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KENNESTONE HOSPITAL INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
KENNESTONE HOSPITAL INC (EIN 58-2032904)
Tax period
2013-07-01 to 2014-06-30
Filed
2015-05-15
IRS object ID
201521359349302422
Schema version
2013v4.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2015-05-15T09:02:03-05:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PricewaterhouseCoopers LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12001 MARKET ST SUITE 1700AddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code19103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN582032904EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KENNESTONE HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of% JAMES M SWARTZInCareOfNm
Business Name ControlKENNBusinessNameControlTxt
Phone7707925023PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1805 Sandy Plains RoadAddressLine1
Address Line2SuiteAddressLine2
CityMariettaCity
StateGAState
ZIP Code300666340ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJAMES SWARTZPersonNm
Person TitleVP ACCOUNTINGPersonTitleTxt
Phone7709567827PhoneNum
Signature2015-05-08SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMATTHEW D PETROSKIPreparerPersonNm
PTINP00853132PTIN
Phone7709567827PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerREYNOLD J JENNINGSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1805 SANDY PLAINS ROADAddressLine1
CityMARIETTACity
StateGAState
ZIP Code30066ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$836,438,847GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.wellstar.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1993FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionTo provide world-class charitable healthcare to the community.ActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers389TotalVolunteersCnt
Total Gross UBI$570,939TotalGrossUBIAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$772,656,090PYProgramServiceRevenueAmt
CY Program Service Revenue$816,044,685CYProgramServiceRevenueAmt
PY Investment Income-$468,013PYInvestmentIncomeAmt
CY Investment Income$242,878CYInvestmentIncomeAmt
PY Other Revenue$18,814,851PYOtherRevenueAmt
CY Other Revenue$20,151,284CYOtherRevenueAmt
PY Total Revenue$791,002,928PYTotalRevenueAmt
CY Total Revenue$836,438,847CYTotalRevenueAmt
PY Grants And Similar Paid$890PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$500CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$289,902,566PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$291,503,229CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$377,828,313PYOtherExpensesAmt
CY Other Expenses$431,687,279CYOtherExpensesAmt
PY Total Expenses$667,731,769PYTotalExpensesAmt
CY Total Expenses$723,191,008CYTotalExpensesAmt
PY Revenues Less Expenses$123,271,159PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$113,247,839CYRevenuesLessExpensesAmt
Total Assets BOY$571,422,413TotalAssetsBOYAmt
Total Assets EOY$650,984,427TotalAssetsEOYAmt
Total Liabilities BOY$279,660,854TotalLiabilitiesBOYAmt
Total Liabilities EOY$265,817,652TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$291,761,559NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$385,166,775NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO CREATE AND DELIVER HIGH QUALITY HOSPITAL, PHYSICIAN AND OTHER HEALTHCARE RELATED SERVICES THAT IMPROVE THE HEALTH AND WELL-BEING OF THE INDIVIDUALS AND COMMUNITIES WE SERVE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$645,573,909ExpenseAmt
Grant$500GrantAmt
Revenue$816,044,685RevenueAmt
DescAs discussed herein, Kennestone Hospital, Inc (an affiliate of Wellstar Health System, Inc.) operates as a charitable organization consistent with the requirements of Internal Revenue Code Section 501(c)(3) and the "community benefit standard" of IRS Revenue Ruling 69-545. In this regard, the governing body of the organization and/or its parent is composed of prominent citizens in the community, medical staff privileges in the hospital are available to all qualified physicians in the area, consistent with the size and nature of the facility; one of the hospitals operates a full-time emergency room open to all regardless of the ability to pay; the hospital provides care to needy members of its community consistent with its charity care policy regardless of their ability to pay for these services and admits as patients those able to pay for care, either themselves or through third-party payers such as private health insurance or government programs such as Medicare and Medicaid; and the hospital's excess funds are generally applied to expansion and replacement of existing facilities and equipment, amortization of indebtedness, improvement in patient care, community benefit activities, and charity care. Kennestone Hospital, Inc. consists of two hospitals, Wellstar Kennestone and Wellstar Windy Hill. These hospitals combined to invest approximately $101.4 million in capital expenditures for the fiscal period. Wellstar Kennestone Hospital is a general acute hospital which provides a full range of inpatient and outpatient services for the overall health of the community. The hospital is located in Marietta, Georgia. The original hospital was constructed in 1950. The present main building was constructed in 1975. Kennestone is licensed to operate 633 beds and is currently staffed to operate 588 beds. Wellstar Windy Hill Hospital is located in the unincorporated area of Cobb County in northwest metropolitan Atlanta. It is an acute care hospital concentrating at the present time on long term care inpatient and outpatient services. The original structure was built in 1973 and renovated in 1987. The beds at Windy Hill serve medically complex patients whose average stay is approximately 30 days. Kennestone Hospital, Inc. affiliated with Northwest Georgia Health System in 1993. In 1994 Northwest Georgia Health System helped form the Promina Health System and changed its name to Promina Northwest Health System. In 1998 Promina Northwest changed its name to Wellstar Health System. Wellstar became totally independent of Promina in 2000. Kennestone Hospital, Inc. was organized in 1993 and is subordinate to, and subject to the authority of, Wellstar Health System and its governing board. Kennestone offers most major inpatient clinical services, a variety of outpatient services, women's services and open heart surgery. It is one of the largest hospitals in the state of Georgia. Kennestone is also home to a variety of state-of-the-art procedures and equipment not offered elsewhere in the larger Atlanta metro service area. The hospital has also opened several satellite outpatient imaging centers to provide easier access to our patient population. One additional service offered on the campus of Kennestone is called Atherton Place. This residential facility provides independent housing as well as assisted living to residents needing these services--especially the elderly. Kennestone also now operates a residential hospice facility at Kennesaw Mountain near the Kennestone campus. Windy Hill has transitioned its focus to long-term inpatient and outpatient services. These services include a concentration in geriatrics, rehabilitation, orthopedics and senior care. An additional service offered at Windy Hill Hospital includes a women's imaging department. The following stats constitute the overall program services for the period ended June 30, 2013: Kennestone Hospital Total Adult Discharges-35,895 Med/Surg Short StayCases-1,073 Newborn Discharges-5,418 Emergency Room Visits-122,883 Total surgery cases-22,736 Non ED OP Radiology Procedures-151,685 Cath Lab Procedures-6,754 GI Lab Procedures-3,509 Radiology Oncology procedures-16,145 Total FTEs (Paid)-3,880 Windy Hill Hospital Total Adult Discharges-379 Total Surgery Cases-2,200 Non ED OP Radiology Procedures-10,205 GI Lab Procedures-312 Sleep Lab Procedures-1,928 Total FTEs (Paid)-248 Community Benefit Reporting Community Outreach and Health Improvements-$1,566,595 Unreimbursed Charity Care (at cost)-$44,751,019 (based on charges of $159.5 million) Health professions education-$221,678 Medicaid Shortfalls(at cost)-$5,664,727 Total community benefit expense for the two hospitals was $52,204,019. Community Benefits Detail Kennestone and Windy Hill, affiliates of Wellstar Health System, participate in many community and educational programs for the overall health and benefit of the area that it serves. The following are examples of programs or services that are provided by Kennestone Hospital, Inc. for the charitable benefit of the community: Community Health/Education Wellstar's Marketing and Public Relations department provides free brochures on a variety of health-related topics such as blood pressure, diabetes, cholesterol, osteoporosis, and nutrition. Kennestone Hospital specifically offers the community the space and instructors for many support groups and educational opportunities--some free of charge and others at a nominal fee (examples of the offerings are women's health, palliative care, birthing classes, etc.) Kennestone and Windy Hill also offer free and/or low cost screenings for health issues such as blood pressure, cholesterol, flu shots, and others. System-wide for the reporting period over 200,000 area residents were seen at either the screenings or health fairs. School Health Program--This program is operated in conjunction with area school systems and seeks to teach school-aged children about health and safety topics such as dental health, water safety, seat belt safety and others. Safe Kids-Cobb/Cherokee Wellstar and the Cobb Public Health Department sponsor safety education events on an annual basis to the community, specifically the Cobb County area. The safety initiatives are centered around car seat checks, bike helmets, water safety and other preventive initiatives. The mission is to reduce the number of accidental injuries for children ages 14 and under. The SafeKids Cobb program provided 1,700 car seat checks with a number of car seats distributed to families in need. The Partner-in-Education program provides health-related supplies and support to area elementary and middle schools. Through the "Partners in Ministry" program, the Pastoral Care Department leads a partnership between the health system and local area congregations to link between the spiritual and clinical community needs. Sponsorships and Community Activities As part of the October Breast Cancer Awareness Month WellStar and the WellStar Cancer Network has partnered with a local television station to sponsor "Buddy Check 11", an 11Alive program designed to encourage breast self exam. The participants choose a buddy and subsequently remind their buddy to perform a monthly self exam. The program is now in its third year. WellStar Health System was the only Atlanta health system honored with a "Celebrating Our Heritage" Award by Renovacion Conyugal, a nonprofit organization dedicated to strengthening, supporting and empowering Latino youth. WellStar has a 10-year partnership with the organization to provide financial and facility support. Team members from the Acworth Health Park participated in the building of a Habitat for Humanity home in Acworth, Georgia. The home was built on property donated to Northwest Atlanta Habitat by a retired Army Lt Col Ashley Ivey before his passing. He had stipulated that a home be built and presented to a disabled veteran. Accomplishments and Recognition Kennestone and Windy Hill Hospitals are accredited by the Joint Commission. Wellstar was granted accreditation by the Intersocietal Commission for the Accreditation of Echocardiography Labs after rigorous testing and quality outcomes for diagnosis of heart disease. All five Wellstar hospital labs earned "Accreditation with Distinction" from the College of American Pathologists (CAP), recognized as one of the most stringent in laboratory quality assurance. Wellstar's labs are part of the 6,000 CAP-accredited laboratories nationwide. Wellstar Sleep Disorders Center at Windy Hill Hospital offers world class care as one of the 10 largest sleep centers nationwide. The center consists of 12 rooms with more board-certified sleep specialists on staff than any sleep center in the southeast US. The program is accredited by the American Academy of Sleep Medicine. As affiliates of Wellstar Health System, Kennestone and Windy Hill are part of a system that is ranked in the Top 100 in the nation according to Verispan's annual listing of the Top 100 InDesc
Total Program Service Expenses$645,573,909TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
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PY Excess Benefit TransfalsePYExcessBenefitTransInd
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Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
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IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
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Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
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Excess Business HoldingsfalseExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
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Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJAMES M SWARTZPersonNm
Phone7707925023PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1805 SANDY PLAINS ROADAddressLine1
CityMariettaCity
StateGAState
ZIP Code300666340ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (80 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
AVRIL P BECKFORD MD
TRUSTEE2.048.0Yes (X)$0$456,909$29,970
RANDALL BENTLEY JR
TRUSTEE1.05.0Yes (X)$0$20,619$0
OTIS BRUMBY III
TRUSTEE1.05.0Yes (X)$0$3,687$0
SHAN COOPER
TRUSTEE1.05.0Yes (X)$0$1,218$0
ROBERT N CROSS MD
TRUSTEE1.05.0Yes (X)$0$5,266$0
T E RUSTY DURHAM
TRUSTEE1.014.0Yes (X)$0$37,928$13,445
THOMAS GEARHARD MD
TRUSTEE2.048.0Yes (X)$0$484,242$72,307
DAVID HAFNER MD
TRUSTEE1.05.0Yes (X)$0$24,386$0
T FITZ JOHNSON
TRUSTEE1.05.0Yes (X)$0$18,008$0
CHARLES J JONES
TRUSTEE1.05.0Yes (X)$0$17,308$0
JANIE MADDOX
TRUSTEE - CHAIR1.05.0Yes (X)$0$19,581$0
GARY A MILLER
TRUSTEE - VICE CHAIR1.05.0Yes (X)$0$4,249$0
STEVEN W OWEIDA MD
TRUSTEE1.05.0Yes (X)$0$0$21,472
TOM PHILLIPS
TRUSTEE1.05.0Yes (X)$0$2,734$0
WALTER G ROBINSON
TRUSTEE1.05.0Yes (X)$0$10,640$0
FRANK ROS
TRUSTEE1.05.0Yes (X)$0$3,747$0
W ALLEN SEPARK
TRUSTEE1.07.0Yes (X)$0$9,844$0
JEFFERY THARP MD
TRUSTEE2.048.0Yes (X)$0$566,320$72,948
VALERY A AKOPOV MD
VP & CHIEF HOSPITALISTS2.048.0$0$394,355$53,783Yes (X)
DAVID W ANDERSON
EXEC VP HR/OL/CCO2.048.0$0$590,159$64,119Yes (X)
NICOLE V ASHE
VP FINANCE & CFO WMG2.048.0$0$256,832$46,130Yes (X)
BARBARA G BALLARD
VP HOMECARE & HOSPICE2.048.0$0$376,870$73,407Yes (X)
JOSEPH L BRYWCZYNSKI
SVP HEALTH PARKS DEVELOPMENT2.048.0$0$319,737$59,522Yes (X)
A JAMES BUDZINSKI
EXEC VP and CFO2.050.0$0$645,375$67,649Yes (X)
DONALD CAMPBELL MD
SVP PHYS EDUC & STUDENT AFF2.048.0$0$437,419$45,134Yes (X)
LAURA CARAMANICA
VP CNO PATIENT CARE SRV KENNE50.00.0$303,372$0$55,319Yes (X)
LEE RANDOLPH COOK
VP MEDICINE & BEHAVIORAL HLTH2.048.0$0$292,193$48,389Yes (X)
BARBARA B COREY
SVP MANAGED CARE2.048.0$0$353,009$44,619Yes (X)
BRUCE A DEAN
VP REAL ESTATE & DEP GEN COUN2.048.0$0$260,414$64,294Yes (X)
SARATH DEGALA
VP REVENUE CYCLE MGMT2.048.0$0$289,953$34,966Yes (X)
MARCIA DELK-PAYNE MD
SVP MED AFFAIRS & CQO2.048.0$0$434,313$51,552Yes (X)
MARTIN L GUTKIN
VP FINANCE & HOSPITAL CFO50.00.0$239,617$0$12,168Yes (X)
ROBERT D JANSEN MD
EXEC VP & PRES WMG2.048.0$0$791,804$71,531Yes (X)
REYNOLD J JENNINGS
PRESIDENT & CEO2.050.0$0$1,389,700$2,200Yes (X)
CHRISTOPHER M KANE
SVP STRATEGIC PLAN & BUS DEV2.048.0$0$403,363$54,031Yes (X)
BETH KOST
VP COMPLIANCE & CHF PRVCY OFCR2.048.0$0$278,339$37,798Yes (X)
ELLEN LANGFORD
VP & COO WELLSTAR PHYS GRP2.048.0$0$251,119$36,691Yes (X)
LOUIS W LITTLE
SVP POST ACUTE & HOSP PRES48.02.0$303,532$0$53,864Yes (X)
ROBERT M LUBITZ MD
VP MEDICAL AFFAIRS KH50.00.0$377,038$0$49,781Yes (X)
ROBERT MANDLER
VP DIAGNOSTIC OUTREACH2.048.0$0$274,343$59,721Yes (X)
CAROL B MAXWELL
VP TALENT ACQUISTION2.048.0$0$128,331$12,302Yes (X)
PATRICIA A MAYNE
VP EMERGENCY SERVICES50.00.0$226,244$0$41,555Yes (X)
KIMBERLY W MENEFEE
SVP MARKETING & GOV'T AFFAIRS2.048.0$0$334,382$49,550Yes (X)
JONATHAN B MORRIS MD
SVP & CIO2.048.0$0$479,551$47,874Yes (X)
BRADFORD B NEWTON
VP INFO TECHNOLOGY ADMIN2.048.0$0$215,090$38,727Yes (X)
LEO E REICHERT
EXEC VP & GENERAL COUNSEL2.048.0$0$595,331$27,431Yes (X)
MICHELLE M ROBINSON
VP MARKETING/PR/INTERNAL COMM2.048.0$0$230,978$33,982Yes (X)
DEBORAH ROEGGE DE VITA
VP WOMEN & NEWBORN SVC LINE2.048.0$0$243,970$8,440Yes (X)
CANDICE L SAUNDERS
PRESIDENT & COO2.048.0$108,137$539,392$65,639Yes (X)
CHRISTOPHER B SCULLEN
VP PULMONARY OPERATIONS2.048.0$0$196,607$2,497Yes (X)
JEFFERY D STANLEY
VP PHARMACY & SYS COORDINATOR2.048.0$0$200,737$27,947Yes (X)
JAMES M SWARTZ
VP ACCOUNTING2.048.0$0$228,870$36,502Yes (X)
MARY L TAVERNARO
VP HUMAN RESOURCES OPERATIONs2.048.0$0$241,535$41,187Yes (X)
ADAM C THOMPSON
VP SURGERY2.048.0$0$202,684$17,822Yes (X)
AMANDA TRASK
VP OPERATIONS KENNESTONE50.00.0$116,650$0$28,155Yes (X)
ANTHONY M TRUPIANO
SVP SUPPLY CHAIN2.048.0$0$361,685$47,393Yes (X)
MARY L WESLEY
SVP NURSING SERVICES CNE2.048.0$0$349,633$56,860Yes (X)
ROBIN WILSON MD
SVP CHIEF HLTH INNOV OFFICER2.048.0$0$510,364$28,431Yes (X)
DANIEL J WOODS
SVP & PRES KENNESTONE HOSPITAL48.02.0$425,017$73,209$80,773Yes (X)
CHESTER A ZBOROWSKI
VP HEALTH PARK OPERATIONS2.048.0$0$207,340$18,413Yes (X)
KRISTYN GREIFER MD
VP POPULATION MANAGEMENT2.048.0$0$263,708$10,138Yes (X)
PETER JUNGBLUT MD
SVP & MEDICAL DIRECTOR WMG2.048.0$0$358,267$56,395Yes (X)
JAMES CLEMENTS
VP BUS DEV & STRATEGIC PRTNSHP2.048.0$0$131,463$11,124Yes (X)
JIMMY FRANCIS
VP INFO TECHNOLOGY OPERATIONS2.048.0$0$150,343$580Yes (X)
STEVEN GRACE
VP TALENT ACQUISITION2.048.0$0$144,341$4,206Yes (X)
ELIZABETH LOUDERMILK
VP ENT INTELLIGENCE & INTGRTN2.048.0$0$240,446$11,978Yes (X)
SANDRA LUCIUS
VP INFO TECHNOLOGY APPS2.048.0$0$177,459$26,570Yes (X)
MICHAEL PAUL
VP FACILITIES ENG SUPPORT SVCS2.048.0$0$86,864$1,985Yes (X)
BETHANY ROBERTSON
VP & CHIEF LEARNING OFFICER2.048.0$0$200,645$39,317Yes (X)
RICHARD SIEGEL
VP CARDIOLOGY & CVM ADMIN2.048.0$0$337,829$62,810Yes (X)
DANIEL STYF
SVP PW HEALTH PLAN2.048.0$0$185,654$13,376Yes (X)
MONTE WILSON
VP & COO KENNESTONE50.00.0$143,154$0$3,318Yes (X)
BETTY BRAKOVICH
VP CNO PATIENT CARE SERVICES50.00.0$188,531$0$35,454Yes (X)
JYOTSNA R VANAPALLI
RADIATION ONCOLOGY PHYSICIST50.00.0$194,946$0$33,722Yes (X)
ROBERT J DeCOUX
AVP HUMAN RESOURCES50.00.0$169,607$0$34,564Yes (X)
LOUIS LOVETT
AVP PHYSICIAN ADVISOR50.00.0$272,157$0$66,672Yes (X)
ANN E GRAY
RN CLINICAL NURSE50.00.0$161,458$0$24,197Yes (X)
SHERRON KURTZ
EXEC DIR SURGICAL SVCS KH/CH50.00.0$174,441$0$14,912Yes (X)
MICHAEL L GRAUE
FMR EXEC VP & COO0.00.0$0$1,166,074$36,144Yes (X)
KENNETH C KUNZE MD
FMR SVP & CHIEF MEDICAL OFCR0.00.0$0$665,985$26,607Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,403,901TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$19,174,750TotReportableCompRltdOrgAmt
Total Other Compensation$2,522,359TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K253IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
Brasfield Gorrie
1990 Vaughn Rd NW Suite 100KENNESAWGA30144General Contractor$30,744,086
CDH Partners Inc
675 Tower RoadMARIETTAGA30060General Contractor$2,741,282
Batchelor and Kimball Inc
PO Box 70LITHONIAGA30058Maintenance$4,690,645
Emory Clinic Inc
101 W Ponce De Leon Ave Suite 400DECATURGA30030Medical Services$1,383,409
Quest Diagnostics
PO Box 740736ATLANTAGA303740736Medical Services$2,055,540
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K44CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT REVENUE621990$809,994,301$809,994,301
MEDICAL RECORDS621990$420$420
INDEPENDENT & ASSISTED LIVING REVENUE623000$5,939,724$5,939,724
PATIENT EDUCATION621990$110,240$110,240
FieldValueIRS element (for citing)
Total Program Service Revenue$816,044,685TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$453,313RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$453,313RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$453,313TotalRevenueColumnAmt
Exclusion$453,313ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$242,878OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$242,878OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$242,878TotalRevenueColumnAmt
Exclusion$242,878ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
PHARMACY/RETAIL PHARMACY446199$10,029,704$570,939$9,458,765
LAB OUTREACH621990$230,848$230,848
CAFETERIA621990$4,694,100$4,694,100

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,743,319TotalRevenueColumnAmt
Exclusion$4,743,319ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$19,697,971OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$836,438,847TotalRevenueColumnAmt
Related Or Exempt Func Income$816,044,685RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$570,939UnrelatedBusinessRevenueAmt
Exclusion$19,823,223ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$500TotalAmt
Program Services$500ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,757,741TotalAmt
Program Services$2,404,444ProgramServicesAmt
Management And General$353,297ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$239,691,413TotalAmt
Program Services$217,424,564ProgramServicesAmt
Management And General$22,266,849ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$9,896,745TotalAmt
Program Services$8,972,558ProgramServicesAmt
Management And General$924,187ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$21,276,382TotalAmt
Program Services$19,297,416ProgramServicesAmt
Management And General$1,978,966ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$17,880,948TotalAmt
Program Services$16,213,304ProgramServicesAmt
Management And General$1,667,644ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$50,436TotalAmt
Program Services$0ProgramServicesAmt
Management And General$50,436ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$30,777,430TotalAmt
Program Services$30,744,829ProgramServicesAmt
Management And General$32,601ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$209,530TotalAmt
Program Services$168,457ProgramServicesAmt
Management And General$41,073ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$30,288,579TotalAmt
Program Services$28,169,185ProgramServicesAmt
Management And General$2,119,394ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$13,144,084TotalAmt
Program Services$5,539,645ProgramServicesAmt
Management And General$7,604,439ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$243,510TotalAmt
Program Services$206,311ProgramServicesAmt
Management And General$37,199ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$260,119TotalAmt
Program Services$199,627ProgramServicesAmt
Management And General$60,492ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$4,285TotalAmt
Program Services$0ProgramServicesAmt
Management And General$4,285ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$156,879,274TotalAmt
Program Services$142,276,397ProgramServicesAmt
Management And General$14,602,877ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$35,227,759TotalAmt
Program Services$18,175,324ProgramServicesAmt
Management And General$17,052,435ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$6,850,727TotalAmt
Management And General$6,850,727ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
REPAIRS & MAINTENANCE$12,217,321$9,867,634$2,349,687
MEDICAL SUPPLIES$145,349,422$145,865,932-$516,510
OTHER OPERATING EXPENSES$184,803$47,782$137,021

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$723,191,008TotalAmt
Program Services$645,573,909ProgramServicesAmt
Management And General$77,617,099ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$21,975BOYAmt
EOY$32,275EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY-$17,973BOYAmt
EOY$104,910EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$147,987,765BOYAmt
EOY$193,622,402EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$13,895,896BOYAmt
EOY$15,840,014EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$6,697,514BOYAmt
EOY$4,384,708EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$771,139,502LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$338,612,860LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$394,313,943BOYAmt
EOY$432,526,642EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$1,280,943BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$7,242,350BOYAmt
EOY$4,473,476EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$571,422,413BOYAmt
EOY$650,984,427EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$32,046,308BOYAmt
EOY$29,668,001EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$18,178BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$247,596,368BOYAmt
EOY$236,149,651EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$279,660,854BOYAmt
EOY$265,817,652EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$291,761,559BOYAmt
EOY$385,166,775EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$291,761,559BOYAmt
EOY$385,166,775EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$571,422,413BOYAmt
EOY$650,984,427EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$113,247,839ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$19,842,623OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$44,606,550OtherCostOrOtherBasisAmt
Book Value$44,606,550BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$419,537,115OtherCostOrOtherBasisAmt
Depreciation$139,192,632DepreciationAmt
Book Value$280,344,483BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,653,494OtherCostOrOtherBasisAmt
Depreciation$5,325,086DepreciationAmt
Book Value$10,328,408BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$287,118,891OtherCostOrOtherBasisAmt
Depreciation$193,551,030DepreciationAmt
Book Value$93,567,861BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,223,452OtherCostOrOtherBasisAmt
Depreciation$544,112DepreciationAmt
Book Value$3,679,340BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$432,526,642TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
ASSET RETIREMENT - OTHER LT$1,127,380
TAX EXEMPT BOND LIAB-DUE TO WHS$235,022,271
FieldValueIRS element (for citing)
Total Liability$236,149,651TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D Part X Line 2 FIN 48 FOOTNOTEFormAndLineReferenceDesc
ExplanationThe following footnote is related to the organization's application of FIN 48 (ASC 740). "Wellstar (including Douglas Hospital) and all but one of its affiliates have been recognized as exempt from Federal income tax under Internal Revenue Code Section 501 (a) as organizations described in Section 501 (c)(3) and, therefore, related income is generally not subject to Federal or state income taxes. Community Assurance Corporation is a controlled foreign corporation not subject to Federal tax. Wellstar applies FASB ASC 740, Income Taxes, which addresses accounting for uncertainties in income tax positions. It also provides guidance on when tax positions are recognized in an entity's financial statements and how the values of these positions are determined. There is no impact on Wellstar's combined financial statements as a result of the application of ASC 740."ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other125.FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$27,774,515TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$27,774,515NetCommunityBenefitExpnsAmt
Total Expense0.03840TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$66,335,267TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$54,978,129DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,357,138NetCommunityBenefitExpnsAmt
Total Expense0.01570TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$94,109,782TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$54,978,129DirectOffsettingRevenueAmt
Net Community Benefit Expns$39,131,653NetCommunityBenefitExpnsAmt
Total Expense0.05410TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,854,622TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,854,622NetCommunityBenefitExpnsAmt
Total Expense0.00260TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$267,012TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$52,457DirectOffsettingRevenueAmt
Net Community Benefit Expns$214,555NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,121,634TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$52,457DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,069,177NetCommunityBenefitExpnsAmt
Total Expense0.00290TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$96,231,416TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$55,030,586DirectOffsettingRevenueAmt
Net Community Benefit Expns$41,200,830NetCommunityBenefitExpnsAmt
Total Expense0.05700TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$35,944,468BadDebtExpenseAmt
Bad Debt Expense Attributable$8,539,536BadDebtExpenseAttributableAmt
Reimbursed By Medicare$244,911,643ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$300,420,166CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$55,508,523MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities2HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeWebsite AddressWebsiteAddressTxtState LicenseStateLicenseNumLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndEmergency Room24 HrsEmergencyRoom24HrsIndOtherOtherDesc
KENNESTONE HOSPITAL
1677 CHURCH STREETMARIETTAGA30060www.wellstar.org033-548Yes (X)Yes (X)Yes (X)HEALTH PARK INPATIENT HOSPICE
WINDY HILL HOSPITAL
22540 WINDY HILL ROADMARIETTAGA30067www.wellstar.org033-545Yes (X)Yes (X)LONG TERM ACUTE CARE

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

FacilityFacilityNumCHNA ConductedCHNAConductedIndCommunity DefinitionCommunityDefinitionIndCommunity DemographicsCommunityDemographicsIndExisting ResourcesExistingResourcesIndHow Data ObtainedHowDataObtainedIndCommunity Health NeedsCommunityHealthNeedsIndOther Health IssuesOtherHealthIssuesIndCommunity Hlth Needs Id ProcessCommunityHlthNeedsIdProcessIndConsulting ProcessConsultingProcessIndInformation GapsInformationGapsIndOtherOtherIndCHNA ConductedCHNAConductedYrTake Into Account Others InputTakeIntoAccountOthersInputIndCHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsIndCHNA Report Widely AvailableCHNAReportWidelyAvailableIndRpt Available On Own WebsiteRptAvailableOnOwnWebsiteIndRpt Available Upon RequestRptAvailableUponRequestIndAdopt Implementation StrategyAdoptImplementationStrategyIndDevelop Community Wide PlanDevelopCommunityWidePlanIndInclude Operational PlanIncludeOperationalPlanIndPrioritize Health NeedsPrioritizeHealthNeedsIndAll Needs AddressedAllNeedsAddressedIndOrganization Incur Excise TaxOrganizationIncurExciseTaxIndElig Criteria ExplainedEligCriteriaExplainedIndFPG Used Deter Elig Free CareFPGUsedDeterEligFreeCareIndFPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePctFPG Used Determ Elig Dscnt CareFPGUsedDetermEligDscntCareIndFPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePctExplained BasisExplainedBasisIndIncome LevelIncomeLevelIndMedical IndigencyMedicalIndigencyIndInsurance StatusInsuranceStatusIndUninsured DiscountUninsuredDiscountIndMedicaid MedicareMedicaidMedicareIndState RegulationStateRegulationIndApp Financial Asst ExplnAppFinancialAsstExplnIndIncludes Publicity MeasuresIncludesPublicityMeasuresIndPosted On WebsitePostedOnWebsiteIndAttached To InvoiceAttachedToInvoiceIndPosted In Emergency RoomPostedInEmergencyRoomIndPosted In Admission OfficePostedInAdmissionOfficeIndProvided On AdmissionProvidedOnAdmissionIndAvailable On RequestAvailableOnRequestIndOther PublicityOtherPublicityIndFAP Actions On NonpaymentFAPActionsOnNonpaymentIndCollection ActivitiesCollectionActivitiesIndFAP Notified Upon AdmissionFAPNotifiedUponAdmissionIndFAP Notified Before DischargeFAPNotifiedBeforeDischargeIndFAP Notified All PatientsFAPNotifiedAllPatientsIndDocumented Elig DeterminationDocumentedEligDeterminationIndNondis Emergency Care PolicyNondisEmergencyCarePolicyIndAverage Negotiated RatesAverageNegotiatedRatesIndAmounts Generally BilledAmountsGenerallyBilledIndGross ChargesGrossChargesInd
KENNESTONE HOSPITAL
1Yes (true)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)12Yes (true)falseYes (true)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)falsefalseYes (true)Yes (true)125.Yes (true)300.Yes (true)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (true)Yes (true)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (true)falseYes (X)Yes (X)Yes (X)Yes (X)Yes (true)Yes (X)falsefalse
WINDY HILL HOSPITAL
Yes (true)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)12Yes (true)falseYes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)falsefalseYes (true)Yes (true)125.Yes (true)300.Yes (true)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (true)Yes (true)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (true)falseYes (X)Yes (X)Yes (X)Yes (X)Yes (true)Yes (X)falsefalse

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H Part I Line 6aKennestone Hospital, Inc.(consisting of Kennestone Hospital and Windy Hill Hospital) is an affiliate of Wellstar Health System, Inc. which on an annual basis issues a community benefit report. This report is subsequently distributed in and around the five county service area of the health system. It is also annually filed with Cobb County and the state of Georgia Department of Community Health. Additionally the information on community benefit is included in aggregate for Wellstar Health System, Inc. and affiliated hospitals as part of the Georgia Hospital Association's annual report.
Schedule H Part I Line 7For purposes of the IRS Form 990 Schedule H, Wellstar Health System and Affiliates (including Kennestone and Windy Hill Hospitals) have estimated the current year cost to charge ratio for each hospital as it is reported in the annual community benefit report and as it will be reported in the state's Annual Hospital Financial Survey.
Schedule H Part III Line 4The following footnote is detailed in the Wellstar Health System, Inc. and Affiliates Combined Financial Statements related to bad debt or uncollectible accounts: "During 2011, Wellstar adopted the provisions of FASB Accounting Standards Update (2011-07), Healthcare Entities (Topic 954). ASU 2011-07 requires the reclassification of the provision for uncollectible accounts associated with patient service revenue from an operating expense to a deduction from patient service revenue (net of contractual allowances and discounts)." " Wellstar recognizes patient service revenue associated with services provided to patients with third-party payor coverage on the basis of contractual rates for the services rendered. For uninsured patients that do not qualify for community financial aid, Wellstar recognizes revenue on the basis of its discounted rates for services provided. On the basis of historical experience, a significant portion of Wellstar's uninsured patients are unable or unwilling to pay for the services provided. Thus, Wellstar records a significant provision for uncollectible accounts related to uninsured patients in the period the services are provided." Subsequent to the end of the reporting period a propensity to pay review of patient accounts often results in prior year bad debt accounts which are deemed eligible for the organization's financial assistance policy. Those bad debt accounts are reclassified as charity and thus our rationale for including in community benefit.
Schedule H Part III Line 8Kennestone and Windy Hill Hospitals are providers 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 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.
Sch H Part III Sec C Line 9bThe 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 VKennestone Hospital is a general acute care hospital providing a full range of services, is licensed to operate 633 beds, and is presently staffed to operate 588 beds. It is located on an approximately 41-acre campus in Marietta, Georgia and is housed within a complex of connected buildings containing a total square footage in excess of 1,112,000 square feet. The original hospital was constructed in 1950, major structural additions were made during the 1960s, 1975, 1998, and 2006. A new patient tower was completed in 2005 and greatly expanded the cardiac services capabilities of the hospital. Additionally a fourth patient tower recently opened to transition the hospital to private rooms from the current semi-private bed methodology. Kennestone Hospital provides medical, surgical, obstetrical, and rehabilitative inpatient care and outpatient care, including one of the busiest emergency rooms in the state of Georgia--recently designated a level II Trauma center for the service area. The hospital experiences over 300,000 annual visits in its adult and pediatric emergency room facilities. With its full range of inpatient and outpatient services the hospital has expanded programs in open-heart surgery and services including a Congestive Heart Failure Clinic which opened in February of 2012; ambulatory surgery; oncology services and surgery including cyberknife technology; radiology services and surgery; and women's and children's services. In May of 2012, Kennestone began performing Transcatheter Aortic Valve Replacement surgery (TAVR). Windy Hill Hospital, located in the unincorporated area of Cobb County in northwest metropolitan Atlanta, is an acute care hospital concentrating on long-term acute inpatient and outpatient services. It is licensed to operate 115 beds, is presently staffed to operate 55 beds, is located on an approximately 15-acre campus, and contains total square footage of approximately 100,000 square feet. A twelve bed sleep disorder center is located at Windy Hill. Windy Hill was originally constructed in 1973 and renovated in 1987. The main areas of focus for Windy Hill Hospital include long-term acute care, rehabilitation, orthopedics, and diagnostics. Windy Hill also offers a service in the treatment of sleep disorders.
Schedule H Part VI Line 2Wellstar Health System (and affiliates) is a key stakeholder in MAPP, Mobilizing for Action through Planning and Partnerships. MAPP, developed by the National Association of County and City Health Officials (NACCHO) in collaboration with the CDC, provides a structured guidance on creating and implementing a community-wide strategic planning process focused on improving the health and safety of our population. Through MAPP, a broad collection of community partners and residents come together to identify and prioritize health and safety issues and to identify resources for addressing them. The process results in an actionable community health improvement plan (CHIP) for measurable improvements in the community's health and quality of life as well as a scorecard for implementation and evaluation. The resulting community plan does not focus on one agency or community health challenge; rather, MAPP provides a long-term strategy that addresses the multiple factors that affect health in the community. Community involvement throughout the creation and the implementation of a health improvement plan results in creative solutions to community health problems with an improved focus on priorities, reduced duplication of services, increased collaboration on projects and activities, and increased capacity to garner additional resources. Moreover, continous community involvement leads to community ownership of the process. Community ownership, in turn, increases the credibility and sustainability of the health improvement efforts.
Schedule H Part VI Line 3Kennestone and Windy Hill Hospitals provide its patients with hospital personnel or contracted personnel who are trained in all aspects of governmental programs, payments plans, charity discounts, and other financial assistance offered to assist them in their hospital bills. If the patient is eligible for federal or state assistance programs, a staff member is knowledgeable in the steps necessary to qualify those individuals. If a 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 patient are afforded these opportunities.
Schedule H Part VI Line 4Kennestone and Windy Hill Hospitals are two of five hospitals that are affiliated with Wellstar Health System. The primary service area of the system is located in the Northwest Georgia area and receives the majority of its patients from one of five counties (Cherokee, Cobb, Douglas, Bartow and Paulding). Generally about 85% to 90% of the patient volume comes from this service area although other health systems have a presence in the area as well. Demographically the region is one of the fastest growing in the state as well as the country and the expansion of the services for the patient population reflects a desire to offer healthcare "closer to home" since Wellstar is considered a part of a larger metropolitan Atlanta market. Economically the region is strong in per capita income but given recent trends a rise in the uninsured and indigent population has occured.
Schedule H Part VI Line 5As stated in the Wellstar Health System, Inc and Affiliates audited financial statments for the period ended June 30, 2013, Kennestone and Windy Hill Hospitals (affiliates of Wellstar Health System, Inc.) operate as charitable organizations consistent with the requirements of Internal Revenue Code Sect 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 qualifed physicians in the area consistent with the size and nature of the facility; Kennestone Hospital operates a full-time emergency room open to all regardless of ability to pay; and the hospitals (Kennestone and Windy Hill) provide care to the needy members of the community consistent with its charity care policy. The hospital's excess funds are genrally applied to expansion and replacement of existing facilities and equipment, amortization of indebtedness, improvement fo patient care, community benefit activities, and charity care. Kennestone Hospital committed approximately $91.6 million and Windy Hill Hospital committed approximately $9.8 million in capital expenditures for the year to meet those needs.
Sch H Part V Line 13gIn addition to the other methods of posting the financial assistance policy, the hospital makes available for patients in admissions and outpatient registration areas a brochure including frequently asked questions.
Part V Section B Line 1jThe Community Health Needs Assessment for both Kennestone and Windy Hill also provide a list of WellStar Health System CHNA collaborators including individuals, organizations and governmental agencies consulted that contributed special knowledge of medically underserved and low income populations and/or expertise in public health
Part V Section B Line 3WellStar Kennestone and Windy Hill Hospitals integrated multiple sources of data from national and state web-based data platforms with multiple primary data gathering methods (see list below). As a partner in the strategic planning process utilized by Cobb & Douglas Public Health (CDPH) called Mobilizing for Action through Planning and Partners (MAPP) from the National Association of County & City Health Officials, the hospital leveraged the findings from community health needs assessments conducted in tax year 2012. Through a grant by the Centers for Disease Control and Prevention, WellStar Kennestone and Windy Hill partnered with CDPH and formed a coalition, Cobb 2020, to conduct its needs assessment via multiple modalities: MAPP workgroups, focus groups, surveys, Key Informant interviews, and implementation teams to act upon identified strategic issues in the community. To collect robust data for counties WellStar serves outside of Cobb, WellStar enlisted expertise of county and regional public health officials, independent consultants, and other Key Informants. A listing of collaborators can be found in the Appendix of both of the hospital facility's CHNA reports publicly available at wellstar.org. Quantitative Data Sources Including: 1. Georgia Department of Public Health, OASIS 2. Centers for Disease Control and Prevention (CDC) Vital Statistics 3. Agency for Healthcare Research and Quality (AHRQ) 4. U. S. Census Bureau 5. U.S. Department of Health and Human Services 6. Kaiser Permanente Web-Based CHNA Platform 7. Catholic Health Association CHNA resources 8. County Health Rankings & Roadmaps, University of Wisconsin 9. Healthy People 2020 10.Behavorial Risk Factor Surveillance System (BRFSS) 11.WellStar Health System - WellStar Kennestone & Windy Hill Hospital's FY2012 utilization data to assess service area zip codes accounting for 90 percent of hospital admissions and visits and primary service areas. Qualitative Data Sources Including: 1. Cobb County Focus Group Report-58 people participated in six focus group representing 14 zip codes. Demographics varied among the groups indicative of the zip codes represented. Two groups were conducted in Spanish and reflected low-income, low education attainment and medically underserved populations. 2. MAPP Assessment Workgroups with representatives from Douglas and Cobb counties conducted four community assessments which helped develop the Cobb2020 Community Health Improvement Plan. This included the 2011 Field Test Local Public Health System Assessment by the National Public Health Performance Standards Program (NPHPSP) 3. Cobb Key Informant Interview Report-20 participants identified by Cobb 2020's Community Strengths and Themes Workgroup to represent different sectors of the Cobb community who possessed above average knowledge of the healthcare issues, healthcare system or the community. 4. Cobb MAPP Community Survey Report-44-question telephone surveys of 1,244 adults ages 18-94 performed by the A.L. Burruss Institute for Public Service and Research, Kennesaw State University. 5. Cobb County 2010 - How Healthy Are We? 6. Cobb County MAPP Forces of Change Assessment Summary Report 7. Bartow, Cherokee and Paulding County Key Informant interviews of community stakeholders led by Ron Chapman, Principal, Magnetic North, LLC, a third-party consultant LLC, a third-party consultant
Part V Section B Line 4While both WellStar Kennestone and WellStar Windy Hill each conduct its own community health needs assessment there may be some overlap with the other hospitals in WellStar Health System simply because of the geographic constraints and structure of the organization. The community served therefore is defined by similar zip codes and areas of services.
Part V Section B Line 7Selection criteria for WellStar Kennestone and Windy Hill Hospital's prioritized health needs were primarily based upon the bandwidth to build a sustainable community benefit model focused on preventable health behaviors and access to care. Sexually transmitted infections and teen pregnancy are not addressed leaving awareness education with schools, family and churches since the health needs are more cultural and societal. Improvement to health needs stemming from socioeconomic and physical environmental such as air quality and transportation, gain traction from public policy and education. A health system can complement efforts to impact policy, but has to rely on public health, state and local municipalities and federal governmental agencies to drive these types of health improvements. Key questions when addressing health needs are do we have existing facilities and resources dedicated to the health needs showing clear disparities and poor performance? And do we have effective and feasible interventions, a successful solution that has the potential to solve multiple problems, and the opportunity to intervene at the prevention level? WellStar Health System, Inc. and its affiliates will continue to address these and other questions.
Part VI Line 6WellStar Health System, Inc., as the parent corporation, and Cobb Hospital, Douglas Hospital, Kennestone Hospital, Paulding Medical Center and Windy Hill Hospital provide a variety of health care and related services to the community. In addition a nursing home, two residential hospice facilities, an assisted living and retirement facility as well as a group of physicians provide a full continuum of care to the area we serve.
Schedule H Part VI Item 2In order to access the proposed Community Health Needs Assessment Implementation Strategy for Kennestone Hospital Inc. (Kennestone and Windy Hill Hospitals), a link has been established at www.wellstar.org under the "about us" tab of the website.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelYes (X)FirstClassOrCharterTravelInd
Travel For CompanionsYes (X)TravelForCompanionsInd
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Discretionary Spending AcctYes (X)DiscretionarySpendingAcctInd
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssfalseWrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (59 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
AVRIL P BECKFORD MD
TRUSTEE$0$389,384$0$60,399$0$7,126$0$28,100$0$1,870$0$486,879$0$0
THOMAS GEARHARD MD
TRUSTEE$0$384,953$0$90,185$0$9,104$0$43,876$0$28,431$0$556,549$0$0
JEFFERY THARP MD
TRUSTEE$0$468,886$0$90,202$0$7,232$0$45,600$0$27,348$0$639,268$0$0
VALERY A AKOPOV MD
VP & CHIEF HOSPITALISTS$0$310,404$0$70,715$0$13,236$0$28,100$0$25,683$0$448,138$0$0
DAVID W ANDERSON
EXEC VP HR/OL/CCO$0$404,417$0$159,785$0$25,957$0$45,600$0$18,519$0$654,278$0$0
NICOLE V ASHE
VP FINANCE & CFO WMG$0$214,535$0$31,427$0$10,870$0$22,501$0$23,629$0$302,962$0$0
BARBARA G BALLARD
VP HOMECARE & HOSPICE$0$232,916$0$126,392$0$17,562$0$45,600$0$27,807$0$450,277$0$0
JOSEPH L BRYWCZYNSKI
SVP HEALTH PARKS DEVELOPMENT$0$260,476$0$40,655$0$18,606$0$45,600$0$13,922$0$379,259$0$0
A JAMES BUDZINSKI
EXEC VP and CFO$0$526,234$0$102,668$0$16,473$0$45,600$0$22,049$0$713,024$0$0
DONALD CAMPBELL MD
SVP PHYS EDUC & STUDENT AFF$0$319,526$0$97,801$0$20,092$0$26,376$0$18,758$0$482,553$0$0
LAURA CARAMANICA
VP CNO PATIENT CARE SRV KENNE$265,225$0$25,731$0$12,416$0$45,600$0$9,719$0$358,691$0$0$0
LEE RANDOLPH COOK
VP MEDICINE & BEHAVIORAL HLTH$0$250,291$0$29,549$0$12,353$0$28,100$0$20,289$0$340,582$0$0
BARBARA B COREY
SVP MANAGED CARE$0$294,105$0$45,904$0$13,000$0$21,192$0$23,427$0$397,628$0$0
BRUCE A DEAN
VP REAL ESTATE & DEP GEN COUN$0$222,219$0$26,013$0$12,182$0$45,600$0$18,694$0$324,708$0$0
SARATH DEGALA
VP REVENUE CYCLE MGMT$0$256,000$0$24,631$0$9,322$0$14,300$0$20,666$0$324,919$0$0
MARCIA DELK-PAYNE MD
SVP MED AFFAIRS & CQO$0$361,498$0$56,423$0$16,392$0$45,600$0$5,952$0$485,865$0$0
MICHAEL L GRAUE
FMR EXEC VP & COO$0$539,531$0$596,480$0$30,063$0$22,000$0$14,144$0$1,202,218$0$0
MARTIN L GUTKIN
VP FINANCE & HOSPITAL CFO$186,244$0$36,693$0$16,680$0$0$0$12,168$0$251,785$0$0$0
ROBERT D JANSEN MD
EXEC VP & PRES WMG$0$576,801$0$191,534$0$23,469$0$45,600$0$25,931$0$863,335$0$0
REYNOLD J JENNINGS
PRESIDENT & CEO$0$975,000$0$392,445$0$22,255$0$0$0$2,200$0$1,391,900$0$0
CHRISTOPHER M KANE
SVP STRATEGIC PLAN & BUS DEV$0$333,404$0$52,038$0$17,921$0$28,100$0$25,931$0$457,394$0$0
BETH KOST
VP COMPLIANCE & CHF PRVCY OFCR$0$238,762$0$27,950$0$11,627$0$22,218$0$15,580$0$316,137$0$0
KENNETH C KUNZE MD
FMR SVP & CHIEF MEDICAL OFCR$0$557,251$0$79,798$0$28,936$0$21,789$0$4,818$0$692,592$0$0
ELLEN LANGFORD
VP & COO WELLSTAR PHYS GRP$0$215,010$0$25,595$0$10,514$0$17,494$0$19,197$0$287,810$0$0
LOUIS W LITTLE
SVP POST ACUTE & HOSP PRES$241,301$0$46,915$0$15,316$0$30,800$0$23,064$0$357,396$0$0$0
ROBERT M LUBITZ MD
VP MEDICAL AFFAIRS KH$339,914$0$25,182$0$11,942$0$45,600$0$4,181$0$426,819$0$0$0
ROBERT MANDLER
VP DIAGNOSTIC OUTREACH$0$209,039$0$45,374$0$19,930$0$45,168$0$14,553$0$334,064$0$0
PATRICIA A MAYNE
VP EMERGENCY SERVICES$173,645$0$40,128$0$12,471$0$21,180$0$20,375$0$267,799$0$0$0
KIMBERLY W MENEFEE
SVP MARKETING & GOV'T AFFAIRS$0$275,658$0$43,175$0$15,549$0$28,100$0$21,450$0$383,932$0$0
JONATHAN B MORRIS MD
SVP & CIO$0$360,500$0$104,879$0$14,172$0$22,174$0$25,700$0$527,425$0$0
BRADFORD B NEWTON
VP INFO TECHNOLOGY ADMIN$0$187,990$0$17,821$0$9,279$0$20,733$0$17,994$0$253,817$0$0
LEO E REICHERT
EXEC VP & GENERAL COUNSEL$0$477,407$0$93,142$0$24,782$0$0$0$27,431$0$622,762$0$0
MICHELLE M ROBINSON
VP MARKETING/PR/INTERNAL COMM$0$191,580$0$29,902$0$9,496$0$13,817$0$20,165$0$264,960$0$0
DEBORAH ROEGGE DE VITA
VP WOMEN & NEWBORN SVC LINE$0$190,963$0$41,450$0$11,557$0$0$0$8,440$0$252,410$0$0
CANDICE L SAUNDERS
PRESIDENT & COO$88,750$442,689$16,120$80,407$3,267$16,296$7,554$37,680$3,408$16,997$119,099$594,069$0$0
CHRISTOPHER B SCULLEN
VP PULMONARY OPERATIONS$0$168,216$0$19,691$0$8,700$0$953$0$1,544$0$199,104$0$0
JEFFERY D STANLEY
VP PHARMACY & SYS COORDINATOR$0$172,016$0$19,203$0$9,518$0$20,004$0$7,943$0$228,684$0$0
JAMES M SWARTZ
VP ACCOUNTING$0$195,357$0$22,869$0$10,644$0$15,918$0$20,584$0$265,372$0$0
MARY L TAVERNARO
VP HUMAN RESOURCES OPERATIONs$0$206,877$0$24,217$0$10,441$0$27,803$0$13,384$0$282,722$0$0
ADAM C THOMPSON
VP SURGERY$0$162,787$0$19,056$0$20,841$0$0$0$17,822$0$220,506$0$0
ANTHONY M TRUPIANO
SVP SUPPLY CHAIN$0$261,720$0$84,521$0$15,444$0$45,600$0$1,793$0$409,078$0$0
MARY L WESLEY
SVP NURSING SERVICES CNE$0$285,516$0$48,277$0$15,840$0$43,701$0$13,159$0$406,493$0$0
ROBIN WILSON MD
SVP CHIEF HLTH INNOV OFFICER$0$386,250$0$107,359$0$16,755$0$0$0$28,431$0$538,795$0$0
DANIEL J WOODS
SVP & PRES KENNESTONE HOSPITAL$357,456$62,440$49,403$7,977$18,158$2,792$44,249$7,069$25,378$4,077$494,644$84,355$0$0
CHESTER A ZBOROWSKI
VP HEALTH PARK OPERATIONS$0$161,710$0$35,101$0$10,529$0$0$0$18,413$0$225,753$0$0
JYOTSNA R VANAPALLI
RADIATION ONCOLOGY PHYSICIST$187,914$0$5,598$0$1,434$0$20,302$0$13,420$0$228,668$0$0$0
ROBERT J DeCOUX
AVP HUMAN RESOURCES$154,128$0$12,461$0$3,018$0$10,096$0$24,468$0$204,171$0$0$0
KRISTYN GREIFER MD
VP POPULATION MANAGEMENT$0$219,245$0$36,675$0$7,788$0$0$0$10,138$0$273,846$0$0
PETER JUNGBLUT MD
SVP & MEDICAL DIRECTOR WMG$0$288,480$0$47,451$0$22,336$0$40,100$0$16,295$0$414,662$0$0
JIMMY FRANCIS
VP INFO TECHNOLOGY OPERATIONS$0$96,160$0$39,913$0$14,270$0$0$0$580$0$150,923$0$0
ELIZABETH LOUDERMILK
VP ENT INTELLIGENCE & INTGRTN$0$206,215$0$24,140$0$10,091$0$0$0$11,978$0$252,424$0$0
SANDRA LUCIUS
VP INFO TECHNOLOGY APPS$0$161,658$0$12,427$0$3,374$0$23,999$0$2,571$0$204,029$0$0
BETHANY ROBERTSON
VP & CHIEF LEARNING OFFICER$0$177,162$0$16,307$0$7,176$0$11,898$0$27,419$0$239,962$0$0
RICHARD SIEGEL
VP CARDIOLOGY & CVM ADMIN$0$266,559$0$59,361$0$11,909$0$40,777$0$22,033$0$400,639$0$0
DANIEL STYF
SVP PW HEALTH PLAN$0$148,086$0$30,000$0$7,568$0$9,327$0$4,049$0$199,030$0$0
LOUIS LOVETT
AVP PHYSICIAN ADVISOR$240,000$0$22,707$0$9,450$0$41,547$0$25,125$0$338,829$0$0$0
ANN E GRAY
RN CLINICAL NURSE$158,701$0$599$0$2,158$0$14,492$0$9,705$0$185,655$0$0$0
SHERRON KURTZ
EXEC DIR SURGICAL SVCS KH/CH$157,186$0$9,895$0$7,360$0$11,394$0$3,518$0$189,353$0$0$0
BETTY BRAKOVICH
VP CNO PATIENT CARE SERVICES$153,834$0$22,360$0$12,337$0$22,263$0$13,191$0$223,985$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 Schedule J Line 7As part of the WellStar Executive Compensation Philosophy a performance pay plan was instituted several years ago whereby the WellStar Board od 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 for "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 received through the annual external audit process and approved by the Board of Trustees at that time.
Schedule JPursuant 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 received severance pay during the period: Michael Graue $323,718; Kenneth Kunze, MD $334351; and Elizabeth Person $41,928.
Form 990, Schedule J, Part I, Line 1b & 2While Wellstar Health System and its affiliates do not have a written policy regarding payment or reimbursement for the items listed in Part 1 Line 1a, the organization follows IRS guidelines in the payment of any of these items to individuals listed in Form 990 Part VII Section A. These items are added as taxable wages on the individual's Form W-2 as appropriate.
Compensation Exceptions

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (8 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Pamela Etheridge
Wife of Officer$61,285Employee of WellStarfalse
Greg Fortgang
Son-in-Law of Trustee$100,521Employee of WellStarfalse
George Fleming
Brother of Officer$66,332Employee of WellStarfalse
Matthew Maddox
Son of Trustee$78,440Employee of WellStarfalse
Bonnie Miller
Wife of Trustee$34,394Employee of WellStarfalse
Jessica Haney
Daughter of Officer$62,455Employee of WellStarfalse
Greg Kost
Brother-in-law of officer$49,327Employee of WellStarfalse
Jennifer Haney
Daughter-in-law of offcer$79,812Employee of WellStarfalse

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceForm 990 Schedule L Part IVFormAndLineReferenceDesc
ExplanationAll transactions listed in Schedule L Part IV are for interested parties or in this case family members of either trustees or officers of Kennestone Hospital, Inc. or its related organizations. The transactions all represent payment of services as employees of Wellstar Health System.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 Part V Line 2All compensation amounts reported on Form 990 Part V, Part VII, and Part IX as well as Schedule J represent compensation provided to individuals that provide services to the organization. Likewise, the number of employees reported on Form 990 represent the number of individuals providing services to the organization. All Federal employment tax responsibilities for these individuals (including Federal Employment Tax reporting responsibilities) are handled by Wellstar Health System, Inc. (EIN 58-1649541).
Form 990 Part VI Section B Lines 12A - 12COur 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 Lines 15A & 15BWellstar 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 himself/herself from that process but is a non-voting committee member for discussions on all other officers. The executive compensation philosophy empowers the committee to oversee the executive compensation process and administer the executive compensation program on behalf of the full board of trustee of Wellstar; provided, however, the full Board of Trustees evaluates and approves the compensation of the Chief Executive Officer. The philosophy requires annual disclosure of the committee's actions and decisions to the full board, which it has done. The committee is guided by the board-approved philosophy. Overall, the philosophy is intended to reward for organizational and individual performance. When performance is at a predetermined targeted level, the compensation is intended to be at or around the median of compensation paid to similar positions at similar organizations (the "market"). Wellstar's executive compensation philosophy defines the market as being comprised of comparable not-for-profit health care delivery systems, i.e., not-for-profit organizations similar in complexity and scale to Wellstar. To assist the committee in fulfilling its duties, the committee engaged the Hay Group to provide market compensation data to compare to the Wellstar positions whose compensation the committee oversees. The committee uses this data to provide context when making decisions in administering the compensation program. Accurate minutes of the committee's discussion and decisions are recorded during each committee meeting, and reviewed and approved by the full Board of Trustees at its next scheduled meeting.
Form 990 Part IV Line 12 & Part IXKennestone Hospital, Inc. is audited on an annual basis by an outside auditing firm, KPMG, and as part of that audit a consolidated financial statement is issued for all of WellStar Health System, Inc. and its Affiliates. "The independent auditors report includes the accounts of Wellstar and its controlled affiliates, Kennestone Hospital, Inc., Cobb Hospital, Inc., Douglas Hospital, Inc., Paulding Medical Center, Inc., Wellstar Foundation, Inc. CHS Foundation, Inc., Community Assurance Company, Ltd., various Wellstar owned physician practices, a hospice facility, a nursing facility, home health business, and entities for infusion therapy and durable medical equipment. All significant intercompany accounts and transactions have been eliminated in combination. The Board of Trustees of Wellstar has the authority to approve appointments of the members of the board of trustees of all affiliate corporations."
Form 990 Part IV Line 24a & Part XFor purposes of the Form 990 reporting, Wellstar Health System, Inc. (EIN 58-1649541) will list all tax-exempt bonds issued since January 1, 2003 on Schedule K as it typically allocates the proceeds of the bonds to members of the Obligated Group (including the hospitals and physician group). Kennestone Hospital, Inc. will report this tax exempt bond liability on Part X, Line 25 Other Liabilities-Due to WHS, Inc.
Form 990 Part VI Section A Lines 6, 7a & 7bAs per the Articles of Incorporation, the sole member of the organization is Wellstar Health System, Inc., a GA 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 General StatementThe officers devote their time to all of the organizations within Wellstar Health System that are listed in Schedule R, Part II. As such, the total hours worked by the officers across all organizations exceeds 40 hours a week.
Form 990 Part VI Line 11AInternal staff prepare the organization's Form 990. Before filing the return with the Internal Revenue Service an external accounting firm, PricewaterhouseCoopers, reviews and sign-offs on the completed return of each organization. The current year Form 990 is then reviewed by the Finance Committee along with a question and answer session. A motion is then made by the Finance committee to approve the returns and present to the full board copies of the forms in an electronic (pdf. format) version as well as a hard copy. The organization's CFO or designee subsequently signs the return for either manual or electronic filing by the appropriate due date.
FORM 990 PART VI SECTION C Line 19The organization and its subsidiaries are subject to the Open Records Law in the State of Georgia. Therefore, by law, citizens are permitted to inspect and copy its governing documents, policies and financial statements as may be requested from time to time. Additionally, the organization's Form 990 is made readily available on the Guidestar website. Periodically, the organization publishes its financial performance in the local newspaper for citizens to review, and it also publishes a community benefit report once a year for distribution to the public.
Form 990 Part XI Line 9For the reporting period Kennestone Hospital, Inc. had a change in net assets of ($19,842,623) related to transfers to affiliates as part of the allocation of income statement and balance sheet transactions over the year.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationInd
CHS Foundation Inc
805 Sandy Plains RoadMariettaGA30066581649540FoundationGA501(C)(3)11 Type 2WHS IncYes (true)
Cobb Hospital Inc
805 Sandy Plains RoadMariettaGA30066580968382HealthcareGA501(C)(3)3WHS IncYes (true)
Douglas Hospital Inc
805 Sandy Plains RoadMariettaGA30066582026750HealthcareGA501(C)(3)3WHS IncYes (true)
Paulding Medical Center Inc
805 Sandy Plains RoadMariettaGA30066582095884HealthcareGA501(C)(3)3WHS IncYes (true)
Wellstar Foundation Inc
805 Sandy Plains RoadMariettaGA30066581627413FoundationGA501(C)(3)11 Type 2WHS IncYes (true)
Wellstar Health System Inc
805 Sandy Plains RoadMariettaGA30066581649541HealthcareGA501(C)(3)11 Type 2NAfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeTxt
Cobb Hospital Parking Company LLC
805 Sandy Plains RoadMariettaGA300666340752999669ParkingGANAN/A
Kennestone East Parking Deck LLC
805 Sandy Plains RoadMariettaGA300666340200537100ParkingGANAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Community Assurance CoBusinessNameLine1

Foreign Address ForeignAddress

FieldValueIRS element (for citing)
Address Line13rd Fl Barclays House Shedden RdAddressLine1
CityGeorge TownCity
Province Or StateGrand CaymanProvinceOrState
CountryCJCountry
FieldValueIRS element (for citing)
EIN581649541EIN
Primary ActivitiesInsurancePrimaryActivitiesTxt
Legal Domicile Foreign CountryCJLegalDomicileForeignCountryCd
Entity TypeC-CORPEntityTypeTxt
Controlled OrganizationYes (true)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd