2016-07-05T13:15:57-05:00 2015-06-30 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2014-07-01 581649541 WELLSTAR HEALTH SYSTEM INC % JAMES M SWARTZ WELL 7707925023 805 SANDY PLAINS ROAD MARIETTA GA 300666340 JAMES M SWARTZ VP ACCOUNTING 2673303000 2016-07-05 true JOANNE KRUEGER P01235586 2673303000 2014 2016-09-27 15:27:22Z X CANDICE L SAUNDERS 805 Sandy Plains Road Marietta GA 300666340 823915973 false X www.wellstar.org X 1994 GA TO DELIVER WORLD-CLASS CHARITABLE HEALTHCARE TO THE COMMUNITY. 18 9 5944 401 937006 -134370 0 0 664865794 800436589 54674985 -17068471 26362125 40547855 745902904 823915973 1167763 1558623 0 0 420122898 507948700 0 0 1780384 239109495 264562149 660400156 774069472 85502748 49846501 2289388627 2287456665 1012073035 1043356754 1277315592 1244099911 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 THAT WE SERVE. false false 517911013 1558623 800436589 SEE SCHEDULE O 517911013 true false false true false false false false true true false false true true true false true false true false false false false false false false true true true true false false false false false true false true true false false false false false true true true true false false true 702 0 5944 true true true true CJ false false false false false false false false false X 18 9 false false false false false false false true true false false true true true true true true true true true true GA X JAMES M SWARTZ 7707925023 805 SANDY PLAINS ROAD MARIETTA GA 300666340 X Avril P Beckford MD TRUSTEE 40.0 10.0 X 484008 0 29400 Jeffrey L Tharp MD TRUSTEE 40.0 10.0 X 630869 0 74725 RANDALL BENTLEY JR TRUSTEE 1.0 5.0 X 19268 0 0 OTIS A BRUMBY III TRUSTEE 1.0 5.0 X 14475 0 0 ROBERT N CROSS MD TRUSTEE 1.0 5.0 X 14446 0 0 TE RUSTY DURHAM TRUSTEE EMERITUS 1.0 5.0 X 661 0 0 THOMAS E GEARHARD MD TRUSTEE 40.0 10.0 X 347375 0 73211 DAVID H HAFNER MD TRUSTEE 1.0 5.0 X 26223 0 0 T FITZ JOHNSON TRUSTEE 1.0 7.0 X 20712 0 0 CHARLES J JONES TRUSTEE 1.0 5.0 X 4075 0 0 JANIE MADDOX TRUSTEE - CHAIR 1.0 5.0 X 8850 0 0 GARY A MILLER TRUSTEE - VICE CHAIR 1.0 5.0 X 4387 0 0 MITZI MOORE TRUSTEE 1.0 5.0 X 1730 0 0 TOM PHILLIPS TRUSTEE 1.0 5.0 X 2903 0 0 WALTER ROBINSON TRUSTEE 1.0 5.0 X 4672 0 0 FRANK ROS TRUSTEE 1.0 5.0 X 2820 0 0 ORIN SWAYZE MD TRUSTEE 1.0 5.0 X 4624 0 0 GREG MORGAN TRUSTEE 1.0 5.0 X 1624 0 0 WILLIAM C BROCK TRUSTEE 1.0 5.0 X 20247 0 0 STEVEN W OWEIDA MD TRUSTEE EMERITUS 1.0 5.0 X 31409 0 0 W ALLEN SEPARK TRUSTEE EMERITUS 1.0 7.0 X 8177 0 0 Valery A Akopov MD VP & Chief of Hospitalist Svcs 40.0 10.0 X 399745 0 53663 David W Anderson EVP HR/OL/CCO 40.0 10.0 X 648929 0 70290 Nicole V Ashe VP Finance & CFO WMG 40.0 10.0 X 262185 0 45885 Tracey Atwater VP & FDN. PRESIDENT (DEP. 6/5) 2.0 48.0 X 433923 0 47847 Barbara G Ballard VP Homecare & Hospice 40.0 10.0 X 282836 0 64915 Joseph L Brywczynski SVP Health Parks Development 40.0 10.0 X 570096 0 70144 Anthony J Budzinski EVP & CFO 40.0 10.0 X 689236 0 71096 Donald Campbell md SVP Phys Educ & Student Aff 40.0 10.0 X 513317 0 62483 Jill M Case-Wirth SVP Nursing SRVS.(BEGIN. 12/1) 40.0 10.0 X 72410 0 4759 James E Clements VP Bus Dev & Strategic Prtnrsp 40.0 10.0 X 264016 0 17453 Lee R Cook VP Med & Behavioral Health 40.0 10.0 X 592708 0 45052 Barbara B Corey SVP Managed Care 40.0 10.0 X 379163 0 48129 Bruce A Dean VP Real Estate Deputy Gen Cnsl 40.0 10.0 X 282461 0 69841 Sarath Degala VP Revenue Cycle Management 40.0 10.0 X 19850 0 2923 Marcia Delk-Payne MD SVP Med Affair & Chf Qlty Ofcr 40.0 10.0 X 925812 0 49890 Nancy R Doelling VP Pediatric SRVS.(BEGIN. 8/4) 40.0 10.0 X 141009 0 11811 Jimmy E Francis VP Info Technology Operations 40.0 10.0 X 257027 0 36192 Steven L Grace VP Talent Acquisition 40.0 10.0 X 266953 0 32731 Kristyn M Greifer md VP POPULATION HEALTH MGMT. 40.0 10.0 X 369983 0 28680 Timothy Haney SVP & Hospital President 2.0 48.0 X 0 354817 41580 Joel W Helmke VP Oncology (BEGIN. 7/21) 40.0 10.0 X 165514 0 28875 Robert D Jansen md EVP & Pres Medical Group 40.0 10.0 X 782540 0 75243 Reynold J Jennings PRESIDENT & CEO 40.0 12.0 X 1701981 0 2056 Peter R Jungblut md SVP & Medical Dir WMG 40.0 10.0 X 398803 0 69399 Christopher M Kane SVP Strategic Plan & Bus Dev 40.0 10.0 X 806400 0 42332 Beth Kost VP Compliance Chf Privacy Ofcr 40.0 10.0 X 331700 0 34022 Ellen Langford SVP & COO WellStar Med Group 40.0 10.0 X 279307 0 58966 Louis W Little SVP Post Acute Svc & Hosp Pres 2.0 48.0 X 0 579061 66520 Elizabeth H Loudermilk VP Ent Intelligence & Intgrtn 40.0 10.0 X 308160 0 25651 Sandra Lucius VP Info Technology Apps 40.0 10.0 X 224424 0 46993 Robert Mandler VP Diagnostic Outreach 40.0 10.0 X 290840 0 61524 Patricia A Mayne VP Emergency Services 10.0 40.0 X 0 311329 50119 Kimberly W Menefee SVP Strategic Community Dev 40.0 10.0 X 362955 0 46026 Christopher L Morgan VP & Admin. CLIO (BEGIN. 7/7) 40.0 10.0 X 168139 0 21747 Jonathan B Morris SVP Chief Info Officer 40.0 10.0 X 462389 0 50258 Kem M Mullins SVP & Hospital President 2.0 48.0 X 0 477879 50745 Bradford B Newton VP INFO. TECHNOLOGY ADMIN. 40.0 10.0 X 232340 0 47711 Craig Owens SVP & Hospital President 2.0 48.0 X 0 344496 67184 Michael G Paul VP Facilities Eng Support Svcs 40.0 10.0 X 220953 0 24150 Leo E Reichert EVP & General Counsel 40.0 10.0 X 752077 0 29200 Bethany Robertson VP & Chief Learning Officer 40.0 10.0 X 218673 0 41608 Michelle M Robinson VP Mktng/PR/Internal Comm 40.0 10.0 X 238847 0 40651 Wanda Y Robinson VP Compliance PWHP(BEGIN.9/15) 40.0 10.0 X 82927 0 2538 Deborah Roegge De Vita VP Women & Newborn Svc Line 40.0 10.0 X 231925 0 31900 Candice LYNN Saunders EXECUTIVE VP & COO 40.0 10.0 X 812226 0 72916 Christopher B Scullen VP Pulmonology Operations 40.0 10.0 X 292246 0 17839 Richard S Siegel VP Cardiology & CVM Admin 40.0 10.0 X 323664 0 70462 Jeffery D Stanley VP Pharmacy & System Coor 40.0 10.0 X 216271 0 30238 Daniel J Styf SVP PW Health Plan 40.0 10.0 X 337033 0 27733 James M Swartz VP Accounting 40.0 10.0 X 272353 0 42262 Mary L Tavernaro VP Human Resources Operations 40.0 10.0 X 259157 0 49126 Adam C Thompson VP Surgery 40.0 10.0 X 228073 0 21830 Anthony M Trupiano SVP Supply Chain 40.0 10.0 X 345219 0 47596 Sean P Turner VP Rev.Cycle MGMT (BEGIN.9/28) 40.0 10.0 X 273082 0 46665 Robin Wilson MD SVP Chief Hlth Innov Officer 40.0 10.0 X 637993 0 22144 Chester A Zborowski VP Health Parks Operations 40.0 10.0 X 223151 0 24265 DANIEL WOODS MD SVP & HOSPITAL PRESIDENT 2.0 48.0 X 0 482590 70359 William Benedict MD MD Physician Group 50.0 0.0 X 1020951 0 69963 SAID ELISHIHABI MD MD Physician Group 50.0 0.0 X 1441325 0 62008 WILLIAM COOPER MD MD Physician Group 50.0 0.0 X 1210719 0 71579 RICHARD MYUNG MD MD Physician Group 50.0 0.0 X 1194187 0 50488 AHMAND KHALDI MD MD Physician Group 50.0 0.0 X 1029664 0 46693 Michael L Graue FORMER EVP & COO 0.0 0.0 X 522266 0 0 Kenneth C Kunze MD FRMR SVP CHIEF MEDICAL OFFICER 0.0 0.0 X 383389 0 0 28309077 2550172 2912284 940 true true true EPIC SYSTEMS CORPORATION POBOX 88314 MILWAUKEE WI 532880314 INFORMATION SERVICES 13129709 IMPACT ADVISORS LLC 931 W 75TH STREET SUITE 137-304 NAPERVILLE IL 60565 CONSULTING 6120300 PRESIDIO NETWORKED SOLUTIONS PO BOX 822169 PHILADELPHIA PA 191822169 INFORMATION SERVICES 12954941 INGLETT AND STUBBS INC PO BOX 932506 ATLANTA GA 311932506 CONSTRUCTION 9263889 ETTAIN GROUP INC PO BOX 60070 CHARLOTTE NC 282600070 STAFFING SERVICES 4246207 166 0 PATIENT REVENUE 621990 291974859 291974859 COBB COUNTY DETENTION CENTER 621990 5808972 5808972 EQUITY IN EARNINGS OF HOSP AFFILIATES 621990 207747365 207747365 SHARED SERVICES COSTS RECOUPMENT 621990 254817237 254817237 WELLNESS CENTER 621400 2265299 2265299 37822857 37822857 800436589 -14098875 -14098875 0 0 1210954 0 0 1210954 1210954 1210954 -2969596 0 -2969596 -2969596 -2969996 0 0 0 LAUNDRY 812300 937006 937006 CHILDCARE REVENUE 621990 1662295 1662295 OTHER REVENUE 621990 36737600 36737600 39336901 823915973 800436589 937006 22541978 X 640885 640885 917738 917738 0 0 29526925 23792941 5707596 26388 335328 268262 67066 391985211 300029270 91026821 929120 16944654 13301141 3609949 33564 44847477 29843405 14784982 219090 24309105 17376138 6837097 95870 0 1597534 5382 1592152 306200 306200 404660 404660 0 0 77598478 41132911 36287905 177662 7578923 2138390 5279120 161413 8247150 6249410 1910036 87704 0 0 28950068 19722194 9225089 2785 2320409 1132675 1173757 13977 0 2631335 1058907 1561570 10858 1457986 1457986 0 44443402 8287754 36141296 14352 26909350 9792512 17116838 REPAIRS & MAINTENANCE 36583745 25181567 11401699 479 MEDICAL SUPPLIES 16629010 16615890 13120 OTHER OPERATING EXPENSES 8903899 18981 8877796 7122 774069472 517911013 254378075 1780384 65044 0 33898944 52896450 0 0 32995490 31871362 0 0 0 0 0 0 8096858 7271962 34888229 31079463 646323919 317609319 356337498 328714600 675250308 744692488 0 0 0 0 0 0 1147856256 1090930340 2289388627 2287456665 227603596 189760804 0 0 0 0 516089829 9327364 0 0 0 0 0 0 0 0 268379610 844268586 1012073035 1043356754 X 1262583371 1227850129 9983343 11430819 4748878 4818963 1277315592 1244099911 2289388627 2287456665 X 49846501 -18252733 -64809449 X false true X true false X X 4 COBB HOSPITAL INC 580968382 3 true 67219347 0 PAULDING MEDICAL CENTER INC 582095884 3 true 21975864 0 KENNESTONE HOSPITAL INC 582032904 3 true 146797654 0 DOUGLAS HOSPITAL INC 582026750 3 true 25904585 0 4 261897450 0 0.00000 true false false false false false false false false false false false false false false true true true false 0 true 440 true 2191 true 4000 true 241416 true 10938 true 145675 404660 false SCHEDULE C, PART II-B, LINE 1 OTHER LOBBYING EXPENSES During 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. 6485000 64000 62000 6611000 4915000 771000 799000 6485000 4286000 162000 467000 4915000 4416000 75000 -37000 168000 4286000 3810000 24000 -70000 652000 3112000 0.73000 0.27000 false true true 43697889 43697889 111096966 50720317 60376649 14309389 9608781 4700608 473877022 256023362 217853660 3183866 1098072 2085794 328714600 UNAMORTIZED BORROWING COSTS 1961293 OTHER RECEIVABLES 2044612 OTHER PREPAIDS 500480 EQUITY IN AFFILIATES 1081600527 OTHER LT ASSETS 4823428 1090930340 0 ACCRUED PENSION LIABILITY 224792568 OTHER LONG TERM LIABILITIES 518145758 INSURANCE RESERVES 84126308 ASSET RETIREMENT OBLIGATION LT 721576 SWAP CONTRACT 2005 ISSUE LT LI 16482376 844268586 X SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS The 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 The following footnote is related to the organization's application of FIN 48 (ASC 740): Wellstar (including WELLSTARE HEALTH SYSTEM, INC.) and all but one of its affiliates have been recognized as exempt from Federal income tax under Internal Revenue Code Section 501(a) as organizations described in Section 501(C)(3) and, therefore, related income is generally not subject to Federal or state income taxes. Community Assurance Corporation is a controlled foreign corporation not subject to Federal tax. Wellstar applies FASB ASC 740, Income Taxes, which addresses accounting for uncertainties in income tax positions. It also provides guidance on when tax positions are recognized in an entity's financial statements and how the values of these positions are determined. There is no impact on Wellstar's combined financial statements as a result of the application of ASC 740. true American Cancer Society 250 Williams Street Atlanta GA 30303 131788491 501(C)(3) 86400 0 FMV N/A Sponsor Fundraiser American Diabetes Association 233 Peachtree St Harris Tower Suite 2225 Atlanta GA 30303 135613797 501(C)(3) 10000 0 FMV N/A Sponsor Fundraiser American Heart Association 1101 Northchase PKWY Marietta GA 30067 580198114 501(C)(3) 50000 0 FMV N/A Sponsor Fundraiser Cherokee County Chamber of Commerce 3605 Marietta Hwy Canton GA 30114 582487501 501(C)(3) 7644 0 FMV N/A Sponsor Fundraiser Cobb Chamber of Commerce PO Box 671868 Marietta GA 30006 582487501 501(C)(6) 140343 0 FMV N/A Sponsor FUNDRAISER Georgia Ballet 1255 Field Parkway Marietta GA 30066 581420599 501(C)(3) 10000 0 FMV N/A Contribution March of Dimes 1776 Peachtree St NW Atlanta GA 30309 131846366 501(c)(3) 10000 0 FMV N/A Sponsor Fundraiser MUST Ministries PO Box 1717 Marietta GA 30061 582034725 501(C)(3) 40000 0 FMV N/A Sponsor Fundraiser The Center for Family Resources 995 Roswell StSTE 100 Marietta GA 30060 580876634 501(C)(3) 25000 0 FMV N/A Sponsor Fundraiser Tommy Nobis Foundation 1480 Bells Ferry Rd Marietta GA 30060 582080817 501(C)(3) 25000 0 FMV N/A Sponsor Fundraiser YWCA of Northwest Georgia 48 Henderson St Marietta GA 30064 580617782 501(c)(3) 10000 0 FMV N/A Sponsor Fundraiser Susan G Komen for the Cure Atlanta 3525 Piedmont Rd Building 5 Suite 215 Atlanta GA 30305 581959763 501(c)(3) 10000 FMV N/A SPONSORSHIP United Arts of Cobb 307 North Marietta Pkwy Marietta GA 30060 205909579 501(c)(3) 15000 0 FMV N/A Sponsor Fundraiser City of Kennesaw 2529 JO Stephenson Ave Kennesaw GA 30144 586010582 11000 0 FMV N/A Contribution Goshen Vallley 387 Gosgen Church Way Waleska GA 30183 582361483 501(C)(3) 50000 0 FMV N/A Sponsor Fundraiser AAA Amateur Advocate 514 Gresham Road SW Mableton GA 30126 222313220 501(c)(3) 7500 0 FMV N/A SPONSOR FUNDRAISER Cobb Senior Services 1150 Powder Springs St Marietta GA 30064 586000804 501(c)(3) 15000 0 FMV N/A SPONSORSHIP Georgia Trend 5880 Live Oak Pkwy 280 Norcross GA 30093 582431474 5498 0 FMV N/A Contribution Greater NFulton Chamber COMM 11605 Haynes Bridge Rd Alpharetta GA 30009 581557316 11000 FMV N/A Sponsor Fundraiser Greenprints Trail Alliance PO Box 447 Woodstock GA 30188 264607137 501(c)(3) 24000 0 FMV N/A Sponsor Fundraiser KEMO Trail Corps Inc 900 Kennesaw Mtn Dr Kennesaw GA 30152 331064049 6500 0 FMV N/A Sponsorship Fundraiser LATIN AMERICAN ASSOCIATION 2750 Buford Hwy Atlanta GA 30324 581237316 10000 0 FMV N/A SPONSORSHIP Sweetwater Mission 6289 Veterans Memorial Hwy Austell GA 30168 581992771 501(c)(3) 6000 0 FMV N/A Sponsor Fundraiser 18 5 SCHEDULE I, PART I, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANTS 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 TAX EXEMPT ORGANIZATIONS IN THE FURTHERANCE OF THE COMMUNITY NEEDS. WELLSTAR ALSO HAS SEVERAL AGREEMENTS WITH AREA COLLEGES AND UNIVERSITIES TO PROMOTE HEALTHCARE RELATED CAREER OPPORTUNITIES. WELLSTAR PROVIDES SCHOLARSHIPS TO LOCAL STUDENTS FOR HEALTHCARE COURSES OF STUDY. ALL SPONSORSHIPS AND SCHOLARSHIPS ARE AWARD 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 Valery A Akopov MD VP & Chief of Hospitalist Svcs 329534 0 59170 0 11041 0 28200 0 25463 0 453408 0 0 0 David W Anderson EVP HR/OL/CCO 414523 0 205272 0 29134 0 45700 0 24590 0 719219 0 0 0 Nicole V Ashe VP Finance & CFO WMG 219898 0 32783 0 9504 0 22403 0 23482 0 308070 0 0 0 Tracey Atwater VP & FDN. PRESIDENT (DEP. 6/5) 105634 0 198681 0 129608 0 37865 0 9982 0 481770 0 0 0 Barbara G Ballard VP Homecare & Hospice 238742 0 33691 0 10403 0 43913 0 21002 0 347751 0 0 0 Joseph L Brywczynski SVP Health Parks Development 266989 0 285443 0 17664 0 45700 0 24444 0 640240 0 0 0 Anthony J Budzinski EVP & CFO 539386 0 134954 0 14896 0 45700 0 25396 0 760332 0 0 0 Donald Campbell md SVP Phys Educ & Student Aff 327517 0 167537 0 18263 0 45700 0 16783 0 575800 0 0 0 James E Clements VP Bus Dev & Strategic Prtnrsp 207563 0 49762 0 6691 0 0 0 17453 0 281469 0 0 0 Lee R Cook VP Med & Behavioral Health 256547 0 327425 0 8736 0 27624 0 17428 0 637760 0 0 0 Barbara B Corey SVP Managed Care 301454 0 65765 0 11944 0 21292 0 26837 0 427292 0 0 0 Bruce A Dean VP Real Estate Deputy Gen Cnsl 227781 0 40345 0 14335 0 45675 0 24166 0 352302 0 0 0 Marcia Delk-Payne MD SVP Med Affair & Chf Qlty Ofcr 370531 0 544886 0 10395 0 45700 0 4190 0 975702 0 0 0 Nancy R Doelling VP Pediatric SRVS.(BEGIN. 8/4) 117427 0 16910 0 6672 0 11120 0 691 0 152820 0 0 0 Jimmy E Francis VP Info Technology Operations 205005 0 42280 0 9742 0 33822 0 2370 0 293219 0 0 0 Steven L Grace VP Talent Acquisition 200013 0 52892 0 14048 0 14653 0 18078 0 299684 0 0 0 Michael L Graue FORMER EVP & COO 0 0 0 0 522266 0 0 0 0 0 522266 0 0 0 Kristyn M Greifer md VP POPULATION HEALTH MGMT. 307528 0 52230 0 10225 0 18722 0 9958 0 398663 0 0 0 Timothy Haney SVP & Hospital President 0 272688 0 64247 0 17882 0 28200 0 13380 0 396397 0 0 Joel W Helmke VP Oncology (BEGIN. 7/21) 110000 0 51610 0 3904 0 20081 0 8794 0 194389 0 0 0 Robert D Jansen md EVP & Pres Medical Group 591219 0 170344 0 20977 0 45700 0 29543 0 857783 0 0 0 Reynold J Jennings PRESIDENT & CEO 975000 0 708390 0 18591 0 0 0 2056 0 1704037 0 0 0 Peter R Jungblut md SVP & Medical Dir WMG 307528 0 78959 0 12316 0 40200 0 29199 0 468202 0 0 0 Christopher M Kane SVP Strategic Plan & Bus Dev 341744 0 454243 0 10413 0 21954 0 20378 0 848732 0 0 0 Beth Kost VP Compliance Chf Privacy Ofcr 244733 0 77006 0 9961 0 22318 0 11704 0 365722 0 0 0 Kenneth C Kunze MD FRMR SVP CHIEF MEDICAL OFFICER 0 0 0 0 383389 0 0 0 0 0 383389 0 0 0 Ellen Langford SVP & COO WellStar Med Group 220376 0 46995 0 11936 0 36643 0 22323 0 338273 0 0 0 Louis W Little SVP Post Acute Svc & Hosp Pres 0 247333 0 321759 0 9969 0 44057 0 22463 0 645581 0 0 Elizabeth H Loudermilk VP Ent Intelligence & Intgrtn 225680 0 73283 0 9197 0 6309 0 19342 0 333811 0 0 0 Sandra Lucius VP Info Technology Apps 185834 0 30026 0 8564 0 44758 0 2235 0 271417 0 0 0 Robert Mandler VP Diagnostic Outreach 214261 0 58412 0 18167 0 45249 0 16275 0 352364 0 0 0 Patricia A Mayne VP Emergency Services 0 177986 0 122895 0 10448 0 26305 0 23814 0 361448 0 0 Kimberly W Menefee SVP Strategic Community Dev 282547 0 66726 0 13682 0 28200 0 17826 0 408981 0 0 0 Christopher L Morgan VP & Admin. CLIO (BEGIN. 7/7) 110770 0 52731 0 4638 0 20102 0 1645 0 189886 0 0 0 Jonathan B Morris SVP Chief Info Officer 369512 0 80613 0 12264 0 23553 0 26705 0 512647 0 0 0 Kem M Mullins SVP & Hospital President 0 380078 0 85723 0 12078 0 22700 0 28045 0 528624 0 0 Bradford B Newton VP INFO. TECHNOLOGY ADMIN. 192691 0 30661 0 8988 0 20598 0 27113 0 280051 0 0 0 Craig Owens SVP & Hospital President 0 270317 0 60546 0 13633 0 45700 0 21484 0 411680 0 0 Michael G Paul VP Facilities Eng Support Svcs 181401 0 27532 0 12020 0 0 0 24150 0 245103 0 0 0 Leo E Reichert EVP & General Counsel 489341 0 247184 0 15552 0 0 0 29200 0 781277 0 0 0 Bethany Robertson VP & Chief Learning Officer 178067 0 31215 0 9391 0 13097 0 28511 0 260281 0 0 0 Michelle M Robinson VP Mktng/PR/Internal Comm 196373 0 33264 0 9210 0 14300 0 26351 0 279498 0 0 0 Deborah Roegge De Vita VP Women & Newborn Svc Line 195728 0 27621 0 8576 0 25759 0 6141 0 263825 0 0 0 Candice LYNN Saunders EXECUTIVE VP & COO 621461 0 174240 0 16525 0 45334 0 27582 0 885142 0 0 0 Christopher B Scullen VP Pulmonology Operations 172411 0 112906 0 6929 0 0 0 17839 0 310085 0 0 0 Richard S Siegel VP Cardiology & CVM Admin 271627 0 40496 0 11541 0 45700 0 24762 0 394126 0 0 0 Jeffery D Stanley VP Pharmacy & System Coor 176156 0 30945 0 9170 0 21580 0 8658 0 246509 0 0 0 Daniel J Styf SVP PW Health Plan 281902 0 39983 0 15148 0 18663 0 9070 0 364766 0 0 0 James M Swartz VP Accounting 200242 0 63140 0 8971 0 16856 0 25406 0 314615 0 0 0 Mary L Tavernaro VP Human Resources Operations 212056 0 37659 0 9442 0 27690 0 21436 0 308283 0 0 0 Adam C Thompson VP Surgery 166858 0 51698 0 9517 0 0 0 21830 0 249903 0 0 0 Anthony M Trupiano SVP Supply Chain 268258 0 61742 0 15219 0 45700 0 1896 0 392815 0 0 0 Sean P Turner VP Rev.Cycle MGMT (BEGIN.9/28) 233395 0 36468 0 3219 0 20091 0 26574 0 319747 0 0 0 Robin Wilson MD SVP Chief Hlth Innov Officer 395907 0 232368 0 9718 0 0 0 22144 0 660137 0 0 0 Chester A Zborowski VP Health Parks Operations 165755 0 45188 0 12208 0 0 0 24265 0 247416 0 0 0 William Benedict MD MD Physician Group 679170 0 339700 0 2081 0 40200 0 29763 0 1090914 0 0 0 Avril P Beckford MD TRUSTEE 395084 0 86393 0 2531 0 27460 0 1940 0 513408 0 0 0 Jeffrey L Tharp MD TRUSTEE 480597 0 147676 0 2596 0 45700 0 29025 0 705594 0 0 0 THOMAS E GEARHARD MD TRUSTEE 293273 0 48916 0 5186 0 42688 0 30543 0 420606 0 0 0 SAID ELISHIHABI MD MD Physician Group 1149174 0 290197 0 1954 0 40200 0 21808 0 1503333 0 0 0 WILLIAM COOPER MD MD Physician Group 829200 0 378802 0 2717 0 40200 0 31379 0 1282298 0 0 0 RICHARD MYUNG MD MD Physician Group 813600 0 378428 0 2159 0 40200 0 10288 0 1244675 0 0 0 AHMAND KHALDI MD MD Physician Group 928950 0 98374 0 2340 0 22700 0 23993 0 1076357 0 0 0 STEVEN W OWEIDA MD TRUSTEE EMERITUS 0 0 0 0 31409 0 0 0 0 0 31409 0 0 0 DANIEL WOODS MD SVP & HOSPITAL PRESIDENT 0 379267 0 87679 0 15644 0 45700 0 24659 0 552949 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 Part I Line 1a, the organization follows IRS guidelines in the payment of any of these items to individuals listed in Form 990 Part VII Section A. These items are added as taxable wages on the individual's Form W-2 as appropriate. SCHEDULE J, PART I, LINE 4A SEVERANCE PAYMENTS Pursuant to their respective employment agreements, the following groups of officers are entitled to severance payments based on their compensation at that time in the event of certain identified circumstances. The severance payment periods are 24 months for Executive Vice Presidents, 18 months for Senior Vice Presidents, and 12 months for Vice Presidents. The following officers/KEY EMPLOYEES received severance pay during the 2014 CALENDAR YEAR FROM EITHER THE ORGANIZATION OR A RELATED ORGANIZATION: KENNETH C. KUNZE, MD $ 383,389 MICHAEL L. GRAUE, MD 522,266 SCHEDULE J, PART I, LINE 4B The following officers/KEY EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN DURING THE YEAR. Valery Akopov Nicole Ashe Tracey Atwater Joseph L. Brywczynski Anthony J. Budzinski Barbara B. Corey Bruce ALAN Dean Sarath Degala Marcia Delk-Payne Jimmy E. Francis Kristyn M. Greifer Timothy M. Haney Robert D. Jansen Peter R. Jungblut Christopher MICHAEL Kane Beth Kost Ellen Langford Louis W. Little Elizabeth Loudermilk Patricia A. Mayne Kimberly W. Menefee Jonathan B. Morris Kem Mullins Bradford Newton Craig Owens Leo Reichert Bethany Robertson Michelle Robinson Candice LYNN Saunders Richard Siegel Christopher B. Scullen Jeffery Stanley Daniel Styf James M. Swartz Mary LOUISE Tavernaro Adam Thompson Anthony MICHAEL Trupiano Robin WILSON Daniel Woods DONALD CAMPBELL ROBERT MANDLER DEBORAH ROEGGE DE VITA DAVID W. ANDERSON CHESTER ZBOROWSKI BARBARA BALLARD LEE R. COOK James Clements SCHEDULE J, PART I, LINE 7B NON-FIXED PAYMENTS TO OFFICERS As part of the WellStar Executive Compensation Philosophy a performance pay plan was instituted several years ago whereby the WellStar Board of Trustees approves an annual incentive plan which consists of several performance goals or factors that upon attainment will result in payouts to eligible plan participants. Those factors are: People & Customer Service goal for employee "Trust Index", Quality & Safety goal for clinical excellence and patient satisfaction, Financial goal for attaining a positive operating margin. Confirmation of achieving these goals is typically received through the annual external audit process and approved by the Board of Trustees at that time. to eligible plan participants. Those factors are: People & Customer Service goal for employee "Trust Index", Quality & Safety goal for clinical excellence and patient satisfaction, Financial goal for attaining a positive operating margin. Confirmation of achieving these goals is typically received through the annual external audit process and approved by the Board of Trustees at that time. goals is typically received through the annual external audit process and approved by the Board of Trustees at that time. to eligible plan participants. Those factors are: People & Customer Service goal for employee "Trust Index", Quality & Safety goal for clinical excellence and patient satisfaction, Financial goal for attaining a positive operating margin. Confirmation of achieving these goals is typically received through the annual external audit process and approved by the Board of Trustees at that time. patient satisfaction, Financial goal for attaining a positive operating margin. Confirmation of achieving these goals is typically received through the annual external audit process and approved by the Board of Trustees at that time. employee "Trust Index", Quality & Safety goal for clinical excellence and patient satisfaction, Financial goal for attaining a positive operating margin. Confirmation of achieving these goals is typically received through the annual external audit process and approved by the Board of Trustees at that time. 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. employee "Trust Index", Quality & Safety goal for clinical excellence and patient satisfaction, Financial goal for attaining a positive operating margin. Confirmation of achieving these goals is typically received through the annual external audit process and approved by the Board of Trustees at that time. employee "Trust Index", Quality & Safety goal for clinical excellence and patient satisfaction, Financial goal for attaining a positive operating margin. Confirmation of achieving these goals is typically received through the annual external audit process and approved by the Board of Trustees at that time. Trustees at that time. 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. Trustees at that time. Trustees at that time. Trustees at that time. 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. through the annual external audit process and approved by the Board of Trustees at that time. Trustees at that time. A HOSPITAL AUTHORITY OF COBB COUNTY 582464600 19081PEM4 2004-04-30 25000000 EQUIPMENT POOL false false false B COBB COUNTY KENNESTONE HOPSITAL AUTHORITY 581147004 190813LN3 2005-10-31 120000000 CAP. IMPROVEMENTS (SERIES A & B) false false false C HOSPITAL AUTHORITY OF COBB COUNTY 582464600 19081PEN2 2005-06-30 25000000 EQUIPMENT POOL false false false D COBB COUNTY KENNESTONE HOSPITAL AUTHORITY 581147004 190813NM3 2011-11-01 127345930 CONSTRUCTION false false false A 0 0 25000000 96810 0 0 0 0 0 25000000 0 0 2004 false false true true B 6150000 0 120000000 1026000 0 0 1167300 0 0 116948276 1884424 0 2007 false false true true C 0 0 25000000 82775 0 0 0 0 0 25000000 0 0 2006 false false true true D 11440000 0 127345930 0 0 50962739 1383191 0 0 75000000 0 0 2011 true true true true A false false false false 0 false false true B false false false false 0.00200 0.00200 0.00400 false false true C false false false false 0 false false true D false false false false 0 false false true A false true true false 0 false 0 false B false true false 0 false 0 false C false true false 0 false 0 false D false true false 0 false 0 false A true B true C true D true SCHEDULE K, PART V PROCEDURES TO UNDERTAKE CORRECTIVE ACTION WELLSTAR HEALTH SYSTEM, INC (THE BORROWER ON TAX EXEMPT BONDS) HAS ESTABLISHED POLICIES AND PROCEDURES THAT WILL MAXIMIZE THE LIKELIHOOD THAT ALL APPLICABLE POST-ISSUANCE REQUIREMENTS OF FEDERAL INCOME TAX LAW NEEDED TO PRESERVE THE TAX-EXEMPT STATUS OF THE BONDS ARE MET. THE PROCEDURES INCLUDE EXTERNAL ADVISORS SUCH AS BOND COUNSEL AND OTHER LEGAL COUNSEL WHO ASSIST THE BORROWER IN MAINTAINING THE TAX-EXEMPT STATUS OF ALL BONDS; ARBITRAGE REBATE CALCULATIONS THAT NEED TO BE MADE FOR EACH BOND ISSUE; DOCUMENTATION OF THE USE OF BOND PROCEEDS INCLUDING POTENTIAL PRIVATE BUSINESS USE APPLICABLE TO THE BONDS AFTER AN ANNUAL INTERNAL REVIEW OF THOSE USES; AND PROPER RECORD KEEPING OF ALL DOCUMENTS RELATED TO THE ISSUANCE OF TAX-EXEMPT BONDS. THESE PROCEDURES APPLY TO ALL LISTED TAX-EXEMPT BONDS. A PAULDING COUNTY HOSPITAL AUTHORITY 586011214 703596DH6 2012-06-28 32711016 CONSTRUCTION SERIES A false false false B PAULDING COUNTY HOSPITAL AUTHORITY 586011214 703596DK9 2012-06-28 68750000 CONSTRUCTION SERIES B false false false C COBB COUNTY KENNESTONE HOSPITAL AUTHORITY 586011214 190813PH2 2012-11-15 122366879 ADVANCED REFUNDING CONSTRUCTION false false false A 0 0 32711016 14896852 446282 0 437500 0 0 17151433 0 0 2014 false false true true B 0 0 68750000 27382125 1945963 0 471875 0 0 39576733 0 0 2014 false false true true C 5475000 0 122366879 0 0 121287509 1079370 0 0 0 0 0 false true true true A false false false false 0 false false true B false false false false 0 false false true C false false false false 0 false false true A false true false 0 false 0 false B false true true false 0 false 0 false C false true false 0 false 0 false A true B true C true THOMAS GEARHARD MD TRUSTEE SALARY ADVANCE X 7428 7428 false true true AVRIL P BECKFORD MD TRUSTEE SALARY ADVANCE X 1855 1855 false true true JEFFREY THARP MD TRUSTEE SALARY ADVANCE X 109854 109854 false true true 119137 PAMELA ETHERIDGE WIFE OF OFFICER 60872 EMPLOYEE OF WELLSTAR true GREG FORTGANG SON-IN-LAW OF TRUSTEE 102145 EMPLOYEE OF WELLSTAR true JESSICA HANEY DAUGHTER OF OFFICER 59962 EMPLOYEE OF WELLSTAR true GEORGE FLEMING BROTHER OF OFFICER 67246 EMPLOYEE OF WELLSTAR/COBB true MATTHEW MADDOX son of trustee 80260 EMPLOYEE OF WELLSTAR true BONNIE MILLER wife of trustee 34692 EMPLOYEE OF WELLSTAR true GREG KOST BROTHER-IN-LAW OF OFFICER 46791 EMPLOYEE OF WELLSTAR true JENNIFER HANEY DAUGHTER-IN-LAW OF OFFcr. 81209 EMPLOYEE OF WELLSTAR true MISTY DECOUX WIFE OF OFFICER 74447 EMPLOYEE OF WELLSTAR true NADINE FRANCIS WIFE OF OFFICER 1442 EMPLOYEE OF WELLSTAR true SCHEDULE L, PART IV, lines 1-10 BUSINESS TRANSACTIONS WITH INTERESTED PARTIES WELLSTAR HEALTH SYSTEM IS ONE OF THE LARGEST COMPANIES AND EMPLOYERS IN THE COMMUNITIES WE SERVE. FURTHER, AS A COMMUNITY BASED, NOT-FOR-PROFIT HEALTH SYSTEM, WELLSTAR HEALTH SYSTEM SEEKS BOARD MEMBERS FROM VARIOUS BUSINESSES WITHIN THE COMMUNITIES WE SERVE, FOR THE PURPOSE OF ENSURING WELLSTAR HEALTH SYSTEM HAS COMMUNITY REPRESENTATION ON ITS BOARD. IN LIGHT OF THE ABOVE, IT IS INEVITABLE THAT WELLSTAR HEALTH SYSTEM WILL HAVE ROUTINE BUSINESS TRANSACTIONS WITH INTERESTED PERSONS, ASSOCIATED WITH ITS BOARD MEMBERS AND OFFICERS. The transactions all represent payment of services as employees of Wellstar Health System. All transactions listed in Schedule L Part IV are for interested parties or in this case family members of either trustees or officers of wellstar health system, inc. or its related organizations. AMENDED RETURN FORM 990, HEADING, ITEM B, AMENDED RETURN SCHEDULE L, PART II HAS BEEN AMENDED TO REFLECT CERTAIN SALARY ADVANCES WITH INTERESTED PERSONS. THESE HAVE OCCURRED THROUGH THE NORMAL COURSE OF THE ADMINISTRATION OF COMPENSATION PLANS FOR PHYSICIANS AND HAVE BEEN APPROVED BY THE COMPENSATION COMMITTEE OF WELLSTAR HEALTH SYSTEM. FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS WELLSTAR HEALTH SYSTEM IS A VERTICALLY INTEGRATED HEALTH CARE DELIVERY SYSTEM WHICH PROVIDES THROUGH AFFILIATED BUSINESS ORGANIZATIONS A FULL SPECTRUM OF HEALTH SERVICES, INCLUDING WELLNESS PROGRAMS, PHYSICIAN OFFICE VISITS, OUTPATIENT CARE, INPATIENT CARE, AND POST-ACUTE SERVICES SUCH AS HOME HEALTH AND LONG TERM NURSING CARE. THE SYSTEM THROUGH ITS AFFILIATED BUSINESS ORGANIZATIONS OPERATES 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 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 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. KENNESTONE HOSPITAL ALSO OPENED A RESIDENTIAL HOSPICE FACILITY NOT FAR FROM ITS MAIN CAMPUS. 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. IN FISCAL YEAR 2015 AND 2014, WELLSTAR AFFILIATE HOSPITALS MADE $17.1 MILLION AND $16.0 MILLION, RESPECTIVELY, IN PROVIDER PAYMENTS AND RECOGNIZED SUCH PAYMENTS AS A REDUCTION IN NET PATIENT SERVICE REVENUE IN THE ACCOMPANYING COMBINED FINANCIAL STATEMENTS. The System also participates in certain governmental insurance programs, including Medicare and Medicaid. Under these programs, the System provides care to patients at payment rates which are determined by the Federal and State governments, regardless of the System's actual charges. In most cases, these programs pay the System at amounts which are less than its cost of providing services. The System offers many wellness and educational services at little or no cost to the community. Health fairs are held throughout the year at convenient locations, providing various health screenings, such as mammograms, blood pressure and cholesterol checks. A large number of educational programs are offered for all ages. These programs include bicycle safety, car seat safety, defensive driving, CPR and first-aid classes. Flu shots are available to the community during flu season. Health screenings, medical supplies, and immunizations are provided to children through local health departments and health fairs with System sponsorship in many cases. The costs of these services are included in operating expenses. The System promotes health education and activities for students, parents, and teachers through its Partner-in-Education programs. The physicians of the System make significant contributions to improve the health status of the community, including involvement in many community activities promoting health awareness and improvement, emergency room care, and delivery of care to the indigent population of the System's service area. The System also made significant contributions to the nursing program at a local university. This financial support has helped to grow the program, which benefits the System as well as the community. The System and all but one of its affiliates have been recognized as organizations exempt from Federal income tax under Internal Revenue Code Section 501(A) as organizations described in Section 501(c)(3) and, therefore, related income is generally not subject to Federal or state income taxes. One of the System's affiliates is a controlled foreign corporation not subject to Federal income tax. The Physician Hospital Organization (EIN 58-2116179) is a taxable affiliate of the System and files IRS Form 1120 US Corporation Income Tax Return." Financial Data and Statistics (Services Provided System-Wide) - Licensed Beds - 1,350 Adult Discharges - 69,721 Newborn Discharges - 9,617 Emergency Room Visits - 362,947 Surgeries - 44,978 Cath Lab/Pacemakers/EP - 9,695 Non-ED O/P Radiology Procedures - 315,781 Med/Surg. Short Stay Cases - 59 GI Lab Procedures - 4,429 Radiology Oncology Procedures - 7,567 COMMUNITY BENEFITS - Wellstar Health System participates and collaborates with patients and residents in meeting health needs and improving the overall quality of life in the community. This is especially important in responding to the needs of the underserved regardless of the system's ability to generate a positive margin. Some services would possibly be discontinued if based on a purely financial basis. The following are some examples of the system's services that provide community benefits (and a monetary value of those benefits if known). Clinics Wellstar is affiliated with several clinics which provide free or discounted health services to persons who cannot afford to pay or those who are not expected to pay. Community Health/Education Wellstar's Marketing and Public Relations department provides free brochures on a variety of health-related issues. On a quarterly basis Wellstar sends out a wellness magazine entitled "Health and You" to 180,000 homes in the community/service area. The magazine provides information on health issues and a schedule of health related classes/seminars available throughout the system. While the magazine is an excellent referral source for Wellstar's varied services, it provides free medical information to the households receiving the publication. Wellstar provides support groups and educational opportunities to the community on a variety of topics (examples-- men's and women's health issues, palliative care, FORM 990, PART VI, LINE 12B AUDITED FINANCIAL STATEMENTS WellStar 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." 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 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. Currently the executive compensation committee consists of five members of the Board of Trustees as well as the CEO. 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 at the following committee meeting. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS MADE AVAILABLE TO THE PUBLIC The organization and its subsidiaries are subject to the Open Records Law in the State of Georgia. Therefore, by law, citizens are permitted to inspect and copy its governing documents, policies and financial statements as may be requested from time to time. Additionally, the organization's Form 990 is made readily available on the Guidestar website. Periodically, the organization publishes its financial performance in the local newspaper for citizens to review, and it also publishes a community benefit report once a year for distribution to the public. FORM 990, PART VII OFFICERS HOURS WORKED The officers devote their time to all of the organizations 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. 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 HEALTH SYSTEM, INC. HAD THE FOLLOWING CHANGES IN NET ASSETS: Pension Adjustment ($66,840,000) Assets Released from Restriction 708,000 Other Changes 1,322,551 -------------- Total Other Changes in Net Assets ($64,809,449) FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES TOTAL FEES:77598478 Wellstar Medical Group LLC 805 Sandy Plains Road Marietta GA 30066 273818647 Healthcare GA 0 0 WHS Inc Cobb Gynecologists 2 LLC 805 Sandy Plains Road Marietta GA 30066 020808099 Healthcare GA 0 0 NA South Cobb OB-GYN 2 LLC 805 Sandy Plains Road Marietta GA 30066 020808071 Healthcare GA 0 0 na WellStar Psychiatry LLC 805 Sandy Plains Road Marietta GA 30066 582500211 Healthcare GA 0 0 NA WellStar Kennestone OBGYN 2 LLC 805 Sandy Plains Road Marietta GA 30066 300355553 Healthcare GA 0 0 NA WellStar Kennestone OBGYN LLC 805 Sandy Plains Road Marietta GA 30066 582499183 Healthcare GA 0 0 NA WellStar Medical Specialists 2 LLC 805 Sandy Plains Road Marietta GA 30066 753261729 Healthcare GA 0 0 NA WellStar Homecare Billing Services LLC 805 Sandy Plains Road Marietta GA 30066 582479534 Healthcare GA 0 0 NA Wellstar Windy Hill Apothecary Bill Srv 805 Sandy Plains Road Marietta GA 30066 562511925 Healthcare GA 0 0 NA Wellstar Home Health LLC 805 Sandy Plains Road Marietta GA 30066 270277843 Healthcare GA 0 0 WHS INC Wellstar Health Network LLC 805 Sandy Plains Road Marietta GA 30066 273870970 Healthcare GA 0 0 WHS Inc Wellstar Health Ventures LLC 805 Sandy Plains Road Marietta GA 30066 453754932 Healthcare GA 0 0 WHS INC Wellstar IPA LLC 805 Sandy Plains Road Marietta GA 30066 581649541 Insurance GA 0 0 NA Wellstar Community Hospice LLC 805 Sandy Plains Road Marietta GA 30066 134350580 Healthcare GA 0 0 NA Center for Health Transformation 805 Sandy Plains Road Marietta GA 30066 581649541 Healthcare GA 0 0 NA WellStar Clinical Partners LLC 805 Sandy Plains Road Marietta GA 30066 581649541 HEALTHCARE GA 0 0 NA CHS Foundation Inc 805 Sandy Plains Road Marietta GA 30066 581649540 Foundation GA 501(C)(3) 11 Type 2 WHS true Cobb Hospital Inc 805 Sandy Plains Road Marietta GA 30066 580968382 Healthcare GA 501(C)(3) 3 WHS true Douglas Hospital Inc 805 Sandy Plains Road Marietta GA 30066 582026750 Healthcare GA 501(C)(3) 3 WHS true Kennestone Hospital Inc 805 Sandy Plains Road Marietta GA 30066 582032904 Healthcare GA 501(C)(3) 3 WHS true Paulding Medical Center Inc 805 Sandy Plains Road Marietta GA 30066 582095884 Healthcare GA 501(C)(3) 3 WHS true Wellstar Foundation Inc 805 Sandy Plains Road Marietta GA 30066 581627413 Foundation GA 501(C)(3) 11 Type 2 WHS true Kennestone EAST Parking Deck LLC 793 SAWYER ROAD Marietta GA 300666340 200537100 PARKING GA NA investment -50032 2433017 false 0 false 0.73000 Cobb Hospital Parking DECK LLC 805 Sandy Plains Road Marietta GA 300666340 752999669 PARKING GA NA INVESTMENT 35474 684228 false 0 false 0.62500 Community Assurance Co 3rd Fl Barclays Hse Shedden Rd George Town Cayman Islands CJ 581649541 INSURANCE CJ WHS INC C-CORP 14877506 66909587 1.00000 true false false false false false false false true true true false false false true true true true true Cobb Hospital Inc q 67219347 actual cost Douglas Hospital Inc q 25904585 actual cost Kennestone Hospital Inc q 146797654 actual cost Paulding Medical Center Inc q 21975864 actual cost WELLSTAR FOUNDATION INC q 1252465 actual cost COBB HOSPITAL PARKING DECK LLC S 78599 ACTUAL COST SCHEDULE R, PART V, LINE 2 The 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. organizations.