PAULDING MEDICAL CENTER INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- PAULDING MEDICAL CENTER INC (EIN 58-2095884)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-15
- IRS object ID
- 201521359349302602
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-15T09:02:14-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PricewaterhouseCoopers LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2001 MARKET ST SUITE 1700 | AddressLine1 |
| City | PHILADELPHIA | City |
| State | PA | State |
| ZIP Code | 19103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 582095884 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAULDING MEDICAL CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JAMES M SWARTZ | InCareOfNm |
| Business Name Control | PAUL | BusinessNameControlTxt |
| Phone | 7707925023 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 Sandy Plains Road | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | Marietta | City |
| State | GA | State |
| ZIP Code | 300666340 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES SWARTZ | PersonNm |
| Person Title | VP ACCOUNTING | PersonTitleTxt |
| Phone | 7709567827 | PhoneNum |
| Signature | 2015-05-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MATTHEW D PETROSKI | PreparerPersonNm |
| PTIN | P00853132 | PTIN |
| Phone | 7709567827 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | REYNOLD J JENNINGS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 Sandy Plains Road | AddressLine1 |
| City | Marietta | City |
| State | GA | State |
| ZIP Code | 300666340 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $75,931,425 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.wellstar.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1993 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | To deliver world-class charitable healthcare. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 100 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $65,428,844 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $75,573,580 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$26,622 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,894 | CYInvestmentIncomeAmt |
| PY Other Revenue | $407,260 | PYOtherRevenueAmt |
| CY Other Revenue | $355,951 | CYOtherRevenueAmt |
| PY Total Revenue | $65,809,482 | PYTotalRevenueAmt |
| CY Total Revenue | $75,931,425 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $30,928,542 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $34,868,051 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $27,684,242 | PYOtherExpensesAmt |
| CY Other Expenses | $36,003,218 | CYOtherExpensesAmt |
| PY Total Expenses | $58,612,784 | PYTotalExpensesAmt |
| CY Total Expenses | $70,871,269 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,196,698 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,060,156 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $111,173,600 | TotalAssetsBOYAmt |
| Total Assets EOY | $177,640,983 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $119,313,944 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $111,994,863 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$8,140,344 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $65,646,120 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO CREATE AND DELIVER HIGH QUALITY HOSPITAL, PHYSICIAN AND OTHER HEALTHCARE RELATED SERVICES THAT IMPROVE THE HEALTH AND WELL-BEING OF THE INDIVIDUALS AND COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $57,843,861 | ExpenseAmt |
| Revenue | $75,573,580 | RevenueAmt |
| Desc | Paulding Medical Center, Inc. (an affiliate of Wellstar Health System, Inc.) operates as a charitable organization consistent with the requirements of IRS Section 501(c)(3) and the "community benefit standard: of IRS Revenue Ruling 69-545. In this regard, the governing body of the organization and/or its parent is composed of prominent citizens in the community, medical staff privileges in the hospital are available to all qualified physicians in the area, consistent with the size and nature of the facility; the hospital operates a full-time emergency room open to all regardless of ability to pay; the hospital provides care to needy members of its community consistent with its charity care policy regardless of their ability to pay for these services; and the hospitals 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. Paulding had $107.6 million in capital expenditures disbursed during the tax period reviewed with the construction of a new replacement hospital contributing to a majority of that total. Wellstar Paulding Hospital is a general acute care hospital providing a full range of services to the community. The hospital is licensed to operate 83 beds and is presently staffed to operate 34 beds. The existing hospital will be replaced by a 253,000 square foot, 112-bed replacement acute care hospital in the spring of 2014. Paulding Medical Center, Inc. was organized in 1994. 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. Paulding Medical Center is subject to the authority and governing board of Wellstar Health System and the Paulding County Hospital Authority. Paulding Hospital provides a full range of inpatient and outpatient services characteristic of a community hospital. Paulding Nursing Home is located on the campus of the hospital and functions as part of the full range of health services provided to the community. The nursing home provides skilled long-term nursing care to persons requiring those services by reason of age or physical impairment. The nursing home is the only such facility in the Wellstar system. The following stats consitute the overall program services provided for the period ended June 30, 2013: Adult Discharges-2,031 Nursing Facility Days-62,343 Medical & Surgical Short Stay Cases-206 Emergency Room Visits-40,445 Outpatient Surgical Cases-1,475 Inpatient Surgical Cases-426 Outpatient Procedures Non ED OP Radiology-29,736 GI Laboratory-360 Total FTEs Paid-478 Community Benefit Reporting Unreimbursed Charity Care (at cost)$4,234,494 Medicaid Shortfalls (at cost)$163,151 As an affiliate of Wellstar Health System, Paulding Hospital participates in many community and educational programs for the overall health and benefit of the area that they serve. Accomplishments and Awards--The Paulding Nursing Home provides both subacute and long term care services to patients in the community. Since the nursing home is one of very few in the area and located on the medical complex campus it is very crucial to an ever expanding service area. Paulding Hospital is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The parent company, Wellstar Health System, was again honored as one of the top 100 health systems in the country by Verispan. The system was ranked at #5 as listed in the magazine, "Modern Healthcare", and is the highest ranked system in the state. All of Wellstar hospital laboratories including Paulding were awarded "Accreditation with Distinction" by the Commission on Laboratory Accreditation of the College of American Pathologists (CAP). CAP awards are considered one of the most stringent in laboratory quality assurance in the industry. Wellstar Health System ranks as the top company in the Working Mother 100 Best Companies List. Wellstar ranked seventh in the large company category in Atlanta's Top 25 Employers by the publication "Atlanta Business Chronicle". Wellstar was recognized as a "Company that Cares" for 2013 which was the sixth year in a row the system was honored. The system began participating in Terrific Tales, a Company that Cares sponsored literacy project. Several Wellstar hospitals took on the challenge of purchasing quality books for local elementary school libraries in underserved areas. Paulding Hospital adopted a local school(Poole Elementary) and helped the system raise funds to purchase books for that and other local schools. WellStar Health System received two national work-life distinctions during the year. The National Association of Female Executives honored the system for the fourth year as one of the Top 10 Nonprofit Companies for female executives. Eighty-two percent of the WellStar workforce are women. In 2012, 80 percent of promotions to manager and above went to women and of the 13 employees promoted to executive positions there were six that were for females. WellStar is also one of the 54 organizations nationwide to earn the Alliance for Work-Life Progress Seal of Distinction. This award identifies organizational success in the area of work-life effectiveness. WellStar was one of only two Georgia organizations to be honored. In October of the reporting period WellStar completed the system-wide implementation of a new cleaning process called Xenex. The process uses ultraviolet light technology/machines to decontaminate rooms in five to 12 minutes. This includes patient rooms, emergency departments, public restrooms, supply rooms and nursing stations. Independent studies and lab samples have shown that the system is 20 times more effective than regular cleaning protocols for eliminating harmful bacteria and many other organisms. All hospitals have a least one machine in operation. WellStar Paulding Nursing Center received two national Excellence in Action Awards from the National Research Corporation. The nursing center received the awards for customer and employee satisfaction. The Nursing Center ranked in the top 10 percent of a field of more than 5,000 surveyed facilities. Paulding Nursing Center is one of only 83 facilities in the country and one of 17 in Georgia to receive both awards. Orthosport WellStar opened a new orthopedic and sports physical therapy clinic in the Paulding Physicians Center and very near the new replacement hospital for Paulding Hospital in Hiram, Georgia. Orthosport became a part of WellStar in January of 2012 and has locations in Marietta, Kennesaw, Woodstock, Austell and Douglasville which are all in the communities it serves. Orthosport is the only physical therapy provider in the area to offer aquatic therapy at each location allowing patients with acute and chronic injuries to heal much faster and with less pain. WellStar Kennestone Hospital launched an initiative called Best In Georgia (BIG) with a goal to improve patient safety and well-being across the system. A multidisiplinary team of physicians and other team members meets on a periodic basis to evaluate performance measures at the hospital. As many consumers become more savvy and research healthcare performance in sources such as Health Grades, and US News and World Report as well as other computer websites, it is important for hospitals to focus on raising their standing in the community and public in general. Cobb, Douglas, Paulding and Windy Hill hospitals have also joined in this initiative. The Paulding Hospital Surgical Services Team raised more than $600 to purchase a new computer, desk and chair for the WellStar Paulding Nursing Center. The department hopes that the internet access will help the nursing home residents keep in better touch with family and friends and improve their quality of life. The new Paulding replacement hospital is scheduled to open in April of 2014. The new hospital will be a state-of-the-art facility with eight floors and over 250,000 square feet of space. It will include a 40-room emergency department which greatly enhances that service for the Paulding County community. Over 100 new jobs will be added to the workforce. The hospital will also have a glass atrium that will connect it to an 82,200 square-foot existing medical office complex. Paulding Nursing Center received a five-star rating from the Centers for Medicare and Medicaid Services (CMS) for its overall performance in health inspections, nurse staffing and quality of medical care. Only 10 percent of nursing homes in the country earn this top rating, and only about 17 percent of more than 350 homes in Georgia earned an overall five-star rating. Approximately 150 team members serve the 182 residents of Paulding Nursing Center. Kennestone and Paulding Hospitals were named to the Georgia Hospital Association's Partnership for Health and Accountabil | Desc |
| Total Program Service Expenses | $57,843,861 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES M SWARTZ | PersonNm |
| Phone | 7707925023 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 SANDY PLAINS ROAD | AddressLine1 |
| City | Marietta | City |
| State | GA | State |
| ZIP Code | 300666340 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (74 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| ARVIL P BECKFORD MD | |||||||||
| TRUSTEE | 2.0 | 48.0 | Yes (X) | $0 | $456,909 | $29,970 | |||
| RANDALL BENTLEY JR | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $20,619 | $0 | |||
| OTIS BRUMBY III | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $2,687 | $0 | |||
| SHAN COOPER | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $1,218 | $0 | |||
| ROBERT N CROSS MD | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $5,266 | $0 | |||
| T E RUSTY DURHAM | |||||||||
| TRUSTEE | 1.0 | 14.0 | Yes (X) | $0 | $37,928 | $13,445 | |||
| THOMAS E GEARHARD MD | |||||||||
| TRUSTEE | 2.0 | 48.0 | Yes (X) | $0 | $484,242 | $72,307 | |||
| DAVID HAFNER MD | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $24,386 | $0 | |||
| T FITZ JOHNSON | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $18,008 | $0 | |||
| CHARLES J JONES | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $17,308 | $0 | |||
| JANIE MADDOX | |||||||||
| TRUSTEE - CHAIR | 1.0 | 5.0 | Yes (X) | $0 | $19,581 | $0 | |||
| GARY A MILLER | |||||||||
| TRUSTEE - VICE CHAIR | 1.0 | 5.0 | Yes (X) | $0 | $4,249 | $0 | |||
| STEVEN W OWEIDA MD | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $21,472 | $0 | |||
| TOM PHILLIPS | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $2,734 | $0 | |||
| WALTER G ROBINSON | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $10,640 | $0 | |||
| FRANK ROS | |||||||||
| TRUSTEE | 1.0 | 5.0 | Yes (X) | $0 | $3,747 | $0 | |||
| W ALLEN SEPARK | |||||||||
| TRUSTEE | 1.0 | 7.0 | Yes (X) | $0 | $9,844 | $0 | |||
| JEFFERY THARP MD | |||||||||
| TRUSTEE | 2.0 | 48.0 | Yes (X) | $0 | $566,320 | $72,948 | |||
| VALERY A AKOPOV MD | |||||||||
| VP & CHIEF OF HOSPITALISTS | 2.0 | 48.0 | $0 | $394,355 | $53,783 | Yes (X) | |||
| DAVID W ANDERSON | |||||||||
| EXEC VP HR/OL/CCO | 2.0 | 48.0 | $0 | $590,159 | $64,119 | Yes (X) | |||
| NICOLE V ASHE | |||||||||
| VP FINANCE & CFO WMG | 2.0 | 48.0 | $0 | $256,832 | $46,130 | Yes (X) | |||
| BARBARA G BALLARD | |||||||||
| VP HOMECARE & HOSPICE | 2.0 | 48.0 | $0 | $376,870 | $73,407 | Yes (X) | |||
| JOSEPH L BRYWCZYNSKI | |||||||||
| SVP HEALTH PARKS DEVELOPMENT | 2.0 | 48.0 | $0 | $319,737 | $59,522 | Yes (X) | |||
| A JAMES BUDZINSKI | |||||||||
| EXEC VP & CFO | 2.0 | 50.0 | $0 | $645,375 | $67,649 | Yes (X) | |||
| DONALD CAMPBELL MD | |||||||||
| SVP PHYS EDUC & STUDENT AFFL | 2.0 | 48.0 | $0 | $437,419 | $45,134 | Yes (X) | |||
| LEE RANDOLPH COOK | |||||||||
| VP MEDICINE & BEHAVIORAL HLTH | 2.0 | 48.0 | $0 | $292,193 | $48,389 | Yes (X) | |||
| BARBARA B COREY | |||||||||
| SVP MANAGED CARE | 2.0 | 48.0 | $0 | $353,009 | $44,619 | Yes (X) | |||
| BRUCE A DEAN | |||||||||
| VP REAL ESTATE & DEP GEN COUNS | 2.0 | 48.0 | $0 | $260,414 | $64,294 | Yes (X) | |||
| SARATH DEGALA | |||||||||
| VP REVENUE CYCLE MANAGEMENT | 2.0 | 48.0 | $0 | $289,953 | $34,966 | Yes (X) | |||
| MARCIA DELK-PAYNE MD | |||||||||
| SVP MED AFFAIRS & CQO | 2.0 | 48.0 | $0 | $434,313 | $51,552 | Yes (X) | |||
| TIMOTHY MARK HANEY | |||||||||
| SVP & HOSPITAL PRESIDENT | 48.0 | 2.0 | $334,058 | $0 | $46,179 | Yes (X) | |||
| VICKY LYNN HOGUE | |||||||||
| VP/CNO PATIENT CARE SERVICES | 50.0 | 0.0 | $213,279 | $0 | $48,338 | Yes (X) | |||
| ROBERT D JANSEN MD | |||||||||
| EXEC VP & PRES WMG | 2.0 | 48.0 | $0 | $791,804 | $71,531 | Yes (X) | |||
| REYNOLD J JENNINGS | |||||||||
| PRESIDENT & CEO | 2.0 | 50.0 | $0 | $1,389,700 | $2,200 | Yes (X) | |||
| CHRISTOPHER M KANE | |||||||||
| SVP STRATEGIC PLAN & BUS DEV | 2.0 | 48.0 | $0 | $403,363 | $54,031 | Yes (X) | |||
| BETH KOST | |||||||||
| VP COMPLIANCE/CHIEF PRIV OFCR | 2.0 | 48.0 | $0 | $278,339 | $37,798 | Yes (X) | |||
| ELLEN LANGFORD | |||||||||
| VP & COO MED GRP | 2.0 | 48.0 | $0 | $251,119 | $36,691 | Yes (X) | |||
| ROBERT MANDLER | |||||||||
| VP DIAGNOSTIC OUTREACH | 2.0 | 48.0 | $0 | $274,343 | $59,721 | Yes (X) | |||
| CAROL B MAXWELL | |||||||||
| VP TALENT ACQUISITION | 2.0 | 48.0 | $0 | $128,331 | $12,302 | Yes (X) | |||
| KIMBERLY W MENEFEE | |||||||||
| SVP MARKETING & GOV AFFAIRS | 2.0 | 48.0 | $0 | $334,382 | $49,550 | Yes (X) | |||
| JONATHAN B MORRIS MD | |||||||||
| SVP & CIO | 2.0 | 48.0 | $0 | $479,551 | $47,874 | Yes (X) | |||
| BRADFORD B NEWTON | |||||||||
| VP INFO TECH ADMIN | 2.0 | 48.0 | $0 | $215,090 | $38,727 | Yes (X) | |||
| LEO E REICHERT | |||||||||
| EXEC VP & GENERAL COUNSEL | 2.0 | 48.0 | $0 | $595,331 | $27,431 | Yes (X) | |||
| MICHELLE M ROBINSON | |||||||||
| VP MARKETING/PR/INT COMMUNICAT | 2.0 | 48.0 | $0 | $230,978 | $33,982 | Yes (X) | |||
| DEBORAH ROEGGE DE VITA | |||||||||
| VP WOMEN & NEWBORN SERVICES | 2.0 | 48.0 | $0 | $243,970 | $8,440 | Yes (X) | |||
| CHRISTOPHER B SCULLEN | |||||||||
| VP PULMONARY OPERATIONS | 2.0 | 48.0 | $0 | $196,607 | $2,497 | Yes (X) | |||
| JAMES M SWARTZ | |||||||||
| VP ACCOUNTING | 2.0 | 48.0 | $0 | $228,870 | $36,502 | Yes (X) | |||
| MARY L TAVERNARO | |||||||||
| VP HUMAN RESOURCES OPERATIONS | 2.0 | 48.0 | $0 | $241,535 | $41,187 | Yes (X) | |||
| ADAM C THOMPSON | |||||||||
| VP SURGERY | 2.0 | 48.0 | $0 | $202,684 | $17,822 | Yes (X) | |||
| ANTHONY M TRUPIANO | |||||||||
| SVP SUPPLY CHAIN | 2.0 | 48.0 | $0 | $361,685 | $47,393 | Yes (X) | |||
| MARY L WESLEY | |||||||||
| SVP NURSING SERVICES & CNE | 2.0 | 48.0 | $0 | $349,633 | $56,860 | Yes (X) | |||
| ROBIN WILSON MD | |||||||||
| SVP CHIEF HLTH INNOV OFFICER | 2.0 | 48.0 | $0 | $510,364 | $28,431 | Yes (X) | |||
| CHESTER A ZBOROWSKI | |||||||||
| VP HEALTH PARKS OPERATIONS | 2.0 | 48.0 | $0 | $207,340 | $18,413 | Yes (X) | |||
| KRISTYN GREIFER MD | |||||||||
| VP POPULATION HLTH MGMT | 2.0 | 48.0 | $0 | $263,708 | $10,138 | Yes (X) | |||
| PETER JUNGBLUT MD | |||||||||
| SVP & MEDICAL DIRECTOR | 2.0 | 48.0 | $0 | $358,267 | $56,395 | Yes (X) | |||
| JAMES CLEMENTS | |||||||||
| VP BUS DEV & STRATEGIC PTNRSP | 2.0 | 48.0 | $0 | $131,463 | $11,124 | Yes (X) | |||
| JIMMY FRANCIS | |||||||||
| VP INFO TECHNOLOGY OPERATIONS | 2.0 | 48.0 | $0 | $150,343 | $580 | Yes (X) | |||
| STEVEN GRACE | |||||||||
| VP TALENT ACQUISITION | 2.0 | 48.0 | $0 | $144,341 | $4,206 | Yes (X) | |||
| ELIZABETH LOUDERMILK | |||||||||
| VP ENT INTELLIGENCE & INTGTN | 2.0 | 48.0 | $0 | $240,446 | $11,978 | Yes (X) | |||
| SANDRA LUCIUS | |||||||||
| VP INFO TECHNOLOGY APPS | 2.0 | 48.0 | $0 | $177,459 | $26,570 | Yes (X) | |||
| MICHAEL PAUL | |||||||||
| VP FACILITIES ENG SUPPORT SVC | 2.0 | 48.0 | $0 | $86,864 | $1,985 | Yes (X) | |||
| GUILLERMO PIERLUISI MD | |||||||||
| VP MEDICAL AFFAIRS | 48.0 | 2.0 | $272,238 | $0 | $51,328 | Yes (X) | |||
| BETHANY ROBERTSON | |||||||||
| VP & CHIEF LEARNING OFFICER | 2.0 | 48.0 | $0 | $200,645 | $39,317 | Yes (X) | |||
| CANDICE SAUNDERS | |||||||||
| EXEC VP & COO | 2.0 | 48.0 | $0 | $539,392 | $54,677 | Yes (X) | |||
| RICHARD SIEGEL | |||||||||
| VP CARDIOLOGY & CVM ADMIN | 2.0 | 48.0 | $0 | $337,829 | $62,810 | Yes (X) | |||
| JEFFERY STANLEY | |||||||||
| VP PHARMACY & SYSTEM COOR | 2.0 | 48.0 | $0 | $200,737 | $27,947 | Yes (X) | |||
| DANIEL STYF | |||||||||
| SVP PW HEALTH PLAN | 2.0 | 48.0 | $0 | $185,654 | $13,376 | Yes (X) | |||
| DWIGHT T STILL | |||||||||
| RADIATION ONCOLOGY PHYSICIST | 50.0 | 0.0 | $184,353 | $0 | $29,200 | Yes (X) | |||
| CAROL S O'CONNELL | |||||||||
| AVP SUPPORT SRVCS & LTC | 50.0 | 0.0 | $157,294 | $0 | $32,368 | Yes (X) | |||
| ANDREA PARSON | |||||||||
| DIRECTOR PHARMACY | 50.0 | 0.0 | $155,800 | $0 | $42,990 | Yes (X) | |||
| ELIZABETH CONNER | |||||||||
| PHARMACEUTICAL CARE PHARMACIST | 50.0 | 0.0 | $136,501 | $0 | $30,038 | Yes (X) | |||
| JANET D FAULKNER | |||||||||
| DIRECTOR NURSING | 50.0 | 0.0 | $132,949 | $0 | $25,449 | Yes (X) | |||
| MICHAEL L GRAUE | |||||||||
| FMR EXEC VP & COO | 0.0 | 0.0 | $0 | $1,166,074 | $36,144 | Yes (X) | |||
| KENNETH C KUNZE MD | |||||||||
| FMR SVP CHIEF MEDICAL OFFICER | 0.0 | 0.0 | $0 | $665,985 | $26,607 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,586,472 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $19,122,013 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,261,361 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 40 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Brasfield Gorrie LLC | |||||
| 1990 Vaughn Rd NW Suite 100 | KENNESAW | GA | 30144 | General Contractor | $61,449,762 |
| CDH PARTNERS INC | |||||
| 675 TOWER RD | MARIETTA | GA | 30060 | General Contractor | $803,609 |
| PRESIDIO NETWORKED SOLUTIONS | |||||
| PO BOX 822169 | PHILADELPHIA | PA | 191822169 | IS | $710,316 |
| INGLETT AND STUBBS LLC | |||||
| PO BOX 932506 | ATLANTA | GA | 311932506 | GENERAL CONTRACTOR | $481,640 |
| MARTIN GENERAL CONTRACTING INC | |||||
| 3633 IVY GULLEDGE RD | DALLAS | GA | 30132 | GENERAL CONTRACTOR | $232,382 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HOSPITAL PATIENT REVENUE | 621990 | $75,573,300 | $75,573,300 |
| MEDICAL RECORDS | 621990 | $280 | $280 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $75,573,580 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $24,507 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $24,507 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,507 | TotalRevenueColumnAmt |
| Exclusion | $24,507 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,894 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,894 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,894 | TotalRevenueColumnAmt |
| Exclusion | $1,894 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA | 722210 | $280,088 | $280,088 |
| IMMUNIZATIONS | 621990 | $8,147 | $8,147 |
| OTHER INCOME | 621990 | $43,209 | $43,209 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $331,444 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $75,931,425 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $75,573,580 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $357,845 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,010,208 | TotalAmt |
| Program Services | $827,880 | ProgramServicesAmt |
| Management And General | $182,328 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,298,873 | TotalAmt |
| Program Services | $24,039,885 | ProgramServicesAmt |
| Management And General | $4,258,988 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,074,392 | TotalAmt |
| Program Services | $911,622 | ProgramServicesAmt |
| Management And General | $162,770 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,357,160 | TotalAmt |
| Program Services | $2,000,050 | ProgramServicesAmt |
| Management And General | $357,110 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,127,418 | TotalAmt |
| Program Services | $1,805,114 | ProgramServicesAmt |
| Management And General | $322,304 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,549 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $2,549 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,788,527 | TotalAmt |
| Program Services | $1,802,492 | ProgramServicesAmt |
| Management And General | -$13,965 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,570,961 | TotalAmt |
| Program Services | $2,891,783 | ProgramServicesAmt |
| Management And General | $679,178 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,834,754 | TotalAmt |
| Program Services | $588,052 | ProgramServicesAmt |
| Management And General | $1,246,702 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,854 | TotalAmt |
| Program Services | $24,410 | ProgramServicesAmt |
| Management And General | $9,444 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,561 | TotalAmt |
| Program Services | $27,348 | ProgramServicesAmt |
| Management And General | $22,213 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $63 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,531,340 | TotalAmt |
| Program Services | $13,178,342 | ProgramServicesAmt |
| Management And General | $2,352,998 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,520,200 | TotalAmt |
| Program Services | $2,222,120 | ProgramServicesAmt |
| Management And General | $2,298,080 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $834,926 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $834,926 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| REPAIRS & MAINTENANCE | $1,758,625 | $1,278,098 | $480,527 |
| MEDICAL SUPPLIES | $5,938,073 | $6,245,779 | -$307,706 |
| OTHER OPERATING EXPENSES | $139,785 | $886 | $138,899 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,871,269 | TotalAmt |
| Program Services | $57,843,861 | ProgramServicesAmt |
| Management And General | $13,027,408 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,650 | BOYAmt |
| EOY | $5,400 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $210,508 | BOYAmt |
| EOY | $75,049 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,010,804 | BOYAmt |
| EOY | $18,673,393 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $951,414 | BOYAmt |
| EOY | $1,598,812 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $820,523 | BOYAmt |
| EOY | $1,014,410 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $187,960,317 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $32,054,872 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $98,727,981 | BOYAmt |
| EOY | $155,905,445 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $38,324 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $450,720 | BOYAmt |
| EOY | $330,150 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,173,600 | BOYAmt |
| EOY | $177,640,983 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,137,002 | BOYAmt |
| EOY | $5,020,344 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $107,176,942 | BOYAmt |
| EOY | $106,974,519 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $119,313,944 | BOYAmt |
| EOY | $111,994,863 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$8,140,344 | BOYAmt |
| EOY | $65,646,120 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$8,140,344 | BOYAmt |
| EOY | $65,646,120 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,173,600 | BOYAmt |
| EOY | $177,640,983 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $5,060,156 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $68,726,308 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,170,973 | OtherCostOrOtherBasisAmt |
| Book Value | $3,170,973 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $142,945,289 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,936,954 | DepreciationAmt |
| Book Value | $130,008,335 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,164,039 | OtherCostOrOtherBasisAmt |
| Depreciation | $217,401 | DepreciationAmt |
| Book Value | $4,947,638 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,864,305 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,800,195 | DepreciationAmt |
| Book Value | $17,064,110 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $814,711 | OtherCostOrOtherBasisAmt |
| Depreciation | $100,322 | DepreciationAmt |
| Book Value | $714,389 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $155,905,445 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT - OTHER LT | $857,421 |
| TAX EXEMPT BOND LIAB-DUE TO WH | $106,117,098 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $106,974,519 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCH D PART X, LINE 2-LIABILITIES | FormAndLineReferenceDesc |
| Explanation | The following footnote is taken from the audited financial statements for Wellstar Health System and Affiliates (including Paulding Medical Center): "WellStar and all but one of its affiliates have been recognized as exempt from Federal income tax under Internal Revenue Code Section 501(a) as organizations described in Section Sec 501(c)(3) and, therefore, related income is generally not subject to Federal or state income taxes. CAC is a controlled foreign corporation not subject to Federal tax. WellStar applies FASB ASC 740, Income Taxes, which addresses accounting for uncertainties in income tax positions. It also provides guidance on when tax positions are recognized in an entity's financial statements and how the values of these positions are determined. There is no impact on WellStar's combined financial statements as a result of the application of ASC 740." | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 125. | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,778,887 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,778,887 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05330 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,725,008 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,680,272 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,044,736 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02890 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,503,895 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,680,272 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,823,623 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08220 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $178,766 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $178,766 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00250 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $178,766 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $178,766 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00250 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,682,661 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,680,272 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,002,389 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08470 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,648,174 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $928,410 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $15,151,956 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $24,536,260 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$9,384,304 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLSTAR PAULDING HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 WEST MEMORIAL DRIVE | AddressLine1 |
| City | DALLAS | City |
| State | GA | State |
| ZIP Code | 30132 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.wellstar.org | WebsiteAddressTxt |
| State License | 110-547 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | SKILLED NURSING HOME | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLSTAR PAULDING HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| All Needs Addressed | false | AllNeedsAddressedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (true) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 125. | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (true) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 300. | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Sch H Part I Line 6a | Paulding Medical Center, Inc. is an affiliate of Wellstar Health System, Inc. which on an annual basis issues a community benefit report. This report is subsequently distributed in and around the five county service area of the health system. |
| Sch H Part I Line 7 | For purposes of the IRS Form 990 Schedule H, Wellstar Health System and Affiliates (including Paulding Hospital) have estimated the current year cost to charge ratio for each hospital as it is reported in the annual community benefit report and as it will be reported in the state's Annual Hospital Financial Survey. |
| Schedule H Part III Line 4 | The following footnote is detailed in the Wellstar Health System, Inc. and Affiliates Combined Financial Statements related to bad debt or uncollectible accounts: "During 2011, Wellstar adopted the provisions of FASB Accounting Standards Update (2011-07), Healthcare Entities (Topic 954). ASU 2011-07 requires the reclassification of the provision for uncollectible accounts associated with patient service revenue from an operating expense to a deduction from patient service revenue (net of contractual allowances and discounts)." " Wellstar recognizes patient service revenue associated with services provided to patients with third-party payor coverage on the basis of contractual rates for the services rendered. For uninsured patients that do not qualify for community financial aid, Wellstar recognizes revenue on the basis of its discounted rates for services provided. On the basis of historical experience, a significant portion of Wellstar's uninsured patients are unable or unwilling to pay for the services provided. Thus, Wellstar records a significant provision for uncollectible accounts related to uninsured patients in the period the services are provided." Subsequent to the end of the reporting period a propensity to pay review of patient accounts often results in prior year bad debt accounts which are deemed eligible for the organization's financial assistance policy. Those bad debt accounts are reclassified as charity and thus our rationale for including as community benefit. |
| Sch H Part III Line 8 | Paulding Hospital is a provider of inpatient and outpatient services to Medicare program beneficiaries at determined rates. Without the participation in the Medicare program these patients may not have had convenient access to those services. The Medicare shortfall on 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 9b | The policy written for collection practices that applies to all Wellstar Health System entities incorporates guidelines for personnel in the admissions and patient access areas to be trained in identifying patients that might qualify for financial assistance. It is also the policy of all Wellstar facilities to have at least one employee or contractor available at all times, especially in the hospitals with emergency rooms, who can provide assistance with the paperwork necessary to help patients who would qualify for governmental and other assistance programs. |
| Schedule H Part V | Wellstar Paulding Hospital is a general acute care hospital providing a full range of services. It is licensed to operate 83 beds by the State of Georgia but is staffed to operate 34 beds. The hospital is located on 50-acre campus in Dallas, Georgia in a complex of commercial buildings containing approximately 230,000 square feet. The original hospital was built in 1958 and since that time has seen at least five major structural additons and renovations. A new state of the art replacement hospital is planned to open in 2014. In addition WellStar Paulding Hospital has expanded services to include a Medical Office Building with local physicians and services that include radiation oncology, sleep disorder and medical imaging. |
| Schedule H Part VI Line 2 | Wellstar 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 ownershiop of the process. Community ownership, in turn, increases the credibility and sustainability of the health improvement efforts. |
| Schedule H Part VI Line 3 | Paulding Hospital provides its patients with hospital personnel or contracted personnel who are trained in all aspects of governmental programs, payments plans, charity discounts, and other financial assistance offered to assist them in their hospital bills. If the patient is eligible for federal or state assistance programs, a staff member is knowledgeable in the steps necessary to qualify those individuals. If a patient is indigent or charity eligible they will be offered assistance through the hospital's charity and indigent care policy including the state's indigent care trust fund. If the patient has no other insurance and fails to qualify for indigent care assistance, the financial counselor can then offer the patient an opportunity to accept a payment plan with discounted payment options based on their ability to pay immediately or over time. All patient are afforded these opportunities. |
| Schedule H Part VI Line 4 | Paulding Hospital is one of five hospitals that are affiliated with the parent corporation, 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 5 | As stated in the Wellstar Health System, Inc and Affiliates audited financial statments for the period ended June 30, 2013, Paulding Hospital (an affiliate of Wellstar Health System, Inc.) operates as a charitable organization 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 ist 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; the hospital operates a full-time emergency room open to all regardless of ability to pay; and the hospital provides 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. Paulding Hospital committed approximately $107.6 million in capital expenditures for the year to meet those needs with the majority of those funds used in the new replacement hospital construction. |
| Sch H Part V Line 13g | In addition to the posting of the financial assistance policy in various locations throughout the hospital, the patient financial servies and patient access service departments provide a brochure which includes frequently asked questions about the terms and conditions associated with the policy. |
| Part V Section B Line 1j | The Community Health Needs Assessment also provides 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 3 | WellStar Paulding Hospital 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 the tax year 2012. Through a grant by the Centers for Disease Control and Prevention, WellStar Paulding Hospital 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 including Paulding and Bartow counties, WellStar enlisted expertise of county and regional public health officials, independent consultants, and other Key Informants. A listing of collaborators can be found in the Appendix of the hospital facility's CHNA report publicly available at wellstar.org. Quantitative Data Sources Including: 1. Georgia Department of Public Health, OASIS 2. Centers for Disease Control and Prevention (CDC)-Vital Statistics 3. Agency for Healthcare Research and Quality (AHRQ) 4. U. S. Census Bureau 5. U.S. Department of Health and Human Services 6. Kaiser Permanente Web-Based CHNA Platform 7. Catholic Health Association CHNA resources 8. County Health Rankings & Roadmaps, University of Wisconsin 9. Healthy People 2020 10.Behavorial Risk Factor Surveillance System (BRFSS) 11.WellStar Health System - WellStar Paulding 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. Paulding Key Informant Interview Report-20 participants identified by Cobb 2020's Community Strengths and Themes Workgroup to represent different sectors of the 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 4 | While WellStar Paulding Hospital conducts its own community health needs assessment there may be some overlap with the other hospitals in the WellStar system simply because of the geographic constraints and structure of the organization. The community served therefore will have many common zip codes and assessment areas. |
| Part V Section B Line 7 | Selection criteria for WellStar Paulding 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 6 | WellStar 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 and a vast network of physicians provide a full continuum of care to the area we serve. |
| Schedule H Part VI Item 2 | In order to access the proposed Community Health Needs Assessment Implementation Strategy for Paulding Medical Center, Inc. a link has been established at www.wellstar.org under the "about us" tab of the website. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | Yes (X) | FirstClassOrCharterTravelInd |
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Discretionary Spending Acct | Yes (X) | DiscretionarySpendingAcctInd |
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | false | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (55 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ARVIL 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 E 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 OF 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 & CFO | $0 | $526,234 | $0 | $102,668 | $0 | $16,473 | $0 | $45,700 | $0 | $22,518 | $0 | $713,593 | $0 | $0 |
| DONALD CAMPBELL MD | ||||||||||||||
| SVP PHYS EDUC & STUDENT AFFL | $0 | $319,526 | $0 | $97,801 | $0 | $20,092 | $0 | $26,376 | $0 | $18,758 | $0 | $482,553 | $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 COUNS | $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 MANAGEMENT | $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 |
| TIMOTHY MARK HANEY | ||||||||||||||
| SVP & HOSPITAL PRESIDENT | $266,032 | $0 | $49,532 | $0 | $18,494 | $0 | $28,100 | $0 | $18,079 | $0 | $380,237 | $0 | $0 | $0 |
| VICKY LYNN HOGUE | ||||||||||||||
| VP/CNO PATIENT CARE SERVICES | $175,049 | $0 | $24,621 | $0 | $13,609 | $0 | $26,458 | $0 | $21,880 | $0 | $261,617 | $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/CHIEF PRIV 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 OFFICER | $0 | $557,251 | $0 | $79,798 | $0 | $28,936 | $0 | $21,789 | $0 | $4,818 | $0 | $692,592 | $0 | $0 |
| ELLEN LANGFORD | ||||||||||||||
| VP & COO MED GRP | $0 | $215,010 | $0 | $25,595 | $0 | $10,514 | $0 | $17,494 | $0 | $19,197 | $0 | $287,810 | $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 |
| KIMBERLY W MENEFEE | ||||||||||||||
| SVP MARKETING & GOV 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 TECH 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/INT COMMUNICAT | $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 SERVICES | $0 | $190,963 | $0 | $41,450 | $0 | $11,557 | $0 | $0 | $0 | $8,440 | $0 | $252,410 | $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 |
| 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 |
| CHESTER A ZBOROWSKI | ||||||||||||||
| VP HEALTH PARKS OPERATIONS | $0 | $161,710 | $0 | $35,101 | $0 | $10,529 | $0 | $0 | $0 | $18,413 | $0 | $225,753 | $0 | $0 |
| DWIGHT T STILL | ||||||||||||||
| RADIATION ONCOLOGY PHYSICIST | $179,722 | $0 | $627 | $0 | $4,004 | $0 | $10,751 | $0 | $18,449 | $0 | $213,553 | $0 | $0 | $0 |
| CAROL S O'CONNELL | ||||||||||||||
| AVP SUPPORT SRVCS & LTC | $138,091 | $0 | $15,956 | $0 | $3,247 | $0 | $12,458 | $0 | $19,910 | $0 | $189,662 | $0 | $0 | $0 |
| ANDREA PARSON | ||||||||||||||
| DIRECTOR PHARMACY | $144,706 | $0 | $10,494 | $0 | $600 | $0 | $20,586 | $0 | $22,404 | $0 | $198,790 | $0 | $0 | $0 |
| ELIZABETH CONNER | ||||||||||||||
| PHARMACEUTICAL CARE PHARMACIST | $134,746 | $0 | $199 | $0 | $1,556 | $0 | $19,204 | $0 | $10,834 | $0 | $166,539 | $0 | $0 | $0 |
| JANET D FAULKNER | ||||||||||||||
| DIRECTOR NURSING | $120,453 | $0 | $8,735 | $0 | $3,761 | $0 | $7,772 | $0 | $17,677 | $0 | $158,398 | $0 | $0 | $0 |
| KRISTYN GREIFER MD | ||||||||||||||
| VP POPULATION HLTH MGMT | $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 | $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 & INTGTN | $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 |
| GUILLERMO PIERLUISI MD | ||||||||||||||
| VP MEDICAL AFFAIRS | $211,000 | $0 | $52,162 | $0 | $9,076 | $0 | $36,358 | $0 | $14,970 | $0 | $323,566 | $0 | $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 |
| CANDICE SAUNDERS | ||||||||||||||
| EXEC VP & COO | $0 | $442,689 | $0 | $80,407 | $0 | $16,296 | $0 | $37,680 | $0 | $16,997 | $0 | $594,069 | $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 |
| JEFFERY STANLEY | ||||||||||||||
| VP PHARMACY & SYSTEM COOR | $0 | $172,016 | $0 | $19,203 | $0 | $9,518 | $0 | $20,004 | $0 | $7,943 | $0 | $228,684 | $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 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J | 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 received severance pay during the period: Michael Graue $323,718; Kenneth Kunze, MD $334351; Elizabeth Person $41,928. |
| Form 990 Schedule J Line 7 | 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. |
| Form 990, Schedule J, Part I, Lines 1B & 2 | While Wellstar Health System and its affiliates do not have a written policy regarding payment or reimbursement of the items listed in Part 1 Line 1a, the organization follows IRS guidelines in the payment of any of these items to individuals listed in Form 990 Part VII Section A. These items are added as taxable wages on the individual's Form W-2 as appropriate. |
| Schedule J Part III |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (9 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| PAMELA ETHERIDGE | |||
| WIFE OF OFFICER | $61,032 | WELLSTAR EMPLOYEE | false |
| GREG FORTGANG | |||
| SON-IN-LAW OF BD MEMBER | $100,521 | WELLSTAR EMPLOYEE | false |
| GEORGE FLEMING | |||
| BROTHER OF OFFICER | $66,332 | WELLSTAR EMPLOYEE | false |
| JESSICA HANEY | |||
| DAUGHTER OF OFFICER | $62,455 | WELLSTAR EMPLOYEE | false |
| MATTHEW MADDOX | |||
| SON OF BOARD MEMBER | $78,440 | WELLSTAR EMPLOYEE | false |
| BONNIE MILLER | |||
| WIFE OF BOARD MEMBER | $34,394 | WELLSTAR EMPLOYEE | false |
| JENNIFER HANEY | |||
| DAUGHTER-IN-LAW OF OFFICE | $79,812 | WELLSTAR EMPLOYEE | false |
| GREG KOST | |||
| BROTHER-IN-LAW OF OFFICER | $49,327 | WELLSTAR EMPLOYEE | false |
| GREYSTONE POWER | |||
| TRUSTEE - PRES OF CO | $163,626 | ELECTRIC SERVICES | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Form 990 Schedule L Part IV | FormAndLineReferenceDesc |
| Explanation | All transactions listed in Schedule L Part IV are for interested parties or in this case family members of either trustees or officers of Paulding Medical Center, Inc. or its related organizations. The transactions all represent payment of services as employees of Wellstar Health System. The transaction with Greystone Power is for utility services provided to Paulding Hospital by a company whose CEO is also a Trustee of Wellstar Health System. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V Lines 3a & 3b | Paulding Medical Center, Inc. had no unrelated business income for the reporting period but is filing a 990-T to supplement discovery of that income in future periods. |
| Form 990 Part VI Section B Lines 12A - 12C | Our Conflict of Interest Policy requires all covered persons to annually review the policy and 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 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 | Wellstar engages the Hay Group to work with the governing board to review and recommend executive compensation. The executive compensation process at Wellstar is overseen by a committee of independent trustees, which follows a board-approved executive compensation philosophy. The committee consists of five board members and the CEO acting in an ex-officio capacity. In committee discussions about the compensation for the Chief Executive Officer, the CEO will recuse himself from that process but is a non-voting committee member for discussions on all other officers. The executive compensation philosophy empowers the committee to oversee the executive compensation process and administer the executive compensation program on behalf of the full board of trustee of Wellstar; provided, however, the full Board of Trustees evaluates and approves the compensation of the Chief Executive Officer. The philosophy requires annual disclosure of the committee's actions and decisions to the full board, which it has done. The committee is guided by the board-approved philosophy. Overall, the philosophy is intended to reward for organizational and individual performance. When performance is at a predetermined targeted level, the compensation is intended to be at or around the median of compensation paid to similar positions at similar organizations (the "market"). Wellstar's executive compensation philosophy defines the market as being comprised of comparable not-for-profit health care delivery systems, i.e., not-for-profit organizations similar in complexity and scale to Wellstar. To assist the committee in fulfilling its duties, the committee engaged the Hay Group to provide market compensation data to compare to the Wellstar positions whose compensation the committee oversees. The committee uses this data to provide context when making decisions in administering the compensation program. Accurate minutes of the committee's discussion and decisions are recorded during each committee meeting, and reviewed and approved at the following committee meeting. |
| Form 990 Part IV Line 12 & Part XI Line 2b | Paulding Medical Center, Inc. is audited on an annual basis by an outside auditing firm, KPMG, and as part of that audit a consolidated financial statement is issued for all of WellStar Health System, Inc. and its 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 X | For purposes of the Form 990 reporting, Wellstar Health System, Inc. (EIN 58-1649541) will list all tax-exempt bonds issued since January 1, 2003 on Schedule K as it typically allocates the proceeds of the bonds to members of the Obligated Group (including the hospitals and physician group). Paulding Medical Center, Inc. will report this tax exempt bond liability on Part X, Line 25 Other Liabilities. Paulding Medical Center, Inc. has also restated its beginning balance sheet with respect to tax exempt bond liabilities as the amounts allocated to tax exempt bond liabilities are now included on Line 25. |
| Form 990 Part X Lines 5-10 & Schedule J, J-1 & J-2 | All compensation amounts reported on Form 990 Part IX Lines 5-10 and Schedules J, J-l & J-2 represent compensation provided to individuals that provide services to Paulding Medical Center, Inc. Likewise the number of employees reported on Part V Line 2a represent the number of individuals providing services to the organization. All Federal Employment Tax responsibilities for those individuals are handled by Wellstar Health System, Inc. (EIN 58-1649541). |
| Form 990 Part VI Section A Lines 6, 7a & 7b | As 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 holds certain powers of election an approval in connection with the governing body of the organization. These powers are presented in detail in the governing documents which the company makes available to the public upon request. |
| Form 990 Part VI Line 11A | Internal 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 General Statement & Schedule J | 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 VI SECTION C Line 19 | 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. |
| SCHEDULE L PART IV TRANSACTIONS WITH INTERESTED PARTIES | Several transactions with interested parties of Paulding Medical Center, Inc. all fall below the $100,000 threshold in business transactions. |
| Form 990 Part XI Line 9 | For the reporting period Paulding Medical Center, Inc. had a change in net assets of $68,726,308 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/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CHS Foundation Inc | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 581649540 | Foundation | GA | 501(C)(3) | 11 Type 2 | WHS | Yes (true) |
| Cobb Hospital Inc | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 580968382 | Healthcare | GA | 501(C)(3) | 3 | WHS | Yes (true) |
| Douglas Hospital Inc | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 582026750 | Healthcare | GA | 501(C)(3) | 3 | WHS | Yes (true) |
| Kennestone Hospital Inc | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 582032904 | Healthcare | GA | 501(C)(3) | 3 | WHS | Yes (true) |
| Wellstar Foundation Inc | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 581627413 | Foundation | GA | 501(C)(3) | 11 Type 2 | WHS | Yes (true) |
| Wellstar Health System Inc | ||||||||||
| 805 Sandy Plains Road | Marietta | GA | 30066 | 581649541 | Healthcare | GA | 501(C)(3) | 11 Type 2 | WHS | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeTypeTxt |
|---|---|---|---|---|---|---|---|---|
| Cobb Hospital Parking Company LLC | ||||||||
| 805 Sandy Plains Road | Marietta | GA | 300666340 | 752999669 | Parking | GA | NA | N/A |
| Kennestone East Parking Deck LLC | ||||||||
| 805 Sandy Plains Road | Marietta | GA | 300666340 | 200537100 | Parking | GA | NA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Community Assurance Co | BusinessNameLine1 |
Foreign Address ForeignAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3rd Fl Barclays Hse Shedden Rd | AddressLine1 |
| City | George Town | City |
| Province Or State | Grand Cayman | ProvinceOrState |
| Country | CJ | Country |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581649541 | EIN |
| Primary Activities | Insurance | PrimaryActivitiesTxt |
| Legal Domicile Foreign Country | CJ | LegalDomicileForeignCountryCd |
| Entity Type | C-CORP | EntityTypeTxt |
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |