR A RELATED ORGANIZATION: DONALD CAMPBELL, MD $69,282 SCHEDULE J, PART I, LINE 4B PARTICIPATION IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: DURING THE YEAR, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS AND CERTAIN PHYSICIANS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SPONSORED BY WELLSTAR HEALTH SYSTEM, INC. THE AMOUNTS RELATED TO THIS PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THE PLAN INCLUDED IN SCHEDULE J, PART II, COLUMN (B): JONATHAN B. MORRIS, MD $362,682 CANDICE L. SAUNDERS 305,375 BRUCE A. DEAN 264,569 PETER R. JUNGBLUT, MD, MBA 141,932 DAVID W. ANDERSON 120,302 STEPHEN L. BADGER 112,403 KEM M. MULLINS 101,800 GERALD L. FULKS 90,000 VALERY A. AKOPOV, MD 59,811 JOSEPH L. BRYWCZYNSKI 58,660 BRADFORD B. NEWTON 28,517 MICHELLE M. ROBINSON 27,733 CHARIS L. ACREE 26,300 ROBERT MANDLER 22,391 SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS TO OFFICERS: AS PART OF THE WELLSTAR EXECUTIVE COMPENSATION PHILOSOPHY A PERFORMANCE PAY PLAN WAS INSTITUTED SEVERAL YEARS AGO WHEREBY THE WELLSTAR BOARD OF TRUSTEES APPROVES AN ANNUAL INCENTIVE PLAN WHICH CONSISTS OF SEVERAL PERFORMANCE GOALS OR FACTORS THAT UPON ATTAINMENT WILL RESULT IN PAYOUTS TO ELIGIBLE PLAN PARTICIPANTS. THOSE FACTORS ARE: (1) PEOPLE & CUSTOMER SERVICE GOAL FOR EMPLOYEE "TRUST INDEX (2) QUALITY & SAFETY GOAL FOR CLINICAL EXCELLENCE AND PATIENT SATISFACTION; AND (3) FINANCIAL GOAL FOR ATTAINING A POSITIVE OPERATING MARGIN. CONFIRMATION OF ACHIEVING THESE GOALS IS TYPICALLY RECEIVED THROUGH THE ANNUAL EXTERNAL AUDIT PROCESS AND APPROVED BY THE BOARD OF TRUSTEES AT THAT TIME. A LAGRANGE-TROUP COUNTY HOSPITAL AUTHORITY 562609278 507154af9 2008-07-31 45434268 CONSTRUCTION false false false B LAGRANGE-TROUP COUNTY HOSPITAL AUTHORITY 562609278 2014-08-15 22389764 REFUNDING false false false A 5835000 0 46001275 0 4619242 0 900528 0 0 45782302 0 0 2011 false false true true B 1164268 0 22389764 0 0 0 164498 0 0 0 22240003 0 2014 true false true true A false false false false 0.00000 0.00000 0.00000 false false false false B false false false false 0.00000 0.00000 0.00000 false false false false A false false true false false false 0 false 0 false true B false false true false false false 0 false 0 false true A false B false SCHEDULE K, PART I, COLUMN (F) DESCRIPTION OF PURPOSE: PROCEEDS FOR ALL BONDS LISTED ARE FOR THE PURPOSE OF FINANCING HEALTHCARE FACILITIES OF A 501(C)(3) ORGANIZATION. SERIES 2008A WAS ISSUED FOR THE FOLLOWING PURPOSE: 1.) TO FINANCE OR REFINANCE A PORTION OF THE COSTS OF CERTAIN FACILITIES INCLUDING THE ACQUISITION AND CONSTRUCTION OF ADDITIONAL HEALTHCARE FACILITIES AND THE RENOVATION OF EXISTING HEALTHCARE FACILITIES OF THE AUTHORITY IN TROUP COUNTY, GEORGIA, WHICH ARE PART OF WEST GEORGIA MEDICAL CENTER; 2.) TO PAY CAPITALIZED INTEREST DURING THE CONSTRUCTION PERIOD OF THE PROJECT; AND 3.) TO PAY COSTS OF ISSUANCE OF THE SERIES 2008A CERTIFICATES. SERIES 2014 WAS ISSUED FOR THE FOLLOWING PURPOSE: 1.) TO REFUND THE OUTSTANDING SERIES 2010 CERTIFICATES; AND 2.) TO PAY ALL OR A PORTION OF THE COST OF ISSUING THE CERTIFICATES. FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS WELLSTAR HEALTH SYSTEM IS A VERTICALLY INTEGRATED HEALTH CARE DELIVERY SYSTEM WHICH PROVIDES THROUGH AFFILIATED BUSINESS ORGANIZATIONS A FULL SPECTRUM OF HEALTH SERVICES, INCLUDING WELLNESS PROGRAMS, PHYSICIAN OFFICE VISITS, OUTPATIENT CARE, INPATIENT CARE, AND POST-ACUTE SERVICES SUCH AS HOME HEALTH, HOSPICE AND LONG-TERM NURSING CARE. THE SYSTEM THROUGH ITS AFFILIATED BUSINESS ORGANIZATIONS OPERATES 11 HOSPITALS (KENNESTONE, COBB, PAULDING MEDICAL, DOUGLAS, WINDY HILL, ATLANTA MEDICAL CENTER DOWNTOWN AND SOUTH, NORTH FULTON, SPALDING, SYLVAN GROVE AND WEST GEORGIA), MULTIPLE PHYSICIAN OFFICES, PRIMARY CARE CENTERS, OUTPATIENT CARE FACILITIES, A NURSING HOME AND OTHER HEALTH RELATED SERVICES INCLUDING TWO INPATIENT HOSPICE FACILITIES. THE SYSTEM IS SUPPORTED FINANCIALLY BY A FUNDRAISING ORGANIZATION, WELLSTAR FOUNDATION, INC. THE SERVICE AREA FOR THE SYSTEM ENCOMPASSES PARTS OF THE NORTHWESTERN, CENTRAL AND WESTERN SECTIONS OF THE STATE OF GEORGIA - THE PRIMARY AREA BEING IN BARTOW, CHEROKEE, COBB, DOUGLAS, PAULDING, FULTON, BUTTS, SPALDING AND TROUP COUNTIES. APPROXIMATELY MORE THAN 90% OF INPATIENT DISCHARGES AND OUTPATIENTS SERVED ARE FROM THE AFOREMENTIONED COUNTIES. THE WELLSTAR VISION IS TO DELIVER WORLD CLASS HEALTHCARE. OUR MISSION IS TO CREATE AND DELIVER HIGH QUALITY HOSPITAL, PHYSICIAN AND OTHER HEALTHCARE RELATED SERVICES THAT IMPROVE THE HEALTH AND WELL-BEING OF THE INDIVIDUALS AND COMMUNITIES WE SERVE. HISTORY IN 1993, WHAT WAS THEN KNOWN AS THE COBB HEALTH SYSTEM, THE KENNESTONE REGIONAL HEALTH CARE SYSTEM, AND THE DOUGLAS GENERAL HOSPITAL AFFILIATED TO FORM THE NORTHWEST GEORGIA HEALTH SYSTEM. PAULDING MEMORIAL MEDICAL CENTER AFFILIATED WITH NORTHWEST GEORGIA HEALTH SYSTEM IN 1994. IN 1994, THE NORTHWEST GEORGIA HEALTH SYSTEM HELPED FORM THE PROMINA HEALTH SYSTEM AND CHANGED ITS NAME TO PROMINA NORTHWEST HEALTH SYSTEM. IN 1998, PROMINA NORTHWEST HEALTH SYSTEM CHANGED ITS NAME TO WELLSTAR HEALTH SYSTEM. WELLSTAR DISASSOCIATED FROM AND BECAME TOTALLY INDEPENDENT OF PROMINA IN 1999. IN 2016 WELLSTAR ACQUIRED ATLANTA MEDICAL CENTER, NORTH FULTON HOSPITAL, SPALDING HOSPITAL, SYLVAN GROVE HOSPITAL AND WEST GEORGIA MEDICAL CENTER. WELLSTAR HEALTH SYSTEM IS A PARENT CORPORATION, WHICH PROVIDES OVERALL COORDINATION INCLUDING GOVERNING BODY TO ITS 11 AFFILIATES: - COBB HOSPITAL, INC.; - CHS FOUNDATION, INC. (INVESTMENT MANAGEMENT); - DOUGLAS HOSPITAL INC.; - KENNESTONE HOSPITAL, INC.; - PAULDING MEDICAL CENTER, INC.; - WELLSTAR FOUNDATION INC.; - WELLSTAR ATLANTA MEDICAL CENTER, INC.; - WELLSTAR NORTH FULTON HOSPITAL, INC.; - WELLSTAR SPALDING REGIONAL HOSPITAL, INC.; - WELLSTAR SYLVAN GROVE HOSPITAL, INC.; - WELLSTAR WEST GEORGIA HEALTH SERVICES, INC. SERVICES WELLSTAR HEALTH SYSTEM IS ABLE TO OFFER A FULL RANGE OF HEALTHCARE SERVICES THROUGH ITS AFFILIATES. THE SERVICES OFFERED INCLUDE BUT ARE NOT LIMITED TO: - MOST MAJOR INPATIENT CLINICAL SERVICES, - OUTPATIENT SERVICES, - DIAGNOSTIC AND THERAPEUTIC SERVICES, - ANCILLARY AND SUPPORT SERVICES, - URGENT CARE SERVICES, - HOME HEALTH SERVICES, - SKILLED NURSING SERVICES AND - HOSPICE SERVICES. THE SYSTEM INCLUDES A RESIDENTIAL FACILITY ON THE KENNESTONE HOSPITAL CAMPUS, CALLED ATHERTON PLACE. ATHERTON PLACE ALSO HOUSES AN ASSISTED LIVING UNIT AS AN ADDITIONAL LEVEL OF CARE. THE 11 HOSPITAL LOCATIONS ARE ACUTE CARE FACILITIES WITH INPATIENT, OUTPATIENT, AND EMERGENCY SERVICES. PAULDING MEDICAL CENTER IS HOME TO A FULL CARE NURSING HOME, PAULDING NURSING CENTER AND WEST GEORGIA MEDICAL CENTER ALSO HOME TO TWO FULL CARE NURSING HOMES. COBB HOSPITAL IS HOME TO A HOME HEALTH AGENCY AND A RESIDENTIAL HOSPICE FACILITY CALLED TRANQUILITY FOR THOSE PATIENTS IN THE END STAGES OF LIFE. KENNESTONE HOSPITAL ALSO OPENED A RESIDENTIAL HOSPICE FACILITY NOT FAR FROM ITS MAIN CAMPUS. THE SYSTEM IS COMPLIMENTED WITH APPROXIMATELY 250 PHYSICIAN PRACTICES AND SEVERAL URGENT CARE CENTERS. THE SYSTEM IS THUS ABLE TO PROVIDE A COMPLETE CONTINUUM OF CARE FOR THE COMMUNITY IT SERVES. THE FOLLOWING STATEMENTS OF COMMUNITY BENEFIT AND PROGRAM SERVICE ACCOMPLISHMENTS REPRESENT SYSTEM-WIDE ACTIVITY FOR WELLSTAR HEALTH SYSTEM, INC. (THE "SYSTEM") - EIN 58-1649541. ALL AFFILIATED ENTITIES OF THE SYSTEM EXCEPT THE PHYSICIAN HOSPITAL ORGANIZATION (EIN 58-2116179) OPERATE AS CHARITABLE ORGANIZATIONS CONSISTENT WITH THE REQUIREMENTS OF INTERNAL REVENUE CODE SECTION 501(C)(3) AND THE "COMMUNITY BENEFIT STANDARD" OF IRS REVENUE RULING 69-545. THE FOLLOWING EXCERPT FROM THE AUDITED FINANCIAL STATEMENTS IDENTIFIES A BROAD OVERVIEW OF THE CHARITABLE PURPOSE FOR THE SYSTEM. "THE SYSTEM MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES THROUGH ITS AFFILIATES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. IN FISCAL YEAR 2017 AND 2016, WELLSTAR AFFILIATE HOSPITALS MADE $251.9 MILLION AND $147.9 MILLION, RESPECTIVELY, IN PROVIDER PAYMENTS AND RECOGNIZED SUCH PAYMENTS AS A REDUCTION IN NET PATIENT SERVICE REVENUE IN THE ACCOMPANYING COMBINED FINANCIAL STATEMENTS. THE SYSTEM ALSO PARTICIPATES IN CERTAIN GOVERNMENTAL INSURANCE PROGRAMS, INCLUDING MEDICARE AND MEDICAID. UNDER THESE PROGRAMS, THE SYSTEM PROVIDES CARE TO PATIENTS AT PAYMENT RATES WHICH ARE DETERMINED BY THE FEDERAL AND STATE GOVERNMENTS, REGARDLESS OF THE SYSTEM'S ACTUAL CHARGES. IN MOST CASES, THESE PROGRAMS PAY THE SYSTEM AT AMOUNTS WHICH ARE LESS THAN ITS COST OF PROVIDING SERVICES. THE SYSTEM OFFERS MANY WELLNESS AND EDUCATIONAL SERVICES AT LITTLE OR NO COST TO THE COMMUNITY. HEALTH FAIRS ARE HELD THROUGHOUT THE YEAR AT CONVENIENT LOCATIONS, PROVIDING VARIOUS HEALTH SCREENINGS, SUCH AS CHOLESTEROL AND GLUCOSE FINGERSTICKS, BLOOD PRESSURE SCREENINGS, BONE DENSITY AND BMI WEIGHT ASSESSMENTS. A LARGE NUMBER OF EDUCATIONAL PROGRAMS ARE OFFERED FOR ALL AGES. THESE PROGRAMS INCLUDE SCHOOL HEALTH PROGRAMS FOR ELEMENTARY AND MIDDLE SCHOOL STUDENTS, SPEAKING ABOUT WELLNESS SEMINARS, NUTRITION CONSULTING AND CPR AND FIRST-AID CLASSES. THE COSTS OF THESE SERVICES ARE INCLUDED IN OPERATING EXPENSES. 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 STATISTICS SERVICES PROVIDED SYSTEM-WIDE: LICENSED BEDS 2,775 ADULT DISCHARGES 112,334 NEWBORN DISCHARGES 13,754 EMERGENCY ROOM VISITS 684,560 SURGERIES - 68950 CATH LAB/PACEMAKERS/EP 17,643 NON-ED O/P RADIOLOGY PROCEDURES 464,275 MED/SURG. SHORT STAY CASES - 1401 GI LAB PROCEDURES 11,721 RADIOLOGY ONCOLOGY PROCEDURES 36,315 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 SLIDING SCALE HEALTH SERVICES TO PERSONS WHO CANNOT AFFORD TO PAY OR THOSE WHO ARE NOT EXPECTED TO PAY. COMMUNITY HEALTH/EDUCATION: WELLSTARS COMMUNITY EDUCATION & OUTREACH DEPARTMENT PROVIDES FREE BROCHURES ON A VARIETY OF HEALTH-RELATED ISSUES. WELLSTAR PROVIDES SUPPORT GROUPS AND EDUCATIONAL OPPORTUNITIES TO THE COMMUNITY ON A VARIETY OF TOPICS INCLUDING MEN'S AND WOMEN'S HEALTH ISSUES, CARDIAC HEALTH, NUTRITION, CANCER, DIABETES, ETC.. SOME OF THESE OPPORTUNITIES ARE PROVIDED FREE OF CHARGE OR AT A MINIMAL FEE. WELLSTAR ALSO PROVIDES FREE OR LOW-COST SCREENINGS ON HEALTH ISSUES SUCH AS BLOOD PRESSURE, CHOLESTEROL SCREENINGS, GLUCOSE SCREENINGS AND MANY OTHERS. COMMUNITY EDUCATION AND OUTREACH PROVIDES HEALTH AND WELLNESS PROGRAMS AND SERVICES ACROSS ALL WELLSTAR MARKETS REACHING OVER 200,000 PEOPLE ANNUALLY. SOME OF THE MORE SPECIFIC PROGRAM/DEPARTMENTS ARE DOCUMENTED AS FOLLOWS: SCHOOL HEALTH PROGRAM: THIS PROGRAM TEACHES SCHOOL CHILDREN ABOUT HEALTH AND SAFETY TOPICS TO INCLUDE NUTRITION, PHYSICAL ACTIVITY, HEALTHY HYGIENE, BIKE AND PEDESTRIAN SAFETY AND MORE. THE PROGRAMS ARE TAUGHT IN ELEMENTARY SCHOOLS (GRADES K-5) AND MIDDLE SCHOOLS (GRADES 6-8) IN COBB, CHEROKEE, PAULDING AND DOUGLAS COUNTIES. SAFE KIDS: SAFE KIDS COBB COUNTY IS COMMITTED TO REDUCING AND PREVENTING ACCIDENTAL INJURIES TO CHILDREN AGES 14 AND UNDER IN COBB COUNTY. SAFE KIDS COBB COUNTY WORKS TOWARD THIS GOAL THROUGH YOUTH AND ADULT EDUCATION AND THE DISTRIBUTION OF SAFETY EQUIPMENT TO FAMILIES IN NEED. WITH THE HELP OF THE LEAD AGENCIES OF WELLSTAR COBB AND DOUGLAS PUBLIC HEALTH, SAFE KIDS COBB COUNTY HOSTS SAFETY EDUCATION EVENTS AND DISTRIBUTES SAFETY EDUCATION MATERIALS AND EQUIPMENT INCLUDING: CAR AND BOOSTER SEATS, BICYCLE/WHEEL SAFETY, POISON PREVENTION, HOME SAFETY, AND WATER SAFETY. MOST OF THE EVENTS ARE FREE AND OPEN TO THE PUBLIC. THE IMPORTANT MESSAGE TAUGHT AT THESE EVENTS IS THAT SAFETY BEGINS WITH THE PARENTS AND CAREGIVERS. WITH THIS PROGRAM ABOUT 700 CAR SEATS WERE PRESENTED TO FAMILIES IN NEED, AND 1,200 INFANT CAR SEATS CHECKED AT NEARLY 150 CAR SEAT EVENTS. WOMEN & CHILDREN RESOURCE CENTERS: THE WOMEN'S AND CHILDREN'S RESOURCE CENTER AT COBB, DOUGLAS, AND KENNESTONE HOSPITALS PROVIDE MUCH NEEDED SUPPORT FOR MOTHERS AND THEIR NEWBORN BABIES THROUGH PHONE CALLS, BREASTFEEDING CLASSES, AND OTHER EDUCATIONAL OPPORTUNITIES. THESE PROGRAMS DEMONSTRATE WELLSTARS COMMITMENT TO THE HEALTH AND WELL-BEING OF THE NEW MOTHERS AND THEIR BABIES IN OUR COMMUNITY. IN FY2017 THE UNREIMBURSED COSTS ASSOCIATED WITH THE PROGRAM TOTALED APPROXIMATELY $ 350,000 AND MORE THAN 2,500 PARENTS PARTICIPATED IN PRENATAL AND CHILDBIRTH PROGRAMS. THE GOOD LIFE CLUB: WELLSTAR PROVIDES A SPECIAL PROGRAM FOR AREA RESIDENTS--50 AND OLDER CALLED THE GOOD LIFE CLUB. THIS PROGRAM PROMOTES HEALTH, WELLNESS, AND AN ACTIVE LIFESTYLE THROUGH CLASSES, SCREENINGS AND OTHER OPPORTUNITIES. A SMALL MEMBERSHIP FEE INCLUDES: - HEALTH AND WELLNESS EDUCATION AND PROGRAMS - A QUARTERLY NEWSLETTER, - FREE HEALTH SCREENINGS, - DISCOUNTED PARKING AT HOSPITALS AND OTHER RETAIL DISCOUNTS - TRAVEL DISCOUNTS THE GOOD LIFE CLUB CURRENTLY HAS MORE THAN 2,000 MEMBERS. COMMUNITY ACTIVITIES - WELLSTAR HAS PARTNERED WITH A LOCAL COLLEGE, KENNESAW STATE UNIVERSITY ("KSU") TO DEVELOP EDUCATIONAL AND ON-SITE TRAINING PROGRAMS WHICH WILL HOPEFULLY IMPROVE THE CURRENT AND FUTURE HEALTH OF OUR COMMUNITY. MANY OF THE NURSES IN THE SYSTEM ARE TRAINED THROUGH THE NURSING PROGRAM OFFERED BY KSU. WELLSTAR IS ALSO AFFILIATED WITH THE CHATTAHOOCHEE TECHNICAL COLLEGE- NORTH METRO CAMPUS'S RADIOLOGIC TECHNOLOGY PROGRAM. WELLSTAR SERVES AS THE CLINICAL AFFILIATE FOR THE STUDENTS IN THIS TWO-YEAR PROGRAM. THE STUDENTS TRAIN AT WELLSTAR'S HOSPITALS AND OUTPATIENT FACILITIES. THE PROGRAM RECEIVED ACCREDITATION FROM THE JOINT REVIEW COMMITTEE ON EDUCATION IN RADIOLOGIC TECHNOLOGY. THE GOAL IS TO HAVE TRAINED STUDENTS WHO CAN SUBSEQUENTLY CONTRIBUTE TO THE HEALTH OF THE COMMUNITY WE SERVE. SPONSORSHIPS - WELLSTAR PARTICIPATES AS A SPONSOR IN MANY EVENTS WITHIN THE COMMUNITY RELATED TO THE HEALTH AND WELL-BEING OF ITS RESIDENTS. THE AMERICAN HEART ASSOCIATION, AMERICAN CANCER SOCIETY, AMERICAN LUNG ASSOCIATION, THE AMERICAN DIABETES ASSOCIATION, MARCH OF DIMES, AS WELL AS NUMEROUS LOCAL ORGANIZATIONS ARE JUST A FEW OF THE RECIPIENTS OF EVENTS SPONSORED BY WELLSTAR. MANY EMPLOYEES ALSO VOLUNTEER AND PARTICIPATE IN SOME OF THE EVENTS HELD BY THESE ORGANIZATIONS SUCH AS WALKS, FUNDRAISERS AND SCREENINGS. IN FY2017 THE TOTAL UNCOMPENSATED AND OTHER COMMUNITY BENEFITS PROVIDED BY WELLSTAR WAS OVER $ 780 MILLION. COMMITMENT TO THE COMMUNITY: PARTICIPATION IN COALITIONS - $ 602,400 COMMUNITY HEALTH EDUCATION - $ 455,000 UNIVERSITY & COLLEGE PARTNERSHIPS - $ 504,000 HEALTH CARE SUPPORT - $ 8,077,000 MEDICAID SHORTFALLS (UNCOMPENSATED COSTS) - $ 78,000,000 UNREIMBURSED COMMUNITY FINANCIAL AID (CHARITY & INDIGENT): GROSS CHARGES FOR THE YEAR - $1,244,000,000 UNREIMBURSED SERVICES (AT COST) - $ 251,912,000 INVESTMENTS OF EXCESS FUNDS BACK INTO INFRASTRUCTURE AND COMMUNITY: WELLSTAR SYSTEM-WIDE FOR FY2016 - $ 132,000,000 WELLSTAR CONTINUES TO PARTICIPATE IN THE CENTER FOR MEDICARE AND MEDICAID SERVICES (CMS) MEDICARE SAVINGS PROGRAM AS AN ACCOUNTABLE CARE ORGANIZATION (ACO). WELLSTARS ACO IS THE LARGEST ACO IN GEORGIA INCLUDING 50,000 MEMBERS AND 1,400 PHYSICIANS. THE ACO HAS BEEN RECOGNIZED AS ONE OF THE TOP 100 ACOS IN THE COUNTRY. THE PROGRAM HAS BEEN SUCCESSFUL THROUGH A FOCUS ON WELLNESS AND THE IMPROVED MANAGEMENT OF CHRONIC ILLNESSES AND THE RELATED COORDINATION OF CARE, TO ENSURE PATIENTS, ESPECIALLY CHRONICALLY ILL, GET THE RIGHT CARE AT THE RIGHT TIME TO MAINTAIN THEIR OPTIMAL HEALTH, AND AVOID THE NEED FOR HIGH-COST EMERGENCY AND HOSPITAL CARE. AWARDS, RECOGNITION AND ACCOMPLISHMENTS WELLSTAR HEALTH SYSTEM (WELLSTAR) WAS RECOGNIZED FOR DIVERSITY IN THE WORKPLACE. DIVERSITY MAGAZINE LISTS WELLSTAR AS ONE OF ITS 50 BEST PLACES FOR WOMEN AND DIVERSE MANAGERS TO WORK. WELLSTAR WEST GEORGIA MEDICAL CENTER (WGMC) WAS NAMED TO BECKER HOSPITAL REVIEW'S 2016 LIST OF "100 GREAT COMMUNITY HOSPITALS." WGMC IS ONE OF ONLY THREE COMMUNITY HOSPITALS IN GEORGIA TO RECEIVE THIS HONOR. WELLSTAR KENNESTONE REGIONAL MEDICAL CENTER RECEIVED THE PRESTIGIOUS AMERICAN ACADEMY OF MEDICAL SURGICAL NURSED PRISM AWARD. THIS HONOR RECOGNIZED EXCEPTIONAL NURSING PRACTICE, LEADERSHIP AND OUTCOMES IN HOSPITAL MEDICAL-SURGICAL UNITS ACROSS THE COUNTRY. KENNESTONE REGIONAL MEDICAL CENTER IS JUST ONE OF 14 HOSPITALS TO RECEIVE THIS HONOR IN 2016 AND THE ONLY ONE IN THE STATE OF GEORGIA. US NEWS AND WORLD REPORT NAMED WELLSTAR KENNESTONE REGIONAL MEDICAL CENTER TO ITS ANNUAL LISTING OF BEST REGIONAL HOSPITALS RANKING IT THIRD IN GEORGIA. WELLSTAR DOUGLAS HOSPITAL WAS DESIGNATED AS A REMOTE TREATMENT STROKE CENTER BY THE OFFICE OF EMS AND TRAUMA IN THE GEORGIA DEPARTMENT OF PUBLIC HEALTH BECOMING ONE OF THE FIRST HOSPITALS IN THE STATE TO GARNER THE RECOGNITION. WELLSTAR EARNED A SPOT IN THE DAVE THOMAS FOUNDATION FOR ADOPTIONS 100 BEST ADOPTION-FRIENDLY WORKPLACES. THIS IS THE SYSTEMS FIFTH TIME ON THE FOUNDATIONS TOP 100 LIST. WELLSTAR OFFERS FULL-TIME TEAM MEMBERS 120 HOURS AND ELIGIBLE PART-TIME TEAM MEMBERS 60 HOURS OF PAID LEAVE. IN ADDITION, WELLSTAR OFFERS TEAM MEMBERS A MAXIMUM OF $19,000 PER FINALIZED ADOPTION ($20,000 PER FAMILY LIFETIME AMOUNT.) EMPLOYEE RECRUITING AND COMMITMENT TO PROPER WORK-LIFE BALANCE OF PERSONAL AND PROFESSIONAL TIME ARE IMPORTANT TO THE DESIGNATION OF THIS AWARD. WELLSTAR WAS NAMED TO WORKING MOTHER 100 BEST COMPANIES LIST FOR THE 9TH TIME FOR ITS COMMITMENT TO PROGRESSIVE WORKPLACE PROGRAMS, INCLUDING ADVANCEMENT OF WOMEN, FLEXIBILITY, CHILD CARE AND PAID PARENTAL LEAVE. WELLSTAR WAS NAME TO THE 2016 BEST PLACES TO WORK FOR WOMEN LIST BY GREAT PLACES TO WORK. COBB HOSPITAL WAS DESIGNATED A BABY-FRIENDLY HOSPITAL BY BABY-FRIENDLY USA. ONLY 5 OTHER GEORGIA HOSPITALS HOLD THIS DESIGNATION. GEORGIA TREND MAGAZINE NAMED WELLSTAR WGMC THE NUMBER 1 LARGE HOSPITAL IN THE STATE. FIVE OF WELLSTAR HEALTH SYSTEMS HOSPITALS HAVE BEEN GRANTED THREE-YEAR ACCREDITATION WITH THE GOLD COMMENDATION BY THE COMMISSION ON CANCER(COC), A QUALITY PROGRAM BY THE AMERICAN COLLEGE OF SURGEONS. THIS IS THE HIGHEST HONOR AWARDED TO A CANCER PROGRAM. TO EARN THIS ACCREDITATION THE PROGRAM MUST MEET OR EXCEED COCS QUALITY CARE STANDARDS, BE EVALUATED EVERY THREE YEARS AND SHOW EXCELLENCE IN THE DELIVERY OF PATIENT CENTERED CARE. WELLSTAR CANCER NETWORK ALSO RECEIVED NATIONAL DISTINCTION BY BEING GRANTED A THREE- YEAR ACCREDITATION BY THE COC. THIS IS THE HIGHEST HONOR AWARDED TO A CANCER PROGRAM. WELLSTAR KENNESTONE REGIONAL MEDICAL CENTER AND WELLSTAR ATLANTA MEDICAL CENTER RECEIVED THE PLATINUM HONOR BY THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES AND SERVICES ADMINISTRATION FOR THEIR CONTINUED EFFORTS TO PROMOTE ORGAN DONOR REGISTRATION. OTHER HOSPITALS HONORED INCLUDED WELLSTAR COBB, DOUGLAS, NORTH FULTON, WEST GEORGIA MEDICAL CENTER AND PAULDING HOSPITALS. THE PARTNERSHIP FOR HEALTH AND ACCOUNTABILITY(PHA) AN AFFILIATE OF THE GEORGIA HOSPITAL ASSOCIATION, RECENTLY PRESENTED ITS QUALITY AND PATIENT SAFETY AWARD TO SEVERAL WELLSTAR HOSPITALS AS WELL AS TO THE SYSTEM ITSELF. THESE AWARDS RECOGNIZE GEORGIA HEALTHCARE ORGANIZATIONS FOR ACHIEVEMENT IN REDUCING THE RISK OF MEDICAL ERRORS AND IMPROVING PATIENT SAFETY AND MEDICAL OUTCOMES. WELLSTAR SPALDING REGIONAL HOSPITAL WON FIRST PLACE IN THE HOSPITALS WITH 100-299 BEDS CATEGORY FOR ITS HELP ME, DONT HURT ME REDUCING CAUTIS PROJECT. WELLSTAR COBB HOSPITAL WON SECOND PLACE IN THE HOSPITALS WITH GREATER THAN 300 BEDS CATEGORY FOR ITS INTERDISCIPLINARY MODEL BEDSIDE MEDICATION DELIVERY TO REDUCE 30-DAY READMISSION RATES PROJECT. WELLSTAR DOUGLAS HOSPITAL WON THIRD PLACE IN THE HOSPITALS WITH 100-299 BEDS CATEGORY FOR ITS MISSION NOT IMPOSSIBLE: STRATEGIES TO DECREASE CLOSTRIDUM DIFFICILE PROJECT. IN THE HOSPITALS/HEALTH SYSTEMS CATEGORY, WELLSTAR HEALTH SYSTEM EARNED FIRST PLACE FOR ITS OUTPATIENT SURGERY CENTER PRE-OP THROUGHPUT PROJECT, WHICH IMPROVED THE SAFETY OF PATENTS UNDERGOING CT-SCANS. WELLSTAR COBB HOSPITAL WAS ALSO PRESENTED WITH A CIRCLE OF EXCELLENCE AWARD, AN HONOR GIVEN TO HOSPITALS AND HEALTH SYSTEMS THAT HAVE DEMONSTRATED A SUSTAINED COMMITMENT TO QUALITY AND PATIENT SAFETY. EVERY YEAR THE ATLANTA BUSINESS CHRONICLE PUBLISHES ITS LIST OF THE 100 MOST INFLUENTIAL LEADERS IN GEORGIAS HEALTHCARE INDUSTRY. SEVEN MEMBERS OF WELLSTAR HEALTH SYSTEMS SENIOR LEADERSHIP TEAM WERE INCLUDED IN THE 2017 LIST. WELLSTAR KENNESTONE REGIONAL MEDICAL CENTERS CARDIAC PROGRAM IS ONE OF ONLY TWO PROGRAMS IN THE UNITED STATES TO RECEIVE THE JOINT COMMISSION GOLD SEAL DISEASE-SPECIFIC CERTIFICATION FOR HEART-VALVE, CORONARY ARTERY BYPASS SURGERY (CABS) AND CONGESTIVE HEART FAILURE. WELLSTAR WEST GEORGIA MEDICAL CENTER WAS NAMED ONE OF THE NATIONS 100 TOP HOSPITALS BY TRUVEN HEALTH ANALYTICS. TRUVEN IS A LEADING PROVIDER OF INFORMATION AND SOLUTIONS THAT SUPPORT HEALTHCARE COST AND QUALITY IMPROVEMENT. WELLSTAR COBB HOSPITALS INTENSIVE CARE UNIT WAS HONORED WITH THE BEACON AWARD FOR EXCELLENCE BY THE AMERICAN ASSOCIATION OF CRITICAL CARE NURSES. THE BEACON AWARD HONORS INDIVIDUAL HOSPITAL UNITS THAT DISTINGUISH THEMSELVES BY IMPROVING EVERY FACET OF PATIENT CARE. WELLSTAR PAULDING HOSPITAL RECEIVED TWO BRILLIANCE AWARDS FROM VIZIENT MIDSOUTH. THE HOSPITAL WAS RECOGNIZED FOR INNOVATION AND EXCELLENCE IN CLINICAL CARE FOR PATIENTS WITH COPD AND DIABETES. TWO OF WELLSTAR KENNESTONE REGIONAL MEDICAL CENTERS NURSES HAVE BEEN NAMED AS TWO OF THE TOP 10 NURSES IN GEORGIA BY THE ATLANTA JOURNAL CONSTITUTION. WELLSTARS SUPPLY CHAIN SERVICES WAS RECOGNIZED AS A BEST PERFORMER BY THE ECRI INSTITUTE, A NONPROFIT ORGANIZATION THAT USES RESEARCH TO DISCOVER WHICH MEDICAL PROCEDURES, DRUGS AND PROCESSES ARE BEST TO ENABLE IMPROVED PATIENT CARE. THIS AWARD IS GIVEN FOR DEMONSTRATING EXCELLENCE IN OVERALL SPEND MANAGEMENT. THE WOUND CARE CENTER AT WELLSTAR WEST GEORGIA MEDICAL CENTER HAS BEEN RECOGNIZED WITH A CENTER OF DISTINCTION AWARD FOR CLINICAL EXCELLENCE BY HEALOGICS, THE NATIONS LEADING AND LARGEST WOUND CARE MANAGEMENT COMPANY. THE CENTER FOR COMPANIES THAT CARE RECENTLY NAMED WELLSTAR TO ITS HONOR ROLL FOR THE 10TH YEAR IN A ROW. THIS HONOR FOCUSES ON WELLSTARS EFFORT TO OFFERING WORKLIFE SERVICES THAT CREATE A CULTURE OF INCLUSION AND ASSISTANCE FOR TEAM MEMBERS UTILIZING SERVICES THAT PROVIDE A BALANCE BETWEEN WORK AND HOME LIFE. THE PURPOSE OF THE AWARD IS TO RECOGNIZE MEMBER ORGANIZATIONS THAT HAVE ACHIEVED A CERTAIN LEVEL OF EXCELLENCE ACROSS THREE KEY FOCUS AREAS- FINANCIAL AND OPERATIONAL EXCELLENCE, CLINICAL QUALITY EXCELLENCE AND INNOVATION. WELLSTAR WAS NAMED ONE OF BEST AND BRIGHTEST COMPANIES TO WORK FOR BY WSBTV2, BIZ 1190AM-WAFS, CORP! MAGAZINE, BAUDVILLE, BASIC AND THE ORSUS GROUP. THIS AWARD IS GIVEN TO COMPANIES THAT DISTINGUISH THEMSELVES AS HAVING THE MOST INNOVATIVE AND THOUGHTFUL APPROACH TO HUMAN RESOURCES. WELLSTAR HEALTH SYSTEM WAS A WINNER OF THE LEADERSHIP IN EXCELLENCE AWARD BY VIZIENT MIDSOUTH, A MEMBER ALLIANCE FOR NOT FOR PROFIT HEALTHCARE PROVIDERS. THE PURPOSE OF THIS AWARD IS TO RECOGNIZE ORGANIZATIONS THAT HAVE ACHIEVED A CERTAIN LEVEL OF EXCELLENCE ACROSS THREE KEY FOCUS AREAS- FINANCIAL AND OPERATIONAL EXCELLENCE, CLINICAL QUALITY EXCELLENCE AND INNOVATION. FORM 990, PART I, LINES 7A & 7B UNRELATED BUSINESS INCOME: WELLSTAR WEST GEORGIA MEDICAL CENTER, INC. GENERATED NO UNRELATED BUSINESS THE REPORTING YEAR. AS A RESULT THE FILED 990-T SHOWS NO ACTIVITY. IF SUBSEQUENT REVIEW OF THE BOOKS REVEALS ANY UNREPORTED UBI WE WILL FILE AN AMENDED RETURN FOR THE TAX PERIOD ENDED JUNE 30, 2017. FORM 990, PART IV, LINE 12B AUDITED FINANCIAL STATEMENTS WEST GEORGIA MEDICAL CENTER, INC. is audited on an annual basis by an outside auditing firm, KPMG, and as part of that audit a consolidated financial statement is issued for all of WellStar Health System, Inc. and its CONTROLLED Affiliates. The independent auditors report includes the accounts of Wellstar and its controlled affiliates, WELLSTAR Kennestone Hospital, Inc., WELLSTAR Cobb Hospital, Inc., WELLSTAR Douglas Hospital, Inc., WELLSTAR Paulding Medical Center, Inc., WELLSTAR ATLANTA MEDICAL CENTER, INC., WELLSTAR NORTH FULTON HOSPITAL, INC., WELLSTAR SPALDING REGIONAL HOSPITAL, INC., WELLSTAR SYLVAN GROVE HOSPITAL, INC., WELLSTAR WEST GEORGIA HEALTH SERVICES, INC., WELLSTAR WEST GEORGIA MEDICAL CENTER, INC., Wellstar Foundation, Inc., WELLSTAR WEST GEORGIA FOUNDATION, INC., VERNON WOODS RETIREMENT COMMUNITY, INC., CHS Foundation, Inc., Community Assurance Company, Ltd., various Wellstar owned physician practices, a hospice facility, a nursing facility, home health business, and entities for infusion therapy and durable medical equipment. All significant intercompany accounts and transactions have been eliminated in combination. The Board of Trustees of Wellstar HEALTH SYSTEM, INC. has the authority to approve appointments of the members of the board of trustees of all affiliate corporations. FORM 990, PART VI, SECTION A, LINE 7B POWERS OF THE BOARD As per the Articles of Incorporation, the ULTIMATE sole member of WEST GEORGIA MEDICAL CENTER, INC. 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 VI, 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. 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. 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 VI, SECTION B, LINES 15A & 15B COMPENSATION OF OFFICERS WELLSTAR HEALTH SYSTEM, INC. ENGAGES THE HAY GROUP TO WORK WITH THE GOVERNING BOARD TO REVIEW AND RECOMMEND EXECUTIVE COMPENSATION. THE EXECUTIVE COMPENSATION PROCESS AT WELLSTAR IS OVERSEEN BY A COMMITTEE OF INDEPENDENT TRUSTEES, WHICH FOLLOWS A BOARD-APPROVED EXECUTIVE COMPENSATION PHILOSOPHY. THE COMPENSATION COMMITTEE CONSISTS OF FIVE TRUSTEES AS WELL AS THE CEO IN AN ADVISORY ROLE AND NOT A VOTING MEMBER. FURTHER IN COMMITTEE DISCUSSIONS ABOUT THE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER, THE CEO WILL RECUSE HIM/HERSELF FROM THAT PROCESS AND IS A NON-VOTING COMMITTEE MEMBER FOR DISCUSSIONS ON ALL OTHER OFFICERS. THE EXECUTIVE COMPENSATION PHILOSOPHY EMPOWERS THE COMMITTEE TO OVERSEE THE EXECUTIVE COMPENSATION PROCESS AND ADMINISTER THE EXECUTIVE COMPENSATION PROGRAM ON BEHALF OF THE FULL BOARD OF TRUSTEE OF WELLSTAR; PROVIDED, HOWEVER, THE FULL BOARD OF TRUSTEES EVALUATES AND APPROVES THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER. THE PHILOSOPHY REQUIRES ANNUAL DISCLOSURE OF THE COMMITTEE'S ACTIONS AND DECISIONS TO THE FULL BOARD, WHICH IT HAS DONE. THE COMMITTEE IS GUIDED BY THE BOARD-APPROVED PHILOSOPHY. OVERALL, THE PHILOSOPHY IS INTENDED TO REWARD FOR ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE. WHEN PERFORMANCE IS AT A PREDETERMINED TARGETED LEVEL, THE COMPENSATION IS INTENDED TO BE AT OR AROUND THE MEDIAN OF COMPENSATION PAID TO SIMILAR POSITIONS AT SIMILAR ORGANIZATIONS (THE "MARKET"). WELLSTAR'S EXECUTIVE COMPENSATION PHILOSOPHY DEFINES THE MARKET AS BEING COMPRISED OF COMPARABLE NOT-FOR-PROFIT HEALTH CARE DELIVERY SYSTEMS, I.E., NOT-FOR-PROFIT ORGANIZATIONS SIMILAR IN COMPLEXITY AND SCALE TO WELLSTAR. TO ASSIST THE COMMITTEE IN FULFILLING ITS DUTIES, THE COMMITTEE ENGAGED THE HAY GROUP TO PROVIDE MARKET COMPENSATION DATA TO COMPARE TO THE WELLSTAR POSITIONS WHOSE COMPENSATION THE COMMITTEE OVERSEES. THE COMMITTEE USES THIS DATA TO PROVIDE CONTEXT WHEN MAKING DECISIONS IN ADMINISTERING THE COMPENSATION PROGRAM. ACCURATE MINUTES OF THE COMMITTEE'S DISCUSSION AND DECISIONS ARE RECORDED DURING EACH COMMITTEE MEETING, AND REVIEWED AND APPROVED BY THE FULL BOARD OF TRUSTEES AT ITS NEXT SCHEDULED MEETING. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS MADE AVAILABLE TO THE PUBLIC The organization and its AFFILIATES 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 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 of the organizations exceeds 40 hours per week. FORM 990, PART VII & FORM 990, SCHEDULE J COMPENSATION ALL 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). FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: FOR THE REPORTING PERIOD WELLSTAR WEST GEORGIA MEDICAL CENTER, Inc. HAD A CHANGE IN NET ASSETS OF $6,031,382 RELATED TO TRANSFERS TO AFFILIATES AS PART OF THE ALLOCATION OF INCOME STATEMENT AND BALANCE SHEET TRANSACTIONS OVER THE YEAR. FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT LABOR TOTAL FEES:2299897 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:16673997 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:6385224 FORM 990 PART IX LINE 11G DESCRIPTION:BANKING FEES TOTAL FEES:319776 FORM 990 PART IX LINE 11G DESCRIPTION:LICENSES & TAXES TOTAL FEES:65324 CHS Foundation Inc 793 SAWYER ROAD Marietta GA 300622222 581649540 Foundation GA 501(C)(3) 12 II WHS INC true Douglas Hospital Inc 793 SAWYER ROAD MARIETTA GA 300622222 582026750 Healthcare GA 501(C)(3) 3 WHS INC true Kennestone Hospital Inc 793 SAWYER ROAD Marietta GA 300622222 582032904 Healthcare GA 501(C)(3) 3 WHS INC true Paulding Medical Center Inc 793 SAWYER ROAD MARIETTA GA 300622222 582095884 Healthcare GA 501(C)(3) 3 WHS INC true Wellstar Foundation Inc 793 SAWYER ROAD MARIETTA GA 300622222 581627413 Foundation GA 501(C)(3) 12 II WHS INC true Wellstar Health System Inc 793 SAWYER ROAD MARIETTA GA 300622222 581649541 Healthcare GA 501(C)(3) 12 II NA false WELLSTAR ATLANTA MEDICAL CENTER INC 793 SAWYER ROAD MARIETTA GA 300622222 810837031 HEALTHCARE GA 501(C)(3) 3 WHS INC true WELLSTAR NORTH FULTON HOSPTIAL INC 793 SAWYER ROAD MARIETTA GA 300622222 810851756 HEALTHCARE GA 501(C)(3) 3 WHS INC true WELLSTAR SPALDING REGIONAL HOSPITALINC 793 SAWYER ROAD MARIETTA GA 300622222 810864789 HEALTHCARE GA 501(C)(3) 3 WHS INC true WELLSTAR SYLVAN GROVE HOSPITAL INC 793 SAWYER ROAD MARIETTA GA 300622222 810875069 HEALTHCARE GA 501(C)(3) 3 WHS INC true WEST GEORGIA HEALTH SERVICES INC 793 SAWYER ROAD MARIETTA GA 300622222 205497622 HEALTHCARE GA 501(C)(3) 12 II WHS INC true COBB HOSPITAL INC 793 SAWYER ROAD MARIETTA GA 300622222 580968382 HEALTHCARE GA 501(C)(3) 3 WHS INC true VERNON WOODS RETIREMENT COMMUNITY INC 793 SAWYER ROAD MARIETTA GA 300622222 582575049 HEALTHCARE GA 501(C)(3) 10 WGHS INC true WEST GEORGIA HEALTH FOUNDATION INC 793 SAWYER ROAD MARIETTA GA 300622222 200936376 FOUNDATION GA 501(C)(3) 12 II WGHS INC true MEDICAL PARK FOUNDATION INC 1514 VERNON ROAD LAGRANGE GA 30240 581303478 FOUNDATION GA 501(C)(3) 7 WGHS INC true COBB SOUTH PARKING DECK 793 SAWYER ROAD MARIETTA GA 300622222 752999669 PARKING GA NA N/A KENNESTONE EAST PARKING DECK LLC 793 SAWYER ROAD MARIETTA GA 300622222 200537100 PARKING GA WHS INC N/A GRIFFIN IMAGING LLC 793 SAWYER ROAD MARIETTA GA 300622222 IMAGING CENTER GA NA N/A TENET EMSSPALDING 911 LLC 793 SAWYER ROAD MARIETTA GA 300622222 OFF. BLDG/EMS CTR GA NA N/A NORTH FULTON PARKING DECK LP 793 SAWYER ROAD MARIETTA GA 300622222 PARKING GA NA N/A Community Assurance Co 3rd Fl Barclays Hse Shedden Rd George Town CJ 581649541 INSURANCE CJ WHS INC C CORP WEST GEORGIA HEALTH PHYSICIANS INC 793 SAWYER ROAD MARIETTA GA 300622222 275125341 PHYSICIAN PRAC. GA WGHS INC C CORP false true true false false false false false false false true false true false true true false false false